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.

"Papa, I'm in pain," said the 44-year-old Indian origin man, Prashant Sreekumar to his father, before he died at a Canadian hospital's ER due to delay. He had a cardiac arrest and was rushed to the Grey Nuns Community Hospital in Canada's Edmonton. He had been complaining of severe chest pains at work on December 22. The 44-year-old was also father of three, and was kept in the hospital's emergency room waiting area for over eight hours. This has now sparked serious questions on Canadian healthcare system.

His father, Kumar Sreekumar told the Global News that he was checked in at triage and then seated in the waiting room. When his father reached the hospital, he told him, "Papa, I cannot bear the pain."

The father said that his son felt the pain was a '15 out of 10'. The staff had given him some Tylenol for his pain, but his blood pressure kept increasing.

"It went up, up, and up. To me, it was through the roof," his father said. He was finally called for treatment after more than eight hours of wait."After sitting maybe 10 seconds, he looked at me, he got up and put his hand on his chest and just crashed," his father said.

Nurses raised the alarm and attempted to revive him, but their efforts were unsuccessful. Prashant Sreekumar died from what is believed to be a cardiac arrest. He is survived by his wife and three children, aged three, 10 and 14.

Grey Nuns Hospital, which is part of the Covenant Health network, said it could not comment on individual patient care. In a statement to Global News, the organization confirmed the death is being reviewed by the Office of the Chief Medical Examiner.

“Our thoughts are with the patient’s family and friends. The safety and care of our patients and staff remain our highest priority,” the statement said.

External Affairs Ministry spokesperson Randhir Jaiswal in New Delhi, said that the person who died was a Canadian citizen and the government must look into the matter. “The person is of Indian origin but he happens to be, I understand, a Canadian national. So the Canadian government should take responsibility in the matter,” he said at a media briefing.

What Is A Cardiac Arrest?

As per the Heart Organization, a cardiac arrest is the abrupt loss of heart function in a person who may or may not have been diagnosed with heart disease. It happens because of an electrical issue that makes your heart stop beating. Your heart stops pumping blood and you become unconscious.

Symptoms Of Cardiac Arrest

• Fatigue
• Dizziness
• Shortness of breath
• Nausea
• Chest pain
• Heart palpitations (fast or pounding heart beat)
• Loss of consciousness

Who Are At More Risk Of A Cardiac Arrest?

If you follow a lifestyle heavily indulged in alcohol or drug abuse, or have a family history of heart disease or cardiac arrest, or have a heart disease, high blood pressure, high cholesterol, low potassium or magnesium, obesity or indulge into smoking, you make be more prone to having a cardiac arrest.

The phrases “heart attack” and “cardiac arrest” are often used as if they mean the same thing, but they refer to two distinct heart conditions.

A heart attack happens when a blockage in one or more arteries cuts off blood flow to the heart. This lack of blood and oxygen damages the heart muscle. A heart attack can raise the risk of cardiac arrest because it may disrupt the heart’s electrical signals. When cardiac arrest strikes suddenly in someone without known heart disease, it is often triggered by a heart attack.

H3N2's mutation or the influenza A's subclade K is now the new aggressive virus that has swept the United States with flu cases. This is the culprit in rising flu cases, globally. The World Health Organization (WHO) on its website said that K variant marks "a notable evolution in influenza A (H3N2) viruses". Some are also questioning the effectiveness of this season's influenza vaccine against the strain.

What Are The Common Symptoms This Season For The Flu?

K variant causes more intense flu symptoms, they include:

• Fever
• Chills
• Headache
• Fatigue
• Cough
• Sore throat
• Runny nose

According to a report by the Centers for Disease Control and Prevention (CDC), among 216 influenza A (H3N2) viruses collected since September 28, 89.8% belonged to the subclade K. CDC had been releasing weekly influenza surveillance reports and tracked which states have been seeing the most activity for outpatient respiratory illness.

The highest number of cases were reported from New York. New Jersey, Rhode Island, Louisiana, and Colorado came under 'Very High' category in level 3. Massachusetts, Connecticut, Michigan, Idaho, and South Carolina were under 'High' category level 1, New Mexico, under level 2, and Washington D.C., Maryland, North Carolina, and Georgia under level 3.

The CDC estimates that this flu season has already led to around 4.6 million illnesses, nearly 49,000 hospitalizations and about 1,900 deaths. Health authorities continue to stress that getting the flu vaccine remains the most effective way to protect against the virus.

Are The Old Vaccines Effective Against This New Variant?

"The vaccine remains the most effective means to prevent disease. We still want to encourage people to get the vaccine," said Professor Antonia Ho, Professor and Honorary Consultant in Infectious Diseases at the University of Glasgow. Experts have stressed enough on the immunity that one can receive from the vaccine that that these flu jab remain the best defense against the flu, even though the current strain circulated may have drifted away from the strain included in this year's jab.

Data from the UK Health Security Agency (UKHSA) also show that vaccines is performing as expect, despite the emergence of subclade K.

Also Read: Will The Old Flu Vaccine Protect You Against The New Subclade K?

Why Is This New Strain Hitting Hard?

Doctors explain that subclade K enhances the ability of the virus to slip through our immune protection. However, it does not mean that vaccination offers no protection against the flu. In fact, experts and doctors have been emphasizing the need to get yourself vaccinated to help you protect from the worst effects of the virus.

If you look at deaths and severe illness with flu, the vast majority both in adults and in children are unvaccinated.

Do vaccines give full protection? Doctors have pointed that you may get the flu even if you are vaccinated, it’s that the severity, the chance that you’re going to end up in hospital and worst-case scenario in the ICU or die does seem to be significantly protected against by being vaccinated.

Australia issued a health advisory warning travellers and healthcare providers about counterfeit batches of a rabies vaccine that have reportedly been circulating in India since November 1, 2023. The alert has raised concerns for anyone who may have received the vaccine while travelling or living in the country.

This Is What The Australian Advisory Says:

The warning was issued on December 22 by the Australian Technical Advisory Group on Immunisation. It flagged counterfeit batches of the rabies vaccine Abhayrab. While the vaccine is not supplied or used in Australia, the advisory notes that Australians or other travellers who were vaccinated in India could still be at risk.

The advisory clearly states that people who may have received the counterfeit vaccine might not be fully protected against rabies. As a precaution, it recommends that they receive replacement doses using a rabies vaccine that is registered and approved for use in Australia.

As it can be difficult to verify whether a dose was genuine or fake, the advisory takes a cautious approach. It says that anyone who received Abhayrab in India on or after November 1, 2023, should be considered as potentially having been given a counterfeit vaccine. Such individuals should be offered replacement doses as per Australian guidelines.

Why rabies protection is critical

Rabies is a viral zoonotic disease that attacks the central nervous system. In humans, it is most commonly transmitted through the bite of an infected dog. According to the World Health Organization (WHO), once rabies reaches the central nervous system and symptoms begin to appear, the disease is fatal in almost all cases.

India continues to bear a significant burden of the disease. WHO estimates suggest that rabies causes between 18,000 and 20,000 deaths every year in the country. India alone accounts for about 36 percent of rabies deaths globally, making effective vaccination and timely treatment especially critical.

Vaccine manufacturer responds

Abhayrab is manufactured by the Human Biologicals Institute, which is a division of Hyderabad-based Indian Immunologicals Limited. Responding to the advisory, the company said that it had proactively identified an issue in January related to a specific batch of the vaccine, as reported by Scroll.

According to the company, the issue involved Batch Number KA 24014, which was found in the marketplace with packaging that differed from the original. Indian Immunologicals Limited said it immediately informed Indian regulators and has been working closely with regulatory authorities and law enforcement agencies to address the issue. A formal complaint has also been lodged to support an investigation.

The company stressed that every batch of vaccine it produces is tested and released by the Central Drugs Laboratory under the Government of India before being made available for public use.

Broader concerns around medical quality

The advisory also comes at a time when India-made medical products have faced scrutiny abroad. In recent years, deaths allegedly linked to Indian-manufactured cough syrups were reported in countries like Gambia and Uzbekistan. Separately, Indian-made eye drops were suspected to be linked to infections in Sri Lanka.

Read: After Coldrif, WHO Bans 2 More Drugs, But This Is Not the Only Death from Indian Cough Syrup

Indian Immunologicals Limited, however, reiterated its commitment to safety and quality. It noted that Abhayrab has been manufactured since 2000, with over 210 million doses supplied in India and more than 40 countries. The company said the vaccine holds nearly 40 percent of the market share and assured healthcare professionals and the public that supplies made through authorized distributors are safe and meet quality standards.