Edmund Schweppe

It's done: Kevin McCarthy voted out as Speaker of the House
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Those of us who've been doing Zoom meetings for the past few years know the sensation of the speaker being on mute. This is, AFAICT, the first time a Speaker has been put on boot ...

The US government's free home COVID tests website is once again taking orders for no-cost, at-home COVID tests delivered via the US Mail. Each household in the US can order four more free rapid tests.

I put my order in today. According to the USPS, "Orders will ship free starting the week of October 2, 2023." There's also the following note regarding test expiration dates:

Tests may show "expired" dates on the box, but FDA has extended those dates; see the full list of extended expiration dates.

Presumably, that means they'll at least start by shipping more of what's already in stock, rather than wait for the new-build tests announced last week.

It stinks that we still need these; given the need, though, far better to have them than not.

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A big jump in COVID deaths compared to last week (29 vs 19); reported confirmed cases up slightly, but the test rate ticked up as well, so the percent-positive ratio actually dropped a bit. The current census of COVID patients in hospitals is up slightly, but the ICU population this week is more than double last week (39 vs. 19), and the total number of new hospitalizations is up almost 15%. At least the week-over-week MWRA wastewater numbers are down. On the other hand, there was a lot of rain in the Boston area late last week; since many of the MWRA cities and towns have combined sewer and storm drainage flowing out to Deer Island, I have to wonder how much of that decrease is due to dilution.

Once the news formally broke that the FDA and CDC had signed off on the latest COVID vaccines, I signed myself up for a booster at my more-or-less-local CVS. The appointment was early this evening, so I hied myself down at the appropriate time and presented myself at the vaccine check-in counter - only to be told that my health insurance wasn't covering the shot, and would I like to spend almost two hundred bucks out of pocket instead? According to the pharmacy tech, the insurers have yet to update their coverage files for the new vaccine. Left unexplained (because the tech had no information) was how CVS' online vaccination scheduling tool, which supposedly specifically checked my insurance status as part of the signup process, let me make the appointment in the first place.

Mumble, grumble, and whiskey tango foxtrot? I'll likely call the insurer on Monday and see if I can get an answer; I have a cynical suspicion, though, that much pointing of fingers and blaming someone else will ensue.

Anyway, I did not get vaccinated today. Which annoys me no end.

More thunderstorms this afternoon. Also, a fortunately brief loss of power; presumably one of the system's automatic transferring dinguses successfully transferred this time.

Many of the branches and trees downed by the Friday storms are still lying about, waiting to be collected. Not to mention all the pine cones that haven't been ground to mush by local traffic.

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Welp, that ain't good. Not yet horrible, perhaps, but definitely not good. Newly confirmed deaths are up by 50%. So are newly confirmed cases, even as tests dropped back below 20k per week; the percent-positive ratio is now over twelve percent. The current hospital census is up almost eleven percent from last week, while the number of new hospitalizations is up over twenty percent. And the MWRA wastewater numbers are up over forty percent from last week on the north side and nearly sixty percent on the south side.

In hopefully good news, a study at Beth Israel Deaconess Medical Center in Boston found that people's immune systems have as good (if not better) responses to the latest BA.2.86 variant than the other variants currently circulating:
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I was hoping that the CDC's new "weekly" CDC Respiratory Virus Updates page might include an update, but no such luck as of this posting.

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The good news (such as it is) is that there were fewer deaths this reporting period. Also, tests are up fractionally (although still far below the testing rate of April 2020). However, cases are also up, and the percent-positive ratio is now up to 11.39%, the highest reported since January 12 (when we were averaging four times as many tests per day). Hospitalization rates are also up, and the wastewater levels from both the north and south sides of the Massachusetts Water Resources Authority sewershed are both up compared to last week, not to mention way up compared to their June levels and way, way up from their all-time lows in previous Junes.

One other point in the wastewater numbers: back in April, the MWRA went from daily sample collecting to a three-day-per-week cycle. As of last Thursday (August 24), they've gone back to daily collections. I haven't seen any official announcement as to why.

Meanwhile, the Centers for Disease Control and Prevention have launched a new site, CDC Respiratory Virus Updates, in which "CDC is posting updates on the respiratory illness season here every week", apparently on Wednesdays. The first such update (last Wednesday) reported the initial risk assessment for the new BA.2.86 COVID variant; the second (yesterday) updated that risk assessment:
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The new variant hasn't officially been spotted in Massachusetts, and it's still very early days figuring out whether it'll be better or worse than any of the other variants floating around. On the other hand, the local trends are mostly going in the wrong directions anyway, even without this new variant. There's no need to panic - yet - but I can't say there's any basis for lowering one's guard.

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Newly reported deaths ticked up by one. Newly reported confirmed cases up nearly thirty percent, while newly reported tests are only up around ten percent; thus the percent-positive ratio has broken the ten-percent mark for the first time since January 19, when it was reported at 10.86%. The current hospitalization count is up to three hundred, the highest level reported since April 6.

At least the MWRA wastewater levels haven't been showing big jumps over the last couple of weeks. And the absolute numbers of hospitalizations and deaths are still low compared to previous surges. But a percent-positive ratio over ten percent and climbing is bad news.

Former President Donald J. Trump was indicted for the fourth time last night; this time in Fulton County, Georgia, along with eighteen other named co-conspirators:
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The indictment covers ninety-eight pages, nineteen defendants, and forty-one separate counts starting with violations of the Georgia state Racketeer Influenced and Corrupt Organizations Act. That first RICO count alleges one hundred sixty one separate and distinct criminal acts in furtherance of the conspiracy to overturn the results of the 2020 Presidential election.

That's four indictments, in four separate courts, in three states and the District of Columbia, in less than five months.

Way to go, Donnie.

In today's Boston Globe, an op-ed piece by Dr. Jerome Adams: Ignoring COVID-19 is still not an option for most Americans
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I'm glad to see somebody in public health calling out that ridiculous op-ed by Dr. Ashish Jha claiming that we can now ignore COVID. And goodness knows health equity is a huge problem in these United States. But Dr. Adams makes no mention of masking, ventilation improvements, or even air monitoring.

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Oh, joy. Confirmed deaths actually up this week, along with confirmed cases and hospitalizations. (At least the number of tests also climbed - barely - compared to last week.) The percent-positive rate also rose, now up to 7.76% (the first time over seven percent since February 20). And the MWRA wastewater levels are up again compared to last week.

Just like last week, the absolute numbers aren't at all terrible. But the case counts dramatically underestimate the actual prevalence of COVID around here, and the trends are in the wrong direction.

Hey, I scooped the Boston Globe! Back on Thursday, I noted that not only were the MWRA COVID-19 wastewater levels trending upward, but that the state's COVID hospitalization counts were rising. Today, the Globe (finally) noticed the same thing:

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I suppose I should be glad that I'm not the only one unsure of the future. But I sure as hell don't have good feelings about the fall and winter ...

Dr. Aahish Jha, the former White House COVID-19 Coordinator who left that position back in June, has an op-ed in today's Boston Globe: With a few basic steps, most of us can finally ignore COVID

I am ... not at all convinced by his arguments. Specifically, his discussion of long COVID:

What about long COVID? The evidence here is reassuring as well. Those who are up to date on their vaccines are far less likely to get long COVID, and when they do, it tends to be shorter-lived and less severe. And treatments may help reduce it too. For now, there is no foolproof way of avoiding long COVID short of avoiding infections altogether. But you can substantially reduce your risk with vaccines and, likely, treatments.

Long COVID, at this point, is the thing I'm most worried about. I would dearly, dearly like to see Dr. Jha's evidence that the current vaccines protect against long COVID, especially given that they don't give great protection against infection in the first place. Unfortunately, the publicly reported evidence I have seen is both (a) sparse and (b) wildly uncertain. 15%? 80%? More? Less? Who knows?

And as for treatments? Last I heard, Paxlovid and metformin both had some effect (twenty to thirty percent less likely, compared to nothing), but I've yet to hear of any treatment that definitively prevented folks with COVID infections from progressing to long COVID.

Huge disclaimer here: I'm not a medical professional of any sort. I'm just this guy who really, really doesn't want long COVID, and would really, really, really like to see some solid evidence that long COVID was no threat to me. I still haven't seen anything resembling such evidence.

I cannot tell for certain that Dr. Jha is wrong, here. However, I equally cannot tell that he is correct.

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The good news is that overall deaths are still low and hospitalizations are dropping; in fact, for the first time since the pandemic started, the state is reporting zero intubated COVID patients.

The bad news is that, even as test rates continue to slowly decay away, the case rates actually rose (up 14% from last week), and the percent-positive ratio leapt over a full percentage point, from 4.78% last week to 5.83% this week. And the Massachusetts Water Resources Authority wastewater averages are both up over three hundred copies per milliliter again. Even the Boston Globe noticed:
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Yes, those wastewater numbers dropped below one hundred very briefly back in late June. Yes, there's a whole lot of noise in these numbers. And yes, the experts quoted in the Globe story aren't ready to sound any alarms.

But the trend over the last month is pretty clearly upward, which bodes ill for the future.

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Not horrible numbers in absolute terms. Deaths are up from last week but are still less than ten a week. Cases are up while tests continue to drop, which is not encouraging at all; on the other hand, hospitalizations are down slightly.

MWRA wastewater levels are mixed compared to last week (northside up, southside down) but are up on both sides compared to two weeks ago (and way, way above the lows from two years ago). The state's wastewater dashboard hasn't picked up the July 11 MWRA readings, though, and they're both in the high three-hundreds (rather than the low one-hundreds from late June). That bodes ... poorly ... for upcoming weeks.