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Europe battles ‘tridemic’ of respiratory illnesses

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Europe battles ‘tridemic’ of respiratory illnesses

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Europe is facing a “tridemic” that threatens to push health systems to the limit as a surge in flu cases is compounded by Covid-19 and other respiratory illnesses.

Spain and Italy are among the countries worst affected as hospitals struggle to cope with an influx of patients and coronavirus-era mask mandates are reintroduced in health facilities in some regions.

Upticks in cases have also been reported in Germany, where the public health authority said a flu wave officially began on December 11, and in France, where 10 out of 18 regions are officially in an epidemic phase. In the UK, there has been a slight rise in flu cases and hospitalisations, with officials warning that the peak was yet to come.

In Spain, Christmas superspreader events led to an increase in flu cases by 75 per cent in the final week of 2023, according to data from the state-backed Carlos III Health Institute. Reports of flu leading to severe pneumonia are proliferating.

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Nearly half of all flu tests in Spain came back positive in the last week of December versus 27 per cent in the previous seven days. Covid-19 cases stabilised with only 10 per cent of tests positive at the end of 2023, but the virus was causing a rising number of hospital admissions, especially among people over 80, the Carlos III institute said.

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Children, meanwhile, were coming down with respiratory syncytial virus, which can cause bronchiolitis and has led to a sharp rise in hospitalisations of infants aged under one.

The mix of flu, Covid and RSV cast a shadow over a European festive season punctuated by coughs, colds and people bowing out of celebrations because they felt too unwell. Those who made it were met with conversations about who was vaccinated against flu and whether it was too late to get a jab.

By Saturday, three Spanish regions — Catalonia, Valencia and Murcia — had made mask-wearing mandatory at health facilities. Mónica García, Spain’s health minister, has convened a meeting of regional health chiefs on Monday to discuss extending the obligation across the country.

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García said on Friday that the rise in illness would “intensify” in the coming days and called on people to exercise caution at large indoor gatherings and health facilities. “In short, we appeal to common sense and ask for the same resilient spirit that people demonstrated during the pandemic,” she said.

A flu and Covid vaccination
A flu and Covid vaccination campaign is under way in the Spanish region of Valencia © Rober Solsona/Europa Press via Getty Images

CSIF, a Spanish union whose members include health professionals, has warned that some hospitals are at saturation point. In addition to obligatory mask-wearing at health facilities, it has called for special ventilation measures and for people to exercise prudence in deciding whether they need to see a doctor.

A similar trend was registered in Italy, where an estimated 2mn people came down with flu, Covid and RSV in the last two weeks of 2023, according to the Italian National Institute of Health. The spike in cases added to pressure on hospitals and emergency rooms which are struggling with a chronic shortage of beds and staff. 

Non-urgent surgery has been delayed as a consequence, with over 1,000 patients in the Rome region waiting to be moved from emergency rooms to wards, according to the Italian Society of Emergency Medicine. 

Roberto Cosentini, head of the emergency room at Bergamo Hospital in northern Italy, told the Financial Times that the combination of respiratory viruses and Christmas holidays had produced a “perfect storm”, with many young people and children needing hospital treatment. 

“This year’s flu was quite virulent, especially on the respiratory system, even on young people. We had to hospitalise more people with complications due to flu than usual.” Cosentini said the first days of 2024 were the worst, when his hospital had to rush to add doctors and nurses and create new wards “because there were too many sick people”. 

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The European Centre for Disease Prevention and Control warned last month that respiratory infections would be higher than usual this winter because of lower immunity levels after the anti-Covid measures of recent years had led to an overall reduction in such cases. 

It told national governments to increase vaccination rates for Covid and influenza and boost emergency department capacity, as well as to encourage handwashing and mask-wearing for the most vulnerable.

José María Molero of the infectious diseases team at the Spanish Society of Family and Community Medicine said the term “tridemic” should not be taken to mean that individuals were catching multiple viruses but rather that they were suffering from one of the three diseases. “There are very few cases of co-infection,” Molero said.

The UK has yet to experience a major flu surge this winter.

Data for the last week of 2023 in Britain showed a slight uptick in the percentage of people who tested positive for flu, according to lab samples: it rose to 11.8 per cent from 11.2 per cent in the previous week. Influenza hospitalisations increased to 6.8 per 100,000 from 5.1 per 100,000 last week and admissions to intensive care and high dependency units increased week-on-week but remained low.

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There was also a slight reduction in consultations with primary care staff for flu-like illness. Mary Ramsay, director of public health programmes at the UK Health Security Agency, warned: “The winter peak for flu is still to come and may coincide with high levels of Covid-19.”

Additional reporting by Sarah White in Paris, Guy Chazan in Berlin and Sarah Neville in London

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Women are getting most of the new jobs. What’s going on with men?

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Women are getting most of the new jobs. What’s going on with men?

The Labor Department says the vast majority of new jobs created over the last year went to women, most of them in health care.

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In December 2016, as Donald Trump was headed to the White House for the first time, Betsey Stevenson offered the incoming president some economic advice.

Stevenson, a professor of public policy and economics at the University of Michigan, argued in an op-ed that it would be a disservice to encourage men “to cling to work that isn’t coming back.” She cited Trump’s promise to bring an iPhone factory to the U.S.

“If Trump really wants to get more Americans working,” she wrote at the time, “he’ll have to do something out of his comfort zone: make girly jobs appeal to manly men.”

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It’s a message she believes is even more relevant today.

For decades, the focus has been on getting more women into male-dominated fields. Some efforts have been more successful than others. But now, with the vast majority of new jobs going to women, it’s clear that men need help, too.

“This is happening at a time where it’s become verboten to talk about diversity, equity and inclusion,” Stevenson says. “And yet the people we need to be talking about right now are men.”

17 times as many jobs filled by women

In the mid-1970s, women held about 40% of jobs in the U.S, not including farm work or self employment. By the early 2000s, women’s share of jobs had grown to just under half. It’s hovered around there since, crossing the 50% threshold just a few times, including during the Great Recession, just before COVID, and now.

That parity masks the significant gains women have recently made in the labor market. Of the 369,000 jobs the Labor Department says were created since the start of Trump’s second term, nearly all — 348,000 of them — went to women, with only 21,000 going to men. That’s nearly 17 times as many jobs filled by women as by men.

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The lopsidedness was driven by huge growth in health care, where women hold nearly 80% of jobs. Over the past 12 months, health care alone added 390,000 jobs, more than in the economy overall, making up for job losses elsewhere.

“If we want to see job growth that’s as robust for men as it is for women, we’re going to have to see men embracing those kinds of jobs,” says Stevenson.

So far, that hasn’t happened in any meaningful way. Stevenson believes it’s because men are more likely than women to have an identity tied to a particular occupation, making it harder for them to find work outside that field, much less in one dominated by women.

Meanwhile, in his second term, Trump has not strayed from his message that manufacturing will make the country strong. It’s something he emphasized in his second inaugural address, declaring that “America will be a manufacturing nation once again,” and in his repeated promises that tariffs would “bring factories roaring back.”

When manufacturers added 15,000 jobs in March, the White House called it proof that “the best days for American workers, manufacturers, and families are still ahead,” despite the fact that the sector is still down 82,000 jobs from when Trump took office.

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“We have seen a year of a president absolutely fixated [on] growing the manufacturing sector,” Stevenson says. “There’s not enough of those jobs for men as a whole to thrive.”

A push for policies to open doors for men

What’s happening now in the labor market comes as no surprise to Richard Reeves, president of the American Institute for Boys and Men, a nonpartisan think tank.

He says not enough attention has been paid to the scarcity of men in certain professions, and now we’re seeing the consequences.

“There is no cause for panic here,” says Reeves, who’s been studying the decades-long decline in labor force participation among men. “But I do think we should be alert to signs that the labor market might be moving even more quickly in directions that are leaving too many men behind.”

Reeves notes that for years, the country has embraced policies and programs aimed at getting more women into science, technology, engineering and math, and the share of women in STEM jobs has grown.

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“But that didn’t happen by itself. It happened as a result of concerted efforts to break down gender stereotypes,” he says.

Still, gaps remain, and some of those efforts have seen their government funding cut under Trump.

Now Reeves says what’s needed are policies and programs to draw male workers into fields such as nursing, teaching and social work.

“Those are occupations that serve people, and they should look like the people that they serve,” he says. “And it’s good for men because it means they won’t lose out on those jobs if that’s where the growth is coming from.”

Framing jobs as more masculine

Stevenson has been thinking about ways to make the fastest-growing sectors of the economy more welcoming to men.

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“I think there are ways for us to talk about those jobs as being particularly masculine,” she says.

For instance, many health care jobs could be framed as roles requiring the strength to lift people. Preschools could highlight the need for teachers who serve as positive male role models.

“Kids love to be rough and tumble and build things,” she says.

Stevenson knows some people will be offended by such gender stereotyping.

“But I do want to encourage us to realize that we have to help men understand that they can do caregiving roles and stay masculine,” she says.

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Ongoing challenges for women and men

What Stevenson doesn’t want people to conclude is that everything is okay now that women are leading on jobs.

“We know that there is still discrimination that holds people back,” she says.

For women, she says, that discrimination might be preventing them from getting the promotion that they deserve, contributing to the widening gender pay gap. For men, it may mean sitting on the sidelines because they don’t think there’s a role for them in the economy.

“I think we can use this moment to realize that discrimination, occupational segregation… these are things that harm all of us, not just one narrow group,” she says.

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Video: How Trump’s Advisers Felt About Going to War With Iran

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Video: How Trump’s Advisers Felt About Going to War With Iran

new video loaded: How Trump’s Advisers Felt About Going to War With Iran

Our reporters Maggie Haberman and Jonathan Swan discuss how individual members of President Trump’s administration felt in the leadup to the war in Iran, and how they communicated their thoughts to Mr. Trump.

By Maggie Haberman, Jonathan Swan, Christina Shaman, John Pappas and Ray Whitehouse

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Exclusive: Trump weighs pulling some US troops from Europe amid NATO strains, official says

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Exclusive: Trump weighs pulling some US troops from Europe amid NATO strains, official says
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