A report by Swachh Bharat Mission says that 74.5 per cent of public places are equipped with toilets. Another report by the Ministry of Jal Shakti states that there are 2.23 lakh Community Sanitary Complexes built across all States and UTs under the Swachh Bharat Mission (SBM) since October 2014. Over 92 lakh toilets have been constructed since the launch of SBM Gramin (SBM (G)) in April 2020.

While toilets are there, are they accessible? This is the question one should ask. The National Family Health Survey (NFHS) focuses on 131 health indicators, but not until the NFHS 5 survey did they include the question of accessibility of toilets in the survey. This happened after the inputs from the Department of Drinking Water and Sanitation (DDWS) and the Ministry of Health & Family Welfare questioned the accessibility.

One might ask, why is the question of accessibility so important? The answer is quite simple. Access to water, sanitation and hygiene is the most basic human need and is also included under the Sustainable Development Goals by the UN.

Are These Numbers Real?

This thought crossed my mind because back in 2021, I went on a solo trip, on a bus to Udaipur from Delhi. There, the bus made two stoppages. This was done so people could get a quick dinner and freshen up, relieve themselves and be prepared for the rest of the journey. This was a nightmare. The bus only stopped for 10 minutes. While some men used the washroom, others went to the bushes.

For the women, there were three cubicles. One of them was broken, and the other one did not have a light bulb, which meant only one was usable. There was a long queue for that cubicle, and time was short. There was no point in trying to find an isolated corner, because it was past midnight, in an unknown area.

I waited anxiously. When finally, my turn came, I saw an overused, dirty washroom. The toilet seat is in a horrible condition. I wanted to touch nothing there. But I had to pee. So, I used my mask to cover my nose from the odour, folded my pants so they did not touch the floor and squatted. It was quite a task to balance.

On my way back to Delhi, I made sure to not drink any water for over a 13-hour bus journey. I dehydrated myself so I did not have to use the washroom. When I did reach, I was severely dehydrated and was sick for three days.

I shared my experience with my friends only to realise that many women have faced the same. There are no washrooms for women.

A friend of mine told me that it is because these roads and dhabas are mainly designed to serve men. They are the ones who travel at night or are on the roads most of the time. As a result, the few women who do travel or are on the road suffer.

Health Risks Women Are Prone To

Well, it is true, but partially. While holding your pee for too long can lead to health risks, peeing on a dirty toilet seat cannot lead to infections unless your urethra is in contact with the bacteria present on that toilet seat. However, nobody wants to sit on a dirty toilet seat, even if you do not get an infection. A safe and hygienic toilet is a basic need.

One of the regular saleswomen, Usha, who visits my house shared her experience with me. “Being on the road constantly means I must use the dirty public washrooms. But I do not want to use them. So, sometimes I ask my regular customers to let me use their washrooms. Some say yes, and some say no. I understand they are also concerned about their safety and privacy,” she says. As a result, Usha spends most of her day not drinking enough water and holding her pee when she is at work. Due to this, she also suffered from a Urinary Tract Infection (UTI).

Her friend, Halima too faced similar problems and due to increased levels of uric acid in her body, she suffered from Hyperuricemia.

Other health risks are kidney stones and other kidney problems, headaches, dull skin, xerostomia or dry mouth, fatigue, and urinary incontinence, which means losing control over your pelvic floor muscles leading to uncontrolled leakage of urine, seizures and weakness.

What Can You Do?

Wear comfortable clothes and capris. Capri pants are comfortable and are short in length, which means this won’t touch the toilet floor when you squat or sit.

Carry Essentials

Even though you cannot get a UTI alone from sitting on a toilet seat, it is always safe to carry a toilet seat sanitiser. If nothing, it can help you get rid of the bad odour so you can use your stand and pee device inside the toilet. You can also use disposable toilet seat covers if your knees are weak, and you cannot squat. Always flush with your seat down.

Always keep disposable gloves, a portable bidet (fill it with water before use), a pocket liquid handwash, wet wipes, tissues and sanitiser handy. Do not forget to keep extra sanitary pads. It might sound a lot, but I promise that it all fits in one pouch. Use this travel-friendly pouch every time you are on the road, or using a public washroom.

What Can We Learn From Others?

However, in case we do not get these technologically advanced toilets here, you can always pack a travel-friendly toilet kit!

Influenza and other respiratory viruses are surging, note the United Nations. In fact Dr Wenqing Zhang, Unit Head for Global Respiratory Threats at the Department of Epidemic and Pandemic Threats Management of the World Health Organization said that this year is marked by "the emergence and rapid expansion of a new AH3N2 virus subclade". This new variant is called J.2.4.1 or subclade K. This was first reported in August in Australia and New Zealand and has since been detected in over 30 countries.

2025 - A Year Of Flu

Earlier in November, the Public Health Ontario's (PHO) data revealed that Ontario and Canada as a whole could be in a "very tough" flu season this year, thanks to the Influenza A or the flu A. The PHO data revealed a 1.8% rise in influenza cases in the last week of October. Now, amid the influenza A outbreak, 3 children have died from the same in Ottawa and Eastern Ontario region.

US is also facing a flu outbreak and as per the Centers for Disease Control and Prevention (CDC) data, an estimated 2.9 million people have gotten sick so far this season. Among them, 1,200 have also died. This is the 'worst' flu season, point out many experts. For US, the country is seeing a post-Thanksgiving spike in influenza, and saw an 8% increase in people testing positive for the flu.

Super flu or the mutated variant of flu, clade K, has swept the world and caused an early spike in cases worldwide. In Australia, it has caused an early summer spike, while in the UK, it has caused a surge in hospitalization. As per the National Health Service (NHS) England, the number of cases of K flu has been increasing since December 7 and December 11. Hospitalization is up 55% in a week, noted NHS.

Read: Flu Outbreak: Close To 3 Million People Affected, With 1.2k Dead In the US; Where's the Virus Hitting Hardest

Is Flu Shot Effective?

The strain driving the current spike has picked up the nickname “super flu” because it is believed to be a mutated form of influenza A (H3N2), known as “subclade K.”

Influenza H3N2 does not circulate as often as some other flu strains. Dr Simon Clarke, associate professor of cellular microbiology at the University of Reading, explains that the letters “H” and “N” refer to two proteins found on the virus surface, haemagglutinin and neuraminidase. “The numbers simply tell us which versions of those proteins are present,” says Dr Clarke. “It’s a way of grouping strains. This year, H3N2 happens to be the one in the lead.”

“H3 subtypes are relatively uncommon,” he adds. “That means fewer people have built up immunity. There is also evidence they spread more easily and mutate faster, which makes them harder for vaccines to keep up with.

“What we are seeing now is the outcome of that: cases rising sharply earlier than usual, with numbers likely to climb further as winter goes on.”

Recent figures suggest the flu vaccine cuts the risk of hospital admission by roughly 30 to 40 per cent in older adults. That protection rate is lower than for some other vaccines, but it is in line with flu vaccine performance in past years. For that reason, advice has not changed. Vaccination remains the single most effective step people can take to protect themselves and to ease pressure on the NHS.

Super Flu or The K Strain

Known as the superfly, this is H3N2 'subclade K'. It is a type of seasonal influenza A virus and people have not encountered much of it in the recent years. This is why there is less immunity against it. However, the National Health Service (NHS), UK, has already sent out a 'flu jab SOS' to vulnerable people.

NHS has confirmed that the super flu is circulating in England this year, and due to less immunity, it is making it easier to spread across people. The UK Health Security Agency (UKHSA) has urged people to get a flu jab. As per the early data, this year's vaccine has offered good protection despite the new strain.

Daniel Elkeles, chief executive of NHS Providers, said that the major concern is that H3N2 is associated with a more severe illness and superflu could be "a very nasty strain of flu". He said that UK could be experiencing a "tidal wave" of illness.

What Is Influenza A?

As per the National Institutes of Health, US, influenza viruses that contains single-stranded RNA that are classified into three types: A, B, and C. Type A and B cause annual epidemics and even pandemics, while type C is a less common disease.

As per the Centers for Disease Control and Prevention (CDC), Influenza A viruses are descendants of the 2009 H1N1 pandemic virus that emerged in the spring of 2009 and caused a flu pandemic. These viruses, scientifically called the "A(H1N1)pdm09 virus," and more generally called "2009 H1N1," have continued to circulate seasonally since 2009 and have undergone genetic and antigenic changes.

Influenza A(H3N2) viruses also change genetically and antigenically. Influenza A(H3N2) viruses have formed many separate, genetically different clades in recent years that continue to co-circulate.

It is Monday morning and your alarm rings at 6am. You hit snooze at least twice and feel why weekends are so short. A little bit rewind to two days back, Friday night after work, you did some binge watching and slept till noon on Saturday and again woke up late on Sunday. By evening, you finally felt like a human and again in a few hours, Monday came in. Your body, still confused, groggy, and also a slightly resentful. You feel like you are jetlagged even though you have not even boarded a flight.

This is not laziness or poor discipline, this is social jetlag. Many Indians are living through it. Many of us have two sleep times. One for weekdays and one for the weekends and if you are on a roaster, then your sleeping time adjusts according to your off-days. But the truth is you are not sleeping enough at least for the five days you work and make up for it on your off days. This is what scientists call a social jet lag and it is raising long-term health risks.

What Exactly Is Social Jetlag?

A 2012 study by Till Roenneberg explains that the term 'social jetlag' refers to the mismatch between your biological clock and your social clock. Your biological clock is governed by circadian rhythms, internal processes that decide when you feel sleepy or alert. Your social clock is set by work timings, school schedules, household responsibilities, and social expectations.

Most people sleep earlier and wake up earlier on weekdays because they have to. On weekends, they sleep later and wake up later to recover lost sleep. Researchers describe this as similar to flying across time zones and back every week, except your environment does not change. The sun rises at the same time, but your sleep does not.

Studies suggest that nearly 80 percent of people experience some degree of irregular sleep by shifting sleep times between weekdays and weekends. This pattern has become common due to artificial lighting, late-night screen exposure, and work schedules that are misaligned with natural circadian preferences.

Modern Life Makes It Worse, Here's Why

Artificial light has quietly changed how humans interact with night and day. Evening exposure to bright lights from phones, televisions, and laptops delays the body’s internal clock. This makes it harder to fall asleep early, even when you need to wake up early the next morning.

Over time, this weakens the natural cues that tell the body when it is time to rest and when it is time to be active. Researchers note that this effect creates more late chronotypes, people who naturally feel alert later at night. Unfortunately, most school and office schedules still reward early risers.

The result is a repeated pattern of sleep restriction during weekdays and catch-up sleep on weekends. Unlike travel jetlag, which resolves once the body adjusts to a new light-dark cycle, social jetlag does not correct itself. The solar cycle stays the same, while sleep timing keeps shifting back and forth.

Light is the primary driver of circadian rhythm. In the morning, exposure to sunlight tells the brain to stop producing melatonin, the hormone that makes us sleepy so we feel alert and ready for the day. By evening, melatonin production rises, pushing us toward rest. Night shifts turn this cycle upside down. Instead of winding down, the body is forced to stay active at the very hours it is wired for repair and recovery.

This constant mismatch creates what scientists call 'social jetlag. Your body never gets used to it, because it runs on an internal clock and this is why despite working the same shifts for years, you feel confused.

Indians Are Sleeping Way Less

Data from India paints a worrying picture. A nationwide LocalCircles survey found that 55 percent of Indians get less than six hours of uninterrupted sleep each night. This is an increase from 50 percent the year before, showing that sleep deprivation is getting worse, not better.

Among the reasons cited were late bedtimes combined with early household responsibilities, frequent nighttime awakenings, environmental noise, mosquitoes, and medical conditions like sleep apnea. Even those who spend enough time in bed often experience fragmented sleep.

Wearable sleep data tells a similar story. Fitbit’s global sleep analysis placed Indians as the second most sleep-deprived population after Japan. On average, Indians sleep just over seven hours a night, nearly 50 minutes less than users in the UK and significantly less than Americans. Indians also get the lowest amount of REM sleep globally, a stage critical for memory, emotional regulation, and mental health.

Social jetlag is especially pronounced among adolescents and young adults. Research consistently shows that teenagers naturally shift toward later sleep and wake times due to developmental changes. However, early school start times force them to wake up before their biological clocks are ready.

Late chronotypes accumulate sleep debt during the week and try to repay it on weekends. This pattern has been linked to higher body mass index, metabolic issues, daytime sleepiness, and poorer academic performance. Living against the clock, researchers suggest, may be quietly contributing to the rising burden of obesity and mental health concerns.

In India, academic pressure, coaching classes, screen use, and reduced parental control over sleep schedules only amplify this misalignment.

Social Jet Lag Is Not Just About Feeling Tired, It Has Grave Health Impact

Hormones take the first hit. Our body gets confused on how to regulate melatonin, which is a sleep hormone and cortisol, which is the wake up hormone. It also reduces appetite suppressing hormone leptin, while turning up the hunger hormone ghrelin. This is why you feel the midnight munchies. Chronic sleep deprivation could also lead to prediabetics, as increasing sugar cravings make it difficult for people to prioritize healthy eating.

Studies have associated it with increased risks of obesity, metabolic syndrome, and mental health disorders. It has also been linked to lower productivity, reduced concentration, and mood disturbances.

Addressing social jetlag requires more than sleep tips. Experts suggest later school start times, flexible work hours, reduced evening light exposure, and greater awareness of circadian health. Small changes, like maintaining similar sleep timings on weekdays and weekends, can help, but they cannot fully solve a systemic problem.

Until then, millions of Indians will continue waking up exhausted, wondering why rest feels so elusive.

COVID symptoms still there? For many people, long COVID is a reality. They continue to live with symptoms like breathlessness, fatigue, and brain fog. To understand this better and why does this continue to persist, a team of microbiologists now have uncovered an important clue. The findings are published in eLife. The researchers suggest that co-infections acquired before or during the bout of COVID could lead to these long-lasting symptoms.

These additional infections have occurred alongside the SARS-CoV-2 and have continued to stay. Maria Laura Gennaro, a microbiologist at Rutgers New Jersey Medical School says, "This is an aspect of long COVID that is not talked about a lot," on the impact of other pathogens on continuous COVID symptoms.

Long COVID Affects Millions

Long COVID has affected around 400 million people from around the world and it has created problems from mild disruptions to severe disability. The research suggests that it can impact the brain, heart, lungs, and even the digestive system.

The new review pulls together existing research and expert insights to spotlight a factor that has largely flown under the radar: infections other than the coronavirus itself may be playing a significant role.

Also Read: Flu Vs Covid: This ONE Key Symptom Will Help You Tell Them Apart, According To Doctor

Other Pathogens That Impact Long Covid

A growing body of evidence points to the Epstein-Barr virus (EBV), best known for causing mononucleosis. Nearly 95 percent of adults carry EBV in a dormant state, where it usually stays quiet unless the immune system is stressed. Infections like COVID can trigger its reactivation.

An early study found that about two-thirds of people with long COVID showed signs of recent EBV activity, with higher antibody levels seen in those reporting more severe symptoms. Later research has linked EBV reactivation to common long COVID complaints, such as persistent fatigue and brain fog.

Another infection drawing attention is tuberculosis, or TB. Around one in four people worldwide carry latent TB. Some evidence suggests that COVID can reduce the immune cells that normally keep TB in check, increasing the chances of reactivation. The link may also run both ways, as TB has been shown to worsen COVID outcomes in some cases.

Researchers stress that timing matters. Infections that occur before COVID may already weaken the immune system. Those that happen during the initial illness could add to tissue damage. Infections that emerge after recovery may take advantage of the immune disruption that COVID leaves behind.

Rising Infections and the Idea of “Immunity Theft”

The authors note that 44 countries have reported tenfold increases in at least 13 infectious diseases compared with pre-pandemic levels. They discuss a concept known as immunity theft, which suggests that an acute COVID infection may leave people more vulnerable to other infections.

If co-infections are found to play a role in long COVID, existing treatments could offer some help. Antibiotics and antivirals already in use might be repurposed to target specific infections. Clinical trials could then test whether treating these infections eases long COVID symptoms.

A Hypothesis Still Under Review

The researchers are careful to point out that this idea is still at an early stage. While the links they describe make biological sense, they have not been proven. No direct cause-and-effect relationship has yet been established between any co-infection and long COVID.

As one researcher put it, correlation does not equal causation. Proving the theory would require large population studies and animal research, which is challenging due to the lack of reliable animal models for long COVID.