Less than 10 per cent of mining companies in Australia mention Aboriginal engagement, study finds

Less than 10 per cent of companies mining in Australia have publicly stated their positions regarding engagement with Aboriginal communities, land rights, and the preservation of culturally significant sites, research shows.

A Uni SA study assessed the 2017 annual and sustainability reports of 448 companies against a range of outcomes developed by Reconciliation Australia.

It found just 36 companies, or eight per cent, mentioned any ideology, policy, or initiatives related to Aboriginal people.

Mining companies’ interactions with Australia’s Indigenous community have been in the spotlight since Rio Tinto’s destruction of sacred rock shelters at Juukan Gorge in northern Western Australia earlier this year.

The report quoted Minerals Australia research that found more than 60 per cent of the country’s mines neighbour Aboriginal communities.

Larger companies better at disclosure

The research further analysed the 36 companies that did publicly disclose their policies and found that “large mining companies provided detailed disclosure on their Aboriginal engagement initiatives”.

It found “land use and native title agreements were the highest disclosed Aboriginal engagement issue”, which the research said was unsurprising given it was the only area governed by strict regulation.

Given broader reporting was voluntary, the report said a “low level of disclosure on Aboriginal engagement issues does not necessarily indicate a lack of effective engagement practices”.

Instead, it said there was a “need to develop an accounting and reporting framework at the organisational level to capture these social disclosures”.

Researchers say larger miners have policies on Indigenous engagement, but need to employ more Aboriginal people in senior leadership.(AAP: Dan Peled)

‘Power imbalance’ still exists

Uni SA researcher Amanpreet Kaur said disclosures were important not only for the public, but for the “insight gained by the company itself, as [it] requires directors to carefully assess and plan their own course of action”.

Dr Kaur said the analysis also highlighted a lack of Indigenous people in senior leadership positions.

“We found there was a power imbalance,” she said.

The report said Aboriginal people were mostly employed in “supervisory roles or as individual contributors” with “little evidence … regarding their involvement in specialised and leadership roles”.

Rio Tinto was quoted as saying it was “proud to be one of the largest private sector employers of Indigenous Australians”.

It said it employed “1,431 full-time Indigenous employees … [which] represented approximately eight per cent of our Australian employees in 2017”.

But the research found those statistics did not translate into executive and leadership positions across the industry.

“Although the Aboriginal communities are regarded as traditional custodians and owners of mining lands, they are largely perceived as receivers of the benefits, not providers of resources that are crucial for mining companies and their businesses,” Dr Kaur said.

She said “Aboriginal communities were largely treated as a marginalised stakeholder group, similar to women”.

Indigenous leadership could help avoid mistakes

Dr Kaur said a greater concentration of Indigenous people in leadership positions could help to prevent incidents like the destruction at Juukan Gorge.

“That will give Aboriginal communities power to control what happens and is something that is really needed to minimise or reduce – or even possibly eliminate, if that’s possible – such incidents,” she said.

A group of people holding signs reading 'sacred land' and Aboriginal flags surround a smoking fire in a CBD park.
The destruction of sacred Aboriginal sites at Juukan Gorge prompted protests in Perth.(ABC News: Hugh Sando)

Dr Kaur also said companies would likely benefit from Aboriginal employees’ executive input.

“They have thousands of years of knowledge and expertise of land management and the local environment,” she said.

Dr Kaur said progress was being made, with some companies in particular “fostering meaningful engagement with marginalised stakeholders by acknowledging the expertise of the Aboriginal community in local environmental and cultural sustainability”.

“The next phase of our research will construct a framework for companies to develop these kinds of disclosure statements to help them learn from each other and ensure there are techniques for evaluating their effectiveness.”

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Conservatives push for parliamentary committee study of failed vaccine deal

The federal Conservatives are calling for a parliamentary committee probe of the Liberal government’s plan to refit a National Research Council facility in Montreal to start producing a COVID-19 vaccine.

The government announced the $44 million project in May as part of a partnership between the NRC and a Chinese company to develop a made-in-Canada vaccine.

By August, the Liberals had confirmed the partnership with CanSino Biologics had fallen apart after the Chinese government blocked shipments of vaccine samples meant to be used in clinical trials in Canada.

Conservative Leader Erin O’Toole has criticized the Liberals for putting too much faith in Beijing, and blamed the failed deal for Canada being late to order vaccines from other foreign companies.

The proposed committee probe would look at the investment intended to upgrade the NRC facility and how the deal affected Canada’s efforts to ensure the country has timely access to vaccines.

Prime Minister Justin Trudeau admitted last week that Canada might have to wait for other countries to get access to vaccines, though the government and vaccine-makers have since downplayed any delay.

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Study Casts Doubt on Plasma as COVID Treatment

By Ernie Mundell

HealthDay Reporter

WEDNESDAY, Nov. 25, 2020 (HealthDay News) — Early in the COVID-19 pandemic, anecdotal reports suggested that infusing very sick patients with the blood plasma of people who’d survived the disease might help boost outcomes.

But study findings released Nov. 24 in the New England Journal of Medicine, along with disappointing results from prior trials, suggest that those initial hopes may have been unfounded.

The new study was conducted by researchers in Argentina. It compared outcomes for 228 hospitalized COVID-19 patients who got an infusion of so-called “convalescent plasma” against those of 105 patients who did not (the “placebo group”). All were so sick as to have developed pneumonia.

However, one month later, “no significant difference was noted between the convalescent plasma group and the placebo group” in terms of clinical outcomes, with about 11% of patients dying in both groups, according to a team led by Dr. V.A. Simonovich of the Italian Hospital of Buenos Aires.

The theory behind the use of survivors’ blood plasma in people battling COVID-19 is that plasma contains immune system agents that might aid recipients in their fight against the disease.

But a prior study from India — this time in patients with “moderate” COVID-19 — also found little benefit of the treatment in stopping illness from progressing to a more severe stage. That study was led by Dr. Anup Agarwal, of the Indian Council of Medical Research in New Delhi, and was published Oct. 22 in the BMJ.

According to one U.S. expert unconnected to either trial, it may be time to give up on convalescent plasma as a viable COVID-19 treatment.

“There have been several major trials that have shown the same results: Convalescent plasma does not seem to have an impact on the course of COVID-19,” said Dr. Mangala Narasimhan. She’s senior vice president and director of Critical Care Services at Northwell Health, in New Hyde Park, N.Y.

Narasimhan also noted that in the Argentinian trial, “even with good measurement of the amount of antibody they were giving people [in the transfusions], there was no benefit seen.”

She believes that other treatments should remain first-line options for severe COVID-19.

“The new monoclonal antibodies will give a more targeted and reliable antibody load to COVID-19 patients and may have an impact on the course of disease if given early after positive testing,” Narasimhan said.

More information

Find out more about how to treat coronavirus at home from the U.S. Centers for Disease Control and Prevention.

SOURCES: New England Journal of Medicine, Nov. 24, 2020; Mangala Narasimhan, DO, SVP, director of critical care services, Northwell Health, New Hyde Park, N.Y.

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CDC study finds coronavirus rarely kills children, but minorities at higher risk

Children from ethnic and racial minorities, those with underlying health conditions and those between the ages of 18 and 20 are more likely to die, a CDC-led research team wrote in a study published Tuesday in the agency’s Morbidity and Mortality Weekly Report.

The report also showed just how unusual it is for children and young adults to die from coronavirus. Among the 190,000 deaths tallied in the country, only 0.08% — or 121 — were reported in those under 21. The most updated report from the CDC shows 377 children, teens and young adults aged up to 24 have died from coronavirus.

The researchers asked 50 states, New York City, the District of Columbia, Puerto Rico, Guam, and the US Virgin Islands to submit information on coronavirus deaths in those under 21, between February 12 and July 31. Forty-seven jurisdictions responded.

Among the approximately 6.5 million Covid-19 cases in the country, the researchers found a total of 391,814 cases of Covid-19 and MIS-C in those under 21. While people under 21 make up 26% of the US population, they make up only 8% of all reported cases.

Hispanics, Blacks and American Indian/Alaska Natives were disproportionately affected.  A total of 44% of the 121 who died were Hispanic children, 29% were Black children, 4% were American Indian/Alaska Natives and 4% were Asian or Pacific Islander. While these groups represent 41% of the US population under the age of 21, they accounted for approximately 75% of deaths in that age range. Fourteen percent of the deaths were in white children.

“Infants, children, adolescents, and young adults, particularly those from racial and ethnic minority groups at higher risk, those with underlying medical conditions, and their caregivers, need clear, consistent, and developmentally, linguistically, and culturally appropriate COVID-19 prevention messages,” the researchers wrote.

While 25% of the deaths were in previously healthy children, 75% had at least one underlying health condition and 45% had two or more. The most frequently reported medical conditions were chronic lung disease, including asthma; obesity; neurologic and developmental conditions and cardiovascular conditions.

The breakdown among the different age groups varied substantially, with those in the younger age groups doing better than adolescents and young adults. Approximately 10% of the deaths were in infants under the age of 1, an additional 9% were in children between 1 and 4, with another 11% in the 5-9 range and 10% in the 10-13 range. But almost 20% of the deaths were seen in teenagers between the ages of 14 and 17 and more than 40% were in 18 to 20 year-olds.

This matches up somewhat with earlier CDC statistics that found 0 to 4-year-olds are four times less likely to be hospitalized and nine times less likely to die than 18 to 29-year-olds, and 5 to 17-year-olds are nine times less likely to be hospitalized and 16 times less likely to die than 18 to 29-year-olds.

Boys fared worse than girls: males accounted for 63% of the deaths compared with 37% for females.

Even children with no symptoms can spread Covid-19, CDC report shows

Even though children are reassuringly less likely to get severely ill and die, they can still get infected and transmit SARS-CoV-2 to others, according to numerous studies.

For example, in one study published last week in the MMWR, researchers analyzed contact tracing data from 184 people with links to three child care facilities in Salt Lake County from April to July.

They found at least two children who had no symptoms not only caught the virus, but passed it to other people, including one mother who was hospitalized. One eight-month-old baby infected both parents.

“The infected children exposed at these three facilities had mild to no symptoms. Two of three asymptomatic children likely transmitted SARS-CoV-2 to their parents and possibly to their teachers,” the researchers from the Salt Lake County Health Department wrote in their report.

Kids can carry coronavirus in respiratory tract for weeks, study suggests
Another study out of South Korea analyzed data on 91 asymptomatic, pre-symptomatic and symptomatic children diagnosed with Covid-19 between February 18 and March 31 at 22 centers throughout that country. It found that 22% of the children were asymptomatic. The study was published at the end of August in JAMA Pediatrics.
“This highlights the concept that infected children may be more likely to go unnoticed either with or without symptoms and continue on with their usual activities, which may contribute to viral circulation within their community,” wrote two doctors from Children’s National Hospital in Washington, DC, in an accompanying editorial.

The CDC researchers of the current study said it is important to keep a close eye on children infected with Covid-19. “Although infants, children, and adolescents are more likely to have milder COVID-19 illness than are adults, complications, including MIS-C and respiratory failure, do occur in these populations. Persons infected with or exposed to SARS-CoV-2 should be followed closely so that clinical deterioration can be detected early,” they wrote.

Jacqueline Howard, Sandee Lamotte and Lauren Mascarenhas contributed to this report.

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Vegans more likely to break bones than meat eaters, study finds | UK News

Vegans are more likely to suffer fractured bones than people who have meat and fish in their diet, according to new research.

A study based on data from nearly 55,000 people – of which nearly 2,000 were vegans – found that those who were not meat eaters were 43% more likely to suffer any type of broken bone.

The participants in the EPIC-Oxford study were followed for 18 years on average.

The results showed 3,941 fractures occurred in total, and the biggest difference was found in hip fractures, where the risk in vegans was 2.3 times higher than in people who ate meat.

The study has been published in BMC Medicine and lead author Dr Tammy Tong, a nutritional epidemiologist at the Nuffield Department of Population Health, said: “We found that vegans had a higher risk of total fractures which resulted in close to 20 more cases per 1,000 people over a 10-year period compared to people who ate meat.”

In addition to a higher risk of hip fractures in vegans, vegetarians and pescatarians than meat eaters, vegans also had a higher risk of leg fractures and breaks at other main sites, including the arm, wrist, ribs and clavicle.

However, data on whether the fractures were caused by poor bone health or accidents was not available.

Dr Tong added: “Well-balanced and predominantly plant-based diets can result in improved nutrient levels and have been linked to lower risks of diseases including heart disease and diabetes.

“Individuals should take into account the benefits and risks of their diet, and ensure that they have adequate levels of calcium and protein and also maintain a healthy BMI, that is, neither under nor overweight.”

According to the Vegan Society, there were 600,000 vegans in the UK in 2019, equivalent to 1.2% of the population.

The society has reported a rise in people choosing to avoid meat and other animal products during the coronavirus pandemic.

They say it could be due to the cost, convenience or an increased concern for their own health, the environment and animals.

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New Brain Scan Study Could Help Find Best Therapy for OCD

New research has found key differences in the brains of patients with obsessive-compulsive disorder who respond to one form of therapy over another.

The findings could improve the odds that people with OCD will receive a therapy that really works for them, something that eludes more than a third of those who currently get OCD treatment, according to researchers at the University of Michigan in Ann Arbor.

The study suggests the possibility of predicting which of two types of therapy will help teens and adults with OCD: one that exposes them to the specific subject of their obsessive thoughts and compulsive behaviors, or one that focuses on general stress reduction and a problem-solving approach.

While the researchers caution that it’s too early for their work to be used by patients and mental health therapists, they note they are conducting further studies that will test the framework and see if it also applies to children with OCD or obsessive tendencies.

Published in the American Journal of Psychiatry, the new study examines advanced brain scans of 87 teens and adults with moderate to severe OCD who were randomly assigned to one of the two types of therapy for 12 weeks.

The researchers found that, in general, both types of therapy reduced the patients’ symptoms.

They also found that the approach known as exposure therapy, a form of cognitive behavioral therapy or CBT, was more effective and reduced symptoms more as time went on, compared with stress-management therapy or SMT.

But when the researchers looked back at the brain scans taken before the patients began therapy, and linked them to individual treatment response, they said they found striking patterns.

The brain scans were taken while patients performed a simple cognitive task and responded to a small monetary reward if they did the task correctly.

Those who started out with more activation in brain circuits for processing cognitive demands and reward during the tests were more likely to respond to CBT. But those who started out with less activation in those same areas during the same tests were more likely to respond well to SMT, the findings suggest.

“We found that the more OCD-specific form of therapy, the one based on exposure to the focus of obsession and compulsion, was better for relieving symptoms, which in itself is a valuable finding from this head-to-head randomized comparison of two treatment options,” said Stephan Taylor, M.D., the study’s senior author and a professor of psychiatry at Michigan Medicine, U-M’s academic medical center.

“But when we looked at the brain to see what was behind that response, we found that the more strength patients had in certain brain areas were linked to a greater chance of responding to exposure-based CBT.”

The brain regions and circuits that had the strongest links to treatment have already been identified as important to OCD and have even been targets for treatment with an emerging therapy called transcranial magnetic stimulation, the researchers noted.

Specifically, stronger activity in the circuit called the cingulo-opercular network during the cognitive task, and stronger activity in the orbitostriato-thalamic network when the reward was at stake, was associated with better response to exposure-based CBT.

Lower activity in both regions was associated with better response to the stress-reduction SMT.

The effects didn’t vary across age groups, the researchers added.

“These findings speak to a mechanism for therapy’s effects, because the brain regions associated with those effects overlap substantially with those implicated previously in this disorder,” said Luke Norman, Ph.D., who led the work as a U-M neuroscience postdoctoral fellow. “This suggests we need to draw upon the most-affected networks during therapy itself, but further research is needed to confirm.”

The brain scans were done while patients underwent a test that required them to pick the correct letter out of a display, and offered a potential monetary reward if they performed the task correctly. This measured both their ability to exert control over their cognitive processes in picking out the right letter, and the extent to which the promise of a reward motivated them, the researchers explained.

One of the areas most linked to CBT treatment response was the rostral anterior cingulate cortex (rACC). Past research has already linked it to OCD and treatment response, and it’s thought to play a key role in self-regulation of response to OCD triggers, the researchers said. Previously, the University of Michigan team had shown that people with OCD tend to have reduced activation in the rACC when asked to perform tasks that involve cognitive control.

Among those who responded best to CBT, the researchers saw stronger pre-treatment activation in areas of the brain associated with learning how to extinguish fear-based responses to something that has caused fear in the past.

Because exposure therapy for OCD involves facing the thing or situation that provokes obsessive and fearful responses, having a stronger ability to be motivated by rewards might help someone stick with therapy despite having to face their triggers, the researchers suggested.

The findings suggest a path to personalizing the choice of therapy not by doing brain scans on everyone with OCD — which would be impractical, according to the researchers— but by using everyday tests that measure the kinds of characteristics that might predict better success with one therapy or the other.

Easily administered behavioral tests could be developed to help therapists recommend CBT to those who have the most cognitive control and reward responsiveness. Likewise, they could suggest SMT to those who would benefit most from being taught to relax and use problem-solving techniques to improve their response to stressors, said Kate Fitzgerald, M.D., a pediatric OCD specialist at Michigan Medicine. Fitzgerald is co-senior author of the paper and leads multiple studies of OCD therapy for children and adolescents.

Computer-based brain-training exercises that can strengthen these tendencies, and rewards for exposing yourself to the thing or action that triggers OCD symptoms, may hold the potential to improve therapy response, she said.

“This kind of research may help inform efforts to do cognitive control training and ramp up the circuits that help patients overcome conflict between obsessive fears and insight that these fears don’t make sense so that patients can dismiss the fear as improbable, rather than trying to make it go away with compulsive behaviors,” she said.

“Our research shows that different brains respond to different treatments, and if we can build on this knowledge we could move toward a more precision-medicine approach for OCD.”

In children and teens, whose brains are still maturing, there’s an especially good chance of helping them improve their brains’ control functions, she said.

Fitzgerald and her research team are recruiting young people with diagnosed OCD, and OCD-like tendencies, for a clinical trial that provides CBT and includes brain scanning before and after therapy.

Since OCD symptoms typically start in the tween years, though diagnosis may not occur until the teen or young adult years, it’s important to study children with sub-clinical symptoms, she noted.

Though the study involves in-person interactions for the brain scans, the CBT exposure therapy is done through video chat. In fact, Fitzgerald says, this can make it easier for children and teens to confront the item or situation that triggers their OCD-like impulses, because these are often found in the home.

“We need families and patients to engage with researchers in studies like these,” she said. “Only through research can we understand what works best for different groups of patients. And perhaps by doing so we can expand the availability of the most evidence-based OCD therapies, including by engaging psychologists and clinical social workers in leading treatment programs, in addition to psychiatrists at specialized centers.”

Source: Michigan Medicine — University of Michigan

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Study warns elderly individuals less able to reduce contacts during COVID-19 lockdown

In a rigorous medRxiv* preprint paper, a group of researchers demonstrate shifts in age structure and clinical characteristics of individuals affected with coronavirus disease (COVID-19) after social and economic reopening in three US states and show how elderly individuals were less able to reduce contacts when compared to the younger ones.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of the ongoing COVID-19 pandemic, has resulted in significant morbidity and mortality – especially within the United States (US).

Accordingly, state-level re-openings that happened in spring 2020 created a perfect opportunity for the resurgence of SARS-CoV-2 transmission. During this period, one pertinent question was whether human contact and mixing patterns could increase gradually without the increase in viral transmission.

The rationale for the latter was that mixing patterns would likely be linked to better distancing, masking and hygiene practices. Moreover, there was also a question of whether the outbreak’s clinical characteristics would improve after the inceptive surge of cases.

A group of researchers, led by Dr. Nathan Wikle from the Pennsylvania State University, analyzed the age-structured case, hospitalization, and death time series from the three US states (Rhode Island, Massachusetts and Pennsylvania) which have not experienced substantial epidemic rebounds during summer 2020 in comparison to March/April levels.

Transmission-capable mixing βt (in gray and blue) and mobility changes (yellow) from March 1 to August 31. The average population mixing for March 5-15 is set to 1.0 as the pre-epidemic level of transmission-capable mixing, and all other values are reported relative to this. Gray lines show 1000 sampled posterior β-trajectories with the blue lines showing the median and 95% credible intervals. Note that there is substantial uncertainty in these estimates during the first weeks of March, as case numbers were low and reporting may not have been catching a large proportion of true cases at this time. Yellow lines show the fraction of Facebook and SafeGraph users that left home at least once per day. The correlation between populationmovement (yellow) and transmission-capable population movement (gray+blue) begins to disappear in early May in all three states.

Evaluating epidemiological patterns and clinical data streams

These researchers evaluated eleven clinical data streams outlined by the respective state health departments in a Bayesian inference framework. Basically, this is constructed on an ordinary differential equation (ODE) age-structured epidemic model that entails compartments (i.e., clinical states) for hospitalization, critical care, and mechanical ventilation.

More specifically, they have inferred parameters on clinical characteristics, surveillance and transmission patterns of the first epidemic wave that took place in Rhode Island, Massachusetts, and Pennsylvania.

Then they have delineated the patterns of constantly low transmission in the three states mentioned above through August 31, subsequently comparing them to changes in human mobility metrics and appraising changes in age structure and clinical outcomes.

Finally, they have gauged the impact of the spring epidemic on elderly populations in these three states and compared infection fatality rates to the available estimates from other parts of the US.

Shifts in age structure and clinical outcomes

“We show that population-average mixing rates dropped by more than 50% during the lockdown period in March/April and that the correlation between overall population mobility and transmission-capable mobility was broken in May as these states partially reopened”, say study authors in this medRxiv paper.

In their analysis, infection fatality rates were estimated to be higher when compared to the recently published summary studies, with the differences particularly notable in the 60-79 age group where the rates were 1.5 to 2.5 times as high.

Likewise, the researchers have demonstrated that elderly individuals were much less able to decrease contacts during the lockdown period than younger individuals, leading to the outbreak concentrating within elderly congregate settings – despite the lockdown.

Furthermore, the study has also suggested that individuals infected during the spring wave and summer interval were more likely to progress to symptomatic disease in comparison to the average person in the population.

This is actually consistent with the observation that children were the least exposed during the spring and summer months. Hence the exposed population was more prone to progress to apparent symptoms and more likely to develop severe clinical outcomes.

Posterior distributions of reporting rate (panel A) and clinical parameters (panels B to E) for Rhode Island (purple, left column), Massachusetts (orange, middle column), and Pennsylvania (green, right column). (A) Reporting parameter ρ, i.e. the fraction of symptomatic SARS-CoV-2 cases that are reported to the health system, plotted as a function of time. In Rhode Island, it was known that in March testing was not available and cases could not be confirmed; therefore a spline function was fit for ρ. This same function provided a better fit for Pennsylvania data, but not for Massachusetts data. (B) Median length of medicalfloor hospital stay was 7.5 days in RI, 11.9 days in MA, and 15.7 days in PA. This parameter was constrained to be between 11.8 and 12.8 days in MA, as without this constraint identifiability issues arose due to the lack of the ‘cumulative hospitalizations’ data stream. (C) Probabilities of dying at home for the 60-69, 70-79, and 80+ age groups; 60-69 age group was included only for RI as data were insufficient in PA and MA. These are largely reflective of the epidemics passing through nursing home populations where individuals are not counted as hospitalized if they remain in care at their congregate care facility in a severe or advanced clinical state. These probabilities are important when accounting for hospital bed capacity in forecasts. (D) Age-adjusted ICU admission probability during the lockdown period in spring 2020 (lighter color) and after the lockdown (darker color). (E) Probability of hospitalization (median and 95% CIs) for symptomatic SARS-CoV-2 infections, by age group; MA estimates are excluded as these had priors set based on estimates in RI.

Posterior distributions of reporting rate (panel A) and clinical parameters (panels B to E) for Rhode Island (purple, left column), Massachusetts (orange, middle column), and Pennsylvania (green, right column). (A) Reporting parameter ρ, i.e. the fraction of symptomatic SARS-CoV-2 cases that are reported to the health system, plotted as a function of time. In Rhode Island, it was known that in March testing was not available and cases could not be confirmed; therefore a spline function was fit for ρ. This same function provided a better fit for Pennsylvania data, but not for Massachusetts data. (B) Median length of medicalfloor hospital stay was 7.5 days in RI, 11.9 days in MA, and 15.7 days in PA. This parameter was constrained to be between 11.8 and 12.8 days in MA, as without this constraint identifiability issues arose due to the lack of the ‘cumulative hospitalizations’ data stream. (C) Probabilities of dying at home for the 60-69, 70-79, and 80+ age groups; 60-69 age group was included only for RI as data were insufficient in PA and MA. These are largely reflective of the epidemics passing through nursing home populations where individuals are not counted as hospitalized if they remain in care at their congregate care facility in a severe or advanced clinical state. These probabilities are important when accounting for hospital bed capacity in forecasts. (D) Age-adjusted ICU admission probability during the lockdown period in spring 2020 (lighter color) and after the lockdown (darker color). (E) Probability of hospitalization (median and 95% CIs) for symptomatic SARS-CoV-2 infections, by age group; MA estimates are excluded as these had priors set based on estimates in RI.

How to protect the most vulnerable?

In a nutshell, statistical inference described in this paper on attack rates, underreporting and shifting age-profiles may actually provide improved guidance for real-time decision making and adequate public health messaging.

“As recent policy discussions have been diverted by the capitulation and laziness of an epidemic management approach that would encourage younger/healthier populations to become infected, we should restate that our state-level analyses indicate that older individuals are not able to fully isolate during lockdown periods”, accentuate study authors.

Basically, this means that ‘protecting the vulnerable’ strategy is unworkable, as more endangered individuals will still necessitate essential care and contact. Thus, any policy aiming to protect just the vulnerable while granting the rest of the population to move freely would almost certainly fail at preventing viral introduction.

In conclusion, as individuals in the oldest age groups are more or less unaffected by the lockdown, the best solution to protect these (but also other) vulnerable populations is to limit the spread in the general population.

*Important Notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

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How do you campaign for a UN job from your study? Ask Natasha Stott Despoja

Stott Despoja, founding chair of Our Watch, and a former Ambassador for Women and Girls, turned out to be an excellent choice.

But back in March, just after she received the official nomination from the Australian government and she flew to New York to begin her lobbying campaign, Stott Despoja felt she was an outside chance.

“I was nervous, especially given the large number of incumbent candidates,” she says.

Also, the timing could not have been more terrible.

“I spent two days in the UN and then it shut down,” Stott Despoja says from her Adelaide home, where she is in lock-down with her family.

“I had 42 bilateral meetings in that time. It was United Nations speed dating.”

This was less romantic than it sounds: it consisted of sitting in the delegates lounge “with a little flag up” and meeting as many convention signatory states as possible, to lobby for their vote.

On her second day there, Stott Despoja went to shake someone’s hand, only to have the person resile from contact and ask if she had “read the memo” on social distancing.

Then a state of emergency was declared in New York.

She travelled to Washington to give a speech, set for Friday, March 13, but was informed on arrival that the Australian embassy was shut, following Home Affairs Minister Peter Dutton’s COVID-19 diagnosis (he had recently been in the Embassy).

She was told to get home, now, and her flight back to Australia was one of the first where passengers were required to quarantine on arrival.

Stuck at home, she was forced to rely on the dreaded Zoom.

“There are 189 countries eligible to vote – all the member states that have ratified the convention,” she explains.

“You want to talk to as many of them as possible.”

Stott Despoja also travelled to Canberra several times (quarantining for a fortnight after two of those trips) and personally lobbied the heads of mission there – between March and October she had a staggering 190 or so meetings.

“I found nearly every country was fascinated by my primary prevention of violence work,” she says.

“Most countries wanted to ask about COVID and how it would affect violence against women and children.”

The variety of countries she spoke to was dizzying. Some asked for her thoughts on forced marriage, others wanted to know her view on how climate change impacts women in the South Pacific.

“Talking to Guyana, to India and St Lucia before breakfast, it reminded me that while we have some beautiful things in common, some of the things affecting the world are so different,” she says.

“I am excited by it and slightly terrified.”

As with any successful election campaign, the candidate did not work alone. The push was headed by the Office for Women, but won with the substantial work of DFAT, UN Ambassador Mitch Fifield and his staff, and overseen by Minister Payne, who had a “particular passion” for the undertaking.

Says Ambassador Fifield: “Minister Payne led ceaselessly from the front and the DFAT diplomatic network applied a full court press.” The wooing included delivering to ambassadors lamingtons in “Natasha boxes”, which were very well received, he says.

Stott Despoja watched the vote live last week, on UNTV, at about 4.30 in the morning.

She felt relief, happy shock, and crushing fatigue, in that order.

Then she went back to work – she had an Our Watch meeting to chair.

Elizabeth Broderick, who in 2017 was appointed by the UN as a special rapporteur and independent expert on discrimination against women, says Stott Despoja is stepping onto a committee with divergent views.

“It’s going to be a really interesting ride,” says Broderick.

“It’s a diverse group of countries. There are a few issues where there will be hugely different opinions. The committee sets out new human rights standards on certain things, for example on surrogacy – which will be quite divisive, [as is] sex work. ”

Stott Despoja is pragmatic, rather than starry-eyed, about the value of multilateralism in a world where many nations are turning away from it.

“When you have large powerful countries that have expressed their disdain for multilateralism and a stretch in resources at the United Nations, it’s challenging, but that doesn’t mean you give up on it,” she says.

Broderick, who loves her UN job, says that before she started there, the organisation was described to her as “like stirring wet cement with your eyelashes”.

Former sex discrimination commissioner Elizabeth Broderick Elizabeth Broderick is a UN appointed special rapporteur and independent expert on discrimination against women.Credit:Tim Bauer

“It is a huge bureaucracy, but when no one else is there, the UN is there.”

Broderick says there is a global backlash on women’s rights.

“In the new world, being a moderate, measured, considered voice from a mature democracy on some of these issues that are so divisive, is very important.”

Broderick is “excited for Natasha”, and for Australia, although she points out that Stott Despoja sits on the committee as an independent expert, not an Australian representative, and is not required to toe a government line.

“We will definitely hang out in Geneva,” Broderick says.

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Women leaving workforce faster than men, childcare playing big role in exodus: study

TORONTO – A new report from Royal Bank of Canada says more than 20,000 women left Canada’s workforce between February and October, but about triple the number of men joined it.

The study says raising children is likely the cause of the exodus, which is seeing women between ages 20 and 24 and 35 and 39 abandoning work faster than most other cohorts.

Mothers with children under six only made up 41 per cent of the labour force in February and yet, they account for two-thirds of the exodus.

The study warns that this pattern could slow down the economic recovery from the COVID-19 pandemic and impact the future of industries largely dominated by women.

The economists behind the study are particularly worried because the high number of women who have lost their jobs during the pandemic are not temporarily laid off and don’t appear to be looking for work like their male counterparts.

RBC says this could be happening because women are more likely to work in industries slower to recover from COVID-19 restrictions, their ability to work from home may be much lower than men because they dominate the hospitality, retail and arts sectors and they often take on more onerous responsibilities associated with raising kids.

This report by The Canadian Press was first published Nov. 19, 2020.

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