Getting antivirals for COVID too often depends on where you live and how wealthy you are
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
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.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Recommended
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Early Dementia Screening From Your Blood & More
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Dementia is, statistically speaking, the most feared disease in the US. Notwithstanding…
- heart disease killing more
- COVID being more of a lottery
- cancer being the “yes you can modify risk factors but it can come for anyone” life-changing (and often life-ending) disease,
…it’s still dementia that Americans report fearing the most.
And yet… Early dementia screening is seriously underused
It may be a case of a head-in-sand approach to avoid unwanted news, or it could be a case of not knowing what’s available.
So, with that in mind…
How to watch out: first line warning signs
You walk into a room of your house, and suddenly stop: “what did I come in here for?”, you wonder.
A moment later, you’re worrying whether this is a sign of age-related cognitive decline.
The good news: it usually isn’t. In fact, you did that when you were younger, too, you just didn’t pay enough attention at the time to remember it now.
Dementia-related memory loss is less “where did I put my car keys?”, and more “what is this thing for?” (it’s your car keys). Or at a less advanced stage: “whose are these car keys?” (they are yours).
You can read about some of the nuances here:
Is It Dementia? Spot The Signs (Because None Of Us Are Immune) ← If you’d like an objective test of memory and other cognitive impairments, this article also has a link to the industry’s gold standard test (it’s free)
(The Self-Administered Gerocognitive Exam (SAGE) is designed to detect early signs of cognitive, memory or thinking impairments)
Tests you can’t do at home
We wrote a little while back about how one kind of blood testing for Alzheimer’s disease works:
The Brain Alarm Signs That Warn Of Dementia
Why “Brain Alarm Signs” if it’s a blood test? Because the blood gets (in very lay terms) bits of broken brain in it. Or more specifically, they tested the blood for density of cerebrovascular endothelial extracellular vesicles (CEEVs), which are bits of the cells from the lining of blood vessels in the brain. These cerebrovascular endothelial extracellular vesicles should not, ideally, be falling off and riding around your bloodstream, and the greater the density of them, the greater likelihood of mild cognitive impairment now, and by extension, dementia later.
It’s not the only blood test available though, see:
Highly accurate blood test for Alzheimer’s disease is similar or superior to clinical cerebrospinal fluid (CSF) tests ← this one checks the ratio of phosporylated-tau217 to non-phosphorylated tau (which is a protein antibody), which equalled or outperformed FDA-approved CSF tests in classifying amyloid-β positron emission topography (PET, as in a PET scan) status, with a confidence interval as high as, or better than, industry standards.
If you don’t like having your blood taken, trust us that you’d find having your cerebrospinal fluid taken even less enjoyable, so this is a very welcome improvement!
In case you’re curious about how the CSF test works, here you go: NPTX2 in Cerebrospinal Fluid Predicts the Progression From Normal Cognition to Mild Cognitive Impairment ← NPTX2 is a protein biomarker of Alzheimer’s risk
…but again, we really think the blood test is preferable.
Tests beyond the physiological
There are, of course, psychological tests that can be done, including a linguistic analysis of your conversation, compared with a vast database of other people’s conversations, with and without various degrees of cognitive impairment
As Dr. Ioannis Paschalidis explains:
❝We wanted to predict what would happen in the next six years—and we found we can reasonably make that prediction with relatively good confidence and accuracy.
Rather than using acoustic features of speech, like enunciation or speed, the model is just pulling from the content of the interview—the words spoken, how they’re structured.
You can think of the score as the likelihood, the probability, that someone will remain stable or transition to dementia. It had significant predictive ability.
Digital is the new blood. You can collect it, analyze it for what is known today, store it, and reanalyze it for whatever new emerges tomorrow.❞
You can read the full paper here: Prediction of Alzheimer’s disease progression within 6 years using speech: A novel approach leveraging language models
See also: AI: The Doctor That Never Tires?
What if the news isn’t good?
While bad news is never welcome per se, it is preferable to not knowing, insofar as we can then take steps to manage the situation.
You may be wondering: what can be done that I wouldn’t already be doing to minimize my dementia risk in the first place?
And the answer is: yes, do continue those things of course, but there is more to do:
See: Beyond Guarding Against Dementia: When Age’s Brain-Changes Come Knocking
Take care!
Share This Post
-
It’s A Wrap
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
We hope all our readers have had a great and healthy week! Here are some selections from health news from around the world:
A lack of transparency
Thousands of chemicals blanket-approved for food contact in packaging, under the FDA’s “Generally Recognized As Safe” umbrella, have been found in humans.
This highlights a gap in the safeguarding system, because the GRAS classification is given when there’s no known significant association with disease—but in this case, a problem can occur when the build-up in the blood and brain cause problems much later.
Read in full: Thousands of toxins from food packaging found in humans – research
Learn more: We Are Such Stuff As Bottles Are Made Of (It’s Not Fantastic To Be Plastic)
Cafestol for weight loss?
Most coffee intervention studies use instant coffee. Which is understandable; they are scientists on a budget, not coffee shop baristas. But, instant coffee is low in some of coffee’s important compounds, such as cafestol—which as it turns out, can lower not only overall body fat, but also (importantly!) visceral fat.
Read in full: 12-week coffee compound study shows promising results for weight and fat reduction in at-risk individuals
Learn more: The Bitter Truth About Coffee (or is it?)
Doing something is better than doing nothing
While a lot of the bad news both locally and around the world can be infuriating and/or depressing, turning a blind eye may not be the best approach for dealing with it. This study was in teens, but it’s likely that the benefits are similar for other ages too:
Read in full: Racial justice activism, advocacy found to reduce depression, anxiety in some teens
Learn more: Make Social Media Work For Your Mental Health
A ray of hope!
Sometimes, the topic of sun and sunscreens can seem like “damned if you do; damned if you don’t”, with regard to the harmful effects of the sun, and in some cases, potentially harmful effects of some sunscreen chemicals. We’ve argued ultimately in favor of sunscreens in this tug-of-war, but it’s nice to see improvements being made, in this case, with lignin-based sunscreen (a plant-based by-product of the pulp industry).
Read in full: Researchers create high-performing, eco-friendly sunscreen
Learn more: Who Screens The Sunscreens?
All about the pores
Researchers have identified a protein, and from that, a stack of protein fragments, that are involved in the formation of large pores. This is important, as it’s pointing to a means of relief for a lot of inflammatory diseases.
Read in full: Scientists unravel the process of pore formation in cells
Learn more: Why Do We Have Pores, And Could We Not?
Getting to the bottom of Crohn’s
If you have Crohn’s, or perhaps someone close to you has it, then you’ll be familiar with the common medical refrain of “we don’t know”. While this honesty is laudable, it’s not reassuring. So, it’s good that researchers are making progress in understanding why many people with Crohn’s may respond differently not only to lifestyle interventions, but also to various relevant drugs—allowing doctors to prescribe the right treatment for the right person.
Read in full: Patient-derived gut organoids reveal new insights into Crohn’s disease subtypes
Learn more: Diet Tips for Crohn’s Disease
Another carotenoid that holds back Alzheimer’s
Phytoene is a carotenoid that is found in many red, orange, or yellow foods, including tomatoes, carrots, apricots, red peppers, oranges, mandarins and passion fruit, among others. Researchers have found that it slows the onset of symptoms associated with the formation of amyloid plaques, by 30–40%, and increases longevity by 10–19%:
Read in full: Carotenoid phytoene shows potential in slowing Alzheimer’s plaque formation and increasing lifespan
Learn more: Brain Food? The Eyes Have It! ← this is about a different carotenoid, lutein, found mostly in dark green leafy vegetables, but it’s best to enjoy both 😎
Take care!
Share This Post
-
Hazelnuts vs Pistachios – Which is Healthier?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Our Verdict
When comparing hazelnuts to pistachios, we picked the hazelnuts.
Why?
An argument could be made for either, depending on what we prioritize! So there was really no wrong answer here today, but it is good to know what each nut’s strengths are:
In terms of macros, pistachios have more fiber, carbs, protein, and (mostly healthy) fat. That does make them the “more food per food” option, but it’s worth noting that while hazelnuts have more fiber, they also have a higher margin of difference when it comes to their greater carb count, and resultantly, hazelnuts do have the lower glycemic index. That said, they’re still both low-GI foods, so we’ll call this section a win for pistachios overall.
When it comes to vitamins, hazelnuts have more of vitamins B3, B5, B9, C, E, K, and choline, while pistachios have more of vitamins A, B1, B2, and B6. So, a fair 7:4 win for hazelnuts here.
In the category of minerals, hazelnuts have more calcium, copper, iron, magnesium, manganese, and zinc, while pistachios have more phosphorus, potassium, and selenium. A clear 6:3 win for hazelnuts.
In short, both are good sources of many nutrients, so choose according to what you want to prioritize, or better yet, enjoy both.
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts
Take care!
Share This Post
Related Posts
-
Citicoline: Better Than Dietary Choline?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Citicoline: Better Than Dietary Choline?
Citicoline, also known as cytidine diphosphate-choline (or CDP-Choline, to its friends, or cytidine 5′-diphosphocholine if it wants to get fancy) is a dietary supplement that the stomach can metabolize easily for all the brain’s choline needs. What are those needs?
Choline is an essential nutrient. We technically can synthesize it, but only in minute amounts, far less than we need. Choline is a key part of the neurotransmitter acetylcholine, as well as having other functions in other parts of the body.
As for citicoline specifically… it appears to do the job better than dietary sources of choline:
❝Intriguing data, showing that on a molar mass basis citicoline is significantly less toxic than choline, are also analyzed.
It is hypothesized that, compared to choline moiety in other dietary sources such as phosphatidylcholine, choline in citicoline is less prone to conversion to trimethylamine (TMA) and its putative atherogenic N-oxide (TMAO).
Epidemiological studies have suggested that choline supplementation may improve cognitive performance, and for this application citicoline may be safer and more efficacious.❞
Source: Citicoline: A Superior Form of Choline?
Great! What does it do?
What doesn’t it do? When it comes to cognitive function, anyway, citicoline covers a lot of bases.
Short version: it improves just about every way a brain’s healthy functions can be clinically measured. From cognitive improvements in all manner of tests (far beyond just “improves memory” etc; also focus, alertness, verbal fluency, logic, computation, and more), to purely neurological things like curing tinnitus (!), alleviating mobility disorders, and undoing alcohol-related damage.
One of the reasons it’s so wide in its applications, is that it has a knock-on effect to other systems in the brain, including the dopaminergic system.
Long version: Citicoline: pharmacological and clinical review, 2022 update
(if you don’t want to sit down for a long read, we recommend skimming to the charts and figures, which are very elucidating even alone)
Spotlight study in memory
For a quick-reading example of how it helps memory specifically:
Keeping dementia at bay
For many older people looking to improve memory, it’s less a matter of wanting to perform impressive feats of memory, and more a matter of wanting to keep a sharp memory throughout our later years.
Dr. Maria Bonvicini et al. looked into this:
❝We selected seven studies including patients with mild cognitive impairment, Alzheimer’s disease or post-stroke dementia
All the studies showed a positive effect of citicoline on cognitive functions. Six studies could be included in the meta-analysis.
Overall, citicoline improved cognitive status, with pooled standardized mean differences ranging from 0.56 (95% CI: 0.37-0.75) to 1.57 (95% CI: 0.77-2.37) in different sensitivity analyses❞
The researchers concluded “yes”, and yet, called for more studies, and of higher quality. In many such studies, the heterogeneity of the subjects (often, residents of nursing homes) can be as much a problem (unclear whether the results will be applicable to other people in different situations) as it is a strength (fewer confounding variables).
Another team looked at 47 pre-existing reviews, and concluded:
❝The review found that citicoline has been proven to be a useful compound in preventing dementia progression.
Citicoline has a wide range of effects and could be an essential substance in the treatment of many neurological diseases.
Its positive impact on learning and cognitive functions among the healthy population is also worth noting.❞
Source: Application of Citicoline in Neurological Disorders: A Systematic Review
The dopamine bonus
Remember how we said that citicoline has a knock-on effect on other systems, including the dopaminergic system? This means that it’s been studied (and found meritorious) for alleviating symptoms of Parkinson’s disease:
❝Patients with Parkinson’s disease who were taking citicoline had significant improvement in rigidity, akinesia, tremor, handwriting, and speech.
Citicoline allowed effective reduction of levodopa by up to 50%.
Significant improvement in cognitive status evaluation was also noted with citicoline adjunctive therapy.❞
Source: Citicoline as Adjuvant Therapy in Parkinson’s Disease: A Systematic Review
Where to get it?
We don’t sell it, but here’s an example product on Amazon, for your convenience
Enjoy!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
End Your Carb Confusion – by Dr. Eric Westman & Amy Berger
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Carbs can indeed be confusing! We’ve written about it ourselves before, but there’s more to be said than fits in a single article, and sometimes a book is in order. This one is such a book.
The authors (an MD and a nutritionist) explain the ins and outs of carbohydrates of various kinds, insulin responses, and what that means for the body. They also then look at the partly-similar, partly-different processes that occur with the metabolism of fats of various kinds, and what that means for the body, too.
Ultimately they advocate for a simple and clear low-carb approach broadly consistent with keto diet macro principles, without getting too overly focused on “is this fruit/vegetable ok?” minutiae. This has the benefit of putting it well aside from the paleo diet, for example (which focuses more on pseudo-historical foods than it does on macros), and also makes it a lot easier on a practical level.
The style is very textbook-like, which makes for an easy read with plenty of information that should stick easily in most reader’s minds, rather than details getting lost in wall-of-text formatting. So, we approve of this.
There is not, by the way, a recipes section. It’s “here’s the information, now go forth and enjoy” and leaves us all to find/make our own recipes, rather than trying to guess our culinary preferences.
Bottom line: if you’d like an easy-to-read primer on understanding how carbs work, what it means for you, and what to do about it, then this is a fine book.
Click here to check out End Your Carb Confusion, and end your carb confusion!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Farmed Fish vs Wild Caught
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small 😎
❝Is it good to eat farm raised fish?❞
We’ll answer this as a purely health-related question (and thus not considering economy, ecology, ethics, or taste).
It’s certainly not as good as wild-caught fish, for several reasons, some more serious than others:
Farmed fish can have quite a different nutritional profile to wild-caught fish, and also contain more contaminants, including heavy metals.
For example, farmed fish tend to have much higher fat content for the same amount of protein, but lower levels of minerals and other nutrients. Here are two side-by-side:
Wild-caught salmon | Farmed salmon
See also:
Quantitative analysis of the benefits and risks of consuming farmed and wild salmon
Additionally, because fish in fish farms tend to be very susceptible to diseases (because of the artificially cramped and overcrowded environment), fish farms tend to make heavy use of antibiotics, which can cause all sorts of problems down the line:
So definitely, “let the buyer beware”!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails: