> The second method is more troubling. At altitudes above 3,000 metres, mild symptoms of altitude sickness are common. Blood oxygen saturation can drop, hands and feet tingle, headaches develop. In most cases, rest, hydration or a gradual descent is all that is needed. ...investigators found that Diamox (Acetazolamide) tablets, used to prevent altitude sickness, were administered alongside excessive water intake to induce the very symptoms that would justify a rescue call.
This doesnt sound accurate. I have trekked the Himalayas for over a decade - the risks of AMS are very real. Two people I have trekked with have died due to AMS on separate himalayan treks - both had trekked multiple times before, and were well aware of the risks. Both the fatalities were around 12000-14000 feet - much below the Everest Base Camp trek. When AMS hits, you need to descend - as fast as possible, with whatever means you have at your disposal. Otherwise you have unknowingly entered a Russian Roulette.
And Diamox is used as a preventative course for AMS - alongside excessive water intake - this is standard guidelines in all high altitude himalayan treks.
In Nepal, my parents always warned me before eating at some rest stops because they said the food was doctored with baking soda to make you feel fuller, guess it was true after all and not just an urban legend heh.
"You" don't take antacid after eating unless "you" have problems with your stomach acid or something. Neutralizing your stomach acid isn't generally a smart thing to do, because it's acidic for a reason (digesting food). Some people even recommend not drinking to much water with your meals because it dilutes your stomach acid, though that might be overly cautious. Whether adding baking soda to food makes you feel fuller I wouldn't know, but it certainly won't make you "feel better", unless you have some medical condition.
I've sometimes used baking soda to accelerate softening of beans, and I imagine the effect is more appreciable at higher altitudes perhaps? Some of the usage of baking soda could be innocent enough.
Both are used, for different reasons, but it's a pretty loose term. Can also use enzymes or other alkaline things. With or without a marinade. Pass through oil or water, or just stir fry with a little extra oil.
No reasonable person would be confused by use of baking soda as an ingredient in cooked food (reasonable) vs the addition of baking soda after cooking as an adulterant.
An amount of soda sufficient to make you ill would be very VERY detectable in food. Speaking as someone who makes their own honeycomb toffee and soda bread, it's really easy to mess up the ratios and end up with an excess that tastes nasty, and that excess is pretty small.
A small amount won't make a different, it'll just stimulate a bit more H+ production from your stomach's proton pumps.
Edit: The article I read claims the scam involved baking powder, which makes even less sense given that it's even more noticeable, bitter and metallic.
Were there other issues involved in the fatalities around 12-14k ft? Freezing etc?
In aviation rules you can have passengers at 12k ft without oxygen for an unlimited amount of time. The crew needs to use oxygen if you're between 10k and 13k for more than 30 minutes. Above 13k both crew and passengers must use oxygen immediately (EASA rules, FAA is different).
So they seem to consider 12k to not be dangerous to passengers.
Speaking from experience in the mountains: 12k at rest and 12k under subsequent days of exercise produce very different responses. What might be a mild headache sitting in the back of a plane could be a pretty distinct AMS case lugging a pack up and down mountains.
Namche (damn autocorrect) Bazaar which everyone in the Everest region passes through is a bit over 11K feet. 12-15K feet just isn’t that high in the scheme of things. Many peaks in the western US are in that range or more. Yes, minor headaches are pretty normal when acclimatizing. But anything more, you need to go down.
I think you mean continental United States, as Alaska and Hawaii are excluded, where-as Alaska is contiguous with the United States, but requires crossing through parts of Canada to reach by land. That said, yes Whitney is the highest in the continental US, and McKinley in Alaska is the highest in the US (and contiguous US) and is also the tallest in the world from base to peak and the third most prominent peak in the world.
It's exactly the other way around actually, continental US would include Alaska since it's still on the North American continent whereas contiguous US excludes both Hawaii and Alaska. Contiguous US refers to the lower 48 states.
Continental "could" include Alaska (it's even in the official U.S. Board on Geographic Names definition), but in practice when "continental US" are casually mentioned, it's rarely implied as included. Most use it as interchangeable with contiguous.
>where-as Alaska is contiguous with the United States, but requires crossing through parts of Canada to reach by land.
Contiguous means the 48 connected (contiguous) states. It never includes Alaska.
And even though definitionally/officially continental could include it (it's in the same continent), in common use "continental US" is not meant to include Alaska either.
That’s like saying the US is contiguous with Japan, you just have to cross through parts of the Pacific Ocean to get there. Contiguous precisely means you don’t have to cross anything else to get there, it is connected.
I went from sea level to 11k feet in the same day many times before. I would say the altitude effect is there but not as much as you might expect. A little quicker to be out of breath a little longer to recover it. Not sure what it is like at higher elevations or greater daily altitude delta.
Very much dependent on age, rest and general conditioning. I went from sea level to 14K at Pikes peak in 1 day and it was quite uncomfortable. I managed, but folks who lived in Denver with lower physical fitness levels than me, did better.
Agreed, we live at ~5K and went up to Pikes Peak; my wife and I had no problems (beyond minor headache), but my son's lips were turning blue and he was feeling pretty bad.
Other amusing things from that trip: we went up there the 3rd of July, and it snowed. We charged the car in Colorado Springs before we left, got up to the peak with 36% battery remaining. My wife worried we wouldn't be able to make it back. Got back to CS with ~70% battery left.
I guess fitness makes a difference from what these other comments are saying. My ex-wife and I lived in Long Beach (which is obviously sea level) when we were in ROTC and pretty regularly took day trips out to San Gogornio and walked to the summit in about five hours, which is ~11,500ft. Not once did that have any noticeable effect, but we were both pretty serious runners back in the day trying to become Army officers. On the other hand, she tried to summit Aconcagua during a spring break and couldn't make it due to altitude sickness. I've never been higher than Mt. Whitney, personally.
Even if you don't feel it, the altitude still makes a difference, though. I recall doing two-a-day hell weeks at Big Bear at the end of summer cross-country training in high school and there was a 5k up there at the end of that week. We all got worse times than typical at sea level, and somewhat amusingly, I recall a high school senior from Rim of the World High School (who lived up there) getting 2nd place overall the first year I ever competed in that race, beating way more seasoned competitors just because he was used to the altitude.
It works in reverse, too. There was an officer in my Armor Basic Officer Course from Colorado who gave himself rhabdo during the two-mile test the first week we in-processed, apparently because he was so used to altitude that he hadn't quite acclimated to Fort Knox atmosphere.
If anything, fitness makes you more susceptible to altitude sickness. It's not an inherent effect, but rather your habits driving you to do things you shouldn't. You are supposed to take things lazy and slow when acclimatizing to high altitude. But if you're fit, you may be used to moving too fast and pushing yourself too hard. You may not recover from exertion as quickly as you expect, and you may end up climbing higher every day than you should.
Altitude sickness typically starts after 12–24 hours. If you climb high and come back down in the same day, there is usually not enough time for the symptoms to start. And 11,500ft is not that high altitude. People routinely fly to Cuzco, La Paz, Lhasa, and Leh from sea level, and most of them suffer no serious ill effects.
It's pretty widely accepted in the climbing world that the primary effect of altitude in the short-term is a reduction in your cardiovascular fitness.
The better your heart is at getting oxygen into your muscles and organs, the better it can compensate for less oxygen.
Not a bulletproof solution to altitude sickness, but it's definitely one of a lot of variables that matters. It's also just true that some people are way more susceptible regardless, I've got friends who run competitive marathon times who get splitting headaches flying from sea level to denver.
Not really. Altitude sickness seems quite random in who it effects worst. I trekked to the top of Mera Peak (~21,000 ft) many years ago. 3 of the fittest people in our party got altitude sickness and didn't make it to the peak.
I went from ~500 ft above sea level (Palm Springs) up to 8,500 feet above sea level (San Jacinto Peak) in less than an hour via the aeria tram a couple months ago and it was very noticeable, my walking speed fell by a third and I was breathing a lot harder than I usually do.
I've been to Nepal a few times and started feeling AMS symptoms about 1-2 hours after arriving at our lodge in Namche. Diamox kept me going great for the nxt few days on our way to Tengboche where we maxed out about 13k feet, besides the heli flight back to Lukla. Similar symptoms even at a ski resort at 9k feet in the US. It's "not that high" but plenty high to induce AMS.
There's a big difference between doing a day trip to those altitudes which is normally ok, and sleeping that high which causes problems if not acclimatised.
> There's a big difference between doing a day trip to those altitudes which is normally ok, and sleeping that high which causes problems if not acclimatised.
I'm not sure what point you're trying to make. People regularly experience AMS at the heights far below what OP mentioned, whether on the day they arrive or on days 2-4, and that's not even accounting for strenuous physical activity.
> But guides and hotel staff ... tell them they are at risk of dying, that only immediate evacuation will save them.
I got Acute Mountain Sickness at just 11k feet. Headache, nausea, dizziness, fatigue. I passed out until hitting the ground woke me up. I was very disoriented and vulnerable. If someone had told me that I had to get to a hospital or I'd die they could have led me like a tame goat. And they could be right. If you have high-altitude cerebral or pulmonary edema it is life threatening.
A guide getting a kickback can make it a lot more likely just by cutting short the boring acclimatization time.
Ya that was a very serious situation for you. I knew when my dad was barely able to stand but insisted we hike the 1000ft back up to then get back down it was also serious. But when we got home I read how deadly altitude sickness is.
I did the Everest base camp trek in late 2015, at that time it was quite common (saw it myself and heard about it) that people would do the trek up but to get down they would fake a leg/back injury or blame altitude sickness and the chopper from Kathmandu would come pick you up, as long as you had the right insurance.
The people doing that could probably afford the copter ride outright, so they can afford the "right" insurance that wouldn't ask any questions. The uber-wealthy live under a completely different system than the average schmuck like me.
Not an insurance underwriter - but wouldn't the obvious counter-move be to exclude coverage for medical assistance/transportation when you're climbing mountains overseas, spelunking, within X miles of the north or south pole, traveling in a submarine, or have otherwise ventured into "high-dollar extraction" territory?
I went to Nepal two years ago. The standard insurance of my Mastercard Gold specifically excluded medical assistance/transportation for acute altitude sickness from the coverage (and rescue operators are reluctant to intervene without proof of proper insurance coverage).
As a precaution (having read about it on forums) I had taken an additional insurance from a French shop specialized in hiking and mountaineering (le Vieux Campeur) to cover more events.
Good thing I did because I ended up having to be evacuated for something that was initially considered as acute altitude sickness and turned out to be a lot more life threatening once in the hospital.
The obvious counter move is just to charge higher premiums. It works whether the crises are real or fabricated. The real losers are not the insurance companies, but other tourists overpaying on their premiums.
In my experience, it's only the cheap insurance policies bundled with credit cards and various memberships that consider high-altitude hiking a high-risk activity. Any travel insurance you buy as individual should cover it. If there is an altitude limit, it's usually 6000 m, so Everest Base Camp and Kilimanjaro would be covered but Aconcagua wouldn't. And any actual mountaineering would also be high-risk, regardless of altitude.
I can tell you exactly what it cost for me. I took the helicopter from Gorakshep, the highest/last town on the EBC trek, to Lukla, the crazy airport people call the most dangerous one in the world. For me, a 255 lbs / 115kg guy, 2 Nepalis that are each half my size, a pilot, and our not-that-heavy hiking gear was 2000 USD in October of 2024.
Having something scheduled is cheaper than on-demand, too. You may even end up using the same equipment, but at a lower priority (it costs $200 or so to have an ambulance sit at your event, for example).
Why would it be fixed? Insurance companies aren’t willing to invest in oversight, and everyone else profit, there is no incentive for changing the system.
Nepal is a low income and high corruption country, where the government and formal business structures are unstable enough that 'tipping' becomes common even for government investigators...
It's basically a way for everyone to get more tourists dollars, which is one of Nepals primary exports.
Why don't they just charge [more] for a mountain license? A few thousand per hiker would probably be tolerated by people who view the hike as a lifetime achievement kind of thing.
They do charge quite a lot for mountain climbing permits but trekking is mostly just walking from village to village along the usual paths the locals use.
If the cost to an individual insurance company is low enough (in the few millions) and they're not really at risk of it suddenly exploding, and the cost for them to mitigate is also in the millions (or risks killing a customer), they're unlikely to improve. Fight Club, but the other way around.
However, if they all gang up together they might do something - but that can cause other issues (a local insurer becomes the only insurance available, etc).
Just include helicopter rides in the ticket. These aren't adventures anymore - just "natural" theme parks for monied elites that need talking points and social media posts flexing their wealth. Does Six Flags charge your insurance for security to drive you back to your car?
While it is true that guides and business owners are always looking for opportunities to earn extra cash, the reporting is a tiny bit off here.
Start of AMS like symptoms can easily be mistaken for walking fatigue and dehydration. It is easier to identify if you are at rest, but during the trek that is seldom the case. So when you actually start realizing something is wrong, you already are at an elevated risk. The only thing that works in these cases is to descend and as fast as possible at that.
Considering the fact that AMS will absolutely and a 100% kill you if you play around with it, guides presenting trekkers with an option of helicopter rescue is not that bad, at least if you look at the worst that can happen.
I did the EBC trek last year and at ~4400 meters, we heard about a local Nepalese woman dying from complications of AMS in the local clinic. There might be fishy things going on with the rescues, but the health risks are real.
> But none of that worked “The scam continued due to lax punitive action,”
It percolated up. It’s usually what happens with corruption. If lower levels are found out to have a lucrative scheme, the higher ups (auditors, police, legislators) make a big fuss about stumping it publicly, but behind the scenes go and ask for a cut.
A story older than Nepal (misleading tourists). And an article from 6 months ago shows how the govt treats its own people with more examples in HN discussion. https://news.ycombinator.com/item?id=45166972
What is less discussed is what happened to people who were able to identify the scam and refused to let it happen.
Since then, the govt has been overthrown by a Gen Z protest. An interim govt led the national elections and a young party led by young leaders have won 2/3 majority in the parliament.
The new parliament is a radical departure in many ways. Its very hollywoodish if you happen to read the development.
To be honest I'm surprised insurance is offered at all. I did the EBC trek a couple years ago. The temptation to take a helicopter down was real & I didn't have insurance.
As someone who has done quite a few 14ers in Colorado, many of which I wasn't in the greatest shape for, most people do not get AMS especially below 12k, and therefore the numbers in this article definitely do look like somebody somewhere is faking it or being defrauded. Much of the time you just need to hydrate better if you're going up in elevation above 10k and you'll be fine.
Pro-tip: if you propose to your wife at 13000 feet, don’t actually have her put the ring on. Her fingers may swell causing her to panic about circulation and you’ll have to run down the mountain and to this day she will not think it is as funny as you
It makes a good story to share with new friends in the future though. I've got one of those too, heh. I proposed to my now-wife on the bow of a sailboat at sunset on a local lake, overlooking the water. Should have been an amazing moment, except I didn't know until that trip that my now-wife gets seasick/motion sickness. Luckily it did not ruin things, but we've never been on a boat together since except for a ferry crossing between Tallinn and Helsinki once.
It is a surprise to me that anyone summiting has access to insurance at all. I suppose that if the fraud rate is as low as 3.5% and insurance is contracted specifically for the trip, then a rational payor will raise rates and carry on.
On the whole, there is finite capacity of certain assets, like helicopters. If the emergency carrying capacity is X and true emergencies are .6 X then there is spoiled capacity of .4 X, in which fraudulent emergencies are placed, keeping everyone in the system whole so that when true emergencies approach .9 X there is no need for fraud. This follows the "optimal amount of fraud is non-zero" and eliminating this fraud might remove the margin needed for the system to exist at all.
An anecdote tells of the British government's bounty on dead Indian cobras
giving locals the perverse incentive to start breeding the snakes, to be able
to kill more of them and collect more bounty
The people in the article are just trekking around the valleys, not going for the summit. I did a summit attempt a while back and didn't bother with insurance because here wasn't much they could do - helicopters didn't go that high and getting some sherpers to carry you down would be better achieved with cash.
"In at least one case cited in the investigation, baking powder was mixed into food to make tourists physically unwell."
The only ill effect I can find from overconsumption is a "tingly sensation on the tongue". Of course, that doesn't mean the 'poisoner' wasn't ignorant of this, and genuinely did it trying to make them sick. Or maybe they simply said, "If you feel your tongue tingling, YOU ARE DYING!!!".
I feel like "make physically unwell" here just means they'll taste something gross, not realize it is the baking powder, and treat the feeling as if something is wrong with their body. I know mixing up baking soda and baking powder has made for some pretty unpleasant tasting food for me.
Yes, which is why it's easy to then convince people to evacuate. People do die on Everest, including EBC treks from altitude sickness alone, so severe symptoms usually lead to taking the trekking back down the mountain.
Baking powder is used by some athletes as it is shown to enhance performance.[0] I find it more realistic that they are adding it for that effect than making anyone unwell. As its not really something that makes you ill.
Stop pointlessly climbing mountains and ruining the natural environment. Climbing Mt Everest at this point is just a sign of conspicuous consumption and not any achievement other than financial. Would have been better to spend your money lighting it on fire.
This is mostly trekking related evacuation, which is far easy and lower impact. EBC is about 100x cheaper overall per person than summit attempts, if not 500x.
And Sagarmartha national park and the whole valley up to EBC is an amazingly beautiful part of the world.
to be fair, the approach is usually covered in snowpack for most of the year, so impact is minimal by foot traffic. However, most of the protection is fixed, which could have lasting effects if something were to rip out.
For other mountains with dry summits in the summers, I would agree: the effects of erosion are frightening
> The second method is more troubling. At altitudes above 3,000 metres, mild symptoms of altitude sickness are common. Blood oxygen saturation can drop, hands and feet tingle, headaches develop. In most cases, rest, hydration or a gradual descent is all that is needed. ...investigators found that Diamox (Acetazolamide) tablets, used to prevent altitude sickness, were administered alongside excessive water intake to induce the very symptoms that would justify a rescue call.
This doesnt sound accurate. I have trekked the Himalayas for over a decade - the risks of AMS are very real. Two people I have trekked with have died due to AMS on separate himalayan treks - both had trekked multiple times before, and were well aware of the risks. Both the fatalities were around 12000-14000 feet - much below the Everest Base Camp trek. When AMS hits, you need to descend - as fast as possible, with whatever means you have at your disposal. Otherwise you have unknowingly entered a Russian Roulette.
And Diamox is used as a preventative course for AMS - alongside excessive water intake - this is standard guidelines in all high altitude himalayan treks.
The very next sentence from that quote sounds a lot worse and harder to explain away though:
> In at least one case cited in the investigation, baking powder was mixed into food to make tourists physically unwell.
In Nepal, my parents always warned me before eating at some rest stops because they said the food was doctored with baking soda to make you feel fuller, guess it was true after all and not just an urban legend heh.
I've heard the same from South Indian friends, so I guess it's pretty widespread.
Totally an urban legend. What do people think Alia seltzer is made from? You know the thing you take to feel better after eating too much?
"You" don't take antacid after eating unless "you" have problems with your stomach acid or something. Neutralizing your stomach acid isn't generally a smart thing to do, because it's acidic for a reason (digesting food). Some people even recommend not drinking to much water with your meals because it dilutes your stomach acid, though that might be overly cautious. Whether adding baking soda to food makes you feel fuller I wouldn't know, but it certainly won't make you "feel better", unless you have some medical condition.
>> I wouldn't know, but it certainly won't make you "feel better", unless you have some medical condition.
It makes me feel better and I don’t have a medical condition. What is your point? Maybe throw in a fact or two?
I've sometimes used baking soda to accelerate softening of beans, and I imagine the effect is more appreciable at higher altitudes perhaps? Some of the usage of baking soda could be innocent enough.
Alkalinity softens the husk of legumes. Look up nixtamalization. It’s what the Aztecs invented.
Did we discover a new diet hack?
A few thousand years ago:
https://en.wikipedia.org/wiki/Nixtamalization
Try using it on meat. Turns it into pink slurry.
You're using too much! Its commonly used to improve meat texture, especially in Chinese cuisine. It's called "velveting".
you're thinking of corn starch
Both are used, for different reasons, but it's a pretty loose term. Can also use enzymes or other alkaline things. With or without a marinade. Pass through oil or water, or just stir fry with a little extra oil.
No reasonable person would be confused by use of baking soda as an ingredient in cooked food (reasonable) vs the addition of baking soda after cooking as an adulterant.
An amount of soda sufficient to make you ill would be very VERY detectable in food. Speaking as someone who makes their own honeycomb toffee and soda bread, it's really easy to mess up the ratios and end up with an excess that tastes nasty, and that excess is pretty small.
A small amount won't make a different, it'll just stimulate a bit more H+ production from your stomach's proton pumps.
Edit: The article I read claims the scam involved baking powder, which makes even less sense given that it's even more noticeable, bitter and metallic.
Were there other issues involved in the fatalities around 12-14k ft? Freezing etc?
In aviation rules you can have passengers at 12k ft without oxygen for an unlimited amount of time. The crew needs to use oxygen if you're between 10k and 13k for more than 30 minutes. Above 13k both crew and passengers must use oxygen immediately (EASA rules, FAA is different).
So they seem to consider 12k to not be dangerous to passengers.
Speaking from experience in the mountains: 12k at rest and 12k under subsequent days of exercise produce very different responses. What might be a mild headache sitting in the back of a plane could be a pretty distinct AMS case lugging a pack up and down mountains.
Namche (damn autocorrect) Bazaar which everyone in the Everest region passes through is a bit over 11K feet. 12-15K feet just isn’t that high in the scheme of things. Many peaks in the western US are in that range or more. Yes, minor headaches are pretty normal when acclimatizing. But anything more, you need to go down.
> 12-15K feet just isn’t that high in the scheme of things. Many peaks in the western US are in that range or more.
The highest peak in the contiguous United States is Mt. Whitney at ~14.5k feet
There are 50+ peaks in Colorado higher than 14,000 ft and 1000+ higher than 12000 ft
https://en.wikipedia.org/wiki/List_of_the_highest_major_summ...
Many peaks in the western US are in that range. Lots more with several exceeding if you include Alaska in “the western US”.
I think you mean continental United States, as Alaska and Hawaii are excluded, where-as Alaska is contiguous with the United States, but requires crossing through parts of Canada to reach by land. That said, yes Whitney is the highest in the continental US, and McKinley in Alaska is the highest in the US (and contiguous US) and is also the tallest in the world from base to peak and the third most prominent peak in the world.
It's exactly the other way around actually, continental US would include Alaska since it's still on the North American continent whereas contiguous US excludes both Hawaii and Alaska. Contiguous US refers to the lower 48 states.
Continental "could" include Alaska (it's even in the official U.S. Board on Geographic Names definition), but in practice when "continental US" are casually mentioned, it's rarely implied as included. Most use it as interchangeable with contiguous.
Contiguous states is the correct term.
“Continental” would be in Europe.
>where-as Alaska is contiguous with the United States, but requires crossing through parts of Canada to reach by land.
Contiguous means the 48 connected (contiguous) states. It never includes Alaska.
And even though definitionally/officially continental could include it (it's in the same continent), in common use "continental US" is not meant to include Alaska either.
That’s like saying the US is contiguous with Japan, you just have to cross through parts of the Pacific Ocean to get there. Contiguous precisely means you don’t have to cross anything else to get there, it is connected.
I went from sea level to 11k feet in the same day many times before. I would say the altitude effect is there but not as much as you might expect. A little quicker to be out of breath a little longer to recover it. Not sure what it is like at higher elevations or greater daily altitude delta.
Very much dependent on age, rest and general conditioning. I went from sea level to 14K at Pikes peak in 1 day and it was quite uncomfortable. I managed, but folks who lived in Denver with lower physical fitness levels than me, did better.
Agreed, we live at ~5K and went up to Pikes Peak; my wife and I had no problems (beyond minor headache), but my son's lips were turning blue and he was feeling pretty bad.
Other amusing things from that trip: we went up there the 3rd of July, and it snowed. We charged the car in Colorado Springs before we left, got up to the peak with 36% battery remaining. My wife worried we wouldn't be able to make it back. Got back to CS with ~70% battery left.
I guess fitness makes a difference from what these other comments are saying. My ex-wife and I lived in Long Beach (which is obviously sea level) when we were in ROTC and pretty regularly took day trips out to San Gogornio and walked to the summit in about five hours, which is ~11,500ft. Not once did that have any noticeable effect, but we were both pretty serious runners back in the day trying to become Army officers. On the other hand, she tried to summit Aconcagua during a spring break and couldn't make it due to altitude sickness. I've never been higher than Mt. Whitney, personally.
Even if you don't feel it, the altitude still makes a difference, though. I recall doing two-a-day hell weeks at Big Bear at the end of summer cross-country training in high school and there was a 5k up there at the end of that week. We all got worse times than typical at sea level, and somewhat amusingly, I recall a high school senior from Rim of the World High School (who lived up there) getting 2nd place overall the first year I ever competed in that race, beating way more seasoned competitors just because he was used to the altitude.
It works in reverse, too. There was an officer in my Armor Basic Officer Course from Colorado who gave himself rhabdo during the two-mile test the first week we in-processed, apparently because he was so used to altitude that he hadn't quite acclimated to Fort Knox atmosphere.
If anything, fitness makes you more susceptible to altitude sickness. It's not an inherent effect, but rather your habits driving you to do things you shouldn't. You are supposed to take things lazy and slow when acclimatizing to high altitude. But if you're fit, you may be used to moving too fast and pushing yourself too hard. You may not recover from exertion as quickly as you expect, and you may end up climbing higher every day than you should.
Altitude sickness typically starts after 12–24 hours. If you climb high and come back down in the same day, there is usually not enough time for the symptoms to start. And 11,500ft is not that high altitude. People routinely fly to Cuzco, La Paz, Lhasa, and Leh from sea level, and most of them suffer no serious ill effects.
It's pretty widely accepted in the climbing world that the primary effect of altitude in the short-term is a reduction in your cardiovascular fitness.
The better your heart is at getting oxygen into your muscles and organs, the better it can compensate for less oxygen.
Not a bulletproof solution to altitude sickness, but it's definitely one of a lot of variables that matters. It's also just true that some people are way more susceptible regardless, I've got friends who run competitive marathon times who get splitting headaches flying from sea level to denver.
>I guess fitness makes a difference
Not really. Altitude sickness seems quite random in who it effects worst. I trekked to the top of Mera Peak (~21,000 ft) many years ago. 3 of the fittest people in our party got altitude sickness and didn't make it to the peak.
I went from ~500 ft above sea level (Palm Springs) up to 8,500 feet above sea level (San Jacinto Peak) in less than an hour via the aeria tram a couple months ago and it was very noticeable, my walking speed fell by a third and I was breathing a lot harder than I usually do.
I've been to Nepal a few times and started feeling AMS symptoms about 1-2 hours after arriving at our lodge in Namche. Diamox kept me going great for the nxt few days on our way to Tengboche where we maxed out about 13k feet, besides the heli flight back to Lukla. Similar symptoms even at a ski resort at 9k feet in the US. It's "not that high" but plenty high to induce AMS.
*Naamche Bazaar
> 12-15K feet just isn’t that high in the scheme of things. Many peaks in the western US are in that range or more.
It's "not that high", but people frequently do get AMS at those attitudes or even lower.
There's a big difference between doing a day trip to those altitudes which is normally ok, and sleeping that high which causes problems if not acclimatised.
> There's a big difference between doing a day trip to those altitudes which is normally ok, and sleeping that high which causes problems if not acclimatised.
I'm not sure what point you're trying to make. People regularly experience AMS at the heights far below what OP mentioned, whether on the day they arrive or on days 2-4, and that's not even accounting for strenuous physical activity.
I can’t provide cites but I understand people have had issues flying into Denver.
> But guides and hotel staff ... tell them they are at risk of dying, that only immediate evacuation will save them.
I got Acute Mountain Sickness at just 11k feet. Headache, nausea, dizziness, fatigue. I passed out until hitting the ground woke me up. I was very disoriented and vulnerable. If someone had told me that I had to get to a hospital or I'd die they could have led me like a tame goat. And they could be right. If you have high-altitude cerebral or pulmonary edema it is life threatening.
A guide getting a kickback can make it a lot more likely just by cutting short the boring acclimatization time.
Ya that was a very serious situation for you. I knew when my dad was barely able to stand but insisted we hike the 1000ft back up to then get back down it was also serious. But when we got home I read how deadly altitude sickness is.
I did the Everest base camp trek in late 2015, at that time it was quite common (saw it myself and heard about it) that people would do the trek up but to get down they would fake a leg/back injury or blame altitude sickness and the chopper from Kathmandu would come pick you up, as long as you had the right insurance.
Surely the insurers would quickly become aware of this, I mean, there are people whose job it is to monitor all claims and adjust prices accordingly.
So while it might feel like the insurers were getting fleeced, it was almost certainly the insured who didn't get the copter ride.
The people doing that could probably afford the copter ride outright, so they can afford the "right" insurance that wouldn't ask any questions. The uber-wealthy live under a completely different system than the average schmuck like me.
Not an insurance underwriter - but wouldn't the obvious counter-move be to exclude coverage for medical assistance/transportation when you're climbing mountains overseas, spelunking, within X miles of the north or south pole, traveling in a submarine, or have otherwise ventured into "high-dollar extraction" territory?
I went to Nepal two years ago. The standard insurance of my Mastercard Gold specifically excluded medical assistance/transportation for acute altitude sickness from the coverage (and rescue operators are reluctant to intervene without proof of proper insurance coverage).
As a precaution (having read about it on forums) I had taken an additional insurance from a French shop specialized in hiking and mountaineering (le Vieux Campeur) to cover more events.
Good thing I did because I ended up having to be evacuated for something that was initially considered as acute altitude sickness and turned out to be a lot more life threatening once in the hospital.
The obvious counter move is just to charge higher premiums. It works whether the crises are real or fabricated. The real losers are not the insurance companies, but other tourists overpaying on their premiums.
Priced into the premium. It's not your run of the mill health insurance.
When I actually climbed one of the 6K meter peaks I had to get some special alpine insurance. Don’t remember the details. Was a long time ago.
Extreme activities are excluded from standard travel insurance packages. This is happening with insurance specifically for these activities.
In my experience, it's only the cheap insurance policies bundled with credit cards and various memberships that consider high-altitude hiking a high-risk activity. Any travel insurance you buy as individual should cover it. If there is an altitude limit, it's usually 6000 m, so Everest Base Camp and Kilimanjaro would be covered but Aconcagua wouldn't. And any actual mountaineering would also be high-risk, regardless of altitude.
Normal travel insurance doesn't cover high-risk activities like mountaineering. You have to buy a specialist policy.
I wonder how much a chopper ride would cost at "reasonable rates" (e.g, not the air ambulance but just a chopper).
I can tell you exactly what it cost for me. I took the helicopter from Gorakshep, the highest/last town on the EBC trek, to Lukla, the crazy airport people call the most dangerous one in the world. For me, a 255 lbs / 115kg guy, 2 Nepalis that are each half my size, a pilot, and our not-that-heavy hiking gear was 2000 USD in October of 2024.
Pics/video: https://www.instagram.com/p/DBTpLGtydZW/
probably mean 255 lb / 115kg
Yes, thanks for noticing. I fixed.
Nothing beats good quality, freshly sourced, all natural ground truth data
Per person around $1500. Over 10k of you can’t fill the chopper.
I'm assuming less than the average ambulance ride in the USA
From personal experience it's about twice the cost of an ambulance ride from my house to the hospital. Air ambulances here are about 10 times as much.
Having something scheduled is cheaper than on-demand, too. You may even end up using the same equipment, but at a lower priority (it costs $200 or so to have an ambulance sit at your event, for example).
Yes, but it might be in some ancient Russian helicopter of unknown provenance.
“Wasn’t the system supposed to be fixed?“
Why would it be fixed? Insurance companies aren’t willing to invest in oversight, and everyone else profit, there is no incentive for changing the system.
Nepal is a low income and high corruption country, where the government and formal business structures are unstable enough that 'tipping' becomes common even for government investigators...
It's basically a way for everyone to get more tourists dollars, which is one of Nepals primary exports.
Why don't they just charge [more] for a mountain license? A few thousand per hiker would probably be tolerated by people who view the hike as a lifetime achievement kind of thing.
They do charge quite a lot for mountain climbing permits but trekking is mostly just walking from village to village along the usual paths the locals use.
Scamming bored rich people is one of the more victimless crimes.
Idk they gave SBF 25 years for it.
How can it possibly be defined as victimless
In my experience people use “victimless” to mean “the victims are people I lack sympathy for”.
If the cost to an individual insurance company is low enough (in the few millions) and they're not really at risk of it suddenly exploding, and the cost for them to mitigate is also in the millions (or risks killing a customer), they're unlikely to improve. Fight Club, but the other way around.
However, if they all gang up together they might do something - but that can cause other issues (a local insurer becomes the only insurance available, etc).
Just include helicopter rides in the ticket. These aren't adventures anymore - just "natural" theme parks for monied elites that need talking points and social media posts flexing their wealth. Does Six Flags charge your insurance for security to drive you back to your car?
While it is true that guides and business owners are always looking for opportunities to earn extra cash, the reporting is a tiny bit off here.
Start of AMS like symptoms can easily be mistaken for walking fatigue and dehydration. It is easier to identify if you are at rest, but during the trek that is seldom the case. So when you actually start realizing something is wrong, you already are at an elevated risk. The only thing that works in these cases is to descend and as fast as possible at that.
Considering the fact that AMS will absolutely and a 100% kill you if you play around with it, guides presenting trekkers with an option of helicopter rescue is not that bad, at least if you look at the worst that can happen.
I did the EBC trek last year and at ~4400 meters, we heard about a local Nepalese woman dying from complications of AMS in the local clinic. There might be fishy things going on with the rescues, but the health risks are real.
> But none of that worked “The scam continued due to lax punitive action,”
It percolated up. It’s usually what happens with corruption. If lower levels are found out to have a lucrative scheme, the higher ups (auditors, police, legislators) make a big fuss about stumping it publicly, but behind the scenes go and ask for a cut.
A story older than Nepal (misleading tourists). And an article from 6 months ago shows how the govt treats its own people with more examples in HN discussion. https://news.ycombinator.com/item?id=45166972
What is less discussed is what happened to people who were able to identify the scam and refused to let it happen.
Since then, the govt has been overthrown by a Gen Z protest. An interim govt led the national elections and a young party led by young leaders have won 2/3 majority in the parliament.
The new parliament is a radical departure in many ways. Its very hollywoodish if you happen to read the development.
Misread this as "fake rescue rocket" and it took a bit before I realized that.
Sounds pretty bad until you look at the numbers.
And then it looks very bad?
The amount of each incident is fairly low, and probably goes a long way to funding the local community.
But the number of incidents is nuts - well over 1000 per year.
"Around 100,000 people hike to Everest Base Camp every year"
I have no idea how many of those people have to buy insurance.
Source: https://everestcamptrek.com/how-many-people-hike-to-everest-...
To be honest I'm surprised insurance is offered at all. I did the EBC trek a couple years ago. The temptation to take a helicopter down was real & I didn't have insurance.
Rescue insurance was required by the trekking company when I did EBC a few years back.
As someone who has done quite a few 14ers in Colorado, many of which I wasn't in the greatest shape for, most people do not get AMS especially below 12k, and therefore the numbers in this article definitely do look like somebody somewhere is faking it or being defrauded. Much of the time you just need to hydrate better if you're going up in elevation above 10k and you'll be fine.
Pro-tip: if you propose to your wife at 13000 feet, don’t actually have her put the ring on. Her fingers may swell causing her to panic about circulation and you’ll have to run down the mountain and to this day she will not think it is as funny as you
It makes a good story to share with new friends in the future though. I've got one of those too, heh. I proposed to my now-wife on the bow of a sailboat at sunset on a local lake, overlooking the water. Should have been an amazing moment, except I didn't know until that trip that my now-wife gets seasick/motion sickness. Luckily it did not ruin things, but we've never been on a boat together since except for a ferry crossing between Tallinn and Helsinki once.
Why is hiking the tallest mountain in the world not an insurance carve out
Make coverage void in the Himalayas... problem solved
As the name suggests, Everest Base Camp is just the starting point of the actual climb.
It is a surprise to me that anyone summiting has access to insurance at all. I suppose that if the fraud rate is as low as 3.5% and insurance is contracted specifically for the trip, then a rational payor will raise rates and carry on.
On the whole, there is finite capacity of certain assets, like helicopters. If the emergency carrying capacity is X and true emergencies are .6 X then there is spoiled capacity of .4 X, in which fraudulent emergencies are placed, keeping everyone in the system whole so that when true emergencies approach .9 X there is no need for fraud. This follows the "optimal amount of fraud is non-zero" and eliminating this fraud might remove the margin needed for the system to exist at all.
https://en.wikipedia.org/wiki/Perverse_incentiveThe people in the article are just trekking around the valleys, not going for the summit. I did a summit attempt a while back and didn't bother with insurance because here wasn't much they could do - helicopters didn't go that high and getting some sherpers to carry you down would be better achieved with cash.
Are we supposed to feel bad for insurance companies here?
"In at least one case cited in the investigation, baking powder was mixed into food to make tourists physically unwell."
The only ill effect I can find from overconsumption is a "tingly sensation on the tongue". Of course, that doesn't mean the 'poisoner' wasn't ignorant of this, and genuinely did it trying to make them sick. Or maybe they simply said, "If you feel your tongue tingling, YOU ARE DYING!!!".
It’s a leavener when you get it wet, so swallowing enough will definitely feel like digestive upset from all the gas.
I feel like "make physically unwell" here just means they'll taste something gross, not realize it is the baking powder, and treat the feeling as if something is wrong with their body. I know mixing up baking soda and baking powder has made for some pretty unpleasant tasting food for me.
Could it be a symptom of high altitude oxygen deprivation?
Yes, which is why it's easy to then convince people to evacuate. People do die on Everest, including EBC treks from altitude sickness alone, so severe symptoms usually lead to taking the trekking back down the mountain.
Baking powder is used by some athletes as it is shown to enhance performance.[0] I find it more realistic that they are adding it for that effect than making anyone unwell. As its not really something that makes you ill.
[0] https://pmc.ncbi.nlm.nih.gov/articles/PMC8427947/
I saw a good yt video on this the other day, investigating baking soda and athletics. https://youtu.be/Y_aTfQmqc5o
The creator certainly got pretty crook from ingesting baking soda
Unnecessary CT scans mean unnecessary radiation exposure. This is a direct harm to the “patient”.
Seems minimal though in the grand scheme of things
Holy crap, why are they using anything more than pine for something of such high stakes?
Stop pointlessly climbing mountains and ruining the natural environment. Climbing Mt Everest at this point is just a sign of conspicuous consumption and not any achievement other than financial. Would have been better to spend your money lighting it on fire.
This is mostly trekking related evacuation, which is far easy and lower impact. EBC is about 100x cheaper overall per person than summit attempts, if not 500x.
And Sagarmartha national park and the whole valley up to EBC is an amazingly beautiful part of the world.
The "Everest Economy" is worth around $500 million annually.
Thats surprisingly low.
to be fair, the approach is usually covered in snowpack for most of the year, so impact is minimal by foot traffic. However, most of the protection is fixed, which could have lasting effects if something were to rip out.
For other mountains with dry summits in the summers, I would agree: the effects of erosion are frightening
Do people still leave oxygen bottles up there? And what do they do with all of their excrement?
The saying is that the snowpack gives back everything you put in it.