Cancer patients as well as patients with conditions such as cystic fibrosis and chronic pancreatitis are now confronted with an acute shortage of an essential medication—Creon. This pancreatic enzyme replacement therapy (PERT) is crucial to digesting food, one of the most fundamental of human activities which becomes all but impossible for those with pancreatic insufficiency.

The consequences are frightening- patients are forgoing meals, dividing up doses, and driving more than 30 miles just to receive the capsules. The effect is not just nutritional but life-threatening, because not being able to properly digest food can make a person vulnerable to infection, make them weaker, and restrict access to life-saving treatment like chemotherapy.

Creon is the brand name of pancreatic enzyme replacement therapy that is used to manage exocrine pancreatic insufficiency (EPI)—a disease in which the pancreas is unable to produce enzymes to help digest food. This inability can be due to a variety of reasons, such as pancreatic cancer, cystic fibrosis, chronic pancreatitis, and complications after surgery like gastric-bypass or pancreatic surgery.

For individuals with EPI, Creon® is not merely a supportive therapy—it is a lifeline. It allows them to extract nutrition from food and sustain body weight, energy, and immune capacity. Without it, patients experience persistent diarrhea, abdominal pain, malnutrition, and ultimately, reduced quality of life and survivability.

The Government in the UK has prolonged the Serious Shortage Protocol (SSP) for Creon until November 2025, enabling pharmacists to dispense a reduced quantity without a fresh prescription. Although the policy tries to make things more accessible, this is a short-term solution to an ongoing and hazardous shortage.

One survey carried out by the National Pharmacy Association (NPA), surveying more than 300 pharmacies, shows a dire picture. A whopping 96% of these pharmacies are struggling to get Creon, the essential pancreatic enzyme replacement therapy. Additionally, 89% have the same shortages with other drugs like Nutrizym and Pancrex. This shortage is making many patients go distances of over 30 miles just to get a pharmacy that will fill their prescriptions. Even more alarming, many patients are said to be skipping meals or cutting their doses in order to stretch their short supplies, jeopardizing their health and wellbeing in the process.

The shortage is primarily due to "European-wide supply issues" and production limitations on the drug that have caused interruptions in the manufacture and distribution of Creon, as reported by the Department of Health and Social Care. The interruptions are not specific to Creon but point to systemic weaknesses in pharmaceutical production.

In Creon's case, though, the end result is worse. Unlike certain drugs that can be skipped or substituted for others, Creon® is instantly vital with each patient meal. There is no "respite" from taking it, and even temporary discontinuation can cause health emergencies.

How is the Shortage of the Drug Affecting Cancer Patients?

The psychological and physical strain on the patients cannot be estimated. As Alfie Bailey-Bearfield, Pancreatic Cancer UK's Head of Influencing & Health Improvement, stressed, "It's completely unacceptable that they are still taking desperate steps which risk their health, wellbeing, and their suitability for treatment."

Patients going without meals in order to cut corners on enzyme capsules put themselves at significant risk of malnutrition and severe weight loss. Not only does this compromise the immune response of the body, it lowers tolerance to chemotherapy, effectively excluding patients from life-sustaining or curative therapy. The medical risk is not abstract—it's real and measurable.

What is EPI?

Exocrine Pancreatic Insufficiency (EPI) is more prevalent than many people know. In the UK alone, approximately 61,000 patients need pancreatic enzyme therapy. Reasons are:

• Pancreatic cancer (especially advanced)
• Cystic fibrosis
• Chronic and acute pancreatitis
• Pancreatic surgery or gastric bypass
• Untreated celiac disease or inflammatory bowel disease

EPI results in undigested food entering the colon, leading to bloating, gas, cramps, and diarrhea. With time, the nutrient deficiencies cause weight loss, bone loss, and even increased cardiovascular risk. In children, it impairs growth and development.

Unlike regular prescriptions, Creon is not prescribed with a set amount. It has to be individualized for each patient, for each meal, and even for each snack. The dosing is 3,000 to 36,000 enzyme units per capsule. For comparison, a normal pancreas will release up to 720,000 units for a small meal.

Patients are instructed to self-regulate according to their intake, so that a consistent and plentiful source becomes not only the preferred but also the necessary mode of correct dosing. Under shortages, this individualized dosing is a luxury many cannot enjoy.

Healthcare providers and patient advocacy groups alike are demanding immediate government action. Bailey-Bearfield and Picard have issued public calls for a strategic restructuring to solve manufacturing constraints and enhance distribution systems.

"This crisis continues to put people's health at risk, and they cannot afford to wait any longer," Bailey-Bearfield implored.

It takes not only stockpiling but also long-term planning, such as investment in alternative manufacturing hubs, local production incentives, and better global supply chain coordination.

As per the latest American Lung Association report, nearly half of Americans, around 156 million people live in areas that received a failing grade in air quality.

The East Coast has seen a rise in air pollution that came after wildfires and heatwaves, breaking through West Coast city domination of the most annual exposure to fine particulate matter. These were based on the association's "State of the State" report based on 2021 to 2023 data. Most of this is to be attributed to the 2023 Canadian wildfires and the extreme heatwaves.

How Was Air Quality Measured?

Three indicators were used to measure air quality, namely: ozone air pollution, short-term particle pollution and long-term particle pollution.

Exposure to unhealthy air can cause many health risks to a person and could increase the chance of stroke, ischemic heart disease, severity in asthma attacks, chronic obstructive pulmonary disease, lung cancer, and pneumonia. Air pollution is also linked with increased fetal and infant mortality and pregnancy complication, along with cognitive decline.

Here Are The Top 10 US Cities With Worst Air Pollution:

10. Fairbanks-College, Alaska

This region continues to perform poorly on particulate matter pollution. The area has also been prone to wildfire smoke, use of wood-burning stoves, aggressive heating methods, and large vehicles.

9. Cleveland-Akon-Canton, Ohio

This region experienced a dramatic fall that placed it from 54th to ninth rank in highest exposure of annual particulate matter.

8. Houston-Pasadena, Texas

It is on the list due to the ozone pollution.

7. San Jose-San Francisco-Oakland, California

The Bay Area is one of six regions in California that rank among the top 10 in the country for annual particle pollution exposure. Frequent wildfires driven by dry conditions contribute to poor air quality across all three pollution measures in the report. The region also ranks 11th for short-term particle pollution and 14th for ozone pollution. These environmental hazards impact a population of 9 million people, nearly 6 million of whom are people of color.

6. Detroit-Warren-Ann Arbor, Michigan

The Detroit metro area is a latest addition in the long-term air pollution list, the region was impacted by the Canadian wildfires.

5. Lod Angeles-Long Beach, California

This is the worst rank for ozone pollution in the 25th time in the 26-year history of the 'State of the Air' report.

4. Eugene-Springfield, Oregon

This has ranked third for short-term air quality. The pollution has affected 381,000 people.

3. Fresno-Hanford-Corcoran, California

This region scored firth for both short-term and long-term air pollution and ozone pollution, and has slightly improved from precious years.

2. Visalia, California

This city experienced the highest-ever spike in particulate pollution since the start of the report.

1. Bakersfield-Delano, California

This region top the worst air pollution list for the sixth consecutive year, affection a population of 914,000 people.

Air Pollution And Its Impact

Previously, residents of the US, Canada, and UK also reported mysterious, dense fog. Many residents posted videos that claimed the fog smelled like "burning chemical".

Many on TikTok shared the video of the dense fog, calling it "toxic". The people also shared: "The weirdest part is the taste and smell. It smells like after you set off a bunch of fireworks, and the air tastes toxic. It is super weird". Someone else on X, previously Twitter claimed that the air smells like burning plastic.

Pollution is related with many health risks, a thick fog during winter may not be a reason for concern. However, the residents claiming it to be toxic due to the smell or the adverse affects on their health may lead to it being a cause of concerns. Also, new research highlights a disturbing connection between long-term exposure to air pollution and a heightened danger of deadly blood clots, a condition which is underappreciated but also poses significant health risks. A study, published in Blood, examined how long-term exposure to some pollutants, including fine particulate matter, nitrogen dioxide, and nitric oxide, may heighten the chances of VTE hospitalizations.

The outcomes showed that the individuals who had exposure to pollutants in the higher quartile had:

• 43% increased risk of hospitalization for VTE associated with fine particulate matter.
• 2.8 times increased risk from nitrogen dioxide exposure.
• 2.3 times increased risk due to nitric oxide.

Another 2021 study titled Effect of Air Pollution on Obesity in Children: A systematic Review and Meta-Analysis, there is a connection between air pollution and weight gain through biological behavioral mechanism. The major pollutants causing obesity are nitrous oxides, nitrogen dioxide, ozone, and particulate matter. These could lead to systematic inflammation and metabolic disturbances, which can lead to weight gain and obesity. The study mentions that fine particulate matter [PM2.5], when it enters our body, it influences the metabolism rates.

A different study published in the JAMA Network Open, stated that higher levels of particulate matter (PM2.5) and nitrogen dioxide (NO2) exposure can increase the risk of Parkinson's and Alzheimer's.

India is again facing with a familiar warning sign—a spike in COVID-19 cases, localized outbreaks, and fresh deaths. India reported seven COVID-related fatalities in the past 24 hours and recorded 564 new cases, pushing the number of active cases to 4,866 as of June 5, the Ministry of Health and Family Welfare reported. Though still relatively low, the age group spread, spatial concentration, and comorbid condition of the deceased are generating public health signals.

The spike, although not at the level of earlier waves, is significant. Kerala, once the state that was being widely acclaimed for the model response it had followed in the initial phases of the pandemic, now leads the active caseload list with 1,487 cases. Delhi and West Bengal are next with 562 and 538 cases respectively.

Maharashtra (526), Gujarat (508), and Karnataka (436) complete the list of states with more than 400 active cases. These six states collectively account for more than 83% of the nation's present active cases—a stark clustering that indicates the need for focused interventions.

Seven fatalities registered in the last 24 hours present a complicated picture of risk. Of these, three were from Maharashtra, two from Delhi, and two from Karnataka. Importantly, five out of the seven were elderly citizens above the age of 60 with pre-existing conditions like pneumonia, cardiac problems, and states of immunocompromised.

Two of the most troubling fatalities are that of a 42-year-old Delhi man and a five-month-old child from Karnataka. Both were fighting advanced comorbidities when they tested positive for COVID-19, which implies that the virus continues to be opportunistic and targets hardest where there is existing weakness in immunity.

Even while case numbers swell, hospitalization rates are low, and most infections are being treated with home isolation. Nevertheless, the Indian government is not leaving anything to chance. Mock drills were held on June 2 at government hospitals to assess their preparedness.

Sources within the Ministry have also made comments stating that the Centre has asked all states to keep a watchful stockpile of equipment and make sure frontline health workers are ready for any sudden surges.

The distribution of new cases is uneven and appears to be affected, at least in part, by travel-associated exposures. In Madhya Pradesh's Indore, for example, seven new cases were reported—three of them who had recently traveled back from Uttar Pradesh, Odisha, and Kerala.

District epidemiologist Dr. Anshul Mishra confirmed that Indore currently has 17 active cases of COVID, none of which are critical. All of the patients are in home isolation and under observation for symptoms. But the travel connection points to the necessity of continued vigil at domestic transit points.

Likewise, Himachal Pradesh also confirmed its first case in the past weeks, that of an 82-year-old woman who was admitted with COVID-like symptoms at a government medical college in Sirmour. Her case has been closely monitored because of her weak health profile.

Why There Is A Sudden And Sharp Surge In COVID Cases?

What makes this modest but meaningful surge of concern isn't so much the numbers—it's who it is impacting and how. The intersection of at-risk demographics (infants, seniors, and the comorbid), extensive geographical dissemination, and the chronic unpredictability of viral mutations makes waves past come flooding back.

Complacency is another important consideration. With limitations significantly eased, masking now a rarity, and vaccination emphasis on catch-up shots for seniors instead of widespread precautions, professionals fear that individuals are dropping their guard too soon.

The World Health Organization (WHO) continues to emphasize that COVID-19 hasn't gone away and that endemic status doesn't mean harmlessness. Similar to influenza, it remains potentially lethal—particularly for risk groups.

As global surveillance weakens and test rates fall, health officials highlight the importance of ongoing testing and genome sequencing. These are vital measures to track for any new variants that could act in a different way or lower the effectiveness of vaccines.

India's INSACOG network, which is in charge of genomic surveillance, is being called upon to enhance efforts, especially in clusters such as Kerala, Delhi, and Maharashtra.

The resurgence also places an onus on the community. The public must remain aware of:

Early Signs of COVID-19 Infection In 2025

• Getting vaccinated or boosted, especially for those over 60 or with existing health issues
• Doctors also advise basic precautionary steps, such as:
• Wearing masks in crowded indoor settings
• Maintaining hand hygiene
• Avoiding unnecessary travel if unwell

These small but efficacious steps can come a long way in checking further transmission and safeguarding the vulnerable.

This recent increase in COVID-19 infections and deaths is a reminder, not an alarm call. Unlike the first three waves, India today is better prepared with medical facilities, public awareness, and vaccination access but preparedness does not nullify responsibility.

The Australia’s Therapeutic Goods Administration (TGA) has approved the use of tirzepatide, a powerful weight-loss injection for the treatment of obstructive sleep apnoea (OSA) in adults living with obesity.

Known commercially as Mounjaro, this glucagon-like peptide-1 (GLP-1) receptor agonist was initially developed to manage type 2 diabetes. Its subsequent approval for chronic weight management had already positioned it as a frontrunner in the global anti-obesity arsenal. Now, with its newest indication, Mounjaro becomes the first drug officially approved to treat OSA in people with obesity a significant advancement in both sleep medicine and obesity care.

Obstructive sleep apnea affects nearly 1 billion adults globally and is estimated to impact more than 780,000 Australian adults alone. In the United States, the National Sleep Foundation estimates that around 25 million adults suffer from OSA — many undiagnosed.

The disorder occurs when the muscles in the throat relax excessively during sleep, blocking the upper airway and causing breathing to stop and start repeatedly. These interruptions often result in loud snoring, choking sensations, disrupted sleep, and serious daytime fatigue.

More than just an inconvenience untreated OSA has been linked to high blood pressure, stroke, heart disease, type 2 diabetes and even cognitive decline. Yet, traditional treatments like CPAP (continuous positive airway pressure) machines and lifestyle changes have been plagued by poor compliance and limited long-term success.

Mounjaro’s New Role in Sleep Apnea Management

The latest decision by the TGA adds Mounjaro to the small list of pharmacological tools available to combat OSA — but with a twist. The medication doesn’t directly address the mechanics of airway collapse, but instead reduces excess body fat, particularly around the neck, chest, and abdomen, that contributes to upper airway obstruction.

This indirect yet impactful approach leverages Mounjaro’s proven efficacy in promoting substantial weight loss, making it particularly relevant to the subset of OSA patients who also struggle with obesity (defined as a BMI of 30 or higher).

“Losing weight has long been shown to improve obstructive sleep apnea, and this new indication gives patients a clinically backed tool to help them get there,” says Professor Nick Zwar, a GP and sleep health researcher in Australia.

Importance of Lifestyle Change to Treat Sleep Apnea

Experts are cautiously optimistic. While Mounjaro’s new approval represents progress, it’s not a cure-all.

“Weight-loss drugs like Mounjaro can be life-changing, but they are not substitutes for long-term lifestyle change,” Professor Zwar emphasized. “Patients must still commit to sustainable dietary habits and physical activity to maintain their progress and prevent relapse if they discontinue medication.”

This view is echoed by Dr. Moira Junge, CEO of the Sleep Health Foundation, who noted that many individuals with OSA suffer in silence due to limited treatment options. “A pharmacological approach provides hope, especially for those who have struggled with weight loss and CPAP adherence,” she said.

Who Can Take Mounjaro for Sleep Apnea?

As per the TGA’s updated guidance, Mounjaro is now approved for use in adults with moderate-to-severe obstructive sleep apnea and a BMI of 30 or more. It is not indicated for patients with mild OSA nor for children or adolescents under 18.

It cannot be prescribed to individuals with type 1 diabetes, and caution is advised in people with a history of pancreatitis, thyroid tumors, or severe gastrointestinal issues.

How Much Does It Cost?

Despite the excitement surrounding its approval, access remains a challenge. Mounjaro is currently not subsidized under the Pharmaceutical Benefits Scheme (PBS) in Australia and remains available only via private prescription.

The starting monthly cost of the initiation dose is approximately $395 USD, a figure that could place it out of reach for many potential users particularly those from lower socioeconomic backgrounds.

In the U.S., where off-label prescription practices are more flexible, it’s anticipated that sleep specialists and primary care doctors may begin evaluating its relevance for similar patient populations, especially as more data becomes available.

What Are the Known Side Effects?

No medication comes without risks and Mounjaro is no exception. While most people tolerate it well, common side effects include:

• Nausea
• Upset stomach
• Constipation or diarrhea
• Low blood sugar (especially when used with other diabetes medications)
• Injection site discomfort

These side effects often diminish over time but serious reactions, although rare, can occur. These include pancreatitis, gallbladder disease, and potential thyroid tumor risks. Hence, it’s critical that the drug be prescribed and monitored by a qualified healthcare professional.

This approval highlights a major global trend of the intersection of metabolic health and sleep health and how it is becoming increasingly relevant. With rising rates of obesity, diabetes, and sedentary lifestyles worldwide, the demand for integrated, accessible treatment solutions has never been greater.

Although the TGA’s decision currently applies only to Australia, it could influence regulatory bodies in the U.S., Europe, and other parts of the world to consider similar approvals. Already, sleep and obesity researchers across the globe are taking note of this development as a potential shift in OSA treatment paradigms.

For millions battling the exhausting cycle of sleep apnea and obesity, this new use for Mounjaro could be a life saver provided it is prescribed responsibly, accessed affordably, and used as part of a long-term wellness plan.