Thank you for a great update. Question about covid wastewater levels being "very high" and "27% higher than last winter and yet to slow down."
I know a lot of people with "colds" right now - sore throats, congestion, fatigue, sometimes coughs and fever. They keep testing for covid but their tests remain negative. Are the covid at home tests still working with the newer variants?
The Philadelphia measles outbreak has been made worse by a parent and daycare who ignored isolate and quarantine instructions from the health department.
Katelyn, about the variation in wastewater from era to era -- Marc Johnson (AKA SolidEvidence) has tweeted about how equipment improvements can completely change sensitivity in detection. He pulled a sample from his lab and compared old equipment vs new 2023 upgrades, he found that the new equipment was more sensitive (higher reading) by 2x-10x, which would severely skew if comparing readings against previous eras. I have actually seen a few local sewersheds post an announcement when they upgrade equipment and the jump in y-axis levels appears to be 2-3x. Is this something you can dig into and combine with the "replication in stool" factor for a primer? I feel like so many people are modeling based on exact y-axis values when every wastewater team I've seen is telling them specifically NOT to do that (which is why SCAN's category system focuses on trends and limits any back comparison to a 12 month window).
Thanks for the update. I've seen several folks point to the decreasing hospitalization and death rates from COVID as indicating we have better immunity now, but I've been wondering how much this is skewed by survivor bias. The people most likely to die have died already, we don't have the same population we had a year or two or three ago. As someone who is high risk and has still managed to avoid COVID, to would be good to know the relative contributions of improved immunity vs. survivorship bias.
I'm a 66 year old cancer survivor and just managed to complete the vaccine trifecta last week - Sanofi Fluzone high-dose flu, Moderna Spikevax COVID, and GSK Arexvy RSV - despite local shortages of all three vaccines due to high local community uptake. Side effects were noticeable (the vaccine's working!) but tolerable.
I visited my PCP the week before and she made several points:
1) Small to medium clinical practices are having the most trouble getting vaccines - they have no leverage against the big hospital and pharmacy groups. The practice my PCP is in has given up on adult vaccines to focus on early childhood inoculations. They're referring adult patients to local pharmacies for their shots.
2) Most of the elderly patients she's admitted to the local hospital for respiratory infections this year have been for flu, followed by COIVD. She hasn't admitted anyone for RSV, but she's seeing a lot of it - and it's a tenacious infection (2 weeks plus) that's leaving patients with depleted immunity - after recovering from RSV some are returning in a week or two with bad colds, flu, COVID... After she related this I went out and immediately scheduled my RSV vaccine.
COVID looks like it's going to be part of the respiratory illness picture indefinitely, and long covid is going to disable people long after nasal/oral COVID vaccines - which are the best hope to dramatically reduce incidence and transmission - have been approved and deployed. Get vaccinated. Wear a mask in congregate settings. Take anti-virals and isolate if you get sick.
I'd say that we should pressure our political representatives to shake lose more money to speed up development and approval of new vaccines and anti-virals, but that's not going to happen in an election year
Thank you! I agree that the lack of vaccinations in nursing homes is a tragic failure to learn from the pandemic. Do you know if the CDC or state health departments are urging them to vaccinate?
Hello, Thank you, as always for the information. I'm writing from Massachusetts. That being said I know from conversations that the vaccination rates in my suburban area are very low, even in high risk elderly. The local senior centers have clinics but with not much uptake there and that's the "healthy population" of seniors. But could you tell me why you think nursing home rates of vaccination are so low? I just don't understand why the doctors there don't order them for the patients, especially since they are covered by Medicare.
Thanks so very much for the update & all the info! I very much appreciate, as I don't see it elsewhere.
Q.: We don't seem to have much flu in Oregon (yet), but I don't know why, as we're surrounded by states that do. I also read that experts here are predicting a mild flu season for Oregon, but how could that be? Oregon is NOT an island! I have neighbors who have Covid now, brought home by one of them who spent the holidays in California. So I'd think flu would be similar.
Also, I know at least one well-educated, elderly friend, who thinks Covid is 'over'--he insists it is! Maybe that's partly because he doesn't see hardly anyone masking anymore in grocery stores etc. I've never stopped (masking). I can't take Paxlovid, for one thing--can't swallow pills. Plus I'm old (80), & have no one to help me if I get sick.
Q: About the above on Paxlovid: could I crush the pills, regardless of icky taste? Am told no....but just wondering.
Q: And further on masks: my nose runs, often profusely, under my KN95 masks, has since the beginning of the pandemic. Always in grocery stores, not always, but usually, in other stores. I've tried various allergy meds, Sudafed, Afrin etc....no help. It seems I'm the ONLY person in America with this problem, but how could that be?? It has limited my life a lot, as I have to be able to get out of a store/place quickly....to take off the mask while I blow my nose. If anyone has any ideas, I'd appreciate!
As always thanks for all the info and informed opinion. I subscribe to and read your publication to hep stay alive. I’m 72 and a recipient of a kidney transplant so I’m immunocompromised. I would really appreciate it if you could devote some attention to the problems of the immunocompromised. Should time of year affect what we can safely do? Can we fly safely? Are restaurants and hotel rooms safe yet? Do we need special masks? How effective are air cleaners? If we get Covid how does that affect CPAP use? Can we visit with very small numbers of people indoors?
We are about 2.5 percent of the population and almost no one is giving us very specific advice. HELP!!!
Thanks. We have, so far, managed to dodge this latest wave without a lot of upheaval. We have kept our vaccinations current and always wear an N/KN95 mask in public indoor spaces. Nothing is 100%, but I figure it can't hurt to shave the odds in one's favor.
J Weiland tries to estimate infections from wastewater. What is your hunch JN.1 is significantly different in wastewater concentration? "No knowing" isn't the same as completely unknown.
Thank you for a great update. Question about covid wastewater levels being "very high" and "27% higher than last winter and yet to slow down."
I know a lot of people with "colds" right now - sore throats, congestion, fatigue, sometimes coughs and fever. They keep testing for covid but their tests remain negative. Are the covid at home tests still working with the newer variants?
The Philadelphia measles outbreak has been made worse by a parent and daycare who ignored isolate and quarantine instructions from the health department.
Katelyn, about the variation in wastewater from era to era -- Marc Johnson (AKA SolidEvidence) has tweeted about how equipment improvements can completely change sensitivity in detection. He pulled a sample from his lab and compared old equipment vs new 2023 upgrades, he found that the new equipment was more sensitive (higher reading) by 2x-10x, which would severely skew if comparing readings against previous eras. I have actually seen a few local sewersheds post an announcement when they upgrade equipment and the jump in y-axis levels appears to be 2-3x. Is this something you can dig into and combine with the "replication in stool" factor for a primer? I feel like so many people are modeling based on exact y-axis values when every wastewater team I've seen is telling them specifically NOT to do that (which is why SCAN's category system focuses on trends and limits any back comparison to a 12 month window).
Thanks for the update. I've seen several folks point to the decreasing hospitalization and death rates from COVID as indicating we have better immunity now, but I've been wondering how much this is skewed by survivor bias. The people most likely to die have died already, we don't have the same population we had a year or two or three ago. As someone who is high risk and has still managed to avoid COVID, to would be good to know the relative contributions of improved immunity vs. survivorship bias.
I have anti-vaxxer fatigue.
I'm a 66 year old cancer survivor and just managed to complete the vaccine trifecta last week - Sanofi Fluzone high-dose flu, Moderna Spikevax COVID, and GSK Arexvy RSV - despite local shortages of all three vaccines due to high local community uptake. Side effects were noticeable (the vaccine's working!) but tolerable.
I visited my PCP the week before and she made several points:
1) Small to medium clinical practices are having the most trouble getting vaccines - they have no leverage against the big hospital and pharmacy groups. The practice my PCP is in has given up on adult vaccines to focus on early childhood inoculations. They're referring adult patients to local pharmacies for their shots.
2) Most of the elderly patients she's admitted to the local hospital for respiratory infections this year have been for flu, followed by COIVD. She hasn't admitted anyone for RSV, but she's seeing a lot of it - and it's a tenacious infection (2 weeks plus) that's leaving patients with depleted immunity - after recovering from RSV some are returning in a week or two with bad colds, flu, COVID... After she related this I went out and immediately scheduled my RSV vaccine.
COVID looks like it's going to be part of the respiratory illness picture indefinitely, and long covid is going to disable people long after nasal/oral COVID vaccines - which are the best hope to dramatically reduce incidence and transmission - have been approved and deployed. Get vaccinated. Wear a mask in congregate settings. Take anti-virals and isolate if you get sick.
I'd say that we should pressure our political representatives to shake lose more money to speed up development and approval of new vaccines and anti-virals, but that's not going to happen in an election year
So you think Flu/COVID/RSV will always be this high every winter? Uuughh. Time for businesses to start being more flexible with sick time.
Thank you! I agree that the lack of vaccinations in nursing homes is a tragic failure to learn from the pandemic. Do you know if the CDC or state health departments are urging them to vaccinate?
Despite my best efforts and limited socializing, I get covid following Christmas. Work? Asymptomatic kid? Those are the only possibilities.
Had to miss a busy work week.
But- I did clean my house... a lot.
Thank you Paxlovid. That’s really all I have to say.
Thank you so much as always! So much important information!
Hello, Thank you, as always for the information. I'm writing from Massachusetts. That being said I know from conversations that the vaccination rates in my suburban area are very low, even in high risk elderly. The local senior centers have clinics but with not much uptake there and that's the "healthy population" of seniors. But could you tell me why you think nursing home rates of vaccination are so low? I just don't understand why the doctors there don't order them for the patients, especially since they are covered by Medicare.
Thank for continuing to provide these updates!
Thanks so very much for the update & all the info! I very much appreciate, as I don't see it elsewhere.
Q.: We don't seem to have much flu in Oregon (yet), but I don't know why, as we're surrounded by states that do. I also read that experts here are predicting a mild flu season for Oregon, but how could that be? Oregon is NOT an island! I have neighbors who have Covid now, brought home by one of them who spent the holidays in California. So I'd think flu would be similar.
Also, I know at least one well-educated, elderly friend, who thinks Covid is 'over'--he insists it is! Maybe that's partly because he doesn't see hardly anyone masking anymore in grocery stores etc. I've never stopped (masking). I can't take Paxlovid, for one thing--can't swallow pills. Plus I'm old (80), & have no one to help me if I get sick.
Q: About the above on Paxlovid: could I crush the pills, regardless of icky taste? Am told no....but just wondering.
Q: And further on masks: my nose runs, often profusely, under my KN95 masks, has since the beginning of the pandemic. Always in grocery stores, not always, but usually, in other stores. I've tried various allergy meds, Sudafed, Afrin etc....no help. It seems I'm the ONLY person in America with this problem, but how could that be?? It has limited my life a lot, as I have to be able to get out of a store/place quickly....to take off the mask while I blow my nose. If anyone has any ideas, I'd appreciate!
As always thanks for all the info and informed opinion. I subscribe to and read your publication to hep stay alive. I’m 72 and a recipient of a kidney transplant so I’m immunocompromised. I would really appreciate it if you could devote some attention to the problems of the immunocompromised. Should time of year affect what we can safely do? Can we fly safely? Are restaurants and hotel rooms safe yet? Do we need special masks? How effective are air cleaners? If we get Covid how does that affect CPAP use? Can we visit with very small numbers of people indoors?
We are about 2.5 percent of the population and almost no one is giving us very specific advice. HELP!!!
Thanks. We have, so far, managed to dodge this latest wave without a lot of upheaval. We have kept our vaccinations current and always wear an N/KN95 mask in public indoor spaces. Nothing is 100%, but I figure it can't hurt to shave the odds in one's favor.
J Weiland tries to estimate infections from wastewater. What is your hunch JN.1 is significantly different in wastewater concentration? "No knowing" isn't the same as completely unknown.
Some color here might be helpful.
https://twitter.com/JPWeiland/status/1743420513999868363?t=AXINWLDXHFyk2I-iM7n1nA&s=19