77 Comments

Someday scientists will come up with tiny shots we can inject in our shoulders that will reduce the risk of dying from these diseases by >90%, or even contracting them in the first place by 50-80%!

They will be called “vaccines.” This word comes from the Latin “vacca” meaning cow. They will be better than cowpox inoculation to prevent smallpox.

And even crazier is that in the future we will be dialing up entire viral proteins using synthetic mRNA molecules so our immune systems can target practice before the viral invasions. People are going to be so thrilled!

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You just won the internet today

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Science marches forward! You're right, people should be thrilled that we no longer lose 50% of children before reaching adulthood.

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Learned in med school (of all places!) that public and population health initiatives accounted for most of the improvement in life span in the last century. Just wanted to express my gratitude and wish they taught more about it (and its methodologies) in med school and CME

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I am in Florida. Our Surgeon General is anti- science. Our Governor tried to exterminate us during the pandemic. I don’t trust anything that comes from them. Thanks for your clear explanations and your figures.

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Our school district just put out guidance that because there are so many absences, it is ok to come to school if you are not feeling well. Gotta keep that A rating and get the state funding! Our local health department no longer requires a covid isolation/quarantine, so the schools will not either.

It is no great mystery why numbers aren’t going down. And it is sad that our health department is no longer a leader:

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It's not just in schools, adults who are sick are not staying home anymore. In the last month, I have had several indoor encounters with people who have visible symptoms (coughs, runny noses, lots of Kleenex). They assure me "it's only a cold." I politely decline to shake their hand, then veer away.

Do people test every day for 5 days once symptoms start (expensive!)? Are covid tests still working?

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As someone who masked and got vaccines as soon as eligible and tried so hard to stay well and follow guidance, I now understand why others chose differently. People don’t have time off if they are sick. Schools are beating the attendance drum. Nothing was learned during the pandemic, and the public health messaging as a whole was a disaster. And definitely now, when our local department says quarantines are not required, my trust is gone.

People don’t test. Our free tests were from the government. Otherwise, I have spent hundreds, if not over a thousand dollars on tests (family of four). We have tested for any symptom, and quite honestly, I am over it. I have become cynical about it all.

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Yes, the percentage of people who don't get paid sick time is disturbing. I thought one positive result of the pandemic would be that some paid sick time would be mandated, but that has only happened in a very, very few places in the US.

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That's what happened to me. She said "I'm near the end of a cold and not contagious." Still I was cautious and did not touch her, but four days late I got a humdinger of a cold and coughed like crazy for 10 days. Fortunately I was able to cancel everything I had planned and stay at home.

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You could have avoided by masking.

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Mask mandates are illegal in FL. We will not get any precautions or mitigations while the GOP still controls Florida. They could control absences but adding filters (those fan filter box things seem to work well) but they won't even let parents build them amd bring them in. They are actively trying to kill us off. We're looking at an entire generation of brain damaged kids if we let this continue. Our economy will tank as more people are disabled by Long Covid.

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Simply put, we seen poor adherence and people faking it. We need no steekin guidline....

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Unfortunately the 54% is...54% of the people who actually got the shot. One of the most heartbreaking aspects of the current state of affairs is how many people aren't doing *anything.*

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Anecdotally, I have watched people I know do nothing the whole pandemic, living their best lives while my family did all the “right” things. And the folks doing nothing aren’t getting sick. At least not seriously ill. So, I guess it is not heartbreaking for them. It is surely confusing for me, though.

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Many people have had your experience. Thus, people are mostly rejecting more booster shots now, not doing the "right" thing - what they're told to do.

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They are getting sick. And they are also spreading it and killing others but they don't know or care about it because they are strangers to them. No one has a right to spread a potentially deadly disease to others.

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Well, I agree with you, but some are definitely not getting sick. Or they are asymptomatic. I mean, vaccinated folks can be walking around spreading things asymptomatically too.

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Which is why we still need mask mandates and other precautions. I'm caregiver to my very high-risk cancer survivor mother amd I have 2 degenerative inflammatory conditions. I only leave my house to go to the doctor or the grocery store. And I always mask which is hard for me because I have PTSD that makes wearing a mask for more than 1.5 hours at a time trigger panic attacks

And that is the best I can do after 4 years of 'immersion'. Vulnerable communities can no longer safely participate in public life. I'm a hostage because I cannot take the chance of catching it even once. I'm fully vaccinated and have every booster I'm eligible for. I'm also uninsured and have been for 18 years. I deserve to be able to go outside without the possibility of death or disability. I don't really care if people are tired of Covid precautions. I'm tired of not being able to live any kind of meaningful life. I'm tired of watching people I care about die. Another friend just passed away a few weeks ago. A single Covid infection killed her because she had an auto-immune disease, and she was careful and vaccinated. I couldn't go to her memorial because of the risk.

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Feb 9·edited Feb 9

"I deserve to be able to go outside without the possibility of death or disability"

No, you don't. That possibility exists for everyone at all times. I could get hit by a bus when I step outside tomorrow or get t-boned in my neighborhood.

Viruses are all around us. When we had mask mandates and other precautions in place, covid was spreading like wildfire. Viruses like this are not controllable. I'm sorry that you were lied to and are now living in fear.

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Feb 7·edited Feb 7

It was evident in 2021 that no one cared any more. People won’t mask. They won’t get vaccines. They won’t stay home. I think we are all doomed honestly. And the public health messaging has been abysmal and failed us all.

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founding

I’ve seen the same thing. More than “confusing” to me though, more like ‘maddening’!

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Thank you for these updates. Have you seen any data about how JN.1 is affecting the body physiologically? Purely anecdotal, I have noticed an uptick in bleeding / clotting issues at the hospital I work in. Several patients have had GI bleeds while also having DVTs. None have tested positive on our antigen screening tests, but it has the feel of the CVA / PE increase when covid first hit. I’m curious if this strain (or flu or RSV) is proving to cause certain non respiratory problems again.

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Interesting anecdote, yet I'm curious, how do you know these are covid cases if none have tested positive on antigen screening tests. Does the hospital confirm with a PCR test? Thank you

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Oh I don’t know at all. I’m just wondering if they may have had Covid during the recent spike and that is contributing to their hospitalizations / clotting issues. Initially in the pandemic it was easier to find out because we could test for antibodies, now that doesn’t mean much of anything. It’s just reminiscent of the second half of 2020.

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@PR: If you want to hear more about our efforts to address this novel virus spectrum and repurposed drug protocols successfully prescribed for nearly 2,500 acute and several PASC victims over 4 1/2 years, feel free to contact me at my “G address” sullray for your consideration of our unique science-based positive outcomes.References to pertinent literature upon request.

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Hi Sara, yes it seems almost as bad as 2020. More clots or integrity issues with the blood vessels clinically this year with my covid patients. Still have time where patients are not dying in front of you but shorter than late 2021 into 2022 anecdotally.

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@PR: Might I suggest that the issue of thrombogenesis is intimately related to lingering endotheliitis and that is a complication of COVID19, the Long Covid issues. A recent admission to a local hospital was a man with chest pain and dyspnea. CT Chest showed large pulmonary embolism. PCR tested neg although the testing currently is routine for all respiratory issues. The man did have pos COVID19 several mos ago but the current w/u makes NO mention of the that nor the correlation. We physicians must be ready and willing to say that these life-threatening issues (PE, DVT, cardiac arrhythmias, acute coronary syndromes, myocarditis, thrombocytopenia, red cell aplasia, chronic recurrent diarrhea, biliary disease In the aftermath of pos COVID19 illnesses ARE part of the lingering effects, specifically inflammation. For the those with Long Covid and have had a myriad of labs to define the symptomatology (see NYT article by Giorgi Lupi describing her ordeal of 3 1/2 years of Long Covid and all that she has suffered...), markers such as elevated IL-6 pro-inflammatory cytokines remain elevated in these patients. There is an immune modulator that addresses that inflammation and renders the IL-6 an anti-inflammatory since IL-6 is pleotropic - it is pro or anti in its function. Steroids won't modulate and anti-coagulants only address the immediate clotting cascade, not the ongoing idiotypic antibody network. See Skok, M discussing a7nAChRs and PASC.

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YES! YES! and Yes! With so much basic science research I'm surprised that this data is not collected and then presented to us as a whole. So many things that are PASC symptoms mimic so many other disease. The "late onset ADHD," menopausal symptoms or neuropathy was actually PASC. I have seen pos IL 6 plus d dimer and fibrinogen are many months after a covid infection in my practice. I also find many times TNF alpha is positive. The other thing that I will see are decrease in T cell and B cell count post covid and UCSF long covid studies have seen exhausted Cd4 and Cd8 cells in their patients. https://www.youtube.com/watch?v=rMt6ZV-hHSE Usually I'll do a "forensic" covid antibody surveillance to see where someone is with "natural" infection (nucleocapside IgG, covid IgM, total spike protein), in addition to detailed covid and vaccination history. Jak inhibitors are now FDA approved for acute hospitalized covid and I know that Vanderbilt is looking at this as potential long covid treatment which makes sense at least in those that are IL- 6 elevated.

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Is there anyway to have hospitals continue to report? I think this year is going to be a different year with all the role backs. It is so vitally important when comparing sewer studies to ER visits and then hospitalizations then to excess deaths. I’ve been having a tough time just finding the cdc page for excess deaths that is current. Anyone have that? For my patients these visuals really hit home. It takes more of the “politics” out. Additionally, I was able to get more traction at the state level for ventilation and schools. Not sure if this is lip service, true concern or combo. But it is an election year and covid is the virus that has no name. Any recommendations of how we can continue this data?

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What data have hospitals stopped reporting? COVID hospitalizations? Flu hospitalizations? Was there any reason given for allowing hospitals to stop reporting data that they used to report?

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Hi Doug, in the new letter said that the reporting mandate will stop in April. How can we ask and who can we ask to keep this going?

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I have no idea, but our writer Katelin should be able to answer that question. I’m wondering why it is being stopped.

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founding

Offering my grateful thanks to you, once again, for a clear, concise, and invaluable state of affairs. BTW, speaking of clear and concise, a while back you noted a book you had read about clear writing. If you see this and have time, can you ID the name of that book again? Thanks for all you do. You are a national treasure.

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author

Smart Brevity! So good

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Thank you so much for the wonderful information!

On the “few more thoughts” on vaccines, I cannot access because I don’t have Twitter (X). How else can I read this?

Thanks

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Don't read Twitter/X etc. Read Topol's substack Ground Truths. He doesn't add anything to this therapy or immunomodulation a7nAChR discussion but he's a wealth of information about prevention and pure antivirals.

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Thank you! As we are navigating this with so little actionable data, your updates are so helpful! This validates my sense of what is happening. I’d asked for your sources and on a reread, you cite them under the graphs.

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Looking forward - I'd be interested if you could engage an expert to talk us through the science of vaccine updates and what we will probably be looking at in fall of 2024. Seems that we are still getting offshoots of Omicron, even though far afield, so I am guessing that the fall vaccine will be more finely tuned to JN1, even though it will have long passed its peak. Would the assumption be that if tuned to JN1 and all its mutations, that it will still be "sticky" enough to work with whatever progeny JN1 shoots off?

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I appreciate your evaluation of the two data sets from CDC comparing COVID to Influenza. The nuances between the two are apparent to many in the field, and confuse the public. Add in wild conspiracy claims and you increase the number of people who mistrust government scientists. Makes me recall an old communication adage, “Be the first source of information, and the best source of information.”

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founding

Why is there seemingly no consideration being given to allowing and recommending at least two shots a year for seniors, since we are so much more at risk than others except the immunocompromised? We are also a huge group- 30+ million people over 65. But “radio silence” on this issue!

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As a retired doc I really really appreciate your work! Two comments. First, to emphasize handwashing for norovirus, since alcohol hand san doesn't work. Second, since communication is an emergent property of two (or more) people, I think a lot of the complaining about unclear communication from public health officials reflects the failures of the educational system to prepare people to deal with complex and ambiguous data. I won't go into why that has happened except to suggest it may be somehow related to politics. YLE is the epitome of clear presentation of complex data, yet I would guess the majority of our fellow citizens would see it as being way to complicated to guide action. In my primary care practice of 40 years I often felt I was trying to make up for what the educational system hadn't helped people learn. Not the fault of teachers, but of our national priorities.

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Thank you for another informative article. I am ready for this respiratory season to be over.

Regarding the "different data stories" - if covid is more contagious than the flu, isn't it likely that in urban areas, covid would have peaked sooner than the flu?

As far as "Vaccine effect. Urban places have more Covid-19 vaccinated than rural; thus Covid-19 hospitalizations are lower on the bottom graph than the top." On the lower graph (urban areas), Covid-19 hospitalizations are higher than flu hospitalizations except until recently, which supports the "covid peaked before flu" theory, and (unfortunately) doesn't seem to support the "vaccine effect" theory.

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Do you periodically write updates on the state of Public Health reporting and changes to regulations requiring specific data to be sent to the CDC from every state in a standardized electronic format to allow timely reporting and reaction?

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I'm wondering why Oregon hasn't had much flu at all this year....so far (?). We've been green on the Flu Bites map the whole time, & yet Washington & California were, at one time, both red (high flu). Oregon isn't an island! And I don't recall a year, other than 2020, when we didn't have a flu season, like others have. Any ideas?

I really appreciate your State of Affairs posts, Katelyn! Can't find this info elsewhere. I'd also like more info on norovirus; is there anything else we can do to prevent other than washing hands? Terrible virus! And one I hugely fear....

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