Thursday, April 30, 2026

It's Not 'Mental Illness'. It's Deliberate Anti-Jewish Violence - To Kill Us.

I'm so sick and tired of hearing the usual excuses. These attacks on the Jewish people are by people who want to kill us, thanks to the continual anti-Jewish/anti-Israel rhetoric and actions.  This is how the Holocaust started, with attacks on property, synagogues, and individuals.

Just as the constant anti-Trump rhetoric has resulted in assassination attempts against Donald Trump, so has the anti-Israel vitriol (and even the 10/7  massacre of Israelis) resulted in attacks and killings against Jews. Both things are always downplayed  and excused away, with more sympathy for the attackers than for the victims. Even after Bondi Beach, nothing has changed.

Wake up before it's too late.

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Here's Brendan O'Neill at Spiked 4-30-26:

Anti-Zionism is a menace to every Jew on Earth. The stabbing in Golders Green was a violent expression of the transatlantic ideology of Israelophobia. 

and read about this frightening antisemitic attack of a Jewish man in Los Angeles:

‘Thought it was end of my life,’ says Jewish man attacked near Los Angeles synagogue
“People shouldn’t think that, ‘Oh this is not going to happen to me,’” the 32-year-old Judaic studies teacher told JNS. “It can happen to anyone walking the streets, anyone with their groceries.”

By Aaron Bandler at JNS, Apr. 29, 2026

A 32-year-old Jewish man, who was attacked on Monday evening near left Adas Torah, an Orthodox synagogue in Los Angeles, told JNS that his life flashed before his eyes.

“I don’t know if he said the words, ‘I want to kill you,’ but his facial expression and his attitude definitely gave that message,” said the victim, who spoke to JNS on the condition that he not be named. “I thought it was the end of my life.”

The victim, who said he is a Judaic studies teacher and “just a regular person,” told JNS that “I never would have thought such an incident would happen to me.”

After studying at Merkaz Hatorah Community Kollel, around the corner from the synagogue, on Monday evening, he walked home through an alleyway, as he has done for the past five years, and noticed a blue minivan following slowly beside him. He said he was wearing a kippah at the time.

He made a “Hey, how are you” facial expression toward the driver, whom he described as a black man. The driver made the same expression in response, the victim told JNS.

“All of a sudden, he just opens the door,” he said. “I don’t know what he was saying. He pounced me, immediately put his hands over my neck, shaking me back and forth, trying to choke me.”

The man used “a window breaker or window chiseler, I don’t know what you call it” as “a weapon as he was choking me against my neck,” the victim told JNS.

“He pinned me to the corner, and I don’t even know how, I just see I’m rolling on the floor, and as I’m vulnerable on the floor,” the victim said. “He gives me a stare and he says, ‘free Palestine’ and he goes back to his car.”

“I just ran back to safety, try to find a friend in the kollel, go into his car and call the cops from there,” he told JNS. He added that since the attack, it has been “definitely harder to walk alone.”

“You take your regular daily walk for granted, which you think should be fine and safe,” he said. “Now it’s a little bit hard to walk to shul.”

He added that the incident shows that “this can happen to anybody.”

“People shouldn’t think that, ‘Oh this is not going to happen to me,’” the victim told JNS. “It can happen to anyone walking the streets, anyone with their groceries, anyone. Anyone going anywhere.”

The incident has made the victim more motivated to be “100 times more effective” in teaching the next Jewish generation on “what it means to be Jewish” and “how we should always be proud to be Jewish,” he told JNS.

Ron Galperin, interim Los Angeles regional director at the American Jewish Committee, told JNS that “we are outraged by the reports of an assault Monday night near Adas Torah Synagogue in the Pico-Robertson neighborhood.”

“While facts are still emerging, the details known so far are deeply concerning,” he said. “From what we’ve learned so far, this attack was not an isolated act of violence. It reflects a troubling pattern: the normalization of antisemitic behavior in our communities. No one should be targeted or attacked because they are Jewish. Period.”

The attack occurred in the district of Katy Yaroslavsky, a member of the Los Angeles City Council and a Democrat, who is Jewish.

“Last night, an individual assaulted a man leaving Adas Torah Synagogue in Pico-Robertson. According to preliminary information, the suspect approached the victim, attacked him and fled the scene while shouting antisemitic remarks,” she told JNS. “The victim received medical attention and is recovering. LAPD has informed our office that this is being investigated as a hate crime.”

“Hate incidents and hate crimes in Los Angeles have increased significantly over the past several years. When hate speech targeting Jewish communities increases and becomes normalized, violence against our community follows,” Yaroslavsky told JNS. “This pattern has existed for thousands of years, and we need to call it out directly for what it is. Antisemitism has no place in Los Angeles, and I call on my colleagues and fellow community leaders to condemn this violence, protect the freedom to worship and stand with Jewish Angelenos.”

This Nasal Spray Helps With COVID Symptoms

This is good to know!  I looked it up and discovered that the nasal spray azelastine is sold at CVS as Astepro for under $25.00.

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Prevention Magazine, 4-29-26 

Scientists Say This Surprising OTC Medication Lowers Your Risk of COVID. It may shorten how long you’re sick, too. 

  • The over-the-counter nasal spray azelastine may reduce your risk of COVID-19, according to one study.
  • Azelastine may also shorten how long you’re sick and reduce your risk of other viruses like the common cold.
  • Doctors explain how it works, plus whether you should try it during COVID season.

While staying up to date with your vaccines, regular hand-washing, and avoiding crowds or wearing a mask in crowded settings can all help protect you from viruses like COVID-19, scientists continue to look for other strategies and treatments that can help keep you healthy. One study, for instance, found a surprising link between the nasal spray azelastine and COVID risk. Read on to discover what the researchers found, plus how to apply their findings to your healthy routine.

According to a phase 2 clinical trial published in JAMA, using azelastine (an antihistamine nasal spray used to treat allergy symptoms and sold under the brand name Astepro Allergy) may help fend off COVID-19 and the common cold. For the randomized, double-blind, placebo-controlled study, researchers recruited 450 healthy volunteers in Germany. Of those, more than 99% had received the COVID-19 vaccine at least once.

The participants were split into two groups: One used an azelastine nasal spray in each nostril at least three times a day for about 56 days. The other used a placebo spray. Everyone was tested for COVID-19 twice a week.

The researchers discovered that people in the azelastine group were about three times less likely to contract COVID-19 compared to those in the placebo group. Ultimately, just five people in the azelastine group (or 2.2%) tested positive for the virus, while 15 (6.7%) tested positive in the placebo group. People in the azelastine group also had a positive test for less time than their placebo-using counterparts (3.4 days compared to 5.14 days).

It doesn’t stop there: People in the azelastine group were also less likely to get any type of virus, including the common cold. The researchers discovered that only 8.4% of people in the azelastine group contracted a virus compared to 18.8% in the placebo group. The azelastine users reported only being sick for 1.73 days compared to 2.75 days in the placebo group.

Those are some pretty impressive findings, and it’s not the only data to suggest that azelastine may help lower your risk of getting sick. While doctors say azelastine may be a promising option to lower your risk of COVID, they want you to keep a few things in mind before running to your local pharmacy to stock up.

How does azelastine help prevent COVID and the common cold?

This study simply found a connection between using azelastine and a lowered risk of getting COVID-19 and other viruses—it didn’t determine an exact reason for this. But doctors say there could be a few things behind this.

For allergies, azelastine works by blocking histamine, a substance in the body that causes allergy symptoms, explained Jamie Alan, Pharm.D., Ph.D., an associate professor of pharmacology and toxicology at Michigan State University. “This is an antihistamine similar to Claritin or Zyrtec,” she said. “Azelastine is found typically in nasal sprays and eye drops.”

Azelastine also interferes with the function of proteins in viruses, making them less likely to be able to infect you, said Amesh A. Adalja, M.D., an assistant professor at the Johns Hopkins Bloomberg School of Public Health.

It seems to be able to inhibit the H2 receptor—a type of histamine receptor—which may impact how well a virus is able to get into your cells, explained Thomas Russo, M.D., a professor and chief of infectious diseases at the University at Buffalo in New York. “It appears to block viral attachments and maybe even moderate the immune response,” he said.

Inflammation may be a factor, too, Alan said. “I hypothesize that by using a nasal antihistamine, it would reduce the local response in the upper respiratory system, and therefore would reduce the local inflammation,” she said. “By reducing the local inflammation, it would be theoretically harder for a virus to attach and infect the upper respiratory system.”

Azelastine was first explored as a potential treatment for COVID-19 earlier on in the pandemic. There is some research to suggest azelastine may bind to a receptor that SARS-CoV-2 uses to access your cells, and it also may reduce viral load in your nasal passages. There’s other datato suggest that azelastine may also work against other viruses, including RSV and the flu.

Potential side effects of azelastine

While azelastine is considered a safe medication and is designed for long-term use, it comes with a risk of potential side effects. According to the National Library of Medicine, those may include:

  • Bitter taste
  • Nasal burning, pain, or discomfort
  • Sneezing, runny nose
  • Headache
  • Sore throat
  • Dry mouth
  • Nosebleeds
  • Dizziness
  • Nausea
  • Tiredness

Participants in both groups had side effects, but they were more common in the azelastine group. Those included bitter taste, nosebleeds (not many, but in 6.6% of the azelastine group compared to 4% of the placebo group), and fatigue.

Should you use azelastine to help lower your risk of COVID?

Doctors agree that azelastine may be helpful in lowering your risk of COVID—but more research is needed. “This is a phase 2 clinical trial, so the intervention will need more study before it can be confirmed as an effective prophylactic,” Dr. Adalja said.

But azelastine “does seem to have some antiviral properties,” said William Schaffner, M.D., an infectious disease specialist and professor at the Vanderbilt University School of Medicine. “Who knows? You might reduce your risk of RSV and influenza as well,” he said. “There seems to be no risk to using the medications.”

Alan agreed, noting that there’s likely no harm to using azelastine as long as you’re not allergic to any of the ingredients in the nasal spray.

But Dr. Russo pointed out that it’s tricky to use a nasal spray several times a day. “The data suggest that if you use this three to five times a day, it may be similar to decreasing the likelihood of contracting COVID as getting the vaccine,” he said. “But it’s really hard to take a medication once a day, let alone five times a day.” For many people, it’s ultimately easier—and cheaper—to just get the vaccine, he said.

Dr. Schaffner agreed. “Getting people to be compliant with this over the entire COVID season is substantial,” he said.

That said, Dr. Russo noted that there may be some benefit in using azelastine before a big event. “You may think, ‘I’m going to a wedding and it’s going to be a high-risk situation.’ So, you might start taking this a few days beforehand and a few days afterward as extra protection,” he said.

As there’s no data comparing azelastine to more traditional methods of preventing COVID-19, like getting the vaccine and wearing masks, doctors recommend doing those first. “This should not be a substitute for vaccination,” Dr. Schaffner said.

Dr. Adalja agreed. “In the best-case scenario, it will likely have a complementary role to vaccines—especially if shown to block infection, which vaccines against COVID are not able to do durably—and possibly provide protection against viruses for which there are no vaccines,” he said. But ultimately, doctors say that more research is needed first.

Wednesday, April 29, 2026

Advice From A Security Expert On How To Protect Our President

Patrick J. Brosnan is a former NYPD detective and founder of Brosnan Risk Consultants, the nation’s largest privately held security company. This article is from the 4-27-26 New York Post:

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How Trump's protectors are failing him over and over again -- and will get him killed unless we act now

Patrick J. Brosnan 

In my four decades protecting lives — from the streets of the South Bronx as an NYPD detective in the robbery and gun squads to building and leading a powerhouse security company — I have never seen a more alarming pattern of incompetence.

In the past 22 months, four documented assassination attempts have been made against President Trump.  

My experience growing Brosnan Risk Consultants from a one-man basement operation into a firm deploying over 7,000 elite security professionals across 43 states has sharpened my ability to spot the micro-gaps, systemic breakdowns and unforgivable lapses that others overlook.

And I’ve been physically present at every one of those four would-be assassination locations.

I’ve walked the rooftops, scoured the perimeters and tested the protocols myself.

What I’ve found is not just failure, but an alarming level of negligence that will get the president killed unless we act now.

On July 13, 2024, in Butler, Pa., Thomas Matthew Crooks exploited catastrophic failures in communication, coordination, command and control.

Local, state and federal agencies collapsed at the most basic level.

The shooter was the only person who thought to put a drone in the air that day: Incredibly, none of the multiple agencies on scene did.

With readily available counter-drone technology, integrated with ironclad security protocols and real-time command, Crooks would have been identified and neutralized long before he climbed atop Building 6 and fired.

Two months later, on Sept. 15, 2024, Ryan Wesley Routh hid in the bushes at Trump International Golf Course with an automatic weapon for nearly 12 hours.

Twelve hours — when a simple canine patrol would’ve identified him in minutes.

The complete absence of proactive, layered detection assets at that golf course was inexcusable, and nearly fatal.

On Feb. 22 of this year, Austin Tucker Martin tried to breach the North Gate at Mar-a-Lago armed with a shotgun and a gas can.

I have personally ridden my motorcycle through that exact gate more than 100 times, so I saw it in action: It was a legacy, heavy gate with a slow cycle that took up to 60 seconds to close.

Any competent security plan would have ensured that gate would snap shut almost instantly, like a mousetrap, when a threat was spotted, eliminating the window for penetration.

The danger was identified after the February breach and was quickly corrected, now replaced by an updated gate that closes lightning fast.

This is what intelligent security planning requires — constant reassessment — because the Winter White House cannot be protected with half-measures.

Then came Saturday’s attempt at the White House Correspondents’ Dinner, when Cole Tomas Allen allegedly sprinted through the magnetometer with multiple weapons and shot a Secret Service officer en route to the International Ballroom as the event got underway.

Plainclothes and uniformed officers positioned strategically in the Hilton Hotel’s lobby would have dropped him cold before he ever reached the checkpoint.

Moreover, magnetometers should have been mandatory at the hotel’s Connecticut Avenue entrance for the duration of the event.

This 1,107-room Hilton — potentially packed with 2,000 or more guests and 2,500 attendees — required full choke-and-funnel screening: metal detectors, bag searches and ID checks for everyone, hotel guests included.  

Even then, a second magnetometer checkpoint was essential outside the ballroom, with armed officers at the escalator base, staircases and throughout the lobby.

Yet such basic layered security measures were ignored.

These attempts on Trump’s life were not random acts of God.

And the near misses were the predictable result of outdated thinking, weak technology, fragmented command and personnel who lack the elite training and battlefield mindset required for this threat level.

After a lifetime spent building systems that close every micro-gap, I know what works: seamless integration of the best and brightest — former Delta Force, Navy SEALs, Army Rangers, top law enforcement — paired with world-class canines, counter-drone capability, rapid-response protocols and zero tolerance for slow gates or blind spots.

We are running out of time.

We must immediately get smarter — demanding truly comprehensive, ironclad security built by top professionals — or we’ll see attempts like these again and again.

Sooner or later, one will succeed, and someone will kill the president of the United States.

The American people deserve better. Trump does, too.

No previous president has had so many confirmed attempts on his life.

What worked for Jimmy Carter clearly doesn’t work for Donald Trump.

Different world, different rules: The US Secret Service’s entire playbook — from protocol and policy to procedures and staffing — must undergo a total overhaul.

We need the highest level of protection this nation can provide before the next attempt on Trump becomes the final one.

Your Local Epidemiologist 4-29-26

This newsletter was written by Kristen Panthagani, MD PhD, who is completing a combined emergency medicine residency and research fellowship focusing on health literacy and communication. In her free time, she writes the newsletters You Can Know Things and The Public Health Roundup.

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5 (more) logical fallacies in the era of RFK Jr.; Common rhetorical tricks that are used to spread false health information

Kristen Panthagani, MD, PhD, Apr 29, 2026 

Last month I wrote about 5 logical fallacies that are trending right now in the world of health, and there was a resounding request for round two. So here you have it!

But first: why should you care? Learning to identify logical fallacies is a form of prebunking. There are SO MANY false health claims on the internet, and chasing them down one by one is not possible. Instead, if you can learn to recognize these common errors in reasoning and manipulative patterns, you can be prepared to discern unreliable information when you encounter it in the wild.

And research has shown prebunking works: teaching people logical fallacies helps them discern what information is reliable, and what is not.

Alright, now to the fallacies.

Anecdotal fallacy

The anecdotal fallacy occurs when people use their limited personal experience to make sweeping conclusions. Our personal experiences are important, and they guide many of our decisions. But they also often give us incomplete information because they only reflect one experience or point of view. The error in reasoning occurs when a person assumes their limited experience provides complete information and is enough to make much broader conclusions.

Examples of this fallacy in action:

  • My child didn’t get vaccinated and they’re fine! (anecdote) Vaccines aren’t really needed. (broader conclusion)

  • I stopped eating bread and felt better (anecdote)—gluten is causing so much inflammation in the modern diet. (broader conclusion)

  • I started taking this new supplement and have so much energy (anecdote)—it really works! (broader conclusion)

Appeal to emotion fallacy

The appeal to emotion fallacy tries to win an argument not by providing evidence, but by distracting people with strong, emotionally charged language or imagery to evoke feelings such as fear, anger, or sadness.

The image below is a great example. It was used to try to convince Americans that children in the U.S. receive too many vaccines. Instead of providing accurate data, the image triggers an emotional reaction by using images of lots of needles, which feels scary, and by showing the U.S. baby as unhappy (frowning).

This emotionally charged imagery distracts people from the fact that the message is inaccurate. U.S. babies do not receive 72 injections, and the image creates a distorted view of immunization by emphasizing fear of needles while ignoring the benefits.

Emotion, by itself, isn’t inherently wrong or invalid, and it can be used appropriately in health messaging. The error in reasoning occurs when emotion is used in place of a reasoned argument, or when it is used to distract from the fact that insufficient or inaccurate evidence has been provided (as was the case here).

Appeal to authority

The appeal to authority fallacy says that authority figures (experts) are always right. But this is not always true; reality does not bend to the will or whims of experts. Right now I think this one is especially confusing, because the scientific community says “trust the experts!” but then when an expert says something a bit weird, they say “ignore them!”

In science, what ultimately matters is the quality of the data and analysis—not who is making the claim. Experts are often more reliable because they’re trained to evaluate evidence, which is why it usually makes sense to trust them.

But their credentials alone aren’t proof—people with MDs and PhDs have to provide data to back up what they’re saying. The error in reasoning comes from assuming that a person’s title or credentials alone are enough to say they are correct, without requiring they provide additional evidence to support their argument.

Examples of this fallacy in action:

  • “Dr. Malone is the inventor of mRNA vaccines; he knows what he’s talking about!”

  • “I’ve seen five doctors online recommend this supplement—it must work.”

  • “A Harvard study showed Tylenol during pregnancy is linked to autism, it must be true!”

The appeal to authority fallacy in action.

Moving the goal posts fallacy

The moving the goalposts fallacy occurs when someone refuses to accept valid evidence supporting an argument and instead changes their demands. This tactic makes it so an argument is never settled because the demands are constantly changing.

One of the most famous examples of this fallacy is the rumor around vaccines and autism. Back in the 1990s, the original argument was the MMR vaccine may be linked to autism. This was studied extensively, and no link was found. But instead of saying “oh that’s great!” the goalposts changed and the rumor lived on: next it was alleged it was actually thimerosal (a vaccine ingredient) that was causing autism. When studies found no link between thimerosal and autism, the demands shifted again. This has happened over and over again for the last three decades, turning what was once a valid hypothesis into an unfalsifiable rumor that is designed to never die. When moving the goal posts is used, no amount of data is ever deemed “enough.”

See this video on YouTube, Instagram, or Facebook.

Straw man fallacy

The straw man fallacy occurs when someone misrepresents an argument to make it easier to attack. Instead of engaging with what was actually said, they oversimplify or exaggerate it, making it sound more extreme or simplistic than it really is. This fake version (“the strawman”) is easier to knock down, creating the illusion of winning the argument. But in reality, the original point was never addressed.

Examples of this fallacy in action:

“You said vaccines are safe, but clearly they have side effects!

  • Real claim: “Safe” means the benefits of vaccines outweigh the risks, and serious side effects are very rare.

  • Straw man version: “Safe” means no risks of any side effects whatsoever.

“Doctors just want you to take a pill for everything.”

  • Real claim: Chronic health conditions are complex, and sometimes diet and exercise alone are the best approach, while other times medications may be needed.

  • Straw man version: Doctors just want to push pills for conditions that are really caused by poor diet and lack of exercise.

Communication tips for talking about fallacies

Prebunking by teaching these logical fallacies can be an effective strategy for helping people recognize unreliable health information. Here are a few communication tips to keep in mind when sharing these with your communities.

  1. The goal is not to make people feel stupid. EVERYONE uses and falls for these fallacies from time to time, and they are not a sign of lack of intelligence. The goal is to empower people to identify and resist manipulation tactics, not to make them feel stupid. In general, shame-based messaging does not work, and it won’t work here.

  2. Don’t just name the fallacy, explain the reasoning error. Naming the fallacy alone likely won’t help—the goal is to help people understand for themselves why the reasoning doesn’t hold up, so they can be equipped to identify the flaw in the future.

  3. Provide real-world examples when possible. Hypothetical examples can be useful, but real-world examples help people see and understand these manipulation tactics in the wild, setting them up to identify them in the future.

Stay tuned for part three of this series, where we’ll dive into other rhetorical tricks that are commonly used to spread false health information. Subscribe below to follow along!


A version of this post was originally published on You Can Know Things.

Tuesday, April 28, 2026

Your Local Epidemiologist - The Dose, 4-28-26

Here's Katelyn Jetelina with the latest fact-filled issue of The Dose. 

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Triple the ticks, military ends flu vaccine, Vitamin K refusal and rotavirus surging, alpha-gal trends, and good news

The Dose (April 28) - Katelyn Jetelina

The weather is changing, and so is public trust in medical evidence—and both are showing up in the data.

Tick season is off to a bad start, a decrease in trust is pulling several diseases down with it, and the Pentagon just ended its flu immunization requirement. But there’s a lot of good news this week, too. Plus, we answer your questions on alpha-gal syndrome, a tick-triggered meat allergy.

Here’s what’s circulating and what it means for you.


Disease weather report

Ticks are unusually high

Well, it wasn’t a blip. Tick season really is off to an unusually bad start. Emergency department visits for tick bites are running at roughly 114 per 100,000 people per week, nearly triple the typical rate at this time of year (44 per 100,000). The Northeast is bearing the brunt of it, with the Midwest running a close second.

Data from CDC; Annotated by Your Local Epidemiologist.

What this means for you: The main concern is Lyme disease (carried by black-legged ticks), but lone star ticks and dog ticks are also active and can transmit other illnesses, such as alpha-gal syndrome (see more below). There are many things you can do to prevent tick bites, and remember: nymphs are the size of a poppy seed.

Respiratory viruses are back to typical patterns

If you’re sick right now, it’s almost certainly a common cold. Rhinoviruses and enteroviruses dominate this time of year, and everything else—flu, RSV (which had a notably late season), and Covid—is finally declining for the first time in a long time!

Percent of positive tests for respiratory viruses. Source: NREVSS; Annotated by Your Local Epidemiologist

What this means for you: Rest and fluids. (Yes, this really helps your immune system.)

Other diseases are increasing: Rotavirus and Vitamin K

Rotavirus (a contagious gut virus and the leading cause of severe diarrhea in young children) is generating headlines, with levels higher than last year. Wastewater monitoring shows a striking signal, though this monitoring technique is relatively new for rotavirus, making interpretation difficult. CDC test positivity rates (a more established metric) are modestly elevated compared to last year.

Levels of rotavirus in wastewater compared to last year. Source: Wastewater Scan; Annotated by Your Local Epidemiologist.

Why the uptick? Vaccination rates have declined gradually (74% compared to 77% in 2018).

But, as David Higgins notes, hesitancy alone likely isn’t the driver. Rotavirus vaccination is uniquely vulnerable to access barriers: The first dose must be given before 15 weeks, and the full series must be completed by 8 months. A child who loses Medicaid coverage, can’t find a pediatrician, or misses a single visit simply ages out of eligibility.

Vaccination data is delayed. So the current rates reflect children who should have been vaccinated in 2021, at the height of the pandemic-era disruption in care. Watching how these trends evolve alongside new access challenges, like Medicaid cuts, will be critical.

Vitamin K refusal shows concerning trends, increasing 77% (from 2.1% to 5.2%) from 2017 to 2024. This shot prevents Vitamin K Deficiency Bleeding (VKDB), a condition where newborns bleed spontaneously because they can’t yet produce enough clotting factors. The classical form affects as many as 1 in 60 to 1 in 250 unprotected infants. In other words, even a small increase in refusal translates directly into preventable harm.

What this means for you: If your child receives standard care (the routine childhood vaccination schedule and no refusal of the Vitamin K shot), they are very well protected. On a population level, we have a real problem. This will take all of us listening to questions, concerns, and confusion, answering questions from a place of empathy, and creating systems that make it easier (and more affordable) for people to access care.


Spotlight: Alpha-gal syndrome

We’ve gotten a lot of questions about alpha-gal syndrome from ticks lately, including a lovely snailmail note from a reader asking us to cover it.

What is it? A meat allergy triggered by a Lone Star tick bite. The tick introduces a sugar molecule called alpha-gal into your bloodstream. Your immune system responds. The next time you eat red meat, your body reacts.

Who is at most risk? The Lone Star tick is most common in the Southeast and South-Central U.S., but its range is expanding. For example, last year, there was an explosion of cases in the Northeast (Martha’s Vineyard).

Is alpha-gal actually increasing, or does it just feel that way? Both. Awareness has grown enormously in the last few years, which means more doctors are testing for it, and more cases are being caught that would previously have been written off as mystery GI issues or unexplained allergies. But the underlying cases are also genuinely rising. The lone star tick’s range is expanding northward and westward, driven largely by climate and deer population changes. CDC estimates there are around 450,000 cases in the U.S., but that’s almost certainly an undercount.

How would I know if I have it? The reaction is delayed two to six hours after eating, so by the time hives, stomach cramps, or nausea appear, most people don’t connect it to the meal. It can progress to anaphylaxis. People spend months thinking they have IBS or a sensitive stomach. If you have unexplained allergic reactions, especially delayed ones after meals, ask your care team about the possibility of an allergy.

Is it just red meat? Mostly. Beef, pork, lamb, and venison are the main triggers. Some people also react to dairy, gelatin, or mammalian-derived medications. Sensitivity varies a lot, which is part of why it’s so hard to diagnose.

Will I have this forever? Not necessarily. Some people regain tolerance if they avoid further tick bites, which is what prevents the immune system from re-sensitizing. Others don’t recover. No treatment exists beyond avoidance.

How do I avoid getting it? Take precautions against tick bites.


Good news

  1. The South Carolina measles outbreak—the largest in the U.S. in 35 years—has officially ended, marking a significant milestone in containment.

  2. Suicide prevention is working. A new study found that roughly 4,300 fewer teens and young adults died by suicide in the years following the launch of the 988 Suicide and Crisis Lifeline. Tell people about this resource.

Source: JAMA
  1. A pancreatic cancer trial is showing real progress. Pancreatic cancer is one of the deadliest cancers because it’s caught late and responds poorly to treatment. Follow-up results from a very small phase 1 clinical trial testing a vaccine to treat pancreatic cancer showed that nearly 90% of people whose immune systems responded to the vaccine were still alive up to six years after receiving the last treatment. (Typically, the five-year survival rate is ~13%.)

  2. Good news on dengue vaccines. A dengue vaccine trial kept every vaccinated participant out of the hospital over five years and reduced symptomatic infections by 65%. Dengue infects an estimated 100–400 million people annually worldwide.


Question grab bag

What is your take on the Pentagon recently ending its flu immunization requirement for active-duty military?

Here’s the deal: scientifically and economically, this new policy just doesn’t add up. I did some back-of-the-napkin math,1 and the military immunization requirement saves 30,000–98,000 duty days a year from the flu, which amounts to about $10-40 million in taxpayer dollars. This policy has been in place since the 1950s precisely because military readiness depends on keeping troops healthy and in the field.

But values and politics shape a huge portion of health policy. That’s what happened here. The performative political statement against vaccines as well as the intersection of individualism coming to the fore against the collective good.

If you have questions or requests, comment or email us at hello@yle.health. We read everything! And love to hear from you.


Bottom line

The weather is changing, trust is changing, and both are reshaping the diseases we face and how we protect ourselves. In the background, public health and research continue to fight to bring you good news.

Love, YLE


Your Local Epidemiologist (YLE) is founded and operated by Dr. Katelyn Jetelina, MPH PhD—an epidemiologist, wife, and mom of two little girls. YLE reaches over 425,000 people in over 132 countries with one goal: “Translate” ever-evolving public health science so that people are well-equipped to make evidence-based decisions. This newsletter is free to everyone, thanks to the generous support of fellow YLE community members.  

Monday, April 27, 2026

The Babylon Bee Outdoes Itself

After the 3rd assassination attempt that occurred this weekend, I continue to admire Trump's courage under fire and his amazing aplomb. 

The Democrats won't read this, but here's a perfect article from The Babylon Bee that the Dems could have written themselves:

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Liberals Applaud Improving Diversity Of Would-Be Trump Assassins
U.S. · Apr 27, 2026 · BabylonBee.com

"U.S. — Following the harrowing incident at the White House Correspondents' Dinner over the weekend, progressives across the United States applauded the steadily improving diversity of would-be Trump assassins.

"With many liberals concerned over the lack of minority representation among people trying to assassinate Trump, Democrats breathed a sigh of relief after learning that the latest failed assassin was black.

"For too long, the would-be Trump killer space has been dominated by white men," said local liberal Jamie Gallagher. "Today was a long-overdue step forward in assassin representation. It's really encouraging to see people from different ethnic backgrounds engage in political violence. I just hope it helps little kids know that their skin color and sexual orientation do not have to hold them back from trying to kill Donald Trump."

"While stating there was still more work to be done, DEI advocacy groups hailed the news of a minority assassin as a landmark victory. "When you see people of all different skin tones and socioeconomic classes trying to murder political figures, you know you've done your job," said DEI consultant Mary Harding. "To be clear, we are not there yet. There are still so many underrepresented groups who face significant barriers in trying to assassinate world leaders. We will continue the hard work of ensuring real equity among people shooting guns at President Trump."

"At publishing time, progressives admitted that they had been crossing their fingers in hopes that the failed assassin would also turn out to be gay."

Dr. Ruth Report, 4-26-26

Here's the latest info-packed newsletter from Dr Ruth Ann Crystal. It's nice to see some encouraging news about COVID, but don't let your guard down too much!

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Dr. Ruth Report 4/26/26

Viral respiratory illness activity as of April 24 per the CDC:

  • RSV activity is elevated but has peaked in most parts of the country.

  • Seasonal influenza activity continues to decrease. Influenza A activity is low across all regions and influenza B activity continues to trend downward.

  • COVID activity is low in most areas of the country.

COVID

According to JP Weiland, “we are at the lowest transmission levels in almost 5 years”. He expects this lull in COVID transmission to last at least 6 weeks and he estimates that there are currently only about 90,000 new COVID infections per day in the United States.

According to the CDC through 4/18/26, wastewater levels of SARS-CoV-2 were moderate in Wyoming and West Virginia, and high in Mississippi. This translates to about 1 in 58 people infected with COVID in Wyoming and West Virginia, and 1 in 36 people in Mississippi per Mike Hoerger.

From: https://www.cdc.gov/respiratory-viruses/data/activity-levels.html
Acute COVID infections, General COVID info

4/20/26 Medical Microbiology and Immunology: Acute COVID-19 is associated with altered CD8 T-cells indicative of impaired ability to control Epstein–Barr virus reactivation https://buff.ly/nkauvdc

German researchers studied moderate to critical hospitalized COVID patients and found that their T cells were no longer able to control latent viruses like EBV. In the 61 patients studied, 68% to 73% had EBV reactivation and this was associated with CD8 T cell exhaustion as seen by reduced CD28 and increased CD57 expression. These findings suggest that acute COVID infection causes impaired antiviral control of latent viruses by T cells.

4/20/26 BioRxiV: SARS-CoV-2 spike protein-associated sialoglycoconjugates induce nanoscale filipodia to facilitate micro-size platelet clotting https://buff.ly/FAKgJvu

Researchers at Griffith University, using platelets from 9 donors, found that sugar molecules attached to the SARS-CoV-2 spike protein trigger platelets to extend projections called filopodia and then aggregate into microclots. The clotting effect was driven by sialic acid on glycan chains rather than the spike protein itself. This carbohydrate-mediated mechanism may help to explain COVID coagulopathy and vascular injury seen in Long COVID.

Made with ChatGPT
Pregnancy

4/20/26 Nature: Higher expression of SOX1, miR-155, and miR-21 in the colostrum of SARS-CoV-2-infected mothers https://buff.ly/wEa4iVZ

A Polish study of 19 people who had COVID during pregnancy vs. 21 healthy women who did not found that “SARS-CoV-2 infection during pregnancy induces changes in the molecular composition of early breast milk, promoting immunomodulatory (miR-155) and regenerative (miR-21, SOX1) molecules.” These immune signals modulate the newborn’s immune responses.

Pediatrics

4/22/26 Pediatric Research: Endovascular profiles linked to neutrophil activation in children and young adults with long COVID https://buff.ly/82qJh0y

Researchers at Massachusetts General Hospital studied 84 children and young adults and found that those with Long COVID had significantly elevated fibrin amyloid microclot burden and markers of endothelial injury compared to healthy controls. In vitro assays showed that SARS-CoV-2 spike immune complexes trigger neutrophils to release extracellular traps (NETs), directly damaging blood vessel lining. They noted intravascular NETosis from activated neutrophils as a key driver of ongoing endovascular pathology in pediatric Long COVID.

More Microclot Info

4/23/26 Preprint (Kell and Pretorius): On the Correspondence of Diseases Showing Microparticles, Fibrinaloid Microclots and Disorders of the Microcirculation https://buff.ly/miIxfrD

In a preprint, researchers Kell and Pretorius propose that numerous chronic diseases share a common pathological signature: circulating microparticles and amyloid rich fibrinaloid microclots that disrupt microvascular blood flow. Their analysis points to a shared pathway of persistent inflammation and vascular injury.

From: https://www.preprints.org/manuscript/202604.1728

Vaccines

4/23/26 CIDRAP: Moderna’s combo flu-COVID vaccine receives European authorization https://buff.ly/PbRoyWf

The European Commission granted marketing authorization to Moderna’s mCombriax, the world’s first combination mRNA influenza and COVID-19 vaccine. A phase 3 trial showed a single dose produced statistically higher immune responses against three flu strains and SARS-CoV-2 in adults 50 and older, with no major safety concerns identified. Approval by the U.S. FDA is pending, with a decision expected in August 2026.

4/19/26 Nature: Antibody profiling and plasma proteomics in SARS-CoV-2 infection: a pilot study https://buff.ly/FkAYCSn

Tokyo University scientists tracked plasma antibodies and proteomics in a single person over 310 days, finding minimal proteomic shifts after vaccination but distinct, coordinated immune and inflammation changes after SARS-CoV-2 infection.

Antiviral treatments

4/22/26 NEJM: Oral Nirmatrelvir–Ritonavir for Covid-19 in Higher-Risk Outpatients https://buff.ly/C81nxdP

In trials across the UK and Canada enrolling 4,232 predominantly vaccinated, high-risk adults, Paxlovid did not reduce hospitalization or death compared to placebo. The drug did shorten symptom duration and lower viral load, suggesting potential benefit for recovery even where it fails to prevent severe outcomes.

Long COVID

4/23/26 Physiological Reports: Impaired peripheral oxygen delivery during submaximal exercise in adults with long COVID https://buff.ly/J4umKr2

University of Derby researchers studied 56 adults with Long COVID using a 2-day submaximal CPET protocol combined with NIRS of the calf muscle and found reduced muscle oxygen delivery during mild exercise that worsened on day two of testing. Results suggest impaired peripheral oxygen extraction and delayed recovery, and not deconditioning, may be central drivers of post exertional malaise and fatigue in Long COVID.

Dr. Putrino announced this week that the Mount Sinai Long COVID trial of low dose Rapamycin will now be offering the medication to all study participants.

Phase I Open-Label Safety Trial of Pembrolizumab for Neurological Post- Acute Sequelae of SARS-CoV-2 (PD1-PASC I) https://buff.ly/Sge4Exd

The NIH has launched an open-label, Phase I trial of Keytruda (Pembrolizumab) for Neuro Long COVID. Keytruda is an immunotherapy that may help T cell exhaustion in Long COVID as it does in cancer therapy.

4/21/26 Journal of Translational Medicine: Identification of novel reproducible combinatorial genetic risk factors for myalgic encephalomyelitis in the DecodeME patient cohort and commonalities with long COVID https://buff.ly/jfpIDpq

Using the UK DecodeME cohort of 14,767 participants, researchers identified 22,411 reproducible genetic risk signatures for Myalgic Encephalomyelitis (ME) across three independent patient groups, with higher signature counts associated with 1.64 times greater odds of disease. Notably, 76 of 180 genes linked to Long COVID also mapped to ME, pointing to shared biological mechanisms and potential drug repurposing opportunities for both conditions.

H5N1

4/23/26 CIDRAP: More California marine mammals confirmed to have H5N1 avian flu, as USDA tracks poultry outbreaks in Midwest https://buff.ly/Kq0gJNQ

Eleven additional marine mammals tested positive for H5N1 in California, bringing the ongoing outbreak total to 58 animals across four counties, including 57 sea lions and one otter, mostly in San Mateo County. Separately, four new commercial poultry facilities in the Midwest and Southeast reported H5N1 outbreaks, though the overall pace of detections has slowed compared to March.

David Cook / Flickr cc

4/6/26 BioRxiV (T. Peacock lab): Bovine H5N1 influenza viruses have adapted to more efficiently use receptors abundant in cattle https://buff.ly/UEorl2r

Researchers at the Pirbright Institute found that two mutations now common in dairy cattle H5N1 strains allow the virus to bind NeuGc, a sugar molecule present on cattle mammary cells but absent in humans and birds. This increases viral replication in bovine tissue and may facilitate cow-to-cow transmission.

Measles

CDC Measles updates (on Wed.): https://buff.ly/zbA8Vtv

As of April 23rd, 1,792 confirmed measles cases were reported in the United States in 2026.

South Carolina Department of Public Health (Measles): https://buff.ly/w688rud

The South Carolina Department of Public Health (DPH) reports no new cases of measles with the exception of an isolated case in Saluda County for which 41 people are in quarantine. The number of measles cases in the Upstate, SC outbreak remains at 997.

Utah Department of Public Health (Measles): https://epi.utah.gov/measles-response/

The Utah measles outbreak saw 197 cases in 2025 and 410 measles cases so far in 2026. There have been 31 newly reported measles cases in Utah in the last 3 weeks.

John Hopkins US Measles Tracker: https://publichealth.jhu.edu/ivac/resources/us-measles-tracker

Government Health News

4/21/26 NBC: Pete Hegseth says the U.S. military will no longer require flu shots https://buff.ly/4tUJZc7

4/23/26 Dr BK. Titanji: Why Militaries Vaccinate https://buff.ly/drXft6O

This week, Pete Hegseth announced that the U.S. military will no longer require flu shots. Infectious diseases like the flu can spread like wildfire through the military, as soldiers live and work in close quarters. If many soldiers get sick at the same time, it could become a national security threat.

4/22/26 NY Times: C.D.C. Cancels Publication of Study Showing Benefits of Covid Vaccines https://buff.ly/Oi4TlTW

CDC Director Jay Bhattacharya blocked publication of a completed CDC study in the agency’s flagship journal, the MMWR, after it had already cleared internal scientific review. The study found COVID vaccines cut emergency room visits and hospitalizations by roughly 50% last winter, using a methodology long accepted for flu and COVID vaccine effectiveness research and published without objection in a flu vaccine study just weeks earlier.

4/25/26 NY Times: Trump Fires Board Members of Group That Oversees U.S. Science Funding https://buff.ly/vq7AjfA

“The dismissals from an independent board that oversees the National Science Foundation marked the president’s latest assault on scientific research organizations.”

Other news

4/21/26 Nature Medicine: Epigenetic fingerprints link early-onset colon and rectal cancer to pesticide exposure https://buff.ly/EFEReKw

4/20/26 Nature Medicine: Microbiome signature of Parkinson’s disease in healthy and genetically at-risk individuals https://buff.ly/3mjyfQL

A UK and France research group found that a gut microbiome signature typical of Parkinson’s disease can occur in both genetically at-risk individuals and in healthy people without known risk. These microbiome patterns are linked to disease progression in Parkinson’s patients and to early, prodromal Parkinson’s symptoms in both genetically and non-genetically at-risk individuals in the general population.

4/18/26 NBC: Pancreatic cancer mRNA vaccine shows lasting results in an early trial https://t.co/13GBL8ujOV

This is great news! “Scientists caution that more research is needed, but nearly all of the [Pancreatic Cancer] patients who responded to the personalized vaccine are still alive six years later.”

4/25/26 NEJM: Pulsed Field Ablation as Initial Therapy for Persistent Atrial Fibrillation https://buff.ly/AM07xtp

In a randomized trial for preventing recurrent atrial arrhythmias, “Among patients with persistent atrial fibrillation, the risk of recurrence of atrial arrhythmia was significantly lower among those who received pulsed field ablation (PFA) as first-line treatment than among those who received antiarrhythmic-drug therapy.”

This week, I received a Health Advisory from the California Medical Board and CDPH regarding risking Silicosis cases in countertop workers who work with quartz countertops. Cutting engineered quartz releases silica dust causing an accelerated, incurable lung disease called Silicosis, which is now a reportable disease. As of April 23, 2026, 547 countertop workers in California have been diagnosed with Silicosis since 2019, 30 of whom died and 58 of whom required lung transplants.

4/20/26 Nature Reviews Cardiology: Beyond GLP1: modulating multiple nutrient-stimulated hormone pathways to reduce cardiovascular risk https://buff.ly/Beibd0W

A new review in Nature looks at GLP-1 receptor agonists combined with other hormone related medications and how they reduce cardiovascular risk. Tirzepatide is a GLP1 and GIP receptor co-agonist, while Retatrutide is a GLP1, GIP and glucagon agonist that has been shown to reduce body weight by 24% in obese individuals.

Fig. 1: Potential complementary actions of multi-NuSH agents and ongoing cardiovascular outcomes trials.

CNN: Hot air balloon makes emergency landing in backyard

A hot air balloon with 13 people in its basket made an unexpected emergency landing in a family’s backyard in Temecula, California this week. After refueling, the balloon company flew the 80 foot balloon over the houses to the street, where they were able to deflate it safely and remove it. No one was hurt.

Photos by Hunter Perrin

Have a great week,

Ruth Ann Crystal MD