If we spent the cost of COVID-19 on pandemic preparations it would have lasted 500 years

COVID-19 has taken advantage of a world in disorder, causing catastrophic health, social, and economic consequences and irreparable harm to humanity. The virus has killed close to a million people and many more may die as a result of its impact on health systems, food supplies, and the economy. The financial cost will be in the trillions.

This will not be the last global health emergency. The world simply cannot afford to be unprepared again, warns the Global Preparedness Monitoring Board (GPMB) in its second report “A World in Disorder,” released today.

Last year, the GPMB warned that the world was unprepared for the very real likelihood of a deadly pandemic spreading around the globe, killing millions of people, disrupting economies, and destabilizing national security. The Board called for urgent action to break the cycle of panic and neglect that has characterized the response to global health crises in the past.

In its new report, the GPMB provides a harsh assessment of the global COVID-19 response, calling it “a collective failure to take pandemic prevention, preparedness, and response seriously and prioritize it accordingly.” In many countries, leaders have struggled to take early decisive action based on science, evidence and best practice. This lack of accountability by leaders has led to a profound and deepening deficit in trust that is hampering response efforts.

“Transparency and accountability are essential in responding to the COVID-19 pandemic,” said Elhadj As Sy, co-Chair of the GPMB. “Trust is the foundation of government-community relationships for better health but that trust dissipates when governments and leaders do not deliver on their commitments.”

Responsible leadership and good citizenship have been key determinants of COVID-19’s impact, the report finds—systems are only as effective as the people who use them.

The report also finds that, while COVID-19 has demonstrated that the world is deeply interconnected through economics, trade, information, and travel, one of the greatest challenges of the pandemic has been faltering multilateral cooperation. Leadership by the G7, G20, and multilateral organizations has been hampered by geopolitical tensions. The Board calls on leaders to renew their commitment to the multilateral system and strengthen WHO as an impartial and independent international organization. Weakening and undermining the multilateral action will have serious consequences on global health security, it warns. No-one is safe until all are safe.


https://youtube.com/watch?v=newsxe0Fmro%3Fcolor%3Dwhite

“Viruses don’t respect borders. The only way out of this devastating pandemic is along the path of collective action, which demands a strong and effective multilateral system,” said H.E. Dr. Gro Harlem Brundtland, co-chair of the GPMB. “The UN system, which includes the WHO, was created after World War II and has helped make the world a better place for billions of people. It needs to be defended, strengthened, and revitalized, not attacked and undermined.”

The report highlights how the devastating social and economic impact of pandemics, especially for the vulnerable and disadvantaged, is often underestimated and ignored. COVID-19’s long-term socioeconomic impacts are predicted to last for decades, with the World Bank’s conservative scenario estimating a US$ 10 trillion earning loss over time for the younger generation as a result of pandemic-related educational deficits.

COVID-19 has demonstrated the importance of protecting lives and livelihoods and widening our understanding of preparedness to make education, social, and economic sectors pandemic proof. “A World in Disorder” reveals that the return on investment for pandemic preparedness is immense. It would take 500 years to spend as much on preparedness as the world is currently losing due to COVID-19.

“The pandemic has shown the fragility of not only our health systems, but also our global economy. The impact of COVID-19 has been huge in the world and particularly in my region, the Americas, with a sharp increase in health, social and economic inequities,” said Jeannette Vega, GPMB member and Chief Medical Innovation and Technology Officer, La Red de Salud UC-Christus, Chile. “Let’s hope that this time we finally learn the lesson and invest in preparedness and public goods for health to avoid similar tragedies in the future.”

The report highlights the actions that must be taken to end the COVID-19 pandemic and avoid the next catastrophe—to bring order out of chaos. It calls for responsible leadership, engaged citizenship, strong and agile systems for health security, sustained investment, and robust global governance for preparedness.

“A World in Disorder” identifies the specific commitments and actions leaders and citizens must take—boldly, decisively, and immediately. These include sustainable and predictable financing for global and national health security, and a call to hold a UN Summit on Global Health Security to develop an international framework for health emergency preparedness and response.

Source: Read Full Article

Only 25% of older Australians have an advance care plan. Coronavirus makes it even more important

Older adults and those with chronic health conditions share an increased risk of experiencing severe symptoms if they contract COVID-19.

But they’re not a homogeneous group. In the event they become very sick, one person may want all available treatment, even if this includes intensive care and an extended period of rehabilitation. Another may prefer to avoid life-sustaining but highly invasive medical interventions.

If either of these people became suddenly unwell, how likely is it health professionals would know their wishes? Understanding a person’s wishes in advance makes it easier for the health-care system to provide care that matches the person’s preferences.

Yet research shows only 25% of older Australian adults accessing health and aged-care facilities have documented their wishes for future care through advance care planning.

What is advance care planning?

Advance care planning is about discussing your goals for future care, in case of a time when you’re unable to communicate or make your own decisions. It works best when it includes health professionals, family members and other significant people (for example, a spiritual advisor).

A competent adult can specify their preferences for future health care in an advance care directive, or nominate a substitute decision-maker to make health-care decisions on their behalf.

The goal is even if a person is too unwell to make decisions, health-care professionals can still respect their preferences.

Why is advance care planning important during COVID-19?

In a recent paper, my colleagues and I make the case for incorporating advance care planning into the COVID-19 response.

First, it allows us to better prepare for any unexpected surges and reduce the need for rationing of medical resources in this event.

The recent outbreak of COVID-19 in Victoria has severely impacted aged-care settings and the broader community, and reignited concerns about the health-care system’s capacity to cope with local outbreaks.

Much debate about ethical decision-making has focused on the “rationing” scenario, in which outbreaks overwhelm health-care resources and some people are refused treatment.

However, we shouldn’t put our ethics hat on only when the truck gets close to the cliff. Ethics and evidence should inform all decision-making in the COVID-19 response, including taking all sensible steps to avoid a rationing scenario.

If future surges in demand push health-care systems beyond capacity, it will be too late to have advance care planning discussions with people at the time of their admission to hospital.

The public health response to prevent and control outbreaks is of course crucial. Beyond this, advance care planning can ensure those who wish to refuse certain treatments have communicated this, and are not inadvertently “competing” with others for scarce health-care resources.

This is not about abandoning people or an excuse to provide less care. Advance care planning must always be a voluntary process, aimed at respecting a person’s informed preferences.

Importantly, routine care delivery is more complicated in the COVID-19 context, and respecting a person’s preferences can require preparation. For example, a person’s wish to receive care at home may depend on supplies of consumables and personal protective equipment, visiting rosters and backups in case family members or care staff need to quarantine.

Finally, it’s a matter of respecting human rights. Advance care planning enables a person to exercise some level of control over their care, even while highly dependent.

How can we boost the uptake of advance care planning?

In terms of policy, the Australian health sector’s emergency response plan for COVID-19 does indicate aged-care providers should encourage advance care planning among residents.

But the plan should be updated to incorporate a more strategic approach to increasing advance care planning across primary care, hospital and community settings—not just aged care.

Health professionals, including primary care, allied health and aged-care workers, can all help patients and family members understand their condition and options for future treatment, and encourage further discussion about advance care planning.

Lawyers, trained community volunteers, health promotion units and mass media strategies can also play a role in encouraging the broader community to discuss their wishes with family members and health professionals, in non-acute community settings.

The COVID-19 pandemic has stimulated changes in attitudes and accepted practices across the board. We should leverage this to promote increased uptake of advance care planning.

Notably, telehealth technology enables advance care planning discussions from a distance, and new legislation in some states allows remote witnessing of legal documents.

Source: Read Full Article

Children notice race several years before adults want to talk about it

Adults in the United States believe children should be almost 5 years old before talking with them about race, even though some infants are aware of race and preschoolers may have already developed racist beliefs, according to new research published by the American Psychological Association.

Delays in these important conversations could make it more difficult to change children’s misperceptions or racist beliefs, said study co-author Jessica Sullivan, Ph.D., an associate professor of psychology at Skidmore College.

“Children are capable of thinking about all sorts of complex topics at a very young age,” she said. “Even if adults don’t talk to kids about race, children will work to make sense of their world and will come up with their own ideas, which may be inaccurate or detrimental.”

In an online study with a nationally representative sample, more than 600 participants were asked the earliest age at which they would talk with children about race. They were also asked when they thought children first develop behaviors and cognitive abilities relating to race and other social factors. More than half of the participants were parents while 40% were people of color. The research was published online in the Journal of Experimental Psychology: General.

The participants believed conversations about race should begin near a child’s fifth birthday even though children begin to be aware of race when they are infants. Previous research has shown that 3-month-old babies prefer faces from certain racial groups, 9-month-olds use race to categorize faces, and 3-year-old children in the U.S. associate some racial groups with negative traits. By age 4, children in the U.S. associate whites with wealth and higher status, and race-based discrimination is already widespread when children start elementary school.

Participants who believed children’s capacities to process race developed later also believed conversations about race should occur later. The researchers were surprised that the participants’ race did not affect the age at which they were willing to talk with children about race. The participants’ parental status, gender, education level, or experience with children also didn’t have any bearing on the findings.

Another online experiment in the study found that when participants learned about children’s developmental abilities relating to race, they said adults should start talking about it when children are 4 years old. This was approximately a year earlier than in the previous experiment.

Many white parents often use well-meaning but ineffective strategies that ignore the realities of racism in the United States, said study co-author Leigh Wilton, Ph.D., an assistant professor of psychology at Skidmore College. Some harmful approaches include a colorblind strategy (e.g., telling children “Skin color doesn’t matter,” or “We’re all the same on the inside”) or refusing to discuss it (e.g., “It’s not polite to talk about that”).

The study didn’t address exactly when or how adults should talk with children about race, but Wilton said this can begin early.

“Even if it’s a difficult topic, it’s important to talk with children about race, because it can be difficult to undo racial bias once it takes root,” she said. “Toddlers can’t do calculus, but that doesn’t mean we don’t teach them to count. You can have a conversation with a toddler about race that is meaningful to them on their level.”

Parents, especially white parents, need to become comfortable talking about race or it will only get more difficult as their children get older, Wilton said.

Source: Read Full Article

Here's What It Really Means When a Narcissist Says 'I'm Sorry'

Clinical psychologist and therapist Dr. Ramani Durvasula makes videos educating people about how to best spot harmful toxic behavior in others, and what to do to protect yourself and limit the damage that can be wrought when you have a narcissist in your life. Having previously explained why it’s not wise to call out a narcissist, Durvasula’s most recent post explores how to respond if a narcissist actually apologizes for the way they have acted.

“The idea that their apology means they understand what they did, and they’re going to change their behavior, it isn’t true,” she says, “and if you hold that belief, it’s likely that you’re going to be very disappointed.”

Men’s Health

Subscribe to Men’s Health

SHOP NOW

“An apology, done correctly, is taking responsibility; addressing the other person’s feelings, striving for reconciliation, and committing to learning from it,” she continues. “Unfortunately, that’s not what a narcissistic apology is. A narcissistic apology is sort of a way of keeping the trains running on time, of getting off the hook for something, of getting back to the way they want things to be.”

A narcissist doesn’t actually care that they hurt somebody else, and often, Durvasula points out, an apology only comes after a lengthy argument where they believe the person they hurt may take away their “supply.” And in each instance, the narcissist does not learn from the experience or adapt their behavior, and the cycle continues.

It’s pretty easy to identify a narcissist’s apology, simply because they won’t take responsibility for what they did. We’ve all heard that particular kind of non-apology, when somebody sounds like they’re apologizing but really they’re talking around their own accountability by saying things like “I’m sorry you feel that way.”

“In all of these apologies, what you see is that they are not apologizing for something they did or said,” says Durvasula. “They are in essence, though, using the apology as a way of gaslighting you and invalidating your experience: ‘I’m sorry you feel that way,’ meaning ‘you probably shouldn’t.'”

A healthy apology, Durvasula explains, involves acknowledging and owning the original action, not just the reaction. There’s a huge difference between saying “I’m sorry you’re hurt” and “I’m sorry I hurt you, I’ll try to do better.” Durvasula’s three hallmarks of a healthy apology are responsibility, acknowledgment, and commitment.

Source: Read Full Article

What is numerology and how does it work?

You already believe, at least a little bit, in numerology, if you have a lucky number and think there’s truth to expressions like, “bad things happen in threes.” Numerology is the mystical study of numbers, and similar to astrology, believers say it can offer insights on everything from personality traits to what the future holds (via Allure). If you’re intrigued by numerology, you’re in good company; celebrities ranging from Cardi B to Taylor Swift to Jay Z and Beyoncé have embraced this ancient practice (via Fader), which was founded by ancient Greek mathematician Pythagoras (of the famed Pythagorean theorem.) 

Pythagoras’ ah-ha moment that (a² + b² = c²) was something we all had to learn in high school math, but most of us did not learn the more “New Age” theory that this grandfather of mathematics posited: that certain numbers have specific personal, spiritual and predictive meaning to us. Explained numerologist Felicia Bender: “Numbers carry with them not only a quantitative value, like one apples, two apples, three apples, but also a vibration and a frequency,” she told Women’s Health.

So how can you apply the principles of numerology to better understand your life?

Numerology can give you insight into your life

Your life path number is similar to a horoscope birth chart and will be the basis of all of the numerology insights about your life. You can calculate yours by adding up the numbers in your birthdate. If you end up with double digits, you keep adding together those digits until you reach a single number. So if your birthday is June 5, 1995, you start with your birth year, and add 1+9+9+5, getting the sum of 24. Then you add 2+4 to get 6. You would add to 6 the 6 for June and 5 for the fifth, resulting in 17, or 1+7. That gives you a life path number of 8. Oh, 8. We see you, you overachiever, you (via Numerology.com).

Not sure if you’re doing the math right? There are a number of free numerology calculators online. Once you know your life path number, you will have pre-ordained suggestions for your optimal career paths, what to look for in a romantic partner, and yes, what your lucky number actually is for when you’ve got a lottery ticket or a roulette wheel to spin (via How Stuff Works.

But note that this number is just the tip of the iceberg when it comes to numerology; your name also tells a story, as each letter in the alphabet has a numerical value (A=1, B=2, etc.) A psychic advisor can combine these insights with a tarot deck, birth chart and other tools in a more formal reading. If you believe in that stuff, that is. 

Source: Read Full Article

We may be able to eliminate coronavirus, but we’ll probably never eradicate it. Here’s the difference

Compared to many other countries around the world, Australia and New Zealand have done an exceptional job controlling COVID-19.

As of May 7, there were 794 active cases of COVID-19 in Australia. Only 62 were in hospital.

The situation in New Zealand is similar, with 136 active cases, only two of whom are in hospital.

If we continue on this path, could we eliminate COVID-19 from Australia and New Zealand?

Control –> elimination –> eradication

In order to answer this question, we first to need to understand what elimination means in the context of disease, and how it differs from control and eradication.

Disease control is when we see a reduction in disease incidence and prevalence (new cases and current cases) as a result of public health measures. The reduction does not mean to zero cases, but rather to an acceptable level.

Unfortunately, there’s no consensus on what is acceptable. It can differ from disease to disease and from jurisdiction to jurisdiction.

As an example, there were only 81 cases of measles reported in Australia in 2017. Measles is considered under control in Australia.

Conversely, measles is not regarded as controlled in New Zealand, where there was an outbreak in 2019. From January 1, 2019, to February 21, 2020, New Zealand recorded 2,194 measles cases.

For disease elimination, there must be zero new cases of the disease in a defined geographic area. There is no defined time period this needs to be sustained for—it usually depends on the incubation period of the disease (the time between being exposed to the virus and the onset of symptoms).

For example, the South Australian government is looking for 28 days of no new coronavirus cases (twice the incubation period of COVID-19) before they will consider it eliminated.

Even when a disease has been eliminated, we continue intervention measures such as border controls and surveillance testing to ensure it doesn’t come back.

For example, in Australia, we have successfully eliminated rubella (German measles). But we maintain an immunization schedule and disease surveillance program.

Finally, disease eradication is when there is zero incidence worldwide of a disease following deliberate efforts to get rid of it. In this scenario, we no longer need intervention measures.

Only two infectious diseases have been declared eradicated by the World Health Organisation – smallpox in 1980 and rinderpest (a disease in cattle caused by the paramyxovirus) in 2011.

Polio is close to eradication with only 539 cases reported worldwide in 2019.

Guinea worm disease is also close with a total of just 19 human cases from January to June 2019 across two African countries.

What stage are we at with COVID-19?

In Australia and New Zealand we currently have COVID-19 under control.

Importantly, in Australia, the effective reproduction number (Reff) is close to zero. Estimates of Reff come from mathematical modelling, which has not been published for New Zealand, but the Reff is likely to be close to zero in New Zealand too.

The Reff is the average number of people each infected person infects. So a Reff of 2 means on average, each person with COVID-19 infects two others.

If the Reff is greater than 1 the epidemic continues; if the Reff is equal to 1 it becomes endemic (that is, it grumbles along on a permanent basis); and if the Reff is lower than 1, the epidemic dies out.

So we could be on the way to elimination.

In both Australia and New Zealand we have found almost all of the imported cases, quarantined them, and undertaken contact tracing. Based on extensive community testing, there also appear to be very few community-acquired cases.

The next step in both countries will be sentinel surveillance, where random testing is carried out in selected groups. Hopefully in time these results will be able to show us COVID-19 has been eliminated.

It’s unlikely COVID-19 will ever be eradicated

To be eradicated, a disease needs to be both preventable and treatable. At the moment, we neither have anything to prevent COVID-19 (such as a vaccine) nor any proven treatments (such as antivirals).

Even if a vaccine does become available, SARS-CoV-2 (the virus that causes COVID-19) easily mutates. So we would be in a situation like we are with influenza, where we need annual vaccinations targeting the circulating strains.

The other factor making COVID-19 very difficult if not impossible to eradicate is the fact many infected people have few or no symptoms, and people could still be infectious even with no symptoms. This makes case detection very difficult.

At least with smallpox, it was easy to see whether someone was infected, as their body was covered in pustules (fluid-containing swellings).

Source: Read Full Article