Hey everyone, welcome back to My Weird Prompts. I am Corn, and I have to say, looking out the window today at the Jerusalem hills, it feels like a completely different world than the one we were living in just a few years ago.
It really does. Herman Poppleberry here, and I think that sense of a different world is exactly what is driving the prompt we got from our housemate Daniel this week. He was asking about something that I think a lot of us have pushed into the back of our minds, but it still shapes so much of our daily infrastructure and health decisions.
Right, Daniel was essentially asking: how did the COVID-19 pandemic actually end? Was there a buzzer? Did someone wave a checkered flag? And more importantly, where are we now, especially for someone like him, a healthy thirty-six-year-old who happens to have asthma. Should he still be keeping up with the boosters?
It is such a timely question because, while the headlines have moved on to other things, the virus itself has not moved on from us. It has just changed its relationship with our society. We are sitting here in February of two thousand twenty-six, and the landscape of global health has shifted so dramatically in just the last twelve months that it is worth taking a step back to look at the timeline.
Well, let us start with that checkered flag moment Daniel was looking for. Because for most people, it felt like the pandemic just sort of... evaporated. But there were official dates, right?
There were. But they were not declarations that the virus was gone. They were administrative shifts. The biggest one was back in May of two thousand twenty-three. On May fifth, the World Health Organization officially declared an end to COVID-19 as a Public Health Emergency of International Concern, or PHEIC. Then, just a few days later on May eleventh, the United States ended its own federal public health emergency.
I remember those dates being a huge deal in the news, but I also remember the WHO Director-General, Tedros, saying very clearly at the time that this did not mean COVID was no longer a global threat. It just meant it was no longer an emergency.
Exactly. It was a transition from a crisis response to long-term management. Think of it like a forest fire. The emergency ends when the active, out-of-control wall of flame is contained, but that does not mean the fire is out or that you stop patrolling for hotspots. You move into a phase where you are managing the landscape so it does not explode again.
So, if that was the official end of the emergency phase, where does that leave us today? Because Daniel’s prompt mentions that it feels like it has just faded into the background. Has it just become part of the normal pool of circulating viruses, like the flu or the common cold?
In many ways, yes, but with some very specific differences. We have entered what epidemiologists call the endemic phase, though that word is often misunderstood. People think endemic means harmless. It does not. Malaria is endemic in many parts of the world, and it is still incredibly dangerous. Endemic just means the virus is consistently present in the population at a predictable level, without those massive, society-shattering surges we saw in twenty-twenty and twenty-twenty-one.
And the tracking has changed too, right? I do not see case counts on the news every night anymore.
Right, because we stopped testing everyone. Most of the data we rely on now comes from wastewater surveillance. It is actually a much more accurate way to see what is happening in a community without needing thousands of people to stick swabs up their noses. And if you look at the wastewater data from early two thousand twenty-six, we are still seeing significant circulation. In the United States alone, we are seeing around five thousand to six thousand hospital admissions per week. That is a far cry from the hundreds of thousands we saw during the Omicron peak, but it is certainly not zero.
It is interesting you mention Omicron, because I feel like people stopped paying attention to variant names after that. It was Alpha, Beta, Delta, then Omicron, and then it just seemed like the alphabet stopped. But the virus is still evolving. What are we actually dealing with right now?
You are right, the public naming fatigue is real. But the evolution has been relentless. We are currently seeing the dominance of what the media has been calling the Stratus and Nimbus lineages. Technically, the dominant strain right now is XFG, or Stratus. It is making up more than sixty percent of cases in some regions. And then there is the NB-dot-one-dot-eight-dot-one variant, which people call Nimbus.
I have been hearing about Nimbus because of the symptoms. People are talking about this razor blade sore throat again.
Yes, that has been a hallmark of the Nimbus variant over the last few months. It is interesting how the symptoms cycle. We went from the loss of taste and smell in the early days to more of a deep lung infection with Delta, then to the upper respiratory, cold-like symptoms of the early Omicron sub-variants. Now, with XFG and NB-one-eight-one, we are seeing these intense, sharp sore throats and significant congestion. The virus is getting better and better at evading the antibodies we built up from previous infections or older vaccines.
Which brings us to the political side of this, which has also had a massive shift recently. Daniel mentioned that it feels like the infrastructure has changed. And he is right. We just saw a huge development last month, didn't we?
We did. On January twenty-second, two thousand twenty-six, the United States officially completed its withdrawal from the World Health Organization. This was a process that started exactly one year prior, when President Trump returned to office and signed that executive order on his first day.
That is a massive shift in how global health is managed. If the U.S. is no longer part of the WHO, how does that affect the tracking of these variants we were just talking about?
It complicates things, for sure. The U.S. has pivoted to what they are calling the America First Global Health Strategy. They are moving away from multilateral organizations like the WHO and focusing on bilateral deals—direct agreements with specific countries for disease surveillance and supply chain management. The argument from the current administration is that the WHO mishandled the early days of the pandemic and failed to reform, so the U.S. is going its own way.
But from a scientific perspective, does that not create blind spots? If we are not sharing data through a central hub, are we not just waiting for the next variant to surprise us?
That is the big concern among public health experts. Organizations like the National Medical Association have been very vocal about how this might weaken our ability to respond to the next threat. When you withdraw personnel and stop funding, you lose that seat at the table where global decisions are made. It is a gamble that our own internal surveillance, like the CDC’s wastewater programs, will be enough to protect us.
Okay, so we have this landscape where the virus is endemic but still evolving, the global health infrastructure is fracturing, and the news coverage has largely moved on. Now let's get to the heart of Daniel’s question: the vaccine. He is thirty-six, healthy, but has asthma. He mentioned a tech at the clinic actually told him he might not need the booster. What is the current guidance for someone in his position?
This is where it gets really nuanced, and I think that tech was likely reflecting a shift in how the CDC frames its recommendations now. In May of two thousand twenty-five, the CDC actually updated its guidance to move away from a universal recommendation for certain age groups. For children and adolescents aged six to eighteen, they moved to a shared clinical decision-making model. But for adults eighteen and older, the recommendation is still an annual COVID-19 vaccine, similar to the flu shot.
But if Daniel is healthy and thirty-six, why the hesitation from the person at the clinic?
I think there is a growing sentiment that for young, healthy people who have already had three or four doses plus a natural infection, the marginal benefit of another booster is lower than it was in twenty-twenty-one. However—and this is a huge however—Daniel mentioned he has asthma. And in the eyes of the CDC and the medical community, that changes the math significantly.
Because asthma is a chronic respiratory condition.
Exactly. Even if it is well-managed, any virus that targets the respiratory system is a greater threat to an asthmatic. But there is actually some fascinating new research that came out just last year that Daniel should know about. In August of two thousand twenty-five, the Karolinska Institutet published a massive study in the Journal of Allergy and Clinical Immunology. They looked at over a million people who had been infected with COVID.
And what did they find regarding asthma?
It was pretty startling. They found that a COVID-19 infection was associated with a sixty-six percent higher risk of developing new-onset asthma. And for people who already had respiratory issues, it increased the risk of chronic sinusitis by seventy-four percent.
Wait, so the infection itself can actually trigger asthma in people who never had it?
Yes, it seems to trigger what they call type-two inflammation in the airways. But here is the kicker: the same study found that vaccination had the opposite effect. People who were vaccinated had a thirty-two percent lower risk of developing these post-viral respiratory complications compared to those who were unvaccinated.
That is a really strong argument for Daniel to stay up to date. It is not just about avoiding a week in bed; it is about protecting the long-term integrity of his lungs, which are already vulnerable because of his existing asthma.
Right. And there was another study from the Korean National Health Insurance System, published in December of two thousand twenty-five. They looked specifically at people with asthma and found that those who were vaccinated had a sixty-one percent reduction in mortality if they did end up with a severe case of COVID. So, for Daniel, the vaccine is not just a general health suggestion; it is a specific tool to manage his underlying condition.
It sounds like the advice he got at the clinic might have been a bit over-generalized. If you are a thirty-six-year-old with zero health issues, maybe you can have a conversation about the necessity of a fifth or sixth dose. But with asthma, you are in a different risk category.
Exactly. And we have to remember that the vaccines we are using now, the two thousand twenty-five and twenty-six formulations, are designed to target these newer lineages like XFG. Using an old vaccine from twenty-twenty-two today is like using a weather map from last year to plan your commute today. The terrain has changed.
So, let's talk about the practical reality of getting these shots now. Since the emergency ended, the way we pay for them has changed, right? It is no longer just a free-for-all at every pharmacy.
That is another big shift. Since the U.S. government stopped buying the doses in bulk, it has moved into the commercial market. If you have private insurance, Medicaid, or Medicare, they are still required to cover it as a preventive service, much like the flu shot. But for the uninsured, it has become much more difficult. Some states, especially those with Democratic leadership, have set up their own programs to maintain access, but in other places, the cost can be a real barrier.
It is interesting how much the local context matters now. Depending on where you live, your access to testing, vaccines, and even reliable data can vary wildly. It makes me think about our situation here in Jerusalem. We have seen our own set of challenges, especially with the regional security issues over the last couple of years. It feels like public health has taken a backseat to national security.
It has, and that is a global trend. We are seeing funding being diverted from health systems into defense budgets. The WHO just pointed this out in a report a few days ago, on the six-year anniversary of the initial pandemic alarm. They warned that the progress we made in pandemic preparedness is fragile. We built up these incredible lab networks and surveillance systems, but if we don't maintain them, they will be useless when the next novel pathogen hits.
It’s the classic cycle, isn't it? Crisis, panic, massive investment, and then as soon as the immediate threat fades, we move into apathy and defunding.
It is. And that is why Daniel’s question is so important. By asking, where are we now? he is refusing to let that apathy set in. He is recognizing that even if the world has moved on, the biological reality remains.
So, to recap for Daniel and for everyone listening who might be in a similar boat: The pandemic ended officially as an emergency in May of twenty-three, but it remains an endemic, seasonal reality. We are currently dealing with variants like XFG and NB-one-eight-one that are very good at causing sharp sore throats and evading old immunity. And if you have asthma, the data from twenty-twenty-five is very clear: the virus is a significant risk for lung complications, and the vaccine is your best defense against those long-term effects.
I would also add that we should be looking at wastewater data for our local areas. If you see a spike in your city, that is the time to maybe pull the mask back out for a week or two when you are on the bus or in a crowded shop. It does not have to be a permanent lifestyle change, just a responsive one.
That makes a lot of sense. It is about being a smart consumer of health information. You do not need to panic, but you do need to be aware. Herman, you mentioned that the U.S. is now focusing on the America First Global Health Strategy. Does that mean they are developing their own independent vaccines now, or are they still collaborating with international pharmaceutical companies?
The collaboration with big pharma is still there, but the regulatory pathway is becoming more insular. There is a push for more domestic manufacturing and less reliance on global supply chains that might be disrupted. But the science is still global. You cannot stop a virus from crossing a border just because you left a treaty. The researchers are still talking to each other, even if the politicians aren't.
That is a bit of a relief, at least. The scientific community has always been more collaborative than the political one.
Usually, yes. And we are seeing some incredible work on what they call pan-coronavirus vaccines—shots that would target the parts of the virus that do not change from variant to variant. If we can get one of those to work, we might finally get off this annual booster treadmill.
That would be the real checkered flag. Imagine just one shot that protects you for five or ten years against any version of a coronavirus.
That is the dream. We are not there yet, but the research funded during the pandemic has put us decades ahead of where we would have been otherwise.
Well, I think we have covered a lot of ground today. From the official end dates in twenty-twenty-three to the U.S. withdrawal from the WHO just last month, and the specific risks for people with asthma. Daniel, I hope that gives you the clarity you were looking for. It sounds like a trip to the pharmacy for that annual shot is probably a good move for you.
Definitely. And for everyone else, stay curious and keep looking at the data. The world is changing fast, and the best way to navigate it is with good information.
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Until next time, stay safe and keep asking those questions. This has been My Weird Prompts. Bye for now!
Goodbye everyone!
