[Hac-announce] Fwd: A Summer Covid-19 Wave
Manny Sholem Ratafia
manny at ratafias.com
Thu Jul 18 09:46:55 EDT 2024
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
"...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
-------- Forwarded Message --------
Subject: A Summer Covid-19 Wave
Date: Thu, 18 Jul 2024 13:12:20 +0000
From: Your Local Epidemiologist <yourlocalepidemiologist at substack.com>
Reply-To: Your Local Epidemiologist
<reply+2fc3ag&a13t&&a5963235a6dfd7b6e1f59d43e70f2dda77c092790941031af17ecefa535215ae at mg1.substack.com>
To: manny at ratafias.com
A Summer Covid-19 Wave
A brief update and your top questions answered
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------------------------------------------------------------------------
A Summer Covid-19 Wave
<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>
A brief update and your top questions answered
Katelyn Jetelina <https://substack.com/@yourlocalepidemiologist>
Jul 18
<https://substack.com/@yourlocalepidemiologist>
<https://substack.com/app-link/post?publication_id=281219&post_id=146690728&utm_source=substack&isFreemail=true&submitLike=true&token=eyJ1c2VyX2lkIjo0Njc5OTMsInBvc3RfaWQiOjE0NjY5MDcyOCwicmVhY3Rpb24iOiLinaQiLCJpYXQiOjE3MjEzMDgzNjgsImV4cCI6MTcyMzkwMDM2OCwiaXNzIjoicHViLTI4MTIxOSIsInN1YiI6InJlYWN0aW9uIn0.b-QlYmjxROFFY5JCI8QpVyBL5C_pCLlwPAn4LNMCmXI&utm_medium=email&utm_campaign=email-reaction&r=a13t>
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READ IN APP
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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!
Let’s jump in.
*We are in the middle of an infection wave.*
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.
<https://substack.com/redirect/34c8216e-15bb-4b70-a94e-4772a717e3e2?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo>
Data Source: CDC
<https://substack.com/redirect/910f61b6-7c31-47e4-ba76-c7f546a72550?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo>;
Annotated by YLE
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.
Other regions are following suit. In fact, 26 states have “high” or
“very high” levels of Covid-19. (Enter your state here
<https://substack.com/redirect/095090d4-4da3-4135-ae39-c55b2c1cf183?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo>to
see local levels.)
<https://substack.com/redirect/794c0194-a73c-4536-8344-8fc07218cbb5?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo>
Covid-19 levels across states. Source: CDC
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.)
<https://substack.com/redirect/e5a81996-5975-4486-b30d-8c07fdba8391?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo>
Source: CDC; Annotated by YLE
In the UK, which always seems slightly ahead of the U.S. in waves,
hospitalizations have
<https://substack.com/redirect/190a9a76-a7ae-4382-95cf-8bbdd4f3e750?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo>peaked
and remained lower than in Winter.
Image
<https://substack.com/redirect/4c15a2bc-2cee-460c-82ac-c10cb4458364?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo>
*We’ve had a wave each summer. Why? *
This is due to the combination of three things:
1.
/*Behavior change*/. People move inside due to the heat, and most
spread happens indoors.
2.
/*Covid-19 keeps mutating quickly—about twice as much as flu. */The
latest variant, KP.3, specifically its descendant KP.3.1.1, is a
little booger because it /dropped/a mutation on the spike protein,
which seems to be effective in getting past our first immunity wall
(called neutralizing antibodies.)
3.
/*Waning immunity. */~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
/mild/Covid-19 winters, like Hawaii and Oregon, summer waves are
/very high/.
<https://substack.com/redirect/8dc7983d-affa-444d-a1ed-335742aed89f?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo>
Source: CDC
<https://substack.com/redirect/095090d4-4da3-4135-ae39-c55b2c1cf183?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo>;
Annotated by YLE
I /am/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.
*Should older people get the vaccine now or wait for fall? *
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 /least/four months between this and the upcoming fall dose,
so that it works best. Last year, the winter Covid-19 wave started in
November.
*How do I read the latest CDC guidance? *
This is the first wave since the updated CDC Covid-19 guidance
<https://substack.com/redirect/bfe30916-97cf-4bad-92b6-8df41cbed7a7?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo>.
As a reminder, if you get infected, CDC recommends approaching isolation
in two phases:
*
/*Phase 1: Stay home when sick */until your fever resolves for 24
hours or your symptoms improve. But many people remain contagious
beyond this timeframe, though, so…
*
/*Phase 2: Use caution*/**for five days by taking additional
precautions (e.g., wear a mask; or test before seeing grandma at the
nursing home).
/But what is the best approach?/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.
<https://substack.com/redirect/b86d8680-11ae-493f-a15d-a92826ef4811?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo>
Figure Source: Nature; Annotated by YLE
*Is anything new happening with Paxlovid?*
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.
Unfortunately, Paxlovid is not as effective as we had hoped for everyone
else. Evidence suggests that it doesn’t protect
<https://substack.com/redirect/dabd449c-48f0-4ac2-a94e-cfc53dcc6bd4?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo>against
long Covid, and it doesn’t decrease the number of days
<https://substack.com/redirect/0c55e300-c245-4388-a314-eb84f063f632?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo>you’re
sick (if you’re up-to-date on vaccines).
*What about airplanes? *
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 every
1-hour increase
<https://substack.com/redirect/99a4909e-7c8b-4f11-b146-71c1c4c595fa?j=eyJ1IjoiYTEzdCJ9.fXnNfjqEHuJb90uhUC5MuKSqDSSONTVxMYyEVAne1uo>in
flight duration, there is an additional 53% risk of infection.
*Bottom line*
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.
Love, YLE
------------------------------------------------------------------------
/“Your 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 a number of organizations,
including CDC. At night, she writes this newsletter. Her main goal is to
“translate” the ever-evolving public health science so that people will
be well-equipped to make evidence-based decisions. This newsletter is
free, thanks to the generous support of fellow YLE community members. To
support this effort, subscribe below: /
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