[ad_1]
Four and half months after suddenly closing stores in Chicago, Texas, and Washington, D.C., Foxtrot will attempt a comeback by opening its first store this week. Outfox Hospitality, the company that ran those 33 stores filed for bankruptcy in May, leaving a wake of angry vendors, workers scrambling to find new jobs, and accusations of breaking federal labor law. Since then, a new entity has been formed by the chain’s co-founder who says he’ll return the company to its roots by showcasing cool snacks made by local artisans and avoid the pitfalls that lead to the chain’s failure.
The first store is scheduled to open on Thursday, September 5 at 23 W. Maple Street in Gold Coast, according to a news release. An Old Town location at the corner of North Avenue and Wells Street will follow, though an opening date hasn’t been announced. A few vendors Eater spoke with last week said one of the reasons they joined the comeback effort is Foxtrot isn’t rushing to reopen all the stores they closed. Mike LaVitola, who founded Foxtrot in 2013, and is now chairman of the newly named Foxtrot Cafe & Market. He was part of an effort that bought Foxtrot’s assets in an auction for $2.5 million. LaVitola told Eater he wanted to focus on “getting it right” at individual locations rather than opening multiple stores at once. The initial plan announced was to open about 15 stores scattered in Chicago and Texas, with the majority in Chicago. There are two new details from the company’s latest release: They’re not specifying the number of stores anymore (last week, LaVitola said they were negotiating leases in unannounced locations including Wicker Park and Willis Tower.) The other details might be bitter for those in Austin, Texas, as it appears Foxtrot is focusing on reopening in Dallas, at least in the interim. Austin was home to four locations.
The closures caused a nationwide commotion in April, with a combination of anger (a class-action lawsuit alleging Outfox violated federal law by failing to provide proper notice for a mass layoff is pending; October 1 is the next court date), sadness (customers who lived nearby grew attached, one famously bemoaned moving to their residence to be near a Foxtrot), and resentment (some South Siders who had never been to a Foxtrot wondered why folks were being so dramatic). Foxtrot had found a niche in North Side Chicago neighborhoods as a corner store with trendy snacks, a coffee bar, and a cafe space to get work done or to sip wine or beer. It was a kind of third place for former office workers who had transitioned into a hybrid work-from-home schedule during the pandemic. Foxtrot saw an opportunity to scale, and after merging with local Chicago grocer Dom’s Kitchen & Market — which also had its own ambitious expansion plans — in 2022, Foxtrot announced intentions to open as many as 100 locations by 2024. By that point, LaVitola was no longer chief executive officer. He says he was pushed out to an advisory role. Foxtrot began opening in neighborhoods with pricey real estate like Fulton Market and at Wrigley Field. They were spending in the hope of getting noticed.
That detail is important as vendors have been gunshy about joining Foxtrot 2.0 and worried the chain would repeat mistakes. LaVitola told them he wasn’t involved in a leadership role at Outfox. Some have accepted LaVitola’s reassurances, saying they need Foxtrot’s customer base. Others have picked other retail routes.
But, as LaVitola points out, Foxtrot is about more than gourmet gummies or hot dog-flavored potato chips. The coffee bar was “the biggest revenue driver” — it was so much that nearby coffee shops were losing business to Foxtrot. The previous interaction of Foxtrot made a big deal of partnering with Philadelphia’s La Colombe. That relationship will continue, but the new Foxtrot will also stock items from local roasters Metric and Kyoto Black. They’re also adding new food items to complement its morning breakfast tacos, which will remain. Look for new panini sandwiches, salads, lunch bowls, and cookies.
Expect to see growing pains. As of last week, LaVitola wasn’t sure if customers would need to create new profiles on the store’s app, which was vital to the chain’s business. Before it was a brick-and-mortar, Foxtrot used its app for liquor and beer delivery. Still, LaVitola says he’s committed to “delivering an awesome experience in the stores.” One way is making sure customers better connect with the stories behind the people who make their products. He feels the previous iteration of Foxtrot relied too much on its website to do that.
“There’s just going to be a lot more of that content — for lack of a better word — and storytelling happening in the store versus online,” LaVitola says. “Online is still really important, and it’s still there, but I think that gap is going to be bridged.”
[ad_2]
Ashok Selvam
Source link
[ad_1]
Calumet Fisheries, the famed smoked fish shop on Chicago’s far South Side, is nearing a triumphant return about six months since a ravaging electrical fire forced its closure.
The iconic red-roofed shack should reopen in early June at 3259 E. 95th Street, much to the relief of its fans who stop in to check on the proceedings beside the 95th Street Bridge. Calumet was founded in 1928 and purchased by its current owners two decades later.
“Every day we get a new set of people coming in [to ask], ‘Are you still closed?’” says GM Javier Magallanes. “I’m excited — I know we’re going to get rushed with a lot of eager customers… but the nerves are coming. I don’t want to run out of anything, I want to get them well situated.”
Despite the initial shock of the fire, which extensively damaged the roof just days before Thanksgiving in 2023, co-owner Mark Kotlick contended a comeback would happen. Sid Kotlick and Leonard Toll — Kotlick’s late father and uncle respectively — bought the business in 1948 and rapidly earned a reputation for some of the most delectable smoked seafood in town, from delicate and flaky sable to snappy shrimp and zesty pepper and garlic trout.
Along the way, Calumet managed to rise from local fame to national notoriety, a trajectory set in motion by the shack’s immortal 1980 cameo in The Blues Brothers, visible just as Jake and Elwood prepare for their gravity-defying bridge jump. The shack returned to the national stage thanks to the late Anthony Bourdain, who paid a visit in a 2009 episode of No Reservations, and the James Beard Foundation dubbed it an America’s Classic the following year.
Though Kotlick now oversees operations from Florida, he and Magallanes attest that he remains deeply involved in the business and will fly into Chicago for the reopening. “We’re going to keep things the same,” says Kotlick, eager to assuage the fears of anxious devotees. “The signs all look the same, the employees will pretty much be the same — the store’s just got a nice, clean coat of paint, new floors, and new refrigeration.”
There is, however, a noteworthy change on the horizon. When it returns, Calumet will resume cash-only business, but “it’s a credit card world,” Kotlick observes. He acknowledges that at some point, he’ll have to make the shift.
In the meantime, stay tuned for more Calumet Fisheries’ eagerly anticipated reopening.
Calumet Fisheries, 3259 E. 95th Street, scheduled to open in early June.
[ad_2]
Naomi Waxman
Source link
[ad_1]
It’s “tearin’ up our hearts” to see so many pets waiting to find a family of their very own all across the Austin area! So, in honor of Justin Timberlake’s unofficial “It’s Gonna Be May” month, Austin area shelters are working together to get pets into loving homes — “no strings attached.” Join us May 20th-27th to meet all of the pets vying to win your heart and who “just wanna be with you!”
[ad_2]
[ad_1]
Listen to this article
Produced by ElevenLabs and News Over Audio (NOA) using AI narration.
Donald Trump loves the musical Cats, and like the titular creatures, the former president seems to have nine lives. Today, in the face of yet another near-death financial experience, Trump got his latest reprieve. An appeals-court panel in New York State reduced the bond he must post in a civil fraud case from more than $464 million to just $175 million.
Given that the past few months have seen Trump repeatedly use legal procedures to his advantage, drawing out the cases against him in the hope of eventually escaping them, this decision may look like yet another infuriating case of Trump extracting injustice from the justice system. But in fact it is not such an instance, and the reduction is actually quite appropriate.
Recall the timeline. In mid-February, Justice Arthur Engoron ruled that Trump must pay more than $350 million, plus interest, after he, his sons, and the Trump Organization engaged, according to the judge’s findings, in a years-long pattern of fraud, inflating and deflating the reported value of his assets in order to profit long-term. Trump promptly appealed the ruling, but as a defendant, he must post the value of his judgment while appealing.
The problem for Trump is that $350 million (which interest soon brought to nearly half a billion dollars) is a huge amount, even for him. He claims to have a net worth in the billions, but that number includes a great deal of assets that aren’t really available. Part of it is nebulous brand value, but a lot is in real estate—value that can’t be quickly accessed. Trump claimed in a deposition in the case that he had more than $400 million in cash and growing. That’s questionable and, even if true, wouldn’t leave him enough to cover the bond.
Instead, he sought to obtain a bond from a company that specializes in such products. Bonding companies promise courts to cover the cost of a judgment. In return, they usually demand collateral from a client such as Trump—or maybe particularly from Trump, given his long history of not paying his debts. One of them this month posted a bond in the much smaller judgment against Trump for defaming the writer E. Jean Carroll. But Trump was unable to obtain a bond large enough to cover the fraud judgment, even after approaching 30 companies. His lawyers said it was a “practical impossibility” in a filing. (Trump, ever helpful to his own defense, claimed on social media that he actually has more than $500 million in cash.)
The bond was due today, and Trump got his good news from the court just in time. It is a stay, or pause, not a permanent reduction. For now, the original judgment amount will still be due if Trump doesn’t win on appeal. Today’s outcome is neither a shock nor a travesty.
Offering temporary relief on the bond makes some sense. Imagine that the panel had not reduced the bond amount. Attorney General Letitia James could have started seizing his accounts or his properties, or else he would have been forced to start selling them. But this is a terrible moment to be selling commercial real estate, because the office market has not recovered from COVID. Beyond that, any buyers would know Trump was in a pinch and be happy to profiteer off him.
But then imagine that a few weeks from now, Trump won his appeal, convincing the court that Engoron’s finding was incorrect, or that the calculated amount of the penalty was unfair. Trump would have no way to recover the assets he’d been forced to unload at fire-sale prices. It doesn’t take any affection for Trump to see why a court would want to avoid such an outcome, and why—even if Trump would still be filthy rich—this would be unjust punishment.
The problem for Trump remains winning on appeal. He railed against Engoron in a statement and claimed that the judge was wrong on law, but legal experts told me that they thought Trump would struggle to win his appeal. Engoron’s decision was written in clear detail, as was his calculation of Trump’s penalty, which is based on how much ill-gotten gain Trump extracted from his fraud. “The judge here did a very good job,” Jim Wheaton, a law professor at William & Mary, told me. “Whether you agree or not, the judge very carefully made factual conclusions based on testimony in front of the judge. The judge made credibility decisions based on testimony of witnesses before him.”
Trump’s instinct for stalling the legal cases against him is pernicious. U.S. courts must find a way to balance the need for procedural protection with the principle that justice delayed is justice denied, and so far they have shown themselves ill-equipped; consider that the U.S. Supreme Court won’t even hear arguments about Trump’s immunity from criminal prosecution until a month from today. But forcing Trump to put a FOR SALE BY OWNER sign out in front of Trump Tower today wouldn’t serve justice, and might actually undermine it. As for Trump, he may just be delaying that outcome—but that’s another problem for him to try to wriggle, cat-like, out of on another day.
[ad_2]
David A. Graham
Source link
[ad_1]
February 1st was a big day in the City of Austin — a potential butterfly effect in the history of No Kill. While our city leadership is working to find solutions, there is much work to be done in the next six months and beyond in order to help us continue our forward movement as leaders in animal advocacy.
[ad_2]
Source link
[ad_1]
[ad_2]
[ad_1]
Kevin McCarthy began his 269th day as House speaker by recounting all the times he proved his doubters wrong. In January, after a series of humiliating defeats, the California Republican hung on to become speaker of the House. In the months since, he reminisced, he has narrowly averted the twin crises of a national-debt default and, this past weekend, a government shutdown. “I just don’t give up,” McCarthy told reporters after making one more plea to his party to keep him in his post.
Today, McCarthy’s streak of defying his skeptics came to an end as a group of his GOP critics joined Democrats to vote him out of the speakership after fewer than nine months in office. The unprecedented move could paralyze the House for days or even weeks, as Congress faces a November 17 deadline for funding the federal government.
Whether McCarthy is done for good as speaker remains unclear. The vote to remove him will trigger a new election, and McCarthy was coy with reporters earlier in the day about whether he’d try to reclaim the gavel. Assuming he doesn’t, his tenure atop the House—the briefest in nearly 150 years—was as historic as it was short-lived: He won the office after fighting through more ballots than any speaker in a century, and he was the first to be removed in the middle of a term by a vote of the House.
Few of McCarthy’s 54 predecessors had assumed the speakership with lower expectations. His years rising through the GOP leadership had left him with a reputation as a glad-handing lightweight with few convictions. And his majority seemed ungovernable from the start. He had just a five-vote margin over the Democrats, and was surrounded by hard-liners who demanded confrontation over compromise. McCarthy traded away much of his power as speaker during the marathon series of votes that ended, after 15 rounds, with his election. As part of the horse trade, McCarthy handed his Republican foes the means of his own destruction: the ability for a single member to call, at any time, a vote on whether to remove the speaker.
“From day one, he knew and everyone knew that he was living on borrowed time,” Representative Gerry Connolly of Virginia told me recently.
McCarthy’s most ardent Republican critic, Representative Matt Gaetz of Florida, had made the speaker’s ouster his singular mission even before McCarthy made a surprise reversal on Saturday to avert a government shutdown. Gaetz ultimately persuaded seven Republicans to join him in voting to remove McCarthy via a procedural maneuver known as a motion to vacate the chair.
Democrats faced their own conundrum: Was the speaker they knew a safer bet than a replacement they didn’t? Whichever Republican succeeds McCarthy is likely to be just as conservative and just as beholden to the hard-line faction that deposed him—if not more so. Yet Democrats ultimately decided that McCarthy was not worth rescuing; all 208 in attendance today voted to remove him.
The speaker had lurched to the right far more often than he governed from the center; he had joined the bulk of the GOP in forgiving former President Donald Trump for his role in fomenting the Capitol insurrection on January 6, 2021, and just a month ago buckled to conservative demands to launch an impeachment inquiry into President Joe Biden. “It is now the responsibility of the Republican members to end the House Republican Civil War,” the House minority leader, Representative Hakeem Jeffries of New York, declared after a lengthy Democratic Party conference this morning, urging members to support McCarthy’s removal as speaker.
In the end, McCarthy almost survived only because Democrats struggled to get their members to the Capitol in time for the crucial votes. McCarthy, however, had suffered too many Republican defections for it to matter. The process began with a vote on a motion to table Gaetz’s motion to vacate the chair. Eleven Republicans voted with the entire Democratic caucus to clear the way for McCarthy’s ouster, more than twice as many members as the speaker could afford to lose within his own party. “The office of speaker of the House of the United States House of Representatives is hereby declared vacant,” Representative Steve Womack of Arkansas, presiding over the vote, said after the 216–210 roll call concluded.
No obvious successor has emerged. McCarthy’s top lieutenant, Majority Leader Steve Scalise, is popular with conservatives but is now undergoing treatment for blood cancer. Majority Whip Tom Emmer or GOP Conference Chair Elise Stefanik could also emerge as alternatives, but neither has been openly campaigning for the job.
Ever the optimist in public, McCarthy seemed to sense before the votes that the run of good fortune and political survival that had taken him to the nation’s third-highest office would not last much longer. He had struck a defiant tone, defending to the end his decision to keep the government open even if it cost him his job. “If you throw out a speaker” for averting a government shutdown, he warned reporters and, implicitly, his Republican colleagues, “then I think we’re in a really bad place.”
[ad_2]
Russell Berman
Source link
[ad_1]
With most summer days reaching at least 90 degrees in Austin, Texas, Austin Pets Alive! is alerting pet owners to exercise caution on these hot days. Temperatures like these can be very dangerous for pets, especially dogs, leading to dehydration and in some cases, death.
As we moved into these summer months, be sure to follow these helpful pointers:
There are other summer heat tips that are less commonly heard about but are just as important such as supervising your pet in the pool. To avoid a dangerous situation, consider fencing off or covering your pool for when you aren’t home. Another tip to keep in mind is that when grooming your pet, avoid cutting their hair too short. Their fur helps combat sunburns and regulate body temperature. For these upcoming summer months, pet sunscreen is a great investment – we bet you didn’t know it was a thing!
Don’t have a pool for your water-loving dog? While Austin has plenty of bodies of water to explore, some may not be appropriate for your dog due to the toxic blue-green algae that has cropped up over the last few years. Make sure to familiarize yourself with the latest information here!
Dogs most susceptible to heatstroke are overweight dogs, dogs with long fur, short nose dogs, senior dogs, and those who have lung or breathing issues. It’s important to remember that dogs only sweat through their mouth, feet, and ears, which is why they suffer from heat exhaustion faster than humans. So, even though you may be tolerating the heat, your dog may be suffering.
To help keep pet safety top of mind at a popular Austin-outdoor fave location, we’ve posted signage around the trail looping Lady Bird Lake. Be on the lookout for those tips and warnings!
Austin Pets Alive! wants to keep all pet lovers informed and our furry friends safe from the Texas summer heat! Follow our friendly tips and refer back when needed for a fun, safe summer!
[ad_2]
[ad_1]
On the November morning when the sulfur burps began, Derron Borders was welcoming prospective students at the graduate school where he works in New York. Every few minutes, no matter how hard he tried to stop, another foul-smelling cloud escaped his mouth. “Burps that taste and smell like rotten eggs—I think that’s what I typed in Google,” he told me.
Eventually, Borders learned that his diabetes medication was to blame. Sulfur burps appear to be a somewhat rare side effect of semaglutide, tirzepatide, and other drugs in their class, known as GLP-1 receptor agonists. Over the past several years, these medications have become more popular under the brand names Ozempic, Wegovy, and Mounjaro, as a diabetes treatment and a weight-loss drug. And as prescription numbers rise, a strange and unpleasant side effect has been growing more apparent too.
GLP-1 receptor agonists are well known to cause gastrointestinal symptoms, including abdominal pain, diarrhea, and vomiting. In clinical trials of semaglutide for weight loss, 44 percent of participants experienced nausea and 31 percent had diarrhea. (The same conditions afflicted only about one-sixth of participants who received a placebo.) Burping, a.k.a. “eructation,” showed up in about 9 percent of those who got the drug, versus less than 1 percent of those who took a placebo. The FDA lists eructation as a possible side effect for semaglutide and tirzepatide alike.
But I couldn’t find any information in the clinical-trial reports or FDA fact sheets about sulfur burps in particular, and neither Novo Nordisk nor Eli Lilly, the companies that make these drugs, responded to my inquiries. Laura Davisson, the director of medical weight management at West Virginia University Health Sciences, told me that more than 1,000 of her clinic’s patients are currently on a GLP-1 receptor agonist, and about one-fifth experience sulfur burps at first. For all but a handful of these patients, she said, the issue goes away after a few months. Holly Lofton, an obesity-medicine specialist at NYU, guesses that it affects just 2 percent of her patients.
Experts aren’t sure why taking GLP-1 receptor agonists might lead to having smelly burps, but they have some theories. Davisson proposed that semaglutide boosts the number of bacteria in patients’ digestive tracts that produce hydrogen sulfide, a gas that can be expelled from either end of the digestive tract, and that smells (as Borders found) like rotten eggs. She also noted that the drugs slow down digestion, which could give the stomach more time to break down food and produce gas. In this situation, Lofton told me, the putrid air may escape most readily up through the mouth, because it’s lighter than the liquids and semi-solids that also fill the stomach. “Whatever’s on top will come up,” she said.
Eating more than usual while on the medications seems to be a common trigger. Davisson said that certain foods, such as dairy, may also lead to more odorous emissions. “Sometimes it’s a matter of trial and error,” she said. “Some tips that we give people are things like: Don’t eat really heavy meals; don’t eat large portions at once; don’t eat right before bed.” In addition to these behavioral approaches, Craig Gluckman, a gastroenterologist at UCLA Health, told me he recommends antacids and anti-gas medications to patients with GLP-1-agonist-related sulfur burps. (Online, apple-cider vinegar is commonly recommended as a fix, but Gluckman said he would not recommend it.)
The providers I spoke with said that, in general, patients tend to experience sulfur burps when they’re first starting an Ozempic-like drug, or raising their dose. That was the case for Crystal Garcia, an HR administrator in Texas who started taking semaglutide from a compounding pharmacy after her doctor told her she was prediabetic. (Garcia vlogs about her experience with weight-loss drugs.) Three months later, while out to breakfast at a restaurant, Garcia’s family started to complain about a gross and eggy smell. Garcia figured that the smell was coming from the food, but it lingered in the car after the meal. The family wondered whether Garcia’s young son had had an accident. “I was like, it could not be me. There’s no way,” she told me. But when she burped again, she was forced to change her mind.
Many patients are unaware that sulfur burps are a possible side effect of their medication until they start, well, burping sulfur. For a while, Borders had no idea that his diabetes medicine might be the culprit; when he saw a physician’s assistant to discuss his issue, “Ozempic didn’t even come up,” he said. The side effect is relatively new to physicians. Earlier GLP-1 agonists didn’t seem to produce sulfur burps so frequently, Lofton said. In her practice, the phenomenon wasn’t really apparent until Ozempic hit the American market in 2018, and even then, she learned about it only from her patients. “I’d never heard of sulfur burps before I started prescribing this medicine,” she said.
Though the sulfur burps are (physically) harmless, some patients do stop taking their diabetes or weight-loss drugs because of them, Lofton told me. But most, including Garcia and Borders, end up sticking with their program. As bad as the side effects may be, patients think the drugs’ benefits are worth it. “I have had a patient say that her burps smelled like poop,” Davisson said. But even then, she did not want to stop the medication.
[ad_2]
Rachel Gutman-Wei
Source link
[ad_1]
Imagine you need to send a letter. The mailbox is only two blocks away, but the task feels insurmountable. Air hunger seizes you whenever you walk, you’re plagued by dizziness and headaches, and anyway, you keep blanking on your zip code for the return address. So you sit in the kitchen, disheartened by the letter you can’t send, the deadlines you’ve missed, the commitments you’ve canceled. Months have passed since you got COVID. Weren’t you supposed to feel better by now?
Long COVID is a diverse and confusing condition, a new disease with an unclear prognosis, often-fluctuating symptoms, and a definition people still can’t agree on. And in many cases, it is disabling. In a recent survey, 1.6 percent of American adults said post-COVID symptoms limit their daily activities “a lot.” That degree of upheaval aligns with the Americans With Disabilities Act’s definition of disability: “a physical or mental impairment that substantially limits one or more major life activities.”
But for many people experiencing long COVID who were able-bodied before, describing themselves as “disabled” is proving to be a complicated decision. This country is not kind to disabled people: American culture and institutions tend to operate on the belief that a person’s worth derives from their productivity and physical or cognitive abilities. That ableism was particularly stark in the early months of the pandemic, when some states explicitly de-prioritized certain groups of disabled people for ventilators. Despite the passage of the ADA in 1990, disabled people still confront barriers accessing things such as jobs and health care, and even a meal with friends at a restaurant. Most of our cultural narratives cast disability as either a tribulation to overcome or a tragedy.
Consequently, incorporating disability into your identity can require a lot of reflection. Lizzie Jones, who finished her doctoral research in disability studies last year and now works for an educational consultancy, suffered a 30-foot fall that shattered half of her body a week before her college graduation. She told me that her accident prompted “radical identity shifts” as she transitioned from trying to get the life she’d imagined back on track to envisioning a new one.
These are the sorts of mindset changes that Ibrahim Rashid struggled with after contracting COVID in November 2020, when he was a graduate student. He dealt with debilitating symptoms for months, but even after applying for disability accommodations to finish his degree, he “was so scared of that word,” he told me. Rashid was afraid of people treating him differently and of losing his internship offer. Most terrifying, calling himself disabled felt like an admission that his long COVID wasn’t going to suddenly resolve.
Aaron Teasdale, an outdoors and travel writer and a mountaineer, has also been wrestling with identity questions since he got COVID in January 2022. For months, he spent most of his time in a remote-controlled bed, gazing out the window at the Montana forests he once skied. Although his fatigue is now slowly improving, he had to take Ritalin to speak with me. He was still figuring out what being disabled meant to him, whether it simply described his current condition or reflected some new, deeper part of himself—a reckoning made more difficult by the unknowability of his prognosis. “Maybe I just need more time before I say I’m a disabled person,“ he said. “When you have your greatest passions completely taken away from you, it does leave you questioning, Well, who am I?”
Long COVID can wax and wane, leaving people scrambling to adapt. It doesn’t mesh with the stereotype of disability as static, visible, and binary—the wheelchair user cast in opposition to the pedestrian. Nor does the fact that long COVID is often imperceptible in casual interactions, which forces long-haulers to contend with disclosure and the possibility of passing as able-bodied. One such long-hauler is Julia Moore Vogel, a program director at Scripps Research, who initially hesitated at the idea of getting a disabled-parking permit. “My first thought was, I’m not disabled, because I can walk,” she told me. But if she did walk, she’d be drained for days. Taking her daughter to the zoo or the beach was out of the question.
Once she got over her apprehension, identifying as disabled ended up feeling empowering. Getting that permit was “one of the best things I’ve done for myself,” Vogel told me. She could drive her kid to the playground, park nearby, and then sit and watch her play. After plenty of therapy and conversations with other disabled people, Rashid, too, came to embrace disability as part of his identity, so much so that he now speaks and writes about chronic illness.
Usually, the community around a disease—including advocacy among those it disables—arises after scientists name it. Long COVID upended that order, because the term first spread through hashtags and support groups in 2020. Instead of doctors informing patients of whether their symptoms fit a certain illness, patients were telling doctors what symptoms their illness entailed. And there were a lot of symptoms: everything from life-altering neurocognitive problems and dizziness to a mild, persistent cough.
As long-COVID networks blossomed online, members began seeking support from wider disability-rights communities, and contributing fresh energy and resources to those groups. People who’d fought similar battles for decades sometimes bristled at the greater political capital afforded to long-haulers, whose advocacy didn’t universally extend to other disabled people; for the most part, though, long-haulers were welcomed.
Tapping into conversations among disabled people “has shown me that I’m simply not alone,” Eris Eady, a writer and an artist who works for Planned Parenthood, told me. Eady, who is queer and Black, found that long COVID interplayed with struggles they already faced on account of their identity. So they sought advice from disabled Black women about interdependence, mutual aid, and accessibility, as well as about being dismissed by doctors, an experience more prevalent among women and people of color.
Disabled communities have years of experience supporting people through identity changes. The writer and disability-justice organizer Leah Lakshmi Piepzna-Samarasinha told me that when she was newly disabled, she was dogged with heavy questions: Am I going to be able to make a living? Am I datable? Her isolation and fear dissipated only when she met other young disabled people, who taught her how to be creative in “hacking the world.”
For long-haulers navigating these transitions for the first time, the process can be rocky. Rachel Robles, a contributor to The Long COVID Survival Guide, told me she spent her early months with long COVID “waking up every day and thinking, Okay, is this the day it’s left my body?” Conceiving of herself as disabled didn’t take away her long COVID. She didn’t stop seeing doctors and trying treatments. But thinking about accessibility did inspire her to return to gymnastics, which she’d quit decades earlier because of a heart condition. If she couldn’t lift her hands over her head sometimes, and if a dive roll would never be in her future, then so be it: Gymnastics could be about enjoying what her body could do, not yearning for what it couldn’t. Before she identified as disabled, returning to gymnastics “was something I would have never, ever imagined,” Robles said. And she never would have done it had she remained focused only on when she might recover.
Hoping for improvement is a natural response to illness, especially one with a trajectory as uncertain as long COVID’s. But focusing exclusively on relinquished past identities or unrealized future ones can dampen our curiosity about the present. A better way to think about it is “What are the things you can do with the body that you have, and what are the things you might not know you can do yet?” Piepzna-Samarasinha said. “Who am I right now?”
[ad_2]
Lindsay Ryan
Source link
[ad_1]
[ad_2]
[ad_1]
In the early days of the pandemic, one of the scariest and most surprising features of SARS-CoV-2 was its stealth. Initially assumed to transmit only from people who were actively sick—as its predecessor SARS-CoV did—the new coronavirus turned out to be a silent spreader, also spewing from the airways of people who were feeling just fine. After months of insisting that only the symptomatic had to mask, test, and isolate, officials scrambled to retool their guidance; singing, talking, laughing, even breathing in tight quarters were abruptly categorized as threats.
Three years later, the coronavirus is still silently spreading—but the fear of its covertness again seems gone. Enthusiasm for masking and testing has plummeted; isolation recommendations have been pared down, and may soon entirely disappear. “We’re just not communicating about asymptomatic transmission anymore,” says Saskia Popescu, an infectious-disease epidemiologist and infection-prevention expert at George Mason University. “People think, What’s the point? I feel fine.”
Although the concern over asymptomatic spread has dissipated, the threat itself has not. And even as our worries over the virus continue to shrink and be shunted aside, the virus—and the way it moves between us—is continuing to change. Which means that our best ideas for stopping its spread aren’t just getting forgotten; they’re going obsolete.
When SARS-CoV-2 was new to the world and hardly anyone had immunity, symptomless spread probably accounted for most of the virus’s spread—at least 50 percent or so, says Meagan Fitzpatrick, an infectious-disease transmission modeler at the University of Maryland’s School of Medicine. People wouldn’t start feeling sick until four, five, or six days, on average, after being infected. In the interim, the virus would be xeroxing itself at high speed in their airway, reaching potentially infectious levels a day or two before symptoms started. Silently infected people weren’t sneezing and coughing—symptoms that propel the virus more forcefully outward, increasing transmission efficiency. But at a time when tests were still scarce and slow to deliver results, not knowing they had the virus made them dangerous all the same. Precautionary tests were still scarce, or very slow to deliver results. So symptomless transmission became a norm, as did epic superspreading events.
Now, though, tests are more abundant, presymptomatic spread is a better-known danger, and repeated rounds of vaccination and infection have left behind layers of immunity. That protection, in particular, has slashed the severity and duration of acute symptoms, lowering the risk that people will end up in hospitals or morgues; it may even be chipping away at long COVID. At the same time, though, the addition of immunity has made the dynamics of symptomless transmission much more complex.
On an individual basis, at least, silent spread could be happening less often than it did before. One possible reason is that symptoms are now igniting sooner in people’s bodies, just three or so days, on average, after infection—a shift that roughly coincided with the rise of the first Omicron variant and could be a quirk of the virus itself. But Aubree Gordon, an infectious-disease epidemiologist at the University of Michigan, told me that faster-arriving sicknesses are probably being driven in part by speedier immune responses, primed by past exposures. That means that illness might now coincide with or even precede the peak of contagiousness, shortening the average period in which people spread the virus before they feel sick. In that one very specific sense, COVID could now be a touch more flulike. Presymptomatic transmission of the flu does seem to happen on occasion, says Seema Lakdawala, a virologist at Emory University. But in general, “people tend not to hit their highest viral levels until after they develop symptoms,” Gordon told me.
Coupled with more population-level immunity, this arrangement could be working in our favor. People might be less likely to pass the virus unwittingly to others. And thanks to the defenses we’ve collectively built up, the pathogen itself is also having more trouble exiting infected bodies and infiltrating new ones. That’s almost certainly part of the reason that this winter hasn’t been quite as bad as past ones have, COVID-wise, says Maia Majumder, an infectious-disease modeler at Harvard Medical School and Boston Children’s Hospital.
That said, a lot of people are still undoubtedly catching the coronavirus from people who aren’t feeling sick. Infection per infection, the risk of superspreading events might now be lower, but at the same time people have gotten chiller about socializing without masks and testing before gathering in groups—a behavioral change that’s bound to counteract at least some of the forward shift in symptoms. Presymptomatic spread might be less likely nowadays, but it’s nowhere near gone. Multiply a small amount of presymptomatic spread by a large number of cases, and that can still seed … another large number of cases.
There could be some newcomers to the pool of silent spreaders, too—those who are now transmitting the virus without ever developing symptoms at all. With people’s defenses higher than they were even a year and a half ago, infections that might have once been severe are now moderate or mild; ones that might have once been mild are now unnoticeable, says Seyed Moghadas, a computational epidemiologist at York University. At the same time, though, immunity has probably transformed some symptomless-yet-contagious infections into non-transmissible cases, or kept some people from getting infected at all. Milder cases are of course welcome, Fitzpatrick told me, but no one knows exactly what these changes add up to: Depending on the rate and degree of each of those shifts, totally asymptomatic transmission might now be more common, less common, or sort of a wash.
Better studies on transmission patterns would help cut through the muck; they’re just not really happening anymore. “To get this data, you need to have pretty good testing for surveillance purposes, and that basically has stopped,” says Yonatan Grad, an infectious-disease epidemiologist at Harvard’s School of Public Health.
Meanwhile, people are just straight-up testing less, and rarely reporting any of the results they get at home. For many months now, even some people who are testing have been seeing strings of negative results days into bona-fide cases of COVID—sometimes a week or more past when their symptoms start. That’s troubling on two counts: First, some legit COVID cases are probably getting missed, and keeping people from accessing test-dependent treatments such as Paxlovid. Second, the disparity muddles the start and end of isolation. Per CDC guidelines, people who don’t test positive until a few days into their illness should still count their first day of symptoms as Day 0 of isolation. But if symptoms might sometimes outpace contagiousness, “I think those positive tests should restart the isolation clock,” Popescu told me, or risk releasing people back into society too soon.
American testing guidelines, however, haven’t undergone a major overhaul in more than a year—right after Omicron blew across the nation, says Jessica Malaty Rivera, an infectious-disease epidemiologist at Boston Children’s Hospital. And even if the rules were to undergo a revamp, they wouldn’t necessarily guarantee more or better testing, which requires access and will. Testing programs have been winding down for many months; free diagnostics are once again growing scarce.
Through all of this, scientists and nonscientists alike are still wrestling with how to define silent infection in the first place. What counts as symptomless depends not just on biology, but behavior—and our vigilance. As worries over transmission continue to falter and fade, even mild infections may be mistaken for quiet ones, Grad told me, brushed off as allergies or stress. Biologically, the virus and the disease may not need to become that much more muted to spread with ease: Forgetting about silent spread may grease the wheels all on its own.
[ad_2]
Katherine J. Wu
Source link
[ad_1]
I am still afraid of catching COVID. As a young, healthy, bivalently boosted physician, I no longer worry that I’ll end up strapped to a ventilator, but it does seem plausible that even a mild case of the disease could shorten my life, or leave me with chronic fatigue, breathing trouble, and brain fog. Roughly one in 10 Americans appears to share my concern, including plenty of doctors. “We know many devastating symptoms can persist for months,” the physician Ezekiel Emanuel wrote this past May in The Washington Post. “Like everyone, I want this pandemic nightmare to be over. But I also desperately fear living a debilitated life of mental muddle or torpor.”
Recently, I’ve begun to think that our worries might be better placed. As the pandemic drags on, data have emerged to clarify the dangers posed by COVID across the weeks, months, and years that follow an infection. Taken together, their implications are surprising. Some people’s lives are devastated by long COVID; they’re trapped with perplexing symptoms that seem to persist indefinitely. For the majority of vaccinated people, however, the worst complications will not surface in the early phase of disease, when you’re first feeling feverish and stuffy, nor can the gravest risks be said to be “long term.” Rather, they emerge during the middle phase of post-infection, a stretch that lasts for about 12 weeks after you get sick. This period of time is so menacing, in fact, that it really ought to have its own, familiar name: medium COVID.
Just how much of a threat is medium COVID? The answer has been obscured, to some extent, by sloppy definitions. A lot of studies blend different, dire outcomes into a single giant bucket called “long COVID.” Illnesses arising in as few as four weeks, along with those that show up many months later, have been considered one and the same. The CDC, for instance, suggested in a study out last spring that one in five adults who get the virus will go on to suffer any of 26 medical complications, starting at least one month after infection, and extending up to one year. All of these are called “post-COVID conditions, or long COVID.” A series of influential analyses looking at U.S. veterans described an onslaught of new heart, kidney, and brain diseases (even among the vaccinated) across a similarly broad time span. The studies’ authors refer to these, grouped together, as “long COVID and its myriad complications.”
But the risks described above might well be most significant in just the first few weeks post-infection, and fade away as time goes on. When scientists analyzed Sweden’s national health registry, for example, they found that the chance of developing pulmonary embolism—an often deadly clot in the lungs—was a startling 32 times higher in the first month after testing positive for the virus; after that, it quickly diminished. The clots were only two times more common at 60 days after infection, and the effect was indistinguishable from baseline after three to four months. A post-infection risk of heart attack and stroke was also evident, and declined just as expeditiously. In July, U.K. epidemiologists corroborated the Swedish findings, showing that a heightened rate of cardiovascular disease among COVID patients could be detected up to 12 weeks after they got sick. Then the hazard went away.
This is all to be expected, given that other respiratory infections are known to cause a temporary spike in patients’ risk of cardiovascular events. Post-viral blood clots, heart attacks, and strokes tend to blow through like a summer storm. A very recent paper in the journal Circulation, also based on U.K. data, did find that COVID’s effects are longer-lasting, with a heightened chance of such events that lasts for almost one full year. But even in that study, the authors see the risk fall off most dramatically across the first two weeks. I’ve now read dozens of similar analyses, using data from many countries, that agree on this basic point: The greatest dangers lie in the weeks, not months, after a COVID infection.
Yet many have inferred that COVID’s dangers have no end. “What’s particularly alarming is that these are really life-long conditions,” Ziyad Al-Aly, the lead researcher on the veterans studies, told the Financial Times in August. A Cleveland Clinic cardiologist has suggested that catching SARS-CoV-2 might even become a greater contributor to cardiovascular disease than being a chronic smoker or having obesity. But if experts who hold this assumption are correct—and the mortal hazards of COVID really do persist for a lifetime (or even many months)—then it’s not yet visible at the health-system level. By the end of the Omicron surge last winter, one in four Americans—about 84 million people—had been newly infected with the coronavirus. This was on top of 103 million pre-Omicron infections. Yet six months after the surge ended, the number of adult emergency-room visits, outpatient appointments, and hospital admissions across the country were all slightly lower than they were at the same time in 2021, according to an industry report released last month. In fact, emergency-room visits and hospital admissions in 2021 and 2022 were lower than they’d been before the pandemic. In other words, a rising tide of long-COVID-related medical conditions, affecting nearly every organ system, is nowhere to be found.
If mild infections did routinely lead to fatal consequences at a delay of months or years, then we should see it in our death rates, too. The number of excess deaths in the U.S.—meaning those that have occured beyond historic norms—should still be going up, long after case rates fall. Yet excess deaths in the U.S. dropped to zero this past April, about two months after the end of the winter surge, and they have stayed relatively low ever since. Here, as around the world, overall mortality rates follow acute-infection rates, but only for a little while. A second wave of deaths—a long-COVID wave—never seems to break.
Even the most familiar maladies of “long COVID”—severe fatigue, cognitive difficulties, and breathing trouble—tend to be at their worst during the medium post-infection phase. An early analysis of symptom-tracking data from the U.K., the U.S., and Sweden found that the proportion of those experiencing COVID’s aftereffects decreased by 83 percent four to 12 weeks after illness started. The U.K. government also reported much higher rates of medium COVID, relative to long COVID: In its survey, 11 percent of people who caught the virus experienced lingering issues such as weakness, muscle aches, and loss of smell, but that rate had dropped to 3 percent by 12 weeks post-infection. The U.K. saw a slight decline in the number of people reporting such issues throughout the spring and summer; and a recent U.S. government survey found that about half of Americans who had experienced any COVID symptoms for three months or longer had already recovered.
This slow, steady resolution of symptoms fits with what we know about other post-infection syndromes. A survey of adolescents recovering from mononucleosis, which is caused by Epstein-Barr virus, found that 13 percent of subjects met criteria for chronic fatigue syndrome at six months, but that rate was nearly halved at one year, and nearly halved again at two. An examination of chronic fatigue after three different infections—EBV, Q fever, and Ross River virus—identified a similar pattern: frequent post-infection symptoms, which gradually decreased over months.
The pervasiveness of medium COVID does nothing to negate the reality of long COVID—a calamitous condition that can shatter people’s lives. Many long-haulers experience unremitting symptoms, and their cases can evolve into complex chronic syndromes like ME/CFS or dysautonomia. As a result, they may require specialized medical care, permanent work accommodations, and ongoing financial support. Recognizing the small chance of such tragic outcomes could well be enough to make some people try to avoid infection or reinfection with SARS-CoV-2 at all costs.
But if you’re like me, and trying to calibrate your behaviors to meet some personally acceptable level of COVID risk, then it helps to keep in mind the difference between the virus’s medium- and long-term complications. Medium COVID may be time-limited, but it is far from rare—and not always mild. It can mean a month or two of profound fatigue, crushing headaches, and vexing chest pain. It can lead to life-threatening medical complications. It needs recognition, research, and new treatments. For millions of people, medium COVID is as bad as it gets.
[ad_2]
Benjamin Mazer
Source link
[ad_1]
For about 60 years, health authorities in the United States have been championing a routine for at least some sector of the public: a yearly flu shot. That recommendation now applies to every American over the age of six months, and for many of us, flu vaccines have become a fixture of fall.
The logic of that timeline seems solid enough. A shot in the autumn preps the body for each winter’s circulating viral strains. But years into researching flu immunity, experts have yet to reach a consensus on the optimal time to receive the vaccine—or even the number of injections that should be doled out.
Each year, a new flu shot recipe debuts in the U.S. sometime around July or August, and according to the CDC the best time for most people to show up for an injection is about now: preferably no sooner than September, ideally no later than the end of October. Many health-care systems require their employees to get the shot in this time frame as well. But those who opt to follow the CDC current guidelines, as I recently did, then mention that fact in a forum frequented by a bunch of experts, as I also recently did, might rapidly hear that they’ve made a terrible, terrible choice.
“There’s no way I would do what you did,” one virologist texted me. “It’s poor advice to get the flu vaccine now.” Florian Krammer, a virologist at Mount Sinai’s Icahn School of Medicine, echoed that sentiment in a tweet: “I think it is too early to get a flu shot.” When I prodded other experts to share their scheduling preferences, I found that some are September shooters, but others won’t juice up till December or later. One vaccinologist I spoke with goes totally avant-garde, and nabs multiple doses a year.
There is definitely such a thing as getting a flu shot too early, as Helen Branswell has reported for Stat. After people get their vaccine, levels of antibodies rocket up, buoying protection against both infection and disease. But after only weeks, the number of those molecules begins to steadily tick downward, raising people’s risk of developing a symptomatic case of flu by about 6 to 18 percent, various studies have found. On average, people can expect that a good portion of their anti-flu antibodies “are meaningfully gone by about three or so months” after a shot, says Lauren Rodda, an immunologist at the University of Washington.
That decline is why some researchers, Krammer among them, think that September and even October shots could be premature, especially if flu activity peaks well after winter begins. In about three-quarters of the flu seasons from 1982 to 2020, the virus didn’t hit its apex until January or later. Krammer, for one, told me that he usually waits until at least late November to dose up. Stanley Plotkin, a 90-year-old vaccinologist and vaccine consultant, has a different solution. People in his age group—over 65—don’t respond as well to vaccines in general, and seem to lose protection more rapidly. So for the past several years, Plotkin has doubled up on flu shots, getting one sometime before Halloween and another in January, to ensure he’s chock-full of antibodies throughout the entire risky, wintry stretch. “The higher the titers,” or antibody levels, Plotkin told me, “the better the efficacy, so I’m trying to take advantage of that.” (He made clear to me that he wasn’t “making recommendations for the rest of the world”—just “playing the odds” given his age.)
Data on doubling up is quite sparse. But Ben Cowling, an epidemiologist and flu researcher at Hong Kong University, has been running a years-long study to figure out whether offering two vaccines a year, separated by roughly six months, could keep vulnerable people safe for longer. His target population is Hong Kongers, who often experience multiple annual flu peaks, one seeded by the Northern Hemisphere’s winter wave and another by the Southern Hemisphere’s. So far, “getting that second dose seems to give you additional protection,” Cowling told me, “and it seems like there’s no harm of getting vaccinated twice a year,” apart from the financial and logistical cost of a double rollout.
In the U.S., though, flu season is usually synonymous with winter. And the closer together two shots are given, the more blunted the effects of the second injection might be: People who are already bustling with antibodies may obliterate a second shot’s contents before the vaccine has a chance to teach immune cells anything new. That might be why several studies that have looked at double-dosing flu shots within weeks of each other “showed no benefit” in older people and certain immunocompromised groups, Poland told me. (One exception? Organ–transplant recipients. Kids getting their very first flu shot are also supposed to get two of them, four weeks apart.)
Even at the three-ish-month mark past vaccination, the body’s anti-flu defenses don’t reset to zero, Rodda told me. Shots shore up B cells and T cells, which can survive for many months or years in various anatomical nooks and crannies. Those arsenals are especially hefty in people who have banked a lifetime of exposures to flu viruses and vaccines, and they can guard people against severe disease, hospitalization, and death, even after an antibody surge has faded. A recent study found that vaccine protection against flu hospitalizations ebbed by less than 10 percent a month after people got their shot, though the rates among adults older than 65 were a smidge higher. Still other numbers barely noted any changes in post-vaccine safeguards against symptomatic flu cases of a range of severities, at least within the first few months. “I do think the best protection is within three months of vaccination,” Cowling told me. “But there’s still a good amount by six.”
For some young, healthy adults, a decent number of flu antibodies may actually stick around for more than a year. “You can test my blood right now,” Rodda told me. “I haven’t gotten vaccinated just yet this year, and I have detectable titers.” Ali Ellebedy, an immunologist at Washington University in St. Louis, told me he has found that some people who have regularly received flu vaccines have almost no antibody bump when they get a fresh shot: Their blood is already hopping with the molecules. Preexisting immunity also seems to be a big reason that nasal-spray-based flu vaccines don’t work terribly well in adults, whose airways have hosted far more flu viruses than children’s.
Getting a second flu shot in a single season is pretty unlikely to hurt. But Ellebedy compares it to taking out a second insurance policy on a car that’s rarely driven: likely of quite marginal benefit for most people. Plus, because it’s not a sanctioned flu-vaccine regimen, pharmacists might be reluctant to acquiesce, Poland pointed out. Double-dosing probably wouldn’t stand much of a chance as an official CDC recommendation, either. “We do a bad enough job,” Poland said, getting Americans to take even one dose a year.
That’s why the push to vaccinate in late summer and early fall is so essential for the single shot we currently have, says Huong McLean, a vaccine researcher at the Marshfield Clinic Research Institute in Wisconsin. “People get busy, and health systems are making sure that most people can get protected before the season starts,” she told me. Ellebedy, who’s usually a September vaccinator, told me he “doesn’t see the point of delaying vaccination for fear of having a lower antibody level in February.” Flu seasons are unpredictable, with some starting as early as October, and the viruses aren’t usually keen on giving their hosts a heads-up. That makes dillydallying a risk: Put the shot off till November or December, and “you might get infected in between,” Ellebedy said—or simply forget to make an appointment at all, especially as the holidays draw near.
In the future, improvements to flu-shot tech could help cleave off some of the ambiguity. Higher doses of vaccine, which are given to older people, could rile up the immune system to a greater degree; the same could be true for more provocative vaccines, made with ingredients called adjuvants that trip more of the body’s defensive sensors. Injections such as those seem to “maintain higher antibody titers year-round,” says Sophie Valkenburg, an immunologist at Hong Kong University and the University of Melbourne—a trend that Ellebedy attributes to the body investing more resources in training its fighters against what it perceives to be a larger threat. Such a switch would likely come with a cost, though, McLean said: Higher doses and adjuvants “also mean more adverse events, more reactions to the vaccine.”
For now, the only obvious choice, Rodda told me, is to “definitely get vaccinated this year.” After the past two flu seasons, one essentially absent and one super light, and with flu-vaccination rates still lackluster, Americans are more likely than not in immunity deficit. Flu-vaccination rates have also ticked downward since the coronavirus pandemic began, which means there may be an argument for erring on the early side this season, if only to ensure that people reinforce their defenses against severe disease, Rodda said. Plus, Australia’s recent flu season, often a bellwether for ours, arrived ahead of schedule.
Even so, people who vaccinate too early could end up sicker in late winter—in the same way that people who vaccinate too late could end up sicker now. Plotkin told me that staying apprised of the epidemiology helps: “If I heard influenza outbreaks were starting to occur now, I would go and get my first dose.” But timing remains a gamble, subject to the virus’s whims. Flu is ornery and unpredictable, and often unwilling to be forecasted at all.
[ad_2]
Katherine J. Wu
Source link
[ad_1]
In less than two weeks, you could walk out of a pharmacy with a next-generation COVID booster in your arm. Just a few days ago, the Biden administration indicated that the first updated COVID-19 vaccines would be available shortly after Labor Day to Americans 12 and older who have already had their primary series. Unlike the shots the U.S. has now, the new doses from Pfizer and Moderna will be bivalent, which means they’ll contain genetic material based both on the ancestral strain of the coronavirus and on two newer Omicron subvariants that are circulating in the U.S.
These shots’ new formulation promises some level of protection that simply hasn’t been possible with the original vaccines. “A bivalent vaccine will have some benefit for almost everybody who gets it,” Rishi Goel, an immunologist at the University of Pennsylvania, told me. “How much benefit that is, we’re still not exactly sure.” People who aren’t at high risk could end up only marginally more protected against severe outcomes, and no one thinks the shots will banish COVID infections for good. There is, however, a simple rule of thumb that nearly everyone can follow to maximize the uncertain gains from a shot: Wait three to six months from your last COVID infection or vaccination.
Put that rule into action, and it plays out a little differently, depending on your circumstances.
If you haven’t had COVID since about November 2021, the advantage of a bivalent booster over the original formula is obvious, and as long as you haven’t gotten boosted recently, there’s every reason to get the new one right away. (If you have been boosted in the past few months, your antibody levels are probably still too high for a new shot to do much for you.) Marion Pepper, an immunologist at the University of Washington, told me that Americans who have already gotten three or more doses “have probably maxed out the protective capacity” of the original shots. By contrast, the bivalent vaccines offer something new to those who have so far escaped Omicron: a lesson on the spike proteins of the BA.4 and BA.5 subvariants, which will help the immune system fight the real thing should it get into your body. “I’m just super excited to get the bivalent vaccine,” says Jenna Guthmiller, an immunologist at the University of Colorado who has not yet had COVID. “I think it’ll be really nice and ease my mind a little bit.”
Veterans of Omicron infections might still have something to gain from seeing the BA.4 and BA.5 spike proteins—especially if your goal is to avoid getting sick with COVID at all. Past a certain number of shots, boosters’ impact on your long-term protection against severe disease is unclear, Goel told me. Paul Offit, the director of the Vaccine Education Center at Children’s Hospital of Philadelphia, told me he doesn’t plan on getting a booster at all this fall because, after three vaccine doses and an infection, “I think I’m protected against serious illness.” But if you want to stave off infection, Goel said, “the bivalent vaccines, or really any variant-containing vaccines, have real value.” That’s because formulas based on a given variant have been shown to temporarily increase your stock of antibodies that target that variant.
How long that extra-protective state lasts, or whether it’s sufficient to prevent any infection whatsoever, is still a scientific puzzle. The original boosters were shown to increase antibody levels to a peak about two weeks after the shot, then decay steadily over the following three months. We don’t know yet whether a bivalent formula will change that timeline, Goel said.
But you can still use it to estimate approximately when your protection will be at its highest. You might, for example, choose to err on the early side of that three-to-six-month timeline if you have a particularly high-risk event coming up in the next few weeks. “If all we had was the original booster and I was going to an indoor wedding or something, I think it would be reasonable to get that booster,” Pepper said.
“You’re still riding the wave of antibodies that you generated as a result of that infection,” Guthmiller told me, so a shot won’t do much for you yet. That’s true regardless of which Omicron subvariant you might have been infected with, she said, because BA.2 infections have been shown to protect fairly well against today’s dominant strains, BA.4 and BA.5. (BA.2 became dominant in the United States back in March.) The severity of your illness doesn’t really matter either, Goel said. A higher fever and more intense cough might indicate that your immune system got extra revved up, he said, but they could just as easily mean that your body needs more help responding to the coronavirus. In either case, once a little more time has passed, getting the bivalent vaccine could help extend your body’s memory of its last COVID encounter, and keep infection at bay.
Certain groups of people should get any booster as soon as it’s available to them, the experts I spoke with emphasized to me: immunocompromised people, people over the age of 50 or so, and people with medical conditions that put them at high risk of severe disease. If you fall in one of these categories and haven’t received all the boosters you’re eligible for, “I wouldn’t wait for the bivalent,” Offit said. For people in these high-risk categories who have already gotten the recommended number of boosters, you should get the new one as soon as it’s available to you. (The FDA and CDC have not yet indicated whether they will recommend a waiting period between your most recent shot and the bivalent booster.) Goel recommended waiting at least a month after your most recent infection or shot, but if you’re very worried about your risk, you don’t need to stretch the delay to three months. Your body might still have extra antibodies floating around, but with no practical way to check at scale, “I’m honestly in favor of recommending boosting as a way to maximize individual benefit,” he said.
Waiting is always an option if you want to know more about how the bivalent vaccines perform. The FDA and CDC are set to green-light the shots based on human data from the existing boosters and other experimental bivalent boosters that didn’t make it to market in the U.S.—plus trials on the new formula in mice. Pfizer and Moderna simply haven’t progressed very far in their human trials. While there’s no reason to suspect that the new shots won’t be safe, Offit recommended opting for the original boosters until more safety and efficacy data are available, which could be as soon as a couple of months after the rollout—as long as the vaccine makers or the government collects that information and makes it public. But Guthmiller and Goel said they weren’t concerned about the lack of human data, and the bivalent shot is almost certainly the better bet.
There is one significant reason to avoid waiting too long for the bivalent shot: It offers the greatest protection against infection from the subvariants it’s actually designed around. BA.4 and BA.5 might be with us through the fall and winter—or they might give way to a different branch of Omicron, or even a variant that’s entirely unlike Omicron. You’d certainly be better off against this new variant with a bivalent booster than no booster at all. But if you want to maximize your anti-infection shield while you have it, consider putting it up against the enemy you know.
[ad_2]
Rachel Gutman-Wei
Source link
[ad_1]
With most summer days reaching at least 90 degrees in Austin, Texas, Austin Pets Alive! is alerting pet owners to exercise caution on these brutally hot days. Temperatures like these can be very dangerous for pets, especially dogs, leading to dehydration and in some cases, death.
As we ease into the summer months, be sure to follow these helpful pointers:
There are other summer heat tips that are less commonly heard about but are just as important such as supervising your pet in the pool. To avoid a dangerous situation, consider fencing off or covering your pool for when you aren’t home. Another tip to keep in mind is that when grooming your pet, avoid cutting their hair too short. Their fur helps combat sunburns and regulate body temperature. For these upcoming summer months, pet sunscreen is a great investment – we bet you didn’t know it was a thing!
Dogs most susceptible to heatstroke are overweight dogs, dogs with long fur, short nose dogs, senior dogs, and those who have lung or breathing issues. It’s important to remember that dogs only sweat through their mouth, feet, and ears, which is why they suffer from heat exhaustion faster than humans. So, even though you may be tolerating the heat, your dog may be suffering.
To help keep pet safety top of mind at a popular Austin-outdoor fave location, we’ve posted signage around the trail looping Lady Bird Lake. Thank you to Rocket Banners, a company that generously donated the print of these heat safety signs reminding trail-goers to keep their pets safe. Be on the lookout for those tips and warnings!
Austin Pets Alive! wants to keep all pet lovers informed and our furry friends safe from the ravaging heat! Follow our friendly tips and refer back when needed for a fun, safe summer!
We have an important PSA while we have your attention! While scooping the poop may not seem important, and at times pretty gross, it is crucial to the health and safety of our community. Just to put things into perspective, there are over 250,000 dogs in Austin, which in turn creates 150,000 pounds of poop per day. And now, more than ever before, we each have an obligation to care for, and look after, the health and safety of our neighbors and fellow Austinites. Click here to learn more!
[ad_2]
[ad_1]
We are so grateful to everyone who stepped up to foster one of the dogs or puppies who tested positive for distemper and needed immediate foster placement. Because of you, we exceeded our goal of finding 20 fosters and more than 150 people signed up to help, so we’re able to save even more lives than we imagined!
“I hadn’t planned to take on another foster for a few months, but this was too extreme of a situation to ignore. Goofy is an extremely cute dog, so I hope he will get adopted quickly,” said Cassie Swayze, one of the Austin fosters who answered APA!’s call. “Since the pandemic, APA! has made fostering super easy because you can do everything online! They also have a huge shed with tons of supplies like leashes, toys, beds, and crates.”
Goofy in his foster home with Cassie.
Gary in his foster home.
Another Austin resident who volunteered to foster one of the dogs recovering from distemper is Sierra Gonzales. She is fostering Gary and said, “I sleep better at night, knowing that I helped save his life. Gary is so playful and I like him so much.”
We would like to extend a huge shout-out to our local media partners who helped us get the word out immediately to as many people as possible, and special thanks to our colleagues at Bastrop Animal Services for working alongside us to get these dogs to safety. While this situation could have turned out very differently without the mutual collaboration of our two organizations, the compassionate team at Bastrop got to work to get them into foster homes and save their lives. We’re all in this together and we are so grateful for our partnership with them.
[ad_2]
[ad_1]
With most summer days reaching at least 90 degrees in Austin, Texas, Austin Pets Alive! is alerting pet owners to exercise caution on these brutally hot days. Temperatures like these can be very dangerous for pets, especially dogs, leading to dehydration and in some cases, death.
As we ease into the summer months, be sure to follow these helpful pointers:
There are other summer heat tips that are less commonly heard about but are just as important such as supervising your pet in the pool. To avoid a dangerous situation, consider fencing off or covering your pool for when you aren’t home. Another tip to keep in mind is that when grooming your pet, avoid cutting their hair too short. Their fur helps combat sunburns and regulate body temperature. For these upcoming summer months, pet sunscreen is a great investment – we bet you didn’t know it was a thing!
Dogs most susceptible to heatstroke are overweight dogs, dogs with long fur, short nose dogs, senior dogs, and those who have lung or breathing issues. It’s important to remember that dogs only sweat through their mouth, feet, and ears, which is why they suffer from heat exhaustion faster than humans. So, even though you may be tolerating the heat, your dog may be suffering.
To help keep pet safety top of mind at a popular Austin-outdoor fave location, we’ve posted signage around the trail looping Lady Bird Lake. Thank you to Rocket Banners, a company that generously donated the print of these heat safety signs reminding trail-goers to keep their pets safe. Be on the lookout for those tips and warnings!
Austin Pets Alive! wants to keep all pet lovers informed and our furry friends safe from the ravaging heat! Follow our friendly tips and refer back when needed for a fun, safe summer!
We have an important PSA while we have your attention! While scooping the poop may not seem important, and at times pretty gross, it is crucial to the health and safety of our community. Just to put things into perspective, there are over 250,000 dogs in Austin, which in turn creates 150,000 pounds of poop per day. And now, more than ever before, we each have an obligation to care for, and look after, the health and safety of our neighbors and fellow Austinites. Click here to learn more!
[ad_2]