The Brief

Remember early pandemic Thanksgivings?

Scouring store shelves for rapid tests. Turkey dinners in the backyard. Panic over a stray cough.

Hard to believe we are in our fourth holiday season with COVID-19 potentially crashing the party — always an unwelcome guest.

"It's going to be a persistent threat," says Justin Lessler, an epidemiologist at UNC Gillings School of Global Public Health. "I suspect that next year will look just like this year and the year after that with some variation, just like we see with flu."

And by all accounts, most Americans are essentially back to business as usual. One recent poll found at least two thirds of the public are not worried about getting COVID over the holidays or spreading it to people who are close to them. Meanwhile, half said they plan to take at least one precaution over this fall and winter.

While there was an uptick of cases in the late summer, the virus is now a fixture of the winter respiratory illness season. As expected, emergency department visits and the number of people being admitted to the hospital are ticking up around the country, alongside other bugs.

Hospitalizations have risen more than 8% in recent weeks, but it's not yet clear how severe a wave the U.S can expect this season, says Caitlin Rivers, an epidemiologist at Johns Hopkins University.

"We're also seeing very high levels of RSV, and influenza is also starting to cause trouble," she says. "So there's quite a bit heading into this holiday season."

Luckily, Rivers says there's nothing about the new omicron variants that looks particularly alarming and the updated vaccines still match those circulating strains of the virus quite well.

The winter travel season generally helps usher in more viral illness as people zoom around the country and spend time indoors. Practically speaking, this makes it unlikely most of us will coast through airports or big family get-togethers without running the risk of being exposed, but infectious disease doctors and epidemiologists largely agree that COVID-19 doesn't need to rule our holiday plans anymore.

"This holiday season is going to be different than previous ones and it's because vaccines work," says Dr. Daniel Griffin, an infectious disease specialist at Columbia University. "Almost every American at this point has some degree of immunity."

Even though only about 15% of adults have opted for the latest booster, Griffin says it's important for people to realize that the original three shots are generally holding up quite well against severe disease, although boosted people may feel an extra sense of security, especially if they're at high risk.

"We are approaching it like a normal holiday," says Dr. Helen Chu, a professor at UW Medicine in Seattle. "We all realize that if we're symptomatic, obviously, we would not interact with each other."

Chu says she's comfortable doing this because those she'll be spending time with have received the updated vaccine, and they don't plan to be around people who have a high risk of serious illness.

There are still obvious risks that come with getting infected. In early November, more than 16,000 people were hospitalized in the U.S. in a week. An infection also carries the possibility of long COVID, a debilitating condition for some people, with no proven treatment.

But Lessler says it's clear the calculus has changed for more people.

"It's reasonable to be really focusing on protecting those people at the highest risk in your life rather than earlier in the pandemic, when you may have wanted to take precautions more universally," says Lessler.

Some people are still vulnerable

The patients who remain most vulnerable to COVID-19 and are still ending up in the hospital tend to be highly immunocompromised and dealing with multiple underlying health conditions, says Dr. Emily Landon, a hospital epidemiologist at UChicago Medicine. And they are likely to be older.

"Age is still one of the biggest risk factors," says Landon, "75 or 80 year olds are definitely at much higher risk than younger individuals, but that doesn't mean it's a death sentence at all."

Landon describes how she manages risks in her own life.

She has an autoimmune condition and takes medication that suppresses her immune system. Plus, her mother is 80 and undergoing cancer treatment.

"We're definitely being careful, but we're still going out," she says. "I went to the opera this week. I wore a mask during the performance. It didn't stop me from going and didn't stop my mom from going either."

A mask while traveling is still a good idea

The majority of Americans are going to be just fine having their family Thanksgiving or their holiday gathering without taking precautions like masking or testing beforehand, says Landon.

"But I do think that there are some things that a savvy person who doesn't want to have their holiday season messed up with a respiratory virus can do to make that go a lot better," she says.

Her number one tip for people getting on a plane? Mask up.

"I still see tons and tons of patients who pick up COVID right after they've been on an airplane and they didn't wear a mask," she says.

That's why she recommends wearing an N-95 or KN-95, especially when people are boarding. Once in the air, she will take breaks to eat and drink, but will otherwise keep it on.

Testing is your friend

It may not be as fashionable anymore, but rapid antigen tests still work if you're trying to suss out a COVID-19 infection. (And the government just announced another round of free tests you can order by mail.)

"All the testing continues to show that they are able to detect the variants that are circulating out in the world today," says Nate Hafer, an assistant professor of molecular medicine at UMass Chan Medical School.

One thing to keep in mind: Rapid tests aren't that great at picking up an infection if you don't have symptoms, so don't treat a negative test as rock solid evidence that your Thanksgiving is COVID free.

If you aren't symptomatic, Hafer suggests testing at least twice 48 hours apart "to get the most confidence in whether or not the test is accurate."

While some experts like Landon don't see the point in testing if no one has symptoms, others think it can still be an added layer of security against the virus.

"Testing would be ideal, but I don't think people are going to be doing a lot of that," Griffin says.

Still, it's important to identify COVID infections early, particularly if you or someone you're with is at high risk. That's because Paxlovid, an antiviral medicine that helps people shake the virus, should be given within the first five days of symptoms.

And that means it's crucial to test as soon as a symptom appears or after exposure to confirmed cases. Griffin says not everyone who is high risk may want to be totally candid about it because they don't want to be perceived as "frail."

He says the patients he sees in his hospital tend to be those who did not get treatment during that first week.

"COVID isn't going anywhere. It's going to be a part of our life for many years to come," says Landon. "That said, there are still really good reasons to avoid getting it."

The federal government has drastically scaled back the number of recommended childhood immunizations, sidelining six routine vaccines that have safeguarded millions from serious diseases, long-term disability and death.

Just three of the six immunizations the Centers for Disease Control and Prevention says it will no longer routinely recommend — against hepatitis A, hepatitis B and rotavirus — have prevented nearly 2 million hospitalizations and more than 90,000 deaths in the past 30 years, according to the CDC's own publications.

Vaccines against the three diseases, as well as those against respiratory syncytial virus, meningococcal disease, flu, and COVID, are now recommended only for children at high risk of serious illness or after "shared clinical decision-making," or consultation between doctors and parents.

The CDC maintained its recommendations for 11 childhood vaccines: measles, mumps, and rubella; whooping cough, tetanus, and diphtheria; the bacterial disease known as Hib; pneumonia; polio; chickenpox; and human papillomavirus, or HPV.

Federal and private insurance will still cover vaccines for the diseases the CDC no longer recommends universally, according to a Department of Health and Human Services fact sheet; parents who want to vaccinate their children against those diseases will not have to pay out-of-pocket.

Experts on childhood disease were baffled by the change in guidance. HHS said the changes followed "a scientific review of the underlying science" and were in line with vaccination programs in other developed nations.

HHS Secretary Robert F. Kennedy Jr., an anti-vaccine activist, pointed to Denmark as a model. But the schedules of most European countries are closer to the U.S. standard upended by the new guidance.

For example, Denmark, which does not vaccinate against rotavirus, registers around 1,200 infant and toddler rotavirus hospitalizations a year. That rate, in a country of 6 million, is about the same as it was in the United States before vaccination.

"They're OK with having 1,200 or 1,300 hospitalized kids, which is the tip of the iceberg in terms of childhood suffering," said Paul Offit, the director of the Vaccine Education Center at the Children's Hospital of Philadelphia and a co-inventor of a licensed rotavirus vaccine. "We weren't. They should be trying to emulate us, not the other way around."

Public health officials say the new guidance puts the onus on parents to research and understand each childhood vaccine and why it is important.

Here's a rundown of the diseases the sidelined vaccines prevent:

RSV. Respiratory syncytial virus is the most common cause of hospitalization for infants in the U.S.

The respiratory virus usually spreads in fall and winter and produces cold-like symptoms, though it can be deadly for young children, causing tens of thousands of hospitalizations and hundreds of deaths a year. According to the National Foundation for Infectious Diseases, roughly 80% of children younger than 2 who are hospitalized with RSV have no identifiable risk factors. Long-awaited vaccines against the disease were introduced in 2023.

Hepatitis A. Hepatitis A vaccination, which was phased in beginning in the late 1990s and recommended for all toddlers starting in 2006, has led to a more than 90% drop in the disease since 1996. The foodborne virus, which causes a wretched illness, continues to plague adults, particularly people who are homeless or who abuse drugs or alcohol, with a total of 1,648 cases and 85 deaths reported in 2023.

Hepatitis B. The disease causes liver cancer, cirrhosis, and other serious illnesses and is particularly dangerous when contracted by babies and young children. The hepatitis B virus is transmitted through blood and other bodily fluids, even in microscopic amounts, and can survive on surfaces for a week. From 1990 to 2019, vaccination resulted in a 99% decline in reported cases of acute hepatitis B among children and teens. Liver cancer among American children has also plummeted as a result of universal childhood vaccination. But the hepatitis B virus is still around, with 2,000-3,000 acute cases reported annually among unvaccinated adults. More than 17,000 chronic hepatitis B diagnoses were reported in 2023. The CDC estimates about half of people infected don't know they have it.

Rotavirus. Before routine administration of the current rotavirus vaccines began in 2006, about 70,000 young children were hospitalized and 50 died every year from the virus. It was known as "winter vomiting syndrome," said Sean O'Leary, a pediatrician at the University of Colorado. "It was a miserable disease that we hardly see anymore."

The virus is still common on surfaces that babies touch, however, and "if you lower immunization rates it will once again hospitalize children," Offit said.

Meningococcal vaccines. These have been required mainly for teenagers and college students, who are notably vulnerable to critical illness caused by the bacteria. About 600 to 1,000 cases of meningococcal disease are reported in the U.S. each year, but it kills more than 10% of those it sickens, and 1 in 5 survivors have permanent disabilities.

Flu and covid. The two respiratory viruses have each killed hundreds of children in recent years — though both tend to be much more severe in older adults. Flu is currently on the upswing in the United States, and last flu season the virus killed 289 children.

What is shared clinical decision-making?

Under the changes, decisions about vaccinating children against influenza, covid, rotavirus, meningococcal disease, and hepatitis A and B will now rely on what officials call "shared clinical decision-making," meaning families will have to consult with a health care provider to determine whether a vaccine is appropriate.

"It means a provider should have a conversation with the patient to lay out the risks and the benefits and make a decision for that individual person," said Lori Handy, a pediatric infectious disease specialist at the Children's Hospital of Philadelphia.

In the past, the CDC used that term only in reference to narrow circumstances, like whether a person in a monogamous relationship needed the HPV vaccine, which prevents a sexually transmitted infection and certain cancers.

The CDC's new approach doesn't line up with the science because of the proven protective benefit the vaccines have for the vast majority of the population, Handy said.

In their report justifying the changes, HHS officials Tracy Beth Høeg and Martin Kulldorff said the U.S. vaccination system requires more safety research and more parental choice. Eroding trust in public health caused in part by an overly large vaccine schedule had led more parents to shun vaccination against major threats like measles, they said.

The vaccines on the schedule that the CDC has altered were backed up by extensive safety research when they were evaluated and approved by the FDA.

"They're held to a safety standard higher than any other medical intervention that we have," Handy said. "The value of routine recommendations is that it really helps the public understand that this has been vetted upside down and backwards in every which way."

Eric Ball, a pediatrician in Orange County, Calif., said the change in guidance will cause more confusion among parents who think it means a vaccine's safety is in question.

"It is critical for public health that recommendations for vaccines are very clear and concise," Ball said. "Anything to muddy the water is just going to lead to more children getting sick."

Ball said that instead of focusing on a child's individual health needs, he often has to spend limited clinic time reassuring parents that vaccines are safe. A "shared clinical decision-making" status for a vaccine has no relationship to safety concerns, but parents may think it does.

HHS' changes do not affect state vaccination laws and therefore should allow prudent medical practitioners to carry on as before, said Richard Hughes IV, an attorney and a George Washington University lecturer who is leading litigation against Kennedy over vaccine changes.

"You could expect that any pediatrician is going to follow sound evidence and recommend that their patients be vaccinated," he said. The law protects providers who follow professional care guidelines, he said, and "RSV, meningococcal, and hepatitis remain serious health threats for children in this country."

This story comes from NPR's health reporting partnership with KFF Health News, a national newsroom that produces in-depth journalism about health issues. KFF Health News is one of the core operating programs at KFF, the independent source for health policy research, polling, and journalism.

The National Park Service has updated its policy to discourage visitors from defacing a picture of President Donald Trump on this year's pass.

The use of an image of Trump on the 2026 pass — rather than the usual picture of nature — has sparked a backlash, sticker protests, and a lawsuit from a conservation group.

The $80 annual America the Beautiful pass gives visitors access to more than 2,000 federal recreation sites. Since 2004, the pass has typically showcased sweeping landscapes or iconic wildlife, selected through a public photo contest. Past winners have featured places like Arches National Park in Utah and images of bison roaming the plains.

Instead, of a picture of nature, this year's design shows side-by-side portraits of Presidents George Washington and Trump. The new design has drawn criticism from parkgoers and ignited a wave of "do-it-yourself" resistance.

Photos circulating online show that many national park cardholders have covered the image of Trump's face with stickers of wildlife, landscapes, and yellow smiley faces, while some have completely blocked out the whole card. The backlash has also inspired a growing sticker campaign.

Jenny McCarty, a longtime park volunteer and graphic designer, began selling custom stickers meant to fit directly over Trump's face — with 100% of proceeds going to conservation nonprofits.

"We made our first donation of $16,000 in December," McCarty said. "The power of community is incredible."

McCarty says the sticker movement is less about politics and more about preserving the neutrality of public lands. "The Interior's new guidance only shows they continue to disregard how strongly people feel about keeping politics out of national parks," she said.

The National Park Service card policy was updated this week to say that passes may no longer be valid if they've been "defaced or altered." The change, which was revealed in an internal email to National Park Service staff obtained by SFGATE, comes just as the sticker movement has gained traction across social media.

In a statement to NPR, the Interior Department said there was no new policy. Interagency passes have always been void if altered, as stated on the card itself. The agency said the recent update was meant to clarify that rule and help staff deal with confusion from visitors.

The Park Service has long said passes can be voided if the signature strip is altered, but the updated guidance now explicitly includes stickers or markings on the front of the card.

It will be left to the discretion of park service officials to determine whether a pass has been "defaced" or not. The update means park officials now have the leeway to reject a pass if a sticker leaves behind residue, even if the image underneath is intact.

In December, conservation group the Center for Biological Diversity filed a lawsuit in Washington, D.C., opposing the new pass design.

The group argues that the image violates a federal requirement that the annual America the Beautiful pass display a winning photograph from a national parks photo contest. The 2026 winning image was a picture of Glacier National Park.

"This is part of a larger pattern of Trump branding government materials with his name and image," Kierán Suckling, the executive director of the Center for Biological Diversity, told NPR. "But this kind of cartoonish authoritarianism won't fly in the United States."

The lawsuit asks a federal court to pull the current pass design and replace it with the original contest winner — the Glacier National Park image. It also seeks to block the government from featuring a president's face on future passes.

Not everyone sees a problem with the new design. Vince Vanata, the GOP chairman of Park County, Wyoming, told the Cowboy State Daily that Trump detractors should "suck it up" and accept the park passes, saying they are a fitting tribute to America's 250th birthday this July 4.

"The 250th anniversary of our country only comes once. This pass is showing the first president of the United States and the current president of the United States," Vanata said.

But for many longtime visitors, the backlash goes beyond design.

Erin Quinn Gery, who buys an annual pass each year, compared the image to "a mug shot slapped onto natural beauty."

She also likened the decision to self-glorification.

"It's akin to throwing yourself a parade or putting yourself on currency," she said. "Let someone else tell you you're great — or worth celebrating and commemorating."

When asked if she plans to remove her protest sticker, Gery replied: "I'll take the sticker off my pass after Trump takes his name off the Kennedy Center."

The 83rd annual Golden Globe Awards take place Sunday evening beginning at 5 p.m. at the Beverly Hilton Hotel, and that means parking restrictions and street closures in the city.

Here are places to avoid, as well as some alternative routes:

North Santa Monica Boulevard:

• Westbound lane closures: Complete lane closures, from Wilshire Boulevard to Century Park East through 6 a.m. Monday.
  
• Eastbound lane closures: Complete lane closures, from Century Park East to Wilshire Boulevard from 2 p.m. Saturday through 6 a.m. Monday. 

The city suggests using South Santa Monica Boulevard, which will remain open in both directions. There also are alternative east-west routes such as Olympic, Sunset and Pico boulevards.

Wilshire Boulevard:

• Eastbound/Westbound lane reduction: Lane reductions are in effect and will last through 9 p.m. Wednesday.
  
• Eastbound/Westbound full closure: All of Wilshire Boulevard between Comstock Avenue and North Santa Monica Boulevard will be closed from 10 p.m. Saturday through 6 a.m. Monday.
  
• Eastbound lanes of Wilshire Boulevard: An eastbound closure from Comstock to North Santa Monica Boulevard will occur between 10 p.m. Monday through 6 a.m. Tuesday.

Other streets:

Several other streets like Whittier Drive, Carmelita Avenue, Elevado Avenue and Lomitas Avenue, as well as Trenton Drive and adjacent alleys will have limited closures with local access available only to residents. Closures begin at 10 p.m. Saturday and last through 6 a.m. Monday.

Parking notices:

Residential streets surrounding the venue will be completely restricted, no exceptions made, from 6 a.m. Sunday until 6 a.m. Monday on the following streets:

• Whittier Drive — from Wilshire Boulevard to Elevado Avenue
• Carmelita Avenue — from Wilshire Boulevard to Walden Drive
• Elevado Avenue — from Wilshire Boulevard to Walden Drive
• Trenton Drive — from Whittier Drive to Wilshire Boulevard
• Walden Drive — from Santa Monica Boulevard to Elevado Avenue
• Lomitas Avenue — from Wilshire Boulevard to Walden Drive

Residents without permit parking can obtain parking exemptions by contacting the city of Beverly Hills’ parking exemption line at (310) 285-2548 or online at beverlyhills.org/parkingexemptions.

Demonstrations against this week’s deadly ICE shooting in Minneapolis are planned this weekend across Los Angeles. The protests are being organized by the “ICE Out For Good Coalition” — a network of several groups including the ACLU and 50501.

Here are a some of the planned actions across the city:

Saturday

• Pasadena: Noon to 2 p.m. at Garfield and Colorado Boulevard, across from the Paseo Mall
• Eagle Rock: 1 to 2 p.m. at Colorado and Eagle Rock boulevards
• City of Los Angeles: 2 to 4:30 p.m. in Pershing Square

Sunday

• West Hollywood: 11 a.m. to 1 p.m. at 647 N. San Vicente Blvd., across from the Pacific Design Center.
• City of Los Angeles: Noon to 2 p.m. at The Home Depot on 2055 N. Figueroa St.
• Beverly Hills: 2 and 4 p.m. at 9439 Santa Monica Blvd., between Beverly and Canon drives