God, I needed someone to say this, and you say it so well. Carefully and clearly. The CDC's guidance is quintessentially "American" in its focus on individual preference and, sadly, in its choice of what's palatable (5 days) over what is actually in the data (the infectious period is longer than that). Finally, for those of us at medical high risk -- a non-trivial 9-15 million people, depending on which definition you select -- the latest guidance conveys that the CDC, like many in this country just... doesn't... care. Doesn't see our lives as worth protecting. It's a bitter reality.
As a high risk person and as a family doc I thank you for your practical explanation of the CDC guidance and recommendations for continuing individual risk reduction. However, I regret that out of kindness or professionalism or diplomacy, your list of the shortcoming in the CDC guidance does not explicitly call them out for abandoning the basic foundation of equitable population protection inherent in public health values to emphasize individual guidance. They continue to leave high risk people, the uninsured, those in medical deserts, those who have experienced discrimination unprotected. They put out guidance (out of isolation in 5 days) not based on good science. We are watching the destruction of the system of public health as a public resource.
As another family doc here, I appreciate and affirm your comments! The CDC has become something people like to quote to justify minimal and insufficient measures.
The underlying driver of behavior is that the vast majority of people cannot sustain pandemic psychology for more than 2 years. Some people can and do continue to mask indoors, ensure good ventilation, and stay up to date with boosters, but they are also the minority of Americans who value the common good over individualism, expertise over ideology, and evidence over anecdote.
I don’t think answering the “why”questions posed in this post will lead to actionable strategies. People have settled into their choices regarding vaccination and whatever trust they place in the medical community by now, and the only budge I get these days is persuading sick patients to take Paxlovid. At least that is gratifying, until they are back into the world on day 5 without the mask I/CDC recommend. I tell them to stay home for 10 if they can swing it.
Imagine how impossible monkeypox 2-4 week isolation is going to be.
Anyway, Dr J, wear that mask indoors at the wedding. BA.5 is romping through my patients for the past month plus, with a steady Covid churn for months, and the PASC stuff like you said is worth avoiding.
When I picked up groceries wearing a mask in early March, 2020… people stared at me, some snickered, and some probably thought “hey that guy with the scrubs on wearing a mask probably knows what’s up.” I have never stopped wearing that mask indoors because it’s not time yet, and you would just have to think that in any other world than the warped collective fiction we are stuck in - that people would see a doc wearing a mask and still think “he knows what’s up, maybe I should wear a mask, too.”
Don’t compromise on this yet, we have your back. Sublimate that awkward, embarrassed feeling into moral and scientific righteousness!
Thank you for this. We are trying to do the right stuff and do get embarrassed when other people clearly think we are being silly. Your comments are great reinforcement and very much appreciated.
Katelyn, this is a very much better newsletter than I felt the last one was. I appreciate your setting out the facts as you see them. I might quarrel with the notion that shifting the risk to the individual versus protecting the overall population is very "American". I think there are lots of times that Americans come together and accept limitations imposed on them in the interest of the good of all. But I am really glad to see you make critical comments of the CDC when appropriate and to candidly acknowledge that politics and public health policy have become intertwined. I think that is a terrible development and could (maybe) be somewhat altered by urging, not "suggesting" that people remain masked indoors all the time in public places out of concern for the safety of immunocompromised and older people. After all older people account for a huge slice of our population. I am confused though by your comment about the wedding. You said you will be. unmasked but using antigen tests. If I understanding it correctly that would probably protect other people from being infected by you if you are positive (you'll stay home, i assume) but how will that protect you from the doubtless many other people who are much less considerate?
Again, thanks for a great article. Speaking "truth to power" is hard but badly needed - congratulations.
I was hoping for a more broad societal reminder that if you are symptomatic with any upper respiratory infection (new cough, worsening cough, fever) and you need to go out: wear a mask and keep your hands clean. Many people have signs of COVID, test negative and go about their daily life with other contagious viruses, which we see as Rhinovirus outbreaks in other settings. Many other countries, before the pandemic, had this societal norm of wearing a mask when you were sick. I really hope this is a lesson we use moving forward!
As always, thank you so much for all that you do to keep us well informed, and for your honesty about how confusing it can be! It’s so hard to navigate the level of risk.
You mentioned that long Covid is still a big enough worry (at least for adults), even if one is up to date on vaccines, that it keeps you cautious. It has been a while since you wrote a post dedicated to long Covid - would you consider a post to update us on the latest research?
Yes, please, _please_ write more about long Covid. Our family doctor has told us it’s a very substantial risk (not just to us, but to all healthy adults) and to keep up with everything we’ve been doing. We’re putting off dental care, other desperately needed “masks not possible in this situation” healthcare, and our friends and family have totally lost patience with us, which is so hard. If we could understand, even a little better than we do now, what our actual risk was (=how likely are we to develop it, and if we do, is it permanent disability vs temporary, and how long is temporary), then perhaps we could take some calculated risks. But with no nuanced data, we do what our doctor says, stay safe, but are growing seriously depressed.
Let's be honest, the US has given up, covid has won and the collective decision has been made that 500 deaths a day is an acceptable price to return to pre-pandemic normal.
Even if that number goes up and hospitals are stressed again, I doubt that most people will be willing to change their behavior.
I'm afraid we're seeing American "rugged individualism" mutate into straight out sociopathy. I't's no longer "e pluribus unum"; more like "I've got mine, screw you." We don't care how many *other* people are dying, as long as it's not us. It's not a problem until it happens to us, and then it's clearly somebody else's fault.
Thanks again for your cogent review of the confusing situation. Once again my very active otherwise very healthy immunocompromised husband and I are feeling like we’re being considered disposable. At least we are saving lots of money being unable to fly, travel, go to concerts or eat indoors at restaurants. Even some close friends don’t get why we can’t have dinner indoors at their house. Even with Evushield the prospect of getting Covid is very scary and likely life threatening.
"I just don’t want to get sick. (I just don’t have the time with two toddlers running around and a career.) " followed by "I’m going to a wedding this weekend and will not wear a mask, but we are antigen testing." Do as I say, not as I do? She knows and I know that antigen testing is not a guarantee to clear not masking. PCR can do that. Who is administering the antigen tests, how good is the sampling, and how good are the tests? We know from testing of the tests that quality is all over the place from worthless to very very good. None of this is controlled so therefore not masking at a wedding is a bad joke. Asserting that antigen tests are somehow going to make it okay is not okay. Depending on the sample and test quality, maybe you can catch a highly positive individual, but the less than highly positive, but still infectious will likely waltz right through. Holding out to followers that this is a sound procedure is a disservice to all of them.
No offense to Katelyn but when Omicron was spreading, she flew to see her family and later noted that her family got Omicron. None of which I fault her for, but then she never talked about her catching Omicron again.
Presumably she is not really that concerned about catching it again bc she already caught it and recovered just fine. Again, I wouldn't fault her for that at all.
But acting like she is worried about becoming disabled thru long covid and then saying she'll go unmasked to an indoor wedding (she would point out if it were outdoors)...just doesn't seem to make much sense. Would be much better to be honest with us...
I don't fault her for seeing her family. I do bristle somewhat when someone who caught it lectures the rest of us about not letting our guard down, as if we aren't allowed to do the same cost/benefit calculations they made.
I also get annoyed by sweeping pronouncements that we're all going to get it.
I can't read into her motivation or divine the intent, but like you I can read the statements and see the contradiction. To me it doesn't make much sense either, but it is a personal choice. My issue is with the inference that antigen testing will make this okay.
I had the same question (and concern) about event antigen testing. See the antigen test sensitivity test posted at the top of Katelyn's article - it says that on the day the PCR becomes pos, there are 40% false antigen-test negatives. Though if the measurement group for the chart is symptomatic people, hopefully they would be screened out from the event. Possibly an asymptomatic person could have a pos PCR and never test pos on antigen testing? ALSO: Is an asymptomatic infected person whose PCR is not yet positive capable of transmitting? I understand even well-informed people's risk tolerances do (and probably should) vary - there just seem to be some important unknowns for those who want to continue a low-risk life while venturing out into the world. Appreciations to Katelyn for raising and clarifying the issues with such compassion and grace - and for creating a place to discuss them!
"Is an asymptomatic infected person whose PCR is not yet positive capable of transmitting?" I believe the answer is "no." If you do not have enough viral level to be detected by PCR, you're not even asymptomatic. I guess the question is where is the cycle count cutoff? If you are asymptomatic but your PCR cycle count is <=30, you are infectious unless you are in recovery and this is not viable virus that is being detected. Somewhere above 30 I guess (because I don't know), you stop being considered infectious.
Not realistic economically in many situations but curious: How do home "PCR" (molecular) tests compare with lab PCR tests? They claim to match lab PCR tests in the mid to high 90%s but I'd love to see a chart comparing lab PCR, home molecular, and antigen tests similar to the one at the top of Katelyn's post.
Sadly, the food pyramid is _also_ politicized. Compare Harvard's Healthy Eating Plate which follows the science vs the officially published USDA MyPlate; some of the food items on the latter are absolutely the result of industry lobbying. :(
I like the simplicity of Harvard’s Healthy Eating Plate. Question about potatoes: if they “don’t count” as a (preferred) vegetable, does that mean we shouldn’t eat them at all? Or is it okay to eat them as long as we also eat plenty of other veggies?
I thought cooked potatoes were good for us, especially if the skin is still on.
The new CDC guidelines are a complete “copout” and some of the worst data analytics I have witnessed. They should upset everyone – even if you oppose vaccine and mask mandates. CDC is paid to lead. Some key points
1. Although COVID is no longer racking piles of dead people per day filling up hospital parking lots, it can be dangerous and a regular case on a healthy adult age 40 can put them in bed for days and take 3 weeks to feel strong again. Long COVID is real.
2. The new variation appears to be in full spread mode a few days before major symptoms are shown.
3. Any rational organization would work to make testing increasingly accurate, easily available, and have results available quickly. Waiting 3 days to get a COVID appointment and then 3 more days to get results makes the testing worthless. The failure to stress quality testing was a lack of leadership.
4. The entire issue of when you can return requires REAL scientific investigation. You can return when you are no longer a spread risk. It may well be you feel fine, still test positive, and are not a spread risk. Or you might be a spread risk. The failure to articulate this and call for better investigation was a lack of leadership.
5. Make mask available for free when a person enters a store.
6. Put in place ventilation plans – especially for schools. This failure is viewed as CDC in the pocket of Big Pharma
7. The US needs to get over the mind set of “when you are sick”, you just suck it up and go to work (or school) – this terrible public health. There is ZERO chance you will get anyone to buy into public health initiatives when CDC leaves them hanging out to dry with their employer.
8. Pressing the need for vaccination without the other items and acknowledging lots of vaccinated folks get COVID – no credibility – simply sounds like you are business agents for pharma.
Yes, being an effective agent of chance requires pressing forward on the best path. That is the role you signed up for.
I was hoping the pandemic would at least lead to mandatory paid sick leave in the US, but no dice so far. I am lucky to live in a state, NY, that recently instituted it. Now my son who is a temp worker can get paid leave to go to medical appointments!
Erica, in 1944 the great FDR proposed a Second Bill of Rights that included universal access to "adequate" health care. If he had been able to serve out his last term, he might have even got the enabling legislation. Missed opportunity. :(
All the CDC is offering to the disabled or immunocompromised is thoughts and prayers. I will never pay attention to what they say again. This comes from someone with a MPH.
HI Katelyn, I am still wondering if you could explain how your antigen testing before the wedding would protect you from other less sensible people in attendance. Know you're probably very busy, but am confused.
I think she means all the guests have been asked to take an antigen test, and hopefully since it's a wedding, the bride and groom's request would be honored
would make sense, but she doesn't say she's relying on that. and would everybody honor that request? doesn't seem likely given the general attitudes and behavior of most of the public.
Depending how close someone was to the bride and groom and the size of the wedding, they could make a better assessment of whether the people at the wedding would likely honor that request compared to the general public.
true, but in the context of her comment, it wasn't at all clear that those would be preconditions of her electiong to go unmasked. Gives the wrong impression as to what is "ok"
How likely is transmission to occur among people at the gathering who were asymptomatic and tested antigen-negative at the door at an indoor event like the wedding? Am guessing that this criterion would be moderately--but not very--reassuring. Of course there are lots of variables to take into account like if I'm wearing an N95, etc. But people who are at (or live with those who are) at high risk often need to make an estimate.
Another comment- I am completely baffled about how ignoring the risks and sequelae of Covid infection is good for the economy. The same consequences that affect the economy exist.
Covid infection occurs-
-person is sick- misses work- disrupts work, affects ability to share parenting/family responsibilities
-person transmits to those in house- which then causes disruption above
-no test to negative- so now unmasks- goes back into society and transmits - see above.
-long covid is real and may affect ability to resume normal ADLs
-Yes, some people are asymptomatic but many are not. Symptoms impact ability to be productive. Long covid (1:5) means persistent symptoms affecting productivity.
-schools are now completely ignoring the risk to children and even more to those who work in schools. We had National Guard driving out buses and in our schools because there were so many people out. The current policy will enhance this problem because now we have no protection in guidance for people who should stay home or wish to. Instead the protocol will encourage re-entry way to soon and ensure higher transmission.
The unvaxxed have been blithely and unknowingly relying on those who have been acting responsibly to protect themselves and their community are now at higher risk. With the current messaging having no stress on personal or communal responsibility spread is for sure going to happen at a greater rate. There is no consideration that the unvaxxed have higher potential to burden the medical system.
As Fall progresses, with all the nice opportunities for encouragement of vectors to circulate, I can't see we will be in a better place having pretended that it will all be OK.
Hospitals are down 20-40% of bedside care givers. For rural hospitals it’s even worse.
Also- “risk” is much higher for Black people. The hospital algorithms are biased against us- not to mention human bias. Rich Black people, get worse care for covid19 than poor white people.
That said, as an older Black woman living in the State with the worst healthcare disparities in the country- I will not take any risk of getting covid. I wont go anywhere masks are not required. I cant take the risk.
I think you will eventually have to go some places where masks are not required and in preparation for that, you should consider getting the best mask you can get: elastomeric half-face respirator with P100 filters. Completely breathable and the filters last basically forever. I always carry one with me in case I find myself in a situation where I cannot retreat, but can safely exchange N95 for the half-face.
Indeed. And the situation for indigenous peoples is equally bad if not worse. I remember the "hospital" in late mid century Oklahoma my in-law relatives went to. Could have been 1800's era for its lack of all but the barest amount of equipment. The BIA wasn't throwing very much money into health care.
I am a one-trick pony when it comes to long covid. I said sometime back that my fear was that everyone who had tested and diagnosed covid, was probably a long hauler whether they were asymptomatic or not... They just wouldn't see the lasting damage until years down the road. Even if we discount the danger of long covid, this virus hasn't exhausted its bag of mutations. By sheer fecundity of invention it's may come up with something with both high escape and high lethality and then where will we be with the CDC's laissez faire guidance? It's no good to declare victory and go home as the CDC seemingly has.
KB, The CDC needs to determine what its primary task is and subordinate everything to the achievement of that. I'm an outsider, but I think they've fallen victim to mission creep and are spreading themselves too thin, given their funding corridor and staffing.. Caveat lector here tho'
I am 85 and have had 4 doses of Moderna. I cannot take Paxlovid as it increases QTC interval and I take cardiac meds. That is the reason a number of people who get infected do not take Paxlovid. I have considered the antibody but do not qualify. I still use my N95 mask when I leave my property. I will get the Moderna variant vaccine when it is available. For me a mask is going to be part of my wardrobe whenever I leave home for the rest of my life.
Just for interest, how protective is the small pox vaccine which I got as a child in protecting against monkey pox?
God, I needed someone to say this, and you say it so well. Carefully and clearly. The CDC's guidance is quintessentially "American" in its focus on individual preference and, sadly, in its choice of what's palatable (5 days) over what is actually in the data (the infectious period is longer than that). Finally, for those of us at medical high risk -- a non-trivial 9-15 million people, depending on which definition you select -- the latest guidance conveys that the CDC, like many in this country just... doesn't... care. Doesn't see our lives as worth protecting. It's a bitter reality.
Man’s inhumanity to man is very much in evidence. 😡
As a high risk person and as a family doc I thank you for your practical explanation of the CDC guidance and recommendations for continuing individual risk reduction. However, I regret that out of kindness or professionalism or diplomacy, your list of the shortcoming in the CDC guidance does not explicitly call them out for abandoning the basic foundation of equitable population protection inherent in public health values to emphasize individual guidance. They continue to leave high risk people, the uninsured, those in medical deserts, those who have experienced discrimination unprotected. They put out guidance (out of isolation in 5 days) not based on good science. We are watching the destruction of the system of public health as a public resource.
As another family doc here, I appreciate and affirm your comments! The CDC has become something people like to quote to justify minimal and insufficient measures.
The underlying driver of behavior is that the vast majority of people cannot sustain pandemic psychology for more than 2 years. Some people can and do continue to mask indoors, ensure good ventilation, and stay up to date with boosters, but they are also the minority of Americans who value the common good over individualism, expertise over ideology, and evidence over anecdote.
I don’t think answering the “why”questions posed in this post will lead to actionable strategies. People have settled into their choices regarding vaccination and whatever trust they place in the medical community by now, and the only budge I get these days is persuading sick patients to take Paxlovid. At least that is gratifying, until they are back into the world on day 5 without the mask I/CDC recommend. I tell them to stay home for 10 if they can swing it.
Imagine how impossible monkeypox 2-4 week isolation is going to be.
Anyway, Dr J, wear that mask indoors at the wedding. BA.5 is romping through my patients for the past month plus, with a steady Covid churn for months, and the PASC stuff like you said is worth avoiding.
When I picked up groceries wearing a mask in early March, 2020… people stared at me, some snickered, and some probably thought “hey that guy with the scrubs on wearing a mask probably knows what’s up.” I have never stopped wearing that mask indoors because it’s not time yet, and you would just have to think that in any other world than the warped collective fiction we are stuck in - that people would see a doc wearing a mask and still think “he knows what’s up, maybe I should wear a mask, too.”
Don’t compromise on this yet, we have your back. Sublimate that awkward, embarrassed feeling into moral and scientific righteousness!
Thank you for this. We are trying to do the right stuff and do get embarrassed when other people clearly think we are being silly. Your comments are great reinforcement and very much appreciated.
Thank you.
Very well expressed and appreciated.
Katelyn, this is a very much better newsletter than I felt the last one was. I appreciate your setting out the facts as you see them. I might quarrel with the notion that shifting the risk to the individual versus protecting the overall population is very "American". I think there are lots of times that Americans come together and accept limitations imposed on them in the interest of the good of all. But I am really glad to see you make critical comments of the CDC when appropriate and to candidly acknowledge that politics and public health policy have become intertwined. I think that is a terrible development and could (maybe) be somewhat altered by urging, not "suggesting" that people remain masked indoors all the time in public places out of concern for the safety of immunocompromised and older people. After all older people account for a huge slice of our population. I am confused though by your comment about the wedding. You said you will be. unmasked but using antigen tests. If I understanding it correctly that would probably protect other people from being infected by you if you are positive (you'll stay home, i assume) but how will that protect you from the doubtless many other people who are much less considerate?
Again, thanks for a great article. Speaking "truth to power" is hard but badly needed - congratulations.
I was hoping for a more broad societal reminder that if you are symptomatic with any upper respiratory infection (new cough, worsening cough, fever) and you need to go out: wear a mask and keep your hands clean. Many people have signs of COVID, test negative and go about their daily life with other contagious viruses, which we see as Rhinovirus outbreaks in other settings. Many other countries, before the pandemic, had this societal norm of wearing a mask when you were sick. I really hope this is a lesson we use moving forward!
As always, thank you so much for all that you do to keep us well informed, and for your honesty about how confusing it can be! It’s so hard to navigate the level of risk.
You mentioned that long Covid is still a big enough worry (at least for adults), even if one is up to date on vaccines, that it keeps you cautious. It has been a while since you wrote a post dedicated to long Covid - would you consider a post to update us on the latest research?
Yes, please, _please_ write more about long Covid. Our family doctor has told us it’s a very substantial risk (not just to us, but to all healthy adults) and to keep up with everything we’ve been doing. We’re putting off dental care, other desperately needed “masks not possible in this situation” healthcare, and our friends and family have totally lost patience with us, which is so hard. If we could understand, even a little better than we do now, what our actual risk was (=how likely are we to develop it, and if we do, is it permanent disability vs temporary, and how long is temporary), then perhaps we could take some calculated risks. But with no nuanced data, we do what our doctor says, stay safe, but are growing seriously depressed.
Let's be honest, the US has given up, covid has won and the collective decision has been made that 500 deaths a day is an acceptable price to return to pre-pandemic normal.
Even if that number goes up and hospitals are stressed again, I doubt that most people will be willing to change their behavior.
I'm afraid we're seeing American "rugged individualism" mutate into straight out sociopathy. I't's no longer "e pluribus unum"; more like "I've got mine, screw you." We don't care how many *other* people are dying, as long as it's not us. It's not a problem until it happens to us, and then it's clearly somebody else's fault.
"sauve qui peut" we used to say.. as we ran for the hills, and let the devil take the hindmost. Nothing new under the sinking sun....
"I'm alright jack" is the British equivalent, I guess.
So sad what this says about society at large.
Yes, that's a symptom of the broader trend towards sociopathy.
Thanks again for your cogent review of the confusing situation. Once again my very active otherwise very healthy immunocompromised husband and I are feeling like we’re being considered disposable. At least we are saving lots of money being unable to fly, travel, go to concerts or eat indoors at restaurants. Even some close friends don’t get why we can’t have dinner indoors at their house. Even with Evushield the prospect of getting Covid is very scary and likely life threatening.
"I just don’t want to get sick. (I just don’t have the time with two toddlers running around and a career.) " followed by "I’m going to a wedding this weekend and will not wear a mask, but we are antigen testing." Do as I say, not as I do? She knows and I know that antigen testing is not a guarantee to clear not masking. PCR can do that. Who is administering the antigen tests, how good is the sampling, and how good are the tests? We know from testing of the tests that quality is all over the place from worthless to very very good. None of this is controlled so therefore not masking at a wedding is a bad joke. Asserting that antigen tests are somehow going to make it okay is not okay. Depending on the sample and test quality, maybe you can catch a highly positive individual, but the less than highly positive, but still infectious will likely waltz right through. Holding out to followers that this is a sound procedure is a disservice to all of them.
No offense to Katelyn but when Omicron was spreading, she flew to see her family and later noted that her family got Omicron. None of which I fault her for, but then she never talked about her catching Omicron again.
Presumably she is not really that concerned about catching it again bc she already caught it and recovered just fine. Again, I wouldn't fault her for that at all.
But acting like she is worried about becoming disabled thru long covid and then saying she'll go unmasked to an indoor wedding (she would point out if it were outdoors)...just doesn't seem to make much sense. Would be much better to be honest with us...
Hopefully I'm just missing something...
I don't fault her for seeing her family. I do bristle somewhat when someone who caught it lectures the rest of us about not letting our guard down, as if we aren't allowed to do the same cost/benefit calculations they made.
I also get annoyed by sweeping pronouncements that we're all going to get it.
I can't read into her motivation or divine the intent, but like you I can read the statements and see the contradiction. To me it doesn't make much sense either, but it is a personal choice. My issue is with the inference that antigen testing will make this okay.
I had the same question (and concern) about event antigen testing. See the antigen test sensitivity test posted at the top of Katelyn's article - it says that on the day the PCR becomes pos, there are 40% false antigen-test negatives. Though if the measurement group for the chart is symptomatic people, hopefully they would be screened out from the event. Possibly an asymptomatic person could have a pos PCR and never test pos on antigen testing? ALSO: Is an asymptomatic infected person whose PCR is not yet positive capable of transmitting? I understand even well-informed people's risk tolerances do (and probably should) vary - there just seem to be some important unknowns for those who want to continue a low-risk life while venturing out into the world. Appreciations to Katelyn for raising and clarifying the issues with such compassion and grace - and for creating a place to discuss them!
"Is an asymptomatic infected person whose PCR is not yet positive capable of transmitting?" I believe the answer is "no." If you do not have enough viral level to be detected by PCR, you're not even asymptomatic. I guess the question is where is the cycle count cutoff? If you are asymptomatic but your PCR cycle count is <=30, you are infectious unless you are in recovery and this is not viable virus that is being detected. Somewhere above 30 I guess (because I don't know), you stop being considered infectious.
Not realistic economically in many situations but curious: How do home "PCR" (molecular) tests compare with lab PCR tests? They claim to match lab PCR tests in the mid to high 90%s but I'd love to see a chart comparing lab PCR, home molecular, and antigen tests similar to the one at the top of Katelyn's post.
Sadly, the food pyramid is _also_ politicized. Compare Harvard's Healthy Eating Plate which follows the science vs the officially published USDA MyPlate; some of the food items on the latter are absolutely the result of industry lobbying. :(
Excellent article as always!
Oh boy, you're going to make me go down a rabbit hole now
Please do. You are very good at finding those rabbits!👍😀
I like the simplicity of Harvard’s Healthy Eating Plate. Question about potatoes: if they “don’t count” as a (preferred) vegetable, does that mean we shouldn’t eat them at all? Or is it okay to eat them as long as we also eat plenty of other veggies?
I thought cooked potatoes were good for us, especially if the skin is still on.
I am ABSOLUTELY not a dietitian, but some digging around on Harvard's site pulls up this: https://www.hsph.harvard.edu/nutritionsource/2014/01/24/the-problem-with-potatoes/
Thank you, Graham. Time to buy a wok and learn how to stir fry veggies!
The new CDC guidelines are a complete “copout” and some of the worst data analytics I have witnessed. They should upset everyone – even if you oppose vaccine and mask mandates. CDC is paid to lead. Some key points
1. Although COVID is no longer racking piles of dead people per day filling up hospital parking lots, it can be dangerous and a regular case on a healthy adult age 40 can put them in bed for days and take 3 weeks to feel strong again. Long COVID is real.
2. The new variation appears to be in full spread mode a few days before major symptoms are shown.
3. Any rational organization would work to make testing increasingly accurate, easily available, and have results available quickly. Waiting 3 days to get a COVID appointment and then 3 more days to get results makes the testing worthless. The failure to stress quality testing was a lack of leadership.
4. The entire issue of when you can return requires REAL scientific investigation. You can return when you are no longer a spread risk. It may well be you feel fine, still test positive, and are not a spread risk. Or you might be a spread risk. The failure to articulate this and call for better investigation was a lack of leadership.
5. Make mask available for free when a person enters a store.
6. Put in place ventilation plans – especially for schools. This failure is viewed as CDC in the pocket of Big Pharma
7. The US needs to get over the mind set of “when you are sick”, you just suck it up and go to work (or school) – this terrible public health. There is ZERO chance you will get anyone to buy into public health initiatives when CDC leaves them hanging out to dry with their employer.
8. Pressing the need for vaccination without the other items and acknowledging lots of vaccinated folks get COVID – no credibility – simply sounds like you are business agents for pharma.
Yes, being an effective agent of chance requires pressing forward on the best path. That is the role you signed up for.
I was hoping the pandemic would at least lead to mandatory paid sick leave in the US, but no dice so far. I am lucky to live in a state, NY, that recently instituted it. Now my son who is a temp worker can get paid leave to go to medical appointments!
All three branches of NY government are democrats and we STILL can't get universal care passed, even though it was first introduce in 1992.
Erica, in 1944 the great FDR proposed a Second Bill of Rights that included universal access to "adequate" health care. If he had been able to serve out his last term, he might have even got the enabling legislation. Missed opportunity. :(
All the CDC is offering to the disabled or immunocompromised is thoughts and prayers. I will never pay attention to what they say again. This comes from someone with a MPH.
HI Katelyn, I am still wondering if you could explain how your antigen testing before the wedding would protect you from other less sensible people in attendance. Know you're probably very busy, but am confused.
I think she means all the guests have been asked to take an antigen test, and hopefully since it's a wedding, the bride and groom's request would be honored
would make sense, but she doesn't say she's relying on that. and would everybody honor that request? doesn't seem likely given the general attitudes and behavior of most of the public.
Depending how close someone was to the bride and groom and the size of the wedding, they could make a better assessment of whether the people at the wedding would likely honor that request compared to the general public.
true, but in the context of her comment, it wasn't at all clear that those would be preconditions of her electiong to go unmasked. Gives the wrong impression as to what is "ok"
How likely is transmission to occur among people at the gathering who were asymptomatic and tested antigen-negative at the door at an indoor event like the wedding? Am guessing that this criterion would be moderately--but not very--reassuring. Of course there are lots of variables to take into account like if I'm wearing an N95, etc. But people who are at (or live with those who are) at high risk often need to make an estimate.
Another comment- I am completely baffled about how ignoring the risks and sequelae of Covid infection is good for the economy. The same consequences that affect the economy exist.
Covid infection occurs-
-person is sick- misses work- disrupts work, affects ability to share parenting/family responsibilities
-person transmits to those in house- which then causes disruption above
-no test to negative- so now unmasks- goes back into society and transmits - see above.
-long covid is real and may affect ability to resume normal ADLs
-Yes, some people are asymptomatic but many are not. Symptoms impact ability to be productive. Long covid (1:5) means persistent symptoms affecting productivity.
-schools are now completely ignoring the risk to children and even more to those who work in schools. We had National Guard driving out buses and in our schools because there were so many people out. The current policy will enhance this problem because now we have no protection in guidance for people who should stay home or wish to. Instead the protocol will encourage re-entry way to soon and ensure higher transmission.
The unvaxxed have been blithely and unknowingly relying on those who have been acting responsibly to protect themselves and their community are now at higher risk. With the current messaging having no stress on personal or communal responsibility spread is for sure going to happen at a greater rate. There is no consideration that the unvaxxed have higher potential to burden the medical system.
As Fall progresses, with all the nice opportunities for encouragement of vectors to circulate, I can't see we will be in a better place having pretended that it will all be OK.
My thoughts exactly.
Hospitals are down 20-40% of bedside care givers. For rural hospitals it’s even worse.
Also- “risk” is much higher for Black people. The hospital algorithms are biased against us- not to mention human bias. Rich Black people, get worse care for covid19 than poor white people.
That said, as an older Black woman living in the State with the worst healthcare disparities in the country- I will not take any risk of getting covid. I wont go anywhere masks are not required. I cant take the risk.
White privilege is real in America.
I think you will eventually have to go some places where masks are not required and in preparation for that, you should consider getting the best mask you can get: elastomeric half-face respirator with P100 filters. Completely breathable and the filters last basically forever. I always carry one with me in case I find myself in a situation where I cannot retreat, but can safely exchange N95 for the half-face.
Indeed. And the situation for indigenous peoples is equally bad if not worse. I remember the "hospital" in late mid century Oklahoma my in-law relatives went to. Could have been 1800's era for its lack of all but the barest amount of equipment. The BIA wasn't throwing very much money into health care.
I am a one-trick pony when it comes to long covid. I said sometime back that my fear was that everyone who had tested and diagnosed covid, was probably a long hauler whether they were asymptomatic or not... They just wouldn't see the lasting damage until years down the road. Even if we discount the danger of long covid, this virus hasn't exhausted its bag of mutations. By sheer fecundity of invention it's may come up with something with both high escape and high lethality and then where will we be with the CDC's laissez faire guidance? It's no good to declare victory and go home as the CDC seemingly has.
KB, The CDC needs to determine what its primary task is and subordinate everything to the achievement of that. I'm an outsider, but I think they've fallen victim to mission creep and are spreading themselves too thin, given their funding corridor and staffing.. Caveat lector here tho'
I am 85 and have had 4 doses of Moderna. I cannot take Paxlovid as it increases QTC interval and I take cardiac meds. That is the reason a number of people who get infected do not take Paxlovid. I have considered the antibody but do not qualify. I still use my N95 mask when I leave my property. I will get the Moderna variant vaccine when it is available. For me a mask is going to be part of my wardrobe whenever I leave home for the rest of my life.
Just for interest, how protective is the small pox vaccine which I got as a child in protecting against monkey pox?