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The Health Wrap: coronavirus, other critical health issues, bushfires, music and the majestic mundane

In her latest edition of The Health Wrap, written from self-quarantine, Dr Lesley Russell aims not to cover the novel coronavirus pandemic in detail, given its saturation coverage elsewhere, though she notes a range of important issues, including mental health, equity in health care access, and the need to protect our democracy.

She is also concerned that many other critical health issues will go under the radar as this huge crisis consumes us, not least the impact of the devastating 2019-20 bushfires and a range of policies and programs that would have awaited now postponed May Budget announcements.

And the wrap has welcome good news: not just in the importance of the mundane in our lives, particularly at such a time, but also in how music can bring us together in newly discovered ways.


Lesley Russell writes:

I’m reporting in from self-quarantine in our Sydney home after arriving back from the United States last week, just ahead of the mandatory offsite quarantine requirement  and Qantas international flights ceasing.

We are well, suffering a little from cabin fever, and I’m missing my walks. A wonderful side-effect has been how many friends and even people we don’t know well have volunteered to help us out during this time. We will look for opportunities to do the same for others when our lock up time is done.

(Ed: Dr Lesley Russell has written on many of her long walks for Croakey, which can be read via our #CroakeyExplore category. They make great reading for those in quarantine and isolation).

Thoughts on the coronavirus pandemic

The coronavirus pandemic and its consequences have consumed the news recently. Little else is reported.

I am therefore deliberately not seeking to cover pandemic issues here: my Croakey colleagues are doing an excellent job of keeping on top of the huge amount of information, data, stories and problems that just come at us hour after hour.

Their articles are right at the top of this home page. In particular, health researcher Alison Barrett is collating a regular COVID-19 Wrap of research. The Conversation also has a good collation of their stories.

Other sources you might find useful are the daily situation reports from the Word Health Organization, the US Centers for Disease Control newsroom, journalist and communications consultant Juliette O’Brien’s website for Australian data, and the Australian Department of Health’s data reporting.

I can’t resist adding several points:

  1. Prime Minister Scott Morrison and Health Minister Greg Hunt today announced a major mental health, family violence and other emergency supports package. This recognises the need to address address elevated anxiety, isolation and loneliness fueled by the COVID-19 lockdown, the dreadful fact that for some people (especially women and children) experiencing family violence, home is not a safe place, the value of telehealth consultations, and the extra effort and risk for those doctors still doing necessary face-to-face consultations. 

    I haven’t had time to analyse this package, which you can find here. A recent media article indicated that the impact of coronavirus on mental health is seven times that of the bushfires. I don’t think that statement (not particularly scientifically based) should be used to downgrade the ongoing mental health issues from the bushfires, just to indicate the high levels of community concern – not helped by the Government’s confusing public pronouncements.

  2. I think Australians should push for a parliamentary oversight committee to operate while Parliament is risen over the next few months along the lines of that established in New Zealand. The New Zealand committee, bipartisan and chaired by an Opposition member, will act as a way to hold the Government to account while Parliament is not sitting by enabling the questioning of ministers and public servants on actions around the pandemic. The committee has special powers to summon people to present to the committee and answer questions about coronavirus, as well as the power to request papers and reports relating to the response. It will be livestreamed to the public.
  3. The pandemic is of course requiring all hands on deck in government, but it is critical that all other policy issues are not pushed aside, a concern that is aggravated here in Australia by the Morrison Government’s decision to delay the annual federal budget until October.

    What does this mean for initiatives that expire or need further funding at the start of the new financial year?  For example, what is happening with negotiations over the 7th Community Pharmacy Agreement, expected to cost some $20 billion? Someone somewhere in government needs to be thinking about these issues, telling us what is going on, and providing commitments for ongoing funding where these are needed.

  4. The pandemic raises a number of ethical issues that must be confronted. First, it highlights inequalities and, in the absence of action to address these (within nations and between nations), there will be a widening of the social and economic divisions that also make the virus deadlier. It becomes a self-reinforcing cycle that experts warn could have consequences for years to come (see for example this article).

    Second, if the healthcare system is overwhelmed by people with COVID-19 needing intensive care, then it is possible that not everyone will get the level of care they need. In Italy this is already the case; in New York state they are already debating how decisions about who gets ventilators might be made.

    I have written more about this in a piece published online this week. Is Australia ready to have these difficult public discussions and debates? It has been reported that Australians waiting for organ transplants might not get their needed surgery and precious donated organs will be discarded.

Imperative we don’t forget bushfires

It’s hard to believe that just two months ago we were overwhelmed by the bushfire crisis and its consequences.

Yet while people whose lives were irrevocably changed by the bushfires must get on with the exigencies of everyday life and the impact of coronavirus, this is a classic example of where government must walk and chew gum at the same time, dealing with the monumental issues around the pandemic and also the many issues that remain from the drought and the bushfires.   

You may remember that I spent a lot of words arguing that we needed to invest in long-term monitoring and research to better understand and address the health consequences (physical and mental) of the bushfires (see for example this piece). Research published this week in the Medical Journal of Australia gives some early understanding of what those health impacts have been to date.

The paper, entitled “Unprecedented smoke‐related health burden associated with the 2019–20 bushfires in eastern Australia”, estimated the numbers of excess deaths, hospitalisations for cardiovascular and respiratory problems, and emergency department presentations with asthma in NSW, Queensland, the ACT and Victoria between 1 October 2019 and 10 February 2020 that could be attributed to bushfire smoke exposure.

The research found that bushfire smoke was responsible for 417 excess deaths, 1,124 hospitalisations for cardiovascular problems, 2,027 hospitalisations for respiratory problems and 1,305 presentations to emergency departments for asthma. It did not attempt to estimate health effects for which exposure–response relationships are less well characterised, such as primary health care attendances and ambulance calls. 

An accompanying Insight article boosts my case, stating that: “Situational awareness of whole of community health impact is important during disasters as it contextualises health facility surveillance and may identify unmet needs and guide resource allocation.”

For example, current disease surveillance systems do not capture how many people in the community are suffering from smoke-related illnesses but not presenting to emergency departments or other health services. There is a need for flexible platforms to rapidly assess such health impacts at a community level across Australia after extreme events, which will only become more frequent due to climate change. 

Suicide reporting in the media

A systematic review and meta-analysis published last month by the British Medical Journal looks at the association between reporting on suicides, especially those of celebrities, and subsequent suicides in the general population.

The evidence indicates an increase in total suicides in the period after the reporting of a death of a celebrity by suicide. When the suicide method used by the celebrity was reported, evidence of a corresponding increase in the number of suicides by the same method was found.

Mental health and suicide prevention organisations worldwide have guidelines for responsible reporting of suicide by the media. See for example the beyondblue media guidelines.  

But specific information on individual deaths by suicide continues to be published; the paper cites the suicide of the actor Robin Williams as an example of the guidelines not being fully followed.

Did you know that media related imitation of suicide has been dubbed the Werther effect?

That’s based on a reported spike in suicides in young men in Germany and across Europe after the publication of Goethe’s The sorrows of young Werther in 1774, depicting the circumstances leading to the suicide of the male protagonist Werther.

Music  sparks synchronised brain activity

Something new out of China, and it’s not a virus, although it’s interesting enough to go viral.

We understand that when a musician is playing, they and the audience can develop physical synchronies, tapping their feet, or clapping their hands. Now a new paper from researchers in China shows a neural connection – a synchronisation in brain activity – between a musician and the audience. The researchers call this “inter-brain coherence”.  

The research used near-infrared spectroscopy (which involves shining beams of light through the skull to monitor blood flow) to look at the brain activity of a professional violinist and the audience while he was playing a series of 12 brief classical pieces.

There were similar patterns of heightened activity in certain key regions of the brain while the violinist played and the audience listened.

The key regions included the left temporal cortex (which is thought to focus on processing the rhythm of sound information), the right inferior frontal cortex and the postcentral cortices. These two latter regions have been highlighted as important hubs of a hypothesised mirror system that allows a sender and receiver to share brain representations.

The strength of this inter-brain coherence could be used to predict how much the audience enjoyed a piece. “This study expands our understanding of music appreciation,” the researchers write.

You can read a summary of the paper from the British Psychological Society here.

Not surprisingly, these sorts of results have previously been found for musicians playing together in an ensemble and for choristers. There’s further information about this in the introduction section to the original paper – although the rest of it I found very difficult to follow!

The good news story

Why Mundane Moments Truly Matter: “How we spend our days is how we spend our lives.”

I found this article in the The New York Times and it seemed appropriate for these times. It explores how paying attention to the mundane can help us hold on to what is important. Some of the discussion is about how we later recognise the value of the small everyday things that didn’t seem exceptional at the time. 

Much of this work is predicated around journaling and what people write in their daily diaries.

I was intrigued to learn that there is research to show introspective writing  can help reduce blood pressureincrease immune function and mitigate impacts of stressdepression and diseases ranging from to irritable bowel syndrome and breast cancer to asthma and rheumatoid arthritis.

So it’s about more than the ability to look back and be reminded of the small things that gave us joy.


Croakey thanks and acknowledges Dr Lesley Russell for providing this column as a probono service to our readers. Follow her on Twitter at @LRussellWolpe.

Previous editions of The Health Wrap can be read here.

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