Japan Suicide Rates Reveal COVID-19’s Mental Health Toll

AsianScientist (Jan. 19, 2021) – In a wide-ranging study covering the entire Japanese population, researchers found that suicide rates among women, children and adolescents surged during COVID-19’s second wave. Their results were published in Nature Human Behaviour.

While COVID-19’s varied list of symptoms (or even lack thereof) is well-documented, the disease’s psychological toll has received less attention. Referred to as a ‘hidden epidemic,’ mental health issues have spiked during the pandemic—likely due to anxiety caused by the threat of catching COVID-19 as well as loneliness resulting from social distancing measures.

To investigate COVID-19’s impact on mental health, Dr. Shohei Okamoto from the Tokyo Metropolitan Institute of Gerontology and Mr. Takanao Tanaka from the Hong Kong University of Science and Technology examined changes in Japan’s suicide rates before and after the pandemic’s onset.

The researchers analyzed city-level data covering the entire Japanese population—more than 120 million people—from November 2016 to October 2020. They found that monthly suicide rates dwindled by 14 percent during the pandemic’s first five months, covering a period of February to June 2020.

Suicides among adults saw the greatest decline during Japan’s state of emergency from March to April 2020, in both women (27 percent) and men (21 percent). This decline was likely linked to lower economic stress resulting from the provision of government subsidies along with reduced working hours and commuting time, leading to improved quality of life and mental health. Likewise, the closure of schools during the first wave may have lessened COVID-19’s mental toll on children and adolescents.

In contrast, during the pandemic’s second wave from July to October 2020, monthly suicide rates grew by 16 percent overall, with a respective increase of 37 percent and 49 percent observed among females and adolescents. Meanwhile, suicide mortality rates increased by only about 7 percent in Japanese males.

Considering that the suicide rate among males in Japan is typically 2.3 times higher compared to females, their findings represent a marked difference from historical suicide patterns. Across both waves of the pandemic, suicides among married and unemployed women also increased. These results are consistent with recent studies that show the outsized impact of COVID-19 on industries dominated by women, as well as the greater burden of stay-at-home orders on mothers.

In summary, the pandemic may have disproportionately affected the mental health of women, children and adolescents. Suicide prevention strategies should therefore consider the factors that may have contributed to reduced suicide rates during the first wave, with these strategies tailored towards specific population groups.

“Our results offer a number of important insights on suicide mortality during the pandemic that may be relevant even after normal life resumes,” wrote the paper’s authors. “Overall suicide trends must be monitored, so that immediate policy responses can be considered.”

The article can be found at: Tanaka & Okamoto (2021) Increase in Suicide Following an Initial Decline During the COVID-19 Pandemic in Japan.


Source: Nature; Photo: Shutterstock.
Disclaimer: This article does not necessarily reflect the views of AsianScientist or its staff.

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Registries Could Offer Insight Into COVID-19’s Impact on College Athletes’ Hearts

TUESDAY, Jan. 12, 2021 (American Heart Association News)

Researchers are soon expected to release initial findings from a national cardiac registry of NCAA athletes who have tested positive for COVID-19, giving hope to health care professionals trying to better understand the impact of the disease on the heart.

The data could help doctors diagnose and treat athletes recovering from COVID-19 who have developed myocarditis, an inflammation of the heart. While the number of such cases known publicly among athletes is low, the American College of Cardiology’s Sports and Exercise Cardiology Leadership Council has outlined recommendations for when athletes who have tested positive for the coronavirus can resume physical activity. Guidelines include cardiac testing for those who had COVID-19 symptoms.

Sports medicine and cardiology experts at Harvard University and the University of Washington formed the national registry in collaboration with the American Medical Society for Sports Medicine and the American Heart Association to track cases of COVID-19 and its heart-related aftermath in NCAA athletes. More than 60 schools are currently contributing to the registry.

Before COVID-19, myocarditis accounted for 7% to 20% of deaths attributed to sudden cardiac events in young athletes, according to a recent study in the journal JACC: Cardiovascular Imaging. But data on heart injury in athletes recovering from COVID-19 is limited.

“Registry data of cardiac testing and outcomes in athletes after COVID-19 are needed to guide future screening strategies,” the study authors said.

The research database, called Outcomes Registry for Cardiac Conditions in Athletes, or ORCCA, already has collected data from more than 3,000 athletes. It initially will focus on athletes who have been diagnosed with COVID-19 to identify how the condition impacts the cardiovascular system and injures the heart muscle, the AMSSM statement said. The long-term objective is a registry for athletes diagnosed with cardiovascular disease, regardless of whether it was related to COVID-19.

“You wouldn’t want someone working out intensely in the middle of an inflammation of the heart because it could weaken the heart in the long term,” said Dr. Rachel Lampert, a cardiologist with Yale Medicine in New Haven, Connecticut. She is on the steering committee for the registry. “That’s why the question is particularly relevant in athletes.”

According to a small study published in September in JAMA Cardiology, 4 out of 26 athletes (15%) from Ohio State University who had been diagnosed with COVID-19 and underwent heart MRIs had results “suggestive of myocarditis.”

Ohio State, which lost to the University of Alabama in Monday’s college football championship, is among the 14 schools in the Big Ten Conference. The conference has its own cardiac registry and is contributing to ORCCA.

Dr. Eugene H. Chung is an electrophysiologist and sports cardiologist at Michigan Medicine and member of the Big Ten Cardiac Registry Steering Committee. “It would be very interesting to get a sense of how often we’re seeing myocarditis in student-athletes infected with COVID-19 – we don’t quite know that yet,” said Chung, who also is chair of ACC’s Sports and Exercise Cardiology Leadership Council.

The Big Ten plans to separately review its registry data and have specialists not involved in the initial data collection report independently on findings from cardiovascular evaluations. The Big Ten registry also will include control groups of athletes not affected by COVID-19 and those suffering from other illnesses such as the flu to compare cardiac risk among all three groups.

“With the cardiac registry, the Big Ten will take the lead to further our understanding of the athletic heart as well as the course of COVID-19 infection in the collegiate student-athlete population,” Chung and fellow conference registry steering committee members wrote in a recent article in the AHA journal Circulation.

“Our findings will be informative for broader public health policy as we fight coronavirus and all strive for safe return to play.”

American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. If you have questions or comments about this story, please email [email protected]


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study shows COVID-19’s spread indoors

The study – adding to a growing body of evidence on airborne transmission of the virus – highlighted how South Korea’s meticulous and often invasive contact tracing regime has enabled researchers to closely track how the virus moves through populations.

“In this outbreak, the distances between infector and infected persons were … farther than the generally accepted two metre droplet transmission range,” the study’s authors wrote. “The guidelines on quarantine and epidemiological investigation must be updated to reflect these factors for control and prevention of COVID-19.”

KJ Seung, an infectious disease expert and chief of strategy and policy for the nonprofit Partners in Health’s Massachusetts COVID response, said the study was a reminder of the risk of indoor transmission as many nations hunker down for the winter. The official definition of a “close contact” – 15 minutes, within two metres – isn’t foolproof.

In his work on Massachusetts’ contact tracing program, he said, business owners and school administrators have fixated on the “close contact” standard, thinking just 14 minutes of exposure, or spending hours in the same room at a distance farther than two metres, is safe.

“There’s a real misconception about this in the public,” said Seung, who was not involved in the South Korea study. “They’re thinking, if I’m not a close contact, I will magically be protected.”

Seung said the study pointed to the need for contact tracers around the world to broaden the net in looking for people who had potentially been infected and to alert people at lower risk that they may have been exposed.

An employee disinfects handles on a subway train in Seoul.Credit:AP

Linsey Marr, a civil and environmental engineering professor at Virginia Tech who studies the transmission of viruses in the air, said the five-minute window in which the student, identified in the study as “A,” was infected was notable because the droplet was large enough to carry a viral load, but small enough to travel six metres through the air.

“‘A’ had to get a large dose in just five minutes, provided by larger aerosols probably about 50 microns,” she said. “Large aerosols or small droplets overlapping in that grey area can transmit disease further than one or two metres if you have strong airflow.”

The South Korean study began with a mystery. When a high school senior in Jeonju tested positive for the coronavirus on June 17, epidemiologists were stumped because the city hadn’t had a COVID-19 case in two months. North Jeolla province, where Jeonju is located, hadn’t had one for a month. The girl hadn’t travelled out of the region in recent weeks, and had largely gone from home to school and back.

Containers to be used as a ward to treat people infected with the coronavirus are set up on the grounds of the Seoul Medical Center.

Containers to be used as a ward to treat people infected with the coronavirus are set up on the grounds of the Seoul Medical Center.Credit:AP

Contact tracers turned to the country’s Epidemic Investigation Support System, a digital platform introduced in South Korea amid the pandemic that allows investigators to access cellphone location information and credit card data of infected individuals in as little as 10 minutes.

Cellphone GPS data revealed that the student had briefly overlapped with another known coronavirus patient from a different city and province altogether, a door-to-door saleswoman who had visited Jeonju. Their connection was a first-floor restaurant on the afternoon of June 12 – for just five minutes.

Authorities in the city of Daejeon, where the door-to-door saleswoman was visiting from, said the woman did not tell contact tracers she’d visited Jeonju, about an hour’s drive away, where her company held a meeting with 80 people on the sixth floor of the building with the restaurant.

Lee, a professor at the Jeonbuk National University Medical School who has also been helping local authorities carry out epidemiological investigations, went to the restaurant and was surprised by how far the two had been sitting. CCTV footage showed the two never spoke, or touched any surfaces in common – door handles, cups or cutlery. From the sway of a light fixture, he could tell the air conditioning unit in the ceiling was on at the time.

Lee and his team recreated the conditions in the restaurant – researchers sat at tables as stand-ins – and measured the airflow. The high school student and a third diner who was infected had been sitting directly along the flow of air from an air conditioner; other diners who had their back to the airflow were not infected. Through genome sequencing, the team confirmed the three patients’ virus genomic types matched.

“Incredibly, despite sitting a far distance away, the airflow came down the wall and created a valley of wind. People who were along that line were infected,” Lee said. “We concluded this was a droplet transmission, and beyond two metres.”

The pattern of infection in the restaurant showed it was transmission through droplets landing on the face rather than from aerosols, which are breathed in, said Marr, the Virginia Tech professor who was not involved in the study. The measured air velocity in the restaurant, which did not have windows or a ventilation system, was about a metre per second, the equivalent of a blowing fan.

Students have their temperature checked in Seoul in June.

Students have their temperature checked in Seoul in June. Credit:AP

“Eating indoors at a restaurant is one of the riskiest things you can do in a pandemic,” she said. “Even if there is distancing, as this shows and other studies show, the distancing is not enough.”

The study was published at a time when South Korea, like many other countries, is on edge amid a new wave of COVID-19 infections, with daily case rates hovering around 600 in recent days. Seoul this week began requiring restaurants to close by 9pm, limiting coffee shops to take-away only and forcing clubs and karaoke venues to shut down.

The research echoed the findings of a July study out of Guangzhou, China, which looked at infections among three families who dined at a restaurant along the flow of air conditioning in tables that were about one metres apart, overlapping for about an hour.

Ten of the diners tested positive for the coronavirus. Contact tracers in South Korea similarly mapped out a large outbreak at a Starbucks in Paju in August, when 27 people were infected by a woman sitting under a second-floor ceiling air-conditioning unit.

Seung, of Partners in Health, said by retracing infection routes, epidemiological investigators in South Korea had helped researchers worldwide better understand the coronavirus’s spread.

“I showed it to my team doing contact tracing in Massachusetts, and their jaws are dropping,” Seung said. “We know how hard it is to do something like that – it’s impressive.”

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Regional Victoria and Melburnians embrace as COVID-19’s ‘ring of steel’ falls

Melbourne woman Sarah Vincent was on the road with her family well before the crack of dawn today as Victoria’s “ring of steel” was lifted.

Over four months, Ms Vincent and millions of friends and family members were kept apart by the separation of greater Melbourne and the rest of the state, enforced at the height of the state’s coronavirus crisis to limit travel.

On Sunday at 11:59pm it was finally relaxed, and Melburnians and regional Victorians came together on Monday for the first time since July.

“We know so many people have missed those they love the most, those they need to see and have been desperately keen to see for such a long period of time,” Premier Daniel Andrews said.

Ms Vincent had not seen her mother, Wodonga resident Jennie Johnson, in six months — aside from the odd message or video call.

The escape to the north-east Victoria also meant her two-year-old son Blake would have more space to play and spend precious time with his grandparents.

“It felt so good to see my mum and have a cuddle. I’ve been waiting a long time for it,” Ms Vincent said.

“It’s been very difficult, especially with a little one and not being able to have everyone around.

“I had a lot of mental health issues being in lockdown all the time, I couldn’t go anywhere.”

Emotional reunion for mother and daughter

Jennie Johnson said she was on the verge of tears when she saw her daughter pull into the driveway with her young family after counting down the hours.

Family stand closely together at front of house holding toddler in arms
Sarah Vincent, partner Justin and their two-year-old left as early as they could to see her parents.(ABC Goulburn Murray: Mikaela Ortolan)

“We’ve been hanging out for this, it’s been very difficult not being able to see them all,” Ms Johnson said.

The family said they planned to go on picnics, visit the shops, and spend some quality time together.

“Blake seeing his grandparents is a massive thing, and him being able to be a kid and run around having fun, getting muddy, and not being locked down,” Ms Vincent said.

“It’s so different out here. It’s like I can breathe again.”

Surf trips and waiting to see family

Melbourne woman Zoe told ABC Radio she was headed for Anglesea this morning for a surf at long last.

She told Virginia Trioli’s Mornings program it “felt like life was coming back”.

“It looks like it’s going to be heaven,” she said.

Three police officers at a coronavirus checkpoint on a highway.
The checkpoint between regional Victoria and Melbourne is no more.(ABC News: Simon Winter)

Kate from Ballarat said she was looking forward to seeing her son this weekend, having been separated for five months.

She said the most frustrating thing had been tough restrictions in areas of the state where there had been few cases.

“We’ve been waiting for Melbourne to open up, we’ve had very low numbers. Some areas in the western region have had none,” she said.

“You’ve got little businesses that are struggling because we’re waiting for the whole state to be on par, and that’s the hardest part.”

Family reunites for wedding anniversary

The timing of the Government’s decision could not have been better for Gordon Bahn from Leongatha in South Gippsland.

An elderly man, an elderly woman and an adult woman standing together against a wall
Gordon Bahn, his wife Gillian and their daughter Diane were reunited today after the internal border was removed.(Supplied: Gordon Bahn)

Mr Bahn and his wife Gillian today celebrated their 52nd wedding anniversary with their daughter Diane and granddaughter Zoe who travelled from their home in Melbourne’s south-east.

He said it was “lovely” to see his family for the first since June.

“One of the things that Diane wanted to come down for was to wish us a happy anniversary,” Mr Bahn said.

“And Zoe loves to do her cooking, so she cooked us a little cake for our anniversary, that was very enjoyable, and just an enjoyable time to have them here together.”

But he said he did not have plans to travel to Melbourne to see his other grandchildren while there was still a risk of catching coronavirus.

Clinical GP says ‘take it easy’

Australian mental health service Beyond Blue received hundreds of thousands of phone calls from Victorians seeking support over the past four months.

Among the main queries received were concerns about isolation, general uncertainty, job losses, and not being in touch with family and friends.

Beyond Blue’s lead clinical advisor Grant Blashki said with the state now open again there was a great feeling of enthusiasm and relief as people could reunite.

“There’s obviously a lot of joy and relief, but I’m also seeing mixed emotions,” Dr Blashki said.

“There’s a bit of apprehension — particularly older members of the community who have lost confidence and are nervous, and also those who may be dealing with anxiety getting back out there.

“I think a lot of regional people not having access to tourist dollars has been a really big hit and they’re excited to see people visit again.”

Dr Blashki said it could be tough for some people affected by the lockdown and separation moving forward.

“I’m suggesting people take it slow, particularly those who have had anxiety or stress.”

For Beyond Blue’s Coronavirus Mental Wellbeing Support Service call 1800 512 348.

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COVID-19’s changed drugs, alcohol patterns

Two in five Australians have reported drinking more alcohol during lockdown, while the same proportion said they were drinking less, a new study shows.

Dr Monica Barratt from RMIT University, the co-lead researcher of the Global Drug Survey COVID-19 Special Edition, said drinkers who had a diagnosed mental health condition — like feeling depressed, anxious and finding it difficult to cope — were more likely to report increased drinking compared to before the pandemic.

The survey also found twice as many drinkers reported drinking alone while connected with friends through video/audio calls or ‘watch parties’, compared to the 12 months before COVID-19.

“We’re all going through so much at the moment and I don’t know if education alone would help because we need to connect with each other and support each other,” Dr Barratt said.

“What was quite striking was almost half of the sample who reported drinking alone said they were drinking alone more often compared to before the pandemic.

“Many of us are isolated at home and in some ways it’s understandable but the more you drink alone, this is a danger sign for problematic drinking so it’s something to keep an eye on.”

With more than half of the Australian sample aged 25 and under, she said the reason for two in five Australians drinking less was because of limited access to the same locations they would normally be in to drink.

As for drugs, about half of the sample increased their cannabis use and more than 50 per cent said they were more likely to consume the drug alone, compared to pre-pandemic February.

MDMA and cocaine use were the most likely to have decreased compared to seven months ago, with the inability to attend nightclubs, festivals and parties being the most common reason.

“Those who had decreased their use of drugs noted the financial and mental health positives for that,” Dr Barratt said.

“For some people, slowing down might have given them cause to think about the positives and build on a different lifestyle once the restrictions ease.

“But we do have to be prepared for more harm occurring due to bingeing on alcohol and drugs once we’re able to do so because it’s been such a difficult time and people might want to let off steam.

“The concern there is if people haven’t been using drugs for a long time, they may not realise they’ve reduced their tolerance and may need to be concerned about how much they take.”

Drug market shifts were also reported: including half of Australian respondents saying it was harder to access illegal drugs, one-third reported increases in drug prices, and one in five reported decreased drug purity.

“Closing our borders, you would expect a shock to supply but in saying that, people can still access drugs. We are a relatively isolated country with relatively closed borders compared other countries so our drug markets are affected by these global changes and restrictions,” Dr Barratt said.

“Of those who did access illegal drugs during March to June this year, 64 per cent said there was no change in the drug transaction.

“Only a few reported signs of a constricted drug market when profiling their last drug purchase, such as higher price (8 per cent), difficulty finding a supplier (6 per cent) or taking longer than usual to get the drugs (6 per cent).”

The findings were released on Wednesday as part of the world’s largest drug survey.

There were 55,000 participants from around the world, including 1889 in Australia.

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Coming of age under COVID-19’s shadow

Turning 18 is a moment unlike any other. It’s an age when everything out of reach suddenly becomes attainable. Alcohol, the right to vote, driving. A child in society’s eyes one day, an adult the next.

And, for tens of thousands of people, the final year of school. An ending punctuated by milestones – formals, dances, athletics carnivals, valedictory, muck up day, schoolies – a time that, good or bad, most will remember for the rest of their lives.

But what happens in a coming-of-age story when those occasions are experienced alone or cancelled, probably forever? This is what Melbourne’s class of 2020 faces, as COVID-19 puts growing up on hold.

“The whole year has been like this, I’ve had so many letdowns at this point that I’m just used to it by now,” says Sophie Glover, who turns 18 on Tuesday.

Sophie Glover turns 18 on Tuesday and will have dinner with her parents rather than the usual party.Credit:Justin McManus

“It is quite sad, I’ve been looking forward to this birthday for the majority of my life.”

It’s a story repeated across the city for this unlucky group of teenagers reaching adulthood during a pandemic. They understand the serious health reasons but are still a bit mournful that they won’t get the experiences those before them have had.

That’s not to say they haven’t tried. In the beginning, 18th birthday parties were replaced with virtual events. But, as it has for most of us, the enthusiasm for Zoom is starting to wane.

For Sophie, what would have been a get-together with family and friends is now going to be a dinner with her parents. Her friends are sending presents in the mail, which she appreciates.

But it’s not just cake and speeches that 18-year-olds are missing out on.

“I’m pretty bummed out by not being able to spend the final year with my friends,” says Wai Yan Moe, a Cheltenham Secondary College student.

We don't really see the light at the end of the tunnel': Wai Yan Moe.

We don’t really see the light at the end of the tunnel’: Wai Yan Moe.Credit:Simon Schluter

Moe is acutely aware, like many his age, that year 12 is when lifelong friendships are forged. VCE is a pressure-cooker environment and doing it in the presence of others creates lasting relationships.

That’s not happening, at least not in the way it used to. Classes have been held remotely online for at least part of the year, while the small moments that build up — like studying in the library together for an exam — are gone.

Even reuniting in term four, which the state government has flagged could happen, will only provide fleeting sustenance, with exams looming a month later.

“We don’t really see the light at the end of the tunnel,” Moe says. “With VCE coming to a close really soon, there isn’t much time for us left to spend with each other.”

Tahlia Selzer thought 2020 was going to be a series of Jewish festivals and dances that were for senior students only. But she also misses making toasties on Fridays in the year 12 common room at The King David School in Armadale.

Missing out on rites of passage: Tahlia Selzer.

Missing out on rites of passage: Tahlia Selzer.Credit:Jason South

“It’s those silly little things when our whole year level was all together that by themselves may seem insignificant,” the 17-year-old says.

This is also the point when young people become school leaders. For the captains and prefects, it’s been a series of missed opportunities to run events such as assemblies.

“You go into year 12 and you get a mindset about this is what you’re going to do,” says South Oakleigh College captain Andrew Leap, who is 18 next February.

“You see other year levels going through the same thing and you look forward to that. Because we’re at home we kind of don’t get that anymore.”

South Oakleigh College school captain Andrew Leap.

South Oakleigh College school captain Andrew Leap.Credit:Penny Stephens

Then there’s the typically packed social calendar, which has now been all but deleted — at least in a physical sense.

No big deal, some may say, other generations did it tougher by going off to war or full-time work at their age. But that would downplay the importance of many cultural rituals. There’s a reason why just about every coming-of-age movie made by John Hughes in the 1980s featured the high school dance.

Graduation events, typically one of the last for the school year, are also under threat.

“I understand that I come from a privileged position to talk about it. But these are really important rites of passage. Not just 18ths but things like formals,” says Methodist Ladies College student Charlotte Young, who turned 18 in April.

Charlotte  Young wanted to get her P-plates this year so she could go on road trips during summer. She won't be able to get them as she couldn't get the practice hours in due to COVID.

Charlotte Young wanted to get her P-plates this year so she could go on road trips during summer. She won’t be able to get them as she couldn’t get the practice hours in due to COVID.Credit:Justin McManus

“It’s almost like a point to look forward to, to work towards when you’re getting through those trying hours of study. It’s just an emotional cathartic release.”

For those who play school sport, it was also due to be the final year to compete together after several seasons building up to this point.

“As a younger kid, we always looked up to the year 12s playing in the footy team,” says Darby Hipwell, the captain of the Brighton Grammar School firsts football side. “It was kind of our year and our chance to do that.”

As captain of the Sandringham Dragons, a team which regularly produces top-level talent, Darby has the extra challenge of trying to get drafted into the AFL when all junior leagues have been cancelled.

Darby Hipwell is the captain of Brighton Grammar first football team and the Sandringham Dragons. Neither team has played a game this year.

Darby Hipwell is the captain of Brighton Grammar first football team and the Sandringham Dragons. Neither team has played a game this year.Credit:Justin McManus

Like many, and not just those his age, he is hopeful that 2021 turns out to be better than this year.

“At the moment the celebration of turning into an adult is not living up to its expectations,” he says.

The first summer after graduating is a big deal for school leavers. No more exams, maybe a job and some disposable income. And for those going to university, four whole months off until classes start.

For VCE students, true liberation usually comes after the release of the ATAR results in early December. But even that has been delayed, prolonging the stress for a few more weeks.

Rumaan Baryalai, 17, was planning on a family holiday to Uzbekistan, working in his father’s Afghan restaurant and preparing for his next studies.

Now he is dealing with the uncertainty of what going to university will look like, as the pandemic wreaks havoc on tertiary education.

“A lot of my mates are annoyed about missing the uni open days,” the Minaret College student says.

Rumaan Baryalai says missing out on uni open days has added to uncertainty for him and his classmates.

Rumaan Baryalai says missing out on uni open days has added to uncertainty for him and his classmates.Credit:Simon Schluter

Letting loose in the way young people like to do also seems a long way off. The first visit to a pub as an adult, another milestone in Australian cultural life, can’t happen under lockdown. Packed nightclub dancefloors are even further away.

“Everyone talks about the summer after year 12 being the most freeing but I don’t know how that feels for us,” says Chloe Williams, 17.

This week, the Queensland government announced that it was cancelling schoolies week due to the threat of COVID-19. The organisers of Falls Festival, a major event on the music calendar, also threw in the towel.

“We started talking about schoolies last year, all that pent-up excitement is sort of quashed now,” says the Ivanhoe Girls Grammar student.

Delayed independence was a recurring theme for many 17 and 18-year-olds who spoke with The Age about their experiences this year.

For Chloe Williams, her first summer after school arrives under a shadow.

For Chloe Williams, her first summer after school arrives under a shadow.Credit:Jason South

A drivers’ licence is key to that freedom; no more relying on parents for a lift somewhere. But Victoria’s various lockdowns have put paid to learners being allowed to practice their skills on the road or book a driving test.

Even just being able to drive somewhere for no reason, a staple of youth culture since the invention of the car, is off the table.

“I was going to get my licence the day I turned 18,” says Glover, a Melbourne Girls College student.

“I planned out all my hours when I needed to drive, but I’m not able to.”

Katherine Ellis, CEO of Youth Affairs Council Victoria, says young people have made enormous sacrifices in their lives to keep the community safe from COVID-19.

“Many of these sacrifices are a vital part of their transition to adulthood, from missing once-in-a-lifetime rites of passage like graduations, school trips and schoolies, to being stuck in isolation with family at a time when normally they would be expanding their friendship networks, exploring their identities and asserting their independence,” she says.

“These are crucial aspects of growing up that other generations have all experienced.”

But despite this year looking different to what they ever imagined, many 17 and 18-year-olds feel that what they have dealt with may help them in the future.

Williams says she tries to stay positive. “I look at it as being unique, I’ll have great stories to tell,” she says.

Baryalai has a similar view: “I’ll remember that it was a hard time, but I feel it will help us out for university and things like that.”

After missing out on his 18th party in July, Moe is getting excited for his 19th. “I like to think of my friendship groups as tight-knit,” he says.

Selzer doesn’t see it as a missed year. “I’ve realised the resilience of myself and of others,” she says.

“You’re just forced to deal with so much change, we’ve had to step up or be lost in the change.”

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Watch: NYC Doctor Warns of COVID-19’s Long-Term Effects

Most people who are infected with COVID-19 ultimately survive. But for many patients, that may mean living with life-altering symptoms that linger—or become permanent.

In a conversation with Katie Couric for TIME, Dr. Rony Shimony, a cardiologist at Mount Sinai Hospital in New York, said he and his colleagues have noticed that patients as young as their 30s who survived COVID-19 are reporting lasting symptoms. Doctors have discovered issues including kidney damage, reduction in heart function, and cognitive impairment in patients who had been infected with COVID-19, Shimony said, adding that the sicker the patients had been from COVID-19, the greater the damage to their organs.

“We’re now beginning to understand the impact on the brain, on the heart, on the lungs, on the kidneys,” Shimony said. “This particular infection is involving all the body. We need to really take time to understand further the impact on it. And it really causes us to be more cautious about what’s coming ahead.”

History raises further cause for concern. After the Spanish flu of 1918, Shimony said as many as 50% to 60% of patients were found to still have effects four years later. He expects we will see a similar effect with COVID-19.

Fortunately, scientists and doctors are learning about how to treat patients with the disease, including the importance of starting treatment early to head off the risk of organ damage, Shimony said. However, the risk of long-term effects means it’s vital to prevent the disease from spreading.

“This is a disease that can leave people disabled for years to come, or a lifetime,” Shimony said. “The impact it has on a family, psychologically, financially, et cetera, that’s an impact for the country. So we have to build up prevention. We have to listen to the experts. Wear the mask and the social distancing.”

This interview is part of a special series produced in collaboration with Katie Couric. Read more from TIME Reports with Katie Couric, and sign up for her weekday morning newsletter Wake-Up Call with Katie Couric.

Contact us at editors@time.com.

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New Study Reveals COVID-19’s Impact on LGBTIQ Tasmanians

“The biggest issue for me is actually going out to the shops. It’s just so stressful now. I cannot handle the vibes.”

Since the outbreak of coronavirus in Australia earlier this year, many Tasmanians might relate to the sentiment above. It is undeniable that COVID-19 has impacted everyone, but new research shows that some groups are effected differently to others.

During natural disasters and other emergencies all over the world, people who identify as lesbian, gay, bisexual, transgender, intersex, or queer (LGBTIQ) face further marginalisation and barriers to health and wellbeing. For example, during natural disasters, LGBTIQ people experience increased religious stigmatisation and abuse, particularly when disasters are perceived as ‘divine retribution.’

LGBTIQ people are particularly affected by loss of safe personal and community spaces, which may expose them to harassment. Despite these issues, disaster and emergency policy and planning rarely consider gender and sexuality as important factors.

To understand how the current COVID-19 pandemic is affecting LGBTIQ Tasmanians and their families, last month we conducted a survey of over 200 people ranging in age from 14-78. The survey, which is the first of its kind in Australia, explored issues that are concerning LGBTIQ Tasmanians, healthcare access and their feelings of safety and community connection.

Interestingly, LGBTIQ Tasmanians reported being less concerned about contracting the virus themselves, but were much more worried about their family or friends becoming ill or the risk of infecting others with the virus. Overwhelmingly, the impact of COVID-19 on mental health, including feelings of loneliness and boredom in isolation, were key concerns for the community.

Although these feelings are not specific to LGBTIQ people, some participants noted that being LGBTIQ exacerbated feelings of anxiety and loneliness. For example, one participant said “I’ve asked to meet people at a safe distance for exercise, but people have referred to meeting me as ‘non-essential’.”

Another noted that “people have not respected my requests for physical distancing because I am outwardly [gender non-conforming].

Others see me as a hipster who is overreacting and I don’t deserve their time.”

Here, physical distancing and social isolation have had a clear impact on LGBTIQ Tasmanians’ sense of safety and community belonging. Our findings suggest that before COVID-19, most LGBTIQ Tasmanians felt safe and ‘at home’ in their local communities, with a sense that others in their local areas accepted their sexuality or gender identity. But since the outbreak, these feelings of safety and belonging have dropped by up to 20 per cent.

While some of these findings were to be expected, or aren’t necessarily anything new. Our survey also revealed some concerns not widely raised elsewhere. For example, HIV+ people and transgender people were concerned about safe access to medication and hormones during COVID-19. Some same-sex couples were worried that police might not recognise them as being family members and target them for breaching social distancing. People with multiple sexual or romantic partners were finding it hard to navigate public health directives that are often only targeted to nuclear families.

Although many LGBTIQ Tasmanians reported feeling lonely and disconnected from friends and LGBTIQ community, our survey did not find high preferences for more social events online. Interestingly several participants described finding online events and socialising via video chat ‘overwhelming’. One person said that “online interaction is not real connection. It feels forced and actually feels counterproductive in exacerbating loneliness in many regards.” This suggests that, as is no doubt the case for many Tasmanians, LGBTIQ people look forward to spending more time with friends and family in person, and attending physical events where they can enjoy a renewed sense of community in the future.

Heart-warmingly, many participants expressed concern for other LGBTIQ people, especially young people, who may be in isolation with unsupportive family. For example, one participant said “I’m old and gay and out. I worry about those kids for whom it should be time to come out, but there’s nowhere to hide if it goes wrong.”

As well as the wellbeing of other LGBTIQ community members, LGBTIQ Tasmanians were also worried about how COVID-19 would impact both LGBTIQ organisations and the ongoing need for activism. When given a preference, LGBTIQ Tasmanians overwhelmingly reported wanting to receive supports from LGBTIQ organisations. This even included supports like food delivery, public health information, and aged care advice. However, some were concerned about the viability of these services in a post-pandemic economy. The suggested solutions to are more funding for LGBTIQ support services and for the needs of LGBTIQ people to be factored into public health emergency planning in the future.

What these findings show is that while ‘we are all in this together’, different groups in our communities can be affected by COVID-19 in different ways and it is important for us all to be aware of these.

Dr Ruby Grant is a Lecturer in Sociology at the University of Tasmania, specialising in gender and sexuality studies.

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