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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

India could see a shift in foreign direct investment (FDI) trends in the second term of Donald Trump (Trump 2.0) as President of the United States, says a research report by the State Bank of India. The report highlighted that under his first term, Trump 1.0, the Trump administration made sweeping regulatory changes aimed at attracting investments back to the U.S., which impacted FDI inflows globally, including India. It added that if similar policies are reintroduced in Trump 2.0 also, it could create challenges for emerging markets like India, which rely on FDI as a significant driver of economic growth. Notably, a recent Kotak report highlighted that a complete Republican control over all arms of the US government would mean increased US earnings via corporate tax cuts, higher tariffs on imports into the US and greater US fiscal deficits. The first two could spell doom for emerging markets like India and China, since foreign investors will make a beeline for investing more money in the US markets, which will come at the cost of intense selloff in emerging markets. However, higher fiscal deficits will eventually lead to the dollar weakening after the initial euphoria dies down. "India may see shifts in foreign direct investments (FDIs) during Trump 2.0. The Trump 1.0 administration saw significant regulatory changes aimed at attracting investments back to the US," the SBI report stated. However, given that India has been gradually diversifying its sources of FDI (foreign direct investments), this trend could serve as a buffer against any potential decline. Moreover, domestic institutional investors have been stepping up big time, maintaining some balance to the massive exodus of FIIs over the past month. So far in November 2024, FIIs have withdrawn Rs 19,849 crores from the cash segment in Indian markets, while DIIs have poured in Rs 14,014.18 crores as of November 10th, 2024. "India is no longer dependent on the traditional sources of FDI inflows... unlike the recent past, FDI is now coming in many new sectors," noted the SBI report. Unlike a decade ago, when most FDI inflows came from a limited number of traditional sectors, India is now attracting investment in a wide array of industries, including renewable energy, sea transport, medical devices, and surgical appliances. Data suggests over the last 24 years, i.e., between April 2000 and June 2024, FDIs have poured in $1,013.4 billion in the Indian economy. Out of this, 67%, i.e., $689.88 billion, has come in just the last 10 years. The report added there are up to 12 emerging sectors showing strong FDI interest, which could help offset any loss of inflows in conventional sectors if there is a shift in global investment patterns under another Trump administration. In the last financial year, the top 5 sectors that have received the highest quantum of FDI inflow include the services sector (finance, banking, insurance, and business) which makes up about 16% of the inflows. This is followed computer software &amp; hardware, which constitute around 15% of total FDI flows. Trading and telecommunications follows with a share of 6% each, and Automobile Industry comes next with a 5% share. In the short term, the potential for increased U.S. tariffs, more restrictive H-1B visa policies, and a stronger dollar could bring some volatility to India's trade and investment landscape. However, in the long term, these challenges might also encourage India to expand its manufacturing capabilities, diversify export markets, and focus on becoming economically more self-reliant. Notably, India has maintained a merchandise trade surplus with the U.S. despite tariffs imposed during Trump's first term. This indicates that Indian exports have remained resilient, and there is potential to strengthen this trade relationship further by capitalizing on emerging sectors and reducing dependency on traditional industries. Suman Chowdhury, Executive Director &amp; Chief Economist, Acuité Ratings &amp; Research Limited cautions that in the medium to long term, the trade relationship with the US may see a structural improvement. "Higher tariff and trade restrictions in the US with China should translate into better opportunities for exports of manufactured goods from India", he adds.

FDIs may shift to US under Trump 2.0 but it is unlikely to severely impact FDIs inflow to India, says SBI Report

<ul class="summary-list"><li>An easyJet copilot fainted mid-flight from London to Lisbon; paramedics met the plane on landing.</li><li>Former pilots from the US told BI that medical emergencies are routine and procedures are in place.</li></ul>The last thing airline passengers want or expect is for a pilot to have a <a target="_blank" class="" href="https://www.businessinsider.com/passengers-forced-to-stay-on-plane-six-hours-medical-diversion-2023-2">medical emergency</a> during a flight.But that's exactly what happened on Saturday when the copilot of an easyJet flight from London to Lisbon <a target="_blank" class="" href="https://www.businessinsider.com/copilot-fainted-during-easyjet-flight-from-london-to-portugal-2024-7">fainted while in the air</a>.The plane landed at its intended destination. An airline spokesperson told Business Insider that it was "met by the paramedics upon landing due to a pilot feeling unwell.""The captain landed the flight routinely in line with procedures and passengers disembarked normally," they added. "At no point was the safety of the flight compromised."But the incident raises an important question: What happens if a pilot becomes unwell and can no longer fly?Retired US pilots Kent Davis and Mark Stephens said it's not something they ever stressed over.<h2 id="38d7f4d6-6a5e-4013-905b-f72d92347143">Medical emergencies are planned for</h2><a target="_blank" class="" href="https://www.businessinsider.com/southwest-flight-tampa-diverted-fort-lauderdale-flew-dangerously-low-faa-2024-7">Kent Davis</a> spent over 30 years as a pilot for commercial airlines and private clients.He now operates his own aviation consulting company in the US, Trans Global Aviation Solutions.Speaking to BI via email, Davis said it is "not a big deal" when pilots become unwell as they are trained to prepare for this. <div type="image" title="aircraft interior" height="683" width="1024" msid="112170936" hostid="261" sizebytes="70636"></div>"It really is something that is made more of by the press than it really is. I had this happen years ago and I landed quickly as the first officer was very ill," he said.Davis said he was flying from Montreal to Toronto when the first officer began passing a <a target="_blank" class="" href="https://www.businessinsider.com/guides/health/conditions-symptoms/what-causes-kidney-stones">kidney stone</a>. He said he made an emergency landing in Ottawa, while the flight attendants on board cared for the pilot."I declared an emergency primarily to get expedited arrival into Ottawa because my first officer was in so much pain, I thought he was dying," Davis said. "An ambulance met us on arrival."<a target="_blank" class="" href="https://www.businessinsider.com/delta-pilot-thirty-years-career-salary-pay-captain-airlines-2023-12">Retired Delta pilot Mark Stephens worked in the industry for 30 years</a> and was an Airbus A350 captain until 2021.Stephens told BI that domestic flights usually have at least two pilots, while international flights can have two pilots and two captains."Pilots know what they are doing, and they do it repeatedly," he said.The first thing the remaining pilot or pilots would do is find another crew member to handle the radio work while they focus on landing or diverting the plane.In the US, for example, pilots must sign a release confirming they are fit for duty before each flight. Stephens said pilots shouldn't sign this even if they have a non-life-threatening illness.He recalled one instance several years ago where he refrained from flying for around a month because he had the flu.<h2 id="16fe7333-3f76-49e2-ad78-2bdc52963f8f">Life-threatening illnesses</h2>However, Stephens said the situation would be handled slightly differently if a crew member encountered a life-threatening emergency in midair."It is a dire situation if the captain has a heart attack, or is not breathing. But there are procedures in place," he said.Flight attendants in the US are trained in CPR and have defibrillators, Stephens said. He added that Delta flights also have a direct line to a medical doctor.There have been several reported cases of pilots dying mid-flight or shortly after landing.In August, a LATAM Airlines pilot on a three-person crew had a <a target="_blank" class="" href="https://www.businessinsider.com/a-pilot-for-latam-airlines-died-medical-emergency-during-flight-2023-8">medical emergency</a> during a flight from Miami, Florida, to Santiago, Chile.He received medical attention after the plane made an emergency landing in Panama, but was later declared dead.In February, a flying instructor who accompanied a pilot in a Piper PA-2 because of windy conditions reportedly died from acute cardiac failure, per <a target="_blank" class="" href="https://www.nbcnews.com/news/world/pilot-thought-instructor-died-flight-was-just-joking-safety-report-say-rcna71729">NBC News</a>.

Fainting, heart attacks, and death. How pilots handle medical emergencies in midair.

<ul class="summary-list"><li>A Turkish Airlines captain died in midair during a flight from Seattle to Istanbul.</li><li>59-year-old İlçehin Pehlivan's death led to the flight being diverted to New York.</li></ul>An airline <a target="_blank" class="" href="https://www.businessinsider.com/pilot-medical-emergency-mid-flight-what-happens-next-2024-7">pilot died midflight</a> on Wednesday, as other crew members diverted the plane for an emergency landing.The <a target="_blank" class="" href="https://www.businessinsider.com/turkish-airlines-economy-review-worth-it-good-perks-2024-3">Turkish Airlines</a> Airbus A350 was flying from Seattle to Istanbul when the captain lost consciousness."After the initial medical intervention on board proved ineffective, the cockpit crew, consisting of one captain and one co-pilot, decided to make an emergency landing," an airline spokesperson, Yahya Üstün, said in a statement.Data from <a target="_blank" class="" href="https://www.flightradar24.com/data/flights/tk204#3775e0f6">Flightradar24</a> shows the A350 flying over Canada's far north when it changed course and eventually landed at New York's JFK Airport."Unfortunately, our captain passed away before they could land," Üstün said.He named the pilot as 59-year-old İlçehin Pehlivan, who had been employed with Turkish Airlines since 2007.The statement said that a routine health check in March detected "no health issues that would prevent him from performing his duties.""As Turkish Airlines, we deeply feel the loss of our captain and extend our sincerest condolences to his bereaved family, colleagues, and all his loved ones," it added.Turkish Airlines did not provide confirmation of the cause of Pehlivan's death.<h2 id="6114114b-e09c-43df-a5ce-2a453fa2d235">The incident highlights the reason behind having multiple pilots</h2>Wednesday's incident illustrates the continued importance of aircraft operating with more than one pilot.It comes as the prospect of <a target="_blank" class="" href="https://www.businessinsider.com/commercial-airlines-two-pilots-rule-medical-emergency-2024-8">single-pilot operations</a> — in which there is only one pilot on the flight deck at certain points during flights — continues to be debated in the industry. Back in 2021, Airbus CEO Guillaume Faury said that the A350 Freighter might be a "candidate" for <a target="_blank" class="" href="https://www.businessinsider.com/airbus-cargo-plane-may-be-candidate-for-single-pilot-operations-2021-11">single-pilot operations</a>, noting that the industry faced a labor shortage during COVID.Regulators and pilot unions have frequently criticized the idea. In July, the <a target="_blank" href="https://www.eurocockpit.eu/news/pilots-take-stand-against-single-pilot-flights-one-means-none">European Cockpit Union,</a> a pilots' union, launched a campaign against single-pilot operations using the tagline: "One means none.""One pilot in the cockpit during an extensive period of a flight is a gamble with the safety of our 200 to 400 passengers in the back of the plane and those on the ground," the ECU's president, Otjan de Bruijn, said in a statement at the time.The <a target="_blank" class="" href="https://www.easa.europa.eu/en/research-projects/emco-sipo-extended-minimum-crew-operations-single-pilot-operations-safety-risk">European Union Aviation Safety Agency</a> is currently undertaking a nearly three-year-long assessment of the potential viability of single-pilot operations in Europe.

A pilot on a Transatlantic flight died in midair, prompting an emergency landing in New York

<ul class="summary-list"><li>A doctor shortage is projected to hit 86,000 by 2036. Rural communities already feel the impact.</li><li>Educational initiatives and congressional bills aim to combat issues like limited appointment slots.</li></ul>Every three to four months, Mellisa Case drives three and a half hours from her small town of Prineville, Oregon, to Portland to see her orthopedist for help with arthritis, a condition she believes she could have avoided at this stage in her life.In 2021, Case had surgery for a meniscus tear at an orthopedic center in Bend, an hour away from her home. However, she couldn't schedule appointments for follow-up care, which doctors consider necessary for proper recovery. For several months after her meniscus surgery, Case kept calling the center for an appointment with no success while her knee deteriorated.Now Case takes time off from work and spends up to $125 round trip on gas while traveling to Portland for arthritis care. Case said that symptoms like stiffness, swelling, and discomfort — which resulted from a lack of postsurgical medical support — could interfere with her sleep, gait, and ability to enjoy her hobbies like hiking and gardening."Until you've experienced not being able to see a doctor, you don't really realize how frustrating it is," Case, who is 53, told Business Insider. Eventually, she will need surgery for a <a target="_blank" class="" href="https://www.businessinsider.com/nc-woman-plans-finally-getting-knee-surgery-after-winning-lottery-2023-1">full knee replacement</a>.Case said that she remains concerned that the overall lack of medical care in her community, as she's observed doctors retiring or leaving her area.Some of her family members and friends also struggle to find physicians close to home, Case said, so they have to drive long distances or wait for appointments.A March report from the Association of American Medical Colleges projected that the US would face a <a target="_blank" class="" href="https://www.businessinsider.com/why-hospital-wait-times-are-bad-physician-shortage-low-pay-2024-4">physician shortage</a> of up to 86,000 specialists and primary-care doctors by 2036.Michael Dill, the organization's director of workforce studies, said this estimate was conservative."The country needs hundreds of thousands of doctors to provide an equal amount of care to everyone, including minorities, those without medical insurance, and people living in rural areas," he told BI.An aging population, physician retirement, and the administrative challenges of running a practice contribute to the shortage and disproportionally affect vulnerable populations such as older people, those lacking transportation options, and people with disabilities, public-health advocates told BI.Two solutions could be increasing medical-training programs in rural communities and passing legislation to retain and <a target="_blank" class="" href="https://www.businessinsider.com/best-high-paying-jobs-hiring-doctors-construction-accounting-2024-4">bolster the physician workforce</a>.<h2 id="0a289233-786f-4ff1-969a-24da2c3ab5eb">An aging population and provider burnout are contributing to a worsening doctor shortage</h2>The effects of a doctor shortage are already here, Dr. Bruce Scott, the president of the American Medical Association, said.Scott practices in Louisville, Kentucky, and said that in addition to patients in rural areas driving hours to appointments, they're waiting months to see a doctor.Various factors, including an aging population, play a part in the situation, Dill said.In 2020, 55.8 million Americans, or 16.8% of the population, were 65 or older, and by 2030, all baby boomers will have reached age 65, according to a <a target="_blank" class="" href="https://www.census.gov/library/stories/2023/05/2020-census-united-states-older-population-grew.html ">US Census report.</a> As people age, they require more physician services, such as cardiologic or neurological care, and at the same time, doctors are aging and retiring, adding to the shortage, Dill said.<a target="_blank" class="" href="https://www.businessinsider.com/labor-shortage-hospital-beds-empty-nurses-doctors-staff-covid-vaccine-2021-10">Physician burnout</a> further exacerbates the problem, Scott said. In one survey that was part of AMA Organizational Biopsy report, of over 12,400 doctors, 48% of respondents said they were burned out. In another survey from the same report, one in three respondents said they planned to retire or reduce hours within two years.One AMA survey found some doctors were leaving their practices because they were being paid less to handle more <a target="_blank" class="" href="https://www.businessinsider.com/electric-health-records-causing-doctor-burnout-2018-12">administrative burdens</a>, such as spending 12 hours a week filling out prior-authorization requests. "Medicare is paying us nearly 30% less in 2024 than it did in 2001, when adjusted for inflation," Scott said, citing further data compiled by the AMA.<h2 id="1d068686-c4d6-4ee0-81d9-f17918ad516a">Strategies to alleviate the shortage</h2>To help alleviate the physician shortage in rural areas, medical students need to receive training there, said Molly Fox, the vice president of institutional advancement at Kansas Health Science University."We engage students with the rural community because we know that people tend to practice where they feel connected," Fox said.At KHSU's Kansas College of Osteopathic Medicine, for example, third- and fourth-year students can complete clinical rotations at St. Catherine Hospital in Garden City, four hours from Wichita, where the university is.Chase Hearn, a third-year student, said he'd seen doctors at the hospital who have worked 26-hour shifts to meet patient needs."I've also heard patients say they can't take a day off work to travel 200 miles to see their OB-GYN," Hearn said. He added that his training had strengthened his resolve to practice in a rural community but that he anticipated challenges, like burnout and working with patients who lack consistent access to care.<a target="_blank" class="" href="https://www.businessinsider.com/how-el-paso-trying-solve-us-physician-shortage-2023-7">Rural residency programs</a> are also needed to address the shortage, Dill said. Only 2% of residency training occurs in rural areas, the US Government Accountability Office says.A residency program through Oregon Health &amp; Sciences University aims to alleviate the doctor shortage in three central-Oregon counties, including Crook County, where Case lives. The program is training physicians in primary care, family birthing, emergency medicine, behavioral health, and hospital medicine.According to the Rural Medical Training Collaborative, 133 rural residencies in family medicine and 69 rural-track programs are recruiting for 2025 enrollment, along with 30 internal-medicine residencies and 16 psychiatry residencies.Several pieces of legislation have also been introduced to Congress to address the doctor shortage. Scott said bills to adjust Medicare payments for doctors — no matter where they practice — to the annual rate of inflation and rules to reduce the need for prior authorization could help ease administrative burdens.Some legislation, if passed, would specifically influence rural areas.For example, HR 7855, the Association of American Medical Colleges-endorsed Rural Residency Planning and Development Act of 2024, would codify the Rural Residency Planning and Development Program, which funds the startup costs of residency training in rural areas, Dill said. From 2019 to 2024, the program has enabled the launch of 46 accredited rural residency programs across 38 states and Puerto Rico.Hollie Davis Frick, an immigration lawyer for Wintersteen Patel Law Group, said congressional action could easily incentivize doctors born abroad and who receive advanced medical training in the US to remain here and practice in rural areas."Many doctors who come here for residencies and fellowships return abroad because of our ineffective immigration policies," Davis Frick said.If passed, S 665, the Conrad State 30 and Physician Access Reauthorization Act, would allow state health departments to sponsor additional visa waivers for foreign-born doctors who agree to practice in underserved areas within those states.While Case remains skeptical that doctor-training initiatives and legislation will directly affect her community anytime soon, she considers herself fortunate, she said."I have the ability to drive, afford travel expenses, and pay for out-of-network doctors," Case said. "Not everybody does."

Medical schools and legislation aim to address a worsening doctor shortage that's already hitting rural communities 

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.

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

<ul class="summary-list"><li>Most American voters are concerned about healthcare costs, which impacts their economic outlook.</li><li>Eighty percent of voters think it's important for presidential candidates to discuss medical prices.</li></ul>Most Americans worry they won't be able to pay expensive medical bills if they experience an emergency, and it's impacting their <a target="_blank" href="https://www.businessinsider.com/2024-economic-outlook-forecast-state-of-the-economy-recession-inflation-2023-12">economic outlook</a>.Ahead of the presidential election, 80% of voters — regardless of party affiliation — believe it's "very important" for candidates to discuss healthcare costs on the campaign trail, <a target="_blank" href="https://www.kff.org/affordable-care-act/poll-finding/kff-health-tracking-poll-february-2024-voters-on-two-key-health-care-issues-affordability-and-aca/?utm_campaign=KFF-Health-Costs&amp;utm_medium=email&amp;_hsmi=295044909&amp;_hsenc=p2ANqtz-9YLOFwxmJDu2FSq9a51XObKPML65p1r_Vs9lj2U4rDKgFXp6WQp3xgw1uueVFNks2eKg2Mp8H9paxMfHabwU7aOIPi3Q&amp;utm_content=295044909&amp;utm_source=hs_email">according to a survey of 1,309 adults by KFF</a> (formerly known as Kaiser Family Foundation) between January 30 and February 7.Three in four adults say that unexpected medical bills are one of their top financial worries. Voters also identified <a target="_blank" href="https://www.businessinsider.com/big-pharma-hiking-prices-on-500-drugs-in-2024-report-2024-1">prescription drug prices</a>, out-of-pocket medical costs, and <a target="_blank" href="https://www.businessinsider.com/supreme-court-upholds-affordable-care-act-california-v-texas-2021-6">The Affordable Care Act</a> as priorities for how they will vote in the 2024 election.So far, the survey showed that neither <a target="_blank" href="https://www.businessinsider.com/category/joe-biden">President Joe Biden</a> nor <a target="_blank" href="https://www.businessinsider.com/category/donald-trump">former President Donald Trump</a> —the GOP frontrunner — have a clear advantage with voters on healthcare issues.<h2>Voters across the aisle worry about healthcare costs</h2>An individual's assessment of the national economic landscape is largely shaped by their <a target="_blank" href="https://www.businessinsider.com/income-inequality-mental-health-crisis-money-life-expectancy-social-comparison-2024-2">own experience with money</a>, the survey found.Affordability concerns affect voters similarly across the aisle. Over 70% of Democrats, Republicans, and Independents answered that general healthcare costs are their main financial stressor.That may be because healthcare costs are rising. <a target="_blank" href="https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/projected">The Center for Medicare and Medicaid Services</a> expects American healthcare spending to increase an average of 5.5% annually through 2031. One in six insured adults skipped or postponed medical care because of cost last year, and over 20% of people delayed filling necessary prescriptions, <a target="_blank" href="https://www.kff.org/health-costs/issue-brief/americans-challenges-with-health-care-costs/">per KFF</a>.Additionally, about 40% of adults have some form of medical debt, <a target="_blank" href="https://www.healthsystemtracker.org/brief/the-burden-of-medical-debt-in-the-united-states/#Share%20of%20adults%20who%20have%20medical%20debt,%20by%20health%20status%20and%20disability%20status,%202021">according to KFF data</a>.However, voters differ in their approval of Biden and Trump's efforts to address high costs. Ninety percent of Democratic voters believe Biden has done more to address healthcare costs, while 91% of Republicans say Trump did more to address costs while he was in office.<h2>Presidential candidates disagree on ACA and national healthcare plans</h2>The President's reelection strategy has largely centered on <a target="_blank" href="https://www.cnn.com/2023/12/04/politics/biden-health-care-2024/index.html">medical access messaging</a>, with healthcare-based <a target="_blank" href="https://www.nbcnews.com/meet-the-press/meetthepressblog/biden-campaign-hits-trump-health-care-new-tv-ad-rcna127319">campaign ads airing in major swing states</a>. In recent campaign appearances, Biden has said he will <a target="_blank" href="https://19thnews.org/2024/02/trump-biden-rematch-abortion-reproductive-rights/">restore Roe v. Wade</a> abortion protections.During his presidency, Biden passed the <a target="_blank" href="https://www.businessinsider.com/house-passes-inflation-reduction-act-sending-it-to-biden-2022-8">2022 Inflation Reduction Act</a>, <a target="_blank" href="https://www.businessinsider.com/medicare-drug-price-negotiations-part-d-biden-pharmaceutical-companies-2023-10#:~:text=The%20Biden%20administration%20announced%20Tuesday,and%20people%20with%20disability%20status.">negotiated with pharmaceutical companies to lower drug costs</a>, <a target="_blank" href="https://www.businessinsider.com/insulin-price-cap-costs-diabetes-supplies-pump-monitor-tiktok-2024-2">placed a $35 cap on insulin</a>, and took steps to expand Medicare and <a target="_blank" href="https://www.businessinsider.com/boomers-medicare-part-d-prescription-drug-costs-biden-inflation-reduction-2024-2">Medicaid</a>. He also built on <a target="_blank" href="https://www.businessinsider.com/supreme-court-upholds-affordable-care-act-california-v-texas-2021-6">The Affordable Care Act </a>— a policy enacted under former President Barack Obama — that is favored by a majority of voters, according to KFF.As of 2023, The US Department of Health and Human Services reported that <a target="_blank" href="https://aspe.hhs.gov/reports/current-health-coverage-under-affordable-care-act#:~:text=As%20of%20early%202023%2C%20the,the%20highest%20total%20on%20record.">over 40 million Americans</a> get healthcare coverage through the ACA, the highest recorded number since the law was passed. It includes coverage of emergency medicine, prescription drugs, hospitalization, maternal and pediatric care, lab services, and more.Trump has been vocal about his <a target="_blank" href="https://www.businessinsider.com/what-is-trump-plan-healthcare-obamacare-aca-replacement-tweaks-2020-10">plans to repeal and replace the Affordable Care Act</a> should he win reelection. Although many Democrats want to expand the law, about two-thirds of Republicans <a target="_blank" href="https://www.kff.org/affordable-care-act/poll-finding/kff-health-tracking-poll-february-2024-voters-on-two-key-health-care-issues-affordability-and-aca/?utm_campaign=KFF-Health-Costs&amp;utm_medium=email&amp;_hsmi=295044909&amp;_hsenc=p2ANqtz-9YLOFwxmJDu2FSq9a51XObKPML65p1r_Vs9lj2U4rDKgFXp6WQp3xgw1uueVFNks2eKg2Mp8H9paxMfHabwU7aOIPi3Q&amp;utm_content=295044909&amp;utm_source=hs_email">want the law to be scaled back or repealed entirely</a>.Still, KFF found that seven in 10 Republican voters don't think Trump has an alternate affordable healthcare plan.Like Trump, <a target="_blank" href="https://www.businessinsider.com/haley-trump-new-york-house-special-election-suozzi-pilip-gop-2024-2">Republican presidential candidate Nikki Haley</a> has expressed support for bans on abortion and gender-affirming healthcare. In recent debates, <a target="_blank" href="https://kffhealthnews.org/news/article/nikki-haley-health-policy-governor-president-agenda/#:~:text=In%202013%2C%20Haley%20announced%20her,don't%20pay%20their%20bills.">Haley has criticized</a> the Biden Administration's spending on COVID-relief, Affordable Care Act, and Medicaid, suggesting that individual states should set their own health insurance plans.Have you struggled to afford emergency medical costs or pay off medical debt? Are healthcare costs impacting how you plan to vote this November? Reach out to <a target="_blank" href="mailto:allisonkelly@insider.com">allisonkelly@insider.com</a>.<h2></h2>

Emergency medical bills worry Americans — and it could affect the presidential election

“I started <keyword id="20024281" type="General" weightage="20" keywordseo="investing" source="keywords">investing</keyword> when I was 24, and had just taken up my first job. At first, it felt like a herculean task, setting aside Rs 15,000 every month for long-term investing. But now, at 29, I have a comfortable corpus with me, and I am able to even fund my sister’s education. I now realise how investing is the first step towards achieving some level of financial independence”. That was Yumna, a 29-year-old Delhi-based communication professional’s “tryst with her finances”. Tomorrow, India will celebrate its “tryst with destiny”, its 78th day of independence from Britishers. And so, it is certainly the right time to revisit our personal journeys towards independence, at least financially. If we heavily rely on our monthly salaries, being broke towards the end of the month, and desperately waiting for that end-of-the-month fund credit “ting”, then are we really independent? So, this Independence Day, consider gifting yourself (and your friends and loved ones) these five presents that promise you financial freedom. <h2>Start SIP-ing in Mutual Funds, stocks</h2>The British ruled India for almost 200 years, starting from the battle of Plassey in 1757, to when India finally ousted the British Raj in 1947. Nearly 200 years of tireless persistence, struggle and revolution was what it took to achieve freedom. Keep that in mind when you feel constantly investing for 10-15 years is “way too long!”. Consider this. Yumna started investing Rs 15,000 every month, five years ago. Assuming 12% p.a. in return, she has already amassed over Rs 12,00,000, out of which her investments are worth Rs 9,00,000, while her returns come to Rs 3,37,295. What if Yumna continues to invest at this pace for the next 20 years? If she invests Rs 15,000 (and assuming 12% p.a. return), she’d have invested Rs 36,00,000, while her returns would be a whopping Rs 1,13,87,219, making her total corpus worth Rs 1,49,87,219. The best time to start investing in the market was yesterday. So, if you’re yet to start investing, do so right away. But remember, it’s a marathon, and not a sprint, so remember to stay in and invested for the long run. <keyword id="20481917" type="General" weightage="20" keywordseo="index-funds" source="keywords">Index funds</keyword>, which basically mirror popular market indices like Nifty and Sensex are a good place to start. <h2>Insure yourself</h2>Getting a term and <keyword id="19894985" type="General" weightage="20" keywordseo="health-insurance" source="keywords">health insurance</keyword> should be at the top of your to-do list, immediately after you start earning. And no, don't rely just on your employer-provided <keyword id="19996817" type="General" weightage="20" keywordseo="insurance" source="keywords">insurance</keyword>. Plus, having term insurance can also help you save on taxes (an annual premium paid of up to Rs 25,000 for those aged less than 60 is tax-free under old tax regime), apart from saving you during medical emergencies. Says Sabyasachi Sarkar, Appointed Actuary, Go Digit Life Insurance, “a life insurance plan is a tool that provides a safety net for your family in case of unexpected events and for your need of savings or pension. Ideally one should take a term life cover that is at least 10-15 times your annual income. Moreover, adding riders like death benefits or disability coverage to your policy can offer protection and advantages beyond the basic coverage. Moreover, when picking a life insurance company, consider factors like the claim settlement ratio, returns etc”. Once you’ve insured your life, it's time to safeguard your health as well, with a solid health insurance policy. As Vivek Chaturvedi, CMO and Head of Direct Sales at Go Digit General Insurance notes, “Ensure the plan that you are picking does not come with any cap on the choice of room or ICU as this may impact your overall hospitalization bill. Second, make sure your policy provides a sum insured backup or reinstatement benefit.” Also, check for the pre- and post-hospitalization benefits in your health coverage. Ensure that expenses like diagnostic tests, doctor’s fees, medical check-ups, etc. that you might have to incur before you get hospitalized or after you are discharged are covered. A good plan should provide at least 60/90 days of pre- and post-hospitalization coverage. And lastly, check the coverage for organ donor expenses. While it is a low-probability event, any organ transplant is an expensive affair. This ensures such costs are covered by the insurer. <h2>Save for a rainy day</h2>“It can’t happen to us until it does”. When you are flooded with a daily deluge of news about accidents, deaths, fires, train wrecks and more, it’s easy to disassociate and think “Oh, this won’t happen to me”. But when emergencies arrive at your doorstep, they don't knock but rather break the door down. As such, it's best to be financially prepared for any contingencies, and the best way to do so is to have an <keyword id="20747810" type="General" weightage="20" keywordseo="emergency-fund" source="keywords">emergency fund</keyword> handy. For this, you can set aside 3-6 times your monthly income in a liquid mutual fund, recurring deposit (RD) or savings bank account. This will help you tide over a medical emergency, job loss and more. But remember, this is not to be broken into for funding those impromptu vacations! <h2>Upskill, Upskill</h2>Earning money is hard, but still easier than effectively managing it. Most of us run away from managing and investing our own hard-earned money because it sounds difficult and looks too complicated and jargon-y. This Independence Day, gift yourself a basic course on <keyword id="20762784" type="General" weightage="20" keywordseo="money-management" source="keywords">money management</keyword>, budgeting and investing. You won’t become <keyword id="19921921" type="General" weightage="20" keywordseo="warren-buffett" source="keywords">Warren Buffett</keyword> overnight, but it will certainly be a good start. Start with a basic budget and importantly, stick to it. Write and track how much you earn and spend on a monthly basis, so that you’re more in charge of your funds, and not looking (hopefully!), at maxed-out credit cards and empty wallets at the end of the month. <h2>Be free of anything that looks easy money</h2>These days, it’s super easy to get credit, a personal loan, and buy your favourite gadget, or your latest fascination via <keyword id="19985897" type="General" weightage="20" keywordseo="BNPL" source="keywords">BNPL</keyword> (Buy Now Pay Later). And in the short run, it can be incredibly satisfying as well. But then, when you get your monthly statements, and find a never-ending stream of interest charges, and penalties, which eventually pull you into a spiral of debt trap. If something looks too good to be true, it might really just be too good to be true. BNPL and instant credit are very much like that. So, the next time you want to buy something expensive, hold that thought for at least 48 hours, before revisiting it. Most of the time, you’ll find you don't even desire it anymore. If you still have the urge to buy it, try the saving and buying approach, instead of swiping your credit card or signing up for BNPL apps!

Five gifts you can give to yourself, friends, or family, towards achieving financial independence

<ul class="summary-list"><li>A United Airlines pilot ordered pizza for over 100 passengers after an emergency landing.</li><li>The flight from San Francisco to Houston diverted to Albuquerque due to a medical emergency.</li></ul>A <a target="_blank" class="" href="https://www.businessinsider.com/why-united-isnt-buying-boeing-new-777x-widebody-plane-2024-8">United Airlines</a> pilot ordered pizza for over 100 passengers after their flight made an emergency landing.The Boeing 737 Max was flying from San Francisco to Houston on September 13 when it diverted to Albuquerque, data from <a target="_blank" class="" href="https://www.flightaware.com/live/flight/UAL2480/history/20240913/2015Z/KSFO/KABQ">FlightAware</a> shows.On TikTok, passenger Tanya Stamos shared photos of the pilot at an airport gate, handing out boxes of pizza. Stamos said that there was a <a target="_blank" class="" href="https://www.businessinsider.com/pilot-medical-emergency-mid-flight-what-happens-next-2024-7">medical emergency on board</a> which saw the passengers deplaned at Albuquerque for around seven hours.She told <a target="_blank" class="" href="https://www.foxnews.com/travel/emergency-landing-prompts-united-airlines-pilot-order-dinner-150-passengers">Fox News</a> that the flight was delayed after the cabin crew timed out, so replacement staff were needed to continue onto Houston.Stamos added that United Airlines gave everyone a $15 food voucher, but the airport food outlets were all closed — prompting the pilot to take matters into his own hands."Most organizations do not go above and beyond, but that captain did not hesitate," she told Fox News. "His display that evening is what we should have more of: selfless acts of love, compassion, and humanity."She added that new flight attendants arrived and the plane was able to take off again at 11 p.m.Data from FlightAware shows it landed in Houston around 1:30 a.m. local time — about six hours later than expected.Stamos told Fox News that upon landing, the pilot thanked everyone for their patience, and several passengers shook his hand as they left.United did not immediately respond to a request for comment sent by Business Insider outside US working hours.Have you witnessed a similar incident? Get in touch with this reporter at <a target="_blank" class="" href="mailto:psyme@businessinsider.com">psyme@businessinsider.com</a>.

You Searched For "medical emergencies" and got 9 results

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