As holiday lights twinkle and festive cheer fills the air, the shadow of COVID-19 looms once again. The past few winters have almost come to be identified with the dreaded "winter wave" of infections, which could potentially disrupt holiday gatherings and stretch healthcare systems to breaking point. Unlike in the summit of 2020 and the height of 2021 cases, hospitalizations, and death levels the panorama for 2024 continues proving complex and unpredictable. Having reached the sixth year from the start of the epidemic, COVID-19 challenges health systems worldwide.

From reports by the World Health Organization, between October 14 and November 10, 2024, fresh cases were reported from 77 countries. Then 27 nations documented the death toll due to coronavirus. Although the number of cases has been decreasing the past few months, the virus is not eradicated. In fact, it has mutated, and new types have emerged, such as the KP.3.1.1 and XEC, which are being followed closely for their possible role in altering transmissibility, severity, and vaccines' effectiveness.

Uncommon Patterns of Viral Activity This Year

What makes this year different is a peculiar trend that occurred from September to November. Levels of the virus in wastewater—a good predictor of community transmission—were surprisingly low. Hospitalizations and deaths were also trending toward record lows during this period. Yet recent CDC data shows a sharp uptick in viral activity in December, which leaves experts wondering if a delayed winter wave is on the horizon.

The unusual timing of this potential wave could also present a silver lining: it may fall outside the typical flu and RSV seasons, thereby decreasing the peak burden on hospitals simultaneously. However, uncertainty continues to prevail, and so, this holiday season remains one of the most unpredictable in history.

Also Read: Could COVID-19 Help Fight Cancer? A Groundbreaking Study Finds Out the Link

Lingering Health Crisis Post-COVID-19

Even as acute cases decline, the long-term effects of COVID-19 remain a significant concern. Post-COVID-19 condition, commonly referred to as "long COVID," affects approximately 6.2% of individuals who had symptomatic infections. Symptoms such as fatigue, breathlessness, and cognitive impairments like "brain fog" continue to plague millions, imposing a substantial burden on healthcare systems worldwide.

The WHO emphasizes the urgency of addressing PCC and requests that researchers, healthcare providers, and policymakers work more closely together. Even though there is a reported reduction in new cases of PCC-this is likely because of the widespread vaccination, new treatment protocols, and less virulent variants-the numbers are overwhelming.

Other Emerging Global Health Threats

While SARS-CoV-2 remains a global concern, there are many other infectious diseases health officials keep track of. Malaria, HIV, and tuberculosis together claim close to 2 million lives annually, which reminds people of the persistent threat that these longstanding diseases have on people. There are emerging pathogens that are resistant to current treatments, so vigilance by scientists and public health experts is constantly called for.

One of the most widely recognized viruses is H5N1, or bird flu. The influenza A subtype has been shown to cross species boundaries, affecting not only birds but also dairy cattle in the U.S. and horses in Mongolia. According to experts, H5N1 can be one of the key public health concerns for the year 2025. This can further complicate the fight against SARS-CoV-2. Essential

Vital Role of Vaccines in the COVID-19 Fight

The core of COVID-19 prevention continues to be vaccines. Vaccines have been recommended in various new formulations in the hope of preparing for current variants ahead of the winter virus season. But vaccine effectiveness may change as new strains emerge, thus requiring ongoing research and adjustment.

The global community needs to focus on equitable access to vaccines. Inequalities in access continue to plague efforts to control the pandemic, especially in regions where healthcare resources are already spread thin in low-income regions.

With life adapting to COVID-19, the need for vigilance and preparedness remains. Measures in public health such as mask-wearing in crowded places, regular hand hygiene, and keeping abreast with the vaccinations are important weapons against the spread of the virus.

Future threats include H5N1. Looking ahead, addressing the long-term challenge of PCC and preparing for future threats like H5N1 will be robust with proper global collaboration. Investment in health care infrastructure, research, and education is very crucial for resilience against pandemics.

Preparing for 2025: Lessons to Learn

The end of 2024 is nigh, and the COVID-19 landscape has never looked so familiar yet unpredictable. While hope lies in improvements in vaccines and treatment, there are still new variants appearing, and PCC's lingering presence reminds everyone that COVID-19 is far from won. Being informed and taking proactive steps can get through uncertainties while securing public health and well-being.

This holiday season, let's celebrate responsibly, keeping both loved ones and broader communities safe. The lessons of the past six years underscore the importance of resilience, adaptability, and collective action in overcoming the challenges that lie ahead.

A chronic kidney disorder of unknown origin, referred to as Chronic Kidney Disease of unknown etiology (CKDu), is leading to kidney failures in Hyderabad and nearby districts of Telangana, alarmingly affecting younger adults who are economically active and have no prior history of diabetes or high blood pressure.

A team of senior nephrologists from Osmania General Hospital (OGH) and Apollo Hospitals studied 75 patients and published their findings in the Indian Journal of Nephrology (August 2024). The study revealed that while the disease resembles the mysterious kidney failures reported in Andhra Pradesh and other states, it shows a distinct, city-specific pattern of risk in Hyderabad.

Mysterious Kidney Disease In Hyderadabad

A mysterious kidney condition, called chronic kidney disease of unknown etiology (CKDu), is increasingly being reported among younger, non-diabetic residents in Hyderabad and nearby districts of Telangana, a study led by nephrologists reveals. Unlike traditional CKDu cases, which are often associated with agricultural work and heat exposure, this urban group largely comprises small business owners and service-sector workers with no farming history.

“Our research confirms the presence of the CKDu phenotype in Telangana, beyond the established hotspot regions, showing that an agricultural background is not required for the disease to develop,” said Dr. Manisha Sahay, Head of Nephrology at OGH and lead author of the study.

While CKDu in other regions is typically linked to strenuous farm labor and heat exposure, clinical data from OGH indicate that different, non-occupational factors may be driving the disease in younger, economically active individuals with no farming history. The condition progresses silently, often only producing symptoms once the kidneys are severely damaged, making urgent treatment at hospitals like Osmania General Hospital necessary.

What Is Chronic Kidney Disease Of Unknown Etiology?

Chronic kidney disease of unknown etiology (CKDu) is a type of chronic kidney disease with no identifiable cause, commonly observed in agricultural communities in certain regions. It is believed to arise from multiple factors, including environmental exposures such as pesticides, heavy metals, heat stress, dehydration, and contaminated water. According to the International Society of Nephrology, CKDu is diagnosed when known risk factors for chronic kidney disease, such as diabetes and hypertension, are absent.

What Are The Possible Causes Of Chronic Kidney Disease Of Unknown Etiology?

While the exact cause of CKDu is not confirmed, researchers suggest several possible contributors. The disease is likely multifactorial, arising from a combination of factors rather than a single cause. Environmental toxins, including heavy metals, pesticides, and mycotoxins, are under investigation. Heat stress and repeated dehydration from strenuous work in hot climates may also damage kidney tubules. Other potential factors being studied include contaminated water supplies and viral infections.

Kidney biopsies of patients at OGH revealed widespread scarring and inflammation in the kidney’s filtering units, indicating that the disease starts silently in this critical compartment.

“The damage observed in these biopsies highlights the severe consequences of late diagnosis, a pattern seen consistently across all CKDu-affected regions. Since the disease remains largely asymptomatic in its early stages, patients often reach urban hospitals only when they urgently need dialysis or renal replacement therapy,” said Dr. Manisha Sahay, Head of Nephrology at OGH.

CKDu in Hyderabad Linked To Urban Lifestyles and Unregulated Herbal Remedies

“While globally, 60 to 80 percent of CKDu cases occur among agricultural workers, only 21.3 percent of the Hyderabad patients were involved in rice farming,” noted Dr. Manisha Sahay in the study. “This shows that the CKDu phenotype affects a broad range of individuals from non-agricultural backgrounds, including small business owners, service-sector employees, and urban residents.”

Adding to the concern, 40 percent of patients in the OGH study reported using unregulated alternative or herbal medicines. Researchers emphasize that this widespread local practice may represent a significant risk factor, highlighting the need for urgent public health investigations targeting local dispensaries and providers of traditional remedies.

Health authorities have reported an active outbreak of hand, foot and mouth disease in Tennessee, impacting close to 200 children and staff members across multiple schools.

In its latest update on Monday, October 20, the Shelby County Health Department confirmed that 178 cases have been identified among students and staff in 31 schools and three daycare centers.

What Is Hand, Foot And Mouth Disease?

Health officials in Tennessee have issued a warning about a “highly contagious” illness spreading through several schools and childcare facilities.

The Shelby County Health Department confirmed in a recent statement that an outbreak of hand, foot and mouth disease (HFMD) has been detected across 31 schools and three childcare centers in the state.

According to the Centers for Disease Control and Prevention (CDC), hand, foot and mouth disease is a contagious viral infection that typically leads to fever, mouth ulcers, and a skin rash. Although it most often affects children under the age of five, people of any age can contract it. Symptoms usually persist for about a week to ten days.

The CDC explains that the virus spreads easily through droplets released when an infected person coughs, sneezes, or talks, as well as through contact with contaminated objects, surfaces, or fluid from blisters.

Symptoms Of Hand, Foot And Mouth Disease

Hand, foot and mouth disease (HFMD) usually develops in two stages. In the beginning, children often experience mild, flu-like symptoms such as a low fever, sore throat, runny nose, stomach discomfort, and loss of appetite. These early signs typically subside after a few days, followed by the appearance of an itchy rash on the palms, soles, elbows, knees, or buttocks, along with painful mouth sores that may form on or around the tongue, as per Cleveland Clinic.

These sores usually start as small pink spots before turning into blisters, and some children may also develop swollen lymph nodes in the neck. Most cases clear up within a week to ten days, though recovery can take longer in children under two years old.

What Causes Hand, Foot And Mouth Disease?

The illness is caused by viruses from the coxsackievirus and enterovirus families, which are commonly found in the mouth and digestive tract. HFMD is highly contagious, especially in the first few days of infection and often before the rash appears. While the blisters usually dry up within ten days, the virus can linger in stool for several weeks, meaning children may still spread it after symptoms have disappeared. The infection spreads through droplets released when an infected person coughs or sneezes, through direct contact with saliva, stool, or fluid from blisters, and by sharing utensils, cups, or towels. It can also spread by touching contaminated toys, surfaces, or doorknobs and then touching the mouth, nose, or eyes.

The Shelby County Health Department stated that it has been working closely with schools and childcare centers to track the outbreak and reduce the spread of the infection.

Dr. Bruce Randolph, Director and Health Officer of the department, noted that while most cases of hand, foot and mouth disease are mild, the virus can spread rapidly in group settings such as classrooms and daycare facilities. He advised parents to keep affected children at home until their fever has subsided, they are feeling better, and their mouth sores or blisters have started to heal.

Covid could have accelerated arterial ageing by up to five years, with women experiencing the greatest impact, according to groundbreaking research. The study revealed that even mild Covid infections can stiffen blood vessels, a change normally linked to aging, which increases the risk of heart attacks, strokes, and other cardiovascular issues.

Encouragingly, vaccinated individuals generally showed less arterial stiffness compared to those who were unvaccinated. Study leader Professor Rosa Maria Bruno explained that many people affected by Covid continue to experience symptoms months or even years later, and researchers are “still uncovering how the virus triggers these lingering effects.”

The findings follow advice from an emergency doctor who recently highlighted a simple five-second test that could indicate heart problems.

Early Vascular Ageing Explained

Professor Bruno said: “We know Covid can directly impact blood vessels. This can lead to what we term early vascular aging, meaning your arteries are older than your actual age, increasing susceptibility to heart disease. Identifying at-risk individuals early is crucial to preventing heart attacks and strokes.”

How the Study Was Conducted

The research included 2,390 participants from 16 countries, including the UK and the US. Conducted from September 2020 to February 2022, participants were divided into four groups: those who never contracted Covid, those with recent mild infections who were not hospitalised, patients admitted to general wards, and the most severe cases treated in intensive care.

Stiffer Arteries Found Across All Covid Groups

The results were striking as all Covid-infected groups, including those with mild infections, showed stiffer arteries than people who had never been infected. Women were more affected than men, and individuals with long Covid symptoms like fatigue and shortness of breath showed the strongest vascular changes.

Reassuringly, vaccinated participants had less stiff arteries than unvaccinated ones, and over time, the Covid-related vascular ageing tended to stabilise or slightly improve.

How Arterial Stiffness Was Measured

Researchers determined vascular age by measuring how fast a blood pulse travels from the carotid artery in the neck to the femoral arteries in the legs, using a device to calculate carotid-femoral pulse wave velocity (PWV). A higher PWV indicates stiffer blood vessels and a higher vascular age. Measurements were taken six months after infection and repeated at 12 months. The analysis accounted for participants’ sex, age, and other cardiovascular risk factors.

The study found that PWV increased in women by 0.55 metres per second for mild Covid cases, 0.60 for hospitalised women, and 1.09 for those in intensive care. Researchers note that an increase of 0.5 metres per second is “clinically significant,” roughly equivalent to five years of vascular ageing, and raises the cardiovascular risk by 3 percent in a 60-year-old woman.

How Covid Affects Blood Vessels

Professor Bruno from Université Paris-Cité explained: “Covid-19 targets angiotensin-converting enzyme 2 receptors found on blood vessel linings. By entering these cells, the virus can cause vascular dysfunction and speed up arterial ageing. Our immune and inflammatory responses, which normally protect against infection, may also contribute to this damage.”

Covid Could Be Causing Women To Age Faster

Discussing the sex differences, she added: “Women generally mount a faster, stronger immune response, which helps defend against the infection. However, this same response can sometimes increase damage to the blood vessels after the virus has passed.”

The study found that Covid’s impact extends far beyond the respiratory system, silently affecting blood vessels and accelerating vascular aging, especially in women. While vaccination appears to offer some protection, awareness and early monitoring of heart health are important.