COVID & Health News, 5/25/25
COVID, Flu and RSV are at low or very low levels in wastewater.
COVID
SARS-CoV-2 levels in wastewater are low and Emergency Department visits and COVID deaths are also low across the country. Friday, JP Weiland estimated that there are 175,000 new COVID cases per day in America with about 1 in 190 people currently infected. We are in a lull.
SARS-CoV-2 Variants
Unfortunately, the CDC did not update their SARS-CoV-2 variant reporting this week. Variant data is projected through 5/10/25 only. At that time, LP.8.1 was 70% of COVID cases and XFC (aka XFG) was up to 9% of cases.
XFG was first found in Quebec and is more common in North America and Europe. We are seeing an increase of XFG in the bellwether state of New York. XFG has a 65% weekly growth advantage and JP Weiland predicts that XFG will be dominant in New York by about June 2, dominant across the United States in June, and dominant in Europe in June or July.
NB.1.8.1 is high in Hong Kong and China. In fact, pediatric COVID wards are full in Hong Kong and authorities are asking people to vaccinate their children against COVID.
From: https://substack.com/@bhawkins3
According to Cornelius Roemer, “Per recent work by Yunlong Cao's group, NB.1.8.1 has relatively higher ACE2 binding affinity than XFG but lower immune escape (in serum neutralization assays using breakthrough infection samples). This could result in the two lineages becoming dominant in different regions, depending on prior lineage exposure, vaccination history and population immunity.”
From: https://www.biorxiv.org/content/10.1101/2025.04.30.651462v1.full.pdf
Acute COVID infections, General COVID info
Researchers at UCSF found that a single gene, OLAH, or a three-gene blood signature can predict COVID death within 48 hours of hospital admission with up to 88% accuracy. These simple gene expression patterns could speed up triage and improve outcomes during hospital surges.
A study from Johns Hopkins reveals that SARS-CoV-2 infection reprograms neutrophils to degranulate and transform into myeloid-derived suppressor cells (MDSCs). MDSCs suppress T cell activity which can weaken the body's immune response to SARS-CoV-2 and contributes to severe COVID infection. The research highlights a mechanism by which the virus may undermine the body’s immune defenses offering insights that could inform future treatments targeting immune regulation in COVID.
From: https://www.eurekalert.org/news-releases/1084908
Pediatrics
A study of 16 children hospitalized with COVID found they had abnormal gut microbiota and significantly lower levels of key fecal vitamins and lipids compared to healthy peers. These changes are believed to impair immune function and may contribute to worse outcomes, highlighting the potential role of gut health in pediatric COVID severity and recovery.
Infants under 8 months hospitalized with COVID infection showed distinct immune responses that varied with disease severity and differed significantly from adult responses. Unlike adults, infants had heightened interferon-stimulated gene activity in T and B cells. These findings could help guide infant-specific treatments and vaccine development.
Vaccines
This week, the FDA announced a dramatic shift in COVID vaccine policy under the Trump administration. The agency will no longer approve or recommend COVID vaccines for healthy individuals aged 6 months to 64 years without a high-risk condition, such as chronic illness or immune compromise. People over age 65 are still allowed to be vaccinated against COVID. The change was announced via an editorial in JAMA by political appointees (Prasad and Makary) rather than through standard advisory panels and has sparked controversy. Critics, including physicians and public health experts, warn that the decision undermines scientific norms, excludes high-risk groups like health care workers, caregivers and overweight individuals, and could severely limit vaccine access for millions of Americans. The new U.S. FDA recommendation comes as officials in Hong Kong are urging that children be vaccinated against COVID because a new COVID wave has filled pediatric wards with sick children, further underscoring the potential dangers of the U.S. policy shift.
Despite approving a new formula targeting the JN.1 lineage for fall 2025 boosters and greenlighting the Novavax vaccine with restrictions, the FDA now requires vaccine manufacturers to conduct large, new studies if they want approval for broader public use. Experts have called out misleading data presentations and the lack of consultation with advisory committees like ACIP. COVID vaccines have been shown to reduce viral shedding, reduce illness severity and reduce the risk of Long COVID. Meanwhile, former U.S. Surgeon General Dr. Jerome Adams emphasized that COVID remains a deadly threat, killing over 47,000 Americans in 2024, which is more deadly than car crashes or breast cancer. Critics warn this change in vaccine policy erodes trust, sets a dangerous precedent, and could limit access to vaccines for millions of Americans from age 6 months to 64 years without justification while the SARS-CoV-2 virus continues to evolve and cause waves of disease and disability.
From: Katelyn Jetelina, YLE
For fact checked, reliable information on vaccines, please see the American Academy of Pediatricians’ website.
A new preprint in Nature of more than 33,000 individuals shows that for men over age 70, vaccinated people had significantly fewer post-COVID heart attacks, strokes, and deaths compared to unvaccinated individuals. This study used a target trial emulation to mimic a randomized trial.
Moderna has withdrawn its application to license a combined flu-COVID vaccine, citing ongoing regulatory and data hurdles. This is a shame since the combined dual vaccine was more effective than the separate vaccines.
Antiviral treatments
Masitinib, a tyrosine kinase inhibitor, was found to effectively inhibit SARS-CoV-2 replication by targeting its main protease 3CLpro, both in vitro and in mice. It has broad spectrum antiviral activity against SARS-CoV-2, OC43 and picornaviruses and also has anti-inflammatory activity by controlling activated macrophages and mast cells involved in COVID. AB Science has licensed the drug from the University of Chicago and recently was issued a Chinese patent for the Masitinib.
Long COVID
Dianna Cowern, also known as the Physics Girl on YouTube, made a touching new video about her battle with severe Long COVID and ME/CFS and her recent significant improvement. After 2 years of being bedridden, she now is able to walk, talk and enjoy life more.
A new study from Germany found that intravenous administration of the SARS-CoV-2 spike protein in mice led to neuroinflammation and accumulation of alpha-synuclein in brain regions associated with Parkinson’s disease. Authors also discovered “sex-dependent alterations in astrocyte reactivity and parvalbumin-positive interneurons.” These findings suggest that exposure to the spike protein alone, without full viral infection, may contribute to neurodegenerative processes linked to Parkinson's, thus highlighting potential long-term neurological risks following COVID infection. This is yet another reason to allow everyone to protect themselves with vaccination.
The above mentioned study builds upon Ali Erturk’s lab report from December 2024 which showed that persistence of spike protein at the skull-meninges-brain axis induced neurological damage in mice.
From: https://www.cell.com/cell-host-microbe/fulltext/S1931-3128(24)00438-4
A large genome-wide association study of 6,450 Long COVID cases identified a genetic link between Long COVID and the FOXP4 gene, independent of its known role in severe COVID infection. This finding was then replicated in an even larger group of 9,500 Long COVID patients. “Higher FOXP4 levels in nonacute COVID-19 [blood] samples were associated with increased risk of long COVID (OR = 2.31 per 1 s.d. increase in FOXP4 expression).”
This study shows that genetic variants in the FOXP4 gene may influence the risk of developing Long COVID through effects on lung function and immune responses to viral infection. This link may vary depending on SARS-CoV-2 variant and vaccination status. Most study data were collected before the Omicron wave and widespread COVID vaccination. Still, it makes me wonder if FOXP4 could be used as a biomarker for Long COVID in some way.
More studies are showing the important relationship between the gut and Long COVID. Researchers from Vienna found that people with Long COVID fatigue have damaged gut barriers and signs of immune activation. Preexisting gastrointestinal symptoms before COVID infection predisposed people to developing Long COVID fatigue. Long COVID patients were found to have “an increased LBP/sCD14 ratio and lower IL-33 levels, which indicates altered immune activation and a reduced intestinal barrier. In addition, there were increased IL-6 levels, which are considered a marker for systemic inflammatory reactions.”
Graphical Abstract
LBP/sCD14 is the ratio of lipopolysaccharide binding protein to soluble CD14.
From: https://onlinelibrary.wiley.com/doi/10.1111/all.16593
Low-dose naltrexone was found to restore function of TRPM3 ion channels in Natural Killer cells from people with Long COVID back to levels seen in healthy controls. These ion channels are important for immune cell signaling and their dysfunction may contribute to ongoing symptoms.
In a placebo-controlled UCSF trial of 36 Long COVID patients, AER002 monoclonal antibodies did not show a significant benefit over placebo, though some individuals in both groups experienced symptom improvement. The study confirmed the treatment’s safety, but raised questions about whether viral persistence is truly driving symptoms or if multiple doses of monoclonal antibodies are needed to resolve Long COVID symptoms. Dr. Peluso emphasized the importance of identifying biomarkers to target specific subgroups more effectively in future trials. UCSF is launching new studies to explore other Long COVID treatments, including drugs for inflammation, neurological symptoms, and immune modulation.
H5N1
A new H5N1 bird flu mRNA vaccine designed for cattle showed strong immune responses and safety in initial trials. The development could help curb H5N1 transmission in farm environments and reduce risks of zoonotic spillover.
Measles
Since January 1, there have now been 1046 Measles cases reported in the United States, with 12% of cases requiring hospitalization (127 of 1046), and 3 deaths.
Health officials in New Jersey are warning that a person infected with measles attended a Shakira concert in East Rutherford, New Jersey, on May 15. Measles symptoms could develop up to 21 days later (June 6). Two doses of the MMR vaccine protect 97% against the measles.
Babies vaccinated early with the MMR before 8.5 months of age, instead of at 12 months of age, had a rapid decline in measles antibodies, with >70% losing protection by 6 years, even with a second MMR dose at 14 months. The CDC recommends “Infants 6–11 months old should get 1 dose of the MMR vaccine before [international] travel. Then they should get 2 more doses after their first birthday.”
From: https://academic.oup.com/cid/article/80/4/904/7874423?login=false
ME/CFS
A group from Yale and Sweden analyzed cerebrospinal fluid and blood samples from 40 ME/CFS patients and 41 healthy controls and discovered two ME/CFS patient clusters that were identified based on matrix metalloproteinases (MMPs) profiles in the CSF. Despite similar clinical presentations, these subgroups exhibited different pathogen exposures and CSF inflammatory profiles. MMPs are linked to tissue remodeling and inflammation. The results show that ME/CFS is not a single disease but includes multiple immune-based subtypes.
From: https://academic.oup.com/jimmunol/advance-article/doi/10.1093/jimmun/vkaf087/8133211
Other news:
China will donate $500 million to the World Health Organization to bolster global health initiatives, particularly in low-income countries. This move follows significant American funding cuts and signals China’s intent to take on a more prominent role in international public health.
Despite increasing cases of infectious diseases like measles and whooping cough, the CDC has stopped important communications. One of the main CDC newsletters on outbreaks has not been sent to health professionals since March and CDC social media accounts have not posted new content in over a month. Experts say the lack of timely updates could hinder effective prevention and response, especially as misinformation fills the gap.
Former President Joe Biden, age 82, was diagnosed with prostate cancer that has spread to his bones. “While this represents a more aggressive form of the disease, the cancer appears to be hormone-sensitive which allows for effective management.”
CT scans may be linked to more cancer cases than previous estimates. “If current CT practices persist, the scans could eventually account for an estimated 5% of new cancer diagnoses each year" because of radiation associated with CT scans.
Antibiotic use in infants can disrupt the gut microbiota and weaken their response to vaccination.
The Restaurant of Mistaken Orders in Kyoto, Japan embraces its servers- all of whom have dementia. About 40% of orders are wrong, but customers don’t mind because whatever dish is served, they know that it will taste good. Mistakes are accepted and it allows the elders to interact with their community.
From: Restaurant of Mistaken Orders
Have a great week,
Ruth Ann Crystal MD
NOTES & REFERENCES
CDC RESPIRATORY ILLNESSES
https://www.cdc.gov/respiratory-viruses/data/index.html This site is updated on Fridays.
As of May 23, 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.
Wastewater SCAN: https://data.wastewaterscan.org/
Regional wastewater levels for COVID, RSV, Flu A, Flu B and Norovirus.
CDC Respiratory viruses (COVID, Flu, RSV) Hospitalizations (for those states reporting): https://www.cdc.gov/resp-net/dashboard/index.html
COVID news notes:
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
US Variant tracker: https://covid.cdc.gov/covid-data-tracker/#variant-proportions
Through 5/10/25. The CDC variant tracker has not updated in more than 2 weeks.
2 new variants are emerging (NB.1.8.1 in Asia, and XFG in the US).
5/21/25 Monthly World SARS-CoV-2 Variant report from Cornelius Roemer https://github.com/neherlab/SARS-CoV-2_variant-reports/blob/main/reports/variant_report_latest_draft.md
Variant report 2025-05-21
Global overview
Based on sequences collected in 2025 and shared until 2025-05-18:
XEC continues declining and is no longer dominant in almost all countries, except for Japan where it is still dominant and growing.
LP.8.1 is dominant in North America, parts of South America (Brazil), much of Europe and South Africa (the only continental African country with more than 10 sequences from 2025). It is still growing in Australia.
LF.7 appears to have peaked. In Russia and Peru it was was dominant in Q1 2025 and at around 40% in Singapore and Chile.
NB.1.8.1 is growing globally. It is dominant in Hong Kong and China and at 5-30% in most other countries with sequences collected end of April 2025.
XFG (described below) is most common in North America and Europe where it is growing around as fast as NB.1.8.1 and at similar frequencies.
XFG
XFG is most common in North America and Europe, where it made up around 10% of sequences collected at the end of April. It has also been sequenced sporadically in Australia, New Zealand and Singapore.
Comparison of XFG and NB.1.8.1
In Europe and North America, both XFG and NB.1.8.1 are at similar frequencies and growing at similar rates (doubling every 1-2 weeks). It is currently unclear which lineage will be more successful in the long run.
Per recent work by Yunlong Cao's group, NB.1.8.1 has relatively higher ACE2 binding affinity than XFG but lower immune escape (in serum neutralization assays using breakthrough infection samples). This could result in the two lineages becoming dominant in different regions, depending on prior lineage exposure, vaccination history and population immunity.
Weekly variant roundup by Mike Honey:
JP Weiland: https://twitter.com/JPWeiland https://bsky.app/profile/jpweiland.bsky.social
5/23/25
Michael Hoerger modeling: http://pmc19.com/data/, https://twitter.com/michael_hoerger
US Wastewater Monitoring:
CDC wastewater reporting: https://www.cdc.gov/nwss/rv/COVID19-nationaltrend.html
CDC wastewater map: https://www.cdc.gov/nwss/rv/COVID19-currentlevels.html
Wastewater SCAN: https://data.wastewaterscan.org/
California statewide view https://buff.ly/3YObiul
Vallejo 218 PMMoV
Davis 125 PMMoV
San Jose 123 PMMoV
California from CDC: https://www.cdc.gov/nwss/rv/COVID19-statetrend.html?stateval=California
California SARS-CoV-2 in Wastewater from CDPH: https://skylab.cdph.ca.gov/calwws/
Data through 5/15/25 shows MEDIUM.
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
European wastewater dashboard for COVID, Flu and RSV
https://arcgis.jrc.ec.europa.eu/portal/apps/dashboards/e296cdf0c0d042e6b60b07a351f2dc5c
Taiwan: Weekly COVID-19 hospital visits surge 88%
Acute COVID infections, General COVID info
5/21/25 Science: SARS-CoV-2 induces neutrophil degranulation and differentiation into myeloid-derived suppressor cells associated with severe COVID-19 https://buff.ly/tA6cAMs
5/19/25 MedRxiV (UCSF): Minimalistic Transcriptomic Signatures Permit Accurate Early Prediction of COVID-19 Mortality https://buff.ly/ywjKtwP
"The expression of OLAH alone, a gene recently implicated in severe viral infection pathogenesis, yielded an AUC of 0.86 (0.79-0.93)."
Pediatrics
5/17/25 SCMP: Hong Kong children urged to get Covid jabs as ‘whole paediatric ward full’ https://buff.ly/kBcDA14
5/20/25 PLOS One (Spain): Hospitalised children with COVID-19 display an aberrant intestinal microbiota and a shift in faecal compounds related with the metabolism of vitamins and lipids https://buff.ly/uSI9V7Z
5/19/25 Nature Immunology: Antibiotics, microbiota and the calibration of infant vaccine responses https://buff.ly/lDHsNVr
5/16/25 Nature: SARS-CoV-2 induced immune perturbations in infants vary with disease severity and differ from adults’ responses https://buff.ly/KooCdXs
Vaccines
5/20/25 AP news: New Trump vaccine policy limits access to COVID shots https://buff.ly/nArsU1P
Fall 2025 COVID vaccines will be "available to adults 65 and older, as well as children and adults with at least one high-risk health problem."
What about healthcare workers, caretakers, and anyone else who would like the vaccine?
5/17/25 SCMP: Hong Kong children urged to get Covid jabs as ‘whole paediatric ward full’ https://archive.is/BpXFd
12/23/25 CIDRAP: FDA approves formula for fall COVID vaccines https://buff.ly/eFkoXv6
5/20/25
https://x.com/JeromeAdamsMD/status/1924994884705927426
https://x.com/DrIanWeissman/status/1925025485165133869
5/21/25 Katelyn Jetelina: Covid-19 vaccines, what just happened at the FDA, and why it matters https://buff.ly/NnJojLX
From:
5/20/25 NEJM (V. Prasad & M. Makary): An Evidence-Based Approach to Covid-19 Vaccination https://nej.md/3F6EIhV
Figure 1 (which was printed in NEJM, but is incorrect- see below)
But, Figure 1 is incorrect:
5/20/25 Eric Meyerowitz @ericmeyerowitz.bsky.social
Figure 1 is also wildly misleading
In most countries you are eligible for annual boosters from 18-64 regardless of comorbidities or immune compromise, and the vaccines are specifically recommended for all over age 65
See Australia: https://www.health.gov.au/our-work/covid-19-vaccines/getting-your-vaccination
5/20/25 ChristophersDad @christophersdad.bsky.social
In Austria, infants from 6 months of age can receive a free vaccination against Covid, and the national vaccination plan for 2024/25 says everyone aged 12 and over can get the annual booster, see p. 13–14
5/2025 Lancet: Adaptive immune responses are larger and functionally preserved in a hypervaccinated individual https://buff.ly/qOaHE7n
A man in Germany received COVID vaccinations 217 times with no safety issues and no abnormal lab tests. He also never became infected with COVID.
5/18/25 PBS News: FDA approves Novavax COVID-19 vaccine, but with unusual restrictions on its use https://buff.ly/nn3gtZ4
5/16/25 Preprint (Nature Scientific Reports): The effect of vaccination on post-COVID-19 major acute cardiac events and mortality: a target trial emulation https://buff.ly/JKe2vx3
5/21/25 CIDRAP: Moderna pulls licensing submission for combo flu-COVID vaccine https://buff.ly/BEC2qBh
Fact Checked: Reliable Information on Vaccines from the American Academy of Pediatricians https://www.aap.org/en/news-room/fact-checked/
Antiviral treatments
5/19/25 Press Release: AB Science receives Chinese patent protecting Masitinib in the treatment of Covid-19 until 2041, adding one more indication with long term intellectual property protection https://buff.ly/Kq5SpzL
8/19/21 Science: Masitinib is a broad coronavirus 3CL inhibitor that blocks replication of SARS-CoV-2 https://www.science.org/doi/10.1126/science.abg5827
Long COVID
5/22/25 Video: First Update From Dianna (Physics Girl)
From: https://x.com/thephysicsgirl/status/1926047907830018375
5/20/25 Brain, Behavior and Immunity preprint: Intravenous SARS-CoV-2 Spike protein induces neuroinflammation and alpha-synuclein accumulation in brain regions relevant to Parkinson’s disease https://buff.ly/yASDZPR
12/11/24 Cell (Erturk lab): Persistence of spike protein at the skull-meninges-brain axis may contribute to the neurological sequelae of COVID-19 https://buff.ly/WAfTM3t
https://www.cell.com/cell-host-microbe/fulltext/S1931-3128(24)00438-4
5/21/25 Nature Genetics: Genome-wide association study of Long COVID https://buff.ly/xAHU1wg
5/22/25 Eurekalert (Catalan): FOXP4 gene identified in the first large-scale genetic study on Long COVID with participation of the GCAT https://buff.ly/JR4TC01
5/15/25 Allergy (Vienna): Gastrointestinal Barrier Disruption in Post-COVID Syndrome Fatigue Patients https://onlinelibrary.wiley.com/doi/10.1111/all.16593
5/21/25 Medical Xpress: Study links gut health to fatigue in post-COVID syndrome patients https://buff.ly/a4ttcbz
5/18/25 Frontiers in Molecular Bioscience: Low‐Dose naltrexone restored TRPM3 ion channel function in natural killer cells from long COVID patients https://buff.ly/ELRgumh
5/16/25 SF Chronicle: Monoclonal study: 36 people with long COVID tested a potential treatment. Here’s what the study found https://archive.is/fwS9D
H5N1
5/20/25 Nature: Bird-flu vaccine for cattle aces early test https://buff.ly/ZCj7eY2
Measles
Measles CDC Measles updates (on Fridays): https://www.cdc.gov/measles/data-research/index.html
Since January 1st, there have been 1046 Measles cases reported with 12% of cases hospitalized (127 of 1046), 3 deaths.
5/21/25 NBC: Officials warn of potential measles exposure at Shakira concert at MetLife Stadium https://buff.ly/HDyZUPX
11/4/24 Clinical Infectious Diseases: Long-term Dynamics of Measles Virus–Specific Neutralizing Antibodies in Children Vaccinated Before 12 Months of Age https://buff.ly/tm6fqXe
https://www.cdc.gov/measles/vaccines/index.html
ME/CFS
5/15/25 J of Immunology (Iwasaki): Cerebrospinal fluid immune phenotyping reveals distinct immunotypes of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) https://buff.ly/g2QnZho
Other news:
5/21/25 Washington Post: China to donate $500 million to WHO, stepping into gap left by U.S.
5/21/25 NPR: Diseases are spreading. The CDC isn't warning the public like it was months ago https://buff.ly/39mpeRO
5/19/25 CNN: Biden diagnosed with ‘aggressive form’ of prostate cancer https://buff.ly/QIGa5yL
5/16/25 JAMA: CT Scans Linked to More Cancer Cases Than Previously Estimated https://buff.ly/96ck46L
5/19/25 Nature Immunology: Antibiotics, microbiota and the calibration of infant vaccine responses https://buff.ly/lDHsNVr
I learn new and important facts with each newsletter. And the sweet/happy/interesting last item is a joy every time. Thank you, Dr. Crystal!
Thank you! Fighting! 💪💙