First, there is now a Resources Page here for the most commonly asked questions I'm getting.
Happy to continue to answer your questions/concerns as best I can, so don't be shy about that.
Reminder, Resilience: One Family's Story... is increasingly pertinent, as some of our politicians shift rightward. All proceeds go to Holocaust education.
My Op-Ed w Dr. Gregg Gonsalves on 2/14/23 is now freely available:
You can’t mandate the end of a pandemic | GUEST COMMENTARY
By Judy Stone and Gregg Gonsalves
Recently, Washington, D.C., Mayor Muriel Bowser urged an end to telework, citing the empty offices downtown, the economic engine of the district. The Washington Post soon followed, shortsightedly declaring that it is time federal employees return to the office. Then President Biden decided to go bigger, declaring that he was ending the pandemic emergency protections on May 11 for the entire U.S.
After more than three long years, everyone is tired of the COVID-19 pandemic, but it clearly has not yet run its course. Still, politicians and business owners are beating the drum of getting “back to normal,” even if normal doesn’t make sense.
The rationale for this back-to-the-office, virus-be-damned movement is based on a specious logic. Case in point: Rep. James Comer’s “Stopping Home Office Work’s Unproductive Problems” Act (H.R. 139), also known as the SHOW UP Act. But the Kentucky Republican’s argument that on-site employees are more productive is wrong, and ignores data showing that employees working remotely can be, and often are, more productive than commuters. They tend to work longer hours, enjoy a better work-life balance and report being better able to concentrate.
Forcing employees to return to work will put their health at risk. There are currently about 450 deaths from COVID daily, according to the Centers for Disease Control. The reported daily new cases hover around 40,400, but those case estimates are vastly undercounted since most people test at home now and that data is not collected. Furthermore, CDC estimated that 20% of people infected with SARSCOV2 may develop long COVID. Recent data from Kaiser Family Foundation suggest 15% of Adult Americans have reported long COVID symptoms at some point, and 6% are actively experiencing it. That 6% represents over 12 million Americans.
Harvard University economist David Cutler estimated the costs of long COVID at $3.7 trillion, $11,000 per person, or 17% of the 2019 gross domestic product. Even if you think the prevalence of long COVID is overstated, cutting these numbers in half, or to a quarter points toward a staggering human and economic toll.
If politicians feel an imperative to get people back into the office, they have to make it safer to do so for both those working at home now and the millions who never had any choice — the front line workers in grocery stores, Amazon warehouses, meatpacking plants, health care, and elsewhere, who had to show up or lose their jobs.
We know how to reduce the risk of COVID-19 infection. At the World Economic Forum (WEF) recently held in Davos, Switzerland, we saw vaccinations required for attendees, free PCR testing before the meeting, the ready availability of free high quality (FFP2-94%) masks and rapid tests, and good ventilation and HEPA filters throughout the meeting spaces.
If we want employees to return to face-to-face work in the office, we should offer them the “Davos standard” of protection. Mandating a return to the office, without mandating protection on public transport or in workplaces, means we get to play Russian roulette with the virus, for ourselves, our families at home, and our communities.
This becomes more important with President Biden’s intention to end the pandemic public health emergency (PHE). The end of the PHE means that insurance may not cover these interventions and cost-sharing is certain to be put in place. With Pfizer and Moderna’s COVID vaccine prices going up 400%, these costs are likely to be forwarded to patients. Telemedicine will likely be severely curtailed, making it difficult for those with transportation difficulties to receive care. All of this will pose a disproportionate burden on the poor, elderly, rural and people of color, who have less access to medical care. Only those with resources will be able to afford rapid tests, the latest vaccines and treatments for COVID-19.
Forcing people back to work without public transit and workplace protections, just as the PHE is lifted, depriving millions of access to key interventions against the disease, may be good politics for some officials, but there is only one clear winner to their proposals and decisions: the virus, which is still very much with us, whether we care to acknowledge it or not.
FDA offers radio silence on question of spring Covid boosters, as other countries push ahead
The FDA declined a request to interview Marks for this article. In an email, the agency sidestepped most of STAT’s questions, saying only on the issue of spring boosters that “We continue to closely monitor the emerging data...
the U.K.’s Joint Committee on Vaccination and Immunisation and Canada’s National Advisory Committee on Immunization have both issued recommendations that high-risk individuals should be offered the opportunity to get a Covid booster shot this spring.
In the U.K., where an astonishing 82.5% of people aged 75 and older received a bivalent booster last fall, the recommendation is that people who are 75 and older, or who live in a care home for older adults, or who are 5 years and older and are immunocompromised should be offered a spring booster, as long as it has been six months since their last shot.
Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, would go further, saying people who are 50 and older in the U.S. should be offered the chance to get a second booster. He noted that in the second half of 2022, 97.3% of people who died from Covid in this country were aged 50 and older.
U.S.: Doctors’ offices and pharmacies would not face a tsunami of people seeking a spring booster, if one were allowed. Only 16.3% of people eligible for the updated jab have received one; even among the highest-risk population, people aged 65 and older, fewer than half of those eligible — 41.6% — have gotten the shot.
With no clearance from FDA for a spring booster, ACIP is not able to recommend one.
[fwiw, I think immunocompromised or those over 65 should have the boosters freely available 6 months after their last vax. The FDA seems to be penny-wise and pound foolish on this.]
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The FDA’s Antimicrobial Drugs Advisory Committee voted Thursday to support the approval of Paxlovid for the treatment of mild-to-moderate COVID-19 in adults at high risk for severe disease, hospitalization or death.
In July 2022, the FDA expanded the EUA to allow pharmacists to prescribe the drug to qualifying people immediately after testing positive for the virus.
During Thursday’s meeting, the FDA said it is looking at widening the number of people eligible for a prescription, and recommending those prescriptions be made earlier after infection.
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Unearthed genetic sequences from China market may point to animal origin of COVID-19
Science BYJON COHEN 16 MAR 2023
A scientific sleuth in France has identified previously undisclosed genetic data from a food market in Wuhan, China, that she and colleagues say support the theory that coronavirus-infected animals there triggered the COVID-19 pandemic...
“The data does point even further to a market origin,” says Kristian Andersen, an evolutionary biologist at Scripps Research who attended the meeting and is one of the scientists analyzing the new data. If so, the findings weaken the view of a vocal minority that a virology lab in Wuhan was the likely origin of SARS-CoV-2, perhaps when the coronavirus infected a lab worker, who spread it further.
Florence Débarre, a theoretician who specializes in evolutionary biology and works at the French National Centre for Scientific Research, unearthed the data, which consists of genetic sequences posted in GISAID, a virology database, by Chinese researchers. The Chinese team had collected environmental samples from the Huanan Seafood Market, which was connected to a cluster of early COVID-19 cases and despite its name also sold a variety of mammals for food. Since Débarre spotted the sequences, GISAID has removed them, noting that this was at the request of the submitter.
Given that the mystery of SARS-CoV-2’s origin has been a matter of intense global interest and divisive debate, the data’s discovery and subsequent disappearance will certainly raise questions about why the Chinese team—which includes the former head of China’s Center for Disease Control and Prevention (CDC), George Gao--did not make the sequences public earlier. Contacted by Science, Gao said the sequences are “[n]othing new. It had been known there was illegal animal dealing and this is why the market was immediately shut down.”...
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Did Covid-19 originate w raccoon dogs in the Wuhan food market?
A new analysis of genetic samples from China appears to link the origin of COVID-19 to raccoon dogs. (The Atlantic)
The common raccoon dog (Nyctereutes procyonoides), also called the Chinese or Asian raccoon dog to distinguish it from the Japanese raccoon dog, is a small, heavy-set, fox-like canid native to East Asia. Named for its raccoon-like face markings, it is most closely related to foxes. Common raccoon dogs feed on many animals and plant matter, and are unusual among canids (dogs, foxes, and other members of the family Canidae) for climbing trees and for hibernating in cold winters.
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Do COVID-19 vaccine mandates still make sense?
COVID-19 vaccines clearly prevent severe disease, but they worry maintaining the mandates could undermine future public health efforts. “Having to show these old vaccination proofs or certificates really doesn’t make sense, and it could cause harm, because people might lose trust in the competence of the organization,” says University of Konstanz psychologist Katrin Schmelz, whose research has found that institutional trust is crucial for health policy acceptance.
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West Nile, Lyme, and other diseases are on the rise with climate change. Experts warn the U.S. is not prepared
STAT By Sara Van Note
Even before Covid-19 arrived, the public health response to diseases transmitted to humans by vectors like fleas, ticks and mosquitoes — including West Nile, Zika, dengue fever, Lyme disease, and others — was muted, perhaps because the number of reported cases has been relatively low, and the public largely unaware of the health risks such diseases pose.
With climate change accelerating, however, shifting the ranges of many disease-carrying species and sharply increasing infections, scientists and others warn that the nation’s public officials, as well as hospitals and doctors, are underprepared for a potentially devastating surge in infections. Research on vector-borne diseases and disease surveillance, they note, are underfunded by federal and local governments, leaving the country vulnerable to outbreaks.
In the United States, cases of 17 different vector-borne diseases have been reported to the Centers for Disease Control and Prevention, and nine pathogens new to the country have been identified since 2004, according to a 2020 report by the agency, which noted that the data for 2019 and 2020 might be incomplete due to underreporting during the Covid-19 pandemic.
Reported cases of vector-borne diseases more than doubled from 2004-2019, to more than 800,000 cases. But those figures are almost certainly an undercount, CDC officials said in a presentation to Congress last year.
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Tick-borne babesiosis in New England
The prevalence of babesiosis is increasing in certain states, including Maine, New Hampshire, and Vermont, which should now be considered to have endemic transmission, according to research published in the March 17 issue of the MMWR
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New Bed Nets available against Malaria:
...The new nets endorsed yesterday are treated with pyrethroid and a second chemical called chlorfenapyr. It is a relatively new insecticide that targets mosquitoes’ mitochondria, inducing muscle cramps and preventing them from moving or flying.
This is the first time WHO has given its full recommendation to a new insecticide formulation.
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Artificial sweetener found to dampen immune response to disease in mice
by The Francis Crick Institute MARCH 15, 2023
Scientists at the Francis Crick Institute have found that high consumption of a common artificial sweetener, sucralose, lowers activation of T-cells, an important component of the immune system, in mice.
If found to have similar effects in humans, one day it could be used therapeutically to help dampen T-cell responses. For example, in patients with autoimmune diseases who suffer from uncontrolled T cell activation.
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Nordstream blasts...stirred up toxic sediment
the blasts happened in the vicinity of a historical dumping ground for chemical warfare, including mustard and arsenic agents from the Second World War. They scrambled to work out how these chemicals might affect marine life.
The sediment thrown up by the Nord Stream 1 blast contained contaminants that breached the threshold safety level for 15 days, at depths of between 95 and 53 metres. For the Nord Stream 2 pipeline, the threshold was breached for 34 days, at depths of between 78 and 42 metres. In total, the blasts contaminated 11 cubic kilometres of seawater for more than a month. The work, which is under peer review at a journal, has been published as a preprint1.
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Millions of People Could Lose Medicaid Starting in April
— In 2 weeks, states will begin unwinding pandemic's continuous enrollment provisions
still an incredible, negligent last of testing.
Drugs and Vaccines:
Experimental COVID shot made via egg-based technology elicits higher antibody proportion than mRNA vax
researchers are still racing to develop new COVID-19 vaccines because of the ongoing need, especially in low- and middle-income countries.
Findings from the research suggest that even in regions with previously limited vaccine-production infrastructure, it's possible to manufacture robust COVID shots at low cost.
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Application of the Principles of #MECFS Care to an Individual with #LongCOVID
a Case Study from Hopkins peds/adolescents, Peter C. Rowe firstname.lastname@example.org
" ...this guidance on treatment [has] the potential to... serve as an alternative to therapeutic nihilism."
Devices and Masks:
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“patient reported outcomes are sufficient to identify Covid patients with 94% accuracy” based on their immune profiling research.
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1 in 16 people with omicron (6.2%) received medical care for symptoms associated with long covid within several months of being infected. (down from 1 in 12 earlier)
the rate detected by The Post translates into about 14 million U.S. residents who survived the virus and are struggling with long-lasting effects
13% if obese
12% if have prior lung disease.
11% if diabetic
10.6 if > 65 yo
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Tips, general reading for public:
If there's no lasting immunity to covid and no upper limit on infections and the CDC's central estimate is a 70% risk of long covid after 5 infections won't most people that don't die get long covid? Isn't this the brutal logic on the current path? What am I missing? pic.twitter.com/CEtMJq8316— Nate Bear (@NateB_Panic) March 17, 2023
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Utah Gov. Spencer Cox (R) signed into law a bill that fully bans abortion clinics in the state by 2024. (ABC News)
Meanwhile, North Dakota's Supreme Court called the state's abortion ban unconstitutional. (ABC News)
And in California, a new bill was introduced that would legally protect doctors who mail abortion pills to patients in other states. (AP)
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Medicaid and contraception:
Medicaid beneficiaries face barriers in accessing medical care—and that includes contraceptive care. A new study finds that despite birth control being an essential health service, all primary care physicians that see them may not be offering Medicaid patients some of the most effective, longer-acting birth control methods. While nearly half (48%) of primary care physicians who treat Medicaid patients provided prescription contraception like the birth control pill, only 10% provided longer-acting methods like IUDs and implants, according to a new study published in JAMA Health Forum.
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We asked @jodipicoult if she would write something on her book being banned by a Florida school district: “We’ve seen, historically, what the next chapter looks like when we don’t speak out against book challenges.”
The 92 books that were pulled from Martin County School District shelves were based on the complaint of a single parent.
When I read through the list of the 20 novels of mine that were pulled from the Martin County School District bookshelves, one surprised me the most. The Storyteller is a novel about the Holocaust. It chronicles the growth of anti-Semitism and fascism in Nazi Germany. There was a strange irony that a parent wanted this particular book removed, because it felt a bit like history repeating itself....
The most common sentence in letters I receive from readers is: “I never really thought about this issue before.” That is what books do. They introduce kids to worlds and situations outside of their own. They help kids see themselves in a different way; they help kids see the world in a different way.
Last fall, when I sat in a theater every night and watched a prop book burn, I was reminded that now is not the first time we have seen bans and challenges to literature. Because of that, we can say with historical accuracy that we know what happens next. If you want to control the thoughts of a nation you start by controlling what they read. Removing books from a library or labeling them as problematic is the first step on a very slippery slope...
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A friend of mine, who works in a public university, sent this to me earlier this week 👇🏻— Doug Ponder (@dougponder) March 14, 2023
It's p. 1 of the DEI training his department is forced to take, starting w/ an exercise that asks which intersectional identities you'd save and which you'd leave to die.
This is demonic. pic.twitter.com/tfjDFFiOQX
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Brazilian researchers find ‘terrifying’ plastic rocks on remote island
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G.O.P. leaders are declining to enforce a court-supervised settlement for Mazars, Donald J. Trump’s former accounting firm, to turn over records in an investigation into whether he profited from the presidency.
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TFG: On 3/18, Donald Trump claimed on Truth Social that he will be "arrested" on Tuesday and called for public protests:
"THE FAR & AWAY LEADING REPUBLICAN CANDIDATE & FORMER PRESIDENT OF THE UNITED STATES OF AMERICA, WILL BE ARRESTED ON TUESDAY OF NEXT WEEK. PROTEST, TAKE OUR NATION BACK!"
[How are you celebrating?]
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Health insurers' AI Denies Seniors Care
Although health insurance companies have long rejected certain medical claims, an investigation by STATopens in a new tab or window found that artificial intelligence (AI) is "now driving their denials to new heights in Medicare Advantage."
Specifically, STAT found that insurers are "using unregulated predictive algorithms, under the guise of scientific rigor, to pinpoint the precise moment when they can plausibly cut off payment for an older patient's treatment."
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Insurers and prior authorization:
A Third of Docs Blame Prior Authorizations for Serious Harm to Patients
— Four in five say they waste resources, forcing use of ineffective treatments, extra visits
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Working people are striking over France raising the retirement age to 64. Rep. @MarcMolinaro, @RepMikeLawler, Republican colleagues have suggested they want to raise the age to 70—6 years more than the French plan (which is raising retirement from 62 to 64).
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Kentucky is the latest state where lawmakers passed a ban on gender-affirming care for transgender minors. (Washington Post)
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Florida bans the use of all puberty blockers, hormone therapies and/or surgeries for any patient under 18, whether or not those minors have parental approval for such care.
There are also bans in Arkansas, Alabama, Kentucky, Utah, Mississippi, South Dakota and Tennessee.
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DeSantis is punishing the Hyatt Regency Miami for hosting a Drag Christmas ball back in December. He’s actually taken away its liquor license.
DeSantis is out of control, obsessed with oppressing freedom and gender identity expression and willing to abuse state power to do it.
At a Republican political rally in Davenport, Iowa today someone gave @GovRonDeSantis and @IAGovernor Kim Reynolds a handmade “snowflake” with the word "Fascist" secretly embedded in it. pic.twitter.com/as8UN3WRsp— Steven Goffman (@SteveGoffman) March 11, 2023
Ukraine war: The shrimp shell fabric saving lives
An "anti-bleeding" fabric made from shrimp shells is saving thousands of lives in Ukraine, according to an NHS doctor working in the war-zone.
The bandages are coated with an extract known as chitosan that can stem bleeding by forming clots.
Made by Nonwovenn in Somerset, the bandages are in first-aid kits being sent out to the Ukrainian military.
Feel good du jour:
the number of people receiving lifesaving HIV treatment through the President's Emergency Plan for AIDS Relief (PEPFAR) has increased 300 times in under 20 years, to more than 20 million people in 2022.
PEPFAR, started by former President George W. Bush while he was in office, initially offered HIV antiretroviral therapy to just 66,500 individuals in 2004.
The numbers of people receiving HIV treatment through PEPFAR with a viral load test who subsequently tested as virally suppressed also increased, from 80% to 95% between 2015 and 2022.
This means their virus was under control, thanks to the treatment, which can also help prevent transmission to sexual partners and reduces the risk of transmission from mothers to children.
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Daniel Scheinert, an Alabama-raised filmmaker, was accepting his third Oscar of the night for his film “Everything Everywhere All at Once,” which he co-wrote and co-directed with Daniel Kwan.
“I had a fantasy as a kid of winning an award and going up and telling off all the teachers that gave my brother and I detention so here goes,” Scheinert said.
“I’m just kidding, these are teachers that changed my life, mostly public school teachers,” Scheinert said, before reading from a list, “Ms. Dummier, Mr. Toole, Mr. Hudson, Mr. Chambers, Madame George, Ms. NFL [Nidia Fernandez-Lee]...”
European starlings are so good at mimicry, they can even do human speech. pic.twitter.com/qLLxg9uHiu— Fascinating (@fasc1nate) October 25, 2022
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Bits of beauty: