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Over-the-counter ivermectin availability added to Georgia public health bill

2026-03-20T15:26:09+00:00

This story was originally published at Georgia Recorder. Public health, explained: Sign up to receive Healthbeat’s free Atlanta newsletter here.

Georgians who want to buy a controversial anti-parasitic drug may soon be able to pick it up from their local pharmacist without a prescription.

A state House committee Thursday amended a bill to allow pharmacists to distribute ivermectin over the counter to Georgians 18 and older.

The ivermectin language was added to a bill aimed at updating provisions around the Department of Public Health that had already passed the Senate during the final madcap days of Georgia’s legislative session, set to end April 2. Because the bill was amended, it will need to pass the Senate again, as well as the House, if it is to become law.

The bill passed the House Public and Community Health Committee mostly along party lines despite warnings from medical experts like Johns Creek Democratic Rep. Michelle Au, who is also a physician, that it could endanger Georgians’ health.

“It is galling at this point in session, when time is running out, to have to hear this bill now for the fourth time in the public health committee – a bill that was fine and passed out twice and was yanked back in order to insert this language about ivermectin availability, to waste that amount of time when there are hundreds of real public health bills that would have immediate effect on patients in Georgia,” she said.

Georgia lawmakers advance bills aimed at easing nurse and doctor shortages

Doctors prescribe ivermectin for parasitic infections ranging from the extremely serious, like river blindness, to the more mundane, like head lice. It’s also commonly used in large doses to protect livestock from parasites.

False rumors started on the internet claim that the drug can be used to treat ailments including Covid-19 and cancer, leading some to purchase the drug from agriculture and livestock supply stores for personal rather than animal use. Studies have not found the drug to be effective for those uses.

State Rep. Karen Mathiak, a Griffin Republican who sponsored the original proposal, said her goal is to make sure people who choose to take the drug do so as safely as possible.

“Right now, what people are doing in the state of Georgia is using equine ivermectin out of places like Tractor Supply or your feed store,” she said. “It’s been told to me that farmers have been taking it for years when they’re around cattle and horses, because they tend to have parasites. So that’s the bill, and the thing that I do like about it being behind the counter is then the pharmacist has the availability to speak with their customer about dosage and contraindications.”

Au said drugs available without a prescription typically treat ailments that are easy to self-diagnose, like a headache or stuffy nose, and have a low risk of serious side effects, neither of which are the case for ivermectin.

“You do need specific types of clinical tests to determine, do you have intestinal worms, for example. Some of those diagnostics are not available to a patient at home, and it is also not available to a pharmacist. For example, a pharmacist, as we discussed last time, will not be doing a fecal smear and looking at that under the microscope to look for [parasites].”

According to the Georgia Poison Center, a mild ivermectin overdose can lead to symptoms including rash, headache, dizziness, sleepiness, nausea, vomiting, abdominal pain, diarrhea and mild increased heart rate, while more severe toxicity can cause seizures, coma, acidic blood, respiratory failure, and low blood pressure.

Overdoses may be more likely when using products designed for large farm animals.

Other health care professionals on the committee objected to the bill, including Tucker Democratic state Rep. Imani Barnes, who holds a doctorate in public health.

In addition to potential health risks, opponents said the bill could make pharmacists liable to legal challenges or cause them to choose not to carry ivermectin at all, which could be bad news for people with parasitic infections and prescriptions from a doctor.

Committee Chair Sharon Cooper, a Marietta Republican and registered nurse, expressed reservations of her own.

“I have concerns as a registered nurse, but unfortunately, I think we’re becoming a nation of people who want to be their own doctors,” she said. “I think this may be one step in at least trying to get this into an arena where at least somebody with medical training, i.e., the pharmacist, would be able to talk to them.”

“It may not be the best thing, but better than just going and buying it at the feed and seed,” Cooper added.

At least five other states — Tennessee, Arkansas, Idaho, Louisiana and Texas — have made ivermectin available over the counter.

Georgia flu deaths highest in five years as RSV, other respiratory viruses rise

2026-03-13T21:28:43+00:00

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Deaths from flu in Georgia – 243 since the season started in October – are the highest they’ve been in five years, according to data released Friday from the Georgia Department of Public Health.

The deaths include five children. At this point in the season last year, 95 people had died, with 50 deaths at this point during the 2023-24 season.

Meanwhile, respiratory syncytial virus and human metapneumovirus, a lesser-known respiratory illness, have also been on the rise, said Dr. Andrew Thornton, a doctor with Wellstar in Cobb County. Those two conditions, while typically mild, can be more serious in children and the elderly. Covid rates remain low.

Here’s a look at what’s happening.

Flu rates, death toll still climbing

The death toll for flu since last fall hit 243 this week. Flu can be severe in any year, Thornton said, but the higher death toll could be related to the circulation of a new strain of flu this year.

“It’s possible that this became more severe in some patients and, sadly, led to unexpected death. Influenza can be a bit unpredictable, and it does depend on medical conditions and the immune system of the particular patient, and often the age of the patient,” Thornton said, adding that young children and older adults are often at higher risk.

“I don’t know that we know for sure why certain patients might die from the flu, but that is one of the reasons why we want to vaccinate for it, because it can be unpredictable, it can be severe,” Thornton said.

Nationally, 85% of the 101 reported influenza-associated pediatric deaths from this season were in unvaccinated patients, according to the Centers for Disease Control and Prevention.

Flu will continue to circulate through the spring, Thornton said, so it’s not too late to get a vaccine.

“We are still seeing plenty of flu cases, and we don’t know for sure that we’re not going to get any more spikes during the spring, so I would definitely still recommend it if a patient has not been vaccinated,” Thornton said.

Still, positivity rates are lower than earlier in winter. The positivity rate for tests conducted at select Georgia labs was 16.8% for the week ending March 7. While at the start of the season, most cases were Flu Type A, there has been a slight increase in the rate of Flu B cases, starting in late January, according to DPH data.

Covid rates have remained relatively low this winter, Thornton said. CDC data show low wastewater levels, and hospitalization and emergency room visit rates are lower this year than the same time last year in Georgia.

“We’ve seen less Covid this winter compared to last winter, as well as less hospitalizations, emergency room visits, and death compared to last year, which are obviously great trends for this disease,” he said.

RSV and HMPV rates higher than last year

Respiratory syncytial virus usually causes mild, cold-like symptoms but can be more serious in young children and older adults, according to the CDC.

“We are seeing a later rise in RSV this year compared to most recent years,” Thornton said. “RSV seems to be increasing right now, as opposed to last year, it was decreasing at this point in the year.”

At the same time last year, 1.6% of PCR tests for RSV were positive, while this year that rate is 8.3%, according to DPH data. Georgia wastewater data from the CDC also shows moderate levels of RSV. Hospitalization rates for RSV are also higher than at the same time last year, according to the CDC.

While RSV is typically mild, it can be serious in young people and older adults, especially those with risk factors like lung and heart diseases, a compromised immune system, or residence in a nursing home.

“We really, really pay attention to those younger kids with RSV, and that’s where we are still seeing elevated emergency room visits and hospitalizations in those younger patients.”

There aren’t anti-viral drugs to treat RSV for less severe cases, though there is a treatment that is used in hospitalized patients, Thornton said. Outpatient treatment focuses on managing symptoms. But there are steps parents and older adults can take to protect themselves.

Pregnant women can get an RSV vaccine that passes antibodies on to their infants. There’s also a vaccine for infants whose mothers did not get the shot during pregnancy.

The CDC also recommends that all adults over age 75 get a RSV vaccine and those with risk factors for serious illness who are over 50 get an RSV vaccine.

Another lesser-known virus is also on the rise, Thornton said: human metapneumovirus. The disease is also usually mild and causes cold-like symptoms like cough, fever, nasal congestion, and shortness of breath, according to the CDC.

HMPV tests from selected clinical laboratories in Georgia had a positive rate of 6.4% for the week ending March 7, while at the same time last year the positivity rate was 3%, according to DPH data.

Wastewater levels are also high, having climbed over the past three months, according to Georgia data from WastewaterSCAN.

Thornton said the virus belongs to the same family as RSV and is not related to pneumonia, but both viruses can cause pneumonia in more serious cases. There is no vaccine for it.

HMPV peaked in April nationally last year, Thornton said, and he expects this year’s pattern to be similar to last year.

“In general, a human metapneumovirus will often be more severe than the more mild viruses like rhinovirus,” Thornton said and will be more likely to cause a fever or a severe cough. “It also has a lot to do with the patient and their current medical conditions and immune status.”

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Georgia bill would make ivermectin available over the counter. Critics warn of risks.

2026-02-13T14:46:35+00:00

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Georgia lawmakers are considering a bill to make a controversial anti-parasitic drug available over the counter. Even though ivermectin has been shown to have no effect on Covid or cancer, false claims spread on social media encourage those uses.

A state House committee held a hearing on the bill this week but did not vote.

State Rep. Karen Mathiak, a Griffin Republican, said she wants people to be able to buy the drug at pharmacies rather than farm supply stores. She said that though the U.S. Food and Drug Administration has not approved the drug for Covid treatment, people are using it that way.

“What happens now is people are buying it out of Tractor Supply and farm supply houses, and dosing by weight, by the patient’s weight,” Mathiak said. “I’m asking for it just to be over the counter.”

Sen. Colton Moore, a Trenton Republican, introduced a similar bill last year. It was assigned to the Agriculture and Consumer Affairs committee but did not get a hearing.

At least four states – Tennessee, Arkansas, Idaho, and Louisiana – had enacted similar legislation as of last summer, and similar bills were proposed in at least 12 other states, NBC News reported.

U.S. cancer institute studying ivermectin’s ‘ability to kill cancer cells’

Ivermectin was discovered in the 1970s and was first used to treat parasites in animals. During the pandemic, it was promoted by fringe medical groups as a treatment for Covid. Some social media influencers have hyped it as a miracle cure for a variety of diseases, including cancer.

“We’ve done clinical studies looking at ivermectin, and there is not enough evidence clinically for the FDA to approve this as an indication for Covid, in terms of having it as an over-the-counter medication,” said Dr. Colleen Kraft, a professor in the Departments of Pathology and Infectious Diseases at Emory University School of Medicine.

Inappropriate use of the drug can cause harm, ranging from mild symptoms like vomiting and diarrhea to more severe effects like confusion, loss of balance, seizures, and even death, said Dr. Tom Moore, a parasitologist who is a clinical professor of medicine at the University of Kansas School of Medicine.

He said that’s especially true for people who take the drug in large doses or via transdermal application or subcutaneous injections.

The number of cancer-related social media posts mentioning ivermectin doubled in the first half of 2025 compared to all of 2024. Such posts touted ivermectin’s purported ability to treat cancer or enhance chemotherapy or immunotherapy’s benefits, KFF, a nonprofit health policy think tank, found last year.

The National Cancer Institute is studying the drug, director Anthony Letai said. He said results are expected in a few months, KFF Health News reported this week. The move has prompted criticism from career scientists at the agency, who said it diverts resources from more promising treatments “based on nonscientific ideas.”

Ivermectin does have limited use for humans in the United States. As a pill, it can be used to treat strongyloidiasis, a type of roundworm infection, and river blindness, a neglected tropical disease found primarily in Africa.

A topical version of ivermectin can also be used for scabies and head lice but is typically not a frontline treatment for simple cases, Kraft said. It can also be prescribed for rosacea.

Kraft and Moore said some of the confusion around ivermectin during the pandemic was prompted by early test tube studies in which scientists experimented with a wide range of drugs to find something that would work for Covid. An early signal of the potential efficacy for ivermectin against Covid took on a life of its own, even as large-scale clinical trials failed to show evidence of the drug’s efficacy.

That focus on ivermectin during the pandemic deterred some people from seeking more effective medical treatments.

“There are some people that wish they had come to the hospital sooner instead of taking ivermectin,” Kraft said about patients she saw. There are now proven treatments like Paxlovid and remdesivir that have FDA approval for Covid, she said.

It’s important that physicians be able to help patients manage their medications and potential interactions, and opening the door to over-the-counter ivermectin could mean patients take the drug without proper medical guidance, she said.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Trump policies at odds with emerging understanding of Covid’s long-term harm

2026-01-27T15:54:55+00:00

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Possible risk of autism in children. Dormant cancer cells awakening. Accelerating aging of the brain.

Federal officials in May 2023 declared an end to the national Covid pandemic. But more than two years later, a growing body of research continues to reveal information about the virus and its ability to cause harm long after initial infections resolve, even in some cases when symptoms were mild.

The discoveries raise fresh concerns about the Trump administration’s Covid policies, researchers say. While some studies show Covid vaccines offer protective benefits against longer-term health effects, the Department of Health and Human Services has drastically limited recommendations about who should get the shot. The administration also halted Biden-era contracts aimed at developing more protective Covid vaccines.

The federal government is curtailing such efforts just as researchers call for more funding and, in some cases, long-term monitoring of people previously infected.

“People forget, but the legacy of Covid is going to be long, and we are going to be learning about the chronic effects of the virus for some time to come,” said Michael Osterholm, an epidemiologist who directs the University of Minnesota’s Center for Infectious Disease Research and Policy.

The Trump administration said that the Covid vaccine remains available and that individuals are encouraged to talk with their health providers about what is best for them. The Covid vaccine and others on the schedule of the Centers for Disease Control and Prevention remain covered by insurance so that individuals don’t need to pay out-of-pocket, officials said.

“Updating CDC guidance and expanding shared clinical decision-making restores informed consent, centers parents and clinicians, and discourages ‘one size fits all’ policies,” said HHS spokesperson Emily Hilliard.

Is Covid during pregnancy linked to autism? What a new study shows, and what it doesn’t

Although Covid has become less deadly, because of population immunization and mutations making the virus less severe, researchers say the politicization around the infection is obscuring what science is increasingly confirming: Covid’s potential to cause unexpected, possibly chronic health issues. That in turn, these scientists say, drives the need for more, rather than less, research, because over the long term, Covid could have significant economic and societal implications, such as higher health care costs and more demands on social programs and caregivers.

The annual average burden of the disease’s long-term health effects is estimated at $1 trillion globally and $9,000 per patient in the United States, according to a report published in November in the journal NPJ Primary Care Respiratory Medicine. In this country, the annual lost earnings are estimated to be about $170 billion.

One study estimates that the flu resulted in $16 billion in direct health costs and $13 billion in productivity losses in the 2023-24 season, according to a Dec. 30 report in medRxiv, an online platform that publishes work not yet certified by peer review.

Studies show Covid’s growing reach

Much has been learned about Covid since the virus emerged in 2019, unleashing a pandemic that the World Health Organization reports has killed more than 7 million people. By the spring of 2020, the term “long Covid” had been coined to describe chronic health problems that can persist post-infection.

More recent studies show that infection by the virus that causes Covid, SARS-CoV-2, can result in heightened health risks months to more than a year later.

For example, researchers following children born to mothers who contracted the virus while pregnant have discovered they may have an increased risk for autism, delayed speech and motor development, or other neurodevelopmental challenges.

Another study found babies exposed to Covid in utero experienced accelerated weight gain in their first year, a possible harbinger of metabolic issues that could later carry an increased risk for cardiovascular disease.

These studies suggest avoiding severe Covid in pregnancy may reduce risk not just during pregnancy but for future generations. That may be another good reason to get vaccinated when pregnant.

“There are other body symptoms apart from the developing fetal brain that also may be impacted,” said Andrea Edlow, an associate professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School who was involved in both studies. “We definitely need more research.”

Epidemiologists point to some specific, emerging challenges.

A U.K. study in the New England Journal of Medicine found people who fully recovered from mild Covid infections experienced a cognitive deficit equal to a three-point drop in IQ. Among the more than 100,000 participants, deficits were greater in people who had persistent symptoms and reached the equivalent of a nine-point IQ drop for individuals admitted to intensive care.

Ziyad Al-Aly, a clinical epidemiologist who has studied longer-term health effects from Covid, did the math. He estimated Covid may have increased the number of adults in the United States with an IQ of less than 70 from 4.7 million to 7.5 million — a jump of 2.8 million adults dealing with “a level of cognitive impairment that requires significant societal support,” he wrote.

“People get Covid-19, some people do fine and bounce back, but there are people who start experiencing problems with memory, cognition, and fuzzy brain,” he said. “Even people with mild symptoms. They might not even be aware.”

Diane Yormark, 67, of Boca Raton, Florida, can relate. She got Covid in 2022 and 2023. The second infection left her with brain fog and fatigue.

MRNA vaccines, once a Trump boast, now face attacks from some in GOP

“I felt like if you had a little bit too much wine the night before and you’re out of it,” said Yormark, a retired copywriter, who said the worst of her symptoms lasted for about three months after the infection. “Some of the fog has lifted. But do I feel like myself? Not like I was.”

Data from more than a dozen studies suggest Covid vaccines can help reduce risk of severe infection as well as longer-lasting health effects, although researchers say more study is needed.

But vaccination rates remain low in the United States, with only about 17% of the adult population reporting that they got the updated 2025-26 shot as of Jan. 16, based on CDC data.

Trump administration officials led by HHS Secretary Robert F. Kennedy Jr. have reduced access to Covid vaccines despite the lack of any new, substantiated evidence of harm. Though the shots were a hallmark achievement of the first Trump administration, which led the effort for their development, Kennedy has said without evidence that they are “the deadliest vaccine ever made.”

In May he said on X that the CDC would stop recommending Covid shots for healthy children and pregnant women, citing a lack of clinical data. The Food and Drug Administration has since issued new guidelines limiting the vaccine to people 65 or older and individuals 6 months or older with at least one risk factor, though many states continue to make them more widely available.

The Trump administration also halted almost $500 million in funding for mRNA-based vaccines. Administration officials and a number of Republicans question the safety of the Nobel Prize-winning technology — heralded for the potential to treat many diseases beyond Covid — even though clinical trials with tens of thousands of volunteers were performed before the Covid mRNA vaccines were made available to the public.

And numerous studies, including new research in 2025, show Covid vaccine benefits include a reduction in the severity of disease, although the protective effects wane over time.

How Covid may affect brain health

Researchers say more and broader support is important because much remains unknown about Covid and its impact on the body.

The growing awareness that, even in mild Covid cases, the possibility exists for longer-term, often undetected organ damage also warrants more examination, researchers say. A study published this month in eBioMedicine found people with neurocognitive issues such as changes in smell or headaches after infection had significant levels of a protein linked to Alzheimer’s in their blood plasma. EBioMedicine is a peer-reviewed, open-access journal published by The Lancet.

In the brain, the virus leads to an immune response that triggers inflammation, can damage brain cells, and can even shrink brain volume, according to research on imaging studies that was published in March 2022 in the journal Nature.

An Australian study of advanced brain images found significant alterations even among people who had already recovered from mild infections — a possible explanation for cognitive deficits that may persist for years. Lead study author Kiran Thapaliya said the research suggests the virus “may leave a silent, lasting effect on brain health.”

Al-Alay agreed.

“We don’t know what will happen to people 10 years down the road,” he said. “Inflammation of the brain is not a good thing. It’s absolutely not a good thing.”

That inflammatory response has also been linked to blood clots, arrhythmias, and higher risk of cardiovascular issues, even following a mild infection.

A University of Southern California study published in October 2024 in the journal Arteriosclerosis, Thrombosis, and Vascular Biology found the risk for a major cardiac event remains elevated nearly three years after Covid infection. The findings held even for people who were not hospitalized.

“We were surprised to see the effects that far out” regardless of individual heart disease history, said James R. Hilser, the study’s lead author and a postdoctoral fellow at the UCLA David Geffen School of Medicine.

Covid can also reactivate cancer cells and trigger a relapse, according to research published in July in the journal Nature. Researchers found that the chance of dying from cancer among cancer survivors was higher among people who’d had Covid, especially in the year after being infected. There was nearly a twofold increase in cancer mortality in those who tested positive compared with those who tested negative.

The potential of the Covid virus to affect future generations is yielding new findings as well. Australian researchers looked at male mice and found that those who had been infected with and then recovered from Covid experienced changes to their sperm that altered their offspring’s behavior, causing them to exhibit more anxiety.

Meanwhile, many people are now living — and struggling — with the virus’ after-effects.

Dee Farrand, 57, of Marana, Arizona, could once run five miles and was excelling at her job in sales. She recovered from a Covid infection in May 2021.

Two months later, her heart began to beat irregularly. Farrand underwent a battery of tests at a hospital. Ultimately, the condition became so severe she had to go on supplemental oxygen for two years.

Her cognitive abilities declined so severely she couldn’t read, because she’d forget the first sentence after reading the second. She also had to leave herself reminders that she is allergic to shrimp or that she likes avocados. She said she lost her job and returned to her previous occupation as a social worker.

“I was the person who is like the Energizer bunny and all of a sudden I’d get so tired getting dressed that I had to go back to bed,” Farrand said.

While she is better, Covid has left a mark. She said she’s not yet able to run the five miles she used to do without any problems.

This story originally published at KFF Health News, Healthbeat’s national reporting partner.

Flu rates remain high in Georgia but show signs of easing after holidays

2026-01-23T18:58:32+00:00

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Flu rates are still high in Georgia this month but appear to be dropping slightly as people resume regular schedules after the winter holidays.

That’s in line with national trends that show a drop in flu positivity rates from prior weeks, according to the latest data from the U.S. Centers for Disease Control and Prevention.

The percentage of flu tests that came back positive at selected labs in the metro Atlanta area dropped from a high of 40% for the week ending Dec. 20 to about 18% for the week ending Jan. 10, according to data from the Georgia Department of Public Health.

The CDC predicts a moderately severe flu season for adults 18-64 and those over age 65. However, it predicts a “high-severity” season for children 17 and under.

Why flu season will likely be worse this year and how to prepare

That doesn’t mean the threat is over. Six people died in Georgia in the week ending Jan. 10, bringing the death toll from the flu since the season started in October to 69. That includes two deaths of children between the ages of 5 and 17. The flu season usually runs through March.

Vaccination remains the best way to protect against the flu, said Dr. M.G. Finn, a professor of biochemistry at Georgia Tech and an expert in viruses and immunology.

Finn said there is a gap between this year’s vaccine and the variant of flu that is circulating widely, in part because scientists design the vaccine well in advance of the flu season. Still, the vaccine reduces the risk of hospitalization by about 40%, he said, making it a valuable tool for protecting health.

“You want to bias the odds in your favor of not getting seriously ill if you happen to come across somebody who has the flu, and you want to minimize the chances of you passing it along to people around you,” Finn said. “It’s completely and utterly safe, so there is no risk whatsoever for taking it.”

Other respiratory viruses also continue to circulate. The positivity rate for RSV at selected clinical laboratories was 10.6% for PCR tests, about the same rate it’s been since late November, according to DPH data

However, the CDC has identified low rates of Covid in wastewater for the week ending Jan. 10, with very low rates of Georgians visiting emergency rooms for Covid and lower rates of Covid-related hospitalizations than at the same time last year.

Meanwhile, Georgia reported its first measles case of the year, on Jan. 12, in a child who was too young to be vaccinated and who had a history of international travel. The case was reported in the Coastal Health District, which covers eight counties around Savannah.

The CDC and the American Academy of Pediatrics recommend that children get the first dose of the measles, mumps, rubella vaccine at ages 12 to 15 months and the second dose between 4 and 6 years of age.

That case was acquired during international travel, according to DPH, meaning it is not likely linked to the large outbreak in neighboring South Carolina.

There have been 700 cases reported since the outbreak in the region around Spartanburg began in October.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

NYC’s new deputy mayor for health went from Covid patient to hospital CEO

2026-01-09T13:47:07+00:00

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The new deputy mayor overseeing the New York City health department and related agencies is a veteran health professional and hospital executive with strong community ties and very much a product of Queens, where she and her family immigrated from Ecuador.

Helen Arteaga Landaverde, 49, comes to the job at Health and Human Services after five years as the CEO of NYC Health + Hospitals/Elmhurst, a 545-bed public hospital in Queens that was at the “epicenter of the epicenter” in the early days of the Covid-19 pandemic, when a refrigerated truck stored bodies, and overwhelmed doctors and nurses rationed ventilators.

Arteaga Landaverde herself was a Covid-19 patient at Elmhurst, treated only a few weeks into the outbreak. Years before, her father had been treated for leukemia at Elmhurst. His death helped shape her worldview.

“You see, here is where my advocacy was born. It is here where my dad died without having … insurance. It was here that I survived Covid,” Arteaga Landaverde said at the Elmhurst news conference on Dec. 30 when Mayor Zohran Mamdani announced her appointment. Her voice catching with emotion, she looked up from the lectern and into the crowd. “And it’s here that I want to say, ‘Madre, tu sacrificio valió la pena.’”

Mom, your sacrifice was worth it.

Here’s a look at who’s advising Zohran Mamdani on health policy

Arteaga Landaverde steps into the new mayor’s administration with challenging responsibilities at a chaotic time for public health. In addition to the Department of Health and Mental Hygiene, she will lead the departments of Social Services, Aging, Veterans’ Services, Youth and Children’s Services, NYC Health + Hospitals, and Office of the Chief Medical Examiner. She succeeds Suzanne Miles-Gustave, who was named to the post in March 2025 following an exodus at City Hall tied to the U.S. Department of Justice asking a court to drop federal corruption charges against then-Mayor Eric Adams.

Federal funding cuts, primarily from President Donald Trump’s One Big Beautiful Bill Act, will have a profound impact on the health and well-being of New Yorkers from all five boroughs. The changes include cuts of $10 trillion over 10 years to Medicaid, the source of health coverage for almost half the city’s population, and the Affordable Care Act.

On Monday, the Trump administration froze $10 billion in funding for child care subsidies, social services, and cash support for low-income families in Democratic-run states, including New York. The suspension of such funding will surely complicate Mamdani’s efforts of realizing his affordability agenda, which consists of introducing free child care.

How Mamdani and Arteaga Landaverde plan to protect the health of New Yorkers is not yet clear. During the campaign and his transition, and since his Jan. 1 inauguration, Mamdani has said little about his health policies. Arteaga Landaverde, too, has offered few details.

How states and cities can defend public health in 2026

“To every New Yorker that trusts us enough to show up, and to those that are suffering in silence wherever you are because they do not know if government will protect them or treat them with dignity, I promise you today that I will work so hard to ensure that you are seen and that we are thinking big and courageous about solutions that will allow you to thrive in the city that we love,” Arteaga Landaverde said at the Elmhurst press conference. “You see, I see you. ’Cause your struggles are mine. I am who I am, because of them.”

Arteaga Landaverde did not respond to multiple requests to be interviewed.

One of her first tasks will be picking a permanent health department commissioner. Dr. Michelle Morse has been serving in an acting capacity since October 2024, her limbo status a source of constant speculation. She applied for the permanent job with the Mamdani administration via an online portal and has conveyed her interest in staying on through allies. (Morse is on the board of directors for NYC Health + Hospitals.)

In a statement Thursday, Morse said she looked forward to Arteaga Landaverde’s leadership. The two had met in 2021 — Morse as the inaugural chief medical officer and deputy health commissioner, Arteaga Landaverde as the Elmhurst CEO — just after officials had announced Covid-19 vaccination mandates for health care workers.

“Dr. Arteaga personally met with every employee who had initially refused vaccination. She heard their concerns at all hours of the day and night, and it was thanks to her leadership that vaccine uptake increased. That story has long stayed with me as an example of her grace, compassion, and deep understanding of public health.”

A father’s lesson: ‘How can I help my neighbor?’

Born in the United States and raised in Ecuador, Arteaga Landaverde returned to Corona, Queens, as a girl with her parents and sisters. With a full scholarship at New York University, she studied chemistry because she saw so many of her neighbors die of AIDS and wanted to find a cure. To that end, she had enrolled in medical school but withdrew following the death of her father.

She later earned a master’s degree in public health from Columbia University and a PhD in community health and health policy from CUNY. Her dissertation explored flu vaccine hesitancy among Hispanic adults in the United States. The loss of her father offered an epiphany of sorts: The quality of health care in Hispanic neighborhoods wasn’t the same as in other neighborhoods, and she felt compelled to change that.

“He used to tell me, ‘My daughter, you can’t change the world, but you can change this block, this house,’” she recounted in a 2022 Spanish-language interview with Fox 5 New York. “That stayed with me. He said, ‘I can’t fix the whole world, but how can I help my neighbor?’”

In 2009, she co-founded Plaza Del Sol Family Health Center in Corona, Queens, a federally qualified health center that brought to the community rare specialty care like mental health services, gynecology, family planning, mammography screening, breast imaging, optometry, and nutrition guidance. Patients found a family center where staff spoke Spanish. Arteaga Landaverde fought hard to secure a mammogram machine.

“This would have happened only because of Helen and her innovation,” Matthew Kusher, a family doctor who is the center’s clinical director, told Healthbeat. “Her ingenuity, her insight was able to force this health center to continue to grow and to thrive and to be as it is today.”

Queens was especially hard hit in the early days of the Covid-19 outbreak, and center records show that the novel virus was circulating in the borough in late 2019, Kusher said. But by March 2020, the facility and others nearby became inundated with patients, many of them belonging to large families living in close quarters and unable to practice social distancing.

That spring, Arteaga Landaverde caught Covid from her son, Kusher said, and sought treatment in the emergency room at Elmhurst, which had become synonymous with the horror of the outbreak: Doctors and nurses were forced to ration ventilators. A refrigerated truck parked outside held bodies of those who had died. In just one 24-hour period, at least 13 patients died of Covid at the hospital.

It took a few months for Arteaga Landaverde to recover and return full time to work, Kusher said. By February 2021, she received a job offer she couldn’t pass up: CEO of Elmhurst. She became the first Latina to lead the hospital’s executive team. Competition was stiff: According to an NBC interview with her in 2024, she had 21 interviews for the job, and there were 300 applicants.

“I was actually surprised when she told me that she became the CEO of Elmhurst, because she doesn’t have that hard-driving vibe, and I think that’s what makes her special,” said Chris Palmedo, a clinical professor at the CUNY Graduate School of Public Health & Health Policy who served as her dissertation adviser.

Elmhurst experience key to Mamdani appointment

Three years later, in May 2023, Elmhurst became the target of a rare strike. Galvanized by tough working conditions during the pandemic, some 165 trainee doctors belonging to the Committee of Interns and Residents-SEIU went on strike to air their grievances of being paid less than their counterparts on the other side of the East River, in Manhattan. It was the first physician strike at a hospital in New York City in more than 30 years.

While the doctors worked at Elmhurst, part of the public Health + Hospitals system, their residency program was run by Mount Sinai’s Icahn School of Medicine in Manhattan. The strikers delivered a letter to Arteaga Landaverde hoping that the CEO would come to the bargaining table and use her influence to help avoid a walkout.

After three days, the strike ended. A tentative agreement included wage increases of 18% over three years, a $2,000 ratification bonus, and an enforceable agreement to negotiate on hazard pay.

Central to her selection as deputy mayor, Mamdani said, was her experience growing up in Queens and running the borough hospital.

“It was the kind of leadership Elmhurst residents came to expect from a daughter of the community – someone who grew up like them, cared about people like them, and understood New Yorkers with less are often treated with less,” Mamdani said as Arteaga Landaverde looked on. “That leadership, driven by empathy and guided by an unshakable belief that every New Yorker deserves a life of dignity, is no less than what the people of this city will expect from their new deputy mayor.”

This story has been updated to reflect that Arteaga Landaverde was the first Latina to lead Elmhurst’s executive team.

Trenton Daniel is a reporter covering public health in New York for Healthbeat. Contact Trenton at tdaniel@healthbeat.org or on the messaging app Signal at trentondaniel.88.

Flu and RSV climb in Georgia as winter virus season starts slowly

2025-12-05T22:06:33+00:00

Public health, explained: Sign up to receive Healthbeat’s free Atlanta newsletter here.

Georgia’s winter respiratory virus season is off to a slow start, with Covid numbers low. But local doctors say they are seeing an uptick in flu and RSV cases, and they expect numbers to rise over the coming months.

There are steps people can take to mitigate the spread of these viruses ahead of the holidays, Dr. Sara Turbow, a doctor at Grady Health and a professor of medicine at Emory University, and Dr. Andrew Thornton of Wellstar said, starting with vaccinations for all three illnesses.

“It’s never too late. Even if you get it five days before Christmas, I would say that that’s better than not getting it at all,” Turbow said. The vaccines are widely available at pharmacies and many doctor’s offices. The vaccines take about two weeks to provide full coverage.

Getting the vaccines is well worth it because the viral respiratory diseases can cause people to feel unwell, have to take time off work or school, and, in some cases, progress to bacterial pneumonia, the doctors said.

“I worry more about the complications that come from these illnesses, and pneumonia is a big one,” Thornton said. “We have already started to see an increase in pneumonia in the last month.”

While many patients can successfully be treated for pneumonia at home, others may require hospitalization, and it could lead to serious complications like sepsis, a systemic infection. He said people should also make sure they are up-to-date on pneumonia vaccines.

Much of the U.S. Centers for Disease Control and Prevention data collection about the three respiratory viruses was put on hold during the government shutdown. Since operations resumed Nov. 13, those surveillance systems have started to publish data again, though there is a lag of a few weeks.

The data mirror what the local doctors are reporting, with increases in RSV and flu rates and relatively low Covid rates.

“Usually, December, January, we start to see a lot of Covid cases, right along with an increase in flu, as well as RSV,” Thornton said. He reported an increase in flu and pneumonia among the patients of all ages that he sees at Wellstar urgent care clinics. Turbow said she’s seeing an increase in RSV among adult patients.

People can take other steps like masking in group settings, including airplanes and airports, and frequently washing their hands to help prevent the spread of these diseases, Turbow and Thornton said.

Turbow said she’s not as strict about masking as she was during the Covid pandemic but always tries to have a mask with her in case she’s in a crowded setting or next to someone who is coughing.

“It’s good to have that mask on hand if you find yourself near someone or sitting next to someone who’s visibly sick,” Turbow said. “You don’t want to be stuck on a multiple-hour flight next to somebody who’s coughing and sneezing.”

Drugs like Paxlovid, taken within five days of contracting of Covid, and Tamiflu, within about 48 hours of contracting flu, can help ward off more serious complications, especially for those at high risk, Thornton said.

“If you do it in the right patient and at the right time frame, it can reduce risk of complications like pneumonia,” Thornton said. Urgent care centers and retail clinics are able to test and treat the diseases, Turbow said, and people should consider going to those if they can’t get in to see their regular doctor instead of an emergency room.

Here’s what the data show:

Covid

Hospitalization rates per 100,000 are lower than last year for October and November in Georgia, with few emergency department visits (under 0.5%) for Covid in the same period.
While Covid rates are likely to grow or are already growing in many Midwestern and Northeastern states, as well as Alabama, the CDC does not predict a change in Covid rates in Georgia.

Flu

Nationally, seasonal activity is on the rise, according to the CDC, with an increase in positive tests over the past week.
That’s mirrored in a rise in positive flu tests in Georgia, according to state Department of Public Health data. More than 18% of flu tests at clinical laboratories tested positive for flu from Nov. 16 to 29, up over just 5.6% the week prior to Nov. 16. The vast majority of the positive flu tests were for Influenza A.

Visits to select outpatient health care facilities for illnesses like influenza have also increased since September, but at 3.4% are lower than in the past four flu seasons beginning in 2021, according to state data.
Flu hospitalization rates have ticked up since mid-November, with the latest data from Nov. 29 showing a rate of 1.2 hospitalizations per 100,000 people, according to data from the CDC’s Flu View. Last year, Georgia’s flu-related hospitalizations started to climb in early December and peaked in late January and early February at a rate of 13.4 per 100,000 people before falling.
In real terms, that means 194 hospitalizations in Georgia since early October, with four deaths. That’s higher than last year, when there were 75 hospitalizations in the same period.

RSV

RSV positivity rates are increasing in Georgia, from 2.8% in early October to 14.4% for the last week in November, according to DPH data. At the same time last year, about one-fifth of all RSV tests were positive.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Idaho’s Medical Freedom Act disarms public health

2025-11-21T20:08:33+00:00

Dr. Jay K. Varma is a special contributor to Healthbeat. Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

While most national attention has focused on the dismantling of public health infrastructure at the federal level, a new law in Idaho may be one of the most consequential.

On the surface, the Idaho Medical Freedom Act affirms an individual’s right to bodily autonomy. In practice, its broad language threatens the state’s ability to prevent illness and death from infectious diseases, and, if replicated elsewhere, it could unravel decades of progress in public health.

U.S. Constitution delegates public health to state ‘police powers’

Under the Constitution’s Tenth Amendment, states are primarily responsible for public health through their “police powers.” The federal government is only permitted to intervene in public health when an issue involves interstate commerce or international borders.

The power of states to protect health is vast, including the ability to restrict an individual’s freedom and mandate they receive a medical intervention. In 1905, the Supreme Court’s Jacobson v. Massachusetts decision confirmed that states may compel people to get vaccinated to protect the community from a dangerous infectious disease (in this case, smallpox). The court ruled that individual liberty does not include the right to expose others to harm. Or, as is often said in public health discussion, the right to swing your fist ends where the other person’s nose begins.

The Jacobsen decision supports many accepted public health practices that limit one person’s individual freedom in order to protect another person’s safety: requiring vaccination for school attendance, isolating ill people with tuberculosis, quarantining exposed persons during measles or Ebola outbreaks, and mandating masks or other protective equipment for health care workers.

What the Idaho Medical Freedom Act does

The Idaho Medical Freedom Act prohibits any government or private entity from requiring a “medical intervention,” defined broadly as any procedure, drug, device, or action used to diagnose, prevent, or treat disease. While drafted in response to Covid-era rules, its reach extends far beyond Covid vaccines.

The statute bars health departments, employers, and schools from requiring medical interventions unless explicitly mandated by federal law. This includes treatments, testing, vaccination, and any preventive practices that alter “biological function.” In doing so, the law removes public health authority at the state and local level to enforce measures that have long been essential for disease control and occupational safety.

A narrow exemption in the law does permit employers to require personal protective equipment if consistent with “traditional and accepted industry standards.” Yet the law excludes vaccines, masks, or any “medical interventions introduced during the Covid-19 pandemic.” This language leaves unclear whether respiratory protection like N95 respirators counts as traditional PPE or as prohibited “Covid-era” requirements.

The statute also forbids excluding any “healthy” person during a disease outbreak because of vaccination status. This provision directly contradicts standard outbreak management practices, which rely on temporarily excluding people who have been exposed to a disease if they are not immune to that disease.

Public health and legal risks of the Idaho Medical Freedom Act

Tuberculosis control. Isolation and treatment orders for active tuberculosis could be contested as compelled medical interventions. Preventive therapy for exposed contacts might be viewed as coercive. Hospitals could hesitate to require N95 masks for infectious patients and health care providers, as well as restrict patients to negative-pressure isolation rooms, potentially causing TB outbreaks in health care facilities.

Health care infection control. Facilities may face lawsuits for requiring flu vaccines, N95 masks, or testing among staff. The “traditional PPE” clause is vague, leaving health care administrators uncertain whether basic protective standards remain enforceable. Federal Occupational Health and Safety Administration rules might override the law, but only after litigation.

Outbreak management. Health departments could lose authority to exclude unvaccinated or exposed individuals during outbreaks of vaccine-preventable infections, such as measles and meningococcal disease. As a result, people who are incubating an infectious disease will be permitted to develop and potentially spread that disease.

Occupational safety. Laboratories and emergency services may be unable to require hepatitis B vaccination, gloves, or N95 masks unless explicitly mandated by federal law. This creates conflicts with federal occupational health standards and uncertainty for employers seeking to protect workers.

Conflicts between federal and state authority to protect health

The Idaho law could result in legal challenges on multiple fronts. Prohibiting isolation or exclusion of contagious individuals could violate others’ rights to health and safety under substantive due process. The Tenth Amendment allows states to regulate health but not to obstruct federal laws for infectious disease control. Federal supremacy gives OSHA, the Centers for Medicaid and Medicare Services, and the Centers for Disease Control and Prevention authority to enforce workplace and health care safety rules that pre-empt conflicting state statutes. At the same time, it’s unclear if the current federal administration would pursue these cases, given its negative views of public health interventions.

Until courts resolve these conflicts, Idaho’s hospitals, clinics, schools, and employers will operate in legal uncertainty. Some will comply with federal rules and risk violating state law, while others will comply with state law and risk outbreaks.

Idaho is choosing to disarm its police powers for health

By stripping itself of the authority to require basic infection control, Idaho has weakened both its own government and its private institutions. The Medical Freedom Act’s sweeping ban on medical interventions, ambiguous exemptions for PPE, and prohibition on excluding unvaccinated individuals during outbreaks dismantle standard infectious disease control practices.

Public health law balances liberty with the collective right to safety, i.e., the freedom to do something versus the freedom from something. What Idaho calls freedom leaves its citizens less free from infection and less protected from harm. The state has used its police power not to defend public health but to take that power away.

Dr. Jay K. Varma is a physician and epidemiologist. An expert in the prevention and control of infectious diseases, he has led epidemic responses, developed global and national policies, and implemented large-scale programs that saved hundreds of thousands of lives in Asia, Africa, and the United States.

A flu surge, NYC overdose decline, and a shift in emergency mental health services

2025-11-21T17:00:00+00:00

This article originally appeared at Your Local Epidemiologist New York. Sign up for the YLE NY newsletter here. Public health, explained: Sign up to receive Healthbeat’s free New York City newsletter here.

There’s a lot to cover before the holiday next week, so let’s jump right in.

Infectious disease ‘weather report’

Flu: Flu is increasing quickly. The most recent data show that cases and hospitalizations in the state have increased by 78% and 53%, respectively. In New York City, emergency department visits for the flu rose by 104%.

Cases of respiratory viruses in New York.

Earlier this week, YLE National reported on a new flu virus mutation that could potentially lead to a bad flu year in the United States. We don’t know exactly how things will play out, but the bottom line is that flu vaccination remains our best protection.

RSV: Also increasing across the state and in New York City, mostly in kids under 4. Statewide, hospitalizations increased by 70%, while emergency department visits in New York City went up by 40%.

Covid-19: Cases and hospitalizations are decreasing in both New York City and across the state.

As we head into Thanksgiving, when many of us will be traveling to see loved ones, flu and RSV are top of mind. To reduce the spread of illness, consider masking in indoor crowded spaces — I’ll be wearing mine on the train and in the airport — and reducing contact with others if ill.

Good news: Overdose deaths are declining in NYC — but progress is uneven

For the first time in years, New York City saw a significant drop in overdose deaths — a 28% decrease last year from 2023 — but that still totals 2,192 deaths: far too high.

Last year, 78% of overdose deaths in New York City involved an opioid, a reduction from 83% in 2023. Fentanyl remains the leading driver, involved in 73% of deaths, but that’s also down from 80% in 2023.

One success story is Staten Island, which saw the steepest drop in overdose deaths. A possible reason: the implementation of a hot-spotting strategy. Officials analyzed emergency medical services and hospital data to identify where overdoses were happening most. Then they deployed peer counselors to those areas with the life-saving opioid overdose-reversing medication naloxone (also known as Narcan), support services, and treatment referrals.

Over the summer, a hot-spotting program based off Staten Island’s was launched in the Bronx, as well. This is greatly needed as the Bronx still has the highest overdose death rate compared to other boroughs. I’ll be keeping an eye on the program’s progress and any outcomes reported.

Despite the encouraging drop, overdose is still a leading cause of premature death in New York City. And huge inequities still exist. Overdose deaths in Black and Latino New Yorkers remain about twice as high as the rate among white New Yorkers.

There are still actions we can take to continue to reduce the risk of overdose death among our fellow New Yorkers:

Carry naloxone (Narcan)

All New Yorkers can receive free naloxone and training from registered Opioid Overdose Prevention Programs on how to recognize the signs of an overdose and administer the medication.
Health Department vending machines: Locations can be found on this page.
Over-the-counter naloxone at pharmacies: Available without a prescription at most major chains (map here).
- Most insurance providers will cover all or part of the cost of naloxone, and New York state will cover copayments of up to $40.

There is also a hotline for individuals seeking support or treatment for substance use for themselves or their loved ones. Call or text 988, or visit the 988 website for 24/7, confidential support.

Changes to the B‑HEARD program

Last week, Mayor Eric Adams announced a shift to B-HEARD — the Behavioral Health Emergency Assistance Response Division, a pilot program launched in 2021 to respond to 911 mental health emergency calls with trained medical and mental health teams. Under the new model, teams will move from two emergency medical technicians and a social worker to one nurse, a social worker, and an ambulance driver — all employed by NYC Health + Hospitals.

These teams are dispatched in cases of nonviolent but urgent behavioral health crises: suicidal ideation, substance misuse, acute mental health episodes, and similar situations.

In the triage process, 911 operators route mental health‑related calls based on criteria around safety and risk. If a situation is assessed as nonviolent and primarily behavioral health driven, it may be routed to B‑HEARD instead of the traditional law enforcement/emergency medical services response. The program operates in Northern Manhattan, the Bronx, Central and South Brooklyn, and Western Queens, from 9 a.m. to 1 a.m.

Let’s give it a closer look.

Why does this program exist?

Historically, almost all mental health 911 calls in New York City were routed to the New York City Police Department, sometimes alongside basic EMS responders. Some experts argue that this approach often lacks the de‑escalation skillset, therapeutic lens, and follow‑up needed for mental health emergencies.

There is evidence that when police are first responders in a mental health crisis, outcomes can be worse: Individuals in crisis may feel criminalized, unsafe, reluctant to seek help, and in worst cases may face use of force. For example, in the United States, people with untreated serious mental illness are estimated to be up to 16 times more likely to be killed by law enforcement during an encounter.

By deploying mental or behavioral-centered teams, B‑HEARD tries to reduce unnecessary police involvement, deliver more appropriate care at the scene, and connect people to community‑based follow‑up.

Has B‑HEARD been effective so far?

A city comptroller audit earlier this year found the program is promising in concept but hard to evaluate due to limited data and implementation gaps.

Key findings:

Between fiscal years 2022 and 2024, B-HEARD covered 96,291 mental health-related 911 calls during operating hours.
Only about 25% (just over 24,000 calls) resulted in a B-HEARD response.
Around 60% were deemed ineligible (some due to safety concerns, others because no EMS operators were available to screen).
Even among eligible calls, 35% never received a response for unknown reasons.
Critical process steps (assessments, follow-up referrals) were often incomplete or not documented.

On the positive side, among clients surveyed, the results were strong:

99 % said they were treated with respect.
96 % said the team helped them.

In short, the idea is promising, but the current program lacks data to properly evaluate its effectiveness at meeting its goals.

Why the change?

New York faces a shortage of EMTs and paramedics and has long ambulance response times. By freeing up EMS workers for broader medical emergencies, the city hopes to improve ambulance response times across the city.

New York City average end-to-end response times for ambulances for life-threatening emergencies was 12 minutes and 53 seconds during the week of Oct. 20 (the latest week available).

Importantly, during a behavioral health crisis, if additional medical backup is needed (e.g., someone becomes medically unstable), the driver/nurse team can summon an ambulance. The nurse offers stronger clinical capacity on‑scene than EMTs alone, potentially improving care and triage.

Looking ahead and my thoughts

With longer ambulance wait times, it’s a logical step to free up EMTs to shorten response times. And if there are enough nurses at NYC Health + Hospitals to redirect some to B-HEARD teams without disrupting hospital operations, having advanced medical support on the response teams could be beneficial. But the bigger question remains how effective this program has been at responding to mental health issues, while maintaining safety for those experiencing mental health crises and for first responders.

The other question at hand is the timing of this change. Adams has one more month on the job before Mayor‑elect Zohran Mamdani takes the helm on Jan. 1. Mamdani has signaled plans to expand B‑HEARD city‑wide beyond the pilot, and fold it into a new Department of Community Safety. Will these changes hold in Mamdani’s new administration? If not, will shoring up EMTs in New York City for one month make any real difference in ambulance wait times? Will the program go through another overhaul, potentially further limiting our ability to assess its effectiveness? These are the things I’ll be looking out for over the coming months, and I will report back with any updates.

Bottom line

As we head into the holiday, I’m feeling especially grateful for New York’s public health champions — the heroes and systems working behind the scenes to keep us safe. The encouraging decline in opioid deaths, expanded mental health outreach, and strong infectious disease surveillance systems are testaments to that.

To everyone working toward a healthier state: Thank you for all you do. Your work makes New York better, every single day.

I’m wishing everyone a restful Thanksgiving — indulge in that pie, wear those stretchy pants, and I’ll see you after our break next week!

Love,

Your NY Epi

Dr. Marisa Donnelly, PhD, is an epidemiologist, science communicator, and public health advocate. She specializes in infectious diseases, outbreak response, and emerging health threats. She has led multiple outbreak investigations at the California Department of Public Health and served as an Epidemic Intelligence Service Officer at the Centers for Disease Control and Prevention. Donnelly is also an epidemiologist at Biobot Analytics, where she works at the forefront of wastewater-based disease surveillance.

Is Covid during pregnancy linked to autism? What a new study shows, and what it doesn’t

2025-11-05T15:42:36+00:00

Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

A large study from Massachusetts has found that babies whose mothers had Covid-19 while pregnant were slightly more likely to have a range of neurodevelopmental diagnoses by age 3. Most of these children had speech or motor delays, and the link was strongest in boys and when the mother was infected late in pregnancy.

The increase in risk was small for any one child, but because millions of women were pregnant during the pandemic, even a small increase matters. The study doesn’t prove that Covid infection during pregnancy causes autism or other brain conditions in the fetus, but it suggests that infections and inflammation during pregnancy can affect how a baby’s brain grows, something scientists have seen before with other illnesses. It’s a reason to help pregnant women avoid Covid and to keep a close eye on children who were exposed in the womb.

What the study found

Researchers at Massachusetts General Hospital examined medical records from more than 18,000 mothers and their children born from March 2020 through May 2021, before vaccines were widely available to pregnant women. Because everyone giving birth during that period was tested for Covid, the team could clearly see which pregnancies were exposed to the virus causing it.

About 5% of those mothers had Covid while pregnant. Their children were modestly more likely to be diagnosed with a neurodevelopmental condition by age 3 than those whose mothers weren’t infected, even after accounting for differences in maternal age, race, insurance status, and preterm birth.

The link appeared strongest among boys and when infection occurred in their mother’s third trimester. Still, most children in both groups showed typical development.

‘Sick to my stomach’: Trump distorts facts on autism, Tylenol, and vaccines, scientists say

“This was a very clean group to follow,” said Andrea Edlow, a maternal-fetal medicine specialist at Mass General and one of the study’s authors. “Because of universal testing early in the pandemic, we knew who had Covid and who didn’t.”

Independent authorities say Covid, which causes a powerful immune response in some people, fits the biological pattern seen with other infections in pregnancy. Alan Brown, a professor of psychiatry and epidemiology at Columbia University who studies maternal infection and brain development and was not involved in this research, explained, “Covid would be a very strong candidate for it to happen because the amount of inflammation is very extreme.”

How might infection affect brain development?

Scientists are still piecing together how various infections during pregnancy can affect fetal development. Severe illness can cause inflammation that disrupts brain growth or can trigger preterm birth, which carries its own risks.

“There’s a long history of evidence showing that maternal infection can slightly raise the risk for many neurodevelopmental disorders,” said Roy Perlis, vice chair for research in psychiatry at Massachusetts General Hospital and co-author of the new study.

Edlow’s lab is investigating how infection and inflammation may interfere with brain development. In a healthy brain, immune cells help shape developing neural circuits by trimming away extra or unnecessary connections, a process known as “synaptic pruning,” which sculpts the brain’s wiring. When a mother’s immune system is activated by infection, inflammatory molecules can reach the fetal brain and alter the pruning process.

Animal studies support Edlow’s hypothesis. When scientists trigger inflammation in pregnant mice, their offspring often show changes in how brain cells grow and connect, changes that can alter learning and behavior.

Why late pregnancy and why boys?

In Edlow and Perlis’ study, the link between Covid and developmental delays was strongest when infection occurred late in pregnancy, during the third trimester. That’s also when the fetal brain is growing most rapidly, forming and refining millions of neural connections.

“When we think of organ development, we think earlier in pregnancy, but the brain is an exception in this regard, where there’s a massive amount of brain development in the third trimester. And that continues after birth,” Perlis said. “It is entirely plausible that the third trimester is a period of vulnerability specifically for brain development.”

At least 3 babies have died of congenital syphilis in NY this year amid rise in cases

But not all researchers agree that the third trimester is uniquely vulnerable. Brian Lee, a professor of epidemiology at Drexel University, cautioned that because most mothers in the study were tested at delivery, there were simply more late-pregnancy infections to analyze. “That gives the study more power to find a difference in the third trimester,” he said. “It doesn’t prove earlier infections aren’t important.”

The study also found stronger effects in boys. That pattern is familiar: Boys are generally more likely than girls to have speech or motor delays and to be diagnosed with autism. Researchers suspect that male fetuses may be more susceptible to stress and inflammation, though the biology isn’t fully understood.

What the study can and can’t show

Edlow and Perlis are careful to say the study shows an association, not proof that Covid infection in pregnancy causes developmental problems. Many other factors could explain the correlation.

Mothers who get sick with Covid may have other health issues, such as obesity, diabetes, or mental health conditions, that increase the risk of developmental delays in children. “Persons with mental disorders are much more likely to get Covid. Women with mental disorders are much more likely to have kids with neurodevelopmental problems,” Lee said. “Mothers with worse physical health are also at higher risk of having children with neurodevelopmental problems.”

Lee’s research has shown that even infections before or after pregnancy can be linked to autism, suggesting that shared genetics or environment, rather than the infection itself, could be at play. That’s why experts say much larger, longer studies are needed to understand the extent of any risk from the infection.

Edlow, Perlis, and their team plan to follow the children in their study as they grow older to see whether early differences persist or fade. They’re also studying how inflammation during pregnancy affects the placenta and fetal brain, and how to counteract these effects.

What about vaccination?

Because this study followed pregnancies from early in the pandemic, it doesn’t answer whether vaccination changes the risk. But other research offers reassurance.

A large national study in Scotland found no difference in early developmental outcomes between children whose mothers were vaccinated and those who weren’t. Another study in the United States found the same: no link between prenatal Covid vaccination and developmental delays through 18 months. Both align with decades of data showing that vaccination during pregnancy is safe for both the mother and the baby.

“Vaccination is a short spike … your immune system revs up, then it goes back to normal,” Edlow said. “Covid [infection] is much more prolonged, unpredictable, and people can get … a dysregulated immune phenomenon that really doesn’t exist in vaccine responses.”

What this means for parents and clinicians

Since late 2020, there’s been widespread confusion and misinformation about the safety of Covid vaccination during pregnancy. Some women have hesitated to get vaccinated out of fear it might harm their baby. But the evidence since then has been clear: Covid vaccines are safe in pregnancy. The American College of Obstetricians and Gynecologists strongly recommends Covid vaccination to protect both mother and child.

Experts say the broader lesson is that pregnancy is a period of vulnerability, and prevention matters, not only for Covid, but other infections as well.

Janet Currie, a professor of economics at Yale University, said these risks remain “underappreciated,” despite decades of evidence. “Even though the flu vaccine is recommended for pregnant women, very few pregnant women get it,” she said. “Physicians seem to be reluctant to vaccinate pregnant women.”

As Gil Mor, scientific director of the C.S. Mott Center for Human Growth and Development at Wayne State University in Detroit, put it, “Protecting the mother is protecting the long-term health of the offspring. … The best intervention is vaccination.”

A century-old echo

The idea that what happens in the womb can shape life after birth took root with studies of famine, like the Dutch “Hunger Winter” in the final months of World War II. In 1944 and 1945, as German forces blockaded the western Netherlands, rations fell to just a few hundred calories a day. Thousands died of starvation, and women pregnant during that period gave birth to babies who later faced higher risks of heart disease, diabetes, and schizophrenia. The episode became a cornerstone of the “fetal origins” idea, that deprivation or stress in pregnancy can have lifelong effects.

The 1918 flu pandemic broadened that idea to infection. Babies exposed to influenza in utero later showed small but lasting differences in education and earnings, a sign that illness during pregnancy could affect brain development.

Researchers in Taiwan, Sweden, Switzerland, Brazil, and Japan found similar consequences. Some argued that those findings reflected the disruptions of World War I, not the flu itself. But later studies, including those from the United Kingdom and Finland, have strengthened the case for a biological effect, reinforcing that the infection itself, not wartime upheaval, was the key driver.

“It isn’t simply influenza that can alter fetal neurodevelopment,” Kristina Adams Waldorf, a professor of obstetrics and gynecology at the University of Washington, explained. “Many types of infections … in the mother can be transmitted as a signal to the fetus, which can alter its brain development.”

A century later, the same question has returned with Covid: Could infection during pregnancy subtly shape how children grow and learn? The new Massachusetts General Hospital study offers an early look at an answer.

This story was originally published at KFF Health News, Healthbeat’s national reporting partner.

Watch Healthbeat’s Alison Young on media’s role in investigating origin of Covid-19 pandemic

2025-10-29T20:54:55+00:00

Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

Healthbeat Senior National Reporter Alison Young moderated a discussion this week on the media’s role in investigating the origin of the Covid-19 pandemic: Was it caused by an accident at a lab in Wuhan, China? Or an infected animal at a Wuhan market or in the wild?

The discussion, hosted by the Brookings Institution in Washington, D.C., focused on the media’s role in exploring those two theories – and why they appeared to receive unequal coverage.

The question of the pandemic’s origin has been the subject of controversy and debate.

Government authorities in China have refused to provide international investigators from the World Health Organization with key data that would help solve the origin question. Information being withheld includes hundreds of viral sequences from people sickened earliest in the pandemic, details about animals sold in Wuhan markets, and details about research and biosafety conditions in Wuhan.

“As things stand, all hypotheses must remain on the table, including zoonotic spillover and lab leak,” the WHO’s director general, Tedros Adhanom Ghebreyesus, said in June, when the organization released its latest report on the pandemic’s origin.

Over the years prominent scientists have published research that they have said provides an “extraordinarily clear picture that the pandemic started at the Huanan market” in Wuhan, and that their work “lays to rest the idea that the virus escaped from a laboratory.”

Meanwhile, intelligence agencies remain divided in their assessments of how the pandemic began. The Central Intelligence Agency, the U.S. Department of Energy, and the Federal Bureau of Investigation lean toward a lab-related event being the most likely cause. Other intelligence agencies lean toward a natural origin. All had “low confidence” in their assessments except for the FBI, which had “medium confidence.”

Young is a longtime public health reporter and is author of the 2023 book “Pandora’s Gamble: Lab Leaks, Pandemics, and a World at Risk.”

As part of Brookings’ work on biosafety and pandemic prevention, Young moderated a “fireside chat” with Vanity Fair journalist Katherine Eban, who broke stories on the pandemic’s origin.

Watch the video here.

How the debate over health insurance subsidies affects New Yorkers

2025-10-10T14:27:01+00:00

From debates on health insurance subsidies and innovations in patient care during outbreaks, to rising concerns of mosquito-borne diseases, a lot is unfolding in public health. Let’s unpack what it means for New Yorkers.

Infectious disease ‘weather report’

Covid: All New York wastewater data are delayed. The Centers for Disease Control and Prevention dashboard isn’t updating during the federal government shutdown, the state dashboard paused reporting due to a lab transition, and New York City’s data download hasn’t been refreshed since July. In short, our early warning system is offline.

Right now, hospitalizations, our best proxy, are trending down, which is good news. Hospitalizations lag community spread, so we are likely well on our way down the summer wave.

New York state Covid-19 hospitalizations.

Flu: Flu reports haven’t kicked off yet, and with wastewater data paused, we’re relying on last week’s low activity. So far, no sign of an early start.

RSV: This is the one to watch. RSV season usually starts around now, but delayed CDC data means we don’t have as many signals to rely on. New York state will start publishing its weekly respiratory report soon (they always start in October), so that will give us insight. I expect cases to rise soon.

Now is still a great time to get your fall vaccines.

New York health insurance on the line

What the heck is going on?

During the height of the pandemic, Congress passed temporary health insurance subsidies through the 2021 American Rescue Plan and extended them in the Inflation Reduction Act of 2022. These subsidies expanded eligibility for the Affordable Care Act plans and increased financial assistance for people with lower incomes. The goal was to make health insurance more accessible.

Now, Congress is debating whether to let those subsidies expire at the end of this year, or renew them. This decision has become a sticking point in federal budget negotiations and the subsequent federal shutdown.

How will this affect New Yorkers?

About 140,000 New Yorkers across the state currently benefit from these enhanced ACA subsidies. If they expire, those New Yorkers would pay an average of $114 per month for coverage.

Because these subsidies help lower income families afford insurance, any increase in cost could be a serious financial burden. This would likely result in more people delaying or dropping coverage altogether.

When fewer people have health insurance, health problems are more likely to go untreated until they become emergencies. This is more expensive for everyone in the long run — treatment costs more for individuals, hospitals, and the health system.

Why would we ever reduce health insurance subsidies?

Simply put, to cut costs. The Congressional Budget Office estimates that extending ACA subsidies would increase the federal deficit by $350 billion over the next decade. But, they would also keep coverage for about 3.8 million Americans who might otherwise lose it.

It’s a tradeoff: shorter-term budget savings versus long-term health.

My take

It would be a mistake to let these subsidies expire. While it may look like big budget savings on paper, the reality is that it will shift costs elsewhere, including to local hospitals, state budgets, and families already under financial burden.

When coverage becomes more expensive, many make tough decisions: delaying treatment, skipping preventative care, or forgoing insurance entirely. This can push illnesses to later, costlier stages — more late-stage cancers, unmanaged chronic conditions, and more infectious disease spreading in communities.

This isn’t just numbers. It hits real families who are already juggling to pay rent, buy food, and pay medical bills. I don’t see anything about this that leads to a healthier New York.

Reimagining patient care and safety during outbreaks

Recently, I visited a demonstration at NYC Health + Hospitals/South Brooklyn that reimagines how we protect both patients and providers during infectious disease outbreaks. At the center of it: a clear plastic containment chamber fully equipped with a hospital bed and monitors inside. Inside, a patient can receive care from clinicians who work through glove ports — similar to a neonatal incubator — without the need for full personal protective equipment.

The containment chamber is being piloted by doctors at NYC Health + Hospitals to determine if it’s feasible and worth investing in. In the image above, clinicians are running a simulation as if a patient potentially has MERS-CoV, a high-risk respiratory virus.

This setup has two big benefits:

First, it dramatically reduces exposure risk for health care workers by fully enclosing the patient and their respiratory droplets.
Second, it allows patients to see and be seen by loved ones — a stark contrast to the isolation we witnessed during the height of Covid, when loved ones couldn’t enter hospitals or patients’ rooms.

During the exercise, doctors and nurses performed routine care and even practiced an intubation through the chamber’s walls. They showed that, with training, complex procedures could still be done safely and efficiently.

It’s early days for this technology, and it won’t replace all infection control measures. But innovations like this are part of a growing toolkit that prepares us for future respiratory outbreaks, while maintaining human connection.

A big thank you to Dr. Syra Madad and the incredible team at NYC Health + Hospitals for their work, and for including me in this simulation.

Question grab bag

Will outbreaks of dengue, chikungunya, or malaria become more common in the United States?

Short answer: Probably yes, but only sporadically.

This goes back to the long history the United States has with mosquito-borne diseases. In the early 1900s, malaria was widespread across the country. It was such a huge problem that the CDC was founded in 1946 specifically to control it.

Dengue and yellow fever (spread by a different mosquito species), also caused outbreaks in the United States, mostly in the South. Through large-scale vector (i.e. mosquito) control programs — like draining wetlands, improving housing, and widespread insecticide use (including DDT, which was widely used at the time but is now banned in most countries because of environmental damage) — malaria, dengue, and yellow fever were all eliminated as a locally transmitted disease by the early 1950s.

Fast-forward to today. The mosquitoes that transmit malaria (Anopheles species) and dengue and yellow fever (Aedes aegypti) still live here, but the pathogens themselves rarely enter local populations. Occasional local cases, like the malaria in Florida, Texas, and Arkansas in 2023, remind us that vector control programs work well, but aren’t perfect.

For chikungunya, the primary vector (Aedes albopictus) arrived in the United States in the 1980s, through used tires imported from Asia. They’ve since spread widely across the Southeast and parts of the East Coast.

Aedes albopictus mosquitoes are the primary vector of chikungunya virus.

These mosquitoes are resilient. The mosquitoes that transmit dengue, yellow fever, and more recently Zika can breed in tiny amounts of standing water — think bottle caps, potted plants, or gutters — and thrive in warm, humid, urban environments. Vector control programs have slowed their spread but can’t eliminate them entirely.

For any outbreak to occur, four things need to align:

The right mosquitoes must be present.
The virus or parasite must be introduced (often by travelers).
The climate must support mosquito survival and pathogen replication (the right temperature, humidity, and availability of standing water).
People and mosquitoes must come into contact.

While vector control efforts are still in place to keep these pests at bay, climate change and international travel will make these conditions easier to occur in more places in the United States. This means that we’ll likely see more localized outbreaks of dengue, chikungunya, or malaria, especially in warmer states like Florida, Texas, and Arizona. But widespread, sustained transmission remains unlikely thanks to strong vector control and public health systems.

That said, we need to stay vigilant. The key is to continue investing in mosquito control and community prevention, like removing or treating standing water, mosquito surveillance and testing, and using repellents.

What else to know

Onondaga County is offering free naloxone (Narcan) training courses in person or over Zoom. Schedule it here.

Oneida County is giving a limited number of free car seats to eligible families on Oct. 21. Call 315-798-5461 or email carseatsafety@oneidacountyny.gov if you need a new car seat to see if you qualify.

The New York Citizen Preparedness Training Program in Erie County is providing tools and resources to prepare for disasters, respond accordingly, and recover quickly. They have multiple workshops scheduled for October.

You’re all caught on this week’s New York public health news. I’ll see you next week!

Love,

Your NY Epi

Georgians can now get updated Covid shots at pharmacies without a prescription

2025-10-07T21:11:18+00:00

Public health, explained: Sign up to receive Healthbeat’s free Atlanta newsletter here.

Georgians should now be able to get the updated Covid vaccines at pharmacies without a prescription after the Centers for Disease Control and Prevention approved the latest federal guidelines.

The same goes for access at county health departments, the state Department of Public Health said in a Tuesday press release.

In line with federal guidance announced Monday, “health department nurses or other providers will counsel patients on the risk-benefit of the vaccine based not only on age but other health conditions or considerations an individual may have,” DPH said.

Disruptions to the usual process for recommending who should receive the vaccines caused weeks of confusion over the availability of the shots, which started arriving in pharmacies in late August.

The Advisory Committee on Immunization Practices didn’t meet until September to vote on who should receive the shots, so many pharmacies were requiring a prescription.

Georgia law is tied to the ACIP recommendation. The panel decided to allow people to decide for themselves whether to get the shot, in consultation with a health care provider or pharmacist. Now that the ACIP recommendation has been approved by the CDC, people can get the vaccine without a prescription, and most insurance plans will cover it at no cost to patients.

“We are able to give the vaccine now without a prescription. We just have to have a convo with the patient and review the screening form,” said Dr. Johnathan Hamrick, an Atlanta pharmacist who serves on the board of directors of the Georgia Pharmacy Association. “This is no different than how our pharmacies approach any vaccine.”

Some county health departments have started offering the shots, according to a DPH press release, and the departments are ordering a supply under federal programs to distribute for free or low cost to low-income children and adults.

The cost for uninsured adults will vary depending on the situation and location, DPH spokesperson Eric Jens said.

People who want to get the vaccine at their local health department should call in advance to ensure the shots are in stock, the press release said.

National pharmacy chains like CVS and Walgreens confirmed they are offering the shot without a prescription in Georgia.

Dr. Ashley Chinchilla, a professor at the University of Georgia College of Pharmacy, hailed the move.

“I’m glad patients will once again have access to Covid-19 vaccines without a prescription,” she said. The ACIP recommendation is “not quite the same as a universal recommendation,” Chinchilla said, but adults can still get the shot at pharmacies as in past years.

Ninety percent of American adults got their Covid shots in pharmacies during last year’s respiratory season, according to CDC data.

For people without insurance, the shots cost around $225 at CVS. A Walgreens spokesperson didn’t have information on its price.

The latest federal guidance does not specifically address Covid vaccines for children. However, the American Academy of Pediatrics issued recommendations in August that said those age 6 months to 23 months are at high risk of severe Covid and should get the updated vaccine.

Children 2 years old to age 18 who do not have risk factors for severe Covid should also get the shot if their parents want them to, the recommendations say. The AAP recommends that pediatric patients with risk factors like being immunocompromised, living with people who are at high risk or in congregate settings, and not having had the vaccination before get the vaccine.

Dr. Joanna Dolgoff, an Atlanta pediatrician, said she is following those recommendations for her patients.

Georgia’s Covid rate is low based on data from wastewater samples, and emergency department visits for Covid are declining from the summer, according to CDC data. But cases are expected to rise again around the holidays, state epidemiologist Dr. Cherie Drenzek said at a September DPH board meeting.

It’s important to get vaccinated ahead of time, physicians emphasized.

“As we head into fall and winter, during these months in particular, people spend more time indoors, and those respiratory viruses like flu and RSV and Covid spread much more easily because of the close contact,” Dr. Jennifer Brull, president of the American Academy of Family Physicians, said during a fall media briefing.

“Vaccines help protect not only ourselves but those who are around us, the people we love, older adults, young children, pregnant people, and those who have chronic health conditions.”

Tell us about your experiences in trying to get the new Covid vaccine. Write to Atlanta public health reporter Rebecca Grapevine at rgrapevine@healthbeat.org with your story and questions.

Cold and flu season is coming. Flu shots are widely available.

2025-09-26T16:15:43+00:00

Public health, explained: Sign up to receive Healthbeat’s free Atlanta newsletter here.

As Georgia heads into the fall respiratory virus season, public health officials say now is the time to get a flu shot.

“People forget how many people die every year in the U.S. and in Georgia of influenza,” Georgia Department of Public Health Commissioner Dr. Kathleen Toomey said during the Board of Health’s September meeting.

There have been 168 deaths, including five children, and over 5,000 hospitalizations from flu in Georgia since last October, according to DPH data. The number of deaths this year is much higher than the past two years – 61 deaths last year and 53 the year before.

Measles spreads from Georgia State student to three others

Last year’s flu season was particularly severe, with the 280 pediatric flu-associated deaths nationwide, a record high, according to the Centers for Disease Control and Prevention.

Wastewater surveillance data show very low rates of Influenza A and respiratory syncytial virus rates along with moderate rates of Covid in Georgia for the week of Sept. 7-13. Flu cases typically start to increase in the fall and peak between December and February.

State epidemiologist Dr. Cherie Drenzek, speaking at the meeting, urged people to get the flu shot in September or October.

Flu shots are widely available as usual at pharmacies and public health departments. So, too, are RSV vaccines, which are recommended by the CDC for everyone 75 and older and adults ages 50 to 74 who are at increased risk of a severe case.

DeKalb Public Health is hosting a drive-through event for flu shots Saturday at the Lou Walker Senior Center, 2538 Panola Rd. in Lithonia, from 9 a.m. until 1 p.m. Three types of flu shots will be available, along with FluMist, a nasal vaccine spray for children ages 6 to 18.

People with insurance can get the shots for no cost. For low-income people without insurance, there are programs to provide the shots at low or no cost, spokesperson Eric Nickens said. For others, the shots range $50-$94 out of pocket, depending on the shot, he said.

Covid declining after summer bump

Georgia’s summer uptick in Covid cases appears to be on the decline, according to the latest wastewater surveillance, after rising since July.

“What we see is this late summer little bump in Covid activity, and then we see another one that usually occurs after the holidays,” Drenzek said.

For the last week in August and the first two weeks in September, the Covid hospitalization rate ranged between 3 and 3.6 per 100,000, around the same rate as last February and March, according to CDC data. The hospitalization rate refers to how many people are hospitalized with a confirmed case of Covid within 14 days before or during the hospitalization per 100,000 people.

The increase was also reflected in emergency department visits, when rates were over 1% for each week from Aug. 3 to Sept. 6, according to CDC data.

Confusion around federal guidance has disrupted access to this fall’s updated Covid vaccine. The shots are on the market, but pharmacies are waiting to start distributing them without a prescription until the acting CDC director signs off on new guidance from the Advisory Committee on Immunization Practices.

The ACIP, meeting last week in Atlanta, recommended that all Americans over 6 months old be able to get a Covid shot after consultation with a health care provider, a category that includes pharmacists.

Once the CDC signs off on the recommendations, Georgians should be able to get the Covid shot in pharmacies without a prescription.

DPH has not started providing the new vaccines yet, spokesperson Nancy Nydam Shirek said. The agency will review the new ACIP guidance once the CDC signs off on it, she said.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Covid declining, no flu or RSV yet in New York. What to know about Tylenol and autism.

2025-09-26T15:30:00+00:00

It’s been a whirlwind week in public health. From shifting Covid-19 vaccine recommendations and a debate over Tylenol and autism, to declining Covid levels in New York and even a case of eastern equine encephalitis, there’s a lot to sort through. Here’s what you need to know this week.

Infectious disease ‘weather report’

Covid is past its peak in New York

Forecast: Moderate and declining as measured by wastewater data, signaling that we’ve made it through the worst of the summer surge.

New York state Covid-19 wastewater activity levels.

Covid hospitalizations are still elevated. Because wastewater is a leading indicator and has just started decreasing, we can expect hospitalizations to follow and begin decreasing in the next week or two.

New York state Covid-19 hospitalizations.

The flu

Forecast: No activity in New York yet.

All states, including New York, are at the minimal influenza-like illness level, and New York wastewater shows no flu activity.

I’m planning on getting my flu shot this week before I travel out of the country in early October.

RSV

Forecast: No activity in New York yet.

Wastewater and hospitalizations still show no RSV activity in New York.

Nationally, we moved from 0 hospitalizations per 100k to 0.1, which could be a very early sign that the season is starting or about to start.

Mosquito-transmitted viruses

Human infection of eastern equine encephalitis virus in Central New York

Last week a resident of Madison County was hospitalized with eastern equine encephalitis, a virus transmitted by some species of mosquitoes. This is the county’s first ever human EEE infection. EEE is rare in New York and the rest of the United States — last year, New York had its first human case since 2015 in a resident of Ulster County, who sadly died.

Most people infected with EEE won’t have any symptoms. But for those who develop symptoms, the illness can be severe and involve inflammation of the brain (encephalitis) and spinal cord (meningitis).

About one-third of people who develop severe illness die.
There is no specific treatment available.
People over age 50 or younger than 15 are at greatest risk.

EEE is rare in New York, but is more concentrated in Central New York this year.

Since 1971, only 13 human cases have been identified in the state, including the most recent one. Of these patients, seven died.

By this time last year, 14 counties across the state detected EEE in mosquitoes, mammals, or birds. So far this year, EEE has only been detected in four counties: Madison, Onondaga, Oswego, and Oneida.

Eastern equine encephalitis virus detections in mosquitoes, humans, and animals.

But more mosquitoes have tested positive so far this year compared to last. Even though there are fewer counties detecting EEE, the detections are more concentrated in a smaller area — there’s a hotspot in Central New York.

Prevention of EEE is the same as for West Nile virus: It’s focused on reducing the mosquito populations and avoiding insect bites.

West Nile virus is active across New York

The most recent data show mosquitoes tested positive in:

Erie
Nassau
Onondaga
Oswego
Rockland
Suffolk
NYC: all five boroughs

So far, the number of human infections seen this year is comparable to the average of the previous three years.

What this means for you:

Mosquito transmitted viruses are active right now.
Protect yourself by wearing repellent (Deet or picaridin), long sleeves, or staying indoors when mosquitoes are most active at dawn and dusk.
Dump standing water around your house to reduce mosquito breeding habitat.

Follow-up on ACIP meeting updates

I tuned into last week’s Advisory Committee on Immunization Practices meeting — and it was messy. Members openly said they weren’t sure what they were voting on, some votes had to be redone or skipped, and there was repeated confusion over whether certain issues even fell within ACIP’s jurisdiction.

That said, the outcome was more patient-friendly than many expected. Katelyn Jetelina covered the details in a recent YLE National piece here.

Here are the high-level outcomes:

Covid vaccines: ACIP shifted Covid vaccine recommendations to shared clinical decision-making for everyone aged 6 months and older. That means that the decision to vaccinate now falls to conversations between patients (or parents) and clinicians — whether your primary care provider, specialist, or pharmacist.

Depending on what state you live in, though, you may still need a prescription. ACIP’s guidance is now more broad than the Food and Drug Administration’s: FDA continues to classify the Covid vaccine as “off-label” for some groups (like healthy adults and children without underlying conditions). In some states, this ACIP/CDC vs. FDA mismatch could mean patients need a prescription to access the vaccine.

In New York, this discrepancy will not disrupt vaccine access. Gov. Kathy Hochul earlier issued an executive order that allows pharmacists to both prescribe and administer Covid-19 vaccines for people aged 3 and older without a patient-specific prescription. That law means that even under the new federal guidance emphasizing shared decision-making, folks in New York should still be able to get vaccinated conveniently, including via pharmacies.

What this means for New York: The executive order put forward earlier this month ensures continued access to Covid-19 vaccines in New York. The CDC basically recommended Covid-19 vaccines off-label (different from FDA’s recommendations). This off-label use means that pharmacists can’t administer them without special authority. In New York, the EO and standing order granted pharmacists that authority, even before the ACIP meeting, which means that you can get vaccinated at your local pharmacy. Most insurers — including Medicaid, Medicare, CHIP and major private insurers (AHIP, ACHP) — have also affirmed they will keep covering the vaccine.

New York joins the Northeast Public Health Collaborative

New York state and New York City joined Connecticut, Maine, Massachusetts, New Jersey, Pennsylvania, and Rhode Island in the Northeast Public Health Collaborative to share expertise and protect evidence-based public health. A cornerstone of the voluntary regional coalition is to collaborate on vaccine recommendations.

And they are already making moves. All states in the Northeast Collaborative have taken action through executive orders, legislation, or other means to decouple Covid-19 vaccine guidelines from federal rules, protecting access within their own states.

What we do and don’t know about autism and Tylenol

What was said at the presidential press conference earlier this week is not true: We do not have evidence that Tylenol causes autism. The largest and most rigorous study to date — a Swedish sibling study of over 2.5 million pregnancies — found no link between prenatal Tylenol use and autism when controlling for genetics and environment.

That said, the picture is more complicated. Some observational studies have reported associations between Tylenol use during pregnancy and autism. But others show that fever itself during pregnancy can increase risk, making it hard to know whether the risk comes from the medication, the underlying illness, or something else entirely.

The bottom line: This science is complex, and we don’t have a clear answer. What we do know is that the association is nowhere near as strong as it was described from the podium earlier this week. Many of the statements given were misleading or straight up false. On top of that, they also create stigma against our neurodiverse community members, and pregnant women who are doing the best they can to keep their babies and themselves healthy. Katelyn and Kristen Panthagani did a great job breaking it down here for YLE National.

For now, guidelines remain unchanged: Consult with your doctor, and if you need Tylenol during pregnancy, use the lowest effective dose for the shortest possible time.

Bottom line

You’re all caught up on New York public health news this week! And a happy 220th birthday to the NYC Department of Health and Mental Hygiene. 🥳

Love,

Your NY Epi

What to know about getting a Covid vaccine in New York this fall

2025-09-25T13:59:15+00:00

This story was originally published by THE CITY. Sign up to get the latest New York City news delivered to you each morning. Public health, explained: Sign up to receive Healthbeat’s free New York City newsletter here.

We’re headed into cold and flu season and you want your shots, including an updated Covid booster. Where can a New Yorker go to get the jab?

After the Food and Drug Administration changed its regulations around the Covid vaccine this summer to limit access, New York state crafted a workaround to preserve people’s ability to get a booster. Nonetheless, confusion has reigned in pharmacies across New York City.

An executive order by Gov. Kathy Hochul technically allows pharmacies to administer the vaccine to anyone 3 years old and older. But the Centers for Disease Control and Prevention recently changed its guidelines around the Covid vaccine that further mixed messaging, creating a choose-your-own-adventure scenario for shot-seekers.

Here’s what to know now about finding (and paying for) the new Covid shots in New York City 2025.

Can I get a Covid booster in New York City, and where?

Yes, you can, but where you get it depends on a few factors.

At CVS, Walgreens, and independent pharmacies, the Covid vaccine is allowed to be administered, but availability and whether you will have to pay for it varies (more on this below).

Hochul’s Sept. 5 executive order allows pharmacies in the state to offer the Covid vaccine to those under 65 without an underlying health condition and without a prescription.

Amid confusion over U.S. vaccine recommendations, states try to ‘restore trust’

She did this in response to the FDA releasing the most restrictive Covid vaccine regulations since the shot’s inception. The federal policy said that only those 65 and older or people with an underlying condition are eligible to get the updated vaccine.

Hochul’s executive order suspends those federal rules until Oct. 5, and she may choose to extend it further.

Despite the governor’s order, availability of the vaccines is spotty in New York City. When THE CITY reached out to pharmacies across the five boroughs in recent days, many were not offering the shot, or were administering it only to certain populations.

At Esco Pharmacy in Hell’s Kitchen — where Hochul herself received the COVID booster last week — pharmacists are following FDA guidelines and not offering the vaccine to anyone between the ages of 18 and 65 who do not have a health condition.

“It is confusing to our staff and the patient, as well,” said Danny Dang, pharmacist at Esco, of the current guidelines. “We do see the benefits of the vaccination. I’ve seen a lot of patients who came to us for Covid treatment that could have been prevented by the vaccine if we had done it earlier.”

Dr. Marisa Donnelly, epidemiologist and author of the column “Your Local Epidemiologist New York,” explains that just because pharmacies are allowed to administer a vaccine doesn’t mean they will.

“There’s still, I think, a lot of internal policies that different pharmacy companies have,” Donnelly says. “They’re all allowed to give vaccines, but that doesn’t mean that they necessarily will. They can still go with their own guidelines and decide not to give a vaccine if they don’t want to. But they are allowed within the state.”

Who should get the booster?

Under the executive order from Hochul, everyone over 3 years old should be able to get the Covid shot. But, as stated above, the CDC and FDA says something else entirely, muddying the waters.

The New York City Health Department says it is especially important for the following groups of people to get the Covid booster:

All adults ages 65 and older
All children ages 6 to 23 months
People who are pregnant or recently gave birth
People of any age who have an underlying condition that increases their risk for severe Covid-19
People at high risk of exposure, such as health care workers and people living or working in a nursing home or other congregate setting
People living with someone with an underlying condition that increases their risk for severe Covid-19
People who have never been vaccinated before

Dr. Bruce Y. Lee, a professor at the CUNY Graduate School of Public Health & Health Policy, recommends the shot for anyone whose last vaccine was over six months ago, since immunity starts to wane after four to six months.

“On top of that, the last set of vaccines were protected against an earlier variant,” Lee says. “Right now, the variants that are circulating are different from previous, so your protection is probably even lower against the current variants. So if you haven’t gotten a vaccine for at least six months or greater, then it’s a good idea to get the vaccine, especially headed into winter.”

What about shots for city kids?

All kids 3 years to 18 are eligible to be vaccinated in New York state – no prescription or underlying health condition needed. (Six- to 23-month-old kids are considered a high-risk population and so their eligibility for the vaccine was never under threat)

However, THE CITY found that availability for shots for young people is spotty. Some independent pharmacies that are offering the vaccine for adults just don’t have it available or stocked for kids.

Kennedy’s take on vaccine science fractures cohesive national public health strategies

Lauren Naturale, a Sunset Park mom, tried to get her 6-year-old daughter vaccinated before traveling for a family wedding where a lot of older people would be in attendance.

Naturale attempted to make a vaccine appointment for her daughter at CVS, but when she went to finalize, would repeatedly get an error message. She tried again the following week and was able to make an appointment. Upon arrival at a CVS that was 40 minutes away, Naturale was told the store must have miscategorized them in CVS’s system because they did not have vaccines for children under 12.

“It sounds like you can get them, it would just be great if there was clear information,” Naturale said about children’s vaccines in New York.

She wasn’t able to get her daughter one before they left for the wedding.

“Hopefully we’ll be able to make that happen when we get back to the city,” Naturale said.

Shots for all young people under 19 years old should be covered by your insurer by law. (More on this below.)

Do I need a prescription?

No, you do not need a prescription to get the Covid shot. Hochul’s executive order from earlier this month made it clear that people seeking the Covid vaccine do not need a prescription. If a provider demands one, try another pharmacy, call your local health department about finding a vaccine, or contact your primary care doctor.

What is this going to cost me?

This really depends on your insurance and whether your insurer is choosing to cover the Covid vaccine right now.

That’s because a key committee at the CDC — the Advisory Committee on Immunization Practices — declined last week to recommend the Covid vaccine this season. Its recommendation is the federal standard insurers traditionally follow for coverage of all kinds of medical services.

What this means: Local pharmacies are allowed to give the Covid vaccine, but it may not be paid for by your insurance. At CVS, an out-of-pocket Covid vaccine could cost you up to $249.99. At Esco Pharmacy, an independent pharmacy in Hell’s Kitchen, it costs about $265, staff there said.

Earlier this month, the state’s Department of Financial Services issued guidance encouraging insurers to continue covering the Covid vaccine, but that isn’t binding. However, the letter notes that New York state law requires insurers to fully cover vaccines for children under 19, because they were deemed necessary immunizations in 2020 – a decision that still stands. Some insurers, like UnitedHealthcare, are choosing to continue covering the shot for everyone despite the ACIP declining to recommend the shot.

“For our standard commercial plans, we will continue to cover claims for Covid-19 vaccines with no cost share,” UnitedHealthcare said in a statement. The insurer said they recommend members who use an employer-sponsored plan to confirm benefits with their specific plan.

My local pharmacy isn’t offering the shot. What now?

Dr. Lee recommends contacting your doctor’s office or the local health department if you’re having trouble getting the vaccine.

Walgreens and CVS have the Covid vaccine available for those under 65 without a health condition. But to schedule an appointment online, you have to “confirm you are eligible,” or answer yes that you have a health condition.

“My guess is the reason that that is existing is because it’s a national website,” Donnelly says. “And so I imagine that they have some of those settings for everywhere across the country, even if they don’t necessarily apply to New York state. But I do think that that’s a potential source of confusion for people.”

Donnelly worries that mixed messaging around the Covid vaccine is causing fewer people to get it, and even worse, sowing distrust in the medical system.

“I think the biggest issue right now is there’s so much noise around vaccines, and it’s so confusing to follow,” Donnelly says. “So I think that’s actually a potential deterrent for a lot of families that want to get vaccinated, but that maybe don’t understand that they can or they are eligible now.”

What else can I do to prevent Covid?

Lee notes that while the Covid vaccine does protect against the worst outcomes of the virus, it doesn’t guarantee not getting it.

“You also want to continue to take other types of precautions, especially when you’re in a location or an area where the risk of getting infected is high,” Lee says. “Say you’re in a very crowded location, it’s still important to make sure that the area is well ventilated. That, and evidence has shown that masks can help cut down transmission. So, all of these things that came out during the beginning of the Covid pandemic still hold.”

During this time of mixed messaging, it’s important to distinguish which evidence is scientifically sound.

“If you see something that’s repeated across different respectable and evidence-based websites, then you can feel more confident that it’s a consensus that different folks have come to the same conclusion,” Lee says.

Some of the most reliable sources, he says, include international health organizations like the World Health Organization, Health Canada, and the U.K.’s The National Health Service. Major U.S. health systems like John Hopkins, the Mayo Clinic, and the Cleveland Clinic also provide trustworthy guidance. New York City’s health department is also considered one of the largest public health agencies in the world and offers evidence-based health recommendations.

Federal vaccine committee recommends personal choice for new Covid shots

2025-09-20T00:46:59+00:00

Public health, explained: Sign up to receive Healthbeat’s free Atlanta newsletter here.

After a two-day meeting marked by contention and confusion, a federal vaccine committee voted in Atlanta on Friday to allow people to decide for themselves whether to get a Covid shot – without a prescription.

The decision by the Advisory Committee on Immunization Practices will likely make it easier for Georgians to get the shots than it has been over the past month, after the Food and Drug Administration narrowed eligibility, forcing many to get a prescription. Since Georgia law relies on the ACIP recommendations, Georgians age 6 months and older should now be able to get the shots without prescriptions.

“The good news is anyone is allowed to get this vaccine,” Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Pennsylvania, said during a media briefing after the meeting. “The bad news is no one is encouraged to get it.”

Under this recommendation, the shots should be covered by private insurance and federal programs like Medicaid, the Children’s Health Insurance Plan, Medicare, and Affordable Care Act marketplace plans.

Even so, America’s Health Insurance Plans, which represents many private insurers, excluding United Healthcare, said before the meeting its members would continue to cover all vaccines that were recommended as of Sept. 1 through the end of next year.

ACIP, which advises the Centers for Disease Control and Prevention, suggested the agency substantially revise its vaccine information statements provided to patients to say evidence for the protection provided by the shots is “low quality,” that the vaccines come with potential serious risks, and other information that many scientists say lacks evidence. The ACIP resolutions still must be approved by acting CDC Director Jim O’Neill or Health and Human Services Secretary Robert F. Kennedy Jr.

The Covid working group chairman, MIT operations management professor Restef Levi, relied on opinions rather than facts and cherrypicked studies to support his position that the vaccine information statement needs to be revised, Jesse Goodman, a professor of infectious diseases at Georgetown University and a former FDA chief scientist, said at a media briefing after the meeting.

The committee narrowly voted against encouraging state and local governments to require a prescription for the shot, with Chairman Martin Kulldorff casting a tie-breaking vote.

The committee deferred votes on recommendations for Covid shots for pregnant women, but didn’t exclude them from its approved guidance.

Meanwhile, members voted to change its recommendation on the first dose of the childhood measles, mumps, rubella, and varicella (chickenpox) vaccine and deferred a decision on whether to end the recommendation of a hepatitis B vaccine at birth.

The chaotic meeting began Thursday with 12 new committee members picked by Kennedy to align with his anti-vaccine views. He had removed the previous 17 expert members. Representatives of major medical societies, including the American Academy of Pediatrics, have criticized the changes as undermining the scientific rigor of the process.

Dr. Jason Goldman, president of the American College of Physicians, urged the committee to return to the evidence-to-recommendation framework and other procedures ACIP has previously used to evaluate evidence for vaccines.

“We’re concerned about how vaccine recommendations are being developed by this new panel. Data is being selectively used to justify specific conclusions rather than considering all of the available evidence, and this lack of transparency diminishes trust, introduces bias and raises doubts,” Atlanta physician Sandra Fryhofer told committee members during the meeting on behalf of the American Medical Association.

The committee also voted to recommend that the first dose of the childhood measles, mumps, and rubella vaccine be given separately from the varicella (chickenpox) vaccine.

That change is expected to have limited impact because about 85% of American children already receive the first dose of the MMR and varicella shots separately, with only about 15% receiving the combination shot.

The combination shot eliminates the need for two shots but comes with a small increased risk of a febrile seizure – an issue that became the centerpiece of Thursday’s debate.

The CDC formerly recommended that the first shot in the series be the single MMR shot – but it gave parents the option to get the combined shot after counseling about the elevated risk of febrile seizure from the pediatrician.

The meeting served as an indicator of how the United States may handle vaccine policy going forward, with many members casting doubt on the safety of vaccines that have been used for years.

The committee established two new working groups, one focused on vaccines and pregnancy and the second focused on the childhood vaccine schedule.

The ACIP decided to postpone a vote on whether to end the universal recommendation of the hepatitis B vaccine that is typically administered within the first 24 hours of birth. The practice of vaccinating newborns before they are discharged from the hospital, introduced in 2005, has dramatically reduced the number of cases of hepatitis B in infants in the United States, according to data presented by Dr. Adam Langer, the associate director for science for the National Center for HIV, Viral Hepatitis, STD, and TB Prevention

Meanwhile, the committee unanimously voted to recommend that all pregnant women be screened for hepatitis B, a practice the CDC already recommended.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

New York health update: Covid, vaccine recommendations, West Nile virus, a Legionella outbreak

2025-09-18T15:22:58+00:00

Infectious disease ‘weather report’

Ugh, even epidemiologists get Covid.

Recently, my partner and I both felt like we had “allergies” — itchy eyes, mildly scratchy throats, and some lung irritation. It was so mild that at first we didn’t even think to test. When we finally did, his turned positive instantly. Mine never did. But, based on the timing of symptoms, I’m pretty sure I caught it first and then cleared the infection by the time we tested.

Consider this my firsthand evidence that Covid activity is elevated in New York, and the data agree.

Wastewater data is showing an upward trend. I’ll note that the latest data is usually unstable as all the sites submit data, but it stabilizes after about two weeks. This likely explains what looks like a big drop near the end of August.

New York state Covid-19 wastewater activity levels.

That said, the recent rise in wastewater concentrations aligns with increased hospitalizations.

Everything else is quiet still:

Flu: Outpatient visits for flu-like illness haven’t started rising in New York yet, but I’m keeping a close eye on it. In other parts of the country, numbers have started to climb.

RSV: Still quiet.

I was planning on getting my fall Covid booster soon, but after just getting over Covid, I’m deciding to wait. Data show that after a Covid infection, delaying immunization by about ~6 months can increase its effectiveness. (YLE national covered the timing of Covid vaccines here). I’m getting my flu shot soon though!

Speaking of immunizations …

Updates to routine immunization eligibility are expected this week

There’s a lot happening right now around vaccine access and eligibility, both for Covid and routine immunizations.

Last week we covered New York’s steps to keep Covid-19 vaccination accessible, including executive and standing orders that allow pharmacists to vaccinate anyone over age 3 without a prescription. In practice, you may still need to check “yes” to the eligibility question on pharmacy websites when scheduling, but New York pharmacists have the authority to vaccinate you whether or not you have an underlying condition.

CVS appointment scheduler questions. Check “yes” that you would like to receive a Covid vaccine and are eligible.

Today, the Advisory Committee on Immunization Practices is starting a two-day meeting to vote on Covid-19, hepatitis B, and MMRV (measles, mumps, rubella, varicella) vaccine recommendations. There is a very real possibility that ACIP will vote against recommending some of them for certain ages. Such a decision would truly be unprecedented given overwhelming evidence supporting their safety and effectiveness. If that happens, the availability of these vaccines will be reduced.

I do expect New York state will step in to protect these vaccines. Gov. Kathy Hochul has issued an executive order and standing order to safeguard Covid-19 vaccine access (we covered it here), and I anticipate something similar if ACIP votes against hepatitis B or MMRV. Even so, a quick executive order can’t erase the confusion. Potentially conflicting messaging from federal and state departments will undoubtedly create uncertainty and confusion, making it harder for some to get vaccinated.

While I don’t think that Covid vaccines should be removed, most people in New York have a buffer of community immunity, and access to Covid vaccines through the executive order. If recommendations change, it will have the greatest impact on those who don’t have immunity, like young children, pregnant women, and people who are immunocompromised. But hepatitis B and MMRV are a different story. Removing these vaccines sets us back in the progress we’ve made in protecting babies, and puts kids and vulnerable populations at risk of serious, preventable diseases.

That’s why now it’s more important than ever to stay informed, and remember that vaccines remain one of the safest, most effective tools to protect babies, children, and everyone else from severe and preventable illness. I’ll be back next week with the implications for New Yorkers after we know with certainty what the ACIP votes will be.

We are in peak West Nile virus season

New York is seeing West Nile virus activity across the state. This is typical — September is when we often see the highest West Nile virus infections. This most recent data show mosquitoes tested positive in:

Erie
Nassau
Orange
Rockland
Suffolk
NYC: all five boroughs

A few mosquitoes in Oswego County also tested positive for Eastern Equine Encephalitis virus, which is rare but more dangerous than West Nile. So far, there have been 26 human West Nile cases across the state, and no cases of EEE.

In New York, it’s too early to tell if this is a normal year or not because this is the time of the year when West Nile cases typically really pick up.

Nationally, West Nile is 40% higher than normal. In New York, we’re getting close to last year’s total West Nile-positive mosquito pools (1,638 so far, compared to 2,167 last year), and the season usually runs until the first few freezes in November. So it’s too soon to tell how bad this year will be.

New York counties continue to use mosquito control to reduce risk. Many have conducted or plan to conduct aerial insecticide spraying, where a plane disperses chemicals to kill mosquitoes or prevent breeding. (You can check your local health department website for local schedules.) There are recent or upcoming events for New York City (Brooklyn and Queens this week).

To minimize exposure to insecticides during spraying:

Stay indoors
Bring pets inside
Close windows

Legionnaires’ disease in Westchester

Yes, another outbreak. This time Westchester County is investigating a spike in Legionnaires’ disease. So far this year:

38 people have been diagnosed
2 people have died

This is an increase — last year there were 24 cases total in the county. Across the state, excluding New York City, we are at 383 cases so far for this year.

Officials recently confirmed a cluster of five cases in Yonkers and said that cooling towers are being inspected in response. But we don’t know where the cases reside or where they could have been exposed. I’m concerned that not enough information is being shared, or shared quickly enough. Knowing which neighborhoods or ZIP codes are affected helps us assess personal risk. And clear, timely, and consistent communication from public health departments is essential, not just for managing outbreaks, but for building and maintaining community trust.

Legionnaires’ disease is a serious lung infection caused by breathing in tiny water droplets containing the Legionella bacteria. Symptoms usually start 2-10 days after exposure and can include:

Cough
Fever
Chills
Shortness of breath
Muscle aches
Diarrhea

Most healthy people exposed won’t get sick. Those at higher risk are adults over age 50, smokers, and people with chronic lung disease, diabetes, cancer, or weakened immune systems.

It’s not spread person-to-person because it doesn’t infect cells the same way a respiratory virus does (like Covid). You also can’t usually get it from drinking water — water rarely enters the lungs while drinking, and stomach acid likely kills it when ingested. In New York, and especially around New York City, outbreaks with cases across communities (like this one) are typically linked to cooling towers, which are separate from residential plumbing. This means that your tap water is not a risk.

Why has there been so much Legionnaires’ this summer?

The increase in Westchester Legionnaires’ cases follows the large outbreak in Central Harlem, where seven people died and 114 were diagnosed. We covered it here. And Legionnaires’ disease has been increasing nationally.

National Legionnaires’ disease rates have been increasing, though data after 2022 have not yet been published.

Several factors may be driving the increase in Legionnaires’ cases this summer in New York:

Warmer temperatures and higher humidity can promote bacterial growth in water systems. This has been one of the hottest summers on record for many parts of New York.
Potential lapses in regulation and inspection can allow Legionella to grow undetected, especially when buildings aren’t maintaining cooling towers properly. In New York, building owners are legally required to test cooling towers for Legionella every 90 days. During the Central Harlem outbreak, Gothamist reported that most of the towers linked to the outbreak were behind on testing and hadn’t been inspected by the city in over a year.
Increased awareness can lead to more identified cases. When large outbreaks happen, media and public health alerts can increase the chance that milder cases are caught. Doctors might be more on the lookout and the public may be paying closer attention to their symptoms, which are good things.
Climate change may also be playing a role, as longer and hotter warm seasons can create more opportunities for Legionella growth.

Grandparents for vaccines

Think Moms Against Drunk Driving, but for polio and measles. A new grassroots group of grandparents just launched to protect kids’ vaccine access. They’re driven by lived experience — remembering when these diseases ran rampant — and are elevating their stories.

Fueled by personal experiences, they are asking for support and stories. Learn more and join them here.

What else you need to know

Measles in NYC

The NYC Department of Health and Mental Hygiene has confirmed two adult cases of measles in Manhattan. They are investigating potential exposures at two unnamed restaurants in SOHO and the Lower East Side, and contacting those who may have been exposed. Reminder — if you are fully vaccinated, you are well protected.

Blue-green algae in Onondaga

Onondaga County has issued an advisory for a harmful algal bloom at Skaneateles Lake. These blooms, caused by overgrowth of blue-green algae (cyanobacteria), can cause skin rashes, stomach upset, or more serious illness if swallowed or inhaled. Before swimming at lakes or ponds, check local advisories and pay attention to posted signs. If you or your pet were exposed, rinse off really well and seek medical care if symptoms develop.

Bottom line

You’re all caught up on New York public health news this week!

Love,

Your NY Epi

Access to Covid shot and 2 childhood vaccines may change this week. Here’s what to know.

2025-09-17T11:00:00+00:00

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Americans may get some movement – but maybe not much clarity – this week on their future access to Covid vaccines and two childhood immunizations as a federal committee convenes in Atlanta to vote on recommendations.

The guidance that emerges from the Advisory Committee on Immunization Practices meeting on Thursday and Friday could influence how and when pharmacists and doctors give the vaccines and whether insurers will pay for them.

The committee has become a political battleground as Health and Human Services Secretary Robert F. Kennedy Jr. seeks to rework the country’s health infrastructure. Kennedy fired the previous expert members of ACIP and replaced them with his own picks, many of whom share his anti-vaccine views.

Public health experts are expecting mixed messages from the meeting. The committee may recommend some shots, with restrictions that could keep people confused as to who should get them.

“For those who are opposed to vaccination, making people feel uncertain about vaccines is kind of their stock in trade,” said Brian Abramson, an attorney who has published a textbook on vaccine law.

Here’s what to know about the meeting and how it could affect access to Covid shots, as well as hepatitis B and MMRV vaccines for children.

What is ACIP? Why does it matter?

ACIP’s recommendations guide how the CDC sets child and adult immunization schedules.

The panel’s recommendations create the standards most health care providers follow and are “considered the gold standard,” said Dr. Ashley Chinchilla, a professor at the University of Georgia College of Pharmacy.

For example, in Georgia and many other states, state law governing which vaccines pharmacists can administer relies on ACIP recommendations. That’s what caused the recent confusion around Covid shots.

While the Food and Drug Administration approved the vaccines for people over 65 and for adults with underlying health conditions last month, ACIP has not issued a recommendation for the updated Covid shots. That’s left patients and pharmacists in limbo, with many pharmacies requiring a prescription to get the shot, a departure from past practice.

“We’re in this holding pattern until there is an official recommendation,” Chinchilla said.

The recommendations also guide which vaccines insurers cover. While private insurers could decide to cover vaccines even if they are not recommended by ACIP, many government programs are bound by the ACIP recommendations, said Matt Motta, a professor at the Boston University School of Public Health.

That includes Vaccines for Children, a federal program that pays for vaccines for under- and uninsured children. About half of all U.S. children are eligible for the program, according to the CDC.

What is on the ACIP agenda?

There are three items on the ACIP agenda for this week: the MMRV vaccine, the hepatitis B vaccine, and the Covid vaccine.

MMRV

The first time on the agenda for Thursday is the measles, mumps, rubella, and varicella, or chickenpox, shot.

It combines the MMR vaccine with the varicella vaccine into one shot that was designed “to make it easier for families to give this vaccine to their children” by eliminating an extra shot, said Dr. Yvonne Maldonado, a former ACIP voting member and a professor of pediatric infectious disease at Stanford University.

There is a higher incidence of febrile seizures in young children who get the combination dose, Maldonado said, but families are advised of this risk and can decide whether to get the MMRV shot as one vaccine or separately.

“In many cases, it’s just easier to give the combination and saves the baby an extra shot,” she said.

ACIP could recommend that the MMR shot be given separately from the varicella shot, Maldonado said.

If that happens, “it’s not going to be a tremendous impact in terms of vaccination overall, as long as people continue to get MMR and V or MMRV together. But it does start to weaken the recommendations around vaccination,” Maldonado said. “It does make it harder for people to get vaccines, and it starts to make people question … what the schedule was.”

Hepatitis B

The committee is scheduled to discuss the hepatitis B vaccine on Thursday afternoon. Currently, the CDC recommends the vaccine for all infants and most adults.

The birth dose is on the agenda for the Thursday meeting, and ACIP could decide to recommend that infants get it later in life instead.

Dr. Tony Fiore, a retired CDC infectious disease expert, said it’s important for the United States to continue to provide the vaccine to infants because hepatitis B can cause serious medical conditions, like cirrhosis or liver cancer, and early death.

The blanket dose for all newborns has helped dramatically reduce cases of hepatitis B. The disease is highly contagious and can be transmitted in a variety of ways, including from mother to child.

“The vaccine is very safe,” Fiore said. He’s concerned removing the recommendation of the birth dose could lead to an increase in cases. While there are screening procedures to check pregnant women for the disease, Fiore said those are complex, and the birth dose ensures that babies born to mothers with the disease do not get it.

Covid

The committee is slated to spend Friday discussing the Covid vaccine.

Ideally, ACIP would recommend that the vaccine be recommended for everyone over 6 months, as in past years, Fiore said.

But several public health experts said it’s more likely that ACIP will follow the FDA’s decision last month to recommend the shots only for adults over 65 and adults with underlying health conditions.

That would be better than further narrowing the eligibility requirements, Motta said.

But it would mean that groups outside the ACIP recommendation may have to get a prescription to receive the shots off-label and that could jeopardize insurance coverage.

This chart shows the 2025-26 combined respiratory vaccine recommendations from various organizations.

What has changed at ACIP?

Kennedy’s remaking of ACIP has drawn criticism and lawsuits from professional medical societies, including the American Academy of Pediatrics and the Infectious Diseases Society of America.

“The committee is staffed [with] a very small number of very extreme people,” Motta said. “Yes, they have scientific credentials. Yes, many of them are medical doctors, but their opinions do not reflect where most of the scientific community is on those issues.”

The committee normally uses a rigorous scientific review process, working in close consultation with experts at the CDC. Representatives from a variety of professional organizations attend the meetings and advise the members, Maldonado said.

That hasn’t been happening this year, and it’s unclear whether the professional groups’ liaisons will participate in the meeting, Maldonado said.

“It feels like this new ACIP since the June meeting has been incredibly ideological,” she said. “That’s very concerning when it comes to understanding how we’re going to be able to utilize vaccines to protect public health.”

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

How Hochul’s executive order affects Covid-19 vaccine access in New York

2025-09-11T17:19:17+00:00

Amid federal vaccine regulation upheaval, last week, Gov. Kathy Hochul signed Executive Order 52 to make Covid-19 vaccines more available to New Yorkers. This was one of the first moves across the nation to ensure better access to Covid-19 vaccines. But this is a temporary Band-Aid, and much more needs to be done. The overall message is this: You can now get a Covid-19 vaccine at New York pharmacies without a prescription.

What the heck is going on?

Right now, access to Covid-19 vaccines depends on your state. Many state laws, including New York, link vaccine access directly to guidance from the Food and Drug Administration or the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices. But in June, the ACIP was replaced with members handpicked by Health and Human Services Secretary Robert F. Kennedy Jr., and they declined to vote on Covid-19 vaccine recommendations. Their next meeting is set for next week.

Until that happens, guidance is stalled, leaving state statutes tied to ACIP in limbo. In the meantime, there are a few things states can do depending on politics, legislature, etc.:

Change the legislation
Declare an emergency/executive order
Change the standing order (so pharmacists can prescribe)
Change the pharmacy board statutes

Last week, New York chose No. 2 and No. 3.

What exactly did the executive order do?

EO 52 declared a state of disaster emergency in New York effective Sept. 5 through at least Oct. 5, 2025. Declaring a state of emergency gives the governor the legal authority to temporarily change existing state regulations. In public health, states of emergency are typically declared to unlock faster action.

Within the state of emergency, the order broadened pharmacists’ ability to prescribe and administer Covid-19 vaccines to individuals age 3 and older without needing prescriptions from doctors.

The EO provides a temporary solution while New York works on long-term legislation to protect access to vaccines in the state. In other words, the law will need to change to decouple recommendations and pharmacy access from the federal government. No one ever saw the need for this before, but here we are.

This will not only help with Covid-19 vaccines, but other vaccines should the federal government continue to chip away at recommendations.

Why did New York take this step now?

There are two big reasons why New York took this step:

To broaden and protect access to vaccines. As I shared last week, current federal vaccine guidance effectively leaves many people under 65 without clear access to the Covid-19 vaccine. In practice, that looks like pharmacies, including big chains like CVS or Walgreens/Duane Reade, limiting who could get vaccinated. This executive order changes that in New York. It allows pharmacists to both prescribe and administer vaccines to anyone 3 and older, regardless of shifting CDC/ACIP recommendations.
To defend public health and science. Covid-19 vaccines remain our best protection against severe illness, and no new evidence says otherwise. Yet recent federal changes have limited their access. New York’s executive order is a safeguard against those limits, ensuring that the state government can make its own evidence-based recommendations, and help preserve access to care.

How does this impact vaccine access and equity?

More convenience and reduced barriers. Before the executive order, a prescription was required to get a Covid-19 vaccine at most New York pharmacies. Now, you can just go straight to the pharmacy, no prescription needed. This is important because 90% of Americans get their seasonal vaccines at pharmacies. Requiring a prescription would mean that many people likely wouldn’t get vaccines this year, but not everyone has time to get a prescription or even has a primary care provider.
Inclusivity: The executive order expands eligibility to cover children age 3 and older, pregnant people, and all adults, regardless of underlying conditions, groups previously squeezed out by federal restrictions. 
Strengthening the role of pharmacists: Parts of New York state, particularly rural communities and some neighborhoods in New York City, experience shortages of doctors or health clinics. Allowing pharmacists to provide and prescribe Covid-19 vaccines can be especially impactful in these underserved communities.

How does NY compare to other states?

New York is part of a growing trend of states stepping up to make Covid-19 vaccines more available in the midst of federal restrictions. It’s helping lead a regional coalition of New England states to coordinate health guidance. On the West Coast, California, Oregon, Washington, and Hawaii formed a West Coast Health Alliance to do the same.

Individual states are also taking action on their own. For example:

Massachusetts now requires insurers to cover vaccines recommended by the state.
New Jersey, Connecticut, Colorado, and New Mexico issued orders allowing pharmacists to give Covid vaccines without prescriptions.

With the Common Health Coalition, YLE recently broke down which states are moving forward — you can find that resource here (though things may change quickly as more states take action).

Conversely, some states are moving in the opposite direction. Florida, for instance, has rolled back routine school immunization requirements, raising concerns about long-term herd immunity in the state.

Will insurance cover vaccines?

This is a big “to be determined” for New York. Unlike Massachusetts, the New York executive order does not say anything about insurance coverage for Covid-19 vaccines. It’s safe to assume that if you have an underlying condition or if you’re over 65, insurance will cover the vaccine. This is because the vaccine is considered “on label.” For everyone else (who would be considered “off label”), it’s best to call your insurance provider and ask directly. Covid vaccines can run about $200 out of pocket without insurance.

What’s temporary, and what’s next?

The EO is in effect until Oct. 5 to give New York time to create more permanent vaccine protection legislation. At which point, the EO can be extended if new legislation hasn’t been put in place.

What’s my take on this?

We needed New York to act. In the absence of a stable CDC, state health leaders need to step up and fill the void. Hochul’s executive order is a big step in that direction. It enables continued, more equitable access to Covid-19 vaccines in New York, even amid federal uncertainty.

But the work can’t end here. Florida recently ended routine school immunization requirements, and similar rollbacks could spread to other states. This raises the risk of confusion not just about Covid vaccines, but about routine vaccines, too. We also know that the ACIP may be questioning other routine vaccinations in their upcoming meeting, Sept. 18-19. (I’ll be back with updates on that.) New York needs to be proactive about protecting all immunizations, not just Covid-19.

Does this solve the issue completely?

Not quite. There are a couple of important questions remaining:

Legal liability. Pharmacies and pharmacists need clarification on what legal protections they have when prescribing or administering Covid vaccines under this order because the recommendations differ from federal entities like the FDA and CDC.
Insurance coverage. It’s uncertain if Covid vaccines will be consistently covered by insurance.
Implementation. Each pharmacy will ultimately decide how its pharmacists will carry this out, which could affect access across the state if some choose to follow the more restrictive federal recommendations.

Bottom line

Pharmacies can now give Covid-19 vaccines without a prescription in New York. We’ll update you on outstanding questions, like which pharmacies are offering it, once we know.

Love,

Your NY Epi

Ga. public health board chair: RFK Jr.’s disruptions are creating barriers to Covid shots

2025-09-09T22:29:04+00:00

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Georgia Board of Public Health Chairperson James Curran criticized Health and Human Services Secretary Robert F. Kennedy Jr.’s disruption of a vaccine guidance system that was working well.

“As far as I can tell, a major goal is to diminish the CDC role in vaccines in a lot of ways,” Curran said at Tuesday’s board meeting.

Kennedy removed members of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices and replaced them with his own appointees. The panel typically provides Covid vaccine recommendations for the fall respiratory season earlier in the summer, but did not do so this year.

The U.S. Food and Drug Administration last month approved the updated shots, but only for those 65 and older and those with underlying conditions that put them at risk for severe Covid. That has prompted many Georgia pharmacies to require a prescription to get the latest Covid shots, with some doctors refusing to write prescriptions until the ACIP meets Sept. 18-19.

Curran, who was a longtime dean of the Rollins School of Public Health at Emory University, said this has created confusion and introduced barriers to getting the shots, disrupting a system that had worked well.

“The whole idea that everyone has a doctor is not true,” Curran said.

Department of Public Health Commissioner Kathleen Toomey, who was appointed by Republican Gov. Brian Kemp, as were the nine board members, said the agency has paused distributing this year’s Covid vaccines amid regulatory uncertainty, at least until the ACIP meets. She said the decision was guided by concerns over medical liability in the wake of the FDA’s narrowing of the categories of people for whom the shot is approved.

Health departments do not yet have the shots in stock, she said.

Toomey said she met with Kemp to discuss how the state will approach Covid vaccines. Four states – California, Oregon, Washington, and Hawaii – have formed an alliance to provide residents with science-backed vaccine recommendations. Governors of other states have also taken steps – such as issuing executive orders – to make it easier for their residents to get vaccines amid the regulatory confusion.

Toomey said the agency would look at the ACIP’s recommendations and make a decision about how Georgia health departments will handle the Covid shots. The agency may consider following guidelines from another organization, like the American Academy of Pediatrics, if the ACIP guidelines don’t follow good science.

This chart shows the 2025-26 combined respiratory vaccine recommendations as of Sept. 3.

Curran also criticized Kennedy’s focus on processed food as a cause of chronic disease even as the HHS chief has cut programs that help prevent chronic diseases like those focused on stopping smoking.

That decision has impacted Georgia. DPH has ended the Georgia Tobacco Use Prevention Program due to “a lack of ongoing federal funding and the closure of the CDC’s Office of Smoking and Health,” state Department of Public Health spokesperson Nancy Nydam Shirek said.

That resulted in the layoffs of five people working on the program, as well as the reassignment of an epidemiologist to another team, she said.

“DPH’s core tobacco and vaping prevention and cessation programs are continuing uninterrupted, including Tobacco-Free Schools and the Georgia Tobacco Quitline,” Nydam Shirek said.

The state also lost $334.2 million in March after the federal government “clawed back” Covid-era funding.

Curran said he anticipates additional funding cuts.

“It’s a distressing time for public health at the federal level, and it’s going to have implications at the state and local levels,” he said.

Meanwhile, an administrator who was laid off from the CDC was hired as director of the state public health laboratory, a position that had been open for “years,” Toomey said.

Ellen Kersh started the job on July 1 after leaving the CDC, where she had been the STD Laboratory branch chief.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Georgia clinics that serve uninsured are offering the new Covid vaccines

2025-09-04T21:34:08+00:00

Public health, explained: Sign up to receive Healthbeat’s free Atlanta newsletter here.

As retail pharmacies and many health clinics and doctors’ offices await federal guidance on who should get the new Covid vaccine, federally qualified health centers, which serve the uninsured, are offering the shots in Georgia.

Dr. Theresa Jacobs, clinical director for the Georgia Primary Care Association, which represents 34 FQHCs across the state, said they will write prescriptions for people to get the shots at pharmacies or provide the vaccine on-site.

Some clinics in the network have the shots in stock, while others do not.

“Anyone that wants it, we will write the prescription, or we will give the Covid-19” shot, Jacobs told Healthbeat on Thursday.

Unlike previous years, when the Covid vaccine was widely available at retail pharmacies, this year you may need a prescription – at least for now.

The centers typically charge fees on a sliding scale for uninsured or underinsured patients, she said. People with insurance can also be seen at the clinics and get vaccinated.

It’s a different story at the county clinics that are part of the Georgia Department of Public Health. They are holding off on providing the latest Covid shots, which have been updated to protect against the coronavirus strains that are currently circulating.

New Covid shots arriving in pharmacies. Why you may need a prescription - for now

Georgia DPH is awaiting guidance from a key U.S. Centers for Disease Control and Prevention committee on who should get the shots, according to a statement from spokesperson Nancy Nydam Shirek.

That CDC committee – the Advisory Committee on Immunization Practices, or ACIP – is set to meet Sept. 18-19 in Atlanta. The panel typically provides Covid vaccine recommendations for the fall respiratory season earlier in the summer, but did not do so this year, leaving Georgia doctors, pharmacists, and patients in limbo as the updated vaccines arrive.

Health and Human Services Secretary Robert F. Kennedy Jr., who has spread false information about vaccines, replaced the committee’s 17 members with his own picks. The new committee’s decisions about vaccine policies have drawn criticism from scientists and many professional medical organizations.

The confusion has been compounded by recent changes to Food and Drug Administration vaccine guidance, which limited eligibility for the Covid shot to those who are over 65 and those who have an underlying medical condition that puts them at risk for severe disease.

The changes only apply to the updated Covid shots. The flu and RSV vaccines are available as usual and widely recommended.

The regulatory uncertainty around the Covid shots has prompted Georgia pharmacies to require patients to get a prescription for them, a departure from prior years.

Children who qualify for the Vaccines for Children program, which provides free vaccines to un- and underinsured children, can still get the vaccines under that program at FQHCs, Jacobs said.

“Since the wholesale firing of all 17 ACIP members, trust in the integrity of ACIP recommendations has plummeted. This has many physicians turning to medical organizations for specific recommendations,” said Dr. Sandra Fryhofer, an Atlanta internist who serves on the board of the American Medical Association.

This chart shows which vaccines for the 2025-26 respiratory season are recommended by which medical associations.

“I continue to encourage my own patients to get a dose of the updated vaccine as soon as they can and when they can,” Fryhofer said. “We are in the midst of a late summer wave of Covid. I have had many patients come in recently with Covid infections.”

Some doctors in private practice are providing the vaccine or prescriptions for it. Dr. Cecil Bennett of Newnan Family Medicine Associates said his patients will be able to get the shot at his practice when it arrives in stock, which he estimates will be at the end of the month.

Bennett said he no longer trusts the CDC’s vaccine guidance and is instead turning to professional medical societies like the American Academy of Family Physicians. He recommends the new Covid vaccine for anyone 6 months or older, especially the elderly and people with underlying conditions.

“The sooner the better,” Bennett said, suggesting anytime before November is the best time to get vaccinated.

Doctors at Morehouse Healthcare, which has three clinics in Atlanta, are only writing prescriptions for patients to get the new Covid shots at local pharmacies in line with the latest FDA guidance, said spokesperson Bill Marks. That means only those who are age 65 and older and those who are at high risk for complications from Covid.

CVS pharmacies will require patients to have a prescription in Georgia, spokesperson Amy Thibault told Healthbeat.

CVS has over 50 MinuteClinics in Georgia, where medical providers can administer the updated shots to patients who meet the FDA’s eligibility criteria.

Patients are “asked to attest to their eligibility” when signing up for MinuteClinic appointments, according to a list of CDC medical conditions that increase risk for severe Covid, including obesity, diabetes, hypertension, and many others.

It’s still unclear how insurers will handle the cost, though they typically cover the shots recommended by ACIP.

The latest Covid vaccine will cost about $225 out-of-pocket at CVS stores, Thibault said.

Some doctors in private practice are not providing the shots yet. Piedmont Healthcare spokesperson John Manasso said Piedmont providers can write prescriptions “as clinically appropriate.”

Atlanta resident Ashutosh Sharma said his primary care physician in the Piedmont network asked him to wait.

“As the ACIP has not yet met, we don’t have any knowledge as to the policies/procedures that will be required by pharmacies or insurers with regard to obtaining new Covid vaccines,” a note to Sharma from his doctor said.

Shana Cohen said her doctor is in the Wellstar network and a webpage there said her physician could not offer the Covid shot at this time. And she couldn’t get the vaccine at a commercial pharmacy without a prescription.

Tell us about your experiences in trying to get the new Covid vaccine. Write to Atlanta public health reporter Rebecca Grapevine at rgrapevine@healthbeat.org with your story and questions.

What to know about Covid-19 vaccine access in New York

2025-09-04T14:10:29+00:00

Fall is right around the corner, and so are respiratory viruses. Each fall and winter, the big three viruses (Covid-19, flu, and RSV) cause hundreds of thousands of hospitalizations in the United States. The good news is that we have vaccines for all three that help prevent against severe disease.

For the flu and RSV, vaccines are business as usual. Eligibility is clear, and you can show up to most pharmacies or doctors’ offices to get vaccinated. (Check out YLE National’s fall vaccine guide to help determine which vaccines you or your child should get.)

But Covid vaccines are a different story this year. Chaotic government processes and upheaval have left Covid vaccine recommendations in limbo, especially in New York. This is a rapidly evolving situation, and while there’s still a good amount we don’t know, we’re here to help you stay grounded. We’ll share information as it comes in, and break down what it means for you as the respiratory virus season begins.

What changed last week regarding Covid-19 vaccines?

On Aug. 27, the Food and Drug Administration approved updated Covid-19 vaccines from Pfizer, Moderna, and Novavax but with limited eligibility. Specifically, they were approved for:

Adults 65 and older, and
Individuals under 65 with at least one high-risk health condition, listed here:

The FDA also revoked the Emergency Use Authorization for Pfizer’s vaccine in children under 5. This leaves only Moderna’s vaccine for children 6 months and older, but only for those who have an underlying condition or who see a doctor.

Why is this causing confusion?

It feels murky because we’re in a limbo period. While the FDA has approved the new vaccines, the Advisory Committee on Immunization Practices has not yet issued recommendations, and the Centers for Disease Control and Prevention hasn’t updated its guidance. ACIP and CDC won’t make changes until after the next ACIP meeting, which is scheduled for Sept. 18-19. Many states, including New York, require that the FDA and the CDC/ACIP approve vaccines before pharmacists are permitted to administer them.

This means that even though the updated Covid vaccines are FDA approved, not all pharmacies can actually offer them yet. It depends on each state’s individual regulations and the written protocols individual pharmacy chains have. In practice, this means that many patients who want Covid vaccines need to see their doctor or get a prescription to bring to a pharmacy. This creates barriers to vaccine access — in 2021, 80% of New Yorkers got their vaccines directly from a pharmacy. Nationally, it’s about 90%.

What’s the situation in New York specifically?

Covid-19 vaccine access via pharmacies depends on which pharmacy you go to:

Walgreens/Duane Reade: If you are over 65 or have an underlying condition (determined by self-attestation on the scheduling portal) you can make an appointment online for a vaccine at a Walgreens or Duane Reade in New York. But you need to have a prescription from a doctor and bring it to the appointment.
CVS: Not currently offering Covid vaccines to anyone in New York. CVS is being more conservative than Walgreens, likely because of how the pharmacy chain has written their protocols, but this isn’t totally clear. Until ACIP/CDC makes official recommendations, or New York changes its recommendations, I’m guessing Covid vaccines will stay on hold at CVS. However, you can make an appointment at CVS pharmacies in New Jersey or Connecticut if you are over 65 or have one of the high-risk conditions. It appears that some Minute Clinics in New York may be offering vaccines, but it’s not consistent.

There hasn’t been any formal guidance yet from the New York State Department of Health or the NYC Department of Health and Mental Hygiene. There have been reports that New York state and New York City are considering issuing their own vaccine recommendations, but no official announcements have been made.

What is the state doing about this?

New York and most other New England states recently met to discuss forming a regional health coalition to coordinate health guidance in response to instability at the CDC and ACIP. They discussed what to do when the CDC’s vaccine recommendations differ from the scientific consensus and whether New England states should follow the recommendations of professional medical societies instead. Organizations like the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists have called for broader access to vaccines for children and pregnant individuals, which contradicts the current FDA restrictions.

But the hard truth is that New York should have seen this coming. Increasing instability in federal health has been ongoing for months and has widened cracks in our vaccine systems. New York state and city health departments have yet to issue local vaccine guidance or contingency plans. We need our local health leaders to step up and provide guidance in a way that the CDC and ACIP can’t right now. Without it, the burden of understanding and navigating the complex vaccine landscape falls on the individual, which is not something we should have to do alone.

What should New Yorkers do right now?

If you are over 65 or have a high-risk condition, you can make an appointment for a Covid shot at Walgreens/Duane Reade, but you need to have a prescription from a doctor. The closest CVS pharmacies currently giving Covid vaccines are in New Jersey or Connecticut.
If you have a high-risk condition, call your primary care provider to ask if they can vaccinate you or give you a prescription, and if they have the vaccine in stock. If you’re not in a high-risk group, it could still be worth checking in with your doctor. But you can also wait: More clarity is expected in the coming weeks as guidance and state policies catch up.
Stay tuned for more information from YLE following the upcoming ACIP meeting in mid-September. If they recommend the vaccines and CDC signs on, then we can expect more pharmacies to start vaccinating those who are eligible.
For those who can’t get their Covid vaccine right now, it’s still a good idea to get your flu shot, and pay attention to your health. If you are feeling ill, avoid social gatherings, wear a mask around others, and get lots of rest.

What else to know this week: Legionnaires’ updates

The Legionnaires’ outbreak in Central Harlem has officially ended. Over the course of the outbreak there were 114 confirmed cases, 90 hospitalizations, and seven deaths.

Final lab results identified the source: two city-owned cooling towers, including Harlem Hospital. Investigators confirmed this by matching the genetic fingerprint of the Legionella bacteria found in patients samples to those collected from the cooling towers.

In response to the outbreak, New York City has proposed new policies that would require building owners to test for Legionella every 30 days instead of 90, and increase the number of Health Department employees who conduct inspections and respond to outbreaks. I’ll be watching to see if these policies are implemented.

The city is also investigating a new, unrelated cluster of Legionnaires’ at an apartment complex in the Bronx. So far, four cases have been identified over the past several months. Unlike the Central Harlem outbreak, this cluster appears to be linked to the building’s internal plumbing, not cooling towers. This usually means that the risk of widespread transmission is lower.

Under city laws, the building owners are now required to evaluate the water system, test for Legionella bacteria, and take steps to control it to prevent future infections.

Bottom line

Vaccines remain the best option to prevent severe respiratory disease this season. Given the confusion surrounding Covid vaccine eligibility and availability, it’s best to consult your doctor about getting a shot.

Love,

Your NY Epi

New Covid shots arriving in pharmacies. Why you may need a prescription - for now

2025-08-29T22:04:27+00:00

Public health, explained: Sign up to receive Healthbeat’s free Atlanta newsletter here.

As Georgia Covid rates rise, people who want to get the latest vaccine as it hits pharmacy shelves over the coming weeks will likely face a new hitch: They’ll need a doctor’s prescription, at least for now.

Pharmacies became a key distributor of Covid shots during the pandemic, and many Georgians are used to getting annual flu and Covid shots there.

But uncertainty about how the federal government is regulating the newest Covid shots, which have been updated for the 2025-26 season and are starting to arrive in stores, has created a new wrinkle in that process.

Many pharmacies in Georgia said they will require a prescription for the shot until an influential federal committee meets and makes firm recommendations on who should get the vaccine, expected in September. Those pharmacies include CVS, as well as independent drugstores.

“Everyone will need a [prescription] until ACIP makes a recommendation,” said Dr. Johnathan Hamrick, a member of the board of directors of the Georgia Pharmacy Association who formerly taught pharmacy law at Mercer University and practices in metro Atlanta.

His colleague, Dr. Jonathan Marquess, who owns independent pharmacies and serves as vice president of the Academy of Independent Pharmacy for the state pharmacy association, agreed.

CDC panel’s actions could decide access to shots

All eyes are on ACIP: the Advisory Committee on Immunization Practices. It develops policies on vaccination in the United States as part of the Centers for Disease Control and Prevention. It’s set to meet Sept. 18 and 19 in Atlanta.

The committee’s policies help govern how pharmacists in Georgia and many other states administer vaccines.

Under Georgia law, if ACIP has approved a vaccine, pharmacists can typically administer it, as long as they have an agreement with a supervising doctor, which most pharmacies do.

Sorting out Covid vaccine confusion: New and conflicting federal policies raise questions

If ACIP votes to recommend the Covid vaccine for certain or most populations in the United States, that would allow pharmacists to go back to providing the shots without a prescription, Hamrick said, although how that will work for different age groups and categories of people will depend on the exact details of the new recommendations.

It’s not clear how the committee will vote. Robert F. Kennedy Jr., secretary of the Department of Health and Human Services who has disrupted the vaccine system, dismissed the committee’s 17 members in June and appointed eight of his own picks, seven of whom remain.

Kennedy’s actions have drawn criticism and even lawsuits from professional medical societies, including the American Academy of Pediatrics and the Infectious Diseases Society of America. Medical professionals and public health experts have raised concerns that the committee will curtail its recommendations for the vaccine to only certain populations, stymieing widespread access.

This week, the Food and Drug Administration approved the latest version of the shot, but with more restrictions on who should get it than last year, raising questions about access. But Georgia pharmacists, and many others, are waiting to see what the ACIP does in September.

“That’s what we’re all waiting on,” Hamrick said.

Marquess, who owns several independent pharmacies in Georgia, said he has ordered the shots and expects them in soon.

In Georgia, as of last week, about 1.6% of emergency room visits were due to Covid, according to the latest data from the CDC, the highest rate since this time last year. And wastewater Covid levels have ticked up in Georgia from “very low” in mid-July to “moderate” as of last week, according to CDC data.

Many older people embrace vaccines. Research is proving them right.

“Immunizations have been proven to be safe and effective and healthy to keep people [from getting] those terrible diseases,” Marquess said. During the most recent Covid season, from fall 2024 to spring 2025, only about 16% of Georgia adults got at least one shot, according to the CDC.

CVS, which has over 300 pharmacy locations in Georgia, has started receiving the new shots in stores, spokesperson Amy Thibault said. She did not directly answer a question about whether the chain had ordered fewer shots than last year but said it would have “ample supply” to meet the need.

People with a prescription will be able to get the shots at drugstores or at one of the company’s nearly 50 MinuteClinic locations in the state, Thibault said.

Representatives from Publix and Walgreens did not immediately respond to requests for information on how they are handling the shots.

To be determined: insurance coverage for shots

Marquess said the pharmacists who work for him would typically be willing to put in a quick call to a patient’s doctor to get the needed approval, obviating the need for an office visit.

Thibault of CVS said it would vary by location as to whether pharmacists would call a patient’s doctor for them, or the patient would need to reach out directly.

“It makes it much simpler for the whole medical system if we can utilize our protocol and not call every time to get a prescription,” Marquess said.

Hamrick said it’s unclear how insurers will handle the cost, though they typically cover the shots recommended by ACIP.

The latest Covid vaccine will cost about $225 out-of-pocket at CVS stores, Thibault said.

‘I hope this is a tipping point’: 3 CDC leaders walk out over RFK Jr. policies

The updated vaccines are not yet available at county health departments, said Georgia Department of Public Health spokesperson Eric Jens. He said each county’s health department places its own orders, “typically based on need.”

“Covid vaccinations are administered at public health departments by nurses working under protocols established by DPH. DPH does not require a prescription for Covid vaccines,” Jens said. “At this time, DPH does not know what the cost of the updated Covid vaccine will be for individuals without insurance.”

Much of the confusion could be resolved when ACIP meets next month. But turmoil at the CDC, including the ouster of newly appointed Director Susan Monarez and the resignation of four senior officials citing political interference in the vaccine process, could affect the meeting.

U.S. Sen. Bill Cassidy, a Louisiana Republican who cast the deciding vote to confirm Kennedy as HHS secretary, this week called on ACIP to “indefinitely delay” its meeting.

“Serious allegations have been made about the meeting agenda, membership, and lack of scientific process being followed,” Cassidy said. “If the meeting proceeds, any recommendations made should be rejected as lacking legitimacy given the seriousness of the allegations and the current turmoil in CDC leadership.”

No matter what ACIP does, Georgia pharmacists may have a legal pathway to providing the shots without an individual prescription “under Georgia law pursuant to vaccine protocol agreements,” said Greg Reybold, general counsel and vice president of public policy for the American Pharmacy Cooperative.

Meanwhile, the pharmacists voiced concerns that people are growing tired of hearing about the politics of vaccines and confused by the dizzying array of policy changes.

“We have to untie health care from the politics,” Hamrick said.

“Less outbreaks, less severe complications, less hospitalizations, less death,” Hamrick said. Vaccines “keep people in the population healthier in the long run.”

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

It’s peak bug season in New York: Covid, measles, mosquitoes are thriving

2025-08-29T19:40:14+00:00

Before we begin, I want to touch on some news we received late Wednesday — Centers for Disease Control and Prevention Director Dr. Susan Monarez was abruptly removed, just weeks after the Senate swore her in. Immediately following, three of CDC’s most senior leaders (Drs. Deb Houry, Daniel Jernigan, and Demetre Daskalakis) resigned in protest, citing increased political interference. (You can read Demetre’s powerful resignation letter here.)

This type of leadership implosion at the CDC is not normal. And it definitely widens the vacuum in federal public health guidance that’s been growing over the past year. This instability at our nation’s top public health agency should concern us all. It raises questions about whom we should turn to in the face of health threats, whether it’s seasonal respiratory viruses or the next pandemic. I’m still wrapping my head around this, but I’ll be back with updates as it further unfolds.

For now, let’s get back to this week’s dose.

It’s peak bug season and Covid-19, measles, and mosquitoes are thriving across the state. But it’s not just the bugs: Recent events, from a tragic bus crash in upstate New York to the close of a Legionnaires’ outbreak, show how fragile our systems can be, and how directly that fragility impacts our health.

Here’s what you need to know this week.

Covid-19 ‘weather report’ and an update on fall vaccine availability and FDA approval

All regions of New York show that Covid-19 hospitalizations are elevated. Hospitalizations are still substantially lower than they were this time last year, but are increasing. Given what’s happening in other states, like Florida and Hawaii, we expect increases to continue.

New York City Covid-19 hospitalizations across race and ethnicity groups.

Risk is not spread evenly, and these groups are seeing the highest rates of hospitalization:

Central New York and the Finger Lakes have the highest rates, when adjusting for population.
75 and older age group has higher rates according to data we have in New York City. (We expect it to be the same elsewhere.)
Hispanic and Latino people have about twice the rate of hospitalization compared to white people. This likely reflects longstanding structural inequities, including greater exposure to risk (from factors such as relying on public transportation or working in more public-facing jobs), more crowded housing, and limitations in health care access, rather than differences in underlying health alone.

What does this mean for you? The best thing to do is wear a mask in crowded indoor areas. I’m going to wear one on the train and at the airport, for example. The Food and Drug Administration just approved fall Covid-19 vaccines, with some significant changes to who will be eligible. YLE National answered several questions on fall Covid-19 vaccines here.

Reflections on the Legionnaires’ outbreak

First, the good news: the Legionnaires’ outbreak in Central Harlem is ending, with fewer and fewer cases being reported after the identification of contaminated cooling towers.

Now, the bad news: Rarely in public health is something random. This outbreak revealed deep cracks in prevention systems in the area:

Cooling tower monitoring. As I explained a few weeks ago, building owners are legally required to test cooling towers for Legionella every 90 days, and the city aims to inspect each tower at least once per year. But, according to Gothamist, most towers linked to this outbreak were behind on testing and hadn’t been inspected by the city in over a year. And despite increases in funding, the number of inspectors has dropped by more than 30% over the past three years. Enforcement and staffing need attention.
Health equity. Central Harlem, a predominantly low-income and Black neighborhood, has high risk factors for Legionnaires’ disease among residents, like asthma and diabetes. The city should prioritize enforcement and staffing of inspections in Central Harlem and the surrounding areas, in particular.
Climate change. Legionella bacteria thrive in warm climates. We should expect Legionella to become more common with climate change and plan accordingly to stay ahead of it.
Risk communication. In the posts where I covered this outbreak, I tried to communicate that risk was low for most people. However, risk is unevenly distributed, and local communications about the outbreak fell short. Many in Central Harlem feared leaving their homes, and workers said they weren’t given adequate info to keep them healthy. We need timely and transparent communication, including guidance for those at greatest risk, that is grounded in trust and not just broad reassurance.

An outbreak of this size signals that the system failed somewhere upstream. Six people died, and dozens were hospitalized. Everyone deserves to step outside and breathe clean air without fear, regardless of ZIP code.

Mosquito-borne threats: malaria and West Nile

New Jersey, in partnership with the CDC, is investigating a case of malaria in a Morris County resident who may have been infected locally — the patient had not traveled internationally.

For local transmission to occur, two conditions must be met: 1. the right mosquito species (Anopheles), which is commonly found in New Jersey, New York, and most other states, and 2. the malaria parasite itself, which is usually absent here.

If confirmed, this would be big news. Every year, New Jersey reports around 100 malaria cases, almost all among travelers returning from abroad. The last time the state saw a locally acquired case was in 1988. The risk to the public is very low, but public health officials are likely moving quickly to test mosquitoes, treat the patient, and prevent any spread.

The results of mosquito testing will tell us if any local mosquitoes are positive for malaria, but the bottom line is that risk is very low. The best thing you can do is avoid mosquito bites:

Wear repellent (DEET, picaridin), especially at dawn and dusk.
Wear long sleeves.
Dump standing water around your home.

Conveniently, the same recommendations apply for preventing West Nile virus. On that note, the first two human cases of West Nile virus in New York City this year were detected in Queens last week. Now’s the time to break out that repellent!

Tragic Erie bus accident and blood supply

On Aug. 22, a tour bus returning from Niagara Falls overturned on Interstate 90 near Pembroke, killing five adults and injuring dozens. Hospitals quickly drew on local blood supplies, prompting ConnectLife, the area’s primary blood bank serving Erie County Medical Center and Kaleida Health hospitals, to issue an emergency appeal for blood donations.

Smaller cities often lack the blood reserve capacity of large, urban centers. This means mass casualty events can drain the supply overnight, especially for rare blood types or platelets, which have shorter shelf lives. While the emergency need for blood following this accident has likely passed, it’s a sobering reminder that routine blood donations are critical for ensuring readiness for unexpected medical crises.

Here’s where you can donate blood:

New York City: New York Blood Center.
Rest of New York state: American Red Cross Blood Donation Centers.

Measles in New Jersey

The New Jersey health department confirmed a measles case in Hudson County, linked to contact with a case from outside the state. Key details remain unclear:

Did the exposure/transmission occur in a public place?
Was the non-N.J. resident case associated with international travel or the result of domestic transmission?
Was either patient vaccinated?

What we do know: The Hudson County case rode PATH and the light rail during commuting hours while potentially infectious. Anyone on those routes may have been exposed. If you are fully vaccinated for measles, you are well protected. If you develop symptoms, contact your health care provider before arriving in person at the doctor’s office.

What else to know this week

Coming up: Free back-to-school vaccine clinics in Buffalo

The Erie County Department of Health is partnering with the University of Buffalo School of Nursing to provide free back-to-school vaccine clinics for Buffalo public school students. These free clinics are taking place as follows:

Sept. 12, 10 a.m.-2 p.m. at the Buffalo Public School 95 Waterfront, 95 Fourth St.
Sept. 18, 2 p.m.-6 p.m. at the Buffalo Public School 309 East Community High School, 820 Northampton.
Sept. 19, 2 p.m.-6 p.m. at the Buffalo Public School 363/415 Lewis J. Bennett/Middle Early College, 2885 Main St.

The vaccines offered include all required school immunizations: DTap/DTP/Tdap/Td; polio; MMR, hepatitis B, varicella, meningococcal, Hib, and PCV (pneumococcal). Students must be up to date on vaccines by Sept. 17 to remain in school, as required by New York State Public Health Law 2164.

Bottom line

From Covid and measles to malaria, Legionnaires’, and even blood shortages, this week’s headlines share a theme: Local preparedness matters. Global diseases, chronic inequities, and unexpected crises all land in our neighborhoods. Staying healthy depends on how much our systems — and our communities — are ready to respond.

Love,

Your NY Epi

West Nile virus, Covid, hand foot and mouth disease in New York — and tragedy at CDC

2025-08-15T16:00:00+00:00

This week’s dose is heavier than usual. I’ll cover the typical summer health updates (West Nile virus, Covid, and algal blooms) but am also sharing some reflections on the tragedy at the Centers for Disease Control and Prevention last week: a mass shooting. As a former CDC employee, this one shook me.

But before we jump in, we’re hiring! If you or someone you know is passionate about public health communication, apply here for our Managing Editor position.

West Nile Virus is being detected across New York state

We continue to see West Nile virus pick up across New York, which is typical for this time of year. This week, mosquitoes tested positive in Erie, Nassau, Onondaga, Rockland, Suffolk, and Westchester counties. In New York City, mosquitoes carrying the virus were found in all five boroughs. New York, Richmond, Bronx, Queens, and Kings counties also reported positive mosquitoes. A small number tested positive for Eastern Equine Encephalitis virus, which is rare but more dangerous than West Nile.

New York counties are ramping up mosquito control. Many have conducted or plan to conduct aerial insecticide spraying, where a plane disperses chemicals to kill mosquitoes or prevent breeding. (You can check your local health department website for local schedules.) Recent or upcoming events include Cattaraugus County (Aug 17–23), Onondaga County (last week), and New York City (Brooklyn and Queens this week).

If spraying is scheduled in your community, you can reduce exposure to chemicals by:

Staying indoors
Bringing pets inside
Closing windows

Covid continues to increase, though slowly

Due to delays on the CDC wastewater dashboard, most New York sites aren’t reporting public wastewater data, so I’m focusing on clinical data to understand trends in Covid activity.

All regions of New York, except for Mohawk Valley and North Country, show that Covid hospitalizations are increasing. Hospitalizations are still substantially lower than they were this time last year.

New York state Covid-19 hospitalizations.

If you are feeling sick and take an at-home rapid test, make sure to check the expiration date. Many tests had their expiration dates extended, but they are now approaching those dates. This guide by the North Carolina Department of Health has good instructions on how to check.

Reflections on the tragic CDC shooting

It was the last day of the summer course. The culmination of a month of daily, intensive training for this year’s class of Epidemic Intelligence Service Officers, a program I went through myself. EIS officers are CDC disease detectives, trained to investigate and respond to outbreaks and other urgent public health threats in the United States and around the world. Instead of celebrating, they spent hours sheltering in place on the CDC’s campus as a single shooter sent over 180 rounds of bullets into the windows of four buildings. Many are now afraid to even display their CDC parking decals on their cars for fear of being targeted in public.

There have been more than 260 mass shootings this year in the United States, nine of them in New York, and the effects of each one ripple across individual lives and entire communities. This week, I’m worrying about the long reach of this attack on my friends and colleagues at the CDC and on our entire public health system.

I have more questions than answers. Who will pick up the torch in the next pandemic if our frontline people burn out or leave? Where does this leave us in 10 or 20 years, or in the wake of another health emergency? Why is health leadership so silent on this? What does it say about our country if our government employees are afraid to go to work?

For those in public health here in New York, or elsewhere, I see you. You aren’t alone. Feel free to drop a comment or directly reply to this email; let’s process it together. For everyone else, check in on your people in public health. Thank them for their service.

I’m also donating to the fund for the family of the officer who lost his life protecting the CDC from the shooting. You can join me here: https://give.cdcfoundation.org/give/715122#!/donation/checkout.

What else you need to know this week

Algal blooms: Some New York freshwater beaches — like Sylvan Beach, Verona Beach Park, and Oneida Shores — were closed this week due to harmful algal blooms. These blooms, caused by overgrowth of blue-green algae (cyanobacteria), can cause skin rashes, stomach upset, or more serious illness if swallowed or inhaled. Before swimming at lakes or ponds, check local advisories, and pay attention to posted signs. If you or your pet were exposed, rinse off really well and seek medical care if symptoms develop.

Rabies vaccine campaign in Erie County: From Aug. 13 to 23, the U.S. Department of Agriculture will be dropping fish-scented bait packets containing oral rabies vaccine across Erie County by helicopter. When raccoons and other animals eat the bait, they become immunized against rabies. If you find a packet, don’t touch it. If you must handle it, wash your hands immediately. Keep an eye on kids and pets when outdoors during distribution, and keep pets leashed to keep them from eating the bait. See the distribution map here.

Rabies vaccine bait.

Hand, foot, and mouth disease in New York: Some doctors in New York are reporting that this year is an exceptionally bad year for hand, foot, and mouth disease. So if you feel like this is tearing through your kid’s daycare or preschool, you aren’t alone. HFM is a super common and very contagious virus that mainly affects children under 5. It’s usually mild, but symptoms can include fever, mouth sores, and skin rash. There isn’t a ton to be done about it. The best things to do are to keep things clean (wash hands and surfaces) and talk to your child’s health care provider if they develop symptoms.

Bottom line

This week we’re reminded of how vulnerable public health can be, and how much it relies on people who care about it deeply. If you are in public health, know that we are with you and are so so grateful for your work. If you’re not in public health, it’s a good time to check in on those who are.

Love,

Your NY Epi

Run. Hide. Fight. What the CDC shooting means for public health

2025-08-10T18:49:40+00:00

This is a guest essay for Healthbeat. Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

I had an unusually long and emotionally challenging day in my clinic on Friday. When I broke the news to a patient that he had advanced HIV and that his sore throat was due to complications of AIDS, he began crying, terrified that he might die at any moment. A counselor and I sat next to him, trying to comfort him. As I looked into his eyes, tears forming in mine, I kept repeating, “We’re here for you. We’re going to protect you.”

At 5:30 p.m., I opened my phone and saw hundreds of messages in a private forum for current and former CDC employees. A man had fired bullets into several Centers for Disease Control and Prevention buildings. Colleagues were asking for help as they hid under their desks, sharing pictures of bullet holes in their office windows. There was praise and sadness for the slain police officer. There was anger, sorrow, and fear about the future of their work and their organization.

After that long day in clinic, I found it hard to summon either surprise or grief. All I could think was, “Just what I expected. I wonder which health department will be targeted next.”

Public health workers bound by commitment to help people

I worked at CDC for 20 years and had the privilege of serving my country as a United States Public Health Service officer at the national and local level in the United States, and in Asia and Africa. The most enduring lesson I learned from public health officials everywhere was that we were bound by common values.

From village health volunteers to ministers of health, there was a shared commitment to making other people’s lives better, helping friends and neighbors live healthier, safer, and longer lives. In doing so, we were helping to protect each other, advance justice, and increase economic opportunity.

We often disagreed about data, methods, and policies, sometimes vehemently, but those disagreements always took place within the framework of those common principles.

Covid brought backlash against public health

When Covid emerged, many of us hoped it would be a 9/11 moment for public health. Public health workers fight threats that are invisible: microbes, pollutants, metabolic diseases. There are no bumper stickers that say, “Thank you for protecting me from a disease I did not even know I was at risk of getting.”

We hoped Covid would help the public, media, and government recognize public health as public safety, as important as police, fire, and the military. We hoped it would trigger long-term investment in staff and systems, as happened with homeland security after 9/11.

The opposite happened. People lost agency over their lives, lost jobs and businesses, and endured physical and mental health harms. Instead of blaming the virus — and the ways we failed to protect against pandemics — many chose to blame the virus-control measures. Pandemic response critics rose to prominence by arguing that public health workers were motivated not by service and beneficence, but by fame, power, and money.

As a prominent public health official during Covid, I became inured to threats. Some came from anonymous social media accounts. Others happened in person. After an outdoor community meeting in fall 2020, a man followed me down the street, shouting obscenities and yelling in my face, “I hope your kids all get Covid and die, and then you do too.”

The hostility has not abated. Before he took office, the current Health and Human Services secretary declared that the CDC and public health agencies were corrupt. This past week, he said mRNA vaccines — the very vaccines recommended by the CDC and local public health agencies and received by over 200 million Americans — are now proven to be dangerous.

The man who shot at the CDC offices in Atlanta and killed a police officer, according to media reports, believed this, as well. He blamed vaccines for his ill health and sought vengeance on those he thought had harmed him.

I think the CDC attack felt unsurprising because all of us in public health have been under constant threat for almost five years. Just two months ago, I received an email that read: “You’re going to be targeted on June 27. Good riddance.”

Run. Hide. Fight.

CDC colleagues told me that the message they received on Friday was the same one now used in all active shooter scenarios: “Run. Hide. Fight.”

Many have chosen to run. Even before this year’s budget cuts, 20% to 30% of public health jobs were unfilled. Almost every county public health officer in California left during or after the peak of the Covid pandemic. Those of us in public health have skills valued in other sectors. We can make more money in industry or health care. We can live calmer lives in academia.

Others remain in public health but feel the need to hide. At social events, they obscure the name of the agency they work for, or avoid saying they work on infectious diseases, vaccines, or other contentious issues. One message sent to CDC staff this weekend instructed them to remove parking decals that say “CDC.” U.S. Public Health Service officers have been asking if they should now wear only civilian clothes.

Public health officials are choosing to fight

The third option is to fight. Public health has always struggled to build a strong constituency. Now, with attacks greater and more public than ever, there is no choice but to fight back.

CDC alumni have protested program cuts and vaccine policy changes, and have briefed elected officials to defend the agency. A new organization, Defending Public Health, is training advocates to speak up in communities, on social media, and with elected officials.

Many in public health cannot fight openly. They work for agencies that limit their ability to speak. They have families to protect. But those of us who can fight need to be present on every social media channel, in every community group, and at every civic event possible: town councils, school boards, boards of health, elected official town halls.

We need to share our personal stories and our values. We need to remind people that our work is to promote health and longevity. It may take decades of organizing to rebuild trust and create a lasting constituency. But the only way that will happen is if we keep sending the same message: “We’re here for you. We’re going to protect you.”

Emory University contract cut in Trump administration’s mRNA vaccine research ‘wind-down’

2025-08-08T19:16:28+00:00

Public health, explained: Sign up to receive Healthbeat’s free Atlanta newsletter here.

A research project at Emory University is among the 22 grants and contracts that are being cancelled as the U.S. Department of Health and Human Services begins a “coordinated wind-down” of research studying mRNA vaccine technology.

The grants, which were being developed under the Biomedical Advanced Research and Development Authority, amounted to nearly $500 million in funding to research projects. According to the agency website, researchers at Emory received $750,000 to develop an inhalable dry powder that could be used to immunize patients against influenza and SARS-CoV-2, the virus that causes Covid-19. Emory University did not respond to a request for comment.

Vaccines using mRNA were first developed by Pfizer-BioNTech and Moderna in response to the Covid-19 pandemic, and won a Nobel Prize in Physiology or Medicine in 2023. While traditional vaccines can take years to develop, mRNA vaccines can be developed much faster, and can be more quickly adapted in response to virus mutations.

However, U.S. Health Secretary Robert F. Kennedy Jr. — who has repeatedly questioned the safety and efficacy of vaccines and promoted widely debunked claims about vaccine harm — claimed that the Trump administration was terminating the grants because mRNA vaccines “fail to protect effectively against upper respiratory infections like Covid and flu.”

In axing mRNA contracts, Trump delivers another blow to U.S. biosecurity, former officials say

“We’re shifting that funding toward safer, broader vaccine platforms that remain effective even as viruses mutate,” he said in a Tuesday announcement. Research contracts with companies like Luminary Labs, ModeX Therapeutics, and CSL Seqirus are also being cancelled.

The most recent round of grant terminations comes on the heels of a nearly $600 million contract with Moderna aimed at developing a vaccine against bird flu that was cancelled by the Trump administration in May.

Public health experts, including state Rep. Michelle Au, a Johns Creek Democrat, condemned the decision to terminate the grants.

“Many preventable diseases will not, in fact, be prevented,” she said. “We will see the result of many chronic health conditions resulting from preventable disease, and those effects are going to last decades. This is a generational change in how we approach vaccine support and funding, not just in this country, but worldwide.”

Georgia’s current childhood vaccine rates are also far below the 95% rate needed to ensure herd immunity from measles, mumps and rubella, according to data from the Centers for Disease Control and Prevention. Only 88.4% of kindergarten students in Georgia received the MMR vaccine during the 2023-24 school year.

Au, who works as an anesthesiologist, also warned of the harm that could await future patients due to vaccine research cuts.

“We’re only starting to scratch the surface of the damage that we’re going to see,” she said. “When you stop research in its tracks like this, even if you say, ‘oh, maybe we’ll restore the cuts in the future,’ these are harms that will carry through even beyond what the immediate funding cuts generate.”

This story was originally published at Georgia Recorder.

Sorting out Covid vaccine confusion: New and conflicting federal policies raise questions

2025-08-04T13:32:07+00:00

Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

If you want a Covid-19 shot this fall, will your employer’s health insurance plan pay for it? There’s no clear answer.

Health and Human Services Secretary Robert F. Kennedy Jr., a longtime anti-vaccine activist, has upended the way Covid vaccines are approved and for whom they’re recommended, creating uncertainty where coverage was routine.

Agencies within HHS responsible for spelling out who should get vaccinated aren’t necessarily in sync, issuing seemingly contradictory recommendations based on age or risk factors for serious disease.

But the ambiguity may not affect your coverage, at least this year.

“I think in 2025 it’s highly likely that the employer plans will cover” the Covid vaccines, said Jeff Levin-Scherz, a primary care doctor who is the population health leader for the management consultancy WTW and an assistant professor at Harvard’s T.H. Chan School of Public Health. They’ve already budgeted for it, “and it would be a large administrative effort to try to exclude coverage for those not at increased risk,” he said.

With so much in flux, it’s important to check with your employer or insurer about coverage policies before you roll up your sleeve.

Here’s what we know so far, and what remains unclear.

How have the recommendations changed?

What used to be straightforward is now much murkier. Last year, the Moderna and Pfizer-BioNTech Covid vaccines were recommended for anyone at least 6 months old.

This year, the recommendation by the Centers for Disease Control and Prevention is narrower. Although the vaccines are broadly recommended for adults 19 and older, they are no longer recommended for healthy pregnant people or for healthy children 6 months through 17 years old.

Kennedy announced the changes in a video in May, citing safety risks for young people and pregnant people as justification.

But his claims have been widely disputed by experts in vaccines, pediatrics, and women’s health. An analysis by FactCheck.org found that the secretary “misrepresented scientific research to make unfounded claims about vaccine safety for pregnant people and children.”

What RFK Jr. isn’t talking about: How to make vaccines safer

In addition, recently announced changes to the vaccine approval framework have further chipped away at eligibility.

Moderna announced July 10 that the Food and Drug Administration had fully approved its Spikevax Covid vaccine — but approval is restricted to adults 65 and older, and for people from 6 months through 64 years old who are at increased risk of developing a serious case of Covid.

Two other Covid vaccines expected to be available this fall, Novavax’s Nuvaxovid and Moderna’s mNexspike, are also restricted. They are approved for people 65 or older and those 12 to 64 who have underlying health conditions that put them at higher risk of developing severe Covid.

Notably, Pfizer’s Comirnaty Covid vaccine is still approved or authorized for people 6 months of age and older without any restrictions based on risk factors for Covid — at least for now. But the FDA could change that at any time, experts said.

Increasing restrictions “is definitely the direction they are moving,” said Jen Kates, a senior vice president at KFF who authored a KFF analysis of vaccine insurance coverage rules. KFF is a health information nonprofit that includes KFF Health News.

HHS did not provide an on-the-record comment for this article.

How might these changes alter my insurance coverage for the vaccine?

That’s the big question, and the answer is uncertain. Without insurance coverage, people could owe hundreds of dollars for the shot.

Most private health plans are required by law to cover recommended vaccines, whether for Covid, measles, or the flu, without charging their members. But that requirement kicks in after the shots are recommended by a federal panel — the Advisory Committee on Immunization Practices — and adopted by the CDC director, according to the KFF analysis. The committee hasn’t yet voted on Covid vaccine recommendations for this fall. Its next meeting is expected to occur in August or September.

Still, employers and insurers can opt to cover the vaccines on their own, as many did before the law required them to do so. But they may require people to pay something for it.

In addition, the narrower recommendations from different HHS agencies might result in some health plans declining to pay for certain categories of people to get certain vaccines, experts said.

“I don’t think an employer or insurer would deny coverage,” Kates said. “But they could say: You have to get this product.”

That could mean a 45-year-old with no underlying health conditions raising their Covid risk might have to get the Pfizer shot rather than the Moderna version if they want their health plan to pay for it, experts said.

In addition, up to 200 million people may qualify for the vaccines because they have health conditions such as asthma or diabetes that increase their risk of severe disease, according to a commentary published by FDA officials in the New England Journal of Medicine.

Health care professionals can help people determine whether they qualify for the shot based on health conditions.

Tina Stow, a spokesperson for AHIP, which represents health plans, said in a statement that plans will continue to follow federal requirements for vaccine coverage.

What are the options for people who are pregnant or have children they want to have vaccinated?

Many parents are confused about getting their kids vaccinated, according to a KFF poll released on Friday. About half said they don’t know whether federal agencies recommend healthy children get the vaccine this fall. Among the other half, more said the vaccine is not recommended than recommended.

Meanwhile, Kennedy’s recommendation that healthy children not get vaccinated has a notable caveat: If a parent wishes a child to get a Covid vaccine and a health care provider recommends it, the child can receive it under the “shared clinical decision-making” model, and it should be covered without cost sharing.

Many older people embrace vaccines. Research is proving them right.

Some policy experts point out that this is the way care for kids is typically provided anyway.

“Outside of any requirements, vaccines have always been provided through shared decision-making,” said Amanda Jezek, senior vice president of public policy and government relations at the Infectious Diseases Society of America.

There’s no similar allowance for pregnant people. However, even though Kennedy has stated that Covid vaccines are no longer recommended for healthy pregnant people, pregnancy is one of the underlying medical conditions that put people at high risk for getting very sick from Covid, according to the CDC. That could make pregnant people eligible for the shot.

Depending on the stage of someone’s pregnancy, it could be difficult to know whether someone should be denied the shot based on their condition. “This is uncharted territory,” said Sabrina Corlette, co-director of Georgetown University’s Center on Health Insurance Reforms.

How will these changes affect access to the vaccine? Will I still be able to go to the pharmacy for the shot?

“If far fewer are expected to be vaccinated, fewer sites will offer the vaccinations,” Levin-Scherz said. This could be an especially notable hurdle for people looking for pediatric doses of a Covid vaccine, he said.

In addition, pharmacists’ authority to administer vaccines depends on several factors. For example, in some states they can administer shots that have been approved by the FDA, while in others the shots must have been recommended by the ACIP, said Hannah Fish, senior director of strategic initiatives at the National Community Pharmacists Association. Since ACIP hasn’t yet recommended Covid shots for the fall, that could create a speed bump in some states.

“Depending on the rules, you still may be able to get the shot at the pharmacy, but they might have to call the physician to send over a prescription,” Fish said.

What do these changes mean long-term?

It’s impossible to know. But given Kennedy’s vocal skepticism of vaccines and his embrace of long-disproven theories about connections between vaccines and autism, among other things, medical and public health professionals are concerned those views will shape future policies.

“The recommendation changes that were made with respect to children and pregnant women were not necessarily made in good science,” Corlette said.

It’s already a challenge to convince people they need annual Covid shots, and shifting guidelines may make it tougher, some public health experts warn.

“What’s concerning is that this could even further depress the uptake of the Covid vaccines,” Jezek said.

This story originally published at KFF Health News, Healthbeat’s national reporting partner.

New York health update: gun violence in Midtown, increasing Covid, and Legionella

2025-07-31T19:00:00+00:00

It’s been a tough week in New York City. In this post, I break down the latest on gun violence, Covid trends across the state, and a new cluster of Legionnaires’ disease. Here’s what you need to know.

A mass shooting in New York City

Tragically, four New Yorkers lost their lives last Monday when a man opened fire in an office building in Midtown, New York City. My heart goes out to the families of those lost, and the New York Police Department, which lost an officer.

I was only 10 blocks away, getting ready to watch an outdoor movie, when alerts and frantic texts began. I became acutely aware of how crowded the plaza I was in was, heard helicopters overhead, and nervously checked my phone and scanned the crowd. I was fine, but scared the rest of the evening.

When I think about the context of last week’s tragedy, I’m left feeling profoundly confused, and frankly, angry. In a state with some of the strictest gun laws and lowest firearm mortality rates, in a city with declining gun violence and increasing removal of firearms from the streets, in an office building with security guards and bulletproof saferooms, and with the rapid and heroic response of the NYPD, we still had a mass shooting. Guns were brought across state lines. Multiple people died. This system is not working.

Gun violence in New York: the bigger picture

In 2023, the most recent year with complete data, the Centers for Disease Control and Prevention showed that almost 47,000 people died of gun-related injuries in the United States. In 2022, our state’s most recent data, there were 1,044 gun-related deaths in New York state.

The risk of gun violence depends heavily on which state you live in. Despite the recent New York City tragedy, data show that population-adjusted shootings are actually lower in New York compared to most other states.

But even at ~5 deaths per 100,000 people, the state loses roughly three New Yorkers to gunfire every day — far too many. And, while our rates are low relative to most other states, gun violence in New York state has increased in recent years.

While the New York state data reported to the CDC is delayed, early New York City data for 2025 show that gun violence is down this year compared to last. From January–May 2025, New York City recorded 264 shootings and 112 murders, while the NYPD removed more than 2,265 illegal guns off the streets. At this point, it’s hard to tell what the trend for New York state looks like over the past two years, but I’ll be back with updates when data is released.

What New York has done

Many attribute lower gun-related mortality in New York to our strict gun laws — some of the strictest in the country.

Since 1993, universal background checks have been in place to obtain a firearm in New York.
“Red flag” laws were instituted starting in 2019, which allow judges to temporarily suspend a person’s access to firearms with credible evidence that they might be dangerous to themselves or others. (Evidence can include information from family members, doctors, teachers, or other community members.)
Permits are required in New York to carry a handgun, and the state prohibits magazines holding more than 10 rounds of ammunition.

While these policies likely affect firearm death and injury in New York, attributing causation for these lower death rates is complex.

Did CTE play a role in the shooting?

The short answer is that we don’t know. CTE (chronic traumatic encephalopathy) is a brain disease caused by repeated head trauma, seen most often in athletes and military veterans. It’s linked to impulsivity, depression, cognitive impairment, and suicidal thoughts. The gunman in the recent tragedy claimed he had CTE from football. Because CTE can only be diagnosed after death during a brain autopsy, it is notoriously hard to study. We need further scientific research, especially because it’s been connected to other violent incidents.

There are resources available for those with suspected CTE:

CDC’s Heads Up Program and the Concussion Legacy Foundation HelpLine can provide resources to those at risk of or struggling with brain injury.

Aftermath and action

We talk about gun violence and mass shootings as public health issues because of their impact. Beyond immediate loss of life, they leave lasting and damaging effects on communities. Four years after the 2017 Las Vegas attack, 63% of surveyed survivors still met the criteria for post-traumatic stress disorder, and half had major depression. Today, a third of American adults say that fear of mass shootings prevents them from going to certain places or events. In 2025, there have already been 253 mass shootings across the country.

From a public health perspective, I think we need two things:

Better science. We need clearer data on CTE’s causes, diagnosis, and treatment.
Policy action. We need coordinated gun laws. As long as we have a patchwork of policies, guns will continue to move across state lines.

I’ll be calling my congressional reps this week to let them know how I feel. Find your local reps’ contact information here.

Also know that there are resources to support those who have experienced gun violence. The Sandy Hook Promise provides guidance and mental health resources for those coping with shootings.

Covid-19 is increasing in New York

Wastewater data is showing that Covid-19 is increasing in New York City and across the state, though on average levels remain low.

Concentrations of Covid-19 in wastewater in New York state.

The most recent data show hotspots in Suffolk and Nassau counties, where wastewater activity levels are very high and high, respectively.

Covid-19 hospitalizations also continue to increase, though they are still at pretty low levels.

Covid-19 hospitalizations in New York state.

Cluster of Legionnaires’ disease in Central Harlem

Last week, health officials quickly identified a cluster of Legionnaires’ disease in Central Harlem. So far, 22 people have been diagnosed across five ZIP codes: 10027, 10030, 10035, 10037, and 10039.

The cluster was identified using a super cool surveillance software that scans New York City’s health data daily. It looks for unusual spikes or patterns and alerts public health officials of any signals. You can think of it like a smoke detector, signaling when something changes so officials can investigate further.

Legionnaires’ disease is a serious lung infection caused by the Legionella bacteria. It spreads when people breathe in mist or small droplets that contain the bacteria, not through person-to-person contact or by drinking water. Common sources include cooling towers (which we have a lot of in New York City), hot tubs, and showers. This is not an issue with any residential building’s plumbing system. it’s safe for you to drink water, bathe, shower, cook, and use your air conditioner.

Most people exposed to Legionella bacteria will not get sick. But some groups are at higher risk for severe illness, especially:

Adults age 50 or older
People who smoke or who have chronic lung disease
Those with weakened immune systems
People taking medications that suppress the immune system

Symptoms can look like the flu: fever, cough, muscle aches, or shortness of breath. If you’ve spent time in the affected areas since late July and have any of these symptoms, seek medical care right away. Early treatment can prevent more serious complications.

The next steps for the city are to keep investigating the cluster and try to find the source. They have started testing cooling water towers for Legionella in the area. If they find a positive hit, they’ll remediate by intensely cleaning it to remove the bacteria.

Bottom line

That’s it for this week. As always, stay safe, stay healthy, and take care of each other. I’ll see you next week.

Love,

Your NY Epi

NY health update: West Nile virus, Covid uptick, air quality after congestion pricing

2025-07-25T13:11:25+00:00

It’s never a dull week in the world of New York public health. This week we’re reporting on the first West Nile Virus cases of the season, increasing Covid-19 levels in New York City, measles in New Jersey, the first peek at air quality data from congestion pricing, and celebrating a couple of public health wins. Let’s jump in.

West Nile Virus in humans in upstate New York

This week, New York state confirmed its first two human cases of West Nile Virus in 2025, reported in Erie and Onondaga Counties. While the numbers are still low, it’s an early sign the season is heating up.

Mosquito surveillance also found two new WNV-positive mosquito pools (groups of mosquitoes “pooled” for testing) in Rockland and Suffolk Counties.
New York City has reported 52 WNV-positive mosquito pools so far (including Richmond, the Bronx, and Queens).
There have been no WNV detections in horses or blood donors.

Mosquitoes in New York can also carry the virus that causes Eastern Equine Encephalitis, which is rarer and usually more serious than WNV. So far in 2025, they have only detected EEE in mosquitos in Onondaga County.

While risk to the general public remains low, now’s the time to double down on prevention. WNV and EEE are spread by mosquitoes — not people — so it’s all about bite protection:

Wear repellent (DEET, picaridin), especially at dawn and dusk. If you are using sunscreen, apply sunscreen first and insect repellent second.
Cover up: Wear long sleeves if it’s not too hot.
Dump standing water (think flower/plant saucers, buckets, fountains, toys that have been sitting outside, etc.) to eliminate mosquito habitats.

COVID is increasing in New York City

Wastewater data is showing that Covid-19 is starting to increase in New York City, signaling that the summer surge is underway.

New York City average Covid-19 wastewater concentrations.

On average, Covid-19 levels remain low across the rest of the state.

Wastewater Covid-19 concentrations in New York state.

We are noticing some hot spots though. Onondaga County has a very high Covid-19 wastewater level, while Warren County is high. And we’re starting to see this reflected in the increasing number of hospitalizations in New York. The good news is that they are still relatively low.

Update on New Jersey measles

The New Jersey health department is now reporting two measles cases in the state, though they are unrelated to each other. The cases are in Ocean County (which we highlighted last week) and in Hudson County.

Anyone who visited the following locations during the specified times may have been exposed. Potentially exposed people should contact a healthcare provider if they develop any measles symptoms, which usually start like a cold and progress to a rash.

If you do develop symptoms, it’s important to call your doctor or clinic before you visit in person so special precautions can be taken to prevent further spread. Reminder—if you are fully vaccinated, you are well protected.

Initial look at air quality following congestion pricing

Congestion pricing in Manhattan has been in effect since January. (We wrote about it here.) Last week, a report shared a first look at air quality data since the program’s start.

The report looked at data for fine particle air pollution (PM2.5) from locations inside and outside the tolling zone, three months before the tolling started (from October to December 2024) and three months after tolling began (from January to March 2025).

PM2.5 is important to track because long-term exposure increases risk of lung and heart disease, and short-term exposure increases risk of asthma.

Inside the zone: PM2.5 held steady or ticked down.
Outside the zone: Most monitors mirrored that trend, suggesting traffic — and pollution — aren’t simply shifting elsewhere. The lone exception, Hamilton Bridge, registered a rise even though traffic counts barely budged, so the cause remains unclear.

The initial data look good, but it’s for a short period of time, and PM2.5 is heavily influenced in the winter by heating and boiler use. We’ll need more data to draw conclusions on how effective this program is at reducing air pollution in New York City.

For some good news, here are some NY public health wins

DuPont settlement

After a decade-long legal battle, the chemical maker DuPont agreed to pay a $27 million settlement to the 3,000-person town of Hoosick Falls for contaminating local drinking water with PFOA, a “forever chemical” linked to cancer that lingers in the body for decades.

The suit began in 2016 when residents of Hoosick Falls found PFOA levels in their blood more than 30 times the national average. PFOA was used to make Teflon at a Hoosick Falls facility.

Following the finding of drinking water contamination, the manufacturing facility was declared a superfund site by the EPA. As part of the remediation, Honeywell and Saint-Gobain (other companies involved) agreed to pay $45 million, including funding the replacement of all drinking water lines in Hoosick Falls. The drinking line replacement was completed this March.

NYC doula program met its goals

New York City Mayor Adams and Health Commissioner Morse announced last week that several milestones had been reached for the NYC Citywide Doula Initiative. The program provides free access to home visits and doula support for moms and parenting families. A doula is a professional, trained childbirth assistant who provides non-medical support.

So far the program has:

Provided doula services to 1,128 new clients in 2024, exceeding its goal of 1,000.
Served 3,245 people over the last three years.
Not had a single maternal death among program participants.
Seen a 25% increase in doula coverage for NYC residents since 2022.
Served a large proportion of women of color, shelter residents, and non-English-speakers.

Families are eligible for free doula services through the program if they live in areas hit hardest by Covid-19 and other health and socioeconomic disparities.

Bottom line

You’re all caught up on New York public health news. See you next week!

Love,

Your NY Epi

How to protect against NYC summer health threats: Floods, mosquitoes, and ticks

2025-07-18T13:33:11+00:00

There’s a ton going on in the world of New York public health. This week we’ll cover measles, Covid, tick bites, and West Nile virus. Let’s dig in.

Flooding in New York

Extreme rainfall early this week paired with old sewer systems caused flooding in parts of New York and New Jersey. Central Park recorded its second-wettest hour in history, with over 2 inches of rainfall in an hour Monday night. Inundated roads and subway lines disrupted transportation. Sadly, two people in New Jersey died after being swept away in a river. The governor issued a state of emergency.

While the waters have since receded, this event once again revealed our community vulnerability to floods, and the need to be prepared. Just last month, the New York City Department of Health identified flooding as a top public health hazard for New Yorkers.

What can we do to prepare for floods in New York?

FloodHelpNY is an online resource hub for New York residents, created through the Governor’s Office of Storm Recovery, the Federal Emergency Management Agency and other partners. Enter your address to assess your specific flood risk.
Sign up for NYC Emergency Alerts or NOAA Weather Radio for notifications.

Flooding is NYC’s most pressing public health threat, new city report says

Be prepared to shelter safely during floods or extreme rain events. Move to higher ground — if you live in a basement apartment, be prepared to move to a higher floor during periods of heavy rain. Never drive or walk through floodwaters - just 6 inches can sweep a person away.

YLE national offered suggestions in a piece this week tied to the floods in Texas.

Measles in Ocean County, New Jersey

New Jersey is reporting a measles case in Ocean County. The health department is investigating the case, but so far there isn’t a ton of information. Contact tracing is underway, and people who may have been exposed are being notified. Potentially exposed individuals, if infected, could develop symptoms as late as July 22.

The recommendation to stay up to date with MMR vaccinations remains the same. New Jersey and New York state departments of health are also urging anyone not fully vaccinated to get the measles vaccine before traveling internationally or to any U.S. region with a measles outbreak.

They recommend:

Being fully vaccinated with the MMR vaccine at least two weeks before departure.
If the trip is less than two weeks away, and the traveler is not immunized, getting one dose of MMR is advised.

As always, consult your medical provider to discuss what’s right for you and your family.

In case you missed it, Katelyn Jetelina and Kristin Panthagani’s YLE National post last week contextualized why public health is raising alarms about record high measles cases in the United States.

Covid still low in New York

We still aren’t seeing much COVID activity in New York—welcome news for the summer! As always, I’ll share updates when I have them.

Tick bites are still very high in the Northeast

The Fordham Tick Index, which measures the risk of being bitten by a tick in the tri-state area (Southern New York, Connecticut, and Northern New Jersey) is 9 out of 10 — very high risk. The index is based on current and historical data from the Fordham’s Biological Field Station in Westchester County, New York.

We see this playing out in emergency department visits for tick bites in the Northeast, which have been higher this year than last.

In New York, we are most concerned about Lyme disease, which is transmitted by black-legged ticks (aka deer ticks). New York reports some of the highest numbers of Lyme disease in the country, with more than 9,000 cases annually. Lyme is found in every region of New York, including urban centers like New York City.

Tick populations have surged in the Northeast. Here’s how to keep you and your pets safe this summer.

Protecting yourself and family means avoiding ticks:

Use repellent that contains 20% or more DEET, picaridin, or IR3535 on exposed skin.
Treat clothing and gear with products containing 0.5% permethrin.
Walk in the center of trails and avoid brushing against tall plants.
Do tick checks after spending time outdoors. For kids, especially check under arms, in and around ears, in the belly button, and in their hair.
Toss your clothes in a hot dryer for 10 minutes to kill any hidden hitchhikers.
Treat dogs for ticks. Dogs are very susceptible to tick bites and may also bring ticks into your home.

If you find a tick attached to your skin, remove it promptly with tweezers and monitor for symptoms. Early treatment is key to preventing severe illness.

Mosquitoes test positive for West Nile virus in NYC

We are in the thick of mosquito season in New York, and we can expect the pests to hang around until about November when temperatures start to drop.

Most mosquitoes do not carry pathogens that can hurt us. Among those that do, the most common is West Nile virus, and even that is relatively rare. In 2024, 100 human cases were reported across New York state, including in New York City. While most people who get West Nile virus won’t show symptoms, the virus can be more dangerous for those who are over 60 years old or have immunocompromising conditions.

In New York City, the virus has been detected in mosquitoes in the Bronx, Queens, and Staten Island so far this season. There have been no human cases. We are still waiting for New York state to post their data and will be back with updates when that happens.

The best thing you can do is avoid mosquito bites:

Wear EPA-approved mosquito repellent outside, especially during peak mosquito activity time: dawn and dusk. If you are using sunscreen, apply sunscreen first and insect repellent second.
Avoid being outside when mosquitoes are most active (the morning and evening) — but this can be really hard.
If it’s not too hot, long sleeves and long pants can protect against bites.
Dump standing water (think flower/plant saucers, buckets, fountains, toys that have been sitting outside, etc.) to eliminate mosquito habitats.

There aren’t any spraying events currently scheduled, but I’ll be back with an update when that happens.

Bottom Line

You’re all caught up with New York health. See you next week!

Love,

Your NY Epi

‘A place of empathy’: Queer mutual aid group helps New Yorkers with disabilities

2025-06-27T15:32:57+00:00

Public health, explained: Sign up to receive Healthbeat’s free New York City newsletter here.

On a spring afternoon, Umi Khokhar found herself standing in the hospital room of a patient she had never met in person. But she knew they had no one else to retrieve supplies from home, and she was there to help.

“They mentioned that they really needed some medication from their house, and that if they didn’t receive this medication, they would have to be in the hospital longer, essentially,” Umi said.

The patient’s health had declined, and regular hospital visits are part of their life with a disability, Umi said. She knew that the patient could not get the medication they needed from the hospital.

So Umi picked up the patient’s keys, went to their house and packed up their medication, books, and art supplies to bring back to the hospital. They also gathered the patient’s dirty laundry and dropped it off at a laundromat.

“I was just coming from a place of empathy and the fact that they said that they didn’t have anyone else they can rely on,” said Umi, a web designer and educator based in Woodside, Queens, who founded Queer Disability Aid.

The group of queer New Yorkers with disabilities offers assistance with unskilled and skilled tasks to other queer people with disabilities. Those they serve reach out through help by filling out a Google form linked in Queer Disability Aid’s Instagram bio.

Volunteers provide help calling doctors, pet sitting, raising funds for mobility supports, grocery shopping, laundry, and other errands. There are times when a volunteer who has a specialized skill will offer that – like give a haircut, for example. QDA reimburses transportation fees for volunteers.

It’s a public health service for a group that is particularly susceptible to chronic illnesses and Long Covid.

People who request services pay if they are able, but usually they are provided for free, Umi said. More than 120 volunteers have spent more than 340 hours helping people since Umi started the group in June 2024. Umi spends 20 to 40 hours a week organizing it all, and sometimes filling requests, too.

Uncertain vaccine access stokes worries about Long Covid

Queer Disability Aid serves a community that is worried about Covid and fears that access to vaccinations will be disrupted under changes implemented by the Trump administration.

Federal health agencies are narrowing vaccination recommendations, pushing drugmakers to perform clinical studies, and making other changes that could limit who gets booster shots. Hundreds of people in the United States still die of Covid every week.

Even though people with chronic illnesses would still fall under Food and Drug Administration guidance to receive updated Covid shots, the risk of transmission could still be high if other people are not vaccinated.

A Centers for Disease Control and Prevention survey shows more people in the LGBTQ community have Long Covid than others. And a 2023 study from experts at Central Michigan University shows that queer people have a higher likelihood of suffering with chronic illnesses, which make them more vulnerable to Covid.

Queer Disability Aid keeps events accessible to people who are immunocompromised by requiring masking at its events.

How mutual aid groups improve care for people with disabilities

In New York state, more LGBTQ people suffer with mental illness than their straight counterparts, the Department of Health reported.

University of Manchester research shows the importance of mutual aid groups for those who battle disabilities. One of the researchers, Luan Cassal, found that the groups have helped bridge disparities in disaster care for LGBTQ communities.

For instance, in 2020 at the height of the Covid pandemic, LGBTQ communities in the United Kingdom and Brazil benefitted from LGBTQ support groups providing each other mental health support online.

Because marginalized groups face vulnerabilities in crises due to inequitable treatment — such as the LGBTQ community’s lack of access to food and shelter following the fatal 2010 earthquake in Haiti — mutual aid groups are especially useful as they can fill those gaps, the study found.

Trump’s team cited safety in limiting Covid shots. Patients, health advocates see more risk.

Aristotle University of Thessaloniki’s Sotiris Lainas found in a review of psychology papers that mutual aid groups improve the well-being of people who are fighting disabilities.

“They face a two-way exclusion, not only regarding their disability, but also the orientation,” Lainas said. “Find other people with common issues with you and try, because they have ears that they can hear you, they have a sorrow that they can feel you, and together, you can act together to change these things or not to change just to protect yourself and others.”

QDA aims to make events more accessible

Queer Disability Aid hosts support groups at venues with an activity like art, or mapping out a support network with a pen and paper, Umi said.

In the future, the group plans to produce small business market events that are accessible for those who use mobility aids and for those sensitive to noise.

“I’ve been to so many markets where, like if you are in a wheelchair, you just can’t navigate if there’s lots of people,” Umi said.

Like QDA’s other events, masks would also be required, to allow people whose chronic illnesses compromise their immunity to reduce their risk.

“It’s really important to have spaces that are accessible, both in terms of mobility, people who are immunocompromised, people who are neurodivergent as well and might have some sensory overload,” Cassal said. “And that’s important. So we keep people united, and we keep together rather than excluding people from following the expectations of abilities.”

Supplying people the help they need through the mutual aid group brings Umi joy.

“Connecting people who I think sometimes have a hard time finding community is definitely one of the best parts of the role,” Umi said. “I just love seeing our community members engage with each other.”

This story was produced in partnership with the Health & Science Reporting Program at the Craig Newmark Graduate School of Journalism at CUNY.

NY health update: Zohran Mamdani’s proposals, help for asthma in the heat, Pride month resources

2025-06-27T11:00:00+00:00

With so much going on, taking breaks and recharging are key to preventing burnout. We’ll be taking next week off to do just that.

But before we sign off, here’s your dose of New York health news.

Zohran Mamdani wins NYC mayoral Democratic primary

Former Gov. Andrew Cuomo conceded to state Assemblyman Zohran Mamdani on Tuesday night. New Yorkers will vote in the general election in November to determine the next New York City mayor.

I highlighted some of Mamdani’s health-related plans in our Mayoral Primary Voter Guide earlier this month. To recap, Mamdani’s proposals include:

Establishing a Department of Community Safety, backed by $1.1 billion in funding, that aims to prevent violence and strengthen social safety nets. This program would invest ~$350M in mental health services, expanding preventive and ongoing mental care, as well as crisis intervention for severe mental illness through increasing the number of mobile crisis teams.
Creating city-funded grocery stores to improve healthy food access and combat food insecurity.
Providing new parents with baby baskets that contain essential goods and resources, like diapers and baby wipes, and information on newborn home visiting programs, breastfeeding, and postpartum depression.

We’ll be back with more info as we get closer to the general election.

Free AC program for those with asthma

We just made it through our first heat wave of the year, with temps across the state hitting 100°F. While next week looks cooler, more extreme heat is likely in the weeks ahead. In addition to last week’s heat safety tips, there’s now a new resource available to help New Yorkers manage heat-related health risks.

Last week, Gov. Kathy Hochul launched the Essential Plan Cooling Program, which offers free air conditioners to eligible New Yorkers. Specifically, it’s for those enrolled in the Essential Plan (New York’s Medicaid expansion) who also have persistent asthma. This program is different from the Home Energy Assistance Program. The application and additional details are available here.

Why asthma? Hot, humid weather is a known trigger of asthma symptoms. It also increases ozone in the air (smog), which can trigger asthma. Heat speeds up the chemical reaction that creates ozone, so air is often smoggier on hot days.

There are things you can do to prepare for the heat if you have asthma:

Check the air quality, temperature, and humidity using airnow.gov before you go outside. If air pollution or temperature is high, limit how much you’re out.
Stay hydrated. Drinking water can help cool the mucus in your lungs and airways.
Always have your medication on hand.
Use a HEPA air filter to reduce pollution indoors.
Prepare for power outages, which can be caused by excessive heat. If you use a nebulizer, oxygen concentrator, or other electronic medical device, have a backup plan with your health care team for what to do in the event of a power outage.

A win for SNAP

Over the weekend, a bill moving through Congress proposing to cut $128 billion in federal funding from the Supplemental Nutrition Assistance Program, formerly known as food stamps, failed to meet Senate requirements. This means the bill can’t move forward with the cuts — good news for the nearly 3 million people in New York who rely on SNAP to put food on the table.

The bill would have required states to shoulder at least 5% of SNAP benefit costs, substantially slashing federal support. Because the bill is moving through a special “budget reconciliation process,” it must follow certain rules. The Senate parliamentarian (essentially a non-partisan referee) evaluated the bill and determined that the SNAP cuts didn’t meet the criteria. They also determined that another part of the bill, a proposal to bar non-citizens from receiving SNAP benefits, didn’t meet the criteria. That means that immigrants who qualify for SNAP, regardless of immigration status, can still receive benefits.

In New York City alone, 1.8 million people rely on SNAP. Statewide, nearly 1 in 7 residents depend on it — 30% of recipients are children, and 21% are elderly people. Since the pandemic, the number of New Yorkers needing food assistance has mostly grown.

SNAP isn’t just a lifeline for feeding families, it also adds to the economy. Every $1 spent on SNAP generates an estimated $1.54 in economic activity. This means that the $7.4 billion spent on the program in New York annually generates about $11.5 billion in economic activity.

While this win is meaningful, it’s not final. Lawmakers will likely look for alternative means to fund tax cuts, potentially affecting SNAP down the line.

Medicare Advantage update for NYC retirees

Last week, New York City Mayor Eric Adams stated that ~250,000 retired city workers would not be switched from traditional Medicare to privatized Medicare Advantage plans. The original plan to switch city workers to private Medicare Advantage was proposed to save the city about $600 million annually. However, it garnered significant criticism.

Medicare Advantage is a type of Medicare plan offered by private insurance companies, approved by Medicare. While it can offer additional benefits like dental, vision, and hearing coverage, it has some drawbacks:

Limited networks. Fewer doctors and hospitals accept these plans.
Pre-approvals for care. Services often require prior authorization.
Potential for higher out-of-pocket costs. Plans may have lower up-front premiums, but can lead to higher out-of-pocket costs depending on the services needed.

Because of these drawbacks, many retirees raised concerns and pushed back against the Medicare Advantage plans. With this change, City Hall will now continue to look for other ways to save money on health care.

Pride month resources, and a mental health update

New York has been celebrating Pride for the past month, from the Capital Pride Parade in Albany to Rainbow City in Niagara Falls. And there’s still more ahead — the New York City annual Pride March and PrideFest are this Saturday.

To safely celebrate, the New York City and New York state health departments have put together resources and recommendations, including spending time with community, practicing safe sex (including PrEP and PEP), and checking in on mental health.

LGBTQ+ individuals often face unique mental health challenges, driven by factors like family rejection, discrimination, or social isolation. These stressors have tragically contributed to higher suicide rates in this community.

Since 2022, the national 988 suicide hotline has provided an option for LGBTQ+ callers to be connected to specially trained counselors who share similar life experiences to offer support. But last week, the federal government ended this specialized support to cut costs.

It’s important to know the 988 line is still active and available to everyone. But this loss in dedicated support for the LGBTQ+ community is a step in the wrong direction for addressing mental health a high-risk population.

For LGBTQ+-specific mental health services, the following hotlines are still available:

The Trevor Project provides national, 24/7 crisis care for LGBTQ+ young people. Call (866-488-7386), text (678-678), or chat from anywhere in the United States.
The Trans Lifeline is a national, English/Spanish hotline (877-565-8860) offering peer support phone service for trans people.
NYC Teenspace is a free mental health support program available to any teenager age 13 to 17 living in New York City. It connects teens to licensed therapists for ongoing support.
The NYC Anti-violence Project offers an English/Spanish hotline (212-714-1141) that can connect callers with trained counselors specializing in LGBTQ+ and HIV-affected mental health.

Covid-19 activity remains low in New York

The summer wave I’m expecting still hasn’t taken off in New York. Both wastewater and hospitalizations data show that Covid-19 activity is still low across the state. Though I do anticipate things will pick up soon.

I’ll be keeping a close eye on things and report back with updates.

Bottom line

You’re all caught up with New York health this week! See you after our break next week.

Love,

Your NY Epi

What RFK Jr. isn’t talking about: How to make vaccines safer

2025-06-25T13:49:02+00:00

Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

Within an hour of receiving a Covid vaccination in November 2020, Utah preschool teacher Brianne Dressen felt pins and needles through her arms and legs. In the medical odyssey that followed, she suffered double vision, chronic nausea, brain fog, and profound weakness. Once a rock climber, she became a couch potato.

Although Dressen’s symptoms were rare in that season of hundreds of millions of Covid vaccinations, they were common enough to draw the attention of a National Institutes of Health neuroscientist named Avindra Nath, who examined Dressen and more than 30 other people with a similar syndrome in 2021. He recommended Dressen take steroids and antibodies — treatments that saved her life, she said.

And then, according to emails reviewed by KFF Health News, Nath said he couldn’t help anymore. His clinical study was ending. He directed the patients to seek local help. But, Dressen said, there wasn’t any.

Nath declined to speak to KFF Health News for this article. The Food and Drug Administration searched international vaccine safety databases for small-fiber neuropathy, one of the most common symptoms he mentioned in a write-up of the patients, and found it was less prevalent in vaccinated than in unvaccinated patients, said Peter Marks, who led the FDA division responsible for vaccines until Health and Human Services Secretary Robert F. Kennedy Jr. forced him out in May.

While it’s possible that Nath’s patients suffered Covid vaccine injuries, Marks said, their symptoms were so varied it was hard to characterize a possible syndrome.

‘We need to keep fighting’: HIV activists organize to save lives as Trump guts funding

But for Dressen and others convinced the vaccines injured them, their experiences were symptomatic of a well-intentioned but flawed U.S. system for monitoring the rare ill effects of vaccines. The system isn’t well-funded enough to answer questions that people urgently want answered, and that can feed vaccine hesitancy, safety experts say.

Its shortcomings were on particular display during the mass vaccination campaigns of the pandemic, when even rare, serious side effects could affect thousands of people.

Now some leading vaccine scientists are calling for more resources to research vaccine safety and support people with claims of injury — and asking Kennedy, who has a history as an anti-vaccine activist, to step up.

“Spending money on vaccine safety is not saying vaccines aren’t safe; it’s showing a commitment to continued improvement,” said Y. Tony Yang, a professor of health policy at George Washington University’s Milken Institute School of Public Health.

So far, they’ve been disappointed. While Kennedy gives the public the impression that vaccines are harmful, he hasn’t talked about ways to make them safer. And he’s made the problem worse by cutting programs and dismissing scientists who are most knowledgeable of the problems, according to numerous vaccine experts.

“The reduction in emphasis on the unbiased ascertainment of vaccine safety signals, and redirection toward certain specific issues like autism in vaccines, which we know is not true — that is what’s dangerous,” Marks said.

In March, the Trump administration abruptly canceled a contract with researchers just as they began a massive Covid vaccine study aimed at discovering the genetic traits that make certain people vulnerable to vaccine-triggered myocarditis. That condition struck about 1 in 13,000 teenage boys and young men who received two doses of the Pfizer or Moderna mRNA vaccine in 2020 and 2021.

Then, on June 9, Kennedy sacked the entire 17-member Advisory Committee on Immunization Practices, which during the pandemic impaneled a group of experts that reviewed safety data from nearly 700 million Covid vaccinations.

The new ACIP contains members who have said most vaccines are dangerous and improperly tested. Sen. Bill Cassidy, a Louisiana Republican who chairs the Senate committee with oversight of HHS, said Monday on X that the ACIP meeting scheduled for Wednesday and Thursday should be delayed until ACIP is staffed with less biased, more knowledgeable members.

HHS officials have suggested that Kennedy intends to throw out the whole vaccine safety system and start over. In a statement to KFF Health News, spokesperson Emily Hilliard accused the Centers for Disease Control and Prevention of “suppressing information about vaccine injuries” and said the Vaccine Adverse Event Reporting System and the Vaccine Safety Datalink. monitoring systems in place since the early 1990s, were “designed to fail” and “templates of regulatory malpractice.”

She said HHS was “building surveillance systems that will accurately measure vaccine risks as well as benefits.” Asked for details, Hilliard did not respond. The HHS budget proposal for fiscal year 2026 makes no mention of vaccine safety programs.

Many older people embrace vaccines. Research is proving them right.

The current U.S. vaccine safety system began with passage of the 1986 National Childhood Vaccine Injury Act, which aimed at stabilizing the vaccine supply by stopping lawsuits against drug companies. At the time, they were getting out of the vaccine business, finding it less risky and more profitable to produce drugs for chronic diseases. The act set up the National Vaccine Injury Compensation Program and VAERS.

CDC vaccine safety officer Robert Chen built on VAERS to create the Vaccine Safety Datalink, which looks for evidence of vaccine harms in electronic health records. In 2001, the CDC set up the Clinical Immunization Safety Assessment project, through which a network of eight U.S. centers study rare vaccine reactions.

But the vaccine safety system’s budget has been stuck at around $20 million most years. That hasn’t been enough to study rare but recurring vaccine injuries in a serious way.

“$20 million to look at all the licensed vaccines in this country is woefully inadequate,” Dan Salmon, director of Johns Hopkins University’s Institute for Vaccine Safety, said at a recent conference. Without a more serious commitment, he said, “our products won’t be as safe as they could be.”

As an HHS vaccine safety official during the Clinton, Bush, and Obama administrations, Salmon helped write two plans that called for expanded safety work, including examinations of whether the vaccine schedule might be contributing to an increase in allergic diseases.

A little-publicized CDC-led 2022 study suggested that the aluminum salts added to make some pediatric vaccines more effective might cumulatively be linked to an increased incidence of asthma. Salmon thinks it merits further research — to refute or confirm the results. The issue “should have been studied decades ago,” he said.

Government compensation program has failed

Vaccine advocates and skeptics agree that the government program established to compensate people injured by vaccines or other public health measures during emergencies — the Countermeasures Injury Compensation Program — has miserably failed those with Covid vaccine-related injuries. As of June 1, the program has compensated only 39 of nearly 14,000 people who have filed Covid vaccine injury claims. Only five have gotten awards of more than $10,000.

The program is far less generous and user-friendly than the National Vaccine Injury Compensation Program, funded since 1988 by an excise tax on vaccines. It has paid out about 12,000 awards worth a total of $4.8 billion, mostly to care for vaccine-injured children.

People with Covid vaccine injuries, however, are stuck in a kind of limbo, often without clear medical options. It’s unfair and “very bad for public confidence in vaccines,” said Amy Pisani, CEO of Vaccinate Your Family, a nonprofit that promotes vaccination, speaking on a panel with Salmon at the April conference.

Kennedy has condemned the injury compensation system for shielding drug companies from lawsuits, but if he wants to help patients, he should move Covid vaccines into the program, said Renée Gentry, who runs a law clinic for vaccine injuries at George Washington University Law School.

“The longer you hang these people out to dry, you are creating a perfect storm where nobody’s going to want to get vaccinated,” she said.

Vaccine injury investigation curtailed

In December 2021, the NIH’s Nath emailed Dressen and the other patients suffering from postvaccine problems that he could no longer help them. He told Science magazine that investigating vaccine side effects was a delicate business when public health leaders were urging everyone to get their shots.

“You have to be very careful. You can make the wrong conclusion,” he said. “The implications are huge.”

Nath published an article in 2023 calling for more investigation of vaccine-related neurological conditions. His lab also released preliminary results from its study of Dressen and the other patients, which pointed to helpful treatments. But the paper has not been published in a peer-reviewed journal.

And none of the federal agencies recognized that her condition might be vaccine-related, said Dressen, who received her shot in an AstraZeneca clinical trial. (FDA officials were concerned about the vaccine’s side effect profile, and it was never distributed in the United States.)

Dressen said Nath’s withdrawal left her distraught.

“They reassure everyone there’s a safety net, but every one of those things is a complete failure,” she said. “I didn’t speak out because of my injury. The reason I spoke out is because of what happened after my injury.”

“People are suffering, and we don’t yet understand why or how to help them,” said Harlan Krumholz, a cardiologist who is part of a research project at Yale University led by immunobiologist Akiko Iwasaki that includes hundreds of patients with postvaccine issues. “Worse, many of them have felt ignored or dismissed by the very institutions meant to help and support them.”

The NIH appears not to have funded studies of postvaccine syndrome, whose symptoms mimic those of Long Covid. Yet genetic studies could help “to determine who might be more susceptible to this condition,” Iwasaki said in an email.

‘We dissent’: NIH workers protest Trump policies that ‘harm the health of Americans’

Such research appears ideal for the Clinical Immunization Safety Assessment, established to examine rare vaccine reactions. But the network has published nothing on Covid vaccines, nor are any trials related to the issue listed on government websites.

German researchers have studied postvaccine syndrome in more depth. Germany’s Paul-Ehrlich-Institut, a sort of FDA for vaccines, reported in December that it had reviewed 919 cases of postvaccine syndrome that were similar to Long Covid — a rate of about 1 in 100,000 vaccinations. It said causality was hard to establish because of the diverse symptoms reported.

Can vaccine safety move out of HHS?

In 1999, Chen, the CDC scientist, published an article suggesting that to speed studies and boost public confidence, vaccine safety should be moved to an independent agency, perhaps modeled on the National Transportation Safety Board, that could subpoena records from industry or other government agencies for its crash investigations.

Although HHS did not respond to a query about the idea, vaccine litigant Aaron Siri, who has been a personal attorney to Kennedy, told KFF Health News that Kennedy supported it.

In the meantime, some vaccinologists hope they can persuade Kennedy to spend more money on good vaccine safety research.

While it is “very painful to watch” what Kennedy is doing to HHS vaccine policy, “it would behoove us to find common ground,” Salmon said at the conference. That doesn’t mean “funding terrible studies to confirm hypotheses that some people believe,” he added.

Though that is what many see Kennedy doing. One of his first moves as secretary was to hire David Geier, whose previous publications are considered junk science by many in the field, to conduct a review of vaccine links to autism. Studies around the world have thoroughly debunked such a connection.

Loss of CDC payment halts work on myocarditis

When HHS’ Vaccine Safety Datalink was set up in the early 1990s, it was the envy of the world. There are now also good systems in Denmark, England, Israel, and Australia, but the U.S. system has worked pretty well, said Steve Black, who co-directed the Kaiser Permanente Vaccine Study Center from 1985 until 2007.

The Vaccine Safety Datalink was largely responsible for the 1999 removal of a rotavirus vaccine that triggered rare intestinal disorders in babies. And its discovery of a rare but deadly side effect helped keep the AstraZeneca Covid vaccine off the U.S. market and led to the removal of the Johnson & Johnson vaccine, Black said. It also helped pinpoint myocarditis soon after young men began getting mRNA shots in 2021.

Since 2019, Black has co-directed an ambitious, 30-country consortium called the Global Vaccine Data Network, which enables vaccine safety analyses across massive, diverse populations around the world.

The group was just beginning its study of genetic predispositions to myocarditis when the Trump administration withdrew a $2 million CDC payment, halting the work.

An email from the Department of Government Efficiency “asked a bunch of irrelevant questions like, Had we ever been funded by China? Did we have collaborators in Europe?” It ordered the network to cease and desist with no due process or means of appeal, Black said.

Research funded by the grant had progressed to the point of finding seven genetic variants known to be related to cardiac inflammation in people who got myocarditis postvaccination, said Bruce Carleton, the lead investigator, at the University of British Columbia. Work remains, but the data suggests a $6 test could clear vulnerable patients before they are vaccinated, Carleton said.

“Millions got mRNA vaccines. Very few got myocarditis,” Black said. “The public would like to know, ‘Am I at risk?’ Genetics can answer that.”

The CDC has been an honest broker of vaccine safety information, Black added, but if taking the issue out of HHS would improve public confidence, he’s for it.

Vaccines need to be safer, Dressen said, but the idea of banning them doesn’t sit well with her.

“There’s the crowd that wants mRNA vaccines to be pulled off the market, but that’s not going to fix the problem. Vaccines are not going to go away,” she said.

As of June 5, a patient group she leads had provided $1.2 million to 162 people needing medical care for injuries they attributed to vaccination.

Meanwhile, the federal countermeasures program, which doles out Covid vaccine injury awards through a trust, has committed $2.6 million for one patient and $370,376 for another. As of June 1, it had granted an additional 37 claimants a grand total of $198,809.92.

This story was originally published at KFF Health News, Healthbeat’s national reporting partner.

Many older people embrace vaccines. Research is proving them right.

2025-06-23T14:26:33+00:00

Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

Kim Beckham, an insurance agent in Victoria, Texas, had seen friends suffer so badly from shingles that she wanted to receive the first approved shingles vaccine as soon as it became available, even if she had to pay for it out-of-pocket.

Her doctor and several pharmacies turned her down because she was below the recommended age at the time, which was 60. So, in 2016, she celebrated her 60th birthday at her local CVS.

“I was there when they opened,” Beckham recalled. After getting her Zostavax shot, she said, “I felt really relieved.” She has since received the newer, more effective shingles vaccine, as well as a pneumonia shot, an RSV vaccine to guard against respiratory syncytial virus, annual flu shots, and all recommended Covid-19 vaccinations.

Some older people are really eager to be vaccinated.

Robin Wolaner, 71, a retired publisher in Sausalito, California, has been known to badger friends who delay getting recommended shots, sending them relevant medical studies. “I’m sort of hectoring,” she acknowledged.

Deana Hendrickson, 66, who provides daily care for three young grandsons in Los Angeles, sought an additional MMR shot, though she was vaccinated against measles, mumps, and rubella as a child, in case her immunity to measles had waned.

For older adults who express more confidence in vaccine safety than younger groups, the past few months have brought welcome research. Studies have found important benefits from a newer vaccine and enhanced versions of older ones, and one vaccine may confer a major bonus that nobody foresaw.

The new studies are coming at a fraught political moment. The nation’s health secretary, Robert F. Kennedy Jr., has long disparaged certain vaccines, calling them unsafe and saying that the government officials who regulate them are compromised and corrupt.

On June 9, Kennedy fired a panel of scientific advisers to the Centers for Disease Control and Prevention, and later replaced them with some who have been skeptical of vaccines. But so far, Kennedy has not tried to curb access to the shots for older Americans.

Vaccines can prevent much serious illness for seniors

The evidence that vaccines are beneficial remains overwhelming.

The phrase “Vaccines are not just for kids anymore” has become a favorite for William Schaffner, an infectious diseases specialist at Vanderbilt University Medical Center.

“The population over 65, which often suffers the worst impact of respiratory viruses and others, now has the benefit of vaccines that can prevent much of that serious illness,” he said.

Take influenza, which annually sends from 140,000 to 710,000 people to hospitals, most of them seniors, and is fatal to 10% of hospitalized older adults.

For about 15 years, the CDC has approved several enhanced flu vaccines for people 65 and older. More effective than the standard formulation, they either contain higher levels of the antigen that builds protection against the virus or incorporate an adjuvant that creates a stronger immune response. Or they’re recombinant vaccines, developed through a different method, with higher antigen levels.

Georgia reports sixth case of measles of the year

In a meta-analysis in the Journal of the American Geriatrics Society, “all the enhanced vaccine products were superior to the standard dose for preventing hospitalizations,” said Rebecca Morgan, a health research methodologist at Case Western Reserve University and an author of the study.

Compared with the standard flu shot, the enhanced vaccines reduced the risk of hospitalization from the flu in older adults, by at least 11% and up to 18%. The CDC advises adults 65 and older to receive the enhanced vaccines, as many already do.

More good news: Vaccines to prevent respiratory syncytial virus in people 60 and older are performing admirably.

RSV is the most common cause of hospitalization for infants, and it also poses significant risks to older people. “Season in and season out,” Schaffner said, “it produces outbreaks of serious respiratory illness that rivals influenza.”

Because the FDA first approved an RSV vaccine in 2023, the 2023-24 season provided “the first opportunity to see it in a real-world context,” said Pauline Terebuh, an epidemiologist at Case Western Reserve School of Medicine and an author of a recent study in the journal JAMA Network Open.

In analyzing electronic health records for almost 800,000 patients, the researchers found the vaccines to be 75% effective against acute infection, meaning illness that was serious enough to send a patient to a health care provider.

The vaccines were 75% effective in preventing emergency room or urgent care visits, and 75% effective against hospitalization, both among those ages 60 to 74 and those older.

Immunocompromised patients, despite having a somewhat lower level of protection from the vaccine, will also benefit from it, Terebuh said. As for adverse effects, the study found a very low risk for Guillain-Barré syndrome, a rare condition that causes muscle weakness and that typically follows an infection, in about 11 cases per 1 million doses of vaccine. That, she said, “shouldn’t dissuade people.”

The CDC now recommends RSV vaccination for people 75 and older, and for those 60 to 74 if they’re at higher risk of severe illness (from, say, heart disease).

As data from the 2024-25 season becomes available, researchers hope to determine whether the vaccine will remain a one-and-done, or whether immunity will require repeated vaccination.

Study finds shingles vaccine reduced risk of dementia

People 65 and up express the greatest confidence in vaccine safety of any adult group, a KFF survey found in April. More than 80% said they were “very “or “somewhat confident” about MMR, shingles, pneumonia, and flu shots.

Although the Covid vaccine drew lower support among all adults, more than two-thirds of older adults expressed confidence in its safety.

Even skeptics might become excited about one possible benefit of the shingles vaccine: This spring, Stanford researchers reported that over seven years, vaccination against shingles reduced the risk of dementia by 20%, a finding that made headlines.

Biases often undermine observational studies that compare vaccinated with unvaccinated groups. “People who are healthier and more health-motivated are the ones who get vaccinated,” said Pascal Geldsetzer, an epidemiologist at the Knight Initiative for Brain Resilience at Stanford and lead author of the study.

“It’s hard to know whether this is cause and effect,” he said, “or whether they’re less likely to develop dementia anyway.”

Community health workers increased Covid-19 vaccination in NYC, a new study finds

So the Stanford team took advantage of a “natural experiment” when the first shingles vaccine, Zostavax, was introduced in Wales. Health officials set a strict age cutoff: People who turned 80 on or before Sept. 1, 2013, weren’t eligible for vaccination, but those even slightly younger were eligible.

In the sample of nearly 300,000 adults whose birthdays fell close to either side of that date, almost half of the eligible group received the vaccine, but virtually nobody in the older group did.

“Just as in a randomized trial, these comparison groups should be similar in every way,” Geldsetzer explained. A substantial reduction in dementia diagnoses in the vaccine-eligible group, with a much stronger protective effect in women, therefore constitutes “more powerful and convincing evidence,” he said.

The team also found reduced rates of dementia after shingles vaccines were introduced in Australia and other countries. “We keep seeing this in one dataset after another,” Geldsetzer said.

In the United States, where a more potent vaccine, Shingrix, became available in 2017 and supplanted Zostavax, Oxford investigators found an even stronger effect.

By matching almost 104,000 older Americans who received a first dose of the new vaccine (full immunization requires two) with a group that had received the earlier formulation, they found delayed onset of dementia in the Shingrix group.

How a shingles vaccine might reduce dementia remains unexplained. Scientists have suggested that viruses themselves may contribute to dementia, so suppressing them could protect the brain. Perhaps the vaccine revs up the immune system in general or affects inflammation.

“I don’t think anybody knows,” said Paul Harrison, a psychiatrist at Oxford and a senior author of the study. But, he added, “I’m now convinced there’s something real here.”

Shingrix, now recommended for adults over 50, is 90% effective in preventing shingles and the lingering nerve pain that can result. In 2021, however, only 41% of adults 60 and older had received one dose of either shingles vaccine.

A connection to dementia will require further research, and Geldsetzer is trying to raise philanthropic funding for a clinical trial.

And “if you needed another reason to get this vaccine,” Schaffner said, “here it is.”

This story originally published at KFF Health News, Healthbeat’s national reporting partner.

Community health workers increased Covid-19 vaccination in NYC, a new study finds. Here’s why their efforts worked.

2025-06-06T15:06:37+00:00

Public health, explained: Sign up to receive Healthbeat’s free New York City newsletter here.

In the depths of the Covid-19 pandemic, community health workers played a significant role in increasing vaccine uptake in hard-to-reach New York City communities, a new study has found.

Community health workers are public health workers with close connections to the communities they serve, and often act as intermediaries between local residents and health systems or social services. Across the country, many regions invested in community health worker initiatives as part of pandemic response efforts. But the workforce is particularly vulnerable to public health’s boom and bust funding cycle.

Quantifying the impact of community health workers who don’t work in clinical settings has long been challenging, said Dr. Maureen Miller, an epidemiologist and contractor with the New York City Department of Health and Mental Hygiene. But the data that emerged from the pandemic — and the Health Department’s significant investment in community health workers — offered an unusual opportunity to show their value, she said.

At MoMA, celebrating the ‘invisible workforce’ of community health workers

In the study, recently published in the American Journal of Public Health, Miller and other researchers affiliated with the Health Department found that community health workers, in partnership with the agency and community-based organizations, helped drive sharp increases in vaccination levels among local residents.

In 75 ZIP codes targeted for public health interventions, residents were primarily Black and Latino — demographics that had experienced disproportionately high mortality rates in the early weeks of the pandemic. At the beginning of the initiative in July 2021, 44% of all residents had completed their primary series Covid-19 vaccination. By June 2022, vaccine uptake rose to 76%. The majority of those communities received high levels of engagement from community health workers, defined as interactions during at least 11 months of the year.

Dr. Maureen Miller, an epidemiologist, studied the impact of community health workers on Covid-19 vaccination in New York City along with other researchers affiliated with the New York City Department of Health and Mental Hygiene.

Over the course of that year, community health workers also provided vaccination information to local residents more than 18 million times and participated in more than 22,000 outreach events, according to the study. They made 800,000 linkages to Covid-19 vaccination appointments, created more than 200,000 referrals to testing sites, distributed 17 million face masks and handed out 73,000 at-home antigen tests. They also helped residents tackle other issues, from food insecurity to housing instability.

In an interview this week with Healthbeat, Miller discusses the study, the role of community health workers, and why their approach to community engagement proved so effective. This interview has been edited for length and clarity.

Take us back to where New York City was in the pandemic when this project began. What motivated this research?

I was hired just as [the Covid-19 variant] Omicron was taking off, as were all of my colleagues. It was a very crazy period in the pandemic. Although vaccines were increasingly available, they were kind of challenging to get in New York City. You had to make appointments through computers and online. Not everyone knows how to operate that, not everybody has access to that, and we were also in the communities that had been left behind already by vaccines, by treatments. People had already died.

The statistics are astounding: Almost half of the people who died in the pandemic in New York City died in the first month or two. That’s staggering, and I think we’ve swept that loss under the rug because it’s enormous. It has affected all of us.

Against that background, people were mistrustful. They said, ‘You want us to take this vaccine now, we don’t understand it. We hear bad things about it.’ There was already a great deal of misinformation and skepticism on the part of community members that we were working with. So the idea was not, as the city Department of Health, to go in and say, ‘Get vaccinated.’ It was to partner with community-based organizations who hire people who are centered in the community. We provided funding for the community-based organizations to hire community health workers who we would help train and keep updated on all the new variants, the new vaccines, the boosters.

The community health workers and the community-based organizations developed a lot of their own methods of interacting with the community. We would provide the information, but they would make up songs and get them on the local radio, they’d have flyers. They would do videos and put them on social media. We had biweekly meetings with community members and with community-based organizations. We had a series of trainings for community health workers. It was probably the largest effort that the New York City Department of Health has ever made to integrate community with government in the city.

How did you set up this study?

One of the reasons that community-based community health workers get no respect is because it’s been extremely difficult to find a database that shows the impact of population-level change. We wanted to change entire communities, not just one person at a time. We didn’t interact with every single person in the community, yet our impact was felt, as evidenced by the huge increase in vaccine uptake over time.

We had an outcome: how many people had received the full series of vaccinations. We had that data, and it was collected on a weekly basis for everyone who became vaccinated. I can’t even tell you how unusual that is in the world of public health — but so is a pandemic. This provided a unique opportunity to look at the outcomes and then to see how our work with the community was impacting our objective, which was vaccine uptake.

We didn’t interact with every single person in the community, yet our impact was felt, as evidenced by the huge increase in vaccine uptake over time.
Dr. Maureen Miller

The contracts were based on X number of outreach engagements, X number of handing out materials and documentation. You had to satisfy a minimum set of criteria in terms of engagement that you would then get paid for. That’s unique in my experience, but it was extremely effective, because the community-based organizations wanted to help the community in any way they could. So most of the time they exceeded [the goals].

What were the main findings of your research?

I was shocked — I hadn’t looked at the data until things started to settle down with the pandemic. I wondered: Well, how big of an impact did we have? And we had an enormous impact. I don’t know of vaccine uptake that has happened so quickly for any other disease.

Community health workers distributed face masks and Covid-19 tests, helped residents make Covid-19 vaccination appointments, and also provided connections to food and housing social services.

Within one year, from the initiation of the project in July 2021 through June 2022, we had a 30% increase in vaccine uptake in a community that is under-resourced, marginalized, distrustful, and disinvested. People went out and got vaccinated.

One of the projects that we did was a storytelling project. We wanted to know, ‘Why did you get vaccinated? Why are you encouraging others to get vaccinated?’ And it was all about family. It was about, ‘I’m going to protect my family.’ It was about community. In an individualistic society such as ours, it was really heartening to hear that that was a fundamental reason why people were choosing to get vaccinated and to convince others to get vaccinated. Not only were our community health workers acting as advocates for vaccination, eventually so were community members.

How do community health workers’ efforts to help residents with other issues, like food insecurity or housing instability, connect to the broader goal of increasing vaccine uptake?

The Health Department wanted people to get vaccinated right away. And the community came back and said, ‘Listen, my kid doesn’t have diapers. I’m not getting a vaccine before I can get diapers.’ There was such a great deal of need — and there continues to be need — for food, for housing, for money for child care, for elder care. There is just so much need in these communities that they can’t afford to think about the Health Department’s priority of getting people vaccinated and not spreading Covid.

People really wanted help, and they didn’t necessarily want the help that we came in with — to provide vaccines. They wanted help with daily living needs that were not being met, and in fact, were exacerbated by the pandemic. So we started providing referrals. We pulled together a list of organizations where people could go to get food. We partnered with the Department of Homeless Services to provide vaccine information and opportunities to make reservations to get vaccinated, and also to find housing for people. Community-based organizations also corralled their networks of food pantries and other resources so that we could amplify their ability to refer others to these services.

That’s how we build trust. We need to pay attention to what it is you need and want; it’s not only about getting vaccinated. It’s dealing with community priorities to ensure that when we would like to do an important health intervention, we’ve already built up the trust.

Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org.

NY public health update: Wildfire smoke, new Covid variant, diabetes, and a fish consumption advisory

2025-06-05T16:58:07+00:00

There’s a ton going on in the world of public health. This week we’ll cover wildfire smoke in New York, an emerging Covid variant, updates to Covid vaccine eligibility, diabetes in New Yorkers, and an advisory on local fish consumption.

Wildfire smoke in New York

Smoke from wildfires in Canada has made its way down to New York and surrounding states.

Poor air quality from wildfire smoke poses health risks to everyone, but some groups are especially sensitive:

Older adults
Pregnant women
Children
People with pre-existing respiratory and heart conditions

Air quality is measured by sensors that detect the concentration of pollutants in the air. Results are reported as the Air Quality Index, which is a number between 0 and 500. The higher the AQI, the more polluted the air is, and the higher the health risk. When the AQI exceeds 50 (the yellow category), people who are more sensitive to poor air quality should reduce strenuous activity outdoors (like working out). Once the AQI tops 100 (the orange category), everyone should reduce strenuous activity outdoors.

You can easily check the air quality of your local area on some weather apps, like AirNow, or download the EPA’s AirNow mobile app. And for a deeper dive on wildfire smoke, check out our post from last year.

New Covid variant in NYC

A new Covid variant has been detected in international travelers who arrived to New York City airports this month, as well as other airports in the United States. The new variant, NB.1.8.1, is getting some attention because it’s the major variant associated with a surge in Covid cases in China.

The good news is that this variant doesn’t appear to be any more severe than other circulating variants — it’s not meaningfully better at evading the immune system. The reason China may be seeing more Covid cases is not entirely clear, but we do see that this variant grows faster than many other circulating variants in cell culture, meaning it may be more transmissible.

What does this mean for you?

In New York, and the rest of the United States, we can expect another Covid wave this summer, with things likely picking up in the next two to three weeks. We’ve had summer Covid waves the past four summers, so it’s expected at this point.

New York City average SARS-CoV-2 wastewater concentrations. Data from the New York City Wastewater Testing Program.

Wastewater data for New York City is delayed, with the most recent data available as of May 6. The most recent data show that Covid began increasing earlier in May, but it was still at low levels in New York City. I’ll be back with updates once we get more data.

Will the current vaccine be effective against this new strain?

We think so. The new NB.1.8.1 strain seems to evade antibodies similarly to the last two strains vaccines were developed for, JN.1 and KP.2, meaning that the current vaccine should offer protection against severe disease. If you are moderately or severely immunocompromised or over 65, and you got a Covid vaccine in the fall, you can talk to your doctor about getting a second dose. I got the fall vaccine last year, so personally, I am not going to get another shot until this fall. But, I will be paying close attention to the Covid data (and sharing it here) and will likely mask up on the train and in grocery stores once virus activity starts to pick up more.

Covid vaccines will still be available for kids and pregnant women in New York

In last week’s post, we covered new proposed guidelines for Covid vaccines that would make it harder for adults and kids without chronic conditions to get vaccinated if they want to. Late last week, the Centers for Disease Control and Prevention released recommendations based on the proposal.

The communication over the vaccine guidelines was a total mess and is still confusing as heck (YLE National covered it here). After it was initially announced that Covid vaccines would not be recommended for healthy kids and pregnant women, the CDC walked that back, and are now recommending that kids, pregnant women, and all adults can still get vaccinated if they and their doctor agree it’s appropriate (called shared clinical decision-making).

Covid vaccine eligibility as of now:

Age 65+: Vaccines are recommended.
Under age 65 with certain health conditions: Vaccines are recommended.
Adults, kids, and pregnant women may get the vaccine if they and their clinician agree it’s appropriate.

This is a win because little kids, particularly those under 6 months old, and pregnant women are still at high risk of severe Covid. Babies continue to make up the most emergency department visits for Covid (even more so than older adults). It also upholds medical freedom and the choice to get vaccinated if one wants to.

The CDC requires insurance to cover kids’ shots that are recommended by shared clinical decision-making. But for adults, insurance coverage is still up in the air. When ACIP (an independent group of advisers to the CDC) meets at the end of June to make their recommendations, they’ll vote on whether Covid vaccines should be recommended for healthy adults, and this will likely dictate insurance coverage.

Diabetes is high in NYC

The NYC Health Department released a report last week showing just how deeply diabetes, one of the most common chronic diseases, affects New Yorkers. In New York City, and the rest of the United States, diabetes is a leading cause of illness, disability, and death.

In 2022, about 11% of the New York City adult population (800,000 New Yorkers) had diabetes. Statewide, it’s similar — 11.4% of New Yorkers have diabetes.

And risk is not evenly spread. Diabetes is highest among older adults, with 26% of New York City adults over 65 having diabetes. The risk of diabetes increases with age — as people get older, the body’s ability to produce insulin declines, muscle mass decreases, and many will have reduced physical activity, all of which contribute to insulin resistance.

Asian/Pacific islander, Black, and Latino New Yorkers have nearly twice the rate of diabetes compared to white New Yorkers. Diabetes risk among racial and ethnic groups is a combination of genetic, environmental, and socioeconomic factors.

Poverty and access to healthy food play a huge role in diabetes risk. NYC residents in high poverty neighborhoods (15%) were almost twice as likely to have diabetes as residents in low poverty neighborhoods (8%). People from lower-income households may not have access to healthy food options (often more expensive) or opportunities to exercise regularly in their communities.

How do we fix this issue?

It’s a complex issue, but more funding and smart investments would help. Diabetes, like many other chronic diseases, is shaped by a person’s environment. Do they have time to cook? Safe spaces to exercise? Access to regular medical care? These are material and environmental conditions, not just personal choices.

Lifestyle interventions, like the National Institutes of Health’s Diabetes Prevention Program (which sadly lost its funding recently) can be very effective. Here’s what we as individuals can keep in mind to reduce risk:

Get regular checkups that include lab work — prediabetes can be reversed with early action.
Strive for a balanced diet — emphasizing protein, fiber-rich carbohydrate foods, and healthy fats.
Stay physically active — exercise benefits blood sugar, insulin sensitivity, and weight management.
Manage weight — if you are carrying excess weight, just losing 5%-10% of your body weight has been shown to have substantial benefits.

New York City’s Health Department has laid out a Citywide Diabetes Reduction Plan that calls for evidence-based programs, such as peer-led education, community health workers, support for healthy food, and self-management services.

Having a plan is great, but the NYC Diabetes Report highlights that the plan’s initiatives are not yet funded at levels needed to reach all New Yorkers who could benefit. We also need long-term solutions that enable people to afford healthier lifestyles. For example, Medicaid and Medicare reimbursement of diabetes prevention and self-management programs, as well as investments in efforts that address the root causes, such as housing, transportation, and food access.

We have the blueprint. Now we need the resources to scale it.

A big thank you to Megan Maisano, MS, RDN, for her expert insight and contribution to this section.

New York advisory on fish contamination

Did you know it’s striped bass season in New York? My dad used to take me fishing when I was little as a way to connect with nature. It’s a great family activity, but some fish can accumulate pollutants from their environment, which can be dangerous if consumed in high amounts.

Last week, New York State Department of Health announced an advisory on which fish from New York state bodies of water are safe to eat, and which ones should be avoided. Some fish in New York have high levels of chemicals that can be harmful, including mercury, polychlorinated biphenyls, and PFAS.

The state is divided into four different water regions, each with its own fish consumption guidelines.

There are different guidelines based on who you are, where you fish, what you catch, and how much fish you eat. Chemicals in fish can have a greater effect on children’s development and babies, so women of childbearing age (under 50) and children under 15 are advised to limit the kinds of fish they eat and how often they eat them. The chemicals from fish can also build up in the body and affect the development of future pregnancies, so women who may become pregnant should limit their consumption of riskier fish.

In addition to the New York-specific guides, the Food and Drug Administration also has recommendations on which fish are safe to eat for women and children.

What you can do

If you fish in New York, look up the guidance for your local fishing spot. Avoid eating the fish listed as not safe to consume. If you are eating out, you can ask where fish was sourced from.

Eating fish can be part of a healthy diet, providing key nutrients like high-quality protein, omega-3 fatty acids, and iron. And not all fish are risky to consume. Fishing can still be a fun activity for the family, but equipping yourself with knowledge of your local environment can help you make healthy decisions about how much fish to eat and from where.

Bottom line

You’re all caught up on New York public health this week. We’ll be back next week with some info on the New York City mayor’s election and how it could influence public health. Stay tuned!

Love,

Your NY Epi

RFK Jr. says healthy pregnant women don’t need Covid boosters. What the science says.

2025-06-02T14:15:06+00:00

Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

You’re pregnant, healthy, and hearing mixed messages: Health and Human Services Secretary Robert F. Kennedy Jr., who is not a scientist or doctor, says you don’t need the Covid vaccine, but experts at the Centers for Disease Control and Protection still put you in a high-risk group of people who ought to receive boosters. The science is on the side of the shots.

Pregnant women who contracted Covid-19 were more likely to become severely ill and to be hospitalized than non-pregnant women of the same age and demographics, especially early in the Covid pandemic.

A meta-analysis of 435 studies found that pregnant and recently pregnant women who were infected with the virus that causes Covid were more likely to end up in intensive care units, be on invasive ventilation, and die than women who weren’t pregnant but had a similar health profile. This was before Covid vaccines were available.

Neil Silverman, a professor of clinical obstetrics and gynecology and the director of the Infectious Diseases in Pregnancy Program at the David Geffen School of Medicine at UCLA, said he still sees more bad outcomes in pregnant patients who have Covid. The risk of severe Covid fluctuated as new variants arose and vaccinations became available, Silverman said, but the threat is still meaningful. “No matter what the politics say, the science is the science, and we know that, objectively, pregnant patients are at substantially increased risk of having complications,” Silverman said.

Restrictions on healthy people's Covid vaccine access fuel worry

A request for comment regarding the scientific literature that supports Covid vaccination for pregnant women sent to HHS’s public affairs office elicited an unsigned email unrelated to the question. The office did not respond when asked for an on-the-record comment.

Kennedy, a longtime anti-vaccine activist before joining the Trump administration, announced Tuesday that Covid vaccines would be removed from the CDC’s immunization schedule for healthy pregnant women and healthy children. His announcement, made in a video posted on the social media platform X, blindsided CDC officials and circumvented the agency’s established, scientific processes for adding and removing shots from its recommended schedules, The Washington Post reported.

There’s still much unknown about how Covid affects a pregnant person. The physiological relationship between Covid infections and mothers and fetuses at different stages of a pregnancy is complex, said Angela Rasmussen, a virologist at the University of Saskatchewan.

How pregnancy changes the immune system

The increased risk to pregnant patients comes in part because pregnancy changes the immune system, Rasmussen said.

“There is natural immune suppression so that the mother’s body doesn’t attack the developing fetus,” Rasmussen said. “While the mother does still have a functioning immune system, it’s not functioning at full capacity.”

Pregnant patients are more likely to get sick and have a harder time fighting off any infection as a result.

In addition to changing how the immune system works, being pregnant also makes women five times as likely to have blood clots. That risk is increased if they contract Covid, said Sallie Permar, chair of pediatrics at Weill Cornell Medicine.

CDC funding cuts impact Georgia vaccine access, other public health programs

The virus that causes Covid can affect the vascular endothelium — specialized cells that line blood vessels and help with blood flow, Rasmussen said. In a healthy person, the endothelium helps prevent blood clots by producing chemicals that tweak the vascular system to keep it running. In a person infected with the Covid virus, the balance is thrown off and the production of those molecules is disrupted, which research shows can lead to blood clots or other blood disorders.

Permar said those clots can be especially dangerous to both pregnant women and fetuses. Inflammation and blood clots in the placenta could be connected to an increased risk of stillbirth, especially from certain Covid variants, according to studies published in major medical journals as well as by the CDC.

When the placenta is inflamed, it’s harder for blood carrying oxygen and nutrients to get to the developing baby, said Mary Prahl, an associate professor of pediatrics at the University of California-San Francisco School of Medicine.

“If anything is interrupting those functions — inflammation or clotting or differences in how the blood is flowing — that’s really going to affect how the placenta is working and being able to allow the fetus to grow and develop appropriately,” she said.

It makes sense that we see the effects of Covid in the placenta, Silverman said. “The placenta is nothing more than a hyper-specialized collection of blood vessels, so it is like a magnetic target for the virus.”

Blood vessels in the placenta are smaller and may clot more easily than in the mother’s circulatory system, he said.

How Covid can complicate pregnancy

Permar said recent data suggests that pregnant women sick with Covid still have a higher risk of pregnancy complications such as preeclampsia, preterm birth, and miscarriage, even with existing immunity from previous infection or vaccination. Covid, she said, can still land women in the hospital with pregnancy complications.

Prahl said the connection between stillbirth and Covid may be changing given the immunity many people have developed from vaccination or prior infection. It’s an area in which she’d like to see more research.

There’s already strong evidence that both mRNA-based and non-mRNA Covid vaccines are safe for pregnant women.

Prahl co-authored a small, early study that found no adverse outcomes and showed antibody protection persisted for both the mother and the baby after birth. “What we learned very quickly is that pregnant individuals want answers, and many of them want to be involved in research,” she said. Later studies, including one published in the journal Nature Medicine showing that getting a booster in pregnancy cut newborn hospitalizations in the first four months of life, backed up her team’s findings.

Prahl expects more evidence will be available soon to support the benefits of mothers receiving a Covid booster during pregnancy.

“I can say, kind of behind the scenes, I’m seeing a lot of this preliminary data,” she said.

She blames the delay in part on the Biden administration’s scaling back of federal efforts to track Covid. “A lot of the surveillance of these data were pulled back,” she said. The Trump administration is further cutting money used to track Covid.

But because the vaccines give a pregnant woman’s immune system a boost by increasing neutralizing antibodies, virologist Rasmussen is confident that getting one while pregnant makes it less likely a pregnant woman will end up in the hospital if she gets Covid.

“It will protect the pregnant person from more severe disease,” she said.

How Covid vaccine in pregnancy protects newborns

Getting a Covid vaccine while pregnant also helps protect newborns after birth. Pregnant women who get vaccinated pass that protection to their young babies, who can’t get their own shots until they are at least 6 months old.

According to data released by the CDC in 2024, nearly 90% of babies who had to be hospitalized with Covid had mothers who didn’t get the vaccine while they were pregnant.

As recently as April 2024, research showed that babies too young to be vaccinated had the highest Covid hospitalization rate of any age group except people 75 and older.

The Trump administration’s decision to remove the Covid vaccine from the list of shots it recommends for pregnant women means insurance companies might no longer cover it. Pregnant women who want to get it anyway may have to pay hundreds of dollars out-of-pocket.

“I don’t want to be that doctor who just says, ‘Well, it’s really important. You have to vaccinate yourself and your kids no matter what, even if you have to pay for it out-of-pocket,’ because everyone has their own priorities and budgetary concerns, especially in the current economic climate,” Silverman said. “I can’t tell a family that the vaccine is more important than feeding their kids.”

But he and his colleagues will keep advising pregnant women to try to get the shots anyway.

“Newborns will be completely naive to Covid exposure,” he said. “Vaccinating pregnant women to protect their newborns is still a valid reason to continue this effort.”

This story was originally published at KFF Health News, Healthbeat’s national reporting partner.

New York public health update: Salmonella outbreak in cucumbers, measles at Shakira concert, Covid vaccines

2025-05-28T15:30:13+00:00

I hope you all had a restful Memorial Day weekend. For those honoring loved ones lost in service, my heart is with you, and I’m deeply grateful.

Let’s get into this week’s dose of New York public health news, what you can do, and why it matters.

Cucumber recall affecting New York

A multistate Salmonella outbreak has been traced to cucumbers grown in Florida. As of Friday, 26 people across 15 states — including New York— have fallen ill, with nine hospitalized.

The Food and Drug Administration has issued a nationwide recall of cucumbers grown by Florida-based Bedner Growers and distributed by Fresh Start Produce Sales.

The affected cucumbers were:

Sold between April 29 and May 19.
Distributed to various retailers, restaurants, and food service providers. In New York these include Albertsons, Walmart, and other grocery stores.
Added to sushi rolls, salads, and other veggie mixes.

What this means for you

If you have cucumbers, or cucumber-containing premade salads or sushi at home that was purchased between April 29 and May 19, it’s safest to throw them out. Sanitize any surfaces that may have come into contact with the cucumbers. If you are eating out, consider asking the restaurant if they’re aware of the recall before ordering foods with cucumbers.

Symptoms of Salmonella infection include diarrhea, fever, and stomach cramps, which typically appear 12 to 72 hours after consumption. The Centers for Disease Control and Prevention reports an average of 420 Salmonella-related deaths annually in the United States. Children under 5 years old, adults over age 65, and people with weakened immune systems are at highest risk for severe illness.

Measles exposures in New Jersey

New Jersey has reported two possible measles exposures in the past week: one at Newark Airport and one at the MetLife Shakira concert. Anyone who visited the following locations during the specified times may have been exposed. Potentially exposed people should contact a health care provider if they develop any measles symptoms, which usually start like a cold and progress to a rash.

Newark Liberty International Airport, Terminal B. May 12, 12:30-4 p.m. Monitor for symptoms until Monday.
MetLife Stadium at the Shakira concert. May 15, 7:30 p.m.-1 a.m. Monitor for symptoms until June 6.

So far, no cases have been identified following these two exposure events. If you do develop symptoms, it’s important to call your doctor or clinic before you visit in person so special precautions can be taken to prevent further spread.

With measles continuing to spread in Texas and other states — and more than 1,060 cases reported nationwide — it’s not entirely surprising to see exposures at large events like the Shakira concert. Around 55,000 people attended (and as a Shakira fan, I’m a little jealous).

What this means for you

If you went to the concert or were at Newark Airport during the exposure period, monitor your symptoms over the next two weeks. If you are vaccinated, you likely have little to worry about. Fortunately, the Shakira concert mostly had adults in attendance, and most adults are vaccinated against measles, which helps limit the risk of an outbreak.

Being fully vaccinated is still the best way to prevent getting measles. Here are common FAQs on the vaccine from YLE National.

Tuberculosis in Suffolk County

A tuberculosis case was reported at Sachem High School East in Suffolk County, Long Island. On May 15, more than 120 students and staff were notified via letter about potential exposure to an individual diagnosed with TB.

TB is an infectious disease that’s transmitted mainly through the air. It primarily affects the lungs and can be serious if untreated. Symptoms include persistent cough, fatigue, fever, and weight loss. Public health officials take any TB exposure seriously because the disease is relatively rare in the United States, and infections can cause serious illness.

Tuberculosis is on the rise in NYC. Here’s why — and what to know about the disease.

The Suffolk County Department of Health is offering free testing to those with prolonged contact with the infected person. For TB, prolonged contact means several hours in close proximity, not just passing them in the hallway. Unlike measles and other pathogens, TB infection generally requires a longer period of exposure. So it’s common to only test people who have had prolonged close contact. In college, I was tested for TB after spending several hours near someone in my dorm who was later diagnosed. (I tested negative.)

In 2024, there were 250 confirmed TB cases in New York state, a 19% increase from 2023. Suffolk County reported 52 TB cases in 2024, the highest in New York.

2024 tuberculosis cases in New York counties.

What this means for you

TB is treatable if identified, and it’s much better to get it treated before symptoms start. So if you got a letter from the county health department, getting tested is a good idea. This TB FAQ from the New York Health Department is helpful.

Update on Medicaid cuts

Last week, the House of Representatives passed multiple health care revisions as part of the budget reconciliation bill. According to analysis done by Gov. Kathy Hochul’s office, these bills have two significant implications for health care in New York:

A potential annual loss of nearly $13.5 billion for New Yorkers’ health care sector, and
Nearly 1.5 million New Yorkers could lose Medicaid coverage and become uninsured

The bills would cut over $7.5 billion in federal funding from the Essential Plan (New York’s Medicaid expansion) and shift almost $3 billion of other costs to New York state. This means that the state would have to take on those costs or reduce funding for health care. We cover this in more detail in our recent Medicaid deep dive here.

Another major change included in the bill is a new work requirement: Starting in 2029, adults without children who are not disabled need to prove they’re working at least 80 hours per month to qualify for Medicaid. Community service, work training programs, and going to school also qualify.

Work requirements for Medicaid are being proposed to reduce federal spending — by shrinking the number of people who qualify — and to encourage employment. There are a couple of important issues with this:

Administrative difficulties would reduce access. When work requirements for Medicaid eligibility were tested in Arkansas, over 18,000 people lost coverage, and 60% delayed medical treatment due to costs, without increasing employment in the state. The study found that most of those who lost coverage were working and still eligible for Medicaid, but struggled with new reporting requirements, paperwork, and red tape.
The health insurance-work feedback loop. Research shows that having health insurance improves someone’s ability to find and maintain work, while poor health is associated with job loss. Taking away someone’s health insurance could leave them without health resources, making finding or keeping a job harder.

From my perspective, no matter how you slice it, reducing Medicaid funding and adding work requirements will result in millions losing health care coverage. When people lose access to health care, they are more likely to wait until they are sicker to get care, and often depend on emergency rooms. This will increase health care costs for people.

What happens next?

The bills will move on to the Senate for debate and approval. Congress will vote on them later this summer. You can call your representatives to let them know how you feel about the budget proposals. Here are some tips. Find their contact information here. If you’re a Medicaid recipient, it will be important to keep up to date with the latest information and reporting requirements as this evolves, so your coverage doesn’t fall through the cracks.

Changes to Covid-19 vaccine availability

Big changes may be coming to Covid-19 vaccine access in the United States, including here in New York. Last week, FDA Commissioner Marty Makary and his new adviser, Vinay Prasad, proposed limiting new Covid vaccine access to only people over 65 or those with chronic conditions. That means if you’re generally healthy and under 65, you may not be eligible for a booster this fall, or your insurance may not cover the shot. For more details, see YLE National’s deep dive.

If the proposed FDA policy goes through, the eligible chronic conditions are as follows:

Conditions for Covid-19 vaccine eligibility under the new proposed guidelines.

Judging from the New York State Department of Health estimates of chronic disease rates and our age demographics, only about half of New Yorkers may still qualify for Covid vaccines if the proposed changes go through. But nothing is final yet. The decision also depends on what specific vaccine the FDA recommends, who the CDC recommends should get it, and if a new formula is needed if a new variant comes onto the scene.

We’ll be watching closely and providing updates. This could impact millions of New Yorkers — and your ability to stay protected this respiratory season.

Bottom line

You’re all caught up! See you next week. 🙂

Love,

Your NY Epi

Trump’s team cited safety in limiting Covid shots. Patients, health advocates see more risk.

2025-05-23T15:32:52+00:00

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Larry Saltzman has blood cancer. He’s also a retired doctor, so he knows getting Covid-19 could be dangerous for him — his underlying illness puts him at high risk of serious complications and death. To avoid getting sick, he stays away from large gatherings, and he’s comforted knowing healthy people who get boosters protect him by reducing his exposure to the virus.

Until now, that is.

Vaccine opponents and skeptics in charge of federal health agencies — starting at the top with Health and Human Services Secretary Robert F. Kennedy Jr. — are restricting access to Covid shots that were a signature accomplishment of President Donald Trump’s first term and cost taxpayers about $13 billion to develop. The agencies are narrowing vaccination recommendations, pushing drugmakers to perform costly clinical studies, and taking other steps that will result in fewer people getting protection from a virus that still kills hundreds each week in the United States.

“There are hundreds of thousands of people who rely on these vaccines,” said Saltzman, 71, of Sacramento, California. “For people who are immunocompromised, if there aren’t enough people vaccinated, we lose the ring that’s protecting us. We’re totally vulnerable.”

The Trump administration on Tuesday rolled out tougher approval requirements for Covid shots, described as a Covid-19 “vaccination regulatory framework,” that could leave millions of Americans who want boosters unable to get them.

The Food and Drug Administration will encourage new clinical trials on the widely used vaccines before approving them for children and healthy adults. The requirements could cost drugmakers tens of millions of dollars and are likely to leave boosters largely out of reach for hundreds of millions of Americans this fall.

Under the new guidance, vaccines will be available for high-risk individuals and seniors. But the FDA will encourage drugmakers to commit to conducting post-marketing clinical trials in healthy adults when the agency approves Covid vaccines for those populations.

For the past five years, the shots have been recommended by the Centers for Disease Control and Prevention for everyone 6 months and older. They have been available each fall after being updated to reflect circulating strains of the virus, and the vaccines have been shown to be safe and effective in clinical trials.

CDC funding cuts impact Georgia vaccine access, other public health programs

Vinay Prasad, who leads the FDA’s division overseeing vaccines, cited “distrust of the American public” as he announced the new guidelines at a briefing on Tuesday.

“We have launched down this multi-year campaign of booster after booster after booster,” he said, adding that “we do not have gold-standard science to support this for average-risk, low-risk Americans.”

The details were outlined in a Tuesday article in the New England Journal of Medicine, written by FDA Commissioner Marty Makary. He and Prasad later followed up with the briefing, which appeared the same day on YouTube.

The added limits on access aren’t the result of any recent data showing there are new health risks from the Covid vaccines. Instead, they reflect a different regulatory stance from Kennedy, who has a history of anti-vaccine activism, and Makary, who has questioned the safety data on Covid mRNA shots.

Announcing a major regulatory change in a medical journal and YouTube video is a highly unusual approach that still leaves many questions about implementation unanswered. It remains unclear when the changes will go into effect or whether there will be any public comment period. The changes were announced by the administration before an FDA advisory committee meeting on Thursday to consider the 2026 Covid vaccine formula.

It’s a sharp reversal from the first Trump administration, which launched Operation Warp Speed — the effort that led to the development of the Covid shots. Trump called the vaccines the “gold standard” and a “monumental national achievement.”

Concerns raised about higher transmission

The announcement is rattling some patient advocacy groups, doctors, nursing home leaders, and researchers who worry about the ramifications. They say higher-risk individuals will be more likely to get Covid if people who aren’t at risk don’t get boosters that can help reduce transmission. And they say the FDA’s restrictions go too far, because they don’t provide exceptions for healthy individuals who work in high-risk settings, such as hospitals, who may want a Covid booster for protection.

The limits will also make it harder to get insurance coverage for the vaccines. And the FDA’s new stance could also increase vaccine hesitancy by undermining confidence in Covid vaccines that have already been subject to rigorous safety review, said Kate Broderick, chief innovation officer at Maravai Life Sciences, which makes mRNA products for use in vaccine development.

“For the public, it raises questions,” she said. “If someone has concerns, I‘d like them to know that of all the vaccines, the ones with the most understood safety profile are probably Covid-19 vaccines. There is an incredible body of data and over 10 billion doses given.”

Some doctors and epidemiologists say it could leave healthy people especially vulnerable if more virulent strains of Covid emerge and they can’t access Covid shots.

“It’s not based on science,” said Rob Davidson, an emergency room doctor in Michigan and executive director of the Committee to Protect Health Care, which works to expand health care access. “It’s what we were all worried would happen. It risks peoples’ lives.”

Current federal regulators say there is no high-quality evidence showing that vaccinating healthy people, including health workers who are near or around immunocompromised people, provides an additional benefit.

“It is possible, actually, that such approvals and strategies provide false reassurance and lead to increased harms,” Prasad said.

NIH cuts halted CUNY research on Covid-19 vaccination and mental health. Here’s what that means for the unfinished project.

The Covid vaccines underwent clinical trials to assess safety, and they have been subject to ongoing surveillance and monitoring since they obtained emergency use authorization from the FDA amid the pandemic. Heart issues and allergic reactions can occur but are rare, according to the CDC.

On a separate track, the FDA on Wednesday posted letters sent in April to makers of the mRNA Covid vaccines to add information about possible heart injury on warning labels, a move that one former agency official described as overkill. The action came after the Permanent Subcommittee on Investigations, a panel of the Senate Homeland Security and Governmental Affairs Committee, held a hearing on alleged adverse events associated with Covid vaccines.

Limiting boosters to healthy people goes against guidance from some medical groups.

“The Covid-19 vaccine is safe, effective, and the best way to protect children,” Sean O‘Leary, chair of the Committee on Infectious Diseases at the American Academy of Pediatrics, said in an email. “Young children under 5 continue to be at the highest risk, with that risk decreasing as they get older.”

Unsupported claims circulating about mRNA vaccines

The Covid booster clampdown is supported by many adherents of the “Make America Healthy Again” movement, which casts suspicion on traditional medicine. Some opponents of Covid mRNA vaccines say without evidence that the shots cause “turbo” cancer, are genetic bioweapons, and cause more heart damage than the Covid virus.

There is no evidence the shots lead to rapid and aggressive cancers. Cancer rates decreased an average of 1.7% per year for men and 1.3% for women from 2018 to 2022, according to the National Institutes of Health. The Covid vaccines debuted in 2021.

Federal regulators say narrowing who can get the boosters will align the United States with policies of European nations. But other countries have vastly different economic structures for health care and approaches to preventive care. Many European countries, for example, don’t recommend flu shots for the entire population. The United States does in part because of the financial drain attributed to lost productivity when people are sick.

They also want more information. “I think there’s a void of data,” Makary told CBS News on April 29. “And I think rather than allow that void to be filled with opinions, I‘d like to see some good data.”

A massive five-year study on Covid vaccine safety by the Global Vaccine Data Network, involving millions of people, was underway, with about a year left before completion. The Trump administration terminated funding for the project as part of cuts directed by the president’s Department of Government Efficiency, and work on the study has stopped for now.

There are a multitude of studies, however, on the vaccines’ effectiveness in preventing severe illness, hospitalization, and death.

Limiting boosters for healthy people can be risky, some doctors say, because people don’t always know when they fall into higher-risk categories, such as individuals who are prediabetic or have high blood pressure. The Covid vaccine restrictions could deter them from getting boosted, and they might experience worse complications from the virus as a result. For example, about 40% of people with hepatitis C are unaware of their condition, according to a 2023 study.

The number of people getting Covid vaccines has dropped significantly since the height of the crisis. More than half of the more than 258 million adults in the United States had gotten a Covid vaccination as of May 2021, according to the CDC. In each of the past two seasons, less than 25% of Americans received boosters, CDC data shows.

While deaths from the virus have dropped, Covid remains a risk, especially when cases peak in December and January. Weekly Covid deaths topped 2,580 as recently as January 2024, according to CDC data.

Some high-risk individuals are worried that the new restrictions are just the first salvo in halting all access to mRNA shots. “The HHS motivation really is hidden, and it’s to dismiss all mRNA technology,” said Michael Osterholm, an epidemiologist at the University of Minnesota.

Officials at the NIH have told scientists to remove references to mRNA in grant applications. HHS also announced plans in May to develop new vaccines without mRNA technology, which uses messenger RNA to instruct cells to make proteins that trigger an immune response.

Rose Keller, 23, is concerned about future access to Covid shots. She would be eligible under the current announcement — she has cystic fibrosis, a progressive genetic condition that makes the mucus in her lungs thick and sticky, so Covid could land her in the hospital. But she is concerned the Trump administration may go further and restrict access to the vaccines as part of a broader opposition to mRNA technology.

“I‘ve had every booster that’s available to me,” said Keller, a government employee in Augusta, Maine. “It’s a real worry if I don’t have the protection of a Covid booster.”

This story originally published at KFF Health News, Healthbeat’s national reporting partner.

CDC funding cuts impact Georgia vaccine access, other public health programs

2025-04-23T14:32:59+00:00

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Groups that work to provide access to vaccines, especially for Black Georgians and others in underserved communities, are among those affected as the state Department of Public Health absorbs a $334.2 million loss from the Centers for Disease Control and Prevention.

The abrupt cancellation of funds announced March 25 sent DPH leaders scrambling to understand the impact and inform contractors, including many community organizations, to stop work immediately, according to emails Healthbeat obtained under open records laws.

“I personally called several of these recipients myself, as these funds were not slated to end until late 2026,” Georgia Public Health Commissioner Kathleen Toomey wrote March 28 to Amy Doehrman and Russell Crutchfield, the deputy and chief operating officers, respectively, in the governor’s office.

Cuts to CDC Covid-era funding totaled nearly $12 billion nationwide. “These grants and cooperative agreements were issued for a limited purpose: to ameliorate the effects of the pandemic. Now that the pandemic is over, [they] are no longer necessary as their limited purpose has run,” stated a federal notice to grant awardees.

Federal cuts force Out of Hand Theater to halt vaccine outreach, affecting overall operations

A group of Democratic-led states have filed a lawsuit challenging the cuts, prompting a federal judge to issue a temporary restraining order blocking the reductions. But the order does not apply to Georgia, which is not among the states that sued.

DPH has shared few details about how the cuts will impact its work and did not respond to multiple requests for more information. Leaders at the Cobb and Douglas Public Health said in March that they would lose about $467,000. State officials have said the agency’s core services will continue.

Many of the affected community groups couldn’t be reached or declined to comment.

Here’s what we know.

Epidemiology lab capacity funding cut

State epidemiologist Dr. Cherie Drenzek notified Toomey and DPH agency leaders at 10:10 a.m. on March 25 that she had received a notice terminating CDC “epidemiology laboratory capacity” Covid funding. The funding was a Covid supplement to regular CDC lab funding to support state public health laboratory capacity.

Later that day, Drenzek wrote to senior leaders that only one grant had been impacted: “‘Only’ but HUGE.” The grant apparently had a previous end date of July 31, 2026. DPH did not respond to requests for additional information about how the state’s lab services would be impacted.

By that evening, the agency had started sending out termination notices to temporary employees “due to loss of funding.” The agency laid off 170 temporary contact tracers, according to DPH spokesperson Nancy Nydam.

Another 13 employees were laid off, including four who worked in epidemiology, four who worked on lab services, and three who worked on emergency preparedness, Nydam said.

Sean Penn’s CORE loses $3.3 million for vaccine work

The Community Organized Relief Effort, founded by actor Sean Penn, lost nearly $3.3 million of Vaccines for Children Covid funding, according to a preliminary spreadsheet Healthbeat obtained via an open records request.

Penn co-founded CORE in 2010 in response to an earthquake in Haiti. CORE now bills itself as a “global humanitarian organization.” It started working in Georgia during the Covid-19 pandemic and has since continued to help underserved communities get access to vaccines, according to its website.

Georgia contained a measles outbreak. But low vaccination rates keep the state vulnerable.

CORE hosted 90 mobile vaccination events and administered 385 vaccines in March 2025 at a women’s shelter, a flea market in Pendergrass, Ga., a community shower and hygiene event in Clayton County, and others, according to a report submitted to DPH last month. Since March 2021, CORE has administered more than 149,000 Covid vaccines in Georgia.

“While DPH would like to provide sufficient notice, we must ask CORE to cease all activities effective tomorrow,” DPH Deputy Commissioner Chris Rustin wrote in a March 25 email to Sam Archbold, CORE’s Georgia area director.

The loss of CDC funds comes after CORE in February lost about $5 million of a $12 million contract with DPH to coordinate and manage Covid and flu vaccine events and outreach in high-risk and underserved communities, according to documents.

Atlanta nonprofit loses about $500,000 for vaccine equity work

Atlanta nonprofit BLKHLTH Inc. lost about half a million dollars in federal funding, co-founder Kadijah Ameen said.

The organization received notice of the cuts in late March, resulting in the cancellation of 10 upcoming events under a federal grant focused on Covid vaccine equity, Ameen said. BLKHLTH had planned to use information gleaned from listening sessions across the state to shape vaccine outreach efforts.

“We’re using data from the listening sessions to form our community-based vaccine clinics….We had to halt that programming,” Ameen said. “It was disruptive.”

Concerns over whether information about Covid and vaccines could be removed from the CDC website under orders from the Trump administration added urgency to BLKHLTH’s work, Ameen said.

“We don’t know how long Covid-19 info is going to be on the CDC website, and so we want to make sure that folks had a space to access information that was culturally responsive,” Ameen said. The group’s listening sessions had revealed that Black Georgians want reliable vaccine information that can help “cut through … disinformation.”

The hit to her organization’s budget was large, Ameen said. “We are a small non-profit and this was a million-dollar reimbursable grant, so that was a large percentage of our anticipated budget for the year.”

The organization has rearranged funding and plans to find alternative sources to continue its vaccine work, Ameen said.

Center for Black Women’s Wellness loses funds

The news prompted swift dismay from Jamea Dorsey, president and CEO of the Atlanta nonprofit Center for Black Women’s Wellness, which lost about $438,000 in the cuts, according to the preliminary spreadsheet.

“We are saddened and disappointed, especially due to the fact that we are receiving this communications after our Covid outreach event and listening session, which occurred on 3/25, and we have another event scheduled for tomorrow,” Dorsey wrote in a March 26 email to Jamillia Valentine, director of office of procurement and contracting services at DPH.

The organization was notified March 26 that its contract had ended at midnight two days before.

“Will we not be compensated for this work? These expenses were committed and allocated prior to 3/24,” Dorsey wrote. “Please advise, as this will cause hardship for our organization.”

“We are also deeply concerned about the loss of trust in the community,” Dorsey added.

Dorsey did not respond to a request for comment. The center provides health care services and maternal and postpartum support. It had about $3.3 million in revenue in 2023, according to its tax documents.

Red Covid testing kiosks removed

Red self-serve Covid testing kiosks DPH set up during the pandemic are being removed. They were provided under a contract with Longview International Technology Services, according to the spreadsheet of preliminary cuts.

The kiosks were programmed to deactivate on March 31, with Longview set to pick them up, according to an email from Rustin to district health directors.

“DPH has already paid for the test kits in the machines, so any expense between 3/24 and 3/31 will be absorbed by LTS.”

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Winter respiratory illnesses winding down in Georgia, but some Covid and flu still circulating

2025-04-18T20:08:46+00:00

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As spring temperatures rise along with pollen counts in Georgia, the state is seeing a decline in winter respiratory infections.

Data from the Centers for Disease Control and Prevention show the amount of respiratory illness causing people to seek health care is low nationwide and in Georgia. Flu, Covid, and RSV emergency department visits are all low and decreasing.

However, wastewater surveillance data still show moderate rates of Influenza A and high rates of Covid in Georgia.

Flu health care visits are down

The CDC collects data about ILI, or “influenza-like illness,” visits to over 3,400 health care providers nationwide. The data track patients who show up with flu-like symptoms, including fever, sore throat, and cough.

Those numbers in Georgia show a downward trend over the past weeks, at 2.3% for the week ending April 12, down from a high of 8.8% in late January.

The decline is mirrored in a drop in the number of positive flu tests at selected labs in Georgia. That was down to about 4.6% for the week ending April 12, from a high of 27% in late January, according to the latest available data from the CDC. A total of 1,367 specimens from Georgia were tested in the week ending April 12.

That system has eight sites in Georgia, from Alma to Columbus to Gainesville, including the state public health lab in Decatur, according to the CDC.

CDC wastewater surveillance data set Georgia’s level for influenza A at moderate for the week ending April 12, down from “very high” in January and February.

Since the season started in October, flu has killed 138 Georgians, according to data from the state Department of Public Health. Most of the fatal cases occurred in people over 50. Three children under 18 years old also died.

Covid and RSV levels declining

Wastewater viral activity level for Covid is high in Georgia for the week ending April 12, according to the CDC. That’s down from “very high” in August.

When it comes to positive Covid tests, rates are down from their highest rate this season but still up over the start of the season in the fall, according to DPH data from Georgia clinical labs.

For the week ending April 5, 5.5% of Covid tests were positive. That’s down from over 8%, the highest point in December 2024, and March, according to DPH data.

It’s important to note this data does not reflect all Covid tests performed in Georgia, just those performed at certain labs.

Rates for RSV, or respiratory syncytial virus, which often hits young children and the elderly the hardest, are down, with a positivity rate for the week ending April 5 of 0.3%. They hit a high of 26.9% in late fall, according to DPH.

The CDC’s wastewater RSV activity in Georgia for the week ending April 12 is very low.

Proliferation of pollen aggravates allergies

Meanwhile, people are sniffling, sneezing and even avoiding the beautiful Atlanta weather due to pollen rates, which have been high for several days over the past few weeks. The count, which tallies pollen from trees, grass, and weeds, ranged between 338 and 2128 this week.

Nurses who are certified pollen counters at Atlanta Allergy and Asthma count the pesky pollen spores daily. The clinic is the only National Allergy Bureau-certified pollen center in Georgia.

For Georgians, the pollen season appears to be lengthening, allergist Dr. Lily Hwang told Healthbeat recently.

“Our pollen is only going to get worse,” she said, adding that models predict an increase in severity and intensity until 2035. “They show that ragweed is moving more northward. We’re getting longer seasons. All these things are changing as we’re following them.”

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

NIH cuts halted CUNY research on Covid-19 vaccination and mental health. Here’s what that means for the unfinished project.

2025-04-18T16:44:04+00:00

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As the Covid-19 pandemic spread through New York City in March 2020, researchers affiliated with the City University of New York launched a nationwide research project tracking the disease, its financial and mental health impacts, and eventually, vaccine uptake.

Over time, they became particularly interested in understanding the barriers to Covid-19 vaccination for people with anxiety and depression. That led to a research project funded by about $3 million from the National Institutes of Health, exploring what prevents people with anxiety and depression from getting vaccinated, and testing out possible interventions.

But last month, the project’s grant was terminated, part of a wave of deep cuts to NIH funding that has impacted research institutions throughout New York and the United States. The team of about 15 people working on the project had completed collecting data, but still had significant analysis and writing to do, said Dr. Denis Nash, a distinguished professor of epidemiology at the CUNY School of Public Health and one of the project’s principal investigators, alongside Dr. Angela Parcesepe, an associate professor at the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill.

Dr. Denis Nash is a distinguished professor of epidemiology at the CUNY School of Public Health and the executive director of the CUNY Institute for Implementation Science in Population Health in New York.

It was a “devastating” development for research that took root at the start of the pandemic, Nash, who is also the executive director of the CUNY Institute for Implementation Science in Population Health, told Healthbeat.

Last spring, CUNY researchers had recruited about 1,500 people from their CHASING COVID Cohort Study who had received a primary series Covid-19 vaccination but were not up to date on their vaccines. As part of the study, participants were texted or emailed a questionnaire that included a link to one of three videos showing an interaction between a doctor and patient. One video used cognitive behavioral therapy techniques to encourage vaccination, another countered vaccine misinformation, and a third presented standard public health messaging on the benefits of vaccination. Researchers returned to the participants after four weeks and again at six months to record their vaccination status.

In this interview, edited for length and clarity, Nash describes what his team’s research involved, and what it means to have their grant terminated.

Where did this research emerge from?

[The CHASING COVID Cohort Study] measured mental health and depression and anxiety pretty frequently over the course of the four or five years that we followed the cohort. When things started to subside with the pandemic, we were realizing that the next set of problems is: How do we contribute to an understanding of improving vaccination outcomes?

Amid fears of deeper federal cuts, New York health leaders affirm commitment to health equity

When we started this latest study, maybe 21% of adults around the U.S. had received the latest Covid vaccine, which is not nearly as high as it needs to be. Angela and I decided to do something we hadn’t done with the cohort before, which was to develop some kind of intervention that we could deploy to see if we could improve outcomes. Before that, we were just observing people and gathering information about them. It was useful and important, but we had not tried to see if there were things that we could do to influence their health behaviors and outcomes.

We had another researcher on the team who had done some intervention work around inoculation theory, around misinformation and disinformation. It’s this idea that if you prepare people in advance that they might be exposed to inaccurate information, or deliberately deceptive information, when they are confronted with those messages later on, they’re better prepared to deal with it and not be manipulated by it.

Based on our research, we learned that people with common mental disorders in our cohort were more likely to endorse misinformation and disinformation. In other words, they were more likely to cite that as reasons for not being vaccinated. And they also reported barriers that especially the mental health experts on our team thought could be overcome, with cognitive behavioral therapy-type interventions.

So we designed these three brief videos, and we wanted to see if we randomized people to get one of these three videos, did it have an effect on people’s decision to get vaccinated over the subsequent four weeks? Did it change their likelihood of making an appointment, or deciding to make an appointment, and then actually going to get vaccinated?

What did your research find?

We didn’t, unfortunately, see an impact of the intervention on outcomes. But it was important for us to do the study to assess whether there was a theory-informed low-touch strategy that could be used here. There have been other studies in the literature, for example, where pharmacies would send text outreach reminders to people, and [differences in vaccine uptake] tended to be pretty small, like a 1% increase. That’s in line with what we saw. But we were taking a different approach, in that we were trying to get people to engage in a way of thinking about what might be delaying them or getting in the way of something they want or feel that they need.

Did the research suggest interventions that could work better?

The things that are getting in the way among people who have been vaccinated before, but are not up to date, are bigger than a brief one-minute video could potentially overcome. It doesn’t mean that an approach like this couldn’t work; it may need to be a little more intensive in some ways.

How did you find out your funding was terminated?

I was at an HIV conference in San Francisco at the time, and I heard from a reporter at Science that a reputable source at NIH leaked a list of canceled grants. Mine was on it; did I care to comment?

Local health projects across New York in limbo after abrupt HHS cuts

We had heard in the days before that there were going to be a bunch of vaccine-related grants canceled. We were bracing ourselves, but the messaging was such that everyone whose grant was canceled had been told the night before. So part of me was thinking, maybe we dodged a bullet. But the fact was, they hadn’t told everyone yet. A few hours after that interaction with the reporter, we got the official notice from NIH.

It was devastating. It was a horrible time. The feeling at this conference was kind of like a funeral. I was running into so many people with cancelled grants. The Columbia cancellations had just happened, and my colleagues from Columbia were there. It was a horrible week.

Where does this leave your research?

The devastating thing is that we still had a lot of analysis and writing to do, and it was all abruptly halted when the grant was canceled. So we have the paper with the four-week outcomes that was already submitted to a journal. We are busily revising that, but there are many other papers that we want to write to contribute to this knowledge, that we’re not going to be able to do, or it’s going to happen way more slowly.

We have faculty and staff, and many of the staff are PhD and master’s students that we pay to work on these research projects, and they learn how to do research in the process. [Now] they’re not allowed to work on it because we don’t have funding to support it. They can volunteer their time to do that, but that’s not the same as paying someone 40 hours a week to do data cleaning, to help us do literature searches, and analyze data in support of preparing a manuscript. It’s really a team effort. Without paid staff, it’s going to move much more slowly.

What did it mean for you to have NIH supporting this research?

We launched the [CHASING COVID Cohort] of our own accord, with very limited institutional funds, but we thought it was important to start. At the same time, we wrote a grant to NIH to support it going forward, including the blood specimens we needed to collect from all participants over time. And we did get emergency funds from NIH to do the cohort.

So the investment in this work goes way back, to March of 2020, on the part of NIH. If you want to think about efficiency, in this particular grant, they paid for all the data collection. And participants have volunteered their time and contributions to the work, only to have the most important part — the contributions to knowledge, to science, to the field — be abruptly curtailed. It is a huge loss, and definitely not part of the mission of NIH and [the U.S. Department of Health and Human Services]. They’re all about trying to contribute to scientific knowledge and improving public health outcomes. It’s a very untimely termination.

Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org.

Was the U.S. Covid pandemic response too much? Six questions to consider

2025-03-28T13:59:24+00:00

This is a guest essay for Healthbeat. Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

In January 2020, countries around the world were forced to confront a brand new virus. We had no prior understanding of how it spreads or what it does to the body, and we lacked tests, drugs, and vaccines for it.

Five years later, it is abundantly clear that governments at all levels made missteps in how they managed what became the Covid pandemic, and, given the high likelihood of future pandemics from emerging infectious diseases, it is important to re-examine what we got right and wrong, so societies can respond more effectively the next time.

In recent months, a particular narrative has gained momentum. This narrative — often labeled Covid revisionism — suggests that the U.S. government’s response to the virus did more harm than good, that efforts to slow transmission through physical distancing, masks, and vaccines were misguided or excessive. Had we simply accepted the virus’ spread, society would have been better off, some argue.

The narrative that the United States should have had fewer or different virus control measures glosses over some important considerations. From April 2020 to May 2021, I served as the lead health adviser to the New York City mayor for the Covid response. Based on my experience, I offer six questions for everyone to consider.

1. How much power did public health experts actually have over elected leaders?

A common concern raised by those critical of Covid control measures is that a small number of scientists and public health officials exerted too much power. A recent New York Times podcast said one major problem with the U.S. pandemic response was “too much power was accorded to narrow experts in public health and epidemiology.”

In practice, however, virtually all significant policy decisions — particularly those affecting business closures, schools, and masks — were made by elected officials. Governors and mayors consulted with health experts within government and academia, but they were almost always the ones weighing the trade-offs, exerting their legal authority to restrict personal liberties, and taking responsibility for the choices that were made.

To suggest otherwise overlooks how democratic governance actually functioned during the pandemic. In the United States, public health officials at state and local levels report to a democratically elected executive or, in some situations, a board of public representatives. These health officials made recommendations, and elected leaders chose whether and how to implement them. If we want to improve our response to future infectious disease emergencies, it is important to scrutinize how these leaders used expert advice — not paint an inaccurate picture of technocratic overreach.

2. Were the social and economic costs ignored?

Another claim we often hear is that only a small group of dissenters were willing to talk about the mental health effects, economic damage, or social disruption caused by Covid control measures. These dissenters argue that public health officials were singularly focused on lives saved and failed to consider the loss of livelihoods.

In my experience, this was never the case. When I served in City Hall in New York, almost every major discussion I had with government officials involved me presenting multiple scenarios. I would start with the extreme scenario of us attempting to avert every illness and death, contrast that with the opposing extreme scenario of taking no action, and then discuss various policy options between these two.

How improving air quality in schools would minimize the threat of bird flu spread

Every policy option presented to the mayor was developed by a diverse team that included public health experts and people with backgrounds in law, policy, business, and community engagement. We spent countless hours debating how to protect vulnerable populations, support small businesses, and address acute and long-term mental health harms of these measures. Every decision involved excruciating trade-offs, and no one took them lightly.

Criticism is vital. Some measures seemed irrational — for example, liquor stores stayed open, while schools closed — and some measures lasted too long or were applied unevenly. These were the result of a messy democracy, reflecting a need for elected officials to balance competing centers of power in our society. To suggest that these consequences were ignored doesn’t reflect the reality I witnessed, where leaders agonized over these issues.

3. How should society think about acceptable loss of life?

Perhaps the most difficult — and least discussed — question is this: How many deaths are acceptable in a public health emergency? There is no simple or comfortable answer. Every pandemic policy requires balancing lives lost against the costs of prevention.

Those who supported strict control measures prioritized preventing illness and death. The rationale for this argument was straightforward: We have technologies to address poverty and depression from virus control measures; we do not have a technology to resuscitate the dead from the virus; and restrictions can be progressively lifted as vaccines and treatments become available.

Most important, as I have written elsewhere, how much a society should sacrifice to avert one death is not a question to be answered by scientists or epidemiologists. It should be answered by democratically elected leaders. These are decisions about values: How much is a life worth, and what responsibility do I have as an individual and does my government have overall for protecting a person’s life?

While it is ethically sound to argue that government should prioritize liberty over public health, I often hear Covid revisionists make an alternative argument. They try to impugn scientific understanding or epidemiologic statistics — questioning death estimates, vaccine effectiveness, or studies that show the risk of Covid to cardiovascular health — without wrestling with the more difficult question: If the scientific consensus is, in fact, accurate, do we still believe that fewer restrictions are acceptable?

To have an honest reckoning, we must be explicit about our values. Just as those advocating for strict measures made it explicitly clear that they prioritize averting deaths over personal liberty, the contrarians should be explicit in saying that they accept deaths as the cost of preserving liberty — and be willing to say exactly how many deaths are acceptable.

4. What was the alternative to stay-at-home orders when hospitals were overwhelmed?

One of the most sobering realities of spring 2020 was the strain placed on hospitals. In New York City, refrigerator trucks lined the streets to store bodies. Emergency departments were filled beyond capacity. Health care workers pleaded on social media with the public to stay home, because the system could not handle more patients. Many severely ill people, sadly, took this message to the extreme and died at home without seeking care.

Some critics argue that younger, healthier people should have been allowed to go about their lives during this time. But what would that have meant in practice when the health care system was already on the brink? Would we have told people that, if they got sick or injured, care might not be available? That their grandparents, neighbors, or co-workers might die unattended? That there may not be any space in the emergency department for young and healthy people if you are in a car accident or break your leg on the basketball court?

If we’re rethinking the response, it is worth asking what options we realistically had when we could not build more hospital beds or staff those beds safely, when the very infrastructure of care was at risk of collapse.

5. Should long-term health effects be part of the conversation?

The dominant focus in many debates about Covid policy is acute outcomes, such as hospitalizations and deaths. But, over time, we’ve learned that the virus can cause significant long-term health problems: heart attacks, strokes, clots, and a debilitating, poorly understood condition broadly referred to as “Long Covid.”

These conditions affect millions of Americans and have real consequences for people’s ability to work, care for families, and enjoy daily life. If we had known more about these long-term impacts in 2020, would that have changed how we weighed risks and benefits?

Any honest reassessment of the pandemic response should include these effects in the equation. Ignoring them presents an incomplete picture of the harm Covid can cause.

6. Do those who died from Covid get a voice in our reassessment of the past?

Finally, it is worth reflecting on who is not part of today’s debate: the millions who died. Survivor bias is powerful. It’s easy to criticize restrictions when you were lucky enough to come through the crisis without death or disability. I suspect many who died of Covid would have welcomed more efforts to protect their lives.

Keeping society functioning during a pandemic requires more than just protecting those fortunate to survive. A large percentage of the population had risk factors that put them at greater risk of Covid complications, and many of these still had to serve as “essential workers.”

Another group of advocates — some of whom have been diagnosed with Long Covid or who have medical conditions that put them at higher risk of Covid complications — argue that the United States did too little to contain the virus during the peak of the pandemic and continues to do too little to protect vulnerable populations.

There is no single right answer to how societies should handle pandemics. Every approach will involve trade-offs, regrets, and a need for humility. I used to tell colleagues and reporters that all options before us are bad and that we are trying to choose the least bad path forward. Each decision ideally starts with science, but turning science into policy requires a complex assessment of benefits, harms, feasibility, acceptability, affordability, legality, and ethics.

It is healthy in a democracy to challenge consensus, to debate what went wrong during the peak of the pandemic, and to listen to those who felt unheard or harmed by policy decisions. As we do so, we should also be wary of oversimplified narratives. The truth of the Covid response is more complex than either triumph or failure. As we reflect, we must hold space for different perspectives — while also insisting that those perspectives wrestle with the full scope of the crisis, not just the parts that fit our preferred narrative.

Covid cases in Georgia could soon see an uptick, CDC data show

2025-03-21T18:14:11+00:00

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While severe respiratory disease cases in Georgia have subsided significantly over the past few months, some early signs indicate the state could soon see a rise in Covid-19 infections.

Compared to the previous few winters, Georgia saw a relatively low number of hospitalizations and deaths related to the disease. But state wastewater data, which can help predict those two health outcomes, from the Centers for Disease Control and Prevention show an uptick in Covid-19 levels that is nearing the highest estimates of this year.

The virus more responsible for hospitalizing Georgians over the past few months has been the flu. Since October, it’s hospitalized more state residents than Covid and respiratory syncytial virus combined, according to data from the CDC.

But unlike Covid, flu and RSV measures from the Atlanta-based health agency indicate that new cases of the respiratory viruses continue to decrease as the winter turns to spring. As of the first week of March, new Georgia hospitalizations for the flu have dropped about 70% since the beginning of February.

Although it’s been responsible for less hospitalization this year, Covid-19 continues to be more deadly than flu. Since December, the virus has killed over 200 state residents, according to the CDC. In contrast, the Georgia Department of Public Health reports there’ve been 124 Georgia flu deaths since October.

The most recent surveys from the CDC estimate that between 13% and 18% of Georgia adults have received an updated Covid-19 vaccine for the 2024-25 respiratory virus season. That’s lower than the national average, which the agency puts at around 23%.

Allen Siegler is a reporter covering public health in Atlanta for Healthbeat. Contact Allen at asiegler@healthbeat.org.

Respiratory viruses continue to circulate throughout Georgia

2025-02-28T20:29:59+00:00

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As Atlanta and Georgia enter the end of the traditional winter respiratory illness season, there are still signs that airborne viruses are circulating widely.

Data from the Centers for Disease Control and Prevention related to flu, Covid-19, and respiratory syncytial virus indicate a wide range of trends. The number of flu hospitalizations, which have made up the vast majority of Georgia in-patient visits among the three diseases this year, continue to decrease from a second winter peak. But Covid hospital stays have risen throughout February to the highest numbers this winter.

Still, there continues to be significantly fewer state hospitalizations for Covid infections than for flu, which has killed 70 Georgia residents since early October. Georgia’s Covid hospitalization rate remains lower than any winter since U.S. cases were first detected in 2020.

These trends are reflected by the CDC’s wastewater data, which can help public health analysts predict future disease patterns. As of late February, Georgia’s Covid levels have elevated significantly compared to January, whereas flu wastewater sites have detected the opposite pattern.

Additionally, levels of RSV in Georgia have slightly ticked up after declining throughout January and February, indicating that hospitals could soon be seeing more patients with the virus. The rise has yet to approach the state’s December numbers, which were among the highest Georgia levels in years.

Georgia doctors have cautioned that while respiratory disease cases typically decline throughout March, there could be another surge in infections at untraditional times. That’s why many recommend that anyone who has yet to receive a Covid or flu shot over the past few months get one.

A different highly infectious virus, measles, appears to be contained in Georgia. Nancy Nydam, a spokesperson for the Georgia Department of Public Health, said there have been no additional cases related to the outbreak that infected three unvaccinated metro Atlanta residents earlier this winter. She added that potentially exposed residents, most of whom were in communication with local and state public health officials, are now out of the period where a new infection may emerge.

Georgia’s outbreak was relatively small compared to others across the United States. In Texas and New Mexico, 155 residents have contracted measles cases this winter. Earlier this week, Texas health officials announced a child had died of the disease — the first U.S. measles death since 2015.

Allen Siegler is a reporter covering public health in Atlanta for Healthbeat. Contact Allen at asiegler@healthbeat.org.

Public health data chaos: How New York is protected from federal communications freeze

2025-02-05T15:10:40+00:00

Sign up for Your Local Epidemiologist New York and get Dr. Marisa Donnelly’s community public health forecast in your inbox a day early.

Have questions, comments, or ideas for future topics? Email me at mdonnelly@healthbeat.org. I would love to hear from you.

After navigating to the New York respiratory virus dashboards, where I usually start my analysis for these reports, I breathed a sigh of relief. The data were still being updated, and I could do my job: translating public health science for you.

Before we get into the state of affairs of respiratory illnesses, though, here is what is happening with data at the federal level and why New York has been spared the widespread closures of federal data sets we’ve seen this week.

Decentralized public health system

In the United States, our public health system is decentralized. This means that local and state health departments collect and own the data rather than the federal government. During the Covid-19 pandemic, limitations to this setup slowed our understanding of what was happening nationally — the Centers for Disease Control and Prevention had to knit all the local and state pieces together. However, with current uncertainties surrounding federal data sharing, this is a good thing, as it provides a sort of firewall.

All states have slightly different models of how this works.

Blue dots = county health departments; red dots = state health departments; blue arrows = data flow.

New York is a mostly decentralized state. Local health departments retain authority and are led by local government employees. They collect health data from their communities and share it with the state and then with the CDC. Data flow from the bottom up, and remain available to us regardless of what the feds do or don’t do with it. Importantly, states don’t have to send the majority of data to the CDC (really only hospitalizations).

While this is good news, there are some vulnerabilities associated with a potentially weakened CDC that epidemiologists like myself are paying close attention to:

During big outbreaks or public health emergencies, like a measles outbreak or hurricane, coordination across states and with the CDC is absolutely essential. We often rely on CDC expertise when new or rare diseases pop up.
Reduced funding for the CDC would affect local and state health department funding. Eighty percent of local and state public health funding comes from the CDC.
Not all states have the resources to maintain their own health dashboards, like in North Dakota, for example. Many rely on CDC’s dashboards, and without them, residents of those states could be left without critical public health information.

What this means to you and New York communities

New York can (and continues to) publish its data for New Yorkers without interference from federal government chaos. For example, dashboards for influenza, RSV, Covid-19, and wastewater remain unaffected.

With gratitude for the strength of our New York public health system, let’s dive into the most recent data on respiratory viruses.

The flu: High and increasing

The number of people with flu in New York is abnormally high for this time of year, and the increase is widespread across all state regions. With so much flu, New York hospitals are being pushed to their limits. In Rochester, for example, recent spikes in flu hospitalizations have pushed the Strong Memorial Hospital beyond its capacity.

Influenza hospitalizations from the New York State Flu Tracker.

New York’s flu season started later than last year’s, but it’s shaping up to be worse. Severe flu infections requiring hospitalization are the highest they’re been in three years and may not have peaked yet. Over the past two seasons, flu hospitalizations peaked before New Year’s Day.

We’re seeing the flu hit nursing homes and older populations hard. In the week ending Jan. 25, 41 outbreaks were reported in nursing homes — a 32% increase compared with the previous week. This is concerning because older residents are at much higher risk for bad flu outcomes: In a typical season, about 70-85% of flu deaths are among people age 65 or older (CDC Flu). Across the state, flu hospitalizations are highest in the 75+ age group.

Influenza hospitalizations by age from the New York State Flu Tracker.

With the flu so high, there are a couple of things we can do to protect our most vulnerable fellow New Yorkers, including:

Wearing a mask in crowded spaces (while traveling, on the subway, in supermarkets, etc.).
Avoiding social interactions if you aren’t feeling well.
Getting vaccinated.
- Flu usually has a second peak later in winter due to flu B circulation (right now, most flu cases are from flu A), and infections can go into March or April, so it’s not too late to get your flu vaccine at a local pharmacy or clinic.
People who are at increased risk of serious flu complications (pregnant people, people over age 65, people with asthma and chronic lung disease, diabetes, or heart disease) should contact their doctor for possible treatment within two days of symptom onset.

Covid-19: Minimal and holding steady

Covid-19 activity in New York has remained surprisingly low — this is our mildest Covid-19 winter to date.

It’s striking that Covid-19 levels are so low in New York compared to national and Northeast regional averages. High community immunity from vaccinations and past infections — especially following a big summer wave — likely plays a role, but I don’t think it tells the whole story. Milder infections may be leading to less viral shedding, and behavioral changes like isolating when sick or masking could also be reducing spread. Given the high flu activity in New York, I also wonder if interactions or competition between respiratory viruses are slowing Covid-19 transmission.

SARS-CoV-2 concentrations in New York state (yellow line) are minimal, while national concentrations (black) are high and increasing, according to data from the CDC National Wastewater Surveillance System.

RSV: Moderate and decreasing

RSV has peaked and continues to decline in New York. This season looks like a middle-of-the-road RSV season, like last year’s. The shape of the RSV seasonal curve in New York is similar to the past three years.

New York City RSV testing data from the Influenza and RSV Surveillance Report.

We still expect there to be several weeks of RSV activity, so we aren’t entirely out of the woods yet.

Emerging diseases: Avian flu

Two weeks ago, avian flu (bird flu, H5N1) was detected on a Long Island duck farm. This is important because, up to now, New York has been relatively spared the impacts of H5N1 compared to other states. We’ve had no reported cases among humans or cattle. The duck farm outbreak is only our second in a commercial flock statewide and our first in three years (United States Department of Agriculture Avian Influenza Tracker). Thankfully, New York agriculture and public health authorities are taking steps to prevent further spread.

All 100,000 ducks at the Crescent Duck Farm in Aquebogue on Long Island had to be culled (euthanized). Culling birds after an avian flu detection happens for two main reasons:

To contain the spread by preventing transmission to other birds or animals, including humans. The goal is to keep this an isolated event.
To protect public health by reducing opportunities for mutation. Every infection is a chance for the virus to pick up mutations that could make it more transmissible to humans and potentially spark a pandemic.

Bird flu isn’t an immediate health threat in New York. But preparations have begun.

These efforts don’t come without risks. The workers tasked with culling animals are at high risk for exposure to the virus. Of the human avian influenza infections in the United States, 23 of 67 had exposure at poultry farms. Proper personal protective equipment and handling of animals are essential.

The risk of avian flu to the general public remains low, with no human cases reported in New York. But there are some precautions we can take, especially for those who spend time around birds or keep backyard flocks. In the past three years, 27 backyard flocks have tested positive for avian flu in New York.

Report sick or dead birds immediately.
- For poultry, call the New York State Department of Agriculture and Markets at 518-457-3502.
- For wild birds, call the New York State Department of Environmental Conservation at 718-482-4922 or 518-478-2203.
- For other animal-related concerns, call 311.
Avoid contact with birds that appear sick or have died, and avoid contact with surfaces that have bird feces.
- If you must touch sick or dead birds:
- - Wear gloves and a facemask (preferably N95 or better).
  - Place dead birds in a double-bagged garbage bag.
  - Throw away your gloves and facemask after use.
  - Wash your hands well with soap and warm water.

Avian flu has also been affecting cattle nationally. Thankfully, New York, which ranks fifth in dairy-producing states, has not detected avian flu in cattle. To bolster public health surveillance, New York joined a national USDA program to test bulk raw milk (both milk that will be pasteurized and remain raw) for avian flu. We are still being onboarded, and milk testing has not yet started.

Bottom line

These are uncertain times for federal public health agencies. I’m grateful we can rely on strong local and state public health systems in New York to keep us informed. For now, winter virus transmission, especially the flu, is still high. Stay healthy: Mask up, avoid social interactions when you’re sick, and get vaccinated.

Love,

Your Local Epidemiologist

Dr. Marisa Donnelly, a senior epidemiologist with wastewater monitoring company Biobot Analytics, has worked in applied public health for over a decade, specializing in infectious diseases and emerging public health threats. She holds a PhD in epidemiology and has led multiple outbreak investigations, including at the California Department of Public Health and as an Epidemic Intelligence Service Officer at the Centers for Disease Control and Prevention. Marisa has conducted research in Peru, focusing on dengue and Zika viruses and the mosquitoes that spread them. She is Healthbeat’s contributing epidemiologist for New York in partnership with Your Local Epidemiologist, a Healthbeat supporter. She lives in New York City. Marisa can be reached at mdonnelly@healthbeat.org.

Georgia respiratory disease hospitalizations decline, but flu and Covid could be rising

2025-01-31T20:46:24+00:00

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Georgia hospitalizations for the three most common U.S. respiratory diseases have continued to decline, but updates from Covid-19 and influenza data sources suggest that might change in the coming weeks.

In a Friday update, data from the Centers for Disease Control and Prevention continued to show the number of Georgia overnight hospital stays for flu, Covid-19, and respiratory syncytial virus has decreased from the first week of January through last Saturday. Flu hospitalizations continue to outnumber stays for either of the other two viruses, as they have since mid-December.

But other sources of data, ones that can be quicker to reveal disease trends in communities, indicate that flu and Covid infections are on the rise. State wastewater sites in the metro Atlanta area and eastern Georgia show rising virus levels for both diseases over the latter half of January, as does the percentage of emergency department visits for the illnesses.

Measles case reported in unvaccinated metro Atlanta patient

Still, most Georgia data indicate that this year’s respiratory disease season remains less severe than some recent winters. Covid and flu wastewater levels and hospitalization rates have yet to reach last year’s peaks. These data are in line with a December outlook from the CDC, which predicted national severe infection rates to be lower than last year but higher than before Covid’s emergence.

The state’s Department of Public Health has continued to update its seasonal flu death count, adding nine more to last week’s total. At the Board of Public Health’s January meeting, state epidemiologist Dr. Cherie Drenzek said these types of updates can reflect completed morbidity investigations from weeks earlier.

The state health department also announced this week that it had detected the first measles case of the year and emphasized the effectiveness of the disease’s vaccine.

The status of another concerning respiratory disease is less clear. Last month, Georgia’s DPH warned residents and state physicians to be on the lookout for pertussis, also known as whooping cough. As of the last week in December, the CDC had reported nearly three times as many cases as it did for 2023.

But the CDC hasn’t updated its counts of this or other nationally notifiable infectious diseases since then, making it unclear whether this trend has continued into 2025. The federal agency has stopped most external communications since President Donald Trump took office last week, and a CDC spokesperson said he couldn’t answer when the pertussis numbers would be updated.

Allen Siegler is a reporter covering public health in Atlanta for Healthbeat. Contact Allen at asiegler@healthbeat.org.

Georgia reports first flu deaths of the season, but most data show declines in respiratory viruses

2025-01-24T16:51:00+00:00

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While the Georgia Department of Public Health recorded the first influenza deaths of the winter this month, many data indicate that flu and other respiratory illnesses are continuing to decline.

The agency’s most recent weekly respiratory disease report, which tracked the second week of January, noted that five people died of influenza throughout the state. The number of Georgia deaths since October, which had been at zero the week prior, was updated to 14 in the same report.

At last week’s Georgia Board of Public Health meeting, state epidemiologist Dr. Cherie Drenzek raised the possibility that there had already been deadly flu cases.

“These deaths can get delayed in reporting because they get investigated for other causes of death as well,” she told the board. She also highlighted that throughout this winter, influenza had caused the bulk of Georgia’s respiratory virus emergency department visits.

Warming centers fill up as metro Atlanta experiences its coldest week of winter yet

Respiratory virus death counts can lag behind other disease spread indicators, and many other Georgia flu data suggest cases are declining from January peaks. Preliminary numbers from the Centers for Disease Control and Prevention show state hospitalizations dropped the second week of this month, as did the percentage of health care visits for flu-like illnesses. Wastewater data, which provides some of the most up-to-date information about disease spread, also show a recent plateau and decline in state flu case levels.

Other respiratory diseases of concern also appear to be spreading slower than a few weeks ago in Georgia. Covid-19 hospitalization and wastewater data from the CDC show the lowest early January per-person numbers since the agency began tracking these measures. State respiratory syncytial virus detectors, which reached concerning levels in early December, also show signs of waning.

It’s unclear when the CDC will release its next data update. President Donald Trump’s administration instructed federal health agencies to pause most external communications this week.

This week, the CDC did not publish a Morbidity and Mortality Weekly Report, which updates the country on emerging health threats. It did, however, update its weekly lists of diseases that state health agencies track within their borders.

Meanwhile, H5N1 bird flu has been detected at two commercial poultry operations in Elbert County, Georgia. No human cases have been reported in the state. DPH and the state Department of Agriculture have said they’ll continue to monitor the situation closely.

Allen Siegler is a reporter covering public health in Atlanta for Healthbeat. Contact Allen at asiegler@healthbeat.org.

Long Covid in New York City data findings: Symptoms, treatments and risk factors

2025-01-23T12:00:00+00:00

Sign up for Your Local Epidemiologist New York and get Dr. Marisa Donnelly’s community public health forecast in your inbox a day early.

Covid-19 is here to stay, and with it come persistent and potentially life-altering symptoms from Covid-19 infections, also known as Long Covid. This is where most concerns lie for the majority of us when encountering Covid-19.

A new report found just how much it has impacted New York City—80% of New York respondents suffered symptoms for more than one month after infection. HowNew does this figure hold up? And what can we do about it?

Let’s dig in.

What is Long Covid, exactly?

Early in the pandemic, clinicians quickly found that patients with severe infections had lasting and sometimes debilitating symptoms, from brain fog to headaches to being bedridden. Long Covid has since been documented after mild or moderate disease, too. The long-term effects cause a wide range of physical, mental, emotional, and psychological symptoms.

We still don’t fully know the physiological pathways, but hypotheses include continued viral replication, overactive immune response, micro-blood clots, inflammation of blood vessels, or organ damage from initial infection. Tightly controlled studies put the prevalence of Long Covid around 3%-6%.

In 2022, long-term Covid symptoms were common among New Yorkers

Last month, the New York City Department of Health published survey results from 2022 to understand the burden of Long Covid on New Yorkers.

Most New Yorkers had Covid symptoms for more than a month, Health Dept. survey finds

Before we jump into the data, keep this in mind: Measuring Long Covid is really hard. While New York tracks Covid-19 hospitalizations and deaths, Long Covid cases aren’t reportable, and there’s no diagnostic test. Many of the symptoms are common, like fatigue and headache. These results are also coming from a subset of people who chose to respond to a voluntary survey about enduring symptoms, so the findings may not represent the experience of New York City residents overall.

The Covid-19 Experiences Survey asked 2,081 New York City residents about longer-term symptoms following Covid-19 infection. These are the results:

80% reported at least one symptom lasting one month or longer.
- Half of respondents reported at least one moderate or severe symptom lasting at least one month.
Fatigue and decreased exercise tolerance were the most common long-lasting symptoms—about half of adults reported these.
Black and Latino communities, women, transgender people, and those living in low-income neighborhoods were more likely to have symptoms lasting more than one month. These communities were hit hardest during the pandemic, and inequities have persisted for Long Covid.

Black and Latino communities, women, transgender people, and those living in low-income neighborhoods were more likely to report severe symptoms lasting more than one month following Covid-19 infection.

Severe symptoms had big impacts on mental health and activity

Among adults reporting at least one severe long-term symptom, 1 in 3 (33%) had probable depression, much higher than those with mild symptoms (6%) or no symptoms (2%).

People with severe Covid symptoms were more likely to report activity limitations and depression.

These numbers highlight the impact of long-term Covid-19 symptoms in limiting daily activities, which can result in social, economic, and mental health difficulties.

Take this with a grain of salt

While reports like this one are important, and highlight patterns in symptoms and risk factors for those most affected (like fatigue and lower exercise tolerance in New Yorkers), take the 80% metric with a grain of salt:

2022 is very different from 2025 for Covid-19, thanks to immunity from vaccines, infections, or both. As we’ve seen in the United Kingdom, the risk of developing Long Covid is declining over time. Other studies show staying up to date on vaccines lowers risk of Long Covid. (The jury is still out on whether taking Paxlovid—a Covid antiviral—reduces Long Covid.)
The survey focused on symptoms lasting one month or more after a Covid-19 infection—an outdated definition of Long Covid. Today, the official definition of Long Covid is symptoms lasting more than three months.
People with lingering symptoms may have been more likely to participate in a survey like this, so the findings may not represent the wider population.
There is no control group or comparison group among people who weren’t infected. This is especially critical when assessing a broad range of symptoms, like headaches, for which there are other causes.

Regardless of the exact number of cases, some people are still suffering from Long Covid with debilitating symptoms, and the condition should be taken seriously.

New York researchers are enrolling people in studies

Answers and treatments are not coming fast enough for Long Covid patients. But research is ongoing, and many studies are happening in New York:

NYU Langone is enrolling adult patients with Long Covid symptoms in a National Institutes of Health-funded post-Covid registry.
Mount Sinai is enrolling adult patients with fatigue-related Long Covid symptoms in an NIH-funded study to determine the effect of vagus nerve stimulation on Long Covid recovery.
- Some research shows that dysregulation of the vagus nerve could be responsible for fatigue and worsening symptoms after exercise.
Last year, the New York City Department of Health and Mental Hygiene launched a multi-year research study following 10,000 New Yorkers experiencing Long Covid to better inform support services and policy using New York-specific data.

Treatment for Long Covid is getting better in New York

Navigating and getting care for Long Covid can be overwhelming. However, many New York clinics and hospitals are on the leading edge of understanding and treating Long Covid. Here are some resources for getting treatment for Long Covid in New York:

Call New York City’s Long Covid hotline. New Yorkers recovering from Covid-19 or Long Covid can be connected to care by calling 212-COVID19 (212-268-4319).
Find a Long Covid clinic that specializes in treatment:
1. NYC Health + Hospitals has three Covid-19 centers in the Bronx, Queens, and Brooklyn, offering care for Long Covid. The AfterCare program provides excellent resources for getting support.
2. NYU Langone Health runs the Post-Covid Care Program, which provides treatment for adults with Long Covid.
3. Mount Sinai at the Cohen Center for Recovery from Complex Chronic Illness (CoRE) and Center for Post-COVID Care. Reach out to CORE@mountsinai.org to obtain more information.
4. 1. An Upper East Side location of Mount Sinai is providing targeted Long Covid care for South Bronx and East Harlem residents, neighborhoods that were particularly hard hit during the pandemic.

I also found the Centers for Disease Control and Prevention appointment checklist for Long Covid helpful for patients and providers to get the most out of appointments.

Bottom line

While our understanding of the causes and treatments for Long Covid is slowly evolving, some still struggle with its long-lasting impact. Many New York hospitals are at the forefront of developing better treatments, offering relief and hope to those affected in our city.

Love,

Your Local Epidemiologist

Many schools used Covid aid on long-term needs like curriculum and buildings, new report says

2025-01-16T17:21:04+00:00

This story originally published at Chalkbeat, Healthbeat’s sister site. Sign up for Chalkbeat’s free weekly newsletter to keep up with how education is changing across the United States. Sign up for Healthbeat’s national newsletter here.

When schools were handed an unprecedented $129 billion in federal pandemic aid, it wasn’t surprising that Covid-related equipment topped the shopping list as schools rushed to snap up hotspots, laptops, desk dividers, and air filters.

But another widespread pattern is emerging as federal officials tally up the spending: Many districts also used their one-time funding to take care of longstanding needs, like replacing aging infrastructure and outdated textbooks, that schools previously wanted to tackle but could not afford.

Around 1 in 3 school districts and charter operators nationwide, or some 5,200, used Covid relief during the 2022-23 school year to adopt new curriculum or learning materials, a report released Wednesday by the U.S. Department of Education found. That made it the most common strategy to address learning loss, which schools spent $11 billion on that year.

Schools spent some $6 billion in federal pandemic aid that same year to upgrade and maintain their facilities. That meant 1 out of every 10 Covid relief dollars spent during the 2022-23 school year went toward a school building. It was six times more than states spent on tutoring.

And half of all Covid relief dollars schools spent that year, or just under $25 billion, were spent on staff salaries and benefits. A good chunk of that went toward paying new social workers and school nurses, which schools added to their ranks in droves with the aid.

Now that the Covid aid is mostly gone — schools have until the end of this month to spend it, unless they seek an extension — schools are confronting big questions about how they will cover curriculum overhauls and critical building repairs going forward, as well as how many of those additional staffers will lose their jobs. Many school districts, especially those with declining enrollments, are considering closing schools or cutting programs to balance their budgets.

The report looks at how the nation’s roughly 16,000 school districts and charter operators spent just over $49 billion in Covid relief dollars during the 2022-23 school year. Nearly all of the first two Covid relief packages had been exhausted, and schools were halfway through spending their last and largest aid package by the end of the 2022-23 school year. Schools had spent some $117 billion in pandemic aid by that point.

Investing in long-term projects encouraged

Investing in people and projects with the potential for long-term payoffs made sense, federal officials say, and the Biden administration encouraged this type of spending.

Federal officials also believe provisions in the Covid aid laws that required states to maintain their own school funding will help schools return to more usual levels of funding more easily than they did following the Great Recession. When stimulus packages enacted in the wake of that financial crisis expired, many states slashed education funding and schools cut hundreds of thousands of jobs, dramatically shrinking the size of the K-12 education workforce.

“There are certainly difficult decisions that are going to get made after $130 billion is fully invested,” said Adam Schott, the principal deputy assistant secretary in the Education Department’s Office of Elementary and Secondary Education. “We are just not seeing the type of fiscal cliff that we saw 10, 12, 15 years ago.”

Part of the reason for that, Schott said, is that the Biden administration urged schools to spend the pandemic aid on immediate needs, but also long-term academic goals.

To the administration, investing in school buildings — and getting rid of issues like asbestos, mold, and lead — was also crucial.

“For decades, we’ve known that a classroom that’s 90 degrees in May or in September is an impediment to in-person learning,” Schott said. “We saw this as really core to academic recovery.”

Pennsylvania's New Kensington-Arnold School District, like many across the U.S., used COVID aid to make long-term improvements to school buildings.

Many schools spent on curriculum amid worrying test scores

The new data about spending on curriculum and classroom materials comes as many states and districts overhaul their approach to teaching reading and math, opting for materials that better align with the science of how children learn.

That spending also coincides with several years of national and international test score data showing that American children are academically stagnant or falling behind their earlier counterparts. That was true even before the pandemic. But the trend is especially stark for kids who score the lowest on math and reading tests.

And while recent state test scores have shown some students are rebounding to pre-pandemic levels, “We are clearly not where we ought to be,” Schott said.

Federal COVID relief dollars improved student test scores, two new studies find

Now that the federal Covid aid is gone, “states have to be ready to grab the baton,” he added, whether that’s finding new ways to spend existing federal funding, or adding money to state education budgets. “We’re going to keep beating that drum with every minute we’ve got left.”

The new federal report also comes as President-elect Donald Trump prepares to start his second term in a few days. It’s unclear how or if top education officials in his administration will push schools to continue pandemic-era programs.

On the campaign trail, Trump and his supporters said they wanted to get rid of the federal education department or shrink its powers and give more responsibility to state officials — who already largely control what and how kids learn.

By the 2022-23 school year, most students were back to learning in person for a second school year. The Covid-19 global health emergency was declared officially over halfway through the school year. But many students were struggling to follow the routines of school. Student absenteeism rates were still abnormally high.

Expanded summer programming was a very common investment — though it’s unclear if some of these programs helped kids improve academically. About 2 in 5 school districts or charter school operators used Covid aid on summer programs that school year, reaching around 4.5 million students.

A smaller number of districts and charter operators — around 1 in 10 nationally, or around 2,100 — used pandemic money to add instructional time. Researchers were a fan of that strategy, but educators often found it was difficult to pull off.

Money went to tutoring and staffing

Meanwhile, states spent $1 billion on tutoring that school year, and districts ran intensive tutoring programs that reached some 3 million kids, or around 6% of public school students. Of those students, around half were from low-income families, while 13% were students with disabilities and 14% were learning English as a new language — suggesting that many students from historically disadvantaged backgrounds did not receive tutoring.

Earlier estimates have suggested less than 10% of students were getting tutoring thanks to Covid aid — a figure researchers have said was likely much smaller than the share of kids who needed extra academic help after the pandemic’s disruptions to learning.

The report points out that Covid aid helped to put “more people working in America’s schools than at any time in the last decade.” As of October 2024, the report notes, schools had added some 643,000 jobs since 2021, with a 43% increase in social workers and a 23% increase in school nurses.

Some school finance experts have criticized schools for adding many new staffers or programs that they couldn’t afford to keep after the Covid aid ran out. They’ve said the hiring and firing is destabilizing, especially for schools that had more staff turnover prior to the pandemic.

Still, Schott defended that use of the money. He pointed out that some of the added spending helped to raise low teacher pay or invest in gummed-up educator pipelines. Other spending got “more caring eyes on kids” at a chaotic time.

“You couldn’t maintain consistency for kids, you couldn’t deliver instruction, you couldn’t get core nutrition services flowing without people,” he said.

Kalyn Belsha is a senior national education reporter based in Chicago. Contact her at kbelsha@chalkbeat.org.

New York winter virus report: Norovirus, flu, and Covid-19 on the rise

2025-01-15T12:00:00+00:00

Sign up for Your Local Epidemiologist New York and get Dr. Marisa Donnelly’s community public health forecast in your inbox a day early.

Have questions, comments, or ideas for future topics? Email YLE NY at mdonnelly@healthbeat.org. I would love to hear from you.

Does it feel like everyone around you is sick right now? Yeah, me too. It seems like half my friends and family have the sniffles, and I’m still recovering from a respiratory infection. Our New York communities are in peak respiratory season. Let’s dive into the most recent respiratory data following the holidays, plus a bit on norovirus. Here’s your State of Affairs.

The flu: High and increasing

The number of people with flu in New York is high — hospitalizations in the state increased by 44% during the week ending Jan. 4, compared to the prior week. Increases are widespread across all regions of the state.

Influenza hospitalizations from the New York State Influenza Surveillance Report.

In an earlier post, I mentioned that flu activity started later this year compared to last year and shared some guesses as to what that could mean for flu intensity this year.

At this point, the flu season is shaping up to be similar to pre-pandemic times. Flu activity hasn’t peaked yet (unlike last year when it peaked the last week of December). The question is, will the number of severe infections be similar to last year, or worse?

Flu hospitalizations in New York. During the 2020-21 season, there were very few flu cases in the state.

Only time will tell, but in the meantime, it’s a good idea to take protective measures against the flu, like wearing a mask in crowded spaces (while traveling, on the subway, in supermarkets, etc.) and avoiding social interactions if you aren’t feeling well. Flu usually has a second peak later in winter due to flu B circulation (right now, most flu cases are from flu A), and infections can go into March or April, so it’s not too late to get your flu vaccine at a local pharmacy or clinic.

Covid-19: Minimal and increasing

Covid-19 activity in New York this season has been surprisingly low, with levels inching up more slowly compared to last season. This is our mildest winter for Covid-19 since the start of the pandemic. This is likely because we had such a big Covid-19 wave late last summer, resulting in a lot of immunity. I expect Covid-19 activity to continue increasing in New York, as national and regional Covid-19 levels are high and continue to increase.

SARS-CoV-2 concentrations in New York state (yellow line) are minimal, while national concentrations (black) are high and increasing.

Covid-19 continues to increase in New York City, where wastewater levels are increasing.

New York City average SARS-CoV-2 wastewater concentrations.

RSV: High but decreasing

RSV has peaked and is now declining in New York. This season’s peak happened about two weeks later than last year, but it was largely a middle-of-the-road season (so far there have been a similar number of cases compared to last year).

New York City RSV testing data from the Influenza and RSV Surveillance Report.

RSV infections in kids, who are usually hit hardest, have been similar this season to pre-pandemic levels. We hoped that RSV vaccines would have a stronger effect this year in keeping kids out of hospitals. I’ll be looking for more data on how RSV vaccines affected hospitalizations after the season ends.

National RSV hospitalization rates for people 4 years of age and younger.

We still expect there to be several weeks of high RSV activity, so we aren’t out of the woods yet.

Norovirus: Surging, and you don’t want it

Norovirus cases are surging in New York City and many other parts of the United States. Norovirus is a highly contagious group of viruses responsible for gastrointestinal issues like vomiting and diarrhea. It’s the most common cause of the stomach “flu” or “bug,” causing 19 million-20 million cases in the United States annually. In New York City, there were about 1,300 cases in December — almost triple the number during the same time in 2023 (488 cases).

Norovirus outbreaks in the United States reported by NoroSTAT-participating states.

Norovirus is spread through contact with infected people, contaminated surfaces, and food. It’s notoriously infectious. While infected with norovirus, people shed billions of virus particles, but it only takes a couple of particles to infect someone. Unfortunately, hand sanitizer doesn’t kill the virus because it has no outer membrane.

To prevent norovirus spread:

Wash hands frequently with soap and warm or hot water for at least 20 seconds.
Use detergents with bleach to clean and disinfect surfaces.
- To make your own, mix 1 teaspoon of bleach in 1 gallon of cool water.
Any material handled by people infected with norovirus — linens, towels, dishware, utensils, doorknobs, and especially surfaces in the bathroom — should be cleaned well to prevent spread.

Most people should recover from norovirus on their own in 2-3 days.

Emerging diseases: Avian flu

Last week, news broke of the first avian flu (H5N1) death in the United States, a tragic reminder that this virus is dangerous and that we as a country need to be on alert. Thankfully, we still haven’t seen any person-to-person transmission, and only two of the 74 cases identified in the United States have had severe illness. (See this recent YLE post for more details.)

We haven’t had any known cases of avian flu in dairy herds or humans in New York, so the current risk to New Yorkers is low. However, we may be missing cases, given testing cattle is voluntary. Starting this month, though, we should have more visibility. New York is part of a national milk testing program led by the USDA and is one of 28 states testing milk for H5N1 in bulk raw milk (both milk that will be pasteurized and remain raw). I’ll be back with a deeper dive when we have more information.

Bottom line

Winter virus transmission is high right now. Stay healthy: Mask up, wash your hands, and bleach surfaces.

Love,

Your Local Epidemiologist

Respiratory diseases reach new seasonal heights in Atlanta and Georgia

2025-01-10T12:00:00+00:00

Public health, explained: Sign up to receive Healthbeat’s free Atlanta newsletter here.

As the new year begins, Atlanta and Georgia respiratory disease spread has accelerated to some of the highest levels seen this winter.

Over the last week of 2024, flu cases hospitalized 220 residents in the metro Atlanta area, according to the latest report from the Georgia Department of Public Health. That week alone makes up over a third of the region’s count since October.

Statewide cases appear to be paralleling that trend. Preliminary data from the U.S. Centers for Disease Control and Prevention suggest that Georgia’s hospitalization rate for the virus also rose at the end of 2024 to its highest level in recent months. Additionally, the state percentage of health care visits for suspected flu cases has continued to increase and outpace the national average.

Respiratory syncytial virus, known as RSV, and Covid-19 are infecting many Georgians as well. Wastewater surveillance sites detect high levels of the viruses in communities across the state. RSV levels appear to have remained at the new heights they reached last month.

These state benchmarks show yearly rises in the three viruses, but many also indicate a less severe season so far relative to recent winters. In the last three months of 2023, metro Atlanta area health care centers hospitalized about 1,000 more people for the flu than they did at the end of 2024.

And while CDC numbers indicate that December’s final week was a recent peak for Georgia hospitalizations related to any of the three viruses, that rate is significantly lower than it was any of the past four years at the same time.

Still, there are other respiratory diseases that have outpaced recent Georgia recordings. One of them is pertussis, also known as whooping cough. The bacterial disease, most common in children, can compromise babies’ breathing and cause coughing strong enough to break ribs. For 2024, the CDC has recorded 280 Georgia cases — nearly three times the count of 2023.

The system used to detect whooping cough is updated frequently, and the 2023 and 2024 counts could continue to change. But in a health advisory last month, the state health department warned providers to be on the lookout for any patients presenting with severe coughs.

The CDC recommends five doses of vaccines throughout a child’s first six years that helps protect against whooping cough. The organization says besides some groups like pregnant people and seniors, most adults don’t need to seek additional immunizations.

Allen Siegler is a reporter covering public health in Atlanta for Healthbeat. Contact Allen at asiegler@healthbeat.org.

Covid-19, influenza, and RSV increasing around the holidays in New York

2024-12-23T12:00:00+00:00

Sign up for Your Local Epidemiologist New York and get Dr. Marisa Donnelly’s community public health forecast in your inbox a day early.

Have questions, comments, or ideas for future topics? Just reply to this email. I would love to hear from you.

We’ll be taking a break for the next two weeks to recharge (and recuperate after getting sick myself 🤧), but we wanted to share the latest data on respiratory viruses in time for holiday travels. Here’s the State of Affairs.

RSV: high and increasing

RSV continues to increase in New York and nationally. In New York City, there was a 30% increase in positive RSV tests during the week ending Dec. 7, compared to the prior week. We’re seeing a serious RSV surge, and it seems to be happening later than usual. During the past two seasons, RSV rates peaked in November and declined in December. (Looks like we are back to pre-pandemic trends.) This year, rates continue to rise, and it’s too early to tell when they might peak.

New York City RSV testing data from the Influenza and RSV Surveillance Report.

RSV continues to have the largest effect on children, but older adults are also at increased risk for severe RSV and hospitalization. The Centers for Disease Control and Prevention estimates that, nationally, there are 100,000–150,000 hospitalizations among adults age 60+ years due to RSV. While I’m not aware of public data for New York, we’ve seen recent increases in hospitalizations for people age 65+ years across the United States.

National hospitalization rates for people 65 years of age and older.

Because older adults are also at increased risk of severe RSV, it’s recommended that anyone age 75+ years get an RSV vaccine.

The RSV vaccine is also recommended for those who are 60+ years and who have heart or lung disease, are immunocompromised, or who live in a nursing home.
The RSV vaccine for adults is a single dose, given once — it’s not an annual vaccine.

In one of our recent posts, we discussed the importance of also vaccinating pregnant women and giving monoclonal antibodies to protect babies against RSV. (See the post here.)

The RSV vaccine works for older adults

A recent study published in JAMA Network Open showed that the RSV vaccine for adults age 60+ years was highly effective at preventing severe disease.

In fact, the study estimated that the RSV vaccine had 90-91% efficacy at protecting against hospitalizations and emergency department visits for adults age 60+ years — that’s great vaccine efficacy.

With that kind of efficacy, high RSV vaccine coverage could cut the number for folks hospitalized annually from 100,000 to closer to 10,000.

The flu: moderate and increasing

Seasonal flu transmission is also ramping up in New York — the number of cases in the state increased by 53% during the week ending Dec. 7, compared to the prior week. Flu hospitalizations are increasing in every region of the state.

Influenza hospitalizations from the New York State Influenza Surveillance Report.

Like RSV, this year’s flu season in New York is off to a slower start compared to the last two years, with fewer positive tests and hospitalizations so far. I see two possible scenarios for this year’s flu season:

A flu season with a similar number of hospitalizations compared to last year’s, but with a later peak. Last year, seasonal flu peaked in the last week of December. This year is shaping up to be more like pre-pandemic flu seasons. (In the 2018-19 and 2019-20 seasons, flu hospitalizations peaked in March and February, respectively.)
We could also have a milder flu season overall, with fewer hospitalizations compared to last year. In the 2021-22 season, flu hospitalizations were much lower overall. But we were masking up a lot more that winter. We don’t know yet if the slow start is just pushing everything back, or if it’s a sign that we’ll have a milder year. Either way, it’s a good time to get vaccinated, since flu is rising.

Flu hospitalizations in New York.

You may also have seen national headlines about H5N1 (bird flu). This is a type of flu, but not like the seasonal strain. It hasn’t spread from human to human yet; those at risk are people with direct contact with sick animals (dairy, wild birds, and poultry). New York hasn’t detected H5N1 yet in humans or dairy herds, but I predict it’s only a matter of time given that more and more states are finding it. If/when that happens, I’ll be back with a deeper dive.

Covid-19: minimal but increasing

Covid-19 levels in New York state are minimal, but expect an increase soon. Nationally, Covid-19 levels have risen from minimal to low, and this trend is likely to carry over to New York in the near future.

SARS-CoV-2 concentrations in New York state (yellow line) are minimal while national concentrations (black) are low and increasing, according to data from the CDC National Wastewater Surveillance System.

Covid-19 continues to pick up in New York City, where wastewater shows that levels are increasing.

New York City average SARS-CoV-2 wastewater concentrations.

Reduce your chances of infection while traveling

These tips to stay healthy while traveling generally apply, regardless of what is circulating.

Mask up while traveling. This includes on the subway, at airports, train stations, and when boarding or deboarding for a flight.
- Planes typically have good air filtration when moving. However, air filters are not usually run at full strength when the plane is stationary or during taxiing. This means that during boarding and deboarding, when everyone is close together waiting, air circulation is minimal, and the risk of being exposed to a respiratory pathogen is higher. This is a good time to mask up, as I plan to do.
- Well-fitting filtration masks like N95s are the best, but a KN95 or a surgical mask are still good options.
Ventilate and filter air to help reduce transmission. When you’re indoors together, turn on an air purifier, use a fan, or open a window.
Stay home if you feel sick. I know it’s really hard around the holidays, but this is the most important way to protect vulnerable friends or relatives who may be over age 65, pregnant, or immunocompromised from getting sick.

Bottom line

Though they came late, RSV and flu are here and on the move in our communities. Respiratory virus transmission will likely increase over the holidays as many of us travel and expand our social networks. However, we still have several tools to stay healthy. I hope you all have a happy and restful holiday!

Love,

Your Local Epidemiologist

Where to find Covid and flu shots if you’re uninsured in Atlanta

2024-12-19T15:17:23+00:00

Public health, explained: Sign up to receive Healthbeat’s free Atlanta newsletter here.

Uninsured Georgians seeking flu and Covid vaccines this holiday season may have to shop around to find the cheapest shots.

Flu shots start at about $45, and Covid shots start at $160 for people paying out of pocket at commercial pharmacies.

Prices are much lower at some county health departments in the metro Atlanta area, while DeKalb and Fulton county health clinics reported costs of $150 or more for a Covid shot without insurance.

DeKalb County has used up its supply of low-cost Covid vaccines for uninsured people provided by the state, spokesperson Eric Nickens said. A few Fulton County clinics said they are entirely out of Covid shots.

There are some sources of help for people who can’t afford the vaccines. For example, consumers may be able to get discounts by using GoodRx or other pharmacy coupon programs.

Pfizer has a patient assistance program for Covid shots for uninsured people, though it requires an application. And Moderna provides shots for free to some charitable clinics.

Information about how much the vaccines will cost could depend on supply, so people are urged to call ahead.

Georgia health department limits some vaccines for uninsured adults

Some 6,750 doses of Covid vaccines for uninsured adults had been distributed through local health departments and charitable clinics as of last week, state Department of Public Health spokesperson Nancy Nydam said. Earlier this year, the state purchased about 38,000 shots for uninsured people.

Close to 20,000 of the 27,000 state-purchased flu shots have been distributed.

Here’s a guide to finding the vaccines.

Fulton County Board of Health: Costs vary

Some vaccines remain available for uninsured adults, spokesperson Darryl Carver said.

A representative of the Adamsville Regional Health Center said her center is out of Covid vaccines, which normally cost $156. Flu shots for adults under 65 cost $35.

At the College Park Regional Health Center, a representative said Covid shots cost $202, and flu shots cost $35.

At the North Fulton Regional Health Center, a representative said a flu shot would cost $21.93. There were no Covid shots available.

Carver said the health centers will not turn away anyone for inability to pay.

DeKalb Public Health: $44 (flu), $147-$150 (Covid)

The agency has run out of free vaccines for uninsured adults that the state government purchased earlier this year, Nickens said.

Flu shots for adults under 65 are typically $44. Covid shots range between $147 and $150.

Nickens emphasized that no one will be turned away for inability to pay, and payment plans can be arranged. He encouraged people concerned about cost or wanting to set up an appointment to call 404-294-3700.

Vaccines for uninsured children are available for a $21.93 administration fee.

Gwinnett Newton Rockdale Public Health: $22

Covid and flu vaccines are available at all of the agency’s health centers, except for its Buford Health Center.

The shots will cost the $21.93 administration fee as long as supply remains from the state-provided vaccines for un- and underinsured adults, spokesperson Michele Kehler said.

The agency urges people to call ahead to check availability of appointments: 770-904-3717.

No one will be turned away due to inability to pay, Kehler said. Bring documents such as pay stubs and insurance cards to the appointment to help public health staffers determine eligibility and cost.

“Individuals who are not eligible for low-cost vaccines may qualify for vaccines at a reduced cost based on a sliding fee scale,” Kehler said.

Cobb and Douglas Board of Health: $21

Smyrna, Douglasville, Marietta, and Acworth-Kennesaw have flu and Covid shots for uninsured adults.

They each cost $21, an administration fee the board of health charges to cover its cost, spokesperson Valerie Crow said.

However, people will not be turned away from getting a vaccine due to inability to pay.

CVS: $69 (flu), $202 (Covid)

Standard flu vaccines for adults cost $68.99 for people without insurance or who want to pay in cash, CVS spokesperson Amy Thibault said.

Shots for adults older than 65, or those who need an egg-free vaccine, cost $113.99.

Covid shots at CVS cost about $202.

Publix: $68 (flu), $202 (Covid)

Standard flu vaccines for uninsured adults under 65 cost $68, a representative at an Atlanta-area Publix said.

Covid shots are $202.

Walgreens: $76 (flu), $205 (Covid)

Standard flu vaccines for uninsured adults under 65 cost $75.99, a representative at an Atlanta-area Walgreens said.

Covid shots are about $205.

Kroger: $45 (flu), $160-$170 (Covid)

Standard flu vaccines for uninsured adults under 65 cost around $45 for those without insurance, a representative at an Atlanta-area Kroger pharmacy said.

Moderna and Pfizer Covid vaccines cost $160 to $170, she said.

Help for people who can’t afford Covid shots

Pharmaceutical companies have programs for uninsured people who can’t afford a Covid vaccine:

Pfizer (Comirnaty): Eligible uninsured people can get the vaccine for free through the company’s patient assistance program.
Moderna (Spikevax): The company provides free vaccines to charitable clinics. People can search for a clinic near them using the links on this website.
Novavax: A company representative said Novavax does not offer a patient assistance program for the Covid vaccine.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Georgia and Atlanta flu circulation rise as Covid cases remain limited

2024-12-13T17:35:56+00:00

Public health, explained: Sign up to receive Healthbeat’s free Atlanta newsletter here.

While Georgia influenza and Covid-19 rates appear to be lower than last year at this time, flu circulation has reached a level that concerns some local health officials.

In data published by the Centers for Disease Control and Prevention, the percentage of state hospital visits for flu-like illnesses remains higher than the national average as of the first week of December.

In the metro Atlanta area, there were 12 hospitalizations for influenza throughout Thanksgiving week, according to the Georgia Department of Public Health. While that’s one of the largest weekly in-patient admission counts of this fall, it’s only about 15% of the rate experienced last year at that time. CDC emergency department data further indicate that Georgia respiratory virus visits, including for influenza, remain less common than last respiratory disease season.

At the Thursday Cobb County Board of Health meeting, Cobb and Douglas Public Health epidemiology and infectious disease director Rachel Franklin said Georgia flu transmission levels had switched from “moderate” to “high” earlier that week. She said that trend contrasts local and state Covid rates, which remain at relatively low levels.

“Right after Thanksgiving, right on time, it went up to high,” she told the Cobb County health board members. “Not too late for the flu vaccines, but remember that they do take about two weeks to actually give you some protection.”

A CDC survey from the last week of November estimates that in Georgia, about 30% of adults and 32% of kids have received a flu vaccine this season. Both of those approximations are lower than their national counterparts, but small Georgia sample sizes mean it’s difficult to determine how different the state and U.S. percentage of vaccinated residents actually is.

Incidents of respiratory syncytial virus, or RSV, grew to high levels throughout November. But recent wastewater and hospitalization data further indicate that the rate of new cases is plateauing, if not declining. Nationally, there appears to be less frequent but increasing circulation of the virus.

Allen Siegler is a reporter covering public health in Atlanta for Healthbeat. Contact Allen at asiegler@healthbeat.org.

RSV, Covid, flu cases are on the rise in New York

2024-12-11T12:00:00+00:00

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The respiratory season has continued to pick up in New York and nationally. We now have data from the week of Thanksgiving, so it’s time for another State of Affairs to kick this week off. But first…

Your Local Epidemiologist visited the White House!

Last week, I had the privilege of attending a White House convening of public health communication and advocacy experts. A special shoutout to Your Local Epidemiologist founder Dr. Katelyn Jetelina for her incredible insights on the panel!

Hearing stories from people across the country — healthcare workers, teachers, community leaders, pastors, caregivers, and many others — was profoundly inspiring. These individuals tirelessly share health information and advocate for their communities. Here are a few takeaways I wanted to share:

Health communication is a team effort. We need to stick together and support each other.
Science isn’t finished until it’s communicated.
Science communication needs to be rooted in truth — opinions without facts can’t stand.
Trust is mutual and earned — you must give it to get it.
Lead with empathy. Everyone makes decisions for themselves and their loved ones based on the information they have. We need to meet people where they are, without judgment, to build trust and connection.

I left the event energized, hopeful, and motivated to keep sharing actionable health information with you all, and I look forward to continuing this work together.

Now, back to the data.

RSV and flu: increasing

Respiratory Syncytial Virus is on the rise and is affecting a lot of young children. Recent data from laboratories across New York show that positive RSV tests are increasing. In New York City, RSV cases are significantly rising — there was a 22% increase in positive RSV tests during the week ending Nov. 30, compared to the week prior.

New York City RSV testing data from the Influenza and RSV Surveillance Report.

We are seeing the effects of increasing RSV activity in hospitals — national RSV hospitalization rates in children have shot up in the past couple of weeks.

Hospitalization rates for RSV (green), Covid-19 (red), and influenza (blue) among children aged 4 or under.

Children are being hit hardest by respiratory viruses, especially RSV. National Centers for Disease Control and Prevention data show that children aged 4 and under currently account for 8% of emergency department visits for COVID-19, flu, or RSV, while adults aged 65 and older account for just 1.4%.

The good news is that there are now two key ways to protect babies against RSV:

An RSV vaccine that pregnant women can get. The timing of this vaccine is very important. Time is needed for antibodies to develop, cross the placenta, and protect the infant during the RSV season over the winter. That is why it’s given between weeks 32 and 36 of pregnancy, from September through January. With this timing, the protection passed to the baby will last for their first RSV season.
Monoclonal antibodies for infants. For pregnant women who miss the RSV vaccination window, infants can receive RSV monoclonal antibodies (named nirsevimab) just before or at the start of the RSV season. This is an effective option — research has shown that nirsevimab is 90% effective against RSV-associated hospitalization in infants during their first RSV season.

RSV vaccines are also recommended for all adults ages 75 and older and adults ages 60–74 who are at increased risk for severe RSV.

RSV vaccine and immunization recommendations from the CDC.

The flu is also increasing in New York — the number of cases in the state increased by 47% during the week ending Nov. 30, compared to the week prior. The biggest increases are happening in New York City and the surrounding metro area, but hospitalizations are increasing across the state.

Influenza regional incidence from the New York State Influenza Surveillance Report.

Covid-19: minimal but increasing

Covid-19 levels are minimal in New York, but we are starting to see some signals that transmission is increasing.

SARS-CoV-2 concentrations in New York (yellow line) are minimal and declining, according to data from the CDC National Wastewater Surveillance System.

Covid-19 is picking up in New York City, where wastewater shows that levels are increasing.

New York City average SARS-CoV-2 wastewater concentrations.

Fortunately, hospitalizations for Covid-19 among New Yorkers are low, especially among those over the age of 65, who have the highest risk.

This year’s Covid-19 season is looking a bit different from last year’s. In 2023, Covid-19 hospitalizations in New York started to rise as early as mid-November. However, this year Covid-19 activity is beginning later. One key factor may be the large summer wave that occurred this past July and August. With so many people infected over the summer, community immunity has likely remained higher into the fall, delaying the start of this winter’s Covid-19 season. It’s been a welcome reprieve.

It’s easy to find a place to get vaccinated

I was able to make a same-day appointment at my local pharmacy for Covid-19 and flu vaccines. If you haven’t had a chance to get your vaccines (I get it — the holidays are crazy), the time is now.

We shared a lot of information on how to get vaccines in New York City and the rest of the state in our holiday respiratory virus post, available here.

Bottom line

Respiratory viruses (especially RSV) are picking up, it’s not too late to get vaccinated, and there are many people out there working hard to keep us healthy!

Love,

Your Local Epidemiologist

Georgia RSV reached peak levels last month, influenza appears to be rising

2024-12-06T19:29:10+00:00

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While Georgia has had relatively few Covid and influenza cases this fall, data from the Centers for Disease Control and Prevention indicate that respiratory syncytial virus, also known as RSV, recently peaked at the state’s highest levels in years.

Numbers from late November indicate state hospitalization rates for the virus were the highest they’ve been since at least fall 2018, according to the CDC’s Respiratory Virus Hospitalization Surveillance Network. Wastewater sampling, which can be used to detect some infectious disease levels in localities, also reveals that there have been high amounts of RSV circulating in Fulton, Muscogee, and Chattahoochee County communities.

These trends are distinct from RSV levels in the rest of the country. For the United States as a whole, data suggest infection levels are rising but not yet approaching peaks in 2022 or 2023.

Georgia’s recent relative RSV increase is higher than previous markers, but visits for the virus haven’t surpassed 1% of hospital visits in a sample of eight CDC-monitored Georgia hospitals. In comparison, flu visits accounted for about 8% of visits at these sites last December.

Hospitalization counts can lag behind testing data, and the most recent preliminary CDC data show that in-patient RSV stays are decreasing in Georgia. Emory Director of Pulmonary and Critical Care Medicine Dr. Greg Martin said his system’s testing data also indicate cases have declined over the past two weeks. He said influenza cases appear to be on the rise after a more limited Georgia spread compared to the last two flu seasons.

This year’s flu vaccine, which is expected to provide an extra layer of protection from severe disease, appears to be embraced by most Georgia residents. A CDC survey from late November found that about 67% of adults in the state said they either have or intend to get a flu shot for this season. About 71% of Georgia parents said their kids are or probably will be vaccinated this season — about 6% higher than the national average.

That’s significantly lower than plans for the updated Covid-19 shot. The same survey noted that about half of Georgia adults plan to get or have gotten that vaccine, and only about 42% of parents are taking those steps for their children. Both responses are about 6% lower than the United States as a whole, respectively.

The CDC only recommends certain groups — seniors over 70, adults over 60 at high risk of severe symptoms, and infants under 8 months old — receive a vaccine that protects people from RSV. An October CDC survey showed that over 90% of U.S. infant parents said they had gotten or plan to get their babies immunized against RSV, and 76% American adults in recommended groups said they have received or intend to get the shot.

In contrast, 67% of adults in those high-risk categories living in a group of southeastern states, including Georgia, said they have done or plan to do the same.

Allen Siegler is a reporter covering public health in Atlanta for Healthbeat. Contact Allen at asiegler@healthbeat.org.

Nursing homes have fallen behind on vaccinating patients for Covid

2024-12-04T14:54:01+00:00

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It seems no one is taking Covid-19 seriously anymore, said Mollee Loveland, a nursing home aide who lives outside Pittsburgh.

Loveland has seen patients and co-workers at the nursing home where she works die from the viral disease.

Now she has a new worry: bringing home the coronavirus and unwittingly infecting her infant daughter, Maya, born in May.

Loveland’s maternity leave ended in late June, when Maya wasn’t yet 2 months old. Infants cannot be vaccinated against Covid until they are 6 months old. Children younger than that suffer the highest rates of hospitalization of any age group except people 75 or older.

Between her patients’ complex medical needs and their close proximity to one another, Covid continues to pose a grave threat to Loveland’s nursing home — and to the 15,000 other certified nursing homes in the United States where some 1.2 million people live.

Despite this risk, a Centers for Disease Control and Prevention report published in April found that just 4 in 10 nursing home residents in the United States received an updated Covid vaccine in the winter of 2023-24. The analysis drew on data from Oct. 16, 2023, through Feb. 11, 2024, and was conducted by the CDC.

The CDC report also revealed that during January’s Covid peak, the rate of hospitalizations among nursing home residents was more than eight times that of all U.S. adults age 70 and older.

Patients getting more skeptical of Covid vaccines

Last winter’s low vaccination rate was partly driven by the end of the federal government’s paying for administering the shots, said Rajeev Kumar, a Chicago-based geriatrician.

While the vaccines remain free to patients, clinicians must now bill each person’s insurer separately. That makes vaccinating an entire nursing home more logistically complicated, Kumar said.

Kumar is president of the Post-Acute and Long-Term Care Medical Association, which represents clinicians who work in nursing homes and similar settings, such as post-acute care, assisted living, and hospice facilities.

“The challenges of navigating through that process and arranging vaccinations, making sure that somebody gets to bill for services and collect money, that’s what has become a little bit more tedious,” he said.

In April, after the study was released, the CDC recommended that adults 65 and older get an additional dose of an updated vaccine if it’s been more than four months since their last dose. That means most nursing home patients who have had only one shot in fall or winter are not considered up to date on the Covid vaccines.

Kumar and his colleagues are encountering more skepticism of the Covid vaccines, compared with their rollout.

“The long-term care population is a microcosm of what’s happening across the country and, unfortunately, Covid vaccine reluctance remains persistent throughout the general public. It’s our most significant challenge,” according to an emailed statement from David Gifford, chief medical officer at AHCA/NCAL, which represents for-profit and nonprofit nursing homes.

Nursing aide Loveland also has observed doubts and misinformation cropping up among patients at her job: “It’s the Facebook rabbit hole.”

But there are ways to push back against bad information, and states show wide variation in the proportion of nursing home residents who got vaccinated last winter.

For example, in North and South Dakota, more than 55% of residents at nursing homes that reported data have gotten an updated Covid vaccine this fall. Nationally, that share is 32%.

Dakotas system builds trust through relationships

One major medical system operating in the Dakotas, Sanford Health, has managed more than two dozen nursing homes since a 2019 merger with the long-term care chain Good Samaritan Society.

In some of these nursing homes more than 70% of residents were vaccinated last fall and winter — at one Sanford facility in Canton, South Dakota, the rate exceeded 90%.

Sanford achieved this by leveraging the size of the health system to make delivering vaccines more efficient, said Jeremy Cauwels, Sanford’s chief medical officer. He also credited a close working relationship with a South Dakota-based pharmacy chain, Lewis Drug.

But the most crucial factor was that many of Sanford’s nursing home patients are cared for by doctors who are also employed by the health system. At most Sanford’s North and South Dakota nursing homes, these clinicians provide on-site primary care, meaning patients don’t have to leave the facilities to see doctors.

These employed doctors have been critical in persuading patients to stay up to date on their Covid shots, Cauwels said. For example, a medical director who worked at the Good Samaritan nursing home in Canton was a long-serving physician with close ties to that community.

“An appropriate one-on-one conversation with someone who cares about you and has a history of doing so in the past, for us, has resulted in much better numbers than other places have been able to get to nationally,” said Cauwels, who added that Sanford still needs to work on reaching more patients.

Sanford’s success shows the onus of getting patients vaccinated extends beyond nursing homes, said Jodi Eyigor, director of nursing home quality and public policy for LeadingAge, which represents nonprofit nursing homes. She said primary care providers, hospitalists, pharmacists, and other health care stakeholders need to step up.

“What conversations have occurred before they walked into a nursing home’s doors, between them and their doctors? Because they’re probably seeing their doctors quite frequently before they come into the nursing home,” said Eyigor, who noted these other clinicians are also regulated by Medicare, the federal health insurance program for adults 65 and older.

Critics: Shot uptake linked to residents’ dissatisfaction

Nursing homes are required to educate patients — as well as staff — about the importance of the Covid vaccines. Industry critics contend that one-on-one conversations, based on trusted relationships with clinicians, are the least that nursing homes should do.

But many facilities don’t seem to be doing even that, according to Richard Mollot, executive director of the Long Term Care Community Coalition, a watchdog group that monitors nursing homes. A 40% recent vaccination rate is inexcusable, he said, given the danger the virus poses to people who live in nursing homes.

A study from the Journal of Health Economics estimates that from the start of the pandemic through Aug. 15, 2021, 21% of Covid deaths in the United States were among people living in nursing homes.

Mollot said that the alarmingly low Covid vaccination rate is a symptom of larger issues throughout the industry. He hears from patients’ families about poor food quality and a general apathy that some nursing homes have toward residents’ concerns. He also cites high rates of staff turnover and substandard, even dangerous, care.

These problems intensified in the years since the start of the Covid pandemic, Mollot said, causing extensive stress throughout the industry.

“That has resulted in much lower care, much more disrespectful interactions between residents and staff, and there’s just that lack of trust,” he added.

Loveland, the nursing aide outside Pittsburgh, also thinks the industry has fundamental problems when it comes to daily interactions between workers and residents. She said the managers at her job often ignore patients’ concerns.

“I feel like if the facilities did more with the patients, they would get more respect from the patients,” she said.

That means that when administrators announced it was time for residents to get one of the newest Covid vaccines this year, Loveland said, residents often simply ignored the message, even if it meant putting their own health at risk.

This article is from a partnership that includes NPR and KFF Health News, Healthbeat’s national reporting partner.

Respiratory viruses creep up as we head into the holidays

2024-11-27T12:00:00+00:00

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Happy (early) Thanksgiving! As many of us get ready to travel and spend time with loved ones this week, it’s a good idea to check in on the state of respiratory viruses and share tips to stay healthy this Thanksgiving. I’m personally looking forward to indulging in some pumpkin pie, guilt- and respiratory virus-free. 🥧

Covid-19: minimal

Covid-19 transmission has continued to decrease across New York. Levels are “minimal.”

SARS-CoV-2 concentrations in New York (yellow line) are minimal and declining, according to data from the CDC National Wastewater Surveillance System.

It’s the same story in the city — transmission of Covid-19 is low. Good news for travelers: Covid-19 transmission is also low in the Midwest and West, and minimal in the South and Northeast.

Influenza and RSV: low but increasing

Influenza (flu) is increasing in New York; the number of cases in the state increased by 12% compared to the previous week. The biggest increases are happening in New York City and the metro area.

Laboratories report that positive RSV tests are also increasing in New York state and New York City. Younger kids, especially infants, older adults, and people with weakened immune systems are at greatest risk for severe RSV. If this is you, consider taking extra precautions this week.

New York City RSV testing data from the Influenza and RSV Surveillance Report.

Other viruses: circulating

Even though we are seeing low levels of Covid-19, influenza, and RSV, the percent of clinic visits for general fever, cough, or runny nose is similar to last year — people are still showing up sick to clinics.

Percent of influenza-like illness among patients from New York State Influenza Surveillance Report.

Two viruses are the likely culprits: enteroviruses or rhinoviruses, which cause the common cold. It turns out the common cold is, well, common in New York right now.

New York City respiratory virus testing data from the Influenza and RSV Surveillance Report.

Walking pneumonia: increasing

Nationally and in parts of New York, clinics are seeing more children with walking pneumonia, a respiratory illness often caused by the bacteria Mycoplasma pneumoniae (and other pathogens). Symptoms include fever, sore throat, and persistent cough, but in severe cases, lungs can fill with fluid, causing difficulty breathing.

Walking pneumonia is harder to track because healthcare providers aren’t required to report cases. This year, the Centers for Disease Control and Prevention put together a national surveillance system of hospitalizations to track walking pneumonia — and it’s much higher right now than previous years (it flares every 3-5 years.) There’s no reason to think it’s any different in New York. The largest rise in cases is among children ages 1 to 4.

National percentage of pneumonia-associated emergency department visits with Mycoplasma pneumoniae infection.

Because it’s caused by a bacteria, severe Mycoplasma pneumonia cases can be treated with antibiotics, but most people fully recover without them. The CDC has helpful information about walking pneumonia here.

Avoid getting sick leading up to the holidays

Regardless of what is circulating, things you can do to stay healthy generally apply across all viruses and bacteria.

It’s not too late to get vaccinated. Immunity helps prevent infection for Covid-19, flu, and RSV. It’s also a great time to ask family members if they are vaccinated.
- Find locations using the NYC Vaccine Finder, including sites offering free vaccines for people without insurance.
- Vaccination locations throughout the rest of New York state can be found at Vaccines.gov.
- RSV vaccines and monoclonal antibodies are also available for a subset of people (pregnant people, older adults, and babies).
Mask up in the days leading up to the holidays to prevent bringing a virus to the celebration. Well-fit filtration masks like N95s are the best, but I find I’m less likely to wear these for long periods of time, so I’ve settled for a surgical mask or KN95. I’ll be wearing a mask at the airport and on the plane, and I have started to use one when I remember in the subway.

Reduce spreading infection during holiday events

Stay home if you feel sick. This is the most important way to avoid spreading illness, especially to vulnerable friends or relatives who may be over age 65, pregnant, or immunocompromised.
Ventilate and filter air to help reduce transmission. When you’re together indoors, open a window, use a fan, or turn on an air purifier.
Test at home for Covid-19 and flu. Tests are more accurate if taken when symptoms are present (in which case, stay home to reduce spread regardless). Rapid tests can catch about 40% of asymptomatic infections if two tests are taken 48 hours apart. This is a good way to take extra precaution before visiting someone who’s immunocompromised.
- Four free rapid tests from the U.S. Department of Health and Human Services can be ordered here and mailed to you.
- There is now an Food and Drug Administration-approved combined Covid-19 and flu rapid test. It is helpful to test for both because the earlier you find out if you have flu or Covid-19, the earlier you can call your doctor and get started on antiviral treatments.

Get treatment if you do get sick

If you have symptoms or test positive, assume you are contagious and stay home.
At-home rapid tests. If you test positive, you are infectious. Stay in isolation and wear a mask (preferably an N95) around others for at least 5 days or until you test negative.
Antivirals can help reduce severe illness, especially if you are over age 65.
- Paxlovid helps treat Covid-19 but should be taken within 5 days of symptom onset.
- Tamiflu helps treat influenza and should be taken within 48 hours of symptom onset.

Bottom line

Respiratory season is starting to pick up, and it will likely be intensified this Thanksgiving and thereafter because we are increasing our social networks. But there are tons of ways we can stay healthy and still celebrate with loved ones. Happy Thanksgiving, all. I’m very grateful for this community :)

Love,

Your Local Epidemiologist

Emory researchers find clues to Covid severity in nasal swabs

2024-11-19T14:42:05+00:00

Public health, explained: Sign up to receive Healthbeat’s free Atlanta newsletter here.

Heading into the fifth U.S. winter of Covid-19, an Emory University lab has found the presence — or absence — of a particular antibody in the nose of patients can predict how severe their illness would be.

The presence of the antibody, called anti-interferon alpha, indicated the infection would likely be limited to mild symptoms like coughing or sore throats, according to a study published earlier this month in Science Translational Medicine. Those without the antibodies in their nostrils often experienced shortness of breath, indicative of a more severe case of Covid.

Emory and University of California San Francisco researchers developed diagnostic technology to test for the antibodies in nasal swabs for the disease, like those found in over-the-counter tests. Eliver Ghosn, an Emory Vaccine Center researcher and the study’s senior author, said if clinicians could use a commercialized version of this technology with the standard tubular tests, they may be able to determine which patients need more care.

“You have a lot of biological waste,” he said. “Because those tubes that we collect [and] the nasal swab, they go as biological waste. Our proposal is, why not collect that waste?”

Previous research suggested the presence of anti-interferon alpha antibodies could have the opposite effect, predicting that someone’s Covid infection symptoms would be severe or fatal. But those studies examined the biomarkers in blood samples — not mucus samples like Ghosn and his colleagues tested.

To Ghosn, the study results resolve a contradiction of what scientists know these antibodies can do and how they interact with Covid.

“We never looked at the nose,” he said. “And the nose was the key, right? That’s where the virus goes first.”

The antibodies keep the virus from flourishing in petri-dish tests, Ghosn said. But his team doesn’t claim the association between the nasal antibodies and quick infection recovery is causal, and he said more research is needed to better determine that relationship.

If in the next two to three months his lab finds a pharmaceutical company that could develop a commercial product using this technology, Ghosn said clinicians might be able to use such tests by this winter. But it has not yet signed an agreement to bring a product to market.

Georgia public health board: Respiratory viruses are low

Dr. Greg Martin, Emory’s director of pulmonary and critical care medicine, said the technology Ghosn’s lab developed and their research could bring clinicians insights beyond general risk factors as to what someone’s Covid-19 infection will be like. With that knowledge, health care workers can make better decisions as to who should be prescribed treatments like Paxlovid and how quickly they should be connected to care.

“This you could easily see as an important next step for particularly all these people in the gray zone, where you’re not sure the likelihood of them having a more severe course of disease,” he said.

Although the virus’ death rate has decreased significantly since 2020, it has contributed to the death of about 43,000 Americans and over 1,200 Georgians in 2024. That’s why Martin said innovations like those developed in Ghosn’s lab and new over-the-counter tests that can detect both flu and Covid-19 are important for keeping families healthy.

Last week at the Georgia Department of Public Health’s board meeting, the state’s epidemiologist said she expected the risk of Covid-19 death to be lower this winter than previous seasons. But that risk could be exacerbated if hundreds of thousands of uninsured Georgians don’t have access to updated vaccines.

Martin noted that recent seasonal data from the Southern Hemisphere can help scientists estimate what the U.S. flu season will be like. Because countries in South America and Oceania had mild respiratory disease winters, that may indicate Georgia could expect a similar situation.

But that could change if people let their guard down and forgo testing and vaccination, especially as families gather for the winter holidays.

“Which is why we still advocate for people to be attentive,” Martin said.

Allen Siegler is a reporter covering public health in Atlanta for Healthbeat. Contact Allen at asiegler@healthbeat.org.

Respiratory weather report for New York: Covid levels low as flu and RSV rise

2024-11-14T12:00:00+00:00

Sign up for Your Local Epidemiologist New York and get Dr. Marisa Donnelly’s community public health forecast in your inbox a day early.

I want to start this week’s YLE New York by acknowledging the uncertainties and anxieties around what the election results mean for public health in the United States, and by recommitting to our YLE mission. Regardless of politics, we will continue sharing accurate, honest, and reliable public health information. We are still here to empower you all to make evidence-based decisions to keep yourselves and your loved ones healthy. That won’t change.

Now, let’s get back to this week’s public health updates.

New Yorkers voted to protect abortion rights

In last week’s election, New Yorkers passed Proposition 1, a ballot measure that makes abortion rights part of the New York state constitution.

Proposition 1 was also known as the Equal Rights Act because it prevents discrimination based on pregnancy, pregnancy outcomes, and reproductive health care, as well as age, gender identity, and sexual orientation. New York joined six other states that voted to protect abortion rights last week.

In New York, abortion has been legal since 1970 (three years before Roe vs. Wade). People of all ages have the right to abortions in New York:

Through the 24th week of pregnancy, or
After that, if a medical provider decides the fetus is not viable, or if the mother’s life or health are at risk.

Minors do not need parental permission to receive an abortion or birth control in New York.

In 2021, there were 59,616 abortions in New York state, including 37,813 in New York City. While the data are not finalized, we have more recent estimates of between 9,000 and 11,000 abortions per month in the state.

Estimated monthly abortions in New York state.

Covid-19 remains minimal across New York

Covid-19 is minimal and continues to decline in New York. SARS-CoV-2 wastewater concentrations (a good proxy for Covid-19 infections) continue to be minimal. The hospitalization rate in New York state is only 0.47 per 100,000 persons, which is down from the summer peak of 1.12 in August.

New York state Covid-19 wastewater activity levels from CDC NWSS. There are now 105 New York sites reporting data to CDC NWSS.

Influenza and RSV increasing in New York

The respiratory season has “officially” begun in New York. The state and city health departments are sharing weekly updates on influenza and RSV transmission for the respiratory season.

The number of flu cases in New York state is still low but starting to increase quickly. It’s increased by 12% since last week. These increases are happening in all New York regions except the West. It’s not clear why, but I expect increases there soon, too.

Influenza regional incidence from the New York State Influenza Surveillance Report.

RSV is also starting to increase. Testing data for New York City show that positive RSV tests increased by 34% last week.

New York City RSV testing data from the Influenza and RSV Surveillance Report.

Severe influenza and RSV remain low in New York state: influenza has 0.1 hospitalizations per 100,000 people, and RSV has 0.6.

Now is a great time to get vaccinated before the respiratory season

Influenza and updated Covid-19 vaccines are available throughout New York City; find locations using the NYC Vaccine Finder, including sites offering free vaccines for people without insurance.
Vaccination locations throughout the rest of New York state can be found at Vaccines.gov.
- The New York State Vaccines for Adults Program provides vaccines at no cost to underinsured, eligible adults throughout the state. More info here.
RSV vaccines and monoclonal antibodies are available for a subset of people (pregnant people, older adults, and babies). YLE National had a great post on how effective these treatments were in preventing severe disease last year.

Adults aged 65+ or immunocompromised: Expect a Covid-19 shot this spring

The Centers for Disease Control and Prevention and the New York State Department of Health recommend that those aged 65 and over or who are immunocompromised get two doses per year, six months apart. This is because protection wanes. Last fall, there was zero additional protection against hospitalization six months after vaccination. (Note: This is additional protection compared to all the immunity already out there.)

Vaccine effectiveness against Covid-19 hospitalization.

Bottom line

You’re all caught up on this week’s New York public health news. See you next week with more!

Love,

Your Local Epidemiologist

Georgia public health board: Respiratory viruses are low; new infant screening detects threat to hearing

2024-11-13T01:12:01+00:00

Public health, explained: Sign up to receive Healthbeat’s free Atlanta newsletter here.

Georgia is expecting a “typical” respiratory virus season for Covid, flu, and RSV, and the state public health department has instituted a new testing protocol to catch a potentially harmful virus among infants.

Those updates came Tuesday during the first meeting since May of the Georgia Department of Public Health board. The meeting was online, as the board has not resumed in-person gatherings since the Covid-19 outbreak.

State epidemiologist Dr. Cherie Drenzek said Georgia is seeing a “much more typical picture for the seasonality” of respiratory viruses Covid, influenza, and RSV.

In the past few years, RSV — respiratory syncytial virus — hit high levels in the summer. It is now peaking in the fall, closer to a pre-Covid pattern, Drenzek said. The same is true for flu.

High simultaneous rates of all three viruses could impact health care capacity.

Respiratory viruses are lower overall right now, Drenzek said, suggesting that as the Centers for Disease Control and Prevention has predicted, the chances of a “tripledemic” – the three viruses hitting the population at once – will be lower.

“We’re starting to see just some slight increases,” but the levels are low overall, Drenzek said, especially compared to the prior few years.

While Georgia is seeing a “record low” level of Covid cases, Drenzek said most of the cases, including hospitalizations and deaths, are among people over age 65.

While the KP.3.1.1 Covid variant is still predominant, about 20% of cases appear to be caused by a new strain called XEC that is a hybrid of two variants. The XEC variant could be the primary driver of winter infections, Drenzek said, but vaccines are effective against it and there is no evidence it causes more severe infections.

Rockdale public health officials criticize poor communication, lack of EPA leadership in BioLab fire response

Flu levels are also low, Drenzek said, with few hospitalizations and the most outpatient visits among school-age children.

She expects flu to start peaking at the end of December and January, which is more typical of the virus’ pre-pandemic spread.

RSV is also following a more “traditional” pattern this year. Typically, RSV spread starts in October and is primarily concerning for infants.

Drenzek said there has been an increase in positive RSV tests in October, with about 16% of tests coming back positive. The positivity rate typically peaks at around 20%. Georgia is starting to see an increase in hospitalizations “but nowhere near where we were a year ago.”

Georgia seeing more kids with ‘walking pneumonia’

The state is seeing “large spikes” in “walking pneumonia,” or mycoplasma pneumoniae, in children. The infection typically affects older children but is now being found in children ages 2 to 4 or even younger. It is characterized by a fever, upper respiratory symptoms, and especially a lingering cough.

It’s called walking pneumonia because it’s “relatively mild,” Drenzek said, and children can end up returning to school or daycare while they are still infectious.

Children who do not have a fever for more than 24 hours without the use of fever-reducing drugs can return to school, Drenzek said.

In Georgia, the disease is not “notifiable” — health care providers do not have to report it to the state — and sometimes the diagnosis is based on symptoms, not testing.

That makes it hard to get exact numbers, Drenzek said, “but we have heard from many healthcare partners and pediatricians that they have seen more mycoplasma pneumonia in young kids than they really had ever seen before.”

Though there is no vaccine, it is treatable with antibiotics, if needed. Drenzek said “respiratory etiquette” and keeping kids home from school when they are sick can help stop the spread.

Respiratory illnesses are preventable, Drenzek said. New CDC guidance says seniors should get two doses of the latest Covid vaccine six months apart. There are immunizations for RSV for older adults and infants. And everyone over age 6 months is advised to get a flu shot.

Drenzek said Georgia has seen no cases of bird flu, which has affected almost 500 dairy herds in 15 states and 46 farmworkers in the United States.

“We have great plans in place in case we ever come across bird flu in our dairy birds or in our poultry,” Drenzek said.

Infant screening finds virus that can cause hearing loss

A new state screening regulation implemented last month has identified eight cases of congenital cytomegalovirus, Melanie Morris, child health deputy director at the department, told the board.

The new regulation requires all birthing facilities to screen newborns who fail hearing tests for cCMV before discharge or within 21 days of age, whichever comes first, Morris said.

The tests are designed to detect the congenital infection, which can cause hearing loss, that might not otherwise be caught among newborns. It’s not a universal screening protocol, Morris said, but only focuses on those infants who fail their hearing screenings.

Positive cases must be reported to the state health department so the agency can follow up with health care providers and parents or guardians.

The tests are typically performed via saliva or urine samples.

Since the new regulation was implemented on Oct. 10, eight cases have been found, Morris said.

The board’s next meeting is scheduled for Jan. 14, 2025.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Respiratory season begins in New York: Flu and RSV levels low but rising

2024-11-06T12:12:26+00:00

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Have questions, comments, or ideas for future topics? Just reply to this email. I would love to hear from you.

It’s officially the respiratory season. The New York state and New York City health departments have begun releasing data. Time for a State of Affairs to kick us off.

Covid-19: minimal

Covid-19 transmission has continued to decrease in New York. Levels are considered “minimal.”

SARS-CoV-2 concentrations in New York (yellow line) are minimal and declining.

It’s the same story in the city — transmission of Covid-19 is low.

New York City average SARS-CoV-2 wastewater concentrations.

To continue the good news (there is a lot of it this week!), hospitalizations for Covid-19 have gone down among New Yorkers, especially those over 65 years old, who have the highest risk.

New York City daily hospitalizations by age.

Influenza and RSV: low but increasing

Influenza is increasing in New York — the number of cases in the state increased by 42% last week. These increases are widespread across the state; influenza cases and hospitalizations are going up in all regions except for the Western region (but I expect things will begin picking up there soon).

Influenza regional incidence from the New York State Influenza Surveillance Report. Annotations by YLE.

RSV data are harder to analyze because cases are not required to be reported to public health departments in New York. However, six New York labs (Liverpool, Albany, Syracuse, and three from New York City) participate in an optional Centers for Disease Control and Prevention surveillance program. Data for the most recent week show that positive tests for RSV remain low.

Testing data for RSV, influenza, and Covid-19 for New York state labs participating in the Centers for Disease Control and Prevention National Respiratory and Enteric Virus Surveillance System NREVSS.

Data for the city show that positive RSV tests increased by 12% last week, but we’re still at very low levels.

New York City RSV testing data from the Influenza and RSV Surveillance Report.

Severe influenza and RSV remain very low in New York state: Both are less than 0.1 hospitalizations per 100,000 people.

Other viruses: circulating

If you’re feeling sick, it’s most likely due to enteroviruses or rhinoviruses, which cause the common cold, or parainfluenza viruses, which also cause cold or flu-like illness. Those are testing very high, which is normal once kids go back to school.

New York City respiratory virus testing data from the Influenza and RSV Surveillance Report.

Typically, these infections are milder, but they can still be annoying. If you are feeling ill, wearing a mask and limiting social gatherings are ways to slow down disease transmission.

It’s still a great time to get your vaccines

Ideally, we want to get these before respiratory waves start, as they are a prevention tool. The time is now!

Influenza and updated Covid-19 vaccines are available throughout New York City; find locations using the NYC Vaccine Finder, including sites offering free vaccines for people without insurance.
Vaccination locations throughout the rest of New York state can be found at Vaccines.gov.
- The New York State Vaccines for Adults Program provides vaccines at no cost to underinsured, eligible adults throughout the state; find more info here.
RSV vaccines and monoclonal antibodies are available for a subset of people (pregnant people, older adults, and babies). YLE National has a great post on how effective these treatments were in preventing severe disease last year.

Bottom line

Respiratory diseases are still low, but influenza and RSV are starting to heat up, marking the start of the respiratory season. Now is a great time to consider getting your fall vaccines!

Love,

Your Local Epidemiologist

Your waste isn’t wasted: How New York’s wastewater network keeps you healthy

2024-10-23T11:00:00+00:00

Sign up for Your Local Epidemiologist New York and get Dr. Marisa Donnelly’s community public health forecast in your inbox a day early.

Disclosure: At my day job, I am an epidemiologist at Biobot Analytics, a wastewater company. While we don’t have wastewater sites in New York City, we work with several New York counties.

Ever wonder what is streaming in the sewers below the New York streets? Our wastewater system provides more than just sanitation. It can also act as an unbiased surveillance system (an epidemiologist’s dream).

This approach grew in popularity during the COVID-19 emergency and delivers an insightful, near-real-time view of our community’s health. Turns out, the best way to understand what’s going around — and what we can do to keep healthy — is by watching what’s going down — literally.

We New Yorkers don’t just have any old system, though. We have one of the strongest state-level systems in the United States. In August, the New York State Wastewater Surveillance Network was named a CDC Center of Excellence.

What is the NY state wastewater system?

Wastewater surveillance began only three years ago in New York during the Covid-19 emergency. Wastewater detected increases in virus activity before other data sources, like hospitalization records, making it an incredibly useful tool for early warning. Everyone uses the toilet, so wastewater can give a picture of the entire community (when connected to sewers) instead of relying on individuals getting swabbed and tested.

How it works: Sewage samples are collected from multiple sites and sent to labs for testing. The data is then analyzed to detect the spread of pathogens within communities. This process is the same across the United States.

One big difference between states, though, is coverage. Our state has over 200 wastewater surveillance sites, covering more than 75% of the New York population — one of the highest coverages in the United States.

For Covid-19 alone, New York can track levels across 60 counties, including all five counties in New York City.

One big reason the New York wastewater network is so strong is funding from the state and Centers for Disease Control and Prevention. Last year, Gov. Kathy Hochul added it to the fiscal budget: $5 million per year for three years (starting in 2023), totaling $15 million. New York is one of the only states with a state-line budget item for wastewater surveillance.

You have two places to see data (and thus take action)

Checking wastewater trends can help with personal decision-making, like wearing a mask when Covid-19 levels are high.

First, you can go to the state website. Covid-19 data, for example, is available on this public dashboard. I’ll also keep you updated once fall respiratory season kicks off.

Wastewater monitoring sites in the New York State Wastewater Surveillance Network

There is also the CDC National Wastewater Surveillance System dashboard, where average wastewater activity levels for New York state and individual sites are available.

There may be differences between the two dashboards, though. This can happen for three main reasons:

Local differences. Some communities have more or less Covid-19 activity than the statewide average, leading to differences between local levels and state averages.
Levels are defined differently. New York’s wastewater levels are based on early pandemic data (2020-21), while the CDC recalibrates its levels every six months, making them more adaptive to current trends, such as increased viral shedding from new variants.
Delays in reporting. Averages will fluctuate depending on how many sites are contributing data and if there are delays in reporting.

For example, the most recent New York data on CDC NWSS shows an apparent increase from recent minimal levels to moderate this week. However, the New York data sent to NWSS is delayed this week, with only two sites reporting. In other words, the most recent data displayed is not representative of the entire state. I expect the New York wastewater level on NWSS to go back down once the data is updated.

New York state Covid-19 wastewater activity levels from Centers for Disease Control and Prevention National Wastewater Surveillance System. Note, the New York data on CDC NWSS is delayed this week and the most recent uptick on this figure represents only two New York sites.

I like to use the New York dashboard for site-specific trends and the CDC NWSS dashboard for state-level averages and activity. Not every community in New York state has wastewater monitoring, but following the average state levels can often be good enough.

Wastewater system is also useful for polio

In July 2022, after 25 years, the first case of paralytic poliovirus in the state was confirmed in Rockland County, New York. The state public health system quickly adapted its Covid-19 wastewater program to begin tracking polio — after all, the process is the same; the test in the lab is just different.

After taking many samples across the state, wastewater showed that polio was present elsewhere: Sullivan, Orange, and Nassau counties, and New York City. When they tested historical wastewater samples, polio was present in wastewater as early as April 2022, three months before the case was identified. Public health departments prioritized resources — like education and vaccine campaigns — to communities where wastewater showed that polio was circulating.

Center of Excellence Award will allow even more

The quick move to scale the program to track polio likely played a significant role in the program being recognized as a CDC Center of Excellence. This places the New York wastewater system alongside five other CDC Centers of Excellence to continue expanding wastewater monitoring for public health.

This award:

Recognizes the excellent work thus far, and
Provides an additional $1 million in funding to support program expansion. New York plans to expand to test for more diseases, including influenza, RSV, hepatitis A, and norovirus, as well as the presence of antimicrobial-resistance genes.

Wastewater must have limitations, right?

Yes, like anything in this world, it’s not perfect:

It doesn’t cover everyone. Sampling is very difficult in communities that rely on septic systems. The >200 sites in the New York wastewater monitoring program cover about 75% of the state’s population (representing 95% of those connected to sewer systems.) However, the remaining 25% — not currently monitored — are in non-sewered areas, making it difficult to get a hyperlocal perspective on diseases in these areas. (If you’re in these areas, follow the wastewater site closest to you for rough estimates of disease activity.)
Ethical and privacy concerns. Although wastewater data is anonymized (sampled at pipes that several houses/blocks feed into), concerns could still arise about monitoring. Acknowledging these concerns is important, but a recent national survey found that nearly 75% of adults support wastewater monitoring for infectious diseases.
Interpretation for epidemiologists is … tough. Wastewater data is great for showing increases or decreases in disease levels. However, it can’t provide the number of people who are sick. When people get sick, the amount of virus they shed is quite variable.
Non-standardized methods. In New York state (and across the United States), different lab methods are used across counties, making comparisons difficult. In other words, we don’t know if “high” Covid-19 levels in one county are the same as “high” levels in another. New York City uses consistent methods across all sites, allowing for easier comparison within the city.

Bottom line

The wastewater pipelines below our streets provide pivotal information about diseases in New York and how (and when) to protect ourselves. However, this information is not a standalone solution and should be combined with other data sources to provide a holistic view of public health trends.

Love,

Your Local Epidemiologist

P.S. Ever wonder how much waste actually goes into the sewer? On average, individuals will flush the toilet five to seven times daily. With about 8.4 million people, that’s an average of 42 million to 58.8 million toilet flushes daily in New York City. 💩

Most infants with severe Covid had moms who didn’t get vaccine in pregnancy

2024-10-04T13:31:14+00:00

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Nearly 90% of babies who had to be hospitalized with Covid-19 had mothers who didn’t get the vaccine while they were pregnant, according to new data released by the Centers for Disease Control and Prevention. The findings appear in the agency’s Morbidity and Mortality Weekly Report.

Babies too young to be vaccinated had the highest Covid hospitalization rate of any age group except people over 75.

The study looked at infant medical data from October 2022 to April 2024 in 12 states and underscores the critical importance of vaccinating pregnant people. It also echoes what physicians have anecdotally reported for more than three years — that people are still skeptical of Covid vaccines due to persistent misinformation.

Of the 1,470 infants sick enough to be hospitalized due to Covid, severe outcomes occurred “frequently,” according to the report. Excluding newborns hospitalized at birth, about 1 in 5 infants hospitalized with Covid required intensive care, and nearly 1 in 20 required a ventilator.

“These aren’t necessarily high-risk, ill newborns. These are just regular, full-term, healthy newborn kids who happen to get Covid and wind up on a ventilator in the hospital,” said Neil Silverman, a professor of clinical obstetrics and gynecology and the director of the Infectious Diseases in Pregnancy Program at the David Geffen School of Medicine at UCLA.

Babies can’t get the Covid vaccination until they are at least 6 months old. That leaves a “huge window” when infants are most vulnerable, Silverman said. Vaccinating pregnant women so they pass the antibodies on to their newborns is an effective way of protecting babies during that time. Vaccination during pregnancy also protects pregnant people from severe disease.

But persistent vaccine misinformation online has led to skepticism among Silverman’s pregnant patients.

“The most frustrating response that I get from folks is that they need to do more research before they think about getting the Covid vaccine,” Silverman said. “We have dozens and dozens of studies showing the safety of the mRNA vaccine. I don’t know how much more research we can provide to skeptics.”

Among the 1,000-plus babies hospitalized with Covid, the median age was just 2 months old, according to the report. Nine of the infants died.

South Carolina pediatrician Deborah Greenhouse said she plans to share the study with families she cares for. “There absolutely is a proportion of the population who will look at this and say, ‘Hey, wow, I should get that vaccine. It could protect my baby,’” she said.

Greenhouse believes the new data could solidify the risk of skipping the vaccine when she speaks to families.

“I think that it might help to convince some parents when you can actually show them hospitalization numbers and you can show them intensive care numbers and you can show them mechanical ventilation numbers,” Greenhouse said. “Those things are a big deal.”

Often, Greenhouse waits to be informed that a person is pregnant before bringing up the updated Covid shot. Now she’s rethinking that strategy. “As pediatricians we do get moms in our office who are pregnant and we have an opportunity to intervene and to do some education and make them understand how important this is,” she said.

Physicians can encourage vaccination by making it as easy and simple as possible, Silverman said. He encouraged fellow doctors to offer the shots in their offices, rather than sending patients to pharmacies or other providers.

“We lose probably 30 to 40% of vaccination opportunities once someone has to leave the office to get a vaccine,” Silverman said.

But offering Covid shots in their clinics leaves some doctors with a difficult calculation. They are struggling to predict how many patients will be interested in the vaccine and may not be able to return all their excess doses. Many providers can’t afford to lose money on doses that won’t be used, but they still need to order enough to vaccinate vulnerable patients who want the shot.

Jackie Fortiér is a reporter for KFF Health News, Healthbeat’s national reporting partner.

Covid-19 declines in NYC, and other diseases stay at bay

2024-10-02T11:00:00+00:00

Sign up for Your Local Epidemiologist New York and get Dr. Marisa Donnelly’s community public health forecast in your inbox a day early.

Welcome to the first edition of Your Local Epidemiologist New York.

These reports will provide essential information about public health issues in New York every week and tips on keeping yourself and your loved ones healthy — directly from me, an epidemiologist.

I’m Dr. Marisa Donnelly, Your Local Epidemiologist in New York. I have a PhD in epidemiology and have spent the past 10 years as a disease detective on the front lines — doing everything from investigating Covid-19 and mpox, to searching for the source of food poisoning (i.e., E. coli) outbreaks and researching mosquitoes that transmit viruses. When I’m not writing these reports or analyzing wastewater data (my day job), you can find me jogging or doting on my two cats 🐈🐈‍⬛.

Let’s kick things off with the State of Affairs — an infectious disease “weather report” for New Yorkers.

Covid-19: minimal

SARS-CoV-2 levels in wastewater, one of our best proxies for Covid-19 infections and spread throughout New York state, are “minimal.”

SARS-CoV-2 concentrations in New York (yellow line) are minimal and declining.

In more good news, severe Covid-19 disease remains low in New York City (2.0 per 100,000 people) and continues to decline. Hospitalizations in New York City are lower than the national average (2.3 per 100,000). These rates are so low because most New Yorkers have some sort of immunity, either through vaccination or prior infections.

New York City daily hospitalization counts continue to decline.

Most New Yorkers getting hospitalized for Covid-19 are those over 65 years old.

New York City daily hospitalizations by age.

Influenza and RSV: minimal (we assume), but increasing

New York typically begins releasing influenza and RSV data in October, marking the “official” start of the respiratory season. Although they haven’t posted any updates for this season yet, I expect the data to be available later this month.

Right now, we assume levels are low for three reasons:

Wastewater data can also detect flu and RSV, and activity for New York is low.
Testing data for New York shows that the percent of tests positive for influenza, RSV, rhinovirus, or enteroviruses are low, but starting to show some increases.
Influenza-like illness (ILI) — a physician tally of coughs, sore throats, and fevers — is minimal. (You’ll notice that New York and other states in the east and south are starting to change colors other than dark green. This indicates that seasonal flu activity is just beginning.)

This may be a great time to get your fall vaccines. Ideally, we want to get these before respiratory waves start, as they are a prevention tool.

Updated Covid-19 vaccines are now available for free throughout New York City; find locations here. Vaccination locations throughout the rest of New York state can be found here.
For those without insurance or whose insurance does not cover the Covid-19 vaccine, the New York State Vaccines for Adults Program provides vaccines at no cost to eligible adults throughout the state; find more info here.

Mpox (monkeypox): Clade II present in NYC

Mpox — formally known as monkeypox—is an infectious disease spread through very close contact, like sex. New York City has one of the highest case counts this year, with more than 350 cases. In the past month, 38 cases have been detected in the city. As shown in the graph below, this year has been worse than last.

Daily mpox cases diagnosed in New York City.

You may also be hearing about mpox in Africa in the news. But, keep in mind there are two types of mpox:

Clade I is causing an emergency in Central Africa and seems to be causing more severe disease. However, it has yet to be detected in the United States (or New York).
Clade II caused a massive outbreak in 2022 and has stuck around at endemic levels since. Severe disease is rare, but regardless, infection can be painful. In New York, we only have Clade II cases at this time.

Fortunately, the JYNNEOS vaccine provides protection, but be sure to get both doses. Who is eligible?

Men who have sex with men
People who identify as trans, nonbinary, genderqueer, or gender non-conforming.

Find mpox vaccination locations here.

Bottom line

Respiratory diseases are low, giving us a bit of a break before picking up again due to social networks changing (students going to school, holiday gatherings) and the weather cooling.

Mpox is still lingering around New York. There’s a lot we can do to stay healthy though: Stay up to date on your vaccines!

Love,

Your Local Epidemiologist

Dr. Marisa Donnelly, a senior epidemiologist with wastewater surveillance firm Biobot Analytics, has worked in applied public health for over a decade, specializing in infectious diseases and emerging public health threats. She holds a PhD in epidemiology, and has led multiple outbreak investigations, including at the California Department of Public Health and as an epidemic intelligence service officer at the Centers for Disease Control and Prevention. Marisa has conducted research in Peru, focusing on dengue and Zika viruses, as well as the mosquitoes that spread them. She is Healthbeat’s contributing epidemiologist for New York in partnership with Your Local Epidemiologist, a Healthbeat supporter.

For uninsured Atlantans, conflicting information, fluctuating supplies complicate access to new Covid shot

2024-09-27T14:22:16+00:00

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It’s been over a month since the FDA approved new Covid vaccines, but for uninsured and underinsured Atlantans who rely on the public health system to get the shots at low cost, the process is fraught with conflicting information and fluctuating supplies.

Some county health departments still don’t have the vaccine; others have a limited supply earmarked for the uninsured, which are free but carry service fees of about $21. (Paying out of pocket at a pharmacy chain will cost about $202, CVS says).

The vaccines will still be free for Marketplace and Medicare enrollees. Uninsured, underinsured and Medicaid-eligible kids should be able to get the vaccines for free under the Vaccines for Children program. And CVS said the shots should be free under most insurance plans at in-network pharmacies.

The Georgia Department of Public Health planned to purchase about 38,000 updated Covid vaccines for underinsured and uninsured adults, spokesperson Nancy Nydam told Healthbeat last month.

There are around 1 million uninsured Georgians under age 65.

In calling 20 public health clinics in metro Atlanta this week, Healthbeat found that some don’t have the vaccines and it’s unclear how uninsured people can get the shots at others.

After inquiries from Healthbeat, some county health departments said they would try to ensure their frontline workers provide accurate information about how to access the shots.

“Training will be provided to staff to ensure they have accurate and consistent information,” Fulton County Board of Health spokesperson Tia McCullough said after Healthbeat shared difficulties getting a vaccine appointment.

Spokesperson Eric Nickens of DeKalb Public Health said clinical leadership was working to ensure frontline staffers provide accurate information to callers after Healthbeat attempted to schedule vaccine appointments at four clinics and got inconsistent information.

That uninsured Georgians have to cover any of the costs out of pocket is a health equity problem, said Laura Colbert, executive director of Georgians for a Healthy Future, a nonprofit advocacy group.

“This imbalance unfairly leaves uninsured folks exposed to illnesses that others are protected from, putting their health and financial stability at risk,” she said.

Shots available for $21 service fee

Healthbeat attempted to contact 20 public health clinics in eight counties: Fulton, DeKalb, Clayton, Gwinnett, Newton, Rockdale, Cobb, and Douglas.

Many of the clinics said the vaccines would cost around $21.93 for an uninsured patient.

Representatives at a few clinics, including the College Park Health Center, part of the Fulton County Board of Health system, and the Norcross and Newton Health Centers, part of GNR (Gwinnett, Newton and Rockdale) Public Health, said a shot would cost more than $150.

Covid vaccines for kids may be harder to find after many went unused

Michele Kehler, a spokeswoman for the agency, said that was incorrect. Uninsured and underinsured patients would need to pay just the $21 administration fee.

Likewise, Fulton spokeswoman McCullough told Healthbeat the shots should cost only $21 for uninsured patients and the clinics will not turn away anyone who is unable to pay.

Colbert said even $21 is too much.

“For families already struggling to make ends meet, an administration fee for a vaccine may make the difference between getting protected or going without it,” Colbert said. “This means more Georgians will be at greater risk of getting sick, missing work, and losing wages they can’t afford to lose.”

Dr. Cecil Bennett, a family medicine doctor and fellow at Morehouse School of Medicine, told Healthbeat last month, “This season is going to be a very difficult Covid and flu season.”

Uptake has been low in Georgia for the flu and Covid vaccines.

Only about 17% of adult Georgians got last year’s Covid shot, according to the U.S. Centers for Disease Control and Prevention.

GNR Public Health chief clinical officer Alana Sulka said the agency’s clinics have not had to turn away any patients for lack of supply of Covid shots.

As of mid-September, Covid caused about 2.7% of all deaths in Georgia, according to the CDC.

The state’s Covid death rate should be close to zero, since deaths are largely preventable with vaccination, said Jodie Guest, senior vice chair of the Department of Epidemiology at Emory University’s Rollins School of Public Health.

“This is a vaccine preventable death for almost every case … At a minimum, we’d want to see it under 1%,” she said.

Shots not available in all counties

Some county health clinics don’t have the vaccine at all or only a limited supply for uninsured patients.

For example, a call center representative at the Clayton County Health District said Wednesday the vaccine wasn’t available for uninsured people and she didn’t know when it would be.

In the GNR district, supply “fluctuates daily.” People are urged to call the main line at 770-904-3717 to schedule an appointment, Kehler said.

Reached on Wednesday, representatives at two of four clinics, in Lawrenceville and Newton, said they did not have the vaccines.

Meanwhile, a representative at the Norcross clinic that is part of the same county system said the clinic has a limited supply for uninsured patients. The Rockdale clinic does have the shots and appointments were available.

It’s also a patchwork picture in the Cobb and Douglas Public Health system.

The Douglas and Kennesaw clinics do not have the shots in stock. The Marietta and Smyrna clinics are accepting appointments, as well as walk-ins, though the Smyrna clinic has a very limited supply for uninsured patients, a representative said.

Some clinics difficult to reach

Fulton County’s local health clinics can be difficult to access. The county website touts a main phone number, 770-520-7500, through which people can access local clinics to set up appointments.

But a Healthbeat reporter was only able to speak to a representative at two of those clinics, the Neighborhood Union and College Park Health Centers. At Neighborhood Union, a representative said the new Covid vaccines would cost $21.93 and appointments were available the next day.

It was difficult to reach other clinics in the Fulton health system, with some calls going to voicemail and other clinics not listed in the automatic phone directory system.

In DeKalb, Nickens said appointments are preferred, but walk-ins are accepted. But when contacted, three of the four clinics said the only way to get a vaccine is by walking in and not with an appointment.

Nickens said health department leaders are working to ensure staffers provide accurate information to callers.

Some local nonprofit clinics may also have free or low-cost Covid vaccines for uninsured people, Nydam said.

Here is the situation at five local public health agencies, plus the Grady Health System:

Fulton County Board of Health

Vaccine status: Appointment system unreliable; try walking in

The Fulton County Board of Health’s website lists seven clinics where people can get the Covid vaccines. The website states vaccine appointments and walk-ins are available at those centers.

However, a Healthbeat reporter faced difficulty reaching most of the clinics through the main phone number (770-520-7500) and received inconsistent information from phone representatives about the cost of the vaccines.

Spokesperson Tia McCullough said the agency would work to address those problems.

While uninsured and underinsured patients will not be charged a fee for the actual vaccine, they will need to pay a $21 administrative fee, McCullough said. However, no one will be turned away due to inability to pay.

Adamsville Health Center: 3700 MLK Jr Dr. SW, Atlanta. Monday-Friday: 9 a.m.–4 p.m.
College Park Health Center: 1920 John Wesley Ave., College Park. Monday–Friday: 8:30–11 a.m. and 1–3 p.m.
Neighborhood Union Health Center: 186 Sunset Ave. NW # 186, Atlanta. Monday & Tuesday, 8:30 a.m.– 5 p.m.

Healthbeat was unable to reach these clinics using the automated phone system (770-520-7500).

North Fulton Regional Health Center: 3155 Royal Dr., Alpharetta. Monday–Friday, 9 a.m.–4 p.m.
4700 North Point: 4700 North Point Pkwy., Alpharetta. Tuesday and Saturday: 9:30 a.m.–4:30 p.m.
Fulton County Government Center: 141 Pryor St. (near the Pryor Street entrance), Atlanta. Wednesday and Friday: 9:30 a.m. – 4:30 p.m.
Stonewall Tell: 5710 Stonewall Tell Rd., South Fulton. Monday & Tuesday, 9 a.m.– 5 p.m.

DeKalb Public Health

Vaccine status: Call for hours, appointments; walk-ins available

Spokesperson Eric Nickens said people should call 404-294-3700 and ask to schedule an appointment. Walk-ins are also available. DeKalb Public Health leadership is working to ensure phone representatives have accurate information, Nickens said.

For uninsured patients, the vaccines will cost $21.93. Call ahead.

Clifton Springs Health Center: 3110 Clifton Springs Rd., Decatur.
East DeKalb Health Center: 2277 S. Stone Mountain Lithonia Rd., Lithonia.
North DeKalb Health Center: 3807 Clairmont Rd., Chamblee.
T.O. Vinson Health Center: 440 Winn Way, Decatur.

Cobb and Douglas Public Health

Vaccine status: Marietta and Smyrna clinics have shots; call ahead

Two of the counties’ public health clinics have the shots for uninsured people in stock, while two do not. The Kennesaw and Douglasville clinics do not have the shots, representatives said, while the Marietta and Smyrna clinics do.

People are urged to call ahead to ensure the vaccines are still in stock. Uninsured people will be charged a $21 fee.

Call 770-514-2300 for an appointment or make an appointment online.

Marietta: 1650 County Services Pkwy.
Smyrna: 3001 South Cobb Dr.

Gwinnett, Newton, Rockdale Public Health

Vaccine status: Norcross, Rockdale clinics have shots; supply fluctuates so call ahead

GNR Public Health has a limited supply of Covid-19 vaccines, spokesperson Michele Kehler said. Call 770-904-3717 to inquire about availability.

On Wednesday, the vaccines were available at these locations:

Norcross Health Center: 5030 Georgia Belle Ct., Norcross.
Rockdale Health Center: 985 Taylor St. SW, Conyers.

Clayton County Health District

Vaccine status: None available

The Clayton County Health District does not have the vaccines in stock. A representative said she is unsure when they will be available.

Grady Health System

Vaccine status: Shots available

The new Covid vaccines are available at Grady Hospital in the primary care center and Grady’s neighborhood health clinics in the primary care center and Grady’s neighborhood health clinics, spokesperson Danielle Hackett said. For uninsured patients, the vaccine is still available at a nominal cost.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Nursing aides plagued by PTSD after ‘nightmare’ Covid conditions, with little help

2024-09-26T09:00:00+00:00

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One evening in May, nursing assistant Debra Ragoonanan’s vision blurred during her shift at a state-run Massachusetts veterans home. As her head spun, she said, she called her husband. He picked her up and drove her to the emergency room, where she was diagnosed with a brain aneurysm.

It was the latest in a drumbeat of health issues that she traces to the first months of 2020, when dozens of veterans died at the Soldiers’ Home in Holyoke, in one of the country’s deadliest Covid-19 outbreaks at a long-term nursing facility. Ragoonanan has worked at the home for nearly 30 years. Now, she said, the sights, sounds, and smells there trigger her trauma. Among her ailments, she lists panic attacks, brain fog, and other symptoms of post-traumatic stress disorder, a condition linked to aneurysms and strokes.

Scrutiny of the outbreak prompted the state to change the facility’s name to the Massachusetts Veterans Home at Holyoke, replace its leadership, sponsor a $480 million renovation of the premises, and agree to a $56 million settlement for veterans and families. But the front-line caregivers have received little relief as they grapple with the outbreak’s toll.

“I am retraumatized all the time,” Ragoonanan said, sitting on her back porch before her evening shift. “How am I supposed to move forward?”

Covid killed more than 3,600 U.S. health care workers in the first year of the pandemic. It left many more with physical and mental illnesses — and a gutting sense of abandonment.

What workers experienced has been detailed in state investigations, surveys of nurses, and published studies. These found that many health care workers weren’t given masks in 2020. Many got Covid and worked while sick. More than a dozen lawsuits filed on behalf of residents or workers at nursing facilities detail such experiences. And others allege that accommodations weren’t made for workers facing depression and PTSD triggered by their pandemic duties. Some of the lawsuits have been dismissed, and others are pending.

Health care workers and unions reported risky conditions to state and federal agencies. But the federal Occupational Safety and Health Administration had fewer inspectors in 2020 to investigate complaints than at any point in a half-century. It investigated only about 1 in 5 Covid-related complaints that were filed officially, and just 4% of more than 16,000 informal reports made by phone or email.

Nursing assistants, health aides, and other lower-wage health care workers were particularly vulnerable during outbreaks, and many remain burdened now. About 80% of lower-wage workers who provide long-term care are women, and these workers are more likely to be immigrants, to be people of color, and to live in poverty than doctors or nurses.

Some of these factors increased a person’s Covid risk. They also help explain why these workers had limited power to avoid or protest hazardous conditions, said Eric Frumin, formerly the safety and health director for the Strategic Organizing Center, a coalition of labor unions.

He also cited decreasing membership in unions, which negotiate for higher wages and safer workplaces. One-third of the U.S. labor force was unionized in the 1950s, but the level has fallen to 10% in recent years.

Like essential workers in meatpacking plants and warehouses, nursing assistants were at risk because of their status, Frumin said: “The powerlessness of workers in this country condemns them to be treated as disposable.”

In interviews, essential workers in various industries told KFF Health News they felt duped by a system that asked them to risk their lives in the nation’s moment of need but that now offers little assistance for harm incurred in the line of duty.

“The state doesn’t care. The justice system doesn’t care. Nobody cares,” Ragoonanan said. “All of us have to go right back to work where this started, so that’s a double whammy.”

Debra Ragoonanan picked out her funeral dress in 2020, worried she was going to die as Covid ripped through the long-term care facility where she still works. “I am retraumatized all the time,” she says. “How am I supposed to move forward?” (Amy Maxmen/KFF Health News)

Employees called the home ‘a war zone’

The plight of health care workers is a problem for the United States as the population ages and the threat of future pandemics looms. Surgeon General Vivek Murthy called their burnout “an urgent public health issue” leading to diminished care for patients. That’s on top of a predicted shortage of more than 3.2 million lower-wage health care workers by 2026, according to the Mercer consulting firm.

The veterans home in Holyoke illustrates how labor conditions can jeopardize the health of employees. The facility is not unique, but its situation has been vividly described in a state investigative report and in a report from a joint oversight committee of the Massachusetts Legislature.

The Soldiers’ Home made headlines in March 2020 when The Boston Globe got a tip about refrigerator trucks packed with the bodies of dead veterans outside the facility. About 80 residents died within a few months.

The state investigation placed blame on the home’s leadership, starting with Superintendent Bennett Walsh. “Mr. Walsh and his team created close to an optimal environment for the spread of Covid-19,” the report said. He resigned under pressure at the end of 2020.

Investigators said that “at least 80 staff members” tested positive for Covid, citing “at least in part” the management’s “failure to provide and require the use of proper protective equipment,” even restricting the use of masks. They included a disciplinary letter sent to one nursing assistant who had donned a mask as he cared for a sick veteran overnight in March. “Your actions are disruptive, extremely inappropriate,” it said.

To avoid hiring more caretakers, the home’s leadership combined infected and uninfected veterans in the same unit, fueling the spread of the virus, the report found. It said veterans didn’t receive sufficient hydration or pain-relief drugs as they approached death, and it included testimonies from employees who described the situation as “total pandemonium,” “a nightmare,” and “a war zone.”

Because his wife was immunocompromised, Walsh didn’t enter the care units during this period, according to his lawyer’s statement in a deposition obtained by KFF Health News. “He never observed the merged unit,” it said.

In contrast, nursing assistants told KFF Health News that they worked overtime, even with Covid, because they were afraid of being fired if they stayed home. “I kept telling my supervisor, ‘I am very, very sick,’” said Sophia Darkowaa, a nursing assistant who said she now suffers from PTSD and symptoms of long Covid. “I had like four people die in my arms while I was sick.”

Nursing assistants recounted how overwhelmed and devastated they felt by the pace of death among veterans whom they had known for years — years of helping them dress, shave, and shower, and of listening to their memories of war.

“They were in pain. They were hollering. They were calling on God for help,” Ragoonanan said. “They were vomiting, their teeth showing. They’re pooping on themselves, pooping on your shoes.”

Nursing assistant Kwesi Ablordeppey said the veterans were like family to him. “One night I put five of them in body bags,” he said. “That will never leave my mind.”

Four years have passed, but he said he still has trouble sleeping and sometimes cries in his bedroom after work. “I wipe the tears away so that my kids don’t know.”

In 2020, nursing assistants at the Soldiers’ Home in Holyoke were overwhelmed by the pace of death among residents they had become close with over the years. Kwesi Ablordeppey says he still has trouble sleeping and carries post-traumatic stress. (Amy Maxmen/KFF Health News)

Workers see high demands, low autonomy

A third of health care workers reported symptoms of PTSD related to the pandemic, according to surveys between January 2020 and May 2022 covering 24,000 workers worldwide. The disorder predisposes people to dementia and Alzheimer’s. It can lead to substance use and self-harm.

Since Covid began, Laura van Dernoot Lipsky, director of the Trauma Stewardship Institute, has been inundated by emails from health care workers considering suicide. “More than I have ever received in my career,” she said. Their cries for help have not diminished, she said, because trauma often creeps up long after the acute emergency has quieted.

Another factor contributing to these workers’ trauma is “moral injury,” a term first applied to soldiers who experienced intense guilt after carrying out orders that betrayed their values. It became common among health care workers in the pandemic who weren’t given ample resources to provide care.

“Folks who don’t make as much money in health care deal with high job demands and low autonomy at work, both of which make their positions even more stressful,” said Rachel Hoopsick, a public health researcher at the University of Illinois at Urbana-Champaign. “They also have fewer resources to cope with that stress,” she added.

People in lower income brackets have less access to mental health treatment. And health care workers with less education and financial security are less able to take extended time off, to relocate for jobs elsewhere, or to shift careers to avoid retriggering their traumas.

Such memories can feel as intense as the original event. “If there’s not a change in circumstances, it can be really, really, really hard for the brain and nervous system to recalibrate,” van Dernoot Lipsky said. Rather than focusing on self-care alone, she pushes for policies to ensure adequate staffing at health facilities and accommodations for mental health issues.

In 2021, Massachusetts legislators acknowledged the plight of the Soldiers’ Home residents and staff in a joint committee report saying the events would “impact their well-being for many years.”

But only veterans have received compensation. “Their sacrifices for our freedom should never be forgotten or taken for granted,” the state’s veterans services director, Jon Santiago, said at an event announcing a memorial for veterans who died in the Soldiers’ Home outbreak. The state’s $56 million settlement followed a class-action lawsuit brought by about 80 veterans who were sickened by Covid and a roughly equal number of families of veterans who died.

The state’s attorney general also brought criminal charges against Walsh and the home’s former medical director, David Clinton, in connection with their handling of the crisis. The two averted a trial and possible jail time this March by changing their not-guilty pleas, instead acknowledging that the facts of the case were sufficient to warrant a guilty finding.

An attorney representing Walsh and Clinton, Michael Jennings, declined to comment on queries from KFF Health News. He instead referred to legal proceedings in March, in which Jennings argued that “many nursing homes proved inadequate in the nascent days of the pandemic” and that “criminalizing blame will do nothing to prevent further tragedy.”

Nursing assistants sued the home’s leadership, too. The lawsuit alleged that, in addition to their symptoms of long Covid, what the aides witnessed “left them emotionally traumatized, and they continue to suffer from post-traumatic stress disorder.”

The case was dismissed before trial, with courts ruling that the caretakers could have simply left their jobs. “Plaintiff could have resigned his employment at any time,” Judge Mark Mastroianni wrote, referring to Ablordeppey, the nursing assistants’ named representative in the case.

But the choice was never that simple, said Erica Brody, a lawyer who represented the nursing assistants. “What makes this so heartbreaking is that they couldn’t have quit, because they needed this job to provide for their families.”

The state-run Soldiers’ Home in Holyoke, Massachusetts, was the scene of one of the country’s deadliest Covid outbreaks at a long-term nursing facility. Scrutiny of the outbreak prompted the state to change the home’s name, replace its leadership, and agree to a $56 million settlement for veterans and their families. But front-line caregivers have received little relief as they continue to grapple with the trauma. (Amy Maxmen/KFF Health News)

Bill would let workers retire early

Brody didn’t know of any cases in which staff at long-term nursing facilities successfully held their employers accountable for labor conditions in Covid outbreaks that left them with mental and physical ailments. KFF Health News pored through lawsuits and called about a dozen lawyers but could not identify any such cases in which workers prevailed.

A Massachusetts chapter of the Service Employees International Union, SEIU Local 888, is looking outside the justice system for help. It has pushed for a bill — proposed last year by Judith García, a Democratic state representative — to allow workers at the state veterans home in Holyoke, along with its sister facility in Chelsea, to receive their retirement benefits five to 10 years earlier than usual. The bill’s fate will be decided in December.

Retirement benefits for Massachusetts state employees amount to 80% of a person’s salary. Workers qualify at different times, depending on the job. Police officers get theirs at age 55. Nursing assistants qualify once the sum of their time working at a government facility and their age comes to around 100 years. The state stalls the clock if these workers take off more than their allotted days for sickness or vacation.

Several nursing assistants at the Holyoke veterans home exceeded their allotments because of long-lasting Covid symptoms, post-traumatic stress, and, in Ragoonanan’s case, a brain aneurysm. Even five years would make a difference, Ragoonanan said, because, at age 56, she fears her life is being shortened. “Help us to retire,” she said, staring at the slippers covering her swollen feet. “We have bad PTSD. We’re crying, contemplating suicide.”

Certain careers are linked with shorter life spans. Similarly, economists have shown that, on average, people with lower incomes in the United States die earlier than those with more. Nearly 60% of long-term care workers are among the bottom earners in the country, paid less than $30,000 — or about $15 per hour — in 2018, according to analyses by the Department of Health and Human Services and KFF, a health policy research, polling, and news organization that includes KFF Health News.

Fair pay was among the solutions listed in the surgeon general’s report on burnout. Another was “hazard compensation during public health emergencies.”

If employers offer disability benefits, that generally entails a pay cut. Nursing assistants at the Holyoke veterans home said it would halve their wages, a loss they couldn’t afford.

“Low-wage workers are in an impossible position, because they’re scraping by with their full salaries,” said John Magner, SEIU Local 888’s legal director.

Despite some public displays of gratitude for health care workers early in the pandemic, essential workers haven’t received the financial support given to veterans or to emergency personnel who risked their lives to save others in the aftermath of 9/11. Talk show host Jon Stewart, for example, has lobbied for this group for over a decade, successfully pushing Congress to compensate them for their sacrifices.

“People need to understand how high the stakes are,” van Dernoot Lipsky said. “It’s so important that society doesn’t put this on individual workers and then walk away.”

Amy Maxmen, a public health correspondent at KFF Health News, is Healthbeat’s national reporter.

Florida’s new Covid booster guidance is straight-up misinformation

2024-09-23T13:16:07+00:00

In what has become a pattern of spreading vaccine misinformation, the Florida health department is telling older Floridians and others at highest risk from Covid-19 to avoid most booster shots, saying they are potentially dangerous.

Clinicians and scientists denounced the message as politically fueled scaremongering that also weakens efforts to protect against diseases like measles and whooping cough.

A prominent Florida doctor expressed dismay that medical leaders in the state, leery of angering Republican Gov. Ron DeSantis, have been slow to counter anti-vaccine messages from Surgeon General Joseph Ladapo, including the latest Covid bulletin. Ladapo is a DeSantis appointee and the top official at the state health department.

The bulletin makes a number of false or unproven claims about the efficacy and safety of mRNA-based Covid vaccines by Pfizer and Moderna, including that they could threaten “the integrity of the human genome.” Florida’s guidance generally regurgitates ideas from anti-vaccine websites, said John Moore, a professor of microbiology at Weill Cornell Medicine.

Ladapo did not respond to a request for comment. DeSantis referred questions to the health department, which said the surgeon general’s guidance and citations “speak for themselves” and pointed to a post he made on the social platform X accusing the Centers for Disease Control and Prevention and FDA of “gaslighting Americans.”

DeSantis has styled himself and his administration as a bulwark against vaccine mandates, lockdowns, and other restrictive public health protections adopted during the pandemic to curb infections and save lives. Covid vaccination has become a partisan issue, with surveys by KFF, the health information nonprofit that includes KFF Health News, finding that Republicans have far less confidence in the safety and efficacy of the shots than Democrats.

But vaccine historians consulted for this article could not recall any previous state health leader urging residents to shun an FDA-approved and CDC-recommended vaccination. “It’s unprecedented,” said Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia.

Florida medical leaders should speak out more forcefully against Ladapo’s attacks on public health, said Jeffrey Goldhagen, a pediatrician and professor at the University of Florida College of Medicine in Jacksonville. Ladapo urged people under 65 to avoid Covid shots last year and has rejected public health protocols for fighting measles outbreaks.

“What you see is a pattern of fear and neglect of professional responsibilities across the state, in part because of the fear of this governor and the vindictiveness of this governor,” said Goldhagen, a former health department director in Jacksonville.

He specifically criticized the Florida Medical Association, a trade group for physicians, noting that Ladapo is a nonvoting member of the group’s board of governors. The association did not respond to emails requesting comment.

Covid vaccines meet rigorous standards

The Florida Health Care Association, whose members run more than 600 long-term care facilities, declined to comment on Ladapo’s bulletin. One nursing home chain, LeadingAge Southeast, said it was aware of both federal and state recommendations on Covid boosters and encouraged providers to “engage with their residents, families, and healthcare professionals to make informed decisions.”

A spokesperson for the U.S. Food and Drug Administration, Cherie Duvall-Jones, said the agency “strongly disagrees with the State Surgeon General of Florida’s characterization of the safety and effectiveness of the updated mRNA Covid-19 vaccines.” The vaccines met the FDA’s “rigorous, scientific standards,” she said, and she urged people to get boosters since the population’s Covid immunity has waned.

Among its incorrect claims, the Florida bulletin says the new mRNA boosters wrongly target a viral variant, omicron, that is no longer circulating widely. This is false, since all major variants of Covid in the past two years evolved from omicron and subsequent mutations.

“You start off with that and then you go into head-exploding-emoji territory,” Moore said. “It’s a litany of lies out of the anti-vaxxer playbook.”

Other claims in Ladapo’s bulletin include:

Covid boosters don’t undergo clinical trials. It’s true that covid booster shots, whose mRNA sequences are changed slightly from previous shots, aren’t tested in large trials. Neither are annual influenza vaccines. By the time such tests would be completed, flu season would be over. But the original mRNA shots underwent clinical trials, and as with flu shots, “a lot of evidence has been collected in support of the ongoing use of the vaccines,” said Natalie Dean, a biostatistician at Emory University’s Rollins School of Public Health.
The shots pose a risk of infections, autoimmune disease, and other conditions. “I don’t know where these claims come from, but they aren’t accepted by the general medical community,” said William Schaffner, a Vanderbilt University School of Medicine infectious disease specialist. Serious side effects do occur, rarely, as with any medication. U.S. authorities were among the first to detect rare occurrences of myocarditis, an inflammation of the heart tissue, in young adults who got the covid vaccine. Most patients recovered quickly. Myocarditis is more commonly caused by covid infection itself.
The shots could cause elevated levels of spike protein and foreign genetic material in the blood. These concerns, which circulate on social media, have been disproved or have not panned out. For example, the billionths-of-a-gram quantities of bacterial DNA alleged to be contaminating covid shots are dwarfed by our other exposures, Offit said. “You encounter foreign DNA all the time, assuming you live on the planet and eat anything made from animals or vegetables,” he said. “I don’t know Dr. Ladapo, but I assume he does.”
Americans face “unknown risk” from too many booster shots. Scientists look at the possibility of “overvaccination” every time they study boosters. So far, no safety risks have been associated with multiple immunizations, Schaffner said.
Floridians should get exercise and eat vegetables and “healthy fats.” “These things will benefit your general health, but none of them will prevent Covid,” Schaffner said.

The bulletin urges all Floridians, including older residents, to avoid mRNA vaccines and find alternatives. But it comes off as “not in good faith” because it doesn’t specifically mention the only non-mRNA vaccine available, from Novavax, Dean said.

Florida statement aligns with Project 2025

Several critics of Ladapo’s bulletin said it read like a tryout for a job in a Trump administration advised by longtime anti-vaccine activist Robert F. Kennedy Jr., who has said Trump wants him to help vet senior health officials. Trump has said children receive too many vaccines and suggested that vaccines cause autism, a myth debunked by years of scientific research.

Ironically, although his administration oversaw the triumphantly rapid creation of the first Covid vaccines, Trump declined to receive his shots in public, as presidents have done during past epidemics.

Ladapo’s vaccine statement “aligns with Project 2025,” Offit said, referring to the conservative Heritage Foundation policy blueprint. While the plan’s authors include officials from Trump’s first term, he has said it doesn’t reflect his views.

The document calls the CDC “perhaps the most incompetent and arrogant agency in the federal government.”

Organized resistance to vaccines has existed as long as vaccination itself. Within six months of the release of the mRNA vaccines in December 2020, about 70% of American adults were vaccinated. Those who refused put themselves at greater risk of hospitalization or death if they contracted Covid, studies have shown.

Cheryl Holder, an internist who practices in Miami, said Ladapo’s statements had dampened interest in vaccination overall. People who are blasé about Covid “also don’t want to take the tetanus vaccine, and they don’t want to take the pneumococcal vaccine, or the flu vaccine,” she said.

“We’re in the disinformation age,” Offit said. “It’s certainly a lucrative business, more lucrative than the information business. But what really bothers me is when you have people who are credentialed stand up and say these ridiculous things.”

Ladapo, he noted, has medical and doctoral degrees from Harvard.

Arthur Allen, Daniel Chang and Sam Whitehead are reporters with KFF Health News, Healthbeat’s national reporting partner.

Don’t expect a new Covid policy for NYC schools, even as the virus surges

2024-09-04T15:44:42+00:00

This story was originally published by Chalkbeat. Sign up for Chalkbeat New York’s free daily newsletter to keep up with the city’s public schools.

More than 900,000 students will return to New York City schools on Thursday, after a summer that saw Covid cases surge across the nation and the five boroughs.

But don’t expect any changes to Covid guidance for the start of the 2024-25 school year.

Students will not be mandated to quarantine at home upon testing positive for the virus, under a policy adopted by city agencies in the spring that eliminated a prior five-day isolation requirement. Instead, officials ask individuals to remain at home until their symptoms improve as per the latest guidance from the U.S. Centers for Disease Control and Prevention.

“There is no real new guidance, because this is going to be our new normal,” said Anne Williams-Isom, the city’s deputy mayor for Health and Human Services, during a Tuesday press conference.

She urged New Yorkers to get their updated Covid vaccine and stay home if feeling ill.

“If you’re not feeling well, if you have sniffles, you should stay at home so we’re not spreading it,” she said. “We just have to make sure that we’re taking those precautions, and it’s the same thing for kids as they’re going back to school.”

New Covid vaccines are coming to New York; will they be accessible?

It may be difficult to track the city’s COVID rates as fewer people test for the virus. (The federal government discontinued its free at-home test program in March but plans to bring it back at the “end of September,” according to the CDC’s website.) A “very high” level of the virus was still being detected in New York state’s wastewater as of late August, according to CDC data.

Since March 1, the CDC has instructed people to stay home until their symptoms improve and they remain fever-free for at least 24 hours without using fever-reducing medication. The federal agency still advises people to take precautions over the following five days, including wearing a mask, social distancing, and testing. It’s part of a shift in health policy toward treating Covid like other common illnesses, including RSV and the flu.

Under current New York City Education Department policy, those who are experiencing Covid symptoms should isolate themselves from others and get tested. Like the CDC, the city advises students and staff to remain at home until symptoms have improved and they’re fever-free for 24 hours without medication.

The department also urges students and staff to wear a mask and take other precautions for five days after returning to school.

Those who test positive for Covid but do not exhibit symptoms do not need to stay home from school, according to the city’s policies. But upon returning to school, the city instructs individuals to take precautions to avoid getting others sick, such as wearing a mask and practicing good hygiene by covering coughs and sneezes, washing hands often, and using hand sanitizer.

The city’s Education Department did not immediately respond to a request for comment.

Julian Shen-Berro is a reporter covering New York City for Chalkbeat. Contact him at jshen-berro@chalkbeat.org.

Pediatricians scale back on Covid shot orders as families’ interest in vaccine wanes

2024-09-04T15:16:10+00:00

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When pediatrician Eric Ball opened a refrigerator full of childhood vaccines, all the expected shots were there — DTaP, polio, pneumococcal vaccine — except one.

“This is where we usually store our Covid vaccines, but we don’t have any right now because they all expired at the end of last year and we had to dispose of them,” said Ball, who is part of a pediatric practice in Orange County, California.

“We thought demand would be way higher than it was.”

Pediatricians across the country are pre-ordering the updated and reformulated Covid-19 vaccine for the fall and winter respiratory virus season, but some doctors said they’re struggling to predict whether parents will be interested. Providers like Ball don’t want to waste money ordering doses that won’t be used, but they need enough on hand to vaccinate vulnerable children.

The Centers for Disease Control and Prevention recommends that anyone 6 months or older get the updated Covid vaccination, but in the 2023-24 vaccination season only about 15% of eligible children in the United States got a shot.

A refrigerator contains tens of thousands of dollars’ worth of childhood vaccines. (Jackie Fortiér/KFF Health News)

Ball said it was difficult to let vaccines go to waste last year. It was the first time the federal government was no longer picking up the tab for the shots, and providers had to pay upfront for the vaccines. Parents would often skip the Covid shot, which can have a very short shelf life compared with other vaccines.

“Watching it sitting on our shelves expiring every 30 days, that’s like throwing away $150 repeatedly every day, multiple times a month,” Ball said.

This year, Ball slashed his fall vaccine order to the bare minimum to avoid another costly mistake.

“We took the number of flu vaccines that we order, and then we ordered 5% of that in Covid vaccines,” Ball said. “It’s a guess.”

That small vaccine order cost more than $63,000, he said.

Pharmacists, pharmacy interns, and techs are allowed to give Covid vaccines only to children age 3 and up, meaning babies and toddlers would need to visit a doctor’s office for inoculation.

It’s difficult to predict how parents will feel about the shots this fall, said Chicago pediatrician Scott Goldstein. Unlike other vaccinations, Covid shots aren’t required for kids to attend school, and parental interest seems to wane with each new formulation, he said. For a physician-owned practice such as Goldstein’s, the upfront cost of the vaccine can be a gamble.

“The cost of vaccines, that’s far and away our biggest expense. But it’s also the most important thing we do, you could argue, is vaccinating kids,” Goldstein said.

Insurance doesn’t necessarily cover vaccine storage accidents, which can put the practice at risk of financial ruin.

“We’ve had things happen like a refrigerator gets unplugged. And then we’re all of a sudden out $80,000 overnight,” Goldstein said.

South Carolina pediatrician Deborah Greenhouse said she would order more Covid vaccines for older children if the pharmaceutical companies that she buys from had a more forgiving return policy.

Murals adorn the walls of the waiting room at Eric Ball’s pediatrics practice in Orange County, California. (Jackie Fortiér/KFF Health News)

“Pfizer is creating that situation. If you’re only going to let us return 30%, we’re not going to buy much,” she said. “We can’t.”

Greenhouse owns her practice, so the remaining 70% of leftover shots would come out of her pocket.

Vaccine maker Pfizer will take back all unused Covid shots for young children, but only 30% of doses for people 12 and older.

Pfizer said in an Aug. 20 emailed statement, “The return policy was instituted as we recognize both the importance and the complexity of pediatric vaccination and wanted to ensure that pediatric offices did not have hurdles to providing vaccine to their young patients.”

Pfizer’s return policy is similar to policies from other drugmakers for pediatric flu vaccines, also recommended during the fall season. Physicians who are worried about unwanted Covid vaccines expiring on the shelves said flu shots cost them about $20 per dose, while Covid shots cost around $150 per dose.

“We run on a very thin margin. If we get stuck holding a ton of vaccine that we cannot return, we can’t absorb that kind of cost,” Greenhouse said.

Vaccine maker Moderna will accept Covid vaccine returns, but the amount depends on the individual contract with a provider. Novavax will accept the return of only unopened vaccines and doesn’t specify the amount they’ll accept.

Greenhouse wants to vaccinate as many children as possible but said she can’t afford to stock shots with a short shelf life. Once she runs out of the doses she’s ordered, Greenhouse said, she plans to tell families to go to a pharmacy to get older children vaccinated. If pediatricians around the country are making the same calculations, doses for very small children could be harder to find at doctors’ offices.

“Frankly, it’s not an ideal situation, but it’s what we have to do to stay in business,” she said.

Ball, the California pediatrician, worries that parents’ limited interest has caused pediatricians to minimize their vaccine orders, in turn making the newest Covid shots difficult to find once they become available.

“I think there’s just a misperception that it’s less of a big deal to get Covid, but I’m still sending babies to the hospital with Covid,” Ball said. “We’re still seeing kids with long Covid. This is with us forever.”

Jackie Fortier is a reporter for KFF Health News, Healthbeat’s national reporting partner.

New Covid-19 vaccines coming to New York, but getting shots may be a challenge for uninsured

2024-08-26T09:00:00+00:00

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Updated Covid-19 vaccines are expected to roll out as soon as this week in New York, following the Food and Drug Administration’s approval Thursday of the new shots. But accessing the vaccines may be challenging for some New Yorkers.

The new vaccines arrive at an uncertain time in the pandemic. Covid-19 infections spiked in New York City this summer. Once widely distributed for free by the federal government, Covid-19 vaccines are now sold commercially. And a program from the Centers for Disease Control and Prevention that covered the cost of Covid-19 shots for uninsured and underinsured Americans is ending prematurely — this month.

“As programs like this end, we’re going to see less availability of vaccines, we’re going to see more people have to pay out of pocket for vaccines,” said Dr. David Scales, an assistant professor of medicine at Weill Cornell Medical College. “We’re going to see the convenience of vaccination go down, and that means vaccination rates are going to go down. It’s a shame.”

Nationwide vaccination rates were low for last year’s updated vaccine. In New York, 23% of adult residents received the 2023-24 Covid-19 vaccine, according to CDC estimates.

The new shots will cost around $201.99 for uninsured patients paying out of pocket at CVS, spokesperson Amy Thibault told Healthbeat.

They will still be free for Marketplace and Medicare enrollees and for uninsured, underinsured and Medicaid-eligible kids under the Vaccines for Children program. CVS said the shots should be free under most insurance plans at in-network pharmacies.

To obtain the updated shot, the New York City Department of Health and Mental Hygiene recommends that New Yorkers reach out to their health care providers or use the city’s vaccine finder.

“Updated vaccines are another opportunity to protect against the latest variant,” Health Department spokesperson Patrick Gallahue said in a statement. “The COVID-19 vaccines are now distributed through the commercial market and manufacturers will work to fulfill orders placed by pharmacies and other providers.”

Will you get the new Covid shots? Tell us your thoughts.

Federal funding for Covid-19 vaccinations has long run dry. When Covid-19 vaccines hit the commercial market last year, the CDC’s Bridge Access Program offered a temporary solution for uninsured and underinsured adults, providing roughly 1.5 million free Covid-19 vaccines. The program was expected to run through December, but is ending months early.

Some state funding will help fill gaps when the Bridge Access Program — which the state and New York City participate in — ends this month, Danielle R. De Souza, a spokesperson for the New York State Department of Health, said in a statement.

The state’s Vaccines for Adults Program has roughly $1 million allocated this budget year for Covid-19 vaccines for uninsured and underinsured adults and plans to make up to 12,500 doses of the new vaccine available, De Souza said. That’s a tiny fraction of the roughly 1 million New Yorkers who are uninsured.

However, NYC Health + Hospitals, the city’s public health system, continues to offer Covid-19 vaccines at no cost to patients, said Dr. Jonathan Jimenez, a primary care doctor and the executive director of NYC Care, a health care access program that connects uninsured New Yorkers to services within the health system.

“The way we work at all of our facilities and clinics is to offer vaccines with no out-of-pocket costs to the patient, but also other preventive services,” Jimenez said. “Luckily, the end of the program doesn’t change how we’re operating.”

It’s smaller clinics and community health centers that may bear more of the brunt of the shift to commercial Covid-19 vaccines.

Callen-Lorde Community Health Center, a federally qualified health center in New York City that provides services to primarily LGBTQ+ patients, is poised to administer the updated vaccines. The health center uses a sliding scale payment system for uninsured and underinsured patients.

Immunization clinical director Elsbet Servay hopes that grants, patient assistance programs offered by vaccine manufacturers and state support might be able to help offset the cost of the new vaccines.

“Coverage has been an issue since commercialization rolled out last year and we unfortunately expect some challenges in maintaining access for un- and under-insured individuals,” Servay told Healthbeat in an email.

It’s difficult to know how many city residents are currently vaccinated against Covid-19. The Health Department stopped reporting new Covid-19 vaccination data last September. By that point, 91% of city residents had received at least one dose of a Covid-19 vaccine and 81% had completed the primary series, but only 16% had received the bivalent dose, introduced in 2022.

Jimenez urged New Yorkers to get flu and Covid-19 shots at the same time, particularly in anticipation of flu season this winter — and a likely rise in Covid-19 infections during that period.

“When you go into your fall visit, and you would typically get your flu shot, go ahead and ask for your Covid-19 shot as well,” he said.

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Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org. Healthbeat Atlanta reporter Rebecca Grapevine contributed to this report.

What to do if you test positive for Covid-19: Test and isolate

New Covid vaccines: Should you get now or wait for winter wave?

New Covid shots may be hard to come by for uninsured Georgians

2024-08-26T09:00:00+00:00

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Updated Covid vaccines, slated to hit shelves this week, could come with serious sticker shock for more than a million Georgians who don’t have health insurance.

The shots will cost around $201.99 for uninsured patients paying out of pocket at CVS, spokesperson Amy Thibault said.

The newly approved Covid vaccines should provide “great coverage” for current versions of the virus and will be effective in preventing serious hospitalizations and death, Emory University epidemiologist Jodie Guest said.

But doctors and public health practitioners are concerned about vaccine access and equity as Georgia is seeing “very high” rates of Covid and the federal Bridge Access Program, which provided vaccines to uninsured adults, ends this month.

With about 1 million uninsured adults under age 65, Georgia has one of the highest uninsured rates in the country. It also has a low vaccination rate, with only around 17% of adults having received last year’s Covid vaccine as of May this year, according to U.S. Centers for Disease Control and Prevention data.

“This season is going to be a very difficult Covid and flu season,” said Dr. Cecil Bennett, a family medicine doctor and fellow at Morehouse School of Medicine.

He warned that the ending of the federal vaccine access program could contribute to lost productivity and more deaths. Covid caused 2.4% of all deaths in Georgia in the week the week leading up to Aug. 10, according to the CDC.

“This is not the time that I would say the federal government should be penny wise and pound foolish,” Bennett said.

For comparison, New York state also has about 1 million uninsured people. But NYC Health + Hospitals, the city’s public health system, continues to offer Covid-19 vaccines at no cost to patients, said Dr. Jonathan Jimenez, a primary care doctor and executive director of NYC Care, which connects uninsured New Yorkers to services.

Nationwide, the vaccines will still be free for Marketplace and Medicare enrollees. Uninsured, underinsured and Medicaid-eligible kids should be able to get the vaccines for free under Vaccines for Children. And CVS said the shots should be free under most insurance plans at in-network pharmacies.

The CDC last week announced a tranche of $62 million that states across the country can use to buy vaccines for uninsured people as the Bridge Access Program ends.

Georgia already planned to purchase 4,600 updated Covid shots for underinsured and uninsured people, and last week applied to the CDC for funds to cover an additional 33,540 shots, Department of Public Health spokesperson Nancy Nydam said.

That would bring the state’s supply to 38,140 vaccines for uninsured and underinsured adults. Those would be distributed to county health departments and around 30 external providers through the state’s Adult Vaccine Program.

While that’s “still not enough to cover every uninsured and underinsured adult in Georgia,” Nydam said, “This still puts us in a better position to serve adults who seek service through our [Adult Vaccine Program] provider sites.”

Campaign to take on vaccine hesitancy

Beyond that program, the state health department plans to roll out its annual multi-platform campaign in the fall encouraging people to be vaccinated for COVID and flu, Nydam said. The campaign will include billboards, radio/TV, digital, web and social media.

Vaccine events are typically held at the district level. Events and clinic hours and appointments are listed on district websites and social media. DPH also works with the Community Organized Relief Effort to provide vaccines through local organizations and faith-based groups.

Will you get the new Covid shots? Tell us your thoughts.

Dr. Harry Heiman, a clinical professor at Georgia State University’s School of Public Health, said he would love to see how the state might work to boost federal efforts and fill any gaps.

“Those are the kinds of state level plans that even in the absence of guidance from the federal government you would hope are being put into place,” Heiman said.

For many local Georgia health departments, uptake remains a challenge.

For example, in DeKalb County, with a population of about 760,000, fewer than 200 people got Covid vaccines from the board of health between January and April, spokesperson Eric Nickens said.

In neighboring Fulton County, with a population just over 1 million, spokesperson Darryl Carver said the board of health has “actively continued promoting” vaccines as part of its #VaccineWorks campaign. But the agency has administered just 375 Covid vaccines so far this year.

Charity clinics lack funds for Covid shots

The end of the free federal vaccine program also means that nonprofit and charity clinics must now cobble together funds to provide vaccines, and some clinics are not able to provide them at all.

Georgia’s 35 federally funded nonprofit health centers will be able to continue providing vaccines, said Dr. Theresa Jacobs, medical director for the Georgia Primary Care Association, which represents the clinics.

The clinics serve around 650,000 patients a year, about a third of whom are uninsured. The clinics will rely on partnerships with public health departments and other groups as well as “small grants” to fill in the gaps for uninsured adults.

“They’re not going to miss a beat,” Jacobs said. “They’re going to still be able to offer them either free or at a very low discounted price for those that are uninsured.”

But some charity clinics are not able to offer Covid vaccines. For example, Clarkston Community Health Center, a free health clinic that serves uninsured people, including many refugees, is no longer able to provide any vaccines, said executive director Jeremy Cole, because of “funding shortages.”

“Funding for a charitable clinic is always a challenge, and we have not had grants or funding in the past few years that would allow us to relaunch a vaccine program,” Cole said. “But we are working on it.”

Many large metro Atlanta health systems like Wellstar, Emory and Children’s Healthcare of Atlanta do not offer the vaccine onsite, instead referring patients to other providers. Grady Health System provides Covid vaccines at its primary care clinic and neighborhood health centers, spokesperson Danielle Hackett said.

Representatives another large health system, Piedmont Healthcare, did not respond to questions about whether they provide the vaccine.

Uninsured left vulnerable to Covid risks

Some vaccine advocates say that given Georgia’s low uptake rates, health care providers and policymakers should focus on removing as many barriers to access as possible.

“The way that I think about this is that the second someone decides they’re ready to get a vaccine, there should be no additional barriers to that,” said Marquisha Johns, associate director for public health policy at the Center for American Progress, a left-leaning think tank.

“We should make it as easy as possible for them to take the very next step into actually getting the shot in their arm, because there are already so many barriers to getting the person to the first step,” Johns said.

The end of the program puts a burden on uninsured Georgians who need key preventive care like the Covid-19 vaccines, said Laura Colbert, executive director of Georgians for a Healthy Future, a health advocacy group in Atlanta.

Uninsured Georgians may have to cover their own vaccine costs, Colbert said, which “unfairly leaves them vulnerable to illnesses and health conditions that other Georgians are better protected from.”

Johns pointed out that Georgia policymakers could find a way to increase funding for vaccines in the state, especially since the state has a large uninsured population.

“If they wanted to make that a priority, they definitely, absolutely could say, like, ‘Us as the state of Georgia will guarantee that all of our uninsured people will have access to these. Every uninsured person will have access to these five vaccines,’” Johns said.

“The vaccine should be available for everyone,” said Christopher Pride, the director of clinical care at Positive Impact Health Centers, which provides comprehensive sexual health care in Atlanta. “Cost can make people, you know, determine whether they’re going to put food on their table or get a vaccine.”

Pride said he ensures the Positive Impact clinics always have vaccines available to patients. With the ending of the Bridge Access Program, the clinic has turned to other funding streams to ensure it can continue to offer the shots at low or no cost to patients.

“People who are hesitant are more likely to accept the vaccine from someone they trust, and that’s why the doctor’s office is key,” Pride said. “We will ensure that we always have it, regardless if you’re insured or uninsured.”

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Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org. New York Healthbeat reporter Eliza Fawcett contributed to this report.

The new Covid vaccine is out: Why you may not want to rush to get it

What to do if you test positive for Covid-19: Test and isolate

New Covid vaccines: Should you get shot now or wait for winter wave?

2024-08-26T09:00:00+00:00

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The FDA has approved an updated Covid shot for everyone 6 months old and up, which renews a now-annual quandary for Americans: Get the shot now, with the latest Covid outbreak sweeping the country, or hold it in reserve for the winter wave?

The new vaccine should provide some protection to everyone. But many healthy people who have already been vaccinated or have immunity because they’ve been exposed to Covid enough times may want to wait a few months.

Covid has become commonplace. For some, it’s a minor illness with few symptoms. Others are laid up with fever, cough, and fatigue for days or weeks. A much smaller group — mostly older or chronically ill people — suffer hospitalization or death.

It’s important for those in high-risk groups to get vaccinated, but vaccine protection wanes after a few months. Those who run to get the new vaccine may be more likely to fall ill this winter when the next wave hits, said William Schaffner, an infectious disease professor at Vanderbilt University School of Medicine and a spokesperson for the National Foundation for Infectious Diseases.

On the other hand, by late fall the major variants may have changed, rendering the vaccine less effective, Peter Marks, the FDA’s top vaccine official, said at a briefing Friday. He urged everyone eligible to get immunized, noting that the risk of long Covid is greater in the un- and undervaccinated.

Of course, if last year’s Covid vaccine rollout is any guide, few Americans will heed his advice, even though this summer’s surge has been unusually intense, with levels of the Covid virus in wastewater suggesting infections are as widespread as they were in the winter.

Covid hitting West and South hardest

The Centers for Disease Control and Prevention now looks to wastewater as fewer people are reporting test results to health authorities. The wastewater data shows the epidemic is worst in Western and Southern states. In New York, for example, levels are considered “high” — compared with “very high” in Georgia.

Hospitalizations and deaths due to Covid have trended up, too. But unlike infections, these rates are nowhere near those seen in winter surges, or in summers past. More than 2,000 people died of Covid in July — a high number but a small fraction of the at least 25,700 Covid deaths in July 2020.

Partial immunity built up through vaccines and prior infections deserves credit for this relief. A new study suggests that current variants may be less virulent — in the study, one of the recent variants did not kill mice exposed to it, unlike most earlier Covid variants.

Public health officials note that even with more cases this summer, people seem to be managing their sickness at home.

“We did see a little rise in the number of cases, but it didn’t have a significant impact in terms of hospitalizations and emergency room visits,” Manisha Juthani, public health commissioner of Connecticut, at said at a news briefing on Wednesday.

Unlike influenza or traditional cold viruses, Covid seems to thrive outside the cold months, when germy schoolkids, dry air, and indoor activities are thought to enable the spread of air- and saliva-borne viruses. No one is exactly sure why.

“Covid is still very transmissible, very new, and people congregate inside in air-conditioned rooms during the summer,” said John Moore, a virologist and professor at Cornell University’s Weill Cornell Medicine College.

Or “maybe Covid is more tolerant of humidity or other environmental conditions in the summer,” said Caitlin Rivers, an epidemiologist at Johns Hopkins University.

Covid vaccine uptake has waned

Because viruses evolve as they infect people, the CDC has recommended updated Covid vaccines each year. Last fall’s booster was designed to target the omicron variant circulating in 2023. This year, mRNA vaccines made by Moderna and Pfizer and the protein-based vaccine from Novavax — which has yet to be approved by the FDA — target a more recent omicron variant, JN.1.

The FDA determined that the mRNA vaccines strongly protected people from severe disease and death — and would do so even though earlier variants of JN.1 are now being overtaken by others.

Public interest in Covid vaccines has waned, with only 1 in 5 adults getting vaccinated since last September, compared with about 80% who got the first dose. New Yorkers have been slightly above the national vaccination rate, while in Georgia only about 17% got the latest shot.

Vaccine uptake is lower in states where the majority voted for Donald Trump in 2020 and among those who have less money and education, less health care access, or less time off from work. These groups are also more likely to be hospitalized or die of the disease, according to a 2023 study in The Lancet.

While the newly formulated vaccines are better targeted at the circulating Covid variants, uninsured and underinsured Americans may have to rush if they hope to get one for free. A CDC program that provided boosters to 1.5 million people over the last year ran out of money and is ending Aug. 31.

The agency drummed up $62 million in unspent funds to pay state and local health departments to provide the new shots to those not covered by insurance. But “that may not go very far” if the vaccine costs the agency around $86 a dose, as it did last year, said Kelly Moore, CEO of Immunize.org, which advocates for vaccination.

People who pay out-of-pocket at pharmacies face higher prices: CVS plans to sell the updated vaccine for $201.99, said Amy Thibault, a spokesperson for the company.

“Price can be a barrier, access can be a barrier” to vaccination, said David Scales, an assistant professor of medicine at Weill Cornell Medical College.

Without an access program that provides vaccines to uninsured adults, “we’ll see disparities in health outcomes and disproportionate outbreaks in the working poor, who can ill afford to take off work,” Kelly Moore said.

New York state has about $1 million to fill the gaps when the CDC’s program ends, said Danielle De Souza, a spokesperson for the New York State Department of Health. That will buy around 12,500 doses for uninsured and underinsured adults, she said. There are roughly 1 million uninsured people in the state.

What to do this fall

CDC and FDA experts last year decided to promote annual fall vaccination against Covid and influenza along with a one-time respiratory syncytial virus shot for some groups.

It would be impractical for the vaccine-makers to change the Covid vaccine’s recipe twice every year, and offering the three vaccines during one or two health care visits appears to be the best way to increase uptake of all of them, said Schaffner, who consults for the CDC’s policy-setting Advisory Committee on Immunization Practices.

At its next meeting, in October, the committee is likely to urge vulnerable people to get a second dose of the same Covid vaccine in the spring, for protection against the next summer wave, he said.

If you’re in a vulnerable population and waiting to get vaccinated until closer to the holiday season, Schaffner said, it makes sense to wear a mask and avoid big crowds, and to get a test if you think you have Covid. If positive, people in these groups should seek medical attention since the antiviral pill Paxlovid might ameliorate their symptoms and keep them out of the hospital.

As for conscientious others who feel they may be sick and don’t want to spread the Covid virus, the best advice is to get a single test and, if positive, try to isolate for a few days and then wear a mask for several days while avoiding crowded rooms. Repeat testing after a positive result is pointless, since viral particles in the nose may remain for days without signifying a risk of infecting others, Schaffner said.

The Health and Human Services Department is making four free Covid tests available to anyone who requests them starting in late September through covidtests.gov, Dawn O’Connell, assistant secretary for preparedness and response, said at Friday’s briefing.

The government is focusing its fall vaccine advocacy campaign, which it’s calling “Risk less, live more,” on older people and nursing home residents, said HHS spokesperson Jeff Nesbit.

Not everyone may really need a fall Covid booster, but “it’s not wrong to give people options,” John Moore said. “The 20-year-old athlete is less at risk than the 70-year-old overweight dude. It’s as simple as that.”

Arthur Allen is a reporter with KFF Health News, Healthbeat’s national reporting partner. Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Amy Maxmen, Healthbeat’s national reporter through KFF, contributed to this report.

New Covid vaccines coming to NY, but getting them may be challenge for uninsured

New Covid vaccines may be hard to come by for uninsured Georgians

Covid cases surge in Georgia, FDA approves new vaccines

2024-08-22T18:41:19+00:00

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As the United States heads toward a new summer record for Covid cases, rates in Georgia are “very high,” with related deaths and hospitalizations on the rise.

The surge comes as updated Covid vaccines were approved Thursday and granted emergency use authorization by the Food and Drug Administration.

The shots are expected to be available as soon as next week, said Jodie Guest, senior vice chair of the Department of Epidemiology at Emory University’s Rollins School of Public Health.

“It appears that we’re about to hit a new summer record for Covid [nationally], and so we are seeing currently the biggest summer wave since July of 2022,” Guest said.

While state-specific information about the rates of positive test results is not available, regionally, nearly 17% of tests reported in the Southeast are positive, more than three times the ideal of 5% or less, Guest said. “We want to be below 5% if we have some control over the outbreak.”

But those positivity rates don’t give the full picture, since many people are now testing for the virus at home and not reporting results, Guest said.

More reliable is wastewater surveillance data, which shows that Georgia’s Covid virus level is “very high,” with viral activity greater than 8, while less than 1.5 is considered “minimal,” according to the U.S. Centers for Disease Control and Prevention.

Georgia’s wastewater virus levels – measured against a baseline formula – were twice as high for the week of Aug. 10 as the same week last year, according to CDC data. It measured 9.18 as of Aug. 10, compared to 4.47 for the same week last year. Levels have been increasing over the summer.

A state government epidemiologist said the summer Covid bump was expected, given a seasonal increase in travel and people congregating indoors to escape the heat.

“This is a pretty typical pattern that we have been seeing each of the summers since Covid emerged,” said Dr. Cherie Drenzek of the Georgia Department of Public Health.

Death and hospitalization rates are also increasing, Drenzek said, though the increases are “not at a very high level.” Just over 2% of deaths in Georgia were caused by Covid in the week leading up to Aug. 10, according to the CDC.

What to do if you test positive for Covid

People who test positive for Covid should take a two-pronged approach to recover and avoid spreading the virus, starting with staying home while sick.

The CDC recommends resuming normal activities if symptoms are improving and you have been fever-free, without fever-reducing medications, for at least 24 hours.

After that, the CDC urges people to take preventative measures for the next five days, including physically distancing from others, masking, improving air purification, and testing when around other people indoors.

Other health experts recommend isolating until you test negative for Covid, which could be three to 15 days.

“Although many have fallen to Covid fatigue, it is important to remember to test if symptoms arise and speak with your provider about treatment options,” said Dr. Danny Branstetter, medical director of infection prevention for Wellstar Health System.

Guest said parents may need to test their children twice to accurately determine whether they have Covid.

A single at-home (antigen) test cannot rule out Covid, Guest said, but false negatives are less likely when a second test is given 48 hours later.

That’s a result of how the at-home tests work, since they’re more likely to give false negatives, and the timing of the testing, because testing early on can result in a negative even when someone is infected with Covid, Guest said.

No widespread guidelines encourage people to mask up in public places, Drenzek said, but it’s good “respiratory etiquette” for those who have symptoms.

“If you’ve been recently sick and had a positive Covid test, then you should really be masking for a period of at least five days after … your respiratory symptoms improve and you have no fever,” said Dr. Harry Heiman, a clinical professor at Georgia State University’s School of Public Health.

“That’s just really a respectful and appropriate way to behave, in terms of not giving it to other people around you,” he said.

Death rate ‘much higher than it should be’

The increase in Covid-related hospitalizations and deaths is frustrating to public health experts, who contend that severe outcomes are largely preventable through widespread Covid vaccination.

“The death rate is going up” in Georgia, Guest said. “It is lower than 2020 … but it is much higher than it should be.”

About 2.4% of all deaths in Georgia for the week leading up to Aug. 10 were caused by Covid, and that number was up over the previous week, according to CDC data.

Guest said Georgia’s Covid death rate should be close to zero, since deaths are largely preventable with vaccination. “This is a vaccine preventable death for almost every case … At a minimum, we’d want to see it under 1%.”

Vaccine uptake in Georgia has been low.

As of this spring, only about 10% or 11% of Georgians are fully boosted, Heiman said. That means about 9 in 10 Georgians “are not protected in the way they should be.”

“We continue to squander the tools that we have to prevent [serious outcomes] … I’m talking first and foremost about vaccination,” Heiman said.

He gave several reasons for the low vaccine uptake rate in Georgia, including a high rate of uninsured people — nearly 12% of the population, or about 1.2 million people, are uninsured, according to KFF’s State Health Facts — as well as “a failure of both our health care and our public health systems to do active outreach to patients and to communities” to ensure people understand the “critical importance” of vaccines.

Atlanta health systems seeing more cases

Metro Atlanta health systems said they are seeing more Covid cases among patients.

“The total number of inpatients with Covid-19 has increased, but the severity of cases has not worsened,” said Danielle Hackett, a spokesperson for Grady Health System. Many patients admitted to the hospital for non-Covid reasons are found to have Covid.

The number of children with Covid at a large local pediatric health system is also increasing.

“Children’s Healthcare of Atlanta has seen an increase in the number of children with Covid-19, especially over the past three weeks. Approximately one-quarter of our respiratory virus tests across our system have detected [Covid],” said Dr. Andi Shane, division chief of pediatric infectious diseases at Children’s Healthcare of Atlanta.

“Most of the children who test positive have mild illness, but we have cared for some children who have other medical conditions who have had more severe illness,” Shane said.

New vaccines on the way

The rising Covid rates come as new vaccinations are expected to be available as soon as next week.

“It will have great coverage for the vaccines or for the variants that we currently see circulating,” Guest said.

Epidemiologists and doctors recommend the new vaccines for everyone 6 months and older.

“Vaccination of children not only helps to protect them but also indirectly protects other people, including young babies under 6 months of age, who cannot be vaccinated, and grandparents, whose immune systems may not work as well,” Shane said.

People who have already been vaccinated need only wait four months between the last vaccine and this new one, Guest said. “Many people got theirs last fall, so most will be eligible right away.”

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

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What to do if you test positive for Covid-19

2024-08-09T12:31:33+00:00

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Covid-19 is on the rise in New York and across much of the United States this summer.

In recent years, the Centers for Disease Control and Prevention has significantly shifted its guidance for people who test positive for Covid-19. In 2021, the CDC shortened its recommended isolation period for people with Covid-19 to five days, down from 10 days, in most cases. The agency’s guidance became even less restrictive this year, though some public health experts urge stricter measures to stop the spread of disease.

Here’s what you need to know if you test positive.

How long should you isolate?

The CDC recommends a two-part approach if you test positive.

First, you should stay home when sick. You can resume normal activities if your symptoms are improving overall and you have not had a fever for 24 hours (without taking fever-reducing medications).

Second, when you end isolation, you should take preventative measures for the next five days, including physical distancing, air purification, masking, and testing when around other people indoors.

Some public health experts recommend taking stricter measures to ensure that you are not infecting others. Katelyn Jetelina, an epidemiologist, Healthbeat partner, and author of the “Your Local Epidemiologist” newsletter, says the best approach is to isolate until your at-home Covid-19 test is negative, which could range from three to 15 days. And if you must leave isolation beforehand, she urges wearing an N95 mask.

Dr. Bruce Y. Lee, a professor at the CUNY Graduate School of Public Health & Health Policy, recommends erring on the side of caution, particularly to protect vulnerable people around you.

“The bottom line is, a lot of the original aspects of the virus still hold,” he said. “There are people that remain contagious after five days, or after two days, or three days, and that’s what should guide isolation. If you’re still contagious, you can still pass it on to someone else.”

How do you get tested?

Four years into the pandemic, much of the Covid-19 testing infrastructure in New York and across the country has faded away.

In New York, residents can find rapid and PCR testing at NYC Health + Hospitals facilities and community care clinics.

Pharmacies sell rapid test kits, typically for about $12 per test. But private insurers are no longer required to cover the cost of tests.

The federal government has resumed its Covid-19 test kit program, which mails free tests to Americans.

Should you take Paxlovid?

The antiviral medication Paxlovid is available for anyone ages 12 and older who is at high risk of developing severe Covid-19 — and particularly for people who are at least 65 years old.

Anyone who tests positive for Covid-19 should see if they are eligible for Paxlovid, said Dr. Sean T. Liu, the medical director of Mount Sinai’s COVID Clinical Trials Unit and an associate professor of medicine at the Icahn School of Medicine at Mount Sinai. Paxlovid is effective when taken within the first five days of developing symptoms.

“The faster you get the Paxlovid, the more effective it is,” Liu said. “It’s a timing thing.”

New Yorkers can call the city’s Covid-19 hotline (212-COVID19) to connect with a NYC Health + Hospitals clinician who can prescribe antiviral medication, according to Patrick Gallahue, a spokesperson for the Health Department.

Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org.

WHO overturns dogma on airborne disease spread. The CDC might not act on it.

2024-07-30T16:36:41+00:00

The World Health Organization has issued a report that transforms how the world understands respiratory infections like Covid-19, influenza, and measles.

Motivated by grave missteps in the pandemic, the WHO convened about 50 experts in virology, epidemiology, aerosol science, and bioengineering, among other specialties, who spent two years poring through the evidence on how airborne viruses and bacteria spread.

However, the WHO report stops short of prescribing actions that governments, hospitals, and the public should take in response. It remains to be seen how the Centers for Disease Control and Prevention will act on this information in its own guidance for infection control in health care settings.

The WHO concluded that airborne transmission occurs as sick people exhale pathogens that remain suspended in the air, contained in tiny particles of saliva and mucus that are inhaled by others.

While it may seem obvious, and some researchers have pushed for this acknowledgment for more than a decade, an alternative dogma persisted — which kept health authorities from saying that Covid was airborne for many months into the pandemic.

Specifically, they relied on a traditional notion that respiratory viruses spread mainly through droplets spewed out of an infected person’s nose or mouth. These droplets infect others by landing directly in their mouth, nose, or eyes — or they get carried into these orifices on droplet-contaminated fingers. Although these routes of transmission still happen, particularly among young children, experts have concluded that many respiratory infections spread as people simply breathe in virus-laden air.

“This is a complete U-turn,” said Julian Tang, a clinical virologist at the University of Leicester in the United Kingdom, who advised the WHO on the report. He also helped the agency create an online tool to assess the risk of airborne transmission indoors.

Emphasis on improving ventilation

Peg Seminario, an occupational health and safety specialist in Bethesda, Maryland, welcomed the shift after years of resistance from health authorities. “The dogma that droplets are a major mode of transmission is the ‘flat Earth’ position now,” she said. “Hurray! We are finally recognizing that the world is round.”

The change puts fresh emphasis on the need to improve ventilation indoors and stockpile quality face masks before the next airborne disease explodes. Far from a remote possibility, measles is on the rise this year and the H5N1 bird flu is spreading among cattle in several states. Scientists worry that as the H5N1 virus spends more time in mammals, it could evolve to more easily infect people and spread among them through the air.

Traditional beliefs on droplet transmission help explain why the WHO and the CDC focused so acutely on hand-washing and surface-cleaning at the beginning of the pandemic. Such advice overwhelmed recommendations for N95 masks that filter out most virus-laden particles suspended in the air. Employers denied many health care workers access to N95s, insisting that only those routinely working within feet of Covid patients needed them. More than 3,600 health care workers died in the first year of the pandemic, many due to a lack of protection.

However, a committee advising the CDC appears poised to brush aside the updated science when it comes to its pending guidance on health care facilities.

Lisa Brosseau, an aerosol expert and a consultant at the Center for Infectious Disease Research and Policy in Minnesota, warns of a repeat of 2020 if that happens.

“The rubber hits the road when you make decisions on how to protect people,” Brosseau said. “Aerosol scientists may see this report as a big win because they think everything will now follow from the science. But that’s not how this works and there are still major barriers.”

Money is one. If a respiratory disease spreads through inhalation, it means that people can lower their risk of infection indoors through sometimes costly methods to clean the air, such as mechanical ventilation and using air purifiers, and wearing an N95 mask. The CDC has so far been reluctant to press for such measures, as it updates foundational guidelines on curbing airborne infections in hospitals, nursing homes, prisons, and other facilities that provide health care. This year, a committee advising the CDC released a draft guidance that differs significantly from the WHO report.

Whereas the WHO report doesn’t characterize airborne viruses and bacteria as traveling short distances or long, the CDC draft maintains those traditional categories. It prescribes looser-fitting surgical masks rather than N95s for pathogens that “spread predominantly over short distances.” Surgical masks block far fewer airborne virus particles than N95s, which cost roughly 10 times as much.

Viruses travel like smoke

Researchers and health care workers have been outraged about the committee’s draft, filing letters and petitions to the CDC. They say it gets the science wrong and endangers health. “A separation between short- and long-range distance is totally artificial,” Tang said.

Airborne viruses travel much like cigarette smoke, he explained. The scent will be strongest beside a smoker, but those farther away will inhale more and more smoke if they remain in the room, especially when there’s no ventilation.

Likewise, people open windows when they burn toast so that smoke dissipates before filling the kitchen and setting off an alarm. “You think viruses stop after 3 feet and drop to the ground?” Tang said of the classical notion of distance. “That is absurd.”

The CDC’s advisory committee is comprised primarily of infection control researchers at large hospital systems, while the WHO consulted a diverse group of scientists looking at many different types of studies. For example, one analysis examined the puff clouds expelled by singers, and musicians playing clarinets, French horns, saxophones, and trumpets. Another reviewed 16 investigations into covid outbreaks at restaurants, a gym, a food processing factory, and other venues, finding that insufficient ventilation probably made them worse than they would otherwise be.

In response to the outcry, the CDC returned the draft to its committee for review, asking it to reconsider its advice. Meetings from an expanded working group have since been held privately. But the National Nurses United union obtained notes of the conversations through a public records request to the agency. The records suggest a push for more lax protection. “It may be difficult as far as compliance is concerned to not have surgical masks as an option,” said one unidentified member, according to notes from the committee’s March 14 discussion. Another warned that “supply and compliance would be difficult.”

The nurses’ union, far from echoing such concerns, wrote on its website, “The Work Group has prioritized employer costs and profits (often under the umbrella of ‘feasibility’ and ‘flexibility’) over robust protections.” Jane Thomason, the union’s lead industrial hygienist, said the meeting records suggest the CDC group is working backward, molding its definitions of airborne transmission to fit the outcome it prefers.

Tang expects resistance to the WHO report. “Infection control people who have built their careers on this will object,” he said. “It takes a long time to change people’s way of thinking.”

The CDC declined to comment on how the WHO’s shift might influence its final policies on infection control in health facilities, which might not be completed this year. Creating policies to protect people from inhaling airborne viruses is complicated by the number of factors that influence how they spread indoors, such as ventilation, temperature, and the size of the space.

Adding to the complexity, policymakers must weigh the toll of various ailments, ranging from Covid to colds to tuberculosis, against the burden of protection. And tolls often depend on context, such as whether an outbreak happens in a school or a cancer ward.

“What is the level of mortality that people will accept without precautions?” Tang said. “That’s another question.”

This story originally published on May 1, 2024 at KFF Health News, Healthbeat’s national reporting partner.

Summer Covid-19 cases rise in NYC as testing, vaccines wane

2024-07-29T20:48:00+00:00

Public health, explained: Sign up to receive Healthbeat’s free New York City newsletter here.

Covid-19 cases in New York City have trended upward this summer, as vaccine uptake remains low and testing and surveillance systems have been significantly scaled back.

Nationwide, Covid-19 test positivity rates have been rising since the spring, according to data from the Centers for Disease Control and Prevention. “FLiRT” variants — descendants of the JN.1 variant, which was dominant earlier this year — account for the vast majority of current Covid-19 cases across the country, according to CDC data.

The New York City Department of Health and Mental Hygiene reported an average of 888 Covid-19 cases per day in the week ending July 25. That’s a big jump from the weekly average of about 200 Covid-19 cases that the city recorded for much of the spring, though it’s still far lower than New York’s biggest Covid-19 surges. For the week ending July 25, the city reported an average of 36 hospitalizations per day and no deaths.

The NYS Wastewater Surveillance Network, which publishes wastewater data from participating counties statewide, showed “high” levels of Covid-19 detection in the sewage of the vast majority of New York City communities as of mid-July.

“We’re definitely seeing an uptick in the hospital at Mount Sinai,” Dr. Sean T. Liu, medical director of Mount Sinai’s COVID Clinical Trials Unit and an associate professor of medicine at the Icahn School of Medicine at Mount Sinai, said. “Personally, I know people who are getting it as well, so I do hear it in the community, and I see it in the hospital.”

What to do if you test positive

The Covid-19 cases Liu sees often include symptoms like a fever, a runny nose and a cough. Anyone who tests positive for Covid-19 should try to stay home from work, isolate from other people and mask, he said. The antiviral medication Paxlovid can also help, he said, noting that treatment is more effective the sooner it is started.

“Be mindful of others by taking care of yourself,” Liu said. “If you’re sick, try to isolate and try not to spread the virus, because it’s a very transmissible virus. Talk to your doctor — you might get Paxlovid. And get better soon.”

The CDC currently recommends resuming normal activities when, for at least 24 hours, you have not had a fever and your symptoms are improving overall. The CDC also encourages taking precautions for the next five days, including masking, physical distancing, air purification and testing.

“Cases are rising right now but we have the tools and experience to protect ourselves as well as one another,” Patrick Gallahue, a spokesperson for the Health Department, said in a statement.

He noted that New Yorkers can call the city’s Covid-19 hotline (212-COVID19) to connect with a NYC Health + Hospitals clinician who can prescribe antiviral medication.

Data has limitations

Even as Covid-19 continues to spread nationally and in New York, surveillance systems for tracking the virus have significantly diminished, said Dr. Bruce Y. Lee, a professor at the CUNY Graduate School of Public Health & Health Policy and executive director of Public Health Informatics, Computational, and Operations Research.

“Previously, we were relying on testing, and of course a lot of testing is now done at home, with these kits,” Lee said. “When people are positive, they don’t really report it to anyone, most of the time.”

Much of the city’s Covid-19 testing infrastructure has also faded, making free tests harder to come by. New York offers rapid and PCR testing at NYC Health + Hospitals facilities and community care clinics. But the Health Department’s network of free express testing sites, which offer fast PCR results, has almost entirely disappeared.

Large-scale programs to distribute free rapid tests have also dwindled. The federal government’s free Covid-19 test kit program ended in March. Rapid test kits are available for purchase at pharmacies, but private insurers are no longer required to cover their cost.

“The strategies that have beaten back COVID time and again continue to be available to us, though now as part of our routine health care system,” Gallahue said in a statement. “At-home tests are sold at pharmacies and online, and testing is offered by many pharmacies and providers.”

Covid-19 test-tracking operations have scaled back, too. The CDC halted its community-level tracking of Covid-19 when the public health emergency expired last year, and turned its focus to wastewater surveillance.

Yet wastewater data has its own limitations, Lee said, noting that it is a “very blunt and broad measurement” of the prevalence of Covid-19 in a community. Meanwhile, data on Covid-19 hospitalizations, emergency room visits and deaths, while precise, are all “after the fact,” he said.

Virus protection reduced

More than four years into the Covid-19 pandemic, vaccination rates are low and many mitigation measures have fallen by the wayside, enabling the virus to continue to spread.

“You’re seeing a lot fewer people wearing masks, you’re not seeing as much attention to air quality, like filtration and ventilation, and social distancing,” Lee said. “It’s largely nonexistent.”

Vaccination remains a key weapon in the fight against Covid-19, but nationwide uptake of last year’s booster was low. As of May, 22.5% of adults in the U.S. reported having received an updated 2023-24 Covid-19 vaccine, according to the CDC.

Lee noted that the protection the Covid-19 vaccine offers generally wanes after four to six months, meaning that people who were vaccinated last fall became vulnerable to the virus again this past spring.

Updated Covid-19 vaccines are expected to become available this fall, and the CDC recommends that everyone older than 6 months receives the shot.

The NYC Health Department stopped reporting new Covid-19 vaccination data last September. By that point, more than 90% of city residents had received at least one Covid-19 vaccine dose, but only 16% had received a bivalent vaccine dose, which became available in late 2022 to fight new variants.

Liu, who runs studies at Mount Sinai about long Covid — a range of often debilitating symptoms that can occur after a Covid-19 infection — noted that recent data indicate that vaccination can lower the risk of long Covid.

“People’s lives are really devastated by long Covid,” he said. “Long Covid is a real, terrible illness that if you can avoid at all costs, please do.”

Meet Healthbeat’s NYC reporter: Covid was baptism by fire

2024-07-29T20:23:47+00:00

Public health, explained: Sign up to receive Healthbeat’s free New York City newsletter here.

In early 2020, six months into my first full-time reporting job, Covid-19 tore across the United States. A journalist for the Hartford Courant in Connecticut, I was reassigned from state politics to public health. My world suddenly shifted from voters to ventilators.

Following that baptism-by-fire moment, I began to settle into the work of covering the pandemic as a local reporter. Over my years on the beat, I got to know doctors and researchers throughout the state as they struggled to understand a virus that changed at warp speed — and claimed patient after patient. As vaccines rolled out, I followed a fleet of nurses who went to the bedsides and kitchen tables of homebound residents, putting shots into arms. I memorialized residents who died, and wrote about the struggles of those who survived with lives irrevocably altered by long Covid.

I also covered the politicization of Covid-19 mitigation measures and the spread of misinformation. I reported on the successes of the state’s public health response, and the times at which it faltered and failed. And as a statewide crisis emerged in children’s mental health, I chronicled families’ desperate attempts to secure psychiatric care for their kids, only to encounter long waitlists and overwhelmed ERs. Above all, I tried to capture an unprecedented era — and help readers navigate it.

Four years into the pandemic, I’ve found my way back to my hometown to cover public health as Healthbeat’s first New York City reporter. Covid-19 remains with us, and much of what I learned as a reporter during those early years has stayed with me, too.

At Healthbeat, I aim to center the experiences of frontline health workers and those directly affected by public health issues. I intend to use all the tools at my disposal — interviews, research, data and public records — to help readers understand key topics in public health. And I hope to deliver vital accountability reporting on public health systems, which don’t have enough watchdogs — even in New York.

Before landing at Healthbeat, I covered national news as a fellow for The New York Times and worked as a freelancer in New York, investigating county jails for New York Focus and reporting on city news. I remain interested in the intersection of public health and criminal justice issues, as well as the opioid crisis, which I’ve reported on in Chicago and from a small corner of West Virginia.

Growing up in Brooklyn, I’ve seen firsthand the immediate devastation — and enduring public health ramifications — of many of New York’s greatest catastrophes, from 9/11 and Hurricane Sandy to Covid-19. The city is still grappling with the long tails of those crises as it prepares for the disasters of the future.

We face a slew of other pressing public health issues as well, from infectious disease outbreaks and environmental hazards in our air, water, and homes, to gun violence and the worsening effects of climate change. I’m keen to dive into those issues, and more, in communities across the city.

I’m eager to hear what you think I should cover, or anything that deserves a closer look. If you’d like to send a comment or question my way — or just say hi! — please reach out: efawcett@healthbeat.org.

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