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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Walk Like You’re 20 Years Younger Again
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How fit, healthy, strong, and mobile were you 20 years ago? For most people, the answer is “better than now”. Physiotherapist Dr. Doug Weiss has advice on turning back the clock:
The exercises
If you already have no problems walking, this one is probably not for you. However, if you’re not so able to comfortably walk as you used to be, then Dr. Weiss recommends:
- Pillow squat: putting pillow on a chair, crossing hands on chest, standing up and sitting down. Similar to the very important “getting up off the floor without using your hands” exercise, but easier.
- Wall leaning: standing against a wall with heels 4″ away from it, crossing arms over chest again, and pulling the body off the wall using the muscles in the front of the shin. Note, this means not cheating by using other muscles, leveraging the upper body, pushing off with the buttocks, or anything else like that.
- Stepping forward: well, this certainly is making good on the promise of walking like we did 20 years ago; there sure was a lot of stepping forward involved. More seriously, this is actually about stepping over some object, first with support, and then without.
- Heel raise: is what it sounds like, raising up on toes and back down again; first with support, then without.
- Side stepping: step sideways 2–3 steps in each direction. First with support, then without. Bonus: if your support is your partner, then congratulations, you are now dancing bachata.
For more details (and visual demonstration) of these exercises and more, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like:
4 Tips To Stand Without Using Hands
Take care!
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Built to Move – by Kelly starrett & Juliet Starrett
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In our everyday lives, for most of us anyway, it’s not too important to be able to run a marathon or leg-press a car. Rather more important, however, are such things as:
- being able to get up from the floor comfortably
- reach something on a high shelf without twinging a shoulder
- being able to put our socks on without making a whole plan around this task
- get accidentally knocked by an energetic dog or child and not put our back out
- etc
Starrett and Starrett, of “becoming a supple leopard” fame, lay out for us how to make sure our mobility stays great. And, if it’s not already where it needs to be, how to get there.
The “ten essential habits” mentioned in the subtitle “ten essential habits to help you move freely and live fully”, in fact also come with ten tests. No, not in the sense of arduous trials, but rather, mobility tests.
For each test, it’s explained to us how to score it out of ten (this is an objective assessment, not subjective). It’s then explained how to “level up” whatever score we got, with different advices for different levels of mobility or immobility. And if we got a ten, then of course, we just build the appropriate recommended habit into our daily life, to keep it that way.
The writing style is casual throughout, and a strong point of the book is its very clear illustrations, too.
Bottom line: if you’d like to gain/maintain good mobility (at any age), this book gives a very reliable outline for doing so.
Click here to check out Built to Move, and take care of your body!
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90% Of People Skip This Essential Exercise—Are You One Of Them?
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Single-leg strengthening is essential for joint health at any age (unless you want to bunny-hop up and down the stairs with both feet at once, for example), yet many people overlook it. This neglect often leads to pain, stiffness, and a higher risk of injury.
Dr. Alyssa Kuhn, arthritis specialist, explains how to do it:
On the rise
In this video, different exercise variations—beginner, intermediate, and advanced—are presented to help you build strength at your own pace:
Beginner: start by using a chair, adding a cushion for support if needed. Sit at the edge and position one foot slightly in front of the other in a staggered stance. Stand up and sit down in a controlled manner, allowing the back leg to bear more weight and work harder than the front leg. Do 8–10 repetitions per side and pay attention to whether one side feels weaker. To build strength, incorporate this movement into daily activities, such as standing up from the couch. Master this variation before progressing, to avoid knee injury.
Intermediate: to make the exercise more challenging, you can either use a lower chair, or extend your front foot further out, shifting more weight to your back leg. Only modify one variable at a time to maintain control. Do 8–10 repetitions per side, ensuring proper form. A common mistake is allowing the back knee to move inward, which can cause knee stress. To prevent this, use a mirror to check your form and keep the knee and ankle aligned during movement.
Advanced: when you’re ready, extend your front leg completely with the heel on the ground and toes up, removing its stability and forcing the back leg to work even harder. Maintain controlled movement while keeping your knee and ankle aligned. Repeat the exercise on both sides, focusing extra effort on the weaker leg to build balanced strength.
For more on each of these, plus visual demonstrations, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like:
The Secret To Better Squats: Foot, Knee, & Ankle Mobility
Take care!
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Nine Pints – by Rose George
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Rose George is not a scientist, but an investigative journalist. As such, she’s a leave-no-stone-unturned researcher, and that shows here.
The style throughout is, as one might expect, journalistic. But, she’s unafraid of diving into the science of it, interviewing many medical professionals as part of her work. She also looks to people living with various blood-related conditions, ranging from hemophilia to HIV.
Speakling of highly-stigmatized yet very manageable conditions, there’s also a fair section devoted to menstruation, menstrual blood, and societies’ responses to such, from shunning to active support.
We also learn about the industrialization of blood—from blood banks to plasma labs to leech farms. You probably knew leeches are still used as a medical tool in even the most high-tech of hospitals, but you’ll doubtlessly learn a fascinating thing or two from the “insider views” along the way.
Bottom line: if you’d like to know more about the red stuff in all its marvelous aspects, with neither sensationalization nor sanitization (the topic needs neither!), this is the book for you.
Click here to check out Nine Pints, and learn more about yours!
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CBD Oil
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Q&A with the 10almonds Team
Q: Very interested in this article on CBD oil in the states. hope you do another one in the future with more studies done on people and more information on what’s new as far as CBD oil goes
A: We’re glad you enjoyed it! We’ll be sure to revisit CBD in the future—partly because it was a very popular article, and partly because, as noted, there is a lot going on there, research-wise!
And yes, we prefer human studies rather than mouse/rat studies where possible, too, and try to include those where we find them. In some cases, non-human animal studies allow us to know things that we can’t know from human studies… because a research institution’s ethics board will greenlight things for mice that it’d never* greenlight for humans.
Especially: things that for non-human animals are considered “introduction of external stressors” while the same things done to humans would be unequivocally called “torture”.
Animal testing in general is of course a moral quagmire, precisely because of the suffering it causes for animals, while the research results (hopefully) can be brought to bear to reduce to suffering of humans. We’re a health and productivity newsletter, not a philosophical publication, but all this to say: we’re mindful of such too.
And yes, we agree, when studies are available on humans, they’re always going to be better than the same study done on mice and rats.
As a topical aside, did you know there’s a monument to laboratory mice and all they’ve (however unintentionally) done for us?
❝The quirky statue depicts an anthropomorphic mouse as an elderly woman, complete with glasses balanced atop its nose. Emerging from two knitting needles in its hands is the recognizable double-helix of a strand of DNA.❞
~ Smithsonian Magazine
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Vitamin D2 vs Vitamin D3: What You Would Benefit From Knowing
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
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 😎
❝Hi, is there any important difference between vitamin d2 and vitamin d3? Is one better than the other?❞
There is indeed! And one is better than the other!
Where they come from
You’ll find a lot of sources that will tell you “Vitamin D2 is from plants, D3 is from animals”, and in fact only the second half of that is true.
In nature, there are no plants that are known to produce vitamin D.
Vitamin D2, however, is produced by many fungi, as well as algae, neither of which are part of the Kingdom Plantae.
Vitamin D3, meanwhile, is produced by many animals (including humans).
When “the sun” is sometimes considered a source of vitamin D, that’s true only insofar as the sun is also a source of tomatoes, for example, which required the sun to grow. While we humans (and other animals) cannot photosynthesize in general, producing vitamin D is something we can do if exposed to UV light (such as from the sun).
However, of course exposure to UV light (such as from the sun) comes with other problems, so… Should we get sun exposure or not?
We weighed up the balance of evidence, here: The Sun Exposure Dilemma
If, like this writer, you are a mostly crepuscular being who avoids the sun, we have good news: mushrooms can do the sunbathing for us!
❝Exposing mushrooms to UV (from sunlight or in a laboratory) increases the amount of vitamin D in mushrooms by nearly eightfold. Putting five store-bought button mushrooms in the sun, or just one portobello mushroom, produces 24 µg of vitamin D, which translates to nearly 1000 international units, providing the amount of vitamin D one needs in an entire day, and the equivalent found in most vitamin D supplements.
If you’re wondering if the vitamin D from mushrooms actually makes it into your bloodstream, it does. A recent meta-analysis of randomized controlled trials showed that tanned (UV-exposed) mushrooms may be effective in increasing active vitamin D levels in adults with low levels of vitamin D, and studies (randomised controlled trials) have shown that it may be just as effective as supplements at increasing vitamin D levels in the blood (here, and here).
Some research is very positive, saying that putting your mushrooms in direct sunlight for 10–15 minutes may provide you with 100% of your daily vitamin D needs, and the vitamin D content in sunlight-exposed mushrooms may be retained with refrigeration for up to 8 days.
The production of vitamin D may be increased by a further 30% by placing them in the sun with the underside, or gills, facing up, or by 60% if you slice them.❞
Read all about it: Tan your mushrooms, not your skin
Which is better?
In few words: D3 is better.
They both do the exact same job, but with D3, you simply get more bang-for-buck:
❝The WMD in change in total 25(OH)D based on 12 daily dosed vitamin D2-vitamin D3 comparisons, analyzed using liquid chromatography-tandem mass spectrometry, was 10.39 nmol/L (40%) lower for the vitamin D2 group compared with the vitamin D3 group.
Vitamin D3 leads to a greater increase of 25(OH)D than vitamin D2, even if limited to daily dose studies, but vitamin D2 and vitamin D3 had similar positive impacts on their corresponding 25(OH)D hydroxylated forms.❞
Note: “WMD” here means “weighted mean difference”, not “weapons of mass destruction”
About that “and importance of BMI”, by the way: in persons with a BMI >25, there was no longer a difference between the two forms. Literally, no difference at all; the difference was reduced to 0%.
Another study found similarly, but with different numbers (finding a greater difference), and without recording BMI as a factor:
❝D3 is approximately 87% more potent in raising and maintaining serum 25(OH)D concentrations and produces 2- to 3-fold greater storage of vitamin D than does equimolar D2.❞
See the paper: Vitamin D3 Is More Potent Than Vitamin D2 in Humans
“Well that sucks, because I’m vegan”
Fear not, you can get vegan D3 too.
Much like “you can’t get vegan B12” (but you can; it’s made by yeast), there are vegan D3 supplements, made by lichen.
The trouble with lichen, when it comes to classifying it, it that it’s actually a hybrid colony of many small, strange things (beyond the scope of this article, but they are fascinating, so this writer is holding herself back by the scruff of the neck from explaining in detail), some of which are technically part of Kingdom Animalia, but it is hard to find even the most ardent vegan who will object to consuming bacteria, for example.
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon 😎
But watch out with the doses, if supplementing vitamin D in either form, because…
Vit D + Calcium: Too Much Of A Good Thing? ← this also talks about safe and effective doses, and what goes wrong if you take too much
Take care!
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