Bird Flu spreads to cats, concern for human infections heighten


So far, 43 types of mammals have tested positive for bird flu in the U.S.


Lazy cat
The bird flu cases are rising in cats. A pet from the Champaign-Urbana area was recently diagnosed infected with the virus.
Photo: Annette Meyer/Pixabay

(Urbana) - A growing number of cases of H5N1 avian influenza, commonly known as bird flu, have been detected in domestic cats across the United States, raising concerns about its potential transmission to humans. Veterinary experts and public health officials are warning pet owners to be vigilant as the virus spreads across multiple states and is linked to contaminated food sources.

Dr. Leyi Wang, a virologist and professor of veterinary medicine at the University of Illinois Urbana-Champaign, recently confirmed the presence of H5N1 in a cat at the university’s Veterinary Diagnostic Laboratory. The U.S. Department of Agriculture (USDA) has reported 130 cases of bird flu in domestic cats, spanning 23 states, including Illinois. Since 2022, 126 domestic cats have been infected, with around half of those cases occurring in 2024. Many cats were exposed through contaminated food or raw milk.

Lethality and Transmission Risk
"Bird flu H5N1 infections in cats are usually serious and life-threatening, with a high mortality rate. Infected cats show severe clinical signs such as lethargy, fever, loss of appetite, difficulty breathing, discharge from the eyes and nose, and neurological issues like tremors, seizures, incoordination or blindness," Wang explains. "Domestic cats are companion animals and have close contact with humans, potentially transmitting viruses to owners. A previous report revealed a cat-to-human transmission of influenza A virus, so H5N1 transmission might be possible as well."


Infections have been reported most often after prolonged and unprotected exposure to an infected animal.

Although no confirmed cases of cat-to-human transmission of H5N1 have been recorded in the current outbreak, Wang and other experts warn that as the virus circulates in mammals, the risk of mutation increases. "Previously, H5N1 had limited infection in mammals. However, the new H5N1 involved in outbreaks since 2022 mutated and acquired the capability to infect different mammal species including domestic and wild cats. So far, 43 types of mammals have tested positive for bird flu in the U.S., with domestic cats being the highest number," Wang says.

Pathways of Infection
The Centers for Disease Control and Prevention (CDC) states that people can be infected with avian influenza viruses through contact with infected wild, stray, feral, or domestic animals. Infections have been reported most often after prolonged and unprotected exposure to an infected animal. The CDC has previously documented avian influenza transmission from mammals to humans in the U.S., including a case involving a cat in New York City in 2016 and a cow in 2024.

The virus has been detected in poultry and cattle, allowing it to enter the raw food supply. Concerns over food contamination led the U.S. Food and Drug Administration (FDA) to recall Savage Cat Food Large Chicken Boxes (84 ounces) and Small Chicken Boxes (21 ounces) due to the potential presence of H5N1. These products, with a “better if used by” date of November 15, 2026, were distributed in multiple states, including Arizona, California, Colorado, Maryland, New York, and Pennsylvania.

Pet owners who have fed their cats the recalled products should watch for symptoms of bird flu, including fever, lethargy, loss of appetite, reddened or inflamed eyes, nasal and eye discharge, difficulty breathing, and neurological signs such as tremors, seizures, or blindness. If a cat exhibits these symptoms, immediate veterinary attention is advised.

Public Health Concerns
Public health experts fear that as H5N1 spreads among mammals, the likelihood of a pandemic increases. The New York Times recently reported that domestic cats could serve as a critical pathway for the virus to evolve and potentially become more transmissible to humans. If the virus mutates or swaps genes with another flu virus, it could pose a greater threat to human populations.

"If you work with animals, wash your hands well after interacting with poultry, livestock or animals outside the household. I also would suggest changing clothing and shoes after interacting with animals or birds with unknown health status, before interacting with your own pets," Wang advised.

Prevention and Protection
With no available vaccine or antiviral treatment for H5N1 in cats, prevention is key. Experts recommend keeping cats indoors to limit exposure to infected birds and wildlife. Pet owners should also avoid feeding raw meat or raw milk to their pets and ensure they do not come into contact with potentially contaminated food sources.

Wang stresses the importance of vigilance among pet owners. "Cat owners should contact their veterinarians if they are concerned their pet has contracted bird flu. Tell the veterinarian if your pet has been exposed to raw meat, raw milk, backyard birds or wild waterfowl. Unfortunately, only supportive care is available for cats with bird flu, and no antiviral drugs are yet available."

Beyond pet care, experts urge the public to remain cautious when handling animals and animal products. Personal protective equipment (PPE) is recommended for veterinarians and those working closely with animals at risk of infection.


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Respiratory illnesses being seen by hospitals, health care providers on the increase

by Matt Sheehan
OSF Healthcare

PEORIA - Respiratory illnesses like influenza, COVID-19 and respiratory syncytial virus (RSV) are leading to many people being seriously ill, overwhelming hospitals and health care providers across Illinois.

Flu remains the dominant virus
“We're seeing a lot of patients be positive with the flu. It makes you feel really bad with headache, body aches, chills, cough and fevers to name a few,” says Sarah Overton, chief nursing officer of OSF Medical Group, Home Care and Employee Health. “But we're also seeing some COVID-19 and RSV. RSV attacks very young children and older adults."

Sarah Overton from OSF Healthcare
Photo provided

Sarah Overton
OSF Medical Group, Home Care and Employee Health


All the viruses spiking at the same time have been "somewhat crippling" for healthcare providers, Overton says OSF HealthCare hospitals are seeing high inpatients counts, with many people coming in sick with respiratory illnesses through the emergency department.

Across Illinois, nearly 20% of emergency department visits were for acute respiratory illness, according to the Illinois Department of Public Health (IDPH). 7.8% of those visits are attributed to patients with the flu.

"From Chicago and Rockford down to Alton, we're seeing a large number of respiratory illnesses. And I think the country is seeing it overall," Overton says. "The SIREN notifications from the IDPH show that other health systems in Illinois, not just OSF, are seeing this."

Illinois’ respiratory activity level, calculated by the Centers for Disease Control and Prevention (CDC) moved up to High in late December, dipped to Moderate in January, and has now returned to High to start February.

“These viruses can kill”
The IDPH has reported five flu deaths this respiratory illness season. Along with three people dying from RSV, and one person dying from RSV and COVID-19.

"There's a little bit of complacency or feeling like the COVID-19 pandemic is done. But these viruses can kill, and they can lead to major medical complications and hospital admissions. I've talked to some of my colleagues who are the nursing leaders in the hospitals, and patients coming in are indeed sick. If you can manage at home, we recommend you do so," Overton says.

For those who are immunocompromised or chronically ill, Overton says you should consult with a medical professional in person if you are sick, but if you’re a fairly healthy individual who is mildly ill, consider staying home and rest. OSF Medical Group and OSF OnCall offer Urgent Care services for many outpatient appointments, including visits with primary care providers and specialists.

For those caring for themselves at home, there are several over-the-counter medications to help alleviate symptoms. Additionally, a health care provider may prescribe antiviral medication.

“Antiviral medication is most effective is initiated less than 48 hours after your symptoms begin,” says IDPH Director Dr. Sameer Vohra.

Flu vaccine rates down
"We've got ample flu vaccine. We are behind our influenza vaccine rates of where we've been in years past," Overton says. "It's not too late to get your flu shot, it's not too late to get your pneumonia shot. If you get it at a retail pharmacy, that's great. You can also get it at OSF or another healthcare provider. We just want you to get vaccinated.”

Flu vaccines are offered at OSF primary care and many medical specialty offices, along with commercial pharmacies. The CDC’s Flu Vaccine Finder allows you to type in your zip code and find options closest to you. Overton also recommends speaking with your healthcare provider about the recently-approved RSV vaccine available for some.

Respiratory illnesses impacting care teams
"Unfortunately, we have had some experiences with respiratory illnesses in our staff," Overton says. "We need to do everything we can to protect them. OSF Mission Partners (employees) have started masking in those areas we know exposure is likely." Respiratory cough stations with hand sanitizer, tissues and masks are available at all OSF facilities.

How health systems being overloaded impacts patients
"When we overwhelm the health system, it could lead to delays in other critical illnesses that need to come to the emergency room or urgent care to receive adequate management," Overton says.

To protect yourself and others, Overton recommends regularly washing and sanitizing your hands. Also make sure to cover your cough to decrease the spread of respiratory droplets, which is a major way the flu and other respiratory illnesses spread.

When to head to the emergency department
“Those hallmark signs of when to see care is when a fever isn't responding to medications after 24-48 hours. Or when you’re extremely uncomfortable and experiencing respiratory impacts like shortness of breath that you are struggling to breathe,” Overton says.

Warning signs look different for kids and adults. The CDC breaks down symptoms to keep a close eye on:

In children
  • Fast breathing or trouble breathing
  • Bluish lips or face
  • Ribs pulling in with each breath
  • Chest pain
  • Severe muscle pain (child refuses to walk)
  • Dehydration (no urine for 8 hours, dry mouth, no tears when crying)
  • Not alert or interacting when awake
  • Seizures
  • Fever above 104 degrees Fahrenheit that is not controlled by fever-reducing medicine
  • In children younger than 12 weeks, any fever
  • Fever or cough that improve but then return or worsen
  • Worsening of chronic medical conditions

In adults
  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest or abdomen
  • Persistent dizziness, confusion, inability to arouse
  • Seizures
  • Not urinating
  • Severe muscle pain
  • Severe weakness or unsteadiness
  • Fever or cough that improve but then return or worsen


How to discuss getting vaccinated with family and friends


Focus on the facts. For certain people, the risk of serious respiratory illness remains high. These include adults ages 65 and older, residents of long-term care facilities, pregnant people, people with certain health conditions and those living in rural areas.

Family Features - During the fall and winter months, respiratory infections such as flu, COVID-19 and RSV can surge. People who are vaccinated lower their risk of getting seriously ill and needing medical care if they get infected.

About 70% of adults in the United States said they probably or definitely will get a flu shot, and more than 50% said they probably or definitely will get an updated COVID-19 vaccine. While many people are ready to get this season's vaccines, others might still have questions.


Photos courtesy USDHHS

"It is normal for people to have questions about vaccines," said Peter Marks, MD, PhD, director of the U.S. Food and Drug Administration's Center for Biologics Evaluation and Research, which oversees and reviews vaccine clinical trials. "It's important for everyone to know that all vaccines go through extensive testing before they are approved and that following approval, they are carefully monitored to identify any safety concerns so that they can be addressed quickly. Hundreds of thousands of volunteers have taken part in respiratory vaccine trials. The results tell us that these vaccines are safe and effective in preventing severe disease caused by flu, COVID-19 and RSV."

Here are some ways to talk about the importance of this season's vaccines with a family member or friend who is unsure about getting vaccinated.


Hear them out. When talking about vaccination, it's important to make others feel heard. There are many reasons why people may have questions and concerns about vaccines or even the health care system in general. Listen to their thinking and try not to judge. They want to know their thoughts and feelings matter.

Focus on the facts. Instead of calling out vaccine myths, focus on vaccine truths. Concentrating on myths can cause them to become the topic of your conversation. Instead, speak about the benefits of vaccines. For instance, you can mention vaccines cut your risk of being hospitalized for flu or COVID-19 by about half.

Ask if they need help getting vaccinated. Sometimes, people just need some help to find, schedule and get a vaccination. You can help them find a vaccine location at Vaccines.gov. They may also need help finding child care or figuring out whether they can take time off from work. Offering a ride or accompanying them can also be helpful, especially if the closest vaccination site is far away. If English is not their primary language, offer to help them schedule the appointment and arrange for a medical translator if needed. When it's easier to get vaccinated, people are more likely to take this important step to help protect their health.

Having open, honest and supportive conversations about vaccines with family members and friends can make all the difference. For more information, visit cdc.gov/RiskLessDoMore or talk to your doctor.

Flu, COVID-19 and RSV Vaccines Help People Risk Less Severe Illness and Do More of What They Enjoy

This season's vaccines are now available. Everyone 6 months and older should get an updated flu and COVID-19 vaccine. Everyone ages 75 and older, or 60 and older with certain health conditions such as such as heart disease, lung disease, obesity or diabetes, should get an RSV vaccine if they have not been vaccinated for RSV before.

For certain people, the risk of serious respiratory illness remains high. These include adults ages 65 and older, residents of long-term care facilities, pregnant people, people with certain health conditions and those living in rural areas. People in some racial and ethnic groups, including people who are Black or Hispanic, are also at higher risk. People who are not up to date on flu, COVID-19 and RSV vaccines can reduce their risk by getting their 2024-25 vaccines as soon as they can.


Few states are tracking dairy farmer worker health protections amid current Bird Flu outbreak

Records from 15 states with confirmed cases of bird flu in dairy cattle in the USA. Nearly 700 dairy cattle have been found infected.
Photo: Kylee Alons/Unsplash

by John McCracken
Investigate Midwest

In May, the Centers for Disease Control recommended that state public health departments, veterinarians and epidemiologists provide personal protective equipment, or PPE, for workers in direct contact with animals and their fluids, such as raw milk, that could be exposed to bird flu.

As of early December, almost 60 people have been infected with the virus, with the majority of cases stemming from human contact with dairy cattle. Nearly 700 dairy cattle herds have been infected.

The most effective way to protect workers is with face shields, latex gloves and respirators, the CDC advised.

However, records from 15 states with confirmed cases of bird flu in dairy cattle reveal inconsistent responses by agencies when it comes to providing farmworkers with personal protective equipment. Most state health agencies, which are often responsible for the human impacts of communicable diseases, have left PPE distribution to local county health officials.

The documents, which Investigate Midwest obtained through multiple public records requests, found:

  • At least a third of state health departments in states with confirmed dairy cattle outbreaks do not track the distribution of PPE.
  • Ohio, Wyoming and New Mexico, which have had active bird flu cases in dairy cattle, have either not tracked requests for farmworker PPE or are currently not accepting requests.
  • Only one dairy farm in Wisconsin, a major dairy state that has not had a confirmed cattle outbreak, has requested PPE from the state’s health department.
  • Minnesota has had few cases of bird flu in dairy cattle, but more than 200 agriculture businesses have received PPE from the state.
  • Michigan and North Carolina, which are also major dairy-producing states, have provided PPE to less than a dozen farms.

“It looks like a failure in how we’re communicating on the public health side to producers,” said Bethany Alcauter, director of research and public health for the National Center for Farmworker Health, a Texas-based nonprofit that provides resources and training to farmworkers and advocacy groups across the country.

Alcauter said farm operators and processors don’t have the same knowledge and outlook as public health officials because sick workers and animals are often part of the job.

“It’s not to say that they’re not getting sick, but because it’s maybe not that different from what they experience normally, it’s not going to change their perception of the risk just because it’s a different pathogen,” she said.


How dairy-producing states differ in providing PPE to workers during bird flu outbreaks

When dairy workers are milking cows, raw milk can come into contact with their hands, faces and bodies, increasing the risk of infection. The CDC advises that dairy workers wear PPE, including gloves, rubber overalls and face shields, to minimize the spread of the virus.

The Occupational Safety and Health Administration, OSHA, states that employers of workplaces where exposure to bird flu viruses could occur are responsible for providing PPE to workers and keeping records on infected animals and employees.

However, OSHA cannot enforce its standards on farms with less than 11 employees, an exemption that has harmed dairy workers in the past when dairy worker deaths and injuries went unreported. This makes the enforcement and responsibility of safety measures hard to pin down, Alcauter said.

“Workers are on their own in terms of actually enforcing anything,” she said.

Michigan and Colorado Workers Aren’t Using or Getting PPE

In a recent CDC study, the agency said that the prevention of human infections is critical to mitigating changes in the bird flu virus that could lead to a pandemic.

Employers can best reduce the risk of infection by providing and educating workers on the use of PPE, as well as monitoring and testing animals and workers for the virus, the study said.

While PPE is a needed tool to prevent the spread, the practical application can be hard for workers who are working long hours and completing repetitive motion tasks in tight corners and hot environments.

Every worker who contracted the virus has been tasked with cleaning and working in milking parlors, according to the study.

After surveying the predominantly Spanish-speaking workers at Michigan and Colorado dairies, the agency found that none of the workers who were infected with the virus reported using PPE. In fact, the use of PPE was low among all workers.

“This investigation identified low PPE adherence among dairy workers, which has been an ongoing challenge in hot, tight spaces where visibility around large animals is important and the use of eye protection can be challenging,” the study states.

Records obtained by Investigate Midwest show inconsistent PPE distribution processes in both Michigan and Colorado, where dairy industries have been wrestling with the virus since early this year.

From January 2023 to late September 2024, records show only 11 dairy farms requested PPE for farmworkers in Michigan. Only 16 other operations requested PPE from the state during this time.

Farms that have requested PPE from the state have had an average of nine farmworkers per dairy farm, according to the self-reported request forms, which Investigate Midwest received through its records requests.

Conversely, the handful of poultry farms that have requested PPE have an average of 60 farmworkers per operation.

In Colorado, 40 dairy farms have requested PPE from the state agency between the beginning of 2023 and September 2024, according to documents and interviews with the agency.

Most requests came over the summer when Colorado started seeing repeated outbreaks of bird flu at dairy operations. As of early December, the state has had 64 confirmed cases in dairy herds.

The average number of dairy farmworkers operating on Colorado dairy farms that have requested PPE was roughly 40 people per farm.

“Some farms also reported that they had already purchased PPE and therefore didn’t need to make a request,” David Ellenberger, a spokesperson for the Colorado Department of Public Health and Environment, CDPHE, wrote in an email to Investigate Midwest.

“Additionally, CDPHE has sent bulk orders of PPE to an agricultural workers outreach group, who has relationships with individual workers, and was able to further distribute PPE on an individual level,” Ellenberger added.

Texas, California Take Different Approaches

Earlier this year, Texas was the first state in the country to have a confirmed case of bird flu in dairy cattle and, soon after, became the second site of mammal-to-human transmission of the virus in the country.

Since then, Texas has had nearly 30 cases of bird flu in cattle.

The state’s department of health has eight regional offices and it instructs farmers to contact their local office to request PPE.

“Each region fills them as they come in,” Texas spokesperson Douglas Loveday told Investigate Midwest.

In California, which now leads the country in the number of confirmed dairy cattle cases, the health and agriculture departments do not track or manage the distribution of PPE to farms and affected facilities. This task is left to the state’s 58 local health agencies.

In an email, a California Department of Public Health spokesperson said the state supported a one-time distribution of PPE to dairy farms earlier this year. When local requests can’t be fulfilled, the state agency fulfills the request.

As of early December, the agency has fulfilled or is currently fulfilling 43 PPE requests from dairy farms, six from poultry farms and 11 from farmworker organizations.

A similar system is used in Iowa and Idaho, which have also had numerous cases of bird flu in dairy cattle.

Ken Gordon, Ohio Department of Health spokesperson, told Investigate Midwest that when bird flu was detected in northwest Ohio earlier this year, the state made PPE available as the USDA investigated the outbreak. The state received two requests for PPE from agricultural operations during that time.

Now that the farm is no longer being investigated, the state is no longer offering PPE to farmworkers upon request.

“The state-level Ohio Department of Health made PPE available, via the survey, to farms and agricultural businesses on a temporary basis as the situation was new and evolving,” Gordon said.

Other states have received few requests or do not track disbursements:

  • As of early December, only one Oklahoma farm had requested PPE from the state’s health department to manage bird flu. The state agency used to have a formal request process for PPE, but it has since closed. “The purpose of this program was to support farms as part of the immediate response until these farms were able to ascertain PPE on their own,” an Oklahoma State Department of Health spokesperson wrote in an email to Investigate Midwest. 
  • Idaho Department of Public Health spokesperson AJ McWhorter said the agency worked with the industry group Idaho Dairymen’s Association and local public health districts to identify dairy worker needs for equipment and filled a one-time request for PPE for dairy workers in June.
  • An Iowa health department spokesperson told Investigate Midwest they direct people to local agencies or to the U.S. Department of Agriculture. 
  • In Wyoming, a state with one confirmed affected dairy herd, the health department said it did not track PPE requests or make a request form available to producers. Wyoming Department of Health spokesperson Kim Deti said the state’s poultry and dairy industries are small and PPE requests have been taken on a case-by-case basis.
Few Farms in North Carolina, New Mexico and Wisconsin Request PPE

North Carolina has one confirmed case of dairy cattle infected with bird flu. The state has also seen numerous cases of infected poultry, which is a major industry in the state.

One farm and four farmworkers requested PPE from the state during the ongoing outbreak. The majority of the state’s requests for PPE have come from farmworker organizations and advocacy groups.

The Association of Mexicans in North Carolina requested 2,000 face shields for dairy workers, stating that the association will make PPE available through health fairs aimed at farmworkers and contractors and their families held across the state.

In New Mexico, a state with nine confirmed outbreaks in dairy cattle, only two farms have requested PPE, according to state health department spokesperson David Morgan.

Some major agricultural states are preparing for outbreaks, even if a confirmed case hasn’t been reported.

When dairy workers are milking cows, raw milk can come into contact with their hands, faces and bodies, increasing the risk of infection. The CDC advises that dairy workers wear PPE, including gloves, rubber overalls and face shields, to minimize the spread of the virus. graphic provided by the CDC

In Wisconsin, a major dairy-producing state, the state health agency has received 11 requests for PPE from the beginning of 2023 to September of this year. The state has yet to have a confirmed case of bird flu in dairy cattle or humans.

Only one Wisconsin dairy farm and one egg production company have requested protective equipment for employees.

Most of the state’s requests have come from cheese or dairy product manufacturers in the state, as well as veterinary offices.

In addition to workers on farms with dairy cattle, employees who work in dairy processing plants are at risk of exposure to the virus. The CDC states that employees on dairy and poultry farms, dairy processing plants and poultry slaughter plants, should receive PPE to prevent the spread.  The virus is destroyed when raw milk is pasteurized at a processing plant.

A spokesperson for Dairy Farmers of America, the country’s largest milk co-op and owner of nearly 50 dairy processing plants nationwide, told Investigate Midwest that the company has a safety protocol to provide PPE for workers at their plants.

DFA was not listed as a PPE recipient in the state of Wisconsin, where the company has three plants.

“PPE is (and was) standard protocol at our plants, prior to the bird flu, as many of our employees work around cleaning chemicals, “ a DFA spokesperson told Investigate Midwest in an email. “To date, we’ve had no requests for extra PPE.”

Wisconsin Department of Health Services spokesperson Elizabeth Goodsitt, said the agency has worked alongside the state’s agriculture department to provide updates about bird flu to producers, including information on how producers and industry groups can receive PPE.

“We know from our experience across public health that getting resources to agencies, organizations, and individuals who are most trusted by specific populations is the best way to share important information,” she said.

“Producers should continue to enhance their biosecurity efforts and monitor and control disease in their herds and flocks,” she said in an email to Investigate Midwest.

Minnesota Stands from the Rest

Minnesota’s Department of Public Health has fulfilled more than 200 requests for PPE since May despite the state having far fewer confirmed outbreaks in dairy cattle compared to its peers.

As of December, Minnesota has had 9 outbreaks in dairy cattle herds.

The majority of the state’s requests came from dairy producers, with 138 farms requesting. Twenty poultry farms requested PPE and nearly a dozen processing facilities, either dairy or poultry, requested equipment.


This story was originally published on Investigate Midwest. This article originally appeared in Sentient at https://sentientmedia.org/ppe-dairy-farm-workers-bird-flu/.

Investigate Midwest is an independent, nonprofit newsroom. Our mission is to serve the public interest by exposing dangerous and costly practices of influential agricultural corporations and institutions through in-depth and data-driven investigative journalism. Visit us online at www.investigatemidwest.org

Recent study suggests childhood trauma could haunt Illinois adults for life

fence with signs
Photo: Dan Meyers/Unsplash
by Terri Dee
Illinois News Connection

New data from the Centers for Disease Control and Prevention showed 75% of U.S. high school students said they have had at least one adverse childhood experience, or ACE.

Research has shown ACEs can alter a child's brain chemistry and produce a prolonged toxic stress response. Experiencing at least one ACE as a child is linked to having alcohol and substance use problems in adulthood, and chronic diseases such as diabetes and obesity.

Joe Bargione, a certified school psychologist, said the symptoms are troubling.

"We're seeing some of the same kinds of patterns," Bargione pointed out. "That increased sense of loneliness, isolation in our youth, increased levels of suicide ideation, exposure to violence, exposure to other adverse childhood experiences."

The Illinois Department of Public Health said 61% of adults have had at least one ACE, including witnessing domestic violence in the home, parental separation, or physical and sexual abuse. Females and several groups who identify as a racial or ethnic minority were at greater risk for experiencing four or more ACEs.

The Illinois Department of Health said preventing ACEs may lower the risk for depression, asthma, cancer, and diabetes in adulthood. Bargione added schools can help address the youth mental health crisis by cultivating a sense of belonging and connectedness, as well as increasing suicide prevention programs.

"Promoting mental health awareness," Bargione urged. "Teaching kids around social-emotional learning and dealing with their emotions in an effective way, increased mental health services."

The Illinois Department of Health said healthy childhoods can provide lasting benefits throughout their lives. One way to help at-risk youth is by educating communities, youth-serving and faith-based organizations, coaches, and caregivers to better understand ACEs.


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The new Covid vaccine has been approved, why you might not want to rush out to get it yet

by Arthur Allen and Eliza Fawcett, Healthbeat
Rebecca Grapevine, Healthbeat

Because viruses evolve as they infect people, the CDC has recommended updated covid vaccines each year.

The FDA has approved an updated covid shot for everyone 6 months old and up, which renews a now-annual quandary for Americans: Get the shot now, with the latest covid outbreak sweeping the country, or hold it in reserve for the winter wave?

The new vaccine should provide some protection to everyone. But many healthy people who have already been vaccinated or have immunity because they’ve been exposed to covid enough times may want to wait a few months.

Covid has become commonplace. For some, it’s a minor illness with few symptoms. Others are laid up with fever, cough, and fatigue for days or weeks. A much smaller group — mostly older or chronically ill people — suffer hospitalization or death.

It’s important for those in high-risk groups to get vaccinated, but vaccine protection wanes after a few months. Those who run to get the new vaccine may be more likely to fall ill this winter when the next wave hits, said William Schaffner, an infectious disease professor at Vanderbilt University School of Medicine and a spokesperson for the National Foundation for Infectious Diseases.

On the other hand, by late fall the major variants may have changed, rendering the vaccine less effective, said Peter Marks, the FDA’s top vaccine official, at a briefing Aug. 23. He urged everyone eligible to get immunized, noting that the risk of long covid is greater in the un- and undervaccinated.

Of course, if last year’s covid vaccine rollout is any guide, few Americans will heed his advice, even though this summer’s surge has been unusually intense, with levels of the covid virus in wastewater suggesting infections are as widespread as they were in the winter.

The Centers for Disease Control and Prevention now looks to wastewater as fewer people are reporting test results to health authorities. The wastewater data shows the epidemic is worst in Western and Southern states. In New York, for example, levels are considered “high” — compared with “very high” in Georgia.

Hospitalizations and deaths due to covid have trended up, too. But unlike infections, these rates are nowhere near those seen in winter surges, or in summers past. More than 2,000 people died of covid in July — a high number but a small fraction of the at least 25,700 covid deaths in July 2020.

Partial immunity built up through vaccines and prior infections deserves credit for this relief. A new study suggests that current variants may be less virulent — in the study, one of the recent variants did not kill mice exposed to it, unlike most earlier covid variants.

Covid rapid tests will no longer be free

Alexandra Koch/Pixabay

Public health officials note that even with more cases this summer, people seem to be managing their sickness at home. “We did see a little rise in the number of cases, but it didn’t have a significant impact in terms of hospitalizations and emergency room visits,” said Manisha Juthani, public health commissioner of Connecticut, at a news briefing Aug. 21.

Unlike influenza or traditional cold viruses, covid seems to thrive outside the cold months, when germy schoolkids, dry air, and indoor activities are thought to enable the spread of air- and saliva-borne viruses. No one is exactly sure why.

“Covid is still very transmissible, very new, and people congregate inside in air-conditioned rooms during the summer,” said John Moore, a virologist and professor at Cornell University’s Weill Cornell Medicine College.

Or “maybe covid is more tolerant of humidity or other environmental conditions in the summer,” said Caitlin Rivers, an epidemiologist at Johns Hopkins University.

Because viruses evolve as they infect people, the CDC has recommended updated covid vaccines each year. Last fall’s booster was designed to target the omicron variant circulating in 2023. This year, mRNA vaccines made by Moderna and Pfizer and the protein-based vaccine from Novavax — which has yet to be approved by the FDA — target a more recent omicron variant, JN.1.

The FDA determined that the mRNA vaccines strongly protected people from severe disease and death — and would do so even though earlier variants of JN.1 are now being overtaken by others.

Public interest in covid vaccines has waned, with only 1 in 5 adults getting vaccinated since last September, compared with about 80% who got the first dose. New Yorkers have been slightly above the national vaccination rate, while in Georgia only about 17% got the latest shot.

Vaccine uptake is lower in states where the majority voted for Donald Trump in 2020 and among those who have less money and education, less health care access, or less time off from work. These groups are also more likely to be hospitalized or die of the disease, according to a 2023 study in The Lancet.

While the newly formulated vaccines are better targeted at the circulating covid variants, uninsured and underinsured Americans may have to rush if they hope to get one for free. A CDC program that provided boosters to 1.5 million people over the last year ran out of money and is ending Aug. 31.

The agency drummed up $62 million in unspent funds to pay state and local health departments to provide the new shots to those not covered by insurance. But “that may not go very far” if the vaccine costs the agency around $86 a dose, as it did last year, said Kelly Moore, CEO of Immunize.org, which advocates for vaccination.

People who pay out-of-pocket at pharmacies face higher prices: CVS plans to sell the updated vaccine for $201.99, said Amy Thibault, a spokesperson for the company.

“Price can be a barrier, access can be a barrier” to vaccination, said David Scales, an assistant professor of medicine at Weill Cornell Medical College.

Without an access program that provides vaccines to uninsured adults, “we’ll see disparities in health outcomes and disproportionate outbreaks in the working poor, who can ill afford to take off work,” Kelly Moore said.

New York state has about $1 million to fill the gaps when the CDC’s program ends, said Danielle De Souza, a spokesperson for the New York State Department of Health. That will buy around 12,500 doses for uninsured and underinsured adults, she said. There are roughly one million uninsured people in the state.

CDC and FDA experts last year decided to promote annual fall vaccination against covid and influenza along with a one-time respiratory syncytial virus shot for some groups.

It would be impractical for the vaccine-makers to change the covid vaccine’s recipe twice every year, and offering the three vaccines during one or two health care visits appears to be the best way to increase uptake of all of them, said Schaffner, who consults for the CDC’s policy-setting Advisory Committee on Immunization Practices.

At its next meeting, in October, the committee is likely to urge vulnerable people to get a second dose of the same covid vaccine in the spring, for protection against the next summer wave, he said.

If you’re in a vulnerable population and waiting to get vaccinated until closer to the holiday season, Schaffner said, it makes sense to wear a mask and avoid big crowds, and to get a test if you think you have covid. If positive, people in these groups should seek medical attention since the antiviral pill Paxlovid might ameliorate their symptoms and keep them out of the hospital.

As for conscientious others who feel they may be sick and don’t want to spread the covid virus, the best advice is to get a single test and, if positive, try to isolate for a few days and then wear a mask for several days while avoiding crowded rooms. Repeat testing after a positive result is pointless, since viral particles in the nose may remain for days without signifying a risk of infecting others, Schaffner said.

The Health and Human Services Department is making four free covid tests available to anyone who requests them starting in late September through covidtest.gov, said Dawn O’Connell, assistant secretary for preparedness and response, at the Aug. 23 briefing.

The government is focusing its fall vaccine advocacy campaign, which it’s calling “Risk less, live more,” on older people and nursing home residents, said HHS spokesperson Jeff Nesbit.

Not everyone may really need a fall covid booster, but “it’s not wrong to give people options,” John Moore said. “The 20-year-old athlete is less at risk than the 70-year-old overweight dude. It’s as simple as that.”

KFF Health News correspondent Amy Maxmen contributed to this report.

Healthbeat is a nonprofit newsroom covering public health published by Civic News Company and KFF Health News. Sign up for their newsletters here.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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Florida defies CDC advice telling parents it's okay to send unvaccinated kids to school during recent outbreak

by Amy Maxmen
Kaiser Health News
Ladapo sent parents a letter granting them permission to send unvaccinated children to school amid the outbreak

With a brief memo, Florida Surgeon General Joseph Ladapo has subverted a public health standard that’s long kept measles outbreaks under control.

On Feb. 20, as measles spread through Manatee Bay Elementary in South Florida, Ladapo sent parents a letter granting them permission to send unvaccinated children to school amid the outbreak.

The Department of Health “is deferring to parents or guardians to make decisions about school attendance,” wrote Ladapo, who was appointed to head the agency by Florida Gov. Ron DeSantis, whose name is listed above Ladapo’s in the letterhead.

Ladapo’s move contradicts advice from the Centers for Disease Control and Prevention.

“This is not a parental rights issue,” said Scott Rivkees, Florida’s former surgeon general who is now a professor at Brown University. “It’s about protecting fellow classmates, teachers, and members of the community against measles, which is a very serious and very transmissible illness.”

Most people who aren’t protected by a vaccine will get measles if they’re exposed to the virus. This vulnerable group includes children whose parents don’t get them vaccinated, infants too young for the vaccine, those who can’t be vaccinated for medical reasons, and others who don’t mount a strong, lasting immune response to it. Rivkees estimates that about a tenth of people in a community fall into the vulnerable category.

Measles is so contagious. It is very worrisome.

The CDC advises that unvaccinated students stay home from school for three weeks after exposure. Because the highly contagious measles virus spreads on tiny droplets through the air and on surfaces, students are considered exposed simply by sitting in the same cafeteria or classroom as someone infected. And a person with measles can pass along an infection before they develop a fever, cough, rash, or other signs of the illness. About 1 in 5 people with measles end up hospitalized, 1 in 10 develop ear infections that can lead to permanent hearing loss, and about 1 in 1,000 die from respiratory and neurological complications.

“I don’t know why the health department wouldn’t follow the CDC recommendations,” said Thresia Gambon, president of the Florida chapter of the American Academy of Pediatrics and a pediatrician who practices in Miami and Broward, the county affected by the current measles outbreak. “Measles is so contagious. It is very worrisome.”

Considering the dangers of the disease, the vaccine is incredibly safe. A person is about four times as likely to die from being struck by lightning during their lifetime in the United States as to have a potentially life-threatening allergic reaction to the measles, mumps, and rubella vaccine.

Nonetheless, last year a record number of parents filed for exemptions from school vaccine requirements on religious or philosophical grounds across the United States. The CDC reported that childhood immunization rates hit a 10-year low.

In addition to Florida, measles cases have been reported in 11 other states this year, including Arizona, Georgia, Minnesota, and Virginia.

Only about a quarter of Florida’s counties had reached the 95% threshold at which communities are considered well protected against measles outbreaks, according to the most recent data posted by the Florida Department of Health in 2022. In Broward County, where six cases of measles have been reported over the past week, about 92% of children in kindergarten had received routine immunizations against measles, chickenpox, polio, and other diseases. The remaining 8% included more than 1,500 kids who had vaccine exemptions, as of 2022.

Broward’s local health department has been offering measles vaccines at Manatee Bay Elementary since the outbreak began, according to the county school superintendent. If an unvaccinated person gets a dose within three days of exposure to the virus, they’re far less likely to get measles and spread it to others.

For this reason, government officials have occasionally mandated vaccines in emergencies in the past. For example, Philadelphia’s deputy health commissioner in 1991 ordered children to get vaccinated against their parents’ wishes during outbreaks traced to their faith-healing churches. And during a large measles outbreak among Orthodox Jewish communities in Brooklyn in 2019, the New York City health commissioner mandated that anyone who lived, worked, or went to school in hard-hit neighborhoods get vaccinated or face a fine of $1,000. In that ordinance, the commissioner wrote that the presence of anyone lacking the vaccine in those areas, unless it was medically contraindicated, “creates an unnecessary and avoidable risk of continuing the outbreak.”

Ladapo moved in the opposite direction with his letter, deferring to parents because of the “high immunity rate in the community,” which data contradicts, and because of the “burden on families and educational cost of healthy children missing school.”

Yet the burden of an outbreak only grows larger as cases of measles spread, requiring more emergency care, more testing, and broader quarantines as illness and hospitalizations mount. Curbing a 2018 outbreak in southern Washington with 72 cases cost about $2.3 million, in addition to $76,000 in medical costs, and an estimated $1 million in economic losses due to illness, quarantine, and caregiving. If numbers soar, death becomes a burden, too. An outbreak among a largely unvaccinated population in Samoa caused more than 5,700 cases and 83 deaths, mainly among children.

Ladapo’s letter to parents also marks a departure from the norm because local health departments tend to take the lead on containing measles outbreaks, rather than state or federal authorities. In response to queries from KFF Health News, Broward County’s health department deferred to Florida’s state health department, which Ladapo oversees.

“The county doesn’t have the power to disagree with the state health department,” said Rebekah Jones, a data scientist who was removed from her post at the Florida health department in 2020, over a rift regarding coronavirus data.

DeSantis, a Republican, appointed Ladapo as head of the state health department in late 2021, as DeSantis integrated skepticism about covid vaccines into his political platform. In the months that followed, Florida’s health department removed information on covid vaccines from its homepage, and reprimanded a county health director for encouraging his staff to get the vaccines, leading to his resignation. In January, the health department website posted Ladapo’s call to halt vaccination with covid mRNA vaccines entirely, based on notions that scientists call implausible.

Jones was not surprised to see Ladapo pivot to measles. “I think this is the predictable outcome of turning fringe, anti-vaccine rhetoric into a defining trait of the Florida government,” she said. Although his latest decision runs contrary to CDC advice, the federal agency rarely intervenes in measles outbreaks, entrusting the task to states.

In an email to KFF Health News, the Florida health department said it was working with others to identify the contacts of people with measles, but that details on cases and places of exposure were confidential. It repeated Ladapo’s decision, adding, “The surgeon general’s recommendation may change as epidemiological investigations continue.”

For Gambon, the outbreak is already disconcerting. “I would like to see the surgeon general promote what is safest for children and for school staff,” she said, “since I am sure there are many who might not have as strong immunity as we would hope.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.


Read our latest health and medical news

Dirty nails and mouths don’t mix

by Tim Ditman
OSF Healthcare

DANVILLE - Emily Isom has a new year’s resolution for kids and their parents: pledge to keep your hands clean and away from your face to prevent the spread of illness.


Emily Isom

Isom, a certified medical assistant in pediatrics at OSF HealthCare, often sees young people biting dirty fingernails and not washing their hands properly. Here’s a primer:

Nail hygiene

Isom says people of all ages should trim their nails regularly. Once a week for fingernails and once or twice a month for toenails is a good rule of thumb. In between trimmings, watch for dirt and other filthy matter caught under the tip of the nail. Some nail clippers come with a scraper tool to remove that debris. But don’t use your mouth to clean your nails.

“Our nails carry so many germs and bacteria. That’s how people keep getting sick and spreading illness,” Isom warns, referring to putting fingernails in your mouth or on your face. You can also chip teeth and get facial warts and pimples from putting nails on your face, she says.

Some people have long nails, either real or artificial. In these cases, use a nail brush to regularly wipe the nails clean. If you’re at work or school and don’t have a brush, wash the nails thoroughly. Lather warm water and soap on the palms of your hands. Take your fingertips and scratch against the palm of the other hand to get the soap in the fingernail. Do that for 20 seconds. Then, pull down the fingertips to the palm of the same hand and massage the soap in further. Put your hands upside down under hot running water to rinse.

Hand washing

Isom says most people concentrate on their palms when hand washing.

“You need to get in between the fingers, underneath the nails, on the back of the hands, rub your knuckles together and scrub your wrists,” Isom says.

After wetting your hands, scrub all those areas in soap for 20 seconds. Find a song that has a 20-second chorus and hum it while you scrub. Then, rinse under warm water, and dry your hands with a clean, dry towel. Isom also suggests wrapping a paper towel around your hand when touching dirty surfaces on your way out of the bathroom. Use the towel to shut off the faucet and open the door, then throw the towel away after you exit.

If a hand dryer is what’s available, run your hands under the warm air until they are completely dry. Resist the urge to dry halfway and walk out. Isom says that may do more harm than good and attract bacteria faster.

“Bacteria want to live on wet surfaces. They’re attracted to moistness,” she points out.

If a soap and sink aren’t available, Isom says to use sanitizer or wipes that are at least 60% alcohol based. The same process applies – lather or wipe all parts of your hand and wrist thoroughly.

If you have a cut or wound on your hand, like a paper cut, wash with care.

“Get a washcloth wet with warm water. Put soap on it. Then, clean around the cut or wound,” Isom says. “Don’t put [soap] directly into the cut. That could really irritate it.” Handwashing

Convincing kids

Isom is a pediatrics provider and a mother. So, she knows getting kids to wash their hands and mind their nails is easier said than done. Her advice: make it fun.

“When handwashing, sing the ABCs for 20 seconds. Or have them sing to you.” Isom suggests. “Make a chart. Every time they wash their hands, have them put a sticker on the chart. They are going to fall in love with it and want to wash their hands over and over again.”

And remember Simon Says? Isom says it works with her daughter.

“Simon says don’t touch your face,” Isom says with a smirk.

Key takeaways:

  • Nail hygiene involves trimming and cleaning them regularly and keeping them away from your face.
  • You should also thoroughly wash and dry your hands and wrists often. Use a paper towel to grab surfaces like a doorknob in a public bathroom.
  • Don't put soap directly on a wound or cut.
  • When using sanitizer and wipes, choose ones that are at least 60% alcohol based.
  • For kids, turn hand hygiene into a game to encourage good habits.

  • COVID-19 second boosters now available for age-eligible county residents

    CHAMPAIGN -- Champaign County residents 65 and older can now receive a second Covid-19 booster. Citizens 50 and older with an underlying medical condition are also eligible to receive a second booster.

    This week, the Centers for Disease Control and Prevention (CDC) recommended on Tuesday, March 29, that "expanded eligibility for an additional booster dose for certain individuals who may be at higher risk of severe outcomes from COVID-19. Boosters are safe, and people over the age of 50 can now get an additional booster four months after their prior dose to increase their protection further."

    Eligible members of the community may sign-up online at https://www.signupgenius.com/go/60B054CA8A82CA5F94-2ndcovid to receive the vaccination at the Champaign-Urbana Public Health District office located at 201 W. Kenyon Road in Champaign.

    Vaccination appointments are being booked now for April 4 – 22 from 8:30 am – 4:00 pm.

    Boosters will also be available from Promise Healthcare, Carle Health, OSF Healthcare, and Christie Clinic. Patients are urged to contact their primary care provider for more information or to schedule an appointment.

    Meanwhile, those under the age of 50 and interested in receiving a second booster will have to wait for government approval for the time being. In a release issued today by the CUPHD, the "CDC, in collaboration with FDA and our public health partners, will continue to evaluate the need for additional booster doses for all Americans."

    Christie Clinic will offer the booster at most of their primary care offices. According to today's press release, appointments will be limited to Christie patients 50 years old and older. "If patients have an upcoming appointment, they are encouraged to discuss their eligibility with their primary care provider."

    Appointments for the second Covid-19 booster at Promise Healthcare can be made by calling (217) 356-1558.

    For more information visit vaccine.gov to find a vaccine site nearest to you or log into www.vaccinefinder.org for available appointments at local pharmacies.


    As Covid cases surge across the country, CDC only tracks a fraction of breakthrough cases


    Jenny Deam and Jodi S. Cohen, ProPublica


    Meggan Ingram was fully vaccinated when she tested positive for COVID-19 early this month. The 37-year-old’s fever had spiked to 103 and her breath was coming in ragged bursts when an ambulance rushed her to an emergency room in Pasco, Washington, on Aug. 10. For three hours she was given oxygen and intravenous steroids, but she was ultimately sent home without being admitted.

    Seven people in her house have now tested positive. Five were fully vaccinated and two of the children are too young to get a vaccine.

    As the pandemic enters a critical new phase, public health authorities continue to lack data on crucial questions, just as they did when COVID-19 first tore through the United States in the spring of 2020. Today there remains no full understanding on how the aggressively contagious delta variant spreads among the nearly 200 million partially or fully vaccinated Americans like Ingram, or on how many are getting sick.

    The nation is flying blind yet again, critics say, because on May 1 of this year — as the new variant found a foothold in the U.S. — the Centers for Disease Control and Prevention mostly stopped tracking COVID-19 in vaccinated people, also known as breakthrough cases, unless the illness was severe enough to cause hospitalization or death.

    Individual states now set their own criteria for collecting data on breakthrough cases, resulting in a muddled grasp of COVID-19’s impact, leaving experts in the dark as to the true number of infections among the vaccinated, whether or not vaccinated people can develop long-haul illness, and the risks to unvaccinated children as they return to school.



    If you’re limiting yourself to a small subpopulation with only hospitalizations and deaths, you risk a biased viewpoint.


    "It’s like saying we don’t count,” said Ingram after learning of the CDC’s policy change. COVID-19 roared through her household, yet it is unlikely any of those cases will show up in federal data because no one died or was admitted to a hospital.

    The CDC told ProPublica in an email that it continues to study breakthrough cases, just in a different way. "This shift will help maximize the quality of the data collected on cases of greatest clinical and public health importance,” the email said.

    In addition to the hospitalization and death information, the CDC is working with Emerging Infections Program sites in 10 states to study breakthrough cases, including some mild and asymptomatic ones, the agency’s email said.

    Under pressure from some health experts, the CDC announced Wednesday that it will create a new outbreak analysis and forecast center, tapping experts in the private sector and public health to guide it to better predict how diseases spread and to act quickly during an outbreak.

    Tracking only some data and not releasing it sooner or more fully, critics say, leaves a gaping hole in the nation’s understanding of the disease at a time when it most needs information.

    "They are missing a large portion of the infected," said Dr. Randall Olsen, medical director of molecular diagnostics at Houston Methodist Hospital in Texas. "If you’re limiting yourself to a small subpopulation with only hospitalizations and deaths, you risk a biased viewpoint."

    On Wednesday, the CDC released a trio of reports that found that while the vaccine remained effective at keeping vaccinated people out of the hospital, the overall protection appears to be waning over time, especially against the delta variant.

    Among nursing home residents, one of the studies showed vaccine effectiveness dropped from 74.7% in the spring to just 53.1% by midsummer. Similarly, another report found that the overall effectiveness among vaccinated New York adults dropped from 91.7% to just under 80% between May and July.

    The new findings prompted the Biden administration to announce on Wednesday that people who got a Moderna or Pfizer vaccine will be offered a booster shot eight months after their second dose. The program is scheduled to begin the week of Sept. 20 but needs approval from the Food and Drug Administration and a CDC advisory committee.



    No vaccine is 100% percent effective against transmission, health officials warned.


    This latest development is seen by some as another example of shifting public health messaging and backpedaling that has accompanied every phase of the pandemic for 19 months through two administrations. A little more than a month ago, the CDC and the FDA released a joint statement saying that those who have been fully vaccinated "do not need a booster shot at this time.”

    The vaccine rollout late last year came with cautious optimism. No vaccine is 100% percent effective against transmission, health officials warned, but the three authorized vaccines proved exceedingly effective against the original COVID-19 strain. The CDC reported a breakthrough infection rate of 0.01% for the months between January and the end of April, although it acknowledged it could be an undercount.

    As summer neared, the White House signaled it was time for the vaccinated to celebrate and resume their pre-pandemic lives.

    Trouble, though, was looming. Outbreaks of a new, highly contagious variant swept India in the spring and soon began to appear in other nations. It was only a matter of time before it struck here, too.

    "The world changed," said Dr. Eric Topol, director of the Scripps Research Translational Institute, "when delta invaded."

    The current crush of U.S. cases — well over 100,000 per day — has hit the unvaccinated by far the hardest, leaving them at greater risk of serious illness or death. The delta variant is considered at least two or three times more infectious than the original strain of the coronavirus. For months much of the focus by health officials and the White House has been on convincing the resistant to get vaccinated, an effort that has so far produced mixed results.

    Yet as spring turned to summer, scattered reports surfaced of clusters of vaccinated people testing positive for the coronavirus. In May, eight vaccinated members of the New York Yankees tested positive. In June, 11 employees of a Las Vegas hospital became infected, eight of whom were fully vaccinated. And then 469 people who visited the Provincetown, Massachusetts, area between July 3 and July 17 became infected even though 74% of them were fully vaccinated, according to the CDC’s Morbidity and Mortality Weekly Report.

    While the vast majority of those cases were relatively mild, the Massachusetts outbreak contributed to the CDC reversing itself on July 27 and recommending that even vaccinated people wear masks indoors — 11 weeks after it had told them they could jettison the protection.

    And as the new CDC data showed, vaccines continue to effectively shield vaccinated people against the worst outcomes. But those who get the virus are, in fact, often miserably sick and may chafe at the notion that their cases are not being fully counted.

    "The vaccinated are not as protected as they think," said Topol, "They are still in jeopardy."

    The CDC tracked all breakthrough cases until the end of April, then abruptly stopped without making a formal announcement. A reference to the policy switch appeared on the agency’s website in May about halfway down the homepage.

    "I was shocked," said Dr. Leana Wen, a physician and visiting professor of health policy and management at George Washington University. "I have yet to hear a coherent explanation of why they stopped tracking this information.”

    The CDC said in an emailed statement to ProPublica that it decided to focus on the most serious cases because officials believed more targeted data collection would better inform "response research, decisions, and policy."

    Sen. Edward MMarkey, D-Mass., became alarmed after the Provincetown outbreak and wrote to CDC director Dr. Rochelle Walensky on July 22, questioning the decision to limit investigation of breakthrough cases. He asked what type of data was being compiled and how it would be shared publicly.

    It is unclear how often breakthroughs occur or how widely cases are spreading among the vaccinated.

    "The American public must be informed of the continued risk posed by COVID-19 and variants, and public health and medical officials, as well as health care providers, must have robust data and information to guide their decisions on public health measures," the letter said.

    Markey asked the agency to respond by Aug. 12. So far the senator has received no reply, and the CDC did not answer ProPublica’s question about it.

    When the CDC halted its tracking of all but the most severe cases, local and state health departments were left to make up their own rules.

    There is now little consistency from state to state or even county to county on what information is gathered about breakthrough cases, how often it is publicly shared, or if it is shared at all.

    "We’ve had a patchwork of information between states since the beginning of the pandemic,” said Jen Kates, senior vice president and director of global health and HIV policy at Kaiser Family Foundation.

    She is co-author of a July 30 study that found breakthrough cases across the U.S. remained rare, especially those leading to hospitalization or death. However, the study acknowledged that information was limited because state reporting was spotty. Only half the states provide some data on COVID-19 illnesses in vaccinated people.

    "There is no single, public repository for data by state or data on breakthrough infections, since the CDC stopped monitoring them,” the report said.

    In Texas, where COVID-19 cases are skyrocketing, a state Health and Human Services Commission spokesperson told ProPublica in an email the state agency was "collecting COVID-19 vaccine breakthrough cases of heightened public health interest that result in hospitalization or fatality only."

    Other breakthrough case information is not tracked by the state, so it is unclear how often breakthroughs occur or how widely cases are spreading among the vaccinated. And while Texas reports breakthrough deaths and hospitalizations to the CDC, the information is not included on the state’s public dashboard.

    "We will be making some additions to what we are posting, and these data could be included in the future," the spokesperson said.

    I thought, ‘COVID is over and I’m going to Disney World,’

    South Carolina, on the other hand, makes public its breakthrough numbers on hospitalizations and deaths. Milder breakthrough cases may be included in the state’s overall COVID-19 numbers but they are not labeled as such, said Jane Kelly, an epidemiologist at the South Carolina Department of Health and Environmental Control.

    "We agree with the CDC,” she said, "there’s no need to spend public health resources investigating every asymptomatic or mild infection.”

    In Utah, state health officials take a different view. "From the beginning of the pandemic we have been committed to being transparent with our data reporting and … the decision to include breakthrough case data on our website is consistent with that approach," said Tom Hudachko, director of communications for the Utah Department of Health.

    Some county-level officials said they track as many breakthrough cases as possible even if their state and the CDC does not.

    For instance, in Clark County, Nevada, home of Las Vegas, the public health website reported that as of last week there were 225 hospitalized breakthrough cases but 4,377 vaccinated people overall who have tested positive for the coronavirus.

    That means that less than 5% of reported breakthrough cases resulted in hospitalization. "The Southern Nevada Health District tracks the total number of fully vaccinated individuals who test positive for COVID-19 and it is a method to provide a fuller picture of what is occurring in our community,” said Stephanie Bethel, a spokesperson for the health district in an email.

    Sara Schmidt, a 44-year-old elementary school teacher in Alton, Illinois, is another person who has likely fallen through the data hole.

    "I thought, ‘COVID is over and I’m going to Disney World,’" she said. She planned a five-day trip for the end of July with her parents. Not only had she been fully vaccinated, receiving her second shot in March, she is also sure she had COVID-19 in the summer of 2020. Back then she had all the symptoms but had a hard time getting tested. When she finally did, the result came back negative, but her doctor told her to assume it was inaccurate.

    "My guard was down," she said. She was less vigilant about wearing a mask in the Florida summer heat, assuming she was protected by the vaccination and her presumed earlier infection.

    On the July 29 plane trip home, she felt mildly sick. Within days she was "absolutely miserable." Her coughing continued to worsen, and each time she coughed her head pounded. On Aug. 1 she tested positive. Her parents were negative.

    Now, three weeks later, she is far from fully recovered and classes are about to begin at her school. There’s a school mask mandate, but her students are too young to be vaccinated. "I’m worried I will give it to them, or I will get it for a third time," she said.

    But it is doubtful her case will be tracked because she was never hospitalized. That infuriates her, she said, because it downplays what is happening.

    "Everyone has a right to know how many breakthrough cases there are," she said, "I was under the impression that if I did get a breakthrough case, it would just be sniffles. They make it sound like everything is under control and it’s not."

    This story was originally published by ProPublica on August 20, 2021. ProPublica is a Pulitzer Prize-winning investigative newsroom. Sign up for The Big Story newsletter to receive stories like this one in your inbox.


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