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Man who lived in airport for 18 years dies

The man who inspired Steven Spielberg’s The Terminal, as well as a French film and an opera, has died in the airport where he lived for 18 years. Mehran Karimi Nasseri suffered a heart attack in Terminal 2F of the Charles de Gaulle airport on Saturday and died after police and a medical team were unable to save him, according to an official with the Paris airport. Mr Nasseri, believed to have been born in 1945 in Soleiman, the then-British controlled area of Iran, lived in Terminal 1 between 1988 and 2006, at first while he was in a legal limbo because he was without residency papers and later by choice. The airport official said the 76-year-old had been living in the airport again in recent weeks. His first stint at the airport, when he spent years sleeping on a red plastic bench, making friends with airport workers, showering in staff facilities and spending time writing in his diary, studying economics and watching passing travellers inspired The Terminal starring Tom Hanks, as well as French film Lost in Transit and the opera Flight. Mr Nasseri published his autobiography, The Terminal Man, the same year The Terminal was made. <img src="https://oversixtydev.blob.core.windows.net/media/2022/11/mehran-nasseri1.jpg" alt="" width="1280" height="720" /> Mehran Karimi Nessari lived in the Charles de Gaulle airport for 18 years, with his belongings surrounding a red plastic bench he slept on. Image: Getty Images After leaving Iran to study in England in 1974, he was reportedly imprisoned on his return for protesting against the shah while abroad and was exiled soon after. He applied for political asylum in several European countries and was given refugee credentials by the United Nations High Commissioner for Refugees in Belgium in 1981, but was later denied entry into England after the briefcase containing his documents was stolen at a Paris train station. Although he was arrested by French police after being sent back to Charles de Gaulle from England, he couldn’t be deported because he had no official documents and stayed. After lengthy legal campaigning, more bureaucratic bungling and increasingly strict European immigration laws kept him in a legal no-man’s land for years, Mr Nasseri was offered French and Belgian residency, but he refused to sign the papers as they listed him as Iranian and didn’t show his preferred name, Sir Alfred Mehran. He stayed at the airport for several more years before being admitted to hospital in 2006 and he later lived in a French shelter. Those at the airport who befriended him said Mr Nasseri’s years of living there had taken a toll on his mental health, while the airport doctor described him as “fossilised here” in 1990. One friend, a ticket agent, compared him to a prisoner incapable of “living on the outside”. “Eventually, I will leave the airport,” Mr Nasseri told the Associated Press in 1999, looking frail with thin hair, hollow cheeks and sunken eyes. “But I am still waiting for a passport or transit visa.” Image: Getty Images

Health

The Crown sparks backlash over plans to recreate Diana’s final moments

Royal drama The Crown has drawn criticism after announcing plans to recreate Princess Diana’s final moments in Paris, with crew members fearing “a line has been crossed”. The show, which stars Australian actress Elizabeth Debicki as Diana, is facing increasing upset over its plotlines and claims of insensitivity in the wake of Queen Elizabeth II’s death. Scenes suggesting that Prince Philip had an affair with a female friend are also causing strife for the producers. But, The Sun reports that scenes focusing on Diana’s ill-fated Paris trip in 1997 and the days and hours before the fatal car crash in the Alma tunnel are being worked on, with a source from the show telling the outlet that some crew members are starting to push back on the show’s ideas. “To be going back to Paris and turning Diana’s final days and hours into a drama feels very uncomfortable,” the source said. “Finally, some of the crew members are pushing back on the ideas being tabled. “The show always tried to present a fictional version of royal history with as much sensitivity as possible. “But lately, as things get closer to the present day, it feels harder to strike that balance. “With some of those moments still so fresh and upsetting, it feels as though a line is being crossed. “Some production staff are now starting to speak up about their feelings.” A spokesman for Netflix told the outlet that the “exact moment of the crash impact” won’t be recreated or shown. Meanwhile, sources close to Prince William said they expect him to be angered by the show’s reproduction of his mother’s final days for entertainment purposes New scenes alleging then-Prince Charles went against his late mother, suggesting she was too old and out of touch, are also facing criticism - but a Crown spokesman defended the controversial scenes as “fictional dramatisation”. “Series five is a fictional dramatisation, imagining what could have happened behind closed doors.” Image: @thecrownnetflix (Instagram)

Entertainment

UK national anthem undergoes change now Charles is King

After 70 years of singing ‘God save the Queen’, Brits will be faced with a change to their national anthem, prompted by the shock death of Queen Elizabeth II. With King Charles III to take the throne, the national anthem will change to God Save the King. Though nearly all of the lyrics will stay the same, there will be some key replacements: ‘queen’ with ‘king’, and ‘she’ and ‘her’ swapped for ‘he’ and ‘him’. The change will see the anthem return to its original title, as it was first publicly performed in 1745 after Prince Charles Edward Stuart defeated the army of King George II at Prestonpas, according to the royal family’s <a href="https://www.royal.uk/national-anthem" target="_blank" rel="noopener">website</a>. It became the national anthem at the beginning of the 19th century, with the lyrics changing when a King or Queen takes the throne. Queen Elizabeth II began her reign in 1952, when she was 25, resulting in the lyrics changing from ‘God save the King’ during her father King George VI’s reign to ‘God save the Queen’. Image: Getty Images

Entertainment

Dismantling the police: lessons from three places that tried it

The killing of George Floyd by Minneapolis police officers sparked protests across the US and brought the Black Lives Matter movement back to the forefront of American politics. The intensity of these protests means that previously unthinkable demands for radical reform are now on the table. The defunding of America’s heavily armed police forces, a long-term demand of racial justice activists, looks increasingly achievable. In early June, a veto-proof supermajority of Minneapolis City council members supported efforts to <a href="https://theappeal.org/minneapolis-city-council-members-announce-intent-to-disband-the-police-department-invest-in-proven-community-led-public-safety/">“dismantle” and “abolish”</a> the police department and replace it with a new system of community policing. In Los Angeles, the mayor put forward a proposal to <a href="https://www.latimes.com/california/story/2020-06-03/lapd-budget-unrest-garcetti">divert between US$100 million and US$150 million</a> from the police department to invest in jobs and education for communities of colour. What this would look like in practice is still unclear. While reforms need to be matched to the specific national context and goals, there are a number of countries that have attempted to defund, demobilise and radically reform their police forces. Although this often occurs following armed conflict, the experience of three places in particular can provide important lessons for today. Iraq and de-Ba’athification Following the 2003 occupation of Iraq, the US ambassador Paul Bremer took the decision to “de-Ba’athify” the Iraqi state by removing civil servants from the era of Saddam Hussein en masse. US military planners <a href="https://www.jstor.org/stable/resrep12200">had assumed</a> they would inherit a functioning state, including the security system. However de-Ba’athification changed this by essentially disbanding the Iraqi security forces, leaving its personnel with no re-integration programme or alternative source of work. This top-down imposition created <a href="https://doi.org/10.1080/02684521003588120">a large pool of unemployed men</a>, many of whom retained their access to arms and explosives in the post-war chaos. Many felt humiliated and hostile to the US forces, which <a href="https://books.google.co.uk/books/about/Surge.html?id=9dQ_AQAAQBAJ&redir_esc=y">researchers have argued</a> led to the <a href="https://books.google.co.uk/books/about/Surge.html?id=9dQ_AQAAQBAJ&redir_esc=y">political basis for the subsequent Iraqi insurgency</a>. From the elite level to the rank-and-file, these newly desperate men helped to create and sustain the insurgency, with many of Hussein’s ex-generals and spies going on to <a href="https://time.com/3900753/isis-iraq-syria-army-united-states-military/">direct the activities of the Islamic State group</a>. The Minneapolis Police Department will not be demobilised into an environment of generalised chaos, foreign occupation and sectarian violence. Nevertheless, the blunders in post-war Iraq provide a clear lesson: you shouldn’t take jobs away from people who are trained in the use of coercion and violence without some idea of how to retrain and reintegrate them. In the US context this would be unlikely to lead to outright civil conflict as in Iraq – although anything is possible. A more realistic worry is that the police could simply move sideways into private security, a <a href="https://pulitzercenter.org/reporting/industry-inequality-why-world-obsessed-private-security">quickly expanding sector</a> that was ironically trialled <a href="https://www.brookings.edu/articles/the-dark-truth-about-blackwater/">with horrifying results</a> in Iraq and Afghanistan. The extended use of private security on US soil could be even <a href="https://doi.org/10.1080/0731129X.2012.740907">more violent and less accountable</a> than the current system of policing. Guatemala – rebranding not reform The end of the 36-year-long Guatemalan civil war in 1996 saw an ambitious peace programme. It promised to demilitarise the country’s internal security by transitioning from a brutal military-led counterinsurgency to a civilian police force. However, in practice the reforms failed to effectively move past the legacy of wartime repression. One important factor was that the newly democratic government adopted wholesale the model of the Spanish Guardia Civil, a highly militarised internal security force. The Guardia Civil has been used for internal repression in Spain since its <a href="https://english.elpais.com/elpais/2014/10/20/inenglish/1413807111_949949.html">inception</a> in the mid-19th century, to the recent attempts to <a href="https://www.independent.co.uk/news/world/europe/catalonia-independence-referendum-catalan-police-storm-ministries-arrested-josep-maria-jov-a7956581.html">target the Catalan independence movement</a>. Guatemala’s decision to follow the Spanish model ran against the idea of a new policing approach even at the time. The reasoning behind the government’s decision was unclear, but bears the hallmarks of the continued influence <a href="https://www.jstor.org/stable/3339023">of the Guatemalan military establishment</a>. The outcome is a security state that is still extremely violent towards both <a href="https://www.insightcrime.org/news/brief/extrajudicial-killings-on-the-rise-in-guatemala/">suspected criminals</a> and <a href="https://nacla.org/news/2018/06/21/terror-guatemala">political activists</a>. The lesson for the US here is that meaningful reform requires a clear sense of direction rather than simply a re-packaging of the existing model. Beyond this, it also shows the dangers of a fragmented security system. Changing the practices of local police forces will be less effective if agencies such as immigration and customs enforcement are able to continue engaging <a href="https://www.aclu.org/issues/immigrants-rights/ice-and-border-patrol-abuses">in widespread violence</a>. This is a particular vulnerability for the US, given its <a href="https://journals.sagepub.com/doi/abs/10.1177/0022343320913089">overlapping security agencies</a> which lack centralised Federal control. Bougainville and bottom-up reform More positive lessons can be taken from the experiences of countries that have radically re-orientated their policing model away from retribution and towards reconciliation and restoration. The autonomous region of Bougainville, <a href="https://www.npr.org/2019/12/30/789697304/trying-to-form-the-worlds-newest-country-bougainville-has-a-road-ahead?t=1591805961684">likely to become the world’s newest nation</a>, used the end of a secessionist conflict with Papua New Guinea in 1998 as an opportunity to return to a form of community justice which emphasised honesty, forgiveness and rehabilitation. This functioned as a way of overcoming wartime trauma and encouraging reconciliation but was also extended out as a general policing model. This approach, while supported by international donors and peacekeepers, relied on long-standing local customs and practice. The result is a society which, while not problem free, is <a href="https://www.researchgate.net/publication/273755447_Bougainville_Community_Crime_Survey_2006">significantly safer</a> than the rest of Papua New Guinea. Crucially, the community-based police force enjoys <a href="http://dx.doi.org/10.1080/13533312.2013.853961">broad popular support</a> among previously victimised rural communities. The US can’t replicate the traditional cultural practice of Bougainville, but it can learn the lessons from its experience. Rather than imposing a particular model, local politicians and international peacekeepers empowered local people to take control of their own safety and security. It is this bottom-up, consensual approach that can form the basis of effective security reform in the US. Written by Daniel Odin Shaw. Republished with permission of <a href="https://theconversation.com/dismantling-the-police-lessons-from-three-places-that-tried-it-140303">The Conversation.</a>

Health

Traversing the coastline of the Catlins

Justine Tyerman has an encounter with some feisty sea lions in the Catlins. The sign said to stay well clear of the sea lions at Cannibal Bay in the Catlins, but the sea lions clearly could not read. We were standing at a safe distance from a cluster of these magnificent creatures, watching them cavorting in the surf. They were engaged in some sort of territorial dispute and were creating a heck of a ruckus. So fascinated were we with their behaviour, we were completely taken by surprise when two more large sea lions suddenly appeared from the sand dunes behind us and came lolloping towards us at great speed. After scaring the living daylights out of us, the pair joined the noisy fray among the other sea lions which had escalated into a full-on battle between two huge bulls with shaggy manes. Cannibal Bay, on the wild south-east coast of New Zealand’s South Island, is a favourite habitat of these critically endangered mammals, known in Maori as rapoka. A remote, windswept bay with a huge rock standing sentinel at the northern end and a long curve of sand stretching south, the place-name conjures up all sorts of macabre visions. Long ago, a surveyor found human bones on the beach but there was never any evidence of foul play so one wonders why he leapt to the conclusion that the deceased had been eaten. Earlier in the day, just along the coast at Kaka Point, hubby Chris and I had embarked upon our much-anticipated Catlins adventure, all new territory for us. An information board overlooking the silvery sea and white sands of Molyneux Bay told us we were standing where the Clutha River used to flow to sea until a massive flood in 1878 moved the river mouth to the north. Maori settled here about 900AD living on moa and seal meat, and Captain James Cook sailed by in 1770 but did not make landfall. He named the bay Molyneux after the ship’s master who died on the journey. Whalers and sealers from England and Europe came to hunt in the abundant coastal waters of the southern coast in the early 19th century and European settlers arrived in the mid-1850s to mill timber. The name Catlins was bestowed upon the region in honour of a whaling captain, Edward Catlin, who bought a block of land beside the river from Kāi Tahu chief Hone Tūhawaiki in 1840. Ten minutes down the coast, the headland at Nugget Point looks as though it has thrust itself into the Pacific Ocean with such force that fragments have broken off. Captain Cook decided the rocky outcrops scattered at the tip of the long, deeply-weathered finger looked like gold nuggets — hence the name. A lighthouse, one of the oldest in the country, was built on the promontory at the far end of the point in 1869-70 at the height of the coastal shipping era. The 600-metre walk to the impressive white beacon runs along a narrow ridge allowing breath-taking views of the coastline to the north and south. Vertiginous cliffs rise almost vertically in both directions. Built from locally-quarried stone, the Tokata Lighthouse stands an impressive 9.5 metres high and is 76 metres above the sea. Watching the surge of the waves pummelling the rocks far below, even on a calm day, was a lesson in the awesome power of the sea to shape and fashion the face of Aotearoa. I’d love to return at the height of a storm and witness the winds that force all the trees there to grow horizontal to the land. A hotspot for marine diversity, over 40 species of seabird inhabit or visit the headland, and fur seals and sea lions are a common sight. Orca, southern right whales, humpbacks and dolphins are occasionally spotted off the point... but not that day. We did, however, see fur seal pups frolicking far below in sheltered rock pools. Roaring Bay, just south of Nugget Point, is a breeding ground of the yellow-eyed penguin or hoiho, the world’s rarest penguin. Standing 65cm tall and weighing about 5kg, they are the fourth largest penguin. Hoiho means noise shouter, a name given to them because of their shrill call. We spent a good half hour scouring the seashore from a hide above the beach but there was no sign of the creatures coming ashore. Reading about their life cycle on information boards in the hide, visitors are unlikely to see the penguins in March and April because they are moulting and confined to land until their new feather coats grow. They are not waterproof during the moult so they cannot forage at sea, relying on their fat stores to survive. According to the Yellow-eyed Penguin Trust, despite efforts to protect this critically endangered species, there are only 225 breeding pairs left on mainland New Zealand, the lowest level since 1990-91. This is indeed sad news. As the light began to fade, we found an excellent overnight camp site called Newhaven Holiday Park at Surat Bay named after the sailing vessel Surat that was wrecked there in 1874. We got there just in time to set up our comfy, cosy double bed in the back of the JUCY campervan and stroll down to the beach with a bubbly and beer to watch a stunning sunset. Our campsite was on beautiful Pounawea Estuary, fed by the Owaka and Catlins rivers, a place rich in birdlife and virgin podocarp forest. It was so mild, we cooked outdoors in our little ‘kitchen’... very convenient, like an upmarket tent on wheels. Far from ‘freezing to death’, as our Wanaka friends had warned us when we left their centrally-heated house early that day — the campervan was so warm, we had to open the windows wide during the night. Young ones camping in tents around us thought it was pretty cool (or crazy?) to see a couple of ‘oldies’ sleeping in the back of a bright purple and green station wagon. It brought back memories of the carefree roadies of our youth. To be continued… See part <a rel="noopener" href="https://www.oversixty.asia/travel/international-travel/exploring-our-own-backyard" target="_blank">one</a> and <a rel="noopener" href="https://www.oversixty.asia/travel/international-travel/driving-along-central-otago-highway" target="_blank">two</a> of Justine’s road trip here.

Travel

Scientists around the world are already fighting the next pandemic

If a two-year-old child living in poverty in India or Bangladesh gets sick with a common bacterial infection, there is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4775002/">more than a 50%</a> chance an antibiotic treatment will fail. Somehow the child has acquired an antibiotic resistant infection – even to drugs to which they may never have been exposed. How? Unfortunately, this child also lives in a place with limited clean water and less waste management, bringing them into frequent contact with faecal matter. This means they are regularly exposed to millions of resistant genes and bacteria, including potentially <a href="https://www.thelancet.com/pdfs/journals/lanplh/PIIS2542-5196(18)30186-4.pdf">untreatable superbugs</a>. This sad story is shockingly common, especially in places where pollution is rampant and clean water is limited. For many years, people believed antibiotic resistance in bacteria was primarily driven by imprudent use of antibiotics in clinical and veterinary settings. But <a href="https://www.sciencedirect.com/science/article/pii/S016041201832587X?via%3Dihub">growing evidence</a> suggests that environmental factors may be of equal or greater importance to the spread of <a href="https://theconversation.com/to-defeat-superbugs-everyone-will-need-access-to-clean-water-95202">antibiotic resistance</a>, especially in the developing world. Here we focus on antibiotic resistant bacteria, but drug resistance also occurs in types of other microorganisms – such as resistance in pathogenic viruses, fungi, and protozoa (called antimicrobial resistance or AMR). This means that our ability to treat all sorts of infectious disease is increasingly hampered by resistance, potentially including coronaviruses like SARS-CoV-2, which causes COVID-19. Overall, use of antibiotics, antivirals, and antifungals clearly must be reduced, but in most of the world, improving water, sanitation, and hygiene practice – a practice known as WASH – is also critically important. If we can ensure cleaner water and safer food everywhere, the spread of antibiotic resistant bacteria will be reduced across the environment, including within and between people and animals. As <a href="https://www.who.int/water_sanitation_health/publications/wash-wastewater-management-to-prevent-infections-and-reduce-amr/en/">recent recommendations on AMR</a> from the Food and Agriculture Organization of the United Nations (FAO), the World Organisation for Animal Health (OIE), and World Health Organization (WHO) suggest, to which David contributed, the “superbug problem” will not be solved by more prudent antibiotic use alone. It also requires global improvements in water quality, sanitation, and hygiene. Otherwise, the next pandemic might be worse than COVID-19. Bacteria under stress To understand the problem of resistance, we must go back to basics. What is antibiotic resistance, and why does it develop? Exposure to antibiotics puts stress on bacteria and, like other living organisms, they defend themselves. Bacteria do this by sharing and acquiring defence genes, often from other bacteria in their environment. This allows them to change quickly, readily obtaining the ability to make proteins and other molecules that block the antibiotic’s effect. This <a href="https://www.ncbi.nlm.nih.gov/pubmed/21711367">gene sharing process</a> is natural and is a large part of what drives evolution. However, as we use ever stronger and more diverse antibiotics, new and more powerful bacterial defence options have evolved, rendering some bacteria resistant to almost everything – the ultimate outcome being untreatable superbugs. Antibiotic resistance has existed <a href="https://www.nature.com/articles/nature10388">since life began</a>, but has recently accelerated due to human use. When you take an antibiotic, it kills a large majority of the target bacteria at the site of infection – and so you get better. But antibiotics do not kill all the bacteria – some are naturally resistant; others acquire resistance genes from their microbial neighbours, especially in our digestive systems, throat, and on our skin. This means that some resistant bacteria always survive, and can pass to the environment via inadequately treated faecal matter, spreading resistant bacteria and genes wider. The pharmaceutical industry initially responded to increasing resistance by developing new and stronger antibiotics, but bacteria evolve rapidly, making even new antibiotics lose their effectiveness quickly. As a result, new antibiotic development has almost stopped because it garners <a href="https://theconversation.com/big-pharma-has-failed-the-antibiotic-pipeline-needs-to-be-taken-under-public-ownership-126058">limited profit</a>. Meanwhile, resistance to existing antibiotics continues to increase, which especially impacts places with <a href="https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196%2818%2930186-4/fulltext">poor water quality and sanitation</a>. This is because in the developed world you defecate and your poo goes down the toilet, eventually flowing down a sewer to a community wastewater treatment plant. Although treatment plants are not perfect, they typically reduce resistance levels by well over 99%, substantially reducing resistance released to the environment. In contrast, over <a href="https://www.unicef.org/reports/progress-on-drinking-water-sanitation-and-hygiene-2019">70% of the world</a> has no community wastewater treatment or even sewers; and most faecal matter, containing resistant genes and bacteria, goes directly into surface and groundwater, often via open drains. This means that people who live in places without faecal waste management are regularly exposed to antibiotic resistance in many ways. Exposure is even possible of people who may not have taken antibiotics, like our child in South Asia. Spreading through faeces Antibiotic resistance is everywhere, but it is not surprising that resistance <a href="https://www.ncbi.nlm.nih.gov/pubmed/30177008%20and%20https://www.thelancet.com/pdfs/journals/lanplh/PIIS2542-5196(18)30186-4.pdf">is greatest</a> in places with poor sanitation because factors other than use are important. For example, a fragmented civil infrastructure, political corruption, and a lack of centralised healthcare also play key roles. One might cynically argue that “foreign” resistance is a local issue, but antibiotic resistance spread knows no boundaries – superbugs might develop in one place due to pollution, but then become global due to international travel. Researchers from Denmark compared antibiotic resistance genes in long-haul airplane toilets and found <a href="https://www.nature.com/articles/srep11444">major differences in resistance carriage</a> among flight paths, suggesting resistance can jump-spread by travel. The world’s current experience with the spread of SARS-CoV-2 shows just how fast infectious agents can move with human travel. The impact of increasing antibiotic resistance is no different. There are no reliable antiviral agents for SARS-CoV-2 treatment, which is the way things may become for currently treatable diseases if we allow resistance to continue unchecked. As an example of antibiotic resistance, the “superbug” gene, blaNDM-1, was first detected in <a href="https://www.ncbi.nlm.nih.gov/pubmed/21478057">India</a> in 2007 (although it was probably present in other regional countries). But soon thereafter, it was found in a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2786356/">hospital patient in Sweden</a> and then <a href="https://academic.oup.com/jac/article/66/9/1998/768777">in Germany</a>. It was ultimately detected in 2013 in Svalbard in <a href="https://www.sciencedirect.com/science/article/pii/S016041201832587X?via%3Dihub">the High Arctic</a>. In parallel, <a href="https://www.ncbi.nlm.nih.gov/pubmed/24521347">variants</a> of this gene appeared locally, but have evolved as they move. Similar evolution has occurred as <a href="https://www.pnas.org/content/early/2020/04/07/2004999117">the COVID-19 virus</a> has spread. Relative to antibiotic resistance, humans are not the only “travellers” that can carry resistance. Wildlife, such as migratory birds, can also acquire resistant bacteria and genes from contaminated water or soils and then fly great distances carrying resistance in their gut from places with poor water quality to places with good water quality. During travel, they defecate along their path, potentially planting resistance almost anywhere. The global trade of foods also facilitates spread of resistance from country to country and across the globe. What is tricky is that the spread by resistance by travel is often invisible. In fact, the dominant pathways of international resistance spread <a href="https://www.ncbi.nlm.nih.gov/pubmed/30924539">are largely unknown</a> because many pathways overlap, and the types and drivers of resistance are diverse. Resistant bacteria are not the only infectious agents that might be spread by environmental contamination. SARS-CoV-2 has been found in faeces and inactive virus debris found in sewage, but all evidence suggests water is <a href="https://www.who.int/publications-detail/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations">not a major route</a> of COVID-19 spread – although there are limited data from places with poor sanitation. So, each case differs. But there are common roots to disease spread – pollution, poor water quality, and inadequate hygiene. Using fewer antibiotics is critical to reducing resistance. However, without also providing safer sanitation and improved water quality at global scales, resistance will continue to increase, potentially creating the next pandemic. Such a combined approach is central to the new WHO/FAO/OIE recommendations on AMR. Other types of pollution and hospital waste Industrial wastes, hospitals, farms, and agriculture are also possible sources or drivers of antibiotic resistance. For example, about ten years ago, one of us (David) studied metal pollution in a Cuban river and <a href="https://pubs.acs.org/doi/abs/10.1021/es102473z">found</a> the highest levels of resistant genes were near a leaky solid waste landfill and below where pharmaceutical factory wastes entered the river. The factory releases clearly impacted resistance levels downstream, but it was metals from the landfill that most strongly correlated with resistance gene levels in the river. There is a logic to this because toxic metals can stress bacteria, which makes the bacteria stronger, incidentally making them more resistant to anything, including antibiotics. We saw the same thing with metals in <a href="https://pubs.acs.org/doi/full/10.1021/acs.est.7b03797">Chinese landfills</a> where resistance gene levels in the landfill drains strongly correlated with metals, not antibiotics. In fact, pollution of almost any sort can promote antibiotic resistance, including metals, biocides, pesticides, and other chemicals entering the environment. Many pollutants can promote resistance in bacteria, so reducing pollution in general will help reduce antibiotic resistance – an example of which is reducing metal pollution. Hospitals are also important, being both reservoirs and incubators for many varieties of antibiotic resistance, including well known resistant bacteria such as Vancomycin-resistant Enterococcus (VRE) and Methicillin-resistant Staphylococcus aureus (MRSA). While resistant bacteria are not necessarily acquired in hospitals (most are brought in from the community), resistant bacteria can be enriched in hospitals because they are where people are very sick, cared for in close proximity, and often provided “last resort” antibiotics. Such conditions allow the spread of resistant bacteria easier, especially superbug strains because of the types of antibiotics that are used. Wastewater releases from hospitals also may be a concern. <a href="https://www.ncbi.nlm.nih.gov/pubmed/31295654">Recent data</a> showed that “typical” bacteria in hospital sewage carry five to ten times more resistant genes per cell than community sources, especially genes more readily shared between bacteria. This is problematic because such bacteria are sometimes superbug strains, such as those resistant to <a href="https://www.ncbi.nlm.nih.gov/pubmed/28949542">carbapenem antibiotics</a>. Hospital wastes are a particular concern in places without effective community wastewater treatment. Another critical source of antibiotic resistance is agriculture and aquaculture. Drugs used in veterinary care can be very similar (sometimes identical) to the antibiotics used in human medicine. And so resistant bacteria and genes <a href="https://www.ncbi.nlm.nih.gov/pubmed/30924539">are found</a> in animal manure, soils, and drainage water. This is potentially significant given that animals produce <a href="https://www.nature.com/articles/s41893-018-0167-0?WT.feed_name=subjects_environmental-sciences">four times more</a> faeces than humans at a global scale. Wastes from agricultural activity also can be especially problematic because waste management is usually less sophisticated. Additionally, agricultural operations are often at very large scales and less containable due to greater exposure to wildlife. Finally, antibiotic resistance can spread from farm animals to farmers to food workers, which has been seen in <a href="https://doi.org/10.2807/1560-7917.ES.2015.20.37.30021">recent European studies</a>, meaning this can be important at local scales. These examples show that pollution in general increases the spread of resistance. But the examples also show that dominant drivers will differ based on where you are. In one place, resistance spread might be fuelled by human faecal contaminated water; whereas, in another, it might be industrial pollution or agricultural activity. So local conditions are key to reducing the spread of antibiotic resistance, and optimal solutions will differ from place to place – single solutions do not fit all. Locally driven national action plans are therefore essential – which the new <a href="https://www.who.int/water_sanitation_health/publications/wash-wastewater-management-to-prevent-infections-and-reduce-amr/en/">WHO/FAO/OIE guidance</a> strongly recommends. In some places, actions might focus on healthcare systems; whereas, in many places, promoting cleaner water and safer food also is critical. Simple steps It is clear we must use a holistic approach (what is now called “<a href="https://www.cdc.gov/onehealth/basics/index.html">One Health</a>”) to reduce the spread of resistance across people, animals, and the environment. But how do we do this in a world that is so unequal? It is now accepted that clean water is a human right embedded in the UN’s 2030 <a href="https://sustainabledevelopment.un.org/sdg6">Agenda for Sustainable Development</a>. But how can we achieve affordable “clean water for all” in a world where geopolitics often outweigh local needs and realities? Global improvements in sanitation and hygiene should bring the world <a href="https://www.who.int/water_sanitation_health/publications/wash-wastewater-management-to-prevent-infections-and-reduce-amr/en/">closer to solving the problem of antibiotic resistance</a>. But such improvements should only be the start. Once improved sanitation and hygiene exist at global scales, our reliance on antibiotics will decline due to more equitable access to clean water. In theory, clean water coupled with decreased use of antibiotics will drive a downward spiral in resistance. This is not impossible. We know of a village in Kenya where they simply moved their water supply up a small hill – above rather than near their latrines. Hand washing with soap and water was also mandated. A year later, antibiotic use in the village was negligible because so few villagers were unwell. This success is partly due to the remote location of the village and very proactive villagers. But it shows that clean water and improved hygiene can directly translate into reduced antibiotic use and resistance. This story from Kenya further shows how simple actions can be a critical first step in reducing global resistance. But such actions must be done everywhere and at multiple levels to solve the global problem. This is not cost-free and requires international cooperation – including focused apolitical policy, planning, and infrastructure and management practices. Some well intended groups have attempted to come up with novel solutions, but those solutions are often too technological. And western “off-the-shelf” water and wastewater technologies are rarely optimal for use in developing countries. They are often too complex and costly, but also require maintenance, spare parts, operating skill, and cultural buy-in to be sustainable. For example, building an advanced activated sludge wastewater treatment plant in a place where 90% of the population does not have sewer connections makes no sense. Simple is more sustainable. As an obvious example, we need to reduce open defecation in a cheap and socially acceptable manner. This is the best immediate solution in places with limited or unused sanitation infrastructure, such as <a href="https://blogs.lse.ac.uk/southasia/2018/08/08/book-review-where-india-goes-abandoned-toilets-stunted-development-and-the-costs-of-caste-by-diane-coffey-and-dean-spears/">rural India</a>. Innovation is without doubt important, but it needs to be tailored to local realities to stand a chance of being sustained into the future. Strong leadership and governance is also critical. Antibiotic resistance is <a href="https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(18)30186-4/fulltext">much lower</a> in places with less corruption and strong governance. Resistance also is lower in places with greater public health expenditure, which implies social policy, community action, and local leadership can be as important as technical infrastructure. Why aren’t we solving the problem? While solutions to antibiotic resistance exist, integrated cooperation between science and engineering, medicine, social action, and governance is lacking. While many international organisations acknowledge the scale of the problem, unified global action is not happening fast enough. There are various reasons for this. Researchers in healthcare, the sciences, and engineering are rarely on the same page, and experts <a href="https://theconversation.com/why-we-should-expect-scientists-to-disagree-about-antibiotic-resistance-and-other-controversies-82609">often disagree</a> over what should be prioritised to prevent antibiotic resistance – this muddles guidance. Unfortunately, many antibiotic resistance researchers also sometimes sensationalise their results, only reporting bad news or exaggerating results. Science continues to reveal probable causes of antibiotic resistance, which shows no single factor drives resistance evolution and spread. As such, a strategy incorporating medicine, environment, sanitation, and public health is needed to provide the best solutions. Governments throughout the world must act in unison to meet targets for sanitation and hygiene in accordance with the UN Sustainable Development Goals. Richer countries must work with poorer ones. But, actions against resistance should focus on local needs and plans because each country is different. We need to remember that resistance is everyone’s problem and all countries have a role in solving the problem. This is evident from the COVID-19 pandemic, where some countries have displayed <a href="https://ec.europa.eu/international-partnerships/topics/eu-global-response-covid-19_en">commendable cooperation</a>. Richer countries should invest in helping to provide locally suitable waste management options for poorer ones – ones that can be maintained and sustained. This would have a more immediate impact than any “toilet of the future” technology. And it’s key to remember that the global antibiotic resistance crisis does not exist in isolation. Other global crises overlap resistance; such as climate change. If the climate becomes warmer and dryer in parts of the world with limited sanitation infrastructure, greater antibiotic resistance might ensue due to higher exposure concentrations. In contrast, if greater flooding occurs in other places, an increased risk of untreated faecal and other wastes spreading across whole landscapes will occur, increasing antibiotic resistance exposures in an unbounded manner. Antibiotic resistance will also impact on the fight against COVID-19. As an example, secondary bacterial infections are common in seriously ill patients with COVID-19, especially when admitted to an ICU. So if such pathogens are resistant to critical antibiotic therapies, they will not work and result <a href="https://www.medpagetoday.com/infectiousdisease/covid19/86192">in higher death rates</a>. Regardless of context, improved water, sanitation, and hygiene must be the backbone of <a href="https://www.who.int/water_sanitation_health/publications/wash-wastewater-management-to-prevent-infections-and-reduce-amr/en/">stemming the spread of AMR, including antibiotic resistance</a>, to avoid the next pandemic. Some progress is being made in terms of global cooperation, but efforts are still too fragmented. Some countries are making progress, whereas others are not. Resistance needs to be seen in a similar light to other global challenges – something that threatens human existence and the planet. As with addressing climate change, protecting biodiversity, or COVID-19, global cooperation is needed to reduce the evolution and spread of resistance. Cleaner water and improved hygiene are the key. If we do not work together now, we all will pay an even greater price in the future.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/115246/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/david-w-graham-473578">David W Graham</a>, Professor of Ecosystems Engineering, <a href="https://theconversation.com/institutions/newcastle-university-906">Newcastle University</a> and <a href="https://theconversation.com/profiles/peter-collignon-61">Peter Collignon</a>, Professor of Infectious Diseases and Microbiology, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/scientists-around-the-world-are-already-fighting-the-next-pandemic-115246">original article</a>.

Health

Could taking hydroxychloroquine for coronavirus be more harmful than helpful?

A <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext">paper published in The Lancet</a> has cast fresh controversy on the use of the malaria drug hydroxychloroquine as a potential treatment for COVID-19. The study’s authors reported they were “unable to confirm a benefit” of using the drug, while also finding COVID-19 patients in hospital treated with hydroxychloroquine were more likely to die or suffer life-threatening heart rhythm complications. The publication prompted the World Health Organisation to <a href="https://www.abc.net.au/news/2020-05-26/who-pauses-trial-of-hydroxychloroquine-for-coronavirus-patients/12285652">suspend its testing of hydroxychloroquine to treat COVID-19</a>, while a <a href="https://www.ascot-trial.edu.au/blogs/news/statement-on-the-status-of-australasian-covid-19-trial-ascot">similar Australian trial</a> has paused recruitment. A bit of background Hydroxychloroquine has been used since the 1940s to treat malaria, but has been making headlines as a <a href="https://www.nps.org.au/media/hydroxychloroquine-and-covid-19">potential treatment for COVID-19</a>. US President Donald Trump recently declared <a href="https://theconversation.com/donald-trump-is-taking-hydroxychloroquine-to-ward-off-covid-19-is-that-wise-139031">he was taking it daily</a>, while Australian businessman and politician Clive Palmer <a href="https://www.sbs.com.au/news/the-feed/clive-palmer-has-bought-30-million-doses-of-an-anti-malaria-drug-to-fight-covid-19-but-experts-warn-this-may-not-be-the-cure-all">pledged to create a national stockpile</a> of the drug. The drug alters the human immune system (it’s an <a href="https://www.nps.org.au/hcq-and-covid-19">immunomodulator, not an immunosuppressant</a>) and has an important role in helping people with rheumatoid arthritis and lupus. It does have a range of serious <a href="https://www.tga.gov.au/alert/new-restrictions-prescribing-hydroxychloroquine-covid-19">possible side-effects</a>, including eye damage and altered heart rhythm, which require monitoring. <a href="https://www.nature.com/articles/s41421-020-0156-0">Laboratory studies</a> suggest hydroxychloroquine may disrupt replication of the SARS-CoV-2 virus that causes COVID-19. It’s also possible hydroxychloroquine could reduce “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7161506/">cytokine storm</a>” – the catastrophic immune system overreaction that happens in some people with severe COVID-19. A huge global effort is underway to investigate whether hydroxychloroquine is safe and effective for preventing or treating COVID-19, especially to improve recovery and reduce the risk of death. Previous studies have been inconclusive as they were anecdotal, observational or small randomised trials. Doubts about hydroxychloroquine’s effectiveness have been increasing, with a large observational study from New York <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2012410">showing it had no benefit</a> in treating people with COVID-19. The new <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext">Lancet study</a>, published last week, has found it could increase the risk of death among COVID-19 patients in hospital. But there’s more to the story. What did the new study do? The <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext">Lancet study</a> collected real-world data on more than 96,000 hospitalised patients with COVID-19 from more than 600 hospitals across six continents. About 15,000 patients were treated with hydroxychloroquine (or a closely related drug, chloroquine) alone or in combination with an antibiotic. Using a global registry the researchers investigated the safety of these treatments. They looked at whether people died in hospital, as well as the risk of developing life-threatening heart rhythm problems (called ventricular arrhythmias). What did the study find? Treatment with hydroxychloroquine was associated with increased rates of death in people with COVID-19, even after the researchers adjusted for other factors (age, other health conditions, suppressed immune system, smoking, and severity of the COVID-19 infection) that might increase the risk of death. About 18% of people who received hydroxychloroquine died in hospital, compared with 9% of people with COVID-19 who did not receive these treatments. The risk of death was even higher (24%) in people receiving hydroxychloroquine in combination with either of the antibiotics azithromycin or clarithromycin. Hydroxychloroquine (6%) and chloroquine (4%) treatment was also associated with more cases of dangerous heart rhythm problems when compared with untreated people with COVID-19 (0.3%). Any evidence of benefit, while not the focus of this study, was unclear. How can we interpret the results? This was an observational study, so it can only explore the association between treatments and death – rather than telling us hydroxychloroquine caused these patients to die. It is <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31174-0/fulltext">unclear</a> why the death rate for patients treated with hydroxychloroquine and chloroquine was double that of those who weren’t, as the cause of death was not reported in this study. Importantly, the study cannot account for all the factors that might contribute to death in these hospitalised patients and how these factors interact with each other. However, the researchers did a good job of “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3144483/">matching</a>” the characteristics of people who were receiving hydroxychloroquine with those who were not receiving the drug, which makes the results more reliable. But there may still be other factors, or medicines, that contributed to these findings. So there remains uncertainly about whether hydroxychloroquine causes, or even contributes to, the death of people with COVID-19. Further, it was not possible to have careful control over the hydroxychloroquine dose people received – or other medicines people might be taking such as antivirals or other medicines for heart conditions (which potentially interact in sick hospitalised patients). The average dose of hydroxychloroquine in this study was at the upper end of the regular recommended dose range for rheumatoid arthritis and lupus. But the wide range of hydroxychloroquine (and chloroquine) doses in this study makes interpretation of the findings difficult, especially when we know <a href="https://www1.racgp.org.au/ajgp/coronavirus/hydroxychloroquine-use-during-the-covid-19-pandemi">harmful effects</a> are associated with larger doses. Broader implications This study provides important information about the safety of hydroxychloroquine in treating vulnerable people with COVID-19 receiving hospital care. While the implications for using hydroxychloroquine to treat COVID-19 in the community or for prevention of COVID-19 remain unclear, if nothing else this study highlights the need to carefully monitor people receiving the drug. Some hydroxychloroquine trials are continuing, such as the very large <a href="https://www.recoverytrial.net/for-site-staff/site-staff/#alert">RECOVERY trial</a> in the UK. This new information must be considered when balancing harm and potential benefit of these trials and will likely result in renewed safety monitoring. We’ll need to see results from <a href="https://www.mja.com.au/journal/2020/clinical-trials-prevention-and-treatment-coronavirus-disease-2019-covid-19-current">ongoing</a> high-quality randomised controlled trials to truly know if hydroxychloroquine is effective and safe in treating or preventing COVID-19. Further questions about what dose should be used, and which patients will benefit most, are topics under active investigation. You <a href="https://www.tga.gov.au/alert/new-restrictions-prescribing-hydroxychloroquine-covid-19">should not take hydroxychloroquine</a> for COVID-19 unless you’re part of a clinical trial. – Andrew McLachlan and Ric Day Blind peer review This is a fair and reasonable review of the Lancet paper, its relationship to previous studies, and its impact on ongoing clinical trials. As stated in the review the Lancet article adds to the body of knowledge, including recent substantial studies in the <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2012410">New England Journal of Medicine</a> and the <a href="https://www.bmj.com/content/369/bmj.m1849">British Medical Journal</a>, that hydroxychloroquine is without significant effect in treatment trials. The high death rate is concerning but not unprecedented, given that a clinical trial in Brazil was <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2765499">halted</a> because of adverse effects on the heart. However, recent <a href="https://www.theguardian.com/science/2020/may/28/questions-raised-over-hydroxychloroquine-study-which-caused-who-to-halt-trials-for-covid-19?CMP=share_btn_tw">media reports</a> suggest the data may have to be revised due to <a href="https://statmodeling.stat.columbia.edu/2020/05/25/hydroxychloroquine-update/">misclassification</a> of the participating hospitals. – Ian Musgrave <hr /> Research Checks interrogate newly published studies and how they’re reported in the media. The analysis is undertaken by one or more academics not involved with the study, and reviewed by another, to make sure it’s accurate.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/139309/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/andrew-mclachlan-255312">Andrew McLachlan</a>, Head of School and Dean of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/ric-day-14406">Ric Day</a>, Professor of Clinical Pharmacology, <a href="https://theconversation.com/institutions/unsw-1414">UNSW</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/could-taking-hydroxychloroquine-for-coronavirus-be-more-harmful-than-helpful-139309">original article</a>.

Health

Why do old people hate new music?

Why do old people hate new music? – Holly, age 14, Belmont, Massachusetts <hr /> When I was a teenager, my dad wasn’t terribly interested in the music I liked. To him, it just sounded like “a lot of noise,” while he regularly referred to the music he listened to as “beautiful.” This attitude persisted throughout his life. Even when he was in his 80s, he once turned to me during a TV commercial featuring a 50-year-old Beatles tune and said, “You know, I just don’t like today’s music.” It turns out that my father isn’t alone. As I’ve grown older, I’ll often hear people my age say things like “they just don’t make good music like they used to.” Why does this happen? Luckily, <a href="https://scholar.google.com/citations?user=MxorsyYAAAAJ&hl=en">my background as a psychologist</a> has given me some insights into this puzzle. We know that musical tastes <a href="https://www.altpress.com/news/why_people_dont_like_new_music_study/">begin to crystallize</a> as early as age 13 or 14. By the time we’re in our early 20s, these tastes get locked into place pretty firmly. In fact, studies have found that <a href="https://www.businessinsider.com/why-we-stop-discovering-new-music-around-age-30-2018-6">by the time we turn 33</a>, most of us have stopped listening to new music. Meanwhile, <a href="https://www.nytimes.com/2018/02/10/opinion/sunday/favorite-songs.html">popular songs released when you’re in your early teens</a> are likely to remain quite popular among your age group for the rest of your life. There could be a biological explanation for this. <a href="https://www.vice.com/en_us/article/4w7kzp/science-has-discovered-why-your-parents-hate-your-music">There’s evidence</a> that the brain’s ability to make subtle distinctions between different chords, rhythms and melodies gets worse with age. So to older people, newer, less familiar songs might all “sound the same.” But I believe there are some simpler reasons for older people’s aversion to newer music. One of the most researched laws of social psychology is something called the “<a href="http://socialpsychonline.com/2016/03/the-mere-exposure-effect/">mere exposure effect</a>.” In a nutshell, it means that the more we’re exposed to something, the more we tend to like it. This happens with people we know, the advertisements we see and, yes, the songs we listen to. When you’re in your early teens, you probably spend a fair amount of time listening to music or watching music videos. Your favorite songs and artists become familiar, comforting parts of your routine. For many people over 30, job and family obligations increase, so there’s less time to spend discovering new music. Instead, many will simply listen to old, familiar favorites from that period of their lives when they had more free time. Of course, those teen years weren’t necessarily carefree. They’re famously confusing, which is why so many TV shows and movies – from “<a href="https://www.imdb.com/title/tt1327801/">Glee</a>” to “<a href="https://www.imdb.com/title/tt5164432/?ref_=nv_sr_1?ref_=nv_sr_1">Love, Simon</a>” to “<a href="https://www.imdb.com/title/tt7014006/?ref_=nv_sr_1?ref_=nv_sr_1">Eighth Grade</a>” – revolve around the high school turmoil. Psychology research has shown that the emotions that we experience as teens <a href="https://theconversation.com/why-high-school-stays-with-us-forever-56538">seem more intense than those that comes later</a>. We also know that <a href="https://theconversation.com/why-high-school-stays-with-us-forever-56538">intense emotions are associated with stronger memories and preferences</a>. All of this might explain why the songs we listen to during this period become so memorable and beloved. So there’s nothing wrong with your parents because they don’t like your music. In a way, it’s all part of the natural order of things. At the same time, I can say from personal experience that I developed a fondness for the music I heard my own children play when they were teenagers. So it’s certainly not impossible to get your parents on board with Billie Eilish and Lil Nas X. <a href="https://theconversation.com/profiles/frank-t-mcandrew-194161">Frank T. McAndrew</a>, Cornelia H. Dudley Professor of Psychology, <a href="https://theconversation.com/institutions/knox-college-2259">Knox College</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-old-people-hate-new-music-123834">original article</a>.

Health

Is isolation a feeling?

I am feeling isolated. Is this a state, or an emotion? Rather than getting into the semantics of language, I will ask another question: what does isolation feel like? Isolation feels like being <a href="https://psycnet.apa.org/record/2011-08649-001">stuck on the couch</a> despite having time for a walk. Isolation feels like <a href="http://www.sciencedirect.com/science/article/pii/S0195666315000768">comfort eating</a> nachos and box wine. Our bodies are tired. Our minds slip and skid between blank boredom and anxious <a href="https://www.mdpi.com/1660-4601/17/5/1729">overthinking</a>. What is happening to us, here in our homes, away from the routines and interactions that used to shape our days? I am feeling isolated. Scholars of emotion talk about feelings as <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/1468-5914.00135">judgements</a> – our considered response to what’s happening. These judgements tint our experience as we live it: like the transferred epithets of Wodehouse’s Bertie Wooster, “pronging a <a href="https://books.google.com.au/books?id=HC-OBeh2d3sC&pg=PA138&lpg=PA138&dq=wodehouse+pronging+a+moody+forkful&source=bl&ots=-jlwqbbiST&sig=ACfU3U1jjr3u00Sa3Ngax_5ioUjOj6lzeQ&hl=en&sa=X&ved=2ahUKEwimxMnkmqvpAhUF73MBHa9EAf0Q6AEwA3oECAYQAQ#v=onepage&q=wodehouse%20pronging%20a%20moody%20forkful&f=false">moody forkful</a>” of eggs, or “balancing a <a href="https://books.google.com.au/books?id=iJwnDQAAQBAJ&pg=PT226&lpg=PT226&dq=wodehouse+thoughtful+lump+of+sugar&source=bl&ots=NCQB0-OyXU&sig=ACfU3U3l6CVTHqRvcVseIz-ZWEYMv2EDDg&hl=en&sa=X&ved=2ahUKEwinxI7QmqvpAhVVjuYKHRubDisQ6AEwA3oECAkQAQ#v=onepage&q=wodehouse%20thoughtful%20lump%20of%20sugar&f=false">thoughtful lump of sugar</a>” on his teaspoon. Experience reaches us through these filters of judgement. This morning I made myself a lonely piece of toast and am writing this article drinking a grateful-for-free-childcare cup of tea. Every lonely person is lonely in their own way Some of the effects of isolation are <a href="https://psycnet.apa.org/record/2008-07715-005">common to all</a> human beings, across times and places. Humans have evolved as communal animals <a href="https://www.elsevier.com/books/the-psychological-journey-to-and-from-loneliness/rokach/978-0-12-815618-6">living in</a> “families, tribes, and communities”. We <a href="https://www.ncbi.nlm.nih.gov/pubmed/21219047">feel</a> “the pain of social isolation and the rewards of social connection”. Beyond these human constants, our emotional experiences are powerfully shaped by our individual circumstances. Our communal and personal histories affect our expectations of life and our responses to events. In this sense, your feeling of isolation is different to mine. Like Tolstoy’s <a href="https://theconversation.com/guide-to-the-classics-anna-karenina-86475">unhappy families</a>, each of us is feeling this crisis in our own way. Medical researchers of isolation note this recursive flow of emotion: symptoms like poor sleep and high blood pressure correlated not with measures of patients’ objective isolation, but their <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3166409/">perceived isolation</a>. One person’s agonising loneliness is another’s boring staycation. We are as isolated as we feel. This does not mean our feelings aren’t real. They are, in fact, the only reality we can know. Is there a meaningful difference between asking “How are you?” and “How are you feeling?” Full bodied feeling Our feelings are experienced by our whole selves: bodies, minds, emotions, <a href="https://blogs.bmj.com/bmj/2020/01/24/coronavirus-the-psychological-effects-of-quarantining-a-city/">all intertwined</a>. We feel the absence of human touch, we feel anxiety as we obsess over daily statistics, we feel exhausted by shopping trips that feel like ventures into no-man’s-land, we feel grief at the horrific headlines of death, and frustration at government responses. We feel loss and confusion about our about our <a href="https://link.springer.com/book/10.1057%2F9780230305625">identity and value</a> as <a href="https://www.abc.net.au/news/2020-05-11/coronavirus-sudden-unemployment-and-impact-on-identity/12206868">jobs disappear</a>. Those who contract COVID-19 report <a href="https://www.cambridge.org/core/journals/disaster-medicine-and-public-health-preparedness/article/is-there-a-case-for-quarantine-perspectives-from-sars-to-ebola/451C41BD5A980A45FFA9F9AE8670CC85">not only</a> fear of dying, but boredom and anger at being isolated from family and friends. We are feeling isolated. Despite our Tolstoyan uniqueness, we find comfort in shared feelings. We share memes about interminable Zoom meetings, or homeschooling, or day drinking. We feel seen, heard, understood – less isolated. These are called <a href="https://psycnet.apa.org/doiLanding?doi=10.1037%2F0003-066X.55.2.205">affiliative behaviours</a> and they are a powerful coping strategy for all kinds of crises. Somehow our suffering is more bearable if another human being knows how we feel, and feels it too. Connecting with one another, and feeling that we are in this together, can mitigate some of the pain of isolation. Sufferers during previous pandemics who felt their isolation was serving an altruistic goal of protecting their neighbours <a href="https://www.ncbi.nlm.nih.gov/pubmed/19497162">reported less negative emotions</a> about isolation. Political exiles have, throughout history, found ways to endure isolation. Early modern English nuns in exiled European convents <a href="https://muse.jhu.edu/article/685784">drew upon antique history</a> to comfort themselves, identifying with Biblical stories of suffering that finally resolve in homecoming and restored community. Prisoners in solitary confinement have <a href="https://books.google.com.au/books/about/Health_and_Human_Rights_in_a_Changing_Wo.html?id=kJXM_eptt0MC&redir_esc=y">relied</a> on simple things like sunlight and human voices on the radio to keep the worst at bay. They are feeling isolated. Isolation feels like being alone but it also feels like reaching beyond our usual spheres, feeling new empathy with people who were strangers before. Isolation is a long-term state for many. From <a href="http://www.sciencedirect.com/science/article/pii/S1550857910001002">professional women</a> in male-dominated fields, to caregivers and those in <a href="https://doi.org/10.1177/153331759601100305">remote communities</a>, to religious and queer <a href="https://doi.org/10.1080/10894160.2010.490503">minorities</a>. <a href="http://www.sciencedirect.com/science/article/pii/S1755458617300397">Asylum seekers</a> in detention <a href="https://doi.org/10.1080/1323238X.2017.1314805">report</a> deep feelings of <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/ejsp.2543">isolation</a> and invisibility. Their <a href="http://www.freedomfromtorture.org/real-voices/six-refugee-poems-a-unique-insight-into-the-life-of-refugees-and-asylum-seekers">poems</a> open up for us in new ways now. New parents, especially mothers, experience isolation with feelings <a href="https://www.ncbi.nlm.nih.gov/pubmed/15066113">familiar</a> to many of us right now: “powerlessness, insufficiency, guilt, loss, exhaustion, ambivalence, resentment and anger”. Those who are young, or poor, or single, are <a href="http://asistdl.onlinelibrary.wiley.com/doi/abs/10.1002/asi.24037">especially</a> at risk of feeling isolated, overwhelmed and worried. In our empathy we are connected across social and economic gaps. Emotional force We are feeling isolated. Now, our shared emotions become a central part of how we <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1467-6486.2010.00908.x">make sense</a> of the crisis. Shared, collective emotion can be a strong driver of <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/9781118900772.etrds0155">collective activity</a>. Enough shared emotion can cause us to feel like a <a href="https://www.cambridge.org/core/journals/international-theory/article/feeling-like-a-state-social-emotion-and-identity/C14A88754EF067C70A32B8BEEBBC44B4">unified nation</a>, our common humanity stronger than our superficial differences. Conversely, emotional sparks can create <a href="https://www.theguardian.com/australia-news/2020/may/10/ten-arrested-and-police-officer-injured-at-protest-against-victorias-covid-19-lockdown-laws">political cliques</a> who cohere around shared anger towards other groups. Scholars of emotion describe emotions as a <a href="https://uk.sagepub.com/en-gb/eur/emotions-and-social-relations/book237448">force</a>, not only felt within, but acting upon the external world. Emotions do things. Big, collective emotions do big things. We are only beginning to discover what isolation is doing to us.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/138009/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/carly-osborn-770314">Carly Osborn</a>, Visiting Research Fellow, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/is-isolation-a-feeling-138009">original article</a>.

Health

Why some twins aren't identical

When a mother gives birth to twins, the offspring are not always identical or even the same gender. Known as fraternal twins, they represent a longstanding evolutionary puzzle. Identical twins arise from a single fertilised egg that accidentally splits in two, but fraternal twins arise when two eggs are released and fertilised. Why this would happen was the puzzle. In research <a href="https://www.nature.com/articles/s41559-020-1173-y" title="An age-dependent ovulatory strategy explains the evolution of dizygotic twinning in humans">published in Nature Ecology & Evolution</a> we used computer simulations and modelling to try to explain why natural selection favours releasing two eggs, despite the low survival of twins and the risks of twin births for mothers. Why twins? Since Michael Bulmer’s landmark 1970 <a href="https://books.google.com.au/books/about/The_Biology_of_Twinning_in_Man.html?id=awo-AAAAYAAJ">book on the biology of twinning in humans</a>, biologists have questioned whether double ovulation was favoured by natural selection or, like identical twins, was the result of an accident. At first glance, this seems unlikely. The embryo splitting that produces identical twins is not heritable and the incidence of identical twinning does not vary with other aspects of human biology. It seems accidental in every sense of the word. In contrast, the incidence of fraternal twinning changes with <a href="https://doi.org/10.1017/S0021932000007896" title="Ethnic differences in twinning rates in Nigeria">maternal age</a> and is <a href="https://doi.org/10.1016/S0140-6736(03)14237-7" title="Twinning">heritable</a>. Those do not sound like the characteristics of something accidental. The twin disadvantage In human populations without access to medical care there seems little benefit to having twins. <a href="https://doi.org/10.1046/j.1420-9101.2001.00287.x" title="The fitness of twin mothers: evidence from rural Gambia">Twins</a> are more likely to die in childhood than single births. Mothers of twins also have an increased risk of dying in childbirth. In common with other great apes, women seem to be built to give birth to <a href="https://doi.org/10.1111/j.1558-5646.1990.tb05211.x" title="ON THE EVOLUTION OF HUMAN BROOD SIZE">one child at a time</a>. So if twinning is costly, why has evolution not removed it? Paradoxically, in high-fertility populations, the mothers of twins often have <a href="https://doi.org/10.1046/j.1420-9101.2001.00287.x" title="The fitness of twin mothers: evidence from rural Gambia">more offspring</a> by the end of their lives than other mothers. This suggests having twins might have an evolutionary benefit, at least for mothers. But, if this is the case, why are twins so rare? Modelling mothers To resolve these questions, together with colleagues Bob Black and Rick Smock, we <a href="https://doi.org/10.1038/s41559-020-1173-y" title="An age-dependent ovulatory strategy explains the evolution of dizygotic twinning in humans">constructed simulations and mathematical models</a> fed with data on maternal, child and fetal survival from real populations. This allowed us to do something otherwise impossible: control in the simulations and modelling whether women ovulated one or two eggs during their cycles. We also modelled different <a href="https://doi.org/10.1016/j.tree.2007.09.002" title="The status of the conditional evolutionarily stable strategy">strategies</a>, where we switched women from ovulating one egg to ovulating two at different ages. We could then compare the number of surviving children for women with different patterns of ovulation. Women who switched from single to double ovulation in their mid-20s had the most children survive in our models – more than those who always released a single egg, or always released two eggs. <a href="https://images.theconversation.com/files/333966/original/file-20200511-49558-4l8o82.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/333966/original/file-20200511-49558-4l8o82.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" alt="" /></a> Author provided This suggests natural selection favours an unconscious switch from single to double ovulation with increasing age. A strategy for prolonging fertility The reason a switch is beneficial is fetal survival – the chance that a fertilised egg will result in a liveborn child – <a href="https://doi.org/10.1126/science.aaa3337" title="Common variants spanning PLK4 are associated with mitotic-origin aneuploidy in human embryos">decreases rapidly as women age</a> So switching to releasing two eggs increases the chance at least one will result in a successful birth. But what about twinning? Is it a side effect of selection favouring fertility in older women? To answer this question, we ran the simulations again, except now when women double ovulated the simulation removed one offspring before birth. In these simulations, women who double ovulated throughout their lives, but never gave birth to twins, had more children survive than those who did have twins and switched from single to double ovulating. <a href="https://images.theconversation.com/files/333982/original/file-20200511-49558-d6tomg.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/333982/original/file-20200511-49558-d6tomg.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" alt="" /></a> Author provided This suggests the ideal strategy would be to always double ovulate but never produce twins, so fraternal twins are an accidental side effect of a beneficial strategy of double ovulating.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/138209/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/joseph-l-tomkins-311105">Joseph L Tomkins</a>, Associate Professor in Evolutionary Biology, <a href="https://theconversation.com/institutions/university-of-western-australia-1067">University of Western Australia</a>; <a href="https://theconversation.com/profiles/rebecca-sear-1067265">Rebecca Sear</a>, Head of the Department of Population Health, <a href="https://theconversation.com/institutions/london-school-of-hygiene-and-tropical-medicine-859">London School of Hygiene & Tropical Medicine</a>, and <a href="https://theconversation.com/profiles/wade-hazel-1067264">Wade Hazel</a>, Professor of Biology, <a href="https://theconversation.com/institutions/depauw-university-1274">DePauw University</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/not-all-twins-are-identical-and-thats-been-an-evolutionary-puzzle-until-now-138209">original article</a>.

Health

How to beat weight gain at menopause

For many women, the journey through menopause is a roller coaster of <a href="https://www.jeanhailes.org.au/health-a-z/menopause/menopause-symptoms">symptoms including hot flushes</a>, night sweats, sleep disturbance, dry and itchy skin, mood changes, anxiety, depression and weight gain. For some, it can be relatively uneventful. Menopause <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/menopause">is medically defined</a> as not having any menstrual bleeding for 12 months. Most women reach this milestone <a href="https://www.jeanhailes.org.au/health-a-z/menopause/about-menopause">between the ages of 45 to 55</a>. Even though weight gain is common, you can beat it by using menopause as an opportunity to reset your eating and exercise habits. Do women gain weight at menopause? During menopause, women also experience a shift in <a href="https://www.ncbi.nlm.nih.gov/pubmed/28982486">how fat stores are distributed</a> around the body. Fat tends to move from the thigh region up to the waist and abdomen. A review of studies that quantified changes in body fat stores before and after menopause found <a href="https://www.ncbi.nlm.nih.gov/pubmed/31034807">total body fat mass also increased significantly</a>. While the average weight increase was only about one kilogram, the increase in percentage total body fat was almost 3%, with fat on the trunk increasing by 5.5% and total leg fat decreasing around 3%. Average waist circumference increased by about 4.6 centimetres and hips by 2.0 centimetres. Other bad news is that once postmenopausal, <a href="https://www.ncbi.nlm.nih.gov/pubmed/25191611">women have lower total daily energy needs</a>. This is partly because body fat requires less energy to maintain it compared to muscle. So even if your weight doesn’t change, the increase in body fat means your body needs fewer kilojoules each day. In addition to this, <a href="https://www.ncbi.nlm.nih.gov/pubmed/1522233">the menstrual cycle had a small energy cost</a> to maintain ovarian function. This amounted to about 200 kilojoules a day, which is now “saved”. The bottom line is that unless your transition to menopause is accompanied by a reduction in your total energy intake or an increase in your physical activity, you’re at high risk of weight gain. But there is some good news Around <a href="https://www.ncbi.nlm.nih.gov/pubmed/16491110">60% of women manage to avoid weight gain</a> at menopause. They <a href="https://www.ncbi.nlm.nih.gov/pubmed/17264847">manage this by</a> either decreasing the total amount of food they eat, cutting down on fat and sugar, using commercial weight loss programs, doing more exercise, or a combination of all these. They key thing is that they change some aspects of their lifestyle. So what works best? Until recently, only <a href="https://www.ncbi.nlm.nih.gov/pubmed/24971172">three major studies</a> had tested interventions. The <a href="https://www.ncbi.nlm.nih.gov/pubmed/14644697">Women’s Healthy Lifestyle Project</a> compared the impact of receiving support to improve diet and exercise habits over four years covering menopause, to making no changes at all. Women who changed their lifestyle had lower body weights, less abdominal fat and better blood sugar levels compared to those in the control group. The second study, of 168 women, enrolled <a href="https://www.ncbi.nlm.nih.gov/pubmed/19339904">them into a 90 minute Nordic walking program</a>, three times a week. This was associated with a reduction in weight, body fat and waist circumference, as well as blood levels of <a href="https://en.wikipedia.org/wiki/Low-density_lipoprotein">bad cholesterol</a> and fats, highlighting the benefits of endurance walking. The third study divided 175 Nigerian women into two groups: one group undertook a <a href="https://www.ncbi.nlm.nih.gov/pubmed/22547191">12-week circuit training exercise program</a>, the other was a control group. Women in the exercise group reduced their waist circumference relative to their hips, indicating a reduction in abdominal fat, even though their total body weight did not change. The 40-something trial More recently, we studied 54 women aged 45-50 years in the <a href="https://www.ncbi.nlm.nih.gov/pubmed/24156558">“40-Something” trial</a>. We randomly assigned half the participants to receive healthy eating and physical activity support from health professionals, using motivational interviewing to encourage behaviour change. The other half received information only and were asked to self-direct their lifestyle changes. Our aim was to prevent weight gain in women who were in either the overweight or healthy weight range as they entered early menopause. We encouraged women who were overweight to reduce their body weight to achieve a body mass index (<a href="https://www.heartfoundation.org.au/your-heart/know-your-risks/healthy-weight/bmi-calculator">BMI</a>) in the healthy weight range (BMI 18 to 25). We encouraged women already in the healthy weight range to maintain their weight within one kilogram. We gave all women the same healthy lifestyle advice, including to eat: <ul> <li>2 serves of fruit and at least 5 serves of vegetables every day</li> <li>1-1.5 serves of meat or meat alternatives</li> <li>2-3 serves of dairy</li> <li>wholegrain breads and cereals.</li> </ul> And to: <ul> <li>limit foods high in fat and sugar</li> <li>cut down on meals eaten outside the home</li> <li>engage in moderate to vigorous physical activity for 150-250 minutes per week</li> <li>sit for less than three hours per day</li> <li>take at least 10,000 steps per day.</li> </ul> Women in the intervention group had five consultations with a dietitian and exercise physiologist over one year to provide support and motivation to change their eating habits and physical activity. After two years, women in the intervention group had <a href="https://www.ncbi.nlm.nih.gov/pubmed/31108930">lower body weights, less body fat and smaller waist circumferences</a> compared to the control group who received information pamphlets only. When we evaluated changes based on their starting BMI, the intervention was more effective for preventing weight gain in women initially of a healthy weight. Of all the health advice, <a href="https://www.ncbi.nlm.nih.gov/pubmed/25062965">eating five serves of vegetables and taking 10,000 steps per day</a> were the most effective strategies for long-term weight control during menopause. Although weight gain, and especially body fat gain, is usual during the menopausal transition, you can beat it. Rather than menopause being a time to put your feet up, it’s a time to step up your physical activity and boost your efforts to eat a healthy, balanced diet, especially when it comes to the frequency and variety of vegetables you eat.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/123368/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, Professor in Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>; <a href="https://theconversation.com/profiles/jenna-hollis-171991">Jenna Hollis</a>, Conjoint Lecturer, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>, and <a href="https://theconversation.com/profiles/lauren-williams-14548">Lauren Williams</a>, Professor of Nutrition and Dietetics, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-to-beat-weight-gain-at-menopause-123368">original article</a>.

Health

How Shinzo Abe has fumbled Japan’s coronavirus response

As countries around the world debate when and how to ease pandemic restrictions, <a href="https://toyokeizai.net/sp/visual/tko/covid19/en.html">coronavirus infections continue their steady rise</a> in Japan. On April 16, Prime Minister Shinzo Abe was forced to <a href="https://the-japan-news.com/news/article/0006492744">declare a national state of emergency</a> until at least May 6, covering all 47 prefectures. This extended an initial state of emergency declaration on April 7 for seven prefectures, including the cities of Tokyo, Osaka and Fukuoka. Two medical groups <a href="https://www.smh.com.au/world/asia/coronavirus-infection-surge-threatens-to-collapse-japan-hospitals-20200418-p54l1a.html">have also warned</a> that a “collapse in emergency medicine” has already happened as hospitals are being forced to turn away patients, presaging a possible collapse of the overall health care system. How did Japan get to this point? The country had initially been held up as having one of the more effective responses to the coronavirus in the early days of the pandemic. Yet, its curve <a href="https://www3.nhk.or.jp/nhkworld/en/news/backstories/1048/">has not even started to flatten</a> like those of its neighbours, South Korea, China, Taiwan and Hong Kong. The relatively low rate of infections from January to March was <a href="https://mainichi.jp/english/articles/20200418/p2g/00m/0fe/059000c">credited by some</a> to Japanese societal norms: bowing instead of handshakes and hugs, the use of masks in flu season and generally high standards of personal hygiene. Japan has long had a reputation for conformity and adherence to rules, so a high level of compliance with public safety directions was expected. However, overconfidence in these practices, and the ongoing lack of firm direction from Prime Minister Shinzo Abe’s government, may have lulled many Japanese into a false sense of security. This has been starkly demonstrated in recent weeks as <a href="https://www.npr.org/sections/pictureshow/2020/03/24/820109359/tokyo-cherry-blossom-festival-draws-crowds-despite-coronavirus-warnings">crowds have flocked</a> to parks to view the cherry blossoms, ignoring requests from local authorities to stay home. Opinion polls now <a href="https://www3.nhk.or.jp/nhkworld/en/news/backstories/1029/">show</a> at least half of Japanese disapprove of the government’s handling of the crisis and believe Abe’s national emergency declaration came too late. Erratic decision-making from the start From the start of the pandemic, Abe’s government has been criticised for being too offhand in its response and erratic in its decision-making. Japan’s first major misstep occurred in early February, when the Diamond Princess cruise ship was quarantined in Yokohama. At least 23 passengers were <a href="https://www.sciencemag.org/news/2020/02/coronavirus-infections-keep-mounting-after-cruise-ship-fiasco-japan">allowed to disembark</a> and go home without being tested, and around 90 government employees returned directly to their Tokyo offices after visiting the stricken vessel. More than 700 cases were eventually linked to the cruise ship, in total. Weeks later, Abe then ordered schools to remain closed until the end of the spring break in April, a <a href="https://www.bbc.com/news/world-asia-51663182">sudden decision</a> that caught both teachers and parents by surprise, leaving them little time to plan and prepare. Then came the <a href="https://theconversation.com/why-havent-the-olympics-been-cancelled-from-coronavirus-thats-the-a-20bn-question-133445">lack of decisiveness</a> on the Tokyo Olympics. Abe reluctantly announced in late March that the games would be postponed in 2020, but only after countries began to pull out and the government was accused of dragging its feet. Abe’s government has also faced criticism over relatively low levels of testing. Over 112,000 tests <a href="https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/newpage_00032.html">have been conducted</a>, at a rate of around 7,800 per day in April. But the government’s decision to <a href="https://www3.nhk.or.jp/nhkworld/en/news/backstories/1038/">restrict most tests</a> to highly symptomatic patients means actual cases are likely being under-counted. At a press conference in mid-April, Abe pledged to rectify shortages of personal protective equipment for medical workers and ramp up testing. As an interim measure, two cloth masks are being mailed to every household, an unpopular gesture <a href="https://mainichi.jp/english/articles/20200416/p2a/00m/0na/010000c">widely lampooned</a> on social media as “Abenomasks”. Even when Abe has tried to send the right message, the tone has been off. This was perhaps best symbolised by the <a href="https://www.scmp.com/news/asia/east-asia/article/3079761/abe-arisnitocrat-japan-pms-stay-home-twitter-appeal-amid">mocking reaction</a> to his well-intentioned “stay home” Twitter post, which portrayed him drinking tea and patting his dog. Critics said it showed just how out of touch he was with the lives of ordinary Japanese. Tokyo’s governor outshines Abe As cases began to spike in late March, Tokyo Governor Yuriko Koike <a href="https://www3.nhk.or.jp/nhkworld/en/news/20200330_34/">held an emergency press conference</a> to urge residents refrain from nonessential outings, such as visits to parks to view cherry blossoms. But despite rising concerns from medical authorities, as late as March 31, Abe’s government still <a href="http://www.asahi.com/ajw/articles/13259581">denied</a> there was a need for a national state of emergency. When the state of emergency was finally declared in mid-April, many feared it still wasn’t enough. Under the law, governors can requisition property and medical supplies to use to treat COVID-19 patients, but crucially, police have no enforcement powers to close businesses or restrict the movements of individuals. People and companies <a href="https://www.nippon.com/en/news/fnn2020040529068/emergency-but-no-lockdown-the-impact-of-the-new-pandemic-measures.html">can only be asked</a> to voluntarily comply. The Japanese government could interpret two articles in the constitution to impose a stricter lockdown, as long as appropriate legislation is passed in the Diet, Japan’s parliament. However, Abe has thus far avoided doing so. He seems to be bowing to pressure from the Keidanren, a major corporate lobby group and donor to his party, out of fear the economy could descend into an even deeper recession than the <a href="https://www.imf.org/en/Countries/JPN">-5.2% reduction in economic growth</a> projected by the IMF. Demands have been increasing from health authorities, prefectural governments and opposition parties for Abe to take more forceful action. Revealing his diminishing political authority, he is <a href="http://www.asahi.com/ajw/articles/13302380">even being pressed</a> by both senior figures and rank-and-file members within his own Liberal Democratic Party (LDP). The LDP’s junior coalition partner, the Komeito party, also threatened to break from the ruling coalition. The move forced Abe to <a href="https://www.japantimes.co.jp/news/2020/04/19/national/politics-diplomacy/komeito-cash-handout-shinzo-abe-power-coronavirus/#.Xp7aWcgzbIU">extend a planned income support scheme</a> for low-income households into a universal payment of 100,000 yen (nearly A$1,500) to all citizens, as part of the government’s record 117 trillion yen (A$1.7 billion) <a href="https://japantoday.com/category/politics/Japan-to-boost-stimulus-to-%C2%A5117-tril-due-to-cash-payouts-to-ease-virus-pain">emergency stimulus spending</a>. And while Abe has floundered, Koike, his <a href="https://www.reuters.com/article/us-health-coronavirus-japan-koike/tokyo-governor-koike-a-pm-abe-rival-takes-tough-stance-on-coronavirus-idUSKCN21V0EI">longtime rival</a>, has <a href="http://www.asahi.com/ajw/articles/13294064">emerged as a strong leader</a> during the crisis, praised for her <a href="https://english.kyodonews.net/news/2020/04/4476dc6b7ab1-tokyo-governors-call-for-social-distancing-sparks-viral-hit-game.html">clear public communication</a> and decisive action. Abe’s third consecutive term as LDP president expires in September 2021, around the time national elections are due. Even if Japan recovers by then, his <a href="https://www.scmp.com/week-asia/opinion/article/3038417/abe-japans-longest-serving-pm-extent-his-legacy">legacy</a> as Japan’s longest-serving prime minister is now surely being tarnished.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/136860/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/craig-mark-3560">Craig Mark</a>, Professor, Faculty of International Studies, <a href="https://theconversation.com/institutions/kyoritsu-womens-university-2953">Kyoritsu Women's University</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-shinzo-abe-has-fumbled-japans-coronavirus-response-136860">original article</a>.

Travel

Unearthed snaps of baby Prince Harry with Princess Diana reveals adorable detail

Prince Harry has been a super fan of the children’s show Thomas The Tank Engine since he was a tot still in nappies and now is starring in an on-camera introduction to a very special episode of Thomas The Tank Engine, a new royal TV special called Thomas and Friends: The Royal Engine. The classic show has been a must-watch for children all around the world for decades, including the Duke of Sussex who has pictures of him as just a young boy sporting memorabilia while alongside his mother, Princess Diana. <img style="width: 500px; height: 281.1284046692607px;" src="https://oversixtydev.blob.core.windows.net/media/7835867/sg-21.jpg" alt="" data-udi="umb://media/695130b9b9d0459bb23d50e0f0d0d612" /> Prince Harry’s latest project, which is him appearing in a 22-minute episode to mark Thomas & Friends' 75th anniversary, definitely holds a special place for the royal. The episode even features a cameo from The Queen and Prince Charles set back in the time frame of when our future King was just a boy. The story follow Thomas as he transports Sir Topham Hatt, the controller of the railway yard, to Buckingham Palace in London. <img style="width: 500px; height: 281.1284046692607px;" src="https://oversixtydev.blob.core.windows.net/media/7835868/sg-20.jpg" alt="" data-udi="umb://media/40aa882884c7439aba99adddd712a474" /> He has been invited by The Queen to be honoured with an award for his distinguished service to the railway. Her Majesty’s son, a young Prince Charles, has asked that Thomas be the engine to transport him on his journey. In a statement, Prince Harry said it was an honour to be involved in the project. "Thomas the Tank Engine has been a comforting, familiar face to so many families over the last 75 years – entertaining, educating and inspiring children on important issues through exciting stories and characters," he said. <blockquote style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" class="instagram-media" data-instgrm-permalink="https://www.instagram.com/p/B_jK59rnYqw/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="12"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"></div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"></div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"></div> </div> </div> <div style="padding: 19% 0;"></div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"></div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" rel="noopener" href="https://www.instagram.com/p/B_jK59rnYqw/?utm_source=ig_embed&utm_campaign=loading" target="_blank">A post shared by T&F Fan Club (@thomasthetankenginefanclub)</a> on Apr 28, 2020 at 8:22pm PDT </div> </blockquote> "I certainly have fond memories of growing up with Thomas & Friends and being transported to new places through his adventures. I am very proud to have been asked to take part in this special episode. I wish Thomas & Friends a very happy anniversary." Harry's on-camera introduction was recorded earlier this year, in January, with the Duke donating his fee to charity.

Entertainment

How to read Shakespeare for pleasure

In recent years the orthodoxy that Shakespeare can only be truly appreciated on stage has <a href="https://www.telegraph.co.uk/news/celebritynews/11956151/Sir-Ian-McKellen-Dont-bother-reading-Shakespeare.html">become widespread</a>. But, as with many of our habits and assumptions, lockdown gives us a chance to think differently. Now could be the time to dust off the old collected works, and read some Shakespeare, just as people have been doing for more than 400 years. Many people have said they find reading Shakespeare a bit daunting, so here are five tips for how to make it simpler and more pleasurable. 1. Ignore the footnotes If your edition has footnotes, pay no attention to them. They distract you from your reading and de-skill you, so that you begin to check everything even when you actually know what it means. It’s useful to remember that nobody ever understood all this stuff – have a look at Macbeth’s knotty “<a href="https://www.nosweatshakespeare.com/quotes/soliloquies/if-it-were-done-when-tis-done/">If it were done when ‘tis done</a>” speech in Act 1 Scene 7 for an example (and nobody ever spoke in these long, fancy speeches either – Macbeth’s speech is again a case in point). Footnotes are just the editor’s attempt to deny this.<a href="http://creativecommons.org/licenses/by-nc-sa/4.0/" class="license"></a> Try to keep going and get the gist – and remember, when Shakespeare uses very long or esoteric words, or highly involved sentences, it’s often a deliberate sign that the character is trying to deceive himself or others (the psychotic jealousy of Leontes in <a href="https://www.shakespeare.org.uk/explore-shakespeare/shakespedia/shakespeares-plays/winters-tale/">The Winter’s Tale</a>, for instance, expresses itself in unusual vocabulary and contorted syntax). 2. Pay attention to the shape of the lines The layout of speeches on the page is like a kind of musical notation or choreography. Long speeches slow things down – and, if all the speeches end at the end of a complete line, that gives proceedings a stately, hierarchical feel – as if the characters are all giving speeches rather than interacting. Short speeches quicken the pace and enmesh characters in relationships, particularly when they start to share lines (you can see this when one line is indented so it completes the half line above), a sign of real intimacy in Shakespeare’s soundscape. Blank verse, the unrhymed ten-beat <a href="http://www.shakespeare-online.com/sonnets/sonnetstyle.html">iambic pentamenter structure</a> of the Shakespearean line, varies across his career. Early plays – the histories and comedies – tend to end each line with a piece of punctuation, so that the shape of the verse is audible. John of Gaunt’s famous speech from Richard II is a good example. <blockquote> This royal throne of kings, this sceptered isle, This earth of majesty, this seat of Mars. </blockquote> Later plays – the tragedies and the romances – tend towards a more flexible form of blank verse, with the sense of the phrase often running over the line break. What tends to be significant is contrast, between and within the speech rhythms of scenes or characters (have a look at Henry IV Part 1 and you’ll see what I mean). <iframe width="440" height="260" src="https://www.youtube.com/embed/6u009U1q69A?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe> 3. Read small sections Shakespeare’s plays aren’t novels and – let’s face it – we’re not usually in much doubt about how things will work out. Reading for the plot, or reading from start to finish, isn’t necessarily the way to get the most out of the experience. Theatre performances are linear and in real time, but reading allows you the freedom to pace yourself, to flick back and forwards, to give some passages more attention and some less. Shakespeare’s first readers probably <a href="https://www.theguardian.com/stage/2020/apr/01/reading-shakespeare-book-plays-emma-smith">did exactly this</a>, zeroing in on the bits they liked best, or reading selectively for the passages that caught their eye or that they remembered from performance, and we should do the same. Look up <a href="https://shakespeare.folger.edu">where a famous quotation comes</a>: “All the world’s a stage”, “To be or not to be”, “I was adored once too” – and read either side of that. Read the ending, look at one long speech or at a piece of dialogue – cherry pick. <iframe width="440" height="260" src="https://www.youtube.com/embed/pjJEXkbeL-o?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe> One great liberation of reading Shakespeare for fun is just that: skip the bits that don’t work, or move on to another play. Nobody is going to set you an exam. 4. Think like a director On the other hand, thinking about how these plays might work on stage can be engaging and creative for some readers. Shakespeare’s plays tended to have <a href="https://www.shakespeareswords.com/Public/LanguageCompanion/ThemesAndTopics.aspx?TopicId=37">minimal stage directions</a>, so most indications of action in modern editions of the plays have been added in by editors. Most directors begin work on the play by throwing all these instructions away and working them out afresh by asking questions about what’s happening and why. Stage directions – whether original or editorial – are rarely descriptive, so adding in your chosen adverbs or adjectives to flesh out what’s happening on your paper stage can help clarify your interpretations of character and action. One good tip is to try to remember characters who are not speaking. What’s happening on the faces of the other characters while Katherine delivers her long, controversial speech of apparent wifely subjugation at the end of The Taming of the Shrew? <iframe width="440" height="260" src="https://www.youtube.com/embed/ti1Oh9imI8I?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe> 5. Don’t worry The biggest obstacle to enjoying Shakespeare is that niggling sense that understanding the works is a kind of literary IQ test. But understanding Shakespeare means accepting his open-endedness and ambiguity. It’s not that there’s a right meaning hidden away as a reward for intelligence or tenacity – these plays prompt questions rather than supplying answers. Would Macbeth have killed the king without the witches’ prophecy? Exactly – that’s the question the play wants us to debate, and it gives us evidence to argue on both sides. Was it right for the conspirators to assassinate Julius Caesar? Good question, the play says: I’ve been wondering that myself. Returning to Shakespeare outside the dutiful contexts of the classroom and the theatre can liberate something you might not immediately associate with his works: pleasure.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/136409/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/emma-smith-221714">Emma Smith</a>, Professor of Shakespeare Studies, <a href="https://theconversation.com/institutions/university-of-oxford-1260">University of Oxford</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-to-read-shakespeare-for-pleasure-136409">original article</a>.

Entertainment

5 classic isolation movies recommended by a film scholar

As a film scholar, I am constantly being asked if I am enjoying the lockdown because it has given me more time to watch films. My answer is not simple. Yes, it is good to catch up on some films I missed at the cinema, or finally get around to rewatching <a href="https://www.youtube.com/watch?v=Q9nZFUgyclE">Berlin Alexanderplatz</a>. But, for someone like me, who finds social isolation very difficult, watching movies alone can be a painful reminder of what a communal activity cinema-going usually is, as this <a href="https://www.iser.essex.ac.uk/files/iser_working_papers/2005-14.pdf">research from Essex University</a> has found. So I have started to watch films that reassure me that I am not the only one feeling lonely and going stir crazy. Here, then, are five great films about being stuck indoors or in forced isolation. Some of these may not be for the faint-hearted, but they are all well worth watching. Rear Window (Alfred Hitchcock, 1954) <a href="https://variety.com/1954/film/reviews/rear-window-1200417736/">Rear Window</a> may be the definitive lockdown movie. The story is simple: Jimmy Stewart’s adventure-seeking photographer finds himself trapped in his apartment with a broken leg. He begins to semi-innocently spy on his neighbours until he becomes convinced that one of them may have murdered their wife. <iframe width="440" height="260" src="https://www.youtube.com/embed/6kCcZCMYw38?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe> The film is both a mischievous examination of the voyeur in us all, and a cautionary tale about the devil making work for idle hands. It is also a testament to the power of imagination. We might not be able to have meals, complete with champagne, delivered to us by Grace Kelly, but we can make up stories about what that strange man across the street is up to. It will help pass the time. And you know he’s doing the same about you. The Exterminating Angel (Luis Buñuel, 1962) Buñuel’s <a href="https://www.rogerebert.com/reviews/the-exterminating-angel-1968">surrealist masterpiece</a> remains cinema’s definitive portrait of societal breakdown, and 90% of it takes place in one room. Following a lavish dinner party at one of their houses, a large group of aristocrats find themselves inexplicably unable to leave the drawing room. The longer they remain there together the more the thin veneer of civilisation cracks. <iframe width="440" height="260" src="https://www.youtube.com/embed/ERHL5nzEMmM?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe> First the servants leave and the guests are reduced to using antique vases as toilets. Soon the food and water run out and precious medication is stolen. The elderly and frail start to die. Some respond by indulging their hedonistic desires, some resort to prayer and calls for sacrifice, others kill themselves in despair. This might sound unbearably bleak, but Buñuel plays it all for the most mordant kind of comedy. Six decades have not blunted the fangs on this one. This is Not a Film (Jafar Panahi, 2011) In late 2010, Jafar Panahi, one of Iran’s greatest filmmakers, was sentenced by his government to six years in prison and a 20-year ban on making films for allegedly conspiring to produce “propaganda against the Islamic Republic”. Awaiting the final verdict under house arrest, Panahi did what any good dissident would do: he made a film. <iframe width="440" height="260" src="https://www.youtube.com/embed/AgZy00svH08?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe> Shot on an iPhone and a digital camcorder, <a href="https://www.nytimes.com/2012/02/29/movies/hes-jafar-panahi-but-this-is-not-a-film.html">This is Not a Film</a> shows Panahi going about his daily routine, speaking to his lawyers, acting out scenes from a film he expects to never make, talking about his previous work, and interacting with a few neighbours and workmen. The result is a powerful riposte to state censorship and a sly work of meta-cinema typical of its maker. But the film also has an incredible urgency about it. It is as if Panahi had to make the film simply to stay sane. A timely reminder that you don’t need expensive equipment or money to make great art, and that sometimes the best work comes out of crisis and restraint. Housebound (Gerard Johnstone, 2014) It is easy to see why Peter Jackson went <a href="https://www.hollywoodreporter.com/heat-vision/new-line-remake-new-zealand-772536">out of his way to champion</a> this low-budget effort by first-time writer-director Gerard Johnstone (the famed New Zealand director called it “bloody brilliant”). Like Jackson’s own early films, Housebound shoots for a difficult balance of irreverent comedy, suspense, and splatter, and somehow pulls it off. <iframe width="440" height="260" src="https://www.youtube.com/embed/ji8Tsuj3u0c?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe> The story revolves around a 20-something tearaway named Kylie who placed under house arrest in her childhood home, which her mother casually insists is haunted. At first Kylie thinks her mother is just dotty, but when she is also confronted by mysteriously opening doors, disappearing objects and noises in the night, she begins to wonder. Essential viewing for people with old, noisy houses. Extra points for the probation officer who reveals himself to be an amateur ghost hunter, and the very plucky female protagonist whose response to encountering a creepy doll is to smash its face in. Crowhurst (Simon Rumley, 2017) Independent British filmmaker <a href="https://www.thetimes.co.uk/article/film-review-crowhurst-b9lrx9rbp">Simon Rumley’s retelling</a> of Donald Crowhurst’s <a href="https://www.independent.co.uk/news/uk/this-britain/drama-on-the-waves-the-life-and-death-of-donald-crowhurst-421934.html">disastrous attempt</a> to sail solo and non-stop around the world in 1968, which ended in his disappearance and probable suicide, offers a masterclass in low-budget filmmaking. A good deal of the movie consists of Crowhurst (played by the excellent Justin Salinger) alone on a very small trimaran. Rumley, however, puts the viewer squarely inside Crowhurst’s head as his loneliness, isolation and fear of failure slowly cause him to crack. <iframe width="440" height="260" src="https://www.youtube.com/embed/qgWC8bJTld4?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe> This is not a movie for everyone. It is intense to say the least, and the more unhinged Crowhurst gets, the more self-consciously raw the filmmaking becomes. The fact that it was championed by Nicolas Roeg, the late, great maestro of mind-bending British cinema, will be the ultimate recommendation for those looking for something more adventurous. This list is hardly exhaustive. There are many more films about isolation to watch while in isolation: from <a href="https://www.theguardian.com/film/2017/dec/29/persona-review-ingmar-bergman-rerelease">Persona</a> to <a href="https://www.americamagazine.org/arts-culture/2020/04/11/1995-film-safe-has-new-meaning-during-our-coronavirus-isolation">Safe</a>, from <a href="https://www.chicagotribune.com/news/ct-xpm-1997-10-03-9710030449-story.html">Repulsion</a> to <a href="https://variety.com/2006/film/markets-festivals/right-at-your-door-1200519062/">Right at Your Door</a>. I just wanted to guide people to a few lesser-known films alongside a pair of classics that worth revisiting now more than ever. Stay safe and happy viewing.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/135705/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/brian-hoyle-475856">Brian Hoyle</a>, Senior Lecturer in Film Studies, <a href="https://theconversation.com/institutions/university-of-dundee-955">University of Dundee</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/five-classic-isolation-movies-recommended-by-a-film-scholar-135705">original article</a>.

Entertainment

Coronavirus jargon buster

Unless you have been on a remote island with no access to the internet (if so, you should have stayed there!), several new words will have been added to your vocabulary in the past few months. Terms such as case fatality rate, antibody, and PPE are no longer just used by scientists. Consider this your coronavirus jargon-buster. ACE2: A protein on the cells in your airways that coronavirus attaches to. Antibody: Large Y-shaped proteins that stick to the surface of bacteria and viruses. Antigen: A foreign substance that induces an immune response in the body – especially the production of antibodies. Case fatality rate: The percentage of confirmed cases that resulted in death is the case fatality rate, or CFR. The World Health Organization estimates the CFR for COVID-19 to be <a href="https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---3-march-2020">about 3.4%</a>. But this number is likely to come down as more tests are performed and we identify more of the large number of cases with no symptoms. In South Korea, where lots of testing was performed, the CFR is <a href="https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/">about 1.5%</a>. COVID-19: The disease, not the virus that causes the disease. That’s SARS-CoV-2 (see below). Endemic: Not to be confused with “epidemic”. A disease that is regularly found among a particular group or in a particular region, such as malaria. Epidemic: The widespread occurrence of an infectious disease in a population at a particular time. So COVID-19 is a pandemic (because of its global spread), but it is also an epidemic in the UK, for example. Flattening the curve: Hospitals can only cope with so many patients. Flattening the curve is an attempt to reduce how many cases of COVID-19 occur at the same time so that hospitals aren’t overwhelmed. Herd immunity: When a large number of people in a population are immune to a disease, either through vaccination of through having the disease naturally, it is difficult for that disease to spread. For highly infectious disease, such as measles, if 95% of the population is vaccinated, the number of cases of the disease will be dramatically reduced and can even be wiped out. For COVID-19, which is less infectious than measles, herd immunity would work if <a href="https://theconversation.com/coronavirus-can-herd-immunity-really-protect-us-133583">around 60%-70%</a> of the population was vaccinated. Incubation period: This is the length of time between being infected and showing symptoms. Most people show symptoms within five days of being infected within SARS-CoV-2, but it <a href="https://www.ncbi.nlm.nih.gov/pubmed/32150748">can take up to two weeks</a>. N95 mask: These are also called respirator masks. All the air being breathed in passes through a filter which reduces the chances of someone be infected. These masks only work if they fit properly. They do not work if you have any facial hair, so you’re unlikely to see many bearded doctors. Pandemic: When many people in several countries on several continents have a disease. COVID-19 is considered a pandemic with <a href="https://www.worldometers.info/coronavirus/#countries">over 203 countries and territories</a> reporting confirmed cases. Patient zero: Not a medical term and one that is <a href="https://theconversation.com/patient-zero-why-its-such-a-toxic-term-134721">stigmatising</a>. Best avoided. In medicine, we usually refer to an “index case”, but that’s something different. It refers to the first known case of a disease. PCR test: This is the test used to find out if you have a COVID-19 infection (contrast with serological test). It’s a genetic test. A swab is taken from the mucous membrane lining your nose and throat. Any RNA (the genetic instructions contained within the virus) samples are turned into DNA using an enzyme called reverse transcriptase. The DNA is then amplified in a process called polymerase chain reaction – hence PCR. This test can take hours to get a result, but several companies are trying to develop rapid molecular testing methods. Pre-print: A research paper that is yet to be peer-reviewed. There are published in “pre-print servers”, such as <a href="https://www.biorxiv.org/">BioRxiv</a> and <a href="https://www.medrxiv.org/">MedRxiv</a>, and are free for anyone to access. Usually, research that hasn’t been reviewed by other experts in the field is frowned upon, but in a rapidly growing and evolving crisis, such as the current one, they serve a very useful purpose. PPE: No, not mis-sold insurance. This is personal protective equipment. Stuff front-line healthcare staff need to keep them safe. Things like masks, disposable gloves and goggles. The level of protection that PPE needs to provide is different depending on how risky the activity being performed is. Reagent: A reagent is any chemical needed to conduct an experiment. Like an ingredient in a recipe. There has been a <a href="https://www.bbc.co.uk/news/uk-politics-52118781">lot of talk</a> about reagents in the press lately as it is one of the “ingredients” needed to make the COVID-19 tests. R0 (pronounced R nought): The average number of people a sick person will infect. And the word “average” here is key because, depending on how many people are being tested and how many cases are identified, the R0 will change. The R0 of SARS-CoV-2 is between two and three, meaning that each infected person will infect <a href="https://www.ijidonline.com/article/S1201-9712(20)30123-5/fulltext">two or three other people</a>. This is why it can spread so quickly. SARS-CoV-2: The virus that causes COVID-19. Initially named 2019-nCoV by the World Health Organization (which <a href="https://www.sciencemag.org/news/2020/02/bit-chaotic-christening-new-coronavirus-and-its-disease-name-create-confusion">caused a lot of confusion</a>), but later given its official moniker by the people actually in charge of naming viruses: the Coronavirus Study Group (CSG) of the International Committee on Taxonomy of Viruses (yeah, we don’t go for snappy names in biology). Serology test: Blood tests that look for the presence of antibodies that indicate if someone has already been exposed to a disease. These tests will not work early in an infection, it takes some time for our bodies to start producing the antibodies against the virus. Super spreader: A pejorative term for someone who infects lots of people with the disease they have. It sounds like a medical term, but it’s not. It’s also stigmatising and shouldn’t be used – by anyone.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/134845/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lindsay-broadbent-1009352">Lindsay Broadbent</a>, Research Fellow, School of Medicine, Dentistry and Biomedical Sciences, <a href="https://theconversation.com/institutions/queens-university-belfast-687">Queen's University Belfast</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/coronavirus-jargon-buster-134845">original article</a>.

Health

Why your brain evolved to hoard supplies and shame others for doing the same

The media is replete with COVID-19 stories about people clearing supermarket shelves – and the backlash against them. Have people gone mad? How can one individual be overfilling his own cart, while shaming others who are doing the same? <a href="https://scholar.google.com/citations?user=TFX9eJ0AAAAJ&hl=en&oi=ao">As a behavioral neuroscientist</a> who has studied hoarding behavior for 25 years, I can tell you that this is all normal and expected. People are acting the way evolution has wired them. Stockpiling provisions The word “hoarding” might bring to mind relatives or neighbors whose houses are overfilled with junk. A small percentage of people do suffer from what psychologists call “<a href="https://hoarding.iocdf.org">hoarding disorder</a>,” keeping excessive goods to the point of distress and impairment. But hoarding is actually a <a href="https://mitpress.mit.edu/books/interdisciplinary-science-consumption">totally normal and adaptive behavior</a> that kicks in any time there is an uneven supply of resources. Everyone hoards, even during the best of times, without even thinking about it. People like to have beans in the pantry, money in savings and chocolates hidden from the children. These are all hoards. Most Americans have had so much, for so long. People forget that, not so long ago, survival often depended on working tirelessly all year to <a href="https://dustyoldthing.com/forgotten-root-cellars/">fill root cellars</a> so a family could last through a long, cold winter – and still many died. Similarly, <a href="https://emammal.wordpress.com/2013/09/24/gray-squirrels-and-scatter-hoarding/">squirrels work all fall to hide nuts</a> to eat for the rest of the year. Kangaroo rats in the desert <a href="https://doi.org/10.1016/S0003-3472(05)81018-8">hide seeds the few times it rains</a> and then remember where they put them to dig them back up later. A Clark’s nutcracker <a href="https://www.nationalgeographic.com/science/phenomena/2015/12/03/how-a-5-ounce-bird-stores-10000-maps-in-its-head/">can hoard over 10,000 pine seeds</a> per fall – and even remember where it put them. Similarities between human behavior and these animals’ are not just analogies. They reflect a deeply ingrained capacity for brains to motivate us to acquire and save resources that may not always be there. Suffering from hoarding disorder, stockpiling in a pandemic or hiding nuts in the fall – all of these behaviors are motivated less by logic and more by a <a href="https://www.livescience.com/32773-what-causes-hoarding.html">deeply felt drive to feel safer</a>. My colleagues and I have found that stress seems to signal the brain to switch into “get hoarding” mode. For example, a kangaroo rat will act very lazy if fed regularly. But <a href="https://doi.org/10.1098/rstb.2009.0225">if its weight starts to drop</a>, its brain signals to release stress hormones that incite the fastidious hiding of seeds all over the cage. Kangaroo rats will also <a href="https://doi.org/10.1037/0735-7036.119.2.187">increase their hoarding if a neighboring animal steals</a> from them. Once, I returned to the lab to find the victim of theft with all his remaining food stuffed into his cheek pouches — the only safe place. People do the same. If in our lab studies my colleagues and I make them feel anxious, our study subjects <a href="https://www.psychologicalscience.org/observer/under-pressure-stress-and-decision-making/comment-page-1">want to take more stuff home</a> with them afterward. Demonstrating this shared inheritance, <a href="https://doi.org/10.1016/j.neuropsychologia.2012.01.033">the same brain areas are active</a> when people decide to take home toilet paper, bottled water or granola bars, as when rats store lab chow under their bedding – the orbitofrontal cortex and nucleus accumbens, regions that generally help organize goals and motivations to satisfy needs and desires. <a href="https://global.oup.com/academic/product/the-oxford-handbook-of-hoarding-and-acquiring-9780199937783">Damage to this system can even induce abnormal hoarding</a>. One man who suffered frontal lobe damage had a sudden urge to hoard bullets. Another could not stop “borrowing” others’ cars. Brains across species use these ancient neural systems to ensure access to needed items – or ones that feel necessary. So, when the news induces a panic that stores are running out of food, or that residents will be trapped in place for weeks, the brain is programmed to stock up. It makes you <a href="https://www.psychologytoday.com/us/blog/hope-relationships/201409/the-psychology-behind-hoarding">feel safer, less stressed</a>, and actually protects you in an emergency. More than a fair share At the same time they’re organizing their own stockpiles, people get upset about those who are taking too much. That is a legitimate concern; it’s a version of the “<a href="https://www.econlib.org/library/Enc/TragedyoftheCommons.html">tragedy of the commons</a>,” wherein a public resource might be sustainable, but people’s tendency to take a little extra for themselves degrades the resource to the point where it can no longer help anyone. By shaming others on social media, for instance, people exert what little influence they have to ensure cooperation with the group. As a social species, human beings thrive when they work together, and have <a href="https://www.sciencedaily.com/releases/2010/05/100501013529.htm">employed shaming – even punishment – for millennia</a> to ensure that everyone acts in the best interest of the group. And it works. Twitter users went after a guy reported to have hoarded 17,700 bottles of hand sanitizer in the hopes of turning a profit; he ended up donating all of it and is under <a href="https://www.nytimes.com/2020/03/15/technology/matt-colvin-hand-sanitizer-donation.html">investigation for price gouging</a>. Who wouldn’t pause before grabbing those last few rolls of TP when the mob is watching? People will continue to hoard to the extent that they are worried. They will also continue to shame others who take more than what they consider a fair share. Both are normal and adaptive behaviors that evolved to balance one another out, in the long run. But that’s cold comfort for someone on the losing end of a temporary imbalance – like a health care worker who did not have protective gear when they encountered a sick patient. The survival of the group hardly matters to the person who dies, or to their parent, child or friend. One thing to remember is that the news selectively depicts stockpiling stories, presenting audiences with the most shocking cases. Most people are not <a href="https://www.usatoday.com/story/money/2020/03/03/coronavirus-hand-sanitizer-face-masks-price-gouging-amazon-walmart-ebay/4933920002/">charging $400 for a mask</a>. Most are just trying to protect themselves and their families, the best way they know how, while also <a href="https://www.mother.ly/news/uplifting-stories-of-people-helping-each-other-during-coronavirus">offering aid wherever they can</a>. That’s <a href="https://www.nature.com/scitable/knowledge/library/how-does-social-behavior-evolve-13260245/">how the human species evolved</a>, to get through challenges like this together. <a href="https://theconversation.com/profiles/stephanie-preston-1006858">Stephanie Preston</a>, Professor of Psychology, <a href="https://theconversation.com/institutions/university-of-michigan-1290">University of Michigan</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/your-brain-evolved-to-hoard-supplies-and-shame-others-for-doing-the-same-134634">original article</a>.

Health

Love and a happy ending: Romance fiction to help you through a coronavirus lockdown

Romance fiction has two <a href="https://www.rwa.org/Online/Romance_Genre/About_Romance_Genre.aspx">defining features</a>. First, it centres on a love story. Secondly, it always ends well. Our protagonists end up together (if not forever, then at least for the foreseeable future) and this makes the world around them a little bit better, too. In times of uncertainty, upheaval and chaos, readers often turn to romance fiction: during the second world war, Mills & Boon was able to maintain its paper ration <a href="https://www.oxfordscholarship.com/view/10.1093/acprof:oso/9780198204558.001.0001/acprof-9780198204558">by arguing</a> its books were good for the morale of working women. The books the company was producing in this period were not about the war. Most never even mentioned it. Instead, they provided an escape for readers to a world where they could be assured everything was going to turn out all right: love would conquer all, villains would be defeated, and lovers would always find their way back to each other. Today, romance publishing is a <a href="https://www.rwa.org/Online/Romance_Genre/About_Romance_Genre.aspx">billion-dollar industry</a>, with thousands of novels published each year. It covers a wide range of subgenres: from historical to contemporary, paranormal to sci-fi, from novels where the only physical interaction between the protagonists is a kiss, to erotic romance where sex is fundamental to the story. <a href="https://en.wikipedia.org/wiki/Rule_34_(Internet_meme)">Rule 34</a> of the internet states if you can think of something, then there’s porn of it. The same, I would argue, is true for romance fiction. But where to begin? As both a scholar of romance fiction and an avid reader of it, I’ve put together this list of five great reads for people who might want to start exploring the genre. If you like Jane Austen, try… <a href="https://www.goodreads.com/book/show/42279630-the-austen-playbook">The Austen Playbook</a> by Lucy Parker The Austen Playbook is the fourth book in Parker’s London Celebrities series (all only loosely connected, so you can jump in anywhere). Heroine Freddy is an actress from an esteemed West End family, trying to balance her desire to perform in musicals and crowd-pleasers over her family pushing her towards serious drama. Hero Griff is a theatre critic and his family estate is playing host to a wacky live-action Jane Austen murder mystery, in which Freddy is playing Lydia. Parker is a gifted author, and this book is a light, bright and sparkling delight. If you like (or hate!) dating apps, try… <a href="https://www.goodreads.com/book/show/39863092-the-right-swipe">The Right Swipe</a> by Alisha Rai Many people now find partners on dating apps, but these apps are often <a href="https://theconversation.com/right-swipes-and-red-flags-how-young-people-negotiate-sex-and-safety-on-dating-apps-128390">not exactly friendly</a> for women. Rai addresses that to great effect in The Right Swipe, where heroine Rhiannon is the designer of a dating app designed specifically for women. She meets hero Samson the first time as a result of swiping right, and then the second time, months later, when he’s teamed up with one of her primary business rivals… If you’re fascinated by psychology, try … <a href="https://www.goodreads.com/book/show/35852829-the-love-experiment">The Love Experiment</a> by Ainslie Paton Paton is one of Australia’s smartest and most underrated romance authors. The Love Experiment draws on the <a href="https://journals.sagepub.com/doi/abs/10.1177/0146167297234003">36 questions</a> developed by psychologist Arthur Aron to explore whether intimacy could be generated or intensified between two people if they exchanged increasingly personal information. The 36 questions were popularised in Mandy Len Catron’s 2015 New York Times essay <a href="https://www.nytimes.com/2015/01/11/style/modern-love-to-fall-in-love-with-anyone-do-this.html">To Fall In Love With Anyone, Do This</a>. Here, journalist protagonists Derelie and Jackson undertake the experiment in Paton’s book, only to find love is more complex than 36 questions. If you think we need to save the oceans, try… <a href="https://www.goodreads.com/book/show/42016094-project-saving-noah">Project Saving Noah</a> by Six de los Reyes This book emerges from <a href="https://romanceclassbooks.com/about/">RomanceClass</a>, a fascinating community of English-language romance writers and readers based in the Philippines. One of their distinctive features is their collaboration with local actors in Manila to perform excerpts from the books (including Project Saving Noah) at their <a href="https://romanceclassbooks.com/live-reading/aprilfeelsday2019/">regular gatherings</a>. I was privileged enough to attend one of these last year. Protagonists Noah and Lise are graduate students in oceanography competing for one spot on a research project, while simultaneously being forced to work together. Their romance is conflicted and compelling, but what stands out about this book is the vividness with which their environment – natural and academic – is constructed. If you like your protagonists to have some maturity, try… <a href="https://www.goodreads.com/book/show/44084867-mrs-martin-s-incomparable-adventure">Mrs Martin’s Incomparable Adventure</a> by Courtney Milan If Milan’s name sounds familiar, it’s because she was at the centre of the <a href="https://theconversation.com/if-the-romance-writers-of-america-can-implode-over-racism-no-group-is-safe-130034">recent scandal</a> engulfing the Romance Writers of America, which penetrated through romance’s usual cultural invisibility. When she’s not standing up against systemic racism, Milan writes excellent, mostly historical, romance. Mrs Martin is a delightful historical romp, as our two heroines Bertrice (aged 73) and Violetta (aged 69) team up against Violetta’s terrible nephew, and fall in love and eat cheese on toast together.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/133784/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jodi-mcalister-135765">Jodi McAlister</a>, Lecturer in Writing, Literature and Culture, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/love-and-a-happy-ending-romance-fiction-to-help-you-through-a-coronavirus-lockdown-133784">original article</a>.

Entertainment

Why perfume could be the riskiest gift you’ll ever buy

When it comes to making careful plans to impress that significant other, certain things can seem like musts. Classy restaurant – check. Romantic atmosphere – check. Best suit or little black dress – check. Many will pay just as much attention to how they smell, of course. And if it’s a special occasion, a gift of perfume might well be on the agenda too. Either way, read on. There are some must-knows about the science of smell and perfume that may well be new to you. The nose knows Smell is the <a href="http://www.cambridge.org/gb/academic/subjects/life-sciences/animal-behaviour/pheromones-and-animal-behavior-chemical-signals-and-signatures-2nd-edition">dominant sense</a> in many animals, including humans, and meetings between individuals usually begin with a period of intense mutual sniffing. From this olfactory exploration, animals glean relevant information about a potential mate’s fertility and quality, enabling decisions about whether to breed now or wait until someone better comes along. While our greetings tend to be more reserved, research on the perception of human body odour reveals that similar messages lurk within our armpits. Researchers commonly test such perceptions using armpit odour collected on worn t-shirts or underarm pads, the wearers having been asked to avoid using fragranced products beforehand. In <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1439-0310.2006.01125.x/abstract">experimental tests</a>, men find women’s odour more pleasant and sexy when they are in the fertile part of their menstrual cycle than at other times. Women are more attracted to odours of men who have attractive non-olfactory qualities, such as being <a href="http://rsbl.royalsocietypublishing.org/content/1/3/256">socially dominant</a>, <a href="http://rspb.royalsocietypublishing.org/content/266/1422/869">facially attractive</a>, or having an <a href="http://www.ncbi.nlm.nih.gov/pubmed/21879430">air of confidence</a> about them. So smells are important when assessing partners, <a href="http://www.sciencedirect.com/science/article/pii/S0191886908002250">especially for women</a>. Our body’s natural smells also appear to provide a for couples to check out their genetic compatibility. Research using the same t-shirt method <a href="http://www.ncbi.nlm.nih.gov/pubmed/19054623">indicates that</a> both sexes prefer the odour of potential partners who are genetically dissimilar when it comes to a set of genes known as the major histocompatibility complex (MHC). A range of other vertebrates, from fish and reptiles to birds and mammals, <a href="http://onlinelibrary.wiley.com/doi/10.1046/j.1439-0310.2002.00768.x/abstract">show the same smell preference</a>, apparently because this ultimately produces healthier offspring. Arcane aromas So where do perfumes fit into the picture? Applying perfume to the body <a href="http://www.oxfordscholarship.com/view/10.1093/acprof:oso/9780199586073.001.0001/acprof-9780199586073-chapter-0020">probably emerged</a> as a means of disguising the build-up of odour on clothing, which in times past was often worn for weeks or months at a time. Because ingredients were expensive, perfumes were associated with high social status. There are numerous references to people using perfume in ancient scripts including the <a href="http://www.kubik.org/health/perfumes.htm">Old Testament</a> and the writings of the Roman natural historian <a href="http://blogs.getty.edu/iris/the-scent-of-love-ancient-perfumes/">Pliny the Elder</a>. The oldest known perfume factory, <a href="http://news.nationalgeographic.com/news/2007/03/070329-oldest-perfumes.html">discovered 12 years ago</a> near the Cypriot town of Pyrgos, dates back about 4000 years. Eau de yes please Nowadays, of course, perfumes are relatively cheap and accessible. Despite this and the advent of washing machines and ventilated kitchens, we continue to use them. The social stigma of bad body-odour persists, and the modern fragrance industry is worth billions of pounds worldwide. But if we need perfumes to simply mask our bad odour, why are there so many different products available? And how do perfumes change or block the potentially relevant information contained within body odour? Research is now challenging the conventional view that perfumes simply mask bad odour. <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0033810">In one study</a>, researchers asked participants to wear cotton underarm pads, as described above, but they were instructed to apply a particular fragrance under one armpit while leaving the other fragrance-free. Unsurprisingly perhaps, volunteer sniffers later found the fragranced armpit odour to be more pleasant. But then the researchers asked a new set of participants to apply their fragrance of choice under one armpit and to apply another fragrance, chosen by the experimenters, under the other. This time, the sniffers judged the fragrance/body odour blends as more attractive when they involved the wearer’s own preferred fragrance – even though the sniffers found the two fragrances roughly comparable when there was no body odour involved. The conclusion? People select fragrances that complement their own body odour, producing a favourable blend. How might we achieve this? This question brings us back to the MHC genes that we mentioned earlier. A <a href="http://beheco.oxfordjournals.org/content/12/2/140.short">key study</a> determined the MHC group of different sniffers and then noted which odours they preferred among a range of common ingredients that might contribute to a perfume that they would wear. The results revealed a correlation between certain MHC groups and preferences for certain ingredients, suggesting that we choose fragrances that enhance the MHC signals that we are already giving off. Yet these correlations disappeared when the same sniffers rated the ingredients for a perfume their partner might choose to wear. At the genetic level, perfume preferences only work when thinking about ourselves. <a href="http://rspb.royalsocietypublishing.org/content/280/1755/20122889">Another experiment</a> took a slightly different approach to reach a similar conclusion. Researchers first extracted MHC peptides, a signature component of MHC molecules, from a number of volunteers. They then spiked samples of the volunteers’ body odour with peptides representative of either their own MHC or of other people’s MHC. When they were then asked to choose which spiked odour sample smelled like themselves, they tended to choose the one spiked with their own MHC peptides. Back to the perfume counter Taken together, these studies suggest that we evaluate perfumes, at least in part, according to whether they suit our individual, genetically influenced odour. In an ideal world we might all know our partner’s MHC genotype and choose perfumes that suited them accordingly, perhaps following some helpful system of colour coding or the like. Unfortunately this doesn’t look likely to happen in any major way any time soon – the test currently costs about £160 a head. So what lessons can be learned from these studies? One main point is that choosing a perfume for your partner based on your own preference is unlikely to work well. Your best bet is to ask perfume shop staff to select a perfume that smells roughly similar to the one you know your partner likes. Or do it yourself using perfume finders online, such as <a href="http://perfumesociety.org/fred/">FR.eD</a> or <a href="http://nose.fr/en/the-project/introduction">Nose</a>. For those choosing a fragrance for themselves, the lesson is to ensure you select one that really suits you. In the study of odour/fragrance blends, there were a few wearers who bucked the trend and smelled better with the experimenter-assigned perfume than with the brand they chose themselves. So it’s always worth investing some time in making a choice, and to test-drive it on your skin first. If this sounds daunting, you can at least proceed in the knowledge that the person best placed to decide what perfume suits you best is looking back at you in the mirror.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/37601/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/s-craig-roberts-152483">S Craig Roberts</a>, Senior Lecturer in Psychology, <a href="https://theconversation.com/institutions/university-of-stirling-1697">University of Stirling</a>; <a href="https://theconversation.com/profiles/caroline-allen-155046">Caroline Allen</a>, Researcher, <a href="https://theconversation.com/institutions/university-of-stirling-1697">University of Stirling</a>, and <a href="https://theconversation.com/profiles/kelly-cobey-155033">Kelly Cobey</a>, Honourary Researcher (Psychology: Hormones and Behaviour), <a href="https://theconversation.com/institutions/university-of-stirling-1697">University of Stirling</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/perfume-could-be-the-riskiest-gift-youll-ever-buy-37601">original article</a>.

Lifestyle

7 science-based strategies to cope with coronavirus anxiety

As the SARS-CoV-2 virus continues its global spread and the number of diagnosed COVID-19 cases continues to increase, anxiety related to the outbreak is on the rise too. <a href="https://scholar.google.com/citations?user=jlev7ekAAAAJ&hl=en&oi=ao">As a psychologist</a>, I am seeing this in my practice already. Although feeling anxiety in response to a threat <a href="https://doi.org/10.1037/0033-295X.105.2.325">is a normal human reaction</a>, sustained high anxiety can undermine constructive responses to the crisis. People who already suffer from anxiety and related disorders are especially likely to have a hard time during the coronavirus crisis. The following suggestions, based on psychological science, can help you deal with coronavirus anxiety. 1. Practice tolerating uncertainty Intolerance of uncertainty, which has been <a href="https://doi.org/10.1080/16506073.2018.1476580">increasing in the U.S.</a>, makes people <a href="https://doi.org/10.1586/ern.12.82">vulnerable to anxiety</a>. A <a href="https://doi.org/10.1111/bjhp.12058">study during the 2009 H1N1 pandemic</a> showed that people who had a harder time accepting the uncertainty of the situation were more likely to experience elevated anxiety. The solution is to learn to gradually face uncertainty in daily life by easing back on certainty-seeking behaviors. Start small: Don’t text your friend immediately the next time you need an answer to a question. Go on a hike without checking the weather beforehand. As you build your tolerance-of-uncertainty muscle, you can work to reduce the number of times a day you consult the internet for updates on the outbreak. 2. Tackle the anxiety paradox <a href="https://doi.org/10.1016/j.beth.2014.07.001">Anxiety rises</a> proportionally to how much one tries to get rid of it. Or as Carl Jung put it, “<a href="https://www.routledge.com/C-G-Jung-The-Basics/Williams/p/book/9781138195448">What you resist persists</a>.” Struggling against anxiety can take many forms. People might try to distract themselves by drinking, eating or watching Netflix more than usual. They might repeatedly seek reassurance from friends, family or health experts. Or they might obsessively check news streams, hoping to calm their fears. Although these behaviors can help momentarily, they can <a href="https://doi.org/10.1111/j.1468-2850.2010.01213.x">make anxiety worse</a> in the long run. Avoiding the experience of anxiety almost always backfires. Instead, allow your anxious thoughts, feelings and physical sensations to wash over you, accepting anxiety as an integral part of human experience. When waves of coronavirus anxiety show up, notice and <a href="https://www.newharbinger.com/mindfulness-based-stress-reduction-workbook-second-edition">describe the experience</a> to yourself or others <a href="https://www.uclahealth.org/marc/body.cfm?id=22&iirf_redirect=1">without judgment</a>. Resist the urge to escape or calm your fears by obsessively reading virus updates. Paradoxically, facing anxiety in the moment will lead to less anxiety over time. 3. Transcend existential anxiety Health threats trigger the fear that underlies all fears: <a href="https://wwnorton.com/books/9780393350876">fear of death</a>. When faced with reminders of one’s own mortality, people might become consumed with health anxiety and hyperfocused on any signs of illness. Try connecting to your life’s purpose and sources of meaning, be it spirituality, relationships, or pursuit of a cause. Embark on something important that you’ve been putting off for years and take responsibility for how you live your life. Focusing on or discovering <a href="https://doi.org/10.1002/smi.1095">the “why” of life</a> can go a long way in helping you deal with unavoidable anxiety. 4. Don’t underestimate human resiliency Many people fear how they will manage if the virus shows up in town, at work or at school. They worry how they would cope with a quarantine, a daycare closure or a lost paycheck. Human minds are good at predicting the worst. But research shows that people tend to <a href="https://doi.org/10.1111/j.0963-7214.2005.00355.x">overestimate how badly they’ll be affected</a> by negative events and <a href="http://bit.ly/3cFFkIk">underestimate how well they’ll cope with</a> and adjust to difficult situations. Be mindful that you are more resilient than you think. It can help attenuate your anxiety. 5. Don’t get sucked into overestimating the threat Coronavirus can be dangerous, with an estimated <a href="https://doi.org/10.1056/NEJMoa2002032">1.4%</a> to <a href="https://doi.org/10.1001/jama.2020.2648">2.3%</a> death rate. So everyone should be serious about taking all the <a href="https://theconversation.com/what-really-works-to-keep-coronavirus-away-4-questions-answered-by-a-public-health-professional-132959">reasonable precautions against infection</a>. But people also should realize that humans tend to <a href="https://doi.org/10.1111/1539-6924.00276">exaggerate the danger of unfamiliar threats</a> compared to ones they already know, like seasonal flu or car accidents. Constant incendiary media coverage <a href="https://doi.org/10.1093/eurpub/ckp061">contributes to the sense of danger</a>, which leads to heightened fear and further <a href="https://doi.org/10.1111/j.1467-8721.2006.00461.x">escalation of perceived danger</a>. To reduce anxiety, I recommend limiting your exposure to coronavirus news to no more than 30 minutes per day. And remember that we become more anxious when faced with situations that have no clear precedent. Anxiety, in turn, makes everything seem more dire. 6. Strengthen self-care During these anxiety-provoking times, it’s important to remember the tried-and-true anxiety prevention and reduction strategies. Get <a href="https://doi.org/10.5665/sleep.2810">adequate sleep</a>, <a href="https://doi.org/10.1016/j.amepre.2019.05.012">exercise regularly</a>, <a href="https://doi.org/10.1016/j.brat.2017.12.002">practice mindfulness</a>, <a href="https://theconversation.com/anxiety-and-depression-why-doctors-are-prescribing-gardening-rather-than-drugs-121841">spend time in nature</a> and <a href="https://doi.org/10.1186/1471-244X-8-41">employ relaxation techniques</a> when stressed. Prioritizing these behaviors during the coronavirus crisis can go a long way toward increasing your psychological well being and <a href="https://theconversation.com/a-strong-immune-system-helps-ward-off-colds-and-flus-but-its-not-the-only-factor-99512">bolstering your immune system</a>. 7. Seek professional help if you need it People who are vulnerable to anxiety and related disorders might find the coronavirus epidemic <a href="https://doi.org/10.1007/s10608-015-9701-9">particularly overwhelming</a>. Consequently, they might experience anxiety symptoms that interfere with work, maintaining close relationships, socializing or taking care of themselves and others. If this applies to you, please get professional help from your doctor or a mental health professional. <a href="https://doi.org/10.1016/j.psc.2010.04.002">Cognitive behavioral therapy</a> and <a href="https://doi.org/10.1002/msj.20041">certain medications</a> can successfully treat anxiety problems. Although you might feel helpless during this stressful time, following these strategies can help keep anxiety from becoming a problem in its own right and enable you to make it through the epidemic more effectively. <a href="https://theconversation.com/profiles/jelena-kecmanovic-472294">Jelena Kecmanovic</a>, Adjunct Professor of Psychology, <a href="https://theconversation.com/institutions/georgetown-university-1239">Georgetown University</a> This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/7-science-based-strategies-to-cope-with-coronavirus-anxiety-133207">original article</a>.

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