Germany to ease virus curbs for vaccinated people

COVID-19

People who have been fully vaccinated against COVID-19 will no longer have to abide by curfews and contact restrictions in Germany under a draft law agreed by the cabinet on Tuesday.

The law, which would also apply to people who have recovered from COVID-19, must still be signed off by parliament but could come into force as early as this week, Justice Minister Christine Lambrecht said.

There must be a “good reason” for any restrictions on public life, Lambrecht said. “As soon as this reason ceases to exist… these restrictions should then no longer be in place,” she said.

Under national measures introduced in April, areas of Germany with an incidence rate of more than 100 new infections per 100,000 people over the last seven days must introduce overnight curfews and people may only meet with one other person from another household during the day.

But people who have been vaccinated, or who have recovered from COVID and therefore have natural immunity, should in future be exempt from these rules, Lambrecht said.

The draft law seen by AFP would also exempt vaccinated and recovered people from quarantine rules for people returning from abroad, even from areas deemed high risk.

No more tests

Areas of Germany with incidence rates under 100 are currently allowed to open shops, restaurants, cinemas and other facilities, but only to people who can provide a negative test.

Under the new regulations, vaccinated and recovered people would also be exempt from this requirement.

Some German states, including Berlin and Bavaria, have already announced plans to scrap the negative test requirement for vaccinated people when they go shopping or visit the hairdresser.

The Bavarian cabinet on Tuesday also signed off a plan to allow hotels, holiday homes and campsites to open in regions with low incidence rates from May 21.

However, Bavaria’s iconic Oktoberfest beer festival, which usually attracts millions annually in September and October, will be cancelled this year for the second year running.

Germany has been in some form of virus shutdown since November, with numbers of new infections remaining consistently high amid an initially sluggish vaccination campaign.

But the campaign has since picked up pace, with more than a million jabs issued in one day last week, and new infection numbers have started to come down.

The Robert Koch Institute health agency recorded 7,534 new infections in the past 24 hours on Tuesday and 315 deaths, with a national incidence rate of 141.4.

But despite these successes, critics say it is too soon to be lifting restrictions.

Ute Teichert, the head of the Federal Association of German Public Health Officers, said it was “imperative that vaccinated people continue to be tested”.

“Without comprehensive testing, we will lose sight of the incidence of infections—especially with regard to virus variants,” she told the Funke media group on Tuesday.

MP and epidemiologist Karl Lauterbach said it was reasonable to lift some restrictions for vaccinated people, but restaurants, bars and other facilities should not be reopened just for them.

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DR MICHAEL MOSLEY: Should doctors prescribe dummy pills to ease pain?

DR MICHAEL MOSLEY: Should doctors now prescribe dummy pills to ease pain? (…and tell you they’re fake)

How would you feel if you went to see your GP with severe pain caused by a bad back or irritable bowel syndrome (IBS), and you were told they had just the thing to help — a placebo; a pill containing nothing but rice flour or sugar.

That possibility has come closer, thanks to a new study showing that giving patients an ‘honest’ placebo, one where they know they are getting a dummy pill, can be extremely effective at reducing pain.

And with a recent report from the Office of National Statistics showing that deaths from taking high-strength painkillers, such as tramadol and codeine, have doubled over the past ten years, there is clearly a need for safe and effective alternatives.

I’ve been involved in studies of the placebo effect, including one where we recruited more than 100 patients with chronic back pain and told them they were either getting a powerful new painkiller or a placebo. In fact, they were all given a placebo

But if the placebo effect is so effective, why don’t doctors make more use of it?

I’m a huge fan of the placebo effect. I think it’s remarkable that you can give someone a bright-coloured pill, which contains no active ingredient, and this will reduce their pain.

But it is also misunderstood. The assumption is that people who respond either weren’t ill in the first place or are credulous. Neither is true.

I’ve been involved in studies of the placebo effect, including one where we recruited more than 100 patients with chronic back pain and told them they were either getting a powerful new painkiller or a placebo. In fact, they were all given a placebo.

In this study, which was published last July in the European Journal for Person Centred Healthcare, nearly half the patients reported significant pain relief, despite swallowing dummy pills.

As I was told by Dr Jeremy Howick, an expert from Oxford University who designed our study, people who respond best to a placebo are not gullible; they are simply more open minded, especially when it comes to new experiences.

So how does it work? Well, a couple of years ago I watched an intriguing experiment carried out by Manchester University’s Human Pain Research Group. They started by attaching electrodes to a volunteer, Jack, so they could measure his brainwave activity. Then he was given two identical-looking creams and told one was a normal moisturiser, and the other may or may not contain an anaesthetic.

In reality, they were both just moisturisers. He was asked to rub cream from one tub into his left arm, the other into his right.

Next, they heated Jack’s arms with a laser, which he had to rate for painfulness on a scale from one to ten. What they didn’t tell him was that while his left arm got a full blast, his right arm had a weaker zap. They did this several times until Jack was convinced the cream he’d rubbed on his right arm contained an anaesthetic.

Finally, they gave his right arm a full blast with the laser. Amazingly, when that happened, part of Jack’s brain, the frontal cortex, began producing large amounts of brainwaves called alpha waves and this immediately moderated the pain signals reaching the brain.

This, and other research they’ve done, suggests the placebo effect works by ‘persuading’ your brain to express more alpha waves, thereby dialling down the pain, although no one knows why the waves work in this way.

But if the placebo effect is so effective, why don’t doctors make more use of it?

My sister, Susie Stead, has just published a book, Stephen From The Inside Out, about a friend who, when young, was labelled ‘schizophrenic’ and spent more than 25 years in psychiatric wards. Stephen wasn’t diagnosed with autism until his late 40s 

Well, there is a belief among doctors that a placebo treatment works only if patients think they are getting a ‘real’ pill. And that would mean lying to patients, which is unethical. A new study, however, involving people with IBS suggests the placebo effect can work even when you know you are taking a placebo. IBS affects around 20 per cent of adults in the UK and can cause crippling stomach cramps, as well as bloating, diarrhoea and constipation.

There is no known cure, though lifestyle changes can help.

To see whether giving patients an ‘honest’ placebo can help, researchers from the Beth Israel Deaconess Medical Centre in the U.S. recruited 262 people with IBS.

The patients were randomly allocated to three different groups. One group was told it would be getting placebo pills, containing no active ingredient, though the patients were also told that taking the pills could improve their symptoms. The second group was told it would get either a placebo or a pill containing peppermint oil (which can help with IBS), but didn’t know which.

A third group acted as a control and received nothing.

Those given a pill were asked to take it three times a day, 30 minutes before meals, for six weeks. At the end of the study, the patients in both of the pill groups reported a much bigger improvement in their symptoms than the control group.

Seventy per cent of those swallowing pills reported at least a 50-point improvement in their symptom score, while 30 per cent reported their score had increased by at least 150 points, which was considered a ‘very strong’ response.

I wasn’t surprised. In our back- pain study, most of the patients who got relief from taking our placebo pills said they wanted to continue taking them, despite knowing that they were swallowing nothing but ground up rice.

It seems you don’t have to deceive people to tap into the power of the placebo, at least for certain conditions. If you trust the doctor prescribing them, then simply taking pills which you have been told might do you good, really can help.

There’s a powerful connection between the microbes living in your gut, known as the microbiome, and your brain. Not only does your microbiome influence your mood, but there is evidence that children with severe autism can be helped by changing their gut bacteria. More on that in a moment.

The popular image of autism is either of a child rocking to and fro, barely able to speak, or someone who is brilliant at science but bad at human relationships. The truth is more complicated. Autistic spectrum disorder (ASD), can range from those who are severely affected to those who simply find it hard to communicate and interact with other people.

A recent study by the University of Cambridge suggests that around 1.76 per cent of children in England are on the autism spectrum, a higher figure than previously thought.

What’s tragic is that so many people with ASD have been misunderstood or misdiagnosed. My sister, Susie Stead, has just published a book, Stephen From The Inside Out, about a friend who, when young, was labelled ‘schizophrenic’ and spent more than 25 years in psychiatric wards. Stephen wasn’t diagnosed with autism until his late 40s, and none of his talents, including his extraordinary memory and aptitude for poetry, was celebrated in his lifetime.

While autism can’t be ‘cured’, speech and social therapy can help. There is also research that suggests changing the gut microbiome with a faecal transplant (using a treated sample from a donor) can improve some of the symptoms and behavioural problems associated with severe autism.

Evidence for this comes from a small study by researchers at Arizona State University in the U.S. At the start of the study, 83 per cent of the children were rated as having ‘severe’ autism, but two years after the transplant, only 17 per cent were rated ‘severe’. The parents also reported significant improvements in their language, interactions and behaviour.

The researchers are now carrying out a bigger, placebo-controlled trial in adults.

Sleeping well? This is not a rhetorical question, I really want to know. So much so that I recently launched, with the help of researchers from Oxford University, what we are hoping will be the UK’s largest ever sleep study.

If you fill in our questionnaire — find it by googling ‘BBC2 Horizon Sleep Census’ — you will get your own personalised sleep score and discover where you are on the owl-lark spectrum, i.e. the extent to which you’re better suited to late nights or early mornings. We’ll be using the anonymous data to build a detailed picture of what we all do to get a good night’s sleep, as well as the impact that sleep has on how we think and feel.

I will report back on our findings later in the year.

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Swiss ease COVID restrictions despite ‘fragile’ situation

COVID-19

Switzerland’s government announced Wednesday it will significantly ease its COVID-19 restrictions despite acknowledging that the country’s virus situation “remains fragile” and has even worsened recently.

As of Monday, Swiss restaurants and bars, which have been closed since December, will be permitted to open outdoor seating areas, the government said.

Cinemas and other leisure facilities will reopen, as will outdoor and indoor sports facilities.

Public events with up to 50 people indoors and 100 people outdoors will be permitted, as will face-to-face teaching at universities and other higher education institutions.

The government acknowledged it is lifting restrictions despite the fact that the epidemiological situation in the landlocked country “remains fragile and has even worsened in recent weeks”.

But, it estimated that “the risks associated with this easing (of restrictions) are acceptable”.

Switzerland, a country of 8.6 million people, has to date counted more than 625,000 coronavirus cases and 9,790 deaths.

Daily case rates in the landlocked, Alpine nation are roughly the same as in neighbours Germany and Italy, though lower than the European Union average—and nearly a third of the rate in neighbouring France.

Swiss daily case rates bottomed out in the second half of February but have been on the rise since early March.

‘Maintain control’

Health Minister Alain Berset told reporters that a strategy of slowly lifting restrictions in recent months had allowed the country to “maintain control over the pandemic”.

“We’re not facing an explosion,” he said.

While the case incidence rate remains too high, the government pointed out that hospitals are not overburdened.

It also highlighted progress made on vaccinations, with nearly half of people aged over 80 and around 30 percent of those aged between 70 and 79 now fully immunised.

Switzerland has administered 1.8 million vaccine doses, with 686,000 people now having received both injections—giving the country one of Europe’s higher fully-vaccinated rates.

Berset cautioned that the easing of restrictions should not be seen as a signal that the danger is over and the population can let down its guard.

“That is not at all the case,” he said. “We need to continue being careful.”

Virtually all the activities again permitted from Monday should be practised only while wearing a face mask and with appropriate physical distancing, the government said.

And as far as possible, activities should take place outdoors, where the risk of infection is far lower.

The government meanwhile said that other restrictions, including a requirement for most people to work from home and the closure of indoor restaurants and bars, would remain in place for the time being.

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Can Mindfulness Help Ease Migraine?

THURSDAY, Dec. 17, 2020 — A mind-body practice that combines meditation and yoga might help people better manage migraine pain, a new clinical trial finds.

The trial, which tested the effects of mindfulness-based stress reduction (MBSR), found that the approach helped relieve migraine sufferers’ depression and disability. It also boosted how they rated their quality of life.

MBSR is a standardized, eight-week program developed in the 1970s. It combines meditation and gentle yoga postures, with the goal of shifting people’s responses to stress, including body pain.

It’s not that mindfulness makes pain go away, explained Daniel Cherkin, a senior investigator emeritus at Kaiser Permanente Washington Health Research Institute, in Seattle.

Instead, he said, it helps people first become aware of their habitual reactions to their pain — whether they tend to ruminate or “catastrophize,” for example. From there, they can learn to “reframe” how they think about the pain and what it means.

Cherkin wrote an editorial published with the new findings in JAMA Internal Medicine on Dec. 14. His own research has found that MBSR can help people deal with chronic lower back pain.

Less has been known about whether people with migraines can benefit.

Worldwide, an estimated one billion people have migraine headaches, according to the Migraine Research Foundation. Along with intense head pain, migraines often cause nausea, visual disturbances, and sensitivity to light and sound.

For people who suffer frequent migraine episodes, medications can help prevent them. But they’re not always enough.

Some people end up taking potentially addictive opioids, which is not recommended, said Dr. Rebecca Wells, a neurologist who led the new trial.

Still other patients, she added, stop taking their migraine medication because of side effects.

So there’s a need for additional options, including non-drug ones, said Wells, an associate professor at Wake Forest School of Medicine in Winston-Salem, N.C.

To study MBSR, her team recruited 89 patients who were having anywhere from four to 20 “migraine days” a month. The researchers randomly assigned half to the eight-week mindfulness program, and the other half to receive education about migraines. All kept using their standard medications.

Three months later, both study groups had improved similarly on one measure: the number of migraine days. On average, patients reported about two fewer per month.

But the mindfulness group was doing better in other ways, including depression symptoms and how much disability their migraines caused. They also gave improved ratings to their quality of life.

“Those outcomes are very important to patients’ lives,” Wells said.

More research is needed to see what happens in the long run, according to Wells. But, in this study, the improvements in the MBSR group held up over nine months.

It’s hard to know the specific reasons why, Wells said. But, like Cherkin, she pointed to the general principles of MBSR, including the fact that it helps people “live in the present moment,” rather than allowing the mind to spin off.

No one is saying the physical pain is just “in people’s heads.” But the mind is intimately involved in how people experience pain.

“The mind and the body interact,” Cherkin said. “They’re connected.”

If pain treatment does not acknowledge that, he added, it’s a “missed opportunity.”

Beyond specific effects of mindfulness, Cherkin said it’s “empowering” for people to have a way to help themselves, rather than relying solely on treatments given by someone else.

“I think a lot of the benefit has to do with the fact that it engages people in their own care,” he said.

But mindfulness practices are not for everyone. Just as people with an aversion to needles are unlikely to line up for acupuncture, people who view mindfulness as “weird” probably won’t engage with it, Cherkin said.

And active participation is clearly key: The MBSR program is eight weeks, but people have to continue the practices afterward. During the course, they’re encouraged to practice at home every day for 30 minutes.

There can also be practical barriers. The MBSR course is widely available, including online, but there is a cost. And, in general, insurance coverage of mind-body therapies is spotty, Cherkin said.

One question, according to Wells, is whether mindfulness practices in “other formats” could have the same benefit as MBSR. Her team wanted to study a standardized approach, in part, to identify a specific program that works.

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The placenta jab that could ease pain of creaky knees

The placenta jab that could ease pain of creaky knees: Injection of tissue may help alleviate agony of arthritis

A jab of placental tissue may help alleviate the pain of arthritic knees.

The treatment is made from the inner layer of the placenta, which provides the growing foetus with oxygen and nutrients.

Earlier research shows that a single injection of the tissue — which is first processed — can reduce pain and other symptoms associated with osteoarthritis for up to one year.

The treatment is made from the inner layer of the placenta, which provides the growing foetus with oxygen and nutrients [File photo]

Now around 700 people are taking part in a trial due to start in the U.S. this month to compare the jab to a placebo of saline solution. 

Around one in five adults aged over 45 years — more than four million people — has osteoarthritis of the knee, according to the charity Versus Arthritis.

In a healthy knee, cartilage (a firm but rubbery material) covers the end of the bones in a joint, acting as a cushion, and provides a smooth, gliding surface to allow painless movement.

But in osteoarthritis, this protective surface breaks down through wear and tear, causing pain, swelling and problems moving the joint. Bony growths can develop, and the area may become red and swollen.

A wide range of treatments are available, from weight loss to take pressure off the joint, to painkillers. Many people ultimately need a joint replacement.

The new treatment, ReNu, developed by UK-U.S.-based firm Organogenesis is made of cells from the amniotic membrane, the inner layer of the placenta which is, with the mother’s permission, harvested from the placenta donated after childbirth.

The tissue is processed and kept frozen at -70c to -90c until it is needed.

Amniotic tissue is a rich source of stem cells, which can develop into many different types of cells, including cartilage.

It also contains anti-inflammatory compounds, collagen (a protein that provides strength and structure to tissue), and growth factors that, as well as the stem cells, can trigger the repair and regeneration of tissues, including cartilage.

The placenta also contains hyaluronic acid which lubricates joints, helping to ease pain and restore movement.

Doctors carrying out the trial will monitor patients for up to a year, comparing outcomes against people not having the treatment.

Previous research involving 100 patients who had the treatment found that 69 per cent of patients had an improvement of symptoms lasting for at least six months.

On average, patients who responded to the treatment, had a 63 per cent reduction in pain.

Roger Hackney, a consultant orthopaedic surgeon at the Spire and Nuffield hospitals in Leeds, says that as cartilage cannot heal in humans, the experimental jabs could have promise.

He said: ‘Studies such as this are hugely important if they can provide evidence that the product has something other than the placebo effect. ’

Did you know?

Snorers may be at greater risk of developing severe Covid-19. Research based on 5.5 million records shows that Covid patients with obstructive sleep apnoea (OSA) are 5.2 times more likely to be hospitalised.

A hearing test could detect autism spectrum disorder in babies, according to research from the University of Miami and Harvard Medical School in the U.S.

Currently the condition is diagnosed through behaviour assessments and may not be picked up until age five or older.

The scientists looked at records of children with learning disabilities and matched the data with 140,000 hearing tests. They found those later diagnosed as autistic had slower brain responses to sound.

Spinach extract may help to prevent muscle loss as we age. In a trial at Spain’s Universidad Catolica San Antonio de Murcia, 50 people will take a spinach supplement or a placebo daily for three months. 

Spinach is a source of iron, needed to make myoglobin, which provides oxygen to muscles, helping to increase muscle mass. 

Scientists learn how to ‘print’ kidneys in a lab

Tiny kidneys created using 3D printing are helping scientists understand more about the causes of kidney damage, and could pave the way for growing transplant organs in the lab.

Researchers from Murdoch Children’s Research Institute in Australia, together with biotech company, Organovo, took stem cells from patients with genetic kidney disease, and used ‘bioprinting’ — in other words using the stem cells to make other new cells to create an artificial living tissue.

These mini organs — some as small as a grain of rice — were used to study the effects of aminoglycoside antibiotics, which damage the kidney, reported the journal Nature Materials.

Tiny kidneys created using 3D printing are helping scientists understand more about the causes of kidney damage, and could pave the way for growing transplant organs in the lab [File photo]

Dogs that can sniff out Parkinson’s disease

Trials are under way to see if sniffer dogs can identify Parkinson’s disease.

More than 300 patients with the neurological disorder — which can cause mobility problems, insomnia and depression — are taking part in a trial to test the accuracy of the dogs.

The dogs will be given samples from patients with and without Parkinson’s to test their accuracy. There is no specific test for Parkinson’s and it can be hard to get a timely diagnosis, which can delay treatment.

Previous research has shown the disease is linked with a distinct musky odour, as it kick-starts the production of volatile organic compounds that are detectable in breath, urine and sweat.

The study is being carried out at Central South University Hospital in China.

New treatment could banish dry itchy skin

Scientists have discovered that a protein plays a key role in itchy skin condition eczema, raising new treatment prospects.

The finding, from an international team led by Manchester University, came from a ten-year study of mice and human tissue.

The results showed that the second immunoglobulin-binding protein (Sbi) triggers the condition by causing the release of another protein known to play a role in the immune response that causes eczema (by disrupting the structure of skin cells).

Writing in the Journal of Allergy and Clinical immunology, the scientists suggested treatments could move on from the standard steroid cream.

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The Creative Activities That Could Ease Your Anxiety

It’s no secret that an anxious mind needs a place to focus. So, instead of having it focused on what’s out of your control, using your creativity can offer a healthy outlet for ruminating thoughts. Per Insider, a Journal of Positive Psychology study found that daily creative activities could foster an increased sense of well-being. The reason behind this phenomenon comes as a result of getting out of your head and back into your body. Your project is taking place in the moment, not in the future. As such, your mind will slowly follow your hands’ lead.

For instance, baking has long been a pastime of the anxious-minded. As Instagram becomes riddled with delicious-looking posts captioned with the term, “stress baking,” it appears that these social media accounts are on to something. Measuring out the ingredients and mixing them together provides a tactile experience that requires full presence. The Atlantic attributes the activity’s relaxation effects to the “calming” sense of creating, but Professor Philip Muskin, who’s also the secretary of the American Psychiatry Association, feels that the mindfulness properties are the impetus for its anti-anxiety benefits. “Baking is mindful,” he tells the outlet. “Mindfulness means paying attention to yourself in the moment and not being in the past or the future, but really being there.”

If baking isn’t your thing, try adding a longer, more comprehensive process to daily routines like making your coffee. Insider suggests trying a slow-steep method for your brew by using a French press or pour-over apparatus for a relaxing twist. 

Work on your handwriting to help ease your anxiety

Even if you don’t consider yourself quite an artist, getting your creative juices flowing can bring on a sense of exhilaration. The Daily Mail reports that 76 percent of survey respondents to a University College London study called calligraphy a “distraction tool” that helped alleviate symptoms of nervousness. Using various pens, strokes, and colors can take up more of your headspace than you think, and nailing the perfect fancy “U” never felt so calming. Plus, you can put your new skill to the test and write out any holiday cards or invitations you need!

In a similar vein, tapping into your childlike state through activities such as coloring are known to bring about feelings of tranquility. Insider reports that a Creativity Research Journal study found that subjects who colored daily exhibited “significantly lower levels of depressive symptoms and anxiety after the intervention” than those who didn’t color. There are tons of coloring books available that are created for adults — so, find your coloring utensil of choice and get down to having fun! Bonus points if you find a mindfulness-based book.

When it comes to slowing your racing thoughts, give your new hobby time. It may take a few minutes or tries to feel the full effects. Everyone is different, so have fun finding a hands-on outlet and see how it impacts your mental health.

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Haircuts and golf in Melbourne as virus curbs ease

Residents of Australia’s second-biggest city flocked to salons and golf courses Monday as some stay-at-home restrictions were eased after coronavirus infection rates fell.

Melbourne’s five million people had been barred from leaving their homes with a few exceptions—including shopping for essentials, exercising, or going to work—for three months.

They still face a litany of travel restrictions and tough-to-remember rules for even the most mundane activities, but will now be able to get a much-needed haircut and do more outdoor socially distanced activities.

“We’re already fully booked until December,” salon owner Daniel Choi told AFP.

“From yesterday, there are so many messages for me: ‘I want a haircut’. They want to change their style.”

Salon owners still have to contend with restrictions on the number of people allowed on the premises at the same time, meaning those eager to correct self-inflicted dye jobs or improvised trims could face a long wait.

But for the lucky first customers there was a sense of elation.

“It’s a sense of relief actually that finally I could get it done,” said customer Karen Ng.

“It’s nice actually to have some normality.”

Golfers can also tee it up again, although they will have to go around in groups of two and, according to Golf Australia, “masks must still be worn when playing”.

“It’s a great sight… GOLFERS ON COURSE!” Green Acres Golf Club tweeted.

But many restrictions remain in place in the city.

Masks are mandatory, restaurants are limited to takeaways and deliveries, non-essential shops have to remain closed and there is a ban on travel outside the greater Melbourne area or more than 25 kilometres (16 miles) from home.

The city’s second round of stay-at-home restrictions began in July, when the state of Victoria saw around 190 new cases a day, rising to 700 in August.

Victoria recorded just four new cases on Monday.

But not everyone was happy with the limited easing, including Australia’s conservative treasurer Josh Frydenberg, who criticised the regional authorities for not going further.

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