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      New Report Underscores the Seriousness of Long Covid

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      The National Academies said the condition could involve up to 200 symptoms, make it difficult for people to work and last for months or years.One of the nation’s premier medical advisory organizations has weighed in on long Covid with a 265-page report that recognizes the seriousness and persistence of the condition for millions of Americans.More than four years since the start of the coronavirus pandemic, long Covid continues to damage many people’s ability to function, according to the National Academies of Sciences, Engineering and Medicine, a nongovernmental institution that advises federal agencies on science and medicine.“Long Covid can impact people across the life span, from children to older adults, as well as across sex, gender, racial, ethnic and other demographic groups,” it said, concluding that “long Covid is associated with a wide range of new or worsening health conditions and encompasses more than 200 symptoms involving nearly every organ system.”Here are some of the National Academies’ findings, drafted by a committee of 14 doctors and researchers:How many people have long Covid?The report cited data from 2022 suggesting that nearly 18 million adults and nearly a million children in the United States have had long Covid at some point. At the time of that survey, about 8.9 million adults and 362,000 children had the condition.Surveys showed that the prevalence of long Covid decreased in 2023 but, for unclear reasons, has risen this year. As of January, data showed nearly 7 percent of adults in the United States had long Covid.Diagnosis and consequencesThere is still no standardized way to diagnose the condition and no definitive treatments to cure it. “There is no one-size-fits-all approach to rehabilitation, and each individual will need a program tailored to their complex needs,” the National Academies said, advising that doctors should not require patients to have a positive coronavirus test to be diagnosed with long Covid.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Biden Admin Struggles to Address Sharp Rise in Deaths From Extreme Heat

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      For more than two years, a group of health experts, economists and lawyers in the U.S. government has worked to address a growing public health crisis: people dying on the job from extreme heat.In the coming months, this team of roughly 30 people at the Occupational Safety and Health Administration is expected to propose a new rule that would require employers to protect an estimated 50 million people exposed to high temperatures while they work. They include farm laborers and construction workers, but also people who sort packages in warehouses, clean airplane cabins and cook in commercial kitchens.The measure would be the first major federal government regulation to protect Americans from heat on the job. And it is expected to meet stiff resistance from some business and industry groups, which oppose regulations that would, in some cases, require more breaks and access to water, shade and air-conditioning.But even if the rule takes effect, experts say, the government’s emergency response system is poorly suited to meet the urgency of the moment.Last year was the hottest in recorded history, and researchers are expecting another record-breaking summer, with temperatures already rising sharply across the Sun Belt. The heat index in Miami reached 112 degrees Fahrenheit last weekend, shattering daily records by 11 degrees.The surge in deaths from heat is now the greatest threat to human health posed by climate change, said Dr. John M. Balbus, the deputy assistant secretary for climate change and health equity in the Health and Human Services Department.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      The Disease Detectives Trying to Keep the World Safe From Bird Flu

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      As Dr. Sreyleak Luch drove to work the morning of Feb. 8, through busy sunbaked streets in Cambodia’s Mekong river delta, she played the overnight voice messages from her team. The condition of a 9-year-old boy she had been caring for had deteriorated sharply, and he had been intubated, one doctor reported. What, she wondered, could make the child so sick, so fast?“And then I just thought: H5N1,” she recalled. “It could be bird flu.”When she arrived at the airy yellow children’s ward at the provincial hospital in Kratie, she immediately asked the child’s father if the family had had contact with any sick or dead poultry. He admitted that their rooster had been found dead a few days before and that the family had eaten it.Dr. Luch told her colleagues her theory. Their responses ranged from dubious to incredulous: A human case of avian influenza had never been reported in their part of eastern Cambodia. They warned her that if she set off the bird flu warning system, many senior government officials might get involved. She risked looking foolish, or worse.Anxious but increasingly certain, Dr. Luch phoned the local public health department, located just across the street. Within minutes, a team arrived to collect a sample from the child, Virun Roeurn, for testing in a lab.By then, Virun’s distraught parents had lost faith in the hospital. They demanded that he be sent by ambulance to the capital, Phnom Penh. His flu swab sample traveled with him.Virun died on the journey. At 8 p.m., Cambodia’s National Public Health Laboratory confirmed Dr. Luch’s suspicion: He had died of highly pathogenic avian influenza.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Report Finds ‘Catalog of Failures’ in U.K. Contaminated Blood Scandal

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      A six-year inquiry found that the deaths of about 3,000 people and the infection of tens of thousands of others could have mostly been avoided.A “catalog of failures” by government and medical officials in Britain, most of them avoidable errors, led to blood contaminations that killed about 3,000 people and infected more than 30,000 others over two decades, according to a long-awaited report published on Monday.The report is the product of a six-year inquiry that the British government ordered in 2017 after decades of pressure from victims and their families, and it could pave the way for sizable compensation payments.The independent report puts a harsh spotlight on Britain’s state-run National Health Service, identifying “systemic, collective and individual failures” by British authorities as they dealt with the infections of tens of thousands of people by tainted blood transfusions or contaminated blood products between the 1970s and the 1990s.The authorities at the time refused to acknowledge those failings — including the lack of proper screening and testing of blood — by “hiding the truth,” the report said.“This disaster was no accident,” Brian Langstaff, a former High Court judge who led the inquiry, said at a news conference on Monday. “People put their trust in doctors and the government to keep them safe, and that trust was betrayed.”He added, “The N.H.S. and successive governments compounded the agony by refusing to accept that wrong had been done.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Hilary Cass Says U.S. Doctors Are ‘Out of Date’ on Youth Gender Medicine

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      Dr. Hilary Cass published a landmark report that led to restrictions on youth gender care in Britain. U.S. health groups said it did not change their support of the care.After 30 years as one of England’s top pediatricians, Dr. Hilary Cass was hoping to begin her retirement by learning to play the saxophone.Instead, she took on a project that would throw her into an international fire: reviewing England’s treatment guidelines for the rapidly rising number of children with gender distress, known as dysphoria.At the time, in 2020, England’s sole youth gender clinic was in disarray. The waiting list had swelled, leaving many young patients waiting years for an appointment. Staff members who said they felt pressure to approve children for puberty-blocking drugs had filed whistle-blower complaints that had spilled into public view. And a former patient had sued the clinic, claiming that she had transitioned as a teenager “after a series of superficial conversations with social workers.”The National Health Service asked Dr. Cass, who had never treated children with gender dysphoria but had served as the president of the Royal College of Pediatrics and Child Health, to independently evaluate how the agency should proceed.Over the next four years, Dr. Cass commissioned systematic reviews of scientific studies on youth gender treatments and international guidelines of care. She also met with young patients and their families, transgender adults, people who had detransitioned, advocacy groups and clinicians.Her final report, published last month, concluded that the evidence supporting the use of puberty-blocking drugs and other hormonal medications in adolescents was “remarkably weak.” On her recommendation, the N.H.S. will no longer prescribe puberty blockers outside of clinical trials. Dr. Cass also recommended that testosterone and estrogen, which allow young people to develop the physical characteristics of the opposite sex, be prescribed with “extreme caution.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Maximizing Profits at the Patients’ Expense

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      More from our inbox:The Brave Trump JurorsBlack Voters ‘Want to Be Courted’ by DemocratsBetter Than Debates NATo the Editor:Re “Patients Hit With Big Bills While Insurers Reap Fees” (front page, April 7):Chris Hamby’s investigation uncovers the hard truth for patients who receive care from providers outside their insurance network. While most of us try to save out-of-pocket costs by using in-network health professionals and hospitals, it’s not always possible. And there’s no way to determine what we’ll owe until after we get that care — when it’s too late to reconsider based on the costs we’ve incurred.So, it’s more important than ever for the government to swiftly implement an essential element of the No Surprises Act: Providers should have to give patients an advance explanation of benefits so patients can estimate their financial burden before they get treatment, in or out of network.Health price transparency is improving, but it’s outrageous that even two years after the No Surprises Act passed, everyone except the patient knows the price of a procedure or doctor’s visit in advance, leaving patients unpleasantly surprised.Patricia KelmarAlexandria, Va.The writer is senior director of Health Care Campaigns for U.S. PIRG.To the Editor:This is just the latest example of the schemes deployed by insurers to maximize profits by cutting reimbursements to physicians and shifting medically necessary health care costs onto patients.Whether it’s through third-party entities like MultiPlan or using tactics such as narrowing provider networks and restrictive prior authorization policies, insurers have the perverse incentive to boost revenue over offering adequate payment for quality patient care under the guise of “controlling costs.”More and more patients are being forced to decide whether they should forgo treatment because their insurer won’t pay the bill.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Heat Wave in Gaza Challenges Pharmacists Ability to Store Medicine

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      A heat wave in the Gaza Strip this week, with temperatures soaring above 100 degrees Fahrenheit the past few days, has not only made life intolerable for the hundreds of thousands of displaced people trying to rebuild their lives in tent cities but has made it hard for some businesses to operate.By Saturday, the heat had significantly eased and the forecast was for more moderate temperatures in coming days. But the recent highs offered a vision of what the summer likely holds.“This hot weather is a challenge for us,” said Mohammed Fayyad, a displaced pharmacist who started selling medications from a tent he built out of wooden slabs, curtains and metal scraps at a camp for displaced people in Al-Mawasi.With no electricity or alternative sources of power, Mr. Fayyad, 32, said that he could not keep the medicines — which he buys from pharmacies that have had to shut down — stored at cool enough temperatures to keep them from being damaged.“Fifty percent of the medicines for chronic diseases are not available because we do not have any source of power to keep them cool,” said Mr. Fayyad, speaking from his makeshift pharmacy that he named after his 3-year-old daughter Julia.Mr. Fayyad is trying to find ways to generate power for a refrigerator to store medication.“I hope I can find those solar panels, which are very expensive, to make the options wider for the displaced people,” he said.Mr. Fayyad was displaced with his wife and only daughter from Khan Younis, where they lived and owned a pharmacy. They have been in Al-Mawasi for more than two months. When they recently went back to Khan Younis after the Israeli military withdrew from the area, he found his pharmacy had been burned and looted.Nearly two million Palestinians in Gaza were forced to flee their homes under Israeli bombardment and military evacuation orders. Many had to live in tents that provided little protection from the cold and rainy months earlier in the war and that offer them no protection against the scalding heat and humid weather now.Parents across the Gaza Strip are relying on water to keep their children cool when it is already not easy to get. The hot weather is also bringing insects that help spread disease.“My children were stung by insects and mosquitoes because there is no sanitation around, and sewage is leaking almost everywhere,” said Mohammed Abu Hatab, a father of four, including a 7-month-old. His family has been spending their days outside, under the shade of nylon tents, which trap heat and make the tents more unbearable.“I had to undress my children to their underwear only,” said Mr. Abu Hatab, 33. He added: “The tent, the heat wave, and the horror of this war are all a nightmare. How can my children live healthily and safely?” More

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      Ozempic and Wegovy Have Health Benefits Beyond Weight Loss

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      Last year was called the year of Ozempic, though it was also a year of Ozempic backlash and Ozempic shortages, which could persist for years. Even so, we appear very far from a peak for GLP-1 drugs, like Ozempic and Wegovy, which are powered by a molecule called semaglutide, and Mounjaro, which uses its cousin tirzepatide. It seems possible to imagine a future in which almost everyone is taking some variety of GLP-1 drug, and with a pretty good reason to do so.Probably, you have heard about the game-changing impact of such drugs on obesity, a condition that affects 40 percent of Americans and increases the risk of heart disease, stroke and hundreds of other comorbidities. Patients on Ozempic and Wegovy can lose 15 to 20 percent or more of their weight in a little over a year, and if they stay on the drugs, the weight tends to stay off. That may not sound like a monumental effect, but consider that on average, an obese 210-pound man who loses 20 percent of his body mass generally passes quickly through the overweight stage all the way to a normal weight.If anything, though, we’ve probably talked too much about cosmetic weight loss and Hollywood vanity — and certainly made too many comparisons to fen-phen, Botox and Viagra. The GLP-1 drugs have been shown to cut risk of heart attacks, strokes and death from coronary disease by 20 percent among overweight and obese patients, presumably through the salubrious effect of weight loss, though the researchers can’t yet say for sure. Semaglutide has been shown to eliminate or reduce the need for insulin among those with recent-onset Type 1 diabetes. In a clinical trial of people with Type 2 diabetes and moderate to severe kidney disease, the drug reduced the risk of kidney disease progression and cut the death rate from cardiovascular and kidney-related causes by 24 percent — such a clear result that the trial was ended early. Semaglutide has reduced fatty liver deposits in patients with H.I.V. and nonalcoholic steatotic liver disease. It has normalized the menstrual cycles of those with polycystic ovary syndrome. (It has also, somewhat mysteriously, seemed to produce a wave of unintended pregnancies among women taking birth control, at least if TikTok videos are to be trusted.)Studies have shown promise in treating Alzheimer’s and Parkinson’s with GLP-1 drugs, perhaps by regulating insulin levels and reducing inflammation, and the drugs may yet prove useful in treating many other conditions made worse by chronic inflammation. Some studies have found large decreases in the risk of depression and anxiety; others found smaller but still positive effects. There are potential applications for schizophrenia and neurological dysfunction, thanks to the role that insulinlike hormones like GLP-1 play in the development of the central nervous system and the way semaglutide reshapes the brain’s chemical reward system. It seems to bend the curve on alcoholism and drug addiction and curb other addictive behaviors, as well — compulsive shopping and sex addiction, gambling and nail biting, smoking and skin picking. A compulsive nation has stumbled into what looks like a treatment for compulsion and one that happens to protect against some of the country’s biggest killers and curb some of its most pervasive pathologies and inner demons.Americans love to dream of miracle drugs, but hardly anything ever seems to fill the bill. True, semaglutide has arrived with real questions trailing like bunting: Much of the weight loss is from lean muscle mass, which isn’t ideal, and there are reasons to worry over the possibility of thyroid problems, loss of bone density and sarcopenia, a weakness disorder associated with aging. There are potentially other serious long-term side effects, though millions of Americans have been taking Ozempic for Type 2 diabetes for years without serious issues. (Some of them do report more familiar side effects, like nausea.) The GLP-1 drugs aren’t a permanent fix in a single shot — whether the thing being addressed is body mass index or cardiac risk or the progression of Alzheimer’s — but a permanent disease-management program. They also haven’t exactly cured cancer, although more than a dozen cancers are linked to obesity, and in at least one case, colorectal cancer, there is reason to believe GLP-1 drugs may directly cut the chances of developing the disease.All that means that semaglutide isn’t exactly a cure-all, in the vernacular sense. But it seems to be about as close as we’ve gotten, even in a time of racing biomedical progress, to that old science-fiction proposition — one pill for almost everything and almost everyone forever.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More