Invaluable, as always. It was particularly interesting to see the chart on ED visits from year to year. Promising, if Covid does turn into a seasonable virus. (BTW, I want, once again, to give a tip of the hat to your graphing team. I find many graphs impossible to read, but these, I do understand, and they do that wonderful thing of encapsulating information that would take a lot of words to describe into a single image.)
A few months ago, in one of your surveys, I suggested that gun violence should be a topic to discuss in your newsletter. Today, the NYT reports that “The Surgeon General Declares Gun Violence a Public Health Crisis.” I’m pleased we agree! I hope you will consider this a topic to explore in future newsletters. And thank you for everything you do.
Can someone show me the the data that says that anyone has any immunity for Covid? Infection doesn't seem to prevent reinfection so, no immunity there and the vaccines have never prevented infection or transmission. Long Covid wouldn't exist if we had any sort of immunity to Covid. Why do people keep talking about Covid immunity like it exists?
I think "immunity" as she is using it here (and the study below) is the medical definition. It does not mean "completely immune" as the English word suggests, but "has some protection against." Protection against future infection is high right after vaccination or infection and wanes; odds of severe disease are very low immediately after vaccination or infection and go up. But anyone who has had a vaccine or an infection will have some T-cells and B-cells that remember the spike protein on covid and will respond faster than if they had never seen the protein at all. https://yourlocalepidemiologist.substack.com/p/t-cells
Here is a study that compares immunity from different lineages of Covid (delta, omicron, etc.), which illustrates different "meanings" of the word immunity (i.e., different levels, or "how much immunity"). "We meta-analysed the effectiveness of past infection by outcome (infection, symptomatic disease, and severe disease), variant, and time since infection." https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)02465-5/fulltext
That's great, but that doesn't help the general public understand that there's no real immunity from Covid like people are suggesting. It's confusing to people who are not scientificly literate. There are no new boosters and I'm a few months away from no more protection from the last one and they won't give me any more boosters unless they are new because I don't have the 'right' kind of issues to get any more boosters. Vaccine 'immunity' doesn't work if you can't keep getting boosters annually. And I'm uninsured so I can't just got to the doctor.
Thanks for your question. Our immune systems have three walls of defense. The first (neutralizing antibodies) which prevents infection degrades over time due to the emergence of new variants. But our second lines of defense are still very strong-- T-cells which is our immune memory. This cannot prevent infection, but it does help against severe disease. Then there are B-cells-- these are our antibody factories-- that are also very strong. So when we say there is "immunity" in the community, this typically refers to severe disease; or the secondary walls of defense. Over 99% of Americans have some sort of immunity-- whether it's a vaccine or infection or both. Here is more about those three walls if you want to read more! Hope this helps. Katelyn https://yourlocalepidemiologist.substack.com/p/go-get-your-vaccine-especially-with?utm_source=publication-search
I know the difference, but that vast majority of people don't and it's misleading. I thought the point of good science communication was removing confusion and ambiguity. A lot of people think they have concrete immunity and no one does. It's making them not care about covid anymore. Vulnerable communities can no longer safely participate in public life as a result.
It's not just you. It's a pattern I have noticed among most of the science communicators I have seen. It seems like most science communicators are operating under the idea that there's a baseline of knowledge and that simply doesn't exist. The vast majority of people are misinformed or disinformed when it comes to Covid and even basic science. The anti-science movements of the past few decades have insured that peoole do not all have the same understanding of even basic scientific concepts. The average American IQ is 98. Over 30% of HS graduates never read another book after HS. We have to think about who we are talking to because those of us who are informed are just an echo chamber now.
I appreciate your work and the time you spend helping us stay informed. I just feel like we're failing at making any sort of difference. I no longer see a future where I will ever be comfortable in public spaces again.
Very good point Ms Welborn. Many terms, scientific or not, have specific meanings/interpretations to some but not to all. Immunity varies among recipients of the particular preventive whether a drug or a vaccine and greatly dependent on the individual’s various risk parameters. It’s a tough sell when someone accepts only 100% cure or protection as the correct definition for achieving cure or immunity. Expectations need to be grounded in reality and reality usually requires a personal effort to research and assess the science, as I view it.
Most people still don't understand that the definition for mild infection has ny changed and that it means 'didn't require hospitalization'. Because we aren't being specific when we talk about these things. We can't hope to change even a single mind if they don't understand what's at stake.
I’m curious if it is appropriate to say that at some point Covid will become endemic like a cold — for one, most colds do not cause all the symptoms and havoc as long Covid— immune dysfunction ( husband just got pneumonia 4 months after getting covid and kid got a sinus infection that wouldn’t go away 2 months after his covid infection. The rest of us are fine), heart attacks and strokes, neuro damage ( esp infants- lots of kids not talking now), and most likely this uptick in cancers ( know 5 people that just got diagnosed or died this week- 2 pancreatic ca, bladder ca, recurrent nose, brain cancer ages 39-67, also a melanoma cancer that started fungating after a second covid infection). All of this after getting Covid. 2 were unvaccinated for covid. Additionally, we are potentially seeing a decrease in ER visits because they are no longer required to track that data and report it.
Thanks for all your reporting and work though. So appreciate the info and ability to discuss in real time.
Seeing a jump in Covid19 over “no reports” for a while.
This physician saw a positive Covid test last month, unfortunately. My first large gathering, unmasked, since March 2020. About 60% of attendees tested positive, involving travel from a few different countries as well as a variety US geographic regions. Big sigh.
"We don’t know, but summer waves on the mainland seem to be becoming less pronounced over time. Many epidemiologists expect Covid-19 virus will eventually become a winter respiratory virus, like its relatives. Thanks to hybrid immunity (vaccines + infections) proving longer immunity, smaller stepwise waves occur yearly."
That's going by hospitalization data, but looking at the wastewater, the US had its second-highest wave since the pandemic's start this past winter. Neither vaccines nor prior infection are proving adequate at preventing reinfection, and with the risk of Long Covid increasing with each infection, and the population with LC steadily growing, it seems misleading to say the waves are shrinking. By not focusing on reducing transmission, PH is just kicking the consequence can slightly down the road, when people are impacted by elevated rates of heart attacks, strokes, diabetes, neurological issues, and debilitating autonomic and mitochondrial conditions.
Hi! I noticed that Substack adds goop at the end of a URL that makes the link not work, so if anyone is curious, just delete the ? and everything after it so that it looks like this: https://ephtracking.cdc.gov/Applications/HeatRisk/
I appreciate you so much! Is KP.2 being targeted in the fall, and KP.3 is if possible? I thought KP.2 was the updated decision.
Edit to add: which wastewater is more accurate, CDC or WastewaterSCAN? I thought the latter has Covid as much higher (or high nationally).
Also, the new variants confuse me. If we recently tested positive (6/1 exposure, 6/2 symptoms, 6/3 positive) do we have any protection from getting JN.1, KP.2, or KP.3 (& LB.1) right now? I think we need to wait 4 months to vax?
(Previous “novid” w/all mRNA vax’s (STRONG reactions) didn't do spring ‘24, northern Illinois, 1st & last indoor w/o mask, 12 days positive & still recovering, pre-existing dysautonomia. “Mild” is a misnomer IMHO.)
Thank you so much! I’m an early, ongoing subscriber & close follower
I had whooping cough in April and am still coughing. (There’s a reason its name is the 100-day cough.) I strongly, strongly recommend everybody getting boosters for these childhood illnesses. They created vaccines for a reason. It’s been awful.
Thanks so much for what you do. You explain very complex concepts in a manner that is easy to understand. You are a very trusted source for me. One question, maybe I missed it in the past newsletters , but I was curious where risk of West Nile virus lies relative to these other risks.
Thank you. I am getting a booster this week. Immune compromised from immunotherapy. Do you see a difference in the current Novavax vs Mrna vaccines with the newest variants K and L?
Invaluable, as always. It was particularly interesting to see the chart on ED visits from year to year. Promising, if Covid does turn into a seasonable virus. (BTW, I want, once again, to give a tip of the hat to your graphing team. I find many graphs impossible to read, but these, I do understand, and they do that wonderful thing of encapsulating information that would take a lot of words to describe into a single image.)
Thanks for the positive feedback!
Hi Susan -- Just clicking on the graphs (at least in my browsers) expands each graph so the legends and axes are easily read!
A few months ago, in one of your surveys, I suggested that gun violence should be a topic to discuss in your newsletter. Today, the NYT reports that “The Surgeon General Declares Gun Violence a Public Health Crisis.” I’m pleased we agree! I hope you will consider this a topic to explore in future newsletters. And thank you for everything you do.
Already working on it given the news! Lots of gun violence covered before. Check out the tab in the archive here https://yourlocalepidemiologist.substack.com/s/your-local-violence-epidemiologist
Can someone show me the the data that says that anyone has any immunity for Covid? Infection doesn't seem to prevent reinfection so, no immunity there and the vaccines have never prevented infection or transmission. Long Covid wouldn't exist if we had any sort of immunity to Covid. Why do people keep talking about Covid immunity like it exists?
I think "immunity" as she is using it here (and the study below) is the medical definition. It does not mean "completely immune" as the English word suggests, but "has some protection against." Protection against future infection is high right after vaccination or infection and wanes; odds of severe disease are very low immediately after vaccination or infection and go up. But anyone who has had a vaccine or an infection will have some T-cells and B-cells that remember the spike protein on covid and will respond faster than if they had never seen the protein at all. https://yourlocalepidemiologist.substack.com/p/t-cells
Here is a study that compares immunity from different lineages of Covid (delta, omicron, etc.), which illustrates different "meanings" of the word immunity (i.e., different levels, or "how much immunity"). "We meta-analysed the effectiveness of past infection by outcome (infection, symptomatic disease, and severe disease), variant, and time since infection." https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)02465-5/fulltext
That's great, but that doesn't help the general public understand that there's no real immunity from Covid like people are suggesting. It's confusing to people who are not scientificly literate. There are no new boosters and I'm a few months away from no more protection from the last one and they won't give me any more boosters unless they are new because I don't have the 'right' kind of issues to get any more boosters. Vaccine 'immunity' doesn't work if you can't keep getting boosters annually. And I'm uninsured so I can't just got to the doctor.
Hi Leslie-
Thanks for your question. Our immune systems have three walls of defense. The first (neutralizing antibodies) which prevents infection degrades over time due to the emergence of new variants. But our second lines of defense are still very strong-- T-cells which is our immune memory. This cannot prevent infection, but it does help against severe disease. Then there are B-cells-- these are our antibody factories-- that are also very strong. So when we say there is "immunity" in the community, this typically refers to severe disease; or the secondary walls of defense. Over 99% of Americans have some sort of immunity-- whether it's a vaccine or infection or both. Here is more about those three walls if you want to read more! Hope this helps. Katelyn https://yourlocalepidemiologist.substack.com/p/go-get-your-vaccine-especially-with?utm_source=publication-search
I know the difference, but that vast majority of people don't and it's misleading. I thought the point of good science communication was removing confusion and ambiguity. A lot of people think they have concrete immunity and no one does. It's making them not care about covid anymore. Vulnerable communities can no longer safely participate in public life as a result.
Thanks for the constructive feedback! I try my best
It's not just you. It's a pattern I have noticed among most of the science communicators I have seen. It seems like most science communicators are operating under the idea that there's a baseline of knowledge and that simply doesn't exist. The vast majority of people are misinformed or disinformed when it comes to Covid and even basic science. The anti-science movements of the past few decades have insured that peoole do not all have the same understanding of even basic scientific concepts. The average American IQ is 98. Over 30% of HS graduates never read another book after HS. We have to think about who we are talking to because those of us who are informed are just an echo chamber now.
I appreciate your work and the time you spend helping us stay informed. I just feel like we're failing at making any sort of difference. I no longer see a future where I will ever be comfortable in public spaces again.
It's possible that we should start speaking of "protection" instead of "immunity," if that seems more like a spectrum to regular folks.
Very good point Ms Welborn. Many terms, scientific or not, have specific meanings/interpretations to some but not to all. Immunity varies among recipients of the particular preventive whether a drug or a vaccine and greatly dependent on the individual’s various risk parameters. It’s a tough sell when someone accepts only 100% cure or protection as the correct definition for achieving cure or immunity. Expectations need to be grounded in reality and reality usually requires a personal effort to research and assess the science, as I view it.
Most people still don't understand that the definition for mild infection has ny changed and that it means 'didn't require hospitalization'. Because we aren't being specific when we talk about these things. We can't hope to change even a single mind if they don't understand what's at stake.
I’m curious if it is appropriate to say that at some point Covid will become endemic like a cold — for one, most colds do not cause all the symptoms and havoc as long Covid— immune dysfunction ( husband just got pneumonia 4 months after getting covid and kid got a sinus infection that wouldn’t go away 2 months after his covid infection. The rest of us are fine), heart attacks and strokes, neuro damage ( esp infants- lots of kids not talking now), and most likely this uptick in cancers ( know 5 people that just got diagnosed or died this week- 2 pancreatic ca, bladder ca, recurrent nose, brain cancer ages 39-67, also a melanoma cancer that started fungating after a second covid infection). All of this after getting Covid. 2 were unvaccinated for covid. Additionally, we are potentially seeing a decrease in ER visits because they are no longer required to track that data and report it.
Thanks for all your reporting and work though. So appreciate the info and ability to discuss in real time.
We are seeing a local outbreak of pertussis in Jefferson County WA as well. Some appear to be break through case in vaccinated individuals.
NJ has recently seen outbreaks of pertussis.
Seeing a jump in Covid19 over “no reports” for a while.
This physician saw a positive Covid test last month, unfortunately. My first large gathering, unmasked, since March 2020. About 60% of attendees tested positive, involving travel from a few different countries as well as a variety US geographic regions. Big sigh.
Ditto, but 1st any indoor unmasked. Still upset with myself & still recovering.
"We don’t know, but summer waves on the mainland seem to be becoming less pronounced over time. Many epidemiologists expect Covid-19 virus will eventually become a winter respiratory virus, like its relatives. Thanks to hybrid immunity (vaccines + infections) proving longer immunity, smaller stepwise waves occur yearly."
That's going by hospitalization data, but looking at the wastewater, the US had its second-highest wave since the pandemic's start this past winter. Neither vaccines nor prior infection are proving adequate at preventing reinfection, and with the risk of Long Covid increasing with each infection, and the population with LC steadily growing, it seems misleading to say the waves are shrinking. By not focusing on reducing transmission, PH is just kicking the consequence can slightly down the road, when people are impacted by elevated rates of heart attacks, strokes, diabetes, neurological issues, and debilitating autonomic and mitochondrial conditions.
Hi! I noticed that Substack adds goop at the end of a URL that makes the link not work, so if anyone is curious, just delete the ? and everything after it so that it looks like this: https://ephtracking.cdc.gov/Applications/HeatRisk/
Thank you! I've had that issue at Substack before. Very helpful solution.
The ACIP is deciding *who* is eligible for a fall covid vaccine? What happened to the annual vaccine for all, as with the flu vaccine?
I appreciate you so much! Is KP.2 being targeted in the fall, and KP.3 is if possible? I thought KP.2 was the updated decision.
Edit to add: which wastewater is more accurate, CDC or WastewaterSCAN? I thought the latter has Covid as much higher (or high nationally).
Also, the new variants confuse me. If we recently tested positive (6/1 exposure, 6/2 symptoms, 6/3 positive) do we have any protection from getting JN.1, KP.2, or KP.3 (& LB.1) right now? I think we need to wait 4 months to vax?
(Previous “novid” w/all mRNA vax’s (STRONG reactions) didn't do spring ‘24, northern Illinois, 1st & last indoor w/o mask, 12 days positive & still recovering, pre-existing dysautonomia. “Mild” is a misnomer IMHO.)
Thank you so much! I’m an early, ongoing subscriber & close follower
Thank you for this! One question, while it seems ER visits are tracked, are urgent care visits tracked as well? The data on tick bites made me wonder.
I had whooping cough in April and am still coughing. (There’s a reason its name is the 100-day cough.) I strongly, strongly recommend everybody getting boosters for these childhood illnesses. They created vaccines for a reason. It’s been awful.
Thanks so much for what you do. You explain very complex concepts in a manner that is easy to understand. You are a very trusted source for me. One question, maybe I missed it in the past newsletters , but I was curious where risk of West Nile virus lies relative to these other risks.
Thank you. I am getting a booster this week. Immune compromised from immunotherapy. Do you see a difference in the current Novavax vs Mrna vaccines with the newest variants K and L?
huffington post has an interesting article on uptick in Covid.
Do you recommend COVID vaccine now for elderly low risk if last vaccine was Fall ‘23? Or, wait until Fall vaccines are out