I’m seeing a good amount of flu in my practice still, so appreciate the national validation chart.
Having milked a cow, and seen the udders up close, pasteurize my milk, please.
I’ll break this rule for some high end cheese from DiBrunos in the Italian Market down the street every once in a while…😋
Measles, Covid, Ladapo, seniors, Florida make for a perfect storm. If I make it to retirement I’m absolutely headed north instead! Hygge over humid, community over hyper-individualism, embryos are not people deserving more protection under the constitution than women.
Good spot for climate change, too. I visited Traverse City this summer and feasted on roadside cherry stands and went sailing and tasted local wine. Amazing little spot, who knew, and love the motor city, too.
We are in Florida and have COVID in our household for the first time (that we know). It came home with the 10-yo from school. They are usually the only one masking at school and have no option for outdoor (safe) eating. They are still testing positive on RAT's on day 7. Their school said they could come back on day 5 regardless of test results as long as they didn't have a fever. They never had a fever. Public health as a whole is completely broken, and is essentially nonexistent in Florida.
Thankfully, we are not willfully/maliciously ignorant and our family's COVID mitigations (isolating the infected child in a separate room, high quality masking indoors, open windows, tons of HEPA filters/CR boxes in every room, outdoor dining, serial testing, Betadine Cold Defense nasal spray, CPC mouthwash, as-up-to-date-as-possible vaccinations, etc.) have prevented spread to any of the other 5 members of the household (so far), including high-risk members. However, we also know that we are very privileged to be able to do these things, but so very frustrated that we have had to do them completely on our own with absolutely no support from supposed experts and officials. I honestly know more about COVID than any of our medical doctors where we live which is apparent by the fact that NONE of them mask at all. We live in the dumbest of times and there is absolutely no excuse for it.
Northeastern Ohio here. My son’s middle school is having attendance issues and literally said, “it is ok to come to school if you are not feeling well. Vomiting and fever mean you should stay home, but otherwise, you need to come to school!” There is no quarantine requirement for Covid. None.
My teen tested positive for Flu B this week. He is a wreck dealing with makeup work and worrying he will be penalized. He only had a fever for a day and so could be back at school, but I am keeping him home until his cough is improving along with his appetite and energy. He is a straight A student and so worried about repercussions.
Interestingly, we wore masks at the pediatrician’s office. No one else did. Even when the ped came back in to say the swab was positive. So, I am wondering if all the data saying masks do not work is correct. Otherwise, why would doctors not be wearing them around sick people?!
@Sarahb: I applaud your sane and scientific mindset about this novel virus that has yet to be fully contained after 4+ yrs. As for the staff that were infected outside your office, have any developed issues that could be attributed to the virus, including but not limited to: new onset cardiac arrhythmias, myocarditis, acalculous cholecystitis, thromboembolic events, cognitive disorders, chronic fatigue? Anecdotal to be sure but interesting to me and others. In our area, despite a clear history of antecedent COVID19, even within 30 days, presentations of new onset arrythmias, CHF, P.E.’s are recorded as singular events and any suggestion in the official record that smacks of a correlation is not deemed proper/appropriate. It baffles me. During the height of the pandemic, hospital systems were subsidized several $$$$ for a COVID19 dx but no longer, yet patients without other risk factors than recent COVID19 are suddenly acquiring a new dx without adequate explanations or analysis as to etiology. I was always taught that certain disorders, esp CHF, were only a sign/symptoms and not a diagnosis. It was up to the physician to determine the etiology if an adequate therapy and POA is to be formulated.
Well… interestingly, I had an abnormal EKG, benign but abnormal, for a few months after my first Covid. It resolved.
One staff had Bell’s after her presumptive Covid in April 2020.
My friends got Covid in early March 2020 and one was horribly ill for months, still has decreased lung function, and she was a very active athletic person. She has had it SIX times and has variable responses to infection.
I have young patients with long Covid, healthy kids, that just cannot shake it.
As for the PCR test, I still struggle with how accurate it works. I have so many absolutely positive they have covid (4 of 5 household members all positive all same sxs but 5th took five days till PCR converted to detected).
I still feel like we know so little.
We are inundated with pink eye right now, and a few have covid. Do they all? I have no idea. None.
But I don’t trust the PCRs. I only hope they indicate less likely to be contagious.
I am so sorry you and your son are going through this. It is so very wrong and I hope you give yourselves grace and the time to sufficiently recover so that he is able to continue performing at a high level over the long term. It will not serve anyone if we cause ourselves long-term damage in the hopes of checking boxes in the short-term. Folks can also suffer "Long Flu" like we see with Long COVID (we are seeing more and more long-term impacts to viral infections).
Masks absolutely work (when worn and correctly), but unfortunately the massive gas-lighting campaign combined with how susceptible humans are to socially-driven peer pressure are leading to supposed sane, intelligent people doing many things that are against their own self-interests (this includes doctors/healthcare workers). #MaskUp
I was listening to Dr Offit promote his new book on The Michael Shermer show, he too talked about how only n95 offer some protection but they are really hard to wear a long time.
Everywhere I look it seems physicians are quietly returning to the scientific consensus pre 2020, that they don’t stop viruses, which is ok.
I am guessing that is the reality. I cannot imagine doctors not choosing to protect themselves from illness, if they could. I know you are in the same geographical area, and between my husband, myself, and kids, we have seen no masks at Cleveland Clinic, Akron Children’s, University Hospitals, and a stand alone urgent care.
Maybe the doctors mask at the start of respiratory season, get sick despite wearing a mask, get better and figure "now I'm immune and don't need a mask anymore."
Or, masking at the beginning of the season is enough to slow transmission *at work* when it matters the most, operationally. They're probably vaccinated as well, so if they get Covid they've got a nice double boost. It doesn't have to be "all or nothing"
Does that make it correct? All those unmasked licensed “caregivers” willfully carrying or transmitting lethal infectious material to immune-compromised patients? If I’m in an enclosed space with a professional and they aren’t wearing a mask I sure as heck have mine snugged up on my mug. Imagine how many exposures a healthcare “professional” has in the course of his/her day! How many others will he/she infect? It’s not rocket science. A good electrostatic mask worn correctly reduce viral loads by containing or preventing access to the vehicle into which the virus is contained - droplets.Porosity relative to the virus size isn’t the issue.
I disagree with that assumption that physicians are caving in to the belief that masks don’t work. As I view it and as SarahB supports, masks work but the users often don’t make them work as they are intended. Note bearded faces and masking. Pitiful coverage even with a non-N95, but I’ve not seen a bearded physician wearing anything but a loose surgical-type mask. Perhaps those Physicians are not stating masks don’t work but they are non-verbally declaring “I too am tired of wearing anything on my face and since many unmasked people are confused about it, I’ll be casual and not be dogmatic.” That’s how I read the message coming from an unmasked physician. IMHO, the physician is abrogating his de facto role as a public health official, even if he doesn’t get a weekly check from such an entity. We are educators and we need to take the lead, not follow the herd.
I can tell you why the wastewater level of Covid are high in FL. Only 6.89% of people are boosted with the latest booster. Bad messaging and the illegality of mask mandates, even in hospitals, are a major contributing factor. They are actively trying to make the vaccines illegal here. And according to studies, 70% of household transmission starts with a child and we can't get protections in schools. It will never get better until we get better support from the CDC and other agencies that are currently failing at public health and safety. Just look at who our SG is and what he's done here. Vulnerable communities can no longer safely participate in public life. I no longer see a future where I will ever be comfortable in public spaces again.
I continue to be utterly appalled at the behavior of Florida officials. They should be doing everything they can to maximize measles vaccinations of children, flu shots for everybody, and COVID boosters for those at high risk.
They are actively trying to make the vaccines illegal and mask mandates already are illegal, even in hospitals. No protections can be mandated in the state of FL. They are actively trying to unalive us.
I don't understand this at all. I get that lay people might want this or be swayed by misinformation, but why in the world are doctors and other health people supporting or putting up with this?
Quick question about vaccines in general: The last time I had boosters for all of the childhood vaccines was when I was 26 (for grad school). I’m now almost 60. Do people my age need to get boosted again given the trend of non-vaccination of some children these days? Or is it too small of a population to worry about? (And no other concerns — I’m completely vaccinated for everything available seasonally!)
I’m not a medical person. But I was born in 1963, and my primary care physician had me get a measles booster around 5 years ago. Apparently, there was some issue with the measles shots given to kids around the early 1960s. We both felt it was “better safe than sorry,” especially since I was traveling to Europe where the measles vaccination rate is even worse than ours.
Yes- mine was given prior to a year old and did not give lasting immunity. That’s why you “can” get one at 6 ninths old, but should get it after 12 months.
You might consider talking to your doctor about getting your titers checked. It's not perfect, but it's better than being anxious simply because you're lacking info.
With regard to high wastewater COVID in Florida and the South you report: " South has a very weird pattern." It is not so weird. Due to public health nihilism these states are an extreme outliers. Looking at their stats, I have to assume that new cases are hugely underreported (compared to other states), that their reported COVID death rate is rather higher (especially Florida), and you can assume a large population vulnerability due to lack of vaccine take up, and disregard for masking in public assemblies and other systemic measures. Fortunately the dominant variable does not seem to cause a lot of serious morbidity.
[The Washington Post] “Tax records reveal the lucrative world of covid misinformation,” headline of article dated February 21, 2024, accessible to all here: https://wapo.st/49on7f5
According to the WaPo article, “The influx of pandemic cash enabled organizations to deepen their influence in statehouses, courtrooms and communities across the country.”
Closing paragraphs read as follows:
“Georges C. Benjamin, executive director of the American Public Health Association, said he thinks the funding of misinformation by conservative donors is particularly disheartening because their communities faced higher rates of coronavirus vaccine refusal — and death — during the pandemic.
“In his view, he said, ‘we should be as a society really concerned that people are spending this amount of money to distort the truth.’”
It seems clear that stabilizing at stubbornly high - in excess of epidemic rates - levels of respiratory illness will be the best we can hope for, for the foreseeable future. Aren’t we proud of what we‘ve accomplished for ourselves, for our children and our children’s children?
Pasteurization is good, don't get me wrong. But part of the problem at the time was that milk producers weren't regulated at all and were adding all sorts of bad things to make bad milk LOOK fresh. (See the "swill milk" scandal in NYC.) For rural people who knew the farmers they got milk from, there was much lower risk (and we aren't usually in that situation anymore).
You wrote : “E. coli outbreak linked to raw milk cheese.” It would be nice to have some context here – like how much of that contaminated batch of raw cheese was consumed by people who did not get sick. Were the people who got sick more at risk due to a weakened immune system or other health condition? How often does raw milk cheese make people sick, as it’s widely used in Europe?
Certified raw milk is much more expensive to produce and is tested far more frequently than conventional milk. In some part of the U .S. it’s illegal, and is sometime sold underground there.
Here's something few people know:
“It is true that raw milk produced as “intended for pasteurization” and sourced from Concentrated Animal Feeding Operations (CAFOs) is generally unsanitary and unsafe to consume raw. Such milk is being produced in conditions where animal health is compromised, antibiotics are utilized, hormones are used to stimulate higher levels of milk production, there is an abundance of manure, and there is a corresponding high rate of pathogens. This type of milk is generally commingled with milk from multiple dairies, which increases the risk of pathogenic exposure.”
So we have a sterilize the filth program. Years ago health authorities found cases where milk intended for pasteurization was not pasteurized and thus made many people sick. They lumped those cases together with the few certified milk cases and then said look at all the evidence saying raw milk is dangerous. I don’t know if they are still doing this devious “science.” You can get sick from pasteurized milk also.
As far as potential benefits from raw milk, that is debatable. If a newborn calf was fed only pasturized milk, would that baby cow thrive ? I suspect not.
Excellent comments Doug, thank you. I'm a retired public health scientist, and foodie. This is such a complex issue and I don't pretend to have all the answers. But I would like to hear from Katelyn whether she's familiar with the "multi-year, multistate outbreak of Listeria monocytogenes infections linked to queso fresco and cotija cheeses manufactured by Rizo Lopez Foods, Inc., of Modesto, California." (linked below.) These are pasteurized cheeses, not raw, so should one be advised to avoid pasteurized cheeses as well? There are other examples of outbreaks associated with pasteurized cheeses, but I don't know of a credible study that has compared raw vs. pasteurized.
Regarding the claim that "Raw milk (cheese) has zero additional health benefits," there's at least one good study from the highly regarded Journal of Allergy and Clinical Immunology that found that "Early life consumption of raw cow’s milk reduced the risk of manifest respiratory infections and fever (in infants) by about 30%." (linked below)
Personally, I take a middle road approach -- I don't drink raw milk or eat raw soft cheeses, but I do greatly enjoy quality raw hard cheeses from Europe, and believe (although the evidence is not definitive) that they contribute to my beneficial gut microbiome bacteria.
Prior to the 1920's there was a lot of illness and fatality due to milk. Tuberculosis, Scarlet Fever, Typhoid Fever are just a few examples of food-borne illness. There is even debate that cow milk is really not suitable for humans, raw or not. Even beer is pasteurized. As far as calves are concerned. https://extension.umn.edu/dairy-youngstock/dairy-calf-scours
Yes, in the past raw milk was far more dangerous than today. Times change .
I don’t think that video claiming 1/3 of foodborne illness is caused by raw milk is based on evidence. I just looked at a webpage linked by the CDC’s page on raw milk.
“During 1998–2018, health departments reported 21919 foodborne outbreaks and 423 595 outbreak-associated illnesses to FDOSS. Of these, 202 outbreaks (0.9%) and 2645 illnesses (0.6%) were linked to unpasteurised milk (Table 1), including 228 hospitalisations and three deaths. During the same time period, 9 outbreaks (0.04%) and 2133 illnesses (0.5%) linked to pasteurised milk were reported, including 33 hospitalisations and three deaths.”
“It is important to note that there is no such thing as a perfectly safe food [20]. An analysis of foodborne illnesses from 2009-2015 showed that the top food categories commonly linked to illnesses were chicken, pork, and seeded vegetables [31]. Pasteurized milk is not perfectly safe, either, and is implicated in foodborne illnesses and outbreaks every year. CDC outbreak and illness data since 1972 shows at least 82 deaths from pasteurized dairy products.
The CDC outbreak and illness data which is used to assert that raw milk is unsafe does not distinguish raw milk intended for pasteurization from raw milk that is carefully produced and intended for direct human consumption. The FDA has no standard for raw milk intended for human consumption. It has only the Pasteurized Milk Ordinance (PMO). It is known that raw milk intended for pasteurization often contains pathogens; studies have shown that up to 24% of this type of milk tests positive for pathogens [32]. Additionally, the CDC data used to implicate raw milk includes outbreaks and illnesses from “bathtub cheese” (i.e. Mexican-style Queso Fresco made illegally at home); queso fresco is inherently more dangerous than raw milk, and is associated with more serious outbreaks and illnesses. The CDC data reports only two deaths from raw dairy products since 1972, and both of these deaths were associated with queso fresco.
Nearly 10 million people in the USA were consuming raw milk regularly as of 2007 [33], and the number of people consuming raw milk is likely to be higher now given the growing popularity of raw milk. An independent assessment of raw milk risks from 2000-2007, which excluded queso fresco-related illnesses and outbreaks, concluded that there was a "a roughly 1 in 94,000 chance of becoming ill from drinking unpasteurized milk during that period... During the 2000−2007 period, there were 12 hospitalizations for illnesses associated with raw fluid milk. That’s an average of 1.5 per year. With approximately 9.4 million people drinking raw milk, that means you have about a 1 in 6 million chance of being hospitalized from drinking raw milk" [34].
Furthermore, recent improvements in raw milk risk management methods and training have led to a significant reduction in raw milk-related illnesses and outbreaks. The Raw Milk Institute, founded in 2011, has developed farmer training and Common Standards for raw milk which is intended for direct human consumption. These rigorous standards and training result in low-risk raw milk, as documented in a 2018 peer-reviewed paper titled, " Recent Trends in Unpasteurized Fluid Milk Outbreaks, Legalization, and Consumption in the United States." This paper concluded that, "The rate of unpasteurized milk-associated outbreaks has been declining since 2010, despite increasing legal distribution. Controlling for growth in population and consumption, the outbreak rate has effectively decreased by 74% since 2005" [35]. “
Those are some pretty long odds – 1 in 6 million chance of being hospitalized some years ago before certified raw milk got even safer.
I concede that all forms of raw milk are more likely to cause outbreaks and illness. But for many, the advantage of raw milk are worth that tiny risk. And some states allow people to have a choice.
Regarding my idea that pasteurized milk is likely unhealthy for newborn baby cows, your link does not indicate if pasteurized milk is OK or not
There are people not vaccinating their children and how about not testing or treating for Strep! Yup, inconceivable. They may recover but are carriers for 2 weeks. What is wrong with people?
Are there many older adults who did not have the UCDs as children. As an old retired public health nurse and nurse practitioner, that was my standard chart notation for usual childhood diseases. Most folks in my cohort had measles, mumps, rubella, and chicken pox. I remember the experience too well... Thank goodness we were spared DPT! And so glad we now have the shingles vaccine as well now.
It also looks like the Fla surgeon general tells parents of kids with measles that they can return to school if their symptoms are getting better?? Nothing about timing with the onset of rash.
Thank you for this very helpful update. Seeing a lot of ILI--some testing positive for flu and some that "feels" like Covid, but not testing positive on rapid tests. I do wonder if the rapid tests are just less helpful at this point.
I’m seeing a good amount of flu in my practice still, so appreciate the national validation chart.
Having milked a cow, and seen the udders up close, pasteurize my milk, please.
I’ll break this rule for some high end cheese from DiBrunos in the Italian Market down the street every once in a while…😋
Measles, Covid, Ladapo, seniors, Florida make for a perfect storm. If I make it to retirement I’m absolutely headed north instead! Hygge over humid, community over hyper-individualism, embryos are not people deserving more protection under the constitution than women.
We headed north to retire, to Detroit.
Good spot for climate change, too. I visited Traverse City this summer and feasted on roadside cherry stands and went sailing and tasted local wine. Amazing little spot, who knew, and love the motor city, too.
Traverse City is terrific and I think underserved currently in respect of family physicians. Check out the Holland/Zeeland/Grand Rapids area too.
If you join us here in Los Angeles you can have great weather, and sane citizens. It's expensive to live here, but some of us think its worth it. : )
We get what we pay for… was in San Diego this summer and loved it. Can you promise fish tacos will be as good?
I will personally guarantee that you will like our fish tacos, or I will buy you a beer. : ) Still, nothing wrong with San Diego. It's a great city!
We are in Florida and have COVID in our household for the first time (that we know). It came home with the 10-yo from school. They are usually the only one masking at school and have no option for outdoor (safe) eating. They are still testing positive on RAT's on day 7. Their school said they could come back on day 5 regardless of test results as long as they didn't have a fever. They never had a fever. Public health as a whole is completely broken, and is essentially nonexistent in Florida.
Thankfully, we are not willfully/maliciously ignorant and our family's COVID mitigations (isolating the infected child in a separate room, high quality masking indoors, open windows, tons of HEPA filters/CR boxes in every room, outdoor dining, serial testing, Betadine Cold Defense nasal spray, CPC mouthwash, as-up-to-date-as-possible vaccinations, etc.) have prevented spread to any of the other 5 members of the household (so far), including high-risk members. However, we also know that we are very privileged to be able to do these things, but so very frustrated that we have had to do them completely on our own with absolutely no support from supposed experts and officials. I honestly know more about COVID than any of our medical doctors where we live which is apparent by the fact that NONE of them mask at all. We live in the dumbest of times and there is absolutely no excuse for it.
Northeastern Ohio here. My son’s middle school is having attendance issues and literally said, “it is ok to come to school if you are not feeling well. Vomiting and fever mean you should stay home, but otherwise, you need to come to school!” There is no quarantine requirement for Covid. None.
My teen tested positive for Flu B this week. He is a wreck dealing with makeup work and worrying he will be penalized. He only had a fever for a day and so could be back at school, but I am keeping him home until his cough is improving along with his appetite and energy. He is a straight A student and so worried about repercussions.
Interestingly, we wore masks at the pediatrician’s office. No one else did. Even when the ped came back in to say the swab was positive. So, I am wondering if all the data saying masks do not work is correct. Otherwise, why would doctors not be wearing them around sick people?!
Pediatrician here. I wear my n95 all day. For almost 4 years.
When we lean into a patient and they could or sneeze unexpectedly, any barrier (plain mask) will absolutely help.
I wear a face shield as well when I examine a patient.
I have a HEPA filter that blows between me and the patient while I am speaking with them.
My staff wear an n95, shield, and not one staff has gotten Covid19 in my office. Zero. In 4 years.
About half have had Covid and they clearly were infected during social events.
So I do indeed feel masks and shields and HEPA filters are helpful. Helpful.
@Sarahb: I applaud your sane and scientific mindset about this novel virus that has yet to be fully contained after 4+ yrs. As for the staff that were infected outside your office, have any developed issues that could be attributed to the virus, including but not limited to: new onset cardiac arrhythmias, myocarditis, acalculous cholecystitis, thromboembolic events, cognitive disorders, chronic fatigue? Anecdotal to be sure but interesting to me and others. In our area, despite a clear history of antecedent COVID19, even within 30 days, presentations of new onset arrythmias, CHF, P.E.’s are recorded as singular events and any suggestion in the official record that smacks of a correlation is not deemed proper/appropriate. It baffles me. During the height of the pandemic, hospital systems were subsidized several $$$$ for a COVID19 dx but no longer, yet patients without other risk factors than recent COVID19 are suddenly acquiring a new dx without adequate explanations or analysis as to etiology. I was always taught that certain disorders, esp CHF, were only a sign/symptoms and not a diagnosis. It was up to the physician to determine the etiology if an adequate therapy and POA is to be formulated.
Well… interestingly, I had an abnormal EKG, benign but abnormal, for a few months after my first Covid. It resolved.
One staff had Bell’s after her presumptive Covid in April 2020.
My friends got Covid in early March 2020 and one was horribly ill for months, still has decreased lung function, and she was a very active athletic person. She has had it SIX times and has variable responses to infection.
I have young patients with long Covid, healthy kids, that just cannot shake it.
As for the PCR test, I still struggle with how accurate it works. I have so many absolutely positive they have covid (4 of 5 household members all positive all same sxs but 5th took five days till PCR converted to detected).
I still feel like we know so little.
We are inundated with pink eye right now, and a few have covid. Do they all? I have no idea. None.
But I don’t trust the PCRs. I only hope they indicate less likely to be contagious.
Thank you for being one of the few who have maintained sanity and their Hippocratic oath. 💜😷
I am so sorry you and your son are going through this. It is so very wrong and I hope you give yourselves grace and the time to sufficiently recover so that he is able to continue performing at a high level over the long term. It will not serve anyone if we cause ourselves long-term damage in the hopes of checking boxes in the short-term. Folks can also suffer "Long Flu" like we see with Long COVID (we are seeing more and more long-term impacts to viral infections).
Masks absolutely work (when worn and correctly), but unfortunately the massive gas-lighting campaign combined with how susceptible humans are to socially-driven peer pressure are leading to supposed sane, intelligent people doing many things that are against their own self-interests (this includes doctors/healthcare workers). #MaskUp
I was listening to Dr Offit promote his new book on The Michael Shermer show, he too talked about how only n95 offer some protection but they are really hard to wear a long time.
Everywhere I look it seems physicians are quietly returning to the scientific consensus pre 2020, that they don’t stop viruses, which is ok.
I am guessing that is the reality. I cannot imagine doctors not choosing to protect themselves from illness, if they could. I know you are in the same geographical area, and between my husband, myself, and kids, we have seen no masks at Cleveland Clinic, Akron Children’s, University Hospitals, and a stand alone urgent care.
Maybe the doctors mask at the start of respiratory season, get sick despite wearing a mask, get better and figure "now I'm immune and don't need a mask anymore."
Or, masking at the beginning of the season is enough to slow transmission *at work* when it matters the most, operationally. They're probably vaccinated as well, so if they get Covid they've got a nice double boost. It doesn't have to be "all or nothing"
I haven’t seen any* doctors masking, and I’ve been in a lot of hospitals this past year - especially those focused on late stage cancer patients.
(*maybe 1/50)
Does that make it correct? All those unmasked licensed “caregivers” willfully carrying or transmitting lethal infectious material to immune-compromised patients? If I’m in an enclosed space with a professional and they aren’t wearing a mask I sure as heck have mine snugged up on my mug. Imagine how many exposures a healthcare “professional” has in the course of his/her day! How many others will he/she infect? It’s not rocket science. A good electrostatic mask worn correctly reduce viral loads by containing or preventing access to the vehicle into which the virus is contained - droplets.Porosity relative to the virus size isn’t the issue.
I disagree with that assumption that physicians are caving in to the belief that masks don’t work. As I view it and as SarahB supports, masks work but the users often don’t make them work as they are intended. Note bearded faces and masking. Pitiful coverage even with a non-N95, but I’ve not seen a bearded physician wearing anything but a loose surgical-type mask. Perhaps those Physicians are not stating masks don’t work but they are non-verbally declaring “I too am tired of wearing anything on my face and since many unmasked people are confused about it, I’ll be casual and not be dogmatic.” That’s how I read the message coming from an unmasked physician. IMHO, the physician is abrogating his de facto role as a public health official, even if he doesn’t get a weekly check from such an entity. We are educators and we need to take the lead, not follow the herd.
N95s, KN 94s definitely DO work!
The southern states are not "weird." They are willfully ignorant.
Maliciously ignorant. The only way some people become as ignorant as they are is deliberately and maliciously.
I can tell you why the wastewater level of Covid are high in FL. Only 6.89% of people are boosted with the latest booster. Bad messaging and the illegality of mask mandates, even in hospitals, are a major contributing factor. They are actively trying to make the vaccines illegal here. And according to studies, 70% of household transmission starts with a child and we can't get protections in schools. It will never get better until we get better support from the CDC and other agencies that are currently failing at public health and safety. Just look at who our SG is and what he's done here. Vulnerable communities can no longer safely participate in public life. I no longer see a future where I will ever be comfortable in public spaces again.
I continue to be utterly appalled at the behavior of Florida officials. They should be doing everything they can to maximize measles vaccinations of children, flu shots for everybody, and COVID boosters for those at high risk.
They are actively trying to make the vaccines illegal and mask mandates already are illegal, even in hospitals. No protections can be mandated in the state of FL. They are actively trying to unalive us.
And they call themselves "Pro-Life".
I don't understand this at all. I get that lay people might want this or be swayed by misinformation, but why in the world are doctors and other health people supporting or putting up with this?
‘Unalive us’! What a great description for the state of affairs under the devil - santis. Next, how do we dems deselect deborn him?
thank you for continuing to write, publish! I really appreciate your view and insights
Quick question about vaccines in general: The last time I had boosters for all of the childhood vaccines was when I was 26 (for grad school). I’m now almost 60. Do people my age need to get boosted again given the trend of non-vaccination of some children these days? Or is it too small of a population to worry about? (And no other concerns — I’m completely vaccinated for everything available seasonally!)
I’m not a medical person. But I was born in 1963, and my primary care physician had me get a measles booster around 5 years ago. Apparently, there was some issue with the measles shots given to kids around the early 1960s. We both felt it was “better safe than sorry,” especially since I was traveling to Europe where the measles vaccination rate is even worse than ours.
Yes- mine was given prior to a year old and did not give lasting immunity. That’s why you “can” get one at 6 ninths old, but should get it after 12 months.
You might consider talking to your doctor about getting your titers checked. It's not perfect, but it's better than being anxious simply because you're lacking info.
With regard to high wastewater COVID in Florida and the South you report: " South has a very weird pattern." It is not so weird. Due to public health nihilism these states are an extreme outliers. Looking at their stats, I have to assume that new cases are hugely underreported (compared to other states), that their reported COVID death rate is rather higher (especially Florida), and you can assume a large population vulnerability due to lack of vaccine take up, and disregard for masking in public assemblies and other systemic measures. Fortunately the dominant variable does not seem to cause a lot of serious morbidity.
There's no reporting or tracking anymore. And when we did have it the people running it were told to lie.
[The Washington Post] “Tax records reveal the lucrative world of covid misinformation,” headline of article dated February 21, 2024, accessible to all here: https://wapo.st/49on7f5
According to the WaPo article, “The influx of pandemic cash enabled organizations to deepen their influence in statehouses, courtrooms and communities across the country.”
Closing paragraphs read as follows:
“Georges C. Benjamin, executive director of the American Public Health Association, said he thinks the funding of misinformation by conservative donors is particularly disheartening because their communities faced higher rates of coronavirus vaccine refusal — and death — during the pandemic.
“In his view, he said, ‘we should be as a society really concerned that people are spending this amount of money to distort the truth.’”
It seems clear that stabilizing at stubbornly high - in excess of epidemic rates - levels of respiratory illness will be the best we can hope for, for the foreseeable future. Aren’t we proud of what we‘ve accomplished for ourselves, for our children and our children’s children?
*Fermented* raw milk (yogurt, kefir, etc.) can have benefits and is much less likely to be contaminated. https://consensus.app/papers/microbes-milk-fermented-dairy-products-wouters/3fb3440b140454b4bbb9dacbf0f85071/?q=fermented+raw+milk
Pasteurization is good, don't get me wrong. But part of the problem at the time was that milk producers weren't regulated at all and were adding all sorts of bad things to make bad milk LOOK fresh. (See the "swill milk" scandal in NYC.) For rural people who knew the farmers they got milk from, there was much lower risk (and we aren't usually in that situation anymore).
You wrote : “E. coli outbreak linked to raw milk cheese.” It would be nice to have some context here – like how much of that contaminated batch of raw cheese was consumed by people who did not get sick. Were the people who got sick more at risk due to a weakened immune system or other health condition? How often does raw milk cheese make people sick, as it’s widely used in Europe?
Certified raw milk is much more expensive to produce and is tested far more frequently than conventional milk. In some part of the U .S. it’s illegal, and is sometime sold underground there.
Here's something few people know:
“It is true that raw milk produced as “intended for pasteurization” and sourced from Concentrated Animal Feeding Operations (CAFOs) is generally unsanitary and unsafe to consume raw. Such milk is being produced in conditions where animal health is compromised, antibiotics are utilized, hormones are used to stimulate higher levels of milk production, there is an abundance of manure, and there is a corresponding high rate of pathogens. This type of milk is generally commingled with milk from multiple dairies, which increases the risk of pathogenic exposure.”
So we have a sterilize the filth program. Years ago health authorities found cases where milk intended for pasteurization was not pasteurized and thus made many people sick. They lumped those cases together with the few certified milk cases and then said look at all the evidence saying raw milk is dangerous. I don’t know if they are still doing this devious “science.” You can get sick from pasteurized milk also.
As far as potential benefits from raw milk, that is debatable. If a newborn calf was fed only pasturized milk, would that baby cow thrive ? I suspect not.
For those interested in reading the other side here’s a website I quickly found: https://www.rawmilkinstitute.org
Excellent comments Doug, thank you. I'm a retired public health scientist, and foodie. This is such a complex issue and I don't pretend to have all the answers. But I would like to hear from Katelyn whether she's familiar with the "multi-year, multistate outbreak of Listeria monocytogenes infections linked to queso fresco and cotija cheeses manufactured by Rizo Lopez Foods, Inc., of Modesto, California." (linked below.) These are pasteurized cheeses, not raw, so should one be advised to avoid pasteurized cheeses as well? There are other examples of outbreaks associated with pasteurized cheeses, but I don't know of a credible study that has compared raw vs. pasteurized.
Regarding the claim that "Raw milk (cheese) has zero additional health benefits," there's at least one good study from the highly regarded Journal of Allergy and Clinical Immunology that found that "Early life consumption of raw cow’s milk reduced the risk of manifest respiratory infections and fever (in infants) by about 30%." (linked below)
Personally, I take a middle road approach -- I don't drink raw milk or eat raw soft cheeses, but I do greatly enjoy quality raw hard cheeses from Europe, and believe (although the evidence is not definitive) that they contribute to my beneficial gut microbiome bacteria.
https://www.fda.gov/safety/major-product-recalls/2024-recalls-food-products-associated-dairy-products-rizo-lopez-foods-inc-due-potential-risk
https://www.jacionline.org/action/showPdf?pii=S0091-6749%2814%2901274-3
There is more science showing the benefit of raw milk on the Weston Price Foundation website, and this letter I used in replies to others:
https://www.rawmilkinstitute.org/updates/letter-to-medical-professionals-about-raw-milk
Prior to the 1920's there was a lot of illness and fatality due to milk. Tuberculosis, Scarlet Fever, Typhoid Fever are just a few examples of food-borne illness. There is even debate that cow milk is really not suitable for humans, raw or not. Even beer is pasteurized. As far as calves are concerned. https://extension.umn.edu/dairy-youngstock/dairy-calf-scours
You might find this informative.
https://youtu.be/qIHnCleRDr4
Yes, in the past raw milk was far more dangerous than today. Times change .
I don’t think that video claiming 1/3 of foodborne illness is caused by raw milk is based on evidence. I just looked at a webpage linked by the CDC’s page on raw milk.
“During 1998–2018, health departments reported 21919 foodborne outbreaks and 423 595 outbreak-associated illnesses to FDOSS. Of these, 202 outbreaks (0.9%) and 2645 illnesses (0.6%) were linked to unpasteurised milk (Table 1), including 228 hospitalisations and three deaths. During the same time period, 9 outbreaks (0.04%) and 2133 illnesses (0.5%) linked to pasteurised milk were reported, including 33 hospitalisations and three deaths.”
That’s nowhere near 1/3.
https://www.cambridge.org/core/journals/epidemiology-and-infection/article/foodborne-illness-outbreaks-linked-to-unpasteurised-milk-and-relationship-to-changes-in-state-laws-united-states-19982018/4822109E69DDAB37E92CAAB41AB1CC0F
When looking data this needs to be kept in mind:
“It is important to note that there is no such thing as a perfectly safe food [20]. An analysis of foodborne illnesses from 2009-2015 showed that the top food categories commonly linked to illnesses were chicken, pork, and seeded vegetables [31]. Pasteurized milk is not perfectly safe, either, and is implicated in foodborne illnesses and outbreaks every year. CDC outbreak and illness data since 1972 shows at least 82 deaths from pasteurized dairy products.
The CDC outbreak and illness data which is used to assert that raw milk is unsafe does not distinguish raw milk intended for pasteurization from raw milk that is carefully produced and intended for direct human consumption. The FDA has no standard for raw milk intended for human consumption. It has only the Pasteurized Milk Ordinance (PMO). It is known that raw milk intended for pasteurization often contains pathogens; studies have shown that up to 24% of this type of milk tests positive for pathogens [32]. Additionally, the CDC data used to implicate raw milk includes outbreaks and illnesses from “bathtub cheese” (i.e. Mexican-style Queso Fresco made illegally at home); queso fresco is inherently more dangerous than raw milk, and is associated with more serious outbreaks and illnesses. The CDC data reports only two deaths from raw dairy products since 1972, and both of these deaths were associated with queso fresco.
Nearly 10 million people in the USA were consuming raw milk regularly as of 2007 [33], and the number of people consuming raw milk is likely to be higher now given the growing popularity of raw milk. An independent assessment of raw milk risks from 2000-2007, which excluded queso fresco-related illnesses and outbreaks, concluded that there was a "a roughly 1 in 94,000 chance of becoming ill from drinking unpasteurized milk during that period... During the 2000−2007 period, there were 12 hospitalizations for illnesses associated with raw fluid milk. That’s an average of 1.5 per year. With approximately 9.4 million people drinking raw milk, that means you have about a 1 in 6 million chance of being hospitalized from drinking raw milk" [34].
Furthermore, recent improvements in raw milk risk management methods and training have led to a significant reduction in raw milk-related illnesses and outbreaks. The Raw Milk Institute, founded in 2011, has developed farmer training and Common Standards for raw milk which is intended for direct human consumption. These rigorous standards and training result in low-risk raw milk, as documented in a 2018 peer-reviewed paper titled, " Recent Trends in Unpasteurized Fluid Milk Outbreaks, Legalization, and Consumption in the United States." This paper concluded that, "The rate of unpasteurized milk-associated outbreaks has been declining since 2010, despite increasing legal distribution. Controlling for growth in population and consumption, the outbreak rate has effectively decreased by 74% since 2005" [35]. “
Those are some pretty long odds – 1 in 6 million chance of being hospitalized some years ago before certified raw milk got even safer.
The above is from here: https://www.rawmilkinstitute.org/updates/letter-to-medical-professionals-about-raw-milk
I concede that all forms of raw milk are more likely to cause outbreaks and illness. But for many, the advantage of raw milk are worth that tiny risk. And some states allow people to have a choice.
Regarding my idea that pasteurized milk is likely unhealthy for newborn baby cows, your link does not indicate if pasteurized milk is OK or not
There are people not vaccinating their children and how about not testing or treating for Strep! Yup, inconceivable. They may recover but are carriers for 2 weeks. What is wrong with people?
Your thoughts on the many older adults who didn’t get the MMR vaccine because it didn’t exist when they were kids?
Are there many older adults who did not have the UCDs as children. As an old retired public health nurse and nurse practitioner, that was my standard chart notation for usual childhood diseases. Most folks in my cohort had measles, mumps, rubella, and chicken pox. I remember the experience too well... Thank goodness we were spared DPT! And so glad we now have the shingles vaccine as well now.
It also looks like the Fla surgeon general tells parents of kids with measles that they can return to school if their symptoms are getting better?? Nothing about timing with the onset of rash.
Thank you for this very helpful update. Seeing a lot of ILI--some testing positive for flu and some that "feels" like Covid, but not testing positive on rapid tests. I do wonder if the rapid tests are just less helpful at this point.