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Does it matter if I have had COVID-19 and not realized it?

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In line with studies that report moderate to severe illness in a minority of people (usually older with other risk factors) and that up to one in three positive people exhibit no symptoms.

Given the ubiquitous presence of this highly infectious coronavirus in our community and the high rate of asymptomatic illness, those who have not been diagnosed with COVID might wonder, “how would I know if I had been infected?” And, “does it matter if I have?”.

 

 

How COVID-19 is diagnosed

At the beginning of 2022, many people with consistent symptoms or high-risk exposures were not able to access PCRs or RATs to confirm their diagnosis, but instead presumed themselves positive and quarantined.

It is possible to diagnose past infection in those who never tested positive. A blood test can look for SARS-CoV-2 antibodies (also known as immunoglobulins). When we are infected with SARS-CoV-2, our immune system launches a precision counter strike by producing antibodies against viral targets, specifically the Spike (S) and Nucleocapsid (N) proteins. COVID vaccination induces a similar immune response against the S protein only. The S antibody “neutralises” the invader by preventing the virus from attaching to human cells.

These antibodies can be detected within one to three weeks after infection and persist for at least six months – potentially much longer. A blood test that shows antibodies to S and N proteins indicates someone has been previously infected. Detection of antibodies to the S protein only indicates vaccination (but not infection).

 

 

The problem with antibody tests

Before you rush off to get a COVID antibody test, there are a few notes of caution. There is still much to learn about the characteristics of the immune response to COVID infection. Not everyone mounts a detectable antibody response following infection and levels can decline to undetectable levels after several months in some people.

Because there are other circulating seasonal coronaviruses (such as those that cause the common cold), tests may also pick up antibodies to non-SARS-CoV-2 strains, leading to “false positive” results.

Commercial and public hospital pathology labs can perform SARS-CoV-2 antibody testing, but the interpretation of results should be undertaken carefully.

So, antibody testing should really only be done when there’s a good reason to: say, when confirming past infection or effectiveness of vaccination is important for the current care of an individual. Diagnosing a post-infectious complication or eligibility for a specific treatment, for example. It could also be useful for contact tracing or for assessing the background population rate of infection.

 

 

Does it matter if I have had COVID and didn’t know?

For most people, knowing your COVID infection status is unlikely to be more than a topic of dinnertime conversation.

While some studies have pointed to a less robust and durable antibody response following mild or asymptomatic infection compared with severe illness, it is not known how this influences protection from reinfection. Certainly, the knowledge we have antibodies from past infection should not deter us from being fully up-to-date with COVID vaccination, which remains the best protection against severe illness.

There are reports of people with mild or asymptomatic COVID infection developing long COVID – new, persistent or relapsing symptoms that last four weeks or more after initial infection. Symptoms can include shortness of breath, physical and mental fatigue, exercise intolerance, headaches, and muscle and joint pain.

However, the likelihood of developing this condition appears higher in those who suffer a heavier initial bout of COVID illness. This might be linked with higher viral load at that time.

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5 steps in writing an effective e-mail

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  1. Keep your e-mails short

Less is more. The shorter you can keep your e-mail while still relaying your message or question the better. At most we suggest no more than three paragraphs of text.

 

  1. Make the subject line clear and easy to read

The subject of the e-mail should contain enough information to let the recipient know the contents of an e-mail.

 

  1. Make the e-mail personal

Always include the name or alias of the e-mail recipient. If you want the e-mail to be even more personal include your real name in the e-mail as well.

 

  1. Watch your spelling and grammar

E-mail with spelling and other grammatical errors tells the reader it’s not that important. Always spell check, keep the below suggestions in mind, and proofread the e-mail before sending it out.

– Always use proper punctuation and capitalization.

– Never use shorthand or acronyms people don’t understand.

– Do not WRITE IN ALL CAPS; it gives the impression you’re YELLING.

 

  1. Use a clean signature

Signatures is an effective method of displaying your contact information at the bottom of e-mails. However, follow e-mail signature etiquette when creating a signature.

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Is Australia a Covid success?

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The pandemic – and PM Scott Morrison’s handling of it – was once expected to be a central element of his campaign to be re-elected. But with the election just a week away, Covid seems to have taken a backseat in Australian politics.

Mr Morrison took credit for saving thousands of lives in his first campaign video – a reminder of 2020 when infections first gripped Europe and the US, but life in much of Australia largely went on as usual.

Australia was hailed as a Covid success story as days went by with zero cases. But as the pandemic h1as worn on, that theory has been put to test.

The initial success

When the first cases emerged in Australia, Mr Morrison’s government reacted quickly with strict measures that controlled its spread. Every state too adopted fast and firm lockdowns, test and trace protocols, social distancing and mask mandates to contain outbreaks.

The country shut its borders – Australians couldn’t leave without official permission and those allowed in had to go through a two-week hotel quarantine. When the vaccines arrived, the drive picked up after a slow start. Australia is now one of the most vaccinated countries in the world with 95% of its eligible population double-jabbed.

It has also recorded just over 7,000 Covid deaths to date – a small number compared to other developed nations. Last week, the World Health Organization found Australia had recorded fewer deaths in 2020 and 2021 – from Covid or otherwise – than it had in a normal year.

But Australia’s harsh border policies and lockdowns came at a huge cost. Tens of thousands of people were locked in or out of the country, separated from their families.

The restrictions, however, couldn’t stop the highly transmissible and vicious Delta variant from breaking through in the middle of 2021. Mr Morrison, who had frequently boasted of Australia’s success in controlling the virus’ spread, asked people to “hang in there”. And when he was criticised for the slow vaccine rollout, he made a now-infamous comment that it “isn’t a race”.

From control to crisis

But the Omicron variant brought fresh panic and the government was caught off-guard again.

Australia’s case count, which stood at nearly 400,000 cases by the end of 2021, jumped to 2.1 million over the next month. While deaths have remained relatively low, Australia has already had more than twice as many Covid deaths this year compared to 2020 and 2021 combined.

Australians had swung from one extreme to another. After months of restrictions, they were left to navigate the new reality of living with the virus on their own – and this was while cases soared.

People queued for hours at overwhelmed PCR testing clinics, only to be turned away in the end. Rapid antigen tests were expensive and not available for a time. Rules about what constituted a “close contact” were confusing and officials flip-flopped on mask and other safety mandates.

As staffing and supply chains suffered, supermarkets emptied out and businesses struggled to survive.

But one of the starkest failures happened in the aged care sector. It was already struggling, but Covid proved devastating. Three quarters of the 910 Covid deaths in 2020 were aged care residents, according to a review by Lyn Gilbert, honorary professor at the Faculty of Health and Medical Science in the University of Sydney.

 

Will Covid matter in this election?

Mr Morrison has at times used the campaign to talk up his economic handling of Covid. And his opponent, Anthony Albanese, used one question in a leader’s debate to get the prime minister to concede that his comment – “it’s not a race” – was miscalculated.

And yet, Covid has barely been mentioned otherwise. Professor “It’s somewhat surprising given that Australian news coverage for the last few years was dominated by Covid stories and different appraisals of state and federal government’s handling of the various aspects of Covid,” said Andrea Carson, associate professor of journalism and political science at La Trobe University.

Professor Carson added that data from a sample survey of 100,000 people by the national broadcaster ABC showed that Covid was a long way down the list of issues on voter’s minds.

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Living with Covid: Are Australians accepting people dying from Covid?

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We seem to be at the point in this pandemic where people die every day from COVID-19 … and we’re OK with that. Just last week, on average, 39 Australians died each day after catching the virus.

For example, just last week numerous videos circulated in the United States showing airline passengers cheering as the announcement was made that a federal judge had voided the mask mandate.

This is despite mask-wearing being one of the most effective ways of containing super-spreader events, according to epidemiologists like Saskia Popescu, who looked at the dropping of the mandate in despair. The US President’s chief medical adviser, Antony Fauci, said it was a decision a judge did not have the medical experience to make.

There have been similar scenes here in Australia as COVID-19 restrictions have been relaxed. Witness the jubilation at the lifting of the dancing ban in December, 2020 or the joyous airport reunions as the Queensland border opened to domestic hotspots in time for Christmas, 2021.

By that point Queensland had still only recorded seven COVID-related deaths. We all knew what was coming and yet we did it anyway. The eighth death was reported on January 7 and by yesterday the total number of deaths of people with COVID-19 in the state had reached 869.

The impact has been disproportionately felt by older people. The federal health department has broken down the number of deaths in Australia by age group and it shows almost 83 per cent were aged 70 years or older.

 

‘Learn to live with the virus’

Perhaps government messaging has been a factor. As the phrase “learn to live with the virus” became more and more common people may have thought the worst was past.

The requirement to use the QR check-in app to enter restaurants and retailers was dropped. Even if people did check in, they weren’t being contacted if it later emerged that a positive case was present at the same time.

On Thursday, the rules for close contacts changed meaning those who are asymptomatic no longer had to isolate for seven days. A day later, the Queensland government announced it had disbanded its central contact-tracing team after 15 months of work that involved tracking more than 15,000 contacts and 10,000 cases. This is while Queensland goes through an Omicron outbreak.

What has changed is our attitudes. The federal government read the room when they shut international borders. It is hard to imagine going back to these or other restrictions without significant pushback or disobedience.

 

Getting life ‘back to normal’

What seems more plausible is that with the passage of time and the gaining of knowledge about COVID-19, people have shifted the virus in their mind to be a given risk of life.

We could do more — wearing masks at all times, investing in air filtration to remove airborne virus particles, or reinstating restrictions on the unvaccinated – but we seem more interested in getting life “back to normal”. It is like our acceptance of influenza, which claimed 1,080 Australian lives in 2019.

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