Medicine

DEVELOPING STORYDEVELOPING STORY,

The international team discovered how the immune system is kept in check to prevent it attacking the body.

The Nobel Prize in physiology or medicine has been awarded to Mary E Brunkow, Fred Ramsdell and Shimon Sakaguchi for their work on the functioning of the human immune system.

The award, announced by Sweden’s Karolinska Institute on Monday, will be presented to the trio in December for “their groundbreaking discoveries concerning peripheral immune tolerance that prevents the immune system from harming the body”.

The research “relates to how we keep our immune system under control so we can fight all imaginable microbes and still avoid autoimmune disease”, said Marie Wahren-Herlenius, a rheumatology professor at the Karolinska Institute.

The prize of 11 million Swedish kronor ($1.17m) is to be shared equally between Brunkow and Ramsdell of the United States and Japan’s Sakaguchi. The king of Sweden will also present them with gold medals.

“Their discoveries have laid the foundation for a new field of research and spurred the development of new treatments, for example for cancer and autoimmune diseases,” the prize-awarding body said in a statement.

The prize for medicine kicks off the annual Nobel awards, arguably the most prestigious prizes in science, literature, peace and economics. The winners of the remaining prizes will be announced over the coming days.

US President Donald Trump has asserted numerous times that he should receive the Nobel Peace Prize, having claimed to have halted seven wars since taking office at the start of the year.

However, regardless of apparent resistance among the assemblies that select the winners, the US president is unlikely to receive this year’s peace prize, as nominations had to be made in January.

This is a developing news story. More to come…

US President Donald Trump announced earlier this week that his administration would launch a new website, called TrumpRx, which will allow American consumers to buy prescription drugs from pharmaceutical companies at discounted prices.

Pfizer, the first United States pharmaceutical group to sign up to the website, said it would offer discounts of up to 85 percent on the cost of its medicines for those not using health insurance policies to pay and for those on the government’s low-cost insurance programme, Medicaid. Pfizer will also sell medicines to the Medicaid programme itself at lower prices.

The announcement prompted shares in the pharmaceuticals sector to lift sharply this week, signalling a favourable response from markets and the pharmaceuticals industry.

Here’s what we know about the new service, why it is being launched and how it will work.

What is TrumpRx and when is it being launched?

The new website will be launched in early 2026. It is a platform from which consumers will be able to buy prescription medicines directly from pharmaceutical companies without going through insurance.

On the site, consumers will be able to search for the prescription drug required and then be directed to the drug’s manufacturing company.

They will have access to discounted prices much closer to those typically paid by national health services in foreign countries at what are known as “most favoured nation” prices.

Beneficiaries of Medicaid – the federal government insurance programme for adults and children from lower-income backgrounds – will also be able to use the site.

“By taking this bold step, we’re ending the era of global price gouging at the expense of American families,” Trump told a news conference on Tuesday.

What are ‘most favoured nation’ prices?

“Most favoured nation” (MFN) prices are those that national health services in other countries, including Canada, France, Germany, Italy, Japan, the United Kingdom, Switzerland and Denmark, pay US pharmaceutical companies for prescription drugs.

As these countries buy medicines in bulk, they have much greater purchasing power to demand lower prices than ordinary consumers. This means pharmaceutical companies tend to sell their drugs at a much lower price to other countries than they do domestically.

The US cannot leverage this sort of purchasing power because it does not have a national health service, so the government cannot influence the price of drugs in the same way.

The Trump administration argues that this means US pharmaceutical companies are effectively subsidising foreign health services while artificially inflating prices for American consumers. In May this year, therefore, he signed an executive order aimed at reducing prescription drug prices in the US, stating: “The United States will no longer subsidise the health care of foreign countries.”

When a country grants MFN status, it commits to providing the recipient country with the same trade advantages it gives to any other country with MFN status, but not necessarily the same low prices – prices still vary from country to country. However, it is understood that companies will be expected to offer drugs at their lowest selling price in any other country.

What else has Trump done about the cost of medicines in the US?

The launch of the new website is just one part of Trump’s strategy to reduce prescription medicine prices in the US.

In July this year, he sent a letter to the CEOs of 17 pharmaceutical companies ordering them to reduce their prices.

In the letter, he laid out demands and promises:

• He called on manufacturers to provide MFN prices to every single Medicaid patient.
• He required manufacturers to stipulate that they will not offer other developed nations better prices for new drugs than prices offered in the United States.
• He promised to provide manufacturers with an avenue to cut out middlemen and sell medicines directly to patients, provided they do so at a price no higher than the best price available in developed nations.
• He promised to use trade policy to support manufacturers in raising prices internationally, provided that increased revenues abroad are reinvested directly into lowering prices for American patients and taxpayers.

The new TrumpRx website addresses the first of these promises.

To address the second promise, Trump has also announced new 100 percent tariffs on imported, branded pharmaceutical products. Companies which set up production facilities and operations in the US will be exempt from these.

He cited the cost of prescription drugs as one of the reasons for levying these tariffs.

How much more do medicines cost in the US than other countries?

According to a 2022 study commissioned by the Office of the Assistant Secretary for Planning and Evaluation, published on the US government website, standard insulin prices in the US are as much as 10 times higher than prices in 33 OECD countries.

“Average gross prices in the US were more than 10 times prices in France and the United Kingdom; nearly nine times prices in Italy; more than eight times prices in Japan; about seven times prices in Germany; and more than six times prices in Canada,” the study found.

Many people who take insulin already pay a “net price”, which is lower than the standard price via rebates that the manufacturer agrees with insurance companies. But the net price is still, on average, 2.33 times the price paid in other countries, the report found.

Who will benefit most from this platform?

Anyone who wants to buy prescription drugs direct from pharmaceutical companies, instead of via insurance coverage, at a discounted price can use the platform.

A 2024 report from the US Census Bureau showed that about 8 percent of the US population (26 million people) did not have health insurance in 2023 – so these people may be able to benefit.

The Medicaid programme is also likely to benefit from lower prices as its deal with Pfizer includes more favourable terms. However, details of how this part of the deal will work have not been fully explained.

Currently, most Americans use insurance policies to provide medical care, so initially, most will not use the website, experts said.

Stacie B Dusetzina, professor of health policy at the Vanderbilt University Medical Center in Nashville, told Al Jazeera: “There are a small number of people who may be better off purchasing their medicine this way, but the majority of Americans won’t benefit from this type of model.”

However, she added: “There are other components to the deal that could save the public Medicaid programme money, but without knowing more about how that deal is structured, we can’t say for sure that it would produce savings.”

Which drug companies will sell via the new website?

On Tuesday, Trump said pharma group Pfizer was the first to sign up for the new website.

In return for direct access to consumers, the US pharmaceuticals major has agreed to lower the cost of its prescription drugs for those buying direct via the site (and not using insurance to pay), as well as those on the Medicaid programme. Customers will pay prices closer to “most favoured nation” prices, Trump said.

In a news release, Pfizer said it had “voluntarily agreed to implement measures designed to ensure Americans receive comparable drug prices to those available in other developed countries” and said it will also price “newly launched medicines at parity with other key developed markets”.

“The large majority of the Company’s primary care treatments and some select specialty brands will be offered at savings that will range as high as 85 percent and on average, 50 percent,” the company said in a statement.

The White House and Pfizer gave some examples of primary-care Pfizer medicines which will be available on the TrumpRx website. This is not an exhaustive list:

• Eucrisa, a topical ointment for atopic dermatitis, which will be made available at an 80 percent discount for patients purchasing directly.
• Xeljanz, a widely used oral medication for types of arthritis which will be available at a 40 percent discount.
• Zavzpret, a drug used to treat migraines, which will be sold at a 50 percent discount.
• Duavee, used to treat menopause symptoms, which will be offered at around an 85 percent discount.
• Toviaz, a drug for for overactive bladder.
• Abrilada and Xeljanz, both autoimmune drugs which will be available at significant discounts.

Some of these drugs will remain very expensive even with the discounts. According to Pfizer’s website, Xeljanz, for example, costs around $6,000 per month at the standard price. A 40 percent discount brings this down to $3,600 per month.

Currently, Americans with health insurance can obtain the drug for up to $20 a month – in many cases, their insurance policy terms mean they pay nothing at all.

What else have Pfizer and Trump agreed to under this deal?

Pfizer has agreed to reduce drug prices in the US generally, putting prices in line with those paid in other developed countries, the company said.

The group has also committed to spending $70bn on domestic manufacturing facilities, which will be dedicated to “US research, development and capital projects in the next few years”.

In return, the company will be given a three-year grace period from Trump’s tariffs on branded pharmaceuticals made abroad.

“I think today we are turning the tide, and we are reversing an unfair situation,” Pfizer’s CEO Albert Bourla said at a news conference on Tuesday alongside Trump, referring to the difference in prices that people in the US pay for medicines compared with consumers overseas.

Will other drug companies follow suit?

Trump said on Tuesday that other pharmaceutical companies are expected to sign up for the new website, but there have been no new official announcements so far.

“It is clear that the deal that Pfizer struck is a friendly one to the industry,” said Dusetzina. “The companies that received letters requesting that they act are all likely to make agreements that I would expect to be similarly structured.

“If nothing else, these companies will want commitments that they can avoid any potential tariffs. That is worth a lot to them and to their shareholders. It will still be unclear, I think, whether the changes that they make have any tangible benefits for the average American.”

Overseas pharmaceutical companies may be able to sign up as well.

Swiss companies, including Novartis and Roche, said that they were eager to work with the Trump administration to make their drugs more affordable to US patients.

Stephan Mumenthaler, director general of scienceindustries – which represents about 250 Swiss chemical and pharmaceutical companies – told the Reuters news agency on Wednesday that he expected “mini deals” to come from Swiss and global pharmaceutical companies in the coming days.

“They are thinking in similar schemes … How can you omit the margins that middlemen are taking away so that you basically have a similar price than before, but the end consumer still gets a lower price,” he said.

Meanwhile, on Monday, the Pharmaceutical Research and Manufacturers of America (PhRMA) announced the launch of its own website AmericasMedicines.com, which will enable consumers to directly buy drugs from manufacturers as well.

In a media release, Stephen J Ubl, president and CEO of PhRMA said: “We need policymakers to protect innovation, fix the broken insurance system that burdens patients with high out-of-pocket costs, and ensure foreign governments pay their fair share.”

How have markets reacted?

Pfizer’s share price rose 7 percent in the US on Tuesday and jumped 8 percent on the UK’s stock exchange on Wednesday.

The announcement of the new website also lifted the shares of European pharmaceutical companies, including Merck, Roche and AstraZeneca by about 5 percent.

MILLIONS of Brits who pop pills for heartburn could be at greater risk of a deadly tummy bug, experts warn.

The drugs, called proton pump inhibitors (PPIs) and handed out by GPs and bought over the counter to tackle heartburn and indigestion.

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The latest NHS figures show more than 73 million prescriptions were dished out in England in 2022/23 alone, making them some of the most prescribed drugs in England.

The pills work by reducing the amount of acid in the stomach, easing the burning pain that comes with acid reflux.

And although generally considered safe PPIs, which include omeprazole, lansoprazole and pantoprazole, are not without risks.

Experts have long warned the drugs can increase the chances of Clostridioides difficile, otherwise known as C. diff, a nasty bug that causes severe diarrhoea and can sometimes be fatal.

Last year, the UK saw a spike in cases of the nasty bacteria.

From February 2024 to January 2025, the UK Health Security Agency (UKHSA) received 19,239 reports of C. diff sufferers. The higest number of cases since 2011/12.

A new study, published in The Journal of Infection in May of this year, checked for the first time if taking higher doses of the pills makes the risk even worse.

Pharmacist Deborah Grayson, dubbed the “godmother of pharmacology” on TikTok, also sounded the alarm in a viral video.

She said: “It can be helpful to have omeprazole if you’ve got gastritis or erosion in your oesophagus, but if you’ve only got simple heartburn-related problems, longer term it can have greater impacts on the body.”

While reflux is uncomfortable, stomach acid is essential for digestion.

It activates pepsin, an enzyme that breaks down proteins in the gut, and helps soften food. 

It also protects against harmful microbes in food. 

“Reduced stomach acid can also compromise the gut’s natural defense barrier, increased susceptibility to infections such as C. diff, campylobacter and small intestinal bacterial overgrowth (SIBO),” Deborah added. 

“These can cause further gastrointestinal symptoms and, in some cases, serious complications.”

But researchers behind the new review said that while PPIs are linked to a higher risk of C. diff overall, there was no strong evidence that taking bigger doses raised the danger further.

The team from Karolinska Institutet in Stockholm, Sweden, carried out what’s called a “dose-response meta-analysis”, pooling results from previous trials and studies to see if higher amounts of the drug meant higher risk.

The study confirmed the pills are linked to a higher risk of C. diff, but found no clear proof that bigger doses make things worse.

The experts say it’s still a wake-up call to stop overprescribing and keep patients under review.

Patients should never suddenly stop taking PPIs without medical advice, as this can make acid reflux worse.

Anyone worried about their prescription should speak to their GP.

A HIGHER ‘golden dose’ of Wegovy than is currently approved is safe and could be more effective – helping patients lose nearly a fifth of their body weight.

The once-weekly injection containing the semaglutide – also the active ingredient in diabetes jab Ozempic – is prescribed on the NHS at a maximum dose of 2.4mg.

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Now, two major studies show that tripling doses to 7.2mg can trigger significant weight loss, without bringing on more side effects or risking patient safety.

The findings, published in The Lancet Diabetes & Endocrinology journal, suggest a higher dose of semaglutide could be an option for people with obesity – as well as type 2 diabetes – who haven’t lost enough weight on standard doses.

“Once-weekly subcutaneous semaglutide 2.4 mg is approved for weight management in people with obesity and related complications,” researchers said.

“However, some individuals do not reach their therapeutic goals with this dose.

“We aimed to test the efficacy and safety of a higher dose of semaglutide in people with obesity.”

Researchers investigated whether 7.2mg semaglutide injections could provide patients with “further benefits” and boost fat loss for people whose weight had plateaued “without jeopardising safety or significantly increasing the risk of adverse events”.

The two trials involved more than 2,000 adults with obesity, some of whom also had diabetes.

They were conducted across 95 hospitals, specialist clinics, and medical centres in 11 countries, including Canada, Germany, Greece, Norway and the US.

Researchers randomly assigned participants the 7.2mg dose, the 2.4mg dose, or placebo injections.

All participants received advice on improving diet and increasing exercise.

After 72 weeks, people without diabetes given the higher dose lost an average of 18.7 per cent of their body weight.

Those on the standard dose 15.6 per cent of their weight and those on placebo injections lost just 3.9 per cent.

Almost half of those on the higher dose lost at least 20 per cent of their body weight, while nearly a third shed 25 per cent or more.

This rivals the average weight lost with competitor jab Mounjaro, known as the ‘King Kong’ of weight loss injections.

Participants on the higher dose also saw their waists shrink and reported improvements in their blood pressure, blood sugar, and cholesterol levels – all key factors in reducing obesity-related health risks.

As for obese adults with type 2 diabetes, the 7.2mg dose caused them to lose 13 per cent of their weight.

Those on 2.4mg lost 10 per cent of their body weight on average, while placebo-users lost 4 per cent.

Both trials showed the higher semaglutide dose to be safe and generally well tolerated, though people taking 7.2mg did report more side effects.

“Serious adverse events” were reported by 68 of 1004 participants receiving the 7.2mg dose of semaglutide – about 7 per cent – researchers said.

Meanwhile, 22 of 201 taking 2.4mg reported side effects – about 11 per cent – and 11 of 201 receiving placebo injections, researchers said.

Nausea and diarrhoea, and some sensory symptoms like tingling, were the most common.

However, most side effects were manageable and resolved over time, researchers said.

One in 20 patients taking the higher dose stopped treatment because of side effects, similar to the standard jab.

Study authors concluded: “Semaglutide 7.2 mg was superior to placebo and semaglutide 2.4 mg in reducing bodyweight, including reaching reductions of 20 per cent or greater and 25 per cent or greater over 72 weeks.

The higher dose was “well tolerated and provided additional clinically meaningful weight loss compared with 2.4 mg, suggesting that higher doses could help patients who do not achieve sufficient weight loss with the currently approved dose”, they added.

But Professor Alex Miras, an obesity expert at Imperial College London, was more hesitant in touting the benefits of the 7.2mg dose.

He told the Daily Mail: “Tripling the dose only gives a marginal extra benefit, but the dose increase is massive.

“Going from 2.4mg to 7.2mg is a very big jump. I’m concerned many patients won’t tolerate such a high dose.

“In clinical practice people already struggle at 2.4mg.

“Even if 7.2mg is approved, I suspect uptake will be low because of cost and side-effects – the top dose is already expensive.”

It comes as many Brits taking weight loss jabs privately are priced out of paying for Mounjaro – after manufacturer Eli Lilly hiked up prices.

The highest dose was set to rise from £122 to £330 a month – an increase of 170 per cent – from September 1.

It was later reported that some pharmacies would be able to offer the jabs at a discount, saving patients £83 on the cost of the maximum dose.

But the price rise has still made Mounjaro unaffordable for many – leading Brits to switch to cheaper Wegovy or give up the jabs altogether.

In the UK, fewer than 200,000 people are thought to be accessing weight-loss jabs through the NHS, but over 1.4 million are estimated to be using them privately, according to the health think-tank the King’s Fund.

Meanwhile, jabs such as Ozempic, Wegovy and Mounjaro have been connected to 24 deaths in the 21 weeks since January, The Sun revealed.

AS the UK waves goodbye to summer, experts are urging people to take extra precautions to stay healthy.

As winter illnesses start to circulate, one virus parents are being asked to be especially wary of is RSV – as new evidence shows it can be just as risky to healthy babies as those born premature of with underlying health conditions.

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RSV, which stands for respiratory syncytial virus, is a common cause of respiratory infections in young children and accounts for around 245,000 hospital admissions annually in Europe. 

In some cases, it can lead to more severe respiratory issues like bronchiolitis and pneumonia, which can lead to hospitalisation, the need for oxygen or mechanical ventilation, and even death.

Researchers have now analysed data from more than 2.3 million children born in Sweden between 2001 and 2022 to find out who is at greatest risk of suffering serious complications or dying from an RSV infection

Almost all children will get RSV at least once before they’re two years old.

Premature babies and children with chronic diseases are known to be at increased risk of developing severe illness when infected with the virus.

And children under three months of age are also particularly vulnerable – although it hasn’t been entirely clear how common severe disease is among previously healthy children. 

As part of their findings, scientists from Karolinska Institutet in Sweden found the largest group among the children who required intensive care or were hospitalised for a long period of time were under three months of age, previously healthy and born at full term.

“When shaping treatment strategies, it is important to take into account that even healthy infants can be severely affected by RSV,” said the study’s first author, Giulia Dallagiacoma, a physician and doctoral student at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet.

“The good news is that there is now preventive treatment that can be given to newborns, and a vaccine that can be given to pregnant women.”

The NHS RSV vaccine programme was launched in England on September 1, 2024 offering protection to pregnant women from 28 weeks gestation to protect their baby and to older adults aged 75 to 79.

Several factors were linked to an increased risk of needing intensive care or dying by the researchers.

Children who were born in the winter, or had siblings aged 0–3 years or a twin, had approximately a threefold increased risk, while children who were small at birth had an almost fourfold raised risk.

Children with underlying medical conditions had more than a fourfold increased risk of severe illness or death.

“We know that several underlying diseases increase the risk of severe RSV infection, and it is these children who have so far been targeted for protection with the preventive treatment that has been available,” said the study’s last author, Samuel Rhedin, resident physician at Sachs’ Children and Youth Hospital and associate professor at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet.

“However, the study highlights that a large proportion of children who require intensive care due to their RSV infection were previously healthy.

“Now that better preventive medicines are available, it is therefore positive that the definition of risk groups is being broadened to offer protection during the RSV season to previously healthy infants as well.”

In the UK, if you’re pregnant, you should be offered the RSV vaccine around the time of your 28-week antenatal appointment.

If you’re aged 75 to 79 (or turned 80 after 1 September 2024) contact your GP surgery to book your RSV vaccination.

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Spotting RSV symptoms is important to help prevent serious complications.

Most people who get an RSV infection will only get cold-like symptoms, according to the NHS, including the five following signs:

• a runny or blocked nose
• a cough
• sneezing
• tiredness
• a high temperature – signs include your back or chest feeling hotter than usual, sweatiness and shivering (chills)

Babies with RSV may also be irritable and feed less than usual.

But if RSV leads to a more serious infection (such as pneumonia or bronchiolitis) it may also cause a worsening cough, shortness of breath, faster breathing, difficulty feeding in babies, wheezing, and confusion in older adults.

It’s important to note cold-like symptoms are very common in babies and children and aren’t usually a sign of anything serious.

They should get better within a few days.

There’s no specific treatment for an RSV infection as it often gets better on its own in one or two weeks.

If you or your child have mild RSV symptoms, there are some things you can do to help ease symptoms at home, including taking paracetamol or ibuprofen if you have a high temperature and are uncomfortable (giving children’s paracetamol or children’s ibuprofen to your child) and drinking lots of fluids.

But children and adults who get a more serious infection may need to be treated in hospital.

It was my childhood dream to study medicine. I wanted to be a doctor to help people. I never imagined that I would study medicine not in a university, but in a hospital; not from textbooks, but from raw experience.

After I finished my BA in English last year, I decided to enrol in the medical faculty of al-Azhar University. I started my studies at the end of June. With all universities in Gaza destroyed, we, medical students, are forced to watch lectures on our mobile phones and read medical books under the light of our mobile phones’ flashlights.

Part of our training is to receive lectures from older medical students, who the genocidal war has forced into practice prematurely.

My first such lecture was by a fifth-year medical student called Dr Khaled at Al-Aqsa Martyrs Hospital in Deir el-Balah.

Al-Aqsa looks nothing like a normal hospital. There are no spacious white rooms or privacy for the patients. The corridor is the room, patients lie on beds or the floor, and their groans echo throughout the building.

Due to the overcrowding, we have to take our lectures in a caravan in the hospital yard.

“I’ll teach you what I learned not from lectures,” Dr Khaled began, “but from days when medicine was [something] you had to invent.”

He started with basics: check breathing, open the airway, and perform cardiopulmonary resuscitation (CPR). But soon, the lesson shifted into something no normal syllabus would have: how to save a life with nothing.

Dr Khaled told us about a recent case: a young man pulled from beneath the rubble – legs shattered, head bleeding. The standard protocol is to immobilise the neck with a stabiliser before moving the patient.

But there was no stabiliser. No splint. No nothing.

So Dr Khaled did what no medical textbook would teach: he sat on the ground, cradled the man’s head between his knees, and held it perfectly still for 20 minutes until equipment arrived.

“That day,” he said, “I wasn’t a student. I was the brace. I was the tool.”

While the supervising doctor was preparing the operating room, Dr Khaled did not move, even when his muscles began aching, because that was all he could do to prevent further injury.

This story was not the only one we heard from Dr Khaled about improvised medical solutions.

There was one which was particularly painful to hear.

A woman in her early thirties was brought into the hospital with a deep pelvic injury. Her flesh was torn. She needed urgent surgery. But first, the wound had to be sterilised.

There was no Betadine. No alcohol. No clean tools. Only chlorine.

Yes, chlorine. The same chemical that burns the skin and stings the eyes.

She was unconscious. There was no alternative. They poured the chlorine in.

Dr Khaled told us this story with a voice that trembled with guilt.

“We used chlorine,” he said, not looking at us. “Not because we didn’t know better. But because there was nothing else.”

We were shocked by what we heard, but perhaps not surprised. Many of us had heard stories of desperate measures doctors in Gaza had had to take. Many of us had seen the gut-wrenching video of Dr Hani Bseiso operating on his niece on a dining table.

Last year, Dr Hani, an orthopaedic surgeon from al-Shifa Medical Complex, found himself in an impossible situation when his 17-year-old niece, Ahed, was injured in an Israeli air strike. They were trapped in their apartment building in Gaza City, unable to move, as the Israeli army had besieged the area.

Ahed’s leg was mangled beyond repair and she was bleeding. Dr Hani did not have much choice.

There was no anaesthesia. No surgical instruments. Only a kitchen knife, a pot with a little water, and a plastic bag.

Ahed lay on the dining table, her face pale and eyes half-closed, while her uncle – his own eyes brimming with tears – prepared to amputate her leg. The moment was captured on video.

“Look,” he cried, voice breaking, “I am amputating her leg without anaesthesia! Where is the mercy? Where is humanity?”

He worked quickly, hands trembling but precise, his surgical training colliding with the raw horror of the moment.

This scene has been repeated countless times across Gaza, as even young children have had to go through amputations without anaesthesia. And we, as medical students, are learning that this could be our reality; that we, too, may have to operate on a relative or a child while watching and hearing their unbearable pain.

But perhaps the hardest lesson we are learning is when not to treat – when the wounds are beyond saving and resources must be spent on those who still have a chance of survival. In other countries, this is a theoretical ethical discussion. Here, it is a decision we need to learn how to make because we may soon have to make it ourselves.

Dr Khaled told us: “In medical school, they teach you to save everyone. In Gaza, you learn you can’t – and you have to live with that.”

This is what it means to be a doctor in Gaza today: to carry the inhuman weight of knowing you cannot save everyone and to keep going; to develop a superhuman level of emotional endurance to absorb loss after loss without breaking and without losing one’s own humanity.

These people continue to treat and teach, even when they are exhausted, even when they are starving.

One day, midway through a trauma lecture, our instructor, Dr Ahmad, stopped mid-sentence, leaned on the table, and sat down. He whispered, “I just need a minute. My sugar’s low.”

We all knew he hadn’t eaten since the previous day. The war is not only depleting medicine – it is consuming the very bodies and minds of those who try to heal others. And we, the students, are learning in real time that medicine here is not just about knowledge and skills. It is about surviving long enough to use them.

Being a doctor in Gaza means reinventing medicine every day with what is available to you, treating without tools, resuscitating without equipment, and bandaging with your own body.

It is not just a crisis of resources. It is a moral test.

And in that test, the wounds run deep – through flesh, through dignity, through hope itself.

The views expressed in this article are the author’s own and do not necessarily reflect Al Jazeera’s editorial stance.

IT was 1984 and newly qualified doctor Daniel Drucker was excited to dive into the world of ­scientific research.

Fresh out of the University of Toronto Medical School, the 28-year-old was working at a lab in Boston in the US when his supervisor asked him to carry out a routine experiment — which proved to be anything but.

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For it led to Dr Drucker’s discovery of a previously unknown hormone, sparking a new era in medicine.

What he modestly calls a “happy accident” then kick-started a series of ­discoveries that made today’s game-changing weight loss jabs a reality.

The hormone was called glucagon-like peptide 1 — or GLP-1, as the world now knows it.

And the drugs that have resulted from its discovery have produced amazing effects — with users losing up to a fifth of their body weight.

So far around 50,000 of us have been prescribed jabs on the NHS for weight loss, but it is ­estimated around 1.5million people here are buying them privately — a figure that is expected to rise sharply.

Dr Drucker, now 69, tells The Sun: “I never felt like I was on the brink of something huge.

“It was just a fantastic stroke of luck to be in the right place at the right time and to be part of an ­innovation that could improve the health of hundreds of millions of people all over the world.”

The drugs are now being hailed as a possible cure for a range of other conditions too, including dementia and migraine.

But Dr Drucker warns: “We need to be cautious, respect what we don’t know, and not rush into thinking these medicines are right for everyone.

‘Full of hope’

“There could be side-effects we haven’t seen yet, especially in groups we haven’t properly studied.”

Some studies have also raised concerns about gallbladder problems and in rare cases, even ­suicidal thoughts.

GLP-1 was found to play a key role in regulating the appetite and blood sugar levels, by slowing digestion and signalling a feeling of fullness to the brain.

Fat jabs such as Mounjaro and Wegovy contain synthetic versions of GLP-1, tirzepatide and semaglutide, which mimic the natural hormone with astonishing, fat-busting results.

Originally these drugs — known as GLP-1 agonists — were licensed to treat Type 2 diabetes, due to their ability to stimulate the body’s production of insulin, which cuts high blood glucose levels.

But over the past 15 years, after studies ­confirmed the potential to tackle obesity, pharmaceutical firms have reapplied to have the drugs approved as weight loss treatments.

And now evidence is emerging almost daily to suggest these drugs could help treat and even prevent other chronic and degenerative diseases.

Hundreds of scientific trials are under way, and Dr Drucker is “full of hope”, adding that he would consider taking the drugs himself, to ward off ­Alzheimer’s disease.

He says: “I think the next five years is going to be massive. These drugs won’t fix everything, but if they help even half the ­conditions we are testing them for, we could finally find ­treatments for conditions once thought untreatable.”

Decades after his discovery, Dr Drucker is now a professor of ­medicine at the University of Toronto, and a senior investigator at the affiliated Lunenfeld-Tanenbaum Research Institute, where GLP-1 research now fills his life.

He says: “Every morning I turn on my phone and check what’s happened overnight — what new ­discovery has been made, what could this hormone cure or treat.”

Even so, in May UK health chiefs warned that the jabs must not be taken during pregnancy or in the two months before conception, after studies of animals found that semaglutide can cause ­pregnancy loss and birth defects.

But with human use, no such ­danger has been ­confirmed, Dr Drucker says, and dozens of women have ­conceived while taking them.

5

5

Some scientists even believe GLP-1 drugs may boost ­fertility, and could become a go-to for infertility treatment.

Dr Drucker, listed in Time magazine’s 100 Most Influential People in 2024, says: “It wouldn’t surprise me if five years from now, once we have more clinical trial evidence, if we start recommending these medicines to help people get pregnant, and have safer pregnancies.”

It is exciting stuff, but Dr Drucker admits he also worries about people using the drugs for the wrong ­reasons — such as slim, young women in pursuit of unrealistic beauty ideals on social media.

He says: “If I’ve got a 17-year-old who wants to lose another five per cent of her body weight to look like some celebrity, that’s a real concern.

“We haven’t studied 10,000 teenage girls on these drugs over five years. We don’t know how they affect bones, fertility, mental health or development in the long term.”

Last year model Lottie Moss, sister of supermodel Kate, revealed she had ended up in hospital after a seizure linked to high doses of weight loss drug Ozempic.

I think the next five years will be massive. These drugs won’t fix everything, but if they help even half the conditions we are testing for, we could find treatments for conditions thought untreatable

Dr Daniel Drucker

A nurse told her the dose she had been injecting was meant for someone twice her size.

Dr Drucker warned that older adults, people with eating disorders and those with mental health ­conditions may respond differently to the drugs.

He says: “We’re still ­learning, and just because a medicine works well in one group doesn’t mean it is safe for everyone.”

One of the biggest risks is dehydration, which OnlyFans star Lottie blamed for her seizure.

Dr Drucker says: “Some people experience nausea and vomiting, which can lead to dehydration, and that in itself can be dangerous.”
He also warns that losing weight too quickly can reduce muscle mass and bone density, which is especially risky for older people.

He adds: “This is why it is important people only take these drugs when being monitored by medical professionals, so they can be properly assessed for side-effects and receive the safest, most effective care.”

5

So far at least 85 people in the UK have died after taking weight loss jabs, according to reports sent to the Medicines and Healthcare Products Regulatory Agency watchdog.

While none of the deaths has been definitively linked to the drugs, health bodies noted a “suspicion” that they may have played a role.

Dr Drucker says: “Reports like these can raise flags, but without proper comparison groups they don’t tell the full story.

‘Drugs aren’t candy’

“In fact, large trials show GLP-1 drugs actually reduce death rates in people with Type 2 diabetes and those with obesity and heart disease.

“So far, the evidence looks solid and reassuring.”

With millions of patients treated over the years, GLP-1s have a well-established safety record for diabetes and obesity.

But Dr Drucker warns that for newer uses, such as ­Alzheimer’s, fatty liver disease or sleep apnoea, we need more data.

He says: “I don’t think there are any hidden, terrifying side-effects waiting to be uncovered.

“But that doesn’t mean people should take them lightly. We don’t yet have 20 years of experience ­treating some of these ­conditions.

“We need to approach each new indication with appropriate caution, to really understand the benefits ­versus the potential risks.

“These drugs aren’t candy, they won’t fix everything — and like all medicines they have side-effects.

“I don’t think we should abandon our focus on safety. We need to move carefully and thoughtfully as this field evolves.”

I’m not struggling with Type 2 diabetes or obesity, but I do have a family history of ­Alzheimer’s. I’m watching the trials closely and, depending on the results, I wouldn’t rule out taking them in the future

Dr Daniel Drucker

He continues: “I’m not struggling with Type 2 diabetes or obesity, but I do have a family history of ­Alzheimer’s. I’m watching the trials closely and, depending on the results, I wouldn’t rule out taking them in the future.

“I have friends from college who are already showing early signs of cognitive decline, and there’s hope that in some cases, ­semaglutide might help to slow it.”

Several studies over the years ­support that theory.

A recent study by a US university found that the jabs could prevent Alzheimer’s-related changes in people with Type 2 diabetes.

Separate research from Taiwan found that people on GLP-1 agonist drugs appeared to have a 37 per cent lower risk of dementia.

Dr Drucker now regularly receives messages from people around the world whose lives have been changed by the drugs his lab helped to create.

He says: “I get tons of stories. ­People send me emails and photos, not just showing their weight loss, but how their health has changed in other ways too.”

Some say the jabs have helped their chronic pain, cleared brain fog or improved long-standing health conditions such as ulcerative colitis or arthritis.

Dr Drucker adds: “It’s incredibly heartwarming and I never get tired of hearing these stories.”

But for him there is even deeper meaning attached to his discovery.

His 97-year-old mother Cila, ­originally from Poland, survived the Holocaust, spending months as a child hiding in the family’s attic before they were captured and held in a ghetto, where her mother and sister were later shot dead.

At the end of the war in 1945 she became a refugee in Palestine, then in 1953 she emigrated to Canada, first settling in Montreal then making Toronto her home in the 1990s.

Dr Drucker says his work has helped to ease Cila’s survivor’s guilt which had consumed her for decades.

He says: “She looks at my work and she’s so proud of how many people it could potentially help.”

A BABY whose mother was not vaccinated against whooping cough has died after contracting the infection.

The UK Health Security Agency said the tot, thought to be under the age of one, died between March and June.

It is the first whooping cough death in the UK this year and comes after a child died of measles in Liverpool last month.

The agency’s Dr Gayatri Amirthalingam said: “Sadly, we are again reminded how severe whooping cough can be for very young babies.

“Vaccination is the best defence.

“It is vital pregnant women and infants receive their vaccines at the right time, ideally between 20 and 32 weeks.

“This passes protection to their baby in the womb so that they are protected from birth.”

Overall vaccination rates for primary school pupils are at the lowest for 15 years — with almost one in five not fully protected from diseases.

Over the coming weeks, millions of children will be flooding into classrooms across the UK.

And there’s a real risk they will return home with more than a few new friends and knowledge.

Pharmacist Thorrun Govind tells Sun on Sunday Health: “There’s often lots of hugging and playing between friends they haven’t seen all summer — and all that close contact means germs can easily spread.

“They also tend to cough and sneeze without covering their mouths and don’t always wash their hands without supervision.

“With early wake-ups, hard work in lessons and sports clubs, children can also get tired, which weakens their immune systems, leaving them prone to picking up illnesses.”

1

CHICKENPOX has gained a reputation as a ‘harmless’ childhood illness that it’s best to get over with – but it could result in dangerous complications for some and may even prove fatal.

It was announced that children will be given chickenpox vaccines for free on the NHS for the first time from January 2026.

The jab is already used in the US, Canada, Australia and Germany.

One to three-year-olds in the UK will receive the chickenpox vaccine along with the measles, mumps and rubella (MMR) jab.

The combined vaccine will now be dubbed MMRV, as it will protect against the varicella zoster virus.

Responding to news of the chickenpox vaccine rollout in the UK, Dr Gayatri Amirthalingam, from the UK Health Security Agency, said: “For some babies, young children and even adults, chickenpox can be very serious.

“It is excellent news that we will be introducing a vaccine. It could be a lifesaver.”

The news was coupled with warnings from experts that nearly one in five school-starters are not fully protected against preventable diseases – with uptake for the four-in-one diphtheria, tetanus, polio and whooping cough booster and MMR jabs having dropped again.

Chickenpox is a highly contagious infection known for its telltale itchy, spotty rash that blisters and scabs over.

But before these spots appear, the virus can also cause a high temperature, aches and pains, and loss of appetite.

Though it’s mostly known to infect children, adults can also catch chickenpox if they didn’t pick it up in childhood.

These infections tend to be more severe and adults with a varicella infection are more likely to be admitted to hospital.

Most people will recover on their own within a week or two, but the infection can be serious, even life-threatening, for some – especially if they’re very young or old, pregnant or have a weakened immune system.

The illness can result in bacterial skin infections and in rare cases, pneumonia, brain swelling and stroke.

For some, these complications can be fatal.

An average of around 20 people die of chickenpox per year, according to the Vaccine Knowledge Project at the University of Oxford.

This ranges from 17 deaths in 2017, to four in 2020, according to Office for National Statistics data.

Eighty per cent of deaths from chickenpox infections in England and Wales occur in adults, the National Institute for Health and Care Excellence (NICE) states.

1. Bacterial infections

Chickenpox spots can appear anywhere on the body – including inside the mouth and around the genitals.

They tend to develop into fluid-filled blisters, before bursting and scabbing over, which can take a few days.

The spots tend to be maddeningly itchy, so it can be hard to resist the temptation of scratching them – though soothing creams and cool baths can help.

Sometimes the chickenpox spots can get infected with bacteria – probably from scratching, according to healthcare provider Bupa.

Signs of a bacterial infection include a high temperature and redness and pain around the chickenpox spots.

You should seek urgent medical help if you or your child develop these symptoms.

2. Dehydration

Young children do run the risk of becoming dehydrated due to chickenpox.

For babies and kids, fewer wet nappies and peeing less can be telltale signs of dehydration.

Other signs may include:

• Feeling thirsty
• Dark yellow, strong-smelling pee
• Feeling dizzy or lightheaded
• Feeling tired
• A dry mouth, lips and tongue
• Sunken eyes

Call NHS 111 if you suspect you or your little one are dehydrated from chickenpox.

3. Pneumonia

Some people – especially adults – can develop pneumonia, inflammation of the lungs, after being infected with chickenpox.

Pneumonia is the most common chickenpox complication in adults, according to NICE.

Smokers are particularly at risk.

Symptoms of pneumonia can include:

• A cough with yellow or green mucus
• Shortness of breath
• A high temperature
• Chest pain
• An aching body
• Feeling very tired
• Loss of appetite
• Making wheezing noises when you breathe
• Feeling confused

4. Brain swelling

Infection or swelling of the brain, known as encephalitis, is a rare complication of the chickenpox infection.

Professor Benedict Michael, Institute of Infection, University of Liverpool, said: “Varicella-zoster virus is the second leading cause of brain infection (or ‘encephalitis’) in the UK, which can be life-threatening.

“Early diagnosis and treatment are essential, but prevention through vaccination is the most effective way to protect children and families from this serious complication.”

Dr Ava Easton, Chief Executive of Encephalitis International, added: “By making [the chickenpox vaccine] available to every child, we’re not only reducing the spread of chickenpox but also helping to stop some families from ever facing the devastating impact of encephalitis.

“That’s a powerful step forward for children’s health and for awareness of a condition too few people know about.”

Encephalitis usually starts off with flu-like symptoms, such as a high temperature and headache.

More serious symptoms develop in the next few hours, days or weeks, including:

• Confusion or disorientation
• Seizures or fits
• Changes in personality and behaviour
• Difficulty speaking
• Weakness or loss of movement in some parts of the body
• Loss of consciousness

Dial 999 for an ambulance immediately if you or someone else has these serious symptoms.

5. Stroke

According to the Stroke Association, children who develop chickenpox may have a four times higher risk of stroke in the six months following infection.

“However, stroke in children is still rare and the finding translates into a very small actual increase in their stroke risk,” it noted.

Studies by the organisation also found that adults with shingles – also caused by the varicella zoster virus – may also have an increased risk of stroke up until six months afterwards.

“This is particularly within the first few weeks, and for individuals with shingles around the eye,” Stroke Association said.

“Oral antiviral drugs used to treat shingles may be able to reduce this risk.”

6. Sepsis

In rare cases, chickenpox can result in sepsis – when the body’s immune system overreacts to an infection, attacking its own tissues and organs.

Sepsis can be life threatening and requires immediate medical help.

It can also be hard to spot, as there are lots of possible symptoms.

In adults, remember the SEPSIS acronym:

• Slurred speech or confusion
• Extreme shivering or muscle pain
• Passing no urine (in a day)
• Severe breathlessness
• It feels like you’re going to die
• Skin mottled, discoloured, or cold

Other signs include:

• High or very low body temperature
• Rapid heart rate
• Low blood pressure
• Rapid breathing

In children, look out for: 

• Fast breathing
• Lethargy or difficulty waking up
• Mottled, pale, or bluish skin
• Very cold hands and feet
• Seizures
• A rash that doesn’t fade when pressed ,which is a sign of meningococcal sepsis
• Babies not feeding or vomiting 

In the Emmy-season finale of The Envelope video podcast, Tramell Tillman opens up about the jobs that made him “miserable” before acting — and how they informed his performance as Mr. Milchick in “Severance.” Then, Katherine LaNasa explains what her Emmy nomination for “The Pitt” means to her as a self-described “character actress.”

Kelvin Washington: Hello, everyone, and welcome to The Envelope. I’m Kelvin Washington, alongside folks you are used to seeing at this point: Yvonne Villarreal, Mark Olsen. And we are excited about this episode because it’s Emmy season. Mark, I even wanna start with you. What sticks out to you? Maybe it’s just someone you think’s gonna win or something you’re expecting, maybe a trend with the theme of the show as well. What jumps out?

Mark Olsen: Well, I’m looking at the category of supporting actress in a drama, where all the ladies from “The White Lotus” were nominated, and people are really thinking that Carrie Coon will probably be winning in that category. Also, she’s just kind of on such a hot streak right now with “The Gilded Age” as well. But I have to say, I am so excited, my indie film queen, Parker Posey — who played, of course, the matriarch of the Ratliff family on the show — I’ve seen her give some award speeches before, and we would be in for a real doozy if they would pick Parker Posey. I don’t know if that’s gonna happen, but I think that category just in general is gonna be sort of a fun category to watch.

Yvonne Villarreal: Do you think she’ll thank Lorazepam? She mentions it so much as her character.

Washington: We didn’t even get an answer. Just a laugh.

Olsen: Well, mine just kicked in.

Washington: OK, copy that. So I go to you now, Yvonne. What about you? So we got a whole “White Lotus” phenomenon, as you mentioned, Mark. If you’re on the show, you’re nominated. What about you, Yvonne?

Villarreal: I’m really curious to see how the drama category shakes out. This idea of “Severance,” that was gone for so long, is really dominating, but then you have a breakout like “The Pitt” that’s really strong, and it’ll be interesting to see how that shakes out. I’ll be happy either way. If they miss the opportunity to stage an emergency with “The Pitt” people there, c’mon.

Washington: That makes sense. And plus, I like how you did that, kind of foreshadowing this episode with the two shows that you picked. Mark, I want to go to you. You had a chance to talk with Tramell Tillman, speaking of “Severance.” By the way, before you go, I brought this up one time. We talked about this. I did something on the morning news that I anchor. I came out with a marching band from the Palisades. We had the fires in Los Angeles in January, and we had a marching band bring us in the show. And everyone was saying that I was his character. That’s all it was. That’s literally all my entire timeline was about. And I think it dropped just a Sunday prior to me posting that.

Villarreal: You’ve got your Halloween costume ready.

Washington: Yes. So tell me more about your chat, Mark.

Olsen: Tramell plays what’s become a real fan-favorite character on the show, Mr. Milchick, who is the middle manager in the office there. And as much as this has been a huge breakout role for Tramell, it’s really fascinating the road that he’s had to get here. He didn’t really start acting professionally until he was into his 30s. He had originally studied medicine, then he had finally gone back to school, studied acting, and then kind of was outside the business for a while, and then really has sort of hit a stride, and it’s just exciting to see that happen for him. And then, of course, he has the marching band sequence this year, which became such a huge, popular thing; sort of a viral moment. And on top of that, he also had just an absolute scene-stealing performance in “Mission: Impossible — The Final Reckoning,” and so this has just been a huge year for him so far.

Washington: We see those moments happen, right? Where someone has that role that finally [breaks through], and then you look at it and you realize, “Oh, I’ve seen him or her in a million other movies.” You just didn’t notice him until they finally had that role. And so it’s awesome to see when that happens for folks. I go to you, Yvonne. Tell us a bit more about Katherine LaNasa. You just mentioned “The Pitt.” Tell us about your conversation.

Villarreal: Well, it fits perfectly, because Katherine LaNasa is having a moment too on this show. You know, she’s been a working actor for a long time, but she’s really had this breakout moment on “The Pitt.” The medical drama really took off when it launched in January, just because of the format. You just want to keep going. It covers a 15-hour shift, and it just felt revelatory. And she plays Dana, the charge nurse at this hospital. And you really get a sense early on that she’s the one that makes this place work. She’s the one that knows everything. And she knows how to deal with all the personalities. And she really has, over this 15-hour shift, an existential moment where she experiences violence on the job. And it really rattles her. And she is grappling with, “This job that I’ve had for so long, is this still where I need to be? Is it time to go?” And that’s how the season sort of ends with her, of her having this reckoning of, “Is this over for me? Or am I going to keep going?” And it was really just great to talk to her about having this moment at this point in her career.

Washington: And that’s what we’re talking about. Folks get their moment. Whenever it comes, obviously, I’m sure very appreciated. All right, let’s get to Tramell Tillman and Mark’s conversation. Here it is.

Tramell Tillman in “Severance.”

(Apple TV+)

Mark Olsen: Before we start talking about “Severance,” I want to go back to talk about — and please correct me if I’m wrong, but as I understand it, you didn’t really start acting professionally until you were in your 30s. You’d been in school and working. And I’m always so curious about when people aren’t a prodigy, aren’t a success right out of the gate. For you, what was that road like? What was it like for you getting to be able to say, I’m going be an actor?

Tramell Tillman: It’s more like a cul-de-sac. I was kind of going in and out, going in circles a bit. It was not a straight journey for me at all. I had made the commitment that I wanted to be an actor when I was 10 and was really shy about pursuing it because I didn’t have a lot of mentors around that were doing the work that I wanted to do at that level. So I leaned on the academic side, more so in the sciences and studying medicine. And I told myself I was going to become an orthopedic surgeon and was going down that route. But performing was always a part of my life. I would perform for my family, especially the adults in the house. When they were bored and didn’t want to watch TV, they put all the cousins, the babies and the grandkids up in front of them. We had to do little talent shows. And my first performance in front of a live audience of strangers, if you will, was at the church when I was 10. But there was something that clicked, and I wanted to follow that spark and it never went away. Even when I was studying medicine or selling knives door-to-door in Maryland or teaching about abstinence in Mississippi or rallying and pushing kids about the importance of education here and there.

Olsen: So you always had the goal of becoming an actor. In your mind, you were on your path.

Tillman: Well, I didn’t commit to the path until I felt like life had just beat me down, and only in the sense that I was miserable doing everything else and had to tap back into myself. And I was fortunate to have a wonderful mentor, Dr. Mark G. Henderson, who basically inspired me to do a lot of soul-searching and figure out what was that thing that lit my fire, and it was performing. And it was he that inspired me to go to grad school to get the tools. He saw that I had the talent, but I needed to learn the craft. And I’m grateful I made that decision.

Olsen: Was there a movie or a performance, a play, some other actor that you saw that felt like a possibility model for you, like, “Oh, I want to do that. I could do that too.”

Tillman: Honestly, there were so many, so many actors. Denzel Washington, Morgan Freeman, Angela Bassett, Laurence Fishburne, Meryl Streep, Gene Hackman. I was watching so many films as a kid growing up, and I loved what they were doing. I loved the stories that they were telling. And so they were all examples of what could be. I just didn’t know how they went about their journey. And then, if you look at all of their stories, it’s very different. So there’s no one way to get to where you wanna be. Specifically in this industry. But you just gotta keep trying.

Olsen: Even after you went to graduate school, I think there were a few years after school before you really sort of got your career going. What were those years like for you?

Tillman: They were tough. After graduate school, I had four jobs. I was living in New York and I was determined not to be a starving artist. So I had two jobs working at a nonprofit. I had a job working in catering. And then, of course, I have my acting gig. And so that kept me incredibly busy. But it’s a grind. The acting itself, the business of it is a grind, and then New York City is a hustle. So you’re always going, you’re always moving and learning, and you’ve got to move quick and learn quicker. But it really prepared me for “Severance,” in a way. I’d had all these corporate jobs, which who’d have thought would come in handy? These were just survival gigs, but it all fueled me to where I am now.

Olsen: With “Severance,” the first season was well received, but this second season has just seemed like a phenomenon. It just seems like the show has really skyrocketed. What do you think it is that audiences are really responding to?

Tillman: Definitely the mystery. We want to know what is going on at Lumon. But it’s also — there’s a human story there. We give so much of ourselves at work. And a lot of times, we are not who we are at work versus home. And so this show really speaks to that. It speaks to the human condition, the investments that we have within ourselves and the relationships. And it begs the question, why are we doing this and who is it for?

Olsen: Do you find that those are the same things that you responded to when you first read the script, when you first were approached about the project?

Tillman: I was very curious about what this show was. So I got the sides, and my audition sides were the red ball scene and the scene with Milchick and — we learned later — Helena in the stairwell where he’s encouraging her that she’s doing the right thing, go back into the wall and finish her work. So I didn’t really have a concept of what this thing was. I just knew that this guy was a motivator. He was a leader. He was a teacher. He was someone that you can trust, but he was also someone that you didn’t want to mess with. So I just really leaned into trying to find who this guy was and make him a whole human. And I really had fun with the process.

Olsen: There are so many wild fan theories around the show. I don’t know how much you even engage with all that or are aware of it, but does that inform your own understanding of the show at all?

Tillman: I had to kind of avoid it. First of all, it’s very addictive. You’re reading the comments, you’re reading the Reddit threads, and the contributions, the thoughts behind it are so intoxicating, and they’re really well thought out. And it makes me think as an actor, “But is that what we were doing? Is that the story we’re telling?” And then I’ll call Dan [Erickson] or Ben [Stiller] and [say], “Wait, but someone said this, and this is kind of a little spot-on.” And they’re like, “No, that’s not what’s happening at all.” But it’s just this whole journey. And I think it’s a testament to how great the show is. It also speaks to the intelligence of our fans and the passion behind the show. It’s enriching, it’s empowering as well.

Olsen: But is it challenging with this show in particular — how do you play to the enigma? How do you grapple with all the unknown factors to this world, to your character? Are you having to answer all those questions for yourself before you perform a scene, or can you somehow embrace the mystery and know that there are going to be unknowns?

Tillman: Well, with this character, he’s really special because this is one of the rare instances where the character knows more than the actor. And so that gets really tricky as well. And so there are things that you’re just not going to know and you have to let go to that, I found. And there are constant conversations that I have, with Dan and Ben and with the fellow directors, of trying to figure out what this world is. And so because the world itself is an enigma, you don’t have to play the enigma. You just lean into the circumstances that have been set up and trust that it will reveal itself in the process.

Olsen: The idea that the character knows more than the actor playing the character, does that make you feel wrong-footed? At any point, do you learn something about the character down the line and maybe wish you’d played an earlier scene a little different?

Tillman: Oh, yeah. All the time, all the time. But you know, that’s where the trust comes in. You’re trusting that you have a team of people that will lead you in the right direction, that there are people that have vision. That you have great writers and cinematographers and directors that really understand the journey. And while I might not get it, I can lean on them to help me get there. And they’re very vocal. If I’m off, they’ll tell me.

Olsen: Especially in this second season, it’s been so exciting in that your character of Milchick is very much a company man, but also there seems to be a growing sense of conflict inside of him. And so for you, how do you interpret that? What’s going on with him?

Tillman: We started in chaos from Season 1, Day 1. And Season 2 really ups the ante because now he’s in a position of leadership and no one is helping him navigate this new space. And he’s being thrust in[to] all these different situations and circumstances and the Innies are not helping him by any means. They’re making his job a lot harder. And he’s learning the lessons of what it is to move up in corporate America, that it’s not so much easier just because you have this leadership title. And I think that’s what the audience is experiencing. We’re starting to see the cracks beneath the veneer.

Olsen: Are you approaching him in a sense as a prison guard who’s suddenly becoming too sympathetic to his charges?

Tillman: I wouldn’t say a prison guard who’s too sympathetic. I’ve approached him as a man who is committed to the job. He’s a person of duty, by any means necessary. And we see the differences in how Cobel leads, which is very much old school, versus Milchick, which is, “Let’s do kindness reforms. Let’s give them what they want. Let’s kind of help them along, and maybe that will bring about positive results.” But we see it doesn’t.

Olsen: I think audiences have been really surprised by how empathetic they are feeling towards Milchick. I don’t think people expected that. And one way to put that as a question is simply, do you see him as one of the villains of the story?

Tillman: My tendency was to think he was a villain in Season 1, but as I stepped further into the script, I think there’s something more interesting about this story. And to categorize him as a villain, I think it’s a bit shortsighted. It’s easy to go that route. And so what I really enjoy is the conversation where people are discussing if he is a villain because I think that there is more to mine. There’s more to understand.

Olsen: How have you been exploring that for yourself? As you get a script for each episode, how are you sort of continuing to evolve your own understanding of who Milchick is?

Tillman: I really just allow the page to inform me, you know, try not to have any preconceived notions of where you think it’s going to go and just lean into the circumstances. And you know, Dan Erickson and his writing team do such a great job in presenting a wonderful road map to get you from point A to point B, and then C and then D. And if you don’t anticipate, it’s really quite a fascinating journey.

Olsen: How have your own experiences with office culture informed your performance as the character and your understanding of this world?

Tillman: One of the jobs I had, I was an assistant to the vice president of accounting and controls for a finance company, a world I knew nothing about. But essentially, my job was to file financial reports, do travel and scheduling and so forth. But on top of that, I was in charge of office culture. So I had to come up with these innovative ideas to keep positive morale in the office. Sound familiar? So that was a wonderful exercise that really helped me fuel building and constructing Milchick. I spent years as a cater waiter. So customer service was really important. I used to sell, I was in retail. So being [able] to anticipate a need, being able to offer a product or an idea, like we see in Season 2, where Milchick visits Mark’s Outie, he gives him all of these incentives, being able to construct that in such a way that is pleasant and not threatening was really important. So this guy, he’s having to go from being an administrator to the Innies to being almost a customer service rep to the Outies. And that was really intriguing to me.

Olsen: This season, we’ve seen Milchick suffer a lot of micro- and some not-so-micro-aggressions, many of them based around race. Was that something that was familiar to you from your own time in office culture?

Tillman: I think it’s just familiar to me, period. Just living and being in various circumstances, living in the South, being in the Midwest at times, just kind of a symptom of existing, unfortunately.

Olsen: I’ve seen you describe yourself as a reformed people pleaser. Would you say that Milchick is on that same trajectory?

Tillman: I was 100% a people pleaser. I don’t know, he’s definitely not reformed. He’s definitely not. When we see him at the end of the second season, we don’t know what to think. We don’t know where he’s gonna go next. And that’s exciting to me.

Olsen: But what made you change that in yourself?

Tillman: Being a reformed people pleaser? It’s exhausting. It’s 100% exhausting. And it’s impossible. Someone’s always gonna be upset about something or find fault in anything. So once I started following my bliss and going after the things that I wanted to do, there was a sense of freedom there. It was a liberation, and at a certain point you just realized that, you know what, I don’t have to prove myself to people. I can just be, I can just exist.

Olsen: I know there’s one line in particular in this past season, “devour feculence,” which turns into a real turning point for the character. He is standing up to one of his superiors, who had reprimanded him for the language that he uses. Can you tell me a little bit about what that moment meant to you and for the character?

Tillman: I felt it was a defining moment. Just like you said. We don’t see him talking back to administration at any point, even in Season 1. He’s always been respectful, always played by the rules. And so again, just like I talked about the road map earlier, what the writers have done is create a series of circumstances where it would make sense for him to respond in such a way that could jeopardize his job. And if you really think about it, this man has gone through a lot in a short period of time. So there really is no way for him to process any of this information. This company has been turned upside down, seemingly overnight, and he’s had to bear it all. And even though he’s keeping things on the track as best as he can, he still doesn’t get the respect that he deserves. So yeah, he would tell him, “devour feculance.” Just like, get off my back, dude. I’m doing what I can.

Olsen: But when you see that moment in the script, in particular that very distinctive two-word phrase — your delivery of it is so fantastic because you don’t oversell the line. Can you tell me how you decide on how to deliver that phrase? Because it could obviously go in many different directions.

Tillman: Sure. So first I had to look up the word. I was like, “What is that? Wait, what?” I didn’t know what this was. And I said, “OK, this is what we’re doing.” He’s telling him what to do. And this felt like such an empowering moment for him because this is the one moment we see him stand up for himself. And I said, “OK, you gotta sell this, but you have to sell it in only the way that Milchick would sell it.” And this man is very measured. He doesn’t need to raise his voice a lot to get a point across. I believe he knows his power. He’s able to manipulate people very easily and very quickly. So for him to deliver that line in that monotone and that simple delivery speaks to his power and the knowledge that he has of himself. And also it makes it so much more effective because if you yell it at somebody, you know, they’ll kind of overlook it. They don’t hear it as well. But to just like whisper it, it lands.

Olsen: And then I, of course, I have to ask you about the drumline sequence this season. It takes the kind of the “Music Dance Experience” from Season 1 to a whole new place. And I’m just so curious about the origins of that performance. When was it first just presented to you, “Oh, and by the way, we want you to lead a a marching band drumline through the office.”

Tillman: I believe we were in the middle of filming Season 2, and I was approached about this marching band idea. And I was reticent about it because I did not want to replicate what we did in the Music Dance Experience, because that’s iconic of itself. But we continued having [a] conversation with the creative team and trying to explore ways of making sense of the moment so it didn’t feel like just a one-off, like, “Oh, this man just has a band” and whatever. So we tried to find purpose behind it. And so knowing that this man was at a breaking point with Lumon and at this mysterious moment of where his next moves were, I felt that it was really important to infuse his own identity in this. Because in the second season, we start to see that race becomes a thing in the world of Lumon. So it’s how can we dovetail the microaggressions that you had mentioned before, his journey, his role in leadership, and also the showmanship this man has. If he’s gonna do anything, it’s gonna be big. It’s gonna be massive. And it was a wonderful marriage.

Olsen: Already, at PaleyFest, you did a live performance with a band and you’re going to be doing another one coming up soon. How are you finding that? Like, how are you preparing for these live performances leading a marching band?

Tillman: It’s a dream. Coming from a historically Black college and university, I would see the marching bands and I was in awe. I was in marching band when I was in high school, I played the alto saxophone. And to be able to serve as bandleader and drum leader, or drum major, for a group of incredible musicians is an absolute dream.

Olsen: But now is there a part of you that’s kind of like, “What exactly did I sign up for here?” Are you concerned you’re going to be asked to lead marching bands for the rest of your career?

Tillman: When I signed up to join the cast of “Severance,” and we had to pause for the pandemic, and I was reading through the rest of the script. It was at that point I realized, “Oh, this is something different. I signed up for something that is insane.” And every addition ever since in Season 2, I said, “Yep, that’s insane. That’s insane, this is insane. But you know what, it makes sense.”

Olsen: Are you enjoying that surprise aspect of it? That every time you get a script, you kind of genuinely have no idea what could be coming next?

Tillman: I am leaning into that now. More and more. Just allowing life to take its course.

Olsen: There was a big time gap just between Season 1 and Season 2. And there’s been a lot of talk that it’s not gonna take as long to make Season 3. How is that for you? Schedule-wise, are you able to take on other projects, do other things? In a way I’m asking if you are able to take advantage of this moment that you’re having, the great attention and success that it seems the show has brought you.

Tillman: Oh, absolutely. I filmed “Mission: Impossible” right after I had wrapped my portion of Season 2. I filmed a project with Mahershala Ali, “Your Mother Your Mother Your Mother.” I just wrapped a project with Lena Dunham and Natalie Portman. So I’ve been staying busy and staying active. And that’s just me, going from a shy kid to being a hustler and grinder and living in New York and just continuing the pace and doing more and more.

Olsen: And tell me about the Lena Dunham project, her new film, “Good Sex.” What was that like?

Tillman: Oh, it was fantastic. It’s a wonderful crew. Cast is beautiful. It’s a really lovely rom-com. And Natalie is a queen. And Lena is such a delight. She has a passion for this. She is so supportive. And I can’t wait to see it.

Olsen: And then you also mentioned Bassam Tariq’s “Your Mother Your Mother Your Mother,” which has you, Mahershala Ali is in the cast, Giancarlo Esposito is in the cast. And I can only hope that the three of you have scenes together. Like, I would love to see the three of you onscreen together.

Tillman: Yeah, I would like that too.

Olsen: And I want to be sure to ask you about the “Mission: Impossible” film, “Mission: Impossible — The Final Reckoning.” I have to tell you, I saw the film at a public screening and simply when you came onscreen, the crowd burst into cheers, like people were very excited. And I think it really has been one of the scene-stealing performances of the year.

Tillman: Oh, wonderful. I have seen this movie about four times, and every time I came onscreen, it was quiet. So it’s nice to know that people were excited to see me in this movie.

Olsen: You have this one line, the word “Mister,” that you say throughout your screen time, and you just deliver it with such like verve and gusto. It’s really exciting. And again, like I don’t even know if that line was specifically in the script that you were referring to him like that —

Tillman: It was.

Olsen: But how do you come to decide just how much sort of spin to put on the ball there?

Tillman: How do I come to decide? I don’t know, you just feel it in the moment. And again, like when you’re in a position of power, I feel that these roles like Captain Bledsoe and Seth Milchick, they know that they’re in a position of power, and when you know it, you don’t have to do too much. It’s just, you command the room, you own it.

Olsen: Because the world of that submarine that you’re a part of, like yourself, Katy O’Brian, some of the other actors there, there’s just like a really specific and exciting energy among the people on that submarine. How did that come to be? Like, were you having conversations among the cast or with the director, Christopher McQuarrie, as far as what the world of that submarine was gonna seem like?

Tillman: The conversations were very much present, but a lot of it was really in the moment. We just dove in, and what all of those actors did beautifully was create these characters that were real. They weren’t playing at being in a submarine or playing being in military forces. They were just themselves and just allowed things to blossom as it is.

Olsen: And was it exciting for you to be a part of a movie at that that scale?

Tillman: Absolutely. I remember. Watching “Mission: Impossible” as a kid. You know, I never thought I’d be in it. And then working alongside Tom Cruise, I mean, that’s a big deal. That’s kind of huge.

Olsen: But in particular, again, you more than almost any other character in this movie in particular, you’re kind of putting him in his place, and there’s something that’s really — I think that’s part of the reason why audiences got such a kick out of your character, is you’re sort of dressing him down in a way that people aren’t used to seeing.

Tillman: Yeah, I don’t know how that happened. No, it was a lot of fun. It was so much fun. And Tom and Chris were so game and really allowed me the space to fly and have fun with it. It was a delight.

Olsen: And now with moving forward to Season 3 of “Severance,” have you seen any scripts yet? Like, do you know anything that’s gonna be happening?

Tillman: I haven’t seen anything, I don’t know anything. I know nothing.

Olsen: One of the ways you’ve described Milchick is as an iceberg, meaning that there’s a lot that we haven’t seen yet. Are there specific things about him that you would like to see revealed?

Tillman: I am interested in knowing how the man grew up, his background. I’m always interested in history, how people — their origin story, right? And I think he has a very compelling story. As an actor, I built my own idea of what the origin story is because that, for me, helps fuel the character or fuel my performance into the character. But we’ll see.

Olsen: For you as a performer, have you already conceived of what that backstory is? Do you have an idea of what you think his previous life was like?

Tillman: Yeah, I do.

Olsen: Anything you care to share?

Olsen: It’s probably invalid because it’s all wrong. That’s another thing I’ve learned about working on this show. Everything you think is going to happen, nope.

Olsen: And how do you grapple with that? Especially for you as a performer, you have ideas about the character, where he’s from, maybe where he is heading, and then the script takes him in a totally different direction. What do you do with that?

Tillman: There was a point it would make me break out in hives because it felt like I had no control over it. But then you realize how that bleeds into the state of the character. This man, Milchick, who thinks he has control every day, is shown that he has very little control. So being in that environment, while it’s not fun, to a certain extent, for someone who likes to have all of the answers, it really does fuel the performance in a whole other way.

Olsen: And now for you, with the attention, the acclaim that the role has brought you, your Emmy nomination, is this the acting life that you envisioned for yourself? Like, those times when you wanted to be an actor and you were trying to get your career going, is this what you were dreaming of for yourself?

Tillman: Did I dream that I would be on a show with Adam Scott, Patricia Arquette, John Turturro? It wasn’t that specific, no. I did have dreams of performing and being proud of the work that I did. I did dream of being in movies and television. The vision was not clear, but the desire was there.

Olsen: And do you feel like, as you’ve been moving forward and gaining some success, has the dream changed at all? Like, what what are your goals now?

Tillman: What are my goals now? I definitely want to continue telling stories and narratives that I believe in. Stories we haven’t heard before or perspectives that we’re not familiar with. I want to keep working with quality actors and expanding in a whole different way. And it’s not just in front of the camera. I’m also interested in producing and directing as well.

Olsen: Do you have any specific projects you want to make?

Tillman: I’m really interested in African folktales. I really want to tell, retell, those stories. And I think there’s an avenue for it. So I’m trying to figure that out.

Katherine LaNasa in “The Pitt.”

(Warrick Page / HBO Max)

Villarreal: Katherine, thanks so much for being here. I don’t want to alarm you but before this interview is over, we’re going to have a patient roll through and we’re not gonna tell you what’s wrong. You’re going to have to figure it out.

LaNasa: That patient better pray! They better have a god they pray to because I don’t know anything about medicine — literally, even the fake stuff grosses me out so much.

Villarreal: Really, you don’t have the stomach for it?

LaNasa: Yeah, you’ll see. There’s some stuff in [Season 2]. I actually told the producer, “I think I need some jewelry for that.” I need a gift for dealing with it. It’s so disgusting. It’s so disgusting that I had to process that it was going to happen, and when [it] happened, I had kind of detach from my body and get through it.

Villarreal: OK, so Hour 4 in Season 2, we’re going to know what you’re talking about?

LaNasa: Oh no, I think it’s in [Episode 2].

Villarreal: What part of the body are you dealing with? Can you share that?

LaNasa: No. It’s gross, though. It is gross! It was a lot in [Episode 2]. It was a lot had to deal with in [Episode 2]. I was like, “Wow, OK, guys.”

Villarreal: Oh, my gosh, I can’t wait. Well, congratulations — Emmy nominee! You guys were in production on Season 2 when the news hit. Put me in that moment.

LaNasa: Well, my husband [actor Grant Show] and daughter came. They were in my dressing room, and I knew it was [time for the nominations announcement]. At that moment, Noah [Wyle, star and executive producer] ran up and he says, “I need a bathroom break.” So they gave us a break and I ran up to my room and they announced everybody — and somebody that they announced in some category that wasn’t mine, it was like a [last name that began with an S] or something, and my husband’s like, “Oh, no, it’s in alphabetical order. Oh, no!” He got so upset. I go, “Honey, it’s not my category.” But then they didn’t announce it. They didn’t announce it [in the live segment], and [Grant] couldn’t get [the online list] up in time. I said, “I have to go back to work.” I was waiting outside the trauma room [set], and [Myriam Arougheti, the show’s head of makeup] came and she’s like [makes excited facial expression], and I looked at her, and we went in a little hallway, and I posted those pictures of us. And she got nominated too. Then I went out and my husband was there and then [R.] Scott Gemmill [the show’s creator] came up and my daughter and the head writers. It was just a really neat moment. Then when we went in, they announced, and Noah came walking in. I hadn’t seen him. And that was just his response — that hug. It was surreal.

Villarreal: We’re very thankful you put that on Instagram so we could live in that moment. What do you shoot after something like that?

LaNasa: I don’t even know. I think we had a moment. We kind of hung around for a while. They had to take Noah to do press, so we had some time to kind of decompress for the excitement and stuff. We actually shoot short, so we had time; we had space [for a break].

Villarreal: Have you fully processed it? Is there processing of something like that?

LaNasa: I’m going to start crying. I’m trying to just live in the power of it; live in the blessing of it, because I didn’t know this was going to happen, and it doesn’t matter how good of an actress I might have been, if you don’t get the opportunity, if [executive producer] John Wells didn’t give me that shot, it wouldn’t have happened and, so, I’m so blessed by it. A friend is having a dinner for me, and it really was hard for me to say, “Will you come to this dinner for me?” It doesn’t matter that these wonderful people that I’ve worked with have written me [their congratulations] and they’re so excited, but it’s really hard to say, “Will you come celebrate me?” It’s hard to believe that it’s me. I’ve loved my career. I’ve always, at heart, been a character actress, and I’ve always been a supporting actress, and I think I know how to push on the story and push on the lead actor and make them look great, and I think I shine in that too, but it’s just — I’m not used to being in the spotlight.

Villarreal: You’ve been part of medical dramas before — “The Night Shift,” you’re on “ER” as the mother of a patient who has a little dalliance with with one of the doctors, and then you were on “Grey’s Anatomy.” What do you remember about those moments, just being like a small part of the thing and now to be at the center?

LaNasa: There isn’t a day that goes by that I don’t remember all the years of struggle and all the auditions and the hallowed corridors of Warner Bros., where we [shoot] now, they’ve always just held a magic for me. I just was thinking this morning: “Here I am; I’m a series regular in in a hit show at Warner Bros.” It doesn’t pass me by. Doesn’t matter how many shows I do, it’s always so hard to get that next job. To be on one that’s a hit, that really sings, that you love — I’m so lucky.

I have a funny story about “ER.” So, my dad’s a surgeon. He hates every medical drama that’s ever been made, except “The Pitt.” And I was telling this to John Wells. We were at a cast lunch, and he says, “Yeah, we don’t have people making out in broom closets.” And I said, “[My ‘ER’ character] made out in the broom closet with Goran [Višnjić, who played Dr. Luka Kovač].” And he goes, “Well, it was like the seventh season or something. We jumped the shark already.” It was a very funny moment. What I remember about “Grey’s” — I was that girl that people would say, “Can you play like a witch doctor on Monday?” or “Can you have this weird disease?” I had Munchausen [syndrome] — not Munchausen [syndrome] by proxy — that was offered to me on a Friday to do on Monday. I was always that girl: “LaNasa will do it. She’ll try anything!” Like [Little] Mikey with the [Life] cereal. I was a vegetarian for about 35 years, and during that period I find myself on that show and, without any warning, they put a huge raw piece of steak on top of me that I guess is what they used to cauterize and look real in the TV operations. We don’t use steak on “The Pitt.” With “The Night Shift,” I was actually pregnant.

Villarreal: What do you remember about the audition for “The Pitt”? Noah wrote a note to people auditioning, right?

LaNasa: He wrote a note, and he talked about top-to-toe immersion. And I had this feeling — in the first episode, they write about how he [Dr. Robby] is outside, and when he comes through into the ER, that it’s just this whole vibe all of a sudden. Ever since I did “Judging Amy” — it sounds like a very weird thing — but I was left alone [as] a [district attorney] on “Judging Amy” for hours on end, and I figured out during that show how to create my own life and to have an inner life and have my business going all the time. And I thought, “I’ll use all this time just to [think about]: ‘What would I do now? And then what would I do? What does a lawyer do?’” Figuring all that out. So, it’s become a part of my craft that I find very grounding. I always like to be fully alive in my body, in the imaginary life of the character at all times. So when he [Noah] wrote that, I was like, “That’s what I’m into.” I got it. He also said, “Leave your ego and bring your creativity.” And, for some reason, that just spoke to me — that I could be as offbeat as I am; that I didn’t have to be, “Oh, now you’re the strict boss” or “Now you’re this” or “Now you’re the pretty lady” or something that was all constricted. I had this little feeling in the back of my head, even though I hadn’t gotten a good job in a couple of years, I thought, “I think if I can get in front of them, I think they would want me. I think they’d be happy with me. I think I’m the kind of actor they want in that job.” I didn’t really seem like the prototype for it, but then, lo and behold, the tape made it up there. I had a Zoom [meeting] with John Wells. I was out in L.A. and not prepared for an audition. [I] didn’t have any Dana clothes; had to rush to Target and get a sweatsuit. And the Zoom camera, when they came on, it was all upside down. It was just all kind of wonky, but it worked. Then they sent me another scene — the scene when I tell them I’m going to quit, which was a different scene than ended up in the show, but it was a dramatic scene, and I sent that to them and then I found out [I got it].

Villarreal: Did you have the accent all along?

LaNasa: I had done something vaguely East Coast for my first tape, and they told me to take it down a little bit for the second audition, so I took it down a little bit and I asked him, “Was it OK?” He’s like, “Don’t worry about it now.” I was like, “OK.” So I just let it go. But I knew that if I didn’t learn a Pittsburgh accent I would sound vaguely East Coast or like I was from New Jersey in the show. And being from Louisiana and being a Southerner, and having people get that wrong so much, I didn’t want to offend the people of Pittsburgh, and I thought I would try it, and it went actually quite terribly. It was really bad, and I cried a lot and I told my acting coach, “Why am I doing this? Why can’t I just be like a normal actor and not have to always be so extra?” She said, “Is there any way in hell you would play this character onstage and not do this accent?” And I said, “No.” She said, “Keep going.” And then I was watching “Mare of Easttown” so much that it was on in my bathtub and then it rolled out, and the [behind-the-scenes footage] came on and they started talking about the accent and the dialect coach came on. And I contacted her on IMDB Pro; I figured out how to find her, and she hooked me up with Susanne Sulby, who put my accent into shape in time to do the show.

Villarreal: Not even three minutes into Hour 1, we really get a sense of Dana and how crucial she is to this ecosystem. And it’s not only how crucial she is to the place of where she works but how crucial [she] is to us as viewers. It’s through her that we learn that Collins is pregnant. It’s through her that we realize why Dr. Robby is going to have a rough day. What did that unlock for you about who she is and how she moves through this space and interacts with her co-workers?

LaNasa: I think I was just at a place in my life where I’ve been through a lot, so I think I had a great understanding of a human condition, just as a person, and I think that I’m the kind of person, for whatever reason, strangers tell me a lot of stuff, so I have some of that. I think John Wells is good at casting and Cathy Sandrich [“The Pitt’s casting director] is good casting people a little bit close to who they are. I also think that I’m a very take-charge person — some people that are married to me might think I’m bossy — but I think I had a lot of the qualities of Dana. I think playing the role and dealing with people that are in such traumatic situations and having to focus on that in my imagination, like believe that this is what’s going on with them, it really did soften me up as a person. It’s a lesson every day in, you don’t know what people are going through. And how much a soft hand matters; how much empathy and compassion matters.

Villarreal: Dig into that a little bit more. You wrote a really lovely and touching essay for Women’s Health magazine about how this role was a love letter to the nurses who cared for you during your breast cancer treatment. Talk to me a little about how that formed or shaped what you brought to Dana and what do you remember about that time, in terms of the little details that really do, like, make a day or break a day for a patient?

LaNasa: I was pretty stoic during the process, but I have to say that at Piedmont [Hospital] in Atlanta, the nursing staff was incredibly kind. It was not like I’d experienced maybe in other places where I’d had babies. I was like, “I don’t know if everyone’s just nice to you because you have cancer; I don’t know what’s going on, but these people are really nice.” And it really mattered. The warm blankets really mattered a lot. It’s just so thoughtful. When you have to constantly be going in an MRI or these different machines, the radiation machines — that’s a head trip, to go get radiated every day. When someone is caring and offers you a warm blanket or offers you something like that, it really matters.

After my cancer treatment, I went through a rough period of a few months where we weren’t sure if there was some other things wrong with me, and I had to keep going back to the ER, and that was the part that kind of broke me because I had been very healthy and then, now, I never stopped going to the hospital. “Do I have this? Do I have that?” There was a lot of scans and a lot of stuff, and I broke down in the ER and the triage nurse just took me aside, and she basically wrapped me in her arms and was like, “The first six months after cancer are really bumpy. It’s not going to stay like this. Do you need an Ativan?” [Laughs.] And I was like, “No.” My husband’s like, “Are you sure?” But just the way that she was — and she said that, I think it was her sister-in-law, was just going through the same thing. Just taking that time [with me], it was so human. There’s just something about nurses; good nurses are so capable and yet they’re so human. They’re not coming down from the ivory tower like the doctors. They’re right there with you. They are in it with you. It really mattered, and so that’s what I wanted to show. But I think that tired, old working women everywhere relate to Dana. You don’t have to be a nurse. It’s like, “Oh, that’s me. I know her. That’s me or that’s my mom or that’s my aunt.” Everybody tells me: “My mom, my aunt — you’re their favorite character.” It’s always some tired, old lady and I get it. I see you, tired, old, working women.

Villarreal: She [Dana] covers the feet.

LaNasa: Yes, that was so sweet. They wrote that after I told them about the blankets. I’ll do anything for a warm blanket. If you ever have bad news, just bring me a warm blanket.

Villarreal: Dana is also loosely based on Kathy Garvin, a nurse at L.A. General [Medical Center]. What do you remember about shadowing her? What impressed you about what this job entails? What did it illuminate for you?

LaNasa: I think the two most impressive things were one, that she told me that she wouldn’t do this job if it wasn’t at a public hospital. She wanted to work for people who needed her — they kind of put that into the story — and that was really impressive. Also they had a [patient] there that was one of their regulars like we have our regulars and she knew him, and I couldn’t see him but I could see his feet and there were some guards there — because he was having a psychotic episode of some sort and they have to just be on guard — but no one was touching him or anything. And she was like, “He’s probably going to die soon. He’s lost this many pounds. He really comes [in] for attention.” And [listed] all the things that she knew about him. It was just so matter-of-fact, but there was a lot of compassion in it as well.

The other thing was about the sandwiches. They cut my line with Earl — I had a whole bit with Earl in Episode 1 about sandwiches and they ended up cutting it. Earl of Sandwich — inside joke. I wanted to know what’s the deal with the sandwiches, and she said, “Technically we’re supposed to write down if we give patients food, but if they’re hungry, I just give them a sandwich.” And I wanted see where the sandwiches were and everything. I also asked her: “If people are jerks — if they are Doug Driscolls [“The Pitt’s” agitated patient fed up with his wait time] — do you give them less preferable treatment?” And she said, “No, because it’s so serious whatever people are going through, if they’re here. But I might not give them a sandwich.” So, I understood the power.

Villarreal: Well, let’s talk about Doug Driscoll. Episode 9 is a big turning point for Dana. She’s attacked by Doug at the end and it’s a shocking moment that’s been building. And this episode was written by Noah, right?

LaNasa: Yes.

Villarreal: What do you remember about shooting that moment?

LaNasa: That was such a fun episode for me. That was the first episode where I really got to do a lot [to] showcase Dana, and I think he [Wyle] wanted just to showcase what a nurse in the ER might do and what it might look like to somebody that doesn’t know what she’s doing. You see both [sides] — his [Driscoll’s] frustration building and her exhaustion building — in a way that she needs a smoke break. He punches her — I think that I read it and I was detached from it. I thought, “Oh, and there’s a stunt. I do all of this fun stuff and I go out for a cigarette and stunt.” And I didn’t think about how I would have to process it until we did it and that was like, “Oh, this is a thing. I’m getting hit right now,” which I think was good. I trust my own instrument. But the journey after that was just so beautiful; to get that opportunity to play that and to think about her in a deeper way. It’s a person whose mother died when she was in high school — that’s what they told me — and then she’s worked there since she was in high school, and so you have to think: If you’re working with trauma every day, it’s convenient to not feel your feelings. I think that punch just brought a lot crashing down for Dana, and I think she’s going through an existential crisis in like [Episodes] 11 and 12 and there’s trauma [patients], so she’s taken out of her own feelings and sets it aside to keep working and keep saving lives. It was beautiful to get to consider all of that.

Villarreal: What did that do for you — did it make you think about [what you observed growing up] with your dad and what he brought home as a surgeon? When you reach a certain age and you look back at your parents, things sort of click into place or you understand things differently when you consider what they’re carrying into their role as parent.

LaNasa: My dad was a flight surgeon in Vietnam. I asked him once: What was the worst thing you ever saw? He’s there when he’s like 24 years old. He said that he had to tag and bag a gymnasium full of dead boys his own age. So, that’s a lot. I think he rubs really high, and I’m not sure if that’s not from the war.

Villarreal: In the final episode, it’s sort of unclear if Dana’s saying goodbye. It feels like a goodbye, but it also doesn’t feel like a goodbye. We know you’re in Season 2, but with the format of the show [covering one shift], I imagine you end with uncertainty — am I coming back? Am I not? And she hasn’t wanted to go home because, if she goes home, she has to confront everything. How were you thinking her journey, and how soon did sort of John and Scott fill in things for you about where she’s headed?

LaNasa: I really relax into the writing a lot in and just trust it. Scott Gemmill is really such a great architect. I thought it was so beautiful. Everyone’s stories paid off and everything. They told me when we got picked up that I was part of [the new season], so I knew pretty soon, but I think I’m still — even though we’re in shooting right now — just now coming into focus of where she is.

Villarreal: What can you tease about where she’s at?

LaNasa: I think that she’s changed. It’s funny because it’s not a broad stroke; they write in such subtleties. I think there’s definitely less porousness in Dana and less willingness to give her whole self over to situations the way that she did — to always put herself last. I think she’s trying to find some healthy balance. I filled in for myself that she wasn’t doing well, at all, and that one of her daughters confronted her and said, “This is not working — this white-knuckling of this situation; I think you need to get help.” And that I have gone and gotten some grief counseling for myself, going all the way back to dealing with my mother, [to] help me deal with this situation that happened. I think I view her as someone that’s now doing more self-care and taking care of herself like that. She’s got her meeting, she’s got her stuff, maybe she even has her impact classes — like, her self-defense classes. She’s got some stuff to fortify herself so that she could come back. A lot of people that go through [an act of violence like that] need to counterbalance that in a way that they feel like they can protect themselves should that incident come into their life again so that they’d feel safe enough to go back into the world. So I imagined something like that for her.

Villarreal: What do you think her husband thought when he saw the black eye?

LaNasa: I think he was probably pretty ticked. As they wrote it, I probably stayed out for a while. So I think he got what he wanted.

Villarreal: I know there’s the boot camp that happens. What can you share with me about the boot camp? Who’s the star student of the boot camp?

LaNasa: I think Taylor Dearden [who plays Dr. Melissa “Mel” King] would be the star student of the boot camp. I bet you she’s the star student wherever she goes.

Villarreal: And where do you fall?

LaNasa: I’m still the class clown, as I’ve been my whole life. I remember one time they had this video — a woman had an earring in her throat because she had scooped up a handful of pills and scooped up the earrings with a handful pills. I’m like, “I’m sorry, Mary, do you just have a pile of pills all over the table and are just like, ‘Oh, let me grab some of these!’” What happens when you accidentally get an earring in your handful of pills?

Villarreal: Wait, but was this an actual person?

LaNasa: An actual person in a video, and we had to watch [a doctor] going in with an instrument and get it out of the throat. There’s a lot videos.

Villarreal: How do you do in emergency situations? Are you calm?

LaNasa: Definitely calm. I get stuff done. I can remember when my son — I’d heard him fall and my ex-husband went up the stairs. It was such a crash, and I was freaked out when it was my own kid. I wasn’t sure if he had cut up his whole face or whatever. He did have an arm where he broke both bones and the arm was like a twisted snake, and that was kind hard.

I hate dead animals, dead birds. They’re very upsetting to me. But I’m super face-forward into death. I’ve been with a few people when they died, and I can handle that. I can handle a very scary-looking dying person and what they’re going through. People hallucinate a lot when they’re super sick and they look like a skeleton. And for some reason, I’m like, “Y’all can go home, I got it.” I don’t know what it is about it. I’m really happy that I’m able to do it. I don’t feel afraid of it, let’s put it that way. And I know that it’s scary for most people. I feel like I can just show up and be present with people when they’re dying and be in it with them for some reason. I didn’t know I could do it until my ex-husband [actor Dennis Hopper] was dying. And then I was like, “OK, I can do this.” And I could do it when my grandmother was dying. It’s not earned. I feel like it just came down from something. In other words, I don’t think I’m a virtuous person because of it. I just think it’s some part of my psychology, I can be present in that.

Villarreal: Before we wrap, Dr. Robby listens to [Baby” by Robert Bradley’s Blackwater Surprise], as he starts and ends his day of work. Tell me what you think that song is for Dana.

LaNasa: Rema, “Calm Down.” I love that song. It’s also a little bit sad. Something about it has a lot of longing in it. I listened to that song when I was going through some of that stuff with Dana.

Villarreal: As we leave you, you’re taking a break from production, but what gory thing is coming up?

LaNasa: I’m going to have some stuff that I just talked about coming up. I’m going to have to deal with some death.

Villarreal: Well, I’m sorry in advance.

LaNasa: They picked the right actor.

Villarreal: Is there anyone you’re excited to see on Emmys night?

LaNasa: Oh, my gosh, I am just a fan of so many people. I’m a big fan of Jessica Williams [“Shrinking”]. I’m a big fan of Julianne Nicholson [“Paradise”]. I’m a huge fan of Jean Smart [“Hacks”]. Sharon Horgan [“Bad Sisters”]. It’s going to be a great night. I’m a fan of all of our competitors. Sterling K. Brown. It’s an honor to be nominated because there’s some really great work out there. And I kind of hate that both of my comedies are up against each other. Because I love “Shrinking” and I love Paul [W.] Downs [of “Hacks”]. That’s a deep bench over there. I feel like “Shrinking” and “Hacks” should not be on at the same time. I don’t like them competing. I love those shows.

HEALTH officials have warned a surge of a “nasty disease” could be on the way if vaccination isn’t prioritised.

Cases still remain high, particularly in two areas of the UK.

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The UK Health Security Agency (UKHSA) is urging patients to prioritise vaccine catch-up appointments this summer, with the latest data showing continued high levels of measles cases.

Fears have now been raised over a further surge once the new school term begins.

Measles activity has increased since April 2025, says the UKHSA.

The most recent figures show an additional 145 measles cases have been reported since the last report was published on July 3.

Cases continue to predominantly be in children under the age of 10 years, and London and the North West have been driving the increase most.

Since January 1, there have been 674 laboratory confirmed measles cases reported in England, with 48 per cent of these cases in London, 16 per cent in the North West, and 10 per cent in the East of England.

There’s also been a global increase in measles cases, including Europe, over the last year. 

The UKHSA has also stressed holiday travel and international visits to see family this summer could lead to rising measles cases in England when the new school term begins.

Dr Vanessa Saliba, UKHSA Consultant Epidemiologist, said: “The summer months offer parents an important opportunity to ensure their children’s vaccinations are up to date, giving them the best possible protection when the new school term begins.

“It is never too late to catch up. Do not put it off and regret it later.

“Measles spreads very easily and can be a nasty disease, leading to complications like ear and chest infections and inflammation of the brain with some children tragically ending up in hospital and suffering life-long consequences.

“Two doses of the MMR vaccine is the best way to protect yourself and your family from measles.

“Babies under the age of 1 and some people who have weakened immune systems cannot have the vaccine and are at risk of more serious complications if they get measles.

“They rely on the rest of us getting the vaccine to protect them.”

The first MMR vaccine is offered to infants when they turn one year old and the second dose to pre-school children when they are around three years and four months old. 

Around 99 per cent of those who have two doses will be protected against measles and rubella.

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Although mumps protection is slightly lower, cases in vaccinated people are much less severe. 

Anyone, whatever age, who has not had two doses can contact their GP surgery to book an appointment.

Dr Amanda Doyle, National Director for Primary Care and Community Services at NHS England, said: “The MMR vaccine is provided free by the NHS and I would urge all parents to check their child’s vaccination records before the new school year or summer travel, particularly as Europe is reporting the highest number of measles cases in 25 years.

“While the NHS delivered tens of thousands of additional MMR vaccinations last year, too many eligible children remain unvaccinated, and we are working with local authorities and the UK Health Security Agency to reach more youngsters, with enhanced vaccination offers in areas with higher cases, including vaccination buses and community catch-up sessions.”

The travel experts at Which? have called out the travel health products that are a “waste of money” and have warned consumers against purchasing them ahead of a summer holiday

While many of us enjoy making the most of the good weather next to a pool or beach, jetting off during the summer holidays often costs more than it would if you travelled off-peak.

Whether it’s sticking to hand luggage or bagging a last-minute flight for less than £20, many of us are also conscious of making our money go further when planning a summer holiday, but there are certain items you could be splashing cash on that simply aren’t worthwhile.

There are, however, some things you simply can’t plan for, and that’s falling ill while travelling. Investing in some mosquito repellent to ensure you don’t spend the entire holiday scratching at them, or stockpiling on allergy medicines in local Boots might seem like an essential task to do before travelling, but it could be a waste of time and money depending on what you purchase.

While many of us want to avoid getting sick on holiday, the travel gurus at Which? have revealed the travel health products that are actually a “waste of money”, reports the Express.

In a clip shared on Instagram, the travel specialists highlighted the popular items many of us buy to ensure we feel our best before jetting off, which aren’t entirely essential and could be setting you back more than they’re worth.

Mosquito wristbands

Remembering to reapply repellent can prove tricky whilst on holiday, which explains why numerous holidaymakers opt for wristbands as an alternative. Emitting a combination of components that deter the insects, Which? warned that they’re not actually the most efficient.

Whilst it may shield your wrist or at least the upper portion of your body, the specialists noted: “You’re better off using a spray or lotion with 20% to 50% DEET on all exposed skin.”

Travel sickness bands

If you’re facing a lengthy car journey from the airport to your accommodation, or need to board a ferry, you might splash out on an anti-travel sickness band.

A type of acupressure that’s claimed to ease queasiness and nausea, the experts at Which? said: “The NHS says there’s little scientific evidence that these work and when we put them to the test at a fairground, they didn’t work either.”

Instead, they recommended buying tablets such as Kwells which contain hyoscine, a medication that prevents nausea signals.

Once-a-day sunscreen

Whilst once-a-day sunscreen may appear to be a perfect answer if you forget to reapply it, Which disclosed that they discovered a 74% reduction in protection throughout the day.

It’s safer for your skin to use sunscreen that you can reapply during the day, and you should top it up every two hours.

Branded medicines

Numerous branded medications are frequently pricier than generic alternatives available in supermarkets, despite containing identical ingredients.

Which? recommended that whilst brands such as Piriteze and Clarityn might cost you £11, supermarket alternatives of the allergy treatment typically cost under half the price, and the same principle applies to Immodium.

Search for the active component loperamide hydrochloride, and save cash by switching to an unbranded alternative.

Millions of Brits are preparing for summer holidays but a leading pharmacist is warning that some everyday UK prescriptions could be banned overseas

As the UK anticipates the summer holiday season, a leading pharmacist has issued a crucial warning to those planning to travel with medicines. Peter Thnoia of PillTime urges holidaymakers to think ahead or face potential complications due to stringent drug regulations in various destinations.

Highlighting that common UK prescriptions could be prohibited abroad, Peter is alerting travellers about the danger of leaving medication arrangements to the last minute. With school holidays approaching, he stresses the necessity for people to order their medications no less than a fortnight prior to departure.

Peter also underscores the significance of carrying appropriate documents for your medication to avoid the inconvenience of confiscation at the airport. He prompts tourists to research the specific pharmaceutical laws of their destination, particularly as certain meds like Co-codamol may be restricted in some countries, reports the Liverpool Echo.

Peter urges people going abroad to process their prescription orders at least two weeks before their holidays and alert their GP of any unusual early requests. “We’d always recommend people put in their prescription requests around two weeks before, but if you’re ordering earlier than normal, your GP might flag or reject the request,” Peter advises.

“If that’s the case, then you need to contact your GP in good time, explaining your holiday, so they can approve the request.” With over a quarter-century of experience in the pharmacy sector, Peter highlights that many people leave prescriptions until the last minute, causing unnecessary stress before a trip.

“Pharmacies are accustomed to busy periods, but late requests add pressure for everyone,” he said. “Ordering well in advance helps us deliver your medication without any hitches – and gives you peace of mind as your holiday draws near.”

However, it’s not just about timely ordering. Peter also advises travellers on the correct way to carry medication to avoid complications at security or border control.

“Always keep your medication in your hand luggage, in its original packaging with the prescription label intact,” he says. “Security staff may need to verify it, particularly if it’s liquid or regulated,” he added. “If you’re unsure, ask your doctor or pharmacist for a supporting letter. This can be particularly useful when travelling with larger quantities.”

When going abroad with medication, it is essential to confirm that you can transport it legally and safely. Always keep your medication in its original packaging, complete with the prescription label, and include a doctor’s letter if necessary. Make sure to pack your medication in your hand luggage for easy access and to reduce the chances of loss or damage. Review the regulations of the airline and the destination country, particularly concerning controlled substances and liquids exceeding 100ml.

What medication could cause issues?

As the six-week holiday period approaches, Peter shares a simple tip to ensure your holiday goes ‘without a hitch’. He says: “Know the rules of the country you’re travelling to, because you’d be surprised how many everyday tablets are banned or regulated abroad.”

He went on to say: “For example, Co-codamol is available over the counter and in supermarkets here in the UK. But in Greece, the codeine element is treated as a controlled drug – so you can only bring it into the country with a prescription and a doctor’s note.”

Open Prescribing data reveals that more than 3.5 million prescriptions for Co-codamol have been issued in the first quarter of this year (January-March 2025). While lower strengths of Co-codamol can be purchased without a prescription in the UK, higher doses necessitate one.

This implies that millions of Brits who depend on this medication for pain relief could potentially run afoul of foreign laws if they take their medication abroad. Some countries have restrictions or outright bans on drugs like codeine, tramadol, and loperamide.

• Japan: Has intricate regulations concerning prescription and over-the-counter drugs. Some widely used allergy and cold treatments, including those with pseudoephedrine, are either prohibited or necessitate special authorisation. Attempting to bring in banned drugs may lead to arrest.
• Indonesia: Prohibits medications that contain codeine and tramadol.
• Qatar: Certain over-the-counter cold treatments require a prescription.
• India, Pakistan, Turkey: Maintain stringent lists of banned medications, and travellers are advised to consult their respective embassies prior to carrying any drugs.
• United Arab Emirates: Enforces strict regulations on numerous prescription medications, including those with codeine, tramadol, and specific anxiety drugs.

Certain countries also enforce stringent regulations on medications containing pseudoephedrine and other components commonly found in cold and allergy remedies. Pseudoephedrine, a key ingredient in decongestants such as Sudafed, is often regulated due to concerns about its potential misuse in the illegal production of substances, particularly methamphetamine.

What should you do?

Peter recommends: “If you’re unsure whether your medication is restricted in the country you’re travelling to, then check the official embassy website for your destination. It will explain exactly what you can and cannot bring into the country. It’s always best to be safe and check before you travel so that you have all the essential medication you need to make sure your holiday is as enjoyable as possible.”

Do consult with your GP regarding any trips abroad and the medicines you’ll need to bring along. Your doctor can provide a letter explaining why certain medications are necessary and may offer alternative solutions if needed.

Always carry medications in their original containers with labels visible. It’s also wise to request any permits or certificates in good time before setting off. Be prepared for inspections at customs by declaring any medication, which might mean enduring some delays.

DIY cervical cancer tests will be sent to women’s homes under NHS plans to boost uptake and help eradicate the disease.

The kits will be posted to those who have ignored or missed their smear test invitation and are therefore “underscreened”.

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They contain a swab to self-sample the cervix for human papillomavirus (HPV), a group of viruses that cause 99 per cent of cervical cancers.

The NHS wants to eliminate the cancer entirely by 2040 using screening and vaccination.

But only 69 per cent of women take part in screening, well below the 80 per cent target.

This means that more than five million women in England are not up to date with their check-ups.

The screening programme saves an estimated 5,000 lives per year in England but the number could be higher with better uptake.

Health chiefs said women may avoid their smear test for fear it will hurt or be embarrassing, or because they struggle to find the time.

The new test is a quick at-home sample that is then sent off to a lab in the post.

Health bosses hope it will help overcome barriers that prevent some women from attending cervical cancer screening appointments.

The initiative will be rolled out in January 2026.

Health Secretary Wes Streeting said: “These self-sampling kits represent healthcare that works around people’s lives, not the other way around.

“They put women firmly in control of their own health, ensuring we catch more cancers at their earliest, most treatable stages.”

“We know the earlier cancer is diagnosed the better the chances are of survival.

“By making screening more convenient, we’re tackling the barriers that keep millions of women from potentially life-saving tests.”

Research has suggested that offering DIY testing kits could boost uptake.

A trial – led by King’s College London in partnership with NHS England – found that offering self-sampling kits to “under-screened” women when they attend their GP practice and by posting kits to women’s homes could boost uptake in England by about 400,000 each year.

The Department of Health and Social Care said that the new programme “specifically targets those groups consistently missing vital appointments” including younger women, those from minority ethnic backgrounds, people with disabilities and LGBTQ+ people.

The initiative comes after the UK Health Security Agency revealed that young women in certain parts of England are at higher risk of cervical cancer due to “alarmingly” low uptake of HPV jabs.

At-home cervical cancer screening is part of the government’s upcoming 10 Year Health Plan, due to be published in the coming weeks, which will focus preventing illness instead of only treating it when symptoms appear.

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Eve Appeal chief executive, Athena Lamnisos, said: “There are so many different reasons why those who are eligible aren’t responding to their cervical screening invitation letter.

“HPV self-testing will be a step change for some. Being able to do the test in their own time and following simple instructions is what many people want and need.

“Ensuring that the under-screened and never screened know about this new test is vital for Eve.”

Michelle Mitchell, chief executive of Cancer Research UK, added: “We welcome the UK government’s decision to roll out cervical cancer home screening kits in England – to help remove barriers and make cervical screening more accessible.

“The gold standard way to test for HPV is still a sample taken by a clinician and this will be suitable for most people.

“But beating cervical cancer means beating it for everyone, and this move helps to bring us closer to that goal.

“It’s important to remember that cervical screening is for people without symptoms so, if you notice any unusual changes for you, do not wait for a screening invitation – speak to your doctor.”

The NHS Cervical Screening Programme invites women and people with a cervix aged 25 to 64 for regular screening.

Under current guidelines, people aged 25 to 49 are called back for a check-up every three years if they test negative for HPV, whereas 50 to 64-year-olds are invited for checks every five years.

But from July, people who test negative during an in-person test with their clinician will be invited back after five years, rather than three, following a recommendation by the UK National Screening Committee.

The change comes after evidence showed that people who test negative for HPV are extremely unlikely to develop cervical cancer within the next decade.

Anyone whose sample shows traces of HPV will continue to be invited to more frequent screenings.  

Digital invitations and reminders for cervical screening were also recently rolled out as part of the NHS App’s ‘ping and book’ service to boost uptake.

Cervical cancer symptoms, such as bleeding between periods and during sex, should be investigated by a GP.

Around 13 high-risk types of HPV are known to cause 99.7 per cent of cervical cancers.

They cause cell changes which can eventually turn cancerous.

Dangerous strains of the common virus can also lead to mouth, anal, penile, vulval and vaginal cancer.

WEIGHT loss jabs could prevent a medication taken by millions of women from working – and increase patients’ risk of cancer.

The British Menopause Society said the jabs could cause hormone imbalance in women taking hormone replacement therapy (HRT), particularly for those with obesity, putting them “at increased risk of womb cancer”.

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It follows warnings to women on weight loss medications to take effective contraception, as the jabs could render the pill less effective.

That’s because weight loss drugs Wegovy and Mounjaro – as well as diabetes jab Ozempic – can delay the absorption of pills taken orally, as well slowing down the passage of food through the gut.

Guidance suggests women taking HRT in pill form may also be at risk.

The British Menopause Society (BMS) told doctors to closely monitor menopausal women on HRT who are also using weight-loss jabs.

The treatment tops up the hormones oestrogen and progesterone, which dip to low levels as the menopause approaches.

Data from 2023-24 showed that 2.6 million women in England rely on the drugs to alleviate hot flushes, night sweats, difficulty sleeping and mood changes.

“During the last two years, since semaglutide and tirzepatide [the active ingredients in Wegovy and Mounjaro] received licenses for weight loss, there has been an increase in uptake of these medications through private clinics, while NHS prescribing is limited to specialist weight management services,” the BMS guidance stated.

“There are no current data available about numbers of women receiving HRT concurrently with semaglutide or tirzepatide.”

The most common form of HRT is a progesterone pill alongside a skin patch or gel to deliver oestrogen, but some people opt for a combined pill.

Progesterone balances out the effects of oestrogen, which on its own stimulates the growth of the womb lining, and can cause “abnormal cells and cancer” to grow.

The menopause experts expressed concern over the loss of the progesterone’s protective effect on the womb as a result of weight loss jabs.

They recommended that doctors move women taking progesterone orally to an intrauterine device, such as a Mirena coil, or increase their dose of progesterone.

Prof Annice Mukherjee, a consultant endocrinologist and member of the society’s medical advisory council, who led on the guidance, told The Telegraph that a hormone imbalance could put women “at increased risk of womb cancer” – particularly if they are obese.

“Oestrogen is almost always given through the skin for HRT in women living with obesity, but progesterone is frequently given as a tablet, and that formulation is thought to be the safest route for women who have complicated health issues,” she said.

“If we then start one of these injectable weight-loss drugs, then you’re preferentially stopping absorption of the progestogen that’s coming in orally, but you’re allowing plenty of the oestrogen through the skin.

“The rules are very clear that if you give a very high dose of oestrogen and you don’t give enough progesterone, however that happens, you’re putting that woman at risk of womb cancer,” she said.

Prof Mukherjee said there was currently a “culture of putting women on very high doses of oestrogen”, which can make the womb lining thicken.

“It’s like having a lawn in a woman’s womb. Oestrogen makes the lawn grow. Progestogen cuts the lawn. But if it’s not being cut, it grows thicker, and then you can get abnormal cells and cancer.”

But she also stressed that the biggest risk factor for womb cancer was obesity – meaning that on the whole, weight loss jabs can cut the risk of disease.

“These drugs reduce the risk of cancer,” Prof Mukherjee said.

“But if they are prescribed to a woman who’s on oestrogen through the skin, and she might already have womb thickening because she’s living with obesity, and she’s not absorbing the progesterone because she’s been put on a weight-loss injection, she’s potentially getting loads of oestrogen on top of her thickened womb lining, and that could potentially unmask cancers that are there or drive an early cancer to a more advanced stage.”

The BMS put together the guidelines after calls from GPs for advice to give to patients.

Dr Janet Barter, the president of the Faculty of Sexual and Reproductive Healthcare, told The Telegraph that weight loss jabs can cause side effects such as “vomiting and severe diarrhoea in some patients”.

“Obviously this could render any medication, such as HRT tablets or oral contraception, ineffective if there hasn’t been enough time for them to be fully absorbed,” she said.

“If these side-effects are occurring, then people should discuss the matter with their doctor or specialist clinician to find the combination of drugs that’s right for them.”

Sun Health has contacted Novo Nordisk and Eli Lilly – the makers of Wegovy and Mounjaro – for comment.

It follows warnings from the Medicines and Healthcare products Agency (MHRA) that GLP-1 weight loss drugs could reduce the absorption of contraceptives, due to the fact they slow down the emptying of the stomach.

The watchdog also said the jabs should not be used during pregnancy, while trying to conceive or breastfeeding, over fears they could lead to miscarriage or birth defects.

The MHRA explained: “This is because there is not enough safety data to know whether taking the medicine could cause harm to the baby.”

Dr Bassel Wattar, a consultant gynaecologist and medical director of clinical trials at Anglia Ruskin University, told The Sun: “It’s not the medication itself, but the weight loss that helps regulate a woman’s hormones allowing her ovaries to function properly again.

“Pregnancy is more of a happy side effect.”

EVERYONE’S talking about fat jabs – the ‘miracle’ injections trimming inches off waistlines, and helping turn the tide on the obesity epidemic.

But what if there was an even easier – and cheaper – way than Ozempic-like injections, Wegovy and Mounjaro?

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Science sits still for no slimmer and already, the next big thing is looming large on the horizon – and it could be as simple as popping a pill.

Slimming tablets have been around for decades, but now scientists want to harness the new momentum in obesity medicine – and use the billions being made from the jabs – to bring pills back with a bang.

Professor Jason Halford, of the European Association for the Study of Obesity, tells Sun Health: “I think pills will eventually replace injections.

“People don’t particularly like them and they’re a bit afraid of injecting themselves.

“You’ve got to have the device, the needle, the sharps bin, it’s got to be refrigerated, there are all sorts of challenges.

“If you can move it all to a tablet you can increase acceptance and hopefully it will be cheaper and become more widely available.”

Professor Richard Donnelly, editor of the medical journal Diabetes, Obesity and Metabolism, and clinical adviser at online weight loss clinic Juniper, agrees.

“Thirty years ago weight loss tablets had a terrible reputation and nobody really wanted to prescribe them,” he adds.

“They had rare but severe side effects and weren’t particularly effective.

“Now there is a whole flood of development and a lot to be optimistic about.

“There is a big hope that developing pills will improve accessibility and cost less.”

There are several pills in development – some stimulate the same hormones as jabs to make us feel full, while others mimic bariatric surgery.

The end goal is the same – to do what willpower alone fails to achieve and stop us eating so much.

While some are yet to even be trialled in humans, one has already been submitted for approval in the US, meaning they could be available before the end of the year.

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The most advanced pills being made are by the same companies behind the fat jabs.

Novo Nordisk, creator of Wegovy and Ozempic, has developed a tablet version of semaglutide, the active drug in those injections.

It applied for approval from the US Food and Drugs Administration last month.

Trials showed patients lost an average of 15 per cent of their bodyweight over 17 months on a 50mg daily dose, compared with eight per cent over 12 months on Wegovy.

Participants were three times more likely to achieve “meaningful” weight loss when they were taking the pill, compared to those not taking the tablet.

Rival company Eli Lilly, which makes Mounjaro (tirzepatide) announced the results of its pill orforglipron in April.

The two drugs both work by stimulating GLP-1 hormones that make you feel full.

Patients taking 36mg of orforglipron lost eight per cent of their bodyweight in 10 months, equating to 1st 2lbs from an average starting weight of 14st 3lbs – while participants taking a placebo lost just 3lbs.

It compares with 15 per cent weight loss in a year on Mounjaro.

Lilly said their pill “could be readily manufactured and launched at scale for use around the world”.

But injections and pills have not been compared head-to-head yet.
Studies are ongoing and taking the science behind these game-changing jabs and applying it to tablets, does not guarantee success.

Pfizer abandoned the development of its drug lotiglipron in 2023 when a trial indicated potential liver damage as a side effect.

Drugs tend to be more easily absorbed by the body when they are injected directly into the bloodstream, compared to being digested through the gut.

And that’s another key consideration – what the potential side effects of these new pills could be.

Unpleasant side effects were the downfall of the old generation of slimming pills.

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The NHS has prescribed a pill called orlistat for years, dishing out £12million worth of it in England last year.

It works by preventing the gut from absorbing fat from food – but it means fat must be passed out in poo instead of digested.

This can lead to flatulence, more regular bowel movements and diarrhoea.

It can also cause bladder pains and breathing troubles – and weight loss doesn’t match up to the jabs.

About eight in 10 patients suffer at least one side effect when using injections, most commonly tummy upset, according to trials.

Early data suggests pills might have similar rates.

Around six per cent of people taking any of Lilly or Novo Nordisk’s pills or injections quit the medicines because of side effects.

Dr Leyla Hannbeck, of the Independent Pharmacies Association, says: “The old generation drugs tended to be uncomfortable for a lot of people whereas these new ones are much more effective.

“All medicines will have side effects but the fact that the results are much better now means people are more willing to endure them.”
Prof Donnelly said he still does not expect new tablets to be as strong as jabs, adding: “I don’t think anybody believes these will cause the same level of weight loss that you might be reporting with Mounjaro.

“The flipside of that is that major weight loss might not all be good.

“Some of that might be muscle and if you lose 30 per cent of your body weight that is a fairly major transformation.

“Having an oral agent that reduces your weight by, say, 10 or 15 per cent, might actually be more sustainable, better tolerated and medically safer in some respects.”

While the GLP-1 tablets are likely to be first to market, inventors are also working on a daily pill that mimics the effects of gastric bypass surgery.

‘GASTRIC BYPASS’ PILL

US company Syntis Bio’s offering, named Synt-101 creates a 24-hour lining in the gut that means food cannot be absorbed in the top six inches of the small intestine.

Rather, digestion is redirected to the lower areas of the gut, where hormones that tell the brain we are full, are triggered faster.

Working in a similar vein to surgery, it means patients feel fuller faster – and the lining is passed when the patient goes to the loo the next day.

Synt-101 has passed its first human safety tests and is expected to enter a full-scale clinical trial next year.

Another pill in development, Sirona, is made by UK-based Oxford Medical Products, and contains a “dual polymer hydrogel” that expands in the stomach when it comes into contact with water.

It works like a gastric balloon, filling the patient’s tummy making them feel full for hours, but is passed in their stools “several days” later.

Early data from an NHS trial found patients lost 10 to 12 per cent in a year of treatment and there were no serious side effects.

Experts believe weight loss pills will serve a variety of purposes – as a follow-on treatment after stopping fat jabs, as an option for those who can’t or don’t want to use jabs and for people with less severe obesity, and less weight to lose.

There are hopes they will be less toxic than injections, which often cause side effects like stomach aches, vomiting or diarrhoea.

Weight regain after treatment is also an emerging issue with the jabs, which can currently only be prescribed for up to two years in the UK.

Rahul Dhanda, chief executive of Syntis Bio, said: “Patients don’t want to be stuck on a revolving door of injections and their side effects; they want to be on a manageable and sustainable weight loss path.

“Oral drugs that are simple, tolerable and safe will be the rational choice for maintenance therapy.”

DOES it feel like you’ve tried everything in your quest to lose those final pounds?

While the world is obsessed with Ozempic-like fat jabs, not everyone wants to resort to injecting drugs to shed weight. But what’s the answer when all the fad diets have failed?

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As a nutritionist with over a decade of experience, I’ve seen it all from quick fixes to restrictive plans that rarely deliver long-lasting results. I’m not alone – most professionals in this space would agree that rigid diets don’t work long-term.

But here’s what does…. Rethinking your approach to weight loss and health by focusing on sustainable habits known as diet ‘anchors’.

Anchors are a common concept that many wellness experts (myself included) use with our clients. Think of them as an antidote to fad diets that don’t hold up over time. 

Like the name suggests, these fundamental vows help keep you grounded and consistent. They are easy to weave into your daily routine, making them sustainable, unlike rigid rules that come with most diets. They become so ingrained that they become natural, which is the key to success.

Many of my clients come in thinking they need to overhaul their diet overnight, but when it comes to health, it’s actually the small, steady shifts that have the biggest impact. 

So if you’re fed up of complicated calorie counting, are struggling with flagging energy levels or can’t seem to stick to the new gym routine, try implementing these tried and tested non-negotiable rules to flip the weight loss switch… 

1. BREAKFAST OF CHAMPIONS

It may be the first thing you eat, but breakfast sets the tone for the whole day. The food choices you make have an impact on your blood sugar levels.

Slurping a bowl of milky cereal or a chowing a syrupy stack of pancakes might hit your sweet spot, but sugary breakfasts send your blood sugar levels on a rollercoaster.

What this means, is that after they spike your blood sugar, you soon experience a crash. It results in a mid-morning energy dip and cravings for the biscuit tin come 10am.

Make sure your breakfast choices lean more towards savoury, protein-rich meals to feel fuller for longer with no nasty blood glucose crashes. 

Protein takes more energy to digest than fat or carbohydrates, which means it slightly increases calorie burn, whilst keeping you feeling fuller for longer.

Panfried mushrooms with melted cheese on toast, anchovy and tomato bruschetta or eggs cooked shakshuka style are a protein-fuelled start to the day.

But if you’re limited on time, or on-the-go, try:

• Boil a couple of eggs the night before and serve with salad leaves or wholemeal toast. Make a veggie frittata which can be eaten cold.
• Whizz together a bowl of fruity overnight oats. Pop some oats in a mason jar and cover with milk. In the morning, add a sprinkling of seeds (which are high in plant-based protein), your favourite fruit and a drizzle of honey. 
• Combine plain Greek yoghurt with berries and top with mixed nuts or chia seeds. 
• Nibble a protein bar with a piece of low-sugar fruit such as an apple or pear.

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2. COLOUR, NOT QUANTITY 

Variety is the spice of life, so if you’re eating the same foods day after day you’ll hit a boredom wall and risk nutritional deficiencies. 

To avoid this food rut, rotate the colours on your plate, aiming for a total of nine different shades every day. 

This is easier than it sounds, and the simplest way is to aim for three different vegetables at each meal. 

For example, sneak diced courgette and colourful peppers into bolognese sauces, make use of frozen bagged vegetables into casseroles and soups and add a side salad to your lunch. 

When you lose inspiration, find new recipes on social media; it’s saturated with accounts showing how to make meals that hit all the spots; healthy, delicious, cheap and quick.

Try doubling up on everything you make for a week or two, so that you can freeze portions. That way you always have a healthy meal when you’re in a hurry.

3. UP AND OUT

Kicking back on the sofa and flicking on Netflix might be your current go-to after dinner, but gentle exercise after eating is a science-backed no-brainer weight loss hack that us nutritionists swear by. 

A short walk within a 60-minute window of finishing your meal can help with weight loss as well as ward off disease. It makes all the difference in how your body absorbs carbohydrates. 

A 2023 study published in the Journal of Sports Medicine showed that 20 minutes of walking straight after eating helped muscle cells use glucose more efficiently from the bloodstream which reduces insulin demand and boosts weight loss. 

No time to walk, or stuck at the house? Pace up and down the stairs – set a goal and see if you can increase how many flights you can do over time – or get some chores done around the house.

4. SPICE AND NICE

Lots of us have to make a conscious effort to cook things from scratch. It’s easier to grab ready-to-eat meals for the family, but this is certainly not the best way to lose weight.

If there’s one thing you can do to liven up meals that you’re cooking from scratch – and keep your diet on track – it’s adding flavour. So, include at least one herb or spice at each meal. 

From adding blood-sugar balancing cinnamon to porridge, topping green smoothies with anti-inflammatory golden turmeric and being extra liberal with herbs like sage, basil and parsley in pasta sauces, getting in the habit of seasoning will help to elevate your meals both in taste and nutrition. 

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You can use dried herbs and spices or buy fresh. To keep costs down and wastage low, you can now buy pre-chopped herbs, as well as onions and garlic, in the frozen section.

Want to take it one step further? Create your own little herb garden on a sunny windowsill. Basil, thyme and mint are all super-easy varieties to grow at home. 

5. SELF-WORTH REIGNS

Sustaining motivation to workout and eat well can be difficult at the best of times, but anchoring your thoughts to your goals is the best way to keep your get-up-and-go firing. Keep in mind that success is about consistency, and it’s those small wins that add up over time.

Mantras can help to reinforce your diet choices, so put pen to paper and make up a few that resonate with your goals. 

Some of my personal favourites include “your choices today build results tomorrow”, and “nothing changes unless you change it”.

Self-worth can often shatter on fad diets, but with diet anchors you feel shaped by your positive health choices, so when you do smash one of your micro goals, be kind to yourself.

Even something simple like getting your nails done, or pampering yourself with a candlelit bath, can help to keep motivation high. And if you do fall off the wagon? Don’t beat yourself up for it, every day is a new day with new possibilities to better your health. 

6. PLATE ART

Learning to become meticulous about how you organise your plate is a simple yet powerful anchor that can help to speed up weight loss, and keep those stubborn pounds off.

To build the perfect plate, it’s important to re-think the way you serve your food; Fill half your plate with non-starchy vegetables such as broccoli, cauliflower and peppers as these are high in fibre and contain a hefty dose of nutrients.

Next, dedicate one quarter to protein – this includes foods like eggs, poultry, red meat or tofu to help support muscle health and promote fullness.

Finally, split the remaining quarter between healthy fats, (including avocado, nuts, and seeds), along with complex carbohydrates such as brown rice, wholemeal pasta or sweet potato as these help to sustain energy whilst providing essential nutrients.

The order in which you eat your food can also make a difference to weight loss – it’s a concept called ‘food sequencing’ and can help to improve your body’s insulin response to food.

To practice food sequencing, eat your non-starchy veg first, followed by your protein and healthy fat sources. Save your carbs until last to help minimise blood sugar spikes and aid fullness. 

Louise Pyne is a registered nutritionist. Find her at www.louisepynenutrition.com and on Instagram @loulou_nutrition.

What a balanced plate looks like

How can you make sure you are eating a balanced, filling and nutritious plate at every meal?

Think of your plate divided into different food groups – protein, carbs, fat and fruit and veg.

Protein: David Wiener, training and nutrition specialist at AI-based lifestyle and coaching app Freeletics, told The Sun: “Aim for one to two palm-size portions of lean protein in each meal.”

Protein includes meat (chicken, turkey, pork, beef), beans, peas, lentils and fish.

The NHS Eatwell Guide says to choose lean cuts of meat and mince, and eat less red and processed meat like bacon, ham and sausages.

Aim for at least two portions (two x 140g) of fish every week, one of which should be oily, such as salmon, sardines or mackerel.

Carbs: Carbohydrates should make up about a third of your plate, or a fist-sized portion.

The Eatwell Guide says: “Choose higher fibre or wholegrain varieties, such as wholewheat pasta and brown rice, or simply leave the skins on potatoes.

“There are also higher fibre versions of white bread and pasta.

“Starchy foods are a good source of energy and the main source of a range of nutrients in our diet.”

Fat: Generally the advice is to think of fat like a thumb-sized amount on your plate.

The Eatwell Guide says: “Remember all types of fat are high in energy and should be eaten in small amounts.

“These foods include chocolate, cakes, biscuits, sugary soft drinks, butter, ghee and ice cream.

“They’re not needed in our diet, so should be eaten less often and in smaller amounts.”

But a small amount is still essential for the diet. Try and eat more unsaturated fats (avocado, nuts, olive oil), which are healthier than saturated fats (butter, hard cheese, sour cream).

Fruit and veg: David says: “Make sure you also get lots of colourful fruit and vegetable carbohydrates too.

“Aim for at least five of these portions a day.

“One to two fist-sized portions of fruits and vegetables with every meal is generally recommended.”

Fruit and veg can be fresh, frozen, tinned or dried. You can roast, boil, steam or grill veggies.

WASHINGTON, D.C. — Annual COVID-19 shots for healthy younger adults and children will no longer be routinely approved under a major new policy shift unveiled Tuesday by the Trump administration.

Top officials for the Food and Drug Administration laid out new requirements for yearly updates to COVID shots, saying they’d continue to use a streamlined approach that would make vaccines available to adults 65 and older as well as children and younger adults with at least one health problem that puts them at higher risk.

But the FDA framework urges companies conduct large, lengthy studies before tweaked vaccines can be approved for healthier people. In a framework published Tuesday in the New England Journal of Medicine, agency officials said the approach still could keep annual vaccinations available for between 100 million and 200 million adults.

The upcoming changes raise questions about people who may still want a fall COVID-19 shot but don’t clearly fall into one of the categories.

“Is the pharmacist going to determine if you’re in a high-risk group?” asked Dr. Paul Offit, a vaccine expert at Children’s Hospital of Philadelphia. “The only thing that can come of this will make vaccines less insurable and less available.”

The framework, published in the New England Journal of Medicine, is the culmination of a series of recent steps scrutinizing the use of COVID shots and raising major questions about the broader availability of vaccines under President Trump.

For years, federal health officials have told most Americans to expect annual updates to COVID-19 vaccines, similar to the annual flu shot. Just like with flu vaccines, until now the FDA has approved updated COVID shots when manufacturers provide evidence that they spark just as much immunity protection as the previous year’s version.

But FDA’s new guidance appears to be the end of that approach under Health and Human Services Secretary Robert F. Kennedy, who has filled the FDA and other health agencies with outspoken critics of the government’s handling of COVID shots, particularly their recommendation for young, healthy adults and children.

Tuesday’s update, written by FDA Commissioner Marty Makary and FDA vaccine chief Vinay Prasad, criticized the United States’ “one-size-fits-all” approach and states that the U.S. has been “the most aggressive” in recommending COVID boosters, when compared with European countries.

“We simply don’t know whether a healthy 52-year-old woman with a normal BMI who has had COVID-19 three times and has received six previous doses of a COVID-19 vaccine will benefit from the seventh dose,” they wrote.

Outside experts say there are legitimate questions about how much everyone still benefits from yearly COVID vaccination or whether they should be recommended for people at increased risk. An influential panel of advisors to the Centers for Disease Control and Prevention is set to debate that question next month.

The FDA framework announced Tuesday appears to usurp that advisory panel’s job, Offit said. He added that CDC studies have made clear that booster doses do offer protection against mild to moderate illness for four to six months after the shot even in healthy people.

Perrone and Neergaard write for the Associated Press. The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

ENGLAND will roll out the world’s first gonorrhoea vaccine campaign this summer.

The NHS said it will begin immunising against the sexually transmitted infection, also known as ‘the clap’, in August.

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Health chiefs reckon they can prevent around 10,000 cases per year with an existing meningitis vaccine.

Cases have tripled since 2012 and hit a record 85,000 in 2023.

Local sexual health clinics will offer the jab to gay and bisexual men, who are most at risk.

Patients will receive the 4CMenB vaccine for meningitis B, which has been found to nearly halve the chances of catching gonorrhoea in adults.

The jab is already routinely given to babies to protect them from MenB, but its protection wears off as they grow up.

Vaccination could also head off growing concerns about superbug versions of the infection, which are resistant to antibiotics.

Dr Amanda Doyle, of NHS England, said: “The launch of a world-first routine vaccination for gonorrhoea is a huge step forward for sexual health.

“It will be crucial in helping to reduce the rising rates of antibiotic resistant strains of the bacteria.”

Gonorrhoea is a bacterial infection spread by unprotected sex.

Many people do not have any symptoms but if it is left untreated it can spread and lead to infertility.

It is the second most common STI in Britain by new cases per year, after chlamydia.

The vaccine rollout was approved by the Joint Committee on Vaccination and Immunisation (JCVI) after research by Imperial College London suggested it could prevent 100,000 cases and save the NHS £8million over the next 10 years.

Dr Sema Mandal, from the UK Health Security Agency, said: “In 2023 we saw gonorrhoea diagnoses reach their highest since records began in 1918. 

“Not only will this rollout protect those that need it most, but it will make the UK the first country in the world to offer this.

“STIs aren’t just an inconvenience – they can have a major impact on your health and that of your sexual partners.”

Public health minister Ashley Dalton added: “Once again our NHS is leading the way.”