Measles is off to an ugly start, EPA removes lives lost, ICE and hospitals, and lots of good news
The Dose (January 20)
I’m back from the Amazon jungle, where monkeys, anacondas, and piranhas somehow felt calmer than everything happening in the U.S. landscape. One cartoon captured the moment here perfectly:
What’s happening here is not normal. It’s dark and disorienting, and it’s hard to keep all the balls in the air, including our health. So I’ll continue to pull together a clear snapshot of what’s happening in public health (“translated,” timely, and actionable) to make things a little easier on your end.
This week: infectious diseases are moving, policy shifts are reshaping health protections, and communities are navigating new realities, including how to respond to ICE. But there is also real, meaningful good news. I’m finding myself holding onto that more these days.
Let’s get into it.
Infectious disease “weather” report
Measles. This year is off to a rough start—the worst January in more than 30 years. The U.S. has already reported hundreds of measles cases. That’s especially concerning because January is usually a slower month for measles. School breaks often slow spread, and temperatures help measles peak later, closer to spring.
Most of the cases are coming from a large and fast-growing outbreak in South Carolina:
243 cases in just the past 10 days
558 total cases since October
96% of cases are unvaccinated
90% are children
531 people are in quarantine, meaning weeks of missed school or work
Spread has reached other states, including North Carolina, Colorado, and Washington
This outbreak could easily become larger than last year’s Texas outbreak.
Another outbreak in Utah and Arizona has reached 433 cases since late last year, but the pace there seems to be slowing.
Like wildfires igniting in dry tinder, measles ravages areas with low vaccination rates. A new tool from Boston Children’s Hospital, Harvard Medical School, and the Icahn School of Medicine at Mount Sinai highlights high-risk pockets. Zooming in on the South Carolina hot zone shows multiple very high-risk zip codes. Some news outlets reports some schools have less than 30% vaccination rate. (Measles herd immunity requires 95%.)
What this means for you: Check out your zip code here. If you’re fully vaccinated, you are very well protected, even if you live in a “high-risk” area. If there’s an active outbreak and you have a baby under 12 months, talk with your pediatrician about early vaccination at 6 months.
Winter respiratory illnesses
Visits for fever, cough, and sore throat are finally dropping. That’s good news. But respiratory seasons often have two waves. Schools are back in session, and different flu strains—like Flu B—can take over. Flu season often lasts into March, so we’re not done yet.
Covid-19 levels are moderate nationwide but vary by region. The Midwest is seeing very high levels, followed by the Northeast. Overall, things seem to be slowing, which suggests another relatively mild Covid winter.
What does this mean to you? There are still plenty of sick people around. Wash your hands, consider masking in crowded indoor spaces, and stay home when you’re sick.
Toss this supplement out
LiveItUp Super Greens has been recalled due to a Salmonella outbreak that has sickened more than 45 people and hospitalized 12 nationwide. If you have it, toss it:
Expiration dates August 2026–January 2028
Sold online, including Amazon
EPA pollution rules no longer count lives
One of the most important ways the U.S. government protects public health is by regulating pollution so that companies’ activities don’t harm people’s health or the environment. The Environmental Protection Agency (EPA) sets and enforces limits on air, water, and soil pollution under laws like the Clean Air Act.
When the EPA evaluates a new regulation, it typically uses cost-benefit analysis to compare:
Costs— what companies (and sometimes consumers) will have to spend to comply (e.g., upgrading equipment, changing processes).
Benefits — how much better off the public will be if pollution goes down, including fewer illnesses, fewer hospital visits, less lost work time, and lives saved. To do this, economists estimate the value of reduced health risks in dollar terms, including a widely used figure called the value of a statistical life. This is essentially the amount society is willing to pay for reductions in mortality risk and has ranged from $6.8 million under the Bush administration to roughly $9.8 million under Biden.
Last week, the EPA announced a big change. For some major air pollutants, such as fine particles and ozone, cost-benefit analyses will no longer include the dollar value of health benefits. This is a significant shift because health benefits, especially avoided premature deaths, historically accounted for a large share of the quantified benefits in air pollution rules. This tilts the math in favor of corporate interests. Pollution rules now appear far more costly, making it easier for companies to push for weaker protections.
What happens next? Companies now have stronger legal arguments that pollution rules cost “too much.” Expect lawsuits aimed at weakening air quality standards.
Who is most at risk? The effects won’t be immediate, but they will add up over time. Communities near highways, factories, and industrial sites, which are often low-income or historically marginalized communities, are likely to be hit hardest.
What can you do? Track your local air quality. AirNow uses official data and can be found in your phone's weather apps. PurpleAir offers community-level data, though it’s less precise (but getting better). Also, you may want to purchase an indoor air filter (Wirecutter has some good ones).
ICE and public health
The scenes of fear, trauma, and threat to safety in communities, like in Minneapolis, are hard to watch. And many are not just watching, they are living it, like my daughter’s school friend.
This situation has direct and indirect impacts on health, as it changes how families live, work, and, critically, how and when they seek medical care. When people worry about enforcement on the way to a clinic or hospital, many delay or avoid care even for serious conditions, which can worsen illness and increase community health risks.
What this means for you: Communities can still be a source of strength. Educators play a critical role in schools. Clinical care teams, whose primary role is to ensure patient safety, can take actionable steps to support these communities within the clinical setting.
But this is new territory. Marisa, YLE’s correspondent in New York, pulled together resources for you to help support families carrying this burden. She also took a deeper dive into the data and noted the recent rollback of protections for sensitive locations. Check it out here:
Bright spots this week
Exhale. There is good news.
Funding restored
The American Academy of Pediatrics had $12 million in grants reinstated after a court order.
$2 billion for mental health, substance use treatment, and overdose prevention was restored to SAMHSA after bipartisan pressure. This was less than a day after cuts affected 2,000+ organizations.
Overdose deaths are falling. From August 2024 to August 2025, overdose deaths dropped in 45 states. This is in big thanks to naloxone access, service expansions, and improved treatment. There’s still work to do, but this is progress to celebrate.
Cancer survivorship is at an all-time high. Seventy percent of U.S. cancer patients diagnosed between 2015 and 2021 reached five-year survival. Gains were seen even among some of the deadliest cancers, including liver, lung, and multiple myeloma. Better prevention, screening, and treatments are saving and extending lives.
New hope for multiple myeloma. A recent trial of a new immunotherapy combination showed that more than 80% of patients remained alive and progression-free for nearly three years (compared to 30% of patients who didn’t receive the therapy).
In case you missed it
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Bottom line
Please be healthy and safe out there. And remember, power comes not only from the top down, but also from the bottom up.
Love, YLE
Your Local Epidemiologist (YLE) is founded and operated by Dr. Katelyn Jetelina, MPH PhD—an epidemiologist, wife, and mom of two little girls. YLE reaches more than 425,000 people in over 132 countries with one goal: “Translate” the ever-evolving public health science so that people will be well-equipped to make evidence-based decisions.
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From Mpls—one way to work around ICE’s affect on health care-
Pediatric visits with Park Nicollet/Health Partners: 🏥
🩺 Currently Park Nicollet/ Health Partners pediatricians are offering video visit for any families who cannot safely come into the clinic, regardless of complaint (except well child visits). Even those without insurance can be seen.
If at the video visit it is determined a child needs to be seen in person. Any adult can accompany the child to the visit with parents available on the phone at time of visit to confirm consent for treatment. If it is not possible for the parent to be available by phone. Written consent for treatment can be sent with the child.
From our local community support chat.
I'm curious about the data on office visits. The combined home tests can make office visits unnecessary--I tested positive for Flu A, called the doctor, and got Tamiflu prescriptions for me and my husband, who never even tested but obviously had what I had. Does a phone call ending in a prescription get reported as an office visit? And more generally, while the home tests are fantastic (they include COVID and RSV too!), are they skewing the data on ILI office visits?