A neurologist said you should never ignore this

A neurologist has warned about a particular type of headache that could “kill you in hours”. He stressed that people “should not ignore” this headache, as it may be triggered by a potentially deadly infection.

Headaches are relatively commonplace. They can stem from colds or flu, dehydration, stress, vision issues, and skipping regular meals among other causes.

However, in certain instances they can indicate something far more severe. In a video posted to social media, neurologist Dr Baibing Chen cautioned that a headache resulting from meningitis is an “emergency”.

He said: “This headache can kill you in hours. And these are the warning signs that you should never ignore. Now, I want to say most headaches are not emergencies, but meningitis is different.”

Meningitis is an infection affecting the protective membranes surrounding the brain and spinal cord. It can prove extremely serious and potentially fatal if not treated promptly. Dr Chen continued: “And it can be caused by things like viruses, bacteria, or even fungi.

“The bacterial form of meningitis is the one that scares us the most because it can become life-threatening very quickly. And that’s also one reason vaccines against bacteria like haemophilus, influenza type B, pneumococcus, and meningococcus have saved countless lives by preventing some of the most dangerous forms of bacterial meningitis.”

If you develop a headache alongside other meningitis symptoms, immediate medical attention is essential. Dr Bing explained: “The classic symptoms of meningitis are a severe headache, a high fever, a stiff neck and sensitivity to light.

“Some people also become confused, extremely sleepy or develop a purple rash that doesn’t fade when you press on it.”

The NHS website characterises a meningitis headache as “a severe headache that is getting worse”. Dr Bing cautioned that in its initial stages, meningitis may not present as a serious condition. He stated: “Early on, meningitis can look a lot like common viral illnesses.

“And that’s one reason people sometimes wait too long before seeking medical care. So if someone has these symptoms, especially if they’re not vaccinated, go to the emergency department immediately because getting evaluated and treated early gives doctors the best chance to identify the cause and start the right treatment as quickly as possible.”

Causes of meningitis

According to the NHS, meningitis can be caused by many different types of viruses or bacteria, which are spread through close contact with a person who has them. For example:

• Contact with the person’s spit, such as kissing them, or sharing drinks or vapes
• Being in close contact with the person for a lot of time, such as living in the same home

The infection is usually spread by people who carry these viruses or bacteria but are not ill themselves.

Although anyone can get it, meningitis is more common in:

• Babies and young children
• Teenagers and young adults
• Older people
• People with a weakened immune system – for example, people with HIV or having chemotherapy

It’s important to note that it’s possible to get meningitis more than once.

When to call 999

The NHS says you should call 999 or go to A&E if an adult or child aged five years or over:

• Has a very high or very low temperature, feels hot or cold to the touch, or is shivery
• Has a very painful headache
• Is confused, has slurred speech, or is not making sense
• Has a stiff neck and cannot look at bright lights
• Has a rash that does not fade when you press it
• Has a seizure (fit) for the first time
• Has symptoms you’re worried might be meningitis

You should also call 999 if a baby or child under five years:

• Has a very high temperature – 38C or more in babies under three months old, or 39C or more in babies three to six months old
• Has a very low temperature – less than 36C, or feels cold to the touch or is shivery
• Has a weak, high-pitched or continuous cry
• Has a rash that does not fade when you press it
• Is not responding like they normally do, is not feeding, or is floppy, difficult to wake or more sleepy than usual
• Has symptoms you’re worried might be meningitis

For more information, visit the NHS website here.

LA GUAIRA, Venezuela (AP) — The situation has grown more desperate by the hour in Venezuela as people dig through the rubble of collapsed homes and apartment buildings three days after the devastating one-two punch of 7.2 and 7.5-magnitude earthquakes, knowing time is running out to find survivors.

Authorities announced Friday night that they would block access to La Guaira, the epicenter of the destruction, as chaos and traffic began to hamper search efforts. Officials said anyone who wants to enter would now have to seek official permits, but provided few details of who would be allowed in.

Venezuelans took the search for missing loved ones into their own hands, citing a scarcity of government rescuers, as the human toll of Wednesday’s quakes climbed to at least 920 dead and more than 51,000 missing. People reported seeing few state rescue teams in the hardest-hit areas, despite authorities projecting an image of a robust government response.

Aid agencies consider the first 48 to 72 hours to be a crucial time frame to retrieve people alive, though that can be extended if they have access to food and water.

“Each person saved is a miracle,” said Jorge Rodríguez, president of the National Assembly. “We are not going to hide absolutely anything about the magnitude of this tragedy.”

Anxious families wait to see if relatives survived

In the state of La Guaira, just north of the capital, Caracas, Nazareth Jimenez sobbed into a loved one’s shoulder as she watched neighbors use hammers and power tools to try to cut through slabs of concrete in a building reduced to a mountain of debris. She was wracked with anxiety as she waited to see if her siblings, nephews, nieces and friends would emerge alive.

“My God, how are we going to get them out of there?” Jimenez murmured.

“We’re making a call for help to the government and countries across the world,” she said, pleading for machinery capable of moving collapsed structures. “There are still people alive in there.”

Government forces distributed food and water to survivors in La Guaira, and acting President Delcy Rodríguez said her government was mounting a full response during these “critical hours for rescuing people alive.”

She welcomed the arrival of international rescuers and humanitarian aid. She said La Guaira had been militarized and more help was on the way, even as residents said it was just a fraction of what they needed.

The disaster poses a huge challenge for Rodríguez, the former vice president who took office in January after the capture and removal of then-President Nicolás Maduro by the United States. Venezuela has been facing economic disarray for more than a decade, and many people reject the legitimacy of the political movement Rodríguez represents.

The number of dead was expected to climb, and people reported tens of thousands of missing on independent digital databases. Those figures likely included people who have been incommunicado due to the lack of cellphone signals, and some reports may be duplicates.

The number of injured was more than 3,300 as of midday Friday, and authorities said they rescued 243.

Millions of people reeling

The International Organization for Migration said up to 6.76 million people could be affected, some 2 million of them in Caracas alone. The destruction was amplified by the quick succession of shallow quakes, experts said.

Loyce Pace, the International Red Cross’ regional director for the Americas, said “people are still terrified to reenter what were their homes.”

Indeed, many continued to sleep on the street.

Omar Reyes said around 20 family members died.

“I’ve been left alone in this life,” Reyes said, walking through the rubble where two of his children were buried.

In the city of Maiquetia, people lined up outside stores and pharmacies that served them one by one behind closed doors. At one point a woman in a crowd threw herself to the ground to protect a package of diapers with her body, desperate to keep it.

Traffic and throngs of motorcyclists at times disrupted search efforts. Mexican soldiers and volunteers repeatedly asked for silence to try to hear signs of life under the rubble, but bikers — civilian and uniformed — continued to honk horns and rev engines to the first responders’ frustration.

Some people began to carry off basic goods such as toilet paper and food from stores in Catia La Mar, adjacent to the country’s main airport. Others swarmed a civilian pickup truck that was giving out bread and water, until a soldier intervened. The parking lot of a pharmacy turned into a makeshift shelter with tarps, hammocks and tents.

A few miles away, Yuleidy Cadenas, 28, stood across the street from a collapsed public housing building, hoping her son, mother and brother would be pulled out alive.

She fled barefoot from another building as it collapsed Wednesday and found her mother’s 12-floor apartment tower had pancaked.

“I got on top of the rubble and told them to yell back, and nobody did, not my brother, nor my son or my mother,” Cadenas said.

International aid on the way

Venezuelan authorities said Friday that 861 volunteers from Mexico, the U.S., El Salvador, Switzerland, Colombia and beyond were in the country, and more were coming from elsewhere.

Acting President Rodríguez said she spoke to U.S. President Donald Trump and Secretary of State Marco Rubio on Friday and they reaffirmed their commitment to send rescue teams and aid equipment.

___

Janetsky reported from Mexico City. Associated Press journalists Clara Preve in Buenos Aires, Argentina, and Dánica Coto in San Juan, Puerto Rico, contributed.

Manchester United are in the midst of a midfield rebuild after losing Casemiro and now Bruno Fernandes’ future plans are in focus

Manchester United have already shown signs of this being an action-packed transfer window, and there could be a great deal more to come. Several high-profile players have confirmed their departures, and further ins and outs are anticipated.

On the incoming front, Ederson appears set to become the first of several big-money arrivals, with an eight-figure deal to bring in the Atalanta midfielder virtually sewn up. A number of permanent departures have already been rubber-stamped, with Rasmus Hojlund and Casemiro the most notable, while Andre Onana is set for another year on loan at Trabzonspor rather than a permanent switch.

Last summer saw Marcus Rashford and Bruno Fernandes dominate the headlines, and the pattern continues this year. Rashford’s spell at Barcelona on loan failed to produce a permanent transfer, leaving his future uncertain, while captain Fernandes rejected a move to the Saudi Pro League in 2025 but remains the subject of speculation.

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There is also fresh news surrounding another of United’s midfield targets as the squad rebuild gathers pace in the wake of Casemiro’s departure. Here are our latest updates from around Old Trafford.

Fernandes makes decision on future

Bruno Fernandes has informed his Manchester United team-mates that he intends to remain at the club, according to talkSPORT. A definitive verdict on the captain’s future is not anticipated until after the World Cup, though there is understood to be little concern that he could depart.

The Portugal international attracted interest from a number of Saudi clubs last summer but opted to remain where he was. Fresh reports have emerged of renewed attention from Gulf clubs this year, most notably Al Nassr, who could have the midfielder’s international manager Roberto Martinez in the dugout next season.

However, Fernandes’ decision to stay put is understood to be driven by family considerations and is therefore unlikely to shift.

The 31-year-old has started both of Portugal’s opening two World Cup group stage fixtures, registering an assist in the 5-0 thrashing of Uzbekistan. Martinez’s side require a victory in their final group match against Colombia to claim top spot, though they are still all but certain of a top-two finish even if they lose.

Nmecha won’t come cheap

Germany international Felix Nmecha is amongst the midfielders being considered by United as they look to bolster their engine room following Casemiro’s departure and a potential exit for Manuel Ugarte. However, landing the 25-year-old is likely to set them back a pretty penny.

Nmecha came through the ranks at Manchester City as a youngster and represented England at youth level, meaning he would qualify as a homegrown player. The asking price could prove a big obstacle, though, with Kicker reporting that his contract contains no release clause and his club Borussia Dortmund value him at £86million.

The 25-year-old was used sparingly during Germany’s World Cup qualifying campaign but has been a consistent presence for Julian Nagelsmann throughout the tournament itself, starting all three group stage matches and marking his major tournament debut with a goal in the 7-1 rout of Curacao.

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Police made the arrest after attending a quarterly Partners and Communities Together (PACT) meeting, where residents reported suspected drug activity on Old Road.

Officers later searched a man on Eden Street, located off Old Road, and arrested him on suspicion of possession with intent to supply class A drugs.

Eden Street is usually a more quiet street, home to residential flats for pensioners and Astley Bridge Cemetery.

The man remains in police custody for questioning.

A spokesman for Bolton GMP said: “Yesterday evening, the Bolton North Neighbourhood Team held the quarterly Partners and Communities Together (PACT) meeting.

“The PACT meeting is an opportunity for the community to raise concerns about crime in their area with the police, local councillors and the council.

“One concern raised by the community was around people supplying drugs on the street in the Old Road area of Astley Bridge.

“After the meeting, officers from the Bolton North Neighbourhood Team searched a man on Eden Street (off Old Road) suspected to be involved in supplying drugs in the area.”

Manchester United plan to sign a third midfielder during the transfer window, as long as they can find a buyer for Manuel Ugarte.

United are working on a deal for a second midfielder at the moment, at which point the focus is expected to turn to other positions, with the need to sign a left-sided player high on the agenda.

But United are willing to listen to offers for Ugarte this summer and if strong enough interest emerges to sanction a deal for the Uruguayan, they will turn to the market again.

Leeds United look to take the next step in their progression in the summer transfer window with one Champions League star a key target for the Premier League side

Leeds United are firmly in the running to land Germany midfielder Julian Brandt who is set to become a free agent in just three days’ time. The 30-year-old will officially part ways with Borussia Dortmund on June 30 after seven years at the Bundesliga club.

Brandt is widely expected to be one of the standout players available on a free transfer this summer window – handing Leeds the opportunity to snap him up at no cost. The Premier League outfit have already looked into the possibility of a deal, and securing his signature could prove to be a remarkable piece of business for the club.

Landing a player of Brandt’s calibre and pedigree would undoubtedly represent a stunning coup for Leeds. The attacking midfielder rounds off a campaign in which he helped Dortmund finish second, contributing seven goals and four assists in 29 league appearances.

Although it wasn’t sufficient to earn him a place in Germany’s 2026 World Cup squad, the 43-cap international’s quality and versatility would significantly bolster Farke’s attacking options.

Predominantly a number 10, Brandt has featured in over 200 matches across both flanks – with the majority of those coming on the left – yet operated exclusively behind Dortmund striker Serhou Guirassy throughout the past season. A creative midfielder has been high on Leeds’ wishlist, having already secured their long-pursued right-wing target Harry Wilson on Wednesday, according to The Athletic.

Wilson, 29, and the potential signing of Brandt, 30, would represent a shift in transfer approach for Leeds, who last season focused on bringing in players approaching their prime – rather than those who may have already reached it.

Nevertheless, landing a player with 82 Champions League appearances and two World Cup campaigns to his name would be a remarkable piece of business and one that could propel Leeds to the next level. That said, such an impressive list of achievements means Brandt will have no shortage of admirers.

The likes of Roma, Lazio and Galatasaray have already been credited with an interest in his signature, but the prospect of linking up with fellow German Farke and experiencing English football for the first time could prove decisive in the battle to secure Brandt.

The Whites manager has made no secret of his desire for another versatile number 10 alongside Brenden Aaronson since last year. Farke said last August: “There’s always room for more quality. Wingers who can work hard and are good against the ball, disciplined, wingers who are quick and good one vs one, wingers who can play like a 10. This (latter option) would be a good solution for us.”

The American now has 12 months remaining on his deal and Farke’s demands have grown more urgent as the new campaign draws closer. Leeds’ transfer activity last summer focused on strengthening the squad with 10 first-team additions, whereas this summer involves a smaller pool of targets that would likely prove more exciting to supporters.

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A league-high 92.8% of the club’s squad last season fell between the ages of 23 and 29, and while overlooking that for the acquisitions of Brandt and Wilson – with the latter turning 30 next March – it could prove a move that propels Leeds beyond 14th in the standings.

With Brandt poised to become a free agent and Farke requiring quality in his position, he could represent the ideal summer capture.

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Wales’ new Deputy First Minister is responsible for many of the policy areas that Nigel Farage’s party has attacked in the early days of the new Plaid government

It is still only a matter of weeks since the ballot boxes were tipped onto tables at leisure centres and venues across Wales and Plaid Cymru knew the threshold it had set itself had been crossed to form a minority government led by Rhun ap Iorwerth.

His second in command is Sioned Williams. The 54-year-old is a former BBC journalist who previously worked for the party in communications. In both of those roles she crossed paths with her party’s now-leader but the pair go further back than that having met when she was 17 at the Cwrs ddrama Urdd.

“I’ve known him as long as my husband,” she laughs, as we meet in the Senedd. Yet she says she never expected he would appoint her as Deputy First Minister.

“Our paths have crossed many times and we’ve known each other a long time so we’ve got a very good relationship and it was the honour of my life to be asked and I’m absolutely delighted to be able to support him,” she says.

Her chance to get to take that role came as a result of a historic win for the party she has been a member of since she was a student.

Plaid Cymru won 43 of the available 96 seats.

“There was a long preparation period for us running up to this election,” she says.

“We were working extremely hard on policy development knowing that it was going to be a four-year term, knowing that finances were going to be constrained [and] we weren’t going to able to do everything that we’ve been talking about for the last 100 years so getting that really tight focus on what we thought really mattered what was important,” she says.

“We also knew that this was going to be an election like no other for all kinds of reasons so we fought the campaign of our lives.”

The result was, she admits, at the “top end” of the party’s expectations and she was personally thrilled it would not only mean they had representation all across Wales but there was a good gap between them and the second-placed party, and official opposition, Reform UK.

Reform UK has dominated the early days of the Senedd. An exchange between one of their new members, Joe Martin, with the First Minister about the Nation of Sanctuary followed by their choice of cutting all international spending as topic for an opposition day debate led to a walkout of politicians from Plaid, the Greens, and Labour.

Equality, community cohesion, and Wales in Africa are all things that fall under her brief and she is already hearing concerns about the topics and tone being used in this seventh Senedd. Is she surprised?

“I’m not surprised that Reform are latching onto things that they know will be inflammatory, things which I think that they’re misrepresenting, policies they’re misrepresenting, expenditure that they are misrepresenting, and missing the wider point of the effect of some of the rhetoric,” she says.

Aside from those two issues Reform UK did scrutinise the new government’s flagship childcare bill, which is “absolutely their job as opposition”, although she says “it did feel rather strange that they’d pick that when they hadn’t even mentioned childcare in their manifesto”.

There is, she says, “much that needs to be done” to help people in their everyday lives. “To be choosing those issues for debate I would say is rather missing the point of an effective opposition,” she says – but adds the party will stick to its own values.

“The decisions we make, the policies that we’ll enact, will show those values and those are the values that have been supported by the majority of people in Wales who elected us as their government.

“That’s how we will demonstrate where we sit on those issues. I understand, having said that, the strength of feeling [that led to the walkout].

“It is shocking to many members, especially perhaps newer members, but to all of us the level and the language and the rhetoric that has been used.

“I hope that the Llywydd will be able to make sure that we don’t see a continuation of the type of language.

“I personally was accused of something which is completely untrue, my position completely misrepresented. This has real-life impact obviously for us as politicians, especially as female politicians online, but also more broadly about people who are minoritised, who are marginalised, and who are impacted. Their lives and their safety is impacted by this type of rhetoric.

“As the First Minister said we are all about uniting our communities, strengthening our communities, celebrating the diversity in our communities – that’s the Wales we want to see. So we will demonstrate that through our actions but also, yes, I think we have to make sure that we don’t see a type of rhetoric allowed to become normalised in our national parliament.”

The things she wants to talk about are the things that drive her to be a politician. In the last Senedd regular viewers would regularly see her passionate contributions to debates about children and poverty and holding onto the brief she had when she was in opposition was non-negotiable.

“This is really the reason I’m in politics,” she says.

Elected for the first time aged 49 she had been a member of Plaid Cymru since she was a student. Her political journey came via her community council before being chair of her local Cylch Meithrin, then chair of school governors, and campaigning on local issues.

“I wasn’t really active in the party until Leanne Wood became leader 14 years ago because I saw a passion in her and coming from the South Wales Valleys as I do that’s where my politics comes from,” she said.

Both her grandparents were miners while one grandmother died at 50 from asthma, likely from the conditions she lived in, and the other was an uncertified teacher.

She and her sister were the first in their family to go to university.

“So I understand the impact that poverty can have in and just closing off those opportunities. That’s where my politics comes from so this portfolio is really why I’m here. Without these issues to fight on I don’t know if I would be here in elected politics.

“It’s a huge honour and that’s why I am absolutely determined to achieve what I can for those people in Wales who, through no fault of their own, don’t have the same opportunities as everybody else,” she says.

Since the election there have been murmurings that Plaid was backing down on its flagship policy and then there was a very public row after an attempt to force them to release their costings backfired in the Senedd.

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So I ask her to spell out what is the government’s position on childcare. By the end of this four-year term, in 2030, what is her aim? “I want 20 hours for every child offended from the age of nine months to four years,” she states simply.

“I am absolutely thrilled to be talking about childcare.

“I have been wanting to talk about childcare – as a feminist, as a female politician, as someone who believes in social justice and equality and also believes that the children are the future of our nation and we need to be supporting them and condemning them to high levels of child poverty in Wales – for years and years and years.

“We understand that this is an intervention that is fully in the power of the Welsh Government to make.

“It more than pays for itself. It is a complex policy because of the system we’ve inherited, which committee report after committee report, anti-poverty organisations, equality organisations have demonstrated in report after report, isn’t currently working for children and families in Wales.

“What I want to do, and we have to do this in a phased way because it’s so complex, is make sure that we have a uniform, universal offer funded for all families between nine months and four years,” she says.

She would have said that before the election, I put it to her, so now she is in office and has spoken to officials, has seen the books, is it still realistic? “It is realistic,” she says, pointing to a recent announcement about extending childcare. But surely that was that something that would have happened anyway?

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“This was a programme that was initiated, first of all, under the cooperation agreement [with the last Labour government] because we put that first and foremost as one of our policies, along with free school meals.

“It was initiated in the last government. It wasn’t completed. It didn’t have adequate focus or funding. So what we saw [is] it wasn’t achieved so the first step that we wanted to do was make sure that that was achieved because the local authorities already have plans in place for that. They just haven’t been given the direction or funding that they needed in order to be able to complete it,” she says.

She references one of the key questions, aside from finding the money, which is finding a workforce.

“This is one of the work streams that we have obviously. We absolutely know that the workforce are key to this expansion,” she says.

“But there’s also other things that we can do. We know that at the moment people have to move settings, for instance, in order to be able to access their entitlement under the two years so what we want to do is look at the whole system. I’m not just talking about adding hours here and there – I want to transform this system so it is one system and that it is in the best interest of the children and families who need to access that system.”

“I couldn’t just announce funding and say: ‘There will be more hours’. We absolutely recognise that. It is about working in partnership with local authorities. We’ve got a skills audit happening.

“My colleague Cefin Campbell is looking at post-16 education making sure that we are preparing the pipeline. But we also know that it is about giving assurance to providers and to local authorities – all the partners that are key and fundamental in this, the education sector – bringing people in who currently their qualifications aren’t recognised for instance,” she says. For our free daily briefing on the biggest issues facing the nation, sign up to the Wales Matters newsletter here

She adds there is nothing she has learnt since getting into office that makes her think she will deliver a policy different to what was spelled out in the manifesto.

The new government has been criticised for ordering data, reports, and audits. “I think it’s about doing things sustainably and responsibly and there is a lot of data gaps.

“We’ve got a certain focus on our key priority areas as a party and in order to make progress on those we need to have an absolutely comprehensive view of what we’re dealing with.

“We need to work to better understand what some of those data gaps are,” she says.

“We have made it very clear we want to work on the basis of evidence. We also want to work transparently and we need to work responsibility, ground all our policies in the reality that is in front of us, not make empty promises”.

The childcare policy will, she says, make a difference. “This can help all children get the best start in life and get the best start towards their education journey.

“We know that’s not a level playing field. It can also help families who are currently in poverty to be able to increase their income, that’s economic inequality, and then we know of course gender inequality.

“This mainly impacts women and I’ve had experience of this myself. I was earning more than my husband when we had children. I didn’t catch up until I was 49 and I had my first when I was 30. So we know that this impacts women mainly and I’m really clear about the effect that it can have on our society broadly and especially obviously our children, the difference that this policy can make.”

She has already spoken in the Senedd chamber about Cynnal, a Welsh child payment, providing £10 a week for children aged from birth to six in households claiming universal credit. “Evidence has shown that this is one of the key interventions that can be made.

“Scotland has shown the way on this – it’s undeniable evidence. So we want to show the difference that a policy like this can make. Because of the fact that we don’t have the same powers as Scotland currently over the benefits system and welfare payments we have to do this as a pilot but I think that we can demonstrate the impact this can have and it’s about reaching those children who are in the deepest poverty,” she says.

She hopes it will help 15,000 children across different backgrounds and areas of Wales. For some families it will mean being able to go to a cinema or theatre, to have swimming lessons, to be able to say yes instead of no to a birthday party because you can’t afford to buy a present.

“Those everyday childhood experiences that every child should have this hopefully could just make an impact around that and we know it’s those direct cash payments that make the difference,” she says.

For most people, a hot summer’s day is uncomfortable. For someone with scarred lungs, it can become a medical risk.

People living with interstitial lung disease (ILD) are especially vulnerable during extreme heat. As climate change drives more frequent and intense heatwaves, people with ILD will need better protection from hot weather and related health risks.

ILD is an umbrella term for more than 200 lung conditions. These conditions cause inflammation, the body’s immune response to injury or irritation, and fibrosis, which means lung scarring. As scar tissue builds up, the lungs become stiffer and less able to transfer oxygen into the bloodstream, making breathing harder.

Many ILDs, particularly idiopathic pulmonary fibrosis (IPF) – a form of lung scarring that develops without a clear known cause – affect people over 65. Older adults with ILD often also live with other long-term conditions, such as heart disease, diabetes, high blood pressure or chronic kidney disease. These can reduce the body’s ability to cope with stresses such as extreme heat.

Hot weather forces the body to work harder to stay cool. The heart pumps more blood towards the skin, breathing can become more difficult, and oxygen demand may increase. For people with ILD, whose lungs already struggle to supply enough oxygen, this can lead to worsening breathlessness, fatigue and reduced exercise tolerance.

Dehydration, which is common during heatwaves, can cause weakness, dizziness or low blood pressure. This can be a particular problem for older adults taking medicines such as diuretics, often known as water tablets, which help the body get rid of excess fluid.

Heatwaves can also bring environmental hazards. Higher levels of ground-level ozone, a harmful air pollutant formed when sunlight reacts with emissions from vehicles and industry, can irritate the lungs. Wildfire smoke and airborne particles, meaning tiny pieces of pollution in the air, can also worsen breathing symptoms. A 2026 review concluded that these exposures may trigger flare-ups and could contribute to disease progression by increasing inflammation and biological processes linked to lung fibrosis.

Risk reduction

There are practical steps that can reduce the risks.

People with ILD should check local weather forecasts and heat-health alerts during hot weather. It can also help to make a simple plan: who to contact if symptoms worsen, where to go if the home becomes too hot, what to do during a power cut if using oxygen equipment, and how to get medical advice.

During extreme heat, people with ILD should avoid being outdoors during the hottest part of the day. For people with moderate to severe ILD, fatigue is often already a limiting factor. Essential activities are best planned for the early morning or evening, when temperatures are lower.

Keeping indoor spaces cool is equally important. Closing curtains or blinds during the day, improving ventilation during cooler evenings, and using air conditioning where available can help maintain a safer indoor temperature. Fans may also help some people manage breathlessness. A small pilot study of handheld fans in people with ILD found that some patients considered them useful for breathlessness relief, although they should not replace medical care. Where air conditioning is unavailable, public buildings such as libraries, community centres or shopping centres may provide a cooler refuge.

Staying hydrated is another important measure. Drinking water regularly helps replace fluid lost through sweating, although people with heart failure or kidney disease should follow advice from their healthcare team if they have fluid restrictions.

People with ILD should continue taking prescribed medications exactly as directed. Antifibrotic medicines, which are drugs used to slow lung scarring in some types of ILD, remain important during hot weather and should be stored according to the manufacturer’s recommendations.

Those using home oxygen should ensure they have an adequate supply. People who use an oxygen concentrator, a machine that takes oxygen from room air and delivers it through tubing, should know what to do during power cuts. Oxygen equipment should also be kept away from heat sources.

Some people with ILD use home spirometry to monitor lung function between clinic visits. Spirometry is a breathing test that measures how much air a person can blow out and how quickly. While home spirometry can provide useful information, it should not be interpreted in isolation, especially during a heatwave. Qualitative research has shown that patients value home spirometry but can find fluctuating results difficult to interpret without support. Heat, dehydration, fatigue or difficulty blowing out the fullest possible breath may also affect readings.

Instead of focusing on spirometry alone, people should pay attention to the bigger picture. Increasing breathlessness, needing more oxygen than usual, walking shorter distances, worsening cough, unusual fatigue or finding everyday activities more difficult may all be signs that the body is struggling with the heat. These changes should prompt discussion with a GP, specialist nurse or ILD team.

Because many people with ILD are older and may live alone, support from family members, neighbours and carers becomes important during heatwaves. A simple phone call or visit to check that someone is staying cool, drinking enough fluids and coping with symptoms can make a significant difference.

People should also know when to seek medical advice. Worsening breathlessness, increasing oxygen requirements, chest pain, confusion, fainting, fever or symptoms that do not improve with rest should never be ignored. Early assessment can help identify an exacerbation, also called a flare-up, which is a sudden worsening of the condition. Prompt treatment may help limit serious complications.

As the climate continues to warm, healthcare will need to adapt to protect people who are especially vulnerable to heat. Helping people understand environmental risks, prepare for extreme weather and recognise changes in symptoms will become an essential part of living well with ILD.