Is there a new pandemic lingering over us? Is Japan at the brink of declaring a health epidemic? After the COVID-19 pandemic, this question has been looming over everyone for a while now. However, it is an undeniable fact that with climate change, illness are now staying all round the year, talking about the COVID-19 virus specifically, it too has now become a seasonal-like virus. However amid this, Japan has declared a nationwide flu outbreak, which has a high rise in hospitalization, school closures and has left public healthcare system under a lot of pressure.

What Is Happening In Japan?

As per the media reports in Japan, the Health Ministry has confirmed the national average has surpassed the epidemic threshold reaching 1.04 patients per medical institution.

Typically, Japan's flu season is in late November or December, however, this year, it seems to have arrived sooner.

The Health Ministry also noted on October 3 that more than 4,000 people have been hospitalized with influenza and that there was a four-fold increase seen in Japan in the previous week. As of now, 28 of the 47 prefectures in Japan has reporting rise in cases, especially in Tokyo, Okinawa and Kagoshima. It has forced over 130 schools and childcare centers to close. Okinawa reported the highest numbers.

Read: Covid, Cold, Or Flu: How To Differentiate Between These Infections?

Is The Flu Happening Only In Japan?

Similar trends have been reported in Singapore, Thailand, and India. In northern India, the H3N2 strain—descended from the 1968 Hong Kong flu virus, has been spreading, while Thailand recorded more than half a million flu cases this year with 59 deaths. Singapore also saw a steady rise in flu and respiratory infections as inter-monsoon rains forced people indoors.

Climate Change Could Lead To Virus' New Variant

Experts suggest that changes in weather patterns, global travel, and evolving viral strains could be contributing to these early and frequent outbreaks. Warmer climates and extreme weather may be influencing how and when flu viruses spread, with studies hinting that heavy rainfall and higher humidity could drive people indoors, creating ideal conditions for transmission. Climate change could also affect virus survival and migration patterns of wild birds, further influencing outbreaks.

The World Health Organization’s (WHO) latest vaccine guidelines for the Southern Hemisphere introduced new H1N1 and H3N2 strains, indicating that mutated versions are circulating. Experts are particularly monitoring subtypes like H5, H7, and H9 in animals, as new strains could potentially trigger another pandemic similar to the 1957 H2N2 “Asian Flu.” The recent detection of bird flu strains in mammals has raised further concerns about possible cross-species mutations.

While there’s no evidence that influenza viruses are mutating faster than before, experts agree the virus continues to evolve in ways that challenge immunity from previous infections or vaccines. Regular flu vaccination remains the best defense, especially for the elderly and vulnerable. Experts also stress the need for better awareness, improved hygiene practices, and policies that discourage working while sick. A universal flu vaccine that covers multiple strains could offer a long-term solution—but it’s still in development.

Vaccine safety, a debate the Trump administration just cannot let go. Once again, the same debate is stirring up, and this time an internal Food and Drug Administration memo that The New York Times obtained has linked death of at least 10 children to the COVID vaccine. While the document has not been released publicly, it has already caused controversy and prompted talk of tighter regulations.

The New York Times however reports that the memo did not include essential such as the ages of the affected children, any underlying health conditions, or how the agency reached its conclusions. It also did not identify which manufacturers’ vaccines were involved. Since the findings have not been published in a peer-reviewed journal, many critics of Health Secretary Robert F. Kennedy Jr. have raised concerns about the accuracy and timing of the claims. Kennedy has long questioned the safety of Covid shots, even as scientific consensus maintains that vaccines are safe and have saved countless lives.

So, What Does The Memo Say About Vaccination And Death Of Children?

Dr Vinay Prasad, who is the head of FDA's vaccine division wrote the memo based on the findings of a review of reports that suggested that the deaths were linked to myocarditis, which is a rare inflammation of the heart muscle.

But, what does the science say? Scientists have studied the connection between Covid vaccines and myocarditis for years, especially among teenage boys and young men. Most studies have shown that the condition is rare and usually resolves quickly.

Even so, Dr Prasad wrote to staff that the memo marked the first time the FDA would acknowledge that Covid vaccines may have played a role in the deaths of American children. He indicated that he would propose several new oversight measures. It is unclear whether the White House had been briefed on these plans or how closely officials would follow them. When The New York Times reached out to Department of Health and Human Services for a comment, the request was declined.

A Shift In Vaccine Policy

This memo comes at the time when the administration has already taken a more cautious stance on vaccines. Kennedy's team has already introduced new limits on who can or cannot receive COVID shots. The shot has now been restricted to people over 65 and younger individuals with medical vulnerabilities. Officials have also called for renewed studies on long-established vaccines that have been considered safe for decades.

Public health experts from previous administrations have warned that casting doubt on vaccines could have serious consequences. Covid has killed more than a million Americans, including about 2,100 children. Experts note that many more lives were saved because vaccines became widely available.

What Are The Experts Saying?

The memo appeared just before a significant upcoming meeting of the CDC’s vaccine committee, which now includes members known for supporting the medical freedom movement. Michael Osterholm, an infectious disease specialist, said the timing did not seem accidental and called the release “irresponsible.”

Other experts expressed concern that the memo lacked important context. Dr. Paul Offit of the Children’s Hospital of Philadelphia pointed out that myocarditis from Covid infection itself has been far more severe than the rare cases linked to vaccines.

Dr. Prasad also criticized previous mandates for school and workplace vaccination, claiming they pressured people into receiving shots that might pose risks. His memo ended by addressing internal disagreements within the agency and outlining how staff should resign if they oppose the new direction.

Delhi woke up to a slightly lower levels of AQI on Sunday Morning, November 30, as city's AQI dropped to 269 at 7am down from 305, which was recorded at 4pm on Saturday. This now falls under the "poor" category. However, experts say that the relief is temporary.

Many health experts and those who have studied the impact of pollution on humans have pointed out that anything above 300 is harmful to humans. These harms are not just limited to respiratory illnesses, and to lungs, causing lung cancers, but can also be the reason why obesity is on the rise.

Can Air Pollution Cause Obesity?

As per a 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.

The 2021 study also revealed that increase in air pollution, and road traffic noise was also associated with childhood obesity.

Also Read: 'Facing Breathing Issues After Morning Walk' Says CJI Surya Kant As Delhi's Toxic Air Worsens

Another 2011 study titled The influence of air pollution on cardiovascular and pulmonary function and exercise capacity: Canadian Health Measures Survey (CHMS), found that air pollutants may indirectly impact body weight by raising the risk of chronic conditions like blood pressure, heart diseases or lung diseases. "Exposure to higher concentrations of air pollution was associated with higher resting blood pressure and lower ventilatory function. Ozone was associated with reduced exercise capacity," researchers of the study wrote.

The latest study published in 2024 titled The association between air pollution and obesity: an umbrella review of meta-analyses and systematic reviews, found that air pollution can impact metabolic function by influencing inflammation in fat tissue. It leads to an increase in oxidative stress and alters one's dietary habits.

Pollution And Women's Health

This does not end here, air pollution could also negatively impact women. As Dr Anuradha Kapur, Principal Director (Obstetrics & Gynaecology) and Head of Unit, Max Smart Super Speciality Hospital, Saket says, "Environmental pollutants, such as pesticides and microplastics, can affect reproductive health and hormone regulation, potentially impacting menstrual cycles."

Dr Sonam Simpatwar, Gynaecologist with a diploma in reproductive medicine, practising at Central Railway Hospital, Mumbai further explained how pollutants impact women's health:

Endocrine Disruptors: Chemicals found in pollution, plastics, and pesticides can mimic or interfere with hormones, potentially affecting menstrual cycles.

Climate Change: Rising temperatures, extreme weather events, and changes in water quality can impact food production, nutrition, and overall health, which can indirectly affect menstrual health.

Stress: Environmental stressors, such as pollution and climate change, can lead to increased stress, which is known to influence menstrual cycles.

"It's important to note that these are potential factors, and more research is needed to fully understand their impact on menstrual health," she said.

High levels of low-density lipoprotein cholesterol (LDL-C), commonly called "bad" cholesterol, continue to be a leading modifiable risk factor for atherosclerotic cardiovascular disease (ASCVD) worldwide. While statins and other cholesterol-lowering medications have significantly improved treatment, many patients still do not reach the LDL-C targets recommended by guidelines.

However, a new potential solution has emerged. The experimental daily oral drug called enlicitide, part of the PCSK9 inhibitor class, demonstrated in a key Phase 3 study (CORALreef Lipids) a reduction in LDL-C of about 55.8% at 24 weeks, with post-hoc analysis suggesting reductions up to 59.7% compared to a placebo.

Statins Vs Enlicitide

Statins are the standard first-line treatment for high LDL-C and have strong evidence for lowering the risk of cardiovascular events. Yet, many patients either cannot tolerate high doses or still have elevated cholesterol levels. Injectable PCSK9 inhibitors, which are monoclonal antibodies, address this gap and can lower LDL-C by up to 70% but are expensive, require injections, and have limited uptake.

Introducing an oral PCSK9 inhibitor could make powerful LDL-C reduction more accessible. According to trial data, enlicitide may achieve reductions similar to injectable options while being more convenient and potentially more widely available.

Enlicitide: A Potential Breakthrough for "Bad" Cholesterol

The CORALreef Lipids Phase 3 study involved 2,912 adults at risk of or with established ASCVD who were either already on lipid-lowering therapy or unable to take statins. Participants were randomly assigned to receive a daily 20 mg dose of oral enlicitide or a placebo. At 24 weeks, the main analysis showed an average LDL-C reduction of 55.8%, with a post-hoc reanalysis estimating 59.7%. The drug’s safety profile was similar to placebo, with no major safety concerns reported and low rates of discontinuation due to adverse effects.

Enlicitide Implications: What Does This Mean Clinically?

These reductions are substantial, suggesting oral enlicitide could:

• Improve adherence since it eliminates the need for injections
• Increase access, particularly in resource-limited areas
• Provide an alternative for patients intolerant or resistant to statins

In India, where ASCVD prevalence is high and expensive therapies are less accessible, this pill could provide a practical, scalable option alongside diet, exercise, and current statin or ezetimibe treatments.

Enlicitide Caveats: Unanswered Questions To Be Mindful Of

Despite the promising LDL-C reductions, several key issues remain:

• Cardiovascular outcomes: It is not yet confirmed whether enlicitide lowers heart attacks, strokes, or mortality. Current data focus on cholesterol reduction, not clinical endpoints.
• Long-term safety: Data beyond 24 weeks and one year is limited.
• Approval and cost: Enlicitide is still investigational and not available for regular use. Regulatory approvals, like FDA evaluation, will review full data. Its real-world adoption in India will depend on cost and accessibility.
• Patient selection and combination therapy: How enlicitide will be integrated with existing statins, ezetimibe, and lifestyle interventions is still under review. Guidelines may require updating.
• Sub-group efficacy: Will results apply across different ethnicities, comorbidities, and specifically the Indian population? Local data will be important.

The investigational oral pill enlicitide could represent a major advance in cholesterol management. For patients whose LDL-C remains high despite statins, or who cannot tolerate injections, it offers a potent and convenient alternative. Yet, medicine requires caution.

Disclaimer: This content is for general informational purposes only and is not a substitute for professional medical advice. Always consult a doctor or specialist before starting or changing any medication