What We Know About COVID

Last updated Nov 28, 2024

Please use this URL to reach this page: https://covidnow.info. You can send corrections and updates to webmaster at the same domain.

How to read this page: scan down for bolded headers with super-short summaries. Then read the details in the sections you care about.

Change log

Table of Contents

• Summary
• Vaccines
  • Nasal vaccines
• Effects on children, kids, and teens
• How safe are Parties
  • Without requiring testing
  • When requiring testing
• Gathering safely
• Masks
• After a gathering - Neti pot, nasal irrigation
• Symptoms as indicators of infection
• Rapid tests, effectiveness, how to do them
  • Affordable tests
• If you get it, what do you do?
• Consequences of Reinfection
• Immune and organ damage caused by COVID
  • Bone damage
  • Heart damage
  • Brain damage
  • Immune system damage
  • Mitochondrial damage
• COVID stays in the body
• Long COVID
• PREVENTION: How to avoid COVID
  • Air travel and COVID safety
• Resources: Research, People to Follow
• Wastewater and other COVID tracking
• FAQ about COVID and viruses
• Change log

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Summary of Current Status (TL;DR)

COVID is a disease that affects multiple body systems—not just respiratory—and is deadlier than the Flu (Journal of the AMA). It causes heart, brain, and immune system damage, (even in mild cases.) Vaccinated or not, roughly 6.9% of those who get COVID have lasting post-COVID symptoms ("long COVID"), which can appear up to 3 years later. It can stay in the body and gut after the acute phase. "Close to half" of all Long COVID cases include some kind of brain fog (brain damage).

Prevention measures include properly fitted respirators (N95, KN95), good ventilation (> 6 air exchanges per hour), good air filtration (MERV-13 or better), and Far-UVC 222nm ultraviolet light. A preclinical study suggests a nasal gel may be effective at prevention.

Mitigation upon exposure includes Paxlovid, with both Metfornin and nasal irrigation being researched for their ability to reduce or eliminate the severity of COVID.

Long COVID affects teens and kids who have previously had COVID. It affects nearly every organ system in kids and teens. It is linked to greatly increased risk of type 2 diabetes in kids and teens. • ScientificAmerican

State of Infection

• October 15: 1 in 111 (US) currently infectious, with cases rising. with COVID. Dashboard

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What We Know: What’s Important

Most people are behaving as if COVID is completely a thing of the past. Science says otherwise.

Our COVID knowledge is still young and developing. Vaccine-resistant strains (variants) evolve faster than we can study them. Long-term effects are unknown, because the virus has only been circulating since 2020. (By contrast, HIV virus causes AIDS ... but only 8-10 years down the line.)

April 2024: Yale School of Public Health graphic presentation about COVID's effects on the immune system. Facebook • Sources & Citations

COVID causes immune dysregulation (lots more sickness), neurological damage (brain damage), and increases risk of heart attacks and strokes. Long COVID can strike even mild cases of COVID, and sometimes doesn't begin until 30+ days after the initial COVID infection.

Fun fact: Vaccines are safe. A man got vaccinated 217 times and had no ill effects. He also didn't get COVID. Source

• Even mild covid causes neurological damage in 60% of cases (small study, sample size 100) Article
• People with high levels of HLA-DQA2 immune system gene expression may be immune to COVID Study • Article
• Long COVID can appear up to 3 years after even a mild infection. Happens at lower rates for non-hospitalized initial infections. Nature
• KP.2, a variant of the JN.1 lineage, may be 3.1x as immune evasive as JN.1, and 1.22 times as contagious (Re). Pre-print
• 2/3 of spread is asymptomatic. CDC
• Children and schools a major vector for spread. Infectious disease modeler
• Two large-scale studies show even mild COVID causes cognitive deficits. • NEJM1 • NEJM2
• Cognitive deficit equivalent to 2-9 IQ points, even in mild, fully-recovered cases Lancet • NEJM
• Vaping certain products can increase susceptibility to COVID-19
• Getting sick more often? If you've had COVID, you could have immune system damage. See below.
• Immunity from JN.1 is completely gone within a year Medrxiv preprint
• Damaged immune response may be causing neurological damage, not the virus itself Source
• Ventilation helps reduce transmission in indoor spaces. CDC
• Wear N95, KN95, or P-100 masks indoors in crowds, or in any poorly-ventilated spaces where virus may accumulate.
• Neti Pots, nasal irrigation, and gargling early in an infection or after exposure substantially reduces severity of symptoms and chances for hospitalization.
• Rapid tests can falsely show negative even when someone is contagious. This is because immune symptoms in vaccinated/previously infected people appear early, before viral load is high enough to show up on a rapid test. So someone can be infected for 4-5 days or more before a test will show positive. Swab both throat and nose for increased sensitivity (though possible false positive) results.
• The virus stays in your system even after you recover. Institut Pasteur
• Reinfection damages your immune system, it doesn't make you stronger.
• Even mild cases can produce long COVID, brain, heart, and organ damage.
• Long Covid can (and most often does) happen in cases that were mild or asymptomatic. Many other non-intuitive co-factors. Medscape article
• Long COVID is real and evidence suggests that it involves brain damage. Long COVID may be caused by the body's immune response, not directly by the COVID virus.
• Dec 2023, State of COVID in Canada. 37.9% of people with 3 or more COVID-19 infections suffer prolonged symptoms. 72.5% of those continued to experience symptoms after 12 months. 22.3% of those with prolonged symptoms took days off and the average was 24 days off in the year since the first report. Most common symptoms included brain fog, fatigue, and shortness of breath. Source • h/t Anthony Kearns, LinkedIn

See below for details and sources.

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What We Know: The Details

Vaccines: they work, but stay current

A twitter thread about how immunity and vaccines work, and what affects how long immunity lasts.

• UT Austin researchers may have discovered an antibody that could protect against all COVID variants Source
• CDC study: COVID vaccines don't cause elevated risk of myocarditis in young adults CDC
• Novavax produces more antibodies than mRNA vaccines Source
• Vaccines reduce the risk of heart damage Source
• Get the latest booster. Pre-2023 vaccines booster produce the same levels of hospitalizations/outcomes against JN.1 as in unvaccinated people. Source
• Vaccine effectiveness wanes over time. Source
• Vaccines reduce transmissibility BUT… It depends which vaccine, and which variant. The original vaccine reduces transmission of original variants by 70%+, but that drops to 55% for Omicron. Source
• Cardiac risk from COVID-19 infection far outweighs risk from the COVID vaccine for all age groups Source

Nasal sprays and vaccines

Nasal sprays and vaccines are being developed for COVID and other diseases.

• Nasal gel Profigel may be effective at blocking COVID uptake in preclinical study. Study Note: the study authors state a conflict of interest in that they have patents and commercial interests in the formulation being studied.
• Nasal vaccines seem extremely promising. They work 100% for hamsters. Source
• A random controlled test on iota-carrageenan sprays in 2021 shows promising COVID protection. Medrxiv
• Iota-carrageenan may neutralize several early Omicron variants in-vitro Source

Effects on children, kids, and teens

COVID doesn't kill them initially, but it can cause organ damage and Long COVID.

• 10-20% of infected kids get Long COVID ScientificAmerican • JAMA
• COVID Greatly Increases Diabetes Risk in Kids and Teens Article • Study
• Children and teens with prior COVID infection have Long COVID symptoms 1.5 years later. Medscape • Journal of the AMA Study
• COVID changed facial recognition in infants. It inhibited it in some ways, and it also enabled infants to better-develop the ability to recognize faces wearing masks. Study
• Pre-school children developed more persistent COVID antibodies, fewer virus-reactive B cells, and T cells displaying higher inflammatory features. Study

Effects on pregnancy and babies

• Maternal COVID-19 infection associated with offspring neurodevelopmental disorders Source

How Safe are Groups Gatherings and Parties?

They're a lot safer now that we have vaccines and testing, but they can still be risky. Even though the chances of any one person having COVID may seem small, if you have many people in a group, the chances that someone in the group currently has it can be high.

See https://tinyurl.com/covidriskcalc for an interactive risk calculator. (It's very broad-stroked and only takes into account the test sensitivity and percent of people who have tested negative.) You can find one estimate of current community prevalence here.

If you are not requiring testing:

1. Identify which line represents the community prevalence you think is accurate.
2. Scan over the X axis to the number of people you think will be at the party.
3. Look up to where that number intersects the community prevalence line you chose.
4. Look at the Y axis to find the percentage chance that someone at the party will have COVID.

Example: 30 person party with 3.5% community prevalence:

Are schools risky?

According to infectious disease modeler JP Weiland, yes.

If you are requiring testing:

Tests are very valuable for reducing risk, even though tests might not be very sensitive and thus might give false negatives (they can show negative even when someone is positive). I've created a small spreadsheet to help you figure out risk based on testing results.

The spreadsheet is based on the 1 Brown 3 Blue "The Medical Test Paradox" explanation of interpreting test results, along with some basic probability to scale up from one person taking a test to a whole party taking a test:

1. Download this EXCEL spreadsheet.
2. For the Rapid Test you're using, look at the data sheet and enter the Sensitivity and Specificity of the test into the appropriate yellow cells.
3. Find out the overall population incidence of COVID, based on Wastewater numbers. For example, wastewater may indicate that roughly 1 in 40 people in your area are positive¹. Enter that in the appropriate yellow cell.
4. Enter the size of your party.
5. Enter the % of people who you believe will test. The risk level varies dramatically depending on how many people test.

The results can be counter-intuitive. Having everyone test with a less sensitive test (column 2) can make the party much less risky than having 80% of the people test with a more sensitive test.

How to gather safely: outdoors or well-ventilated

• Ask people with symptoms to stay home (see Symptoms below)
• Ask people to test beforehand and stay home if they test positive. Make sure to read the section on testing for groups above. The difference between everyone testing and 80% testing can make a huge difference in the riskiness of a gathering, depending on how prevalent COVID is at the moment.
• Important: Rapid tests are only partially effective. Current rapid tests seem to be giving a lot of false negatives. Have people test. If they test positive, they should stay home. If they test negative, they should test again after 48 hours. (No one actually does this, so requiring a negative test will likely allow some positive people who have a false negative through, on average.)
• Party outdoors and/or with good ventilation.
• Ventilation guidelines. CDC guidelines
• Ventilate during a party. Build and use a Corsi-Rosental box. Corsi-Rosental instructions.
• Ventilate after a party. CDC Ventilator Calculator

Masks: use N95s, KN95s, or P-100s when indoors

• Surgical masks are degraded by alcohol vapor from hand sanitizer (if you’re going to mask, N95/KN95 are a far superior choice anyway). Study
• Mandatory masking on medical wards reduced viral infections from 22.1% to 2.1% Nature
• Jul 2024 Study: mask requirements and vaccine mandates were effective and could have saved hundreds of thousands of lives. Journal of AMA • Article
• Another meta-analysis says Masks Work at individual protection and community protection. Mask mandates also work. ASM
• Masks and respirators protect others by catching exhaled virons, even when not fit-tested. Duckbill N95s better than cloth, which were better than surgical masks or the tested KN95. Article • Study
  
• ReadiMasks are NIOSH-approved N95 masks that seal with medical adhesive rather than straps. You can seal them around just your nose(!) during dental procedures to minimize inhaling air during dental work. Video of use • Readimask website
• Masks work for respiratory illness, guidance in plain English. CDC
• Masks work. CDC
• Choosing which mask to use. CDC • Infographic
• Masks work. Source
• Mask using a high-quality respirator like an N95, KN95, or P-100. Learn to check the fit. Source
• 3M Aura N95 9210+ work well and are glasses-compatible. Link
• Blue surgical masks and masks worn incorrectly don't protect you. They protect against droplets, not against aerosols. COVID is an aerosol.
• For a more attractive mask with KN95 equivalence, the Flomask Pro is pricey and NIOSH-certified.

Two-way masking works best to prevent transmission:

After a Gathering: nasal irrigation (Neti Pot or squeeze bottle)

• Use a Neti Pot or other nasal irrigation system Use in the nose and gargle 2-3x per day after a crowded party. Nasal irrigation produces a substantial decrease in hospitalizations and symptom severity if done early in a COVID infection, no matter which saline formulation is used. Source • Source • Source • Article • Source

One safe option is to act as if you've been exposed after a party. For the next three days, use a neti pot or nasal irrigation 2-3x/day and gargle with a CPC containing mouthwash. These are inexpensive, have no downside, and may offer substantial protection.

Symptoms: assume it's COVID

Symptoms start before the virus multiplies. Your immune system is more sensitive than rapid tests. You'll have immune cold symptoms like runny nose, sore throat, and so on as soon as you're exposed, even though you'll still test negative.

When you have symptoms, assume it's COVID: mask around other people and isolate until you know for sure. Ideally, take a test that sorts out COVID vs. flu vs. RSV vs. other infections.

Asymptomatic infection and false negatives are still common in the first several days of COVID.

Some cases have gastro-intestinal symptoms only. Lack of appetite, nausea, vomiting, diarrhoea, and abdominal pain. These may not be the symptoms people expect with covid, but around 50% of people experience them after SARS-CoV-2 infection, and in some people they’re the only symptoms.1 Gastrointestinal (GI) symptoms may be the first sign of infection or may develop later and persist as part of long covid. BMJ

Rapid tests: partially effective, false positives

The current rapid tests were developed for the 2020 variant of the virus, and they still seem to work. However, they often don't show positive until several days after infection.

October 1, 2024: Order free rapid tests from https://special.usps.com/testkits

• Rapid tests good at detecting highly-contagious cases but not necessarily lower-contagious cases. @michael_hoerger
• Testing positive on a rapid test—whether on day 5, 10, or 20—may mean you're still contagious. PBS News Hour • CDC
• Swab throat and nose. Some variants multiply more in the throat than the nose. Swab throat (tonsils) and nose for best results. YouTube how-to
• Rapid tests still work against latest variants (Jan 2024). Annals of Internal Medicine • MSN article • NIH
• Rapid tests can give false negatives. Bloomberg article explaining theories why
• Test twice, 48 hours apart. If you test negative but have symptoms, wait 48 hours and test again before assuming you're genuinely negative. (I've heard that even 48 hours is not enough, but can't find definitive sources for that claim.)
• Safest assumption: be skeptical of negative tests and retest a couple of days later. Assume positive tests are correct.
• 2022 meta-analysis: Rapid Tests most effective in symptomatic cases Cochrane

A rapid test repeated in nose and throat (mid-December 2023)

Affordable rapid tests

At the moment, rapid tests are appearing at all price points, often upwards of \$20 per test. Here are sources to buy them in bulk at cheaper price points. These sources and brands have not been vetted. Order at your own risk.

• Flowflex COVID-10 Rapid Test
• FaStep Rapid Test

What if you get it? Neti pot, nasal irrigation, gargle, Metformin

• Paxlovid reduces hospitalizations by 61% and long COVID incidence by 58%. Article • Study
• Even for mild cases, ease yourself back into exercise slowly. This article is from 2022 but there doesn’t seen to be much updated guidance around this • Article
• NEJM study released April 2024 suggests Paxlovid may not be effective at reducing duration of the disease, but it does still seem to reduce symptom severity. NEJM
  • CDC website last updated Dec 2023 still says: check with your doctor about taking Paxlovid within the first 2-3 days of infection. CDC web site
• There is some evidence that Mouthwash with CPC (cetylpyridinium chloride) may reduce the COVID viral load in the mouth. Example: Crest Pro-Health CLINICAL. Study1 • Study2 • Study3 • Study4 • Study5
• Use a Neti Pot or other nasal irrigation 2-3x per day. Neti pots and squeeze bottle nasal irrigation may decrease the need for hospitalization and may decrease severity of symptoms. Source • Source • Source • Source • Source
• Metformin looks promising, but isn't yet officially approved for treatment. Lancet study done on early variants • NIH web site
• Avoid exercise? Maybe? Exercise is complicated. It may make recovery harder. It may help recovery past a certain point in the disease. The NIH overview suggests that it's complicated. NIH overview • Popular Source

Reinfection

• Feb 13, 2024: Scientific American on what we know about reinfection
• Reinfection damages the immune system. Source
• Reinfection increases Long COVID risk. Canadian study, Dec 2023 • Source • Source
• Reinfection immune system damage may be why it increases LC risk. Source
• Reinfection damages multiple organ systems. Source • Source

Post-COVID brain, immune, heart, and organ damage (there's a lot!)

August 2024 article in Heart.org, American Heart Association

Bone damage

• Multi-faceted impact on bone health. COVID may lead to alterations in bone structure, osteoclast activity and bone loss. Clinical may lead to hypocalcemia, altered bone turnover markers, and a high prevalence of vertebral fractures. Disease severity has been correlated with a decrease in bone mineral density. Source

Mitochondrial damage

• COVID can lead to changes in mitochondrial respiration. (Thus affecting cellular energy metabolist.) Study • Study

Immune system damage

April 2024: Yale School of Public Health slides: COVID and the immune system. Facebook • Sources & Citations

• COVID exhausts CD8 and CD4 T cells. This may mean permanent immune system damage. Study
• Acquired Immune Deficiency "Immune dysregulation caused by infection of CD147 lymphocytes is consistent with clinical data of severe and Long Covid cases." Study
• Even mild COVID leads to long-term immune system changes. "COVID-19 causes long-term reduction of innate and adaptive immune cells which is associated with a Th2 serum cytokine profile." Important note: though published in 2024, the cohort studied all had the pre-vaccination original strain of COVID. Article • Study in Allergy
• post-COVID, increases frequency of other infections, consistent with immune damage World Health Network
• Immune system damage from severe cases. Source
• Immune system damage from mild-to-moderate cases. Source
• Increased risk of auto-immune diseases. Source
• Immune system damage persists after recovery. Source

Viral Persistence

• The virus stays in your system even after you recover. Institut Pasteur • Nature
• COVID virus may stay in the lungs after an infection. • Source
• Meta-analysis: The prevalence of post-COVID symptoms is 30% for two-years after COVID-19 hospitalization. See footnote² for an important note. Source
• Covid fragments assemble into "zombie" sequences provoking immune response after infections are over. Study • Plain English
• COVID found in spermatozoa up to 3 months after infection Source
• Covid fragments assemble into "zombie" sequences provoking immune response after infections are over. Study • Plain English

Brain Damage

• Long COVID neurological impact mainly affects young adults Source
• Cognitive impairment when measured objectively, but no subjects reported feeling as if they were impaired. Study
• Bloomberg 9/13/24 article summarizing COVID-related brain damage Article
• Even mild covid causes neurological damage in 60% of cases (small study, sample size 100) Study • Article
• Cognitive decline for years after infection, even for mild cases. Lancet
• Article detailing brain damage with links to primary studies TheConversation
• A decline in executive function and especially verbal fluency was found in acute patients, partially persisting in recovered. (Small sample size) Source
• 200,000-person study: COVID leads to memory loss NEJM • ScienceNorway
• Even fully recovered mild COVID patients had cognitive deficit equivalent to 3-point loss in IQ NEJM
• Two large-scale studies show even mild COVID causes cognitive deficits. • NEJM1 • NEJM2
• Trinity College-brain fog caused by blood vessel damage Trinity
• Neurological damage (brain damage) from mild COVID Source
• Post-COVID, multiple cognitive impairments ("brain fog") Nature
• Cognitive decline and brain damage in hospitalized patients Source-preprint
• Damaged immune response may cause neurological damage, not the virus itself Source

Heart Damage

• Heart damage Source • Source
• Multiple organ systems. Source
• Even mild cases can produce long COVID and organ damage. Source
• Exercise intolerance-decreased oxygen uptake by organs Source

COVID stays in the body

As of March 2024, COVID appears to stay in the body, like HIV, HPV, Herpes, etc.

• COVID can persist in the gut for 2 years after infection. NIH
• COVID can stay in the body. More severe acute infections lead to higher chances of finding COVID in plasma. Lancet
• Chinese study suggests that Long COVID is caused by Covid in the tissues Lancet
• COVID stays in the lungs Source
• Virus can stay in the body News story I am searching for links to the actual studies.

Long COVID: it's real and common

Most concerns have been about the severity of initial infection. A more troublesome concern is "Long COVID," which can cause extreme disability.

Click here for a graphic from SCIENCE that summarizes currently known mechanisms of Long COVID

Sep 2024: Mayo Clinic study suggests that with medically diagnosed COVID, vaccination does not reduce the chances of Long COVID. Study • Article
July 2024: Layman's article by epidemiologist and COVID researcher on what we know about Long COVID Article

Children and teens with prior COVID infection have Long COVID symptoms 1.5 years later. Medscape • Journal of the AMA Study

• About 7% of all Americans have had Long COVID, as of early 2023 Of those vaxxed and boosted, it's about 5.8%. JAMA
• About half of those with Long COVID have experienced brain fog (brain damage) Yale Medicine writeup • Archive link
• Long COVID can appear up to 3 years after even a mild infection. Happens at lower rates for non-hospitalized initial infections. Nature
• University of York: 28% of COVID patients develop Long COVID. Vaccination reduces chances by factor of four. Article
• Chinese study suggests that Long COVID is caused by Covid in the tissues Lancet
• What we know about Long COVID so far (Jan 2024) Nature • Science
• Increasing evidence of COVID brain damage
  • COVID-19 infections can trigger new-onset dementia in adults over 60 SSRN
  • Long COVID could be brain damage Medscape
  • Long COVID patients show cognitive slowing 2-3 standard deviations below the mean. (2-3 standard deviations is bad, very bad) Source
  • Neurological damage (brain damage) from mild COVID Source
  • Long COVID and Impaired Cognition NE Journal of Medicine 2/29/24
  • Immune dysregulation may cause neurological damage Source
• Sleep apnea associated with increased Long COVID risk NIH
• Long COVID patients have T-cell dysregulation (immune system malfunctions) • Source
• Multiple rounds of vaccinations lower Long COVID risk • Scientific American article with links to primary sources.
• Exercise may harm Long COVID sufferers who have post-exertional malaise • Source
• Most Long COVID patients are from mild or asymptomatic cases. More women than men. Many other co-factors including non-obvious ones like joint hypermobility, history of anxiety or depression. The article is worth reading • Source
• Long COVID affects ~5.3% of COVID cases in vaccinated people • Source
• As of Dec 2022, roughly 7% of all adults have had Long Covid at some point, with ~3,500 LC deaths as of 2022. Source1 • Source2
• Long COVID frequency in Canada, suggests that reinfection increases the risk of Long COVID. • Source
• "Long" diseases are common in viral infections. Long HIV is AIDS. Long chicken pox is Shingles. Long Epstein Barr is Multiple Sclerosis. We already know that Long COVID can be anything from loss of taste/smell to crippling fatigue, stroke, and heart failure. We have no idea what Long COVID is over 5+ years.
• CDC reports "thousands" of deaths from Long COVID • CDC • Medscape commentary

Avoiding COVID: vax, mask, ventilate, far-UVC, immunity

• There may be a genetic component to COVID severity. Study Note this study was done in 2020, at the very start of the outbreak.

• People with high levels of HLA-DQA2 immune system gene expression may be immune to COVID Study • Article

• Brief elevator rides riskier than meetings in conference rooms. Study

• Ventilate CDC

• Don't vape, or make sure your vaping formulations don't increase COVID-19 susceptibility. Source

• Get the latest booster. Pre-2023 vaccines booster don't protect at all aganist JN.1. Source

• Use good ventilation (6 or more air changes per hour) and air filtration (MERV-13 or better) when indoors with others. Mask in unventilated rooms where others have been in the last few hours.

• Build and use a Corsi-Rosental box. Corsi-Rosental instructions.

• Stay up to date with boosters. Pre-2023 vaccines don't protect against JN.1.

• Be on the lookout for sterilizing ultraviolet Far UVC (222nm) technology Source • Source • Source

Air Travel and COVID

When air travel required everyone to wear N95 or better masks, transmission during air travel was almost non-existent.

When no one is masking (late 2024), transmission happens. Single-masking with an N95 or better can provide some individual protection, though not as much as two-way masking.

• Longer flights, more chance of COVID. Masks reduce chances. Source

Other Resources: Research, People, Dashboards

People to Follow

• Michael Hoerger Director of US COVID Forecasting dashboard.
• J.P. Weiland Infectious Disease Modeler
• Dr. Ruth Ann Crystal, MD Prose newsletter on the state of COVID with links to peer-reviewed studies and data sources.

Other research compilations

Collections of links to science:

• Memorial Sloan Kettering Library COVID impacts
• Table of studies grouped by effect
• Database of abstracts and links to studies. Grouped by topic.
• ThatCovid.Life Resources and science-based articles.
• UCSF Long-term Impact of COVID studies

COVID Tracking Dashboards

As part of their commitment to pretend COVID ended in 2022, most United States administrations have dismantled their COVID tracking infrastructure. Here are sites known to work:

• PMC COVID Forecasting Public U.S. COVID forecasting dashboard.
• CDC Wastewater Trend Graph Wastewater is the most reliable indicator we are still tracking of current COVID prevalence. This site aggregates wastewater data by state, and they keep two years' worth. The default only goes back one year, but you can select "All data" from the dropdown to see back two years.
• Verily WastewaterScan.org Dashboard Wastewater tracking for COVID, Flu, RSV, etc. Twitter thead of instructions
• Biobot wastewater graphs Easy-to-use wastewater graphs by state, directly from a wastewater measurement company. Includes historical data going back several years. Replaced by aggregated "narrative" updates.
• COVIDACTNOW.ORG Tracks community risk levels.
• COVID current circulating variants
• CDC COVID data tracker CDC data tracker site³.
• CDC Trend graphs Weekly hospital admissions
• Discontinued
  • Biobot stopped making their wastewater dashboard available, May 2024. They no longer separate out COVID-19 from other respiratory viruses, and there is no way to subscribe to their updates. You must now visit their site and seek out their narrative "risk reports" (which do not break data down by location except very, very broadly).
  • Hospital COVID tracking has been discontinued as of May 2024.

FAQ about COVID and viruses

1. Wastewater numbers are high, but hospitalization numbers are steady. Every single surge, this has been reported. This forgets time lag. Wastewater today turns into symptoms in a week. Symptoms take 5-10 days to get bad, if a case is going to be severe. That leads to hospitalization. Then it takes an additonal week or two to know if hospitalization leads to death. It's an error to try to correlate the two without accounting for the time lag.

2. Wasn't COVID officially declared over in Feb 2022? The declaration was a political communications strategy, not based on public health. Here's the memo from HOUSE.GOV

3. Surely it was over before then. We were back in the office with no precautions. The World Economic Forum at Davos, attended by top world leaders, billionaires, and celebrities, told a different story. They had masking, ventilation, filtration, and Far UVC air sterilization. We got to return to offices without mitigations, while they were using more mitigations than any workplace has yet set up. Source

4. Isn't COVID like the flu now? COVID is much worse than the flu. It causes both immune and organ damage and is several times more fatal. News source • Original study

5. Won't COVID get less severe over time? No. This is a myth. Some viruses get milder over time. Others don't (e.g. encephalitis, flu, measles, HIV, etc.) Source PDF of article from SCIENCE

6. Isn't Omicron milder? Not really. This was inappropriately hopeful reporting before we had much data. These conclusion also had not properly controlled for the new vaccines. Source

7. Are more dangerous variants possible? Yes. Source PDF from Nature Reviews

Caveats about this site

Governmental agencies, businesses, and private media outlets have misrepresented the science through ignorance or for political reasons throughout the pandemic. This page is my attempt to link to scientifically-based research or public health sources. Use it at your own risk.

The virus is changing faster that we can know things for sure. For example, by the time we know the hospitalization rates for a variant, it will be too late to take preventative measures. That's why I include pre-prints in my links. While pre-prints haven't yet been replicated or peer-reviewed, they're at least based on attempts at hard data, rather than hearsay or wishful thinking.

Change Log

• 2024-11-28 Long COVID neurological effects mainly occur among young adults
• 2024-11-19 - Added link to Yale Medicine information about Long COVID
• 2024-11-11 - Added studies on Maternal COVID and NDD babies. Also on skeletal effects.
• 2024-11-02 - Added link to COVID calculator
• 2024-10-30 - new study showing Paxlovid linked with 61% reduction in hospital admissions and 58% reduction in Long COVID
• 2024-10-18 - Added link to Scientific American article about kids and COVID
• 2024-10-17 - Added diabetes risk in kids (study just released this week)
• 2024-10-15 - Link to pediatric study that children and teens show Long COVID symptoms 1.5 years after COVID infection
• 2024-09-30 - added link to free rapid tests
• 2024-09-28 - added Profigel, infant face recognition during COVID, child immune development
• 2024-09-23 - added link to study about COVID severity and genetics. Also added link to study about COVID-caused brain damage and subjective awareness of that damage.
• 2024-09-22 - Added the Bayesian risk calculation spreadsheet for incorporating test results into risk evaluation
• 2024-09-22 - removed Novavax 95% immunity study. Invalid conclusion.
• 2024-09-19 - COVID can persist in the body after the acute infection
• 2024-09-18 - some people may be immune to C19
• 2024-09-16 - surgical masks are degraded by hand sanitizer. Added mandatory masking reduces infection rate 22->2% study.
• 2024-09-10 - Added mention of UT finding what might be a pan-CORONA antibody
• 2024-09-09 - Added links to mitochondrial damage
• 2024-09-04 - Mayo Clinic study shows long COVID chances may not be reduced by vaccination.
• 2024-08-16 - added Northwestern Univ study on cognitive impairment
• 2024-08-12 - Added Heart.org article about COVID multi-system effects
• 2024-08-06 - Duckbill N95s catch exhaled virus, study
• 2024-08-05 - Added just-published Lancet study on cognitive decline.
• 2024-07-28 - vaccine mandates and mask requirements were effective and saved lives, study in JAMA
• 2024-07-19 - Long COVID: added The Conversation article on what we know about it so far.
• 2024-07-16 - Even mild COVID leads to long-term immune system changes.
• 2024-07-14 - RATs good at identifying highly-contagious cases, but not lower infection rates
• 2024-07-11 - Added quick update that we're in a big surge right now
• 2024-06-22 - Link to The Conversation article on brain damage, with lots of links to studies. Added current prevalent stats.
• 2024-06-19 - People with highly active expression of gene HLA-DQA2 may be immune to COVID.
• 2024-06-18 - Added link to Hawaii dashboard re: current surge
• 2024-06-09 - JAMA network survey showing ~7% Long COVID incidence in US as of early 2023
• 2024-06-08 - COVID rising in Hawaii.
• 2024-06-03 - Long COVID can appear up to 3 years later
• 2024-05-24 - Added Air Travel and COVID,
• 2024-05-22 - Added link to ASM meta-analysis about masks working. Updated the (increasingly fewer) tracking websites.
• 2024-05-10 - added CDC link for figure that 2/3 of COVID spread is via asymptomatic people. Added GI symptoms.
• 2024-05-04 - added Readimask links
• 2024-05-03 - clarified that NEJM study showed no reduction in duration of Paxlovid, but, consistent with other studies, did show a reduction in symptom severity. Added KP.2 study link.
• 2024-04-29 - added section on nasal sprays and vaccines
• 2024-04-28 - university of York study
• 2024-04-26 - Chinese study suggests LC due to viral persistence
• 2024-04-22 - Yale publishes slides on current state-of-COVID
• 2024-04-12 - CDC study says no elevated risk of myocarditis from COVID vaccine
• 2024-04-11 - Added study that Novavax may provide 95% protection after 10 months
• 2024-04-05 - NEJM study saying Paxlovid doesn't make a significant difference
• 2024-04-01 - added links to CDC and PBS News Hour regarding rapid tests and isolation periods
• 2024-03-27 - added links to other research archives and LIINC
• 2024-03-26 - for people who really want to read studies, added links to other pages that compile COVID research studies under the "who to follow" section
• 2024-03-24 - added link to Twitter thread about vaccines and waning of immunity
• 2024-03-20 - kids still drive spread, JPWeiland thread link, decline in executive function and language
• 2024-03-18 - Added the still-nascant section on viral persistence
• 2024-03-16 - WHN post covid increase in infections
• 2024-03-13 - New study released, vaccines reduce the risk of heart damage
• 2024-03-12 - COVID found in spermatozoa
• 2024-03-11 - Added information about viral persistence.
• 2024-03-10 - Corrected CDC Tracking description to say you can see all data by clicking a dropdown. Updated with latest research about rapid test effectiveness.
• 2024-03-07 - Added preprint study, JN.1 natural immunity gone after 1 year, 217-time vaccinated dude
• 2024-03-06 - Norweigan study, COVID -> memory impairment
• 2024-02-29 - NEJM Long COVID article on impaired cognition, SSRN new onset dementia study, sleep apnea, Long COVID and Cognitive Deficits
• 2024-02-28 - added state-of-long-COVID Nature and Science
• 2024-02-27 - added Vaping study
• 2024-02-23 - added Longitudinal Canada study link, updated US wastewater numbers, Nature study on brain fog, Trinity college brain fog cause (brain blood vessel leakage)
• 2024-02-21 - 300,000 Coloradans with Long COVID
• 2024-02-16 - JN.1 is 95-97% of all US cases, what we know about COVID so far
• 2024-02-14 - added Scientific American overview of what we know about reinfection
• 2024-02-12 - added study suggesting disregulated immune response, not the virus, is what causes neurological damage
• 2024-02-08 - Medscape article, Long COVID could be long-term brain injury
• 2024-02-05 - Added links to sources for affordable rapid tests (which currently retail for roughly $26 for a package of two)
• 2024-02-03 - New long covid research about COVID "zombie" fragments in Long COVID
• 2024-02-01 - Updated to say we're past the peak surge in the U.S.
• 2024-01-30 - Added meta-analysis to Long COVID section. 30% symptom prevalence 2 years after infection.
  
• 2024-01-26 - Added study showing LC patients show 2-3 STD lower processing speed than controls.
  
• 2024-01-25 - Added link to CDC Long COVID death report. (Most reporting has been on Long COVID treatment or disabilities. This is on the actual LC death count.)
  
• 2024-01-25 - Added link to Belgian study on vaccine effects on transmissibility
  
• 2024-01-21 - Added link to Bloomberg article about rapid tests giving false negatives early in an infection.
  
• 2024-01-20 - Added study that came out this week, mild COVID leads to neurological damage.
  
• 2024-01-18 - Added study: exercise may be bad for certain Long COVID sufferers
  
• 2024-01-17 - Tried again to clarify the JN.1 study wording.
  
• 2024-01-15 - Clarified the JN.1 study synopsis to make it explicit that hospitalization rates were relative to unvaccinated people, but the unvaccinated population may still have had a level of antibodies from an actual COVID infection.
  
• 2024-01-15 - Added the change log.

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