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How can we improve public health communication for the next pandemic? Tackling distrust and misinformation is key

<p><em><a href="https://theconversation.com/profiles/shauna-hurley-203140">Shauna Hurley</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/rebecca-ryan-1522824">Rebecca Ryan</a>, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a></em></p> <p>There’s a common thread linking our <a href="https://www.visualcapitalist.com/history-of-pandemics-deadliest/">experience of pandemics</a> over the past 700 years. From the black death in the 14th century to COVID in the 21st, public health authorities have put emergency measures such as isolation and quarantine in place to stop infectious diseases spreading.</p> <p>As we know from COVID, these measures upend lives in an effort to save them. In both the <a href="https://www.thinkglobalhealth.org/article/pandemic-protests-when-unrest-and-instability-go-viral">recent</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3559034/">distant past</a> they’ve also given rise to collective unrest, confusion and resistance.</p> <p>So after all this time, what do we know about the role public health communication plays in helping people understand and adhere to protective measures in a crisis? And more importantly, in an age of misinformation and distrust, how can we improve public health messaging for any future pandemics?</p> <p>Last year, we published a <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD015144/full">Cochrane review</a> exploring the global evidence on public health communication during COVID and other infectious disease outbreaks including SARS, MERS, influenza and Ebola. Here’s a snapshot of what we found.</p> <h2>The importance of public trust</h2> <p>A key theme emerging in analysis of the COVID pandemic globally is public trust – or lack thereof – in governments, public institutions and science.</p> <p>Mounting evidence suggests <a href="https://www.washingtonpost.com/world/2022/02/01/trust-lancet-covid-study/">levels of trust in government</a> were <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00172-6/fulltext">directly proportional</a> to fewer COVID infections and higher vaccination rates across the world. It was a crucial factor in people’s willingness to follow public health directives, and is now a key focus for future pandemic preparedness.</p> <p>Here in Australia, public trust in governments and health authorities steadily eroded over time.</p> <p>Initial information from governments and health authorities about the unfolding COVID crisis, personal risk and mandated protective measures was generally clear and consistent across the country. The establishment of the <a href="https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/rp/rp1920/Quick_Guides/AustralianCovid-19ResponseManagement#_Toc38973752">National Cabinet</a> in 2020 signalled a commitment from state, territory and federal governments to consensus-based policy and public health messaging.</p> <p>During this early phase of relative unity, <a href="https://theconversation.com/inflation-covid-inequality-new-report-shows-australias-social-cohesion-is-at-crossroads-195198">Australians reported</a> higher levels of belonging and trust in government.</p> <p>But as the pandemic wore on, public trust and confidence fell on the back of conflicting state-federal pandemic strategies, blame games and the <a href="https://theconversation.com/we-lost-the-plot-on-covid-messaging-now-governments-will-have-to-be-bold-to-get-us-back-on-track-186732">confusing fragmentation</a> of public health messaging. The divergence between <a href="https://www.theaustralian.com.au/nation/tale-of-two-cities-gripped-by-covid-fear-outbreak/news-story/cf1b922610aeb0b0ee9b0b53486bf640">lockdown policies and public health messaging</a> adopted by <a href="https://www.theage.com.au/national/victoria/a-tale-of-two-cities-that-doesn-t-seem-fair-20211012-p58z79.html">Victoria and New South Wales</a> is one example, but there are plenty of others.</p> <p>When state, territory and federal governments have conflicting policies on protective measures, people are easily confused, lose trust and become harder to engage with or persuade. Many tune out from partisan politics. Adherence to mandated public health measures falls.</p> <p>Our research found clarity and consistency of information were key features of effective public health communication throughout the COVID pandemic.</p> <p>We also found public health communication is most effective when authorities work in partnership with different target audiences. In Victoria, the case brought against the state government for the <a href="https://www.abc.net.au/news/2023-07-24/melbourne-public-housing-tower-covid-lockdown-compensation/102640898">snap public housing tower lockdowns</a> is a cautionary tale underscoring how essential considered, tailored and two-way communication is with diverse communities.</p> <h2>Countering misinformation</h2> <p>Misinformation is <a href="https://reutersinstitute.politics.ox.ac.uk/hydroxychloroquine-australia-cautionary-tale-journalists-and-scientists">not a new problem</a>, but has been supercharged by the advent of <a href="https://theconversation.com/health-misinformation-is-rampant-on-social-media-heres-what-it-does-why-it-spreads-and-what-people-can-do-about-it-217059">social media</a>.</p> <p>The much-touted “miracle” drug <a href="https://www.vox.com/future-perfect/22663127/ivermectin-covid-treatments-vaccines-evidence">ivermectin</a> typifies the extraordinary traction unproven treatments gained locally and globally. Ivermectin is an anti-parasitic drug, lacking evidence for viruses like COVID.</p> <p>Australia’s drug regulator was forced to <a href="https://www.theguardian.com/australia-news/2021/sep/10/australian-drug-regulator-bans-ivermectin-as-covid-treatment-after-sharp-rise-in-prescriptions">ban ivermectin presciptions</a> for anything other than its intended use after a <a href="https://www.theguardian.com/world/2021/aug/30/australian-imports-of-ivermectin-increase-10-fold-prompting-warning-from-tga">sharp increase</a> in people seeking the drug sparked national shortages. Hospitals also reported patients <a href="https://www.theguardian.com/australia-news/2021/sep/02/sydney-covid-patient-in-westmead-hospital-after-overdosing-on-ivermectin-and-other-online-cures">overdosing on ivermectin</a> and cocktails of COVID “cures” promoted online.</p> <p>The <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01585-9/fulltext">Lancet Commission</a> on lessons from the COVID pandemic has called for a coordinated international response to countering misinformation.</p> <p>As part of this, it has called for more accessible, accurate information and investment in scientific literacy to protect against misinformation, including that shared across social media platforms. The World Health Organization is developing resources and recommendations for health authorities to address this “<a href="https://www.who.int/health-topics/infodemic#tab=tab_1">infodemic</a>”.</p> <p>National efforts to directly tackle misinformation are vital, in combination with concerted efforts to raise health literacy. The Australian Medical Association has <a href="https://www.ama.com.au/media/action-needed-tackle-health-misinformation-internet-social-media">called on the federal government</a> to invest in long-term online advertising to counter health misinformation and boost health literacy.</p> <p>People of all ages need to be equipped to think critically about who and where their health information comes from. With the rise of AI, this is an increasingly urgent priority.</p> <h2>Looking ahead</h2> <p>Australian health ministers recently <a href="https://www.cdc.gov.au/newsroom/news-and-articles/australian-health-ministers-reaffirm-commitment-australian-cdc">reaffirmed their commitment</a> to the new Australian Centre for Disease Control (CDC).</p> <p>From a science communications perspective, the Australian CDC could provide an independent voice of evidence and consensus-based information. This is exactly what’s needed during a pandemic. But full details about the CDC’s funding and remit have been the subject of <a href="https://www.croakey.org/federal-budget-must-deliver-on-climate-health-and-the-centre-for-disease-control-sector-leaders-warn/">some conjecture</a>.</p> <p>Many of our <a href="https://www.cochraneaustralia.org/articles/covidandcommunications">key findings</a> on effective public health communication during COVID are not new or surprising. They reinforce what we know works from previous disease outbreaks across different places and points in time: tailored, timely, clear, consistent and accurate information.</p> <p>The rapid rise, reach and influence of misinformation and distrust in public authorities bring a new level of complexity to this picture. Countering both must become a central focus of all public health crisis communication, now and in the future.</p> <p><em>This article is part of a <a href="https://theconversation.com/au/topics/the-next-pandemic-160343">series on the next pandemic</a>.</em><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/226718/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/shauna-hurley-203140">Shauna Hurley</a>, PhD candidate, School of Public Health, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/rebecca-ryan-1522824">Rebecca Ryan</a>, Senior Research Fellow, Health Practice and Management; Head, Centre for Health Communication and Participation, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-can-we-improve-public-health-communication-for-the-next-pandemic-tackling-distrust-and-misinformation-is-key-226718">original article</a>.</em></p>

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Why are we seeing more pandemics? Our impact on the planet has a lot to do with it

<p><em><a href="https://theconversation.com/profiles/olga-anikeeva-1522907">Olga Anikeeva</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>; <a href="https://theconversation.com/profiles/jessica-stanhope-1129888">Jessica Stanhope</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>; <a href="https://theconversation.com/profiles/peng-bi-1522908">Peng Bi</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>, and <a href="https://theconversation.com/profiles/philip-weinstein-882901">Philip Weinstein</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em></p> <p>Pandemics – the global spread of infectious diseases – seem to be making a comeback. In the Middle Ages we had the Black Death (plague), and after the first world war we had the Spanish flu. Tens of millions of people <a href="https://assets.cureus.com/uploads/review_article/pdf/69273/20211019-25919-an4y6h.pdf">died from these diseases</a>.</p> <p>Then science began to <a href="https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2011.00053/full">get the upper hand</a>, with vaccination eradicating smallpox, and polio nearly so. Antibiotics became available to treat bacterial infections, and more recently antivirals as well.</p> <p>But in recent years and decades pandemics <a href="https://assets.cureus.com/uploads/review_article/pdf/69273/20211019-25919-an4y6h.pdf">seem to be returning</a>. In the 1980s we had HIV/AIDS, then several flu pandemics, SARS, and now COVID (no, COVID isn’t over).</p> <p>So why is this happening, and is there anything we can do to avert future pandemics?</p> <h2>Unbalanced ecosystems</h2> <p>Healthy, stable ecosystems provide services that keep us healthy, such as supplying food and clean water, producing oxygen, and making green spaces available for our <a href="https://www.millenniumassessment.org/documents/document.356.aspx.pdf">recreation and wellbeing</a>.</p> <p>Another key service ecosystems provide is disease regulation. When nature is in balance – with predators controlling herbivore populations, and herbivores controlling plant growth – it’s more difficult for pathogens to emerge in a way that causes pandemics.</p> <p>But when human activities <a href="https://books.google.com.au/books?hl=en&amp;lr=&amp;id=rWozz12K1aUC&amp;oi=fnd&amp;pg=PP15&amp;dq=planetary+overload&amp;ots=c9mWuESUXN&amp;sig=-1iP3uSOWazvC2OFLk4vginWbQQ&amp;redir_esc=y#v=onepage&amp;q=planetary%20overload&amp;f=false">disrupt and unbalance ecosystems</a> – such as by way of climate change and biodiversity loss – <a href="https://academic.oup.com/bioscience/article/58/8/756/381265">things go wrong</a>.</p> <p>For example, climate change affects the number and distribution of plants and animals. Mosquitoes that carry diseases can move from the tropics into what used to be temperate climates as the planet warms, and may infect more people in the months that are normally disease free.</p> <p>We’ve studied the relationship between weather and dengue fever transmission in China, and <a href="https://pubmed.ncbi.nlm.nih.gov/27883970/">our findings</a> support the same conclusion reached by <a href="https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0008118">many other studies</a>: climate change is likely to put more people at risk of dengue.</p> <p>Biodiversity loss can have similar effects by disrupting food chains. When ranchers cleared forests in <a href="https://www.mdpi.com/1999-4915/6/5/1911">South America</a> for their cattle to graze in the first half of the 20th century, tiny forest-dwelling, blood-feeding vampire bats suddenly had a smörgåsbord of large sedentary animals to feed on.</p> <p>While vampire bats had previously been kept in check by the limited availability of food and the presence of predators in the balanced <a href="https://cir.nii.ac.jp/crid/1130000797648461952">forest ecosystem</a>, numbers of this species exploded in South America.</p> <p>These bats carry the rabies virus, which causes <a href="https://www.who.int/news-room/fact-sheets/detail/rabies">lethal brain infections</a> in people who are bitten. Although the number of deaths from bat-borne rabies has now fallen dramatically due to vaccination programs in South America, rabies caused by bites from other animals still <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168224/">poses a global threat</a>.</p> <p>As urban and agricultural development impinges on natural ecosystems, there are increasing opportunities for humans and domestic animals to become infected with pathogens that would normally only be seen in wildlife – particularly when people hunt and eat animals from the wild.</p> <p>The HIV virus, for example, <a href="https://www.tandfonline.com/doi/abs/10.1076/jmep.27.2.163.2992">first entered human populations</a> from apes that were slaughtered for food in Africa, and then spread globally through travel and trade.</p> <p>Meanwhile, bats are thought to be <a href="https://www.sciencedirect.com/science/article/pii/S0006291X20319434">the original reservoir</a> for the virus that caused the COVID pandemic, which has killed more than <a href="https://www.worldometers.info/coronavirus/">7 million people</a> to date.</p> <p>Ultimately, until we effectively address the unsustainable impact we are having on our planet, pandemics will continue to occur.</p> <h2>Targeting the ultimate causes</h2> <p>Factors such as climate change, biodiversity loss and other global challenges are the ultimate (high level) cause of pandemics. Meanwhile, increased contact between humans, domestic animals and wildlife is the proximate (immediate) cause.</p> <p>In the case of HIV, while direct contact with the infected blood of apes was the proximate cause, the apes were only being slaughtered because large numbers of very poor people were hungry – an ultimate cause.</p> <p>The distinction between <a href="https://link.springer.com/article/10.1007/BF02207379">ultimate causes and proximate causes</a> is important, because we often deal only with proximate causes. For example, people may smoke because of stress or social pressure (ultimate causes of getting lung cancer), but it’s the toxins in the smoke that cause cancer (proximate cause).</p> <p>Generally, health services are only concerned with stopping people from smoking – and with treating the illness that results – not with removing the drivers that lead them to smoke in the first place.</p> <p>Similarly, we address pandemics with lockdowns, mask wearing, social distancing and vaccinations – all measures which seek to stop the spread of the virus. But we pay less attention to addressing the ultimate causes of pandemics – until perhaps very recently.</p> <h2>A planetary health approach</h2> <p>There’s a growing awareness of the importance of adopting a “planetary health” approach to improve human health. This <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60901-1/fulltext?nr_email_referer=1">concept</a> is based on the understanding that human health and human civilisation depend on flourishing natural systems, and the wise stewardship of those natural systems.</p> <p>With this approach, ultimate drivers like climate change and biodiversity loss would be prioritised in preventing future pandemics, at the same time as working with experts from many different disciplines to deal with the proximate causes, thereby reducing the risk overall.</p> <p>The planetary health approach has the benefit of improving both the health of the environment and human health concurrently. We are heartened by the increased uptake of teaching planetary health concepts across the environmental sciences, humanities and health sciences in many universities.</p> <p>As climate change, biodiversity loss, population displacements, travel and trade continue to increase the risk of disease outbreaks, it’s vital that the planetary stewards of the future have a better understanding of how to tackle the ultimate causes that drive pandemics.</p> <p><em>This article is the first in a series on the next pandemic.</em><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/226827/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/olga-anikeeva-1522907"><em>Olga Anikeeva</em></a><em>, Research Fellow, School of Public Health, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>; <a href="https://theconversation.com/profiles/jessica-stanhope-1129888">Jessica Stanhope</a>, Lecturer, School of Allied Health Science and Practice, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>; <a href="https://theconversation.com/profiles/peng-bi-1522908">Peng Bi</a>, Professor, School of Public Health, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>, and <a href="https://theconversation.com/profiles/philip-weinstein-882901">Philip Weinstein</a>, Professorial Research Fellow, School of Public Health, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-are-we-seeing-more-pandemics-our-impact-on-the-planet-has-a-lot-to-do-with-it-226827">original article</a>.</em></p>

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People with long COVID continue to experience medical gaslighting more than 3 years into the pandemic

<p><em><a href="https://theconversation.com/profiles/simran-purewal-1405366">Simran Purewal</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kaylee-byers-766226">Kaylee Byers</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kayli-jamieson-1431392">Kayli Jamieson</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>, and <a href="https://theconversation.com/profiles/neda-zolfaghari-1431577">Neda Zolfaghari</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a></em></p> <p>It’s increasingly clear that the <a href="https://www.worldometers.info/coronavirus/country/canada/">SARS-CoV-2 virus is not going away</a> any time soon. And for some patients, their symptoms haven’t gone away either.</p> <p>In January 2023, our team of researchers at the <a href="https://pipps.ca/">Pacific Institute on Pathogens, Pandemics and Society</a> published a <a href="https://pipps.cdn.prismic.io/pipps/bd160219-3281-4c5d-b8be-57c301e7f99b_Long+Covid+Brief+Feb+2023.pdf">research brief</a> about how people seek out information about long COVID. The brief was based on a scoping review, a type of study that assesses and summarizes available research. Our interdisciplinary team aims to understand the experiences of people with long COVID in order to identify opportunities to support health care and access to information.</p> <h2>Lingering long COVID</h2> <p>Long COVID (also called <a href="https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/symptoms/post-covid-19-condition.html">Post COVID-19 condition</a>) is an illness that occurs after infection with COVID-19, lasting weeks to months, and even years. First coined by a <a href="https://doi.org/10.1016%2Fj.socscimed.2020.113426">patient on Twitter</a>, the term also represents a collective movement of people experiencing the long-term effects of COVID-19 and advocating for care. <a href="https://science.gc.ca/site/science/sites/default/files/attachments/2023/Post-Covid-Condition_Report-2022.pdf">Around 15 per cent</a> of adults who have had COVID still have symptoms after three months or more.</p> <p>Long COVID affects systems <a href="https://doi.org/10.1016/j.socscimed.2021.114619">throughout the body</a>. However, symptom fluctuations and limited diagnostic tools make it challenging for health-care providers to diagnose, especially with <a href="https://doi.org/10.1038/s41579-022-00846-2">over 200 symptoms</a> that may present in patients. Perhaps because long COVID presents itself in many different ways, the illness has <a href="https://doi.org/10.1016/j.socscimed.2021.114619">been contested</a> across the medical field.</p> <p>To identify opportunities to reduce barriers to long COVID care, our team has explored how patients and their caregivers access <a href="https://pipps.cdn.prismic.io/pipps/bd160219-3281-4c5d-b8be-57c301e7f99b_Long+Covid+Brief+Feb+2023.pdf">information about long COVID</a>. We have found that one of the most significant barriers faced by patients is <a href="https://doi.org/10.1177/20552076211059649">medical gaslighting</a> by the people they have turned to for help.</p> <h2>Lack of validation leads to stigma</h2> <p><a href="https://doi.org/10.1136/bmj.o1974">Medical gaslighting</a> occurs when health-care practitioners dismiss or falsely blame patients for their symptoms. While new information about long COVID has become more readily available, some patients continue to face gaslighting and feel that their symptoms are <a href="https://doi.org/10.1016%2Fj.ssmqr.2022.100177">treated less seriously</a> by some health-care professionals.</p> <p>This dismissal can <a href="https://doi.org/10.1111/hex.13602">erode trust</a> in the health-care system and can also lead to <a href="https://doi.org/10.1111/hex.13518">stigma and shame</a>.</p> <p>Preliminary findings from our ongoing study with long COVID patients indicate that, when medical practitioners do not validate a patient’s condition, this extends into community networks of family and friends who may also dismiss their symptoms, contributing to further stigmatization at home.</p> <p>Medical gaslighting can present additional barriers to treatment, such as not being referred to specialists or long COVID clinics. This can, in turn, compound other symptoms such as fatigue, and <a href="https://doi.org/10.1192/bjo.2022.38">exacerbate the psychological symptoms of long COVID</a>, such as depression and anxiety.</p> <p>Medical gaslighting isn’t new. It has been documented by patients with other chronic conditions, such as <a href="https://doi.org/10.5772/intechopen.107936">myalgic encephalomyelitis or chronic fatigue syndrome</a>. And while this is common for patients with <a href="https://doi.org/10.1001/amajethics.2021.512">non-visible illnesses</a>, medical gaslighting is more commonly experienced by <a href="https://doi.org/10.1111/1467-9566.13367">women and racialized people</a>.</p> <p>Long COVID patients also note gender biases, as women with prolonged symptoms feel they are not believed. This is particularly worrisome, as studies have found that <a href="https://doi.org/10.1001/jama.2020.17709">women are disproportionately more likely to experience long COVID</a>.</p> <h2>Where do we go from here?</h2> <p>While long COVID information is constantly shifting, it’s clear that patients face many barriers, the first of which is having their illness minimized or disregarded by others. To ensure that patients have access to compassionate care, we suggest:</p> <p><strong>1. Educating physicians on long COVID</strong></p> <p>Because definitions of long COVID, and its presentation, vary widely, primary care physicians need support to recognize and acknowledge the condition. General practitioners (GPs) must also provide patients with information to help manage their symptoms. This requires actively listening to patients, documenting symptoms and <a href="https://doi.org/10.1136/bmj.m3489">paying close attention to symptoms that need further attention</a>.</p> <p>Training physicians on the full range of symptoms and referring patients to available supports would reduce stigma and assist physicians by reducing their need to gather information themselves.</p> <p><strong>2. Raise awareness about long COVID</strong></p> <p>To increase awareness of long COVID and reduce stigma, public health and community-based organizations must work collaboratively. This may include a public awareness and information campaign about long COVID symptoms, and making support available. Doing so has the potential to foster community support for patients and improve the mental health of patients and their caregivers.</p> <p><strong>3. Ensure information is accessible</strong></p> <p>In many health systems, GPs are <a href="https://doi.org/10.1186/s12913-019-4419-0">gatekeepers to specialists</a> and are considered trusted information sources. However, without established diagnostic guidelines, patients are left to <a href="https://doi.org/10.2196/37984">self-advocate</a> and prove their condition exists.</p> <p>Because of negative encounters with health-care professionals, patients turn to social media platforms, including long COVID <a href="https://doi.org/10.7861%2Fclinmed.2020-0962">online communities</a> on Facebook. While these platforms allow patients to validate experiences and discuss management strategies, patients should not rely only on social media given the <a href="https://doi.org/10.3389/fpubh.2022.937100">potential for misinformation</a>. As a result, it is crucial to ensure information about long COVID is multi-lingual and available in a wide range of formats such as videos, online media and physical printouts.</p> <p>The <a href="https://science.gc.ca/site/science/en/office-chief-science-advisor/initiatives-covid-19/post-covid-19-condition-canada-what-we-know-what-we-dont-know-and-framework-action">recent recommendations of the Chief Science Advisor of Canada</a> to establish diagnostic criteria, care pathways and a research framework for long COVID are a positive development, but we know patients need support now. Improving long COVID education and awareness won’t resolve all of the issues faced by patients, but they’re foundational to compassionate and evidence-based care.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/203744/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/simran-purewal-1405366">Simran Purewal</a>, Research Associate, Health Sciences, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kaylee-byers-766226">Kaylee Byers</a>, Regional Deputy Director, BC Node of the Canadian Wildlife Health Cooperative; Senior Scientist, Pacific Institute on Pathogens, Pandemics and Society, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kayli-jamieson-1431392">Kayli Jamieson</a>, Master's Student in Communication, Research Assistant for Pacific Institute on Pathogens, Pandemics and Society, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>, and <a href="https://theconversation.com/profiles/neda-zolfaghari-1431577">Neda Zolfaghari</a>, Project Coordinator, Pacific Institute on Pathogens, Pandemics and Society, and the Pandemics &amp; Borders Project, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/people-with-long-covid-continue-to-experience-medical-gaslighting-more-than-3-years-into-the-pandemic-203744">original article</a>.</em></p>

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Three years into the pandemic, it’s clear COVID won’t fix itself. Here’s what we need to focus on next

<p>On March 11 2020 the World Health Organization classified COVID as a <a href="https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020">pandemic</a>. Three years on, it remains just that.</p> <p>As much as we don’t want it to be, and as much as it is off the front pages, COVID is still very much with us.</p> <p>But how bad has it really been? And, more importantly, what have we learned that could help us accelerate a real and sustained exit?</p> <h2>COVID has hit us hard</h2> <p>There was a <a href="https://theconversation.com/too-late-already-bolted-how-a-faster-who-response-could-have-slowed-covid-19s-spread-160860">slow initial</a> global response to what we now call SARS-CoV-2, the virus that causes COVID. This allowed the virus to get a foothold, contributing to unexpectedly rapid <a href="https://theconversation.com/why-are-there-so-many-new-omicron-sub-variants-like-ba-4-and-ba-5-will-i-be-reinfected-is-the-virus-mutating-faster-182274">viral evolution</a>.</p> <p>Three years into the pandemic, with the removal of almost all mitigation measures in most countries, it’s clear the virus has hit the world very hard. <a href="https://www.worldometers.info/coronavirus/">So far</a>, almost 681 million infections and more than 6.8 million deaths have been reported.</p> <p>This is perhaps best visualised by its impact on life expectancy. There were <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/padr.12477">sharp declines</a> seen across the world in 2020 and 2021, reversing 70 years of largely uninterrupted progress. </p> <p>The excess mortality driving this drop in life expectancy has continued. This includes in Australia, <a href="https://www.actuaries.digital/2023/03/06/almost-20000-excess-deaths-for-2022-in-australia/">where over 20,000 more lives</a> than the historical average are estimated to have been lost in 2022.</p> <h2>Not just COVID deaths</h2> <p>The indirect impacts on the health systems in rich and poor countries alike continue to be substantial. Disruptions to health services have led to <a href="https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00079-6/fulltext">increases</a> in stillbirths, maternal mortality and postnatal depression.</p> <p>Routine <a href="https://www.who.int/news/item/15-07-2022-covid-19-pandemic-fuels-largest-continued-backslide-in-vaccinations-in-three-decades">child immunisation coverage</a> has decreased. Crucial malaria, tuberculosis and HIV programs have been <a href="https://www.theglobalfund.org/en/news/2021/2021-09-08-global-fund-results-report-reveals-covid-19-devastating-impact-on-hiv-tb-and-malaria-programs/#:%7E:text=GENEVA%20%E2%80%93%20The%20COVID%2D19%20pandemic,history%20of%20the%20Global%20Fund">disrupted</a>. </p> <p>A paper out this week highlights the <a href="https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1107560/full">severe impact</a> of the pandemic on mental health globally.</p> <h2>Then there’s long COVID</h2> <p>Meanwhile, more evidence of long COVID has emerged around the world. At least <a href="https://www.nature.com/articles/s41579-022-00846-2">65 million people</a> were estimated to be experiencing this debilitating syndrome by the end of 2022. </p> <p>The Australian Institute of Health and Welfare <a href="https://www.aihw.gov.au/reports/covid-19/long-covid-in-australia-a-review-of-the-literature/summary">estimates</a> 5-10% of people who are infected with SARS-CoV-2 will develop long COVID, with symptoms persisting more than three months. That’s between 550,000 and 1.1 million Australians, based on the more than 11 million cases reported <a href="https://www.worldometers.info/coronavirus/country/australia/">so far</a>.</p> <h2>COVID highlighted inequalities</h2> <p>The pandemic has also had a huge economic impact, both directly and indirectly. </p> <p>The United States alone spent <a href="https://impact.economist.com/perspectives/economic-development/understanding-economic-consequences-covid-19-pandemic">US$4 trillion</a> on its response. Economists have estimated the pandemic will contribute an average 0.75% reduction in GDP in countries with high infection rates and high productivity in 2025.</p> <p>Studies in the <a href="https://www.local.gov.uk/health-inequalities-deprivation-and-poverty-and-covid-19">United Kingdom</a>, <a href="https://www.theguardian.com/world/2022/apr/04/us-covid-devastating-toll-poor-low-income-communities">US</a> and <a href="https://www.theguardian.com/australia-news/2022/feb/25/disease-of-disadvantage-melbournes-lower-socioeconomic-areas-suffer-most-covid-deaths-amid-omicron">Australia</a> show COVID has had a disproportionate impact – including higher death rates – in disadvantaged communities and ethnic minorities. </p> <p>The causes range from high exposure in low-paid jobs to inadequate access to health care. And <a href="https://www.brookings.edu/blog/future-development/2021/05/27/covid-19-is-a-developing-country-pandemic/">poorer countries</a> have fared terribly on all fronts from COVID, including inequitable access to vaccines.</p> <h2>There’s no end in sight</h2> <p>We cannot assume there will be a natural exit to the pandemic, where the virus reaches some benign endemicity, a harmless presence in the background. </p> <p>In fact, there is little indication anything like that is imminent.</p> <p>In Australia, since the beginning of January, <a href="https://www.worldometers.info/coronavirus/country/australia/">more than 235,000 COVID cases</a> have been reported, almost as many as in 2020 and 2021 combined. Since the start of January, there have been 2,351 COVID-related deaths, more than twice as many as in the whole of 2020 and around the same as in the whole of 2021.</p> <h2>What needs to happen next?</h2> <p>The future response can be practically distilled into three overlapping actions.</p> <p><strong>1. Politicians need to be frank</strong></p> <p>Our political leaders need to communicate frankly with the public that the pandemic is not over. They need to stress we still have an exceptional problem on our hands with acute disease as well as worrying concerns about long COVID. It’s crucial politicians acknowledge sufferers and those who have died. They need to do this while delivering the good news that addressing COVID does not require lockdowns or mandates. </p> <p>If our politicians did this, the public would be more likely to have their booster vaccines, get tested and treated, and adopt measures such as improving indoor ventilation and wearing high-quality masks.</p> <p>The health system also needs to be greatly strengthened to deal with long COVID.</p> <p><strong>2. Avoiding infections is still important</strong></p> <p>Suppressing the virus is still important. We still can and should reduce the burden of newly acquired COVID and, therefore, long COVID. We have the tools to do this. </p> <p>We need full recognition that COVID is transmitted largely through the air. As this just-published article in the journal <a href="https://www.nature.com/articles/d41586-023-00642-9">Nature</a> discusses, there are things we can do right now to ensure we all breathe air that is safer, not just from SARS-CoV-2 but from other respiratory viruses.</p> <p><strong>3. Adopt new knowledge and technology</strong></p> <p>We should be focusing on the science and be ready to adopt new knowledge and products rapidly. </p> <p>Just a few days ago we had trials of a <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4375620&amp;utm_source=substack&amp;utm_medium=email">promising new approach</a> to treat long COVID with the diabetes drug metformin. </p> <p>There is also intriguing research that has identified <a href="https://www.nature.com/articles/s41579-022-00846-2">persistent infection</a> as a potential underlying cause of organ damage and disease after COVID and in long COVID. This suggests anti-viral drugs such as Paxlovid may have an important role to play in reducing the impact of chronic disease. </p> <p>Many types of new COVID vaccines are being trialled, such as <a href="https://www.nature.com/articles/d41586-022-02824-3">versions administered by nasal sprays</a>, which may be game changers.</p> <h2>The virus won’t fix itself</h2> <p>As we enter the fourth year of the pandemic, we must not leave it up to the virus to fix itself. </p> <p>The biggest lesson of the past three years is there’s little chance that is going to work, at least without an intolerably high cost. </p> <p>Rather, we can end the pandemic by choice. We know <a href="https://theconversation.com/from-covid-control-to-chaos-what-now-for-australia-two-pathways-lie-before-us-174325">what to do</a>. But we are simply not doing it.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/three-years-into-the-pandemic-its-clear-covid-wont-fix-itself-heres-what-we-need-to-focus-on-next-201181" target="_blank" rel="noopener">The Conversation</a>. </em></p>

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The wellbeing ‘pandemic’ – how the global drive for wellness might be making us sick

<p>Are we in the midst of a wellbeing pandemic? The question may seem curious, even contradictory. But look around, the concept is everywhere and spreading: in the media, in government institutions and transnational organisations, in schools, in workplaces and in the marketplace. </p> <p>To be clear, it’s not just wellbeing’s infectiousness in public discourse that makes it pandemic-like. It’s also the genuine malaise that can be caused by the term’s misuse and exploitation.</p> <p>Do you sense, for example, that your wellbeing is increasingly being scrutinised by peers, managers and insurance companies? Are you noticing an increasing number of advertisements offering products and services that promise enhanced wellbeing through consumption? If so, you’re not alone. </p> <p>But we also need to ask whether this obsession with wellbeing is having the opposite to the desired effect. To understand why, it’s important to look at the origins, politics and complexities of wellbeing, including its strategic deployment in the process of what we call “<a href="https://otagouni-my.sharepoint.com/personal/jacst99p_registry_otago_ac_nz/Documents/Documents/SJ-Wellness/SJ-Conversation-Wellbeing/Jackson-Sam-Dawson-Porter-Frontiers-Sociology-Wellbeing-2022.pdf">wellbeing washing</a>”.</p> <h2>The halo effect</h2> <p>While concerns about wellbeing can be traced to antiquity, the term has emerged as a central feature of contemporary social life. One explanation is that it is often conflated with concepts as diverse as happiness, quality of life, life satisfaction, human flourishing, mindfulness and “wellness”. </p> <p>Wellbeing is flexible, in the sense that it can be easily inserted into a diverse range of contexts. But it’s also surrounded by a kind of halo, automatically bestowed with a positive meaning, similar to concepts such as motherhood, democracy, freedom and liberty. </p> <p>To contest the value and importance of such things is to risk being labelled a troublemaker, a non-believer, unpatriotic or worse.</p> <p>These days, there are two main concepts of wellbeing. The first – subjective wellbeing – emphasises a <a href="https://www.frontiersin.org/articles/10.3389/fsoc.2022.950557/full#B21">holistic measure</a> of an individual’s mental, physical and spiritual health. This perspective is perhaps best reflected in the World Health Organization’s <a href="https://www.corc.uk.net/outcome-experience-measures/the-world-health-organisation-five-well-being-index-who-5/">WHO-5 Index</a>, designed in 1998 to measure people’s subjective wellbeing according to five states: cheerfulness, calmness, vigour, restfulness and fulfilment.</p> <p>Translated into more than 30 languages, the overall influence of the WHO-5 Index should not be underestimated; both governments and corporations have embraced it and implemented policy based on it. </p> <p>But the validity of the index, and others like it, has been questioned. They’re prone to oversimplification and a tendency to marginalise alternative perspectives, including Indigenous approaches to physical and mental health.</p> <h2>Individual responsibility</h2> <p>The second perspective – objective wellbeing – was a response to rising social inequality. It focuses on offering an <a href="https://www.frontiersin.org/articles/10.3389/fsoc.2022.950557/full#B60">alternative to GDP</a> as a measure of overall national prosperity. </p> <p>One example of this is New Zealand’s <a href="https://www.treasury.govt.nz/information-and-services/nz-economy/higher-living-standards/our-living-standards-framework">Living Standards Framework</a>, which is guided by four operating principles: distribution, resilience, productivity and sustainability. These new and purportedly more progressive measures of national economic and social outcomes signal societal change, optimism and hope.</p> <p>The trouble with such initiatives, however, is that they remain rooted within a particular neoliberal paradigm in which individual behaviour is the linchpin for change, rather than the wider political and economic structures around us.</p> <p>Arguably, this translates into more monitoring and “disciplining” of personal actions and activities. Intentionally or not, many organisations interpret and use wellbeing principles and policies to reinforce existing structures and hierarchies. </p> <p>Consider how the wellbeing agenda is playing out in your organisation or workplace, for example. Chances are you have seen the growth of new departments, work units or committees, policies and programs, wellness workshops – all supposedly linked to health and wellbeing. </p> <p>You may even have noticed the creation of new roles: wellbeing coaches, teams or “champions”. If not, then “lurk with intent” and be on the lookout for the emergence of yoga and meditation offerings, nature walks and a range of other “funtivities” to support your wellbeing. </p> <h2>Wellbeing washing</h2> <p>The danger is that such initiatives now constitute another semi-obligatory work task, to the extent that non-participation could lead to stigmatisation. This only adds to stress and, indeed, unwellness. </p> <p>Deployed poorly or cynically, such schemes represent aspects of “wellbeing washing”. It’s a strategic attempt to use language, imagery, policies and practices as part of an organisation’s “culture” to connote something positive and virtuous. </p> <p>In reality, it could also be designed to enhance productivity and reduce costs, minimise and manage reputational risk, and promote <a href="https://otagouni-my.sharepoint.com/personal/jacst99p_registry_otago_ac_nz/Documents/Documents/SJ-Wellness/SJ-Conversation-Wellbeing/Jackson-Sam-Dawson-Porter-Frontiers-Sociology-Wellbeing-2022.pdf">conformity, control and surveillance</a>. </p> <p>Ultimately, we argue that wellbeing now constitutes a “field of power”; not a neutral territory, but a place where parties advance their own interests, often at the expense of others. As such, it’s essential that scholars, policymakers and citizens explore, as one author <a href="https://www.google.com.au/books/edition/Measuring_Wellbeing/lWBXjk1nocIC?hl=en&amp;gbpv=1&amp;dq=%E2%80%9Cwhat+and+whose+values+are+represented,+which+accounts+dominate,+what+is+their+impact+and+on+whom%E2%80%9D&amp;pg=PA4&amp;printsec=frontcover">put it</a>, “what and whose values are represented, which accounts dominate, what is their impact and on whom”. </p> <p>Because if wellbeing is becoming a pandemic, we may well need the “vaccine” of critical reflection.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/the-wellbeing-pandemic-how-the-global-drive-for-wellness-might-be-making-us-sick-198662" target="_blank" rel="noopener">The Conversation</a>. </em></p>

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How the pandemic affected our approach to reading and interpretation of books

<p>During the pandemic, reading took on new meaning. People turned to books for comfort. Some read to confront difficult issues, especially following the murder of George Floyd in 2020. Others used reading as a way to care for their children in locked-down houses.</p> <p><a href="https://www.theguardian.com/books/2020/mar/25/book-sales-surge-self-isolating-readers-bucket-list-novels" target="_blank" rel="noopener">Sales figures and lending data</a> showed a huge spike in people buying and borrowing books. We wanted to follow the stories of real readers and <a href="https://global.oup.com/academic/product/reading-novels-during-the-covid-19-pandemic-9780192857682?q=reading%20novels%20during%20the%20pandemic&amp;lang=en&amp;cc=dk" target="_blank" rel="noopener">our new book</a> uses a rare combination of literary analysis and qualitative interviewing to capture these dynamics of reception.</p> <p>While many commentators at the beginning of the pandemic <a href="https://www.refinery29.com/en-us/2020/03/9581961/long-books-to-read-in-quarantine" target="_blank" rel="noopener">endorsed reading</a> as a straightforward way to relax, our readers showed that the practice morphed and took on new forms and meanings.</p> <p>Based on hundreds of survey responses and hours of reader interviews from Denmark and the UK, the study makes the interpretation of literature something dynamic and ongoing. And it suggests that readers themselves are agents of meaning, even in the case of novels that seem the most stable in our culture.</p> <p>Reading during the pandemic showed how books and their meanings change. Novels that we think of as settled in their significance acquire new meaning as they are read under unfolding conditions, exposed to the vagaries of history.</p> <p>In our research we show how Albert Camus’s The Plague became an unlikely hit in 2020, how the affordances of Sally Rooney’s romantic fiction seemed suddenly to apply to the lovers unable to meet, and how long novels that had intimidated pre-pandemic readers became lifelines in their heft.</p> <h2>Tricky reading</h2> <p>For many people, reading became more difficult during this time.</p> <p>Far from giving everyone uninterrupted time to attend to long novels by authors like Tolstoy, lockdown exacerbated the separations and challenges of everyday life.</p> <p>Take Jane Eyre, a novel that many readers picked up during lockdown because it was on their shelves. Suddenly, this classic seemed to be a novel about a woman locked in small rooms and living through a cholera epidemic. Many also took it up under conditions that overlapped directly with the book’s scenes of homeschooling.</p> <p>One respondent called Phoebe, for instance, deliberately avoided rereading Jane Eyre for these reasons. Charlotte Brontë’s classic novel of loneliness and love was, in 2020, “too creepy”. The story of Jane being locked up made her feel unsafe while she lived alone through lockdown in the confines of her own room.</p> <p>Another interviewee, Alexandra, was troubled by the idea of reading Hilary Mantel’s bestseller The Mirror and the Light, explaining:</p> <blockquote> <p>I knew that I would be saying goodbye to Sir Thomas Cromwell […] I looked at it and I thought, what if I die before I get to the end of this? It will be the most unsatisfactory experience.</p> </blockquote> <p>Rather than sizing up the third part of Mantel’s intimate portrayal of the life of Thomas Cromwell as offering the ideal opportunity for narrative immersion, Alexandra viewed the very thickness of the book as problematic. Her intense fear of death in the pandemic and expectation of Cromwell’s literary demise converge on the length of narrative, which stretches into a future that had become harder to face.</p> <h2>Slipperiness of time</h2> <p>For the reader caught up in a global pandemic, a novel like The Plague, Albert Camus’s famous story of a town suffering a deadly virus, reads differently than it usually would for, say, the school student of French literature. One interviewed reader, for instance, discussed the novel’s temporal slipperiness.</p> <p>Normally, of course, the very lack of measurable time would suggest the novel as an allegory – untied to a particular time, a warning of dark political forces turning up and spreading at any moment. But in 2020, when time <a href="https://theconversation.com/a-philosophical-idea-that-can-help-us-understand-why-time-is-moving-slowly-during-the-pandemic-151250" target="_blank" rel="noopener">felt like it was moving oddly</a> The Plague’s confused sense of time felt realistic, as if it were mimicking our lived experience of a pandemic.</p> <figure></figure> <p>Yet, it would be a mistake to assume all readers suddenly ditched allegory for realism or real-life correspondence. As Kirsten, a Danish woman in her 30s, explained:</p> <blockquote> <p>I ended up buying The Plague because I was more interested in the metaphorical portrait of the occupation (of France by the Nazis) than in what epidemics do to a society.</p> </blockquote> <p>By following real readers, our study provides a snapshot of a phenomenal moment in modern history and shows the movement of readers between new purchases and books long kept in their collections. By exploring these varied experiences, we investigated the larger question of how the consumption of novels depends on and shapes people’s experience of non-work time, providing a specific lens through which to examine the experience of reading more generally.</p> <p>Perhaps most importantly, it demonstrates the dynamic process of reading and the ways in which books change depending on where and when they are read and by whom.</p> <p><strong>This article originally appeared on <a href="https://theconversation.com/how-the-pandemic-affected-our-approach-to-reading-and-interpretation-of-books-195238" target="_blank" rel="noopener">The Conversation</a>.</strong></p> <p><em>Image: Shutterstock</em></p>

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Can ‘voluntourism’ outgrow the white saviour stereotype and make a positive change post-pandemic?

<p>As the tourism industry emerges from pandemic shutdowns and border closures, so too is “voluntourism”, the sometimes controversial combination of overseas volunteer work and more traditional tourist experiences.</p> <p>Although hard to measure, pre-pandemic estimates suggest voluntourism was worth <a href="https://sites.lsa.umich.edu/mje/2022/01/22/the-paradox-of-voluntourism-how-international-volunteering-impacts-host-communities/">US$2 billion annually</a>, with up to <a href="https://www.cbi.eu/market-information/tourism/save-tourism/market-potential">ten million volunteers</a> globally. While COVID shut the practice down for the duration, it remains a <a href="https://roadbook.com/opinion/negative-effects-of-voluntourism/">multi-billion-dollar industry</a>, now poised to <a href="https://www.sbs.strath.ac.uk/blogs/SBS/post.aspx?id=1420">return and rebuild</a>.</p> <p>But volunteer tourism has met with considerable criticism. Voluntourists have been accused of putting <a href="https://www.stuff.co.nz/travel/news/109983663/nz-school-students-pay-thousands-to-visit-orphanages-and-volunteer-overseas">vulnerable people at risk</a> (<a href="https://drivingchange.org/do-no-harm-the-dark-side-of-voluntourism/">including children</a>), <a href="https://tourismteacher.com/commodification-volunteer-tourism/">commodifying volunteer work</a>, perpetuating <a href="https://darbymatt.medium.com/voluntourism-is-neo-colonialism-56b6a25f6924">neo-colonialism</a> and <a href="https://www.euronews.com/travel/2022/02/21/how-white-saviour-voluntourism-gets-you-famous-on-tiktok">reinforcing</a> a “white saviour” complex.</p> <p>Voluntourism is also <a href="https://www.thenewhumanitarian.org/2021/06/14/travel-opens-again-aid-voluntourism-needs-get-real">largely unregulated</a>, raising important <a href="https://journalofethics.ama-assn.org/article/voluntourism/2019-09">ethical questions</a> about who it really aims to serve – travellers or hosts. These issues are now being felt in the Pacific, where voluntourism is a relatively new but growing industry. As <a href="https://e-tangata.co.nz/reflections/the-problem-with-white-saviours/">Simone Kaho wrote</a> of her experience in Tonga:</p> <blockquote> <p>In many cases, voluntourism asks the local community to stand back, and allow themselves to be helped. It turns helping into a business model.</p> </blockquote> <p><a href="https://blog.geographydirections.com/2019/09/03/global-encounters-voluntourism-in-fiji/">My research</a> in Fiji has also highlighted the problems associated with the commercialisation and commodification of volunteering. These are real and important issues that need close examination as tourism in general picks up.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">End voluntourism and the white saviour industrial complex <a href="https://t.co/gMHkZfTlsf">https://t.co/gMHkZfTlsf</a> via <a href="https://twitter.com/mailandguardian?ref_src=twsrc%5Etfw">@mailandguardian</a></p> <p>— NGO Watch Africa (@NGOWatchAfrica) <a href="https://twitter.com/NGOWatchAfrica/status/1582376611449491457?ref_src=twsrc%5Etfw">October 18, 2022</a></p></blockquote> <p><strong>Behind the ‘bula smile’</strong></p> <p>The Fiji case study – conducted with an international, for-profit, specialist voluntourism agency – tells a complex story about the benefits and downsides of voluntourism.</p> <p>Volunteers are hosted by local families and included in household life, attending church or religious functions, learning to cook Fijian food, and spending time with children and other family members. Through this, they gain an understanding of life behind the famous “bula” smile. As one staff member said:</p> <blockquote> <p>The host may get angry with you if you leave the light on, you may feel like you are back living with mum and dad because they may give you a lunch box, things like that. But it’s important that they see the person who is paid to smile at the Hilton, what they are like at home with their kids, how they make ends meet, how they eat.</p> </blockquote> <p>Hosts often put considerable energy into sharing their way of life and teaching volunteers Fijian culture. Most hosts and staff took pride in helping travellers find their way around and teaching them Fijian ways. In turn, this helped Fijian staff build knowledge and pride in their own culture.</p> <blockquote> <p>Also the good thing is that we keep up with our culture. Because if you are talking about it every day and you show them and try to talk about it, then the history remains […] Now when we go to the village we do the <em>sevusevu</em> [kava ceremony] and all those things, and we go with the elders. It was our mothers that did that, but now we are doing it, the next generation.</p> <p>When we have volunteers in a Fijian village we will go to any lengths to give them what they want, to try and serve them […] But of course then the volunteers change to become more Fijian!</p> </blockquote> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Are you itching to start travelling, but want to do it with care?</p> <p>Listen to this week's <a href="https://twitter.com/hashtag/WisdomWalks?src=hash&amp;ref_src=twsrc%5Etfw">#WisdomWalks</a> to discover how you can avoid traps like voluntourism and greenwashing when travelling.</p> <p>🎧 27 mins.<a href="https://t.co/f366FJcyQG">https://t.co/f366FJcyQG</a></p> <p>— Curio (@curioio) <a href="https://twitter.com/curioio/status/1587821837932797953?ref_src=twsrc%5Etfw">November 2, 2022</a></p></blockquote> <p><strong>A chance to improve voluntourism</strong></p> <p>The growth of voluntourism in Fiji follows half a century of <a href="https://medium.com/tourism-geographic/paradise-the-noble-savage-and-the-white-savior-in-fiji-7ac7e302e5ec">mass tourism</a>, in which contact between Fijians and tourists has been largely limited and manufactured. Hosts embrace the opportunity to interact with tourists more directly and to build connections across the globe.</p> <p>However, the commercial nature of the encounter has the potential to significantly undermine these connections. The large fees paid by voluntourists mean they – like any tourist – are consumers.</p> <p>Volunteers have certain expectations, ranging from the mundane (internet access, good food and logistical support) to the more profound (a sense of accomplishment, a feeling they’ve made a difference). They will complain if these expectations aren’t met.</p> <p>The pandemic also raised questions about the sustainability of voluntourism. The organisation I studied cut its global workforce significantly. In Fiji it had provided jobs for about a dozen Fijian staff, as well as home-stay income for many households.</p> <p>While there is evidence that <a href="https://theconversation.com/traditional-skills-help-people-on-the-tourism-deprived-pacific-islands-survive-the-pandemic-148987">reliance on customary knowledge, systems and practices</a> helped tourism workers to survive and even thrive during the pandemic, the future for many is uncertain.</p> <p>COVID-19 has been something of a wake-up call that we need to move beyond voluntourism as a pseudo-development practice or as a commodified, profit-making experience. This is an opportunity for the industry to take on board the criticisms, examine past practice and reassess the role and impact of volunteering.</p> <p>Rather than rush back to business as usual, this is the perfect moment to look at reconfiguring the industry in line with the principles of sustainability and <a href="https://medium.com/activate-the-future/understanding-the-opportunity-of-regenerative-tourism-894136cafd3b">regenerative tourism</a>. In the process, perhaps voluntourism’s strengths – building cross-cultural relationships, learning and solidarity – can contribute more to meaningful social and environmental change.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/195719/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em>Writen by Sharon McLennan. Republished with permission from <a href="https://theconversation.com/can-voluntourism-outgrow-the-white-saviour-stereotype-and-make-a-positive-change-post-pandemic-195719" target="_blank" rel="noopener">The Conversation</a>.</em></p> <p><em>Image: Getty Images</em></p>

International Travel

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Elizabeth Strout’s Lucy By the Sea: a claustrophobic portrait of a terrible pandemic year

<p>In her latest novel, Lucy by the Sea, Elizabeth Strout captures the bewilderment of us all at the onset of the pandemic. Her character Lucy Barton admits not only did she not see it coming, but even when she did notice the virus’s existence, she did not really believe it would ever reach New York.</p> <p>It is March, 2020, and Lucy, a writer, had been scheduled to travel to Italy and Germany, a book tour which she had, with fortuitous prescience, cancelled back in December. Lucy is a woman who is given to sudden flashes of insight – much like her mother, who was known for having “visions” – which is why, looking back at those early days of the pandemic, not having sensed its threat surprises her.</p> <p>Even when her ex-husband William’s oldest friend is put on a ventilator and subsequently dies, it is still difficult for her to accept that this is happening to people she knows. With hindsight, Lucy remarks: “It’s odd how the mind does not take in anything until it can.”</p> <p>William has been quicker to spot the looming danger. He pleads with their two daughters Becka and Chrissy to leave New York city with their husbands, before hastily scooping up Lucy from her apartment and carrying her away to the town of Crosby on the coast of Maine.</p> <p>At this point in the book, devotees of Strout’s Pulitzer Prize-winning novel Olive Kitteridge, will experience a shiver of recognition and anticipation, for the fictional coastal town of Crosby is “Olive territory”. With this one deft move, Strout draws together the separate threads of much of the fiction she has written since Olive Kitteridge was published in 2008.</p> <p>Before establishing herself as a successful writer in New York, Lucy Barton’s territory was the small Midwest town of Amgash, Illinois. The deprivation of her Amgash childhood has haunted Lucy through Strout’s earlier novels, My Name is Lucy Barton, and Oh William! (the latter now <a href="https://www.abc.net.au/news/2022-10-01/booker-prize-shortlist-best-books-2022/101482730" target="_blank" rel="noopener">shortlisted for the 2022 Booker Prize</a>) and in two of the short stories in Anything is Possible. Now it continues to tug at her in the house beside the sea in Maine.</p> <p>In My Name is Lucy Barton, Lucy is told by a writer she admires:</p> <blockquote> <p>You will have only one story … You’ll write your one story many ways don’t ever worry about story. You will have only one.</p> </blockquote> <p>The story Lucy has to tell, over and over, and in many different ways, is the story of her childhood, its poverty and isolation, and her complex relationship with a mother who was unable to tell her own child that she loved her.</p> <p>Even as an adult, Lucy does not know her mother’s story. In Lucy by the Sea she has invented for herself a “nice mother” she can talk to in private as distinct from the real mother with whom the silences that fell between them were necessarily more poignant than words.</p> <h2>Emotional lockdown</h2> <p>Locked down in a house on a cliff with a view of the waves, Lucy and William endeavour to fill their days. Lucy struggles to read, and as for writing, she believes she will never write another word. This sense of being frozen and unable to concentrate was all too common at that uncertain and anxiety-inducing point in the pandemic, especially among writers. But for Lucy there is the realisation that this is a state she recognises, having spent her childhood in a kind of emotional lockdown.</p> <p>In Maine, unable to retreat into the activities that usually soothe her, Lucy is also grieving for her husband David, a cellist with the New York Philharmonic, who has died only a year earlier. William, too, is unexpectedly single since his wife, Estelle, walked out and took their daughter Bridget, along with a good bit of their furniture.</p> <p>With no escape from the monotony of their self-isolation, Lucy, who in ordinary circumstances is endearingly quick to declare her love – especially for people – finds herself continually finding things to hate: she hates being in other people’s houses, hates the smell; she hates being cold, but hates sitting inside a house with a coat on; she hates the jigsaw puzzle of Van Gogh William insists they try; she hates snow, and she hates William after dinner when she suspects he is not really listening to her. With extraordinary patience, William tells Lucy to stop hating everything.</p> <p>To make matters worse, far from being welcome in Maine, some locals are so antagonistic towards the couple that a message urging them to go back to New York is anonymously attached to their car. Then, on a visit to a grocery store, a woman shouts at Lucy: “You goddamn New Yorkers! Get the hell out of our state!”</p> <p>When Lucy reproaches William for not being nice to her after the woman yelled, William, becoming uncharacteristically emotional, answers that hers is the life he has wanted to save.</p> <blockquote> <p>‘My own life I care very little about these days. But Lucy, if you should die from this, it would –’ He shook his head with weariness. ‘I only wanted to save your life, and what if some woman yelled at you.’</p> </blockquote> <p>When their daughters experience difficulties – one still in New York, the other in Connecticut – Lucy and William must support them as best they can from Maine. Many readers will recognise the torment of handling family crises at arm’s length, and of not being able to hug loved ones even when distance is finally overcome.</p> <h2>Not Olive</h2> <p>Elizabeth Strout has captured perfectly the fear, frustration, and boredom experienced by so many of us during the first year of Covid. Even her fragmentary writing style adds authenticity to a time when few of us could concentrate, when we flicked from news broadcast to news broadcast, to tallies of the latest case numbers, and deaths, while feeling that the very air we breathed carried risk.</p> <p>Among Strout fans Lucy Barton is a much-loved character, but it is Olive Kitteridge who has most often made headlines, with the <a href="https://www.imdb.com/title/tt3012698/" target="_blank" rel="noopener">television mini-series</a> based on the book, starring Frances McDormand, winning multiple awards. The polarising nature of Olive’s character stirs a strong response in readers, whereas the more reticent Lucy speaks quietly, like someone whispering in the reader’s ear.</p> <p>Strout’s extraordinary achievement as a writer has been to illuminate so many flawed, ordinary, yet far from unremarkable lives, through a series of interconnected stories and novels. Though each book is complete, they work satisfyingly together as a cohesive whole, so that reading them we come to know not just a handful of characters but entire communities in a few small towns on the coast of Maine, and in New York and Illinois.</p> <p>Olive Kitteridge and its sequel are elegantly wrought, with their third-person (and at times omniscient) point of view allowing for more nuanced storytelling. Lucy Barton’s intimate, first-person voice in the reader’s ear, with its tendency to speak in run-on sentences that often end with ‘"… is what I mean"’ or “‘… is what I’m saying"’, can become tiresome.</p> <p>In the end, one feels as if one has spent a year in lockdown inside the head of a small, loving, anxious, slightly neurotic person named Lucy Barton.</p> <p>Lucy By the Sea is a pitch-perfect portrait of a terrible year, and oh, how sweet it is to get out and about, to breathe fresh air, and to see the world from other, less claustrophobic angles, both for Lucy Barton and the reader.</p> <p><strong>This article originally appeared in <a href="https://theconversation.com/elizabeth-strouts-lucy-by-the-sea-a-claustrophobic-portrait-of-a-terrible-pandemic-year-191073" target="_blank" rel="noopener">The Conversation</a>.</strong></p> <p><em>Images: Yahoo/Penguin</em></p>

Books

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Did our personalities change during the pandemic?

<p dir="ltr">While we might think our personality won’t change that easily, it turns out that might not be the case after a new study reported measurable changes following the COVID-19 pandemic.</p> <p dir="ltr">The study, published in the journal <em><a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0274542#sec010" target="_blank" rel="noopener">PLOS One</a></em>, found that the personalities of people they surveyed before and after the pandemic changed - and that several particular traits were affected.</p> <p dir="ltr">A total of 7,109 people, ranging from 18 to 109 years old, took part in the Understanding America Study, which saw them take surveys before the pandemic, in 2020, and between 2021-2022.</p> <p dir="ltr">They found that extraversion, openness, agreeableness and conscientiousness declined when they compared results from 2021-2022 and pre-pandemic, with younger adults seeming particularly affected.</p> <p dir="ltr">Interestingly, the researchers reported that levels of neuroticism declined significantly in 2020, and that older adults showed the largest change in this trait. </p> <p dir="ltr">“There was limited personality change early in the pandemic but striking changes starting in 2021,” they write. </p> <p dir="ltr">“Of most note, the personality of young adults changed the most, with marked increases in neuroticism and declines in agreeableness and conscientiousness. That is, younger adults became moodier and more prone to stress, less cooperative and trusting, and less restrained and responsible.”</p> <p dir="ltr">They concluded that, if these changes are enduring, stressful events that affect a wider population could slightly change the trajectory of our personalities over time.</p> <p dir="ltr">But, they stress that other significant nationwide events were also occurring during this period, such as the highly publicised death of George Floyd and resulting protests, and the January 6th Capitol riots.</p> <p dir="ltr">With most of the changes to our personalities occurring while we are adolescents and young adults, it’s not surprising that the impact of the pandemic was seen most strongly in younger people.</p> <p dir="ltr">Even though previous research has indicated that our personalities stabilise around the age of 30, the researchers found similar disruptions to personality among middle-aged participants that were absent in the oldest participants. They argue that this could be due to greater malleability of personality during middle age or because of different stressors and strains that this age group experienced in comparison to older adults.</p> <p dir="ltr"><strong>Why this matters</strong></p> <p dir="ltr">We like to think our personality is who we are, and certain traits are even associated with our health and trajectory of our life.</p> <p dir="ltr">Previous studies have found that people who are more conscientious have a lower risk of dementia, develop fewer chronic illnesses, and tend to achieve more in education, while a higher level of neuroticism is a risk factor for mental health conditions such as anxiety and depression.</p> <p dir="ltr">“It is especially worrying that the largest changes in these two traits were among younger adults, as the implications of these changes may ripple throughout their adult lives,” the authors write.</p> <p><span id="docs-internal-guid-2b82fcee-7fff-00ee-6449-a94894c48cfa"></span></p> <p dir="ltr"><em>Image: Getty Images</em></p>

Mind

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The pandemic’s gardening boom shows how gardens can cultivate public health

<p>As lockdowns went into effect in the spring of 2020 to slow the spread of the coronavirus, reports emerged of a <a href="https://www.sfchronicle.com/culture/article/A-comeback-for-victory-gardens-amid-Bay-Area-15177272.php">global gardening boom</a>, with plants, flowers, vegetables and herbs sprouting in backyards and on balconies around the world.</p> <p>The data backs up the narrative: An analysis of Google Trends and infection statistics found that during the first few months of the COVID-19 pandemic, country-by-country interest in gardening, from Italy to India, <a href="https://www.bostonglobe.com/2021/11/26/opinion/covid-inspired-gardening-was-worldwide-phenomenon/">tended to peak just as infections peaked</a>.</p> <p>Why did so many people find themselves being pulled toward the earth in a time of crisis? And what sort of effect did gardening have on them?</p> <p><a href="https://doi.org/10.1016/j.ufug.2022.127483">In a new study</a> conducted with a team of environmental and public health scholars, we highlight the extent to which gardening became a coping mechanism during the early days of the pandemic.</p> <p>Even as restrictions related to COVID-19 have eased, we see some real lessons for the way gardening can continue to play a role in people’s lives.</p> <h2>Dirt, sweat, tranquility</h2> <p>To conduct our study, we used an online questionnaire to survey more than 3,700 respondents who primarily lived in the U.S., Germany and Australia. The group included experienced gardeners and those who were new to the pursuit.</p> <p>More than half of those we surveyed said they felt isolated, anxious and depressed during the early days of the pandemic. Yet more than 75% also found immense value in gardening during that same period. Whether done <a href="https://doi.org/10.3733/ucanr.6720">in cities or out in the country</a>, gardening was almost universally described as a way to either relax, socialize, connect with nature or stay active.</p> <p>More than half of the respondents reported a significant increase in the amount of time they were able to spend gardening. Other respondents found some value in growing their own food, but few felt financially compelled to do so. </p> <p>Instead, most respondents saw gardening as a way to connect with their community and get some exercise.</p> <p>People with more personal difficulties due to COVID-19, like the inability to work or struggling with child care, were more likely to spend more time gardening in their spare time than they had in the past.</p> <h2>The garden as a refuge</h2> <p>In our analysis of written responses to the survey, most gardeners seemed to either experience a heightened sense of joy and reassurance or feel more attuned to the natural world. This seemed to have positive therapeutic and psychological benefits, regardless of age or location.</p> <p>To many people, <a href="https://doi.org/10.1016/j.wss.2021.100055">gardening became a sort of safe space – a haven from daily worries</a>. One German gardener started seeing their garden as a sanctuary where even “birds felt louder.” </p> <p>“Gardening has been my salvation,” a respondent from the U.S. noted. “I’m very grateful I can surround myself with beauty as a buffer to the depressing news COVID brings each day.”</p> <p>Another German gardener wrote that their garden became their “little safe universe in a very uncertain and somewhat dangerous time. … We have learned to appreciate the so far very high value of ‘own land, own refuge’ even more.”</p> <h2>A green prescription</h2> <p>As life returns to normal, work ramps up and obligations mount, I wonder how many pandemic gardens are already being neglected.</p> <p>Will a hobby born out of unique circumstances recede into the background?</p> <p>I hope not. Gardening shouldn’t be something that’s only taken up in times of crises. If anything, the pandemic showed how gardens serve a public health need – that they’re not only places of beauty or sources of food, but also conduits for healing. </p> <p>In fact, several countries like New Zealand, Canada and some in Europe now allow “<a href="https://www.weforum.org/agenda/2022/02/green-prescriptions-health-wellbeing/">green prescriptions</a>” to be issued as alternatives to medication. These are directives from doctors to spend a certain amount of time outdoors each day or month – an acknowledgment of the very real health benefits, from lowered stress to better sleep and improved memory, that venturing into nature can offer.</p> <p>I also think of the people who never had a chance to garden in the first place during the pandemic. Not everyone has a backyard or can afford gardening tools. Improving access to home gardens, urban green spaces and <a href="https://theconversation.com/not-all-community-gardens-are-environmental-equals-10485">community gardens</a>could be an important way to boost well-being and health.</p> <p>Making seeding, planting, pruning and harvesting part of your daily routine seems to open up more opportunities, too.</p> <p>“I never previously had the time to commit to a garden,” one first-time gardener told us, “but [I’ve] found such satisfaction and happiness in watching things grow. It has been a catalyst for making other positive changes in my life.”</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/the-pandemics-gardening-boom-shows-how-gardens-can-cultivate-public-health-181426" target="_blank" rel="noopener">The Conversation</a>.</em></p>

Home & Garden

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Global emissions almost back to pre-pandemic levels after unprecedented drop in 2020, new analysis shows

<p>Global carbon dioxide emissions have bounced back after COVID-19 restrictions and are likely to reach close to pre-pandemic levels this year, <a href="https://essd.copernicus.org/preprints/essd-2021-386/">our analysis</a> released today has found.</p> <p>The troubling finding comes as world leaders meet at the COP26 climate talks in Glasgow in a last-ditch bid to keep dangerous global warming at bay. The analysis was undertaken by the <a href="https://www.globalcarbonproject.org/carbonbudget">Global Carbon Project</a>, a consortium of scientists from around the world who produce, collect and analyse global greenhouse gas information.</p> <p>The fast recovery in CO₂ emissions, following last year’s <a href="https://theconversation.com/global-emissions-are-down-by-an-unprecedented-7-but-dont-start-celebrating-just-yet-151757">sharp drop</a>, should come as no surprise. The world’s strong economic rebound has created a surge in demand for energy, and the global energy system is still heavily dependent on fossil fuels.</p> <p>Most concerning is the long-term upward trends of CO₂ emissions from oil and gas, and this year’s growth in coal emissions, which together are far from trending towards net-zero by 2050.</p> <p><img src="https://images.theconversation.com/files/429724/original/file-20211102-28770-1s1j889.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt="people seated around U-shaped table" /> <span class="caption">The troubling findings come as world leaders meet at the COP26 climate summit in Glasgow.</span> <span class="attribution"><span class="source">Evan Vucci/AP</span></span></p> <h2>The global emissions picture</h2> <p>Global CO₂ emissions from fossil fuels dropped by 5.4% in 2020, compared to the previous year. But they are set to increase by about 4.9% above 2020 levels this year, reaching 36.4 billion tonnes. This brings them almost back to 2019 levels.</p> <p>We can expect another 2.9 billion tonnes of CO₂ emissions this year from the net effect of everything we do to the land, including deforestation, degradation and re-vegetation.</p> <p>This brings us to a total of 39.4 billion tonnes of CO₂ to be emitted by the end of this year.</p> <p>The fast growth in emissions matches the corresponding large increase in energy demand as the global economy opens up, with the help of <a href="https://www.f4b-initiative.net/post/majority-of-17-2-trillion-covid-stimulus-packages-doing-more-harm-than-good-to-environment">US$17.2 trillion</a> in economic stimulus packages around the world.</p> <p>CO₂ emissions from all fossil fuel types (coal, oil and natural gas) grew this year, with emissions from coal and natural gas set to grow more in 2021 than they fell in 2020.</p> <p>Emissions from global coal use were declining before the pandemic hit in early 2020 but they surged back this year. Emissions from global gas use have returned to the rising trend seen before the pandemic.</p> <p>CO₂ emissions from global oil use remain well below pre-pandemic levels but are expected to increase in coming years as road transport and aviation recover from COVID-related restrictions.</p> <p><a href="https://images.theconversation.com/files/429469/original/file-20211031-17-1pa5f0i.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/429469/original/file-20211031-17-1pa5f0i.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt="" /></a> <span class="caption">Global fossil CO₂ emissions.</span> <span class="attribution"><span class="source">Source: Global Carbon Project, https://www.globalcarbonproject.org/carbonbudget</span></span></p> <h2>Nations leading the emissions charge</h2> <p>Emissions from China have recovered faster than other countries. It’s among the few countries where emissions grew in 2020 (by 1.4%) followed by a projected growth of 4% this year.</p> <p>Taking these two years together, CO₂ emissions from China in 2021 are projected to be 5.5% above 2019 levels, reaching 11.1 billion tonnes. China accounted for 31% of global emissions in 2020.</p> <p>Coal emissions in China are estimated to grow by 2.4% this year. If realised, it would match what was thought to be China’s peak coal emissions in 2013.</p> <p>India’s CO₂ emissions are projected to grow even faster than China’s this year at 12.6%, after a 7.3% fall last year. Emissions this year are set to be 4.4% above 2019 levels – reaching 2.7 billion tonnes. India accounted for 7% of global emissions in 2020.</p> <p>Emissions from both the US and European Union are projected to rise 7.6% this year. It would lead to emissions that are, respectively, 3.7% and 4.2% below 2019 levels.</p> <p>US and EU, respectively, accounted for 14% and 7% of global emissions in 2020.</p> <p>Emissions in the rest of the world (including all international transport, particularly aviation) are projected to rise 2.9% this year, but remain 4.2% below 2019 levels. Together, these countries represent 59% of global emissions.</p> <p><a href="https://images.theconversation.com/files/429471/original/file-20211031-75805-1jh07jf.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/429471/original/file-20211031-75805-1jh07jf.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt="" /></a> <span class="caption">Regional fossil CO₂ emissions 2019-2021.</span> <span class="attribution"><span class="source">Source: Global Carbon Project, https://www.globalcarbonproject.org/carbonbudget</span></span></p> <h2>The remaining carbon budget</h2> <p>The relatively large changes in annual emissions over the past two years have had no discernible effect in the speed at which CO₂ accumulates in the atmosphere.</p> <p>CO₂ concentrations, and associated global warming, are driven by the accumulation of greenhouse gases – particularly CO₂ – since the beginning of the industrial era. This accumulation has accelerated in recent decades.</p> <p>To stop further global warming, global CO₂ emissions must stop or reach net-zero – the latter meaning that any remaining CO₂ emissions would have to be compensated for by removing an equivalent amount from the atmosphere.</p> <p>Carbon budgets are a useful way of measuring how much CO₂ can be emitted for a given level of global warming. In our latest analysis, we updated the carbon budget outlined by the Intergovernmental Panel on Climate Change (<a href="https://templatelab.com/climate-change-report-2021/">IPCC</a>) in August this year.</p> <p>From the beginning of 2022, the world can emit an additional 420 billion tonnes of CO₂ to limit global warming to 1.5℃, or 11 years of emissions at this year’s rate.</p> <p>To limit global warming to 2℃, the world can emit an additional 1,270 billion tonnes of CO₂ – or 32 years of emissions at the current rate.</p> <p><a href="https://images.theconversation.com/files/429886/original/file-20211103-19-fl69o8.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/429886/original/file-20211103-19-fl69o8.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt="" /></a> <span class="caption">The remaining carbon budgets to limit warming to 1.5℃ and 2℃. Updated from IPCC 2021.</span> <span class="attribution"><span class="source">Source: Global Carbon Project, https://www.globalcarbonproject.org/carbonbudget</span></span></p> <p>These budgets are the compass to net-zero emissions. Consistent with the pledge by <a href="https://eciu.net/netzerotracker">many countries</a> to reach net-zero emissions by 2050, CO₂ emissions need to decline by 1.4 billion tonnes each year, on average.</p> <p>This is an amount comparable to the drop during 2020, of 1.9 billion tonnes. This fact highlights the extraordinary challenge ahead and the need to increase short- and long-term commitments to drive down global emissions.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/170866/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/pep-canadell-16541">Pep Canadell</a>, Chief research scientist, Climate Science Centre, CSIRO Oceans and Atmosphere; and Executive Director, Global Carbon Project, <em><a href="https://theconversation.com/institutions/csiro-1035">CSIRO</a></em>; <a href="https://theconversation.com/profiles/corinne-le-quere-315624">Corinne Le Quéré</a>, Royal Society Research Professor of Climate Change Science, <em><a href="https://theconversation.com/institutions/university-of-east-anglia-1268">University of East Anglia</a></em>; <a href="https://theconversation.com/profiles/glen-peters-114835">Glen Peters</a>, Research Director, <em><a href="https://theconversation.com/institutions/center-for-international-climate-and-environment-research-oslo-707">Center for International Climate and Environment Research - Oslo</a></em>; <a href="https://theconversation.com/profiles/pierre-friedlingstein-903247">Pierre Friedlingstein</a>, Chair, Mathematical Modelling of Climate, <em><a href="https://theconversation.com/institutions/university-of-exeter-1190">University of Exeter</a></em>; <a href="https://theconversation.com/profiles/robbie-andrew-422668">Robbie Andrew</a>, Senior Researcher, <em><a href="https://theconversation.com/institutions/center-for-international-climate-and-environment-research-oslo-707">Center for International Climate and Environment Research - Oslo</a></em>, and <a href="https://theconversation.com/profiles/rob-jackson-213135">Rob Jackson</a>, Professor, Department of Earth System Science, and Chair of the Global Carbon Project, <em><a href="https://theconversation.com/institutions/stanford-university-890">Stanford University</a></em></p> <p>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/global-emissions-almost-back-to-pre-pandemic-levels-after-unprecedented-drop-in-2020-new-analysis-shows-170866">original article</a>.</p> <p><em>Image: Shutterstock</em></p>

Travel Trouble

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“Please come back”: Bali’s plea over pandemic fallout

<p dir="ltr">Before the world was struck with Covid-19, Bali was a thriving holiday hotspot for millions of global travellers each year. </p> <p dir="ltr">The sandy beaches and bustling nightlife saw more than 1.3 million Australians descend on Bali in 2019 alone, injecting billions into the local economy. </p> <p dir="ltr">However, two years later, the pandemic has had a devastating effect on the Indonesian island, with local businesses struggling to survive. </p> <p dir="ltr">The busy streets of Seminyak, which were once filled with boutiques and shops, are now dead and devoid of people. </p> <p dir="ltr">Shop windows are boarded up, while other businesses have been abandoned all together. </p> <p dir="ltr">An employee at a local jewellery shop, whose store was the only one open in the street, told news.com.au, that the past two years had “not been good”.</p> <p dir="ltr">“We barely see anybody, it’s so quiet. Nothing is open. Most of the people I know haven’t been able to work. We are one of the only places that managed to stay open,” she said.</p> <p dir="ltr">A local tour guide said she had spent the last years of the pandemic doing whatever she could to survive, by making snacks and selling them to local shops. </p> <p dir="ltr">“Please, please come back to Bali,” she said.</p> <p dir="ltr">“We are ready for Aussies.”</p> <p dir="ltr">The guide also asked travellers to be patient and understanding of the Balinese people when they return for holidays. </p> <p dir="ltr">“Before the pandemic, the shops would charge maybe four or five times the price but now they’re not. They know they need to build that trust and relationship back with the Aussies so you can barter a little bit but please don’t do it too much,” she said.</p> <p dir="ltr">On March 15th, the first flight from Australia to Bali was packed full of eager travellers, with the people of Bali welcoming tourists back to their home to reinvigorate their economy. </p> <p dir="ltr"><em>Image credits: Getty Images</em></p>

International Travel

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"We’ve got a pandemic baby and a flood baby": Mum’s twin miracles

<p dir="ltr">A woman trapped by flood waters was rescued by a heroic neighbour in his kayak just in time for her to give birth.</p> <p dir="ltr">Krystle Henry was stranded in her home in Taringa, Brisbane, after flood waters surged up the driveway - preventing her from leaving to go to the hospital.</p> <p dir="ltr">But her quick-thinking neighbour Rob came to the rescue, kayaking Ms Henry to dry land on Sunday afternoon.</p> <p dir="ltr">She and her partner Matt Bridges welcomed their newborn son, Angus, into the world at Mater Mothers’ Hospital Brisbane on Tuesday morning.</p> <p dir="ltr">Mr Bridges said he would be forever grateful to his neighbour for helping their son arrive safely.</p> <p><span id="docs-internal-guid-d7bec5d6-7fff-1b1e-d4d5-32ff681a8afa">“We didn’t know Bob, but he was more than happy to help us out and I’m so thankful Angus arrived safely,” he <a href="https://7news.com.au/lifestyle/parenting/mum-gives-birth-to-baby-boy-after-she-was-rescued-in-a-kayak-from-flood-waters-in-brisbane-c-5911798" target="_blank" rel="noopener">said</a>.</span></p> <p><img src="https://oversixtydev.blob.core.windows.net/media/2022/03/krystle.jpg" alt="" width="1280" height="720" /></p> <p dir="ltr"><em>Krystle Henry and Matt Bridges with their newborn son, Angus. Image: Krystle Henry</em></p> <p dir="ltr">“I’m so glad I got to the delivery room in time.</p> <p dir="ltr">Angus is the couple’s second child, after Ms Henry gave birth to their daughter Olive in 2020.</p> <p dir="ltr">“We’ve got a pandemic baby… and now we have a flood baby,” Mr Bridges said.</p> <p dir="ltr">Mater obstetrician Dr Paul Conaghen said he had never delivered a baby in such a chaotic situation, and praised the couple for their calm attitude.</p> <p dir="ltr">“Considering the situation, Krystle and Matt remained very calm,” he said.</p> <p dir="ltr">“I couldn’t imagine being 39 weeks pregnant stuck in flood waters.”</p> <p><span id="docs-internal-guid-5ed40b1b-7fff-3e60-4fe4-22eba811394b"></span></p> <p dir="ltr">But Angus isn’t the only flood baby to be born in such circumstances, after another couple were rescued by kayak, this time by the SES.</p> <p dir="ltr"><img src="https://oversixtydev.blob.core.windows.net/media/2022/03/felicity-jacques.jpg" alt="" width="1280" height="720" /></p> <p dir="ltr"><em>Felicity and Alex were rescued by SES volunteers before going on to welcome their newborn son into the world. Image: Felicity Jacques</em></p> <p dir="ltr">Sherwood couple Felicity and Alex Jacques called the SES for help when their cars flooded in the underground carpark of Alex’s parents home, where they were staying.</p> <p dir="ltr">The couple stayed in a hotel near the hospital overnight, before Ms Jacques went into labour early on Monday morning.</p> <p dir="ltr">Their baby son, Andrew Jacques, was also born on Tuesday, weighing 3.35 kg.</p> <p dir="ltr">“I hate to think what would have happened if we weren’t close to the hospital,” Ms Jacques said.</p> <p dir="ltr">“I’m so relieved our little one is here. He is definitely a little miracle.”</p> <p dir="ltr">Paula Foley, the chief operating officer at Mater Mothers’ Hospital, said the past week had seen many mums and families going to extraordinary lengths to get to the hospital to give birth.</p> <p dir="ltr">“It’s been an incredibly stressful time for many of our new mums and dads,” she said.</p> <p dir="ltr">“But we’ve had 188 babies born at Mater Mothers’ South Brisbane in the past week, despite the flooding.”</p> <p dir="ltr"><span id="docs-internal-guid-db22e156-7fff-5997-fa8e-9066a18ab3b8"></span></p> <p dir="ltr"><em>Image: Krystle Henry</em></p>

News

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Two years on from the first COVID case, New Zealand’s successful pandemic response still faces major challenges

<p>Two years ago today, the first confirmed case of COVID-19 was reported in Aotearoa New Zealand. Few of us could have imagined the huge impact this pandemic would still be having two years later.</p> <p>As New Zealand enters its third year of the pandemic, we are facing widespread community transmission as an epidemic wave of the Omicron variant sweeps across the country. A majority of New Zealanders <a href="https://cpb-ap-se2.wpmucdn.com/blogs.auckland.ac.nz/dist/c/828/files/2021/07/omicron-preliminary.pdf" target="_blank" rel="noopener">may become infected</a> in coming months, but many with few or no symptoms.</p> <p>Australian experience suggests we might see a peak of around <a href="https://blogs.otago.ac.nz/pubhealthexpert/covid-19-hospitalisation-peaks-in-australian-states-since-omicron-emerged-potential-relevance-to-aotearoa-nz/" target="_blank" rel="noopener">1,100 people with COVID-19 in hospitals</a> during March and April.</p> <p>We have previously written about the challenges apparent after <a href="https://theconversation.com/6-months-after-new-zealands-first-covid-19-case-its-time-for-a-more-strategic-approach-144936" target="_blank" rel="noopener">six months</a> and <a href="https://theconversation.com/a-year-on-from-the-arrival-of-covid-19-in-nz-5-lessons-for-2021-and-beyond-155367" target="_blank" rel="noopener">one year</a> of the pandemic. Today, we examine what we’ve learned — the major challenges that have persisted or emerged and how New Zealand can manage them to achieve the best possible outcomes.</p> <p><strong>Shifting strategies</strong></p> <p>New Zealand has demonstrated the benefits of a science-informed response with a <a href="https://www.bmj.com/content/371/bmj.m4907" target="_blank" rel="noopener">strong strategic focus</a>. During the first year of the pandemic when there were no vaccines available, the <a href="https://journal.nzma.org.nz/journal-articles/new-zealands-elimination-strategy-for-the-covid-19-pandemic-and-what-is-required-to-make-it-work" target="_blank" rel="noopener">elimination strategy</a> protected people and the economy.</p> <p>Following the emergence of the Delta variant, <a href="https://journal.nzma.org.nz/journal-articles/the-next-phase-in-aotearoa-new-zealands-covid-19-response-tight-suppression-may-be-optimal-for-health-equity-and-wellbeing-in-the-months-ahead" target="_blank" rel="noopener">tight suppression</a> was also highly effective. Now, with the growing surge driven by the Omicron variant, New Zealand has been forced to shift to a <a href="https://blogs.otago.ac.nz/pubhealthexpert/preparing-for-omicron-a-proactive-government-response-is-urgently-needed-to-minimise-harms/" target="_blank" rel="noopener">mitigation strategy</a>.</p> <p>New Zealand’s strategic approach has supported the country in achieving some of the world’s <a href="https://blogs.otago.ac.nz/pubhealthexpert/mortality-declines-in-aotearoa-nz-during-the-first-two-years-of-the-covid-19-pandemic/" target="_blank" rel="noopener">lowest COVID-19 mortality rates and increased life expectancy</a>. New Zealand has also had a relatively small amount of time in lockdown and comparatively <a href="https://www.oecd.org/economy/new-zealand-economic-snapshot/" target="_blank" rel="noopener">good economic performance</a>.</p> <p>To achieve these successes, New Zealand has had to deliver major public health interventions very rapidly and their limitations have become apparent over time.</p> <p>Border quarantine is <a href="https://www.mja.com.au/journal/2021/215/7/failures-quarantine-systems-preventing-covid-19-outbreaks-australia-and-new" target="_blank" rel="noopener">difficult to maintain</a> if not done well and creates <a href="https://www.nzherald.co.nz/nz/its-a-case-of-wait-and-see-grounded-kiwis-wrap-up-two-day-bid-for-judicial-review/X43JEMEEEL47I7JBPHTZIBJPFI/" target="_blank" rel="noopener">severe consequences for some</a>. The vaccine rollout has been <a href="https://www.bmj.com/content/376/bmj.o180" target="_blank" rel="noopener">highly inequitable</a>. Mandates for vaccine and mask use have been divisive and <a href="https://www.theguardian.com/world/2022/feb/09/lets-remember-why-we-are-here-new-zealand-anti-vax-protest-splinters-into-jibes-and-jabs" target="_blank" rel="noopener">sometimes vigorously opposed</a> by a vocal minority.</p> <p><strong>Challenges and opportunities ahead</strong></p> <p>The experience of the last two years highlights five major opportunities to enhance New Zealand’s pandemic response and achieve lasting benefits for our ability to manage other major public health threats.</p> <p><strong>1. Taking a precautionary approach in the face of uncertainty</strong></p> <p>Possibly the biggest challenge has been the changing nature of the pandemic threat itself. The virus <a href="https://www.nature.com/articles/s41586-021-03792-w" target="_blank" rel="noopener">continues to evolve</a> and new variants of concern with increased infectiousness have emerged. We do not know whether future variants will be <a href="https://www.theguardian.com/world/2022/jan/11/will-covid-19-become-less-dangerous-as-it-evolves" target="_blank" rel="noopener">more or less virulent</a>.</p> <p>Omicron shows a <a href="https://www.nature.com/articles/d41586-022-00438-3" target="_blank" rel="noopener">high capacity for reinfection</a> which will need to be managed if this variant remains dominant. Optimistically, we may see the <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00100-3/fulltext?s=09" target="_blank" rel="noopener">end of the pandemic</a> though not the end of COVID-19. The full population impact of <a href="https://www.nature.com/articles/d41586-020-02598-6" target="_blank" rel="noopener">post-acute illness</a> (long COVID) is not yet known and evidence about <a href="https://www.nature.com/articles/d41586-022-00177-5" target="_blank" rel="noopener">prevention</a> and management is still at an early stage.</p> <p><strong>2. Enhancing equity and better protecting the most vulnerable</strong></p> <p>The move to mitigation (from elimination and suppression) shifts protection away from the collective, population-level focus to individual measures like vaccination, mask use and self-isolation.</p> <p>Despite a strongly stated commitment to equity, Māori and Pasifika have <a href="https://thespinoff.co.nz/business/23-02-2022/the-spinoff-covid-tracker-the-live-graphs-that-tell-the-story-of-delta-in-aotearoa" target="_blank" rel="noopener">lower vaccine and booster coverage rates</a>. They are also <a href="https://www.health.govt.nz/covid-19-novel-coronavirus/covid-19-data-and-statistics" target="_blank" rel="noopener">over-represented among COVID-19 cases and hospitalisations</a>.</p> <p>Mitigation aims to flatten the epidemic curve to protect the healthcare system from being overwhelmed. During such periods, there is potential for the most vulnerable (people who are Māori, Pasifika, low-income, living with other illnesses and disabilities) to miss out on care.</p> <p>There are multiple ways of improving equity in the response. These include greater support for Māori and Pasifika <a href="https://www.waitangitribunal.govt.nz/assets/Documents/Publications/Covid-Priority-W.pdf" target="_blank" rel="noopener">health providers</a>, further efforts to <a href="https://www.newsroom.co.nz/ideasroom/eliminating-maori-inequities-in-covid-19-outcomes" target="_blank" rel="noopener">raise vaccine coverage for Māori</a> in particular, policies to <a href="https://www.stuff.co.nz/business/125804726/sick-leave-increase-what-you-need-to-know" target="_blank" rel="noopener">support sick workers staying at home</a> and a <a href="https://blogs.otago.ac.nz/pubhealthexpert/making-the-most-of-masks/" target="_blank" rel="noopener">national mask strategy</a> that makes effective masks freely available.</p> <p>We also need a stronger focus on protecting children’s health and well-being, including a pivot to a whānau-centred approach and efforts to reduce transmission in <a href="https://blogs.otago.ac.nz/pubhealthexpert/tag/ventilation-schools/" target="_blank" rel="noopener">schools</a> and <a href="https://blogs.otago.ac.nz/pubhealthexpert/strengthening-omicron-mitigation-strategies-in-early-childhood-education-settings/" target="_blank" rel="noopener">early childhood education</a>.</p> <p><strong>3. Improving communication, policy responsiveness and trust</strong></p> <p>Pandemics are different from other public health emergencies because the behaviour of individuals directly affects the level of risk for the wider population. Inevitably, after two years, the response has become more contested and social cohesion has weakened. Some of this shift appears fuelled by the global pandemic of <a href="https://www.theguardian.com/world/2022/feb/26/so-many-rabbit-holes-even-in-trusting-new-zealand-protests-show-fringe-beliefs-can-flourish" target="_blank" rel="noopener">disinformation</a>.</p> <p>The New Zealand government can enhance public trust by showing that the response is risk-based, for example by phasing out travel restrictions and border isolation requirements now that Omicron infection is widespread. Some mandates are needed for critical public health interventions but require continuing review to ensure they are proportionate.</p> <p>Trust and <a href="https://informedfutures.org/social-cohesion/" target="_blank" rel="noopener">social cohesion</a> will also be improved by maximising transparency around the pandemic response, with clear statements about the rationale and level of risk, supported with evidence and local surveillance data presented in meaningful ways. We also need <a href="https://www.newsroom.co.nz/cracking-the-misinformation-code" target="_blank" rel="noopener">specific strategies</a> to reduce misinformation and disinformation on social media.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/448759/original/file-20220227-95880-851xvy.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/448759/original/file-20220227-95880-851xvy.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/448759/original/file-20220227-95880-851xvy.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/448759/original/file-20220227-95880-851xvy.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/448759/original/file-20220227-95880-851xvy.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/448759/original/file-20220227-95880-851xvy.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/448759/original/file-20220227-95880-851xvy.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=3 2262w" alt="Tent and sign from an anti-mandate protest." /><figcaption><span class="caption">Anti-mandates protests have been partly fuelled by misinformation.</span> <span class="attribution">Adam Bradley/SOPA Images/LightRocket via Getty Images</span></figcaption></figure> <p><strong>4. Improving evidence-informed leadership and adaptability</strong></p> <p>While New Zealand’s science-informed strategic response has been generally successful, it has at times been reactive rather than proactive in rapidly adapting to changes in the pandemic. We need better mechanisms, such as the multi-party <a href="https://www.parliament.nz/en/visit-and-learn/history-and-buildings/special-topics/epidemic-response-committee-covid-19-2020/" target="_blank" rel="noopener">epidemic response committee</a> of parliamentarians, and advisory processes that ensure high-level science input into the all-of-government response. This could include the formation of a COVID-19 science council/rōpu.</p> <p>Other measures include a <a href="https://www.mbie.govt.nz/science-and-technology/science-and-innovation/research-and-data/nzris/covid-19-research-database/" target="_blank" rel="noopener">well-resourced research strategy</a> to provide high-quality scientific evidence and an <a href="https://blogs.otago.ac.nz/pubhealthexpert/five-key-reasons-why-nz-should-have-an-official-inquiry-into-the-response-to-the-covid-19-pandemic/" target="_blank" rel="noopener">official inquiry</a> to assess the pandemic response and drive wider system improvements.</p> <p><strong>5. Investing in public health infrastructure</strong></p> <p>The current <a href="https://dpmc.govt.nz/our-business-units/transition-unit/response-health-and-disability-system-review/information" target="_blank" rel="noopener">health sector reforms</a> are an opportunity to establish essential infrastructure, including a Public Health Agency and Māori Health Authority.</p> <p>Investment in the national immunisation register may help with reversing the recent <a href="https://www.immune.org.nz/sites/default/files/publications/Coverage%20Report%20-%20July%202021.pdf" target="_blank" rel="noopener">decline in childhood immunisations</a>. The pandemic also demonstrates that <a href="https://www.newsroom.co.nz/rethinking-rebreathing-how-to-end-the-pandemic" target="_blank" rel="noopener">clean indoor air</a> is as essential to health as clean drinking water.</p> <p>We should learn from other countries that have also delivered effective responses. <a href="https://www.thelancet.com/journals/lanwpc/article/PIIS2666-6065(20)30044-4/fulltext" target="_blank" rel="noopener">Taiwan is an example</a> we have previously documented.</p> <p>In summary, New Zealand is well placed to navigate the pandemic and the Omicron wave successfully. As we enter our third pandemic year, we can improve the effectiveness of our response by maintaining a precautionary approach in the face of uncertainty. We also need to improve equity, communication and trust, and evidence-informed leadership, as well as investing in public health infrastructure.</p> <p>These improvements will provide legacy benefits that <a href="https://ojs.victoria.ac.nz/pq/article/view/6550/5715" target="_blank" rel="noopener">prepare us well for other public health challenges</a> we face.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/177134/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/michael-baker-169808" target="_blank" rel="noopener">Michael Baker</a>, Professor of Public Health, <a href="https://theconversation.com/institutions/university-of-otago-1304" target="_blank" rel="noopener">University of Otago</a>; <a href="https://theconversation.com/profiles/amanda-kvalsvig-1143399" target="_blank" rel="noopener">Amanda Kvalsvig</a>, Senior Research Fellow, Department of Public Health, <a href="https://theconversation.com/institutions/university-of-otago-1304" target="_blank" rel="noopener">University of Otago</a>; <a href="https://theconversation.com/profiles/matire-harwood-1323164" target="_blank" rel="noopener">Matire Harwood</a>, Associate Professor Department of General Practice and Primary Care, <a href="https://theconversation.com/institutions/university-of-auckland-1305" target="_blank" rel="noopener">University of Auckland</a>, and <a href="https://theconversation.com/profiles/nick-wilson-133898" target="_blank" rel="noopener">Nick Wilson</a>, Professor of Public Health, <a href="https://theconversation.com/institutions/university-of-otago-1304" target="_blank" rel="noopener">University of Otago</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com" target="_blank" rel="noopener">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/two-years-on-from-the-first-covid-case-new-zealands-successful-pandemic-response-still-faces-major-challenges-177134" target="_blank" rel="noopener">original article</a>.</em></p> <p><em>Image: Getty Images</em></p>

Domestic Travel

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Did the pandemic make us lose our hair?

<p dir="ltr">Over the past five years, there has been a steady increase in searches for hair loss treatment all around the world. </p><p dir="ltr">In more recent times, the search terms peaked during the middle of the pandemic, reflecting how the mental health and stress effects of Covid-19 have manifested physically. </p><p dir="ltr">Unsurprisingly, more than two thirds of people with hair loss issues have cited stress as the number one reason for the thinning and lack of volume in their hair, ahead of factors such as age, illness and medication, and hormonal changes. </p><p dir="ltr">With hair loss affecting both men and women equally, this physical change can often be stigmatised, with people often afraid to reach out to find a solution. </p><p dir="ltr">There are multiple solutions available for hair loss, which can often be fraught with risk and include dangerous or invasive procedures or harsh drugs. </p><p dir="ltr">Luckily, Nioxin is a non-invasive solution to hair loss, with thousands of people turning to the simple three step treatment to deliver a newfound confidence though thicker and fuller looking hair.</p><p dir="ltr"><img src="https://oversixtydev.blob.core.windows.net/media/2022/02/Nioxin-1.jpg" alt="" width="1280" height="720" /></p><p dir="ltr"><em><span id="docs-internal-guid-98b3a7ae-7fff-f032-a67a-7a24be2a52c2">Before and after pictures from dedicated Nioxin customers. Image credit: Instagram</span></em></p><p dir="ltr"><em><img src="https://oversixtydev.blob.core.windows.net/media/2022/02/Nioxin-2.jpg" alt="" width="1280" height="720" /></em></p><p dir="ltr"><em><span id="docs-internal-guid-a46a929c-7fff-7846-aabf-9495bb3201aa">Before and after pictures from dedicated Nioxin customers. Image credit: Instagram</span></em></p><p dir="ltr">The cleansing shampoo, scalp therapy conditioner and leave-in treatment targets the scalp, roots and strands of the hair, helping to remove oil and residue, hydrate hair from root to tip and increase volume in every strand. </p><p dir="ltr">Nioxin’s tailored systems provide a solution for all hair types, at any stage of the hair loss process. </p><p dir="ltr">If you have progressive thinning and your hair is natural, you need the System Two Kit.</p><p dir="ltr"><img src="https://oversixtydev.blob.core.windows.net/media/2022/02/Nioxin-system-2.jpg" alt="" width="1280" height="720" /></p><p dir="ltr"><span id="docs-internal-guid-45f00ccc-7fff-d413-08a5-efd24a776107">If your hair is progressively thinning and your hair is coloured, the System Four Kit is here to help.</span></p><p dir="ltr"><img src="https://oversixtydev.blob.core.windows.net/media/2022/02/Nioxin-system-4.jpg" alt="" width="1280" height="720" /></p><p dir="ltr">If your hair is only just starting to thin and your hair is natural, look no further than the System One kit. </p><p dir="ltr"><img src="https://oversixtydev.blob.core.windows.net/media/2022/02/Nioxin-system-1.jpg" alt="" width="1280" height="720" /></p><p dir="ltr">If your hair is only just starting to thin and your hair is coloured, the System Three kit has you covered. </p><p dir="ltr"><span id="docs-internal-guid-1fc84a9e-7fff-f1b0-c865-767854c58c52"><img src="https://oversixtydev.blob.core.windows.net/media/2022/02/Nioxin-system-3.jpg" alt="" width="1280" height="720" /></span></p><p dir="ltr">With dedicated customers all over the world, Nioxin has helped to change the lives of many. </p><p dir="ltr">Customers have even reported how their hair helped to grow back fuller and stronger than before after undergoing extensive medical treatment that saw them lose their luscious locks. </p><p dir="ltr">Nioxin is the non-invasive answer to hair loss, with loyal customers being completely converted to the simple system that helped them gain control of their hair and rediscover their confidence. </p><p dir="ltr">Nioxin is available at <a href="https://au.wella.professionalstore.com/comingsoon/">Wella Store</a>, <a href="https://www.adorebeauty.com.au/nioxin.html">Adore Beauty</a>, <a href="https://www.ozhairandbeauty.com/collections/nioxin">Oz Hair &amp; Beauty</a> and other international retailers. </p><p dir="ltr"><em>All image credits: Instagram @nioxin</em><span id="docs-internal-guid-2efc9068-7fff-5fc0-fb6d-120896acff5b"></span></p>

Beauty & Style

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When each pandemic day feels the same, Phil the Weatherman in “Groundhog Day” can offer a lesson in embracing life mindfully

<p>Many of us will recall the comic film “<a href="https://www.imdb.com/title/tt0107048/">Groundhog Day</a>.”</p> <p>Originally released in 1993, it stars the incomparable Bill Murray as Phil Conners, an insufferable Pittsburgh weatherman. A minor local celebrity who believes himself destined for much better things, he resents his piddling assignment to report on the Groundhog Day celebration in Punxsutawney, Pennsylvania.</p> <p><img src="https://images.theconversation.com/files/381172/original/file-20210128-19-1q2x4lm.jpg?ixlib=rb-1.1.0&amp;rect=26%2C3%2C2493%2C1560&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt="Punxsutawney Phil on Groundhog Day" /> <span class="caption">Punxsutawney Phil after emerging from his burrow on Gobblers Knob in Punxsutawney, Pennsylvania.</span> <span class="attribution"><a href="https://newsroom.ap.org/detail/GroundhogDay/bd8d5370e7854bfea728a485b9c16bbf/photo?Query=groundhog&amp;mediaType=photo&amp;sortBy=&amp;dateRange=Anytime&amp;totalCount=603&amp;currentItemNo=11" class="source">AP Photo/Gene J. Puskar</a></span></p> <p>The plan is to return to Pittsburgh after the festivities. But when a blizzard shuts down the highway, Phil finds himself trapped in Punxsutawney. He wakes up the next day, only to discover that it’s not the next day at all. It’s Groundhog Day all over again.</p> <p>For some reason he’s trapped in Feb. 2, forced to relive the same day over and over again.</p> <p>“What if there is no tomorrow?” he asks at one point, adding: “There wasn’t one today.”</p> <p>It is a question that will resonate with millions forced to stay indoors as the Omicron variant of the coronavirus spreads and people wake up every morning wondering if the day ahead will be any different from the 24 hours they have just endured.</p> <p>But I have a more positive spin. As a <a href="https://cas.la.psu.edu/people/jde13">scholar of communication and ethics</a>, I argue that the lesson at the heart of the movie is that because we can never count on tomorrow, life must be lived fully in the present, not just for oneself, but also for others. Ultimately, “Groundhog Day” gives us a lesson in mindfulness.</p> <h2>Metaphor for mindlessness?</h2> <p>Phil was trapped in Groundhog Day, perhaps for hundreds of years. <a href="https://www.nytimes.com/2020/04/21/movies/groundhog-day.html">The original script said 10,000 years, though the director reportedly said it was 10</a>. Either way, that’s a long time to wake up to the same song every morning.</p> <p>Finally, Phil awakens, and it’s Feb. 3, that is, the next day.</p> <p>I believe what brings about tomorrow for Phil is that he learns to practice mindfulness.</p> <p>Phil’s repetitive existence can stand for a metaphor for mindlessness, for how we all get stuck in cycles of reactivity, addiction and habit. Locked in our routines, life can lose its luster.</p> <p>It can quickly seem like nothing we do matters all that much. “What would you do if you were stuck in one place, and every day was exactly the same, and nothing that you did mattered?” Phil asks two local guys at the bowling alley. “<a href="https://www.youtube.com/watch?v=DazUImBLEhM">That about sums it up for me</a>,” one of them responds.</p> <p><iframe width="440" height="260" src="https://www.youtube.com/embed/DazUImBLEhM?wmode=transparent&amp;start=0" frameborder="0" allowfullscreen=""></iframe></p> <p>Contemporary practices of mindfulness can trace their roots back to <a href="https://plumvillage.org/books/the-heart-of-the-buddhas-teaching/">Buddhism</a>. For Buddhists, the concept of reincarnation or <a href="https://www.lionsroar.com/just-more-of-the-same/">rebirth</a> is important. Many Buddhists believe that all living beings go through many births until they achieve salvation.</p> <p>As a scholar, I believe the idea of rebirth is more complex than is often understood in popular culture.</p> <p>Pali is the ancient sacred language of Theravada Buddhism. Scholar of Buddhism <a href="https://www.stephenbatchelor.org/index.php/en/stephen">Stephen Batchelor</a> notes that the ancient Pali language word “punabbhava,” often translated as “rebirth,” literally means “<a href="https://yalebooks.yale.edu/book/9780300205183/after-buddhism">again-becoming</a>,” or what we might think of as “repetitive existence.”</p> <p>That’s Phil’s life, stuck in Groundhog Day. That’s what Phil is trying to escape, and what we are all trying to escape in COVID times – repetitive existence, a life stuck in one gear, frozen by habits and patterns that make every day feel the same, as though nothing matters.</p> <h2>Taking a moment – to respond, mindfully</h2> <p>If Phil’s stuckness is a metaphor for mindlessness, Phil’s awakening, I argue, is a metaphor for mindfulness. <a href="https://www.penguinrandomhouse.com/books/204352/the-miracle-of-mindfulness-by-thich-nhat-hanh/">Mindfulness</a> is the practice of experiencing life as it is happening, squarely in the now, without immediately reacting to it or being carried away by it.</p> <p>Mindfulness is <a href="https://www.youtube.com/watch?v=3nwwKbM_vJc">a practice</a> of getting to know ourselves and our conditioning a little better. Conditioning is an automatic pattern of reacting to the world. By stepping out of autopilot, pausing, and noticing, many of us can find that we <a href="https://www.parallax.org/product/the-mindfulness-survival-kit-five-essential-practices/">are no longer captive </a> to our conditioning. Consequently, we gain the space to make choices about how we want to respond to life.</p> <p>That is what Phil does in the movie – he escapes repetitive existence by overcoming his initial conditioned, obnoxious, egotistical reactions to the world. At the beginning of the film, he calls himself the “talent” and berates the “<a href="https://www.youtube.com/watch?v=KFgpsHrGvWY">hicks</a>” who live in the small town. He is too good for Groundhog Day. He wants to escape Punxsutawney as fast as possible.</p> <p>As the film continues, Phil accepts his situation and turns repetition into an opportunity for growth. He begins to find meaning in the place where he is trapped. He embraces life, fully, which also means that he notices his own suffering and the suffering of those around him.</p> <p>Phil addresses his own suffering by pursuing his passions and developing his skills. He learns to play the piano and becomes an accomplished ice sculptor.</p> <p>Initially, Phil felt nothing for those around him. People were objects to him, if he noticed them at all. By the end of the film, he feels compassion, which, according to the mindfulness teacher <a href="https://www.rhondavmagee.com/about-mindfulness-trainer/">Rhonda Magee</a>, means “<a href="https://www.penguinrandomhouse.com/books/565790/the-inner-work-of-racial-justice-by-rhonda-v-magee-foreword-by-jon-kabat-zinn/">the will to act to alleviate the suffering of others</a>.” Mindfulness is a practice that draws us into the world, into service. <a href="https://pennstate.pure.elsevier.com/en/publications/compassion-and-human-development-current-approaches-and-future-di">Compassion</a> is at the heart of a mindfulness practice.</p> <h2>Mindfulness in pandemic times</h2> <p><a href="https://images.theconversation.com/files/381175/original/file-20210128-21-kdi02x.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/381175/original/file-20210128-21-kdi02x.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt="Mediation in times of Covid." /></a> <span class="caption">Compassion is at the heart of meditation.</span> <span class="attribution"><a href="https://www.gettyimages.com/detail/news-photo/woman-wearing-a-scary-face-mask-clasps-her-hands-in-news-photo/1228160036?adppopup=true" class="source">Mark Makela/Getty Images</a></span></p> <p>Mindfulness does not mean turning away from <a href="https://www.ted.com/talks/rhonda_magee_the_inner_work_of_racial_justice?language=en">difficulty</a>. It is a practice of meeting difficulty with <a href="https://www.tenpercent.com/covid">compassion</a>. Though Phil finally accepts that there might not be a tomorrow, nevertheless he acts to ensure that if tomorrow comes for himself and those around him, it will be better than today.</p> <p>For example, Phil saves the lives of at least two people: a young boy who, before Phil’s intervention, falls out of a tree onto a hard sidewalk, and the town’s mayor, who, before Phil bursts in to give him the Heimlich, chokes on his lunch.</p> <p>Phil’s mindful awareness of what is happening in the moment allows him to act for tomorrow without losing track of today. Phil’s mindfulness, and his compassion, drive the film’s central love story between Phil and Rita. At the beginning of the film, he was capable of loving only himself. By the end of the film, Phil has learned to love mindfully.</p> <p>According to <a href="https://theconversation.com/thich-nhat-hanh-who-worked-for-decades-to-teach-mindfulness-approached-death-in-that-same-spirit-175495">Thich Nhat Hanh</a>, who died recently, <a href="https://www.shambhala.com/true-love-1594.html">loving mindfully</a> means that “you must love in such a way that the person you love feels free.” Phil has learned that love is not about manipulation or possession but about collaboration in making a shared life together.</p> <p>To the best of his ability, Phil dedicates himself to alleviating the suffering of others in a present that is real and for a future that might not come. He does this in small acts of compassion like fixing a flat tire and more momentous acts like saving a life. This mindful dedication to the future in the face of uncertainty is, I argue, what allows him to wake up to a new day.</p> <p>This is a <a href="https://theconversation.com/5-buddhist-teachings-that-can-help-you-deal-with-coronavirus-anxiety-134320">good lesson</a> for us all, stuck, as we are, in a perpetual pandemic Groundhog Day, and dreaming, as we are, of tomorrow.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/153605/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><span><a href="https://theconversation.com/profiles/jeremy-david-engels-222106">Jeremy David Engels</a>, Professor of Communication Arts and Sciences, <em><a href="https://theconversation.com/institutions/penn-state-1258">Penn State</a></em></span></p> <p>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/when-each-pandemic-day-feels-the-same-phil-the-weatherman-in-groundhog-day-can-offer-a-lesson-in-embracing-life-mindfully-153605">original article</a>.</p> <p><em>Image: <span class="attribution"><a href="https://www.gettyimages.com/detail/news-photo/bill-murray-and-andie-macdowell-in-a-scene-from-the-film-news-photo/163063765?adppopup=true" class="source">Columbia Pictures/Getty Images</a></span></em></p>

Movies

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‘Welcome to our world’: families of children with cancer say the pandemic has helped them feel seen, while putting them in peril

<p>For billions of people across the world, life as we knew it stopped in 2020.</p> <p>Families and friends were separated. Masks mandated. Hand washing essential. Every trip outside became risky.</p> <p>As news of deaths, variants and long-term effects of COVID trickled in daily, we were forced to adjust to a new normal marked by constant anxiety and fear, which has only worsened with the recent surge in Omicron cases in Australia.</p> <p>But for a particular group of Australians, this lifestyle is all too familiar.</p> <p>As both the mother of a childhood cancer survivor and a Curtin University PhD student exploring families’ experiences of childhood cancer, I embarked on a study to understand the pandemic’s effects on kids going through cancer treatment, and their families.</p> <p>In mid-2020 I interviewed 34 parents of children with cancer across Australia about their experiences during the pandemic.</p> <p>The answer I received was a resounding: “welcome to our world”. The pandemic lifestyle we are all adjusting to is the life families of children with cancer have already been living.</p> <p>The parents in our study, <a href="https://academic.oup.com/jpepsy/advance-article/doi/10.1093/jpepsy/jsab125/6448612?login=true">published in December</a> with a team of Curtin University researchers, painted a picture of both benefits and devastating costs.</p> <h2>Even a cold can lead to hospitalisation</h2> <p>Every year, almost <a href="https://www.ccia.org.au/about-childhood-cancer">1,000 Australian kids</a> are diagnosed with cancer.</p> <p>With advances in treatment, survival rates have increased and <a href="https://www.aihw.gov.au/reports/children-youth/australias-children/contents/health/cancer-incidence-and-survival">84% of children</a> now survive to five years after diagnosis. But this comes at the cost of long, gruelling and complex treatments involving a combination of chemotherapy, surgery and radiotherapy.</p> <p>Chemotherapy leaves children profoundly vulnerable to infection. Even a simple cold can leave a child in hospital struggling for their life.</p> <p>For the families in this study, wearing masks, washing hands, isolating and missing social events was already a way of life during treatment. Some even placed hand sanitiser outside their front door.</p> <p> </p> <h2>COVID silver linings</h2> <p>For this reason, many of the parents welcomed the increased infection control which came with COVID.</p> <p>“When COVID happened, [people] started taking care […] social distancing, wiping everything, covering their mouths,” said one father. Another added: “it’s actually positively impacted us […] she wasn’t getting colds and flus she’d normally get”.</p> <p>Previous research has found parents of children with cancer often struggle trying to care for siblings and <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/pbc.28345">keep up an income</a> while being in hospital with the child with cancer. The shift to online work and school helped reduce some of this burden.</p> <p>“One of the good things is that COVID allows me to work remotely […] it’s a big weight off my shoulders […] allows for income to keep coming in,” commented one dad, adding “if it had happened in 2019 it would have been a different approach.”</p> <p>For both the child with cancer, and their siblings, it’s a lonely road. These kids are forced to miss out on having a normal childhood, missing birthday parties, school and time spent with friends. This is an isolating experience, leaving kids feeling like the “odd one out”, and leaving parents feeling profoundly guilty for the impact on their children.</p> <p>But parents in our study noticed a silver lining to COVID: their kids no longer felt like the only one missing out. “Either way she didn’t miss out on anything, because everybody missed out,” said one parent.</p> <h2>A lonely road</h2> <p>Despite some silver linings of COVID for the families in our study, they also told a story of devastating isolation and fear.</p> <p>Because of restrictions which allowed only one parent with a child in hospital, several of the parents in our study recalled being alone when they were told of their child’s diagnosis.</p> <blockquote> <p>“The very first moment we discovered their diagnosis, I was sitting alone, and my husband was in the ED waiting room. I then stayed with my child and it meant we were left to process this news solo and not together […] the last thing I wanted was to sit with my own thoughts.”</p> </blockquote> <p>As treatment progressed, hospital visitor restrictions kept families apart for months: “I couldn’t see my partner for three months […] five minutes at the door of the hospital […] a little kiss and good night, that was horrible.”</p> <p><img src="https://images.theconversation.com/files/441416/original/file-20220118-19-wbxuud.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt="Mother cuddling child with cancer in hospital bed" /> <span class="caption">COVID restrictions have made for a lonely pandemic for many parents of kids with cancer.</span> <span class="attribution"><span class="source">Shutterstock</span></span></p> <p>One mother described the gruelling experience as restrictions kept friends and family from visiting hospital: “For the whole year I was on my own […] it was the loneliest year”.</p> <p>Travel restrictions also meant overseas parents and relatives couldn’t visit to provide support. One parent said: “we definitely felt like we were in the trenches, just the three of us”.</p> <p>Even though our study was conducted before the recent wave of Omicron cases, it can still teach us some valuable lessons going forward.</p> <p>Despite the hardships of COVID, the virus has allowed us to develop new ways of connecting online, and increased flexibility for those unable to be there in person.</p> <p>As we renegotiate what life with COVID looks like, we can use these lessons to protect and support the most vulnerable among us.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/175143/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><span><a href="https://theconversation.com/profiles/jenny-davies-1307737">Jenny Davies</a>, PhD researcher, <em><a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a></em></span></p> <p>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/welcome-to-our-world-families-of-children-with-cancer-say-the-pandemic-has-helped-them-feel-seen-while-putting-them-in-peril-175143">original article</a>.</p> <p><em>Image: Shutterstock</em></p>

Family & Pets

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Understanding how animals become infected with COVID-19 can help control the pandemic

<p>When veterinarians at the Antwerp Zoo noticed <a href="https://www.theguardian.com/world/2021/dec/05/hippos-test-positive-covid-antwerp-zoo-belgium">two hippopotamuses with runny noses</a>, they didn’t just offer them tissues to blow their noses. They administered tests, which came back positive for COVID-19, the worldwide virus that has plagued the globe.</p> <p>Since the start of the global pandemic almost two years ago, humans have not been the only species to contract the COVID-19 virus. Although the Belgian hippos were the first of their species to contract the virus, it has spread throughout the entire animal kingdom.</p> <p>COVID-19 has revealed how health connects humans, animals and the environment — <a href="https://www.who.int/news-room/questions-and-answers/item/one-health">the approach that considers these relationships and connections is known as “One Health.”</a></p> <p>Responding to the pandemic has been a model of One Health in action. Veterinarians, physicians and environmental experts have needed to collaborate to determine which <a href="https://ovc.uoguelph.ca/news/node/632">species are susceptible to better understand how the COVID-19 virus spreads</a>.</p> <h2>Infected pets</h2> <p>In the early days of the COVID-19 pandemic — if you can remember that far back — alarming reports of pets infected with the COVID-19 virus <a href="https://www.psychologytoday.com/ca/blog/canine-corner/202003/unfounded-fears-dogs-can-spread-covid-19-can-cause-harm">raised unfounded fears regarding the potential exposure and risk of viral infections</a>.</p> <p>In April 2020, two cats from different households in different parts of New York state became <a href="https://www.cdc.gov/media/releases/2020/s0422-covid-19-cats-NYC.html">the first domestic cats in America to contract the COVID-19 virus</a>, followed several months later by the <a href="https://www.ctvnews.ca/health/coronavirus/cat-becomes-first-animal-in-u-k-to-test-positive-for-covid-19-1.5040581">first positive British cat</a>.</p> <p>And although the first American dog to test positive for the COVID-19 virus died within a few months, <a href="https://www.nationalgeographic.com/animals/article/first-dog-to-test-positive-for-covid-in-us-dies">his symptoms indicated he likely had cancer</a>, suggesting that the virus may not have been the sole cause of his death. Although confirmed COVID-19 in pets is relatively uncommon, dogs and cats are at risk from <a href="https://www.eurekalert.org/news-releases/615304">catching the virus</a> from an infected household member.</p> <p>Conversely, however, and to great relief, overwhelming agreement has <a href="https://www.bva.co.uk/coronavirus/frequently-asked-questions/#frequently-asked-questions-owners">emerged among major</a> <a href="https://www.canadianveterinarians.net/coronavirus-covid-19">veterinary societies</a> that <a href="https://www.avma.org/resources-tools/animal-health-and-welfare/covid-19/sars-cov-2-animals-including-pets">the risk of humans</a> contracting COVID-19 <a href="https://www.cdc.gov/healthypets/covid-19/pets.html">from their dogs and cats</a> is extremely low.</p> <p><iframe width="440" height="260" src="https://www.youtube.com/embed/KDne4Zm4HBE?wmode=transparent&amp;start=0" frameborder="0" allowfullscreen=""></iframe> <span class="caption">A VICE report on COVID-19 and pets.</span></p> <p>Interestingly, an article in <em>Scientific American</em> reported on studies that showed that of the dogs and cats who lived in a household with a positive family member, <a href="https://www.scientificamerican.com/article/people-with-covid-often-infect-their-pets/">one of every five of the pets had the virus, though symptoms were relatively mild</a>.</p> <p>Currently, there is <a href="https://doi.org/10.1126/science.abg2296">no need for dogs and cats to be vaccinated</a>, but <a href="https://globalnews.ca/news/8423409/covid-19-vaccine-animals-zoos/">pharmaceutical representatives are confident</a> in their ability to readily produce a vaccine to protect pets.</p> <h2>Animals at risk</h2> <p>At the beginning of this pandemic, researchers were eager to discover the extent to which COVID-19 was transmittable from animals to humans, given the potential for animals to “<a href="https://doi.org/10.1038/d41586-020-01574-4">spark new outbreaks</a>.”</p> <p>Early on, at least seven big cats — lions and tigers — at the Bronx Zoo <a href="https://www.nationalgeographic.com/animals/article/tiger-coronavirus-covid19-positive-test-bronx-zoo">tested positive for COVID-19</a>. By the end of 2021, more than 300 animals representing 15 different species contracted COVID-19, <a href="https://www.nationalgeographic.com/animals/article/more-animal-species-are-getting-covid-19-for-the-first-time">including hyenas, lions, tigers, snow leopards, gorillas, otters and deer</a>.</p> <p>Recently, <a href="https://www.theguardian.com/us-news/2022/jan/08/snow-leopard-dies-covid-19-illinois-zoo">four snow leopards who contracted the disease</a> from humans have died in American zoos.</p> <p>Risks remain elsewhere in the animal kingdom. Captive gorillas, for instance, <a href="https://www.ctvnews.ca/health/coronavirus/nearly-all-gorillas-at-atlanta-s-zoo-have-contracted-covid-19-1.5586112">are highly susceptible to COVID-19</a>. Were the disease to spread to <a href="https://doi.org/10.1126/science.abc5635">gorillas in the wild</a>, it would likely contribute to the depletion of the <a href="https://www.iucnredlist.org/species/9404/136250858">critically endangered species</a>.</p> <p><a href="https://images.theconversation.com/files/439954/original/file-20220110-23-1a86u4f.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/439954/original/file-20220110-23-1a86u4f.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt="an adult lowland gorilla and two smaller ones in an enclosure" /></a> <span class="caption">Nearly all of Zoo Atlanta’s Western lowland gorillas tested positive for the COVID-19 Delta variant in September 2021 after catching it from a zoo staff worker.</span> <span class="attribution"><span class="source">(AP Photo/Ron Harris)</span></span></p> <h2>Animal vaccines</h2> <p>If humans are not contracting COVID-19 from animals, why are scientists worried? After all, pets are more at risk from infected humans, and individuals who work closely with wild animals take appropriate precautions to prevent transmission. However, it is important to remember that <a href="https://doi.org/10.1038/d41586-021-00531-z">animals are the likely source of the current pandemic</a>: bats, in particular, carry a number of <a href="https://www.bbc.com/news/science-environment-51496830">different coronavirus strains and are considered by many as the original carriers of SARS-CoV-2</a>, the virus that causes COVID-19.</p> <p>The transmission of the COVID-19 virus between humans and animals has been <a href="https://doi.org/10.1126/science.abe5901">found in minks</a>, a phenomenon that spread within <a href="https://www.pbs.org/wgbh/nova/article/mink-covid-virus-mutation/">mink farms in the United States and Europe</a>. As a result, millions of minks have since been culled and there have been calls for banning mink farming.</p> <p>The most recent solution to human-animal transmission has been developing COVID-19 vaccines for animals. Because zoos are responsible for “<a href="https://www.the-scientist.com/news-opinion/the-rise-of-covid-19-vaccines-for-animals-69503">often rare and high-value animals</a>,” some have begun to <a href="https://www.nationalgeographic.com/animals/article/bears-baboons-tigers-are-getting-covid-vaccines-at-zoos-across-the-us">vaccinate their residents</a>.</p> <h2>New viral diseases</h2> <p>There are concerns that <a href="https://www.who.int/news-room/feature-stories/detail/how-who-is-working-to-track-down-the-animal-reservoir-of-the-sars-cov-2-virus">the COVID-19 virus has the potential to remain undetected in an animal</a> and <a href="https://doi.org/10.1038/d41586-021-00531-z">could mutate and become more infectious or dangerous to humans</a>.</p> <p>An estimated <a href="https://www.bbc.com/news/science-environment-54246473">three of every four new infectious diseases in humans originated in animals</a> — and this continues to worry scientists. Researchers worry about “<a href="https://dx.doi.org/10.1590/1678-4685-GMB-2020-0355">zoonotic spillover</a>,” the movement of diseases between animals and humans, given the increased risk of “<a href="https://dx.doi.org/10.17269/s41997-020-00409-z">infectious agents capable of jumping the species barrier</a>.”</p> <p>The current pandemic has been called “<a href="https://impakter.com/coronavirus-china-one-health-solution/">a wake-up call</a>” for recognizing how the importance of One Health: a collaborative global vision committed to the health and well-being of humans, animals and the environment that can thwart future global health crises.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/173978/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><span><a href="https://theconversation.com/profiles/beth-daly-1224943">Beth Daly</a>, Associate Professor of Anthrozoology, <em><a href="https://theconversation.com/institutions/university-of-windsor-3044">University of Windsor</a></em></span></p> <p>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/understanding-how-animals-become-infected-with-covid-19-can-help-control-the-pandemic-173978">original article</a>.</p> <p><em>Image: Shutterstock</em></p>

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Inclusion, walkability will be key to rebuilding cities after the COVID-19 pandemic

<p>Cities emerged as the epicentres of the COVID-19 pandemic: <a href="https://www.un.org/sites/un2.un.org/files/sg_policy_brief_covid_urban_world_july_2020.pdf">roughly 90 per cent of COVID-19 infections worldwide were reported in urban settings</a>. And poor urban neighbourhoods were hit especially hard.</p> <p>Researchers frequently attributed the vulnerability of cities to <a href="https://doi.org/10.1289/EHP8888">high population density, overcrowding and poor air circulation</a>. The vulnerability of cities during the COVID-19 pandemic has highlighted the need to create sustainable cities that promote health.</p> <p><iframe width="440" height="260" src="https://www.youtube.com/embed/AwvtmKqIUCo?wmode=transparent&amp;start=0" frameborder="0" allowfullscreen=""></iframe> <span class="caption">To address the pandemic, municipal governments around the world have changed their approaches to urban planning.</span></p> <h2>Less density, more diversity</h2> <p>As sociologists interested in urban settings, we examined how the <a href="https://doi.org/10.31235/osf.io/3xg5q">physical environment of neighbourhoods shaped the spread of COVID-19 in Toronto</a>. Our findings suggest a few things cities should keep in mind as they rebuild following the pandemic.</p> <p>First, we should create more walkable neighbourhoods. COVID-19 spread at a much slower pace in highly walkable neighbourhoods. Residents in these neighbourhoods <a href="https://doi.org/10.1177/1948550620979259">can travel shorter distances</a> on wider and better maintained sidewalks, which may reduce their exposure to the COVID-19 virus.</p> <p><a href="https://images.theconversation.com/files/439985/original/file-20220110-13-n0n1ip.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/439985/original/file-20220110-13-n0n1ip.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt="An older apartment building with a canadian flag flying from one balcony" /></a> <span class="caption">Higher population density increased the spread of COVID-19 in low-income neighbourhoods, but lowered the infection rate in more affluent neighbourhoods.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></p> <p>Second, we should reduce the number of overcrowded households. <a href="https://theconversation.com/new-study-reveals-intensified-housing-inequality-in-canada-from-1981-to-2016-173633">Soaring real estate prices have forced many socio-economically disadvantaged families into overcrowded housing</a>. Space constraints in these housing units may make it more difficult for residents to practice adequate physical distancing. <a href="https://www.thestar.com/news/gta/2021/04/18/seven-people-one-bathroom-what-its-like-weather-the-pandemic-in-an-overcrowded-toronto-home.html">It may have also deprived them of the space necessary to isolate if they contracted the virus</a>. <a href="https://doi.org/10.1016/j.ssmph.2021.100845">These factors may have increased their risk of contracting COVID-19</a>. Increasing the supply of affordable housing may hold the key to reducing the urban poor’s vulnerability to infectious diseases.</p> <p>Third, we should increase the number of mixed-income housing units and better integrate our neighbourhoods. COVID-19 spread much faster in lower-income neighbourhoods. Housing affordability may have pushed out <a href="https://books.google.ca/books?hl=en&amp;lr=&amp;id=yFw1EAAAQBAJ&amp;oi=fnd&amp;pg=PA175&amp;dq=gentrification+and+displacement+Canada&amp;ots=4M0p8kGebG&amp;sig=gNVS2bkMaVu9MJd09XHBdGCkU4E&amp;redir_esc=y#v=onepage&amp;q=gentrification%20and%20displacement%20Canada&amp;f=false">disadvantaged families from higher-income neighbourhoods and forced them to settle in lower-income areas with fewer amenities</a>.</p> <p>Displacement and higher density due to limited housing affordability may have increased the concentration of residents who were exposed to the COVID-19 virus. Residents of low-income neighbourhoods are more likely than their peers in affluent neighbourhoods to live in close proximity to someone with a COVID-19 infection.</p> <h2>Tailored responses</h2> <p>Residents of low-income neighbourhoods rely more on neighbourhood amenities than their peers in affluent neighbourhoods because they have fewer personal resources at their disposal. And even when communities have the same amenities, those in lower-income neighbourhoods are more likely to be poorly maintained. For example, lower-income neighbourhoods may <a href="https://doi.org/10.1016/j.ssmph.2016.03.004">lack wide and well-maintained sidewalks</a>.</p> <p>They also have fewer health-promoting amenities, such as <a href="https://theconversation.com/how-urban-planning-and-housing-policy-helped-create-food-apartheid-in-us-cities-154433">grocery stores with fresh produce</a> or <a href="https://dx.doi.org/10.1016/j.puhe.2020.05.006">high quality health care facilities</a>. Therefore, a neighbourhood’s physical environment contributes to the spread of COVID-19 differently in lower and higher income neighbourhoods.</p> <p>Our study reveals that <a href="https://osf.io/preprints/socarxiv/3xg5q/">population density increased the spread of COVID-19 in low-income neighbourhoods, but it lowered the infection rate in high-income neighbourhoods</a>. In more affluent neighbourhoods, even high-density apartment buildings come with amenities and protections — like better ventilation systems and additional staff to properly sanitize common areas — that similarly dense buildings in lower-income neighbourhoods lack.</p> <p>Similarly, green space mitigates the spread of COVID-19 in lower-income, but not higher-income, neighbourhoods. Housing units in low-income neighbourhoods are likely smaller, overcrowded, less well-maintained and have poorer ventilation. Residents of low-income neighbourhoods may thus face greater difficulty adhering to stay-at-home policies. Large green spaces in such neighbourhoods may <a href="https://doi.org/10.1088/1748-9326/abb396">provide a safe space where residents can get clean air and safely practice social distancing</a>.</p> <p><a href="https://images.theconversation.com/files/439984/original/file-20220110-25-vqwzn.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/439984/original/file-20220110-25-vqwzn.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt="Groups of people sit on the grassy ground behind a modern building" /></a> <span class="caption">Building more urban green spaces will allow people to socialize safely.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></p> <p>Furthermore, neighbourhood walkability helps mitigate the spread of COVID-19 more in lower-income neighbourhoods than in higher-income neighbourhoods. This pattern likely emerges because residents of <a href="https://doi.org/10.1016/j.tranpol.2017.09.016">low-income neighbourhoods are less likely than their counterparts in affluent neighbourhoods to own cars</a>. They are more likely to rely on public transportation for errands that cannot be completed on foot. For residents of low-income neighbourhoods with poor walkability, <a href="https://doi.org/10.1080/01944363.2021.1886974">running errands may require longer trips and making multiple transfers in the public transportation system</a>.</p> <h2>After the pandemic</h2> <p>The COVID-19 pandemic has highlighted the need for us to build sustainable cities that promote health and reduce the vulnerability to infectious diseases among their residents. Future urban planning efforts should not adopt a one-size-fits-all approach. Instead, they should tailor the rebuilding process to meet the diverse needs of residents of lower and higher income neighbourhoods.</p> <p>Specifically, rebuilding efforts should prioritize low-income neighbourhoods and remedy their high population density, construct more green spaces and improve their walkability.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/174313/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><span><a href="https://theconversation.com/profiles/kate-choi-1074966">Kate Choi</a>, Associate Professor, Sociology, <em><a href="https://theconversation.com/institutions/western-university-882">Western University</a></em> and <a href="https://theconversation.com/profiles/patrick-denice-1078515">Patrick Denice</a>, Assistant Professor of Sociology, <em><a href="https://theconversation.com/institutions/western-university-882">Western University</a></em></span></p> <p>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/inclusion-walkability-will-be-key-to-rebuilding-cities-after-the-covid-19-pandemic-174313">original article</a>.</p> <p><em>Image: Shutterstock</em></p>

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Top Covid expert sees an end to pandemic within two months

<p>A top health official in Denmark has predicted that the Covid pandemic could end within two months in some countries, thanks to the Omicron variant. </p> <p><span>Tyra Grove Krause, the chief epidemiologist at Denmark’s State Serum Institute, told <a rel="noopener" href="https://nyheder.tv2.dk/2022-01-03-ssi-vi-kan-have-vores-normale-liv-tilbage-om-to-maaneder" target="_blank">Danish TV 2</a> that a recent study conducted by the institute has found that Covid hospitalisations have halved with Omicron, as opposed to the previous Delta variant. </span></p> <p><span>When questioned about how long the virus will affect daily life in Denmark, she said, </span>“I think it will have that in the next two months, and then I hope the infection will start to subside and we get our normal lives back”.</p> <p>Dr Grove Krause’s research also stated that “Omicron is here to stay”.</p> <p>“It will provide some massive spread of infection in the coming month. When it’s over, we’re in a better place than we were before,” the paper said.</p> <p><span>Dr Grove Krause claims that daily life may return to normal within a few months as more people are likely to become infected, raising the level of natural immunity for the majority of the population.</span><span></span></p> <p>“Omicron will peak at the end of January, and in February we will see declining infection pressure and a decreasing pressure on the health care system,” she said. “But we have to make an effort in January, because it will be hard to get through”.</p> <p>“In the long run, we are in a place where coronavirus is here, but where we have restrained it, and only the particularly vulnerable need to be vaccinated up to the next winter season,” she said.</p> <p>The optimistic news out of Denmark comes just days after the <a rel="noopener" href="https://www.who.int" target="_blank">World Health Organisation</a> made a similarly positive statement about Omicron. </p> <p><span>“If we put an end to inequality, we will put an end to the pandemic and the global nightmare that we have all gone through,” WHO chief Tedros Adhanom Ghebreyesus said in a speech on New Year’s Eve.</span></p> <p><span>Top US pandemic Adviser Anthony Fauci also said that the experience in South Africa, where the new variant quickly peaked before subsiding, offered some hope to other countries. </span></p> <p><span>“When one looked at the relationship and the ratio between hospitalisations and cases (in South Africa), it was lower, the duration of hospital stay was lower, the requirements for oxygen was lower,” he said. “We’re seeing a bit of that, not as pronounced, in the UK, but certainly that trend. And if you look here at the United States, we don’t want to get complacent at all, and you don’t want to jump to a positive conclusion, because it’s still early," he said. </span></p> <p><em>Image credits: Getty Images</em></p>

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