Taming The World’s Leading Killer: High Blood Pressure

An article published recent in in the New England Journal of Medicine reports some astounding research findings which could save millions of lives. Why did you miss it? Because there was zero media coverage (apart from a few specialty medical blogs). Zero. That tells you something. Tells you a lot, actually. So, here are the details.

High blood pressure is the world’s leading killer — and will kill more people, including more young people, than Covid-19 (and, in usual years, more than all other infectious diseases combined). High blood pressure can be prevented, mostly by reducing dietary sodium, and is effectively treated with safe, low-cost medications.

But globally, we’re doing terribly on blood pressure control. Less than 1 in 7 people with high blood pressure, an abysmal 14%, have it controlled. This is, frankly, pathetic — and is killing millions of people a year. It’s the most important health care intervention for adults to save lives, and we get it right less than 1 in 7 times (and, in the United States, with a $4 trillion dollar health care system, we get this right less than half the time, despite it being the intervention that can save more lives than any other health care intervention in the US!)

Elegant studies by University of Oxford scientists prove that, for every 20-point increase in systolic blood pressure (the larger “top” number), the death rate from cardiovascular disease doubles. What’s more, this starts at a blood pressure of 115/75 — way below the usual level at which we treat, or toward which we aim treatment. Adapted from “Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies” in The Lancet. But showing that lower is better didn’t prove that lowering more is better. That’s where the incredibly important Systolic Blood Pressure Intervention Trial (SPRINT) study, begun in 2010, comes in.

It’s one thing to prove (as Oxford’s Dr. Sarah Lewington did) that lower blood pressure correlates with lower risk of death, but quite another to prove that lowering blood pressure more saves more lives. Lower blood pressure reduces the risk of death, but how low do we need to go? That’s what’s big news about the results from the SPRINT study that were just released. They prove that lower IS better — and that setting a blood pressure goal lower than the standard treatment goal prevented many more deaths.

The SPRINT study also showed that, despite more side effects (far less dangerous than heart attack or stroke), intensive blood pressure treatment to reach the lower blood pressure goal is safe — even for older people. More intensive treatment prevented more heart attacks, strokes and deaths.Based on the SPRINT study, many guidelines now recommend that certain high-risk patients with high blood pressure aim for a systolic blood pressure below 130 rather than the standard target of 140. (SPRINT aimed for an even lower target of 120/80.)

But the bigger implication: We need to do much better at getting people to under 140/90. For years, doctors were afraid to lower their patients’ blood pressures to levels they thought would be too low, and potentially dangerous. Now, it’s proven that “overshooting” the goal of 140/90 isn’t just something that won’t hurt the patient — it could well save their life.

The death rate among people treated with a blood pressure goal of under 120/80 was 27% lower than the death rate of people treated to the usual target of 140/90. And for every death prevented, about two heart attacks are prevented in addition to strokes, kidney failure, dementia, and more. Now, it’s also true that interventions other than medication can be important. Reducing sodium, in particular, can reduce blood pressure and other health harms from our overly salty diet. Getting regular physical activity, eating a healthier diet overall, reducing air pollution, and more can make a big difference. But these interventions are best done on a societal, community-wide basis.

That’s why, although we should empower and inform patients, we shouldn’t expect them to be able to withstand the obesogenic, salty, sedentary, polluted environment we live in. And even if we could magically improve our food and overall environment, there would still be a billion people in the world in need of medications to treat their hypertension. Why are we failing to control high blood pressure? One reason is that we’ve made treatment too complicated — far more complicated than it needs to be for optimal results. For the past four years, Resolve to Save Lives has worked with our global partners to identify characteristics of high-performing hypertension control programs throughout the world.

The WHO HEARTS technical package for improving cardiovascular health simplifies hypertension treatment: standard treatment protocols that any health worker can implement, reliable supply of quality-assured medicines, team-based health care, patient-centered services and a strong health information system. This makes it more likely that patients will achieve and maintain blood pressure control. Think about it. A study came out last week that could save millions of lives. There was not a single news article about it. Though this was “just” the final report from a study whose key results had previously been released in advance (because the findings are so important), we have been slow to implement these recommendations. It shows that we still have a lot to learn about what we need to focus on to save the most lives.

Resolve To Save Lives partners with countries which implement WHO’s HEARTS package to lower blood pressure. Sodium reduction and hypertension treatment can prevent 3 million early deaths — every year. Lowering blood pressure can save millions of lives. We know what we need to do, now let’s make it happen.

By: Dr. Tom Frieden, director of the US Centers for Disease Control and Prevention during the Obama administration, when he oversaw responses to the H1N1 influenza, Ebola and Zika epidemics, is President and CEO of Resolve to Save Lives, an initiative of Vital Strategies and Senior Fellow for Global Health at the Council on Foreign Relations. Twitter: @DrTomFrieden.

Source: Taming the world’s leading killer: high blood pressure – CNN

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Hypertension or high blood pressure is a chronic medical condition in which the blood pressure in the arteries is higher than it should be. This involves the heart working harder than normal to circulate blood through the blood vessels.

The pressure in the arteries changes depending on what the heart is doing. When the heart squeezes, pumping blood into the arteries, the pressure increases. When the heart relaxes, the pressure decreases. When blood pressure is measured, the highest pressure (when the heart is squeezing) is called the systolic blood pressure. The lowest pressure (when the heart is relaxing) is called the diastolic blood pressure.

Blood pressure is written as two numbers. For example, in the picture at the right, the person’s systolic blood pressure was 158. Their diastolic blood pressure was 99. This blood pressure is written as 158/99. It is said “158 over 99.”

Hypertension Types

There are two types of hypertension, called “primary” and “secondary.” Primary hypertension means that the hypertension is not caused by any other disease or condition and it gradually develops over time with age. Secondary hypertension means that the hypertension is caused by another disease or conditions. Secondary hypertension tend to result in higher blood pressure than primary hypertension. In most cases (90-95%), hypertension is primary. Only a small amount of hypertension (5-10%) is secondary.

There are various health conditions that leads to secondary hypertension which includes: Obstructive sleep apnea, Kidney problems, Adrenal gland tumors, Thyroid problems, Certain defects you’re born with (congenital) in blood vessels, Certain medications (birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs), Illegal drugs (cocaine and amphetamines)

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References

  • “High blood pressure (hypertension) – Symptoms and causes”. Mayo Clinic. Retrieved 2019-10-28.
  • Arguedas, JA (Jul 8, 2009). Arguedas, Jose Agustin (ed.). “Treatment blood pressure targets for hypertension”. Cochrane Database of Systematic Reviews (3): CD004349. doi:10.1002/14651858.CD004349.pub2. PMID 19588353. Unknown parameter |coauthors= ignored (|author= suggested) (help)
  • Williams, B; Poulter, NR, Brown, MJ, Davis, M, McInnes, GT, Potter, JF, Sever, PS, McG society (March 2004). “Guidelines for management of hypertension: report of the fourth working party of the British Hypertension Society, 2004-BHS IV”. Journal of Human Hypertension 18 (3): 139–85. doi:10.1038/sj.jhh.1001683. PMID 14973512 Law M, Wald N, Morris J (2003). “Lowering blood pressure to prevent myocardial infarction and stroke: a new preventive strategy”. Health Technol Assess 7 (31): 1–94. PMID 14604498.

How To Lower Resting Heart Rate: 5 Practical Steps To Take Today

How to lower resting heart rate

Wondering how to lower resting heart rate but not sure where to start? We’ve got the expert answers you’re looking for. Heart rate is a great key indicator of overall health and fitness levels. The heart is one of the hardest working muscles in the body so making sure it’s functioning properly is key.

Your heart rate will naturally spike throughout the day depending on how much you move and other factors such as stress levels and stimulants such as coffee, but it’s your resting heart rate that’s most important.

Resting heart rate simply refers to how many times your heart beats per minute whilst in a rested state. The American Heart Association (AHA) recommends taking your resting heart rate when you wake after a good night’s sleep.

You can check your resting heart rate by holding two fingers against one of your pulse points for a minute and counting the number of beats. However, technology can help provide a more accurate reading. The best heart rate monitors can be used in a resting state as well as during physical activity to help you monitor your heart rate zones, whilst today’s best fitness trackers (which include the best Fitbits) also provide heart-rate stats.

Generally speaking, the lower resting heart rate you have, the healthier your heart is and the fitter you are – although factors such as age can play a role. The AHA advises that for most people, a normal resting heart rate should be between 60 – 100. However, for those who are particularly active – professional athletes, for example – it’s okay for it to be between 50 and 60.

Studies have shown that elevated resting heart rates are linked with higher body weight and blood pressure, along with lower levels of physical fitness. If yours is above the recommended range, then there are steps you can take to reduce your resting heart rate. Here are five practical ways to make a start…

Increase your activity levels

There’s a reason that professional athletes have a very low resting heart rate – exercise strengthens the heart muscle. So just like when we get stronger if we increase other muscles, when the heart muscle gets stronger it means it works more efficiently – pumping blood quicker around the body.

Dr Zoe Williams, an NHS GP and wellness ambassador for Garminagrees: “There are a variety of ways you can lower your resting HR, but fitness is a great way to start.  “While it might seem counterintuitive to exercise, as this usually brings your heart rate up, the more frequently you exercise the more your heart will learn to be stronger and be more efficient at pumping blood. Then, when you’re in rest mode, your heart is more easily able to maintain a lower heart rate.”

If you are new to exercise, start slow. You could try walking to lose weight, download one of the best fitness apps, or try the Couch to 5k beginner’s running plan. Alternatively, work with a personal trainer to build a workout routine that is tailored to you. The key is to find something you enjoy doing to ensure you stick with it.

Eat a balanced diet

Of course, one of the main benefits that people talk about when cleaning up their diet is weight loss – but when you start to eat healthily, it has a major effect on how your heart performs too.

Brad Emmott, a personal trainer and Head of Recovery at Manor London explains: “If you’re someone who carries excess weight, your heart is having to work harder to pump blood through it. If you lose that excess weight, it won’t need to work as hard.”

Rather than drastically changing your diet overnight and restricting entire food groups (which is never usually a good idea), take it one step at a time. Try to see it as a lifestyle change, rather than a diet.Start small by increasing the amount of fruit and vegetables you eat every day – five is the recommended daily intake. This will naturally decrease your consumption of processed foods, which are typically high in salt and saturated fat.

From here, start to ‘balance’ your plate at every meal, roughly aiming for half vegetables, a quarter protein and a quarter carbohydrates – the perfect mix for feeling full and fueled. See our portion size guide for more information.

Decrease alcohol and sugar consumption

Most of us like to enjoy the odd glass of wine or gin and tonic with friends. But the effects of regular drinking – especially above the recommended guidelines (14 units a week for Brits, two drinks a day for US men and one drink a day for US women) – can result in an elevated heart rate, high blood pressure and the weakening of the heart muscle over time.

Williams says that too much sugar can have similar effects: “For some, eating sugar in excess can mean the body interprets this significant rise in sugar and energy as the result of stress, and releases cortisol and adrenaline. These hormones cause the heart rate to increase, which will in turn cause blood pressure to rise.”

The guidance in the UK is that adults should have no more than 30g of free sugars a day. In the US, the recommended daily limit is 10 teaspoons.

Get more sleep

Williams says creating better sleeping habits is key to lowering your resting heart rate. “One of the best ways to promote consistent sleep is having a healthy sleep routine. By following a standard schedule, the mind and body become accustomed to a healthy sleep pattern.”Many of the best fitness watches now also have sleep monitoring, which can be a useful tool in understanding your existing sleep patterns.

“By monitoring your sleep you can track improvements and adjust your bedtime accordingly to ensure you are getting between seven- and nine-hours sleep, which should ultimately help lower your resting heart rate overtime,” advises Williams. The best sunrise alarm clocks can also help to establish healthy and regular sleep patterns.

Manage your stress levels

Whether it’s down to your job, home life or personal issues, stress will take its toll on your health. Emmott believes we need to learn to manage it so it doesn’t negatively impact our resting heart rate and overall health.“Stress of any kind, physical or emotional does increase heart rate and can have long-term adverse effects on your health,” he says.

“There is no way to eliminate stress in daily life, but managing it is important to keeping a healthy heart.”In addition to the action points outlined above, he recommends that meditation, social interaction (virtual included) and being in nature can help manage stress levels.

Once again, using a fitness tracker to help assess your stress levels is also a good idea. “Knowing your stress level can help you identify stressful moments throughout your day and could help identify triggers of your stress, so you can begin to eliminate and manage stressful situations,” Williams says.

“For example, if your stress scores were high, it would be a great time to take five minutes away from what you were doing to do some deep breathing. This doesn’t have to impact your day, you can do it while boiling the kettle, but breaking the chronic stress cycle is so important for your long-term health and short-term mental wellbeing.”

 

 

Source: How to lower resting heart rate: 5 practical steps to take today | Fit&Well

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What Is Coronavirus & What Happens Now It Is a Pandemic

The disease appears to have originated from a Wuhan seafood market where wild animals, including marmots, birds, rabbits, bats and snakes, are traded illegally. Coronaviruses are known to jump from animals to humans, so it’s thought that the first people infected with the disease – a group primarily made up of stallholders from the seafood market – contracted it from contact with animals.

Although an initial analysis of the virus that causes Covid-19 suggested it was similar to viruses seen in snakes, the hunt for the animal source of Covid-19 is still on. A team of virologists at the Wuhan Institute for Virology released a detailed paper showing that the new coronaviruses’ genetic makeup is 96 per cent identical to that of a coronavirus found in bats, while an as-yet unpublished study argues that genetic sequences of coronavirus in pangolins are 99 per cent similar to the human virus. Some early cases of Covid-19, however, appear to have inflicted people with no link to the Wuhan market at all, suggesting that the initial route of human infection may pre-date the market cases.

The Wuhan market was shut down for inspection and cleaning on January 1, but by then it appears that Covid-19 was already starting to spread beyond the market itself. On January 21, the WHO Western Pacific office said the disease was also being transmitted between humans – evidence of which is apparent after medical staff became infected with the virus. Since then, evidence of widespread human-to-human transmission outside of China has been well established, making chances of containing the virus much harder.

What exactly is Covid-19?

Coronaviruses are a large group of viruses that are known to infect both humans and animals, and in humans cause respiratory illness that range from common colds to much more serious infections. The most well-known case of a coronavirus epidemic was Severe Acute Respiratory Syndrome (Sars), which, after first being detected in southern China in 2002, went on to affect 26 countries and resulted in more than 8,000 cases and 774 deaths. The number of people infected with Covid-19 has now well surpassed those hit with Sars.

While the cause of the current outbreak was initially unknown, on January 7 Chinese health authorities identified that it was caused by to a strain of coronavirus that hadn’t been encountered in humans before. Five days later the Chinese government shared the genetic sequence of the virus so that other countries could develop their own diagnostic kits. That virus is now called Sars-CoV-2.

Although symptoms of coronaviruses are often mild – the most common symptoms are a fever and dry cough – in some cases they lead to more serious respiratory tract illness including pneumonia and bronchitis. These can be particularly dangerous in older patients, or people who have existing health conditions, and this appears to be the case with Covid-19. A study of 44,415 early Chinese Covid-19 patients found that 81 per cent of people with confirmed infections experienced only mild symptoms. Of the remaining cases, 14 per cent were in a severe condition while five per cent of people were critical cases, suffering from respiratory failure, septic shock or multiple organ failure. In the Chinese study, 2.3 per cent of all confirmed cases died, although the actual death rate is probably much lower as many more people will have been infected with the virus than tested positive.

How far has it spread?

China has borne the brunt of Covid-19 infections (so far). As of March 11, Chinese health authorities had acknowledged over 81,250 cases and 3,253 deaths – most of them within the province of Hubei. On March 17, China recorded just 39 new cases of the virus – a remarkable slowdown for a country which, at the peak of its outbreak in mid-February, saw more than 5,000 cases in a single day.

But while things were slowing down in China, the outbreak started picking up in the rest of the world. There are now confirmed cases in at least 150 countries and territories. Outside of China, Italy has seen the highest number of cases, with 47,035 confirmed infections, mostly in the north of the country, and 4,032 deaths – more than in China. The entire country is now on lockdown after the quarantine covering the north of the country was extended on March 9.

Spain is also in the grip of a significant outbreak. The country has 20,410 confirmed infections and 1,043 deaths – the second-highest number within Europe. There, citizens are under lockdown, with the government shutting all schools, bars, restaurants and non-essential supermarkets down. People are only allowed to leave their homes to buy food or to go to work. Germany has 19,711 cases and 53 deaths, with the state of Bavaria implementing a full lockdown.

Iran, too, is seeing a surge in cases. The country has confirmed at least 1,433 deaths and 19,664 cases. In the US, there have been more than 14,631 cases and 210 deaths – 74 of them in Washington State, which has become the epicentre of the US outbreak.

While the number of new cases continues to rise sharply, people are also recovering from the infection. Globally, 84,960 people have recovered from Covid-19 – about 32 per cent of all of the people who had confirmed infections, although the true number of coronavirus cases will be much higher.

What’s the latest in the UK?

As of March 18, the UK has reported 3,983 confirmed Covid-19 infections and 177 deaths. On March 16, prime minister Boris Johnson led the first daily coronavirus press conference, saying that the government now advised all UK residents to avoid non-essential social contact and travel where possible. On Friday March 20 this was extended to include a shutdown of all bars, pubs, cafes and restaurants in the UK. From the same day all schools in England, Scotland and Wales were shut until further notice. Only vulnerable children, or those who are the sons and daughters of employees in the NHS or other key industries, will be permitted to remain at school.

People who currently live alone are recommended to self-isolate for seven days if they develop a fever or persistent dry cough – the two most common symptoms of coronavirus. For families and other people who live together, the advice is that the entire household should self-isolate if any member develops either of those symptoms. This strategy is part of the government’s ‘delay phase‘ plan to flatten the peak of the virus and reduce the burden on the NHS.

A key part of this plan is shielding those who are most vulnerable to Covid-19: people older than 70, or those who have underlying health conditions. The prime minister said that this shielding may last as long as 12 weeks in order to ensure that the peak of the outbreak has passed, although modelling from Imperial College London suggests that these measures may have to be in place for as long as 18 months. Despite these measures, some have been critical that the government’s stance doesn’t go far enough. Italy and Spain have both in place widespread lockdowns, while South Korea has rolled-out extremely comprehensive testing for many of its population.

The outbreak has also had a serious impact on the UK’s stock market. On March 9 the FTSE 100 fell by more than eight per cent, knocking billions off the value of major UK companies. Cinema changes Odeon, Cineworld and Vue closed their doors while Euro 2020 was also delayed until 2021, which is an added blow to broadcasters, particularly ITV.

What are the symptoms of Covid-19?

Covid-19 shares many of its symptoms with the flu or common cold, although there are certain symptoms common to flu and colds that are not usually seen in Covid-19. People with confirmed cases of Covid-19 rarely suffer from a runny nose, for instance.

The most common Covid-19 symptoms are a fever and a dry cough. Of 55,924 early Chinese cases of the disease, nearly 90 per cent of patients experienced a fever and just over two-thirds suffered with a dry cough. That’s why the UK government is advising anyone with a high temperature or a new, continuous cough to stay at home for seven days or, if they live with other people, for the entire household to isolate for 14 days from the first onset of symptoms.

Other Covid-19 symptoms are less common. Just under 40 per cent of people with the disease experience fatigue, while a third of people cough up sputum – a thick mucus from within the lungs. Other rarer symptoms include shortness of breath, muscle pain, sore throats, headaches or chills. According to the WHO, symptoms tend to appear between five and six days after infection.

What’s happening with a vaccine?

A vaccine for Covid-19 isn’t around the corner. Bringing vaccines to the market is a notoriously slow process and any potential vaccine will have to pass multiple stages of testing for safety and effectiveness. And once we know a vaccine is safe, we will also need to manufacture it at a scale high enough to use across the world. It’s likely that any vaccine is around 18 months away.

That said, there is lots of work being done to develop a vaccine for Covid-19. The pharmaceutical firm Sanofi is trying to build on its already-approved flu vaccine and turn it into something suitable to treat Covid-19. Other approaches – such as one being trialled by the University of Oxford – are focusing on the external spike proteins on the Covid-19 virus as a way to target vaccines.

But accelerating these efforts will require funding. The Coalition for Epidemic Preparedness Innovations (CEPI) has called for $2 billion in funding to support the development of new coronavirus vaccines.

What’s going to happen next?

WHO chief Tedros Adhanom Ghebreyesus has warned that the window of opportunity to contain Covid-19 is “narrowing”. Recent outbreaks in Italy and Iran, which so far have no clear link to China, pose a significant challenge to health authorities trying to stop the spread of the virus.

After initially delaying the decision, on March 11, the WHO declared the Covid-19 outbreak a pandemic. The agency cited the rapid growth of cases outside of China and the global spread of the disease as reasons behind the designation. In January, it also declared the outbreak a “public health emergency of international concern” – the highest category of warning for an infectious disease outbreak.

Since 2009 there have only been five declarations of international public health emergencies: the swine flu pandemic in 2009, a polio outbreak in 2014, the Western Africa Ebola outbreak in 2014, the Zika virus outbreak in 2015 and another Ebola outbreak in the Democratic Republic of the Congo in 2019.

Matt Reynolds is WIRED’s science editor. He tweets from @mattsreynolds1

Source: What is coronavirus and what happens now it is a pandemic?

Please follow my instagram: http://instagram.com/arminhamidian67

And why the disease first appeared in China. NOTE: As our expert Peter Li points out in the video, “The majority of the people in China do not eat wildlife animals. Those people who consume these wildlife animals are the rich and the powerful –a small minority.” This video explains how the people of China are themselves victims of the conditions that led to coronavirus. The virus is affecting many different countries and cultures, and there is never justification for xenophobia or racism. You can find further reading on this on Vox: https://www.vox.com/2020/2/7/21126758… https://www.vox.com/policy-and-politi… https://www.vox.com/identities/2020/3…

China’s E-Learning Leaders Add $3.2 Billion As Coronavirus Fears Drive Students Online

The coronavirus outbreak has been hitting China’s economy hard as many businesses have had to temporarily shut down their operations amid tight quarantine rules. But measures to stop the spread of the illness have also become an unexpected boon for at least one industry: online education.

With the opening of schools pushed back to March and all extracurricular activities suspended, tens of millions of students have been told to go online to study. And the country’s providers of online tutoring services are suddenly experiencing a surge in interest from students and their parents.

The biggest winner appears to be TAL Education’s Zhang Bangxin, who saw his wealth increase by $1.7 billion, giving him a current net worth of at least $10 billion. His New York-listed company rallied 20% last month on expectations of strong growth. The 40-year-old Zhang has catapulted past the likes of JD.com’s founder Richard Liu ($8.7 billion) and Baidu’s Robin Li ($7.1 billion) to reach No. 24 on China’s wealth rankings.

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“This is like a natural marketing campaign for these companies,” says Jiao Wei, an analyst at Shanghai-based research firm 86 Research. “Parents who didn’t know much about online education can now see how it works and how classes are being streamed online.”

TAL has partnered with more than 300 public schools across China to stream free classes, and its Xueersi unit is providing complementary K-12 online tutoring sessions. Other education companies are also launching more e-learning courses, while developing data tools to analyze student performance and help teachers track their progress.

Shares of New York-listed New Oriental rose 7.3% last month, adding $190 million to the wealth of its founder Yu Minhong. His current net worth is estimated at $3.4 billion. And Chen Xiangdong, founder of GSX Techedu, also listed in New York, has seen his net worth rise to $4.75 billion, thanks to a 40% rally that added another $1.3 billion to the value of his stake in the same period. The three education billionaires’ combined $3.2 billion gain makes them stand out as rare winners at a time when the coronavirus outbreak has battered industries ranging from hospitality to retail and logistics. As of Thursday, the virus that had infected nearly 80,000 people in China has been estimated to shave $60 billion off China’s economic growth.

More Sources:

https://commodity.com/blog/biggest-lost-fortunes/

Analysts say that education companies are likely to benefit from the increased attention for their services for some time. After both students and parents become more familiar with virtual classrooms, they can be enticed to try other products and pay for services down the road. Terry Weng, a Shenzhen-based analyst at research firm Blue Lotus Research Group, estimates that 22% of Chinese K-12 students will take part in online tutoring by end of this year, up from 17% in 2019. Driven by tough competition for good schools and jobs, as well as technological advances in virtual learning, China’s online education market is expected to more than triple to 696 billion yuan ($99.3 billion) in 2023 from last year’s 203 billion yuan, according to research firm Frost & Sullivan.

More on Forbes: No Customers, Closed Stores: Chinese Entrepreneurs Brace For The Worst Amid Coronavirus Outbreak

But analysts also caution that the current e-learning boom may not translate into higher revenue or profit—at least not in the short term. In a bid to attract more users, many services are being offered for free or at a discount. Blue Lotus’s Weng estimates that when TAL actually charges its virtual classes, they are sold at a 10% to 30% discount compared with lessons for its offline learning centers. The company generated $6.5 million in profits from $2.5 billion in sales during the first nine months of 2019. Before the virus struck, TAL was estimated to derive between 20% and 30% of its revenues from online learning and the remainder came from its offline centers.

Still, investors seem willing to overlook any short-term loss and focus on future gains. Aside from faster user growth for their online services, TAL and New Oriental’s offline businesses may also capture a larger share of the overall education market. This is due to the fact that smaller service providers are running out of cash, and probably won’t stay in business much longer. They still have to pay rent and teachers’ salaries, even when China suspended all types of offline classes and ordered tuition refunds.

“The gradual exit of smaller education firms means there are more opportunities for TAL and New Oriental,” Weng says. “Investors are more keen for their future performance.”

I am a Beijing-based writer covering China’s technology sector. I contribute to Forbes, and previously I freelanced for SCMP and Nikkei. Prior to Beijing, I spent six months as an intern at TIME magazine’s Hong Kong office. I am a graduate of the Medill School of Journalism, Northwestern University. Email: ywywyuewang@gmail.com Twitter: @yueyueyuewang

Source: China’s E-Learning Leaders Add $3.2 Billion As Coronavirus Fears Drive Students Online

 

There are at least 29 confirmed cases of Covid-19 in the United States. It’s a small fraction of the number of cases in China, but the fear surrounding the coronavirus outbreak knows no bounds. Many Chinese students in America are on edge, and worry for family members in China. CGTN’s Dan Williams met some students at Northwestern University.

Coronavirus Pushes Airlines To Their Worst Financial Hit In 17 Years

The deadly coronavirus discovered in China has traveled by air to some 25 other countries. It’s no wonder a lot of those countries are restricting flights and handing airlines their worst event-driven financial hit since 2003.

More than 25,000 flights were canceled in the first full week of February, according to data from air travel intelligence firm OAG. Thirty airlines have suspended services to China, reaching a combined 8,000 seats per week, OAG says. The virus, discovered in the central Chinese city of Wuhan in December, has sickened more than 40,000 people and killed over 900 as of February 10.

Airlines will feel a financial pinch that reminds them of the deadly outbreak of Severe Acute Respiratory Syndrome (SARS) that started in China in 2003, aviation experts predict. They say today’s suspensions are already as bad as the SARS peak from March through June 2003. They attribute that to the coronavirus’s quick, widely-reported spread and the equally fast moves around the world to ban travel-related activity—a result of everyone learning from the SARS crisis.

“The levels of cancelations that we are seeing are unprecedented and exceed any other pandemic event that we can recall,” says Mayur Patel, head of Asia at OAG. He attributes the pileup of cancelations to “swift action from regulators and airlines.”

The SARS epidemic hollowed out 8% of annual revenue per kilometer for Asia Pacific airlines and cost them $6 billion in revenues due to lost business, Singapore’s Business Times reports. That epidemic hit Hong Kong, Taiwan and Singapore as well as major mainland Chinese cities.

Losses expected from the coronavirus-linked cancelations are “broadly consistent with the SARS level” when China-headquartered airlines alone slashed at least 50% of flights, says Eric Lin, aviation analyst in Hong Kong with the investment bank UBS. He anticipates industry losses at least in the first quarter this year.

Mainland Chinese airlines have felt most of the impact this year to date, Lin says. Among those are state-owned carriers such as Air China and China Southern Airlines. Privately-owned peers including Hainan Airlines have cut back, too.

Taiwan’s airlines and Hong Kong-based Cathay Pacific will be especially hit hard because of their dependence on China flights, Lin forecasts. Going farther out, United Airlines and British Airways have both reduced China flights.

A spokesperson for Taiwan-based EVA Airways said Friday the carrier planned to scale back China flights through April and that it was “monitoring the development of coronavirus outbreak and passengers’ travel demand to adjust route network and flight frequency.” Taiwanese peer China Airlines set up a Q&A website for worried passengers on February 4 and said it would refund fares booked directly through the company.

Losses this year could add up further if the virus spreads more outside China, Moody’s Investors Service said in a January 31 research note, though a dip in oil prices might offset that. “Carriers with weaker business models or liquidity profiles are likely to be hit harder and take longer to recover,” Moody’s said in the note.

Airlines will probably cope with losses by cutting costs, including non-paid leave for employees, Lin says. But some diversified routes to avoid depending on China, he adds. On whether or not airfares will rise, “do not expect a lot of bargains,” he says.

Civil aviation will bounce back fast once the virus recedes, if the SARS progression repeats this year, analysts believe. The main airport in Beijing, a SARS outbreak area, reported peak passenger flows a month after SARS passed, while the country’s airlines were selling 90% of their seats, China Daily reported back then.

Lin expects a V-shaped recovery from the coronavirus slump that’s now addling airlines. That’s because passengers who spiked travel during the disease outbreak suddenly jump back into it with extra demand, Lin says.

“Our experience of such events is that air services will return quickly after the virus has been contained and demand will rapidly follow,” Patel says.

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As a news reporter I have covered some of everything since 1988, from my alma mater U.C. Berkeley to the Great Hall of the People in Beijing where I followed Communist officials for the Japanese news agency Kyodo. Stationed in Taipei since 2006, I track Taiwanese companies and local economic trends that resonate offshore. At Reuters through 2010, I looked intensely at the island’s awkward relations with China. More recently, I’ve studied high-tech trends in greater China and expanded my overall news coverage to surrounding Asia.

Source: Coronavirus Pushes Airlines To Their Worst Financial Hit In 17 Years

Airlines have begun suspending flights as fears mount over the coronavirus epidemic. Indonesia’s Lion Air is halting all flights to and from China from Feb 1, while Jetstar Asia will suspend flights between Singapore and several cities in China because of a drop in demand. British Airways said it is stopping all direct flights to and from mainland China. Subscribe to our channel here: https://cna.asia/youtubesub Subscribe to our news service on Telegram: https://cna.asia/telegram Follow us: CNA: https://cna.asia CNA Lifestyle: http://www.cnalifestyle.com Facebook: https://www.facebook.com/channelnewsasia Instagram: https://www.instagram.com/channelnews… Twitter: https://www.twitter.com/channelnewsasia

First Death In China From New Coronavirus Pneumonia Outbreak

Health Screenings In Bangkok For China's Wuhan Pneumonia

Barney Stinson of the television show How I Met You Mother was wrong. New is not always better.

The latest news about the mystery pneumonia outbreak in Wuhan, China, is that scientists may have found a new virus. And this novel virus may be the culprit in the outbreak that has already left over 40 people sick and now a 61-year-old man dead.

Yes, this is the “mystery pneumonia” outbreak that I covered for Forbes last week. Now, as CBS News reported, a lead scientist in the ongoing investigation of the outbreak in China, Xu Jianguo, has said that it’s been “preliminarily determined” that a new strain of coronavirus may be the culprit. That would preliminarily suck because who wants yet another virus to worry about that can potentially kill.

Those of you who took Latin in high school so that you can talk to nobody may recognize that “corona” is the Latin word for “crown.” Coronaviruses are a family of viruses that have spikes on their surface that make them look like little crowns as you can see in this photo:

Can you you imagine one of these viruses on your head?

While it may be good to have a real crown on you, you probably do not want one of these on or in you. That’s because there are now seven different types of coronaviruses that can infect humans. The most common types of these so-called human coronaviruses are two, 229E and NL63, that fall into the alpha subgroup, and two, OC43 and HKU1, that fall into the beta subgroup of coronaviruses. These four may not be that easy to remember because their names sound a bit like droids on Star Wars.

https://i1.wp.com/onlinemarketingscoops.com/wp-content/uploads/2020/01/Secrets-to-ebay-and-amazon-success-Ad-Gif-2.gif?resize=136%2C136&ssl=1But that’s OK, because these four aren’t the most worrisome ones. They tend to cause mild-to-moderate upper respiratory illnesses that consist of cold-like symptoms such as a runny nose, cough, headache, sore throat, fever, and general feeling of bleck. Occasionally, the infection can involve your lower-respiratory tract, resulting in bronchitis or pneumonia, which is more likely to happen when your immune system, heart, or lungs are weakened.

The human coronaviruses to worry much more about are the remaining three. One is the SARS-Coronavirus (CoV), which causes, you guessed it, SARS or severe acute respiratory syndrome. This was the beta coronavirus that sickened 8,098 people and killed 774 around the world during the 2003 SARS outbreak, according to the Centers for Disease Control and Prevention (CDC). The World Health Organization (WHO) estimated that the SARS-CoV killed 14% to 15% of those infected.

A second is the MERS-CoV, which causes MERS or Middle East Respiratory Syndrome. As the WHO describes, MERS was first found in Saudi Arabia in 2012. This beta coronavirus has also been quite a killer, with around 35% of those infected dying.

The third human coronavirus in this uh-oh group and seventh overall is this new coronavirus just found in Wuhan, China. It doesn’t have an official name yet and is listed on the CDC website as “Novel Coronavirus 2019.”

This new one is still a quite a mystery. The MERS-CoV and SARS-CoV, like other human coronaviruses, can spread from one human to another through contact with respiratory secretions. So far, word is that there haven’t been any clear cases of one human infecting another with “Novel Coronavirus 2019.”

For example, reportedly no health care workers who have been taking care of the patients with the virus have gotten sick themselves. Ah, but don’t rule out human-to-human transmission of the virus just yet. If human-to-human transmission is not possible then how the heck did so many people get infected? Did everyone somehow interact with the same group of animals? If so what animals are responsible? As they say, I have so many questions.

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Plus, even if a virus can’t go from human-to-human now, who knows what may happen in the future? A new virus that has managed to finally learn how to infect a human can be a bit like a contestant who has finally made it intothe reality television show The Bachelor or The Bachelorette. It can explore and learn how to wreak further havoc. Eventually, it may figure out how to jump from one human to another. After all, viruses and reality show participants can evolve quite quickly.

Stay tuned as this remains an evolving situation. For now, many countries in Asia are taking precautions and screening those traveling from Wuhan. If you are traveling to Wuhan, don’t interact closely with someone who appears to be sick and don’t hang out with animals. You don’t want to get caught off guard the next time something new emerges about this new virus.

Follow me on Twitter or LinkedIn. Check out my website.

I am a writer, journalist, professor, systems modeler, computational and digital health expert, avocado-eater, and entrepreneur, not always in that order. Currently, I am a Professor of Health Policy and Management at the City University of New York (CUNY), Executive Director of PHICOR (@PHICORteam), Associate Professor at the Johns Hopkins Carey Business School, and founder and CEO of Symsilico. My previous positions include serving as Executive Director of the Global Obesity Prevention Center (GOPC) at Johns Hopkins University, Associate Professor of International Health at the Johns Hopkins Bloomberg School of Public Health, Associate Professor of Medicine and Biomedical Informatics at the University of Pittsburgh, and Senior Manager at Quintiles Transnational, working in biotechnology equity research at Montgomery Securities, and co-founding a biotechnology/bioinformatics company. My work involves developing computational approaches, models, and tools to help health and healthcare decision makers in all continents (except for Antarctica) and has been supported by a wide variety of sponsors such as the Bill and Melinda Gates Foundation, the NIH, AHRQ, CDC, UNICEF, USAID and the Global Fund. I have authored over 200 scientific publications and three books. Follow me on Twitter (@bruce_y_lee) but don’t ask me if I know martial arts.

Source: First Death In China From New Coronavirus Pneumonia Outbreak

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Health Authorities Know What’s Potentially Causing Vaping-Related Deaths

Topline: The CDC announced on Thursday that vitamin E acetate, a chemical found in skincare products that is dangerous when heated or inhaled, is a “very strong culprit” in the spate of vaping-related lung injuries and deaths have for months perplexed and alarmed federal health officials.

  • The CDC determination comes from a study that examined 29 samples from patients with vaping-related lung illnesses. All 29 of them contained traces of vitamin E acetate.
  • No other potential toxins were detected.
  • Vitamin E acetate is a chemical commonly found in skincare products, and it isn’t dangerous when applied to the skin or swallowed. But when heated and inhaled through vaping devices, the chemical can cause harm to a patient’s lungs.
  • Vitamin E acetate has been recently used in black market products containing THC, the psychoactive chemical in cannabis, as a thickening agent.
  • But officials do not yet know exactly where the vitamin E acetate is coming from.
  • THC was found in 23 of 28 patients, including three who said they had not used THC products, while nicotine was detected in 16 of 26 patients.
  • Officials cautioned that there could more than one toxin causing the illnesses, and more evidence is needed to establish a causal link between vitamin E acetate and the injuries.

Crucial quote: “These findings provide direct evidence of vitamin E acetate at the primary site of injury within the lungs,” said Anne Schuchat, principal deputy director at the CDC, in a press call Thursday. “And the samples reflect patients from across the country.”

Key background: As of Tuesday 2,051 cases of vaping-related illnesses have been reported along with 39 deaths, according to the CDC. The cause of the lung injuries and deaths have prompted health officials to warn against vaping altogether and for state and federal lawmakers to mull or impose vaping sale bans.

Further reading: Read the CDC’s report on the study here.

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I’m a San Francisco-based reporter covering breaking news at Forbes. Previously, I’ve reported for USA Today, Business Insider, The San Francisco Business Times and San Jose Inside. I studied journalism at Syracuse University’s S.I. Newhouse School of Public Communications and was an editor at The Daily Orange, the university’s independent student newspaper. Follow me on Twitter @rachsandl or shoot me an email rsandler@forbes.com.

Source: Health Authorities Know What’s Potentially Causing Vaping-Related Deaths

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Vaping & E-Cigarette related illnesses & deaths have gathered significant media attention. Join Dr. Seheult of https://www.MedCram.com as he illustrates key points about vaping and E cigarette-related acute pulmonary illness & disease symptoms, diagnosis, CXR, and CT scan findings that we understand at this time. More information and studies are needed as vaping deaths and hospitalizations in 2019 continue to rise (some are calling it a “vaping epidemic”). See the second video in this series on the treatment of vaping associated pulmonary injury: https://youtu.be/7TO7Cfi_o38 Links to articles from the New England Journal of Medicine referenced in this video: Pulmonary Illness Related to E-Cigarette Use in Illinois and Wisconsin — Preliminary Report: https://www.nejm.org/doi/full/10.1056… Vaping-Induced Lung Injury: https://www.nejm.org/doi/full/10.1056… Instructor: Roger Seheult, MD Co-Founder of MedCram.com Clinical and Exam Preparation Instructor Board Certified in Internal Medicine, Pulmonary Disease, Critical Care, and Sleep Medicine. Visit https://www.MedCram.com for top-rated medical videos, over 30 hours of category 1 CME and CE, and over 100 free lectures. MedCram: Medical education topics explained clearly including: Respiratory lectures such as Asthma, COPD, and vape / E cigarette related lung disease. Renal lectures on Acute Renal Failure and Adrenal Gland. Internal medicine videos on Oxygen Hemoglobin Dissociation Curve and Medical Acid Base. A growing library on critical care topics such as Shock, Diabetic Ketoacidosis (DKA), and Mechanical Ventilation. Cardiology videos on Hypertension, ECG / EKG Interpretation, and heart failure. VQ Mismatch and Hyponatremia lectures have been popular among medical students and physicians. The Pulmonary Function Tests (PFTs) videos and Ventilator-associated pneumonia bundles and lectures have been particularly popular with RTs. NPs and PAs have given great feedback on Pneumonia Treatment and Liver Function Tests among many others. Dr. Jacquet teaches our FAST exam tutorial & bedside ultrasound courses. Many nursing students have found the Asthma and shock lectures very helpful. We’re starting a new course series on clinical ultrasound/ultrasound medical imaging. Recommended Audience – Medical professionals and medical students: including physicians, nurse practitioners, physician assistants, nurses, respiratory therapists, EMT and paramedics, and many others. Review and test prep for USMLE, MCAT, PANCE, NCLEX, NAPLEX, NBDE, RN, RT, MD, DO, PA, NP school and board examinations. More from MedCram.com medical lectures: Blog: https://blog.medcram.com Facebook: https://www.facebook.com/MedCram Google+: https://plus.google.com/u/1/+Medcram Twitter: https://twitter.com/MedCramVideos Subscribe to the official MedCram.com YouTube Channel: https://www.youtube.com/subscription_… Produced by Kyle Allred PA-C Please note: MedCram medical videos, medical lectures, medical illustrations, and medical animations are for medical education and exam preparation purposes, and not intended to replace recommendations by your doctor or health care provider. #Vaping #ECigarettes #vapingdeaths

Heart Checks While You Shop: NHS Announces Plan To Have Pharmacies Check Shoppers’ Heart Health In Bid To Cut Deaths

Shoppers will be offered on-the-spot NHS heart checks to detect signs of killer conditions.

High street pharmacies will be overhauled under the national plan to prevent up to 150,000 heart attacks and strokes within a decade.

The country’s most senior doctor said the new approach would be a “game changer,” helping to identify risks far earlier, with advice on lifestyle overhauls as well as targeted medication.

Pilot schemes have seen some types of strokes fall by a quarter.

From October, chemists will begin rolling out the “rapid detection service,” which includes mobile electrocardiograms to spot irregular heartbeats, as well as checks on blood pressure and cholesterol levels.

If successful, the scheme will be rolled out to every pharmacist in the country within three years.

An NHS sign is pictured at St Thomas’ Hospital  Credit: AFP

The plans aim to identify those at risk far earlier, when treatment and lifestyle changes are most likely to be effective.

Pharmacists will be expected to dole out advice on exercise and diet, with results passed directly to GP practices, who can prescribe the right medication.

Professor Stephen Powis, NHS England medical director, said: “Heart disease and strokes dramatically cut short lives, and leave thousands of people disabled every year, so rapid detection of killer conditions through high street heart checks will be a game-changer.”

The plans, launched to coincide with the world’s biggest heart conference, follow proposals to scrap “one size fits all” health MOTs at GP surgeries.  In future, GPs will be expected to increasingly target checks on those thought to be at greatest risk, due to their medical and genetic history, while routine screening tests are offered by pharmacists.

Heart disease is Britain’s biggest killer, with deaths from heart attacks, strokes and circulatory diseases accounting for 160,000 deaths in the UK every year.

More than 7 million people are living with heart and circulatory diseases.

Speaking at the European Society for Cardiology (ESC) conference, in Paris, Professor Bryan Williams, author of its guidelines on disease prevention, said: “This is hugely important. Heart disease and stroke remain the most important cause of premature death and disability and we have the means to prevent the many of them.

“The key is early detection of those at risk and doing this is a way that is convenient for the public, not having to wait for a GP appointment that could be done simply the local pharmacy.”

Chemists will begin rolling out the “rapid detection service,” which includes mobile electrocardiograms to spot irregular heartbeats, as well as checks on blood pressure and cholesterol levels. Credit: Anthony Devlin/PA

Yesterday Dexter Canoy, clinical epidemiologist from the University of Oxford, presented research showing that raised blood pressure at the age of 40 is a clear indicator of the risk of suffering heart attacks and strokes in later life.

He said: “We need to find ways to target the people who aren’t seeing their GP regularly – the middle-aged men who think they are healthy, but haven’t actually been checked.”

“If opening it up to pharmacies and shopping malls means that people are more likely to have their blood pressure checked, that could make a significant difference,” he said, calling for proper evaluation of the measures.

The checks are part of a new £13 billion five year contract for community pharmacists which aims to expand their roles and offer earlier detection of diseases.

More than 100 pharmacies in Cheshire and Merseyside have begun offering blood pressures screening services, under a local initiative, backed by the British Heart Foundation, with plans to recruit more than 200 more chemists to the service as it expands.

Medics said widespread use of the monitors by pharmacies, hospitals and individual patients could cut costs, speed diagnosis and avoid preventable hospital admissions.

Pilot schemes in Lambeth and Southwark in south London identified more than 1,400 patients suffering from atrial fibrillation – an irregular heart rhythm –  who should have been taking blood thinning drugs, but were not. In total, 1,300 of the patients have now been put on the medication, leading to a 25 per cent reduction in the rate of strokes linked to their heart condition.

Keith Ridge, England’s chief pharmaceutical officer, said: “This new contract makes the most of the clinical skills of local pharmacists and establishes pharmacies across England as local health hubs – open in the evenings and at weekends – where people can go for an ever-increasing range of clinical health checks and treatment.”

Simon Gillespie, chief executive of the British Heart Foundation, said: “Millions of people in England are living with conditions such as high blood pressure which, if left untreated, significantly increase the risk of having a potentially deadly heart attack or stroke. Reaching more people and encouraging them to check their blood pressure, working with them to lower it where necessary, will play an absolutely critical role in saving lives in the coming years.”

By:

 

Source: Heart checks while you shop: NHS announces plan to have pharmacies check shoppers’ heart health in bid to cut deaths

72 People Ill From E. Coli Outbreak, What Is The Cause?

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Pictured here is one strain of Shiga toxin-producing Escherichia coli. (Photo: Getty Images)

Oh 103, no. Today, the Centers for Disease Control and Prevention (CDC) announced that at least 72 people in 5 states have already gotten sick from an outbreak of Shiga toxin-producing Escherichia coli (E. coli) O103. Therefore, for now, be careful when eating anything. Anything? Yes, anything.

That’s because so far there is no clear cause of the outbreak that has affected at least 8 people in Georgia, 36 people in Kentucky, 5 in Ohio, 21 in Tennessee, and 2 in Virginia and has resulted in at least 8 hospitalizations.  A timeline provided by the CDC shows that illnesses started on March 2 , 2019. Those affected have ranged in age from one year old to 74 years young. The median age of people who have gotten ill is 17 years.

I’ve already written for Forbes about another STEC, Shiga toxin-producing E. coli, that goes by the name O157:H7. This agent, not to be confused with 007, was the cause of the outbreak that was eventually linked to Romaine lettuce last year. A STEC by any name is not good. Besides causing all kinds of poop, including bloody poop, that starts 2 to 8 days after entering your mouth, a STEC can, in some cases, be life threatening.

The biggest concern is hemolytic uremic syndrome (HUS). As I have described before, this is HUS and it’s not good: the Shiga toxin triggers destruction of your red blood cells, which can then result in pieces of red blood cells clogging up your kidneys, your kidneys potentially failing, and you potentially dying. The typical symptoms of an “uncomplicated” STEC infection are bad stomach cramps, vomiting, and bloody diarrhea. You should worry about HUS if you develop a fever, a pale skin tone, fatigue and irritability, small, unexplained bruises or bleeding from the nose and mouth, and especially decreased urination.

STEC can be all kinds of different foods and beverages. The Foodsafety.gov website includes the following examples:

  • Contaminated food, especially undercooked ground beef, unpasteurized (raw) milk and juice, soft cheeses made from raw milk, and raw fruits and vegetables (such as sprouts)
  • Contaminated water, including drinking untreated water and swimming in contaminated water
  • Animals and their environment: particularly cows, sheep, and goats. If you don’t wash your hands carefully after touching an animal or its environment, you could get an E. coli infection
  • Feces of infected people

So take precautions when potentially eating or drinking anything, including the feces of other people. I know, I know, you say that feces is not part of your diet. But you would be surprised by how much poop gets around if you don’t wash your hands. So wash your feces-ed hands, frequently and thoroughly, especially when handling food or your mouth.

Here’s how:

Besides washing your hands, which you should do frequently and thoroughly, the CDC recommends that you cook meats thoroughly (steaks and roasts to at least 145˚F and ground beef and pork to at least 160˚F), thoroughly clean anything that touches raw meat, wash fruits and vegetables before eating them, and avoid raw dairy products and unpasteurized juices. Oh, and you should wash your hands, thoroughly and frequently.

For now, the CDC and other authorities are searching for a source of this latest STEC outbreak. Therefore, wait for updates and wash your hands, thoroughly and frequently. The aforementioned food safety recommendations should apply regardless of whether there is a STEC outbreak. In other words, don’t return to wearing raw meat masks, guzzling raw milk, licking cutting boards clean, using unwashed celery as floss, and not washing your hands, frequently and thoroughly after an outbreak has passed.

Follow me on Twitter @bruce_y_lee and visit our Global Obesity Prevention Center (GOPC) at the Johns Hopkins Bloomberg School of Public Health. Read my other Forbes pieces here

My career has spanned the worlds of digital and computational health, business, academia, medicine, global health, and writing. Currently, I am the Executive Director of..

Source: 72 People Ill From E. Coli Outbreak, What Is The Cause?

Top Surgeon : How To Proporly Wash Out Your Bowels – Gundry MD

Millions of Americans suffer from low energy, digestive discomfort, and trouble losing weight. Many also experience achy muscles and joints, skin problems, headaches, and even frequent colds. “If you’re experiencing any of these health issues, the real problem may be Leaky Gut,” says Dr. Steven Gundry. According to Dr. Gundry — who has studied leaky gut for over 20 years — certain foods can cause tears in our gut lining. This, in turn, allows toxins to enter our body that lead to digestive discomfort, food cravings, fatigue, weight gain, and even more health issues…..

Source: https://thenewgutfix.com/leaky-gut-fix_181102A.php?n=rev