As Sydneysiders and those living in Greater Sydney continue to be in the midst of another lockdown due to multiple outbreaks of COVID-19, our mental health and ability to juggle family and working life from home is again being put to the test.
The original two-week lockdown of Greater Sydney, Wollongong, Shellharbour, Blue Mountains and the Central Coast that was originally scheduled to end on Friday, July 9, was extended by an additional week until midnight on Friday, July 16 (7News 2021). However, as case numbers continue to climb over 100 (as of July 12, 2021) including large numbers of active cases in the community, the lockdown now has no end in sight unless case numbers are reduced significantly.
Just when it felt like things were going back to ‘normal’, stay-at-home orders are back in place, our face masks are back on, non-essential businesses are closed, many Sydney schools have not returned in a face-to-face capacity this term, and working from home is expected if possible until further notice (NSW Government 2021). This was challenging the first and second time around, but with each new lockdown comes new compounding challenges, stressors and effects on our mental health.
Chief Executive of the Australian Psychological Society, Zena Burgess, says that people can expect to feel upset, anxious, frustrated, fatigued irritable and exhausted by the news of enduring another lockdown (ABC 2021).
While the public health measures that have been enforced are necessary to curb the spread of COVID-19, the impacts of uncertainty and isolation can cause loneliness, stress and anxiety and have already seen the rates of psychological distress, anxiety, and depression symptoms rise among adults in Australia during the peak of the pandemic (Dr. Mandal 2020).
Life at the best of times can be busy and stressful, but the expectation of being able to balance working from home with kids who aren’t at school can be extremely challenging.
Centers for Disease Control and Prevention recommends a number of ways to cope with stress associated with the effects of lockdowns on our lives including the following:
- Take breaks from watching, reading, or listening to news stories. While it’s good to be informed, hearing about the pandemic constantly can be upsetting.
- Take care of your body including exercising regularly, getting plenty of sleep, maintain a healthy diet, and avoiding excessive alcohol, tobacco, and substance use.
- Make time to unwind by doing some activities you enjoy.
- Connect with others. Talk with people you trust about your concerns and how you are feeling (CDC 2021).
Anyone worried about their mental health, loneliness, finances, family, or other circumstances should be reassured that help is available and accessible and can contact the Beyond Blue Coronavirus Mental Wellbeing Support Service for free advice and counseling on 1800 512 348 or online. Immediate advice and support is also available through Lifeline (13 11 14) or Kids Helpline (1800 55 1800) (Department of Health 2021).
ABC Everyday 2021 – Managing your mental health when facing a new COVID-19 Lockdown – https://www.abc.net.au/everyday/managing-mental-health-in-new-covid-lockdown/100169688
Centers for Disease Control and Prevention, 2021 – Coping with Stress – https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html
Department of Health, 2021 – Looking after your mental health during coronavirus (COVID-19) restrictions – https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert/ongoing-support-during-coronavirus-covid-19/looking-after-your-mental-health-during-coronavirus-covid-19-restrictions
Dr Mandal. A, 2020 – Mental health problems peak alongside COVID-19 in Australia – https://www.news-medical.net/news/20200729/Mental-health-problems-peak-alongside-COVID-19-in-Australia.aspx
NSW Government – Additional Restrictions for NSW, 2021 https://www.nsw.gov.au/covid-19/rules/greater-sydney
7News 2021 – Why Sydney students won’t be returning to classrooms next week – https://7news.com.au/lifestyle/health-wellbeing/nsw-schools-regional-students-to-return-to-classrooms-while-those-in-greater-sydney-to-work-remotely–c-3331951
7NEWS 2021 – NSW records 27 new COVID cases as Greater Sydney lockdown is extended – https://7news.com.au/lifestyle/health-wellbeing/nsw-records-rise-in-covid-cases-as-sydney-lockdown-is-extended-c-3331119
More than 4 million Australians struggle with back pain on a daily basis, majority of whom report that the pain interferes with their basic activities of daily living (AIHW 2020). When pain lingers, it can significantly compromise our quality of life by causing us physiological pain and disability as well as psychological distress.
With an estimation that 70–90% of Australians will suffer from lower back pain in some form at some point in their lives, (AIHW 2020) optimisation of the treatment and management of this pain is critical.
The Biopsychosocial Model of Health implies that pain cannot simply be seen as a physical experience, but as a social and psychological experience also (Discover the Power of Drug Free Pain Relief 2018). Therefore, in conjunction with treating pain with medications, pain treatment should also focus on treatments that effect the holistic and interrelated experience of pain physically, psychologically and socially.
In our three part series on the subject of drug free pain relief for back pain, we have previously discussed Physical Movement Therapies including staying active, Pilates, Yoga and Thai Chi through focusing on core strength, posture and flexibility, as well as Spinal Decompression Therapy as a treatment of slipped discs, pinched nerves, bulging or herniated discs and worn discs. We then discussed the role of Dietary Medicine and Medicinal Cannabis in relieving back pain.
Among 100 life-changing drug-free pain relief developments as detailed in Discover the Power of Drug Free Pain Relief 2019 (2018), are also Mind-Body Treatments and Electrical Therapies.
- Strength and Aerobic Exercise
While many people may discount the idea of beginning an exercise program if they are suffering from chronic back pain, tense, weak muscles can amplify the experience of pain (Discover the Power of Drug Free Pain Relief 2018).
In consultation with a health care professional as well as a personal trainer in order to develop a personalised program to suit your individual needs, regular weight training can help to build strength in areas where it has been lost and may be contributing to the experience of pain (Discover the Power of Drug Free Pain Relief 2018). Importantly, strength training also plays a crucial role in maintaining bone density which is said to deplete from the age of 30.
Aside from strength training, aerobic exercise promotes the release of endorphins which are the body’s natural pain killers (Discover the Power of Drug Free Pain Relief 2018).
- Weight Loss
Some studies have identified that on average, 7 out of 10 people with chronic pain are overweight. Research has also identified that because excess weight results in chronic mild inflammation in the body, excess fatty tissue may produce chemical that elevate sensitivity to pain (Discover the Power of Drug Free Pain Relief 2018).
While being heavier can place excess strain on joints and make it harder to exercise, exercise itself is important in the management of chronic pain (Discover the Power of Drug Free Pain Relief 2018). Therefore participating in non-weight bearing exercise like swimming may be beneficial as a starting point, however discussing any proposed exercise plan with a doctor is also important in order to discuss safety implications before commencing.
The use of heat or thermotherapy is suitable for soothing aching muscles, stress and chronic pain by helping to ease muscle spasms and sore spots. Heat can calm the nerves and settle the mind, however heat should not be applied to inflammation, so it’s a bad choice for fresh injuries (Discover the Power of Drug Free Pain Relief 2018).
It is theorised that because pain, heat and cold each have their own sensory mechanisms, the application of hot or cold stimuli may distract from sensing painful stimuli, reducing pain (Discover the Power of Drug Free Pain Relief 2018).
Pain relief is one of the many reasons why people meditate. Studies have suggested that meditation impacts different areas of the brain involved in the processing of pain messages, with pain reduction of up to 40% noted in some instances amongst subjects who meditated (Discover the Power of Drug Free Pain Relief 2018).
The nervous system is affected by stress, resulting in physiological effects such as heightened blood pressure, pulse rate and increased metabolism which can make pain feel more severe. When stress is minimised, it is thought that there is a corresponding reduction in pain (Discover the Power of Drug Free Pain Relief 2018).
Transcutaneous Electrical Nerve Stimulation (TENS)
Electricity has been used for pain relief for several thousand years. TENS units consist of a battery powered controller and electrodes that are placed on the body at the site of the pain which deliver an adjustable electrical current directly into the skin.
The electrical pulses are thought to scramble pain signals in the body by stimulating the nerves. The treatment is also believed to enhance the flow of endorphins, the body’s natural painkillers (Discover the Power of Drug Free Pain Relief 2018). TENS units are widely utilised by physiotherapists and in hospitals, indicating the accepted validity of the therapy.
To read more from our series on drug free relief of pain with a focus on low back pain, please see our articles – Challenging Traditional Views of Health & Treatments of PAIN and Pain Pain Go Away, DON’T Come Back Another Day.
Australian Institute of Health and Welfare – Back Problems 2019 – https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/back-problems/contents/what-are-back-problems
E-Book – Discover the Power of Drug Free Pain Relief 2019: 100 of the latest life changing Developments in 2019
Bullying and harassment in the workplace can not only cause detrimental physical and psychological health problems for employees, it can also greatly effect job performance and a business’s bottom line (Gordon 2020). While there are obvious forms of bullying including physical and psychological, there can be more subtle and indirect forms of bullying such as deliberate exclusion of someone from work-related activities (Safe Work Australia 2020).
Regardless of its form, businesses have legal obligations to consider all health and safety risks in the workplace including workplace bullying. Failure to take steps to manage the risk of workplace bullying can result in a breach of Workplace Health and Safety laws (Safe Work Australia 2020). Taking steps to prevent bullying from occurring in the workplace and responding quickly if it does is the best way to deal with workplace bullying (Safe Work Australia 2020).
What is workplace bullying?
According to Safe Work Australia, “workplace bullying is repeated and unreasonable behaviour directed towards a worker or group of workers that creates a risk to health and safety (as it may affect the mental and physical health of workers)” (Safe Work Australia 2020). Unreasonable behaviour includes victimising, humiliating, intimidating or threatening (Fair Work Ombudsman 2020).
Some examples of workplace bullying include:
- abusive or offensive language or comments
- aggressive and intimidating behaviour
- belittling or humiliating comments
- practical jokes or initiation
- unjustified criticism or complaints.
Risks to the worker
The effects of workplace bullying can be all consuming for victims as they often don’t confine themselves to the workplace and can cause physical and psychological health problems, including:
- Higher blood pressure
- Panic attacks
- Trouble sleeping
- Ulcers (Gordon 2020).
Effect on work performance
Workers who are experiencing bullying can become so preoccupied with their situation that they lose their ability to work or concentrate because they’re trying to avoid the bully, trying to defend themselves, or ruminating about the situation (Gordon 2020). These outcomes may adversely impact the workplace in the form of workers taking sick leave and being less productive, both of which damage productivity (Safe Work Australia 2020). Other performance issues can include:
- A loss of self-esteem
- Having trouble making decisions
- Lower productivity (Gordon 2020).
Risk to the employer
Workplace bullying has detrimental effects on employers by creating a hostile work environment, impacting worker morale, promoting absenteeism and ultimately reducing productivity (Gordon 2020). Other effects on the employer can include:
- Increased risk of costly legal action
- Increased use of sick leave, health care claims and staff turnover
- Additional costs to recruit and train new employees
- Poor public image and negative publicity (Gordon 2020).
Why prevent workplace bullying?
A report on the psychosocial safety climate and worker health in Australia (The Australian Workplace Barometer 2016), found that workers with psychological distress took four times as many sick days per month and had a 154% higher performance loss at work than those not experiencing psychological distress. This equates to an average cost of $6,309 per annum in comparison with those not experiencing psychological distress.
Therefore it is in the best interests of employers to minimise the risk of workplace bullying by taking a proactive approach to identify early, any unreasonable behaviour and situations likely to increase the risk of workplace bullying occurring, and act upon them (Safe Work Australia 2020).
Australian Workplace Barometer Report: Psychosocial safety climate and worker health Australia, 2016 – https://www.safeworkaustralia.gov.au/doc/australian-workplace-barometer-report-psychosocial-safety-climate-and-worker-health-australia
Fair Work Ombudsman: Bullying & Harassment – https://www.fairwork.gov.au/employee-entitlements/bullying-and-harassment
Gordon, S. 2020. The Effects of Workplace Bullying –https://www.verywellmind.com/what-are-the-effects-of-workplace-bullying-460628
Safe Work Australia 2020: Bullying – https://www.safeworkaustralia.gov.au/bullying
The World Health Organisation defines ‘HEALTH’ as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (WHO 1948). This definition champions the idea that health is a multifaceted state of being, mimicking the Biopsychosocial Model of Health which acknowledges that it is the deep interactions between biological, psychological, and social factors that lead to outcomes of wellness and disease (Community Development and Health Network 2018).
The same concept can be applied to the treatment of pain, whereby pain relief should not be limited to the use of analgesia medications to relieve physical pain. Pain, just like health, should be approached in a multifaceted way that combines the use of pharmacological treatment with drug-free pain relief therapies and treatments that effect the holistic and interrelated experience of pain physically, psychologically and socially.
PAIN in Australia
Unfortunately for many Australians, pain is a pervading and debilitating part of life. In 2018, 1 in 3 Australians (that’s 6.9 million) suffered from arthritis or and other musculoskeletal conditions such as back pain and osteoporosis, making musculoskeletal conditions the fourth leading contributor to the total disease burden in Australia (AIHW 2018).
Specifically speaking, more than 4 million Australians struggle with back pain on a daily basis (AIHW 2019). And with an estimation that 70–90% of Australians will suffer from lower back pain at some point in their lives, (AIHW 2019) optimising the treatment and management of this pain is critical in order to reduce its impact on our quality of life and its burden on society as a whole.
Drug-Free Pain Relief of Back Pain
In our previous article, we discussed drug-free pain relief for back pain including Physical Movement Therapies including staying active, Pilates, Yoga, and Thai Chi through focusing on core strength, posture, and flexibility, as well as Spinal Decompression Therapy as a treatment of slipped discs, pinched nerves, bulging or herniated discs, and worn discs.
Delving deeper into drug-free pain relief, a recently released E-Book titled, Discover the Power of Drug-Free Pain Relief 2019 (2018), discusses 100 of the latest life-changing drug-free pain relief developments which also includes a number of elements of Dietary Medicine and Medicinal Cannabis among many others.
Let thy food be thy medicine and let thy medicine by thy food. (Hippocrates, The Father of Medicine – 400 B.C)
Healthy and balanced food choices play a major role in supporting our overall well-being. Of specific interest within dietary medicine is the concept that food is a huge contributor to inflammation in the body which has follow-on effects on pain. Dietary Medicine as a form of drug free pain relief is thus attracting the attention of researchers (Discover the Power of Drug Free Pain Relief 2019).
● The Mediterranean Diet is centred around foods with anti-inflammatory properties including; fresh fruits and vegetables, beans and nuts, whole grains, fish, olive oil, small portions of meat and dairy and red wine.
According to Discover the Power of Drug Free Pain Relief 2019 (2018), an anti-inflammatory diet is thought to be beneficial for rheumatoid arthritis and joint pain, assist in lowering cholesterol and guard against the risk of heart disease. It is also suggested that maintaining a healthy body weight is crucial in reducing inflammation within the body.
● Ginger, Tumeric & Apple Cider Vinegar are three popular dietary elements which boast strong anti-inflammatory properties.
o Ginger extract could become a viable alternative to anti-inflammatory drugs as it has been shown to minimise discomfort and stiffness in arthritic joints by 40% over placebo. Ginger’s anti-inflammatory, anti-oxidant and slight analgesic properties are also thought to produce a reduction in pain by inhibiting inflammation on a cellular level.
o While the health benefits of India’s ‘holy powder,’ Tumeric, is the subject of ongoing research, its active ingredient, phytonutrient curcumin, is a powerful inhibitor of enzymes that cause swelling and pain and may assist with osteoarthritis, joint pain, lower back pain, weight loss and ulcerative colitis (Discover the Power of Drug-Free Pain Relief 2019).
o Apple Cider Vinegar (ACV) is also most commonly known for its ability to ease arthritis and joint pain due to its strong anti-inflammatory properties. Simply drinking a spoonful of ACV every day has resulted in many anecdotal reports of people who have found lasting relief from arthritis, repetitive stress injury (RSI), and other painful joint conditions (Discover the Power of Drug-Free Pain Relief 2019).
The interest and research in the use of medicinal cannabis for the relief of chronic pain and multiple other conditions continues to grow globally.
While most of us are aware that THC has psychoactive effects on the brain, another chemical in cannabis called cannabidiol (CBD) has no effect on the mind. Instead, CBD shows promise both for the treatment of epileptic seizures, and as an anti-inflammatory and analgesic (Discover the Power of Drug Free Pain Relief 2019). CBD is also commonly used to manage painful muscle spasms caused by multiple sclerosis, and has been used in the final stages of cancer to combat pain and chemotherapy-induced nausea (Neuroscience Trials Australia 2018).
As this is such a vast and varied area, our look into Drug Free Relief of Pain with a focus on low back pain will continue in our next article with a focus on Mind-Body Treatments and Electrical Therapies.
Australian Institute of Health and Welfare, Australia’s Health 2018 – https://www.aihw.gov.au/getmedia/fe037cf1-0cd0-4663-a8c0-67cd09b1f30c/aihw-aus-222.pdf.aspx?inline=true
Australian Institute of Health and Welfare 2018 – Back problems – https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/back-problems/contents/what-are-back-problems
E-Book – Discover the Power of Drug Free Pain Relief 2019 – 100 of the latest Life Changing Developments in 2019.
Models of Health Fact Sheet – Community Development and Health Network 2018 – https://www.cdhn.org/sites/default/files/downloads/FACTSHEETS%201_Screen%20View%281%29.pdf
Neuroscience Trials Australia – LEGALISING MEDICINAL CANNABIS IN AUSTRALIA 2018 – https://www.neurotrialsaustralia.com/legalising-medicinal-cannabis-in-australia/
As much as no-one would ever want to spend two weeks in hotel quarantine with no ability to venture outside, or months under strict lockdowns, it is these severe preventative restrictions that have allowed countries including Australia to eventually suppress the spread of the COVID-19 virus and pandemic.
In particular, Melbourne, Victoria endured some of the longest and strictest lockdowns in the world in late 2020. And just weeks before Christmas 2020, Sydney’s Northern Beaches faced (and continue to face) strict restrictions and lockdown measures in order to reduce the spread of a surge in cases originating from an Avalon cluster.
When the World Health Organisation (WHO) declared the coronavirus outbreak as a Public Health Emergency of International Concern (PHEIC) on the 30th January 2020, (Kantis et al 2020) strict lockdowns weren’t the immediate response. However, it didn’t take long before world leaders began to make unprecedented decisions to prevent the spread of the virus including closing international borders, restricting all non-essential internal travel, enforcing social-distancing measures, and mandatory quarantining of travelers (BBC News 2020).
In order to appreciate how strict lockdowns and quarantining was and continues to be necessary in aiding the prevention of the spread of the COVID-19 virus, its important to understand how the virus is spread.
The virus can spread from person to person through:
close contact with an infectious person (including in the 48 hours before they had symptoms)
contact with droplets from an infected person’s cough or sneeze
touching objects or surfaces (like doorknobs or tables) that have droplets from an infected person, and then touching your mouth or face (Australian Government Department of Health 2020).
It is also known that symptoms may appear 2-14 days after exposure to the virus, meaning that infected people can spread the virus while not even knowing they are infected (Centers for Disease Control and Prevention 2020). This fact combined with the fact that there is no known immunity within our community means that coronavirus has the ability to spread widely and quickly.
Therefore, Quarantine was and is applied to people who are well but may have been in contact with someone with COVID-19, have returned from overseas, or are entering a state or territory that has a required a quarantine period, requiring them to isolate from other people for 14 days in order to prevent the spread of the virus (Department of Health 2020).
Lockdowns of varying levels were also enforced across Australia in order to prevent the spread of COVID-19. By closing businesses, restricting numbers of people at large social gatherings, sending schooling online, limiting visits between family members, preventing visits to nursing homes, canceling sporting events, enforcing strict social-distancing measures, and almost all public life in Melbourne ceasing to exist for 111 days of lockdown (among many other restrictions), people had very limited exposure to each other, thus limiting the ability for the COVID-19 virus to spread amongst the community.
Prior to Sydney’s recent Northern Beaches outbreak, Australia had been referred to as a ‘pandemic success story’ as towards the end of 2020, it was close to eliminating community transmission of COVID-19 while many other counties were seeing infections surge (Odysseus 2020). This is said to be largely due to our leaders urging Australians to take the pandemic seriously from very early on, and Australians’ willingness to give up civil liberties that had never been lost before (Odysseus 2020).
While many lives have sadly been lost and there will of course be many ongoing and long-lasting effects of the pandemic mentally, emotionally and financially, Australians’ respect for and compliance with (albeit some errors) quarantining, lockdowns and unprecedented social restrictions has allowed us to largely gain control over the spread of Covid-19 as many countries around the world continue to struggle to gain control over the virus.
Australian Government Department of Health. Quarantine for Coronavirus, 2020. https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert/how-to-protect-yourself-and-others-from-coronavirus-covid-19/quarantine-for-coronavirus-covid-19 (accessed December 2020).
BBC NEWS. Coronavirus: The world in lockdown in maps and charts, 2020. https://www.bbc.com/news/world-52103747 (accessed December 2020).
Centers for Disease Control and Prevention. Symptoms of Coronavirus, 2020. https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html (accessed December 2020).
Kantis C, Kiernan, S, Socrates Bardi J. Think Global Health. UPDATED: Timeline of the Coronavirus. A frequently updated tracker of emerging developments from the beginning of the COVID-19 outbreak, 2020. https://www.thinkglobalhealth.org/article/updated-timeline-coronavirus (accessed Oct 2020).
Odysseus Patrick, A. Washington Post. Australia has almost eliminated the coronavirus — by putting faith in science. https://www.washingtonpost.com/world/asia_pacific/australia-coronavirus-cases-melbourne-lockdown/2020/11/05/96c198b2-1cb7-11eb-ad53-4c1fda49907d_story.html (accessed December 2020).
Odysseus Patrick, A. Washington Post. The secret to Australia’s success in beating the coronavirus? Being an island helps, 2020. https://www.washingtonpost.com/world/asia_pacific/coronavirus-australia-borders-quarantine/2020/10/01/29e53608-0223-11eb-b92e-029676f9ebec_story.html (accessed December 2020).
The extreme life changes that have been thrust upon the world by the COVID-19 lockdowns have taken a considerable toll on our physical and mental health, without discrimination.
Children, adolescents, adults and the elderly have all been challenged by factors including social isolation, boredom and loneliness, unemployment, financial instability, school and business closures, state and international border closures and extreme and unprecedented social restrictions.
“Common consequences of disease outbreaks include anxiety and panic, depression, anger, confusion, uncertainty and financial stress, with estimates of between 25% to 33% of the community experiencing high levels of worry and anxiety during similar pandemics.” (Black Dog Institute 2020)
As can be expected, the COVID-19 pandemic has led to a significant impact on mental health of the Australian population at large, especially among those who are already vulnerable (Dr. Mandal 2020). Nationally, since 16 March 2020, there has been a 15% increase in the number of Medicare-subsidised mental health services delivered to Australians and 7.4 million services provided (Department of Health 2020).
With around 45% of Australians aged 16-85 said to experience a mental illness in their life (Australian Institute of Health and Welfare 2018), the circumstances of the COVID-19 lockdowns and pandemic have amplified our experience of mental health issues.
It is not surprising that the restrictions imposed on socialising with friends and family, visiting elderly loved ones in care facilities, mourning the death of a loved one at a funeral, celebrating a marriage, attending religious gatherings, working amongst work colleagues, frequenting gyms for exercise or even exercising outdoors (Melbourne, Victoria), have seen the rates of psychological distress, anxiety, and depression symptoms rise among adults in Australia during the peak of the pandemic (Dr Mandal 2020).
Melbourne, Victoria underwent some of the strictest and longest lockdowns in the world (Fernando 2020), triggering an increase in usage of mental health services across the state. The use of Beyond Blue’s Support line was 77% higher in Victoria than in the rest of the country, Victorian use of Lifeline was 16% higher and use of Kids Helpline was 24% higher than in the rest of the country (Department of Health 2020).
Ensuring that essential support was available, the Australian Government prioritised mental health and suicide prevention services with record investment in mental health estimated to be $5.7 billion in 2020–21 including an additional 10 Medicare-subsidised individual psychological therapy sessions available each calendar year, a commitment of $2.4 billion to provide all Australians with access to telehealth, $5 million to fast track electronic prescribing and $25 million to support home delivery of medicines (Department of Health 2020).
This unprecedented investment in mental and physical health funding is assisting Australians to deal with the challenges of lockdowns, isolation, fear for loved ones, and concerns about employment (Aust Government Department of Health 2020). However, despite this, the physical health of many Australians with existing chronic health conditions has been a mounting concern following the sharp fall in healthcare participation as a result of the isolation and social distancing advice, as well as a 40% drop in pathology testing – equivalent to over 60,000 Australians per day not getting tests vital to manage their healthcare (Hepatitis Australia 2020).
This delaying or avoiding necessary routine medical care (despite the availability of telehealth consultations) compounded by the fear of becoming infected with COVID-19 as well as feelings of overburdening the health-care system in a time of crisis could put Australians’ long-term health at risk (Ferguson 2020).
Therefore, while the public health messaging has focused on urging people to stay home as a way of saving lives and preventing the spread of COVID-19, it’s important to highlight that as concern over COVID-19 continues, one of the key exceptions to this is the need to seek medical treatment – even if it is in person.
Anyone worried about their mental health, loneliness, finances, family, or other circumstances should be reassured that help is available and accessible and can contact the Beyond Blue Coronavirus Mental Wellbeing Support Service for free advice and counseling on 1800 512 348 or online. Immediate advice and support is also available through Lifeline (13 11 14) or Kids Helpline (1800 55 1800) (Department of Health 2020).
- Australian Government Department of Health. The mental health impact of COVID-19, 2020. https://www.health.gov.au/news/the-mental-health-impact-of-covid-19 (accessed Nov 2020).
- Australian Institute of Health and Welfare. Australia’s Health 2018: in brief – how do we compare with similar counties, 2018. https://www.aihw.gov.au/reports/australias-health/australias-health-2018-in-brief/contents/how-do-we-compare-with-similar-countries (accessed Nov 2020).
- Black Dog Institute. Mental Health Ramifications of COVID-19: The Australian context, 2020. https://www.blackdoginstitute.org.au/wp-content/uploads/2020/04/20200319_covid19-evidence-and-reccomendations.pdf (accessed Nov 2020).
- Department of Health – Ministers. Caring for Mental and Physical Health during the pandemic, 2020. https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/caring-for-mental-and-physical-health-during-the-pandemic (accessed Nov 2020).
- Dr Mandal, A. Mental health problems peak alongside COVID-19 in Australia, 2020 https://www.news-medical.net/news/20200729/Mental-health-problems-peak-alongside-COVID-19-in-Australia.aspx (accessed Nov 2020).
- Ferguson, C. SBS Insight. Managing chronic conditions in the time of coronavirus, 2020. https://www.sbs.com.au/news/insight/managing-chronic-conditions-in-the-time-of-coronavirus (accessed Nov 2020).
- Fernando, G. SBS News. Is Melbourne’s coronavirus lockdown really the longest in the world? Here’s how other countries stack up, 2020. https://www.sbs.com.au/news/is-melbourne-s-coronavirus-lockdown-really-the-longest-in-the-world-here-s-how-other-countries-stack-up (accessed Oct 2020).
- Hepatitis Australia. Not seeking help may place your health, or your life, at risk, 2020. https://www.hepatitisaustralia.com/news/not-seeking-help-may-place-your-health-or-your-life-at-risk (accessed Nov 2020).
On the 3rd of January 2020, China officially notified the World Health Organisation (WHO) of an outbreak of viral pneumonia of unknown cause (Xinhuanet 2020). Cases and deaths around the world rose astronomically over the coming days and weeks, specifically in China. By January 25, a man from Wuhan, China who had flown to Melbourne on 19 January became Australia’s first confirmed case of coronavirus (Ministers Department of Health 2020).
By the 30th January 2020, the WHO declared the coronavirus outbreak as a Public Health Emergency of International Concern (PHEIC) (Kantis et al 2020). World leaders began to make major and unprecedented decisions to prevent the spread of the virus by closing international borders, enforcing travel bans and mandatory quarantining of travellers.
Since the outbreak of what has become known as the coronavirus COVID-19 global pandemic, the virus has thrown the world into complete upheaval in every sense of the word, flooring healthcare systems, entire countries, industries, economies, families and life as we know it.
As of early October 2020, 214 countries have had COVID-19 cases, over 36.7 million cases have been confirmed globally, and over 1 million deaths have been confirmed worldwide (Kantis et al 2020).
Australia’s COVID-19 battle has included nationwide lockdowns, border closures, major governmental blunders involving cruise ships and hotel quarantining, critical issues regarding a lack of PPE and government direction faced by healthcare workers, mental health and employment crises, and Melbourne undergoing one of the strictest and longest lockdowns in the world (Fernando 2020).
Melbourne has been under social restrictions since 16 March in line with the national restrictions. These were initially extended to 11 May, but on 8 July, Melbourne’s restrictions were reimposed following significantly increasing COVID-19 cases. By 2 August, a state of disaster and an 8pm-5am curfew was ordered (Fernando 2020).
To date in Victoria;
817 people have lost their lives to COVID-19
20,320 total number of cases
122 active cases
11 cases in hospital
no cases in intensive care
19,313 people have recovered
While our state government leaders have been praised for implementing strict restrictions and social distancing laws to reduce the spread of COVID-19, they have also been widely criticised regarding issues faced by healthcare workers including a lack of PPE, support and direction.
Along with the extreme dependence on frontline healthcare workers over the past ten months, inadequate national safety guidance resulted in an inconsistent and non-standardised approach to airborne precaution PPE across health care settings, with some making their own independent safety recommendations to their staff (The Conversation 2020).
A lack of available PPE including adequate face masks and shields, hand sanitiser, gowns and gloves put the lives of these healthcare workers at risk and indeed lead to large numbers of cases in the sector (Grenfell 2020). Furthermore, the Royal Australasian College of Physicians (RACP) found that 20% of health workers across the country lacked access to the most basic protective equipment including masks, with some reports of staff being forced to reuse disposable equipment (RACP 2020). This is something that no healthcare worker should be asked to do, ever. Equally as troubling, the survey also found that only 61% of respondents reported having had recent workplace training in the use of PPE which is crucial to the prevention of transmission (RACP 2020).
RACP President and Respiratory Physician Professor John Wilson said,
Our Government must be doing everything they can to provide them with sufficient protective equipment. We must do everything we can to ensure that healthcare workers are protected from infection while at work – and that includes urgent PPE training for all hospitals who have not yet rolled this out .
As our country endeavours to pull itself from the grasp of an economic, employment and mental health crisis, it is imperative that we learn from the mistakes made in order to improve national policies surrounding our response to such a devastating pandemic as that of COVID-19.
Professor Nick Talley, Editor-in-Chief of the Australian Medical Journal, said the outbreaks in the two states (NSW and VIC) are actually the first wave of the virus in the pandemic.
People talk about the 2nd coronavirus WAVE. It’s NOT the 2nd in Australia.
We essentially never had serious community COVID transmission. Until now.
Please see full article for clarification here – https://7news.com.au/lifestyle/health-wellbeing/coronavirus-outbreak-seen-in-victoria-and-nsw-is-actually-australias-first-covid-19-wave-expert-says-c-1166607
- Fernando, G. SBS News. Is Melbourne’s coronavirus lockdown really the longest in the world? Here’s how other countries stack up, 2020. https://www.sbs.com.au/news/is-melbourne-s-coronavirus-lockdown-really-the-longest-in-the-world-here-s-how-other-countries-stack-up (accessed Oct 2020).
- Grenfell O. World Socialist Web Site. Twenty percent of Australian health workers lack PPE as infections in the sector soar, 2020. https://www.wsws.org/en/articles/2020/08/10/vict-a10.html (accessed Oct 2020).
- Kantis C, Kiernan, S, Socrates Bardi J. Think Global Health. UPDATED: Timeline of the Coronavirus. A frequently updated tracker of emerging developments from the beginning of the COVID-19 outbreak, 2020. https://www.thinkglobalhealth.org/article/updated-timeline-coronavirus (accessed Oct 2020).
- Ministers Department of Health. Media Release: First confirmed case of novel coronavirus in Australia, 2020. https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/first-confirmed-case-of-novel-coronavirus-in-australia (accessed Oct 2020).
- Royal Australasian College of Physicians. RACP survey: 20 per cent of physicians in public hospitals sourcing their own PPE – calls for greater transparency on government stockpile, 2020. https://www.racp.edu.au/news-and-events/media-releases/racp-survey-20-per-cent-of-physicians-in-public-hospitals-sourcing-their-own-ppe-calls-for-greater-transparency-on-government (accessed Oct 2020).
- The Conversation. PPE Unmasked: Why health-care workers in Australia are inadequately protected against coronavirus, 2020. https://theconversation.com/ppe-unmasked-why-health-care-workers-in-australia-are-inadequately-protected-against-coronavirus-143751 (accessed Oct 2020).
- Victoria State Government Health and Human Services. Media Release – Coronavirus Update for Victoria – Tuesday 20 October, 2020. https://www.dhhs.vic.gov.au/coronavirus-update-victoria-20-october-2020 (accessed Oct 2020).
- XINHUANET. https://www.linkedin.com/redir/general-malware-page?url=www%2enews%2ecn%2e China publishes timeline on COVID-19 information sharing, int’l cooperation, 2020. http://www.xinhuanet.com/english/2020-04/06/c_138951662.htm (accessed Oct 2020).
History has long presented a dominating Medical Model of Health since the 18th Century, and the idea that science could cure all illness and disease has remained a core element of modern medicine. The Medical Model of Health measures health simply by determining if a disease is present or not (Community Development and Heath Network 2018). However, this underlying emphasis on the absence of disease as an indicator of good health ignores the power of other important influences, leaving no room for the social, psychological, and behavioural dimensions of illness (Farre & Rapley 2017).
Developed in 1977 by psychiatrist George Engel, the Biopsychosocial Model of Health instead recognises that many factors affect health. This model acknowledges that deep interactions between biological, psychological, and social factors lead to outcomes of wellness and disease (Community Development and Health Network 2018).
Pain Prevalence in Australia
According to the Australian Institute of Health and Welfare, 1 in 3 (6.9 million) Australians suffer from arthritis and other musculoskeletal conditions such as back pain and osteoporosis, making musculoskeletal conditions the fourth leading contributor to the total disease burden in Australia (AIHW 2018).
Specifically speaking, more than 4 million Australians struggle with back pain on a daily basis, the majority of whom report that the pain interferes with their basic activities of daily living (AIHW 2019). When pain lingers, it can significantly compromise our quality of life by causing us physiological pain and disability as well as psychological distress – suffering we don’t want and can’t afford.
And with an estimation that 70–90% of Australians will suffer from lower back pain in some form at some point in their lives, (AIHW 2019) optimisation of treatment and management of this pain is critical.
The Biopsychosocial Model of Pain Management
When applied to the issue of pain, the Biopsychosocial Model of Health implies that pain cannot simply be seen as a physical experience, but as a social and psychological experience also (Discover the Power of Drug Free Pain Relief 2018). Furthermore, treating pain should not solely focus on medications used to relieve physical pain, but on treatments that effect the holistic and interrelated experience of pain physically, psychologically and socially.
Drug-Free Pain Relief
While analgesia (pain medication) will always have its place in pain relief, drug-free pain relief is a vast and varied subject worthy of exploration. A common theme behind many alternative complementary therapies is the concept of the mind-body connection, recognising wellness on a multi-dimensional and holistic level, and providing remedies responsive to this understanding (Discover the Power of Drug Free Pain Relief 2018).
Drug-Free Pain Relief for Low Back Pain
When it comes to alternate and drug-free pain relief, a recently released E-Book titled, Discover the Power of Drug-Free Pain Relief 2019 (2018), discusses 100 of the latest life-changing drug-free pain relief developments, including;
- Physical Movement Therapies
- Dietary Medicine
- Mind-Body Treatments
- Energy Healing
- Electrical Therapies
- Environmental Therapies
Physical Movement Therapies including staying active (while of course avoiding aggravating movements) and practicing Pilates have been shown to provide relief for lower back pain.
The focus on core strength and correct posture is key, as strong abdominal muscles support the lower back and can assist in decreasing strain on joints and discs (Discover the Power of Drug-Free Pain Relief 2018). A similar focus on core strength, posture and flexibility in the practice of Yoga and Thai Chi have also shown to be beneficial in the relief of lower back pain, joint pain and fibromyalgia (Discover the Power of Drug-Free Pain Relief 2018).
Spinal Decompression Therapy (following assessment by a qualified medical professional) is also commonly used in the treatment of slipped discs, pinched nerves, bulging or herniated and worn discs.
As this is such a vast and varied area, our look into Drug-Free Relief of Pain with a focus on low back pain will continue in our next article which will focus on Dietary Medicine, Mind-Body Treatments and Electrical Therapies.
- Models of Health – Medical Model – (Community Development and Heath Network 2018). https://www.cdhn.org/sites/default/files/downloads/FACTSHEETS%201_Screen%20View%281%29.pdf
- Farre & Rapley 2017 – The New Old (and Old New) Medical Model: Four Decades Navigating the Biomedical and Psychosocial Understandings of Health and Illness https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5746722/
- World Health Organisation Definition of Health https://www.who.int/about/who-we-are/frequently-asked-questions
- Australia’s Health 2018: in brief https://www.aihw.gov.au/getmedia/fe037cf1-0cd0-4663-a8c0-67cd09b1f30c/aihw-aus-222.pdf.aspx?inline=true
- Australian Institute of Health and Welfare – Back Problems 2019 https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/back-problems/contents/how-do-back-problems-affect-quality-of-life
How will the COVIDSafe app work?
A user voluntarily downloads the app from the app store. The user registers to use the app by entering a name, phone number and postcode, and selecting their age range. They will receive a confirmation SMS text message to complete the installation of the app. On the basis of this information, an encrypted reference code is generated for the app on that phone. That code is changed every 2 hours to make it even more secure.
The app uses Bluetooth to look for other devices that have the app installed. It takes a note when that occurs, securely logging the other users’ encrypted reference code. The date and time, distance and duration of the contact are generated on the user’s phone and also recorded. The location is not recorded.
This information is securely encrypted and stored on the phone.
The app uses a rolling 21 day window to allow for the maximum 14 day incubation period, and the time taken to confirm a positive test result. The rolling 21 day window allows the app to continuously note only those user contacts that occur during the coronavirus incubation window. Contacts that occurred outside of the 21 day window are automatically deleted from the user’s phone.
The contact information on the phone is not accessible by anyone (including the user of the phone), until the user is diagnosed with coronavirus and they upload the contact information to a highly secure information storage system.
The uploaded information enables state or territory health officials to contact the user and close contacts to provide advice on actions they should take to manage their health.
This cycle continues if a user of the app who was a close contact subsequently tests positive.
What will the app do?
The COVIDSafe app will allow state and territory health officials to contact you if you have been in contact with someone with COVID-19 (coronavirus). They tell you:
- what to look out for
- whether you need to quarantine
- how, when and where to get tested, and
- how you can protect yourself and your family and friends
If you become infected with coronavirus, the app will assist state and territory health officials to notify people with whom you have had close contact and advise them about self-quarantine and getting tested.
This will speed up current manual processes and make it quicker to stop the spread of the virus, particularly if restrictions are eased.
The app operates on a person’s phone as they go about their day.
It securely logs the encrypted reference codes of devices of other people who are using the app who have been in close proximity to you.
The close contact information can only be accessed by relevant health officials if there has been a positive case to help alert those who may need to be tested.
The app will never track your location.
Is there a risk that people may report false positives?
Information collected by the app that is uploaded to the highly secure information storage system will only be accessed by state and territory health officials once a user has a positive diagnosis. This positive diagnosis must be verified by health officials.
Who is a ‘close contact’ for notification purposes?
State and Territory public health officials will have the contact information for other users who have been within approximately 1.5 metres of the infected user for 15 minutes or more.
How does the app know a ‘close contact’ has occurred?
When 2 (or more) app users come into close proximity their phones exchange Bluetooth signals and make a series of ‘digital handshakes’.
The app records the encrypted reference code, time and proximity of 2 users, through the strength of the Bluetooth signals. This allows the approximate distance between the users and the duration the contact occurred to be determined once the data is uploaded to the highly secure information storage system.
The proximity for a close contact is approximately 1.5 metres, for a period of 15 minutes or more.
To be effective, users should have the app running in the background of their phone whenever they are coming into contact with people. Users of the app will receive daily notifications to ensure the app is running.
Why does the app only notify close contacts in the last 21 days?
The average incubation period for someone who contracts COVID-19 is typically 5 to 6 days, however the World Health Organization currently estimate that the incubation period can be up to 14 days.
The app uses a rolling 21-day window to allow for the maximum 14-day incubation period, and the time taken to confirm a positive test result.
The rolling 21-day window allows the app to continuously monitor only those user contacts that occur during the coronavirus incubation window.
Contacts that occurred outside of the 21-day window are automatically deleted from the user’s phone.
What information is captured by the COVIDSafe app?
The app only uses the information that’s needed to alert close contacts and allow health officials to make contact with them.
This information is only the encrypted reference code, date, time, duration and proximity of contacts.
At registration, the user provides their name, phone number and postcode, and selects their age range, which generates an encrypted code
All further information about contacts collected by the app is encrypted and stored within the app on the phone. Users cannot access contact information stored on their phone.
If the user deletes the app, all contact information is deleted.
The contact information on the phone is not accessible by anyone, unless the user is diagnosed with coronavirus and they upload the contact information to a highly secure information storage system.
Can a user or health official view the information stored on the phone including the contact log?
No. All information that is stored on the phone is digitally encrypted and cannot be accessed or viewed by any users or health officials.
Contact information older than 21 days on your phone is automatically deleted.
Can the app be used to track a user or contact?
No. It does not record an individual’s location or movements. The app only records that a contact occurred to allow health officials to contact those users to enable them to quickly self-quarantine and/or seek medical attention.
The app cannot be used to enforce quarantine or isolation restrictions or any other laws.
Commonwealth and state/territory law enforcement agencies will not be allowed to access any information from the app, unless investigating misuse of that information itself.
Do I have to use the COVIDSafe app?
No. Its use is entirely voluntary but using it will help save lives.
For the app to work, it must be running in the background on your phone. Other apps can be used at the same time.
You can delete the app from your phone at any time. This will delete all the app information from your phone.
At the end of the Australian pandemic, users will be prompted to delete the app from their phone. This will delete all app information on a person’s phone. The information contained on the highly secure information storage system will also be destroyed at the end of the pandemic.
If a user receives a close contact notification, will they be advised who the contact was?
No. This will operate in the same way as existing contact processes run by State and Territory health officials.
A phone call will be made to users who have had close contact with another user once that user is independently confirmed as having COVID-19. This phone call will be made by State or Territory health officials.
Close contact information is only available to State and Territory health officials once a user is confirmed as coronavirus positive, and the user securely uploads the information stored on their phone.
These calls will only be made to close contacts that have occurred in the 21 days before the information has been uploaded. This early notification allows users to quickly self-quarantine and seek medical attention.
Why should I use the COVIDSafe app?
Receiving early notification that you may have been exposed to coronavirus means you can be tested or go into quarantine, so your health and others’ is protected.
Without the assistance of technology, finding people who may have been exposed to the virus relies on people being able to recall who they have been around and knowing the details of every individual they have been in close contact with. In many cases, we don’t know the names and contact details of those we’ve been in close contact with (for example, at the supermarket or on the train).
The COVIDSafe app uses technology to make this process faster and more accurate.
The COVIDSafe app has been developed to ensure your information and privacy is strictly protected.