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Five Years On: COVID-19 Pandemic Leaves Lingering Mysteries and Challenges

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More than five years after the first cluster of COVID-19 cases emerged in Wuhan, China, the virus continues to evolve, leaving behind unanswered questions and a legacy of global disruption. The pandemic reshaped public health policies, exposed systemic inequities, and brought groundbreaking advances in vaccine development.

Origins of the Virus Remain Unclear

The origins of SARS-CoV-2, the virus causing COVID-19, remain uncertain. While scientists believe it likely originated in bats and was transmitted to humans through an intermediary species such as raccoon dogs or civet cats, this theory remains unproven. Speculation about a potential laboratory leak in Wuhan has further fueled political tensions.

The World Health Organization (WHO) recently urged China to share more data, calling transparency a “moral and scientific imperative” to help prevent future pandemics. However, experts caution that the true origin may never be definitively established.

Global Death Toll and Vaccination Efforts

The pandemic’s death toll remains staggering. While the WHO reports over seven million deaths worldwide, the actual number is estimated to exceed 20 million. Vulnerable populations, especially older adults, continue to account for a significant proportion of fatalities.

Despite these losses, the rapid development of COVID-19 vaccines has saved tens of millions of lives. The introduction of mRNA vaccines by Pfizer and Moderna in less than a year marked a scientific milestone, with more than 13 billion doses administered globally since 2021.

Vaccines have proven effective in reducing severe illness, hospitalizations, and deaths, though their protection against mild infections wanes over time. Researchers are working on next-generation vaccines, including nasal options, to better prevent infections.

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Variants and Virus Evolution

The virus has continually mutated, with the omicron variant and its subvariants dominating since late 2021. Currently, KP.3 and a hybrid strain, XEC, are the primary variants in Europe. While these variants remain highly transmissible, existing vaccines and treatments have shown efficacy against them.

Long COVID: A Lingering Concern

Millions globally continue to grapple with long COVID, a condition characterized by persistent symptoms such as fatigue, brain fog, and cardiovascular issues. While vaccination reduces the risk, the root cause of long COVID remains unclear, complicating efforts to develop effective treatments.

Emerging research suggests remnants of the virus may linger in some patients’ bodies, offering clues but no definitive answers.

Looking Ahead

As humanity adjusts to a world where COVID-19 is no longer a leading cause of death but still a public health concern, the focus remains on monitoring variants, improving treatments, and addressing the long-term effects of the virus.

“The virus is still with us,” said WHO Director-General Tedros Adhanom Ghebreyesus. “We cannot talk about COVID in the past.”

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Experts Call for Stricter Fireworks Rules as Injuries Rise Across Europe

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Fireworks remain a popular feature of public celebrations, but health experts are calling for tighter regulations and greater public awareness as thousands of people suffer injuries each year.

In an opinion article published in the medical journal The BMJ, researchers from the University of California, Los Angeles (UCLA), warned that the dangers of fireworks are often underestimated and represent a significant public health concern.

Common injuries include severe burns, blast damage caused by shockwaves, traumatic brain injuries, amputated fingers and permanent loss of sight. Children, young men, rural communities and people from lower-income backgrounds are among those at greater risk. Bystanders can also be injured without handling fireworks themselves.

The authors are urging governments and health organisations in the United States and elsewhere to strengthen safety rules and invest in public education.

They recommend encouraging people to attend professionally organised displays rather than setting off fireworks at home. Medical and public health organisations could also challenge social media content that promotes private fireworks use.

The researchers propose school-based awareness campaigns for primary and secondary pupils, using real-life accounts and images of people injured by fireworks. They also suggest placing graphic injury warnings on packaging, similar to health warnings on cigarette packets.

Thousands seek medical treatment across Europe

Available figures highlight the scale of the problem, although many European countries do not maintain national records of firework-related injuries.

The Netherlands systematically collects data on incidents. During the 2025-2026 New Year celebrations, an estimated 1,239 people received emergency medical treatment at hospital emergency departments or out-of-hours general care services. This was 7% higher than the previous year.

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Italy’s Ministry of the Interior reported 283 injuries during New Year’s Eve celebrations, including 54 people who required hospital treatment.

Healthcare professionals say more countries need systematic reporting systems to establish the full extent of the injuries and identify where prevention measures are most needed.

Fireworks imports continue to grow

The health concerns come as the European fireworks market expands. Eurostat data published in December 2025 showed that the EU imported 120,000 tonnes of fireworks from outside the bloc in 2024, worth €406.7 million. Import volumes increased by 9.5% and their value by 21.5% compared with 2023.

A separate European Commission working document put the value of EU pyrotechnic imports at a record €452 million in 2024. The Netherlands accounted for 37% of extra-EU imports, followed by Germany at 35.6% and Poland at 7.4%.

Different rules across member states

EU legislation sets common safety requirements and divides consumer fireworks into four categories according to their hazard and intended use. Member states can impose stricter national restrictions on their sale, possession and use.

Minimum ages vary by category. Very low-hazard products, including some sparklers and party poppers, can generally be used from age 12, while certain low-hazard outdoor fireworks have higher age limits. Medium-hazard products intended for large open spaces carry a minimum age of 18 and require specialist knowledge.

Countries including the Netherlands, Germany, France and Italy have adopted additional restrictions, reflecting different national approaches to fireworks safety.

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One in Four Teenagers Worldwide Does No Weekly Exercise, Study Finds

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Around 240 million adolescents worldwide did not take part in physical activity on any day of the week in 2025, with girls falling further behind boys, according to a major global study published in The Lancet Global Health.

The research found that teenagers averaged 2.7 active days per week, a figure that remained unchanged between 2010 and 2025. Only 14 per cent, or about one in seven adolescents, reported being active every day.

The study analysed 389 surveys covering 3.2 million young people aged 11 to 17 across 140 countries. The data represented approximately 59 per cent of the global adolescent population.

Researchers defined an active day as one on which a teenager completed at least 60 minutes of moderate-to-vigorous physical activity. This follows the recommendation of the World Health Organization (WHO), which counts activity at school, during travel and in leisure time.

The findings raise concerns about progress towards the WHO’s target of reducing the proportion of adolescents who fail to achieve 60 minutes of daily activity by 15 per cent between 2010 and 2030. The researchers found that no country or region was currently on track to meet the goal.

A clear gender gap emerged from the data. Boys averaged three active days per week in 2025, compared with 2.4 days for girls. The difference widened as girls grew older, suggesting that existing opportunities and programmes were not reaching them equally.

Geographical differences were also substantial. Adolescents in Central and Eastern Europe and Central Asia, East Asia and the Pacific, and high-income Western countries averaged around four active days each week. In these regions, between 6.9 and 7.7 per cent of teenagers reported no physical activity at all.

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In contrast, young people in Latin America and the Caribbean, the Middle East and North Africa, Oceania, South and Southeast Asia, and sub-Saharan Africa averaged approximately two active days per week. The share reporting complete inactivity ranged from 22.7 to 33.1 per cent.

Finland, Canada and Serbia recorded the highest activity levels, with adolescents averaging between 4.5 and 4.8 active days weekly. Cambodia, Jordan and Madagascar were among the least active, averaging between 1.7 and 1.9 days.

The study’s authors linked these differences partly to structural conditions. Wealthier countries generally have more resources to support physical activity policies, provide public spaces and develop safe routes for walking and cycling.

The researchers said adolescence is an important period for establishing habits that influence health throughout adulthood. Regular exercise supports physical and mental wellbeing, but existing programmes are failing to reach large numbers of young people.

They called for stronger policies tailored to local conditions, with schools and neighbourhoods made more supportive of everyday activity. They also urged governments to address barriers affecting girls, including restrictive gender expectations, safety concerns and limited access to suitable sports and recreational activities.

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Health Groups Urge WHO to Tighten Drinking Water Nitrate Limits Over Cancer Risks

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A coalition of 85 international health and environmental organisations has urged the World Health Organization (WHO) to revise its drinking water standards for nitrate, warning that exposure to levels below the existing limit may be associated with colorectal cancer and premature births.

In an open letter sent on Tuesday, the groups called on the United Nations health agency to include nitrate in its forthcoHealth Groups Urge WHO to Tighten Drinking Water Nitrate Limits Over Cancer Risks

ming review of drinking water guidelines. Signatories include Greenpeace International, the World Organization of Family Doctors (WONCA) and the European Environmental Bureau.

The organisations argue that the WHO’s current nitrate limit is based on standards established decades ago and does not adequately reflect more recent scientific evidence about the potential effects of long-term exposure.

Nitrates and nitrites are naturally occurring compounds found in soil, water and food. However, human activities, including the use of agricultural fertilisers, manure runoff and poorly maintained septic systems, can increase nitrate concentrations in water supplies.

The current WHO guideline sets the maximum acceptable nitrate concentration at 50 milligrams per litre (mg/L), equivalent to 11.3 mg/L when measured as nitrate-nitrogen. The standard dates back to 1958 and was originally designed to prevent methaemoglobinaemia, commonly known as blue-baby syndrome. The condition reduces the blood’s ability to carry oxygen and can be fatal in infants.

The organisations say the existing threshold does not account for epidemiological research linking prolonged exposure to lower nitrate concentrations with other health risks, particularly bowel cancer and adverse pregnancy outcomes.

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“Studies now link nitrate in drinking water, at levels well below the current WHO limit, to bowel cancer and premature birth,” said Pratyush Kumar, chair of WONCA, in a joint statement.

Amanda Larsson, Greenpeace’s global project lead for agriculture, said access to safe drinking water should be treated as a basic guarantee rather than a privilege.

The coalition also cited a report commissioned by the Danish government last year, which concluded that the existing international standard was insufficient to protect public health. The expert panel recommended reducing the nitrate limit to 6.0 mg/L.

Denmark has committed to adopting the lower threshold, although it has not announced a timetable for implementation. The organisations said this creates a growing difference between international guidance and national drinking water policies.

Most governments use WHO recommendations as the basis for their own drinking water standards, making changes to the agency’s guidelines important for wider regulatory reform, the letter said.

The appeal was issued on World One Health Day, which highlights the links between human, animal and environmental health.

The signatories also called on governments to reduce pollution from intensive livestock farming and support producers in adopting more environmentally sustainable agricultural practices.

They said stronger protections against nitrate contamination were needed to safeguard drinking water supplies and reduce potential health risks, particularly for children and pregnant women.

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