The outdoor temperature flirted with 100 degrees and heat advisories blanketed the region earlier this month as workers arrived at a commercial poultry operation in Weld County to start killing chickens.
Of the 1.8 million egg-laying hens inside the operations barns, at least some were infected with highly pathogenic avian influenza bird flu. The strain of the virus that is now circling the globe has shown a remarkable ability to infect all kinds of animals, from seals to skunks to mountain lions. But it spreads most rapidly and lethally in wild birds and domestic poultry.
When a commercial flock is infected, standard practice is grim but efficient: Kill all the birds at the farm, devastating one operation in the hopes of stopping the virus and sparing the rest of the industry. By the time the workers in Weld County were done, though, some discovered that the virus had survived at least for one infection longer. It had found a new host: Their own bodies.
The unprecedented cluster of six cases of bird flu reported this month in Colorado is the largest outbreak of human cases in the United States from the current strain in fact, it is the only time in this country that more than one person has been confirmed to be infected from a single incident. And there is a possibility the outbreak may be worse than the headlines.
Colorado health officials tested at least 69 workers who showed flu-like symptoms, out of more than 150 workers who were at the farm. Of those, only six have tested positive three of those cases were confirmed initially by the federal Centers for Disease Control and Prevention, while three others were confirmed later, most recently on Friday.
Combined with another human case reported in the state this month a dairy worker who had contact with infected cattle as well as the states worst-in-the-nation outbreak of bird flu cases on dairy farms, Colorado has become the epicenter of bird flu in the U.S.
A state health official last week said public health agencies are monitoring more than 700 people who may have been exposed to bird flu, looking for signs to see if they were infected. A team from the federal Centers for Disease Control and Prevention arrived in Colorado to help track the epidemiological evidence.
But the outbreak has also shined a light on a much more mundane factor in the infections: Those soaring temperatures.
The CDC says that workers who have contact with infected animals should wear a thick suit of personal protective equipment, or PPE.
Head covering, goggles, mask, water-resistant coveralls, apron, gloves and boots. In a drawing of the outfit on the CDC website, only slivers of a workers forehead and cheekbones are uncovered.
But there are no requirements for workers to wear PPE. The U.S. Department of Agriculture has issued only recommendations. The state has no requirements, either.
The result is that workers may not be wearing PPE in bird flu hot zones.
My understanding is that PPE is available to workers, but theres not been 100% uptake in the use of PPE, Dr. Rachel Herlihy, the state epidemiologist, said in an interview last week. Weve been working very closely with the producer to ensure improvements are made in uptake of PPE in workers. Theres been significant work to train workers on the use of PPE.
This is where the weather comes in. All that PPE designed to be fairly un-breathable, in order to keep pathogens out is hot.
While temperatures outside were scorching, it was likely even hotter inside the barns where the workers were culling birds. Workers may have chosen to forego PPE or taken it off. Sweat running down faces made goggles fog up and masks slip. Large fans pushed around air, likely laden with virus, and ruffled PPE.
Every crack in the protective armor provided an opportunity for the virus to slip through.
Its really difficult to try and control the weather right now, Herlihy said.
While the difficulties of working in extreme heat might explain the outbreak, they dont offer an excuse for not better protecting workers, some experts said.
Thats absolutely crazy to me, said Jennifer Nuzzo, a nationally recognized epidemiologist who is the director of the Pandemic Center at Brown University School of Public Health in Rhode Island. Putting people into a situation where they are culling birds that are known to be infected without sufficient protection is just gambling with their lives.
Nuzzo said officials could have considered waiting to do the culling until temperatures subsided. Or they could have sent workers in for shorter shifts.
Bird flu has not resulted in any serious infections in humans in the United States so far. The workers in Colorado who tested positive had symptoms ranging from eye redness all the way up to classic flu symptoms of fever, chills and cough. All were offered the antiviral drug Tamiflu and told to isolate themselves. None required hospital treatment.
Herlihy, the state epidemiologist, said her agency takes seriously the health of workers who have contact with infected animals.
Im certainly concerned about workers that have exposures, she said.
There is no evidence of the virus spreading person-to-person. Wastewater testing and data from hospital emergency department visits do not indicate that the virus is silently spreading. This means the risk to the general public remains low and mostly confined to contact with infected animals.
Nuzzo said this is all important for the public to keep in mind.
My concern for a potential pandemic is growing, she said. I wouldnt call it high yet.
But, despite the mild illnesses, Nuzzo said flu viruses should not be taken lightly. In the wrong circumstances, they do have the ability to cause severe illness as this bird flu virus has in other parts of the world. And every infection of a person is a chance for the virus to evolve and crack the code on more efficiently spreading to other people.
Nuzzo said that makes it vitally important to better protect farm workers, for their own health and for the health of others. She pointed to the example of Finland, which is offering bird flu vaccinations to farmworkers as a precaution.
I think were maybe a little bit naive about the potential of this virus, she said. Theres a thought that its going to whip through and be gone. But Im here to tell you, flu viruses dont disappear.
Based on facts, either observed and verified directly by the reporter, or reported and verified from knowledgeable sources.
An additional worker became infected with the H5N1 avian flu virus while culling sick hens at a Colorado egg farm, saystate public health officials, raising the U.S. total of infected workers to 11, all with mild symptoms. Eight of the cases, seven involving poultry and one involving dairy, have occurred in Colorado.
The Centers for Disease Control says the risk to the general public from the disease is low. It recommends using protective equipment, such as goggles, masks, and gloves, by people in contact with infected or possibly infected animals.
The Colorado Department of Public Health and Environment said six workers, one more than reported earlier, contracted bird flu while killing and disposing of H5N1-infected hens on a poultry farm in Weld County, northeast of Boulder. The workers had mild symptoms, including conjunctivitis [pink eye] and common respiratory infection symptoms. None were hospitalized, the agency said.
In addition, a Colorado dairy farmworker contracted bird flu in early July; and in 2022 a correctional inmate participating in a pre-release program was infected with the virus. Since April, three other dairy farmworkers, in Michigan and Texas, have been diagnosed with bird flu.
Some 100.4 million birds in domestic flocks, mostly egg-laying hens and turkeys being raised for meat, have died of highly pathogenic avian influenza (HPAI) since the disease appeared in the United States in February 2022, says aUSDA database. Thats twice as many as in an HPAI outbreak in 201415 that was described as the greatest animal disease event in U.S. history.
Since late March, the virus has been confirmed in163 dairy herdsin 13 states from Idaho to Michigan. Colorado has the most, 42 herds, followed by 30 in Idaho, and 26 in Michigan.
The answer to curbing influenza could be right under our noses or, more accurately, inside them. New research maps happenings in the nose during the course of influenza in exquisite detail, and could potentially lead to new targets and more effective nasal flu vaccines.
The nose is often the gateway to respiratory infections, where viruses first set up shop and start replicating. But strangely, the immune response in the nose has been relatively unexplored.
The National Heart, Lung, and Blood Institute has traditionally covered the lung through the trachea, and another NIH institute funds research for craniofacial and dental disorders, says Boston Childrens Hospital researcher Jos Ordovs-Montas, PhD. Where does the nose fit?
Ordovs-Montas first took on this underfunded body part during the COVID-19 pandemic. His lab showed that people who developed severe COVID-19 had weak antiviral responses in the nose and throat.In new work led by Samuel Kazer, PhD, the team analyzed what happened in the noses of mice during flu infection.
Unlike the COVID study, which analyzed patients nasal swabs at a single point in time, the new study tracked events throughout the nose, including parts not reachable with a nasal swab, throughout a flu episode. To better understand immune memory, the researchers resampled the mice after a second influenza infection. They published their findings last week in the journal Immunity.
Over the course of infection, the researchers sequenced the RNA of thousands of individual cells in the nasal mucosa (the tissue lining the nasal cavity) in all, more than 150,000 readouts over two weeks. This created a dynamic atlas, cataloguing what kinds of cells were there and how each was responding. The team identified 127 cell types and subtypes, including the epithelial cells that line the mucosa, multiple types of immune cells, cells making up connective tissue, and even neurons that facilitate smell.
We saw lots of interesting cellular diversity within this micro-anatomy, says Ordovs-Montas. When we sample people with swabs, we just scrape the surface. Sam was able to look at the full tissue.
Different cells came and went during influenza infection. For example, neutrophils (first-responder immune cells) appeared almost immediately, but left once the virus was cleared. Tissue-resident memory T cells (TRM cells), which maintain memory of an infection in the tissue, showed up around day 14. They remained in the nose thereafter, right through the second bout of flu, as did plasmablasts, which matured into antibody-producing plasma cells.
One previously undescribed group of cells took the stage one to two weeks after the start of infection. Dubbed Krt13+ nasal immune-interacting floor epithelial cells (KNIIFE cells), they run along the bottom of the nasal cavity, just above the palate of the mouth. Kazers expertise at the intersection of biology and computational science made their discovery possible, says Ordovs-Montas.
We almost threw those cells out because they looked so weird, he adds.
These cells may be key to the more rapid, coordinated immune responses the team saw during the second influenza infection.
KNIIFE cells express many genes associated with immune function that were not used to seeing in epithelial cells, Kazer elaborates. They expand after the virus is cleared, in the same anatomical location as the TRM cells. We think they may help maintain the memory of an infection.
The team is now further exploring the role of KNIIFE cells and plans to correlate the findings from mice with nasal-swab data from people with influenza and from children seen at Boston Childrens Hospital with other viral infections. Kazer hopes their work will one day lead to a long-lasting nasal vaccine that could limit the spread of disease beyond the nose by helping the nose remember the flu virus.
Memory can take place in many types of cells, he says. Understanding how memory looks in a barrier tissue like the nasal mucosa is some basic biology were trying to get at.
For regular science updates from Boston Childrens, subscribe to our research newsletter.
The bodys first encounter with SARS-CoV-2, the virus behind COVID-19, happens in the nose and throat, or nasopharynx. A ...
Inflammatory bowel disease (IBD), causing devastating abdominal pain, persistent diarrhea, and rectal bleeding, is hard to control with current treatments. ...
While conventional flu vaccines are designed to anticipate the influenza strains projected to dominate in the next flu season, they...
As we age our immune systems start to flag, leaving us more susceptible to cancer and infections and less responsive ...
Vaccines during pregnancy can protect both parent and fetus from serious infections. Examples of the vaccinations doctors usually recommend include Tdap, the flu vaccine, and a COVID-19 booster.
Pregnancy alters the immune system, making it more likely that people will get serious symptoms from certain infections. Sometimes serious infections can lead to pregnancy complications.
Vaccines can reduce this risk and can also boost the immunity of the baby from birth. However, not all vaccinations are safe during pregnancy.
Read on to learn more about the vaccines that are beneficial, which to avoid, and when to get them.
In the United States, doctors recommend several vaccines for pregnant individuals, including:
The following sections explore these vaccines in more detail.
The Tdap vaccine protects against three bacterial diseases that can be very serious in children. They are:
When a person receives Tdap during pregnancy, their body begins making antibodies for these bacteria, giving them protection should they contract the bacteria in the future.
However, these antibodies also pass to the fetus, giving them immunity from all three conditions, too.
Doctors recommend administering a dose of the Tdap vaccine during each pregnancy, ideally early in the third trimester.
People who are pregnant or postpartum are more likely to get severe flu symptoms and complications than others. The seasonal flu vaccine reduces this risk.
The flu vaccine works by stimulating the bodys immune system so that it knows how to respond to the newest strains of flu virus circulating during a given flu season.
The Centers for Disease Control and Prevention (CDC) advises that people who are or will be pregnant during flu season receive either the inactivated influenza vaccine or recombinant influenza vaccine. These vaccines contain no living virus.
Doctors should not give the live attenuated influenza vaccine during pregnancy. It contains a live but weakened form of flu virus, which could theoretically pose a risk to the fetus.
Pregnant people are at a higher risk of complications from COVID-19 than people who are not pregnant.
As a result, the CDC recommends that individuals should stay up to date with COVID-19 booster vaccines if they are pregnant, trying to get pregnant, or if they are nursing.
Some people may feel hesitant about getting a vaccine that is still relatively new. However, a 2024 study involving over 100,000 babies in Sweden and Norway found that exposure to the COVID-19 vaccine during pregnancy did not have any association with negative outcomes after birth.
In most situations, the benefits of vaccination outweigh the potential risks of getting COVID-19.
RSV is a common cause of serious respiratory infections in babies. People can get an RSV vaccine during pregnancy, which will protect the baby from birth onwards.
Alternatively, babies can receive an RSV vaccination after birth if they are under 8 months old during their first RSV season.
While some vaccines are safe during pregnancy, there are others people should avoid. These include:
Some of these vaccines contain weakened live microbes. Outside of pregnancy they usually do not cause problems, but because the microbes could affect the fetus, doctors do not generally give them to pregnant people.
Other vaccines on this list have little data showing they are safe for use during pregnancy, which is why doctors will usually try to avoid giving them.
If a person needs one of these vaccines, or they had one of them before finding out they were pregnant, they should speak with a doctor.
Typically, doctors recommend the following schedule for vaccines before, during, and after pregnancy:
If possible, people should aim to get the following vaccines at least 1 month prior to conceiving if they have not had them already:
Similarly, people who have recently received travel vaccines, such as the yellow fever vaccine, should wait at least 4 weeks before conceiving.
During pregnancy, people should get:
Alternatively, people can immunize the baby during their first RSV season if they are 8 months or younger.
It is safe to receive vaccines postpartum, even while breastfeeding. The only exception to this is the yellow fever vaccine. If a person needs this vaccine for travel that they cannot postpone, they should speak with a doctor.
Under certain circumstances, a doctor may recommend additional vaccines during pregnancy. This could be because a person:
For example, those at high risk of the following conditions may receive the:
Sometimes doctors also use vaccines as an emergency treatment. This may be necessary if a person becomes exposed to uncommon but potentially dangerous microbes, such as those that cause rabies, anthrax, or smallpox.
Certain vaccines may be necessary if a person is pregnant and needs to travel abroad. However, both parents and healthcare professionals need to consider this decision carefully.
Some travel vaccines sometimes contain live organisms. Others have not undergone testing in pregnant people. A doctor may suggest certain ones if the risk of getting the infection outweighs any potential risk of the vaccine. This could include:
The vaccines that doctors recommend during pregnancy are safe for parent and fetus.
Vaccine Safety Datalink (VSD) monitors vaccine safety in the United States and has been collecting data on any adverse outcomes since 1990. To date, it has found no evidence that Tdap has associations with:
Research has found no association between COVID-19 vaccination and adverse outcomes in newborns, and it does not increase the risk of pregnancy loss, preterm delivery, or stillbirth.
A 2021 study in Canada that involved following over 28,000 children over the first few years of life reached similar conclusions.
Specifically, the study found no association between the flu vaccine and health conditions, including:
It also notes that previous research has found no link with autism, epilepsy, or meningitis.
Most people who receive vaccines get mild or no side effects. If they do experience side effects, they often get better on their own in a few days.
The most common side effects of Tdap, COVID-19 boosters, and the flu vaccine are:
Occasionally, people can also have a mild fever. This can be a side effect that requires treatment in pregnant people. If a person experiences fever at any time, they should contact a doctor. They may give acetaminophen (Tylenol) to reduce it.
Below are some frequently asked questions about vaccines during pregnancy.
The 3-in-1 vaccine is another name for the Tdap vaccine, which protects against tetanus, diphtheria, and pertussis, or whooping cough.
Yes, if a person wants to protect their baby from whooping cough, tetanus, and diphtheria, a Tdap vaccine is necessary during each pregnancy.
Vaccines during pregnancy are an important part of prenatal care, offering protection against infectious diseases for both the pregnant individual and the fetus.
While doctors recommend certain vaccines during pregnancy, individuals should approach others with caution.
Consultation with a healthcare professional is important to help ensure a person gets the vaccinations they need and at the right time.
Avian influenza viruses have infected the worlds birds for millennia. We first became aware of them in the 19th century, when mass deaths of poultry triggered interest in what was then called fowl plague.
But in 2021, something fundamental changed. As the world grappled with COVID lockdowns and economic chaos, the birds of the world were encountering a new strain, known formally as Highly Pathogenic Avian Influenza (HPAI) H5N1 2.3.4.4.b. It spread easily and was capable of causing disease and death in a far wider number of bird species than previously seen before.
So far, it has triggered the culling of half a billion farmed birds and killed millions of wild birds. (This is a different strain to the HPAI H7 strains which have infected poultry farms in Australia).
If this new strain gets to Australia, carried on a migratory wild bird, it could pose similar risks to our unique wildlife. But we havent been sitting still. Australian researchers, governments, veterinarians and wildlife rehabilitators have been urgently preparing for its arrival.
This strain has now made it to every part of the world bar Australia, New Zealand and Pacific nations. The virus killed many birds in the northern hemisphere before crossing to the Americas. In South America it proved particularly lethal, infecting and killing massive numbers of birds and marine mammals such as sea lions.
Many strains of bird flu are low pathogenicity, meaning they tend not to cause severe disease. But these strains can evolve into highly pathogenic strains if they spill over from wild birds into poultry, as were seeing with the current outbreaks in poultry farms in Victoria, New South Wales and the ACT.
Prior to 2024, Australia had experienced eight previous outbreaks of H7 HPAI in poultry, all of which were eradicated by culling poultry and isolating farms.
This new H5N1 2.3.4.4.b strain is much more worrying for our wildlife, because it transmits very easily between wild birds. It has proven it can kill mammals, including marine mammals, predators and scavenger species that eat birds.
It also poses a real threat to our poultry industries. If H5N1 2.3.4.4b were to enter Australia, we could see more outbreaks in domestic poultry, which in turn could affect the supply of chicken and eggs both very popular sources of animal protein in Australia.
Given the virus is present worldwide, including in Antarctica, you might wonder why it hasnt made it to Australia yet.
Avian influenza travels most easily in waterfowl such as ducks. Australias waterfowl are not migratory and only travel short distances between Australia and countries to the north.
But Australia is on the path of several flyways from Asia, along which millions of shorebirds migrate every year in spring. Some seabirds also migrate from the Atlantic.
The devastation the virus has caused overseas has given Australia time to prepare.
We cant stop wild birds from migrating here. But we can slow the spread and protect at-risk wildlife from other threats such as invasive predators, giving them the best chance to survive the virus if it arrives.
Around Australia and on our sub-Antarctic islands, a network of veterinarians, researchers, government officials, rangers and wildlife rehabilitators is on alert looking for sick birds with signs, such as respiratory illness.
If a bird showing these signs is spotted, they will call the Emergency Animal Disease Hotline (1800 675 888). Members of the public are also encouraged to report sightings.
Other plans for the virus include:
We have created information toolboxes to help wildlife managers and carers to manage risk and reduce transmission if the virus is confirmed here. These include improving baseline biosecurity, clearing away carcasses, restricting human movement to reduce spread, and euthanasing dying birds.
For threatened species, we can explore the merits of vaccination trials for captive birds. New Zealand authorities are trialling this method.
But such vaccination must ultimately serve the welfare interests of wildlife. There are many complexities to consider.
Globally, vaccination of free-ranging wild birds has occurred for just one species the endangered Californian condor, considered particularly at risk because of its low numbers.
Overseas, waterfowl, shorebirds and seabirds have proven especially susceptible to the virus. Avian predators are also at risk if they eat sick birds or their carcasses.
Specific data on Australian species are limited, but at least one local species, the black swan, has been found to be highly vulnerable to the virus because they lack some protective genes.
The sheer variation of our ecosystems might offer some protection. We have many transient bodies of water, such as Kati Thanda-Lake Eyre. If the virus arrived during a period of drought, it could have a different impact than if it arrived during flooding rains, which fill lakes and encourage movement of wild waterfowl.
Because this strain is very new, we dont know yet what the long term outcome will be.
Its possible birds which survive an infection will become immune and survive to breed. But some species and populations may not be able to survive this first assault.
This threat is new territory for Australia. Many of the other animal diseases we worry about and prepare for only attack one species, such as African swine fever, or only affect non-native wildlife (such as foot and mouth disease). But this strain of bird flu has attacked over 500 bird species and is infecting a growing number of mammal species.
What can you do? Keep an eye out for any sick or dead birds and call the Emergency Animal Disease Hotline if you do.
Read more: Chickens, ducks, seals and cows: a dangerous bird flu strain is knocking on Australia's door
Headlines are again warning of a new COVID variant in Australia. This time its LB.1, or as some experts have dubbed it, D-FLiRT.
Emerging evidence suggests LB.1 could be more transmissible than earlier Omicron subvariants, though theres nothing to suggest it will cause more severe disease.
But before we look more closely at LB.1, how did we get here in the first place? The COVID virus is a crafty thing, continuing to evolve so it can keep infecting us.
Our current COVID vaccines are based on XBB.1.5, a subvariant of Omicron. Along with other XBB subvariants, XBB.1.5 caused a wave of COVID cases around the world in 2023.
In August 2023, a new subvariant called JN.1 was discovered in Luxembourg. Until that point, new Omicron subvariants only had small genetic changes from their predecessors (called genetic drift).
However, JN.1 was unusual in that it was 41 mutations away from XBB.1.5 (big changes like this are called genetic shifts). Because of these changes, it was expected that JN.1 would take off, and indeed, JN.1 caused another wave of infections in Australia and around the world at the end of 2023 and the beginning of this year.
JN.1 then mutated further, giving us the FLiRT subvariants such as KP.1.1, JN.1.7 and KP.2.
Proteins including the spike protein (a protein on the surface of the virus which allows it to attach to our cells) are made up of amino acids, essentially molecular building blocks. When scientists sequence new variants, they work out the exact order of amino acids in the spike protein, as this can change the behaviour of the virus.
Each amino acid has its own letter abbreviation. The FLiRT variants were named for two genetic mutations to the spike protein. The sequence changed from phenylalanine (F) to leucine (L) at position 456 (genetic mutation F456L), and from arginine (R) to threonine (T) at position 346 (R346T).
Research yet to be peer-reviewed suggests these genetic changes gave the FLiRT subvariants better capacity to evade our immune responses, but slightly poorer ability to establish an infection once they get into our cells (sometimes called binding efficiency).
The FLiRT subvariants have themselves now mutated. Some of these new subvariants are called FLuQE, and include KP.3, which along with KP.2 is currently dominating around the world.
These are similar to the FLiRT subvariants with additional genetic mutations. One is called Q493E hence the name FLuQE. Along with another mutation, F456L, these changes appear to have helped the virus regain some of its reduced ability to infect cells compared to FLiRT by increasing binding efficiency.
Reports suggest LB.1 was first detected in March 2024. LB.1 is similar to the FLiRT subvariants but with an additional mutation in the spike protein called S:S31del. The del refers to a deletion a genetic change where a part of the virus genetic sequence is removed or lost during replication. In this case, the 31st amino acid (serine) in the spike protein is removed.
For this reason, its been given the nickname D-FLiRT or DeFLiRT. This also covers other variants carrying the same mutations as FLiRT but with this deletion, such as KP.2.3.
Preliminary results from a research group at the University of Tokyo, who conducted modelling and lab experiments with these emerging subvariants, indicate the transmissibility of LB.1 and KP.2.3 may be higher than both KP.2 and KP.3.
LB.1 has been detected in multiple countries, including Australia, and is being monitored closely by bodies like the World Health Organization and the CDC.
In the United States, as of July 15, KP.3 accounted for about 37% of cases, KP.2 for 24% and LB.1 for another 15%, having been steadily rising over recent weeks.
KP.3 and its descendants such as KP.3.2 and KP.3.2.1 (FLuQE subvariants) are similarly dominating in Australia, accounting for at least 50% of cases. We dont know what proportion of cases LB.1 is making up in Australia at present. Its possible LB.1 infections are still negligible, but they may well grow over time.
While COVID cases appear to be declining after a recent wave in Australia, LB.1 may eventually out-compete KP.3, and between them, cause another wave of cases.
We are already seeing a bad season for respiratory viruses with both RSV and influenza cases higher than last year. So a variant with increased transmissibility could add to our winter woes.
The good news is theres no evidence to suggest LB.1 causes any different symptoms or more severe illness than previous Omicron subvariants.
The current vaccines based on XBB.1.5 should still give some cross immunity against LB.1, and oral antivirals such as Paxlovid and Lagevrio should still work. We will likely be getting an updated vaccine based on KP.2, probably towards the end of the year. That should provide better protection against these new subvariants since genetically, theyre very similar to KP.2.
Coronavirus levels in Californias wastewater now exceed last summers peak, an indication of the rapid spread of the super-contagious new FLiRT strains.
California has very high coronavirus levels in its wastewater one of 21 states in that category, up from seven the prior week, according to estimates published Friday by the U.S. Centers for Disease Control and Prevention.
That means about 155 million people nearly half of Americas population live in areas with very high coronavirus levels in sewage. Besides California, the other states with very high levels are Alaska, Colorado, Connecticut, Florida, Hawaii, Idaho, Louisiana, Maryland, Minnesota, Nevada, New Hampshire, New Mexico, North Carolina, Oregon, Texas, Utah, Vermont, Washington, West Virginia and Wyoming. Washington, D.C., is also in that category.
Coronavirus levels in wastewater are also surging in Los Angeles County and the rate of increase has been accelerating. The county also has seen notable jumps this month in newly confirmed infections, coronavirus-positive hospitalizations and the share of emergency room visits attributable to COVID-19.
Nationally, overall viral levels in wastewater are considered high for the second straight week, the CDC said. The estimates are subject to change as more data come in.
Most Americans probably know a family member, friend, co-worker or acquaintance who has come down with COVID-19 recently, perhaps being infected while traveling or at a social gathering.
If you call I dont know 20 or 30 friends, youre very, very likely to find a bunch of them actually have COVID, or have had COVID recently, or are starting to be symptomatic, said Dr. Ziyad Al-Aly, a COVID expert and chief of research and development at the Veterans Affairs St. Louis Health Care System in Missouri.
One notable recent case was President Biden, who tested positive for COVID-19 on Wednesday while traveling in Las Vegas. Biden returned to Delaware to recover. Los Angeles Mayor Karen Bass tested positive a few weeks ago, and Rep. Barbara Lee (D-Oakland) said Tuesday that she was celebrating her birthday while recovering from COVID.
Our fight against COVID is not over! Lee said on social media.
Across the nation, COVID-19s shadow has become more pronounced lately, with the usual seasonal uptick in travel and socialization spawning a fresh spate of infections. Many cases are relatively mild, but nevertheless disruptive forcing trips or plans to be canceled.
Some recently infected people have described painful COVID symptoms, such as a throat that feels like its studded with razor blades. Overall, however, there are no indications the FLiRT subvariants are associated with increased illness severity that would trigger a substantial increase in hospitalizations.
The CDC estimates that COVID-19 infections are growing or likely growing in 41 states, including California. There are no states where the coronavirus is declining or likely declining.
The COVID resurgence comes as the sprawling FLiRT family is increasing its dominance nationally. For the two-week period that ended Saturday, the CDC estimates that about 80% of the nations coronavirus specimens are of the FLiRT subvariants, up from about 65% for the same period a month earlier.
Across California, the rate at which COVID tests are returning positive results is also on the rise. For the week that ended July 15, 12.8% of tests came back positive. Thats up from 5.9% a month earlier and close to last summers peak of 13.1%, which was recorded at the end of August and early September.
For the 10-day period that ended July 6, the most recent for which data are available, coronavirus levels in Los Angeles County wastewater were at 36% of last winters peak, up from 27% for the 10-day period that ended June 29.
Newly confirmed COVID cases are rising faster, too. For the week that ended July 14, there were an average of 359 new cases a day in L.A. County, up from 307 the prior week. A month earlier, there were 154 cases a day.
Official COVID-19 case tallies are certainly an undercount, as those figures include only tests done at medical facilities, not those taken at home, and also dont account for the fact that fewer people are testing when they feel sick. But the overall trends are still helpful to determine the trajectory of the summer wave.
COVID hospitalizations are also ticking up, though they remain below last summers peak. For the week that ended July 13, there were an average of 287 COVID-positive people per day in L.A. County hospitals, up from 139 for the comparable period a month earlier. Last summers peak was the week that ended Sept. 9, when an average of 620 COVID-positive patients were in the regions hospitals per day.
For the week that ended July 14, L.A. County reported that 2.8% of all emergency room visits were COVID-related up from 1.8% for the comparable period a month earlier, but below last summers peak of 5.1%.
Coronavirus levels are also high in the sewage of Santa Clara County, the San Francisco Bay Areas most populous region and home to Silicon Valley. As of Friday, coronavirus levels were high in all of its sewersheds San Jos, Palo Alto, Sunnyvale and Gilroy.
Doctors say its important to get tested if you have COVID symptoms, such as fever, aches, sore throat, chills, fatigue, cough, runny nose or headache, as well as less-common ailments such as vomiting, diarrhea and stomachache.
Most health insurance plans in California at least those regulated by the state are required to reimburse covered people for eight at-home test kits per month, if an in-network provider is used.
Additionally, if you have insurance, your health insurer is required to cover the entire cost of testing if a doctor orders the test. You do not need to have symptoms to request a test, according to the L.A. County Department of Public Health.
Eligible individuals can also search for no-cost testing locations through a CDC website, testinglocator.cdc.gov. Those who have insurance may need to provide insurance information.
People who dont have health insurance in L.A. County can also get free COVID testing at the countys public health center nurse-only clinics and multi-service vaccination sites. Seniors age 65 and up who live in L.A. County, as well as residents who are unable to leave home, can also ask for two free test kits to be mailed to them by filling out a form online. Libraries in L.A. County, as well as food banks and senior centers, may also have free COVID test kits available.
Health officials also have urged people to consider asking medical providers for antiviral treatments, such as Paxlovid, to help battle an active COVID illness. Antivirals can be used to treat people with mild to moderate illness who are at risk of seeing their condition deteriorate.
Waiting for symptoms to worsen is not recommended, the California Department of Public Health says.
Health officials previously have said that antiviral drugs are underused and they implored healthcare providers to properly prescribe them when indicated.
In an advisory, the California Department of Public Health said, Most adults and some children with symptomatic COVID-19 are eligible for treatments. ... Providers should have a low threshold for prescribing COVID-19 therapeutics.
The state of California once made virtual medical COVID visits free for residents, but that program ended in March. The contractor that provided the service, sesamecare.com/covid, now offers those medical services for a fee, though with a discount for California residents.
There has been relatively low uptake of the updated COVID-19 vaccine, which became available in September. Since then, 36.7% of Californias seniors 65 and older have received at least one dose of the updated vaccine, as have 18.5% of adults age 50 to 64 and 10% of younger adults, up to age 49.
For people who havent received an updated COVID vaccine within the last year, you should think about getting it, especially if youre older and immune-compromised, said UC San Francisco infectious diseases expert Dr. Peter Chin-Hong. People at highest risk of dying from COVID are those who are older or have weakened immune systems and havent been recently vaccinated.
Getting the 2023-24 vaccine now will still allow you to get the updated COVID vaccination that is on track to become available this fall. The CDC will recommend everyone 6 months and older get the updated 2024-25 version of the vaccine.
Now, were at 22% positivity, and this trend is going up, Mannepalli said. There is definitely a surge going on.
The Centers for Disease Control and Prevention no longer tracks COVID-19 case numbers but estimates the trend of the virus spread based on emergency room visits. According to the CDC, in the week that ended July 13, Georgia reported 1.1% of emergency room visits were diagnosed as COVID-19, a 40% increase from the previous week a high percentage that reflects a rise in the small number of emergency department cases. Nationally, 1.6% of all emergency visits were due to COVID-19, up 16% from the previous week.
Even President Joe Biden couldnt dodge the outbreak. The president was scheduled to return to the White House today after several days of isolation at his Delaware home following a diagnosis last week of COVID-19. The White House reported last week that his symptoms were mild and that he responded quickly to the antiviral Paxlovid.
The virus seems to be causing fewer emergency visits this summer than last year. During last summers peak, 2.5% of emergency department patients were diagnosed with COVID-19. It accounted for 3.5% of emergency patients in 2022, and 7% during summer 2021.
The CDC reports as of July 16 infections are growing or likely growing in 42 states and territories, including Georgia.
A summertime COVID-19 outbreak has become the norm since the pandemic, tied to people enjoying holiday travel and gathering indoors where its cooler. The virus has shown a seasonal surge twice each year, spiking in July and August, and again in December and January.
The CDC tracks a sample of over 300 hospitals in 13 states to estimate COVID-19 activity. For the week ended July 13, the agency reports a rate of 2 hospitalizations per 100,000 people. The highest rate of hospitalizations this year was reported for the week ended Jan. 6, when 7.6 hospitalizations per 100,000 people was reported.
Health experts and doctors have said they expect this summers COVID-19 illnesses to be milder than some past versions, but the latest iterations of the ever-evolving coronavirus seem to be more contagious.
At the Northeast Georgia Health System, Mannepalli said milder infections are the norm, with people presenting flu-like symptoms including coughing, runny nose, muscle aches, fever and sometimes sore throat. In more severe cases, shortness of breath can also be an issue.
COVID-19s greater transmissibility is a product of the new, more contagious strains of the virus.
There are new variants that keep evolving every few months. And as the new variants evolve, they (become) easily transmissible. Thats the way the virus tries to survive, Mannepalli said.
The FDA has announced a new COVID-19 booster shot is expected to arrive in August or September and will better target the more recent variants.
Credit: Miguel Martinez
Credit: Miguel Martinez
For many people who have already had COVID-19, a reinfection is often milder. But those who are 65 and older, pregnant or immunocompromised remain at higher risk of serious complications from COVID-19.
Protocols for whether to isolate and wear a mask changed in March, when the CDC released new guidelines for people with COVID-19. They now recommend those with the infection treat it the same as the flu and RSV staying home while they have symptoms and fever. The agencys latest recommendation is that people can return to normal activities 24 hours after their fever has resolved and symptoms have improved.
The CDC encourages people recovering from COVID-19 or any other respiratory illness to wear a mask as part of an overall strategy to reduce transmission, but masks are not mandated. The CDC said the new guidelines are intended to make it easier for people to know how to protect others and take into account that other people might not know which virus they have.
Mannepalli said vaccination remains the number one precaution people can take, even as she allows that everyone gets confused whenever they hear about a new vaccine for COVID.
While newer vaccines might be more effective at blocking the variants now in circulation, Mannepalli recommends staying up to date with currently available vaccines rather than waiting for new boosters.
Especially if somebodys high risk of getting severe COVID or having complications from COVID, its so important that they stay up to date with the vaccination instead of delaying it, she said.
For those seeking to minimize their exposure to COVID-19, Mannepalli says masks are advisable, especially in crowded indoor settings with poor ventilation. And if somebody has symptoms, they should source a test, so they can take steps to avoid passing the virus onto others if a COVID-19 infection is confirmed.
I think the most important thing if somebody tests positive for COVID is to reach out to their primary care physician and talk to them, she said, so they can evaluate and see if they need to be started on antiviral medication.
COVID-19 dealt an outsized blow to India during the first year of the pandemic, reveals an analysis of survey data from 765,180 residents that fills a gap left by the incomplete vital statistics and disease surveillance often seen in low- and middle-income countries (LMICs).
Thestudy, led by researchers from the University of Oxford and the Research Institute for Compassionate Economics in Connecticut, estimates a 2.6-year lower life expectancy at birth and a 17% higher death rate, with the greatest losses among females, the youngest and oldest people, and marginalized groups.
The investigators compared high-quality empirical data on death rates and socioeconomic characteristics from Indias National Family Health Survey-5 from 2019 to 2021 with official estimates from the United Nations and the Indian government. Prepandemic rates and characteristics from the two data sources matched closely.
The team used a subsample of households from 14 states and territories (representative of roughly a quarter of India's population) interviewed in 2021 to compare death rates in 2020 with those in previous years.
The research was published late last week in Science Advances.
Life expectancy fell 2.6 years from 2019 to 2020, a decline larger than that in modeled life-expectancy estimates in India and in any high-income country (HIC) during the same period. While drops in life expectancy in HICs were mainly driven by rising death rates among people aged 60 or older, nearly all Indian age-groupsespecially the youngest and oldestcontributed to lower life expectancy.
The death rate was 17% higher in 2020 than in 2019 in India, implying an estimated 1.19 million excess deathseight times higher than the official number, 1.5 times higher than World Health Organization (WHO) estimates, and more than 2.5 times higher than US deaths.
Higher death rates among children were likely due to other causes in addition to COVID-19 (eg, worse economic conditions, public health service disruptions), but excess deaths in 2020 among older people was higher than expected based on age-specific infection deaths in HICs and the SARS-CoV-2 seroprevalence seen in India, the authors said.
"Greater observed than expected excess mortality for older age groups could have been due to higher age-specific infection fatality rates in India as well as due to indirect effects of the pandemic," they wrote.
Unlike other countries, Indian women lost 3.1 years in life expectancy1 year more than males, which the authors said could be attributed to healthcare inequalities and uneven allocation of resources in households. And Muslims and Scheduled Tribes lost 5.4 and 4.1 years, respectively, compared with 1.3 years among high-cast Hindu groups.
Support truly independent journalism Find out more Close
Our mission is to deliver unbiased, fact-based reporting that holds power to account and exposes the truth.
Whether $5 or $50, every contribution counts.
Support us to deliver journalism without an agenda.
Those going to Greece for their summer holidays have been warned of a spike in Covid cases related to the new FLiRT variant.
The increase has been reported by the Mediterranean country over the last 20 days.
In its latest report Greeces National Public Health Organization, EODY, said it had seen an increase in hospital admissions, with 669 new Covid patients admitted from July 8 to 14, 2024. The report adds that this was a 44% increase in the average weekly number of new admissions over the previous four weeks.
In total 26 Covid deaths were recorded.
Greece has recently stuggled with heatwaves that has left many vulnerable people shieding from high temperatures inside.
Last week the Metaxa Oncology Hospital in Piraeus, the port area of Athens, reintroduced masks and other protective measures within its wards.
Visitors are limited to two per patient and there is a 48-hour rapid test requirement for those visiting.
Hospital Director Sarantos Efstathopoulos announced the measures to safeguard its patients, adding that they will be reassessed on July 29.
President of EINAP Matina Pagoni told the Greek television network MEGA: Its summer, were going on vacation, we never said the coronavirus was gone. The truth is that this year, compared to last year, the cases have nothing to do with it. There are too many, there are many hospitalisations and also deaths. 21-22 deaths are too many.
According to EuroNews the city of Thessaloniki has seen a rise in cases reported through sewage testing.
Bulgaria, who shares a border with Greece, issued a warning to any of its residents visiting the country this summer. On the number of cases in Greece, the Bulgarian Ministry of Foreign Affairs added: In this regard and considering the large number of Bulgarian citizens visiting the country during the summer period, the Ministry of Foreign Affairs recommends strict compliance with preventive and hygienic measures in the context of the spread of the disease.
The Association of Hospital Doctors Union of Athens and Piraeus (EINAP) warned that the outbreak of the coronavirus is expected to continue until the end of July.
UK health experts have suggested that FLiRT and LB.1 might be able evade immunity, which is why people who have been vaccinated are still getting ill.
Increased travel and big events such as festivals often result in crowded settings where the virus can spread more easily, and there are no longer any legal restrictions like wearing masks or social distancing, says Dr Mariyam Malik, an NHS and private GP at Pall Mall Medical.
The FLiRT variant has specific changes in its spike protein that might make it spread more easily and dodge immunity from past infections or vaccines, Dr Malik added. Similarly, the LB.1 variant has mutations that help it spread and possibly weaken the protection we get from previous immunity, making these variants different from earlier versions of the virus.
New variants come about because the virus naturally changes over time, added the GP. When lots of people get infected, the virus has more chances to mutate. Also, our immune responses from past infections or vaccines can push the virus to evolve.
The symptoms of the FLiRT and LB.1 variants are generally like those of earlier Covid-19 strains. Common symptoms include fever, cough, fatigue, loss of taste or smell, sore throat, muscle or body aches, shortness of breath, headache, and a runny nose.
Last week, the World Health Organization released a statement indicating Covid-19 is still responsible for around 1,700 deaths per week globally. WHO encouraged vulnerable populations to get vaccinated.
