1-

This is exactly why I find this administration disgusting besides the fact that it is completely tone deaf. However, there is plenty of evidence that this is nothing new for Americans, even though we are all immigrants.

https://twitter.com/DHSgov/status/1932820723606958122

2-

1850s

historicipswich.net/2024/11/02/kno…

1-4 @HHSGov RFK Jr is a danger to public health. 2-4 I can make a claim to back this increasing climb in autism cases...

1-17

I read In the Garden of the Beasts in the spring of 2016, before the melon felon even had the Republican nomination. I found the parallels very disturbing.

eriklarsonbooks.com/book/in-the-ga… 2- When he got elected, I decided to fly to Munich to study the rise of Nazism right after the Inauguration. I wanted to understand how what was probably a normal population of people allowed it to happen. I could have just stayed here.

1-10 LP.8.1

Back when we had good case data early in the pandemic, I could predict the day cases would climb about 10 days out with nearly 99% accuracy. Unfortunately, that data supply and resolution is long gone. 2-

Now the earliest warning I can give is based on my observations of surges occurring when a variant becomes about 50% of submitted samples.

icemsg.org/2025/01/26/var…

1- 17

I was asked to talk about the risks of dust in healthcare at a regulatory and accreditation meeting tomorrow, so I put a few slides together this morning for it you might enjoy. Most are my images over the years with a few exceptions. 2- I might be the only person you come across that ties dust bunnies, Godzilla, the ISS, historic architecture preservation, and Monty Python together. There is a strategy to that in making neural connections to reinforce memory. I'll add a description to any slides that need it.

1-7

Since hantavirus is trending because of the death of Gene Hackman's wife, I thought I would share some of the bigger picture I wrote on ProMED about 15-20 years ago, tying in West Nile virus (WNV) and climate change. 2- One major route of hantavirus infection is through breathing in the urine and feces of rodents, particularly deer mice. This is a problem particularly in the western US, especially when people clean cabins in the spring.

1- 6 The recipe for healthcare collapse.

Mix in one very top-heavy population pyramid due to the baby boomers hitting the age that they will need much more medical care. 2- Add equal parts of a major healthcare worker shortage.

oracle.com/human-capital-…

jamanetwork.com/journals/jaman…

1-3 Someone sent me a study after my piece about MVAs and COVID. It's stunning.

"Findings indicate an association between acute COVID-19 rates and increased car crashes with an OR of 1.5 (1.23-1.26 95%CI)... 2- The OR of car crashes associated with COVID-19 was comparable to driving under the influence of alcohol at legal limits or driving with a seizure disorder...

1-4 This is really interesting data and worth a breakdown. This is all fatal injuries by month in the US. I've split it into pre-covid and pandemic. I included provisional data, but it only looks like it's going down because that data is incomplete. 2- Look at the big jump once COVID came into play. That in itself is alarming.

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.