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This just came in from Katelyn Jetelina who I've found to be one
of the best sources of practical advice on COVID. If you are over
65, don't miss the section on vaccination advice. --Manny<br>
<br>
<pre class="moz-signature" cols="72">"...it has been said that democracy is the worst form of Government
except for all those other forms that have been tried from time to time..."
Winston S Churchill, November 11, 1947</pre>
<div class="moz-forward-container"><br>
<br>
-------- Forwarded Message --------
<table class="moz-email-headers-table" cellspacing="0"
cellpadding="0" border="0">
<tbody>
<tr>
<th nowrap="nowrap" align="RIGHT" valign="BASELINE">Subject:
</th>
<td>A Summer Covid-19 Wave</td>
</tr>
<tr>
<th nowrap="nowrap" align="RIGHT" valign="BASELINE">Date:
</th>
<td>Thu, 18 Jul 2024 13:12:20 +0000</td>
</tr>
<tr>
<th nowrap="nowrap" align="RIGHT" valign="BASELINE">From:
</th>
<td>Your Local Epidemiologist <a
class="moz-txt-link-rfc2396E"
href="mailto:yourlocalepidemiologist@substack.com"
moz-do-not-send="true"><yourlocalepidemiologist@substack.com></a></td>
</tr>
<tr>
<th nowrap="nowrap" align="RIGHT" valign="BASELINE">Reply-To:
</th>
<td>Your Local Epidemiologist
<a class="moz-txt-link-rfc2396E"
href="mailto:reply+2fc3ag&a13t&&a5963235a6dfd7b6e1f59d43e70f2dda77c092790941031af17ecefa535215ae@mg1.substack.com"
moz-do-not-send="true"><reply+2fc3ag&a13t&&a5963235a6dfd7b6e1f59d43e70f2dda77c092790941031af17ecefa535215ae@mg1.substack.com></a></td>
</tr>
<tr>
<th nowrap="nowrap" align="RIGHT" valign="BASELINE">To: </th>
<td><a class="moz-txt-link-abbreviated"
href="mailto:manny@ratafias.com"
moz-do-not-send="true">manny@ratafias.com</a></td>
</tr>
</tbody>
</table>
<br>
<br>
<meta charset="utf-8">
<title>A Summer Covid-19 Wave</title>
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</style><img
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alt="" style="height:1px !important;width:1px
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<div
style="display:none;font-size:1px;color:#333333;line-height:1px;max-height:0px;max-width:0px;opacity:0;overflow:hidden;"
class="preview">A brief update and your top questions answered</div>
<div
style="display:none;font-size:1px;color:#333333;line-height:1px;max-height:0px;max-width:0px;opacity:0;overflow:hidden;"
class="preview">͏ ͏ ͏ ͏ ͏ ͏ ͏
͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏
͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏
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͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏
͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏
͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏
͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏
͏ ͏ ͏ ͏ </div>
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translated="" class="pencraft
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this email? <a
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class="pencraft pc-reset
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style="-webkit-text-decoration-line:
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<p style="color: rgb(54, 55, 55); font-size:
16px; line-height: 26px; margin: 0 0 20px 0;
margin-bottom: 0; margin-top: 0;"><em><span>Si
quiere leer la versión en español, pulse </span><a
href="https://substack.com/redirect/16753ff1-d4a5-4d03-a53d-649b8dc4cc17?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="color: #538cfa;
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moz-do-not-send="true">aquí</a><span>.</span></em></p>
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<h1 class="post-title published"
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font-family: 'SF Pro Display', -apple-system,
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Symbol'; font-size: 32px; font-weight: 900;
line-height: 36px; margin: 0;"><a
href="https://substack.com/app-link/post?publication_id=281219&post_id=146690728&utm_source=post-email-title&utm_campaign=email-post-title&isFreemail=true&r=a13t&token=eyJ1c2VyX2lkIjo0Njc5OTMsInBvc3RfaWQiOjE0NjY5MDcyOCwiaWF0IjoxNzIxMzA4MzY4LCJleHAiOjE3MjM5MDAzNjgsImlzcyI6InB1Yi0yODEyMTkiLCJzdWIiOiJwb3N0LXJlYWN0aW9uIn0.9HcbkkyCg3TcaJ4T-XYuCsX3bml90H1lezrshMpu5dY"
style="color: rgb(54, 55, 55);
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Summer Covid-19 Wave</a></h1>
<h3 class="subtitle" style="-moz-appearance:
optimizelegibility; -moz-osx-font-smoothing:
antialiased; -webkit-appearance:
optimizelegibility; -webkit-font-smoothing:
antialiased; appearance: optimizelegibility;
color: #777777; font-family: 'SF Pro Display',
-apple-system-headline, system-ui,
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Color Emoji', 'Segoe UI Emoji', 'Segoe UI
Symbol'; font-size: 18px; font-weight: normal;
line-height: 24px; margin: 4px 0 0; margin-top:
12px;">A brief update and your top questions
answered</h3>
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500; letter-spacing:
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none; margin: 0;
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href="https://substack.com/@yourlocalepidemiologist"
class="pencraft
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moz-do-not-send="true">Katelyn
Jetelina</a></div>
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style="color: rgb(119,
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Emoji', 'Segoe UI
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11px; font-weight: 500;
letter-spacing: .2px;
line-height: 20px;
list-style: none;
margin: 0;
text-decoration: unset;
text-transform:
uppercase;"><time
datetime="2024-07-18T13:12:30.864Z">Jul
18</time></div>
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href="https://substack.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.JENU8SM8G8v3U3LiHORkZD7APlaxPS7otgs40_kCmzM?&utm_source=substack&utm_medium=email"
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class="email-button-text">READ
IN APP</span><img
src="https://substackcdn.com/image/fetch/w_36,c_scale,f_png,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack.com%2Ficon%2FLucideArrowUpRight%3Fv%3D4%26height%3D36%26fill%3Dnone%26stroke%3D%2523808080%26strokeWidth%3D2"
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<div dir="auto" class="post typography"
style="font-size: 16px; line-height: 26px; padding:
16px 0 0 0;">
<div dir="auto" class="body markup"
style="font-size: 16px; line-height: 26px;
margin-bottom: 16px; text-align: initial; width:
100%; word-break: break-word;">
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;
margin-top: 0;">I’m briefly coming out from
hiding (a.k.a. summer break) to bring you a
Covid-19 update. It seems like everyone has it
right now (including the President). And I’m
getting a ton of questions!</p>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;">Let’s
jump in.</p>
<h4 class="header-anchor-post"
style="-moz-appearance: optimizelegibility;
-moz-osx-font-smoothing: antialiased;
-webkit-appearance: optimizelegibility;
-webkit-font-smoothing: antialiased; appearance:
optimizelegibility; color: rgb(54, 55, 55);
font-family: 'SF Pro Display',
-apple-system-headline, system-ui,
-apple-system, BlinkMacSystemFont, 'Segoe UI',
Roboto, Helvetica, Arial, sans-serif, 'Apple
Color Emoji', 'Segoe UI Emoji', 'Segoe UI
Symbol'; font-size: 1.125em; font-weight: bold;
line-height: 1.16em; margin: 1em 0 0.625em 0;
position: relative;"><strong>We are in the
middle of an infection wave.</strong></h4>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;">Covid-19
levels in wastewater—one of the best (only?)
metrics of community spread these days—have
reached the “high” category. This means that if
you’re sick today, it’s likely Covid-19. This
also means it’s time to get that indoor air
moving and to wear a mask if you don’t want to
get sick. </p>
<div class="captioned-image-container-static"
style="font-size: 16px; line-height: 26px;
margin: 32px auto;">
<figure style="margin: 0 auto; width: 100%;">
<table class="image-wrapper"
data-component-name="Image2ToDOMStatic"
style="mso-padding-alt: 1em 0 1.6em;"
width="100%" cellspacing="0" cellpadding="0"
border="0">
<tbody>
<tr>
<td style="text-align: center;"><br>
</td>
<td class="content" style="text-align:
center;" width="1456" align="left"><a
class="image-link" target="_blank"
href="https://substack.com/redirect/34c8216e-15bb-4b70-a94e-4772a717e3e2?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="align-items: center;
border: none; display: block;
flex-direction: column; height:
auto; margin: 0; padding: 0;
position: relative; text-decoration:
none; width: auto;"
moz-do-not-send="true"><img
data-attrs="{"src":"https://substack-post-media.s3.amazonaws.com/public/images/76f3b9e2-a574-46be-8a92-fe1aab5ee7c7_1844x576.png","srcNoWatermark":null,"fullscreen":null,"imageSize":null,"height":455,"width":1456,"resizeWidth":null,"bytes":272162,"alt":null,"title":null,"type":"image/png","href":null,"belowTheFold":false,"topImage":true,"internalRedirect":null}"
alt="" class="wide-image"
src="https://substackcdn.com/image/fetch/w_2912,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F76f3b9e2-a574-46be-8a92-fe1aab5ee7c7_1844x576.png"
style="-ms-interpolation-mode:
bicubic; border: none !important;
display: block; height: auto;
margin: 0 auto; margin-bottom: 0;
max-width: 100% !important;
vertical-align: middle; width:
auto !important;"
moz-do-not-send="true" width="550"
height="171.875"></a></td>
<td style="text-align: center;"><br>
</td>
</tr>
</tbody>
</table>
<figcaption class="image-caption"
style="box-sizing: content-box; color:
#777777; font-size: 14px; font-weight: 400;
letter-spacing: -.15px; line-height: 20px;
margin-top: 8px; padding-left: 15%;
padding-right: 15%; text-align: center;
width: 70%;"><span>Data Source: </span><a
href="https://substack.com/redirect/910f61b6-7c31-47e4-ba76-c7f546a72550?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="text-decoration: underline;"
moz-do-not-send="true">CDC</a><span>;
Annotated by YLE</span></figcaption></figure>
</div>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;">The West
is leading the way with infections, and levels
are higher than last summer’s peak. It’s hard to
tell if the West is peaking. While Hawaii has
already peaked after its huge infection wave,
California and Oregon continue to increase
considerably. </p>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;"><span>Other
regions are following suit. In fact, 26 states
have “high” or “very high” levels of Covid-19.
(Enter your </span><a
href="https://substack.com/redirect/095090d4-4da3-4135-ae39-c55b2c1cf183?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="color: #538cfa; text-decoration:
none;" moz-do-not-send="true">state here</a><span>
to see local levels.) </span></p>
<div class="captioned-image-container-static"
style="font-size: 16px; line-height: 26px;
margin: 32px auto;">
<figure style="margin: 0 auto; width: 100%;">
<table class="image-wrapper"
data-component-name="Image2ToDOMStatic"
style="mso-padding-alt: 1em 0 1.6em;"
width="100%" cellspacing="0" cellpadding="0"
border="0">
<tbody>
<tr>
<td style="text-align: center;"><br>
</td>
<td class="content" style="text-align:
center;" width="510" align="left"><a
class="image-link" target="_blank"
href="https://substack.com/redirect/794c0194-a73c-4536-8344-8fc07218cbb5?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="align-items: center;
border: none; display: block;
flex-direction: column; height:
auto; margin: 0; padding: 0;
position: relative; text-decoration:
none; width: auto;"
moz-do-not-send="true"><img
data-attrs="{"src":"https://substack-post-media.s3.amazonaws.com/public/images/00d91d8b-06c6-4c2d-9c6e-5dbd65ecac48_952x784.png","srcNoWatermark":null,"fullscreen":null,"imageSize":null,"height":784,"width":952,"resizeWidth":510,"bytes":179863,"alt":null,"title":null,"type":"image/png","href":null,"belowTheFold":false,"topImage":false,"internalRedirect":null}"
alt="" class=""
src="https://substackcdn.com/image/fetch/w_510,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F00d91d8b-06c6-4c2d-9c6e-5dbd65ecac48_952x784.png"
style="-ms-interpolation-mode:
bicubic; border: none !important;
display: block; height: auto;
margin: 0 auto; margin-bottom: 0;
max-width: 100% !important;
vertical-align: middle; width:
auto !important;"
moz-do-not-send="true" width="510"
height="420"></a></td>
<td style="text-align: center;"><br>
</td>
</tr>
</tbody>
</table>
<figcaption class="image-caption"
style="box-sizing: content-box; color:
#777777; font-size: 14px; font-weight: 400;
letter-spacing: -.15px; line-height: 20px;
margin-top: 8px; padding-left: 15%;
padding-right: 15%; text-align: center;
width: 70%;">Covid-19 levels across states.
Source: CDC</figcaption></figure>
</div>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;">Severe
disease is also increasing, but starting at low
levels. Thanks to population immunity building,
rates are not as high as last summer’s peak (or
the summer before). (Note for those data gurus:
The figure below is among a subset of hospitals
that have consistently reported data over time.
In other words, the lower hospitalization rate
isn’t due to a change in reporting behaviors.) </p>
<div class="captioned-image-container-static"
style="font-size: 16px; line-height: 26px;
margin: 32px auto;">
<figure style="margin: 0 auto; width: 100%;">
<table class="image-wrapper"
data-component-name="Image2ToDOMStatic"
style="mso-padding-alt: 1em 0 1.6em;"
width="100%" cellspacing="0" cellpadding="0"
border="0">
<tbody>
<tr>
<td style="text-align: center;"><br>
</td>
<td class="content" style="text-align:
center;" width="468" align="left"><a
class="image-link" target="_blank"
href="https://substack.com/redirect/e5a81996-5975-4486-b30d-8c07fdba8391?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="align-items: center;
border: none; display: block;
flex-direction: column; height:
auto; margin: 0; padding: 0;
position: relative; text-decoration:
none; width: auto;"
moz-do-not-send="true"><img
data-attrs="{"src":"https://substack-post-media.s3.amazonaws.com/public/images/2e87cb38-9d51-4d99-84f5-cbdbfb331c21_1168x874.png","srcNoWatermark":null,"fullscreen":null,"imageSize":null,"height":874,"width":1168,"resizeWidth":468,"bytes":150403,"alt":null,"title":null,"type":"image/png","href":null,"belowTheFold":true,"topImage":false,"internalRedirect":null}"
alt="" class=""
src="https://substackcdn.com/image/fetch/w_468,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F2e87cb38-9d51-4d99-84f5-cbdbfb331c21_1168x874.png"
style="-ms-interpolation-mode:
bicubic; border: none !important;
display: block; height: auto;
margin: 0 auto; margin-bottom: 0;
max-width: 100% !important;
vertical-align: middle; width:
auto !important;"
moz-do-not-send="true" width="468"
height="350.1986301369863"></a></td>
<td style="text-align: center;"><br>
</td>
</tr>
</tbody>
</table>
<figcaption class="image-caption"
style="box-sizing: content-box; color:
#777777; font-size: 14px; font-weight: 400;
letter-spacing: -.15px; line-height: 20px;
margin-top: 8px; padding-left: 15%;
padding-right: 15%; text-align: center;
width: 70%;">Source: CDC; Annotated by YLE</figcaption></figure>
</div>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;"><span>In
the UK, which always seems slightly ahead of
the U.S. in waves, </span><a
href="https://substack.com/redirect/190a9a76-a7ae-4382-95cf-8bbdd4f3e750?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="color: #538cfa; text-decoration:
none;" moz-do-not-send="true">hospitalizations
have </a><span>peaked and remained lower than
in Winter. </span></p>
<div class="captioned-image-container-static"
style="font-size: 16px; line-height: 26px;
margin: 32px auto;">
<figure style="margin: 0 auto; width: 100%;">
<table class="image-wrapper"
data-component-name="Image2ToDOMStatic"
style="mso-padding-alt: 1em 0 1.6em;"
width="100%" cellspacing="0" cellpadding="0"
border="0">
<tbody>
<tr>
<td style="text-align: center;"><br>
</td>
<td class="content" style="text-align:
center;" width="532" align="left"><a
class="image-link" target="_blank"
href="https://substack.com/redirect/4c15a2bc-2cee-460c-82ac-c10cb4458364?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="align-items: center;
border: none; display: block;
flex-direction: column; height:
auto; margin: 0; padding: 0;
position: relative; text-decoration:
none; width: auto;"
moz-do-not-send="true"><img
data-attrs="{"src":"https://substack-post-media.s3.amazonaws.com/public/images/5fd6adb6-3a9e-4e2e-bcef-cd975d0f49bc_900x661.jpeg","srcNoWatermark":null,"fullscreen":null,"imageSize":null,"height":661,"width":900,"resizeWidth":532,"bytes":null,"alt":"Image","title":null,"type":null,"href":null,"belowTheFold":true,"topImage":false,"internalRedirect":null}"
alt="Image" title="Image" class=""
src="https://substackcdn.com/image/fetch/w_532,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F5fd6adb6-3a9e-4e2e-bcef-cd975d0f49bc_900x661.jpeg"
style="-ms-interpolation-mode:
bicubic; border: none !important;
display: block; height: auto;
margin: 0 auto; margin-bottom: 0;
max-width: 100% !important;
vertical-align: middle; width:
auto !important;"
moz-do-not-send="true" width="532"
height="390.72444444444443"></a></td>
<td style="text-align: center;"><br>
</td>
</tr>
</tbody>
</table>
</figure>
</div>
<h4 class="header-anchor-post"
style="-moz-appearance: optimizelegibility;
-moz-osx-font-smoothing: antialiased;
-webkit-appearance: optimizelegibility;
-webkit-font-smoothing: antialiased; appearance:
optimizelegibility; color: rgb(54, 55, 55);
font-family: 'SF Pro Display',
-apple-system-headline, system-ui,
-apple-system, BlinkMacSystemFont, 'Segoe UI',
Roboto, Helvetica, Arial, sans-serif, 'Apple
Color Emoji', 'Segoe UI Emoji', 'Segoe UI
Symbol'; font-size: 1.125em; font-weight: bold;
line-height: 1.16em; margin: 1em 0 0.625em 0;
position: relative;"><strong>We’ve had a wave
each summer. Why? </strong></h4>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;">This is
due to the combination of three things: </p>
<ol style="margin-top: 0; padding: 0;">
<li style="margin: 8px 0 0 32px;">
<p style="box-sizing: border-box; color:
rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0; margin-bottom:
0; padding-left: 4px;"><em><strong>Behavior
change</strong></em><span>. People move
inside due to the heat, and most spread
happens indoors. </span></p>
</li>
<li style="margin: 8px 0 0 32px;">
<p style="box-sizing: border-box; color:
rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0; margin-bottom:
0; padding-left: 4px;"><em><strong>Covid-19
keeps mutating quickly—about twice as
much as flu. </strong></em><span>The
latest variant, KP.3, specifically its
descendant KP.3.1.1, is a little booger
because it </span><em>dropped</em><span>
a mutation on the spike protein, which
seems to be effective in getting past our
first immunity wall (called neutralizing
antibodies.) </span></p>
</li>
<li style="margin: 8px 0 0 32px;">
<p style="box-sizing: border-box; color:
rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0; margin-bottom:
0; padding-left: 4px;"><em><strong>Waning
immunity. </strong></em><span>~20-30%
of the U.S. population was infected with
Covid-19 this past winter, which means the
virus has plenty of pathways to find due
to low immunity. Among states with </span><em>mild</em><span>
Covid-19 winters, like Hawaii and Oregon,
summer waves are </span><em>very high</em><span>.</span></p>
</li>
</ol>
<div class="captioned-image-container-static"
style="font-size: 16px; line-height: 26px;
margin: 32px auto;">
<figure style="margin: 0 auto; width: 100%;">
<table class="image-wrapper"
data-component-name="Image2ToDOMStatic"
style="mso-padding-alt: 1em 0 1.6em;"
width="100%" cellspacing="0" cellpadding="0"
border="0">
<tbody>
<tr>
<td style="text-align: center;"><br>
</td>
<td class="content" style="text-align:
center;" width="1456" align="left"><a
class="image-link" target="_blank"
href="https://substack.com/redirect/8dc7983d-affa-444d-a1ed-335742aed89f?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="align-items: center;
border: none; display: block;
flex-direction: column; height:
auto; margin: 0; padding: 0;
position: relative; text-decoration:
none; width: auto;"
moz-do-not-send="true"><img
data-attrs="{"src":"https://substack-post-media.s3.amazonaws.com/public/images/c3d4c2ce-f3b7-46c1-bf12-560c16d541bb_1584x654.png","srcNoWatermark":null,"fullscreen":null,"imageSize":null,"height":601,"width":1456,"resizeWidth":null,"bytes":189878,"alt":null,"title":null,"type":"image/png","href":null,"belowTheFold":true,"topImage":false,"internalRedirect":null}"
alt="" class="wide-image"
src="https://substackcdn.com/image/fetch/w_2912,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fc3d4c2ce-f3b7-46c1-bf12-560c16d541bb_1584x654.png"
style="-ms-interpolation-mode:
bicubic; border: none !important;
display: block; height: auto;
margin: 0 auto; margin-bottom: 0;
max-width: 100% !important;
vertical-align: middle; width:
auto !important;"
moz-do-not-send="true" width="550"
height="227.0260989010989"></a></td>
<td style="text-align: center;"><br>
</td>
</tr>
</tbody>
</table>
<figcaption class="image-caption"
style="box-sizing: content-box; color:
#777777; font-size: 14px; font-weight: 400;
letter-spacing: -.15px; line-height: 20px;
margin-top: 8px; padding-left: 15%;
padding-right: 15%; text-align: center;
width: 70%;"><span>Source: </span><a
href="https://substack.com/redirect/095090d4-4da3-4135-ae39-c55b2c1cf183?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="text-decoration: underline;"
moz-do-not-send="true">CDC</a><span>;
Annotated by YLE</span></figcaption></figure>
</div>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;"><span>I
</span><em>am</em><span> surprised by how early
this summer wave is (typically, we see it
later in the summer) and how high infections
are getting. I hoped we would see smaller and
smaller summer infection waves each year.
Alas, Covid-19 has different plans. </span></p>
<h4 class="header-anchor-post"
style="-moz-appearance: optimizelegibility;
-moz-osx-font-smoothing: antialiased;
-webkit-appearance: optimizelegibility;
-webkit-font-smoothing: antialiased; appearance:
optimizelegibility; color: rgb(54, 55, 55);
font-family: 'SF Pro Display',
-apple-system-headline, system-ui,
-apple-system, BlinkMacSystemFont, 'Segoe UI',
Roboto, Helvetica, Arial, sans-serif, 'Apple
Color Emoji', 'Segoe UI Emoji', 'Segoe UI
Symbol'; font-size: 1.125em; font-weight: bold;
line-height: 1.16em; margin: 1em 0 0.625em 0;
position: relative;"><strong>Should older people
get the vaccine now or wait for fall? </strong></h4>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;"><span>We
are seeing uncomfortable mortality rates among
medically vulnerable people, like older adults
in nursing homes, who are more than 6 months
out from their last vaccine. For older adults
who didn’t get their vaccine this spring, I
suggest getting a vaccine now. But do it soon,
as we want at </span><em>least</em><span>
four months between this and the upcoming fall
dose, so that it works best. Last year, the
winter Covid-19 wave started in November. </span></p>
<h4 class="header-anchor-post"
style="-moz-appearance: optimizelegibility;
-moz-osx-font-smoothing: antialiased;
-webkit-appearance: optimizelegibility;
-webkit-font-smoothing: antialiased; appearance:
optimizelegibility; color: rgb(54, 55, 55);
font-family: 'SF Pro Display',
-apple-system-headline, system-ui,
-apple-system, BlinkMacSystemFont, 'Segoe UI',
Roboto, Helvetica, Arial, sans-serif, 'Apple
Color Emoji', 'Segoe UI Emoji', 'Segoe UI
Symbol'; font-size: 1.125em; font-weight: bold;
line-height: 1.16em; margin: 1em 0 0.625em 0;
position: relative;"><strong>How do I read the
latest CDC guidance? </strong></h4>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;"><span>This
is the first wave since the </span><a
href="https://substack.com/redirect/bfe30916-97cf-4bad-92b6-8df41cbed7a7?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="color: #538cfa; text-decoration:
none;" moz-do-not-send="true">updated CDC
Covid-19 guidance</a><span>. As a reminder, if
you get infected, CDC recommends approaching
isolation in two phases: </span></p>
<ul style="margin-top: 0; padding: 0;">
<li style="margin: 8px 0 0 32px;
mso-special-format: bullet;">
<p style="box-sizing: border-box; color:
rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0; margin-bottom:
0; padding-left: 4px;"><em><strong>Phase 1:
Stay home when sick </strong></em><span>until
your fever resolves for 24 hours or your
symptoms improve. But many people remain
contagious beyond this timeframe, though,
so…</span></p>
</li>
<li style="margin: 8px 0 0 32px;
mso-special-format: bullet;">
<p style="box-sizing: border-box; color:
rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0; margin-bottom:
0; padding-left: 4px;"><em><strong>Phase 2:
Use caution</strong></em><strong> </strong><span>for
five days by taking additional precautions
(e.g., wear a mask; or test before seeing
grandma at the nursing home).</span></p>
</li>
</ul>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;"><em>But
what is the best approach?</em><span> Isolate
until your at-home Covid-19 test turns
negative, which could be anywhere between 3
and 15 days. Once it turns negative, you can
be confident you’re no longer infectious.
Unfortunately, many people cannot afford tests
or to miss work for this long. If you leave
isolation beforehand, please wear an N95.</span></p>
<div class="captioned-image-container-static"
style="font-size: 16px; line-height: 26px;
margin: 32px auto;">
<figure style="margin: 0 auto; width: 100%;">
<table class="image-wrapper"
data-component-name="Image2ToDOMStatic"
style="mso-padding-alt: 1em 0 1.6em;"
width="100%" cellspacing="0" cellpadding="0"
border="0">
<tbody>
<tr>
<td style="text-align: center;"><br>
</td>
<td class="content" style="text-align:
center;" width="542" align="left"><a
class="image-link" target="_blank"
href="https://substack.com/redirect/b86d8680-11ae-493f-a15d-a92826ef4811?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="align-items: center;
border: none; display: block;
flex-direction: column; height:
auto; margin: 0; padding: 0;
position: relative; text-decoration:
none; width: auto;"
moz-do-not-send="true"><img
data-attrs="{"src":"https://substack-post-media.s3.amazonaws.com/public/images/9e572f7a-1763-4c2f-b77b-1f8bfc38dab1_1116x612.png","srcNoWatermark":null,"fullscreen":null,"imageSize":null,"height":612,"width":1116,"resizeWidth":542,"bytes":342693,"alt":null,"title":null,"type":"image/png","href":null,"belowTheFold":true,"topImage":false,"internalRedirect":null}"
alt="" class=""
src="https://substackcdn.com/image/fetch/w_542,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F9e572f7a-1763-4c2f-b77b-1f8bfc38dab1_1116x612.png"
style="-ms-interpolation-mode:
bicubic; border: none !important;
display: block; height: auto;
margin: 0 auto; margin-bottom: 0;
max-width: 100% !important;
vertical-align: middle; width:
auto !important;"
moz-do-not-send="true" width="542"
height="297.2258064516129"></a></td>
<td style="text-align: center;"><br>
</td>
</tr>
</tbody>
</table>
<figcaption class="image-caption"
style="box-sizing: content-box; color:
#777777; font-size: 14px; font-weight: 400;
letter-spacing: -.15px; line-height: 20px;
margin-top: 8px; padding-left: 15%;
padding-right: 15%; text-align: center;
width: 70%;">Figure Source: Nature;
Annotated by YLE </figcaption></figure>
</div>
<h4 class="header-anchor-post"
style="-moz-appearance: optimizelegibility;
-moz-osx-font-smoothing: antialiased;
-webkit-appearance: optimizelegibility;
-webkit-font-smoothing: antialiased; appearance:
optimizelegibility; color: rgb(54, 55, 55);
font-family: 'SF Pro Display',
-apple-system-headline, system-ui,
-apple-system, BlinkMacSystemFont, 'Segoe UI',
Roboto, Helvetica, Arial, sans-serif, 'Apple
Color Emoji', 'Segoe UI Emoji', 'Segoe UI
Symbol'; font-size: 1.125em; font-weight: bold;
line-height: 1.16em; margin: 1em 0 0.625em 0;
position: relative;"><strong>Is anything new
happening with Paxlovid?</strong><span> </span></h4>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;">Evidence
shows that Paxlovid works for a small subgroup
of people: medically vulnerable over 65 years
and those who are not up-to-date on Covid-19
vaccines. </p>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;"><span>Unfortunately,
Paxlovid is not as effective as we had hoped
for everyone else. Evidence suggests that it </span><a
href="https://substack.com/redirect/dabd449c-48f0-4ac2-a94e-cfc53dcc6bd4?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="color: #538cfa; text-decoration:
none;" moz-do-not-send="true">doesn’t protect</a><span>
against long Covid, and it </span><a
href="https://substack.com/redirect/0c55e300-c245-4388-a314-eb84f063f632?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="color: #538cfa; text-decoration:
none;" moz-do-not-send="true">doesn’t decrease
the number of days</a><span> you’re sick (if
you’re up-to-date on vaccines). </span></p>
<h4 class="header-anchor-post"
style="-moz-appearance: optimizelegibility;
-moz-osx-font-smoothing: antialiased;
-webkit-appearance: optimizelegibility;
-webkit-font-smoothing: antialiased; appearance:
optimizelegibility; color: rgb(54, 55, 55);
font-family: 'SF Pro Display',
-apple-system-headline, system-ui,
-apple-system, BlinkMacSystemFont, 'Segoe UI',
Roboto, Helvetica, Arial, sans-serif, 'Apple
Color Emoji', 'Segoe UI Emoji', 'Segoe UI
Symbol'; font-size: 1.125em; font-weight: bold;
line-height: 1.16em; margin: 1em 0 0.625em 0;
position: relative;"><strong>What about
airplanes? </strong></h4>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;"><span>A
lot of people are traveling this summer.
Remember that the virus likes crowded, indoor
areas with poor circulation, like airport
terminals and planes before takeoff. Longer
flights also pose more risk—for </span><a
href="https://substack.com/redirect/99a4909e-7c8b-4f11-b146-71c1c4c595fa?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo"
rel="" style="color: #538cfa; text-decoration:
none;" moz-do-not-send="true">every 1-hour
increase</a><span> in flight duration, there
is an additional 53% risk of infection. </span></p>
<h4 class="header-anchor-post"
style="-moz-appearance: optimizelegibility;
-moz-osx-font-smoothing: antialiased;
-webkit-appearance: optimizelegibility;
-webkit-font-smoothing: antialiased; appearance:
optimizelegibility; color: rgb(54, 55, 55);
font-family: 'SF Pro Display',
-apple-system-headline, system-ui,
-apple-system, BlinkMacSystemFont, 'Segoe UI',
Roboto, Helvetica, Arial, sans-serif, 'Apple
Color Emoji', 'Segoe UI Emoji', 'Segoe UI
Symbol'; font-size: 1.125em; font-weight: bold;
line-height: 1.16em; margin: 1em 0 0.625em 0;
position: relative;"><strong>Bottom line</strong></h4>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;">Covid-19
continues to do its thing. We are in the middle
of an infection wave, and hopefully, it won’t
find you, so you can continue to enjoy your
summer. Given these news cycles, we could all
certainly use a break. </p>
<p style="color: rgb(54, 55, 55); font-size: 16px;
line-height: 26px; margin: 0 0 20px 0;">Love,
YLE</p>
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<p style="color: rgb(54, 55, 55); font-size: 16px;
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Local Epidemiologist (YLE)” is written by Dr.
Katelyn Jetelina, MPH PhD—an epidemiologist,
wife, and mom of two little girls. During the
day, she is a senior scientific consultant to
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night, she writes this newsletter. Her main
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