Getting antivirals for COVID too often depends on where you live and how wealthy you are
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Medical experts recommend antivirals for people aged 70 and older who get COVID, and for other groups at risk of severe illness and hospitalisation from COVID.
But many older Australians have missed out on antivirals after getting sick with COVID. It is yet another way the health system is failing the most vulnerable.
Who missed out?
We analysed COVID antiviral uptake between March 2022 and September 2023. We found some groups were more likely to miss out on antivirals including Indigenous people, people from disadvantaged areas, and people from culturally and linguistically diverse backgrounds.
Some of the differences will be due to different rates of infection. But across this 18-month period, many older Australians were infected at least once, and rates of infection were higher in some disadvantaged communities.
How stark are the differences?
Compared to the national average, Indigenous Australians were nearly 25% less likely to get antivirals, older people living in disadvantaged areas were 20% less likely to get them, and people with a culturally or linguistically diverse background were 13% less likely to get a script.
People in remote areas were 37% less likely to get antivirals than people living in major cities. People in outer regional areas were 25% less likely.
Even within the same city, the differences are stark. In Sydney, people older than 70 in the affluent eastern suburbs (including Vaucluse, Point Piper and Bondi) were nearly twice as likely to have had an antiviral as those in Fairfield, in Sydney’s south-west.
Older people in leafy inner-eastern Melbourne (including Canterbury, Hawthorn and Kew) were 1.8 times more likely to have had an antiviral as those in Brimbank (which includes Sunshine) in the city’s west.
Why are people missing out?
COVID antivirals should be taken when symptoms first appear. While awareness of COVID antivirals is generally strong, people often don’t realise they would benefit from the medication. They wait until symptoms get worse and it is too late.
Frequent GP visits make a big difference. Our analysis found people 70 and older who see a GP more frequently were much more likely to be dispensed a COVID antiviral.
Regular visits give an opportunity for preventive care and patient education. For example, GPs can provide high-risk patients with “COVID treatment plans” as a reminder to get tested and seek treatment as soon as they are unwell.
Difficulty seeing a GP could help explain low antiviral use in rural areas. Compared to people in major cities, people in small rural towns have about 35% fewer GPs, see their GP about half as often, and are 30% more likely to report waiting too long for an appointment.
Just like for vaccination, a GP’s focus on antivirals probably matters, as does providing care that is accessible to people from different cultural backgrounds.
Care should go those who need it
Since the period we looked at, evidence has emerged that raises doubts about how effective antivirals are, particularly for people at lower risk of severe illness. That means getting vaccinated is more important than getting antivirals.
But all Australians who are eligible for antivirals should have the same chance of getting them.
These drugs have cost more than A$1.7 billion, with the vast majority of that money coming from the federal government. While dispensing rates have fallen, more than 30,000 packs of COVID antivirals were dispensed in August, costing about $35 million.
Such a huge investment shouldn’t be leaving so many people behind. Getting treatment shouldn’t depend on your income, cultural background or where you live. Instead, care should go to those who need it the most.
People born overseas have been 40% more likely to die from COVID than those born here. Indigenous Australians have been 60% more likely to die from COVID than non-Indigenous people. And the most disadvantaged people have been 2.8 times more likely to die from COVID than those in the wealthiest areas.
All those at-risk groups have been more likely to miss out on antivirals.
It’s not just a problem with antivirals. The same groups are also disproportionately missing out on COVID vaccination, compounding their risk of severe illness. The pattern is repeated for other important preventive health care, such as cancer screening.
A 3-step plan to meet patients’ needs
The federal government should do three things to close these gaps in preventive care.
First, the government should make Primary Health Networks (PHNs) responsible for reducing them. PHNs, the regional bodies responsible for improving primary care, should share data with GPs and step in to boost uptake in communities that are missing out.
Second, the government should extend its MyMedicare reforms. MyMedicare gives general practices flexible funding to care for patients who live in residential aged care or who visit hospital frequently. That approach should be expanded to all patients, with more funding for poorer and sicker patients. That will give GP clinics time to advise patients about preventive health, including COVID vaccines and antivirals, before they get sick.
Third, team-based pharmacist prescribing should be introduced. Then pharmacists could quickly dispense antivirals for patients if they have a prior agreement with the patient’s GP. It’s an approach that would also work for medications for chronic diseases, such as cardiovascular disease.
COVID antivirals, unlike vaccines, have been keeping up with new variants without the need for updates. If a new and more harmful variant emerges, or when a new pandemic hits, governments should have these systems in place to make sure everyone who needs treatment can get it fast.
In the meantime, fairer access to care will help close the big and persistent gaps in health between different groups of Australians.
Peter Breadon, Program Director, Health and Aged Care, Grattan Institute
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Syringe Exchange Fears Hobble Fight Against West Virginia HIV Outbreak
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CHARLESTON, http://w.va/. — More than three years have passed since federal health officials arrived in central Appalachia to assess an alarming outbreak of HIV spread mostly between people who inject opioids or methamphetamine.
Infectious disease experts from the Centers for Disease Control and Prevention made a list of recommendations following their visit, including one to launch syringe service programs to stop the spread at its source. But those who’ve spent years striving to protect people who use drugs from overdose and illness say the situation likely hasn’t improved, in part because of politicians who contend that such programs encourage illegal drug use.
Joe Solomon is a Charleston City Council member and co-director of SOAR WV, a group that works to address the health needs of people who use drugs. He’s proud of how his close-knit community has risen to this challenge but frustrated with the restraints on its efforts.
“You see a city and a county willing to get to work at a scale that’s bigger than ever before,” Solomon said, “but we still have one hand tied behind our back.”
The hand he references is easier access to clean syringes.
In April 2021, the CDC came to Charleston — the seat of Kanawha County and the state capital, tucked into the confluence of the Kanawha and Elk rivers — to investigate dozens of newly detected HIV infections. The CDC’s HIV intervention chief called it “the most concerning HIV outbreak in the United States” and warned that the number of reported diagnoses could be just “the tip of the iceberg.”
Now, despite attention and resources directed toward the outbreak, researchers and health workers say HIV continues to spread. In large part, they say, the outbreak lingers because of restrictions state and local policymakers have placed on syringe exchange efforts.
Research indicates that syringe service programs are associated with an estimated 50% reduction in HIV and hepatitis C, and the CDC issued recommendations to steer a response to the outbreak that emphasized the need for improved access to those services.
That advice has thus far gone unheeded by local officials.
In late 2015, the Kanawha-Charleston Health Department launched a syringe service program but shuttered it in 2018 under pressure, with then-Mayor Danny Jones calling it a “mini-mall for junkies and drug dealers.”
SOAR stepped in, hosting health fairs at which it distributed naloxone, an opioid overdose reversal drug; offered treatment and referrals; provided HIV testing; and exchanged clean syringes for used ones.
But in April 2021, the state legislature passed a bill limiting the number of syringes people could exchange and made it mandatory to present a West Virginia ID. The Charleston City Council subsequently added guidelines of its own, including requiring individual labeling of syringes.
As a result of these restrictions, SOAR ceased exchanging syringes. West Virginia Health Right now operates an exchange program in the city under the restrictions.
Robin Pollini is a West Virginia University epidemiologist who conducts community-based research on injection drug use. “Anyone I’ve talked to who’s used that program only used it once,” she said. “And the numbers they report to the state bear that out.”
A syringe exchange run by the health department in nearby Cabell County — home to Huntington, the state’s largest city after Charleston — isn’t so constrained. As Solomon notes, that program exchanges more than 200 syringes for every one exchanged in Kanawha.
A common complaint about syringe programs is that they result in discarded syringes in public spaces. Jan Rader, director of Huntington’s Mayor’s Office of Public Health and Drug Control Policy, is regularly out on the streets and said she seldom encounters discarded syringes, pointing out that it’s necessary to exchange a used syringe for a new one.
In August 2023, the Charleston City Council voted down a proposal from the Women’s Health Center of West Virginia to operate a syringe exchange in the city’s West Side community, with opponents expressing fears of an increase in drug use and crime.
Pollini said it’s difficult to estimate the number of people in West Virginia with HIV because there’s no coordinated strategy for testing; all efforts are localized.
“You would think that in a state that had the worst HIV outbreak in the country,” she said, “by this time we would have a statewide testing strategy.”
In addition to the testing SOAR conducted in 2021 at its health fairs, there was extensive testing during the CDC’s investigation. Since then, the reported number of HIV cases in Kanawha County has dropped, Pollini said, but it’s difficult to know if that’s the result of getting the problem under control or the result of limited testing in high-risk groups.
“My inclination is the latter,” she said, “because never in history has there been an outbreak of injection-related HIV among people who use drugs that was solved without expanding syringe services programs.”
“If you go out and look for infections,” Pollini said, “you will find them.”
Solomon and Pollini praised the ongoing outreach efforts — through riverside encampments, in abandoned houses, down county roads — of the Ryan White HIV/AIDS Program to test those at highest risk: people known to be injecting drugs.
“It’s miracle-level work,” Solomon said.
But Christine Teague, Ryan White Program director at the Charleston Area Medical Center, acknowledged it hasn’t been enough. In addition to HIV, her concerns include the high incidence of hepatitis C and endocarditis, a life-threatening inflammation of the lining of the heart’s chambers and valves, and the cost of hospital resources needed to address them.
“We’ve presented that data to the legislature,” she said, “that it’s not just HIV, it’s all these other lengthy hospital admissions that, essentially, Medicaid is paying for. And nothing seems to penetrate.”
Frank Annie is a researcher at CAMC specializing in cardiovascular diseases, a member of the Charleston City Council, and a proponent of syringe service programs. Research he co-authored found 462 cases of endocarditis in southern West Virginia associated with injection drug use, at a cost to federal, state, and private insurers of more than $17 million, of which less than $4 million was recovered.
Teague is further concerned for West Virginia’s rural counties, most of which don’t have a syringe service program.
Tasha Withrow, a harm reduction advocate in bordering rural Putnam County, said her sense is that HIV numbers aren’t alarmingly high there but said that, with little testing and heightened stigma in a rural community, it’s difficult to know.
In a January 2022 follow-up report, the CDC recommended increasing access to harm reduction services such as syringe service programs through expansion of mobile services, street outreach, and telehealth, using “patient-trusted” individuals, to improve the delivery of essential services to people who use drugs.
Teague would like every rural county to have a mobile unit, like the one operated by her organization, offering harm reduction supplies, medication, behavioral health care, counseling, referrals, and more. That’s an expensive undertaking. She suggested opioid settlement money through the West Virginia First Foundation could pay for it.
Pollini said she hopes state and local officials allow the experts to do their jobs.
“I would like to see them allow us to follow the science and operate these programs the way they’re supposed to be run, and in a broader geography,” she said. “Which means that it shouldn’t be a political decision; it should be a public health decision.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
This article first appeared on KFF Health News and is republished here under a Creative Commons license.
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The Dangers Of Fires, Floods, & Having Your Hair Washed
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It’s a dangerous business, going out of your door… And this week’s news round-up looks at 5 reasons why that might be:
Superspreading like wildfire
Environmental health risks are a big topic these days, with our changing climate. As for wildfires? Some of the risks are obvious: burning to death or choking to death in the smoke—but even upon surviving the seemingly worst, more threats remain that themselves can still kill.
Those threats include that both burns and smoke inhalation can cause acute and chronic changes in the immune system. Specifically: changes for the worse. The mechanisms by which this happens depend on the nature of any burns received, and in the case of smoke, what exactly was in the smoke. Now, there is no kind of smoke that is healthy to inhale, but definitely some kinds are a lot worse than others, and let’s just say, people’s homes contain a lot of plastic.
Additionally, if you think someone coughing near you spreads germs, imagine how far germs can be spread by miles-high, miles-wide billowing hot air.
In short, there’s a lot going on and none of it is good, and we’ve barely had room to summarise here, so…
Read in full: Wildfires ignite infection risks by weakening the body’s immune defenses and spreading bugs in smoke
Related: What’s Lurking In Your Household Air?
A flood of diseases
*record scratch*
Environmental health risks are a big topic these days, with our changing climate. As for floods? Some of the risks are obvious: drowning to death or having your house washed away—but even upon surviving the seemingly worst, more threats remain that themselves can still kill.
Those threats include increases in deaths from infectious and parasitic diseases, and respiratory diseases in general. Simply, a place that has been waterlogged, even if it seems “safe” now, is not a healthy place to be, due to bacteria, viruses, fungi, and more. In fact, it even increases all-cause mortality, because being healthy in such a place is simply harder:
Read in full: Linked to higher mortality rates, large floods emerge as an urgent public health concern
Related: Dodging Dengue In The US
Don’t lose your head
Visiting the hairdresser is not something that most people consider a potential brush with death—your hairdresser is probably not Sweeney Todd, after all. However…
There is an issue specifically with getting your hair washed there. Backwash basins—the sink things into which one rests one’s head at a backwards tilt—create an awkward angle for the cervical vertebrae and a sudden reduction in blood flow to the brain can cause a stroke, with the risk being sufficiently notable as to have its own name in scientific literature: beauty parlor stroke syndrome (BPSS).
❝While research suggests BPSS is most likely to occur in women over 50—and previous history of narrowing or thinning of blood vessels and arthritis of the spinal column in the neck are particular risk factors—it could happen to anyone regardless of age or medical history.❞
Read in full: The hidden health risk of having your hair washed
Related: Your Stroke Survival Plan
The smartwatch wristbands that give you cancer
It’s about the PFAS content. The article doesn’t discuss cancer in detail, just mentioning the increased risk, but you can read about the link between the two in our article below.
Basically, if your smartwatch wristband is a) not silicone and b) waterproof anyway, especially if it’s stain-resistant (as most are designed to be, what with wearing it next to one’s skin all the time while exercising, and not being the sort of thing one throws in the wash), then chances are it has PFAS levels much higher than normally found in consumer goods or clothing.
You can read more about how to identify the risks, here:
Read in full: Smartwatch bands can contain high levels of toxic PFAS, study finds
Related: PFAS Exposure & Cancer: The Numbers Are High
The cows giving milk with a little extra
Bird flu (HPAI) is now not the only flu epidemic amongst cattle in the US, and not only that, but rather than “merely” colonizing the lungs and upper respiratory tracts, in this case the virus (IAV) is thriving in the mammary glands, meaning that yes, it gets dispensed into the milk, and so far scientists are simply scrambling to find better ways to vaccinate the cattle, in the hopes that the milk will not be so risky because yes, it is currently a “reservoir and transmission vector” for the virus.
There are, however, barriers to creating those vaccines:
Read in full: Unexpected viral reservoir: influenza A thrives in cattle mammary glands
Related: Cows’ Milk, Bird Flu, & You
Take care!
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Twenty-One, No Wait, Twenty Tweaks For Better Health
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Dr. Greger’s 21 Tweaks… We say 20, though!
We’ve talked before about Dr. Greger’s Daily Dozen (12 things he advises that we make sure to eat each day, to enjoy healthy longevity), but much less-talked-about are his “21 Tweaks”…
They are, in short, a collection of little adjustments one can make for better health. Some of them are also nutritional, but many are more like lifestyle tweaks. Let’s do a rundown:
At each meal:
- Preload with water
- Preload with “negative calorie” foods (especially: greens)
- Incorporate vinegar (1-2 tbsp in a glass of water will slow your blood sugar increase)
- Enjoy undistracted meals
- Follow the 20-minute rule (enjoy your meal over the course of at least 20 minutes)
Get your daily doses:
- Black cumin ¼ tsp
- Garlic powder ¼ tsp
- Ground ginger (1 tsp) or cayenne pepper (½ tsp)
- Nutritional yeast (2 tsp)
- Cumin (½ tsp)
- Green tea (3 cups)
Every day:
- Stay hydrated
- Deflour your diet
- Front-load your calories (this means implementing the “king, prince, pauper” rule—try to make your breakfast the largest meal of your day, followed my a medium lunch, and a small evening meal)
- Time-restrict your eating (eat your meals within, for example, an 8-hour window, and fast the rest of the time)
- Optimize exercise timing (before breakfast is best for most people, unless you are diabetic)
- Weigh yourself twice a day (doing this when you get up and when you go to bed results in much better long-term weight management than weighing only once per day)
- Complete your implementation intentions (this sounds a little wishy-washy, but it’s about building a set of “if this, then that” principles, and then living by them. An example could be directly physical health-related such as “if there is a choice of stairs or elevator, I will take the stairs”, or could be more about holistic good-living, such as “if someone asks me for help, I will try to oblige them so far as I reasonably can”)
Every night:
- Fast after 7pm
- Get sufficient sleep (7–9 hours is best. As we get older, we tend more towards the lower end of that, but try get at least those 7 hours!)
Experiment with Mild Trendelenburg(better yet, skip this one)*
*This involves a 6º elevation of the bed, at the foot end. Dr. Greger advises that this should only be undertaken after consulting your doctor, though, as a lot of health conditions can contraindicate it. We at 10almonds couldn’t find any evidence to support this practice, and numerous warnings against it, so we’re going to go ahead and say we think this one’s skippable.
Again, we do try to bring you the best evidence-based stuff here at 10almonds, and we’re not going to recommend something just because of who suggested it
As for the rest, you don’t have to do them all! And you may have noticed there was a little overlap in some of them. But, we consider them a fine menu of healthy life hacks from which to pick and choose!
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ADHD For Smart Ass Women – by Tracy Otsuka
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We’ve reviewed books about ADHD in adults before, what makes this one different? It’s the wholly female focus. Which is not to say some things won’t apply to men too, they will.
But while most books assume a male default unless it’s “bikini zone” health issues, this one is written by a woman for women focusing on the (biological and social) differences in ADHD for us.
A strength of the book is that it neither seeks to:
- over-medicalize things in a way that any deviation from the norm is inherently bad and must be fixed, nor
- pretend that everything’s a bonus, that we are superpowered and beautiful and perfect and capable and have no faults that might ever need addressing actually
…instead, it gives a good explanation of the ins and outs of ADHD in women, the strengths and weaknesses that this brings, and good solid advice on how to play to the strengths and reduce (or at least work around) the weaknesses.
Bottom line: this book has been described as “ADHD 2.0 (a very popular book that we’ve reviewed previously), but for women”, and it deserves that.
Click here to check out ADHD for Smart Ass Women, and fall in love with your neurodivergent brain!
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New California Laws Target Medical Debt, AI Care Decisions, Detention Centers
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SACRAMENTO, Calif. — As the nation braces for potential policy shifts under President-elect Donald Trump’s “Make America Healthy Again” mantra, the nation’s most populous state and largest health care market is preparing for a few changes of its own.
With supermajorities in both houses, Democrats in the California Legislature passed — and Democratic Gov. Gavin Newsom signed — laws taking effect this year that will erase medical debt from credit reports, allow public health officials to inspect immigrant detention centers, and require health insurance companies to cover fertility services such as in vitro fertilization.
Still, industry experts say it was a relatively quiet year for health policy in the Golden State, with more attention on a divisive presidential election and with several state legislators seeking to avoid controversial issues as they ran for Congress in competitive swing districts.
Newsom shot down some of legislators’ most ambitious health care policies, including proposals that would have regulated pharmaceutical industry middlemen and given the state more power to stop private equity deals in health care.
Health policy experts say advocates and legislators are now focused on how to defend progressive California policies such as sweeping abortion access in the state and health coverage for immigrants living in the U.S. without authorization.
“I think everyone’s just thinking about how we’re going to enter 2025,” said Rachel Linn Gish, a spokesperson with the consumer health advocacy group Health Access California. “We’re figuring out what is vulnerable, what we are exposed to on the federal side, and what do budget changes mean for our work. That’s kind of putting a cloud over everything.”
Here are some of the biggest new health care laws Californians should know about:
Medical debt
California becomes the eighth state in which medical debt will no longer affect patients’ credit reports or credit scores. SB 1061 bars health care providers and debt collectors from reporting unpaid medical bills to credit bureaus, a practice that supporters of the law say penalizes people for seeking critical care and can make it harder for patients to get a job, buy a car, or secure a mortgage.
Critics including the California Association of Collectors called the measure from Sen. Monique Limón (D-Santa Barbara) a “tremendous overreach” and successfully lobbied for amendments that limited the scope of the bill, including an exemption for any medical debt incurred on credit cards.
The Biden administration has finalized federal rules that would stop unpaid medical bills from affecting patients’ credit scores, but the fate of those changes remains unclear as Trump takes office.
Psychiatric hospital stays for violent offenders
Violent offenders with severe mental illness can now be held longer after a judge orders them released from a state mental hospital.
State officials and local law enforcement will now have 30 days to coordinate housing, medication, and behavioral health treatment for those parolees, giving them far more time than the five-day deadline previously in effect.
The bill drew overwhelming bipartisan support after a high-profile case in San Francisco in which a 61-year-old man was charged in the repeated stabbing of a bakery employee just days after his release from a state mental hospital. The bill’s author, Assembly member Matt Haney (D-San Francisco), called the previous five-day timeline “dangerously short.”
Cosmetics and ‘forever chemicals’
California was the first state to ban PFAS chemicals, also known as “forever chemicals,” in all cosmetics sold and manufactured within its borders. The synthetic compounds, found in everyday products including rain jackets, food packaging, lipstick, and shaving cream, have been linked to cancer, birth defects, and diminished immune function and have been increasingly detected in drinking water.
Industry representatives have argued that use of PFAS — perfluoroalkyl and polyfluoroalkyl substances — is critical in some products and that some can be safely used at certain levels.
Immigration detention facilities
After covid-19 outbreaks, contaminated water, and moldy food became the subjects of detainee complaints and lawsuits, state legislators gave local county health officials the authority to enter and inspect privately run immigrant detention centers. SB 1132, from Sen. María Elena Durazo (D-Los Angeles), gives public health officials the ability to evaluate whether privately run facilities are complying with state and local public health regulations regarding proper ventilation, basic mental and physical health care, and food safety.
Although the federal government regulates immigration, six federal detention centers in California are operated by the GEO Group. One of the country’s largest private prison contractors, GEO has faced a litany of complaints related to health and safety. Unlike public prisons and jails, which are inspected annually, these facilities would be inspected only as deemed necessary.
The contractor filed suit in October to stop implementation of the law, saying it unconstitutionally oversteps the federal government’s authority to regulate immigration detention centers. A hearing in the case is set for March 3, said Bethany Lesser, a spokesperson for California Attorney General Rob Bonta. The law took effect Jan. 1.
Doctors vs. insurance companies using AI
As major insurance companies increasingly use artificial intelligence as a tool to analyze patient claims and authorize some treatment, trade groups representing doctors are concerned that AI algorithms are driving an increase in denials for necessary care. Legislators unanimously agreed.
SB 1120 states that decisions about whether a treatment is medically necessary can be made only by licensed, qualified physicians or other health care providers who review a patient’s medical history and other records.
Sick leave and protected time off
Two new laws expand the circumstances under which California workers may use sick days and other leave. SB 1105 entitles farmworkers who work outdoors to take paid sick leave to avoid heat, smoke, or flooding when local or state officials declare an emergency.
AB 2499 expands the list of reasons employees may take paid sick days or use protected unpaid leave to include assisting a family member who is experiencing domestic violence or other violent crimes.
Prescription labels for the visually impaired
Starting this year, pharmacies will be required to provide drug labels and use instructions in Braille, large print, or audio for blind patients.
Advocates of the move said state law, which already required translated instructions in five languages for non-English speakers, has overlooked blind patients, making it difficult for them to monitor prescriptions and take the correct dosage.
Maternal mental health screenings
Health insurers will be required to bolster maternal mental health programs by mandating additional screenings to better detect perinatal depression, which affects 1 in 5 people who give birth in California, according to state data. Pregnant people will now undergo screenings at least once during pregnancy and then six weeks postpartum, with further screenings as providers deem necessary.
Penalties for threatening health care workers (abortion clinics)
With abortion care at the center of national policy fights, California is cracking down on those who threaten, post personal information about, or otherwise target providers or patients at clinics that perform abortions. Penalties for such behavior will increase under AB 2099, and offenders can face felony charges, up to three years in jail, and $50,000 in fines for repeat or violent offenses. Previously, state law classified many of those offenses as misdemeanors.
Insurance coverage for IVF
Starting in July, state-regulated health plans covering 50 employees or more would be required to cover fertility services under SB 729, passed and signed last year. Advocates have long fought for this benefit, which they say is essential care for many families who have trouble getting pregnant and would ensure LGBTQ+ couples aren’t required to pay more out-of-pocket costs than straight couples when starting a family.
In a signing statement, Newsom asked legislators to delay implementation of the law until 2026 as state officials consider whether to add infertility treatments to the list of benefits that insurance plans are required to cover.
It’s unclear whether legislators intend to address that this session, but a spokesperson for the governor said that Newsom “clearly stated his position on the need for an extension” and that he “will continue to work with the legislature” on the matter.
Plans under CalPERS, the California Public Employees’ Retirement System, would have to comply by July 2027.
This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
This article first appeared on KFF Health News and is republished here under a Creative Commons license.
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How To Keep Your Mind From Wandering
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Whether your mind keeps wandering more as you get older, or you’re a young student whose super-active brain is more suited to TikTok than your assigned reading, sustained singular focus can be a challenge for everyone—and yet (alas!) it remains a required skill for so much in life.
Today’s edition of 10Almonds presents a nifty trick to get yourself through those tasks! We’ll also be taking some time to reply to your questions and comments, in our weekly interactive Q&A.
First of all though, we’ve a promise to make good on, so…
How To Stay On The Ball (Or The Tomato?) The Easy Way
For most of us, we face three main problems when it comes to tackling our to-dos:
- Where to start?
- The task seems intimidating in its size
- We get distracted and/or run out of energy
If you’re really not sure where to start, we recommended a powerful tool in last Friday’s newsletter!
For the rest, we love the Pomodoro Technique:
- Set a timer for 25 minutes, and begin your task.
- Keep going until the timer is done! No other tasks, just focus.
- Take a 5-minute break.
- Repeat
This approach has three clear benefits:
- No matter the size of the task, you are only committing to 25 minutes—everything is much less overwhelming when there’s an end in sight!
- Being only 25 minutes means we are much more likely to stay on track; it’s easier to defer other activities if we know that there will be a 5-minute break for that soon.
- Even without other tasks to distract us, it can be difficult to sustain attention for long periods; making it only 25 minutes at a time allows us to approach it with a (relatively!) fresh mind.
Have you heard that a human brain can sustain attention for only about 40 minutes before focus starts to decline rapidly?
While that’s been a popular rationale for school classroom lesson durations (and perhaps coincidentally ties in with Zoom’s 40-minute limit for free meetings), the truth is that focus starts dropping immediately, to the point that one-minute attention tests are considered sufficient to measure the ability to focus.
So a 25-minute Pomodoro is a more than fair compromise!
Why’s it called the “Pomodoro” technique?
And why is the 25-minute timed work period called a Pomodoro?
It’s because back in the 80s, university student Francesco Cirillo was struggling to focus and made a deal with himself to focus just for a short burst at a time—and he used a (now “retro” style) kitchen timer in the shape of a tomato, or “pomodoro”, in Italian.
If you don’t have a penchant for kitsch kitchenware, you can use this free, simple Online Pomodoro Timer!
(no registration/login/download necessary; it’s all right there on the web page)
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