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"As the weather gets warmer and people are starting to spend more time outdoors, respiratory illnesses like COVID and the Flu are decreasing.
Respiratory Viruses
"Overall, respiratory illness activity has decreased to LOW levels across the United States. Emergency department visits for COVID, Flu and RSV are decreasing, but wastewater levels for Influenza are still MODERATE nationally and Influenza B remains very high in the Northeast. Of note, the Northeast and Midwest continue to have high levels of Norovirus which causes the stomach flu.
From: https://www.cdc.gov/respiratory-viruses/data/index.html
Regional levels of various viruses in wastewater:

From: Wastewater SCAN: https://data.wastewaterscan.org/
"Regarding COVID, 1 in 128 people is actively infectious now with SARS-CoV-2 nationally. According to Mike Hoerger, there are higher rates of COVID in the South including Oklahoma and in Washington DC. He expects that we will have between 300,000 to 500,000 daily COVID infections in America over the next few weeks. Variant data will update next Friday, but last week LP.8.1 was 47% and XEC 26% of COVID cases in the U.S.
"Friday, the CDC reported SARS-CoV-2 wastewater levels as MODERATE nationally because the South is in the HIGH range again. SARS-CoV-2 levels are LOW for most of the Bay Area now. In Santa Clara County, COVID levels and Flu A have decreased, but Influenza B levels are still high.
California and the Pandemic
"The Mercury News came out with some interesting statistics regarding the long term effects of the pandemic on California. Monthly deaths in California from all causes remains higher than pre-pandemic averages. UC Berkeley Professor John Swartzberg commented that “COVID caused a lot of premature deaths from heart attacks. Also the disruption had effects on the populace that were deleterious to its health: increased alcohol consumption, decreased activity, depression.”
"The California unemployment rate spiked to 16% in 2020 and then returned to pre-pandemic levels around 4% after two years. BART ridership is about 40% of what it was pre-pandemic as more people work from home. Bay Bridge use, however, is back to about 90% of pre-pandemic numbers.
"Testing for school achievement in California went from 51% of the expected standard for the English language pre-pandemic which was already low, to an even lower 47% of expected standards now. Math scores which were at 40% of expected standard pre-pandemic are now at only 35.5% of expected standards for math in California schools overall.
From: https://buff.ly/DAV83cx
COVID and Pregnancy
"A group from the University of Michigan presented a case of SARS-CoV-2 placentitis with a review of the literature. Placentitis happens when SARS-CoV-2 infects the placenta's syncytiotrophoblasts, disrupting placental function and leading to fetal complications including stillbirth, spontaneous abortion, and preterm delivery, even in asymptomatic COVID infections. Diagnosis relies on identifying a specific pattern of placental damage—chronic histiocytic intervillositis, perivillous fibrin deposition, and trophoblast necrosis—while immunohistochemistry and RNA in situ hybridization confirm the presence of the virus.
Pediatrics
"A newsletter written by children and young adults with Long COVID called The Long Covid Chronic-ill just posted its first issue.
"Families in Britain are struggling financially and emotionally as they try to support their children suffering from Long COVID, which has left many children bedridden and unable to attend school. With limited public healthcare options, parents are forced to quit jobs, go into debt, and seek costly private treatments. "My savings have long gone. I'm maxed out on my overdraft and have debts," said mother Louise.
Long COVID
"A study from January 2025 shows that "Long COVID could be costing the U.S. between $2 billion and $6.5 billion annually. The authors concluded "The current health and economic burden of long COVID may already exceed that of a number of other chronic diseases and will continue to grow each year as COVID-19 cases increase. This could be a significant drain on businesses, third-party payers, the healthcare system, and society."
"By analyzing NHS England survey data, a group from the University of Southampton found that about one in ten (9.1%) of people in England are unsure if they have Long Covid, while 4.8% report certainty about having the condition, with higher rates among socially disadvantaged groups. Researchers highlight the need for increased awareness, diagnosis, and support, as Long Covid continues to impact individuals, families, and society, contributing to existing health inequalities.
"In a proof-of-concept study, people with cognitive impairment in Long COVID were found to have asymmetrical glymphatic dysfunction in the left hemisphere of the brain which also correlated with disruption of the blood-brain barrier (BBB). A group from Thomas Jefferson University used special MRI techniques to assess perivascular spaces in the brain of 14 individuals with Long COVID compared to 10 healthy controls. A significant reduction in the DTI-ALPS index—a measure of glymphatic function—in the left hemisphere of Long COVID patients was found, indicating impaired waste clearance in the brain. Additionally, there was a strong inverse correlation between BBB permeability and glymphatic function, suggesting that both factors may contribute to neurocognitive impairment in Long COVID patients.
The left hemisphere is more affected. From: https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-025-04133-4/figures/4
"Research suggests that Long COVID may affect the brain's auditory processing, leading to slower nerve signal transmission in the midbrain, similar to what is seen in aging. People with Long COVID also experience more tinnitus, anxiety, depression, and cognitive fatigue than healthy individuals. A new study from Dartmouth shows that auditory tests, like the Auditory Brainstem Response (ABR) that measure the brain’s response to sound, could serve as objective measures to help assess cognitive fatigue in Long COVID patients.
"Visuoconstructive deficit (VCD) is a cognitive impairment that affects a person's ability to perceive, organize, and accurately reproduce visual information. It impacts tasks requiring spatial processing and motor coordination, such as drawing, copying geometric figures, assembling objects, or navigating spaces. VCD is often associated with neurological conditions like stroke, traumatic brain injury, dementia, and, as recent studies suggest, Long COVID, where it may be linked to neuroinflammation and structural brain changes.
"A new study explores Vitamin B12 as an epidrug to regulate inflammatory biomarkers in Long COVID patients with persistent visuoconstructive deficit (VCD). Researchers found that individuals with VCD had elevated CCL11, a chemokine linked to neurodegeneration, but supplementation with Vitamin B12 normalized its expression and increased neuroprotective HGF levels. These findings suggest that Vitamin B12 may help mitigate neuroinflammation in Long COVID by modulating gene expression through methylation, offering a potential therapeutic approach for cognitive impairment.
Graphical abstract
From: https://www.nature.com/articles/s41598-025-86637-0
"An excellent review of 29 studies (through January 2024) explores the omics-based landscape of Long COVID, analyzing genomics, transcriptomics, proteomics, metabolomics, and metagenomics to understand the underlying pathophysiology and identify biomarkers and treatment targets. The review shows that Long COVID affects multiple organ systems, with key findings including mitochondrial dysfunction, immune dysregulation, blood–brain barrier disruption, coagulopathy, and microbiome disturbances. Despite the heterogeneity of studies, the review highlights the need for integrated, longitudinal research to develop precision medicine approaches for diagnosing and treating Long COVID.
Figure 2:
Omics layers included in this systematic review include the totality of biomolecules that they measure in a biological sample.
From: https://onlinelibrary.wiley.com/doi/10.1111/all.16526
Figure 4: Treatable traits in Long COVID stratified by phenotype.
From: https://onlinelibrary.wiley.com/doi/10.1111/all.16526
"A study from Italy found that women with endometriosis or adenomyosis are significantly more likely to experience Long COVID compared to those without these conditions. Patients with endometriosis or adenomyosis had higher rates of persistent symptoms like chest pain and loss of taste beyond 12 weeks. The findings suggest that pre-existing immune dysregulation and inflammation in endometriosis and adenomyosis may contribute to prolonged symptoms after acute COVID infection. Further research is needed to explore the connection between chronic inflammatory diseases and Long COVID.
"Another study examined the prevalence and impact of Long COVID nearly two years after initial infection in a Michigan-based cohort. Among 1,547 respondents, 24% reported ongoing Long COVID symptoms, which were strongly associated with increased disability in cognition, mobility, independent living, self-care, vision, and hearing. The findings highlight the significant and lasting burden of Long COVID.
“Pulmonary Rehabilitation (PR) was initially developed to manage chronic obstructive pulmonary disease (COPD), but clinicians around the world have used it to help patients who experience persistent respiratory symptoms after COVID-19 infections, including shortness of breath and exercise intolerance.” A meta-analysis of 37 randomized controlled trials, including 22 trials of patients hospitalized with COVID, shows that pulmonary rehabilitation can improve lung function in Long COVID after 4 to 8 weeks of therapy.
H5N1
"H5N1 and H7N9 are both highly pathogenic avian influenza (HPAI) viruses. This week it was reported that chickens on a Mississippi farm became sick with the H7N9 strain of bird flu. People who get H7N9 Avian flu can become very sick, although mortality from H7N9 may be lower than for the H5N1 Bird flu strain. H7N9 can spread from human-to-human and tends to spread quickly which increases the risk of it mutating. For now, the affected birds were culled and the situation is being monitored.
"A study from Cornell University found that the H5N1 bird flu virus can remain infectious in raw milk cheese for months, raising public health concerns. While pasteurization effectively inactivates the virus, the traditional 60-day aging process for raw milk cheese does not eliminate the risk, highlighting the need for stricter surveillance and caution when consuming unpasteurized dairy products.
"The CDC confirmed the first known human case of H5N1 avian flu in the U.S. involving the D1.3 genotype in an Ohio poultry worker, though genetic analysis did not reveal markers for increased mammalian adaptation or antiviral resistance. Meanwhile, serology testing ruled out human-to-human transmission in a San Francisco child’s H5N1 case, reinforcing that no such spread has been detected in the United States. In response to ongoing outbreaks, the USDA announced up to $100 million in funding for avian flu research, including vaccine development, while confirming new poultry infections in four states.
Measles
"As of Friday March 21, the CDC reported 378 Measles cases in America in 2025 with 95% of cases seen in unvaccinated people. Hospitalization was needed for 17% (64 of 378) of cases for complications such as Measles pneumonia and there have been 2 deaths in 2025 related to Measles.
"As of 3/21/25, Texas reported 309 Measles cases, 40 hospitalized, and one fatality in an unvaccinated school-aged child. Sadly, anti-vaccine activists have exploited the tragic death of a 6-year-old from measles, reframing it as evidence against vaccines rather than a warning about the dangers of the disease.
"Quoted from NBC News:
“The child’s grieving parents have given just one on-camera interview, to Children’s Health Defense, the anti-vaccine nonprofit group founded and led until recently by Robert F. Kennedy Jr., now the health and human services secretary. In a video that aired online Monday, the young parents stifled sobs, recalling how their unvaccinated daughter got sick from measles, then pneumonia, how she was hospitalized and put on a ventilator, and how she died.
“Don’t do the shots,” the girl’s mother said. Measles, she added, is “not as bad as they’re making it out to be.” She noted that her four other children all recovered after having received alternative treatments from an anti-vaccine doctor, including cod liver oil, a source of vitamin A, and budesonide, an inhaled steroid usually used for asthma.
“Also, the measles are good for the body,” the girl’s father said.”
Other news
mRNA Vaccines
"Less than two years ago, Katalin Kariko and Drew Weissman were awarded the Nobel Prize for mRNA vaccines against COVID-19. This week, “NIH acting Director Matthew Memoli sent an email across the NIH instructing that any grants, contracts, or collaborations involving mRNA vaccines be reported
up the chain to Health and Human Services Secretary Robert F. Kennedy
Jr.’s office and the White House. Memoli sent a similar message ahead of
the agency canceling other research, including studies on vaccine
hesitancy.” As Eric Topol posted,
this is a threat to “one of the most important advances in
biotechnology of our time [mRNA vaccines], already being used to
successfully treat refractory cancers, enable genome editing, develop
vaccines for infectious diseases for which there are none, treat
autoimmune diseases, and more.”
"Katelyn Jetelina and Andrea Tamayo wrote an excellent article this week entitled, “Vaccines don’t cause Autism. So what does?” They reviewed "over 25 epidemiological studies, including a fantastic 2019 analysis of more than 600,000 children in Denmark" proving that vaccines do not cause autism. They said that the autism community is unhappy about being used as a reason to avoid vaccination and that wasting money on another vaccine study takes away research money that could be used to discover the true causes of autism.
"In a placebo controlled trial in JAMA, children between 28 days and 4 years of age with a fever (≥38.5 °C) and Upper Respiratory Tract Infection (URTI) were given daily single dose of 0.5 mL probiotic mixture containing Bifidobacterium breve M-16V, Bifidobacterium lactis HN019, and Lactobacillus rhamnosus HN001 for 14 days. Young children who received the probiotics had 2 days less of fever than those on placebo.
"Lean Cuisine and Stouffer's recalled the following meals with expiration dates between September 2025 and April 2026 for 'wood-like material' linked to choking:
Lean Cuisine Butternut Squash Ravioli,
Lean Cuisine Spinach Artichoke Ravioli,
Lean Cuisine Lemon Garlic Shrimp Stir Fry
Stouffer’s Party Size Chicken Lasagna.
"A group from France used hybridoma technology to improve the process of making monoclonal antibodies (mAbs). By using a method called fluorescence-activated cell sorting (FACS) to select the best ASCs from immunized mice, researchers increased the success rate of cell fusion to 100% and produced more effective antibodies, making the process faster and more efficient for medical treatments and research.
"There was a really interesting, albeit long, article in the Washington Post about Heather Stone, an FDA worker who started CURE ID to help doctors find new treatments and cures for rare diseases. The information posted on CURE ID helped to save the life of a little girl who had an unusual amoeba infection called Balamuthia. CURE ID is also documenting possible treatments for Long COVID.
"Obeldesivir is an oral form of the antiviral medication Remdesivir. A new study shows that giving oral Obeldesivir (ODV) to non-human primates gave 100% protection to rhesus macaques and 80% to cynomolgus macaques against a lethal dose of Ebola when given 24 hours after exposure. ODV may potentially be used in the future as “an oral postexposure prophylaxis with broad spectrum activity across filoviruses” such as Ebola and the Marburg virus.
"96 year old Bill Tallyn rides his bike every day around his RV park delivering treats to over 50 dogs and cats. His human neighbors and his canine and feline neighbors all love Bill.
From: https://www.abc15.com/news/uplifting-arizona/watch-mesa-man-delivers-smiles-and-wagging-tails-one-treat-at-a-time
"I’ll be taking next week off from the newsletter.
"Have a great week,
Ruth Ann Crystal MD"










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