I keep an eye on a number most people have never heard of: how much COVID virus is showing up in Wake County’s sewage. It is the most honest early-warning signal we have. If the virus is moving through the community, it shows up in the wastewater first, usually a week or two before I see it in the office. That number is going up. In early July, the largest treatment plant serving Raleigh was reading close to zero. By the end of August it had climbed roughly forty-fold, and ev

Travel season is here, and for many of us, it brings the inevitable compromise: the trade-off between the excitement of a new destination and the high-risk environment of modern transit. In my practice, we don't just "hope" for health; we anticipate challenges and optimize our defenses. Travel is, by definition, a long-duration, high-exposure event. You are in a pressurized cabin or a crowded terminal, and despite rigorous hand hygiene or masking, you are inhaling the same re

Right on schedule, a new COVID variant has arrived. And right on schedule, the headlines are coming. "New COVID Variant Detected in 25 States." "75 Mutations May Evade Immunity." ... The Facts BA.3.2 is a new Omicron subvariant first identified in South Africa in November 2024. As of this month, it has been detected in 23 countries and found in wastewater samples from 25 U.S. states. Those two sentences are going to generate a month's worth of alarming chyrons. Wastewater sur

Over the past few weeks, many of you have asked me about measles. Some of you are vaccinated. Some of you are not. Many of you are simply unsure what to think. When several of you bring up the same concern, I pay attention. So I reviewed the CDC surveillance data myself. What the Data Shows Confirmed measles cases in the United States have increased compared to recent years. Early 2026 case counts are already significantly higher than typical early-year baselines from prior o

As we head into Christmas week, many of you are traveling, hosting family, or attending large gatherings. I want to briefly address the new circulating flu strain—commonly referred to in the media as the “K variant,” and medically classified as Influenza A (H3N2)—that we are seeing this season, and more importantly, what it means practically for you and your family over the next 10 days. What’s different about this flu season? The term “K variant” refers to a subclade within