05/16/2026
🦠 May 2026 NEWSLETTER 🦠
🦠 HANTAVIRUS, WANT-A-VIRUS
Before I say anything else, I want you to understand that these Hantavirus reports seem to be really overhyped. Why? Because hantavirus cases happen every year in the United States, and no one gets their feathers ruffled. The CDC even provides us with a very helpful map.
Note: These are the cumulative confirmed cases since 1993:
https://assets.newsweek.com/wp-content/uploads/2026/05/HantaVirusMap-1-2.png
For those keeping score at home:
- 890 total cases in 35 years, or
- About 25 cases per year.
For comparison, you're more likely to:
- Get bitten by a dog (96 cases/year)
- Drown (800/year)
- Airplane crashes (45/year)
Okay, so what do we know?
☑️ WHAT IS HANTAVIRUS, EXACTLY?
Hantavirus is a family of RNA viruses carried by rodents.
In the U.S., the dominant strain is Sin Nombre Virus (SNV), spread primarily through contact with deer mouse f***s, urine, or saliva — typically in enclosed spaces like cabins, barns, or attics (or landfills!) where rodent droppings dry out and become aerosolized.
SNV causes Hantavirus Pulmonary Syndrome (HPS): rapid, severe respiratory failure with a historical case fatality rate around 35–40%.
There is no approved antiviral. Supportive care — ideally ICU-level respiratory support — is what moves the needle. Early recognition is everything.
☑️ WHY IS THIS OUTBREAK DIFFERENT?
The MV Hondius outbreak involves Andes virus (ANDV) — a South American strain with one critical distinction: it is the only known hantavirus with documented person-to-person transmission. This is not common nor efficient. But it is real and it's why this outbreak warranted the federal response it received.
During a 2018 Argentina outbreak, one symptomatic patient infected five people through close contact. Critically: 94 other partygoers did not contract it, and 82 healthcare workers — many without proper PPE — remained negative. This is not a highly contagious respiratory pathogen.
☑️ WHAT SHOULD YOU ACTUALLY WATCH FOR?
Hantavirus Pulmonary Syndrome begins with a flu-like prodrome: fever, myalgias, headache, fatigue. Then it deteriorates fast — pulmonary edema, hypoxia, shock. The window between early symptoms and respiratory failure can be as short as 48–72 hours.
If you have any possible exposure history and develop these symptoms: do not wait. Message us directly or go to an ER. Early escalation matters more with hantavirus than almost anything else I can name.
☑️ WHAT MAKES ME CAUTIOUSLY OPTIMISTIC
✅ Genetic sequencing confirms passenger samples are nearly identical to 1997 and 2018 strains — no worrying mutations.
✅ The U.S. infrastructure is functioning. Nebraska's National Quarantine Facility was built for exactly this.
✅ No new infections in people without documented MV Hondius exposure — that is the key number to watch.
☑️ GENERAL HANTAVIRUS RISK IN CENTRAL TEXAS (YEAR-ROUND)
Here in Central Texas, we have deer mice and other rodent species that carry SNV. U.S. endemic hantavirus has NO person-to-person spread, but direct rodent exposure is a real risk.
If you're cleaning out a barn, cabin, shed, or garage that has been closed for a while: wear an N95 (not a surgical mask), wear gloves, and wet-wipe surfaces before any sweeping. Never dry-sweep or vacuum. This kills a handful of people in the U.S. every year who simply did not know the protocol.
☑️ MY BOTTOM LINE
This is not COVID. Andes virus is too difficult to transmit efficiently, the infrastructure is functioning, and the outbreak appears contained. Federal communication has been slow — the HAN physician alert only dropped on the May 10th weekend, well into the outbreak. That is a systems failure worth noting.
BOTTOM LINE: Do not cancel your trips. Do avoid dry-sweeping rodent droppings in enclosed spaces.
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🏛️ THE CHILDHOOD VACCINE SCHEDULE GOT OVERHAULED — THEN FROZEN
-- HHS / CDC, January–March 2026
In January 2026, HHS issued a major update to the childhood immunization schedule, acting on a December 2025 Presidential Memorandum directing CDC to compare U.S. vaccination practices against peer developed nations and re-evaluate the evidence base. The result: the schedule was trimmed from 18 targeted diseases down to 11, with a new three-tier structure:
-- Tier 1: Recommended for all children
-- Tier 2: Recommended for high-risk groups
-- Tier 3: Shared clinical decision-making (this is where hepatitis A, hepatitis B, RSV, meningococcal B, and dengue now live)
Then, in March 2026, a federal court in Massachusetts issued a stay, pausing the implementation of the revised schedule and reverting the effective recommendations back to the 2025 versions. So for now, it's legally frozen — but the policy fight is very much alive.
What this means practically: CDC's stated position is that all vaccines on the December 31, 2025 schedule remain covered by ACA plans, Medicaid, CHIP, and VFC programs. Insurance coverage hasn't changed. What has changed is that this debate is now explicitly in the public square.
🔥 BUT WAIT! IT GETS MORE INTERESTING!
The New York Times (that bastion of all things intellectual) recently published an article titled, "RFK Jr. Is Driving a Vast Inquiry Into Vaccines, Despite His Public Silence".
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This part is from the excellent article on the Coffee and Covid Substack, by Jeff Childers:
“Behind the scenes,” the Times explained, “Kennedy is spearheading an intense push to examine his long-held theory that vaccines are helping to fuel an epidemic of chronic disease.” And, “the wide-ranging inquiry is a top priority for Mr. Kennedy, who sees vaccines as a potential culprit.”
Well, well, well. Since its hit piece last week failed to fracture MAHA, the Times has flipped sides. Now it’s admitting that, in fact, vaccine reform has sped up, if anything. “The effort is being led by Dr. Martin Kulldorff, a critic of Covid restrictions and vaccine mandates.”
What most alarmed the Times is that the vaccine safety initiative spans the entire federal government. “Career scientists at the Food and Drug Administration and the Centers for Disease Control and Prevention are conducting the research alongside contractors who provide statistical expertise and access to millions of patient medical records.”
Worse, “Kennedy has tasked some government scientists,” the article grimly continued, “with studying the health status of vaccinated children compared with those who were not vaccinated.” You’d think the Times would be excited about a scientific study like that. If vaccines are so wonderful, the vaccinated group should crush the unvaccinated kids. I mean, at minimum they should be calling for the study to be well-designed, not trying to shut it down altogether.
The article reported that “vaccine scholars” were alarmed that Kennedy might use the results of the new study to “erode confidence in vaccines.” To be clear, the Times described the studies as straightforward comparisons of health outcomes between vaccinated and unvaccinated children, conducted by CDC scientists and Kaiser Permanente officials. The scholars are not worried the study will be rigged. They are worried it won’t be.
The article reeked with the stench of fear.
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☑️ MY TAKE: This is the most significant restructuring of federal vaccine policy in my lifetime. WHATEVER your personal position on individual vaccines, the shift toward a tiered, risk-stratified approach is closer to how any thoughtful clinician actually practices.
One-size-fits-all mandates have always been a blunt instrument. I'll have more to say on specific vaccines in future issues. For now: your Code 1 members can always schedule a dedicated vaccine discussion if you want my honest breakdown of your family's specific situation.
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✅ THE LDL NUMBER WARS JUST GOT SETTLED (FOR SOME OF YOU)
-- Source: Ez-PAVE Trial, NEJM — March 2026
For years, we've argued about how low LDL needs to go in people who've already had a cardiac event, or those with existing heart disease (coronary plaque). There is a lot of confusion, lots of well-meaning and emotional stances that really weren't supported by the data (on both sides).
FYI: The old target was
