Voluntary assisted dying could soon be legal in Queensland. Here’s how its bill differs from other states

Originally published on theconversation.com


Queensland has become the latest Australian state to move forward on the issue of voluntary assisted dying. Draft legislation, developed by the Queensland Law Reform Commission, is expected to be tabled in parliament next week.

This reflects moves across the country over the past few years to permit voluntary assisted dying (also sometimes called voluntary euthanasia).

The Queensland laws, if passed, would be similar to those in other states, but not identical.

A quick recap

Victoria’s law was passed in November 2017 and came into force in June 2019 after an 18-month implementation period.

Next was Western Australia, whose 2019 law will come into effect on July 1, 2021.

Tasmania passed a voluntary assisted dying law in March this year, set to begin in 2022.

And South Australia’s lower house is now considering its own bill, after the upper house approved the proposed law earlier this month.

In New South Wales, independent MP Alex Greenwich is drafting a voluntary assisted dying law. It’s due to be released in July for consultation.

The Australian Capital Territory and the Northern Territory don’t have legislative power to pass laws about voluntary assisted dying. But there are active efforts to repeal the Commonwealth law that prohibits the territories considering it.

Read more:
WA’s take on assisted dying has many similarities with the Victorian law – and some important differences

Reflecting on Victoria’s experience

In preparing the draft legislation, the Queensland Law Reform Commission had the opportunity to reflect on the emerging body of evidence about how the Victorian law is operating in practice.

While the safeguards in Victoria’s voluntary assisted dying system are working to ensure only eligible patients can access it, questions have been raised about challenges in accessing the law. For example, some people don’t necessarily know the option exists, while navigating the eligibility assessment process can be demanding.

Background like this from Victoria’s experience led the commission to recommend some departures from laws enacted elsewhere in Australia.

In Victoria, voluntary assisted dying laws have been operating for almost two years.

The commission’s approach aimed to design “the best legal framework for a voluntary assisted dying scheme in Queensland” and not to be “constrained by similar laws in other Australian states”.

In other words, the focus was on designing optimal law, rather than simply adopting another state’s law because it happened to be passed first.

How is Queensland’s proposed law different?

Some features are common to all Australian voluntary assisted dying laws. For example, eligibility criteria broadly include requirements that a person has an advanced and progressive condition that will cause death, and they are suffering intolerably from it. The person must also be an adult, have decision-making capacity, be acting voluntarily and satisfy various residency requirements.

The Queensland proposal’s eligibility criteria are different in relation to the person’s life expectancy. A person is eligible for voluntary assisted dying under the Queensland bill if they are expected to die within 12 months. Under other Australian models, the period is six months, except for progressive neurological conditions, in which case it’s 12 months.

Although some commentators (including us) question the need for a designated time period, a 12-month limit is a more coherent approach than the existing six or 12-month approach elsewhere.

First, it’s very hard to justify having different time limits to access voluntary assisted dying depending on the nature of your illness.

Second, a longer eligibility period allows a person who is diagnosed with a medical condition more time to apply for voluntary assisted dying. This may allow patients to start the application process a little earlier, and reduce the likelihood they may die before accessing voluntary assisted dying (given the process can take some time).

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Another novel feature is the Queensland bill limits the ability of institutions to object to voluntary assisted dying. This is an Australian-first as Victorian, Western Australian and Tasmanian laws only deal with permitting individual health professionals to conscientiously object.

This is important because there’s evidence in Victoria that institutions are blocking access to voluntary assisted dying. One media report described a Catholic hospice barring access to pharmacists delivering the voluntary assisted dying medication to a patient.

The commission recommends creating legislative processes so eligible patients’ access to voluntary assisted dying is not unreasonably hindered by institutional objections.

A person could be eligible for voluntary assisted dying under Queensland’s proposal if they are expected to die within 12 months.

Will the Queensland bill become law?

After the bill is tabled in Queensland parliament next week, it will be referred to the Parliamentary Health Committee (which originally recommended reform). That committee will have a consultation period of 12 weeks.

Parliament is expected to vote on the bill in September, and if the law is passed, it will likely come into effect in January 2023. As in other states, a period of implementation ensures the voluntary assisted dying system is ready before the law takes effect.

As is usually the case in such debates, both major parties have offered their MPs a conscience vote. Although Queensland is the only Australian state never to have considered a voluntary assisted dying bill, its single house of parliament may mean the law is more likely to pass.

Further, given the growing national trend to permit voluntary assisted dying and the careful and measured law reform process, we anticipate Queensland is likely to pass voluntary assisted dying laws this year.

Read more:
From Oregon to Belgium to Victoria – the different ways suffering patients are allowed to die

Ben White receives funding from the Australian Research Council, the National Health and Medical Research Council and Commonwealth and State Governments for research and training about the law, policy and practice relating to end-of-life care.

In relation to voluntary assisted dying, he (with colleagues) has been engaged by the Victorian and Western Australian Governments to design and provide the legislatively-mandated training for doctors involved in voluntary assisted dying in those States. He (with Lindy Willmott) has also developed a model Bill for voluntary assisted dying for parliaments to consider. Ben White is a recipient of an Australian Research Council Future Fellowship (project number FT190100410: Enhancing End-of-Life Decision-Making: Optimal Regulation of Voluntary Assisted Dying) funded by the Australian Government.

Lindy Willmott has received funding from the Australian Research Council, the National Health and Medical Research Council and Commonwealth and State Governments for research and training about the law, policy and practice relating to end-of-life care.

In relation to voluntary assisted dying, she (with colleagues) has been engaged by the Victorian and Western Australian Governments to design and provide the legislatively-mandated training for doctors involved in voluntary assisted dying in those States. She (with Ben White) has also developed a model Bill for voluntary assisted dying for parliaments to consider.

Lindy Willmott is a former member of the board of Palliative Care Australia.

Most people consider climate change a serious issue, but rank other problems as more important. That affects climate policy

Originally published on theconversation.com


Straight denial of climate change is now relatively rare. Most people believe it is happening and is a serious problem. But many rank other issues — healthcare and the economy — as more important.

This means people can’t be easily classified as either deniers or believers when it comes to climate change. In my research, I focused on understanding the complexity of climate opinion in light of the slow political response to climate change around the world.

I conducted an online survey in the UK and found 78% of respondents were extremely or fairly certain climate change is happening.

But when asked to rank eight issues (climate change, healthcare, education, crime, immigration, economy, terrorism and poverty) from most to least important to the country, 38% ranked climate change as least important, with a further 15% placing it seventh out of eight.

Recent pledges from a number of large countries to reach net zero in greenhouse gas emissions by 2050 have led Climate Action Tracker to project that limiting warming to 2℃ by 2100 may be possible.

Although this progress is heartening, it has taken many years to reach this point and the challenges in actually meeting these emission targets cannot be overstated.

Climate ranking in other countries

I found similar results in other countries. Based on a Eurobarometer survey of 27,901 European Union citizens, a majority of the populations in all EU member countries are concerned about climate change, but only 43% across the EU rank it in the top four most important issues for the world. There are some differences between countries — climate change tends to be ranked higher in Nordic countries and lower in Eastern Europe.

Fewer than 5% of 3,445 respondents in the 2017 New Zealand Election Study said the environment was the most important election issue and an even smaller number specifically mentioned climate change.

Read more:
NZ election 2020: survey shows voters are divided on climate policy and urgency of action

Why are some people more engaged with climate change than others? People’s worldview or ideology seem to be particularly important.

In many countries — including, as illustrated in my research, the UK and New Zealand — there are partisan and political divides in climate change with supporters of right-wing parties less likely to support climate change policies or to see it as an important issue.

People who support free-market economics, hold authoritarian attitudes or have exclusionary attitudes towards minorities are also less likely to engage with climate change.

Consequences for climate policy

In democracies, politicians often respond to public opinion; ignoring it risks being voted out at the next election. But the degree to which they do so depends on how important the issue is to the public relative to other issues.

If people are not thinking about an issue when they go to vote, politicians are less likely to give that issue much attention. As my research shows, people in most countries don’t give climate change a high importance ranking, and politicians are therefore not under enough public pressure to take the difficult steps required to combat climate change.

There are other reasons for the slow political response to climate change, besides the low importance of climate change among the public. Vested interests, such as fossil fuel companies, are undoubtedly involved in slowing the adoption of strong climate policies in many countries.

Read more:
Climate explained: Why are climate change skeptics often right-wing conservatives?

Although only a minority of the population, climate change deniers may also make some politicians hesitate to act. But, regardless of the influence of vested interests and deniers, it is difficult for politicians to act on climate change when the public believes other issues are more important.

Understanding the relationship between public opinion and climate policy can help focus the efforts of climate campaigners. Perhaps less attention could be paid to the influence of vested interests.

Given the deep ideological reasons climate change deniers have for their disbelief, it’s unlikely they will be convinced otherwise. Fortunately, this may not be required to move climate policy forward.

As my research reveals, the majority of the public want action on climate change but tend to be more concerned about other issues. Campaigners might find it useful to focus their attention on persuading this section of the population about the urgency of climate action.

Sam Crawley does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

‘Devastated and sad’ after 36 years of research — early detection of ovarian cancer doesn’t save lives

Originally published on theconversation.com


My colleages’ and my efforts to develop a screening test for the early detection of ovarian cancer capable of saving lives arrived at a sad moment last week. The final trial results of the research I’ve focused on for 36 years, published in The Lancet, found early ovarian cancer detection doesn’t save lives.

The advances we have seen in science and technology over the past three decades have been nothing short of phenomenal. Each smartphone has more computational power than NASA had at its disposal during the moon landings. In medicine, researchers have sequenced the human genome, created life-saving treatment for HIV and rapidly developed vaccines for COVID-19.

There have been significant improvements in ovarian cancer treatment involving surgery and chemotherapy, but the sad and frustrating truth is of the four women diagnosed with ovarian cancer in Australia each day, three will eventually die from the disease.

Read more:
INTERACTIVE: We mapped cancer rates across Australia – search for your postcode here

The diagnosis of ovarian cancer is dependent on women reporting symptoms to their doctor. However, few develop symptoms until they have advanced stage cancer, by which time the outlook is poor. Of all women’s cancers, ovarian cancer has the lowest survival rate, with just 46% of patients in Australia surviving five years. For breast cancer, it’s now 91%.

Back in the 80s

I was motivated to improve the outcome for women with ovarian cancer by my experience as a junior doctor in London in 1985. I was training with a brilliant surgeon who undertook operations for many women with ovarian cancer. In spite of the exhaustive surgery and the chemotherapy that followed, we saw far too many women suffer and die from ovarian cancer.

That experience inspired me to initiate a program of research designed to find a screening test to detect this cancer early. Women with the earliest stage of ovarian cancer had survival rates of 70%, but less than 20% of women with ovarian cancer were diagnosed that early.

My hypothesis was that if we could detect more cancers at an early stage it would save lives.

We saw too many women suffer and die from ovarian cancer.

Based on evidence from other cancers, there was reason to be hopeful and two potential tests were available – a blood test called CA 125 and the use of ultrasound scanning which was then widely used in obstetrics.

Over the next 15 years, working with colleagues in the United Kingdom and United States, I developed and refined the screening tests and had great hope for what we called “multimodal screening”. This involved a “risk of ovarian cancer algorithm” for interpreting the change in blood levels of CA 125 over time to identify women who had a rising pattern, indicating an elevated risk of ovarian cancer. Women with an elevated risk could then have a secondary test involving ultrasound scanning.

During those 15 years, we published convincing evidence in studies involving over 50,000 women that this approach to screening was safe, acceptable to women, could detect over 85% of the cancers early and would probably be cost effective if sufficient lives were saved.

Promising early results

Before advocating screening of the general population, a massive trial would be needed to determine whether the screening would actually save lives.

The trial needed to involve screening and follow up of approximately 200,000 women for around 20 years. This would eventually include 2,000 women with ovarian cancer – enough to determine whether or not screening saved lives.

The trial involved great numbers of participants.

Work got underway in the United Kingdom in 2000 and optimism grew as initial results confirmed the ability of multimodal screening to detect cancer early in over 85% of cases.

By 2015, the preliminary mortality data were available and were tantalising. The curves hinted at a 20% or more reduction in deaths from ovarian cancer, but the findings did not quite reach statistical significance. So another five years of painstaking follow up was needed.

Disappointing final results

The final results of the UK Collaborative Trial of Ovarian Cancer Screening showed the multimodal screening approach could detect cancers early and increase the number of early-stage ovarian cancers by almost 50%.

But to our surprise and despair, that did not reduce the number of deaths from ovarian cancer. All it seemed to do was to bring forward the time of diagnosis of the cancers in these women, without improving their survival.

Under the multimodal screening program, women were first given a blood test for levels of CA 125.

This is deeply disappointing. Disappointing of course for those who like myself have dedicated much of their professional lives to this effort, but much more importantly for the women across the world who we had hoped would have access to an effective screening test able to save lives.

The hope had been to deploy ovarian cancer screening for women in the general population alongside breast and cervical cancer screening, but that will not happen – for a while at least.

Why didn’t early detection save lives?

To answer that, we need to further analyse samples and data from the trial. Our suspicion is that the women whose cancers were detected early by screening had more aggressive cancers than those (the 10%) whose cancers were detected early without screening, on the basis of symptoms.

So even with early detection, their cancers progressed relentlessly despite them receiving the best available surgery and chemotherapy.

If that is the case, we are likely to require screening tests which can detect ovarian cancer even earlier than our algorithm, which we estimate picks up ovarian cancer 18 to 24 months early. Saving lives may require a test capable of picking up the cancers five or more years early.

Read more:
Why we need to pay more attention to negative clinical trials

Fortunately, there are exciting avenues of research involving advances in protein and DNA technologies which researchers in Australia and around the world are exploring. So there is hope.

But realistically, given the five-plus years needed to develop better screening tests and the ten to 15-plus years needed to have enough cases to conduct another large randomised trial, the solution is likely to be more than 20 years away.

Still, we’ve learnt a lot

This massive commitment of expertise, time, energy and funding has most definitely not been wasted. Much has been achieved along the way in this 36-year journey in developing ways to assess risk, diagnose cancer and prevent ovarian cancer which are now used in clinical practice.

New generations of researchers have been trained. The data and the blood bank collected is available to all researchers seeking new and better screening tests and is a unique resource. And the ability to detect ovarian cancer early may be invaluable in assessing new treatments.

I feel privileged to have led this effort and will always be grateful to the collaborators, researchers, health professionals, funding agencies and above all the 200,000 women who took part in the trial.

I feel a deep sadness that lives will not yet be saved by ovarian cancer screening, but I’m confident the next generation of researchers will build on our work and find approaches to screening and treatment of ovarian cancer which dramatically reduce the loss and suffering caused by this insidious disease.

Read more:
COVID has left Australia’s biomedical research sector gasping for air

Ian Jacobs is a President and Vice-Chancellor of UNSW Sydney and a Board member of Ovarian Cancer Australia. He is a director and shareholder of Abcodia Ltd which holds a licence from Massuchusetts General Hospital for the Risk of Ovarian Cancer Algorithm and as a Co-Inventor of the Algorithm he has a potential royalty stream. He received funding awards for UKCTOCS from the Medical Research Council, Cancer Research UK, the National Institute of Health Research and the Eve Appeal.

A year after New Zealand’s first COVID-19 lockdown, discrimination and racism are on the rise

Originally published on theconversation.com


More than two in five New Zealanders (41%) say incidents of racism have increased during the COVID-19 pandemic, according to a national survey carried out in February and March this year.

The experience of racism is skewed towards Māori, Pasifika and people of Asian descent, about half of whom say racism has been on the rise, compared with about a third of European New Zealanders.

Of the 1,083 survey participants, more than half (52%) say racism has remained the same and 7% say it has decreased.

Discrimination and racism

The pandemic has led to a global increase in anti-Asian hate. At the same time, ethnic minorities are also disproportionately affected by severe disease and deaths due to COVID-19. Death rates among minority ethnic groups were two or more times greater than for the white population in the United Kingdom. In New Zealand, Māori and Pasifika were about two times more likely to die of COVID-19.

About two in five respondents said they have witnessed other people discriminate against individuals because of how they looked or spoke English. About a quarter reported experiencing discrimination due to their ethnic origin in a variety of contexts, including at government departments, workplaces, when dealing with the commercial sector and when accessing health care.

Māori and Pasifika reported experiencing discrimination most often when dealing with government departments.

Read more:
Māori and Pasifika leaders report racism in government health advisory groups

People of Asian descent reported experiencing discrimination most often when applying for work, in their workplace, and when shopping or visiting restaurants.

The survey results align with the New Zealand Human Rights Commission’s recent survey. Four in ten (39%) of the 1,904 respondents have experienced discrimination since the start of the COVID-19 outbreak. Māori and ethnic Chinese reported most instances of discrimination.

Negative online comments or abuse targeting people like them was the most prevalent, followed by instances of staring and increased physical distancing in public places.

Attitudes towards immigration

In our survey, many New Zealanders showed favourable attitudes towards immigrants. More than 80% of survey respondents said the contribution of immigrants from the UK to New Zealand’s economy and culture has been very or somewhat good.

A majority also said immigrants from other countries have contributed positively to New Zealand, including those from South Africa (74%), Fiji (71%), China (66%) and India (64%).

However, there was strong support to reduce or stop immigration following COVID-19. More than three in four somewhat or strongly supported reducing immigration from countries that have managed their response to the coronavirus poorly, such as the United States.

A majority also supported reducing or stopping immigrants and tourists from China, and more than three in five (64%) also supported (somewhat or strongly) reducing or stopping international students from countries such as China.

More than six in ten (61%) supported reducing or stopping immigration from all countries — a result slightly lower than a similar national survey conducted in June and July 2020 (69%).

In the past, New Zealand has consistently ranked among countries most accepting of migrants. It is possible the opposition to immigration may subside as the world recovers from the pandemic.

Racism is no joke

The Human Rights Commission received more than 100 complaints about racism following the first COVID-19 lockdown. In response, it launched the Racism is No Joke campaign to address racism towards Chinese and other Asian communities.

It also launched the Voice of Racism website to provide real examples of racist statements New Zealanders have experienced or witnessed.

Read more:
Everyday racism fuels prejudice and hate. But we can challenge it

Discrimination and racism triggered by COVID-19 are likely to compound disproportionate economic and mental health impacts among minorities. They may also affect the uptake of COVID-19 vaccination among at-risk groups due to experiences of racism in healthcare settings.

Racism is an everyday experience for many ethnic minorities. But we can challenge it through dialogue and cooperation, and by establishing relationships with people who are different from ourselves to reduce prejudice.

Jagadish Thaker received funding from Massey University.

It may not be possible to bring all Australians with COVID home from India. But we can do better than we are now

Originally published on theconversation.com

A 47-year-old Sydney man has died in India after contracting COVID-19.

This news comes amid anger after the first repatriation flight from India following the controversial travel ban arrived in Darwin half empty on Saturday. Some 40 passengers tested positive for COVID-19 meaning neither they, nor their close contacts, were allowed to travel.

There’s no suggestion the Sydney man was due to board that flight, or any subsequent repatriation flight. But his case puts a spotlight on the current situation in India, where countless Australians are imploring the government to bring them home from a country in deep COVID crisis.

I would argue we can, and should, bring home at least some COVID-positive Australians — particularly those at highest risk of needing hospital-level care.

Weighing up the risks

Since Saturday’s repatriation flight, there’s also been controversy over the reliability of the tests which deemed so many passengers ineligible to travel. It’s critical the Australian government irons this out to ensure pre-flight testing is as accurate as possible.

Although, even if all passengers do test negative before flying, we still can’t guarantee a flight out of India, or any country, will have no positive cases on board. There’s a blind spot in testing between the time a person is exposed and when testing will reveal the infection. This gap could be up to ten days, but for most would be two to three days.

We know even with pre-flight screening requirements up to 1% of passengers are positive by the time they arrive in Australia.

At least if we know certain passengers are COVID positive at the time of boarding, we can manage the risk of transmission in transit.

Read more:
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Flying COVID-positive Australians home safely

Despite our best efforts, we can’t rule out the risk of transmission if there are COVID-positive travellers on a flight.

However, transmission on planes appears to have been relatively infrequent. Recent reports of high positive rates on arrival and in quarantine may signal high rates of pre-flight exposure and transmission in transit — it’s hard to assess to what degree on-board transmission is a factor.

Although we know being in an enclosed space with someone with COVID-19 for a long time is high risk, the air in the cabin is filtered and turned over very regularly and therefore protects against viral spread. This could be why transmission on flights is not as common as we might expect.

That said, if we do knowingly put COVID-positive people on a flight with other passengers and crew, it would be important to take extra precautions.

In the age of COVID, there’s always some level of risk associated with taking a flight.

All crew on repatriation flights should be vaccinated regardless. To minimise the risk further, all crew dealing directly with COVID-positive passengers should be wearing full personal protective equipment (PPE).

COVID-positive passengers should be seated in a separate section of the plane to those who have tested COVID negative. An analysis of possible on-board transmission during a flight from London to Hanoi demonstrated most infection risk was restricted to the business class section, with attack rates dropping when people were two or more seats apart.

Commissioning large planes with more space to spread passengers out and group them according to risk would help in this regard.

It’s already a requirement that everyone on board must wear a mask unless eating or drinking. Of course, none of this eliminates the risk completely, just as negative tests might still allow someone incubating the virus on board.

It would also be important to consider end-to-end safety including using separate buses from the airport for COVID-positive patients.

Read more:
How can the world help India — and where does that help need to go?

Another option would be dedicated flights for COVID-positive passengers.

Either way, it’s essential to have medical staff on board to provide care for travellers, if needed, and oversee infection control.

Accommodating COVID-positive returned travellers in quarantine

At present, Howard Springs, the Darwin quarantine facility housing returned Australians from India, is aiming to keep the number of COVID-positive residents at 50 or below.

Over time, COVID cases are increasingly likely to be asymptomatic or have mild disease if more people are vaccinated, and therefore shouldn’t need high levels of medical care. If most can stay in normal quarantine accommodation, maybe this could see the number of positive cases Howard Springs can accommodate increased.

If there’s a sound reason for this cap to remain as is, we should still use this capacity to enable evacuation of known cases at high risk of needing hospital care in India.

Sticking to a cap of 50 would likely mean we couldn’t accommodate every COVID-positive Australian who wanted to return home. But we could prioritise those at greatest risk of serious COVID disease, such as older people and those with underlying illnesses. Medical professionals would be on the ground to decide who qualifies as the highest priority.

We need to shift our mindset

Would we feel we had balanced the risks well if our thorough off-shore screening were to result in only a few positive cases in Howard Springs this month, while some people left in India were to die as a result of the virus and inadequate hospital care?

We pat ourselves on the back for what we achieved in containing the first wave by moving hard and fast, and rightly so. But as we’ve learnt more about the virus, we have become more determined to simply keep it out rather than use our knowledge and increased public health response capacity to control it.

We are now vulnerable and are resorting to inhumane steps to protect ourselves. Given the devastating situation in India, I believe it’s time to step back and weight up the true costs of the “zero tolerance” strategy underpinning our approach to repatriation.

Read more:
Why variants are most likely to blame for India’s COVID surge

Catherine Bennett receives funding from NHMRC and MRFF. Catherine is an independent expert advisor on the nelwy formed Advisory Board for AstraZeneca Australia.

Have Australian researchers developed an effective COVID-19 treatment? Potentially, but we need to wait for human trials

Originally published on theconversation.com

The world is now 18 months into the COVID-19 pandemic and we’ve yet to find a single drug that can stop the virus. At best, we can treat the effects of the virus through oxygen therapy for those who can’t breathe, and with drugs that reduce the inflammation associated with the infection.

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But an Australian-United States research team, led by Griffith University’s Menzies Health Institute, have shown promising results in their mouse trials of a new treatment for COVID-19.

The technology is based on “short interfering RNA”, which prevents the virus from replicating inside human cells. They found a 99.9% drop in the number of virus particles in the mice they studied.

The researchers hypothesise the drug could be injected into patients daily for up to five days, for example for sick patients in hospital, or as a once-off if someone has just been exposed to the coronavirus; however, there’s no data on this specifically, so it’s speculative for now.

While the results are very promising, the technology has only been tested in mice. Human clinical trials will take some time to complete before we know whether a drug will be approved by the government.

How viruses work

Viruses are tricky to treat because they are biological molecules made of the same types of materials as the human body. Virus particles are just packets of information on how to make more virus, encoded in a molecule called “ribonucleic acid” or RNA (although some contain DNA instead) within a protein coating.

Read more:
Explainer: what is RNA?

Once a virus particle penetrates into a cell, it either hijacks the machinery of the cell to make copies of itself, or in some cases, has its RNA copied into the host cell’s DNA. Either way, the cell becomes a manufacturing facility making hundreds and thousands of copies of the virus.

So the best way to stop a virus is to stop its RNA information being copied and transcribed by the cell.

We already have drugs capable of doing this for specific viruses. A drug called PrEP (pre-exposure prophylaxis) is available as a prophylactic against infection with HIV and the development of AIDS. A prophylactic can prevent a disease before it takes hold in the body.

The PrEP medicine works because the two active ingredients it contains, tenofovir and emtricitabine, block a molecule called reverse transcriptase which the virus needs to embed the RNA information into human DNA. Unfortunately, neither drug works to block COVID-19.

Short interfering RNA

Unlike PrEP, the new technology is particularly clever because it uses a molecule called short/small interfering RNA or “siRNA” to prevent the reading and copying of the virus information. This siRNA was specifically designed to recognise a sequence of the coronavirus’ own RNA that is common across COVID-variants.

This means the siRNA can seek out and lock onto the viral RNA because it perfectly complements it, regardless of the COVID-19 strain. When it locks with the virus RNA, the viral information becomes trapped and can’t be copied, or it causes the RNA to be cut and degraded.

At this point there is no virus production, and our immune system can just mop up the small number of virus particles floating around the body.

Read more:
Why are there so many drugs to kill bacteria, but so few to tackle viruses?

To prove their technology, the researchers enclosed their siRNA in lipid nanoparticles, which are essentially tiny fat-like particles. Without this protective coating, the siRNA would be destroyed in the blood stream before it could lock onto the virus. Lipid nanoparticles are also used in the formulation of the Pfizer and Moderna COVID-19 vaccines.

With the protective nanoparticle shell, the siRNA could then be delivered via a water-based injection into veins.

When the researchers administered the siRNA to mice that had been infected with COVID-19, they found the mice didn’t lose as much weight when compared with untreated mice. Weight loss was an indicator of how sick the mice were.

The researchers also found a 99.9% drop in the number of virus particles in the mice.

On occasion, when biological molecules are injected into the blood stream, this can trigger a severe allergic reaction called anaphylaxis. Importantly, the researchers found their siRNA didn’t trigger an immune response in the mice, and therefore will be unlikely to cause anaphylaxis.

So as well as being effective, the technology appears to be relatively safe.

Will this drug be available soon?

As promising as the results are, we shouldn’t get our hopes up that a drug will be available any time soon. Data derived from animal tests doesn’t always translate to success in humans. Often, the way an animal’s body processes a drug can be different from the human body, and it ends up being ineffective.

Also, animal tests are just the first step in a long regulatory process to prove a drug works and is safe. Even with accelerated clinical trials and fast-tracked assessment from governments, an approved drug is still a year or more away.

Read more:
Of mice and men: why animal trial results don’t always translate to humans

Associate Professor Wheate in the past has received funding from the ACT Cancer Council, Tenovus Scotland, Medical Research Scotland, Scottish Crucible, and the Scottish Universities Life Sciences Alliance. He is Fellow of the Royal Australian Chemical Institute and a member of the Australasian Pharmaceutical Science Association. Nial is science director of the medicinal cannabis company Canngea Pty Ltd, a board member of the Australian Medicinal Cannabis Association, and a Standards Australia committee member for sunscreen agents.

The story of Rum Jungle: a Cold War-era uranium mine that’s spewed acid into the environment for decades

Originally published on theconversation.com

Gavin Mudd, Author provided

Buried in last week’s budget was money for rehabilitating the Rum Jungle uranium mine near Darwin. The exact sum was not disclosed.

Rum Jungle used to be a household name. It was Australia’s first large-scale uranium mine and supplied the US and British nuclear weapons programs during the Cold War.

Today, the mine is better known for extensively polluting the Finniss River after it closed in 1971. Despite a major rehabilitation project by the Commonwealth in the 1980s, the damage to the local environment is ongoing.

I first visited Rum Jungle in 2004, and it was a colourful mess, to say the least. Over later years, I saw it worsen. Instead of a river bed, there were salt crusts containing heavy metals and radioactive material. Pools of water were rich reds and aqua greens — hallmarks of water pollution. Healthy aquatic species were nowhere to be found, like an ecological desert.

The government’s second rehabilitation attempt is significant, as it recognises mine rehabilitation isn’t always successful, even if it appears so at first.

Rum Jungle serves as a warning: rehabilitation shouldn’t be an afterthought, but carefully planned, invested in and monitored for many, many years. Otherwise, as we’ve seen, it’ll be left up to future taxpayers to fix.

The quick and dirty history

Rum Jungle produced uranium from 1954 to 1971, roughly one-third of which was exported for nuclear weapons. The rest was stockpiled, and then eventually sold in 1994 to the US.

Rehabilitation of Rum Jungle began in the 1980s.
Mick Stanic/Flickr, CC BY-NC-SA

The mine was owned by the federal government, but was operated under contract by a former subsidiary of Rio Tinto. Back then, there were no meaningful environmental regulations in place for mining, especially for a military project.

The waste rock and tailings (processed ore) at Rum Jungle contains significant amounts of iron sulfide, called “pyrite”. When mining exposes the pyrite to water and oxygen, a chemical reaction occurs generating so-called “acidic mine drainage”. This drainage is rich in acid, salts, heavy metals and radioactive material (radionuclides), such as copper, zinc and uranium.

Acid drainage seeping from waste rock, plus acidic liquid waste from the process plant, caused fish and macroinvertebrates (bugs, worms, crustaceans) to die out, and riverbank vegetation to decline. By the time the mine closed in 1971, the region was a well-known ecological wasteland.

Once an ecosystem, now a wasteland.
Gavin Mudd, Author provided

When mines close, the modern approach is to rehabilitate them to an acceptable condition, with the aim of minimal ongoing environmental damage. But after working in environmental engineering across Australia for 26 years, I’ve seen few mines completely rehabilitated — let alone successfully.

Many Australian mines have major problems with acid mine drainage. This includes legacy mines from historical, unregulated times (Mount Morgan, Captains Flat, Mount Lyell) and modern mines built under stricter environmental requirements (Mount Todd, Redbank, McArthur River).

This is why Rum Jungle is so important: it was one of the very few mines once thought to have been rehabilitated successfully.

Salts litter the bed of the Finniss River.
Gavin Mudd, Author provided

So what went wrong?

From 1983 to 1986, the government spent some A$18.6 million (about $55.5 million in 2020 value) to reduce acid drainage and restore the Finniss River ecology. Specially engineered soil covers were placed over the waste rock to reduce water and oxygen getting into the pyrite.

The engineering project was widely promoted as successful through conferences and academic studies, with water quality monitoring showing that the metals polluting the Finniss had substantially subsided. But this lasted only for a decade.

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By the late 1990s, it became clear the engineered soil covers weren’t working effectively anymore.

First, the design was insufficient to reduce infiltration of water during the wet season (thicker covers should have been used). Second, the covers weren’t built to design in parts (they were thinner and with the wrong type of soils).

The first reason is understandable, we’d never done this before. But the second is not acceptable, as the thinner covers and wrong soils made it easier for water and oxygen to get into the waste rock and generate more polluting acid mine drainage.

The iron-tainted red hues of the Finniss River near the waste rock dumps leaking acid mine drainage.
Gavin Mudd, Author provided

The copper-tainted green hues of the Finniss River near the waste rock dumps leaking acid mine drainage.
Gavin Mudd, Author provided

The stakes are higher

There are literally thousands of recent and still-operating mines around Australia, where acid mine drainage remains a minor or extreme risk. Other, now closed, acid drainage sites have taken decades to bring under control, such as Brukunga in South Australia, Captain’s Flat in NSW, and Agricola in Queensland.

We got it wrong with Rum Jungle, which generated less than 20 million tonnes of mine waste. Modern mines, such as Mount Whaleback in the Pilbara, now involve billions of tonnes — and we have dozens of them. Getting even a small part of modern mine rehabilitation wrong could, at worst, mean billions of tonnes of mine waste polluting for centuries.

So what’s the alternative? Let’s take the former Woodcutters lead-zinc mine, which operated from 1985 to 1999, as an example.

Given its acid drainage risks, the mine’s rehabilitation involved placing reactive waste into the open pit, rather than using soil covers. “Backfilling” such wastes into pits makes good sense, as the pyrite is deeper and not exposed to oxygen, substantially reducing acid drainage risks.

Backfilling isn’t commonly used because it’s widely perceived in the industry as expensive. Clearly, we need to better assess rehabilitation costs and benefits to justify long-term options, steering clear of short-term, lowest-cost approaches.

The Woodcutters experience shows such thinking can be done to improve the chances for successfully restoring the environment.

Getting it right

The federal government funded major environmental studies of the Rum Jungle mine from 2009, including an environmental impact statement in 2020, before the commitment in this year’s federal budget.

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The plan this time includes backfilling waste rock into the open pits, and engineering much more sophisticated soil covers. It will need to be monitored for decades.

And the cost of it? Well, that was kept confidential in the budget due to sensitive commercial negotiations.

But based on my experiences, I reckon they’d be lucky to get any change from half a billion dollars. Let’s hope we get it right this time.

Gavin Mudd has acted as a consultant to the Environment Centre of the Northern Territory. He is also Chair of the Mineral Policy Institute.

Climate explained: is natural gas really cheaper than renewable electricity?

Originally published on theconversation.com

Shutterstock/AVN Photo Lab


Climate Explained is a collaboration between The Conversation, Stuff and the New Zealand Science Media Centre to answer your questions about climate change.

If you have a question you’d like an expert to answer, please send it to climate.change@stuff.co.nz

The government wants us to phase out fossil fuels. Yet natural gas is much cheaper for households to buy per kWh than electricity. Why?

Natural gas is often touted as a transition fuel to use while we move away from coal and oil and as renewable energies continue to mature technologically and economically.

But the key point to note is that we simply cannot continue to produce greenhouse gases and the demand for natural gas, as for coal and oil, will soon have to decline rapidly.

In its draft package of recommendations to the government, New Zealand’s Climate Change Commission has called for a stop to new connections to the natural gas grid for commercial and residential buildings after 2025.

In that context, comparing the retail price of gas with electricity is not useful unless all other costs and likely future trends are considered.

Read more:
‘Renewable’ natural gas may sound green, but it’s not an antidote for climate change

The natural gas grid

Natural gas is extracted from gas fields and processed to “scrub” out other gases and condensates. The resulting gas, mainly methane, is then distributed through pipelines.

In New Zealand, natural gas is reticulated around much of the North Island, but it is not available in the South Island, where bottled liquid petroleum gas (LPG) is the alternative.

LPG is pressurised butane and propane that come from the scrubbed natural gas condensates as well as from oil refineries. A few cars such as taxis still use LPG, as do gas barbecues.

Natural gas is also combusted in gas-fired power stations to generate electricity. In New Zealand, this accounts for around 15% of total generation. Large volumes of gas are purchased relatively cheaply by power-generating companies and the electricity is then distributed through the grid to homes and businesses.

Cost comparison

The retail cost of electricity varies but is typically around 25 cents per kWh (also known as “c/unit”) for domestic users. Some retailers offer cheaper rates during “off-peak” times (to heat water for example).

The retail price for natural gas also varies and can be around 8c/kWh in Auckland or 5c/kWh in Wellington. If used for cooking, it can be cheaper than electricity. But to heat a building, an electric heat pump can be a cheaper option than a gas heater.

A heat pump concentrates the heat taken from the outside air and “pumps” it into the house very efficiently. One kWh of electricity consumed to run a heat pump can produce 3-4kWh of heat energy inside the house. It can also run the process in reverse and cool the air inside during hot summer days.

When comparing the cost of gas with electricity, two other cost factors must be considered. Under New Zealand’s Emissions Trading Scheme, there is a cost on the carbon dioxide produced when the gas is combusted because, like LPG, it is a fossil fuel and produces greenhouse gases.

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The current cost per tonne of carbon dioxide emitted is around NZ$35 (or around 1c per kWh of gas), but it is likely to increase significantly over the next few years. This will be added to domestic gas bills. Electricity bills are less affected by carbon price rises because (more than 80% of electricity) in New Zealand is generated from low-carbon renewable resources.

The other cost to consider is the fixed connection charge for having a gas pipeline coming into the house. This cost also varies, but in Auckland some customers pay $1.15 per day. In Wellington, some pay $1.60 per day.

A house running fully on electricity will avoid this fixed cost. There will be a fixed daily supply charge for the electricity connection but most homes have to pay this anyway in order to have lighting and electrical appliances.

Additional risks

When gas is combusted inside a building to provide heat, the process consumes oxygen and produces water vapour. If ventilation is poor, oxygen levels drop and carbon monoxide is also produced, which can lead to poisonous air.

The water vapour results in condensation, obvious on windows at certain times of the day. That, too, can lead to unhealthy mould in poorly ventilated homes.

And there are further risks with gas. As exemplified by an explosion last year in a Christchurch home, natural gas (methane) is volatile as well as toxic.
Of course there are also risks with using electricity, though fairly rare, such as getting an electric shock or vermin eating through plastic cable coverings and shorting the wires, which can start fires.

While gas may appear cheaper, this applies only to certain energy uses (such as cooking). Overall, the cost of gas is likely to rise significantly in the near future.

The Climate Change Commission’s final advice to government is due at the end of May and will provide a time frame for the end of new gas connections — but there is no intention to disconnect existing gas supplies to buildings at this stage.

Ralph Sims does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

Question Time reforms are worthy but won’t solve the problem of a broken political culture

Originally published on theconversation.com

Schoolchildren are told democracy, especially Australian parliamentary democracy, is a great and glorious thing. Question Time, in which our elected representatives ask questions of the government of the day, is meant to be emblematic of all that is best in that democracy.

Australian parliamentary democracy is a form of the Westminster system, and one of the key features of that system is that parliament keeps the government of the day accountable by scrutinising its actions.

In a democracy, the people have a right to know just how well the government is performing. Question Time is meant to be central to ensuring government accountability.

That, of course, is the ideal. The reality is somewhat different. Question Time is now often seen as something of an embarrassment, in which government and opposition members manoeuvre for political advantage. The tone and the outcome are often less than edifying.

Governments too often spend their time avoiding answering questions asked by the opposition and using the questions asked by their own supporters (known as “Dorothy Dixers”) to paint a rosy picture of their performance.

It would not be so bad if Question Time was, like so much parliament does, largely outside of public view. Instead, it is the primary means through which parliament displays itself to the public, so it becomes the public face of parliament.

So instead of an advertisement for the virtues of Australian parliamentary democracy, Question Time is instead a running sore that oozes many unsavoury aspects of parliamentary behaviour into the wider public sphere.

In light of this, a parliamentary committee has released a report on ways of improving question time. The aim is to make it, as committee chair Ross Vasta puts it in his foreword,

offer greater opportunities for scrutiny, and show parliamentarians as better role models.

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There are two issues here: one is that Question Time does not enable proper scrutiny of the government. The other is enhancing the public profile of parliamentarians.

To this end, the recommendations have much to commend themselves. They seek to:

restrict the use of Dorothy Dixers by preventing ministers attacking opposition policies as part of their answers

allow a non-government member to ask a supplementary question, a follow-on question for clarification

allow at least ten questions from opposition MPs

increase the number of constituency questions from government members

reduce the time limit for all questions to 30 seconds and all answers to two minutes.

Regarding the “role model” issue, the report recommends that the Speaker should tell an MP who behaves in an unbecoming matter to leave the chamber for one or three hours.

It also recommends a trial of “very limited use of mobile phones” by MPs during Question Time. From an image perspective, a parliamentarian sitting and fiddling with his or her phone during a televised Question Time is not desirable.

The real issue is whether these reforms will actually create greater scrutiny and a better image of parliament. There is no doubt the authors of this report genuinely want both of these things. However, one wonders whether this goal could be achieved by what is essentially “tinkering” with procedural mechanisms. As with any institution, parliament is much more than the rules and regulations its members follow.

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It also has an animating culture that influences how people deal with those rules and regulations. As with all Westminster systems, the Australian parliament is adversarial in nature. It relies on a certain amount of conflict between the government of the day and the opposition. For quite some time, the focus of that conflict has been Question Time.

Question Time is where the prime minister establishes his or her credentials as leader, and where the opposition leader seeks to dent the reputation of the prime minister and establish his or her credentials as a better alternative. It is a crucial arena in the ongoing battle of politics.

Question Time is caught between the high-minded civic conception of politics and the reality of the struggle for dominance in our adversarial system of politics.

It is difficult to measure such things, but one could argue that Australian politics has become more adversarial over the past 25 years. Politics, as exemplified by such things as conflict between those seeking to become prime minister, has become quite brutal at times.

Given recent debates about the treatment of women in Parliament House, one wonders if the real issue may be the desirability of an adversarial culture underpinning the conduct of politics in Australia.

Perhaps, rather than seeking to reform such institutions as Question Time, we should be looking more closely at the values that animate our political life. At the moment, it would seem to be the case that winning the political battle and establishing dominance are far more important than developing policies that benefit the public, and which can be scrutinised in a calm and rational fashion.

Gregory Melleuish receives funding from the Australian Research Council.

Why is accountability for alleged war crimes so hard to achieve in the Israel-Palestinian conflict?

Originally published on theconversation.com

Hatem Moussa/AP

The latest outbreak of conflict in Gaza and Israel is escalating rapidly. At the time of writing, at least 192 Palestinians are reported dead, including 58 children. Ten Israelis are reported dead, including two children.

Hamas is firing rockets into Israel from Gaza. Some cause casualties, while many are intercepted by Israeli anti-missile systems or fall short of the border. Israel is conducting aerial and artillery bombardment of Palestinian targets. In recent days, it has destroyed a building that housed the Associated Press and Al Jazeera offices in Gaza, and levelled multiple Palestinian homes.

The conflict is the most intense outbreak of violence since the 2014 Israel-Gaza war. Prime Minister Benjamin Netanyahu said Israel will do “whatever it takes to restore order and quiet” and this could take some time.

The question of Palestinian statehood and the enduring Israeli-Palestinian conflict is the perennial dilemma of the international legal system. The failure of the international community to bring about a resolution in the decades-long conflict reflects the highly politicised nature of international law.

Even though the International Criminal Court’s chief prosecutor opened an investigation into alleged war crimes in the conflict two months ago — and is closely watching the current violence for potential crimes — legal accountability will likely remain elusive.

Palestine’s status in the international community

Statehood is the preeminent status of an entity under international law. It grants the fullest range of rights and carries key assumptions, including freedom from interference with territorial integrity.

Israel declared statehood in 1948 and was admitted as a UN member state in 1949. Its statehood — combined with its abiding US alliance — has given it significant protection from external intervention.

Palestine, in contrast, claims a right to statehood but lacks effective statehood. The international legal position is clear — the Palestinian people are entitled to self-determination and statehood but they have been living under Israel’s occupation since 1967.

On this basis, in 2012, Palestine’s UN standing was upgraded to the special status of “non-member observer state”. Although the majority of UN General Assembly members expressed their hope this would lead to actual statehood for Palestine, a two-state solution to the conflict appears less likely as time goes on.

UN Security Council response

The UN Security Council is charged with promoting and preserving international peace and security. It has frequently addressed the conflict involving Israel and Palestine in the past.

The Security Council met in an emergency session on Sunday, with UN Secretary-General António Guterres calling for an immediate ceasefire and warning of “an uncontainable security and humanitarian crisis”. Over 38,000 Palestinians are internally displaced in the Gaza Strip following the recent surge in hostilities.

Jordanian Foreign Minister Ayman Safadi argued Israeli settlement activities violate international law and stand in the way of peace. Palestinian Foreign Minister Riyad al-Maliki accused Israel of committing war crimes and crimes against humanity, and pursuing a policy of apartheid.

Israel’s UN ambassador, Gilad Erdan, meanwhile, accused Hamas of targeting civilians as a power play against the Palestinian Authority.

The council took no action in this special session. The US, one of five permanent members with veto power, has a track record of resisting action in relation to Israel. China’s Foreign Minister Wang Yi said it was regrettable the US was blocking the council from making a statement with “one voice”.

US officials are maintaining their position that Israel is exercising its right to self-defence against Hamas terror attacks.

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Investigating alleged war crimes

This conflict comes in the wake of a significant development in international criminal law. In 2015, Palestine acceded to the Rome Statute that established the International Criminal Court (ICC). Palestine also accepted ICC jurisdiction over alleged crimes committed in its territory since June 2014.

In February, the ICC determined its jurisdiction extended to the Occupied Palestinian Territories. Its office of the prosecutor then initiated an investigation into the “situation in Palestine”. Prosecutor Fatou Bensouda said her office would seek justice for crimes committed against Palestinian and Israeli victims.

Read more:
What admitting Palestine to the International Criminal Court means

The ICC exists to prosecute the gravest crimes against humanity and war crimes. Israel has been accused of war crimes in Palestine, including wilful unlawful killings and disproportionate military attacks causing unnecessary civilian casualties.

Human Rights Watch alleges Israel is also engaged in crimes against humanity in the form of apartheid and persecution.

The ICC probe will likely encompass the 2014 war, border clashes in 2018, and Israeli settlement activities in the West Bank. It will also examine whether Hamas and other groups in Gaza have committed war crimes by firing rockets at Israel.

Obstacles to accountability

Accountability for international crimes is complicated for non-state actors like Hamas. Indiscriminate attacks on civilian targets undoubtedly violate the laws of war. Yet, Hamas is not acting on behalf of a Palestinian state, nor does the Palestinian Authority have the capacity to halt its actions.

As for Israel, the American alliance has been a constant obstacle to accountability. However, some important trends are emerging within American Jewish communities and the Democratic Party.

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Many American Jews are showing increasing scepticism about Netanyahu’s unflinching prosecution of Israel’s conflict with Hamas. Liberal Jewish lobbyists are challenging the Biden administration to oppose Israeli efforts to evict Palestinians in East Jerusalem.

Some prominent Democratic politicians now publicly oppose the position that Israel’s right to self-defence must be asserted by the US, regardless of whether its military actions are proportionate. Senator Bernie Sanders wrote this week:

the fact of the matter is that Israel remains the one sovereign authority in the land of Israel and Palestine, and rather than preparing for peace and justice, it has been entrenching its unequal and undemocratic control.

Prominent progressive congresswoman Alexandria Ocasio-Cortez also asked why the US could not stand up to Israel, which she called an “apartheid state”.

The ICC investigation certainly opens a new and legally intriguing avenue. But previous efforts at truth and peace-building indicate little cause for hope.

President Joe Biden, for one, has a long-established position in favour of Israel’s right to defend itself.

Israel is also not a member of the ICC and rejects the court’s jurisdiction over its territory and nationals.

The long war persists. International law — hamstrung by its own institutions, entrenched power relations and politicisation — offers no clear or quick solution.

Amy Maguire does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.