COVID News:

• There are over 300 variants circulating globally right now, and one isn’t a clear winner. In the U.S. BQ.1 and BQ1.1 makeup about half of cases. (Your Local Epidemiologist)
• A large study found no link between the COVID vaccine and shingles. (Medpage Today)
• COVID is still the third leading cause of death in 2022. (Health System Tracker)
• Severe COVID is less likely for kids whose parents are vaccinated. (CIDRAP)
• LA county now strongly recommends indoor masking again as COVID cases have risen 70% in the past month. (LA Times)

Public Health & MPX News:

• New requirements for added traceability records were published in the Federal Register. While allowing quicker traceback for foods, they place an additional and potentially costly burden on those required to maintain food sourcing records. (Federal Register)
• Listeria is on the rise - the second outbreak in two weeks was linked to enoki mushrooms. (CDC)
• Haiti’s cholera outbreak is worsening with over 700 cases. (Reuters)
• Some good news from the Southern Hemisphere - the flu vaccine is a pretty good match for this year’s circulating strains, with about a 49% reduction in hospitalizations. (MMWR)
• A record number of parents are missing work to care for sick kids as respiratory illnesses spike. (Ars Technica)
• Ebola vaccine candidates will be shipped to Uganda next week to help with the outbreak there. (Reuters)
• A measles outbreak in central Ohio is up to 24 cases, almost all children under the age of 5 and all unvaccinated. Nine children have been hospitalized. (NBC)
• Some hospitals are restricting visitors due to RSV and flu surges. (KHN)

Mental Health News:

• Believe it or not, bird watching can be very good for your mental health. (Yahoo)
• Schools are struggling to staff up for the youth mental health crisis. (AP)
• Psychologists say demand for mental health services is increasing, but nearly half were unable to meet that demand and more than 60% had no openings for new patients. (Axios)

If you or someone you know may be considering suicide, call 988 or message the Crisis Text Line by texting HOME to 741741.

Best Questions:

How can we avoid getting sick this Thanksgiving?

First things first - remember that COVID isn’t the only thing you can get sick with. Flu and RSV are surging, too, and hospitals are overwhelmed. If you’re sick, skip this year’s Thanksgiving meal for the sake of your loved ones. Even if your COVID test was negative, you could still have flu or RSV. Getting up to date on your flu shot and your COVID booster are the best things you can do to protect yourself and your family. Ventilation is key for indoor gatherings - open windows, use filters and fans, and get as much air circulating as possible to reduce the spread of flu and COVID. RSV spreads through larger particles and fomites, so handwashing is key for preventing that. It’s also a good idea to have everyone test beforehand!

When should we test if we’re gathering for Thanksgiving?

Our recommendation, when possible, is to take a test 24-48 hours before your gathering, and then another one the day of, just before you or your guests arrive. At-home rapid tests aren’t great at catching asymptomatic COVID, but they’re much more accurate when you do serial testing a day or two apart. Of course, if you have symptoms, it’s best to take one for the team and stay home this Thanksgiving to avoid spreading illness to your loved ones.

How common is COVID rebound?

Our friend Mara Aspinall covered COVID rebound in this week’s Sensitive & Specific newsletter. COVID rebound happens in people who were treated with Paxlovid, the antiviral, and in people who weren’t. It appears to happen more often after Paxlovid, but the exact numbers are hard to pin down and may change based on which variant is in play. A recent study from this past summer when BA.4 and BA.5 were top dogs showed nearly 20% of people had Paxlovid rebound, but that’s tempered by the fact that it found about 7% rebounded even without treatment. It’s still incredibly effective at preventing severe disease (81%!), and most rebound disease is mild. The reality that rebound happens shouldn’t deter anyone from getting treated, especially if they’re at high risk. It saves lives (plus, you might still rebound even if you don’t get treated).

Should we plan for this winter’s surge to be as bad as last year’s?

We don’t think it will be. A new analysis from the Institute for Health Metrics and Evaluation out of the University of Washington says that we’re not likely to get hit as badly this year, unless a new variant crops up out of the blue that isn’t on our radar right now. Obviously, it’s possible since that’s what happened with Omicron last year, but it’s not very likely. The spike in “common” viruses like RSV and flu could be what makes this winter rough, rather than a COVID surge, but if cases don’t skyrocket after next week’s holiday gatherings, we’ll feel better about our overall outlook.

Best Read:

Will We Get Omicron'd Again?

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