tag:theconversation.com,2011:/africa/topics/pandemic-1134/articlesPandemic – The Conversation2024-03-28T03:27:34Ztag:theconversation.com,2011:article/2267322024-03-28T03:27:34Z2024-03-28T03:27:34ZNSW may end its COVID vaccine mandate for health workers. That doesn’t mean it was a bad idea in the first place<figure><img src="https://images.theconversation.com/files/584921/original/file-20240328-26-z9guow.jpg?ixlib=rb-1.1.0&rect=7%2C14%2C4913%2C3260&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/woman-face-mask-getting-vaccinated-hospital-1954364125">Ground Picture/Shutterstock</a></span></figcaption></figure><p>Months after COVID vaccines were introduced in 2021, governments and private organisations mandated them for various groups. Health and aged care workers were <a href="https://www.sciencedirect.com/science/article/pii/S2211883722000648?via%3Dihub">among the first</a> to need two doses to keep their jobs. </p>
<p>State and territory governments subsequently implemented <a href="https://doi.org/10.1016/j.vaccine.2021.11.056">employment and public space mandates</a> which required people to show proof of vaccination to enter hospitality venues and events. A constellation of private companies also required vaccines for their workers or patrons.</p>
<p>Vaccine mandates receive considerable attention when they’re introduced. For COVID vaccine mandates, policymakers offered reasoning including <a href="https://statements.qld.gov.au/statements/93754">protecting the vulnerable</a>, safeguarding health systems, and <a href="https://www.smh.com.au/national/australia-news-live-covid-19-infections-continue-to-grow-across-the-nation-regional-victoria-lockdown-restrictions-to-be-eased-20210908-p58pyj.html">making it possible</a> to open state borders and lift internal restrictions. <a href="https://gh.bmj.com/content/7/5/e008684">Experts</a> and the public sometimes debated the merits of these policies, but the reasons behind them were relatively clear. </p>
<p>By contrast, the removal of vaccine mandates often appears haphazard. <a href="https://theconversation.com/is-it-time-to-rethink-vaccine-mandates-for-dining-fitness-and-events-we-asked-5-experts-176356">Less is known</a> about how or why it happens, or how it should be done. </p>
<p>However, mandate removal may have just as much of <a href="https://theconversation.com/time-to-remove-vaccine-mandates-not-so-fast-it-could-have-unintended-consequences-180781">an influence</a> on people’s future attitudes and behaviour as mandate imposition. As <a href="https://www.abc.net.au/news/2024-03-26/nsw-health-covid-vaccine-requirements-healthcare-worker/103629276">New South Wales</a> considers removing its COVID vaccine mandate for health-care workers, it’s pertinent to explore how to abolish a vaccine mandate in the right way.</p>
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<h2>Why do mandates end?</h2>
<p>Many COVID vaccine mandates <a href="https://www.cambridge.org/core/journals/epidemiology-and-infection/article/medical-exemptions-to-mandatory-vaccinations-the-state-of-play-in-australia-and-a-pressure-point-to-watch/DAAD8CC98E04828A57F1DEB98B4751B5">terminated</a> when state governments stopped classifying the pandemic as an emergency. The mandates which remained in place covered workers in high-risk settings, but even some of these have since ended. </p>
<p>Queensland and Western Australia removed their COVID vaccine requirements for health workers in 2023, and this week NSW <a href="https://www.abc.net.au/news/2024-03-26/nsw-health-covid-vaccine-requirements-healthcare-worker/103629276">announced</a> it’s considering doing the same. </p>
<p>This is good news. Governments should treat vaccine mandates like other health policies and review them regularly in the context of changing evidence. Some <a href="https://www.mja.com.au/journal/2021/215/11/policy-considerations-mandatory-covid-19-vaccination-collaboration-social">criteria</a> governments should think about when implementing or removing vaccine mandates include:</p>
<p><strong>Disease burden in the community</strong></p>
<p>Governments should consider the rate of severe illness and availability of treatment options and hospital resources. In the case of COVID, the general population has developed high levels of hybrid immunity from vaccination and infection.</p>
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Read more:
<a href="https://theconversation.com/queensland-ruling-doesnt-mean-all-covid-vaccine-mandates-were-flawed-heres-why-224646">Queensland ruling doesn't mean all COVID vaccine mandates were flawed. Here's why</a>
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<p><strong>Population vulnerability</strong></p>
<p>Health-care workers are more likely to be exposed to disease, and they may transmit it to patients who are at high risk of serious outcomes. This is why NSW and some other states require staff in health or aged care to get <a href="https://www.lavan.com.au/advice/employment_safety/mandatory_influenza_vaccinations_the_new_norm">flu vaccines</a> each year. </p>
<p><strong>Vaccine effectiveness</strong></p>
<p>It matters how well the mandated vaccine prevents severe disease in people who are vaccinated, which COVID vaccines do well. But whether they reduce transmission to others is also relevant. Importantly, COVID vaccination <a href="https://theconversation.com/no-vaccinated-people-are-not-just-as-infectious-as-unvaccinated-people-if-they-get-covid-171302">reduces</a> but does not prevent disease transmission. Outside an emergency situation, this weakens the argument for mandating vaccination.</p>
<p>Another good reason to revisit NSW’s current two-dose mandate for health workers is the fact it’s obviously outdated. Although some other states and territories <a href="https://www.theage.com.au/politics/victoria/this-midwife-is-double-covid-vaxxed-but-she-s-still-banned-from-returning-to-work-20240208-p5f3eq.html">have required one booster</a>, this did not have to be regular or recent. </p>
<p>Having received two or three doses of the vaccine, often much earlier in the pandemic, is unlikely to offer protection against infection today. Most people – vaccinated or not – have now also developed some immunity through infection. </p>
<p>Since these policies don’t reflect current evidence or recommendations, leaving them in place could actually be damaging. It may erode trust and confidence in the health system and government, both for health-care workers and the public.</p>
<figure class="align-center ">
<img alt="A nurse putting on gloves." src="https://images.theconversation.com/files/584928/original/file-20240328-26-dp7jw8.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/584928/original/file-20240328-26-dp7jw8.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/584928/original/file-20240328-26-dp7jw8.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/584928/original/file-20240328-26-dp7jw8.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/584928/original/file-20240328-26-dp7jw8.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/584928/original/file-20240328-26-dp7jw8.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/584928/original/file-20240328-26-dp7jw8.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Health-care workers in a number of Australian jurisdictions need to be vaccinated against COVID.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/female-nurse-mask-putting-on-gloves-1229815867">Rawpixel.com/Shutterstock</a></span>
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</figure>
<h2>So how should we repeal mandates responsibly?</h2>
<p>While it’s important to review these policies in changing contexts, there’s a risk vaccine or mandate opponents will use this opportunity to claim mandates were never necessary. </p>
<p>No COVID decisions were perfect, and we should evaluate pandemic decision-making across a range of measures. But the circumstances and justifications for introducing mandates were very different from today. This distinction should be kept in mind when communicating changes in mandate policy. </p>
<p>For NSW and any other jurisdictions considering removing mandates, first, they should consult meaningfully with the community to drive decision-making and communication. This includes engaging with those who are subject to the mandate and those indirectly affected by it. </p>
<p>We applaud NSW Health for <a href="https://www.health.nsw.gov.au/news/Pages/20240325_01.aspx">consulting</a> with health workforce stakeholders. However, they haven’t described consulting with patients or vulnerable groups, who may worry mandate removal exposes them to untenable risk from their health-care providers. It’s important to prepare a communication strategy for this group, too.</p>
<p><a href="https://www.mja.com.au/journal/2021/215/1/communicating-patients-and-public-about-covid-19-vaccine-safety-recommendations">Transparency is key</a> to maintaining trust in public health officials. When a decision is made to alter or remove a mandate, we recommend transparently explaining the decision and the data that informed it. For communicating about mandate removal, spokespeople could provide clear, simple data that compares the burden of disease or immunity rates at the time of implementation versus now. </p>
<p>It’s also crucial any announcement about mandate removal makes clear that vaccination is still recommended. NSW Chief Health Officer Kerry Chant framed the early messaging well, saying NSW Health would continue to <a href="https://www.health.nsw.gov.au/news/Pages/20240325_01.aspx">strongly recommend</a> employees stay <a href="https://www.health.gov.au/resources/publications/atagi-statement-on-the-administration-of-covid-19-vaccines-in-2024?language=en">up-to-date</a> with their COVID vaccinations.</p>
<p>Finally, governments should provide clear and accessible legal and health guidance to private companies. These employers may still have mandatory vaccination policies in place, and need support on how best to consider or announce their removal. </p>
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<strong>
Read more:
<a href="https://theconversation.com/unintended-consequences-of-nzs-covid-vaccine-mandates-must-inform-future-pandemic-policy-new-research-222989">Unintended consequences of NZ's COVID vaccine mandates must inform future pandemic policy – new research</a>
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<p>The abolition of COVID vaccine mandates is an important milestone in our journey out of the pandemic. At the same time, it means governments need to <a href="https://www.nature.com/articles/d41586-022-00495-8">ensure high voluntary vaccine uptake</a>. </p>
<p>This requires funding, efficient service delivery, support for health-care workers who administer vaccines, and persuasive public health campaigns. When governments manage mandate removal well, they make it easier for themselves to continue to protect the public against disease.</p><img src="https://counter.theconversation.com/content/226732/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Katie Attwell is a specialist advisor to the Australian Technical Advisory Group on Immunisation. She is a past recipient of a Discovery Early Career Researcher Award funded by the Australian Research Council of the Australian Government (DE19000158). She leads the "Coronavax" project, which is funded by the Government of Western Australia. She leads “MandEval: Effectiveness and Consequences of Australia's COVID-19 Vaccine Mandates” funded by the Medical Research Future Fund of the Australian Government. All funds were paid to her institution. Funders are not involved in the conceptualization, design, data collection, analysis, decision to publish, or preparation of manuscripts.</span></em></p><p class="fine-print"><em><span>Jessica Kaufman receives funding from the Australian government and the Victorian state government. She is the deputy chair of the Collaboration on Social Science and Immunisation.</span></em></p>The move makes sense at this stage of the pandemic. But abolishing a vaccine mandate needs to be done carefully so as not to damage public trust.Katie Attwell, Associate Professor, School of Social Sciences, The University of Western AustraliaJessica Kaufman, Research Fellow, Vaccine Uptake Group, Murdoch Children's Research InstituteLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2239702024-03-14T19:24:37Z2024-03-14T19:24:37ZFrom malaria, to smallpox, to polio – here’s how we know life in ancient Egypt was ravaged by disease<figure><img src="https://images.theconversation.com/files/581183/original/file-20240312-29-m4tny7.jpg?ixlib=rb-1.1.0&rect=55%2C30%2C3338%2C2234&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>The mention of ancient Egypt usually conjures images of colossal pyramids and precious, golden tombs. </p>
<p>But as with most civilisations, the invisible world of infectious disease underpinned life and death along the Nile. In fact, fear of disease was so pervasive it influenced social and religious customs. It even featured in the statues, monuments and graves of the Kingdom of the Pharaohs. </p>
<p>By studying ancient specimens and artefacts, scientists are uncovering how disease rocked this ancient culture. </p>
<h2>Tutankhamun’s malaria, and other examples</h2>
<p>The most direct evidence of epidemics in ancient Egypt comes from skeletal and DNA evidence obtained from the mummies themselves.</p>
<p>For instance, DNA recovered from the mummy of the boy pharaoh Tutankhamun (1332–1323 BC) led to the discovery he <a href="https://pubmed.ncbi.nlm.nih.gov/20159872/">suffered from malaria</a>, along with several other New Kingdom mummies (circa 1800 BC). </p>
<p>In other examples:</p>
<ul>
<li>skeletal and DNA <a href="https://pubmed.ncbi.nlm.nih.gov/11289521/">evidence found</a> in the city of Abydos suggests one in four people may have had tuberculosis </li>
<li>the mummy of Ramesses V (circa 1149–1145 BC) has scars indicating smallpox </li>
<li>the wives of Mentuhotep II (circa 2000 BC) were buried hastily in a “mass grave”, suggesting <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9186437/">a pandemic</a> had occurred</li>
<li>and the mummies of two pharaohs, Siptah (1197–1191 BC) and Khnum-Nekht (circa 1800 BC), were <a href="https://link.springer.com/article/10.1007/s10072-016-2720-9">found with</a> the deformed <a href="https://www.shorelineortho.com/specialties/foot_ankle_equinus.php">equinus</a> foot which is characteristic of the viral disease polio.</li>
</ul>
<h2>Signs of a disease-ravaged people</h2>
<p>Amenhotep III was the ninth pharaoh of the 18th dynasty, and ruled from about 1388–1351 BC.</p>
<p>There are several reasons experts think his reign was marked by a devastating disease outbreak. For instance, two separate carvings from this time depict a priest and a royal couple with the polio dropped-foot. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/577699/original/file-20240224-30-9gt04r.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/577699/original/file-20240224-30-9gt04r.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/577699/original/file-20240224-30-9gt04r.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=844&fit=crop&dpr=1 600w, https://images.theconversation.com/files/577699/original/file-20240224-30-9gt04r.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=844&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/577699/original/file-20240224-30-9gt04r.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=844&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/577699/original/file-20240224-30-9gt04r.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1060&fit=crop&dpr=1 754w, https://images.theconversation.com/files/577699/original/file-20240224-30-9gt04r.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1060&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/577699/original/file-20240224-30-9gt04r.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1060&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">This 18th dynasty panel depicts a polio sufferer.</span>
<span class="attribution"><a class="source" href="https://en.m.wikipedia.org/wiki/File:Polio_Egyptian_Stele.jpg">Wikimedia</a></span>
</figcaption>
</figure>
<p>Statues of the lion-headed goddess of disease and health, Sekhmet, also <a href="https://pubmed.ncbi.nlm.nih.gov/33227516/">increased significantly</a>, suggesting a reliance on divine protection.</p>
<p>Another sign of a potential major disease outbreak comes in the form of what may be an early case of quarantine, wherein Amenhotep III moved his palace to the more isolated site of Malqata. This is further supported by the burning of a workers’ cemetery near Thebes. </p>
<p>Grave goods also became less extravagant and tombs less complex during this period, which suggests more burials were needed in a shorter time frame. These burials can’t be explained by war since this was an unusually peaceful period.</p>
<h2>Did disease trigger early monotheism?</h2>
<p>Amenohotep’s son – “the heretic King” Akhenaten (who was also Tutankhamun’s father) – abandoned the old gods of Egypt. In one of the earliest cases of monotheism, Akhenaten made worship of the Sun the official state religion. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/577700/original/file-20240224-26-gurcmn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/577700/original/file-20240224-26-gurcmn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=755&fit=crop&dpr=1 600w, https://images.theconversation.com/files/577700/original/file-20240224-26-gurcmn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=755&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/577700/original/file-20240224-26-gurcmn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=755&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/577700/original/file-20240224-26-gurcmn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=949&fit=crop&dpr=1 754w, https://images.theconversation.com/files/577700/original/file-20240224-26-gurcmn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=949&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/577700/original/file-20240224-26-gurcmn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=949&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">This panel (circa 1372-1355 BC) shows Akhenaten, Nefertiti and their daughters adoring the Sun god Aten.</span>
<span class="attribution"><a class="source" href="https://en.m.wikipedia.org/wiki/File:La_salle_dAkhenaton_(1356-1340_av_J.C.)_(Mus%C3%A9e_du_Caire)_(2076972086).jpg">Wikimedia</a></span>
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</figure>
<p>Some <a href="https://www.thecollector.com/akhenaten-monotheism-plague-egypt/">researchers think</a> Akhenaten’s dramatic loss of faith may have been due to the devastating disease he witnessed during his childhood and into his reign, with several of his children and wives having died from disease. But we’ve yet to find clear evidence for the role of disease in shaping his theology.</p>
<p>There’s also no direct DNA evidence of an outbreak under his father, Amenhotep III. There are only descriptions of one <a href="https://www.nationalgeographic.co.uk/history-and-civilisation/2021/01/these-pharaohs-private-letters-expose-how-politics-worked-3300-years-ago">in letters</a> Amenhotep III and Akhenaten exchanged with the Babylonians. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/580627/original/file-20240308-16-mt400i.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/580627/original/file-20240308-16-mt400i.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/580627/original/file-20240308-16-mt400i.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=302&fit=crop&dpr=1 600w, https://images.theconversation.com/files/580627/original/file-20240308-16-mt400i.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=302&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/580627/original/file-20240308-16-mt400i.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=302&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/580627/original/file-20240308-16-mt400i.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=380&fit=crop&dpr=1 754w, https://images.theconversation.com/files/580627/original/file-20240308-16-mt400i.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=380&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/580627/original/file-20240308-16-mt400i.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=380&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">These clay tablets (circa 14th century BC), inscribed in Babylonian cuneiform, were sent to Amenhotep III or Akhenaten from the ruler Abdi-tirshi of Hazor (modern-day Israel).</span>
<span class="attribution"><span class="source">British Museum</span>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span>
</figcaption>
</figure>
<p>To confirm an outbreak under Amenhotep III, we’d need to first recover pathogen DNA in human remains from this time, has been found in other Egyptian burial sites and for <a href="https://pubmed.ncbi.nlm.nih.gov/21993626/">other pandemics</a>.</p>
<p>Also, while many ancient epidemics are referred to as “plagues”, we can’t confirm whether any outbreaks in ancient Egypt were indeed caused by <em>Yersinia pestis</em>, the bacteria responsible for bubonic plague pandemics <a href="https://www.britannica.com/event/Black-Death">such as the Black Death</a> in Europe (1347-1351). </p>
<p>That said, researchers <a href="https://www.jstor.org/stable/3554655">have confirmed</a> the Nile rat, which was widespread during the time of the Pharaohs, would have been able to carry the <em>Yersinia</em> infection.</p>
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<a href="https://images.theconversation.com/files/579796/original/file-20240305-24-p439xf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/579796/original/file-20240305-24-p439xf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/579796/original/file-20240305-24-p439xf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=427&fit=crop&dpr=1 600w, https://images.theconversation.com/files/579796/original/file-20240305-24-p439xf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=427&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/579796/original/file-20240305-24-p439xf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=427&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/579796/original/file-20240305-24-p439xf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=537&fit=crop&dpr=1 754w, https://images.theconversation.com/files/579796/original/file-20240305-24-p439xf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=537&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/579796/original/file-20240305-24-p439xf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=537&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">This 1811 etching depicts the ancient Plague of Athens (circa 430 BC), which may have been caused by <em>Yersinia</em> or a disease with similar symptoms such as smallpox, typhus or measles.</span>
<span class="attribution"><a class="source" href="https://www.britishmuseum.org/collection/image/1047063001">The British Museum</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span>
</figcaption>
</figure>
<h2>How were outbreaks managed?</h2>
<p>Much like modern pandemics, factors such as population growth, sanitation, population density and mobilisation for war would have influenced the spread of disease in ancient Egypt. </p>
<p>In the case of war, it’s thought the Hittite army was <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9186437/">weakened by</a> disease spread when it was famously <a href="https://www.khanacademy.org/humanities/world-history/world-history-beginnings/ancient-egypt-hittites/a/the-hittites">defeated by</a> Egyptian Pharaoh Ramses the Great in the battle of Kadesh (1274 BC). </p>
<p>In some ways, Egyptian medicine was advanced for its time. While these outbreaks occurred long before the development of antibiotics or vaccines, there is some evidence of public health measures such as the burning of towns and quarantining people. This suggests a basic understanding of how disease spreads. </p>
<p>Diseases caused by microorganisms would have been viewed as supernatural, or as a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1121911/">corruption of the air</a>. This is similar to other explanations held in different parts of the world, before germ theory was popularised in the 19th century.</p>
<h2>New world, old problems</h2>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/579797/original/file-20240305-28-cqzgoc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/579797/original/file-20240305-28-cqzgoc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/579797/original/file-20240305-28-cqzgoc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=750&fit=crop&dpr=1 600w, https://images.theconversation.com/files/579797/original/file-20240305-28-cqzgoc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=750&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/579797/original/file-20240305-28-cqzgoc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=750&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/579797/original/file-20240305-28-cqzgoc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=943&fit=crop&dpr=1 754w, https://images.theconversation.com/files/579797/original/file-20240305-28-cqzgoc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=943&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/579797/original/file-20240305-28-cqzgoc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=943&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The funerary mask of Tutankhamun, who died as a teenager.</span>
<span class="attribution"><a class="source" href="https://en.m.wikipedia.org/wiki/File:CairoEgMuseumTaaMaskMostlyPhotographed.jpg">Wikimedia</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>Many of the most widespread diseases that afflicted the ancient world are still with us.</p>
<p>Along with Tutankhamun, it’s thought <a href="https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(17)30261-X/abstract">up to 70%</a> of the Egyptian population was infected with malaria caused by the <em>Plasmodium falciparum</em> parasite – spread by swarms of mosquitoes occupying the stagnant pools of the Nile delta. </p>
<p>Today, malaria affects about 250 million people, mostly in developing nations. Tuberculosis kills more than a million people each year. And smallpox and polio have only recently been eradicated or controlled through vaccination programs.</p>
<p>More work is yet to be done to detect individual pathogens in Egyptian mummies. This knowledge could shed light on how, throughout history, people much like us have grappled with these unseen organisms.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/did-everyone-in-bridgerton-have-syphilis-just-how-sexy-would-it-really-have-been-in-regency-era-london-180581">Did everyone in Bridgerton have syphilis? Just how sexy would it really have been in Regency era London?</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/223970/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Thomas Jeffries does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Beyond the tombs and riches, life in ancient Egypt wasn’t so luxurious, after all.Thomas Jeffries, Senior Lecturer in Microbiology, Western Sydney UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2252852024-03-11T19:13:13Z2024-03-11T19:13:13ZMother’s little helper: interviews with Australian women show a complex relationship with alcohol<figure><img src="https://images.theconversation.com/files/580616/original/file-20240308-16-prhzxy.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5751%2C3768&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/alcoholism-alcohol-addiction-people-concept-drunk-2187785169">Syda Productions/Shutterstock</a></span></figcaption></figure><p>Men have historically, and still do, <a href="https://pubmed.ncbi.nlm.nih.gov/19686518/">drink more than women</a>. But in recent years there has been an uptick in women’s drinking, particularly among women in their late 30s <a href="https://onlinelibrary.wiley.com/doi/10.1111/dar.13428">through to their 60s</a>. </p>
<p>This is concerning, as <a href="https://www.who.int/europe/news/item/04-01-2023-no-level-of-alcohol-consumption-is-safe-for-our-health">no level of alcohol is considered safe</a> for our health, and <a href="https://www.sciencedirect.com/science/article/abs/pii/S0955395922001189?via%3Dihub">women are especially susceptible</a> to <a href="https://www.sciencedirect.com/science/article/pii/S0376871615016166">alcohol’s long-term health harms</a> (for example, cancer and heart disease). </p>
<p>We’ve also seen the emergence of the “wine mum” <a href="https://theconversation.com/winemom-humour-and-empowerment-or-binge-drinking-and-mental-health-challenges-161338">in popular culture</a> and <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/dar.12215">greater social acceptance</a> of women’s drinking.</p>
<p><div data-react-class="TiktokEmbed" data-react-props="{"url":"https://vt.tiktok.com/ZSFyYHa68/."}"></div></p>
<p>But women still drink differently to men, and there are some important reasons why – particularly for women who <a href="https://doi.org/10.1016/j.drugpo.2022.103699">juggle both paid work and motherhood</a>.</p>
<p>In 2022, we conducted interviews with 22 Australian working mothers aged 36 to 51, to learn more about their daily lives and the role alcohol played. Most of the women were middle-class professionals. Many were partnered to men, some were single, and all had school-aged children they looked after alongside their jobs.</p>
<p>We’ve <a href="https://www.tandfonline.com/doi/full/10.1080/16066359.2024.2314041">recently published</a> two <a href="https://www.tandfonline.com/doi/full/10.1080/09687637.2023.2299392">new papers</a> exploring what we found.</p>
<h2>Modern working mothers</h2>
<p>Now, more than ever, <a href="https://www.abs.gov.au/statistics/labour/employment-and-unemployment/labour-force-status-families/latest-release">women are entering the workforce</a> and developing careers. At the same time, many also have to meet the demands of having children. While we like to think we’re moving towards a more equal society, women are still expected to do the <a href="https://www.tandfonline.com/doi/full/10.1080/13668803.2015.1080664">majority of childcare and domestic duties</a>.</p>
<p>This means many women are having to do “<a href="https://www.sciencedirect.com/science/article/pii/S0955395922001189?via%3Dihub">double shifts</a>” of paid and unpaid labour, increasing the chance they’re stressed, and limiting how much time they have to relax, unwind, and pursue hobbies. This is where alcohol comes in.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/oh-well-wine-oclock-what-midlife-women-told-us-about-drinking-and-why-its-so-hard-to-stop-188882">'Oh well, wine o’clock': what midlife women told us about drinking – and why it's so hard to stop</a>
</strong>
</em>
</p>
<hr>
<p>Most women we talked to felt <a href="https://www.tandfonline.com/doi/full/10.1080/16066359.2024.2314041">over-committed</a> because of their competing roles. Whether they had partners or not, they were often taking on the “default” caregiver role. This involved tasks such as getting kids ready for school, cooking, cleaning, and organising appointments. </p>
<p>At the same time, their jobs could be mentally or emotionally stressful, such as working in health care or project management.</p>
<p>And it wasn’t uncommon for these two worlds to overlap. For example, some women talked about needing to send emails or make calls from home outside work hours, or feeling there was an expectation for them to take time off work to take kids to appointments. </p>
<p>Many women were fatigued, and they felt a sense of guilt at not being able to commit fully to either role. As Mia, a full-time employed, partnered mother said:</p>
<blockquote>
<p>You’ll spend your life feeling compromised, doing a half job as a parent, and a half job as a worker.</p>
</blockquote>
<figure class="align-center ">
<img alt="A woman in the kitchen with two children talking on the phone." src="https://images.theconversation.com/files/580614/original/file-20240308-24-v6huqa.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/580614/original/file-20240308-24-v6huqa.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/580614/original/file-20240308-24-v6huqa.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/580614/original/file-20240308-24-v6huqa.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/580614/original/file-20240308-24-v6huqa.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/580614/original/file-20240308-24-v6huqa.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/580614/original/file-20240308-24-v6huqa.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">For many women, work and home life overlaps.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/busy-stressed-mother-talking-on-phone-1584282157">Onjira Leibe/Shutterstock</a></span>
</figcaption>
</figure>
<p>When participants talked about drinking alcohol, it was something accessible they could do alongside their home duties. For example, a glass of wine while cooking dinner was almost ubiquitous. Drinking helped women manage busy days, and the amount they drunk was not always something they had the capacity to be mindful of. As Caroline, a full-time employed, separated mother explained:</p>
<blockquote>
<p>We don’t sit down and stand around like the boys do drinking, with the beer cans round our feet. We drink a glass of wine while we cook tea […] while we’re sitting doing the kids’ homework or arguing with them about, ‘where’s your sock? Where’s your library book?’ […] it makes it very easy to think ‘I’ve only had one glass of wine’ when you’ve had three or four, because you’re not mindful of what you’re doing.</p>
</blockquote>
<p>Many of the women we talked to also described feeling under-supported. This included at work, where they felt there wasn’t always enough flexibility to accommodate their parental obligations, and at home, where their partners were not always around to share the workload. </p>
<p>These stresses and pressures meant alcohol became a “prize” or “reward” for getting through the day. And when participants felt particularly stressed or under-supported (which was often), the reward of a drink at the end of the day was all the more important. According to Penelope, a part-time employed, separated mother:</p>
<blockquote>
<p>I think that I reach out to drinking at the end of the day because I’m really quite overwhelmed, or quite exhausted mentally and physically from the day.</p>
</blockquote>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/did-you-look-forward-to-last-nights-bottle-of-wine-a-bit-too-much-ladies-youre-not-alone-109078">Did you look forward to last night's bottle of wine a bit too much? Ladies, you're not alone</a>
</strong>
</em>
</p>
<hr>
<h2>What about the pandemic?</h2>
<p>Things became even more complicated during the <a href="https://www.tandfonline.com/doi/full/10.1080/09687637.2023.2299392">COVID pandemic</a>. Women suddenly took on “triple shifts” – mothering, working and home-schooling – leaving many feeling even more overwhelmed. As Belle, a partnered mother who worked part time, said:</p>
<blockquote>
<p>We were all working and trying to home school, and it was just so awful […] so I guess my girlfriends were going through that too, the ones with kids, and they were all definitely drinking a lot more.</p>
</blockquote>
<figure class="align-center ">
<img alt="A woman at a kitchen bench drinking a glass of red wine." src="https://images.theconversation.com/files/580612/original/file-20240308-18-kztkea.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/580612/original/file-20240308-18-kztkea.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/580612/original/file-20240308-18-kztkea.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/580612/original/file-20240308-18-kztkea.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/580612/original/file-20240308-18-kztkea.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/580612/original/file-20240308-18-kztkea.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/580612/original/file-20240308-18-kztkea.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The chaos of the pandemic left working mothers feeling even more overwhelmed.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/portrait-beautiful-lonely-young-woman-drinking-1802268634">Gorodenkoff/Shutterstock</a></span>
</figcaption>
</figure>
<p>Alcohol was classified as an “essential service” during lockdowns (bottle shops remained open while many other retail stores closed), and against this backdrop, participants felt it became even more normalised. They talked about seeing media depictions and advertising of alcohol, including online memes that made wine out as a way to cope with the pandemic. Belle said:</p>
<blockquote>
<p>Everyone would send each other little memes of women just drinking, and it definitely became […] a socially acceptable way of getting through that really shit time.</p>
</blockquote>
<p>Hobbies and exercise activities they would previously turn to to relieve stress were often restricted because of the pandemic. As such, alcohol became one of the few things left. Many women we talked to were either drinking more, more often, or felt an increased desire to drink, especially during the height of the pandemic and when they were home-schooling.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/women-are-drinking-more-during-the-pandemic-and-its-probably-got-a-lot-to-do-with-their-mental-health-139295">Women are drinking more during the pandemic, and it's probably got a lot to do with their mental health</a>
</strong>
</em>
</p>
<hr>
<p>To understand why and how modern working mothers drink alcohol, it’s also important to consider how the alcohol industry targets women, often framing alcohol as a <a href="https://www.tandfonline.com/doi/full/10.1080/16066359.2024.2314041#:%7E:text=This%20study%20investigated%20the%20social,meanings%20around%20reward%20and%20relaxation.">symbol of relief and relaxation</a> among busy working mothers. </p>
<p>But it’s equally important to realise being a modern working mother is tough, especially as traditional gender expectations of women as carers persist. Almost 60 years ago, the Rolling Stones sang about “<a href="https://en.wikipedia.org/wiki/Mother%27s_Little_Helper">mother’s little helper</a>” in reference to women using substances to manage everyday life. </p>
<p>Until we see changes in the way women are supported at work and home, alcohol may continue being “mother’s little helper” for many working mothers.</p><img src="https://counter.theconversation.com/content/225285/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Maree Patsouras receives funding from an Australian Government Research Training Program Scholarship and the Australian Research Council.</span></em></p><p class="fine-print"><em><span>Cassandra Wright receives salary funding from the Australian Research Council. She also receives funding from the Medical Research Future Fund, Northern Territory Motor Accident Compensation Commission, Music NT and Menzies School of Health Research internal grant scheme.</span></em></p><p class="fine-print"><em><span>Emmanuel Kuntsche receives funding from La Trobe University, the Victorian Health Promotion Foundation (VicHealth), the National Health and Medical Research Council (NHMRC), the Australian Research Council (ARC), and the University of Bayreuth Centre of International Excellence "Alexander von Humboldt". Emmanuel Kuntsche serves as that Secretary of the Australasian Professional Society on Alcohol and other Drugs (APSAD).</span></em></p><p class="fine-print"><em><span>Gabriel Caluzzi receives funding via the Australian Research Council and the Victorian Health Promotion Foundation.</span></em></p><p class="fine-print"><em><span>Sandra Kuntsche receives funding from the Australian Research Council. </span></em></p>Men and women often drink alcohol differently. This is especially the case for women who juggle both paid work and motherhood.Maree Patsouras, PhD Candidate, Centre for Alcohol Policy Research, La Trobe UniversityCassandra Wright, Senior Research Fellow in Alcohol and other Drugs, Menzies School of Health ResearchEmmanuel Kuntsche, Director of the Centre for Alcohol Policy Research, La Trobe UniversityGabriel Caluzzi, Research Fellow, Centre for Alcohol Policy Research, La Trobe UniversitySandra Kuntsche, Associate Professor Family Therapy and Systemic Research, La Trobe UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2218262024-03-07T21:28:26Z2024-03-07T21:28:26ZWhy ‘One Health’ needs more social sciences: Pandemic prevention depends on behaviour as well as biology<p>On March 11, 2024, <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">it will be four years since the World Health Organization characterized the SARS-CoV-2 outbreak as a pandemic</a>. And while COVID-19 continues to impact people globally, it is only the most recent in a long history of pandemics with likely origins in animals. Examples include <a href="https://www.cdc.gov/plague/transmission/index.html">plague</a>, which usually spreads from rodents to humans via infected fleas, and the 2009 <a href="https://www.cdc.gov/h1n1flu/general_info.htm">H1N1 flu</a>, also known as swine flu due to its <a href="https://doi.org/10.7554/eLife.16777">origins in pigs</a>. </p>
<figure class="align-right ">
<img alt="Purple spikes covered with a mossy yellow-green substance" src="https://images.theconversation.com/files/580289/original/file-20240306-30-gmkzlc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/580289/original/file-20240306-30-gmkzlc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/580289/original/file-20240306-30-gmkzlc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/580289/original/file-20240306-30-gmkzlc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/580289/original/file-20240306-30-gmkzlc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/580289/original/file-20240306-30-gmkzlc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/580289/original/file-20240306-30-gmkzlc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Microscopic view of Yersinia pestis bacteria, which causes bubonic plague, in a flea.</span>
<span class="attribution"><span class="source">(NIAID)</span>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>Given the animal origins of past pandemics, as well as the many recent cases of disease in people linked to animals — such as <a href="https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON497">anthrax</a>, <a href="https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON506">Middle East respiratory syndrome</a> and <a href="https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON504">avian influenza virus</a> — it is very likely that the next pandemic will again originate in animals. </p>
<p>In fact, <a href="https://doi.org/10.3390%2Fmicroorganisms8091405">over 60 per cent of emerging infectious diseases in people originate in animals. Among these, more than 70 per cent are associated with wildlife</a>. Our close interactions with animals and our shared environment is a major factor for why and how these pathogens spill over. </p>
<h2>Pandemic prevention</h2>
<p>Recognizing our interconnected health, there have been increased calls for <a href="https://doi.org/10.1016/S0140-6736(24)00066-7">primary pandemic prevention</a>, which focuses on reducing the chance of an outbreak occurring by preventing the spread of pathogens from animals to people.</p>
<p>One framework for primary pandemic prevention is called “One Health.” One Health recognizes the close links among human, animal and environmental health, whereby promoting health in one part of this triad promotes the health of all. </p>
<p>While this concept of interconnected health has gained awareness in western science in the past century, it is not new. Instead, it is a reflection of what <a href="https://doi.org/10.1126/science.abe2401">Indigenous Peoples have known and practised for millennia</a>. </p>
<h2>One Health</h2>
<p>Global recognition of One Health has been steadily increasing. For example, the formation of the <a href="https://globalohc.org/what-is-one-health">Quadripartite</a> — which consists of global organizations including the <a href="https://www.fao.org/home/en">Food and Agriculture Organization of the United Nations</a>, the <a href="https://www.unep.org/">United Nations Environment Programme</a>, the World Health Organization, and the <a href="https://www.woah.org/en/home/">World Organisation for Animal Health</a> — has been focused on mobilizing One Health. The Quadripartite is advised by the <a href="https://www.who.int/groups/one-health-high-level-expert-panel/members">One Health High Level Expert Panel</a>. </p>
<figure class="align-center ">
<img alt="Gloved hands injecting a cow" src="https://images.theconversation.com/files/580291/original/file-20240306-20-9ocphi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/580291/original/file-20240306-20-9ocphi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/580291/original/file-20240306-20-9ocphi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/580291/original/file-20240306-20-9ocphi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/580291/original/file-20240306-20-9ocphi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/580291/original/file-20240306-20-9ocphi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/580291/original/file-20240306-20-9ocphi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">A veterinarian vaccinates cattle against disease. Understanding farmers’ barriers to vaccinating livestock is key to successful disease prevention.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
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<p>Yet despite the interdisciplinary nature of One Health, many initiatives are still falling short. Discussions and decisions about One Health issues are often dominated by veterinary and human health sciences, sidelining the social sciences <a href="https://doi.org/10.1016/j.socscimed.2014.09.048">despite the crucial role</a> of disciplines like psychology, sociology, and communications in understanding human behaviour. </p>
<p>Social science researchers aim to understand people — their perceptions and concerns, their histories, their socio-political, cultural and environmental contexts, and their knowledge — with a view to understanding how structural disparities affect personal and societal behaviour, health and political power.</p>
<p>In interdisciplinary fields such as One Health, this understanding is paramount. One Health interventions include measures such as the vaccination of livestock to prevent spillover events to people, such as <a href="https://doi.org/10.1038/s41541-023-00769-w">Rift Valley fever</a>, which can affect both animals and humans. </p>
<p>The success of these interventions hinges not only on vaccine efficacy, but also on societal factors. For example, social scientists uncover <a href="https://doi.org/10.1371%2Fjournal.pone.0256684">barriers faced by farmers in accessing livestock vaccination services</a>. This ultimately improves access and ensures widespread livestock immunization, and therefore contributes to the primary prevention of future pandemics.</p>
<h2>Recognizing intersections</h2>
<p>Another key factor contributing to the successful implementation of One Health interventions is understanding gender dynamics in society. Often women bear the disproportionate caregiving burden, which impacts their access to health care for themselves and their livestock. Gender roles and responsibilities may also decide who interacts closely with animals, affecting possible disease exposure risks as well as <a href="https://doi.org/10.1080/13552074.2015.1096041">narrowing down the target group for educational efforts</a>. </p>
<p>Recognizing these intersections is crucial for developing inclusive and effective interventions.</p>
<p>And while animals may be the potential source of a future pandemic, it is also important to recognize the important positive contributions wildlife have made to our health and well-being, including their roles in the economy and <a href="https://www.indigenousfoodsystems.org/food-sovereignty">food security</a>, as well as their cultural significance. </p>
<p>The perception that animals are a threat to humans can lead to heightened public fears and apprehensions about wildlife, potentially reducing <a href="https://doi.org/10.1093/ilar.51.3.255">support for wildlife conservation</a>. </p>
<p>Addressing this issue requires a deeper understanding of public perceptions, values, priorities and behaviours — emphasizing the <a href="https://doi.org/10.7589/2014-01-004">necessity of integrating social science</a> in the development of informed, relevant and sustainable surveillance of potential infectious disease in wildlife and conservation programs. </p>
<h2>An interdisciplinary approach to pandemic prevention</h2>
<p>Even beyond the role of social science in understanding the complex systems in which health risks occur, social science can also bridge communication gaps between researchers, policymakers and communities. By integrating social science into One Health approaches, we ensure that initiatives are not only scientifically sound, but also socially and culturally acceptable, appropriate and equitable for all rights holders involved.</p>
<p>A movement towards a true, interdisciplinary and holistic approach to primary pandemic prevention will need a proactive approach to health and well-being instead of a reactive one. It will also require us to critically examine our current health systems to identify innovative solutions to ensure its resilience. </p>
<p>We need to mobilize information and understanding across knowledge systems and elevate the critical role of social sciences to meaningfully integrate One Health into primary pandemic prevention in Canada.</p><img src="https://counter.theconversation.com/content/221826/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kaylee Byers receives funding from the Public Health Agency of Canada to strengthen communications and knowledge mobilization of One Health issues. </span></em></p><p class="fine-print"><em><span>Sarah Robinson receives funding from the Public Health Agency of Canada to strengthen communications and knowledge mobilization of One Health issues.</span></em></p><p class="fine-print"><em><span>Lara Hollmann and Salome A. Bukachi do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Pandemics often have animal origins, so prevention is often dominated by health and veterinary sciences. However, social sciences’ role in understanding human behaviour is also crucial to prevention.Kaylee Byers, Assistant Professor, Faculty of Health Sciences; Senior Scientist, Pacific Institute on Pathogens, Pandemics and Society, Simon Fraser UniversityLara Hollmann, Research Fellow, Pacific Institute on Pathogens, Pandemics and Society, Simon Fraser UniversitySalome A. Bukachi, Associate professor, Institute of Anthropology, Gender and African Studies, University of NairobiSarah Robinson, Postdoctoral Fellow, Pacific Institute on Pathogens, Pandemics and Society, Simon Fraser UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2240472024-02-26T19:30:04Z2024-02-26T19:30:04ZA pandemic that won’t go away – as COVID enters its 5th year, NZ needs a realistic strategy<p>February 28 marks four years since COVID-19 was <a href="https://www.linkedin.com/posts/michael-baker-73b18710_rampant-covid-poses-new-challenges-in-the-activity-7166926211187765248-pt32?utm_source=share&utm_medium=member_desktop">first reported</a> in Aotearoa New Zealand. Many of us are probably surprised this virus is still causing a pandemic. </p>
<p>The World Health Organization refers to COVID-19 as a <a href="https://www.scientificamerican.com/article/rampant-covid-poses-new-challenges-in-the-fifth-year-of-the-pandemic/">continuing pandemic</a>. As Scientific American put it recently, it “has been the elephant in every room — sometimes confronted and sometimes ignored but always present”. </p>
<p>It wasn’t meant to be like this. The main wave of the 1918 influenza pandemic <a href="https://wwwnc.cdc.gov/eid/article/29/9/22-1265_article">swept through New Zealand</a> in eight weeks, killing 9,000 people – almost 1% of the population. Then it was largely gone, returning as a new seasonal flu virus. </p>
<p>In doing so, it defined how pandemics were expected to behave. This model was written into pandemic plans and collective thinking across the globe.</p>
<p>But COVID is <a href="https://tewhatuora.shinyapps.io/covid19/">still circulating</a> four years after New Zealand reported its first case, and more than two years after the Omicron variant arrived and infection became widespread. </p>
<p>Constantly present, it is also occurring in waves. Unexpectedly, the current <a href="https://www.phcc.org.nz/briefing/covid-19-finishing-year-high-we-need-vigorous-coordinated-response">fifth wave</a> was larger than the <a href="https://www.phcc.org.nz/briefing/aotearoa-new-zealands-fourth-wave-covid-19-and-why-we-should-care">fourth</a>, suggesting we can’t rely on the comforting assumption that COVID will get less severe over time. </p>
<h2>Unpredictable evolutionary shifts</h2>
<p>These waves are driven by the interaction of the organism (SARS CoV-2 virus), the host (human characteristics such as immunity and behaviour), and environmental factors (such as indoor ventilation). </p>
<p>Continuing viral evolution is a major contributor to the changing dynamic. The virus has demonstrated an ability for large, unpredictable evolutionary shifts that dramatically alter its genome and spike protein. </p>
<p>The result is an enhanced ability to evade prior immunity and infect more people. This jump was seen with the highly mutated <a href="https://www.nature.com/articles/s41467-023-43703-3">BA.2.86 subvariant</a> in mid-2023. </p>
<p>Its offspring, JN.1, has acquired additional changes and is causing such a wave of new infections it could potentially be the <a href="https://theconversation.com/the-emergence-of-jn-1-is-an-evolutionary-step-change-in-the-covid-pandemic-why-is-this-significant-220285">next variant of concern</a>, with its own Greek letter. It is now driving epidemic increases across the globe, <a href="https://esr-cri.shinyapps.io/wastewater/#region=Wellington&log_or_linear=linear&period=twelveMonthsButton">including in New Zealand</a>. This dominance by a single subvariant takes us back to the first year of Omicron in 2022.</p>
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Read more:
<a href="https://theconversation.com/i-have-covid-how-likely-am-i-to-get-long-covid-218808">I have COVID. How likely am I to get long COVID?</a>
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<h2>Under-counting the pandemic impact</h2>
<p>The pandemic continues to have a large, visible health impact. It is a leading cause of serious illness and death, mainly in older populations and those with existing long-term health conditions. </p>
<p>In 2023, it caused more than <a href="https://www.phcc.org.nz/briefing/covid-19-finishing-year-high-we-need-vigorous-coordinated-response">12,000 hospitalisations and 1,000 deaths</a> in New Zealand.</p>
<p>But COVID-19 also has an important and largely unmeasured <a href="https://www.science.org/doi/10.1126/science.adl0867">burden of disease</a> as the cause of long COVID, which may become its biggest health impact. A growing number of studies are describing an estimated incidence of long COVID of 5% to 15% of all infections.</p>
<p>For example, a recent <a href="https://www.nature.com/articles/s41467-023-43661-w">large study</a> of almost 200,000 Scottish adults reported that, after adjustment for factors that might confuse the results, long COVID prevalence following an infection was 6.6% at six months, 6.5% at 12 months, and 10.4% at 18 months. </p>
<p>These findings illustrate an important feature of long COVID: recovery can take <a href="https://theconversation.com/long-covid-symptoms-can-improve-but-their-resolution-is-slow-and-imperfect-212015">two years or more</a>, with <a href="https://gh.bmj.com/content/6/9/e007004">symptoms that fluctuate</a> over time.</p>
<h2>An integrated respiratory disease strategy</h2>
<p>New Zealand now needs a strong, integrated response to COVID-19 and other respiratory infections.</p>
<p>The major pandemic interventions have not changed: vaccination, public health and social measures to prevent infection, and antivirals for more vulnerable groups. The evidence has firmed up that long COVID risk is <a href="https://www.cambridge.org/core/journals/antimicrobial-stewardship-and-healthcare-epidemiology/article/effectiveness-of-covid19-vaccine-in-the-prevention-of-postcovid-conditions-a-systematic-literature-review-and-metaanalysis-of-the-latest-research/A0B115B5D3AA60846799857B801D116E">reduced by vaccination</a>, but research is less certain for antivirals.</p>
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<strong>
Read more:
<a href="https://theconversation.com/vaccination-testing-clean-air-covid-hasnt-gone-away-heres-where-australia-needs-to-do-better-222889">Vaccination, testing, clean air: COVID hasn't gone away – here's where Australia needs to do better</a>
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<p>But growing pandemic complacency from political leaders and the public has changed things. Some of this apparent indifference can be put down to understandable fatigue with response measures. But it remains dangerous in the face of a continuing pandemic.</p>
<p>One way to keep a focus on prevention and control would be to include these measures in an <a href="https://nzmj.org.nz/journal/vol-136-no-1583/continued-mitigation-needed-to-minimise-the-high-health-burden-from-covid-19-in-aotearoa-new-zealand">integrated respiratory infectious disease strategy</a>. This would combine COVID-19 control measures with those used to protect against influenza, respiratory syncytial virus (RSV), and other respiratory infections. </p>
<p>Measles could be added to the list, given the rising <a href="https://www.phcc.org.nz/briefing/urgent-action-needed-prevent-measles-epidemic-aotearoa-new-zealand">threat to New Zealand</a> from a global resurgence of the disease. </p>
<p>This <a href="https://ojs.victoria.ac.nz/pq/article/view/7500">integrated strategy</a> would include vaccination, promoting testing and self-isolation when sick, and measures to reduce transmission in critical indoor environments such as healthcare, public transport and education settings. </p>
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Read more:
<a href="https://theconversation.com/long-covid-stemmed-from-mild-cases-of-covid-19-in-most-people-according-to-a-new-multicountry-study-195707">Long COVID stemmed from mild cases of COVID-19 in most people, according to a new multicountry study</a>
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<p>Such a programme would need to be supported with community engagement, education, surveillance and research.</p>
<p>Structural inequalities mean Māori, Pacific peoples, and those living in relative deprivation, are less vaccinated, less protected from infection, less tested and less likely to have antivirals. </p>
<p>Consequently, they are more likely to be hospitalised and <a href="https://www.health.govt.nz/publication/covid-19-mortality-aotearoa-new-zealand-inequities-risk#:%7E:text=Ethnicity%20and%20age,with%20European%20and%20Other%20groups.">die from COVID-19</a>. These inequities are currently not being systematically tracked and acted on.</p>
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Read more:
<a href="https://theconversation.com/covid-theres-a-strong-current-of-pandemic-revisionism-in-the-mainstream-media-and-its-dangerous-222934">COVID: there's a strong current of pandemic revisionism in the mainstream media, and it's dangerous</a>
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<h2>Ignoring it won’t make it go away</h2>
<p>As we enter the fifth pandemic year, we need a change in thinking about COVID-19. This infection has <a href="https://doi.org/10.3390/ijms242317039">pathological features</a> in common with the other severe coronaviruses (SARS and MERS). </p>
<p>It is wishful thinking to imagine it will suddenly transform into a common cold coronavirus. As a recent <a href="https://www.nature.com/articles/s41579-023-00878-2#Abs1">review article</a> concluded: </p>
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<p>Transition from a pandemic to future endemic existence of SARS-CoV-2 is likely to be long and erratic […] endemic SARS-CoV-2 is by far not a synonym for safe infections, mild COVID-19 or a low population mortality and morbidity burden. </p>
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<p>In the face of this continuing pandemic threat, we need a response that is evidence-informed rather than evidence-ignored.</p><img src="https://counter.theconversation.com/content/224047/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michael Baker is a member of the Ministry of Health's COVID-19 Technical Advisory Group (TAG). The University of Otago receives funding from the Health Research Council of New Zealand and the New Zealand Ministry of Health for his research on COVID-19 and other infectious diseases.</span></em></p><p class="fine-print"><em><span>The University of Otago receives funding from the Health Research Council of New Zealand and the New Zealand Ministry of Health for research on COVID-19 and other infectious diseases.</span></em></p><p class="fine-print"><em><span>Matire Harwood was a member of the Ministry of Health COVID-19 TAG. She receives research funding from Health Research Council, National Heart Foundation and National Science Challenge-Healthier Lives. She also works at Papakura Marae which received funding for COVID-19 testing, vaccination and management.</span></em></p>On the fourth anniversary of New Zealand’s first COVID case it’s clear this is not a normal pandemic. Despite fatigue and indifference, New Zealand must heed the evidence and improve its response.Michael Baker, Professor of Public Health, University of OtagoAmanda Kvalsvig, Associate Professor, Department of Public Health, University of OtagoMatire Harwood, Associate Professor, Department of General Practice and Primary Care, University of Auckland, Waipapa Taumata RauLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2237882024-02-20T21:44:04Z2024-02-20T21:44:04ZThe ArriveCan scandal: How can we avoid similar problems in the future?<p>The release of the recent report on the ArriveCan app by Auditor General of Canada Karen Hogan hit Canadians like a bombshell: the app was supposed to cost Canadians $80,000, <a href="https://www.cbc.ca/player/play/2308469827667#:%7E:text=Andrew%20Chang%20breaks%20down%20the,cost%20Canadians%20nearly%20%2460%20million.">but was updated 177 times and racked up a bill of at least $59.5 million, instead</a>. The company behind the scandal, GC Strategies, <a href="https://www.ctvnews.ca/politics/arrivecan-investigation-gc-strategies-had-dozens-of-government-contracts-now-it-s-not-eligible-for-any-1.6771612">received millions of dollars in federal contracts in less than 10 years</a>. </p>
<p>Hogan mentioned that while it was understandable that the government had to relax certain standards to be able to respond quickly to the pandemic, waiving the requirement to provide documentation for the awarding of contracts related to the creation of the app raises questions. ArriveCan collected health and contact information for people travelling outside the country during the COVID-19 pandemic. </p>
<p>Hogan’s report reveals shameless mismanagement of public funds by the Canada Border Services Agency.</p>
<p>How could this happen? As a specialist in public sector audit, I took a close look at how different factors combined to create this extreme situation. Here is what I found. </p>
<h2>Exceptional measures for an unprecedented situation</h2>
<p>The pandemic, which was exceptional and unprecedented, profoundly disrupted our daily lives and redefined our perception of what is normal on a global scale. </p>
<p>It led governments to take equally exceptional and often unprecedented measures.</p>
<p>For example, between 2020 and 2023, <a href="https://www.canada.ca/en/public-health/corporate/mandate/about-agency/acts-regulations/list-acts-regulations.html">Emergency Orders in Council were issued under the Quarantine Act</a> to protect public health in Canada. </p>
<p>Among other things, Orders in Council issued as part of Canada’s response to the pandemic <a href="https://www.canada.ca/en/health-canada/services/drugs-health-products/compliance-enforcement/covid19-interim-order-drugs-medical-devices-special-foods/note.html">facilitated the rapid acquisition of personal protective equipment</a>, making this an appropriate government response to the health emergency. However, these measures also led to abuses, particularly concerning the creation of the ArriveCan app.</p>
<h2>Conflicts of interest</h2>
<p>In the case of ArriveCan, the Auditor General noted several situations that seemed to show what appears to be a conflict of interest. </p>
<p>In her report, she points to shortcomings in the contract award process. She points out that Public Health Agency employees attended dinners and other events organized by suppliers. However, there is no documentation proving that these employees informed their supervisor of these interactions, as required by the Agency’s code of conduct.</p>
<p>It is important to underline that government entities must adhere to high standards of integrity and fairness in their procurement processes. As a result, even if the legislation does not explicitly state that a government entity which establishes criteria for a call for tenders is prohibited from bidding, it is likely that such actions would be considered a conflict of interest and contrary to the principles of fairness and transparency. </p>
<p>In fact, any supplier wishing to do business with an entity linked to the government, and in particular to the Government of Canada, must comply with the <a href="https://www.tbs-sct.canada.ca/pol/doc-eng.aspx?id=32627">Directive on Conflict of Interest</a> at all times and adhere to <a href="https://www.tbs-sct.canada.ca/pol/doc-eng.aspx?id=25049">the Values and Ethics Code for the Public Sector</a>.</p>
<h2>Preparation of the call for tenders and submission of bids</h2>
<p>The Auditor General found that the company that received the contract, GC Strategies, was also involved in defining the criteria used to evaluate and select the supplier. This represents a violation of the principles of fairness and transparency put forward by Public Services and Procurement Canada, while placing the company in a position of conflict of interest.</p>
<p>Calls for tenders related to government bodies must comply with certain rules and laws <a href="https://www.mccarthy.ca/en/insights/articles/deep-dive-canadas-public-procurement-law-2-part-series">requiring transparency and non-discrimination</a>. The fundamental principles of the legal framework for calls for tenders in Canada emphasize openness, fairness and transparency in the procurement processes. This means that <a href="https://buyandsell.gc.ca/for-government/buying-for-the-government-of-canada/the-procurement-rules-and-process">any tendering process must be open</a> (anyone can bid), fair (bidders and potential bidders are treated equally) and transparent (the rules are known to everyone).</p>
<p>This was clearly not the case for ArriveCan.</p>
<h2>Lack of accountability</h2>
<p>Another key issue was project management, where everyone’s responsibilities must be clearly established. The Auditor General noted major shortcomings in this area, noting that no formal agreement had been established to specify the roles and responsibilities of each party in the creation and management of the ArriveCan project. </p>
<p>Yet the <a href="https://www.tbs-sct.canada.ca/pol/doc-eng.aspx?id=32594&section=html">Government of Canada Directive on the Management of Projects and Programmes</a> clearly stipulates the need to assign the various responsibilities of a project in order to ensure accountability. This notion is also part of the <a href="https://www.pmi.org/-/media/pmi/documents/public/pdf/ethics/pmi-code-of-ethics.pdf">Code of Ethics and Professional Conduct of the Project Management Institute</a>, the body that governs project managers. </p>
<p>These shortcomings in terms of accountability and responsibility led to ineffective reporting, as the Auditor General points out in her report.</p>
<h2>An exceptional incident, but not an isolated one</h2>
<p>Although the case of the ArriveCan app is surprising for Canadian taxpayers, with costs skyrocketing from $80,000 to nearly $59.5 million, it is not an isolated incident in the history of Canadian government projects. </p>
<p>The <a href="https://www.thecanadianencyclopedia.ca/en/article/sponsorship-scandal-adscam">Sponsorship scandal</a> is a good example. Between 1997 and 2003, public funds were used to finance public relations campaigns aimed at countering the pro-sovereignty efforts of a provincial political party (the Parti Québécois), without adequate oversight of the spending or effectiveness of these campaigns.</p>
<p>There is also the example of Montréal’s Formula E pilot project in July 2017, which involved electric vehicle races held on its streets. <a href="https://toronto.citynews.ca/2018/05/28/montreals-inspector-general-blasts-ex-mayor-denis-coderre-over-formula-e-race/">In her report on the event</a>, the Auditor General of the City of Montréal claimed that the project suffered from ineffective management, unclear allocation of roles and responsibilities, and lack of accountability. At the time, many commentators felt that the affair was partly responsible for then Mayor Denis Coderre losing his re-election. </p>
<h2>Solutions to avoid such scandals</h2>
<p>The ArriveCan affair is just the most recent example of scandals involving an outrageous use of public funds. This underlines the crucial importance of transparent governance and rigorous management of public funds in maintaining the trust of citizens and preserving the integrity of institutions. </p>
<p>As a result, governmental and paragovernmental entities should implement controls to ensure compliance with the various government policies and directives to which they are subject. </p>
<p>In addition, committees made up of members from outside the organization should be set up to evaluate different projects while ensuring proper management and effective and timely reporting on them. This would ensure that the organization’s decisions and actions are subject to impartial and thorough scrutiny, thereby promoting greater transparency and accountability among the players involved. </p>
<p>Although basic, these measures would nevertheless help reinforce accountability among various stakeholders.</p><img src="https://counter.theconversation.com/content/223788/count.gif" alt="La Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Annie Lecompte ne travaille pas, ne conseille pas, ne possède pas de parts, ne reçoit pas de fonds d'une organisation qui pourrait tirer profit de cet article, et n'a déclaré aucune autre affiliation que son organisme de recherche.</span></em></p>The cost overruns of the ArriveCan app are exceptional, but the scandal is not unique in history. There are solutions available to prevent the excessive use of public funds.Annie Lecompte, Associate professor, Université du Québec à Montréal (UQAM)Licensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2229342024-02-16T16:17:36Z2024-02-16T16:17:36ZCOVID: there’s a strong current of pandemic revisionism in the mainstream media, and it’s dangerous<p>There is no clearer marker that we are now in the “after” phase of the pandemic, than the proliferation of <a href="https://covid19.public-inquiry.uk/#:%7E:text=What%20is%20the%20UK%20Covid,by%20its%20Terms%20of%20Reference.">public inquiries</a>, reports on <a href="https://osr.statisticsauthority.gov.uk/publication/improving-health-and-social-care-statistics-lessons-learned-from-the-covid-19-pandemic/">lessons learned</a> and post hoc analyses. To reassess and agonise over how reasonable lockdown was is now a near-constant in the media, <a href="https://www.theguardian.com/commentisfree/2023/mar/23/lockdown-sceptics-history-academics-left-covid">particularly</a> in the UK. </p>
<p>However, against the backdrop of the continuing COVID inquiry, fringe views are making their way into the mainstream. And online debates have abandoned much of the ethical and political nuance they deserve.</p>
<p>Containing COVID was an imperfect and difficult task that required weighing health, social, ethical, psychological, economic and political interests in the face of a rapidly spreading novel virus in 2020. Yet, with increasing distance, the thorny, difficult issues tend to be flattened to false narratives and a history of simple choices. In other words, <a href="https://www.nytimes.com/2023/08/29/opinion/ezra-klein-podcast-katelyn-jetelina.html">“pandemic revisionism”</a>. </p>
<p>To learn from how communities and governments responded to this pandemic crisis is important. With the benefit of hindsight, established accounts of successful interventions and stories of failure often take on new shades. Investing in a ramp-up of antigen testing probably was <a href="https://digital.nhs.uk/blog/tech-talk/2022/6-things-we-learned-from-the-covid-19-home-testing-rollout">worthwhile</a>. Trusting <a href="https://www.bbc.co.uk/news/uk-politics-64029040">Tory peers</a> with the production of hospital gowns was not.</p>
<p>In a global health culture <a href="https://www.ucpress.edu/book/9780520284098/the-pandemic-perhaps">focused on preparedness</a>, only a solid record of well-evidenced facts, reports and witness statements can clear the pandemic fog to reveal lessons. But post hoc inquiries have also been a political tool to <a href="https://somatosphere.com/2016/diagnosing-failure-the-post-hoc-report-as-an-administrative-epilogue.html/">establish official blame</a> since the 19th century. </p>
<p>The act of looking back is not only a moment of reckoning, but an opportunity of revision. As a result, even detailed analyses cannot prevent simplistic stories about “lockdown-scarred children” from <a href="https://www.thetimes.co.uk/article/our-lockdown-scarred-children-must-relearn-the-school-habit-x6gpdcgn6">taking hold</a>. Most of the time, they become stand-ins for structural social and political problems, inequality, under-funding, and uneasy moral and ethical debates of who gets to be protected or deemed vulnerable. </p>
<p>The response to COVID showed that lessons from <a href="https://www.theguardian.com/politics/2023/jun/19/david-cameron-admits-failures-pandemic-preparations-austerity-covid-inquiry">previous pandemics</a> had limited use and could be harmful when taken out of context. Research has established that such diagnoses of success and failure can shift over time. Long-established accounts of what has been learned from the 1918 flu pandemic, or from polio and HIV/Aids, cannot escape the fact that <a href="https://theconversation.com/why-are-those-lost-to-covid-not-formally-memorialised-how-politics-shapes-what-we-remember-213170">“politics shapes what we remember”</a>. </p>
<p>Polio outbreaks that caused global disruption in the 1940s and 50s have been viewed <a href="https://www.hup.harvard.edu/books/9780674013155">significantly differently</a> over time. The success of vaccination could be publicly celebrated one year, as in Hungary in 1958, only to be dismissed as a spectacular failure the following year when the epidemic came back <a href="https://www.bmj.com/content/340/bmj.b5297">with full force</a>. Lessons learned were highly contingent. </p>
<p>The <a href="https://www.cambridge.org/core/books/polio-across-the-iron-curtain/local-failure-in-a-global-success/BC112B8659C94A77F2878220E711C52A">finger pointing that ensued</a> is all too familiar today: government blaming the public for not taking up the vaccine, people blaming the state for lacking sufficient provisions, debates about travel restrictions and faulty vaccination equipment. </p>
<h2>Streamlined narratives</h2>
<p>The nuances that highlighted the complexities of epidemic management in polio soon gave way to a streamlined narrative: the Salk vaccine, the first vaccine to treat polio, was pinpointed as the cause of all troubles, when <a href="https://www.jstor.org/stable/j.ctt1wn0s1m.9?seq=1">the new Sabin vaccine took its place</a>. After the end of the epidemic in the late 1960s, gone were conversations on the responsibility for health, while children and adults still struggling with the disease were rendered invisible. </p>
<p>More recently, the history of Aids is too often told as the victory of “technoscience” that brought a raging pandemic under control through effective, sophisticated pharmaceutical <a href="https://booksandideas.net/AIDS-Biocapitalisation.html">innovation</a>. In the fear and anger of the 1980s, however, it was a complex story built on years of prejudiced political neglect of the virus’s spread. </p>
<p>It led to activists calling for a shift in drug regulation, to regulators slowly accepting new frameworks for the rapid release of experimental drugs, and of companies such as Burroughs Wellcome seizing the opportunity to make astonishing <a href="https://www.newyorker.com/magazine/2021/06/14/how-act-up-changed-america">profits with AZT</a> – the first effective HIV/Aids antiretroviral medication.</p>
<p>In the flattened narratives of successful pharmaceutical innovation, the politics of activist groups and the pandemic’s implication for sexual politics are too often lost. </p>
<p>In the UK, this embellishment of the historical record is currently under way. Commentators <a href="https://www.telegraph.co.uk/news/2024/01/31/one-by-one-the-lockdown-myths-are-crumbling/">write with glee</a> against proponents of the now-infamous zero COVID strategy, turning the <a href="https://www.thenational.scot/news/24069997.devi-sridhar-englands-covid-strategy-really-frustrated/">retrospective humility</a> of public health advocates into misdirected stories of <a href="https://twitter.com/KevinBardosh/status/1754849904478814244">moral and political culpability</a>. </p>
<p>Scanning the unsparing tone of such opinion pieces and the scathing judgment of prominent social media <a href="https://twitter.com/JuliaHB1/status/1752770854583214133">posts</a>, it is as if they are asking for a few public health scholars, rather than government mismanagement, to shoulder the moral, economic and human toll of the missteps since February 2020.</p>
<p>As the rights and wrongs of shielding and segregation are <a href="https://twitter.com/mendel_random/status/1752252351841267876">raked over</a>, and as the lockdown sceptics believe their long-held concerns were justified given the rising mental health concerns, the risk is not for an extreme public health intervention to lose popular support – lockdown was at best the least worst option. </p>
<p>The real risk is that this false allocation of culpability, in hand with misremembering of the past, continues to erode a principle of solidarity at the heart of public health.</p>
<p>It is the voices of those lost to the pandemic, of those most vulnerable to the virus, past and present, of those most affected by the debilitating effects of long COVID and of those advocating for a pandemic response based on principles of equity, that are written out of this increasingly popular, populist and revisionist picture.</p><img src="https://counter.theconversation.com/content/222934/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lukas Engelmann receives funding from European Research Council (ERC) and British Academy</span></em></p><p class="fine-print"><em><span>Dora Vargha receives funding from the European Research Council (ERC) and The Wellcome Trust. </span></em></p>Simplistic stories often become the popular ones.Lukas Engelmann, Chancellor's Fellow Sociology and History of Biomedicine, The University of EdinburghDora Vargha, Professor of History and Medical Humanities, Humboldt University of BerlinLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2190872024-02-16T13:18:51Z2024-02-16T13:18:51ZA Bronx school district offers lessons in boosting student mental health<figure><img src="https://images.theconversation.com/files/575680/original/file-20240214-30-zch8fe.jpg?ixlib=rb-1.1.0&rect=25%2C42%2C5640%2C3745&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Building a sense of community is critical for students to thrive.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/happy-female-teacher-talking-with-junior-high-royalty-free-image/1439953744?phrase=students+speaking&adppopup=true">Maskot / Getty Images</a></span></figcaption></figure><p>If you are an educator or a parent, you have likely already seen many ways in which “<a href="https://www.psychologytoday.com/us/blog/stressful-lives/202302/the-kids-are-not-alright">the kids are not alright</a>.” </p>
<p><a href="https://doi.org/10.1177/23328584221084722">Mounting evidence</a> shows that the mental health of American youth has been declining for at least a decade. During the pandemic, it took an even sharper downturn. The Centers for Disease Control and Prevention reports that in 2021 – the most recent data available – 42% of high school students experienced persistent feelings of sadness or hopelessness and <a href="https://www.cdc.gov/healthyyouth/data/yrbs/yrbs_data_summary_and_trends.htm">22% seriously considered suicide</a>. This is a significant increase from 10 years earlier, when 28% of students reported persistent feelings of sadness or loneliness and 16% considered attempting suicide.</p>
<p>The isolation of pandemic stay-at-home orders and the trauma of losing loved ones <a href="https://www.aft.org/press-release/educators-say-covid-19-has-greatly-exacerbated-grief-support-crisis-schools">contributed to declines in well-being</a>. Schools have an important role to play in addressing this crisis.</p>
<p>As <a href="https://scholar.google.com/citations?user=gUZyPcUAAAAJ&hl=en">researchers in education</a>, my co-author, <a href="https://scholar.google.co.uk/scholar?as_q=&num=10&btnG=Search+Scholar&as_epq=&as_oq=&as_eq=&as_occt=any&as_sauthors=%22Javaid+E.+Siddiqi%22&as_publication=&as_ylo=&as_yhi=&as_allsubj=all&hl=en">Javaid Siddiqi</a> and I interviewed educators working in <a href="https://link.springer.com/book/10.1007/978-3-031-43237-8#toc">school districts that faced extreme adversity</a> during the pandemic but <a href="https://doi.org/10.1007/978-3-031-43237-8">still found success in supporting their students</a>.</p>
<p>One district in particular stood out for the challenges it faced. At the time of our study in 2020, Bronx Community School District 7 in New York City was not just in the <a href="https://www.cityandstateny.com/politics/2019/12/ny-has-the-richest-poorest-smallest-most-unequal-congressional-districts/176658/">poorest congressional district in the nation</a>, but it also experienced one of the <a href="https://covid.cdc.gov/covid-data-tracker/#deaths-landing_">highest death rates per capita from COVID-19</a>. </p>
<p>Despite these obstacles – all of which were outside of their control – educators told us they found ways to be there for their students and support their mental health.</p>
<p>In the course of our research, three strategies became apparent. The lessons show promise not just in this section of New York City, but for the rest of the country as well.</p>
<h2>1. Connect to community</h2>
<p>In 2023, U.S. Surgeon General Vivek Murthy raised alarm about the essential need for social connection within communities to heal America’s “<a href="https://www.hhs.gov/about/news/2023/05/03/new-surgeon-general-advisory-raises-alarm-about-devastating-impact-epidemic-loneliness-isolation-united-states.html">epidemic of loneliness</a>.” Schools, in particular, have a history of being hubs for connection. In the pandemic, that was especially apparent when they became <a href="https://ethics.harvard.edu/schools-during-covid-19">centers of information</a>, offering academic support and internet access as well as food and nutrition, even when classes were remote.</p>
<p>Across the country, educators quickly realized that psychologically isolated students also needed social connection, and they responded with innovation. They developed <a href="https://www.youtube.com/watch?v=pK5hMspzTaM&ab_channel=AlexaSorden">bedtime story videos</a> for families, online cooking lessons that invited community members into their homes, and socially distanced dance classes on school athletic fields.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/pK5hMspzTaM?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Bedtime videos can be beneficial during difficult times.</span></figcaption>
</figure>
<p>In Bronx CSD 7, a <a href="https://www.nychealthandhospitals.org/pressrelease/mental-health-services-expanded-for-students-in-areas-hardest-hit-by-covid-19/">partnership with a nearby hospital</a> increased access to much-needed mental health services for students and educators.</p>
<p>Community connections help educators understand child and family needs and allow community members to trust schools as a <a href="https://www.wsj.com/articles/a-bronx-school-works-to-help-students-thrive-during-the-coronavirus-pandemic-11590249600">source of support</a>. They also bring community assets, such as free clinics, food pantries, housing programs and mental health resources, into schools where families can more easily access them.</p>
<p>With emergency educational funding from the pandemic <a href="https://www.axios.com/2023/02/02/funding-cliff-student-mental-health">expiring on Sept. 30, 2024</a>, <a href="https://www.ascd.org/books/the-six-priorities?variant=122022">school-community partnerships</a> will be essential for continuing mental health services in schools to support psychological recovery.</p>
<h2>2. Give students a seat at the table</h2>
<p>Relationships within schools are also important for improving and maintaining mental health. Research shows that when school leaders involve students in decision-making, it encourages them to develop leadership skills and <a href="https://doi.org/10.1111/josh.12960">increases the overall well-being of the community</a>, as indicated by civic engagement and health outcomes.</p>
<p>In Bronx CSD 7, students are part of the Superintendent’s Advisory Council. This meant that during the pandemic they were able to bring to light the challenges of engaging in online learning all day without a break. Unlike a regular school day, where students would move between classes and chat with teachers and friends in the hallways, the online school day went from one class period to another with no built-in opportunities to take breaks, socialize and refocus. Experts were quickly recommending that online school days be <a href="https://transcendeducation.org/why-distance-learning-should-not-replicate-school/">restructured to meet student needs</a>. But students knew this first.</p>
<p>When youth are empowered to share their stories, they not only strengthen their school community, but they also serve as trusted messengers for their peers. During the pandemic, students around the country created <a href="https://www.npr.org/2020/06/17/877498373/coronavirus-racism-and-kindness-how-nyc-middle-schoolers-built-a-winning-podcast">youth-led podcasts</a> to learn from each other. They also <a href="https://time.com/6071300/kids-pandemic/">documented their experiences</a>, processing psychological upheaval, communicating their needs and supporting each other. Education researchers have referred to these empowering connection activities as “<a href="https://doi.org/10.1080/10665684.2021.1992603">cultural assets</a>” because they not only support young people, but they also help teachers approach students in more culturally sensitive ways.</p>
<h2>3.Think developmentally</h2>
<p>Since the end of the pandemic, school districts across the country have been dedicating resources and time to recovering “<a href="https://www.nber.org/papers/w29497">lost learning</a>,” the phrase used to describe the test score declines attributed to school closures and emergency online learning. But some students experienced another equally devastating decline that’s gotten less attention – their social and emotional development. </p>
<p>To soften the impact of social isolation, educators in Bronx CSD 7 intentionally dedicated time during remote learning to social interactions. They provided informal connection spaces during the school day, played video games with their students and encouraged them to eat lunch together online. Research shows that young people who communicated more often with friends were <a href="https://doi.org/10.1002/icd.2305">less impacted by the social isolation of the pandemic</a>. The experience of Bronx CSD 7 shows that schools could play an instrumental role in nurturing this force for mental well-being. </p>
<p>Every district faced its own complex challenges during the pandemic, and educators across the country have supported their students, communities and each other in the recovery process. As school leaders consider ways to recover lost academic opportunities and learning, it is equally important to help students stabilize their mental health and boost their overall well-being.</p><img src="https://counter.theconversation.com/content/219087/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Faiza Jamil does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Giving students a voice in decision-making helps foster well-being, research has found.Faiza Jamil, Associate Professor of Education, Clemson UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2216802024-02-12T13:58:36Z2024-02-12T13:58:36ZHow memes transformed from pics of cute cats to health disinformation super-spreaders<figure><img src="https://images.theconversation.com/files/574520/original/file-20240208-20-bdfm5s.jpg?ixlib=rb-1.1.0&rect=53%2C17%2C5908%2C3909&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.gettyimages.co.uk/detail/news-photo/this-photo-illustration-created-in-washington-dc-on-july-26-news-photo/1558455551?adppopup=true">Stefani Reynolds / AFP</a></span></figcaption></figure><p>If you think memes are simply online images of <a href="https://www.msn.com/en-us/lifestyle/lifestyle-buzz/hysterical-cat-memes-that-remind-us-why-cats-rule/ar-AA1mwoLb">cute cats</a> and <a href="https://www.boredpanda.com/funny-celebrity-memes-peter-parkers-glasses-format-suckertom/">celebrities</a> with funny captions, then you might be surprised to learn that they can have a more sinister function.</p>
<p><a href="https://journals.sagepub.com/doi/full/10.1177/20563051231224729">Our research</a> shows that memes form part of a highly sophisticated strategy to spread and monetise health disinformation. </p>
<p>Memes may appear trivial, but they should be taken seriously. Dismissing them as harmless jokes is to grossly underestimate their influence – and bolsters their power to spread potentially harmful health messages.</p>
<h2>Anti-vaccine memes have a long history</h2>
<p>Memes aren’t a recent invention. They have featured prominently in anti-vaccination messaging for centuries. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/574052/original/file-20240207-30-hbm40.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/574052/original/file-20240207-30-hbm40.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/574052/original/file-20240207-30-hbm40.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=483&fit=crop&dpr=1 600w, https://images.theconversation.com/files/574052/original/file-20240207-30-hbm40.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=483&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/574052/original/file-20240207-30-hbm40.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=483&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/574052/original/file-20240207-30-hbm40.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=607&fit=crop&dpr=1 754w, https://images.theconversation.com/files/574052/original/file-20240207-30-hbm40.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=607&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/574052/original/file-20240207-30-hbm40.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=607&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A monster being fed baskets of infants and excreting them with horns; symbolising vaccination and its effects. Etching by C. Williams, 1802.</span>
<span class="attribution"><a class="source" href="https://wellcomecollection.org/works/vbux8st5">Wellcome Collection</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span>
</figcaption>
</figure>
<p>When widespread smallpox immunisation began in the early 19th century, political cartoons published in print media used memes (see image below) to evoke fear about the safety of the vaccine.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/574617/original/file-20240209-26-2yorsd.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/574617/original/file-20240209-26-2yorsd.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=421&fit=crop&dpr=1 600w, https://images.theconversation.com/files/574617/original/file-20240209-26-2yorsd.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=421&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/574617/original/file-20240209-26-2yorsd.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=421&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/574617/original/file-20240209-26-2yorsd.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=529&fit=crop&dpr=1 754w, https://images.theconversation.com/files/574617/original/file-20240209-26-2yorsd.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=529&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/574617/original/file-20240209-26-2yorsd.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=529&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Cartoon from an anti-vaccination publication, titled ‘Do not vaccinate!’, 1892.</span>
<span class="attribution"><a class="source" href="https://museumandarchives.redcross.org.uk/objects/46927">The Historical Medical Library of The College of Physicians of Philadelphia</a></span>
</figcaption>
</figure>
<p>The most infamous anti-vaccination meme, however, emerged from a now discredited <a href="https://theconversation.com/the-media-mmr-and-autism-a-cautionary-tale-23321">1998 study</a> that falsely linked the measles, mumps and rubella (MMR) vaccine with autism. </p>
<p>The meme “vaccines cause autism”, which appeared on billboards and was circulated widely in the media, provoked doubts about the safety of the vaccine. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2831678/">The study</a>, since described as an <a href="https://www.bmj.com/content/342/bmj.c7452">“elaborate fraud”</a>, was published the same year as the launch of Google’s search engine allowing “vaccines cause autism” to became a global meme.</p>
<p>Today, memes remain an important part of the anti-vaccine movement. <a href="https://academic.oup.com/mit-press-scholarship-online/book/20281">The internet</a> enables memes to be created anonymously, repurposed and shared at scale – making them a highly effective medium for spreading health disinformation.</p>
<p>They are often used as part of a <a href="https://mediamanipulation.org/definitions/meme-war">meme war</a>, defined as “the intentional propagation of political memes on social media for the purpose of political persuasion or community building, or to strategically spread narratives and other messaging crucial to a media manipulation campaign.” According to disinformation research platform The Media Manipulation Casebook.</p>
<p>Memes play an integral role in disinformation campaigns by facilitating fear, uncertainty and doubt.</p>
<h2>Influencers and money</h2>
<p>Our study analysed how popular anti-vaccine influencers used memes to galvanise the anti-vaccine movement during the COVID pandemic. </p>
<p>We discovered three recurring themes for encouraging vaccine refusal.</p>
<p>First, memes were used to vilify the government and social institutions, portraying them as corrupt and politically compromised. Anti-government sentiments were used to support several claims. These included claims that the government is corrupt and tyrannical; that vaccines are unsafe and ineffective and that the government is using vaccines as a form of state surveillance, for control and profit.</p>
<p>Second, memes depicted unvaccinated people as unfairly <a href="https://www.simonandschuster.com/books/Stigma/Erving-Goffman/9780671622442">stigmatised</a>. Influencers suggested the unvaccinated were being persecuted, using evocative imagery to imply a false equivalence between those who remain unvaccinated by choice and the persecution of Jews during the Holocaust. Such memes portrayed unvaccinated people as victims subject to Nazi-like sanctions and social exclusion.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/574516/original/file-20240208-16-c32rfv.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/574516/original/file-20240208-16-c32rfv.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=506&fit=crop&dpr=1 600w, https://images.theconversation.com/files/574516/original/file-20240208-16-c32rfv.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=506&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/574516/original/file-20240208-16-c32rfv.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=506&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/574516/original/file-20240208-16-c32rfv.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=636&fit=crop&dpr=1 754w, https://images.theconversation.com/files/574516/original/file-20240208-16-c32rfv.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=636&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/574516/original/file-20240208-16-c32rfv.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=636&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A meme representing the Jewish Star to draw parallels between the victimization of the Jews during the Holocaust and the unvaccinated today.</span>
</figcaption>
</figure>
<p>Third, vaccinated people were depicted as morally and physically inferior to the unvaccinated. Vaccination was associated with infertility, low sex drive and a lack of critical thinking. Those opposed to vaccines, however, were portrayed positively as virile, attractive and intellectually superior. </p>
<p>To establish group membership and promote a sense of belonging, influencers referred to those who are anti vaccines as their “soul family”. But our research suggests there may be a more cynical motivation behind this apparently warm sentiment. </p>
<h2>Going viral – and avoiding challenge</h2>
<p>Influencers were strategic in their use of memes for political persuasion and commercial gain. </p>
<p>Several influencers provided their followers with “meme drops”: packages of memes with dissemination instructions. These memes were tested and produced in <a href="https://theconversation.com/pivot-to-coronavirus-how-meme-factories-are-crafting-public-health-messaging-135557">meme factories</a>, then distributed monthly to a mass audience via personal newsletters and websites, encouraging followers to spread anti-vaccination content. By adapting memes to current affairs, influencers increased their relevance and likelihood of going viral.</p>
<p>Memes weren’t just a method of self-promotion for anti-vaccination influencers, however. They were also a way to profit financially from pandemic anxieties.</p>
<p>Anti-vaccine sentiment became a powerful gateway to promote <a href="https://journals.sagepub.com/doi/full/10.1177/13675494211062623">potentially harmful health products</a>.
We found that memes were used to market unauthorised medical products by directing consumers to online stores. For example, we found that clicking on satirical COVID themed memes directed consumers to purchase hydroxychloroquine (a treatment for autoimmune disorders) and veterinary Ivermectin (used to treat parasites in animals). Both medicines are <a href="https://pubmed.ncbi.nlm.nih.gov/35314650/">unapproved for the treatment</a> of COVID. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/574057/original/file-20240207-22-u5cz68.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/574057/original/file-20240207-22-u5cz68.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/574057/original/file-20240207-22-u5cz68.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/574057/original/file-20240207-22-u5cz68.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/574057/original/file-20240207-22-u5cz68.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/574057/original/file-20240207-22-u5cz68.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/574057/original/file-20240207-22-u5cz68.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A meme depicting the U.S. House of Representatives, which refers to elected officials as parasites, and links to the anti-parasitic drug, Ivermectin, which was promoted by some anti-vaccine influencers as an alternative (and unapproved) treatment for COVID-19.</span>
</figcaption>
</figure>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/574619/original/file-20240209-18-zn1xhe.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/574619/original/file-20240209-18-zn1xhe.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/574619/original/file-20240209-18-zn1xhe.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=421&fit=crop&dpr=1 600w, https://images.theconversation.com/files/574619/original/file-20240209-18-zn1xhe.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=421&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/574619/original/file-20240209-18-zn1xhe.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=421&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/574619/original/file-20240209-18-zn1xhe.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=530&fit=crop&dpr=1 754w, https://images.theconversation.com/files/574619/original/file-20240209-18-zn1xhe.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=530&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/574619/original/file-20240209-18-zn1xhe.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=530&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The Ivermectin pills sold by the influencer for $90USD were intended for animal use only.</span>
</figcaption>
</figure>
<p>Memes are powerful propagators of disinformation because they allow influencers to claim <a href="https://journals.sagepub.com/doi/full/10.1177/1329878X20951301">plausible deniability</a>. Under the protective guise of humour and satire, memes can evade fact checkers and content moderators while promoting anti-vaccine myths and unauthorised treatments. </p>
<p>Influencers promoting vaccine hesitancy use memes to build their online following, sow distrust of health authorities and profit from the promotion of unapproved medicines. This enables them to evade responsibility for any negative consequences of their messaging. </p>
<p>Memes may not look threatening – but that’s why they are such effective super spreaders of health disinformation.</p><img src="https://counter.theconversation.com/content/221680/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Memes have featured in anti-vaccine messaging for centuries and their power to spread harmful health disinformation is growing.Stephanie Alice Baker, Senior Lecturer in Sociology, City, University of LondonMichael James Walsh, Associate Professor in Social Sciences, University of CanberraLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2228892024-02-11T19:05:49Z2024-02-11T19:05:49ZVaccination, testing, clean air: COVID hasn’t gone away – here’s where Australia needs to do better<p>In May 2023 the World Health Organization (WHO) declared COVID was no longer a <a href="https://www.who.int/news/item/05-05-2023-statement-on-the-fifteenth-meeting-of-the-international-health-regulations-%282005%29-emergency-committee-regarding-the-coronavirus-disease-%28covid-19%29-pandemic">public health emergency of international concern</a>. For many, this signalled the pandemic was over. </p>
<p>But the virus continues to <a href="https://ourworldindata.org/covid-cases">infect millions of people</a> <a href="https://theconversation.com/covid-barely-gets-a-mention-these-days-heres-why-thats-a-dangerous-situation-220867">globally</a> and the WHO recognises COVID as <a href="https://www.scientificamerican.com/article/rampant-covid-poses-new-challenges-in-the-fifth-year-of-the-pandemic/">an ongoing pandemic</a>. </p>
<p>In Australia, more than <a href="https://nindss.health.gov.au/pbi-dashboard/">50,000</a> infections have been reported so far in 2024. And this is likely to be a significant underestimate, as we are <a href="https://www.covid19data.com.au/testing">testing</a> much less than we used to. As of February 1 there were 287 outbreaks in <a href="https://www.health.gov.au/resources/publications/covid-19-outbreaks-in-australian-residential-aged-care-facilities-1-february-2024?language=en">residential aged care homes</a>, and <a href="https://www.health.gov.au/sites/default/files/2024-02/covid-19-outbreaks-in-australian-residential-aged-care-facilities-1-february-2024.pdf">people are still dying</a> from the virus. </p>
<p>Although we’ve come a long way since earlier in the pandemic, as we enter its fifth year, COVID continues to have negative effects on individuals, health services and society at large.</p>
<p>To reduce the impact on health services and the community, the Australasian College for Infection Prevention and Control, of which we are on the board of directors, <a href="https://www.acipc.org.au/wp-content/uploads/2024/02/Position-Statement-Current-and-Continuing-Impact-of-COVID-19-Issued-9-February-2024.pdf">is calling for</a> ongoing infection prevention and control strategies in Australia. These include supporting people to access vaccination and testing, and cleaner air in shared indoor spaces.</p>
<h2>Vaccination</h2>
<p>COVID vaccination reduces severe illness and can in turn reduce pressure on the health system. But, to reap the greatest benefits, a high proportion of the population must be vaccinated and receive regular booster doses. </p>
<p>Boosters are important as we know <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2804451">immunity wanes over time</a>, both after <a href="https://theconversation.com/how-long-does-immunity-last-after-a-covid-infection-221398">infection and vaccination</a>. Also, because COVID <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10015854/">continues to evolve</a>, vaccines are updated to keep up with <a href="https://theconversation.com/what-are-the-new-covid-booster-vaccines-can-i-get-one-do-they-work-are-they-safe-217804">circulating strains</a>.</p>
<p>Current advice from the <a href="https://www.health.gov.au/news/atagi-update-on-the-covid-19-vaccination-program">Australian Technical Advisory Group on Immunisation</a> (ATAGI) indicates adults over 75 should receive a <a href="https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/covid-19">routine booster</a>, and adults 65 to 74 should consider doing so. Younger people are only eligible if they have an increased risk of severe COVID, for example due to a particular medical condition. </p>
<p>There’s also no recommendation that people <a href="https://immunisationhandbook.health.gov.au/contents/vaccination-for-special-risk-groups/vaccination-for-people-at-occupational-risk">at greater occupational risk</a> of catching COVID, such as health-care workers, childcare workers or emergency and essential services workers receive another vaccination at this stage.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/its-4-years-since-the-first-covid-case-in-australia-heres-how-our-pandemic-experiences-have-changed-over-time-220336">It's 4 years since the first COVID case in Australia. Here's how our pandemic experiences have changed over time</a>
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<p>Yet broadening eligibility could help in several ways. For example, having a high proportion of the population unvaccinated or undervaccinated may increase opportunities for the virus <a href="https://theconversation.com/the-emergence-of-jn-1-is-an-evolutionary-step-change-in-the-covid-pandemic-why-is-this-significant-220285">to mutate</a> and for new variants to develop. </p>
<p>Also, although older people are generally at greatest risk from a COVID infection, <a href="https://www.abc.net.au/news/2024-02-05/nsw-multiple-covid-19-infections-health-immunology/103417278">COVID in younger age groups</a> can still in some cases cause severe and potentially long-term illness (and we know vaccination <a href="https://aci.health.nsw.gov.au/statewide-programs/critical-intelligence-unit/post-acute-sequelae">reduces the risk</a> of long COVID). </p>
<p>We believe the current advice provided by the <a href="https://www.health.gov.au/top-up-covid-19-protection">Australian government</a> is <a href="https://www.health.gov.au/our-work/covid-19-vaccines/information-for-aged-care-providers-workers-and-residents-about-covid-19-vaccines">out of date</a>. There needs to be a review of ATAGI advice to allow booster access for more people, as is offered in other <a href="https://www.cdc.gov/mmwr/volumes/73/wr/mm7304a2.htm?s_cid=mm7304a2_e&ACSTrackingID=USCDC_921-DM121333&ACSTrackingLabel=This%20Week%20in%20MMWR%3A%20Vol.%2073%2C%20February%201%2C%202024&deliveryName=USCDC_921-DM121333">countries</a>, such as the United States. </p>
<figure class="align-center ">
<img alt="A male health-care worker draws up a vaccine." src="https://images.theconversation.com/files/574565/original/file-20240209-22-ckbqbl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/574565/original/file-20240209-22-ckbqbl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/574565/original/file-20240209-22-ckbqbl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/574565/original/file-20240209-22-ckbqbl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/574565/original/file-20240209-22-ckbqbl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/574565/original/file-20240209-22-ckbqbl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/574565/original/file-20240209-22-ckbqbl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Younger people are no longer routinely offered COVID boosters in Australia.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/cu-covid19-vaccine-doctor-hands-male-1897030525">Supamotionstock.com/Shutterstock</a></span>
</figcaption>
</figure>
<p>Even among those who are eligible, uptake is poor. Recent <a href="https://www.health.gov.au/resources/publications/covid-19-vaccine-rollout-update-12-january-2024?language=en">figures</a> show only 16.6% of people aged between 65 and 74 have received a booster dose in the past six months. </p>
<p>As such, in tandem with updated guidelines, there should be focused promotion of COVID boosters to all vulnerable people, as well as nation-wide promotion of free access to vaccinations for the wider population.</p>
<p>The <a href="https://www.health.gov.au/resources/publications/national-covid-19-health-management-plan-for-2023?language=en">Australian government has recognised</a> the need for a strong vaccination program as a means to minimise levels of severe COVID and death. So securing and delivering an ongoing supply of up-to-date vaccinations is paramount.</p>
<h2>Testing</h2>
<p>While testing <a href="https://www.health.gov.au/topics/covid-19/testing">is encouraged</a> if you have COVID symptoms, there’s no requirement or incentive to test or report positive results. This poses two problems: under-reporting of COVID cases, and people not knowing they have COVID (and therefore not knowing they might transmit it). </p>
<p>In <a href="https://www.health.nsw.gov.au/Infectious/covid-19/Pages/reports.aspx">New South Wales</a> for example, laboratory confirmed cases are trending downwards while wastewater testing suggests COVID prevalence remains high.</p>
<p>Reinstating easy access to rapid antigen and PCR testing would enable people to better manage their illness, and provide a clearer picture for health authorities. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/should-we-still-be-using-rats-to-test-for-covid-4-key-questions-answered-218016">Should we still be using RATs to test for COVID? 4 key questions answered</a>
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<h2>Ventilation</h2>
<p>COVID <a href="https://www.nature.com/articles/d41586-022-00925-7">is airborne</a> and evidence shows <a href="https://theconversation.com/ventilation-reduces-the-risk-of-covid-so-why-are-we-still-ignoring-it-194820">clean air is key</a> to minimising <a href="https://academic.oup.com/cid/article/75/1/e97/6414657">its spread</a>.</p>
<p>In September 2023 the Australasian Health Infrastructure Alliance released <a href="https://healthfacilityguidelines.com.au/news/new-project-resource-pandemic-preparedness-health-infrastructure-planning-design-guidance">guidance</a> on pandemic preparedness. This document calls for the design of any new health-care building to take minimising the risk of infection transmission into account.</p>
<p>There are <a href="https://www.idhjournal.com.au/article/S2468-0451(23)00061-5/fulltext">examples</a> where investment in building design to minimise infectious disease transmission has had positive results. But guidance documents lack the legal clout needed to drive true change, and these examples are the exception. COVID still spreads in our hospitals and aged care facilities.</p>
<figure class="align-center ">
<img alt="Two hospital staff pushing a bed through a hospital corridor." src="https://images.theconversation.com/files/574544/original/file-20240208-18-mttc4d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/574544/original/file-20240208-18-mttc4d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/574544/original/file-20240208-18-mttc4d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/574544/original/file-20240208-18-mttc4d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/574544/original/file-20240208-18-mttc4d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/574544/original/file-20240208-18-mttc4d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/574544/original/file-20240208-18-mttc4d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">New health-care facilities should be built with ventilation in mind.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/male-female-multi-ethnic-nursing-staff-606480698">Spotmatik Ltd/Shutterstock</a></span>
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<p>Infection prevention and control specialists should play a key role in designing health-care facilities and residential aged care homes. Strategies to <a href="https://www.cdc.gov/coronavirus/2019-ncov/community/ventilation.html">optimise ventilation in buildings</a> must involve early consultation with qualified ventilation specialists who can address requirements such as the <a href="https://www.mja.com.au/journal/2022/217/11/healthy-indoor-air-our-fundamental-need-time-act-now">air exchange rate</a> relative to the size of the building and number of expected occupants. </p>
<p>Mandating this would ensure we build facilities which minimise the transmission of most respiratory infections – not just COVID.</p>
<h2>Other things</h2>
<p>Support for communities to engage in key prevention strategies such as promoting the use of <a href="https://royalsociety.org/topics-policy/projects/impact-non-pharmaceutical-interventions-on-covid-19-transmission/">surgical masks</a> or preferably <a href="https://www.covid19.act.gov.au/stay-safe-and-healthy/face-masks#:%7E:text=Particulate%20filter%20respirators%20(PFRs)%2C,tight%20seal%20to%20the%20face.">P2/N95 respirators</a> and <a href="https://www.australianunions.org.au/2024/01/30/half-of-workers-are-working-while-sick-or-injured/">staying home when unwell</a> is important. Employers have a responsibility to enable access to paid sick leave, especially for those working with vulnerable communities and in health care. </p>
<p>Hand hygiene, although a foundation of infection prevention and control, appears to have <a href="https://www.nature.com/articles/d41586-023-00642-9">less of a role</a> in controlling COVID transmission. So we need to spend less time thinking washing our hands will protect us from COVID, and more time on what the evidence actually shows will help us ride this stage of the pandemic. </p>
<p>We also need new research initiatives such as large-scale clinical trials to prevent and treat <a href="https://www.health.gov.au/topics/covid-19/long-covid">long COVID</a>, and more funding for the development of new vaccines and antiviral drugs as new variants arise.</p><img src="https://counter.theconversation.com/content/222889/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Stephane Bouchoucha is affiliated with Deakin University Centre for Quality and Patient Safety (QPS) research in the Institute for Health Transformation (IHT) and the Centre for Innovation in Infectious Disease and Immunology Research (CIIDIR). Stephane is also the President of the Australasian College for Infection Prevention and Control (ACIPC) and was the recipient of an Early Career Research Grant from ACIPC in 2016. </span></em></p><p class="fine-print"><em><span>Matt Mason is affiliated with The Australian College for Infection Prevention and Control, the Australian Centre for Pacific Islands Research at the University of the Sunshine Coast, the Pacific Region Infectious Diseases Association, and the Collaborative for the Advancement of Infection Prevention and Control. He is also a member of CRANAplus. Matt is a current recipient of an Australian College for Infection Prevention and Control Early Career Researcher Grant and has undertaken contracted consultations for the Pacific Community. </span></em></p><p class="fine-print"><em><span>Peta-Anne Zimmerman is affiliated with the Menzies Health Institute, Queensland, the Australasian College for Infection Prevention and Control, the Pacific Region Infectious Diseases Association, and the Collaborative for the Advancement of Infection Prevention and Control. Peta-Anne undertakes contracted consultancies for the World Health Organization and is a focal point for the Global Outbreak Alert and Response Network.</span></em></p><p class="fine-print"><em><span>Sally Havers is affiliated with the University of Queensland and the Herston Infectious Diseases Institue. Sally is President Elect of the Australasian College for Infection Prevention and Control and a recipient of an ACIPC Early Career Researcher Grant in 2023. </span></em></p>We need to see suitable infection prevention measures alongside targeted public health campaigns to reduce COVID infections across the community.Stephane Bouchoucha, Associate Professor in Nursing and Associate Head of School (International), Deakin UniversityMatt Mason, Lecturer and Academic Lead for Work Integrated Learning, University of the Sunshine CoastPeta-Anne Zimmerman, Senior Lecturer/Program Advisor, Griffith Graduate Infection Prevention and Control Program, Griffith UniversitySally Havers, Conjoint Nurse Researcher, School of Nursing, Midwifery and Social Work, The University of QueenslandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2216072024-02-06T06:03:26Z2024-02-06T06:03:26ZFinding a reasonably priced new car is almost impossible. And the second hand market is not much better<figure><img src="https://images.theconversation.com/files/573679/original/file-20240206-17-h0yyn4.jpg?ixlib=rb-1.1.0&rect=246%2C202%2C5060%2C3470&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/couple-dealer-selling-cars-look-car-1579747456">Studio Romantic/Shutterstock</a></span></figcaption></figure><p>Despite most businesses around the world returning to some form of normal after the pandemic, supply chain problems continue to disrupt the manufacturing and availability of new and second hand cars.</p>
<p>This disruption has caused vehicle prices to sky-rocket, adding to cost-of-living pressures already being experienced by most Australians.</p>
<p>Car prices in Australia rose throughout 2023 with an <a href="https://premium.goauto.com.au/car-prices-exceed-inflation/">average increase of almost 20%</a> since April 2020, even faster than the consumer price index.</p>
<p>The increase has varied depending on the model, but the biggest increases – of about 25% – have been in the small car sector.</p>
<p><iframe id="ILUD0" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/ILUD0/1/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<p>This resembles the situation in Europe where the prices of the cheapest models produced by the five biggest carmakers have increased by <a href="https://www.transportenvironment.org/discover/carmakers-are-hiking-the-prices-of-small-cars-far-above-inflation/">an average of 41% since 2019</a>.</p>
<h2>The impact of supply not matching demand</h2>
<p>The availability and cost of buying new cars in Australia have been impacted by both demand and supply issues.</p>
<p>On the demand side, many new orders have been delayed by time lost during the lockdowns followed by strict social distancing requirements holding up work at all stages of the manufacturing process.</p>
<p>This has been worsened by new car demand increasing across all markets. In Europe, new vehicle registrations rose <a href="https://www.bloomberg.com/news/articles/2023-10-20/europe-car-sales-extend-winning-streak-on-large-order-backlogs">11% in October 2023 for 14th consecutive month</a>. The Federal Chamber of Automotive Industries in Australia also recorded <a href="https://www.fcai.com.au/news/index/view/news/806">breaking new vehicles sales</a> in August 2023 with 15.4% increase compared to the same period in 2022.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/what-the-red-sea-crisis-could-mean-for-the-electric-vehicle-industry-and-the-planet-221074">What the Red Sea crisis could mean for the electric vehicle industry and the planet</a>
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</em>
</p>
<hr>
<p>There has also been an ongoing global shortage of semiconductors to make
<a href="https://www.techrepublic.com/article/global-chip-shortage-cheat-sheet/">computer chips</a>. Not only are these chips commonly used in household devices, they are essential as cars are increasingly automated and electric vehicles become popular.</p>
<h2>Geopolitical tensions</h2>
<p>The shortage and associated hold ups, has been exacerbated by conflict in the Middle East, particularly the Israel-Hamas war as <a href="https://techinformed.com/israel-hamas-war-could-endanger-advanced-chip-supply/">Israel</a> is a major supplier of chips to the world.</p>
<p>Shipping delays caused by the need to re-route <a href="https://www.ft.com/content/97dd4654-995f-4bfa-aa45-2f6f4736cdef">car carriers</a> due to attacks by Houthi rebels on ships operated by supporters of Israel in the conflict have also held up supply.</p>
<p>A shortage of the special RORO (roll on, roll off) shipping carriers used to transport cars has added to delays. While demand for car carriers has <a href="https://www.tradewindsnews.com/opinion/car-carrier-shortage-bodes-well-for-pctc-sector-as-demand-for-vehicles-drives-upwards/2-1-1525444">grown 37%</a> since 2019, the fleet has barely grown.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/573652/original/file-20240206-25-u47b93.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Thousands of new cars parked on a wharf waiting to be loaded onto a cargo ship" src="https://images.theconversation.com/files/573652/original/file-20240206-25-u47b93.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/573652/original/file-20240206-25-u47b93.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=337&fit=crop&dpr=1 600w, https://images.theconversation.com/files/573652/original/file-20240206-25-u47b93.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=337&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/573652/original/file-20240206-25-u47b93.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=337&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/573652/original/file-20240206-25-u47b93.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/573652/original/file-20240206-25-u47b93.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/573652/original/file-20240206-25-u47b93.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A shortage of RORO (roll on, roll off) carriers is contributing to delays in new car supplies.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/aerial-view-vehicle-carrier-vessel-loading-2104257590">Avigator/Fortuna/Shutterstock</a></span>
</figcaption>
</figure>
<h2>Problems at the Australian end</h2>
<p>When shipments do finally arrive at the Australian ports, they face port congestion. This is caused by several factors: </p>
<ul>
<li><p>large amounts of cargo arriving at Australian ports and terminals at the same time as previously delayed exports are being sent offshore</p></li>
<li><p>higher demand for <a href="https://www.drive.com.au/news/quarantine-crisis-deepens-thousands-cars-stranded/">quarantine checks</a> after pests and seeds were found in 1000s of vehicles being brought in from Asia and Europe last year</p></li>
<li><p>insufficient labour to conduct biosecurity checks and handle cargo</p></li>
<li><p>industrial action, such as the ongoing dispute at <a href="https://www.afr.com/work-and-careers/workplace/dp-world-calls-for-circuit-breaker-to-ports-disputes-20240122-p5ez4p">DP World-operated ports</a>, affecting productivity.</p></li>
</ul>
<h2>A second hand solution?</h2>
<p>Understandably, when there is a shortage of new cars and prices are high, consumers have turned to second-hand cars which are already in the country. However, this has led to a supply-demand imbalance, reducing the availability and increasing the cost of this once cheaper option.</p>
<p>The longer the wait for new cars and the higher the costs, the greater the pressure on the second-hand car market.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/attacks-on-cargo-ships-in-the-red-sea-threaten-australias-trade-we-need-a-plan-b-220541">Attacks on cargo ships in the Red Sea threaten Australia's trade – we need a Plan B</a>
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<hr>
<p>Some strategic customers may worsen the problem by registering to buy several different cars and then only buying the first one that arrives, therefore jacking up the demand and slowing down the process. They may also demand a high price for their used car, putting a vehicle out of reach for some would-be buyers.</p>
<h2>It will take time to resolve</h2>
<p>Supply will gradually catch up with demand, therefore easing the problem. But the current global geopolitical tensions and industrial action on the wharves, makes it difficult to predict when this will happen.</p>
<p>In the short term, the Albanese government may need to intervene to deter unhealthy trading practices. This could be achieved in the short term by imposing higher taxes on people who register to buy more cars than they need for personal use.</p><img src="https://counter.theconversation.com/content/221607/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Vinh Thai does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Several years on from the pandemic, the demand for new cars still outstrips supply. But turning to the second hand market is not the solution.Vinh Thai, Professor, RMIT UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2203362024-01-24T19:08:47Z2024-01-24T19:08:47ZIt’s 4 years since the first COVID case in Australia. Here’s how our pandemic experiences have changed over time<figure><img src="https://images.theconversation.com/files/571024/original/file-20240124-17-t6k3t1.jpg?ixlib=rb-1.1.0&rect=0%2C10%2C6709%2C4456&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/sydney-nswaustralia-apr-01-2020-traffic-1689817072">Sebastian Reategui/Shutterstock</a></span></figcaption></figure><p>It might be hard to believe, but four years have now passed since the <a href="https://www.health.gov.au/topics/covid-19/about">first COVID case</a> was confirmed in Australia on January 25 2020. Five days later, the <a href="https://www.who.int/publications/m/item/covid-19-public-health-emergency-of-international-concern-(pheic)-global-research-and-innovation-forum">World Health Organization</a> (WHO) declared a “public health emergency of international concern”, as the novel coronavirus (later named SARS-CoV-2) began to spread worldwide.</p>
<p>On March 11 the WHO would declare COVID a pandemic, while around the same time Australian federal and state governments hastily <a href="https://www.aph.gov.au/About_Parliament/Parliamentary_departments/Parliamentary_Library/pubs/rp/rp2021/Chronologies/COVID-19StateTerritoryGovernmentAnnouncements">introduced measures</a> to “stop the spread” of the virus. These included shutting Australia’s international borders, closing non-essential businesses, schools and universities, and limiting people’s movements outside their homes.</p>
<p>I began my project, <a href="https://www.frontiersin.org/articles/10.3389/fpubh.2023.1092322/full">Australians’ Experiences of COVID-19</a>, in May 2020. This research has continued each year to date, allowing me to track how Australians’ attitudes around COVID have changed over the course of the pandemic.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/life-death-intimacy-and-privilege-4-works-of-covid-fiction-and-what-they-say-about-us-189311">Life, death, intimacy and privilege: 4 works of COVID fiction – and what they say about us</a>
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</em>
</p>
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<h2>Evolving pandemic experiences</h2>
<p>We recruited participants from across Australia, including people living in regional cities and towns. Participants range in age from early adulthood to people in their 80s. </p>
<p>The first three stages of the project each involved 40 interviews with separate groups of participants (so 120 people in total). These interviews were done in May to July 2020 (stage 1), September to October 2021 (stage 2), and September 2022 (stage 3). Stage 4 was an online survey with 1,000 respondents, conducted in September 2023.</p>
<p>Limitations of this project include the small sample sizes for the first three stages (as is common with qualitative interview-based research). This means the findings from those phases are not generalisable, but they do provide rich insights into the experiences of the interviewees. The quantitative stage 4 survey, however, is representative of the Australian population.</p>
<p>The findings show that as the conditions of the pandemic and government management have changed across these years, so have Australians’ experiences. </p>
<p>In the <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-10743-7">early months of the pandemic</a>, some people reported becoming confused, distressed and overwhelmed by the plethora of information sources and the fast-changing news environment. On the other hand, seeking out information provided reassurance and comfort in response to their anxiety and uncertainty about this new disease.</p>
<p>Australians <a href="https://www.taylorfrancis.com/chapters/edit/10.4324/9781003280644-28/covid-19-crisis-communication-deborah-lupton">continued to rely heavily</a> on news reports and government announcements in the first two years of the pandemic. Regular briefings from premiers and <a href="https://theconversation.com/chief-health-officers-are-in-the-spotlight-like-never-before-heres-what-goes-on-behind-the-scenes-166828?utm_source=twitter&utm_medium=bylinetwitterbutton">chief health officers in particular</a> were highly important for how they learned what was happening, as were updates in the media on case numbers, hospitalisations, deaths and progress towards vaccination targets.</p>
<h2>Trust has eroded</h2>
<p>Australians appear to have lost a lot of trust in COVID information sources such as news media reports, health agencies and government leaders. Early strong support of federal, state and territory governments’ pandemic management in <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-10743-7">2020</a> and <a href="https://www.tandfonline.com/doi/full/10.1080/14649365.2023.2240290">2021</a> has given way to much lower support more recently.</p>
<p>My <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4626720">2023 survey</a> (this is published as a report, not peer-reviewed) found doctors were considered the most trustworthy sources of COVID information, but even they were trusted by only 60% of respondents. </p>
<p>After doctors, participants trusted other experts in the field (53%), Australian government health agencies (52%), global health agencies (49%), scientists (45%) and community health organisations (35%). Australian government leaders were towards the lower end of the spectrum (31%). </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/covid-remains-a-global-emergency-the-world-health-organization-says-but-were-at-a-transition-point-what-does-this-mean-198876">COVID remains a global emergency, the World Health Organization says, but we're at a transition point. What does this mean?</a>
</strong>
</em>
</p>
<hr>
<p>In <a href="https://academic.oup.com/heapro/article/38/1/daac192/7026242?login=false">2021</a>, Australians responded positively to the vaccine targets and “<a href="https://www.premier.vic.gov.au/victorias-roadmap-delivering-national-plan">road maps</a>” set by governments. These clear guidelines, and especially the promise that the initial doses would remove the need for lockdowns and border closures, were strong incentives to get vaccinated in 2021. </p>
<p>Unfortunately, the prospect that vaccines would control COVID was shown to be largely unfounded. While COVID vaccines were and continue to be very effective at protecting against severe disease and death, they’re less effective at <a href="https://coronavirus.jhu.edu/vaccines/vaccines-faq">stopping people becoming infected</a>. </p>
<p>Once very high numbers of eligible Australians became vaccinated against the delta variant, <a href="https://pubmed.ncbi.nlm.nih.gov/37068078/">omicron reached Australia</a>, resulting in Australia’s first big wave of infection. This led to disillusionment about vaccines’ value for many participants. </p>
<p>In the <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4626720">2023 survey</a>, respondents reported a high uptake of the first three COVID shots. But when asked whether they planned to get another vaccine in the next 12 months, almost two-thirds said they did not, or they were unsure.</p>
<h2>Enter complacency</h2>
<p>Complacency now seems to have set in for many Australians. This can be linked to the progressive withdrawal of strong public health measures such as quarantine, mandatory isolation when infected, and testing and tracing regimens. </p>
<p>Meanwhile, the media, government leaders and health agencies have played less of an active public role in conveying COVID information. This has led to uncertainty about the extent to which COVID is still a risk and lack of incentive to take protective actions such as mask wearing.</p>
<p>In <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4626720">2023</a>, after mandates had ended, only 9% of respondents said they always wore a mask in indoor public places. Only a narrow majority of respondents even supported compulsory masking for workers in health-care facilities. </p>
<figure class="align-center ">
<img alt="Two people wearing masks in an office." src="https://images.theconversation.com/files/571055/original/file-20240124-15-m95huw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/571055/original/file-20240124-15-m95huw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=364&fit=crop&dpr=1 600w, https://images.theconversation.com/files/571055/original/file-20240124-15-m95huw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=364&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/571055/original/file-20240124-15-m95huw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=364&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/571055/original/file-20240124-15-m95huw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=457&fit=crop&dpr=1 754w, https://images.theconversation.com/files/571055/original/file-20240124-15-m95huw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=457&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/571055/original/file-20240124-15-m95huw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=457&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">People have become more lax with mask wearing since mandates ended.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-people-face-masks-back-work-1746069578">Ground Picture/Shutterstock</a></span>
</figcaption>
</figure>
<p>The <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4626720">2023 survey</a> confirmed many Australians no longer feel at risk from COVID. Some 17% of respondents said COVID was definitely still posing a risk to Australians, while a further 42% saw COVID as somewhat of a risk. This left 28% who did not view COVID as much of a continuing risk, and 13% who thought it was not a risk at all.</p>
<h2>COVID is still a risk</h2>
<p>Whether or not people feel at continuing risk from COVID, the pandemic is still significantly affecting Australians. The <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4626720">2023 survey</a> found more than two-thirds of respondents (68%) reported having had at least one COVID infection to their knowledge, including 13% who had experienced three or more. Of those who’d had COVID, 40% said they experienced ongoing symptoms, or long COVID.</p>
<p>If the pandemic loses visibility in public forums, people have no way of knowing the risk of infection continues, and are therefore unlikely to take steps to protect themselves and others.</p>
<p>Updated case, hospitalisation, death and vaccination numbers should be communicated regularly, as <a href="https://theconversation.com/covid-is-surging-in-australia-and-only-1-in-5-older-adults-are-up-to-date-with-their-boosters-220839">used to be the case</a>. To combat confusion, complacency and misinformation, all health advice should be based on the latest robust science.</p>
<p>Australians are operating in a vacuum of information from trusted sources. They need much better and more frequent public health campaigns and risk communication from their leaders.</p><img src="https://counter.theconversation.com/content/220336/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Deborah Lupton does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Trust, particularly in government leaders, has diminished over time.Deborah Lupton, SHARP Professor, Vitalities Lab, Centre for Social Research in Health and Social Policy Centre, and the ARC Centre of Excellence for Automated Decision-Making and Society, UNSW SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2211832024-01-24T17:21:13Z2024-01-24T17:21:13ZFive books about the COVID pandemic to look out for in 2024<figure><img src="https://images.theconversation.com/files/569571/original/file-20240116-26651-g7hw7a.jpg?ixlib=rb-1.1.0&rect=89%2C89%2C5901%2C3898&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/beautiful-blonde-woman-wearing-face-mask-1857379738">Luis Monasterio/Shutterstock</a></span></figcaption></figure><p>Vi-fi, short for virus fiction, describes contemporary fiction that features the devastating events of world-changing outbreaks and epidemics. Rooted in science fiction, vi-fi draws on bio-thrilling realism and parallel worlds with multiple, dystopian possibilities.</p>
<p>Since 2020 there has been an exponential rise in vi-fi by a new COVID generation of authors who came out of isolation having experienced a pandemic in real time. </p>
<p>We <a href="https://open.spotify.com/show/4AlmyluJOBTdreBkx8YvX6">present a podcast</a> about the latest in pandemic fiction. Here are five books about COVID we’ll be looking out for in 2024:</p>
<h2>1. Day by Michael Cunningham, released January 18</h2>
<p>Published 25 years after his literary masterpiece, The Hours, Cunningham’s new book, Day, taps into the COVID genre’s sense of a distortion of time. </p>
<p>The plot recounts the troubles of married couple, Dan and Isabel, and their children, Nathan and Violet and Isabel’s younger wayward brother, who lives a secret life on Instagram in the attic, as they navigate the pressures of lockdown in a brownstone townhouse in Brooklyn. </p>
<p>The narrative is built around the events of three separate days, each a year apart. The first is just as the pandemic is about to hit in 2019, the second during the middle of the lockdown in 2020, and the third as they are coming out of the lockdown in April 2021. </p>
<p>COVID is never mentioned by name, but the narrative promises tumultuous themes of incarceration and isolation, the extremely difficult accommodations that families had to make and the ways that so much is left unspoken between people.</p>
<h2>2. Fourteen Days by Margaret Atwood and Douglas Preston, released February 6</h2>
<p>Inspired by Italian Renaissance writer Giovanni Boccaccio’s book, The Decameron (1353), and a short story collection by the New York Times called The Decameron Project (2020), comes this much anticipated collaborative pandemic novel. </p>
<p>Beginning on the first week of lockdown in March 2020 the narrative takes place in a rundown New York City apartment complex where tenants share stories on the rooftop. </p>
<p>The book features different chapters written by A-list authors such as Emma Donoghue (Pull of the Stars), John Grisham, Celeste Ng (Little Fires Everywhere) and Weike Wang (Joan is Okay). </p>
<p>The book vows to be packed with secrets, ghost tales and sensational revelations from self-isolation, when the residents’ outlook on their situation is forever altered by the story of the newest, anonymous tenant: the Super.</p>
<h2>3. Blue Ruin by Hari Kunzru, released May 16</h2>
<p>Kunzru’s portrait of the pandemic is tipped to be the most gripping COVID-noir novel yet. </p>
<p>Twenty years after graduating from a London art school, Jay is working as a delivery driver in New York in 2020. Having just returned to work afer the first lockdown, he unknowingly collapses on the porch of an enormous mansion in the middle of a remote woodland. There, his former lover from art school, Alice, is living with Rob, the man she she left him for and who was also his former best friend, as well as with Marshal, a gallery owner, and his girlfriend. </p>
<p>Exhausted with sickness, Jay is confronted by the personal history he has tried to shove into the rearview mirror. But this chance encounter in the middle of lockdown begins to unravel the secrets of his darkly destructive past with fateful consequences.</p>
<h2>4. Dear Dickhead by Virginie Despentes, translated by Frank Wynne, released in September</h2>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/569579/original/file-20240116-29-og0e3x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Author Virginie Despentes, a white woman with brown hair." src="https://images.theconversation.com/files/569579/original/file-20240116-29-og0e3x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/569579/original/file-20240116-29-og0e3x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=862&fit=crop&dpr=1 600w, https://images.theconversation.com/files/569579/original/file-20240116-29-og0e3x.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=862&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/569579/original/file-20240116-29-og0e3x.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=862&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/569579/original/file-20240116-29-og0e3x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1083&fit=crop&dpr=1 754w, https://images.theconversation.com/files/569579/original/file-20240116-29-og0e3x.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1083&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/569579/original/file-20240116-29-og0e3x.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1083&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Virginie Despentes.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Virginie_Despentes_2012.jpg">Georges Biard/WikiCommons</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
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<p><a href="https://pledgetimes.com/virginie-despentes-on-dear-asshole-be-radical-with-ideals/">Dubbed</a> “a French punk on the literary scene” and the “literary Balzac”, Virginie Despentes – who was shortlisted for the The Man Booker International Prize 2018 for her novel Vernon Subutex 1 – takes on #MeToo, COVID and social media cancel culture in Wynne’s translation of her new book. </p>
<p>A writer threatened by the public scrutiny of his “flirtations” with women, Oskar Jayack, finds himself at the centre of an Instagram hate when he rants on social media about the 50-year-old declining actress, Rebecca Latte, blaspheming her in a string of brutal insults which degenerates her as a dirty, worn-out, loud old woman. </p>
<p>Despentes uses email exchanges between the characters, but the author’s real message comments on a string of modern social problems: on transphobia, addiction, abuse and the effects of COVID policies.</p>
<h2>5. Real Americans by Rachel Khong, published April 30</h2>
<p>Khong’s take on the popular genre of generational saga ushers us into the past, across three continents and onto a post-pandemic Washington island. </p>
<p>This is an expansive social novel about the lives of three members of a Chinese American family, spanning 70 years: May (who we meet in 2030), Lily (in 2000) and Nick Chen (in 2021). </p>
<p>Nick is only 15, but he can’t help feeling that his mother, Lily, is hiding something from him. The only thing Nick knows about himself is that his dad is white and has never wanted to be in his life. He sets out to search for his biological father and get some answers. </p>
<p>Khong queries modern concerns through questions which plague her cast of characters. How much of our lives come from a spark of chance? Are we destined, or made, and if so, who gets to do the making? What makes a real American?</p>
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<img alt="" src="https://images.theconversation.com/files/536131/original/file-20230706-17-460x2d.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/536131/original/file-20230706-17-460x2d.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/536131/original/file-20230706-17-460x2d.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/536131/original/file-20230706-17-460x2d.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/536131/original/file-20230706-17-460x2d.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/536131/original/file-20230706-17-460x2d.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/536131/original/file-20230706-17-460x2d.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><em>Looking for something good? Cut through the noise with a carefully curated selection of the latest releases, live events and exhibitions, straight to your inbox every fortnight, on Fridays. <a href="https://theconversation.com/uk/newsletters/something-good-156">Sign up here</a>.</em></p>
<hr><img src="https://counter.theconversation.com/content/221183/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Since 2020 there has been exponential rise in ‘virus fiction’ by a new COVID generation of authors who came out of isolation having experienced a pandemic in real time.Lucyl Harrison, PhD Candidate, School of Humanities, University of HullCatherine Wynne, Associate Dean for Research and Enterprise, Faculty of Arts, Cultures and Education, University of HullLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2213982024-01-23T06:51:20Z2024-01-23T06:51:20ZHow long does immunity last after a COVID infection?<figure><img src="https://images.theconversation.com/files/570785/original/file-20240123-17-tcgvhd.jpg?ixlib=rb-1.1.0&rect=8%2C0%2C5529%2C3686&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/adult-man-lies-on-couch-home-1946857264">Kazantseva Olga/Shutterstock</a></span></figcaption></figure><p>Nearly four years into the pandemic, Australia, like many other countries, is still seeing large numbers of <a href="https://nindss.health.gov.au/pbi-dashboard/">COVID cases</a>. Some 860,221 infections were recorded around the country in 2023, while 30,283 cases have already been reported in 2024. </p>
<p>This is likely to be a significant underestimate, with fewer people testing and reporting than earlier in the pandemic. But the signs suggest parts of Australia are experiencing yet <a href="https://www.abc.net.au/news/2024-01-23/covid-19-case-numbers-from-australia-states-and-territories/103374656">another COVID surge</a>. </p>
<p>While some lucky people claim to have never had COVID, many are facing our second, third or even fourth infection, often despite having been vaccinated. You might be wondering, how long does immunity last after a previous infection or vaccination?</p>
<p>Let’s take a look at what the evidence shows.</p>
<h2>B cells and T cells</h2>
<p>To answer this question, we need to understand a bit about how <a href="https://theconversation.com/what-happens-in-our-body-when-we-encounter-and-fight-off-a-virus-like-the-flu-sars-cov-2-or-rsv-207023">immunity</a> to SARS-CoV-2 (the virus that causes COVID) works. </p>
<p>After being infected or vaccinated, the immune system develops specific antibodies that can neutralise SARS-CoV-2. B cells remember the virus for a period of time. In addition, the immune system produces memory T cells that can kill the virus, and remain in the blood for some months after the clearance of the infection or a vaccination.</p>
<p>A <a href="https://www.science.org/doi/full/10.1126/science.abf4063?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org">2021 study</a> found 98% of people had antibodies against SARS-CoV-2’s spike protein (a protein on the surface of the virus that allows it to attach to our cells) one month after symptom onset. Six to eight months afterwards, 90% of participants still had these neutralising antibodies in their blood.</p>
<p>This means the immune system should have recognised and neutralised the same SARS-CoV-2 variant if challenged within six to eight months (if an infection occurred, it should have resulted in mild to no symptoms).</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/what-happens-in-our-body-when-we-encounter-and-fight-off-a-virus-like-the-flu-sars-cov-2-or-rsv-207023">What happens in our body when we encounter and fight off a virus like the flu, SARS-CoV-2 or RSV?</a>
</strong>
</em>
</p>
<hr>
<h2>But what about when the virus mutates?</h2>
<p>As we know, SARS-CoV-2 has mutated over time, leading to the emergence of new variants such as alpha, beta, delta and omicron. Each of these variants carries mutations that are new to the immune system, even if the person has been previously infected with an earlier variant. </p>
<p>A new variant likely won’t be <a href="https://www.science.org/doi/10.1126/science.adj0070">perfectly recognised</a> – or even <a href="https://www.cell.com/cell/pdf/S0092-8674(21)01578-6.pdf">recognised at all</a> – by the already activated memory T or B cells from a previous SARS-CoV-2 infection. This could explain why people can be so readily reinfected with COVID.</p>
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<img alt="A close up of a person performing a RAT." src="https://images.theconversation.com/files/570803/original/file-20240123-21-9mk3k7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/570803/original/file-20240123-21-9mk3k7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/570803/original/file-20240123-21-9mk3k7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/570803/original/file-20240123-21-9mk3k7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/570803/original/file-20240123-21-9mk3k7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/570803/original/file-20240123-21-9mk3k7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/570803/original/file-20240123-21-9mk3k7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">COVID reinfections are common.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/close-person-using-coronavirus-covid19-rapid-1969543405">Ink Drop/Shutterstock</a></span>
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<p>A recent <a href="https://www.thelancet.com/article/S0140-6736(22)02465-5/fulltext#seccestitle10">review of studies</a> published up to the end of September 2022 looked at the protection conferred by previous SARS-CoV-2 infections.</p>
<p>The authors found a previous infection provided protective immunity against reinfection with the ancestral, alpha, beta and delta variants of 85.2% at four weeks. Protection against reinfection with these variants remained high (78.6%) at 40 weeks, or just over nine months, after the previous infection. This protection decreased to 55.5% at 80 weeks (18 months), but the authors noted there was a lack of data at this time point. </p>
<p>Notably, an earlier infection provided only 36.1% protection against a reinfection with omicron BA.1 at 40 weeks. Omicron has been described as an <a href="https://www.nature.com/articles/s41564-022-01143-7">immune escape variant</a>.</p>
<p>A prior infection showed a high level of protection against severe disease (above 88%) up to 40 weeks regardless of the variant a person was reinfected with.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/there-are-still-good-reasons-to-avoid-catching-covid-again-for-one-your-risk-of-long-covid-goes-up-each-time-196041">There are still good reasons to avoid catching COVID again – for one, your risk of long COVID goes up each time</a>
</strong>
</em>
</p>
<hr>
<h2>What about immunity after vaccination?</h2>
<p>So far almost 70 million COVID vaccines <a href="https://www.health.gov.au/topics/covid-19/reporting">have been administered</a> to more than <a href="https://www.health.gov.au/resources/publications/covid-19-vaccine-rollout-update-12-january-2023?language=en">22 million people</a> in Australia. Scientists estimated COVID vaccines prevented around <a href="https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00320-6/fulltext">14.4 million deaths</a> in 185 countries in the first year after they became available.</p>
<p>But we know COVID vaccine effectiveness wanes over time. A <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2804451?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=050323">2023 review</a> found the original vaccines were 79.6% and 49.7% effective at protecting against symptomatic delta infection at one and nine months after vaccination respectively. They were 60.4% and 13.3% effective against symptomatic omicron at the same time points.</p>
<p>This is where booster doses come into the picture. They’re important to keep the immune system ready to fight off the virus, particularly for those who are more vulnerable to the effects of a COVID infection. </p>
<p>Plus, regular booster doses can provide immunity against different variants. COVID vaccines are constantly being <a href="https://mvec.mcri.edu.au/references/covid-19/">reviewed and updated</a> to ensure optimal protection against <a href="https://www.who.int/activities/tracking-SARS-CoV-2-variants">current circulating strains</a>, with the latest shot available designed to target <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/new-covid-19-vaccines-available-to-target-current-variants">the omicron variant XBB 1.5</a>. This is similar to how we approach seasonal flu vaccines.</p>
<figure class="align-center ">
<img alt="A woman coughing at her desk." src="https://images.theconversation.com/files/570795/original/file-20240123-19-6v7f8u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/570795/original/file-20240123-19-6v7f8u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/570795/original/file-20240123-19-6v7f8u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/570795/original/file-20240123-19-6v7f8u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/570795/original/file-20240123-19-6v7f8u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/570795/original/file-20240123-19-6v7f8u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/570795/original/file-20240123-19-6v7f8u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">COVID immunity wanes over time – both from infection and vaccination.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/sick-african-american-girl-working-home-1109017139">Diego Cervo/Shutterstock</a></span>
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<p>A <a href="https://www.nature.com/articles/s41598-023-50335-6">recent study</a> showed a COVID vaccination provides longer protection against reinfection than natural protection alone. The median time from infection to reinfection in non-vaccinated people was only six months, compared with 14 months in people who had received one, two or three doses of vaccine after their first infection. This is called <a href="https://www.science.org/doi/10.1126/science.abj2258">hybrid immunity</a>, and other research has similarly found it provides better protection than natural infection alone.</p>
<p>It also seems timing is important, as receiving a vaccine too soon after an infection (less than six months) appears to be <a href="https://www.nature.com/articles/s41598-023-50335-6">less effective</a> than getting vaccinated later.</p>
<h2>What now?</h2>
<p>Everyone’s immune system is slightly unique, and SARS-CoV-2 continues to mutate, so knowing exactly how long COVID immunity lasts is complicated. </p>
<p>Evidence suggests immunity following infection should generally last six months in healthy adults, and can be prolonged with vaccination. But there are exceptions, and all of this assumes the virus has not mutated so much that it “escapes” our immune response.</p>
<p>While many people feel the COVID pandemic is over, it’s important we don’t forget the lessons we have learned. Practices such as wearing a mask and staying home when unwell can reduce the spread of many viruses, not only <a href="https://www.bmj.com/content/375/bmj-2021-068302">COVID</a>.</p>
<p>Vaccination is not mandatory, but for older adults eligible for a booster under the <a href="https://www.health.gov.au/news/atagi-update-on-the-covid-19-vaccination-program">current guidelines</a>, it’s a very good idea.</p><img src="https://counter.theconversation.com/content/221398/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lara Herrero receives funding from NHMRC. </span></em></p><p class="fine-print"><em><span>Wesley Freppel does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>While some lucky people believe they’ve never had COVID, many are facing their second, third or even fourth infection. Here’s what the evidence shows.Lara Herrero, Research Leader in Virology and Infectious Disease, Griffith UniversityWesley Freppel, Research Fellow, Institute for Glycomics, Griffith UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2211362024-01-19T10:04:37Z2024-01-19T10:04:37ZJobs in South Africa: the labour market is recovering from COVID – but unskilled and less educated people are still being left behind<p>For more than three decades the South African economy has had very high rates of joblessness. The country’s economy has been unable to create enough jobs <a href="https://www.ekon.sun.ac.za/wpapers/2022/wp032022/wp032022.pdf">for its growing army of workers</a>. This has partly been because of the <a href="https://www.statssa.gov.za/?page_id=1866&PPN=P0441&SCH=73565">stagnant economic growth rate</a> of only 1.7% during the 2010s (it was even lower at 0.9% in 2015-2019). </p>
<p>Another factor that limited the economy’s capacity to create jobs at a rapid enough pace to absorb new job seekers and previously employed people was the impact of restrictions imposed during the coronavirus (COVID-19) pandemic. Compared with the global financial crisis of 2008/2009 the impact was much greater. Then about 600,000 jobs were lost in South Africa. During the COVID restrictions there were a staggering <a href="https://businesstech.co.za/news/business/416483/report-reveals-shocking-number-of-job-losses-in-south-africa-during-lockdown/">1.5 million job losses</a>.</p>
<p>We <a href="https://www.tandfonline.com/doi/full/10.1080/0376835X.2023.2229875">examined</a> the labour market during the lockdown period. We compared the 2020 first quarter and 2022 second quarter data of the Quarterly Labour Force Survey data released by Statistics South Africa. 2020 first quarter was the last survey before the pandemic hit the country. The 2022 second quarter survey took place just before all the remaining lockdown restrictions were abolished.</p>
<p>To complement the findings of this study, we also analysed the most recently released 2023 third quarter survey data to find out whether the most vulnerable groups had recovered and whether their labour market outcomes had at least returned to the pre-COVID levels.</p>
<p>We found that the employment number (as per 2023 third quarter data) had recovered to its pre-pandemic levels. But, we found, this hadn’t been enough to keep up with the increase in the new working-age population joining the labour force. This finding is once again consistent with the performance of the labour market over the past 30 years. That is, job creation is not rapid enough to absorb all the job seekers.</p>
<p>We also found that most of the gains from the recovery had gone to semi-skilled and skilled workers, leaving out the unskilled and those without 12 years of schooling, who make up more than 40% of the labour force. These were people who took a big hit from the pandemic-related job losses. (For those without the school leaving qualification, in absolute terms there was still an increase of unemployment of over 200,000 after the lockdown restrictions were lifted.) </p>
<p>This is a repetition of the pattern over the last 30 years – that South Africa’s unskilled and less educated (without grade 12) are left behind in terms of job opportunities.</p>
<h2>Lockdown</h2>
<p>Employment dropped by 822,000 (from 16.42 million to 15.59 million) when comparing the 2020 first quarter (just before the start of the lockdown) and 2022 second quarter (the end of lockdown) period. The unemployment rate increased from 30.1% to 33.9%.</p>
<p>The demographic groups that suffered the most job losses included Africans aged 25-44 years without grade 12 and those previously involved in unskilled occupations. These include craft and related trades, elementary occupations and domestic workers.</p>
<p>During the same 2.25-year period, the number of unemployed rose by almost a million – from 7.07 to 7.99 million. In fact the 2022 second quarter total unemployment number of 7.99 million was the highest ever in the South African labour market. On the other hand, the unemployment rate increased from 30.1% to 33.9% (this rate was at its peak level of 35.2% during the fourth quarter of 2021).</p>
<p>African males aged 15-44 years who did not have post-secondary school qualifications and had no prior work experience suffered the greatest increase of unemployment.</p>
<h2>After lockdown</h2>
<p>We uncovered two encouraging findings in the latest <a href="https://www.statssa.gov.za/?page_id=1854&PPN=P0211&SCH=73573">2023 third quarter data</a>.</p>
<p>First: employment increased to 16.78 million, which was higher than the 2020 first quarter (just before COVID) level of 16.42 million. </p>
<p>However, the 0.34 million employment growth was lower than the increase in the labour force (from 23.48 to 24.63 million – a rise of 1.15 million) during the same period.</p>
<p>The second encouraging finding was that the unemployment rate showed a gradual downward trend, dropping from the all-time high of 35.2% in the last quarter of 2021 to 31.9% in the third quarter of 2023. Nonetheless, the latter rate was still higher than the unemployment rate recorded before 2020 (below 30%).</p>
<p>In addition, 31.9% is still much higher than the key labour market goal of the New Growth Path. This was launched in <a href="https://www.gov.za/about-government/government-programmes/new-growth-path">November 2010</a>, and aimed at enhancing economic growth, employment creation and equity. The goal was to reduce the unemployment rate to 6% by 2030. </p>
<p>Given the dire and chaotic state of the economy during the lockdown, this 6% goal was unofficially and temporarily “put aside” without any official announcement. The goal nevertheless remains in place. But it’s a tall order.</p>
<p>South Africa’s unemployment rate would need to drop by about 3.7 percentage points per annum between 2023 and 2030 before the country would be able to achieve it. </p>
<p>It is obvious that this rapid decline is very unlikely to happen in the next seven years.</p>
<p>One worrying finding was that only a slight drop of total unemployment took place. The number remained very high in 2023 third quarter at 7.85 million. This is not far from the all-time high level of 7.99 million in 2022 second quarter.</p>
<p>This implies that despite job creation taking place again after the lifting of the lockdown restrictions, it was not great enough to absorb the more rapidly increasing labour force entrants. Thus unemployment increased. </p>
<p>This is what happened to the country’s labour market <a href="https://www.tandfonline.com/doi/full/10.1080/0376835X.2016.1203759">before COVID-19 took place</a>.</p>
<p>Lastly, between 2020 first quarter and 2023 third quarter, employment actually increased marginally by nearly 0.4 million. Most of the increase went to female Africans aged 45-54 years in the urban areas of two provinces: the Western Cape and KwaZulu-Natal. They had the grade 12 secondary school leaving qualification (or more) and were involved in either high-skilled or semi-skilled occupations, in the finance and community, social and personal services industry categories. </p>
<p>This finding aligns with <a href="https://open.uct.ac.za/items/a3821a49-f3c8-43cd-bdd5-1d6f1f2493bd">structural change</a> in the country’s economy: highly educated and high skilled workers are of greater demand in the labour market.</p>
<h2>The road ahead</h2>
<p>The findings show that the South African labour market has moved on from its worst ever state, and that various aspects have been gradually improving. </p>
<p>However, two worrying – yet expected – findings are that unemployment levels remained high while most of the job gains post-COVID went to highly skilled and highly educated people. </p>
<p>The long-term challenge is how relatively less skilled and less educated people (some of whom suffered job losses during the lockdown period) can find work again (through greater promotion of informal entrepreneurial activities, for example). Otherwise they could end up as chronic unemployed who may not be employable in the long term.</p>
<p><em>This article is based on a <a href="https://www.tandfonline.com/doi/full/10.1080/0376835X.2023.2229875">journal article</a> which the writers co-authored with Jade Botha, an economics master’s graduate at the University of the Western Cape.</em></p><img src="https://counter.theconversation.com/content/221136/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Derek Yu does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>South Africa’s challenge is how to break the cycle of people becoming locked in chronic unemployment who may not be employable in the long term.Derek Yu, Professor, Economics, University of the Western CapeLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2179862024-01-18T17:30:42Z2024-01-18T17:30:42ZExcessive social media use during the COVID-19 pandemic exacerbated adolescent mental health challenges<figure><img src="https://images.theconversation.com/files/569404/original/file-20240115-19-cpvqvk.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C2695%2C1517&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Research shows a strong link between screen time and mental health concerns, including anxiety and depression.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>How does time spent online, and especially social media, affect the brains and behaviours of children and youth?</p>
<p>Social media platforms are seemingly designed to capture the attention of users and produce habitual checking of apps and notifications. In recent years, our lives have become increasingly dominated by social media, either as a source of information, entertainment, or just a way to connect with others. </p>
<p>In Canada alone, <a href="https://madeinca.ca/social-media-statistics-canada/#:%7E:text=Social%20Media%20Statistics%20for%20Canadians,with%20over%2026%20million%20users.">more than 30 million social media accounts</a> are currently registered, with <a href="https://doi.org/10.25318/36280001202100300004-eng">teenagers one of the highest user groups</a>. </p>
<p>During the COVID-19 pandemic, young people were drastically affected by the sudden shift to a digital world and the explosion of a reliance on screens. School closures, coupled with social isolation, led to <a href="https://doi.org/10.1016/j.jadr.2021.100217">dramatic increases in daily screen time use</a> and exacerbated <a href="https://doi.org/10.1186/s40359-023-01240-0">mental health challenges</a> for many young people. </p>
<p>Research shows strong links between screen time and mental health concerns, including <a href="https://doi.org/10.1080/02673843.2019.1590851">anxiety and depression</a>, although few longitudinal studies have been conducted in the pandemic or post-pandemic eras to determine causal relationships. The stress of lockdowns and the absence of typical support networks left adolescents more vulnerable than ever to the negative effects of social media. </p>
<p>Now, in the years following the pandemic lockdowns, it’s imperative that we study and address the impact excessive screen time can have on brain development.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/569606/original/file-20240116-25-l42kqm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="a teen girl wearing a face mask makes a peace sign to her phone" src="https://images.theconversation.com/files/569606/original/file-20240116-25-l42kqm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/569606/original/file-20240116-25-l42kqm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/569606/original/file-20240116-25-l42kqm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/569606/original/file-20240116-25-l42kqm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/569606/original/file-20240116-25-l42kqm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/569606/original/file-20240116-25-l42kqm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/569606/original/file-20240116-25-l42kqm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">During the pandemic, social media provided distraction and a way to maintain contact with friends.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
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<h2>Reward and punishment</h2>
<p>A key facet of social media is that it engages brain systems involved in reward and punishment, which could place children and adolescents at risk for <a href="https://doi.org/10.1001/jamapediatrics.2022.4924">adverse brain development</a>. During childhood and adolescence, our brains are still going through <a href="https://doi.org/10.1093/cercor/bhz279">dramatic periods of development</a>, making them more susceptible to the impact of excessive screen time.</p>
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Read more:
<a href="https://theconversation.com/how-much-time-do-kids-spend-on-devices-playing-games-watching-videos-texting-and-using-the-phone-210118">How much time do kids spend on devices – playing games, watching videos, texting and using the phone?</a>
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<p>Children and youth have very active reward systems in the brain. Natural rewards can cause a brief release of “feel good” chemicals in the brain like <a href="https://doi.org/10.1016/j.pneurobio.2021.101997">dopamine</a>. Social media can offer constant levels of rewards that are higher than normal and affect brain chemistry, leading to <a href="https://doi.org/10.1007/s40473-023-00261-8">children seeking out more rewards</a>, even to addictive levels. </p>
<p>The part of our brain that monitors risky but rewarding activity — <a href="https://doi.org/10.1038/s41586-022-04554-y">the prefrontal cortex — does not fully mature until we reach our 30s</a>. The fact that this brain area has not fully developed in children and teens might affect their ability to control scrolling behaviours and monitor emotional triggers.</p>
<p>Coupled with changes in brain chemistry, this could lead to excessive screen time use. The timeline of the prefrontal cortex’s development could also explain why adults are less likely to face the same consequences of the negative effects of social media. </p>
<p>Additionally, some studies have reported <a href="https://doi.org/10.1038/s41467-018-03126-x">changes in cortical and subcortical brain activation and structure in children and teenagers</a> that were associated with high screen time use. These studies have reported changes in the brain’s <a href="https://doi.org/10.1001/jamapediatrics.2022.4924">reward and punishment centres</a>. </p>
<p>Another example of this comes from a <a href="https://doi.org/10.1016/j.dcn.2022.101088">longitudinal study that followed children for three years</a>, showing delayed development of regions involved in social connectedness and understanding the thoughts and feelings of others.</p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/jR59s2mv24Q?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">CBC News looks at the impact of social media on teens.</span></figcaption>
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<h2>Different impacts</h2>
<p>However, not all research points to screen time as being associated with changes in brain development. A large-scale imaging study that was designed to examine childhood experiences throughout the United States — including smoking, video games and sleep — in nearly 12,000 children showed <a href="https://doi.org/10.1016/j.cortex.2023.09.009">no association between screen time and brain development</a>. </p>
<p>There may be several explanations for the dissonance between the large-scale child development study and smaller studies that were designed to look at screen time. For example, potentially heavy users of screen time chose to participate in smaller, more focused studies. In turn, children who are most at risk for the adverse effects of screen time may represent a smaller fraction of the data in a large cohort. </p>
<p>Given the widespread use of social media, it’s no surprise that not all children and youth are impacted in the same way. Adolescents and young adults who have pre-existing mental health concerns, particularly anxiety, may be most at risk to the <a href="https://doi.org/10.1016/j.jad.2016.08.040">harmful effects of social media use on the brain and behaviour</a>. </p>
<p><a href="https://doi.org/10.1016/j.jad.2013.06.038">Those who experience anxiety may use social media more frequently</a> to seek validation and reassurance, or as a <a href="https://doi.org/10.1016/j.jad.2013.06.038">maladaptive coping mechanism to avoid in-person interactions and real-world stressors</a>. </p>
<p>More longitudinal research is needed to better understand mental-health risk factors for adverse outcomes associated with excessive social media use as well as the long-term effects on brain development.</p>
<h2>Adapting to a digital world</h2>
<p>As we move forward and adapt to an increasingly digital world, clear guidelines are needed concerning the amounts, types and content of screen time that are most harmful to children’s development, as well as the associated risk and resilience factors, which are informed by science. </p>
<p>For this reason, it is more important than ever that researchers design studies that allow us to understand what is happening to children’s and adolescents’ brains and their behaviours, and how that is affecting long-term outcomes. </p>
<p>In the meantime, educators and parents should engage in open dialogue to help children and teenagers understand the consequences that excessive screen time might have on brain development and mental health. Teenagers should also be given strategies and learn about setting boundaries to help them manage screen time responsibly. </p>
<p>It is crucial that we encourage healthy relationships with technology to minimize the potential for long-term societal issues and concerns in the future.</p><img src="https://counter.theconversation.com/content/217986/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Emma Duerden receives funding from the Canada Research Chairs, Brain Canada, and the Children's Health Foundation.</span></em></p><p class="fine-print"><em><span>Michaela Kent does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>During the pandemic, many people relied on social media for distraction and social connection. However, excessive social media use can negatively affect mental health, especially for young people.Emma G Duerden, Canada Research Chair, Neuroscience & Learning Disorders, Assistant Professor, Western UniversityMichaela Kent, PhD Candidate, Neuroscience, Western UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2190712024-01-18T13:29:28Z2024-01-18T13:29:28ZStudents do better and schools are more stable when teachers get mental health support<figure><img src="https://images.theconversation.com/files/568750/original/file-20240110-23-z8tb6j.jpg?ixlib=rb-1.1.0&rect=43%2C21%2C7195%2C2387&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Teachers report worse well-being than the general population. </span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/tensed-school-teacher-sitting-in-classroom-royalty-free-image/1305187925?phrase=stress+teacher&adppopup=true">VectorFusionArt via Getty Images</a></span></figcaption></figure><p>When it comes to mental health at school, typically the focus is on helping students, especially as they emerge from the pandemic with <a href="https://youthtruthsurvey.org/swiiv/">heightened levels of anxiety, stress and emotional need</a>. But as school officials seek to <a href="https://journals.sagepub.com/doi/10.1177/1477878520988432">put resources toward student well-being</a>, another school population is possibly being overlooked: teachers.</p>
<p>Teachers are experiencing high levels of stress, anxiety and work-related trauma in the classroom – much of it stemming from <a href="http://dx.doi.org/10.1177/00317217231212004">student behavioral problems</a>. The pandemic exacerbated this issue, impacting students and teachers alike.</p>
<p>According to 2022 data from the National Center for Education Statistics, 87% of public schools reported that the pandemic “<a href="https://nces.ed.gov/whatsnew/press_releases/07_06_2022.asp">negatively impacted student socioemotional development</a>.” Additional stressors from the pandemic, including <a href="https://doi.org/10.1111/bjep.12450">new levels of uncertainty, higher workloads and a more negative perception of teachers in society</a>, have also <a href="https://doi.org/10.1111/bjep.12450">impacted teachers’ mental health</a> and well-being.</p>
<p>As teachers navigate the highs and lows of their profession, taking care of their emotional and mental well-being is essential. Research backs this up. Not only do teachers personally benefit from improved mental health, but <a href="https://doi.org/10.1016/j.edurev.2021.100411">their students do, too</a>. </p>
<p>As the author of a forthcoming paper about teacher experiences during the pandemic, I have identified four benefits of prioritizing teacher mental health that create a more stable and effective educational environment.</p>
<h2>Reduces burnout and turnover</h2>
<p>An undeniable link exists between teacher mental health and burnout and turnover, especially for <a href="https://doi.org/10.1177/1052684619836823">early career teachers</a>. For young teachers in particular, a <a href="https://www.ascd.org/el/articles/the-elephant-in-the-classroom">workaholic culture</a> can contribute to the deterioration of their mental health. </p>
<p>The demanding nature of teaching, characterized by <a href="https://doi.org/10.1080/00131911.2023.2196607">heavy workloads and high performance expectations</a>, can take a toll on all teachers. This is especially true for teachers of color, who are more likely to leave their schools, or the profession, due to <a href="https://doi.org/10.1177/105268461702700504">poor working conditions and a lack of support</a>. </p>
<p>According to the <a href="https://doi.org/10.7249/RRA1108-7">2023 State of the American Teacher Survey</a> by the Rand Corporation, 13% of respondents said their schools offered teachers no mental health or well-being supports. Furthermore, teachers report <a href="https://www.rand.org/education-and-labor/projects/state-of-the-american-teacher-and-the-american-principal.html">worse well-being than the general population</a>.</p>
<p>This is where schools can really make a difference in teacher retention. In schools with more positive leadership and support, including for mental health, <a href="https://doi.org/10.19030/cier.v12i1.10260">teachers are more likely to stay</a>. Examples of mental health supports include setting appropriate <a href="https://doi.org/10.4148/0146-9282.2175">work-life boundaries</a>, incorporating <a href="https://doi.org/10.2196%2F32312">self-care and stress management techniques</a> into the school day, and creating an open environment where <a href="HTTPS://DOI.ORG/10.22329/JTL.V16I1.6856">mental health can be discussed</a> without stigma. </p>
<h2>Improves teaching effectiveness</h2>
<p>Teachers excel at their jobs when school leaders prioritize their mental well-being. Research has directly linked <a href="https://doi.org/10.1080/00131881.2021.1980416">teachers’ well-being with greater resilience</a>. For instance, the research found, when a teacher remains calm and solution-oriented in the face of challenging classroom situations, it creates a more positive environment and supportive atmosphere for students.</p>
<p>Teachers also burn out less when they’re <a href="https://doi.org/10.1080/2331186X.2015.1034494">encouraged</a> to be <a href="https://blog.adobe.com/en/publish/2023/07/26/creativity-in-classroom-reduces-burnout-improves-teacher-student-wellbeing">creative in the classroom</a>. Creative activities allow for a greater level of connection between student and teacher – and satisfaction on the job.</p>
<p>Being creative and having a positive rapport with their teachers also <a href="https://doi.org/10.1016/j.tsc.2023.101302">develops students’ competence</a> and <a href="https://www.researchgate.net/publication/325248514_Effects_of_Teacher's_Behavior_on_Academic_Performance_of_Students">improves their academic performance</a>. A teacher with poor mental health, however, may have a hard time showing up for their students in such a positive way.</p>
<h2>Preserves institutional knowledge</h2>
<p>Reduced turnover has a profound impact on preserving <a href="https://doi.org/10.1177/016146810710900301">institutional knowledge</a> – the collective understanding of how a school and its students work best. When experienced educators leave unexpectedly or earlier than planned, schools <a href="https://www.govtech.com/education/higher-ed/opinion-undervalue-institutional-knowledge-at-your-own-risk">lose a lot of valuable insight and expertise</a>. Reducing turnover enables schools to benefit from experienced teachers for longer periods of time.</p>
<p>When teachers remain at their schools, they contribute to the schools’ ongoing stability and the accumulation of best practices over time. </p>
<h2>Fosters a positive organizational culture</h2>
<p>Prioritizing the mental health of teachers is not just about personal well-being. It’s also about building a <a href="https://www.gse.harvard.edu/ideas/usable-knowledge/18/07/what-makes-good-school-culture">positive and supportive organizational culture within schools</a>. </p>
<p>A <a href="https://icma.org/articles/pm-magazine/addressing-mental-and-emotional-wellness-through-organizational-culture">culture that prioritizes mental health and wellness</a> creates an environment where teachers feel acknowledged, understood and supported. This positive culture <a href="https://doi.org/10.1093/cs/cdw048">impacts the satisfaction and morale</a> of educators, which can in turn positively affect student learning. A supportive atmosphere <a href="https://doi.org/10.1093/cs/cdw048">encourages collaboration</a>, open communication and a shared dedication to the well-being of everyone within the academic community. </p>
<p>Recognizing and supporting the needs of teachers is crucial. It’s not just about problem-solving. It’s a smart investment in the long-term success and resilience of the entire educational community.</p><img src="https://counter.theconversation.com/content/219071/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lee Ann Rawlins Williams does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Mental health for teachers carries critical benefits for students.Lee Ann Rawlins Williams, Clinical Assistant Professor of Rehabilitation and Human Services, University of North DakotaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2209802024-01-15T20:46:57Z2024-01-15T20:46:57ZRSV, flu and COVID: demystifying the triple epidemic of respiratory viruses<figure><img src="https://images.theconversation.com/files/568892/original/file-20240110-27-k3w5hm.jpg?ixlib=rb-1.1.0&rect=0%2C2%2C995%2C663&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The influenza virus, which causes seasonal flu, is back at its usual rate after a hiatus due to health measures.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>Since 2022, a triple epidemic of respiratory viruses — RSV, influenza and SARS-CoV-2 — has been disrupting our daily lives. In addition, the media constantly reminds us of how this is straining emergency departments.</p>
<p>How does the present respiratory virus season differ from seasons during the pre-COVID era?</p>
<p>As a specialist in virus-host interaction, I would like to shed some light on the new dynamics of the respiratory virus season.</p>
<h2>The infamous SARS-CoV-2</h2>
<p>SARS-CoV-2, the instigator of the COVID-19 pandemic, is still with us. Despite limited access to screening tests, analysis of the number of hospital admissions shows that the virus is still going strong.</p>
<p>Québec’s Institut National de Santé Publique counted more than 33,000 hospitalizations in Québec in 2023 affecting all age categories, <a href="https://www.inspq.qc.ca/en/node/29197">including 648 children under the age of nine</a>.</p>
<p>The virus is not seasonal. It has a strikingly efficient capacity to spread through aerosols, especially as we take refuge indoors to escape the cold. The virus currently circulating is actually a mixture of different viruses, known as variants, each of which has the potential to partially evade the immunity an individual has acquired through a previous infection or vaccination.</p>
<h2>Resurgence of seasonal flu</h2>
<p>After a hiatus due to health measures, the influenza virus, which causes seasonal flu, has returned with the same force. It is once again circulating <a href="https://www.cdc.gov/flu/about/viruses/types.htm">in different variants belonging to Types (strains) A and B</a>, although scientists believe that one Type B strain, the <a href="http://doi.org/10.2807/1560-7917.ES.2022.27.39.2200753">Yamagata lineage, has disappeared</a>.</p>
<p>A variant of H1N1 Type A, different from the viruses that caused the 1918 and 2009 pandemics, is now dominant in North America where it is causing an increase in hospital admissions, <a href="https://www.canada.ca/en/public-health/services/publications/diseases-conditions/fluwatch/2023-2024/week-49-december-3-december-9-2023.html">especially among the elderly and young children</a>.</p>
<p>However, we must remain vigilant, as the strain may change within the same season. What could this mean? The target population could change, <a href="https://www.canada.ca/en/public-health/services/publications/diseases-conditions/fluwatch/2018-2019/annual-report.html">as it did in the 2018-2019 season</a>.</p>
<h2>And what about RSV?</h2>
<p>The respiratory syncytial virus (RSV) also appears to be <a href="https://www.canada.ca/en/public-health/services/surveillance/respiratory-virus-detections-canada/2023-2024/week-50-ending-december-16-2023.html">resuming its pre-pandemic transmission levels</a>.</p>
<p>RSV causes bronchiolitis and pneumonia. <a href="https://cps.ca/en/documents/position/bronchiolitis">Bronchiolitis is characterized by the obstruction of the small airways, which can progress to wheezing or respiratory distress</a>.</p>
<p>Virtually all children are infected with RSV before the age of 2, and RSV infection is one of the main causes of hospitalization in young children.</p>
<p>Before the COVID-19 pandemic, there was an average of 2,523 hospitalizations per year in Canada, <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2810133">half of them in children under six months of age and more than a quarter requiring admission to intensive care</a>.</p>
<p>But RSV also severely affects the elderly and adults who are immunocompromised or have existing chronic conditions. RSV shows high levels of severe illness, hospital admissions and in hospital deaths in adults, <a href="https://doi.org/10.1093/infdis/jiad559">figures which are comparable to those for influenza</a>.</p>
<p>Admittedly, although these three viruses are attracting attention, other less publicized respiratory viruses are also circulating, <a href="https://www.canada.ca/en/public-health/services/surveillance/respiratory-virus-detections-canada/2023-2024/week-50-ending-december-16-2023.html">demonstrating a diverse viral environment</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/568438/original/file-20240109-27-z61q6c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="woman in hospital" src="https://images.theconversation.com/files/568438/original/file-20240109-27-z61q6c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/568438/original/file-20240109-27-z61q6c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/568438/original/file-20240109-27-z61q6c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/568438/original/file-20240109-27-z61q6c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/568438/original/file-20240109-27-z61q6c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/568438/original/file-20240109-27-z61q6c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/568438/original/file-20240109-27-z61q6c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The continued presence of SARS-CoV-2 means our hospitals can’t catch their breath.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<h2>SARS-CoV-2 has turned everything upside down</h2>
<p>The presence of SARS-CoV-2 marks the principal difference from the pre-pandemic era, since it is augmenting the burden on an already weakened health-care system. The challenge is amplified by the extremely high transmission capacity of SARS-CoV-2 compared with influenza and RSV, which makes seasonal management much more complex.</p>
<p>Until the SARS-CoV-2 pandemic, the respiratory virus season had a fairly predictable beginning and end that was determined by virus surveillance over the years. Our systems were already struggling to absorb this seasonal increase in patients. But today, the picture has become even more complex with the continuing presence of SARS-CoV-2. And our hospitals, with no time to catch their breath, are struggling to keep up.</p>
<h2>Beyond infection</h2>
<p>The second major difference that should not be overlooked is SARS-CoV-2’s ability to cause widespread health problems well beyond the respiratory system. In addition, it causes long-term consequences after infection, such as post-COVID syndrome (also known as long COVID), which affects millions of people.</p>
<p>The extent of the consequences of infection and reinfection on human health remains uncertain, as does the effectiveness of vaccines in limiting these effects. The SARS-CoV-2 pandemic – with its exceptional transmission levels – has produced a large number of patients available for research. Coupled with unprecedented funding, this has made it possible to undertake research that has never been possible before on a post-viral syndrome.</p>
<p>Of course, the number of people infected with RSV or influenza globally each year does not even come close to the number infected with SARS-CoV-2, even at this stage of the pandemic. However, there is considerable evidence that, in addition to the acute symptoms and mortality associated with influenza and RSV, <a href="https://doi.org/10.1038/s41591-022-01810-6">post-viral conditions also exist</a>, as they do with SARS-CoV-2.</p>
<h2>The importance of vaccines</h2>
<p>The final distinction from the pre-pandemic period is the arrival of RSV vaccines. In Canada, the Arexvy vaccine has been approved for people over 60, and the Abrysvo vaccine was also approved for pregnant women, providing immunity to children from birth. However, these two vaccines have not yet been officially recommended. We are still waiting for a vaccine to be made available for children. The trio of vaccines against COVID-19, influenza and RSV will certainly help to reduce the severe symptoms associated with respiratory virus infections in the coming seasons.</p>
<p>However, our primary objective must be to reduce the incidence of respiratory virus infections. Despite vaccination, we can expect the mortality and morbidity associated with these infections to increase as the population ages.</p>
<p>All three viruses share a common trait — they spread through the air. Their transmission could be reduced by implementing passive strategies aimed at reducing the concentration of aerosols in indoor air.</p><img src="https://counter.theconversation.com/content/220980/count.gif" alt="La Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Nathalie Grandvaux received research funding from the Canadian Institutes of Health Research (CIHR), the Natural Sciences and Engineering Research Council of Canada (NSERC), the Fonds de recherche du Québec - Santé (FRQS), the Canada Foundation for Innovation (CFI), the Fondation du centre hospitalier de l'Université de Montréal, and the Ministère de l'économie et de l'innovation du Québec.</span></em></p>The current triple epidemic of respiratory viruses is affecting all age groups, prompting comparisons with the pre-COVID-19 era.Nathalie Grandvaux, Professeure en biochimie des interactions hôte-virus, Université de MontréalLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2099622024-01-15T19:18:02Z2024-01-15T19:18:02ZWorking from home since COVID-19? Cabin fever could be the next challenge<figure><img src="https://images.theconversation.com/files/568741/original/file-20240110-25-1xi2zx.jpg?ixlib=rb-1.1.0&rect=16%2C92%2C5590%2C3640&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Being confined to our homes for long periods without access to different activities can expose teleworkers to cabin fever.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><iframe style="width: 100%; height: 100px; border: none; position: relative; z-index: 1;" allowtransparency="" allow="clipboard-read; clipboard-write" src="https://narrations.ad-auris.com/widget/the-conversation-canada/working-from-home-since-covid-19-cabin-fever-could-be-the-next-challenge" width="100%" height="400"></iframe>
<p>As Canada opened back up after the COVID-19 lockdowns, many businesses encouraged their workers to head back to the office. Yet, despite restrictions being lifted in Canada and around the world, teleworking as a regular working arrangement has remained <a href="https://www.theglobeandmail.com/business/careers/leadership/article-while-most-canadians-prefer-working-from-home-survey-highlights/">popular across different industries</a>. </p>
<p>Different polls over the last three years show an increased interest in teleworking among Canadian workers. The polls indicated that many <a href="https://financialpost.com/fp-work/canadians-work-from-home-more">Canadians prefer teleworking</a> and some <a href="https://globalnews.ca/news/8812305/canadian-workers-remote-jobs-ipsos-poll/">would consider changing careers to maintain their teleworking status</a>. </p>
<p>The popularity of teleworking seems obvious enough. <a href="https://doi.org/10.1016/S0921-3449(02)00082-4">It provides more flexibility</a>, <a href="https://doi.org/10.1016/j.jtrangeo.2006.12.004">reduces the need to commute</a> and can <a href="https://researchbank.swinburne.edu.au/items/3e7c083c-e708-4a31-bf86-a522d65637a1/1/">improve productivity</a>, among other indirect benefits. </p>
<p>However, being confined to our homes for long periods without access to different activities can expose teleworkers to cabin fever, <a href="https://www.medicalnewstoday.com/articles/cabin-fever#signs">a lack of motivation and anxiety</a>. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/568743/original/file-20240110-21-p8398h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A man with a young child in his lap working on a laptop." src="https://images.theconversation.com/files/568743/original/file-20240110-21-p8398h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/568743/original/file-20240110-21-p8398h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=431&fit=crop&dpr=1 600w, https://images.theconversation.com/files/568743/original/file-20240110-21-p8398h.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=431&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/568743/original/file-20240110-21-p8398h.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=431&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/568743/original/file-20240110-21-p8398h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=541&fit=crop&dpr=1 754w, https://images.theconversation.com/files/568743/original/file-20240110-21-p8398h.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=541&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/568743/original/file-20240110-21-p8398h.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=541&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Teleworkers can find contentment in having more daily interactions with their partners, children and immediate family.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<h2>Benefits and downsides of remote work</h2>
<p>In a <a href="https://doi.org/10.1007/978-981-19-9822-5_175">recently published study</a>, we conducted extensive interviews with 14 teleworkers who moved during the first two years of the COVID-19 pandemic. We found that remote working arrangements enabled some people to move away from big cities and economic centres to purchase homes in more affordable areas. In some cases, teleworkers were able to achieve better living standards that were not possible without teleworking. </p>
<p>Another indirect impact of telework was the health benefits associated with higher productivity and less commuting. Most of us have first-hand experience of exhaustion after long commutes in the morning and back from work in the afternoon. That fatigue can often leave us feeling spent. Not needing to commute means we can be more productive and accomplish more with our day.</p>
<p>There are other indirect benefits like having more time to cook meals at home, eating healthier, <a href="https://www.theglobeandmail.com/business/article-canadians-savings-stockpile-is-a-300-billion-quandary-for-the/">having increased financial flexibility</a> and improved overall quality of life.</p>
<p>However, along with all these benefits, there are some downsides that people should consider before signing up for remote work. If you plan to move away from the city to a more affordable area, <a href="https://doi.org/10.1080/00038628.2023.2253780">our research shows you will probably become car dependent</a>. </p>
<p>Moving away might also mean leaving friends and family behind. That means you either need to travel farther to visit them, resulting in higher travel costs, or you will not see them as often as you’d like. </p>
<p>That might be fine for some, but others might need a significant degree of social interaction while working from home. Not being able to see family and friends as often can be isolating and detrimental to our well-being.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/568744/original/file-20240110-22-4hv48m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A woman wearing exercise clothes sits on a floor using a laptop. Dumbbells are on he floor beside her." src="https://images.theconversation.com/files/568744/original/file-20240110-22-4hv48m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/568744/original/file-20240110-22-4hv48m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=370&fit=crop&dpr=1 600w, https://images.theconversation.com/files/568744/original/file-20240110-22-4hv48m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=370&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/568744/original/file-20240110-22-4hv48m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=370&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/568744/original/file-20240110-22-4hv48m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=466&fit=crop&dpr=1 754w, https://images.theconversation.com/files/568744/original/file-20240110-22-4hv48m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=466&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/568744/original/file-20240110-22-4hv48m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=466&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Small actions such as short walks, exercising and social interactions can help reduce cabin fever.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<h2>Dealing with cabin fever</h2>
<p>Teleworkers might experience reduced social interactions after a while or have reduced physical activity. Being at home for extended periods of time can leave some feeling like they’re experiencing <a href="https://doi.org/10.1016/j.shaw.2021.01.010">cabin fever</a>. The symptoms of cabin fever include <a href="https://www.medicalnewstoday.com/articles/cabin-fever">irritability, feelings of restlessness and loneliness</a>.</p>
<p>Habits and behaviours might change over time after moving away or working fully remotely. Behavioural changes can encompass a broad spectrum, including but not limited to shifts in transportation mode, thermostat setpoints, physical activity and numerous other traits, all of which can significantly impact both the lives of teleworkers and the environment.</p>
<p>Some teleworkers find contentment in having more social interactions with their partners, children and family. Others might need a certain degree of social interaction with their co-workers in the office. And some other individuals might need active social interactions with their friends, family members, and co-workers. </p>
<p>Teleworking without social interaction or physical activity can lead to cabin fever in the long run. Most of us who worked during lockdowns experienced the urge to leave the home even for a short walk. Small actions such as short walks, exercising and social interactions can help reduce cabin fever. Teleworkers should constantly be aware of such impacts of teleworking that can impact their quality of life in the long run. </p>
<p>Whether moving away from the city or staying downtown, working fully remotely can trigger cabin fever if teleworkers develop bad habits and behaviours. To avoid such problems in the long run, remote workers should consider how they can maintain social interactions, physical activity, and other wellness practices. Such activities can provide necessary breaks from the confines of their homes, helping to prevent cabin fever and foster healthy teleworking habits and behaviours.</p><img src="https://counter.theconversation.com/content/209962/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>While teleworking can come with many benefits, being alone at home can leave us feeling isolated and unmotivated.Farzam Sepanta, PhD Candidate, Building Engineering, Carleton UniversityLaura Arpan, Professor, Department of Communication, University at BuffaloLiam O'Brien, Professor in Architectural Conservation and Sustainability Engineering, Carleton UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2208392024-01-11T04:25:31Z2024-01-11T04:25:31ZCOVID is surging in Australia – and only 1 in 5 older adults are up to date with their boosters<figure><img src="https://images.theconversation.com/files/568784/original/file-20240111-24-quhz9r.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C4928%2C3253&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/attentive-caregiver-companion-senior-adult-woman-1796298544">verbaska/Shutterstock</a></span></figcaption></figure><p>Do you have family members or friends sick with a respiratory infection? If so, there’s a good chance it’s COVID, caused by the JN.1 variant currently circulating in Australia.</p>
<p>In particular, New South Wales is reportedly experiencing its <a href="https://www.abc.net.au/news/2024-01-09/nsw-sydney-covid-variant-virus-pandemic-hospitalisations/103298610">highest levels</a> of COVID infections in a year, while Victoria is said to be facing a “<a href="https://www.9news.com.au/national/victoria-in-midst-of-double-wave-of-covid19--as-jn1-triggers-infections-surge/4dada2cb-7d56-436a-9490-cad1d908a29a">double wave</a>” after a surge late last year.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1744443029883408695"}"></div></p>
<p>But nearly four years into the pandemic, data collection is less comprehensive than it was, and of course, fewer people are testing. So what do we know about the extent of this wave? And importantly, are we adequately protected?</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/i-have-covid-how-likely-am-i-to-get-long-covid-218808">I have COVID. How likely am I to get long COVID?</a>
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</em>
</p>
<hr>
<h2>Difficulties with data</h2>
<p>Tracking COVID numbers was easier in the first half of last year, when each state and territory provided a weekly update, giving us data on case notifications, hospitalisations, ICU numbers and deaths. </p>
<p>In the second half of the year some states and territories switched to less frequent reporting while others stopped their regular updates. As a result, different jurisdictions now report at different intervals and provide varying statistics. </p>
<p>For example, <a href="https://www.health.vic.gov.au/infectious-diseases/victorian-covid-19-surveillance-report">Victoria</a> still provides weekly reports, while NSW publishes <a href="https://www.health.nsw.gov.au/Infectious/covid-19/Documents/respiratory-surveillance-20240106.pdf">fortnightly updates</a>. </p>
<p>While each offer different metrics, we can gather – particularly from data on hospitalisations – that both states are experiencing a wave. We’re also seeing high levels of COVID <a href="https://www.health.vic.gov.au/infectious-diseases/victorian-covid-19-surveillance-report">in wastewater</a>.</p>
<p>Meanwhile, <a href="https://health.nt.gov.au/covid-19/data">Northern Territory Health</a> simply tell you to go to the Australian government’s Department of Health website for COVID data. This houses the only national COVID <a href="https://www.health.gov.au/topics/covid-19/reporting?language=und">data collection</a>. Unfortunately, it’s not up to date, difficult to use, and, depending on the statistic, often provides no state and territory breakdowns. </p>
<p>Actual case notifications are provided on a separate <a href="https://nindss.health.gov.au/pbi-dashboard/">website</a>, although given the lack of testing, these are likely to be highly inaccurate. </p>
<p>The <a href="https://www.health.gov.au/topics/covid-19/reporting?language=und">Department of Health website</a> does provide some other data that gives us clues as to what’s happening. For example, as of one month ago, there were 317 active outbreaks of COVID in aged care homes. This figure has been generally rising since September.</p>
<p>Monthly prescriptions for antivirals on the Pharmaceutical Benefits Scheme were increasing rapidly in November, but we are not given more recent data on this.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/were-in-a-new-covid-wave-what-can-we-expect-this-time-216820">We're in a new COVID wave. What can we expect this time?</a>
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</em>
</p>
<hr>
<p>It’s also difficult to obtain information about currently circulating strains. Data expert Mike Honey provides a regularly updated <a href="https://github.com/Mike-Honey/covid-19-genomes?tab=readme-ov-file#readme">snapshot</a> for Australia based on data from GISAID (the Global Initiative on Sharing All Influenza Data) that shows JN.1 rising in prevalence and accounting for about 40% of samples two weeks ago. The proportion is presumably higher now. </p>
<h2>What’s happening elsewhere?</h2>
<p>Many other countries are currently going through a COVID wave, probably driven to a large extent by JN.1. These include <a href="https://www.rnz.co.nz/news/national/506301/covid-19-complacency-waning-immunity-contribute-to-fifth-wave-epidemiologist">New Zealand</a>, <a href="https://www.independent.co.uk/news/world/europe/facemasks-mandatory-spain-hospitals-b2475563.html">Spain, Greece</a> and the United States. </p>
<p>According to cardiologist and scientist Eric Topol, the US is currently experiencing its <a href="https://www.latimes.com/opinion/story/2024-01-04/covid-2024-flu-virus-vaccine">second biggest wave</a> since the start of the pandemic, linked to JN.1.</p>
<h2>Are vaccines still effective?</h2>
<p>It’s expected the current COVID vaccines, which target the omicron variant XBB.1.5, are still <a href="https://www.gavi.org/vaccineswork/seven-things-you-need-know-about-jn1-covid-19-variant">effective</a> at reducing hospitalisations and deaths from JN.1 (also an omicron offshoot). </p>
<p>The Australian Technical Advisory Group on Immunisation (ATAGI) updated their <a href="https://www.health.gov.au/news/atagi-update-on-the-covid-19-vaccination-program">advice</a> on booster shots in September last year. They recommended adults aged over 75 should receive an additional COVID vaccine dose in 2023 if six months had passed since their last dose.</p>
<p>They also suggest all adults aged 65 to 74 (plus adults of any age who are severely immunocompromised) should consider getting an updated booster. They say younger people or older adults who are not severely immunocompromised and have already had a dose in 2023 don’t need further doses.</p>
<p>This advice is very confusing. For example, although ATAGI does not recommend additional booster shots for younger age groups, does this mean they’re not allowed to have one? </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/what-are-the-new-covid-booster-vaccines-can-i-get-one-do-they-work-are-they-safe-217804">What are the new COVID booster vaccines? Can I get one? Do they work? Are they safe?</a>
</strong>
</em>
</p>
<hr>
<p>In any case, as of <a href="https://www.health.gov.au/resources/publications/covid-19-vaccine-rollout-update-8-december-2023?language=en">December 6</a>, only 19% of people aged 65 and over had received a booster shot in the last six months. For those aged 75 and over, this figure is 23%. Where is the messaging to these at-risk groups explaining why updating their boosters is so important?</p>
<h2>Should we be concerned by this wave?</h2>
<p>That depends on who we mean by “we”. For those who are vulnerable, absolutely. Mainly because so few have received an updated booster shot and very few people, including the elderly, are wearing masks. </p>
<p>For the majority of people, a COVID infection is unlikely to be serious. The biggest concern for younger people is the risk of long COVID, which research suggests <a href="https://www.nature.com/articles/s41591-022-02051-3">increases</a> with each reinfection.</p>
<figure class="align-center ">
<img alt="A hand holds a positive COVID test, surrounded by other rapid tests." src="https://images.theconversation.com/files/568788/original/file-20240111-29-l6vgvy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/568788/original/file-20240111-29-l6vgvy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/568788/original/file-20240111-29-l6vgvy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/568788/original/file-20240111-29-l6vgvy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/568788/original/file-20240111-29-l6vgvy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/568788/original/file-20240111-29-l6vgvy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/568788/original/file-20240111-29-l6vgvy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">COVID cases are surging.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/rapid-lateral-flow-test-devices-show-2331207181">BBA Photography/Shutterstock</a></span>
</figcaption>
</figure>
<h2>What should we expect in 2024?</h2>
<p>It’s highly likely we will see repeated waves of infections over the next 12 months and beyond, mainly caused by waning immunity from previous infection, vaccination or both, and new subvariants. </p>
<p>Unless a new subvariant causes more severe disease (and at this stage, there’s no evidence JN.1 does), we should be able to manage quite well, without our hospitals becoming overwhelmed. However, we should be doing more to protect our vulnerable population. Having only one in five older people up to date with a booster and more than 300 outbreaks in aged care homes is not acceptable. </p>
<p>For those who are vulnerable, the usual advice applies. Make sure you’re up to date with your booster shots, wear a P2/N95 mask when out and about, and if you do get infected, take antivirals as soon as possible.</p><img src="https://counter.theconversation.com/content/220839/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Adrian Esterman does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Another year, another COVID wave. Here’s what we know about what the virus is doing around the country.Adrian Esterman, Professor of Biostatistics and Epidemiology, University of South AustraliaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2185102024-01-09T19:15:38Z2024-01-09T19:15:38ZWanting to ‘move on’ is natural – but women’s pandemic experiences can’t be lost to ‘lockdown amnesia’<p>The COVID-19 pandemic was – and continues to be – hugely disruptive and stressful for individuals, communities and countries. Yet many seem desperate to close the chapter entirely, almost as if it had never happened. </p>
<p>This desire to <a href="https://www.washingtonpost.com/wellness/2023/03/13/brain-memory-pandemic-covid-forgetting/">forget and move on</a> – labelled “<a href="https://www.ft.com/content/be70b24e-8ca0-4681-a23b-0c59c69a2616">lockdown amnesia</a>” by some – is understandable at one level. But it also risks missing the opportunity to learn from what happened.</p>
<p>And while various official enquiries and royal commissions have been established to examine the wider government responses (including in New Zealand), the experiences of ordinary people are equally important to understand.</p>
<p>As researchers interested in women and gender roles, we wanted to capture some of this. For the past three years, our research has focused on what happened to everyday women during this period of uncertainty and disruption – and what lessons might be learned.</p>
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<h2>Pandemic amnesia</h2>
<p>Individual memory can become vague as time goes on. But this can also be affected by broader narratives (in the media or official responses) that overwrite our own recollections of the pandemic.</p>
<p>Political calls to “<a href="https://www.mdpi.com/2076-0760/11/8/340">live with the virus</a>”, and <a href="https://www.rnz.co.nz/national/programmes/mediawatch/audio/2018849569/sick-and-tired-of-the-sickness">media hesitancy</a> to publish COVID-related stories due to perceived audience fatigue, can create a collective sense of needing to “move on”. Looking back can be seen as questionable, or even attacked.</p>
<p>Indeed, misinformation and disinformation have been used, <a href="https://www.routledge.com/Risk/Lupton/p/book/9781032327006">in the words</a> of leading pandemic social scientist Deborah Lupton, to “challenge science and manufacture dissent against attempts to tackle [such] crises”.</p>
<p>But as the memory scholar <a href="https://journals.sagepub.com/doi/pdf/10.1177/17506980231184563?casa_token=Wrs8pMKoFqcAAAAA:N9DN9rb9XNopHSIF2af2q8z4Ue457oW6l-mqPtBlmUQSy6dw53DYhQWxgk8BLe3SyWIzlkXTnvAPrYw">Sydney Goggins has put it</a>, such “public forgetting leads to a cascade of impacts on policy and social wellbeing”.</p>
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<strong>
Read more:
<a href="https://theconversation.com/jacinda-arderns-resignation-gender-and-the-toll-of-strong-compassionate-leadership-198152">Jacinda Ardern's resignation: gender and the toll of strong, compassionate leadership</a>
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<h2>A gendered pandemic</h2>
<p>Responding to the rapidly changing social, cultural and economic impacts of the pandemic, feminist scholars have highlighted the particular <a href="https://www.frontiersin.org/Articles/10.3389/Fgwh.2020.588372/Full">physical and emotional toll</a> on women worldwide.</p>
<p>This has included <a href="https://academic.oup.com/biomedgerontology/article/77/Supplement_1/S31/6463712">social isolation and loneliness</a>, increased <a href="https://www.tandfonline.com/doi/full/10.1080/15487733.2020.1776561?src=recsys">domestic and emotional labour</a>, the rise in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7262164/">domestic and gender-based violence</a>, <a href="https://www.tandfonline.com/doi/full/10.1080/13545701.2021.1876906">job losses and financial insecurity</a>. Black, Indigenous, minority and migrant women have <a href="https://journals.sagepub.com/doi/full/10.1177/08912432211001302">felt these impacts</a> particularly keenly.</p>
<p>The <a href="https://search.informit.org/doi/abs/10.3316/informit.777013552598989">same trends</a> have been observed in Aotearoa New Zealand. And whereas some countries embraced pandemic recovery strategies that recognised these gender differences, this <a href="https://theconversation.com/nz-budget-2021-women-left-behind-despite-the-focus-on-well-being-161187">hasn’t been the case</a> in New Zealand.</p>
<p>The gendered abuse of women leaders – former prime minister <a href="https://theconversation.com/jacinda-arderns-resignation-gender-and-the-toll-of-strong-compassionate-leadership-198152">Jacinda Ardern</a> and scientist <a href="https://www.rnz.co.nz/national/programmes/atthemovies/audio/2018913516/review-ms-information">Siouxsie Wiles</a>, for example – have been well documented. But the experiences of ordinary women, their struggles and strategies to look after themselves and others, have had much less attention.</p>
<h2>Experiences of everyday women</h2>
<p>Our study involved 110 women in Aotearoa New Zealand. We set out to understand how they adapted their everyday practices – work, leisure, exercise, sport – to maintain or regain wellbeing, social connections and a sense of community.</p>
<p>Despite many differences between the women in our sample, there were also shared experiences. We referred to the ruptures in the patterns, rhythms and routines of their lives as “<a href="https://onlinelibrary.wiley.com/doi/full/10.1111/gwao.12987">gender arrhythmia</a>”.</p>
<p>The women responded to the psycho-social and physical challenges, such as disrupted sleep or weight changes, by creating counter-rhythms – taking up hobbies, exercising, changing diet.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/the-pandemics-disproportionate-impact-on-women-is-derailing-decades-of-progress-on-gender-equality-180941">The pandemic’s disproportionate impact on women is derailing decades of progress on gender equality</a>
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<p>The pandemic also prompted many to reflect on how their pre-pandemic routines and rhythms had caused various forms of “alienation”: from their own health and wellbeing, meaningful social connections, ethical and sustainable work practices, and pleasure.</p>
<p>The disruption of the pandemic caused many to reevaluate the importance of work in their lives. As one reflected: </p>
<blockquote>
<p>COVID-19 has made me reassess what is the most important thing. Is it making money? Actually, no, not at all.</p>
</blockquote>
<p>Others were prompted to question and challenge the gendered demands on women to “do everything” and “be everywhere” for everyone:</p>
<blockquote>
<p>I think as women, because we’re so good at multitasking, we just put so much on our plates. I think we need to learn just to say no, because we’re not superhuman. And ultimately, all of this responsibility is weighing us down.</p>
</blockquote>
<p>Our research also highlighted how the pandemic affected women’s relationships with <a href="https://www.sciencedirect.com/science/article/pii/S1755458623000270?casa_token=KcmGBPnpKLQAAAAA:MmQhDue20CoR0f6lK8rjWfxtBSHsjpzjbJu8tIc03StdccyCvduAs3CUVPwk18rPbklx3_j8DEo">familiar spaces and places</a>. Leaving home for a walk, run or bike ride became important everyday practices that proved highly beneficial for most women’s subjective wellbeing. </p>
<p>Some came to <a href="https://journals.sagepub.com/doi/abs/10.1177/01937235231200288">appreciate physical activity</a> for the general joys of movement and connection with people and places, rather than simply to achieve particular goals like fitness or weight loss. </p>
<h2>Special challenges for young women</h2>
<p>As part of our overall project, we also <a href="https://www.tandfonline.com/doi/full/10.1080/13668803.2023.2268818?needAccess=true">focused on 45 young women</a> (aged 16 to 25). This highlighted the importance of recognising how gender, ethnicity and socioeconomic circumstances intersect. </p>
<p>Listening to their <a href="https://www.tepunahamatatini.ac.nz/2023/11/07/the-invisible-glue-holding-families-together-during-the-pandemic/">pandemic stories</a>, we found young women played important roles in supporting their families and communities. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/covid-19-has-laid-bare-how-much-we-value-womens-work-and-how-little-we-pay-for-it-136042">COVID-19 has laid bare how much we value women's work, and how little we pay for it</a>
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<p>In particular, Māori, Pacific and others from diverse ethnic or migrant backgrounds carried increased responsibilities in the home, including childcare, cleaning, cooking and shopping. While many did so willingly, these extra burdens took a toll on their schooling, mental health and wellbeing.</p>
<p>For many young women, the pandemic was a radical disruption to their everyday lives and routines during a critical stage of identity development. They missed key milestones and events, and crucial phases of education and social development. </p>
<p>Many still grieve for some of those losses. And some are struggling to rebuild social connections, motivation and aspirations.</p>
<p>For example, some described being passionate and aspiring athletes before the pandemic. But social anxieties and body-image issues left over from lockdowns have been hard to shake, and have seen them <a href="https://www.mdpi.com/2673-995X/3/3/55">struggle to return</a> to sport. </p>
<h2>The invisible work of migrant women</h2>
<p>We also looked deeply at the experiences of <a href="https://link.springer.com/chapter/10.1007/978-3-031-38797-5_9">12 middle-class migrant women</a>, and how prolonged border closures created real anxiety about “not being there” for families overseas. </p>
<p>As one nurse working on the front line of COVID care in NZ explained:</p>
<blockquote>
<p>About a year ago, the cases of COVID in my homeland were increasing so rapidly. My family were not very well and I was depending on social media […] trying to reach out to them. I was really scared at that time, not being able to see your family when they really need you, not being able to be with them.</p>
</blockquote>
<p>Some of the women in our sample also experienced <a href="https://www.tandfonline.com/doi/full/10.1080/14649365.2023.2275761">increased anti-immigrant sentiments</a> which further affected their health and wellbeing – and their feelings of belonging. As one said:</p>
<blockquote>
<p>I’ve become extremely sensitive. I cry about small things. My doctor said “go and get some fresh air, it’s good for you” […] I went outside for a walk, and someone shouted at me, screamed at me. I got terrified for my life. How do you expect me to have wellbeing when no one in the society accepts you?</p>
</blockquote>
<p>This arm of the research suggests a real need for <a href="https://www.belong.org.nz/migrant-experiences-in-the-time-of-covid">investment in policies and support strategies</a> specifically for migrant women and their communities in any future global health emergency.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/new-zealanders-are-learning-to-live-with-covid-but-does-that-mean-having-to-pay-for-protection-ourselves-219698">New Zealanders are learning to live with COVID – but does that mean having to pay for protection ourselves?</a>
</strong>
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</p>
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<h2>Communities of care</h2>
<p>A key feature of our study was the highly creative ways women cultivated “<a href="https://journals.sagepub.com/doi/full/10.1177/2043820620934268">communities of care</a>” during the pandemic. Even when they were struggling themselves, they reached out to friends and family – and particularly other women. </p>
<p>The majority of our participants were prompted to think differently about their own health and wellbeing, and what is important in their lives (now and in the future). </p>
<p>Throughout the pandemic, women have worked quietly, behind the scenes, in their families, communities and workplaces, supporting their own and others’ health and wellbeing. This invisible labour is rarely acknowledged or celebrated. </p>
<p>Many still feel the toll of economic hardship, violence and exhaustion. And less tangible feelings of disillusionment remain in a society that has so quickly “moved on” from the pandemic.</p>
<p>Acknowledging and addressing pandemic amnesia – personal and collective – is an important first step in documenting, learning from, and using these experiences to <a href="https://www.sciencedirect.com/science/article/pii/S0277953622008176">better prepare for future events</a>. Next time, we need to ensure the necessary support is available for those most in need.</p>
<hr>
<p><em>The authors wish to acknowledge the other members of the research team: Dr Nikki Barrett, Dr Julie Brice, Dr Allison Jeffrey and Dr Anoosh Soltani.</em></p>
<hr><img src="https://counter.theconversation.com/content/218510/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Holly Thorpe receives funding from a Royal Society Te Apārangi James Cook Research Fellowship.</span></em></p><p class="fine-print"><em><span>Grace O'Leary, Mihi Joy Nemani, and Nida Ahmad do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>COVID was a ‘gendered pandemic’, with women carrying very different burdens to men. A three-year New Zealand research project aimed to overcome the urge to forget, and provide lessons for the future.Holly Thorpe, Professor in Sociology of Sport and Gender, University of WaikatoGrace O'Leary, Research Fellow, University of WaikatoMihi Joy Nemani, Senior Lecturer, Te Huataki Waiora School of Health, University of WaikatoNida Ahmad, Research Fellow, University of WaikatoLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2204842024-01-09T13:42:19Z2024-01-09T13:42:19ZSome believe the 1889 Russian flu pandemic was actually caused by a coronavirus – here’s why that’s unlikely<p>COVID-19 was the first coronavirus pandemic. The original Sars virus from 2003 and the Mers virus that created a health emergency in South Korea <a href="https://theconversation.com/explainer-what-is-the-mers-outbreak-in-south-korea-43344">in 2015</a> were both coronaviruses, but fortunately failed to turn into pandemics in the way that COVID did. </p>
<p>Four years on from its appearance, Sars-CoV-2 (the virus that causes COVID) now seems to be making the transition to an <a href="https://www.unc.edu/discover/covid-19-has-become-endemic/">endemic virus</a>: one that circulates in humans all the time, at least somewhere in the world. As is common in respiratory viruses, it also seems to be developing a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9994397/">seasonal preference</a> for the colder, wetter times of the year.</p>
<p>But Sars-CoV-2 isn’t alone. There are four other <a href="https://theconversation.com/coronaviruses-a-brief-history-135506">circulating coronaviruses</a>, named OC43, NL63, HKU-1 and 229E. The consensus is that these viruses are also descendants of past pandemics and that Sars-CoV-2 is just the latest member of their club. </p>
<p>This theory is based on the model provided by influenza viruses, where the familiar seasonal flus H3N2 and H1N1 are the descendants of the flu pandemics of <a href="https://www.britannica.com/event/1968-flu-pandemic">1968</a> and <a href="https://www.who.int/emergencies/situations/influenza-a-(h1n1)-outbreak">2009</a>, respectively.</p>
<h2>Pinning a date on the last coronavirus pandemic</h2>
<p>But when could these supposed four previous coronavirus pandemics have occurred? </p>
<p>The 19th century had three flu pandemics and so did the 20th century. We can read about these in the medical journals and newspapers of the time. However, we cannot do the same for coronavirus pandemics as the very idea of such a thing only reared its head with Sars-CoV-1 in 2003 (which caused severe acute respiratory syndrome or <a href="https://www.who.int/health-topics/severe-acute-respiratory-syndrome#tab=tab_1">Sars</a>). </p>
<p>Surely a past pandemic of COVID-like coronavirus pneumonia would have made the news? Or are we missing something?</p>
<p>Scientific interest in this topic has focused on one particular member of the endemic coronavirus quartet: OC43. Genome sequencing tells us it is closely related to bovine coronavirus. </p>
<figure class="align-center ">
<img alt="OC43 virions taken with a transmission electron microscopic." src="https://images.theconversation.com/files/567848/original/file-20240104-15-q5itn3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/567848/original/file-20240104-15-q5itn3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=394&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567848/original/file-20240104-15-q5itn3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=394&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567848/original/file-20240104-15-q5itn3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=394&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567848/original/file-20240104-15-q5itn3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=495&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567848/original/file-20240104-15-q5itn3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=495&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567848/original/file-20240104-15-q5itn3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=495&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">OC43 virions taken with a transmission electron microscopic.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/w/index.php?curid=89425412">CDC/Erskine Palmer</a></span>
</figcaption>
</figure>
<p>Indeed, in 2005, the date for its zoonotic transmission – meaning the jump from cattle to humans – was roughly calculated as sometime <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC544107/">between 1870 and 1890</a>. </p>
<p>The historical veterinary record confirms there was an unexplained disease circulating globally in cattle at that time. Could it have jumped to humans, kicking off an <a href="https://www.theguardian.com/world/2020/may/31/did-a-coronavirus-cause-the-pandemic-that-killed-queen-victorias-heir">OC43 pandemic</a>? </p>
<p>Suspiciously, the pandemic of “Russian influenza” began in 1889 and ran well into 1893. Was that pandemic, always supposed to be influenza, really the last coronavirus pandemic prior to COVID? </p>
<p>The idea has caught on, even receiving a mention in the UK COVID <a href="https://covid19.public-inquiry.uk/wp-content/uploads/2023/06/14181206/INQ000207453_1.pdf">public enquiry</a>.</p>
<h2>Or was it flu after all?</h2>
<p>Flu virologists are unconvinced. Although the oldest flu genome sequences are those recovered from the frozen bodies of Alaskan victims of the <a href="https://theconversation.com/world-war-ones-role-in-the-worst-ever-flu-pandemic-29849">devastating 1918-20 influenza pandemic</a>, there is another way to investigate the ancient history of flu: seroarchaeology. </p>
<p>This method takes old blood samples out of the freezer and mixes them with flu viruses. An immunological reaction indicates that the blood sample contains antibodies to the specific types of flu viruses in the experiment. This implies that the person from whom the sample was taken successfully fended off such a flu virus at some time in their lives. </p>
<p>Seroarchaeology on archived blood samples shows that well before the H3N2 flu pandemic of 1968, there were elderly people in the population who mysteriously already had antibodies to similar types of flu viruses. And back in 1968, it had already been observed that older people had better survival rates than young ones, contrary to the usual pattern in influenza outbreaks. </p>
<p>Those octogenarians of 1968 had all been around in 1889-1893. The combination of that clinical observation and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4050607/">further seroarchaeology</a> pinned down the pandemic of 1889-1893 to an influenza of type H3N8.</p>
<h2>But if not 1889, then when?</h2>
<p>The OC43 pandemic theory thus disappeared off the scientific radar. But it left a question: if the 1889-1893 pandemic was influenza H3N8, then when did OC43 make its zoonotic leap from cattle to humans? </p>
<p>A study <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0285481">from 2023</a> examined all the OC43 virus genome information that has accumulated since the original study. The date of the zoonotic transfer from cattle to humans was recalculated, using the latest generation of virus genome analysis software, at 1899-1900. </p>
<p>Examination of the total <a href="https://theconversation.com/why-excess-deaths-have-varied-so-greatly-around-the-world-during-the-pandemic-172255">excess deaths</a> per million of population in England and Wales over 1899 and 1900 gave a figure of 1,576 deaths per million, less than the 2,275 deaths per million for the Russian influenza, but only just short of the 1,866 deaths per million for the two worst COVID years of 2020 and 2021.</p>
<p>So why was this OC43 pandemic not spotted before? The answer is that the pneumonia epidemic of 1899-1900 had always been dismissed as a late wave of the 1889-1893 influenza. The missing coronavirus pandemic had been hiding in plain sight.</p><img src="https://counter.theconversation.com/content/220484/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Derek Gatherer does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The mysterious case of the OC43 coronavirus pandemic.Derek Gatherer, Lecturer, Biomedical and Life Sciences, Lancaster UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2194742024-01-07T12:34:38Z2024-01-07T12:34:38ZNeighbourhood amenities may have helped youth mental health and stress early in the pandemic<figure><img src="https://images.theconversation.com/files/567975/original/file-20240105-25-yskfll.jpg?ixlib=rb-1.1.0&rect=245%2C1003%2C3621%2C1984&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Researchers investigated how the availability of neighbourhood amenities may have contributed to changes in youth mental health and stress levels during the first six months of the pandemic.</span> <span class="attribution"><span class="source">(Unsplash/Paul Hanaoka)</span></span></figcaption></figure><iframe style="width: 100%; height: 100px; border: none; position: relative; z-index: 1;" allowtransparency="" allow="clipboard-read; clipboard-write" src="https://narrations.ad-auris.com/widget/the-conversation-canada/neighbourhood-amenities-may-have-helped-youth-mental-health-and-stress-early-in-the-pandemic" width="100%" height="400"></iframe>
<p>During the COVID-19 pandemic, youth as a population group <a href="https://www150.statcan.gc.ca/n1/daily-quotidien/210201/dq210201b-eng.htm">reported some of the largest declines in their mental health</a> compared to other age groups in Canada. </p>
<p>Research on youth mental health during the pandemic has focused on <a href="https://www.facetsjournal.com/doi/full/10.1139/facets-2021-0096">poor academic engagement</a>, <a href="https://doi.org/10.1139/facets-2021-0080">loss of peer networks</a>, <a href="https://doi.org/10.1016/S2352-4642(20)30109-7">missed milestone events</a> and <a href="https://doi.org/10.1186/s13034-023-00653-4">challenging summer employment experiences</a>. Yet little is known about how the places where young people lived played a role in changes to their mental health during the pandemic.</p>
<p>From walking in a park to ordering takeout food, there was not much to do out in public during the early months of the pandemic. Youth were attending school remotely and no longer participating in organized sports and indoor recreation. </p>
<p>For many, that meant their daily activities outside the home often consisted of what could be reached within walking distance of where they lived. Parks and food-related retail became the main places for physically distanced social interactions. They became a break in the routines of remote school, activities and virtual social networks available at home.</p>
<h2>Neighbourhood amenities</h2>
<p><a href="https://doi.org/10.1080/23748834.2023.2282850">Our study</a> included Canadian youth between the ages of 13 and 19 in London, Ont. We investigated how the availability of neighbourhood amenities may have contributed to positive or negative changes in mental health — interpreted as their own perception of their mood and outlook on life — and stress levels during the first six months of the pandemic.</p>
<p>Amenities included parks, food outlets and convenience stores in close proximity to home.</p>
<p>We investigated whether these amenities could have protected against declines in mental health and increases in stress levels, and also if youth living in suburban neighbourhoods had different perceptions of mental health and stress levels than those living in urban ones.</p>
<h2>The missing role of parks</h2>
<p>Surprisingly, the availability of parks near the home had no significant impact on mental health and stress levels of youth. This finding runs counter to <a href="https://doi.org/10.1186/s12889-022-13148-2">evidence that suggests these places were crucial to supporting well-being</a> during the pandemic. </p>
<p>Given the pre-pandemic challenges of <a href="https://doi.org/10.24095/hpcdp.40.4.02">engaging young people in using their local parks</a>, these places may have not played as substantial a role in supporting better mental health and lowering stress levels for youth compared to other neighbourhood amenities.</p>
<h2>Youth experiences in urban neighbourhoods</h2>
<p>For youth in urban neighbourhoods, having more fast-food outlets available near young people’s homes resulted in lower levels of stress, but worse declines in mental health. When coupled with the <a href="https://doi.org/10.1080/23748834.2023.2282850">observed decline in eating habits</a>, urban youth were almost seven times more likely to report worse mental health. </p>
<p>While the places near young people’s homes can make a difference to their mental health, we found that the impact is greater on their stress levels. </p>
<p>It may be that food-based amenities in urban neighbourhoods provided places for young people to relieve their stress and try to cope with declines in their mental health by eating fast-food and convenience-store snacks and socializing.</p>
<h2>Youth experiences in suburban neighbourhoods</h2>
<p>Youth in suburban neighbourhoods were more likely to report changes (both improvements and declines) to their mental health and stress levels. They also had a greater availability of food outlets near them compared to urban youth. In particular, having more convenience stores near the home was associated with more drastic changes to mental health and higher stress levels. </p>
<p>In addition, youth residing in suburban neighbourhoods who reported a decline in their physical activity levels were also at nearly three times the risk of having worsened mental health than their peers who reported their physical activity levels had not changed since the pandemic. </p>
<p>Overall, boys were substantially less likely than girls to have improved mental health during the study period, and this was especially true for those residing in suburban areas.</p>
<p>One possible reason for this trend could be that boys are <a href="https://doi.org/10.1016/j.ssresearch.2019.03.015">more likely to play organized sports</a> than girls, which are often delivered by schools as extracurricular activities. In addition, boys tend to have less <a href="https://doi.org/10.1080/14742837.2021.2011189">extensive social networks</a> on digital platforms outside of their school than girls. </p>
<p>The loss of opportunities for physical activity and transition away from in-person social networks at schools may have created feelings of isolation and loneliness for boys.</p>
<h2>The role of neighbourhood amenities</h2>
<p>The first six months of the pandemic revealed the importance of neighbourhood amenities in protecting against declines in mental health and reducing stress levels. </p>
<p>Parks may have been a helpful feature for other population groups, but we found their role was limited for youth in terms of mental health and stress. Planners and landscape architects can reflect on how these places could be changed to be more attractive to youth, thereby ensuring they receive the same benefits from them as younger and older groups. </p>
<p>In addition, it is important to consider that the experiences of youth living in suburban and urban neighbourhoods may differ. This highlights the need to include youth perspectives in the planning of public spaces that contribute to healthy and thriving communities. </p>
<p>The pandemic exposed long-standing issues in how youth can access amenities in their community, and how to best meet their needs in Canadian communities.</p><img src="https://counter.theconversation.com/content/219474/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Alexander Wray receives funding from the Social Sciences and Humanities Research Council of Canada and Sport Canada. He is President of the Town and Gown Association of Ontario. </span></em></p><p class="fine-print"><em><span>Kendra Nelson Ferguson was provided with funding through a trainee award from the Children’s Health
Research Institute, funded by the Children’s Health Foundation.</span></em></p><p class="fine-print"><em><span>Gina Martin, Jamie Seabrook, Jason Gilliland, and Stephanie Coen do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Neighbourhood features may have helped youth cope with the mental health impact of pandemic restrictions. Parks didn’t play much of a role but food amenities and the suburbs did.Alexander Wray, PhD Candidate in Geography, Western UniversityGina Martin, Assistant Professor, Faculty of Health Disciplines, Athabasca UniversityJamie Seabrook, Chair and Professor, School of Food and Nutritional Sciences, Brescia University College, Adjunct Research Professor, Paediatrics, Adjunct Professor, Epidemiology & Biostatistics, Western UniversityJason Gilliland, Professor, Director, Urban Development Program, Western UniversityKendra Nelson Ferguson, Postdoctoral Research Associate, Faculty of Social Sciences, Western UniversityStephanie Coen, Associate professor, School of Geography, University of NottinghamLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2192742023-12-29T11:42:50Z2023-12-29T11:42:50ZWhat COVID diaries have in common with Samuel Pepys’ 17th-century plague diaries<figure><img src="https://images.theconversation.com/files/564815/original/file-20231211-21-68cd8r.jpg?ixlib=rb-1.1.0&rect=319%2C275%2C5432%2C3328&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/halloween-holidays-leisure-concept-close-young-2023057376">Ground Picture/Shutterstock</a></span></figcaption></figure><p>People keep diaries for all sorts of reasons – to record events, work through difficult situations, or manage <a href="https://psycnet.apa.org/record/1994-38706-001">stress</a> and <a href="https://www.researchgate.net/publication/19783166_Disclosure_of_Traumas_and_Immune_Function_Health_Implications_for_Psychotherapy">trauma</a>. The ongoing COVID inquiry shows diaries also have important political and historic significance. The UK’s former chief scientific adviser Patrick Vallance’s <a href="https://www.theguardian.com/uk-news/2023/nov/20/how-patrick-vallance-explosive-diaries-exposed-covid-chaos-inside-no-10">diaries</a> have been a key source of evidence, exposing the chaos within government at the time. </p>
<p>In my PhD research, I’ve been exploring the COVID diaries of ordinary people, as well as diaries kept during the Great Plague of London in 1665-66. Though centuries apart, these diaries are full of insight into how people react to crises, and have surprising similarities. </p>
<p>From the first lockdown in March 2020, media outlets, archive centres and researchers encouraged people to record their pandemic experiences. Even BBC children’s entertainer <a href="https://www.bbc.co.uk/iplayer/episode/m000jsf3/at-home-with-mr-tumble-series-1-6-diary">Mr Tumble</a> urged young viewers to start a diary. </p>
<p>This has resulted in a large number of COVID diaries being made available in archive collections around the UK, plus many more online in the form of blogs or social media. I’ve been looking specifically at 13 COVID diaries donated to the Borthwick Institute for Archives and the East Riding Archives, both in Yorkshire. Most were originally private documents, offering a more spontaneous, honest and intimate portrayal of pandemic experiences than their online counterparts. </p>
<p>Diaries written during the Great Plague are not so numerous. Of the few available, the most valuable is that of naval administrator Samuel Pepys (1633-1703), whose exceptionally detailed and candid journals form by far the most comprehensive firsthand account of plague-stricken London.</p>
<p>I have been reading Pepys’s diaries alongside the modern COVID diaries, and have been struck by the common themes in how people navigated their pandemic experiences. </p>
<h2>Recording statistics</h2>
<p>Throughout the COVID pandemic, statistics of cases and deaths were everywhere, and were key to how we judged the impact of the virus. As diarist JF wrote on June 5 2020:</p>
<blockquote>
<p>It was time to watch the Corona Virus update and I was shocked to find that over 40,000 people have now died from the disease in this country and it’s not over yet!</p>
</blockquote>
<p>Relatively accurate information was also widely circulated in 17th-century London via the “bills of mortality” – weekly lists of deaths according to cause and location. Pepys wrote on September 7 1665:</p>
<blockquote>
<p>Sent for the Weekely Bill and find 8252 dead in all, and of them, 6978 of the plague - which is a most dreadful Number - and shows reason to fear that the plague hath got that hold that it will yet continue among us.</p>
</blockquote>
<p>All of the modern and historical diaries I have looked at include these statistics – some sparingly, others with meticulous regularity.</p>
<h2>The blame game</h2>
<p>As cases rose, restrictions were enforced and the effects of plague and COVID loomed large in the lives of our diarists, narratives shifted to confusion and blame. Pepys was largely sympathetic to the government’s handling of the plague and, in February 1666, criticised those who flouted the rules and endangered others: </p>
<blockquote>
<p>In the heighth of it, how bold people there were to go in sport to one another’s burials. And in spite to well people, would breathe in the faces … of well people going by.</p>
</blockquote>
<p>COVID diarists reacted to those who didn’t follow guidelines in a very similar way, as DR wrote in March 2020: </p>
<blockquote>
<p>Not everyone is playing it very well, though, with panic-buying, one last night at the pub and a mass exodus to the coast. Stupid and selfish in equal measure.</p>
</blockquote>
<p>The response and actions of the UK government, and individual members of parliament, also afforded much attention. An anonymous diarist wrote in May 2020:</p>
<blockquote>
<p>People are being allowed out more but the illness is still out there & there’s no treatment or vaccine yet … There are fewer deaths because of social distancing. If they let everyone get on with the ‘new normal’ surely more people will get sick?</p>
</blockquote>
<h2>Staying positive</h2>
<p>A more optimistic theme to emerge in the diaries was the ability to find positivity amid the chaos. Pepys and modern diarists were thankful for the blessings of health, family and security. They praised those who went the extra mile to mitigate the impact of the pandemic on those around them, despite the risk to their own health. An entry from New Year’s Eve in 1665 reads:</p>
<blockquote>
<p>My whole family hath been well all this while, and all my friends I know of, saving my aunt Bell, who is dead, and some children of my cozen Sarah’s, of the plague … yet, to our great joy, the town fills apace, and shops begin to open again. Pray God continue the plague’s decrease!</p>
</blockquote>
<p>DW’s diary from April 2020 expressed appreciation for time out in nature, as well as sympathy for others living in more difficult situations:</p>
<blockquote>
<p>It was lovely walking through the wood. The air was filled with birdsong. It made me realise how lucky I am to live in a village where I can walk from my front door into fields and woods along defined paths. It must be awful to live ten floors up in a high rise block with two children, and not be allowed out except for once per day. </p>
</blockquote>
<figure class="align-center ">
<img alt="A young man sits on the ground in a forest writing in a journal" src="https://images.theconversation.com/files/564817/original/file-20231211-29-uswlqj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/564817/original/file-20231211-29-uswlqj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/564817/original/file-20231211-29-uswlqj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/564817/original/file-20231211-29-uswlqj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/564817/original/file-20231211-29-uswlqj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/564817/original/file-20231211-29-uswlqj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/564817/original/file-20231211-29-uswlqj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Keeping a diary can be good for wellbeing, as well as recording history.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/focused-man-writing-journal-ideas-enjoying-2240364251">Vergani Fotografia/Shutterstock</a></span>
</figcaption>
</figure>
<p>Comparing COVID with historical events such as <a href="https://www.sciencenews.org/article/coronavirus-covid-19-ancient-plagues-pandemics-lessons-society">plague</a>, <a href="https://www.bbc.com/future/article/20200302-coronavirus-what-can-we-learn-from-the-spanish-flu">the Spanish flu epidemic</a> and the <a href="https://www.kent.ac.uk/news/society/25315/expert-comment-the-reality-of-blitz-spirit-during-covid-19">second world war</a> was a core element of the pandemic narrative, and for good reason. History connects.</p>
<p>It is easy to look around us and see the vast differences between the world we live in now, and that which Pepys traversed almost 400 years ago.</p>
<p>But by exploring the innermost thoughts of people with an element of shared experience, we see that fundamental aspects of the human condition endure. When faced with uncertainty and upheaval, our instincts are to record, find answers, and reclaim joy.</p><img src="https://counter.theconversation.com/content/219274/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Mary Rehman receives funding from University of Hull Doctoral College</span></em></p>Keeping a diary has been a common pandemic pastime throughout history.Mary Rehman, PhD Researcher, School of Humanities, University of HullLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2189062023-12-20T13:25:27Z2023-12-20T13:25:27ZFor many who are suffering with prolonged grief, the holidays can be a time to reflect and find meaning in loss<figure><img src="https://images.theconversation.com/files/566537/original/file-20231219-25-tw0fa5.jpg?ixlib=rb-1.1.0&rect=28%2C9%2C6348%2C4235&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">In the post-pandemic world, many people are facing the holidays without their loved ones by their side. </span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/holiday-wreath-on-a-burial-gravesite-royalty-free-image/1792035475?phrase=grief+holidays">Douglas Sacha/Moment via Getty Images</a></span></figcaption></figure><p>The holiday season is meant to be filled with joy, connection and celebration of rituals. Many people, however, are starkly reminded of their grief this time of year and of whom – or what – they have lost.</p>
<p>The added <a href="https://theconversation.com/the-holidays-and-your-brain-a-neuroscientist-explains-how-to-identify-and-manage-your-emotions-218251">stress of the holiday season doesn’t help</a>. Studies show that the holidays <a href="https://sesamecare.com/blog/lowering-holiday-stress-2021">negatively affect many people’s mental health</a>. </p>
<p>While COVID-19-related stressors may have lessened, the <a href="https://doi.org/10.1080/20008198.2021.1957272">grief from change and loss</a> that so many endured during the <a href="https://doi.org/10.1177%2F0030222820966928">pandemic persists</a>. This can cause difficult emotions to resurface when they are least expected. </p>
<p>I am a <a href="https://som.cuanschutz.edu/Profiles/Faculty/Profile/29355">licensed therapist and trauma-sensitive yoga instructor</a>. For the last 12 years, I’ve helped clients and families manage grief, depression, anxiety and complex trauma. This includes many health care workers and first responders who have recounted endless stories to me about how the pandemic <a href="https://www.mdpi.com/2227-9032/10/2/364">increased burnout</a> and <a href="https://doi.org/10.1111/jan.15175">affected their mental health</a> and quality of life.</p>
<p>I developed an online program that research shows has <a href="https://doi.org/10.3389/fpsyg.2023.1227895">improved their well-being</a>. And I’ve observed firsthand how much grief and sadness can intensify during the holidays. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/BQAE7BVMp6U?wmode=transparent&start=5" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Grief expert David Kessler discusses five coping mechanisms to get through the holidays.</span></figcaption>
</figure>
<h2>Post-pandemic holidays and prolonged grief</h2>
<p>During the pandemic, <a href="https://doi.org/10.1016/j.jcbs.2022.08.011">family dynamics</a>, <a href="https://doi.org/10.1177/02654075221115387">close relationships</a> and <a href="https://doi.org/10.1177/02654075221113365">social connections</a> were strained, <a href="https://apps.who.int/iris/bitstream/handle/10665/352189/WHO-2019-nCoV-Sci-Brief-Mental-health-2022.1-eng.pdf">mental health problems increased or worsened</a>, and most people’s holiday traditions and routines were upended. </p>
<p>Those who lost a loved one during the pandemic may not have been able to practice rituals such as holding a memorial service, further delaying the grieving process. As a result, holiday traditions may feel more painful now for some. Time off from school or work can also trigger more intense feelings of grief and contribute to feelings of loneliness, isolation or depression.</p>
<p>Sometimes feelings of grief are so persistent and severe that they interfere with daily life. For the past several decades, researchers and clinicians have been grappling with how to clearly <a href="https://doi.org/10.1177%2F00048674231154206">define and treat complicated grief</a> that does not abate over time. </p>
<p>In March 2022, a new entry to describe complicated grief was added to the <a href="https://www.psychiatry.org/psychiatrists/practice/dsm">Diagnostic and Statistical Manual of Mental Disorders</a>, or DSM, which classifies a spectrum of mental health disorders and problems to better understand people’s symptoms and experiences in order to treat them.</p>
<p>This newly defined condition is called <a href="https://www.psychiatry.org/patients-families/prolonged-grief-disorder">prolonged grief disorder</a>. About <a href="https://doi.org/10.1016/j.jad.2017.01.030">10% of bereaved adults are at risk</a>, and those rates <a href="https://doi.org/10.1001/jamapsychiatry.2021.4201">appear to have increased</a> in the aftermath of the pandemic. </p>
<p>People with prolonged grief disorder experience intense emotions, longing for the deceased, or troublesome preoccupation with memories of their loved one. Some also find it difficult to reengage socially and may feel emotionally numb. They commonly avoid reminders of their loved one and may experience a loss of identity and feel bleak about their future. These symptoms persist nearly every day for at least a month. <a href="https://doi.org/10.1001/jamapsychiatry.2021.4201">Prolonged grief disorder can be diagnosed</a> at least one year after a significant loss for adults and at least six months after a loss for children.</p>
<p>I am no stranger to complicated grief: A close friend of mine died by suicide when I was in college, and I was one of the last people he spoke to before he ended his life. This upended my sense of predictability and control in my life and left me untangling the <a href="https://doi.org/10.5964%2Fejop.5439">many existential themes</a> that <a href="https://theconversation.com/how-to-help-those-who-have-lost-loved-ones-to-suicide-cope-with-grief-during-the-holidays-172750">suicide loss survivors</a> often face. </p>
<h2>How grieving alters brain chemistry</h2>
<p>Research suggests that grief not only has negative consequences for a person’s <a href="https://www.heart.org/en/news/2021/03/10/how-grief-rewires-the-brain-and-can-affect-health-and-what-to-do-about-it">physical health</a>, but <a href="https://www.apa.org/news/podcasts/speaking-of-psychology/grieving-changes-brain">for brain chemistry</a> too. </p>
<p>The feeling of grief and intense yearning may disrupt the <a href="https://doi.org/10.1016%2Fj.pscychresns.2020.111135">neural reward systems in the brain</a>. When bereaved individuals seek connection to their lost loved one, they are craving the chemical reward they felt before their loss when they connected with that person. These reward-seeking behaviors tend to operate on a feedback loop, <a href="https://doi.org/10.1152/jn.00784.2009">functioning similar to substance addiction</a>, and could be why some people get stuck in the despair of their grief.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/JYNk86feyoQ?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">A podcast on understanding grief and loss.</span></figcaption>
</figure>
<p>One study showed an <a href="https://doi.org/10.3390/jcm9030851">increased activation of the amygdala</a> when showing death-related images to people who are dealing with complicated grief, compared to adults who are not grieving a loss. The <a href="https://www.ncbi.nlm.nih.gov/books/NBK537102/">amygdala</a>, which initiates our fight or flight response for survival, is also <a href="https://doi.org/10.31887/DCNS.2012.14.2/snakajima">associated with managing distress when separated from a loved one</a>. These changes in the brain might explain the great impact prolonged grief has on someone’s life and their ability to function.</p>
<h2>Recognizing prolonged grief disorder</h2>
<p>Experts have <a href="https://doi.org/10.1002/wps.20823">developed scales</a> to help measure symptoms of prolonged grief disorder. If you identify with some of these signs for at least one year, it may be time to reach out to a mental health professional. </p>
<p>Grief is not linear and doesn’t follow a timeline. It is a dynamic, evolving process that is different for everyone. There is no wrong way to grieve, so be compassionate to yourself and don’t make judgments on what you should or shouldn’t be doing. </p>
<p>Increasing your social supports and engaging in meaningful activities are important first steps. It is critical to address any preexisting or <a href="https://doi.org/10.1016/j.jadr.2021.100140">co-occurring mental health concerns</a> such as anxiety, depression or <a href="https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd">post-traumatic stress</a>.</p>
<p>It can be easy to confuse grief with depression, as some symptoms do overlap, but <a href="https://tidsskriftet.no/en/2017/04/klinisk-oversikt/what-distinguishes-prolonged-grief-disorder-depression">there are critical differences</a>. </p>
<p><iframe id="rFP9s" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/rFP9s/4/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<p>If you are experiencing symptoms of depression for longer than a few weeks and it is affecting your everyday life, work and relationships, it may be time to talk with your primary care doctor or therapist.</p>
<h2>A sixth stage of grief</h2>
<p>I have found that naming the stage of grief that someone is experiencing helps diminish the power it might have over them, allowing them to mourn their loss. </p>
<p>For decades, most clinicians and researchers have recognized <a href="https://grief.com/the-five-stages-of-grief/">five stages of grief</a>: <a href="https://www.verywellmind.com/five-stages-of-grief-4175361">denial/shock, anger, depression, bargaining and acceptance</a>. </p>
<p>But “accepting” your grief doesn’t sit well for many. That is why a sixth stage of grief, called “<a href="https://brenebrown.com/podcast/david-kessler-and-brene-on-grief-and-finding-meaning/">finding meaning</a>,” adds another perspective. Honoring a loss by reflecting on its meaning and the weight of its impact can help people discover ways to move forward. Recognizing how one’s life and identity are different while making space for your grief during the holidays might be one way to soften the despair.</p>
<p>When my friend died by suicide, I found a deeper appreciation for what he brought into my life, soaking up the moments he would have enjoyed, in honor of him. After many years, I was able to find meaning by spreading mental health awareness. I spoke as an expert presenter for <a href="https://www.lrjfoundation.com/">suicide prevention organizations</a>, wrote about <a href="https://news.cuanschutz.edu/news-stories/expert-untangles-complexities-of-grief-for-suicide-loss-survivors">suicide loss</a> and became certified to teach my local community how to respond to someone experiencing signs of mental health distress or crisis through <a href="https://www.mentalhealthfirstaid.org/">Mental Health First Aid</a> courses. Finding meaning is different for everyone, though.</p>
<p>Sometimes, adding a routine or holiday tradition can ease the pain and allow a new version of life, while still remembering your loved one. Take out that old recipe or visit your favorite restaurant you enjoyed together. You can choose to stay open to what life has to offer, <a href="https://www.ted.com/talks/david_kessler_how_to_find_meaning_after_loss?language=en">while grieving and honoring your loss</a>. This may offer new meaning to what – and who – is around you. </p>
<p><em>If you need emotional support or are in a mental health crisis, <a href="https://988lifeline.org/">dial 988</a> or <a href="https://988lifeline.org/chat/">chat online</a> with a crisis counselor.</em></p><img src="https://counter.theconversation.com/content/218906/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Mandy Doria's position with the University of Colorado is partially funded by the Colorado Department of Public Health and Environment (CDPHE) for her work with the CO-CARES initiative, which offers resources at no cost to Colorado health care and public health workers.</span></em></p>A trauma-informed therapist discusses how grief affects the brain and highlights the role of a sixth stage of grief – finding meaning – in the healing process.Mandy Doria, Assistant Professor of Psychiatry, University of Colorado Anschutz Medical CampusLicensed as Creative Commons – attribution, no derivatives.