THE WORSLEY TIMES

Author: Worsley Times

  • Two Jabs or You’re Out! Sportspeople and the Covid Vaccine

    Two Jabs or You’re Out! Sportspeople and the Covid Vaccine

    Gabriel Brown, Intercalating

    Unless you’ve been living under a rock for the past month, you will have seen the flip flopping and fanfare regarding the unvaccinated Novak Djokovic’s expulsion from Australia. However, the vaccine scepticism of the world tennis number one seems like one of many consecutive controversies regarding COVID and the sporting world. Are sportspeople reluctant to get vaccinated, and should COVID vaccination be mandatory to compete in elite sport?

    In sports such as football, tennis, and basketball there are high profile examples of unvaccinated players. The question is, are these vaccine sceptics a loud minority, or do they reflect a systemic issue with vaccination in sport? According to the premier league—English football’s highest tier—84% of players have received at least one dose of the COVID vaccine. This appears high when compared to the equivalent cohort of the general population (16-29 year olds), where only around 60% have received their 1st dose. Additionally, 98% of British athletes who travelled to the Tokyo olympics received both doses before the games. British teams competing in other sports such as Formula 1, cycling, international cricket and rugby union have similarly impressive vaccination statistics, with almost 100% uptake rates, considerably higher than the general population. 

    On the international stage, vocal alternative medicine proponents such as NFL player Aaron Rodgers and the poster boy for vaccine scepticism himself, Novak Djokovic, appear to be a disproportionately vociferous minority. According to the BBC, over 90% of NFL players, as well as over 95% of the top 100 male tennis players are double-vaccinated. 

    Although it appears from these statistics that most of the major sporting world has been vaccinated against COVID-19, there is still a small but unprotected minority who are rejecting the vaccine. Dr Gavin Weedon, Senior Lecturer in Sport, Health and the Body at Nottingham Trent University states that conspiracy theories surrounding health are not unique to sport, and the unfounded views of those such as Novak Djokovic and Aaron Rodgers are just amplified by the platform that sport has given them. The spreading of misinformation is also seen in the sporting media. When Sheffield United’s John Fleck collapsed during a football game, pundits on the popular radio channel TalkSport were quick to associate the collapse with COVID vaccinations. 

    As with all medical interventions, there are some legitimate risks associated with COVID vaccination. For example, vaccine-induced myocarditis or pericarditis is extremely rare, and is usually a mild presentation with a short recovery period. Additionally, there is no evidence to suggest that sport is a contributing risk factor. Moreover, Professor Jeffrey Morris, the director of biostatistics at the University of Pennsylvania states that the cardiac inflammation from COVID-19 infection could be six times more likely than from a COVID vaccination. Additional research has found COVID vaccines in elite athletes to be well-tolerated, with few significant side effects. 

    The discussion on COVID-19 vaccination is swamped with misinformation and conspiracy—sport is no exception. Examples such as Novak Djokovic might imply that vaccine scepticism is endemic in sport, however more of the sporting community is vaccinated than equivalent groups of the general population. According to a YouGov poll, 46% of respondents believe sportspeople should have to disclose their vaccine status, but with new plans to crackdown on unvaccinated athletes, vaccine-hesitant sportspeople may soon be excluded from competition, especially abroad. Vaccine scepticism is not unique to sport, nor is it more prevalent than in wider society; the public eye merely augments the controversial opinions of a small but loud minority. 

    References

    BBC 2022. Novak Djokovic: Australian Open vaccine exemption ignites backlash. BBC News. [Online]. [Accessed 1 February 2022]. Available from: https://www.bbc.co.uk/news/world-australia-59876203#:~:text=Australians%20have%20reacted%20angrily%20to,by%20an%20expert%20independent%20panel.

    BBC 2022. Covid vaccine: How many people are vaccinated in the UK?. BBC News. [Online]. [Accessed 1 February 2022]. Available from: https://www.bbc.co.uk/news/health-55274833.

    Conner, J. 2022. Should sportspeople have to be vaccinated against coronavirus in order to compete? | YouGov. Yougov.co.uk. [Online]. [Accessed 1 February 2022]. Available from: https://yougov.co.uk/topics/politics/articles-reports/2022/01/10/should-sportspeople-have-be-vaccinated-against-cor.

    Duarte, F. 2022. Covid-19 vaccine: Why are some athletes so reluctant to get the jab?. BBC News. [Online]. [Accessed 1 February 2022]. Available from: https://www.bbc.co.uk/news/health-59958952.

    Gov.uk 2022. Coronavirus.data.gov.uk. [Online]. [Accessed 1 February 2022]. Available from: https://coronavirus.data.gov.uk/details/vaccinations.

    Hull, J., Schwellnus, M., Pyne, D. and Shah, A. 2021. COVID-19 vaccination in athletes: ready, set, go…. The Lancet Respiratory Medicine. 9(5), 455-456.

    Hull, J., Wootten, M. and Ranson, C. 2022. Tolerability and impact of SARS-CoV-2 vaccination in elite athletes. The Lancet Respiratory Medicine. 10(1), pp.e5-e6.

    Ingle, S. 2021. Some GB Olympic athletes refusing Covid vaccine over side-effect fears. the Guardian. [Online]. [Accessed 1 February 2022]. Available from: https://www.theguardian.com/sport/2021/jun/25/some-gb-olympic-athletes-still-refusing-to-have-covid-vaccine-boa-claims-athletics.

    Majendie, M. 2022. Elite athletes, Covid chaos and vaccine hesitancy. Standard.co.uk. [Online]. [Accessed 1 February 2022]. Available from: https://www.standard.co.uk/insider/sports-covid-vaccine-tennis-premier-league-novak-djokovic-b971922.html.

    Reuters 2022. [Online]. [Accessed 1 February 2022]. Available from: https://www.reuters.com/article/factcheck-coronavirus-sport-idUSL1N2SK160.

    Rumsby, B. 2022. The sports Covid chaos brewing from the athletes who refuse to get vaccinated. The Telegraph. [Online]. [Accessed 1 February 2022]. Available from: https://www.telegraph.co.uk/sport/2022/01/07/covid-unvaccinated-antivax-players-effect-sport-tennis-football/.

  • Book Review: The Vegetarian by Han King

    Book Review: The Vegetarian by Han King

    Austin Keane, Year 2

    This book is practically indescribable; I read it in a single sitting and was left exhausted—the images sifted hot and wet beneath my skin. To write this then becomes an act of replication, or transposition, turning feeling from vision to verb, unwritten and hidden and written again; as if I were producing upon the table before me a mouthful of forgotten copper, piece by piece.

    The narrative perspective shifts three times, examining the thoughts and actions of three individuals, but remains fixed on Yeong-hye—our Vegetarian in question—and her actions. This is Kang’s intention, allowing us to see exactly what it is she wishes to escape: the scrutiny of these individuals, their failure to see her beyond the flesh she inhabits; the image of the person she used to be, formed from their own interpretations—a wife, an object of lust, a wounded younger sister—which had until now consumed her.

    But then it happens—the dream: a pair of eyes, blood in her mouth, crimson everywhere. She stops eating meat to evade this vision and thus begins the decline. This vegetarianism is not solely her rejection of meat but one of the boundaries enforced upon her, including—so we are told—those of her mind. Familial abuse, self-mutilation and a frequent impulse to nakedness can be seen as initial markers of this being more than just a picky eater. Her lack of self-consciousness surrounding her nakedness can be construed in several ways—a return to the innocence of Adam and Eve, a time before the weight of self-actualisation, or perhaps a re-articulation of the self in its redundancy—she shows us how being physically exposed is no more telling of her true nature.

    And then towards the end, her outrageous claim: that she is a tree, or at least is becoming one. It’s no accident that at this stage—obsessed with the image of her roots extending into the earth, refusing to eat, only drinking water and taking in sunlight—that those around her plead her insanity. She is convinced of her becoming something ancient, beautiful, and they have finally disassembled their previous notions of her—as someone who is ordinary and controlled—and the disconnect between who she is and the woman they have known is finally exposed, always there but now undeniable in its specificity.

    It comes back to the idea of her dream, what is real here and what is false? Her sister acknowledges the redundancy of this question, so perhaps then it’s only how far we’re willing to go to escape human experience, in all its subjectivity? —or indeed whether we feel we must?

     It’s a book about desire and shame, about removing the understanding of herself as a sexual object—something immutably formed by the men in her life—to become something terrifying, unknowable. She extends herself into the earth, is captured in bloom, and for the first time is at peace with this new identity she forms, one free from the tainting of others’ perspectives—they believe her to be damaged beyond repair, insane—and she can finally exist, for the first time really, uninhibited. Only the liminal space is the truly unobserved.

    It’s stunning in the apparent ease of its beauty, and to quote Donna Tartt, ‘Beauty is terror’ after all; and that is what we get here, a frightening depiction of the means by which one woman escapes the entrapment of her life. It’s a haunting evocation of what it is to be free, and the cost of this truth—that to exist unexamined is an imprisonment in of itself. Again I’m reminded of those eyes—in the dream which starts this madness—and I think they may be my own, the reader’s, willing her to see her own indignity, and to be liberated no matter the price. So finally, I wonder if this is Kang’s vision: if you could, if you wanted to, had to, even, would you dare to see? —your own eyes a searing warning, cast in crimson, beautiful, but terrible too. 

  • What is the BSL Bill and Why is it Important for Medical Students to Know?

    What is the BSL Bill and Why is it Important for Medical Students to Know?

    Alice Barber, Intercalating

    The British Sign Language (BSL) Bill passed its second reading in the House of Commons on the 28th of January 2022. (UK Gov. 2022) The Bill, first introduced in June 2021 by MP Rosie Cooper, aims for BSL to be a recognised language with full legal status. (McSorley, C. 2022) It also mandates increased BSL accessibility in public services, including the NHS. Although BSL was formally recognised 19 years ago, the government has failed to follow up on promises to make it a legal language, which is necessary to improve accessibility for many D/deaf people across the UK. (British Deaf Association. 2022) The unopposed passing of the BSL bill on its second reading will now lead to the next stage of the legislative process where it will be assessed by MPs. (O’Dell, L. 2022)

    Looking closer at the BSL Bill reveals how significant its passing will be for BSL users and the D/deaf community. When it hopefully completes the next stages of the legislative process, it will lead to the formation of a BSL users’ advisory board. This will advise the Department of Work and Pensions on the use of BSL in public services, investigate how to increase the numbers of BSL interpreters and look at how the Access to Work scheme can better support BSL users (UK Gov. 2022). All these measures will help make society more accessible for D/deaf BSL users. 

    This is an incredible step forward for the D/deaf community. Currently, D/deaf and hard of hearing BSL users face many barriers in being able to access public services, such as the NHS. This was illustrated during the House of Commons Debate on the Bill when MP Lyn Brown recounted the case of Francesca Bussey, a child of deaf adults (CODA) who had to interpret for her Deaf father as the doctor told him that he was dying (Iqbal, H & Reid, D. 2021). This was just one of many stories of BSL users not being provided with adequate interpreting services to access key information. Not only is this not adequate, but it’s also not legal. The Equality Act 2010 requires that interpreters be available in hospitals for BSL users but, as has been seen repeatedly, this is not enough to ensure accessibility for D/deaf people (Iqbal, H & Reid, D. 2021). The BSL Bill will lead one step closer to BSL users being able to access all public services, including healthcare, via their language. 

    In the passing of the BSL Bill, the government has publicly declared a commitment to promoting the use of BSL. The past few years have highlighted the government’s failings to facilitate BSL use, specifically lacking a BSL interpreter for the daily coronavirus Downing Street briefings during the pandemic (Where is the Interpreter. 2020). When the British Government themselves are failing to follow their own Equality Act, it sets a precedent for other public services. 

    The NHS is one of the key public services that BSL users are fighting for equal access to.  It can be easy as students to think we can’t do anything, but we can be powerful allies. On placement we are on the frontline meeting patients and so are ideally placed to help to increase accessibility. We can start by advocating for BSL interpreters for patients who request them. We can also learn BSL ourselves – there are enough resources out there made by D/deaf teachers that can help us better communicate with D/deaf patients. We can also educate ourselves on D/deaf awareness so that we can better support D/deaf and hard of hearing patients both now and as future doctors.

     It is estimated that 1 in 5 people in the UK are either D/deaf or hard of hearing and so it is almost certain that we will encounter these patients in clinical settings. We should be prepared to support them as best as we can. So, find out whether there are clear masks on the ward you are based on to allow lip readers to see your face, find out how you can request a BSL interpreter, and do your best to learn more about the D/deaf community and hearing loss. 

    There are many resources to learn about BSL and D/deaf awareness but here are just a few:

    References

    British Deaf Association. 2022. BSL Bill passes 2nd reading: UK Deaf community celebrates important step towards legal status of British Sign Language. [Online]. [Accessed 29th Jan 2022]. Available from: https://bda.org.uk/bsl-act-now/

    Iqbal, H., & Reid, D. 2021. ‘The doctors came and I had to tell my father he was dying’.  [Online]. [Accessed 30th Jan 2022]. Available from: https://www.bbc.co.uk/news/stories-59733533

    McSorley, C. BBC. 2022. Government backs bill to promote the use of British Sign Language. [Online]. [Accessed 30th Jan 2022]. Available from: https://www.bbc.co.uk/news/uk-politics-60171412

    O’Dell, L. 2022. British Sign Language (BSL) Bill passes second reading in Commons. [Online]. [Accessed 29th January 2022]. Available from: https://limpingchicken.com/2022/01/28/breaking-british-sign-language-bsl-bill-passes-second-reading-in-commons/

    UK Government. 2022. Government backs vital British Sign Language Bill. [Online]. [Accessed 29th January 2022]. Available from: https://www.gov.uk/government/news/government-backs-vital-british-sign-language-bill

    Where is the Interpreter? 2020. COVID-19 pandemic has brought additional disadvantage and discrimination to the sign language community in the UK. [Online]. [Accessed 30th Jan 2022]. Available from: https://whereistheinterpreter.com/about/

  • Monday is Pale Pink: Can Synaesthesia Change the Way We Learn?

    Monday is Pale Pink: Can Synaesthesia Change the Way We Learn?

    Adrienne Ives, Year 2 Dentistry

    As students we are constantly searching for new ways to learn, whether it be cramming for a final exam or learning a new language. In the last 5 years, teaching and studying methods have evolved from traditional strategies to a more modern approach, with more of us than ever deviating from pen and paper to online notetaking and revision. A quick Google search of ‘How to Study Effectively’ will provide you with an endless list of suggestions, from flashcards and mind maps to spaced repetition and active recall. However, could the secret to more efficient learning and enhanced memory lie in our power of perception?

    The earliest recorded case of synaesthesia in 1690 is attributed to Oxford University academic and philosopher John Locke, who reported an instance of a blind man who said he experienced the colour scarlet when he heard a trumpet (Ward, 2006). Occurring in at least 4.4% of the adult population (Massy-Beresford, 2014), synaesthesia is a rare perceptual phenomenon where individuals, known as synaesthetes, experience overlap between two or more senses (Huth, 2012). This overlap is caused by the stimulation of one sensory pathway leading to involuntary experiences in a second pathway (Cytowic, 2002), meaning colours can be connected to letters and numbers, smells and tastes to music, or touch to vision (Massy-Beresford, 2014). This is mirrored in the word itself, which is derived from the Greek ‘aisthesis’ meaning sensation, and ‘syn’ meaning together (Huth, 2012). 

    The condition is divided into two forms: projective and associative (Helmenstine, 2018). Projective synaesthesia is more widely recognised and is experienced by those who see colours, forms, or shapes when exposed to a stimulus e.g., a number, word, letter or sound. Associative synaesthesia occurs in those who feel a strong involuntary connection between the stimulus and the sense it triggers (Helmenstine, 2018). For example, in chromesthesia, where exposure to sound produces a colour in the mind’s eye, an associator might hear a violin and strongly associate it with the colour blue, while a projector might hear a violin and see the colour blue projected in space as if it were a physical object. 

    Several forms of synaesthesia exist, with some rarer than others. Synaesthetes with Ordinal-Linguistic Personification (OLP) associate ordered sequences like ordinal numbers or alphabetical letters with personalities or genders (Simner & Hubbard, 2006). For example, the letter G might be a busy mother with a kind face. Rarer still are those to whom taste, smell and music produce colours. Avid Disney lovers may remember that in the 2007 movie ‘Ratatouille’ Remy the rat sees colour and hears music when trying new combinations of flavours.

    However, the predominantly studied form of this phenomenon is the most relevant to improving our learning strategies. Grapheme-colour synaesthesia is set apart from other forms as the sensory stimulus and response both belong to the same sensory pathway: visual. Synaesthetes with this form associate numbers and letters with specific colours, e.g., the letter ‘A’ could be navy blue and the number ‘6’ could be yellow. But how does this improve our memory when it comes to learning? 

    There is a large amount of anecdotal evidence of synaesthetes using these associations to enhance their retentive skills in everyday life, from simple tasks like remembering telephone numbers to more complex tasks of memorising pi to over 20,000 decimal places (Baron-Cohen, Bor and Billington, 2007), or  even recalling a list of random words 20 years after reading it (Luria, 1968). 

    Many studies have been carried out to investigate whether this ability can be ‘learned’ by non-synaesthetes. One from the University of East London trained groups of non-synaesthetic young adults to make associations between certain letters and colours, then tested them to see if they remembered words more easily if they were coloured to match their synaesthetic training (Massy-Beresford, 2014). The impact on their cognitive function was then assessed. Results suggested that participants did have a better memory for information learned using the newly learnt synaesthetic techniques (Massy-Beresford, 2014). New Scientist (2014) details a similar study at the University of Amsterdam which found they could induce short term synaesthesia by giving participants books where some letters appeared in certain colours. They also reported an average gain of 12 IQ points, compared to a control group who gained none. 

    This area of research is still young and, whilst synaesthesia could contribute to the large jump in IQ, these benefits may be due to intensive memory exercises rather than synaesthesia training (New Scientist, 2014). So, the advantage of this training in young people may not be that valuable. 

    However, it may be of service to the ageing population. New studies show that synaesthesia training may slow the cognitive decline that accompanies the early stages of Alzheimer’s or help patients in rehabilitation for brain injuries, such as by creating mnemonics to remember things like shopping lists (Massy-Beresford, 2014).

    Although those who experience synaesthesia can use this perceptive ‘power’ to their advantage, those of us who see the world in a little less colour may yet still have to rely on more traditional learning strategies. Memory exercises and spaced repetition seem to be the key, and whilst learning your anatomy lectures with different colours for each letter might be a more novel way to ace your exam than regular black and white flashcards, perhaps the tried and tested methods are used for a reason.

    References

    Baron-Cohen, S., Bor, D. and Billington, J. 2014. Savant memory in a man with colour form-number synaesthesia and Asperger syndrome. Journal of Consciousness Studies. 14(9-10), pp.237-251.

    Cytowic, R.E. 2002. Synaesthesia: A Union of the Senses. [Online]. 2nd ed. Cambridge, Massachusetts: MIT Press. [Accessed 27 January 2022]. Available from: https://psycnet.apa.org/record/2002-01685-000 

    Helmenstine, A.M. 2018. What Is Synaesthesia? Definition and Types. [Online]. [Accessed 27 January 2022]. Available from: https://www.thoughtco.com/synesthesia-definition-and-types-4153376 

    Huth, A. 2012.  What colour is Wednesday?. [Online]. [Accessed 27 January 2022]. Available from: https://www.spectator.co.uk/article/what-colour-is-wednesday-

    Luria, A.R. 1968. The Mind of a Mnemonist. [Online]. [Accessed 27 January 2022]. Available from: http://arteflora.org/wp-content/uploads/2018/05/Luria-The-Mind-of-a-Mnemonist.pdf 

    Massy-Beresford, H. 2014. How we could all benefit from synaesthesia. [Online]. [Accessed 27 January 2022]. Available from: https://www.theguardian.com/science/2014/apr/27/benefit-synaesthesia-brain-injury-mental-decline 

    New Scientist. 2014. People taught synaesthesia learn to read in colour. [Online]. [Accessed 27 January 2022]. Available from: https://www.newscientist.com/article/dn26578-people-taught-synaesthesia-learn-to-read-in-colour/ 

    Simner, J. and Hubbard, E.M. 2006. Variants of synaesthesia interact in cognitive tasks: evidence for implicit associations and late connectivity in cross-talk theories. Neuroscience. 143 (3), pgp.805-814. Ward, O. 2006. The man who heard his paintbox hiss. [Online]. [Accessed 27 January 2022]. Available from: https://www.telegraph.co.uk/culture/art/3653012/The-man-who-heard-his-paintbox-hiss.html

  • Why is ADHD Often Missed in Female Patients?

    Why is ADHD Often Missed in Female Patients?

    Holly Dobbing, Year 2

    Attention Deficit Hyperactivity Disorder, (ADHD), is a behavioural disorder, causing inattentiveness, hyperactivity and/or impulsiveness (NHS, 2018). Symptoms tend to be most prominent before the age of 6, but may become more noticeable after a big life change such as starting school (NHS, 2018). Most children diagnosed with ADHD do not grow out of it, and for children whose symptoms are missed, living with undiagnosed ADHD can cause multiple problems (Oakes, 2019) including having less stable relationships and a higher likelihood of committing suicide later in life (BBC, 2018). In the UK, there are around 1.5 million people with ADHD, however only 120,000 of those are formally diagnosed, (BBC, 2018). This underdiagnosis is particularly prevalent in the female population, with up to seven boys being diagnosed for every girl (Oakes, 2019). So, why is  ADHD so  often missed in females?

    ADHD presents differently in males and females. Typically, females present with more inattentive symptoms, such as making careless mistakes and having difficulty organising tasks (NHS, 2018), whereas males are more likely to present with the more stereotypical hyperactive and impulsive traits, (Millar, 2018). Females with ADHD are also thought to engage in more ‘internalising’ behaviour (Ortega, 2020), trying harder than boys to conceal their symptoms so they are more likely to attempt to fit in with the other children (Sigler, 2019). Furthermore, whilst boys tend to develop symptoms early in life which then decrease as they approach puberty, girls’ symptoms may be more noticeable around puberty due to the increase in their oestrogen levels, (Millar, 2018). This means that because girls typically present later, they often go undiagnosed, or misdiagnosed, commonly with anxiety or depression (Millar, 2018). 

    The effect of this under-diagnosis can be detrimental to a patient’s health and wellbeing. Carrying undiagnosed ADHD into adulthood has been shown to increase risk of anxiety, depression, self-harm, unemployment, unplanned pregnancies and even early death (Ortega, 2020). Having ADHD also places a significant financial burden on individuals, such as having to pay to replace lost items or being charged due to forgetting to pay bills (Sigler, 2019). These seemingly small mistakes can cause overwhelm and distress in individuals with ADHD, further impacting their mental and physical health. Furthermore, individuals who lack an accurate diagnosis don’t have access to the appropriate support networks that they should be entitled to, for example, psychoeducation, behaviour therapy, education programmes, social skills training and cognitive behavioural therapy (NHS, 2018).

    I feel as though this is yet another example of medicine as an institution being designed solely to treat the average white male. Why does the way that boys present – whether it’s their age or their actions – seem to be the default? So, medical students, I’m calling on you to help. All of us need to be acutely aware of the fact that both males and females are impacted by ADHD equally – it is not a ‘male disorder’. It is absolutely imperative that we learn how ADHD can present itself differently depending not only on gender, but the individual. And finally, we need to be able to recognise these different presentations and understand that individuals don’t always fit the classic diagnostic criteria, and not just in ADHD, but in all aspects of healthcare. Our ultimate goal as medical students is to help people, so why not start here?

    References

    BBC. 2018. ADHD diagnosis for adults can take ‘up to seven years’. BBC.

    MILLAR, A. 2018. Is ADHD in adult women underdiagnosed? Patient.

    NHS. 2018. Attention deficit hyperactivity disorder [Online].  [Accessed].

    OAKES, K. 2019. Why is ADHD missed in girls? The Health Gap. BBC.

    ORTEGA, R. P. 2020. Under-diagnosed and under-treated, girls with ADHD face distinct risks. knowable MAGAZINE.

    SIGLER, E. 2019. ADHD looks different in women. Here’s how – and why. ADDitude.

    BBC. 2018. ADHD diagnosis for adults can take ‘up to seven years’. [Online]. Available from: https://www.bbc.co.uk/news/uk-england-44956540

    Millar, A. 2018. Is ADHD in adult women underdiagnosed? [Online] Available from: https://patient.info/news-and-features/is-adhd-in-adult-women-underdiagnosed 

    NHS. 2018. Attention deficit hyperactivity disorder [Online]. Available from: https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd/

    Oakes, K. 2019. Why is ADHD missed in girls? [Online]. Available from: https://www.bbc.com/future/article/20190530-why-is-adhd-missed-in-girls

    Ortega, R. P. 2020. Under-diagnosed and under-treated, girls with ADHD face distinct risks. [Online]. Available from: https://knowablemagazine.org/article/mind/2020/adhd-in-girls-and-womenSigler, E. 2019. ADHD looks different in women. Here’s how – and why. [Online]. Available from: https://www.additudemag.com/add-in-women/

  • ‘Don’t Look Up’: An A-List Apocalyptic Mess or a Misunderstood Masterpiece?

    ‘Don’t Look Up’: An A-List Apocalyptic Mess or a Misunderstood Masterpiece?

    Harry Daisley, Year 1

    Five Academy Award winners, two nominees and two Grammy winners—this is the cast of Adam McKay’s polarising, new sci-fi/satire ‘Don’t Look Up’. Featuring a remarkable proportion of Hollywood’s most loved alumni, including Meryl Streep, Leonardo DiCaprio and even Ariana Grande, one would expect this alone to evoke standing ovations from film critics across the board. But this comedy has proven hard to swallow for many industry experts, having numerous scathingly-hot reviews to its name. In fact, to some it has become an example of the most disastrous disaster movie of recent years. However, for every sceptic, there is a believer that McKay has struck gold with this apocalyptic tale, making this one of the most memorable motion pictures of the year. But where does The Worsley Times stand amongst the confusion? Is this movie a mere A-list apocalyptic mess or a misunderstood masterpiece? Most importantly, is it worth the watch?

    Written, co-produced and directed by Adam McKay, ‘Don’t Look Up’ follows astronomers Dr Randall Mindy and Kate Dibiasky from Michigan State University, played by Leonardo DiCaprio and Jennifer Lawrence, as they attempt to alert humanity of their discovery of an extinction level asteroid heading towards earth through a manic media tour. They face one single problem: no one believes them, not even apathetic U.S. President Orlean, played by Meryl Streep. With the world in denial, the pair of scientists are forced to plead for humanity to ‘just look up’ and see the science at face value, away from the convolution of politics, media and money that consumes the developing situation. Once the threat is identified as imminent the survival of the human race is put in the cold, incompetent hands of politicians and tycoons, provoking the pertinent question:

    Can we trust those in power to manage our impending crises?

    Such a plot seems timely amid a pandemic and climate crisis. However, the execution of certain messages can easily be accused of being patronising, heavy handed and downright clumsy. McKay’s screenplay is highly engaging and audience members from across the world will find deep pockets of dry humour littered throughout the plot. But when it comes to educating audiences, McKay falls short. The plot explicitly and cynically sheds light upon corruption, the pitfalls of a capitalist society and the blind ignorance of humanity in the face of crises, but in a way that is difficult to digest. This is partly due to the way McKay depicts humanity as a pack of blundering fools that refuse science, leaving audiences feeling bitter and resentful towards the blatant calls for change. Yet, it is the film’s star-studded cast, originally believed to be the film’s greatest asset, that becomes one of its greatest difficulties. McKay’s directorial style in ‘Don’t Look Up’ is very much grounded in the present day. He references common societal features such as meme culture and social media in the effort of making the perilous situation appear just a stone’s throw away from the lives of audiences. But when you mix this style with beloved Hollywood stars such as Jennifer Lawrence, Jonah Hill and Timothée Chalamet, the relatability of the storytelling wavers. Just when you begin to become absorbed by the potential reality of what is unfolding onscreen, a familiar face pops up from ‘Mamma Mia’ or ‘Call Me by Your Name’, distracting from McKay’s artistic intentions. Because of this, there are several moments that appear messy onscreen, amounting to a film that is far from perfect.

    Nevertheless, the film’s messy nature is both charming and quirky, prompting the theory that McKay never set out to craft a ‘perfect’ film in the first place. Instead, he aspired to produce a provocative, engaging comedy that would get the world talking. If this was the case, McKay achieved what he set out to do. The film is highly entertaining both with witty writing and stellar performances from the cast. The serious moments are wrapped up in bizarre comedy which only aids their delivery, amounting to a plot that meanders like a body of water—beginning as a small spring, picking up pace and volume until it climaxes into a treacherous river. 

    ‘Don’t look Up’ holds many golden moments. DiCaprio’s portrayal of a socially anxious astronomer is highly convincing, despite the string of heartthrobs he has played in the past. Through his character, Dr Randall Mindy, DiCaprio accurately transmits the frustrations of ignored intellectuals, which closely mirror (or better yet, imitate) the struggles of scientists and activists who regularly have their data pushed aside by politicians. Throughout the pandemic, it has been observed that a spectrum of scientific logic is not always considered by national leaders when making decisions, making McKay’s perspectives only more pertinent to us as healthcare students. 

    This leads to the all-important question, ‘Is It Worth The Watch?’. If you are in the mood for a seamlessly stylised, Oscar-worthy motion picture, I suggest you look elsewhere. However, if you are in search of a few laughs whilst watching your favourite A-listers unravel a bizarre plot of profound relevance, you are in for a treat. While ‘Don’t Look Up’ is not a perfect film, it has heart, it has an original perspective, and it has Ariana Grande in it for goodness’ sake! So, in answer to the big question—yes, I say look up and take a chance on this refreshing, discussion-generator of a movie.

  • The Psychologist from Balkh

    The Psychologist from Balkh

    Zaynab Ahmed, Year 3

    Depression, anxiety, OCD, personality disorders and the like, have all streamed their way into the daily vocabulary of most people today. Hence, it is often attributed to ‘modern medicine’. Truth be told, I view this as arrogant since we have a lot to thank our forefathers in medicine for. Psychopathology has undoubtedly had many struggles and hurdles along its way to being formally recognised, much of which depends on the fact that mental disorders cannot be observed. These disorders are called ‘latent variables’; they are inferred from a matrix of symptoms and are assumed to be the cause (Salkind, 2010).

    Whilst studying GCSE History Medicine through time, I was disappointed to hear passing mention of only two Muslim physicians/polymaths, by their imposed anglicised names. Yet there is a vast legacy of Muslim physicians belonging to the Golden age of Islam, recognised from the seventh to the sixteenth century (Al-Hassani, 2012).

    Therefore, I humbly invite you to tread the path in pursuit of the forgotten Islamic medical history. Our story begins with Abū Zayd Al-Balkhī, a ninth century polymath born in Balkh, now a part of modern-day Afghanistan (Encyclopaedia Britannica, 2013). Although little is known about Al-Balkhī, he wrote an impressive number of books—the most famous being ‘Maṣāliḥ Al Abdān wa al-Anfus’, translated to mean ‘Sustenance of the Bodies and Souls’. The original Arabic manuscript is held in the Ayasofya library in Istanbul. The book is divided into the body and the soul; the soul is then divided into a further eight chapters. These eight chapters have been translated by Malik Badri in the book Abu Zayd al-Balkhī’s Sustenance of the Soul, The Cognitive Behaviour Therapy of a Ninth Century Physician (Balkhī and Badri, 2013) and this article will aim to provide a modest summary.

    Background

    It is important to note from the onset that al-Balkhī was not writing from purely a treatment perspective. Rather, he spoke with a holistic understanding of mental illnesses, placing more emphasis on their prevention like Greek medicine. Greek philosophy laid the foundations of psychology, which was adjusted through history (Shuttleworth, 2010). However, the information was often scattered, and more focus was on the balance of the four humours (Awaad and Ali, 2015). 

    The soul?

    The Soul?

    Admittedly, reading a translation is never the same as the original manuscript. Arabic is no exception; it is a cornucopia of linguistic achievement. Badri mentioned that the Arabic term ‘nafs’ is synonymous to the psyche, ‘but with an Islamic spiritual dimension’ (Balkhī and Badri, 2013, p.11).

    Generally, ‘nafs’ is used in the meaning of ‘self’; for example, ‘he spoke to himself’. This is found in the Qur’ān in numerous places and sometimes translated as soul. More specific to Islamic spirituality and mindfulness is the aspect of desires and the ‘lower self’. The purpose of a Muslim is worship of God and working for the hereafter by reducing the attachment to the earth and the ‘lower self’ –the nafs; this is another way it is understood within the Qur’ān and prophetic narrations. It is apparent from al-Balkhī’s preventative strategy of mindfulness, gratitude and introspection that he meant a combination of the two. 

    The Mind and Body are Intrinsically Linked

    Compared to Freudian theory—which is criticised today for its lack of evidence (McLeod, 2018) and sole focus on the unconscious mind (Paris, 2017)—al-Balkhī determined it was a mix of internal and external causes, and diseases of the body that could cause diseases of the mind. This is especially pertinent when exploring the relationship between disabilities and depression. Noh et al (2016) mentioned that risk factors for depression include ‘abuse; loss of roles; and stressors related to poverty, environmental barriers, and/ or lack of access to appropriate health care’. Al-Balkhī suggests talking therapy and he notes that negative thoughts are the cause of psychological disorders (Balkhī and Badri, 2013) which we call Cognitive Behavioural Therapy (CBT) today (NHS, 2019). The reality is that we all experience negative feelings on occasion; al-Balkhī does not claim that these feelings will be removed altogether but he offers coping strategies and a rational approach to negative feelings.

    Anxiety

    An example of a discussion in the book is al-Balkhī’s mention of ‘al gham’, anxiety, and it being a trigger for anger, frustration, fear and terror. He holds the view that if anxiety is the root of all negative emotions, then similarly joy is the root of health. This is referred to as opposite therapy. Al-Ghazāli employed this technique for patients with mental disorders and it is widely practiced as a spiritual ailment today (Yaacob, 2013) because as the Prophet Muhammad ﷺ (Peace and Salutations be Upon Him) said:

    The cure for ignorance is to question (Abū Dāwūd).

    Much of what al-Balkhī discusses would fit comfortably in a self-help book today in terms of positive affirmations, meditation and anger management. Often, I found myself shutting the book and spending time introspecting. 

    Mindfulness

    The remedies revolve around a healthy internal dialogue, positive affirmations and reflection, which I would translate as mindfulness. Al-Balkhī does not shy away from the spiritual remedies either, by prescribing contemplation on the blessings surrounding oneself, worship of God and in his words ‘he should strongly hold on to the conviction that Allah (God) has not created a disease of the body or a disorder without creating its antidote’ (Balkhī and Badri, 2013). As a Muslim I firmly believe that spirituality in the religious sense can aid treatment and this is apparent from reading the works of the ninth century polymath al-Balkhī, especially when it is only now researchers are drawing links between spirituality and health (Carmody et al, 2008). Contributions to medicine happened across time and across nations and this article gives just a taste of that.

    References

    Al-Hassani, S., 2012. 1001 Inventions: The Enduring Legacy Of Muslim Civilization. 3rd ed. National Geographic Society, p.17.

    Awaad, R. and Ali, S., 2015. Obsessional Disorders in al-Balkhi′s 9th century treatise: Sustenance of the Body and Soul. Journal of Affective Disorders, 180, pp.185-189.

    Balkhī, A. and Badrī, M., 2013. Abū Zayd Al-Balkhī”s Sustenance Of The Soul. London: International Institute of Islamic Thought.

    Carmody, J., Reed, G., Kristeller, J. and Merriam, P., 2008. Mindfulness, spirituality, and health-related symptoms. Journal of Psychosomatic Research, 64(4), pp.393-403.

    Encyclopedia Britannica. 2013. Balkh | Afghanistan. [online][Accessed 11 November 2020]. 

    Available at: https://www.britannica.com/place/Balkh

    McLeod, S.A, 2018. What Are The Most Interesting Ideas Of Sigmund Freud?. [online]. [Accessed 15 November 2020]. Available from: https://www.simplypsychology.org/Sigmund-Freud.html#:~:text=Sigmund%20Freud%20emphasized%20the%20importance,to%20make%20the%20unconscious%20conscious.

    nhs.uk. 2019. Cognitive Behavioural Therapy (CBT). [online]. [Accessed 15 November 2020]. Available from: https://www.nhs.uk/conditions/cognitive-behavioural-therapy-cbt/

    Noh, J., Kwon, Y., Park, J., Oh, I. and Kim, J., 2016. Relationship between Physical Disability and Depression by Gender: A Panel Regression Model. PLOS ONE, 11(11), p.e0166238.

    Paris, J., 2017. Is Psychoanalysis Still Relevant to Psychiatry?. The Canadian Journal of Psychiatry, 62(5), pp.308-312.

    Salkind, N.J 2010, Encyclopedia of research design, vol. 0, SAGE Publications, Inc., Thousand Oaks, CA.

    Shuttleworth, M., 2010. Aristotle’s Psychology – History Of Psychology. [online]. [Accessed 15 November 2020]. Available from: https://explorable.com/aristotles-psychology 

    Yaacob, N., 2013. Cognitive Therapy Approach from Islamic Psycho-spiritual Conception. Procedia – Social and Behavioral Sciences, 97, pp.182-187.

  • Language Barrier: A Poem and Some Solutions

    Language Barrier: A Poem and Some Solutions

    Hira Zaman, Year 2

    The gentleman was in his mid 60s,

    A dress sense like my grandad which hasn’t shifted since the 70s,

    I watched as he nodded blankly to the nurse’s question,

    At every contradicting statement I saw the nurse’s brows furrow in frustration,

    The gentleman turned to me saying beta,

    Is there any way you could help me understand this nurse bethar,

    I looked towards the nurse and she welcomed my input,

    I turned to the gentleman and he smiled thank you puthr,

    I witnessed the creases on his forehead diminish,

    He spoke in full sentences from start to finish,

    After this encounter I empathised,

    I understood why the visits to the doctors were despised,

    By my mother, my grandfather and many others,

    The struggles many immigrants shared with each other,

    The language barrier uncovered.

    Glossary:

    • Beta and puthr—endearing way of addressing someone younger in Urdu
    • Bethar—Urdu for better

    I wrote this poem on the way home after an encounter I had during my primary care placement. The practice where I was situated had a good understanding of the cultural barriers present in consultations due to a diverse patient demographic. The diabetic clinic had pamphlets with diabetic-friendly curry recipes, which I found so useful that I slipped one into my bag for my diabetic grandad. They were very aware of which ethnic groups were more at risk of certain conditions. An example I learned was that South Asian men were more likely to have pilonidal cysts. It even took me by surprise when the nurse seemed to understand the common family dynamics of my own culture. 

    However, I realised that there was an emotional disconnect between the practitioner and the patient through language barriers, which challenged both patient engagement and shared decision making (Suurmond and Seeleman 2006). As healthcare students, we’re taught all these different consultation and communication methods, but we’re rarely taught about how they would need to be adapted when patients have a different first language or when an interpreter is present.

    Effective communication is vital as miscommunication can lead to a higher prevalence of adverse events (Shamsi and Almutairi 2020) So, what can we do to break this language barrier? One possibility is to make it compulsory to ask patients if they require an interpreter when they’re booking appointments.  This should be done even when the person on the phone speaks fluent English, since a lot of people ask English-speaking family members to book appointments on their behalf—I often book appointments for my mum. 

    Practices should also try to hire at least one bilingual staff member and offer this clinician to patients who aren’t proficient in English. Patients would be more likely to attend regularly having built an understanding with a clinician within the practice (O’Donnel et al. 2008).

    Additionally, practices should encourage healthcare professionals to use diagrams or pictures to explain conditions and instructions. Hospitals regularly have volunteers, ranging from high school students to adults such as porters. I think primary care should also consider volunteers who could interpret for patients when an interpreter isn’t available. Healthcare students would be great for this role, but it would be beneficial to provide volunteers with training beforehand. Alongside these volunteers, the NHS should create a library of short videos made by GPs explaining different conditions or examinations in different languages. These videos could be played during the consultation and would reduce the risk of miscommunication, whilst saving time and improving patient understanding and engagement. It’s important that we encourage interpreters to feel comfortable asking questions and challenging a healthcare providers decision, when they feel that an option hasn’t been explored enough for the patient to form an informed decision.

    No patient should ever have to avoid accessing care just because their first language isn’t English. As future healthcare professionals, we need to put our frustrations aside when patients don’t understand us and realise how challenging it must be for a patient to not be understood when their health is compromised. We need to be more innovative—there is so much room for improvement when it comes to reducing the impact of language barriers on the quality of care. On-call online interpreters, System1 updates that include visual and verbal explanations for different conditions in different languages or even pocket translation devices are three simple changes that could do wonders. 

    Alongside many others, English language proficiency is a major social determinant of health, and that needs to change (Rowlands et al. 2015)

    References

    Al Shamsi, H., Almutairi, A.G., Al Mashrafi, S. and Al Kalbani, T. 2020. Implications of Language Barriers for Healthcare: A Systematic Review. Oman Medical Journal. 35(2).

    O’Donnell, C.A., Higgins, M., Chauhan, R. and Mullen, K. 2008. Asylum seekers’

    expectations of and trust in general practice: a qualitative study. The British Journal of

    General Practice. 58(557), pp.e1–e11.

    Rowlands, G., Shaw, A., Jaswal, S., Smith, S. and Harpham, T. 2015. Health literacy and the

    social determinants of health: a qualitative model from adult learners. Health Promotion

    International. 32(1), pp.130–138.

    Suurmond, J. and Seeleman, C. 2006. Shared decision-making in an intercultural context.Patient Education and Counseling. 60(2), pp.253–259.

  • What #MedBikini Has Taught Us About Professionalism

    What #MedBikini Has Taught Us About Professionalism

    Amy Wilson, Year 2

    A row over female doctors in bikinis has led to fresh debate over privacy and how behaviour on social media might affect the public image of the profession. It began when the Journal of Vascular Surgery published an article entitled ‘Prevalence of Unprofessional Social Media Content Among Young Vascular Surgeons’ (Hardouin et al., 2020). The article was later retracted and the authors apologised on Twitter after it sparked a hashtag on social media that has seen doctors of all genders post pictures of themselves in swimwear to protest traditional views on professionalism. 

    It was written by three senior vascular surgeons with the aim of evaluating how levels of professionalism on physicians’ social media affects doctor-patient relationships (Hardouin et al., 2020). The surgeons created fake Twitter, Instagram and Facebook accounts to surveil the feeds of 480 of their peers—without their permission (Hardouin et al., 2020).

    Though their methods caused debate, it is their conclusions that raised the most objections. The biggest area of contention was around what Hardouin et al (2020) called ‘inappropriate/offensive attire’, referring to female doctors who posted ‘provocative’ images of themselves in bikinis or Halloween costumes.

    The way in which female doctors were singled out in the study—despite the authors concluding that unprofessional conduct did not differ significantly between men and women—sparked a huge response. ‘#MedBikini’ went viral across multiple social media platforms, prompting many doctors to post pictures of themselves in bikinis and other similar attire in an open criticism of restrictive views on professionalism.

    So, is this behaviour actually unprofessional? Given the conclusion that there were no violations of the Health Insurance Portability and Accountability Act (HIPAA; an act designed to protect patient health information), nor was there anything requiring disciplinary action, this would suggest that it is not unprofessional behaviour.

    While this was a US study, the problem of how doctors use social media remains relevant here in the UK. The General Medical Council (GMC) guidelines do not explicitly call this behaviour unprofessional. In ‘Doctors’ Use of Social Media’ (GMC, 2013), the GMC calls for doctors to maintain a professional boundary and not to do anything to jeopardise trust in the profession. The question this raises is whether a balance can be had in maintaining both professionalism and liberty in a doctor’s free time. Does wearing a bikini really jeopardise trust in a doctor?

    The answer is, unfortunately, yes. It appears that this traditional view of professionalism stems from subconscious biases about what a good doctor should look like. A 2017 study by the University of Cambridge found that attractive women are thought of as being worse scientists than their peers (Gheorghiu et al., 2017). A public statement by the editors of the Journal of Vascular Surgery has suggested that this bias was present in the study; the researchers admitted that one error in their review process was the presence of conscious and unconscious bias on their part (Shapiro, 2020).

    Dr. Mudit Chowdary, a Chief Resident in Radiation Oncology at Rush University in Chicago, openly criticised the study. He agreed with the idea that doctors should be held to a higher standard of professionalism, especially when it comes to issues of confidentiality. However, he saw the medical field’s view of higher standards as ‘highly conservative and misogynistic’ (Kato, 2020).

    This is not the first time there has been a viral hashtag surrounding conservative views of what constitutes professionalism. In 2016, #ILookLikeASurgeon began to trend, drawing attention to gender and racial diversity in a typically white and male-dominated field. Dr Elizabeth Comen, a New York oncologist and breast cancer specialist, summed up the importance of these hashtags by saying ‘The more attention we give to these issues, the less women will feel alone in their experiences’ (Kaur, 2020). 

    Feelings of restriction, both in professional and personal life, can easily lead to medic burnout. Toniya Singh, chair of the American College of Cardiology’s Women in Cardiology Council, said, ‘What is inappropriate to one person may not be inappropriate to another person’. She added that the study seemed to ask for, ‘physicians to censor themselves from just doing things that normal people get to do’ (Cox, 2020).

    The nebulous nature of what the study considered unprofessional did not only apply to clothing choices. Although the vascular surgeons study did reference issues like patient privacy, behaviour labelled as unprofessional also included drinking alcohol and ‘controversial social topics’, such as discussions of LGBTQ+ rights, abortion and gun control (Hardouin et al., 2020). Elisabeth Bik, a blogger on science integrity, wrote: ‘Is a doctor who posts about gun control laws after sewing up another gunshot victim being unprofessional?’ (Bik, 2020) 

    The #MedBikini debate continues. Many are calling for changes to long-established, conservative views about what it means to look and act a doctor. Those changes might be a while coming, but they also raises vital questions about the role of a doctor. Perhaps it was put most succinctly by Christina LaGamma who tweeted: ‘In medical school we are taught to honour the body, including all physical, mental, and emotional aspects. That should not preclude me from loving and being confident in my own’ (Cox, 2020).

    References

    Bik, E. 2020. #MedBikini paper will be retracted. Science Integrity Digest. 26 July [Online]. [Accessed 31 October 2020]. Available from: https://scienceintegritydigest.com/2020/07/26/medbikini-paper-will-be-retracted/

    Cox, C. 2020. #MedBikini vs JVS: Paper Spurs Debate Over Sexism, Social Media in Medicine. TCT MD. 30 July [Online]. [Accessed 31 October 2020]. Available from: https://www.tctmd.com/news/medbikini-vs-jvs-paper-spurs-debate-over-sexism-social-media-medicine

    General Medical Council. 2013. Doctor’s Use of Social Media. London, GMC. 22 April [Online]. [Accessed 6 October 2020]. Available from: https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/doctors-use-of-social-media/doctors-use-of-social-media#paragraph-4

    General Medical Council. 2013. Maintaining a professional boundary between you and your patient. London, GMC. 22 April [Online]. [Accessed 6 October 2020]. Available from: https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/maintaining-a-professional-boundary-between-you-and-your-patient/maintaining-a-professional-boundary-between-you-and-your-patient#paragraph-3 

    Gheorghiu, A. I., et al. 2017. Facial appearance affects science communication. Proceedings of the National Academy of Sciences. 114 (23), 5970-5975

    Hardouin, S., et al. 2020. RETRACTED: Prevalence of unprofessional social media content among young vascular surgeons. Journal of Vascular Surgery. 72(2), 667-671.

    Kato, B. 2020. Doctors are sharing bikini selfies after study criticizes ‘inappropriate’ attire. NY Post. 24 July [Online]. [Accessed 31 October 2020]. Available from: https://nypost.com/2020/07/24/doctors-share-bikini-selfies-to-protest-controversial-study/

    Kaur, W. 2020. “Too Pretty To Be A Doctor”: Female Physicians, #MedBikini, And Who Determines What’s ‘Professional’. Elle. 10 September [Online]. [Accessed 6 October 2020]. Available from: https://www.elle.com/beauty/a33796252/women-doctors-medbikini-sexism/

    Segal, J. 2020. Bikinis and Unprofessionalism. Byrdadatto. 3 September [Online]. [Accessed 31 October 2020]. Available from: https://www.byrdadatto.com/banter/bikinis-and-unprofessionalism/?utm_content=139104967&utm_medium=social&utm_source=twitter&hss_channel=tw-732612374306258945

    Shapiro, N. 2020. Viral #MedBikini Response To Controversial Manuscript Leads Editor To Retract Article. Forbes. 23 July [Online]. [Accessed 6 October 2020]. Available from: https://www.forbes.com/sites/ninashapiro/2020/07/25/viral-medbikini-response-to-controversial-manuscript-leads-editor-to-retract-article/#39a8fd331f47

  • How Vaccine Hoarding is Affecting the Course of the Pandemic

    How Vaccine Hoarding is Affecting the Course of the Pandemic

    Amy Wilson, Year 2

    On the 4th of August 2021, The World Health Organisation set a December 2021 deadline to vaccinate 40% of the world’s population and to request High-Income Countries (HICs) to stop distributing boosters for at least two months to reroute their surpluses to other countries via COVAX, the vaccine distribution programme (Towey, R. 2021). As 2022 begins, this target has not been met.

    Doctors Without Borders (2021) reports that, whilst more than 60% of the population of HICs have had at least one dose of a COVID-19 vaccine, less than 3% of those in Low-Income Countries (LICs) have. This is in part due to the lack of vaccines being donated; Brown, G. (2021) states that as of November 2021, the UK has delivered 11% of what it initially promised, the EU 19%, and the US 25%. China and New Zealand have done the best of any HICs but have still only delivered half of their respective targets. This unfair distribution is being called “vaccine hoarding”, and, according to Doctors Without Borders (2021), could lead to 241 million doses being wasted by G7 and EU countries by the end of 2021 as they reach their expiration date.

    This issue starts with the suppliers. Pfizer-BioNTech and Moderna have allocated 78% and 85% respectively of their COVID-19 vaccine delivery to HICs, according to Doctors Without Borders (2021). They are also the main groups with the patent for the vaccines, leaving LICs vulnerable as they cannot make their own vaccines without being sued, and so must rely on what is donated.

    India and South Africa called on the World Trade Organisation (WTO) to change this, according to Dearden, N. (2021), by petitioning for Trips—an intellectual property (IP) agreement which allows pharmaceutical companies a monopoly on medical knowledge—to be partially suspended. The suspension of Trips would allow more vaccines to be produced in bulk by other manufacturers. However, there are some issues with this proposal. Given how new mRNA vaccines are, only a small number of people know how to make them and have the resources to. According to BBC News (2021), BioNTech have said that simply removing the patent won’t account for the time needed to develop the manufacturing process and validating production sites, which could lead to quality and safety issues.

    Despite this, the proposal is now being supported by HICs such as the US, China, and Russia, alongside many LICs, the WHO and UNAIDS, and many bodies agree this may be the best route to boosting global supply, as was stated by Nature (2021).

    Currently, the waiver has not yet gone through, and there still remains a great inequality in the distribution of vaccines. As Omicron continues to spread and a large proportion of the world’s population remains unvaccinated, Doctors Without Borders (2021) predicts almost one million lives may be lost by mid-2022, with most deaths occurring in LICs, and more variants may develop if vaccines aren’t rapidly redistributed.

    Vaccine hoarding is affecting millions around the world, particularly in LICs. If the disparity is not resolved soon, it will continue to do so for months, and maybe even years, to come.

    References

    BBC News. (2021). Covax: How many Covid vaccines have the US and the other G7 countries pledged?. [Online]. [Accessed 17/12/2021]. Available from: https://www.bbc.co.uk/news/world-55795297. 

    Brown, G. (2021). A new Covid variant is no surprise when rich countries are hoarding vaccines. [Online]. [Accessed 17/12/2021]. Available at: https://www.theguardian.com/commentisfree/2021/nov/26/new-covid-variant-rich-countries-hoarding-vaccines.

    David, D. (2021). Covid: The vaccine patent row explained. [Online]. [Accessed 17/12/2021]. Available from: https://www.bbc.co.uk/news/business-57016260. 

    Dearden, N. (2021). Developing nations may give up on the WTO for good if it won’t budge on vaccine patents. [Online]. [Accessed 17/12/2021]. Available from: https://www.theguardian.com/commentisfree/2021/nov/29/developing-nations-wto-vaccine-patents-covid-britain.

    Doctors Without Borders (2021). US must stop hoarding excess COVID-19 vaccine doses. [Online]. [Accessed 17/12/2021]. Available from:
    https://www.doctorswithoutborders.org/what-we-do/news-stories/news/us-must-stop-hoarding-excess-covid-19-vaccine-doses  

    Nature. (2021). A patent waiver on COVID vaccines is right and fair. [Online]. [Accessed 17/12/2021]. Available from: https://www.nature.com/articles/d41586-021-01242-1.

    Towey, R. (2021). WHO criticizes wealthy nations for hoarding Covid treatments and vaccines, saying it’s prolonging pandemic. [Online]. [Accessed 17/12/2021]. Available from: https://www.cnbc.com/2021/09/07/who-says-wealthy-nations-are-prolonging-pandemic-by-hoarding-covid-treatments-and-vaccines.html.