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

Sunday, April 26, 2026

Butler, Part 2

Trump was a rock as he gave that press conference afterwards at the White House.
 

For at least the third time, Donald Trump was the target of a killer, but at least this time the shooter was captured before he could get into the ballroom of the Washington Hilton where the WHCD was being held.  

But just imagine if this terrorist -  and he did create terror -- had had bombs rather than guns, or if he were a suicide bomber. The death and destruction would've been unimaginable.

As it was after Butler, there will have to be a reappraisal of the Secret Service and how they can better  protect these venues and our President. They will also have to keep those radical protesters across the street and away from the venues. And most importantly, the vengeful Democrats have to stop their constant stream of vitriol and demonization, stop obstructing, and get DHS funded, because those Secret Service agents last night were working without pay!

Late last night, I looked online to see some of the reader comments, and as usual, the left is sure that the shooting at the Hilton was "staged" and "a false flag"; or that Israel was somehow involved; and that Erika Kirk's tears were fake as well. These people are soulless and lack any decency.

Here's Matt Vespa at Townhall with more on the reaction:    The Left Were Absolute Psychopaths Following the Attack on the WHCA Dinner  

Saturday, April 25, 2026

Shooting At The White House Correspondents Dinner

I had to turn off the TV because I was shaking so from anger. Thanks to the Democrat Trump-haters, the protesters outside, the constant vitriol, and the letter by the press calling for some kind of demonstrations tonight, the atmosphere was ready for violence. We should not be surprised at all.

If these people had any conscience at all, they would be chastened and ashamed.  Or are there some who wish Trump had been shot tonight? 

Hasn't this man been through enough already? And think of Erika Kirk, who must've instantly relived the shooting of her husband.

They are thinking of going on with the dinner as if nothing had happened. Better to cancel it, and send the press home to look in the mirror.

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Trump rushed off stage after shots fired at White House Correspondents’ Dinner

Wearing Masks Should Be Required at Medical Facilities

I came across this excellent article at The Sick Times today and wish everyone could read it and wear a mask, especially in doctors' offices and waiting rooms. It's not that hard.

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We need masks in healthcare. Now.
By Tesla Bellina-Gustafson, 4-24-26

"Last month I passed out while getting my blood drawn. I woke up with both phlebotomists inches away from my face, and, to my horror, my 3M Aura had been taken off. It had been removed without my consent, presumably to check if my lips were turning blue. No one else in the lab, including the technicians, wore a mask, save for one other patient in a surgical mask.

"As a person with Long COVID, losing consciousness was a terrifying experience made worse by a potential exposure risk. I quickly put my mask back on and thankfully managed to escape unscathed. But this experience reinforced how much power healthcare providers have over those in their care.

"I often bring N95s with me to medical appointments, especially if I will be in a room with a specialist for a long time. This is not ideal for multiple reasons. It can get quite costly and I have to call reception ahead of time to check if the physician will be amenable to the request — which comes with the risk of discrimination or a blanket diagnosis of anxiety. It would be ridiculous if I needed to bring my own hand soap to an appointment and remind my doctors to wash their hands before a physical examination, and yet it has become my responsibility to manage my care in this way.

"Sometimes I get lucky and the specialist will happily don their own mask. But nine times out of ten I am coldly reminded that “masking is no longer mandated.” When it is mandated, staff are often outfitted in loose-fitting surgical masks slung beneath their nose or chin. During a recent visit to the dermatologist, I handed the assistant a 3M Aura. She reluctantly accepted it but had no idea how to navigate the head strap or nose wire, or how to check for fit. I had to coach her through it.

"The onus should not be on patients to provide adequate PPE to the health professionals charged with their care. Nor should we have to beg for safer environments. People with compromised immune systems should be able to access healthcare without fear of leaving the facility with another infection. All healthcare facilities should require masking: It benefits everyone and protects both patients and healthcare workers from the continued risk of Long COVID. 

"Campaigns from organizations such as DoNoHarm BC in British Columbia, Canada, and Senior and Disability Action in California are raising awareness and calling for year-round mask protections. I’ve personally participated in grassroots campaigns with DoNoHarm BC in the past. By using a fact-based approach and making clear, actionable demands, they’ve moved the needle on reintroducing masks in healthcare settings. 

"Prior to 2020, masks were commonplace in healthcare settings, particularly during surgery, as they were designed to stop droplets from entering into open wounds. However, surgical masks do not provide a reliable level of protection from aerosolized particles due to their looser fit, whereas respirator masks such as headstrap N95s significantly reduce infections in healthcare settings. In one recent study, researchers found SARS-CoV-2 in 39% of hospital air samples during outbreaks, even though the facility had good air filtration — making the need for widespread masking even more urgent.

"Some Canadian provinces have adopted a “seasonal” approach with mandating masking, reintroducing them for “respiratory illness season.” This is contrary to how COVID-19 actually spreads, with waves of infection all year round. Not to mention that masks also protect people from other airborne viruses, such as measles; Canada recently lost its elimination status after 27 years of keeping the virus in check, and the U.S. may soon, too.

"Waiting for an infectious illness surge before implementing preventive measures is as effective as waiting to put on your seat belt until after a car crash. 

"Generally speaking, patients have an expectation that when they visit a healthcare setting, they will leave in better shape than when they came in. However, many people end up with healthcare-associated infections (HAIs). In the U.S., roughly 1 in 31 hospital patients has at least one HAI on any given day, according to the Centers for Disease Control and Prevention (CDC). HAIs range from antimicrobial-resistant bacteria to pneumonia. 

"Accurate reporting on SARS-CoV-2 infections transmitted in healthcare settings is hard to find, if it is published at all. The CDC does not track COVID-19 as an official HAI at the federal level. In Canada, 70 hospitals participate in a viral respiratory infection program, tracking HAIs weekly. Healthcare-acquired COVID-19 infections increased after Canadian provinces ended their mask mandates throughout 2022.

Bar chart showing the proportion of laboratory confirmed COVID-19 hospitalizations by source of acquisition. The X axis represents time, going from March 2020 through April 2026, and the Y axis represents proportions, going from 0% to 100%. Healthcare-associated hospitalizations are represented with red bars while community-associated hospitalizations are represented with teal bars, and those with unknown sources are in gray. Healthcare-associated hospitalizations clearly went up in 2022 after Canadian provinces ended their mask mandates.
Healthcare-acquired COVID-19 infections increased after Canadian provinces ended their mask mandates throughout 2022. Chart from the Canadian Nosocomial Infection Surveillance Program, data through April 2026.

"A few scientific studies have found severe outcomes from hospital-acquired COVID-19 cases, further demonstrating the risk of letting it spread without precautionary measures. One 2023 study in Helsinki, Finland, concluded that hospital-acquired COVID-19 was linked to high mortality, and another 2022 study in Quebec, Canada, found hospital-acquired cases led to higher mortality than in community-acquired cases, especially in young people. 

"Year-round required masking is good for healthcare workers, too. A 2025 review study found that 40% of healthcare workers globally have experienced Long COVID. So why don’t healthcare workers mask? Some might argue that masks are expensive, but that makes little sense when workplace-illness claims, staff shortages, healthcare-acquired infections, and Long COVID all cost far more. One study suggests healthcare workers wearing N95 masks could save $1 billion USD per year in healthcare spending. Healthcare administrators could also address other common concerns, like the waste from disposable masks and comfort of long-term wearing.

"Personally, I find it challenging to put my faith in healthcare workers to give me accurate and reliable medical advice when they are choosing to not protect themselves or their patients. Many healthcare workers do not understand how COVID-19 is spread or that many infections are asymptomatic. On average, it takes 14 to 17 years for new medical knowledge to become common practice. In the meantime, patients are left on our own to educate the experts we are expected to trust, on top of the power imbalance.

"But that could change: what we consider the “norm” in modern medicine is actually pretty recent, and it changes all the time. The practice of handwashing and sanitizing in medical settings is less than 200 years old — and that was stigmatized, too.

"DoNoHarm BC began as many grassroots organizations do: turning feelings into action. Several British Columbian residents reacting with outrage to the removal of mask mandates led to a protest outside of the health minister’s office in 2023. From there, it has evolved to include campaigns to improve vaccine and treatment access, weigh in on provincial budgets, and help shape laws with accessibility at the forefront. 

"Masking in healthcare remains the priority. After pressure via phone calls, faxes, and emails, lawmakers reinstated the mask mandate in healthcare settings for two consecutive years, though respirators were unfortunately not the default. Through campaigning, DoNoHarm BC also secured a $3 billion commitment from the BC government to continue funding for pandemic-related health measures, and managed to get Paxlovid covered for high-risk patients. 

"During the successful 2024 Keep Masks in Healthcare campaign, participants sent more than 18,000 letters to lawmakers. There is an incredible power in numbers: it may seem like one person can’t make a difference, but banding together as a collective voice works. For example, DoNoHarm BC signed on to one letter along with over 1,700 healthcare workers, scientists, engineers, occupational health specialists, advocates, and major unions calling for improved, evidence-based mask use in healthcare as standard practice.

"For those interested in starting an organization like DoNoHarm BC, here are tips from the organizers:

  1. Look for existing advocacy groups in your area. You may be able to learn from them or form a coalition.
     
  2. Identify your primary target (e.g., a particular institution or leader) with the most influence on the issue.
     
  3. Develop an understanding of the barriers to change. A lot of the “work” is actually pretty boring, like reading existing policies and processes to know how to best shape them going forward.
     
  4. Utilize the media wisely. Use a template to help you get started.
     
  5. Make your actions as easy as possible. Many participants are disabled or suffering from chronic conditions, so using platforms such as Action Network makes getting involved take very little capacity.

"Masking in healthcare settings should be the norm all year round. I dream of a future where masks are normalized and I can access healthcare spaces without the increased risk of breathing in a new issue to contend with. Advocating for myself as a patient is challenging enough as it is."

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Tesla Bellina-Gustafson is an advocate and longhauler based in Vancouver, British Columbia, Canada. She has organized with various groups including DoNoHarm BC and Vancouver Still Cares.