Why This Year’s Flu Vaccine Will Be So Vital in the Fight Against COVID-19

While the world awaits a proven COVID-19 vaccine, medical experts are turning their attention to a shot that’s long been a key component in the public health toolbox: the flu vaccine.

Experts hope this year’s flu shot can help prevent an influenza epidemic paired with another wave of coronavirus, which could overwhelm hospitals and lead to general confusion, given that it can be difficult to tell a COVID-19 infection from a case of the flu. This flu season is also something of a dress rehearsal for the eventual rollout of a COVID-19 vaccine amid the ongoing pandemic, allowing doctors, nurses and pharmacists a chance to get more people comfortable with the idea of a vaccine while also finding safe ways to inoculate people without spreading the coronavirus.

“While historically it’s fine to line [people] up and put them in close quarters—often in the winter, that’s inside—that’s not what we want to do here,” says Daniel Salmon, director of the Institute for Vaccine Safety at the Johns Hopkins Bloomberg School of Public Health. “So I think finding approaches and environments that are safe from a social distancing standpoint to vaccinate large numbers of people quickly—it’s absolutely an opportunity to get that right.”

Moreover, there are already data showing that people have mentally linked the flu shot with the coronavirus vaccine—suggesting that if public health officials can get more people to receive the former, those same people might be more likely to get the latter when it’s available. Abram Wagner, a research assistant professor at the University of Michigan’s department of epidemiology, recently conducted a yet-to-be-published survey of people from around the world, including 881 Americans, on their inoculation plans this August. He found that Americans who got a flu shot in the previous year were 363% more likely to want the flu shot again this year. More importantly, he found that those who received a flu shot during the last influenza season were 63% more likely to be planning to get the COVID-19 vaccine than those who did not.

Wagner says it would be understandable if some people wanted the flu shot but remained skeptical of the COVID-19 vaccine. After all, the flu vaccine, unlike those currently being developed for COVID-19, has been battle-tested over many decades (although it’s typically changed every year to counter the specific flu viruses expected to circulate in a given season). But people seem to be putting all vaccines in the same emotional bucket. “If you have experience with getting the jab, and you have the shot, it’s no big deal, then I think you will be just more likely to get another shot in the future, even if it’s not the same shot you got in the past,” Wagner says.

Influenza season in the northern hemisphere has only just begun, but there are some signs that the COVID-19 pandemic may be nudging more people than usual to get the flu shot. In an August survey of 1,000 people by the National Foundation for Infectious Diseases, 28% percent of U.S. respondents said the pandemic made them more likely to get the flu vaccine. Overall, 59% of people are planning to get the flu shot this season, the survey found, compared to 52% last season. (The U.S. Centers for Disease Control and Prevention estimates about 48.4% of American adults got the flu vaccine during the 2019-20 season, far short of the agency’s 70% target).

In terms of COVID-19, that 70% figure is also key—scientists think it’s generally about the amount of people in a given community that need to be immune to COVID-19 to reach herd immunity, depending on the vaccine’s effectiveness and the the strength of natural immunity through exposure. We may never reach that point. According to a Pew Research Center survey conducted in September, nearly half of U.S. adults said they probably or definitely would not get a COVID-19 vaccine—a sharp increase since May, when only 27% of Americans said they probably or definitely wouldn’t get the shot. That suggests faith in the eventual vaccine is quickly eroding, especially amid fears that it’s being rushed for political purposes.

Still, this year’s influenza vaccine rollout could help make Americans feel more comfortable about a possible coronavirus vaccine. For instance, medical practitioners could use a patient’s flu shot appointment to answer their questions about vaccines more broadly and make them more comfortable with the process, says Ann Philbrick, an associate professor at the College of Pharmacy and the Department of Family Medicine and Community Health at the University of Minnesota. Healthcare workers can provide “reassurance” about vaccines, she says, and “put the seed in your patient’s mind that we’re working on a COVID vaccine, and once we have one, it’s important to get one.”

How do we break the taboo around mental health?

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The national conversation around how we view mental health is definitely changing. The impact of Time to Change – the anti-stigma campaign run by Mind and Rethink Mental Illness – over the past decade has seen a nearly 10% positive change in public attitudes, which means around 4.1 million people now have more awareness and an improved attitude towards mental health. But when it comes to talking about our mental health at work, there is still a long way for us to go. 

According to Thriving At Work, an independent report co-authored by Mind CEO Paul Farmer, around 300,000 people with a long-term mental health problem lose their jobs each year, which is a much higher rate than seen in those with physical health conditions. 

Plus, around 15% of people at work have symptoms of an existing mental health condition. And what’s more, in a recent survey carried out for Mind’s Workplace Wellbeing Index, we found that four out of five employees with poor mental health cited workplace pressures as a contributory factor. Yet half of employees surveyed say they would not discuss mental health at work with their line manager, so there’s a disconnect. 

You’re not alone 

Just as our physical health fluctuates, so does our mental health, alternating between thriving, struggling and being ill and possibly off work. The World Health Organization defines good mental health as a state of wellbeing in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to her or his community. One in four people in England is diagnosed with a mental health condition in their lifetime. The prevalence of common mental health problems appears to have increased slightly over the last two decades, with the biggest rises in anxiety and depression, particularly among younger women and older men. 

One in three men (32%) attribute poor mental health to their job, compared to one in seven men (14%) who say it’s due to problems outside of work. Women say that their job and problems outside of work are equal contributing factors; one in five women give their job as the reason for their poor mental health, the same as those who say problems outside of work are to blame (19%). 

Breaking the silence 

In recent years, employers have made progress with tackling stress and supporting their staff’s mental wellbeing, including those with a diagnosed mental health problem. But there is more to do. We must create positive and supportive workplace cultures, so people feel comfortable talking about poor mental health without fearing negative career implications. 

If the UK prioritises mental health at work, we can become global leaders in reducing stigma, improving the mental health of the population and support for those who need it. As well as providing employees with good working conditions and ensuring they have a healthy work-life balance and opportunities for development, employers should encourage open conversations about mental health and make information, tools and support accessible. We want to see a time when every one of us will have the knowledge, tools and confidence to understand and look after our own mental health and the mental health of those around us. 

Madeleine McGivern is the former Head of Workplace Wellbeing Programmes at mental health charity Mind. Mind offer free resources for employers to help improve mental wellbeing and employee engagement. For more information, see mind.org.uk/work

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What does magnesium do?

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Why do we need it? 

Mainly stored in our bones, the mineral magnesium helps us turn our food into energy, and helps our bodies produce hormones that are important for bone health. It plays a role in more than 300 enzyme systems that regulate blood glucose control and blood pressure, among other things. It’s also key for nerve function, muscle activity and heart rhythm. Pretty important, then. 

Where can we get it? 

A good rule of thumb is that foods high in fibre also tend to contain magnesium. Green, leafy veg such as spinach and kale, vegetables such as broccoli and squash, nuts (especially almonds), seeds, cereals and legumes are all good sources. Dairy products, chocolate and coffee can provide a little magnesium, and tap water also contains the mineral, particularly if it’s hard water. If you think your levels might be low, you might want to consider a magnesium supplement, which can be taken in the form of a capsule, tablet or transdermal spray.

Any research behind it? 

There’s plenty, for all kinds of health benefits.

Eases sleep trouble

Magnesium is often touted as a remedy for sleepless nights, and there’s evidence behind this claim. One double-blind, placebo-controlled clinical trial – the gold standard in research – compared the effects of a magnesium supplement with a placebo among elderly people with insomnia. Participants received either a placebo or 500mg of magnesium for eight weeks and kept a record of the severity of their insomnia during this period. The magnesium group slept for longer, produced more of the sleep hormone melatonin, took less time to drop off, had less of the stress hormone cortisol in their bloodstream, and didn’t wake up so early. In other words, they slept better and for longer. 

Reduces type 2 diabetes

It’s common for diabetics, both type 1 and type 2, to be deficient in magnesium. Research has shown that increasing consumption of magnesium-rich foods such as wholegrains, beans, nuts and green, leafy vegetables may reduce risk of type 2 diabetes. Guidelines from the Association For Magnesium Research suggest that diabetes patients would benefit from taking a 240-480mg magnesium supplement daily. 

Helps heart health

Evidence from studies on populations have found that higher magnesium intake – whether that’s thanks to a good diet or taking a regular supplement – helps to protect against major cardiovascular problems including high blood pressure, stroke and heart disease. A 2018 review concluded that ‘the current evidence supports the importance of adequate dietary magnesium for lowering the risk of cardiovascular disease’. 

Prevents migraines

Another trial compared a placebo with a supplement containing magnesium, riboflavin and coenzyme Q10 as a treatment for migraine among 130 people. They took it for three months, then researchers analysed migraine frequency, level of pain and impact on daily life. Among the magnesium group, migraine days per month were reduced by nearly a third (from 6.2 days to 4.4), pain intensity reduced and the score for impact on life went down by 4.8 points (compared to two points in the placebo group). 

Who requires more of it? 

Research shows that, since 1940, our foods have contained less magnesium; there’s been a 38 per cent drop in cheddar cheese, 21 per cent in whole milk and 24 per cent in vegetables. Since 1968, the content in wheat has dropped almost 20 per cent, too – so we all need to work a bit harder to get enough. The magnesium content of bone decreases with age, so it’s important older people get enough through their diet, especially as the most recent National Diet And Nutrition Survey found that 65-74-year-olds were lacking. 

How much do I need? 

According to the NHS, women should get 270mg a day. Be careful of taking a high dose magnesium supplement (more than 400mg), as it can cause diarrhoea. However, regularly taking 400mg or less is unlikely to cause you any harm. Magnesium can also interfere with some medications for things such as blood pressure, muscle relaxants and certain antibiotics, so check with your doctor first.

If you are breast-feeding, pregnant or under medical supervision, check with your GP before taking supplements.

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Does your hair need an anti-pollution solution?

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Air pollution – it’s not exactly a promising story. Millions of us are breathing illegal levels of the stuff, and it’s predicted that by 2030, 92.9% of Brits will be living in an urban area. As a result, pollution-proofing skincare is popping up in bathrooms across the UK, while SPF is slathered all-the-more liberally across our increasingly sensitive complexions. But what about anti-pollution haircare? Before you splurge on every vitamin C-enriched shampoo going, it pays to understand how particulate matter (that’s diesel fumes, soot, smoke and metallic elements like lead, arsenic and mercury) interacts with our hair. 

An inside job

‘We know pollutants have a detrimental effect on people’s health,’ says Consultant Trichologist Iain Sallis. ‘That can filter into every path of your body, from your heart to your hair. But the hair was actually designed to mop up pollutants from the body. One of the primary roles of melanocytes – they’re what make your hair coloured – is to extract toxins from the blood that can’t be urinated or defecated out. So things like heavy metals tend to get excreted via the hair fibre rather than the kidneys or the liver, which can’t break these things down. The hair is actually very capable of getting rid of these things from our body – it’s our third excretory system.’ 

Don’t get duped

But that’s not to say anti-pollution haircare isn’t on the rise – analysts at market research firm Mintel placed anti-pollution front and centre in their recent hair ingredient forecast, citing botanical extracts and anti-inflammatory turmeric as key additions to protective formulas. For the most part, says Sallis, the credentials around anti-pollution haircare products are ‘a very interesting marketing tool,’ based more around the aesthetic effects of pollution than any real damage. 

Commonly wheeled out as justification for anti-pollution haircare products is the notion that when exposed to pollution, skin, including the scalp, experiences a higher sebum secretion rate. ‘It’s certainly a possibility, but there’s currently no science to back that up,’ says Sallis. ‘And if that’s the case, that’s no bad thing. Sebum is good for the hair, it’s your natural conditioner. You may not like the way it looks, but having more of it would have no detrimental effect on hair health.’ 

Clean up your act 

The good news (if you want to call it that) is that it’s only the look and feel of your hair that’s likely to be affected. ‘Your hair is a dead fibre, so it’s more like a piece of clothing than a body part,’ says Sallis. ‘Pollution can make it dull, lank and lifeless, and a bit smelly.’ Anabel Kingsley, trichologist at Philip Kingsley, agrees: ‘Pollution can make hair look dull and lacklustre, and feel coated and heavy,’ she says. ‘The dust, dirt and daily grime affects the hair and scalp in a similar way to the skin on our face.’ It might sound like the effects of pollution are the same as having dirty hair under any guise, but there are specialist measures you can take – see below: 

5 steps to pollution-free hair

1 Shake up your shampoo ‘If your hair is dull and lifeless, you need to change your shampoo,’ says Sallis. ‘Try a volumising formula, or one with chelating agents every other wash. Chelating agents bind to certain alkaloids and metals, and pull them off the hair – you’ll often find them in swimming shampoos, as they get rid of chlorinated salts.’ Kingsley recommends washing daily – in which case, use a mild shampoo, says Sallis. ‘Anything too strong will make hair feel stripped and dry at the ends, so use something you can use daily, and a light conditioner if you can. It will depend on your hair type – afro hair doesn’t tend to enjoy being washed, and might take more kindly to oils.’ 

2 Strength and conditioning ‘Porous hair is more likely to become stained by environmental pollution, such as smoke fumes, especially if it is blonde or grey,’ says Kingsley. ‘To reduce porosity, increase shine and seal the outer hair cuticle, use a weekly pre-shampoo conditioning treatment.’ 

3 See to your scalp ‘Pollution, dust, dirt and daily grime can increase the likelihood of scalp problems, such as flaking and itching,’ says Kingsley – and pollution may also exacerbate inflammatory scalp problems associated with hair loss. ‘I suggest using a weekly exfoliating scalp mask to help remove dead skin cells and improve suppleness.’ Combine Himalayan salt and coconut oil for a DIY version. 

4 Be practical ‘The only way to really protect hair is by occluding it, says Sallis. ‘So wear a hat, or tie it up to shield it from pollutants.’

5 Look at your lifestyle ‘Changes to diet and lifestyle will not protect your hair and scalp from external environmental pollution. But looking after yourself, eating well and managing stress levels will help to keep your hair and scalp in their best shape possible – and this in turn can make them more resilient to daily assaults,’ says Kingsley. Sallis agrees, and recommends supplements if you have any dietary deficiencies. ‘You could also equate smoking with being in a polluted environment,’ he adds. ‘Smoking acts as a vasoconstrictor, so is harmful to hair over time.’

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Should I try art therapy?

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Art therapy is based on the idea that you can work through your feelings and emotions by undertaking creative practice. Inspired by psychoanalysis and the importance of the subject’s internal world, one of art therapy’s early pioneers was Austrian-born Edith Kramer, an astute follower of Sigmund Freud. She used his theory of ‘sublimation’ (the idea that we transform socially unacceptable impulses into acceptable behaviours as a defence mechanism), and believed that ‘art tells the truth’. Kramer was employed as an art therapist in a school in 1950 and her seminal text, Art as Therapy with Children, was published in 1971. 

Today, art therapy is available for children and adults. It’s still seen as a type of psychotherapy, but it’s influenced by a range of theories. Meditation-based practices have hit the mainstream in the form of colouring books, but therapy sessions can also help subjects explore feelings of compassion and social engagement. 

What’s involved?

You can have art therapy in groups or individually, and sessions might involve drawing, painting, collaging, crafting and even using electronic devices such as iPads. You don’t need prior experience to get involved, but you might be asked to talk about your work afterwards. 

Art therapy sessions can be offered by charities, hospitals, therapy centres, or day centres. They might be helpful for people with a range of issues including chronic or life-limiting diseases, mental health problems and relationship problems. Guidelines set out by the National Institute for Health and Care Excellence (NICE) recommend it’s considered for people who suffer from psychosis and schizophrenia. If you want to try it, make sure your therapist is registered with the Health and Care Professions Council (HCPC), as anyone who refers to themselves as an art therapist should be. 

What are the benefits? 

For people who struggle to talk about their feelings, or have communication difficulties, art therapy can be used as an alternative to talking therapy. This means it might be useful for people with learning difficulties, offering a means to communicate visually. Additionally, the creative process itself can help to give participants a feeling of purpose and a sense of achievement that might improve overall wellbeing. 

Any science behind it?

There’s been little conclusive research – to date, most of art therapy’s perceived benefits come from anecdotal evidence or small-scale studies. However, the research that exists has had promising results, particularly in treating children with mental health issues and for reducing feelings of depression in adults. 

Treating PTSD

A pilot study looked at the effects of art therapy on children and teens with PTSD. Patients from two New York hospitals took part in 16 creative sessions over two weeks. The activities included beading, making mosaics and stitching purses. Participants also made collages and drawings to express their life stories. They were encouraged to display their work to their peers and discuss feelings relating to their trauma. Despite being encouraged to revisit traumatic memories, the group who took part in the art therapy displayed fewer behavioural problems and a decrease in PTSD symptoms, compared to a control group. However, more studies are needed to assess the long-term effects. 

Cancer patients

In a 2017 comparative study, cancer patients took part in watercolour painting during their chemotherapy sessions, and were given materials for home practice. Afterwards, participants assessed their depression and anxiety levels. The patients who took part in the art therapy showed significant improvement in quality of life, compared to a control group. However, this was a relatively small study. 

Fertility struggles

A 2011 pilot study investigated the use of art therapy as a mental health intervention for 21 women struggling to conceive. Participants showed reduced feelings of hopelessness, depression and anxiety. Again, this was a small study, but the results suggest art therapy might be a meaningful way to improve emotional wellbeing. 

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5 ways to lower your breast cancer risk

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It’s the most common cancer in the UK, yet we know four in 10 cases are preventable. Beat the odds by making these key changes, says breast cancer awareness campaigner Eluned Hughes.

1 Make activity part of life

Being active on a regular basis is one of the main lifestyle factors linked to breast cancer. Aim for the Department of Health’s recommended 150 minutes a week of moderate-intensity activity (something that gets you slightly out of breath), which could be brisk walking, cycling or swimming. Then, ideally, include some more vigorous exercise, such as strength training, gym trips or classes. Try to avoid a sedentary lifestyle the rest of the time by taking desk breaks, using the stairs not the lift, and so on. One reason activity is so important is partly to do with controlling oestrogen levels. Bottom line: get moving. 

2 Maintain a healthy weight 

Gaining weight in adult life adds to your risk, so maintaining a healthy BMI is important. It’s a complex issue with many overlapping factors, but hormones are key. After menopause you mainly make oestrogen via fat cells; the more fat cells you have, the higher your oestrogen levels, which ups your risk. If you’re overweight before menopause, your risk is slightly decreased as excess weight affects your menstrual cycle. But with only 20% of breast cancer cases in women under 50, that’s not a green light to gain weight in your younger decades. Better to stay at a healthy BMI throughout life to reap the protective effects post-menopause. 

3 Watch your alcohol intake 

Sorry, there’s no safe level for alcohol when it comes to breast cancer. The more you drink regularly, the greater your risk; take an honest look at your intake and moderate it if needed. Alcohol affects many systems within the body, including your hormones and weight, but we don’t know why it’s such a strong risk factor. Need more convincing? If you take 100 teetotallers, 11 will develop breast cancer. For 100 women who drink an average of two units of a day (about one 175ml glass of wine), that goes up to 14. For five units (about half a bottle of wine) daily, the number of cases rise to 18 out of the 100. So it’s a pretty convincing link. 

4 Think about HRT or the pill 

Both hormone replacement therapy (HRT) and the contraceptive pill alter your hormone profile, raising oestrogen levels. While taking them, you increase your breast cancer risk. According to the Generations Study – following 100,000 women over 40 years to see how genes and lifestyle affect breast cancer risk – the amount HRT raises risk by may have been underestimated by about 60%. 

But it’s not a simple case of avoiding hormonal medication; they can offer benefits depending on your life stage and health needs. The pill, for example, has a small protective effect against ovarian and endometrial cancers. Breast cancer risk differs according to the formulation, your age, family history, and how long you take the drug. Once you stop taking it, your risk drops off. So have a frank discussion with your GP about your personal risks and benefits before deciding what’s best for you. 

5 Give your breasts some TLC 

Touch them to feel for anything unusual. Look for changes in shape or texture. Check anything unusual with your GP. OK, this isn’t strictly reducing your risk. But it can have a huge impact on outcome, should you develop breast cancer. Most cases are diagnosed after women have spotted and reported a change in their breasts. The earlier breast cancer is picked up, the easier it is to treat, and the higher the survival rate. It doesn’t need to be a specific routine, just be aware of how they look and feel at different stages in your cycle (get the free app from breastcancernow.org/tlc, for help). And notify your GP of any changes straight away. Today, well over 80 per cent of patients are alive five years later. So check your breasts!

Eluned Hughes is former head of public health and information at Breast Cancer Now, the UK’s largest breast cancer research charity. 

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Vegan teriyaki noodles with Tenderstem broccoli

Image: Tenderstem

Looking for a quick and easy midweek meal? Whip up these easy vegan noodles, which are packed with nutritious vegetables. The carrots and mixed peppers are sources of beta-carotene, which our bodies convert into vitamin A to support healthy vision. Plus, the courgettes provide vitamin C, which is important for our immunity. The easy homemade teriyaki sauce combines ginger, garlic and chilli for a deliciously punchy flavour. We’re also adding some Tenderstem broccoli to the top of our vegan noodles for an added boost of fibre, potassium and folate. Enjoy!

Serves 4

For the teriyaki sauce
3 tbsp soy sauce
2 tbsp maple syrup
1 tbsp sesame seeds
2cm fresh ginger, peeled and diced
2 cloves fresh garlic, peeled and finely diced
¼ tsp chilli powder
3 tbsp water
1 tbsp cornflour

For the noodles
3 tbsp cornflour
200g tofu, cut into cubes
2 tbsp vegetable oil
1 onion, finely chopped
2 cloves of garlic, finely chopped
1 red pepper, cut into slices
1 yellow pepper, cut into slices
1 courgette, chopped
2 carrots, cut into thin batons
2 portions of stir fry noodles
250g Tenderstem® broccoli
Chilli flakes
Salt and pepper to taste

1 In a small bowl, combine all the ingredients for the teriyaki sauce. Add in the cornflour last and use a whisk to mix it into the sauce. Set aside.

2 Put 3 tbsp cornflour in a small bowl, then dip the cubes of tofu in one by one to coat. Heat a large frying pan on medium/high and add 1 tbsp vegetable oil. Once the oil is hot, fry the tofu cubes until golden brown and cooked, then remove from the pan and set aside.

3 Using the same pan on a medium heat, add another tablespoon of vegetable oil and fry the onion and garlic for 5 minutes. Once starting to soften, add your veggies to the pan gradually: starting with the peppers, followed by the courgette, then the carrot. Meanwhile, cook the noodles according to pack instructions.

4 Steam the Tenderstem broccoli for 3-4 minutes until it’s cooked, but still slightly crunchy. Take it off the heat, season with salt and pepper and set to one side.

5 Once the noodles have cooked, add them to the pan of vegetables and mix everything together well. Adding the cubes of tofu, continue to mix everything in the pan, pouring in the teriyaki sauce.

6 Stir everything together over the heat for a further 1-2 minutes. Once the teriyaki sauce has coated the noodles, tofu and veg and is fully heated through, split between four bowls. Top each bowl with a sprinkle of chilli flakes and a few pieces of Tenderstem broccoli to serve. 

For more recipes using Tenderstem broccoli, visit tenderstem.co.uk

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