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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Hazelnuts vs Chestnuts – Which is Healthier?
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Our Verdict
When comparing hazelnuts to chestnuts, we picked the hazelnuts.
Why?
This one’s not close.
In terms of macros, we have some big difference to start with, since chestnuts contain a lot more water and carbs whereas hazelnuts contain a lot more protein, fats, and fiber. The fats, as with most nuts, are healthy; in this case mostly being monounsaturated fat.
Because of the carbs and fiber being so polarized (i.e., chestnuts have most of the carbs and hazelnuts have most of the fiber), there’s a big difference in glycemic index; hazelnuts have a GI of 15 while chestnuts have a GI of 52.
In the category of vitamins, hazelnuts contain more of vitamins A, B1, B2, B3, B5, B6, and B9, while chestnuts contain more vitamin C.
When it comes to minerals, the story is similar: hazelnuts contain a lot more calcium, copper, iron, magnesium, manganese, phosphorus, and zinc, while chestnuts contain a tiny bit more potassium.
All in all, enjoy either or both, but nutritionally speaking, hazelnuts are a lot better in almost every way.
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts
Take care!
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Seriously Useful Communication Skills!
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What Are Communication Skills, Really?
Superficially, communication is “conveying an idea to someone else”. But then again…
Superficially, painting is “covering some kind of surface in paint”, and yet, for some reason, the ceiling you painted at home is not regarded as equally “good painting skills” as Michaelangelo’s, with regard to the ceiling of the Sistine Chapel.
All kinds of “Dark Psychology” enthusiasts on YouTube, authors of “Office Machiavelli” handbooks, etc, tell us that good communication skills are really a matter of persuasive speaking (or writing). And let’s not even get started on “pick-up artist” guides. Bleugh.
Not to get too philosophical, but here at 10almonds, we think that having good communication skills means being able to communicate ideas simply and clearly, and in a way that will benefit as many people as possible.
The implications of this for education are obvious, but what of other situations?
Conflict Resolution
Whether at work or at home or amongst friends or out in public, conflict will happen at some point. Even the most well-intentioned and conscientious partners, family, friends, colleagues, will eventually tread on our toes—or we, on theirs. Often because of misunderstandings, so much precious time will be lost needlessly. It’s good for neither schedule nor soul.
So, how to fix those situations?
I’m OK; You’re OK
In the category of “bestselling books that should have been an article at most”, a top-tier candidate is Thomas Harris’s “I’m OK; You’re OK”.
The (very good) premise of this (rather padded) book is that when seeking to resolve a conflict or potential conflict, we should look for a win-win:
- I’m not OK; you’re not OK ❌
- For example: “Yes, I screwed up and did this bad thing, but you too do bad things all the time”
- I’m OK; you’re not OK ❌
- For example: “It is not I who screwed up; this is actually all your fault”
- I’m not OK; you’re OK ❌
- For example: “I screwed up and am utterly beyond redemption; you should immediately divorce/disown/dismiss/defenestrate me”
- I’m OK; you’re OK ✅
- For example: “I did do this thing which turned out to be incorrect; in my defence it was because you said xyz, but I can understand why you said that, because…” and generally finding a win-win outcome.
So far, so simple.
“I”-Messages
In a conflict, it’s easy to get caught up in “you did this, you did that”, often rushing to assumptions about intent or meaning. And, the closer we are to the person in question, the more emotionally charged, and the more likely we are to do this as a knee-jerk response.
“How could you treat me this way?!” if we are talking to our spouse in a heated moment, perhaps, or “How can you treat a customer this way?!” if it’s a worker at Home Depot.
But the reality is that almost certainly neither our spouse nor the worker wanted to upset us.
Going on the attack will merely put them on the defensive, and they may even launch their own counterattack. It’s not good for anyone.
Instead, what really happened? Express it starting with the word “I”, rather than immediately putting it on the other person. Often our emotions require a little interrogation before they’ll tell us the truth, but it may be something like:
“I expected x, so when you did/said y instead, I was confused and hurt/frustrated/angry/etc”
Bonus: if your partner also understands this kind of communication situation, so much the better! Dark psychology be damned, everything is best when everyone knows the playbook and everyone is seeking the best outcome for all sides.
The Most Powerful “I”-Message Of All
Statements that start with “I” will, unless you are rules-lawyering in bad faith, tend to be less aggressive and thus prompt less defensiveness. An important tool for the toolbox, is:
“I need…”
Softly spoken, firmly if necessary, but gentle. If you do not express your needs, how can you expect anyone to fulfil them? Be that person a partner or a retail worker or anyone else. Probably they want to end the conflict too, so throw them a life-ring and they will (if they can, and are at least halfway sensible) grab it.
- “I need an apology”
- “I need a moment to cool down”
- “I need a refund”
- “I need some reassurance about…” (and detail)
Help the other person to help you!
Everything’s best when it’s you (plural) vs the problem, rather than you (plural) vs each other.
Apology Checklist
Does anyone else remember being forced to write an insincere letter of apology as a child, and the literary disaster that probably followed? As adults, we (hopefully) apologize when and if we mean it, and we want our apology to convey that.
What follows will seem very formal, but honestly, we recommend it in personal life as much as professional. It’s a ten-step apology, and you will forget these steps, so we recommend to copy and paste them into a Notes app or something, because this is of immeasurable value.
It’s good not just for when you want to apologize, but also, for when it’s you who needs an apology and needs to feel it’s sincere. Give your partner (if applicable) a copy of the checklist too!
- Statement of apology—say “I’m sorry”
- Name the offense—say what you did wrong
- Take responsibility for the offense—understand your part in the problem
- Attempt to explain the offense (not to excuse it)—how did it happen and why
- Convey emotions; show remorse
- Address the emotions/damage to the other person—show that you understand or even ask them how it affected them
- Admit fault—understand that you got it wrong and like other human beings you make mistakes
- Promise to be better—let them realize you’re trying to change
- Tell them how you will try to do it different next time and finally
- Request acceptance of the apology
Note: just because you request acceptance of the apology doesn’t mean they must give it. Maybe they won’t, or maybe they need time first. If they’re playing from this same playbook, they might say “I need some time to process this first” or such.
Want to really superpower your relationship? Read this together with your partner:
Hold Me Tight: Seven Conversations for a Lifetime of Love, and, as a bonus:
The Hold Me Tight Workbook: A Couple’s Guide for a Lifetime of Love
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My dance school is closed for the summer, how can I keep up my fitness?
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Once the end-of-year dance concert and term wrap up for the year it is important to take a break. Both physical and mental rest are important and taking a few weeks off can help your body repair and have a mental break from dance.
If your mind and body are in need of an extended break (such as more than a few weeks), then it’s more than OK to take longer off, especially if you are training at a competitive or pre-professional level.
There is benefit in enjoying other aspects of your life outside of dance such as spending time with family, friends and enjoying hobbies.
Tatyana Vyc/Shutterstock A safe, fulfilling dancing life
Creating meaning and value in life outside of dance and expanding sense of self can make it easier to lean into other aspects when experiencing change or difficult times during dance training such as being injured.
Taking an extended break from dance training will, however, mean losing some fitness and physical capacity. When you return to dance your body will take time to return to full capacity again.
Approaches such as being “whipped back into shape” can promote sudden spikes in training load (hours and intensity of training) which can increase the risk of injury. It is advised to gradually and progressively increase training load over time to allow the body to adapt and return to full capacity safely.
A four-to-six week period of gradually progressing training load and introducing jumping has been suggested in dance settings.
For dancers wanting to maintain fitness over the summer holidays, a great place to start is focusing on building a physical foundation.
Exercise like running can help build a physical foundation. Jacek Chabraszewski/Shutterstock Building a physical foundation means focusing on targeted areas of fitness such as full body strength, cardiovascular fitness or stamina (such as skipping, cycling walking, running, swimming), flexibility, and some dance-specific conditioning (for example, calf rises for ballet).
A good physical foundation will mean an improved capacity and fitness level so your body is ready to take on more challenging dance movements and routines once you return to the studio.
Building full body strength at home or at the park
A great place to start is by choosing movements that require your muscles to work to support your own body weight.
Fundamental movements such as crawling (moving on the floor on hands and feet) and locomotion (travelling movements such as lunging, hopping, sliding) are great for developing body control, arm and leg stability and coordinated movement patterns.
Below is a sequence that can be used as a warm up and even as a workout itself. The ten minute sequence is based on gross motor and fundamental movement patterns. It includes exercises that work through a range of joint movements and in multiple planes (forwards, sideways, rotating).
This fundamental movement sequence can be used as a warm-up or a workout. Joanna Nicholas, CC BY Once feeling comfortable with the above fundamental movements, it is time to introduce body weight resistance exercises.
Body weight resistance exercises can be beneficial for developing a strong foundation for dance movements such as jumping, landing, floorwork, partnering and aerial work.
Exercises from the above sequence can be used to form a safe and effective neuromuscular warm up.
Aim to include one exercise from each of the below movement categories (squat, horizontal push etc) to build your own workout.
Aim to complete two to three sets (or rounds) of each exercise with about one minute rest between sets. An alternative is to complete one set of each exercise with minimal rest between, then complete a second or third time.
If training with friends, you could set a timer and do each exercise for up to 50 seconds (instead of counting reps) and take ten seconds to transition to the next exercise.
Depending on your level of strength you may need to do fewer repetitions and build up sets and repetitions overtime. After you have completed the body weight exercises complete a cool down including stretches for the upper and lower body muscles. Be sure to use a sturdy bar (such as an outdoor fitness station) for horizontal row and overhead hold.
Exercises may need to be modified depending on fitness level and physical limitations such as injury.
You can build your own full body strength workout using these movements. Joanna Nicholas, CC BY How often should I train?
A common misconception in dance is that “more is better”. This belief can lead to dancers training long hours on most or all days of the week which can lead to overtraining, plateauing and increased risk of injury.
Our bodies require sufficient time between training sessions to adapt and get stronger and fitter. The time between sessions is when our muscles and tissues repair and training gains are made.
By incorporating adequate recovery (including sleep and downtime) and including rest days throughout the week, our bodies can gain the most benefits from training.
Rest days are important, too. Manop Boonpeng/Shutterstock Muscles can take up to 48–72 hours to recover from most types of strength-based exercises (the more intense the longer they’ll need to recover).
Aerobic activity at low intensity, such as a brisk walk, can be done most days (24-hour recovery) while high stress anaerobic exercise such as high intensity intervals or sprints can take three days or more to recover from.
Aim to spread training sessions out over the week and allow time to recover between sessions.
Below is an example weekly schedule based on incorporating adequate recovery between sessions, and incorporating polarised training where some days are harder and others are easier.
Seek guidance from your healthcare provider and/or an exercise professional prior to undertaking a new exercise program.
Joanna Nicholas, Lecturer in Dance and Performance Science, Edith Cowan University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Uric Acid’s Extensive Health Impact (And How To Lower It)
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Uric Acid’s Extensive Health Impact (And How To Lower It)
This is Dr. David Perlmutter. He’s a medical doctor, and a Fellow of the American College of Nutrition. He’s a member of the Editorial Board for the Journal of Alzheimer’s Disease, and has been widely published in many other peer-reviewed journals.
What does he want us to know?
He wants us to know about the health risks of uric acid (not something popularly talked about so much!), and how to reduce it.
First: what is it? Uric acid is a substance we make in our own body. However, unlike most substances we make in our body, we have negligible use for it—it’s largely a waste product, usually excreted in urine.
However, if we get too much, it can build up (and crystallize), becoming such things as kidney stones, or causing painful inflammation if it shows up in the joints, as in gout.
More seriously (unpleasant as kidney stones and gout may be), this inflammation can have a knock-on effect triggering (or worsening) other inflammatory conditions, ranging from non-alcoholic fatty liver disease, to arthritis, to dementia, and even heart problems. See for example:
- David Perlmutter | Uric Acid and Cognitive Decline
- American Heart Association | Uric acid linked to later risk for irregular heart rhythm
- World Journal of Gastroenterology | The role of uric acid in non-alcoholic steatohepatitis development
How can we reduce our uric acid levels?
Uric acid is produced when we metabolize purine nucleotides, which are found in many kinds of food. We can therefore reduce our uric acid levels by reducing our purine intake, as well as things that mess up our liver’s ability to detoxify things. Offsetting the values for confounding variables (such as fiber content, or phytochemicals that mitigate the harm), the worst offenders include…
Liver-debilitating things:
- Alcohol (especially beer)
- High-fructose corn syrup (and other fructose-containing things that aren’t actual fruit)
- Other refined sugars
- Wheat / white flour products (this is why beer is worse than wine, for example; it’s a double-vector hit)
Purine-rich things:
- Red meats and game
- Organ meats
- Oily fish, and seafood (great for some things; not great for this)
Some beans and legumes are also high in purines, but much like real fruit has a neutral or positive effect on blood sugar health despite its fructose content, the beans and legumes that are high in purines, also contain phytochemicals that help lower uric acid levels, so have a beneficial effect.
Eggs (consumed in moderation) and tart cherries have a uric-acid lowering effect.
Water is important for all aspects of health, and doubly important for this.
Hydrate well!
Lifestyle matters beyond diet
The main key here is metabolic health, so Dr. Perlmutter advises the uncontroversial lifestyle choices of moderate exercise and good sleep, as well as (more critically) intermittent fasting. We wrote previously on other things that can benefit liver health:
…in this case, that means the liver gets a break to recuperate (something it’s very good at, but does need to get a chance to do), which means that while you’re not giving it something new to do, it can quickly catch up on any backlog, and then tackle any new things fresh, next time you start eating.
Want to know more about this from Dr. Perlmutter?
You might like his article:
An Integrated Plan for Lowering Uric Acid ← more than we had room for here; he also talks about extra things to include in your diet/supplementation regime for beneficial effects!
And/or his book:
…on which much of today’s main feature was based.
Take care!
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Antioxidant Matcha Snack Bars
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The antioxidants in this come not just from the matcha, but also the cacao nibs and chocolate, as well as lots of nutrients from the hazelnuts and cashews. If you’re allergic to nuts, we’ll give you substitutions that will change the nutritional profile (and flavor), but still work perfectly well and be healthy too.
You will need
For the base:
- ⅔ cup roasted hazelnuts (if allergic, substitute dessicated coconut)
- ⅔ cup chopped dates
For the main part:
- 1 cup raw cashews (if allergic, substitute raw coconut, chopped)
- ½ cup almond milk (or your preferred milk of any kind)
- ½ cup cacao nibs
- 2 tbsp lime juice
- 1 tbsp matcha powder
- 1 tbsp maple syrup (omit if you don’t care for sweetness)
For the topping (optional):
- 2oz dark chocolate, melted (and if you like, tempered—but this isn’t necessary; it’ll just make it glossier if you do)
- Spare cacao nibs, chopped nuts, or anything else you might want on there
Method
(we suggest you read everything at least once before doing anything)
1) Blend the base ingredients in a food processor until it has a coarse sticky texture, but isn’t yet a paste or dough.
2) Line a cake pan with baking paper and spread the base mix on the base; press it down to compact it a little and ensure it is flat. If there’s room, put this in the freezer while you do the next bit. If not, the fridge will suffice.
3) Blend the main part ingredients apart from the cacao nibs, until smooth. Stir in the cacao nibs with a spoon.
4) Spread the main part evenly over the base, and allow everything you’ve built (in this recipe, not in life in general) to chill in the fridge for at least 4 hours.
5) Cut it into blocks of the size and shape you want to eat them, and (if adding the optional topping) separate the blocks slightly from each other, before drizzling with the chocolate topping. Put it back in the fridge to cool this too; an hour should be sufficient.
6) Serve!
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Which Tea Is Best, By Science?
- Which Plant Milk?
- Why You Should Diversify Your Nuts!
- Cashew Nuts vs Coconut – Which is Healthier?
- Cacao vs Carob – Which is Healthier?
Take care!
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4 Tips To Stand Without Using Hands
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The “sit-stand” test, getting up off the floor without using one’s hands, is well-recognized as a good indicator of healthy aging, and predictor of longevity. But what if you can’t do it? Rather than struggling, there are exercises to strengthen the body to be able to do this vital movement.
Step by step
Teresa Shupe has been teaching Pilates professionally full-time for over 25 years, and here’s what she has to offer in the category of safe and effective ways of improving balance and posture while doing the sitting-to-standing movement:
- Squat! Doing squats (especially deep ones) regularly strengthens all the parts necessary to effectively complete this movement. If your knees aren’t up to it at first, do the squats with your back against a wall to start with.
- Roll! On your back, cross your feet as though preparing to stand, and rock-and-roll your body forwards. To start with you can “cheat” and use your fingertips to give a slight extra lift. This exercise builds mobility in the various necessary parts of the body, and also strengthens the core—as well as getting you accustomed to using your bodyweight to move your body forwards.
- Lift! This one’s focusing on that last part, and taking it further. Because it may be difficult to get enough momentum initially, you can practice by holding small weights in your hands, to shift your centre of gravity forwards a bit. Unlike many weights exercises, in this case you’re going to transition to holding less weight rather than more, though.
- Complete! Continue from the above, without weights now; use the blades of your feet to stand. If you need to, use your fingertips to give you a touch more lift and stability, and reduce the fingers that you use until you are using none.
For more on each of these as well as a visual demonstration, enjoy this short video:
Click Here If The Embedded Video Doesn’t Load Automatically!
Further reading
For more exercises with a similar approach, check out:
Mobility As A Sporting Pursuit
Take care!
Don’t Forget…
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