300 MOTORISTS “SNAPPED” IN THE ACT OF PASSING STOPPED SCHOOL BUSES IN SOMERS SCHOOL DISTRICT BY BUSPATROL CAMS.

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Westchester only county in the New York region that has not approved such a program.

WPCNR SCHOOL DAYS. From BusPatrol. December 21, 2022:

BusPatrol and the Somers Central School District today released new data showing nearly 300 motorists that illegally passed a stopped school buses over a two-month period. 

BusPatrol and the school district also released several videos of close encounters, providing the public a firsthand look into the dangerous driving behavior that routinely endangers young children when getting on and off a school bus. The footage was captured using cameras that were installed on stop-arms affixed to 59 school buses.

The school district obtained the data through a pilot program with BusPatrol, the leading stop-arm enforcement technology provider in North America. 

Jean Souliere, CEO and Founder of BusPatrol, said: “These illegal passings are extremely dangerous and demonstrate the need for sensible photo enforcement on our roads. Westchester should follow the lead of other counties and pass a school bus safety program that gives schools and law enforcement the tools they need to keep our kids safe.”

“The BusPatrol program highlights a county-wide problem involving motorists running the red lights and stop arms on school buses,” said Somers schools Assistant Director of Transportation, Gerard Esposito. “In Somers we feel fortunate to have a program in place that deters motorists from putting our children in danger.”    

From August through October, school buses equipped with AI-powered stop-arm cameras recorded a total of 280 illegal passings. This equates to 4.7 stop-arm violations per bus per day and 7.4 violations per weekday, or 0.1 violations per bus per weekday. The pilot data represents the clearest example to date that this type of illegally activity on the roads goes unreported and unenforced on a regular basis. 

Westchester is the only county in the New York City region that has not authorized a school bus safety program. As a result, school districts and police departments across the county are denied the opportunity to utilize advanced photo enforcement technology to catch lawbreakers and issue citations to motorists who illegally pass a stopped school bus.

Meanwhile, neighboring suburban counties including Rockland, Dutchess, Putnam, as well as Suffolk County and several municipalities in Nassau County on Long Island, have all approved bus safety programs.

According to the Governor’s Traffic Safety Committee, stopped school buses are passed illegally an estimated 50,000 times per school day.

In New York State, it is illegal to pass a stopped school bus when the large red visual sign is in operation. Flashing lights mean the bus is picking up or discharging students. All motorists are required to stop whether approaching a stopped school bus from the front or overtaking it from the rear. This applies whenever their visual signal is in operation on any public highway, street, or private road.

Effective August 19, 2019, the new school bus camera law in New York authorizes school districts and municipalities to use stop-arm cameras on school buses to hold vehicle owners responsible for their cars passing a stopped school bus.  This program allows a school district to equip school buses with stop-arm cameras designed to capture images of vehicles illegally passing stopped buses. The images are then transmitted to the municipality and used to identify the owners of vehicles and to send notices of liability to the owners. Tickets given by these cameras can result in fines of $250 for a first violation up to $300 for each violation in an 18-month period. The owners may then pay a fine or contest their liability.

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FORMER WALL STREET TRADER CONVICTED OF FRAUD IN PRECIOUS METALS SPOOFING SCHEME. JPMORGAN PAYS $920 MILLION IN PENALTIES. 4 OTHERS PREVIOUSLY CONVICTED.

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WPCNR FBI WIRE. From the Federal Bureau of Investigation. December 21, 2022:

A federal jury in the Northern District of Illinois convicted a former trader at JPMorgan Chase and Credit Suisse today of fraud in connection with a spoofing scheme in the gold and silver futures markets.

According to court documents and evidence presented at trial, Christopher Jordan, 51, of Mountainside, New Jersey, was an executive director and trader on JPMorgan’s precious metals desk in New York from 2006 to 2009, and on Credit Suisse’s precious metals desk in New York in 2010.

Between 2008 and 2010, Jordan placed thousands of spoof orders, i.e., orders that he intended to cancel before execution, to drive prices in a direction more favorable to orders he intended to execute on the opposite side of the market.

Jordan engaged in this deceptive spoofing strategy while trading gold and silver futures contracts on the Commodity Exchange (COMEX), which is a commodities exchange operated by the CME Group. These deceptive orders were intended to inject false and misleading information about the genuine supply and demand for gold and silver futures contracts into the markets.

Jordan was convicted of wire fraud affecting a financial institution. He is scheduled to be sentenced at a later date and faces a maximum penalty of 30 years in prison. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.

Four other former JPMorgan precious metals traders were previously convicted in related cases.

In August 2022, Gregg Smith and Michael Nowak were convicted after trial in the Northern District of Illinois of wire fraud affecting a financial institution, commodities fraud, attempted price manipulation, and spoofing.

In October 2018, John Edmonds pleaded guilty in the District of Connecticut to one count of commodities fraud and one count of conspiracy to commit wire fraud, commodities fraud, price manipulation, and spoofing.

In August 2019, Christian Trunz pleaded guilty in the Eastern District of New York to one count of conspiracy to engage in spoofing and one count of spoofing. Smith, Nowak, Edmonds, and Trunz are awaiting sentencing.

In September 2020, JPMorgan admitted to committing wire fraud in connection with (1) unlawful trading in the markets for precious metals futures contracts and (2) unlawful trading in the markets for U.S. Treasury futures contracts and in the secondary (cash) market for U.S. Treasury notes and bonds.

JPMorgan entered into a three-year deferred prosecution agreement pursuant to which it paid more than $920 million in criminal monetary penalties, criminal disgorgement, and victim compensation, with parallel resolutions by the Commodity Futures Trading Commission and the Securities Exchange Commission announced on the same day.

Assistant Attorney General Kenneth A. Polite, Jr. of the Justice Department’s Criminal Division and Assistant Director Luis Quesada of the FBI’s Criminal Investigative Division made the announcement.

The FBI New York Field Office investigated the case.

Trial Attorneys Matthew Sullivan, Lucy Jennings, and Christopher Fenton of the Criminal Division’s Fraud Section are prosecuting the case.

Individuals who believe that they may be a victim in this case should visit the Fraud Section’s Victim Witness website at https://www.justice.gov/criminal-vns/case/jpmorgan-chase-co-deferred-prosecution-agreement for more information.

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FORMER CEO PLEADS GUILTY TO DEFRAUDING HIS COMPANY OF MILLIONS OF DOLLARS

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WPCNR FBI WIRE. From the Federal Bureau of Investigation. December 20, 2022:

Damian Williams, the United States Attorney for the Southern District of New York, announced today that SUNI MUNSHANI, the former Chief Executive Officer of a Connecticut-based technology company (the “Victim Company”), pled guilty today in Manhattan federal court in connection with a scheme to defraud the Victim Company of millions of dollars.  Pursuant to his plea agreement with the Government, MUNSHANI agreed to pay $10,485,043 in restitution to the Victim Company.  District Judge Jed S. Rakoff accepted the defendant’s guilty plea. 

U.S. Attorney Damian Williams said: “Not even a year into his appointment as CEO, Suni Munshani began betraying his employer’s trust and breaking the law, stealing millions of dollars to line his pockets.  Company executives are given significant amounts of power, but today’s plea should send the message that this Office will be ready to act if an executive chooses to abuse that power.”

According to the allegations in the Superseding Information and other filings and statements made in court:

Between 2011 and 2019, SUNI MUNSHANI was the CEO of the Victim Company, which provided data security services to its clients. 

Within six months of his appointment as CEO, MUNSHANI and others began an approximately nine-year scheme to defraud the Victim Company.  During the scheme, MUNSHANI created an email account associated with a purported third-party contractor controlled by MUNSHANI and used that email account to correspond with the Victim Company and to obtain payments from the Victim Company totaling at least approximately $3 million dollars for services that were never provided to the Victim Company. 

He also caused the Victim Company to issue a $3.5 million check for a purported tax liability, which check MUNSHANI then deposited into an unauthorized bank account created by MUNSHANI in the name of the Victim Company.  

In addition, MUNSHANI defrauded the Victim Company through fraudulent licensing and reseller agreements between the Victim Company and two other companies (the “Licensing Company” and the “Reseller Company,” respectively). 

Among other things, MUNSHANI instructed another individual to set up the Reseller Company “in the same way as [the Licensing Company],” and then helped create and submit fraudulent invoices from the Reseller Company to the Victim Company.

*                *                *

MUNSHANI, 61, of Easton, Connecticut, pled guilty to one count of conspiracy to commit wire fraud, which carries a maximum sentence of five years in prison. 

The maximum potential sentence in this case is prescribed by Congress and is provided here for informational purposes only, as any sentencing of the defendant will be determined by the judge.

Mr. Williams praised the outstanding investigative work of the Federal Bureau of Investigation’s New York Office.

The prosecution of this case is being handled by the Office’s Complex Frauds and Cybercrime Unit.  Assistant U.S. Attorney Timothy V. Capozzi is in charge of the prosecution.

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LETTER TO THE PLANNING BOARD: AFTER LAST WEEK’S RAIN, FARRELL ESTATES at RIDGEWAY NEEDS TO TAKE A CLOSER LOOK AT THE WATER PROBLEM

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THE PLANNING BOARD MEETS ON THE FARRELL ESTATES PROPOSAL TONIGHT 7 TO 9 PM AT CITY HALL

FORMER RIDGEWAY COUNTRY CLUB FLOODING FRIDAY, DECEMBER 16 DURING LAST WEEK RAINS (Photo by Ron Rhodes)

WPCNR THE LETTER TICKER. December 20, 2022:

Dear Planning Board Members,


Thank you for following up on our email of November 30th relating to “water issues” on the old golf course property.  We understand that many of you made a visit to inspect the property in person and we appreciate your interest and concern.  


The above picture from our house was during last Friday’s rain.  Some of our questions include: 

Are the mini-lakes from the natural sloping of the original golf course?  Or from the piping of the underground streams that may be damaged?  Or maybe the original developer of the golf course planned this area as wetlands?  When Farrell builds 4 homes and a City street over this area where does the water that we see now flow to?

Surrounding residents like ourselves have been seeing wetlands like this for years. . .at times even worse. 

That is why in our prior email we asked for an independent expert to give a Second Opinion on the “water issues” for the whole golf course.  

And hopefully Farrell will use this study as the basis for describing the current water conditions on the old golf course property in his environmental submissions. 

In fact we would like to see Farrell beforehand review his summary of the current conditions with the Gedney Association. . .as we recall from a decade or so ago FASNY’s initial SEQUA description had so much misinformation that we had difficulty recognizing our own neighborhood.Thanks again for your visit and follow up questioning.


Marie and Ron Rhodes

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UPDATE ON COVID VACCINES FOR UNDER-5’S FROM “YOUR LOCAL EPIDEMIOLOGIST” — NATIONALLY VACCINATED UNDER 5 VERY LOW. “ATROCIOUS” COVERAGE NATIONALLY. CONFUSION REIGNS. AVAILABILITY OF UNDER-5 VACCINES DIFFICULT.

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MODERNA UNDER-5 VACCINE AVAILABLE AT WHITE PLAINS DEPT. OF HEALTH CLINIC FRIDAYS IF YOU CALL FOR AN APPOINTMENT.

By Dr. Katelyn Jetelina, Your Local Epidemiologist, December 20,2022. Reprinted with permission

Buried in the news of the triple-demic, an updated Omicron booster was authorized for kids under 5 years old. My weekly Q&A on Instagram has been flooded with questions from parents. Here’s a quick update.

Who is eligible for a fall booster?

This is very confusing, as it depends on what vaccine series (and how much of that series) they have received:

  • Moderna: Every child that had the primary series (2 shots) is eligible for the fall booster
  • Pfizer:
    • If your child completed primary series (3 shots), they are not eligible.
    • If your child did not complete the primary series (i.e., had 1 or 2 shots only), they are eligible for the fall booster.
    • EDITOR’S NOTE: Schedule a First Dose Pediatric Moderna Vaccine (Ages 6 Months to 5 years) AT THE WHITE PLAINS WESTCHESTER COUNTY DEPARTMENT OF HEALTH 134 COURT STREET. CALL THE DEPARTMENT OF HEALTH TO SCHEDULE AND FOR DETAILS ON ELIGIBILITY. https://health.westchestergov.com/157-covid-19-updates/2807-vaccine-information

I’m not sure why this was decided this way. Don’t shoot the messenger.

How is the primary vaccine doing?

Safety. The vaccines continue to be safe. We saw this during the clinical trials, but we continue to see it in the real world. The CDC released results of their active (V-Safe) and passive surveillance (VAERS).

  • The most frequent reactions: injection site pain, fatigue, and fever.
  • Four children received care at a hospital after vaccination: two were unrelated to vaccination, one was unwilling to provide further information, and one is under further review. None have died.
  • No cases of myocarditis were reported.

Effectiveness. The clinical trial data was published in the New England Journal of Medicine. However, we have yet to see any real world effectiveness data. (And I looked hard!) This is likely because uptake has been so low that it’s difficult to assess with certainty.

What is vaccine uptake for kids under 5?

Coverage for the primary series is just atrocious. Only 792,000 children under age 5 have one dose, which equates to 8.4% of this population. This varies widely across states—29% of kids in DC have received their first dose compared to 1.7% in Mississippi.

This is incredibly interesting to me given that, in a recent poll, 1 in 2 parents said they are worried their child will get seriously sick from COVID-19. I would be curious to see the below graph organized by age group.

We are not the only country experiencing slow uptake. Data from Nature show that about a dozen countries, including Canada and Israel, have approved vaccination for children from their first year of life. Yet in Canada, for example, only 8.4% of children aged 0-4 have been vaccinated.

What are you doing with your kids?

My girls (2 and 3 years old) had the primary Moderna series, so they are eligible for a fall booster. It’s not clear how much additional help it will provide in preventing hospitalization. But they will be getting the fall booster for two other reasons:

  1. Broaden protection. SARS-CoV-2 has changed a lot and the fall booster provides updated instructions for our kids’ antibody factories. In other words, it will tell their antibodies how better to recognize Omicron if they get infected.
  2. Short-term protection against infection. A recent study found co-infection of flu and COVID is more severe than just flu or COVID alone for our kiddos.
  3. Also, parents missing work due to respiratory illness is at an all time high right now. I’ll take all the help I can get.

Average number of parents who missed work due childcare problems. Source: Department of Labor

I’ve been struggling with timing the fall booster. It’s clear from adult data that delaying the booster is advantageous. My girls finished their primary series 5 months ago. But delaying it too much more won’t be helpful this winter. I talked to Dr. Ruth Link-Gelles about this last week and decided to get them boosted as soon as possible.

That is, if I can find one.

According to vaccines.gov, I have to travel more than 45 miles to get my 2 year old the updated booster, which is absolutely unacceptable. If we want to improve vaccine uptake, we have to make it easier.

Bottom line

The updated booster is here for our little ones. To me, an updated booster still makes sense, but finding one is another story.

As parents, it’s absolutely exhausting how many viruses are circulating right now. Hang in there—every epi curve comes down.

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White Plains Schools and Common Circles Fight the Tyranny of First Impressions

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Bayete’ Ross Smith photographs State Senator Shelley Mayer for “We are White Plains: Bridging, Belonging and Building Community” a photographic exhibit featuring 36 White Plains Schools and prominent citizens in White Plains to help White Plains students and the community explore identity via a traveling museum. It will be showcased in the halls of White Plains High School in March.
JOE BOYKIN, White Plains High School personality posing for a series of photographs of him in different clothing and styles

WPCNR IMPRESSIONS TAKEAWAYS TRANSITIONS. By John F. Bailey, December 19, 2022:

My father once told me in discussing job intervews, “You never have a second chance to make a first impression.”

I learned that again Friday at a photo shoot involving 36 persons from the White Plains High School and Middle School, including Mayor Tom Roach Council President Justin Brasch and State Senator Shelley Meyer.

Staff administrators from the White Plains School District, members of the police and fire department, the mayor, the state senator, and other dignitaries, along with other well-known individuals working in the White Plains participated.

The  non-profit Common Cause conducted an all-day photography shoot at the high school Friday, capturing 36  school employees in a variety of clothing of their choice.

Each participant was photographed in a variety of outfits of their choosing as part of a planned traveling museum “pilot” program. The program is being used to demonstrate to those looking at 10 different pictures of the same person, instinctively make a snap judgment what the person is as to character, safety, respect, attraction.

The program is named:

“We are White Plains: Bridging, Belonging and Building Community.”

It is scheduled to be unveiled in the halls of White Plains High School March 2023.

Photographer Bayete’ Ross Smith composed the compositions in the all day session.

Beyete’ Ross Smith talks about how he got the idea for the identity demonstration. (Click white arrow > on left to start the interview)

He shot 10 portraits of each  of the 36 participants photographing them in ten distinctly different fashion presentations chosen by the subject who posed with  a blank expression in each outfit.

Sue Spiegel, left, and Marla Felton of Common Circles, creators of “We Are White Plains,” talk about plans for the exhibition. (Click white arrow > at the left to hear the interview)

The blank countenance you encounter  when looking at the  10 photographs of each person, you were not swayed by a smile, a scowl, or grimace or a laugh, forcing you as an individual to discover that seeing the same person in a different outfit, you make a different judgment.

Sue Spiegel and Marla Felton of the non-profit, Common Circles, Inc. are using the arts, conversation, interactives and storytelling to help students in the White Plains School District and the broader White Plains community explore identity.

Superintendent of Schools Dr. Joseph Ricca organized the program with Common Circles

The dynamic revelation was conceived by Mr. Ross Smith as part of his “Our Kind of People” series. “Our Kind of People” examines how perception about someone’s identity, value and character is affected by appearance such as clothing.

Joe Boyin observes why he wanted to pose for the exhibition.

The finished exhibition scheduled to appear at the High School in March consists of photos of each of the participants in 10 different outfits, such as this photo below. on Mr. Ross Smith’s website.

When I observed this Mr. Ross for the first time, I realized how right my father was about not getting a second chance to make a first impression.

This one person wearing 5 different outfits. I think the photo of one person with 5 different looks explains why we should not make judgments based on appearance.

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“MT. COVID.”CURRENT 2-DAY FAST INFECTION OF COVID COMBINED WITH 300 NEW INFECTIONS DAILY IN WESTCHESTER (2,000 A WEEK) COULD CREATE 12,063 CASES THIS CHRISTMAS WEEK. 10 COUNTIES AROUND NYC URGED TO WEAR MASKS BY CENTER FOR DISEASE CONTROL.

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WESTCHESTER COMPLETES THIRD WEEK OF 2,000 NEW COVID CASES IN ROW. 300 A DAY GETTING INFECTED.

Mt. ETNA, SICILY 2019…all quiet but the black dried lava on right remains. (WPCNR PHOTO)

WPCNR COVID SURVEILLANCE From the New York State Covid Tracker. Observation & Analysis by John F. Bailey. December 18: UPDATED DEC. 20, 2022:

I see the covid statistics as a volcano , a Mt. Etna (pictured above IN 2019) on the island of Sicily. The daily rate of infections smoking at the top innocently against a blue sky. The blackened lava eruptions of past thousands of years in wide swaths down its sides

Meanwhile, inside the vast mystery in the base of the volcano containing the lava of unconfirmed untested, or positive tested persons (afraid to report to verify their positive) is building the potential for fast, fast fast infections over the next weeks.

That is what happened to Westchester 12 months ago, when “Mt. Covid”erupted.

The NY Covid Tracker reported Monday that Westchester County has 192 lab-validated new covid cases raising the Westchester total to 2,108 for the week December 11 through December 17.

Last week ended Saturday is the third consecutive week, the covid tracker reported Westchester with over 2,000 new cases, which would total 6,730 new covid cases since the Friday after Thanksgiving, on track to produce 7,000 to 8,000 new cases next week (the week before Christmas.

But the total could double that because of how quickly covid afflicted persons spread the disease to others: within 2 days. I am seeing now for the last 3 weeks sharp increases on Sunday, Monday, Tuesday, Wednesday, Thursday the days when cases used to under 200 new infections before Thanksgiving.

One year ago in 2021, December 12 to 18, Westchester recorded 5,367 new cases of covid (when there were no vaccines available to protect the population).

This year with vaccines, Westchester has exceeded that total.

In the week after Christmas just 5,367 covid cases resulted in the spreading the disease to 12,063 people the week before Christmas. WPCNR estimates the 2,184 infections from last week (December 4-10) will combine with th 2,000 infections this week to infect 300 persons a day during the week before Christmas, or a conservative total of 4,200 people.

If the coronavirus now out there spreads as fast as it did the last two week period ended yesterday infecting people within 2 days, (because of the faster rate of transmission of diseases, reflected in higher cases on the first 5 days of the week the last 3 weeks), you might expect more than 4,200 infections next week.

Last year there were 12, 063 infections from December 18 to 24, but that was when Westchester was masking. If everyone masked this coming week at gatherings, parties, on traveling, and finished off their vaccinations the spread will be reigned in. If you do not mask and do not get fully vaccinated, we may see considerably more than the current 309 infections a day.

Do not forget the percentage of positive tests verified by labs out of Westchester County. It was 7% on Friday and holding at an 8.5% average through 6 days.

Let’s look at the placid NY Covid Tracker that unflinchingly puts out the results of positives of only lab-verified tests .

Last week in one of the most obscure statistics ever created Westchester had an average daily infection rate daily of 33 new cases daily (per 100,000 of population according to the NY Covid Tracker). What does this really mean?

If you multiply 33 by the population of Westchester per 100,000 of the 2022 population 1,004,457 which creates 10 blocks of 100,000 people- 10.04) you get infections of 331 (not 33) daily for 5 of 6 days in the county Sunday, Monday, Tuesday, Wednesday, Friday) which is 2,317 a week with vaccines available, and masking available, personal socializing within citizens’ control, all doable by Westchester citizens, they just have to do it).

This means unless behavior and personal completion of vaccination full quotas of doses responsibilities are not brought up to date by you and me Mr. and Mrs and Ms. Westchester , do not improve we may get considerably more than 2,317 a week.

Here’s why: the week before Thansgiving (Nov 20-26) saw an increase in how many newly infected with covid persons spread it to other persons.

Each newly infected person of the 1,139 infected with covid (lab-test verified only, from November 20 to 26 to the week of November 26 through December 3 infected to 6 others after Thanksgiving holiday lifting new infections to 2,102. Divide 2,102 by 1,139 and you get a 1 infectee infecting 6 other persons.

That is what the pre-Thanksgiving infections did.

As I wrote previously, the 2, 317 infections a week the NY Covid Tracker reports Westchester averaging based on the rate of 33 daily per our 1,004,457 population (10.04 100,000 segments) we can expect those 2,317 infections a week to bring possibly 13,903 infections by the end of next week which totals ,more than last year’s 12,063 when we had no vaccines, just masks and personally being careful.

But, you Mr. and Mrs. and Ms. Westchester can prevent that. It is in your hands, and personal discipline.

The other 8 counties surrounding New York City as well as NYC as of Friday, Dec. 16, these New York counties are in the “orange” zone with “high” COVID levels where masks are currently recommended:

  • Westchester County
  • Rockland County
  • Orange County
  • Putnam County
  • Nassau County
  • Suffolk County
  • Bronx County
  • Kings County (Brooklyn)
  • Queens County
  • Richmond County (Staten Island)
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LONG COVID: An update and gauging risk

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Your Local Epidemiologist

Long COVID: An update and gauging risk

Dr. Katelyn Jetelina

Earlier this year I wrote a four-post series on long Covid: burden; impact on specific health systems, like the heart; long Covid among kidspredictors of long Covid and treatment. Today’s newsletter is meant to be an update—I’m picking up where I left off, so I highly recommend reading those first, if you haven’t already.


The individual risk of death from a COVID-19 infection is now close to the flu thanks to vaccines, immunity, and treatment. However, death is not the only outcome of SARS-CoV-2. Long Covid—or the persistence of symptoms after an infection beyond three months—is still a threat to living a healthy and prosperous life.

Overall burden

A recent study pooled more then 54 long Covid studies (which included a total of 1.2 million people) and found that 6% of individuals who had symptomatic SARS-CoV-2 infection experienced long Covid in 2020 and 2021. This is consistent with a massive study in Sweden (2020-2021) that found the proportion receiving a long Covid diagnosis was 1% among individuals not hospitalized for their COVID-19 infection, 6% among those hospitalized, and 32% among those treated in the ICU.

Today, the U.K. estimates that 3% of the general population has long Covid. In the U.S., the population-level burden of long Covid has been historically difficult to grasp. But in August 2022, the U.S. Census Bureau added four questions about long Covid to its Household Pulse Survey. What did they find?

  • 16 million working-age Americans (aged 18 to 65) have long Covid today. This equates to ~8% prevalence.
  • Of those, 2-4 million are out of work due to long Covid.
    • The annual cost of lost wages is ~$170-$230 billion a year.
  • The prevalence of severe long Covid is unequally distributed across race/ethnicity and age.

Economically, long Covid is a big deal to this country. The total economic cost is $3.7 trillion in the U.S., without accounting for future cases.

Changing risk

Just like the risk of death, the risk of long Covid appears to have changed over time.

In general, there are three things that are decreasing the risk of long Covid today:

  1. Vaccines. A number of studies show vaccines reduce the risk of long Covid. The problem is that these studies greatly vary in the estimated reduction: some say vaccines reduce long Covid by 85%, others say 15%. The “truth” is likely somewhere in-between.
  2. PaxlovidOne study found Paxlovid reduced the risk of long Covid by 25%.
  3. Omicron. A very strong study in the Lancet found the odds of long Covid after an Omicron infection were significantly lower compared to after a Delta infection.

All of these help, but are not bullet proof.

Of course, the more the virus mutates to become more contagious, the risk of infection (and thus long Covid) increases.

Death from long Covid

The National Center for Health Statistics released the first long Covid mortality report yesterday. The scientists started with over 1 million death certificates dated from January 1, 2020 to June 30, 2022 that indicated COVID-19 as the underlying or contributing cause of death. Then they searched for clues that the patient had long Covid by looking for words like: “chronic COVID,” “long COVID,” “long-haul COVID,” or “post-COVID syndrome.” What did they find?

  • 3,544 deaths—or 0.3 percent of the total—had text on their death certificates about long Covid
  • Long Covid peaked in June 2021 (1.2%) and in April 2022 (3.8%)
  • Long Covid death rate was highest among adults aged 85+, non-Hispanic American Indian or Alaska Native people, and males.

A simple search of words like this has major limitations, so we cannot make causal claims. This is more of an exploratory analysis to see if “long Covid” appeared on death certificates. My hunch is that this is a huge underestimate of long Covid deaths, but it could be an overestimate. More work needs to be done.

Increased death from SARS-CoV-2 is not limited to acute illness

We are at the mercy of time to see the impact of SARS-CoV-2 infection beyond symptoms, for example blood clots.

One rattling study in the Lancet found that people infected with SARS-CoV-2 had more than 3 times the risk of dying over the following year compared with those who remained uninfected. For COVID-19 cases aged 60 years or older, increased mortality persisted until the end of the first year after infection, and was related to increased risk for heart and/or respiratory causes of death.

An Australian report of excess death found something similar.

report from Singapore also found an increase in excess mortality after infection (people without recent infections had no additional excess deaths), however it was not linked to cardiovascular events.

Implications

On a population level, it’s clear that the footprint of SARS-CoV-2 will extend for decades to come. But what this looks like is highly debated, and there are two camps of scientists:

  • One camp thinks long Covid will be a mass debilitating event that will define the economies of countries for decades
  • The second believes long Covid is real, incredibly debilitating for the people who have it, but, given the change in risk, will not be such a big event that our future economies or health systems will fail.

Time will tell.

On an individual level, assessing risk of long Covid is extremely difficult. How much should long Covid impact my daily decisions? To me, it’s easiest to understand a new threat by comparing it to familiar threats, like driving. I did this using MicroMorts a few months ago, comparing the risk of dying from COVID-19 to, for example, skydiving.

Here is what I found (keep in mind these are super rough estimates):

  • Driving: The annual risk of getting into a car accident is 1 in 30 per year for the average driver. Of those accidents, 43% are likely to be injured. And, of those injured, 10% are permanently impaired. So, the annual risk of permanent impairment from driving is 1 in 700.
  • Long Covid: The risk of getting an Omicron infection (asymptomatic and symptomatic) per year is ~1 in 2 (before Omicron it was ~1 in 4). If we take into account 3% of infections lead to long Covid and, of those, ~18% will have disease so severe that they are unable to work. So, the annual risk of severe long Covid (unable to work) is 1 in 370.
  • Other annual risk comparisons:
    • Severely injured during a house fire: 1 in 20,000
    • Needing reconstructive surgery after a dog bite1 in 400

So, the risk of debilitating long Covid is double the risk of permanent impairment from driving. Risk of debilitating long Covid is much higher than getting injured during a house fire and about the same as getting a serious dog bite.

Of course, individuals can do a lot of things to reduce risk for all of the above: Wear seatbelts. Drive less. Make sure your fire alarms work. Don’t approach growling dogs. But, we also make conscious (or non-conscious) decisions to increase risk: texting while driving; unplugging the annoying beeping fire alarm. It’s an every day balancing act. But, just like speeding tickets, required fire exit signs, and leash laws, there are policy level initiatives that could help with long Covid, too.

Bottom line

Long Covid is an incredibly debilitating disease and millions are suffering. While risk is changing, we don’t know what the future will hold.

This leaves us with a difficult balancing act. I find myself not willing to take risks in some instances, and more willing in other instances—as with many things I do in my daily life, like driving. A person next to me will be very different. I think it will be years until this calculated decision-making becomes easier.

Editor’s Note: On Monday December 12, the New York State Covid Tracker reported 346 cases of new covid were reported (Lab Test verified) bringing the first two days of this week total to 645 new cases, continuing a third week of highly increased cases immediately after the weekend, putting the county on track for a third week of over 2,000 new cases.

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Cannabis Dispensaries set to open before end of year, more in 2023. Governor says as she unveils “New York Licensed Cannabis Dispensary Symbol

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Governor Kathy Hochul  today unveiled a “New York State Licensed Cannabis Dispensary” verification tool that will be posted in the windows of legally licensed retail dispensaries, which are set to begin opening before the end of this year. The designation will ensure consumers know they are buying from a dispensary regulated by New York State. A universal symbol on each product sold will also show that it is up to standards set by the state. The combination provides consumers certainty that they have acquired a tested, regulated product.   

“It’s critical for New York’s cannabis consumers to understand the risks of buying untested, illicit products and to have the tools to guide them to the safer, legal market that’s poised to open,” Governor Hochul said. “These tools will help to protect public health and strengthen our ability to deliver the equitable cannabis market our law envisions. We will continue to work with our partners in municipalities across the state to enforce the law and shutdown illicit operators who are selling products that put New Yorkers at risk.”  

As stores continue to open in the first quarter of 2023, the state will also be releasing a public education campaign called “Why Buy Legal New York,” which will explain the benefits of purchasing legal adult-use cannabis for cannabis consumers in New York State. The campaign will discuss the risks of buying untested illicit products, and how those products undermine the goals of New York’s cannabis law to build the most equitable and inclusive cannabis market in the nation.   

Tremaine Wright, Chair of the Cannabis Control Board, said, “The dispensary verification tool unveiled by Governor Hochul today combined with requirements for the universal symbol on regulated products sets us off on the right foot.  It is critical that consumers know and trust that the new, legal cannabis market offers tested products and follows protocols designed to protect public health.  These efforts combined with rigorous enforcement, will help build a stable, legal marketplace.” 

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MUSK, FAUCI, TRUST IN SCIENCE AND HOW TO MAKE IT SURVIVE

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By Dr. Katelyn Jetelina, Your Local Epidemiologist December 14, 2022. Reprinted with permission.

Si quiere leer la versión en español, pulse aquí.

Trust in public health is eroding, and the implications are far reaching. We, as a field, have to fix this.

Over the weekend

Any forward-facing scientist can tell you that receiving dangerous messages has been a common occurrence throughout the pandemic. But the hate, resentment, frustration, and anger was crystallized in one instance over the weekend: Elon Musk—the world’s richest man and new owner of Twitter—wrote the post below.

Elon Musk @elonmusk

My pronouns are Prosecute/Fauci10:58 AM ∙ Dec 11, 20221,176,815Likes177,693Retweets

Five words, that were wrong on so many levels, garnered more than 1.17 million “likes,” 177,000 retweets, and international attention in mass media. Anyone who dared to disagree received a wave of truly grotesque comments. Even Musk noticed as he followed up on his original tweet with: “Truth resonates…”

Of course, the viral reaction is due to many things: social media algorithms, a polarized country, politics, misinformation, disinformation, opinions about Twitter, opinions about Elon. I also think Musk is trying to deflect negative attention from himself.

It’s also a reflection of humans’ difficulty coping with randomness—people need someone to blame for the pandemic, the fear they experienced, the people they lost, or the jobs and livelihoods that were changed. The viral reaction was also an indication that people finally felt heard.

But all of the above also overlap with public health. And, their accumulation has been funneled into one sentiment towards our field: distrust.

Change in trust

Every year, the Pew Research Center conducts a survey with Americans on public confidence in certain groups. Overall, trust in scientists has decreased throughout the pandemic, but ever so slightly. Interestingly it remained higher than public confidence in business officials, the military, public school principals, religious leaders, police officers, and elected officials.

If we compare the responses based on political affiliation, though, the story becomes jarring: confidence in scientists among Republicans dropped significantly. In fact, 1 in 3 Republicans have no confidence at all.

Furthermore, declines in trust in science were most pronounced among White adults. Americans with higher levels of education expressed more positive views of scientists than those with lower levels of education.

This is a huge problem, as trust equals lives

An Oxford report continually assesses country-level factors that most strongly predict COVID-19 deaths. The answer?

Not pandemic preparedness. Not government. It was interpersonal trust—a measure of how much people think they can trust another citizen who they don’t already know. In other words, public health worked better in high-trust countries.

We cannot have one group trust public health and another not.

This is not how viruses work.

Infectious diseases violate the assumption of independence—what one person does directly impacts the person next to them.

This is unlike cancer or diabetes, for example. Everyone has to be against a virus, or the virus thrives.

Perhaps most concerning is that this isn’t going to be our last pandemic. Since the 1918 flu, we’ve seen diseases emerge faster and faster. Public health also touches on our daily lives beyond infectious diseases: what we eat, social problems, gun violence, and all other acute and chronic medical problems. We need the trust of the community to move the needle for any of these.

What to do?

As the field of public health copes, self-reflects, and digests the past three years and weighs how to build for a better future, we have to make it our goal, our opportunity, to improve trust.

As one scientist said, “You earn public confidence in small drops and you [lose] it in buckets.”

Bottom-up engagement is absolutely necessary. We need to enter conversations with humility.

A conversation about false dichotomies (lock down vs. throwing caution to the wind) is necessary.

A conversation about disease vs. the needs of a community is necessary.

An honest conversation on what we (CDC, state epi, local epi, leaders, communicators) got wrong, got right, and why.

What does this look like? I have a few ideas:

  1. Listening sessions. Not hearing and not telling, but listening to people and trusted messengers who are not in “our world.” Bringing them into the solution. It will be painful. It will be time consuming. But it has to be done.
  2. A COVID-19 commission that is congressionally mandated, like the 9/11 commission. There is text in the PREVENT Act, but it’s not clear if PREVENT will pass.
  3. Preparation for the future. Putting communication at the center of pandemic preparedness. This is still not being done. Building capacity for effective scientific communication needs to be a core of our national strategy. As I’ve written before, a lot needs to be done in this area.

I’m sure there are more and even better ways. And I would love to hear your thoughts in the comments. But the fact of the matter is there is no one solution.

And this is going to take a whole lot of time.

Bottom line

We need to understand why five words in a Tweet carry so much weight in public health and threaten our entire profession. Will trust in science survive the pandemic? 

MaybeIt depends on what we, as a field, do next.

If we don’t win hearts and minds, we won’t win against this virus or the next. Trust is key in public health.

Our scientific work depends on it. Our health depends on it. Our lives depend on it. Now everyone needs to act like it.

That includes, you, Mr. Musk.

(Editor’s Note: Locally, on Sunday December 11 in Westchester County, 299 persons tested positive to start the week of covid surveillance. Rockland County had 72 new cases. Orange County, 56, Dutchess, 42 and Putnam County 37, Ulster, 17. The Mid-Hudson Region saw 540 person test positive for covid of 9,863 Lab-verified tests an infection rate of 5%. Nassau County and Suffolk County reported 1,158. Of 19,797 tested in those 9 counties (Mid-Hudson and Nassau and Suffolk) there were 1,678 positives in one day an infection rate of 8% . New York City reported 2,376 new cases. )

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