• The Omicron subvariant BA.5 has been the dominant strain in the US over the summer. There are signs that the US summer surge of BA.5 is waning.
  • Other Omicron subvariants are being monitored – BA.4.6 and BA.2.75 are the latest under observation. The former seems to be upticking on the East Coast.
  • On August 11, the CDC loosened its COVID guidelines, including precautions like quarantining and social distancing, but notes that actions should continue to be informed by your community’s transmission levels. We encourage masking in crowded, unventilated spaces to try to decompress the burden of disease and give less leeway to this virus to mutate.
  • On August 15, Britain approved a bivalent booster (Moderna) that will target the original coronavirus variant and the Omicron variant. A similar booster is expected in the US as early as September. As of August 22, Pfizer seeks FDA authorization for their updated bivalent booster. Currently only those 50 and up or those ages 5-11 who are immunocompromised have been eligible for a second booster.
  • A new study shows that the COVID pandemic was associated with increases in pregnancy-related complications (including cardiovascular disorders, hypertension, and hemorrhage) and maternal deaths during delivery hospitalization.
  • How SARS-CoV-2 affects the brain is better understood with a two-year retrospective cohort study published in The Lancet on August 17. There are increased incidences of mood and anxiety disorders related to post-COVID recovery. We continue to learn more about the after affects of COVID-19 – remaining empathetic to those recovered is important as we continue through the pandemic.


  • The emergence of monkeypox has been declared a global health emergency.
  • Symptoms include a rash, which can be very painful. Other symptoms that might appear are headache, fever, muscle aches, sore throat, and swollen lymph nodes, which usually appear before a rash. People are only contagious when they have symptoms.
  • Monkeypox is not considered an efficient virus. In almost all cases, there is prolonged skin-to-skin contact for transmission. On rare occasions, contact with contaminated linens or surfaces can also transmit the virus. Rarely, there is transmission via respiratory secretion. Symptoms usually start within two weeks after exposure to the virus.
  • New York, California, and Florida are leading the country in the number of cases.
  • There are two vaccines available and a therapeutic agent called TPOXX that is accessible, if needed. Those eligible for vaccination, in general, include people who are aware that a sexual partner has been diagnosed with monkeypox in the last two weeks or those with multiple sexual partners in the past two weeks that was in an area known to have monkeypox cases. Importantly, there is a four-day window to receive vaccination after exposure.
  • If someone has symptoms, avoid close contact, such as kissing, cuddling, having sex, talking closely, or touching rashes or scabs. Avoid contact with any objects that have traces of their bodily fluid, such as clothes, towels, or sheets.
  • If one suspects they may have monkeypox, it will be important to isolate and remember to not share bathrooms or linens during infection.
  • As of the week of this publication, there have been 18,417 US cases of monkeypox and zero deaths.


  • In June, a case of polio was identified in an unvaccinated adult in Rockland County, New York. This is the first reported case in the US since 2013. This was a vaccine-derived poliovirus type 2 infection. (Vaccine-derived polio virus emerges only when live, attenuated oral poliovirus vaccine is administered in a community with low vaccination coverage. Oral poliovirus vaccine was removed from the US immunization schedule in 2000, and now only inactivated poliovirus (IPV) vaccine is available here.)
  • A single case of paralytic polio represents a public health emergency in the US.
  • Children under 5 are most at risk if not fully vaccinated, as well as those adults who remain unvaccinated.
  • The virus spreads via person-to-person contact through contact with the stool of an infected person or, less commonly, via respiratory droplets. The virus enters the body through the mouth, usually when hands are contaminated. Polio virus can shed in the stool for weeks.
  • The full polio vaccine series produces at least 99 percent protection against severe disease. If you and your children are vaccinated, it’s safe to assume you are protected.
  • When individuals get infected, 90-95 percent are asymptomatic, and 5-10 percent experience minor symptoms (fever, headache, sore throat, nausea, vomiting, fatigue). In general, one in 1,900 poliovirus type 2 infections among unvaccinated persons is expected to result in paralysis.
  • The NYSDOH, in accordance with the CDC, released the following guidelines:
    • All children should get four doses of the polio vaccine, with the first dose given at 6 weeks through 2 months of age, followed by one dose given at 4 months of age, 6 through 18 months old, and 4 through 6 years old.
    • Adults who are unvaccinated or are unsure if they have been immunized should receive three doses.
    • Adults who have only had one or two doses of the polio vaccine in the past should get the remaining one or two doses – it does not matter how long it has been since the earlier doses.
    • Adults who are at increased risk of exposure to poliovirus and who have previously completed a routine series of polio vaccine (IPV or OPV) can receive one lifetime booster dose of IPV.

NOTE: We are keeping an eye on the severe flu season in the southern hemisphere. We will keep all patients up-to-date when flu vaccines are available this fall.