Hating on the Woodville Pizza guy won’t fix a problem that was entirely foreseeable



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Gemma Beale, Flinders University

Over the course of a single week South Australia was plunged into one of the world’s strictest, and briefest, lockdowns.

The drama, estimated to have cost the state’s economy A$100 million, came down to pizza – specifically, fears the state’s outbreak of COVID-19 was an especially virulent strain transmissable by pizza boxes.

In the end it actually came down to a kitchen hand lying about having a second job at a pizzeria, rather than simply being a customer as he first told contact tracers.

South Australian premier Steven Marshall has said authorities will use “all and every avenue to throw the book at this person”. Members of South Australia Police’s “Taskforce Protect” have reportedly combed through hundreds of hours of CCTV and seized phones, a laptop and a hard drive “directly related to the person of interest”.

It is understandable state authorities would want to signal the importance of truthfulness in this scenario. But the instinct to grasp punitive measures fails to account for the cause of the problem.

This debacle again illustrates the problem of insecure and low-paid work, and the moral jeopardy it forces on hundreds of thousands of people really just trying to make ends meet.

We’ve seen this before, in Victoria, with the problem of nursing home staff and meat processing workers still going to work and not self-isolating despite having COVID symptoms.

Now South Australia has illuminated the problems of workers in “essential” jobs having to moonlight in second jobs, and perhaps feeling the need to lie about it.

We need a holistic response that considers the systemic reasons that force people into such situations to preserve their livelihood.




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Workplace transmissions: a predictable result of the class divide in worker rights


Holding down second jobs

At least two links in the chain of events leading to the South Australian outbreak highlight the problem of precarious and insecure work.

The first is how the pizzeria – the Woodville Pizza Bar – became a transmission vector.

That had to do with a kitchen hand at the pizzeria also working as a security guard at Peppers Hotel, one of the hotels being used to quarantine travellers returning to the state. He apparently caught the virus from a cleaner at the hotel, who caught it from a quarantined guest.

This part of the story has prompted calls for workers at quarantine hotels to be banned from from working second jobs.

To which the obvious retort should be: if we don’t want people to work two jobs, perhaps we should ensure they have enough hours and pay so they don’t need to.




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Uber drivers’ experience highlights the dead-end job prospects facing more Australian workers


Migrants in plight

The second link – the man who lied about working at the pizzeria – speaks to the predicament faced by tens of thousands of people in Australia on visas (in this case, a temporary graduate visa). In a bizarre coincidence, he too was working in the kitchen at another quarantine hotel (The Stamford).

There are an estimated 900,000 foreign nationals in Australia on visas with work rights, almost always with restrictions. The jobs they find are often insecure low-paid casual or gig jobs, possibly cash in hand.

Many of these jobs – in hospitality, for instance – were the first to disappear with lockdowns. And because they aren’t citizens, they have been excluded from federal government financial support.




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We’ve let wage exploitation become the default experience of migrant workers


Address the problem, not the symptoms

Sure lying is wrong – particularly if it shuts a city down.

But it should also be unsurprising in the face of fear – and fear of losing work is central to insecure work.

This is compounded for migrant workers by an additional fear: losing the right to stay in the country, through breaking rules that limit working hours. But they often have little choice, as the only way to make enough money to compensate for being exploited and often earning well below the minimum wage.

What has happened in South Australia is a symptom of the same problem that bedevilled Victoria’s outbreak. It should have been foreseeable. Researchers have been warning about the negatives for years. The pandemic has made them plain.

A punitive and knee-jerk call for punishment is at best another half measure. It won’t fix the systematic problem of precarious work.The Conversation

Gemma Beale, PhD Candidate, Flinders University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Pacific tourism is desperate for a vaccine and travel freedoms, but the industry must learn from this crisis



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Apisalome Movono, Massey University and Regina Scheyvens, Massey University

News of successful COVID-19 vaccine trials has raised hopes in the Pacific that the hard-hit tourism industry will begin to re-open in 2021.

Even before the vaccine announcements, there was excitement in the Cook Islands over a recent New Zealand government delegation to survey the country’s borders and discuss a potential travel bubble.

Cook Islands Private Sector Taskforce chairperson Fletcher Melvin spoke for many when he said:

The New Zealand officials are here, and that has been the biggest breakthrough for many, many months. We are hopeful they will get here and see we are prepared and confirm that we are COVID-free and we are ready to welcome Kiwis back to our shores.

At the same time, New Zealand Prime Minister Jacinda Ardern dampened hopes of a trans-Tasman bubble before Christmas due to different tolerances for community transmission in New Zealand and Australia.

Beyond the ongoing uncertainty, though, the possibility of a Cook Islands-New Zealand bubble raises further questions about how Pacific tourism can and should be revived in general.

Culture and commerce

Our research examines these questions and provides interesting insights into how Pacific peoples are re-imagining the place of tourism in their lives.

The global pandemic has effectively closed Pacific state borders to international tourists for eight months. With thousands of jobs gone and economies undermined, many people in Fiji, Vanuatu, Samoa, Cook Islands and beyond have had to make huge adjustments.




Read more:
Traditional skills help people on the tourism-deprived Pacific Islands survive the pandemic


In many cases, they have adapted to the lack of tourism income by drawing on their natural, cultural and spiritual resources. From this we can appreciate the strengths of Pacific cultures and how they might adapt to future uncertainties, including those associated with climate change.

Those affected by the pandemic now report wanting more time for family (including caring for the vulnerable), planting food and fishing, sharing surplus harvests, attending to cultural and religious obligations, relearning traditional skills and strengthening food systems.

Fale in Samoan village
Beyond the resort (Upolu, Samoa): Pacific communities have been resilient and adaptable.
GettyImages

Old ways should change

The crisis, while difficult, has allowed people to consider a more regenerative approach to tourism based on well-being and better work-life balance. As one Fijian elder put it:

Tourism must complement our way of life, rather than taking over.

The “old” tourism model is now seen by some as compromising their family’s well-being. Working long hours while commuting daily from a village to a hotel, or spending six weeks away from home at an island resort before getting one week off, is not ideal for parents of young children.

Many are on casual contracts and earn just above the minimum wage: FJ$2.68 (NZ$1.84) per hour in Fiji and NZ$7.60 per hour in Cook Islands.

Most tourism employees want tourism to return, but they hope for better terms, wages and working conditions. While a few called for caps on numbers in heavily touristed areas, others urged governments to open up new locations and promote off-season tourism.

People would also like to see greater local ownership and control of tourism enterprises, including joint ventures, building on existing strengths such as cultural or tropical garden tours and agri-tourism.

hands basket weaving
More local control of tourism ventures is called for, building on traditional skills and strengths.
Pedram Pirnia, Author provided

Life beyond tourism

Despite 73% of those surveyed living in households that experienced a major decline in income due to COVID-19, 38% were unsure about staying in tourism, or would prefer to find jobs in other areas.




Read more:
Sun, sand and uncertainty: the promise and peril of a Pacific tourism bubble


Those interviewed sought more opportunities to pursue higher education, training in IT and trades, and wanted greater government support for creative industries.

This need for economic diversification is acknowledged across the Pacific region. But there has been little progress or policy development by governments to diversify economies in meaningful ways during the pandemic.

Perhaps understandably, given the severe economic pressures, many governments have focused on returning to the way things were. Fiji has enthusiastically urged tourists to return, opening “blue lanes” for yachties and a “bula bubble” for wealthy travellers.

Towards a new model

In this context the pandemic is being seen as an interruption, albeit welcome in some ways, to business as usual. As one Cook Islands elder expressed it:

This time to me is about restoring and renewing things, relationships, and giving our environment time to restore and breathe again before it gets busy, because I’m optimistic we will come out of this. People want to travel.

However, the pandemic should also provide an opportunity for Pacific countries to reset and chart a new way forward. When travel bubbles do open, they should do so in a way that benefits Pacific peoples, complements their way of life, and builds resilience in the process.




Read more:
Why NZ’s tough coronavirus travel rules are crucial to protecting lives at home and across the Pacific


If and when Pacific travel is allowed again, the clear calls for culture and well-being to play a more central role in the lives of communities must be heard. One woman, a former resort employee in Fiji, put it well:

This break has given us a new breath of life. We have since analysed and pondered on what are the most important things in life apart from money. We have strengthened our relationships with friends and family, worked together, laughed and enjoyed each other’s company. We have strengthened our spiritual life and have never felt better after moving back to the village.The Conversation

Apisalome Movono, Senior Lecturer in Development Studies, Massey University and Regina Scheyvens, Professor of Development Studies, Massey University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Bad reactions to the COVID vaccine will be rare, but Australians deserve a proper compensation scheme



John Cairns/AP/AAP

Katie Attwell, University of Western Australia; Marco Rizzi, University of Western Australia, and Shevaun Drislane, University of Western Australia

This week brings more good news on the vaccination front, with reports that yet another COVID-19 vaccine trial has produced encouraging results.

According to the federal government, Australia is “on track” to administer the Oxford University AstraZeneca vaccine as early as March next year.




Read more:
Why the Oxford AstraZeneca vaccine is now a global gamechanger


This means we need to be thinking more carefully about how the roll-out will work. This includes looking at a no-fault compensation scheme in the rare and unlikely event someone is harmed by a COVID-19 vaccine.

Most Australians would get vaccinated … but not all

Many Australians will be eager to be vaccinated against COVID-19 as soon as possible. Research in April found nearly 86% of Australian adults surveyed would have a vaccine.

But a significant proportion of people are either unsure about the COVID-19 vaccine, or say they would not have one. This could affect the uptake rates needed for community protection.

Prime Minister Scott Morrison visiting a lab in Melbourne.
CSL in Melbourne has already begun manufacturing the AstraZeneca vaccine.
Darrian Traynor/AAP

In October, a survey done for the ABC also found only 70% of respondents thought a vaccine would be “safe” or “mostly safe”.

Vaccines are rigorously tested and monitored for safety prior to, during, and after administration. But most of us have not given these background processes much thought until recently.

Adverse reactions to vaccination are typically minor, such as brief soreness at the injection site. Sometimes a reaction will need medical attention and cause a short or long-term health impairment. A serious adverse reaction following vaccination is extraordinarily rare.

For Australians who would not automatically get a COVID vaccine, their trust and confidence in both the vaccine and the system could be bolstered if they knew they would be taken care of in the extremely unlikely event of a serious adverse reaction.

Existing protections are not good enough

In the recent federal budget, the government promised to indemnify vaccine manufacturers if members of the public were to sue following an adverse reaction.

This would make the companies feel safe about operating in the country. However, it is a missed opportunity to also make the public feel safe about what would happen following an adverse event.




Read more:
Who pays compensation if a COVID-19 vaccine has rare side-effects? Here’s the little we know about Australia’s new deal


Usually, an injured victim must bring a case to court in order to receive compensation. To win, the victim must demonstrate they suffered a harm, the defendant was at fault, and there is a causal connection between the defendant’s fault and the harm. This is more complex than it sounds.

For example, victims of the recent pelvic mesh implant scandal had to initiate a class action, which has been going since 2012. Victims are still waiting for compensation.

A further problem is that when it comes to vaccinations, extremely rare adverse reactions often occur without negligence. This means there is no one to sue.

Why a no-fault scheme makes sense

A no-fault compensation scheme removes both the adversarial nature of litigation and the onerous requirement of establishing fault.

An injured party is only required to demonstrate they suffered a harm and some form of causal link between the harm and the vaccine.

These schemes already exist in most high-income countries — including the United Kingdom, United States and New Zealand — for non-COVID vaccines.

However, to date, Australia has not had a no-fault compensation scheme for vaccine injury, despite policies that compel Australians to vaccinate their children.

Other countries are leading the way

The lack of no-fault scheme in Australia is problematic in general. In the current pandemic, this policy gap is even more of a concern.

The COVID-19 vaccine will need to meet rigorous safety and efficacy criteria to be approved in Australia. However, the truncated timeframe for its development means governments need to be prepared for any unknowns.

A woman receives a jab.
Experts in the UK are also looking at a specific compensation scheme for a COVID vaccine.
John Cairns/AP/AAP

Some might conclude the National Disability Insurance Scheme could take care of anybody who suffered an adverse event following vaccination. However, the NDIS follows fundamentally different logic, in that it provides services for people living with disability, rather than compensating for an injury.

Other countries with existing no-fault compensation schemes are on the front foot to deal with this issue. So far, some experts in the UK have called for a “bespoke” scheme just for a COVID vaccine rather than using existing systems. This is because the rare adverse events that may follow COVID-19 vaccination are as yet unknown.

So, how should Australia design one?

The roll-out of a COVID-19 vaccine provides a unique opportunity for Australia to implement either a standalone scheme for COVID-19 in the first instance, or move straight to a more comprehensive scheme to cover all vaccines.

There are numerous funding options available. We believe this should be funded out of general government revenue — through the tax system — as this can be targeted towards different incomes and reflects the fact it is a common good.




Read more:
How to read results from COVID vaccine trials like a pro


There are risks in implementing a no-fault compensation scheme, either for routine vaccination or COVID-19. In the US and the UK, such schemes have not necessarily reassured people about vaccine safety, and in some cases have created narratives for anti-vax activists (that certain vaccines are “dangerous”).

However, the absence of such a scheme leaves our country open to scare campaigns about unforeseen injuries. This could place our entire vaccination program in jeopardy.

Aside from the damage of a “bad news” story, we also need to make sure people are properly compensated if they are the rare victims of a vaccine that benefits everybody.

The time of thinking about vaccination as an individual matter is over. Similarly, it is time to stop leaving the rare risk of vaccine injury as a burden on individuals.The Conversation

Katie Attwell, Senior Lecturer, University of Western Australia; Marco Rizzi, Senior Lecturer, University of Western Australia, and Shevaun Drislane, PhD Candidate in Political Science, University of Western Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

When health workers came up against COVID it laid bare gaps in their training



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Jed Montayre, Western Sydney University and Yenna Salamonson, Western Sydney University

COVID-19 turned 2020 on its head for all healthcare workers, particularly those at the front line of the pandemic response.

Unexpectedly, the need to control the spread of the coronavirus has consumed healthcare systems. The healthcare workforce’s pivotal role in our pandemic response has been in the public spotlight. The experience has exposed knowledge gaps in curriculums, bringing to the fore questions about the education and training of front line healthcare workers.

The pandemic has highlighted the importance of including infection control, mental healthcare and ageing and aged care in all educational programs for health professions.

Infection control

All healthcare disciplines are expected to include infection control contents and principles in the curriculum. However, the teaching of this content was not designed to address a pandemic of historic proportions. Nor are healthcare workers specifically taught to apply infection controls in their workplaces with a pandemic in mind.




Read more:
Rising coronavirus cases among Victorian health workers could threaten our pandemic response


Infection control protocol during this pandemic requires all front-line healthcare workers to wear protective personal equipment, observe strict hand hygiene and adhere to contact-tracing measures.

In addition to including the classic “chain of infection” in teaching healthcare, we need to ensure students can apply these concepts in specific clinical settings. For example, aged care homes have a different set of infection control challenges from hospitals. These include potential breaches of isolation and infection containment measures by COVID-positive residents visiting other residents, a lack of dedicated isolation rooms and staff with limited training.




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Infection control goes beyond competence in the use of protective gear and isolation measures. Management skills are needed to ensure everyone follows recommended infection control practices within their organisations.

For example, registered nurses in aged care must oversee and manage staff adherence to infection control protocols with their facility. These workers include students, cooks and cleaners, so they too must have the essential infection control knowledge and training.

Aged care residents smiling as they exercise
Aged care homes that acted decisively to implement measures appropriate for a pandemic protected their residents from COVID-19.
belushi/Shutterstock

Ageing and aged care

Older people are unquestionably at greater risk of serious illness or death from COVID-19. To protect them, visits by family and friends are often curtailed, particularly in residential aged care facilities. Not surprisingly, loneliness and social isolation are increasing among older people.




Read more:
Social isolation: The COVID-19 pandemic’s hidden health risk for older adults, and how to manage it


Psychosocial issues like these underscore the importance of a focus on ageing and aged care in healthcare curriculums. In Australia, pre-pandemic evidence indicated a lack of ageing-related education for health professionals. This was highlighted by the Aged Care Royal Commission recommendation to integrate age-related conditions and aged care into healthcare curriculums as an accreditation requirement.

In the context of the COVID-19 pandemic, it is crucial that healthcare students are well prepared to provide optimal care for our most vulnerable age group.

Mental health

The mental health impacts of COVID-19 have affected all population groups. Preventing further mental health issues is now the main goal.




Read more:
We can’t ignore mental illness prevention in a COVID-19 world


However, not all healthcare programs include content that incorporates approaches to psychological distress and a potential mental health crisis. COVID-19 has exposed this gap in the education of healthcare workers who have had to attend to patients’ mental health needs during the pandemic.

Lonely older man looking out of window
The lack of social contacts under COVID-19 restrictions has been challenging for people’s mental health.
Photographee.eu/Shutterstock

Education and training are essential as complex challenges can arise when non-expert healthcare workers manage mental health issues. There’s a need to consider the inclusion in healthcare curriculums of mental health education encompassing the lifespan and life transitions – for example, maternal mental health with pregnancy and childbirth during a pandemic.

Building in pandemic preparedness

The emergence of COVID-19 has highlighted the need for healthcare curriculums to include pandemic preparedness.

Preparedness of course includes clinical competence of healthcare workers. However, a successful pandemic response also requires building resilience at a time of change in health systems. Students need to be prepared for changes in health-service delivery such as the use of telehealth and digital platforms.

Access to healthcare must be maintained even in the midst of a pandemic.




Read more:
Even in a pandemic, continue with routine health care and don’t ignore a medical emergency


Upholding human rights

COVID-19 has raised ethical and moral issues relating to the rights of every individual to health. The pandemic has exposed inequalities at every level – for example, rationing healthcare resources for older people. It’s vital that healthcare curriculums integrate content on upholding human rights during a pandemic.

Understanding the social determinants of health in a pandemic also helps provide contexts for infection control, care for vulnerable groups and prevention of mental health issues.

Attention to the most vulnerable groups, people and their families who experienced COVID-19 deaths, and an understanding of universal health coverage are fundamental for healthcare students during this pandemic and beyond.The Conversation

Jed Montayre, Senior Lecturer (Nursing), Western Sydney University and Yenna Salamonson, Professor in Nursing, Western Sydney University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

We asked over 2,000 Australian parents how they fared in lockdown. Here’s what they said



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Subhadra Evans, Deakin University; Antonina Mikocka-Walus, Deakin University, and Elizabeth Westrupp, Deakin University

Parents have faced unprecedented stress during the pandemic as they care for children while juggling paid work from home.

However, very little research so far has focused on family well-being during the pandemic.

So we asked more than 2,000 parents to tell us in their own words about the pandemic’s impact on their families. We did this in April 2020, during Australia’s first lockdown. Our published study is the largest of its kind in Australia, and one of very few internationally looking into families’ experiences of the pandemic.

Families’ responses followed six key themes.

1. Boredom, depression and mental health

Parents reported a spectrum of emotions. They said they and their children were stressed, trapped and bored. New and existing mental health conditions also challenged the equilibrium in a number of families. One mother of two children said:

My mental health has taken a really bad hit and I’m struggling to support my children.

2. Families missed things that keep them healthy

Families missed sport, extracurricular activities, visits with family and friends, playgrounds, places of worship, trips to connect with the natural world, and other family supports. A mother of three children said:

We used to see family, friends, go to church and do kids’ activities like playgroup a lot […] Cutting all of that out to stay home has been hard. We miss being able to see our family and friends, to do activities outside of home that are more than a walk around the block. We’re all tense and exhausted.

3. Changing family relationships

Family relationships changed, which we called the “push-pull of intimacy”.

Strained relationships were common, including increased conflict and arguments between parents, parents and children, and between siblings.

The demands of caring for children was a source of discord, requiring more from already exhausted parents or creating tension in the family as a result of bickering and fighting as a result of being “cooped up”. One mother of two said:

We have too much time together. We are often irritable with each other. My child wants more social interaction from me that I can’t give.

For many, there was a sense that goodwill between family members was “wearing thin”. But in some families, closer bonds emerged. A father of three said:

It’s been great. Lots of quality time together.

Father holding birthday cake in front of computer screen with children for a Zoom birthday party
Families faced many new challenges during lockdown.
Shutterstock

4. The unprecedented demands of parenthood

The loss of important structures in the community, particularly schools, reveals the extent to which such institutions play a pivotal role in raising healthy families and children, with parents alone unable to provide the proverbial village that children need. A mother of three said:

COVID-19 had turned me into a stay-at-home mum, primary teacher, speech therapist, occupational therapist, strict budgeter, with no social outlet or relief. And I’m doing this alone with my health-care worker husband being overworked.

5. The unequal burden

For people with physical or mental health conditions, lockdown restrictions were especially hard to endure. A father of one child told us about his family’s experience of being confined to a small space:

My wife is on the spectrum which makes being in a confined space with others quite difficult for her — and those around her. Confined space gives her little room for calming, so her anger events have increased.

Families living in small apartments with limited outdoor space were also highly challenged, using words such as “suffocating” and “going insane”. Families facing economic worries were also a group in need. A single mother of two children said:

Shopping alone is now a huge stress as I don’t want to expose my babies […T]he price rise in food has caused us now to only be able to buy enough food for a week so we are having less in each meal to ensure the children eat three meals a day. Most days I now miss meals so they can eat.

6. Holding on to positivity

Parents told us the pandemic provided an opportunity to cultivate “appreciation”, “tolerance and understanding” as well as “learning to cope and develop patience”.

Some parents said they were grateful for what they had and were relatively fortunate compared with others.

Parents were also grateful for access to the internet, a safe space to call home, enough food to eat, time to spend together, good health, financial stability and “having enough”. One mother of two children said:

I was quite panicked to begin with, but the kids love being with us all the time and are building relationships with each other.




Read more:
It’s OK to be OK: how to stop feeling ‘survivor guilt’ during COVID-19


Why these findings matter

Our large, diverse sample of Australian parents captured a range of experiences. Although more than 80% of our participants were mothers, we also heard fathers’ experiences.

Some of these experiences are likely to be similar to those of families around the world. However, the Australian experience may also be unique. Coming out of a tragic season of bushfires, many families may have already had stretched emotional and financial resources to handle another crisis.

The unique experiences of Victorian families, who endured a second period of longer and harsher lockdown, are worthy of follow-up research, as their resilience was likely pushed to the limit.

COVID-19 is not over, and we need to continue to ask parents and individuals how they are doing. Studies like ours, together with those comparing family experiences around the world, will also help researchers, policymakers, and service providers understand how to preserve community and family supports if we have future lockdowns or pandemics.


If this article has raised issues for you, or if you’re concerned about someone
you know, call Lifeline on 13 11 14.
The Conversation

Subhadra Evans, Senior lecturer, Psychology, Deakin University; Antonina Mikocka-Walus, Associate Professor in Health Psychology, Deakin University, and Elizabeth Westrupp, Senior Lecturer in Psychology, Deakin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Children may transmit coronavirus at the same rate as adults: what we now know about schools and COVID-19



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Zoë Hyde, University of Western Australia

The role children, and consequently schools, play in the COVID-19 pandemic has been hard to work out, but that puzzle is now finally starting to be solved.

The latest research shows infections in children frequently go undetected, and that children are just as susceptible as adults to infection. Children likely transmit the virus at a similar rate to adults as well.

While children are thankfully much less likely than adults to get seriously ill, the same isn’t true for the adults that care for them. Evidence suggests schools have been a driver of the second wave in Europe and elsewhere. This means the safety of schools needs an urgent rethink.

It’s hard to detect COVID-19 in children

Infections with SARS-CoV-2, the virus that causes COVID-19, in children are generally much more mild than in adults and easy to overlook. A study from South Korea found the majority of children had symptoms mild enough to go unrecognised, and only 9% were diagnosed at the time of symptom onset.

Researchers used an antibody test (which can detect if a person had the virus previously and recovered) to screen a representative sample of nearly 12,000 children from the general population in Germany. They found the majority of cases in children had been missed. In itself, that’s not surprising, because many cases in adults are missed, too.

But what made this study important, was that it showed young and older children were similarly likely to have been infected.

Official testing in Germany had suggested young children were much less likely to be infected than teenagers, but this wasn’t true. Younger children with infections just weren’t getting tested. The study also found nearly half of infected children were asymptomatic. This is about twice what’s typically seen in adults.

But children do transmit the virus

We’ve known for a while that around the same amount of viral genetic material can be found in the nose and throat of both children and adults.

But that doesn’t necessarily mean children will transmit the same way adults do. Because children have a smaller lung capacity and are less likely to have symptoms, they might release less virus into the environment.

However, a new study conducted by the US Centers for Disease Control and Prevention (CDC) found children and adults were similarly likely to transmit the virus to their household contacts.

Another study, of more than 84,000 cases and their close contacts, in India found children and young adults were especially likely to transmit the virus.




Read more:
Children might play a bigger role in COVID transmission than first thought. Schools must prepare


Most of the children in these studies likely had symptoms. So, it’s unclear if asymptomatic children transmit the virus in the same way.

But outbreaks in childcare centres have shown transmission by children who don’t show symptoms still occurs. During an outbreak at two childcare centres in Utah, asymptomatic children transmitted the virus to their family members, which resulted in the hospitalisation of one parent.

What we know about outbreaks in Australian schools

Schools didn’t appear to be a major driver of the epidemic in Victoria, although most students switched to remote learning around the peak of the second wave.

However, schools did contribute to community transmission to some extent. This was made clear by the Al-Taqwa College cluster, which was linked to outbreaks in Melbourne’s public housing towers.

When researchers analysed cases in Victorian schools that occurred between the start of the epidemic and the end of August 2020, they found infections in schools mirrored what was happening in the community overall. They also found 66% of all infections in schools were limited to a single person.




Read more:
Behind Victoria’s decision to open primary schools to all students: report shows COVID transmission is rare


A closed-school sign on the gate.
Most students in Victoria switched to remote learning at the peak of the second wave.
Shutterstock

This might seem encouraging, but we have to remember this virus is characterised by superspreading events. We now know that about 10% of infected people are responsible for about 80% of secondary COVID-19 cases.

Two major studies from Hong Kong and India revealed about 70% of people didn’t transmit the virus to anyone. The problem, is the remainder can potentially infect a lot of people.

What happened in Victorian schools was entirely consistent with this.

The risk associated with schools rises with the level of community transmission. The picture internationally has made this clear.

What we know about outbreaks in schools, internationally

After schools reopened in Montreal, Canada, school clusters quickly outnumbered those in workplaces and health-care settings combined. President of the Quebec Association of Infectious Disease Microbiologists, Karl Weiss, said

Schools were the driver to start the second wave in Quebec, although the government did not recognise it.

A report by Israel’s Ministry of Health concluded school reopening played at least some role in accelerating the epidemic there, and that schools may contribute to the spread of the virus unless community transmission is low. In the Czech Republic, a rapid surge in cases following the reopening of schools prompted the mayor of Prague to describe schools as “COVID trading exchanges”.

The opposite pattern has been seen when schools have closed. England just witnessed a drop in new cases, followed by a return to growth, coinciding with the half-term school holidays. This was before any lockdown measures were introduced in the country.

These observations are consistent with a study examining the effect of imposing and lifting different restrictions in 131 countries. Researchers found school closures were associated with a reduction in R — the measure of how fast the virus is spreading — while reopening schools was associated with an increase.

The risk has been spelled out most clearly by the president of the Robert Koch Institute, Germany’s equivalent of the US Centers for Disease Control and Prevention. Last week, he reported the virus is being carried into schools, and also back out into the community.

What we need to do

It won’t be possible to control the pandemic if we don’t fully address transmission by children. This means we need to take a proactive approach to schools.

At a minimum, precautionary measures should include the use of face masks by staff and students (including primary school students). Schools should also improve ventilation and indoor air quality, reduce class sizes, and ensure kids and staff practise hand hygiene.

School closures have a role to play as well. But they must be carefully considered because of the harms associated with them. But these harms are likely outweighed by the harms of an unmitigated epidemic.




Read more:
From WW2 to Ebola: what we know about the long-term effects of school closures


In regions with high levels of community transmission, temporary school closures should be considered. While a lockdown without school closures can probably still reduce transmission, it is unlikely to be maximally effective.The Conversation

Zoë Hyde, Epidemiologist, University of Western Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Scott Morrison’s message to China: Don’t pigeonhole us




Michelle Grattan, University of Canberra

Australia’s actions should not be seen just through the lens of the strategic competition between China and the United States, Scott Morrison has said in a speech rejecting “binary choices”.

With China casting Australia as an extension of America, disrupting trade, and citing multiple grievances, Morrison reaffirmed the importance Australia put on wanting a positive bilateral relationship.

“Australia desires an open, transparent and mutually beneficial relationship with China as our largest trading partner, where there are strong people-to-people ties, complementary economies and a shared interest in regional development and wellbeing, especially in the emerging economies of Southeast Asia,” he said.

Equally, Australia was “absolutely committed” to its alliance with the United States, based on a shared world view, liberal democratic values and market-based economics.

“And at all times we must be true to our values and the protection of our own sovereignty.”

He acknowledged the global competition between China and the US “presents new challenges, especially for nation states in the Indo-Pacific”. Like other countries in the region “our preference is not to be forced into binary choices”.

Addressing the British Policy Exchange on Monday night, Morrison warned that “our present challenge in the Indo-Pacific is the foretaste for so many others around the world, including the United Kingdom and Europe.”

Australia’s pursuit of its interests in the midst of the China-US strategic competition was made more complex by the assumptions made about its actions, he said.

“Our actions are wrongly seen and interpreted by some only through the lens of the strategic competition between China and the United States.

“It’s as if Australia does not have its own unique interests or views as an independent sovereign state. This is false and needlessly deteriorates relationships.

“If we are to avoid a new era of polarisation, then in the decades ahead, there must be a more nuanced appreciation of individual states’ interests in how they deal with the major powers. Stark choices are in no-one’s interests.

“Greater latitude will be required from the world’s largest powers to accommodate the individual interests of their partners and allies. We all need a bit more room to move,” Morrison said.

He said international institutions also had an important role as circuit breakers. “To provide the space and frameworks for meaningful and positive interaction to be maintained, as a bulwark against any emerging divide.”

Morrison talked up the role the OECD had to play “in support of open trade and market-based principles”. The Australian government is currently running a strong campaign to try to have former finance minister Mathias Cormann elected secretary-general of the OECD.

Morrison also noted the importance of the World Trade Organisation in promoting shared interests, as well as the G7-plus, and the Five-Eyes arrangement, where co-operation had extended beyond traditional security to the economic realm.

He lamented that “two of the most important economies in the region – the United States and India” had decided not to joint the Trans-Pacific Partnership and the recently-concluded Regional Comprehensive Economic Partnership respectively.

“Of course, we respect those decisions. But they both remain welcome to join. Our response is straightforward.

“Working with our partners, we plan to make the TPP such a powerful force for open trade and investment that the US and, in the future, India and others will join without reservation. And that includes the UK.

“Interestingly, [China’s] President Xi Jinping has also now expressed interest in possible participation in the TPP,” Morrison said.

“The critical thing about the TPP is that it developed WTO-plus disciplines in key areas of intellectual property, digital commerce and state-owned enterprises.

“These are some of the areas where the WTO has fallen short.”The Conversation

Michelle Grattan, Professorial Fellow, University of Canberra

This article is republished from The Conversation under a Creative Commons license. Read the original article.

COVID has presented unique challenges for people with eating disorders. They’ll need support beyond the pandemic



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Laura Hart, University of Melbourne and Andrea Phillipou, Swinburne University of Technology

COVID-19 has changed the way we live, work and interact with one another. It has also changed the way we move, exercise, shop, prepare food, and eat.

During the pandemic, we’ve seen marked increases in reports of mental distress across the board. But Australian and international research suggests lockdown measures have presented unique challenges for people living with eating disorders.

Eating disorders are complex mental illnesses

Eating disorders include anorexia nervosa, bulimia nervosa, binge eating disorder and other diagnoses. They centre around disordered eating (for example, fasting and dieting, binge eating, or purging behaviours), and often include problems with body image.

Eating disorders are frequently associated with high levels of depression and anxiety.

For some people with these conditions, rigid routines (around exercise, food preparation or eating habits), are a way of coping with symptoms and distress.

It’s no secret the pandemic has significantly disrupted our usual routines. For example, working from home may have led people to be more sedentary, or allowed more time for exercise. Social distancing has meant we’ve spent less time seeing others and sharing meals.

A man and a woman are eating in a cafe, but the man is disinterested in his food.
People of different ages, genders and backgrounds can develop eating disorders.
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COVID-19 restrictions and social distancing measures, though imperative to reduce the spread of the virus, have resulted in a significant rise in psychological distress, especially for people experiencing social isolation, reduced or uncertain employment, financial strain, or health concerns.

We know people with existing mental health problems have been particularly vulnerable. However, people with eating disorders are vulnerable not only to these mental stressors; but also to the physical changes to everyday routines, and social conversations about eating and body weight which have popped up during lockdowns.




Read more:
How many people have eating disorders? We don’t really know, and that’s a worry


What does the research say?

Research published early in the pandemic predicted COVID-19 and the associated restrictions may increase eating disorder risk in a few important ways:

  • disruptions to daily routines and reduced access to social supports

  • increased exposure to anxiety-provoking media (messages about possible links between high body mass index and COVID, or joking on social media about weight gain during lockdown)

  • increased use of videoconferencing where people are exposed to their own image on camera

  • anxiety about contracting COVID-19 — the authors suggested this may lead people with eating disorders to engage in dieting for perceived immune system benefits.




Read more:
Greater needs, but poorer access to services: why COVID mental health measures must target disadvantaged areas


Australian researchers conducted what was to our knowledge the first published study on disordered eating behaviours during COVID-19. Participants with eating disorders reported a worsening of symptoms — they were restricting their food consumption, binge eating and engaging in purging behaviours more often. They also reported doing more exercise, and high levels of depression, anxiety and stress.

Studies from around the world have since shown similar results. They’ve also found people with eating disorders have reported increased fears about not being able to find foods consistent with meal plans, while disruptions to routine have led to heightened psychological distress and worsening of eating disorder symptoms.

It comes as little surprise demand for eating disorder support has increased significantly. The Butterfly Foundation — Australia’s leading support organisation for people affected by eating disorders and body image issues — has reported a 57% increase in calls to its helpline over the course of the pandemic.

Similarly, inpatient and outpatient services around Australia — particularly in Victoria where residents experienced a prolonged second lockdown — have seen demand increase, resulting in longer wait lists for eating disorder services.

A group counselling session.
People with eating disorders are likely to need extra support beyond the pandemic.
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Looking ahead

Although we still don’t know what the long-term psychological effects of COVID-19 will be, previous pandemics such as SARS have taught us these sorts of crises can result in long-term mental health impacts, and may trigger the onset of mental illness, including depression and anxiety.

We don’t know yet conclusively whether the pandemic has triggered the onset of eating disorder symptoms or increased the incidence of these conditions. It doesn’t make it any easier that our understanding of the prevalence of eating disorders in Australia was poor to begin with.

But it does seem highly likely that we will see such increases. The information we have so far suggests pandemic-related challenges can increase the risk for people with eating disorders, or those who may be vulnerable to developing them, in many and varied ways.




Read more:
People with eating disorders saw their symptoms worsen during the pandemic – new study


In addition, some research suggests food insecurity is associated with increases in eating disorders, and binge eating in particular.

So even if the pandemic is brought to an end with widespread vaccination, if the associated economic recession results in ongoing disruptions to food supply chains, or in impoverished households having limited or unreliable access to food, we may see further increases in eating disorders, well beyond the life of COVID-19.

It’s critical clinical services and support organisations provide extra support to these groups, not only during the pandemic, but for a significant amount of time after the crisis has resolved. This includes increased access to treatment, as well as online eating disorder supports like chatbots, and telephone hotlines.


If this article has raised concerns about body image or eating disorders, please contact the Butterfly Foundation national hotline on 1800 334 673, or visit their website.The Conversation

Laura Hart, Senior Research Fellow, University of Melbourne and Andrea Phillipou, Senior Research Fellow, Swinburne University of Technology

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Is Trump’s truculence an attempted coup or the last-ditch efforts of a man whose star is fading?


Daniel Cooper, Griffith University and Brendon O’Connor, University of Sydney

US President Donald Trump’s time in the White House is coming to an end. But, as has become obvious over the past few weeks, he is unlikely to deliver a gracious concession speech.

Instead, the president has spent much of his time since the November 3 election plotting ways to undo what has turned out to be a rather clear victory for President-elect Joe Biden — all credible media outlets have given Biden 306 electoral college votes to the outgoing president’s 232. The successful candidate needs to amass 270 electoral college votes to win the presidency.




Read more:
Joe Biden wins US presidential election as mail-in votes turn key states around


Time is simply running out for Trump. By December 8, all states are required to certify their results, with the electors in each state to cast their votes by December 14. The inauguration of the next president takes place on January 20 2021.

None of this should obscure the anti-democratic coup d’état Trump is attempting as he refuses to concede defeat. However, it is unlikely to succeed.

His legal challenges alleging fraud and misconduct are close to running their course. The Pennsylvania Supreme Court ruled against his claim that election “observers” were too far away in Philadelphia from workers counting ballots. In Georgia, a hand recount has finished with Biden confirmed the victor. And Michigan lawmakers appear ready to defy the president, who now seems intent on wreaking havoc on the certification process.

Trump’s efforts to undermine the legitimacy of the election are real. His attempt to influence Republican state legislators, in effect to persuade them to replace electors committed to voting for Biden with electors ready to vote for Trump, is profoundly undemocratic. Under a winner-takes-all system, Michigan’s 16 electoral college votes should be going to President-elect Biden, the clear winner of the state by almost three percentage points.

If Trump had succeeded in overturning the results, one could go as far as questioning America’s status as a liberal democracy. Not since Southern secessionists contested the legitimacy of Abraham Lincoln’s election in 1860 has a single actor been so nefarious in their attempts to undermine an incoming president.

Look no further than Trump’s actions on the transition. With over 250,000 Americans dead from COVID-19, and case numbers exploding around the country, one would think an orderly transition in which the incoming president is given access to experts knowledgeable about the country’s readiness for mass distribution of a COVID-19 vaccine would be an urgent and unquestioned priority.

But not in Trump’s White House. The General Services Administration, run by a political appointee of the president, must certify Biden as the winner before the incoming administration is given access to top public health officials.

Such certification will eventually take place, as the president simply runs out of options. We suspect he will grudgingly acknowledge he will not be president for the next four years, repeating a never-ending series of fabrications about the legitimacy of the 2020 election. His arguments will resonate with his “base” and will have consequences beyond this election cycle.

Trump supporters continue to rally in protest against the election result.
Jay Janner/AP/AAP

Analysis by the Pew Research Center finds:

While a 59% majority of all voters say elections in the United States were run and administered well, just 21% of Trump supporters have a positive view of how elections were administered nationally. Among Biden supporters, 94% say the elections were run and administered well.

The magnitude of these differences is stark and suggests Biden will have much work to do in bringing the country together — if indeed that is possible. Biden himself is attempting to restore moral leadership to a country torn apart by pandemic, racial division and illiberal tendencies in the executive branch of government.

Rhetorically, Biden has hit many of the right notes, emphasising themes of unity and national healing. How this will play out in a policy sense will be seen once he takes office.

Despite Trump’s attempts to thwart him, Biden is going ahead with a calm and determined transition.
Alex Brandon/AP/AAP

Of course, Trump will continue to make life difficult for the incoming Biden administration. Some reports suggest he is already considering running for office in 2024.

So, it should not be surprising if the outgoing president leaves a number of surprises for President-elect Biden. Some press reports in the US are stating that on Middle East policy, trade with China, securing oil drilling leases in Alaska, and the Iran nuclear deal — which Biden may wish to rejoin — the Trump team is doing its best to reduce the incoming administration’s policy options.

Political theorist David Runciman argues that in democracies molehills are often made out of mountains. Vote counting, constantly updating vote tallies, failed legal challenges, recounts, the wearing effects of days of politics dominating life, Biden’s non-spectacular calmness, certification and the meeting of the Electoral College will turn this post-election mountain into a molehill as Trump’s attempted coup will eventually fail.




Read more:
Joe Biden wins the election, and now has to fight the one thing Americans agree on: the nation’s deep division


However, Trump has regularly shown us that, in the internet age, mountains can also be made out of molehills. The president’s lies and tweets have turned his presidency into a kind of reality TV show that has in turns transfixed, energised or horrified much of the world. Nevertheless, the show is in its final season and has not been renewed.

We are reminded of an article Rebecca Solnit wrote during the earliest days of the Trump presidency. In it, she presciently captures the predicament in which Trump now finds himself. Although his base and a large number of Republicans still support him, Trump has always surrounded himself with loyal followers reluctant to question their leader’s judgment and authority. This produces a form of isolation that is of Trump’s own making, a consequence of the man’s temperament and unwillingness to tolerate uncomfortable truths.

Reflecting on Trump-like leaders, Solnit explained:

In the end there is no one else in their world, because when you are not willing to hear how others feel, what others need, when you do not care, you are not willing to acknowledge others’ existence. That’s how it’s lonely at the top. It is as if these petty tyrants live in a world without honest mirrors, without others, without gravity, and they are buffered from the consequences of their failures.

Of course, sooner or later Trump will realise the presidency must be vacated. He will have to face the one thing in his life he has always tried to avoid: defeat.The Conversation

Daniel Cooper, Lecturer at Griffith University, Griffith University and Brendon O’Connor, Associate Professor in American Politics at the United States Studies Centre, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Worried about COVID risk on a flight? Here’s what you can do to protect yourself — and how airlines can step up



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Ramon Zenel Shaban, University of Sydney and Cristina Sotomayor-Castillo, University of Sydney

Airline travel health advice has so far mostly focused on how to stay hydrated and avoid deep vein thrombosis. What passengers really want, however, is a heightened focus on infection prevention and disease control, free masks, complimentary hand sanitiser, and more space between passengers on the plane.

That’s according to our new study, published in the journal Infection, Disease and Health, which drew on survey responses from 205 frequent flyers across the world.

Airline ticket bookings are likely to soar as borders open between New South Wales, Victoria and Queensland.

The aviation industry, which has been decimated by COVID-19, must work hard to restore customers’ faith in their commitment to infection control measures.

Here’s what you need to know if you’re considering taking a plane trip soon — and what the airlines can do to reduce risk.




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Plane cabins are havens for germs. Here’s how they can clean up their act


Plane trips and COVID risk: what you need to know

Adopting a set of well established infection prevention and control measures will help minimise the risk of contracting COVID during a flight.

We would fly, if we had to — but we would follow all the same measures we would if we were catching a train or other form of public transport.

Those measures include, but are not limited to:

  • staying home if unwell. Even if you have the mildest respiratory symptoms, such as a slightly sore throat or hint of a fever, you should not go to the airport and you should not catch a plane. Self-isolate and get tested without delay
  • washing your hands regularly or using alcohol-based hand rub systematically
  • observing physical distancing
  • staying seated and avoiding touching your face
  • where physical distancing isn’t possible, wearing a face mask.

These are the same long-held set of recommendations you should be following anyway, whether you are catching the train to work or shopping in a supermarket.

Using these well established infection control measures routinely and systematically will render the risk of contracting COVID during a plane trip low.

Virgin planes line up on the tarmac.
Adopting a set of well established infections prevention and control measures will help to minimise the risk of contracting COVID-19 during a flight.
Shutterstock

Passengers want more from airlines

The main finding from our study is that the flying public — in particular, frequent flyers — want more from their airlines about how to keep safe from infectious diseases.

We surveyed 205 frequent-flying adults across Facebook, Twitter and LinkedIn on what they thought airlines need to do to restore passengers confidence and sense of security.

We found:

  • 75.6% reported feeling “somewhat” to “extremely” concerned about contracting an infectious disease while flying, particularly respiratory-related infectious diseases
  • Only 9.8% thought their preferred airline saw their health as an “essential priority”
  • 86.8% wanted airlines to provide complimentary hand sanitiser
  • 86.8% wanted airlines to provide complimentary sanitary wipes
  • 64.4% wanted airlines to provide complimentary masks
  • 90.7% wanted airlines to provide more information about preventing the spread of infections, which would make the majority feel safer to fly.

More than half of respondents reported never carrying their own alcohol-based hand sanitiser or sanitary wipes on flights in the past. Female respondents were more likely to carry alcohol-based hand sanitisers or sanitary wipes while flying.

We also asked respondents how often they wore a face mask before COVID, to protect themselves from infectious diseases while travelling by air. The vast majority (83.4%) said they never wore one.

However, the majority (83.4%) reported they would to “some extent” feel safe to fly if all passengers and staff were required to wear face masks while flying.

In other words, our study showed people are really prepared to engage in behaviours to reduce risk — some of which they expect airlines to support and others they would support themselves.

COVID-19 spreads around the world on planes

According to the International Air Transport Association, since 2020 began there have been “44 cases of COVID-19 reported in which transmission is thought to have been associated with a flight journey (inclusive of confirmed, probable and potential cases)”.

It’s important to note COVID-19 is a disease spread globally very quickly, via travellers who are infected.

Like many countries, Australia has imposed mandatory quarantine for international arrivals, which is where the infection in travellers is identified. That shows we — both passengers and airlines — must do all we can to implement proper infection prevention control measures around air travel.

Many airlines have introduced measures to reduce COVID-19 risk, such as temperature screening, physical distancing at check-in, and encouraging masks at the airport. That’s good but the research is telling us passengers want more.

Passengers walk in an airport
Many airlines have introduced measures to reduce COVID-19 risk, such as temperature screening, physical distancing at check-in and encouraging masks at the airport. But passengers want more.
Shutterstock

As promising results emerge from the many COVID-19 vaccine trials underway around the world, Qantas CEO Alan Joyce has said:

We are looking at changing the terms and conditions to say for international travellers that we will ask people to have the vaccination before they get on the aircraft.

Vaccination is a really important way to prevent the spread of disease and it’s useful for airlines to signal vaccines are coming and are important to them.

We have some way to go before vaccines are available, and there much we don’t yet know — such as how long immunity from a vaccine might last or if booster doses might be required. So there are a range of factors to consider if airlines are to mandate vaccination for their passengers.

People board a Jetstar flight.
It’s useful for airlines to signal vaccines are coming and are important to them.
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Joyce has also said it would be “uneconomical” to leave the middle seat in every row empty, instead pointing out its aircraft air conditioning units feature hospital-grade HEPA filters, which remove 99.9% of all particles, including viruses.

HEPA filters in closed spaces make good sense and are important. But they are not the be all and end all. If I am next to someone on a plane who unknowingly has COVID-19 and they are not wearing a face mask and they sneeze on me, and their droplets get into my eyes, nose or mouth, then I am at risk of contracting COVID-19 despite HEPA filtration in the cabin.

In other words, the best protection comes from adopting basic measures systematically. That includes staying home, isolating and getting tested if you have even the mildest of symptoms. It means regular hand hygiene, avoiding touching your face, physical distancing, and using a face mask if you cannot physically distance.

Practising these measures routinely, together with other measures like cabin air filtration, go a long way to keep us safe from infectious diseases when we fly.




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Why the Oxford AstraZeneca vaccine is now a global gamechanger


The Conversation


Ramon Zenel Shaban, Clinical Chair and Professor of Infection Prevention and Disease Control at the University of Sydney, University of Sydney and Cristina Sotomayor-Castillo, Postdoctoral research fellow, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.