XBB.1.5

A new COVID subvariant has emerged here in the United States. It is designated XBB.1.5 and is considered the most transmissible Omicron variant to date by the World Health Organization. It is also considered to be highly immune evasive, which means it is more likely to cause infection among those who have COVID antibodies, whether from vaccines or prior infection. However, the vaccines should still be effective in reducing hospitalization and death rates from infection.

XBB.1.5 is especially prevalent in the northeastern region of the US. It is powering the rise in regional cases accounting for 72.7% of cases in the past week. It is also likely the driver behind Broome County, New York, where I live, again moving into the CDC’s high community risk level classification. (That will mean mandatory masking at our concerts this weekend.)

The XBB.1.5 subvariant orignated in the US, but has spread to some other countries. Meanwhile, China is suffering through a huge infection wave, although there is no reliable official data on its extent.

In many places, especially in the Northern Hemisphere winter, there are also high rates of flu and RSV.

As always, I’ll repeat my advice. Vaccinate, if you are eligible and vaccines are available to you. In particular, if you are eligible for the bivalent COVID booster, get it as soon as possible because it is much more protective against all Omicron strains than the original formulation. If you are sick, get tested. If you contract COVID or flu, immediately contact a medical provider to see if you can take antiviral medication to cut down on symptom severity. When there is risk in your area, use a high-quality mask in indoor public spaces and avoid crowds. Increase ventilation and/or air filtration indoors. Wash hands frequently and avoid touching your face (more for flu/RSV prevention than for COVID). Try to eat and sleep well. Look out for one another.

We need to work together for this pandemic to end. We are all tired of COVID but we need to fight effectively and continuously. Ignoring the risk and letting the virus spread just gives it even more opportunity to mutate and develop more virulent strains. We are now in our fourth year of the COVID pandemic. Let’s work together to make it the last.
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Join us for Linda’s Just Jot It January! Find out more here: https://lindaghill.com/2023/01/06/the-friday-reminder-for-socs-jusjojan-2023-daily-prompt-jan-7th/

supporting those with lymphoma

I admire Rep. Jamie Raskin of Maryland. He is a lawyer and Constitutional scholar just beginning his fourth term in Congress. He served as an impeachment manager in the second trial of Donald Trump and just completed his work on the 1/6 Select Committee.

It’s heartbreaking that he lost his son just days before the 1/6/21 attack on the Capitol. I admire Rep. Raskin’s ability to continue in public service in the aftermath of both personal and national challenges.

He has recently announced a new challenge, a battle with lymphoma. He is about to embark on chemotherapy and plans to continue working while he is being treated. I wish him every success in beating his cancer.

I have a college friend who is also currently in treatment for lymphoma and continue to pray for her full recovery.

I have a lot of hope for their long-term remission because treatment protocols for many types of lymphoma have a good record of success.

My father, known here at TJCM as Paco, was diagnosed with lymphoma about twenty years ago. He received chemotherapy and lived to be 96 without a recurrence. I know my father’s experience is anecdotal, but, for me, it helps to have a personal story to add to the data and statistics.

I invite readers who are so inclined to send out healing thoughts/prayers for Jamie Raskin, for my friend J, and for all those dealing with lymphoma. People who are in a position to make a charitable donation may wish to support the Leukemia & Lymphoma Society , which is highly rated by Charity Navigator.
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In one of those bizarre coincidences, I had drafted this post earlier, planning to use it for Linda’s Just Jot It January at some point. When I looked up today’s post to do the pingback, I found out the prompt word is “cancer.” Obviously, this post was meant to be shared today.

two years into COVID vaccines

After yet another period of high community risk level for COVID here in Broome County, New York, we have just today returned to medium level. After a post-Thanksgiving spike in infections, we experienced a hospitalization spike which had increased our community risk level. With the US health system also dealing with an early, hard-hitting flu season and RSV, the dreaded triple-demic, in some areas hospitals are reaching capacity and sending patients to other locations. Additionally, infection rates are predicted to rise as family and friends gather for Hanukkah, Christmas, and New Year celebrations in the coming weeks.

This comes at a time when only 14.1% of people five and over in the US have received the new bivalent COVID booster, which was designed to better combat the Omicron BA.4/5 variants and is proving effective against the current dominant strains, BQ1 and BQ1.1, which are part of the BA.5 lineage.

Furthermore, a recent study indicates that the US vaccination program likely saved 3.2 million lives and prevented 18.5 million COVID-related hospitalizations. The vaccines are estimated to have averted nearly 120 million infections. Another recent study shows that in the two years of COVID vaccine availability in the US, the excess death rate among Republicans is significantly higher than among Democrats, mirroring the difference in vaccination rates, a sad reflection of the politicization and misinformation around vaccines by many prominent Republicans.

It’s horrifying.

The mistrust sown over the COVID vaccine among Republicans seems to be spreading to other vaccines as well. A newly published survey finds that over 40% of Republican or Republican-leaning respondents oppose requirements for the MMR (measles, mumps, rubella) for school children.

This does not bode well for public health measures. It’s frightening how many people will believe politicians or media figures rather than doctors and public health experts on these important issues. People have been infected because they weren’t up to date on vaccinations. People have been hospitalized, developed long COVID, experienced complications, or died at higher rates because they refused vaccines or boosters. The data show this.

Please, get a bivalent COVID booster if you are eligible. Begin or continue the primary vaccination series if you haven’t completed it. If you get symptoms, test immediately and contact a health professional if you test positive to see if antiviral medication is right for you. Don’t go out and expose others if you sick with COVID, flu, or anything else. Mask indoors when infection levels for COVID, flu, RSV, etc. are high in your area. Avoid crowds. Increase ventilation. Wash hands and avoid touching your face – more for flu/cold prevention than COVID. Try to eat and sleep as well as possible.

If you are someone who has been getting health information from pundits, please turn to your personal health care provider, public health department, or national health organizations, such as the CDC. Look for data and advice from public health experts, not anecdotes.

For readers outside the US, turn to your public health experts to see what measures are available and appropriate for you.

Reminder to all: COVID 19 is still a global pandemic. Act accordingly for your health, your household’s and community’s health, and global health.

Triple whammy

There are a lot of people sick with respiratory viruses here in the US.

We are still struggling with COVID. Today’s (Oct. 28, 2022) statistics from the Centers for Disease Control show a weekly case count of 265,893 with 2,649 deaths. The case count is almost certainly low, as many at-home positive tests are never reported to health departments and some jurisdictions don’t gather data at all. The uptake of the reformulated boosters has been poor, with only 7.3% of people age five and over having received an updated booster.

While the community risk level map shows the majority of the country in the low (green) level, the community transmission rate is substantial or high in much of the county. You can see the various maps using a drop down menu here. The community transmission rate is based on case counts and/or positive test results; the community risk map also includes data on other factors, such as hospital admissions and stresses on the health care system. A personal illustration: Although the community risk level in my county (Broome in New York State) has been low in recent days, I have had a rash of friends being sickened with COVID. This is explained by our community transmission rate being high, which is the highest of four levels. (As I was writing this post, the maps were updated. Due to the emerging strains on the health care system, our county community risk just shifted from low to high.)

Meanwhile, the flu season has hit earlier and harder than usual. The predominant strain is H3N2, which is known to have a high incidence of complications, especially among young children, elders, and the medically vulnerable. Like many other illnesses, the effects of inflammation from the flu raise the risk of heart attack and stroke for weeks following the initial infection, further endangering not just personal health but also the stability of medical institutions, such as hospitals. So far this flu season in the US, the CDC reports 880,000 flu cases, with 6,900 hospitalizations and 360 deaths. Generally, flu season starts in October but this year it is running about six weeks earlier than usual.

The third virus that is currently surging is RSV (respiratory syncytial virus). For most people, RSV is like a cold but for infants, young children, and elders it can progress to lung infections. These can lead to hospitalization and even death, especially among elders. Unfortunately, there is not yet a vaccine against RSV. I actually participated in a clinical trial for one a few years ago but none has yet reached a level of effectiveness to be approved.

The triple whammy of COVID plus flu plus RSV has already pushed some pediatric hospitals to the edge of their capabilities. Ironically, the RSV rate is a critical factor. Because so many infants and young children were isolated due to COVID risk and lack of day care/school interaction during the pandemic, there is a much larger group than normal that is vulnerable to RSV infection.

There is also concern that the rate of new cases of all three viruses may climb even higher as the weather gets colder and people spend more time indoors.

Some things that people can do to help: Vaccinate as appropriate. Wash hands frequently. Avoid touching your face. Cover coughs and sneezes. Stay home and away from people as much as possible if you get sick. Mask in crowded places or avoid going to them. Get adequate rest and eat healthy foods. If you develop symptoms, talk to a health care provider so you can get testing and supportive treatments to help keep you from developing more severe symptoms and avert a hospital stay, if possible.

I know some level of sickness is inevitable but we can help cut down the case numbers if we watch out for ourselves and our communities.

long COVID and ME/CFS

One of the fears that I have about COVID is the risk of experiencing long COVID, where any number of a vast constellation of symptoms occurs for months/years after the acute infection phase.

The symptoms are very similar to those that characterize ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome). I have a family member with ME/CFS, so I am achingly familiar with the level of disability that can result. ME used to be referred to as fibromyalgia in the US, but now the ME designation is more common.

The October 5, 2022 edition of the (US) National Public Radio show On Point features an extensive discussion of long COVID and ME/CFS and how long COVID researchers and clinicians are learning from their peers who have been working for years on ME/CFS. All of these conditions are underdiagnosed and undertreated, so I wanted to share this with all of you. I believe this link will permanently take you to a recording of the episode. If the link breaks, you can try searching from the On Point link above or searching on your favorite podcast platform.

Anyone who has experienced these conditions or seen a loved one contend with them knows how difficult they can be. I want to raise awareness so that everyone affected can get the help they need. I also want everyone to realize that these conditions exist and are serious. Too often, affected people are dismissed and told their symptoms are “all in their heads.” While there is still much to learn, help is available, although it may be difficult to find, depending on the medical resources nearby. I hope we will all support research and treatment expansion so that the millions of people affected get the help they need.

A fairy tale wedding


A few days ago, spouse B, daughter T, and I attended the wedding of M and S. M is B’s and my niece and is the cousin closest in age to T.

M is also a big fan of Disney World. S chose to propose to M there and M planned their wedding and reception with a Cinderella theme, including the napkin above. There were castles and glass slippers and golden coaches incorporated into decorations, dancing into the night, a beautiful gown with yards of tulle.

Many echoes of a classic fairy tale.

But M and S don’t have an ordinary life. M is nurse with special training in emergency medicine who currently serves as a flight nurse, transporting critically ill or injured people to medical centers that can give them the best care possible. S is a state trooper, doing his best to keep people safe and assist them in emergencies.

They both do extraordinary things on a regular basis.

They also are facing an extraordinary challenge. Early in their courtship, M developed a serious medical issue but S stayed by her side, even when M tried to break up with him in order to protect him.

The strength of their bond in the face of adversity brought more than the usual number of tears at the wedding and during the toasts at the reception, where even the especially-stoic state troopers choked up over M and S’s love story.

Even at a fairy tale wedding, there are no guarantees of how long the “ever after” will be.

M and S showed us, though, that their love is strong and eternal, whatever obstacles are thrown in their path.

COVID bivalent boosters

As you may recall, spouse B, daughter T, and I were all participants in the Phase III clinical trial for the COVID-19 vaccine from Pfizer/BioNTech. We then all participated in a follow-on third dose trial. B and I left the trial this spring because we were eligible to receive a fourth dose and wanted the extra protection before travelling. T stayed in the trial until its end earlier this summer.

Here in the United States, a new booster was recently approved which combines the original formulation with a new one designed to better combat the Omicron BA.4 and BA.5 variants. BA.5 is the dominant variant currently in the US, accounting for about 88% of cases. About 11% are caused by BA.4. The new booster is expected to strengthen protection against serious illness/death and, one hopes, cut down on symptomatic infection somewhat, as well.

Given that I am still trying to remain COVID-free and that I have several trips coming this fall, I decided to receive one of the new boosters at my local pharmacy. I chose to receive the Pfizer formulation because all my others have been theirs, although there is a Moderna version which is also a fine choice. This was my first time receiving the vaccine in a pharmacy setting. My prior doses had all been in a medical office or a state vaccination site. I made an appointment online and everything was very fast and efficient.

Dr. Ashish Jha, who is the White House COVID-19 response coordinator, and Dr. Anthony Fauci, the long-time director of the National Institute of Allergy and Infectious Diseases, have said that it is possible that we may have reached a point where an annual booster will be enough to protect the vast majority of Americans from serious illness/death from COVID, similar to annual flu shots. Some people who are especially vulnerable due to age or medical condition might need more frequent boosters. The wild card, though, would be the emergence of a new strain that could evade our antibodies and current vaccines.

So, my message is to receive one of these new boosters as soon as they become available wherever you are. The US has been first to authorize them, but it seems they will become more widely available globally soon. Remember, though, that these are booster doses given to people who have already completed an initial vaccine series. If you haven’t completed an initial vaccine series, start NOW!

Meanwhile, here in Broome County, our community risk level is still medium. While I wait for the new booster to take full effect, I will still mask for indoor gatherings and shopping. I’ll be evaluating what to do after that, although these boosters are so new that data may be hard to come by.

I hope to stay well and hope that you do, too.

One-Liner Wednesday: still COVID

Another of my occasional reminders that COVID-19 is still with us.

Join us for Linda’s One-Liner Wednesdays, which I occasionally use to shamelessly promote another blog post. 😉 Learn more here: https://lindaghill.com/2022/08/24/one-liner-wednesday-upon-the-throne/

still COVID

I’m sad to report that the total death toll in the United States from COVID-19 is now over 1.04 million with over 93 million confirmed cases. The actual case count is no doubt higher, as some states have stopped reporting and many cases that are detected by at-home testing are not reported to health agencies at all. New cases are still occurring at a rate of 93,000 a day with 457 deaths (7-day rolling average on August 22, 2022).

It’s still heart-breaking.

And still considered by most experts a pandemic, although perhaps heading in the direction of being considered endemic in the United States soon, as influenza is.

Most cases in the US now are Omicron variants BA.4 or BA.5. There is some hope that new boosters that contain components targeted at Omicron variants might give some additional protection going into the fall and winter, especially against hospitalizations and deaths, but we will have to see if a) people actually get vaccinated and b) the vaccines do boost protection for any length of time.

And/or c) a new strain could develop that evades all prior immunity, is even more wildly contagious, doesn’t respond to current treatments, and/or causes more severe illness.

At home, B, T, and I all still remain uninfected to the best of our knowledge. It’s possible that one or more of us have had an asymptomatic case but there is no real way to know. Any time that we have had symptoms, we have tested, as we have also for travel and after known exposures. We also have had extra tests as part of our participation in the Pfizer/BioNTech vaccine trials. T remains a participant in the third shot trial; B and I exited the trial in order to receive a fourth dose before travelling to the UK this spring. I believe that our vaccination status has helped us to avoid infection and plan to receive one of the new booster shots this fall, if I’m eligible for what will be my fifth dose. T may be eligible for a booster after she finishes with her trial participation this fall if those boosters are available to people under 50.

Broome County, New York, managed to have only a few weeks in the Centers for Disease Control category of low community risk for transmission before going back up to medium. I’ve gone back to masking with a KF94 while shopping or in other indoor public places. I’m making determinations on small gatherings on a case by case basis. Other than church services, I’m avoiding large gatherings.

Some people think I’m being overly cautious at this point but I am still trying to avoid infection, if I can. At the very least, if I do become infected, I will know that I was doing everything I could to keep myself healthy so that I don’t suffer guilt on top of COVID. I am well aware that, even with multiple vaccine doses, masking, avoiding crowds, etc., Omicron, especially BA.5, has been quite successful at evading immunity and protections. I know from what the public health experts are saying and also anecdotally among my friends. There are very few left who have managed to stay COVID-free in recent months.

A large part of my motivation to keep from getting infected is fear of long COVID. While SARS-CoV -2 is too new a virus for researchers to fully understand, it’s possible that I may have some genetic risk factors that could come into play regarding long COVID. None of this is helped by the fact that the underlying medical conditions I have are themselves not well understood.

So, I’ll keep on doing the best I can to stay as healthy as possible.

Wish me luck.

I’m going to need it.

US environmental update

Trying to get the United States back to a better position regarding climate change and environmental issues in general has been a major task for the Biden administration. While some things were relatively straightforward, such as rejoining the Paris climate accords, others have been much more difficult.

Unwinding the changes that the prior administration had made to regulations was sometimes blocked by the courts. The biggest blow was the Supreme Court decision in West Virginia v. Environmental Protection Agency, in which a 6-3 majority found that the EPA can’t regulate emissions from coal-fired power plants unless they have been given specific direction by Congress. It was odd that the Supreme Court heard the case because it was brought against the Clean Power Plan, which was proposed by the Obama administration, but never enacted. The Biden administration had no intent to revive that plan, as circumstances have changed, so it appears that the conservative majority heard the case for the purpose of striking down the manner in which executive branch agencies and departments go about executing the laws that have been passed by Congress. This ruling could bog down not only EPA work but also the regulatory work of other Cabinet departments. [Please note that this is my layperson understanding of the case and its implications. There has been a lot of legal commentary which can be found in myriad places online, if you are interested.] An August 26 post with an update on the impact of this case can be found here.

Legislation to address the climate crisis was an important cornerstone of the Biden agenda. The House of Representatives passed a strong bill dealing with climate change and the care economy, including health care, universal education for three- and four-year-olds, provisions for child and elder care, permanent expansion of a fully refundable child tax credit, and other measures for social justice and equity. The bill was paid for by increasing taxes on wealthy individuals and corporations. Unfortunately, the 50-50 split in the Senate combined with Senate rules gave a couple of Democratic senators power over what was in the bill and they opposed some of the financial and energy provisions, so it looked as though it would not pass.

This was extremely discouraging to millions of people in the US, as well as to millions in the rest of the world who are depending on US action to cut carbon in the atmosphere and provide leadership for other countries to do the same.

And then, a surprise announcement that Senator Joe Manchin of West Virginia, who made his money from coal and had shot down prior versions of the bill, had reached an agreement with Senate Majority Leader Chuck Schumer on a version of the bill that he could support. Additional changes wound up being made to get Senator Kyrsten Sinema of Arizona on board. Senator Schumer kept the Senate in session in Washington into their August recess to pass the bill with Vice President Harris casting the tie-breaking vote. House Speaker Pelosi called the House back into session to pass the bill last Friday and President Biden will sign the bill into law this week.

While the Inflation Reduction Act is not as strong as the original legislation, I’m very happy that it will become law. It should bring down energy costs over time. It is projected to lower US greenhouse gas emissions by about 40% of 2005 levels by 2030; the United States goal in the Paris accord is a 50-52% reduction, so we hope that additional measures will be enacted to reach that goal. However, before this bill, we were on track for only a 25% reduction, so this is a major improvement. This article is a good summary of some of the main environmental/energy provisions of the bill.

I am grateful and still a bit shocked that this bill is about to become law. Yes, there is more to do, both on environmental and economic justice issues, but, at least, we have made a good start. This is important because people and the planet need this help and because it shows that the Democrats are actually serious about governing in a bipartisan way when it is possible, such as with the infrastructure law, and alone, if necessary. I hope that the progress in the last 18 months will encourage voters to keep the Democrats in the majority so more can get done in the next session. Perhaps, it will even give more Republican Congresspersons the impetus to support popular, commonsense measures that benefit the public. We have all witnessed past Republican majorities who were unable to pass much substantive legislation; for example, the Trump administration announced multiple “Infrastructure Weeks” but never got close to passing legislation. We have also, sadly, seen Republican minorities block action on legislation and appointments through the filibuster and other holds and delaying tactics. I think these need to be reformed so that the Congress is not bogged down and unable to do the work our country needs to function.

As the new programs ramp up, I encourage people in the US to be on the lookout for provisions that can help them make their lives greener, whether that is rebates on efficient electric appliances, incentives to buy used or new electric vehicles, or the opportunity to purchase renewable energy at lower than current rates. Support candidates who make the health and well-being of people and our environment their top priorities. We need representatives who are looking out for us, not just corporate profits and tax loopholes.

In my district, that means voting for the Democratic candidate. Make sure that you know the candidates’ positions in your area before casting your ballot.

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