“Beyond the pandemic “-- as it morphs into a chronic situation where no information is easily available and the narrative is that it’s over, please continue to address COVID. We’re on our own and it’s very difficult-- especially for people at higher risk who still try to avoid infection.
This. Those of us paying attention know that this pandemic is NOT over. Please, Dr. Jetelina, do not join the chorus of voices telling us to move on, that COVID is in our rear view mirror. All of us are impatiently and hopefully waiting for that day, but it’s not today. Please don’t abandon science and data in favor of towing the party line that we’re all clear. Please use your voice to advocate for masking, indoor air quality standards, and better vaccines that actually block transmission.
It is concerning to me that I am detecting a shift in your messaging. You don’t mention masking. You don’t mention much about Long COVID and its huge risks and ongoing damage. It feels like you’re subtly joining the ranks of those who have decided to peddle the lie that COVID is now mild and we’ll all be fine.
Dr. J, I'd love to see you break down what you're doing now, and why.
I am still having my daughter mask at school--one of maybe a dozen children in her whole school. But CDC is still saying our state has "High Transmission" so it seems like the right thing to do. We're up to date on our vaccines, we've had Covid once, I don't want either of us to get Long Covid.
But we are in an extreme minority. I'd like to see how you're breaking down the numbers and your family's response.
I'll add that the numbers are confusing. The numbers from our State have our County at 94.8/100K for 2 WEEKS (down from 101.1/100K last week);
CDC has our County at High Transmission with 62.27/100K for the last WEEK (-3.76% from the week before, when we were labeled at Severe Transmission?????);
And NYTimes tracker has our County at 8 cases/100K a DAY, -16% from 2 weeks ago.
Reporting is haphazard, at best. CDC is looking at hospital data in a manner different from how NYT looks at things. CDC recommends "Community Level" for the masses, while most of us prefer their Transmission Levels for a better "feel" for how serious things are in an area. And that's not pretty even now.
I'm not sure what your State is following but 95/100K is somewhat frightening. And 300-500 deaths per day nationwide from a single illness is not a benign value. The virus isn't done with this population just yet.
CDC ties masking in healthcare settings to transmission rates which are low in my state, but the state epidemiologist showed a graph that his modeling indicates reported cases are less than 10% of real cases and the transmission rate is still high. But, the masks have become optional in healthcare settings per CDC guidance. So higher risk people have to navigate a higher risk experience to access healthcare.
Can I ask what county you're in? I've noticed that cases per 100K in smaller counties (especially those with less than 100K to begin with) tend to be a bit "noisier" and subject to large rapid swings (as a thought experiment imagine what happens when a county has just one person, who comes down with Covid. Eek! 100K per 100K! Infinity percent increase!)
My great grands in Florida are still masking in school, never had a problem with, I think only ones in school, maybe 1 or 2 others. Still they persevere! Of course we continue to model for them as well!
My high school student also continues to mask at school along with a handful of others. I continue to mask in stores and socially distance. Our community risk level is "medium" but transmission rate is "high." Just wanted you to know you're not the only one :-)
Our county is now calculating their own “low, medium, high risk” based on local wastewater levels and hospital capacity.
The good news is wastewater seems to be a more accurate measure now than cases, because testing and reporting have fallen off.
The not-so-good news is because hospitals are a lagging measure, the new rating system seems to be geared at measuring risk 2-3 weeks ago (hospitalizations), which makes assessing risk today difficult. It seems likely the rating system is geared towards making sure hospitals always have adequate capacity, which is a responsible goal, yet people don’t understand this nuance, which can lead to a false sense of security.
Also, it’s now almost end of March, 4 months after Thanksgiving and 3 months after Christmas, and despite my county being one of the most vaccinated and boosted places in the country, our wastewater levels keep rising and are at or near all time highs. This is very discouraging. I keep hearing about an “immunity wall” (apparently herd/sterilizing immunity isn’t possible with our current tools). When levels of virus in wastewater keep rising, or plateau, this suggests our immunity wall is leaky.
I assume wastewater has some drawbacks too (e.g. only picking up fragments of virus, versus live - so it could remain positive beyond its clinical relevance)
Now that counties seem to have taken how to determine and communicate current transmission risk, it would be great if you could highlight some best practices, so that other counties can learn and emulate.
For starters, what does low, medium, high mean? Is there a standard definition? Thanks!
Thank you for sticking with us through it all. Your information has been invaluable, not only helping me navigate the pandemic with children/high risk family, but serving as a reliable source to educate patients, colleagues, and friends. Your work also helped to resurrect a long-buried interest in data and clinical research. You inspired me to pursue additional training in data analytics, and I hope to transition to a new career path very soon. Here's to continued success with your newsletter. Thank you, again!
I’m a relatively new subscriber but quickly switched to “paid” based on your relative topics and data driven content. I am socially liberal and a fiscal conservative so I fit some of your common demographics, but I’m 72 and helped skew your readership a little higher. I love that a significant percent of your readers are college educated and know how to seek out sources of information they trust. I dropped several major newspaper subscriptions because I’ve lost trust in much of their reporting, but put those dollars back to work on SubStack. While I miss the crinkle of my NYT, I’m drinking more coffee in the morning as I swipe through my trusted morning reads. Thanks for helping me stay informed.
I, too, don't believe Covid is over, and hope you'll continue to cover it here - or consider a separate YLE for those of that still feel Covid it's relevant and a top public health priority. Some of the categories others would like to see covered here are interesting, but they're on an individual health level. I'm still trying to protect myself, and others, from contracting and spreading a highly contagious airborne virus that has long term consequences. Most people I know think I'm the "weird" one for continuing precautions. Almost everyone I know is "over, done with or "not letting it control my life." A friend who is a nurse anesthetist in a Southern State recently said, "Are you still masking up there and having your groceries delivered? Hmmm...we don't have Covid down here..." After having 6 vaccines and boosters, I can't even get good guidance on whether or not I need a 2nd bivalent booster to protect myself (I was booster last September). You have Dr. Peter Hotez and Dr. Michael Osterholm and Dr. Jeremy Faust advocating that seniors should get a 2nd booster because of waning vaccine immunity after 6 months, my PCP tells me wait for more information, that there may be an updated vaccine this Fall. But, Canada and the U.K., based on their data, are currently giving seniors a 2nd bivalent booster. In the U.S., the CDC and FDA remain mostly silent on the issue. Masking in healthcare is ending in some States, people are being asked to remove masks before entering stores, there are anti-Covid, anti-vax politicians making public decisions, Johns Hopkins Covid-19 tracker is shutting down, but 400 people still die per day of Covid, millions have long Covid. I feel like Covid is being "wished" away and ignored, and we're going to end up with a Covid variant that will escape our current protections because of the collective behavior of ourselves and our leaders.
PSPM, You put into words the many things rolling around in my mind on overdrive recently. Masking in hc settings ends in my state soon, and I've noticed a significant decrease in general masking since that announcement. You said "I'm still trying to protect myself and others from contracting and spreading a highly contagious airborne virus that has long term consequences" and I agree wholeheartedly. However, how much do my efforts at this point matter? Are they impactful?
"Most people I know think I'm the "weird" one for continuing precautions.” I know the feeling. I appreciate your mentioning it because it makes me feel less “lonely” when I hear their stories about what they just did. Like going to dinner somewhere (indoors of course) or a concert or the movies - all venues where virtually nobody wears a mask.
THANK YOU FOR YOUR EXCELLENT WORK! With an immunocompromised husband, the pandemic is not over for us. When we both retired January 1, 2020, we looked forward to world travels, but it’s not happening. With time in retirement, I avidly read your emails and pass them along to family and friends. That includes my over- busy daughter who is in your demographic with an academic teaching job where she helped start a public health program at her college just before the pandemic and 3 small children. THE LEVEL OF YOUR INFORMATION IS PERFECT FOR US. Carolyn Gayle MD, MPH, FAAP, retired pediatrician.
BRAVO!!! Thank you for your passionate and tireless efforts to bring forth and articulate the many-faceted enigma that is COVID-19. I was lucky to find YLE early on in the pandemic when Mr. Toad's Wild Ride plunged us straight down the COVID-19 rabbit-hole. YLE's been my source of comfort and sanity, from your wrap-around presentation, wise and compassionate understanding of human nature, and strong analytical analysis, to the comments and discussions of other readers. I'm 57 and want to be like you when I grow up. :)
Selfishly, as someone whose health and life has been seriously affected by long COVID, I would be so appreciative if you would keep us informed as quickly as possible about the latest information about long COVID, especially treatments developed to help improve those people suffering with it. And also any new statistics regarding the incidence of long COVID among people with autoimmune diseases and disorders. Thanks YLE, for helping us to stay smart and as safe as possible during the last three years. You are my hero!
Thank you, thank you, thank you! When I signed up to be a paid subscriber, I wasn't sure what I was doing, but I sensed your honestly, carefulness, intelligence, and empathy. Being a subscriber has turned out to be one of the best moves I ever made, for myself and my family. Thank you!
Remain ever so grateful you expanded your vision beyond 6 weeks! Continue to look forward to reading your posts and encourage my pals to do the same (and several loved the gift subscriptions!) Here’s to SCIENCE and YLE 🎉
Thank you, thank you for your balanced and nuanced posts. Please know that your posts reach people beyond your readership as our patients, friends and families also benefit from your analyses and translations. I am glad that there is an interest in unintentional injuries. I hope that you can also address intentional injuries, as policy decisions need to reflect the true risk factors so that we can implement effective prevention.
Congratulations on three successful years, and here's to several more. I think you've found a niche in PH communication. I only wish I could do as well as you have done!
“Beyond the pandemic “-- as it morphs into a chronic situation where no information is easily available and the narrative is that it’s over, please continue to address COVID. We’re on our own and it’s very difficult-- especially for people at higher risk who still try to avoid infection.
This. Those of us paying attention know that this pandemic is NOT over. Please, Dr. Jetelina, do not join the chorus of voices telling us to move on, that COVID is in our rear view mirror. All of us are impatiently and hopefully waiting for that day, but it’s not today. Please don’t abandon science and data in favor of towing the party line that we’re all clear. Please use your voice to advocate for masking, indoor air quality standards, and better vaccines that actually block transmission.
It is concerning to me that I am detecting a shift in your messaging. You don’t mention masking. You don’t mention much about Long COVID and its huge risks and ongoing damage. It feels like you’re subtly joining the ranks of those who have decided to peddle the lie that COVID is now mild and we’ll all be fine.
Dr. J, I'd love to see you break down what you're doing now, and why.
I am still having my daughter mask at school--one of maybe a dozen children in her whole school. But CDC is still saying our state has "High Transmission" so it seems like the right thing to do. We're up to date on our vaccines, we've had Covid once, I don't want either of us to get Long Covid.
But we are in an extreme minority. I'd like to see how you're breaking down the numbers and your family's response.
I'll add that the numbers are confusing. The numbers from our State have our County at 94.8/100K for 2 WEEKS (down from 101.1/100K last week);
CDC has our County at High Transmission with 62.27/100K for the last WEEK (-3.76% from the week before, when we were labeled at Severe Transmission?????);
And NYTimes tracker has our County at 8 cases/100K a DAY, -16% from 2 weeks ago.
I wish I knew what I should be doing.
Reporting is haphazard, at best. CDC is looking at hospital data in a manner different from how NYT looks at things. CDC recommends "Community Level" for the masses, while most of us prefer their Transmission Levels for a better "feel" for how serious things are in an area. And that's not pretty even now.
I'm not sure what your State is following but 95/100K is somewhat frightening. And 300-500 deaths per day nationwide from a single illness is not a benign value. The virus isn't done with this population just yet.
CDC ties masking in healthcare settings to transmission rates which are low in my state, but the state epidemiologist showed a graph that his modeling indicates reported cases are less than 10% of real cases and the transmission rate is still high. But, the masks have become optional in healthcare settings per CDC guidance. So higher risk people have to navigate a higher risk experience to access healthcare.
Not sure what state you're in... but I think I really like your state epidemiologist.
He volunteers his time to create models. The employed staff aren't as candid. Our health department has been excellent overall.
Can I ask what county you're in? I've noticed that cases per 100K in smaller counties (especially those with less than 100K to begin with) tend to be a bit "noisier" and subject to large rapid swings (as a thought experiment imagine what happens when a county has just one person, who comes down with Covid. Eek! 100K per 100K! Infinity percent increase!)
No, I'm in a populous county in which resides the most populous city in my state.
My great grands in Florida are still masking in school, never had a problem with, I think only ones in school, maybe 1 or 2 others. Still they persevere! Of course we continue to model for them as well!
My high school student also continues to mask at school along with a handful of others. I continue to mask in stores and socially distance. Our community risk level is "medium" but transmission rate is "high." Just wanted you to know you're not the only one :-)
Yes, our Community Risk is low, but that just means there's room in the hospital for us if we need it. :) No thanks.
Our county is now calculating their own “low, medium, high risk” based on local wastewater levels and hospital capacity.
The good news is wastewater seems to be a more accurate measure now than cases, because testing and reporting have fallen off.
The not-so-good news is because hospitals are a lagging measure, the new rating system seems to be geared at measuring risk 2-3 weeks ago (hospitalizations), which makes assessing risk today difficult. It seems likely the rating system is geared towards making sure hospitals always have adequate capacity, which is a responsible goal, yet people don’t understand this nuance, which can lead to a false sense of security.
Also, it’s now almost end of March, 4 months after Thanksgiving and 3 months after Christmas, and despite my county being one of the most vaccinated and boosted places in the country, our wastewater levels keep rising and are at or near all time highs. This is very discouraging. I keep hearing about an “immunity wall” (apparently herd/sterilizing immunity isn’t possible with our current tools). When levels of virus in wastewater keep rising, or plateau, this suggests our immunity wall is leaky.
I assume wastewater has some drawbacks too (e.g. only picking up fragments of virus, versus live - so it could remain positive beyond its clinical relevance)
Now that counties seem to have taken how to determine and communicate current transmission risk, it would be great if you could highlight some best practices, so that other counties can learn and emulate.
For starters, what does low, medium, high mean? Is there a standard definition? Thanks!
Thank you for sticking with us through it all. Your information has been invaluable, not only helping me navigate the pandemic with children/high risk family, but serving as a reliable source to educate patients, colleagues, and friends. Your work also helped to resurrect a long-buried interest in data and clinical research. You inspired me to pursue additional training in data analytics, and I hope to transition to a new career path very soon. Here's to continued success with your newsletter. Thank you, again!
I’m a relatively new subscriber but quickly switched to “paid” based on your relative topics and data driven content. I am socially liberal and a fiscal conservative so I fit some of your common demographics, but I’m 72 and helped skew your readership a little higher. I love that a significant percent of your readers are college educated and know how to seek out sources of information they trust. I dropped several major newspaper subscriptions because I’ve lost trust in much of their reporting, but put those dollars back to work on SubStack. While I miss the crinkle of my NYT, I’m drinking more coffee in the morning as I swipe through my trusted morning reads. Thanks for helping me stay informed.
I, too, don't believe Covid is over, and hope you'll continue to cover it here - or consider a separate YLE for those of that still feel Covid it's relevant and a top public health priority. Some of the categories others would like to see covered here are interesting, but they're on an individual health level. I'm still trying to protect myself, and others, from contracting and spreading a highly contagious airborne virus that has long term consequences. Most people I know think I'm the "weird" one for continuing precautions. Almost everyone I know is "over, done with or "not letting it control my life." A friend who is a nurse anesthetist in a Southern State recently said, "Are you still masking up there and having your groceries delivered? Hmmm...we don't have Covid down here..." After having 6 vaccines and boosters, I can't even get good guidance on whether or not I need a 2nd bivalent booster to protect myself (I was booster last September). You have Dr. Peter Hotez and Dr. Michael Osterholm and Dr. Jeremy Faust advocating that seniors should get a 2nd booster because of waning vaccine immunity after 6 months, my PCP tells me wait for more information, that there may be an updated vaccine this Fall. But, Canada and the U.K., based on their data, are currently giving seniors a 2nd bivalent booster. In the U.S., the CDC and FDA remain mostly silent on the issue. Masking in healthcare is ending in some States, people are being asked to remove masks before entering stores, there are anti-Covid, anti-vax politicians making public decisions, Johns Hopkins Covid-19 tracker is shutting down, but 400 people still die per day of Covid, millions have long Covid. I feel like Covid is being "wished" away and ignored, and we're going to end up with a Covid variant that will escape our current protections because of the collective behavior of ourselves and our leaders.
PSPM, You put into words the many things rolling around in my mind on overdrive recently. Masking in hc settings ends in my state soon, and I've noticed a significant decrease in general masking since that announcement. You said "I'm still trying to protect myself and others from contracting and spreading a highly contagious airborne virus that has long term consequences" and I agree wholeheartedly. However, how much do my efforts at this point matter? Are they impactful?
"Most people I know think I'm the "weird" one for continuing precautions.” I know the feeling. I appreciate your mentioning it because it makes me feel less “lonely” when I hear their stories about what they just did. Like going to dinner somewhere (indoors of course) or a concert or the movies - all venues where virtually nobody wears a mask.
THANK YOU FOR YOUR EXCELLENT WORK! With an immunocompromised husband, the pandemic is not over for us. When we both retired January 1, 2020, we looked forward to world travels, but it’s not happening. With time in retirement, I avidly read your emails and pass them along to family and friends. That includes my over- busy daughter who is in your demographic with an academic teaching job where she helped start a public health program at her college just before the pandemic and 3 small children. THE LEVEL OF YOUR INFORMATION IS PERFECT FOR US. Carolyn Gayle MD, MPH, FAAP, retired pediatrician.
Much gratitude to you, your husband, and your two little girls, heroes, all of you!
BRAVO!!! Thank you for your passionate and tireless efforts to bring forth and articulate the many-faceted enigma that is COVID-19. I was lucky to find YLE early on in the pandemic when Mr. Toad's Wild Ride plunged us straight down the COVID-19 rabbit-hole. YLE's been my source of comfort and sanity, from your wrap-around presentation, wise and compassionate understanding of human nature, and strong analytical analysis, to the comments and discussions of other readers. I'm 57 and want to be like you when I grow up. :)
Selfishly, as someone whose health and life has been seriously affected by long COVID, I would be so appreciative if you would keep us informed as quickly as possible about the latest information about long COVID, especially treatments developed to help improve those people suffering with it. And also any new statistics regarding the incidence of long COVID among people with autoimmune diseases and disorders. Thanks YLE, for helping us to stay smart and as safe as possible during the last three years. You are my hero!
Thank you, thank you, thank you! When I signed up to be a paid subscriber, I wasn't sure what I was doing, but I sensed your honestly, carefulness, intelligence, and empathy. Being a subscriber has turned out to be one of the best moves I ever made, for myself and my family. Thank you!
Remain ever so grateful you expanded your vision beyond 6 weeks! Continue to look forward to reading your posts and encourage my pals to do the same (and several loved the gift subscriptions!) Here’s to SCIENCE and YLE 🎉
YLE is one of the few subscriptions that I'm actually excited to see in my in-box. Thank you for your time, dedication, and expertise!
Hope you keep publishing.So many public health needs exist and will arise. Your work is clear, targets health, and very helpful.
Thank you, thank you for your balanced and nuanced posts. Please know that your posts reach people beyond your readership as our patients, friends and families also benefit from your analyses and translations. I am glad that there is an interest in unintentional injuries. I hope that you can also address intentional injuries, as policy decisions need to reflect the true risk factors so that we can implement effective prevention.
Thanks for all you do! Proud to be paid subscriber!
Congratulations on three successful years, and here's to several more. I think you've found a niche in PH communication. I only wish I could do as well as you have done!