Why scrapping the term ‘long COVID’ would be harmful for people with the condition
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The assertion from Queensland’s chief health officer John Gerrard that it’s time to stop using the term “long COVID” has made waves in Australian and international media over recent days.
Gerrard’s comments were related to new research from his team finding long-term symptoms of COVID are similar to the ongoing symptoms following other viral infections.
But there are limitations in this research, and problems with Gerrard’s argument we should drop the term “long COVID”. Here’s why.
A bit about the research
The study involved texting a survey to 5,112 Queensland adults who had experienced respiratory symptoms and had sought a PCR test in 2022. Respondents were contacted 12 months after the PCR test. Some had tested positive to COVID, while others had tested positive to influenza or had not tested positive to either disease.
Survey respondents were asked if they had experienced ongoing symptoms or any functional impairment over the previous year.
The study found people with respiratory symptoms can suffer long-term symptoms and impairment, regardless of whether they had COVID, influenza or another respiratory disease. These symptoms are often referred to as “post-viral”, as they linger after a viral infection.
Gerrard’s research will be presented in April at the European Congress of Clinical Microbiology and Infectious Diseases. It hasn’t been published in a peer-reviewed journal.
After the research was publicised last Friday, some experts highlighted flaws in the study design. For example, Steven Faux, a long COVID clinician interviewed on ABC’s television news, said the study excluded people who were hospitalised with COVID (therefore leaving out people who had the most severe symptoms). He also noted differing levels of vaccination against COVID and influenza may have influenced the findings.
In addition, Faux pointed out the survey would have excluded many older people who may not use smartphones.
The authors of the research have acknowledged some of these and other limitations in their study.
Ditching the term ‘long COVID’
Based on the research findings, Gerrard said in a press release:
We believe it is time to stop using terms like ‘long COVID’. They wrongly imply there is something unique and exceptional about longer term symptoms associated with this virus. This terminology can cause unnecessary fear, and in some cases, hypervigilance to longer symptoms that can impede recovery.
But Gerrard and his team’s findings cannot substantiate these assertions. Their survey only documented symptoms and impairment after respiratory infections. It didn’t ask people how fearful they were, or whether a term such as long COVID made them especially vigilant, for example.
New Africa/Shutterstock
In discussing Gerrard’s conclusions about the terminology, Faux noted that even if only 3% of people develop long COVID (the survey found 3% of people had functional limitations after a year), this would equate to some 150,000 Queenslanders with the condition. He said:
To suggest that by not calling it long COVID you would be […] somehow helping those people not to focus on their symptoms is a curious conclusion from that study.
Another clinician and researcher, Philip Britton, criticised Gerrard’s conclusion about the language as “overstated and potentially unhelpful”. He noted the term “long COVID” is recognised by the World Health Organization as a valid description of the condition.
A cruel irony
An ever-growing body of research continues to show how COVID can cause harm to the body across organ systems and cells.
We know from the experiences shared by people with long COVID that the condition can be highly disabling, preventing them from engaging in study or paid work. It can also harm relationships with their friends, family members, and even their partners.
Despite all this, people with long COVID have often felt gaslit and unheard. When seeking treatment from health-care professionals, many people with long COVID report they have been dismissed or turned away.
Last Friday – the day Gerrard’s comments were made public – was actually International Long COVID Awareness Day, organised by activists to draw attention to the condition.
The response from people with long COVID was immediate. They shared their anger on social media about Gerrard’s comments, especially their timing, on a day designed to generate greater recognition for their illness.
Since the start of the COVID pandemic, patient communities have fought for recognition of the long-term symptoms many people faced.
The term “long COVID” was in fact coined by people suffering persistent symptoms after a COVID infection, who were seeking words to describe what they were going through.
The role people with long COVID have played in defining their condition and bringing medical and public attention to it demonstrates the possibilities of patient-led expertise. For decades, people with invisible or “silent” conditions such as ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome) have had to fight ignorance from health-care professionals and stigma from others in their lives. They have often been told their disabling symptoms are psychosomatic.
Gerrard’s comments, and the media’s amplification of them, repudiates the term “long COVID” that community members have chosen to give their condition an identity and support each other. This is likely to cause distress and exacerbate feelings of abandonment.
Terminology matters
The words we use to describe illnesses and conditions are incredibly powerful. Naming a new condition is a step towards better recognition of people’s suffering, and hopefully, better diagnosis, health care, treatment and acceptance by others.
The term “long COVID” provides an easily understandable label to convey patients’ experiences to others. It is well known to the public. It has been routinely used in news media reporting and and in many reputable medical journal articles.
Most importantly, scrapping the label would further marginalise a large group of people with a chronic illness who have often been left to struggle behind closed doors.
Deborah Lupton, SHARP Professor, Vitalities Lab, Centre for Social Research in Health and Social Policy Centre, and the ARC Centre of Excellence for Automated Decision-Making and Society, UNSW Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Dietary Changes for Artery Health
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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
❝How does your diet change clean out your arteries of the bad cholesterol?❞
There’s good news and bad news here, and they can both be delivered with a one-word reply:
Slowly.
Or rather: what’s being cleaned out is mostly not the LDL (bad) cholesterol, but rather, the result of that.
When our diet is bad for cardiovascular health, our arteries get fatty deposits on their walls. Cholesterol gets stuck here too, but that’s not the main physical problem.
Our body’s natural defenses come into action and try to clean it up, but they (for example macrophages, a kind of white blood cell that consumes invaders and then dies, before being recycled by the next part of the system) often get stuck and become part of the buildup (called atheroma), which can lead to atherosclerosis and (if calcium levels are high) hardening of the arteries, which is the worst end of this.
This can then require medical attention, precisely because the body can’t remove it very well—especially if you are still maintaining a heart-unhealthy diet, thus continuing to add to the mess.
However, if it is not too bad yet, yes, a dietary change alone will reverse this process. Without new material being added to the arterial walls, the body’s continual process of rejuvenation will eventually fix it, given time (free from things making it worse) and resources.
In fact, your arteries can be one of the quickest places for your body to make something better or worse, because the blood is the means by which the body moves most things (good or bad) around the body.
All the more reason to take extra care of it, since everything else depends on it!
You might also like our previous main feature:
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The Lost Art of Silence – by Sarah Anderson
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From “A Room Of One’s Own” to “Silent Mondays”, from spiritual retreats to noise-cancelling headphones, this book covers the many benefits of silence—and a couple of downsides too.
In an age where most things are available at the touch of a button, a little peaceful solitude can come at quite a premium, but what it offers can effect all manner of physical changes, from reduced stress responses to increased neurogenesis (growing new brain cells).
The tone throughout is a combination of personal and pop-science, and it’s very motivating to find a little more space-between-the-things in life.
The book is best enjoyed in a quiet room.
Bottom line: if you get the feeling sometimes that you could rest and recover fully and properly if you could just find the downtime, this book will help you find exactly that.
Click here to check out the Lost Art of Silence, and find peace and strength in it!
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Why is toddler milk so popular? Follow the money
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Toddler milk is popular and becoming more so. Just over a third of Australian toddlers drink it. Parents spend hundreds of millions of dollars on it globally. Around the world, toddler milk makes up nearly half of total formula milk sales, with a 200% growth since 2005. Growth is expected to continue.
We’re concerned about the growing popularity of toddler milk – about its nutritional content, cost, how it’s marketed, and about the impact on the health and feeding of young children. Some of us voiced our concerns on the ABC’s 7.30 program recently.
But what’s in toddler milk? How does it compare to cow’s milk? How did it become so popular?
What is toddler milk? Is it healthy?
Toddler milk is marketed as appropriate for children aged one to three years. This ultra-processed food contains:
- skim milk powder (cow, soy or goat)
- vegetable oil
- sugars (including added sugars)
- emulsifiers (to help bind the ingredients and improve the texture)
added vitamins and minerals.
Toddler milk is usually lower in calcium and protein, and higher in sugar and calories than regular cow’s milk. Depending on the brand, a serve of toddler milk can contain as much sugar as a soft drink.
Even though toddler milks have added vitamins and minerals, these are found in and better absorbed from regular foods and breastmilk. Toddlers do not need the level of nutrients found in these products if they are eating a varied diet.
Global health authorities, including the World Health Organization (WHO), and Australia’s National Health and Medical Research Council, do not recommend toddler milk for healthy toddlers.
Some children with specific metabolic or dietary medical problems might need tailored alternatives to cow’s milk. However, these products generally are not toddler milks and would be a specific product prescribed by a health-care provider.
Toddler milk is also up to four to five times more expensive than regular cow’s milk. “Premium” toddler milk (the same product, with higher levels of vitamins and minerals) is more expensive.
With the cost-of-living crisis, this means families might choose to go without other essentials to afford toddler milk.
Toddler milk is more expensive than cow’s milk and contains more sugar.
Dragana Gordic/ShutterstockHow toddler milk was invented
Toddler milk was created so infant formula companies could get around rules preventing them from advertising their infant formula.
When manufacturers claim benefits of their toddler milk, many parents assume these claimed benefits apply to infant formula (known as cross-promotion). In other words, marketing toddler milks also boosts interest in their infant formula.
Manufacturers also create brand loyalty and recognition by making the labels of their toddler milk look similar to their infant formula. For parents who used infant formula, toddler milk is positioned as the next stage in feeding.
How toddler milk became so popular
Toddler milk is heavily marketed. Parents are told toddler milk is healthy and provides extra nutrition. Marketing tells parents it will benefit their child’s growth and development, their brain function and their immune system.
Toddler milk is also presented as a solution to fussy eating, which is common in toddlers.
However, regularly drinking toddler milk could increase the risk of fussiness as it reduces opportunities for toddlers to try new foods. It’s also sweet, needs no chewing, and essentially displaces energy and nutrients that whole foods provide.
Toddler milk is said to help fussy eating, but it may make things worse.
zlikovec/ShutterstockGrowing concern
The WHO, along with public health academics, has been raising concerns about the marketing of toddler milk for years.
In Australia, moves to curb how toddler milk is promoted have gone nowhere. Toddler milk is in a category of foods that are allowed to be fortified (to have vitamins and minerals added), with no marketing restrictions. The Australian Competition & Consumer Commission also has concerns about the rise of toddler milk marketing. Despite this, there is no change in how it’s regulated.
This is in contrast to voluntary marketing restrictions in Australia for infant formula.
What needs to happen?
There is enough evidence to show the marketing of commercial milk formula, including toddler milk, influences parents and undermines child health.
So governments need to act to protect parents from this marketing, and to put child health over profits.
Public health authorities and advocates, including us, are calling for the restriction of marketing (not selling) of all formula products for infants and toddlers from birth through to age three years.
Ideally, this would be mandatory, government-enforced marketing restrictions as opposed to industry self-regulation in place currently for infant formulas.
We musn’t blame parents
Toddlers are eating more processed foods (including toddler milk) than ever because time-poor parents are seeking a convenient option to ensure their child is getting adequate nutrition.
Formula manufacturers have used this information, and created a demand for an unnecessary product.
Parents want to do the best for their toddlers, but they need to know the marketing behind toddler milks is misleading.
Toddler milk is an unnecessary, unhealthy, expensive product. Toddlers just need whole foods and breastmilk, and/or cow’s milk or a non-dairy, milk alternative.
If parents are worried about their child’s eating, they should see a health-care professional.
Anthea Rhodes, a paediatrician from Royal Children’s Hospital Melbourne and a lecturer at the University of Melbourne, co-authored this article.
Jennifer McCann, Lecturer Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University; Karleen Gribble, Adjunct Associate Professor, School of Nursing and Midwifery, Western Sydney University, and Naomi Hull, PhD candidate, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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How Tight Are Your Hips? Test (And Fix!) With This
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Upon surveying over half a million people; hips were the most common area for stiffness and lack of mobility. So, what to do about it?
This test don’t lie
With 17 muscles contributing to hip function (“hip flexors” being the name for this group of 17 muscles, not specific muscle), it’s important to figure out which ones are tight, and if indeed it really is the hip flexors at all, or if it could be, as it often is, actually the tensor fasciae latae (TFL) muscle of the thigh. If it turns out to be both, well, that’s unfortunate but the good news is, now you’ll know and can start fixing from all the necessary angles.
Diagnostic test for tight hip flexors (Thomas Test):
- Use a sturdy, elevated surface (e.g. table or counter—not a bed or couch, unless there is perchance room to swing your legs without them touching the floor).
- Sit at the edge, lie back, and pull both knees to your chest.
- Return one leg back down until the thigh is perpendicular to the table.
- Let the other leg dangle off the edge to assess flexibility.
Observations from the test:
- Thigh contact: is the back of your thigh touching the table?
- Knee angle: is your knee bent at roughly 80° or straighter?
- Thigh rotation: does the thigh roll outward?
Interpreting results:
- If your thigh contacts the surface and the knee is bent at around 80°, hip mobility is good.
- If your thigh doesn’t touch or knee is too straight, hip flexor tightness is present.
- If your thigh rolls outwards from your midline, that indicates tightness in the TFL muscle of the thigh.
Three best hip flexor stretches:
- Kneeling lunge stretch:
- Hips above the knee, tuck tailbone, engage glutes, press hips forward, reach arm up with a slight side bend.
- Seated hip lift stretch:
- Sit with feet hip-width apart, hands behind shoulders, lift hips, step one foot back, tuck tailbone, point knee away.
- Sofa stretch:
- Kneel with one shin against a couch/wall, other foot forward in lunge, tuck tailbone, press hips forward, lift torso.
It’s recommended to how each stretch for 30 seconds on each side.
For more on all of the above, and visual demonstrations, enjoy:
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Peas vs Green Beans – Which is Healthier?
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Our Verdict
When comparing peas to green beans, we picked the peas.
Why?
Looking at macros first, peas have nearly 6x the protein, nearly 2x the fiber, and nearly 2x the carbs, making them the “more food per food” choice.
In terms of vitamins, peas have more of vitamins A, B1, B2, B3, B5, B6, B7, B9, C, and choline, while green beans have more of vitamins E and K. An easy win for peas.
In the category of minerals, peas have more copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc, while green beans have more calcium. Another overwhelming win for peas.
In short, enjoy both (diversity is good), but there’s a clear winner here and it’s peas.
Want to learn more?
You might like to read:
Peas vs Broad Beans – Which is Healthier?
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3 bathroom items you shouldn’t really share, according to an expert
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Imagine you’re away from home but forgot to pack your towel, razor or toothbrush.
Should you use other people’s?
Here’s why it’s probably best not to make a habit of it.
Peng Liu/Unsplash Microbes can stay active for a while
Many disease-causing bacteria, viruses or fungi live on cloth, plastic and metal objects in your bathroom. These so-called pathogenic microbes can remain viable on these surfaces for extended periods. That is, they’re able to cause infection for days, months or years.
For example, the fungus Aspergillus can remain viable for more than a month on cloth and plastic. Some bacteria can survive on these surfaces for years. And many viruses can remain viable for hours to months on some materials such as ceramics, metals, cloth and plastics.
But what is the risk from particular items such as used towels, razors and toothbrushes?
Scientists haven’t run randomised controlled trials (the gold standard study design) to determine the risk. This would be when one group in a study is chosen at random to, say, shave their legs with someone’s used razor, and the infection rates of known pathogens compared with those randomised to a control group who didn’t.
But there are other studies that give us some clues.
Can I share towels? If you play footy, maybe not
Less robust studies suggest an increased risk of picking up a skin infection from used towels.
One report from the United States was of an outbreak of antibiotic resistant Staphylococcus aureas (or Staph, for short) in a group of high-school football players. Players who shared a towel were eight times more likely to pick up an infection.
Staph can cause the skin condition impetigo. But in rare cases it can lead to life-threatening septic shock and organs failing.
In this case, the risk of transmitting Staph was probably elevated due to potential cuts and grazes from playing a contact sport.
Another study, also from the US, followed 150 households for 12 months. Each household had a single child infected with Staph.
When household members shared towels, the risk of Staph transmission increased significantly.
You might think that microbes are washed off in the shower. While washing with soap and water reduces the number of microbes on the skin it does not completely eliminate them. And the warm, moist conditions of the average bathroom encourage microbial growth.
Even if you don’t develop an infection, becoming colonised by pathogens (when there is no damage) can be problematic.
That’s because you may be exposed to antibiotic resistant species, increasing the risk of developing antibiotic resistant infections later. These are more time consuming and expensive to treat.
How about a toothbrush? Think of the viruses
Microbes can remain viable on hard objects, such as toothbrushes. And toothbrushes can cause gums to bleed. So sharing them is discouraged as this can transmit blood-borne viruses such as hepatitis C.
Not everyone who is in a risk category for hepatitis C infection has been tested. And people can be infectious without having symptoms.
Anything that has come into contact with saliva (such as your toothbrush) may also transmit pathogens. These include herpes simplex virus type 1 (HSV-1), which causes cold sores, and Epstein-Barr virus, which causes glandular fever.
A person with no signs of HSV-1 infection can still shed viruses and cause infection.
One review found toothbrushes were contaminated with potentially pathogenic species of bacteria such as Staph, E. coli and Pseudomonas. HSV-1 was also found in sufficient numbers to cause infection. This virus can remain viable for two to six days on plastic objects.
Surely a razor’s OK? Not if you hate warts
Microbes can remain viable on hard objects such as razors too. And it’s hard to avoid nicks when using a razor. So there’s a risk of transmitting blood-borne viruses if you share.
Razors, towels and other personal hygiene items can also spread human papillomaviruses that cause warts. So it’s no wonder dermatologists recommend each person has their own items.
Who’s at risk?
If you have cuts or grazes, this provides a portal of entry for microbes, putting you at increased risk of infection. Remember those footy players who shared towels.
Reduced immune function also increases the risk of infection. We see this in:
- babies, whose immune system is still developing
- elderly people, whose immune function declines in later life
- people taking immune suppressing medications, such as cancer drugs, oral corticosteroids and drugs taken after an organ transplant
- people with type 2 diabetes, because increased blood glucose levels damage the function of immune cells and associated molecules.
However, the overall risk of contracting an infection is low on any one occasion. And if you’re sharing a towel, razor or toothbrush with a partner, you’ll be in regular close contact and sharing microbes anyway.
But it’s still a good idea to avoid making a habit of sharing other people’s used bathroom items.
Thea van de Mortel, Professor Emerita, Nursing, School of Nursing and Midwifery, Griffith University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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