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COVID levels are starting to creep up, especially in the South. Using data from 7/11/26, Mike Hoerger calculated that 1 in every 243 Americans was actively infectious with COVID, with about 200,000 new COVID infections daily across the states. On Twitter, he notes an increase in COVID positivity in Mexico, and an uptick starting of SARS-CoV-2 in wastewater in South Korea, Ireland, Denmark.
According to the CDC, American wastewater levels of COVID have increased from very low (light blue) to low (green) in some states. But, CDC modeling shows that COVID cases are increasing in 37 states, declining in 0 states, and are stable in 11 states.
According to CDPH, COVID activity in California is low, but is slowly increasing. If you are 65 years old or older, or if you are immunocompromised, it may be a good idea to get a COVID booster at a local pharmacy sometime soon. Since there are no new variants causing COVID at this time, the pharmacy will offer the same vaccine that was given last winter.
Also, if someone thinks that they have a “summer cold”, it may be COVID. Remember, home rapid antigen tests often won’t be positive until about 2 to 3 days after symptoms start. NPR wrote this about what to do about the latest COVID uptick.
From: CDC SARS-CoV-2 in wastewater
Acute COVID infections, General COVID info
Viral syncytia evolve to resist interferon | Nature 7/20/26
NIH researchers working with cell lines, human airway tissue cultures, and mouse models demonstrated that SARS-CoV-2 spreads through the merging of cells into multinucleated syncytia, a mechanism that shields the virus from both interferon responses and antibody neutralization. These fused cellular masses use host ribosomes to pump out viral proteins, allowing the pathogen to propagate without releasing free viral particles into the surrounding tissues, so the immune system does not see them.
Complement augments antibody neutralization of SARS-CoV-2 variants | Science Translational Medicine 7/22/26
Institut Pasteur researchers studying 93 participants found that complement proteins C1q and C3 substantially strengthened the ability of antibodies to neutralize new SARS-CoV-2 variants. Rather than destroying the virus directly, C3 coated viral particles and worked through antibody Fc regions to amplify neutralization activity against variants that might otherwise evade immune defenses.
IFNγ at the crossroads of systemic protection and brain vulnerability to coronavirus infection | BioRxiV 7/23/26
Scientists from the University of Buenos Aires studied 35 infected mice and found that interferon gamma (IFNγ) suppressed a mouse coronavirus in peripheral organs while simultaneously allowing the virus to accumulate at higher levels in the prefrontal cortex and hippocampus. This reveals a fundamental conflict within the immune response, where IFNγ protects the body while rendering specific brain regions more vulnerable to coronavirus infection.
Vaccines
Multiorgan Outcomes Following BNT162b2 mRNA Vaccination vs SARS-CoV-2 Infection: A 30-Million-Person Real-World Cohort Analysis | npj Vaccines 7/20/26
A study of more than 30 million people shows again that it is much safer to get the COVID vaccine than a COVID infection. SUNY Upstate Medical University researchers analyzed data from more than 30 million people and found that SARS-CoV-2 infection was associated with 3 to 5 times greater cardiovascular risk compared to the BNT162b2 mRNA vaccine, with certain elevated risks persisting beyond nine months after infection. The BNT162b2 vaccine showed no excess cardiovascular or multiorgan risk in the same analysis.
Long COVID
🧠 Neurologic Manifestations of Long COVID Affect Adult Females More Severely Than Males | Annals of Clinical and Translational Neurology 7/21/26
A new study from Northwestern Medicine of 2,329 patients from its Neuro COVID-19 Clinic shows that women have worse neurologic Long COVID symptoms than men. “Females suffer from a higher symptom burden of Neuro-PASC [brain fog, dizziness, headache, numbness, and pain] and had worse subjective quality of life and objective cognitive function. These results highlight the importance of timely diagnosis and targeted interventions in female patients who are often negatively affected by gender bias in medicine.”
Northwestern Medicine study finds women experience more severe neurological symptoms of long COVID than men | Northwestern
“We think that the reason women are more frequently and severely affected by long COVID than men is because long COVID is an autoimmune disease, and women are more prone to autoimmune diseases than men, including multiple sclerosis and rheumatoid arthritis,” Dr. Koralnik said.
🧠 Understanding neuroinflammation in post-COVID-19 syndrome: biological mechanisms, diagnostic biomarkers, and therapeutic prospects | Translational Psychiatry (Preprint) 7/21/26
Experts from King’s College in London reviewed evidence linking Long COVID neurological symptoms to viral proteins persisting in the skull, meninges, and brain tissue alongside activated glial cells and compromised brain barrier integrity. The authors propose a local sleep disruption model, though they acknowledge it remains theoretical rather than clinically established.
From: https://www.nature.com/articles/s41398-026-04286-x
🧠Pathogen effects on the brain: the case of SARS-CoV-2 spike protein and neuro COVID | Frontiers Neurology Review 7/12/26
In a new review, researchers propose that persistent Spike protein reservoirs in the meninges drive Long COVID neuropsychiatric symptoms by activating mast cells and microglia in a feedforward inflammatory loop. This crosstalk disrupts the blood brain barrier and dysregulates the HPA axis, offering a mechanistic explanation for brain fog and cognitive impairment affecting up to half of infected patients.
Figure 1: SARS-CoV-2 Spike protein can exist in a meningeal “reservoir”
These two articles made me think of the impressive 2024 article from the Erturk lab showing:
Persistence of spike protein at the skull-meninges-brain axis may contribute to the neurological sequelae of COVID-19 | Cell 12/2024 Erturk lab
Long-term SARS-CoV-2 Persistence in Syrian Hamsters | bioRxiv 7/21/26
Viral persistence: Brazilian researchers detected SARS-CoV-2 RNA in the lungs, brain, spleen, and thymus of 96 Syrian hamsters for up to one year following infection, with viral proteins still present in lung and thymus tissue at that endpoint. No evidence of active viral replication was identified in any of the reservoir tissues examined.
Rapid recruitment for a remote long COVID clinical trial | Lancet Infectious Disease 7/23/26
Scripps Research’s Julia Moore Vogel reports that the Long COVID Treatment Trial Tirzepatide (LoCITT-T), launched in October 2025, enrolled all 1000 participants in under two months through fully remote eligibility screening, diagnosis documentation, and consent. Enrollment jumped most sharply after a public webinar with live Q&A, suggesting direct engagement drives recruitment even in decentralized trials.
Access to potential long COVID drugs dwindles as trials falter | Chemical & Engineering News 7/21/26
In a 53 participant trial by Argenx, efgartigimod (Vyvgart) failed to outperform placebo as a treatment for Long COVID associated POTS when evaluated across the full study population. Researchers suggest that identifying patients with autoantibody driven disease through improved biomarkers could isolate a subgroup more likely to respond to FcRn blockade therapy.
Altered TRPM3‐Dependent Cytosolic and Mitochondrial Calcium Influx in Natural Killer Cells of Post‐COVID‐19 Condition Patients | European J Immunology 7/22/26
Researchers from Griffith University examined 16 participants and found that natural killer cells in people with Long COVID showed diminished calcium transport into both the cytosol and mitochondria via the TRPM3 channel. This signaling impairment appears to compromise the immune system’s capacity to destroy infected or abnormal cells while also interfering with how those cells regulate their energy supply.
Measles
As of July 23, 2026, 2,318 confirmed measles cases were reported in the United States in 2026.
For the whole year of 2025, there were 2,289 cases of measles. We have already surpassed that number and there are still 5 months left to this year.
Measles cases reach 35-year high in US | CIDRAP 7/22/26
The Johns Hopkins measles tracker reported 2,295 US measles cases so far in 2026, the highest count since 1991, with outbreaks still active in Virginia and Pennsylvania. Johns Hopkins epidemiologist William Moss says under-vaccination driven by disinformation is fueling sustained transmission.
Ebola in Democratic Republic of Congo (DRC)
According to DRC officials as of July 24, 3,075 Ebola confirmed cases have been recorded in DRC, including 755 patients still in isolation or hospitalization, 556 people recovered, and 1,354 deaths. The case fatality rate is 44.0%, while the contact tracing rate stands at 76.4%.
Ebola virus persistence and the hidden cost of immune privilege | Nature Microbiology 7/23/26
Using human brain organoids, researchers discovered that Ebola virus can survive and spread directly between brain cells for a minimum of 120 days, exploiting the central nervous system’s status as an immune privileged environment. Microglia respond to this persistent infection by sustaining chronic inflammation, which may damage neurons and offer a biological explanation for why some patients relapse following initial recovery.
Cross-Reactive Bundibugyo Antibody Responses after Receipt of Licensed Ebola Vaccines | NEJM 7/22/26
The PREVAC Study Team found cross-reactive antibody responses in vitro against the Bundibugyo virus (BDBV) in the sera of people who had been vaccinated with the existing Zaire ebolavirus (EBOV) vaccines. “As expected, BDBV responses remained consistently lower than homologous EBOV responses but were detectable after vaccination.” Vaccination with the Zaire virus specific vaccine may offer some protection.
The world’s first Bundibugyo Ebola vaccine has entered human trials: here’s why it matters | GAVI 7/23/26
A new Phase I trial to establish safety has just started for a new Bundibugyo-specific Ebola vaccine called ChAdOOx1 BDBV.
Other news
A fully integrated smart ring for daily biochemical monitoring | Nature (UCSD) 7/23/26
A new smart ring from UC San Diego engineering can monitor glucose, ketones, lactate, alcohol, uric acid, and vitamin C levels in sweat continuously for up to 12 hours. Tested in Type I diabetic patients and in healthy controls, the glucose readings were as accurate as commercial glucose monitors.
Photo by David Baillot/UC San Diego Jacobs School of Engineering
Asthma Control Before and After Changing Gas Stoves to Electric Stoves | JACI 7/3/26
Indoor air quality can affect health. Cleveland researchers replaced gas stoves with electric induction stoves in homes of 85 people with poorly controlled asthma. Asthma control scores improved significantly and Emergency Department visits and hospitalizations fell from 11.8% to 3.5%. The new electric stoves were also preferred by 98% of participants.
Cleveland Clinic researchers analyzed plasma from 5,090 cardiac catheterization patients and found elevated TMAO, a gut bacteria byproduct of red meat digestion, independently linked to higher atrial fibrillation (AF) risk. Mouse studies showed TMAO promotes AF by inhibiting muscarinic receptor 2, driving autonomic dysfunction and atrial remodeling, while a microbial inhibitor blocking TMAO production delayed AF onset.
Localized PD-1 CAR T therapy reprograms neuroinflammation | Cell 7/22/26
In a mouse model of multiple sclerosis, PD-1 targeting engineered CAR T cells blocked brain inflammation by eliminating pathogenic CD4 T cells (PD-1 positive T follicular helper like cells) and by delivering IL-10 locally which quieted microglia inflammation and restored motor function.
Rapper Pitbull Sets World Record For Largest Gathering Of People In Bald Caps | Today 7/11/26
“A whopping 22,141 of the rapper’s fans [in bald caps], affectionately referred to as the “Bald-E’s,” showed up to London’s BST Hyde Park festival to pull off the feat.”
Have a great week,
Ruth Ann Crystal MD
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