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The Global Wave of Childhood Pneumonia

February 27, 2024

The news that Northern China is dealing with a mystery pneumonia outbreak in children was headlined in many news outlets worldwide. Chinese health officials failed to alert the world about a former novel coronavirus outbreak in 2003 (SARS) and 2019 (SARS-CoV-2). The WHO has stated: Chinese authorities claimed there has been no detection of any unusual or novel pathogens or unusual critical presentations so far, but only multiple known pathogens. 

It’s not only China that is dealing with increasing numbers of respiratory illnesses. The Netherlands and Denmark reported a sharp rise in pneumonia and whooping cough in children, while England is noticing a brutal cold virus in adults and children and Argentina reported a strep A breakout. Most recently in the US, a childhood pneumonia outbreak, dubbed white lung syndrome, has been reported. 

The culprit of the higher number of people affected at the start of this winter is most likely a dramatic degradation of the human immune system, which is a moresuitable environment for many opportunistic pathogens from bacteria to fungi to viruses to take over in human microbiota dysbiosis. 

The past years many people, and especially children, have lost their previous mental and physical strength. Chronic fear, anxiety, and pandemic measures have changed lives and driven more people into disabilities, poverty, and/or homeless, leaving them lonely, in hunger, and in cold. These conditions cause risk for pneumonia and sepsis.

The remarkable sudden fall in usual winter pathogens by pandemic measures needs investigation, as does the mysterious rise in pathogens that varies among areas. Immunity debt as the cause of a rise in respiratory illnesses remains questionable.

In time, treatment for pneumonia and sepsis is crucial as theymay cause death in a few days. As healthcare systems are overstressed with many at the brink of financial and organizational collapse and the number of people needing hospital and primary care is yet in pre-winter season much higher than in previous years, public health is in real trouble. 

There is no other way out than immediate actions to secure the availability of sufficient healthcare staff, safe and effective antibiotics, and/or effective natural treatments for early treatment. At the same time, restoring health to strengthen the immune system with affordable nutritious food and warmth is urgently needed for healthy generations.

Last month, local media reported that hospitals nationwide were seeing an increase in infections, with clusters of cases often emerging in schools and nurseries. Especially in the Northern part of China in cities Beijing and Lianiong, children’s hospitals were crowded with parents waiting for long hours for treatment of sick children with unusual symptoms that included inflammation in the lungs, high fever, and no cough. Many developed pulmonary nodules.

Sources of Epoch Times News reported children with white lung syndrome (Chest scans showing diffusely damaged lungs) were seen. This can be a result of infection by Streptococcus pneumoniae (Sp). 

A report from ProMed – a large publicly available surveillance system which monitors human and animal disease outbreaks worldwide – in mid-November alerted about the widespread outbreak of an undiagnosed respiratory illness. Up to now there are only a very few critical cases and no related deaths so far. The average number of days for patients in the hospital is around 14 days.

Official data provided indicate an increase in cases in Influenzavirus (flu), Respiratory Syncytial Virus (RSV), and Adenovirus since October while a rise in Mycoplasma pneumonia (Mp) known as walking pneumonia was noticed since May. Symptoms of walking pneumonia-which generally affects young children-include sore throat, fatigue, and a lingering cough that can last for weeks or months. In severe cases this can develop into pneumonia. Before Covid, Mp tended to cause major outbreaks every three to seven years in China. 

Physicians noticed that patients with multiple pathogens coexisting and lobar pneumonia, which affects one or more sections, is more frequently observed. Unfortunately, there is a fear of a growth of antibiotic resistance as more than 80% of Mp in children hospitalized in China is already macrolide-resistant. Antibiotic use in China accounts for half of worldwide antibiotic consumption, which mainly takes place in outpatient and community settings and often unnecessarily for self-limiting, community-acquired infections.

Chinese officials and scientists argue that the trend seen in China follows other countries, where strict pandemic restrictions led to weakened population immunity following years of suppressed transmission. In Taiwan, Mp is still circulating at low levels making up less than 1% of flu-like illnesses diagnosed in Taiwanese hospitals. But waves of respiratory diseases have been high after reopening and lifting pandemic measures in many countries all over the world.


The Netherlands

Soon after reporting on the uptick of childhood pneumonia in China, the Netherlands reported unusually high numbers of children hospitalized with pneumonia from unknown origin. Among the age 5-14 years, pneumonia is two times higher than the highest level reached last year. The number of children with pneumonia in the age 0-4 years is rising as well. The Dutch National Public Health Institute reports that there doesn’t seem to be a relation with the outbreak in China. Last week, the Netherlands reported more children with pneumonia and a rise of whooping cough, Bordetella pertussis (Bp), which is now higher than three years ago.

Denmark

On November 29 the Staten Serum Institute (SSI) reported Mp infections have reached the epidemic level, with an increase that started in the summer but has risen significantly over the past 5 weeks. In May and June (SSI) reported an increase in whooping cough with a proportion that was much larger than before the pandemic. An infant died from it this summer. Whooping cough, also called the 100-day cough, with only low fever doesn’t usually cause a danger for older children and adults. Whooping cough typically occurs with increased frequency every three to five years. The previous epidemic was in 2019/2020. 

Norway is also experiencing an increase in whooping cough, while cases have plumped during the Covid pandemic. It is expected that cases will rise in the coming year as the current acellular pertussis vaccine is less protective than the previous whole cellular vaccine. Norway is arguing to introduce vaccinating pregnant women and repeating vaccinations every ten years.

US and UK

Recently US officials announced flu cases are on the rise, and RSV infections may be peaking in the next week or so. RSV is a common cause of mild cold-like symptoms, but it can be dangerous for infants and older people. Reports came from Ohio and Massachusetts about white lung syndrome. Currently Covid-19 causes most hospitalizations and deaths among respiratory illnesses. In April 2023 the US reported Strep A infections remained 30% higher than the pre-pandemic peak in 2017. Argentina is reporting a Strep A outbreak.

Since August, 145 cases of pediatric pneumonia have been reported. Most of the children recovered at home with antibiotics, but infections have been more severe than in previous years. Illnesses were caused by various common bacteria or viruses (Covid-19, flu, RSV, and Mp).

Dr Mandy Cohen, head of the Centers of Disease Control and Prevention, stated that there has been zero evidence of this outbreak being connected to other outbreaks either statewide, nationally, or internationally. Today we believe this is not a novel pathogen. Advice from officials is to stay at home when ill, wash hands, cough in the elbow, and stay up to date with vaccinations. In several places mask mandates have been reintroduced.

Last week the newspapers in the UK reported a brutal cold virus, whose symptoms are worse than any winter bug, is sweeping the UK this month, leaving sufferers bedbound for days and housebound for weeks. The virus has symptoms, including fever headaches, blocked noses, coughs, and fatigue. 

This flu-like season arrives in many countries in times of a collapsing and exhausted healthcare system with increasing shortages of medical staff as compared to the previous year.

The ‘Immunity Debt’ Question

A trend chart of emergency hospital admissions of pneumonia in the UK, shows that while cases went up 50% the previous ten years, they suddenly dropped in 2021. In 2019 charities said the current figure was equivalent to six children being taken to the hospital every hour. Admissions were highest in the most deprived areas of England.

Analysis of UK data for all children aged 0-14 years admitted to NHS hospitals in England with an infection from 1 March 2-17 to 30 June 2021 found substantial and sustained reductions in hospital admission for all but one of the 19 infective conditions studied, while childhood immunization programs had been disrupted and emergency department visits delayed. 

Reductions were similar across all UK geographical regions, and ethnic groups, as well as among children with existing conditions who are at greatest risk of severe illness and death from infection. The authors of the article as well as an editorial at the British Medical Journal argue that the indirect effects of behavioral changes and societal strategies overall on children’s health are substantial, concluding that some pandemic measures like mask wearing had positive effects, although temporary. The authors recognized that school closures came with significant social and economic costs that are likely to increase health disparities.

While in contradiction with their observations, it was noted that the proportion of children admitted for pneumonia who died within 60 days increased. More recent data also indicate that some respiratory infections increased to higher levels than usual after May 2021. Strangely, there were more amoxicillin prescriptions during the summer of 2021 in the UK than in previous summers. 

In the Netherlands a strong increase (28%) in amoxicillin use was observed in 2022 as compared to 2021, while also 2021 showed an increase in antibiotic use as compared to the previous year. Antibiotics prescription is highest for elderly people (> 75 yrs) and relatively high for children (0-10 yrs).

Dynamics of increasing childhood infections seem comparable in other countries, albeit for different pathogens. In December 2022 the WHO reported an increase in invasive Group A streptococcal infections among children under 10 years of age in Europe including fatalities. In France and the UK the number of iGAS (infections usually cause mild illness including sore throat, headache, and fever, along with a fine red rash) in children has been several fold higher than pre-pandemic levels for the equivalent period of time. Observed increases reported to the European Centre for Prevention and Disease (ECDC) followed a period of reduced incidence of infections with GAS during the Covid Pandemic. 

In a race to control a tripledemic with a spike in RSV Covid and flu, hospitals in the US were close to brink in 2022. During several periods in 2021 and 2022 the US had consistently experienced RSV infections and related bacterial infections. In December 2022 RSV hospitalization was seven times higher than it was in 2018, the last full season before the pandemic. 

In the US important medical supplies have been repeatedly unavailable for purchase, with a national shortage for the antibiotic amoxicillin leaving parents in stress. In 2014 a WHO guideline for treatment of lower chest indrawing pneumonia with oral amoxicillin on an out-patient basis was released. Unfortunately, the US, Canada, and the EU have made themselves vulnerable and dependent on production of medicine by China. 

Even in wealthy countries, one in 56 babies who are born on time and are otherwise healthy will be hospitalized with RSV during their first year of life, although severe infection is seen most in premature infants and children with comorbidities. There are no drugs. Supplemental oxygen, intravenous fluids, or mechanical ventilation are needed until they get better. Having sufficient intensive care beds is crucial as the case fatality rate in untreated children with pneumonia is high, reaching 20%, and death can occur as early as 3 days after illness onset. 

Many countries including China are facing worse flu-like illness symptoms and pneumonia than in any previous winter, while until today no novel pathogen has been identified as the cause of the symptoms. The reason for an uptick of common pathogens in China causing more severe symptoms this winter season is explained by many officials and scientists as because of ‘immunity debt.’ 

However, the pandemic measures in the Netherlands, Denmark, the UK, and the US have been lifted before the previous winter season started, whereas this year infection rates with common pathogens are more severe and higher as compared to the 2022/2023 winter season. 


A Mystery of Diagnosis 

The reported sharp drop in emergency hospital admission for pneumonia in children in 2021 in many countries is remarkable. It is hardly possible to find explanations that the immune systems of deprived children who are at the highest risk for pneumonia and sepsis could strengthen during lockdowns, school closures, wearing masks, disrupted immunization schemes, delayed visits to medical doctors, and increasing poverty. 

Massive scientific literature supports the devastating effects of pandemic measures that come at high costs for children’s immune system and mental (depression, learning disabilities) and physical health that will take years or even generations to recover.

New studies found masks are linked with Covid infections, exposure to toxic compounds, and pathogenic bacteria and fungi. Finally a recently published systematic review on child mask mandates for Covid-19 in the BMJ concluded that ‘the current body of scientific data does not support masking children for protection against Covid-19.’ Children have been exposed to more disruptive circumstances as has never been seen before. The number of children in poverty has doubled during one year in the US.

After a 12-day visit in the UK this autumn, the UN rapporteur on extreme poverty stated: ‘UK government policies continue to entrench poverty and inflict unnecessary misery on millions of people.’ Unfortunately, all are cumulative, contributing to disrupt the precious human microbiota of children.

The cities Beijing and Lianiong, reporting high childhood pneumonia rates, followed the most stringent zero Covid policies in the world with quarantine camps built outside the city where people were isolated for up to 40 days with poor food and sanitation. In addition, in-house masking, use of disinfectant, fear, and anxiety for forced isolation in camps could have contributed to weakening children’s developing immune systems. 

The dramatic degradation of the human immune system with an increasing risk for infectious diseases, chronic diseases, and sudden death especially for children and young adults can no longer be ignored. Humanity Project Reports from Phinance Technologies, based on official data, are demonstrating alarming levels of excess mortality in children and young people in the UK, the Netherlands, and other European countries that started in the summer 2021 and continued to increase in 2022 in most age groups.

In 2022 the WHO sounded the alarm for a mysterious rise in acute hepatitis. While an adenovirus infection was thought to be responsible, no specific pathogen could be identified for all cases. 

Mixed viral and bacterial infections are common. However, bacterial infections are frequently underreported. Efforts to identify clinical features to better diagnose bacterial pneumonia have not been successful thus far. There are no reliable signs or symptoms that differentiate Mp infection in Community Acquired Pneumonia (CAP) from other etiologies. Additionally current diagnostic tests do not reliably distinguish between Mp infection and carriage. Moreover, inclusion criteria of certain tests might be a subjective judgement of pediatricians. 

Since the end of 2015 increased incidence of Mp infections have been reported across Japan, China, and England. But data obtained by the first global prospective surveillance study suggest Mp was the only absent respiratory pathogen after long periods with discontinued pandemic measures worldwide while during the same period infections with other pathogens resurged, indicating increased community transmission.

If Mp would resurge, it is suggested that it might affect the world population which has not been exposed to Mp for the past 3 years and result in an increase in rare severe disease and extrapulmonary manifestations. In the surveillance, Mp was not detected by a direct method, often used in pre-pandemic periods, but PCR tests or antibody tests. broad use of Covid-19 PCR tests for surveillance that showed it is difficult, depending on the Ct threshold used, to distinguish between infectious and an asymptomatic carrier.

It starts to be more complex as Chinese researchers state the clinical diagnostic standard for pertussis is not specific in China and differs among age groups. Similar to Mp, a high prevalence of macrolide resistant Bp was found in China in 2014-2016.

There are many differences in testing and treatments among countries and even among areas . A research project among Nordic countries on childhood vaccines, antibiotic prescriptions, and hospitalizations showed widely diverging practices and results. Protocols, transport medium, and methods may differ. It can affect the detection rate, and colder climate can be another reason. For example, Mp infection positively correlates with temperature. Infection rate of Mp gradually increased with the increase in the minimum temperature. Sp is also a seasonal phenomenon.

During the pandemic, coinfections with bacterial pathogens have been underestimated due to limited testing and a low sensitivity of the tests used. Retrospective research suggests that rates of mortality, ventilatory support, and length of hospital stay were significantly worse in patients with a coinfection of SARS-CoV-2 and Mp. A German study showed an increase in respiratory viruses not being SARS-VoV-2 and coinfections with Sp in 2021. In the second half of 2021 near pre-pandemic levels were reached for patients > 60 years. Previous studies showed if Sp coinfection was present; this was associated with a high case-fatality.

To reduce childhood deaths early identification and prompt treatment are essential. The absence of more specific diagnostics for pneumonia hinders both the rational application for treatments and appropriate antibiotic stewardship. As it is clinically impossible to differentiate viral from bacterial pneumonia, prompt treatment of clinical pneumonia with antibiotics will remain a priority for the foreseeable future. Unfortunately, the backslash is that treatment with antibiotics will disrupt the childrens’ microbiome/immune system and if not treated well increase a risk for future chronic diseases.


A Call to Action to Save Children’s Lives

Childhood pneumonia is known to be an important leading cause of death of children in mostly developing countries and deprived areas, and for children with comorbidities. Despite the many programs initiated to reach near zero ventilator-associated pneumonia, the world post-Covid pandemic is facing an alarming rise in childhood pneumonia. A recent paper showed that socioeconomic deprivation, comorbidity, learning disabilities, and a history of extensive antibiotic exposure are associated with developing non-Covid 19 related sepsis (sepsis occurs when the immune system overreacts to an infection and starts to damage our own tissue) and 30-day mortality in England.

Opportunistic pathogenic bacteria like Streptococcus is one of the pathogens that could possibly play an important role. Although childhood pneumococcal vaccines are available, increased risk of infection often with serotypes that are not covered or escape vaccines are seen in children most at risk. Moreover, repeated use of antibiotics may have disrupted a child’s microbiota that may increase the risk for long-term health impacts.

Chinese researchers recently suggested a relation of human microbiota dysbiosis and bacteria like Streptococcus and Prevotella and the potential to predict prognosis of infectious diseases. The immune system and children’s microbial dysbiosis and the role of opportunistic pathogens are an emerging field of discovery. In a previous article published at Brownstone Institute a hidden role of Sp in pandemics and human microbial dysbiosis and diseases has been explored.

For many children time will be too short to await research for the whole picture to solve. Each mandated intervention from mask mandates to vaccine injections without a check on the child’s health condition and informed consent could be the final drop to exacerbate the disbalance of the microbial population into severe disease, sepsis, or sudden death. 

For Public Health Authorities and medical doctors, this is an urgent call to acknowledge the risks of mandates and disruptive effects of poverty, malnutrition, hunger, cold, fear, and anxiety on the child’s immune system/microbiota. From history it is known that early treatments for imbalances are the best way to keep a precious balanced child’s immune system, a prerequisite for healthy generations.

Author: dr. Carla Peeters

First published at Brownstone Institute



The (Lack of) Health in Young Women

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

The Alarming Increase in Female Healthcare Worker Suicide

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