UPDATED: June 18, 2025
Welcome to the Healthy Living Is Good Medicine Newsletter, a free publication covering a wide variety of health-related topics, with timely original articles intended to help people lead healthier and more fulfilling lives.
Waning Immunity
COVID-19 remains a global health threat. Let us not ignore the lessons of the pandemic. One such lesson is that with the passage of time after vaccination and/or an infection, immunity wanes. With each infection, more mutations of the virus are able to occur, potentially resulting in increasingly infectious variants that can spread rapidly across the country, and around the world.
In the U.S., the number of COVID-19 cases, hospitalizations, and deaths increase twice a year, when people spend more time indoors due to very hot and very cold weather. The good news is that this year’s winter surge is not as bad as that of previous years. That’s due to a huge wave of infections this past summer that boosted people’s immunity, and the virus has not changed substantially since then.. The updated vaccines weren’t available until late August, 2024, but their increased uptake has been the “frosting on the immunity cake.” By 2025, nearly half of seniors had received them.
COVID-19 is still a serious illness that needs to be reckoned with. Forecasts based on current excess mortality rates suggest that SARS-CoV-2 infections could cause up to 175,000 U.S. deaths per year. That’s a lot of dead people, underscoring the fact that we should continue paying attention to preventive measures, especially if we are in a higher risk category.
Currently, the best metric for predicting local risks are the statewide levels of viruses found in wastewater surveillance data provided to the CDC on a regular basis. I’ve been glad to see that the current administration’s efforts to stifle government health information communications has not impacted crucial CDC reporting about most infectious diseases.
Masking Is Your Best Defense
Research shows how easily COVID-19 can be caught through the air. Exposure to virus-laden aerosols for less than 20 minutes is sufficient to transmit COVID-19. Wearing a properly fitted N95 or equivalent mask in public indoor settings can effectively prevent infection. The use of face masks in medicine dates back to ancient times, according to a recent article.
A 2024 study of the effects of masking on population-based transmission rates has overcome some of the limitations of epidemiological investigations. It estimated that if a population were all wearing FFP2/N95 masks, it would reduce COVID-19 transmission by a factor of approximately nine. That’s a huge reduction in the risk of infection.
Vaccination, while helping to reduce the severity of infections, doesn’t do nearly as good a job preventing infections as does masking. Consider being up-to-date with your vaccinations as your backup plan, and make masking your first line of defense. This article explains why people are still masking.
The Updated COVID-19 Vaccines
By now you should be well aware that ivermectin is not effective for preventing or treating COVID-19. A 2022 systematic review and meta-analysis, which studied 25 randomized controlled trials (RCTs), showed that ivermectin does not reduce the risk of death or the need for mechanical ventilation in the intensive care unit (ICU).
Reformulated mRNA vaccines that target the KP.2 sub-variant are still available. The conventional Novavax vaccine has been updated for the JN.1 lineage, and should provide good coverage for new strains, according to the manufacturer. The LP.8.1 variant is now the dominant strain in wastewater nationally and has the ability to evade some antibodies induced by the current vaccine. The mRNA vaccines expected this Fall will target it.
The even more evasive NB.1.8.1 variant is gaining ground, and is expected to become the main player in a surge expected in July, 2025. That has raised additional concerns, and targeting this variant may be necessary to maintain vaccine effectiveness. It seems that we will have to find out the hard way, since vaccine research in the United States has been adversely impacted by the anti-vaccine and anti-science MAGA/MAHA agenda.
Because the nation’s health now being overseen by inappropriate political appointees, the CDC has been forced to update its guidance regarding the eligibility and timing of the latest vaccines. The agency is no longer able to recommend COVID-19 vaccinations for healthy children and pregnant women, with dire public health implications. It is high time for the American people to demand that HHS Secretary RFK Jr. be fired.
Seniors have been eligible for vaccine administration every six months. Those who are immunocompromised can receive doses as often as every two months, in consultation with their health-care provider. It remains to be seen what the new guidance will be. If you haven’t yet received the latest COVID-19 vaccine and are eligible, you had best hurry, before the impending summer surge.
When it comes to COVID-19 we’re clearly not out of the woods. The anti-science agenda of the new administration has serious public health implications. The FDA’s vaccine review process by independent scientists, and the CDC’s evidence-based recommendations, have been pre-empted by politics. As a result, eligibility for the Fall vaccines will be restricted:
Please be aware that the COVID-19 vaccines are no longer free of charge, as federal subsidy programs have ended. For those who don’t have an insurance plan that will cover their cost, there are a few other options. Once the new administration takes over, these vaccines might not be covered by any kind of insurance, or could even be blocked.
COVID-19 vaccines work more like the seasonal flu vaccines than the “good for a lifetime” measles vaccine. While they enhance immunity, they don’t provide durable protection against infection. The best reason to stay up-to-date with the latest COVID-19 vaccine is to reduce your risk of severe illness. This is especially important for seniors and people with chronic medical conditions that increase their risk of hospitalization and death.
Adults who are aged 65 years and older, and anyone with greater vulnerability to severe infections due to underlying health conditions should continue taking extra precautions by properly masking with an N95 or equivalent respirator in public indoor spaces, sanitizing hands, and having good indoor ventilation and/or air filtration at home when entertaining guests.
The recent vaccines provide maximal protection two weeks to two months following administration, but it’s still possible to be infected during this period. A CDC analysis found the updated vaccine to be 51 percent effective against covid-associated urgent care or emergency department visits during the first 7 to 59 days following vaccination. This declined to 39 percent between 60 and 119 days.
Among people 65 and older with healthy immune systems, the vaccine’s effectiveness against hospitalization was about 45 percent. Among people in this age group who were also immunocompromised, vaccine effectiveness against hospitalization was 40 percent.
A recent study found that COVID-19 vaccination reduced the risk of infection by about half at the four-week mark. After 10 weeks, the risk of infection was reduced only by about a third. Protection against hospitalization declined from 67 percent to 57 percent over the same time period. Another study (not yet peer-reviewed) found that the updated Pfizer vaccine had a 68 percent effectiveness in preventing hospitalizations.
The CDC’s interim estimates of the current COVID-19 vaccines effectiveness are 33 percent for preventing COVID-19–associated emergency department or urgent care visits among adults aged ≥18 years, and about 45 percent in preventing hospitalizations among immunocompetent adults aged ≥65 years, compared against similar cohorts that did not receive a 2024–2025 vaccine dose. For more about the benefits of vaccination, see:
COVID-19 Complications
Let's not forget that about 56,000 people in the U.S. died as a result of contracting COVID-19 during 2023. Researchers are still investigating the lingering consequences of SARS-CoV-2 infections, including heart and brain damage, neurodegeneration, and the development of autoimmune disorders.
Long-term brain deficits are a serious complication. A recent study found an increased risk of mental illness following severe infections, especially among the unvaccinated. New research suggests that adolescents and young adults with a mild case of COVID-19 can experience persistent alterations in brain structure and connectivity in key areas responsible for memory and cognition. This may cause a lasting impairment in young people’s cognitive function.
Another study lends support to the hypothesis that brain injury producing global cognitive deficits resulting from moderate to severe COVID-19 infections may be immune-mediated and can persist for at least a year. A recent study suggests that mRNA vaccines can reduce the risk of acquired long-term autoimmune disorders following an Omicron variant infection.
Heart damage, with new-onset atrial fibrillation (A-fib, or AF), is a frequent complication of COVID-19, according to a 2023 review. A-fib is the most common cardiac arrhythmia. If left untreated, it presents a serious risk for strokes, myocardial infarctions, chronic kidney disease, and dementia, doubling a person’s risk of death. Adding to the risk is having AF without experiencing any of its tell-tale symptoms.
A new radiographic study suggests that SARS-CoV-2 infections are associated with a more rapid progression of unstable atherosclerotic plaques in the coronary arteries, increasing the risk for adverse cardiovascular events. Once again, the argument can be made that an “ounce of prevention is worth a pound of cure.”
Long-COVID
A new survey found that people who had two COVID-19 infections were more than twice as likely to report having Long-COVID (aka PASC) symptoms, compared to those with only one infection. Those who had three or more COVID-19 infections were almost four times likely. A retrospective cohort study found a significantly higher rate of PASC among people with multiple COVID-19 episodes, a history of a severe infection, and being unvaccinated at the time of the first infection.
A recent review suggests that advancing age increases the risk for developing Long-COVID. A 2024 study found that about 15 percent of infected children developed Long-COVID. Another study found that mRNA COVID-19 vaccination reduced the odds of children aged 5 to 17 years developing post-covid conditions following SARS-CoV-2 infection by at least 57 percent. A 2025 study found that unvaccinated children and adolescents were up to 20 times more likely to develop Long-COVID compared to those who were vaccinated. Most of that effect came from reducing the risk of infection.
Using AI to analyze the medical records of almost 300,000 patients, the algorithm identified Long-COVID by distinguishing symptoms linked specifically to SARS-CoV-2 infection, rather than pre-existing conditions. The study found that nearly a quarter of the patients could be diagnosed with Long-COVID. A 2025 study found that seniors who had received four or more covid vaccinations had 39 percent lower risk of developing Long-COVID.
A new study showed brain changes on MRI were linked to Long-COVID fatigue. Even a mild case of COVID-19 can result in autonomic nervous system dysfunction, a so-called “leaky gut,” or detectable changes in cognition and memory that can persist for at least a year. Yet, a recent poll found that more than half of Americans age 50 and older, the most vulnerable demographic, aren’t going to get the updated vaccine. Vaccination decreases the risk of Long-COVID by about half, according to a European study.
Testing and Treatment
Testing daily is advised for anyone experiencing cold-like symptoms. Free test kits are once again available from COVIDtests.gov. People who test positive should start taking an antiviral medication such as Paxlovid ASAP if they are eligible for treatment. The oral antiviral is expected to be effective against the currently circulating variants, but it can have adverse interactions with some other common medicines.
Alarmingly, about a third of U.S. adults have never even heard of Paxlovid. In order to reduce out-of-pocket costs, enroll in Pfizer’s patient assistance program online or sign up by calling 877-219-7225. Patients on Medicare should be able to get Paxlovid for free and those with private insurance should be charged a reduced co-pay. Tell the pharmacy that you are enrolled. If they don’t accept the program, go to another pharmacy.
Seniors who are up-to-date on their COVID-19 vaccinations may not benefit from taking Paxlovid. While it may reduce the severity of symptoms and reduce hospitalizations and deaths among unvaccinated, at-risk patients, it did not significantly shorten the duration of symptoms in vaccinated adults, according to Pfizer’s own trial. Furthermore, Paxlovid may not reduce the risk of covid-related hospitalizations and all-cause deaths in vaccinated older adults, according to a new study.
The CDC recommends that for any respiratory infection, regardless of its cause, if you have symptoms such as fever, chills, fatigue, cough, or runny nose, you should stay home and keep away from others, including people living in your household. The CDC further recommends that as long as you test positive for COVID-19, you should avoid close contact with household pets to protect them from infection, just as you would with people.
You can stop isolating when when your symptoms have been improving and you have been fever-free, without the use of medications, for at least 24 hours. For the next five days, take steps to avoid spreading your infection such as physical distancing and masking when around other people indoors. Don’t become a health threat, especially to those at greater risk for severe outcomes.
Monitoring the Risk
Nationally, the wastewater activity level of the virus that causes COVID-19 is still quite low. Except in the West and South, where it is now slowly rising, levels have been holding steady in most regions. Of note are levels that have been recently recorded as “high” in Nevada, Texas, Louisiana, and Hawaii.
Your risk of contracting COVID-19 increases with increasing levels of the SARS-CoV-2 virus in wastewater. The map below shows the most recent wastewater levels, according to state reporting.
There may be a higher density of sampling sites in certain geographic areas, so a state’s median wastewater viral activity level may not represent the actual wastewater viral activity level for your particular community. You can check site-specific wastewater levels via this link.
North Dakota’s legislature, citing the perils of “government over-reach and over-reaction,” has consistently blocked any reporting of SARS-CoV-2 wastewater levels to the CDC. Unsurprisingly, that state is among those with the lowest vaccination rates in the country. At one point during the pandemic, North Dakota had the most COVID-19 cases and related deaths per capita. You get what you vote for!
Maps showing current wastewater viral activity levels of SARS-COV-2 at individual wastewater treatment plants or sampling locations by state can be found at this CDC website.
The Current Outlook
When it comes to predicting risks, changes in the wastewater levels of the SARS-CoV-2 virus from week to week is the best way to forecast new case trends. Nationally, the wastewater levels for COVID-19 activity are now low and very low. Is this the calm before the expected summer storm?
The CDC has some helpful guidance on preventing infections by respiratory viruses, and maintains a Respiratory Illnesses Data Channel with community snapshots and updates every Friday about the current situation. The Respiratory Virus Dashboard gives a quick visual indication of the risks. Please continue to be careful out there!
Two thumbs up for Dr. Ryan McCormick and his in-depth look at the science behind the COVID-19 vaccines:
I don’t know how he finds the time and energy, but each month McCormick also takes a detailed look at what’s happening with COVID-19, including many of its medical and political ramifications:
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