The condition has put significant strain on patients and society — at a global economic cost of about $1 trillion a year, a new report estimates.About 400 million people worldwide have been afflicted with long Covid, according to a new report by scientists and other researchers who have studied the condition. The team estimated that the economic cost — from factors like health care services and patients unable to return to work — is about $1 trillion worldwide each year, or about 1 percent of the global economy.The report, published Friday in the journal Nature Medicine, is an effort to summarize the knowledge about and effects of long Covid across the globe four years after it first emerged.It also aims to “provide a road map for policy and research priorities,” said one author, Dr. Ziyad Al-Aly, the chief of research and development at the V.A. St. Louis Health Care System and a clinical epidemiologist at Washington University in St. Louis. He wrote the paper with several other leading long Covid researchers and three leaders of the Patient-Led Research Collaborative, an organization formed by long Covid patients who are also professional researchers.Among the conclusions:About 6 percent of adults globally have had long Covid.The authors evaluated scores of studies and metrics to estimate that as of the end of 2023, about 6 percent of adults and about 1 percent of children — or about 400 million people — had ever had long Covid since the pandemic began. They said the estimate accounted for the fact that new cases slowed in 2022 and 2023 because of vaccines and the milder Omicron variant.They suggested that the actual number might be higher because their estimate included only people who developed long Covid after they had symptoms during the infectious stage of the virus, and it did not include people who had more than one Covid infection.Many people have not fully recovered.The authors cited studies suggesting that only 7 percent to 10 percent of long Covid patients fully recovered two years after developing long Covid. They added that “some manifestations of long Covid, including heart disease, diabetes, myalgic encephalomyelitis and dysautonomia are chronic conditions that last a lifetime.”The consequences are far-reaching, the authors wrote: “Long Covid drastically affects patients’ well-being and sense of self, as well as their ability to work, socialize, care for others, manage chores and engage in community activities — which also affects patients’ families, caregivers and their communities.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Many patients are eager to discontinue Wegovy or Zepbound when their weight loss plateaus. But doctors say it’s difficult to go cold turkey.Susana Parks was delighted when she lost 40 pounds on Eli Lilly’s obesity drug, Zepbound. But now that she is at her goal weight, she has questions: Can she stop taking the drug? And if she does, how can she maintain her weight loss?“I can’t stop cold turkey or I will gain it back — that is clear,” said Ms. Parks, 60, of Bend, Ore. “Do I go to a lower dosage? Do I take it every two weeks instead of weekly? How do I maintain?”These questions are becoming common, obesity medicine specialists say, as more and more people lose weight with obesity drugs. Some struggle to pay for the medicine, have difficulty finding it to purchase or just don’t want to stay on a drug longer than they believe they need to.When doctors are confronted with these queries, here is what they advise — and what they can’t say.What will happen if I stop taking the new weight-loss drugs after losing weight?Dr. David Cummings, a weight-loss specialist at the University of Washington, has been asked this question by many patients. He explains that the makers of the drugs conducted large studies in which people took the drugs and then stopped.“On average, everyone’s weight rapidly returned,” Dr. Cummings said. And, he said, other medical conditions, like elevated blood sugar and lipid levels, return to their previous levels after improving.He also tells patients that while on average, weight is regained when the drugs are stopped, individuals vary in how much weight and how quickly it returns.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

The death in Virginia came amid a nationwide outbreak linked to Boar’s Head deli meats. More than 40 people have been hospitalized.A third person has died from consuming products tainted with listeria, the Centers for Disease Control and Prevention said on Thursday, the latest death connected to a nationwide outbreak that began in May and has been linked to meats sliced at deli counters.Officials also said that the number of people sickened by food contaminated by the bacteria had risen to 43 since they last released numbers in late July. The outbreak has been linked by federal food safety officials to Boar’s Head deli meats, and the company recently recalled millions of pounds of meat.Boar’s Head, which did not immediately respond to a request for comment on the third death, which occurred in Virginia, began recalling sliceable deli meats in late July, after federal food safety officials announced that a sample of Boar’s Head liverwurst for sale at a Maryland store had tested positive for the same strain of the bacteria causing the outbreak of listeriosis.On July 30, Boar’s Head recalled seven million pounds of meat, following an earlier and more limited recall. The recall includes more than 70 products — including those made from ham, beef and poultry — that were manufactured at its plant in Virginia.The two other people who died in the outbreak lived in New Jersey and Illinois.In a statement posted to the Boar’s Head website on July 30, the company said, “No words can fully express our sympathies and the sincere and deep hurt we feel for the families that have suffered losses and others who endured illness.”Boar’s Head is facing at least three lawsuits over the outbreak, in New York, Missouri and Wisconsin. People have reported growing ill in 13 states: Georgia, Illinois, Indiana, Maryland, Massachusetts, Minnesota, Missouri, New Jersey, New York, North Carolina, Pennsylvania, Virginia and Wisconsin.Every year, about 1,600 people in the United States develop serious listeria infections, according to the C.D.C. About 260 of those cases are fatal, according to Laura Gieraltowski, an epidemiologist with the C.D.C.’s outbreak response and prevention branch. Listeria infection is the third leading cause of death from food-borne illness in the United States, according to the C.D.C.Listeria bacteria, which is naturally found in soil, can contaminate a number of foods, from dairy products like cheese and ice cream to leafy greens and fruits such as cantaloupe melons. Most people who ingest the bacteria Listeria monocytogenes don’t get sick, but certain high-risk individuals, including pregnant women and people who are over 65 or immunocompromised, can become seriously ill.The Virginia Department of Health has said on its website that it is collaborating with the C.D.C. to monitor the outbreak and has shared instructions for how to report suspected foodborne illness.

After promising results in monkeys, scientists plan to test the new treatment in a few people with H.I.V.Scientists have developed a new weapon against H.I.V.: a molecular mimic that invades a cell and steals essential proteins from the virus.A study published in Science on Thursday reported that this viral thief prevented H.I.V. from multiplying inside of monkeys.The new therapeutic approach will soon be tested in people, the scientists said. Four or five volunteers with H.I.V. will receive a single injection of the engineered virus. “This is imminent,” said Leor Weinberger, a virologist at the University of California, San Francisco, who led the new study.In a normal H.I.V. infection, the virus slips into an immune cell and hijacks its host’s DNA to make copies of itself, which then burst out of the cell. After a large number of cells have been infected, the immune system collapses, causing AIDS.For decades, scientists have developed drugs for H.I.V. that attack the virus itself. Some drugs, for example, prevent a protein called a protease from activating H.I.V. And a drug called lenacapavir blocks the proteins that form the virus’s shell. Last week, researchers reported that they could keep the virus at low levels by injecting lenacapavir into volunteers once every six months.Twenty years ago, Dr. Weinberger set out to try an entirely different approach: creating an impostor virus that interfered with H.I.V.’s normal life cycle.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

The F.D.A. is poised to rule on the therapeutic use of the club drug Ecstasy, a potential watershed moment in the nascent field of psychedelic medicine.More than a half century after federal regulators banned most psychedelic compounds, the Food and Drug Administration is nearing a decision on a novel treatment for post-traumatic stress disorder that pairs talk therapy with MDMA, the club drug commonly known as Ecstasy or Molly.The decision, which is expected in the coming days, has generated a groundswell of lobbying by veterans groups, researchers and members of Congress from both parties. Eighty lawmakers signed letters to the Biden administration this week, urging the F.D.A. to approve the application by the drug company Lykos Therapeutics.The campaign was prompted in part by an expert panel’s unanimous rejection in June of Lykos’s application, because of what participants said were flaws in the company’s clinical trials and insufficient data.“We have a mental health crisis and a suicide epidemic, with thousands of military veterans taking their own lives every year,” said Representative Jack Bergman, Republican of Michigan and a former Marine Corps general who helped organize the letter’s 60 backers in the House. “I would just ask the F.D.A. to consider the negative ramifications of them not taking action, which means more veterans will die needlessly.”The lobbying campaign, unusual for a prospective new drug, underscores the high stakes and intense emotions surrounding psychedelic medicine, a field that has been growing in recent years as the country’s top universities race one another to establish psychedelic research institutes.The passions — and the millions of dollars in private investment flooding the field — have been buoyed by a growing body of data suggesting that compounds like LSD, psilocybin mushrooms and MDMA can have significant therapeutic effects on hard-to-treat mental health conditions like depression, anxiety and obsessive compulsive disorder. The federally prohibited substances are listed as Schedule I drugs that have “no currently accepted medical use and a high potential for abuse.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

“It’s not just the focus in the first 10 pieces,” the owner said. “It’s being able to maintain that kind of a focus when you’re doing No. 400 and No. 401.”As part of his interview for a job at FTS American Manufacturing in Mesa, Max Cain was asked to take a table clock apart and then put it back together.One of his hobbies is assembling Gundam model kits — the last time he counted, he said, he had put together 97 of the Japanese anime robots — so he completed the clock task in less than half the allotted time. And got the job.Now, after working there for a year and a half, Mr. Cain said he got the same feeling of accomplishment from assembling watch components as he did from completing an arm or leg of one of those robots.“It’s pretty satisfying,” he said during a break on one workday in June. “It boosts my confidence that there’s stuff for me out there.”Mr. Cain, 21, is the fourth person with autism to work at FTS, according to Kunal Naik, its chief executive, who founded the company in 2018. (The initials stand for Fine Timepiece Solutions.)Not every person on the autism spectrum would make a good watch technician, Mr. Naik said. But, “there’s a sliver that really identifies well with the work we do,” he continued, because they can concentrate on a task for a long period of time.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Kirthana BalachandranThe first therapy that uses gene-editing is to be offered on the NHS in a “revolutionary breakthrough” for patients.

Tracey Langford / BBCThe compensation that egg donors receive will rise for the first time in over a decade in the UK, but people should not donate purely for the money, the fertility regulator has warned.

The sometimes fatal condition, MIS-C, may be driven in part by a misdirected immune system, a new study finds.When exposed to a virus, the human body marshals the immune system to fend off the intruder. Sometimes, the defense goes awry, and the body mistakenly turns against itself instead of the attacker.This sort of friendly fire drives multi-inflammatory syndrome in children, or MIS-C, a mysterious condition that in rare cases strikes children who have had a severe bout of Covid-19, according to a new study.In a subset of children with the syndrome, immune cells become confused by the similarity between a protein carried by the coronavirus and one found throughout the human body, said Joseph DeRisi, an infectious disease expert and the president of the Chan Zuckerberg Biohub in San Francisco, who led the study. This phenomenon is called molecular mimicry, Dr. DeRisi said.The study was published on Wednesday in the journal Nature. The results offer the first direct proof that Covid-19 sets off an autoimmune reaction that leads to MIS-C.“This adds a very clear layer of evidence that there is an autoimmune component to MIS-C,” said Dusan Bogunovic, a pediatric immunologist at Columbia University who was not involved in the work.Scientists have long known that infections can befuddle the body into attacking itself, but the new study is among the first to identify the series of events and cast of immune characters involved in the process.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

As videos describing the procedure as agonizing spread on social media, new guidelines advise physicians to consider various anesthetics.In recent years, the process of getting an intrauterine device, or IUD, has become infamous on social media. Videos of women writhing and crying while the T-shaped contraceptive device is inserted have become macabre online staples.“Unless you’re living under a rock, you’re aware of the issue,” said Dr. Beverly Gray, an associate professor of obstetrics and gynecology at Duke University.Doctors have been accused of ignoring the discomfort. For the first time, federal health officials recommended on Tuesday that physicians counsel women about pain management before the procedure.This updated guidance from the Centers for Disease Control and Prevention may lead clinicians to take the pain more seriously and to consider using anesthetics more often, experts said.“Women’s pain and women’s experiences have been downplayed throughout medicine,” Dr. Gray said.“This is really validating that for some people, this can be a really painful experience.”As the number of women opting for IUDs has risen, so have calls for physicians to address the discomfort associated with the procedure. Some women have described it as “the worst pain imaginable” or likened it to a “hot knife” slowly stabbing them.Effective strategies for managing that pain exist, though a 2019 survey found that few doctors offered those options. Less than 5 percent of doctors offered an injection of a local anesthetic during the procedure, many instead prescribing over-the-counter painkillers, which have been shown to be less effective.A study in 2015 found that doctors tended to underestimate the pain their patients experienced during the procedure.While the last version of the C.D.C.’s guidance mentioned pain management for IUD insertion, Dr. Eve Espey, chair of the obstetrics and gynecology department at the University of New Mexico, said she thought these updated guidelines put a much stronger emphasis on the patient’s preferences and experience.“I think it is a significant change,” she said. “The guidance on this topic has gone from a more provider-centered focus to a more patient-centered focus.” Anxiety about pain may dissuade women from considering the contraceptive, which is safe and highly effective, she added.Dr. Antoinette Nguyen, a medical officer in the C.D.C.’s division of reproductive health, said the new guidance emphasized that choices about pain management should be based on “shared decision making,” taking into account patient experiences that may heighten feelings of pain, like anxiety and past trauma.The new guidelines also broadened the pain-relief options available to women during the procedure, a significant addition since lidocaine shots — the sole anesthetic option mentioned in the 2016 guidance — may themselves be uncomfortable, Dr. Espey said.The choices now include anesthetic gel, creams and sprays. While Dr. Espey said the evidence showing these topical anesthetics are effective was not “fabulous,” the new recommendations still expand the arsenal of tools that doctors have at their disposal.“It’s good when the public stamps it’s foot sometimes,” she said.