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"As the government changes continue, I highly recommend Heather Cox-Richardson’s daily newsletter to keep up with what is going on. Christina Pagel is a scientist from the UK who is also doing a great job documenting changes.
Respiratory Viruses
"Overall, respiratory illness activity has decreased to MODERATE across America. Emergency department visits for COVID, Flu and RSV are decreasing, but wastewater levels for Influenza are still MODERATE nationally and Influenza B is quite high still in the Northeast.
From: https://www.cdc.gov/respiratory-viruses/data/index.html
Wastewater SCAN: https://data.wastewaterscan.org/
COVID, RSV, Flu A, Flu B
"Regarding COVID, as of March 10th, there were approximately 310,000 new COVID infections in the US per day and about 1 in every 110 people was currently infected. However, there is variation across our large nation and Mike Hoerger estimated that every 1 in 35 people in Washington DC is currently infected with COVID. It is important to continue masking indoors especially in hot spot areas.
"March 11, 2025 marked the 5th anniversary of the WHO pandemic declaration for COVID. The New York Times presented 30 charts showing “how COVID changed everything in March 2020” including this chart on the unprecedented increase in disability. Long COVID continues to disable more and more people worldwide with many people affected cognitively.
From: https://buff.ly/bV7eRc6
Variants
"LP.8.1 has slowly but surely pushed out XEC as the top SARS-CoV-2 variant. The good news is that the updated 2024-2025 COVID boosters should protect against both LP.8.1 and XEC, but many people’s immunity may have waned since September when this vaccine first came out. Susceptible people including older adults and people who are immunocompromised may want to get another COVID booster.
"This week, Ryan Hisner posted a thread on BlueSky about a new version of BA.3 with 57 amino acid mutations that may or may not cause a new COVID wave. The many mutations happened over time in a chronically infected immunocompromised person and the new mutations could potentially make it more virulent if it adds another mutation or two. Time will tell, but for now scientists are monitoring this new variant.
Acute COVID infections, General COVID info
"A study of 1,035 people with acute COVID shows that people with a common genetic MTHFR variant (homozygous for MTHFR C677T) have higher risk of severe COVID infections and Long COVID. Using genetic testing for the MTHFR gene may help stratify patients for treatment for COVID infection.
From: https://www.medrxiv.org/content/10.1101/2025.02.28.25323089v1.full.pdf
"A group from the Gladstone Institute presented data at the CROI meeting this week showing that the SARS-CoV-2 virus secretes a protein called ORF8 that can reprogram macrophages to help viral spread in lung epithelial cells.
"According to Dr. Lucky Tran, despite the government still having $500 million worth of COVID rapid antigen tests stockpiled, people can no longer order free COVID tests from the government at covidtests.org.
Social and Advocacy
"Therapist Olivia Belknap is offering Pandemic Processing therapy groups to California residents at bit.ly/aprilpandemicprocessing. Potential topics include managing relationships as they relate to COVID, feelings of grief and loss, and self-care.
Pediatrics
"MIS-C is a severe and potentially fatal inflammatory condition that occurs in some children and teens weeks after a SARS-CoV-2 infection. Researchers found that in MIS-C, high levels of TGFβ impaired T cell function allowing Epstein-Barr virus (EBV) to reactivate. Blocking TGFβ restored T cell function and reduced EBV activity, suggesting a possible treatment for MIS-C. EBV is the virus that causes mononucleosis (glandular fever) and is implicated in Multiple Sclerosis and now MIS-C.
Antiviral treatments
"At the CROI Conference this week, Shionogi presented data showing that their antiviral drug Ensitrelvir can be used for post-exposure prophylaxis to prevent COVID infection. They showed “a 67% reduction in the risk of developing COVID-19 in uninfected individuals treated after exposure” with Ensitrelvir.
"Researchers at Stanford developed bispecific antibodies that target both the N-terminal domain (NTD) and receptor binding domain (RBD) of the SARS-CoV-2 spike protein. These antibodies were able to neutralize different SARS-CoV-2 variants by binding to regions that are distinct from the spike protein. The dual or bispecific antibodies, called CoV2-biRN, were able to effectively neutralize all SARS-CoV-2 variants.
"Bispecific antibodies target two areas of the virus: One attaches to the “NTD,” or Spike N-terminal domain, an area on the virus that does not change very much. This allows the second antibody to attach to the “RBD,” or receptor-binding domain, essentially preventing the virus from infecting human cells.
From: https://news.stanford.edu/stories/2025/03/new-antibodies-show-potential-to-defeat-all-sars-cov-2-variants
Long COVID
"March 15th was Long COVID Awareness Day. Many people on social media reflected on this disabling disease. Here are some facts about Long COVID from the Patient-Led Research Collaborative:
From: https://patientresearchcovid19.com/2025-long-covid-fact-sheet/
"Researchers from Catalonia, Spain followed 2764 people who became infected with COVID and found that 23% of adults developed Long COVID, with 1 in 8 adults (13%) still experiencing symptoms for up to two years. Long COVID manifested in three subtypes: mild neuromuscular, mild respiratory, and severe multi-organ, with the latter linked to persistent symptoms. Higher risk for Long COVID was linked to females, severe acute COVID infections, obesity and other conditions. Protective factors for Long COVID included vaccination, infection after the Omicron variant became dominant, and adequate sleep.
"A National Academies of Sciences, Engineering, and Medicine (NASEM) group wrote an article that included the NASEM definition for Long COVID and other pearls for clinicians to help identify patients with Long COVID.
NASEM definition: Long COVID is “an infection-associated chronic condition (IACC) occurring after SARS-CoV-2 infection that is present for at least 3 months as a continuous, relapsing and remitting, or progressive disease state that can present as singular or multiple symptoms and/or diagnosable conditions.”
From: https://link.springer.com/article/10.1007/s11606-025-09415-8/figures/1
"In France, 63,990 people who were hospitalized with COVID were matched to 319,891 controls from the general population and were followed for 30 months. People who had been hospitalized for COVID were more likely to be rehospitalized for cardiovascular, psychiatric, neurological, and respiratory events. Although risk decreased significantly after the first 6 months, people who had been hospitalized for COVID also had a significant increase in Type 2 Diabetes, chronic renal failure, respiratory and neurological disorders for up to 30 months after infection. These findings support prior data from Ziyad Al-Aly and colleagues.
"In a study of 609 men with a median age of 48 years in Japan who were hospitalized with acute COVID infection, 1 in 5 men (19%) had Erectile Dysfunction (ED) at 1 and 2 years post COVID infection.
"An observational study of 977 Long COVID patients revealed that 55% experienced neuropathic symptoms, with small fiber neuropathy confirmed in 57% of those tested via skin biopsy. Notably, 25% of patients with Long COVID neuropathy had detectable anti-ganglioside antibodies (AGAs), suggesting an autoimmune component. In a pilot treatment cohort, intravenous immunoglobulin (IVIG) therapy led to improvement in neuropathic symptoms, indicating potential benefits of immunomodulation for Long COVID neuropathy patients.
"Researchers from Iowa have created the Long COVID Iowa-UNICAMP dataset (LongCIU), comprising 90 axial CT slices with detailed manual segmentations of lung opacities and consolidations. This dataset aims to enhance the understanding and analysis of lung abnormalities associated with Long COVID.
POTS after COVID infection
"A group in China treated 31 patients postural orthostatic tachycardia syndrome (POTS) following COVID infection with vagus nerve stimulation of the tragus nerve via ear clip for 1 hour twice daily for a month. Low-level tragus stimulation (LL-TS) significantly reduced heart rate increases upon standing, improved heart rate variability, and decreased neuropeptide Y levels in POTS patients, with effects persisting for up to one year.
ME/CFS
"Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), Gulf War Syndrome and Fibromyalgia are complex illnesses with different triggers that share overlapping clinical symptoms including severe fatigue, as well as disruptions in metabolism, immune function, and brain activity. The SARS-CoV-2 pandemic has led to a significant rise in ME/CFS cases, highlighting the urgent need for research into biomarkers and key metabolic pathways. In a new review, authors advocate for international collaboration to improve understanding of these conditions, develop effective treatments, and lessen their impact.
"A study from Georgetown shows that ME/CFS patients have elevated serine and reduced 5-methyltetrahydrofolate (5MTHF) in their cerebrospinal fluid. “Serine is a precursor of phospholipids and sphingomyelins that were also elevated in ME/CFS.” These CSF abnormalities worsened after exercise, unlike healthy controls.
H5N1
"On February 28th, the CDC updated the risk of H5N1 Avian Flu to people who work with poultry and dairy cattle to a Moderate to High risk. The risk to the general population is still low.
Measles
"A Measles outbreak continues to spread in Texas and in bordering New Mexico and Oklahoma. As of Friday, there have been more Measles cases in the United States reported in the first 3 months of 2025 than in all of 2024. This week, Health and Human Services Secretary Kennedy recommended cod liver oil and vitamin A to treat the Measles. While vitamin A is given to some hospitalized children with measles, vitamin A does not prevent the Measles and in addition, large doses of vitamin A can be toxic. Only the MMR vaccine can help prevent the Measles (and Mumps and Rubella).
"Kennedy was interviewed in a fast food restaurant by Fox News this week and said, "There are adverse events from the vaccine. It does cause deaths every year. It causes all the illnesses that measles itself cause." This is not true.
"Unfortunately this week, the NIH also cut all research grants on vaccine hesitancy- studying why people decide not to get vaccines. It seems like the stage is being set.
CDC: US Measles cases as of 3/13/25
From: https://abcnews.go.com/Health/video/measles-cases-grow-rfk-jr-makes-controversial-claims-119830333
Adapted from https://www.cdc.gov/measles/data-research/
"This week, a pregnant woman with Measles gave birth in a hospital in Lubbock, Texas and exposed other pregnant individuals and newborn babies unknowingly. Newborn babies who cannot be vaccinated were given immunoglobulins (IVIG). “Each dose of IVIG is made from the pooled plasma of 3,000 to 10,000 blood donors which is purified to contain more than 90% antibodies.”
"It is important to remember that Measles has a very long incubation period of 7 to 14 days (and even up to 21 days in some) after transmission before a person starts to feel symptoms. So, people can be infectious for a while without knowing. Also, the Measles virus can live on surfaces or in the air for up to two hours after an infected person leaves a room. The MMR vaccine protects 97% of people against getting Measles.
"As of Friday, there have been 259 Measles cases in Texas with 34 requiring hospitalization for the disease and 1 death in a healthy child. The child who died was 6 years old and was unvaccinated. Her father Peter was interviewed in a well-written and very sad article in The Atlantic:
“The death of his daughter, Peter told me, was God’s will. God created measles. God allowed the disease to take his daughter’s life. “Everybody has to die,” he said. Peter’s eyes closed, and he struggled to continue talking. “It’s very hard, very hard,” he said at last. “It’s a big hole.”
"Because of changing risks of Measles in America, a third dose of the MMR vaccine is being recommended for high risk groups including health care workers according to a new article in JAMA. Since the MMR vaccine is a live-attenuated vaccine, immunocompromised people should check with their doctor before being vaccinated however. The committee recommends an extra dose for babies age 6 to 11 months before travelling internationally.
Norovirus
"Norovirus is a common cause of vomiting and diarrhea (stomach flu). Norovirus continues to be HIGH in wastewater across the United States in all regions. There has been a downward trend over the last 3 weeks.
From: data.wastewaterscan.org
Lyme Disease
"Lyme disease can actually cause long-term infections in the female reproductive tract, as shown in a mouse model where infected mice developed uterine cysts, endometrial hyperplasia, and vaginal tissue damage lasting up to 15 months. In humans, Lyme disease was linked to a higher risk of gynecological conditions, including menorrhagia (1.5x), miscarriage (1.62x), uterine fibroids (1.42x), and endometriosis (1.93x). These findings suggest that Lyme Disease related reproductive health issues may be underrecognized and that treatment is important.
Other news
The WHO offers an online app called HearWHO to check your hearing.
Starting March 28, anything that you say to your Echo will be sent to Amazon.
Specific microbial ratio in the gut microbiome is associated with Multiple Sclerosis
Original article in Nature: Prohormone cleavage prediction uncovers a non-incretin anti-obesity peptide
"At the end of this month, I will be going to my all time favorite conference called NextMed at the Hotel del Coronado near San Diego. If you enjoy learning about cutting-edge innovation in healthcare and medicine, consider joining us.
"Last weekend, I was fortunate enough to go to Pacific Grove. It was really nice to take a breather and enjoy the beauty of nature and the California coast.
"Have a good week,
"Ruth Ann Crystal MD"
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