There's been an alarming increase of respiratory and gastrointestinal viruses in the United States lately, causing anxiety about a so-called "quad-demic". According to surveillance reports, influenza, COVID-19, RSV and norovirus are at very high levels everywhere. While the surge aligns with patterns typical for this season, several epidemiologists view simultaneous infections of such proportions to pose risks not only to individual healthcare but public health.

The incidence of the quad-demic should vary with seasonal patterns, vaccination rates, and public health interventions. Each virus alone is relatively easy to manage; however, the effect of all together could lead to overburdening of health care facilities and increase risks for those at higher risk. Continuing surveillance, early testing, and proactive prevention measures will play an important role in the control of these infections going forward.

While the term "quad-demic" sounds daunting, it must be taken into perspective. For years, we have had all these viruses together, and we have the capabilities to mitigate some of the risk. Vaccination, proper hygiene and using common sense helps individuals get through the season unscathed. Is the quad-demic a permanent fixture or just another seasonal wave? Let's break this down.

What is the Quad-demic?

Typically, flu, COVID-19, and RSV have been the primary culprits behind seasonal respiratory infections. However, norovirus, a highly contagious stomach bug, has emerged as a fourth significant player, inducing fears of a more severe and widespread viral outbreak. According to the Centers for Disease Control and Prevention (CDC), the U.S. recorded nearly 500 norovirus outbreaks between August and December 2023, a substantial rise from the previous year’s numbers.

While the term "quad-demic" may sound ominous, the seriousness and consequences of such infections should be weighed in light of the U.S. healthcare system's experience with managing viral surges since the start of the COVID-19 pandemic.

1. Influenza (Flu)

Flu continues to be one of the most common and alarming seasonal illnesses. In the period spanning from 2023 to 2024, there were approximately 40 million cases of flu, and thousands of hospitalizations along with reported 47 deaths have been reported this season. Flu symptoms include fever, chills, cough, sore throat, muscle pain, and fatigue, with most recovering within a week or two but risky factors for severe illness effects occur in young children, elderly, and people with chronic conditions.

2. Covid-19

Despite its reduction from the first pandemic peak, COVID-19 is still rampant. The CDC estimates that alone between October and December 2023, there were between 2.7 and 5 million cases in the U.S. Hospitalization has increased by cities such as Los Angeles, Chicago, and New York. Symptoms are closely similar to the flu, fever, cough, and fatigue but uniquely presents in some cases as loss of taste and smell.

3. RSV

RSV is the most common cause of lower respiratory infections in infants, older adults, and immunocompromised individuals. While RSV peaked late in 2023 and early 2024, it continues to be a threat because it can lead to bronchiolitis and pneumonia. It is very similar to the common cold, presenting with symptoms such as congestion, runny nose, coughing, and fever, which can make it difficult to differentiate from flu or COVID-19 without testing.

4. Norovirus

Norovirus, also called the "stomach flu," is a highly contagious infection of the gastrointestinal tract, not a respiratory virus. It transmits quickly from contaminated food and water and contact with contaminated surfaces, causing such symptoms as diarrhea, vomiting, nausea, and stomach pain. Cases have shot up, the CDC said Monday, with reports of outbreaks surging compared with last year.

Is There a Challenge In Diagnosis Due to Overlapping Symptoms?

The greatest challenge during the quad-demic is how the four viruses are alike and thus make identification very hard with no testing applied. Most cases present symptoms common to all viruses: fever, tiredness, body pains, and respiratory, which includes coughing and congestions for influenza, COVID-19, and RSV; the other would be norovirus symptoms as nausea and vomiting can appear even in extreme influenza and COVID-19. This overlap increases the risk of misdiagnosis and delayed treatment, hence the need for early testing and proper medical guidance.

Also Read: Is US Preparing For A Quad- demic 2025?

Effective Prevention Strategies That Work

The best defense against these viruses is a combination of vaccines, hygiene, and lifestyle precautions. While lifestyle modifications are highlighted as part of the constant need to eat healthy, ensure daily movement and drinking adequate amount of fluids. There is a sure short two preventive strategies that are effective:

Vaccination

• Flu vaccine: Annual flu shots reduce the severity of infection, allergic flare ups and hospitalizations.
• COVID-19 vaccine: Though COVID-19 cases have declined, vaccination remains critical in preventing severe outcomes.
• RSV vaccine: Available for those aged 60 years and older, especially those with underlying conditions.
• Norovirus vaccine: No vaccine is yet available, but mRNA vaccine research is in progress.

Hygiene and Sanitation

• Washing hands frequently with soap and water for at least 20 seconds, especially after public exposure.
• Disinfect frequently touched surfaces regularly, use sanitiser when outside.
• Avoid close contact with infected people and wear masks.

Do You Need To Wear A Mask All The Time?

While debates on masked wear continue on, experts on mask-wear affirm that this does not only have a historical precedent but works towards reducing airborne viruses spreading within the environments. Hospitals, though, ensure masking in key sections of themselves. Publicized mask-wear remains a discretion, though massing indoors still goes a longer way in cases like peak flu seasons.

If you notice the symptoms of these viruses, then it's best to be confined at home and avoid having face-to-face interaction with others and seek immediate attention from your physician if your condition worsens. Quarantining for some days can decrease the spread of infection.

As we move into the first half of 2025 and beyond, staying informed and proactive is the best strategy for maintaining health and avoiding unnecessary panic. The key takeaway? Stay vigilant, but don’t be alarmed—these viruses are here, but so are the means to fight them.

The Punjab and Haryana High Court, after 19 years, has finally ended the case of medical reimbursement of heart surgery from a non-empanelled hospital. The surgery happened in 2002. This was a government school teacher, Bhupinder Singh, from Government Elementary School, Phus Mandi, Mansa, who had undergone coronary artery bypass surgery at Escorts Heart Institute and Research Centre in Delhi. The bill was of Rs. 2,20,677 and Rs 11,000 during his admission from November 18 to 30 that year.

Justice Sudeepti Sharma dismissed the earlier regular second appear filed by the State of Punjab, upholding the 2006 order of district judge, Mansa, that allowed the reimbursement.

The court observed that Singh was referred to the hospital through official government channels after an angiography showed serious cardiac issues. It also noted that Escorts Heart Institute was a recognized center for open-heart surgery under a 1991 Punjab government notification, along with Christian Medical College, Ludhiana, and Apollo Hospital, Madras.

Read: Supreme Court Steps In For 31-year-old's Passive Euthanasia Plea Who Has Been In Vegetative State For 10 Years

The Cycle Of Reimbursement Finally Ends

The judgment referred to official records showing that the referral was made by the Punjab Health Systems Corporation because of the patient’s critical condition. It also relied on a 1995 government instruction stating that prior approval from a medical board is not required in life-threatening emergencies.

The court came down strongly on the delay in deciding the case, expressing anguish over the 19-year wait. The judge noted that reimbursement matters should be settled promptly, pointing out that the patient had been pursuing his claim since 2002, only for it to take nearly two decades to reach a decision.

Justice Sharma noted: “The government should be liberal in framing the policies for medical treatment and reimbursement since a person in pain is not expected to choose the hospital and would prefer the nearest one only.”

Read: Andhra Pradesh May Ban Social Media for Under-16s To Protect Teenagers

One More Medical Expense Case Allowed

In another news, in the case of another government employee asking for reimbursement from a non-panelled hospital, the Punjab and Haryana high Court under the judgment directed the Haryana Government to reimburse the remaining medical expenses of a government employee incurred for the emergency treatment of his wife, in a non-empanelled private hospital. Justice Sandeep Moudgil said that the denial of reimbursement without reasons is arbitrary and violative of the right to life under Article 21 of the Constitution.

Read: Delhi High Court Permits JNTL to Sell ₹180-Crore ORSL Stock Despite FSSAI Dispute

The court also found a violation of Article 14. It stated that such rigid application or procedural during a pandemic is arbitrary and unequal treatment. The petition was filed by CRPF personnel Balhar Singh, who is seeking the reimbursement for his wife's medical treatment, which were rejected on technical grounds during the COVID-19 pandemic. Singh began his wife's treatment at an empanelled CGHS hospital in Chandigarh, with limited facility, however, he was compelled to seek further cardiac care at a private hospital with better facilities.

"The medical records established that both the petitioner and his wife faced urgent cardiac emergencies, making the treatment unavoidable. The repeated rejection of the petitioner and his wife's medical reimbursement claims during the COVID-19 pandemic amounts to a clear violation of constitutional rights."

Andy Kershaw, the legendary Radio 1 DJ is diagnosed with cancer that has left him "unable to walk". Now 66, Kershaw revealed that tumors found in his spine back in August 2025 has left him unable to walk. He, however joked, as Daily Star reported, "I am determined not to die before Benjamin Netanyahu, Vladimir Putin, Donald Trump and Ant n Dec. That should keep me going for a while."

Kershaw's friend Peter Everett said, "My friend Andy has been going through a difficult time. Last August he was diagnosed with cancer, mainly affecting his spine and making him unable to walk. Since then he has been undergoing treatment, including chemotherapy, radiotherapy, physiotherapy and a lot of scans and painkillers. Although we have not been able to put together any podcasts in the last six months, we are very grateful to all the patrons and supporters who have stuck with us."

Andy Kershaw Diagnosis: What Are Spinal Tumors?

A spinal tumor is an abnormal growth of cells within or surrounding your spinal cord. Spine is a long flexible column of bones that protects the spinal cord. Usually the spinal tumors are located inside of the spinal cord, in the tissues that cover spinal cord, between the tissues and bones of spine, or in the bone vertebrae of spine.

Tumors that develop on spine are called spinal tumors. Most spinal tumors result from cancer metastasis, which means the cancer has spread from another area of your body to your spine. However, Kershaw has not clarified how his tumor was detected and whether it has spread from another cancer in the body.

Spinal Cancer: Malignant Tumors of the Spine

Most spinal cancers develop within the spinal column itself and do not directly involve the spinal cord. Several types of cancer can affect the spine, either by starting there or spreading from other parts of the body. These include:

Osteosarcoma: A form of bone cancer that can originate in the spine, though it is more commonly found in the long bones of the legs, such as the thigh and shin.

Chondrosarcoma: This cancer begins in cartilage cells surrounding the bone. While it is rare in the spine, it can sometimes arise as a primary tumor in the bones that make up the spinal column.

Multiple myeloma: A blood cancer that affects plasma cells. These abnormal cells accumulate in the bone marrow and the outer layer of bones, with the spine being a frequent site of involvement.

Lymphoma: A group of cancers that affect lymphocytes, which are key cells of the immune system. Lymphoma can develop in the spine as a primary tumor, but more often it starts elsewhere in the body and later spreads to the spine.

Chordoma: A rare malignant bone tumor that forms within the spinal column. It can occur anywhere along the spine but is most commonly diagnosed in the sacrum, the bone at the base of the spine.

Ewing sarcoma: A cancer that affects both bone and surrounding soft tissue. It is uncommon in adults and accounts for roughly one percent of childhood cancers.

Nearly 100 children were harmed by a Great Ormond Street hospital limb reconstruction surgeon, Yaser Jabbar. A London-based children's hospital's internal review published a study that concluded that 94 out of 789 children who were treated by the doctor between 2017 and 2022, came to harm. Of these, 91 were harmed during surgeries he performed. Jabbar specialized in limb-lengthening and complex bone reconstruction procedures for children, many of which are inherently high-risk.

While the hospital said some complications are expected in such procedures, the investigation found that Jabbar’s practice fell below acceptable standards in multiple areas and that this directly contributed to patient harm. Great Ormond Street Hospital said it was deeply sorry for the suffering caused to children and families.

The BBC has attempted to contact Jabbar. He is understood to be living abroad and no longer holds a license to practice medicine in the UK.

Great Ormond Street Hospital: What Did The Report Find?

According to the report, more than a quarter of Jabbar’s surgical patients experienced harm. Thirty-five children suffered severe harm, while another child experienced severe harm unrelated to surgery.

Independent reviewers highlighted a series of troubling patterns. These included premature removal of bone fixation devices, operations carried out without a clear clinical rationale, incorrect placement of pins, and bone cuts made at the wrong anatomical level. The investigation also criticized how complications were identified and managed, suggesting delays and missed warning signs.

While the report stated it could not definitively determine whether every case of harm was avoidable, it concluded that the standard of care was suboptimal in many instances and that this had undoubtedly worsened outcomes for patients.

Nearly 100 Children Harmed: Families Speak Of Lifelong Trauma And Consequences

Although the report did not name individual cases, several families have previously shared their experiences publicly.

One of them is Bunty, a young girl born with a rare bone condition that left her left leg bowed and shorter than the other. She underwent multiple surgeries performed by Jabbar. Eventually, her lower left leg had to be amputated. Her case was classified as moderate harm.

Her father, Dean Stalham, told BBC, that the findings were “too little, too late” and questioned why concerns were not identified earlier. “These problems should have been spotted long before so many children were hurt,” he said.

According to another parent, Lizzie Roberts, as reported in the BBC, her son Tate was left in constant pain after surgery carried out by Jabbar when he was 16. Tate had been injured in a road accident years earlier, and the surgery was meant to address knee problems. Roberts said an operation was also performed on his ankle without consent and without clinical need.

“He is now facing further surgery and has had to drop out of college,” she said. Tate’s case was also classified as moderate harm.

Both families have called for a police investigation. The Metropolitan Police confirmed to the BBC that it would review the findings of the report to decide whether further action is required.

Questions Are Raised Over Hospital Culture

The investigation was launched in 2024, after concerns were raised internally. It followed a review by the Royal College of Surgeons, commissioned by the hospital, which flagged serious issues around working culture. Staff described the environment as toxic and raised concerns about inappropriate and incorrect surgeries being carried out on children.

Although independent clinicians reviewed patient records, Great Ormond Street Hospital collated and published the final findings. NHS England’s London region is now conducting a separate review into how the hospital handled the case.

The trust said it had already implemented recommendations from the Royal College of Surgeons, including better training on complaints handling, increased whistle-blowing support, and mandatory discussions of the most complex cases with the National Royal Orthopedic Hospital.

However, questions remain. Surgeon Sarah McMahon, who worked in the same service as Jabbar, reportedly raised concerns with hospital management in autumn 2021. According to a statement in Parliament by Dame Meg Hillier, no action was taken at the time.

'Bleakest Day' For Hospital

Great Ormond Street Hospital chief executive Matthew Shaw described the publication of the report as the bleakest day in the hospital’s history. He apologized unreservedly to affected families and said the trust acted quickly once formal concerns were raised in June 2022.

Shaw also pointed to the challenges of monitoring highly specialized surgical fields with very few practitioners nationwide. Still, he said transparency was essential.

“By publishing these findings, we hope to begin rebuilding trust with families,” he said. “They rely on us at the most vulnerable moments of their children’s lives.”