1-9 The resistance to evidence about COVID and Trump has puzzled me until now.

KGB agent Yuri Alexandrovich Bezmenov defected to Canada in 1970 and stated 85% of KGB work was “a slow process which we call either ideological subversion, active measures, or psychological warfare.” 2-“What it...means is: to change the perception of reality of every American to such an extent that despite of the abundance of information no one is able to come to sensible conclusions in the interest of defending themselves, their families, their community, and their country.”

1-6

Let's start with a couple of my pandemic slides from 20 years ago. In this one, I was talking about how SE Asia has the densest human, waterfowl, and pig populations anywhere on Earth. 2- The importance of that is a little bit more subtle. Typically, human and avian influenza viruses don't cross between those species. That has a little bit to do with receptors and body temperatures, among other things.

1-3

How to tell a physician is an idiot.

a. They make a comment like this.
b. They don't use their real name.
c. Their twitter name makes one think that they got banned before. 2-

d. Their profile uses all of the virtue signaling buzzwords.

1-12

I pay attention to hurricanes, both from a climate change perspective and because I get deployed for them.

Let's rewind time a bit to the forecast for the 2024 hurricane season. "NOAA predicts above-normal 2024 Atlantic hurricane season."

noaa.gov/news-release/n… 2-

"Despite ideal conditions that fueled pre-season predictions of upwards of 20 named storms, the immediate prospects for one are low, and none have formed in the Atlantic since Ernesto in mid-August – a streak unmatched in 56 years."

cnn.com/2024/09/06/wea…

1-6

Let's just say that this is an overestimate, so I will round down to 150 million cases. What exactly does that mean?

https://twitter.com/COVID19_disease/status/1829333158996975682

2-

So far during the pandemic, about 1-5% of people have needed hospitalization. I'll take the low number of that for argument. That's 15 million hospitalizations.

1-3

I'm writing about COVID and MVAs, but pulled together some data that is really interesting to share now. The black line is road miles, the light blue is air miles, and the red is MVA deaths per 100,000 population per 100,000 miles. 2-3 The orange line is simply to make it easy to look at the year 2000 on all three. The drop in air and road miles is expected, but the big jump in mortality is telling.

1-8

I thought I would explain why I am so concerned about H5N1. Even if it isn't causing severe illness and death at present in humans, each infection exponentially increases the chance of mutation to a version that would. 2- To date, the case fatality rate has been about 56%, although that number could be high due to insufficient testing leading to case ascertainment bias.

cdn.who.int/media/docs/def…

1-6 I'm working on a presentation for physicians beginning residency. I'm building an entire section on
"pandemicene" trends. Here is TB in the US. I found something interesting. 2- The blue line with the red section is the rate of TB per 100,000 population. It has been going downward for decades, which is exactly what we want to see. This also can be visualized as the percentage change (yellow line), which we want to maintain below zero (dashed line).

1-4 I had a third case of mumps come across my desk in the past week. It's worth putting this in some perspective. 2- For the past four years, the US has averaged 421 cases/year. Note the big drop due to when we were using NPIs against COVID.

1-4

It looks like we have hit the bottom of the curve for wastewater in the US. Also notice how the bottoms keep getting higher and higher. Notice how the y-axis gives concentrations. 2- Here is the wastewater data from the CDC for the past year. Notice how the national "activity level" (black line) is climbing.

1-5
I've been thinking about what is going on at the CDC and reached a theory. I think that many people there are trying to do the right thing. However, just like we are seeing with the public related to COVID, I bet there is a similar psychological phenomenon going on. 2- I'm going to posit that it's actually two different social psychology mechanisms working in synergy with each other.

1-7
Today was the first day I stayed in a hotel since the start of the pandemic. I thought some people might like to know my respiratory protection strategy. 2-

First, I picked a hotel that had individual HVAC connected to the outside.

1-4

I was aware of a huge surge of pertussis in England this year.

gov.uk/government/pub…
2-4
Here's the data for the US. 2022-2024 is still provisional data. Note the big drop in cases in 2020 (green) which is definitely attributable to respiratory protection and social distancing. A lower number also contributed to keeping cases low in subsequent years.

1-5

COVID will cause pandemics of chronic disease. I think it will be a number of year before we really have a grasp of the scale of what our indifference has done. One of my questions is who will care for all of these people? 2- The MI Health Council started creating an annual report called the MI Healthcare Workforce Index in 2023. The 2024 report came out just over a week ago.

mhc.org/_files/ugd/71b…

1-6

I found what CDC is now releasing for COVID data. It's pretty bleak. The data comes from 98 counties in 13 states. They even made a surprising admission. 2-

Even someone with zero statistics training would realize that this is not a representative sample by any means and does not characterize meaningful trends, except perhaps in MD.

1-4
They pulled the plug. It's official. The well has gone completely dry. These were the two main datasets I used for my state and metro graphs. 2-
In my region, I saw that about 80% of the hospitals were still reporting data, so I was hoping I could at least provide that data along with the drop in facilities reporting, like I had done with suspected COVID admissions.

1-3

COVID is really a disaster in slow motion. How about increasing your risk for dementia and other neurological disease?

thelancet.com/journals/laneu… 2-

"COVID-19 might confer a larger risk of dementia than influenza, and that (in the short term) the risk of severe neurological impairment as a sequela of SARS-CoV-2 is significant, driven by vascular and probably other complex (possibly amyloid-centric) processes."

1-4

I unrolled this because it is so important. I've spoken on antibiotic resistance at conferences before. If we lose effective antibiotics, we enter what is known as the post-antibiotic era. 2-

Mostly this had been driven by improper prescribing by physicians, inadequate controls in less developed countries, use as growth promoters in agriculture, and adding them to consumer products.

1-12

Since we have a G4 coronal mass ejection inbound, I thought I would share a very abbreviated narrative of an exercise I wrote and facilitated with different teams around the world. I'm leaving out the details of questions I probed them with around their responses. 2-

"NASA indicates that a solar super storm or geomagnetic storm was ejected from the sun this
morning and is traveling on a path that will directly intersect with Earth. This storm is currently rated
as a G5 or ‘Extreme’ storm on their Geomagnetic Storm Scale...

1-6

I spent about 90 minutes on a virtual meeting about HPAI in agriculture. I had a couple of important takeaways. 2- First, it seems that there must be a receptor the virus has an affinity for in mammary tissue. That has me thinking about the impacts of vertical transmission. For example, in the goat incident in MN, only the baby goats got severely sick, not the older ones.

1/4

@PeterHotez

Dr. Hotez, I have to respectfully disagree with your post two days ago.

https://twitter.com/PeterHotez/status/1783943222009450704

2/4

Part of the problem is that the true numbers of COVID admissions are artificially dampened in comparison to prior years due to the elimination of the reporting requirement in suspect cases on 6/1/23. You can see this big drop due to the decreased reporting here.