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Image: Tina Tiller
Image: Tina Tiller

SocietyMarch 22, 2023

Why didn’t I simply wear a mask? 

Image: Tina Tiller
Image: Tina Tiller

Alex Casey asks a psychologist why she was too chicken shit to wear a mask during the flight that probably gave her Covid-19. 

In the live action replay in my head, I can basically see, frame by frame, the moment that one of those puny little Covid-19 Koosh balls did a Delamere flip right into my mouth. It was last Sunday afternoon, on a stinking hot Jetstar flight about to depart from Auckland to Christchurch, when the lights flickered off, the music dropped out and the wheezy air conditioning took its last breath. The captain came over the loudspeaker to explain that the engine controlling the electronics on the plane had broken, and they needed 10 minutes to pop a new one in. 

It didn’t seem like 10 minutes was nearly enough time to replace an engine, but this was Jetstar, so I didn’t ask any questions. Instead, I looked around open-mouthed (first mistake) at the festering flight full of people. Much like inside Auckland airport, which was particularly heaving after three massive concerts the night before, hardly anyone was wearing a mask on the plane.

The white guy with dreads in a Snoop Dogg hoodie wasn’t wearing a mask. The pair of sullen lads decked out in black My Chemical Romance merch weren’t wearing masks. The 40 something year-old woman in a Backstreet Boys T-shirt? Clearly not a fan of their 2009 album This is Us because she hadn’t donned a ‘Masquerade’ either. And who can blame them? Masks haven’t been mandatory since September last year – now only required in health and aged care settings – making those who volunteer to wear them feel more or less like total freaks. 

A mask is a rare sighting in public these days (Image: Tina Tiller)

Last month I got in an Uber wearing a mask and the maskless driver looked back at me, horrified. “Do you have Covid?!” he yelped. “No”, I said. “So why are you wearing a mask then?” he spat back. An acquaintance told me that her family actually took their masks off during a domestic flight – they were the only ones wearing them, and they felt awkward. At a recent comedy show I went to in Christchurch, a mask-wearer was singled out in the crowd. Although he was praised for his choices, it still felt like a fate just as isolating as actually getting Covid-19. 

When I ring psychologist Kirsty Ross, she is quick to reference the famous elevator experiment as an example of how humans are wired to conform, even when it doesn’t make sense. In the 1962 experiment, one person enters an elevator and confidently faces the back wall. Over time, more and more people turned around to face the back wall too. “There are very well established social psychology principles that mean that we are really likely to conform to what’s going on around us,” she explains, adding that there is an evolutionary purpose too. “If we’re identified as still being part of the pack, there is safety in numbers for us.”

Back to the plane. No air, no music, no lights, no masks. Although I had a mask in my bag, I wasn’t wearing one either, paralysed by the idea that I would somehow offend everyone on the plane by suddenly wearing one. Couldn’t simply reach down and put it on now, could I? Wouldn’t want to make a scene and suddenly appear like some sort of ghoulish masked vigilante now, would I? As the stagnant air enveloped us like those green stink lines in Scooby Doo, I instead chose to bravely fall asleep with my mouth open. Not all heroes wear capes, or even masks apparently. 

Where is the masked baby now I ask ye (Photo: Twitter / additional design Toby Morris)

Exactly 48 hours later, I found myself nauseous with a splitting headache, aching bones, a ripper cough and a blocked nose. Covid-19 got me. Again.  

Although I could have caught the germ from a range of places during my recent stint in Auckland, nobody else I spent any time with has become sick. I’m no scientist (although I did go to a Wellington Phoenix game with Joel Rindelaub once) but the plane is looking like the primary location of interest. And even if it wasn’t the source, it was still a sealed tube with 180 other people who had all just spent their weekend yelling into the open mouths of tens of thousands of other people. Once again I must ask: why did I not simply pop a mask on, just in case? 

“I think the choice that you made was really normal,” says Ross. When faced with an uncomfortable decision in a group environment, she says it can come down to a matter of risk assessment – do I take the long term risk of maybe getting Covid for the next week, or the short term risk of offending my new friend in the Backstreet Boys T-shirt? “There’s lots of things we can say to ourselves to help our estimation of risk to get down to a level where you feel comfortable enough to go along with what everyone else is doing,” says Ross.

It also doesn’t help that Covid-19 is not top of mind for a lot of people anymore, even though 1500 people a day are still catching it, around 200 people are in hospital with it, and around 24 people a week are dying with it. “Now that Covid isn’t really talked about in the news quite so much, and the social messaging around mask-wearing isn’t quite so prominent, it’s harder to make that stance,” says Ross. “Without guidance around what you’re supposed to do, it means the decision is largely left up to individuals now – and those decisions aren’t always easy to make.” 

Passengers wearing face masks at Auckland Airport in the distant past of 2020 (Photo: Getty Images)

So perhaps next time you’re crammed into a long, sealed vessel with heaps of other people, have a mull over what could be influencing your decision-making. Consider the fact that catching Covid-19 might wipe you out for a week – or longer – and ruin longstanding plans you made with visiting family (sorry Mum). Consider that you might unknowingly pass it onto someone who could suffer a worse fate than not being able to go to the Proclaimers concert (SORRY MUM). Consider… that your decision-making might not even be entirely your own at all. 

“This scenario really does show that, as people, we are much more in the flow of what’s happening at a broader social level than we realise,” says Ross, “and our individual decisions are not quite as individual as we think they are.” Now if you’ll excuse me, I feel urgently compelled to walk into an elevator and face the back wall – but at least this time I will wear my mask. 

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Calum Henderson
— Production editor
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semaglutide box with french writing because that's what was available on getty, with a blue tint and stripe of orange so it's eyecatching
Originally used for diabetes, celebrities and TikTok have made this drug go viral Image: Archi Banal

ScienceMarch 22, 2023

Viral weight loss drug Ozempic has been approved for use in New Zealand

semaglutide box with french writing because that's what was available on getty, with a blue tint and stripe of orange so it's eyecatching
Originally used for diabetes, celebrities and TikTok have made this drug go viral Image: Archi Banal

Medsafe has approved  an application for Ozempic to be used in New Zealand to treat diabetes. How does this new drug work and why is everyone talking about it? 

What just happened? 

Last Thursday, New Zealand’s medical regulatory body Medsafe gave consent for Ozempic to be prescribed in New Zealand. The approval is for injectable forms of the drug, sold as Ozempic by Danish drug company Novo Nordisk Pharmaceuticals, to be used to treat unmanaged type 2 diabetes.

Wait, what is Ozempic?

Ozempic was initially developed in 2012; after a phase of clinical trials, it was approved for use as a type 2 diabetes treatment in the US in 2017. In 2021, it was approved for use in the US and the UK as a treatment for weight management, under the brand name Wegovy; it’s also available with a prescription in the EU, Australia, and Canada.

Semaglutide, the active ingredient sold under Novo Nordisk’s brands Wegovy and Ozempic, has become exceptionally popular over the past few months, at least online; the tags “Wegovy” “Ozempic” and “semaglutide” have more than 1.1 billion combined views on TikTok. In the US, the drug has been heavily marketed on television. Celebrities have spoken about their use of the drug; Elon Musk has tweeted about it, and Chelsea Handler said that she’d used the prescription before stopping, while others have denied use of or discredited the drug.

How does it work?

Liraglutide and dulaglutide, described as “cousins” of semaglutide, are already being used to treat diabetes and obesity in Aotearoa. Taken in synthetic form, Semaglutide, dulaglutide, and liraglutide make your stomach slower to empty after eating, encourage the pancreas to produce more insulin, and prevent the liver from producing too much blood sugar. It also acts on the central nervous system, meaning you feel less hungry. The combined effect is that you feel full faster and have less appetite, causing you to eat less.

Liraglutide and dulaglutide have proven very effective, says John Baker, an endocrinologist and chairman of the Diabetes Foundation Aotearoa. “The world has been starved – so to speak – of good weight loss medicine. Once the usefulness of [these drugs] became known, the demand has impacted the availability of supply.” 

So now Ozempic will be available in NZ?

Almost. After permission for a drug to be prescribed has been granted, the company that has applied to MedSafe can choose when to start supplying the medication. The approval is only for use of the drug for diabetes, not weight loss – the reason it’s recently gone viral.  If Novo Nordisk chooses to import Ozempic into New Zealand, it will be as a private prescription, not covered by the Pharmac subsidy. It won’t be cheap; based on prices in Australia and the US, a private prescription could cost between $130 to $1000 a month, depending on the dose prescribed. 

“Novo Nordisk welcomes Medsafe’s approval of Ozempic (semaglutide) in New Zealand [and] is exploring options to provide access to Ozempic semaglutide for people living with type 2 diabetes in New Zealand,” a company spokesperson said, in reply to The Spinoff’s request for comment. 

whie coat white hands white boxes sterile medical vibes
Ozempic may be coming to New Zealand (Photo: Getty Images)

What about people who really need these drugs for their diabetes?

Media attention has had a direct impact on use of the drug, causing a temporary shortage, which is difficult for people who use the drug to treat their diabetes. However, Baker says that supply issues are temporary. “These are manufactured drugs – the companies will adjust.”

Pharmac, which has funded dulaglutide since 2021, has also started to fund liraglutide due to supply issues, with the product available in pharmacies this month. 

Liraglutide is sold as Saxenda (for obesity) and Victoza (for diabetes) and is also manufactured by Novo Nordisk; these medications were approved for use in New Zealand in 2016 and 2017 respectively. Victoza is now funded by Pharmac. Even if semaglutide, which studies show is more effective at creating weight loss than liraglutide, becomes available in New Zealand, it’s unlikely that Pharmac will fund it, as the drug subsidisation agency tends to only fund one or two medications in a drug class. 

Empty plate with cutlery and a piece of bread
GLP-1 agonist receptor drugs make you feel less hungry (Photo: Getty Images)

What is taking these drugs like?

Semaglutide, dulaglutide, and liraglutide are usually delivered in EpiPen-like injectable containers that can be self-administered, once a day or once a week. A form of semaglutide in oral pills is available overseas; however, Novo Nordisk have not applied for this medication to be approved by Medsafe. 

The drugs have a number of side effects, including nausea, diarrhoea, constipation, fatigue and heart palpitations. The weight loss isn’t always permanent, too; patients say that they have regained some of the weight they lost after stopping taking the drug. Doctors who prescribe semaglutide expect their patients to also be making shifts in their diet and exercise, which has to be constantly maintained – but often doesn’t work at all

How do weight loss drugs fit into wider ideas about weight and dieting? 

Critics of diet culture have pointed out that semaglutide is far from the first “miracle cure” for weight loss; many of the same claims were made of bariatric surgery, which can help people manage weight, but doesn’t provide instantaneous or straightforward results.

GLP-1 treatments for weight loss also use much higher doses of the drug than when they are used for diabetes treatments, so side effects can be stronger – and many of those side effects contribute to making eating actively unpleasant, increasing users’ avoidance of food. People using these drugs can forget to eat, which can make them lightheaded, dizzy and bad at focusing.  

‘Like a thousand-piece jigsaw puzzle, each member is vital to the whole picture. Join today.’
Calum Henderson
— Production editor

Dieting and exercise alone are not helpful for many people – medical interventions can be more effective than sheer willpower. Losing weight can make it easier to exercise and lower the risk of heart disease and diabetes. Weight and health are linked – but they’re also extraordinarily complex, with ever-evolving science, and corporations prepared to profit from individual shame, guilt, and ill-health. 

So what happens now that Medsafe has given consent?

It’s still not clear when, or if, Novo Nordisk will make semaglutide available in New Zealand; if it does, it will be for insufficiently managed type 2 diabetes, with prescription for other symptoms granted if an authorised prescriber thinks the patient requires it. Consent from Medsafe means that the ball is in the pharmaceutical company’s court, and in the meantime the drug won’t be available at pharmacies. Doctors and pharmacists will probably direct eligible patients to the Pharmac-funded liraglutide and dulaglutide in the meantime.

It’s also worth remembering that New Zealand and the US are the only two high-income countries that allow prescription drugs to be marketed directly to consumers. Perhaps we’ll all be humming Oh-oh-oh-Ozempic soon. 

But wait there's more!