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.

1/?

I was on my way to the next hospital I'll be working at for the next three months. I had heard about a bad outbreak of mad cow disease in Thorp, WI which was right on my way and the situation was far worse than I expected. The prion causing the disease had clearly mootated and given the cows some strange powers.

Part 2 of selected H5N1 and pandemic slides. Here is the cost of normal seasonal influenza.

A few slides from my H5N1 pandemic deck that seem pertinent at the moment. Don't ask me to put them all up, there are 377. This particular one had to do with the 2009 swine flu.

1-5
This is weekly US COVID admissions. The dotted lines that drop in June last year is due to the requirement for reporting suspected admissions, so after that time, this data is only representing about 1/3 of the actual numbers. 2-5 This means that there are about 45,000 COVID admissions/week for 3/17. About 1% of COVID cases need hospitalization, indicating around 450,000 cases/week.

1-6

Another small, but important study on post COVID cognition.

nature.com/articles/s4159… 2-

"Our findings revealed significant attention deficits in post-COVID patients across both neuropsychological measurements and experimental cognitive tasks, evidencing reduced performance in tasks involving interference resolution and selective and sustained attention."

1-7

Here's one of the most disturbing images I've seen in some time. 2-
Zoomed in. The red pin is the Thwaites Glacier. I drew a red line around the Thwaites Tongue. It's the part of the glacier that is not over land, but over the ocean where most of the calving takes place.