Heart attacks and strokes are among the leading causes of death globally, with millions suffering from cardiovascular diseases (CVD) every year. There are more than seven million people in the UK alone, with about 100,000 patients experiencing heart attacks annually. However, a group of researchers at University College London (UCL) estimate that one 'polypill' taken daily day could eliminate a majority of these cases dramatically lowering death tolls.

The proposed polypill, a combination of a statin and three blood pressure-lowering drugs, has been under study for over two decades. Experts argue that introducing this pill universally for individuals aged 50 and above could be more effective than the current NHS Health Check, which assesses risk factors every five years for those aged between 40 and 74.

Studies have repeatedly proven the effectiveness of the polypill in preventing CVD. A groundbreaking 2019 study in The Lancet found that five years' use of the polypill cut the risk of heart attack and stroke by a third. In addition, previous modelling analyses have estimated that if given universally to people over 55, the polypill might be able to prevent 80% of heart attacks and strokes.

Today, the NHS Health Check follows a risk-based model in which patients are tested for CVD risk factors and treated with drugs accordingly. Yet, as per UCL's study, this system has serious flaws:

Low Uptake: Just 40% of those eligible for the NHS Health Check choose to have it, leaving a considerable number of at-risk patients undiagnosed and untreated.

Ineffective Prediction of Risk: The majority of heart attacks and strokes happen to people at average risk levels, thus making it challenging to identify the need for intervention effectively.

Limited Effectiveness: Even at maximum take-up, the NHS Health Check programme is predicted to have fewer health impacts compared to a polypill initiative applied to the whole population.

Simplicity and Affordability of the Polypill Strategy

One of the big benefits of the polypill is that it is so easy. In contrast to the existing screening-based model, the polypill scheme would not involve complicated medical tests or lengthy risk assessments. Instead, people reaching 50 would just have to fill out a few questions to determine possible side effects before they were prescribed.

Professor Aroon Hingorani of the UCL Institute of Cardiovascular Science, one of the strongest proponents of this scheme, says:

"Finally, the time is now to do much better on prevention. A population approach would prevent a lot more heart attacks and strokes than is done today with a strategy of trying to target a smaller group only."

Aside from the possible health implications, the polypill is also an economic solution. The drugs used are off-patent, thus cheap to produce and distribute. With the vast economic cost of managing CVD-related illnesses, a preventive model could result in substantial cost-saving for the NHS in the future.

The polypill has been proven to be effective by numerous international trials. In 2019, a randomised trial in rural Iran discovered that participants who took the polypill for five years had a 34% reduced risk of having a heart attack or stroke compared to non-participants.

Likewise, modelling research has indicated that even if only 8% of people aged over 50 took up the polypill regimen, it would still be more beneficial to their health than the NHS Health Check programme.

Is This a Case of Over-Medicalisation?

One of the main objections to the polypill strategy is the suggestion that it might result in the unnecessary medicalisation of a significant proportion of the population. But, it is argued, it should be considered as a preventative measure, not as mass medication.

Professor Sir Nicholas Wald of UCL's Institute of Health Informatics explains:

"Instead of being a 'medicalisation' of a significant proportion of the population, a polypill programme is a prevention measure to prevent an individual from becoming a patient."

He compares it with public health measures like water fluoridation or compulsory seatbelts—interventions that have been shown to have a significant impact in reducing public health danger at low individual cost.

With the evidence in favour of the polypill's effectiveness and viability overwhelming, experts are calling on the NHS to act now. It is their belief that substituting the NHS Health Check with a polypill-based prevention program could be the UK government's flagship policy under its pledge to put disease prevention ahead of cure.

As Professor Hingorani points out, "The status quo is not a justifiable option." With CVD still a major cause of death globally, taking a population-wide polypill approach could be a turning point for preventative medicine, potentially saving thousands of lives annually. The question now is whether the NHS will take up this call and establish a policy with the potential to transform the prevention of cardiovascular disease on a national level.

The Directorate of Public Health and Preventive Medicine (DPH) has issued a statewide alert across Tamil Nadu due to a sudden uptick in chikungunya cases in multiple cities.

Cases have been reported across Chennai, Villupuram, Tenkasi, Theni, Cuddalore, Chengalpattu, Kancheepuram and Ariyalur. It remains unknown how many people have been affected and if any deaths have occurred.

Caused by the chikungunya virus, chikungunya virus disease (CHIKVD) is spread by the bite of infected mosquitoes (Aedes aegypti and Aedes albopictus) to humans. The illness usually starts with flu-like symptoms including fever, chills, headache, nausea, vomiting, joint pain and rashes.

Also Read: This Is Why Emmanuel Macron Wore Sunglasses At Davos

Typically, the illness has no clear no symptoms, especially in children and can easily be misdiagnosed as dengue and Zika. While there are no specific antiviral treatments for chikungunya virus infections, medications such as antipyretic and analgesic medications (such as paracetamol) for fever and pain can be used to ease the pain.

Most patients recover completely from the infection, but occasional cases of eye, heart, and neurological complications have been previously been reported with CHIKV infections.

What Are Tamil Nadu Officials Doing To Contain Cases?

Authorities have also emphasized that all government and private hospitals as well as diagnostic laboratories, need to timely report cases to ensure the infection does not spread . Any delay in reporting, officials noted, could allow the virus to spread rapidly within communities.

On the local level, district entomologists and health inspectors have been told to eliminate stagnant water in artificial containers and conduct weekly mass-cleaning drives in high-risk areas.

The DPH has also ordered that all designated dengue and chikungunya wards in hospitals be kept mosquito-free, with adequate bed strength and sufficient mosquito nets for patients.

READ MORE: What Is Chikungunya And How Can It Be Prevented?

Can Chikungunya Spread Easily?

Cases typically emerge mostly in the Americas, Asia and Africa and occasionally in Europe. However, nearly 30,000 CHIKVD cases have been recorded, including 83 associated deaths from 12 countries namely from China, Singapore, Pakistan, France, Argentina, Brazil and Mexico, marking it as one of the biggest outbreaks in the world.

French President Emmanuel Macron on Tuesday addressed the World Economic Forum in Davos, Switzerland. As he spoke on the European solidarity amid US President Donald Trumps' treat to annex Greenland, something else seemed to take the attention away. Macron was seen wearing a pair of blue-tinted mirrored aviator sunglasses. The surprising part was that he wore it indoors. French media had already reported that he was seen wearing sunglasses since last week.

Trump also mocked Emmanuel Macron’s sunglasses during his speech at Davos, joking, “what the hell happened?” regarding the French president’s appearance.

Also Read: Nipah Virus Outbreak In India: After Two West Bengal Cases, Tests On Bats Show No Active Infection

Why Was Emmanuel Macron Wearing Sunglasses Indoors?

On Monday, Macron said that reflective glasses were to disguise a minor eye injury that he had sustained after having been spotted with a heavily bloodshot right eye. "Apologies for the shades, but I have to wear them for a while". He further said that it is for a "mild eye condition".

Last week, when he appeared at a military event in southern France with red eye, while addressing the troop, he said, it was "totally benign" and "completely insignificant", he also added, "Please pardon the unsightly appearance of my eye". He also joked about it, calling it "l'oiel du tigre" or the "eye of the tiger". This was a reference to rock band Survivor's song used in the 1982 boxing moving Rocky III. He said, "For those who get the reference, it is a sign of determination".

What Happened To Macron's Eyes?

As per the French media reports, Macron appeared to have a sub-conjunctival hemorrhage. This means there is a broken blood vessel in his eyes. It is harmless, painless, and does not affect the vision. It also cannot cause permanent injury to the eye, and clears within a fortnight.

Macron Wears Sunglasses Indoor: Is It Absolutely Necessary?

Medical doctor and media commentator Jimmy Mohamed told French broadcaster RTL that Macron "opted for this style for aesthetic reasons, because he is a public figure. However, sunglasses are not necessary to protect vision in this condition. Some people wear it to avoid attracting attention.

"Some people might think he's ill, so to avoid being photographed in that state, he decided to wear sunglasses. The glasses protect his image, but not really his eye," said Jimmy Mohamed.

Read: Why Can't I Hear When I Take My Glasses Off?

How Have Netizen Reacted To Macron Wearing Sunglasses?

He has been called 'kéké', which is a French slang for a show off. Others also joked about him being a "cyborg" or emulating Hollywood actor Top Cruise in Top Gun, the 1986 movie that made wearing aviators a fashion statement.

What Is Sub-conjunctival hemorrhage?

Sub-conjunctival hemorrhage or SCH is a common ocular condition defined by extravasation of blood beneath the conjunctiva, producing a sharply demarcated red patch on the scleral surface. The condition is usually painless and does not impair vision. It usually resolves within 1 to 2 weeks, making it a frequent but benign cause of ocular redness.

It usually happens by a sudden pressure increase from coughing, sneezing, vomiting, or heavy lifting. This could rupture tiny eye blood vessels, or from eye trauma like rubbing or foreign bodies, and can be linked to risk factors like high blood pressure, diabetes, blood thinners, or even childbirth in newborns.

Nipah Virus Outbreak India: Two cases of Nipah virus, a rare, bat-borne pathogen had been confirmed in West Bengal. The virus has been detected in two nurses, both working at the private Narayana Multispecialty Hospital in Barasat. Speaking to The Telegraph, Mr Narayan Swaroop Nigam, Principal Secretary, Health and Family Welfare Department, said, "Two nurses at a private hospital are infected with Nipah virus, and one of them is in critical condition."

Was Nipah Virus Found In West Bengal?

A survey conducted on bats in West Bengal found no active Nipah virus infection. Though there were antibodies detected in one specimen, which indicated prior exposure. This was confirmed by a senior state forest department official on Tuesday. The survey was conducted amid the identification of two confirmed Nipah virus cases.

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To conduct the survey, nine bats near Kuberpur on the Kolkata-Barasat Road in Madhyamgram were tested using RT-PCR. All samples were negative, however, one bat, tested positive for antibodies. However, it only suggested prior infection, meaning there was no current risk of transmission.

The survey was conducted by the state forest department in collaboration with scientists form Pune-based National Institute of Virology. "The findings are reassuring, but caution is warranted. Surveillance and prevent measures will continue until we are fully assured that there is no risk," confirmed a senior official of the West Bengal Health Department.

What Is Nipah Virus?

As per the World Health Organization (WHO), Nipah virus infection is a zoonotic illness that is transmitted to people from animals, and can also be transmitted through contaminated food or directly from person to person.

In infected people, it causes a range of illnesses from asymptomatic (subclinical) infection to acute respiratory illness and fatal encephalitis. The virus can also cause severe disease in animals such as pigs, resulting in significant economic losses for farmers.

Although Nipah virus has caused only a few known outbreaks in Asia, it infects a wide range of animals and causes severe disease and death in people.

During the first recognized outbreak in Malaysia, which also affected Singapore, most human infections resulted from direct contact with sick pigs or their contaminated tissues. Transmission is thought to have occurred via unprotected exposure to secretions from the pigs, or unprotected contact with the tissue of a sick animal.

In subsequent outbreaks in Bangladesh and India, consumption of fruits or fruit products (such as raw date palm juice) contaminated with urine or saliva from infected fruit bats was the most likely source of infection.

Human-to-human transmission of Nipah virus has also been reported among family and care givers of infected patients.

Read: Doctor Debunks Five Myths Around Nipah Virus

Nipah Virus Symptoms

• Fever
• Headache
• Breathing difficulties
• Cough and sore throat
• Diarrhea
• Vomiting
• Muscle pain and severe weakness

Unique Symptoms Of Nipah Virus

While most of the symptoms of Nipah virus may resemble the symptoms from any common flu, however, what makes it unique is that the symptoms come in stages.

Dr Shaikh Abdul Kalam, MD Physician, an Andhra Pradesh-based GP writes for Apollo 24 that the symptoms come in three different phases.

Nipah Virus Phase 1: Flu Like Symptoms

Like mentioned above, most symptoms seem like common flu symptoms. Even Nipah virus begins like a common flu or viral infections. This is what makes the diagnosis difficult.

Most common sign is a fever and a headache. It is often a severe headache and does not break with simple pain medication. What follows is myalgia or muscle pain and sore throat.

The initial symptoms could last for 3 to 14 days before more severe symptoms appear. What helps best is to know the patient's travel history to make the right diagnosis.

Also Read: Unique Symptoms Of Nipah Virus Found In West Bengal And How Long Infection Now Last

Nipah Virus Phase 2: Respiratory Symptoms

As the infection progresses, it begins to attack the respiratory system. This causes dry cough, and dyspnea, or acute difficulty with breathing. This means that the virus has started causing inflammation in the respiratory tract.

Atypical pneumonia is also a symptom, which means air sacs in the lungs get filled with fluid and leads to acute respiratory distress.

Nipah Virus Phase 3: Neurological Signs or Encephalitis

This is usually the most dangerous phase of Nipah virus, because it crosses the blood-brain barrier. A person may experience drowsiness, disorientation, and even mental confusion. Complications could lead to seizures and even coma.

All these symptoms could last from 3 to 14 days.