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THE DOSE: YOUR LOCAL EPIDEMIOLOGISTS: COVID-19 INCREASING. LONE STAR TICK CAUSING REACTION TO MEAT REACHES SOUTHERN NEW JERSEY, POLICY ANXIETY AS DECISIVE MEETINGS START THIS WEEK
Enjoying this newsletter? Why not share it with a friend? REPRINTED WITH PERMISSION This week has a few things on deck worth your attention: the FDA is expected to change the Covid-19 vaccine label, cases of alpha-gal syndrome (the “tick that makes you allergic to steak”) are increasing, and Washington is shifting course on both chronic disease strategy and mRNA research. Also, where is bird flu? Welcome to another week in public health. Here’s what it means for you. But first, some announcements
Disease “weather” reportWe’re in the middle of a Covid-19 wave, with all indicators—from wastewater to hospitalizations and deaths—climbing. The pace isn’t as fast as last winter’s surge and levels remain below last summer’s wave, but the trend is clear. Wastewater data show “moderate” Covid activity in the West and South and “low” levels in the Northeast and Midwest, though rates are rising everywhere.
Covid-19 Wastewater Levels in the United States. Source: CDC NWSS; annotated by Your Local Epidemiologist Other viruses remain quiet for now. But with schools reopening and temperatures cooling, RSV typically starts climbing in September, followed by flu. Current levels are very low. What this means for you: If you want to avoid getting sick and/or missing back-to-school events and weddings, it’s time to mask in crowded indoor areas. I started while traveling because I just don’t have the time to get sick. Spotlight:The Lone Star Tick spreads alpha-gal syndrome in Central States East to the Atlantic, reaches New Jersey (see map).One health issue drawing increasing attention is alpha-gal syndrome, a tick-related allergy that’s been spiking on Google Trends.
Image: Alpha Gal Syndrome Google Trends over time The main culprit is the Lone Star tick, found mainly in the Southeast but steadily creeping northward as climate change and ecological shifts expand its territory. So how does a tick bite turn into a meat allergy? After feeding on mammal blood, the Lone Star tick carries a sugar molecule called alpha-gal in its gut. When it bites a person, trace amounts of that sugar slip into the body through its saliva. Because humans don’t naturally carry alpha-gal, our immune system may treat it as foreign and start making antibodies against it. Later, when that same person eats red meat or other mammal products, the immune system recognizes alpha-gal again—and can trigger an allergic reaction, often several hours after a meal.
Geographic distribution of suspected alpha-gal syndrome cases* per 1 million population per year—United States, 2017–2022. Source CDC. Recent CDC data suggest about 0.15% of Americans have been diagnosed, but that’s likely an underestimate. It’s very challenging to track this disease’s trends in real time because cases are not nationally notifiable. In other words, hospitals, doctors, and public health departments aren’t required to collect data. Local reports suggest cases are climbing fast: for example, Martha’s Vineyard Hospital—somewhere this used to be very rare—conducted 1,254 tests last year, with 523 positive—compared to just 2 positive tests (out of 9) in 2020.
The best protection against alpha-gal syndrome is the same as with Lyme disease: prevent tick bites in the first place. Expect a wave of Covid-19 vaccine news this weekFlu and RSV vaccines remain business as usual this fall: if you’re eligible, you should be able to get them without issue. Vaccinations should start in September. Covid-19 vaccines are another story. Federal policy shifts have left a vacuum, and multiple groups are stepping in to fill it. The key questions remain: Who qualifies? Where will vaccines be available? What’s covered by insurance? What’s not? There will be three key developments this week:
Expect discord. The Vaccine Integrity Project and professional organizations will almost certainly not align with RFK Jr.’s FDA license. This rarely happens, so it will cause confusion. What this means for you: Prepare for lots of headlines and mixed messages this week. I’ll return next week with a clear breakdown of what it all means for you. In the meantime, if you’re under 65 and not high risk, the window to get a Covid-19 vaccine is right now—before the FDA label changes. Once it happens, access will be limited immediately (if it isn’t already). Go here if you have more questions on why this process is a mess right now. And, as always, talk to your doctor or pharmacist for more guidance. Initial read of leaked MAHA draft strategy reportA few months ago, the Trump administration tapped RFK Jr. to develop a strategy to tackle chronic disease among kids in the U.S. Last week, RFK Jr.’s highly anticipated action plan was leaked. TL;DR: His plan is disappointing, but unsurprising, as it was more posture than policy to move the needle.
Bottom line: Unless the final report changes substantially, don’t expect transformation. The strategy is minor, performative, and at worst misleading—most notably in doubling down on the false claim that vaccines cause chronic disease. This soft-pedaling reflects growing tensions between MAHA and MAGA, where lobbying interests increasingly shape priorities instead of confronting root causes. Welcome to Washington, MAHA. In case you missed it: a reversal on mRNA researchRFK Jr. cut $500 million across 22 ongoing mRNA research grants—funding that was driving clinical trials for infectious disease vaccines, including bird flu. Trials for cancer and allergy treatments appear spared, which is a small win, but the overall loss is profound. This research was our front line for preparing against the next pandemic and seasonal viruses like influenza. The rationale? That mRNA vaccines don’t prevent all upper respiratory infections and that the risks outweigh the benefits. This is partially true—no vaccine prevents every single infection, especially against highly mutable viruses. But mRNA vaccines are no different from other vaccines in this regard, and the Covid-19 mRNA vaccines saved more than 3 million American lives during the pandemic. This is what makes the cut both fascinating and disappointing: it marks a stunning reversal from President Trump’s Operation Warp Speed—a rare, bipartisan moonshot that fast-tracked mRNA vaccines and stands as one of the most effective public health investments in U.S. history. Why it matters:
What this means for you: These cuts won’t affect existing Covid-19 mRNA vaccines. Those are still being made and will be available to some people this fall. But this will mean fewer options for future threats and stalled progress on next-generation vaccines. Question grab bag“Why haven’t I heard about bird flu lately?” Because the virus has been relatively quiet. There are a few hypotheses for the lull:
It’s also true that federal testing for humans has been scaled back, but a severe case would be very hard to miss since states and local health departments manage those. The U.S. has recorded only three cases of H5N1 in humans this year—compared with 67 in 2024. What we do know: The virus hasn’t disappeared. USDA continues to randomly find bird flu in wild animals, including a rabbit in Arizona last month. Also, Spain reported a large bird culling (6,895 turkeys), a reminder that the virus is still circulating globally. Epidemiologists have also seen cases in South American countries where the birds have migrated. Those birds will come back north, and time will tell what happens. The risk to the general public still remains very low. Bottom lineWishing you strength amid this week’s headlines. Dodge the viruses (and ticks), and we’ll be back soon with more clarity. Love, YLE |
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AUGUST 18 –Board Protects Affordable Housing and Strengthens Safety for Local Communities, Law Enforcement Officers
WHITE PLAINS, NY — The Westchester County Board of Legislators strengthened housing protections and public safety for residents at its meeting on Monday, August 4, 2025.
In three significant votes, the Board secured long-term affordability for more than 160 apartments in Sleepy Hollow, authorized $6.6 million in critical security upgrades at the Westchester County Department of Correction, and enhanced mutual aid agreements to support 29 local police departments during critical emergencies.
Safeguarding Housing Affordability and Maintenance
The Board approved legislation that will deliver significant improvements to 163 affordable apartments in Sleepy Hollow and extend their affordability for decades to come.
The action clears the way for Foundation for Affordable Housing, Inc., a nonprofit with extensive experience managing more than 25,000 affordable units nationwide, to take ownership of the development at 100 College Avenue. The nonprofit will invest approximately $78,000 per apartment in much-needed upgrades, which will improve accessibility and enhance amenities.
Through a 50-year affordability commitment, the Board is ensuring these homes remain available to low-income families well into the future.
AUGUST 18–HOCHUL ON NY HEALTH TO COME: NOT GOOD
GOVERNOR HOCHUL JOINS U.S. REPRESENTATIVE RITCHIE TORRES TO WARN OF CRIPPLING EFFECTS OF REPUBLICANS’ ‘BIG UGLY BILL’
Estimated Health Impacts of Almost $13 Billion Annually, Paralyzing Our Health Care System
1.5 Million New Yorkers Stripped of Health Care Coverage and Become Uninsured; Projected $8 Billion in Losses for New York’s Hospitals
Governor Kathy Hochul today joined U.S. Representative Ritchie Torres, local elected officials, doctors, and healthcare leaders to warn of the destructive ramifications of President Trump and Congressional Republicans’ “Big Ugly Bill” on New York State.
The cuts imposed by Washington Republicans are expected to have a significant impact, with an anticipated nearly $13 billion affecting New Yorkers healthcare system. Additionally, approximately 1.5 million New Yorkers are projected to lose their health insurance coverage, while over 300,000 households are expected to lose some or all of their SNAP benefits.
“Republicans in Washington are resolute in their determination to inflict irreparable harm to the very programs that save the lives of millions of New Yorkers,” Governor Hochul said. “They have one goal in mind: to conceal tax breaks for their wealthy billionaires while simultaneously withdrawing health care and food benefits from families that rely on them. The fight to protect New Yorkers and uphold the very values of our nation is unfolding right now, and I am committed to being at the forefront of this fight every single day.”
Representative Ritchie Torres said, “Donald Trump’s so-called ‘Big Beautiful Bill’ is a big ugly nightmare for the Bronx. By gutting Medicaid and SNAP, Republicans have put hundreds of thousands of New Yorkers at risk just to fund tax breaks for billionaires. I’m grateful to Governor Hochul for standing with us in this fight to protect the families who stand to lose the most.”
One Big Beautiful Bill Act (OBBBA) Impact on NY District 15
- SNAP: There are currently 272,857 individuals across 158,306 households in NY-15 receiving SNAP benefits
- Medicaid: There are currently 512,999 NY-15 Medicaid enrollees; 94,094 of which are estimated to lose Medicaid coverage due to OBBBA changes
- Essential Plan: There are currently 104,400 NY-15 enrollees in the Essential Plan; 12,809 of which are estimated to lose coverage in EP due to OBBBA changes
Essential Plan/Medicaid Cuts Across New York State
Republicans’ cuts to health care and other benefits through the OBBBA will negatively impact all New Yorkers.
These changes will eliminate insurance coverage for millions of New Yorkers, destabilize health insurance programs across the state, and have a substantial fiscal impact on the State and the New York health care system, amounting to nearly $13 billion annually.
The OBBBA will make it challenging for health care providers statewide to continue operating and will make it more difficult for all New Yorkers to access care when needed.
Over two million New Yorkers could lose their current insurance coverage.
This includes approximately 730,000 lawfully present non-citizens who could lose their Essential Plan (EP) coverage, as over half of the budget for the EP, approximately $7.5 billion in federal funding, is being eliminated. Additionally, a further 1.3 million New Yorkers will lose Medicaid coverage due to new eligibility and verification hurdles.
Out of these 2 million people, 1.5 million New Yorkers are expected to become uninsured.
As a result, uncompensated care costs to hospitals and providers are projected to rise to over $3 billion annually. This means that New Yorkers will have less access to care and will face higher medical bills.
Analysis from the Greater New York Hospital Association (GNYHA) and the Healthcare Association of New York State (HANYS) estimates a total $8 billion in annual cuts to New York’s hospitals and health systems, which could force hospitals to curtail critically needed services such as maternity care and psychiatric treatment, not to mention to downsize operations, and even close entirely.
These consequences will not only affect Medicaid enrollees, but also harm everyone who requires hospital care, leading to longer wait times and less access to critical services.
Rural Transformation Fund
The Republican OBBBA also includes $50 billion for rural and community hospitals.
The size and scope of the Rural Transformation Fund — an average of $10 billion annually for five years for rural hospitals nationwide — is wholly inadequate to protect hospitals and health systems when compared to the estimated $8 billion in annual cuts that New York’s hospitals and health systems alone are facing.
Adding insult to injury, these funds will also be awarded on a discretionary basis, meaning there is no guarantee that New York and its nearly 40 critical access and sole community hospitals will benefit.
SNAP and Nutrition Assistance Cuts Statewide
Since the inception of SNAP, the federal government has funded these benefits entirely, receiving bipartisan support from presidents of both parties and in Congress.
For the first time in SNAP’s history, the Republican-enacted law mandates that states contribute to the cost of benefits, or risk ending their SNAP programs entirely. This move jeopardizes a program that nearly three million New Yorkers rely on to put food on the table. As a result, New York and local governments are facing up to $1.4 billion in new costs annually.
This further cuts the federal share of SNAP administrative costs from 50 percent to 25 percent, increasing costs for the State by roughly $36 million annually and for counties and New York City by roughly $168 million annually. Counties will have to incorporate this fiscal hit into their 2026 budgets by this fall.
Additionally, New York State is facing over $900 million in lost SNAP benefits for New Yorkers due to new, more punitive program requirements that will make it harder for people to qualify for the assistance they need:
- The law intentionally imposes unnecessarily administratively complex work requirements on SNAP recipients, which is projected to result in more than 300,000 households losing some or all of their SNAP benefits, devastating low-income families’ grocery budgets. With an average loss of $220 per household per month, New Yorkers are projected to lose more than $800 million of SNAP benefits due to these changes.
- The law further restricts eligibility for legally present noncitizens who have previously been eligible for SNAP, now excluding anyone that does not have legal permanent resident status, Cuban/Haitian status, or Compact of Free Association status. As a result, 41,000 noncitizens in New York State, including individuals granted refugee or asylee status by the federal government, are expected to lose the food assistance they rely on to feed themselves and their families, totaling roughly $108 million in lost SNAP benefits for New Yorkers.
The law also cuts funding for the SNAP-Ed New York Program, which promotes healthy eating and efficient use of already limited SNAP benefits.
This program teaches SNAP beneficiaries how to shop for and cook wholesome, healthy meals on a tight budget. As a result, New York will lose $29 million annually that funded this work by 18 community-based organizations across the entire state. These organizations include Cornell Cooperative Extensions in Albany, Allegany, Erie, Wayne, Oneida, Onondaga, Orange, St. Lawrence, Steuben and Suffolk counties.
New York State Health Commissioner Dr. James McDonald said,
“These cuts will have a devastating impact on all New Yorkers, leaving an estimated 1.5 million people in New York uninsured, stripping social and health care safety net services, driving up food insecurity and leaving hospitals to shoulder the burden of increasing health care costs.
These cuts to health care coverage are unprecedented and cruel. The State Department of Health will continue to work with Governor Kathy Hochul, our dedicated hospital systems and state agency partners to take every measure possible to mitigate the impact of this bill.”