The leaves are falling in earnest. Thanks to the numerous large, old black oak trees, our yard requires weekly grooming between October and December. Employing my two electric leaf blowers in tandem, I fight nature. I know entropy always wins, but Hemingway's words (from The Old Man and the Sea) float through my head, "A man can be destroyed but not defeated." Or at least that's what I tell myself.
https://www.goodreads.com/quotes/111352-but-man-is-not-made-for-defeat-he-said-a
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Hospitalization rates are falling. Wastewater RNA concentrations are stable. Combined with the anecdotal data I am seeing, it appears COVID is enjoying a more significant and persistent community spread than in the summer but less than the Delta or Omicron surges of Fall/Winter 2021-2022 or 2022-2023.
The N.Y. Times COVID Tracker reflects only CDC-gathered hospital data. Hospitalization data are a (lagging) indicator.
https://www.nytimes.com/interactive/2023/us/covid-cases.html
Wastewater monitoring is more of a LEADING indicator.
The Inside Medicine COVID dashboard
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COVID articles
I strongly suggest getting the updated XBB Pfizer, Moderna, or Novavax COVID boosters. Yale offered an update to its consumer-friendly compare-and-contrast of the vaccines.
https://www.yalemedicine.org/news/covid-19-vaccine-comparison
and
https://twitter.com/Billius27/status/1718270918839914497
Every week, I see a large volume of "consequences of COVID" articles - both bench-top and population-level data indicating the long-term clinical impacts of coronavirus. I found the two studies cited below this past week. They are not perfect, but they demonstrate the volume and breadth of published research.
Researchers examined 18,000 Hong Kong healthcare system patients treated for prostate enlargement symptoms between 2021 and 2022. The study is a case-control, retrospective analysis. Half of the patients had had COVID (~9000). As compared to patients who had never had COVID, patients with a history of COVID infection had more and more severe symptoms of prostate enlargement (urinary retention, blood in the urine, urinary infection, and increasing medication doses).
https://onlinelibrary.wiley.com/doi/10.1111/joim.13719
Turkish researchers have demonstrated exposure to the coronavirus spike protein while in the womb alters rat's animal cognitive and social behavior after birth. "Prenatal SARS-CoV-2 Spike Protein Exposure Induces Autism-Like Neurobehavioral Changes in Male Neonatal Rats."
https://link.springer.com/article/10.1007/s11481-023-10089-4
and more information:
https://x.com/vipintukur/status/1717888344611598529
Medical Trends and Technology
Dr. Jeremy Faust offered a thorough update on AI in healthcare, reviewing the latest studies and use cases.
https://insidemedicine.substack.com/p/ai-in-medicine-update
Many of my office patients report using supplements (at least in this respect, they are typical, I suppose). The supplement industry is unregulated. Over-the-counter (OTC) pills' ingredients, purity, and batch-to-batch consistency are not verifiable nor receive governmental oversight. Dr. Josh Trebach (E.R. and toxicology at the University of Iowa) offers a fantastic review of the supplement market through the lens of "gas station energy pills." (Hint from a doctor - don't use gas station energy pills).
https://twitter.com/jtrebach/status/1718272815827189797
Brazilian researchers have been working on a vaccine that generates antibodies that bind to cocaine, making users no longer able to feel high after ingestion (it makes the cocaine molecule so large it can't pass the blood-brain barrier). They won an innovation award from Europharma last week, which has spawned renewed media interest in this topic. Either way, this research demonstrates novel uses of the immune system. [I wonder if we will develop cocaine that can evade the antibodies? I bet Alpha Fold can help - see below.]
https://www.barrons.com/news/brazil-scientists-developing-new-vaccine-for-cocaine-addiction-4e70eca1
Infographics
I did not appreciate that biologists rank various animals by their hunting success. My backyard friend, the dragonfly, catches its prey 95% of the time (compared to polar bears at 10%).