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.

Two experimental heart drugs developed by Novartis and Novo Nordisk have failed to reduce major cardiovascular events in separate late-stage trials, despite successfully targeting cholesterol and inflammation.

Novartis' pelacarsen lowered lipoprotein(a), or Lp(a), by 78%, while Novo Nordisk's ziltivekimab substantially reduced inflammatory markers. However, neither drug reduced heart attacks, strokes or cardiovascular deaths compared with a placebo.

"Everybody in the world, me included, thought that this was going to work," said Dr. Steven Nissen of Cleveland Clinic, presenting the pelacarsen results at the American Heart Association's Scientific Sessions 2026.

Novartis' Pelacarsen Fails To Reduce Heart Events

Also read: Confused By Your Cholesterol Report? Here's What LDL And ApoB Really Mean

The seven-year Phase III Lp(a) HORIZON trial involved 8,323 people with established cardiovascular disease and elevated Lp(a) levels across 42 countries.

Participants received monthly injections of pelacarsen or a placebo. Despite reducing Lp(a) by 78%, the drug did not lower the risk of non-fatal heart attacks, strokes, urgent procedures to unblock arteries or cardiovascular deaths.

Even participants with higher Lp(a) levels showed no cardiovascular benefit.

"I cannot avoid the disappointing conclusion – it didn’t work," Nissen said, adding that cardiovascular outcomes remained unchanged despite the significant reduction in Lp(a).

Novo Nordisk's Ziltivekimab Also Fails

Novo Nordisk's Phase III ZEUS trial tested whether ziltivekimab, an experimental anti-inflammatory drug, could reduce cardiovascular events by blocking interleukin-6 (IL-6).

The trial included 6,376 patients with atherosclerotic cardiovascular disease, chronic kidney disease and systemic inflammation.

In July 2026, Novo announced that the trial had failed to demonstrate a cardiovascular benefit. Results published in the New England Journal of Medicine on November 7 showed that although the drug substantially reduced inflammatory markers, it did not prevent major cardiovascular events.

During a median follow-up of 33 months, cardiovascular death, non-fatal heart attack or non-fatal stroke occurred in 17.6% of patients receiving ziltivekimab and 17.7% receiving placebo.

On September 7, Novo Nordisk discontinued two additional late-stage trials of ziltivekimab in patients with heart failure and inflammation.

An independent data monitoring committee recommended stopping the studies, concluding they were unlikely to succeed.

Read More: This Common Heart Attack Risk Starts Silently In Healthy People In Their 20s

Why Did The Drugs Fail?

Nissen suggested that participants may have had advanced cardiovascular disease, making it too late for the drug to prevent further events.

Dr. Roger Blumenthal of Johns Hopkins suggested that participants' blood pressure and LDL cholesterol were already well controlled, leaving limited scope for additional risk reduction.

Another hypothesis was that anti-clotting medications taken by all participants may have diluted pelacarsen's potential effect, since Lp(a) is thought to contribute to cardiovascular disease partly by promoting blood clots.

These remain hypotheses, not proven explanations.

The findings also do not mean that Lp(a) or inflammation is irrelevant to heart disease. They show that lowering these markers with these particular drugs did not reduce cardiovascular events in the populations studied.

What Happens Next?

People with elevated Lp(a) can manage their cardiovascular risk by addressing other risk factors.

Nissen recommended exercise, weight management and lowering LDL cholesterol with statins when appropriate.

Three other cardiovascular outcome trials involving investigational Lp(a)-lowering drugs are underway. Their results may help determine whether targeting this cholesterol particle can prevent heart attacks and strokes.

Climate change is no longer a distant environmental concern. The effects of increasing temperatures, extreme weather events, melting glaciers, changing rainfall patterns and worsening air pollution on human health are alarming. Countries are continually identifying these health risks but monitoring if their climate policies are actually effective is the big question. This is one of the important areas of discussion at the 31st United Nations Climate Change Conference (COP31), which starts on November 9, 2026 in Antalya, Türkiye.

The World Health Organization (WHO) is stressing upon health to become a central part of climate policy discussions. The health body has urged countries to increase focus on measurable action, healthcare systems that can withstand climate change and funding to execute those actions.

Ahead of the conference, Dr Diarmid Campbell Lendrum, Head of the Climate Change, Energy, and Air Quality Unit at WHO headquarters said, “Health is the strongest argument for climate action."

Countries Need Reliable Health Indicators For Climate Change

Also read: Climate Crisis Is A Health Crisis: Just 6 Actions Could Save 1.6 Million Lives, Says WHO

Climate change has numerous effects on health. Extreme heat can lead to dehydration, heat exhaustion and heatstroke, while floods and droughts can disrupt access to safe drinking water, food and healthcare. Changing temperatures and rainfall patterns can also fuel spread of infectious diseases, including mosquito-borne illnesses.

Air pollution, which is closely linked to the burning of fossil fuels, adds to the burden of respiratory and cardiovascular disease.

However, measuring these effects is not as straightforward as one might think.

An increase in hospital admissions during a heatwave, for instance, could be considered an indicator, but countries also need to monitor who is most affected, whether healthcare facilities can cope and whether preventive measures are working.

A WHO review published in October 2025, Mapping Climate Change and Health Indicators, examined 31 reports from 22 countries. It identified 3,880 indicators being used to assess health risks related to climate change. After removing overlaps and combining similar measures, researchers identified 1,684 unique indicators.

These indicators covered climate hazards, population exposure, vulnerability, health outcomes, the impact on healthcare systems, future risks, and the policies and resources available to address them.

What Will Countries Measure?

Also read: Big Lancet Report: Heat-Related Deaths Rise 36% Since Paris Climate Agreement, Global Warming Blamed

Health indicators can help governments think beyond recording extreme weather events and examine their consequences for public health and healthcare systems. Some of the areas that countries could monitor include:

• Heat-related illness and deaths: Hospital admissions, emergency visits and mortality linked to extreme temperatures.
• Infectious diseases: Changes in the geographical spread of climate-related diseases, including dengue and malaria.
• Food and water security: Malnutrition, food insecurity and illnesses linked with unsafe drinking water.
• Healthcare infrastructure: The number of hospitals vulnerable to floods, heatwaves and other extreme weather events.
• Healthcare preparedness: Availability of early warning systems, emergency response plans, trained health workers and essential emergency medicines.
• Population vulnerability: Health impacts on children, older adults, people with disabilities, outdoor workers and underprivileged communities.

What Is WHO Calling For At COP31?

WHO is using COP31 to push for stronger implementation of existing climate and health commitments. Its priorities include making healthcare systems resilient to climate change, reducing the health sector's environmental footprint and ensuring that health considerations are included in climate policies and financing decisions.

The conference will begin with a dedicated Health Day on November 9, featuring discussions on health technologies related to climate, digital health, humanitarian response and resilient healthcare systems.

WHO's November 2026 briefing estimates that 3.3 to 3.6 billion people live in contexts highly vulnerable to climate change. It also says that scaling up six climate health actions could save 1.6 million lives annually and generate around US$24 in returns for every dollar invested.

Ultimately the challenge for countries is to turn climate and health commitments into measurable improvements. Tracking heat-related deaths, diseases, healthcare preparedness and unequal health impacts can help governments understand where action is working and where gaps remain.

A wearable device developed by Zomato founder Deepinder Goyal has sparked a massive social media debate among doctors over its scientific claims and validity.

Called Temple, the gadget, worn on the forehead, is designed to track physiological signals linked with blood flow in the brain and generate a metric called 'Entropy', which, according to Goyal, is a measure of the body's real-time energy expenditure.

Also Read: Delhi AQI Crosses 2,000 Mark After Diwali: What Happens To Your Body Within Hours Of Exposure?

Priced at Rs 85,000, one of the factors that has sparked arguments, the device is now available pre-orders in India. However, medical experts have questioned whether the technology can accurately measure what it claims to and whether its readings offer meaningful insights into brain health, ageing or longevity.

The controversy intensified after Goyal defended the project against criticism from doctors. In a post on X, he said the development had cost $30 million, including $20 million of his personal money. He also said further research was underway.

“We have a number of new research breakthroughs coming up (especially Entropy), and are validating them as we speak,” Goyal wrote on November 6.

Can Temple Actually Measure Blood Flow To The Brain?

Also read: This Easily Available Nutrient Can Also Slow Down Ageing

One of the main concerns is the device's sensor placement. Temple uses optical sensors based on photoplethysmography (PPG), positioned near the temple. These detect changes in blood flow through superficial blood vessels.

However, the superficial temporal artery supplies blood to the scalp and face. The brain receives its blood supply primarily through the internal carotid and vertebral arteries. A signal detected from a superficial vessel cannot automatically be interpreted as a measurement of blood circulation inside the brain.

Dr. Cyriac Abby Philips, widely known online as The Liver Doc, is one of the many doctors who challenged Goyal's claims about Temple on social media post.

He wrote, "Deepinder's Temple device is very much like Baba Ramdev's Coronil. Only one difference. Former is scienceploitation, latter is pseudoscience and both are harmful in their own ways. Learn to identify a scam and fraud when you see one."

Dr Jason Philip, in an X post, called the research behind the device "pseudoscience". He said that the gravity ageing hypothesis is a flawed concept. Ageing is a result of many factors like metabolic factors, genomic instability, mitochondrial dysfunction, chronic inflammation and more.

Many also slammed Goyal for selling the device without solid research or clinical outcomes.

Dr Rishabh Jain responded to Goyal's post, saying that doctors asking for scientific evidence is a legitimate demand. He also said that Goyal's response to clinical questions are mostly commerce-based and does not "constitute scientific validation".

Dr Kapil Singhal, Director of Neurology at the Institute of Neurosciences, Medanta, Noida, told Mint, “Temple appears to be measuring blood flow in the superficial temporal artery, which supplies blood to the scalp, not the brain. The brain receives blood through the internal carotid and vertebral arteries. These are not the same.”

Dr Praveen Gupta, Chairman of Marengo Asia International Institute of Neuro & Spine, Gurugram, also cautioned against treating a reading from one location as representative of the entire brain.

A device may detect physiological changes near the forehead but establishing that these reflect cerebral blood flow requires comparison with established clinical measurements and independent validation.

What Is Entropy And Why Are Doctors Questioning It?

Also read: Mental Health And Longevity: The Mind-Body Connection To Aging Gracefully

Goyal has described Entropy as a new biomarker that measures how hard the body is working to sustain itself. The score is influenced by factors like sleep, exercise, stress, food and meditation.

However, doctors say that a metric responding to changes in activity does not establish what biological function it measures.

Neurologist Dr Sudhir Kumar told India Today that the idea was interesting but required stronger evidence.

“The idea of developing a novel physiological metric from signals recorded over the temple region is certainly intriguing, and advances in wearable technology have the potential to improve our understanding of human physiology. However, extraordinary claims require extraordinary evidence,” he said.

He added, “The key questions are not whether the signal changes with exercise, stress, or meditation, but whether it reliably measures what it claims to measure, whether it adds information beyond existing metrics, and whether acting on it improves health outcomes.”

In other words, doctors want to know how Entropy is calculated, what it represents biologically and whether it has been independently shown to improve health outcomes.

Gravity Ageing Hypothesis

Temple is also associated with Goyal's Gravity Ageing Hypothesis which proposes that gravity and prolonged periods spent upright may affect blood circulation to the brain and contribute to ageing.

However, the brain has a mechanism called cerebral autoregulation that helps maintain relatively stable blood flow despite changes in posture and blood pressure.

Dr Gupta told The Indian Express, “The brain automatically adjusts the size of its blood vessels and regulates blood supply to ensure that it continues to receive enough oxygen and nutrients, even when we change positions, stand up or exercise.”

He added that there is no established scientific evidence that everyday exposure to gravity progressively damages the brain or accelerates ageing.

More About Temple

Goyal has said that Temple is a wellness and research product rather than a medical device. He has also argued that its claims will be independently verifiable and that more research will be shared soon.

However, doctors say the difference between detecting a physiological signal and demonstrating its clinical significance is crucial. Temple's ability to track certain readings would not, by itself, establish that it can diagnose neurological conditions, predict cognitive decline or measure longevity.