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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The Orchid That Renovates Your Gut (Gently)
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The Orchid That Renovates Your Gut (Gently)
Dendrobium officinale is an orchid that’s made its way from Traditional Chinese Medicine into modern science.
Read: Traditional Uses, Phytochemistry, Pharmacology, and Quality Control of Dendrobium officinale
To summarize its benefits, we’ll quote from Dr. Paharia’s article featured in our “what’s happening in the health world” section all so recently:
❝Gut microbes process Dendriobium officinale polysaccharides (DOPs) in the colon, producing short-chain fatty acids (SCFAs) and oligosaccharides that alter gut microbial composition and improve human health.
DOPs have been shown to decrease harmful bacteria like E. coli and Staphylococcus while promoting beneficial ones like Bifidobacterium.❞
We don’t stop at secondary sources, though, so we took a look at the science.
Dr. Wu et al. found (we’ll quote directly for these bullet points):
- DOPs have been shown to influence the gut microbiota, such as the abundance of Lactobacillus, Bifidobacterium, Akkermansia, Bacteroides, and Prevotella, and provide different benefits to the host due to structural differences.
- The dietary intake of DOPs has been shown to improve the composition of the gut microbiome and offers new intervention strategies for metabolic diseases such as obesity and type 2 diabetes as well as inflammatory diseases such as chronic obstructive pulmonary disease and colitis.
- Compared to drug therapy, intervention with DOPs is not specific and has a longer intervention duration
This is consistent with previous research on Dendrobium officinale, such as last year’s:
❝DOP significantly increased benign intestinal microbe proportion (Lactobacillus, etc.), but reduced harmful bacteria (Escherichia shigella) (P < 0.05), and significantly increased butyric acid production (P < 0.05)❞
In summary…
Research so far indicates that this does a lot of good for the gut, in a way that can “kickstart” healthier, self-regulating gut microbiota.
As to its further prospects, check out:
Very promising!
Where can I get it?
We don’t sell it, but for your convenience here’s an example product on Amazon
Be warned, it is expensive though!
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Nutrivore – by Dr. Sarah Ballantyne
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The core idea of this book is that foods can be assigned a numerical value according to their total nutritional value, and that this number can be used to guide a person’s diet such that we will eat, in aggregate, a diet that is more nutritious. So far, so simple.
What Dr. Ballantyne also does, besides explaining and illustrating this system (there are chapters explaining the calculation system, and appendices with values), is also going over what to consider important and what we can let slide, and what things we might need more of to address a wide assortment of potential health concerns. And yes, this is definitely a “positive diet” approach, i.e. it focuses on what to add in, not what to cut out.
The premise of the “positive diet” approach is simple, by the way: if we get a full set of good nutrients, we will be satisfied and not crave unhealthy food.
She also offers a lot of helpful “rules of thumb”, and provides a variety of cheat-sheets and suchlike to make things as easy as possible.
There’s also a recipes section! Though, it’s not huge and it’s probably not necessary, but it’s just one more “she’s thinking of everything” element.
Bottom line: if you’d like a single-volume “Bible of” nutrition-made-easy, this is a very usable tome.
Click here to check out Nutrivore, and start filling up your diet!
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Polyphenol Paprika Pepper Penne
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This one’s easier to promptly prepare than it is to pronounce unprepared! Ok, enough alliteration: this dish is as full of flavor as it is full of antioxidants, and it’s great for digestive health and heart health too.
You will need
- 4 large red bell peppers, diced
- 2 red onions, roughly chopped
- 1 bulb garlic, finely chopped
- 2 cups cherry tomatoes, halved
- 10oz wholemeal penne pasta
- 1 tbsp nutritional yeast
- 1 tbsp smoked paprika
- 1 tbsp black pepper
- Extra virgin olive oil for drizzling
Method
(we suggest you read everything at least once before doing anything)
1) Preheat the oven to 200℃ / 400℉ / Gas mark 6
2) Put the vegetables in a roasting tin; drizzle with oil, sprinkle with the seasonings (nooch, paprika, black pepper), stir well to mix and distribute the seasonings evenly, and roast for 20–25 minutes, stirring/turning occasionally. When the edges begin to caramelize, turn off the heat, but leave to keep warm.
3) Cook the penne al dente (this should take 7–8 minutes in boiling salted water). Rinse in cold water, then pass a kettle of hot water over them to reheat. This process removed starch and lowered the glycemic index, before reheating the pasta so that it’s hot to serve.
4) Place the roasted vegetables in a food processor and blitz for just a few seconds. You want to produce a very chunky sauce—but not just chunks or just sauce.
5) Combine the sauce and pasta to serve immediately.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Which Bell Peppers To Pick? A Spectrum Of Specialties ← note how red bell peppers are perfect for this, as their lycopene quadruples in bioavailability when cooked
- Black Pepper’s Impressive Anti-Cancer Arsenal (And More)
- The Many Health Benefits Of Garlic
- What Matters Most For Your Heart? Eat More (Of This) For Lower Blood Pressure
Take care!
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Kumquat vs Persimmon – Which is Healthier?
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Our Verdict
When comparing kumquat to persimmon, we picked the kumquat.
Why?
In terms of macros, kumquats have more protein, though like most fruits, it’s unlike anybody’s eating them for the protein content. More importantly, they have a lot more fiber, for less than half the carbs. It bears mentioning though that (again, like most fruits) persimmon isn’t bad for this either, and both fruits are low glycemic index foods.
When it comes to vitamins, it’s not close: kumquats have more of vitamins A, B1, B2, B3, B5, B6, B9, E, and choline, while persimmon has more vitamin C. It’s worth noting that kumquats are already a very good source of vitamin C though; persimmon just has more.
In the category of minerals, kumquats again lead with more calcium, copper, magnesium, manganese, and zinc, while persimmon has more iron, phosphorus, and potassium.
In short, enjoy both, and/or whatever fruit you enjoy the most, but if looking for nutritional density, kumquats are bringing it.
Want to learn more?
You might like to read:
Why You’re Probably Not Getting Enough Fiber (And How To Fix It)
Take care!
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How To Set Anxiety Aside
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How To Set Anxiety Aside
We’ve talked previously about how to use the “release” method to stop your racing mind.
That’s a powerful technique, but sometimes we need to be calm enough to use it. So first…
Breathe
Obviously. But, don’t underestimate the immediate power of focusing on your breath, even just for a moment.
There are many popular breathing exercises, but here’s one of the simplest and most effective, “4–4 breathing”:
- Breathe in for a count of four
- Hold for a count four
- Breathe out for a count of four
- Hold for a count of four
- Repeat
Depending on your lung capacity and what you’re used to, it may be that you need to count more quickly or slowly to make it feel right. Experiment with what feels comfortable for you, but the general goal should breathing deeply and slowly.
Identify the thing that’s causing you anxiety
We’ve also talked previously about how to use the RAIN technique to manage difficult emotions, and that’s good for handling anxiety too.
Another powerful tool is journaling.
Read: How To Use Journaling to Challenge Anxious Thoughts
If you don’t want to use any of those (very effective!) methods, that’s fine too—journaling isn’t for everyone.
You can leverage some of the same benefits by simply voicing your worries, even to yourself:
There’s an old folk tradition of “worry dolls”; these are tiny little dolls so small they can be kept in a pocket-size drawstring purse. Last thing at night, the user whispers their worries to the dolls and puts them back in their bag, where they will work on the person’s problem overnight.
We’re a health and productivity newsletter, not a dealer of magic and spells, but you can see how it works, right? It gets the worries out of one’s head, and brings about a helpful placebo effect too.
Focus on what you can control
- Most of what you worry about will not happen.
- Some of what you worry about may happen.
- Worrying about it will not help.
In fact, in some cases it may bring about what you fear, by means of the nocebo effect (like the placebo effect, but bad). Additionally, worrying drains your body and makes you less able to deal with whatever life does throw at you.
So while “don’t worry; be happy” may seem a flippant attitude, sometimes it can be best. However, don’t forget the other important part, which is actually focusing on what you can control.
- You can’t control whether your car will need expensive maintenance…
- …but you can control whether you budget for it.
- You can’t control whether your social event will go well or ill…
- …but you can control how you carry yourself.
- You can’t control whether your loved one’s health will get better or worse…
- …but you can control how you’re there for them, and you can help them take what sensible precautions they may.
…and so forth.
Look after your body as well!
Your body and mind are deeply reliant on each other. In this case, just as anxiety can drain your body’s resources, keeping your body well-nourished, well-exercised, and well-rested and can help fortify you against anxiety. For example, when it comes to diet, exercise, and sleep:
- Read: Fruit and vegetable intake is inversely associated with perceived stress across the adult lifespan
- Read: Exercise and anxiety: physical activity appears to be protective against anxiety disorders in clinical and non-clinical populations
- Read: Sleep problems predict and are predicted by generalized anxiety/depression
Don’t know where to start? How about the scientifically well-researched, evidence-based, 7-minute workout?
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Is Cutting Calories The Key To Healthy Long Life?
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Caloric Restriction with Optimal Nutrition
Yesterday, we asked you “What is your opinion of caloric restriction as a health practice?” and got the above-depicted, below-described spread of responses:
- 48% said “It is a robust, scientifically proven way to live longer and healthier”
- 23% said “It may help us to live longer, but at the cost of enjoying it fully”
- 17% said “It’s a dangerous fad that makes people weak, tired, sick, and unhealthy”
- 12% said “Counting calories is irrelevant to good health; the body compensates”
So… What does the science say?
A note on terms, first
“Caloric restriction” (henceforth: CR), as a term, sees scientific use to mean anything from a 25% reduction to a 50% reduction, compared to metabolic base rate.
This can also be expressed the other way around, “dropping to 60% of the metabolic base rate” (i.e., a 40% reduction).
Here we don’t have the space to go into much depth, so our policy will be: if research papers consider it CR, then so will we.
A quick spoiler, first
The above statements about CR are all to at least some degree True in one way or another.
However, there are very important distinctions, so let’s press on…
CR is a robust, scientifically proven way to live longer and healthier: True or False?
True! This has been well-studied and well-documented. There’s more science for this than we could possibly list here, but here’s a good starting point:
❝Calorie restriction (CR), a nutritional intervention of reduced energy intake but with adequate nutrition, has been shown to extend healthspan and lifespan in rodent and primate models.
Accumulating data from observational and randomized clinical trials indicate that CR in humans results in some of the same metabolic and molecular adaptations that have been shown to improve health and retard the accumulation of molecular damage in animal models of longevity.
In particular, moderate CR in humans ameliorates multiple metabolic and hormonal factors that are implicated in the pathogenesis of type 2 diabetes, cardiovascular diseases, and cancer, the leading causes of morbidity, disability and mortality❞
Source: Ageing Research Reviews | Calorie restriction in humans: an update
See also: Caloric restriction in humans reveals immunometabolic regulators of health span
We could devote a whole article (or a whole book, really) to this, but the super-short version is that it lowers the metabolic “tax” on the body and allows the body to function better for longer.
CR may help us to live longer, but at the cost of enjoying it fully: True or False?
True or False, contingently, depending on what’s important to you. And that depends on psychology as much as physiology, but it’s worth noting that there is often a selection bias in the research papers; people ill-suited to CR drop out of the studies and are not counted in the final data.
Also, relevant for a lot of our readers, most (human-based) studies recruit people over 18 and under 60. So while it is reasonable to assume the same benefits will be carried over that age, there is not nearly as much data for it.
Studies into CR and Health-Related Quality of Life (HRQoL) have been promising, and/but have caveats:
❝In non-obese adults, CR had some positive effects and no negative effects on HRQoL.❞
❝We do not know what degree of CR is needed to achieve improvements in HRQoL, but we do know it requires an extraordinary amount of support.
Therefore, the incentive to offer this intervention to a low-risk, normal or overweight individual is lacking and likely not sustainable in practice.❞
CR a dangerous fad that makes people weak, tired, sick, and unhealthy: True or False?
True if it is undertaken improperly, and/or without sufficient support. Many people will try CR and forget that the idea is to reduce metabolic load while still getting good nutrition, and focus solely on the calorie-counting.
So for example, if a person “saves” their calories for the day to have a night out in a bar where they drink their calories as alcohol, then this is going to be abysmal for their health.
That’s an extreme example, but lesser versions are seen a lot. If you save your calories for a pizza instead of a night of alcoholic drinks, then it’s not quite so woeful, but for example the nutrition-to-calorie ratio of pizza is typically not great. Multiply that by doing it as often as not, and yes, someone’s health is going to be in ruins quite soon.
Counting calories is irrelevant to good health; the body compensates: True or False?
True if by “good health” you mean weight loss—which is rarely, if ever, what we mean by “good health” here at 10almonds (unless we clarify such), but it’s a very common association and indeed, for some people it’s a health goal. You cannot sustainably and healthily lose weight by CR alone, especially if you’re not getting optimal nutrition.
Your body will notice that you are starving, and try to save you by storing as much fat as it can, amongst other measures that will similarly backfire (cortisol running high, energy running low, etc).
For short term weight loss though, yes, it’ll work. At a cost. That we don’t recommend.
❝By itself, decreasing calorie intake will have a limited short-term influence.❞
Source: Reducing Calorie Intake May Not Help You Lose Body Weight
See also…
❝Caloric restriction is a commonly recommended weight-loss method, yet it may result in short-term weight loss and subsequent weight regain, known as “weight cycling”, which has recently been shown to be associated with both poor sleep and worse cardiovascular health❞
Source: Dieting Behavior Characterized by Caloric Restriction
In summary…
Caloric restriction is a well-studied area of health science. We know:
- Practised well, it can extend not only lifespan, but also healthspan
- Practised well, it can improve mood, energy, sexual function, and the other things people fear losing
- Practised badly, it can be ruinous to the health—it is critical to practise caloric restriction with optimal nutrition.
- Practised badly, it can lead to unhealthy weight loss and weight regain
One final note…
If you’ve tried CR and hated it, and you practised it well (e.g., with optimal nutrition), then we recommend just not doing it.
You could also try intermittent fasting instead, for similar potential benefits. If that doesn’t work out either, then don’t do that either!
Sometimes, we’re just weird. It can often be because of a genetic or epigenetic quirk. There are usually workarounds, and/but not everything that’s right for most people will be right for all of us.
Take care!
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