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Ramaswamy Has a High-Profile Perch and a Raft of Potential Conflicts

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Ramaswamy Has a High-Profile Perch and a Raft of Potential Conflicts

Vivek Ramaswamy is the less famous and less wealthy half of the duo of billionaires that President-elect Donald J. Trump has designated to slash government costs.

His better-known co-leader, Elon Musk, stands to benefit from the job in ways that are numerous and glaring. Mr. Musk’s companies have tremendous influence, billions of dollars in government contracts and ongoing battles with federal regulators.

Less attention has been paid to the potential conflicts that could stem from Mr. Ramaswamy’s complex web of financial interests, which span biotechnology, finance and other holdings.

At 39, he is one of the world’s youngest billionaires, having made his fortune in the pharmaceutical industry. As he reaches into the federal bureaucracy that shapes the fortunes of American companies, he could recommend spending cuts that ultimately make him and his investors richer.

Mr. Ramaswamy, who owns a stake currently valued at nearly $600 million in a biotechnology company he started, has called for changes at the Food and Drug Administration that would speed up drug approvals. He could help shape energy policy to promote fossil fuels, making it more attractive for investors to put their money into an oil-and-gas fund, provocatively called DRLL, offered by his investment firm.

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And if he were to boost officials who embrace cryptocurrency, it may benefit his firm’s new Bitcoin business.

It is not yet known whether leaders of the so-called Department of Government Efficiency, or DOGE, which is not a governmental department but more of an outside advisory organization, will have to meet the same standard divestment requirements that many high-level federal appointees face.

Mr. Ramaswamy waded into controversy late last month when he blamed American culture for failing to produce enough workers suited for technical jobs. He also endorsed continuing to allow certain skilled immigrants into the U.S. labor market, a position shared by Mr. Musk and Mr. Trump but opposed by immigration hard-liners. The episode raised questions as to how long Mr. Ramaswamy will remain with the DOGE effort.

Mr. Ramaswamy, who two years ago stepped away from running his businesses, declined to say whether he plans to divest from any of his holdings.

With a stake valued at $150 million or more, he is the majority owner of his investment fund, Strive Enterprises, which he branded as a nemesis of liberal politics, and which is suddenly in line with the philosophies now ascendant in Washington. Several of Strive’s financial backers have close ties to the incoming Trump administration.

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Investment funds like Strive generate revenue as a percentage of the money they manage. Luring new investors quickly raises the revenues of the firm. Mr. Ramaswamy’s elevated profile advising the Trump administration could help the firm bring in new clients.

Mr. Ramaswamy declined to be interviewed for this article. Strive’s current leadership, Mr. Musk and the Trump transition team also declined to comment.

Anson Frericks, a high school friend of Mr. Ramaswamy’s who co-founded Strive with him and is now a senior adviser at the firm, dismissed concerns about potential conflicts of interest for a firm offering investments in industries under federal regulation.

“We will always have to have a strict separation of church and state and comply with all the rules and regulations,” Mr. Frericks said.

Since being named to jointly lead DOGE, Mr. Ramaswamy had until recently been posting on Mr. Musk’s social media site X, hinting about where he may look to make changes in the government.

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He called for slashing regulation, not just cutting government spending. He pointed to federal workers focused on diversity as potential targets for “mass firings.”

And he has been taking aim at the F.D.A. “My #1 issue with FDA is that it erects unnecessary barriers to innovation,” he wrote on X. He criticized the agency’s general requirement that drugmakers conduct two successful major studies to win approval rather than one.

Mr. Ramaswamy founded his biotechnology company, Roivant Sciences, in 2014, betting that he could find hidden gems whose potential had been overlooked by large drugmakers. The idea was to hunt for experimental medications languishing within large pharmaceutical companies, buy them for cheap and spin out a web of subsidiaries to bring them to market.

The venture is best known for a spectacular failure.

In 2015, Mr. Ramaswamy whipped up hype and investment around one of his finds, a potential treatment for Alzheimer’s disease being developed by one of his subsidiaries, Axovant. Two years later, a clinical trial showed that it did not work, erasing more than $1.3 billion in Axovant’s stock value in a single day.

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Mr. Ramaswamy personally lost money on paper on the failure, but thanks to the savvy way he had structured his web of companies he and Roivant weathered the storm. Six products have won F.D.A. approval, and today Roivant has a market valuation of $8 billion.

Mr. Ramaswamy sold some of his Roivant stock to take a large payout in 2020, reporting nearly $175 million in capital gains on his tax return that year. But he is still one of the company’s largest shareholders.

If Mr. Ramaswamy recommends changes that speed up drug approvals through DOGE, that could be good news for Roivant, which is developing drugs that might come up for approval during Mr. Trump’s second term. The faster it can get medicines onto the market, the more valuable the company — and Mr. Ramaswamy’s stake in it — stands to become.

In 2020, Mr. Ramaswamy started writing opinion pieces attacking the environmental, social and governance, or E.S.G., movement.

He found a perfect foil in the world’s biggest asset manager, BlackRock, and its chief executive, Laurence D. Fink. At the time, Mr. Fink was vocal about pushing companies to rethink their carbon footprints. Mr. Ramaswamy viewed that position as a breach of BlackRock’s duty to try to maximize returns for investors.

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Mr. Ramaswamy was taking on a niche subject that was being debated in obscure journals and business school classrooms but one that was hardly front of mind for most investors.

In July 2020, Mr. Ramaswamy asked D.A. Wallach, a health care investor, to read a proposal for what would become his first book, “Woke, Inc.” Mr. Wallach said he was initially skeptical.

“Do average people really care about Larry Fink putting carbon emissions requests on the board of Exxon?” Mr. Wallach recalled wondering at the time. But Mr. Wallach later became a seed investor in Strive, persuaded by Mr. Ramaswamy over dinner at the upscale Polo Lounge at the Beverly Hills Hotel in Southern California.

In 2021, Mr. Ramaswamy stepped down as chief executive of Roivant. He fished around for a new business idea.

A classmate of Mr. Ramaswamy’s from an all-boys Catholic high school in Cincinnati, Mr. Frericks, had worked as an executive at Anheuser-Busch and shared Mr. Ramaswamy’s views about the E.S.G. movement.

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Mr. Frericks said they knocked several ideas around: “Merit Airlines,” which would hire the top 5 percent of pilots, regardless of race, sex or background; “Pop Without Politics,” an alternative to Coca-Cola; and a “free-speech” version of Twitter, before Mr. Musk ran with the idea and bought the social media platform.

They ultimately landed on a different idea. They would start an investment firm near Columbus, Ohio, that would court an audience they believed had been neglected by Wall Street: everyday investors and public pension fund managers who were alienated by companies adopting liberal policies pushed by money managers like Mr. Fink.

Mr. Ramaswamy recruited financial backers who now have deep ties to the incoming Trump administration. Among them were Howard Lutnick, whom Mr. Trump has picked to be commerce secretary; the former investment firm of Vice President-elect JD Vance; and other large Republican donors and influential voices, including Doug Deason and the billionaire fund manager Bill Ackman.

Strive’s first offering, in August 2022, was the energy fund DRLL.

In television appearances, Mr. Ramaswamy drummed up demand for the fund. He pitched viewers on an opportunity to be part of a renaissance in the American energy sector, which he said had been constrained for too long by “E.S.G. handcuffs.”

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The reality was more complicated. Energy stock price growth has been sluggish for reasons that have nothing to do with diversity quotas and emissions caps. For years, U.S. producers spent big in pursuit of growth, costing investors billions and causing many to sour on the industry. Lower oil prices have further reduced the incentive to drill.

And what Mr. Ramaswamy was pitching was more commonplace than he made it sound.

DRLL was a basket of stocks known as an exchange-traded fund, or an E.T.F., an unglamorous investment vehicle that has grown popular among investors looking for less risk than betting on individual stocks. Mr. Ramaswamy’s E.T.F. was nearly identical to popular offerings from BlackRock and other providers, containing a standard mix of stocks like Exxon, Chevron and dozens of other oil and gas companies.

What Strive promised investors in DRLL was essentially a sustained pressure campaign. Strive would meet with chief executives, carefully vote on board seats and shareholder proposals and publicize its efforts, all with the aim of pushing energy companies to shun liberal policies.

“We wanted a seat at the table, to be able to vote on shareholder resolutions, to engage with management, write letters on our views,” Mr. Frericks said.

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Mr. Ramaswamy sent an angry letter to Chevron, criticizing the company for how it responded to pressure from climate activists to cap emissions produced by its suppliers and consumers. (Chevron set goals related to how clean those emissions should be, but it didn’t limit them overall.)

In November 2022, Mr. Ramaswamy flew to Houston for a meeting with the Exxon chief executive, Darren Woods. When the oil giant subsequently appointed two Strive-approved board members, Strive declared victory.

As a presidential candidate in mid-2023, Mr. Ramaswamy reported that he had between $5 million and $25 million of his own money invested in DRLL.

Strive employees watched with intrigue, and sometimes tagged along, as Mr. Ramaswamy met with governors, other state officials and wealthy contacts. Often, it wasn’t clear whether the motivation was to seek an investment or perhaps to make connections that could fuel Mr. Ramaswamy’s bigger ambitions.

He set a busy pace, using private jets to crisscross the United States and traveling with a body guard. He hated staying in hotel rooms, so if he traveled he would nearly always fly home to sleep.

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He met with heads of public pension funds in Republican-led states, urging them to move their money to Strive from providers like BlackRock.

But Strive’s pitch struggled to land with that audience. According to S&P Global’s Capital IQ database, only one public pension fund, in Texas, appears to have put money in a Strive E.T.F., and it quickly withdrew its position. One official at a public pension fund in a Republican-led state who met with a Strive representative said it was confusing how Strive was different from the competition, or how its mission would generate the best returns.

Employees at Strive were often surprised by the relative extravagance of Strive’s spending.

Before the firm was generating much revenue, many employees were issued a company credit card and had the impression that they could spend freely. The firm built out a new office, with room for some 100 employees, despite having a staff of about 35.

Mr. Ramaswamy was a regular presence in Strive’s office, often dressed in shorts and flip flops.

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In December 2022, the firm held a holiday party in downtown Columbus at The Vault, a former bank repurposed as a lavish event space. In front of his delighted colleagues that evening, Mr. Ramaswamy performed a karaoke rendition of Eminem’s “Lose Yourself.”

Employees were given a pointed holiday gift: a copy of a book, “Fossil Future” by Alex Epstein, arguing for more oil, coal and natural gas consumption.

Two months later, Mr. Ramaswamy announced that he was running for president. He stepped down as chairman and chief executive of Strive. That summer, as a candidate on the campaign trail, he reprised his performance of “Lose Yourself” onstage at the Iowa State Fair.

As Mr. Ramaswamy’s political profile has risen, the ideas he railed against have receded on Wall Street and in American life.

In 2023, Mr. Fink of BlackRock said that he would no longer use the term E.S.G. Last week, BlackRock pulled out of an international climate coalition supporting the goal of net zero greenhouse gas emissions by 2050, while Meta and Amazon ended internal diversity programs.

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Mr. Ramaswamy has taken credit for the change of heart. “Strive’s success, I think, was probably the single greatest factor in the United States of America that turned E.S.G. from the dogma,” he said.

Today, Strive manages over $2 billion in assets, a strong start for a new player in the market, but a drop in the bucket compared with the largest money managers. BlackRock, by comparison, manages $11.6 trillion in assets.

“Strive did better than we thought it would,” said Eric Balchunas, a Bloomberg analyst who tracks E.T.F.s.

But the growth of Strive, which in some cases charges higher fees than its competitors for its E.T.F.s, has been constrained by a mundane reality: Many E.T.F. investors are just looking for low fees and the ability to swiftly and easily make transactions. Politics isn’t a factor.

“Most of them don’t care,” Mr. Balchunas said. “People just want cheap access to stocks.”

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After years in the unglamorous world of traditional E.T.F.s, Strive has been expanding into a more buzzy world of finance after raising $30 million in new funding from a group of backers including Cantor Fitzgerald, the financial services firm led by Mr. Lutnick.

Late last year, Strive poached the leadership team of a firm in Dallas that managed money for wealthy families and individuals, providing Strive a new arm, and a new headquarters, in Texas.

The move got Strive into cryptocurrency, which helped finance Mr. Trump’s campaign but has faced regulatory headwinds in Washington. The firm’s website now points to its “focus as a transformative Bitcoin-company.”

It also opened up a new potential area for conflict in Mr. Ramaswamy’s role at DOGE: the potential power to alter the approach of agencies that regulate the financial sector.

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Measles outbreak explodes in South Carolina; multiple people hospitalized as cases surpass 200

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Measles outbreak explodes in South Carolina; multiple people hospitalized as cases surpass 200

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The South Carolina Department of Public Health (DPH) is sounding the alarm after 26 new measles cases were reported since Friday, bringing the total number of cases in the state’s latest outbreak to 211.

DPH first reported a measles outbreak Oct. 2 in the Upstate region. As of Tuesday, 144 people are in quarantine and seven people are in isolation.

Of the 211 cases, 45 involve children under 5, 143 cases involve children ages 5 to 17, 17 cases involve adults and six cases involve minors whose ages weren’t disclosed.

DPH said 196 of the 211 infected individuals were unvaccinated, four were partially vaccinated, one was vaccinated and 10 are either still being investigated or have an unknown vaccination status.

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MEASLES CASES CONFIRMED AT FOUR MAJOR US AIRPORTS ACROSS COUNTRY AMID PEAK HOLIDAY TRAVEL

Hundreds of people in South Carolina have contracted the measles, and a few have been hospitalized. (Jan Sonnenmair/Getty Images)

Officials said 19 of the new cases were associated with “exposures in known households and previously reported school exposures,” and four resulted from church exposures.

DPH identified public exposures at Sugar Ridge Elementary and Boiling Springs Elementary and began notifying potentially exposed students, faculty and staff Dec. 31. 

There are nine students in quarantine from the two schools.

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Of the 211 cases, 45 involve children under 5 years old. (iStock)

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Exposures also happened at the Tabernacle of Salvation Church, Unitarian Universalist Church of Spartanburg, Slavic Pentecostal Church of Spartanburg and Ark of Salvation Church.

The source of one case is unknown, while two others are still being investigated.

Although complications from measles are not reportable, officials said four people, including adults and children, required hospitalization for complications from the disease.

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Officials recommend all children be vaccinated against measles. (Raquel Natalicchio/Houston Chronicle via Getty Images)

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Additional cases required medical care, but the infected individuals were not hospitalized.

Those infected with measles are contagious from four days before the rash appears and may be unaware they can spread measles before they know they have the disease, according to DPH.

DPH said it is important for those with a mild illness or those who are in quarantine to stay home to protect others.

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“We encourage employers to support workers in following DPH recommendations to stay out of work while ill or in quarantine, which also protects businesses, other workers and clients,” officials wrote in a statement.

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DPH said vaccinations continue to be the best way to prevent measles and stop the outbreak.

Though the CDC recently released new vaccine recommendations under Health and Human Services Secretary Robert F. Kennedy Jr., its guidelines still dictate all children should be immunized for measles, mumps, rubella, polio, pertussis, tetanus, diphtheria, Haemophilus influenzae type B (Hib), pneumococcal disease, human papillomavirus (HPV) and chickenpox.

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Common pain relievers may raise heart disease and stroke risk, doctors warn

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Common pain relievers may raise heart disease and stroke risk, doctors warn

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Many might assume that over-the-counter (OTC) medications are generally safer than stronger prescription drugs, but research shows they can still present risks for some.

Certain common OTC painkillers have been linked to an increased risk of high blood pressure, stroke and heart attacks.

Potential risk of NSAIDs

Non-steroidal anti-inflammatory drugs (NSAIDs) — which are used to reduce pain, fever and inflammation — have been pinpointed as the class of medicines most linked to elevated cardiovascular risk.

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“This is because they reduce the production of certain chemicals called prostaglandins,” Maryam Jowza, M.D., an anesthesiologist at UNC Health in North Carolina, told Fox News Digital. “These chemicals are involved in inflammation, but they are also involved in other body functions, such as influencing the tone of blood vessels.”

Certain common OTC painkillers have been linked to an increased risk of high blood pressure, stroke and heart attacks. (iStock)

Dr. Marc Siegel, Fox News senior medical analyst, echoed the potential risk of NSAIDs. 

“They can lead to high blood pressure, heart attack and stroke via fluid retention and salt retention,” he told Fox News Digital. “This increases volume, puts a strain on the heart and raises blood pressure.”

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Common examples of NSAIDs include ibuprofen, naproxen, aspirin, diclofenac, indomethacin and celecoxib.

Randomized trials found that ibuprofen caused the biggest spikes in blood pressure, followed by naproxen and then celecoxib. 

“In general, the increase in blood pressure is more likely with higher doses and longer duration of treatment,” said Jowza, who is also an associate professor in the Department of Anesthesiology at the UNC School of Medicine.

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NSAIDs can also increase stroke risk, especially at high doses and with long-term use, the doctor added. 

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Diclofenac was linked to the highest cardiovascular risk, the doctor cautioned. Ibuprofen can also raise blood pressure and has been associated with a higher heart attack and stroke risk, but not as high as diclofenac. Naproxen carries a lower cardiovascular risk than ibuprofen or diclofenac, but is not entirely risk-free.

NSAIDs have been pinpointed as the class of medicines most linked to elevated cardiovascular risk. (iStock)

“The practical takeaway is that diclofenac is generally the least favorable choice in patients with elevated cardiovascular risk, and all NSAIDs should be used at the lowest effective dose for the shortest duration,” Dr. Nayan Patel, pharmacist and founder of Auro Wellness in Southern California, told Fox News Digital.

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Aspirin is an exception — although it is an NSAID, it actually reduces the risk of clots when taken at a low dose for prevention, under a doctor’s guidance. However, it can increase bleeding risk and blood pressure at high doses.

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Non-NSAIDs safer, but not risk-free

Non-NSAID pain relievers are commonly used for everyday aches, headaches and fever, but not swelling. They act mainly on the brain’s pain signals, not inflammation, according to medical experts.

Acetaminophen, the most common non-NSAID pain reliever, is also linked to an increase in blood pressure, although to a lesser extent, according to Jowza. 

“All NSAIDs should be used at the lowest effective dose for the shortest duration.”

“Acetaminophen was once thought to have little to no cardiovascular effects, but more recent evidence suggests it can increase blood pressure, especially with higher doses used in the long term,” she said, emphasizing the importance of blood pressure monitoring. “Its effect on stroke risk is less clear.”

Which groups are most vulnerable?

The groups at greatest risk, according to doctors, are those with existing health conditions, such as high blood pressure, prior stroke or heart disease, diabetes or kidney problems.

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“These groups are also more likely to experience NSAID-related fluid retention and destabilization of blood pressure control,” Patel said.

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Cardiovascular risk is generally higher for people 75 and older, the doctors agreed.

“Age amplifies risk largely because baseline cardiovascular risk increases with age, and kidney function reserve tends to decline,” Patel said. “Older adults are also more likely to be on antihypertensives, diuretics, antiplatelets or anticoagulants, so NSAIDs can destabilize blood pressure control and add safety complexity.”

Warning signs

Anyone experiencing chest pain, shortness of breath, sudden weakness or numbness, severe headache, confusion, slurred speech or vision changes should see a doctor immediately, Jowza advised.

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“These symptoms can point to a heart attack or stroke,” she warned. “Other symptoms of concern that may not develop as rapidly, like new swelling in the legs, should also prompt medical attention.”

Anyone experiencing chest pain, shortness of breath, sudden weakness or numbness, severe headache, confusion, slurred speech or vision changes should see a doctor immediately, a doctor advised. (iStock)

“Patients should also seek medical advice if they notice signs of fluid retention or kidney stress, such as rapidly rising blood pressure, swelling in the legs, sudden weight gain over a few days, reduced urine output or worsening shortness of breath,” Patel added.

Safer alternatives

For those at higher risk, Patel recommends non-NSAID approaches whenever possible. 

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“For many patients, this means starting with non-drug strategies such as heat or ice, physical therapy and activity modification,” he told Fox News Digital. “If medication is needed, acetaminophen is generally preferred over oral NSAIDs from a cardiovascular standpoint, although regular use should still be monitored in people with hypertension.”

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For localized joint or muscle pain, the doctor said topical NSAIDs can offer “meaningful relief” with “far lower” risk.

“Overall, pain management in high-risk patients should emphasize targeted therapy, conservative dosing and close blood pressure monitoring.”

Bottom line

The doctors emphasized that the overall risk is “very low” for people taking OTC pain relievers on a short-term basis, but it rises with long-term, high-dose use.

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“I would not hesitate to use an occasional dose if it were a low-risk individual with no prior history of heart attack or stroke,” Jowza said. “I also think short-term use in diabetics and hypertensives who are well-controlled is acceptable.”

Although aspirin is an NSAID, it actually reduces the risk of clots when taken at a low dose for prevention, under a doctor’s guidance. (iStock)

For those taking NSAIDs, the doctor suggested using “guard rails” — such as regularly testing blood pressure and kidney function, and setting limits on dosing — to make treatment as safe as possible.

Patel agreed that for most healthy individuals, occasional NSAID use “does not carry a meaningful cardiovascular risk.”

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“The concern is primarily with repeated or chronic use, higher doses, and use in people with underlying cardiovascular, kidney or blood pressure conditions,” he confirmed to Fox News Digital.

“That said, large population studies show that cardiovascular events can occur early after starting NSAIDs, particularly at higher doses, which is why even short-term use should be approached cautiously in higher-risk patients.”  

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Flu hospitalizations hit all-time weekly high in densely populated state, officials warn

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Flu hospitalizations hit all-time weekly high in densely populated state, officials warn

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The New York State Department of Health has announced the highest number of flu hospitalizations recorded in a single week.

The state confirmed the uptick in hospital visits in a press release on Jan. 2, as flu cases continue to rise in the region and nationwide.

New York State, including New York City, has consistently tracked the highest numbers of recorded respiratory illness cases in the country for the last few weeks, according to CDC data. Several other states have climbed to the “very high” category for respiratory activity as well, as of the week ending Dec. 27.

RECORD-BREAKING FLU NUMBERS REPORTED IN NEW YORK STATE, SPARKING WARNINGS FROM OFFICIALS

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The most recent data from the New York health department showed a total of 4,546 hospitalizations from Dec. 26, 2025, to Jan. 2, 2026 – a week-over-week increase of nearly 1,000. The prior week, the department announced the highest number of flu cases ever recorded in a single seven-day period.

The New York State Department of Health reported a total of 4,546 hospitalizations from Dec. 26, 2025, to Jan. 2, 2026. (iStock)

In a statement, New York’s Acting Commissioner of Health Dr. James McDonald noted the severity of this flu season compared to previous years.

“Almost 1,000 more people were admitted to a hospital during this most recent seven-day period compared to the prior week,” he confirmed. “There is still time to get a flu shot, and remember, flu can be treated with antiviral medication if started within 48 hours of symptom onset [as] your doctor deems appropriate.”

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Health officials are pushing for Americans to consider getting the flu vaccine, as experts consider it to be a top line of defense for preventing viral exposure and spread.

Flu symptoms can include fever, chills, headache, fatigue, cough, sore throat and runny nose. (iStock)

In a previous interview with Fox News Digital, Dr. Neil Maniar, professor of public health practice at Boston’s Northeastern University, emphasized that it’s not too late to get the flu vaccine, as peak season typically occurs in January.

“The vaccine still provides protection against serious illness resulting from the subclade K variant that seems to be going around,” he said.

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Even healthy individuals can become seriously ill from the flu, Maniar noted, “so a vaccine is beneficial for almost everyone.”

“Individuals typically start to develop some degree of protection within a few days and gain the full benefit within about two weeks, so now is the time for anyone who hasn’t gotten the vaccine yet.”

“The vaccine still provides protection against serious illness resulting from the subclade K variant that seems to be going around,” one doctor said. (iStock)

Flu symptoms can include fever, chills, headache, fatigue, cough, sore throat and runny nose.

A mutation of influenza A H3N2, called subclade K, has been detected as the culprit in rising global cases, causing more intense symptoms and higher risk of spread.

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“It’s becoming evident that this is a pretty severe variant of the flu,” Maniar said. “Certainly, in other parts of the world where this variant has been prevalent, it’s caused some severe illness, and we’re seeing an aggressive flu season already.”

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New York State recommends taking preventive actions to avoid flu infection. These include washing hands often; avoiding touching the eyes, nose and mouth; avoiding close contact with sick people; cleaning and disinfecting objects and surfaces; and staying home when feeling sick.

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