Category: Health News Today

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Nutrition, health benefits, and more

There is some anecdotal evidence to counsel that consuming boiled lemons can raise immunity, increase the pores and skin, and even support persons shed bodyweight.

Having said that, scientific studies into the nutritional values and wellbeing rewards of boiled lemons exclusively are scarce.

Lemons are the natural way higher in vitamin C and quite a few other natural vitamins and minerals, but boiling them may possibly in fact lower the quantity of nutrients they comprise.

Retain looking through to understand extra about the nutritional added benefits of lemons when boiled or blended with boiled drinking water.

There are several possible wellness gains involved with boiling lemons. The subsequent sections glimpse at some of these in additional element.

Enhances the skin’s visual appearance

Lemons are rich in vitamin C, which is an antioxidant that guards skin cells from detrimental free radicals, thus lessening the symptoms of ageing.

Some research recommend that ingesting vitamin C aids the skin mend a lot quicker and minimizes scar formation. It might also encourage collagen generation, offering the skin a plumper, firmer visual appeal and reducing fine lines and wrinkles.

Lowers blood tension

Lemons are superior resources of minerals that may well assistance decreased blood strain, this sort of as calcium and potassium. Experts recommend finding these important vitamins from the diet regime as a substitute of having them as nutritional nutritional supplements, in which achievable.

A 2014 research from Japan indicates that a everyday ingestion of lemon juice could reduce blood strain in middle-aged gals. On the other hand, the analyze was sophisticated by the truth that the contributors also took each day walks, which might have had much more of an affect on blood force than the lemon juice.

An before 2012 study into the outcomes of lemon juice on blood strain observed no significant variance in blood stress readings after 2 weeks. Having said that, the authors recommend further more analysis, supplied the anecdotal evidence from men and women with high blood stress suggesting that drinking lemon juice can help lower blood pressure immediately.

Boosts immunity

The vitamin C in lemons may aid raise the body’s immune technique, safeguarding it towards respiratory bacterial infections.

For case in point, a person 2017 overview indicates that big doses of vitamin C (200 milligrams [mg] for every working day) could be helpful in dealing with pneumonia and the common chilly. It also suggests that protecting an consumption of all around 100–200 mg of vitamin C per working day could help stop future infections.

The exact same assessment suggests that people who are extra at possibility of vitamin C deficiency, these kinds of as older grownups, really should assure that they are getting enough vitamin C from their each day eating plan. A warm drinking water and lemon drink might be just one way to major up a person’s vitamin C levels.

Aids fat loss

Even though there is no strong evidence to recommend that lemon h2o is any a lot more effective than simple h2o at encouraging people lose weight, it is nevertheless a quite minimal calorie beverage.

Persons who tend to choose fruit juices and soda drinks to simple drinking water may perhaps uncover that consuming lemon water in put of these beverages will enable them lose fat more quickly.

Lemon water can also support hydration, which can improve bodyweight reduction and lessen water retention.

Improves digestion

Persons with indigestion normally report signs such as bloating and heartburn improving upon right after drinking a glass of scorching h2o and lemon. On the other hand, there is not a fantastic deal of proof to support the notion that lemon is the component doing all the perform.

That explained, there is evidence to propose that consuming warm water can have a soothing influence on the intestine. A person 2019 analyze in rabbits found that a daily dose of warm drinking water aided minimize diarrhea. Also, a 2016 analyze in people uncovered that warm h2o helped boost bowel movements following operation. So, it could be the temperature of the water, alternatively than the additional lemon juice, that is helping digestion.

It is worth noting that the soluble fiber in the fruit may well aid by slowing the digestion of sugars and starches. Nonetheless, this would contain feeding on the pulp of the lemon, not consuming the juice.

Most individuals desire to increase slices of lemon to warm drinking water, or boil lemon in water, to build a lemony beverage. On the other hand, extra and extra people are discovering that boiled full lemons can acquire the position of preserved lemons, adding flavor and texture to dishes.

Here are a few option approaches to put together a boiled drinking water and lemon beverage.

Technique 1

  1. Lower a new lemon in half.
  2. Squeeze the lemon or use a lemon juicer to take away the juice, and discard any peel or pips.
  3. Include the strained lemon juice to a glass of freshly boiled h2o and make it possible for it to cool just before consuming.

System 2

  1. Reduce a lemon into slices or quarters.
  2. Increase a piece of lemon to a freshly boiled cup of h2o.
  3. Permit it to cool in advance of ingesting.

Strategy 3

  1. Convey a compact pot of h2o to the boil.
  2. Slice a contemporary, washed lemon into quarters and increase to the drinking water.
  3. Boil for around 3 minutes.
  4. Enable it to great before drinking.

Folks who obtain lemon water as well bitter to drink may possibly like to incorporate a spoonful of honey to sweeten the flavor.

Folks who desire to use boiled lemon as an added component to dishes may perhaps want to boil the lemon for extended. This may well be for around 20–30 minutes, based on its dimensions.

One 58-gram (g) raw lemon (without the need of the peel) incorporates the next diet:

  • 16.8 calories
  • 1.62 g of fiber
  • 30.7 mg of vitamin C
  • 15.1 mg of calcium
  • .35 mg of iron
  • 4.64 mg of magnesium
  • 9.28 mg of phosphorus
  • 80 mg of potassium

Lemons also consist of the following vitamins and minerals in small amounts:

  • thiamin
  • vitamin B6
  • pantothenic acid
  • zinc
  • copper
  • manganese
  • riboflavin

The Dietary Recommendations for People in america suggest 75 mg of vitamin C for ladies older than 19 years and 90 mg of vitamin C for males more mature than 19 decades every working day. Persons who smoke have to have 35 mg a lot more vitamin C for every working day than people who do not smoke.

It is probably that lemons have much less nutritional worth when cooked. Cooking sure fruits or veggies can split down natural vitamins and minerals, which can leach into the cooking h2o.

Men and women who are boiling lemons to eat the lemons complete may well want to conserve the cooking water to use as an supplemental beverage.

Find out far more about the health gains of lemons below.

A lot of of the feasible health added benefits linked with consuming incredibly hot h2o and lemon tend to be anecdotal.

Nevertheless, there is fantastic evidence to propose that the natural vitamins and minerals in lemons may possibly have a favourable impact on immunity and skin overall look. There is also confined evidence to assistance enhanced digestion.

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How long will ‘natural immunity’ last?

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A new review asks how long purely natural immunity may very last. Noam Galai/Getty Illustrations or photos
  • Obtaining COVID-19 must confer some immunity versus creating the sickness yet again, but wellness experts do not know how extended this immunity lasts.
  • Experts know that some folks have created COVID-19 much more than once, but there are not adequate information for scientists to be able to evaluate how extended “natural” immunity lasts.
  • Acquiring examined the genome of SARS-CoV-2, scientists counsel that, among unvaccinated folks, reinfection could take place as quickly as 3 months soon after contracting the virus.

In accordance to Our Planet in Data, almost 50 percent of the world’s populace have been given at the very least a person dose of the vaccine in opposition to SARS-CoV-2, the virus that will cause COVID-19.

Scientists have shown that COVID-19 vaccines reduce the severity of illness but do not confer total defense in opposition to COVID-19.

At the beginning of the pandemic, some jurisdictions, including those in the United Kingdom and Sweden, pursued a policy of herd immunity, which assumed that letting more than enough persons to catch the virus would confer sufficient immunity on the population to close the pandemic.

Whilst there have been some reports of people today creating COVID-19 more than when, these figures are too modest to have out an epidemiological examine. This suggests that it is difficult to determine how extended immunity conferred from a SARS-CoV-2 an infection lasts.

In the present examine, researchers have performed an evaluation of beforehand released details on viruses identical to SARS-CoV-2. They set out to ascertain how long immunity pursuing COVID-19 could previous.

The investigate, which seems in The Lancet Microbe, reveals that unvaccinated people can hope immunity versus reinfection to last 3–61 months soon after developing COVID-19 — if the virus is nevertheless circulating in the local community.

This examine could enable stimulate persons to get vaccinated, stated Dr. Ajay Sethi, affiliate professor of inhabitants health and fitness sciences at the University of Wisconsin-Madison, who was not involved in the exploration. He told Health care Information Currently,

“The review underscores the value for the general public to understand that immunity from pure infection is not as extensive long lasting as some may perceive, and surely not lifelong.”

He also discussed that “research has demonstrated that vaccination adhering to organic an infection provides an even more robust immune reaction as as opposed [with] vaccination without having any prior background of COVID-19. Hopefully, far more folks who’ve had infection in the earlier will select to get vaccinated.”

A crew from Yale School of Public Health in New Haven, CT, and the College of North Carolina at Charlotte looked at the genes of 177 coronaviruses recognized to affect individuals. The scientists then established which had been the closest viral family of SARS-CoV-2.

They recognized five viruses that satisfied this criterion. They involved SARS-CoV, responsible for the SARS outbreak in 2003, and MERS-CoV, which was very first detected in 2012. They also incorporated viruses that induce the common chilly.

The scientists then analyzed present facts on how antibody amounts decrease around time — from 128 days to 28 a long time immediately after infection. They also looked at the possibility of reinfection at various antibody levels for people viruses.

Making use of this details, they predicted that purely natural immunity conferred by contracting SARS-CoV-2 would very likely past considerably less than 50 percent as very long as the immunity due to contracting similar coronaviruses.

They located that reinfection with SARS-CoV-2 in men and women who had not gained a vaccine could manifest as soon as 3 months following preliminary an infection, with a median danger of reinfection inside of 16 months, beneath endemic situations.

Co-chief of the analyze Alex Dornburg, assistant professor of bioinformatics and genomics at the University of North Carolina, states:

“As new variants come up, previous immune responses develop into a lot less successful at combating the virus. These who had been in a natural way infected early in the pandemic are increasingly very likely to turn into reinfected in the around future.”

The study authors conclude that as novel variants could evade existing immunity, it is crucial to emphasis efforts on accelerating global vaccine systems to cut down the likelihood of variants emerging in the very first area.

It is of notice that the analyze had specified limitations. For instance, it did not glance at how severity of initial SARS-CoV-2 infection or immune standing of an unique might affect how extended their pure immunity would past.

Talking on this level, Dr. Alexander Edwards, affiliate professor in biomedical technological innovation at the College of Looking through in the U.K., who was not involved in the examine, advised MNT:

“Reinfection isn’t seriously the crucial issue for COVID-19. In its place, the most essential point is severity of an infection. If earlier infection guards from severe disease building, it becomes significantly less important to the specific if they get contaminated a second time.”

“However,” he ongoing, “for COVID-19, we still never know if preceding infection will thoroughly protect from serious illness and dying for everyone.”

For are living updates on the most up-to-date developments about the novel coronavirus and COVID-19, click on here.

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Lifting COVID-19 restrictions could lead to a large flu outbreak

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COVID-19 restrictions might have weakened inhabitants immunity, so lifting the limitations could induce a flu outbreak. nito100/Getty Illustrations or photos
  • Flu infections dropped by 60{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} following the introduction of COVID-19 constraints.
  • This diminished exposure to influenza may possibly mean lessened populace immunity.
  • The lifting of COVID-19 controls could guide to a large flu outbreak.
  • Anybody provided a flu vaccination should choose it to reduce the hazard.

A examine in the Journal of Infectious Ailments has predicted a extreme influenza outbreak as soon as COVID-19 regulate actions are lifted, with elevated levels of flu in the pursuing many years.

The researchers from Columbia University Mailman Faculty of Wellbeing used computer modeling to quantify the reduction in transmission and incidence of flu just after the implementation of control steps. They utilised these knowledge with each other with information from the Centers for Condition Command and Avoidance (CDC) FluView web-site to venture influenza transmission over the up coming 5 years.

Non-pharmaceutical interventions (NPIs), these types of as mask-sporting, physical distancing, journey limitations, and university closures, led to a 60{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} fall in flu bacterial infections throughout the 10 weeks after their introduction final 12 months. The review suggests that the lessened publicity to flu all through the handle actions will have led to reduced immunity.

Keep knowledgeable with are living updates on the present COVID-19 outbreak and visit our coronavirus hub for far more assistance on avoidance and treatment method.

Dr. Jonathan Stoye, head of virology at the Francis Crick Institute in London, United Kingdom, told Healthcare News These days: “This modeling research […] suggests that the minimized quantities of bacterial infections in 2020 will lead to waning inhabitants immunity and that this may well, in transform, lead to a surge in flu infections for numerous several years.”

The scientists forecast that comforting steps could direct to a massive-scale flu outbreak, significantly in pieces of the United States where by there had been significant stages of COVID-19 control compliance. They also anticipate that the small concentrations of flu in the course of the pandemic may perhaps make it tough to predict which circulating flu strains they will need to use to inform the future vaccines. This could decrease the efficiency of influenza vaccines.

On a more optimistic note, the authors concede that the predicted bad flu time is not unavoidable. Because of the focus on COVID-19, flu may perhaps have been underreported last yr, so extra men and women may well have been uncovered to the virus than their modeling acknowledges.

Alternatively, since of lessened flu transmission, the virus will have experienced much less prospect to mutate and produce new variants. People might consequently have immunity from previously flu infections, which would guide to a less severe outbreak.

Prof. William Schaffner, Professor of Preventive Medication at Vanderbilt College College of Drugs, TN, is not certain by the suggestion of underreporting: “Last 12 months had the most affordable incidence of flu any of us can keep in mind thanks to the restraints for COVID-19. I do not imagine there was underreporting of influenza. We did not detect a important drop in testing, but minimal flu was detected. I imagine the small flu price was authentic.”

But Dr. Stoye agrees that the severity of an outbreak depends on the variety of variants: “It will be appealing to see regardless of whether such an raise does, in actuality, manifest as charges of viral an infection are driven by various variables, this sort of as adjustments in the rate of physical appearance of new viral variants.”

Prof. Schaffner factors out that other respiratory bacterial infections have greater as daily life starts to return to regular, which would propose that we require to take the warning of a undesirable flu period critically. This summer season, with fewer limits and the return of youngsters to faculty, there has been a surge in instances of respiratory syncytial virus, an infection generally seen only in the winter months. “This could be a harbinger of factors to come,” he pointed out.

“This 12 months, it’s much more essential than at any time to get your flu shot. Although we’re rightly targeted on safeguarding ourselves in opposition to COVID-19, we shouldn’t forget about about the flu, which can be fatal.”

– Senior writer Dr. Sen Pei, Ph.D, Assistant Professor of Environmental Wellness Sciences, Mailman Faculty of Community Well being, Columbia.

“Predicting flu is a hazardous profession,” Prof. Schaffner states. “Because we have had these types of a very low earlier flu time, has our immunity waned in such a way that we are vulnerable to additional transmission and more severe ailment? Flu is fickle — we’ll just have to hold out and see.”

His suggestions is unequivocal: “Take the jab.”

For reside updates on the most recent developments pertaining to the novel coronavirus and COVID-19, simply click in this article.

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What we know about molnupiravir: Data and safety concerns

In the search for effective COVID-19 treatments, many drugs have failed to live up to their early promise. In a recent trial, seen as an important advance, the oral antiviral drug molnupiravir halved the risk of hospital admissions and deaths from COVID-19. Medical News Today explored the evidence to see whether this optimism is justified.

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The experimental drug molnupiravir has brought fresh hope in the fight against COVID-19. But what do we know about it so far? Image credit: Jordan Lye/Getty Images

A global trial, led by the pharmaceutical company Merck — known as MSD outside the United States and Canada — and Ridgeback Therapeutics, has found that the companies’ experimental antiviral drug molnupiravir reduces the risk of hospital admission or death from COVID-19 by approximately 50{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}.

Although this was a small-scale trial, these positive results have led to countries rushing to sign up for supplies of the drug.

In the randomized, phase 3 trial, scientists gave molnupiravir or a placebo to 775 people. All the participants had tested positive for SARS-CoV-2 infections and experienced mild to moderate COVID-19 symptoms that had begun no more than 5 days earlier.

Stay informed with live updates on the current COVID-19 outbreak and visit our coronavirus hub for more advice on prevention and treatment.

Every participant had at least one risk factor for severe COVID-19 but had not been admitted to a hospital. Risk factors included obesity, an age of over 60 years, diabetes, and heart disease.

The scientists allocated each of the 775 participants randomly to one of two groups. One group received molnupiravir and the other a placebo. The participants took the capsules twice a day for 5 days.

Of the 385 patients taking molnupiravir, 28 were admitted to a hospital, compared with 53 of those in the placebo group. Eight of the placebo group participants died, while all those receiving the antiviral were alive at the end of the 29-day study period.

Recruitment into the study has now been halted because of these overwhelmingly positive results. The manufacturer, Merck, is applying for emergency use authorization from the Food and Drug Administration (FDA).

The Singapore health ministry has signed a purchase agreement for molnupiravir, and the European Medicines Agency is considering a rolling review of the drug.

“With these compelling results, we are optimistic that molnupiravir can become an important medicine as part of the global effort to fight the pandemic.”

– Robert M. Davis, chief executive officer and president of Merck

Merck plans to produce 10 million courses of the treatment in 2021 and more in 2022.

The study results have been greeted with optimism. Prof. Tim Spector, a professor of genetic epidemiology at King’s College London, told MNT: “This is an exciting result from a randomized study of 775 patients, showing major effects in reducing severity and death from a simple pill given at the onset of infection.”

Molnupiravir belongs to a class of antivirals called mutagenic ribonucleosides. These change the viral genetic material and introduce errors to prevent replication and transcription of the viral genome.

Inside the host cell, molnupiravir is converted to molnupiravir triphosphate. When the virus tries to replicate, molnupiravir triphosphate is incorporated into the viral RNA instead of the nucleoside cytidine, causing a mutation.

The mutation stops the virus from replicating. This keeps numbers of the virus in the body low and should reduce the severity of the disease.

Other drugs that interfere with viral RNA have shown potential as COVID-19 treatments. Remdesivir, an intravenously administered drug that interferes with an enzyme essential for replicating viral RNA, showed early promise.

Although the FDA has granted approval to remdesivir, the World Health Organization (WHO) no longer recommends it as a COVID-19 treatment, due to insufficient evidence to support its use.

The advantage of molnupiravir is that, unlike all the other potential treatments so far, it is an oral tablet that a person can take outside a clinical setting. At a projected cost of around $700 per person for a 5-day course, it is also more affordable than other drugs. However, this cost is still likely to limit its use.

“Antiviral treatments that can be taken at home to keep people with COVID-19 out of the hospital are critically needed. We are very encouraged by the results from the interim analysis and hope molnupiravir, if authorized for use, can make a profound impact in controlling the pandemic.”

– Wendy Holman, chief executive officer of Ridgeback Biotherapeutics

Prof. Sir Peter Horby, a professor of emerging infectious diseases and global health at the University of Oxford, is largely optimistic: “A safe, affordable, and effective antiviral would be a huge advance in the fight against COVID.”

However, he retained a note of caution: “It is important to remember that the absolute risks were 14{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} reduced to 7{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}, so quite a lot of people need to be treated to prevent one hospitalization or death. This means the drug needs to be very safe and affordable.”

This caution was echoed by Prof. William Schaffner, a professor of infectious diseases at the Vanderbilt University School of Medicine, who said: “In the studies in very high risk patients, it reduced the level of serious disease by only half. It’s not a magic pill.”

He added: “In research settings, you can ensure that people take the pill as directed. In practice, there is usually a lower success rate than in clinical trials.”

Dr. Peter English, a retired consultant in communicable disease and a past chair of the British Medical Association Public Health Medicine Committee, has also expressed doubts: “The problem for antivirals like Merck’s molnupiravir is that they would have to be used before people are (usually) deemed ill enough to need anything other than symptomatic self-care treatment.”

“Unless an antiviral medication could be made so cheap and so safe that it can be used ‘on spec’ by people who might have COVID-19, [it is] unlikely to be widely useful,” he adds.

Despite widespread optimism following the study results, some experts have raised concerns about the safety of a drug that works by causing mutations.

As molnupiravir causes viral RNA to mutate, there are concerns that it might cause mutations in host cells, as well. One study in animal cell cultures found mutations in cells treated with molnupiravir.

This has led to worries that the drug might cause cancers or birth abnormalities. The authors of the animal cell study recommend that this mutagenic potential be assessed in vivo, focusing on rapidly dividing cells. Additionally, they recommend monitoring to assess potential genotoxic side effects.

“It’s worth noting that people involved in the trial were instructed to abstain from heterosexual sex or use contraception. While this is routine practice with some other medicines, such as cancer chemotherapy, it suggests that the drug has the potential to cause birth defects should someone become pregnant.”

– Dr. Simon Clarke, associate professor of cellular microbiology at the University of Reading

Prof. Schaffner was less concerned about the possible genetic implications: “The FDA would certainly not have permitted clinical trials in humans if they thought there were any reasonable danger. […] Animal studies showed no adverse effects.”

In this trial, molnupiravir was effective against all variants, including the Delta variant, which was shown in a recent study to have a 235{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} increased risk of intensive care unit admission, compared with the original variant.

These positive results applied to people who had received molnupiravir soon after the onset of mild to moderate symptoms. A previous trial showed no benefit in giving the drug to patients already in hospital with COVID-19.

As an early treatment, molnupiravir could, Prof. Schaffner agrees, “offer another opportunity to prevent serious disease.”

“Although [this trial] had relatively small numbers analysed (fewer than 400 per group), it had much better results than the study done in hospitalized patients. It approximately halved the rate of hospitalization and notably reduced the number of deaths. Preventing the virus from replicating at an early stage seems very beneficial.”

– Prof. Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene & Tropical Medicine

So, is molnupiravir the drug we have been waiting for to bring COVID-19 under control? Perhaps, but the evidence is not yet conclusive.

Prof. Spector is among those keen to see more trial results. “We are told there were few side effects, but it would be good to know more details and see a full peer-reviewed publication,” he said. “But if this pans out, it will be a major game-changer for [COVID-19] treatment and possibly other viruses.”

For live updates on the latest developments regarding the novel coronavirus and COVID-19, click here.

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WHO issues clinical case definition

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The WHO has just released a formal definition of long COVID. Irina Efremova/Stocksy
  • Long COVID or post-COVID-19 are umbrella terms that refer to COVID-19 symptoms that persist beyond the initial phase of a SARS-CoV-2 infection.
  • The absence of a formal definition for post-COVID-19 has made the research of this condition and its management challenging.
  • The World Health Organization (WHO) recently published a definition of post-COVID-19 according to input from a panel of researchers, patients, and clinicians.
  • A standardized definition of post-COVID-19 will help advance research, facilitate awareness and acceptance, and aid diagnosis and management of this condition.

Depending upon the severity of symptoms, most individuals recover from COVID-19 within the first 3–4 weeks after contracting the SARS-CoV-2 virus. Yet, a significant number of individuals experience lingering COVID-19 symptoms for weeks and months after this initial or acute phase of the infection.

People have collectively described these persistent COVID-19 symptoms with terms such as long COVID, “post-acute COVID-19,” or “post-COVID-19.”

Some of the common symptoms of long COVID include fatigue, breathing difficulties, insomnia, pain, and brain fog. Additionally, post-COVID-19 can adversely impact multiple organ systems, including the kidneys, lungs, pancreas, and heart.

Stay informed with live updates on the current COVID-19 outbreak and visit our coronavirus hub for more advice on prevention and treatment.

The lack of a standardized definition and consistent terminology for post-COVID-19 have been obstacles for researchers studying the condition and its clinical diagnosis and treatment.

The World Health Organization (WHO) recently published a clinical case definition of post-COVID-19 to address these issues. The WHO told Medical News Today, “This standardized clinical case definition will help clinicians to identify patients more easily and provide them the appropriate care, and it is crucial for advancing recognition and research.”

There was a lack of awareness and skepticism about post-COVID-19 among the public and medical professionals when the initial cases of long COVID emerged. Consequently, individuals with persistent symptoms did not get the necessary medical care they required.

Since then, researchers have conducted several studies to estimate the proportion of individuals with persistent symptoms and determine the risk factors and symptoms associated with post-COVID-19.

Although there is more widespread awareness about post-COVID-19 now, the absence of a formal definition for the condition has led to inconsistencies in protocols by research groups studying this condition.

For instance, there is a lack of consensus about the time of onset and duration of post-COVID-19 symptoms. This has led to research groups using different time windows to estimate the incidence of long COVID.

Similarly, the absence of consensus on the symptoms associated with long COVID has resulted in studies including or excluding certain symptoms, influencing the estimates of the incidence of the condition and its symptoms.

The lack of a formal clinical case definition, which can provide criteria for diagnosing long COVID, has created challenges for healthcare professionals to diagnose and treat individuals with persistent symptoms.

Several organizations and societies have issued definitions for post-COVID to facilitate research and help the management of individuals with long COVID. However, a globally standardized definition has been lacking.

The WHO used a protocol called the Delphi method to arrive at its definition of post-COVID. The Delphi method involves multiple rounds of surveying an expert panel to arrive at a consensus.

The WHO panel consisted of clinicians, researchers, patient groups and policy-makers, representing different nations. After two rounds of surveys and a panel discussion, the WHO panel decided on the term “post-COVID-19” and the following definition:

“Post-COVID-19 condition occurs in individuals with a history of probable or confirmed SARS-CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms that last for at least 2 months and cannot be explained by an alternative diagnosis.”

“Common symptoms include fatigue, shortness of breath, cognitive dysfunction but also others, which generally have an impact on everyday functioning. Symptoms may be new onset, following initial recovery from an acute COVID-19 episode, or persist from the initial illness. Symptoms may also fluctuate or relapse over time.”

Anxiety, depression, pain, and changes in hearing, smell, and taste were among the other symptoms that the definition included.

A salient feature of this definition of post-COVID-19 is that the WHO panel was more representative of the global community, comprising participants from middle and low income nations. Moreover, the WHO group included stakeholders, such as patient groups, whose opinions have often been overlooked while formulating previous definitions of post-COVID-19.

According to the WHO, “With a standardized definition, we hope to advance recognition of the condition. It will also help clinicians to identify patients more easily and provide them [with] the appropriate care. With this standardized definition, we will also be able to measure the burden of this illness better, giving us a better understanding of its prevalence globally. Finally, we hope it will aid and promote research on the topic. [Having] a single definition will allow us to synergize global research and advance a globally relevant understanding of the condition.”

The WHO also noted that it expects this definition to evolve as more researchers accumulate more data on the condition. Moreover, the panel highlighted that a separate definition might be necessary to describe the condition in children.

MNT spoke to Dr. Ziyad Al-Aly, who recently published a study characterizing the symptoms of post-COVID-19.

Dr. Al-Aly, the chief of Research and Development Service at the Veterans Affairs St. Louis Health Care System, said: “This definition is too little too late. I was hoping that the WHO definition would be more comprehensive and more inclusive. It does not move the field forward a single inch.”

Dr. Al-Aly noted that the WHO definition “is based on only symptomatology — ignoring a lot of the manifestations caused by COVID-19, including new-onset diabetes, heart disease, kidney disease. [Moreover,] it also conditions the diagnosis on the idea that symptoms cannot be explained by an alternative diagnosis.”

“[This] makes long COVID a diagnosis of exclusion — further marginalizing long COVID. I worry that this myopic definition of long COVID may be used by governments and health insurers to debase long COVID, deny insurance coverage, etc.”

Dr. Al-Aly also cautioned that gaslighters may exploit the shortcomings of this definition.

The WHO’s definition of post-COVID-19 differs from those that a few other agencies issued, such as the time of onset of the condition. For instance, the Centers for Disease Control and Prevention (CDC) use the term “post-COVID conditions” to describe symptoms of COVID-19 that persist beyond the acute phase of 4 or more weeks.

Asked about this discrepancy, Dr. Al-Aly noted that these inconsistencies in defining the condition might lead to differences in research methodologies unfortunately persisting.

For live updates on the latest developments regarding the novel coronavirus and COVID-19, click here.

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Is there truly no COVID-19 in Turkmenistan? Experts weigh in

Turkmen women wearing traditional dress demonstrate how to fumigate a house with the smoke of burning wild rue (known locally as yuzerlik) in Ashgabat on December 11, 2020. – In tightly-controlled Turkmenistan, which still insists it has no virus cases, the pandemic has led to a boom in a herb whose Turkmen name translates as “medicine for a hundred illnesses”. Wild rue — known locally as yuzerlik — has for millennia been popular in North Africa, the Middle East and Central Asia as a panacea for sickness and ill fortune. But in Turkmenistan strongman leader and ex-dentist Gurbanguly Berdymukhamedov has gone a step further. In March he ordered wild rue burning on a “systematic level”, trumpeting the bacteria and infection-killing qualities of its faintly intoxicating smoke. (Photo by Igor SASIN / AFP) (Photo by IGOR SASIN/AFP via Getty Images)Share on Pinterest
Turkmen women wearing traditional dress demonstrate how to fumigate a house with the smoke of burning wild rue, known locally as yuzerlik, in Ashgabat on December 11, 2020. In Turkmenistan, the pandemic has led to a boom in an herb whose Turkmen name translates as ‘medicine for a hundred illnesses.’ (Photo by IGOR SASIN/AFP via Getty Images)
  • COVID-19 has been present in nearly every country in the world.
  • However, the Turkmenistan government claims that there have been no cases or deaths there. The World Health Organization (WHO) has repeated these claims.
  • Experts argue that the WHO needs to do more to investigate the situation.

Since its emergence toward the end of 2019, SARS-CoV-2 has spread around the world. Cases of COVID-19, which is the disease that SARS-CoV-2 causes, have officially been reported in almost every country — as have deaths to the disease. To date, there have been more than 4.8 million confirmed deaths globally.

A small number of countries have reported no cases or deaths. One of these countries is Turkmenistan. The WHO’s official statistics reflect the statistics provided by the country’s government.

However, reports from the country suggest that Turkmenistan has not miraculously escaped the effects of the pandemic. Like the countries it shares a border with, such as Iran and Afghanistan, it has experienced waves of infection — despite the government denying this.

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Speaking with Medical News Today, Prof. Luca Anceschi — a professor of Eurasian Studies at the University of Glasgow in the United Kingdom and an expert on Central Asia — said that like in North Korea, the authoritarian government was attempting to uphold an image of ushering in a golden age for the country.

For the government, a global pandemic does not fit into this picture, so it denies it.

“Turkmenistan and North Korea are similar in the sense of being very authoritarian regimes, run by people who have a very eccentric approach,” said Prof. Anceschi. “They are also extremely isolated states, using their borders as a control mechanism to stop the access of new ideas that could be destabilizing.”

“Like North Korea, in Turkmenistan, the government has control over the media, and on top of that, there is a particular narrative that the government has been putting out for the last 15 or 20 years about Turkmenistan living in this golden age, and the golden age is there because the government brought it with it.”

“That makes the eruption of a pandemic impossible […] because it would challenge this narrative. We have seen the same with [HIV] and [AIDS], which is another illness [that] was never publicly acknowledged in Turkmenistan. It is characteristic of this regime to hide these kinds of situations,” said Prof. Anceschi.

This analysis was also backed up by Dr. Jason Klocek, an assistant professor in politics and international relations at the University of Nottingham in the U.K. and an expert on state repression. Dr. Klocek has also lived in Turkmenistan for 2 years.

Dr. Klocek told MNT that, “[i]n many ways, the Turkmenistan government’s denial of COVID-19 cases is in line with long standing policy.”

“For more than a decade, the government has also claimed there are no people living with [HIV or AIDS] in the country. And a series of outbreaks, including the bubonic plague, were reported by civil society organizations in the early 2000s but denied by government officials.”

“Add to this the fact that the current president, Gurbanguly Berdimuahamedow, has used the image of a healthy nation — coupled with his previous dentistry career — to bolster his legitimacy. Admitting there is a COVID-19 outbreak could undermine that authority,” said Dr. Klocek.

According to Prof. Anceschi, the Turkmenistan government’s denial of COVID-19 in the country has created difficult conditions for people living there.

“It has been very difficult [for people living in the country] because Turkmenistan has had waves of infection, even last year.”

“Turkmenistan shares a border with Iran, which at one point was very significantly hit [by COVID-19], and with Afghanistan, which also has some problems. And, in general terms, all of Central Asia has infection rates as high as everywhere.”

“What is very difficult is the fact that there has been no considered effort to recognize this pandemic, which means no international cooperation. If public health is a human right, which it is, then that’s a lot of human rights violation that the government has perpetrated.”

“So, what can you do? The government at the beginning was saying that [COVID-19] doesn’t exist, and then it said it does exist but we have things like natural cures, and then, of course, people were dying.”

“What is incredible is [that the government’s messaging] is very dissonant: On the one hand, you have the fact that the government does not accept the fact that there is a pandemic, and then on the other, you start to see guidance for use of masks, hand-washing, and compulsory vaccination. So, the idea is that they don’t acknowledge the virus, but it is there.”

– Prof. Luca Anceschi

For Dr. Klocek, a key issue is the limited access to the country that makes getting detailed information on the COVID-19 situation difficult.

“The number of infections and the scale of their consequences are difficult to assess from outside the country,” said Dr. Klocek.

“Reports from civil society groups both within and outside the country suggest that the number of infections remains high and [that] hospitals are currently overwhelmed with COVID-19 patients. Individual reports of [citizens with the infection] are starting to surface via various media outlets.”

“The Turkmenistan government has also recently imposed additional travel restrictions in areas of the country where a high number of people are exhibiting COVID-19 symptoms.”

“Sadly, and similar to past outbreaks in the country, the extent of those suffering on the ground may not be known until it is too late to act,” added Dr. Klocek.

For Dr. Klocek, there has been too little focus on the situation in Turkmenistan from the international community.

“The international community has been largely silent [regarding the government’s claims]. There was a brief uptick in interest during the summer of 2020, when the WHO sent an observation team. But the visit was highly scripted, and the team could not confirm the presence of COVID-19 in the country.”

“[The team] did, however, express concern about ‘increased cases of acute respiratory disease or pneumonia of unknown cause’ and advised the country to carry out measures ‘as if there is coronavirus in the country.’”

“A Turkish diplomat also died of an illness with coronavirus-like symptoms in July 2020, but Turkish authorities remained silent on the matter, including the Turkmenistan government’s refusal to let the diplomat return to Turkey for treatment.”

“Since the summer of 2020, relatively little attention [had been] paid to the situation in Turkmenistan until the WHO’s regional director for Europe, [Dr.] Hans Kluge, traveled to Ashgabat this month.”

“A number of civil society organizations have tried to use the recent visit to put pressure on the WHO to make a formal statement about the situation in Turkmenistan. They are still waiting for a reply,” noted Dr. Klocek.

Prof. Anceschi said that the WHO had a responsibility to not simply repeat the government’s claims that there have been no cases of COVID-19 or related deaths.

“The WHO is as guilty as the regime. I understand that we live in the real world and you need to maintain access to a regime as intractable as Turkmenistan. However, as the WHO, you can’t just pretend that nothing is happening. Being cooperative with the regime means no one is safe.”

“The thing that is surprising is the totally pro-government line we got from the WHO. I tried to contact the WHO. They never replied. Other colleagues have had the same experience.”

“As I understand, in prior epidemic contexts — the avian flu or SARS-CoV-1 — [the WHO] would get back to you within 1 hour. They have been totally uncooperative with disseminating the truth.”

“The problem is that when you create a context in which this information [is] false, you have a further disservice: On top of not providing access to human rights in terms of public health, you also disseminate fake news. And [the WHO is] guilty of this. No one believes that Turkmenistan does not have COVID-19.”

“Now […] the government is making vaccination compulsory [and] running a campaign about washing your hands — what more do the WHO need to say there is a problem in Turkmenistan?”

“This consistent policy of sticking to the government line when the government is corrupt and has a tradition for disseminating fake data — I don’t understand why the WHO keeps being like this. It’s a very big credibility hit,” argued Prof. Anceschi.

On October 8, 2021, the government of Turkmenistan hosted an international forum on infectious disease control and health diplomacy. In it, the WHO’s Dr. Kluge said:

“The COVID-19 pandemic has shown unequivocally the fundamental importance of health for worldwide prosperity and security. There is a demonstrable need to rethink global governance structures, the relationship between the private and public sectors, and the values upon which our nations and societies operate.”

Dr. Kluge also stressed the importance of transparent communication, met with Turkmenistan government officials, and introduced the new WHO representative to Turkmenistan, Dr. Egor Zaitsev, to national officials. According to the WHO’s official page, the meeting explored further opportunities to strengthen the collaboration between the WHO and Turkmenistan.

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