> 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.
Nance (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 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 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.
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.
> 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.
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.
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.
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).
> 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.
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.
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.
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
"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.
Nance (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
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 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 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.
*Naamche Bazaar
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.
> 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.
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.
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).
“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.
Scamming bored rich people is one of the more victimless crimes.
Idk they gave SBF 25 years for it.
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).
> 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.
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.
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.
Are we supposed to feel bad for insurance companies here?
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.
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.
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
Holy crap, why are they using anything more than pine for something of such high stakes?
Unnecessary CT scans mean unnecessary radiation exposure. This is a direct harm to the “patient”.
"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/
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
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.
The "Everest Economy" is worth around $500 million annually.
Thats surprisingly low.