We are going into the fourth year of YLE. Much to my surprise, the number of subscribers continues to grow, even as the emergency has subsided. This is amazing news. At the same time, I’m burned out, particularly in writing about Covid-19. I seem to be good at making people mad. This was fine during an emergency when I thought it was useful, but now I’m just not convinced.
I really like your Covid coverage, even now, because everyone else has moved on. You’re my only source. So while you explore other topics, please don’t give up on Covid. Don’t let the haters drive you off the topic. That’s their goal. Thank you so much for your consideration.
If you're looking for another resource regarding covid and don't already know of it, Dr. Michael Osterholm does a biweekly podcast called the Osterholm update.
Dec 1, 2023·edited Dec 1, 2023Liked by Katelyn Jetelina
Dr. Jetelina, I need you! I count on you and Dr. Rivers to tell me the truth and all of the truth. You have access to information that I don’t have (and I’m pretty good at ferreting out information and ignoring the “if it bleeds, it leads” or fingers in ears, “la la la,” or, “we’ll just tell them what we think they want to hear” media.) That includes information about COVID, which is still with us.
I know you have to take care of yourself, or we risk not having you write this column. Please know you are performing a badly needed public service and I and my family appreciate you! Love, Bee
To be frank, the only reason I am a paid subscriber to your Substack is for COVID information. I can find other public health content in a million other locations, but almost no one is talking about COVID anymore, and we’ve been abandoned by every facet of public health, our government, and even our medical providers. There are so any of us who cannot just decide we are “burned out” on the pandemic, as it rages on while everyone who could make a difference looks the other way. We continue to get disabled and die from COVID in huge numbers, and you are unfortunately one of the last ones standing. The pandemic is ongoing, and just because we aren’t calling it an emergency doesn’t mean that it isn’t.
If you stopped talking about COVID, I would not have any interest or inclination in continuing to engage with your content.
I completely agree with Megan. My spouse and I are here for Covid info. (Can we resume our normal lives? What medications are available or under development for prevention or treatment? Will vaccine companies continue to create vaccines — our imperfect, short -lasting, but best non-mask tool to prevent infection? Or are they going to abandon the effort, leaving all of us with nothing but masks, which have become social poison?)
It’s hard to figure out what Covid is doing, where. So it’s hard to assess risk geographically and seasonally, both in the US and abroad. It would be so amazing if you had a dashboard (with notations of when various items were updated, and when to expect fresh data) where we could go to see data — especially if you had a guide, like “when X measurement reaches Y level, in my family, we do Z, because we are worried about A, B, and C. Here’s what to do depending on what your concern is.”
Also if you knew which agencies had stopped reporting useful data, and could clue us in to who we might write to ask that monitoring be reinstated, maybe as a group we could move at least one needle. Do we write our representatives? Agency heads? What can concerned citizens do to improve public health data?
My husband and I just got Covid for the first time last week. He is still symptomatic and testing positive after 9 days. I am also still symptomatic, but haven’t bothered to retest, as I am not going out in public until both of us have completely cleared the virus. We both got our fall vaccines, mine just two weeks before I got sick. It was definitely not “just the sniffles” - more like a two to three day flu followed by a bad cold lasting way too long. So, Covid is still here, still spreading uncontrolled, still making people sick and still impacting one’s ability to do what one needs and wants in their lives. I understand your burnout. We live in Missouri where most people don’t take any precautions anymore and are perfectly happy spreading their germs around, and many are hostile to any mention of it. Just want you to know I have appreciated your efforts over the past years.
Sharing my narrative submitted in the survey: "I have no criticism. I just hope you can find a way to cover Covid. It is not "over". The latest provisional death counts from the CDC is still far above a bad flu season, annual motor vehicle deaths etc. Covid is evolving. The fascinating science is evolving. Reliable platforms like Twitter (I can't bring myself to use the other name), are devolving to the point where my trusted epidemiologists are leaving (or faced with difficult ethical issues should they stay), the CDC is --frustrating and disorganized. One example, instead of updating the page on the 2.86/JN I see no new news since August. This week, I discovered they have been posting information on a completely different page. The site search and navigation is often dysfunctional. I understand your burn out with the American Bile Epidemic. What if you take a break from composing your amazing, "just right" narratives on Covid, but instead post links to the current statistics and studies related to Covid topics? As the media platforms (Twitter), sources (Our World in Data, Johns Hopkins, YLE), and methods (wastewater) in which we gather the information evolve-you can still be the conduit for the numbers and studies. At the end of your weekly newsletter, you could include links to quality: hospitalization data by age, hospitalization data by other demographics of interest, provisional death counts, wastewater with a standard narrative about current reliability in interpreting case data, variant forecast issues (virulence, test reliability, treatments). Most of the time this "source" or "deeper dive" section would have the same headings and links. But as the CDC conducts their confusing re-dis-organization, and new issues come up-you would still be involved in education the public about this worse-than-flu, worse-than-motor-vehicle-accidents public health issue. I also suggest that rather than making separate regional newsletters: pick out topics that you are called to write about, to sustain your fine advocate's heart, and put links to deep dives on other public health topics in the end section. So if you want to write about the effects of the Canadian fires, write. If you don't post a link to them. For me, I live in Michigan, my young grandchildren are in Tennessee, and Colorado. So I inhabit 3 regions. I'd prefer the national overview, and links to deep dives on the others. These are just ideas, which I hope you can use to confirm your path or spark new ideas. No matter what, I find it a tragedy that good people like you have to endure the threats and anger of the misinformed. I appreciate everything you've done with grace, bravery, and intelligence." Sincerely, Karen Athan
Keep up the good work, this has been a fantastic resource! I ranked chronic diseases 2nd behind infectious diseases, because I hope to continue to see updates on long covid (prevalence, research, treatments, etc). It's clear that it has now joined the ranks of common chronic diseases and will continue to be a major issue indefinitely. Its risk is also why I haven't fully returned to 2019-normal, and a big reason why COVID isn't "just a cold".
I'm really sorry that people get angry with you and, I assume, express that anger in unconstructive ways. You never make me angry. I'm so grateful for the information you provide to this community.
I love the work you've done, and hope to see it continue. I would like to see a combination of topical and deep dives, but we need (NEED) info on, and to combat misinformation. I was reading a piece last night by Francis Collins where he highlights the need for us in PH to get the messages out more frequently and "better" to combat the misinformation campaigns. I think your efforts were a key element in that effort because they were fact based, cited references that were accessible (if technical), explained things well, and were timely. And you put out so much content.
I think what you and Caitlyn are doing is very important and useful. I especially like (and use frequently) Caitlyn's regional summaries to spot trends and make my own decisions on updates and correlations. I think that's something you might also be successful with, but I'd ABSOLUTELY LOVE to see a start on an effort to counter misinformation (and I'm willing to participate).
Per Collins, we may need a "Communications Corps" to provide update and data sooner and faster, and to better counter both misinformation and worse, disinformation. Both were present during the height of the pandemic, and we'll see them again for whatever reason in the next, inevitable outbreak. We need to be prepared and work cohesively to improve the information transfer overall.
Thank you for writing, and for being open to comments.
I echo the sentiments about SARS-2. It really isn't over, regardless of the concerted effort in the US to hide data.
I am also concerned about the state of public health. I'm of the generation that saw the introduction of seat belts and other mitigations in automotive safety, of smoking cessation, of a major effort to eradicate an infectious disease with a survival rate of well over 99% (yes, poliomyelitis), and more. These days "99%" is considered okay, at least in the mind of the general public. Medical folk often use the notation of per 100,000 individuals. For someone my age, the chance of death from colon cancer is about 50/100k per year. That translates to 99.95% survival rate - but I'm expected to get a colonoscopy, and I do. The WHO lists the current case fatality rate for covid as 1% in the US (which I found surprisingly high). That's 1,000/100k.
We are out of balance in terms of risk assessment and mitigations. I'm concerned about this spilling over into areas like childhood vaccinations and other preventative interventions.
I'm not defending their numbers, but the WHO data I saw was labeled case fatality rate, not infection fatality rate. Even so, an IFR of 100/100k is pretty ugly given the number of infections in the US, not to mention the rate of serious long term problems.
If you assume everybody in the US has been infected, then with the acknowledged mortality the overall IFR has been over 0.3% for the pandemic. Of course, that's assuming that one is concerned about the entire population, not just a subset.
I took the survey, however I am repeating myself here. First, I am eternally grateful to you, and I want to be clear about that. Urgency of situation communicates (particularly when it is in media) through frequency of content. In an emergency, lots of content is necessary. In reduced urgency reduced content is consonant with the situation. So keep at it, and allow yourself to do less, as less is needed right now. If things change, in a challenging way, you have space to upgrade how much content to share. I hope that is useful feedback
Over the last four years, I have posted a few of your YLE issues on my Facebook page. I received an excellent reaction as misinformation about shots, masks, research, etc was so prevalent in the US. Thank you for your energy in putting out the information. I also appreciated the research you have cited from other countries. It lended the point that the COVID virus was world wide.
If you downsize to possibly publishing every other month, I understand. You do have a family.
By the way, your very matter-of-fact way of writing is excellent. Currently, there is too much emotion and not enough straight research-based facts. I figure when you receive negative, obnoxious comments, those folks know they really don't know anything.
I’m immunocompromised, so COVID isn’t over for me (or flu, RSV, mycoplasma pneumoniae, strep, etc.) Would love to see more about zoonotic pathogens and the One Health Approach.
Umm, you just gave me a topic for another Substack piece. :-)
Anyway, before SARS-CoV-2 came along, we always had immunocompromised for a number of reasons. How did they cope? We were never very good at protecting the vulnerables.
Well, I’m newly immunocompromised as of April this year, but I worked as an inpatient adult Oncology nurse for 15 years. Those patients were already masters of masking when the pandemic came around. We kept them inpatient when they were severely neutropenic after chemo. There were a bunch of precautions like no fresh flowers in the room, no fresh fruits and vegetables (the NFFV was studied and found not to make enough difference in infection rate to justify limiting the diet of people who already had nutrition challenges.) But some would beat the cancer but die of infection. That wasn’t uncommon. The number of immuno adults in the US is increasing, one study I saw estimated 6.2%, likely due to the use of biologics for rheum diseases. And immuno are also more susceptible to zoonotic illness, tickborne illness. Plenty for your post!
Thank you, this not an area that I am familiar with nor experienced it except for a short course of steroids. I see a lot of concerns in here from susceptible people here but this is not new.
As for vector borne illness, did a two part on arthropod vectors. However, there are a couple of updates. So, Hickam was right! You can have as many diseases as you like. A Pt presented with THREE tick-borne diseases! Read more about it later.
Also a two part on HPAI and maybe an update there too.
Thank you Katelyn for all you do! Through these years of the pandemic I knew I could check in with you and others, and come to my own conclusions as to how to take care of myself and family against the ravages of COVID. I lost an aunt, uncle, and cousin early in the pandemic, and so it was always personal to me. Personally, I check in mostly with you on the infectious diseases aspect of health. I find that people are sleepwalking to what is happening to our world without taking any personal responsibility. But with your advice, I don’t have to be one of those people.
Good faith comment (I promise), then will go back to "lurker" mode a few more weeks, but since you are requesting feedback...
First off, your followers have spoken. Stay on Covid. Yes, keep adding other things that interest you, but at least 1x a month, a good Covid piece.
My "dream scenario" comes from your August interview with David Wallace-Wells [1] which I recently re-read after Jeremy Faust posted it again a few weeks ago:
|YLE: "..it’s going to take time to heal and to understand and to try to hear the other side, and try to |hear what we got wrong and how we can do better in the future."
I would love to see you begin to reach out to the other side and start working through the messy science of figuring out better truth, improving our scientific understanding of what the fuck happened the last 3 years. I'm not suggesting you meet with the Cranks or the Antagonists, but there are many, many reasonable, polite scientists out there who disagree on the current PH "narrative" regarding Covid and I would love to see more collaboration instead of echo-chamber substacking (this applies to them as well).
Below is an "off the top of my head" list of people who hold views in contrast to mainstream PH, are articulate, data driven, and I'm 90% sure would be very polite and courteous would you pursue a dialectic - not a debate - with them. [2]
As you noted in your interview with DWW you agree there should be some sort of "Covid Commission" - and I agree with, not in Congress, so why not pursue this yourself?
Critical questions I would like to see addressed (consider this a "greatest hits" of my prodding posting).
None of these I mean to engage in today, tomorrow, or next week - just think of this as the top questions skeptics have that need to be addressed in the future:
1) How did we not realize Covid was a disease that primarily affects the elderly immediately? Why was there such reluctance to acknowledge this disease was not a threat to children despite overwhelming evidence immediately in Spring 2020? In your DWW interview you noted:
|YLE: "It’s hard to remember how little we knew back then. Are children truly less risk than adults |because this typically isn’t how viruses work."
But we had the data in Italy by April. And again when the NYT published the "Incalculable Loss" 100K deaths story May 24 2020 listing 1,000 names claimed by Covid. [3] The average age was 77. 80% of the people were over the age of 65. 50% over the age of 80. It was in plain sight from the beginning. How did PH not figure this out immediately?
2) Extension of above - considering there were zero excess deaths in children, in any country, throughout the pandemic [4], how would we be able to assign "credit" towards any intervention when the NNT approaches infinity? If every country had the same outcome of child mortality regardless of vaccination approach, school closures, masking, lockdowns, etc, why not consider none of these things mattered? (**Except Canada for some reason - the only country in the world child deaths jumped)
3) Public Health repeatedly engaged in what Francis Bacon called "Counting your hits and forgetting your misses". Why is this acceptable? Why wasn't public health disinterested, self-critical, and obsessed with error checking - all necessary components of science? Examples: South Korea was poster child of "doing it right" when things were going well, but there has been zero coverage of their massive mortality spike in 2022 (+90% excess deaths spring 2022!). Michael Mina and others claimed mass rapid testing could end the pandemic, but when the examples he used to make his case (UK and Slovakia) became overrun with Covid, PH does not grill this hypothesis and many people still seem to believe it. [5], etc
4) How did PH get Sweden wrong? How do so many in PH still get Sweden wrong? Katelyn, in the DWW interview you remarked:
| YLE: "Sweden didn’t also have a perfect response. Compared to the United States, they had less |excess deaths, but compared to their neighbors, like Denmark, they did a much more terrible job if we |judge their job on excess deaths."
This is demonstrably false. [6] This is a bit frustrating to data nerds like me, as we already discussed this almost 6 months earlier. [7] This is on "the paper of record", and despite listing multiple fact checkers, no one is aware that Sweden has lower excess deaths than Denmark. How can this be?
5) How did PH not realize masks were so important fighting respiratory viruses for the 100 years following the 1918 flu, struggling to find any efficacy, yet suddenly, within 6 months of Covid we managed to find 100+ studies showing near 100% efficacy? Does this not strike PH as odd that when masks were apolitical, it was openly known they didn't stop viruses [8], and only after they were politicized every. single. study no, matter how poor [9], managed to find amazing efficacy? And why isn't PH deeply interested in figuring out how the lowest masked countries had far better outcomes than Asia? Why every prediction failed ("will drive pandemic to the ground"... "taking them off is throwing gas on fire")?
What does this say about how we pursue scientific truth if simply by wanting something to be true, we can conjure up the "science" to back up our desires - that is clearly what happened with the 100+ studies saying cloth masks worked so well.
6) Why do spurious vaccine claims go unchecked by PH? How can PH claim that the vaccine saved 3 million people in the US? The Commonwealth Fund Analysis is regularly repeated uncritically [10], but simple replication tests show this can't possibly be true including: a) countries that didn't vaccinate don't have a proportionate increase in mortality predicted by this study [11] b) there is weak correlation between excess mortality and vaccination at the state level in the US and c) half the 1st world countries saw all-cause mortality *increase* after vaccination. [12]
7) Why was PH advocating for censoring dissent? There are few things more antithetical to science than celebration of orthodoxy and branding those who disagree with you a heretic who must not be allowed to speak. I should probably move this to #1.
So that is my wish for 2024, tackle these sorts of questions and engage with experts you don't agree with and see if you can find common ground. Maybe they are wrong?
[8] One of 100's of possible examples, here is Laurie Garret giving a speech to the National Academy of Medicine about pandemics: "Did the mask really help them? Did the mask keep the virus out? Almost certainly not."
[9] "Identifying airborne transmission as the dominant route for the spread of COVID-19" was spread in the media 400 times, had 40,000 tweets, and was the primary "go to" proof that masks worked summer of 2020. But it was so bad even Michael Mina signed the retraction request ignored.
[11] Show me a country with low vaccination rate which had a 100% increase in mortality in 2021. Best I can come up with is Bulgaria which saw deaths in 2021 continue to rise to +37% prepandemic levels, but they quickly fell back to baseline without vaccinating. Then of course, there is Africa...
Great list Michael and welcome back. What we have seen over the last four years is that Public Health officials hold enormous power - to lock us in our houses, close our schools, force vaccines in our arms, take away our jobs, our friends, our workouts, our reasons to live.
Maybe some of these powers are justifiable if a novel virus can be contained or if a vaccine truly can achieve herd immunity. Or temporarily in instances when hospitals are on the verge of collapse.
BUT the very second it was understood the virus could not be contained or that the vaccines weren’t up to the job of herd immunity, PH should have pivoted immediately, changed strategy and given us back our civil liberties.
But it seems the opposite happened, at least for a while. Doubling down on the flawed narrative and labeling anything that dared to challenge it as “misinformation” or “disinformation” became the game plan. This is utterly un-American.
At times there seemed to be too much concern with protecting the vulnerable (not just elderly, but the immunocompromised, the obese and certain racial groups) over everyone else. Finally, the People had enough and started to disobey PH mandates. PH retreated, not because they now understood they had gone too far, but rather because they were fearful of the angry mob.
There seems to be no “lessons learned,” only heads in the sand. That’s what I’m angry about.
Whenever a plane crashes, the first order of business is understanding what went wrong and fixing it so that future aviation will be safer.
What should PH’s role be in the future? Should we revoke their powers to take away civil liberties and ruin our economy? What is being taught in PH schools and should the curriculum change?
The answers here seem to require some type of philosophical ideology. Does one think the average person is “dumb” or are people capable of making decisions that are in their own best interest? How far should we as a society go in prioritizing the needs of the vulnerable over the rights of average citizens, and for how long?
I am thankful that we have a place to explore these questions - here at YLE’s Substack: her posts and reader comments.
I really like your Covid coverage, even now, because everyone else has moved on. You’re my only source. So while you explore other topics, please don’t give up on Covid. Don’t let the haters drive you off the topic. That’s their goal. Thank you so much for your consideration.
If you're looking for another resource regarding covid and don't already know of it, Dr. Michael Osterholm does a biweekly podcast called the Osterholm update.
Thanks!! I didn’t know
Added to my podcasts
I agree!
Dr. Jetelina, I need you! I count on you and Dr. Rivers to tell me the truth and all of the truth. You have access to information that I don’t have (and I’m pretty good at ferreting out information and ignoring the “if it bleeds, it leads” or fingers in ears, “la la la,” or, “we’ll just tell them what we think they want to hear” media.) That includes information about COVID, which is still with us.
I know you have to take care of yourself, or we risk not having you write this column. Please know you are performing a badly needed public service and I and my family appreciate you! Love, Bee
To be frank, the only reason I am a paid subscriber to your Substack is for COVID information. I can find other public health content in a million other locations, but almost no one is talking about COVID anymore, and we’ve been abandoned by every facet of public health, our government, and even our medical providers. There are so any of us who cannot just decide we are “burned out” on the pandemic, as it rages on while everyone who could make a difference looks the other way. We continue to get disabled and die from COVID in huge numbers, and you are unfortunately one of the last ones standing. The pandemic is ongoing, and just because we aren’t calling it an emergency doesn’t mean that it isn’t.
If you stopped talking about COVID, I would not have any interest or inclination in continuing to engage with your content.
Thanks for the feedback!
I completely agree with Megan. My spouse and I are here for Covid info. (Can we resume our normal lives? What medications are available or under development for prevention or treatment? Will vaccine companies continue to create vaccines — our imperfect, short -lasting, but best non-mask tool to prevent infection? Or are they going to abandon the effort, leaving all of us with nothing but masks, which have become social poison?)
It’s hard to figure out what Covid is doing, where. So it’s hard to assess risk geographically and seasonally, both in the US and abroad. It would be so amazing if you had a dashboard (with notations of when various items were updated, and when to expect fresh data) where we could go to see data — especially if you had a guide, like “when X measurement reaches Y level, in my family, we do Z, because we are worried about A, B, and C. Here’s what to do depending on what your concern is.”
Also if you knew which agencies had stopped reporting useful data, and could clue us in to who we might write to ask that monitoring be reinstated, maybe as a group we could move at least one needle. Do we write our representatives? Agency heads? What can concerned citizens do to improve public health data?
Thank you. You have been amazing. I hope you find a path that allows you to continue while filtering out the rage from the gratitude.
My husband and I just got Covid for the first time last week. He is still symptomatic and testing positive after 9 days. I am also still symptomatic, but haven’t bothered to retest, as I am not going out in public until both of us have completely cleared the virus. We both got our fall vaccines, mine just two weeks before I got sick. It was definitely not “just the sniffles” - more like a two to three day flu followed by a bad cold lasting way too long. So, Covid is still here, still spreading uncontrolled, still making people sick and still impacting one’s ability to do what one needs and wants in their lives. I understand your burnout. We live in Missouri where most people don’t take any precautions anymore and are perfectly happy spreading their germs around, and many are hostile to any mention of it. Just want you to know I have appreciated your efforts over the past years.
Sharing my narrative submitted in the survey: "I have no criticism. I just hope you can find a way to cover Covid. It is not "over". The latest provisional death counts from the CDC is still far above a bad flu season, annual motor vehicle deaths etc. Covid is evolving. The fascinating science is evolving. Reliable platforms like Twitter (I can't bring myself to use the other name), are devolving to the point where my trusted epidemiologists are leaving (or faced with difficult ethical issues should they stay), the CDC is --frustrating and disorganized. One example, instead of updating the page on the 2.86/JN I see no new news since August. This week, I discovered they have been posting information on a completely different page. The site search and navigation is often dysfunctional. I understand your burn out with the American Bile Epidemic. What if you take a break from composing your amazing, "just right" narratives on Covid, but instead post links to the current statistics and studies related to Covid topics? As the media platforms (Twitter), sources (Our World in Data, Johns Hopkins, YLE), and methods (wastewater) in which we gather the information evolve-you can still be the conduit for the numbers and studies. At the end of your weekly newsletter, you could include links to quality: hospitalization data by age, hospitalization data by other demographics of interest, provisional death counts, wastewater with a standard narrative about current reliability in interpreting case data, variant forecast issues (virulence, test reliability, treatments). Most of the time this "source" or "deeper dive" section would have the same headings and links. But as the CDC conducts their confusing re-dis-organization, and new issues come up-you would still be involved in education the public about this worse-than-flu, worse-than-motor-vehicle-accidents public health issue. I also suggest that rather than making separate regional newsletters: pick out topics that you are called to write about, to sustain your fine advocate's heart, and put links to deep dives on other public health topics in the end section. So if you want to write about the effects of the Canadian fires, write. If you don't post a link to them. For me, I live in Michigan, my young grandchildren are in Tennessee, and Colorado. So I inhabit 3 regions. I'd prefer the national overview, and links to deep dives on the others. These are just ideas, which I hope you can use to confirm your path or spark new ideas. No matter what, I find it a tragedy that good people like you have to endure the threats and anger of the misinformed. I appreciate everything you've done with grace, bravery, and intelligence." Sincerely, Karen Athan
Keep up the good work, this has been a fantastic resource! I ranked chronic diseases 2nd behind infectious diseases, because I hope to continue to see updates on long covid (prevalence, research, treatments, etc). It's clear that it has now joined the ranks of common chronic diseases and will continue to be a major issue indefinitely. Its risk is also why I haven't fully returned to 2019-normal, and a big reason why COVID isn't "just a cold".
I'm really sorry that people get angry with you and, I assume, express that anger in unconstructive ways. You never make me angry. I'm so grateful for the information you provide to this community.
The small number of people who are doing that are clearly agenda-driven ideologues who are here chiefly to stir up anger. I try to ignore them.
I blocked them and working so far....
I did as well, but their comments keep showing up anyway. A minor annoyance.
Just keep moving guess
I love the work you've done, and hope to see it continue. I would like to see a combination of topical and deep dives, but we need (NEED) info on, and to combat misinformation. I was reading a piece last night by Francis Collins where he highlights the need for us in PH to get the messages out more frequently and "better" to combat the misinformation campaigns. I think your efforts were a key element in that effort because they were fact based, cited references that were accessible (if technical), explained things well, and were timely. And you put out so much content.
I think what you and Caitlyn are doing is very important and useful. I especially like (and use frequently) Caitlyn's regional summaries to spot trends and make my own decisions on updates and correlations. I think that's something you might also be successful with, but I'd ABSOLUTELY LOVE to see a start on an effort to counter misinformation (and I'm willing to participate).
Per Collins, we may need a "Communications Corps" to provide update and data sooner and faster, and to better counter both misinformation and worse, disinformation. Both were present during the height of the pandemic, and we'll see them again for whatever reason in the next, inevitable outbreak. We need to be prepared and work cohesively to improve the information transfer overall.
Thank you for your dedication! Your calm straight information in the face of the insanity has been a godsend. ❤
Thank you for writing, and for being open to comments.
I echo the sentiments about SARS-2. It really isn't over, regardless of the concerted effort in the US to hide data.
I am also concerned about the state of public health. I'm of the generation that saw the introduction of seat belts and other mitigations in automotive safety, of smoking cessation, of a major effort to eradicate an infectious disease with a survival rate of well over 99% (yes, poliomyelitis), and more. These days "99%" is considered okay, at least in the mind of the general public. Medical folk often use the notation of per 100,000 individuals. For someone my age, the chance of death from colon cancer is about 50/100k per year. That translates to 99.95% survival rate - but I'm expected to get a colonoscopy, and I do. The WHO lists the current case fatality rate for covid as 1% in the US (which I found surprisingly high). That's 1,000/100k.
We are out of balance in terms of risk assessment and mitigations. I'm concerned about this spilling over into areas like childhood vaccinations and other preventative interventions.
the infection fatality rate for covid is well under 0.1% for the majority of the population. Most infections go undetected.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9613797/
I'm not defending their numbers, but the WHO data I saw was labeled case fatality rate, not infection fatality rate. Even so, an IFR of 100/100k is pretty ugly given the number of infections in the US, not to mention the rate of serious long term problems.
If you assume everybody in the US has been infected, then with the acknowledged mortality the overall IFR has been over 0.3% for the pandemic. Of course, that's assuming that one is concerned about the entire population, not just a subset.
I took the survey, however I am repeating myself here. First, I am eternally grateful to you, and I want to be clear about that. Urgency of situation communicates (particularly when it is in media) through frequency of content. In an emergency, lots of content is necessary. In reduced urgency reduced content is consonant with the situation. So keep at it, and allow yourself to do less, as less is needed right now. If things change, in a challenging way, you have space to upgrade how much content to share. I hope that is useful feedback
Over the last four years, I have posted a few of your YLE issues on my Facebook page. I received an excellent reaction as misinformation about shots, masks, research, etc was so prevalent in the US. Thank you for your energy in putting out the information. I also appreciated the research you have cited from other countries. It lended the point that the COVID virus was world wide.
If you downsize to possibly publishing every other month, I understand. You do have a family.
By the way, your very matter-of-fact way of writing is excellent. Currently, there is too much emotion and not enough straight research-based facts. I figure when you receive negative, obnoxious comments, those folks know they really don't know anything.
I’m immunocompromised, so COVID isn’t over for me (or flu, RSV, mycoplasma pneumoniae, strep, etc.) Would love to see more about zoonotic pathogens and the One Health Approach.
Umm, you just gave me a topic for another Substack piece. :-)
Anyway, before SARS-CoV-2 came along, we always had immunocompromised for a number of reasons. How did they cope? We were never very good at protecting the vulnerables.
Well, I’m newly immunocompromised as of April this year, but I worked as an inpatient adult Oncology nurse for 15 years. Those patients were already masters of masking when the pandemic came around. We kept them inpatient when they were severely neutropenic after chemo. There were a bunch of precautions like no fresh flowers in the room, no fresh fruits and vegetables (the NFFV was studied and found not to make enough difference in infection rate to justify limiting the diet of people who already had nutrition challenges.) But some would beat the cancer but die of infection. That wasn’t uncommon. The number of immuno adults in the US is increasing, one study I saw estimated 6.2%, likely due to the use of biologics for rheum diseases. And immuno are also more susceptible to zoonotic illness, tickborne illness. Plenty for your post!
Thank you, this not an area that I am familiar with nor experienced it except for a short course of steroids. I see a lot of concerns in here from susceptible people here but this is not new.
As for vector borne illness, did a two part on arthropod vectors. However, there are a couple of updates. So, Hickam was right! You can have as many diseases as you like. A Pt presented with THREE tick-borne diseases! Read more about it later.
Also a two part on HPAI and maybe an update there too.
Thank you Katelyn for all you do! Through these years of the pandemic I knew I could check in with you and others, and come to my own conclusions as to how to take care of myself and family against the ravages of COVID. I lost an aunt, uncle, and cousin early in the pandemic, and so it was always personal to me. Personally, I check in mostly with you on the infectious diseases aspect of health. I find that people are sleepwalking to what is happening to our world without taking any personal responsibility. But with your advice, I don’t have to be one of those people.
Good faith comment (I promise), then will go back to "lurker" mode a few more weeks, but since you are requesting feedback...
First off, your followers have spoken. Stay on Covid. Yes, keep adding other things that interest you, but at least 1x a month, a good Covid piece.
My "dream scenario" comes from your August interview with David Wallace-Wells [1] which I recently re-read after Jeremy Faust posted it again a few weeks ago:
|YLE: "..it’s going to take time to heal and to understand and to try to hear the other side, and try to |hear what we got wrong and how we can do better in the future."
I would love to see you begin to reach out to the other side and start working through the messy science of figuring out better truth, improving our scientific understanding of what the fuck happened the last 3 years. I'm not suggesting you meet with the Cranks or the Antagonists, but there are many, many reasonable, polite scientists out there who disagree on the current PH "narrative" regarding Covid and I would love to see more collaboration instead of echo-chamber substacking (this applies to them as well).
Below is an "off the top of my head" list of people who hold views in contrast to mainstream PH, are articulate, data driven, and I'm 90% sure would be very polite and courteous would you pursue a dialectic - not a debate - with them. [2]
As you noted in your interview with DWW you agree there should be some sort of "Covid Commission" - and I agree with, not in Congress, so why not pursue this yourself?
Critical questions I would like to see addressed (consider this a "greatest hits" of my prodding posting).
None of these I mean to engage in today, tomorrow, or next week - just think of this as the top questions skeptics have that need to be addressed in the future:
1) How did we not realize Covid was a disease that primarily affects the elderly immediately? Why was there such reluctance to acknowledge this disease was not a threat to children despite overwhelming evidence immediately in Spring 2020? In your DWW interview you noted:
|YLE: "It’s hard to remember how little we knew back then. Are children truly less risk than adults |because this typically isn’t how viruses work."
But we had the data in Italy by April. And again when the NYT published the "Incalculable Loss" 100K deaths story May 24 2020 listing 1,000 names claimed by Covid. [3] The average age was 77. 80% of the people were over the age of 65. 50% over the age of 80. It was in plain sight from the beginning. How did PH not figure this out immediately?
2) Extension of above - considering there were zero excess deaths in children, in any country, throughout the pandemic [4], how would we be able to assign "credit" towards any intervention when the NNT approaches infinity? If every country had the same outcome of child mortality regardless of vaccination approach, school closures, masking, lockdowns, etc, why not consider none of these things mattered? (**Except Canada for some reason - the only country in the world child deaths jumped)
3) Public Health repeatedly engaged in what Francis Bacon called "Counting your hits and forgetting your misses". Why is this acceptable? Why wasn't public health disinterested, self-critical, and obsessed with error checking - all necessary components of science? Examples: South Korea was poster child of "doing it right" when things were going well, but there has been zero coverage of their massive mortality spike in 2022 (+90% excess deaths spring 2022!). Michael Mina and others claimed mass rapid testing could end the pandemic, but when the examples he used to make his case (UK and Slovakia) became overrun with Covid, PH does not grill this hypothesis and many people still seem to believe it. [5], etc
4) How did PH get Sweden wrong? How do so many in PH still get Sweden wrong? Katelyn, in the DWW interview you remarked:
| YLE: "Sweden didn’t also have a perfect response. Compared to the United States, they had less |excess deaths, but compared to their neighbors, like Denmark, they did a much more terrible job if we |judge their job on excess deaths."
This is demonstrably false. [6] This is a bit frustrating to data nerds like me, as we already discussed this almost 6 months earlier. [7] This is on "the paper of record", and despite listing multiple fact checkers, no one is aware that Sweden has lower excess deaths than Denmark. How can this be?
5) How did PH not realize masks were so important fighting respiratory viruses for the 100 years following the 1918 flu, struggling to find any efficacy, yet suddenly, within 6 months of Covid we managed to find 100+ studies showing near 100% efficacy? Does this not strike PH as odd that when masks were apolitical, it was openly known they didn't stop viruses [8], and only after they were politicized every. single. study no, matter how poor [9], managed to find amazing efficacy? And why isn't PH deeply interested in figuring out how the lowest masked countries had far better outcomes than Asia? Why every prediction failed ("will drive pandemic to the ground"... "taking them off is throwing gas on fire")?
What does this say about how we pursue scientific truth if simply by wanting something to be true, we can conjure up the "science" to back up our desires - that is clearly what happened with the 100+ studies saying cloth masks worked so well.
6) Why do spurious vaccine claims go unchecked by PH? How can PH claim that the vaccine saved 3 million people in the US? The Commonwealth Fund Analysis is regularly repeated uncritically [10], but simple replication tests show this can't possibly be true including: a) countries that didn't vaccinate don't have a proportionate increase in mortality predicted by this study [11] b) there is weak correlation between excess mortality and vaccination at the state level in the US and c) half the 1st world countries saw all-cause mortality *increase* after vaccination. [12]
7) Why was PH advocating for censoring dissent? There are few things more antithetical to science than celebration of orthodoxy and branding those who disagree with you a heretic who must not be allowed to speak. I should probably move this to #1.
So that is my wish for 2024, tackle these sorts of questions and engage with experts you don't agree with and see if you can find common ground. Maybe they are wrong?
(Resuming lurker mode again)
____________________
[1] https://www.nytimes.com/2023/08/29/podcasts/transcript-david-wallace-wells-interviews-katelyn-jetelina.html
[2] Off the top of my head you could reach out to (all of whom are on Substack as well):
Carl Heneghan - World renowned physician critical of lockdowns and not accounting for age stratification
Martin Neil - He has lots of questions on excess mortality curves in Spring of 2020 and how they don't match behavior of viruses
Tracy Beth Hoeg - Critic of Covid Vaccine efficacy
Paul Offit - On why he doesn't advocate for one-size-fits-all vaccination strategy the CDC rolled out
Paul Thacker - On mis and disinformation
Steve Templeton - On fear of the microbial planet
Aaron Kheriaty - Ethics of mandating vaccines
Tom Jefferson - Why the studies on masks aren't as convincing as you may think
Alina Chan and Alex Washburne - On why the lab leak was most likely scenario
[3] I scanned all the names into a spreadsheet from the print edition of "Incalculable Loss" NYT story here:
https://docs.google.com/spreadsheets/d/1AR9X-Cwu9dUIF50gBz9YOrVtvmrhNIBqJPZJBFSTmDM/edit?usp=sharing
[4] Easy to replicate with mortality.org data:
https://imgur.com/a/wIeMkbJ
[5] https://time.com/5912705/covid-19-stop-spread-christmas/
[6] OWID: https://ourworldindata.org/grapher/excess-mortality-p-scores-average-baseline?country=DNK~SWE
Raw deaths you can see yourself: https://imgur.com/a/fzB6wbI
[7] https://yourlocalepidemiologist.substack.com/p/house-select-subcommittee-gbd-and/comment/13418186
[8] One of 100's of possible examples, here is Laurie Garret giving a speech to the National Academy of Medicine about pandemics: "Did the mask really help them? Did the mask keep the virus out? Almost certainly not."
https://www.youtube.com/watch?v=sSExbHTS3nE&t=2504s
[9] "Identifying airborne transmission as the dominant route for the spread of COVID-19" was spread in the media 400 times, had 40,000 tweets, and was the primary "go to" proof that masks worked summer of 2020. But it was so bad even Michael Mina signed the retraction request ignored.
https://www.pnas.org/content/117/26/14857
[10] https://www.commonwealthfund.org/blog/2022/two-years-covid-vaccines-prevented-millions-deaths-hospitalizations
[11] Show me a country with low vaccination rate which had a 100% increase in mortality in 2021. Best I can come up with is Bulgaria which saw deaths in 2021 continue to rise to +37% prepandemic levels, but they quickly fell back to baseline without vaccinating. Then of course, there is Africa...
[12] Example: https://imgur.com/a/zGPSXpT
Great list Michael and welcome back. What we have seen over the last four years is that Public Health officials hold enormous power - to lock us in our houses, close our schools, force vaccines in our arms, take away our jobs, our friends, our workouts, our reasons to live.
Maybe some of these powers are justifiable if a novel virus can be contained or if a vaccine truly can achieve herd immunity. Or temporarily in instances when hospitals are on the verge of collapse.
BUT the very second it was understood the virus could not be contained or that the vaccines weren’t up to the job of herd immunity, PH should have pivoted immediately, changed strategy and given us back our civil liberties.
But it seems the opposite happened, at least for a while. Doubling down on the flawed narrative and labeling anything that dared to challenge it as “misinformation” or “disinformation” became the game plan. This is utterly un-American.
At times there seemed to be too much concern with protecting the vulnerable (not just elderly, but the immunocompromised, the obese and certain racial groups) over everyone else. Finally, the People had enough and started to disobey PH mandates. PH retreated, not because they now understood they had gone too far, but rather because they were fearful of the angry mob.
There seems to be no “lessons learned,” only heads in the sand. That’s what I’m angry about.
Whenever a plane crashes, the first order of business is understanding what went wrong and fixing it so that future aviation will be safer.
What should PH’s role be in the future? Should we revoke their powers to take away civil liberties and ruin our economy? What is being taught in PH schools and should the curriculum change?
The answers here seem to require some type of philosophical ideology. Does one think the average person is “dumb” or are people capable of making decisions that are in their own best interest? How far should we as a society go in prioritizing the needs of the vulnerable over the rights of average citizens, and for how long?
I am thankful that we have a place to explore these questions - here at YLE’s Substack: her posts and reader comments.