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Doctors in India are grappling to diagnose and treat unexplained and persistent symptoms of <keyword id="9814327" type="General" weightage="100" keywordseo="long-covid" source="Orion">long Covid</keyword> patients due to limited guidelines, whereas researchers have flagged inadequate studies on the condition. With the <keyword id="19896311" type="General" weightage="20" keywordseo="world-health-organization" source="keywords">World Health Organization</keyword> declaring an end to <keyword id="19896627" type="General" weightage="20" keywordseo="covid" source="keywords">Covid</keyword> as a global <keyword id="416511" type="General" weightage="20" keywordseo="health-emergency" source="Orion">health emergency</keyword> in May last year, focused efforts are underway around the world to estimate the burden of long Covid among the population. The condition refers to the set of lingering symptoms affecting varied body parts and persisting well beyond the acute Covid infection period, including cough, muscle and joint pain, fatigue, brain fog and difficulty in focusing. The viral disease is caused by the SARS-CoV-2 virus. While studies have suggested that about a third of those moderately or severely infected are likely to suffer from long Covid, region-wise though, incidence could vary. A study by researchers, including those from <keyword id="19988007" type="General" weightage="20" keywordseo="harvard-medical-school" source="keywords">Harvard Medical School</keyword>, US, estimated that 31 % of the once-infected people in North America, 44% in Europe, and 51% in Asia, have long Covid, which is "challenging the healthcare system, but there are limited guidelines for its treatment". It was published in the International Journal of Infectious Diseases in September. In India, however, studies on long Covid are few and far between. One such study by Maulana Azad Medical College in New Delhi, conducted from May 2022 to March 2023 on 553 patients who had recovered from Covid, found that about 45% had lingering symptoms, persistent fatigue and dry cough being the most common. "There is limited exploratory research on the long Covid syndrome with scarce data on long-term outcomes," the authors wrote in the study published in the journal Cureus in May this year. Understanding the long-term effects of the virus is important for developing management strategies, optimising healthcare delivery, and providing support to recovered Covid patients in the community, they said. Dr Rajesh Sagar, Professor of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, said, "Looking at the current state of long Covid studies in India, it is too premature to say that we understand the condition well enough to know how to diagnose or treat it." Animesh Samanta, assistant professor at School of Natural Sciences in <keyword id="19897094" type="General" weightage="20" keywordseo="shiv-nadar-university" source="keywords">Shiv Nadar University</keyword>, Greater Noida, said, "While studies in India highlight the growing recognition of neurological complications in long Covid patients, more focused research on neuroinflammation is needed." Doctors, too, have reported a rise in patients complaining of symptoms that they did not have pre-Covid. "People who never had <keyword id="6465125" type="General" weightage="20" keywordseo="asthma" source="Orion">asthma</keyword> in the past, post-Covid, with every viral infection, they get a long cough, shortness of breath and wheezing, which require the use of <keyword id="31257" type="General" weightage="20" keywordseo="inhalers" source="Orion">inhalers</keyword> or nebuliser," senior consultant Dr Neetu Jain, who runs a post-Covid care clinic at Pushpawati Singhania Hospital and Research Institute, New Delhi, said. Dr Arun Garg, chairman, Neurology and Neurosciences, Medanta-The Medicity, Gurugram, said he was noticing a spike in stroke cases among young patients not suffering from known risk factors such as diabetes, hypertension and obesity. "Similarly, we are seeing more cases of encephalopathy (swelling of the brain) without reason and having a confused state of mind following one or two days of fever. Their MRI scans show no changes. These patients have increased significantly after Covid," he said. In the absence of medical guidelines to diagnose long Covid, doctors are having to resort to broad, non-specific tests and questionnaires to gauge a patient's 'quality of life'. Studies have shown that the fatigue experienced in long Covid is similar to that in cancer patients, with a quality of life similar to patients of Parkinson's disease. "We really do not have any test to diagnose long Covid, even though it is definitely a clinical diagnosis. We diagnose long Covid for people who had at least moderate to severe infection, following which they could never regain the quality of life pre-Covid. Checking for inflammatory markers like C-reactive proteins (CRP) can support the diagnosis," Dr Jain said. "Other than routine blood tests that measure inflammation, we do antibody tests to look for direct markers. In many of these patients, we are finding rare antibodies which are very new to us and were not there pre-Covid," Dr Garg said. Inflammation persisting despite recovery from acute Covid infection is thought to lie at the heart of long Covid. However, tests to measure this specific immune response are lacking, even as researchers have been working in this direction worldwide. One such effort comes from Shiv Nadar University, where a team led by Samanta has developed a fluorescent probe capable of detecting inflammation in brain cells that can arise due to Covid infection. The probe measures nitric oxide levels in brain cells, especially in human microglia cells, where increased NO levels are linked to the SARS-CoV-2 infection. Microglia are immune cells in the brain that fight disease and help maintain brain health. Lysosomes within microglia, which help clear foreign disease-causing agents like the SARS-CoV-2 virus, produce nitric oxide as part of an immune response to infection. The probe detects nitric oxide produced in lysosomes in response to infection and thereby allows for a measurement of inflammation levels. This examination method can provide "qualitative information on infection status", said Samanta, corresponding author on the study published in the journal Analytical Chemistry in American Chemical Society. He explained that patients with pre-existing conditions such as Alzheimer's disease, Parkinson's disease or multiple sclerosis (an autoimmune disorder) could exhibit prolonged neuroinflammation and loss of brain cells following Covid infection. While the probe has shown efficacy in cell cultures, animal studies would need to be done, before testing it in humans, Samanta said. Looking at the World Health Organization International Clinical Trials Registry Platform, the study by Harvard Medical School had found that 587 clinical studies were conducted on long Covid, of which about 53% (312) were testing potential treatments. Most of these were found to be conducted in the US (58), followed by India (55) and Spain (20). The trials looked at interventions including physical exercise, psychotherapy, and pharmacological ones such as paxlovid and fluvoxamine. However, "to date, only 11 of these 312 studies have published their results that were not confirmative," the researchers wrote. The team called for studies to look into sleep disorders which were rarely included in the registered clinical studies. Further, interventions targeting the biological processes responsible for long Covid are needed but currently lacking, they said.

Doctors struggle to treat long Covid patients in India; researchers point to inadequate studies

Everything is connected. Nature itself thrives on an intricate web of interdependence, with every element—including human beings—complexly intertwined. Now, this fundamental fact is being further reinforced by new findings on COVID-19. The <keyword id="8858345" type="General" weightage="20" keywordseo="SARS-CoV-2" source="Orion">SARS-CoV-2</keyword> virus initially jumped from animals to humans, triggering a pandemic on the global stage. As cases multiplied across populations worldwide, humans have ended up spilling the virus back into the wildlife, leading to new outbreaks among various animal species. Genetic analysis of <keyword id="6383885" type="General" weightage="20" keywordseo="wild-animals" source="Orion">wild animals</keyword> has revealed not only the presence of SARS-CoV-2, but also the emergence of unique <keyword id="22599311" type="General" weightage="20" keywordseo="viral-mutations" source="keywords">viral mutations</keyword>. These mutations show a close relationship to the variants circulating among humans, illustrating the ongoing exchange between our species and wildlife. <cmsannotation type="cmsannotation" annotationid="Nature’s COVID-19 cycle: From wildlife to humans and back again" comment="subhead" text="Nature’s COVID-19 cycle: From wildlife to humans and back again">Nature’s COVID-19 cycle: From wildlife to humans and back again</cmsannotation> The study by Virginia Tech involved analysing 798 nasal and oral swabs from animals trapped in the field or treated at wildlife rehabilitation centres across Virginia, US, along with 126 blood samples from six species. This research, recently published in Nature Communications, aimed to track the virus’s presence in animals from both urban and remote areas. The findings are revealing: the virus was detected in deer mice, Virginia opossums, raccoons, groundhogs, Eastern cottontail rabbits and Eastern red bats. Notably, one opossum exhibited viral mutations not previously reported, which could influence human health and immune responses. Exposure rates varied by species, ranging from 40% to 60%. The study also noted a peculiar finding: two mice at the same site on the same day carried identical viral variants, suggesting possible direct transmission between them, or from a common human source! The highest rates of virus exposure were observed in animals near hiking trails and high-traffic areas, indicating that human activity is a significant factor in the spread to wildlife. The exact transmission pathways remain unclear, with possibilities including wastewater or discarded food. However, researchers emphasise that while the virus is spreading to wildlife, there is no evidence of reverse transmission from animals to humans. <div type="Article" hostid="261" msid="112014490" title="Cows are now spreading bird flu to each other — here&amp;#39;s why that&amp;#39;s problematic for humans" mstype="2" mssubtype="0"></div>Carla Finkielstein, a professor of biological sciences, describes the virus' behaviour as akin to “a hitchhiker switching rides to a new, more suitable host”. With humans largely protected by vaccines, the virus—with the sole goal of spreading and surviving—is adapting and mutating to thrive in animal hosts. Although this study is limited to Virginia, the species affected are found throughout North America. This means the findings may also be applicable to other countries and continents to a certain extent. Moreover, this research doesn’t just highlight the novel mutations in SARS-CoV-2, but also underscores the broad host range of the virus. Therefore, researchers stress the urgent need for extensive surveillance to monitor the virus' impact on wildlife and its potential implications for vaccine development.

Humans are spilling the COVID-19 virus back into wildlife! Study finds widespread infection in backyard animals

<keyword id="19897423" type="General" weightage="20" keywordseo="COVID-19" source="keywords">COVID-19</keyword>, the unwelcome guest that never quite leaves, may well be in the process of ushering in a fresh global wave, with <keyword id="6356662" type="General" weightage="20" keywordseo="singapore" source="Orion">Singapore</keyword> potentially on the front lines. The Singapore government is on alert, with its Ministry of Health reporting a significant rise in COVID-19 cases. There was a doubling of infections in the first half of May, with the numbers increasing from 13,700 in the first week of this month to 25,900 in the second (May 5 to 11). Hospitalisations have also spiked, with average daily admissions rising from 181 to around 250 in the same period. To manage hospital bed capacity, public hospitals have been directed to reduce non-urgent elective surgeries and transfer suitable patients to care facilities. Health Minister <keyword id="19895083" type="General" weightage="20" keywordseo="Ong-Ye-Kung" source="keywords">Ong Ye Kung</keyword> has indicated that Singapore is in the early stages of this wave, which is expected to peak between mid- and end-June. Recognising Singapore's role as a major transport and communications hub, Ong has acknowledged that the city-state is likely to experience COVID-19 waves earlier than other regions. An uptick in infection numbers has also been observed in the neighbouring countries as well, including Philippines. However, no alarming rise in hospitalisation has been reported yet. Regional reports are attributing this surge to new COVID-19 variants, collectively termed FLiRT. This name is based on the technical names for their mutations, one of which includes the letters "F" and "L", and another, the letters "R" and "T". The FLiRT group comprises of variants KP.1, KP.2, KP.3, JN.1.1 and JN.1.7. At present, KP.1 and KP.2 make up over two-thirds of cases in Singapore. While the WHO has classified KP.2 as a variant under monitoring, there is no evidence suggesting these variants are more transmissible or cause more severe illness than existing strains. Nevertheless, Ong has urged high-risk groups, including those aged 60 and above, medically vulnerable individuals, and residents of aged care facilities, to receive an additional COVID-19 vaccine dose if they haven't been vaccinated in the past year. The public has also been advised to consider wearing masks again. Ong emphasised that there are no current plans for social restrictions, as Singapore treats COVID-19 as an <keyword id="21743830" type="General" weightage="20" keywordseo="endemic-disease" source="keywords">endemic disease</keyword>. He noted that additional measures would only be considered as a last resort. “COVID-19 is just something that we have to live with. Every year, we should expect one or two waves,” he said. Meanwhile, 91 cases of the <keyword id="21640619" type="General" weightage="20" keywordseo="FLiRT-variants" source="keywords">FLiRT variants</keyword> have been detected in India. However, there have been no reports of severe cases or unique symptoms associated with these variants so far. (With inputs from TOI)

FLiRT-ing with pandemic! With a sharp rise in COVID cases, could Singapore be witnessing the start of a global wave?

New York [US], April 5 (ANI): The <keyword id="10561122" type="General" weightage="20" keywordseo="bird-flu-pandemic" source="Orion">bird flu pandemic</keyword> with the potential to be "<keyword id="21202249" type="General" weightage="20" keywordseo="100-times-worse" source="Orion">100 times worse</keyword> than COVID" may be on the horizon after a rare human case was discovered in Texas, experts have warned, the New York Post reported on Thursday. The <keyword id="21202246" type="General" weightage="20" keywordseo="H5N1-avian-flu" source="keywords">H5N1 avian flu</keyword> has spread rapidly since a new strain was detected in 2020 affecting wild birds in every state, as well as in commercial poultry and backyard flocks. But the recent cases detected in mammals, with cattle herds across four states becoming infected and on Monday, federal health officials announced that a dairy worker in Texas caught the virus. "This virus [has been] on the top of the pandemic list for many, many years and probably decades," Suresh Kuchipudi, a <keyword id="95867" type="General" weightage="100" keywordseo="bird-flu" source="Orion">bird flu</keyword> researcher from Pittsburgh, said at a recent panel discussing the issue, the New York Post reported citing the Daily Mail. "And now we're getting dangerously close to this virus potentially causing a pandemic." He noted that the <keyword id="565908" type="General" weightage="20" keywordseo="H5N1-virus" source="Orion">H5N1 virus</keyword> has already been detected in species throughout the world and "has shown the ability to infect a range of mammalian hosts, including humans." "So therefore, in my view, I think this is a virus that has the greatest pandemic threat [that is] playing out in plain sight and globally present," Kuchipudi said. John Fulton, a pharmaceutical industry consultant for vaccines and the founder of Canada-based BioNiagara who organized the meeting, also expressed his concerns, the Mail reports, the New York Post reported. "This appears to be 100 times worse than COVID -- or it could be if it mutates and maintains its high case fatality rate," he said. "Once it's mutated to infect humans, we can only hope that the [fatality rate] drops." Around 52 per cent of humans who have contracted H5N1 since 2003 have died, according to the World Health Organization. For comparison, COVID currently kills less than 0.1% of those it infects -- though at the start of the pandemic, the fatality rate was around 20 per cent. Symptoms of the bird flu are similar to those of other flus, including cough, body aches and fever, the New York Post reported. Some people may not develop noticeable symptoms, but others can develop severe, life-threatening pneumonia. The dairy worker in Texas who was infected has reported "eye redness (consistent with conjunctivitis)" as their only symptom, the Centers for Disease Control and Prevention noted. "The patient was told to isolate and is being treated with an antiviral drug for [the] flu," the CDC said. The agency and "the whole US government is taking this situation very seriously," CDC Director Mandy Cohen told the Washington Post. She maintained that the virus does not pose much of a risk to the general public, noting that the dairy worker was in direct contact with infected cattle, and the US Department of Agriculture has said there are currently no changes that would make it more transmissible to humans. "While cases among humans in direct contact with infected animals are possible, this indicates that the current risk to the public remains low," the department said in a statement over the weekend. But the fact that the virus has been found in cattle could mean it is starting to mutate, Cohen told the Washington Post. "We had not seen avian flu in cattle prior to last week. That is new," she said. "It is a reservoir for [the] virus to circulate and potentially change." If the virus does mutate enough to infect humans, it could spread rapidly, the European Food Safety Authority warned on Wednesday, according to Fox News. "If avian A [H5N1] influenza viruses acquire the ability to spread efficiently among humans, large-scale transmission could occur due to the lack of immune defences against H5 viruses in humans," the Food Safety Authority said. To prevent any potential spread, the US is already testing components used to create a vaccine for the virus, and two candidate vaccine viruses appear to be well-matched to protect against H5N1, the Washington Post reports. White House press secretary Karine Jean-Pierre also said the Biden administration is monitoring the threat. "We take the health and safety of the American people seriously," she said at her briefing on Wednesday. "It is very important to this president. Our top priority is to keep communities healthy, safe and informed."

Scientists warn of bird flu pandemic that could be '100 times worse' than COVID after rare human case found in US

<ul><li><keyword id="2467342" type="General" weightage="80" keywordseo="vistara" source="Orion">Vistara</keyword> is the only carrier currently that offers direct flights to <keyword id="19988" type="General" weightage="70" keywordseo="bali" source="Orion">Bali</keyword>.</li><li>After Air Asia, direct flights to Bali were discontinued and this will only further increase travel from India to the island.</li><li>More Indians are travelling abroad for leisure after the pandemic. In 2022, 1.8 crore Indians went abroad. </li></ul> If you have Bali on your bucket list but the long layovers have been a dampner? Worry not, Vistara has announced a direct flight to Bali. Vistara, a full-service carrier and a joint venture of Tata group and Singapore Airlines, has announced daily non-stop flights between Delhi and Bali, starting December 1, 2023. This makes Vistara the only airline offering direct connectivity between the two cities currently. Vistara will be deploying its A321LR aircraft, with a three-class configuration, giving its customers the option to fly in Business, Premium Economy, or Economy cabins when travelling on the route. Bookings for the flights are being progressively opened on all channels, including the airline’s own website, mobile app. Economy round trip fares to Bali from Delhi start at Rs 39,999 per passenger. The airline will also offer premium economy and business class seats on this route. While a business class ticket will set you back by Rs 129,999, a premium economy ticket will cost you Rs 55,000. Bali has become an increasingly sought-after holiday destination for Indians due to its accessibility, proximity, and hassle-free visa on arrival facility. Commenting on the introduction of the new destination, <keyword id="7656482" type="General" weightage="20" keywordseo="vinod-kannan" source="Orion">Vinod Kannan</keyword>, Chief Executive Officer, Vistara said, "India is the second-largest source of foreign tourists to Bali, and with hassle-free visa-on-arrival , Bali remains one of the preferred holiday destinations for Indians, besides being popular for MICE traffic. Additionally, as the second largest trading destination for India in the ASEAN region, Indonesia exhibits great potential for business travel as well. We are delighted to be the only airline offering direct connectivity between Delhi and Bali. We are confident that customers will appreciate having the option to travel on India’s finest full service airline on the route.” Vistara already has direct flights to some other Asian countries like Bangkok and Singapore at very attractive fares. The island’s scenic beauty and cultural heritage is a big draw for not just Indians but people from all over the world. Indians have been travelling abroad for holidays in large numbers. According to data from MHA's Bureau of Immigration (BoI) , 1.8 crore Indians went abroad for leisure between January 2022 and November 2022, compared to 77.2 lakh in the whole of 2021. The number went up by more than 137% compared to last year (2021) and with 2023 being a completely Covid free year, the numbers will be even higher.

Vistara launches direct flights to Bali from Delhi at Rs 39,999

London, Headaches, memory problems, and fatigue -- commonly known to continue post a Covid-19 infection -- may be a result of inflammation in the rest of the body and not because SARS-CoV-2 infects the brain, claims a new research. Early on in the pandemic, researchers surmised that direct infection of the brain could be the cause behind these neurological symptoms. Many studies have also proposed the effect of <keyword id="19896627" type="General" weightage="20" keywordseo="covid" source="keywords">Covid</keyword> virus on the brain symptoms. But a study by researchers at the Charite- Universitatsmedizin Berlin in Germany has now produced evidence to support the new theory. "We took that as our hypothesis at the start, too. But so far, there has been no clear evidence that the coronavirus can persist in the brain, let alone proliferate," said <keyword id="20621224" type="General" weightage="20" keywordseo="dr-helena-radbruch" source="keywords">Dr Helena Radbruch</keyword>, head of the Chronic Neuroinflammation working group at the Department of Neuropathology at Charite. "For that, we would have needed to find evidence of intact virus particles in the brain, for example. Instead, the indications that the coronavirus could infect the brain come from indirect testing methods, so they aren't entirely conclusive," <keyword id="20621226" type="General" weightage="20" keywordseo="radbruch" source="keywords">Radbruch</keyword> added. According to a second hypothesis, the neurological symptoms would instead be a kind of side effect of the strong immune response the body deploys to defend against the virus. For the study, the team of researchers analysed various areas of the brain in 21 people who died in hospital settings, typically in an ICU, due to severe coronavirus infection. For comparison, the researchers studied nine patients who died of other causes after treatment in intensive care. First, they looked to see whether the tissue showed any visible changes and hunted for any indication of coronavirus. Then they conducted a detailed analysis of genes and proteins to identify the specific processes that had taken place inside individual cells. Like other teams of researchers before them, the Charite scientists found coronavirus genetic material in the brain in some cases. "But we didn't find neurons infected with SARS-CoV-2," Radbruch noted. "We assume that immune cells absorbed the virus in the body and then travelled to the brain. They're still carrying the virus, but it doesn't infect cells of the brain. So coronavirus has invaded other cells in the body, but not the brain itself." Still, the researchers did note striking changes in molecular processes in some cells of the brain in those infected with Covid-19: For example, the cells ramped up the interferon signalling pathway, which is typically activated in the course of a viral infection. "Some neurons evidently react to the inflammation in the rest of the body," said Prof. <keyword id="20621225" type="General" weightage="20" keywordseo="christian-conrad" source="keywords">Christian Conrad</keyword>, head of the <keyword id="20621227" type="General" weightage="20" keywordseo="intelligent-imaging" source="keywords">Intelligent Imaging</keyword> working group at the Berlin Institute of Health at Charite (BIH) and one of the principal investigators in the study. "This molecular reaction could be a good explanation for the neurological symptoms we see in Covid-19 patients. For example, neurotransmitters emitted by these cells in the brainstem could cause fatigue. That's because the brainstem is home to groups of cells that control drive, motivation, and mood." Further, the team found that the neurons' reaction to the inflammation is temporary, as shown by a comparison of people who died during an acute coronavirus infection with those who died at least two weeks afterward. The molecular changes are most evident during the acute infection phase, but they do normalise again afterward -- at least in the vast majority of cases.

Covid infection may not be responsible for memory problems & fatigue says new study

New York, Scientists have found that SARS-CoV-2, the virus behind Covid-19, triggers a dangerous immune response in hardened fatty deposits (plaques) lining the heart's largest blood vessels, leading to the risk of heart attack, stroke. Experts have long observed that the <keyword id="8868539" type="General" weightage="20" keywordseo="covid-19-coronavirus" source="Orion">Covid-19 coronavirus</keyword> increases the likelihood of having a heart attack or stroke for up to a year after infection, particularly for those who already have underlying heart conditions. However, the specific mechanisms that account for these risks had until now remained unclear. Researchers at New York University's (NYU) Grossman School of Medicine in the US explored how the coronavirus behaves in those with atherosclerosis -- a disease in which plaque collects in major arteries and prompts chronic inflammation. For the study, published online in the journal <keyword id="17676926" type="General" weightage="50" keywordseo="nature-cardiovascular-research" source="Orion">Nature Cardiovascular Research</keyword>, the team detected the virus within the arteries of eight men and women with a history of atherosclerosis who had died of Covid-19. Besides colonising arterial heart tissue itself, the coronavirus was also spotted inside local immune cells called macrophages, which normally protect the heart by "swallowing" and disposing of excess fat molecules in arteries. The experiments further showed that in response to the infection, the macrophages release inflammatory signalling proteins called cytokines that promote a chronic immune response. Notably, the researchers said, two of the identified cytokines, interleukin-1 beta and interleukin-6, have already been linked to heart attacks. "Our findings provide for the first time a direct mechanistic link between Covid-19 infection and the heart complications it provokes," said lead author Natalia Eberhardt, Postdoctoral fellow in the Department of Medicine at <keyword id="7092848" type="General" weightage="50" keywordseo="nyu-langone-health" source="Orion">NYU Langone Health</keyword>. "The virus creates a highly inflammatory environment that could make it easier for plaque to grow, rupture, and block blood flow to the heart, brain, and other key organs." For the analysis, the research team collected 27 artery tissue samples from autopsies of patients who had died of severe Covid-19 between May 2020 and May 2021. All had been previously diagnosed with heart disease. They team trained an artificial intelligence (AI) computer programme to measure coronavirus levels in plaque cells. It was able to count thousands of viral features on a cell-by-cell basis. The team also examined samples of plaque-covered tissue collected from patients who had received surgery to remove the fatty buildup from their arteries. Using a new technique that allowed them to study coronavirus infection of live tissue in the lab, the researchers showed that exposing plaque to the virus boosts inflammation levels in blood vessels. Together the experimental findings revealed that macrophages rich in engulfed fat were invaded more frequently and for longer periods than those containing less fat. According to the researchers, this suggests that the coronavirus flourishes more easily in people who already have large amounts of plaque buildup in their arteries, explaining in part why those with atherosclerosis are more vulnerable to Covid-19. The research team next plans to more closely explore this potential link between the coronavirus's behaviour during atherosclerosis and long Covid, which includes heart palpitations, chest pain, and fatigue, among other issues.

Explained: How Covid-19 heightens risk of heart attack, stroke

<ul class="summary-list"><li>China's economy is moving in the opposite direction of the US, Goldman Sachs' John Waldron said.</li><li>He said "negative animal spirits" in China point to slow growth as it battles economic malaise.</li></ul>China's economy is battling a host of problems that will weigh on growth for a while, and the country is moving in the opposite direction as the US, according to Goldman Sachs president John Waldron. Waldron said <a href="https://www.youtube.com/watch?v=OinbipEb6GA&amp;ab_channel=CNBCTelevision" target="_blank" rel="noopener">in an interview with CNBC this week</a> that a recent visit to China highlighted the nation's ongoing economic struggle. The situation in the world's second-largest economy is a stark contrast from the US, which has seen steady growth and robust consumer demand, as well as a <a href="https://markets.businessinsider.com/news/stocks/stock-market-news-today-dow-sp500-notch-new-year-highs-2023-12">stock market rally</a> and <a href="https://markets.businessinsider.com/news/stocks/rate-cuts-2024-recession-inflation-stock-market-outlook-federal-reserve-2023-11">predictions of a soft landing in 2024</a>. "My experience when I was there is that it almost felt like there were negative animal spirits. It didn't feel like the US, when we had positive animal spirits when the economy was coming back from COVID. I feel like it's the opposite in China," Waldron said. Waldron notes that China hasn't seen the same level of recovery as other big economies since the pandemic. That's partly because, unlike in the US and Europe, China didn't inject any significant fiscal or monetary stimulus into its economy. Weak consumer demand has caused prices to recently <a href="https://markets.businessinsider.com/news/commodities/china-economy-outlook-crashing-pork-prices-deflation-consumer-beijing-commodities-2023-12">slip into deflation territory</a>, and soured debts from major property developers have <a href="https://markets.businessinsider.com/news/bonds/china-property-crisis-deepens-market-value-wipeout-developers-usd-bonds-2023-8">rocked China's real estate sector</a>. That's dimmed the attractiveness of China's markets to foreign investors. <a href="https://www.businessinsider.com/china-economy-foreign-investment-deficit-beijing-xi-jinping-zero-covid-2023-11">Foreign investment in the nation went negative for the first time</a> ever last quarter, according to State Administration of Foreign Exchange data. "I think they're going to have a tough time. I think they're going to have to tackle some real structural challenges," Waldron said of China's economy. "I think they're focused on that and they're going to get after it, but it's going to take a while, and I feel like they're going to grow below-trend for a fair period of time."Other experts have warned of a grim future ahead for China if it doesn't <a href="https://www.businessinsider.com/china-economy-growth-outlook-hard-landing-deflation-debt-demand-savings-2023-8">adequately loosen policy</a> and stimulate its economy. The nation is at risk of slipping into a "<a href="https://markets.businessinsider.com/news/stocks/china-economy-lost-decade-global-growth-driver-xi-jinping-gdp-2023-6?_gl=1*ayg52k*_ga*MjMxMzA1Mzg2LjE2NTY0NDQxNTU.*_ga_E21CV80ZCZ*MTcwMjQ5MDY3Ny42NTIuMS4xNzAyNDkxNzkwLjQ4LjAuMA..">lost decade</a>," a period of stagnation similar to what Japan experienced in the early 90s, experts say, while others have made far more bleak predictions of a <a href="https://markets.businessinsider.com/news/bonds/china-economy-banking-system-property-crisis-real-estate-debt-losses-2023-12">collapse of the banking system</a> and trillions of dollars in losses stemming from the burst in the country's real estate bubble.

China's structural problems mean growth will continue to sag as 'negative animal spirits' move it in the opposite direction as the US, Goldman Sachs president says

<ul class="summary-list"><li>Demand for a fourth <keyword id="11896136" type="UNKNOWN" weightage="60" keywordseo="pandemic" source="Orion">pandemic</keyword> <keyword id="11922603" type="UNKNOWN" weightage="60" keywordseo="stimulus" source="Orion">stimulus</keyword> check is high, but it's unlikely the federal government will release more support.</li><li>Four states are trying to respond to that demand.</li><li>California, Florida, New Mexico, and Tennessee have set aside funds to provide direct payments to residents.</li></ul>Americans are increasingly calling for more stimulus money as the <keyword id="11893194" type="UNKNOWN" weightage="60" keywordseo="coronavirus" source="Orion">coronavirus</keyword> pandemic drags on. Some states are responding on their own as the prospect of Washington approving a fourth-round of checks seems more and more unlikely. So far, there have been three rounds of stimulus checks. Eligible Americans received <a href="https://www.businessinsider.com/1400-stimulus-checks-already-landing-in-peoples-bank-accounts-2021-3">$1,400 stimulus checks</a> in March. The Trump administration issued two stimulus checks nine months apart: The checks in the first round were <a href="https://www.businessinsider.com/personal-finance/coronavirus-stimulus-check-questions-answers-2020-4">$1,200</a>, the second were <a href="https://www.businessinsider.com/personal-finance/second-stimulus-check">$600</a>.As Insider's Joseph Zeballos-Roig points out, a <a href="https://www.businessinsider.com/fourth-stimulus-check-not-likely-soon-biden-stimulus-direct-payment-2021-7">fourth stimulus check is unlikely</a>. That's because the <keyword id="11893570" type="UNKNOWN" weightage="100" keywordseo="economy" source="Orion">economy</keyword> is regaining jobs, he reported in an analysis published in early July. The White House in May threw the ball in Congress' court, saying <a href="https://www.businessinsider.com/stimulus-checks-biden-white-house-congress-fourth-direct-payment-2021-5">it's up to lawmakers</a> to determine whether a fourth stimulus would be issued. "We'll see what members of Congress propose," said Jen Psaki, the White House press secretary. She added that the stimulus package is generally costly to the federal government.A petition with <a href="https://www.businessinsider.com/nearly-3-million-signed-petition-for-2000-monthly-stimulus-checks-2021-8">almost 3 million signatures</a> illustrates there is wide support for not only a single round but also recurring stimulus checks. Here are the four states that are offering direct payments to residents in an attempt to meet demand for extra support: CaliforniaLast month, California Gov. Gavin Newsom signed a <a href="https://www.gov.ca.gov/2021/07/12/california-roars-back-governor-newsom-signs-100-billion-california-comeback-plan-to-accelerate-states-recovery-and-tackle-persistent-challenges/#:~:text=This%20transformative%20budget%20includes%20the,%24100%20billion%20California%20Comeback%20Plan.&amp;text=The%20budget%20is%20built%20on,down%20long%2Dterm%20retirement%20debts.bts.">$100 billion recovery package</a> that will enable direct payments to go out to millions of residents. The package allocates $12 billion toward stimulus relief, with individuals receiving a $600 check starting in September. Some families with kids will receive an additional $500. Newsom's office says the stimulus checks will reach "nearly two thirds of Californians."FloridaFor first responders, one-time, $1,000 stimulus checks are expected to hit bank accounts shortly, Florida Gov. Ron DeSantis said earlier this week. Nearly 200,000 first responders are qualified to receive the payment, DeSantis' office said.Teachers and educators can also expect to receive stimulus checks in the amount of $1,000."Those should be arriving this week and into next week," DeSantis said on Tuesday. New MexicoThousands of low-income individuals should expect to receive a one-time check of up to $750, according to the <a href="https://www.hsd.state.nm.us/2021/08/02/30045/">New Mexico Human Services Department</a>. The initiative is part of a $5 million state program that provides financial assistance to low-income households in New Mexico. Individuals with the lowest income will receive the checks first, the department said."These support payments are critical to many New Mexico families," said Human Services Secretary David Scrase. "We are proud of this effort and will continue providing support to New Mexicans in need."Tennessee Full-time teachers are eligible for a 1,000 check after the Tennessee legislature <a href="https://www.tennessean.com/story/news/politics/2020/06/17/tennessee-house-passes-budget-arguments-over-racism-teacher-pay-raise-sales-tax-holiday-senate/3206503001/">passed a bill in June</a>. Part-time teachers are eligible to receive a $500 check. The direct payments are expected to roll in <a href="https://www.newsweek.com/fourth-federal-stimulus-check-unlikely-these-8-states-are-sending-more-payments-1621780">over the course of 2021</a>.

Four states dole out direct payments to residents as fourth stimulus check remains unlikely

<ul class="summary-list"><li><keyword id="11920875" type="UNKNOWN" weightage="60" keywordseo="utah" source="Orion">Utah</keyword> Gov. <keyword id="12197506" type="UNKNOWN" weightage="60" keywordseo="spencer-cox" source="Orion">Spencer Cox</keyword> expressed gratitude to <keyword id="12197509" type="UNKNOWN" weightage="60" keywordseo="multi-level-marketing" source="Orion">multi-level marketing</keyword> company <keyword id="12197504" type="UNKNOWN" weightage="60" keywordseo="doterra" source="Orion">doTerra</keyword> on Twitter. </li><li>doTerra has offered to give 1 million wipes to Utah schools to prevent COVID-19 transmission.</li><li>The company received a reprimand from the FTC over promoting its products as COVID-19 cures.</li></ul>Utah Gov. Spencer Cox took to Twitter to thank doTerra, a controversial direct-sales company, for donating its products to prevent COVID-19 transmission in schools. doTerra is a multi-level marketing company that sells essential oil-based products.In the 2020 election cycle, doTerra International donated $10,200 to Cox, according to non-partisan research firm <a href="https://justfacts.votesmart.org/candidate/campaign-finance/114270/spencer-cox">Vote Smart</a>.doTerra has described its On Guard wipes as containing ingredients like "Eucalyptus, Wild Orange, Clove, Cinnamon, and Rosemary essential oils," along with 70% ethyl alcohol. In 2020, Federal Trade Commission <a href="https://www.ftc.gov/system/files/warning-letters/covid-19-letter_to_doterra_international_llc.pdf">ordered doTerra</a> to stop promoting its oils as COVID-19 cures. The Centers for Disease Control and Prevention generally recommend frequent <a href="https://www.cdc.gov/handwashing/show-me-the-science-hand-sanitizer.html">handwashing</a>, and listed "touching mucous membranes with hands soiled by exhaled respiratory fluids containing virus or from touching inanimate surfaces contaminated with virus" as <a href="https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/sars-cov-2-transmission.html">causing infectious exposure</a> to COVID-19."As Gov. Cox mentioned yesterday, we appreciate the willingness of private sector businesses like doTERRA to support our schools," senior advisor of communications Jennifer Napier-Pearce said in a statement sent to Insider.doTerra did not immediately respond to Insider's request for comment.Before he became governor in 2021, Cox served as the state's lieutenant governor for Gary Herbert starting in 2013. In 2016, Herbert presented at the <a href="https://www2.directsellingnews.com/doterra-named-international-company-of-the-year-at-utah-global-forum/">World Trade Association of Utah</a>, where doTerra was recognized as the International Company of the Year.Cox's tweet underscores Utah's strong connection to <keyword id="12197508" type="UNKNOWN" weightage="60" keywordseo="mlms" source="Orion">MLMs</keyword>. In 2016, local station KUTV reported that the state had <a href="https://kutv.com/news/local/follow-the-profit-how-mormon-culture-made-utah-a-hotbed-for-multi-level-marketers#:~:text=Per%20capita%2C%20Utah%20has%20more%20MLMs%20than%20any%20other%20state.&amp;text=%E2%80%9CWe%20are%20able%20to%20run,%2C%20more%20than%20100%20languages.%E2%80%9D0%9D">the most MLMs per capita</a>. MLMs based in Utah include Nu Skin Enterprises, <keyword id="12197505" type="UNKNOWN" weightage="60" keywordseo="young-living" source="Orion">Young Living</keyword>, USANA Health Sciences, Morinda, Inc., and Younique.In the world of MLMs, doTerra has attracted controversy since its founding. The direct-sales company first launched in 2008. Founders David Stirling, David Hill, and Emily Wright previously worked as executives at essential oil giant <a href="https://www.businessinsider.com/young-living-essential-oils-medical-claims-2020-7">Young Living</a>. Young Living sued doTerra over allegations of corporate espionage. In 2018, a judge ruled that Young Living acted in "bad faith" and ordered it to pay attorney fees amounting to $1.8 million to its competitor, according to the <a href="https://www.sltrib.com/news/business/2018/07/12/judge-finds-young-living/">Salt Lake Tribune</a>.But the battle against Young Living doesn't capture the entirety of doTerra's legal history. Insider identified 27 bankruptcy cases naming doTerra as a party. These cases took place between 2008 and 2020, and involved individual doTerra sellers declaring bankruptcy. Financial difficulties or outright ruin are common outcomes for <keyword id="12197507" type="UNKNOWN" weightage="60" keywordseo="mlm" source="Orion">MLM</keyword> sellers: A 2018 survey from the AARP Foundation finding that <a href="https://www.ftc.gov/sites/default/files/documents/public_comments/trade-regulation-rule-disclosure-requirements-and-prohibitions-concerning-business-opportunities-ftc.r511993-00017%C2%A0/00017-57317.pdf">73% of respondents who participated in MLM schemes either lost money or made no money</a>. Of the quarter of respondents who did earn money, 53% made less than $5,000.doTerra is also an defendant in an ongoing civil case from a Minnesota seller named Ruth Van Horn, who alleged that the company's green tea extracts caused her liver to fail. The company's philanthropic efforts have also attracted scrutiny. In 2018, the Pacific Standard <a href="https://psmag.com/social-justice/after-a-natural-disaster-some-multi-level-marketers-profit-handsomely-off-relief-efforts">reported</a> that the company's foundation was accused of pocketing donations intended for the victims of Hurricane Harvey. If you have a MLM story to share, email acain@insider.com.

Utah's governor highlighted a controversial essential-oil MLM as a way to protect school kids from a COVID-19

<ul><li>India may receive the first batch of Russia’s <keyword id="9739267" type="UNKNOWN" weightage="20" keywordseo="Sputnik-V">Sputnik V</keyword> COVID-19 vaccine is time for it to open up vaccinations for everyone above the age of 18 years.</li><li>The head of the <keyword id="1397612" type="COMPANY" weightage="20" keywordseo="Russian-Direct-Investment-Fund">Russian Direct Investment Fund</keyword> (RDIF) told Reuters that the vaccine will reach India by May 1.</li><li>The company plans to manufacture 850 million doses of Sputnik V annually in India, but a lot of that will depend on the momentum of technology transfer.</li></ul>India will receive the first batch of Russia’s Sputnik V COVID-19 vaccine by May 1. This is just in time for the country to open up vaccinations for everyone above the age of 18 years. “The first doses will be delivered on May 1,” the head of the Russian Direct Investment Fund (RDIF), Kirill Dmitriev, told <a href="https://www.reuters.com/business/healthcare-pharmaceuticals/india-receive-first-batch-russias-covid-19-vaccine-may-1-interfax-2021-04-26/">Reuters</a>. However, he did not disclose the number of doses that will be a part of the first batch or where they will be manufactured. Sputnik V, developed by Moscow’s Gamaleya National Research Institute of Epidemiology and Microbiology, is the third vaccine after the Serum Institute of India’s (SII) Covishield and Bharat Biotech’s Covaxin to get approval from the Drug Controller General of India (DCGI). <div type="ExtQuote" text="“Following approval in India, it [Sputnik V] will be approved for use in 60 countries with a total population of over 3 billion people.”" auname="Kirill Dmitriev, head of the Russian Direct Investment Fund (RDIF) told reporters on April 14 after Sputnik V got the Drug Controller General of India’s (DCGI) approval"></div> RDIF is in charge of marketing the Sputnik V vaccine globally and has already signed agreements with six leading Indian manufacturers — Hetero Biopharma, Gland Pharma, Stelis Biopharma, Panacea Biotech, Virchow Biotech, and Shilpa Medicare. In this collaboration, RDIF hopes to manufacture over 850 million doses of the vaccine annually. By summer, it plans to hit 50 million doses a month and continue increasing output from there. A lot of this will depend on the momentum of technology transfer to allow Indian manufacturers to produce the vaccine. Virchow Biotech, for instance, is expected to complete its technology transfer between April to June, according to RDIF. Only then will it be able to commence full-scale commercial production of Sputnik V. The vaccine has also been approved by many of India’s neighbours including Sri Lanka, Myanmar and Pakistan. Russia is also lending a helping hand when it comes to Remdesivir. Pharmasyntez, a Russian company, announced that it is ready to ship up to 1 million packs of Remdesivir by the end of May, once it receives the prerequisite approval from the Russian government. <div type="Article" hostid="261" msid="82210121" title="Inside the treacherous black market for Remdesivir in India— from private hospitals to distributors" mstype="2" mssubtype="0"></div> In India, the stocks of Remdesivir have been in short supply as demand for the anti-viral drug increased alongside the surge in cases. This is despite the fact that the <keyword id="6356311" type="COMPANY" weightage="20" keywordseo="World-Health-Organisation">World Health Organisation</keyword> (WHO) has reiterated that there is no conclusive evidence to support the fact that Remdesivir is effective in the treatment of COVID-19. SEE ALSO: <a href="https://www.businessinsider.in/science/health/news/the-pace-of-infections-and-test-positivity-in-maharashtra-is-slowing-down-but-it-is-too-soon-to-celebrate/articleshow/82256149.cms">The pace of infections and test positivity in Maharashtra is slowing down — but it is too soon to celebrate</a> <a href="https://www.businessinsider.in/india/news/india-covid-19-first-wave-versus-second-wave/articleshow/82216963.cms">'We're in a much better situation' claims India's Principal Scientific Advisor as COVID-19 claims more lives than ever before</a>

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