The Rise of Hepatitis

June 17, 2022

Published at the Brownstone Institute 23 May 2022

Also published at The Epoch Times

 

The number of previously healthy children younger than 16 years of age with mysterious hepatitis cases have doubled in two weeks to 450 cases worldwide , including 11 deaths. Most cases have been reported in the UK (160) and the  US  (currently, 180). In  Europe  most cases are found in Italy (35) and Spain (22). Over 8-14% of the patients needed liver transplantation. These children will be on lifelong medication. Until now the real cause of a sudden spark in hepatitis is not clear. 

 

Although 50-72% of the cases tested positive with a PCR test for Adenovirus, tissue and liver samples taken in the UK do not show any typical features that might be expected with a liver inflammation due to this virus.

In the UK, 18% of the reported cases tested positive for SARS-CoV-2 virus and three cases had tested positive 8 weeks prior to admission. The most plausible cause of hepatitis traces to a viral origin. Brodin and Aditi hypothesize a  SARS-CoV-2 superantigen  mediated immune activation in an Adenovirus-sensitized host.

At this point many of the children with hepatitis are too young to be eligible for COVID-19 vaccination. So far, no common environmental exposure has been found.

Jaundice is characteristic for all children with hepatitis, which could have many reasons including toxins and malnutrition. A search into the peer-reviewed scientific literature on the toxicology of nanoparticles, microplastics, disinfectants and hypercapnia/hypoxia, children have been  extensively exposed  to during the pandemic makes bio corona formation and accumulation of toxic substances a reasonable explanation for disruption of the liver homeostasis.

The capacity for excessive activation of  liver inflammatory pathways  has been described for these materials prior to the pandemic. Effects of the complex mixture of these materials and associated chemical pollutants presented have not yet been assessed. Understanding how these materials interact with its biological surroundings during long-term and frequent exposure is of utmost importance.

Pandemic Measures and Liver Toxicity 

Early in the pandemic several researchers warned of the unsafe use of facemasks, tests, and disinfectants and their weakening effect on the immune system. Many  institutions  are starting research on harmful chemicals due to air pollution as they pose a known threat to public health and the economy, representing 10% of global GDP in health costs and 3.75 billion lost working days at the global level in 2060.

Unfortunately, almost no funded research has been started in the area of the safe, cost/benefit use of the mandates. Instead, during the pandemic large amounts of money were spent on  less urgent  research on non-pandemic related issues.

While Covid-19 was originally thought to be a respiratory infection, various research papers have indicated  myocardial inflammation ,  hepatitis , or  neurological experiences  independent of severity of Covid-19 and sometimes without evidence of a viral infection. Other researchers found that cardiac damage was more related to  clotting  and  microthrombi  were frequent. Almost 25% of people hospitalized develop myocardial injury and many develop arrhythmias or  thromboembolic disease.

Lockdowns, with many people experiencing an ongoing state of fear and anxiety and frequent exposure to nanoparticles, microplastics,  high CO2 exposure  and toxic substances impaired the innate immune system even more.

Furthermore, several studies have indicated a remarkable suppression of the innate immune system after injections with PEGylated lipid nanoparticle (LNP) modified mRNA vaccines. I n vivo  studies for cytotoxicity and genotoxicity of these vaccines, prior to their release under EUA and being mandated for many people and children, have been neglected.

Unfortunately, more than two years into the pandemic an alarming stage of mysterious rises in infectious and  noncommunicable   diseases  and  sudden   non-Covid   deaths  have been reported, even  neonatal deaths.  The  Observer  reported  one in three  people in the UK are experiencing long-term illness.

The Liver Is an Immune Surveillance System 

The liver is an important organ responsible for the storage, synthesis, metabolism and redistribution of carbohydrates, fats and vitamins and numerous essential proteins. It is the main detoxification center of the body. A most important organ for generating an effective innate immune response and covering a robust and  long-lasting  immunity, it works to keep virus, bacteria and excessive inflammations in check.

About 30% of the total blood passes through the liver every minute and is scanned by the mononuclear phagocytic system (MPS) in the liver. The microenvironment in the liver shapes and functions the antigen specific  CD4+ T cell  population with the capacity for  longevity/self-renewal  for more than a decade.

High amounts of CD8, Natural Killer T cells, dendritic cells and macrophages (Kupfer cells) in the liver play an important role in the protective innate immune system during injury and infection deciding for tolerance or excessive inflammation. Specific liver cells, hepatocytes, produce 80-90% of the circulating innate immunity proteins in the body including acute phase proteins, complement, bactericidal proteins and more.

Neutrophils, the most abundant leukocytes in the blood, present in the liver perform important functions in inflammation and act as a functional bridge between the innate and adaptive immunity (B cells and T cells) activating antigen specific immune responses.

Homeostatic inflammation is a normal part of a healthy liver. In the complex microenvironment of the liver, the  hepatic immune system  tolerates harmless molecules while at the same time remaining alert to possible infectious agents, malignant cells or tissue damage. Inflammatory processes are required to rid itself of pathogens, cancer cells or toxic products of metabolic activity. The inflammatory processes are intimately linked to mechanisms that resolve inflammation and promote tissue regeneration.

Excessive and dysregulated inflammatory activity are key drivers of liver pathology, associated with systemic inflammation: chronic infection, autoimmunity and cancer. Mechanisms to resolve liver inflammation are essential to maintain local organ and systemic homeostasis.   It is the balance between activation and tolerance that characterizes the liver as a frontline immunological organ. Disrupting this precious surveillance system increases the risk for severe disease and death.

Immune-Liver Disruptors 

A possible role of the pandemic measures in  excessive inflammation  in the human body by immune-liver disruptors is realistic. Independently they may each cause problems of the liver. Serious drawbacks of the measures have become most visible in children, the obese and immunocompromised and the poor.

Nanoparticles (i.e. inhaled graphene oxide, titanium dioxide, Ag from facemasks or swabs) present in the body are cleared from the blood and will preferentially accumulate and  sequester in the liver , up to  30-99%  from those present in the blood and at much higher quantities as compared to other organs.

Studies in recent years have shown that nanomaterials can modulate and activate  neutrophils  and other immune cells. Nanomaterials may be considered as a particular case of danger signals that are able to trigger sterile inflammatory responses. Rapid accumulation of nanoparticles in the resident liver macrophages can change the expression of anti-inflammatory genes. Changes of genes related to detoxification and cell cycle have been observed.

Systematically administered nanoparticles may directly interact with circulating erythrocytes leading to erythrocyte aggregation and or hemolysis that is accompanied by hemoglobin release. Surface properties of the nanoparticles are known to play a critical role in nanoparticle-erythrocyte interaction.  Most nanoparticles  have been known to activate complements by either themselves or through serum proteins. Activation of complements and complement activation pathways could further promote tumor growth.

Nanoparticles develop a specific bio-corona comprising  complex and dynamic  layers of biomolecules that endow nanoparticles with a new immunological identity.

Studies on polystyrene microplastics (which can be present in facemasks and swabs) showed  hepatotoxicity and dysregulation of the lipid metabolism , causing oxidative stress and inflammatory responses. This implicated a potential risk for liver steatosis, fibrosis and  cancer  and  macrophage foam cell formation , a characteristic feature observed during atherosclerosis posing a serious threat to human health.

Another  study  demonstrated that fish exposed to a mixture of polyethylene with chemical pollutants bioaccumulate the chemical pollutants and suffer liver toxicity and pathology. Moreover 0.1 um microplastics could enter hepatocytes from circulation and result in liver damage even at a low concentration.

Microplastic exposure could induce  DNA damage  in both nucleus and mitochondria indicating a potential risk of hepatotoxicity and fibrosis. Microplastics are found in the  human blood  of 80 % of the people tested, in deep lung tissues and human feces.

Covid-19 mRNA vaccines  use Acuitas’ PEG (Poly Ethylene Glycol) ylated lipid nanoparticles (LNP). The PEGylated lipids support prolonged circulation and shield the highly inflammatory and cytotoxic effects of the cationic lipids used. If insufficiently shielded by PEG they have been shown to mediate aggregation and interact with and damage the membranes of erythrocytes resulting in hemolysis.  PEG content , surface density and conformation of the nanoparticle influence the binding of proteins to a bio corona and the uptake by immune cells.

Despite achieving high dense surface coatings of PEG, no NP formulation has been developed that can completely resist interaction with blood components. Of concern is that 22-25% of individuals who were never exposed to PEGylated therapeutics were found to have PEG antibodies, which is more than two decades ago. PEG coating can improve the penetration of biological barriers including reducing interactions with tissue extracellular matrix cellular barriers and biological fluids such as mucus leading to improved delivery.

After injection of Moderna LNP  very low levels  could be detected in the brain, potentially indicating that the mRNA LNP could cross the blood brain barrier and reach the Central Nervous System (CNS). Unfortunately, the potential  inflammatory nature  of these LNPs was not assessed.

In preclinical studies a strong induction of adaptive immune responses by  CD4+ T-cell activation and protective humoral immune responses was found. The synthetic ionizable lipid is speculated to have approximately 20-30 days of half-life in humans. It has been shown that plasma protein absorption occurs very rapidly and that it affects hemolysis, thrombocyte activation, cellular uptake and endothelial cell death. The  bio corona  formation of the PEGylated nanoparticle may change over time.

The increasing number of side effects and reported high potency for eliciting antibody response may partially stem from the LNP’s highly inflammatory nature characterized by leukocyte infiltration and activation of different inflammatory cytokines and chemokines. Antigen-presenting cells presenting vaccine derived peptides/protein might cause tissue damage and exacerbate side effects, which have been linked to autoimmune diseases.

More severe and systemic side effects after the booster shot might be related to an amplification effect of the adaptive immune response induced by the vaccine resulting in high antibody responses. Neutrophils were found to preferentially internalize PEGylated particles in the presence of human plasma. Also, further studies of  complement activation  in relation to PEG nanoparticles merit rigorous evaluation for immune safe materials. Observational studies found a greater risk for complications following a positive SARS-CoV-2 test. A study of the  University of Lund  has indicated by  in vitro  studies that the BNT162b2mRNA vaccine has a fast take-up into human liver cells. In 6 hours of exposure the RNA was reverse transcribed into DNA.

Sennef et al.  describes the disruption of the innate immune system by the Covid-19 mRNA vaccines caused by an impaired interferon signaling, release of large amounts of exosomes containing Spike protein, potential disturbances in regulatory control of protein synthesis and cancer surveillance of and their potential direct link to liver disease (with over 2,000 reports in VAERS December 2021) and other inflammatory diseases. The presence of Spike protein has been detected in the blood and 60 days after mRNA vaccine injection in the  lymph nodes.

  A functional reprogramming of the innate immune responses after BNT 162b2 injection was also observed by  Fohse et al. with a lower response of innate immune cells, while the fungi-induced cytokine responses were stronger. A study on Biovrix by Nguyen et al. demonstrated an  impaired lipid metabolism and increased lipotoxicity  by the Spike protein.  Jiang et al  observed that the Spike protein localizes in the nucleus and inhibits DNA damage repair by impeding key DNA repair protein recruitment to a damaged site. A mechanism by which the spike protein might impede the adaptive immunity explaining the potential side effects. Suraswaki et al. stated that the virus itself may  dysregulate  the innate cellular defenses using various structural and nonstructural proteins.

Taking Back Control of Our Bodies 

The European Commission  Statement  from May 12, 2022, announces to shorten (from 300 to 100 days) the product to market cycle to develop safe and effective vaccines, therapeutics, and diagnostics following the identification of new threats and work to make them widely available.

As discussed, the Covid-19 pandemic measures have shown to be far from safe. All materials are known to interact and bind proteins forming bio corona’s depleting the body of essentials for processes to function properly.

Subtle changes in materials and biological fluids of persons can significantly change the protein composition of the bio corona and can either lead to an excessive inflammation or resilient homeostasis. Especially in children who need more proteins, vitamins and minerals for mental, physical, and immune system development, the accumulation of toxic substances  in the liver and formation of bio corona can be a serious threat to health.

At this stage, it is not known whether the mysterious rises in diseases are caused by a virus or an intoxication and/or depletion of essentials that result in impaired signaling routes. The Covid-19 routine  diagnostic  tests used for  mass testing  have major flaws which make it impossible to ensure the presence of an infectious virus as a single cause of symptoms.

An increasing number of doctors and researchers agree:  the pandemic is over. All pandemic measures need to be halted immediately. The highest priority is lifting the mandates for children. Healthy children always had a very low risk for severe Covid-19 and are protected by a strong robust and long-lasting  natural immunity. There is no added value to vaccinate any person with natural immunity. Moreover, the risk for side effects of the mRNA vaccine for children is high. mRNA Covid vaccine  accumulates in the liver  30 minutes after it is injected.

Deep investigations on quality, reproducibility and contaminations of the materials of personal protective equipment, facemasks, tests, disinfectants and vaccines, being used with their effects on the human body and the environmental ecosystem need to be prioritized and funded.

During the past two years, the immune system of many people has been harmed and even broken. We need programs to regenerate the liver and immune system so people can face with trust and confidence any possible wave of virus attacks.

Het bericht The Rise of Hepatitis verscheen eerst op Good Care Feels Better.

The (Lack of) Health in Young Women

By Carla Peeters • March 13, 2025
Many countries now face a growing problem with an aging population and declining childbirths. Too many infants still die unnecessarily before the age of five years. Countries increasingly struggle to keep their economies stable. While Public Health experts communicate to focus on healthier future generations, declining health in young females is ignored. The healthiest generation with a flourishing economy is achieved by a holistic strategy addressing Young Women’s Health as a Public Health priority. The Healthiest Generation of the World in 2040 A Federation of Organizations involved in Public Health in the Netherlands has the ambition to reach the healthiest generation of the world in 2040 . Health is aimed at all levels; mental, social, and physical. To achieve this goal, the Netherlands needs the healthiest young females of the world. In contrast, data analysis from the Netherlands shows the opposite; the health of young women is declining fast. In other Western countries, it won’t be much better. The health of young women has worsened worldwide; it is time to face reality. Women’s bodily functioning and metabolism differ from men and need specific female-adapted health support. While many health problems in a population could be prevented when young females are supported for optimal health prior to pregnancy, this is not a priority of Public Health Agencies. Good health for the next generation starts with a strong and resilient immune system before pregnancy and during the first 1,000 days around pregnancy, birth, and postpartum breastfeeding. Childbirth and children’s health are declining; the number of women dying during pregnancy (within 42 days after labor) is increasing, as well as the number of abortions. Without change, these conflicting trends may develop into a disaster touching all levels of society. The Public Health Future Outlook of the Netherlands predicts that close to 12 million people will have a chronic condition by 2050. Young Women’s Health Is Declining Around half of the young people aged 6-25 years in the Netherlands experience mental health problems. Moreover, 47% of the people aged 15-44 years are diagnosed with at least one chronic disease, with young women more often diagnosed than men. When diagnosed with a chronic disease, people work less, experience more sick leaves, and are less productive. Unfortunately, not being able to work contributes to poorer health and income. An even larger percentage of young people (79%) still suffer from a negative impact of the pandemic, with women and lower-educated individuals hit hardest and experiencing mental problems like emotional exhaustion, stress, and hyperactivity. A recent study published in PNAS showed a faster aging of the brains of young females as compared to young males, which might be related to chronic stress exposure. Students experience more stress than before due to worries about inflation and the high costs of living. Within the EU, the Netherlands has grown into the most expensive country to live in. Unfortunately, there is much more that is troubling the health of young females. Increased Drug Use and a Dangerous Beauty Myth During the pandemic, the use of antidepressants increased by 16% for those aged 16-24 years and for children. Women are prescribed antidepressants earlier and take them twice as much as men. While the positive effects of SSRI have been criticized repeatedly and women report more side effects than men, these medicines are still frequently prescribed by medical doctors. One in four young people in the Netherlands use Ritalin or Concerta ( methylphenidate ) without a medical prescription to improve concentration and study results. Most people are unaware of the potential risks, like sudden death, that are well-known as a potential side effect. Research has shown that 5.5-22.5% of the young have used ADHD medication without a doctor’s prescription. Furthermore, in mid-2023, a worrisome increase in NSAID like paracetamol (Tylenol or Acetaminophen) and ibuprofen use was observed, especially in young girls, increasing the risk for poisoning. The use of antibiotics like amoxicillin increased for children 0-10 years (55%) and for those aged 11-20 years with 50%. As 2023 was the first year after the pandemic with all festivals open to the public, an increased use of party drugs (like ecstasy ) among those aged 16-35 years was noticed with regularly registered symptoms of poisoning. The online and interconnected world exposes the risk of cyberbullying among young people. Ironically, many are feeling lonelier than ever before and are struggling with their weight and self-confidence, setting them up for poor health as adults. The beauty myth is another danger. During the years 2019-2022, the use of fillers increased by 80%, and the use of Botox doubled among young women. Exposure to microplastics, nanoplastics, and nanoparticles has increased. Furthermore, the concentration of PFAS/PFOA in Dutch drinking water is found to be above the norm and may decrease the fertility of both women and men. On the other hand, the use of oral hormonal contraceptives by young girls diminished in the Netherlands, with only a slight increase in the use of an intrauterine hormonal device. Recent studies showed that there is an increased risk, although small, of myocardial infarction or stroke when using hormonal contraceptives. The use of an intrauterine device with levonorgestrel did not show the risk. Given the extensive and ongoing reliance of millions of young women on these drugs, ensuring their safety remains a critical responsibility of the medical community. As well as medical doctors informing young women of potential harm based on the latest scientific literature by informed consent. Over the past 4 years, girls and young women have been exposed to repeated HPV vaccinations and Covid-19 mRNA vaccines within a short period of time, for both of which side effects in women have been reported to be more frequent and severe. Possible interactions and/or interference with these vaccines and long-term effects on the immune system and microbiome have not been investigated beforehand. Neither was knowledge available when it started in 2021 on the possible risks and short- and long-term effects when four vaccines before 22 weeks of pregnancy were introduced. Nutritious Food Not Affordable for Many The importance of daily consumption, as recommended by the WHO, of 400 grams of fresh fruit and vegetables, meat, milk products, and eggs for a healthy life and joyful social and working life is unknown by many young people. For most of them, it has become unaffordable . (Ultra)processed foods are the cheapest satisfying foods with a well-designed composition of low-cost ingredients, sugar, fat, and salt that change the microbiome. Home, school, commercials, social media, influencers, mobile phones, and retail environments are driving obesity and being overweight in children and adolescents, often concurrent with undernutrition and anemia. A growing body of evidence shows that the billions of microorganisms present in our body are intimately involved in weight gain and loss and immune training and modulation, as well as overall host homeostasis. Around 33% of the population in the Netherlands does not consume fruit and vegetables daily. As of 2024, 7.1% of Dutch children live in poverty, and this number is still growing . More children might be undernourished, which is associated with impaired growth, neurodevelopment, and increased infectious morbidity and mortality. To reverse the problem of malnutrition, the delivery of free meals has recently started at primary schools. Unfortunately, this does not make a difference for the children at secondary schools. While sending funding to developing countries to prevent malnutrition, a similar problem appears in front of our eyes in the Netherlands. The young generation predominantly eats more plant-based foods, as it would improve climate change. Almost 30% of young women prefer to shop for vegetarian food, and 0.7% of the Dutch population is vegan. In addition, the EU introduced novel food products such as insects and worms, lab-grown meat, and Bovaer for cows to reduce methane production, which might affect the human immune system. Almost one in five adolescents vape. Long-term effects are yet unknown. In the Netherlands, vapes with synthetic liquids that taste like cola, vanilla, apricot, etc., have now been forbidden . Although smoking is declining in adults, young women more frequently smoke than boys but drink less alcohol. All internal and external environmental factors may contribute to weakening or strengthening the resilience of the immune system and may therefore influence the period of pregnancy, labor, nursing, and the health of mother and child for future generations. Pregnancy Is Regulated by a Unique Complexity of the Immune System Pregnancy is a unique immunological state. The changes of the immune system in the three stages of pregnancy (very early, mid, and late stage) are meticulously timed. In the very early stage, the immune system adjusts to prevent her body from rejecting the fetus while at the same time still being strong enough to keep out foreign pathogens. In the late stage, the body is preparing for labor, which is driven by an inflammatory response. A full-term pregnancy will follow an immunological clock . Changes in this immune profile could help to predict and possibly prevent preterm labor. Studies show that pathologically-driven inflammation might trigger pre-term birth (before 37 weeks). In the Netherlands, 14.8% of the children born are preterm with 9.7% low birth weight for the duration of the pregnancy (Big2). Interestingly, in the case of a preterm child labor, the inflammatory reaction is more heated as compared to a full-term child labor. Preterm birth is an important indicator of a risk for early death, chronic and infectious diseases, sepsis, stunting, and delayed neurological and brain development. This may manifest throughout one’s lifespan. Very early birth and extreme early birth occur in only 1.5% of the Dutch baby population and are responsible for 50% of the deaths of newborn babies. The number of abortions jumped in two years in 2023 to 39,000, with most by women aged 25-34 years of age. Abortion in the Netherlands is allowed until 24 weeks of pregnancy. The number of childbirths has declined dramatically to 167,504 in 2022. That is 1.49 children per woman, with a mean age of 30.3 years. The number of women breast-feeding is also decreasing. At 6 months, women feeding breast milk lowered from 60% to hardly 30% of the young mothers. Each year, around 661 babies in the Netherlands die. Mothers dying within 42 days after labor are around 11 persons a year with an additional 5 women dying by suicide each year, and not counting women who died from cancer. Over the past years, mothers’ deaths have been increasing worldwide, with the leading cause being heart diseases and blood clots. Pregnant women with stress , depression , or anxiety , as well as obese women with gut inflammation and chronic disease, have altered immune systems and, as a consequence of malnutrition, have an altered microbiome. A weakened immune system suggests an increased risk for preeclampsia, high blood pressure, HELLP syndrome, gestational diabetes, preterm labor, and/or low birth weight. ‘Gut Feeling’ a Turmoil for Healthy Future Generations The gut presents 70-80% of the immune cells in the human body. In the mucosal layer of the intestine, neuronal cells, endocrine cells, and immune cells cooperate to manage its metabolism and bodily functioning. Recent studies in mice showed villi of the mucosal layer expanding twice its volume during pregnancy and breastfeeding, slowing food passage, improving digestion for an optimal use of available nutrition. The intestinal mucosal layer is strongly connected to various stages of pregnancy with altered gut microbiota, metabolites, and cytokines. These bioactive metabolites modulate and change the ‘innate’ and ‘adaptive’ immune system. Together, the microbial composition and the mucosal layer of the intestine determine long-term health. Mothers’ intestines influence the biodiversity of the microbiome and the resilience of the immune system, which is transmitted to the baby during pregnancy, labor, and nursing. Earlier periods in life facing hunger, extreme stress, or severe diseases may influence health during pregnancy and may transmit to the baby throughout one’s lifespan and even with intergenerational effects. Specific nutrients may have positive effects during pregnancy, labor, and nursing. Sufficient vitamin D , present in sunlight, nutrition (fish, milk products), or supplements, is a prerequisite during this precious time in life for both mother and child. For young women who wish to become pregnant, it is important to learn how to balance the immune system and the microbiome. The immune system of young women could be the most important regulator of the healthiest generations and a population’s workability and income. Author: dr. Carla Peeters First published at Brownstone Institute

The Alarming Increase in Female Healthcare Worker Suicide

By Carla Peeters • March 13, 2025
The increasing number of suicides and fatal overdoses of women healthcare workers has accompanied rising sickness, disability, and women leaving the sector. The total social and economic costs of a workforce in despair are yet unknown. A shortfall of 10 million healthcare workforce (of whom 80-90% is female) is projected by the WHO for 2030 and is of critical concern. When the health of those who look out for people’s health is at risk, the whole population and economy are at risk. This is an emergency of unprecedented scale that needs attention at the highest Public Health level. Humanity and nutrition instead of medicalization as a coping strategy urgently needs to return in the healthcare sector. Alarming Warnings by Healthcare Workers in Despair Recent studies noticed death by suicide and the risk for fatal drug overdose among women in healthcare is much higher as compared with the general population (1-10). It is not only female physicians, but the risk is even higher for nurses and other healthcare workers, especially for those with the lowest-paid jobs and heaviest mental and physical workload who have been most stretched to the limits (7). Worldwide over the last several years thousands of healthcare workers have died by suicide or fatal overdose leaving family, friends, and the workplace in shock and grief. Suicide and self-harm have substantial social and economic costs (12). One death by suicide was calculated in the UK to cost the economy an average of 1.46 million pounds (13). In 2022 more than 360 nurses attempted suicide, and 72 medical professionals took their own lives in 2020 in the UK as data from the Office of National Statistics indicate. Analysis of mortality data from the US Centers for Disease Control and Prevention from 2007 to 2018 identified 2,374 suicides among nurses, 857 among doctors, and 156,141 in the general population. However, the number of death by suicide or fatal overdose is grossly underreported. The WHO reports that over 50% of suicides happen under the age of 50 years (14). To address this avoidable burden, a better understanding of effective and non-effective strategies is paramount. Even before the Covid pandemic started women in healthcare reported substantial workplace stressors (9-11, 15-16). The past four years have put additional strain on women’s health. This is especially true for those women working as front-liners and first responders in highly demanding stressful situations. Increased complexity of care, understaffing, long working hours, additional bureaucratic tasks, moral injury, diminished autonomy, lack of decision-making ability, and low-paid jobs take a burden on their health. Moreover, women routinely face tougher challenges at work and at home such as institutionalized barriers to career advancement as well as additional pressure for domestic labor by frequently being a caregiver for children and/or parents (9). In all parts of the world healthcare workers are at high risk for violence with 8-38% suffering some sort of violence form in their careers. In 2023 for the first time in history, 75,000 healthcare workers in the US went on strike (17). Women are more frequently diagnosed with burnout, major depression, Post Traumatic Stress Syndrome, ME/CFS, and Long Covid. Long Covid is more prevalent in healthcare workers (11,18-20). These diagnoses of chronic illnesses have many symptoms in common that are known to exacerbate the risk for suicidal thoughts, suicide attempts, and suicidal completion beyond occupation and established risk factors such as socioeconomic status and education (7-8,20-24). An Epidemic of Emotional Trauma and Distress Healthcare workers are trying to hide their symptoms by pushing themselves to work despite extreme pain, fatigue, memory inconsistency, exhaustion, and grief of not being able to deliver the quality of care patients need. Being overstressed and with long-term understaffing, healthcare workers hardly take time to eat a nutritious meal. Many have become undernourished, and sleep-deprived. Potential disparities in help-seeking and healthcare access might manifest in non-medical use of prescription drugs among some healthcare workers, which has implications for workers’ safety and well-being (25). Many of the medicines used by healthcare workers might be unprescribed and unnoticed (1-8, 23). Toxic Cocktails: A Danger for Women’s Health Suicides among the healthcare workforce often take place at work. The most frequently used method of suicide is overdose or poisoning (1-8). New studies suggest that most overdoses are caused by psychiatric drugs and multiple medications in their system. Co-administration of antidepressants and opioids deliberate or unplanned is common. Women are more likely to be prescribed and take medication like antidepressants and birth control pills and seem to be more sensitive and experience drug side effects than men. Pharmacokinetic interactions may increase the concentrations and severity of side effects of antidepressants (27-28). Studies demonstrate potential side effects of psychiatric drugs and opioids as insomnia, burnout, fatigue, anxiety, pain, and suicidal thoughts (21-25). The risk of opioid-involved overdose death was nearly twice as high experienced by healthcare support workers such as nursing home workers and home health aides as compared to other healthcare workers in the sector (7). The interaction and side effects of the use of multiple medicines and concentrations are mostly unknown. This is especially true for women as most drugs have been poorly studied in women. Some medicine might even have more disastrous side effects than any benefit as seems to be the case for psychotropic medicine (26). Moreover, interactions of psychotropic drugs with immunosuppressive capabilities and Covid-19 mRNA vaccines have been reported (17). Furthermore, pandemic measures that have been mandated for healthcare workers including long-term wearing of medical facemasks (with potential inhalation of toxins) and repeated Covid-19 vaccinations with women reporting more side effects than men (30-31) might have exacerbated potential risks. Recent publications repeatedly reported a global burden of absenteeism related to Covid-19 vaccine side effects which could negatively impact the strained healthcare system and jeopardize patient care (32-33). Medicalization as a Coping Strategy During the pandemic, prescription of antidepressants and use of other over-the-counter medication like acetaminophen (paracetamol) which is often advised to temper vaccine side effects, has grown substantially. Although harmless in low doses, acetaminophen has direct hepatotoxic effects when taken in overdose or a wrong combination and may cause acute liver failure. Accidental or unintentional overdose usually occurs in patients who have been fasting, or are critically ill with a concurrent illness, alcoholism, malnutrition, or have preexisting chronic liver disease (34). Acetominophen (single or combination products) is one of the most used medications in the United States with 25 billion tablets sold in 2016. It is expected that treatment of trauma ailments and increase in chronic illness will fuel the market sales from $9.8 billion in 2022 to $15.2 billion in 2033. However, after a report showed 8,700 poisonings with high rates of hospitalization and liver injury in 2019-2020 with a sharp rise among females, the Australian medicine regulator is considering restrictions on who can buy paracetamol (35). In Sweden, the sale of acetaminophen in supermarkets was banned in 2015 after they experienced an overdose hike. Increased use of over-the-counter and controlled drugs may fuel a rise in acute liver failure. Awareness of potential unintentional irreversible harm is highly needed among healthcare workers and the public, as many new drugs and vaccines have been introduced since the pandemic. Drug Theft and Diversion Job stress and occupational burnout have been associated with increased risk for opioid use disorder which in turn can increase risk for overdose. Those who prescribe or administer medication have ready access to opioids and other controlled prescription drugs. Drug theft and diversion of controlled drugs in hospitals and nursing homes appear to have accelerated worldwide, bringing healthcare workers and patients at risk (36-38). Taking prescription medicine at work, almost 100 healthcare workers have been fired in The Netherlands. Moreover, the problems with understaffing in the Dutch healthcare sector have introduced the use of falsified certificates with people from illegal drug networks entering healthcare organizations pushing the system to more errors and deficits (39). Increasing stress at work and too many night shifts in a row have contributed to a 70% increase in medicine thefts. Almost 50% of calming and sleeping pills were not delivered to patients putting them at risk for suboptimal treatment or contaminations and errors (40). Drug use may gradually become an attractive and convenient coping mechanism. Although professionals often think knowledge of the medicine may control their use, dependence may slowly develop. Many impaired healthcare workers feel guilt and despair and suffer from physical and mental problems and may be indifferent to the risk of overdose (38) A Return to Humanity in Healthcare The problem of the rise in sudden (un)intended death of healthcare workers comes against the background of increasing long-term sick leaves, permanent disabilities, and hundreds of thousands of healthcare workers leaving the sector, choosing for less stressful and better-paid jobs. This is an unprecedented sign by dedicated women for no longer willing to work in a toxic and overstressed environment with underpaid complex tasks for often severely ill patients. The healthcare system is facing increased clinical error rates and liability exposures while adversely impacting patient satisfaction and organizational reputation. This may develop into a catastrophe when Public Health Officials do not take responsibility for a highly needed change ensuring that the workforce has the tools and resources needed to turn the wheel. Hard times may turn positive when CEOs and insurance companies start to embrace the idea that quality of care and reputation starts with a healthy, fair-paid workforce, gender equity, and a working environment choosing for humanity and good nutrition. A vital well-nourished empowered healthcare workforce that is occupied to guide people to health and work will be a win for all.
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