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Rishi Sunak has pledged to raise the legal age for buying cigarettes by one year every year in a crackdown on smoking.
The prime minister said the proposed legislation would mean a "14 -year-old today will never legally be sold a cigarette and that they and their generation can grow up smoke-free".
He said the changes will be subject to a vote in parliament but this will be a free vote, as was the ban on smoking in public places and raising the smoking age to 18.
Read more: See all the key points from Sunak's conference speech
"There will be no government whip. It is a matter of conscience," he said.
Addressing the annual Tory party conference, Mr Sunak also promised to restrict the availability of vapes under plans to "put the next generation first".
On smoking, he said it would not be fair "to take away the rights of anyone to smoke who currently does".
However he said more could be done stopping teenagers taking up cigarettes in the first place.
"I propose that in future we raise the smoking age by one year every year," he told party delegates in Manchester.
"That means a 14-year-old today will never legally be sold a cigarette and that they and their generation can grow up smoke free."
He added: "People take up cigarettes when they're young - four in five smokers have started by the time they're 20.
"Later the vast majority try to quit. But many fail because they're addicted and they wish they had never taken up the habit in the first place.
"And if we could break that cycle, if we could stop the start, then we would be on our way to ending the biggest cause of preventable death and disease in our country."
Downing Street said it expects that the plans will mean up to 1.7 million fewer people smoking by 2075.
On vapes, the prime minister said: "As any parent or teacher knows, one of the most worrying trends right now is the rise in vaping amongst children - one in five children have used vapes.
"We must act before it becomes endemic.
"So we will also bring forward measures to restrict the availability of vapes to our children, looking at flavours, packaging displays and disposable vapes."
Number 10 said a consultation on vaping will examine restricting the flavours and descriptions of vapes so that vape flavours are no longer targeted at children; regulating sale displays of vapes; regulating packaging; and restricting the sale of disposable vapes.
Ministers have faced repeated calls to ban vapes to help protect children and reduce the significant environmental impact of the single-use products. | Health Policy |
More than 10 percent of young adults are using vapes regularly: CDC study
More than 1 in 10 Americans ages 18-24 are using e-cigarettes regularly, a study from the Centers for Disease Control and Prevention (CDC) released this week found, raising health concerns over nicotine exposure at a young age.
Around 4.5 percent of Americans use vapes overall, CDC reported — but that rate more than doubles to 11 percent among young people. Brains don’t finish developing until a person is about 25 years old, according to the agency, and nicotine could be negatively impacting that development.
While vapes may help people stop smoking cigarettes, the study found an increasing trend of users — especially young people — smoking cigarettes and vaping interchangeably. E-cigarettes are more common with people under 25, and cigarettes more common with older Americans.
“Dual use of tobacco products is a health concern because it may result in greater exposure to toxins and worse respiratory outcomes than using either product alone,” the study reads.
“In 2021, most e-cigarette users aged 18–24 had never smoked cigarettes,” it continues. “Despite this, the percentage of adults aged 18–24 who were dual users of e-cigarettes and cigarettes was similar to the percentage among adults aged 25–44 (1.8% compared with 2.0%).”
A report from the American Heart Association (AHA) this week also found that vapes can damage your heart and lungs over longterm use.
“E-cigarettes deliver numerous substances into the body that are potentially harmful, including chemicals and other compounds that are likely not known to or understood by the user,” the AHA said in a statement.
“There is research indicating that nicotine-containing e-cigarettes are associated with acute changes in several hemodynamic measures, including increases in blood pressure and heart rate,” the association added.
The CDC study also found that vape usage is more common among white Americans — which make up more than 14 percent of users — than Latino, Asian or Black youth in the same age group and those in the lower income bracket. Usage is also higher in men than in woman, according to the research.
The research is based on 2021 data from a National Health Interview Survey and identifies an e-cigarette user as someone who says they vape “every day” or “some days.”
Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. | Epidemics & Outbreaks |
Raisa supported Gomez at the Rare Impact Fund benefit on Oct. 4, and addressed what she called "rocky and tricky" times they've had in their decade-plus friendship. In 2017, Raisa memorably donated a kidney to Gomez, who has lupus. They had a falling out after, but have found their way back to each other again.
"Relationships change," Raisa admitted. "I don’t know any relationship that’s perfect." And while they had a "situation" come up, "I am happy that we are here today, celebrating and supporting each other."
We look back at how they became friends, bonded over organ donation, fell apart and came back together.
2007: They meet doing charity work.
Gomez was the star of Disney Channel's Wizards of Waverly Place and Raisa was cast in ABC Family's The Secret Life of the American Teenager when they both visited Children’s Hospital Los Angeles to spend time with the patients.
"[Selena] was in my group," Raisa later told Extra. "She came up to me and was like, ‘My mom had a teenage pregnancy, she was 16 years old, and we love your show.’ I was like, ‘Oh, my God, thank you! I love your show.’ We started talking, we both had boyfriends at the time, we started kiki-ing."
2008: A friendship grows.
"We just clicked," Raisa later told Latina of their bond, which included navigating their romantic relationships.
She told Extra, "Around the time that my boyfriend and I broke up, and her and her boyfriend broke up," perhaps referring to Gomez and Nick Jonas. "She called me and was like, 'I am going through some stuff... I am going through a breakup.' I was like, ‘Girl, me, too,’ and we were just inseparable after that ever since."
They started being each other's plus-one at events — like when Raisa accompanied Gomez to the Justin Bieber: Never Say Never premiere a few years later. (We assume they had many heart-to-hearts during Gomez's Bieber era.) They also supported each other's work, and made cute dance videos.
2012: They become chosen family.
“I love [Gomez] to death," Raisa told Wetpaint that year. "She’s my sister, and she is one of the sweetest girls I know. She is so caring and so loving and so nurturing. She’s awesome. I don’t know where she came from."
In a social media tribute to Gomez, Raisa wrote, "Met you when you were 15 and u became family to me when you were 16. Since then you have changed my life and I’ve become a better person."
Gomez gave Raisa “a sister is a forever friend" necklace.
2015: Gomez reveals her lupus diagnosis.
The actress publicly shared her health struggle. At the time, she canceled a tour to receive chemo treatments for the disease.
Gomez honored Francia on her birthday, saying, "You have been there through so many phases of life with me. The only thing I want you to know is how much I value YOU. You are more than you realize. I love you."
2017: Raisa donates a kidney to Gomez.
Gomez has a kidney transplant over the summer due to lupus — and Raisa is her donor.
"There aren’t words to describe how I can possibly thank my beautiful friend Francia,” Gomez said when she shared the news. “She gave me the ultimate gift and sacrifice by donating her kidney to me. I am incredibly blessed. I love you so much sis.” Raisa said she was “beyond grateful that God would trust me with something that not only saved a life, but changed mine in the process… Love you sis, so glad we’re on this journey together."
They give a joint interview on the Today show that fall. Gomez said, "I didn’t want to ask a single person in my life" to be the donor. The thought of asking someone to do that was really difficult for me. [Francia] volunteered and did it. And let alone someone wanting to volunteer, it is incredibly difficult to find a match. The fact that she was a match, I mean that’s unbelievable. That’s not real."
— TODAY (@TODAYshow) October 27, 2017
When Gomez was named Billboard’s 2017 Woman of the Year and brought Raisa as her guest. In her acceptance speech she said, through tears: "I think Francia should be getting this award. She saved my life… I feel incredibly lucky."
— billboard (@billboard) December 1, 2017
2018: Raisa reveals she and Gomez went through depression after transplant.
Raisa got candid about post-surgery struggles in multiple interviews. She told W, "Recovery was hard," as she couldn't move for two months. She told Self, “Selena and I both went through a depression.”
In an interview with Harry Connick Jr., Raisa said being Gomez's donor made them family for life. "[Selena] felt bad about even having me do that because we are just friends — I am not her family or anything," she said. "Well, I am now. She has my blood."
Gomez sought mental health treatment for depression and anxiety. She later revealed her bipolar disorder diagnosis.
2019: Gomez and Raisa get matching tattoos.
In an interview with Capital FM, Gomez reveals that she and Francia got June 19th ink to mark the date of the transplant. "I actually got the date of when I got my kidney transplant — and I did that with the girl that gave me her kidney," she told the outlet.
At some point around this time, they had a falling out. The rumor mill ran wild with speculation about why they severed ties, but neither directly spoke about it publicly. Because they had been so close, the silence was deafening.
2021: Gomez and Raisa mark World Kidney Day.
While fans continue to speculate about their friendship status, Raisa shared her experience as a donor. She wrote on social media: "While I wasn't affected personally by kidney disease, I've seen the impacts of it firsthand and want to do my part to help educate others on it. In honor of World Kidney Day, let's talk about the impact of kidney disease and how we can work to ensure those living with kidney disease are living well." Gomez shared the post, adding, "Thank you for blessing me, I am forever grateful to you."
2022: Raisa unfollows Gomez on social media.
Fans were delighted when they seemed to have made amends, appearing together in a TikTok and joking about drama.
Soon after, Selena Gomez: My Mind & Me doc about her mental health journey came out and Raisa wasn't included.
An interview Gomez did with Rolling Stone, in which she said Taylor Swift was her "only friend in the industry," escalated everything. Raisa reacted to seeing Gomez's quote, writing — and then deleting — the comment "interesting" after seeing it on E! News's Instagram. Gomez responded in a TikTok comment section, "Sorry I didn't mention every person I know."
Raisa unfollowed Gomez on Instagram.
2023: They make up.
Gomez called Raisa her "best friend" while talking about the transplant in Dear... "She said, ‘No, I am absolutely getting tested [to see if she was a match],'" Gomez recalled. "And within three days, she went to get tested, and she was a match. And it was one of those moments where I felt watched over. I know I was so so so lucky." She also said she feels "in debt" to her friend.
Raisa said she's getting hate comments online over the friendship drama with Gomez.
Gomez posts a tribute to Raisa on her birthday calling her a "special human being."
Raisa followed Gomez on Instagram again.
Raisa denied being "forced" to donate her kidney to Gomez. "It just came out of the genuine kindness of my heart, and I've been super blessed ever since," she said on the Good Guys podcast.
They both rock the same shoes on a night out, sharing photos to social media, writing, “No beef, just salsa."
Gomez's Rare Impact Fund holds its gala and Raisa attends. She confirmed during a red carpet interview that they had a rift in the past, but they've made up.
“We trauma-bonded, which is beautiful, but also it can get rocky and tricky," Raisa told Extra. "People grow, relationships change. Obviously, I treat her like my little sister, she treats me like her older sister… I don’t know any relationship that’s perfect… When our situation came up… No, I never pictured that, but obviously I never regretted it. I am happy that we are here today, celebrating and supporting each other."
As for their falling out — and then reconciliation, she said, "Sometimes ... people need to spend time apart in order to grow. We had to almost go on our own journey and grow." Now, that they're older — Gomez is 30 and Raisa is 35 — they come back together as grown women. "We can get to know each other again."
Raisa added that for inquiring minds, "Just for the record, it had nothing to do with the kidney." Also, she notes that while their matching silver gowns were not planned, they did go get spray tans together prior to the gala. | Disease Research |
The US Department of Health and Human Services has called on the Drug Enforcement Agency (DEA) to loosen federal rules on cannabis.
The drug is illegal at the federal level despite 40 of 50 US states having passed laws legalising its use in some form.
Cannabis is currently listed in the same class of drugs as heroin and LSD.
If the DEA changes its classification, it could mark the most significant shift in US drug policy in decades.
Cannabis is currently classified as a schedule 1 drug under the Controlled Substances Act, meaning it has no medical use and a high chance of abuse.
The change to schedule 3 would align it with drugs listed as having a low potential for dependency and abuse. Ketamine, codeine, and anabolic steroids fall under that classification.
Last year, President Joe Biden asked his attorney general and health secretary to oversee a review on whether cannabis should be listed as a less serious drug.
The proposal was presented to the DEA by the Department of Health and Human Services (HHS) on Tuesday.
"As part of this process, HHS conducted a scientific and medical evaluation for consideration by DEA," the agency said in a statement.
"DEA has the final authority to schedule or reschedule a drug under the Controlled Substances Act. DEA will now initiate its review."
The HHS, in its statement, said "this administrative process was completed in less than 11 months, reflecting this department's collaboration and leadership to ensure that a comprehensive scientific evaluation be completed and shared expeditiously".
The recommendation stops short of removing cannabis from the Controlled Substances Act's list altogether. Some advocates have pushed the administration to de-schedule the drug, meaning repeal it from the Controlled Substances Act and regulate it in the same way as alcohol or tobacco.
Rescheduling it could open it up to further research and allow banking in the cannabis industry to operate more freely. Currently, most marijuana businesses in the US are forced to operate in cash, due to tax laws banning banks from handling money generated from certain drug sales.
Public opinion polling indicates that a majority of Americans support some form of legalisation of the drug.
Cannabis is legal for adult recreational use in 23 states, including all west coast states and in Washington DC. It is permitted for medical use in 38 states. | Drug Discoveries |
London — Major drug store chains in the United Kingdom plan to start selling the weight loss drug Wegovy, a different version of its hugely popular Ozempic brand, this year, as the company that makes both says it's working to expand supplies of the popular semaglutide medications to Europe.
Semaglutide works by mimicking the action of a hormone that makes people feel full, blunting their appetites so they eat less. Ozempic is marketed and prescribed to treat Type 2 diabetes, but its side effect of dramatic weight loss has made it popular among celebrities for that purpose. Wegovy, made by the same Denmark-based pharmaceutical company Novo Nordisk, is marketed specifically for weight loss and comes in higher doses.
The spike in popularity of semaglutide caused a surge in demand,earlier this year.
Britain's National Institute for Health and Care Excellence (NICE) has issued draft guidance recommending Wegovy for people living with obesity, and its final guidance is expected on March 8. That guidance will serve as a formal instruction to Britain's National Health Service to start providing the drug to patients who need it, a NICE spokesperson told CBS News.
"We know that management of overweight and obesity is one of the biggest challenges our health service is facing with nearly two thirds of adults either overweight or obese. It is a lifelong condition that needs medical intervention, has psychological and physical effects, and can affect quality of life," Helen Knight, program director at the center for health technology evaluation at NICE, said in a statement.
Jo Dent, an NHS worker who visited a private doctor to obtain a prescription for Ozempic late last year after struggling to lose weight, told CBS News that semaglutide has helped her reshape her relationship with food. She said making it more readily available would be a good thing for the country's health service.
"I do think it would support people to be less of a burden on the NHS, in terms of the challenges of obesity and what that means for other health conditions," she said. "It's not a quick fix and it's not the only answer, but actually it will help you if you're serious about wanting to lose weight."
At least one major drug store chain in the U.K. plans to start prescribing and selling Wegovy privately through its online doctor service this year. Boots, the biggest national pharmacy chain, is already offering an online prescription service for the medication, while competitor Superdrug has set up a waiting list.
Declining to offer specific countries or timings, a spokesperson for Novo Nordisk said the company was "really looking to make sure that we only launch if we can provide the product. So obviously, we have ramped up our supply chain. We've invested quite a lot, where our manufacturing is now running 24-hours, seven days a week."
The spokesperson said even after the NICE guidelines in the U.K. are published next week, Wegovy will only be available to the NHS once the company has sufficient supplies to offer it to the market.
"We don't have concrete launch timings," the spokesperson told CBS News. "We're just looking to make it available as soon as possible."
Novo Nordisk launched Wegovy in Norway and Denmark at the end of last year, and the spokesperson said the company expects to launch in a number of additional European countries in 2023.
"We're just focused on, obviously, production for Europe and continuing to supply the U.S.," the spokesperson told CBS News.
NICE said the list price of Wegovy in 0.25 mg, 0.5 mg and 1.0 mg doses was 73.25 pounds (about $88) per pack of four pre-filled injection pens, but that if it becomes available on the NHS, it will either be free or cost patients the standard prescription fee of about $10 per order, depending on the cost structure.
In the U.S. the same pack of four Wegovy injection pens has a list price of $1,349, but some health insurance plans will cover at least some of that cost.
In the U.K., Wegovy will only be available to obese adults who have at least one additional condition, such as heart disease or high blood pressure. It must be prescribed by a doctor or someone with specialist qualifications.
for more features. | Drug Discoveries |
Rishi Sunak is under pressure over his claims about the state of dentistry as figures reveal that the number of active NHS dentists in England is at its lowest level in a decade, leaving millions of people struggling to get checkups or have toothaches fixed.
The British Dental Association (BDA) has warned of an exodus of dentists from the NHS as it published figures showing that the workforce has been reduced to a level not seen since 2012-13.
Sunak has repeatedly said that 500 extra dentists had been recorded as providing NHS services in the 2021-22 financial year.
A growing number of dental surgeries do little or no NHS-funded work, with the BDA citing a £3bn dental budget that has failed to keep pace with inflation and population growth over the past decade.
A total of 23,577 dentists performed NHS work in the 2022-23 financial year, down 695 on the previous year, according to a response to a freedom of information request from the NHS Business Services Authority. That figure is more than 1,100 down on the pre-pandemic numbers.
The loss of dentists within the system has led to nearly 6 million adults trying and failing to get an NHS dentist appointment in the past two years, according to a recent analysis by the BDA.
The official figures on the NHS dentistry workforce appear to contradict the prime minister’s claims that recent reforms have boosted numbers.
The BDA said it thought the prime minister was relying on a rise in activity from dentists in the NHS in the financial year 2021-22 that had naturally followed the end of the Covid lockdown.
Shawn Charlwood, who chairs the British Dental Association’s general dental practice committee, said: “[The] government needs to drop the spin, accept the facts, and provide a rescue package to keep this service afloat. NHS dentistry is haemorrhaging talent, and further tweaks to a broken system will not stem the flow.
“The prime minister once called for this budget to be ringfenced. We face an access crisis, and with hundreds of millions set to be pulled away, funds must be put to work solving these problems.
“Ministers have a choice. They can help thousands of struggling practices fill vacancies and see patients, or just pass by on the other side.”
The BDA has been asking ministers to recycle money returned to the government by dentistry practices that have been unable to hit their contractual targets. It is estimated this could exceed £400m this year.
The fall in workforce numbers highlighted in the figures is also said by the BDA to underplay the full scale of lost capacity in NHS dentistry.
A recent BDA survey of dentists in England revealed that half of dentists (50.3%) had reduced the proportion of NHS work they did by more than a quarter since the start of the pandemic. And 74% indicated that they planned to reduce the amount of NHS work they undertake in the year ahead.
The NHS Business Services Authority did not immediately respond to a request for comment.
A Department of Health and Social Care spokesperson said the latest figures might be lower than the previous year due to not all NHS dentists having submitted their data for the last financial year.
She said: “We are working to improve access to NHS dental care and have already increased the funding practices receive for high-needs patients to encourage dentists to provide more NHS treatments.
“We have also amended the guidelines so dental therapists and hygienists can deliver more treatments as well as making it easier to recruit dentists from overseas, and we will be setting out further measures to improve access shortly.” | Health Policy |
"We live in a society where sex is still quite a taboo topic. Just the discussion 'let's go for an STI test' can be quite a daunting thing."
For Ellie Harrison, getting a positive HIV result came as a shock.
Men who have sex with other men are one of the groups most at risk of getting HIV, so for the 26-year-old - as a straight woman - it was "the last one" she expected.
Ellie was diagnosed five years ago, through a home test small enough to fit through the letterbox.
A drop of blood from a finger prick is tested, which Ellie tells BBC Newsbeat was "easy and efficient".
This week, more free HIV tests are being offered to people in England.
It's part of a government drive to improve diagnosis, which dropped off during the Covid pandemic.
The kit, which arrives in plain packaging through the post, gives a result within 15 minutes.
A "reactive" result means HIV is possible and a clinic check is needed.
"When I found out, I was petrified, and I didn't know anything about HIV at the time," Ellie says.
"I was just really scared of what was going to happen, what the treatment was going to be like, and if I was going to be OK."
Ellie was booked into a specialist HIV clinic and found out specific details, like the amount of virus in her blood - viral load - and the strength of her immune system.
The treatment plan can be as simple as taking tablets to bring viral load down, with Ellie saying she feels HIV is "one of the easiest medical conditions" to manage.
"There's been a bit of a mental ride, but I think that was just my lack of knowledge at the start."
HIV medication can keep the virus at undetectable levels, meaning you cannot pass HIV on and your health is protected.
What is HIV?
- HIV stands for Human Immunodeficiency Virus - the immunodeficiency is the weakening of the immune system by the virus
- If untreated it can lead to late-stage HIV or Aids, the name for a collection of illnesses caused by the virus
- Medication helping those with HIV to live long, healthy lives has been available for decades
- Modern medication reduces the viral load to undetectable levels, meaning someone can't pass on HIV and their health is protected
Ellie feels there is still a stigma around HIV, but she thinks home tests can help.
"I think there's still a lot of fear around being with someone that's got HIV or just being around knowing someone that has it and whether they can pass it on or not."
That's something Ellie has experienced, "especially being a straight woman".
"People that I date, I think the education in that community [young, straight men] is pretty poor," she says.
"I have to go through the whole process of explaining what undetectable means, that I'm actually OK."
But the ease of a home test means more people may feel comfortable getting tested.
"That's how I got diagnosed. It's so easy and efficient," Ellie says.
"I always say to people, I'd rather know my status and be OK, happy and healthy than not." | Disease Research |
A recent study published in the Journal of Affective Disorders examined the impact of screen use before sleep on emotional problems among adolescents. The researchers focused on two crucial factors: chronotype (the timing of one’s biological clock) and social jetlag (the misalignment between biological and social rhythms).
In today’s society, electronic devices are an integral part of adolescents’ lives, but their excessive use has been linked to various negative outcomes, including cardiovascular issues, reduced cognitive performance, and increased psychological problems. The negative effects are particularly pronounced when screen time occurs closer to bedtime.
The study aimed to understand the connection between screen use before sleep, emotional problems, and sleep patterns in adolescents. Previous research suggested that exposure to blue light emitted by electronic devices could disrupt circadian rhythms, leading to delayed sleep and a late chronotype. Adolescents with a late chronotype, in turn, face challenges when their school schedule requires them to wake up early. This misalignment of their biological and social clocks results in social jetlag, which may contribute to emotional difficulties.
The researchers collected data from two independent surveys conducted among Chinese high school students, involving a total of 2,685 and 1,368 adolescents, respectively. Participants reported their screen use before sleep, chronotype, social jetlag, and emotional problems using questionnaires. Serial mediation analyses were performed to investigate the relationships among these variables.
The study’s findings revealed that adolescents who used screens before sleep tended to have a later chronotype and experienced greater social jetlag. These factors put them at a higher risk of emotional problems. Disruption of circadian rhythms emerged as a crucial mechanism linking screen exposure to psychopathology.
Furthermore, adolescents with later chronotypes faced challenges in coping with early social schedules, leading to a mismatch between their biological and social clocks. This misalignment further contributed to social jetlag and its association with emotional difficulties.
It is important to note that the study’s cross-sectional design does not allow for establishing causal links, and self-reported data may be subject to bias. For more definitive conclusions, future studies using objective measures like polysomnography and dim light melatonin onset (DLMO) are needed to replicate these findings.
Despite these limitations, the study underscores the significance of encouraging healthier screen habits among teenagers. Being mindful of their natural sleep patterns can help when creating intervention strategies to support their emotional well-being.
“The present study contributed to the existing literature by examining the mediating effect of chronotype and social jetlag in the relationship between screen use before sleep and emotional problems from a circadian rhythm perspective among two large samples of Chinese high school adolescents,” the researchers concluded.
“More specifically, screen use before sleep was associated with later chronotype and then greater social jetlag, which was further related to higher levels of emotional problems. The findings suggested that healthy media use habits should be developed, and intervention strategies targeting circadian characteristics should be designated to promote emotional health in the adolescent population.”
The study, “Screen use before sleep and emotional problems among adolescents: Preliminary evidence of mediating effect of chronotype and social jetlag“, was authored by Lei Yue, Naixue Cui, Li Jiang, and Naisong Cui. | Mental Health Treatments |
Scientists have gleaned new insights into how psychedelics alter conscious experience via their action on brain activity.
In a study at Imperial College London, detailed brain imaging data from 20 healthy volunteers revealed how the potent psychedelic compound, DMT (dimethyltryptamine), alters brain function. During the immersive DMT experience there was increased connectivity across the brain, with more communication between different areas and systems. The changes to brain activity were most prominent in areas linked with ‘higher level’ functions, such as imagination.
"This work is exciting as it provides the most advanced human neuroimaging view of the psychedelic state to-date." Dr Chris Timmermann Centre for Psychedelic Research
DMT is a potent psychedelic found naturally in certain plants and animals. It occurs in trace amounts in the human body and is the major psychoactive compound in ayahuasca – the psychedelic brew prepared from vines and leaves and used in ceremonies in south and central America.
The study, published in the journal PNAS, is the first to track brain activity before, during and after the DMT experience in such detail.
Dr Chris Timmermann, from the Centre for Psychedelic Research at Imperial College London, and first author on the study, said: “This work is exciting as it provides the most advanced human neuroimaging view of the psychedelic state to-date.
“One increasingly popular view is that much of brain function is concerned with modelling or predicting its environment. Humans have unusually big brains and model an unusually large amount of the world. For example, like with optical illusions, when we’re looking at something, some of what we’re actually seeing is our brain filling in the blanks based on what we already know. What we have seen with DMT is that activity in highly evolved areas and systems of the brain that encode especially high-level models becomes highly dysregulated under the drug, and this relates to the intense drug ‘trip’.”
Unlike other classic psychedelics, such as LSD or psilocybin, DMT’s effects on the brain are relatively brief, lasting a matter of minutes, rather than hours. DMT can produce intense and immersive altered states of consciousness, with the experience characterised by vivid and bizarre visions, a sense of ‘visiting’ alternative realities or dimensions, and similarities with near death experiences. But exactly how the compound alters brain function to account for such effects has been unclear.
In the latest study, 20 healthy volunteers were given an injection of the drug while researchers from Imperial’s Centre for Psychedelic Research captured detailed imagery of their brains, enabling the team to study how activity changes before, during and after the trip.
Volunteers received a high dose of DMT (20mg, given intravenously), while simultaneously undergoing two types of brain imaging: functional magnetic resonance imaging (fMRI) and electroencephalography (EEG). The total psychedelic experience lasted about 20 minutes, and at regular intervals, volunteers provided a rating of the subjective intensity of their experience (on a 1 to 10 scale).
The fMRI scans found changes to activity within and between brain regions in volunteers under the influence of DMT. Effects included increased connectivity across the brain, with more communication between different areas and systems. These phenomena, termed ‘network disintegration and desegregation’ and increased ‘global functional connectivity’, align with previous studies with other psychedelics. The changes to activity were most prominent in brain areas linked with ‘higher level’, human-specific functions, such as imagination.
"Psychedelics are proving to be extremely powerful scientific tools for furthering our understanding of how brain activity relates to conscious experience." Professor Robin Carhart-Harris University of California, San Francisco
The researchers highlight that while their study is not the first to image the brain under the influence of psychedelics or the first to show the signatures of brain activity linked to psychedelics, it is the first to combine imaging techniques to study the brain during a highly immersive psychedelic experience. They explain the work provides further evidence of how DMT, and psychedelics more generally, exert their effects by disrupting high level brain systems.
Prof Robin Carhart-Harris, founder of the Centre for Psychedelic Research at Imperial College London, and senior author on the paper (now working at the University of California, San Francisco), commented: “Motivated by, and building on our previous research with psychedelics, the present work combined two complementary methods for imaging the brain imaging. fMRI allowed us to see the whole of the brain, including its deepest structures, and EEG helped us view the brain’s fine-grained rhythmic activity.
“Our results revealed that when a volunteer was on DMT there was a marked dysregulation of some of the brain rhythms that would ordinarily be dominant. The brain switched in its mode of functioning to something altogether more anarchic. It will be fascinating to follow-up on these insights in the years to come. Psychedelics are proving to be extremely powerful scientific tools for furthering our understanding of how brain activity relates to conscious experience.”
The Imperial team is now exploring how to prolong the peak of the psychedelic experience through continuous infusion with DMT, and some are also advising on a commercially run trial to assess DMT for patients with depression.
The research was funded by a donation from Patrick Vernon, mediated by The Beckley Foundation.
‘Human brain effects of DMT assessed via EEG-fMRI’ by Christopher Timmermann et al. is published in the journal PNAS.
Main image credit: Shutterstock.
Article text (excluding photos or graphics) © Imperial College London.
Photos and graphics subject to third party copyright used with permission or © Imperial College London. | Mental Health Treatments |
The UK's second-largest vape company took down social media accounts after sending vapes to reporters in an online giveaway without age verification.
Chinese government-owned SKE has seen rapid growth in sales of its Crystal Bar disposable vapes, which have been criticised for appealing to children.
In an exclusive interview SKE marketing director Serge Davies said the accounts were taken down for a "review".
SKE also apologised for not signing up to government recycling schemes.
In supermarkets, newsagents and vape shops, Crystal Bar disposable vapes are everywhere in the UK. Designed to deliver a few hundred puffs of nicotine-containing vapour and then be thrown away, disposable vapes have seen astonishing growth in recent years.
SKE, the partly state-owned Chinese company which makes Crystal Bar, is now the second biggest seller of vapes in the UK, according to new figures from data provider NielsenIQ, selling more than 30 million in the past year. Nielsen's figures don't include independent retailers and vape shops - SKE's true sales figure is thought to be over 100 million.
Giving away free samples has been a key part of its rise - last month it ran an online giveaway on the Discord instant messaging platform, promoted via its Instagram feed. Discord began as a platform for gamers, and has a large number of under-18 users.
BBC reporters entered the competition. They were asked to state that they were over 18, but no further verification was required. Two vapes were then sent in the post.
It is illegal to sell vapes to anyone under 18.
After the BBC contacted SKE, some of its social media accounts were taken down pending a "review", including its YouTube and TikTok channels.
"We're looking to relaunch them with a local social media company that has more of an understanding of the local laws, the local customs," Serge Davies, SKE's European communications director, told the BBC.
SKE's two biggest rivals, the Chinese company Elfbar and UK-listed BAT, which makes Vuse vapes, both say they don't publish on TikTok. That's partly because the risk of appearing on children's phones is too great.
SKE, however, is committed to the platform. "We will be looking to relaunch with an exciting new strategy on TikTok," said Mr Davies. It is also committed to continuing with vape giveaways. "It does seem to create a lot of interest in the brand and a lot of excitement for all," he said.
When asked whether he could defend one particular video from SKE's TikTok feeds, which saw a Crystal Bar being opened to a soundtrack saying, "I wish that I could be like the cool kids," Mr Davies said: "None of our policies are geared towards marketing to children. So what we try and do with the [social] media accounts is just try and build up a bit of a buzz really."
MP Steve Brine, chair of the health select committee, said: "It is extremely concerning to hear that vapes could easily fall into the hands of children because proper checks are not being made.
"Responsible manufacturers should not be using giveaway schemes that can act as a green light to children to begin vaping when what they need is protection from potentially harmful effects."
Recycling
Disposable vapes contain electronics, including a small battery, which are difficult and expensive to recycle. Discarded vapes are a common sight, and local councils have called for them to be banned.
Like all makers of electronic goods, vape companies are legally obliged to register with recycling schemes under which producers contribute to the cost of recycling. Until this month, SKE had not registered with these schemes, or paid the contributions, estimated at about £100,000.
Mr Davies said the firm apologised for this, which he blamed on a "communications issue".
"We're glad you highlighted that and we have now signed up to the relevant schemes," he said.
SKE set up a UK company for the first time this month, and the paperwork at Companies House shows that the Shanghai State-owned Assets Supervision And Administration Commission (SASAC) has "significant control". The SASAC administers investments on behalf of the Chinese state.
SKE is owned by Shenzhen Yinghe Technology Co, whose largest shareholder is Shanghai Electric Co, which is in turn more than 50% owned by entities linked to the Chinese state, according to its annual report.
In a report to shareholders last year, Yinghe said it had missed vape sales targets due to a government crackdown in China, and was focusing on international expansion to make up the gap. The UK is now its largest market in Europe.
Gummy Bears
In China, only tobacco or menthol flavoured vapes are legal, but in the UK SKE sells a dazzling variety or flavours. In the Discord giveaway BBC reporters were sent Watermelon Ice and Vimbull Ice - combining the tastes of Red Bull and Vimto.
Some flavours, such as Gummy Bear, are named after sweets, which have been criticised as likely to appeal to children. Mr Davies said SKE would continue to sell them. "You've got to consider that many Gummy Bears are sold to adults," he said. It was down to enforcement to prevent vapes being sold to children, he added.
Health committee chair Mr Brine said: "We've taken evidence from the vaping industry and do not believe it has gone far enough to ensure that its products don't appeal to children.
"Marketing is designed to target exactly this age group with the bright colours and flavours that refer to unicorns, sweets or popular fizzy drinks. We want to see restrictions on packaging and marketing practices in line with those that apply to tobacco products."
Despite many who believe that disposable vapes will be banned, Mr Davies said SKE had set up a headquarters in Manchester, was hiring new staff and expanding.
"We are here to stay," he said. | Epidemics & Outbreaks |
Doctors’ leaders have accused Steve Barclay of “bending the truth” after the health secretary exaggerated – for the second time – how much medics’ pensions are worth when they retire.
The British Medical Association (BMA) has received information from the NHS body that oversees staff pensions that disproves Barclay’s assertion – which he has often made during the ongoing doctors’ strikes – that consultants who retire at 65 receive a £78,000-a-year pension.
The health secretary said on BBC Radio 4’s Today programme on Tuesday 19 September that: “The pensions that a consultant gets at aged 65 is subject to tax, but it is £78,000 a year.”
The BMA issued a furious rebuttal that day, which stated that the real figure – for the median value of a consultant’s pension at retirement – was “around £46,800”. They claimed that Barclay was “misleading the public about doctors’ pensions”.
However, the doctors’ union has since then received new information from NHS Business Services Authority under freedom of information laws. That shows that the median pension is in fact £41,756 – more than £5,000 lower than the £46,776.82 figure the agency first gave.
That is just over half the £78,000 figure quoted by Barclay.
NHS BSA explained its mistake to the BMA by saying: “It has come to our attention that the information provided on 18 August … was incorrect. An error was made when extracting the data that meant that revised benefits were incorrectly included in the total for each member.”
Dr Vishal Sharma, the chair of both the BMA’s consultants and pensions committees, said the new figures showed that Barclay had not been truthful in his repeated use of the £78,000 figure.
“These latest data demonstrate just how far from reality the figures that Mr Barclay continues to peddle are, showing the average consultant receives around half what he has claimed.”
The Department of Health and Social Care (DHSC) continued to insist that Barclay’s statement was correct. But they explained that the £78,000 was in fact a projection for what a newly qualified consultant today would get as a pension when they retired at 65 – in about 30 years’ time.
They did not explain why the minister did not make that clear on Today last week. And they denied that his statement then that a doctor’s pension “is £78,000 a year” was different to a projection for a sum that may be earned several decades in the future and thus could mislead listeners.
Barclay’s £78,000 figure has also been quoted without explanation or challenge in reports on the doctors’ strikes by ITV, Sky News, the Daily Mail and PoliticsHome website.
Sharma added: “He is repeatedly omitting the key detail that he is using what the DHSC itself refers to as an ‘upper limit’ – a hypothetical figure for 30 years’ time, based on completely unrealistic assumptions.
“While on other occasions he has specifically used the word ‘now’, thereby implying this is what consultants currently receive. This is bending the truth.”
He said: “It is frankly disingenuous for Mr Barclay to model future pensions with no pay erosion, whilst refusing to address consultants’ concerns that over the last 14 years of his government, consultants have suffered pay erosion of 35%. This is Mr Barclay having his cake and eating it.”
A DHSC spokesperson said: “The figures used by the health secretary are accurate and the figures used by the BMA are not directly comparable.
“A newly qualified consultant who retires in the future at 65, having worked full-time throughout their career, would expect to receive an inflation-proofed pension of around £78,000 per year. This comes after we recently announced generous reforms to the annual allowance for tax-free pension saving, following direct calls from the BMA.
“We are also giving consultants a 6% pay rise this year, on top of 4.5% last year, increasing their average NHS earnings to around £134,000 a year.”
Barclay was forced to admit that he had misrepresented doctors’ pensions once before. In a previous Today interview on 14 August he said consultants who retire “will get a tax-free pension of £73,000 a year”. But the DHSC later admitted that doctors’ pensions are subject to tax, like everyone else’s. | Health Policy |
Public health officials are considering introducing lateral flow tests to detect avian flu in people in the UK after an unprecedented spread of the virus in birds worldwide in the past 18 months.
The UK Health Security Agency (UKHSA) is stepping up its preparedness for an outbreak of the virus in humans after the highly infectious H5N1 variant showed signs of jumping to mammals. This includes developing “scenarios for early human transmission”.
As part of the increased planning and surveillance, the UKHSA said it is looking at whether lateral flow devices could be deployed to test for H5N1 in humans in the event of asymptomatic transmission among people.
Officials are also looking at developing a blood test that could detect antibodies against the virus and analysis of the genetic mutations that would signal an increased risk to human health.
The planned measures are in contrast to the preparedness in the early stages of the Covid pandemic, when officials and ministers have admitted they were not aware of the extent of asymptomatic transmission of the virus, allowing it to spread undetected through human populations.
At present, the risk of bird flu in humans is described as low, and the only cases have been among poultry workers or others who come into close contact with infected birds.
But in recent weeks there have been recorded incidents of the virus affecting mammals, with fears that it could evolve to spread more easily between wildlife.
Scientists are concerned that the virus could at some stage evolve further to spread between humans and trigger the next pandemic.
The latest assessment from the UKHSA says: “To facilitate preparedness, planning and improvements to surveillance, scenarios of early human transmission are being developed. Parameters for early human outbreak scenarios were agreed by the Technical Group.”
The UKHSA said it is “working with partners to identify ‘knowledge gaps’ around avian influenza, including whether lateral flow devices could be deployed to test for H5N1 in humans, developing a blood test that detects antibodies against the virus and analysis of the genetic mutations that would signal an increased risk to human health”.
Epidemiological analysis of avian flu in the UK shows that, despite a compulsory housing order imposed last autumn, the H5N1 virus has continued to spread in the wild bird population.
There have been 131 cases of avian flu in mammals since October 2021.
Since October, officials have been taking samples from 2,310 people who have had contact with infected birds and no positive cases have been found.
The UKHSA technical briefing says “whilst the very high levels of transmission in wild birds presents a constant risk, there is no evidence so far that the virus is getting better at infecting humans or other mammals”.
But it adds: “While the evidence suggests that the virus does not pass easily to people, there is an increased chance of people coming into contact with the virus due to the high levels in birds.”
The UKHSA urges people to avoid contact with sick or dead wild birds in public areas such as parks or waterways, and wash hands after feeding wild birds.
Dr Meera Chand, incident director for avian influenza at UKHSA, said: “The latest evidence suggests that the avian influenza viruses we’re seeing circulating in birds do not currently spread easily to people. However, viruses constantly evolve, and we remain vigilant for any evidence of changing risk to the population, as well as working with partners to address gaps in the scientific evidence. | Epidemics & Outbreaks |
Peloton instructor Leanne Hainsby, 35, says she is battling breast cancer and has finished 12 weeks of chemotherapy Published: 02:06 EST, 30 January 2023 | Updated: 02:07 EST, 30 January 2023 Peloton personality Leanne Hainsby revealed on Instagram Friday that she has been battling breast cancer the past six months.Hainsby, 35, posted a carousel of photos of her hospital treatment, as well as text in which she opened up about her health battle dating back to last August.'Two days before my best friend's funeral, I found a lump in my breast,' the British fitness professional said. 'That really is a sentence I NEVER imagined writing.' The latest: Peloton personality Leanne Hainsby, 35, revealed on Instagram Friday that she has been battling breast cancer the past six monthsThe spin instructor said she was initially misdiagnosed by a doctor who said there were no problems, as a second opinion revealed the breast cancer diagnosis.'I trusted my gut and got a second opinion,' Hainsby said. 'That saved my life. Check, and check again.'Hainsby said the prior to undergoing chemotherapy, she and fiancé Benjamin Alldis completed a round of in vitro fertilization.'We weren't mentally prepared, but we got it done and we're so grateful,' said Hainsby, who remained busy working during three months of chemotherapy. Hainsby shared images documenting her health journey in detail The spin instructor said she was initially misdiagnosed by a doctor who said there were no problems, as a second opinion revealed the breast cancer diagnosis Hainsby has remained busy working during three months of chemotherapy 'As a Peloton instructor, a huge part of my role is about the members, and despite my diagnosis, that has always mattered to me hugely,' Hainsby said. 'My classes have given me a focus, and some sparkle in an otherwise incredibly tough time, so thank you to the members who had no idea the amount of joy they were bringing to me every day.'Hainsby opened up about her regimen as she underwent treatment following her diagnosis.'I would teach my Wednesday morning LIVE classes, and then meet my Mum and go to the treatment suite for my weekly dose ... Chemo is no joke,' Hainsby said. 'Cold caps are no joke.'Hainsby said that she's slated to have a portacath device, used to dispense medication, taken off her person, and will undergo radiotherapy for a two-week span.She said that she will continued to undergo treatments for a 'long time' and that regular hospital visits will remain 'the norm.' Hainsby said that her life outlook has become 'so very different in times like' these The London-based beauty said she has faith in herself and her medical team amid her brave health battleHainsby said she has faith in herself and her medical team amid her brave health battle.'I'm in fantastic hands, and I've got this,' she wrote. 'Nobody wants to be sat in a room and told they have cancer, and yet I've always felt one of the lucky ones. I am one of the lucky ones. Lucky to be diagnosed early, lucky to be moving fast through treatment, lucky to know I WILL BE OK.'Hainsby said that her life outlook has become 'so very different in times like' these.'I think anyone who has had to ask, "Am I going to die?" to a medical professional would probably say the same,' she said. 'But then you fight. You gain a strength you never knew you had, and you keep pushing forward. Strong, as healthy as possible, and empowered.'Her fiancé Alldis, who is also a Peloton instructor, responded, 'You have shown me time and time again over this last year why I'm the luckiest guy alive that you said yes to marrying me. Showing resilience, grace and still managing to be there for others while you go through this all. Your shining light is shining brighter than ever.' Advertisement | Women’s Health |
Millions of Americans face poor air quality advisories assweeps across the Northeast, afflicting outdoor workers, commuters and just about anyone who ventures outside Wednesday in affected areas.
Although health experts recommend staying indoors, that's not possible for people whose work requires them to be outdoors, noted Dr. Panagis Galiatsatos, a lung specialist who is a spokesperson for the American Lung Association.
"Ideally, a lung doctor would say, 'If you can stay home, stay home'," Dr. Galiatsatos told CBS MoneyWatch. "But people are going to come back to me and say, 'I need to go outside and work'."
If you can't stay inside, Dr. Galiatsatos recommends a few precautions to keep your lungs and heart safe. First, he said, wear a tight-fitting mask, ideally with a one-way valve, that will filter out particulates from the smoke. If you have masks left over from the pandemic that don't have one-way valves, like N95s or surgical masks, wearing one of those can also help protect your lungs, he noted.
"If you work outside, I would urge you to please, please wear a mask to protect yourself," he said.
To avoid both large and small particles carried by smoke, the Environmental Protection Agency says dust masks aren't enough.
"Paper 'comfort' or 'dust' masks — the kinds you commonly can buy at the hardware store — are designed to trap large particles, such as sawdust," the EPA said on its website. "These masks generally will not protect your lungs from the fine particles in smoke."
Change your clothes after working outside
Dr. Galiatsatos also recommends that people who work outside change out of their clothes when they get home and put them directly in the wash. Particulates can infiltrate clothing and then be inhaled by the person or their family members once they return indoors.
"It's like the old days of asbestos — the child breathed it in from their parents' clothes," he noted.
Is it safe to work outside?
Spending time outdoors without a mask during periods of poor air quality can lead to health problems in both the near- and longer-term, Dr. Galiatsatos said.
Landscapers, construction workers, highway maintenance personnel and outdoor recreation workers like lifeguards spend the greatest potion of their workdays outside, according to the Labor Department. Such workers should mask up and wash their clothes when they are done working, experts advise.
But others, like delivery people, bike messengers, preschool teachers and truck drivers, also spend part of their time outdoors and should wear masks while outside.
People with underlying lung or heart problems, like asthma or chronic obstructive pulmonary disease (COPD), are most at risk, but even people without such conditions can be impacted by the particulates from wildfires, Dr. Galiatsatos said.
"Brief exposure to poor air quality can make you a patient later on," he said.
Is it safe to go outside?
People who live farther away from the fires, such as in New York City or Washington, D.C., may in fact be at more risk because the particulates are smaller by the time they reach those locations, compared with people who live closer to the fires, Dr. Galiatsatos said. Smaller particles are more likely to reach the narrowest airways in the lungs, where they can do damage, he added.
Check your air quality levels on your weather app. If theis below 100, a range considered moderate, that should be safe for you to be outside, he said. But if the air quality is poor, it's best to wear a mask — even if you are working in your garden or taking your dog for a walk.
"I would try to minimize the time you spend outside," he said.
for more features. | Epidemics & Outbreaks |
China’s health authorities have said the Covid wave is past its peak, with rapid decline in both severe cases and deaths in hospitals, but experts remain wary of the government’s official data.According to China’s Center for Disease Control (CDC), the number of critically ill patients in hospital peaked in the first week of January, then rapidly declined by more than 70%. The number of deaths also reached its highest level that week, the data said.Prof Chi Chun-huei, director of the centre for global health at Oregon University, said local officials were incentivised – via punishments and rewards – to under-report infection figures during the zero-Covid policy. Now that policy was gone, they were incentivised to exaggerate infection rates and under-report deaths.“Most international experts know this very well – China’s statistics are very unreliable,” he said.Covid cases have swept across China in recent months, escalating rapidly after the government suddenly ended its zero-Covid policy in early December 2022. Last week a senior health official said 80% of people had been infected in this wave, although it was not clear where the figures came from.According to the data, there were 128,000 critically ill Covid patients in Chinese hospitals on 5 January, the highest number reached during this wave. It described a peak inside hospitals over the western new year, with almost 10,000 new critically ill cases a day from 27 December to 3 January.By 23 January the total number of critically ill cases had dropped by 72% to about 36,000, it said.The number of deaths in hospitals reached their highest point on 4 January, with 4,273 recorded, before falling 79% by 23 January to 896.The CDC said the number of visits to fever clinics peaked at 2.867m on 23 December, before falling 96.2% to 110,000 on 23 January. A similar decline was observed in visits to rural clinics, with peaks around the same date, it said.The data, published on Wednesday, was based primarily on hospital in-patients, giving some insight into the severity of the outbreak, but external health experts and observers have cautioned that it only shows one part of the true toll.China’s wave of infections hit major cities first, and there has been concern that travel for lunar new year could spread infections into regional areas. Reporting from inside China has already found apparent high rates of infection and fatalities that appear to exceed official reports.With the end of zero-Covid, travel restrictions, mass testing, mandatory quarantine and other measures were wound back or dropped entirely. Data collection systems quickly fell far behind the reality on the ground, with fewer than 60 deaths officially recorded in the first few weeks until authorities updated the way deaths are attributed.The notice from the CDC acknowledged that PCR testing was not keeping up with infections. Daily tests had dropped to 280,000 by Monday, down from 150m on 9 December, and 7.54m on 1 January. Some provinces had enacted systems for collecting the results of residents or allowing residents to self-report, but the figures were “affected by the willingness of residents to test”.Previously several provinces or major cities had reported infection rates of 70-90%, but some analysts speculated such figures might have been over-inflated to suggest places were on the way to recovery.Prof Antoine Flahault, director of the institute of global health at the University of Geneva, told the Guardian the figure of 80% total infection rate was “mostly plausible” and in line with global knowledge of Omicron’s attack rate.“Having said that, to transfer that to mortality figures is highly difficult.” | Epidemics & Outbreaks |
GoodRx, best known for its prescription drug price comparison tool, has launched a new free offering called “Medicine Cabinet.” The tool will allow GoodRx app users to manage their prescription medications on a single platform. This comes on the heels of the news that the company is working with CVS Health to develop the Caremark Cost Saver, which could lower pharmacy out-of-pocket drug costs for shoppers.
Medicine Cabinet will automatically integrate within the GoodRx app and will feature tools like a “prescriptions dashboard” where a consumer can set up refill reminders and find the best pharmacies to pick up their medications at the lowest price. At the heart of the app are daily pill reminders that are customizable to any treatment plan that is uploaded into the app. GoodRx Chief Product Officer Mark Hull said the reminders feature is huge because 50 percent of the time, Americans are struggling to take their medications as prescribed for reasons as simple as forgetfulness or cost.
The Medicine Cabinet also includes a dashboard for GoodRx’s rewards program which offers users monetary perks like e-gift cards for staying on top of medication refills. “Nobody's integrating or rewarding people for having those healthy habits,” Hull said.
“What we've found is that the winning model for us is to marry the discounts, the value and the rewards, with the basic healthy habits and reminder stuff,” he added. GoodRx claims it can save consumers up to 80 percent off the price of prescription drugs by partnering with pharmacy benefits managers to negotiate deals on drugs. Normally, the average consumer wouldn’t otherwise have access to these discounts without middlemen like GoodRx.
The Medicine Cabinet tool has only been in development for roughly six months and will be available on iOS, but not on Android just yet.
“GoodRx was able to develop Medicine Cabinet so quickly in part due to the data it has already amassed from users and providers over the last decade.” "If a startup were doing this, it would take a long time, they don't have the data, they don't have the relationships with retailers, they don't already have the customer base," Hull said. “We already have a half a billion prescriptions in federal records from the millions of people who have been using us for the last 12 plus years.”
Hull said he actually wishes Medicine Cabinet could have come sooner. He recalls when his stepfather had a heart attack a couple of years ago. "When he came home from the hospital, he had like a dozen medications he had to manage," Hull said, remembering it as a nerve wracking time for his family and specifically his mother. "For the average person who's managing a condition with multiple medications, it's a lot of work and so we're really trying to make it simple, clear and obvious what you need to do at any given point to help manage your condition."
Down the line, Hull hopes Medicine Cabinet will be easier for older people to use, with the inclusion of features that will let a user take a photo of a medication instead of having to look it up in the database.
Still, GoodRx's history of being caught up in legal trouble related to data privacy issues is worth noting. Earlier this year, the Federal Trade Commission fined the company for the unauthorized disclosure of customers' identifiable health information with third parties, such as Facebook and Google. “Our privacy policy applies to Medicine Cabinet, which sits within the GoodRx app. We are very transparent about what information we collect and how we use it to personalize and customize our products for consumers. Additionally, the feature is only available for users who have registered for a GoodRx account,” a representative said. The company’s recent focus on transparency and adherence to privacy policies suggest it's taking the issue seriously, though as with any telehealth company, data privacy will always be a front and center concern. | Drug Discoveries |
Golden retrievers are one of the most popular breeds of dogs. But research shows they have up to a 65% chance of dying from cancer. In a new study, University of California, Davis, researchers set out to find if certain genetic factors could help their survival rate. But instead of searching for genes associated with a cancer diagnosis in the breed, they instead chose to look for genes associated with longer life.
The gene they found is in a family of proteins long known to be important in human cancers. Specific versions or variants of the gene were associated with an increased lifespan of nearly two years. The study was published in the journal GeroScience.
“We assume that the majority of golden retrievers have a genetic predisposition to cancer, but if some of them are living to be 14, 15 or 16, we thought there could be another genetic factor that is helping to mitigate the bad genes, and the gene that popped out for us is HER4,” said co-corresponding author Robert Rebhun, Maxine Adler Endowed Chair in oncology at the UC Davis School of Veterinary Medicine.
HER4, also known as ERBB4, is a member of the family of human epidermal growth factor receptors. It is the same family of genes in humans as HER2, a gene well-known for making cancer cells grow quickly. Rebhun said dogs get many of the same kinds of cancers as humans, which could make this discovery important for humans, as well.
“If we find that this variant in HER4 is important either in the formation or progression of cancer in golden retrievers, or if it can actually modify a cancer risk in this cancer predisposed population, that may be something that can be used in future cancer studies in humans,” he said.
Hope for golden retrievers
More than 300 golden retrievers were part of the study. Researchers compared the DNA from blood samples of golden retrievers that were alive at 14 years of age to those that died before age 12. They found that dogs with certain variants of the gene survived longer, on average 13.5 years compared to 11.6 years.
“Almost two years is a significant difference in a dog’s life,” said co-corresponding author Danika Bannasch, Maxine Adler Endowed Chair in genetics with the UC Davis School of Veterinary Medicine. “Wouldn’t we all want our beloved pets to live another two years? Two years in goldens is about a 15-20% increase in lifespan, the equivalent of 12-14 years in humans.”
Bannasch said the finding is still one small piece to the complex puzzle of what could cause a golden retriever to get cancer.
“There are going to be many genes involved, but the fact that the gene associated with longevity is also a gene involved in cancer was really interesting to us.”
The study also found the gene variant seemed to be most important to the longevity of female dogs compared to male dogs. HER4 has been shown to interact with hormones such as estrogen and may also play a role in processing environmental toxins. Rebhun said the next step is to enroll a larger population of golden retrievers in a study to see if they can reproduce these results and discover how this genetic variant may impact expression or function of the gene.
Co-authors include Daniel York, Michael Kent, Madison Luker, Flora MD De Graaf, Kevin Batcher, Stephanie Ryan, Paula Yoon, and Jamie Peyton of UC Davis, and Joshua A. Stern of North Carolina State University.
The study was funded in part by the UC Davis Center for Companion Animal Health, Maxine Adler Endowed Chair Funds, and private donor funds specifically designated for longevity studies in golden retrievers. | Disease Research |
Quarantining people sooner "might have avoided" the first Covid lockdown, Chancellor Jeremy Hunt has said.
Along with this, the progress of the disease could have been slowed with more testing, the former health secretary told the Covid inquiry.
A "narrow" focus on flu in pandemic planning led to an assumption viruses could not be slowed down, he said.
Mr Hunt told the inquiry that the UK had not learnt lessons from East Asia over the Sars and Mers outbreaks there.
He added that he wished he had done more to challenge this "groupthink" over this.
As health secretary between 2012 and 2018, Mr Hunt, played a key role in overseeing the UK's preparation for a future pandemic.
He is the latest politician to give evidence to the first part of the Covid inquiry, which is looking at how well prepared the UK was to respond to a new disease.
In his testimony on Wednesday, Mr Hunt said the UK was well prepared for pandemic flu, but "we hadn't given nearly enough thought to other types of pandemics that could emerge" during planning exercises during his tenure.
He added that Exercise Cygnus, a government exercise in 2016 to test the response to a flu pandemic, had made no reference to quarantining or testing and took as its "starting point" that 1.2m people were already infected.
He added that there were "no questions asked at any stage" about how the government could stop things getting that bad, something "in retrospect" he now wishes he had challenged at the time.
During the early weeks of the inquiry, one key topic is beginning to dominate: why did the UK not consider in its planning the idea of trying to stop a pandemic virus from taking hold?
Mr Hunt told those assembled that there was a "shared assumption" across western Europe and North America that "herd immunity was inevitably going to be the only way you could contain a virus, because it spread like wildfire".
Lessons were not learned from South Korea, he told the inquiry, which adapted its pandemic approach following the outbreak of Mers, another coronavirus, in 2015, and took greater steps to slow down Covid when it emerged.
South Korea, he told the inquiry, "did not have a lockdown in the first year of the pandemic".
Failing to learn from East Asia was a "blind spot", he said.
'Little attention'
When Covid struck in the UK, he said, government scientific advisers did not come round to a "Korean approach" until transmission of the new disease had increased to 5,000 a day.
"And then it was inevitable you were going to have to use a lockdown," he added. "Had we got on the case much earlier with that approach, we might have avoided that."
He added that a separate government exercise in 2016 based on the Mers outbreak, Exercise Alice, was the "only place" where the "importance of quarantining" was clearly laid out.
However, he said he had not known about the exercise at the time "because it wasn't shown to me," and "it got very little attention, in the grand scheme of things".
Elsewhere in his evidence, he revealed that before Exercise Cygnus there was a protocol that allowed the health secretary to order intensive care beds to be emptied to free up nursing capacity outside hospitals.
The chancellor said he didn't feel comfortable with the idea he might one day be asked to "flick a switch that would have led to instant deaths" - and asked for the protocol to be changed.
He added that he didn't feel comfortable that someone "a long way from front line" could make such a decision, which would be better made by people closer to the situation on the ground, he added.
Sign up for our UK morning newsletter and get BBC News in your inbox. | Epidemics & Outbreaks |
Against the backdrop of a global push for new COVID vaccines that can provide broader and longer lasting protection, Codagenix today announced that its live-attenuated intranasal vaccine candidate prompted robust humoral and cellular immunity in adults who took part in a phase 1 clinical trial.
The New York-based company detailed the findings for the vaccine, called CoviLiv, ahead of an October 13 presentation at the ID Week meeting in Boston. Codagenix is developing the vaccine with the Serum Institute of India, and a phase 3 efficacy trial is already underway as part of the World Health Organization (WHO) Solidarity vaccine trials.
Vaccine just received Project NextGen funding
Experts have been strongly advocating for better COVID vaccines, including ones that can target more conserved parts of the SARS-CoV-2 virus instead of just the spike protein, which often changes as the virus evolves. Their wish list also includes vaccines that can curb transmission and prevent symptoms. In February, a group led by the Center for Infectious Disease Research and Policy, which publishes CIDRAP News, published a roadmap for advancing better vaccines against coronaviruses.
Intranasal vaccines are an attractive option for stimulating mucosal immunity via a needle-free formulation, and several are in development. However, vaccine developers face a number of challenges, such as ensuring that the antigen is absorbed into the mucosa.
Earlier this month, Codagenix announced a contract with the Biomedical Advanced Research and Development Authority (BARDA), part of the Department of Health and Human Services, as part of the Project NextGen program to support the development of CoviLiv. The contract provides an initial $10 million and is worth up to $389 million, with a goal of covering a phase 2 trial with 10,000 participants who completed an earlier primary mRNA vaccine series that will evaluate how well CoviLiv protects against symptoms when compared to the latest authorized mRNA vaccine.
Project NextGen is an HHS initiative to advance innovative treatments and vaccines for COVID.
Phase 1 study details
Participants in the dose-escalation study, who hadn’t been vaccinated against COVID before, received two doses of the inhaled vaccine. At the highest dose (5x106 plaque-forming units), the vaccine prompted robust humoral and cellular responses. T-cell reactivity was specific to for multiple antigens besides the often-mutating spike protein.
At an ID Week media briefing yesterday, Johanna Kaufmann, PhD, executive vice president for oncology and immunology at Codagenix, said frequency of vaccine reactions was lower for CoviLiv recipients than for the placebo group, and no fever or loss of taste or smell were observed. She added that T-cell response researchers saw was similar to natural infection, as expected for a live-attenuated vaccine.
She said the vaccine, which is easy to administer and doesn’t require refrigeration, would be easier to deploy in low-resource settings and might be more appealing to people who are more comfortable with more established vaccine production platform.
From a medical standpoint, Kauffman said live-attenuated intranasal vaccines have the advantage of mimicking the natural route of infection and inducing a specific type of local immune response—one that involves tissue-resident immune cells— different than responses seen from systemic vaccine delivery.
“It’s actually quite fascinating to see how well this attenuated virus mimics natural infection, which gives us high hope to contribute now in a more complex vaccination ecosystem, that this virus can contribute to hybrid immunity,” she said.
So far, research teams haven’t conducted transmission studies involving CoviLiv, but Kauffman said viral shedding was very limited after the second dose. | Vaccine Development |
A recent view of Milan. (Mairo Cinquetti/SOPA Images/LightRocket via Getty Images)BARCELONA, Spain — A report released Friday morning by the European Centre for Disease Prevention and Control (ECDC) found that the ongoing COVID-19 pandemic on the continent was improving compared with the spikes of new cases and hospitalizations experienced in December.But experts who spoke with Yahoo News painted a much less encouraging picture, saying that the new ECDC “Country Overview Report” is based on incomplete, inexact data from 30 European countries.“Due to changes in testing strategies, and the end-of-year holidays, these numbers are a vast underestimate of the true picture,” a spokesperson from the World Health Organization told Yahoo News in an email. The WHO works with the ECDC in helping to compile its assessments.Former WHO crisis manager Daniel López Acuña, who now resides in Spain, agrees that the new ECDC report assessing the state of the pandemic is not providing an accurate appraisal.“The report tries to give an optimistic perspective on the state of COVID-19 transmission in Europe, but it contradicts itself when it admits that delays in reporting, not enough diagnostic tests and [holiday behavior] may be hiding the real magnitude of the problem,” López Acuña told Yahoo News. He believes that part of the underreporting, however, is due to “a collective denial” that has set in across Europe. “All governments want to close this book and go to the next issue.”A research assistant at the Wellcome Sanger Institute in England prepares a sample for genomic sequencing, a practice that is no longer being pursued by some European countries. (Frank Augstein/AP)Over the past year, many European health ministries have simply stopped reporting important COVID information. Spain, for example, now only tracks cases of citizens over age 60. Germany, Portugal and Poland are among eight countries not reporting hospitalizations; Sweden, which saw the highest number of COVID patients requiring medical care since early 2021, declared in April that COVID was no longer a health emergency and stopped reporting numbers.López Acuña points out that thanks to important data consistently missing from recent ECDC reports, Europe’s true COVID landscape is blurred and underestimated. Other health experts concur.“We’re only getting half the picture,” Salvador Macip, director of health sciences at the Open University of Catalonia, told Yahoo News.Since most health ministries stopped routinely testing citizens and many countries dropped genomic sequencing, “We’re flying blind,” said Martin McKee, professor of public health at the London School of Hygiene and Tropical Medicine. Those reporting issues came despite assurances from Germany’s top virologist, who announced in December that the pandemic was finally over. Days later, reports broke about a new and more infectious variant, XBB 1.5, gaining ground in the U.S., and China experienced a surge of new cases after dropping strict zero-COVID policies.Airport workers wearing protective masks and suits help a Chinese traveler at an airport near Rome. (Filippo Monteforte/AFP via Getty Images)Protests in December prompted China’s government to reopen the country, allowing citizens to freely travel — and cases promptly spiked. Earlier this month, some scientists estimated that China was experiencing a million new cases of COVID a day; on Dec. 25, 2022, Financial Times reported that some 250 million people in China contracted COVID in the first three weeks of December.On Dec. 28, Italy became the first European country to demand testing of passengers landing from China, a demand met largely with disapproval, including from the ECDC, which issued a statement saying the agency considered “screenings and travel measures on travelers from China unjustified.”When Italy’s initial tests of passengers from China showed that almost one-half of them tested positive for the virus, criticism quickly died down, and France (which was finding that about one-third of passengers arriving from China were testing positive), Spain, the U.K. and other European countries followed suit with their own testing requirements.On Jan. 4, the European Union recommended that all 27 member states adopt a temporary requirement that passengers on flights originating in China show proof of a recent negative PCR test prior to flying and be required to wear a high-quality mask on board. It also recommended random testing of arriving passengers and surveying airport wastewater, with positive results of both to be sequenced.Thus far, 10 of the EU’s 27 countries have adopted the recommended measures, though they remain controversial, with some experts urging that passengers on all flights be required to take pre-flight tests and that a masking requirement be reinstated across the board. With the measures applying only to flights from China, and with only some countries putting them in place, “it’s like putting up a gate in a wide-open field,” Macip said.A passenger gives his passport to a worker, after Italy has ordered coronavirus disease (COVID-19) antigen swabs and virus sequencing for all travellers coming from China, where cases are surging, at the Malpensa Airport in Milan, Italy, December 29, 2022. (Jennifer Lorenzini/Reuters)“It’s not a panacea,” López Acuña said of the policies singling out China, “but it’s going to help deter incoming cases into Europe.”While the initial concern was that passengers from China would introduce new variants into Europe, none have yet been detected.In a Jan. 3 advisory, the ECDC sought to allay fears about new COVID variants from China.“The variants circulating in China are already circulating in the EU, and as such are not challenging for the immune response of EU/EEA citizens,” the agency wrote. “In addition, EU/EEA citizens have relatively high immunization and vaccination levels, [thus] a surge in cases in China is not expected to impact the COVID-19 epidemiological situation in the EU/EEA.”López Acuña challenges that assertion, pointing out that immunity in Europe is weakening, as a mere 13% of the European population has received the second, more potent, bivalent booster that addresses Omicron variants as well.“It is possible that new increases in cases and hospitalizations due to COVID-19 will be observed in the coming weeks,” an ECDC spokesperson said in an email to Yahoo News, “however, it will be very difficult to attribute this to travelers as overall increases in COVID-19 case numbers and hospitalizations have already been detected [in November and December].”People arrive to receive COVID-19 vaccine boosters at a vaccination center set up in San Giovanni Bosco Hospital in Turin, Italy, on December 30, 2022. (Jessica Pasqualon/EPA-EFE/Shutterstock )López Acuña is also extremely concerned about XBB 1.5, the so-called Kraken variant that appears to be more severe than prior strains, is showing resistance to monoclonal antibody treatments and “is causing a considerable increase in hospitalization and mortality on the East Coast of the US.”ECDC’s advisory on the XBB 1.5 earlier this week struck him as “wishy-washy.” In its Jan. 9 advisory bulletin, ECDC wrote that the new variant has already been found in 16 European countries, but that “The rapid growth in the U.S. does not necessarily mean that the variant will become dominant in the EU/EEA, since major differences in variant circulation between North America and Europe have been observed several times during the pandemic.” The notice conceded, however, that “there is a risk” that the variant could become problematic for Europe, “but not within the coming month.”López Acuña bristles at that messaging. “It’s serious, but not very serious, and we don’t have to worry,” he said sardonically. He added that it’s unclear exactly how much Kraken is already circulating in the EU, since most countries aren’t sequencing positive test results. Overall, he believes the ECDC has been “acting very naively” at a critical juncture.“We are facing two real emergencies of different natures — one of a variant that is much more serious, Kraken,” López Acuña added. “And in the second case, you have a pandemic dynamic that is creating a huge number of contagions and hospitalizations and deaths. So, it’s not just Kraken that’s the threat or China that’s the threat. It’s the sum of both that threatens the delicate balance we were attaining with respect to the pandemic. And that is why the fight must continue.”A streetcar in Erfurt, Germany, requires customers to have "mouth-nose protection." (Martin Schutt/picture alliance via Getty Images)As a result, COVID cases in Europe are likely to shoot higher, according to both López Acuña and Macip. “With more virus circulating, we’re going to have more cases in Europe,” Macip said, and added that he’s worried about the effects on already overwhelmed hospitals. “Whether it’s a tsunami or a small wave,” he said, depends on a variety of factors, including whether Europeans take precautions, including masking — a recommendation that the WHO reinforced on Friday.On Friday afternoon, as if on cue, the ECDC released an updated threat assessment. “According to the current ECDC assessment,” it said, “there is moderate probability of XBB.1.5 becoming dominant in the EU/EEA and causing a substantial increase in the number of COVID-19 cases within the next one to two months.” In an accompanying press release, the ECDC wrote that “In light of this, ECDC recommends carrying out appropriate testing and sequencing, increasing COVID-19 vaccination uptake, and reinforcing infection prevention and control measures. Non-pharmaceutical interventions such as staying home when ill, teleworking, good ventilation of indoor spaces and appropriate use of face masks should also be considered.” | Epidemics & Outbreaks |
NOTE: The following article contains graphic medical imagery. Please read at your own discretion.
Despite the medical odds of siblings Adiah and Adrial Nadarajah — born 126 days earlier than expected — the teensy twosome survived, becoming the world’s most premature set of twins, as per Guinness World Records.
Adiah was born weighing only 330 grams while her brother weighed 420 grams, making the premature twins a combined 1.65 pounds.
Though a full-term pregnancy is usually 40 weeks, mother Shakina Rajendram began labour before the twins were considered “viable.”
At 21 weeks and five days pregnant, Rajendram said she awoke in the night to “extreme pain,” contractions and bleeding. She and her husband, Kevin Nadarajah, feared they would lose the pregnancy. They travelled to hospital for treatment.
The couple lost their first pregnancy only a few months before the twins were born, making doctors’ warnings about the twins’ fates even more heart-wrenching.
Medical specialists told the hopeful parents they would be unable to assist with such an early pregnancy, as most hospitals do not attempt to resuscitate babies born before the 24-week mark.
“We were in shock. The first thought that ran through my mind was, ‘No, not again,'” Rajendram told Guinness.
Despite doctors’ insistence that there was no hope, ultrasound testing showed the twins still had strong heartbeats and were not in distress.
“We were begging the doctors to do something and save the babies,” Rajendram said. “We felt helpless. We didn’t know what else we could do.”
Though Rajendram had yet to cross the 22-week threshold, the parents were told Mount Sinai Hospital in Toronto had a specialist neonatal intensive care unit (NICU) with available care. When Rajendram’s labour continued into the 21 weeks and six-day mark, Mount Sinai Hospital approved their transfer request.
Even still, doctors at Mount Sinai Hospital told the couple that giving birth before the 22-week mark would be a “death sentence” for the twins. Rajendram said she knew she had to “hold the babies in” until the 22nd week, or the 154th day, of pregnancy.
A half hour before midnight on the 153rd day, Rajendram falsely thought her water broke. She said she cried and apologized to her husband, saying the babies “were going to die because of me.”
After doctors informed Rajendram that her water had not yet broken, she went back to sleep and awoke at 12:15 a.m. the next day when she started to give birth.
The twins received treatment and survived, though the first few months were spent battling for their lives.
After nearly six months, the twins were discharged from hospital and allowed to go home.
“I would say to other parents going through the NICU journey, just being there, being present for your babies, makes a huge difference on the outcomes,” Rajendram told Guinness. “Speak positive words to them. Tell them about how much you love them. Tell them about all of the things you hope, and you dream for them.”
“Be brave to stand up and advocate for what your babies need,” she said.
“We’re amazed that our twins have the record title,” Nadarajah said of the Guinness achievement. “But beyond that, what we’re happy about and passionate about is that this is going to help push the dialogue on viability. We do hope this is a record that gets broken.”
Though Adiah and Adrial Nadarajah hold the record for the most premature set of twins ever born, the most premature baby to ever survive is Richard Scott William Hutchinson of Minnesota. He was born 131 days early and weighed just 11.9 ounces. | Medical Innovations |
The former chief medical officer for England has issued an emotional apology to the Covid bereaved as it emerged she asked for a preparedness review following an earlier coronavirus outbreak in Hong Kong but was told “it won’t come here”.
Prof Dame Sally Davies, who described her role as CMO from 2010 to 2019 as “the nation’s doctor”, was being cross-examined at the UK Covid-19 public inquiry about shortcomings in the nation’s preparedness when she said “maybe this is the moment to say how sorry I am to the relatives who lost their families”.
Close to tears, Davies said: “It wasn’t just the deaths, it was the way they died. It was horrible. And I heard a lot about it from my daughter on the frontline, as a young doctor in Scotland. It was harrowing and it remains horrible.”
She also said sorry for the failure of the government to plan for lockdowns, and said of the effects on children: “We have damaged a generation and it is awful.”
Davies said there had been too much “groupthink” and there should have been more external challenge to the UK’s approach of planning mainly for a flu pandemic.
“I tried,” she said. “Following a visit to Hong Kong where I learned a lot about Sars, I did ask unofficially ‘what about doing a Sars review’ and was told ‘oh no it won’t come here.’”
The Department of Health and Social Care has already told the inquiry it would have benefited from a fuller understanding of the response by Asian countries to previous coronavirus outbreaks, including Sars and Mers, said Hugo Keith KC, counsel to the inquiry. Death tolls in several Asian countries from Covid-19 were far lower than the UK.
The UK had an influenza pandemic strategy document, which said the plan could be adapted for a Sars outbreak. Asked why a strategy for a non-flu pandemic was not produced, Davies said she preferred to run exercises gauging preparedness, such as those that were run for E coli and Mers – the latter in 2016 and known as exercise Alice. “There was more we should have done,” she said.
Davies was speaking after the former chancellor George Osborne denied austerity had left Britain vulnerable, as the public inquiry continued its six-week investigation into UK preparedness.
She attacked disinvestment in public health in the years before the pandemic, saying: “You can’t get a good outcome if you don’t have resilience in the public’s health, resilience in the public health system – it has been disinvested in.
“And on comparator data … we were at the bottom of the table on number of doctors, number of beds, number of ITUs [intensive therapy units], number of ventilators. We needed resilience in social care. That was clearly missing.”
After David Cameron gave evidence on Monday, Osborne defended spending cuts in the 2010s. “If we had not had a clear plan to put the public finances on a sustainable path then Britain might have experienced a fiscal crisis, we would not have had the fiscal space to deal with the coronavirus pandemic when it hit,” said Osborne.
Asked whether he saw no connection between austerity and Covid disproportionately affecting the most disadvantaged people, Osborne said: “That’s absolutely my contention.”
The Trades Union Congress, a core participant in the inquiry, said Osborne was “trying to rewrite history and gaslight the British public”.
Also on Tuesday, the former Cabinet Office minister Oliver Letwin, responsible for emergency planning in the coalition government, said Britain’s whole system of critical national infrastructure remains “wildly under-resilient”.
He said it was an “error” that no government had appointed a senior minister with sole responsibility over planning for pandemics and other areas of resilience. He described the churn of ministers and officials tasked with preparing for emergencies as a “disaster for the country”.
The inquiry continues on Wednesday with the cross-examination of the chancellor, Jeremy Hunt, who was previously the health secretary. | Epidemics & Outbreaks |
A woman who received a double lung transplant has accused the Democratic Unionist Party (DUP) of "denying hope" to those awaiting a transplant for the sake of "party politics".
It comes after the Stormont assembly failed to elect a Speaker and progress a stalled organ donation law.
Catherine McCarroll said being on the transplant list was a "death sentence".
The DUP said it was working in Parliament to ensure the legislation is put in place for spring 2023.
The new law would mean all adults in Northern Ireland would be considered a potential organ donor after their death, unless they specifically stated otherwise.
It is named DáithÃ's Law after Dáithà Mac Gabhann, a six-year-old boy who needs a heart transplant and whose campaign has inspired the legislative change.
The Stormont assembly met on Tuesday in a bid to pass DáithÃ's Law but that did not happen because a Speaker was not elected to allow legislative work to go ahead.
The DUP had already said it would block the election of a Speaker as part of its ongoing protest over the Northern Ireland Protocol.
'Every day a struggle'
Dr McCarroll was diagnosed with pulmonary fibrosis in 2018 and after becoming critically ill in 2021 she was placed on the transplant register.
Speaking to BBC News NI, she described it as an "agonising wait for everyone involved."
"It's exhausting mentally and physically - when you are put on a transplant list it really is a death sentence until you get that call about an organ," said Dr McCarroll.
The 31-year-old said that "every day is a struggle" for families who were awaiting that phone call.
Dr McCarroll said it was not until people were in that position that they could really know what it was like and that was why the DUP should not "play politics with people's lives".
She said she was speaking out to try to educate people about organ donation but also to appeal to the DUP to go back to the assembly.
"I just think its ridiculous, it is not a political issue and the DUP are just using this for their party politics," she said.
The DUP "made the wrong choice" by refusing to support a Speaker on Tuesday, she added.
She said it was a "no brainer" that the law should be passed for the "good of the population".
"Of course it's not going to change everything overnight but it is a positive step for those people waiting for transplants," she said.
'Politicians don't know what it's like'
Months after giving birth to her daughter Eve in March 2021, Dr McCarroll said her health went downhill and her breathing became much more difficult.
"I ended up on oxygen 24/7 - just before my transplant I was completely bed-bound," she said.
In January 2022 she was flown to the Freeman Hospital in Newcastle in England, where she was on a life support machine before having surgery and a double lung transplant.
She returned home to Belfast in March 2022 having spent a traumatic two months away from her daughter and husband.
She is due to return to work in the next few weeks.
Dr McCarroll said that a majority of politicians had no idea what the wait for a transplant was like.
"Every day is a fight for your life," she said.
BBC News NI asked the DUP to respond to Dr McCarroll's comments.
The party said: "We are working in the House of Commons to ensure the organ donor legislation is put in place for spring 2023 as originally planned.
"If the [Northern Ireland] Protocol had been replaced with arrangements that unionists could support 18 months ago then devolution would be functioning.
"Parliament is sovereign and the government must ensure the presumed consent legislation is put in place." | Health Policy |
Increasingly long and hot summers are raising the risk of disease-carrying mosquitoes becoming established in Britain, the UK Health Security Agency (UKHSA) has warned.
The tiger mosquito, which transmits several fatal "tropical" diseases, has already spread to 13 countries within the European Economic Area (EEA) since first becoming established in Italy in 1990.
Paris last week became the latest city to fumigate some neighbourhoods amid fears that breeding colonies could lead to an outbreak of dengue fever.
The viral infection is already spreading in the south of France. More than 50 indigenous cases have been reported over the last two years, including a British woman who had been on holiday in the Nice area.
In Britain, Several adult tiger mosquitoes have been found in traps monitored by the UKHSA at rail terminals, ports and motorway service stations. But so far there have been no established colonies in the UK.
Jolyon Medlock, chief medical entomologist at the UKHSA, told Sky News: "With climate change, as the summers warm and the seasons lengthen, every time these mosquitoes come into the country there is greater potential for them to become established."
Scientific modelling done by the Liverpool School of Tropical Medicine suggests the tiger mosquito will become established across much of England and south Wales within 50 years.
It could even be "abundant" in London in hot summers.
To try to slow their spread the UKHSA and local authorities take swift action when the mosquitoes are spotted.
"If we find them then we have a contingency plan to eliminate them," said Dr Medlock.
"Unless you get in there at an early stage the mosquito will establish. Before we know it, we will have mosquitoes all over the country."
There are 36 species of mosquito in the UK, but although they bite - they are harmless.
However, a species of Culex mosquito that can spread West Nile virus began breeding in some areas of the Thames estuary in 2010.
West Nile virus usually causes flu-like symptoms, but can occasionally result in a brain infection.
Sky News joined scientists as they monitored a marsh in North Kent.
We found Culex larvae - immature mosquitoes - in drainage ditches, and adults in monitoring traps.
"This is the warmest part of the country and an ideal wetland habitat.
"The virus also thrives at high temperatures.
"Most of the outbreaks are in warmer areas of the Mediterranean. With climate change and the potential for very hot summers that may also happen in the UK."
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Read more: Heatwave could bring highest temperature of the year this week
But it is the tiger mosquito that the UKHSA is most concerned about.
It lives in urban areas, allowing it to spread diseases to large numbers of people.
That includes dengue fever, with more than 3.7 million cases and 2,000 deaths worldwide so far this year, according to the European Centre for Disease Prevention and Control.
The mosquito also transmits chikungunya, which has caused more than 300 deaths this year, and the Zika virus, which causes birth defects.
The London School of Hygiene and Tropical Medicine has a secure breeding colony of the mosquitoes, so they can be closely studied.
Dr Oliver Brady, a specialist at the hospital, said mosquitoes are such efficient carriers of diseases that they can lead to huge outbreaks.
"These are all acute diseases that are rarely fatal but can be very, very severe and lead to prolonged hospital stays.
"If we were to cycle back five or ten years, we would have thought Zika was just a minor disease.
"But because these mosquitoes are spread across such broad parts of the world, what historically is a mild disease can now have the potential to be a pandemic." | Epidemics & Outbreaks |
Press release -
Groundbreaking research finds Basic Income scheme could save NHS tens of billions of pounds
New research funded by the National Institute for Health and Social Care Research (NIHR) and led by Northumbria University has found that a Basic Income scheme could potentially save the NHS tens of billions of pounds.
Researchers at the Universities of Northumbria, York, Bath and Strathclyde, in collaboration with think tanks Compass and Autonomy, have presented groundbreaking evidence on the role that Basic Income can play in dealing with our public health crisis.
A new report called Treating causes not symptoms: Basic Income as a public health measure uses a range of economic and health modelling, public opinion surveys and community consultation to present cutting-edge evidence on the impact of Basic Income schemes.
A basic income is a regular and unconditional cash payment to all individuals designed to reduce poverty, enhance economic security and improve overall well-being.
As a result of these potential benefits, researchers have looked at the knock-on effects for the economy and public health.
Economic impact:
- Even a more ‘modest’ basic income scheme (£75 a week, £3,900 a year) would reduce child poverty to the lowest level since comparable records began in 1961 and achieve more at significantly less cost than the anti-poverty interventions of the New Labour governments.
- Child and pensioner poverty down by at least 60% each
- Working age poverty down by between 29% and 75% depending on the scheme
- Inequality down 55% to the lowest in the world under the most ambitious scheme
Public health impact:
- Between 125,000 and 1 million cases of depressive disorders could be prevented or postponed.
- Between 120,000 and 1.04 million cases of clinically significant physical health symptoms could be prevented or postponed.
- Between 130,000 and 655,000 quality-adjusted life years (QALYs) could be gained, valued at between £3.9 billion and £19.7 billion.
- Based on depressive disorders alone, NHS and personal social services cost savings in 2023 of between £125 million and £1.03 billion assuming 50% of cases diagnosed and treated.
According to new polling, the report also found that the British public prefers a more generous Basic Income scheme that significantly reduces poverty and inequality and improves physical and mental health. They want to fund those schemes through new wealth and carbon taxes and increased corporation taxes, but also view small increases in income tax as tolerable.
Matthew Johnson, Professor of Public Policy at Northumbria University, and the project lead, said: “The findings of this report are clear: there is no obvious alternative to Basic Income that has the same multipurpose impact across society.
“These first indications of public health impact are debate shifting, while evidence on British public opinion present clear pathways to funding through wealth, carbon and corporation tax increases.
“This should encourage administrations, such as in Wales and Greater Manchester, which have expressed support for policies like this.”
Kate Pickett, Professor of Epidemiology, University of York, and the author of The Spirit Level, said: “Given decades of measurable failure, it should be clear that people in local communities affected by poverty, insecurity and lack of opportunity are the authoritative voice on what they need to enhance their health and wellbeing.
“We need to listen to their expressed needs and lived experience and create policies that support them to flourish.”
Dr Jonathan Coates, GP in Newcastle upon Tyne and NIHR In-Practice Fellow, Durham University, said: “As a GP, I increasingly find that my patients are in financially precarious positions, regardless of whether they are in work or on benefits, and this has a clear impact on their physical and mental health.
“Basic Income represents an opportunity to follow in the footsteps of previous bold interventions to address the causes, not the symptoms, of illness.”
The report, a full copy of which can be found here, will be officially launched at an event held at Northumbria University’s City Campus East in Newcastle upon Tyne on Thursday 13 July. Full event details can be found here.
It follows proposals from the research team to pilot a Basic Income in two communities – Jarrow and East Finchley – which attracted significant media interest.
Ends
Notes to editors
- Participants taking part in the new polling, referred to in the report, were recruited via prolific.co and involved a sample size of 697 UK Adults.
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COVID-19: People urged to book booster appointments before vaccine programme scaled down
More than 400,000 appointments are available at 2,800 sites across England until Sunday 12 February, the final day of the autumn booster campaign, after which the NHS will adopt a targeted approach focusing on vulnerable patients.
Saturday 4 February 2023 01:24, UK
People are being urged to book one of the hundreds of thousands of COVID booster appointments still available before the NHS scales down its vaccination programme and focuses on at-risk patients.
More than 400,000 appointments are available at 2,800 sites across England until Sunday 12 February, the last of the autumn booster campaign.
The date is also the final opportunity for 16 to 49-year-olds, who are not considered at-risk and have not yet had a booster, to get the jab - in line with updated guidance from government advisory group the Joint Committee on Vaccination and Immunisation (JCVI).
The body of scientific experts has recommended adopting a more targeted approach to those at risk of serious illness, ahead of a potential spring booster campaign for the most vulnerable and another autumn programme.
So far more than 17.3 million people have come forward for a booster shot this winter, according to NHS England.
More than 144 million doses of the vaccine have now been delivered since grandmother Maggie Keenan made history as the first person in the world to receive the vaccine outside of a trial.
A smaller programme allowing severely immunosuppressed people to book for first, second and third doses will continue after 12 February.
If you are an NHS worker and would like to share your experiences with us anonymously, please email [email protected]
The JCVI has advised that the primary COVID vaccine course should be withdrawn this year for healthy people aged five to 49.
England's chief medical officer Professor Chris Whitty stressed the importance of being protected against COVID.
He told Sky News: "We know that having the third vaccination, a booster, is a very important part of immunity to COVID and it provides additional protection, even if people have had COVID or had their first vaccination.
"So the autumn programme which includes the ability for everyone to come forward, is coming to an end on 12 February and I'd encourage anybody who's not taken up the offer to do so before then."
NHS director of vaccinations and screening Steve Russell said: "Whether you have had previous doses or a bout of COVID, we know that a booster is the best way to maintain protection against serious illness from COVID for yourself and your loved ones."
Mr Russell also hailed NHS staff for working really hard to deliver a combined 38 million flu and COVID doses this winter "amid record pressures on emergency services, providing crucial protection and keeping thousands out of hospital."
Read more:
COVID infections rise in schools - but total level is lowest in four months
NHS expands 111 service to reduce pressure on hospitals
Health Secretary Steve Barclay also urged anyone who hasn't had their first booster, or is eligible for an autumn booster, to come forward.
"Our hardworking NHS staff and volunteers have done an incredible job getting jabs into arms and they're on hand to top up your immunity and keep you and your loved ones protected," he said. | Vaccine Development |
Cases of leprosy have been on the rise in the U.S., with the Centers for Disease Control and Prevention now suggesting that the historically uncommon disease has become endemic in the Southeast.
In a research letter published last month, the CDC reported that cases of leprosy, also known as Hansen’s disease, have more than doubled in the southeastern U.S. over the last decade. Of the total cases reported nationwide, nearly one-fifth of them were in Central Florida, where 81% of the state’s cases have been reported, the CDC said.
The federal health agency advised physicians to consider travel to Florida a potential risk factor for infection, even when an individual doesn’t have other risk factors for the disease.
“Travel to this area, even in the absence of other risk factors, should prompt consideration of leprosy in the appropriate clinical context,” the letter states.
It’s not clear why cases of leprosy are on the rise. The CDC did not uncover any traditional risk factors in the course of contract tracing for the infected patients it examined.
It’s also not fully clear how the disease is transmitted. It can take years before an infected person shows symptoms, the agency said.
Prolonged human-to-human contact through respiratory droplets is the most widely recognized way leprosy is transmitted. The disease can also spread from contact with animals, specifically armadillos, though there have been several cases in Central Florida where there was no evidence of infection from an animal.
In the past, people infected with leprosy in the U.S. had generally traveled from leprosy-endemic areas. The disease is widespread in some countries in Africa, Asia and South America.
However, the CDC said that roughly 34% of U.S. infections reported from 2015 to 2020 appear to have been locally acquired in Florida, which first reported cases of the disease in 1921, according to the Florida Department of Health.
The CDC cited a 54-year-old Florida man, who was recently diagnosed with the disease after developing a painful rash on his face and body, as an example of someone who had no known risks for infection.
“He denied any domestic or foreign travel, exposure to armadillos, prolonged contact with immigrants from leprosy-endemic countries, or connections with someone known to have leprosy. He has resided in Central Florida his entire life, works in landscaping, and spends long periods of time outdoors,” the CDC said.
The CDC concluded that it’s worth investigating environmental reservoirs in Florida as a potential source of transmission. It also said more physicians should be made aware of how to recognize and report the disease.
“By increasing local physician efforts to report incidence and supporting further research to assess routes of transmission, a congruent effort can be made to identify and reduce spread of the disease,” the letter states.
Florida’s Department of Health did not immediately respond to a request for comment Tuesday.
Leprosy can be cured with prolonged treatment. But if left untreated, it can cause the crippling of the hands and feet, paralysis and blindness. Globally, as many as 2 million people are permanently disabled as a result of the disease, according to the CDC. | Epidemics & Outbreaks |
Tens of thousands of nurses in cancer wards, A&E departments and intensive care units in England will stop work for 48 hours next month in a significant escalation of strike action.
The Royal College of Nursing (RCN) said the strike would affect more than 120 NHS trusts across the country – far more than previous stoppages – amid an increasingly bitter row with the government over pay and staffing levels.
The two-day continuous strike, the largest such action in NHS history, will spark enormous disruption to services.
“These strikes will not just run for longer and involve more people but will leave no area of the NHS unaffected,” the RCN general secretary, Pat Cullen, said in a statement. “I will do whatever I can to ensure patient safety is protected.”
Senior NHS sources said the dramatic escalation was “alarming”, and warned the impact on patients would be “significant”. The effect will be even worse if junior doctors also vote to strike next month, they added.
Previously, nurses’ action took place during day shifts, for 12 hours each time, when it occurred in December, January and February. However, the next strike will run for 48 hours from 6am on 1 March.
For the first time in its history the RCN will involve nursing staff working in emergency departments, intensive care units, cancer care and other services that were previously exempted.
In the strikes last week the RCN agreed to 5,000 exemptions locally through committees of NHS hospitals and RCN staff, but this process will be stopped for the March strikes.
It said it was continuing discussions with the NHS as part of its commitment to “life and limb” care. But the RCN will reduce services to an “absolute minimum” and ask hospitals to rely on members of other unions and other clinical professions instead.
The union announced it would increase financial support for its members who lose wages by taking industrial action. The initial strike benefit rate will be increased from £50 to £80 a day, with the rate increasing to £120 from the fourth day of action.
“It is with a heavy heart that I have today asked even more nursing staff to join this dispute,” said Cullen. “Patients and nurses alike did not want this to happen.
“By refusing to negotiate with nurses, the prime minister is pushing even more people into the strike. He must listen to NHS leaders and not let this go ahead.
“At first, we asked thousands to keep working during the strikes, but it is clear that is only prolonging the dispute. This action must not be in vain – the prime minister owes them an answer.”
NHS leaders expressed alarm. “This is the most worrying escalation of strikes yet,” said Sir Julian Hartley, the chief executive of NHS Providers. “With more than 140,000 appointments already postponed as a result of the walkouts, this is a step no one wants to take.
“A continuous 48-hour strike with no exceptions in A&E, intensive care units or cancer care services will be a huge blow – especially as even more trusts will be affected this time.
“With further strikes by ambulance workers planned in the coming days and weeks, and junior doctors’ walkouts also likely, trust leaders are now in a near-impossible position. They’re deeply concerned the escalation could hamper their efforts to tackle care backlogs and compromise continuity of care for some.
“Without a resolution, this ongoing dispute could lead to serious, long-term damage to the NHS … The government needs to talk to the unions urgently about pay for this financial year.”
Steve Barclay, the health and social care secretary, said: “Failure to provide cover during strike action for key services like cancer care is a significant escalation from the Royal College of Nursing that will risk patient safety.
“We are working closely with NHS England on contingency plans, but this action will inevitably cause further disruption for patients.
“I’ve had a series of discussions with unions, including the RCN, about what is fair and affordable for the coming year, as well as wider concerns around conditions and workload.” | Health Policy |
A second person in the US has died in an outbreak of fungal meningitis linked to surgeries in Mexico that involved epidural anesthesia. While the case count is now up to 18, more than 200 others across 25 states may have also been exposed, the Centers for Disease Control and Prevention warned in an outbreak update Wednesday.So far, the outbreak among US patients spans 224 people, with 206 potentially exposed and under investigation, nine suspected cases, and nine probable cases. Two of the patients with probable cases have died.
Last week, the CDC released a travel advisory and a health alert to clinicians about the cases. At the time, health authorities had identified only five cases, all Texas residents, one of whom had died. An update Wednesday from Texas health officials said that they have since identified two more cases, bringing the state's total to seven. All seven cases were hospitalized, but the officials are still reporting only one death in Texas.
The outbreak is linked to two specific clinics in Matamoros, Tamaulipas, Mexico, just across the border from Brownsville, Texas: River Side Surgical Center and Clinica K-3. Both of the clinics were closed on May 13, and the Mexican Ministry of Health sent the CDC a list of 221 US patients who may have been exposed based on records from the two clinics. But the CDC noted in its update that it has already identified at least three additional people affected who were not on the list.
Get yourself to the doctor
The people exposed had surgeries at one of the two clinics between January 1, 2023, and the time the clinics closed on May 13. Surgeries included cosmetic procedures, such as liposuction, and involved epidural anesthesia. Epidurals involve injecting an anesthetic directly into the spine in a space around spinal nerves called the epidural space.
The CDC is now working with state and local health departments to track down and investigate the 206 exposed people. Health officials are urging those people to go to a health center, urgent care facility, or hospital emergency department as soon as possible—even if they do not have any symptoms. Once there, an exposed person should tell medical staff about the exposure. The CDC even suggests people print out or share this webpage from the agency's website to make sure health care providers understand the situation. Clinicians are advised to perform MRIs and spinal taps to look for infection—again, even if there are no symptoms.
Fungal meningitis is a deadly infection in which a fungal pathogen invades the brain and spinal cord—which it can easily accomplish if it's injected directly into the spine via a contaminated epidural anesthetic. The initial symptoms of fungal meningitis are nondescript, including fever, headache, stiff neck, nausea/vomiting, extreme sensitivity to light, and altered mental status. The first five cases in the outbreak reported that the start of their symptoms ranged between one and eight weeks after their surgeries in Mexico. Treatment involves long courses of high-dose antifungal medications, often by IV at first and followed by oral treatment, the CDC says.
A second outbreak
The CDC is still investigating the specific fungal cause of the outbreak. Many fungi have the potential to cause fungal meningitis. At least one US patient has presented with elevated cerebrospinal fluid levels of the fungal biomarker (1,3)-beta-D-glucan, leading to the suspicion of fungal meningitis.
However, the CDC said Wednesday that the Mexican national laboratory (InDRE) has reported that four patients in Mexico have had spinal fluid test positive for genetic material matching the fungus Fusarium solani.
The finding echoes another large, tragic outbreak that began a year ago in Durango, a northern state directly west of Tamaulipas, which encompasses Matamoros. In that outbreak, Mexican health officials also found Fusarium solani contaminating anesthetic used for epidurals in four private hospitals. As of the latest outbreak update for May 9, 2023, the outbreak involved at least 80 cases, 39 of which were fatal. Most of the cases involved women undergoing gynecological-obstetric procedures. Epidurals are commonly used in labor and delivery, as well as other surgeries. | Epidemics & Outbreaks |
Julia Bradbury is set to return to her childhood home in Ireland for her latest TV show where she explores the landscapes and speaks to walking experts.
The TV presenter, 52, who co-hosted Countryfile from 2004 to 2014, has had a steady return to the screens after being diagnosed with breast cancer in late 2021.
Since then she has made various appearances on shows like This Morning with her own segments, but has reportedly turned down several offers to have her own programmes as it was 'too early' to make a return to presenting.
But now she has decided is the right time to get back into work and is starting to do so with her latest show.
The Irish-British presenter has hosted walking programmes Coast To Coast, Canal Walks, German Wanderlust, Icelandic Walk and South Africa Walks in the past.
And now she is heading back to the country she was born to take a trip down memory lane in Dublin and appreciate the wider landscapes of Ireland.
She told The Sun: 'This is my first big series since my diagnosis and the production company has been amazing.
'They've been really great with the schedule and let me step back into [filming] in a gentle way. We filmed a little bit last year and we're soon filming the remaining blocks.'
The star added that she expects the point when she returns to the Dublin house she was born in will be 'really emotional'.
She continued: 'I was born in Dublin and we’re going to return to the house that I was born. That will be really emotional.'
Julia will interview 'experts in wellness' including a 'neuroscientist who believes in the science of walking' as well as an Irish breathwork teacher.
It comes after Julia revealed she has 'changed her life' since her breast cancer diagnosis as she documented her battle with the disease.
The presenter took to Instagram last month to share a reel documenting her life since being diagnosed with breast cancer in September 2021.
Julia, who is married to Gerard Cunningham, then underwent a mastectomy to have a 6cm tumour removed a month after publicly announcing her diagnosis.
Reflecting on her battle with breast cancer, Julia shared photographs of herself from across the last year as she spoke about how she has changed her life.
She said she has given up alcohol, changed her diet and prioritises sleep as she spoke about the lifestyle changes she has implemented to reduce her risk of her cancer returning.
The reel also included some emotional moments from throughout her cancer battle, including her attending her breast screening and in a hospital bed for treatment.
One video also showed an emotional Julia crying after being diagnosed with breast cancer and pictures of her in hospital while recovering from her mastectomy.
Julia also shared snaps of herself with her kids - Zephyr, 11, and twins Xanthe and Zena, seven - as well as the poster for her documentary Breast Cancer and Me.
In text printed across the reel, she reflected on her life since her breast cancer diagnosis and spoke about her work raising awareness for the disease.
It read: 'Breast screening. Something strange, but nothing to worry about. Until one year later: A breast cancer diagnosis.
'Tell my friends, family and young children. Mastectomy to left breast:breast and 6cm tumour removed.
'Decide to make a documentary to spread awareness. Begin to share as much information about breast cancer diagnosis/prevention/new treatments, as possible.
'Vow to get close to nature every single day of my life and meditate every day. Kick the booze, change the diet.
'Work with beautiful people on worthwhile projects. Stay connected to nature. Reconnect with my family and friends, reconnect with my old self. Keep learning.
'Prioritise sleep and exercise and nutrition. Begin writing a book, keep smiling.'
In an accompanying caption, Julia also went on to speak about her lifestyle changes, saying she 'recognised decades of bad decisions and unhealthy choices'.
She penned: 'What would you do if you got a cancer diagnosis?
'I changed my life. I re-examined my lifestyle, stresses and external factors that I could influence.
'This is not blame game, I'm not saying that any of these things ' gave me cancer', but my diagnosis has made me realise that I couldn't keep getting away with doing the bear minimum.
'I have jumped headlong into research, & I've met some incredible people, many of whom have reset themselves after a deep emotional or physical trauma. The name for these people is Wounded Warriors.
'If some of the information I share helps just one person then it's worthwhile...
'Breast cancer is the most widely diagnosed cancer in the world and 1 in 2 of us will face a cancer diagnosis of some sort in our lifetimes.
'I don't feel shame. I feel empowered by what I'm learning. The small things are the big things.
'If you don't make time for your health, you'll be forced to make time for your illness.
'Heal, Evolve, Act, Love, Thrive, Honour = HEALTH. The things that I have learnt that have an impact on our overall health and susceptibility to a chronic illness are:
Her latest post comes after Julia recently spoke about her fears that having children later in life increased her risk of breast cancer.
Speaking about her diagnosis in October, Julia shared her fears that having her three children over the age of 40 increased her risk of cancer.
Julia had five rounds of IVF with her property developer husband Gerard to conceive her twin daughters, after seeking treatment for endometriosis, which affects fertility.
Although Julia said she is proud to be an older mother, she shared her concern that having her children when she was over the age of 40 increased her risk of cancer.
'I love motherhood and I think there are certain life skills you have more experience with when you're older,' she told The Sun.
'But if you have your children later in life, that increases your risk of breast cancer, so does being a tall woman, as does being extensively on the Pill.'
According to the National Cancer Institute, the older a woman is when she has her first full-term pregnancy, the higher her risk of breast cancer.
It states that women who give birth to their first child when they are older than 40 have a higher risk of breast cancer than women who have never given birth.
Studies have also shown that taller women have an increased risk of breast cancer, while the contraceptive pill has been found to slightly increase the risk of breast cancer.
Elsewhere in the interview, Julia also spoke about how she has 'reset' her lifestyle since her cancer diagnosis last year.
She said being diagnosed with cancer and getting a mastectomy has made her focus on the things that are important in her life.
'So the real focus for me is what I do have in life, the statistics are that one in two of us will get cancer in our lifetime,' she said.
'It's made me reset and relook at my health, my lifestyle and my nutrition.'
Elsewhere, when she featured in a shoot for Woman&Home magazine, Julia said she is doing everything in her power to decrease her odds against her cancer returning.
'I'm a positive person, and I'm trying to use my resilience and health to make a positive impact on my body,' she explained.
Revealing how she has now switched to a mostly plant-based diet, Julia declared: 'My biggest motivation is staying alive for my children.'
The former Countryfile presenter underwent a mastectomy in October during which her breast plus two lymph glands were removed before reconstruction took place.
Julia recently revealed that the risk of her cancer is returning is higher than average and detailed her experience learning to love her body after the mastectomy.
Months after undergoing her surgery, the presenter is having to come to terms with the knowledge that she does not yet have the 'all clear' from doctors.
Julia revealed to You magazine that she has 'micro-invasions' – tiny fragments of cancerous cells which have leached out of her milk duct and into her breast tissue.
Genetic testing has also shown that she has a higher than average risk of her cancer coming back.
Breast cancer is one of the most common cancers in the world and affects more than two MILLION women a year Breast cancer is one of the most common cancers in the world. Each year in the UK there are more than 55,000 new cases, and the disease claims the lives of 11,500 women. In the US, it strikes 266,000 each year and kills 40,000. But what causes it and how can it be treated? Breast cancer develops from a cancerous cell which develops in the lining of a duct or lobule in one of the breasts. When the breast cancer has spread into surrounding breast tissue it is called an 'invasive' breast cancer. Some people are diagnosed with 'carcinoma in situ', where no cancer cells have grown beyond the duct or lobule. Most cases develop in women over the age of 50 but younger women are sometimes affected. Breast cancer can develop in men, though this is rare. Staging means how big the cancer is and whether it has spread. Stage 1 is the earliest stage and stage 4 means the cancer has spread to another part of the body. The cancerous cells are graded from low, which means a slow growth, to high, which is fast-growing. High-grade cancers are more likely to come back after they have first been treated. A cancerous tumour starts from one abnormal cell. The exact reason why a cell becomes cancerous is unclear. It is thought that something damages or alters certain genes in the cell. This makes the cell abnormal and multiply 'out of control'. Although breast cancer can develop for no apparent reason, there are some risk factors that can increase the chance of developing breast cancer, such as genetics. What are the symptoms of breast cancer? The usual first symptom is a painless lump in the breast, although most breast lumps are not cancerous and are fluid filled cysts, which are benign. The first place that breast cancer usually spreads to is the lymph nodes in the armpit. If this occurs you will develop a swelling or lump in an armpit.
Initial assessment: A doctor examines the breasts and armpits. They may do tests such as a mammography, a special x-ray of the breast tissue which can indicate the possibility of tumours.
Biopsy: A biopsy is when a small sample of tissue is removed from a part of the body. The sample is then examined under a microscope to look for abnormal cells. The sample can confirm or rule out cancer. If you are confirmed to have breast cancer, further tests may be needed to assess if it has spread. For example, blood tests, an ultrasound scan of the liver or a chest X-ray. Treatment options which may be considered include surgery, chemotherapy, radiotherapy and hormone treatment. Often a combination of two or more of these treatments are used.
Surgery: Breast-conserving surgery or the removal of the affected breast depending on the size of the tumour.
Radiotherapy: A treatment which uses high energy beams of radiation focused on cancerous tissue. This kills cancer cells, or stops cancer cells from multiplying. It is mainly used in addition to surgery.
Chemotherapy: A treatment of cancer by using anti-cancer drugs which kill cancer cells, or stop them from multiplying.
Hormone treatments: Some types of breast cancer are affected by the 'female' hormone oestrogen, which can stimulate the cancer cells to divide and multiply. Treatments which reduce the level of these hormones, or prevent them from working, are commonly used in people with breast cancer. The outlook is best in those who are diagnosed when the cancer is still small, and has not spread. Surgical removal of a tumour in an early stage may then give a good chance of cure. The routine mammography offered to women between the ages of 50 and 70 means more breast cancers are being diagnosed and treated at an early stage. For more information visit breastcancernow.org or call its free helpline on 0808 800 6000 | Stress and Wellness |
Just as our bodies and organs break down as we age, so do our brains.
While the cognitive aging process can’t be stopped, there are ways we can slow it down, according to Dr. Brett Osborn, a Florida neurosurgeon and longevity expert.
The key, he said, is sending the body "healthy signals" that prevent inflammation and reduce the "damage-inducing free radicals" that can wreak havoc on our cells and DNA.
While there might not be "brain-specific" signals, the same healthy lifestyle choices that benefit the body will also apply to the brain, Osborn said.
Below are 10 of his top recommended changes you can make to slow brain aging and boost cognitive health.
1. Exercise regularly
Humans were born to move, Osborn said. And a sedentary lifestyle is a detriment to our bodies and our minds as well.
"The brain not only sends movement instructions to the muscles, but also receives signals from the muscles," he said. "This back-and-forth communication, from strenuous exercise in particular, forges neuron-to-neuron connections."
Exercise is particularly beneficial for the memory centers of the brain, he said.
"In patients with Alzheimer’s disease, hippocampal volume loss is lessened in those who exercise versus the sedentary group," the doctor pointed out.
Physical activity also lowers levels of the stress hormone cortisol, Osborn said. This in turn helps to improve sleep, which rids the brain of toxins and forms memories.
Osborn recommends engaging in 30 minutes of endurance training five days per week, or one hour of strength training three days per week and two 30-minute endurance training sessions.
2. Get plenty of mental stimulation
Challenging your brain can help build "cognitive reserve," which is the brain’s resistance to damage, Osborn noted.
"These activities encourage neuronal firing in the temporal and parietal regions of the brain, critical areas for language and memory function," he said. "Both functions are affected in patients with Alzheimer’s disease, so ‘exercising’ these brain areas is preservative."
"The age-old adage applies here: Use it or lose it."
Melanie Avalon, a health influencer, entrepreneur and biohacker based in Atlanta, agreed that mental stimulation is essential to maintaining brain health and resilience.
She recommended participating in "multifaceted, layered and complex activities."
"The age-old adage applies here: Use it or lose it."
"Dancing, playing more difficult games, creating arts and crafts, and [engaging in] mentally stimulating occupational activities may support attention, working memory, task switching, mental speed and other characteristics linked to cognitive reserve," Avalon said.
"Such activities have also been found to correlate to increased gray matter volume in the brain."
Some other ideas from Osborn include doing puzzles, reading for 30 minutes nightly, learning a new language or picking up a musical instrument.
He also suggested learning to identify (with your eyes closed) the distinct odors of 10 essential oils, which have been shown to have brain-protective effects.
3. Eat a balanced diet
Nutrition plays a crucial role not only in the body, but also in brain health, Osborn said.
"Ideally, your diet should be low in sugar and refined carbohydrates, high in anti-inflammatory fats, and replete with colorful vegetables, particularly greens," he told Fox News Digital.
The doctor recommended sticking to a Mediterranean diet or a modified ketogenic diet with lots of olive and avocado oil, omega-3 fats from fish or flax, a moderate amount of protein from lean meats, and a lot of greens.
"I eat blueberries and spinach religiously, as both promote healthy brain function," he said.
For those who can’t stomach vegetables, he suggested building them into a smoothie or using a "super-food" powder as a drink fix.
Protein intake should adequately support your muscle mass — 0.75 grams per pound of body weight, the doctor recommended.
"It is a scientific fact that people with sarcopenia — reduced muscle mass and function — suffer not only physical but cognitive impairments," Osborn said. "If you lose muscle as you age, your brain falters."
"If you lose muscle as you age, your brain falters."
Avalon also recommended intermittent fasting, a pattern of eating in which you restrict the hours you eat each day rather than the amount of food you eat, as a means of supporting cognitive function.
"During intermittent fasting, the brain can switch to utilizing ketones generated from fat as an additional fuel source, reducing its reliance on glucose," she said. "This may be protective against cognitive decline."
Additionally, ketones produced during fasting trigger higher levels of proteins that help protect the brain and boost memory and learning, Avalon added.
4. Optimize your gut health
The gut has a robust network of nerves, and is therefore often called our "second brain," Osborn noted.
"There is an intimate interaction between our GI tract and our brain, and the health of one parallels that of the other," he said. "If your gut is healthy, often so is your brain."
He noted, "If you eat properly, for example, you will produce optimal levels of serotonin that regulate appetite and mood."
The vast majority of the body’s circulating serotonin — a neurotransmitter that conveys messages between the brain and the body — is produced by the gut, Osborn noted.
It’s also key to prevent chronic inflammation in the gut, which can cause the same condition in the brain.
Avalon noted that gut dysbiosis (an imbalance in the gut) is often seen in people with Alzheimer’s, and that amyloids created by the gut microbiome can even encourage the development of dementia.
"Gut dysbiosis may also degrade sleep quality, itself a contributing factor to cognitive decline," she said.
Osborn stressed the importance of avoiding fast food and sugary sodas, eating a lot of green leafy vegetables, and supplementing your diet with fermented foods such as kefir, sauerkraut, low-sugar yogurt or aged cheese, as these also promote intestinal health.
5. Get enough quality sleep
Getting a restful night’s sleep is essential for memory formation, cognitive function and overall brain health, Osborn said.
"But here’s the issue: As we age, total sleep time, and particularly time spent in slow-wave sleep (SLS), declines," he said.
During SLS, you brain is washed free of cellular debris and toxins that have collected throughout the day, the doctor said.
"Those who sleep poorly are at a much higher risk for the development of Alzheimer’s disease," Osborn said. "Amyloid plaques accumulate in those with Alzheimer’s disease and cause the brain to malfunction."
To promote quality sleep, he recommended limiting screen time and exposure to blue light that interferes with the production of melatonin, the body’s sleep hormone.
"Those who sleep poorly are at much higher risk for the development of Alzheimer’s disease."
Another tip is to reduce the ambient temperature of your bedroom — "65 to 70 degrees is optimal," Osborn said.
He also suggested avoiding caffeine, alcoholic beverages and heavy meals before bed, which can disrupt sleep.
Exercising regularly also helps to lower cortisol and facilitate sleep, Osborn added.
"The value of restorative sleep cannot be understated," he added. "Your brain functions far more efficiently after a good night’s sleep."
6. Manage stress levels
Chronic stress has detrimental effects on brain health, Osborn said.
"While the body’s primary stress hormone, cortisol, plays a vital role in responding to short-term stressors, it can wreak havoc on the body in the long term," he said. "Over time, high cortisol levels suppress the immune system, meaning a reduced ability to fend off infections."
Cortisol also elevates blood sugar, he added, which can lead to a variety of health problems, including insulin resistance and Type 2 diabetes, primers for Alzheimer’s disease.
To manage stress, Osborn recommended practicing relaxation techniques such as meditation, yoga or deep breathing.
7. Engage socially
Maintaining social connections and engaging in meaningful conversations can help keep your mind sharp, according to Osborn.
"Social engagement has been associated with high quality of life and overall well-being, and inversely related to depressive-type behaviors," he told Fox News Digital.
"Socialization is part of our humanness," he went on. "It makes us feel good and is good for our brains."
For better social engagement, Osborn advised skipping social media in favor of an old-fashioned phone call or in-person meeting.
"There is no substitute for human-to-human interaction, which stokes the biochemical pathways of the brain and encourages the release of ‘feel-good’ hormones such as dopamine and serotonin."
"There is no substitute for human-to-human interaction, which stokes the biochemical pathways of the brain and encourages the release of ‘feel-good’ hormones such as dopamine and serotonin," he said.
"Isolation does nasty things to our brains. It ages us. Humans, almost by definition, are social beings," he said. "Our brains thrive on it — and not via Zoom or Facebook."
8. Limit alcohol consumption
Osborn described alcohol as a "neurotoxin that accelerates brain aging in a multitude of ways."
"In addition to being toxic to neurons and interfering with cognition, alcohol disrupts the gut microbiome, the normally healthy microbes residing in the gut, causing inflammation that spreads throughout the body," he said.
The doctor recommended limiting alcohol consumption, or preferably avoiding it altogether.
"I instruct my patients to reduce their drinking by 50% every six months until they are abstinent," he said.
Some experts, however, believe that moderate drinking may provide some brain benefits.
As Avalon pointed out, the Mediterranean Intervention for Neurodegenerative Delay Diet (MIND Diet), created by researchers at Rush University Medical Center, includes one glass of wine per day to ward off neurodegenerative decline.
"A 2019 review of 28 systematic reviews analyzing the associations of alcohol and cognitive decline found that the majority of the studies indicated light to moderate alcohol intake associated with reduced diagnoses of cognitive impairment, as well as fewer mortalities due to dementia," she said.
On the other hand, both chronic and irregular heavy alcohol intake were found in some reviews to cause cognitive impairment, she added.
9. Consider taking brain-boosting supplements
"Just as there are brain-boosting foods like spinach, blueberries, ginger and turmeric, there are a multitude of supplements that may better your brain performance, enhance learning and memory formation, and/or lower cortisol, which slows brain aging," Osborn said.
Below are just some of the brain-boosting supplements that Osborn uses:
- Omega-3 fatty acids
- Exogenous ketones (powdered beta-hydroxybutyrate)
- Caffeine
- Lion’s mane extract
- Creatine
- Gingko biloba
- Ashwagandha (KSM-66)
"Keep in mind that supplements are not FDA-approved," Osborn said. "Some may work well for you and some will not."
He noted, "As always, before adding anything novel to your current medication or supplement regimen, discuss it with your physician, as some may interfere with or reduce the efficacy of your current medications."
10. Balance hormone levels
Hormones play diverse roles throughout the body, including the brain.
"Sex hormones like testosterone, estrogen and progesterone enhance cognition and may protect the brain from insults like a traumatic brain injury," Osborn said.
Optimal levels of estrogen are integral to brain function, he added.
"Low levels, as is the case with testosterone, are associated with ‘brain fog’ due to heightened inflammation in the brain," the doctor said. "This similarly applies to thyroid hormone."
"Your brain simply does not work right when your hormone levels are suboptimal, but it doesn’t have to be this way."
To naturally increase hormone levels in the body, Osborn recommends strength training regularly, getting adequate sleep, and eating a low-glycemic, anti-inflammatory diet with lots of healthy fats.
If the natural route doesn’t work, hormone replacement therapy (HRT) is another option, but it must be done under medical supervision.
"Do not be dismissive of the central effects of hormones and their potential to enhance cognition or prevent neurodegenerative disease," Osborn said. "It is thought that Alzheimer’s disease is not only a state of insulin resistance in the brain, but also a progesterone-deficient state."
"While both mind and body tend to ‘malfunction’ as we age, the longer we stand on this earth, you can slow its rate of progression — or rather, regression," the doctor concluded.
"And it’s easier than you may believe. What keeps your body healthy, similarly keeps your brain healthy." | Longevity |
Leann Sutherland was 21 and suffering from chronic migraines when one of Scotland's top surgeons offered to operate.
She was told she would be in hospital for a few days and had a 60% chance of improvement. Instead she was in for months while Sam Eljamel operated on her seven times.
The BBC can reveal her surgeon - the former head of neurosurgery at NHS Tayside - was harming patients and putting them at risk for years but the health board let him carry on regardless.
NHS Tayside has consistently claimed it only knew about concerns from June 2013 and that they put him under supervision at that point but an NHS whistleblower has told the BBC the health board knew as early as 2009 that there were serious concerns.
BBC Scotland has spoken to three surgeons who worked under Mr Eljamel at Tayside. All three said he was a bully who was allowed to get away with harming patients.
All three said there was a lack of accountability in the department and that Mr Eljamel was allowed to behave as if he were a "god" - partly because of the research funding he brought to the department.
The health board told the BBC it was working with the Scottish government to support an independent review of patients' care under Mr Eljamel and that it could not comment on individual cases.
'I was his guinea pig'
Before her operation in 2011 Leann used to work full-time and go on holidays abroad with friends but her life was blighted by migraines.
Mr Eljamel, reputed to be the best neurosurgeon in Scotland, told her he could help.
It would be one operation and she would be home in a matter of days, she was told.
He would remove a small part of her skull to alleviate pressure and he told her he would use a new glue to seal the wound.
Leann told the BBC: "Unfortunately it did not seal properly and it burst.
"The wound burst open and the brain fluid started to pour out the back of my neck."
She says the next day her hospital bed was "soaked" with her spinal fluid.
When she got up to use the bathroom she collapsed and said the fluid went all over the floor. A nurse put a wet floor warning sign on the area.
Leann says that her mum had to chase Mr Eljamel down a corridor to get him to come and look at her - at which point she was rushed back into surgery.
Leann spent months in hospital. She contracted meningitis and developed hydrocephalus. Mr Eljamel ordered her to have four lumbar punctures - which her medical notes say she specifically should not have had.
Leann knows now he was using the glue as part of a research trial.
"Experimenting on me - that's what he was doing," she says.
"There can't be any other reason to try a glue, try different shunts, that's experimenting.
"I was his guinea pig."
She adds: "He had free rein on my body. He was playing god with my body and the NHS handed him the scalpel, seven times."
When Leann raised tried to raise concerns with staff she was told that Mr Eljamel had saved her life. She was not told that he was under investigation, nor that he had been later forced to step down.
It was only after seeing recent BBC coverage she realised she was not alone.
The impact
Leann is now 33. She lives in constant pain. She needs crutches to walk and has a tube - called a shunt - through her body controlling her spinal fluid.
"Everything is changed," she says. "My dream was to be a police officer and that will never happen.
"I struggle with that, not being able to have the career you want, not being able to have the lifestyle you want, not being able to have children.
"A lot of things have been taken away through no fault of my own."
Leann is one of 99 patients calling for a public inquiry to find out exactly what harm Mr Eljamel did.
The damage to her and other patients is irreversible but she wants to ensure the health board is held accountable and that no other surgeon can cause such damage.
She says she only realised he had harmed patients after seeing a story by BBC Scotland.
"I thought it was just me, I didn't know there was 99 other people," she says.
"I don't understand how he got to wash the blood off his hands and go home."
Whistleblower
Mr Eljamel was suspended by NHS Tayside following internal and external reviews in 2013 and went to work in Libya.
For the first time, three people who worked with Mr Eljamel have spoken to the BBC.
Mark, not his real name, says he is speaking out now because he fears the health board has still not learnt the lessons of the past.
"I did raise concerns at the time but I was shut down," he says.
"Part of me feels guilty I did not do anything [more] about it but I was too junior.
"We were told we would never get our traineeship."
He says nurses, senior surgeons and managers knew at least as early as 2009 that Eljamel was regularly away from the hospital doing private work when he was meant to be operating on patients.
Mark says that on a weekly basis Mr Eljamel left junior surgeons to operate unsupervised.
"Letting a junior operate when you're not even in the building and a patient coming to harm is negligent," he says.
"NHS Tayside has covered things like this up for a long time in Dundee..
"It went all the way up to the board. They all knew about it."
'Untouchable'
Mark remembers on one occasion being in surgery to watch the junior operating on Mr Eljamel's patient when the junior surgeon accidentally cut through the spinal cord.
He said the spinal fluid was "pouring out" and that he and another surgeon were sent running to find a more senior surgeon. That patient was left permanently disabled.
"What has this top neurosurgeon done to these patients?" He says. "I think serious harm. Cover-ups happen so these things need to be looked into again.
"Drawing a line is easy to say but the culture will not change if you just draw a line in the sand. You need to change the culture first to protect the patients."
The three surgeons told us Mr Eljamel discouraged the use of X-rays because he was so arrogant and because it saved him money.
It is thought that as a result he operated in the wrong place on the spines of at least 70 patients - leaving many permanently disabled.
Mark says one of the reasons Mr Eljamel was considered "untouchable" was that he brought so much money in to the department through research projects which many of them considered to be "odd and even questionable".
A spokeswoman for NHS Tayside said: "The NHS Tayside medical director and chief executive met with the cabinet secretary and local Tayside MSPs in April to discuss the ongoing concerns of patients of Professor Eljamel.
"It was agreed at the meeting that NHS Tayside would work with Scottish government regarding the next steps to support individual patients through a process independent of both the health board and government.
"NHS Tayside remains committed to do whatever is required to support the independent process recognising it will be tailored to the circumstances of individual patients.
"While we cannot comment on individual patients and their treatment due to patient confidentiality, we would invite Ms Sutherland to contact NHS Tayside's Patient Liaison Response Team." | Medical Innovations |
Image source, Getty ImagesDuring the pandemic, nearly half a million people in the UK missed out on starting medication to help prevent heart attacks and strokes, a new study suggests.The British Heart Foundation (BHF) team looked at prescribing data for the first 18 months after Covid hit.Some 491,000 people - 27,000 a month - appear to have missed out on blood pressure pills. And 316,000 did not get treatment to lower their cholesterol. The team says more needs to be done to make sure that anyone who needs treatment gets it. During the pandemic, normal NHS services were severely disrupted. For example, there was a reduction in diagnosis, monitoring and treatment of high blood pressure, and other heart and circulation disease risk factors.Although the NHS took action, including providing more than 220,000 blood pressure monitors for people to use at home, data shows two million fewer people in England were recorded as having controlled hypertension in 2021 compared to the previous year.The BHF researchers analysed 1.32 billion records of routinely dispensed prescriptions in England, Scotland and Wales, from April 2018 to July 2021. Lead investigator Prof Reecha Sofat, who is based at the University of Liverpool, said the findings, published in the journal Nature Medicine, highlight the impact Covid has had on other important health conditions: "Despite the incredible work done by NHS staff, our data show that we're still not identifying people with cardiovascular risk factors at the same rate as we were before the pandemic. "She said it was more than just a blip, and it would take time to catch up. "The NHS has already taken important and positive steps towards identifying people with high blood pressure as early as possible. "However, we need this focus to be sustained in the long term to prevent any increase in heart attacks and strokes which will add to a healthcare system already under extreme pressure." Dr Sonya Babu-Narayan, Associate Medical Director at the British Heart Foundation and consultant cardiologist, said: "Yet again we're seeing clear evidence of the major disruption to healthcare people in the UK experienced during the Covid-19 pandemic. "But it's not too late to limit the damage. These findings demonstrate how getting heart healthcare back on track can curb the additional strain that untreated risk factors - such as high blood pressure - would otherwise place on the NHS."Heart risk factors Some factors - like older age - are unavoidable, but others can be managed:High blood pressureHigh cholesterolDiabetesObesitySmokingPhysical activityImage source, British Heart FoundationImage caption, Adam Toms suffered a stroke in 2015, before the Covid pandemicAdam Toms was 47 when he suffered a stroke in 2015. He had undiagnosed and untreated high blood pressure. Now 54 and living in north-west London, Mr Toms said: "You can appear completely healthy, and it can just happen. then you've got a whole lot of adaptations to make. I was never ill but then bang, everything changed - my whole world changed."My father and my brother had high blood pressure. The connection wasn't made. "I always associated a stroke with somebody who is 70, 75 plus."Who knows, if I had found out earlier and got it under control, I might not be where I am today."His stroke has left him with weakness on the left side of his body and he also has difficulty with finding the right words when he speaks.He wants to encourage others to get their blood pressure and health checked. Related Internet LinksThe BBC is not responsible for the content of external sites. | Disease Research |
State and federal health officials are investigating the cause of a "cluster of illnesses" in Bartlesville, Oklahoma. Early analyses have ruled out the freshwater-residing "brain-eating amoeba" Naegleria fowleri, known for causing a rare but nearly always fatal brain infection called primary amebic meningoencephalitis (PAM), as a potential cause, Oklahoma State Department of Health (OSDH) officials told Live Science in an emailed statement.
"What we know at this time is a few individuals have presented to healthcare providers with varying symptoms," and tests for PAM caused by N. fowleri have been negative, the statement reads. The OSDH is currently investigating the reports and working alongside the Centers for Disease Control and Prevention (CDC) to conduct further tests.
The OSDH statement does not provide more information about the cases, but according to FOX 23, several affected individuals reportedly got sick after swimming in Copan Lake or the Caney River, and at least one child is reportedly being treated in the hospital for suspected bacterial meningitis.
The OSDH has advised residents that public drinking water is safe and that it is tested daily to ensure federal and state quality standards are met.
Meningitis is the inflammation of the layer covering the brain; it leads to symptoms such as headache, stiff neck and light sensitivity, and severe cases can cause seizures, coma and death. Meningitis can be caused by bacteria, viruses or amoebas like N. fowleri infecting the central nervous system; severe cases tend to be caused by bacteria or amoebas rather than by viruses.
It is uncommon to contract meningitis from freshwater. When it does happen, N. fowleri is usually the culprit and, on average, two to three cases of PAM are reported in the U.S. each year. In those cases, patients have usually come into contact with the amoeba after inhaling contaminated water through their noses.
With N. fowleri ruled out as a possible cause of the recent illnesses in Bartlesville, what else could cause meningitis following exposure to freshwater?
According to Dr. Thomas Russo, a professor and chief of infectious diseases in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, the most likely culprit behind the recent cluster of illnesses is bacteria in the genus Leptospira. Exposure to this pathogen can cause an infection called leptospirosis, which can lead to meningitis.
According to the CDC, the urine of infected animals can enter water sources, where the bacteria can then linger for months. Swallowing or bathing with an open wound in water contaminated with Leptospira gives the pathogen an entry point into the body. In the U.S., around 100 to 150 cases of leptospirosis are reported each year, although some of these are caused by contact with infectious urine or consumption of contaminated food.
Enteroviruses present another plausible cause. These are "a group of viruses that cause a number of infectious illnesses, which are usually mild," Russo told Live Science. For example, enteroviruses can cause the common cold and various gastrointestinal symptoms. Enteroviruses can enter freshwater sources via fecal runoff contamination.
"If the water was contaminated with an enterovirus and was ingested, it could potentially cause a meningitis syndrome," Russo said. Infections with enteroviruses are fairly common, but most people who come into contact with an enterovirus don't develop a clinical disease; illnesses that do arise tend to resolve on their own.
Listeria bacteria, a rare but sometimes fatal cause of food poisoning, can also result in meningitis. These bacteria can be found in moist environments, soil, water and animal feces. Certain groups are at a greater risk of illness from exposure to Listeria, including children 6 months old or younger, pregnant people, and people with compromised immune systems.
Balamuthia mandrillaris, an amoeba that is common in freshwater, soil, dust, sewage, swimming pools, water storage, and humidifiers, can cause a rare but serious brain infection called granulomatous amebic encephalitis (GAE). The amoeba can enter the body through broken skin or via inhalation through the nose. Since its discovery in 1896, only 200 cases have been confirmed worldwide, although half of these occurred in the U.S.
Another amoeba, Acanthamoeba, can also cause GAE, although fewer than 50 such cases of GAE have been reported in the literature. The amoeba can be found in swimming pools, lakes, tap water, and heating and air conditioning units. While most people will be exposed to the pathogen at some point in their life, very few will develop an illness — those with a compromised immune system are at most risk of falling ill.
It is also possible for an unknown pathogen to cause meningitis following contact with water, Russo said, and there's a chance that the cases reported in Bartlesville are not related to one another or to the individuals' recent swimming history. So far, limited information has been made publicly available regarding the number of cases and the symptoms or diagnoses of those afflicted. Therefore, it is not possible to conclude the cause of the illnesses, Russo said.
Because of their increased risk of illness when exposed to pathogens, people who are pregnant or have compromised immune systems should consider avoiding swimming in freshwater, according to Russo. Anyone swimming in freshwater should also avoid swallowing the water or allowing it to enter their nose.
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Sarah Moore is a freelance science writer. She has an MSc in neuroscience and a BSc in psychology from Goldsmiths College, University of London. Sarah has experience in academic research and has worked in medical communications with top pharmaceutical companies. As a freelancer, she has contributed work to a wide range of publications. Sarah loves to write on all areas of science, from healthcare to nanotechnology but she is especially intrigued by the workings of the human brain. | Epidemics & Outbreaks |
A cheap and easily taken drug used to treat fungal nail infections has been found to be highly effective against a devastating flesh and bone-eating disease found across Africa, Asia and the Americas.
Researchers say the breakthrough offers hope to thousands of patients who have suffered decades of neglect and can face amputations if the disease is left untreated.
Results of the first clinical trial for a new treatment for mycetoma, which took place in Sudan, have shown that the oral drug fosravuconazole is up to 85% effective and has no side-effects.
Dr Borna Nyaoke, the head of mycetoma at the Drugs for Neglected Diseases Initiative (DNDi) – which coordinated the trial with the Mycetoma Research Center (MRC) in Sudan’s capital, Khartoum, and the Japanese pharmaceutical company Eisai – labelled the discovery “momentous”.
“We were all very excited,” she said. “It’s going to be a gamechanger.”
Mycetoma is a chronic infection caused by certain bacteria and fungi and is on the World Health Organization’s list of 20 neglected tropical diseases. There are no accurate figures on the global number of cases, but Sudan and Mexico report the highest number.
The condition primarily affects young adults in poorer, rural areas, with children making up about 20-25% of all mycetoma patients. Many people become infected through thorn pricks while walking barefoot.
If left untreated, it can lead to amputation and death. The stigma associated with the disease can have serious mental health consequences.
At present, mycetoma is treated with the drug itraconazole, which needs to be taken with food four times a day for a year and has a number of side effects. It is also expensive, costing about $2,000 (£1,600) to treat a patient for a year. It is not available in all endemic countries.
Fosravuconazole, which is already used to treat fungal nail infections, can be taken once a week for a year without food. “In our population, where having two square meals a day is difficult, this is an advantage,” said Nyaoke, who added that the new treatment is expected to be much cheaper.
However, despite the successful trials in Sudan, the war in the country has derailed efforts to fight the disease. Sudan was plunged into a violent crisis in April after fighting broke out in April between the Sudanese armed forces, led by Gen Abdel Fattah al-Burhan, and the Rapid Support Forces loyal to his rival Mohamed Hamdan Dagalo, known as Hemedti.
The MRC in Khartoum, the only dedicated centre for mycetoma in the world and which acts as a reference laboratory for many medical facilities, has been forced to close.
Nyaoke said Sudan’s regulatory authority appeared ready to approve the drug for nationwide use, but it is unknown when a decision will be made.
Ahmed Fahal, a professor of surgery at Khartoum University and founder of the centre, said: “The war had a lot of impact in Sudan in general as well as on the mycetoma centre and on patients. It affected our work; staff have fled and are traumatised. The war has definitely moved us backwards.”
Fahal is hoping to open two new centres in areas of the country not affected by conflict. “We are determined to start again and continue what we are doing,” he said. | Drug Discoveries |
A Colombian Senate committee has approved a bill to legalize marijuana, sending it the full chamber for consideration.
The legislation—which has already moved through committee and on the floor in the Chamber of Representatives in recent months—cleared the First Committee of the Senate on Wednesday. This marks the third of eight planned debates before the measure is potentially sent to the president next year.
Lawmakers nearly enacted a version of the reform into law earlier this year, but it stalled out in the final stage in the Senate last session, meaning the two-year legislative process needed to start over again. Rep. Juan Carlos Losada and Sen. María José Pizarro reintroduced the legislation in July.
Aprobado con 15 votos en 3er debate nuestro proyecto de #CannabisDeUsoAdulto.
Seguimos avanzando en una regulación que le quite el negocio a las mafias, con enfoque en prevención, salud pública, protección a la niñez y oportunidades económicas para las regiones.… pic.twitter.com/dGvZXvsbXa
— Juan Carlos Losada (@JuanKarloslos) November 22, 2023
“The war strategy on drugs has failed,” Pizarro said during Wednesday’s debate, according to a translation. “It has not been effective and consumption has not decreased.”
Losada said ahead of the vote on Wednesday that lawmakers are pursuing “regulation with a public health focus that protects minors and provides economic opportunities.”
Regulating marijuana “is the first step to move forward in changing the failed drug prohibition policy,” he said.
The legislation was previously approved in both chambers last year as part of the two-year process that constitutional amendments must undergo. It then passed the Chamber of Deputies again in May and advanced through a Senate committee in July. But while it received a majority of the votes on the Senate floor, it fell short of the 54-vote threshold it needed for passage.
At a public hearing in the Senate panel last year, Justice Minister Néstor Osuna said that Colombia has been the victim of “a failed war that was designed 50 years ago and, due to absurd prohibitionism, has brought us a lot of blood, armed conflict, mafias and crime.”
The Chamber of Representatives gave initial approval to the legalization bill last year, and the head of the Interior Ministry similarly spoke in favor of the reform proposal at the time.
President Gustavo Petro—a progressive who recently unveiled a new national drug policy focused on loosening criminal penalties and instead working to transition Colombians to legal sectors of the economy—has strongly advocated for an international end to drug criminalization since being inaugurated last year.
Aprobado en 3er debate nuestro proyecto que busca regularizar el #CannabisDeUsoAdulto.
Nos propusimos con @JuanKarloslos no bajar los brazos y volver a dar el debate en el Congreso y nos emociona que avance. Restan cinco debates, sigue la discusión en plenaria de Senado pic.twitter.com/Xjq8faqEIi
— María José Pizarro Rodríguez (@PizarroMariaJo) November 22, 2023
After a recent visit to the U.S., the president recalled smelling the odor of marijuana wafting through the streets of New York City, remarking on the “enormous hypocrisy” of legal cannabis sales now taking place in the nation that launched the global drug war decades ago.
Petro also took a lead role at the Latin American and Caribbean Conference on Drugs in September, noting Colombia and Mexico “are the biggest victims of this policy,” likening the drug war to “a genocide.”
At that event, 19 countries jointly issued a statement asserting that “the expected results have not been obtained when combating the world drug problem, leaving in many cases the underlying problems to be solved and exploiting and exacerbating vulnerabilities of our territories and societies.”
Petro said at the closing of that conference that “what I propose is to have a different and unified voice that defends our society, our future and our history and stops repeating a failed discourse.” He argued that it was wrong to look at drug control “as a military problem and not as a health problem in society.”
In a separate speech, Petro acknowledged that by criminalizing cannabis and other drugs, Colombia and the international community have victimized peasant families as well as Indigenous and Black communities.
“Drug trafficking was not born in Colombian blood. They built it for us,” he said, noting that the low cost of producing drugs makes Colombia an appealing area to grow illicit crops like marijuana and coca, which are processed and then smuggled to sell at higher prices in wealthier countries.
Those countries “never wanted to develop a policy of prevention or regulation or mitigation of harm among consumers,” Petro said, instead preferring to blame poorer, less white countries like Colombia. “That’s an easy policy,” he added, accusing the U.S. and other developed nations of “xenophobic and racist complexes.”
Last year, Petro delivered a speech at a meeting of the United Nations (UN), urging member nations to fundamentally change their approaches to drug policy and disband with prohibition.
He’s also talked about the prospects of legalizing marijuana in Colombia as one means of reducing the influence of the illicit market. And he signaled that the policy change should be followed by releasing people who are currently in prison over cannabis.
Former Colombia President Juan Manuel Santos has also been critical of the drug war and embraced reform. In an op-ed published before he left office, he criticized the UN and U.S. President Richard Nixon for their role in setting a drug war standard that has proven ineffective at best and counterproductive at worst.
“It is time we talk about responsible government regulation, look for ways to cut off the drug mafias’ air supply, and tackle the problems of drug use with greater resources for prevention, care and harm reduction with regard to public health and the social fabric,” he said.
“This reflection must be global in scope in order to be effective,” Santos, who is a member of the pro-reform Global Commission on Drug Policy, said. “It must also be broad, including participation not only of governments but also of academia and civil society. It must reach beyond law enforcement and judicial authorities and involve experts in public health, economists and educators, among other disciplines.”
Image element courtesy of Bryan Pocius. | Drug Discoveries |
A scientist claims he has increased his lifespan by 20 percent after living 93 days underwater.
Joseph Dituri, 55, a retired Naval officer, has been living inside a 100-square-foot pod at the bottom of the Atlantic Ocean for 92 days, researching how a pressurized environment impacts the human body.
The mission was also designed to beat the world record for living underwater - the previous stay was 73 days.
Dituri told DailyMail.com that doctors conducted tests on his body to see how it changed from March to June, including tests that measure telomeres, compounds at the end of chromosomes that shorten with age.
He claims they are now 20 percent longer, and he has up to 10 times more stem cells than when he first moved into the underwater pod in March.
Dituri experiences 60 to 66 percent deep REM sleep every night, his inflammatory markers have been cut by half and his cholesterol has dropped by 72 points, he claims.
The scientist did not provide details of how his telomeres were measured, but there are testing services that measure their length from blood samples.
And most services take about two weeks to provide results.
The health changes are due to the pressure, which is similar to the process in hyperbaric chambers, which are found to improve cerebral blood flow, brain metabolism, and brain microstructure, leading to improved cognitive functions, physical functions, sleep, and gait.
A study conducted by Tel Aviv University in 2020 found hyperbaric oxygen treatments (HBOT) in healthy aging adults can stop the aging of blood cells and reverse the aging process.
The researchers exposed 35 healthy individuals aged 64 or over to a series of 60 hyperbaric sessions over 90 days.
Each participant provided blood samples before, during and at the end of the treatments and sometime after the treatments concluded. The researchers then analyzed various immune cells in the blood and compared the results.
Focusing on immune cells containing DNA obtained from the participants' blood, the study discovered a lengthening of up to 38 percent of the telomeres, according to Tel Aviv University's press release.
Dituri is using the pressurized environment to study how the human body responds to long-term exposure to extreme pressure in a small space for 100 days - a similar environment spacefaring heroes will endure while traveling to the Red Planet.
'You need one of these places that is cut off from outside activity,' Dituri told DailyMail.com, referring to the tiny pod.
'Send people down here for a two-week vacation, where they get their feet scrubbed, relax and can experience the benefit of hyperbaric medicine.'
Dituri began this epic mission on March 1 with not just a goal of breaking the record of living the longest underwater - it was previously 73 days - but also to learn how the pressure can benefit the human body.
He works out for one hour four to five days a week but only has access to exercise bands.
'I am still maintaining the mass that I have, which is insane,' said Dituri.
'My metabolism has increased, so my body has become leaner, and even though my muscle mass has not changed [since I was on the surface], I am still leaner than I was.'
The change in the number of stem cells has also been a part of his research.
Stem cells are a promising potential solution for reversing the visible signs of aging, and Stanford found that old human cells can be rejuvenated with stem cells.
When DailyMail.com first spoke with Dituri, he was just 24 days into the mission and said he suspected his telomeres would grow to be much longer - and he was correct.
Previous research has shown that telomeres, which protect chromosomes from becoming frayed, lengthen when the body is under extreme pressure.
‘We suspect, or we know in hyperbaric medicine, that after about 60 treatments one hour per day at a higher pressure than I'm at right now, one hour per day you will grow them between 25 and 33 percent, the jury is still out on that it is not full of science,' said Dituri in March.
And speaking with the scientist recently, he said the compounds had grown 20 percent.
'We knew this was going to happen. Whether these sticks is the question. That's what we want to see when we come out of this,' Dituri said.
While the underwater lodge is small, the pod has a work area, kitchen, bathroom, two bedrooms, and a small 'swimming pool' that acts as the exit and entrance and a window with a view of the ocean.
Dituri told DailyMail.com from the bunker on day 24: 'I'm loving it. I've got a coffee maker because God knows science does not happen without coffee.'
He has also been testing technology that could be used to help astronauts who make the epic journey to Mars.
One of the devices is a pre-NASA tool, meaning it must be tested before the agency takes it on.
It is similar to Star Trek's tricorder, which scans the body to monitor a person's health and determine if they need medical assistance.
Dituri is also investigating how to prevent muscle mass loss while in space, which plagues astronauts on the International Space Station (ISS).
'We're going to Mars, but it is going to take 200 days to get there on the best home and transfer window,' Dituri told DailyMail.com.
'[When you get there] you are going to have decreased muscle mass, and you're not going to be able to see very far, and you're not going to be in really good shape, and you're going to have decreased bone density, and we're going to land you hard on a re-endurable market as it lands and slams down to the ground.
'I think maybe that's a bad idea, and we need to figure some stuff out first, but that is just me.'
Dituri's home away from home is located at Jules’ Undersea Lodge in Key Largo.
'There is a TV, although I really do not know how to turn it on. I have a small freezer like in a hotel room,' he said, while also noting he keeps a stash of chocolate in the pod.
A small microwave is on a shelf, the only thing that can be used for cooking.
'Every good hotel has to have a pool, and my hotel has a teeny little pool outside,' said Dituri.
'This is how we enter and exit from the habitat. So when I go for a scuba dive with all my scuba diving gear, I get it on. I go out of the hole, and then I dive around. So that's how people come in and come out.'
Dituri sleeps on a twin-size bed with a small bunk on top, which is the same setup in an adjacent room for scientists who visit him.
Dituri found his passion for science while serving as a saturation diving officer in the US Navy for 28 years.
After retiring in 2012 as a commander, Dituri enrolled at the University of South Florida to earn his doctoral degree to learn more about traumatic brain injuries.
And he is also a published author.
'I was bored during COVID because they would not let me treat patients for the first couple of months, so I wrote a book,' Dituri said while noting it is available on Amazon.
'It's called 'Secrets in Depth. It's about a nice Italian boy from New York who joins the Navy and gets to a whole bunch of trouble with the CIA.'
While the scientist is working to find a cure for astronaut ailments, he is also missing his three daughters, who he raves about at any chance he gets.
His 21-year-old daughter, Gabrielle, graduated from the California Institute of Technology in May, an event he could not attend.
Sophie, 19, happily works at a restaurant in South Tampa, Florida and Josephine, 27, has a Masters in psychology and works in New York City. | Longevity |
New research has revealed a potentially important role ginger supplements can play in controlling inflammation for people living with autoimmune diseases.
The research published today in JCI Insight focused on studying the impact of ginger supplementation on a type of white blood cell called the neutrophil. The study was especially interested in neutrophil extracellular trap (NET) formation, also known as NETosis, and what it may mean for controlling inflammation.
The study found ginger consumption by healthy individuals makes their neutrophils more resistant to NETosis. This is important because NETs are microscopic spider web-like structures that propel inflammation and clotting, which contribute to many autoimmune diseases, including lupus, antiphospholipid syndrome and rheumatoid arthritis.
“There are a lot of diseases where neutrophils are abnormally overactive. We found that ginger can help to restrain NETosis, and this is important because it is a natural supplement that may be helpful to treat inflammation and symptoms for people with several different autoimmune diseases,” said senior co-author Kristen Demoruelle, MD, PhD, associate professor of medicine at the University of Colorado School of Medicine on the University of Colorado Anschutz Medical Campus.
In a clinical trial, the researchers found that daily intake of a ginger supplement for seven days (20 mg of gingerols/day) by healthy volunteers boosted a chemical inside the neutrophil called cAMP. These high levels of cAMP then inhibited NETosis in response to various disease-relevant stimuli.
Evidence of ginger’s anti-inflammatory properties
“Our research, for the first time, provides evidence for the biological mechanism that underlies ginger’s apparent anti-inflammatory properties in people,” said senior co-author Jason Knight, MD, PhD, associate professor in the Division of Rheumatology at the University of Michigan.
The researchers say that many people with inflammatory conditions are likely to ask their health care providers whether natural supplements could be helpful for them or they already take supplements, like ginger, to help manage symptoms. Unfortunately, the precise impact on disease is often unknown. The researchers hope that providing more evidence about ginger’s benefits, including the direct mechanism by which ginger impacts neutrophils, will encourage health care providers and patients to more strategically discuss whether taking ginger supplements as part of their treatment plan could be beneficial.
“There are not a lot of natural supplements, or prescription medications for that matter, that are known to fight overactive neutrophils. We, therefore, think ginger may have a real ability to complement treatment programs that are already underway. The goal is to be more strategic and personalized in terms of helping to relieve people’s symptoms,” Knight adds.
As a next step, the researchers hope to use this study to unlock funding for clinical trials of ginger in patients with autoimmune and inflammatory diseases where neutrophils are overactive, such as lupus, rheumatoid arthritis, antiphospholipid syndrome and even COVID-19. | Disease Research |
Vice President Kamala Harris speaks at a memorial service for Ruth Whitfield, a victim of the Buffalo supermarket shooting, at Mt. Olive Baptist Church, Saturday, May 28, 2022, in Buffalo, N.Y. (AP Photo/Patrick Semansky) Vice President Harris is slated to meet with privacy, constitutional law, and technology experts to discuss what is at stake if the landmark Roe v. Wade abortion ruling is overturned by the Supreme Court. A White House official said the discussion on Tuesday will focus on real-world implications should the landmark ruling be overturned, touching on topics such as privacy, contraception, and in vitro fertilization. Participants in the latest meeting include the New York University (NYU) School of Law professors Peggy Cooper Davis and Melissa Murray, Harvard Law School professor Glenn Cohen, UC Irvine School of Law professor Michele Bratcher Goodwin, University of Michigan Law School professor Leah Litman. The Brennan Center for Justice and Ms. Magazine’s Jennifer Weiss-Wolf will also participate in the meeting with Harris. “The Vice President has spent her career fighting for women, and as Vice President, she has continued to be a forceful advocate of protecting women’s reproductive rights, and the right to privacy,” the White House said in a statement. “Over the last several weeks, the Vice President has convened faith leaders and health care providers to hear about what their communities are experiencing and to discuss how to chart the path forward.” “Tomorrow’s engagement is a continuation of the Vice President’s work convening a broad coalition to protect the health, safety, and wellbeing of women,” the statement added. The White House has been quietly preparing for a Supreme Court ruling overturning Roe v. Wade, a consequential decision expected to come this month that will create immediate pressure to respond following the leak of a draft opinion in early May that showed a majority of justices had voted in favor of banning abortion on the federal level. Harris has slammed the possibility of overturning the landmark ruling, adding that women’s rights are at stake. “Roe v. Wade in its power has protected a woman’s right, her right to make decisions about her own body for nearly half a century,” Harris said during a speech last month. “If the court overturns Roe v. Wade, it will be a direct assault on freedom, on the fundamental right to self-determination to which all Americans are entitled.” | Women’s Health |
When is imposing a pre-flight Covid test requirement on travellers from China against medical advice not a breach of a commitment to follow that advice? When it’s done out of an “abundance of caution”, enough other countries are doing it and it might help squeeze China for more information about its Covid outbreak, apparently.Those were the explanations the health minister, Mark Butler, offered throughout the week.Although the requirement itself for a negative Covid test in the 48 hours prior to departure may not be onerous, it was still a surprise to see such a break from the “follow the medical advice” mantra of the first two years of the pandemic. Sign up for a weekly email featuring our best reads To understand how we got here, perhaps it’s best if we start with the government’s messaging last week, when the chief medical officer, Paul Kelly, publicly observed there was no need for pre-flight tests because Australia already had the variant circulating in China.On Thursday 29 December, the prime minister, Anthony Albanese, told ABC News Breakfast the government would “take the appropriate advice from the health experts and follow that advice”.It sounded pretty definitive, but he added: “Our priority is to keep Australians as safe as possible.”Butler then announced on Sunday that Australia would impose pre-flight tests, leading some stakeholders, including Universities Australia and the Tourism and Transport Forum, to back the government, apparently on the assumption this is what advice recommended.In fact, in the advice written on 31 December and published after Butler’s press conference, Kelly said that he did “not believe that there is sufficient public health rationale” for any additional requirements, labelling any restriction on travel from China “disproportionate to the risk”.Butler’s justification was that pre-flight tests were being imposed “out of an abundance of caution”, essentially arguing that it was above and beyond what was recommended.The problem with Butler’s “abundance of caution” and Albanese’s keeping “as safe as possible” is that many public health experts, including Prof Julie Leask and the Australian Medical Association, noted we don’t seem to be taking the same approach with our own outbreak in Australia.After two years of harsh policies including border closures and lockdowns gave Australia world-beating health results, 2022 was the deadliest year, with more than 14,000 Covid deaths.The seven-day average for deaths per day is currently 21 and that’s mid-summer in Australia.While almost nobody is calling for a return to the most restrictive policies, the AMA president, Steve Robson, called for a “comprehensive strategy” – which could include better ventilation and measures like mask-wearing on public transport – rather than what appears to be “a series of political responses”.The pre-flight testing regime seemed to be full of political risks for the government, including criticism from the opposition for abandoning advice and imperilling the fragile relationship with China.But the government has calculated that the risk is actually very low.As one Labor MP told Guardian Australia, there’s more pressure from constituents “to screen Chinese travellers” than there is not to discriminate against China.Australia was acting in step with the rest of the world, unlike Scott Morrison’s aggressive call for the World Health Organization to gain weapons-inspector-style powers to investigate the source of outbreaks.And China itself requires pre-flight tests, so when it huffed and puffed about reciprocal countermeasures, Butler could honestly say Australia is asking no more of our arrivals than China does of theirs.Outrage about the medical advice prompted the second Butler press conference, in which he praised his own transparency for having released it.He continued to put a significant gloss on the advice by stating he had “accepted every positive recommendation” in it, measures to improve surveillance like wastewater testing.Then, the real reason: “I’ve asked my department to reach out to their equivalents in China, to stress our view that it would be valuable for information to be shared more comprehensively by China not just with Australia but with the rest of the world.“Real-time uploading of their genomic sequencing of Covid cases – this is what governments, including Australia, are calling for. This is why we’ve put in place these modest, sensible measures out of an abundance of caution.”It’s good we now know why we’re testing travellers from China, but the government could be clearer on whether there’s any more we could be doing to deal with Covid at home. | Epidemics & Outbreaks |
Earlier this month, a group of 17 House Republicans released several ideas for modernizing the healthcare system, improving access to care, and lowering costs. One of the proposals — safeguarding expanded access to telehealth — could help achieve all three of those goals. Lawmakers would do well to relax permanently the telehealth restrictions that were temporarily waived during the pandemic. Those waivers have eliminated onerous barriers to virtual care. For example, Medicare beneficiaries no longer have to travel to a designated healthcare facility just to connect with their physician online. Waivers have also allowed patients in many states to schedule virtual appointments with doctors licensed in other states. As a result, telemedicine has exploded. According to a recent report from Doximity, a social network for medical professionals, nearly 70% of patients had at least one telehealth visit last year — compared with just one-quarter of patients before the pandemic. But future access to virtual care is far from guaranteed. Many pandemic-era telehealth waivers could run out after the expiration of the federal public health emergency, which could happen later this year. It would be a mistake to let virtual care flexibility lapse. Telehealth makes it easier for patients — especially those in rural areas — to get care. In a recent survey from the American Medical Association, more than 80% of physicians reported their patients had better access to care since they began using telehealth. Telemedicine also saves patients money. A new report from Cigna found that a virtual urgent-care appointment costs $141 less than an in-person one. Telehealth expansion is a commonsense reform that would greatly benefit patients. Lawmakers would be wise to start listening to their 17 colleagues.
Sally C. Pipes is president, CEO, and Thomas W. Smith fellow in Health Care Policy at the Pacific Research Institute. Her latest book is
False Premise, False Promise: The Disastrous Reality of Medicare for All (Encounter 2020)
. Follow her on Twitter @sallypipes. | Health Policy |
Scientists Moungi Bawendi, Louis Brus and Alexei Ekimov won the 2023 Nobel Prize in Chemistry for "the discovery and synthesis of quantum dots," which illuminate computer monitors and television screens and are used by doctors to map tumors.
"The Nobel Laureates ... have succeeded in producing particles so small that their properties are determined by quantum phenomena. The particles, which are called quantum dots, are now of great importance in nanotechnology," the Nobel Committee for Chemistry said in a statement.
"Researchers believe that in the future they could contribute to flexible electronics, tiny sensors, thinner solar cells and encrypted quantum communication."
Nanoparticles and quantum dots are used in LED-lights and can also be used to guide surgeons while removing cancer tissue.
The more than century-old prize is awarded by the Royal Swedish Academy of Sciences and is worth 11 million Swedish crowns ($997,959).
Earlier on Wednesday, the academy appeared to have inadvertently published the names of the three scientists it said had won this year's Nobel Prize in chemistry.
Bawendi is a professor at the Massachusetts Institute of Technology (MIT), Brus is professor emeritus at Columbia University and Ekimov works for Nanocrystals Technology Inc.
Brus was hired by AT&T Bell Labs in 1972 where he spent 23 years, devoting much of the time to studying nanocrystals.
Bawendi was born in Paris and grew up in France, Tunisia, and the U.S. Bawendi did his postdoctoral research under Brus then joined MIT in 1990 and became professor in 1996.
Ekimov was born in the Soviet Union worked for the Vavilov State Optical Institute before moving to the United States. In 1999, Ekimov was named chief scientist at Nanocrystals Technology Inc.
The third of this year's crop of awards, the chemistry Nobel follows those for medicine and physics announced earlier this week.
Established in the will of Swedish dynamite inventor and chemist Alfred Nobel, the prizes for achievements in science, literature and peace have been awarded since 1901 with a few interruptions, primarily due to the world wars.
The economics prize is a later addition funded by the Swedish central bank.
While the chemistry awards are sometimes overshadowed by the physics prize and its famous winners such as Albert Einstein, chemistry laureates include many scientific greats, including radioactivity pioneer Ernest Rutherford and Marie Curie, who also won the physics prize.
Last year's chemistry award went to scientists Carolyn Bertozzi, Morten Meldal and Barry Sharpless for pioneering work in "click chemistry," discovering reactions that let molecules snap together to create new compounds. | Medical Innovations |
Britain’s workforce is unwell. Latest figures from the Office for National Statistics (ONS) show an estimated 185.6 million working days were lost because of sickness or injury in 2022.
And the number of people off work due to long-term sickness has risen to another all-time high, at 2.5 million, over the three months to February this year. The sickness absence rate for those with long-term health conditions is at its highest point since 2008, the figures also show, at 4.9 per cent.
Earlier this week, an employment tribunal in Berkshire dismissed one extreme case: Ian Clifford, a senior IT worker on sick leave since 2008, had tried to sue IBM for discrimination because he hadn’t been given a pay rise in the 15 years he has been unable to work.
Clifford, 50, was initially signed off work on mental health grounds and was later diagnosed with stage four leukaemia, in 2012, and has been unable to work since. His story may be unusual but elements of it are not unusual.
The country’s mental health crisis has been steadily rising over the past two decades, but the past three years have seen a rapid escalation of the problem.
In the year before the pandemic, just 11 per cent of young adults and 10 per cent of middle-aged people showed signs of depressive symptoms, according to the Office for National Statistics.
Two years later this had jumped to 23 per cent and 15 per cent alike.
By the end of the 2022, just a third of the people said they had very low levels of anxiety – a proportion not seen since the height of the pandemic or the worst months of the Great Recession.
As with any health crisis, the impacts have very quickly trickled into the economy, creating an exodus of employees from the workforce. At the end of 2019, around 555,000 people were economically inactive to long-term mental health problems. Less than three years later, this number had risen by 80,000 – equivalent to almost one in 70 working-age adults.
Almost all industries have been impacted by the change.
In the retail sector, an additional 15,300 people are no longer working due to mental health problems compared with 2017, figures from the Labour Force Survey shows.
This means that around 50,000 people who previously worked in the sector no longer do, a figure which has even more urgency when put in the context of a workforce with 142,000 vacancies nationwide. Similar increases have been seen across the transport, hospitality and business sectors. Putting a figure on quite how much this costs the economy is difficult, but a few organisations have given it a shot.
Most recently, accountancy firm Deloitte estimated that the startling rise in staff turnover and absences since the start of the pandemic had driven up the cost to employers from mental health by 25 per cent. In the 2020-21 financial year, they estimated that businesses were losing £56 billion a year compared with £45 billion in 2019.
Of the employees who left or were planning to, almost two-thirds told the survey it was due to problems with mental health.
The issue is exacerbated by the fact the public sector, at a time of severe backlogs, is most acutely affected by mental health problems.
Sickness absences are 50 per cent higher amongst public sector workers and are twice as likely to be linked to mental health problems, figures for the Office for National Statistics show.
The health service is symbolic of the issue. In November 2022, one in 75 working days was lost amongst nurses due to stress or psychological problems, up from over one in 100 in 2015.
For ambulance staff, the figure increases to one in 60 days.
Where five years ago, just 18 per cent of former health and social care workers cited mental health as the illness forcing them into economic inactivity, today the figure is 28 per cent.
That’s equivalent to 20,000 additional people out of the workplace due to their mental health.
At the heart of this is a key public service still reeling from the pressures of Covid against the backdrop of decreasing real wages and staffing shortages.
Outside of hospitals, pressures appear to be impacting a variety of public services.
Last year, civil servant “mental health days” increased by 38 per cent. Across policing, the Police Federation reported a 57 per cent increase in absences due to stress, depression or PTSD. Surveys across teaching show similar growth across the past few years.
With a growing proportion of the people out of work due to mental health, the welfare bill will become increasingly expensive.
Nationally, the number of people claiming welfare benefits for mental health reasons has eclipsed those for more physical ailments.
In October 2021, 310,00 people were eligible for the main mental health benefit, with the most serious cases eligible for upwards of £3,700 a year. This was up from just 205,000 before the pandemic.
Then there are the increased services needed to treat people or the costs incurred by unpaid carers who support family and loved ones.
In the most comprehensive study of its kind, the London School of Economics produced a number combining all these factors, including lost economic productivity.
Each year, it conservatively put the number at £117 billion – a figure greater than the education, policing, prisons and foreign development budget combined.
What can be done?
Almost any public health emergency is best dealt with pre-emptively.
In this case, that likely means the continued growth of the country’s free-to-use mental health services.
Last year, over 1.2 million people accessed the NHS’s talking therapies, for example, up from just 400,000 a decade ago. And the NHS has committed to increasing mental health funding at the same rate as that for physical ailments.
But Deloitte points out that, for businesses’ own posterity, much of the work will need to be done at a hyperlocal level.
The most important finding? For every pound invested in every pound of proactive mental health support, a company can make five pounds on that investment.
For a country struggling with the fallout from Covid and anxiety-inducing financial crisis, this might be a good place to start. | Mental Health Treatments |
Matt Hancock “punished” the people of Manchester with the most severe Covid restrictions during the pandemic because of a political row over furlough cash, the city region’s Mayor, Andy Burnham, said today.
Mr Burnham told the Covid inquiry it was “nothing short of disgraceful” that the former health secretary chose to impose Tier 3 restrictions on Greater Manchester in October 2020 despite being told it “would not work”.
“It makes me angry on behalf of the people of Greater Manchester that [ministers] sat in that room and they imposed a policy that they had been advised by Sage and others would not work,” he said.
It came as regional mayors expressed their anger at being locked out of key discussions and political decision-making during the pandemic.
Sadiq Khan, the Mayor of London, said “his”lives would have been saved” if he had been allowed to Cobra meetings at the beginning of the pandemic.
“I think there was bad faith on the part of some members of the government,” the Labour mayor told the hearing.
“I could have pointed out some of the reasons why community transmission was going to accelerate in London,” he said.
Meanwhile, Mr Burnham said Mr Hancock’s written testimony to the inquiry was “unbelievable” and that he had “only now” realised the former health secretary knowingly imposed ineffective restrictions on Manchester.
Quoting from written evidence from Mr Hancock, Mr Burnham said: “He says in his evidence about Tier 3, ‘I was in despair that we had announced a policy that we knew would not work.’”
“It’s unbelievable for me now to look at evidence saying they knew it didn’t work, they knew Tier 3 didn’t work,” he said.
Mr Burnham accused the Government of dealing a “punishment beating” for the city in late 2020 while imposing lighter restrictions on regions like Lancashire, because Manchester’s leaders had demanded better furlough pay.
“Because we stood up for people in our city region who would have otherwise really struggled… because we took that stand they decided to make an example of us,” he told the inquiry.
Manchester was hit with the highest level Tier 3 restrictions in October 2020, but the move was delayed following a row between Mr Burnham and No 10. Then-chancellor Rishi Sunak had promised to pay two thirds of the salaries of staff who were unable to work under a Tier 3 lockdown, but Mr Burnham had pushed for 80 per cent pay.
Mr Hancock will give evidence later this week.
The Tier 3 measures meant the closure of pubs that did not serve meals and a ban on mixing indoors, prompting Mr Burnham to accuse former prime minister Boris Johnson of playing “poker with people’s lives”.
Minutes from a Covid-O committee – a committee responsible for the Government’s operational response to the crisis at the time – showed ministers referred to Mr Burnham’s behaviour as “appalling” and “obstructive”.
He dismissed the claims, telling the inquiry it was Government ministers who were “behaving appallingly” as they locked regional leaders out of discussions.
The inquiry also heard that Manchester leaders were not consulted on the decision to launch a testing centre at Manchester Airport, which Mr Burnham claimed was difficult to access for many people in the region.
Other regional mayors echoed claims they were shut out from key political decisions during the pandemic. Steve Rotheram, the Liverpool Metro Mayor, told the Covid inquiry he often learned about restrictions affecting his city in the news.
Mr Khan also said it quickly became apparent to him that Covid was being experienced unequally by certain minority ethnic groups.
He said: “If you see the photographs of the first 10 doctors who lost their lives, I think what strikes you is that they’re all people of colour.”
He added that he would write to the families of transport workers who lost their lives, and noticed that the names he was writing “were all ethnic minority names”.
“The phrase I used at the time was: we’re all facing the same storm, but people are in different size boats.” | Epidemics & Outbreaks |
Brain injury patients are getting trapped in the system: How to help
My team sees plenty of familiar faces at our neurosurgery inpatient service. We note them dejectedly during daily rounds. These patients stay in the hospital for months, occasionally years. Some celebrate multiple birthdays in our facility.
They’re no longer actively sick and in need of daily medical interventions — they simply have no place else to go. One main culprit is the structure of Medicaid.
After suffering traumatic brain injuries, many patients are left permanently cognitively impaired, requiring lifetime assistance with daily activities and permanent round-the-clock caregiving. Even for wealthy individuals, it’s a strain on finances and families.
Thus, they can’t be discharged, lingering in medical limbo too healthy to need acute hospitalization yet too disabled to go home. They occupy acute-care beds while patients needing urgent attention pile up in ER hallways or have surgeries canceled because the hospital is full. Acute care nurses are asked to assist these patients with meals, hygiene and supervision, exacerbating nursing shortages.
This is because post-acute care options for patients who cannot discharge home are few. Inpatient rehab facilities can help patients cope with new disabilities but are temporary. Rehab facilities won’t take a patient if there’s no eventual location to discharge to. Thus, patients with few social supports typically need a skilled nursing facility.
How does one finance a lifetime of care?
Medicare and private health insurance typically fund short-term rehab or nursing facility stays, not long-term care, which is funded by private assets, private long-term care insurance or Medicaid. Since most individuals lack the necessary assets or private insurance, Medicaid funds most long-term care. These Medicaid benefits — encompassing post-acute care, nursing homes and home-based community support services — are collectively known as long-term services and supports. Collectively, long-term services and supports take up nearly one-third of Medicaid spending.
States have much leeway in structuring Medicaid. One major variation is offering fee-for-service versus third-party managed care organizations. In fee-for-service, doctors or hospitals submit bills directly to state Medicaid offices for services rendered and get paid their fees. In managed care organization models, private entities receive monthly sums per enrollee, provide care for all enrollees from that pool of funds and keep the balance (or are on the hook for the loss).
States may offer beneficiaries either one or a combination of the two models. Complicating matters, some services might be in one model with others carved out into the other. When long-term services and supports are in a fee-for-service model, this can lead to the disastrous situation traumatic brain injury patients face.
Medicaid fee-for-service typically reimburses at or below cost for skilled nursing facility services. With too many Medicaid patients, a skilled nursing facility can’t pay its staff. A nursing facility can’t be forced to accept patients just because a hospital is overcrowded. A hospital may want a bed freed up but has no recourse. However, when a managed care organization is responsible for all costs associated with a patient’s care, it’s motivated to get the patient out of unnecessary acute care and into post-acute care.
Utilizing managed care puts these incentives to work on the problem. To protect costs, managed care organizations have contracts in both skilled nursing facilities and rehab facilities. Multiple options for medially stabilized patients mean better outcomes. As long as the managed-care market is competitive and patient choice prevails (unfortunately not always the case), they must ensure quality. A reputation for using subpar providers means fewer enrollees.
Ideally, more Americans would already have private long-term care insurance. Medicaid is meant as a safety net for the disabled and destitute, not as the default payer for long-term care. When a patient reaches their private or Medicare coverage limit, they’re left having to use private assets to pay for continued care. They can deplete these assets to “spend down” and qualify for Medicaid, but many protect assets in trusts or property, qualifying while still holding substantial wealth.
State Medicaid agencies should recover these assets more aggressively, reserving Medicaid for the poor. This would encourage broader uptake of private long-term care insurance while leaving Medicaid with more funding for long-term services and supports. This, combined with greater managed care organization long-term service and supports coverage, would increase overall access to post-acute and long-term care services for the old and the young and the temporarily disabled.
More access to post-acute care means more medically stable patients discharged and fewer lingering for months waiting for skilled nursing facility beds. This would free up hospital resources, allowing nurses and doctors to focus on acute patients.
It would improve morale and patient care. I know our clinical team would appreciate it.
Anthony DiGiorgio, DO, MHA, is a neurosurgeon, assistant professor at the University of California, San Francisco School of Medicine, senior affiliated scholar with the Mercatus Center at George Mason University, and the author of a new study, “Traumatic Brain Injury: A Case Study in Failed Incentives to Address the Needs of Medicaid Patients in California.” He is also affiliated faculty at the Institute for Health Policy Studies at UCSF.
Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. | Health Policy |
As cold and flu season gets underway this fall, Fox News Digital reached out to and spoke with a number of health professionals for their advice on natural remedies to consider when a person comes down with either of these illnesses.
Here are their recommendations, advice and insight.
As always, it's wise to check with your physician or health care provider if you have any questions or concerns about your health or symptoms you might be experiencing, as everyone's situation is different.
Here are 10 ideas to consider.
1. Vitamin C
Those who feel that they're coming down with something might look to take vitamin supplements, particularly vitamin C and vitamin D3, experts suggested.
Vitamin C is found in citrus fruits and is also available in supplement form, Dr. Naval Parikh, chief of medicine at Broward Health North, a Level 2 Trauma Center in South Florida, told Fox News Digital.
An ill person should take "at least 1000 mg daily" of vitamin C, he said.
Vitamin C contains antioxidants, which "protect our cells from damaging substances called free radicals," said Dr. Summer Kerley, a North Carolina-based vice president of clinical operations and health plan solutions at Rite Aid.
Still, be careful about the amounts taken.
"Serious side effects from too much vitamin C are very rare, because the body cannot store the vitamin," according to the website of the Mount Sinai Health Network system in New York. "However, amounts greater than 2,000 mg/day are not recommended. Doses this high can lead to stomach upset and diarrhea, and rarely, kidney stones."
Also, "large doses of vitamin C supplementation are not recommended during pregnancy."
2. Vitamin D3
Kerley of North Carolina also recommended vitamin D3. It "serves as a great dose of daily sunshine, and has been known to help support the immune system in fighting off viruses," she said.
Too much of it can also prove harmful.
"The main consequence of vitamin D toxicity is a buildup of calcium in your blood (hypercalcemia), which can cause nausea and vomiting, weakness and frequent urination," according to the Mayo Clinic. "Vitamin D toxicity might progress to bone pain and kidney problems, such as the formation of calcium stones."
3. Zinc
An essential mineral, zinc is another natural remedy that has proven successful in treating cold symptoms.
Zinc is "important for immune cell function, which supports the body's defense against infection," said Kerley. "Supplementing with zinc may help support a healthy immune system."
A person can take zinc supplements or use a product such as Zicam.
"Take zinc supplements within the first three days of the onset of symptoms," said Parikh.
Be sure to follow instructions carefully, however.
The overuse of zinc sprays has "been associated with a permanent loss of smell," said Dr. Benjamin Jack, an emergency physician and founder of the Texas-based company Duration Health.
4. Honey
"Honey has been found to be effective in reducing coughs in both adults and children," said Jack.
He stressed that "it’s important to remember that honey should not be given to infants under one year old" — as it could cause infant botulism.
5. Elderberries
Elderberries, a medicinal plant, have been taken for years to treat cold and flu symptoms as well as to strengthen the immune system.
"Rich in antioxidants, elderberry may support immune function and reduce symptoms of upper respiratory infections," said Kerley.
6. Chicken soup
A study by the University of Nebraska Medical Center (UNMC) in the 1990s found that chicken soup is actually an effective treatment for colds.
The peer-reviewed study was first published in 1993 — and again in 2000.
Stephen Rennard, M.D., put his wife's grandmother's chicken soup recipe to the test in a laboratory — and found that "there are ingredients in common foodstuffs that might have anti-inflammatory actions."
Parikh also spoke highly of a vegetarian cold remedy he was given as a child when he was sick.
"An old natural Indian remedy that is given [is made] of warm water, salt, turmeric and ghee," he said. Ghee is a clarified butter.
"My mother gave this to me as a child and I still use it when I have cold or flu-like symptoms," he added. "It helps relieve chest congestion, soothe a sore throat and relieve my cough."
7. Saline sprays
"Saline nasal sprays are a safe and simple solution" to help address congestion, said Jack.
"They are effective and usually don't have the side effects associated with medicated sprays," the doctor also said.
8. Hot shower
"A hot steamy shower" can do wonders to relieve congestion and make a cold or flu much less miserable, said Parikh.
Vicks Vapo-rub is also effective in reducing cough, he added.
9. Healthy eating
"The best way to strengthen your immune system is to eat a well-balanced, nutrient-rich diet" before getting sick, said Kerley.
This should include "plenty of foods with vitamin C, like broccoli, oranges or cantaloupe."
"Antioxidant-rich, colorful fruits and vegetables, such as berries, carrots and spinach, help support immunity by protecting your body from harmful compounds called free radicals," she said.
"Try to avoid processed foods and excess sugars," and "stay hydrated with plenty of water and other sugar- and caffeine-free beverages."
Tea, as well, can serve as an anti-inflammatory, said Parikh.
10. Good night's sleep
The importance of a good night's sleep and resting when ill cannot be understated, several doctors told Fox News Digital.
"Adults need at least seven to eight hours of quality sleep each night. It is our body’s time to regenerate new cells and acquire the energy needed to fight off infection. Sleep deprivation can decrease immune function," said Kerley.
Those who have trouble falling asleep could try an essential oil, such as lavender oil, to help aid sleep, she said.
Also, "physical exertion is bad for the immune system when sick," said Parikh.
"Get plenty of rest and sleep." | Epidemics & Outbreaks |
UnitedHealthcare, the largest health insurance company in the US, is allegedly using a deeply flawed AI algorithm to override doctors' judgments and wrongfully deny critical health coverage to elderly patients. This has resulted in patients being kicked out of rehabilitation programs and care facilities far too early, forcing them to drain their life savings to obtain needed care that should be covered under their government-funded Medicare Advantage Plan.
That's all according to a lawsuit filed this week in the US District Court for the District of Minnesota. The lawsuit is brought by the estates of two deceased people who were denied health coverage by UnitedHealth. The suit also seeks class-action status for similarly situated people, of which there may be tens of thousands across the country.
The lawsuit lands alongside an investigation by Stat News that largely backs the lawsuit's claims. The investigation's findings stem from internal documents and communications the outlet obtained, as well as interviews with former employees of NaviHealth, the UnitedHealth subsidiary that developed the AI algorithm called nH Predict.
"By the end of my time at NaviHealth I realized: I'm not an advocate, I'm just a moneymaker for this company," Amber Lynch, an occupational therapist and former NaviHealth case manager, told Stat. "It's all about money and data points," she added. 'It takes the dignity out of the patient, and I hated that."
AI-based denials
According to the lawsuit, UnitedHealth started using nH Predict in at least November 2019, and it is still in use. The algorithm estimates how much post-acute care a patient on a Medicare Advantage Plan will need after an acute injury, illness, or event, like a fall or a stroke. Post-acute care can include things like therapy and skilled care from home health agencies, skilled nursing homes, and inpatient rehabilitation centers.
It's unclear how nH Predict works exactly, but it reportedly estimates post-acute care by pulling information from a database containing medical cases from 6 million patients. NaviHealth case managers plug in certain information about a given patient—including age, living situation, and physical functions—and the AI algorithm spits out estimates based on similar patients in the database. The algorithm estimates medical needs, length of stay, and discharge date.
But Lynch noted to Stat that the algorithm doesn't account for many relevant factors in a patient's health and recovery time, including comorbidities and things that occur during stays, like if they develop pneumonia while in the hospital or catch COVID-19 in a nursing home.
According to the Stat investigation and the lawsuit, the estimates are often draconian. For instance, on a Medicare Advantage Plan, patients who stay in a hospital for three days are typically entitled to up to 100 days of covered care in a nursing home. But with nH Predict, patients rarely stay in nursing homes for more than 14 days before receiving payment denials from UnitedHealth.
When patients or their doctors have requested to see nH Predict's reports, UnitedHealth has denied their requests, telling them the information is proprietary, according to the lawsuit. And, when prescribing physicians disagree with UnitedHealth's determination of how much post-acute care their patients need, their judgments are overridden.
Favorable failings
The use of faulty AI is not new for the health care industry. While AI chatbots and image generators are currently grabbing headlines and causing alarm, the health care industry in the US has a longer record of problematic AI use, including establishing algorithmic racial bias in patient care. But, what sets this situation apart is that the dubious estimates nH Predict spits out seem to be a feature, not a bug, for UnitedHealth.
Since UnitedHealth acquired NaviHealth in 2020, former employees told Stat that the company's focus shifted from patient advocacy to performance metrics and keeping post-acute care as short and lean as possible. Various statements by UnitedHealth executives echoed this shift, Stat noted. In particular, the UnitedHealth executive overseeing NaviHealth, Patrick Conway, was quoted in a company podcast saying: "If [people] go to a nursing home, how do we get them out as soon as possible?" | Health Policy |
COVID-19 raises anxiety at start of new school year
COVID-19 cases are on the rise and raising anxiety around the possibility that schools could implement mask mandates or close down again.
But few schools have taken those steps so far, and superintendents contend that without national guidance it is highly unlikely we’ll see a return of mass closures or mask mandates.
In the post-emergency era of COVID-19, schools no longer have the comprehensive surveillance data that was readily available during the pandemic, though some local data remains available to inform their decision-making.
And without specific guidance, decisions on COVID mitigation measures are largely up to school district leaders, in cooperation with local health authorities and in consultation with the community.
“Superintendents will not make these calls in isolation,” said George Roberts, a Maryland superintendent. “What they did do during COVID and what they’re currently doing now — and I suspect will continue to do as we get into the fall and winter season — is work in conjunction with their own internal health office” in the county or city.
A common refrain from health experts with the end of the pandemic is that people should use viral mitigation methods based on their own degree of risk tolerance. With government actions unlikely to occur now, the same can be said for schools.
“Schools need to have a latitude to help protect their staff and their students,” said Sterling Ranson, family physician and board chair of the American Academy of Family Physicians.
“They can contact their health department, they can contact their family physicians and they can respond more rapidly to potential emerging respiratory diseases that are in their community,” Ransone said.
In the current situation, schools are focusing on the COVID-19 mitigation tactics they’ve had in place since mask mandates dropped, such as emphasizing hygiene and making sure anyone who contracted COVID-19 stays home for at least five days.
Ranson lamented that school administrators may find themselves in a “can’t win” position this year as they precariously balance the health needs of their students and staff with politicized blowback if they do take concerted action against viral spread.
School closures and mask mandates became an explosive issue in school board meetings and have been the topic of multiple congressional hearings as student learning plummeted during the pandemic.
The last test scores released by the National Assessment of Educational Progress (NAEP) in June showed average scores for 13-year-olds in mathematics are their lowest point since 1990 and reading shot down to levels seen in 2004.
PJ Caposey, superintendent of the Meridian School District, said he is “terrified” of the prospect at discussions to implement mask mandates or school closures again.
“’I’m terrified of what may happen and that people, on either end of the political spectrum, wouldn’t respond to data and information and respond to their political ideology,” said Caposey.
Despite the difficulties that can come with making the decisions, most superintendents likely prefer having local control.
“I would definitely think people are happy they have the autonomy to make that decision, absolutely,” said Ronnie Harvey Jr, an administrative director of special education at a school district in Louisiana.
Harvey compared the public health approach to how schools cater instruction to the learning needs of different students.
“I think when you do the blanket approach it is just like when we deliver instruction from a district personnel. When we push out some type of mandate for the district, we do focus on individualized instruction,” he said.
The majority of school districts in the U.S. have already started the academic year, meaning students are returning to classrooms without yet having the protection offered by the bevy of new preventive treatments.
Young children this year can benefit from preventives against RSV, a common daycare disease that surged in children last year. The antibody for infants and toddlers is expected to roll out in time for this year’s RSV season, which typically starts in the fall and peaks during winter.
The updated COVID-19 vaccines and are anticipated to become available by the end of September, less than ideal when cases and hospitalizations are on the rise.
Those in the healthcare sphere had hoped these products could have been made available sooner, but also acknowledge the need for a proper review to be conducted before sending them onto the market.
The Advisory Committee on Immunization Practices for the Centers for Disease Control and Prevention (CDC) is scheduled to hold a meeting on the COVID-19 vaccines Sept. 12. Vaccine manufacturers have said they are prepared to roll out shots as soon as approval is granted.
When the federal public health emergency ended, reporting requirements on case rates went away as well. Much of what can be gleaned on viral spread is dependent on hospital admissions and wastewater detection. The current data hints at viral spread potentially becoming worse.
Hospital admissions rates have been rising since July though deaths have not risen to the same degree and early data suggests they may have even declined in recent weeks. Without case data, community COVID levels and their related recommendations are based on hospital admissions.
A few weeks ago, there were no U.S. counties with high COVID-19 hospital admission rates — meaning more than 20 admissions per 100,000 people. There are now seven in Texas and along the border of Mississippi and Alabama.
The vast majority of the country — 96.15 percent — still has low admissions rates, according to CDC data. The number of counties with high admissions account for less than half of one percent of counties.
And though a few districts have reacted similarly to how schools responded to COVID in 2020, the U.S. is far more equipped now than it was then. Testing and antivirals are readily available. Updated vaccines are on the way and almost everyone has some degree of antibody protection from prior infection or immunization.
“I always have concern, but I would just say that, overall, I know that my concern level as of today … is no different than it’s been at any point in the last 15 months,” said Caposey.
Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. | Epidemics & Outbreaks |
An inquest into the death of a head teacher has heard how she felt "powerless" after her school was inspected by Ofsted.
Ruth Perry told her husband Jonathan she believed her career could be over, on the first day of the inspection at Caversham Primary in November 2022.
Mrs Perry, who had been head teacher for 13 years, took her own life in January while awaiting Ofsted's report.
Ofsted downgraded the school to inadequate after the visit.
Mr Perry said his wife was "understandably anxious" when she got the call from Ofsted about the school inspection, but generally she seemed fine.
However, after the first day of the two-day inspection, Mr Perry said this changed.
"She was in a terrible state and couldn't be comforted," he said in a statement heard at the inquest into Mrs Perry's death.
"She was destroyed and humiliated."
Mrs Perry was reportedly "traumatised" by the inspection, and told her husband that the first meeting with the inspector has been "horrendous".
Mr Perry said his wife thought the lead inspector was a bully and she was left feeling "powerless".
Earlier in the inquest, a witness statement said that Alan Derry had a "mocking and unpleasant tone" and "sniggered loudly" in a meeting.
Mr Derry told the inquest in response: "I don't believe that to be correct. The body language and the snigger, I don't recognise that".
He added that he was "very mindful" of Mrs Perry's heightened state of anxiety and called the duty desk.
When asked whether he believed the inspection should have been stopped so Mrs Perry could seek professional help, Mr Derry said there were major safeguarding concerns around the safety of children.
He said Mrs Perry wanted to move forward and resolve the issues that had been found.
Mr Derry added that he was very aware of mental health issues after facing his own difficulties while a head teacher.
He said part of the reason he wanted to become a school inspector was so the process could be done in a "kind" way.
Claire Wilkins and Lewis Evans, the two inspectors who accompanied Mr Derry, told the inquest they agreed the inspection was "fast-paced" as there was a lot to fit into two days.
When asked if it was normal for head teachers to cry, Mr Evans said he had only been an inspector for a short time, but in his experience "there are tears more times than there aren't due to frustration, [or] happiness sometimes".
Ms Wilkins told the inquest she noticed Mrs Perry was upset during the final feedback meeting, and asked if she had someone at home to talk to.
She said Mrs Perry did not answer, but a colleague nodded.
'A tough cookie'
The inquest also heard that a few days after the inspection, Mrs Perry told Nicola Leroy, the school business manager, she had thought about taking her own life.
Mrs Leroy advised her to contact her GP immediately, and with Mrs Perry's permission contacted the local authority and the chair of governors.
Asked by the coroner whether she thought there was a link between the inspection and how Mrs Perry died, Mrs Leroy said "I believe there is yes".
Mrs Leroy said Mrs Perry had been quite well-known as a "tough cookie" who "stood her ground".
She said she had worked with Mrs Perry for nine years and it was a complete change to "the Ruth I had seen before".
Asked why she did not ask for the inspection to be paused, Mrs Leroy said by asking for a pause, she felt she would have put the whole inspection at risk and possibly made Mrs Perry feel undermined.
Senior coroner Heidi Connor said she was keen to weave Mrs Perry's voice into the inquest where possible, before reading a statement from her widower.
Mr Perry said they had "made a good team" and had recently bought his childhood home, which Ruth was excited about redecorating to make it their "forever home".
She had also put herself on the "waiting list for a nearby allotment".
As a head teacher, Mr Perry said she was "close to burn-out at times" but generally she was "resilient and positive" for a job and school "which she loved".
The coroner is expected to deliver her conclusions on 7 December.
If you're affected by the issues in this report, you can find support from the BBC Action Line | Mental Health Treatments |
Most of us know someone affected by hearing loss, but we may not fully appreciate how difficult the condition can be. Hearing loss can lead not only to frustration but also social isolation and tinnitus, a debilitating ringing in the ears. It is also closely correlated with dementia.
The biotechnology company Frequency Therapeutics is seeking to reverse hearing loss — not with hearing aids or implants, but with a new kind of regenerative therapy. The company uses small molecules to program progenitor cells, a descendant of stem cells in the inner ear, to create the tiny hair cells that allow us to hear.
Hair cells die off when exposed to loud noises or drugs including certain chemotherapies and antibiotics. Frequency’s drug candidate is designed to be injected into the ear to regenerate these cells within the cochlea. In clinical trials, the company has already improved people’s hearing as measured by tests of speech perception — the ability to understand speech and recognize words.
“Speech perception is the No. 1 goal for improving hearing and the No. 1 need we hear from patients,” says Frequency co-founder and Chief Scientific Officer Chris Loose PhD ’07.
In Frequency’s first clinical study, the company saw statistically significant improvements in speech perception in some participants after a single injection, with some responses lasting nearly two years.
The company has dosed more than 200 patients to date and has seen clinically meaningful improvements in speech perception in three separate clinical studies. Another study failed to show improvements in hearing compared to the placebo group, but the company attributes that result to flaws in the design of the trial.
Now Frequency is recruiting for a 124-person trial from which preliminary results should be available early next year.
The company’s founders, including Loose, MIT Institute Professor Robert Langer, CEO David Lucchino MBA ’06, Senior Vice President Will McLean PhD ’14, and Harvard-MIT Health Sciences and Technology affiliate faculty member Jeff Karp, are already gratified to have been able to help people improve their hearing through the trials. They also believe they’re making important contributions toward solving a problem that impacts more than 40 million people in the U.S. and hundreds of millions more around the world.
“Hearing is such an important sense; it connects people to their community and cultivates a sense of identity,” says Karp, who is also a professor of anesthesia at Brigham and Women’s Hospital. “I think the potential to restore hearing will have enormous impact on society.”
From the lab to patients
In 2005, Lucchino was an MBA student in the MIT Sloan School of Management and Loose was a PhD candidate in chemical engineering at MIT. Langer introduced the two aspiring entrepreneurs, and they started working on what would become Semprus BioSciences, a medical device company that won the MIT $100K Entrepreneurship Competition and later sold at a deal valued at up to $80 million.
“MIT has such a wonderful environment of people interested in new ventures that come from different backgrounds, so we’re able to assemble teams of people with diverse skills quickly,” Loose says.
Eight years after playing matchmaker for Lucchino and Loose, Langer began working with Karp to study the lining of the human gut, which regenerates itself almost every day.
With MIT postdoc Xiaolei Yin, who is now a scientific advisor to Frequency, the researchers discovered that the same molecules that control the gut’s stem cells are also used by a close descendant of stem cells called progenitor cells. Like stem cells, progenitor cells can turn into more specialized cells in the body.
“Every time we make an advance, we take a step back and ask how this could be even bigger,” Karp says. “It’s easy to be incremental, but how do we take what we learned and make a massive difference?”
Progenitor cells reside in the inner ear and generate hair cells when humans are in utero, but they become dormant before birth and never again turn into more specialized cells such as the hair cells of the cochlea. Humans are born with about 15,000 hair cells in each cochlea. Such cells die over time and never regenerate.
In 2012, the research team was able to use small molecules to turn progenitor cells into thousands of hair cells in the lab. Karp says no one had ever produced such a large number of hair cells before. He still remembers looking at the results while visiting his family, including his father, who wears a hearing aid.
“I looked at them and said, ‘I think we have a breakthrough,’” Karp says. “That’s the first and only time I’ve used that phrase.”
The advance was enough for Langer to play matchmaker again and bring Loose and Lucchino into the fold to start Frequency Therapeutics.
The founders believe their approach — injecting small molecules into the inner ear to turn progenitor cells into more specialized cells — offers advantages over gene therapies, which may rely on extracting a patient’s cells, programming them in a lab, and then delivering them to the right area.
“Tissues throughout your body contain progenitor cells, so we see a huge range of applications,” Loose says. “We believe this is the future of regenerative medicine.”
Advancing regenerative medicine
Frequency’s founders have been thrilled to watch their lab work mature into an impactful drug candidate in clinical trials.
“Some of these people [in the trials] couldn’t hear for 30 years, and for the first time they said they could go into a crowded restaurant and hear what their children were saying,” Langer says. “It’s so meaningful to them. Obviously more needs to be done, but just the fact that you can help a small group of people is really impressive to me.”
Karp believes Frequency’s work will advance researchers’ ability to manipulate progenitor cells and lead to new treatments down the line.
“I wouldn't be surprised if in 10 or 15 years, because of the resources being put into this space and the incredible science being done, we can get to the point where [reversing hearing loss] would be similar to Lasik surgery, where you're in and out in an hour or two and you can completely restore your vision,” Karp says. “I think we'll see the same thing for hearing loss.”
The company is also developing a drug for multiple sclerosis (MS), a disease in which the immune system attacks the myelin in the brain and central nervous system. Progenitor cells already turn into the myelin-producing cells in the brain, but not fast enough to keep up with losses sustained by MS patients. Most MS therapies focus on suppressing the immune system rather than generating myelin.
Early versions of that drug candidate have shown dramatic increases in myelin in mouse studies. The company expects to file an investigational new drug application for MS with the FDA next year.
“When we were conceiving of this project, we meant for it to be a platform that could be broadly applicable to multiple tissues. Now we’re moving into the remyelination work, and to me it’s the tip of the iceberg in terms of what can be done by taking small molecules and controlling local biology,” Karp says.
For now, Karp is already thrilled with Frequency’s progress, which hit home the last time he was in Frequency’s office and met a speaker who shared her experience with hearing loss.
“You always hope your work will have an impact, but it can take a long time for that to happen,” Karp says. “It’s been an incredible experience working with the team to bring this forward. There are already people in the trials whose hearing has been dramatically improved and their lives have been changed. That impacts interactions with family and friends. It’s wonderful to be a part of.” | Medical Innovations |
A safety investigation has warned that young people with complex mental health needs are being put at significant risk, by being placed on general children's wards in England.
The findings come from the Healthcare Safety Investigation Branch (HSIB).
BBC News recently highlighted the plight of a 16-year-old autistic girl, who spent several months in a children's ward.
Other families have since contacted the BBC describing similar situations.
The majority had faced similar difficulties getting appropriate support.
The HSIB - which is a government-funded body - says that paediatric wards are designed to care for patients who only have physical health needs and not for those with mental health needs.
It describes the situation in 18 hospitals it visited as "challenging", and 13 were described as "not safe" for children who were suicidal or at risk of harming themselves to be on their paediatric wards.
Hospitals say they are seeing an increasing number of children with a combination of autism, learning disabilities and complex social and mental health needs.
NHS England says it has an ongoing transformation programme to improve mental health services for children and young people, including adapting hospital environments for those with "sensory needs".
The HSIB started the investigation after a young patient on a paediatric ward tried to harm themselves and staff.
The child was waiting for a mental health assessment. They managed to abscond from the ward and on two occasions took a drugs overdose.
Two weeks ago, the BBC told the story of 16-year-old Molly who has autism, high levels of anxiety and eating problems.
She spent nearly seven months in a side room on a children's ward at the Queen Alexandra Hospital in Portsmouth, because of a shortage of places that could provide her with the support and therapy she needed.
Her family says she found the noisy environment traumatic. Despite having agency mental health nurses watching her 24 hours a day, she ran away from the hospital once and was able to seriously harm herself on a number of occasions. She was also restrained numerous times.
In April, her behaviour became so distressed that the children's ward closed to other patients for 10 days. She was then moved to a mental health unit, where she is doing better.
Her local health and care system said it was "very sorry" it had not been able to support her in a more suitable environment, when "she was most vulnerable".
Molly's story prompted other families to get in touch with the BBC.
Julie's child, who has autism, spent a year in a side room of a children's hospital at the age of 15. The teenager, who does not want their name used, also has eating problems.
Julie says that her child was made to feel at fault, even though "they hadn't asked to be there". She says: "They'd been put there waiting for something that wasn't coming, and how can you... make a vulnerable child feel that they're just a difficulty and a brat."
Jo-Ann's 15-year-old daughter is being assessed for autism and mental health difficulties. She is currently in the burns unit at a children's hospital. She has no physical problems for them to treat, but was moved there from the paediatric ward of another hospital. She was admitted after trying to harm herself nearly three months ago.
"She is classed as too vulnerable to go onto a mental health unit," Jo-Ann said. "She has fallen into no man's land."
She said the NHS and council-run children's services are trying to put together the support her daughter needs at home.
One parent also got in touch describing how terrifying it was for children who were physically very poorly, when there was someone being restrained or who was disruptive on the ward.
It is a mark of HSIB's significant concern about the situation that it decided to publish this interim report, before it has finished its full investigation.
The report said paediatric wards contained many self-harm risks, including ligature points, and that they were busy, noisy places which were unsuitable for children experiencing a mental health crisis, or with sensory needs, for instance, because they have autism.
It found that therapeutic help was limited or non-existent and children deteriorated as a result.
HSIB said on one paediatric ward there were more than 70 security incidents over three months relating to children with high-risk behaviours. Most involved the young person being physically restrained.
"In just over half of the security incidents reported, the child or young person had been sedated, sometimes requiring multiple attempts (up to seven) for the sedation to become effective," it said.
The report said on occasions nearly all the paediatric nursing teams on different wards could be involved in trying to support patients whose behaviour was high risk.
Staff told the investigators they were concerned about the "negative psychological impact" it was having on other patients and their families.
HSIB said it saw "vulnerable and unwell children and babies next to or near a young person who was trying to harm themselves and/or whose behaviour could be violent and aggressive".
The report says there were many incidents where staff were assaulted, and some hospitals, which were struggling to recruit and retain staff, described their workforce as "collapsing".
An NHS England spokesperson said: "The NHS will be reviewing the concerns raised by HSIB and will consider them as part of ongoing work to improve care for the record number of children and young people with mental health needs that the NHS is treating.
"In some circumstances it can be appropriate for young people to receive mental health care in acute settings, such as for treatment of physical health needs, and to support staff in doing this safely there is a clear framework to follow and an online training platform, while several areas are piloting services that better integrate mental and physical health care." | Mental Health Treatments |
A 34-year-old Missouri man was recently saved by surgeons at Northwestern Medicine in Chicago who used breast implants to successfully perform a double-lung transplant.
Davey Bauer, 34, whose nickname is now "Double D Davey," started smoking cigarettes when he was 21 years old, and typically smoked a pack of cigarettes a day.
Bauer, who enjoys staying active by snowboarding, skateboarding and golfing, said that he switched to vaping in 2014, hoping for a "healthier alternative."
"Vaping felt better, and I thought it was the healthier alternative, but in all honesty, I found it more addicting than cigarettes," Bauer said.
Despite switching to vaping, Bauer become extremely ill in May and was rushed to the emergency room.
"I felt a little short of breath, was coughing up a lot of secretions. But other than that, I mean, I felt pretty normal until the weekend, and that was just like I didn't have any energy," Bauer said in a video released by Northwestern Medicine. "Basically, Suzanne brought me into the E.R. and I don't remember much after that."
Dr. Rade Tomic, pulmonologist and medical director of the Northwestern Medicine Canning Thoracic Institute Lung Transplant Program, said that Bauer's lungs were so infected that they "started to liquefy."
"Davey’s lungs were so heavily infected that they started to liquefy. If you looked at his X-ray, there was nothing left — the lungs were completely filled with puss," Dr. Tomic said.
Dr. Ankit Bharat, chief of thoracic surgery at Northwestern, said that surgeon's knew that Bauer needed a double lung transplant.
"It was very clear to me that he needed a double lung transplant, but it was also very clear that he would not survive that transplant," Dr. Bharat said. "And the only way forward there was to somehow get rid of those lungs, because once the lungs get so disease and damaged, you cannot clear them."
In May, Northwestern Medicine Canning Thoracic Institute surgeons removed Bauer’s infected lungs, created an artificial lung to keep him alive, placed DD breast implants inside his chest cavity to keep the heart in place.
Once the infected lungs were removed May 26, Bauer’s body immediately started clearing the infection.
Surgeons also listed Bauer for a double-lung transplant and surgeons found a match within 24 hours.
"Still to this day, I can’t believe Davey lived without any lungs. He was breathing, blood pumping without lungs," Bauer’s girlfriend, Susan Gore, said. "While we waited inside his hospital room at Northwestern, I would take a breath in and say, ‘one breath for me and one for Davey.’ It’s hard to wrap my mind around it, and I’m still in awe that Davey was able to do this — it truly shows his strength."
Dr. Bharat said that he believes that this new technology will "open a lot of doors" for patients who have "no other options."
"Davey’s case is remarkable because it shows that we can keep patients alive after removing their lungs through new technology, which can be transformative for many critically ill patients," Dr. Bharat said in a press release. "With this new approach that we’ve developed, many patients who get to the point of needing a lung transplant — but their damaged lungs are making them too sick to get one — can now potentially get transplanted. I think it’s going to open a lot of doors for many patients who have no other options."
Bauer said that he is grateful to be alive and said that if he could go back in time, he would have never started smoking or vaping.
"I’m so grateful to be alive and know I wouldn’t be here today without the support of my girlfriend, family, friends and my Northwestern Medicine transplant team who never gave up on me," Bauer said. "While we don’t have definitive ways of proving my years of vaping caused my medical condition, doctors do know for a fact that vaping causes lung injury.
"If I could go back in time, I never would have picked up a cigarette or vape pen, and I hope my story can help encourage others to quit, because I wouldn’t wish this difficult journey on anyone." | Medical Innovations |
Respiratory viruses sometimes hit you in pairs, meaning you can catch a cold or the flu along with COVID-19. Itâs called âcoinfection,â but as far as scientists can tell right now, it doesnât happen very often. One review found that less than 1% of people with COVID-19 have also caught the flu at the same time.Â
In 2020, Israeli scientists dubbed a flu-COVID coinfection as âflurona.â Itâs important to note that while the names are combined, the viruses are not. Theyâre still two distinct viruses that you can catch at the same time.Â
Thereâs evidence that when youâre infected with a virus, âit can sometimes be harder to get a second viral infection on top of that,â says Luci Leykum, MD, chief clinical officer at Harbor Health in Austin, TX.Â
There are several reasons why this seems to be the case. Your cells may be a poorer environment for a second virus to take hold. Or proteins on the surface of the cell are expressed a little differently right after an infection. But we donât know yet whether this effect, called viral interference, works in the same way with the viruses that cause COVID-19 and the flu. Scientists are still doing research to find out.
There was a major drop in cold and flu illnesses at the beginning of the COVID-19 pandemic. But by spring 2021, flu and other virus activity began to rebound. This means a higher chance of coinfection. If you do get sick, here are some expert tips on how to get well.
Stay Home
You probably wonât need to go to the hospital to heal from a respiratory virus. Instead, itâs best to stay at home and focus on getting better.Â
âWe just have to use common sense and wash our hands, stay home if weâre sick, and wear masks in public if weâre having symptoms,â says Arti Madhavan, MD, specialist-in-chief of family medicine at Detroit Medical Center.
Some people around you may have a weaker immune system, so youâll need to be extra careful not to spread the virus to them.Â
Get Tested for Flu and COVID-19
If you start having cold-like symptoms, you should get tested for the flu and COVID-19. This is especially true if youâre more likely to get really sick or die from these illnesses.Â
You might get very sick from the flu or COVID-19 if you:
- Are older than 50
- Are pregnant
- Have more than one health condition
- Have asthma or other lung diseases
- Are obese
- Have a weakened immune system
If it turns out you have the flu or COVID-19, your doctor can tailor your treatment to include medicine for that specific illness. But antiviral medicines for COVID-19 and the flu only work when you take them soon after having symptoms, which is why doctors advise people to take action quickly. âDon't wait to see how you feel. Just come in and get tested,â Leykum says.
Some public health labs use a test that checks for both the flu and COVID-19. It helps health officials track each disease, saves time and testing materials, and may give you faster test results.
Monitor and Treat Your Symptoms
The symptoms of a cold, the flu, and COVID-19 can look and feel similar. They include a stuffy nose, tiredness, and muscle aches. No matter which virus causes your symptoms, if theyâre mild, the treatments are the same. Here are some things you can do:
- Drink fluids.
- Sleep more.
- Ask your doctor about over-the-counter drugs, such as acetaminophen or ibuprofen.
If youâre likely to get very sick from COVID-19, your doctor could prescribe an antiviral medicine to help avoid serious illness. The ones you take in pill form at home are molnupiravir (Lagevrio) or nirmatrelvir with ritonavir (Paxlovid). Youâll need to start these drugs within 5 days of testing positive for COVID-19 or the start of symptoms. Thereâs also an antiviral for the flu known as oseltamivir (Tamiflu). Youâll take it within 48 hours of the start of symptoms.
Itâs safe to take flu and COVID antivirals at the same time. While they arenât a cure for COVID-19 or the flu, they can stop the virus from multiplying. This means your symptoms should be milder, and you probably wonât need hospital care.
If you donât have a family doctor, some communities offer âtest and treatâ centers where you get tested for the flu or COVID, and a doctor calls in an antiviral prescription all in the same visit.
Go to the ER right away if you have trouble breathing. Viruses that cause the flu or COVID-19 can damage your lungs. And the common cold virus can narrow the tubes that send air down to your lungs, causing asthma-like symptoms. Before you go to the hospital, call first to see if there are any special rules for people with COVID-19. If you are hospitalized, your doctors may treat you with the antiviral medication remdesivir (Veklury).
Scientists are still studying whether a coinfection makes your symptoms twice as bad. Some lab studies show that certain flu viruses can make the effects of SARS-CoV-2 â the virus that causes COVID-19 â worse. They were animal studies, though, so weâll need more research on humans. Right now, we just donât have enough information to know what happens to people.
Call Your Doctor
Donât hesitate to check in with your health care provider if youâre feeling sick or have questions about an illness. Theyâll want to know if your symptoms worsen or if you have another health condition. And theyâll share advice on how to get better at home and let you know if itâs time to get medical care.
A vaccine can protect most people against future COVID-19 and flu infections. Be sure youâre up to date on your COVID-19 boosters, too. The CDC website or your doctor can guide you on how many shots you need and when. These shots help keep you from getting really sick even after youâve already caught either virus. But you donât want to get a vaccine while youâre still under the weather. Your doctor can tell you how long youâll need to wait.
Show Sources
Photo Credit:Â diovp / Getty Images
SOURCES:
Arti Madhavan, MD, specialist-in-chief of family medicine, Detroit Medical Center.
Luci Leykum, MD, chief clinical officer, Harbor Health, Austin, TX.
Frontiers in Medicine: âCOVID-19 and Influenza Co-infection: A Systematic Review and Meta-Analysis.â
Cell Research: âCoinfection with influenza A virus enhances SARS-CoV-2 infectivity.â
CDC: âCOVID-19: What To Do If You Are Sick,â âFlu: What To Do If You Get Sick,â âCOVID-19 Treatments and Medications,â âFactors That Affect Your Risk of Getting Very Sick from COVID-19,â âPregnant and Recently Pregnant People,â âChanges in Influenza and Other Respiratory Virus Activity During the COVID-19 Pandemic â United States, 2020-2021,â âPeople With Moderate to Severe Asthma,â âStay Up to Date with COVID-19 Vaccines Including Boosters.â
Morbidity and Mortality Weekly Report: âDecreased Influenza Activity During the COVID-19 Pandemic â United States, Australia, Chile, and South Africa, 2020,â âChanges in Influenza and Other Respiratory Virus Activity During the COVID-19 Pandemic â United States, 2020-2021.â
American Hospital Association: âFlurona and Its Impact on Flu Season.â
National Institutes of Health: âInfluenza and COVID-19.â
Journal of Leukocyte Biology: âFrom virus to inflammation, how influenza promotes lung damage.â
HHS.gov: âWhat are oral antivirals?â
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Hospitals in Wales "didn't want to know" about the additional needs of disabled staff, according to a doctor who was looking for work after being paralysed in a car crash.
"They wanted someone that could easily and quickly fill the post without them having to do anything," Dr Georgina Budd who qualified as an A&E medic.
She ended up becoming a GP at a surgery that could accommodate her needs.
Health boards said they were committed to creating inclusive environments.
"There shouldn't be a limit because of my disability," said Dr Budd, known as Georgie, who spent three years as a clinical fellow in the A&E department at Glangwili Hospital in Carmarthenshire as part of her medical training.
"I've been in situations where I've had to deal with a medical emergency and I'm no less effective for being in the wheelchair."
But when the time came to find a full-time job, she said she faced barriers.
"I've had colleagues say: 'You're going to need to think about your career and how you tailor it to your disability'," said Georgie.
"I shouldn't have to. I should be able to work in the specialty that I want to."
Georgie said for one job application, a hospital asked her to do an unpaid "trial shift".
"It was all dressed up in language of 'so we can see how we can help you'," she said.
"What really came across was 'so we can see how many adjustments you would need so we can see if it's financially viable for us to change things around for you'."
She added: "You would think that hospitals are set up for disabled people because they are a big part of our service, but they're not."
Most hospital cupboards are out of a reach for a wheelchair user, she explained, and some buildings were still inaccessible.
"Life has been built around able-bodied people. It is not built for me and it's not built for the rest of the disabled community," she said.
Working hours is another barrier.
"It does take me a longer time to get ready and out of the house in the mornings," she said.
"Without getting up at a ridiculous hour, I might not be able to be on shift at 08:00 like some doctors.
"That was a problem at first because ward rounds happen in the morning.
"We are looking for reasonable adjustments, but it's very difficult to get those changes made and to get people thinking differently about disability and about a disabled doctor."
Originally from Downton in Wiltshire, Georgie started at Cardiff Medical School in 2009.
On her way to a shift at Glangwili Hospital in 2017, she lost control after a tyre on her car punctured. To avoid oncoming traffic, she swerved into a poll at 50mph (80km/h).
At the age of 30 she was paralysed from the waist down and she thought her career was over.
But she fought to complete her doctor training.
"It is not the end of the world. It's hard and there are challenges, but I kept telling myself 'my life isn't over'," she said.
She recalled her first time seeing a patient as a doctor in wheelchair: "She looked at me and... was like, 'oh, hello, love. Are you one of the patients?'
"'No, I'm your doctor today'."
Georgie completed her doctor training at Glangwili Hospital in August, but after failing to find a job she changed her specialty and is now a general practice trainee.
Working as a GP at Tŷ Calon Lân surgery in Mountain Ash, Rhondda Cynon Taf, means more sociable hours and more flexibility.
Her typical day starts with a carer coming to her home in Merthyr Tydfil at around 08:00.
"I could probably just about do it myself... but I was slipping because I was so exhausted," she said.
"Having [a carer] in just sort of makes the morning run smoother, allowing me to conserve my energy and put it into things that I really want to do."
She is co-chairwoman for junior doctors at the British Medical Association in Wales, and is currently doing research with Swansea University on the mental health needs of medical students.
"GP gives me the opportunity to be more active in medical politics and in research and still see my patients and have a good impact on them," she said.
"In an ideal world any child that wanted to grow up to be a doctor and had a disability wouldn't feel that's off limits to them," she said.
That would require a "perspective change in society" she said.
"It's understanding that disability isn't inability," she said. "Being in a wheelchair doesn't limit my ability as a doctor."
She said she wants to see full accessibility as the standard in all health buildings so no-one feels left out.
"I want more disabled kids to know that this kind of opportunity is open to them," she said.
"That it doesn't matter if their legs don't work. I know a consultant who's got one arm... he still takes blood and is an effective doctor and why shouldn't he be?"
"A lot of what a doctor does is up here," she added, touching her temple.
"I've put chest drains in, I've sutured people... all kinds of crazy stuff.
"I adapt it for me but I can still do it. It's just doing it a different way."
Georgie spent months in hospital recovering from her accident, an experience she said gives her more empathy for her patients.
"I think that knowledge is something that can really help the medical community," she said.
"Having more doctors that have gone through poor health experiences, chronic illness, disability is important to widening doctors' understanding of what their patients are going through."
She said more understanding of disability was needed in society more generally, recalling upsetting comments she overheard after her friends had to carry her into a non-accessible café.
"We were sat there and this young woman said really loudly: 'Why would she even come here, it's clearly not disabled accessible. Does she not realise that she's just a nuisance'."
Comments like that could be "hard", Georgie admitted, but said they made her more determined to "normalise" disability.
"I can spend the next 60 years miserable because I can't stand up, or I can do something about this," she said.
Several health boards in Wales said they follow an all-Wales recruitment process designed to ensure "fair and equal opportunities for all" and that disabled candidates who meet the minimum standard were guaranteed an interview.
"Only when shortlisting is complete will a candidate's self-declaration [of a disability] be visible, alerting the appointing manager that reasonable adjustments may be required," said Lisa Gostling, from Hywel Dda health board.
Aneurin Bevan health board said it offered disabled staff access to work assessments, aiming to "create an inclusive environment for our staff and patients".
Powys health board said "tailored adjustments will be made, where possible, to roles and/or workplaces through discussion between the manager and the employee".
Betsi Cadwaladr heath board said it "welcomes applications from individuals with disabilities and value all staff".
A Welsh government spokesperson said it expected "all NHS organisations to comply with the Equality Act 2010, and to follow best practice regarding the recruitment and retention of staff". | Health Policy |
Hundreds of patients are taking up hospital beds across England every day despite being ready to leave, according to NHS data.
Figures show the biggest obstacle to speedy discharge is lack of beds in other settings, such as care homes.
Other reasons include hold-ups in sorting transport, medicines and paperwork.
The government said it wanted to "ensure patients leave hospital as soon as they are medically fit".
It is the first time data has been published which breaks down the reasons for discharge delays.
The need to install specialist equipment in a person's home or disagreements between a patient, their family and medical staff are among other reasons given.
The figures showed that, among patients in England in June who had been in hospital at least 14 days, an average of 1,791 a day were unable to be discharged due the lack of a bed in a residential or nursing home
While 1,727 a day were waiting for a rehabilitation bed in a community hospital or a similar setting.
An average of 2,033 patients a day were waiting for resources to assess and begin care at home, the data showed.
An NHS spokeswoman said: "Delayed discharges put considerable pressure on the NHS, which is why the health service has been working closely with colleagues in local authorities on a range of initiatives to send more patients home when they are medically fit to leave."
Miriam Deakin, director of policy and strategy at NHS Providers, the membership organisation for NHS trusts in England, said: "Delayed discharge is caused by several factors including a capacity crunch of staff and beds in social care and community health services - both of which need appropriate funding."
Around one in five patients in hospitals in the south-east of England experience delays in discharge, a higher proportion than any other region.
University Hospitals Sussex was the NHS trust with the highest average of delayed discharges due to a wait for resources to begin care at home, at 99 patients per day.
It also had the highest average for delays due to waits for a bed in a community hospital at 85 patients per day.
Manchester University NHS trust recorded the highest average due to waits for a bed in a residential or nursing home, at 81 patients per day, followed closely by Leeds Teaching Hospitals and Liverpool University Hospitals trusts, with both averaging 80 per day.
Overall, an average of 12,334 hospital beds in England per day in June were occupied by people ready to be discharged - down from 12,597 in May and 12,760 in April.
The equivalent figure for the same month in 2022 was 11,590.
A Department of Health and Social Care spokesman said: "We are working to ensure patients leave hospital as soon as they are medically fit, and the number of patients each day who are ready to be discharged but still in hospital has reduced by 2,200 in England since January.
"We are investing a record £1.6bn to support timely and safe discharge from hospital.
"This is on top of £700m to ease hospital pressures over last winter and buy thousands of extra care packages and beds." | Health Policy |
Struck by back pain so intense she could barely walk, Katie Taylor went to her GP hoping they would investigate. Yet the only advice she got was to lose weight — even though she was, at most, half a stone overweight — and to exercise, when, despite being just 43 at the time, she could barely move around her house.
‘The pain was too bad for me to do anything,’ says Katie.
‘Simple things like going upstairs, were really difficult. I felt my pain was just being dismissed.’
Over the next four years the pain worsened, moving to her legs and joints. Katie also began to experience migraines for the first time in her life. This was on top of the agonising period pains she had quietly accepted as part of her lot as a woman for years.
Her symptoms were so bad that between the ages of 43 and 47, Katie was forced to give up three jobs in charity communications.
Yet her GP said that Katie’s symptoms, which by then also included heart palpitations, insomnia, anxiety and itchy skin, were all in her head.
‘I was made to feel like a hypochondriac,’ says Katie, now 53, from North London, a mother of four and CEO of an online platform for midlife women.
‘I was told there was no physical cause, that the symptoms were in my head as I may have depression. They wanted to put me on anti-depressants. But I felt I wasn’t being listened to.’
It took four years after her initial visit to the doctor to get to the root cause of her joint pain and other symptoms — and this only happened after her concerned father, a breast surgeon, suggested she see a private gynaecologist.
A blood test revealed Katie was in perimenopause (the lead-up to the menopause) and her oestrogen levels were very low.
As the hormone protects joints and reduces inflammation, low levels can lead to joint pain and her other symptoms, such as heart palpitations and brain fog.
Katie was prescribed HRT (hormone replacement therapy) ‘and within just four weeks most of the symptoms went away — my husband said he heard me laugh for the first time in four years,’ she says.
But she still had crippling period pains. Further tests revealed the ‘heavy periods’ that Katie had endured for decades were due to adenomyosis, a little-known condition despite it affecting one in ten women, where endometrial tissue that normally lines the womb grows in the muscle wall and breaks down and bleeds each month. This causes sharp pelvic pain and heavy bleeding.
Previous attempts to seek medical help for her period pain had resulted in Katie feeling ‘dismissed’ and the impression that her period was no ‘worse than anyone else’s’, she says.
By the time this was diagnosed, just before her 50th birthday, Katie needed a full hysterectomy, i.e. removal of the womb and ovaries.
Adenomyosis is usually treated with anti-inflammatory medication for the pain; hormone therapy to help control heavy or painful periods; and in extreme cases by a hysterectomy.
It was a major operation but freed Katie from the agony she had endured for years. The question is why would so many health professionals be so dismissive of a woman’s pain and for so long?
According to a recent survey, it’s a common problem. The survey of more than 5,000 men and women aged 18 to 65 about their experiences and perceptions of pain found a noticeable disparity: half of the women surveyed (50 per cent) reported a lack of support from their GPs when trying to get help for their pain, compared with 36 per cent of men, according to the results of The Gender Pain Gap Index Report, published last November by Reckitt Benckiser, which manufactures painkillers such as Nurofen.
Nearly two-thirds (63 per cent) of women said they felt men’s pain is taken more seriously owing to ‘gender discrimination by healthcare professionals’.
More than half (56 per cent) of women felt ignored or dismissed as ‘emotional’, compared with 49 per cent of men surveyed.
And the problems weren’t isolated to their treatment by healthcare professionals — one in four women (24 per cent) said generally no one took their pain seriously compared with one in six men (17 per cent). This replicates previous findings showing a difference in the way women seeking help for their pain are treated.
The term ‘gender pain gap’ was coined by Diane Hoffman, a professor of law at the University of Maryland in Baltimore, U.S., to sum up the findings of her research, published in the Journal of Law, Medicine & Ethics in 2001.
It highlighted an imbalance in the treatment of pain between men and women, showing that although women were more likely to report chronic pain from conditions such as osteoarthritis, rheumatoid arthritis, fibromyalgia and migraine, they were less likely to be adequately treated by healthcare providers than men.
Professor Hoffman, who last year published a follow-up article in the same journal, says that two decades on from her original research, little has changed.
‘There was a lot of attention when we published the first paper and as there’s more awareness of diversity and disparity generally I hoped there would have been more change,’ she told Good Health.
‘However, Yentl syndrome [where women are misdiagnosed and poorly treated unless their symptoms or diseases conform to that of men] still exists and women are still treated less effectively than men in their initial encounters in the healthcare system, having to prove that they are as sick as male patients.’
By way of example, she points to a study that showed after a heart bypass graft women are often given sedatives as they are perceived to be anxious, while men are given more appropriate and stronger pain relief.
This was published in 1990 in the journal Sex Roles, but Professor Hoffman says the findings remain true for today.
‘I think treatment of women for pain may have improved in the past 20 years in some institutions where it was made a priority but there are still many places where it is a problem and there is still disparity in the way women and men are treated.’
Professor Hoffman is concerned about the bias that she says remains in medical schools.
A 2015 study, published in the journal Pain Medicine, in which medical trainees were shown avatars with the same symptoms — only their sex was different — had worrying findings.
‘A third of the trainees had stereotypical attitudes that women’s pain has less of an impact on their work, and that antidepressants and counselling were appropriate treatments — yet again a woman’s pain was seen to be psychological, and that’s troubling,’ she says.
Professor Hoffman also found multiple other examples of bias during research for her 2022 paper — there were similar results to the 2015 study in two previous studies, published in 2013 and 2014 (in The European Journal of Pain and the Journal of Pain respectively), using virtual patients to assess the reaction of healthcare providers.
‘The studies found that females were significantly more likely to receive recommendations for antidepressant and psychological treatment than males, despite having similar symptoms and pain facial expressions,’ she says.
‘In those same studies, men were more likely to be prescribed analgesics than women.’
The gender pain gap is a recognised problem. Researchers writing in the Scandinavian Journal of Public Health in 2022 called it ‘a public health concern’ and said it ‘should be considered in any future pain prevention and management strategies going forward’.
They came to that conclusion after examining data from nearly 28,000 men and women aged 25 to 74 in 19 European countries — including the UK. This is despite the fact that women are more likely to live with chronic pain (defined as lasting longer than three months) in all age groups.
A report by the charity Versus Arthritis in 2021 found that among the 16 to 34 age group 22 per cent of women had chronic pain compared with 13 per cent of men.
In the 35 to 44 age group the figures were 33 per cent of women and 25 per cent of men; and in the older 45 to 54 years age group they were 41 per cent of women and 37 per cent of men. This report also found that 14 per cent of women have severe pain compared with 9 per cent of men — again, a disparity consistent in all ages.
One of the reasons for this, says Dr Franziska Denk, a senior lecturer in pain biology at King’s College London, is that autoimmune diseases such as lupus and rheumatoid arthritis are more common in women, who have a stronger immune response.
As these are painful diseases, it partly explains why more women than men live with chronic pain.
Yet while they experience more pain, there is a recognised gender bias in clinical trials generally, including pain.
‘In the past, pre-clinical [i.e. animal] studies were mostly done on male mice,’ says Franziska Denk.
‘As female mice had menstrual cycles, it was thought they would be unpredictable and cause more variation in the results — although there is no evidence to support this view.’
Another factor often overlooked by researchers, says Dr Sarah Love-Jones, a consultant in pain medicine at Southmead Hospital Bristol, is that women’s responses to pain differ from men’s. ‘There are many contributing factors, one being that female hormones can affect the receptors in the nervous system, which affects pain transmission and causes differences in the pain processes in the brain between men and women,’ she says.
This can have a significant clinical impact, she says, pointing to a 2000 study in the New England Journal of Medicine that found that women are seven times more likely to be misdiagnosed and discharged in the middle of a heart attack. ‘This is often because women don’t have the classic chest and arm pain symptoms that are common in men,’ she says.
‘A lot of the concepts of most diseases are based on an understanding of male physiology, with 80 per cent of research studies conducted on male mice and human men.’
One of the things needed to improve the treatment of women in pain is to address the stereotypes, and not just from the doctor’s point of view, says Dr Elinor Cleghorn, a freelance researcher specialising in the history of women’s health, based in Sussex, and author of Unwell Women: A Journey Through Medicine And Myth In A Man-Made World. ‘A lot of these biases are fed by prejudices of what we think when a woman says, “I am in pain”. There’s long been an inherent assumption that women’s pain is related to their mind and emotions, not their body.’
What’s more, she adds, the view that women can cope with high levels of pain is a myth. ‘The truth is pain tolerance is subjective and varies between people,’ she says.Her research was prompted by her experiences after she developed joint pain and swelling that was exacerbated by sunlight.
‘In the hot summer of 2003 I felt I was swollen and full of pain,’ she says. ‘Some days I couldn’t get out of bed, but my doctor said I was probably stressed — at the time I was a university student.
‘I was made to feel like an anxious hypochondriac so I didn’t push for complex blood tests. It wasn’t until eight years later, when I was pregnant with my second son, that it was discovered I actually had the autoimmune disease lupus.’
Lupus causes the immune system to attack healthy tissue, triggering swelling and pain; 90 per cent of those affected are women.
The outlook, however, is looking more hopeful. Franziska Denk says pain research is now being taken more seriously in the UK. She is a member of the government-funded Advanced Pain Discovery Platform on Visceral Pain, which is looking to identify if there is a common cause of the pain experienced in conditions affecting the bladder and bowel in men and women and, in women, the uterus.
Meanwhile, in the U.S. the Society for Women’s Health Research is dedicated to promoting research on differences in disease and improving women’s health through science, policy and education. It has been vocal about the need for equality in the development of new medicines, reporting in 2017 that for the first time women accounted for more than half of research participants for drugs approved by the U.S. regulator, the Food and Drug Administration.
The Association of the British Pharmaceutical Industry says in the UK there is guidance to encourage diversity in clinical trials. Following its survey, the manufacturer of Nurofen has said future trials will consist of equal numbers of men and women.
Professor Kamila Hawthorne, chair of the Royal College of General Practitioners (RCGP), said: ‘It’s clear from these survey results that a significant number of women do not feel as though they have been taken seriously by the NHS and it’s important this is recognised and addressed.
‘Women’s health is a priority for the RCGP and we’ve worked with partners, including the Royal College of Obstetricians and Gynaecologists and Faculty of Sexual and Reproductive Healthcare to develop educational resources to support healthcare professionals deliver the best possible care to women.’
In the meantime, while there may not be a cure for their pain, proper support can help women and men have a better life.
Dr Love-Jones says this won’t necessarily mean medication.
‘The National Institute for Health and Care Excellence guidelines say to offer cognitive behaviour therapy for managing the effects pain has on patients’ lives, and both men and women can receive this if they’re treated at a pain clinic,’ she says.
In fact, research, such as a 2018 study in the journal Medicine, has found that women benefit more than men from this kind of approach.
Katie Taylor says that, while this is welcome news, for too many women this comes too late after years of unnecessary suffering.
‘For four years I wasn’t functioning properly, often spending days asleep on the couch,’ she says. ‘This shouldn’t be the case — our pains and symptoms must be taken seriously.’
How long did it take to get the cause of your chronic pain diagnosed? Tell us your story: email [email protected] | Women’s Health |
Too critical to collapse: Today’s primary care crisis
As our nation recovers from one of the greatest public health emergencies in a generation, not enough attention is being paid to a longer brewing and dangerous trend in U.S. health care: the deterioration of our country’s primary care workforce.
Primary care serves as the frontline of U.S. health care — and is the only health care service associated with improved population health and fewer health inequities. It does this with just under one-third of the health care workforce and less than one-tenth of health care dollars.
Failure to attend to primary care will not only guarantee a continuation of hospital labor woes and stretched resources, but will also threaten our country’s health security, including our capacity to respond to a future pandemic and to assure all people in America have a shot at long and healthy lives.
Primary care, which includes the fields of family medicine, internal medicine and pediatrics, is defined as health care provided by interprofessional teams that are accountable for addressing the majority of an individual’s health and wellness needs across settings and through sustained relationships. The field has been largely ignored by policymakers, even though during the pandemic lockdown many practices converted to telehealth within days and stepped up to provide additional services like behavioral health and dental care.
A recent national report from the Milbank Memorial Fund underscores the urgent need to address a primary care system in crisis, finding:
- Growing workforce shortage: One in three U.S. physicians practiced primary care in 2010, yet only one in five medical residents (20 percent to 21 percent) entered primary care between 2012 and 2020.
- Systemic underinvestment: The U.S. invested less than 6.5 percent of total health spending on primary care between 2010 and 2020.
- Too few physicians training in community settings: Some states are training only 7.5 percent of their residents in medically underserved areas and rural counties, where most primary care is delivered.
- Data gaps: A lack of timely, disaggregated data hinders the accurate measurement and implementation of high-quality primary care at the national and state levels.
Almost half of surveyed primary care clinicians attest that U.S. primary care is crumbling. With focused attention and decisive action, we can fix it.
Achieving high-quality primary care for all will require purposeful steps guided by evidence and data to address our underinvestment in primary care. The solutions start with the Centers for Medicare and Medicaid Services and state authorities increasing the portion of overall spending going to primary care. These payments should foster team-based person-focused care, not just more office visits to physicians. Majorities of surveyed physicians say that reimbursement for responding to questions through emails, texts or telephone calls and partnerships to foster preventive health would improve the state of primary care.
To increase the supply of primary care clinicians, health care organizations and local, state, as well as federal government agencies should expand and diversify the primary care workforce, particularly in areas with shortages of medical professionals. Current federally funded training programs should be augmented and revised to add more primary care training slots and put more emphasis on community-based training, including training in rural counties and some urban communities.
Health care is our nation’s fourth largest industry and primary care is its largest platform — we can no longer survive its virtual invisibility to policymakers. The public sector not only provides $12 billion to $14 billion annually for graduate medical education of physicians through Medicare and Medicaid payments, but also foots half the health care bill in the country.
An Office on Primary Care in the Department of Health and Human Services would help align initiatives, including graduate medical education, Medicare reimbursement and more. A federal office could also support beleaguered primary care clinicians by coordinating workforce training, behavioral health integration, clinical comprehensiveness and payment.
Ensuring everyone has access to a “usual source of care” — one usually found in the primary care offices — is fundamental to a healthy, secure future. Rather than respond to those in the health care industry with money and power, we will need to focus on the crisis in the health care sector we all need first and most: primary care.
Christopher F. Koller is president of the Milbank Memorial Fund.
Rebecca Etz is a professor of Family Medicine and Population Health and Virginia Commonwealth University and codirector of the Larry A. Green Center. | Health Policy |
New image-based cellular profiling tool peers deeply into metabolic biology
LipocyteProfiler captures disease-relevant phenotypes in an inexpensive microscopy assay
To assess LipocyteProfiler, the researchers analyzed white and brown fat cells and liver cells, focusing on traits such as the size, the number, and the location of lipid droplets in a cell. When comparing cells with a particular genetic variant to those without, the team found that the LipocyteProfiler protocol detects morphological and mechanistic differences between the cells, allowing for linkage of genetic variation to phenotypic traits. LipocyteProfiler also highlighted discrete cellular mechanisms and pathways when used to analyze metabolic traits associated with high polygenic risk scores.
“We could identify and examine more than 700 features just related to lipid accumulation,” said Sophie Strobel, a lead author on the paper who is now at TUM. “That teaches us far more than looking for just a single informative data point.”
The researchers also looked at the tool’s ability to detect changes in cellular phenotypes after exposure to drugs and small molecule compounds. Typically, studying drug therapies is an expensive and time-consuming undertaking. With high-resolution, cell-based profiling techniques, extracting a large amount of data can be done cheaply and efficiently.
“I think drug screens are an obvious next step for using the platform because image-based screens tend to be pretty inexpensive, and they can be scaled up so that you can assess and evaluate hundreds of thousands of compounds and see which ones impact the phenotypes that are associated with disease,” said Cell Painting creator Carpenter, who collaborated on the LipocyteProfiler project.
LipocyteProfiler is already being used experimentally to look at relationships between genetic variants and their functions. Claussnitzer and the University of Chicago's Marcelo Nobrega recently used LipocyteProfiler to reveal a mechanism connecting the gene COBLL1 and a diabetes-related metabolic phenotype called metabolically obese normal weight. By using the tool, Clausnnitzer and others saw how a variant that reduces COBLL1 expression interferes with lipid droplets' growth within a cell.
Claussnitzer's lab is now working to expand the machine-learning aspect of LipocyteProfiler, with an eye towards tracking information flow within single cells from transcription to phenotypes. Experimentally, the lab continues to use LipocyteProfiler to assess the relationships between genetic variants and cellular programs, to understand highly granular processes of disease biology.
Claussnitzer notes that LipocyteProfiler is a powerful addition to the -omics tool box, one that looks beyond epigenomics, transcriptomics, and proteomics to allow systematic, unbiased, image-based profiling of cellular phenotypes. And while the technology is the first to adapt the Cell Painting protocol, researchers at the Broad and beyond are already working to create assays like LipocyteProfiler for their own respective fields.
“Just as we applied stains related to lipid biology and metabolism,” Strobel said, “one could instead swap in stains for something related to, say, lymphocyte biology, depending on the question you want to answer and what disease you are looking at.”
Carpenter notes that she is satisfied seeing people expand on her work on Cell Painting, saying “in the end, none of the work matters if biologists aren't adapting it in their labs for the myriad of disease areas that people work on.”
Funding
Support for this work was provided by Novo Nordisk Foundation, the Foundation for the National Institutes of Health, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Human Genome Research Institute, the American Diabetes Association, the Gates Foundation, the Doris Duke Charitable Foundation, the Broad Institute, and other sources.
Papers cited
Laber S, Strobel SM, et al. Discovering cellular programs of intrinsic and extrinsic drivers of metabolic traits using LipocyteProfiler. Cell Genomics. Online June 20, 2023. DOI: 10.1016/j.xgen.2023.100346 | Disease Research |
Night owls' tendency to smoke more cigarettes and drink more alcohol than early birds could explain why evening people have a higher risk of early death than early risers do, a large analysis suggests.
"This can reassure people concerned about what being a morning or evening person means for their life expectancy and health," study co-author Jaakko Kaprio, a professor of genetic epidemiology at the University of Helsinki in Finland, told Live Science. "It's not about the chronotype [being a morning or evening person] itself that is dangerous, but it is the associated lifestyle factors."
Other scientists previously found elevated mortality rates among night owls compared with morning people, but these past analyses didn't account for differences in participants' alcohol consumption or smoking quantity, making it difficult to tell whether being an evening person directly increases mortality risk.
Now, Kaprio and his colleagues have analyzed health and lifestyle data from more than 23,000 people living in Finland to tease out whether being a night owl directly affects the risk of dying within the next few decades. The findings were published Friday (June 16) in the journal Chronobiology International.
In a survey carried out in 1981, participants — who were 41 years old at the time, on average — self-reported their smoking and drinking habits. On a questionnaire, they also stated whether they were "clearly a morning person," "to some extent a morning person," "clearly an evening person" or "to some extent an evening person."
Overall, more than 8,700 participants died during the 37-year follow-up period, which ended in 2018. By analyzing participants' health records collected in that time, the researchers found that participants who initially said they were "clearly" evening people had a 21% higher risk of death from any cause compared with those who were "clearly" morning people.
This initial analysis only adjusted for participants' ages and sex, but the scientists then ran a second analysis that accounted for additional factors that could affect people's mortality risk, such as body mass index (BMI), self-reported sleep duration, educational level, rates of chronic diseases, alcohol consumption and smoking status and quantity. After the researchers controlled for these additional factors, the night owls' overall excess mortality risk dropped to just 9%.
Why did night owls' risk fall by more than half? The team found that most of their raised mortality risk was attributable to higher alcohol consumption and heavier smoking among evening people than in morning people. Supporting this idea, they found that mortality rates did not differ between evening and morning people who were light drinkers that never smoked.
What's more, an analysis that accounted for differences in age and sex found that rates of death due to alcohol-related diseases and accidental alcohol poisoning were 92% higher among "clearly" evening people compared with "clearly" morning people. And deaths due to lung and airway cancers, made more likely by smoking, were 78% higher among night owls. Both of these risks fell "substantially" when other lifestyle factors, including alcohol and smoking habits, were considered. These findings further support the idea that smoking and drinking, not staying up late, raise night owls' risk of death, the authors concluded.
The remaining 9% increase in mortality rate among evening people is unlikely to be directly due to their late bedtimes, Kaprio said.
"We measured people's chronotype and alcohol consumption at one time using one question, which means we don't account for how things might have changed years later," he said. "If we measured alcohol and drinking habits perfectly throughout the study period, I think the raised risk may be much less or absent."
Kristen Knutson, a professor of neurology at Northwestern University who was not involved in the study, agreed that the remaining 9% risk isn't necessarily linked to chronotype.The risk could be related to yet-unknown "unmeasured environmental or behavioral factors, rather than an inherent risk associated with a later internal clock," she told Live Science.
It remains unclear why being an evening person is linked to heavier smoking and drinking, Kaprio said. Beyond potential differences in the social activities of evening and morning people, "one explanation would be that there are genes that predispose you to both being an evening person and also to drinking more alcohol," he said.
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Carissa Wong is a freelance reporter who holds a PhD in cancer immunology from Cardiff University, in collaboration with the University of Bristol. She was formerly a staff writer at New Scientist magazine covering health, environment, technology, nature and ancient life, and has also written for MailOnline. | Epidemics & Outbreaks |
About 49,500 people took their own lives last year in the U.S., the highest number ever, according to new government data posted Thursday.
The Centers for Disease Control and Prevention, which posted the numbers, has not yet calculated a suicide rate for the year, but available data suggests suicides are more common in the U.S. than at any time since the dawn of World War II.
"There's something wrong. The number should not be going up," said Christina Wilbur, a 45-year-old Florida woman whose son shot himself to death last year.
"My son should not have died," she said. "I know it's complicated, I really do. But we have to be able to do something. Something that we're not doing. Because whatever we're doing right now is not helping."
Experts caution that suicide is complicated, and that recent increases might be driven by a range of factors, including higher rates of depression and limited availability of mental health services.
But a main driver is the growing availability of guns, said Jill Harkavy-Friedman, senior vice president of research at the American Foundation for Suicide Prevention.
Suicide attempts involving guns end in death far more often than those with other means, and gun sales have boomed — placing firearms in more and more homes.
A recent Johns Hopkins University analysis used preliminary 2022 data to calculate that the nation's overall gun suicide rate rose last year to an all-time high. For the first time, the gun suicide rate among Black teens surpassed the rate among white teens, the researchers found.
"I don't know if you can talk about suicide without talking about firearms," Harkavy-Friedman said.
U.S. suicides steadily rose from the early 2000s until 2018, when the national rate hit its highest level since 1941. That year saw about 48,300 suicide deaths — or 14.2 for every 100,000 Americans.
The rate fell slightly in 2019. It dropped again in 2020, during the first year of the COVID-19 pandemic. Some experts tied that to a phenomenon seen in the early stages of wars and natural disasters, when people pull together and support each other.
But in 2021, suicides rose 4%. Last year, according to the new data, the number jumped by more than 1,000, to 49,449 — about a 3% increase vs. the year before. The provisional data comes from U.S. death certificates and is considered almost complete, but it may change slightly as death information is reviewed in the months ahead.
The largest increases were seen in older adults. Deaths rose nearly 7% in people ages 45 to 64, and more than 8% in people 65 and older. White men, in particular, have very high rates, the CDC said.
Many middle-aged and elderly people experience problems like losing a job or losing a spouse, and it's important to reduce stigma and other obstacles to them getting assistance, said Dr. Debra Houry, the CDC's chief medical officer.
Suicides in adults ages 25 to 44 grew about 1%. The new data indicates that suicide became the second leading cause of death in that age group in 2022, up from No. 4 in 2021.
Despite the grim statistics, some say there is reason for optimism. A national crisis line launched a year ago, meaning anyone in the U.S. can dial 988 to reach mental health specialists.
The CDC is expanding a suicide program to fund more prevention work in different communities. And there's growing awareness of the issue and that it's OK to ask for help, health officials say.
There was a more than 8% drop in suicides in people ages 10 to 24 in 2022. That may be due to increased attention to youth mental health issues and a push for schools and others to focus on the problem, CDC officials said.
But even the smaller number masks tragedy for families.
Christina Wilbur lost her 21-year-old son, Cale, on June 16 last year. He died in her home in Land O' Lakes, Florida.
Cale Wilbur had lost two friends and an uncle to suicide and had been dealing with depression. On that horrible morning, he and his mother were having an argument. She had confronted him about his drug use, his mother said. She left his bedroom and when she returned he had a gun.
"I was begging him not too, and to calm down," she said. "It looked like he relaxed for a second, but then he killed himself."
She describes her life since as black hole of emptiness and sorrow, and had found it hard to talk to friends or even family about Cale.
"Everything reminds me of what's missing," she said.
It's hard to find professionals to help, and those that are around can be expensive, she said. She turned to support groups, including an organization called Alliance of Hope for Suicide Loss Survivors that operates a 24/7 online forum.
"There's nothing like being with people who get it," she said. | Mental Health Treatments |
In certain cases, a new method can provide as much information from brain images taken with computed tomography (CT) as images captured with magnetic resonance imaging (MRI). The method, presented in a study from the University of Gothenburg, could enhance diagnostic support, particularly in primary care, for conditions such as dementia and other brain disorders.
Computed tomography (CT) is a relatively inexpensive imaging technology that is widely available within healthcare, as well as in many parts of the world that lack access to other imaging methods. However, CT is considered inferior to magnetic resonance imaging (MRI) when it comes to reproducing subtle structural changes in the brain or flow changes in the ventricular system. Certain imaging must therefore currently be carried out by specialist departments at larger hospitals where the more advanced imaging technology is available.
AI trained on MRI images
The new software can provide diagnostic support for radiologists and other professionals who interpret CT images. It has been created using deep learning, a form of artificial intelligence (AI). The software has been trained to transfer interpretations from MRI images to CT images of the same brains.
"Our method generates diagnostically useful data from routine CT scans that, in some cases, is as good as an MRI scan performed in specialist healthcare," says Michael Schöll, a professor at Sahlgrenska Academy who led the work involved in the study, carried out in collaboration with researchers at Karolinska Institutet, the National University of Singapore, and Lund University
"The point is that this simple, quick method can provide much more information from examinations that are already carried out on a routine basis within primary care, but also in certain specialist healthcare investigations. In its initial stage, the method can support dementia diagnosis, however, it is also likely to have other applications within neuroradiology."
Reliable decision-making support
This is a well-validated clinical application of AI-based algorithms, and has the potential to become a fast and reliable form of decision-making support that effectively reduces the number of false negatives. The researchers believe that this solution can improve diagnostics in primary care and thus optimize patient flow to specialist care.
"This is a major step forward for imaging diagnosis," says Meera Srikrishna, a postdoctor at the University of Gothenburg and lead author of the study, which has been published in the journal Alzheimer's & Dementia.
"It is now possible to measure the size of different structures or regions of the brain in a similar way to advanced analysis of MRI images. The software makes it possible to segment the brain's constituent parts in the image and to measure its volume, even though the image quality is not as high with CT."
Applications for other brain diseases
The software has been trained on images of a total of 1,117 people, all of whom underwent both CT and MRI imaging. The current study mainly involved healthy older individuals and patients with various forms of dementia. Another application that the team is now investigating is for normal pressure hydrocephalus (NPH).
With NPH, the team has obtained new results indicating that the method can be used both during diagnosis and to monitor the effects of treatment. NPH is a condition that occurs particularly in older people, whereby fluid builds up in the cerebral ventricular system and results in neurological symptoms. About two percent of all people over the age of 65 are affected. Because diagnosis can be complicated and the condition risks being confused with other diseases, many cases are likely to be missed.
"NPH is difficult to diagnose, and it can also be hard to safely evaluate the effect of shunt surgery to drain the fluid in the brain," continues Michael. "We therefore believe that our method can make a big difference when caring for these patients."
The software has been developed over the course of several years, and development is now continuing in cooperation with clinics in Sweden, the UK, and the US together with a company, which is a requirement for the innovation to be approved and transferred to healthcare.
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Drinking kombucha may help to reduce blood sugar levels in people with type 2 diabetes, new research indicates.
The fashionable drink was given to 12 people, who were asked to take it daily with dinner for four weeks. They also spent four weeks drinking another drink, which was similar in flavour and appearance, so they couldn't tell the difference.
After four weeks of drinking kombucha - which is made by fermenting tea with bacteria and yeast - the volunteers saw their blood sugar level drop significantly, which was not the case with the other drink.
These results are based on analysis of just seven people within the study, so far more research is needed (SUBS - must keep).
However, studies in animals suggest kombucha may increase the proportion of healthy bugs living in someone's gut, which may in turn affect their metabolism and have an effect on blood sugar.
The drink may also help to regenerate beta cells - which produce the hormone insulin to regulate blood sugar. But it may also only appear to have an effect because drinking kombucha fills people up, so that they eat less.
Dr Dan Merenstein, co-author of the study from Georgetown University in the US, said: 'To our knowledge this is the first clinical trial examining effects of kombucha in people with diabetes.
'A lot more research needs to be done but this is very promising.'
The study asked people to drink both kombucha and a non-kombucha drink, with eight weeks off in between.
That meant they could compare the effect of both drinks in the same person, with the same typical diet and lifestyle.
The average blood sugar in the volunteers, after a month drinking kombucha, fell from 164 to 116 milligrams per 100 millilitres of blood.
Good control of blood sugar is important in diabetes to try to avoid complications such as heart attacks, strokes, diabetic ulcers which can lead to amputations, and eye problems.
People's blood sugar was measured using a finger-prick blood test after fasting, before breakfast.
The difference in blood sugar after drinking kombucha appeared to be most significant in people who had poorly controlled blood sugar to begin with, according to the study published in the journal Frontiers in Nutrition.
The kombucha used in the study was produced by a commercial company but the researchers say most kombucha drinks should be fairly similar in their ingredients of bacteria and yeast.
Commenting on the study (SUBS - must keep this quote), Naveed Sattar, professor of metabolic medicine at the University of Glasgow, said: 'This is a very small trial and so the results are far from convincing. 'I would not be tempted to take kombucha on the basis of these results.
'Rather, I would do the things we know work to help improve sugar or diabetes control - and that is better activity, sleep, and trying to reduce my intake of discretionary calories.' | Nutrition Research |
Building work is yet to start for 33 of the government's 40 promised new hospitals in England, the BBC has found.
Most are still waiting to hear what their final budget will be for the projects with a 2030 deadline. Only two are finished and open.
Ministers aimed to have six ready for 2025 - but none of this group has full planning permission or funding yet.
The government insists it remains committed to meeting the targets.
Health leaders say they need urgent clarity.
The BBC looked at the issue last year and since then there has been little progress.
When the pledge was announced, in 2019, there was some controversy about exactly what counts as a "new hospital".
NHS guidance says it can range from an entirely new building on a new site to a major refurbishment or alteration.
By October 2020, the commitment was confirmed, with an initial budget of £3.7bn.
Of the 40 hospitals on the list, eight were projects already planned.
BBC News contacted them all, asking for a progress report:
- 33 said they had not started the main building work yet
- Five are under construction
- Two, the Royal Liverpool and the Northern Centre for Cancer Care, are finished and open to patients
Investment seems to be a factor:
- Eight said they had full funding
- One hospital did not want to answer
- 31 said they did not yet have the money to start the core building work but had received some cash to get the project going
One of the six due to be completed in 2025 is Epsom and St Helier University Hospitals NHS Trust, near London.
Some parts of St Helier's site look more like a derelict building than a functioning NHS hospital.
A makeshift wooden roof at the back is held down with sandbags.
One of the three intensive-care units has a problem with ventilation, so it can be used only as a storeroom.
In another, staff are working around a leak.
In winter, it is not unusual for entire corridors to flood.
When we met Chief Medical Officer Ruth Charlton outside a condemned ward, she told us: "It's not safe to enter - the foundations are crumbling and windows are falling out."
She cannot see a new build happening by 2025. Her "optimistic" estimate is 2027. Ms Charlton would not be drawn on a realistic guess but was blunt about how sad and frustrated she felt.
"I'm frustrated on behalf of our patients, their families or staff that they can't receive healthcare in the sort of facility that I would want my family to receive healthcare in," she told us.
As we talk, we can hear the sound of a maintenance crew drilling.
The trust says its backlog maintenance - to bring buildings and equipment up to standard - will cost £130m.
'Extremely unlikely'
Across the NHS in England, backlog-maintenance costs have more than doubled, from £4.7bn in 2011-12 to £10.2bn in 2021-22.
In other words, it has become twice as expensive just to keep the doors open.
Health think tank the Nuffield Trust chief executive Nigel Edwards says the government started with a "big and slightly vague promise - and it was never clear there was enough money available to do anything like the scale of construction that they wanted to". And ministers hitting their 2030 target is "extremely unlikely".
"They've underestimated how long it takes to change the way they design, build, and plan hospitals," he says.
"It's a great ambition - but I think a bit of realism is now starting to sink in."
'Spend more'
In 2019, Boris Johnson assured voters he could build the 40 new hospitals but only "because we're running a strong economy".
The government has never explicitly allocated a budget for this project - but it has undoubtedly become more expensive.
Inflation means prices have gone up sharply, especially in construction.
Institute for Financial Studies senior research economist Ben Zaranko says: "Either the government sticks to that pledge and accepts it will need to spend more on hospital building or it decides it scales back the number and scope of hospitals."
A Department of Health and Social Care official said: "We remain committed to delivering all 40 new hospitals by 2030 as part of the biggest hospital-building programme in a generation."
'Critical level'
The logic here is the New Hospital Programme is developing a new national approach to building these hospitals across England - and a standard approach should mean more a rapid process.
But there is another - potentially dangerous - complication. Several hospitals across England are at risk of collapse, with roofs propped up with scaffolding and posts, because they were built using reinforced autoclaved aerated concrete (RAAC) - a lightweight concrete with bubbles inside like "a chocolate Aero bar".
The NHS has identified 34 NHS buildings in England containing RAAC planks - and it is believed about five need to be dealt with urgently.
But only a small number of the hospitals with planned new builds are thought to be affected by RAAC, so it would make sense to expect new RAAC hospitals to be added to the list soon.
Sir Julian Hartley, chief executive of NHS Providers, which represents trusts, wants clarity, ideally in the next few weeks.
"We are at a pivotal moment, a key point, where we cannot leave for much longer the scale of deterioration," he says.
'We need to know that if we delay too much longer, the scale of the problems in other hospitals and facilities will get to a critical level." | Health Policy |
Former BBC Technology correspondent Rory Cellan-Jones, now a writer, podcaster and owner of rescue dog Sophie from Romania, has Parkinson's disease. Two weeks ago, after fracturing his elbow in a nasty fall, he found out just how difficult it can be to get answers from the NHS.
Walking down a poorly lit street in heavy rain, I tripped on a branch dislodged by the storm and my face crashed into the pavement. With that, my latest experience of NHS care was under way.
As I stumbled to my feet, blood pouring from my face, I was convinced I had broken my nose. I phoned my wife Diane and she rushed to take me to A&E.
When we saw the triage nurse, the blood pooling on the floor was the first sign of how serious the problem with my elbow was.
I then spent many hours lying on a trolley, waiting for the next stage. The possibility of admission was discussed but I eventually arrived home with my arm in plaster at 03:45 BST.
That weekend, Diane waited on me hand and foot. It was a sobering experience and perhaps a glimpse of my future as Parkinson's gradually makes me less capable of doing things I once took for granted.
From now on, there will be an edge of fear associated with another activity which I never used to think about - going for a walk.
Switchboard hell
The next week, I anxiously awaited a call from Ealing Hospital to tell me when they would be operating on my badly fractured elbow.
One source of the anxiety was the difficulty of contacting anyone at the hospital. Without a name you are lost in switchboard hell, passed from one extension to another as you try to identify the correct department.
A call came on Tuesday to attend a CT scan, which revealed mine was an open fracture, where the bone has pierced the skin - something that should have been noted when I was sent home on Saturday.
The registrar now wanted me to return to the hospital to be admitted, put on an antibiotic drip and prepared for surgery on either Wednesday or Thursday.
At least that sounded like a clear plan of action and when my wife Diane got home, we set off for the hospital.
We arrived at 19:00 under the foolish misapprehension that I would be whisked in and put on that antibiotic drip pronto.
No such luck. It was 21:00 before I was lying on a stretcher with the registrar inspecting my wound and replacing the plaster cast. We were in a cubicle which also housed the linen cupboard so there was a constant stream of medical staff coming through in search of sheets and pillows.
It was 01:00 the following day before they finally found me a bed on a ward.
Blank looks
Now, we all know about the pressures on A&E and the scarcity of beds - and the hard-pressed staff were lovely - so I could accept the long wait. What did worry me was exactly when I was going to be put on the antibiotic drip I had been told was so urgent.
I kept mentioning this to anyone who came near me but got blank looks. After 23:00 I was told I could no longer eat or drink so that I would be ready for surgery in the morning.
Finally, at 03:00 a canula was inserted in my hand and the antibiotics began to flow.
Wednesday morning came after a virtually sleepless night but I felt positive because at last my fracture was going to be sorted out. Or was it?
I kept asking when a decision would be made on my operation but got no answers. Hope began to fade, and then around 10.15 a doctor arrived and seemed surprised that I had ever expected to be heading to theatre - after all, I had only been on the antibiotics for a short while.
I felt a huge sense of anti-climax but at least I could have some breakfast now and I'd be home by Thursday afternoon.
The whole cycle began again - nil by mouth after 23:00, a few hours of fitful sleep, awake at 05.30 eager to go - but with the same result.
At 9.30 I texted Diane: "Still waiting for information. This place is driving me nuts."
Shortly afterwards came confirmation - I had been bumped off the list. A 94-year-old had broken his hip and someone else had been injured in a car accident. It was hard to argue that they should not be given priority in theatre.
Nevertheless, if I'd been kept in back on Saturday I would have been sorted by now.
Fears of decline
My misery plumbed new depths. While my Parkinson's may not have caused my fall, my symptoms were now being exacerbated by the pain and discomfort from my right arm.
Now I feared I would emerge from this ordeal having taken a big step down the Parkinson's ladder of decline.
Until that moment I saw myself as coping well with my Parkinson's and definitely not as an old person. But in the days after the incident I felt 10 years older, shaky, indecisive, a patient waiting to be told what to do rather than a free agent shaping my life.
I explained my fears to those treating me and, to be fair, they appeared to understand. Suddenly I had three doctors and a senior nurse around my bed discussing the options. The decision was made that I should go to a different hospital for an operation on Saturday.
After 36 hours occupying a valuable bed to no purpose, I was released from hospital to go home for the night - although the paperwork for my release took four hours.
Once home, there was more tension. Due to a mishap with passing on my contact details, it took all day Friday to hear about the next step.
But I eventually got the call and the next day I was admitted to Northwick Park Hospital in Harrow.
From then on, everything went smoothly. I was first on the surgery list and woke shortly after 14:00 in some pain but hugely relieved that the job had been done. Eight days after my accident, my recuperation could begin.
I do want to stress that at both hospitals I was treated by excellent staff working under great pressure in difficult circumstances. But what struck me is that the NHS remains a cumbersome beast that struggles to talk to its patients or to itself.
No talking
Getting information about one's treatment seems like an obstacle race where the system is always one step ahead. But communication between medical staff within and between hospitals also appears hopelessly inadequate, with the gulf between doctors and nurses particularly acute.
I also sense that, in some cases, new computer systems are slowing not speeding information through the system. On Saturday morning, as we waited in the surgical assessment unit, four nurses gathered around a computer screen while a fifth explained to them all the steps needed to check-in a patient and get them into a bed. It took about 20 minutes and appeared to be akin to mastering some complex video game beset with bear traps.
One bright spot was the NHS app which was often first with new information, such as my discharge letter, but I still had to wait for it to be printed out before I could go.
I am very grateful that the NHS finally came good and fixed me up and I am slowly getting back my mojo as I prepare for other projects - not least my work with our rescue dog Sophie from Romania, who has been set back in her progress by my inability to work with her.
But my latest experience as a customer of the health service has nevertheless left me convinced that more money and more staff won't solve its problems without some fundamental changes in the way it communicates.
London North West University Healthcare NHS Trust said: "It's clear from Mr Cellan-Jones' recent experience that we must do more to improve the way we communicate with patients who need our trauma service.
"We're always grateful for feedback from our patients and have already arranged to review our trauma pathway at Ealing so we can make improvements to offer as seamless an experience for our patients as possible.
"We wish Mr Cellan-Jones a smooth and swift recovery." | Medical Innovations |
Every Friday, a dedicated group of volunteers travels to the Covid Memorial Wall opposite the Houses of Parliament to preserve the memory of those we lost to the pandemic. Their task is to paint hearts, ensuring the symbols which represent the dead don't fade away through time and the effects of weather. Fittingly, it is a weekly devotion that comes from the heart, as each of the women who make the pilgrimage with their paintbrushes lost at least one loved one as coronavirus took a terrible toll on the country. The 500-metre-long wall is dotted with more than 200,000 red hearts - each representing someone who fell victim to Covid-19. But as well as a symbol of remembrance, it also stands as a reminder to those in power in Parliament to learn from their mistakes, volunteer Amanda Herring told the Mirror. She's regularly joined by other volunteers like Lynn Jones, who travels 140 miles to London every Friday morning to paint, regardless of the weather. Volunteers from The National Covid Memorial Wall group come every Friday to refresh the hearts (
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Alahna Kindred) For those who cannot make the pilgrimage to the wall to place their own heart, the group places the dedication themselves and logs it so no one is forgotten. You can visit their website to make a dedication here. The Wall started as an organic grassroots movement to create a visible representation to show the astronomical death toll in the UK. The volunteer group are now hoping to establish it as an official national memorial with the backing of the government. The Mirror spoke with some of the volunteers who have shared their heartbreak and grief and why they've dedicated themselves to ensuring every Covid death in the UK is remembered forever. Lynn Jones Lynn lost her "fit and healthy" husband Gareth to Covid in March 2021 and travels from Stoke-on-Trent every Friday to paint the hearts. She told The Mirror: "He was perfectly healthy. We had no idea that he was at risk. He was totally healthy. He was fitter than me." When Gareth, 66, went into the hospital it was the height of the third national lockdown, meaning Lynn wasn't able to see him. She said: "The seven weeks he was in hospital we couldn't visit him. He was on his own all that time, he must have been terrified. "I wasn't allowed to see Gareth for seven weeks, imagine that." Volunteers refresh the hearts that have faded away (
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Alahna Kindred) Lynn, 70, says coming to the wall has helped her grieve and she hopes the Covid inquiry will bring answers. "There's 200,000 names on this wall. I come from Stoke every Friday to be to do the work on this wall. We've got dedications to people who are bereaved. "It is a grassroots movement, really, of what bereaved people are really feeling. "And they're feeling left behind because nobody seems to be bothered about us. And nobody treats us with any respect. "And then we're opposite the Houses of Parliament where we are treated with no respect, which is really sad. She added: "I come to the wall every Friday because I'm with women who are also bereaved - all of us are - and we are trying to do something for other people who can't get to London. "We are making sure the hearts don't fade and we are putting dedications in and that is helping all the other people who are suffering and who are ignored and not respected. "It helps me with the grieving because I'm with like-minded people." Fran Hall Fran Hall re-freshes the hearts on the Covid Memorial Wall (
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Ian Vogler / Daily Mirror) Fran, who is one of the leaders of the group, told The Mirror how her husband died three weeks after their wedding when he was 65. She said: "I've been involved with the wall since the very first day. "I was here on the day the first hearts were painted in March 2021. And I've been part of this group of women since August, last year, when we realised that the wall was fading. "We needed to start to restore all of the hearts, there's so many of them. "My partner Steve died from Covid-19, three weeks after we got married in October 2020." Fran with her husband Steve before he died of Covid (
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Supplied) Speaking about travelling to the wall from Buckinghamshire every week, the 61-year-old said: "This has been really cathartic. It's been a way of meeting other people who understand exactly what this kind of grief is." The CEO of the Good Funeral Guide CIC added: "My background is in funerals and bereavement, and I thought I was quite an expert on it. And I realised that I didn't really know anything. "Apart from making sure the wall doesn't fade this is kind of communal, bereavement group." Lorelei King Lorelei King says volunteering at the wall one of the way she honours her husband (
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Ian Vogler / Daily Mirror) Lorelei, an American actor who's appeared on Emmerdale, told the Mirror her husband Vince died when he was 72. She said: "My husband died of Covid. He had young-onset Alzheimer's and died on March 31, 2020. "I heard about the wall in 2021 and I came down and saw they had painted and painted one for my husband. "I used to come down on my own before I found out about the group and this group of women, once you're, once you're in, you're in. "We formed quite a sisterhood. And I find it's almost like an act of prayer for me. "It's an act of devotion to come here and visit my husband's heart but also to paint dedications of hearts for other people because not everyone can get to London. Lorelei with her husband Vince (
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Supplied) "It's a privilege to paint hearts for people who can't get here. "It's like a form of therapy for us or a form of grief counselling because we have this shared experience." Speaking on the importance of the wall, Lorelei said she couldn't imagine any other monument being in its place. Lorelei, who travels from central London to the wall, said: "It's important to me on two levels first, personally, because my husband's heart is here. "It's like a grave. It's a place to come and remember him, but more generally, I think it is a kind of spontaneous and organic tribute that grew out of people's grief. "And it's stunningly beautiful, stunningly impactful. And to keep it as a memorial of that time. And to treasure, the memory of all those lost so that they won't be forgotten is important. "I can't imagine any other monument or memorial would have the impact that this one does. And it would be for the whole country. It is in London, but it would be for the whole country. And it's across from the seat of power, which is also significant. "We want this memorial to be made permanent so that we don't forget that there are lessons to be learned. And I think that's kind of where we are now it's not only about apportioning blame, it's more about accountability and learning for the future. "There is someone for every heart you see here who paid the ultimate price for lessons to be learned. So to squander that would be sinful. "We mustn't forget and we're unlikely to if we can keep this." Anne Grange Anne Grange joined the volunteer group after her son discovered the wall (
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Ian Vogler / Daily Mirror) Anne, who is from Hertfordshire, lost her brother in January 2021 when he died of Covid in a care home. She told the Mirror: "My brother passed away in January 2021. He lived in a care home after suffering a brain injury quite a few years back. "We thought he would be totally protected and safe there, but he died." Anne said her son found the wall when she was just passing by and she later joined the group. Anne lost her brother Robert to Covid (
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Supplied) She said: "In March 2021, my son was walking past with a friend and saw it was all happening on that weekend and he added his dedication for his uncle. "And then a few months later I kind of just walked past by accident one day, and there was a group of them here, refreshing the hearts, and I just kind of tagged along and I've been back every week since then." Anne has been with a group ever since and said she's also suffered more heartbreak this year. She said: "My mum passed away in September. She fell and broke her hip and contracted Covid in the hospital. She then died of Covid and pneumonia in September." Kathryn Butcher Kathryn Butcher works on the wall every Friday (
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Ian Vogler / Daily Mirror) Kathryn, 58, told the Mirror: "I lost my sister-in-law, who was 56. And she died very early on in the pandemic on March 29th, 2020. "We think she contracted Covid in about the first or second week of March. "We are really angry at the government for not locking down sooner." The youth worker from London said that if anyone performed this badly in their jobs, as she believed members of the government had done, they would have been sacked. Kathryn’s sister-in-law Myrna passed away from Covid (
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Supplied) Talking about how she met the volunteer group, she said: "I started coming down here to volunteer to write names into the hearts for people that couldn't get down here because I live fairly locally. "I was working on my own at first and then we noticed that the hearts were significantly fading. I was asked to be part of a group to come together to see what we could do to help to restore the hearts and maintain the wall." Michelle Rumball Michelle Rumball at the Covid Memorial wall (
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Ian Vogler / Daily Mirror) Michelle, 50, said: "What got me involved is my mum. She died at the very beginning of the pandemic. "My mum went into the hospital on the eighth of April when I thought that she would go in there and be treated. And we've later found out since getting our notes that they literally were never going to treat her. "So it clearly states on her medical file that within five minutes of her in the hospital that she wasn't gonna get treated. "We never got any phone calls. No nothing. And two hours later, a consultant put a DNR on her. And I questioned him after my mum died and I said 'why did you put a DNR on my mum and you didn't examine her?' "He said he didn't want to deplete the PPE." Michelle’s mum Violet Partington was 78 when she died of Covid on April 9, 2020 (
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Supplied) Michelle, who is a carer for her sister and travels from Pinner, London, added: "I've actually got that in writing, that's what they actually put in a letter to me. "It's coming up to the third anniversary of my mum dying in April. She has been gone two and a half years and in two and a half years more than 220,000 people have died. "My mum shouldn't have died. She wasn't ill. And she went to the hospital and they just did not treat her. She had nothing, she died 19 hours later. She'd never been treated. "So this is why I come to this wall every week because these people just can't be forgotten the same as my mum." Amanda Herring Amanda Herring says she comes down to the wall to make sure loved one are not forgotten about (
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Ian Vogler / Daily Mirror) Amanda, 51, and travels from Croydon, South London to the wall each week, said: "I came here when it was first set up back in March 2021 to add my brother's heart because I lost him in the pandemic. "He died on March 19, 2020, when he was 54. "When I first came down I met with the fellow bereaved women that are here today. "It's important because I started coming down in August, September last year when we realised it had faded and I connected with these women. "We're like, family, we've come together in our grief and we've all lost someone. And we just understand each other. Amanda's brother Mark, who died on March 19, 2020 aged 54 (
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Supplied) "It helps to keep our loved ones alive by painting the hearts, refreshing them, also doing the dedications for people that can't come here themselves. "It is also important because it's facing the Houses of Parliament and it needs to stay red and vibrant so that those in power over there never forget the mistakes that have caused more than 200,000 deaths in this country." Kirsten Hackman Kirsten, who has been volunteering for 14 months, lost her mum Margaret Sìne Watt during the first wave of the Covid pandemic. "I lost my mum in the first wave. So she had a fall at home, was admitted to hospital with a fractured pelvis and essentially never came out again. She said: "She had a fall at home and was admitted to the hospital with a fractured pelvis and essentially never came out again. "Before she went in, she said she didn't want to go because she said she'd catch the virus and die. And she died on May 2, 2020. "We only had eight people at the funeral and we only had 20 minutes because the room had to then be sanitised for the next people to come in. Margaret Sìne Watt was 85 when she died of Covid (
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Supplied) "She didn't have a funeral that she deserved. She'd lived a long life and should have been longer and didn't get what she deserved. "When I found out about the wall, it was important to me for her heart to be put on the wall because that was one thing that I could do for her to make her be a person, not a statistic. It's not much, but it's something that's got her name on it. "When the hearts started fading, the group came together to repaint and refresh these hearts, and I've been volunteering with this group for over a year. "I've come every Friday for 14 months to refresh the hearts because it's important to me to make sure that all of these lives lost are not forgotten. "They were taken too soon. They have family, they have friends, they have colleagues. And each life loss causes a massive ripple in society to the people that have lost them. "People can't necessarily travel and do their own heart. "I know how much it means to know that my mum is here, and therefore I want to be able to do that heart for those people who can't make it here to say they have not been forgotten. They are not statistics, they are not hidden, they are people." "This memorial needs to be permanent so our loved ones never fade." Irene Houston Irene's mum died of Covid in a care home and says she's still furious she was denied the chance of seeing her say goodbye before she died. Tragically, Irene's mum and brother died within eight weeks of each other. Irene, who is retired and travels from West London to the wall each week, told The Mirror: "I couldn't see my mother for six weeks, who was 97. I begged them when they told me my mother had fainted and told me she wasn't eating. Irene's mum Catherine Goldie Houston died of Covid in May 2020 aged 97 (
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Supplied) "And I begged them to let me see her. And they said: 'Oh, no, she's not at the end of life.' And then the next day, I got a phone call to say 'your mum died 10 minutes ago, do you want to see her?' "They took that goodbye away from me. And not only that, my brother had stage-four cancer at the time and he had to shield himself for three months. People visit the memorial for their loves ones (
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Alahna Kindred) "Then they pulled him in to give him a booster and he died eight weeks after my mum. "We've all got trauma because of the government decisions that were made "They need to get to the bottom of this because it won't bring our loved ones back. We have to live with what's happened." Irene described her mum as a "lovely, kind lady from Glasgow with a great sense of humour". You can virtually visit the National Covid Memorial Wall here. The Covid Memorial Wall group have formed an unincorporated association, ‘The Friends of The Wall’, to help with fundraising efforts. At the moment, all the supplies they use have been generously donated by paint manufacturers Valspar and pen suppliers Sharpie, but funds are needed to cover future costs of sealing the wall and funding permanent signage. The volunteers are in discussions with both the owner of the wall, Guys & St. Thomas NHS Foundation Trust, and Lambeth Council, the planning authority, to achieve planning permission to make the location a permanent national symbol of the nation’s collective loss. Recently, the public consultation for UK Commission on Covid Commemoration ended, which sought to find out from communities how best to remember the pandemic.As part of this consultation, Baroness Nicky Morgan, who is heading the commission, visited the wall to experience it for herself, and to hear from volunteers about what the wall means to them and to the many thousands of bereaved people who have a heart dedicated on the wall. Many contributors to the public consultation have asked that the commission recommend making the site a permanent national symbol.Baroness Morgan is expected to submit the Commission’s recommendations to the Prime Minister by the end of March 2023. Read More Read More Read More Read More Read More | Epidemics & Outbreaks |
Red wine may be on your , but for some people, even a small glass can result in a headache. Now researchers say they may have figured out why.
In a new study, published in the Scientific Reports journal on Monday, scientists at the University of California, Davis, found the culprit may be a flavanol that occurs naturally in red wines and can interfere with the proper metabolism of alcohol. Flavonols are a group of compounds found in many plants.
The flavanol, called quercetin, is naturally present in grapes and other fruits and vegetables and is considered a healthy antioxidant. However, when metabolized with alcohol, issues can occur.
"When it gets in your bloodstream, your body converts it to a different form called quercetin glucuronide," wine chemist and corresponding author Andrew Waterhouse, professor emeritus with the UC Davis Department of Viticulture and Enology, said in a news release about the study. "In that form, it blocks the metabolism of alcohol."
The result is a build up of acetaldehyde, an inflammatory toxin that can cause facial flushing, headache and nausea.
Red wine headaches — not to be confused withthe day after drinking — do not require excessive amounts of wine, the study notes. In most cases, the headache starts 30 minutes to 3 hours after drinking only one or two glasses.
The amount of quercetin in wines also varies greatly, the researchers note. Factors like the sunlight exposure the grapes receive and how the wine is made can impact the amount present in the final product.
"If you grow grapes with the clusters exposed, such as they do in the Napa Valley for their cabernets, you get much higher levels of quercetin. In some cases, it can be four to five times higher," Waterhouse said.
So, is there a way to avoid the risk of a headache besides skipping the sipping? That's what scientists are looking to research next.
"We think we are finally on the right track toward explaining this millennia-old mystery. The next step is to test it scientifically on people who develop these headaches, so stay tuned," co-author Morris Levin, professor of neurology and director of the Headache Center at the University of California, San Francisco, said in the release.
That research, a small human clinical trial funded by the Wine Spectator Scholarship Foundation and led by UCSF, intends to determine why some people are more susceptible to these headaches than others and if quercetin or acetaldehyde is the primary target for ameliorating these effects.
"If our hypothesis pans out, then we will have the tools to start addressing these important questions," Waterhouse said.
for more features. | Nutrition Research |
ATLANTA (AP) — Tortuguita’s cautious voice rang out from a platform amid the tall pines the first time Vienna met them: “Who goes there?” she remembers them calling.
The tree-dweller, who chose the moniker Tortuguita – Spanish for “Little Turtle” – over their given name, was perched above the forest floor in the woods just outside Atlanta last summer.
Vienna quickly identified herself, and Tortuguita’s watchfulness melted into the bubbly, curious, funny persona so many in the forest knew. They welcomed the newcomer and helped her settle in alongside the other self-proclaimed “forest defenders” on an 85-acre (34-hectare) site officials plan to develop into a huge police and firefighter training center. Protesters derisively call it “Cop City.”
“It was a magical experience for me, being able to live out our ideals,” Vienna told The Associated Press, recalling how the protesters shared clothing, food and money, all while engaging in community activism. She and Tortuguita quickly fell in love during those warm, late summer days.
That was before. Before a Jan. 18 police operation that ended in gunfire, leaving 26-year-old Tortuguita dead and a state trooper hospitalized, shot in the abdomen. Officials have said officers fired in self-defense after Tortuguita, whose given name was Manuel Esteban Paez Terán, shot the trooper. Activists argue it was state-sanctioned murder.
Outrage over the events has galvanized leftists around the world, with vigils from Seattle to Chicago to London to Lützerath, Germany.
Environmentalists for years had urged officials to turn the land into park space, arguing that the tall, straight pines and oaks were vital to preserving Atlanta’s tree canopy and minimizing flooding.
Vienna, 25, recalls her first four months there as joy-filled. There were campfires and sleepovers, in her tent or Tortuguita’s, nestled in the large wooded tract that activists call the Weelaunee Forest, the Muscogee (Creek) name for the land.
City Council approved the $90 million Atlanta Public Safety Training Center in 2021, saying a state-of-the-art campus would replace substandard offerings and boost police morale beset by hiring and retention struggles in the wake of violent protests against racial injustice that roiled the city after George Floyd’s death in 2020.
The planned development, largely financed by private corporate donations, enraged activists. Trees would be razed to build a shooting range, a “mock village” to rehearse raids and a driving course to practice chases. All would be within earshot of a poor, majority-Black neighborhood in a city with one of the nation’s highest degrees of wealth inequality.
Like many of those who took to living in the forest to oppose the development, Tortuguita was an eco-anarchist committed to fighting climate change and halting expansion of a police state, Vienna said.
Beyond the distrust many in the “Stop Cop City” movement have toward police, six people who knew Tortuguita told the AP that authorities’ allegations about the protester's final encounter do not match up with the person they knew: someone who, almost to a fault, always put others first.
“They were genuinely so generous and loving and always wanted to take care of people,” Vienna said of her partner, who last year took a 20-hour course to become a medic for the activists. “Their biggest thing was building communities of care.”
Tortuguita’s brother, Daniel Esteban Paez, said his sibling was even growing long hair to donate to children with cancer.
Tortuguita was a “citizen of Earth,” Paez said, growing up in their home country of Venezuela as well as Aruba, London, Russia, Egypt, Panama and the U.S. as their stepfather’s oil industry career led the family around the world. Tortuguita graduated magna cum laude from Florida State University and had been active in Food Not Bombs, helping feed homeless people in Tallahassee, Florida.
They had lived for several months among the “Stop Cop City” campers, a group whose reputation had been growing among leftist activists.
The campers built platforms in the trees and slept out, seeking public support and to block construction. They barricaded forest entrances and have been accused of threatening contractors and vandalizing heavy equipment.
Officials recently ratcheted up pressure. In December, authorities said firefighters and police officers were removing barricades to the site when they were attacked with rocks and incendiary devices. Vienna was among six arrested and accused of domestic terrorism for allegedly throwing rocks at fire department and emergency services workers, as well as a moving police vehicle. She’s fighting the charges in court.
The allegations are designed to scare others away from the cause, argued Marlon Kautz of the Atlanta Solidarity Fund, a group providing legal aid to those arrested.
“These charges are purely being brought for the sake of putting activists in jail ... and demonizing the movement in the public eye,” Kautz said. “When we see the authorities using the criminal justice system to chill speech and prevent activists from associating with the movement, that is a grave threat to democracy.”
DeKalb County District Attorney Sherry Boston declined to comment on the specific facts of each case but said "if a person uses threats and violence in an effort to force a government entity to change a policy ... that is defined as Domestic Terrorism according to the Georgia statute.”
A month after the December altercation with police, Tortuguita was dead, killed as officers tried to clear remaining protesters from the site. Seven others were arrested on domestic terrorism charges during what authorities called a “clearing operation.”
The Georgia Bureau of Investigation has said there is no body camera or dashcam footage of the shooting, but that ballistic analysis shows the trooper was shot by a bullet from a handgun in Tortuguita’s possession.
The GBI said Tortuguita was inside a tent and did not comply with officers’ commands prior to firing at authorities. Vienna declined to comment when asked whether she knew if her partner had a gun, though the GBI says records show Tortuguita legally purchased the firearm in 2020.
Vienna and other activists have questioned the official version of events, calling the shooting a “murder,” accusing officials of an inconsistent, vague narrative and demanding an independent investigation. The GBI says it has a “track record of impartiality” when investigating officer-involved shootings.
On Jan. 21, violence and vandalism broke out when a masked contingent among hundreds protesting in downtown Atlanta began throwing rocks and aiming fireworks at a skyscraper housing the Atlanta Police Foundation. Activists then lit a police cruiser on fire and smashed a few more windows. No injuries were reported.
Authorities arrested six more people that night on charges including domestic terrorism, saying that “explosives” had been recovered. Police declined to elaborate when asked whether they were referring to fireworks or more dangerous incendiary devices.
“Make no mistake about it: these individuals meant harm to people,” Atlanta Mayor Andre Dickens said during a news conference Saturday.
In response, GOP Gov. Brian Kemp on Thursday declared a state of emergency, giving him the option of calling in the Georgia National Guard to help “subdue riot and unlawful assembly.”
Paez, Tortuguita’s 31-year-old brother from Texas, said his family is heartbroken.
“Our family doesn’t want violence toward cops, but we also don’t want violence from cops,” Paez told the AP. “I’m just terrified at the thought that the tactics that were used to kill my sibling are going to be replicated at Cop City.”
He bristles at the allegation that Tortuguita was a domestic terrorist. They were too kind. Too smart. Too caring.
“He was a privileged person but he chose to be with the homeless, to be with the people that needed his caring,” said Tortuguita’s mother, Belkis Terán, who lives in Panama.
For a long time, Paez said he did not care about the forest’s fate. He was far more concerned about Tortuguita’s safety.
“I told my sibling, ‘If you were ever to die, I’m going to dump oil and hazardous materials in your stupid forest,’” Paez recalled, his voice cracking. “They called my bluff. I care about the forest now.” | Epidemics & Outbreaks |
This story discusses suicide. If you or someone you know is having thoughts of suicide, please contact the Suicide & Crisis Lifeline at 988 or 1-800-273-TALK (8255).
Giving birth is one of the most transformative experiences a woman can have — but the postpartum period isn’t always so easy to navigate.
As many as 20% of new moms may experience postpartum depression, which can range from mild "baby blues" to serious mood swings, thoughts of harm and even suicidal tendencies.
Dr. Cluny Lefevre, a board-certified family practice physician at Fem Strong Health in New York City, shared with Fox News Digital these five tips to help new mothers heal and enjoy a healthy relationship with their child.
1. Embrace creative expression
"At this time in your life, it is likely that your mind is racing and [you're] thinking about all of the things you must do to support your newborn," said Lefevre, who has extensive experience in women's health and hormonal health.
She recommends carving out at least 30 minutes daily for other outlets to give the mind the opportunity to relax.
Activities such as painting, writing or playing a musical instrument can serve as a great relaxation tool, she said.
2. Develop mindful eating habits
"New moms tend to make sure they feed their infant and take great time and consideration in when, how and where this will be done — but they may forget that they also need proper nutrition to heal their body and support their strength to care for the baby," said Lefevre.
Busy moms often follow a "grab-and-go" routine for their own meals, but this can leave them short of important nutrients, warned Lefevre.
The doctor suggested practicing "mindful eating" sessions, in which a mom will take 10 to 15 minutes to eat a meal.
"Know what you are eating, take the time to savor and enjoy each bite, and connect with your body and mind," she said.
"This will both relax you and keep you strong."
3. Practice ‘grounding’
To stay in touch with nature, Lefevre suggests that new moms go outside — especially first thing in the morning.
"Don’t stare at the sun," she said — but bask in it.
"If possible, do this barefoot in the grass."
The grounding effect with nature is relaxing, while the sun resets the circadian rhythm.
This will also reduce stress hormones and improve your mood, the doctor noted.
4. Start engaging your body
After childbirth, a woman’s body is in a "state of repair," Lefevre said.
"You are doing a lot of running around, bending in awkward positions and holding your baby until your arms cramp," she said.
The doctor recommends doing a 15-minute stretching and light strengthening program, ideally twice per day while the baby is resting.
"Do some dancing for cardio, simple stretching exercises to get those ligaments and tendons lubricated, and lightweight training to reawaken those muscles," she suggested.
5. Keep a gratitude journal
"Use your mind and remember happy, successful or uplifting moments, then write them in a journal," said Lefevre. "This can be digital or paper, based on your preference."
For the maximum benefit, she said to add a journal entry at least once a day.
"If you can’t find the energy to write one day, then re-read your passages from earlier," Lefevre suggested.
"This will lighten your mood, relax your mind, release positive hormones and generally make you feel better."
To read more pieces in Fox News Digital's "Be Well" series, click here. | Women’s Health |
California teen Chloe Cole, perhaps the most famous American to undergo sex-transition surgery as a child and later regret it, has spoken passionately about her procedure being like 'Nazi-era experiments'.Addressing a think tank in Washington, Cole, 18, said she was coerced into taking puberty blockers and having both breasts surgically removed when she was 15, and warned of other minors being misdiagnosed and pushed into similar operations.Cole late last year unveiled plans to sue the doctors who authorized her surgery and 'gender-affirming care', as it is known, fast becoming a poster child for conservatives who want to protect other kids from a similar outcome.'It's important to know how awful it really is,' Cole told the Heritage Foundation about her double mastectomy.'Really, it's like Nazi-era experiments.' Chloe Cole, 18, who transitioned to male at 13 before later regretting her decision at 16, says breast removal operations on trans kids are 'like Nazi-era experiments'Chloe Cole 'medically transitioned' between the ages of 13 and 16, having her mastectomy surgeries at 15 in June 2020Cole described having mental health issues and family problems as a child and becoming exposed to transgender discussions online.Clinicians railroaded her into taking puberty blockers and then hormones and finally surgery, she says.'They kind of watered it down,' she said of the doctors who explained to her the impending double mastectomy. 'They simplified it a little bit, just to make it a little more digestible for my 15-year-old brain.'Rejecting claims that trans surgeries on children are rare, Cole said 'it happens all the time'. She warned of ever-more adolescents with a range of problems ending up on a bandwagon of gender-affirming care that oftentimes does not help them.Many of those who feel a mismatch between their biological sex and their gender identity — a condition known as gender dysphoria — have other problems that need to be addressed, including autism spectrum disorders, she added.'Everybody my age, I know, who's transitioning, or is dysphoric, they're either on the spectrum, or they have some other learning disorder, or they have depression or social anxiety, or they have a history of abuse or sexual assault, neglect, or issues with their family,' said Cole.Cole is unsure whether the testosterone treatment she underwent affected her ability to have children. She has had to wear bandages because her body is rejecting the skin grafts on her chest. She urged the audience to take transgender ideology more seriously, saying her breast surgery scars and her slimmer chances of being able to have a child should ring alarm bells about the perils. Cole has 'detransitioned' back to being female and now campaigns against trans ideology. Breast removal and other procedures are 'like Nazi-era experiments,' she says. Cole and her lawyer Harmeet Dhillon last year announced they were bringing a medical malpractice suit against the clinicians who signed off on her breast removal surgery 'Conservatives have mostly just been ridiculing the movement… just brushing it off as crazy,' Cole told the right-leaning think tank. 'But it's not, and it's really captured vulnerable children, parents and young people and even entire institutions. And we've really let it go unchecked.'Cole started suffering from gender dysphoria aged nine and spoke to a pediatrician about it when she was 12.She says she was coerced into a gender transition operation and between the ages 13 and 17 took puberty blockers, hormones and had a double mastectomy.In her lawsuit, she says doctors told her gender dysphoria would never go away and that she was at high risk of suicide unless she transitioned.She claims they asked her parents: 'Would you rather have a dead daughter or a live son?'Cole's lawyer Harmeet Dhillon last year said they have brought a medical malpractice suit against the doctors, and she was being represented by Center for American Liberty. Whether or not to help children transition socially or with drugs and surgery has become a frontline in America's culture warsConservatives rail against a 'social contagion' leading to ever more irreversible procedures, while others seek a loosening of gender roles and warn that gender dysphoric minors might kill themselves. The number of young Americans who experience gender dysphoria and seek puberty blockers, hormones and even surgery as a solution has shot up in recent years. This chart shows insurance claims for diagnoses of gender dysphoria by year. These have doubled since 2017 This chart shows insurance claims for puberty blockers in the US by year. It shows claims have doubled since 2017 These graphs of selected states show gender dysphoria diagnoses heading upwardsPrescriptions for puberty-blocking drugs among under-18s doubled between 2017 and 2021, while scripts for hormone therapies have seen a similar rise, according to reports from health insurers.The rise is much more pronounced among girls. The number of breast removals, known as 'top surgery', performed on girls under 18 has risen 13-fold in the past decade, says a study from California.Bottom surgeries, and operations on male-to-female transitioners, are less common.Advocates for gender-affirming care say the rise is down to more awareness of gender dysphoria and support among clinicians. Still, some experts, conservatives and parents warn of an ideologically-driven 'social contagion'.Debate about whether to restrict child gender care has intensified in recent months, as a growing number of former patients who regret having irreversible procedures as children say their desire to medically transition was not challenged enough.The data on how many transitioners change their minds and seek to detransition, or are pressured to do so by relatives or employers, is not reliable, but estimates are in the range of 1 to 8 percent.A popular online forum called the Detransition Subreddit has amassed 42,700 followers. Three 'Detransitioners' who have voiced regret for their decisions An increasing number of people who have undergone gender-transitional procedures are voicing regret for their choices, with many saying they feel they were influenced into making drastic choices without proper counseling. A 32-year-old detransitioner from Massachusetts going by Shape Shifter says he was 'brain washed' into removing his penis by staff at Fenway Health and The Philadelphia Center for Transgender Surgery, who didn't warn him of the negative effects of surgery because it was 'bad for business.''I will never be able to get my penis back which is extremely traumatic for me,' he said in an August interview. 'I want it back and I can't. Sex is traumatic for me now because I've had botched surgeries.' Shape Shifter, pictured, says he even dreams about having a penis, while before his first transition he would dream about having a vaginaA 26-year-old from the UK named Sam says she regrets the transition she undertook at 21.Sam said she made the decision to transition after a mere two-hour counseling session. 'I do believe that therapy should be involved at all stages of the transitioning process to help spot and explore red flags that may appear in someone's transitional journey.'I also think more information should be given to individuals to make sure that their informed consent is truly informed. Sam (pictured after her mastectomy) is now warning others of the dangers of going through gender transition too quickly without proper therapeutic supportAlia Ismail, a 27-year-old from Michigan, is detransitioning after becoming a male at just 18.She legally changed her name to Issa in August 2015 and underwent a double mastectomy in February 2016. But after realizing she wanted to de-transition, the 27-year-old stopped taking male hormones in February 2021 and is going by the name Alia again.Alia Ismail, 27, pictured as both a male and a female | Medical Innovations |
Quick Eating Damage:
Eating too fast and without thinking is one of the most important bad habits that can lead to overeating, weight gain, obesity,
The damage to rapid eating is :
Increased intake of food
The food intake phenomenon has recently spread rapidly, but it should be noted that this can increase the amount of calories in circulation, which can cause an increase in weight; This is because the nervous system takes up to 20 minutes to realize that the stomach has become full, and until then the body has taken large quantities of calories beyond its needs.
Increased risk of obesity
Obesity is one of the most common health problems worldwide, a complex disease not only caused by malnutrition, lack of physical activity or even lack of will, but other factors that play a significant role in causing obesity; Environmental factors and unhealthy lifestyle.
Causing digestive problems
Rapid eating is usually associated with poor digestion; This is the result of some rapid eating products; such as taking large bits of food, not chewing it well, which may affect digestion, and there may also be other factors that may cause indigestion; Eating high-fat foods, eating when feeling stressed, smoking, or using some medication, or fatigue and persistent stress may be one of the causes of indigestion, and sometimes the cause can be a problem in the digestive tract; Like: ulcers, or oesophageal reflux.
Lack of satisfaction
People who eat quickly tend to classify their meals as less fun and a study published in the Journal of the American Dietetic Association in 2008 suggested that eating slowly could help increase satiety, Reducing calorie consumption in meals, as well as increasing satisfaction, This is compared to rapid eating cases that have shown less indicators of satiety and satisfaction.
Increased risk of insulin resistance
A study published in Preventive Medicine in 2008 indicated that rapid eating is largely associated with insulin resistance in both men and women in mid-life.
Increased risk of diabetes
A study published in Metabolism in 2012 indicated that rapid eating was associated with an increased risk of diabetes; Because it has an effect on body weight gain, rapid eating is not a serious factor; It can be controlled by slowly following the eating pattern, adapted to ensure a reduced risk of diabetes, [8] Another study published in Clinical Nutrition in 2013 indicated that rapid eating may cause an increased risk of type 2 diabetes.
Increased risk of metabolic syndrome
A study published in the Journal of Epidemiology in 2015 indicated that rapid eating was associated with metabolic syndrome (Metabolic syndrome), and it is therefore proposed to change the lifestyle to include eating slowly to ensure a reduced risk of metabolic syndrome.
How long to finish a meal
It is recommended that the duration of eating should not be less than (20-30) minutes, so that the nervous system can realize the feeling of filling in the stomach. When the eating process begins, hunger signals are transmitted from the stomach and intestines to the brain, which needs about 20 minutes to stop the desire to eat, so in case of rapid eating; More food will be consumed in 20 minutes more compared to slow eating, and as the person who eats quickly receives satiety signals, it is too late, causing overeating, and uncomfortably achieving satiety.
General tips for healthy and slow dining
There are some tips to start eating more slowly:
- Create conditions for sitting for dining; so that they are far from anything that can cause distractions, and make it easy to eat food without attention; such as: eating in the car, or in front of the TV or computer, instead; It is recommended to sit at the table and try to eat attentively, as this will not only slow down eating, but may also increase satisfaction.
- Leave the tool used to eat while chewing, and place it on the table until the bite is swallowed; To avoid taking more bites on an ongoing basis.
- Eating with a group of friends or family members to enjoy while eating with them, as this contributes to the extension of the meal time.
- Play quiet music while eating, which can help improve mood while eating a meal, and thus spend more time.
- To avoid extreme hunger; Because it has the effect of slowly losing the ability to eat, to avoid this, some healthy snacks need to be kept on hand.
- Eating foods that need to be chewed, by focusing on foods rich in dietary fibres that require a lot of chewing; Such as: vegetables, fruits, nuts; Fiber can also promote weight loss.
- Maintenance of deep breathing exercises; Especially when you start eating at great speed, it helps to refocus while eating.
- conscious and focused eating practice; This helps to pay more attention to what is eaten, and to control cravings for more food.
- Patience during the practice of changing to the pattern of eating slowly; Adapting to any new behaviour can take about 66 days.
- Use a timer or alarm device to help extend the meal time to 30 minutes.
- Increased number of chewing times; Through the experience of chewing each nut 15-30 times, which varies according to the type of food.
- Drinking sips of water while eating; This can help increase satiety. | Nutrition Research |
Less than half of patients in A&E are able to summon help from doctors and nurses when they need it, the NHS watchdog has said.
The Care Quality Commission (CQC) has warned that people’s experience in emergency departments is getting worse as hospitals struggle to cope with increasing demand.
A survey of more than 36,000 people who used NHS urgent and emergency care in England last autumn found that only 45 per cent were confident that they could “always” get help from clinical staff at any point during their stay, down from 58 per cent two years previously.
The results showed that waiting times have increased significantly for both A&E and urgent care centres, with just under a third of people in A&E waiting more than an hour to speak to a doctor or nurse, compared with 15 per cent in 2020, and 18 per cent in 2016.
Meanwhile, the proportion who said they had waited longer than four hours to be examined in A&E in 2022 more than trebled to 17 per cent – up from 4 per cent in 2020 and 5 per cent in 2018.
Three-quarters of people in A&E were also not told how long their wait would be, the survey found.
Dr Sean O’Kelly, the CQC’s chief inspector of healthcare, said: “These latest survey responses demonstrate how escalating demand for urgent and emergency care (UEC) is both impacting on patients’ experience and increasing staff pressures to unsustainable levels.”
He added: “We cannot afford to ignore the long-term decline shown in relation to issues like waiting times, information provided when people leave to go home, access to pain relief and emotional support.”
The CQC has previously said that high call volumes and staff shortages in NHS 111 are leading to delays in people receiving medical advice and more people going to A&E.
A lack of available GP and dental appointments means that NHS 111 cannot always send people to assist, leading to people being asked to call 999 or go to A&E instead, it added.
In the new poll, more than a third – or 37 per cent – of people who used A&E said it was the first service they went to or contacted for help with their condition.
Their top reason for going straight to A&E was that they thought they might need tests, at 40 per cent, followed by being unsure their GP would be able to help with their condition, at 24 per cent.
People who had contacted another service first before going to A&E were most likely to say they contacted NHS 111 by phone (39 per cent), followed by their GP practice (34 per cent) or 999.
Meanwhile, more than half of people who used an urgent treatment centre also said it was the first service they went to or contacted for help.
The main reasons were the condition was urgent, they were unsure their GP would be able to help, and the urgent treatment centre was easy to get to.
More than one in 10 of those who used an urgent treatment centre said they could not get a GP appointment quickly enough, at 17 per cent, an increase on the 12 per cent in 2020 during the pandemic.
The poll also looked at dignity and privacy in A&E and found that people were less likely to feel they had enough privacy at reception and during examination and treatment.
In 2022, less than half, or 45 per cent, of patients felt they “definitely” had enough privacy when discussing their condition with a receptionist, compared with 55 per cent in 2020 during the pandemic.
Similarly, fewer people felt they had enough privacy while being examined and treated (78 per cent compared with 84 per cent in 2020, 83 per cent in 2018 and 82 per cent in 2016).
Other declining standards compared with previous years included the proportion of people who said staff “definitely” did everything they could to control their pain, and levels of patient confidence and trust in doctors and nurses examining and treating them.
The proportion of people feeling they were treated with respect and dignity declined to 72 per cent, compared with 81 per cent in 2020.
Less than half (46 per cent) of A&E patients were also “completely” told about what symptoms to watch for when they went home, compared with 53 per cent in 2020 and 51 per cent in 2018.
Responding to the results, Saffron Cordery, the deputy chief executive at NHS Providers, said: “Urgent and emergency care services are under enormous pressure as demand continues to outstrip capacity.
“Trusts are working towards the milestones in the national recovery plan, with early improvements in the number of patients being seen within four hours in A&E.
“However, performance across UEC is symptomatic of pressure on the whole system, including in mental health and community services.
“Proper investment in capital and workforce – including in social care – could help alleviate pressure by ensuring other, interconnected parts of the NHS run more smoothly. This could lead to fewer ambulance handover delays and ensure patients who are medically fit to leave hospital can do so in a safe and timely manner.”
The CQC said people in A&E were more likely to report a negative experience if they were frail, disabled, if their visit lasted longer than four hours or if they had been to the same A&E for the same condition within the previous week.
An NHS spokesman said: “Since this survey was carried out, NHS staff have delivered significant improvements in performance with faster ambulance response times and a greater number of patients being seen in A&E within four hours in June – this is despite unprecedented levels of demand, pressures on patient flow, and industrial action.
“These findings also demonstrate how patients value the hard work and care from staff, with the vast majority of respondents having confidence and trust in health professionals and we will continue to work with local services to deliver measures outlined in our urgent and emergency care recovery plan to improve the experience for patients and boost capacity ahead of winter.” | Health Policy |
Matt Hancock's handling of the COVID pandemic has come under fresh scrutiny following a leaked trove of more than 100,000 WhatsApp messages.
An investigation by The Daily Telegraph alleges the former health secretary rejected testing advice on care homes and expressed concern this could get in the way of meeting his targets.
The MP strongly denied the "distorted account" with a spokesman alleging the conversations, leaked by journalist Isabel Oakeshott after she worked on his Pandemic Diaries memoir, have been "spun to fit an anti-lockdown agenda".
Former chancellor George Osborne and Conservative MP Jacob Rees-Mogg are also the subject of some of the messages.
Here, Sky News looks at the key exchanges that reportedly took place:
The Telegraph's investigation claims chief medical officer Professor Sir Chris Whitty told the then health secretary in April 2020 there should be testing for "all going into care homes".
Mr Hancock described it as "obviously a good positive step".
But the messages suggest he ultimately rejected the guidance, telling an aide the move just "muddies the waters".
According to the investigation, he said: "Tell me if I'm wrong but I would rather leave it out and just commit to test and isolate ALL going into care from hospital.
"I do not think the community commitment adds anything and it muddies the waters."
However, a source close to Mr Hancock said The Telegraph "intentionally excluded reference to a meeting with the testing team from the WhatsApp".
"This is critical," the source added, "because Matt was supportive of Chris Whitty's advice, held a meeting on its deliverability, told it wasn't deliverable, and insisted on testing all those who came from hospitals.
"The Telegraph have been informed that their headline is wrong, and Matt is considering all options available to him."
How were the WhatsApps leaked?
Meanwhile, a spokesperson for Mr Hancock said: "It is outrageous that this distorted account of the pandemic is being pushed with partial leaks, spun to fit an anti-lockdown agenda, which would have cost hundreds of thousands of lives if followed. What the messages do show is a lot of people working hard to save lives."
Care home testing could 'get in way' of the 100,000 daily test target
Mr Hancock also expressed concerns that expanding care home testing could "get in the way" of the 100,000 daily test target he wanted to hit, the investigation said.
On 2 April, the then cabinet minister put his reputation on the line with a pledge to significantly increase testing by the end of the month as the UK lagged behind Europe in capacity.
Those eligible for the tests initially included the general public and NHS staff, and when advised to widen access to include people in COVID-hit care homes later that month, Mr Hancock said this would be "OK" so long as it did not "get in the way of actually fulfilling the capacity in testing".
According to the leaked messages, a civil servant told Mr Hancock on 24 April: "Asymptomatic testing sub is reading. Top recommendation is that you agree to: Prioritise testing of asymptomatic staff and residents in care homes where an outbreak has been recorded within the past 14 days. We estimate this will result in 60,000 tests being carried out across 2,000 care homes in the next 10 days".
Mr Hancock replied: "This is ok so long as it does not get in the way of actually fulfilling the capacity in testing."
He did not say why this would get in the way of his target but at the time, the government had acknowledged the challenges of getting tests to care homes.
Mr Hancock later approved the extra testing in care homes which was announced on 28 April.
As he struggled to meet his target, leaked messages show Mr Hancock texted former Tory chancellor George Osborne to ask for help.
He said the thousands of spare testing slots were "obvs good news about spread of virus" but "hard for my target".
Mr Osborne, editor of the Evening Standard until July 2020, had reportedly responded: "Yes - of course - all you need to do tomorrow is give some exclusive words to the Standard and I'll tell the team to splash it."
Mr Hancock had later added: "I WANT TO HIT MY TARGET!"
Building a centralised test and trace system was one of the biggest challenges for the government during the pandemic.
The £37bn service is widely seen as having failed in its main objective to reduce the spread of the virus and prevent further lockdowns after its launch on 28 May 2020.
The "lockdown files" suggest then prime minister Boris Johnson was frustrated over its capacity after it got up and running.
On 4 June he appeared to message Mr Hancock saying: "It's all about testing. That's our Achilles' heel. We can't deliver a sensible border policy or adequate track and trace because we can't test enough. Did we go to the Germans for those kits that Angela Merkel was offering? What is wrong with us as a country that we can't fix this?"
In another message, Mr Johnson adds: "We have had months and months.
"I am going quietly crackers about this."
Mr Hancock replied: "Don't go crackers. We have test capacity enough to do this. We now have the biggest testing capacity in Europe. The problem is the false negatives - so the medics are against releasing from self-isolation (whether for quarantine or T&T) with a negative test."
The files also appear to suggest Boris Johnson and the government's most senior advisers raised concerns about shielding - but the guidance was kept in place despite the reservations.
According to The Telegraph, Sir Patrick Vallance, the Chief Scientific Adviser, said in a WhatsApp in Aug 2020 that shielding had not been "easy or very effective".
Meanwhile Professor Chris Whitty, the chief medical adviser, said he would "think twice" about following the advice himself unless it was to protect the NHS - which was not the policy's aim.
Shielding was an intervention to protect extremely vulnerable people from coming into contact with coronavirus and required them to isolate for months on end.
In the WhatsApp group with key officials, Mr Johnson proposed giving over-65s "a choice" between shielding or an "ever-diminishing risk" of living a more normal life. He compared the risk of people in this age group dying from COVID to that of "falling down stairs", adding: "And we don't stop older people from using stairs."
Despite the concerns, the government reintroduced shielding throughout each of the national lockdowns and only officially ended the policy in September 2021.
The "lockdown files" investigation also claims that officials couriered Jacob Rees-Mogg a COVID test for one of his children while there was a shortage in September 2020.
The aide messaged Mr Hancock to say the lab had "lost" the original test for one of the then Commons leader's children, "so we've got a courier going to their family home tonight".
He added: "Jacob's spad [special adviser] is aware and has helped line it all up, but you might want to text Jacob."
It is not clear if Mr Hancock sent a text flagging up the intervention or if the test was delivered.
Commenting on the claim, Liberal Democrat deputy leader Daisy Cooper said: "This is yet more evidence that it's one rule for Conservative ministers and another for everyone else.
"The COVID inquiry must look into reports Conservative ministers were able to get priority access to tests at a time of national shortage."
Appearing on GB News on Wednesday evening, Mr Rees-Mogg confirmed his child's test had been lost, meaning he had to quarantine and was "unable to do my job as a government minister for several days, until it was admitted that this had been lost".
But he insisted he did not ask for another test, adding: "At that point it was raised with the Department of Health, and they decided to send a test to a member of my family so the test could be carried out.
"Not something I asked for, so if I received any special treatment, it wasn't because I had requested it, but actually it allowed a government minister to get back to work with a child that didn't have COVID in the first place, who wouldn't have needed a special test had the system actually been working, but I accept it wasn't working for other people too."
The Telegraph's investigation also claims social care minister Helen Whately advised the health secretary not to stop "husbands seeing wives" in October 2020.
This was in relation to care home visits, which were to be restricted as the UK went into a tiered lockdown system, with tighter rules in areas with higher COVID rates.
Ms Whately said: "I'm hearing there's pressure to ban care home visiting in tier 2 as well as tier 3. Can you help? I really oppose that. Where care homes have COVID-secure visiting we should be allowing it. To prevent husbands seeing wives because they happen to live in care homes for months and months is inhumane."
Mr Hancock replied: "Hearing from whom? Tier 2 was agreed yesterday as far as I'm concerned."
The rules that came into place that month allowed some visits for those in tier one, but banned them unless under "exceptional circumstances" in other tiers.
In January 2021, when some restrictions still remained on care home visits despite the vaccine rollout, Ms Whately also reportedly said: "I am getting v positive updates from David P on care home vaccinations, with just a handful left to do. As I think I've flagged, we do need to be ready with policy on visiting, given risks of lives lost through old people just giving up as well as COVID... and expectation that vaccine = safe to visit."
Hancock replied: "Yes on visiting but only after a few weeks. Meanwhile we need to hit the end-of-month target!"
Osborne: No one thinks testing is going well
Other revelations contained in the files appear to show a disagreement between Mr Hancock and Mr Osborne after the former chancellor gave a radio interview criticising testing.
Mr Hancock messaged his ex-colleague asking: "What was this for?"
Mr Osborne, who was still the editor of the London Evening Standard, replied: "Trying to spread the responsibility from you to Number 10 - I've said it before."
Mr Hancock retorted: "Ok but mass testing is going v well - I fear this looks like you asked for me to be overruled…"
Mr Osborne shot back: "No one thinks testing is going well. If I wanted a test today I can't get one, unless I fake symptoms - and XXXX [redacted] is still waiting test results from three weeks ago (XXXX went private in the end)." | Epidemics & Outbreaks |
The chlorine disinfectant known as bleach, which is used in hospitals, is as ineffective as water at killing off a superbug, a UK study has said.
Bleach is applied for cleaning medics' scrubs and surfaces but it does not work against the spores of Clostridioides difficile (C. diff), a bacteria which infects millions of people globally each year, causing diarrhoea, colitis and other bowel complications, scientists have claimed.
C. diff is the most common cause of antibiotic-associated sickness in healthcare settings across the world.
Researchers at the University of Plymouth suggest that clinical environments may not be clean and safe for staff and patients and have called for disinfectants and guidelines that are "fit for purpose".
The scientists say that susceptible people who work and are being treated in these settings might unknowingly be put at risk of contracting the superbug.
More work should be done to find other ways to disinfect C. diff spores so the chain of transmission in clinical environments can be broken, the researchers say.
It comes as the threat to human health from superbugs is increasing amid a rise in antimicrobial resistance, known as AMR.
AMR occurs when microorganisms which cause diseases, including bacteria and viruses, are no longer tackled effectively by medicines like antibiotics and antivirals.
In the study, the scientists looked at how spores of three different strains of C. diff reacted to three clinical in-use concentrations of sodium hypochlorite (bleach).
The spores were then put on surgical scrubs and patient gowns, and analysed using microscopes to see if there were any changes.
C. diff spores could be recovered from surgical scrubs and patient gowns, with no observable changes, according to the results.
This highlights the potential of these fabrics as vectors of spore transmission, the researchers added.
Read more:
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Hope for drug-resistant superbugs as NHS strikes deal with pharmaceuticals
Dr Tina Joshi, associate professor in molecular microbiology at the University of Plymouth, said: "With incidence of anti-microbial resistance on the rise, the threat posed by superbugs to human health is increasing.
"But far from demonstrating that our clinical environments are clean and safe for staff and patients, this study highlights the ability of C. diff spores to tolerate disinfection at in-use and recommended active chlorine concentrations.
"It shows we need disinfectants, and guidelines, that are fit for purpose and work in line with bacterial evolution, and the research should have significant impact on current disinfection protocols in the medical field globally." | Epidemics & Outbreaks |
The compliance process at pharmaceutical manufacturers is a complicated and prone to errors because many still use paper-based systems to record manufacturing steps. These paper records are reviewed by FDA auditors to ensure that guidelines were followed, but they are prone to errors, often leading to warnings. This results in higher costs and slower manufacturing. Leucine wants to make the compliance process more efficient with its compliance cloud platform for the pharmaceutical industry. It automatically creates digital manufacturing records and uses AI to identify the root cause of deviations.
New York-based Leucine announced today it has raised a $7 million Series A led by strategic investor Ecolab Inc. Participants include returning investors like Pravega Ventures, Axilor Ventures, Techstars and angel investors. Founded in 2019, Leucine is currently used by over 30 companies in more than 300 pharmaceutical manufacturing facilities in 10 countries, including the U.S., India, Brazil, Mexico and the United Arab Emirates. Its target customer include new biotech firms and pharmaceutical giants.
Leucine describes itself as “a digital twin of the pharma manufacturing shop floor.” It enables real-time performance monitoring and compliance management, analyzes the root cause of deviations from proper operating procedures, gives users advice on how to improve efficiency and creates manufacturing records and audit reports. It can be onboarded in eight weeks because of a proprietary AI-enabled system that digitizes paper SOPs to create custom workflows. Gera says Leucine can reduce the digitization cycle of a batch cycle from six to eight weeks to just three to five days.
In addition to its funding, Leucine also announced today the beta launch of Leucine 10X, an AI framework that performs specialized tasks like digitizing paper-based SOPs and creating dynamic production plans with production managers to ensure on-time batch delivery. It also makes the root cause analysis of deviations in the manufacturing process faster by analyzing data from text-based records, logs and staff interview transcripts.
Before starting Leucine, co-founder and CEO Vivek Gera worked as a compliance and automation consultant at Fortune 500 companies. He tells TechCrunch that during his work, he realized the scale of non-compliance issues and the impact they were having on bottom lines. For most of his projects, he introduced companies to technology that helped improve compliance.
“However, I noticed that most of the legacy players in this space didn’t offer solutions that brought in compliance by design and moreover didn’t offer any insights to the manufacturers despite hosting vast amounts of data,” he says.
This led to the creation of Leucine. By working with co-founder Mustaq Singh Bijral, whose background is in product management and data science, Gera says Leucine was able to build a data-driven product from day one, with the goal of creating a digital platform that is simple to use and has built-in compliance guidelines and process interlocks that ensure compliance.
Gera says there are legacy compliance systems that also offer pharmaceutical manufacturing floor digitization, including traditional manufacturing executing systems (MES) like Siemens and Rockwell and newer solutions like MasterControl, Trackwise and Kneat.. But he adds that many have very long implementation of cycles, compared to eight weeks for Leucine, are more difficult to customize and are siloed. They also do not give insights that help prevent potential compliance issues.
Leucine also differentiates from its competitors by using its LLM-based proprietary electronic batch manufacturing record (eBMR) to turn paper SOPs into digital workflows within minutes instead of months. Gera said eBMRs are the most important document in the pharmaceutical manufacturing process because it records every step and is reviewed by FDA auditors to see if manufacturers followed GxP, or quality guidelines.
“Our models have been trained on large volumes of pharma data and enable us to deliver value to our clients quicker than anyone else,” Gera added. “Our platform caters to all use cases on the shop floor, from batch planning to batch release, and breaks the data silos, providing a single source of truth.”
Over the last 12 months, Gera says the number of facilities using Leucine has grown by 100%, with a 300% increase in users. This because facilities are expanding use cases for the platform. It monetizes through a SaaS model with tiered pricing that increases based on volume. Leucine will expand its platforms with more solutions to improve compliance and productivity across the entire pharmaceutical manufacturing ecosystem. It also plans to improve its AI Co-pilot feature. | Drug Discoveries |
While the comedian "immediately invested" in the type 2 diabetes medication—which is now being popularly used as a weight-loss drugs in Hollywood—about a year ago, she said it left her unable to spend time with her and husband Chris Fischer's 4-year-old son, Gene.
"I was one of those people that felt so sick and couldn't play with my son," Amy explained on Watch What Happens Live with Andy Cohen on June 8, "I was so skinny, and he's throwing a ball at me and [I couldn't]."
Ultimately, the Trainwreck star decided using Ozempic was not "livable" for her. Nonetheless, she's still urging other celebrities to come clean about taking Ozempic.
"Everyone and their mom is gonna try it. Everyone has been lying saying, 'Oh, smaller portions,'" she continued. "Like, shut the f--k up. You are on Ozempic or one of those things, or you got work done. Just stop."
She added, "Be real with the people. When I got lipo, I said I got lipo."
Gracie said on Instagram she used Ozempic to assist with her polycystic ovary syndrome diagnosis, while Chelsea revealed in January that she was prescribed the medication.
"My anti-aging doctor just hands it out to anybody," the 47-year-old said on Call Her Daddy. "I didn't even know I was on it. She said, 'If you ever want to drop five pounds, this is good.'"
As for Golnesa, she was open about using injection shots of Semaglutide—the generic version of Ozempic—for weight loss.
"I don't see a reason to hide being on a weight loss [medication] or a cosmetic procedure," the Shahs of Sunset star told Entertainment Tonight last month, "just talk about it because there's so many people out there who want to do the same thing or they want to learn about what you did."
A rep for the pharmaceutical company Novo Nordisk, which makes Ozempic, previously told E! News in a statement that Ozempic is "not approved for chronic weight management." The organization said that Ozempic is intended to treat type 2 diabetes, improve blood sugar and minimize risks of major cardiovascular events for adults with the condition. | Drug Discoveries |
How a suction cup delivers medications to the bloodstream
Painless administration of medications that previously could only be injected: Start-up Transire Bio wants to conquer the market
Many of today’s medications belong to groups of relatively large molecules such as peptides. They are used to treat a wide range of diseases, including diabetes, obesity and prostate cancer. Unfortunately, taking these medications in tablet form is out of the question in most cases because they would break down in the digestive tract or remain too large to reach the bloodstream. Consequently, the patient’s only option is to receive their medication via injection.
A group of researchers at ETH Zurich have developed a suction cup capable of delivering medications comprising large molecules like peptides to the bloodstream via the mucosal lining of the cheek. The group is led by David Klein Cerrejon and Nevena Paunović, both of whom work at the Chair of Drug Formulation & Delivery headed by Jean-Christophe Leroux.
“It’s an entirely new method of delivering medications that could spare millions of people the fear and pain associated with injections,” says Paunović, who has received one of ETH Zurich’s coveted Pioneer Fellowships. Her aim is to bring the suction cup to market through the start-up Transire Bio.
Breaking through the cheek’s mucosal lining
The mucosal lining of the cheek isn’t particularly suitable for delivering medication to the bloodstream. Its dense tissue has so far presented a major obstacle, especially for large molecules like peptides. But the ETH researchers are now about to change this with their suction cup.
Patients press the suction cup – which measures around ten millimetres in diameter and six millimetres in height – onto the lining of their cheek with two fingers. This produces a vacuum that stretches the lining, making it more permeable to the drug contained within the cup’s dome-shaped hollow. But that alone isn’t enough for the drug to reach the blood vessels.
The researchers have thus supplemented the drug with an endogenous agent that fluidises the cell membranes, allowing the drug to penetrate to the deeper layers of tissue. Patients are advised to keep the suction cup on the inside of their cheek for a few minutes. That’s enough time for the drug to dissolve in saliva and enter their bloodstream directly via the now permeable mucosal lining.
Compared to the few oral formulations of peptides on the market, the suction cup developed by the ETH researchers supports the delivery of a wide range of medications without the need for any major technological adjustments.
From peppercorn to suction cup
The original idea for the suction cup came from Zhi Luo, a former postdoc under ETH Professor Leroux and now a professor himself working in China. At dinner with friends, he suddenly noticed he had half a peppercorn stuck to the inside of his oral cavity. Although uncomfortable, this experience gave him the idea of how to keep drugs in place on slippery surfaces. But before the team could turn the idea into a working prototype, they had a few problems to solve.
The biggest challenge was to identify the right shape of the suction cup. “We had to find out what geometry and how much of a vacuum were required to hold the suction cup in place on the mucosal lining of the cheek and to stretch it sufficiently without causing any damage,” Klein Cerrejon says. In addition to producing several prototypes, which the researchers designed and 3D printed themselves, this called for numerous tests using the mucosal lining of a pig’s cheek.
To find the right penetration-promoting agent, the researchers tested a broad range of substances of varying concentrations and under a microscope evaluated how the different mixtures penetrated the tissue. “Since the suction cup is a completely new delivery system, we had to experiment extensively before finding the right substance. It turned out that natural, endogenous substances are extremely well suited for this task,” Klein Cerrejon says.
Tests on dogs and humans
The researchers then moved on to testing their suction cup and the penetration-promoting agent in authorised trials on dogs, because dogs and humans have very similar mucosal lining in their cheeks. No dogs were harmed by the testing. The researchers were pleased with the results: “We could see from the blood samples that the suction cup efficiently delivered medications to the dogs’ bloodstreams,” Klein Cerrejon says.
So far, the team has also tested the empty suction cup on 40 people. Not only did the suction cup remain attached for 30 minutes but also received positive feedback from the people testing it. Most of the volunteers said that they would by far prefer the new delivery system over an injection.
On the way to market entry
Paunović – who completed her doctorate under Leroux – is a trained pharmacist and worked at a major drug company. She will lead the project as a Pioneer Fellow. “We have a prototype and have already patented the technology. Our next step is to manufacture the suction cup in a way that meets current pharmaceutical regulations,” she says.
The researchers will have to carry out further tests with this new delivery system in preparation for conducting a clinical trial on healthy volunteers. There are also several regulatory hurdles to clear before the suction cup hits the market. For this, the researchers need strong partners and sufficient funding. Since the peptide market is worth billions to the pharmaceutical industry, several companies have already voiced an interest.
Original publication
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Three years ago, the first patients to develop long Covid began reporting debilitating symptoms. A recent survey suggested 14% of people with the illness have since lost their jobs.
Before the pandemic, Marcus Whitehead had a demanding and fulfilling career in financial services in London. But after catching coronavirus in 2020, he became far too ill to work.
Three years on, although he is physically much better, brain fog has prevented the 55-year-old from returning to his job.
Marcus, who lives in Harpenden, feels a "sense of loss" at retiring early and losing his mental agility. "I was no longer who I was," he says.
'Like being injected with horse tranquiliser'
It was in April 2020 that Marcus first developed symptoms of Covid-19.
"It was typical corona - a temperature, a cough - a bit like flu. It wasn't too bad and I was able to work a bit," he says.
But a few days later it hit him "like a tonne of bricks" and he experienced "crushing, paralysing fatigue, like you'd been injected with horse tranquiliser".
Marcus also suffered "fierce organ pain" and intense headaches, spending the following three months in bed.
"I spent another 12 months on the couch. For 18 months I didn't drive and had to use a walking stick. And I haven't been able to work since."
Marcus was managing partner of actuary firm Barnett Waddingham, overseeing 1,000 members of staff.
He likens the role of co-ordinating client strategy and supporting employees to "spinning plates".
"I was juggling dozens of plates a day, and then after Covid I was turned into this person who could hardly hold a single plate, let alone spin dozens."
In 2022, he attempted to reintegrate at work with support from his company. "I managed two days", he explains, "and I was back in bed with a massive relapse.
"It was quite soul-destroying, when I'd been so close to getting back to work. The first time I put my brain under any kind of pressure, it just gave up on me again."
Eventually it became clear that Marcus would have to leave his high-performance job, and he decided to retire a decade earlier than planned.
"I'm very fortunate to have a lot of health back. But it's been quite a dramatic change in what I expected of that decade up to my early sixties," he says.
The personal cost to Marcus has also been felt in the wider economy. A survey in March of 3,000 people self-reporting long Covid found 14% of them had lost their jobs for reasons connected to the condition.
Of the two million people in the UK who report having long Covid, 20% feel significantly limited in their ability to undertake day-to-day activities, according to the Office of National Statistics.
Claire Hastie is a founding member of the charity Long Covid Support, whose online support group has over 60,000 members. She set it up after struggling to find any information or help when she failed to recover from the virus.
"Huge numbers of people are no longer able to work at all, or to their previous capacity, having to reduce their hours and take less senior roles," she says.
Claire believes Marcus's story highlights a significant need for "urgent research" into the "debilitating condition".
"At a time of labour and skills shortages, the impact of long Covid on the economy is significant," she says.
As well as those who have stopped working, "others are struggling to keep their jobs but at a huge cost to their health and ability to do anything else", she adds.
And it is not just limited to those with long Covid, but their families too. Marcus's wife Sue also decided to stop working for a while to help him recover.
"I spotted that Marcus's health was better on weekends, when we're doing stuff together and I'm not working ten-hour days, leaving him to his own devices."
She believes that giving up her job, as a capital programme director for a local authority, has been the secret to "unlocking" his recovery.
Although Marcus still struggles with brain fog, his physical health has recently improved.
The couple were left to look for solutions, trawling social media for advice, as "the medical profession did not have any cures and still doesn't".
So they tried anything and everything to improve his condition. "I felt like a guinea pig. At times I would beg Sue not to bring another attempted solution," he says.
He spent time in a hyperbaric oxygen chamber, changed his diet and took all kinds of pills and supplements - "even resorting to buying medication from Bangladesh".
Sue also worked on pacing his energy levels, which led to some improvements alongside "an exceptionally good diet" with no ultra processed foods.
But the real change came earlier this year, through a programme called the lightning process, which is not endorsed by the NHS but has been used to treat people with chronic fatigue syndrome.
The privately funded programme focuses on interactions between the brain and the body.
"The turnaround was really quite dramatic," Marcus says. "I was already on a good underlying healing curve, but this boosted it.
"There isn't medical, scientific proof - it is just my personal experience - but I tried an awful lot of things that haven't worked. Now I feel physically much better."
Sue says the couple are now spending time travelling and visiting friends, after observing that Marcus felt better when they went away.
"We've called it the Year of Yes," she says. "Anything that's happening, we're going to try and do it."
A Department of Health and Social Care spokesperson said it was providing £50 million to scientists to better understand the long-term effects of coronavirus.
"We recognise that long Covid has debilitating impacts on physical and mental health. We have invested £314 million to establish specialist services throughout England to direct people experiencing long Covid into the right treatment and rehabilitation services, including occupational health services." | Disease Research |
When you have multiple sclerosis (MS), your immune system works against you. Left unchecked, immune cells attack the protective layer that surrounds your nerve fibers. Doctors used to think your immune T cells were the main culprit in this. Immune B cells, which make antibodies, were considered innocent bystanders.
That changed as scientists started to realize that the existing MS treatments worked in part by changing what B cells were doing. Would it be possible to treat MS by targeting B cells directly?
Doctors already had a way to do it: an antibody-based treatment called rituximab (Rituxan), used to fight a type of cancer called B-cell lymphoma. A 2008 study showed rituximab did help people with MS. After 48 weeks, people in the study had fewer brain lesions and avoided relapses, too.
The FDA has approved three B-cell therapy treatments:
- ocrelizumab (Ocrevus)Â Â
- ofatumumab (Kesimpta)
- ublituximab-xiiy (Briumvi)
Ocrevus and Briumvi are given through IV once every six months while Kesempa is taken once a month in Shots. You take it in monthly shots at home. Doctors sometimes still use rituximab for MS, too.
No matter which one you take, the goal is to reduce the number of B cells you have. When it works the way it should, you wonât notice anything right away.
âThe real benefit weâre looking for isnât immediate,â says Ari Green, MD, a neurologist at UCSF Health. âIt takes place over years, if not decades. The goal is to prevent long-term disability.â
When to Consider B-Cell Therapy
B-cell therapy prevents disability over time by preventing new harm to your nervous system. It canât fix damage thatâs already there, but it can stop future injury and attacks.
Within the first few months to a year, Green says, you should notice fewer relapses of your MS symptoms. The therapy does an even better job of keeping new brain lesions from forming.
So, if youâre newly diagnosed, should you take B-cell therapy?
âThereâs a debate in the MS world about starting somebody who is new in the disease on medication that's considered high-efficacy versus starting them on one of the earlier therapies,â says Julie Fiol, a registered nurse and associate vice president of health care access for the National MS Society.
Some doctors may try older drugs first to see if they help. That's partly because theyâve been around longer, so thereâs a more extensive track record for their safety. If you relapse or get worse, you can move up to B-cell therapy.
âIt's a step-up approach,â says Eric Seachrist, MD, a neurologist at West Virginia University Hospitals who has MS and takes B-cell therapy himself. âYou start with the safest but least effective medicine and bump up if there's a relapse.â
But he says the newer way of doing things is to use the strongest medicines from the beginning. This is what he recommends for his patients, and what he chooses for himself. The goal is to prevent disease activity and irreparable damage and, hopefully, help keep the disease from getting worse.
âStarting on B-cell therapy first controls the disease better and can delay or prevent secondary progression later,â Seachrist says. âBut we donât know the long-term effects on the body from taking super-strong immune-modulating medicines."
While many doctors now recommend the B-cell-therapy-first approach, there are some things to consider, Fiol says. Most people do well on B-cell therapy. But because it wipes out part of your immune system, it comes with an increased risk for infection. The treatment also makes any vaccines you take less effective. And since the drugs havenât been around that long, the effects of depleting B cells over decades aren't yet known.
Fiol says thereâs no âone-size-fits-all approach.â She says you should talk with your doctor about the risks and benefits of each option before deciding on an MS treatment.
How Long Will You Need B-Cell Therapy?
It's not yet clear whether B-cell therapy is forever. But doctors do have some clue from its earlier use in treating rheumatoid arthritis.
âWe know from the arthritis field, if B cells are depleted for a time and then treatment is stopped, ultimately the disease would come back,â Green says. âWe think that's true in MS, too.â
But, he says, that may only be true if you get B-cell therapy for a relatively short time. Itâs less clear what could happen over the long term. Fiol notes that your immune system naturally changes as you age. As a result, MS can become less active over time.
âIn most cases of MS, the highest disease activity as far as inflammation-causing relapses is early, the first 5 to 10 years or so,â Seachrist says. âSo maybe you only need highly aggressive therapy for a time and then you could de-escalate to something milder on the body. Thatâs a question thatâs up in the air.â
Green says that the B-cell therapies available today surely wipe out more cells than is necessary to control MS. He predicts that in the future, treatments may become more specific. Some treatments now being studied also affect B cells in other ways that may prove less risky.
For now, he says, you should anticipate using B-cell therapy for years, most likely a decade or longer. But as doctors learn more and new treatments become available, this could change.
Show Sources
Photo Credit:Â Digital Vision /Â Getty Images
SOURCES:
Ari Green, MD, neurologist; medical director, Multiple Sclerosis Center, UCSF Health, San Francisco.
Eric Seachrist, MD, neurologist; assistant professor, West Virginia University School of Medicine, Morganton.
Julie Fiol, registered nurse; associate vice president for health care access, National MS Society.
Mayo Clinic: âMultiple Sclerosis.â
Frontiers in Oncology: "Past, Present, and Future of Rituximab -- The Worldâs First Oncology Monoclonal Antibody Therapy.â
Nature Reviews Drug Discovery: "B cell depletion therapies in autoimmune disease: advancesand mechanistic insights.â
Nature: âTargeting B cell leads to breakthrough therapy.â | Disease Research |
A Maryland man who received a pig heart transplant in a highly experimental surgery nearly six weeks ago has died, his Maryland doctors announced Tuesday.
Lawrence Faucette, 58, a 20-year Navy veteran and a married father of two from Frederick, Maryland, had end-stage heart disease and was ineligible for a traditional heart transplant when he underwent surgery to replace his heart with a genetically modified pig heart on Sept. 20.
According to the University of Maryland School of Medicine, the heart appeared to be healthy for at least four weeks and doctors expressed optimism in the treatment. They also withdrew the drugs that were initially supporting his heart. Then he began showing signs of rejection. Faucette died Monday.
Faucette’s wife, Ann, said in a statement released by the hospital that her husband "knew his time with us was short and this was his last chance to do for others. He never imagined he would survive as long as he did."
Attempts at animal-to-human organ transplants — called xenotransplants — have failed for decades, as people’s immune systems immediately destroyed the foreign tissue.
Scientists have begun genetically modifying pigs to make their organs more humanlike.
The Maryland team performed the world’s first transplant of a heart from a genetically altered pig into another dying man last year.
The first patient, David Bennett, survived two months before the transplanted heart failed. The cause for the failure was not immediately clear but doctors said signs of a pig virus were later found inside the organ.
The first case, with its successes and failures, provided crucial data for the subsequent attempt.
"Mr. Faucette's last wish was for us to make the most of what we have learned from our experience," Dr. Bartley Griffith, the surgeon who led the transplant at the University of Maryland Medical Center, said in a statement.
Faucette initially came to the Maryland hospital out of options and expressed a wish to spend a little more time with his family.
"He was deemed ineligible for a traditional transplant with a human heart due to his pre-existing peripheral vascular disease and complications with internal bleeding," Dr. Bartley Griffith, professor of surgery at the University of Maryland School of Medicine, who performed the surgery, told Fox News Digital.
Around the same time, Faucette expressed his own hope for the transplant.
"My only real hope left is to go with the pig heart, the xenotransplant," Faucette said during an interview from his hospital room a few days before his surgery, as reported by UMMC. "At least now I have hope, and I have a chance."
At the time, Ann added: "We have no expectations other than hoping for more time together. That could be as simple as sitting on the front porch and having coffee together."
By mid-October, the hospital said Faucette was doing well and had been able to stand.
It also released a video showing him working hard in physical therapy to regain the strength needed to attempt walking.
Then cardiac xenotransplant chief Dr. Muhammad Mohiuddin said the hospital moved into the next step of the procedure: withdrawing medications to allow the heart to function on its own.
"We are withdrawing all the drugs that were initially supporting his heart," Mohiuddin, M.D., professor of surgery and co-director of the cardiac xenotransplantation program at the University of Maryland School of Medicine, said on Oct. 20.
Mohiuddin said Faucette’s new heart was then "doing everything on its own."
Then, it failed.
Mohiuddin said the team will analyze what happened with the heart. They will also continue studying pig organs.
Many scientists hope xenotransplants one day could compensate for the huge shortage of human organ donations.
More than 100,000 people are on the nation’s list for a transplant, most awaiting kidneys, and thousands will die waiting.
The Associated Press contributed to this report. | Medical Innovations |
New research suggests cannabis may go some way to reducing the risk of developing Type 2 diabetes, while other studies shed light on its potential in fibromyalgia, autism and skin disorders.
Meanwhile, a review suggests cannabis consumption may be associated with a reduced risk of developing Type 2 diabetes, and a US survey highlights the prevalence of use among cancer patients.
We take a closer look.
Cannabis reduces severity of fibromyalgia symptoms
In a new study, researchers conducted a retrospective review of patients seeking medicinal cannabis treatment for fibromyalgia between January 2017- July 2021. Data was collected using the Patient Health Questionnaire-9 (PHQ-9) Generalized Anxiety Disorder-7 (GAD-7) scores, and self-reported illness severity.
According to their findings, a clinically significant reduction in severity was observed in three quarters 75% of patients, as well as reductions in PHQ-9 (27%) and GAD-7 scores (22%).
The authors conclude: “These data show that medical cannabis may play an important role in the management of fibromyalgia and associated symptoms of depression and anxiety.”
Cannabis improves quality of life in autistic patients – and their families
A new study explored the impact of full-spectrum cannabis extracts in 20 patients with autism spectrum disorders (ASD).
Most patients were treated for a minimum of six months, with doses and THC/CBD levels adjusted depending on results. The researchers used a novel online patient- or caregiver-reported outcome survey to collect information on core and co-morbid symptoms and quality of life.
Their retrospective analysis found that 18 out of 20 patients showed improvement in their symptoms, as well as an improved quality of life for patients and their families.
Side effects were mild and infrequent and in most cases, other medications were able to be reduced or discontinued entirely, the researchers say.
Cannabis may reduce risk of developing Type 2 diabetes
A new study has suggested that cannabis may have a protective effect against the risk of developing Type 2 diabetes.
To understand more about the effect of cannabis on metabolism, including glucose regulation and insulin secretion, researchers conducted a systematic review of previous studies in this area.
Their meta-analysis of seven studies, containing 11 surveys and four cohort studies, revealed that the odds of developing Type 2 diabetes was 0.48 times (95%) lower than in those who had not consumed cannabis.
The authors conclude: “A protective effect of cannabis consumption on the odds of diabetes mellitus type 2 development has been suggested. Yet given the considerable interstudy heterogeneity, the upward trend of cannabis consumption and cannabis legalisation is recommended to conduct studies with higher levels of evidence.”
One third of cancer patients use cannabis – but do their doctors know?
Results from a survey of over 1,200 cancer patients, show that almost a third used cannabis following their diagnosis.
Patients with nine different cancers being treated at a centre in the US between March and August 2021 were surveyed on their cannabis use, as well as their attitudes and communication around it.
Overall 31% used cannabis after diagnosis, ranging from 25% of those with lung cancer to 59% of patients with testicular cancer.
Reasons for cannabis use included difficulty sleeping (48%); stress, anxiety, or depression (46%); and pain (42%), with 70-90% reporting symptom improvement.
However, only 25% of those who used cannabis discussed this with their healthcare providers.
CBD holds ‘promise’ for skin disorders
Researchers carried out a review of previous studies looking at CBD in the treatment of skin disorders such as acne, dermatitis, psoriasis, and ageing skin.
They report that the cannabinoid has ‘potential applications’ in the treatment of skin disorders, specifically those which have limited treatment options available or come with side-effects.
It may be a ‘promising’ treatment for chronic skin conditions such as psoriasis and atopic dermatitis. And as it can be used as a ‘multifunctional ingredient’ may increase patient adherence to treatment, through reducing the number of products required to manage the condition.
However, the authors add that more research is needed to establish its use in the treatment of these conditions, as well as investigating new applications and addressing the safety of topical CBD.
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President Biden has promised to sign any bill related to curbing gun violence that Congress could manage to pass — but there is still a long way to go. With just a framework agreed upon, lawmakers still have to hash out legislative text, and most importantly, determine the cost of a host of measures including mental health services and how much money to send to states to strengthen red flag laws. The White House, in the meantime, seems to have taken the advice of some lawmakers in staying out of the negotiations by not appearing to dispatch administration officials to Capitol Hill to help close a deal, which is expected to fall well short of what Biden and many Democrats have called on Congress for years to do after a string of high-profile mass shootings that have devastated the nation. “I think that the negotiators have worked to keep the president sort of at arm’s length so they have room to work without the looming presence of the president of the United States and the political baggage that comes with it,” a gun violence prevention advocate familiar with negotiations told The Hill. The White House deployed a similar tactic to the delicate negotiations over the past few weeks, which is to leave it up to lawmakers on Capitol Hill to come to an agreement. Senators, including some Democrats, called for the White House to leave it up to them. White House press secretary Karine Jean-Pierre said on Monday the administration will continue to hold regular talks with negotiators but continued to give no further details on what those conversations have entailed. “As it relates to his involvement in any of this, his team continues to talk to Congress on a regular basis, as we have been, as they have been this past several weeks. And we’re going to continue talking to negotiators on the Hill, to congressional members and staff on the Hill. And we will continue to have those conversations,” Jean-Pierre said. Biden is limited in actions he could take on guns from the executive office, but the bipartisan Senate framework released over the weekend would at least give Biden the chance to sign the most significant legislation related to gun violence in over 20 years. Biden has called on Congress to pass some form of gun control legislation since he took office, specifically to reinstate an assault weapon ban that expired in 2004, which he helped pass as a senator. But even from his presidential bully pulpit, Biden did not get from the Senate framework what he asked for, or what many advocates and Democrats wanted to be included, such as the assault weapons ban, universal background checks and increasing the age to purchase an assault weapon from 18 to 21 years old. The White House didn’t respond to comment when asked if it will send any officials up to Capitol Hill this week as the Senate put the final touches on a deal that as of Tuesday appears to be on track to become a piece of legislation. A top negotiator, Sen. Chris Murphy (D-Conn.), met with Biden at the White House last week to discuss negotiations before the framework was announced over the weekend. On Sunday, Biden said shortly after senators announced they had come to an agreement that he would sign any legislation on the matter that comes to his desk. The bipartisan deal gained more traction on Tuesday when Senate Minority Leader Mitch McConnell (R-Ky.), said he would support legislation that reflects the framework. Senators are working on finalizing the text of the bill and eyeing to get it passed within the next two weeks — while keeping support from at least 10 Republicans so it is filibuster proof. The framework includes closing the “boyfriend loophole” by preventing partners convicted of domestic abuse from buying a gun. It also includes funding for school mental health and safety programs, increasing penalties for straw purchases of firearms and reviewing juvenile records for purchasers between the ages of 18 and 20, among other provisions. The White House, when asked if it would weigh in on the eventual final legislative text and provisions the administration wants to see in it, did not point to any specifics. Some believe that’s smarter than not. “They’re engaged but I think they are being smart and not making themselves the focus on the deal. I think it shows a commitment to the issue and a savvy understanding of the president’s role,” an advocate familiar with the negotiations said. Gun violence prevention advocates say Biden’s role during negotiations has been through his usage of the bully pulpit and by bringing in high-profile guests, most notably Matthew McConaughey, to spread their message. McConaughey, who grew up in Uvalde, Texas, spoke during a White House briefing last week where he delivered an impassioned plea for gun control measures. Moms Demand Action, which was founded in the wake of the Sandy Hook shooting when Biden was vice president and when compromise legislation on gun control failed in the Senate, applauded the current Senate framework. Founder Shannon Watts said that the gun control grassroot movement has been demanding action from the Senate for nearly a decade, and she vowed to fight to get the deal across the finish line. “This bipartisan framework is a major step in finally getting federal action to address gun violence and, if passed, will save lives,” Watts said in a statement. “We’re breaking the logjam in Congress and proving that gun safety isn’t just good policy – it’s good politics.” The energy marks a shift from December, nearly a year into the Biden administration, when advocates were disappointed in Biden for not making more progress on gun control. Advocates said at the time that the president is an ally to the movement but hadn’t been a leader, wanting him to put more pressure on Congress to move on the matter. Peter Ambler, executive director and co-founder of Giffords, said the latest efforts showed that Biden has at least tried to help by getting to this point. “This is not enough but it is significant and will have an important impact,” he said. “If it’s signed into law, it’s the most significant thing that Congress will have done in decades and I think that the president has been a significant part of helping the Congress and the country get to the point that that’s possible.” | Mental Health Treatments |
We’re cutting waiting lists
The Prime Minister recently claimed in a tweet shared by several other ministers that the government is cutting waiting lists in the NHS. This is a general claim that the Conservative party has also made before.
It has also appeared as a logo on other official government announcements.
The NHS records waiting list data in lots of different ways, and it is true that some specific waiting lists, such as the list of patients waiting more than 18 months for treatment, have shortened in recent months.
However, it is not true that the overall size of the most commonly cited NHS waiting list is falling.
On the contrary, the latest figures at the time of Mr Sunak’s tweet showed that the number of cases waiting for NHS consultant-led treatment in England reached a record high of 7.33 million at the end of March 2023. (New figures published after Mr Sunak made his claim now show that the list has grown further to reach 7.42 million at the end of April.)
Speaking on ITV’s This Morning on 25 May, Mr Sunak acknowledged that the overall size of the waiting list may not start to fall until next year when he said it “should be coming down” by spring 2024.
Full Fact asked Downing Street and the Conservative Party about the evidence for Mr Sunak’s claim and did not receive a response. The Department of Health and Social Care did not offer a full explanation for the claim either, but it has confirmed the overall size of the NHS waiting list continues to rise, and says there has been some success in tackling the list of patients who have been waiting longest.
A similar point appears in some background text in the images attached to Mr Sunak’s tweet, where one line says: “We’ve cut 18 month waiting lists by over 90% since September 2021.”
Politicians must be clear what they mean when making claims using official data to describe public services. Otherwise they risk misleading people about the government’s performance—or, in this case, access to the NHS.
Health policy is devolved, so this article only looks at waiting lists in England, which is the part of the UK health system that the UK government controls.
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What are the waiting lists?
NHS England publishes regular data on what it calls “Consultant-led Referral to Treatment Waiting Times”. This is often called RTT data, and is generally seen as the main measure of its performance in non-emergency care. (For example, it is referred to as “the overall waiting list” in NHS England’s elective recovery plan published last year.)
RTT data counts the number of cases at the end of each month where a patient is waiting to receive some kind of treatment—most often without being admitted to hospital.
Technically, this overall waiting list counts something called “pathways”, not patients. A pathway begins when someone is referred to a consultant, and it ends when their treatment begins, or when the decision is made that they won’t be treated, or if they don’t respond when contacted. As a result, some people may be on more than one pathway at a time, if they are waiting for treatment for two or more conditions.
In a sense there is one RTT waiting list: the total number of cases where someone is waiting for this kind of treatment.
However, because the data shows how long each person has been waiting, it can also be split into several more specific lists: the number where the wait has been less than 18 weeks, the number with a wait of more than 18 weeks, the number waiting more than 52 weeks… and so on.
According to the NHS Constitution, “patients have the right to start non-emergency consultant-led treatment within 18 weeks of referral”. It also sets out an expected standard that “more than 92% of patients on incomplete pathways should have been waiting no more than 18 weeks from referral”.
In practice, NHS England has not met this target since the mid-2010s, and has generally fallen further and further behind in recent years.
What the government promised
A pledge that “NHS waiting lists will fall and people will get the care they need more quickly” was announced bv Mr Sunak in January.
It followed a similar pledge made in the elective recovery plan in February 2022 by Boris Johnson with Sajid Javid, who were Prime Minister and health secretary at the time. That plan said it would “address backlogs built up during the Covid pandemic and tackle long waits for care”.
It also mentioned several specific targets, including to:
- Eliminate waits of more than two years by July 2022
- Eliminate waits of more than 18 months by April 2023
- Eliminate waits of more than a year by March 2025
The first two of these targets have been narrowly missed. At the end of July 2022, an estimated 2,890 cases had been waiting more than two years. At the end of March 2023, 10,737 involved waits of more than 18 months, and this rose slightly to 11,477 at the end of April.
Both these waiting lists had fallen substantially since the targets were announced, however. And waits of over a year have also started to fall in recent months.
In this sense, it is true that some specific “waiting lists” have fallen since Mr Sunak became Prime Minister. However, the overall number of cases where someone is waiting for consultant-led treatment has risen to a record high.
From the outset, the elective recovery plan acknowledged that the future of waiting times was uncertain, in part because it was hard to know how much of the drop in demand for healthcare during the pandemic might lead to higher demand in future.
Describing the plan at the time, NHS England said: “The overall size of the waiting list is likely to increase, at least in the short term. If around half the ‘missing demand’ from the Covid-19 pandemic returns over the next three years, particularly if this is earlier in the period, then we would expect the waiting list will be reducing by around March 2024.”
What about other waiting lists?
NHS England publishes the RTT data by type of treatment and provider, so it is also possible to look at waiting lists in specific areas of the country, and by specific treatment functions.
And there are other kinds of waiting lists, including transplant waiting lists and a variety of different measures of waiting times for cancer treatment, and for diagnostics.
To take just one example, the number of cases on the diagnostic waiting list was about 1.63 million at the end of March 2023, the highest on record, before falling back to 1.56 million at the end of April. | Health Policy |
Thalamus regulates adaptability of the adult brain
6 October 2023
6 October 2023
It is generally believed that the adaptability of the adult brain mainly takes place in the cortex. However, a new study from the Netherlands Institute for Neuroscience shows that the thalamus, a relay station for incoming motor and sensory information, plays an unexpectedly important role in this process. “This could be an interesting starting point for various therapies,” says Christiaan Levelt.
Learning new things requires a tremendous capacity of our brains. The adaptation of our brain as a result of new experiences is called plasticity. There are periods during our development when neural networks show a lot of plasticity, known as critical periods. But also the adult brain is capable of adapting. Where this plasticity takes place in adult brain is not well understood.
To gain more insight into this question, Yi Qin and his colleagues, under the supervision of Christiaan Levelt, examined the visual system of mice. This is a popular model for studying plasticity due to its ease of manipulation. Visual information reaches the thalamus through the retina. This brain nucleus then transmits processed information to the visual cortex and vice versa. An experiment in mice can clearly demonstrate how well the adult brain is able to adapt. When one eye of the mouse is occluded for several days, the visual cortex starts to respond less effectively to the closed eye and better to the open eye. How this is precisely regulated has been unclear for a long time. But these new results bring an important player to the forefront: the thalamus.
Christiaan Levelt: “Five years ago, we discovered that the thalamus plays a crucial role in the plasticity of the visual cortex during critical periods of development. This has changed our perspective on how this whole system works. We all thought that this process was regulated by the visual cortex, but it turned out not to be the whole story. We found out by removing a very specific component, the GABA-alpha 1 subunit, in the thalamus of mice during their critical period for vision. This component is responsible for inhibiting the thalamus, so its removal resulted in reduced inhibition. When we closed one eye in these mice, the shift in responses no longer occurred. Because the adult brain uses different plasticity mechanisms than the developing brain, an important question was whether adaptation in the adult visual system also involved the thalamus”.
Yi Qin: “In the current study, we performed the same experiment in adult mice and observed similar results. We observed that plasticity also took place in the adult thalamus, but disappeared when we removed the alpha-1 subunit. Consequently, there was no longer a shift in the cortex either. Since we know that the visual cortex also sends information back to the thalamus through a feedback mechanism, we were curious if the visual cortex also plays a role in plasticity of the thalamus. We investigated this by reversing the experiment and shutting down the visual cortex. What happens to the shift in responses in the thalamus then? In adult animals, we did not see any difference: the shift persisted. However, in animals during their critical period, we observed that when we shut down the visual cortex, the shift reverted back in the thalamus. So, at a young age, plasticity in the thalamus and cortex influence each other much more, while in the adult brain, the thalamus is particularly important for plasticity in the cortex but not the other way around.”
Levelt continues: “Plasticity is important in many processes. We are currently focusing on sensory plasticity (vision), but plasticity is also fundamental for memory and other functions. These new insights could be relevant, for example, in understanding learning disabilities. It is possible that the origin of these problems lies in the thalamus rather than the cortex. Therefore, a different approach is needed. Instead of solely looking at the cortex, we should also consider the thalamus when it comes to therapies and the pathogenesis of these issues. This is an important new interpretation.”
Qin: “Even in the case of lazy eye, it is assumed to be a problem of the cortex, but it could also involve the thalamus. In Europe, we test for the presence of lazy eye from a young age. This condition can be corrected during the critical period by temporarily patching the ‘good eye,’ which strengthens the connections to the weaker eye. In the US, for example, this is not routinely checked at a young age, resulting in more people carrying a lazy eye into adulthood. Since the critical period has already passed for them, it becomes more challenging to treat these individuals. Our study provides a hint that we need to look beyond the cortex, which can provide guidance for a new treatment strategy.”
Source: eLife
Click here for our infographic | Disease Research |
Brain surgery using artificial intelligence could be possible within two years, making it safer and more effective, a leading neurosurgeon says.
Trainee surgeons are working with the new AI technology, to learn more precise keyhole brain surgery.
Developed at University College London, it highlights small tumours and critical structures such as blood vessels at the centre of the brain.
The government says it could be "a real game-changer" for healthcare in the UK.
Critical structures
Brain surgery is precise and painstaking - straying a millimetre the wrong way could kill a patient instantly.
Avoiding damaging the pituitary gland, the size of a grape, at the centre of the brain, is critical. It controls all the body's hormones - and any problems with it can cause blindness.
"If you go too small with your approach, then you risk not removing enough of the tumour," National Hospital for Neurology and Neurosurgery consultant neurosurgeon Hani Marcus says.
"If you go too large, you risk damaging these really critical structures."
The AI system has analysed more than 200 videos of this type of pituitary surgery, reaching, in 10 months, a level of experience it would take a surgeon 10 years to gain.
"Surgeons like myself - even if you're very experienced - can, with the help of AI, do a better job to find that boundary than without it," Mr Marcus says.
"You could, in a few years, have an AI system that has seen more operations than any human has ever or could ever see."
Trainee Dr Nicola Newell also finds it "very helpful".
"It helps me orientate myself during mock surgery and helps identify what steps and what stages are coming up next," she says.
'Marvel superhero'
AI government minister Viscount Camrose says: "AI makes everybody massively more productive whatever it is you do.
"It kind of almost makes you the Marvel superhero version of yourself."
He said this type of technology could be a game-changer for healthcare, improving outcomes for everyone and offering a "very promising" future.
University College London (UCL) is one of 22 universities recently given government money to help revolutionise healthcare in the UK.
Engineers, clinicians and scientists are working together on the project at the Wellcome / Engineering and Physical Sciences Research Council (EPSRC) Centre for Interventional and Surgical Sciences.
Follow @tulipmazumdar on X, formerly known as Twitter. | Medical Innovations |
Thousands of people in England who get migraines could benefit from a drug that has been approved on the NHS.
The National Institute for Health and Care Excellence (Nice), the drugs regulator, said it was recommending rimegepant for preventing migraines in the approximately 145,000 adults where at least three previous preventive treatments had failed.
The drug, also called Vydura and made by Pfizer, is taken as a wafer which dissolves under the tongue. It is the first time Nice has recommended an oral treatment for preventing migraines.
“Each year the lives of millions of people in England are blighted by migraine attacks,” said Helen Knight, the director of medicines evaluation at Nice. “They can be extremely debilitating and can significantly affect a person’s quality of life.
“Rimegepant is the first oral treatment for migraine to be recommended by Nice and for many thousands of people it is likely to be a welcome and more convenient addition to existing options for a condition that is often overlooked and undertreated.”
Nice has given the green light for use of rimegepant to prevent episodic migraines, which is where a person has fewer than 15 migraine days each month. The draft guidance recommends rimegepant for adults who have at least four migraine attacks a month but fewer than 15.
About 5.6 million people in England are thought to have episodic migraines. It is estimated about 190,000 migraine attacks are experienced every day.
Rimegepant works by stopping the release of a protein around the brain called calcitonin gene-related peptide (CGRP). CGRP causes intense inflammation and is responsible for the severe pain associated with migraine attacks.
Treatment options for preventing migraines include drugs used for other conditions such as beta-blockers, antidepressants and epilepsy medications. These can have significant side-effects and may be ineffective for some people.
Alternatives offered after these have been tried include the Nice-recommended erenumab, fremanezumab or galcanezumab. All are given as injections.
Nice also published draft guidance for consultation on Wednesday that did not recommend rimegepant for treating acute migraine. Charities welcomed the arrival of another treatment to prevent migraines but expressed disappointment it had not also been approved for acute cases.
The chief executive of the Migraine Trust, Rob Music, said: “Too many people with migraine end up with medication overuse headache as a result of their migraine treatment, which has a serious impact on their lives. This is an impact which is preventable if migraine is treated effectively.
“Gepants, the new class of migraine medication which Rimegepant is part of, can help prevent this happening. While we welcome that it has been approved for the preventive treatment of migraine, we are very disappointed by the decision not to approve it for the acute treatment of migraine.” | Drug Discoveries |
Leon Neal/Getty Images
toggle caption
A gull picks up a discarded protective face mask from the shoreline in the marina on August 11, 2020 in Dover, England.
Leon Neal/Getty Images
A gull picks up a discarded protective face mask from the shoreline in the marina on August 11, 2020 in Dover, England.
Leon Neal/Getty Images
How many COVID tests should I keep on hand? Can I toss my masks? Should I still be afraid of long COVID?
These are a few of the questions you sent us when we asked what's on your mind in this new stage of the pandemic. Last month, the World Health Organization and the Centers for Disease Control and Prevention declared that the state of emergency is over even if the virus is still circulating.
The questions you sent revolve around prevention and treatment. We posed a few of them to COVID specialists we have turned to throughout these past 3 years.
One thing to note: While in previous FAQs on the pandemic, there was often consensus about the best ways to keep safe, we're now in a period when different experts sometimes have different opinions. And with mandates largely lifted, the responsibility rests more than ever on the individual to figure out how much risk they can tolerate and what measures make the most sense for them.
How many rapid tests should I have at home ... just in case?
In many places, tests are easy to come by. But if you're exposed to someone you later learn is contagious or you start to show COVID-like symptoms, you don't want to scramble to find a nose swab. Some of the health experts we interviewed suggest having one test per person in a household – or possibly a couple if folks in your home are at high-risk for severe disease, says Charlotte Baker, director of epidemiology and health equity lead for Truveta, a data company that tracks electronic health records. She herself is immune-compromised.
The answer to "how many" is mainly about finding a strategy that puts your mind at ease, says Dr. Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security: "I think it depends how frequently a person anticipates testing. Some people never test, others test frequently." If there are shortages in your neighborhood, keep in mind the tests are also sold online – and that the Food and Drug Administration has extended the expiration dates of some COVID tests and has a list of affected brands.
I've heard all kinds of things about Paxlovid [the pill prescribed to people who contract COVID-19 and are deemed at higher risk of severe disease]. You should get a secret prescription if you're traveling. No, that's against the rules. Visitors to another country can't get it. What's the best advice for travelers?
The Pfizer drug has been approved for use not only in the U.S. but in many other countries. It's currently easy to get a prescription filled in the U.S., but there are reports of international travelers being unable to obtain Paxlovid if they catch COVID in another country. It might sound prudent for a high-risk American traveler to get a prescription filled in the U.S. ahead of time, but there's one problem: That's against the rules of the original FDA authorization for the drug, which says you need to show symptoms before a doctor will write an Rx.
Some doctors will make an exception. Dr. Amesh Adalja of Hopkins says, "I've said for some time that it makes sense for high-risk people who are traveling to have [Paxlovid with them] just in case. The emergency use authorization precludes this type of usage. However, as a physician I would have no problem prescribing this to a patient in this manner, and I suspect other physicians are of the same mind."
An important reminder: Paxlovid can interact with other medications you take, so it's key to check with your doctor before beginning a regimen. If your health-care team nixes a preventive prescription, ask if they consider your travel to another country without the drug risky to your health — then decide if a trip abroad with COVID-19 still circulating is a good idea, suggests Dr. Gregory Poland, an infectious disease specialist at the Mayo Clinic.
Note: Although Paxlovid got full approval from the Food and Drug Administration on May 25, Michael Ganio, senior director of pharmacy practice and quality at the Asssociation of Health System Pharmacists, says the rules of the emergency authorization still apply since U.S. supply of the drug was purchased by the government before the approval and the government continues to oversee distribution of the drug.
You interviewed a doctor who says she doesn't mask in meetings or when traveling unless she feeling symptoms, even mild. But ... you can be asymptomatic and contagious, right? So, shouldn't you still just mask up?
Yes, it's true, you could be contagious and not know it. But right now, transmission rates are low in the U.S. and other countries, points out Dr. Jill Weatherhead, assistant professor of adult and pediatric infectious diseases at Baylor College of Medicine. So that means the likelihood of catching COVID is low, she says – as is the likelihood of being asymptomatic and contagious.
But our interviewees all stress that if you're feeling sick, masking up is a way to be a good citizen — to protect others in case you are contagious with COVID or another virus.
"Please be nice and stay at home," advises Baker. "Hopefully [that's] a lesson we've taken away from this, says Weatherhead.
What about wearing a mask to protect yourself? Still advisable in certain settings?
Okay, let's back up a bit. At surge times during the pandemic, we were urged to layer on a lot of protective measures: vaccines, boosters, masks, avoiding crowds, handwashing ... and remember scrubbing down your mail and groceries back in the early days when we mistakenly thought catching the virus from touching contaminated stuff was a major risk?
When transmission in a community is at a low level, health experts say you can begin peeling off some of those layers.
Masks still have protective benefits, our interviewees stressed. When deciding whether or not to mask up, Dr. Preeti Malani says, "I personally think about air circulation and how close I am to people and for how long." She's an infectious disease specialist at Michigan Medicine. According to the CDC, your risk of infection increases the longer you're exposed to someone with COVID.
To sum up, Malani says about masking: "This is a personal decision of how much risk is acceptable. If rates of infection go up, the benefit of masking also increases. "Right now, for me personally, says Malani, "it feels acceptable to not mask, understanding that others feel differently."
Charlotte Baker of Truveta adds a couple of mask cautionary notes. If you're at risk of severe disease, you might opt for a mask in a crowded setting. Or for anyone in an airport or other transportation hub, she thinks a mask might be advisable – you don't know where all those passengers have been, she says. Aboard a plane, the improved air circulation systems put in place during the pandemic do offer a measure of protection. But if the passenger next to you is sneezy or coughing, you might consider masking up. That's why Baker suggests always having a mask along with you – perhaps dangling from your wrist in case you make an impromptu decision to don it.
Our sources urge you to do what feels right for your circumstances and not worry about being out of sync with everyone else. There's no reason to be embarrassed about being the only masked person in a room.
Also, keep in mind that COVID could surge again. Sometimes it surges in hot weather when lots of people stay inside in air-conditioned comfort. Ditto for winter, when the cold keeps folks inside. So there may be periods ahead when masking and other precautions are again recommended.
How do we monitor levels of COVID in our community – or a destination for a trip — now that many public and private data sources are no longer keeping track.
In the U.S., since the public health emergency ended on May 11, requirements for states to report COVID data such as case counts to federal agencies have ended. Some like Maryland and Texas do offer updates on their public health site and may characterize transmission rates as low, medium or high. Others, like Illinois, do not. To check on a particular state, try searching for "public health" and "COVID" and the name of the state. For a national picture, the Centers for Disease Control and Prevention offers weekly updates on hospitalizations and deaths. The World Health Organization offers updates around the globe. Here's their Kenya page, for example.
Are outdoor gatherings still safer than indoors?
Absolutely, says Dr. Malani. For a respiratory virus like SARS-CoV-2, "outside is extremely safe." That's because COVID-19 is mainly spread from person to person among those in close contact. The virus spreads through respiratory droplets from your lungs, mouth and nose, which are released into the air when you talk, cough, breathe or sneeze. In indoor spaces with poor ventilation the virus can stay in the air for minutes to hours. But outside, fresh air is always moving and the droplets move along with them, so you're less likely to breathe in enough droplets to contract the virus."
How does someone at higher risk (or even just a regular person) think about shopping in a crowded store, going to an indoor concert, going to the gym?
"The amount of close exposure that you have in any of these spaces tends to not be very high," says Malani. If you're worried, she recommends shopping and working out during less busy times. "Of these activities, the indoor concert is probably the highest risk because of the prolonged exposure [to other people]. So that's where masking might provide the most benefit." The same concern applies to other crowded indoor events. And Charlotte Baker reminds us that one positive outcome of the pandemic is the introduction of video-streaming options for those who might be nervous about an indoor event or gathering. (Although with cases waning, live streams could wane as well.)
Has the likelihood of getting long COVID decreased since the beginning of the pandemic? If so, why?
We know that the phenomenon of long COVID exists – but we don't yet know a lot about who's most at risk. One reassuring note is that if transmission is low in your community, your chances of catching COVID altogether — and thus potentially developing long COVID — are lower than during surge times. Being vaccinated and boosted as well as adding layers of protection like a mask will reduce your risk of contracting the virus.
Is there good guidance now for people in contact with kids – when should they be isolated, kept home from school, when should at risk family members stay away?
The guidance for kids is more or less the same as the advice for adults.
"Standard practice for respiratory viruses other than COVID-19 is staying home until 24 hours after fever has resolved without a fever reducer and symptoms are improving," says Dr. Michael Chang, a pediatric infectious diseases physician at UTHealth Houston and Children's Memorial Hermann. "Anyone who tests positive for COVID-19 should follow the CDC's guidance which includes five days of isolation and wearing a mask if around others, followed by another five days of masking after ending isolation."
Dr. Weatherhead also urges that you make sure your kids are "up to date on vaccines and boosters they're eligible for."
I worry for myself and others I know who have not yet had COVID, who have been vaccinated and boosted but like me are very high risk with almost all the risk problems. Am I expected to remain mostly isolated or just wear a mask everywhere or just return to living normally and hope for the best? I am very concerned.
Dr. Malani says she recommends that people who feel anxious speak with their health-care provider to help guide what each person does to manage risk. In general, finding activities that are lower risk (smaller gatherings, well-ventilated spaces, being outdoors, for example) are ways to move while balancing safety and the need to engage socially.
Fran Kritz is a health policy reporter based in Washington, D.C., and a regular contributor to NPR. She also reports for the Washington Post and Verywell Health. Find her on Twitter: @fkritz | Epidemics & Outbreaks |
By Samantha Payne Smith, as told to Keri WigintonÂ
I got married in 2014. I remember waking up with numb feet a couple months after we bought our house. But I didnât think much of it at the time. I could always feel the floor again once Iâd finished brushing my teeth.Â
Later on, the sharp, nagging, sometimes dull pain in my neck started. It got so bad, I couldnât turn my head all the way. Iâd walk around work wearing an ice pack. And sometimes my arm felt heavy, like something was weighing it down.Â
I knew I hadnât hurt myself from lifting something heavy or working out. But I thought it was a muscular problem. Or maybe it was migraines.Â
The ongoing pain in my neck and shoulder lasted for a while before I got any imaging tests done. My doctor gave me muscle relaxers at first. Then she sent me to see a physical therapist. I ended up going to see a chiropractor on my own. That helped, but the pain never really went away.Â
I wasnât diagnosed with relapsing-remitting multiple sclerosis (RRMS) right away. That came in May 2021, when I was 39. But I donât blame my doctor. Unlike what a lot of Black women go through, I felt like she listened to me and took my concerns to heart. But because my pain level would go up and down so much, it was hard to pinpoint the cause.Â
Searching for Answers
I went back to my doctor. I told her I was still having pain every day, and itâd been 2 years. We needed to figure out what was going on. Iâd seen her for more than a decade at that point, and I felt sure she would do something to help.
I asked for a CT scan, but she sent me for an X-ray instead. It didnât show anything, so she ordered an MRI of my neck and shoulders. Almost by accident, they found the lesions on my brain and spinal cord.
I remember looking at my doctor while she read me the report. I saw the lights kind of leave her body, so I knew something was wrong. And then we thought about how Iâd been having chronic urinary tract infections (UTIs) for the past 8 years. I guess she felt like sheâd missed something.
She referred me to a neurologist to confirm the diagnosis. His bedside manner wasnât great, but he did the right follow-up tests. He ordered a full brain MRI, then did a spinal tap. And thatâs when they landed on RRMS.Â
Â
Finding the Right Doctor
Things didnât work out with my first neurologist. I felt like he talked at me, not to me. And I donât know if thereâs a nice way to tell someone they have RRMS, but he was looking at his computer when he said it. It felt cold, and I was confused.Â
Iâd heard of multiple sclerosis, but I didnât really know what it was. And when the doctor didnât ask me if I had any questions, I knew he wasnât right for me.Â
I searched for a Black female neurologist. But I didnât have much luck finding someone who wasnât super far away. So I went back to my regular doctor for advice.Â
The person I see now isnât female or Black, but I like him a whole lot. He asks thoughtful questions about my symptoms and looks me in the eye when we talk. I feel like he really listens. Most of the time, he just lets me talk about what Iâm going through. And my visits are very long.
Starting My Multiple Sclerosis MedicationÂ
Iâm still trying to wrap my head around the details of my disease. But I know the lesions on my spine are serious. And because of that, my neurologist urged me to start a disease-modifying treatment (DMT) right away. Though, I tried a drug-free approach at first.
I opted for lifestyle changes partly because thereâs no cure for MS. And I wanted to help myself in more holistic ways: I changed my diet. I started exercising more. I meditated.
Then, maybe 6 or 7 months after my diagnosis, I was in so much pain that I couldnât move my neck. When I told my doctor about it, he pressed on me the importance of early treatment. Itâs not going to cure you, he told me, but medication can help stop the progression.
He told me that lots of people come to him with loss of vision or feeling. But my symptoms were manageable, and I was in a good space to live a normal life. Aggressive treatment could help keep things that way.
I started a DMT in April 2022. Itâs a shot I give myself once a month. It was a lot to take on at first. I cried every time. But now itâs pretty simple. And while I donât look forward to treatment day, I am grateful to take something that may help.
Iâm trying to talk my husband into giving me a gift each time I give myself a shot. Weâll see what happens.
Â
Finding Support
The support I get from my friends and family is beautiful. I love them for it. But itâs important that I have other outlets. For starters, I see a therapist who helped me work through the funk I was in after my diagnosis.
I also seek out online support groups geared toward Black women. One is called Women of Color with MS. Another is We Are Illmatic, and I love the energy in this group. Itâs filled with what I call powerhouse women.
We talk about lots of stuff in these groups. Sometimes you might vent about your bad day or how your family doesnât really get what youâre going through. Or weâll celebrate each otherâs wins. For instance, maybe someone mentions their new baby or how they no longer need their wheelchair.
But when you get into these groups, itâs important not to take on everyoneâs symptoms. I did that for a while. MS affects everyone in a different way. I had to stop and ask myself: Why are you limiting yourself based off what youâre afraid might happen?
Â
Living Life to the Fullest
My entire perspective on life has changed since my diagnosis. Even though Iâd rather not have RRMS, the disease forces me to pay closer attention to how I feel and to everything around me. Itâs given me the chance to learn more about who I am and what I can do.Â
For example, I started my own business. I was working in a salon owned by someone else. She shut down one week, and I had my own space the next. If this wouldâve happened 2 years ago, I donât know how long I wouldâve sat around trying to figure out the next thing to do.Â
Everybody knows that tomorrow isnât promised. But for me, I feel like RRMS is this big glaring light telling me to keep going. It says: You have things to do. Donât leave anything undone. You deserve to live the best life you can, especially while you can.Â
Samantha Payne Smith, 41, is a multiple sclerosis advocate and owner of Samantha CurlHaus in Chicago. She gets support from her husband, children, family, and friends.Â
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SOURCE:
Photo Credit: Wat'hna Racha / EyeEm / Getty Images
Inset image: Photo: Monday's Are Beautiful
Samantha Payne Smith, Chicago.
 | Disease Research |
Pfizer’s Covid antiviral drug Paxlovid is an important medicine. Doctors can prescribe it to help Covid patients significantly reduce their odds of hospitalization, death and long-term health problems. Despite its efficacy, it’s already not being prescribed as often as it probably should be.
That’s why it’s so depressing to hear that Pfizer is planning to price a five-day course of Paxlovid at $1,390 when it enters the commercial market later this year. That’s more than double the $529 it was charging the U.S. government, which has been purchasing the medicine from Pfizer since 2021 and freely providing it to patients. Harvard University researchers estimate the cost of production for a 5-day course of the drug is about $13.
While many people will not be affected by the change in list price, some people are likely to find it harder to access the drug in the future.
There’s nothing unusual about pharmaceutical companies extracting extraordinary profits from drugs by posting astronomical list prices. But that doesn’t make it any less gross to watch, particularly given how familiar everyone is with the dangers of Covid for high-risk populations. While many people will not be affected by the change in list price, some people are likely to find it harder to access the drug in the future and, thus, be deprived of a great tool for lowering the risk of serious illness from a dangerous virus.
According to The Wall Street Journal, health plans will make it so that “most patients will have a small or no out-of-pocket cost because Pfizer is expected to offer price discounts and help patients with their out-of-pocket charges.” But the high list price might still make insurance companies stingier about covering it, thereby limiting access to it. David Boulware, a professor of medicine at the University of Minnesota Medical School, told The Wall Street Journal, “With a low cost medicine, they’re not going to aggressively police it, but a higher price medicine they likely would.”
CNN notes that the Department of Health and Human Services said that people on Medicare, Medicaid or who lack insurance will be able to get Paxlovid for free through 2024, and that Pfizer says that the program will continue through 2028 for those who are uninsured or “underinsured.” But it’s unclear who qualifies as “underinsured.” Might there be people for whom Paxlovid is far too expensive under their insurance policy who won’t qualify? What happens to people with high deductibles? What happens after 2028? What we do know is that patience assistance programs can be a marketing gimmick to help justify exorbitant prices and that higher prices are going to make it so that many people who need the drug are less likely to be able to get it.
Paxlovid’s price hike mirrors Big Pharma’s price hikes for Covid vaccines, and the price hike has been appropriately slammed by Democrats and by public health advocates. “Life-saving medication is a necessity, not a luxury,” Rep. Ro Khanna, D-Calif., posted on the social media platform X on Friday. “We need to cap what Big Pharma charges for medication to ensure everyone who needs it can get it.”
Posting a high list price for a drug has global implications. The World Health Organization recommends Paxlovid as the preferred antiviral treatment for Covid, and there was already a problem of the drug being out of reach for millions of high-risk people in lower-income countries. This price hike is going to make that problem worse. “Drug corporations’ high prices, contract secrecy and monopoly supply all suppress demand, and make it harder for resource-starved health agencies to purchase the treatment they need to care for people,” Peter Maybarduk, director of the Access to Medicines program at Public Citizen, said in a recent statement.
Pharmaceutical companies often justify their high profit margins by claiming that they’re necessary for the research and development of the drugs in the first place. The problem is that when there’s no cap on profit maximization and our insurance system is riddled with cracks, the drugs end up out of the reach of many of the people they’re supposed to help. | Drug Discoveries |
Dr. Anthony Fauci remains in the spotlight months after leaving his post as President Joe Biden's top medical adviser, as Republicans investigate COVID-19’s origins and Fauci himself, and as the scientist pushes back.
Fauci has become a lightning rod as the public face of the Trump and Biden administration's responses to the pandemic and due to his defenses of U.S. government funding of coronavirus experiments in Wuhan. Republicans intend to haul him before their committees now that they hold a House majority, while Fauci seems to relish his battles with the GOP and continues to be a wanted guest on cable news.
The Republican-led House Select Committee on the Coronavirus Pandemic kicked off this week with three witnesses arguing on Wednesday that it was possible or even most likely that COVID-19 emerged from a Chinese government lab in Wuhan, a hypothesis Fauci has long cast doubt on.
In a sign of things to come, Fauci was the repeated target for criticism by House Republicans, as well as by Dr. Robert Redfield, the former director of Centers for Disease Control and Prevention under President Donald Trump. Fauci continues to argue that a natural emergence is most likely, but Redfield testified this week that the data “indicates that COVID-19 more likely was the result of an accidental lab leak.”
Fauci went on Fox News on Thursday to declare that he would be “more than happy to testify" before the Republican-led committee if he is called to appear.
Scientists consulting with the U.S. government early in the pandemic in 2020 believed COVID-19 originating from a lab in Wuhan was possible or even likely, but emails indicate Fauci and then-NIH Director Dr. Francis Collins worked to shut the hypothesis down. Some previously-released emails included notes from a Feb. 1, 2020, conference call in which at least 11 scientists theorized about the virus's origin, with many leaning toward the lab leak.
The three-year-old call and other actions by Fauci were front and center during the House hearing this week.
Redfield testified Wednesday that he didn’t find out about the early 2020 conference call until the emails were made public long after.
“I was quite upset, as the CDC director, that I was excluded from those discussions,” Redfield said, arguing he was excluded “because I had a different point of view, and I was told they made a decision that they would keep this confidential until they came up with a single narrative.”
Fauci argued Thursday that Redfield “is totally and unequivocally incorrect in what he’s saying that I excluded him” and contended that “I had nothing to do with who would be on that call.” Fauci added that “retrospectively, it would’ve been okay” to have Redfield on the call.
Newly-released emails also show Fauci and others "prompted" an influential scientific paper that pushed back on the Wuhan lab leak hypothesis in the early days of the COVID-19 pandemic.
Redfield had testified Wednesday that Fauci’s actions were “antithetical to science.”
“This was a narrative that was decided that they were going to say this came from the wet market, and they were going to do everything they could to support that and to negate any discussion of the possibility that this came from the lab,” Redfield testified.
Fauci claimed on Thursday that “I’ve always kept an open mind” on COVID-19’s origins.
“I wasn’t leaning totally strongly one way or the other,” Fauci said, adding, “The evidence weighs more likely towards one, namely a natural occurrence, but I would be perfectly acceptant if there were evidence that it was a lab leak.”
FBI Director Christopher Wray confirmed last week that the FBI has long believed COVID-19 originated at a Chinese government lab, and it was recently revealed the Energy Department now believes with “low confidence” that the coronavirus started at a Wuhan lab.
The assessments in favor of a lab leak are the first movement since the Office of the Director of National Intelligence released an assessment in 2021 stating that one U.S. intelligence agency, the FBI, assessed with "moderate confidence" that COVID-19 most likely emerged from a lab in Wuhan, while four U.S. spy agencies and the National Intelligence Council believed with just "low confidence" that COVID-19 most likely had a natural origin.
Redfield testified Wednesday that the Wuhan lab “absolutely” conducted gain-of-function research on coronaviruses and that there was “no doubt” that NIH was funding such research. He argued, “While many believe that gain-of-function research is critical to get ahead of viruses by developing vaccines, in this case, I believe it was the exact opposite — unleashing a new virus to the world without any means of stopping it and resulting in the deaths of millions of people.”
Fauci contended Thursday that virologists “have to have some degree of being able to manipulate organisms” and that it is “absolutely critical for the health of the country.” The doctor has long insisted NIH did not fund gain-of-function research in Wuhan.
EcoHealth Alliance leader Peter Daszak steered hundreds of thousands of dollars in NIH funding to the Wuhan lab and was also an integral World Health Organization-China joint study team member in early 2021 when the group dismissed the lab leak hypothesis as “extremely unlikely” in 2021.
NIH continues to fund coronavirus studies conducted by EcoHealth despite concerns from Republicans that the group assisted with gain of function research in Wuhan and despite the Wuhan lab refusing to hand over key information to NIH. Fauci has repeatedly praised Chinese scientists with whom the U.S. had worked for decades. | Epidemics & Outbreaks |
Valiant Laboratories IPO: All You Need To Know
The company plans to raise Rs 152 crore via a fresh issue of 1.089 crore shares in the price band of Rs 113-140 apiece.
Valiant Laboratories launched its initial public offering on Sept. 27. The IPO issue will close on Oct. 3.
The active pharmaceutical ingredient manufacturer's IPO comprises a fresh issue of 1.089 crore shares, amounting to up to Rs 152.46 crore. The company does not have any offer for sale.
The company intends to establish a new facility in Bharuch, Gujarat, over an area of 57,766 square metres. The project comprises the manufacturing of specialty chemicals such as ketene and diketene derivative products, which are key raw materials for making paracetamol.
Issue Details
Issue Opens: Sept. 27
Issue Closes: Oct. 3
Fresh Issue Size: Rs 152.46 crore
Shares for Fresh Issue: 1,08,90,000 shares
Total Issue Size: Rs 152.46 crore
Price Band: Rs 133 –140 per share
Lot Size: 105 Shares
Face Value: Rs 10 per share
Listing: BSE and NSE
The company has not undertaken any pre-IPO placement.
Business
The company is a bulk drug manufacturing company with a focus on manufacturing paracetamol. Bulk drugs and APIs serve as raw materials for making finished dosage formulations. Paracetamol is one of the most commonly taken pain-relief medicines worldwide.
The company originally started off as a partnership in 1980 and commenced manufacturing paracetamol by late 1982. Their manufacturing facility is located in Palghar, Maharashtra, spread over an area of 2,000 sq ft. The installed capacity of the plant is 9,000 MT per annum.
Paracetamol has several applications, such as in the treatment of headaches, muscle aches, arthritis, back aches, toothaches, colds, and fever. They manufacture paracetamol in various grades, such as IP, BP, EP/USP, as per the pharmacopoeia requirements of customers.
The paracetamol API industry (domestic consumption exports) grew from Rs. 22 billion in FY17 to Rs. 39 billion in FY23.
Use Of Proceeds
Capital Expenditure via subsidiary, Valiant Advanced Sciences: Rs 80 crore
Investment in subsidiary's working capital: Rs 45 crore
Risk Factors
Valiant Advanced Sciences is yet to commence operations, and the investment required towards working capital is based on certain assumptions and management estimates.
The company operates out of a single product manufacturing facility in Palghar and thus faces a concentration risk.
The company is heavily dependent on a single product, and any changes in the paracetamol API industry could adversely affect their revenues.
The company has a limited number of suppliers, the top 10 of which have supplied 99.62% of the total purchases done in fiscal 2023.
Majority of the operating income is derived from the domestic markets. In FY23, 99.61% of operating revenue was from customers in India.
The business is subject to strict quality requirements, regular inspections and audits by customers. Any failure to comply with quality standards may lead to cancellation of existing and future orders. | Drug Discoveries |
A small molecule blocks aversive memory formation, providing a potential treatment target for depression
Depression is one of the most common mental illnesses in the world, but current anti-depressants have yet to meet the needs of many patients. Neuroscientists from City University of Hong Kong (CityU) recently discovered a small molecule that can effectively alleviate stress-induced depressive symptoms in mice by preventing aversive memory formation with a lower dosage, offering a new direction for developing anti-depressants in the future.
“Depression affects millions of individuals worldwide, necessitating more effective treatments. Conventional methods, such as drug therapy with delayed onset of action and psychotherapy, have limitations in yielding satisfactory results for many patients. A pioneering advancement in treatment is urgently needed,” said Professor He Jufang, Wong Chun Hong Chair Professor in Translational Neuroscience at CityU.
Previous research found that stress leads to neural plasticity changes in brain’s valence-coding systems (“valence” refers to the degree to which something is pleasurable or aversive), which are strongly associated with depression, post-traumatic stress disorders and anxiety disorders. Also, some studies revealed that depression is correlated with the hyperactivated amygdala. “However, the neural mechanism that mediates depression in amygdala is still poorly understood,” said Professor He.
Over the years, Professor He’s research group has focused on memory formation and encoding studies. Previously, they discovered that cholecystokinin (CCK), a key neuromodulator, is crucial for inducing long-term potentiation (LTP) – a lasting increase in communication strength between neurons – to enable memory formation. They also found that the CCK and CCK-B receptors (CCKBR is one of three known types of CCK receptors in the central nervous system) mediate neuroplasticity, as well as visual and sound associative memory formation, in the auditory cortex, and trace fear memory formation in the amygdala. Other studies have found that CCKBR antagonist (which blocks the binding of the CCK and CCK-B receptors, thus inhibiting the effect of the binding) exhibited an anti-depressant effect in mice.
So Professor He’s group hypothesized that CCK might facilitate aversive memory formation by enabling LTP in the basolateral amygdala (BLA) – a brain region involved in processing emotional memories and thought to be dysregulated in depression, thus enhancing the development of depression.
In their latest study, they tested this hypothesis using various experimental methods, including in vitro electrophysiological recording, optogenetic manipulation, drug manipulation and behavioural analysis of mice, to examine the critical role of CCK and CCKBR in depression. They found that a CCKBR antagonist called YM022 had an anti-depressant-like effect by blocking neuroplasticity-caused aversive memory formation in mice.
The results of the in-vitro recording in the BLA showed that the YM022 significantly suppressed neuroplasticity. The neuroplasticity induction rate reached 72.3% in the control group; but it was only 10.2% in the drug-treated group.
Moreover, the team underwent a series of behavioural tests to determine the antagonist’s efficacy. The results showed that depressive behaviours in mice treated with a CCKBR antagonist was reduced.
“Remarkably, the YM022 shows anxiolytic effects with a dose of 3.0 ug/kg, which is 3,000 times lower than the required dosage of current antidepressants,” said Professor He. “These results indicate that CCKBR is a potential target for depression treatment, and that the selected antagonist, YM022, may be a good anti-depressant candidate due to its extremely small effective dose. This paves the way for targeted drug development that specifically addresses the abnormalities observed in the basolateral amygdala.”
Next, the research team will focus on the precise mechanisms and potential side effects of CCKBR antagonists to set the stage for future clinical trials involving human subjects.
The findings were published in the scientific journal Molecular Psychiatry, titled “Cholecystokinin B Receptor Antagonists for the Treatment of Depression via Blocking Long-term Potentiation in the Basolateral Amygdala”.
The corresponding author of the paper is Professor He, who is also the Chair Professor of Neuroscience at CityU. The co-first authors of the paper are Dr Zhang Xu, Dr Muhammad Asim and Ms Fang Wei, all former or current PhD students of Professor He.
The research was supported by Hong Kong Research Grants Council, the Innovation and Technology Fund, the Health and Medical Research Fund, and the following charitable foundations: the Wong Chun Hong Endowed Chair Professorship, the Charlie Lee Charitable Foundation, and the Fong Shu Fook Tong Foundation. | Mental Health Treatments |
The waiting list for planned NHS treatment in England has gone up again to another record high - at 7.75 million.
The figure at the end of August was up more than 100,000 on the month before.
Nearly 9,000 people in England are estimated to have been waiting more than 18 months to start their treatment, the data suggests.
All cancer waiting time targets were also missed, and ambulance and A&E waits increased too.
The number of people waiting more than a year for treatment was also higher than the previous month, at just under 397,000.
Despite growing waiting lists, the NHS is treating 10% more patients than before the pandemic - 1.42 million people came off the waiting list in August, compared to 1.29m in August 2019.
Prime Minister Rishi Sunak has made cutting NHS waits one of his priorities.
NHS England says it has hit a target of having 10,000 virtual ward beds in place to treat patients more quickly, in their own home.
Patients are waiting for treatment ranging from hip replacements to surgery to remove cancerous tumours.
Prof Peter Friend from the Royal College of Surgeons of England said increased demand, record staff vacancies and industrial action were adding to the delays.
"Whilst NHS staff continue to work hard to reduce waiting lists, this is happening in extremely challenging circumstances - and that is before winter pressures hit," he said.
NHS national medical director Prof Sir Stephen Powis, said: "We know that industrial action is also continuing to pile pressure on services and impact capacity adding a lot of pressure to hospitals before winter, coming on top of high levels of demand with last month seeing more 999 ambulance calls than any month this year as well as the busiest September ever for A&E attendances, up almost 8% on the same month last year.
"But despite this pressure, it is clear from today's figures that NHS staff are working incredibly hard to deliver for patients with 10% more patients coming off the waiting list in August than the same month before the pandemic."
Meanwhile, Dr Tim Cooksley from the Society for Acute Medicine warned that the winter months for patients needing care could "be appalling".
"High absence levels, burn out and low morale among staff continues to dominate the healthcare picture across the UK," he said.
"I want to reflect upon the immense efforts acute medical teams continue to make to the delivery of patient care - with them the awful experiences for patients last winter would have been even worse.
"Our concern now is that, in light of current immense strain, ongoing industrial action must be resolved before the extreme pressures of winter hit." | Health Policy |
In the U.S., a person has a stroke every 40 seconds, according to the Centers for Disease Control and Prevention (CDC) — making strokes just as widespread as they are dangerous.
There are different causes of stroke, but the most common is a blockage of blood flow to part of the brain, which is called an ischemic stroke.
Transient ischemic attacks, or TIAs — sometimes also called mini-strokes — are also ischemic attacks, but they only last for a few minutes before blood flow is restored.
That doesn’t mean they’re any less serious than a full-fledged stroke, though, noted Dr. Karishma Patwa, a cardiologist with Manhattan Cardiology, which provides cardiac testing and preventive treatment in New York.
Patwa shared with Fox News Digital the most important things to know about identifying and preventing mini-strokes.
"Every second that the brain goes without oxygen increases the likelihood of serious and permanent brain damage," Patwa said.
"Just like a stroke, a TIA deprives the brain of oxygen and should be treated with the same urgency."
Causes of a mini-stroke
There are several possible causes of a TIA.
A clot could form in the brain itself, or a clot from another part of the body can break loose and make its way through the bloodstream until it becomes lodged in the brain, Patwa said.
"In order to best treat a TIA and prevent a future stroke, doctors will want to determine the exact cause of the TIA," the doctor said.
"The longer a person goes without examination, the less likely doctors will be able to determine the cause, leading to a diagnosis of cryptogenic TIA — which means TIA of unknown origin."
Once someone has had a mini-stroke, the risk of having another stroke event is between 5% and 10% within the first seven days, Patwa warned.
"This number actually goes up to about 15% in the first month after a TIA and up to 35% over the course of a patient’s lifetime," she said. "That’s why early recognition and treatment of a TIA is extremely important — to prevent the more devastating complications of a large stroke."
Symptoms of transient ischemic attack
The symptoms of a TIA are the same as symptoms of stroke, Patwa noted.
The symptoms can include:
- Numbness, weakness, or paralysis, especially on only one side of the body (might affect arms, legs or face)
- Slurred speech, difficulty speaking or inability to speak at all
- Difficulty understanding others
- Confusion
- Double vision, blurriness or trouble seeing out of one or both eyes
- Loss of coordination or balance, clumsiness or difficulty walking
- Dizziness
- Intense headache
- Memory loss
- Loss of consciousness
"Symptoms tend to appear suddenly and without any obvious cause," Patwa said.
"In the case of a TIA, the symptoms will last for less than a day, and often just a matter of minutes or even seconds, but it should still be treated as a medical emergency."
It’s important to act quickly as soon as the symptoms begin, she said.
"At that time, there’s no way to know whether an ischemic attack will be transient or not. Don’t wait to find out — call 911 immediately," she advised.
Act ‘FAST’
The doctor recommends using the FAST acronym, a common tool for remembering symptoms and action steps when someone is suspected of having a stroke or TIA.
- F is for Face. Facial drooping, especially on just one side, is a common symptom of TIA. "Ask the person to smile and look to see if it’s asymmetrical," Patwa said.
- A is for Arms. Arm weakness is also common, the doctor noted. "Ask the person to raise both arms and look to see if one or both arms drifts downward."
- S is for Speech. Speech difficulty, including slurred speech, frequently occurs during TIA. "Ask the person to recite something uncomplicated, such as their full name and home address," Patwa said.
- T is for Time. If there is a chance the person is experiencing a TIA, it’s time to call 911, the doctor said.
"It’s important to stress that someone who just experienced a TIA should not get behind the wheel of a car," Patwa also said.
"Calling 911 and requesting an ambulance would be the best course of action, and in lieu of that, the closest responsible adult should drive the person to the emergency room," she added.
Diagnosis and treatment
For people who have had a TIA, prompt diagnosis and aggressive treatment are the best route to an improved outlook, Patwa said.
"People who delay or refuse examination and treatment are much more likely to experience a stroke during the next 90 days."
The symptoms may last for less than a day, and often just a matter of minutes or even seconds, but this should still be treated as a medical emergency.
In most cases, a mini-stroke is diagnosed with a physical and neurological examination, medical history and imaging tests such as an MRI, CT scan or X-ray.
"Depending on what is found during diagnosis, a treatment plan could include medication, the use of stents, angioplasty or surgical procedures," said Patwa.
Tips for preventing mini-strokes
"There are also steps a person can take to help prevent a TIA, or to help prevent a stroke after having a TIA," said Patwa.
These preventative steps can include:
- Quitting smoking, or not starting
- Limiting alcohol
- Managing blood pressure and cholesterol
- Maintaining a healthy weight, along with healthy nutritional, exercise and sleeping habits
- Getting annual physical examinations
People who are at risk for stroke or coronary artery disease are at higher risk for transient ischemic attacks, Patwa said.
"This includes the elderly, smokers and patients with diabetes, hypertension and high cholesterol," she noted.
The highest risk factor for a TIA is a previous TIA or stroke, Patwa added.
"The most important thing is to not treat a TIA like a one-and-done anomaly," she said.
"A TIA is a warning that a stroke is not only possible but likely, and in the near term."
She added, "Anyone suspected of experiencing a TIA should seek medical attention immediately." | Disease Research |
NHS dentistry in Wales could disappear, the British Dental Association has warned.
Welsh government reforms aim to make 112,000 appointments for new patients.
It said it was "always disappointing" when a dentist returned their contract and it was investing £2m annually to improve access to dentists in Wales.
A Senedd committee expressed fears earlier this month that too many people were unable to access an NHS dentist in Wales.
Announced in July 2022, Wales' Chief Dental Officer Andrew Dickenson said the changes to check-ups from six months to 12 months would allow practices to take on up to 112,000 new NHS patients a year.
The British Dental Association (BDA) said the system had left dentists fearing for the survival of NHS practices, with many dentists considering quitting their contracts due to threats of fines.
Out of a recent survey of 250 high street dentists in Wales, conducted by the BDA, more than a third said they would reduce their NHS contract this year, while 13% said they would hand back their contract entirely by March 2023.
Russell Gidney, chairman of the BDA's Welsh General Committee, said the targets were impossible to hit when new patients could take far longer to treat than existing patients who mostly needed check-ups, and that many patients were already only seen once a year.
Combined with a backlog of patients due to Covid, he said the breaking point for the service was "about six weeks ago" and warned it was "going to disappear".
"We've a very real possibility that NHS dentistry as we know it will not in exist in a year or two's time, three months' time," he said.
Mr Gidney anticipated many practices quitting the NHS when the new financial year begins, and accused the Welsh government of refusing to engage.
"We're really expecting to see a snowball effect of practices [quitting] as they deal with the repercussions of this year in six weeks' time.
"If you're trying to make that input and make that change and just not getting listened to, soul-sucking is probably the word I would use," he added.
Dentist Lowri Leeke, who manages Hapus Dental surgery in Merthyr Tydfil, said staff were under huge pressure due to backlogs caused by the Covid-19 pandemic and contract changes.
She said trying to tell people who were used to six-monthly check-ups they would not be seen for a year was "stressful" and she feared health problems - including gum disease and tooth decay - were going unnoticed for months due to less regular routine appointments.
"We are in my practice seeing first hand a big rise in possible oral cancer patients," she said.
"We are constantly just playing catch-up.
"Morale is very low; we are all very tired and very stressed."
Ms Leeke said she knew of dentists who had already handed back their NHS contracts, and many others, including herself, were considering it.
"I'm a practice owner and I'm losing money on a daily basis on my NHS patients," she said.
"The time and the stress that the admin is causing me, I'm spending more of my time ticking boxes and doing paperwork than treating people."
Helen Briscoe, 51, moved to Llanidloes in Powys from Telford, Shropshire, in February 2022 and five members of her family are currently on the waiting list for an NHS dentist.
She has hereditary gum disease which requires her to be seen by a dental hygienist every three months in order to keep her teeth.
But she has not seen a dentist for a year, and said her gums have since "deteriorated".
"I'm very conscious and because I know they've got worse over the year, I don't smile, I don't show my teeth at work, I don't laugh," she said.
Helen used to pay for her treatment through the NHS, which she said made it affordable but she was "worried" how she would cope with the cost of private treatment.
"You manage to save up money, save for a holiday, I'll be saving to have my teeth done every three months," she said.
What does the Welsh government say?
The Welsh government said, while it was "always disappointing" when a dentist reduced or terminated their NHS contract, "less than 20 out of over 400 contracts have been handed back this year [and] most have been re-procured or are in the process of being so".
"We continue to work the BDA to explore how the reform of the national dental contract can encourage dental practices to collaborate and best respond to the dental and oral health needs of their communities," it said.
"The £2m annual funding to improve access to NHS dentistry across Wales will allow health boards to fund dental services based on local needs and issues." | Health Policy |
Tehran, Iran – Iran has banned a weightlifter from sports for life and dissolved a sports committee after the athlete greeted an Israeli counterpart on a podium.
Mostafa Rajaei, a veteran weightlifter, finished second in his category in the 2023 World Master Weightlifting Championships in Poland and stood on a podium with an Iranian flag wrapped around him on Saturday.
On anther step of the podium stood Maksim Svirsky from Israel, who finished third.
The two athletes shook hands and took a picture together, which led to the Iran Weightlifting Federation banning Rajaei from all sports for life due to what it called an “unforgivable” transgression.
“The positions of the federation are aligned with the positions of the holy establishment of the Islamic Republic of Iran,” it said, adding that Rajaei has been banned from entering “all sports facilities” for the rest of his life.
Hamid Salehinia, who headed the weightlifting team, was also removed from his post, and the federation said a committee formed to represent veteran weightlifters has been dissolved as well.
“In addition to apologising to the leader of the revolution, the families of martyrs and all the people of Iran, I promise we will certainly never witness incidents like this in the weightlifting family,” federation chief Sajad Anoushiravani said in a statement.
More than 1,000 athletes from 47 countries participated in the weightlifting championships in Krakow, according to organisers.
Iran does not recognise Israel as a country and strictly forbids any contact between Iranian and Israeli athletes.
For years, Iranian athletes have refused to face Israelis in competitions and many times have been disqualified from tournaments or have bowed out of competitions on medical grounds.
The country has also faced criticism and some bans over its refusal to allow its athletes to compete against Israelis.
Judo’s world governing body in 2021 imposed a four-year suspension on Iran over the issue.
A number of Iranian athletes have defected over pressure from the authorities.
Among them was Alireza Firouzja, a chess prodigy who left Iran after the sports federation banned him from playing in the 2019 world championship due to concerns that he could face an Israeli opponent. Firouzja now plays under the French flag. | Weightlifting & Bodybuilding |
Matt Hancock rejected advice from England’s Chief Medical Officer to replace the 14-day Covid quarantine with five days of testing because it would “imply we’ve been getting it wrong”.
Mr Hancock was told by Prof Sir Chris Whitty in Nov 2020 it would be “pretty well as good” for contacts of positive Covid cases to test for five days “in lieu” of a fortnight’s isolation.
WhatsApp messages between the two men have also revealed that the 14-day quarantine period had likely been “too long all along”.
By then, nearly a million people in England who had come into contact with an infected person had been told to self-isolate for a full fortnight, even if they had no symptoms.
Although ministers reduced the self-isolation period to 10 days in December 2020, it was not until the following August that some groups were made entirely exempt from the requirement.
In November 2020, Sir Chris and other government advisers were “in favour” of trialling the alternative system.
But the then health secretary resisted, saying it “sounds like a massive loosening” and that removing the quarantine requirement could make it appear that ministers had made a mistake.
The release of the messages about isolation came as other leaked WhatsApps revealed how Mr Hancock fought to take credit for the success of Britain’s vaccine campaign, telling colleagues: “Everyone knows I’m Mr Vaccine and this is the route out.”
He feared being overshadowed by others, including the medicines regulator, saying that speeding up approval of jabs was a “Hancock triumph”.
Dame Kate Bingham, the vaccines tsar, was also criticised by Mr Hancock as “totally unreliable” and “wacky” after she questioned the need to inoculate the entire population.
On Sunday a former minister, MPs and scientific experts criticised the “Project Fear” narrative that has been exposed by The Lockdown Files, saying that the “psychological warfare” employed by ministers should never be repeated.
The Telegraph has revealed that Mr Hancock wanted to “deploy” a new variant to ensure public compliance, while his team spoke about how best to use “fear and guilt”.
In the exchange with Mr Hancock on Nov 17 2020, Sir Chris said: “CMOs [chief medical officers] and Sage [the Scientific Advisory Group for Emergencies] in favour of a pilot with presumption in favour of testing for 5 days in lieu of isolation (alternative 10 days isolation). But needs a pilot to test this out and check it works and Mhra [the medines regulator] have not yet signed off for self use.”
Mr Hancock replied: “So test every day for just 5 days? That sounds like a massive loosening.”
Sir Chris told him: “The modelling suggests it’s pretty well as good. And we think adherence likely to be good. The modellers were in favour of 3 days (given the lag time to get a result) but we were not in favour.”
Mr Hancock initially responded that he was “amazed”. But after questioning whether it meant that the 14-day isolation period may have been “too long all this time”, he again pushed back against the scientific advice.
Mr Hancock asked Sir Chris: “So has the 14 day isolation been too long all this time?”
The Chief Medical Officer responded that self-isolating for a fortnight was only “marginally safer” than 10 and that this tiny benefit came “certainly at the expense of reduced adherence”. He concluded: “So it probably balances out.”
Mr Hancock replied: “I think moving to 7-day daily testing for contacts would be HUGE for adherence, but going below that would seriously worry people and imply we'd been getting it wrong.”
Sir Chris replied, saying that he would “go back” and speak to the other chief medical officers, adding that he thought they would be “sympathetic” to Mr Hancock’s concerns.
By the summer of 2021, mandatory isolation for contacts led to the so-called “pingdemic”, when more than 600,000 people a week had to stay at home after the NHS Test and Trace app on their mobile phones alerted them to close contact with a Covid case.
The app was so sensitive that neighbours were reportedly being “pinged” through walls.
Industries including manufacturing, hospitality, transport and healthcare were thrown into chaos. The Government was forced to release some critical workers from the policy in a bid to keep trains running and avoid food shortages.
By the time self-isolation was totally dropped in February 2022, more than 20 million people had been told to self-isolate.
Mr Hancock has always claimed he was “guided by the science” when making policy decisions that curtailed people’s freedom to go about their daily lives.
The messages about isolation came six months after the 14-day self-isolation rule was introduced, and two months after it was enshrined in law.
From May 28 2020, when NHS Test and Trace was launched, to the day when the message was sent, 923,656 people in England were told to stay at home for a full fortnight. Many workers lost out on pay while they were waiting for the all-clear.
In the period from the day the message was sent to Aug 16 2021, when exemptions from self-isolation were announced, more than eight million people were identified as contacts of positive cases and told to stay at home.
Presented with the news that the chief medical officers believed the 14-day isolation period could be removed and replaced with just five days of testing - provided the medicines regulator signed off on at-home testing - Mr Hancock said: “This sounds very risky and we can't go backwards.”
He then asked: “Wouldn't test every day for ten days be a safer starting point?”
Sir Chris replied: “We could push out to 7 but the benefits really flatten off after 5. We would expect symptomatic people to get a pcr test as normal.”
The self-isolation period was shortened to 10 days on Dec 14 2020, the same day that Mr Hancock announced the existence of the so-called Kent variant of Covid and said that cases of this new strain were “increasing rapidly”.
Despite this change, disruption caused by the self-isolation policy escalated in 2021 as thousands of workers every day were “pinged” by the NHS Covid-19 app and told to stay at home.
By July that year, almost a third of people said they had removed the app from their phone, according to a Telegraph poll.
A daily testing pilot for contacts was launched in May 2021. This allowed some people identified as close contacts to take daily tests for seven days rather than isolating. However, it was not offered to people contacted through the NHS app.
From Monday, Aug 16 2021, people who were double jabbed or aged under 18 and six months were no longer legally required to self-isolate if they were identified as a close contact of a positive case.
Everyone else was still legally mandated to self-isolate or risk a fine of at least £1,000.
The requirement to self-isolate was only removed entirely in February 2022.
A year earlier, scientists at the London School of Hygiene and Tropical Medicine published a study in Lancet Public Health that looked at whether “Test to Release” could reduce or replace quarantine for contacts of positive cases.
They found that – provided all tests were returned negative – releasing contacts on day seven, or daily testing for five days without quarantine, were both just as effective at preventing the spread of the disease as making people self-isolate for the full 14 days. | Epidemics & Outbreaks |
Image source, Sarah HutchinsonImage caption, Sarah Hutchinson has been waiting for four years for a kidney, while her son Shae is also a transplant patientBlack patients wait six months longer on average for organ transplants than the general population, NHS data shows. The best match comes from someone of the same ethnicity - but only 2% of donors in 2021/22 were black, while black people are 4% of the population.Black families are also less likely to agree to organ donation than white families, the figures show. The NHS says there's an "urgent need" for more people from ethnic minorities to donate. The NHS Blood and Transplant report, seen by BBC Radio 1Xtra's If You Don't Know podcast ahead of its publication on Thursday, shows that while waiting times have improved for all ethnicities in the UK, black people wait on average 735 days for a kidney.By comparison, the average waiting time for the general population is 550 days. For Asian people, it is 650 days and 488 days for white people.Kidney patients make up the majority of people on waiting lists and face some of the longest waits, because transplants need to be matched by blood and tissue type, whereas other organs only need a blood type match. But there are similar disparities in waiting times for other organ transplants."Black people wait longer because there's less people coming forward to give their organs from their ethnic group," said Winnie Andango from NHS Blood and Transplant."During Covid, so many patients were suspended but those have been added back onto the list, and that means if we had less organs for this ethnic minority group we have even less right now."Sarah Hutchinson - who has Alport Syndrome, a disease which affects the kidney function - has been waiting on the organ transplant list for four years.She is on dialysis, which helps to do the work of her kidneys and remove toxins from her body, but she says it can be painful and tiring."It's an emotional rollercoaster. It's the tiredness, the fatigue. That, if anything, is what gets you down," she told the If You Don't Know podcast."I am struggling at the moment with my energy levels, and things you kind of take for granted I can't do anymore."She says getting a kidney transplant would be "life-changing" and wants to encourage more people from the black community to donate their organs."I totally understand why not many people come forward. To help ourselves - and they say 'black lives matter'- we need to do more for our own community and organ donation is definitely one of them."Listen to the latest If You Don't Know podcast to hear more about black organ donors. Her son, 22-year-old footballer Shae, has the same condition and found it was affecting his career as a striker for Norwich City FC's under-23s."I couldn't really manage to play a full 90 minutes," he said. "My muscles were getting tired quicker - even after an injury it took me longer to recover than it should have."His health improved when he had a transplant - initially from his dad in 2018, and then from a stranger in 2020 when the first transplant stopped working."After that I felt brilliant in myself, I didn't feel tired as much. I'm very grateful to the person who stepped forward," he added.It was thanks to his uncle Simon that Shae was able to get his second transplant.Simon donated his kidney as part of a sharing scheme, which meant his nephew got a kidney that was a better match - and his organ went to someone else. Image caption, Simon ran the London Marathon after donating a kidneyHe says living with one kidney hasn't impacted his life and wants to encourage more people to consider donating while they're alive."It's not changed me whatsoever," Simon said. "I actually ran the London Marathon to raise awareness for people to show it's OK to donate - it's not going to change your life."The law around organ donation in England changed in 2020 to an opt-out system, meaning people are presumed to have consented unless they record a decision not to donate. Scotland adopted the opt-out system in 2021, while Wales has taken this approach since 2015. In Northern Ireland, the law was changed last year.But the number of UK donors last year was still lower than before the change in the law, as transplant services recover from the pandemic.Despite the introduction of the opt-out approach, the families of people who have died are still involved in the decision before an organ donation goes ahead.The NHS report found one of the reasons black families do not consent is because people were unsure what their loved ones would have wanted."Me being from a black family from Africa, death and dying are just not just normal things we discuss at dinner," said Ms Andango."So when it comes to something like this, it can feel like a very big decision and it becomes difficult because you've never discussed it really."The important thing is that people need to start having those conversations."The government says it will be announcing extra measures to make the best use of organs "so we are saving as many lives as possible".Health Minister Neil O'Brien said: "We need more people, especially those from black and Asian heritage, to register their organ donation decision and share it with their family so loved ones can follow their wishes."Listen to the latest If You Don't Know podcast on BBC Sounds to hear more about black organ donors. | Global Health |
A return to pandemic-style home learning for school pupils impacted by the unsafe concrete crisis should only last "days, not weeks", the government has said.
More than 100 schools and colleges have been told by the Department for Education (DfE) to partially or fully shut buildings - just days before the start of the new school year - over fears about the safety of facilities built with reinforced autoclaved aerated concrete (RAAC).
However, the department says a move to remote education should only be considered as a "last resort" and only for a "short period".
Schools impacted by the crisis have instead been advised by the government to find space in nearby schools, community centres or even "empty local office buildings".
They say such spaces should be utilised for the "first few weeks" while structural supports are installed to mitigate the risk of collapse of structures built with RAAC.
Meanwhile, Labour has ramped up its calls for the government to reveal the "full extent" of the impact of RAAC, including by publicly listing the schools which have had to close or partially shut.
Schools Minister Nick Gibb has pledged to publish the list in "in due course", while it is understood a full list will only be released by the DfE when all parents are informed and mitigations are in place.
Read: The list of all the schools we know are affected by concrete safety fears
Labour says it will call for a vote next week in the House of Commons with the aim of forcing the government to publish all official documents about their handling of the RAAC crisis.
The party's shadow education secretary, Bridget Phillipson MP, said: "Parents and the public have the right to know where public buildings affected by this dangerous concrete are, what ministers knew about the risk that this concrete posed to life and why they acted to intervene only days before the start of the school term.
"An urgent, full audit is required to reveal the extent that Conservative ministers failed to replace this dangerous concrete across the public sector estate.
"It's time ministers were transparent about their handling of this debacle: if they still refuse to publish these documents and give parents the reassurances they deserve about the risks to their children's safety, then we will force a vote in parliament next week."
The Liberal Democrats, meanwhile, have called on the prime minister to hold an emergency Cobra meeting over the problem.
Education Secretary Gillian Keegan says she will inform parliament next week "of the plan to keep parents and the public updated on the issue".
In a statement on Saturday, the DfE said: "We are incredibly grateful to school and college leaders for their work with us at pace to make sure that where children are affected, disruption is kept to a minimum, and in the even rarer cases where remote learning is required, it is for a matter of days not weeks."
Read more:
RAAC crisis: Obese patients can't be moved from ground floor at hospital
RAAC: The once wonder material causing a chaotic start to the academic year
RAAC is essentially a lighter-weight form of concrete, used to build roofs, schools, colleges and other buildings from the 1950s until the mid-1990s.
But experts fear that the material has now reached the end of its shelf life and is liable to collapse.
Reinforced Autoclaved Aerated Concrete - handily shortened to RAAC - is essentially a lightweight form of concrete. It was used to build roofs, schools, colleges and other buildings from the 1950s until the mid-1990s, according to GOV.UK. In comparison to traditional concrete, RAAC is weaker. It is made in factories using fine aggregate, with chemicals to create gas bubbles and heat. Both the material properties and structural behaviour differs significantly from traditional reinforced concrete. In 2019, the Standing Committee on Structural Safety highlighted the significant risk of failure of RAAC planks. Three years later in 2022, the Office of Government Property sent a safety briefing notice to all property leaders, saying that "RAAC is now life-expired and liable to collapse". Chris Goodier, professor of construction engineering and materials at Loughborough University, said: "It is RAAC from the 1950s, 60s and 70s that is of main concern, especially if it has not been adequately maintained. "RAAC examples have been found with bearings (supports) which aren’t big enough, and RAAC with the steel reinforcement in the wrong place, both of which can have structural implications."
Though not confirmed, it is estimated that around 24 schools in England have been told to close entirely because of the presence of RAAC.
More schools could be asked to shut classrooms in the future, according to ministers.
But the problem could be far wider than just schools, experts say, with other buildings at risk of "sudden and catastrophic collapse" if RAAC is not removed.
Chris Goodier, professor of construction engineering and materials at Loughborough University, said the "scale of the problem is much bigger than schools".
He says it could cover public sectors including health, defence, and justice, as well as some private sector buildings.
NHS providers have already identified 14 hospitals, which were constructed "either wholly or in major part with RAAC". Seven of these are considered "critical" and not fit for purpose beyond 2030.
Three buildings operated by Police Scotland have also been found to contain RAAC after an investigation of 65 structures.
Matt Byatt, president of the Institution of Structural Engineers, says any high-rise buildings with flat roofs constructed between the late 1960s and early 1990s may also contain RAAC.
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Marlo Thomas celebrates Thanks and Giving's 20th year and $1 billion raised for St. Jude hospital
Actress and activist Marlo Thomas is proud that this year St. Jude Children's Research Hospital's Thanks and Giving campaign celebrates its 20th anniversary and passes the fundraising milestone of $1 billion to support the hospital’s efforts to provide...
NEW YORK -- When families thank Marlo Thomas for the medical treatment they received at St. Jude Children’s Research Hospital, she kindly corrects them.
“I say, ‘Well, you know, I’m not a scientist, I’m a wheelbarrow,’” the actress, producer and activist says with a smile that has been famous since her days starring in “That Girl.” “I take the wheelbarrow, put the money in it and bring it to the scientists.”
And Thomas, who serves as St. Jude’s National Outreach Director, is a really good wheelbarrow.
This year, St. Jude’s Thanks and Giving campaign celebrates its 20th anniversary and passing the fundraising milestone of $1 billion to support the hospital’s efforts to provide free medical care to children with cancer. The drive, which kicked off earlier this month and runs through the holiday season, also raises awareness for the work of the Memphis-based hospital, which was founded by her father, the late “Make Room for Daddy” star Danny Thomas, who pledged that families would never be billed by St. Jude for treatment, travel, housing or food.
“That’s an amazing promise,” Marlo Thomas said. “And we’ve kept it.”
According to Fidelity Charitable’s annual ranking of the most popular nonprofits supported by its donor-advised funds, St. Jude Children’s Research Hospital ranks No. 2, behind only Doctors Without Borders USA. Nonprofit ratings organization Charity Navigator says St. Jude ranks third among its most-followed charities, behind Doctors Without Borders and the American Red Cross. Charity Navigator also gives St. Jude a rare 100% score, meaning that donors can expect that their gifts will be used according to the hospital’s stated mission, said Kevin Scally, Charity Navigator’s chief relationship officer.
“It’s a household name and they’ve built a reputation over many years,” Scally said. “To take care of children stricken with cancer and taking care of their families to the point where the families don’t incur any sort of costs – that’s something that really pulls at the heartstrings, whether you’re somebody that has had a family member that’s been hit with cancer or not.”
Marlo Thomas credits the Thanks and Giving campaign – an idea that she developed with her sister, Terre, and her brother, Tony – for making that possible.
Back in 2003, the Thomases realized they needed a new fundraising campaign that would raise about $100 million a year.
“We thought, ‘What about doing a national day, which had never been done for any charity?’ ” Thomas recalled. “We decided, Thanksgiving was a perfect time because it’s not about anybody’s religion. Everybody gets together. It’s the one holiday of the year where families really do gather. And it’s my favorite holiday because it’s all about food and family.”
Her sister, Terre, came up with the name Thanks and Giving and they created a concept that updated how her father raised awareness and funds.
“My dad in his day brought in Frank Sinatra and Nat King Cole and George Burns and all those great stars,” she said. “In our generation, we brought in Robin Williams – may he rest in peace – and Jennifer Aniston, Luis Fonzi, Michael Strahan, Jon Hamm, and a lot of wonderful contemporary stars who’ve helped us.”
They also brought in numerous retailers – including Target, Best Buy, Williams-Sonoma and Domino’s Pizza – who ask customers to contribute to St. Jude as they check out throughout the holiday season.
“It’s a very exciting campaign because it came out of our family,” Thomas said. “My dad would be really thrilled and proud that we thought of it together and we made it happen.”
Unlike most hospitals, which fund their medical treatment with a mix of payments from patients and insurance, St. Jude funds about 80% of treatment costs with donations – about $2 billion each year. However, Thomas said believing in the generosity of the American public has become part of the hospital’s success.
“That’s why they call it ‘America’s hospital,’ because the children come from all over America and the people of America send in the donations,” she said. “It couldn’t exist without American donors.”
And following a $200 million investment in St. Jude Global in 2021, the hospital hopes to offer its treatments for childhood cancer around the world. Currently, outside of the United States, more than half of children with cancer will die from the disease. In the U.S., the survival rate for childhood cancer is now 80%, up from 20% when St. Jude first opened its doors.
St. Jude Global worked with the World Health Organization to rescue more than 1,000 children with cancer from Ukraine after the Russian invasion began, Thomas said. Russian bombings during the war made it impossible for the children to continue their cancer treatment at hospitals in Ukraine.
“We took eight families ourselves,” said Thomas, adding that the hospital found that one of the Ukrainian children had been misdiagnosed. “We also organized it so that these children and their families could be taken in other countries around the world – in Switzerland, Egypt, all kinds of countries – where they opened their hearts to these children.”
Thomas said that is the natural continuation of the story of St. Jude that she hopes the Thanks and Giving campaign helps tell.
“My father said that no child should die in the dawn of life,” she said. “He didn’t mean ‘no American child.’ He meant no child anywhere.”
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Associated Press coverage of philanthropy and nonprofits receives support through the AP’s collaboration with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content. For all of AP’s philanthropy coverage, visit https://apnews.com/hub/philanthropy. | Global Health |
In the 24 years Linda Tovey has worked for the NHS, she has never seen the health service so short of staff.
"You’re just not doing the job you signed up for - it’s not possible," the 49-year-old critical care nurse told Sky News.
For the last two years, nurses like Linda have been leaving the health service in record numbers, in part due to the pressures of manning a healthcare system with 133,000 vacant posts. Those that remain are left to pick up the slack.
"You can’t do anything the way you’d want to do it," Linda says. "It’s difficult to say for sure, but there are probably more errors. The idea that it’s less safe for patients causes a huge amount of stress."
Data from NHS Digital shows that 15,000 nurses resigned from the health service in the year to March 2022, with 4,000 citing work-life balance as their reason for leaving.
It’s not just nurses - staff across the NHS are now three times more likely to quit due to issues of work-life balance than they were a decade ago, complicating the health service’s efforts to plug vacancies, expand capacity and bring down waiting lists.
Analysis by Sky News shows that this increase in resignations due to work-life balance cost the NHS 10,000 staff last year. That figure includes 203 doctors, 2,800 nurses and more than 4,100 support staff.
The strain on NHS staff is also evident in the growing number taking time off for mental health reasons. In September 2022, nearly half a million working days were lost to anxiety, stress, or depression-related absences. That's equivalent to one in every 80 working days, a 56% increase since 2015.
Had rates of mental health-related absence not increased since 2015, Sky News analysis has found, the NHS would have had an additional 175,000 working days in September.
On any given day that month, one in every 42 ambulance support staff were absent for mental health reasons, along with one in every 52 midwives.
For doctors in their second foundation year, their first year with a full licence to practice, mental health absences have more than tripled since 2015.
One NHS worker feeling the strain is Kafeelat Adekunle, a 57-year-old community matron.
"If we had enough nurses and they were paid well, no one would be getting stretched or broken," she said. "People wouldn’t be falling sick all the time and leaving the profession."
A recent report by the Institute for Fiscal Studies found that nurses and midwives who took at least three days off for mental health were 27% more likely to have left the NHS altogether three months later. For consultants, the figure was 58%.
It’s not just burnout that's causing staff to leave. Sky News found that a rise in relocation-related resignations cost the NHS nearly 3,000 staff last year.
We don’t know exactly where these staff are relocating to, but data from the General Medical Council (GMC) suggests that many doctors are moving overseas.
Last year, the GMC issued 6,950 certificates of the type typically requested by doctors looking to move abroad. Data from previous years suggests that around half of these doctors are likely to cease practicing in the UK within nine years.
"There’s definitely been a movement of EU nurses back to the EU," says Linda Tovey.
"And other international nurses are going to places where the cost of living crisis doesn’t seem as great. People get paid more in America and Australia."
Without an increase in wages, nurses will be paid 10% less in real terms this year than they were in 2010, and consultants 15% less.
"It’s not that doctors in this country are particularly poorly paid compared to other workers," says Billy Palmer, an expert in NHS workforce issues at the Nuffield Trust, a think tank.
"It’s that compared to some high-profile English-speaking countries we lose out. So, it could be quite tempting to go to the US or Australia because you could earn significantly more."
In 2010, a UK medical specialist moving to South Korea would typically see their income fall (in terms of purchasing power) by around 5%, according to OECD data. As of 2020, by contrast, they can expect a pay rise of 25%.
Similarly, a nurse moving to Iceland would previously have taken a 13% pay cut, but is now likely to see a 43% bump to their salary.
Kafeelat Adekunle is among the NHS nurses considering a change of scenery.
"I’m a fighter," she laughs, "but if anything comes up tomorrow I’m ready to go. I have a lot of family in America, and I know I could get more, even double, if I was there today."
The same dynamic is likely to play into foreign healthcare workers’ decisions about relocating to the UK. In 2010, a nurse coming to the UK from Slovenia could expect a 37% boost to their living standards. As of 2020, they would earn 4% more by staying put.
"The international nurses - their expectations are always very high," says Kafeelat. "They’ve given all their savings to escape but now they're earning less, comparably, because of what they have to spend here. It’s a shock.
"One nurse I know has already gone back to Nigeria - she couldn’t cope anymore. I think it was a big shock for her, because she thought she would earn to save. But in this country, you know, you earn to pay your bills."
Fewer EU staff are coming to the UK
A recent study by the Nuffield Trust found that the number of European health workers moving to the UK has declined steeply since the 2016 Brexit referendum.
Martha McCarey, one of the report's authors, says both pay and a tightening of immigration rules for EU staff are likely to have played a role.
"There's lots of reasons people would want to come to the UK - they might be paid better here than elsewhere, or they're provided with the training opportunities they couldn't have at home. With the current situation, getting better working conditions or pay here might be a less realistic prospect."
The UK recruited 27,000 fewer European nurses during the last four years than it did during the four years before the 2016 Brexit referendum.
Recruitment for nurses from other countries has increased by 53,000 - more than making up the difference.
For particular types of doctor, however, that surge in non-European recruitment never happened.
In the six years before the EU referendum, for instance, the number of registered surgeons from outside the European Economic Area (EEA) rose by 861. In the six years since, it has risen by just 726. Combined with a decrease in domestic recruits, that has meant a halving of the growth in the number of surgeons.
The UK relies far more on foreign recruits to staff its health service than other countries. As of 2020, a third of doctors in the UK were trained abroad (32%) - more than double the OECD average of 13%. For nurses the UK is even more of an outlier, sourcing 18% of its staff from abroad compared to an international average of less than 4%.
The UK's reliance on foreign staff is increasing. In 2021, for the first time, doctors from outside the UK or Europe made up the majority of new additions to the medical register.
This could become more of an issue over the coming years, says Martha McCarey, as international competition for doctors and nurses increases.
The World Health Organisation estimates that there will be a global shortage of 18 million healthcare workers by 2030.
The UK’s dependence on foreign staff is also potentially one reason behind the NHS's retention issues.
A recent report by the Institute for Fiscal Studies found that, compared to those trained in the UK, EU-trained consultants were 23% more likely to leave the acute sector in any given month. For those from outside the EU, the difference was 56%.
It’s not just other countries that the NHS is competing with for staff, but other sectors within the UK.
Across the NHS, wages have fallen by 4.6% in real terms since 2010, according to the Nuffield Trust, compared to a 0.6% rise in the private sector. That has put the NHS in direct competition with private employers, particularly for low-paid workers.
It now pays significantly more to be a switchboard operator, assembly line worker or warehouse employee than it does to be a medical secretary, nursing assistant or care worker.
That gap has widened in the last two years, as private-sector employers raised wages to combat their own labour shortages.
Even higher-paying roles, like GPs and specialists, are now facing increased competition from the private sector.
"The feedback you get from junior doctors is that it's pretty toxic working in the NHS at the moment," says Billy Palmer of the Nuffield Trust.
"Feeling valued is important, and a key way people feel valued is through pay. It’s not surprising that people are looking at what other career routes they’ve got."
The government has responded to workforce shortages in part by expanding the number of medical school places, with four new medical schools created between 2019 and 2020.
The increase in medical students has not, however, been matched by a similar increase in training posts, making it harder and harder for trainee doctors to progress.
In 2018, for instance, there were 22,400 applications for 12,400 specialist training posts. By 2022, an increase in the number of medical students meant that the number of applications ballooned to 36,600. The number of posts available, however, shrank to just 12,100. As a result, two in every three applications were rejected (67%) - up from less than half (48%) in 2018.
The UK has long struggled to take advantage of its relatively large supply of medical students. For almost all of the last two decades the UK has produced more medical graduates than the average OECD country. Yet for all that time, it has also had relatively few practicing doctors.
"We’ve got a leaky pipe," says Billy Palmer. "It’s not necessarily that we’re not training enough - there’s something happening in that domestic pipeline."
Those issues with career progression, combined with issues around pay and working conditions, are making it difficult for the NHS to retain staff. That, in turn, is hampering the health service's efforts to meet its ambitious recruitment targets.
The health service has expanded its workforce by 179,000 in the last four years, but growing demand for staff means that vacancies are rising, not falling.
Billy Palmer says that the NHS has been trying to expand its workforce rapidly in order to boost capacity and reduce waiting lists.
"It’s partly about the amount of activity they’ve got to get through. They’ve got a pretty eye-watering backlog facing them.
"There’s ambitions to get levels of output to 30% above pre-pandemic levels. Well, how do you go about getting to that? You probably need something like 30% more staff available."
The NHS remains far from meeting that target, and is only just now returning to pre-pandemic levels of elective activity.
Meeting the target is likely to require even more hiring over the coming years. That’s likely to require more funding, but money isn’t the only obstacle.
"You’ve got capacity constraints all along the recruitment path," Billy Palmer says.
"In the education system you need to have classrooms, supervisors, lecturers, accommodation. You also need to have placements in the services. If you’ve got staff in hospitals working flat out, it’s difficult to get them to scale up training."
For experienced nurses like Linda Tovey, higher turnover means more time devoted to training new recruits, adding to the stresses that have been causing the retention crisis in the first place.
"It’s a real strain - you never get a day when someone isn’t following you around. And meanwhile there’s the increasing pressure to carry on, to increase productivity and get everyone through the system."
Strikes feel like "the only way to be heard"
Disputes over pay and working conditions have led to a historic winter of industrial action by NHS staff, including the first-ever strike by the Royal College of Nursing.
Data from NHS England shows that the strikes have resulted in the cancellation of 92,000 appointments since December.
Earlier this month, nearly 50,000 appointments were cancelled in just two days as nurses staged two 12-hour walkouts. The Royal College of Nursing is now preparing to stage its first-ever 48-hour walk-out, from 1 to 3 March.
Kafeelat Adekunle says she joined her local nurses' strike committee because industrial action feels like "the only way to be heard."
"It’s not just the pay, it's the conditions in which we’re working. The government needs to come and shadow some of us. They don’t know what’s happening. They don’t know what we’re going through.
"It’s heartbreaking seeing my profession going down the drain. I've been a nurse forever and I want to be that until I retire.
“We want to do our job, we want to do it right. We want to see our patients, we want to see them well. We want to take care of them. But everyone is exhausted."
The Data and Forensics team is a multi-skilled unit dedicated to providing transparent journalism from Sky News. We gather, analyse and visualise data to tell data-driven stories. We combine traditional reporting skills with advanced analysis of satellite images, social media and other open source information. Through multimedia storytelling we aim to better explain the world while also showing how our journalism is done. | Health Policy |
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