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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.
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.
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.
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.
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.
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.
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?
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:
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.
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BBC presenter Lauren Laverne has revealed that she has been diagnosed with smoldering myeloma — a blood and bone marrow disorder that currently has no cure.
The chronic condition was discovered by her doctor nearly two years after Laverne recovered from cancer in August 2024. Laverne has not publicly disclosed the exact type of cancer she was treated for.
Taking to Instagram, the 48-year-old TV presenter shared her health update, telling followers that she has been diagnosed with a "chronic condition."
"I’ve been diagnosed with something called smoldering myeloma (yes, that is a weird name and no, I’d never heard of it either)," she wrote. "It’s an asymptomatic blood and bone marrow disorder that in some people can develop into blood cancer."
Stating that her risk "is pretty low," Laverne explained that she does not need treatment at the moment. However, she noted that there is currently no cure and that her immune system is "a bit compromised."
She also clarified that the diagnosis "has nothing to do with my previous illness or my recent surgery, it’s just one of those things."
Also read: Cancer Kills Over 26,000 Daily; Cases to Hit 35 Million by 2050, Says WHO Report
Because of the diagnosis, Laverne said she will be closely monitored with blood tests, MRIs, and bone marrow biopsies, which she joked she has "recently discovered are even less fun than they sound."
She revealed that the condition was identified after her GP noticed she had "persistently low iron levels."
"I've had some difficult experiences in the last eight years, but I have learned more from them than some people do in a lifetime and that is helping me right now. I am so grateful for that," she said.
Laverne also thanked her family, friends, doctors, consultants, nurses, and her team at BBC Radio 6 Music. Many of her fellow TV and radio personalities shared messages of support following her announcement.
According to Blood Cancer UK, "Smoldering myeloma is the name given to myeloma that has no symptoms or signs of damage to your organs."
Myeloma is a type of blood cancer that affects plasma cells in the bone marrow. Smoldering myeloma is an inactive, early form of the disease that does not cause symptoms or organ damage.
The charity says that people with smoldering myeloma usually do not need treatment right away. Instead, they undergo regular checkups so doctors can monitor whether the condition is progressing to active myeloma.
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According to the International Myeloma Foundation, smoldering multiple myeloma (SMM) is an asymptomatic precursor stage of multiple myeloma (MM). While both conditions involve abnormal plasma cells, people with SMM have no symptoms or end-organ damage and are typically monitored rather than treated.
The disease generally progresses through precursor stages:
People with smoldering myeloma are generally managed through active surveillance, with regular blood tests, imaging scans, and other monitoring to detect any signs that the disease is becoming active. Active monitoring is considered a safe approach for most patients.
Doctors may recommend treatment in certain situations, including:
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Healthcare in India is no longer a privilege but is steadily becoming a right, said Prime Minister Narendra Modi today while highlighting the government's efforts to expand affordable medical care, strengthen health infrastructure and improve access to treatment across the country.
Speaking at the foundation stone laying ceremony and launching development projects worth over ₹4,700 crore in Chandigarh, spanning healthcare, education and road infrastructure, PM Modi stated that India's healthcare journey has undergone a transformational change over the past 12 years.
The Prime Minister said lower and middle-income families have benefited the most from the country's healthcare transformation.
"Health services in India are no longer a privilege; they are becoming an absolute right," PM Modi said.
Also read: Fourth COVID Death Reported in Andhra Pradesh: Experts Recommend Boosters For High-Risk Groups
In Chandigarh, the Prime Minister announced the expansion of healthcare facilities at the Postgraduate Institute of Medical Education and Research (PGIMER), including a new Neuroscience Centre, a Mother and Child Centre, and a Critical Care Hospital Block, saying the projects will provide better treatment facilities to millions of people.
He also announced the approval of a new MBBS college at PGIMER, saying the expansion of medical colleges and postgraduate seats will help address the shortage of doctors while creating more opportunities for aspiring medical students.
Highlighting the government's investments in healthcare, Modi said India has approved 15 new AIIMS since 2014, established hundreds of new medical colleges and expanded specialty hospitals across the country.
"Since 2014, fifteen new AIIMS have been approved, hundreds of new medical colleges have been established across the country, and specialized hospitals for the treatment of serious diseases such as cancer have been strengthened."
He added that strengthening primary healthcare remains a key priority under the Ayushman Bharat Health Infrastructure Mission.
The Prime Minister said that under the mission, critical care blocks, integrated public health laboratories and public health units have been established across the country. He added that over 1.75 lakh Ayushman Arogya Mandirs are now operational across rural, urban and tribal areas, providing comprehensive primary healthcare services, including twelve healthcare service packages.
He noted that crores of citizens have been screened for hypertension, diabetes and other non-communicable diseases through these centers.
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The Prime Minister highlighted the growing role of digital healthcare, noting that the e-Sanjeevani telemedicine platform has facilitated more than 48 crore consultations, enabling patients in remote areas to access specialist care without travelling long distances.
PM Modi said the healthcare improvements have contributed to better maternal and child health outcomes, with more than 90% of deliveries now taking place in healthcare institutions. He added that maternal mortality has declined by 86%, while infant mortality has also fallen significantly.
The Prime Minister also underlined the government's emphasis on preventive healthcare through initiatives such as the Poshan Abhiyan, Mission Indradhanush, yoga promotion, HPV vaccination and the U-WIN platform.
PM Modi reaffirmed the Government's commitment to eliminating tuberculosis, stating that the TB Mukt Bharat Abhiyan has strengthened awareness, screening and treatment.
He noted that TB treatment coverage in the country has now crossed 90% and, citing a recent World Health Organization (WHO) report, said India has recorded a 21% decline in tuberculosis cases over the past decade.
Recalling India's response during the COVID-19 pandemic, Modi said the country has evolved from a nation once perceived as dependent on external assistance to a global destination for advanced medical treatment.
He attributed the transformation to sustained investments in healthcare infrastructure and policies aimed at making quality treatment affordable and accessible.
Modi said "India must continue investing in modern healthcare infrastructure and emerging technologies as part of its vision of becoming a developed nation".
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India's southern state of Andhra Pradesh has reported four COVID-19 deaths amid a rise in infections, prompting experts to reiterate the importance of booster vaccination for older adults and people at high risk of severe disease.
While sporadic COVID-19 cases have continued to be reported across the country, fatalities have remained relatively uncommon. Health experts say the current situation does not resemble previous pandemic waves, but immunity from earlier vaccinations has waned, making booster doses important for vulnerable groups.
In an official statement, Andhra Pradesh Health Commissioner G. Veerapandian said that 12 people tested positive for COVID-19 across the state between June 26 and July 16. Of these, four patients with multiple comorbidities died.
The deceased had underlying conditions including hypertension, diabetes, kidney disease, and other serious illnesses.
Although cases have increased in a few states and cities, hospitals are not experiencing the overwhelming admissions, oxygen shortages, or healthcare burden seen during earlier waves.
Also read: Omicron Sub-Lineages Likely Behind COVID Surge In India: Why Deaths Are Occurring
Experts say that while most current infections are mild, severe illness remains more likely in:
Read More: COVID Spikes In India: Experts Allay Fears, Stress Vaccination And Masks
Speaking to HealthandMe, Dr. Atul Kakar, Chairperson, Internal Medicine, Sir Ganga Ram Hospital, said booster doses remain advisable for people at highest risk.
"COVID vaccines are now again recommended, especially for the elderly population, particularly those of advanced age or who are immunocompromised. It is a voluntary vaccine that is indicated because immunity from earlier vaccinations has declined."
Dr. Manjeeta Nath Das, Associate Director, Internal Medicine, PB Health, said COVID-19 cases are rising in small pockets, particularly in South India, while immunity from previous vaccination has gradually waned.
"COVID is rising in India, especially in small pockets in South India. So we should all get re-vaccinated. It has been several years since the pandemic, and immunity from previous vaccinations has waned," Das told HealthandMe.
She recommended booster doses for:
She also said eligible people may consider an annual COVID-19 booster as immunity declines over time.
Dr. Kakar added that people with weakened immunity, immunodeficiency, advanced age, and pregnant women are among those who would benefit most from a booster.
Dr. Neha Rastogi, Senior Consultant, Infectious Diseases, Fortis Memorial Research Institute, Gurugram, said booster vaccination should focus on those at the highest risk rather than the general population.
"The focus has shifted from broad herd immunity to priority boosters for the elderly and high-risk groups such as cancer patients, people on dialysis, those with uncontrolled diabetes, patients on steroids, and immunosuppressed individuals."
She told HealthandMe that people who have previously been vaccinated may also consider a heterologous booster—receiving a different COVID-19 vaccine from the one used for their earlier doses—where appropriate and based on medical advice.
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