Typical respiratory illnesses including COVID, Flu and RSV are at low levels in wastewater across the nation. Because several individuals with active measles infections traveled through major airports this week, including Newark and Seattle-Tacoma, and because whooping cough cases are on the rise, I recommend checking that your vaccinations are up to date. When flying, I would consider wearing an N95 mask as well.
COVID
SARS-CoV-2 wastewater levels are at LOW levels according to the CDC in the U.S., and Emergency Department visits for COVID and COVID deaths are also low. JP Weiland estimates that as of today, there are 175,000 new COVID cases per day in America with about 1 in 190 people currently infected.
The highest levels of COVID in wastewater per WastewaterSCAN are:
Oakhurst NJ 1369 PMMoV
Fremont CA 482 PMMoV
St Petersburg FL 423 PMMoV
Gautier MI 388 PMMoV
SARS-CoV-2 Variants
The US COVID variant proportions data will update next week. Last week, LP.8.1 was at 70% and XFC (aka XFG) was at 9%.
Mike Honey wrote a thread yesterday stating that according to GISAID.org data, he expects that NB.1.8.1 or XFG will be the next COVID variants to push LP.8.1 out of the lead position on a global level. NB.1.8.1 is a descendant of XDV. “XFG is a recombinant of LF.7 and LP.8.1.2, with a presumed origin in Quebec.”
From: https://www.biorxiv.org/content/10.1101/2025.04.30.651462v1.full.pdf
Acute COVID infections, General COVID info
Los Angeles County posted that they will be offering free health supplies including free COVID test kits, fentanyl test strips, condoms, and other items at 51 kiosks across L.A. County.
Photo: LA County Dept of Health
A CDC study found that in 2020 through 2022, an increase in hospital-onset Methicillin Resistant Staphylococcus Aureus (MRSA) bloodstream infections was related to recent COVID infections. In contrast, community-associated and healthcare-associated MRSA rates dropped during that time probably because of mitigation measures like lockdowns and increased use of PPE.
In a study of 1.3 million insured U.S. adults, people with hypertension incurred $8,572 in additional medical costs over two years. If they also had a COVID infection, their healthcare costs rose by another $3,495, along with nearly 3 extra days of short-term disability. The findings highlight the compounded burden of chronic illness and COVID-19 on both healthcare systems and productivity.
Researchers from NYU discovered that a specific type of lung immune cell called a nerve- and airway-associated interstitial macrophages (NAMs) is critical for controlling SARS-CoV-2 infection in mice. Mice without NAMs experienced unchecked viral spread, severe lung damage, and 100% mortality. NAMs use type I interferon signaling to decrease inflammation and protect the lungs from severe damage. Similar protective macrophages were also found in humans.
COVID and the Microbiome
Hamsters given a probiotic mix containing B. longum, L. helveticus, L. lactis, and Streptococcus thermophilus recovered faster from SARS-CoV-2 infection and had lower viral loads in both lungs and airways. The results point to the gut-lung axis as a potential target for immune support during viral infections.
In a German trial involving 900 COVID outpatients, 4 weeks of nicotinamide supplementation improved recovery time, enhanced gut microbiome function, and lowered Long COVID symptom rates at 6 months. No major side effects were reported, supporting nicotinamide’s potential as a safe adjunct therapy during acute COVID infection.
Pregnancy
COVID infection before or during pregnancy was found to be associated with a 2-3 times higher risk of miscarriage (spontaneous abortion). Researchers used electronic health records from the Southeast Texas COVID and Pregnancy Cohort (26,783 pregnancies) and found elevated early pregnancy loss linked to recent COVID infection.
Pediatrics
A Japanese prospective study followed 108 children hospitalized for COVID-19 and their infected parents over six months. At the six-month mark, 22.8% of children had Long COVID symptoms, including cough, fatigue, and sleep disturbance. Sleep disturbance in particular was tied to lower quality of life scores.
A study from the University of Pennsylvania found that unvaccinated children and teens were up to 20 times more likely to develop Long COVID compared to those vaccinated. The vaccine's main benefit was preventing COVID infection, thereby reducing the risk of Long COVID, rather than offering direct protection against it. This research highlights the importance of vaccination in safeguarding young people from Long COVID.
Vaccines
HHS Secretary Robert F. Kennedy Jr. plans to end CDC recommendations for COVID vaccination in children, teens, and pregnant women. COVID infection in pregnancy is associated with adverse outcomes including stillbirth, preeclampsia and preterm delivery. In children and teens, COVID infection can cause Long COVID, but risk is significantly reduced with vaccination. Only 13% of children and 14% of pregnant women received the latest COVID shot as of April and those numbers could decline more if insurance companies refuse to pay for them if this plan goes through.
From: https://www.cdc.gov/acip/downloads/slides-2025-04-15-16/05-Panagiotakopoulos-COVID-508.pdf
At this time, the WHO recommends continued use of the monovalent JN.1 or KP.2 COVID vaccines that were first offered in September 2024 because the variants causing COVID infections now continue to be descendants of JN.1. Antibody titers against LP.8.1 may be slightly lower, but vaccination should not be delayed for new formulations. The WHO will continue to monitor variants and vaccine performance.
A new Yale study shows that a nasal booster using unadjuvanted SARS-CoV-2 spike protein effectively triggered strong lung-specific IgA responses after earlier mRNA vaccination in mice. The immune response relied on the migration of memory B and T cells from lymph nodes into the lungs guided by chemokines CXCL9 and CXCL10. CD4+ T cells acted as natural adjuvants, promoting local immune cell recruitment and IgA class switching. The findings support intranasal boosters as a safe strategy to enhance mucosal protection against respiratory viruses without added adjuvants.
Long COVID
A new article in the Washington Post featuring comments from top Long COVID experts shows that millions of Americans continue to suffer from Long COVID which is a very complex and heterogeneous disease, with no diagnostic tests and no approved treatments. New clinical trials will target specific biological pathways including immune dysfunction and autoimmunity, viral persistence, and microclots rather than treating Long COVID as a single disease. Trials include REVERSE-LC, which will use the immune-modulating drug baricitinib, and ADDRESS-LC, which will test bezisterim, a novel anti-inflammatory that can cross the blood-brain barrier. Researchers stress the urgent need for funding, personalized treatments, and biomarker discovery to guide diagnosis and therapy.
PolyBio Spring Symposium took place on 5/16/25. The line up looked amazing, but unfortunately I was unable to attend. I hope that they will be posting videos of the lectures in the future. Jon Douglas made an excellent summary thread here on the entire symposium.
Two years after severe COVID infection, 18 Long COVID patients still showed increased sympathetic nerve activity, vascular dysfunction, and impaired exercise capacity compared to controls. Elevated markers of endothelial stress and oxidative damage point to long-lasting cardiovascular effects that may underlie persistent fatigue and shortness of breath.
The Bateman Horne Center published a new Clinical Care Guide for managing ME/CFS, Long COVID and Infection-associated chronic conditions (IACCs). The guide offers advice on common comorbidities, assessment tools, clinical pearls and treatments for these very complex diseases.
In a small prospective study from Yale, 16 vaccine-naive individuals with Long COVID were followed before and after COVID vaccination to assess symptom and immune changes. Twelve weeks after vaccination, 10 participants reported improvement, 3 had no change, and 3 worsened (one with post-vaccine myocarditis). Vaccination increased SARS-CoV-2-specific T cells and spike protein antibodies, but symptom improvement was linked to specific immune signatures: higher soluble IL-6 receptor (sIL-6R) predicted improvement, while elevated IFN-β and CNTF were linked to no improvement. Although results suggest immune markers may predict vaccine response in Long COVID, larger studies are needed to confirm these findings.
Measles
As of May 15, 2025, a total of 1,024 confirmed measles cases were reported in 30 U.S. states this year, with 13% of cases requiring hospitalization (128 of 1024) and 3 deaths. Two doses of the MMR vaccine offer 97% protection against the measles.
Texas has 718 confirmed cases of the measles since January 1st and New Mexico reports 74 cases. Kansas has reported 56 measles cases, with 54 linked to a southwestern outbreak tied to a larger one in West Texas.
Seattle officials reported that an infected Canadian visitor visited 16 locations, as Canada faces a major outbreak.
"Anyone who was in Newark Airport's Terminal B between 12:30-4 p.m. Monday 5/12/25 may have been exposed to measles, according to the New Jersey health department."
Ontario, Canada reported 182 new measles cases this week, bringing the total to 1,622 since the outbreak began in October. Measles continues to primarily affect unvaccinated children and teens across Canada, with nearly 400 cases now reported in Alberta.
Health and Human Services (HHS)
This week, HHS Secretary Kennedy went swimming with his grandchildren in a creek that is known to be contaminated with sewage and fecal material.
HHS Secretary Kennedy, a lawyer who has no medical degree, also said in testimony on Capitol Hill, “I don't think people should be taking medical advice from me.”
A new Senate report reveals that the Trump administration quietly slashed $2.7 billion from NIH research budgets, impacting biomedical and pandemic preparedness projects. The NIH website shows that “every $1 of NIH funding generated approximately $2.46 of economic activity.” The cuts will have long-term effects on U.S. scientific capacity and our safety.
Other news
New Mexico made childcare free for most families, lifting 120,000 people out of poverty and cutting poverty among providers nearly in half. Funded by oil and gas revenue, it is a generational investment in kids, parents, and the economy.
Photograph: Isabel Miranda/The Guardian
The FDA approved the Teal Wand for self-screening for HPV and cervical cancer at home. Teal Health plans to get insurance coverage for the home-based test. Congrats Dr. Liz Swenson!
Using processed placenta tissue as medical bandages offers proven benefits for wound healing due to its anti-inflammatory and regenerative properties. Placenta-derived biomaterials have improved outcomes in chronic wounds like diabetic foot ulcers and show promise in heart, bone, and nerve repair.
“In a dramatic shift, the Catholic Church is now promoting HPV vaccination and cervical cancer screening through its nationwide parish network and faith-based hospitals” in Kenya.
Against her family's wishes, a Georgia hospital is keeping nurse Adriana Smith on life support after she was declared brain dead 3 months ago, so that her fetus can develop enough to be delivered. Under Georgia's "heartbeat law," abortion is banned once cardiac activity is detected at 6 weeks and Ms. Smith was 9 weeks pregnant when she died.
The FDA has approved the first blood test to help diagnose Alzheimer’s disease. The test looks at the ratio of two proteins linked to brain amyloid plaques, pTau217 and beta-amyloid 1-42, offering a faster and less invasive alternative to PET scans or spinal taps. In trials, the test showed over 90% accuracy compared to traditional amyloid detection methods.
Gas stove use without adequate ventilation frequently results in benzene concentrations that exceed safety thresholds, particularly in smaller dwellings like apartments. High-efficiency vent hoods and open windows reduced but did not eliminate risk. Children exposed to gas stoves had almost double the lifetime risk of cancer as compared to adults.
A JAMA study shows that living near golf courses increases Parkinson’s disease risk, possibly due to chronic pesticide exposure in the water supply. The highest risk was found in people who lived within 1 to 3 miles of a golf course and risk declined with increasing distance from the course.
From: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2833716
"Montana just passed a new bill backed by longevity enthusiasts that will enable access to drugs and therapies that are not approved by the FDA." Medications will need to have completed Phase I safety studies for use.
A phase I trial in patients with refractory CD30+ lymphoma demonstrated a 66.7% complete response rate using cord blood-derived natural killer (CB-NK) cells combined with the bispecific antibody AFM13. This therapy effectively targeted tumors without severe side effects and even worked in patients who had failed prior CAR T-cell treatment. NK cells, which can be used “off the shelf,” are being engineered with immune engagers to enhance tumor specificity and persistence.
A Magna Carta thought to be a copy and purchased by Harvard Law School for just $27.50 in 1946 has just been confirmed to actually be a rare original from 1300. Historians are calling it a thrilling discovery, and Harvard plans to proudly display the document as a crown jewel of its collection. The Magna Carta is considered the first declaration of human rights in English law, stating that even the king and his government are not above the law.
From: https://iiif.lib.harvard.edu/manifests/view/drs:502532132$1i
Have a good week,
Ruth Ann Crystal MD
NOTES & REFERENCES
CDC Respiratory Illnesses Data Channel- Updated on Fridays.
https://www.cdc.gov/respiratory-viruses/data/index.html
As of May 16, 2025, the amount of acute respiratory illness causing people to seek health care is at a very low level.
Seasonal influenza, COVID-19, and RSV activity is low and declining
Wastewater SCAN: https://data.wastewaterscan.org/
Regional wastewater levels for COVID, RSV, Flu A, Flu B and Norovirus.
5/15/25 Weekly WastewaterSCAN National Resp Report
https://bsky.app/profile/wastewaterscan.bsky.social/post/3lp7zbeixe226
CDC Respiratory viruses, Flu, RSV) Hospitalizations (for those states reporting): https://www.cdc.gov/resp-net/dashboard/index.html
COVID news notes:
US Variant tracker: https://covid.cdc.gov/covid-data-tracker/#variant-proportions
Will update next week. Projected data through 5/10/25.
CDC COVID data tracker: https://covid.cdc.gov/covid-data-tracker/index.html#datatracker-home
COVID Emergency Dept visits: https://covid.cdc.gov/covid-data-tracker/#ed-visits_all_ages_combined
COVID deaths per week: https://covid.cdc.gov/covid-data-tracker/#trends_weeklydeaths_weeklypctdeaths_00
JP Weiland: https://twitter.com/JPWeiland https://bsky.app/profile/jpweiland.bsky.social
Michael Hoerger modeling: http://pmc19.com/data/, https://twitter.com/michael_hoerger
https://x.com/michael_hoerger/status/1922149740654862529
US Wastewater Monitoring:
CDC wastewater reporting: https://www.cdc.gov/nwss/rv/COVID19-nationaltrend.html
Through 5/10/25
CDC wastewater map: https://www.cdc.gov/nwss/rv/COVID19-currentlevels.html
CDC California https://www.cdc.gov/nwss/rv/COVID19-statetrend.html?stateval=California
Wastewater SCAN: https://data.wastewaterscan.org/
SARS-CoV-2
Oakhurst NJ 1369 PMMoV
Fremont CA 482 PMMoV
St Petersburg FL 423 PMMoV
Gautier MI 388 PMMoV
California statewide view https://buff.ly/3YObiul
Palo Alto
California SARS-CoV-2 in Wastewater from CDPH: https://skylab.cdph.ca.gov/calwws/
Santa Clara County wastewater: https://publichealth.santaclaracounty.gov/health-information/health-data/disease-data/covid-19/covid-19-wastewater
Canada wastewater https://health-infobase.canada.ca/wastewater/
UK
UKHSA Dashboard: https://ukhsa-dashboard.data.gov.uk/
UK COVID PCR Test Positivity Map: https://jamestindall.info/skeuomorphology/ladb_covid/index.html
Wastewater monitoring in Scotland
Bob Hawkins UK and Europe https://substack.com/@bhawkins3
Australia https://bsky.app/profile/mikehoney.bsky.social
Variants
Acute COVID infections, General COVID info
5/9/25 COVID-19 tests, other health supplies provided free at 51 kiosks across L.A. County. What you need to know https://archive.is/JlL8t
Free health supplies are now available at 51 kiosks throughout Los Angeles County.
The supplies include COVID-19 test kits, fentanyl test strips and condoms, among other items.
Photo: LA County Dept of Health
5/12/25 CIDRAP: COVID-19 fueled increase in hospital-onset MRSA, study finds https://buff.ly/ngW0OEZ
Original study: 5/12/25 Open Forum Infectious Diseases: Trends in Incidence and Epidemiology of MRSA Bacteremia, 2005–2022 https://buff.ly/H6FUnH3
5/13/25 Am J of Hypertension: Medical Costs, Health Care Utilization, and Productivity Losses Associated with Hypertension Moderated by COVID-19 Diagnosis Among US Commercial Enrollees https://buff.ly/941jGAN
5/13/25 Immunity: Nerve- and airway-associated interstitial macrophages mitigate SARS-CoV-2 pathogenesis via type I interferon signaling https://buff.ly/0fm6oq0
4/12/25, BMC Infectious Diseases, Remdesivir associated with reduced mortality in hospitalized COVID-19 patients https://buff.ly/AEkkDmk
COVID and the Microbiome
5/12/25 Applied and Environmental Microbiology: Marked reduction of SARS-CoV-2 infection and improved recovery following supplementation with a probiotic mix of four strains and two strains of Bifidobacterium breve in hamsters https://buff.ly/i1oNiop
5/12/25 Nature Metabolism (Kiel, Germany): Nicotinamide modulates gut microbial metabolic potential and accelerates recovery in mild-to-moderate COVID-19 https://buff.ly/Xvc7Amp
Pregnancy
5/9/25, BMC Medicine: COVID-19 infection history as a risk factor for early pregnancy loss https://buff.ly/D8lPbs0
Pediatrics
5/12/25 Pediatrics International (Japan Pediatric Society): Long‐COVID in children and their parents: A prospective cohort study https://buff.ly/wQPWZJK
4/21/25 U Penn: COVID vaccine protected kids from long COVID https://buff.ly/pII44lW
Vaccines
5/15/25 WSJ Exclusive: HHS to Stop Recommending Routine Covid Shots for Children, Pregnant Women https://buff.ly/wvg2Hq5
5/14/25
https://www.cdc.gov/covid/hcp/clinical-care/underlying-conditions.html
https://www.cdc.gov/acip/downloads/slides-2025-04-15-16/05-Panagiotakopoulos-COVID-508.pdf
5/15/25 WHO Statement on the antigen composition of COVID-19 vaccines https://buff.ly/c73ftdP
5/13/25 Nature Immunology (Yale): Mucosal unadjuvanted booster vaccines elicit local IgA responses by conversion of pre-existing immunity in mice https://buff.ly/H1Cxo1H
Long COVID
5/16/25 Washington Post: Long covid patients are desperate for treatments. These trials may help. https://archive.is/cDicI
5/16/25 PolyBio Spring Symposium https://polybio.org/spring-2025-symposium/
5/13/25 American Journal of Physiology: Sympathetic Neural Overdrive, Vascular Dysfunction and Diminished Exercise Capacity in Long COVID-19 Patients: A Long-Term Study of Cardiovascular Sequelae https://buff.ly/vV4UEgd
5/9/25 Bateman Horne Center
5/9/25 Nature Communications Medicine Impact of COVID-19 vaccination on symptoms and immune phenotypes in vaccine-naïve individuals with Long COVID https://buff.ly/12A5DqQ
Measles
Measles CDC Measles updates (on Fridays): https://www.cdc.gov/measles/data-research/index.html
As of May 15, 2025, a total of 1,024 confirmed* measles cases were reported by 31 jurisdictions, 13% of cases hospitalized (128 of 1024), 3 deaths.
Measles Texas https://www.dshs.texas.gov/news-alerts
Measles NM https://www.nmhealth.org/about/erd/ideb/mog/
5/14/25 CIDRAP: Kansas measles total grows to 56, with most cases part of outbreak https://buff.ly/2L1RdQF
5/16/25 CIDRAP: US measles outbreak grows to 1,024 cases https://buff.ly/p13IsDy
5/15/25 CBS: Traveler with measles was at Newark Airport while infectious, health officials say https://buff.ly/M9Qs4JH
5/15/25 CBC News: Ontario, Canada reports 182 new measles cases, surpassing 1,600 since outbreak began https://buff.ly/fHQPTgX
5/15/25 Vancouver Sun: Canadian who visited 16 U.S. locations had measles, Seattle health officials say https://buff.ly/8yXHMsV
5/13/25 Washington Public Health Insider: Measles case in visitor to King County: Multiple locations of possible exposure https://buff.ly/FqzWZRQ
HHS, NIH
5/12/25 NY Times: Kennedy Swims in Washington Creek That Flows With Sewage and Bacteria https://buff.ly/xVEqkBm
5/14/25 The Guardian: RFK Jr tells Congress ‘people shouldn’t take medical advice from me’ https://buff.ly/fNuqru9
From NIH.gov: NIH Direct Economic Contributions https://buff.ly/wQM7DhW
Every state and almost every congressional district received a share of NIH investment.
In fiscal year 2023, every $1 of NIH funding generated approximately $2.46 of economic activity.
5/12/25, CNN, Trump administration cut $2.7 billion in NIH research funding through March, Senate committee minority report says https://buff.ly/bYwe9py
Other news
4/11/25 Guardian: New Mexico made childcare free. It lifted 120,000 people above the poverty line https://buff.ly/mKg3Ywj
5/10/25 NPR: The FDA approves first U.S. at-home tool as a Pap-smear alternative https://buff.ly/P6iOpP3
5/16/25 The Conversation: Placenta bandages have far more health benefits than risky placenta pills − a bioengineer explains https://buff.ly/d9fmN8t
5/16/25 AP: Hospital tells family brain-dead Georgia woman must carry 9 week fetus to birth because of abortion ban https://buff.ly/B5uuQzH
5/16/25 STAT News: FDA clears first blood test for diagnosing Alzheimer’s https://archive.is/P9QZE
5/15/25 Preprint Journal of Hazardous Materials (Stanford): Exposure and health risks of benzene from combustion by gas stoves: A modelling approach in U.S. homes https://buff.ly/neDWFij https://archive.is/q42vu
5/15/25 Stanford University & Journal of Hazardous Materials: Cancer risks from gas stove benzene emissions
https://archive.is/npP2A | https://doi.org/10.1016/j.jhazmat.2025.137986
5/8/25, JAMA, Proximity to Golf Courses and Risk of Parkinson Disease https://buff.ly/PnUZjjF
From: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2833716
5/14/25 MIT Technology Review (via Eric Topol): The first US hub for experimental medical treatments is coming to Montana https://buff.ly/j4erQeg
5/13/25 JCI Insight - Early multiple sclerosis activity associated with TBX21+CD21loCXCR3+ B cell expansion resembling EBV-induced phenotypes https://buff.ly/WOEGoAG
5/13/25 Lancet eBio Medicine: A probiotic approach identifies a Treg-centred immunoregulation via modulation of gut microbiota metabolites in people with multiple sclerosis and healthy individuals https://buff.ly/pACaSjr
5/12/25 Nature: The innate power of natural killer cells in cancer therapy https://buff.ly/tR4KPRl
https://www.nature.com/articles/s41591-025-03712-9
5/15/25 CNN: Harvard Law School bought a copy of Magna Carta for $27. Turns out, it’s actually an original https://buff.ly/8MsaNlN
I sent this to my doctor, who was amazed and said she is going to follow you
As ever, thank you for your timely, thorough updates, even more so in these days of contraction of accurate federal public health info dissemination. 🙌