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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.
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.
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.
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Amber cold health alerts have been announced for parts of northern England after forecasts warned that falling temperatures could lead to more deaths, particularly among older and vulnerable people. The UK Health Security Agency has issued two amber-level alerts for north-east and north-west England, which will be in effect from 8pm on Sunday until midday on Monday 5 January.
The agency said the expected cold spell is likely to increase pressure on healthcare services, with more vulnerable people needing medical attention. Officials warned this could lead to a rise in deaths, especially among those aged 65 and above and people with existing conditions such as heart disease, respiratory illnesses, and other long-term health problems.
The agency warned that indoor temperatures in buildings such as hospitals, care homes, and clinics are expected to drop. Maintaining the recommended indoor temperature of 18C may be difficult, increasing health risks for patients and residents. While all other regions in England will be under a lower-level yellow alert, officials said there is still potential for added pressure on health services. Staffing shortages linked to travel disruption were also flagged, along with possible impacts on essential services such as transport and energy.
Cold weather in the UK can worsen existing health problems and create new risks, particularly during prolonged spells of low temperatures. It places extra strain on the heart and lungs, increases the likelihood of infections, and can make daily life harder for people who struggle to keep warm. Those living in poorly insulated homes or facing high heating costs are often hit the hardest.
The Met Office said much of England will remain cloudy overnight, with patches of frost and fog likely to develop. These conditions could lead to difficult and potentially hazardous travel on Monday morning.
Overnight temperatures are expected to fall to around minus 1C in Penrith and hover close to freezing in parts of the Lake District where the amber alert is in place. In northern areas of Scotland, temperatures are forecast to drop further, reaching between minus 6C and minus 7C, as per Sky News.
A brisk northerly breeze is also expected along the north-east coast of England, making conditions feel colder and more uncomfortable. Dr Agostinho Sousa, head of extreme events and health protection at UKHSA, as per Sky News, urged people to look out for friends, family, and neighbours as the cold weather sets in.
“The temperatures we are expecting can have a serious impact on health,” he said. “They increase the risk of heart attacks, strokes, and chest infections, particularly among people over 65 and those with existing health conditions.”
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Nearly 200 residents of Piprauli village in Uttar Pradesh’s Budaun district received anti-rabies injections as a precaution after learning that the raita, a curd-based dish served at a funeral, had been prepared using milk from a buffalo that later died following a dog bite.
Almost 200 people from Piprauli village in Uttar Pradesh’s Budaun district were given rabies vaccines as a safety measure days after consuming raita made from the milk of a buffalo that had been bitten by a dog. Villagers said the funeral ceremony took place on December 23, where raita was served to attendees. It later came to light that the buffalo whose milk was used had been attacked by a dog a few days before the event, as per NDTV.
The buffalo died on December 26, which led to panic in the village amid fears of possible infection. Soon after, villagers visited the Ujhani Community Health Centre, where they were administered rabies vaccinations.
Chief Medical Officer Dr Rameshwar Mishra said on Sunday that authorities were informed about a buffalo in the village that had been bitten by a suspected rabid dog and later died after showing symptoms associated with rabies.
There were reports that villagers had consumed what was believed to be “infected” raita. As a precaution, everyone who may have been exposed was advised to get vaccinated.
“Prevention is better than cure. Anyone who had even the slightest doubt was given the anti-rabies shot. Usually, there is no risk after milk has been boiled, but vaccination was done to eliminate any possible danger,” Dr Mishra said, as per NDTV. The health department confirmed that no cases of illness have been reported in the village so far and that the situation remains stable.
The CMO added that all those who came for vaccination were given the injection without delay at the Ujhani Community Health Centre. To ensure smooth access, primary and community health centres remained open on both Saturday and Sunday.
Rabies pre-exposure prophylaxis, also known as PrEP, involves a series of injections taken before any potential exposure to the rabies virus, as per Cleveland Clinic. It is mainly advised for people at higher risk, including veterinarians, animal handlers, laboratory staff, and travellers visiting areas where rabies is common. While PrEP does not eliminate the need for treatment after a bite, it simplifies post-exposure care. Those who have received PrEP require fewer follow-up doses and do not need rabies immunoglobulin, which can be difficult to obtain during emergencies and can save valuable time.
According to Dr Deepa Aggarwal, MD, DNB, an allergy specialist with over 20 years of experience from LHMC and AIIMS Delhi, who shared insights on her Instagram account, the rabies pre-exposure prophylaxis vaccine helps prepare the immune system in advance.
It allows the body to build antibodies before any exposure occurs. If a vaccinated person is bitten later, they only need two booster shots and no immunoglobulin. This faster immune response reduces the chance of the virus reaching the brain, which is especially important for people at higher risk or in situations where medical care may be delayed.
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Today, Delhi again woke up to a thick layer of smog, and the adjoining cities like Noida, Ghaziabad, Gurugram, and Faridabad too woke up to zero-visibility fog on Monday. The air quality too dipped down to 'severe' category, with AQI registered at 400 plus on the index. While on Sunday, the AQI did show some improvement, as the city registered 'very poor' AQI, however, by the end of the day, the capital city was trapped under fog and pollution.
The Indian Meteorological Department (IMD) has also issued an orange alert for Delhi on 29 December, Monday. The maximum temperature is expected to be around 22 degree Celsius, while the minimum will be at 7 degree Celsius. Mornings would encounter heavily dense fog, while there is an expectation of marginal relief on December 30. Most of North India is also said to be worst hit, including states like Uttar Pradesh, where thick fog is predicted till December 31, Punjab and Haryana is expected to face cold wave through December 30, and Himachal and Uttarakhand could see rain and snowfall from December 30 onwards.
As per IMD, cold wave is a condition of air temperature which becomes fatal to human body when exposed. This happens during the winter seasons and the cold wave impact gets aggravated due to wind speed. Cold Wave is considered when minimum temperature of a station drops to 10 degree Celsius or less for plains and 0 degree Celsius for Hilly regions.
IMD says that cold wave could cause mild to severe hypothermia. The common symptoms include shivering, dizziness, drowsiness, irritability, confusion, slowed, slurred speech, and altered vision. This happens when body experiences a lowered core temperature below 34.4 degree Celsius.
Frostbite is another health hazard that can happen due to cold waves. It is freezing of body tissue, accompanied with hypothermia. When ice crystal form between the cells of the skin and grow by extracting fluid from the cells, the circulation is obstructed, causing additional damage to the tissue affected. It commonly affects hands, feet, ears, nose and cheeks. The common symptoms are redness in skin, or skin turning grey. Some may also experience tingling sensations, fingers turning numb yellowish, waxy, or grey color.
Chilblains could be caused due to exposure to cold, wet, and humid conditions. Repeated prolonged exposure of bare skin could lead to this development in just few hours. It could impact your ears, nose, cheeks, fingers, and toes. Common symptoms include skin turning pale and colorless, prickly sensations, red, swollen, hot, and itchy skin and blisters.
Dehydration could also happen due to lack of fluid intakes, which is common during extreme cold. This could lead to headaches, dizziness, dry mouth, stomach cramps, and increased heartbeat. IMD notes carbon monoxide poisoning or CMP, snow blindness, and trench foot are also common during cold seasons, and provides ways to prevent these from happening.
Delhi is currently under Orange Alert for cold wave. What do these different alerts mean?
Green Alert: This means no action will be taken, as this is a normal day during winter season
Yellow Alert: This means 'be updated' and refers to cold wave alert where the conditions in isolated areas may persist for two days
Orange Alert: This means 'be prepared' and refers to severe cold wave conditions that could persist for two days. This could also mean that though the condition is not severe, but the conditions could persist for four days or more
Red Alert: This means 'take action' and refers to severe cold wave conditions that persists for more than two days, or total number of cold wave days exceeding six days
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