Health
Five Years On: COVID-19 Pandemic Leaves Lingering Mysteries and Challenges
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.
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.”
Health
More Europeans Take Up Sport, but Major Gaps Remain Across Countries
More Europeans are exercising regularly than they were four years ago, but participation continues to vary sharply depending on where people live, their age, education and financial circumstances, according to a new European Commission survey.
The latest Eurobarometer survey on sport and physical activity found that 39% of respondents said they never exercise or play sport, down from 45% in 2022. Nearly half of the 26,508 people surveyed said they exercise or play sport every day or several times a week.
The results also showed wide differences between countries. Finland recorded the highest share of people exercising daily, at 21%, followed by Denmark at 20%. In both countries, another 59% of respondents said they exercise several times a week.
At the other end of the scale, 68% of respondents in Portugal said they never exercise or play sport. Greece and Romania followed, with 66% in each country reporting that they never take part in sport or exercise.
Time was the most commonly cited barrier among people who wanted to exercise more, with 37% identifying it as an obstacle. A lack of motivation or interest was mentioned by 26%, while 15% pointed to health problems or injury. Cost was cited by 12%.
Education and household finances were also closely linked to participation. Some 59% of people who continued their education until at least the age of 20 said they exercise or play sport several times a week. That compared with 23% among those who left education at 15 or younger.
Financial circumstances showed a similar divide. People who said they had the greatest difficulty paying their bills were twice as likely to report never exercising as those who rarely or never faced financial difficulties, at 54% compared with 26%.
“More Europeans are getting active, but the opportunity to take part still depends too much on income, age and education,” said Roxana Mînzatu, Executive Vice-President for Social Rights and Skills, Quality Jobs and Preparedness.
The survey also highlighted a significant age gap. Nearly three-quarters of people aged 15 to 24 exercise or play sport at least several times a week, compared with 25% of those aged 75 and over. Health problems or injury were the main barrier for older respondents, while younger and middle-aged people were more likely to cite a lack of time.
Physical activity linked to everyday life also increased. Active commuting rose from 24% in 2022 to 37%, while 72% of respondents said they now walk for at least 10 minutes at a time.
The survey found, however, that some Europeans do not consider their neighbourhoods suitable for walking or cycling, potentially restricting opportunities for active travel.
Mînzatu said affordable sport and safe places to exercise should be available close to where people live, including for children from families unable to afford club fees, older people and those with disabilities.
Health
Congenital Infections Linked to Higher Risks of Autism and Intellectual Disability
Children born with certain infections acquired during pregnancy face substantially higher risks of autism and intellectual disability later in life, according to a study of more than 3.7 million people in Sweden.
Researchers found that children with congenital infections were about three times more likely to be diagnosed with autism and more than seven times more likely to receive a diagnosis of intellectual disability than those without such infections.
The findings suggest that infections transmitted from a pregnant woman to her foetus may have lasting effects on brain development, although the study identifies an association rather than proving that the infections directly cause autism or intellectual disability.
The research focused on TORCH infections, a group that includes syphilis, rubella, toxoplasmosis, cytomegalovirus and herpesvirus. These infections can cross the placenta and affect the developing foetus, potentially increasing the risk of miscarriage, stillbirth and other pregnancy complications.
“Although these congenital infections are rare, some of them can be prevented, which makes them important from a public health perspective,” said Reneé Gardner of the Department of Global Public Health at Karolinska Institutet, who contributed to the study.
The researchers examined people born in Sweden between 1987 and 2021 and followed them for up to 30 years. Among the 3.7 million participants, 975 had been diagnosed with a congenital TORCH infection.
Although congenital infections accounted for only a small proportion of autism cases across the population, the risk among affected children was considerably higher. The researchers estimated that about one in five children born with a TORCH infection could later develop autism.
The study also found elevated risks of intellectual disability across different levels of severity. The risk of severe to profound intellectual disability was as much as 30 times higher among children with a congenital infection than among those without one.
The researchers found evidence of an impact on educational outcomes even among people who were not diagnosed with autism or intellectual disability. A total of 420 participants with a TORCH infection showed poor school performance without receiving either diagnosis.
Congenital cytomegalovirus, or CMV, is the most common of these infections globally and affects roughly one in 150 newborns. Its burden is substantially greater in low- and middle-income countries.
The researchers said the findings highlight the importance of prevention, particularly in regions where these infections are more common. They pointed to vaccination programmes and other preventive measures as important tools for reducing congenital infections.
They also called for improved identification of affected newborns. Current screening systems, including those used in Sweden, may miss asymptomatic infections because universal screening for TORCH infections is not routinely carried out.
The authors said stronger screening and prevention strategies could help identify children at risk earlier and improve long-term support and care.
Health
AI Chatbots Make Faster, Less Nuanced Kidney Transplant Decisions Than Doctors
Artificial intelligence chatbots may make faster and more confident decisions than human doctors when determining which patient should receive a life-saving kidney transplant, but a new study found that the systems often rely on fewer factors and show less sensitivity to the ethical complexity of such choices.
Researchers from Penn State University in the United States compared decisions made by large language models (LLMs) with choices made by people in earlier studies on kidney allocation. The researchers presented AI models with hypothetical cases based on existing datasets in which human participants had previously chosen between two patients competing for a single available kidney.
The patients were described using characteristics including age, health and drinking habits. Both were considered eligible for the transplant, requiring the decision maker to determine which patient should receive the available organ.
The researchers tested the AI systems in several ways. Some scenarios focused on individual characteristics, while others combined several traits to examine how the models handled competing considerations. In some tests, participants and AI systems were also given the option of flipping a coin, allowing researchers to assess indecision as part of moral decision-making.
Human participants generally placed greater importance on age, often favouring younger patients over older patients. Many of the AI models, however, placed greater weight on lower alcohol consumption.
Hadi Hosseini, the study’s lead researcher at Penn State University, said the findings showed that AI chatbots can diverge from human values when weighing characteristics of patients.
The researchers found that human decisions tended to consider several factors together and were more sensitive to context. LLMs, by contrast, frequently focused on a single characteristic when making their choices.
Another difference involved uncertainty. Human participants were more likely to recognise that organ allocation can involve competing ethical considerations and that there may not be one objectively correct answer. AI models generally showed little hesitation and committed to one choice.
John Dickerson, chief executive officer of Mozilla.ai and a collaborator on the study, said humans recognise ambiguity when allocating scarce resources and use debate to shape how such decisions are made.
The findings come as AI systems are increasingly being used in healthcare for clinical workflows, diagnosis, treatment planning and decisions involving limited medical resources.
The researchers said kidney allocation presents a particularly important test because decisions over deceased-donor and living-donor organs involve medical, ethical and moral considerations.
Hosseini said the ethical stakes are high because decisions involving organ allocation can directly affect patients’ lives. He stressed that the study was not intended to encourage replacing professional medical judgment with AI.
Instead, the researchers said understanding how AI systems behave in high-stakes situations is becoming increasingly important as individuals, organisations and businesses use AI to make decisions or provide recommendations.
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