Lots of chatter on Twitter involving reputable sources about subvariants not responding to some or all of our monoclonal antibody therapeutics.
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I hadnāt considered this one, thanks!
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Itās very likely Topolonoās (if I can snag a res) will be our only indoor dining to finish the trip out. Both because covid but also, as it turns out after discussion, my teens are a lot less interested in the dining opportunities than I am 
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This was very, very helpful. Thank you!
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TL;DR:
Latest on Paxlovid:
Link to the detailed analysis thread, including link to study:
https://twitter.com/michaelzlin/status/1576764552749801472?s=46&t=7rGoQHvLGpmlglcdAg7hHw
I didnāt read the study, just Linās take on it. A few of my takeaways:
- For those for whom Pax is recommended, there is a very clear risk reduction, even if they are vaxxed/boosted.
- Being vaxxed/boosted is still the better first-line approach in terms of both cost and benefit (donāt just rely on Pax in lieu of vax)
- This is regardless of whether āpax reboundā is a significant thing. Itās still preventing severe disease/hospitalizations in those eligible.
- Whether it would have benefits to the rest of the population is likely dependent on whether it reduces the risk of Long Covid, which hasnāt been determined yet.
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Well if itās in TikTok you know itās a dumb idea.
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That sounds revolting 
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Everything you never thought youād want to know about variant naming in a nutshell:
https://twitter.com/tryangregory/status/1576945959824523264?s=46&t=Yl4g9dwmNDXtx41mr8tvHQ
Which brings us to the current state of things:
More here:
https://twitter.com/tryangregory/status/1577617059525140480?s=46&t=Yl4g9dwmNDXtx41mr8tvHQ
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CO2 Monitoring Update - commuter edition (& pics)
I had my first true crowded rush hour commute and readings were better than expected.
Times Square subway platform, crowded: ~650
NYC Subway, uncrowded: 1100+.
I let one train pass b/c it would been shoulder to shoulder inside and probably a lot higher than 1100. It was only a few minutes til the next one.
NJ transit commuter bilevel train, moderately crowded: ~1400
Train was pretty full, with most seats filled, but no standees.
Secaucus junction train station, uncrowded: ~450
The Secaucus rotunda is my indoor low reading champion, with consistent readings below 500. I think itās because it has an immensely high ceiling (50ā), and very low density. Nobody lingers, they just pass through. You could probably fit 500 people in there and thereās rarely more than 50 at any one time, but they probably sized the ventilation system for 500. Result: I take my N95 off and eat my snack with peace of mind while waiting for my train.
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Remember how I asked about the flu vaccine in August and the pediatrician suggested waiting?
Guess which household already has had the flu?
Oddly enough, Flu B, the first case sheās seen this year.
DDās only symptom - a sore throat - was on the heels of her brother having strep throat, or I wouldnāt have taken her to the doctor at all.
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Thanks for these regular readings!
We are pretty much running as precovid, but I wouldnāt get on a plane/busy transit without a solid mask.
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Ugh, Iām so sorry. Sick kids is just no fun.
Yeah, my pediatrician recommends to get the flu vax as soon as convenient. Heād rather we get flu on the back end with waning immunity than on the front end before we get vaxxed. It make sense to me. 
I know other doctors are onboard with yours though. It would be nice if they could have a meeting and gain a consensus or a short statement on the pros/cons or something.
However, there does seem to be fairly good consensus that everyone should get both their flu vax and their bivalent booster by the end of October. So hopefully everyone is making plans to do so. Be sure to allow a day or two after the Covid booster for recovery. Itās hitting some people fairly hard (but itās still better than the alternative risks, unless you are going to extremes to avoid infection entirely).
The one place I might hold off on the Covid booster at this point is kids under 12. Currently, only the original formula is available ad a booster, but Pfizer has put in its application for kids 5-11 and I think theyāll discuss that at the ACIP meeting Oct 19-20.
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Moderna has too as well so they should be reviewed together at whichever meeting they .
Our DS5 is up for a booster Oct 18 from his original vaccine series and he has an appointment at the local HD Fri Oct 21 to get whatever booster shot is available to him. I decided earlier this summer that unless some clear evidence came out to not get the original booster in 5-11ās, he was going to get whatever shot was available to him that week. It was just easier to make the decision than wait & worry to see what happened. (I had enough of that with the <5 approval where we were hunkering down to keep him protected until he turned 5 & even though I definitely wouldāve preferred the original timeline of end of 2021 for <5 approval panning out, a silver lining from him aging into the 5-11 approval allows us to āsee around the cornerā a bit for his risk since by the time heās up for whatever next step, thereās been 6 months of peers going ahead of him to get some data on & make a more informed decision).
At one point I was actually hoping the 5-11 bivalent takes until past Oct 21 bc then he could potentially get a boost now (original) and in another 2-3 months when itās likely going to be peak surge time, he could get the updated version as well for another boost covering more time. But more recently Iām absolutely ok, because this virus is so wily, with him getting the updated shot sooner so that even though his coverage might last less time, itās more synced up with whateverās circulating. Heās our kid with a risk factor so all of the last 2 years has been one risk calculus recalculation after another and this Mama just wants to never open the risk tracking spreadsheet ever again. Thereās some opt-out form for the pandemic, right?? And I was just missing from the distro list when the memo for it went out?
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Goodness, if you find that form, I want in. And I think a number of people have tried to DIY it. And Iām concerned that is going to go very, very badly this winter. Because this virus just isnāt playing.
Oh, you are absolutely right! That had slipped my mind Also, a footnote on younger kids.
Your logic absolutely makes sense. But, Iām not sure how that timing will work out. For the adult bivalent, when it got approved, IIRC they immediately discontinued boosting with the old formula and some places had no boosters available for a few days until the supply of new formula arrived. If the ACIP meeting is Oct 19-20, you could fall in the gap so just be alert to that and have a fall back date picked.
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Oh, a very good call out on the gap for that Friday. I am probably spoiled by our health department. They have been super accessible by way of mobile weekly clinics and almost always having both Pfizer & Moderna in stock in their various health centers county-wide and every new rollout are ready to go with stock the first day itās available. And I have two of their locations easily accessible to our daily lives one of which is one of their bigger/centralized locations which means they often run open-house vaccine clinics usually the first couple of Saturdays following these rollouts.
I think just having made the decision that heāll just get the booster available to him makes me a lot less nervous about exactly which side that day will fall on and ultimately, even though Iād prefer a Friday just in case he has any side effects, Iāll be happy to wait until early the following week if the health department needs that time to get their updated stock in & clinics rolling.
You will be very much on the list I will forward to. As soon as I find it too.
I was avoiding thinking about this fear until this week. And oddly enough starting to think about it is helping me appreciate that things are good right now and to just enjoy right now.
But yes, I hope I am very wrong but the storm that is brewing for Covid, this winter could be the worst winter yet. Partly bc the infrastructure for public and clinical health has been maxed, put the brink, and thatās generally been the case this whole time & nothingās collapsed yet, but how sustainable is this? Is it getting better or have we just stopped talking about how burnt out the system has been after this? My anecdotal experience with a loved one that is a healthcare worker is that she is on her 2nd timeout & pausing on trauma ICU nursing work that she pre-COVID was interested in & drawn to. So my guess is on we just stopped talking about it.
So yes, Iāll get you the opt-out form soon as I can find it.
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DS got his flu and BiV booster today. DH has to wait to have his BiVā¦ what is itā¦ 2 months after his last booster? I havenāt gone to look it up, but I bet someone here knows that number off the top of their head 
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2-3 months
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Thank you! I knew someone would know. Now I just have to look at his vaccination card for the date of his last booster. I believe it was in Aug b4 we went to Aulani.
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