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.

India's active cases of COVID-19 has finally started to decline marginally. On Monday, India logged 7,264 active cases, a decrease from 7,383 the day before, giving rise to hope with caution. The number of daily infections went down by 119, showcasing a pattern that health authorities have been keeping a close eye on. However, lurking behind these bettering figures is a shocking trend- eleven people succumbed to COVID-related factors in 24 hours, most of them in old people suffering from underlying conditions.

This troubling contrast displays the painful reality of the post-peak pandemic world, though the virus is no longer an indiscriminate public risk due to hybrid immunity and vaccination, it is still lethally hazardous to age-vulnerable and disease-ridden individuals.

Seven of the eleven deaths were reported in Kerala, as per data that India's Ministry of Health and Family Welfare has released. Delhi, Chhattisgarh, Maharashtra, and Madhya Pradesh each registered one death.

Two elderly patients with severe comorbidities were among those who died recently of COVID-19 in India. In Chhattisgarh, an 85-year-old man died from complications of chronic respiratory failure and interstitial lung disease (ILD), as well as an active case of COVID-19. In Delhi, a 67-year-old man receiving chemotherapy for metastatic lung cancer died from acute respiratory failure and COVID pneumonia. Both examples highlight how underlying medical conditions, particularly respiratory disease and immunosuppressive cancer treatments, can greatly enhance the risk of developing serious complications from COVID-19 among older people. A 52-year-old Madhya Pradesh woman who is diabetic with a history of bronchial asthma and tuberculosis.

In Kerala, the victims were between 60 and 85 years old and had conditions such as pneumonia, MODS (Multiple Organ Dysfunction Syndrome), cirrhosis, leukemia, and autoimmune complications.

They are not isolated cases, they follow a very predictable, perilous pattern- COVID-19 continues to take advantage of the body's weaknesses among the elderly and chronically ill, very often converting treatable conditions into lethal ones.

Why the Elderly At Maximum Risk of Exposure?

India is presently struggling with upcoming subvariants such as LF.7, XFG, JN.1, and the recently discovered NB.1.8.1. Although not more deadly than previous strains, these variations could be a greater threat to immune-compromised individuals. That includes the elderly, particularly those fighting diabetes, cardiovascular disease, renal dysfunction, respiratory diseases, cancer, or autoimmune conditions.

Infectious disease specialists describe how, though overall population immunity is better, these variants still infiltrate weakened immune defenses. For a cancer or diabetic patient, even a moderate viral load will tip the balance into organ failure.

Also Read: Covid-19 Active Cases Cross 7,100 In India But Signs Point To A Slowdown—How To Stay Protected Now?

Why COVID-19 Becomes Lethal in the Elderly with Comorbidities?

1. Immune Senescence

The natural process of aging drains immune effectiveness. Older people undergo "immune senescence," a state of affairs in which the body's protective mechanisms are slower and less coordinated. Consequently, T-cells and B-cells respond sluggishly to novel threats, permitting viral infections such as COVID-19 to establish themselves more quickly and aggressively.

In the Chhattisgarh death, for example, the 85-year-old man had both chronic lung disease and ILD, which would have severely compromised lung function and immune protection—even a minor infection would have been catastrophic.

2. Comorbidities Compound the Crisis

Diseases such as diabetes, cirrhosis, COPD, chronic kidney disease, or cancer are force multipliers for COVID-19. Such diseases not only weaken organs but also induce systemic inflammation. When the body is entered by SARS-CoV-2, it tends to induce a hyperinflammatory immune response (cytokine storm)—which, in patients with prior health burdens, quickly results in organ failure.

Kerala's toll illustrates this crossing. An 83-year-old man suffering from pneumonia and sepsis died when COVID swung the balance in favor of MODS. A patient with liver cirrhosis and respiratory failure shared the same fatal course.

3. Chain Reaction

When COVID and comorbidities meet, the outcome is usually Multiple Organ Dysfunction Syndrome (MODS) or septic shock. The virus does not target only the lungs—it can impair kidneys, the heart, and the brain, particularly among patients who have pre-existing vulnerabilities.

The 67-year-old Delhi man with metastatic lung cancer didn't only die of COVID pneumonia but of the compounded failure of his immune system and treatment-fatigued body. Such cascading failures are too fast and daunting for even the latest care measures to counter.

4. Special Populations

Some are especially vulnerable, such as those receiving chemotherapy, organ transplant recipients, and those with autoimmune disorders. Immunosuppressive treatments leave such patients vulnerable to infection, even during periods of low community transmission.

One of Kerala's victims, a 71-year-old woman with acute myeloid leukemia, CNS aspergillosis, and graft-versus-host disease, illustrates how rapidly COVID-19 can progress to ARDS and systemic failure in high-risk patients.

Why Vaccine May Not Be the Solution

Indian and international health experts are counseling against broad booster drives in light of the fact that hybrid immunity resulting from vaccination and past infection is present in a majority of the population. Instead, a more focused approach is being suggested: giving priority to boosters and preventive treatment to the elderly and the comorbid. This entails:

• Early vaccination among those above 60
• Preventive antiviral medicines
• Increased indoor ventilation and mask-wearing in healthcare facilities
• Prioritizing early hospitalization and testing for high-risk groups

Although India's COVID-19 trajectory appears stable or trending downwards, the virus is still a threat to certain populations. The story about COVID now being "just a cold" simply isn't true for all people—especially not for the old, chronically sick, or immunocompromised.

As the virus keeps on mutating, its lethal effect on high-risk groups is far from gone. Public health policy has to catch up on that. That implies not only marking reduced case numbers—but actually safeguarding those who remain most vulnerable.

COVID-19 no longer makes front-page news around the world, but it still kills quietly in the back rooms—most often in hospital ICUs full of old folks battling not only the virus, but years of chronic illness.

In 2025, the task is no longer to eliminate COVID but to close the gap between exposure and mortality in high-risk populations. That is to say, clinical watchfulness, policy accuracy, and public sensibility must now be directed towards people who cannot afford to drop their guard.

Senior Congress leader, Sonia Gandhi, has been admitted to Sir Ganga Ram Hospital in Delhi, after her health conditions worsened on Sunday, June 15. She was admitted to the hospital due to stomach-related issues, which had been confirmed by the hospital in a statement. She is now kept under observation under the gastroenterology department.

Last month only, Gandhi underwent an MRI scan at the Indira Gandhi Medical College (IGMC) in Shimla. She had been admitted to Shimla unit from her private residence in Chharabara with restlessness. The IGMC doctors noted that her blood pressure was "marginally higher than normal", however, she was "normal and stable" during her routine checkup and had "some minor ailments."

Sonia Gandhi's Health History

Last year, in an emotional letter that Gandhi penned down right before the Lok Sabha polls, she noted that she will not be contesting for the polls due to her health and age issues.

The now 78-year-old, wrote, "I am proud to say that whatever I am today, I am because of you and I have always done my best to honour your trust. Now on account of health and age issues, I will not contest the next Lok Sabha election."

Before this too, in 2020, when the world was struggling with the COVID-19 pandemic, Gandhi and her son Rahul Gandhi had missed the first part of the Parliament session, as they had gone abroad for Mrs Gandhi's annual check-up.

In 2011, she had gone to the US, for a surgery, the medical condition remains undisclosed. However, the Press Trust of India reported, "It was learnt tonight that the Congress leader had undergone a successful surgery in a US Hospital." In the US, she was admitted to New York's Memorial Sloan-Kettering Cancer Center.

While the medical condition remains unknown, the then Party General Secretary, Janardhan Dwivedi said, that she was "recently diagnosed with a medical condition that required surgery."

While it the cause for the recent medical condition is also unknown, here are some of the common "stomach-related issues" that are related to old age:

As per a 2011 study, titled Gastrointestinal issues in the older female patient, some gastrointestinal issues may be more common in the elderly population and possibly in older women. These issues range from motility disorders, such as fecal incontinence and constipation, to changes in neuropeptide function and its effect on the anorexia of aging.

Another 2019 study published in the Canadian Journal of Gastroenterology and Hepatology, titled Gastrointestinal (GI) Tract Disorder in Older Age notes that GI changes in the elderly are common. "While some changes associated with aging GI system are physiologic, others are pathological and particularly more prevalent among those above age 65 years." notes the study.

An article written by Michael Bartel, MD, PhD, Fairfax, Virginia, aging is a factor in several digestive system disorders.

In particular, older adults are more likely to develop diverticulosis and to have digestive tract disorders (for example, constipation—see Large intestine and rectum) as a side effect of taking certain medications. Also, changes in the gut microbiome (all the bacteria, viruses, protozoa, and fungi that live in the digestive tract) with age may be connected to overall healthy aging and may affect obesity, metabolic disorders, inflammation, cancer, depression, or other health issues.

Esophagus

As people age, the strength of esophageal contractions and the tension in the upper sphincter decline (a condition called presbyesophagus), but food movement usually remains unaffected. However, some older adults may develop disorders that disrupt these contractions.

Stomach

Aging reduces the stomach lining’s ability to resist damage, increasing the risk of ulcers, especially with NSAID use. The stomach also becomes less elastic and empties more slowly, though these changes rarely cause symptoms. Acid and enzyme secretion generally stay stable, but conditions like atrophic gastritis, which lower acid production, become more common and may lead to issues like vitamin B12 deficiency or bacterial overgrowth.

Small Intestine

Aging causes little structural change in the small intestine, so nutrient absorption mostly remains intact. However, reduced lactase levels can cause lactose intolerance, and bacterial overgrowth becomes more common, leading to bloating, pain, weight loss, and poor absorption of nutrients like B12, iron, and calcium.

Pancreas, Liver, and Gallbladder

The pancreas shrinks slightly and may develop some scarring, but its enzyme production remains adequate. The liver and gallbladder undergo structural changes, but these generally don’t impair their digestive functions.

Large Intestine and Rectum

The large intestine changes little with age, though the rectum may enlarge. Constipation becomes more frequent due to slower movement, weaker rectal contractions, reduced activity, medication use, and, in women, pelvic floor weakness—which can also cause fecal incontinence.

Chronic diseases impact six in 10 American adults—amounting to nearly 130 million individuals—public health funding is more than a policy debate. It is a matter of life, longevity, and dignity. From autoimmune disorders to blood conditions like sickle cell disease, chronic illnesses don’t discriminate, but the effects of budget cuts just might. And women, particularly women of color, are poised to bear the brunt.

Chronic disease management relies on continued research, innovation, and the ability to translate scientific breakthroughs into accessible treatments. Yet, that progress hinges on adequate funding. According to a Minority Staff Report released on May 13, the Trump administration had already terminated $13.5 billion in health-related funding and dismissed thousands of workers responsible for America’s scientific infrastructure. Now, proposed fiscal budget reductions for 2026 may deepen the damage.

Among the most contentious measures is a 15% cap on indirect costs for federally funded research at universities. Institutions like those governed by the NIH, DOE, DOD, and NSF could lose billions in essential operational funding. These cuts would not only affect research in cancer and infectious diseases but also severely limit progress in chronic illness management, including diseases with heavy gender and racial disparities such as sickle cell disease.

"The 15% cap will drastically change grant-making for the healthcare community," warns Steven Taylor, president and CEO of the Arthritis Foundation. "We’re going to be going backwards in the research of many diseases."

While legal battles rage over cost caps, the broader budget outlook appears equally grim. The proposed FY2026 budget includes a 37% cut to the NIH, the world’s largest public funder of biomedical research. Coupled with a proposed $880 billion cut to Medicaid and related programs, the implications for patients with chronic diseases are dire. Health disparities are expected to widen, particularly for Black women already navigating compounded risks.

Why Women With Chronic Conditions Are at Greater Risk?

In April, the CDC disbanded a crucial eight-person team that maintained contraception safety guidelines for patients with chronic illnesses. Known informally as the nation’s "contraception bible," this set of guidelines helped clinicians assess birth control safety for individuals with conditions like lupus, kidney disease, and notably, sickle cell disease.

The disbandment means doctors are left without updated, evidence-backed tools to make informed decisions about contraception for medically vulnerable populations. A woman in Michigan living with sickle cell disease expressed concern that her life is now endangered without these vital guidelines. And her fear is not unfounded.

According to the most recent CDC guidance, combined hormonal contraceptives pose an "unacceptable health risk" for people with sickle cell disease due to elevated blood clot risks. This marks a shift from earlier versions that viewed the benefits as outweighing the risks. The latest update also reclassified the Depo-Provera shot with higher risk and highlighted progestin-only pills and IUDs as safer alternatives.

Sickle Cell and the Disproportionate Burden on Black Women

At least 90% of Americans living with sickle cell disease are Black, and the maternal mortality rate for Black patients with the disease is a staggering 26 times higher than for their non-Black counterparts. When federal funding cuts target research and public health programs that cater to this community, the results can be devastating.

The intersectionality of race, gender, and chronic illness in this context highlights the urgency of protecting these programs. Reducing CDC and NIH resources not only curtails research but also removes critical guardrails meant to protect women from life-threatening reproductive complications.

Implications for Chronic Disease Communities

The implications extend beyond sickle cell. The CDC team was also responsible for reviewing contraception safety for those with a wide range of conditions, including HIV, epilepsy, and autoimmune diseases. Without their expertise, clinicians across the country will operate with outdated or incomplete information, increasing the risk of complications and undermining patient trust.

Medical experts worry that continued cuts will halt the momentum achieved in areas like gene-editing therapies, personalized medicine, and immunotherapy. For patients, this could mean fewer treatment options, reduced quality of care, and ultimately, shortened lifespans.

There is still hope that not all is lost. Both NIH and HHS have appealed the cost-cap ruling, and advocacy groups are mobilizing to pressure legislators to reconsider the draconian cuts. Public awareness and civic engagement will be crucial in ensuring that health funding is restored or, at the very least, preserved.

Advocacy groups like the Arthritis Foundation and the American Hospital Association are encouraging constituents to contact their representatives and demand that health funding remain a national priority. Grassroots campaigns, coalition-building, and direct appeals to Congress will likely determine the final outcome of this debate.

As debates around federal spending continue, it’s vital not to lose sight of what’s at stake. Budget lines may be written in ink, but their effects are etched in the lives of real people—particularly women battling chronic illnesses. Stripping research and public health funding not only undermines scientific progress but also endangers the most vulnerable. Now more than ever, robust investment in chronic disease research must remain a cornerstone of public health policy.