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Opinion: The U.S. is facing the biggest COVID wave since Omicron. Why are we still playing make-believe?

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Opinion: The U.S. is facing the biggest COVID wave since Omicron. Why are we still playing make-believe?

The pandemic is far from over, as evidenced by the rapid rise to global dominance of the JN.1 variant of SARS-CoV-2. This variant is a derivative of BA.2.86, the only other strain that has carried more than 30 new mutations in the spike protein since Omicron first came on the scene more than two years ago. This should have warranted designation by the World Health Organization as a variant of concern with a Greek letter, such as Pi.

By wastewater levels, JN.1 is now associated with the second-biggest wave of infections in the United States in the pandemic, after Omicron. We have lost the ability to track the actual number of infections since most people either test at home or don’t even test at all, but the very high wastewater levels of the virus indicate about 2 million Americans are getting infected each day.

In several countries in Europe, wastewater levels reached unprecedented levels, exceeding Omicron. Clearly this virus variant, with its plethora of new mutations, has continued its evolution with mutations adapted for infecting or reinfecting us.

There is, however, some good news about this big wave of infections. It has not resulted in the surge of hospital admissions seen with Omicron. The “updated” booster (based on the XBB.1.5 variant that rose to dominance in the U.S. in February), available here since September, has some cross-reactivity with JN.1 in lab studies for inducing neutralizing antibodies to the virus, and a recent Kaiser Permanente report showed the booster provided protection from hospitalization in the range of about 60% against JN.1 and other recently circulating variants.

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With the marked differences in the spike protein between XBB.1.5 and JN.1, we are very lucky to see this level of vaccine-induced immune response. Nevertheless, only 19% of eligible Americans have gotten the updated booster. The Kaiser study also showed low levels of protection against hospitalization and emergency room visits for people who had received only prior versions of the vaccine, without the updated booster. That aligns with even more striking differences in the virus sequence of early strains compared with JN.1, and the problem we have with waning immunity four to six months after vaccination.

All of this is occurring on top of the flu and RSV waves, both of which are at very high levels, not clearly having peaked yet, with some people experiencing two of these infections at once.

With all three respiratory viruses circulating at full force, you would think we’d be seeing people wearing masks everywhere in public. That couldn’t be further from the truth. The state of denialism and general refusal to take simple steps to reduce the risk of infection can be seen everywhere.

It has taken healthcare systems many weeks after JN.1 showed up in October to recognize the threat. Only very recently have some reinstated mask mandates for healthcare workers and patients. Little has been done across the country to improve indoor air quality, upgrading filtration and ventilation.

Now in its fifth year, SARS-CoV-2 has once again proved to be highly resilient, capable of reinventing itself to infect us. Yet we continue to make-believe that the pandemic is over, that infections have been transformed to common cold status by prior exposure(s), and that life has returned to normal. Sadly, none of this is true.

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The massive number of infections in the current wave will undoubtedly lead to more people suffering from long COVID. For a high proportion of people, especially those of advanced age, immunocompromised or with coexisting conditions, getting COVID is nothing close to a straightforward respiratory infection.

What is the exit strategy that could get us to “return to normal”? It certainly can’t happen with the current complacency and false belief that the virus will burn out and go away. Inevitably, there will be another strain in the future that we are not at all prepared for and will lead to yet another very big wave across the planet.

Still, there has been exciting new data on oral, inhaled vaccines that achieve high levels of mucosal immunity and protection against infections, which would be variant proof. The U.S. has invested hundreds of millions of dollars to rev up clinical trials for two different nasal vaccines with promising early clinical trial data, and for improved, variant-proof shots with better protection and durability. But most of these efforts started only recently and are not getting urgent priority for completion during 2024, nothing like what we saw with Operation Warp Speed in 2020.

It’s crickets from the White House on COVID now, with no messaging on getting the updated booster or masking. The Biden administration has done far too little to accelerate research on effective treatments for long COVID.

This passivity reinforces the illusion that the pandemic is behind us when it’s actually raging. And this season will be followed by a more quiescent period, which will, once again, lull us into thinking the pandemic is over. But there is no getting over it until we recognize reality and double down on the research that will allow us to block infections and virus spread, and achieve lasting, variant-proof immunity.

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Eric J. Topol is a professor of molecular medicine at Scripps Research and author of the Substack newsletter Ground Truths.

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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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