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It’s time to get back into the groove of things. Here’s public health news you can use for the week.
Fall respiratory weather report: “Big three” remain low
Per national wastewater data, Covid-19, flu, and RSV all remain low in the U.S.
I anticipate fall respiratory season “officially” beginning next week, as it will soon cross the epidemic threshold. The holidays may hyperdrive it. I will start publishing a semi-regular State of Affairs again to bring you a deeper dive.
Resources in anticipation of the unknown
Many people are wondering what they can do to prepare for an HHS secretary with a history of ignoring reality. Regardless of what happens, the YLE audience—you—are trusted messengers (religious leaders, business executives, clinicians, public health departments, neighbors, grandparents) and will continue to have a critical role in listening and filling health information voids.
I have started curating a list of resources that may be helpful:
Top 12 questions on routine vaccines.Many people have questions about routine vaccinations: the need, safety, and rumors. YLE, in partnership with Yale School of Public Health, compiled an FAQ document of evidence-based information for you. Feel free to email, print out, distribute, doodle on, or let it guide organic conversations with others.
Communicating health in a polarized era. On Tuesday, December 10, at 10 a.m. PT/1 p.m. ET, I will host a live Q&A with Kyle McGowan, the former CDC Chief of Staff under the first Trump Administration. McGowan has helped me and many other public health programs think strategically about positioning public health in a polarized era. This event will target a public health audience, but anyone is welcome to join! Mark your calendars; more details to come.
Weekly takes on public health news. I have joined America Dissected as a co-host! We will bring you first-draft reactions to public health in the news and how politics, media, culture, tech — everything around us — interact to shape our health. Follow on Apple Podcasts, Spotify, or whenever you get your podcasts.
Eggs are getting expensive thanks to H5N1 (BIRD FLU)
Egg prices are up30%, which means we are paying upwards of $4 for a dozen eggs. That is if you can find them. Why? A constellation of reasons, but there is one we can’t ignore: the avian flu (H5N1) is impacting poultry farmers, although it’s not yet as bad as last year.
Outbreaks in commercial poultry farms can devastate local food supplies, affect farmers’ and employees’ livelihoods, and raise poultry prices due to a limited and strained supply. For example, an egg factory in Iowa killed 5.3 million chickens over a single case of avian influenza in the flock.
There’s no immediate concern for the general public (risk to humans is still low), except that it’s a pain at the grocery store.
WHAT WE KNOW
However, scientists have been learning more about H5N1 and what it may mean to humans. Here’s an attempt to catch you up:
Asymptomatic infection. Fifty-three humans have been infected with H5N1 this year, mostly from direct contact with dairy cows and poultry.Thanks to some new science, we now know we’re missing cases. TheCDC discovered that some dairy workers who never reported symptoms have antibodies. In other words, H5N1 causes asymptomatic infection. This isn’t surprising, given what we know about seasonal flu, a cousin of H5N1.
A Canadian teenager is in the ICU because of an H5N1 infection. This is the country’s first known H5N1 human infection. Unfortunately, health authorities don’t know how the teen got it. They haven’t had any contact with birds, cows, or pigs (although their dog was euthanized because it got so sick; epidemiologists are looking into this). The teen’s severe reaction is likely related to age. The younger the person, the less cross-protection is offered by exposure to seasonal flu.
The virus is mutating in places that we don’t like. Scientists looked more closely at the genetics of the Canadian ICU patient’s virus and found concerning mutations that could make it better adapted to infecting humans. These changes alone do not mean that the virus is poised for efficient human-to-human spread, as many additional changes are likely needed for that to occur. But the more chances the virus gets to infect people, the more likely these changes are to occur together. In addition, CDC has reported that some mutations are associated with reduced effectiveness of antivirals. Still, it’s thought that these changes are not currently big enough to make antivirals ineffective altogether.
It will be interesting to see how a change in administration impacts preparedness for pandemics like H5N1. I will be keeping a close eye on it.
New RSV vaccine data for pregnant women: Earlier is better
There’s been a lack of real-world effectiveness data on RSV vaccination during pregnancy. This week, we got a really useful study on the optimal timing of vaccination during pregnancy:
Researchers collected data on mothers who received an RSV vaccine between 32 and 36 weeks of pregnancy and collected antibody levels in two-month-old newborns.
They found that women vaccinated closer to delivery had significantly lower antibodies in their babies.
To be clear, getting vaccinated during pregnancy at any time will help the baby. However, for maximum protection, aim to receive the vaccine at least five weeks before your due date.
How does this vaccine work again? A mom gets vaccinated, and then she makes antibodies, which takes some time. Then mom’s antibodies are passed to the neonate via the placenta. Once born, the infant has protection up to six months after birth. Pretty cool! Parents also have the option to give a monoclonal antibody to their infant. See here for more information.
Sexually transmitted infections slow down
After years of increasing, sexually transmitted infections (STIs) have turned the tide and decreased by 1.8%. The decline is seen in every region across the United States but is most pronounced in the West. Lower rates of gonorrhea and syphilis are driving the slowdown.
Why the decrease? Mainly due to public health campaigns and innovations:
Ability to test frequently and privately. FDA-authorized self-tests (or at-home tests) for syphilis, gonorrhea, and chlamydia. Awareness of infection can reduce transmission to others.
Doxy PEP. This is a medication one can take within 72 hours of sex that reduces the chances of getting an infection, recommended primarily for men who have sex with men and trans women after unprotected sex.
Public health campaigns driven by a national task force for syphilis and for PrEP to prevent HIV transmission and to test more frequently.
Reader question grab bag
After the future of vaccine policy post last week, a reader emailed: “Why don’t some places allow [vaccination] exemptions? For example, I recall Maine had a very high exemption rate before ending the exemption; is that true of the others? What happened to change the rules?”
In 2015, a Disneyland measles outbreak fueled legislation to remove non-medical exemptions for routine vaccinations in California. Maine changed its law in 2021. I don’t know why—it doesn’t seem like this was in response to an outbreak but rather a groundswell during the pandemic. It was a very close vote. Both states saw dramatic vaccine exemption declines after passing the law eliminating non-medical exemptions.
Bottom line
You’re all caught up for the week! Have a wonderful weekend. It’s time for me to pull out holiday boxes and start decorating the house.
Love, YLE
Your Local Epidemiologist (YLE) is founded and operated by Dr. Katelyn Jetelina, MPH PhD—an epidemiologist, wife, and mom of two little girls. YLE reaches more than 280,000 people in over 132 countries and has a team of 11 whose main goal is to “translate” the ever-evolving public health science so that people will be well-equipped to make evidence-based decisions. This newsletter is free to everyone, thanks to the generous support of fellow YLE community members. To support the effort, subscribe or upgrade below:
STATEMENT FROM GOVERNOR KATHY HOCHUL ON LOOSE BORDER:
“I strongly oppose the U.S. Customs and Border Protection’s decision to reduce operating hours at four crossings on New York’s border with Canada. While the Biden-Harris Administration has achieved measurable success in enhancing southern border security, New York is experiencing a dramatic increase in irregular crossings along our northern border.
“My Administration has already taken actions to further defend our northern border: redirecting $5 million in federal State Homeland Security Program funding to enhance security efforts at New York’s border with Canada, including by purchasing additional tools to support investigations into transnational criminal organizations.
We have also increased staff and technological capacity for New York State Police, which includes a comprehensive drone management system and handheld X-ray machines. While these important resources will help keep New Yorkers safe and manage the spike in illegal border crossings, greater federal support is crucial to meet the magnitude of migration we are seeing.
“Republicans in Congress failed to pass a bipartisan comprehensive immigration bill earlier this year that would have given states like New York greater resources to handle the influx of migrants nationwide, and New York can no longer afford to wait for federal lawmakers to act. We need to expand enforcement at the northern border today and I call on the U.S. Customs and Border Protection to reverse this decision.”
Welcome to the Northeastern edition of Outbreak Outlook! It is only available to paid subscribers. If you wish to become a paid subscriber and access region-specific information, please click the Subscribe now button below. Thanks for reading! -Caitlin
Flu season is still off to a slow start, which is very welcome.
Rhode Island stands out dramatically in the Northeast, with wastewater levels surging to “very high” levels. However, outpatient ILI remains very low at 1.3% and RI only has three wastewater sites, so it’s possible this is a data blip.
New Jersey and New York City report the region’s highest outpatient ILI at 3.9% and 4.2% respectively, though both show unremarkable wastewater activity. New York state shows lower outpatient ILI at 1.5% and minimal wastewater levels.
Pennsylvania and Connecticut report fairly low outpatient ILI (1.5% and 2.3% respectively) with minimal wastewater activity in PA. Vermont shows similar patterns with outpatient ILI at 0.9% and minimal wastewater levels.
Maine, Massachusetts, and New Hampshire all report very low outpatient ILI between 1.1% and 1.9%.
I have no doubt that flu season will pick up at some point, but I’m enjoying the lull while it lasts.
COVID-19
Covid-19 wastewater activity and severe illness are minimal; however, activity seems to be starting to increase again in a few states.
Wastewater concentration in the region. Source: CDC
Wastewater activity is picking up in Massachusetts and Rhode Island (though it remains at moderate levels).
Otherwise, wastewater activity is low or minimal across most of the region, including in New York, Pennsylvania and New Jersey. In Maine, activity is moderate and decreasing.
In terms of severe illness, trips to the emergency room for Covid-19 remain minimal (<1.5% of all visits) across the region. Over the past week, ED visits declined or held steady in most states in the Northeastern region. The exception is Connecticut, where Covid-19-related visits to the ED have increased moderately, but remain minimal at 0.9% of all trips to the ED.
Hospitalizations are quite low and continue to decrease in the two reporting states: Connecticut (1.5 hospitalizations per 100,000) and New York (2.1). Separately, New York City also has low and declining hospitalizations.
RSV
RSV activity is also quiet very quiet! All states have low or minimal levels of wastewater concentration, and hospitalizations are still very low in all states.
Other Bugs
A bunch of other viruses that cause respiratory infections – cold- and flu-like symptoms – are increasing:
Adenoviruses and human coronaviruses are both on an upswing, but remain at middling levels.
Parainfluenza is fairly elevated, with 5.7% test positivity. In the past couple years, when it has gone through a period of higher spread, it tends to peak around 7-9% test positivity.
Rhinoviruses/enteroviruses have a quite-elevated 20-30% test positivity for the past month, and this week increased a bit again, to 28.5%.
Stomach Bugs
Norovirus test positivity in the region is still quite low at 3.6%, but test positivity increase slightly in the past week. Rates in the Northeast are far below rates elsewhere in the country, particularly the South, where test positivity is nearly 20%.
However, this is the time of year norovirus spread typically picks up, so we shall see what the next few weeks bring.
Food recalls
The following foods are being recalled because they are contaminated. Please check your cupboards and throw out any of these items:
New:
Bagged carrots, full size and baby, sold at multiple retailers (more info)
Previously reported:
Soft ripened cheeses, including brie, sold under multiple brand names, including Aldi, La Bonne Vie, and Glenview Farms (more info)
Prepackaged turkey sandwiches with spreadable brie sold under multiple brand names (more info)
Ready-to-eat poultry and meat products sold by Yu Shang Food, including pork belly, beef shank, and whole chicken (more info)
Waffles and pancakes – many flavors and styles – sold under a very large variety of brand names, including numerous store brands, including 365 Organic, Best Choice, Good & Gather, Harris Teeter, H-E-B, Nature’s Promise, Publix, Trader Joe’s and Wegmans.
Given the size of this recall, if you have any variety of frozen/toaster waffles, Belgian waffles or pancakes in your freezer that you bought in the US or Canada, check this list. (more info)
If you have food allergies, you may wish to review these FDA safety alerts and USDA alerts for foods with undeclared allergens.
In other news
I couldn’t find much, happily! Everything is looking quite good in the Northeast right now.
MY PARENTS: CHARLES F. BAILEY AND MILDRED PINNEO BAILEY
WPCNR THE SUNDAY BAILEY. By John F. Bailey. Republished from The CitizeNetReporter of June 17, 2007:
This week celebrates a great American Father, mine and the other fathers across time who provide an eternal legacy their sons and daughters rely on every day and think about their fathers every day.
Charles F. Bailey.
He is my father. He was born November 17, 1918.
My father gave me four pieces of advice in life: Always drive an air-conditioned car. Always central air-condition your home. Stay out of court.
And, oh yes, don’t sit in traffic. Take the next exit and wing it.
Always take the service road on the Long Island Expressway. (He would have loved a Garmin.)
In retrospect, his advice has served me well. I am always comfortable. I sit out traffic delays in comfort. I have not made lawyers rich.
CHARLES F. BAILEY MY DAD OF PLEASANTVILLE, NY 1918-1986
He was not an emotional man. He was a banker and always wore suits crisp white shirts with French Cuffs to work. Starched. To work. I have fond memories of going to meet him in the days of steam engines in Pleasantville – when train tracks were at grade with Manville Road at the old stone station.
I was most impressed as a young child by how he always smelled of coal cinders when he got off the train – like commuter’s cologne.
Sadly on today’s electric trains you do not get that. You always heard those steam engines coming. Chuffing doing serious work.
You could see them coming around the bend but you heard then first. Bell ringing ,chuffing, puffing : Clouds of very busy, inspiring industrious black smoke streaming at the horizon down the line.
He’d get off the train.
My mother would move over and he’d drive the old Hudson Hornet home. He always spoke quietly. Never raised his voice. Drank scotch and soda in the winter. “G & T’s” in the summer, martinis with George and Howard two close friends. He smoked Chesterfield, Philip Morris, Marlboros, Kents with the micronite filter.
He set up a Lionel train set in our basement – perhaps our unspoken connection.
When I was sent in by train for the first time to meet him at the office during Christmas time, he’d have his secretary Margie greet me at Grand Central Terminal which still is a very big and scary place to me .
He would take me to lunch at Jack’s Monte Rosa Restaurant on 49th Street – which I thought was a very great place. Hub bub, tinkling glasses. Sharp-dressed waiters in white jackets black bow ties.
When I first went to it with him, I was a little disappointed that it was not more glamorous but I was really impressed that Jack the owner greeted him by name.
“Hi, Mr. Bailey. Howe are you doing?”
I thought that was great that my Dad was greeted with respect.
When I first started working in Washington, D.C. in 1968 I ate regularly at a restaurant below the television station WMAL-TV where I worked, it was called Marty’s Italian Village.
Marty, the owner (who looked like Humphrey Bogart, the only thing missing was the white sport coat) started calling me when I came in around 7 PM, ‘Hi John, how are you?” People would look at me. They thought I was big. I liked that. Feeling big in my small world at $90 a week.)
When my father came to visit me in Washington where I worked. I took him around town. I told him when he got off the plane. “Hi, Dad, welcome to my town.” I wanted to impress him. We’re always trying to impress our fathers. At least I was.
Another Father time was when my Dad came out for Dad’s Day at college.
I mean this was a big thing to me. He watched me do play-by-play of a football game from atop the press box in 15 degree weather. It was cold. But he watched. Acted impressed. He hated cold weather. No watching from the warm press box for him.
Another time he impressed was when I lost a job where I was working at the television station that I was being considered for. I told him how unfair it was, he put things in perspective:
“Puggy, he said, “The film manager wasn’t going to put you in as his Assistant if you were going to be bucking him all the time.”
It put things in perspective. No false sentiment. No making me feel better, he was tough enough to teach by being realistic while telling me not to feel sorry for myself. It was one of my first lessons in how telling the truth puts situations in perspective. You know the truth, should we recognize it when it is told to us is a way to stop feeling sorry for yourself, that whatever event happened to you it happened not because you handled it wrong, but because others were weak.
Then later in my career, I was fired out of a job completely blindsided. He again intervened, saying to me he thought what the agency head had done was a terrible thing. I needed that at the time.
It taught me then, when bad things are done to you, the person doing them was a coward and took the easy way out.
He also, in a very supportive move, told me if I could make $1,000 a night writing a free lance direct mail package, I should keep trying to do that.
I really needed that. It started my career, working for myself. If I did not like a client or they treated me badly or they stiffed me (common behavior in the advertising business). I did not take a job with them again, and with new clients I took half the fee upfront. When I asked for upfront money, the possible clients simpered “don’t you trust me?” I would simply answer “It’s not that I don’t trust you. It’s my policy.”
Dads are there to say the right things to you at the right time. Sometimes it is not always the right thing, but they try. Often, if you’re lucky, as I was, they say the right thing. Always — when you really really really need it. Not the wrong thing.
With my father, who was not really my father, since I was an adopted child, it was never all about him, it was all about you. Making me better, even when it hurt him to say things that were the truth.
When I bought my first house in White Plains. He never criticized the house. But when I sold it, he complimented me, “I think it’s great how you came out of it (the crummy first house).” He was a personal trainer.
The good ones train you to run a race. If you stumble, no one hurts more than they do. When you succeed, no one is prouder. The good ones push you in front of the cameras, they say interview her or him. They did it.
They know what you should do, but they can’t tell you, because you won’t do it if you’re a kid.
But the more subtler of them tell you anywayin hopes it will sink into the rebellious offspring mind. My dad was subtle.
Another fond memory: My father took me camping once at a friend’s cabin in Pennsylvania. Funny thing was there was such a great comic collection we wound up sleeping in sleeping bags on the porch of the cabin. That was funny.
Another time when I was being threatened in college over a position at the radio station, I asked him if I should just abdicate and assign a play-by-play position to the person who was being forced on me. He advised me to “stick to your guns,” so I reported the threat to the Dean.
The position was compromised, but I was never threatened again. He never shared my love for baseball and sports.
In fact he never played catch with me all that well or that often.
I mean I could have made the big leagues (pipe dream) if he played catch with me more. But that’s a small criticism. I wish I had more of his financial acumen. But I do not. I married that.
As you grow into your 30s and 40s, little things they say to you you begin to understand.
My father never struck me.
He always disciplined me with quiet words. I have not always been that way as a parent myself, being somewhat volatile. I wish I had his even temperament. He always asked me to take care of my mother. And the only time he really got mad at me was when I had made my mother upset with me.
He was a little like Humphrey Bogart in movie roles in the way he disciplined, I remember he would say admonitions quietly. Such as when I got an F in an English course at college.
He told me, that was the last F I would get at Ohio Wesleyan, because the next one he would stop paying my tuition.
That had an effect. And that was when tuition was only $3,000 a year.
I have taken to, after my children have grown, telling them always “Be careful,” “Don’t do anything stupid because someone suggests it,” “Do not go anywhere alone without telling people where you are going,” “Don’t lose your temper,” “Don’t tailgate,” “Don’t stand close to the edge of a sever drop.” In hopes that when I am not with them, they will remember it when they need it.
I think of him every day of my life. I become more like him every day. He is always lingering in the background of my thoughts. I do not know what he would think of what I am doing now. But, he’d say — “If that’s what you want to do. Do it.” He also would say,
“You have to make yourself happy.”
I also think, even today of what advice (laconic as always) he’d give me in a situation.
I wish I could discuss property taxes with him. Banking today and how it has become a predator system.
I especially have to salute him, because I am an adopted child.
That alone makes me appreciate his love and acceptance with a sense of awe to this day. He loved me like his own son. Because in his mind, I was.
He took responsibility. He did what had to be done.
You never outgrow your need for Dad.
The good ones are immortal, alive and with you in your head when you need them.
They are the ghosts that comfort always. Haunt you in memory. You’re always glad when they drop in on you.
You feel them warmly when you do good.
You feel their sympathy when you have done wrong. They are your conscience. They are the God of Judgement in your head. Your trusted advisor.
Immortality is leaving a good memory of you with the ones who knew you.
Because what you give them, lives on for generations.
Your children will talk of you because of the good things and behaviors you gave them when you needed them and you never lose those tools Dad gave you.
I miss my Dad and Mom. They probably have discussions over me to this day.
Charles Bailey. He died in 1986.
His legacy and my mother’s to me keeps me going every day.
I also remember my wife’s parents who welcomed me into their family when I married and who raised an extraordinary woman.
THE COUNTY NEEDS WATER OCTOBER WAS THE DRIEST MONTH ON RECORD AND NOVEMBER CONTINUES 100% OF THE COUNTY IN DROUGHT
WESTCHESTER COUNTY URGES RESIDENTS TO CONSERVE WATER AS DROUGHT WATCH CONTINUES
NEW YORK CITY ISSUED A DROUGHT WATCH THAT AFFECTS WESTCHESTER COUNTY WATER SUPPLIES. AS PART OF THE DROUGHT WATCH, WESTCHESTER COUNTY RESIDENTS ARE ASKED BY THE COUNTY’S DEPARTMENT OF ENVIRONMENTAL FACILITIES TO PRACTICE WATER CONSERVATION MEASURES. EMERGENCY.
TO SUPPORT WATER CONSERVATION, THE COUNTY RECOMMENDS THAT RESIDENTS:
LIMIT LAWN AND GARDEN WATERING TO EARLY MORNING OR EVENING HOURS TO MINIMIZE EVAPORATION
CHECK AND FIX LEAKS IN PLUMBING, FAUCETS, AND HOSES
RUN DISHWASHERS AND LAUNDRY MACHINES ONLY WITH FULL LOADS
AVOID WASHING VEHICLES OR HOSING DOWN SIDEWALKS
RESIDENTS CAN VISIT THE FOLLOWING SITES FOR DROUGHT CONSERVATION MEASURES:
WPCNR BIG APPLE NEWS. From The Gothomist. November 13, 2024:
Gov. Kathy Hochul plans to relaunch the MTA’s congestion pricing program with a $9 base toll for passenger cars — marking a 40% price reduction from the price previously approved by the MTA — according to four sources briefed on the governor’s plan.
The sources, who were not authorized to speak on the matter on Wednesday, said Hochul plans to eventually increase the base toll.
A separate source with direct knowledge of Hochul’s plan who was also not authorized to speak on the topic said the MTA board plans to approve the new tolls during its next meeting on Nov. 20 — and that Hochul plans to launch the program at midnight on Dec. 29.
The governor’s move comes just over a week after the election, and more than five months after she abruptly paused congestion pricing. New York state lawmakers first approved the program in 2019, with the goal of charging drivers a fee for entering Manhattan south of 60th Street. The revenue from the program is legally required to fund $15 billion worth of essential repairs to the MTA’s transit systems.
Representatives from the governor’s office and the MTA did not immediately respond to requests for comment.
In pausing the program, Hochul claimed the new charges would be too costly for drivers who are already wrestling with inflation. Two sources said the governor was asked by congressional Democratic leaders to hold off on launching the tolls until after the election in hopes of winning competitive House races in the city’s suburbs.
The lower toll would save a motorist who drives into Manhattan five days a week $1,500 over the course of a year compared to the prior plan. But Hochul is expected to face questions as to whether the lower toll will discourage motorists from entering the city to reduce congestion in the same way a $15 toll would have, which was a key goal of congestion pricing
The tolls require the Federal Highway Administration’s signoff.
President-elect Donald Trump has vowed to kill the tolling program once he takes office, but transit advocates have said in recent weeks that Trump would have a harder time dismantling the tolling program if it were to launch by the time he takes office.
