Forbes 8-16-26, by Omer Awan, Senior Contributor. Dr. Omer Awan is a practicing physician who covers public health.
"COVID-19 infections are growing or are likely to be growing in all 50 states in the United States, according to CDC reporting.
"The
rise in infections has been eclipsed by other serious illnesses such as
food-borne diseases such as Cyclospora as well as the fastest growing
Ebola outbreak on record in the Democratic Republic of Congo. Although
there is a current summer surge in disease, overall respiratory illness
activity has been low and hospitals have not been overwhelmed secondary
to broad immunity in the population from prior infections and
vaccinations. The virus COVID-19 can, however, cause severe disease,
particularly in the elderly, those with chronic medical conditions and
individuals with weakened immune systems.
How Can You Protect Yourself?
"The CDC has not updated recommendations on the COVID-19 shot due to litigations of the Trump administration’s effort to upend the childhood vaccination schedule. The American Academy of Pediatrics
still recommends everyone 6 months of age and older get the annual
COVID-19 vaccine for maximum protection against severe illness.
Vaccination against COVID-19 offers the best protection against getting
sick, being hospitalized and even death.
"In addition, staying home when sick, improving indoor ventilation,
testing when symptoms develop and using a high-quality mask like an N-95
in crowded or poorly ventilated areas can also reduce transmission.
This type of layered protection can mitigate the spread of disease,
particularly during COVID-19 surges in both the summer and winter.
When Will The Updated COVID-19 Vaccine Arrive?
"The new updated COVID-19 vaccine should be available early this fall
and will likely target the dominant circulating strain, which is the
JN.1-lineage XFG variant. The exact timing of pharmacy availability will
vary as manufacturers distribute the updated vaccine. The shots should
still be covered free of charge from private insurance companies as well
as through government programs like the Vaccines for Children program.
Xocova And Paxlovid
"Two distinct anti-viral medications have been approved by the FDA for the management of COVID-19: Xocova and Paxlovid. Xocova
was approved in May of this year for post-exposure prophylaxis in
adults and adolescents 12 years of age and older after being in contact
with someone with COVID-19. The drug should be taken within 3 days of
exposure, as it has been shown to reduce symptomatic COVID-19 by 67%.
"Paxlovid,
on the other hand, is a treatment for COVID-19. It is usually
prescribed for eligible patients with mild to moderate COVID-19
infection who are at high risk of progressing to severe disease.
Treatment should be started within 5 days of symptom onset.
Vaccine Misinformation Continues To Spread
"Recent false claims
have been circulating online that the COVID-19 vaccine caused an 82%
miscarriage rate among pregnant women. That number does not represent
the miscarriage rate among vaccinated pregnant women. The claim stems
from a misinterpretation of early pregnancy-safety data in which
incomplete follow-up was improperly treated as evidence of miscarriage.
"The CDC itself, on its own website,
states that studies involving more than a million pregnant women have
found no increased risk of miscarriage, stillbirth, preterm delivery or
birth defects.
"COVID-19 has not disappeared, but it certainly has
not returned to levels seen in 2020. Americans should respond to rising
transmission with current evidence as opposed to panic or
misinformation. The best source of information on COVID-19 and vaccines
is your doctor, and these conversations are critical to ensure better
health and well-being."
Mamdani has normalized hateful antisemitic rhetoric and lies against Jews and Israel. Now, this Jew-hater Bilzerian, a Republican, has thought that attacking Florida's Congressman Randy Fine in an outrageously antisemitic ad would be perfectly acceptable.
Where is the condemnation of Bilzerian and his ad by the Republicans? Everyone should be outraged. I can't imagine any decent Floridians actually voting for such a loathsome individual. He should be excoriated and ostracized, and definitely not elected.
Good for Ambassador Huckabee for calling attention to this worsening trend.
"U.S. Ambassador to Israel Mike Huckabee on Saturday condemned
Republican congressional candidate Dan Bilzerian over a series of
antisemitic social media attacks targeting Rep. Randy Fine, R-Fla.,
calling the material ''possibly the most disgusting political thread''
he has seen.
''Bilzerian has taken Jew-hate to a new low,'' Huckabee wrote on X, urging users to follow the thread and adding that Bilzerian ''shouldn't get near Congress.''
"Huckabee’s criticism comes days before Tuesday’s Republican primary
in Florida’s 6th Congressional District, where Bilzerian is challenging
Fine, one of the few Jewish Republicans serving in Congress.
"Bilzerian, an internet personality with millions of social media
followers, has repeatedly attacked Fine over his Jewish identity and
staunch support for Israel.
"The latest controversy centers on a roughly two-minute video Bilzerian posted Thursday
that is predominantly made up of AI-generated imagery and portrays Fine
using antisemitic stereotypes and demonic imagery.
"The video refers to Fine as a ''fat Jew,'' says he has ''poison to
sell'' and includes a reference to reconsidering the views of an
''Austrian painter," a widely understood reference to Adolf Hitler.
"It also declares ''America only and Israel never'' and says Fine ''needs tar and feather.''
"The video follows months of similar rhetoric from Bilzerian.
"He has repeatedly called Fine a ''fat Jew,'' questioned the accepted death toll of six million Jews in the Holocaust and promoted
claims about Jewish control and ''Jewish supremacy.'' Bilzerian has
rejected accusations that he is antisemitic and has argued that his
attacks are directed at what he describes as Jewish supremacy and U.S.
support for Israel."
I remember this squeegee rescue as if it had happened yesterday rather than 25 years ago. You can bet I'll be watching the new National Geographic program about September 11, premiering on August 21.
"When al-Qaeda terrorists struck the World Trade Center on 9/11, six
strangers found themselves trapped in an elevator in a desperate fight
for survival.
"As the express elevator climbed to its first stop on the 67th floor,
American Airlines Flight 11 plowed into the North Tower at 8:46 am,
causing the elevator to shudder and free-fall down the shaft.
"One of the passengers pushed an emergency button, but the elevator
had already plummeted 15 stories before stopping near the 50th floor.
A
National Geographic docuseries premiering Aug. 21 reunites survivors of
the 9/11 terrorist attacks on the Twin Towers 25 years later with the
strangers and rescuers who changed their lives. National Geographic/Virginia Sherwood
"As a choking cloud of thick white smoke that smelled like chemicals
began pouring into the cabin, panic wasn’t an option — it was a death
sentence.
"So the six men — including a window cleaner and two Port Authority officials — calmly pooled their brains and their brawn.
"First, they worked together to open the stuck automatic metal doors with their hands.
"But there was no exit on the other end — just a solid wall with the number “50” stenciled on it.
"Then, a burst of MacGyver-level ingenuity from someone always on the outside looking in at the WTC.
"Window cleaner and Polish immigrant Jan Demczur quickly
whipped out the brass squeegee from the bucket by his feet and began
frantically pecking at layers of drywall in a circular motion.
"Some of the others worked in tandem, punching and kicking the drywall
until there was a hole large enough for everyone to crawl out.
"They landed in a men’s bathroom, where they met firefighters imploring them to leave.
John
Paczkowski, George Phoenix and Jan Demczur (left to right) are reunited
October 9, 2025 in Manhattan. The three previously worked in the North
Tower of the World Trade Center and were stuck in an elevator together
on 9/11. National Geographic/Virginia Sherwood
"So they rushed down 50 flights of stairs and bolted out of the North Tower at 10:23 AM.
"Five minutes later, the tower collapsed.
"Demczur reunited with two of the men — John Paczkowski and George Phoenix — as part of National Geographic’s new docuseries, “9/11 Reunited,”
which premieres Aug. 21 at 8 p.m. The three-part series can also be
streamed in its entirety the following day on Disney+ and Hulu.
"Both Paczkowski and Phoenix are filmed warmly embracing Demczur in a
meet-up at a Manhattan bar, thanking him for helping save their lives.
Firefighters navigate the rubble of the World Trade Center on Sept. 11, 2001. Alamy Stock Photo
“Seeing Jan and George again after all of these years reminded me of
not only the tragedy of that day and the enduring grief we feel for all
who were lost, but also the raw humanity of what we shared, how blessed
we are to still be alive, and the responsibility we have to live life to
its fullest,” Paczkowski told The Post
"The trio are among 14 survivors of the worst terror attack on US soil in history — which left 2,977 dead — who reunited with rescuers and other strangers who changed their lives for the docuseries.
"In the opening episode shared with The Post, both Paczkowski and
Phoenix discussed how the Twin Towers held a special place in their
hearts long before 9/11.
Deborah St. John, who was injured on 9/11 by a falling piece of an airplane. National Geographic/Virginia Sherwood
"Paczkowski, who worked on the 67th floor as the Port
Authority’s assistant director of operations, said working there was a
“dream come true.” Phoenix, a PA senior engineer, recounted falling in
love with his future wife, Martha, during a date at the WTC’s
observation deck.
"The first episode also features Deborah St. John – who suffered
severe injuries after being struck by debris from the second plane to hit the WTC on 9/11
– re-uniting with Stefan Horlacher, a stranger who rushed to her aid,
administering first aid on the street amid mass chaos and flagging down
an ambulance.
“We knew that there were a significant number of 9/11 survivors who
made deeply meaningful connections amidst the horror of 9/11 but, for a
whole host of reasons, hadn’t seen each other since,” said director
Julian Jones, who created the series in collaboration with the National
September 11 Memorial & Museum and production company 72 Films.
“In reaching out to the survivors, we became aware that many felt
they had things they wanted to say but felt they couldn’t — until now.
After 25 years, the reunions became a chance for these survivors to say
‘thank you,’ to pass on a message, to honor the dead, and to reckon with
their past.”
NPE, August 14, 202612:37 PM ET Heard on All Things Considered
"Hantavirus. Ebola. West Nile. Measles. And, of course, cyclospora —
that stomach parasite making people miserable across the country.
Americans have plenty to worry about this summer.
"But remember COVID-19? It may not be surprising that many people
may have almost forgotten about COVID. Unfortunately, COVID hasn't
forgotten about us.
"We're now in the midst of a growing summer surge of COVID here in the United States," says Dr. John Brooks,
an infectious disease doctor at Emory University in Atlanta, Ga., who
used to work at the Centers for Disease Control and Prevention. "I think
most of us kind of feel like it's fading away and are certainly very
grateful for that. But nationally we're seeing it ticking up pretty much
everywhere."
"The virus is spreading
the most again in the South and West, but is also on the rise in the
Northeast and Midwest. The good news is the virus is still at very low
levels. And so far this summer's wave seems to be continuing the trend
of getting milder each year, sending fewer people to the hospital and
causing fewer deaths.
"What we're seeing is very likely
evidence of growing herd immunity if you will," Brooks says. "More and
more people have had one or more infections that give them some immunity
against the virus and have had more than one vaccination, or maybe
both. And all of that really has begun to offer us a lot of protection."
"Now,
that doesn't mean people don't have to worry about COVID at all
anymore. The disease still makes lots of people feel awful for a week or
two, foiling their summer vacations and forcing them to miss work and
school.
"And COVID can still cause serious disease for some
people, sending them to emergency rooms, causing hospitalizations and
even sometimes still causing death.
"COVID-19 is still dangerous, particularly for older adults, infants and people who are immunocompromised," says Caitlin Rivers,
an epidemiologist at Johns Hopkins University in Baltimore, Md. And
that is a lot of Americans. "In a typical office, if you have 20
colleagues, it's likely that one or two of them have some degree of
immunocompromise. So it's very common that people have risk factors that
make COVID-19 dangerous."
"Unlike the flu, which only surges during the winter each year, COVID
sees spikes twice a year – both in the summer and winter. The reason for
that remains unclear.
"It's a big mystery as far as I'm concerned. It is the only
seasonal respiratory virus that has a summer season," River says. "To my
knowledge, we don't know what is causing this seasonality."
"Rivers
says she still masks up when she's in crowded places like busy
airports, and recommends that people stay up to date on their vaccines.
The next shots look like a good match for the dominant strain of COVID that's circulating and should start becoming available soon.
"Unlike
previous years, the CDC hasn't issued updated recommendations for the
vaccines because of litigation over the Trump administration's efforts
to overhaul immunizations in the U.S. The administration no longer
recommends that everyone aged 6 months and older routinely get an annual
shot.
"But major medical groups still do recommend it. And insurers have indicated
they will keep covering vaccines. The shots are likely to remain
available for free through government programs like the Vaccines for
Children program.
"Public health experts worry that conflicting messages will cause confusion, discouraging people from getting another shot.
"The
message is that COVID vaccine and flu vaccine will be available,
they're covered by insurers, they're recommended by medical societies.
People should get them and get them for their kids," says Clare Hannan, executive director of the Association of Immunization Managers, which advocates for immunization programs.
"There's also even a new drug,
called Xocova, that people can take right after they've been exposed to
the virus to cut their chances of actually getting sick from COVID.
"It
is something for people to just have in the back of their mind," Brooks
says. It is expected to be a useful tool in hospitals and nursing homes
when exposures happen to vulnerable people."
Another good reason the Democrat Socialists cannot be allowed to win in November. Meet the charming Emily Gallagher, who somehow got elected to the NY State Assembly and who thinks that stealing is a human right.
When I asked a clerk at my CVS why rows of products were behind lock and key, she told me that every week, groups of thugs would come in and brazenly and quickly steal whatever was on the shelves. The police couldn't respond in time to arrest them. So the store had to lock up the products or continue to lose money. Obviously, these gangs must also have a so-called "biological need".
I have a strong biological need to vote Republican this November!
"A progressive New York City lawmaker says shoplifters should be left in peace to steal items like toothpaste and soap.
"Emily Gallagher - a Democrat Socialist member of the New York State assembly - shared a clip on her X account that also villainized drugstores, which have been forced to lock products in plexiglass cases because of rampant theft.
"Gallagher
wrote that 'no one should be arrested - much less jailed' for stealing
toothpaste' and said in a speech that such thefts were just 'crimes of
poverty.'
"Speaking at an event, she continued:
'People who were stealing things like toothpaste, people who were
stealing things like soap.
"'And that means if you're stealing those things, you need them.
"'And we are choosing to protect billion dollar companies like CVS and Walgreens over the people who are struggling to get by.'
"Gallagher represents NYC's District 50, which comprises the wealthy Brooklyn neighborhoods of Williamsburg and Greenpoint.
"Many
residents of New York and other big cities have complained that
soft-on-crime policies such as those pushed by Gallagher have worsened
their quality of life.
"The drug store
chains she sought to villainize now lock tens of thousands of everyday
products in cases, which can only be opened by staff forced to endure
regular abuse and anti-social behavior.
"But
Gallagher was unrepentant and continued: 'I would say that the true
crime is that there is such incredible wealth disparity in this city.
"'That there are people who can be thrown in jail simply for having a biological need.'
"Gallagher said she would push for 'treatment not jail' punishments."
I thought I'd blog this edition of the California version of Your Local Epidemiologist - The Dose, by Matt Willis, to show how COVID is surging there. And if it can surge there, it can surge in other states as well, so be prepared.
Covid-19 hospitalizations are climbing ahead of a murky vaccine
rollout, West Nile virus is posting its worst numbers in 20 years, and
California is holding the line on vaccine access while the White House
backslides even further. We’ll start with Covid-19.
Covid-19 illnesses are ramping up
After
watching Covid-19 activity rise in wastewater through July, we’re
seeing impacts in emergency departments and hospitals. In the last week
of July, an average of 33 people were hospitalized with Covid-19
per day statewide. Hospitalizations have been steadily increasing, and
are projected to reach over 70 daily Covid-19 admissions by the end of
the month.
Virus levels in California have been upgraded from low to moderate in the national wastewater surveillance system (NWSS).
Covid-19 wastewater levels: California, August 2025 to now
Where are the 2026-2027 fall Covid-19 vaccines? I’ve been looking for any sign of when the new vaccine will hit the market, and it’s been crickets.
This
silence may be related to the uncertainty manufacturers feel this year.
ACIP, the body that turns FDA approval into an actual recommendation,
hasn’t met since December. ACIP was sued based on a lack of scientific
basis for their changes to the childhood vaccine schedule, and won’t
meet again until October 21–23.
The August 10
presidential executive order reinforced that the Covid-19 vaccine was
dropped from the universal recommendation list for kids and pregnant
women, and legal pushback is expected. So it’s kind of a mess at the
federal level, and that has a chilling effect on vaccine roll outs. I
expect we’ll know more by the end of the month.
Should you get vaccinated now?
I recommend that if you’re at risk for more serious illness, go with
the bird in hand and get the current vaccine. The likelihood of being
exposed when you’re out and about is rising daily. You can find a shot
near where you live in California at MyTurn.
Masks: We’re going to see more people using masks out there, and that’s a good thing.These days mask choices are about personal protection, and a well fitted N-95 type mask is highly protective against infection.
For
anyone at higher risk for serious disease, or if you’re really focused
on not getting Covid-19, its a good time to brush off the mask and
consider wearing it in indoor public spaces when the virus is
circulating at high levels. For me, we’re not there yet, but I’ll
continue to provide updates on virus activity to guide your decisions.
West Nile virus update
West Nile virus numbers are rising fast, and California has now recorded its first deaths of the season.
Here’s how the numbers have changes since my last WNV post. Since July 26:
Human cases: 5 → 18(11
counties) — including two deaths, in King and Glenn counties. This was
Glenn county’s first WNV death ever. New first cases for this season
were reported in Glenn, Kern, Riverside, and San Joaquin counties.
Dead birds: 251 → 330(20 counties).
Mosquito samples: 1,001 → 1,890(27 counties)
Sentinel chickens: 2 → 16(6 counties), including a first detection in Colusa County.
Horses: 1 → 4(4 counties), including a first case in Merced County.
This
map shows WNV activity in California, calling out the counties where
first detections in humans or animals happened between July 26 and
October 7.
18 WNV cases is more than twice the average for this time of year in California—peak season is still ahead of us. The national case count has climbed from 91 (July 21) to 181 (August 11), the highest in 20 years.
California is one of five states with elevated WNV activity.
Why is this a severe year for WNV?There’s no formula for predicting year to year variability in West Nile burden. But temperature plays a major role.
This
past winter and spring in California were among the hottest on record.
Normally, in colder winter months, a fraction of mosquito populations
die off. This year more made it through the warmer winter—and into a
record hot spring. Higher temperatures accelerate reproduction for both
mosquitoes and West Nile virus. The warming climate contributes to the
burden of West Nile virus in California.
Sentinel chickens. In
the last two weeks, WNV detection in sentinel chickens jumped from 2 to
16. It’s worth describing what a sentinel chicken actually is. I see
them as unsung surveillance heroes. They’re out there right now,
stationed in coops strategically placed around the state, getting bitten
by whatever mosquitoes happens by. They’re naturally immune to WNV, and
build antibodies after being infected. Local vector control workers
draw a bit of chicken blood every week or two to see what’s shown up.
They’re an inexpensive, low tech and critical part of our infectious
disease intelligence system.
What you can do:
Report dead birds. Call 1-877-WNV-BIRD (1-877-968-2473)—they’ll decide whether to send someone to retrieve and test the bird.
Prevent bites.
Dump standing water around your home at least weekly (flowerpots, pet
bowls, old tires, anything that collects rain or hose runoff), make sure
screens are intact, and use an EPA-registered repellent during dawn and
dusk, when Culex mosquitoes—the species that carries WNV—are most
active. There’s no vaccine and no treatment for WNV, so avoiding the
bite is the best protection.
California’s vaccine firewall
On
Monday, President Trump signed an executive order that recommends
immunizations for 11 diseases, down from the 18 the CDC recommended in
2024. Vaccines against RSV and hepatitis A and B would shift from
universal recommendation to something offered only to higher-risk kids,
and the order calls for the combined MMR shot to be split into three
separate injections given at separate visits.
Does the presidential EO matter? I’d
love to ignore it, because these presidential guest appearances into
the world of science are predictably unscientific, designed to get
attention, and carry less practical relevance for us in California (more
on that later). And an executive order isn’t even the legal mechanism
to impact vaccine policy in the U.S.—this one is already being
challenged. But it’s not benign.
Once again, this
roils the national vaccine waters and leaves people feeling confused
about what it all means— just as we’re preparing to get our kids back to
school. So here’s what to know about this week’s executive order.
First, this is not new rhetoric.
The president is just putting more ink behind the changes RFK Jr
announced months ago — disruptions that are intended to unravel the U.S.
childhood vaccine schedule. Those changes were challenged by the
American Academy of Pediatrics, and have not gone into effect as the
lawsuit unfolds. The EO does not change that.
Second, the EO is not feasible, even
if it were good science. (It isn’t.) The divided MMR vaccine doesn’t
exist in the U.S.—it wasn’t manufactured and distributed in the U.S.
because it makes too much sense, practically, economically, and
scientifically to be protected against three terrible diseases with one
shot.
Third, the EO does not change California’s immunization recommendations or school and child care vaccination requirements.
Last, and most important, California saw this coming and built protections. Last
year, when it became clear the federal science steering wheel was in
reckless hands, California moved fast to get some distance.
In
September the governor signed AB 144, a bill to insulate us from
eroding federal health standards. AB 144 locks in, as a floor, the
preventive-care and immunization recommendations that were in effect on
January 1, 2025—before RFK Jr.’s vaccine overhaul.
Health plans in California must keep covering vaccines, without any new disruptions—no cost-sharing, and no extra paper work or permissions. That extends to Medi-Cal, which can cover childhood vaccines outside the federal Vaccines for Children program for lower income families.
Regional support. California also joined the West Coast Health Alliance,
with Oregon, Washington, and Hawaii, to hold solid, science-based
regional standards. Across the West Coast, instead of being stuck with
federal recommendations, our vaccine access is tied to the guidance of
the American Academy of Pediatrics, the American College of
Obstetricians and Gynecologists, and the American Academy of Family
Physicians. All of which reliably stick to the science, and focus on
what’s best for their patients.
So what does a California family need to know before school starts?
Nothing has changed.
The same vaccines, in the same formulations, on the same schedule, are
still recommended for California kids. Access hasn’t budged—not through
your pediatrician, not through your insurance, not through Medi-Cal.
Because AB 144 already grounds us in a pre-RFK Jr. baseline, and in the
professional societies’ evidence-based guidance.
We’re
benefiting from state public health and elected leaders who read the
moment a year ago. While the federal vaccine conversation lurches from
lawsuit to lawsuit, California families can tune it out and get the
shots they need.
Bottom line
That’s it for this week! Next week we’ll focus on getting kids safely back in school.
Love,
Matt
Dr.
Matt Willis is the author of Your Local Epidemiologist in California. A
California native, he’s served as a primary care physician, CDC
epidemiologist, and public health officer for Marin County, where he
guided the pandemic response. He lives in Marin with his family and
their dogs Teddy and Ramona.
A special thanks to
Emely Bonilla, Masters in Public Health candidate at UC Berkeley and
summer intern at YLE, for her contributions to today’s edition.
Every year, Jill Roberts sends her microbiology students out to swab the filthiest surface
they can find on campus. Most of them march straight to the
bathroom—and every year, they’re wrong. “You won’t believe what I found
in the computer lab,” a lone student will tell her. “Oh yeah, I will,”
says Roberts, a molecular epidemiologist and professor at the University
of South Florida College of Public Health. The bathroom gets cleaned
every day; the keyboard everyone shares does not.
That’s the key to how infectious-disease experts rank risk: The things that feel gross and the things that actually make you sick
aren't always the same. It’s an oddly freeing distinction. Sort the
genuine threats from the merely unpleasant ones, and a surprising amount
of everyday dread will dissipate.
Here are 10 things infectious-disease experts don’t worry about.
Disinfecting every surface
Dr.
Peter Chin-Hong, an infectious-disease specialist at the University of
California, San Francisco, has a simple way of deciding where to focus
his attention: “I respect air more than surfaces,” he says.
That’s
especially true during respiratory virus season. Instead of constantly
wiping down counters and doorknobs, he thinks about ventilation. When a
large group of people comes over, for example, he cracks open a window.
If the heat or air conditioning is running, he makes sure it’s bringing
in outside air instead of simply recirculating what’s already in the
room.
That doesn’t mean surfaces never matter. The U.S. Centers for Disease Control and Prevention recommends cleaning food-preparation surfaces
with hot, soapy water—and sanitizing those contaminated by raw meat or
poultry. If someone is sick, clean frequently touched surfaces first,
then apply a U.S. Environmental Protection Agency-registered
disinfectant according to its label. But a slightly dusty coffee table
isn’t where Chin-Hong directs most of his energy. Improving the air
typically gives you “a bigger bang for your buck,” he says.
Washing their sheets constantly
If
your weekly sheet-washing routine occasionally becomes an
every-other-week routine, Roberts isn’t concerned. She regularly hears
from people who are convinced their bedding needs near-constant
attention. “People are like, ‘I need to wash my sheets every 15
minutes,’” she says. “No, you really don’t. Every once in a while would
be great, but people are excessive with the clean things.”
For
most healthy people, bedding isn’t a major source of infectious
disease. Roberts would much rather see people focus on washing their
hands at important times—like before eating and after using the
bathroom—and handling raw food safely.
“We’re not supposed to be sterile,” she says. “People have microbes, and it’s actually healthy to have microbes on you.”
Antibacterial soap
Chin-Hong
doesn’t seek out soap with an antibacterial label. “I just use plain
soap, because regular soap works really well,” he says.
The
important part is using it—and doing so at the right times. Chin-Hong
washes his hands before eating, after using the bathroom, after handling
raw food, and after caring for someone who’s sick. He thinks about
timing more than frequency, rather than washing or sanitizing
indiscriminately throughout the day.
“It’s
about habit of mind rather than using technology or fancy additives,”
he says. In other words: You don’t need the bougiest bottle on the
shelf. You need to remember to use the ordinary one next to the sink.
Their winter coat
The
COVID pandemic left some people wondering whether everything they wore
needed to go directly into the washing machine. Roberts fielded plenty
of questions about items that had rarely seemed urgent before. “Do I
need to wash my winter coat? Not really,” she says.
Socks
are a different story: They should be washed regularly because fungi
thrive in warm, damp environments. The distinction illustrates how
Roberts evaluates risk. Rather than treating everything we wear as
equally germy, she considers where microbes are likely to grow—and
whether the item could realistically help spread them.
Eating sushi and other foods they love
This one boils down to your personal risk/reward balance. To some food-safety experts,
enjoying a roll of raw fish isn’t worth the risk. Dr. Heidi Torres, an
infectious-disease physician and assistant professor of clinical
medicine at Weill Cornell Medicine, has plenty of colleagues who refuse
to eat raw foods like sushi and beef tartare. She isn’t one of them.
“They’re probably safer than me,” she says. “I love those things, and I
refuse to stop eating them.”
To
reduce her risk, she’s selective about where she eats them. She looks
for restaurants that appear clean, have good health-department ratings,
and are busy enough that ingredients aren’t sitting around for days.
“I’m not gonna pick up that gas-station sushi,” she says.
Dr.
Daniel Griffin, chief of the division of infectious disease at Island
Infectious Disease Medical in Long Island, N.Y., takes a similar
approach when he travels internationally. Despite being a
parasitologist, he still wants to try the local cuisine. “Sometimes I’ll
take risks I wouldn’t normally take,” he says, “but it’s to have that
cultural experience.” He remains thoughtful about what he orders and how
it was prepared—but he doesn’t let his expertise strip the fun out of
eating.
Washing their reusable bags after every grocery trip
The
tote bags living in your trunk are technically supposed to be washed,
and almost nobody does it. Roberts is relaxed about that, within reason.
"You grocery shop once a week? You probably don't need to wash them all
that much," she says. However, it’s a different story if you shop
daily, or if you skip the produce bags and let loose vegetables roll
around in the tote. Then they've earned a trip through the laundry.
One
reason reusable bags don’t get washed: People choose pretty ones
they’re reluctant to ruin in the laundry. Roberts suggests saving those
for other errands and using a plain, machine-washable tote for
groceries. “If you want to save that one, don’t use it for your
groceries,” she says. “Use your ugly one that you got for free, and then
throw it in the laundry.” That way, if raw meat leaks or loose produce
rolls around inside, you won’t hesitate to wash it.
Travel
Chin-Hong
doesn’t dread getting on a plane or visiting a new part of the world.
“I don’t worry about travel,” he says. What does he do instead? Prepare.
Before
a trip, he makes sure he’s up to date on vaccines and learns about the
specific health risks at his destination. Depending on where he’s going,
that might mean packing insect repellent, taking medication to prevent
malaria, or learning what food and water precautions travelers should
follow once they arrive.
That
advance work is what allows him to relax once he gets there. He
identifies the handful of precautions that match the destination—and
doesn’t spend the trip imagining everything that could go wrong.
Following a perfect phone-cleaning routine
Yes,
your phone is dirty. Roberts has her students swab their own phones,
and they’re routinely horrified by what grows. “We pick up things from
the bathroom,” she says. “We pick up E. coli and things like that on the phone.”
Yet
the experts aren’t necessarily disinfecting theirs every night. Dr.
Ashley Drews, medical director of infectious diseases and system
epidemiologist at Houston Methodist, readily admits she doesn’t clean
hers as often as recommended. “Between you and me, I’m not that good
about it,” she says. “Maybe this is one of those
do-as-I-say-not-as-I-do.”
If
you want to clean yours, Drews recommends removing the case and wiping
both it and the phone with a not-too-wet alcohol-based wipe, then
letting everything air-dry before putting the case back on. Roberts
takes an even simpler approach: When the screen starts looking visibly
grimy, she wipes down the entire phone. Neither one is losing sleep over
missing a day.
Settling for hand sanitizer
Hand
sanitizer isn’t a lazy or inferior choice in every situation. “A lot of
people ask, ‘Well, can I just use the hand sanitizer?’” Roberts says.
“And sure—they’re very effective.”
She
keeps it within reach when soap and water aren’t convenient, especially
before eating on the go. “Just pop one of those things into your bag,
and hit that hand sanitizer before you pick up a hamburger,” she says.
There
are exceptions. Alcohol-based sanitizer doesn’t work well against
norovirus, Griffin says. If someone nearby is vomiting or has diarrhea,
he makes a point of washing thoroughly with soap and water. Sanitizer
also isn’t ideal when your hands are visibly dirty. But for ordinary use
when you’re out and about, there’s no reason to feel guilty about
reaching for it.
Eliminating every possible risk
Torres
knows how easily learning about infectious diseases can send someone
spiraling. “You can end up wanting to live in a bubble and never go
outside—and that’s just impossible,” she says. “If you go too far down
the rabbit hole, you get a little depressed.”
Her goal is to minimize risk, not eliminate it. That might mean choosing the reputable sushi restaurant, skipping the overcrowded hot tub,
or washing her hands before eating. It doesn’t mean avoiding every
food, destination, or activity that carries even a remote possibility of
illness.
Chin-Hong
thinks about risk as a continuum, rather than dividing the world into
safe and dangerous. “I want to engage with the world,” he says. “I’m not
afraid of most things. I just prioritize things different ways.”
This
week started off with a bang with an executive order on routine
childhood vaccinations. So much for this administration not touching
childhood vaccines before the midterms. I try to break down the signal
from the noise for you below (there was a lot of noise.)
Plus:
Michigan health officials say iceberg lettuce is now all clear, but we
have a new produce item making us sick in 27 states: jalapeños.
Covid-19, fire smoke, and heat risk continue to march forward. And we
end with some good news.
Here’s your “disease weather report”, and most importantly, what it may mean for you and your family.
Disease weather report
Record-breaking Cyclosporo outbreak coming to a halt
The
nationwide cyclosporiasis count is now more than 20,000 cases for the
year, but that’s an undercount, since many people with milder symptoms
simply stay home rather than seek care. The total will keep climbing,
both because multiple outbreaks are underway and because the largest,
centered in Michigan, is still working through a backlog of
investigations. This could easily become the largest foodborne outbreak
in history.
The contaminated lettuce behind it appears to be out of circulation: several metrics are declining quickly, including the test positivity rate. In Michigan, the outbreak’s epicenter, emergency department visits
are falling, and the number of recent new infections is nearly zero.
(See below.) That second metric is especially useful because it isn’t
skewed by reporting delays or lab-confirmation backlogs.
Thanks to an FDA Enforcement Report, we now know the actual number of lettuce cases recalled was 236,192!
Interestingly, only 2.5% of recalled lettuce was from Taco Bell. Almost
half of the recalled product was supplied to Walmart. This
makes Taylor Farms’ communications that much more atrocious because it
means that many got sick when everyone thought it was just Taco Bell.
What this means for you: You can now return to all your leafy greens.
Salmonella in jalapeños
Another, separate outbreak (Salmonella
this time, which means getting sick 12-72 hours after eating) is now
active and linked to fresh jalapeños from Sinaloa, Mexico. The latest
official CDC count is 345 people sick across 27 states, with 36 hospitalized. Two cases have antibiotic-resistant strains.
Chipotle
and Qdoba both pulled the supplier’s jalapeños, and the recall has
since expanded downstream to include prepared foods from brands such as
Taylor Farms (yes, again), Ready Meals, Meal Simple, Higher Harvest, and
Deli Kitchen that used the contaminated peppers as an ingredient.
What this means for you: Throw away (or avoid purchasing) jalapeños and associated foods at Hannaford, Kroger, Stop and Shop, Target, Trader Joe’s, Walmart, and Whole Foods.
Covid-19 summer wave continues to rise
Covid-19 levels remain low, but emergency visits are increasing in 43 states.
We are clearly in a wave that has come like clockwork every summer
since the pandemic, for reasons that still puzzle epidemiologists. As
expected, hospitalizations have begun to increase after the typical lag
in testing trends, but they remain at a record low.
Test positivity rate for Covid-19 (and flu and RSV). Source: CDC.
What this means for you: If you don’t want to get sick, the time to wear a mask in crowded, indoor areas is starting.
Air quality and heat galore
Air quality remains poor in the Northwest due to wildfires, which seem to be becoming increasingly common these days.
Also, more than 75 million people, concentrated in the South, will be at risk of heat illness.
Heat illness risk across the United States for August 11, 2026. Source: NOAA
What this means for you: Here are six things you need to know about heat illness.
When
I picture a heat death, I used to imagine someone collapsing outside in
the blazing sun while working at a construction site. That definitely
happens, but what I learned while working at CDC is that it can also
look like Shirley.
Yesterday,
an executive order and a press conference announced changes to the
routine childhood vaccination schedule. (So much for the administration
pulling back on vaccine policy before the midterms. More than 80% of
Americans still strongly support having access to vaccines.) As
expected, it was a lot of craziness, so instead of refuting everything,
I’m here to tell you what it means for you today:
Not
much. Families can still access all vaccines on the AAP schedule.
Pediatricians should continue offering vaccines, and these vaccines
remain covered without cost-sharing under current law.
What it is: Most
of what the EO does is set direction and ask for plans. HHS has 90 days
to present a plan for offering MMR as separate shots, which isn’t
possible yet because single-antigen measles, mumps, and rubella vaccines
aren’t currently manufactured in the U.S. In fact, nowhere in the world
is there a single-dose version of vaccines. It would take years of
research and development to execute this. Other pieces, such as a
framework proposing to reclassify hepatitis A, hepatitis B, and
rotavirus vaccines away from “recommended for all children” or the
development of new vaccine adjuvants, don’t have set timelines at all.
What it is NOT:
There is no new scientific data to justify a new policy. This is also
not legislation. In other words, Congress didn’t pass it, and it can’t
override state or federal law on its own. (Remember, vaccine policy is
mainly determined by the states rather than the federal government.)
When I will worry: If one of three things happens:
Autism
is added to the Vaccine Injury Table. This could bankrupt the
compensation program by opening it to a flood of lawsuits. If the
program collapses, two things follow: families with vaccine injuries
would lose their main source of compensation, and manufacturers, no
longer protected from massive liability, would likely stop producing
vaccines altogether.
Funding for the Vaccines for Children Program is withdrawn, which would halt free vaccines for 1 in 2 children in the U.S.
Federal powers (such as withholding funding) are used to compel states to change their vaccine exemption policies.
This
EO may reach #3. It directs the Department of Justice to pursue legal
action against states that don’t offer religious or medical exemptions
from school vaccine requirements. Only a handful of states (California,
Maine, West Virginia, Connecticut, and New York) have no religious
exemptions, so they would be impacted the most, but it would take years
with legal battles. All the other states could be impacted in other
ways, but that depends on how the legal fights unfold, how far DOJ
pushes it, and how states respond. Too many variables to call yet.
What this means for you: Chaos and confusion are the point. Keep a steady head. Families can still access all vaccines on the AAP schedule. Pediatricians should continue offering vaccines, and these vaccines remain covered without cost-sharing under current law.
Good news
Major depression among teens continues to decline, showing
roughly a 30% drop in depression since peak years. This was also the
case for deaths from suicide in older teens and adults through age 34. (Dr. Thomas Farley)
Figure by Dr. Thomas Farley
An ancient protein could aid existing cancer treatments. C3,
a protein that evolved long before the human circulatory system, may
help with treating cancer more efficiently. When produced inside tumors,
C3 blocks cells that suppress the immune system and provides an
opportunity for immunotherapy to work more effectively. This effect was
observed even in treatment-resistant tumors. (ScienceDaily)
Bottom line
Lettuce
is safe, jalapeños aren’t (for now), and despite the headlines and a
purposefully confusing press conference from the Health Secretary,
nothing about your kids’ vaccines actually changed this week. Keep a
steady head out there. It’s a lot to keep up with.
Love, YLE
Your Local Epidemiologist
(YLE) comprises a team of experts, ranging from physicians to
immunologists to epidemiologists to nutritionists, working together with
one goal: to “translate” ever-evolving public health science so that
people are well-equipped to make evidence-based decisions. The YLE suite
of newsletters reaches over 475,000 people across more than 132
countries. This newsletter is free to everyone, thanks to the generous
support of fellow YLE community members.
I got a big kick of Senator Charles Grassley's goodbye to his faithful vacuum cleaner, Beth. The New York Times comments sections had tributes by readers to their own long-time appliances, with a few nasty comments by those with no sense of humor at all.
"The death notice for the
vacuum cleaner was posted at 3.52pm on Saturday afternoon by the senator
Chuck Grassley in a message that seemed, in its abruptness and
grammatical oddities, to hint at genuine heartbreak.
"Grassley is the longest
serving Republican senator in US history and for most of his 45 years in
Congress, in a fickle age of politics, there had been one constant
servant: his mother-in-law’s old vacuum cleaner.
"He named it Beth, after a
former staffer. Beth, a beige vacuum with a red dust bag, had been with
his mother-in-law for 15 years before joining the Grassley household in
1992.
“OLD FAITHFUL,” he called her. “She never lets me down.” It sometimes
seemed, to his followers, that he mentioned Beth more than his wife of
more than 70 years. Now she had taken her last, wheezing breath.
“U willl see BETH no more,” he wrote. “See black that’s from electrical
sparks. It’s not safe to use anymore. GOOD BYE BETH . U hv been a real
workhorse. Ur namesake still is hard worker. I will miss u.”
"It was a eulogy that seemed, in its clunking manner, to mirror the characteristics of its subject. It was almost poetry.
"Tim Scott, a Republican senator for South Carolina, was among the first to offer condolences. “Sorry for your loss,” he wrote on X. “They don’t build them like they used to.”
"Josh Turek, an Iowa
Democrat and state representative who is running for the Senate against
Grassley’s Republican colleague, said: “Sounds like Beth had a heck of a
run.”
"There were, naturally,
those who sought to see, in the passing of a Hoover, a larger political
point. Opponents of Grassley made pointed remarks about term limits and
the decline of American manufacturing. One supporter claimed that it was
Beth’s dying wish that Grassley and other senators immediately pass
legislation, championed by President Trump, requiring voters to show
passports or birth certificates to vote.
"Grassley is not the first
member of Congress to develop a strong attachment to a piece of
machinery. John Boehner, a former Speaker of the House, appears
frequently with his lawn mower.
"The senator John Kennedy has a cross trainer in his garage that he has
named Margaret, “after Margaret Thatcher because both kick butt”. His
wife, Becky, “won’t let me bring Margaret in the house,” he said, in a
video posted this year. So he uses Margaret in his garage and then lifts
weights, watched over, metaphorically speaking, by his Iron Lady
companion.
"Grassley’s Hoover, Beth,
would generally appear in Grassley’s public pronouncements around
Thanksgiving. His wife and daughter were cooking for 30, he announced in
2018. “So my housework contribution begins,” he said. “This is my
machine.” He named the machine after Beth Levine, who served for 20
years as his communications adviser, a role that usually involves a lot
of “clean-up”, in public relations parlance.
“Yes, I am the Beth
namesake!” Levine told The Times in an email on Sunday. “I can vividly
remember him calling into the office when I first learnt about the
vacuum, probably more than 15 years ago, long before the vacuum was
named.”
"Whenever he posted about
his vacuum cleaner, she would get messages from friends. “I have loved
seeing each one of the posts and will always appreciate that that’s how
he remembers my work for him and the people of Iowa,”
she said. “Not only has it been fun and an honour to have a US senator
name his vacuum after you (yes, I would call it an honour!), it’s been a
great way to keep in touch with former colleagues and friends.”
"Grassley would write about
the vacuum during other holidays too. “Faithful Beth has about 3 hours
of cleaning to get ready for 25/30,” he wrote on Christmas Day in 2022.
The following June, the senator Shelley Moore Capito posed with Grassley
and a cardboard cut-out photograph of the vacuum cleaner. “Turns out
Senator Capito is a big fan of Beth,” he said.
Senators Grassley and Capito with Beth
"Followers of Beth received
some footage, a few months later, of the vacuum and the senator in
action together, sucking the dust from a large blue rug. “She never lets
me down & im grateful I can count on OLD FAITHFUL,” he wrote.
"But all political lives,
unless they are cut off in midstream, at a happy juncture, end in
failure, said Enoch Powell. For that is the nature of politics and of
human affairs and of vacuum cleaners.
"Yet for all those lamenting
the end of an era, there were others who said that Beth was not yet
dead, that she only needed a new power cord.
“I manage a hardware &
electronics shop in Ankeny,” one of these said, beneath his
announcement. “We would be honored to pick up and repair Beth free of
charge.”
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