This will be my last 🧵 of caution urging you to take care this New Year's Eve. There's a lot going on that the media and even the CDC are not promoting. I guarantee the risks are greater than you think they are. Some of you think we're in the end-stages of the #COVID19 pandemic. I think we're likely in the Fμ<% Around and Find Out (FAFO) stage. All the maskless crowds, parties and travel combined with the failure to get the bivalent booster is the FA part, and 2023 may bring us the FO portion.
In the US, there has been a leak of CDC info that suggests the agency has failed to disclose just how dangerous the new VBB.1.5 variant is at the current time (https://twitter.com/DrEricDing/status/1608704548536975360). If accurate, XBB.1.5 went from almost no US cases to 40% of cases in a month. It'a already predominant in the Northeast US, and in states where it is most established, COVID hospitalizations are at their peak for the past 12 months.
Eric Feigl-Ding on Twitter

“⚠️NEXT BIG ONE—CDC has royally screwed up—unreleased data shows #XBB15, a super variant, surged to 40% US (CDC unreported for weeks!) & now causing hospitalization surges in NY/NE.➡️XBB15–a new recombinant strain—is both more immune evasive & better at infecting than #BQ & XBB.🧵”

Twitter
Even if this isn't accurate, we know XBB.1.5 is very immune-evasive and growing, and it's likely to spread across the US in the next few weeks, accelerated by all the maskless holiday partying, singing, and traveling. Even the experts who are normally cautious are sounding the alarm on this variant (https://erictopol.substack.com/p/a-new-variant-alert).
A new variant alert

The XBB.1.5 variant is on a growth spurt in the United States

Ground Truths
You don't need to believe the leak to realize the situation is not "normal" right now. COVID in US wastewater is at the highest level it's been in eleven months--in fact, it's the second-highest level of the entire pandemic, and it's rising (https://biobot.io/data/). And the CDC's Transmission Levels Map shows 71% of the US is at the highest transmission level and another 15% are at substantial transmission (https://covid.cdc.gov/covid-data-tracker/#county-view?list_select_state=all_states&list_select_county=all_counties&data-type=).
Biobot's Wastewater Data and Wastewater Intelligence Platform

Our wastewater intelligence platform monitors concentrations of both pathogens and chemicals in wastewater from across the U.S.

Biobot Analytics
COVID hospitalization are still quite moderate, but where XBB.1.5 is taking hold (HHS regions 1 and 2), they are the highest in 11 months (https://covid.cdc.gov/covid-data-tracker/#hospitalizations).
COVID Data Tracker

CDC’s home for COVID-19 data. Visualizations, graphs, and data in one easy-to-use website.

Centers for Disease Control and Prevention
It's not just the US that's FAFOing. COVID deaths in Japan have never been higher (https://ourworldindata.org/explorers/coronavirus-data-explorer?zoomToSelection=true&time=2020-03-01..latest&facet=none&pickerSort=desc&pickerMetric=new_deaths_smoothed_per_million&Metric=Confirmed+deaths&Interval=7-day+rolling+average&Relative+to+Population=true&Color+by+test+positivity=false&country=~JPN). No one is entirely sure why, given the Japanese have a much higher vaccination rate and are much more likely to wear masks. One explanation is that, even though masks help, activity has returned to normal.
COVID-19 Data Explorer

Explore global data on COVID-19.

Our World in Data
Another is that Japan hasn't succeeded in rolling out the Omicron booster (the 5th vvax dose) to a 80% of the population (https://www.kantei.go.jp/jp/headline/kansensho/vaccine.html). And, there is some speculation among those studying COVID's evolution that the COVID variant driving the surge in Japan has picked up a mutation that extends the period of asymptomatic infection.
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新型コロナワクチンの接種に関するお知らせ、ワクチンについての情報などを掲載しています

首相官邸ホームページ
The rest of the globe is seeing it's own share of troubles. Ireland is bracing for record overcrowding in hospitals (https://www.irishtimes.com/health/2022/12/30/hospitals-brace-for-record-overcrowding-in-new-year-as-infections-surge-in-state/). Hospitals in the UK are declaring a wave of "critical incidents" due to overcrowding and a nurses strike (https://inews.co.uk/news/hospitals-england-critical-incidents-a-and-e-departments-struggle-2054842?ico=related_stories). And, of course, the situation is reportedly horrific in China with overcrowded hospitals and morgues, but it's impossible to get a sense of the scale of the COVID disaster in that nation (https://www.nytimes.com/2022/12/29/health/china-covid-outbreak-predictions.html).
Hospitals brace for record overcrowding in new year as infections surge in State

Fresh wave of Covid-19 in China sparks renewed discussions on potential travel restrictions across Europe

The Irish Times
All of our maskless activities are inviting COVID to spread, and as it spreads, it mutates. The more it mutates, the more it finds the holes in our defenses, overcoming immunity protection from past infections and vaccinations. And, with China having reversed its Zero COVID policy and inviting global travel, experts are worried the pace of new variants will only increase (https://www.theguardian.com/world/2022/dec/28/chinas-move-to-open-up-travel-sparks-concern-over-spread-of-new-covid-variants).
China’s move to open up travel sparks concern over spread of new variants

Japan, India and Taiwan introduce measures to prevent influx of cases as experts say lack of data makes it difficult to assess risk

The Guardian
The US faces a mix of issues. COVID testing is the lowest it's been since May 2020 (https://covid.cdc.gov/covid-data-tracker/#trends_7daytestresultsreported_select_00). Activity level is high. Masking is low. And new variants are growing behind BQ (the one perdominant the past month) and XBB (the one about to become predominant.)
COVID Data Tracker

CDC’s home for COVID-19 data. Visualizations, graphs, and data in one easy-to-use website.

Centers for Disease Control and Prevention
Meanwhile, just 1 in 6 people have gotten the bivalent booster (https://covid.cdc.gov/covid-data-tracker/#vaccinations_vacc-people-booster-percent-pop5). And we know vaccine protection fades in four to six months, but 80% of the US hasn't been jabbed in over six months. The nation is poorly prepared for the more immune-evasive variants to come.
COVID Data Tracker

CDC’s home for COVID-19 data. Visualizations, graphs, and data in one easy-to-use website.

Centers for Disease Control and Prevention
And, if COVID was just a mild disease, all of this might seem like much ado about nothing. But we know a significant share of people will get Long COVID. Even more concerning is that more than 100 studies have found COVID can leave our bodies with significant issues (https://docs.google.com/spreadsheets/d/12VbMkvqUF9eSggJsdsFEjKs5x0ABxQJi5tvfzJIDd3U/edit?usp=sharing). COVID raises the risk of heart attacks by 93% in the eight months following infection. Brain scans show two years after COVID, grey matter is reduced in parts of the brain.
COVID-19/SARS-CoV-2 Studies

Google Docs
COVID can causes muscle decline that persists six months after infection. Suicide rates in veterans are 30% higher the year after a positive COVID PCR test. And multiple studies have found immune system damage that persists for at least six to 12 months after infections. Even the WHO, which has been famously slow to act on COVID cautions, is now warning about the immune dysfunction, vascular damage, and neurological issues that those infected with COVID can experience (https://twitter.com/Sandyboots2020/status/1608402400817336322).
Lisa #SafeEdForAll on Twitter

“🧵1. WHO Executive Director @DrMikeRyan warning about immune dysfunction, direct viral damage, vascular harm and neurological issues being seen in people with Long Covid.”

Twitter
Too many are Fμ<%ing Around. Perhaps most of you won't "Find Out," but with the growing body of knowledge that COVID isn't "just the flu," I fear a lot of folks could face diminished health for years and possibly the rest of their lives. That is an awfully steep "find out" price to pay because you couldn't wear a mask or be a little more careful.

Stay informed, be safe, stop pretending the pandemic is over, and do what you can to save your or others' lives in the months ahead--starting tomorrow night on New Year's Eve. I wish you a safe and healthy 2023.

P.S. If you do get COVID in the coming week, you might want to be aware of a new study that found that patients that initiated a twice-daily saline nasal irrigation were 8x less likely to be hospitalized than the current national rate (https://pubmed.ncbi.nlm.nih.gov/36007135/).

Rapid initiation of nasal saline irrigation to reduce severity in high-risk COVID+ outpatients - PubMed

SARS-CoV-2+ participants initiating nasal irrigation were over 8 times less likely to be hospitalized than the national rate.

PubMed

@augieray after two years of diligent masking i got COVID on a train trip.

even double vaxxed and boosted, i have autoimmune issues and the case was nasty.
but i found neti pots absolutely helped me. later, i saw this study and have recommended it to anyone who will listen. thanks for publicizing it!

@rustoleumlove @augieray oh wow! Thanks for sharing this. Also immunocompromised. I use a nasal rinse every day. Glad to know it helps!
@rustoleumlove @augieray Yes, I used a nasal wash the first three days. I was fortunate to have a mild case. I thought I had a cold! Got #covid from attending a college football game.

@augieray Great advice! #CovidIsNotOver #CovidIsNotACold #CovidIsAirborne

So #GetVaccinated #GetBoosted #WearAMask & #FilterYourAir with #HEPA or a #CorsiRosenthalBox

Consider #StayingHome instead of going to New Year’s Eve parties.

#LongCovidIsNoJoke so remember, the best way to avoid #LongCovid is not to get #COVID19 in the first place!

@augieray

ALSO: Consider an end of year charitable gift to the Corsi-Rosenthal Foundation whose mission is to make classroom air cleaner & safer by providing #CorsiRosenthalBoxes to schools with high poverty rates.

Donations to the foundation are fully tax deductible. 100% of proceeds are used to give students cleaner, safer air, 1 #CorsiRosenthalBox at a time.

Send donations to:
Corsi-Rosenthal Foundation
C/O Jim Rosenthal, Director
5757 E. Rosedale, Fort Worth, TX 76112

@augieray
#CovidIsNotOver
#CovidIsNotFlu
And flu can kill. But Covid affects your brain, vascular system, etc which flu does not.
@AutisticMumTo3 @augieray not true. My great uncle got brain damage from the 1918 flu. It’s just that we developed so much immunity to that strain (which is still around) that it can’t cause that kind of damage anymore.

@cadenza @AutisticMumTo3 @augieray

The thing which is driving me nuts is that the exact same precautions we need to stop Covid -- well-fitting #N95 and #P100 masks, #HEPA filters, #CorsiRosenthalBox es -- also stop flu. And RSV. We could just stop all of these diseases.

Instead, DOCTORS are infecting people by refusing to take precautions. It is a world gone crazy.

@neroden @cadenza @AutisticMumTo3 @augieray
At least in NHS settings round here masks are still compulsory which is better than nothing especially with everyone wearing them. The chemists/pharmacies other than the ones in the surgeries have given up.
@AutisticMumTo3 @neroden @AutisticMumTo3 @augieray in NYC, doctors are still wearing masks in hospital settings. They are still compulsory, though some patients won’t wear them.

@augieray famtastic!

not that anyone asked, but we’ve used NOZIN nasal sanitizer for at least a year. we apply by swab prior to N95 masking for general public spaces, and we use the ampules prior to N95 masking with glasses in small, populated spaces. once home, we also gargle with antiseptic. we do believe this has protected us from severe illness.

terrific share! what great validation. thanks for tooting!

@abejaclaustro @augieray

Anecdotally, we also use NOZIN in high risk situations that we can't avoid and are still COVID free.

@BE @augieray ✊🏽 here’s to remaining so for the duration, whatever that should be