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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

Delhi continued to battle with air pollution for the 10th consecutive day post-Diwali as a dense layer of smog blanketed parts of the national capital on Sunday. Several parts of the national capital recorded very poor air quality levels on Sunday morning as per the data issued by the System of Air Quality and Weather Forecasting And Research (SAFAR-India). Today morning, Anand Vihar recorded an AQI of 351, Bawana 383, CRRI Mathura Road 323, Dwarka Sector 8 at 341, IGI Airport at 326, ITO 328, Lodhi Road 319, Mundka at 358, Najafgarh at 341, New Moti Bagh at 394, Okhla phase-2 at 339, RK Puram at 368, and Wazirpur at 366, as per SAFAR-India data. As of 5 pm on November 10, Delhi's AQI stood at 334, with Anand Vihar at 353, Dilshad Garden at 262, and Jahangirpuri at 377. For tomorrow, AQI in adjoining cities of Noida and Gurugram is forecasted to be at 208.92 and 77.51, respectively. Multiple visuals from Delhi's Kartavya Path showed the area surrounding India Gate engulfed by a layer of smog. The AQI in the area was recorded at 357 as of 7 am. High-rise buildings were also covered in smog in the Kalindi Kunj and surrounding locality, as the AQI was recorded as 323 in the area. An AQI is considered "poor" between '200 and 300', "very poor" at '301 and 400', "severe" at '401-450," and 450 and above is "severe plus." As the air pollution levels in the national capital reach "very poor," doctors say that even people with no history of respiratory diseases are suffering from breathing issues. Dr. Nikhil Modi, Senior Consultant for Respiratory Critical Care at Apollo Hospital, told ANI that apart from the regular patients, those who haven't had any respiratory issues in the past are showing up with symptoms such as runny noses, sneezing, coughing, and having increasing difficulties breathing. As it is, respiratory illnesses in the national capital are estimated to have shot up by around 15-20%. The Apollo doctor further suggested that the government close the schools for children as they remain vulnerable. Whenever the pollution levels have gone beyond a certain limit, the government has opted to close the schools, Dr. Modi said. "For the last few years, we have been seeing that the government has taken action. Whenever this pollution level has gone beyond a certain limit, they have opted to close the schools. This is important because children are from a vulnerable group. As adults, we are masked and can protect ourselves better, but children usually are not that effectively taking these measures. Secondly, their lungs are still in developing stages, so they are bound to have more harm due to this pollution," the doctor told ANI. Siddharth Singhal, Head of Health Insurance, Policybazaar.com, notes that while most standard health plans in India cover pollution-related ailments, it is always advised to also go for an OPD plan along with a health insurance plan to cover consultations, medications, and diagnostic tests that may be required frequently due to pollution. "Pollution levels in Delhi-NCR and some other parts of India have shot up post Diwali. Effects of this are very evident in the form of sore throats and breathing problems, among others. This can also result in respiratory ailments and chronic conditions like asthma, bronchitis, Chronic Obstructive Pulmonary Disease (COPD), pneumonia, and severe cases of respiratory or bronchial obstruction. Health insurance becomes critical to cover such expenses. Most policies typically cover emergency hospitalization for respiratory issues like asthma or COPD exacerbations requiring ICU or critical care," he adds.

Layer of smog covers Delhi as air quality remains 'very poor'. Here's why you need an insurance cover for this

A week or two of cold and cough can make you conjure up some pretty odd conspiracy theories. The freshest one that I cooked up this week is that 'Big Tissue' wishes to keep everyone sick, and therefore they collaborate with 'The Scientists' to keep them from making a cure. After all, the world witnessed researchers demonstrate incredible and hasty success in combating <keyword id="19897423" type="General" weightage="20" keywordseo="COVID-19" source="keywords">COVID-19</keyword>, and yet, the <keyword id="20237676" type="General" weightage="100" keywordseo="common-cold" source="keywords">common cold</keyword> remains an seemingly elusive target. But far from being an actual conspiracy, there are several real reasons why we haven’t yet cracked the code to curing the cold, despite decades of research. So grab your tissues, folks, and let's get into them. <h2><keyword id="23387393" type="General" weightage="20" keywordseo="viral-diversity" source="keywords">Viral diversity</keyword></h2>One major hurdle in curing the common cold is the sheer diversity of viruses involved. Over 200 viruses can cause cold symptoms, with <keyword id="23387392" type="General" weightage="20" keywordseo="rhinoviruses" source="keywords">rhinoviruses</keyword> responsible for up to 75% of cases. Rhinoviruses alone consist of more than 160 known strains. This viral diversity makes it extremely difficult to develop a universal vaccine or treatment. Unlike SARS-CoV-2, which has one main spike protein target, cold viruses come in a dizzying array of structures and behaviours, requiring a vast array of medical solutions. In contrast, when COVID-19 emerged, researchers focused primarily on one virus and one major target — its spike protein. That focus allowed for the rapid development of <keyword id="19953288" type="General" weightage="20" keywordseo="vaccines" source="keywords">vaccines</keyword> using mRNA technology, like those from Pfizer and Moderna. For the common cold, a similar solution isn’t feasible due to the multiple viral families involved. <h2><keyword id="20862236" type="General" weightage="20" keywordseo="mutations" source="keywords">Mutations</keyword> and adaptations</h2>Another issue is how quickly cold viruses mutate. Rhinoviruses, for example, are known for their high mutation rates. This rapid evolution allows them to evade the immune system, which is why even if you’ve had a cold before, you're not immune to future infections from different strains. <div type="Article" hostid="261" msid="113757960" title="Healthcare in India faces massive strain as costs rise by 14% annually; most expenses paid out-of-pocket" mstype="2" mssubtype="0"></div>This rapid mutation is akin to how COVID-19 has evolved into variants, but with cold viruses, it happens on an even greater scale. Scientists fear that if they developed a vaccine, new strains would quickly render it ineffective, much like how seasonal flu vaccines must be reformulated annually. <h2>Mildness of the illness</h2>Ironically, one reason the common cold hasn’t been cured is because it’s too mild to warrant massive investment. Most people recover from a cold without medical intervention. While cold symptoms are annoying — runny nose, sore throat, cough — they rarely escalate into serious illness. As a result, pharmaceutical companies and governments have little financial incentive to pour billions into research for a disease that poses no significant threat to public health. COVID-19, on the other hand, caused severe illness and death on a global scale, spurring massive investment from both the public and private sectors. Governments and companies alike invested heavily in research and fast-tracked vaccines, which led to solutions much quicker than we’ve seen for colds. <h2>Complex, complex immune system</h2>The immune system’s response to cold viruses is also a significant factor. Studies have shown that repeated exposure to cold viruses over a lifetime results in limited immunity. For instance, research from Harvard points out that even though the body produces antibodies after a cold, the <keyword id="20082133" type="General" weightage="20" keywordseo="immune-response" source="keywords">immune response</keyword> isn't strong enough to prevent future infections from slightly different strains. This is in stark contrast to diseases like measles, where one infection can result in lifelong immunity. COVID-19 benefitted from its novelty. The immune system had never encountered SARS-CoV-2 before, making it easier to target with vaccines that produce a strong and specific immune response. Here’s an additional fun fact: because there are SO many different strains of common cold-causing viruses, research says that it is unlikely that you will be infected with the same strain of common cold twice throughout your life! <h2>Attempts to develop treatments</h2>There have been attempts to develop treatments for the common cold. Some researchers have targeted the way viruses enter and replicate in human cells. For example, a 2018 study explored inhibiting the protein that cold viruses use to replicate, showing some promise in early trials. However, most of these treatments are in the experimental phase, and none have been widely successful yet. <div type="Article" hostid="261" msid="113284254" title="Gastro problems could heighten Parkinson&amp;#39;s disease risk by 76%, study finds" mstype="2" mssubtype="0"></div>In recent years, attention has shifted towards using broad-spectrum antiviral drugs that can target multiple viruses at once, similar to how some antibiotics work against a range of bacteria. However, this approach has yet to yield a major breakthrough. The idea of a universal cure for the common cold remains distant, but advances in genetic research and vaccine technology offer some hope. For example, CRISPR technology may allow scientists to edit out the genetic components that cold viruses rely on to replicate. Additionally, the mRNA technology used for COVID-19 vaccines has opened new possibilities for antiviral treatments, although these applications are still in early stages. Research continues, but for now, humanity may have to continue battling sniffles and coughs the old-fashioned way: with rest, fluids, and time.

How did we manage to deal with COVID-19 so quickly, but the common cold still remains a persisting problem?

A recent study suggests that lingering <keyword id="23667455" type="General" weightage="20" keywordseo="SARS-CoV-2-proteins" source="keywords">SARS-CoV-2 proteins</keyword> in the blood of <keyword id="20537242" type="General" weightage="100" keywordseo="long-COVID" source="keywords">long COVID</keyword> sufferers could be a key factor in their ongoing symptoms. This discovery offers new insights into the complex nature of long COVID and potentially points towards new treatment strategies. Researchers at Harvard-affiliated <keyword id="23667458" type="General" weightage="20" keywordseo="Brigham-and-Womens-Hospital" source="keywords" meta.keywordsubtype="org" meta.entityname="Brigham and Women’s Hospital" meta.hostid="261" meta.entityid="Brigham and Women’s Hospital">Brigham and Women’s Hospital</keyword> analysed blood samples from 706 individuals who had previously tested positive for COVID-19. They found that those experiencing a wide range of long COVID symptoms were twice as likely to have traces of SARS-CoV-2 proteins in their blood compared to those without symptoms. The study, published in the journal <keyword id="23667460" type="General" weightage="20" keywordseo="clinical-microbiology" source="keywords">Clinical Microbiology</keyword> and Infection, focused on individuals with long COVID symptoms affecting three major body systems: cardiopulmonary, musculoskeletal, and neurologic. A staggering 43% of these patients tested positive for viral proteins within 1 to 14 months of their initial COVID infection. These findings suggest that a persistent viral infection may be contributing to long COVID symptoms in some patients. If this is the case, <keyword id="23667457" type="General" weightage="20" keywordseo="antiviral-treatments" source="keywords">antiviral treatments</keyword> could potentially alleviate their suffering. The study’s lead author, Zoe Swank, emphasised the importance of identifying patients who may benefit from such interventions. However, the researchers also noted that persistent viral proteins were not detected in all long COVID patients. This suggests that other factors, such as <keyword id="21736950" type="General" weightage="20" keywordseo="immune-system-dysfunction" source="keywords">immune system dysfunction</keyword>, may also play a role in the development of long COVID symptoms. To better understand the mechanisms underlying long COVID, researchers are conducting further studies to analyse blood samples and symptom data from larger groups of patients. These efforts aim to identify specific factors that may predispose individuals to persistent viral infections and long COVID symptoms. The discovery of a potential <keyword id="23667459" type="General" weightage="20" keywordseo="viral-reservoir" source="keywords">viral reservoir</keyword> in long COVID patients offers hope for the development of targeted treatments. By addressing the underlying cause of symptoms, antiviral medications could provide relief for many individuals suffering from this debilitating condition. As research continues, a clearer picture of long COVID and its potential treatments is emerging, offering hope for a future where this persistent illness can be effectively managed. <div type="Article" hostid="261" msid="105896840" title="Covid virus can persist in lungs for up to two years: Study" mstype="2" mssubtype="0"></div>

SARS-CoV-2 proteins have been found hiding in blood of long COVID patients. Can this explain the persistent infection?

Sydney, Aug 15 (The Conversation): The <keyword id="19896311" type="General" weightage="20" keywordseo="World-Health-Organization" source="keywords" meta.keywordsubtype="org" meta.entityname="World Health Organization" meta.hostid="261" meta.entityid="World Health Organization">World Health Organization</keyword> (<keyword id="19895006" type="General" weightage="20" keywordseo="WHO" source="keywords">WHO</keyword>) has declared <keyword id="20965747" type="General" weightage="100" keywordseo="mpox" source="keywords">mpox</keyword> a public health emergency of international concern, after rising cases in the <keyword id="22796094" type="General" weightage="20" keywordseo="Democratic-Republic-of-the-Congo" source="keywords">Democratic Republic of the Congo</keyword> and the potential for further spread. This now triggers a coordinated international response to an extraordinary event and the mobilisation of resources, such as vaccines and diagnostic testing, to curb the spread of this infectious disease. But WHO has not declared mpox a <keyword id="19913581" type="General" weightage="20" keywordseo="pandemic" source="keywords">pandemic</keyword>. Rather, the measures it has triggered are designed to prevent it from becoming one. <h2>What triggered this latest alert?</h2> Mpox, once known as monkeypox, is a viral infection closely related to <keyword id="22362924" type="General" weightage="20" keywordseo="smallpox" source="keywords">smallpox</keyword>. Initial symptoms include a fever, headache, swelling of the lymph nodes and muscle ache. A typical rash follows, mainly on the face, hands and feet. The spread of mpox through certain African countries led the Africa Centres for Disease Control and Prevention to declare earlier this week mpox a public health emergency of continental security. This is the first time the organisation has issued such an alert since it was established in 2017. The situation in the Democratic Republic of the Congo in central Africa has been particularly worrying for more than a year. There are two types or clades of mpox. Clade II, which originates in west Africa, is less severe. It has a fatality rate of up to 1 per cent (in other words, roughly one in 100 are expected to die from it). But clade I, from central Africa, has a fatality rate of up to 10 per cent (up to one in ten die). This compares to a 0.7 per cent fatality rate for the Omicron variant of SARS-CoV-2, the virus that causes COVID. The Democratic Republic of the Congo is seeing large epidemics of the more deadly clade I mpox. Mpox is endemic in some parts of central and west Africa, where the virus exists in animals and can spread to humans. Outbreaks have been increasing, with more human-to-human spread, since 2017. This is partly due to very low levels of immunity to the mpox virus, which is related to the virus that causes smallpox. Mass vaccination against smallpox ceased more than 40 years ago globally, resulting in minimal immunity in populations today against mpox. The WHO designation announced this week relates to the clade I. Not only does this have a higher fatality rate, it has new mutations that enhance spread between people. These changes, and the global lack of immunity to mpox, makes the world's population vulnerable to the virus. <h2>There are two different epidemics</h2> In 2022, an epidemic of mpox swept through non-endemic countries, including beyond Africa. This was a variant of clade II originating from Nigeria, called clade IIb. This was sexually transmitted, predominantly affecting men who have sex with men, and had a low fatality rate. That epidemic peaked in 2022, with vaccines made available to people at risk in high-income countries, but there has been an uptick in 2024. At the same time, large clade I epidemics were occurring in the Democratic Republic of the Congo, but with far less attention. Vaccines were not available there, even in 2023, when there were 14,626 cases and 654 deaths. Mortality was 4.5 per cent, and higher in children. In fact, most cases and deaths in the Democratic Republic of the Congo have been children. This means most transmission there is non-sexual and is likely to have occurred through close contact or respiratory aerosols. However, in 2023 an <keyword id="20877025" type="General" weightage="20" keywordseo="outbreak" source="keywords">outbreak</keyword> in a non-endemic part of the country, South Kivu in the east, appeared to be by sexual transmission, indicating more than one epidemic and different transmission modes in the Democratic Republic of the Congo. By mid-2024, there were already more cases in the country than all of 2023 - more than 15,600 cases and 537 deaths. Testing capacity is low in the Democratic Republic of the Congo, most cases are not confirmed by lab testing, and the data we have are from a small sample of genomic sequences from the Kamituga region of South Kivu. This show mutations to the clade I virus around September 2023, to a variant termed clade Ib, which is more readily transmissible between people. We do not have much data to compare these viruses with the viruses causing cases in the rest of the country. <h2>Mpox is spreading internationally</h2> In the past month, the virus has spread to countries that share a border with the Democratic Republic of the Congo - Rwanda and Burundi. It has also spread to other east African countries, such as Kenya and Uganda. None of these countries have had mpox cases previously. In an interconnected, mobile world, cases may spread to other continents, as mpox did in 2018 from Nigeria to the United Kingdom and other countries. A few travel-related cases between 2018 and 2019 may have led to the large multi-country 2022 clade IIb epidemic. <h2>We have vaccines, but not where they are needed</h2> As the mpox virus and smallpox viruses are related (they are both orthopoxviruses), smallpox vaccines offer protection against mpox. These vaccines were used to control the 2022 clade IIb epidemic. However, most of the world has never been vaccinated, and has no immunity to mpox. The newer <keyword id="19959412" type="General" weightage="20" keywordseo="vaccine" source="keywords">vaccine</keyword> (called Jynneos in some countries and Imvamune or Imvanex in others) is effective. However, supplies are limited, and vaccine is scarce in the Democratic Republic of the Congo. WHO's declaration of mpox as a public health emergency of international concern will help mobilise vaccines to where they are needed. The Africa Centres for Disease Control had already begun negotiations to secure 2,00,000 doses of vaccine, which is a fraction of what is required to control the epidemic in the Democratic Republic of the Congo. <h2>What happens now?</h2> Ultimately, a serious epidemic anywhere in the world is a concern for all of us, as it can spread globally through travel, as we saw with the COVID pandemic. Controlling it at the source is the best measure, and WHO's latest declaration will help mobilise the required resources. Surveillance for spread of this more serious version of mpox is also essential, bearing in mind that many countries do not have the capacity for widespread testing. So we'll have to rely on "suspected cases", based on a clinical definition, to keep track of the epidemic. Open-source epidemic intelligence - such as using AI to monitor trends in rash and fever illness - can also be used as an early warning system in countries with weak health systems or delayed reporting of cases. A further complication is that 20-30 per cent of people with mpox may simultaneously have chickenpox, an unrelated infection that also causes a rash. So an initial diagnosis of chickenpox (which is easier to test for) does not rule out mpox. Effective communication and tackling push-back against public health measures and disinformation is also key. We saw how important this was during the COVID pandemic. Now, WHO will coordinate the global mpox response, focusing on equity in disease prevention and access to diagnostics and vaccines. It is up to individual countries to do their best to comply with the International Health Regulations, and the protocols for how such a global emergency are managed.

WHO has declared mpox a global health emergency. What happens next?

<ul class="summary-list"><li>The US deployed its <keyword id="23312251" type="General" weightage="20" keywordseo="Mid-Range-Capability" source="keywords">Mid-Range Capability</keyword>, or <keyword id="23312252" type="General" weightage="20" keywordseo="Typhon" source="keywords">Typhon</keyword>, system to the Pacific earlier this year.</li><li><keyword id="19894886" type="General" weightage="20" keywordseo="China" source="keywords">China</keyword> has expressed frustration with its deployment in the <keyword id="19941735" type="General" weightage="20" keywordseo="Philippines" source="keywords">Philippines</keyword> and possible plans for Japan.</li></ul>China has been up in arms over a new <keyword id="23311373" type="General" weightage="100" keywordseo="US-missile-system" source="keywords">US missile system</keyword> that showed up in the <keyword id="19909557" type="General" weightage="20" keywordseo="Indo-Pacific" source="keywords">Indo-Pacific</keyword> earlier this year, with government officials in Beijing complaining about the weapon repeatedly, including twice in the past week alone. The US military deployed its Mid-Range Capability, or Typhon, missile system to the Philippines in April, and US military officials have expressed interest in deploying it in Japan. The MRC is a versatile new ground-based missile system that is capable of firing the<a target="_blank" href="https://www.businessinsider.com/us-navy-aircraft-spotted-sm6-missile-newly-tested-in-combat-2024-7"> Standard Missile 6 (SM-6)</a> and<a target="_blank" href="https://www.businessinsider.com/us-submarines-getting-ship-killer-missile-able-to-counter-china-2023-12"> Tomahawk Land Attack Missile System</a>. Developed for the US Army, the system is intended to fill a key gap in the US arsenal, but it's raising concerns as the US military begins deploying land-based intermediate-range missiles once barred by a now-defunct arms-control treaty. The US military deployed the missile system overseas for the first time in April, putting it in the Philippines amid a joint exercise between the two militaries. It was characterized as a "landmark deployment" marking "a significant milestone for the new capability while enhancing interoperability, readiness, and defense capabilities in coordination" with the Philippines, US Army Pacific<a target="_blank" href="https://www.usarpac.army.mil/Our-Story/Our-News/Article-Display/Article/3740807/"> said</a> at the time. While the new weapon wasn't fired during the exercise, its presence in the region irked China, which demanded the system be removed. <div type="image" title="Navy USS Savannah SM-6 containerized missile" height="1080" width="1920" msid="113644413" hostid="261"></div>Philippine Foreign Secretary Enrique Manalo said in August that his Chinese counterpart Wang Yi had<a target="_blank" href="https://www.businessinsider.com/china-got-dramatic-over-us-missile-system-in-pacific-ally-2024-8"> expressed concern over Typhon</a> while the two talked at the Association of Southeast Asian Nations meeting in Laos a month earlier. Manalo said China made the situation "very dramatic" despite reassurances. Earlier this month, the US said it had no plans to remove MRC from the Philippines, which also isn't in a rush to see it go. The move angered Beijing further. "China has made clear our opposition more than once," Chinese foreign ministry spokesperson Lin Jian<a target="_blank" href="https://www.fmprc.gov.cn/eng/xw/fyrbt/lxjzh/202409/t20240919_11493204.html"> said</a> last Thursday during a regular press conference. He added that "the deployment is a move to turn back the wheel of history. It gravely threatens regional countries' security, incites geopolitical confrontation, and has aroused high vigilance and concerns of countries in the region." The <a target="_blank" class="" href="https://www.businessinsider.com/us-military-china-missile-problem-getting-worse-2024-5">Chinese military's Rocket Force</a> notably maintains a substantial missile arsenal that includes medium- and intermediate-range systems that put US assets and bases in the region at risk, leading the US to rethink its assets and capabilities in the Indo-Pacific. China's MRC woes may not be limited to the Philippines, which has expressed interest in acquiring its own mid-range weapons and training on the American weapon. Deploying the MRC in Japan is apparently on the table, too. At a Defense News conference on September 4, the secretary of the US Army, Christine Wormuth, said the US and Japan had discussed placing a Typhon there. Lin<a target="_blank" href="https://www.fmprc.gov.cn/eng/xw/fyrbt/lxjzh/202409/t20240918_11492497.html"> said</a> during a press briefing last Wednesday that the US was "hellbent" on its military investment in the Pacific region, noting that putting Typhon in Japan "will heighten arms race, exacerbate regional tensions, threaten peace and security in this region, and disrupt global strategic balance and stability." Lin said that China has urged the US to abandon its plans. <div type="image" title="A Tomahawk land attack missile in flight" height="3571" width="2551" msid="113644415" hostid="261"></div>During the Trump administration, in response to serious allegations of Russian violations, the US officially withdrew from the 1987 Intermediate-Range Nuclear Forces Treaty — which banned nuclear and conventional ground-launched ballistic and cruise missiles with ranges between 500 and 5,500 kilometers. Since 2019, the door has been wide open for the development and deployment of these weapons. US allegations that Russia violated the treaty prompted Moscow to resign from the agreement. Russia is said to have violated the Cold War-era arms-control pact by developing and fielding the SSC-8/9M729 missile system. Arms-control experts have said that Russian President Vladimir Putin's violation of the INF Treaty and subsequent US developments would likely have a snowball effect. Not only are new missiles showing up in the Pacific, but there are plans for Europe as well. The US and some of its NATO allies formally announced in July they were pushing ahead with plans to<a target="_blank" href="https://www.businessinsider.com/us-europe-long-range-weapons-bring-back-cold-war-danger-2024-7"> develop and field new long-range strike options in Europe</a> after seeing the value of such weapons in the war in Ukraine. Some experts suggested that this emerging arms race<a target="_blank" href="https://www.businessinsider.com/nato-allies-to-develop-long-range-missiles-fill-critical-gap-2024-7"> reflects one of the most dangerous aspects of the Cold War</a>. Correction: September 25, 2024 — An earlier version of this story misspelled the surname of the secretary of the US Army. She's Christine Wormuth, not Christine Warmouth.

A new US missile system that showed up in the Pacific this year keeps making China more and more unhappy

The <keyword id="22667872" type="General" weightage="100" keywordseo="mpox-outbreak" source="keywords">mpox outbreak</keyword> in <keyword id="19924003" type="General" weightage="20" keywordseo="africa" source="keywords">Africa</keyword> is yet another example of how <keyword id="20040661" type="General" weightage="20" keywordseo="infectious-diseases" source="keywords">infectious diseases</keyword>, perceived to be "someone else's problem", and affecting mainly poor, developing countries, may suddenly pose unexpected global threats. Other examples of <keyword id="22817243" type="General" weightage="20" keywordseo="neglected-diseases" source="keywords">neglected diseases</keyword> include the West Nile, Zika and Chikungunya viruses. Mpox was discovered in 1958 (in captive monkeys, hence the original misnomer "monkeypox") and the first human case was identified in 1970. Then, for decades it was largely neglected by the scientific and public health communities, regarded as an uncommon infection in remote rural areas in tropical Africa, without relevance for the rest of the world. When a massive mpox outbreak hit developed countries in 2022, increased research funding led to a surge in scientific studies. On just one medical search engine, there's been more research produced since April 2022 than in the preceding 60 years. The 2022-23 global mpox outbreak happened despite repeated calls from African researchers for increased global investment in diagnostic, therapeutic and infection prevention tools for mpox. The WHO has now declared the current upsurge of mpox in central Africa a <keyword id="21952478" type="General" weightage="20" keywordseo="public-health-emergency" source="keywords">public health emergency</keyword> of international concern. This is the highest alert level for events that constitute a public health risk to other countries and requires a coordinated international response. Mpox's recent history is yet another reminder that an infectious disease in one corner of the world should not be regarded as someone else's problem, as it can suddenly start to spread fast and far. It also highlights global inequities in resource allocation and access to vaccines, diagnostics and treatments. These were made available in many industrialised countries and helped curb the global outbreak, but are still largely lacking in most of Africa. <h2>The 2022 outbreak: a total surprise</h2>The disease has been renamed "mpox" but the name of the virus, for now, remains "monkeypox" (MPXV). It is closely related to the smallpox virus. MPXV was considered a <keyword id="21311828" type="General" weightage="20" keywordseo="zoonotic-disease" source="keywords">zoonotic disease</keyword> endemic in parts of central and west Africa. It was acquired mainly through close contact with wild mammals, especially handling bush meat, but there was no sustained human-to-human transmission. Only very occasionally were cases seen outside the endemic areas, due to infected travellers or import of infected small mammals. This changed abruptly in 2022: a massive, rapidly evolving global outbreak caused over 99,000 laboratory-confirmed cases in 116 countries. At its peak in August 2022, over 6,000 cases were reported each week. This outbreak came as a total surprise: most cases were reported from non-endemic countries, mostly in men who have sex with men, who had become infected during recent sexual encounters. Even though most cases were clinically not particularly severe and the death toll stands at just over 200, the global outbreak was declared a public health emergency of international concern by the <keyword id="19896311" type="General" weightage="20" keywordseo="world-health-organization" source="keywords">World Health Organization</keyword> on 23 July, 2022. Fortunately, case numbers soon plummeted due to a combination of behavioural changes and vaccination in at-risk groups. Modern vaccines and antiviral drugs with activity against mpox were made available in many affected high-income countries. These had been developed and stockpiled in the US and Europe, mostly in preparation for a potential bioweapon attack using a poxvirus. The global outbreak in 2022 was caused by clade II of MPXV, which is endemic in west Africa and not as virulent as clade I MPXV, which so far has only been seen in the Congo Basin. That first mpox public health emergency of international concern was declared over in May 2023. Clade II MPXV infections are still occurring globally, but the worst seems over - for now. Complacency would be misguided, as illustrated by the current mpox outbreak that is gathering steam. <h2>Upsurge in Africa</h2>The African region is experiencing an upsurge in mpox cases, which started in 2023. As the continent which includes the areas where mpox has been endemic for a long time, Africa now presents a complex mosaic. The current clade I MPXV (formerly called Congo Basin strain) is more virulent than the clade II (west African) strain, resulting in a higher case fatality rate. The ongoing outbreak has its epicentre in South Kivu province, eastern DRC, and has the potential to fuel a large pandemic. It has a distinct epidemiological pattern with sustained chains of human-to-human transmission, often via the sexual route. It may have increased transmissibility (we don't know yet). The virus which causes it is the newly defined clade Ib lineage. It displays mutations that are the hallmark of human-to-human spread that is estimated to have been happening since September 2023. Case numbers are rising rapidly, even though many suspected cases are likely not tested and thus not counted as confirmed. Complicating matters, a commonly used test was found to miss infections with this lineage of the virus. It affects mostly adults. The case fatality rate is higher than it was in the 2022 global outbreak. Already, this outbreak has resulted in mpox cases occurring in several neighbouring countries, including some (like Kenya), with no previous record of mpox. The challenge is enormous. The eastern DRC is an area beset by multiple problems. This includes natural disasters, violence and infectious diseases including measles, cholera and poliomyelitis for the DRC. In recent years the second-largest Ebola outbreak ever took place in the wider area and, despite the availability of vaccines and treatments, posed considerable challenges. <h2>What needs to happen</h2>Equitable access to diagnostic tests, vaccines and antiviral treatments requires political commitment and financial investments. Scientific investigations are needed to learn more about exposure settings, transmission routes and clinical presentations. It's important to find the best ways to make these interventions. There is no doubt that a disease in one corner of the world can suddenly become a global heath threat. It's time the global health system woke up to this reality.

You Searched For "emergency medical response system" and got 7 results

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

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How did we manage to deal with COVID-19 so quickly, but the common cold still remains a persisting problem?

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SARS-CoV-2 proteins have been found hiding in blood of long COVID patients. Can this explain the persistent infection?

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WHO has declared mpox a global health emergency. What happens next?

PTI

A new US missile system that showed up in the Pacific this year keeps making China more and more unhappy

Chris Panella

Mpox outbreak in Africa was neglected - it could now turn into the next global pandemic

PTI

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