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Amid Signs of a Covid Uptick, Researchers Brace for the ‘New Normal’

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Amid Signs of a Covid Uptick, Researchers Brace for the ‘New Normal’

Echoing patterns in prior years, coronavirus infections are slowly ticking up in parts of the country, the harbinger of a possible fall and winter wave. But the numbers remain low for now, and are unlikely to reach the horrific highs seen in previous winters, experts said in interviews.

Infections have been trending upward for about four weeks now, according to data gathered from wastewater monitoring, test positivity rates and hospitalizations and emergency room visits. Taken together, the figures offer researchers and public health officials the first glimpse of the coronavirus as a post-pandemic, seasonal threat, a permanent fixture of the infectious disease landscape.

Wastewater analyses point to the highest increases in the Northeast and the South, followed by the West and Midwest. After hitting a trough at the end of June, hospitalizations are inching upward again, but fortunately very slowly.

Test positivity has risen to 7.6 percent, a level last seen in November 2021, and that summer, just before the Delta variant swept the nation.

“This is the fourth summer now that we see a wave beginning around July, often starting in the South,” said Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security.

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Nearly all Americans have built up multiple layers of immunity following repeated infections, immunizations or both, so the virus is unlikely to cause the harm this winter that was seen in previous seasons.

Still, for older adults, pregnant women and people with weakened immune systems or certain chronic conditions, the virus may yet pose a serious threat.

The number of deaths is the lowest since the pandemic began, and roughly one-tenth of the levels in January. Most virus fatalities now occur in adults older than 75. But the real toll will be apparent only at the end of the year, after the fall and winter’s respiratory blitz, experts said.

“We are in a very different place, but Covid is still a thing,” said Katelyn Jetelina, a public health expert and author of the widely read newsletter, “Your Local Epidemiologist.”

“I think we do the public a disservice by saying that it’s over and let’s move on, because it is going to be disruptive this winter, and it will cause a number of people to die,” she added. “That’s just not acceptable to the public health world, especially since it’s preventable.”

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Researchers have been trying to assess how updated Covid vaccines and emerging variants might change the course of the pandemic. By the most pessimistic estimates, if no vaccine were available and the circulating variant dodged most immune defenses, Covid might lead to about 839,000 hospitalizations and around 87,000 deaths nationwide between September and April.

In the best-case scenario, with people of all ages opting for an updated vaccine and a variant that is susceptible to that vaccine, Covid might cause 484,000 hospitalizations and 45,000 deaths — about the toll of a bad influenza season.

“Based on these projections, Covid is likely to remain in the leading causes of death in the United States for the foreseeable future,” said Justin Lessler, an epidemiologist at the UNC Gillings School of Global Public Health who coordinated the research effort.

The range of estimated deaths would place Covid somewhere between liver disease and diabetes for causes of death. “Even in that most optimistic scenario, we’re getting into the range of mortality that we see for top 10 causes of death in the United States,” Dr. Lessler said.

Experts worry in particular about the confluence of Covid with respiratory syncytial virus, influenza and other pathogens. Many hospitals buckled under the weight of the so-called tripledemic of Covid, flu and R.S.V. last year, even though waves of the three infections appeared to be slightly staggered.

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R.S.V. peaked in November and caused about twice as many hospitalizations, including among children, as in prepandemic years. The flu peaked in December and may have led to as many as 58,000 deaths.

Covid led to an estimated 50,000 deaths between November and March. It’s unclear whether the viruses will behave similarly this winter or will drift into a new seasonal pattern.

“This fall is something that us epidemiologists are watching with much curiosity,” said Dr. Jetelina. “I think a lot of us are cautiously optimistic that we may start getting a new normal respiratory season.”

Even if the peaks of each viral wave are further apart than they were last year, the health care system may struggle.

“Even before Covid, it was very difficult for health care systems to keep up with the surge of patients,” Dr. Rivers said. “If this is, in fact, what we can expect year over year going forward, I think we’re going to have to adjust the health care system to accommodate that increased load.”

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The coronavirus is still a more formidable threat than the other two other respiratory infections, Dr. Rivers said.

Unlike flu and R.S.V., which tend to disappear in warmer months, coronavirus infections start to pick up in July and remain high through February. “That’s a good chunk of the year where you’ve got to be on alert,” Dr. Rivers added.

One striking change from previous years is that instead of a single dominant coronavirus variant, there now appear to be a cluster of viral types, all derived from the Omicron branch. The virus is mutating now at a more constant rate, akin to the pace of evolution of the flu virus, Dr. Lessler said.

The vaccine expected this fall is designed to target a variant called XBB.1.5, which was dominant this spring. Even if the vaccine is not a perfect match for the variants circulating in the coming months, it is still likely to prevent severe illnesses and death, if not infections.

Dr. Lessler and his colleagues estimated that vaccinating Americans of all ages could reduce the number of hospitalizations and deaths by about 20 percent.

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No researchers foresee a return to the worst days of the pandemic. But some recommend that when the number of cases go up, people consider wearing masks again in crowded indoor spaces, testing when they have symptoms and being mindful of those around them who may be at high risk should they become infected.

“Whether we’re completely out of the pandemic and settled into our seasonal routine, I am going to pencil in the yes,” Dr. Rivers said. “But I’m also prepared to be surprised, because this virus has surprised me before.”

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Cluster of farmworkers diagnosed with rare animal-borne disease in Ventura County

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Cluster of farmworkers diagnosed with rare animal-borne disease in Ventura County

A cluster of workers at Ventura County berry farms have been diagnosed with a rare disease often transmitted through sick animals’ urine, according to a public health advisory distributed to local doctors by county health officials Tuesday.

The bacterial infection, leptospirosis, has resulted in severe symptoms for some workers, including meningitis, an inflammation of the brain lining and spinal cord. Symptoms for mild cases included headaches and fevers.

The disease, which can be fatal, rarely spreads from human to human, according to the U.S. Centers for Disease Control and Prevention.

Ventura County Public Health has not given an official case count but said it had not identified any cases outside of the agriculture sector. The county’s agriculture commissioner was aware of 18 cases, the Ventura County Star reported.

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The health department said it was first contacted by a local physician in October, who reported an unusual trend in symptoms among hospital patients.

After launching an investigation, the department identified leptospirosis as a probable cause of the illness and found most patients worked on caneberry farms that utilize hoop houses — greenhouse structures to shelter the crops.

As the investigation to identify any additional cases and the exact sources of exposure continues, Ventura County Public Health has asked healthcare providers to consider a leptospirosis diagnosis for sick agricultural workers, particularly berry harvesters.

Rodents are a common source and transmitter of disease, though other mammals — including livestock, cats and dogs — can transmit it as well.

The disease is spread through bodily fluids, such as urine, and is often contracted through cuts and abrasions that contact contaminated water and soil, where the bacteria can survive for months.

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Humans can also contract the illness through contaminated food; however, the county health agency has found no known health risks to the general public, including through the contact or consumption of caneberries such as raspberries and blackberries.

Symptom onset typically occurs between two and 30 days after exposure, and symptoms can last for months if untreated, according to the CDC.

The illness often begins with mild symptoms, with fevers, chills, vomiting and headaches. Some cases can then enter a second, more severe phase that can result in kidney or liver failure.

Ventura County Public Health recommends agriculture and berry harvesters regularly rinse any cuts with soap and water and cover them with bandages. They also recommend wearing waterproof clothing and protection while working outdoors, including gloves and long-sleeve shirts and pants.

While there is no evidence of spread to the larger community, according to the department, residents should wash hands frequently and work to control rodents around their property if possible.

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Pet owners can consult a veterinarian about leptospirosis vaccinations and should keep pets away from ponds, lakes and other natural bodies of water.

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Political stress: Can you stay engaged without sacrificing your mental health?

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Political stress: Can you stay engaged without sacrificing your mental health?

It’s been two weeks since Donald Trump won the presidential election, but Stacey Lamirand’s brain hasn’t stopped churning.

“I still think about the election all the time,” said the 60-year-old Bay Area resident, who wanted a Kamala Harris victory so badly that she flew to Pennsylvania and knocked on voters’ doors in the final days of the campaign. “I honestly don’t know what to do about that.”

Neither do the psychologists and political scientists who have been tracking the country’s slide toward toxic levels of partisanship.

Fully 69% of U.S. adults found the presidential election a significant source of stress in their lives, the American Psychological Assn. said in its latest Stress in America report.

The distress was present across the political spectrum, with 80% of Republicans, 79% of Democrats and 73% of independents surveyed saying they were stressed about the country’s future.

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That’s unhealthy for the body politic — and for voters themselves. Stress can cause muscle tension, headaches, sleep problems and loss of appetite. Chronic stress can inflict more serious damage to the immune system and make people more vulnerable to heart attacks, strokes, diabetes, infertility, clinical anxiety, depression and other ailments.

In most circumstances, the sound medical advice is to disengage from the source of stress, therapists said. But when stress is coming from politics, that prescription pits the health of the individual against the health of the nation.

“I’m worried about people totally withdrawing from politics because it’s unpleasant,” said Aaron Weinschenk, a political scientist at the University of Wisconsin–Green Bay who studies political behavior and elections. “We don’t want them to do that. But we also don’t want them to feel sick.”

Modern life is full of stressors of all kinds: paying bills, pleasing difficult bosses, getting along with frenemies, caring for children or aging parents (or both).

The stress that stems from politics isn’t fundamentally different from other kinds of stress. What’s unique about it is the way it encompasses and enhances other sources of stress, said Brett Ford, a social psychologist at the University of Toronto who studies the link between emotions and political engagement.

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For instance, she said, elections have the potential to make everyday stressors like money and health concerns more difficult to manage as candidates debate policies that could raise the price of gas or cut off access to certain kinds of medical care.

Layered on top of that is the fact that political disagreements have morphed into moral conflicts that are perceived as pitting good against evil.

“When someone comes into power who is not on the same page as you morally, that can hit very deeply,” Ford said.

Partisanship and polarization have raised the stakes as well. Voters who feel a strong connection to a political party become more invested in its success. That can make a loss at the ballot box feel like a personal defeat, she said.

There’s also the fact that we have limited control over the outcome of an election. A patient with heart disease can improve their prognosis by taking medicine, changing their diet, getting more exercise or quitting smoking. But a person with political stress is largely at the mercy of others.

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“Politics is many forms of stress all rolled into one,” Ford said.

Weinschenk observed this firsthand the day after the election.

“I could feel it when I went into my classroom,” said the professor, whose research has found that people with political anxiety aren’t necessarily anxious in general. “I have a student who’s transgender and a couple of students who are gay. Their emotional state was so closed down.”

That’s almost to be expected in a place like Wisconsin, whose swing-state status caused residents to be bombarded with political messages. The more campaign ads a person is exposed to, the greater the risk of being diagnosed with anxiety, depression or another psychological ailment, according to a 2022 study in the journal PLOS One.

Political messages seem designed to keep voters “emotionally on edge,” said Vaile Wright, a licensed psychologist in Villa Park, Ill., and a member of the APA’s Stress in America team.

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“It encourages emotion to drive our decision-making behavior, as opposed to logic,” Wright said. “When we’re really emotionally stimulated, it makes it so much more challenging to have civil conversation. For politicians, I think that’s powerful, because emotions can be very easily manipulated.”

Making voters feel anxious is a tried-and-true way to grab their attention, said Christopher Ojeda, a political scientist at UC Merced who studies mental health and politics.

“Feelings of anxiety can be mobilizing, definitely,” he said. “That’s why politicians make fear appeals — they want people to get engaged.”

On the other hand, “feelings of depression are demobilizing and take you out of the political system,” said Ojeda, author of “The Sad Citizen: How Politics is Depressing and Why it Matters.”

“What [these feelings] can tell you is, ‘Things aren’t going the way I want them to. Maybe I need to step back,’” he said.

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Genessa Krasnow has been seeing a lot of that since the election.

The Seattle entrepreneur, who also campaigned for Harris, said it grates on her to see people laughing in restaurants “as if nothing had happened.” At a recent book club meeting, her fellow group members were willing to let her vent about politics for five minutes, but they weren’t interested in discussing ways they could counteract the incoming president.

“They’re in a state of disengagement,” said Krasnow, who is 56. She, meanwhile, is looking for new ways to reach young voters.

“I am exhausted. I am so sad,” she said. “But I don’t believe that disengaging is the answer.”

That’s the fundamental trade-off, Ojeda said, and there’s no one-size-fits-all solution.

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“Everyone has to make a decision about how much engagement they can tolerate without undermining their psychological well-being,” he said.

Lamirand took steps to protect her mental health by cutting social media ties with people whose values aren’t aligned with hers. But she will remain politically active and expects to volunteer for phone-banking duty soon.

“Doing something is the only thing that allows me to feel better,” Lamirand said. “It allows me to feel some level of control.”

Ideally, Ford said, people would not have to choose between being politically active and preserving their mental health. She is investigating ways to help people feel hopeful, inspired and compassionate about political challenges, since these emotions can motivate action without triggering stress and anxiety.

“We want to counteract this pattern where the more involved you are, the worse you are,” Ford said.

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The benefits would be felt across the political spectrum. In the APA survey, similar shares of Democrats, Republicans and independents agreed with statements like, “It causes me stress that politicians aren’t talking about the things that are most important to me,” and, “The political climate has caused strain between my family members and me.”

“Both sides are very invested in this country, and that is a good thing,” Wright said. “Antipathy and hopelessness really doesn’t serve us in the long run.”

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Video: SpaceX Unable to Recover Booster Stage During Sixth Test Flight

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Video: SpaceX Unable to Recover Booster Stage During Sixth Test Flight

President-elect Donald Trump joined Elon Musk in Texas and watched the launch from a nearby location on Tuesday. While the Starship’s giant booster stage was unable to repeat a “chopsticks” landing, the vehicle’s upper stage successfully splashed down in the Indian Ocean.

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