35 Comments

Thank you, Ryan, for another information-filled Covid round-up, and thank you particularly for raising every possible alarm bell about RFK, Jr. I want also to lift up an important observation you made at the outset of today’s round-up: “Nonetheless, we suffered. It was a collective trauma. But be aware if you feel it — that legacy of bitterness and distrust is now a major political force.” This has been much on my mind, as I watch how things are unfolding now—as I said to a couple friends who joined us for Thanksgiving, I think we underestimate the cascade of impacts, psychological as well as physical, that have led us to this moment (which you describe perfectly, to my mind). Not at all easy to overcome, but we must somehow try.

Last, but very much not least, the watercolor is utterly gorgeous.

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Hi Susan - I'm hoping we can continue to find common ground with others who are frustrated, scared, and resentful at the way things are going in this country and world. Otherwise the harnessing of resentment and anger and loss of trust is a powerful weapon, to be turned on "the enemy within." You are so right about both the psychological and physical cascades... so much of this has been cycling towards the present moment for decades now.

Compliment passed on to the artist, who is smiling ear to ear ;)

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Thank you Ryan for being a light in the wildness, always. I'm saving this to reread more carefully.

I agree with Susan that we've all been through a collective trauma and it hasn't really been processed or acknowledged--the fact that you still acknowledge that Covid is here to stay helps me process and move forward.

As I also struggle to process the current challenges in our country, your brave voice is so important and helpful. (I'm hoping the worse don't make it through confirmation process and that ironically, the drug lobby is in alignment with me currently...)

I do hope the near and dear to you are well and please tell the 13 year old artist that her beautiful watercolors are very appreciated.

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Thank you Jan! Yes, this disruptive force (cataclysmic perhaps a better word) running through the world has really shifted some alliances and created strange coalitions. I just started listening to an audiobook called "Nexus" by Yuval Noah Harari. It is an excellent read so far and builds upon his previous brilliant book "Sapiens" and "Home Deus."

Right now he is talking about the power of information networks, with truth and order competing for dominance. Right now we are being fed lies and distorted stories that have people falling in step in a dangerous march. highly recommended, and thank you for the artistry compliments, she was very happy to hear them!

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She’s very talented! Thanks for the book recommendation— the truth is hard to find right now. So trusted messengers like you are even more important.

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Thank you for this. It is getting harder and harder to find any information about Covid at all, at least in Canada.

The trauma aspect is indeed important. I think that’s why people mock those who mask and/or take other precautions. They don’t want to be reminded of what we all went through and how frightening it was. When I look back, a lot of what we went through seems almost unreal.

So glad to see that you are on Bluesky. I quit twitter over a year ago and haven’t missed the craziness, but I’m happy that more and more former twitter contacts have made the leap.

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Hi Catherine - I definitely agree with you. I don't want to be reminded of the pandemic and the virus any more than the mask haters who want to ban them. The world is pressing on with it's collective fictions the way it always does, and that keeps the human world going... but collective fictions built on non-truths eventually crumble or produce massive harm... I hope that we are able to balance truth, trauma processing, compassion, and clear eyed science. Most people can't, and political leaders know this. Certain ones exploit this to the extreme of fascism.

See you over at Bluesky! Not that I'll have much time, as I still like this Substack space best :)

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I shared this on Bluesky and Facebook.

The artwork is a joy to behold.

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Thank you Mim, good to overlap with you in two places now!

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Thank you as always. I am beginning to read articles by medical doctors saying that the Covid vaccine isn't needed, etc. We want to forget this pandemic ever happened but that will not help as we begin to confront a new one. I was so glad Covid cases were low last week--we had 20 people for Thanksgiving and this is the first year I did not require testing (we even had an anti-vaxxer there!) So far everyone is good -- I am in a Project PROTECTS study and have tested for Covid, influenza and RSV for a week after. RFK, Jr scares the sh*t out of me.

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That's great Donna! For those of us who have been cautious, getting together like old times can be ecstatic! We did the same, although we are paying the price as some people traveled by plane and did not wear masks. You can lead a horse to water...

Anyway, the project Protects sounds interesting, will look into that. I always thank people in trials and studies for their service, so thanks for yours.

Many of my older patients in particular are feeling quite concerned about the state of vaccines and medications, from new rules to tariffs and trade wars compromising their medications. It's a connected world, and you can't disconnect suddenly. You can, but find out...

I try to rely on studies in this newsletter, because truth gleaned from science is the best chance we've got. Stories and anecdotes and correlations often mislead us.

Take care out there!

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And yes we had an anti-vaxxer -- a friend of a friend and her son. It was Thanksgiving so I did not want to be unkind (and I do kind of know her). I hope you have dodged Covid!

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Thank you for such a succinct explanation of the current state of Covidlandia! And as a beginner watercolorist myself, may I say that the 13 year old artist is very talented!!

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Thanks Patti! Maybe I'll have the artist in residence lead a zoom watercolor class ;) Her grandmother has taught her well. Both are very talented I agree. Thanks for stopping in.

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Thank you — and I am gutted that these political decisions are going to make it even more difficult for medical professionals, such as yourself.

It’s a poor repayment for everyone who has stayed, putting themselves on the line, after years and years of hardship, for the benefit of the whole.

Thank you for staying, and for speaking up.

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Thank you Erin, that means a lot. On a MUCH smaller scale, I can understand how soldiers coming home from unpopular wars often felt discarded, shunned, and even shamed. My uncle felt this way after Vietnam to some degree I've heard him say. It felt like a war for a while, and everyone wants to forget. Us too, minus forgetting the lessons and the real story when we want to reckon with it.

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Ryan, you are a voice of sanity in insane times; you're a voice of reason contending against unreasonable opponents; you're a voice of science in an increasingly anti-science America. Keep it up!

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Thanks Michael! I don't think voices like mine would have stood out as much without all the misleading stuff. Will keep following all this with you :)

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Nice job Ryan and you're welcome. ;~)

Like you, I plan to keep on writing but it was a struggle for a while, I won't lie.

PS Send that kid to University of Pennsylvania. https://www.niche.com/colleges/search/best-colleges-for-art/

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Thanks again KB - and yes, UPENN is amazing. I did not know it was ranked in terms of art. Might be too close to our backyard and quite a competitive school. Anything with B. Franklin's hand in it usually does well over the centuries though!

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Thank-you for your information. Since moving to Massachusetts, I am, unfortunately, no longer your patient. I don't believe that my PCP is as up to date on Covid as you are. It seems as if everyone wants to just ignore the whole thing and pretend that it is no longer a problem. I had a knee replacement in January and was doing very well until 6 months later when I had a mild case of Covid ( first time). I developed joint pain in the new knee that is still there. Everything else has been ruled out. I had not pain previous to that even when riding a bike for 40 miles. I call it my Covid knee. I really hope this is temporary!

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Hi Patricia, we miss seeing you ;) thanks for the update, and why not add Covid knee to the list of post-Covid conditions that now totals in the hundreds. I sincerely hope it improves and that you are doing well in MA. Love Boston, among other parts of the state. Take care and keep in touch.

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Love your Covidlandia posts, Doc. Thank you for all the work and care you put into them. That watercolor is truly stunning. It made me feel so at peace. Please pass my appreciation to the artist.

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Your posts are a great read always. The watercolor was really stunning to me, and that yellow color at the end of the day is peaceful I agree. I couldn't place why I felt moved by it, but I think you've named it. Appreciation extended to the artist!

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Thank you, Ryan, for the comprehensive and timely update on Covidland. A good reminder to continue to take precautions during my occasional forays to the outside world. I do not understand the hubris of people like Kennedy, more so when they come from the rich and privileged cohorts of society, but perhaps “that” is the problem; wealth and privilege do not necessarily equate with thoughtfulness and compassion. And now, dare I mention “bird flu”? The artist’s work is beautiful and much appreciated.

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Hi Mary, good points. I do feel a certain sorrow and pity if you will for any Kennedy of his generation, especially after the unthinkable assassination of a father. I wish his passion and righteousness could have been channeled into the scientific, and away from the pseudoscientific. We need fighters for people, they just have to be well informed, or at least stay in their lanes if trained as lawyers not public health officials/doctors/researchers. Glad you liked the art too!

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Excellent recap and info on updated data. You’re one of my first go-to’s, Ryan, for intelligent and research-based info. Thank you.

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Thanks Roseanne, will keep striving for that.

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Great art - commend the artist for me, please. And a great update, thanks.

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Really appreciate your graphs and research, thanks!

I'm a bit confused with Bobby 'The Needle' Kennedy's ca ca here. What am I missing?

1-In May 2020 we didn't know much of anything about vaccine and were still learning about Covid, monkey studies are not dispositive (assuming there are some this guy is a reflex liar). 2-If the vaccine reduces symptoms (such as viral projectiles via cough sneeze), reduces time contagious via reduced length of infection, reduces viral load and thus level of contagiousness, how can it NOT reduce transmission? 3-If the vaccine means in some instances I do not get infected after an exposure, that by definition reduces transmission. THUS what I find most disturbing about this clown's statements is that A-he is never wrong and just starts making up lies to justify his position B-changes the topic-discussion to avoid addressing anything directly C-cloaks it all in a cape of helping-protecting others, such as being honest with the public when this POS is incapable of saying anything with honesty. Just like the Covid-vax deniers who got infected and died, maybe his acolytes will get to enjoy the consequences of his 'wisdom' as he endangers us citizens?

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Sound analysis, and logical statements. Binary thinking always gets the mind in trouble. Vaccines have reduced transmission in the ways you have mentioned, though they are certainly not foolproof firewalls, rather part of the layered approach. As I keep reading and highlighting, even in 2024 there is short/medium term benefit over risk, in terms of vaccine effectiveness (see ~40% VE in the study quoted this month, the 50-70% VE of last years shot depending on the study) we will never get to 100%. That doesn’t mean they don’t work period. Binary. Absolutist. Misleading.

Thanks for your thoughts 🤜🤛

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As a person with a primary immunodeficiency, I don't have the luxury of pretending covid isn't a problem. I really appreciate the time you take to put together these updates. Your work and your voice are needed more than ever!

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