Helloooo, fall weather. Yes, even here in San Diego, the air feels different this week— we actually have a cloud, which counts as big news in this town.
Across the country, the forecast is shifting in more ways than one: the federal government has come to a standstill, impacting public health and potentially healthcare coverage; the respiratory viral season is starting to brew; and a few deaths have been linked to Trader Joe’s precooked pasta.
But there’s also plenty of good news—from Covid-19 vaccines finally getting the green light to a Nobel Prize announcement. Plus, I’m answering a question one of my girlfriends texted me this week: What’s going on with pediatric Covid vaccines?
Let’s dive in.
The federal government shutdown means most CDC data updates are on pause. States are still reporting, but the CDC is important because it compiles all data into a single national picture. Currently, that picture is incomplete. I’m relying on PopHIVE from the Yale School of Public Health, which combines multiple data sources beyond the federal government, including Google Trends and medical records, to fill in the gaps. (Disclosure: I helped build it.)
RSV season is starting to brew, with increased activity in Florida. RSV typically emerges in the Southeast and then sweeps across the nation, so this is an indicator that it’s on its way.
Trends in RSV in Florida. Source: PopHIVE; Annotated by Your Local Epidemiologist
Covid-19 trends continue to decrease, coming off the summer wave.
Flu activity is still low. The season “officially” starts on calendar week 40, so all epidemiological eyes are now on flu.
What this means for you: The respiratory season is slowly getting underway. Now is the best time to get respiratory vaccines before the winter season begins. For local updates, your state’s public health department remains the best source.
A Listeria outbreak has been linked to precooked pasta. Four people have died, and 20 became severely ill, with all but one landing in the hospital. This is likely an undercount, as some people improve from Listeria exposure without treatment.
Products include:
What this means for you: At this point, these products are primarily off store shelves, but they might be in your fridge. The recall affects everything with an October 10 use-by date. If you find them, toss them. As the investigation continues, additional products may be recalled.
It’s been more than two weeks since ACIP, the vaccine policy advisory committee, recommended Covid-19 vaccines for everyone over six months old. The acting CDC Director finally signed off today. Typically, this approval happens within 24 to 48 hours, so the delay was highly unusual.
Historical practice of vaccine approval in the U.S. Figure by Your Local Epidemiologist
This may seem like a small procedural detail, but that single signature now sets other steps in motion, like state and federal programs purchasing the vaccines. For example, the Vaccines for Children program, which provides more than half of all childhood vaccines in the U.S. at no cost, couldn’t order Covid-19 vaccines until now. That means many children, especially those who are uninsured or underinsured, couldn’t get vaccinated, even if they wanted to.
What this means for you: Access to Covid-19 vaccines should become easier, especially for under or uninsured children.
Where can you find a Covid-19 vaccine? Unfortunately, there is no longer a government vaccine finder available. There are two other finders I know of:
Boston’s Children (the people who made the federal one)
However, they both have a significant limitation: they only find pharmacies, not whether they have the Covid-19 vaccine, are administering it, or to whom. It’s best to call ahead of time.
Also, be sure to sign up for V-safe! This is a safety monitoring system that allows you to report side effects (or lack thereof) after vaccination by completing brief check-ins.
Between 41–75% of the federal workforce is furloughed across Health and Human Services, like CDC and FDA. However, many federal employees are also embedded in state and local health departments, which keep critical services running. Some states are in an especially tough spot because they haven’t yet finalized a state budget, so salaries are frozen and funds are tied up. This shutdown also hits at a bad time: federal block grant dollars haven’t been distributed yet, meaning there’s far less cushion than usual.
This means there are some immediate impacts, but the longer this shutdown goes, the more it will impact the public health field and, thus, you.
Most immediate:
Data: Many federal dashboards are paused. Wastewater data, for example, isn’t being updated except for measles. That means we’re flying blind on what’s spreading, where, and how fast—and local data reporting may soon stop, too.
Telehealth for Medicare: A pandemic-era rule that allowed Medicare patients to see doctors from home—not just in rural clinics—expired Tuesday, cutting off access for many homebound seniors, especially in rural areas. The service will remain unavailable unless Congress includes it in the next spending bill.
Delays in health care help: With fewer staff available to field calls and questions, Medicare beneficiaries can expect longer wait times and delays in care.
Next to immediate:
WIC (Women, Infants, and Children): This program provides staple foods and infant formula to nearly 7 million pregnant women, infants, and young children. It currently has enough funding to operate for about two weeks.
FDA: Already affected by layoffs and cutbacks, the agency is scaling back non-emergency inspections.
Safe through October:
The longer the shutdown continues, though, the wider the gaps will become: missed outbreaks, delayed guidance and resources for local health departments, and outdated data that hinder people’s ability to protect themselves.
We’ll continue to monitor this closely and keep you updated on its implications for you.
At the heart of the shutdown fight is whether the Affordable Care Act (ACA, also known as Obamacare) tax credits are expended before they expire at the end of the year, and premiums start to skyrocket.
Here’s how it works: If you buy your health insurance through the Affordable Care Act (ACA) Marketplace (which is about 24 million people), the government limits how much of your income you have to spend on your monthly bill—people who earn less pay a smaller share. The government then covers the rest through a tax credit.
This credit started in 2014, but a few years ago, it was increased to make insurance even more affordable. KFF gave a constructive example: someone earning $28,000 a year currently pays about 1% of their income—around $325 per year—for a standard health plan. If these extra tax credits expire, that same person would have to pay almost 6% of their income, or about $1,562 per year. That’s an increase of about $1,200 in annual costs.
What this means for you: Nothing has happened yet, and all of this depends on how this shutdown shakes out. However, for many people, if this passes, health insurance costs are expected to skyrocket.
Sleep is a time when our body repairs itself. It’s essential for everything from brain development and memory to metabolism, mood, and immune function. While we spend about a third of our lives asleep, we’re still learning exactly how it works—and how to do it well.
The market for sleep aids is worth more than $100 billion annually, but we don’t actually know how well they work because we are still learning about how we sleep. New research says that tuning into your body’s network of biological clocks, which produce circadian rhythms (yes, multiple), is the key to successful sleep. Unlike breathing, which runs on an entirely internal rhythm, circadian rhythms depend on external cues like light and routine to stay calibrated.
Scientists have found helpful insights:
Contrast between light and dark is essential for maintaining internal rhythms. Light-sensitive cells in our eyes detect brightness and wavelength, sending that information to a pacemaker in the brain that regulates our circadian clock.
Our brains crave routine for healthy sleep. Changing your sleep and wake times—even if you get the same number of hours—can essentially “jet lag” your body, disrupting your rhythms and leaving you feeling less rested.
What this means for you: You don’t need fancy gadgets. Keep a steady routine: try to go to bed and wake up around the same time every day, and keep mealtimes fairly consistent. Create light contrast: dim lights at night (yes, even hallway or charging lights can interfere), and get sunlight exposure during the day.
This year’s Nobel Prize in Medicine went to the scientists who discovered a special type of immune cell called the regulatory T cell — the body’s built-in peacekeeper. These cells stop the immune system from accidentally attacking healthy parts of our body. The winners also found that these cells rely on a key protein called FoxP3 to do their job; when FoxP3 doesn’t work properly, it can lead to a rare but severe autoimmune disease called IPEX syndrome.
Generic medication abortion drugs gain FDA approval. Even amidst HHS’ call to investigate the safety of mifepristone, a medication abortion drug, the FDA approved another generic version on Tuesday. The first generic version was approved in 2019. This provides additional options for women.
Injuries and deaths have fallen after backup camera requirements. Since backup cameras became mandatory in new cars in 2018, severe injuries and deaths from cars accidentally backing over young children have dropped by about two-thirds. One trauma center found a drop from 7-8 annual fatalities to 2-3 fatalities after the mandate. Researchers say it’s a clear example of how simple safety technology can save lives.
Utah’s public health department moved quickly after 11 infants were exposed to measles at a health clinic, hosting a special clinic on Saturday to give them protective immunoglobulin treatment. The swift response prevented further spread and likely severe disease.
My girlfriend texted me this question, and I figured many parents out there have the same: “Do you have any insight into why our pediatricians still haven’t received any Covid vaccines and have no info on when they will?”
It’s likely a combination of a few things:
Politics and bureaucracy. Some pediatrician offices were waiting on the CDC Director to sign off. (See above about this delay.)
Supply. There is definitely a supply issue, as this is the first year that only one Covid-19 vaccine (Moderna) is available to children under 5 years old.
Demand. Many offices have stopped ordering the vaccine altogether because demand for pediatric Covid-19 vaccines has decreased. If pediatricians purchase the vaccines, but can’t give them, the pediatrician’s office has to eat the costs.
You’re all caught up! Stay healthy and sane out there.
Love, YLE
Your Local Epidemiologist (YLE) is founded and operated by Dr. Katelyn Jetelina, MPH PhD—an epidemiologist, wife, and mom of two little girls. YLE is a public health newsletter that reaches over 400,000 people in more than 132 countries, with one goal: to translate the ever-evolving public health science so that people are well-equipped to make evidence-based decisions. This newsletter is free to everyone, thanks to the generous support of fellow YLE community members. To support the effort, subscribe or upgrade below: