COVID & Health News, 2/2/25

Hi all,

I usually start my newsletter with information on current viral infections, including COVID, but there has been so much governmental chaos affecting public health and medicine that I decided to discuss that first.

Last week, Trump ordered the US withdrawal from the World Health Organization (WHO), despite rules that require the approval of Congress and a one-year notice. This Monday, Trump ordered the CDC to stop communicating with the WHO despite Ebola and Marburg outbreaks in African countries and pathogenic avian flu H5N1 in America.

He also paused all foreign aid. PEPFAR (President's Emergency Plan for AIDS Relief) which provides life saving HIV medications to people in poor countries was taken offline. On Tuesday, Secretary of State Marco Rubio issued a waiver for emergency food aid and for life-saving medicine, and shelter help. But, aid groups were confused as to whether they could continue their work or not. So on Saturday, a new memo clarified that PEPFAR was still covered.

On Tuesday 1/28/25, Caroline Kennedy, cousin of Robert Kennedy Jr, wrote a letter to the Senate about why RFK Jr. is unfit to be secretary for the Department of Health and Human Services saying "He is a predator." Katelyn Jetelina wrote an excellent summary about the two RFK Jr. Senate confirmation hearings that I recommend reading. She states that Robert Kennedy Jr has a long history of ignoring scientific facts and he does not understand key healthcare infrastructure. He is unfit to “lead the Department of Health and Human Services, managing a $1.8 trillion budget and shaping policies that directly impact your health and the health of your community.”

This week, funding for the Women, Infants, and Children (WIC) program which feeds low income Americans was thought to be frozen, as was the SNAP (food stamp) program, but these soon came back online. Tuesday, “Medicaid portals in all 50 states were down following the federal funding freeze” according to Senator Ron Wyden. This was also an error which was fixed the next day.

On Friday, the Trump administration purged key health websites, more than 8,000 web pages, across federal health agencies including the CDC, taking down information for healthcare providers on contraception, sexually transmitted infections including HIV, LGBTQ health and even a site on nutrition in pregnancy, to heed an executive order titled "Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government" and another executive order targeting diversity.

Scientists, public health workers and healthcare professionals started frantically looking for archives of CDC health information that had been taken offline. The Internet Archive Wayback Machine archives web pages daily for the entire internet. Fortunately, many of the CDC web sites and data sets were archived and are available:

CDC Sexually Transmitted Infection (STI) Guidelines

CDC Sexually Transmitted Infections (STI) MMWR

CDC Medical Eligibility Criteria (MEC) for Contraceptives Summary Chart

CDC Medical Eligibility Criteria (MEC) for Contraceptives website

Vaccine Information Sheets

Jessica Valenti posted CDC information on Contraception, Sexual Health including STIs and HIV PrEP, Youth CDC Health Education Curriculum Analysis Tool (HECAT), CDC Youth Risk Behavior Survey Data Summary & Trends Report, CDC LGBTQ Youth Reports, CDC National Partner Violence Survey at CDCGuidelines.com

Melanie Matheu has PDFs for many of CDC guidelines and webpages here on Youth Risk Behavior Surveillance System, National HIV Surveillance System (NHSS), MMWR US Medical Eligibility Criteria For Contraceptive Use 2024, documents on the Household Pulse Survey and many others.

Last night someone released an archive of all CDC Datasets that they had saved on January 28th at https://archive.org/details/20250128-cdc-datasets. In order to find the dataset that you need, click on “Show All Files” and then use CTRL+F to search for keywords related to your search.

Other unusual events happened this weekend. Elon Musk was given full access to the Treasury department’s payment system which he downloaded to private servers and also access to the Office of Personnel Management computer systems. This surprised some people as Mr. Musk was previously unable to qualify for US security clearance.

Respiratory Illnesses

As of 1/31/25, Influenza levels remain VERY HIGH everywhere in the United States and are increasing. RSV has peaked and levels in wastewater are moderate and are decreasing.

COVID

COVID levels in wastewater are HIGH, especially in the midwest. COVID cases and emergency department visits were starting to decrease, but they have plateaued. According to Mike Hoerger, there are about 443,000 new COVID infections per day in America with 1 in every 108 people currently COVID infected.

CDC SARS-CoV-2 wastewater https://www.cdc.gov/nwss/rv/COVID19-nationaltrend.html

Emergency Department visits for COVID were decreasing, but have now plateaued.

From: https://covid.cdc.gov/covid-data-tracker/#ed-visits_all_ages_combined

COVID is not the Flu

A new study of more than 141,000 non-hospitalized US veterans shows that COVID caused more infections than Influenza or RSV. Infections with COVID were more severe and led to more hospitalizations and deaths as compared to Flu or RSV. Vaccination against COVID reduced both short term and long term adverse outcomes.

Pediatrics

A new study in JAMA looked for phenotypes of Multisystem Inflammatory Syndrome in Children (MIS-C). They found that among 8,944 MIS-C cases (median age 8.7 years, 60.5% male), analysis identified three clusters:

1) a respiratory cluster (8.0%, median age 12.7 years) in older children,

2) a shock and/or cardiac cluster (37.6%, median age 10.8 years) and

3) an undifferentiated cluster (54.5%, median age 6.8 years) comprising the remaining cases.

New federal data shows that student test scores in math and reading continue to decline since the beginning of the pandemic, especially for struggling students. Reading scores have dropped further since 2022, with a record number of eighth-graders scoring at the lowest proficiency level. Math scores showed slight improvement for fourth graders, but remained stagnant for eighth graders. “Top students are making up lost ground while struggling students are falling further behind.” Experts warn that the widening achievement gap, chronic absenteeism, and lack of effective interventions could have long-term economic consequences for children and their families.

Vaccines

A new study shows that vaccination prior to COVID infection reduced excessive inflammatory responses, particularly in monocyte and natural killer cells, which are typically seen with severe illness. These findings were confirmed in two separate cohorts, suggesting that vaccination influences the innate immune response and helps regulate inflammation during SARS-CoV-2 reinfection.​

COVID and the Brain

Using data from the UK Biobank, a group found that SARS-CoV-2 infection is associated with an increase in Alzheimer biomarkers (lower Aβ42:Aβ40 ratio and increased pTau-181) in the blood that are “linked to brain structural imaging patterns associated with Alzheimer’s disease, lower cognitive test scores and poorer overall health evaluations.” The biggest effects were seen in those who had been hospitalized with COVID and in people with a history of high blood pressure. This study adds to research suggesting a rise in dementia diagnoses after COVID infection.

A study from Australia used brain SPECT imaging to look at cerebral blood flow in patients with postural orthostatic tachycardia syndrome (POTS) and cognitive dysfunction. About 30% of patients in the study had POTS related to Long COVID. Researchers found that 61% of POTS participants overall had abnormal cerebral blood flow, especially in the prefrontal and sensorimotor regions, which may contribute to symptoms like brain fog, impaired memory, and reduced concentration.

H5N1

Both the highly pathogenic H5N9 avian flu and H5N1 avian flu were found at the same time on a duck farm in Merced, California. Concerns are that ducks coinfected with both H5N9 and H5N1 at the same time could lead to new reassortant viruses which could be unpredictable and could lead to potential human infections. All animals at the farm have been culled.

For the second week in a row, the CDC’s weekly MMWR (Morbidity and Mortality Weekly Report) was not published. Two important MMWR reports on the highly pathogenic H5N1 avian flu virus were not released- one looking at infections in veterinarians treating cattle with H5N1, and another reviewing possible transmission from people infected with H5N1 to their pet cats. Experts warn that delaying reports could harm public health by limiting efforts to track and prevent the spread of H5N1, raising concerns about censorship in scientific communication.

Other news:

Kansas City currently has the largest US Tuberculosis outbreak in recent history with 67 active TB cases and 79 latent cases reported since the beginning of 2024.

This week, the FDA approved a nonaddictive pain medicine called Journavx (Suzetrigine). It has been successfully trialed in two studies.

A megapod of more than 1,500 dolphins was seen in Monterey Bay in California this week. Most of the dolphins seen were Risso’s dolphins which have flatter faces. Dolphins were seen jumping out of the water, slapping their tails and having an overall great time.

Photo of Risso’s dolphins by Douglas Croft, NOAA

Have a good week,

Ruth Ann Crystal MD