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.

Danish drugmaker Novo Nordisk has officially introduced its widely known diabetes medication Ozempic in India, pricing the starter dose of 0.25 mg at ₹2,200 per week. According to a Reuters report, the injectable medicine will be available in three strengths in the country: 0.25 mg, 0.5 mg and 1 mg.

Ozempic is a once-weekly injectable prescribed for people living with type 2 diabetes.

Ozempic Price In India

The weekly injection received approval from the US Food and Drug Administration in 2017 for treating type 2 diabetes. Since then, it has grown into a global blockbuster and is also commonly prescribed off-label for weight loss because of its appetite-suppressing effects.

The lowest strength will cost ₹2,200 per week. Prices for the higher doses have also been announced, as per the Reuters report.

Here are the details:

• 1 mg dose: ₹11,175/month
• 0.5 mg dose: ₹10,170/month
• 0.25 mg dose: ₹8,800/month

All you need To know About Ozempic

India’s drug regulator, the Central Drugs Standard Control Organisation (CDSCO), approved Ozempic, also known as semaglutide, in October this year for adults with type 2 diabetes.

As per the US FDA, Ozempic is prescribed along with diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus. It is also indicated to reduce the risk of major cardiovascular events in adults with type 2 diabetes who already have heart disease.

As per NDTV Profit, currently, Wegovy is priced at Rs 2,712 per week for the 0.25 mg dose, while the 0.5 mg dose costs Rs 3,462 weekly. The 1 mg dose is also priced at Rs 3,462 per week, and the 1.7 mg dose is available at Rs 4,100 per week. Mounjaro (tirzepatide), a combination therapy of GLP-1 receptor agonist and GIP that helps improve blood sugar control in adults with type 2 diabetes when paired with a healthy diet and regular exercise, is priced at Rs 13,500 per month for the 2.5 mg dose.

How Does Ozempic Help In Weight Loss?

Ozempic mimics the action of a naturally occurring hormone called GLP-1. Here’s how it supports weight loss, as outlined in an earlier HT report.

• It boosts insulin release when blood sugar levels increase.
• It slows down the emptying of food from the stomach, helping people feel full for longer after meals.
• At higher doses, it can also curb appetite, which may aid weight management efforts.

Possible Side-Effects Of Ozempic

As previously reported by Mayo Clinic, some potential side-effects of Ozempic include:

• An increased risk of inflammation of the pancreas.
• Possible gallbladder-related problems.
• According to the FDA, the most commonly reported side effects, seen in at least 5 per cent of patients taking Ozempic, include nausea, vomiting, diarrhoea, abdominal pain and constipation.

This article is intended for informational purposes only and should not be taken as a replacement for professional medical advice.

Anti-pollution measures under GRAP-3 came into force in Delhi on Saturday as air quality slipped into the “severe” bracket. By noon, the national capital reported an Air Quality Index of 405, according to figures released by the Central Pollution Control Board (CPCB). Earlier in the day, Delhi’s AQI hovered close to 390 during the morning hours.

Delhi Air Quality Hits ‘Severe'

Each winter, Delhi and the surrounding NCR (National Capital Region) bring in curbs under the Graded Response Action Plan, which divides air quality into four levels: Stage 1 (Poor, AQI 201–300), Stage 2 (Very Poor, AQI 301–400), Stage 3 (Severe, AQI 401–450) and Stage 4 (Severe Plus, AQI above 450).

Under GRAP-3, non-essential construction and demolition activities have been halted, along with stone crushing and mining operations. The measures also include restrictions on older diesel goods vehicles within Delhi. Schools up to Class 5 are required to move to a hybrid learning model, while offices across Delhi-NCR may function with only 50 per cent staff strength, as per Press Information Bureau.

Hazardous AQI levels have become a recurring feature across several parts of Delhi during the winter months. Quoting environmental experts, an IANS report linked the sharp decline in air quality to a mix of stagnant wind conditions, vehicle emissions, industrial pollution and seasonal factors such as crop residue burning in neighbouring states.

What Changed in GRAP?

The biggest shift under the updated GRAP framework is that stricter steps will now come into force earlier, instead of waiting for air quality to deteriorate further.

As per Press Information Bureau, under the revised system, measures that were earlier reserved for Stage 4 will now apply at Stage 3 itself. This means that once the AQI reaches the 301–400 range, public, municipal and private offices will function with only 50 percent staff. Central government offices will also move to work-from-home at this stage, rather than waiting for the AQI to cross 450.

In the same way, actions that earlier fell under Stage 3 have now been pushed to Stage 2. As a result, staggered timings for government offices will begin as soon as the AQI enters the 201–300 category.

Stage 2 measures have also been advanced to Stage 1. This brings uninterrupted power supply arrangements into effect earlier, at an AQI level of 101–200, to reduce the need for diesel generator use and limit additional emissions.

Delhi AQI: GRAP Stage 3 Restrictions Announced

In response to the worsening situation, the Delhi government confirmed that the Commission for Air Quality Management (CAQM) has activated all measures under Stage III of GRAP, which falls under the “Severe” air quality category with AQI levels between 401 and 450, across the entire NCR.

These Stage 3 curbs will apply in addition to the existing Stage I and Stage II measures. Authorities, including NCR Pollution Control Boards, have been instructed to step up enforcement to prevent further deterioration of air quality across the region.

• Ban on the transportation of construction materials such as sand and cement, particularly on non-paved roads
• Complete suspension of demolition and construction work unless unavoidable, including earthwork, piling and trenching
• Advisory for private firms to permit work-from-home or hybrid arrangements to reduce traffic-related pollution
• Restrictions on inter-state diesel buses entering or operating within Delhi
• Prohibition on BS-3 petrol and BS-4 diesel four-wheelers in Delhi and nearby NCR districts
• Shutdown of stone crushers, mining operations and hot-mix plants that do not run on clean fuel
• Ban on the use of diesel generator sets, except for emergency and essential services

GRAP III Imposed in Delhi-NCR: What’s Allowed

Even as Stage III of the Graded Response Action Plan comes into force, certain essential activities and services will continue to operate to minimise disruption to daily life.

• Essential infrastructure and public service projects permitted include:
• Metro, railway, airport, highway, defence, healthcare and sanitation-related projects
• Construction work linked to critical infrastructure, provided strict dust control and proper waste management norms are followed
• Vehicles used by persons with disabilities
• Recommended measures under GRAP III include:
• Greater use of public transport to reduce private vehicle emissions
• Hybrid or online classes for students up to Grade 5 to limit outdoor exposure and traffic movement

The U.S. Food and Drug Administration has cleared an at-home brain stimulation headset developed by Flow Neuroscience to help treat depression, giving patients another option beyond standard antidepressant drugs, which many people struggle to stay on because of long-term side effects, the company announced on Thursday.

Rates of depression in the U.S. have climbed sharply, rising by about 60% over the past ten years and now affecting more than 20 million adults, according to data from the Centers for Disease Control and Prevention.

FDA Approves First At-Home Brain Stimulation Device For Treatment of Depression

The US Food and Drug Administration (FDA) has approved a home-use brain stimulation device designed to treat major depressive disorder in adults. The device, known as FL-100 and made by Flow Neuroscience, is the first at-home treatment of its kind to receive approval in the United States.

The FDA’s decision was supported by results from the Empower phase 2 clinical trial, which found that 58% of participants reached remission after 10 weeks of treatment. Flow Neuroscience also reported that among users worldwide, 77% noticed an improvement in symptoms within three weeks. To date, more than 55,000 patients have used the device in regions including Europe, the UK, Switzerland, and Hong Kong.

Brain Stimulation Device For Depression: How Will The Headset Work?

The prescription device, called FL-100, uses transcranial direct current stimulation to send a mild electrical current to the brain’s prefrontal cortex, an area involved in mood control and stress response. According to Flow, this part of the brain is often less active in people living with depression, a condition that affects over 20 million adults across the U.S.

Flow noted that roughly one in three people with depression does not respond adequately to antidepressant medications, and many others discontinue them because of unwanted side effects.

“Flow’s FDA approval marks a turning point in depression care, representing the first real move away from medication-only treatment toward technology-based therapies with fewer side effects,” said Flow CEO Erin Lee in a statement.

During the study, participants wore the headset for 30 minutes per session while resting, beginning with five sessions a week for the first three weeks, then reducing to three sessions per week for the rest of the trial. The program also included live remote monitoring through video calls.

Researchers observed benefits in patients who were already taking antidepressants for treatment-resistant depression or receiving psychotherapy, as well as in those who were not using medication at all.

“Among people using Flow in real-world settings, 77% report feeling better in as little as three weeks,” said Kultar Garcha, M.D., chief medical officer at Flow. “A treatment that was once limited to clinics can now be used at home, offering a practical way to widen access to effective depression care.”

Flow said it plans to launch the headset commercially in the U.S. in the second quarter of next year and intends to explore its potential use for conditions such as traumatic brain injury, addiction, and sleep disorders.

“We want Flow to become part of the standard pathway for treating depression,” Lee said. “Our focus is clear: to help as many people as possible reach remission and regain their quality of life.”