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    Lisa Bywaters
    18/Jun/2020
    Health InformationMSK articles

    Can we get rid of this virus once and for all?

    With our neighbours across the ditch resuming life in an almost pre-COVID normal – abandoning physical distancing and restrictions on gatherings – it’s hard not to feel a little envious. They’ve recorded zero new cases of COVID-19 in more than two weeks. That’s longer than the incubation period of the virus, so they’re feeling pretty confident that SARS-CoV-2 (the virus that causes COVID-19) has been eliminated in New Zealand.

    In Australia some of our states and territories have also recorded zero new cases in over two weeks or are getting close to this magical number. So can we expect Australia to follow in NZs footsteps and lose all restrictions any time soon? And does this mean we can get rid of this virus once and for all?

    To explore this issue we need to understand some of the terminology that’s being used when we talk about getting rid of the virus – suppression, elimination and eradication. They’re sometimes used interchangeably in the media, but they’re quite different.

    Suppression requires everyone in the community to physically (or socially) distance themselves. It also requires people who have COVID-19, and the people they live with, to socially isolate themselves from the community – that is, stay at home and don’t go out – until they’re COVID-free.

    This is what we’ve been doing in Australia. It aims to flatten the curve so that our health system isn’t overwhelmed and we minimise the spread of the SARS-CoV-2 until a vaccine is developed.

    On the 12 June 2020, a media statement from the PMs office stated that “National Cabinet recommitted to a strategy of suppression of COVID-19”. (1) This means that we’ll be continuing as we have up until now – testing and tracing, controlling outbreaks as they occur and slowly easing restrictions as active case numbers drop.

    Elimination means that there are no cases in a specific area – e.g. a state/territory/country – for a specific period. The aim is to reduce any chance the virus can spread from person to person. NZ achieved this by putting in place strict lockdown measures for about 5 weeks early on in the pandemic, and gradually relaxing restrictions when active cases greatly decreased.

    The incubation period – or the time from when you’re exposed to the virus to the time you start showing symptoms – is two weeks for SARS-CoV-2. NZ declared they had eliminated the virus after there were no new cases in 17 days.

    It’s important to note that elimination doesn’t mean everything’s back to normal. The borders will still remain closed to overseas travel and testing and surveillance will continue to occur so that the virus hopefully doesn’t gain a foothold in the community again.

    It also means that after a vaccine is developed for SARS-CoV-2 we’ll need to vaccinate people regularly, as we do with other infectious diseases such as measles or the seasonal flu. We don’t know yet if people who are exposed to this virus remain immune. We just don’t have the long-term data on this new virus. So we may need a national vaccination program (as we do with measles) or an annual vaccination (as with the flu) and continue to monitor for any emerging cases.

    Finally, eradication means there are no cases anywhere in the world. This is what happened with smallpox. It took a worldwide effort to identify ALL smallpox cases, then vaccinate everyone who could have been exposed to it. It took many years but in 1980 the World Health Organization declared smallpox to be eradicated.

    However eradicating COVID-19 may not be possible.

    As Adrian Esterman, Professor of Biostatistics, at the University of SA wrote recently, “to be eradicated, a disease needs to be both preventable and treatable. At the moment, we neither have anything to prevent COVID-19 (such as a vaccine) nor any proven treatments (such as antivirals).” (2)

    He also went on to say that “even if a vaccine does become available, SARS-CoV-2…easily mutates. So we would be in a situation like we are with influenza, where we need annual vaccinations targeting the circulating strains. The other factor making COVID-19 very difficult if not impossible to eradicate is the fact many infected people have few or no symptoms, and people could still be infectious even with no symptoms. This makes case detection very difficult… So while we may well be on the path to elimination in Australia and New Zealand, eradication is a different ball game.” (2)

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

    References

    Photo by John Bussell on Unsplash

    CONTINUE READING
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    Lisa Bywaters
    18/Jun/2020
    MSK articles

    Our connections are now more important than ever

    As a species we’re social creatures. We need our tribe – whether it’s a large extended family group and lots of friends, a small intimate group of nearest and dearest, or somewhere in between. We need our connections.

    I think that’s one of the hardest things we’ve had to deal with during this pandemic. We’ve been forced to change how we connect with others. We kept away from our people for months, and now that we can gather, we’re told to keep a distance, don’t touch, hug or shake hands. It feels so unnatural.

    That’s the insidiousness of this virus. It’s infiltrated our world and affected the very fabric of our connectedness.

    I need to make a confession – I’m incredibly sad as I write this blog. My aunt died today. She was a beloved mother, sister, grandmother, aunt and – like me – a crazy cat lady. She’s been unwell for quite some time, and I haven’t been able to see her for months. With isolation and the very real risk of spreading the virus to someone who was already so unwell, it was not a risk we could take.

    And so she died, this wonderful, kind, most incredibly well-read woman. Without all of her family around her. And I’m so very sad.

    I know I’m not unique in this situation. So many people have died during this pandemic – due to COVID-19 as well as the many other reasons people leave our world every single day. But sitting at home on a cold Sunday afternoon, I can’t help but reflect on how terribly sad this whole situation is.

    We’ve missed, and will continue to miss, our celebrations and milestones. Weddings have been postponed. Babies have been born with far less fanfare than would normally happen. Special birthdays have been and gone without the usual fuss. Students have finished courses, aced exams or have mastered a difficult skill without the jubilant gathering of family and friends to celebrate. And funerals have occurred with only a small number of mourners allowed to attend in person.

    And it’s not only the milestones and celebrations we’re missing. It’s the small events, the little encounters that go to the very heart of who we are. The big events are important, but the small things, the everyday incidental stuff with workmates, neighbours, friends, family – they’re the things that make our lives rich.

    So we need to find ways to ensure our milestones, gatherings, phone calls, video chats and every day encounters carry as much joy, love, sadness, real emotion and connection as they possibly can.

    Celebrate and bask in the little things. Share your day – the highs and lows with your partner/kids/closest friend – and really listen as they do the same. Take time to sit and reflect on what’s been happening in your life and those close to you. Even though it may feel like life is moving slowly at the moment, it’s moving quickly – can you believe it’s almost the end of June? – and so much can happen in a day, a week, a month. Don’t let these moments pass you by.

    Tell those close to you how much they mean to you. Extend that support and kindness beyond your own bubble to those you encounter at the supermarket, when you’re driving, talking with your child’s teacher, or when you’re in a work meeting. We’re all dealing with all kinds of stuff – big and small – so let’s discard the petty annoyances and frustrations.

    We’re still some way from finding a vaccine or treatment for this virus. It’s vital we continue to support and care for each other in this new normal we live in.

    Life is short, and although it’s changed so dramatically, we have so much to be thankful for.

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    Crisis support

    If this article has raised some issues with you or you feel like you need help during this stressful time, there’s help available. Contact Lifeline Australia on 13 11 14 for 24-hour crisis support and suicide prevention.

    More to explore

    It’s okay to feel sad
    Better Health Channel

    Photo by Hello I’m Nik on Unsplash

    CONTINUE READING
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    Lisa Bywaters
    11/Jun/2020
    Health InformationMSK articles

    Our amazing immune system

    Every day we’re exposed to millions of microscopic germs – bacteria, viruses, fungi, parasites. Our immune system protects us from them so that we don’t get sick.

    But sometimes a germ (or pathogen) is able to get into our system – through a cut, from breathing in droplets from someone’s cough, or if our immune system has become weakened.

    When this happens, our body launches an attack.

    It starts with the white blood cells (or leukocytes). They’re our germ fighting cells. They patrol the body looking for foreign bodies like viruses. When they come across one, they immediately start to multiply. While they do this, they’re also sending signals to other immune cells to saddle up and get ready for battle.

    There are two types of white blood cells: phagocytes and lymphocytes.

    Phagocytes are hungry little buggers that eat pathogens for breakfast. They do this by surrounding the cell and absorbing it. When they do this they receive information from the proteins on the surface of the pathogen. These proteins are called antigens (or antibody generators). Phagocytes then send this info to the lymphocytes.

    There are several types of phagocytes including neutrophils, monocytes, macrophages and mast cells. They all play important roles in the immune system.

    Lymphocytes can be divided into B cells (they’re created in Bone marrow) and T cells (they’re created when they travel from the bone marrow to the Thymus).

    B cells create antibodies. Antibodies neutralise the antigen by binding to it and disabling it. The antigen and antibody fit together like a key in a lock. As with a specific key working for a specific lock, there’s only one antibody that can fit each type of antigen.

    T cells kill any of your infected cells. There are different types of T cells who have specific jobs in the immune response: Helper T cells and Killer T cells.

    Helper T cells help…they send instructions to the other immune cells to help them get coordinated. They tell the B cells to create antibodies. They tell the Killer T cells to do what they do best – kill or destroy the cells infected by the pathogen. And they tell the phagocytes (specifically the macrophages) to join the party for a tasty pathogen feast.

    When the battle is done and dusted, your body will keep copies of the antibody it created against this pathogen. That way if you encounter it again, you have a defence against it.

    That’s your immune system in the very briefest of nutshells. It’s a highly complex, involved system that includes a lot of other cells, organs and body parts. Check out the More to Explore section for more info about the immune system.

    Giving the immune system a head start – vaccines

    Vaccines work by introducing your immune system to a virus or bacteria. This allows it to learn how to protect you from the pathogen before you meet it out in the world. A vaccine is a weakened or inactivated version of the pathogen. It causes your body to create antibodies. We have many vaccines at our disposal for diseases that cause people to get seriously ill – including measles, flu, tetanus, typhoid and polio.

    There are currently more than 100 labs around the world researching and developing a vaccine for COVID-19. Read our blog to find out more.

    When things go wrong – autoimmunity

    Sometimes the immune system gets it wrong. Instead of attacking something foreign, like a virus or bacteria, it attacks healthy cells and tissues in the body. This is called autoimmunity. The attack causes inflammation and damage to the cells.

    We don’t know why the immune system attacks its own body, but it’s thought that it may be the result of genetic factors (or things you’ve inherited) and something from the environment (e.g. a bacteria, virus or some medications).

    There are many autoimmune conditions that are the result of a malfunctioning immune system. They include rheumatoid arthritis, lupus, ankylosing spondylitis, juvenile arthritis, Sjögren’s syndrome, coeliac disease and type 1 diabetes.

    Stopping the spread of disease – herd immunity

    There’s been a lot of talk recently about herd immunity – especially around COVID-19. But what does it mean?

    Simply put herd immunity means that a large proportion of the population (or the herd) is immune to the disease. This can happen if they’ve been vaccinated or they’ve had the disease and are now immune to it. When most of us are immune to a disease, the disease isn’t able to spread as easily from person to person. The people who are immune create a buffer between the disease and those who can’t be vaccinated.

    By building up this herd immunity, we not only look after ourselves (if we’re able to be vaccinated) but we help protect those who are vulnerable to infectious diseases – including babies, people with compromised or suppressed immune systems and older people.

    The number of people we need to be immune to a disease to achieve herd immunity – the herd immunity threshold – varies from disease to disease. It depends on how easily transmissible and how infectious a pathogen is. For example, in the case of measles we need 92-95% of the population to be vaccinated because it’s incredibly infectious and the virus can survive outside the body for up to two hours. So even if you’re not in the room with an infected person, if you touch a surface that they’ve coughed or sneezed on, you can become infected if you’re not immune to the measles virus.

    We don’t at this stage know what the herd immunity threshold will be for COVID-19. Estimates currently suggest around 60%. However we also don’t know if people remain immune to COVID-19 after they’ve recovered from an infection. So it may be that we only truly reach herd immunity if/when a vaccine is created and administered to the majority of us.

    As with so much to do with this virus, we’re still learning and gathering data.

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

    CONTINUE READING
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    Lisa Bywaters
    11/Jun/2020
    Health InformationMSK articles

    Iso aches and pains

    Sore neck? Back? Knees? Feel like you’ve aged 20 years with all the niggles, twinges and outright pain you’re feeling lately? You’re not alone. Many of us, even those who don’t live with a musculoskeletal condition, are feeling the physical effects of months of isolation, changes to our routine and living more sedentary lives than usual.

    There are many reasons for this, and the good news is there’s lots you can do to deal with these annoying aches and pains.

    Working or studying from home

    When many of us first started working from home, it felt strange but also pretty cool. No dreaded peak hour commute. Yay! Instead we moved a bit more leisurely, lingered over coffee and our slippers stayed on all day. But after months of sitting at makeshift desks, or using laptops for hours on end, or struggling with tech issues and video calls, the cool phase is well and truly gone.

    You may notice that you’re getting a sore neck more often, or your back aches, or you’re really tight across your shoulder blades. Or when you stand up your knees and/or hips let you know quite emphatically that you’ve been sitting in one place for a loooong time.

    The problem is most of us don’t have a dedicated working space that’s set up as well as the one we had in the office. And since we’re likely to be working from home for quite some time, we need to deal with these issues rather than continuing to put up with them and the resulting aches and pains. Some simple things you can do include:

    • Have a routine – and stick to it. Find what works best for you and your specific situation. Whether you’re home schooling your kids, sharing your work space and equipment with your partner, or keeping your pets off your laptop, all of these things will factor into your routine. For me, internet access is really poor during the late afternoon, so starting work earlier and finishing earlier meant I could work more productively and with much less frustration. We’ll all have different solutions to suit our unique situations. So work out what’s best for you and stick with it. And don’t forget to talk with your employer if your new routine affects how/when you work.
    • Check out your work space. Is it helping or hindering you? Are you putting up with an uncomfortable space because you’re not sure what else to do? If so Safe Work Australia has a guide to help you set up your workstation and ABC News also has some practical hacks to take some of the pain out of working from home.
    • Move. When you’re working from home it’s easy for time to get away from you. We don’t have our usual cues to move such as getting up to go to the copier or attending a meeting in another room or just going to chat with a workmate. We’re sitting more and moving less. So you need to schedule time to get up, move around, stretch, go outside. Set up regular alerts on your phone/computer/watch – whatever works for you – and make sure you move. You’ll really notice a big difference at the end of your day.
    • Talk with your employer. If you need to adjust your hours, or you’re having issues with equipment or tech, or you’re having other issues working from home, discuss this with your manager or with HR. Together you should be able to come up with some solutions to ease these issues.

    Managing stress

    We’re living through a worldwide pandemic. Even after several months it feels surreal to say that. It’s important to acknowledge that it’s a really stressful time. Apart from worrying about getting sick, we’re also stressed about work, making sure the kids don’t fall behind at school, managing our chronic conditions, our finances, our family, and concern about the future. Add in the current unrest across the globe and it’s amazing we’re not all hiding under the bed.

    But stress can cause physical aches and pains. It can also affect the quality of our sleep, our pain levels and can trigger a flare. So it’s important we find ways to manage stress effectively.

    Many of the practical strategies we use to manage pain can be used to manage stress. These include: deep breathing, exercising, pacing, talking with a friend, mindfulness, guided imagery, progressive muscle relaxation and doing something you enjoy (e.g. reading, gardening, walking your dog, playing music).

    But if you’re finding it difficult to manage your stress, talk with a professional such as your doctor or psychologist. There’s help available. And remember you can access them via telehealth if you prefer.

    Spending more time at home

    Even though isolation is easing we’re still meant to stay at home as much as we can. And with the weather getting really chilly, we’re getting cosy on the couch with the doona and the remote, as we binge lots of TV (or is that just me). There’s just so much to watch!

    Hanging out on the couch and binge watching TV is ok occasionally, but we don’t want to get into the habit of doing it too often. Slouching on the couch and not moving for long periods can aggravate our existing musculoskeletal conditions. And if we’re not moving and being active regularly it can also make it difficult to manage our weight.

    So make sure you get up and move. Take a break. Go for a walk or do some exercises or stretches.

    Break up your day with a mix of activities – both physically active (e.g. walking, gardening, tidying) and more passive (e.g. reading, watching TV, sitting at a computer).

    Be aware of your posture

    Bad posture can sneak up on us. Working at a computer, sitting on the couch reading a book, standing around watching the kids in the playground, lifting shopping out of the boot of your car – if you’re not paying attention to your posture, it’s easy to slouch, hunch over or strain.

    As I’m typing this I’m literally straightening up from the curled position I was in, hunched over my laptop. And wow – it feels amazing when you sit up straight. It’s the same when you’ve been sitting on the couch for a while – when you stand up, stretching feels soooo good.

    So be aware of your posture as you’re sitting and standing. For more info read our tips for good posture.

    Increase your incidental exercise

    Because we’re more sedentary than usual, and don’t have many of our usual outlets for exercise, we need to find ways to become more active. Increasing our incidental exercise is one way to do this. Incidental exercise is the little bits and pieces you do over the course of your day such as walking to a letterbox to post a letter, playing with the grandkids, cleaning the house. It’s not a part of your structured exercise plan, but it is important. There are many ways you can increase your incidental exercise without too much effort or disruption to your day. Read our blog to find out more. Before you know it you’ll be feeling more energised and noticing a difference with your pain levels, sleep quality and mood.

    Dress appropriately

    It’s getting really cold and many of us are a little stressed at the thought of high energy bills as we stay home and use the heater more. It’s tempting to keep the heat down, but that can cause your muscles to become tense, aggravating your musculoskeletal condition. So it’s important to keep warm. One of the simplest things you can do to stay warm is to dress for the weather. Let’s face it we’re not going anywhere, so wear the thick socks, the cuddly jumper and the daggiest track pants. Whatever keeps you warm.

    We also need to be mindful of our footwear. Although it’s tempting to stay in our slippers all day, our feet and ankles need proper support. Wear the right footwear for whatever you’re doing. Going for a walk? Put on your sneakers. Working at home? Wear your casual shoes/boots that support your feet and keep you warm. And lounging around in the evening? Get those slippers on.

    Be careful of trips and falls

    Hands up if you’ve tripped over cables, laptop bags, files, excited dogs, folders, exercise equipment, books, and other stuff that’s suddenly cluttering your home? With all of the other things going on at home at the moment, school, work, exercise, entertainment…we’ve had to make space for all sorts of things in order to be get by. Which means our risk of tripping or falling has suddenly increased, especially if you’ve got nowhere to put these things and they’re constantly in the living area. So be careful as you move around your home – don’t rush, put things away if you can and tie or tape down cables. Preventing a fall, especially if you have a musculoskeletal condition, is easier than dealing with the significant injuries a fall can cause. So please be careful.

    Treating pain

    Even when you’ve done everything you can to prevent joint pain and muscle strain, you may still find you’re a bit sore. Depending on how severe this pain is, you may be able to treat it simply with heat and cold, massage, short term use of medication, distraction and many other strategies. Check out our A-Z guide for managing pain for more hints and tips.
    However if the pain is severe, it’s affecting your day to day activities, your ability to sleep, or it’s lasted for some time with no relief, it’s a good idea to talk with your doctor about it. Together you can find out what’s causing the pain, and the most effective ways to treat it. Don’t simply put up with it.

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    CONTINUE READING
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    Lisa Bywaters
    04/Jun/2020
    Health InformationMSK articles

    When you have COVID but don’t know it

    The silent spread of COVID-19

    By now we’re all aware that some people with COVID-19 may never feel sick or have any symptoms. They’re what’s called asymptomatic – they have no symptoms at all.

    But did you know that people can also spread the virus when they’re pre-symptomatic – contagious before the onset of symptoms; or mildly symptomatic – they have minor symptoms such as a cough or slight fever.

    Understanding how the virus spreads throughout the community gives our health system and researchers more tools to fight it. While there’s still so much we don’t know about this virus, we’re learning more and more every day.

    Asymptomatic

    You can be a carrier of a disease and never show signs of the illness yourself. The most famous case is that of Mary Mallon – or as the press dubbed her – Typhoid Mary. In the early 1900s she worked as a cook in America. She spread typhoid fever to many of the people she cooked for, even though she appeared and felt perfectly well.

    This is what it means to be asymptomatic. You carry the disease but you aren’t sick. In the case of COVID-19, people who are asymptomatic have none of the signs we’re on the lookout for – no cough, fever, breathing issues, fatigue.

    While this is great for them, it means that they could unwittingly share the virus with others – family, friends, the general public. They don’t know they’re carrying the virus, so they don’t isolate themselves to stop the spread.

    We don’t know how common this is. There are estimates that range from 5-80% – obviously a massive difference! This discrepancy in stats is in part due to the fact that they come from different studies around the world, from different, unique settings (e.g. aged care facilities, cruise ships), different demographics of people and the diversity of testing practices around the world.

    Until we’re in a position to test more of the community, not just those who display symptoms, we can’t know how much of the population are asymptomatic.

    We also don’t know to what extent this group is infecting others. Are they highly contagious and infect a lot of people, or do they infect only a small number? We just don’t have enough information to be sure.

    Pre-symptomatic

    This is the group of people who have the virus but aren’t yet showing symptoms. Again they’re out and about living their lives and not realising they’re contagious. They appear to be infectious 1-3 days before they start showing symptoms themselves.

    Mildly symptomatic

    This final group is people who have mild symptoms such as a light cough or low fever or feel a little fatigued, but otherwise don’t feel unwell. At this time of the year many of us may put these symptoms down to things like allergies or a cold or even our musculoskeletal condition. But it may in fact be COVID-19.

    That’s why if you have any symptoms, no matter how mild, you need to stay home and contact your doctor about getting tested. If you’re not sure what the symptoms are, use the healthdirect online symptom checker or call the National Coronavirus Help Line on 1800 020 080.

    Why does this matter?

    We’re learning a lot about COVID-19, but there is still so much we don’t know. And if we’re going to win this fight against the virus, we need to know how many people are unknowingly spreading the virus. This will help make better predictions about how the virus will affect communities going forward, as well as the types of things we can do to combat it.

    But until we have this information we all need to continue to maintain good hygiene, practise physical distancing, self-isolate if we’ve been in contact with someone who’s tested positive to the virus, stay active, eat well and look after our mental health. All of these things will help prevent the spread of COVID-19 and help us stay healthy and well.

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

    Photo by mauro mora on Unsplash

    CONTINUE READING
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    Lisa Bywaters
    04/Jun/2020
    Health InformationMSK articles

    COVID reflections from the MSK Help Line

    As COVID-19 restrictions came into force at the end of March, life as a Musculoskeletal Help Line Nurse began to change. Like many who were lucky enough to be able to work from home, I packed up my office, put it in the boot of my car and set-up my new workspace at home.

    Work looked a little different now – face to face meetings became Zoom meetings, COVID-19 health news dominated our searches and we began recording videos to keep consumers updated. But most importantly one constant remained – we were still on the end of the phone or email for when a consumer needed some help or advice.

    While the usual enquiries kept coming, there were also stories of personal struggles during the lockdown. People shared their feelings of anxiety surrounding social isolation, their vulnerability and how all too often their exercise routine had diminished, and their pain had increased. We talked over ways to try and overcome this – meditation, mindfulness, online exercise, pain management strategies etc – but sometimes it was just enough to have someone to talk things over with, and to feel like someone was really listening.

    While the struggles were evident, it was also lovely to hear reports of some positive experiences that emerged. Social isolation forced many of us to slow down, to reflect on how much we try to squeeze into a day/week, and perhaps allowed us to reflect on the simple things in life that make us happy. For some it was spending more quality time with their immediate family, others enjoyed time to potter in the garden, clear out the cupboards, do some DIY or simply relax with a good book. In a hectic world, pressing the pause button seemed to bring a little light relief in one form or another.

    As a nurse I am privileged to be able to share in peoples life experiences, including their ups and downs, and as we all get used to the ‘new normal’ I hope that I can continue to provide a friendly ear to make the COVID-19 journey just that little bit easier.

    Clare

    And some feedback from one of our recent callers:

    “Thank you so much for your caring, helpful time with me, giving me very important vital information that I truly need in this very big, busy, fast city…I have received your email with excellent advice in all possible ways and hope for a better way of going along this painful journey with chronic conditions…in which I may be able to benefit and try…and not to feel so alone. I truly hope that things will change for the better. Thank you again Anne, have a gentle relaxing evening and keep warm. Can’t wait to see and read all the goodies inside the email you sent me. With best wishes and kind regards, VC”

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    CONTINUE READING
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    Lisa Bywaters
    28/May/2020
    Health InformationMSK articles

    Saying goodbye to iso – easing restrictions

    As we come to the end of May 2020, more and more restrictions are easing all over the country. And we’re being told more restrictions will be lifted in June and July. Yay!!

    While we’re all understandably excited at the prospect of doing the things we took for granted pre-COVID, there are things we need be aware of. The fact is we’re not out of the woods. And we won’t really return to anything resembling the old ‘normal’ until we have a vaccine. 

    So as you make your way out of the front door, blinking into the bright lights of the outside world, make sure you’re ready for it so you and your family stay safe, and you help keep the rest of the community safe.

    What’s up with your hair? And what are you wearing?!?

    OK so this is a little silly, but for many of us it’s been MONTHS since we’ve had a haircut or had a professional give our hair some TLC. So we’re looking a little wild and woolly. Add in the lack of access to beauty salons and we’re a weird, hairy mess – picture Cousin It from the Addams Family. And for many of us we’ll need scissors and a crow bow to get the trackies and slippers off, because staying at home and trying not to spend too much on the heating bill has led to comfort and warmth winning over style and fashion. So maybe check yourself in a mirror before you venture out.

    But seriously apart from sorting out our general dishevelment there are some important things to be aware of as our COVID isolation starts winding down and restrictions continue to lift:

    Hygiene

    It’s still incredibly important. Wash your hands thoroughly and regularly, use hand sanitisers, cough and sneeze into your elbow and avoid touching your face. For a refresher read our hygiene 101 blog for more info.

    Physical distancing

    We’re able to go to more places and see more people, however physical distancing is still vital. Most of us are still susceptible to this highly infectious virus, so we need to maintain at least 1.5 metres between ourselves and others when we’re out in public. This can sometimes be a bit tricky. With the loosening of restrictions, and because people have felt cooped up for so long, LOTS of people are going out. So you need to ask yourself when you pull into the shopping centre carpark and it’s full, or you can see a line of cars heading to the park you’re aiming for. Ask yourself if you’ll really be able to maintain a safe distance between yourself and others. And if the answer’s no, can you go somewhere else instead? Or do something else? Or come back at another, less busy time?

    Gatherings

    We’ve missed our family and friends, and although it was helpful, technology – with all the drop outs and weird pauses – can only do so much. We want to BE with our people. And we’re now allowed to do that in greater numbers. But you need to do a few things if/when your gather:

    • Know the relevant guidelines for your state/territory. It’s different all over the country, so it’s easy to get confused. So check the COVID-19 website applicable to where you live.
    • Only visit or have visitors if you’re healthy and well. Even if you’re chomping at the bit and you’re pretty sure it’s only a sore throat because of your allergies, or you think you’re feeling fatigued because of a late night/your MSK condition/home schooling, don’t take the chance. There may be a slim possibility that you actually have the virus and spread it to others – so don’t be that person.
    • No hugs, kisses or handshakes. This is a tough one, especially if you haven’t seen loved ones in ages, but resist the close contact. And it may seem lame but try the elbow bump or foot tap greeting. Better still, make up your own family greeting. Get the kids involved and make it something fun and uniquely yours.

    Your mental health

    It’s been such a crazy time, and we’ve been isolated in our own cocoons for so long, many of us may be a little anxious or scared about going out. That’s completely understandable. But we do need to go out – for work, groceries, social connection, exercise, healthcare appointments – we need it all.

    However if you do feel anxious about heading out into the world, it’s important to understand why you’re feeling this way and then look for ways you can manage it. For example if you’re freaked out by the crowds at the supermarket, try and do your shopping at quieter times. If you’re concerned about using public transport, follow the capacity restrictions for the specific mode of transport, wash your hands after using it (or use hand sanitiser if you have it) and avoid touching your face.

    The important thing is to start easing your way back into the world. But if you’re having real issues getting out, talk with your doctor. You may need some professional support. You can do this via telehealth from the comfort of your own home.

    There will be outbreaks

    That’s inevitable, but we can all do our best to reduce the risk of an outbreak with good hygiene, physical distancing and staying home if you feel unwell.

    Exercise venues

    Pools, indoor and outdoor gyms and fitness centres are also reopening. This’s great news. We all need a variety of exercises for our general health and wellbeing, and to help us manage our musculoskeletal condition and pain. There are strict guidelines for all public venues about maximum numbers, physical distancing and hygiene that exercise facilities will need to be following. So if your venue hasn’t contacted you to let you know how they’re keeping their clients and staff safe, contact them and ask.

    Staying safe with a musculoskeletal condition

    If you have arthritis, back pain or osteoporosis, you may need to be careful about a few other things.

    • With more places opening up, venue owners are trying to find ways to enforce physical distancing and capacity measures. However some of the makeshift barriers being used may cause a trip hazard for some of us – because they’re low and not very brightly coloured – for example the humble milk crate or cardboard box. They seem to be a handy partition used in many places to limit the number of people in a space and to direct the flow of traffic. But they’re not always easy to see, especially if there’s poor lighting or you’re hurrying – so be careful of trip hazards and other obstacles when you’re out and about to reduce your risk of falling and getting hurt.
    • You may need to stand in queues, at the supermarket, hardware store and other public venues that are reopening, as they all have a maximum number of people they can let in at one time. This can cause or exacerbate pain and fatigue for many people with musculoskeletal conditions. So wear comfy shoes (including orthotics if you have/need them), grab your walking aid, your shopping list (a foggy brain makes remembering almost impossible) and your shopping buggy/bags. And be kind to yourself as you may feel tired and exhausted for some time after your trip. If your battery was already low before you tackled this, it’s may take some time to feel yourself again.

    With restrictions lifting all over the country, we’re getting excited about broadening our horizons beyond our own front doors. But we need to take responsibility and be careful. We’ve done really well at minimising the impact of this virus on Australians – and we don’t want to slide backwards.

    So stay informed, follow the guidance of the government health officers, and we’ll get through this next phase of the COVID journey.

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    CONTINUE READING
    knee.jpg
    Lisa Bywaters
    28/May/2020
    Health InformationMSK articles

    The hidden dangers of iso – home injuries

    It’s a good thing iso is starting to ease around the country. Did you know people have been injuring themselves with all this time at home? Who knew taking time to get fit, being creative with exercise or tackling some of the DIY jobs around the house could be so dangerous?

    So here are some tips to help you stay safe at home:

    Exercise

    We’ll soon be able to go back to our gyms, pools and fitness centres – but the number of people who can be in these spaces at one time will be strictly limited. So you’ll probably still have to make do with home exercise. To keep safe we suggest you:

    • talk with your doctor, exercise physiologist or physiotherapist – in person or via telehealth – if you’re concerned that you’re feeling more pain than usual when exercising or after exercising. They can also tailor a home exercise program to suit your specific needs and health conditions.
    • book an appointment to talk with an instructor at your fitness centre. They can run through your exercises and give you feedback about your exercise technique.
    • before using online exercise videos, classes or apps, check the qualifications of the instructor. Do they have the expertise to provide these exercises safely? And for people with musculoskeletal conditions? Read our blog about evaluating online exercise.
    • warm up before you exercise, and cool down when you finish. Many of us skip this because we don’t feel like we have the time or just can’t be bothered. But it’s an important part of exercising and may help reduce injury. Warming up increases blood flow to the muscles and gives you the chance to get in the right headspace for exercise. Cooling down helps your body return to the resting state it was in before you started, allowing your heart rate to lower and your body to cool down.
    • don’t push yourself too far too quickly. Many of us saw iso as a chance to jump in and get fit. Yay – all this time to exercise, nothing can stop us. Until you hurt yourself or do too much. That’s why it’s important to build up slowly and progress over time. But you do need to challenge yourself, so ensure that your exercise gets more difficult over time.
    • if your joint/s feel particularly painful after exercising (for longer than two hours after an exercise session), reduce the intensity of your next session. And if an activity causes you pain or increases your pain beyond what’s normal for you, then stop this activity. Get advice from a professional to ensure you’re doing the exercise correctly or to modify it for you.

    Cycling

    Wow that’s really taken off! And it’s great to see so many people and families out cycling together. But if you’re not used to riding a bike regularly you can get hurt. So:

    • be realistic. We’ve all heard the saying “it’s just like riding a bike” so we assume it’s simple, but if you’re not riding regularly, start small. It’s easy when you have the wind in your hair and the sun on your face to just ride and ride and ride. But remember, you need to return to where you started. So plan a bike route that’s easy, flat and achievable. You can increase this over time.
    • make sure you have all the right bits and pieces to keep you and others (like pedestrians) safe. So wear a helmet, use your bell when approaching others and have a light fitted just in case you get caught out when the light begins to fade. And wear comfortable, high visibility clothes so you can be seen.
    • use a bike path if there’s one nearby. Especially if you’re starting out or fairly new to riding. Riding in traffic can be scary and intimidating, and if you’re not confident it can be dangerous. So build up your confidence on bike paths.
    • read our blog for more tips about riding a bike.

    DIY

    Like getting fit, iso was going to be a time when we got all those odd jobs and repairs done around the home. But this has seen people falling off ladders and injuring themselves with power tool – yikes. So before you tackle that DIY job:

    • ask yourself – does it require a professional? There are some jobs – like electrical work and larger plumbing repairs or installations – that should only be done by someone with the necessary skills and qualifications.
    • do a risk assessment. Most of the time we just want to get the job done – the gutter unclogged, the new towel rail hung. But are there any risks involved? Do you have the right tools and equipment? Do you know if there are electrical cables behind the wall? You don’t need to write up a full risk assessment report, but just take some time before you get started to make sure you have everything you need to proceed safely.
    • be careful if you use a ladder. This is one of the biggest hazards for the DIYer – falling from a ladder or stepladder. And you can really hurt yourself. So if you’re using one, make sure you have someone around to help you move it and to ensure you’re safe. Move the ladder when you need to – don’t lean over or stretch to reach something – that’s when you can overbalance and fall.
    • whatever DIY job you’re doing – dress for it. Wear suitable clothing, footwear, gloves, and a mask if there’ll be dust or fumes.
    • don’t do anything if you’re not 100% – so if you’re tired, you’ve been drinking or you’re affected by drugs (including prescription meds) – don’t do anything. The job will still be there tomorrow.

    Mental health

    As well as physical injuries we may have suffered during this time, our mental health may have also taken a hit. There’s been a rise in the number of people experiencing anxiety and depression from being cooped up in iso and the loss of normal life and routines. And there’s also the stresses of working and schooling from home, financial pressure and general worry about the future. These issues are no less serious than falling from a ladder or stacking your bike, so if you’re struggling talk with someone. Whether it’s your partner, family member, a close friend or a professional, talk with someone. Don’t ignore these feelings. There’s a lot of help available.

    Get help

    Finally, if you do hurt yourself seek medical advice. Many people are putting off going to see their doctor or the emergency department for fear of COVID-19. However medical facilities have measures in place to keep the general public and their staff as safe as possible. So if you injure yourself, don’t ignore it or soldier on – make an appointment to see your doctor, or if it’s serious go to the emergency department or call an ambulance.

    Contact our free national Help Line

    If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealth, managing your pain or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

    More to explore

    Check out some of our health articles and blogs for more info.

    CONTINUE READING
    treatments.jpg
    Lisa Bywaters
    21/May/2020
    Health InformationMSK articles

    Treating COVID-19

    Note: This blog was written in 2020, and so much has changed since then, including the availability of medications and vaccinations for COVID. For the most up-to-date info about treatments for COVID-19, visit the Australia Government, Department of Health website. 

    At the moment there’s no treatment for COVID-19.

    Wow, that was blunt. I probably should have eased you into it, but unfortunately that’s the truth. Regardless of what you may see on social media, or what a certain President might say at a press conference, we just don’t have a treatment for COVID-19 yet.

    Doctors can treat many of the symptoms people are experiencing, but there’s no specific treatment for SARS CoV-2 (severe acute respiratory syndrome coronavirus-2), the virus that causes the disease we know as COVID-19. There’s also no specific treatment for the severe complications that some people experience which has led to thousands of deaths worldwide

    The reason for this is that it’s a new virus, one we’ve never encountered before. That’s why it’s referred to as novel coronavirus – it’s brand new so we have no immunity to it.

    We have nothing in our medicine cabinet specifically designed to deal with this virus. Antibiotics don’t work – because it’s a virus and antibiotics only work against bacterial infections.

    What we do have in our favour are the efforts of the world’s scientific and medical community working tirelessly to find ways to safely treat this disease. We also have the work that was done at the time of the previous coronavirus outbreaks.

    In 2003 we saw an outbreak of SARS (severe acute respiratory syndrome) and in 2012 we saw MERS (Middle East respiratory syndrome). These coronaviruses are closely related to SARS CoV-2.

    While a treatment for SARS or MERS didn’t make it to large, human trials, there were promising results in labs tests, animal studies and small clinical trials. These drugs were some of the first to be studied for use in COVID-19.

    Medications currently used to treat other conditions, for example hydroxychloroquine which suppresses an overactive immune system in people with lupus and rheumatoid arthritis (RA), are also being investigated. If we can repurpose an existing drug it’s hoped that we may have a treatment sooner rather than later.

    So let’s have a quick look at some of the treatments being investigated

    Anti-virals

    Viruses, like the one that causes COVID-19, have only one job – to make more of themselves. They get into the cells of bacteria, animals and people, hijack them, and turn the cells into virus making factories.

    Anti-virals stop them from making more copies of themselves.

    Researchers are currently investigating several anti-virals including those used to treat viruses such as Ebola and HIV (human immunodeficiency virus).

    There have been some early trials, using small numbers of people with COVID-19, that have had mixed results.

    For example, remdesivir wasn’t effective against Ebola, but it had been effective against SARS and MERS in the lab and in animal studies. However we don’t yet have enough information to know if it will work in humans with COVID-19 or not.

    Repurposing other drugs

    As well as looking at ways to disable the virus and prevent people getting sick, researchers are also looking at medications we currently use for other conditions, to see if they’ll help people manage complications of the infection, especially those that affect the lungs and other internal organs.

    The most widely talked about drug, hydroxychloroquine, works well to suppress the immune system in people with RA and lupus. However there’s limited evidence that it works for people with COVID-19. Trials are ongoing, including COVID SHIELD, a new trial being conducted at the Walter and Eliza Hall Institute in Melbourne.

    Other drugs that suppress the immune system are also being investigated including the RA drug baricitinib.

    The focus on immune suppression is to help manage the “cytokine storm” that some people with severe COVID-19 experience. This is when the immune system releases too much of an immune protein (cytokine) into the blood. This causes a high fever and inflammation, and in severe cases it can lead to multiple organ failure.

    However there’s concern that treating people with an immune suppressing drug when their body is fighting an infection may be dangerous. We need more information from large, randomised controlled trials before we know if these drugs will help or harm people.

    Other therapies

    As well as going through our medicine cabinet and looking at old drugs to treat a new virus, researchers all over the world are looking at other ways to treat COVID-19.

    They include plasma therapy, a process that involves taking the blood plasma from someone who’s recovered from COVID-19 and transferring it to someone who has the disease; stem cell therapy to treat people experiencing acute respiratory distress and the gene-editing technology CRISPR to find antibody targets for the disease.

    These are just some of the innovative therapies that are being investigated to treat COVID-19.

    Lots of work to be done

    While a lot has been achieved in a short amount of time, we need to remember that with all of these trials we’re still very much in the early stages. We just don’t have enough data to know if the drugs or therapies work and if they’re safe.

    We can feel confident though that the world’s scientific and medical communities are making great progress in their efforts to find safe and effective ways to treat COVID-19. But it will take time, both to come up with a vaccine and to find a treatment that we can produce in sufficient quantities to deliver on a global scale.

    So we need to continue with our physical distancing, maintain good hygiene, stay active, eat well  manage our mental health and follow the restrictions that are in place where we live. This will eventually pass, but it will take some time.

    More to explore

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    cocktail5.jpg
    Lisa Bywaters
    21/May/2020
    Health InformationMSK articles

    New virus, new language

    Have you noticed how many new words, acronyms and phrases have entered our vocabulary since rona arrived?

    We thought it was timely to have a quick look at some of the more common ones, so you’re up-to-date in iso.

    • BCV – before corona virus. This is self-explanatory. Those heady days before we’d even heard of COVID-19 or SARS-CoV-2.
    • blursday – seriously what day of the week is it today? They really do all blur together in isolation.
    • corona moaner – we love rhyming don’t we? We all have our moans and complaints about iso and this strange situation we’re living through, but the corona moaner is the person who never stops complaining. You know who I’m talking about.
    • coronials – corona + millennials = a new generation, born about 9 months after isolation began. Lots of time at home together, a few quarantinis and whoops, we have a baby boom.
    • covexit – like Brexit – it’s the strategies for getting out of isolation and the economic issues associated with it. Let’s hope it’s smoother and quicker than Brexit!
    • coronacation – working or schooling from home. Though I’m a little perplexed by this one because it hasn’t felt like a holiday or vacation at all. It’s feels a bit like hard work, right??
    • covidiot – again fairly self-explanatory. Just as we love rhyming, we love joining words together to create new ones. A covidiot is someone who ignores physical distancing, ignores all the restrictions and thinks life can continue as usual, as if it was BCV.
    • covid-kilos – refers to the slightly curvier shape some of us have developed after making endless batches of banana bread or trying to make the perfect sourdough loaf or experimenting with quarantini recipes.
    • flattening the curve – this phrase entered our vocab very quickly. Basically it means limiting the spread of COVID-19 to reduce the impact on the health system. Sadly it’s not a quick fix to covid-kilos or pandemic padding.
    • iso – short for isolation. Der.
    • magpieing – this refers to the covidiots who created a toilet paper/hand sanitisier/flour/cake mix shortage for a time by buying up more than they could use in 10 lifetimes.
    • my corona – showing my age here, but this one always makes me laugh. It’s just a take on the 1979 song My Sharona by The Knack.
    • pandemic padding – see covid-kilos.
    • quarantini – a martini/cocktail you consume during quarantine. Going by the recipes and images on socials it now seems to be anything you want it to be. But it’s essentially an alcoholic drink you create using whatever you have on hand. Enjoy!
    • rona – our short, ‘affectionate’ name for coronavirus. Shortening it somehow makes it seem a little less scary.
    • sanny – short for hand sanitiser. Have you noticed how the world (or every public building you enter) is beginning to smell like sanny?
    • social/physical distancing – social distancing is used more often, but we prefer physical distancing. It simply refers to us staying physically distant from others to stop the spread of rona.
    • WFH – working from home, with all the joys of tech issues, fighting for space with the family, home schooling, pets and kids interrupting video chats. Yay.
    • zoombombing – the intrusion of covidiots you don’t know into your Zoom meeting. This can be for entertainment purposes – can you say bored covidiot? Or it could be for malicious reasons. Make sure you use the waiting room feature of Zoom so you can see who’s wanting to enter before they disrupt your meeting.

    That’s it – you’re up-to-date. For the moment. It’s inevitable that new words and phrases will appear as we continue on our iso journey towards covexit.

    Until then, go and fix yourself a quarantini, sit back and contemplate your coronacation. And as the sweet smell of sanny wafts through your home on this blursday in iso, take heart that we’re flattening the curve and we’ll soon be looking at ways to covexit.

    More to explore

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