High Roads News Sticky , 2020


Ice stupas @ Gangles , 4000-ish meters , above Leh, January 4th. Khardung La road to Nubra in the background.

SRINAGAR , FEB 2 : four civilian , two CRPF wounded in grenade attack at Lal Chowk.

LADAKH & KASHMIR , JAN 15TH : light snowfall here in Leh last night. Army & Air Force evacing 27 Chaddar trekkers over the last days , one with frostbite to Leh hospital. Avalanches in Kashmir , multiple civilian and soldiers dead.

SRINAGAR , JAN 8 : two civilian , zero CRPF wounded in grenade attack near Kashmir University.

CORONAVIRUS IN TIBET : one known case in Lhasa on February 24 . All tourist groups cancelled – and massive restrictions for pilgrims as well . Count on this lasting over the annual closure in to minimum mid-March.

( image via High Peaks Pure Earth

BAI Award 2019 : Leh Tourism Department


”Health Advisory – Welcome to Leh ”

The need for basic info on altitude sickness and health for tourists to Ladakh is – seemingly – met by this brochure . This need has been fed by the dramatical increase of tourism over the last decade , the fatal outcomes of the experiment with ILP rules in 2014 , and the high speed Chaddar treks pushed until now. In the words from the brochure

More than ten persons lost their lives in 2014-2015 after ignoring health advisories & AMS symptoms in Leh.

Unfortunately this product clashes repeatedly  with all established safety guidelines , from the likes of International Society for Mountain Medicine , the Himalayan Rescue Association , CDC from the US and more. The whole impression is a bit like meeting a very vocal dive operator that is unfamiliar with diving tables , or what the air tanks contain.

Continuing with the diving table analogy the first rule agreed on is the importance planning the ascent rate , and knowing what kind of altitude matters : sleeping altitude , not the max altitude gained during the day. First night(s) below 3000 meters , max 500 meters higher per night , one extra night for every thousand meters gained .

The tourism department has another , more dangerous approach : one thousand (!) meters per night. Period.

It also nixes the sleeping altitude concept by saying that flying in to Leh means the highest risk for altitude sickness . This ignores the fact that the second most popular route , the Manali-Leh road always involves the risk -planned or not – of spending a night up to more than a thousand meters higher than Leh . It also involves several passes around 5000 meters . In one of many self contradictions the tourism department cautions against crossing the Khardung La from Leh without mentioning that it means arriving at a sleeping elevation lower than Leh , while being oblivious of the much longer approach and slower descent on the Manali-Leh run around the Tanglang La -same altitude. It also cautions against spending nights at 4000+ in general . The tent camps at The Vomit Hilton/Sarchu & Pang are at 4253 and 4600.

As a horrifying anti-thesis of all good respiratory care the brochure insists , in bold text and with image , that the first 24 hours should be spent in bed , horisontal position.

Another hitherto unknown risk factor for AMS is also introduced here : cold. The claim here is that nights at 5000 meters in Ladakh are minus twenty degrees in the summer. For context the weather forecast for Pangong Tso/Spangmik ( 4300-ish ) right now , early January , says -17.

When ascent guidelines are ignored ( rethink ) or are impossible to follow the advice is to medicate in advance with Diamox/acetazolamide. The treatment times given here are wrong , and the dosage is for those over one hundred kilos body weight.

  • No list of altitude misconceptions would be complete without touching the hydration myth , which also crops up here . The recommendation here , without mentioning altitude , activity level or body weight is to drink a lot more than Tenzing & Hillarky on their Everest climb:

3. Abundant hydration ( 5 liters per day)

This has not been supported in any specialist or national health guidelines for many years , most cases decades. The recommendation to be diligent with adequate fluid intake comes from the concern of mixing up the symptoms of dehydration ( i.e. headaches) with early stages of AMS.

Historically this myth started with misinterpreting Griffith Pughs work on the first Everest summit . The fact that the first successful climbers also were the the first that werent massively dehydrated (summit rations in the order of half a liter per day ) produced a bias for high fluid intake that was understandable. At first , the first decade or so. Today we know that :

* all attempts to prove that a high fluid intake , above actual losses , protects against AMS have failed
* the extra losses at altitude , with the same level of work , is around one liter extra per day . Hence for example the around three liters per base recommendation from Himalayan Rescue Assocation for trekkers
* both severe altitude sickness and water intoxication gives the same effects and symptoms from edema , i.e. excess fluid in the lung & brain tissue. The only way to distinguish between the two is the absence of improvement after descent & deranged electrolyte values after water intoxication
* There are documented cases of misdiagnosing water intoxication as severe altitude sickness , leading not only to intensive care unit treatment but also death .

Update : Leh Health Department has large posters at the hospital stressing rest but not spending the first day in bed , and a fluid intake of 2-3 liters per day.

Age is also hinted at as a independent risk factor. Unsurprisingly the tourism department is out on their own here again . Guidelines are divided between saying that age is not a factor , or that the risk is higher in the group under fifty years -like in the large studies from Annapurna Circuit or Cusco .

Interesting trivia on the subject : the Japanese climber Yuchiuro Miura summited Mt Everest three times between 2003 and 2013. First when seventy years young.

Altitude Sickness Prevention : 2019 Update

Wilderness Medical Society has just rolled out the second update of the evidence based guidelines for prevention & treatment of AMS , HAPE & HACE. This was from the start in 2010 a gold standard document from a highly experienced expert panel . The references now lists more than a hundred sources.

Selected keypoints :

Lowest level for altitude sickness : mentioning the possibility of AMS below 2500 in the extra sensitive group . This was first mentioned in the 2014 update.

Medication : preventive use of Acetazolamide/Diamox to be “strongly considered” for moderate & high risk category. This starts with all first comers and no history of AMS going higher than 2800 meters first night . One small study in 2019 claiming to prove equal effect & equal level of side effects from half dosage ( 62 vs 125 mg x 2 ) reason for more research.

Dexamethason : prevents AMS , but does not ( as opposed to Diamox ) speed acclimatization . Risks with long time use , not to be stopped abruptly , not for children.

Ibuprofen : limited and conflicting evidence , can be taken by those who are unwilling to take acetazolamide or dexamethason.

Ginkgo boloba : conflicting evidence , Diamox considered “far superior”. Not to be used when pregnant or while taking anticoagulants.

Hypoxic tents ( basically a backwards version of Gamow bags : oxygen generator run inside a sealed tent , shunting O2 to the outside ) has a positive effect , given long enough period : nightly for weeks.

Other options : no preventive effect from coca , iron supplements , ASA/Aspirin , or high intake of water . Avoid dehydration.

High Roads News Sticky , 2019

(2018 sticky archived in the sticky category. Still working out the new WP software & tagging )


LEH , DECEMBER 27TH ( LOSAR) : first night below minus twenty . Now a lot warmer & sunny. Occasional power cuts as minor streams freeze over. Srinagar-Leh still out. HIMACHAL/J&K WEATHER , DEC 12 : full day of rain down here in McLeod, snow in the high country. Srinagar airport out for five days in a row , heavy snowfall on Srinagar-Leh.

WEATHER , NOV 27 : heavy rain & thunder thru the night lower elevations HP , snow over the Tohtang La. More snow over the Zoji La. Light snowfall predicted coming days. 
SRINAGAR , NOV 26 : multiple wounded in grenade attack near Kashmir University , Hazrabatal. 
SRINAGAR-LEH , NOV 22 : 350 plus persons, mainly truck drivers,  evaced by army near Zoji La after last days heavy snowfalls. 


Rohtang La , Nov 16 – The Tribune
MANALI-LEH , NOV 15 : HRTC buses begin running thru the Rohtang tunnel if/when the pass is blocked. 
J&K , NOVEMBER 12TH : Srinagar-Baramullah train traffic resumés after 99 day hiatus. 
MANALI-LEH , NOVEMBER 12TH : BRO struggling to clear the Rohtang La, more snow to come next days.
WEATHER , NOV 7TH : rain in Srimagar & Manali , snow in Gulmarg & over the Rohtang coming days. 
SRINAGAR , NOVEMBER 5TH : one dead , forty wounded in grenade attack at Hari Singh Street. 
October 31st : celebrations in Leh and protests in Kargil & Srinagar as Jammu & Kashmir state dissolves. 
J&K , Monday 28th : nineteen wounded , six critical , after grenade attack at bus stand in Sopore. Truck driver shot dead in Anantnag. 
J&K , October 12th : seven wounded , three critical , in Srinagar grenade attack . 
J&K , October 10th : travel restrictions for domestic tourists lifted. 
J&K , October 6th : 14 bystanders wounded in grenade attack against CRPF in Anantnag , S Kashmir. 
MANALI-LEH UPDATE , October 4  : snowfall over the Rohtang La .
J&K UPDATE , October 2 : basically no change . Closed schools , no internet , landline phones only. Talk of “gradual” release of detained politicians . 
MANALI-LEH UPDATE , September 21st : snowfall over the Rohtang La 
KASHMIR UPDATE, AUG 29 : renewed restrictions in Srinagar. Strikes in Kargil & Drass. 
KASHMIR UPDATE, AUG 19TH : partial phone services in the Vale. Schools opening – with few teachers and even fewer pupils turning up. 
HIMACHAL UPDATE , AUG 18 : hundreds of vehicles on Manali-Leh road trapped on N side of the Rohtang La before Keylong. Same situation between Gramphu and the Kunzum La on Manali-Kaza route. 
LADAKH UPDATE , AUGUST 10-12 : protests and clash with police in Kargil , including a few tear gas shells. Protests halted on Sunday , open market and traffic running. 

KASHMIR UPDATE , AUGUST 4 : state police now actively blocking entry to the Vale , Ladakhbound bikers diverted to  to Himachal Pradrsh. 
SRINAGAR-LEH ROAD OUT JULY 27Th for a second day after heavy rains and multiple landslides. Jammu-Srinagar also out at Ramban. 
MANALI-KAZA , June 30TH : Kunzum La opened June 30th. 
MANALI-LEH CLEARED , JUNE 10TH according to BRO. No word on buses from Keylong yet. 

MANALI-KAZA , JUNE 9 : Kunzum La cleared. 
MANALI-LEH , MAY 30 : day tourism to Rohtang top starting tomorrow. Night temperatures down to zero , daytime around ten. 
MANALI-LEH , MAY 22: HRTC state buses start running up to Keylong. 
MANALI-LEH , MAY 19TH : Rohtang La cleared . 
MANALI-LEH , MAY 17TH : 500+ vehicles go beyond Marhi -and gets trapped by landslide. Day tourists start to hike down on foot. Five klicks of road up to the pass remaining to be cleared. Rainy & clouds , to clear up by Sunday. 
MANALI-LEH , MAY 12TH :  voters bused thru Rohtang tunnel for the upcoming elections. 
MANALI-LEH , MAY 5TH : traffic allowed up to Marhi , altitude 3300-ish.


SRINAGAR-LEH OPEN , APRIL 28TH. Good weather forecast today , snow & sleet over the Zoji La next week. 
MANALI-LEH , APRIL 18TH : traffic allowed up to Gulaba

MANALI-LEH , APRIL 6TH : BRO working its way up from Gulaba @ 3000 meters , frequent avalanches.

https://vistet.files.wordpress.com/2011/07/img_3113.jpg” alt=”IMG_3113″ width=”660″ height=”381″ class=”alignnone size-full wp-image-2370″ />

The Tribune , April 6th
APRIL 4 : only military traffic allowed Wednesday & Sunday on Jammu-Srinagar road thru April and May . MANALI-LEH UPDATE , MARCH 22 : BRO makes their first guesstimate on road opening : April 10. Not the first time they have predicted an April opening – which never have worked out so far. More snow over the Rohtang in the weather forecast same day. Subzero at the top , snow turning to rain between the pass and Manali – prime avalanche season.
SRINAGAR-LEH UPDATE , MARCH 20 : road cleared up Sonmarg , but still avalanche prone and closed.
FEB 26TH : SRINAGAR , JAMMU & LEH AIRPORT CLOSED for a day after airfights over both sides of the Line of Control. One Pakistani , two Indian jets shot down.
FEB 22 : Leh airport closed in heavy snowfall.
JAMMU-SRINAGAR HIGHWAY , FEB 14TH : CRPF troopers killed in attack against convoy.Final death toll 42 CRPF , no civilian casualties.
SRINAGAR , FEB 10TH : four civilian , seven CRPF wounded in grenade attack at Lal Chowk. JANUARY 18TH : five dead found after Khardung La avalanche.Five missing.
JAN 18TH : three grenade attacks in Kashmir , one @ Lal Chowk.
J&K , JANUARY 16TH : more heavy snowfall , India Met Department issues avalanche warnings for Srinagar-Leh & Ladakh.

BAI Award 2018 : Yading Skyrun

No one is happier than me for the recent lack of candidates in this contest . But here we are , with a strong candidate for this years Bad Altitude Info Award. The Yading Skyrun has just kicked off , marketed as the ” worlds highest ” running contest. There are nice graphics in the form of maps and elevation profiles on the official site.


And this is where the good news ends. This starts with getting to the event , choosing between the two obvious routes to Yading. One way is flying in to Shangri La , a few hundred meters lower than Lhasa , and take a long bus ride the next day. This could be seen as a good idea knowing that 2 % of soldiers flying in to Lhasa start to develop pulmonary edema , and a even larger group is incapacitated . The other option is flying in direct to Yading …which is the worlds highest airport at 4411 meters. That shouldn’t really be an option for any first comers to these altitudes , without prior acclimatization . The event organizer don’t give any input on this / in fact they literally never mention acclimatization. The plan here is at surreal distance from standard safety guidelines : a run from 4000 meters altitude to 5000 in a single day, without any required acclimatization first.

A given comparison here is the Ladakh Marathon that since seven years organize a similar run to the slightly higher Khardung La . They strongly recommend minimum five days of acclimatization in Leh at 3520 meters . The Everest Marathon , another 5000 plus run , organise the first five nights in the 2600 to 4000 meters range.

Chaddar Trek & ILP/PAP : New Regulations 2018/19

Flying in last to Leh in January I met a lot of tourists heading for the Chaddar trek , with minimal awareness of AMS and rushed itineraries. Interesting medical experiment. Leh Council has apparently grown tired of the resulting high workload at the Sonam Norbu Hospital.

* from this season a check up at the hospital is recommended
before setting out , with a health declaration to be filled in first.

* from next season this check up will be mandatory on day three after arriving Leh.

* foreigners will be required to show proof of travel insurance when applying for PAP/ILP permits for Pangong Tso , Nubra etc.

High Roads News Sticky , 2018

2019 :
JAMMU-SRINAGAR HIGHWAY , FEB 14TH : 20+ CRPF troopers killed in attack against convoy.

SRINAGAR , FEB 10TH : four civilian , seven CRPF wounded in grenade attack at Lal Chowk.
JANUARY 18TH : five dead found after Khardung La avalanche.Five missing.

J&K , JANUARY 16TH : more heavy snowfall , India Met Department issues avalanche warnings for Srinagar-Leh & Ladakh.

( 2017 sticky archived here )
DECEMBER 20TH : on/off conditions for Jammu-Srinagar road last week , now single direction traffic
DECEMBER 16TH , S KASHMIR : seven protesters killed in Pulwama
MANALI-LEH , NOV 15TH : Rohtang La out for traffic , Rescue posts set up in Marhi & Koksar for those crossing on foot. Lahaulis press for a opening of the Rohtang tunnel , not only for emergency purposes.
SRINAGAR-LEH , NOV 12TH out from the Zoji La in heavy snowfall.
MANALI-LEH, NOV 7TH : open road again up to Keylong , tourist traffic stops at Gulaba.
MANALI-LEH , Nov 3RD : Rohtang La out in heavy snowfall.
SRINAGAR-LEH temporary out November 1st in heavy snowfall. Temperatures now subzero at the Zoji & Fatu La.
MANALI-LEH , OCTOBER 11TH : fifteen centimeters of snow over Keylong , road out again.

HRTC buses again running Manali-Keylong , October 3 The Tribune
MANALI-LEH , OCTOBER 2ND : light traffic running south out of Lahaul over the Rohtang. Road cleared up to Sarchu.
MANALI-LEH , SEPTEMBER 26TH : hundreds evaced after last days heavy snowfall : some with IAF helicopters from Sarchu & Baralacha La , others thru the unfinished Rohtang tunnel.One meter of snow beyond Koksar. Weather improving , mixed sunny/clouds coming days. Above zero night time @ Rohtang La till end of week.
SRINAGAR-LEH , SEPTEMBER 23RD : Sonmarg-Drass out for a few hours , re-opened in the afternoon. Night temperatures now around zero at the Zoji La.

MANALI-LEH , SEPTEMBER 23RD : heavy rain thru the weekend at the Rohtang , night temperatures still just above zero at the pass.
MANALI-LEH , SEPTEMBER 18TH : temporary stop between Manali-Keylong after snowfall over the Rohtang. Coming days forecast : mixed sunny to rain , rain or snow in the weekend.

SRINAGAR-LEH , SEPTEMBER 16TH : first snowfall takes out the road for less than a day between Sonmarg and Drass.

AUGUST 9TH : RAINS , FLASH FLOOD NEAR LEH : rains on the W side of the Indus seems to have taken the same path as in 2010 : destroyed houses and road near Sabu and Shey. No reported loss of life.

J&K SECURITY , JULY 8TH : expect tensions on second year mark of Burhan Wanis death.

LEH , JULY 7TH : Happy birthday , Dalai Lama ( on visit until end of month ) .

SRINAGAR , JUNE 1ST : one dead , one wounded after protests at the Jami Masjid. Two grenade attacks in S Kashmir , no casualties.
SRINAGAR-LEH , MAY 30TH : road blocked for a third after landslide

SRINAGAR , MAY 25TH : massive clashes at Jami Masjid after Friday prayers , 40-50 wounded , shots fired inside the mosque.

MANALI-LEH OPEN MAY 14TH in news stories – not officially confirmed on leh.nic.in yet

SRINAGAR , MAY 7TH : three cars with domestic tourists attacked by stone throwers on the outskirts of Srinagar. One dead.
PULWAMA (south J&K ) MAY 7TH : grenade attack against CRPF , one wounded.
WEATHER UPDATE MAY 7TH : heavy rains over the Rohtang , rain in Sonmarg & Kargil.

J&K SECURITY , MAY 6TH : five militants ( including professor from Kashmir University ) and five civilians killed in Shopian. Curfews , transport and internet restrictions in Srinagar.
SNOWFALL AROUND ZOJI LA , APRIL 20 : Srinagar-Leh out after Sonmarg.

ROHTANG LA , APRIL 19-20: night temperatures still just below zero , heavy snowfall


April 14th – The Tribune

SRINAGAR-LEH , APRIL 13TH : traffic resumes , single direction only.

SRINAGAR-LEH ROAD OUT APRIL 11TH beyond Sonmarg after landslide.
MANALI-KEYLONG TRAFFIC , single direction only on alternate days , starts April 6th. Followed by snowfall over the Rohtang on the 8th…
MANALI-LEH , APRIL 4TH : less than a kilometer of road to clear at Rohtang top


Crossing the Zoji La , April 6th – The Tribune

KASHMIR , APRIL 3RD : internet restored in the Vale , but not the south. Strikes continues, including closed schools.
SOUTHERN KASHMIR , APRIL 2ND : second day of strike , internet services and train traffic shut down. 80+ wounded in widespread protests. Ten militants and four soldiers killed in the triggering event.
SRINAGAR-LEH CLEARED MARCH 31ST , opening next week : The Tribune quotes BRO official : “The necessary repair work and widening of the road is being carried out and it may be completed in the next few days”
Weather forecast coming week : mixed sun/cloudy , no rain or snow.
SRINAGAR-KARGIL ZANSKAR OPEN , March 25th – confirmed by Kargil admin

FIRST FRESH VEGGIES OVER THE ZOJI LA , MARCH 21ST : see the recent comment from Leh

MANALI-LEH, MARCH 22ND : snow over the Rohtang La , Kothi ( 10 cm ) and Keylong ( 15 cm ) .

SRINAGAR-LEH , MARCH 19TH : open road up to Sonmarg.


MANALI-LEH ,MARCH 17TH : snowfall over the Rohtang La and Keylong

MANALI-LEH ROAD CLEARING STARTS , MARCH 12TH : kickoff prayers and starting the big machines. Ideal conditions for avalanches – rain down in Manali , snowing at Rohtang top and temperatures swinging just above/below freezing point.
SRINAGAR , MARCH 10TH : grenade attack against Kralkhud police station , no casualties.
J&K 10th : SASE issues low level avalanche for large high areas in Kashmir : Gulmarg , Kargil and more. More snow in next weeks forecast.
GULMARG ( J&K ) FEB 16TH : five skiers hit by avalanche , one dead
FEBRUARY 16TH : one way traffic to Srinagar from Jammu running
HIMACHAL WEATHER UPDATE , FEBRUARY 13TD : first major snowfall , no traffic beyond Solang on the Rohtang road. Six centimeters of snow in Manali, 35 at the Rohtang La, 27 in Kothi, Keylong 11. Light traffic running in Spiti – eight centimeters of snow in Kaza.

Jammu-Srinagar road put for a second day. 23 centimeters in Srinagar, 40-ish in Pahalgam & Gulmarg.
KASHMIR WEATHER UPDATE, JANUARY 29TH : seven weeks long dry spell ends(?) with light rains in the Vale . Eight cm of snow in Gulmarg.

MANALI-LEH : road closed, rescue posts at Marhi & Koksar closed December . This marks the end of the rescue posts , as the Rohtang tunnel should be operational in 2018. The tunnel work is closed for the winter and the Bailey bridge disconnected , so Lahaulis can still only get out with helicopter for medical emergencies. Work resumes May.
SRINAGAR-LEH : closed since December 14th. Zoji La tunnel project approved , estimated building time seven years. This will be a massive undertaking , ending Ladakhs long winter isolation.


Solidly subzero : Leh now in the -3 to -13 range , Rohtang La -5 to -16 , Kargil down to -20 .

Nights only subzero : Srinagar + 10 to -3 ( banks of Dal Lake frozen a week ago ) , Shimla +13 down to zero , Manali +10 to +1 .

JAN 23RD : grenade attack against Baramullah police station , one wounded. Grenade attack against army vehicle in Pulwama , one civilian wounded.
JAN 20 TH : eight police wounded in grenade attack at Pulwama , 40 km from Srinagar.
JAN 11TH : Separatist leaders call for strike on Jan 13th after civilian death in connection to protests in Kulgam district.
JAN 6TH: Four police killed by IED in Sopore , 45 km from Srinagar.

JAN 1ST : Attack against CRPF Camp in Pulwama ( 30 kms from Srinagar ) ends : five soldiers , one militant dead.
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High Altitude Poodle

In Sweden the word poodle is used in two ways. One way is the dog , the other is linked to when you have to give up an earlier strong position. In public. The expression came from a press conference in 2002 with a minister that had the bravery , or  at least  strategical insight , to realise that the only way out was to recant  and act humble. It was described by a journalist as a ” full poodle , all four paws in  the air , asking for forgiveness” . The expression ( ” att göra en pudel ” ) stuck.


In Britain today the National Health Service is in the very slow,  discreet process of making a poodle re their guidelines on fluid intake & prevention of altitude sickness.



“Minimum 4-6 liters per day”

This was the NHS  standard recommendation from the turn of the millenium – for any altitude , any activity . One group that would be  puzzled by this advice was historically  aware climbers , familiar with the new concepts that took Hillary & Tenzing to the top of Mt Everest : the fluid rations were around three liters per day.

Another group were those who had attended the altitude health lecture run by in Pheriche ( alt. 4200-ish ) on the Everest trek , by by the docs from Himalayan Rescue Association. Then and now they talked about avoiding both de- and overhydration , and a base recommendation of around three liters of fluids per day.





“Plenty of fluids”

In 2014 NHS changed course , for reasons unkown  , by going to ” drink plenty of fluids”.




“Drink enough”

Now who could argue with that ? The Scots , as in the Scottish NHS Fit for Travel site , sought a new quarrrel with the sassenach and allied with Himalayan Rescue Association etc : maintain a good intake , and avoid an excessive one.

The stakes involved , and the reason why for example the Himalayan Rescue Association and the Institute for Altitude Medicine warns against talking about fluid intake with no upper limit , is best described by one of the proponents of a high fluid intake.

Enter  Dr Stephen Bezruchka , with a short chilling remark in Altitude Illness – Prevention & Treatment” :

“Like any advice it can be overdone and people have died from drinking too much water.”