can you spot the public health misinformation?

March 7, 2025 Some people blast you all day with information and no translation. I'm trying NOT to do that.

Mar 07, 2025

Dearest reader,

I think I have figured out why you are here: you are concerned about public health but you don’t want to figure out if every dramatic headline is worth your energy. You are tired. Me too.

BIRD FLU!
MEASLES!
EBOLA?!?
ANOTHER PANDEMIC?
VACCINE BANS?
EGG PRICES?
<INSERT SCARY HEADLINE HERE>?!
IS IT TRUE? IS THIS MISINFORMATION?

You just want to know what is most concerning, what you should do about that, and have permission to let the rest go right now. So that’s what we are going to do today!

I’ll warn you, I’m grumpy today. Medicare is about to drop most telehealth services in less than a month, which means I need a new primary doctor. Transfer of care is not going well. Specialty care is not going well. Getting access to ANY accessible medical care right now is proving to be impossible. I spent my entire afternoon making 28 fucking phone calls with nothing to show for it. Send me a whambulance.

But here we are, doing hard things, so let’s get to it. Our trifecta today looks like this:

low-ish stress health updates
“the misinformation game”
some good news

Part I: Public Health Updates

Influenza Updates

Seasonal flu rates are dropping but still high. The seasonal flu appears to have peaked. Although there may be some some minor hiccups I still have no reason to believe we won’t have reasonably effective seasonal flu vaccines this fall.

As expected, the rates of H5N1 aren’t going down and there is a lot of fear about what that means. Currently, the CDC says that “the current public health risk is low” for H5N1 flu. The NYT reported this week, “A human pandemic is not inevitable, even now, more than a dozen experts said in interviews. But a series of developments over the past few weeks indicates that the possibility is no longer remote.”

Human to human transmission has NOT been reported which is what scientists all agree is the tipping point. I’ll give you a bad, goofy analogy in which the flu will be represented by squirrels. The squirrels in this don’t HAVE the flu, they are just wearing little flu-shaped costumes. Got it?

Pretend Larry the Squirrel is wearing a flu costume.

If the squirrels stay outside of your home, all is well. Right now, there are more squirrels in your yard than average but they remain outside. Your door is closed. It’s a bit unnerving to see so many squirrels in your yard and people keep talking about squirrels ad nauseam. It’s very alarming so soon after the COVID pandemic so you are fixated on the squirrels. But they are outside.

Yes, an H5N1 flu pandemic is possible but it’s not inevitable. If we hit that point of no return, things will happen fast. (Much like things would happen quickly if you had to chase Larry the Squirrel through your kitchen.) But we aren’t there yet. Frankly, there isn’t a lot you can personally do to prepare outside of hand washing and masking up. Don’t touch dead birds. Don’t drink raw milk. Skip the petting zoo. Talk to your doctor if you feel sick especially if you touched a dead bird, drank raw milk, or went to a petting zoo.

Here is a great graphic I found this week which shows the big picture. We are only halfway up the scary meter.

A graphic showing how bird flu risk progresses. We are at the midway point of the approximately 9 steps.

Food supply

A reminder that eggs present a low risk for contracting avian flu. That low risk is reduced even more when you cook them thoroughly.

The dairy milk we buy at the regular grocery store has been pasteurized and is safe. Raw milk is not safe to drink.

The UDSA has issued one cat food recall related to bird flu. The cat food recalled was sold in a package that looks like this:

Wild Coast Raw, Free Range Chicken Formula Raw Pet Food for Cats, 24 oz, label example — Cat food recall issued for this product. See FDA for details.

Cow H5N1 vaccines are in the works, which will serve to slow the spread of avian flu. Currently, infected chicken flocks are being culled (killed) to “stamp out” avian flu. The time it takes for a farm to return to production is measured in months, not weeks. At some point, the USDA may choose to vaccinate chickens as well, although that approach has pros and cons that we won’t get into right now.

Measles Updates

The current measles situation is exactly what you would expect to happen after years of vaccine misinformation resulting in lower vaccination rates.

I expected that this week we would see a continuing rise in measles cases along with another death: I was correct. The first death was a school-aged child in Texas last week. The second was an unvaccinated adult in New Mexico who had not sought medical care. The person tested positive after their death, which is still being investigated. As of 3/6/25, there are 222 cases across 33 states and the hospitalization rate has dropped slightly.

That’s really all there is to report right now. Given how many people ARE vaccinated, the worst case scenario is seeing continued large outbreaks like this for some time—all of which are entirely avoidable.

Overall, the risk of measles to vaccinated people is very low but as the outbreaks continue, health officials are concerned for a few specific populations: those who cannot safety get the measles vaccine, babies who are too young for their first dose, and those who choose not to be vaccinated. The measles vaccine is 97% effective and remains the most robust tool we have to reduce or eliminate outbreaks. A reminder that measles was eliminated from the US in 2000 due to the effectiveness of the vaccination program. I hope we can get back there soon.

The two primary factors that contribute to measles outbreaks in the U.S. are global measles activity and declining MMR vaccination coverage in the U.S. — Image courtesy of CDC.

It’s important to know that the measles rashes look different on different skin tones. Dr. Rubin provided three good examples of this in the Instagram post below. (Click through to see the other images.)

rubin_allergy

A post shared by @rubin_allergy

I spoke with a friend this week who checked to see if her vaccination records indicated that she had two measles shots—something I recommend everyone do if you were born between 1968 and 1989. She mentioned that the first shot she was given had been marked “rubeola.” Rubeola is the same as measles. (Do not confuse this with roseola—that’s a different disease often referred to as sixth’s disease.)

You may have begun to hear about vitamin A as a treatment for measles. It’s true that vitamin A treatments can help; however, it’s not the right treatment in every situation as too much vitamin A can be toxic. Only use vitamin A with the advice of your doctor, despite what RFK Jr. may say.

There isn’t much to do about measles right now if you are vaccinated. Wash your hands and mask in high risk situations. See your doctor if you are concerned about being sick: measles can move very, very quickly.

Part II: The Misinformation Game

Your Turn To Decide!

In Trump’s address to the joint session of Congress this week, there were a few things he shared.

Did scientists spend $8 million dollars to “make mice transgender”? They did use $8 million dollars to improve healthcare for transgender people, cancer patients, HIV patients, and those who have asthma or take certain medications, using mice as a model. When the genome of a mouse is altered for research, they can be referred to as “transgenic mice” which may or may not be the case here. Mice share a lot of DNA with humans so using them as models in research has sped up scientific breakthroughs. These studies are legitimately being used to improve human health—including the health of trans people and cis people. Any woman here take testosterone supplements? This research will help you! People keep complaining about the safety of hormone treatments and science is attempting to answer those very questions. You can see the specific studies listed here in a White House statement and decide for yourself if anyone is making mice transgender or if that sounds like reasonable research to you.
Did scientists spend $3.5 million on “larval fish monitoring”? They did spend $3.5 million on larval fish monitoring, a common practice to help assess water quality, habitat loss, and climate change. I couldn’t find the specific study/studies referenced but that should give you enough information to consider whether you personally find that type of spending unnecessary or helpful.
Is autism the biggest health crisis we are facing? When Trump directed his attention at RFK Jr. during the address he only spoke of one thing: rattling off statistics about the rise in autism to 1 in 36 people. I’m a member of the autism community and can tell you that there is a bit of a rift between two groups: those who see autism as a disease that requires fixing and those who see it as a difference in brain wiring that affects people in different ways. (Sidenote: I would bet you real money you actually don’t even understand the “spectrum” part of the autism spectrum. My favorite piece of all time about that is here.) I cannot speak for all of us but I clutched my pearls a little when it was implied as the most pressing health crisis we are facing as a nation. What do you think is the most concerning threat to public health?
Are doctors sexually mutilating youth? A Harvard study has shown what the LGBT community has been saying: there are not gender-affirming surgeries happening on children under 12 at all— not even one of the 16 million children under 12 that were captured in the study. The study concludes:
“In this cross-sectional study of a national insured population in 2019, there were no gender-affirming procedures conducted on transgender and gender diverse (TGD) minors aged 12 years and younger, and procedures on TGD minors older than 12 were rare and almost entirely chest-related procedures. Additionally, when considering breast reductions among cisgender males and TGD people—a surgery that can be considered gender-affirming among both populations—most were performed on cisgender males. Thus, these findings suggest that concerns around high rates of gender-affirming surgery use, specifically among TGD minors, may be unwarranted. Low use by TGD people likely reflects adherence to stringent standards of gender-affirming care.^”
This study’s sole purpose was to determine the prevalence of gender-affirming surgeries in minors and adults. Does it show evidence of sexual mutilation of youth? Here are some graphs from the paper that may help.
Figure 1. Rates of Gender-Affirming Surgical Procedures Associated With a Transgender and Gender Diverse (TGD)-Related Diagnosis per 100 000 People in 2019.

Figure 2. Proportion of Breast Reductions Performed on Males Without a Transgender and Gender Diverse (TGD)-Related Diagnosis and TGD People, 2019.

Part III: Good News!

(Some) job offers are back.

Yay! About 180 CDC employees who were fired are getting their federal government jobs back.

Mystery illness worries are less scary than we thought.

There wasn’t rubella in TX. There isn’t a new “mysterious disease” in DR Congo. They have mostly solved the puzzle there, by the way. It’s a severe form of malaria. That’s not exactly good news but from a public health perspective, it’s not contagious.

I saw a fellow Substacker post a “BREAKING” message this week about a novel alphacoronavirus that jumped from a rat to a human infant in South Korea. I pulled the research paper that was being referenced and I did not share any concern. I responded with this, explaining my reasoning:

I didn’t receive a response, which is fine. But if you’ve heard about this, just know I’m not concerned about this coronavirus.

Let’s talk about masks.

At some point, masks got political and we lost touch with the real reasons people wear them. I found this wholesome piece by Steph Fowler about why folks wear masks. It’s grounded in science, empathy, and curiosity. Like me, she is suffering from post viral illness.

I was out this weekend for the first time in about 5 months and visited a large performing arts theater. My son and I were the only ones I saw who were masked. I felt a kinship with Steph as my son and I talked about the many reasons we wore masks.

Here’s an excerpt of the dozens of reasons Steph lists in their piece:

“What I think when I see someone wearing a mask in 2025:
Maybe they are immunocompromised and they need to avoid any sort of illness because they are at high risk for long-term health impacts, disability, or death.
Maybe they live with or recently had contact with someone who has been sick, and understand they could be carrying that illness but don’t want to spread it to others.
Maybe they enjoy not being sick.
Maybe they avoid illness because they don’t get any paid time off at their job.
Maybe they are actively sick but they cannot stay home, so they are preventing further transmission to others.”
-Steph Fowler, Misfit Mental Health

Montana lawmaker flips 29 Republicans, killing an anti-trans bill.

Trans issues are deeply related to healthcare and public health: I will die on this hill. Erin In The Morning, Substack’s top writer about trans and queer news, covered this extraordinary vote in Montana. For our international friends here, Montana is one of the last states in which you’d expect this to happen. The video is worth a watch if you need a dopamine hit today.

“Something remarkable happened in Montana today. As has become routine, anti-trans bills were up for debate—the state has spent more than half of its legislative days this session pushing such bills through committees and the House floor, with Republicans largely voting in lockstep. But something changed.
A week ago, transgender Representative Zooey Zephyr delivered a powerful speech against a bill that would create a separate indecent exposure law for transgender people. Since then, momentum on the House floor slowed. Today, two of the most extreme bills targeting the transgender community came up for a vote. Transgender Representatives Zooey Zephyr and SJ Howell gave impassioned speeches—this time, they broke through. In a stunning turn, 29 Republicans defected, killing both bills. One Republican even took the floor to deliver a scathing rebuke of the bill’s sponsor.”

COVID VACCINES HELP PREVENT LONG COVID.

This is huge! My disabling condition is called ME and was caused by the Epstein-Barr virus. It was clear early on in the pandemic that COVID was associated with a similar post viral illness. We didn’t know at the time if the vaccine would help prevent it but we did know that less COVID = less long COVID. After all, you can’t get long COVID if you aren’t infected with it to begin with.

I knew I couldn’t send the kids back to school without the protection of a vaccine. I couldn’t stomach the thought of putting them at risk for what I was dealing with. Even a 1% chance that the vaccine would help was worth it. In 2021, my children participated in Pfizer’s COVID vaccine trial at a research university about 30 minutes away. Once it was approved, they headed back to school with what I hoped was a little protection from long COVID too.

Now we have a clearer answer. A study published last week demonstrates that children ages 5-17 who are vaccinated from COVID are at a reduced risk of developing long COVID symptoms. The study uses the medical term “post COVID condition” or PCC. The findings state, “In this case-control study with 622 participants, vaccination was associated with a 57% decreased odds of 1 or more PCC symptoms and a 73% decreased odds of 2 or more PCC symptoms.”

I read through the study to identify any weaknesses. It’s a relatively small study with 622 participants, of which only 28 suffered PCC symptoms. It also underrepresents both Black and Hispanic children, who are at higher risk of COVID hospitalization and severe COVID. I have some questions about how participants were classified but the authors acknowledge that as a limitation.

Overall, this is solid evidence that you can protect your kids from COVID and long COVID by vaccinating them. Long COVID is no picnic, as many of my readers can attest firsthand.

Ok that’s it for today. It’s great having you here as usual. I thought I would try out the poll function for my own amusement so feel free to give this a spin:

Paid subscribers—heads up! I’m changing your perks here. True story—I missed our live Q&A with an unexpected nap last week. My apologies. The chat is now open for any questions you’ve got.