COVID threats emerge across Australia; trial shows promise for managing diabetes and hypertension; could a new class of drugs help prevent end stage kidney disease?; and the harm of long working hours
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What is the overall focus of this Health Report episode?
This is an ABC podcast.
Hello and welcome to this week's health report with me, Norman Swan.
And me, Tegan Taylor.
Today, it's the biggest workplace hazard, according to the World Health Organization. That is, long working hours can be deadly. How type 2 diabetes might be reversible without drugs, as well as the other conditions that often come with it.
Also on diabetes, could a new class of drugs slash the number of people with diabetes who go on to need dialysis or kidney transplants?
And this week's COVID-19 crisis, where the largest outbreak is in Greater Sydney and has spread to WA and Victoria. Sydney and surrounds have been in lockdown since Friday as contact tracers try to get ahead of the community spread. Around the nation, authorities are trying to stamp out small or separate outbreaks before the virus takes off as in New South Wales. Ian Marchner is Professor of Biostatistics at the University of Sydney and specialises in infectious disease modelling. He says the Delta virus was in an exponential growth phase before the city was locked down and things are almost certain to get worse before they get better. So what does the modelling say about this Delta variant versus the previous variants?
Well, the first thing to say is that it's very early on, so it is hard to do very accurate modelling. But what we can say is that the early indications are that the rate of increase is certainly steeper than what we were seeing with the introduction of the Alpha variant in 2020, probably on the order of 50% greater. What that means is that people will get infected more quickly and outbreaks will be bigger and they'll take longer to get under control. And so therefore, locking down early from an epidemiological perspective is always the best strategy in terms of keeping the cluster as small as possible.
So last year, your modelling group worked out what the effect of delay was. Can you just describe what that,
you know, the effects of delay?
Yes, so last year we modelled the effect of a delay on the increase in the number of infections and found that for each one week of delay in bringing in lockdown conditions, we would multiply the final number infected by fivefold. So with the Delta variant being even more infectious, we can expect that multiple to be even greater than five.
And so what does that mean in terms of the current outbreak?
Well, what it means is that we can expect more infections and then potentially a longer period to bring it under control. But remember, we have moved much more quickly in this cluster than we did early on in the outbreak in 2020. That doesn't mean we couldn't have moved quicker. We probably could have in this case, but we're much earlier in the process this time than we were in 2020. Will two weeks be enough? It's plausible that two weeks will be enough. It's also plausible that it won't be enough. And what we really have to do in this first week is expect further cases to come out of the woodwork as undiagnosed people become infected. and to revisit at the end of this week, essentially, to see how we're going with suppressing the outbreak and whether there would be a need of an extension.
What are the key variables that are in play here?
Well, the key variables essentially are the infectiousness and how much people are mixing. So obviously with a lockdown, we've put the stopper on one aspect of that infectiousness. And really, from my perspective, the really high priority at this point is to be thinking about aged care and the elderly, because that's where the potential is for the greatest burden if we do have a mishap and it gets into aged care.
What about time from infection to being contagious and what do we know about that?
There was initially some suggestion that the incubation period was shorter for this Delta variant. My understanding is that that may not be the case. But certainly that delay is pivotal in terms of how many people get infected from an infected individual. But that's something that we've been dealing with all along that hasn't changed with this outbreak.
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Chapters
8 chapters
1
What is the overall focus of this Health Report episode?
0:01–5:26
2
How does the Delta‑variant modelling predict the outbreak’s trajectory in Sydney and other states?
5:26–10:07
3
Can a very‑low‑calorie weight‑loss program actually reverse type‑2 diabetes and hypertension?
10:07–14:28
4
Do SGLT2‑inhibitor drugs have the potential to prevent end‑stage kidney disease in people with diabetes?
14:28–20:23
5
Why does the World Health Organization label long working hours as the biggest workplace health hazard?
20:23–25:02
6
What are the current benefits and risks of taking low‑dose aspirin for cancer and heart disease?
25:02–30:05
7
Should Australia shift its COVID‑19 monitoring from case numbers to hospitalisation and death metrics?
30:05–34:24
8
What listener questions were answered in the mailbag and what are the take‑away messages?
34:24–38:07
Speakers
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