The Centers for Disease Control and Prevention this week posted a list of more than two dozen types of testing that have become unavailable.

This is not the first time the CDC has paused some of its lab testing. But it is pausing more kinds of tests than ever before, and it is not totally clear why, said Scott Becker, chief executive officer of the Association of Public Health Laboratories.

A government spokesman called the pause temporary and attributed it to “a routine review to uphold our commitment to high quality laboratory testing.”

“We anticipate some of these tests will be available through CDC labs again in the coming weeks. In the meantime, CDC stands ready to support our state and local partners to access the public health testing they need,” said Andrew Nixon of the U.S. Department of Health and Human Services, which oversees the CDC.

CDC’s laboratory operations were faulted during the COVID-19 pandemic, and they were the subject of a subsequent work group’s review. The agency has been evaluating its testing since 2024, Becker said.

But there can be other reasons for taking tests offline, including staffing issues, he noted.

The pausing of lab testing comes in the wake of the dramatic downsizing of the CDC in the last year through layoffs, retirements, resignations and the nonrenewal of temporary appointments. Staffing fell by 20% to 25%, according to different estimates, and was felt across the agency — including in the laboratories.

The poxvirus and rabies labs lost about half their prior staff, and the CDC’s malaria branch was gutted even more, according to the National Public Health Coalition, an organization of former and current CDC workers that formed in the wake of the downsizing.

Some of the paused testing focuses on common infections for which commercial testing is available, like Epstein-Barr virus, and the varicella zoster virus behind chickenpox and shingles. But also on the list is testing for some more exotic agents, like the for parasitic worms responsible for “snail fever” and for the virus that causes “sloth fever.”

Some specialized state labs, like those in the New York and California, have the ability to pick up the slack while CDC tests are on pause, Becker said.

He called the pauses “concerning, only if it’s permanent.”

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NEW YORK (AP) — The flu virus is hanging on in the U.S., intensifying in some areas of the country after weeks of an apparent national decline.

Centers for Disease Control and Prevention data released Friday showed a continued national drop in flu hospitalizations, but other indicators were up — including the number of states with high or very high levels for respiratory illnesses.

“Nationally, we can say we’ve peaked, but on a regional level it varies,” said the CDC’s Alicia Budd. “A couple of regions haven’t peaked yet.”

Patient traffic has eased a bit in the Southeast and parts of the West Coast, but flu-like illnesses seem to be proliferating in the Midwest and have even rebounded a bit in some places. Last week, reports were at high levels in 23 states — up from 18 the week before, CDC officials said.

Flu generally peaks in the U.S. between December and February. National data suggests this season’s peak came around late December, but a second surge is always possible. That’s happened in other flu seasons, with the second peak often — but not always — lower than the first, Budd said.

So far, the season has been relatively typical, Budd said. According to CDC estimates, since the beginning of October, there have been at least 22 million illnesses, 250,000 hospitalizations, and 15,000 deaths from flu. The agency said 74 children have died of flu.

COVID-19 illnesses seem to have peaked at around he same time as flu. CDC data indicates coronavirus-caused hospitalizations haven’t hit the same levels they did at the same point during the last three winters. COVID-19 is putting more people in the hospital than flu, CDC data shows.

The national trends have played out in Chapel Hill, said Dr. David Weber, an infectious diseases expert at the University of North Carolina.

Weber is also medical director of infection prevention at UNC Medical Center, where about a month ago more than 1O0 of the hospital’s 1,000 beds were filled with people with COVID-19, flu or the respiratory virus RSV.

That’s not as bad as some previous winters — at one point during the pandemic, 250 beds were filled with COVID-19 patients. But it was bad enough that the hospital had to declare a capacity emergency so that it could temporarily bring some additional beds into use, Weber said.

Now, about 35 beds are filled with patients suffering from one of those viruses, most of them COVID-19, he added.

“I think in general it’s been a pretty typical year,” he said, adding that what’s normal has changed to include COVID-19, making everything a little busier than it was before the pandemic.

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NEW YORK (AP) — Look for flu and COVID-19 infections to ramp up in the coming weeks, U.S. health officials say, with increases fueled by holiday gatherings, too many unvaccinated people and a new version of the coronavirus that may be spreading more easily.

High levels of flu-like illnesses were reported last week in 17 states — up from 14 the week before, the Centers for Disease Control and Prevention said Friday.

“Folks are traveling a lot more this season. They want to see their families,” said the CDC’s Dr. Manisha Patel. “And all of that sort of adds to the mix” in the spread of viruses.

Health officials are keeping an eye on a version of the ever-evolving coronavirus, known as JN.1. The omicron variant was first detected in the U.S. in September and now accounts for an estimated 20% of cases. The CDC expects it to reach 50% in the next two weeks, Patel said.

It may spread easier or be better at evading our immune systems, but there is no evidence that the strain causes more severe disease than other recent variants, health officials say. And current evidence indicates vaccines and antiviral medications work against it.

As for flu, early signs suggest current vaccines are well-matched to the strain that is causing the most illnesses, and that strain usually doesn’t cause as many deaths and hospitalizations as some other versions.

But the bad news is vaccinations are down this year, officials say. About 42% of U.S. adults had gotten flu shots by the first week of December, down from about 45% at the same time last year, according to the CDC.

Americans have also been slow to get other vaccinations. Only about 18% have gotten an updated COVID-19 shot that became available in September. At nursing homes, about a third of residents are up to date with COVID-19 vaccines.

And only 17% of adults 60 and older had received new shots against another respiratory virus. RSV, respiratory syncytial virus, is a common cause of mild coldlike symptoms but it can be dangerous for infants and older people.

The CDC last week took the unusual step of sending a health alert to U.S. doctors urging them to immunize their patients against the trio of viruses.

The Carolinas are currently seeing the heaviest traffic for respiratory infections in emergency rooms, according to CDC data posted this week.

It’s not as dire as some past winters, but some patients are still waiting days to get a hospital bed, noted Dr. Scott Curry, an infectious diseases specialist at the Medical University of South Carolina in Charleston.

“We’ve barely been cold in South Carolina, and flu tends to hit us very hard when people actually get some cold weather to deal with,” he said. “We could get worse, very easily, in the next four to eight weeks.”

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NEW YORK (AP) — The U.S. infant mortality rate rose 3% last year — the largest increase in two decades, according to the Centers for Disease Control and Prevention.

White and Native American infants, infant boys and babies born at 37 weeks or earlier had significant death rate increases. The CDC’s report, published Wednesday, also noted larger increases for two of the leading causes of infant deaths — maternal complications and bacterial meningitis.

“It’s definitely concerning, given that it’s going in the opposite direction from what it has been,” said Marie Thoma, a University of Maryland researcher who studies maternal and infant mortality.

Dr. Eric Eichenwald, a Philadelphia-based neonatologist, called the new data “disturbing,” but said experts at this point can only speculate as to why a statistic that generally has been falling for decades rose sharply in 2022.

RSV and flu infections rebounded last fall after two years of pandemic precautions, filling pediatric emergency rooms across the country. “That could potentially account for some of it,” said Eichenwald, who chairs an American Academy of Pediatrics committee that writes guidelines for medical care of newborns.

Infant mortality is the measure of how many babies die before they reach their first birthday. Because the number of babies born in the U.S. varies from year to year, researchers instead calculate rates to better compare infant mortality over time. The U.S. infant mortality rate has been worse than other high-income countries, which experts have attributed to poverty, inadequate prenatal care and other possibilities. But even so, the U.S. rate generally gradually improved because of medical advances and public health efforts.

The national rate rose to 5.6 infant deaths per 1,000 live births in 2022, up from from 5.44 per 1,000 the year before, the new report said.

The increase may seem small, but it’s the first statistically significant jump in the rate since the increase between 2001 and 2002, said Danielle Ely, the CDC report’s lead author. She also said researchers could not establish whether the 2022 rise was a one-year statistical blip — or the beginning of a more lasting trend.

Overall in the U.S., the death rate fell 5% in 2022 — a general decrease that’s been attributed to the waning impact of the COVID-19 pandemic, especially on people 65 and older. U.S. maternal deaths also fell last year.

More than 30 states saw at least slight rises in infant mortality rates in 2022, but four states had statistically significant increases — Georgia, Iowa, Missouri and Texas.

In numbers, U.S. infant deaths surpassed 20,500 in 2022 — 610 more than the year before nationwide. But Georgia had 116 more infant deaths than the year before, and Texas had 251 more.

“It would appear that some of the states could be having a larger impact on the (national) rate,” Ely said, adding that smaller increases elsewhere also have an effect — and that it’s hard to parse out exactly what places, policies or other factors are behind the national statistic.

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CLAIM: The U.S. Centers for Disease Control and Prevention said that a new COVID-19 variant is more contagious among vaccinated people than those who are unvaccinated.

AP’S ASSESSMENT: False. In a risk assessment summary published Aug. 23, the CDC wrote that the BA.2.86 variant may be more likely to infect people with existing immunity to COVID-19, either from vaccinations or prior infections, than previous variants. It did not say that vaccinated people are at a higher risk than the unvaccinated.

THE FACTS: Social media users have in recent days misrepresented the public health agency’s guidance on BA.2.86, after the new variant emerged in mid-August.

“BREAKING: CDC says new COVID variant is more contagious among vaccinated people than those unvaccinated,” reads a post shared on Instagram and X, the platform formerly known as Twitter.

As of Monday, one tweet that shared the post had received more than 15,000 likes and more than 7,500 shares.

But this is a distortion of the CDC’s current understanding of BA.2.86. The agency has not said that those who have been vaccinated against COVID-19 are more likely than unvaccinated people by the new variant. Rather, it said those who’ve been vaccinated or previously infected may be more susceptible than they were to prior variants.

“Based on what CDC knows now, the large number of mutations in this new variant raises concern that BA.2.86 may be more capable of causing infection in people who have previously had COVID-19 or who have received COVID-19 vaccines,” the agency said in a statement, bolding the word “or.”

Those making the false claim are misrepresenting the CDC’s Aug. 23 risk assessment for the variant, which said: “BA.2.86 may be more capable of causing infection in people who have previously had COVID-19 or who have received COVID-19 vaccines.” It elaborated near the end of the assessment that “the large number of mutations in this variant raises concerns of greater escape from existing immunity from vaccines and previous infections compared with other recent variants.”

In its statement, the agency said that it is still closely monitoring the variant but that it is “too soon to know the real-world impacts on immunity” and encouraged people to stay up-to-date on their COVID-19 vaccines.

As of Aug. 23, BA.2.86 had been reported in the U.S., U.K., Denmark, South Africa and Israel, according to the CDC.
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NEW YORK (AP) — More than 100,000 people in the U.S. have become allergic to red meat since 2010 because of a weird syndrome triggered by tick bites, according to a government report released Thursday. But health officials believe many more have the problem and don’t know it.

A second report estimated that as many as 450,000 Americans have developed the allergy. That would make it the 10th most common food allergy in the U.S., said Dr. Scott Commins, a University of North Carolina researcher who co-authored both papers published by the Centers for Disease Control and Prevention.

Health officials said they are not aware of any confirmed deaths, but people with the allergy have described it as bewildering and terrifying.

“I never connected it with any food because it was hours after eating,” said one patient, Bernadine Heller-Greenman.

The reaction, called alpha-gal syndrome, occurs when an infected person eats beef, pork, venison or other meat from mammals — or ingests milk, gelatin or other mammal products.

It’s not caused by a germ but by a sugar, alpha-gal, that is in meat from mammals — and in tick spit. When the sugar enters the body through the skin, it triggers an immune response and can lead to a severe allergic reaction.

Scientists had seen reactions in patients taking a cancer drug that was made in mouse cells containing the alpha-gal sugar. But in 2011 researchers first reported that it could spread through tick bites, too.

They tied it to the lone star tick, which despite its Texas-themed name is most common in the eastern and southern U.S. (About 4% of all U.S. cases have been in the eastern end of New York’s Long Island.)

One of the studies released Thursday examined 2017-2022 test results from the main U.S. commercial lab looking for alpha-gal antibodies. They noted the number of people testing positive rose from about 13,000 in 2017 to 19,000 in 2022.

Experts say cases may be up for a variety of reasons, including lone star ticks’ expanding range, more people coming into contact with the ticks or more doctors learning about it and ordering tests for it.

But many doctors are not. The second study was a survey last year of 1,500 U.S. primary care doctors and health professionals. The survey found nearly half had never heard of alpha-gal syndrome, and only 5% said they felt very confident they could diagnose it. Researchers used that information to estimate the number of people with the allergy — 450,000.

People with the syndrome can experience symptoms including hives, nausea, vomiting, diarrhea, severe stomach pain, difficulty breathing, dizziness and swelling of the lips, throat, tongue or eye lids. Unlike some other food allergies, which occur soon after eating, these reactions hit hours later.

Some patients have only stomach symptoms, and the American Gastroenterological Association says people with unexplained diarrhea, nausea and abdominal pain should be tested for the syndrome.

Doctors counsel people with the allergy to change their diet, carry epinephrine and avoid tick bites.

The allergy can fade away in some people — Commins has seen that happen in about 15% to 20% of his patients. But a key is avoiding being re-bitten.

“The tick bites are central to this. They perpetuate the allergy,” he said.

One of his patients is Heller-Greenman, a 78-year-old New York art historian who spends summers on Martha’s Vineyard. She has grown accustomed to getting bitten by ticks on the island and said she has had Lyme disease four times.

About five years ago, she started experiencing terrible, itchy hives on her back, torso and thighs in the middle of the night. Her doctors concluded it was an allergic reaction, but couldn’t pinpoint the trigger.

She was never a big meat eater, but one day in January 2020 she had a hamburger and then a big, fatty steak the following evening. Six hours after dinner, she woke up nauseated, then suffered terrible spells of vomiting, diarrhea and dizziness. She passed out three times.

She was diagnosed with alpha-gal syndrome shortly after that, and was told to avoid ticks and to stop eating red meat and dairy products. There have been no allergic reactions since.

“I have one grandchild that watches me like a hawk,” she said, making sure she reads packaged food labels and avoids foods that could trigger a reaction.

“I feel very lucky, really, that this has worked out for me,” she said. “Not all doctors are knowledgeable about this.”

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A Centers for Disease Control and Prevention advisory committee on Thursday voted that the agency should update its recommended immunization schedules to add the COVID-19 vaccine, including to the schedule for children.

But in the lead-up to the vote by the Advisory Committee on Immunization Practices, false claims spread widely that it would mean the vaccine would be required to attend school.

In reality, the CDC doesn’t have the authority to set school immunization requirements, and the vote doesn’t mandate the vaccine for schoolchildren. That’s a decision left to the states.

Here are the facts.

CLAIM: If the CDC adds the COVID-19 vaccine to the immunization schedule for children, the shots will be mandatory to attend school.

THE FACTS: The false claim gained momentum after it was shared by Fox News host Tucker Carlson this week.

“The CDC is about to add the Covid vaccine to the childhood immunization schedule, which would make the vax mandatory for kids to attend school,” Carlson tweeted on Tuesday night. The tweet included a segment from his show in which he began by making the same claim.

Another popular tweet similarly claimed the CDC committee’s vote would make the vaccine “mandatory for school registration.”

But the public health agency doesn’t determine school vaccine requirements.

“States have the authority to enact state laws requiring vaccination, not the CDC,” said Wendy Mariner, a professor emerita of health law, ethics and human rights at Boston University. “ACIP has no authority to make law.”

CDC spokesperson Kate Grusich told The Associated Press in an email that the agency “only makes recommendations for use of vaccines, while school-entry vaccination requirements are determined by state or local jurisdictions.”

Grusich explained that the action was meant to streamline clinical guidance for healthcare providers by adding COVID-19 vaccines to a single list of all currently licensed, authorized and routinely recommended vaccines.

“It’s important to note that there are no changes in COVID-19 vaccine policy,” she said.

The immunization practices advisory committee is a body of experts that makes recommendations to the CDC about vaccines. Its recommendation to update the schedules, which included other revisions, still needs to be formally adopted by the agency and the amended schedules wouldn’t take effect until 2023, Grusich said.

Fox News referred the AP to a follow-up segment by Carlson on Wednesday night, in which he revisited the topic and claimed the CDC was “lying.” Carlson claimed that “more than a dozen states follow the CDC’s immunization schedule to set vaccination requirements — not suggestions, requirements — for children to be educated.”

“For example, the Virginia Department of Health states that ‘vaccines must be administered in accordance with the CDC’s schedule,’” he stated. He cited Massachusetts as another example.

But those states do not list every vaccine from the schedule in their school requirements.

Virginia, for example, does not require the annual flu vaccine in order to attend school — even though the vaccine appears on the CDC’s schedule. Nor does Massachusetts.

A Virginia Department of Health spokesperson, Maria Reppas, said in an email that there “is no direct, immediate impact on COVID-19 vaccine being added to the Immunization Schedule on school required vaccines in Virginia.” Reppas said changes to the school requirements would need legislative or regulatory action.

Dr. William Schaffner, a vaccine policy expert and professor of infectious diseases at Vanderbilt University Medical Center, said he was not aware of any states that automatically require all vaccines on the schedule for school.

“Those are recommendations that go to pediatricians and family doctors as they care for children,” Schaffner said. “They’re just recommendations, there are no automatic mandates that follow.”

There has also been reluctance by many states to require the human papillomavirus, or HPV, vaccine, even though it appears on the childhood schedule, Schaffner said.

States can use legislation to require specific vaccines or can authorize a state agency or local health entity to require specific vaccines for certain age groups, Mariner said. She added that some states include private schools when establishing requirements, though in other cases, private schools may also voluntarily require vaccinations.

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NEW YORK (AP) — Sharply rising cases of some sexually transmitted diseases — including a 26% rise in new syphilis infections reported last year — are prompting U.S. health officials to call for new prevention and treatment efforts.

“It is imperative that we … work to rebuild, innovate, and expand (STD) prevention in the U.S.,” said Dr. Leandro Mena of the U.S. Centers for Disease Control and Prevention in a speech Monday at a medical conference on sexually transmitted diseases.

Infections rates for some STDs, including gonorrhea and syphilis, have been rising for years. Last year the rate of syphilis cases reached its highest since 1991 and the total number of cases hit its highest since 1948. HIV cases are also on the rise, up 16% last year.

And an international outbreak of monkeypox, which is being spread mainly between men who have sex with other men, has further highlighted the nation’s worsening problem with diseases spread mostly through sex.

David Harvey, executive director of the National Coalition of STD Directors, called the situation “out of control.”

Officials are working on new approaches to the problem, such as home-test kits for some STDs that will make it easier for people to learn they are infected and to take steps to prevent spreading it to others, Mena said.

Another expert said a core part of any effort must work to increase the use of condoms.

“It’s pretty simple. More sexually transmitted infections occur when people are having more unprotected sex,” said Dr. Mike Saag, an infectious disease expert at the University of Alabama at Birmingham.

Syphilis is a bacterial disease that surfaces as genital sores but can ultimately lead to severe symptoms and death if left untreated.

New syphilis infections plummeted in the U.S. starting in the 1940s when antibiotics became widely available. They fell to their lowest ever by 1998, when fewer than 7,000 new cases were reported nationwide. The CDC was so encouraged by the progress it launched a plan to eliminate syphilis in the U.S.

But by 2002 cases began rising again, largely among gay and bisexual men, and they kept going. In late 2013, CDC ended its elimination campaign in the face of limited funding and escalating cases, which that year surpassed 17,000.

By 2020 cases had reached nearly 41,700 and they spiked even further last year, to more than 52,000.

The rate of cases has been rising, too, hitting about 16 per 100,000 people last year. That’s the highest in three decades.

Rates are highest in men who have sex with men, and among Black and Hispanic Americans and Native Americans. While the rate for women is lower than it is for men, officials noted that it’s has been rising more dramatically — up about 50% last year.

That ties to another problem — the rise in congenital syphilis, in which infected moms pass the disease on to their babies, potentially leading to death of the child or health problems like deafness and blindness. Annual congenital syphilis cases numbered only about 300 a decade ago; they surged to nearly 2,700 last year. Of last year’s tally, 211 were stillbirths or infant deaths, Mena said.

The increases in syphilis and other STDs may have several causes, experts say. Testing and prevention efforts have been hobbled by years of inadequate funding, and spread may have gotten worse — especially during the pandemic — as a result of delayed diagnosis and treatment. Drug and alcohol use may have contributed to risky sexual behavior. Condom use has been declining.

And there may have been a surge in sexual activity as people emerged from COVID-19 lockdowns. “People are feeling liberated,” Saag said.

The arrival of monkeypox added a large additional burden. CDC recently sent a letter to state and local health departments saying that their HIV and STD resources could be used to fight the monkeypox outbreak. But some experts say the government needs to provide more funding for STD work, not divert it.

Harvey’s group and some other public health organizations are pushing a proposal for more federal funding, including at least $500 million for STD clinics.

Mena, who last year became director of the CDC’s Division of STD Prevention, called for reducing stigma, broadening screening and treatment services, and supporting the development and accessibility of at-home testing. “I envision one day where getting tested (for STDs) can be as simple and as affordable as doing a home pregnancy test,” he said.

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By Amber Dance

Omicron-specific boosters expected after Labor Day

Both Moderna and Pfizer have applied for emergency authorization of their new vaccine formulas targeting both the original strain and the omicron BA.4/5 variant.

These are expected to sail through the regulatory process, with the FDA likely foregoing any consultation with outside experts and the CDC convening its advisory committee Sep. 1–2.

This would set up the next round of boosters — likely the last government freebies — to start soon after Labor Day, report Sharon LaFraniere and Noah Weiland at The New York Times.

Moderna’s booster is a 50-microgram dose, the same used in their previous boosters (which is half the dose of the primary series). They’ve requested authorization for ages 18 and up.

Pfizer’s formulation is 30 micrograms, matching their original vaccine series. The company is currently aiming for authorization in people ages 12 and older. It is reportedly also working on a booster for children as young as 6 months.

The new boosters will amplify antibodies, making people less likely to acquire the virus or pass it on for some unknown number of months following vaccination, writes epidemiologist Katelyn Jetelina on her blog. Moderna’s research with a different booster formulation, targeting the original strain plus the beta variant, suggested the one-two punch could lead to protection for at least six months.

But those seeking more reliable data will have to wait until human studies on the latest formulations are completed.

Results may vary from person to person, too, depending on an individual’s history with the coronavirus. At The Washington Post, Carolyn Y. Johnson explains how what scientists call “original antigenic sin” influences future immune responses.

“The version of virus to which we’re first exposed can dictate how we respond to later variants and, maybe, how well vaccines work,” writes Johnson. “People’s immune systems are on slightly different learning curves, depending in when they were infected or vaccinated, and with what variants or vaccines.”

Since the first exposure to a virus dominates any ongoing immune response, it could be difficult for the current or future variant-specific vaccines to retool that response for novel variants.

Dr. Barney Graham, who was part of the NIH effort that led to the Moderna vaccine and now works at the Morehouse School of Medicine, noted that the vaccines can still perform their most important task of keeping people from getting so sick that they require hospital care.

Racial disparities recur with monkeypox outbreak

The racial disparities in infection rates that have characterized the coronavirus pandemic are recurring with the monkeypox outbreak, writes Peter Sullivan at The Hill.

A new report from the Kaiser Family Foundation indicates that Black people make up 26% of monkeypox cases, though they only represent 12% of the general population.

Similarly, 28% of monkeypox cases are occurring in Hispanic people, much greater than the 19% of the overall population that is Hispanic.

And additional wrinkle to monkeypox is that most cases are occurring among men, particularly those who have sex with other men.

Disparities are also recurring in vaccination rates, though few states have reported the necessary data to track this so far. For example, in the D.C. area, Black people make up 36% of monkeypox cases but only 22% of those getting vaccinated.

With endemicity on the horizon, Fauci to leave office

The U.S. daily case rate has dropped below 100,000, suggesting the summer wave is on the wane at last, writes Carolyn Smith-Schoenwalder at US News & World Report. 

Wastewater data, after weeks of declining, now indicate a plateau in viral presence, writes Arielle Mitropoulos at ABC News. Testing levels have also dropped — which could contribute to the declining case rate — while wastewater is a less biased indicator.

Dr. Anthony Fauci’s announcement that he’ll depart his position at the end of the year is also a sign the COVID situation is improving, though not coming to an end, writes Sarah Owermohle at STAT.

“I think we’re in a good place now,” Fauci told her. “I believe, even though we are still dealing with COVID, that if we succeed in getting more people vaccinated, and enough people get infected, that there’ll be enough background immunity that we’ll be able to live with a low, low level of infection.”

Ingrid Hein at MedPage Today describes this new goal as “herd safety.” She reports how the state of Massachusetts, where 80% of the population is fully vaccinated, weathered the omicron wave with barely a blip in excess death rates.

“We are finally in a phase now where highly immune populations can start to shoulder COVID-19 waves without the guarantee of excess mortality,” said MedPage Today’s editor-in-chief, Dr. Jeremy Faust of Brigham and Women’s Hospital in Boston, who studied the phenomenon.

But COVID is unlikely to be the last viral outbreak with global impact, reports Youri Benadjaoud at ABC News. “Scientists are increasingly warning that global infectious outbreaks could become the new normal,” she writes.

Frequent international travel over the past few decades is one contributing factor. A warming climate is also making it easier for infectious agents to jump into humans.

“I think it’s very clear that we’re living in a new age of pandemics,” said Dr. Jay Varma of Weill Cornell Medicine.

Paxlovid’s benefits limited to seniors

Pfizer’s antiviral drug Paxlovid staves off serious illness from SARS-CoV-2 in people ages 65 and older, but provides little benefit to younger adults, according to a new study published in the New England Journal of Medicine.

The research, conducted in Israel, analyzed data from 109,000 COVID patients, of whom nearly 4,000 took Paxlovid, during the omicron surge. Seniors who took the drug had a 73% lower chance of hospitalization and 79% lower chance of dying, compared to those who didn’t take Paxlovid, but it made no difference to patients in the 40–64 age range.

“The findings throw into question whether taking the drug is worth it for people under 65,” writes Alice Park at Time. The meds come with a range of unpleasant possible side effects, including diarrhea and a garbage-like taste in the mouth.

Park notes that younger adults who have cancer or other conditions that alter immunity might still benefit from Paxlovid, but the study did not analyze this group separately.

Another issue: after a five-day course of Paxlovid, people sometimes test negative but then positive again. First Lady Jill Biden is the latest high-profile case of Paxlovid rebound, which also affected President Joe Biden and his chief medical advisor Dr. Anthony Fauci.

According to Reuters, the FDA has requested Pfizer test an additional course of Paxlovid in people who experience rebound.

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By Amber Dance

CDC plans overhaul amid critiques of latest loosened recommendations 

After more than two years of a bungled U.S. COVID response, the CDC is acknowledging its mistakes and pledging to improve.

“In our big moment, our performance did not reliably meet expectations,” said agency director Dr. Rochelle Walensky on Aug. 17. She promised a new agency culture with a stronger focus on action for public health.

The changes are Walensky’s response to a report based on interviews with about 120 CDC employees. The report said it “takes too long for CDC to publish its data and science” and that the guidance is “confusing and overwhelming,” according to Sasha Pezenik at ABC News.

Part of the overhaul includes restructuring the communications office and updating the website with simpler language.

The slow release of CDC research findings stemmed, in part, from a promotion system that incentivized publication in the agency’s Morbidity and Mortality Weekly Report, report Lena H. Sun and Dan Diamond at The Washington Post. The CDC now plans to release more data by preprint, which is faster.

One of the problems has been a focus on research rather than public health management, reports Joyce Frieden at MedPage Today. “CDC is a great organization, but it has always functioned like a big academic health system and not an emergency response entity,” Dr. Georges Benjamin, executive director of the American Public Health Association, told her.

Another problem was that the staff in charge of outbreaks changed every few months, creating a disjointed response and confusion about who was in charge. According to The Post, Walensky is considering a minimum six-month rotation for staffers charged with handling outbreaks.

The shakeup comes on the heels of criticism over CDC’s latest loosening of COVID-19 guidelines. Notably, the agency eliminated the recommendation for people exposed to COVID-19 to quarantine. It continues to recommend isolation for at least five days for people who have symptoms or test positive.

Some experts noted the agency seems to be ”leading from behind,” acknowledging what people are already doing rather than recommending what they should do.

The latest guidelines are “leaving decision-making mainly to individuals and local officials who lack public health training,” opine professors Wendy Netter Epstein and Daniel Goldberg in the Los Angeles Times. Putting the onus on individuals to avoid illness disproportionately harms low-income communities and people of color, they write.

Meanwhile, the U.S. seems to be repeating its public health missteps with monkeypox. The nation has more cases than any other country in the world.

Outsiders praised Walensky’s plans to fix the CDC, but noted Congressional approval and funding will be needed for some changes — and that it will be difficult to change the agency’s culture, as Helen Branswell reported at STAT.

“It’s an agency run by geeks. It’s run by doctors and Ph.D.s,” Dr. Jay Varma, director of the Cornell Center for Pandemic Prevention and Response and a former CDC employee told Branswell. “They’re really good at hypothesis-driven research and analyzing information and making predictions about what might happen. What they’re really bad at is managing people in an effective way.”

Study finds COVID-related discrimination on AirBnb

Pandemic scapegoating led to a 12% reduction in AirBnb bookings for hosts with Asian-sounding names, according to a new Harvard Business School working paper.

The researchers based their study on data from New York City in 2019 and 2020, using the quantity of reviews as a proxy for bookings.

The authors suggest the platform could minimize racism by hiding host names and photos until a reservation is made. AirBnb is eager to counter discrimination and looking into the research, reports Anissa Gardizy at The Boston Globe.

This latest finding is an example of discrimination against members of the Asian American and Pacific Islander (AAPI) community that has, at times, been much more sinister, even violent, during the pandemic. The latest report from Stop AAPI Hate documented nearly 11,500 hate incidents through March 2022 — mostly harassment but also physical assault and shunning.

“If you’re only watching the news, you aren’t getting the full picture of what AAPIs are experiencing,” the organization’s co-founder Russell Jeung told Michelle De Pacina at Yahoo! News.

White House promises new boosters by September

White House COVID coordinator Dr. Ashish Jha has predicted that updated booster shots could be available for adults within a couple of weeks, assuming the FDA and CDC give the new formulations their approval, reports Cheyenne Haslett at ABC News.

Jha also expressed hope that the government would be able to buy enough doses for everyone in the U.S., but the Biden administration is waiting for Congress to open its purse. So far, it’s only been able to afford a contract for 171 million doses from Pfizer and Moderna.

That might be enough — after all, only 108 million people got their first booster shot.

A recent poll from the University of Michigan found that among adults over 50 who have already received at least one vaccine dose, 61% are very likely to seek the new booster.

These new mRNA vaccines, which target the omicron BA.4/5 spike protein as well as the original spike, will be authorized based not on human trials, but on their performance in mice, explains Rob Stein at NPR. Data from human trials aren’t expected until mid-autumn.

The United Kingdom has already approved a new booster from Moderna, but that one targets the original omicron variant, for which human data are already available. U.S. regulators chose to take aim at the more recently circulating variants.

Last week Novavax requested authorization for its booster shot — a protein-based vaccine tailored to the original coronavirus strain. At an FDA meeting earlier this summer, the company said this shot generated significant antibodies against omicron BA.5 without needing any change to the formula.

If Novavax is authorized alongside mRNA boosters, it could set up a debate over which type of booster is the best to maximize Americans’ immunity before the upcoming winter, when COVID is expected to surge yet again.

Experts are also likely to be debating the best time for people to get a COVID booster, because earlier isn’t always better.

“The concern is that someone who gets a shot in, say, September, may lose a chunk of their protection if the peak of the season is going to be in February,” writes Andrew Joseph at STAT. “Complicating the process is that scientists don’t have a sense yet — after only two winters with SARS-CoV-2 — about just when the virus might peak.”

Jha also said that the White House may soon stop purchasing COVID-19 vaccines, tests and treatments on behalf of Americans, reports Brenda Goodman at CNN.

“My hope is that in 2023, you’re going to see the commercialization of almost all of these products,” Jha said at a U.S. Chamber of Commerce Foundation event. “Some of that is actually going to begin this fall.”

Neurological consequences of COVID may linger for years

Brain fog can persist for at least two years following a bout with COVID-19, according to a new study in The Lancet Psychiatry.

Risks for other neurological conditions, such as dementia and psychosis, also remains heightened for years, and at rates higher than those for other respiratory infections.

The study was based on the medical records of about 1.25 million people who were diagnosed with COVID, mostly in the U.S.

It found that the risk for mood disorders, such as anxiety and depression, was higher in the months immediately following illness but dropped quickly.

Children who had COVID were less likely to suffer neurological consequences than adults, but still had higher risk for seizures and psychiatric disorders than kids recovering from other infections.

The study authors, from the University of Oxford, characterized the absolute risk for neurological consequences as relatively low overall, but “nontrivial,” reports Elizabeth Cooney at STAT.

The study had several caveats. For example, some neurological symptoms may go unrecorded by providers.

“This is only pickup up very blunt stuff,” said Dr. Steven Deeks of UCSF, who was not involved in the study. “At the end of the day, it provides additional proof that long COVID is real, that some people can have profound symptoms, and that they can persist for a couple of years.”

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