Home » Expat Focus International Healthcare Update February 2024

Expat Focus International Healthcare Update February 2024

InterNations: Expat Age Report

As part of the annual Expat Insider survey, InterNations has recently released statistics relating to the average age of expats in 2023. The highest percentage – 18% – consists of expats over the age of 61, with those aged 36-40 in the next bracket at 14% (the average age of an expat is 46.2).

Explaining these stats isn’t rocket science: retirees make up a significant percentage of those who relocate abroad, in search of a sunnier climate, an easier pace of life and a lower cost of living. Joining family may also be an incentive for those who relocate to some regions, such as Australia or Canada, for instance.

The figures also show the importance of healthcare: an older demographic will, inevitably, need to address issues such as primary care, age related illness, and health insurance. 

‘Nolotil Hell’

Back in the autumn, we reported on the phenomenon of illegal and fake painkillers in Mexico and Spain, with over-the-counter remedies turning out to contain illegal substances, and even legal prescription medication turning out to have dangerous side effects. Since then, a number of expats have come forward to the UK press with horror stories about their experiences with the painkiller Nolotil, part of the metamizole family of drugs.

One elderly British woman was given Nolotil after knee surgery at a private hospital in Valencia and suffered an extreme reaction, including complete organ failure and a pulmonary embolism. Despite issuing guidelines for the prescription of Nolotil and metamizole in 2018, it seems that health centres across Spain have been ignoring this advice – with fatal consequences. The drugs are already banned in 30 countries, including the UK, and in Spain, they are supposed to be available only on a prescription basis. However, a journalist from the Observer, was able to buy metamizole over the counter in a pharmacy in November 2023, in the Costa Blanca. 

In late January, the Guardian reported on the death of 42-year-old Mark Brooks, who died after an injection of metamizole for shoulder pain. The newspaper estimates that the drug and its variants have been involved in over 40 deaths in Spain, including a number of British citizens, dating back to 2006. Metamizole and its derivatives are known to cause agranulocytosis, a condition which reduces white blood cells and which can therefore leave the body open to sudden severe infections.

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Cristina García del Campo, who leads the Association of Drug Affected Patients, told the press that a proper medical study needed to be conducted on the effects of metamizole and its derivatives:

“Most of the cases of adverse drug reactions from metamizole are never reported. Until a proper study is done, they should withdraw the drug or only administer it under the tightest restrictions and with proper monitoring.”

In the meantime, we suggest that if you’re in Spain, you should avoid taking this drug, and if you are admitted to hospital, double check that they’re not prescribing or handing out metamizole or associated medication. 

Healthcare Charges For Expats in Italy

In November, we reported on the Italian parliament’s plans to bring in a flat fee for healthcare registration for non-EU nationals. We noted that this initiative might be overturned, but although it may still face some amendments, it now seems likely that it will get through legislative stages, replacing the old system of income-based charges. Now, no matter what your income, you’ll have to pay €2,000 to register with the Italian healthcare system. 

However, there are some exemptions: If you’re self-employed or an employee of an Italian company, you won’t have to pay the new flat fee. It could affect pensioners, and it will inflict a steep rise on students and au pairs. 

Covid: Spain May Introduce Mask Wearing Rule for Hospitals

Spain, following the example of Malta, has introduced mandatory mask wearing in hospitals. Masks are not yet compulsory outside hospitals, although the government is said to be considering the move. This year, however, the concern about infection rates applies to flu as much as to Covid itself, with a 75% increase in cases in the post-Christmas period. The Spanish authorities are recommending that people should be allowed to self-diagnose and take three days off work rather than needing a note from the doctor. Healthcare unions have told the press that hospitals in some regions of Spain are at saturation point. 

In Italy, flu in December was running at 17.5 cases per thousand people (around 2 million people overall), with doctors reporting a reduced uptake in the flu vaccine. Health authorities also report a high number of patients hospitalised with flu, which in some cases can turn to pneumonia. Meanwhile, the Portuguese health authorities are also reporting record numbers of cases of flu, France and Germany have commented on significant upticks in patient numbers, and overall, Europe is said by some to be facing a ‘tridemic,’ of Covid, flu and RSV (respiratory viruses).

The European Centre for Disease Prevention and Control has issued warnings, saying that immune resistance has been lowered by lockdowns during the pandemic. However, doctors note that the term ‘tridemic’ must not be taken to mean that patients are suffering from all three illnesses: the majority have contracted only one. 

WeChat Expands to Include Medical Services

WeChat, which is a popular app among expats in China, is expanding its platform in Shanghai to include medical care, in partnership with a number of the city’s top hospitals, such as the Raffles Hospital Shanghai. The platform, which is also available in English, provides information and health alerts. To access, log into WeChat, and then access the City News Service mini-program, where you will find the Health section in the Service and Living sections.

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