I wish people would understand that insurance underwriters have armies of actuaries calculating risks, and if an insurance company drops you, it's because things have changed in such a way that insuring you will take more out of the financial pool than you're putting in

1/ It sucks, but it's a direct result of the fact that humans are widely inhabiting locations that are rapidly becoming impossible to inhabit safely. If you can't find insurance for your home, it means there's a high likelihood you'll need to move soon anyway.

2/

So here’s the thing about some of the subtle neuro damage related to SARS-CoV-2 infection that I think a lot of people miss: some of the known deficits are correlated with things like impulsiveness and poor emotional control, so we might expect to see deficits there are well

1/ Consider how impatient people seem to be on the road in the last couple years relative to the 2010s, and I think we have a perfect example of where this is LIKELY already manifesting.

2/

NEW STUDY! This exploratory study identifies a SPECIFIC PHENOTYPE OF LONG COVID that appears related to NEUROMUSCULAR DISTURBANCE rather than lung damage—and they've termed it Complex Ventilatory Dysfunction!

Breakdown of the paper (thread written for a general audience!)...

1/ Broadly speaking, there are two groups of acute covid outcomes involving dyspnea (shortness of breath) as a long-term symptom:

- Severe cases that may have physical lung damage
- "Mild" cases that now have ME/CFS-like features, but who have no evidence of lung damage!

2/

NEW STUDY! It VERY thoroughly supports the hypothesis that SARS-CoV-2 emerged as a zoonotic spillover event in the Huanan Seafood Wholesale Market—using multiple methods!

Breakdown of the paper (written for a general audience!)...

1/many (but it's worth it, I promise!) This paper reanalyzes the same data from the April 2023 paper in Nature that cast doubt on the Huanan Market hypothesis (pictured).

In the new paper published in Cell this week, another group conducted far more detailed (and statistically sound) analyses!

2/

Want to see 13 academic cry-bullies throw a hilarious, peer-reviewed tantrum?

The real gold is in the 943-word "Competing Interests" section!

I also discovered that ONE OF THE AUTHORS WROTE HIS OWN WIKIPEDIA PAGE 🤣🤣

Thread...

1/19

Kasper P. Kepp "has been engaged in the pandemic debate in Danish media and social media, where he has been critical of the studied zero-covid groups"

It's wildly unethical to conduct a study *specifically* targeting entities you've personally had conflict with.

2/

NEW PREPRINT! Another study about ABNORMAL BLOOD CLOTTING related to SARS-CoV-2, but unlike the others I've covered, this isn't related to the spike protein.

Turns out that Mpro, a viral protease [pro-tee-ace], can START the cascade.

Thread (written for everybody!)...

1/many Here's the takeaway: The *Main protease* (Mpro) of SARS-CoV-2—an enzyme that cuts up viral polyproteins—can also cleave a few host coagulation factors in a way that ACTIVATES them and BEGINS the blood clot cascade.

So that's uh... that's not ideal.

2/

Whenever I summarize a research paper about the SARS-CoV-2 spike protein, people always ask if the S proteins from the vaccines will do the same thing. It's a fair question!

mRNA vaccines are MUCH less likely to cause spike-related problems than an infection! Here's why...

1/ First, the spike protein used in the mRNA vaccines isn't the same as the spike protein on the actual virus! The US-approved mRNA vaccines (and Novavax) use a stabilized version of the protein that DOES NOT cause many of the issues that the wild SARS-2-S protein does!

2/

NEW STUDY! This one confirms A LOT of other results.

Turns out, SARS-CoV-2 infection can cause lasting EPIGENETIC MODIFICATIONS, which effectively results in ACCELERATED BIOLOGICAL AGING.

Let's dive in! (Breakdown thread written for a general audience...)

1/many This one is dense, so I'll start with the takeaways, then some background, then the details.

The authors conclude that SARS-CoV-2 exposure may have "associations with aging, [stochastic epigenetic mutation] accumulation, and dysregulation in critical pathways."

2/

NEW PREPRINT! This one seems potentially very, VERY SIGNIFICANT!

This study found "significant reductions in measures of mitochondrial content and impaired muscle energetics" in LC fatigue—AND a corresponding biomarker!

Summary thread (for a general audience!)...

1/many So as you probably know (or at least, should know), prolonged fatigue is one of the most common and significant long-term consequences of COVID, even after mild cases.

Studies have pointed to the T cell response having an impact on mitochondrial function.

2/

This preprint (from April 5) is FASCINATING. Someone requested I have a look at it, and I'm glad they did, because it made SO MANY separate things suddenly make sense.

Here's a look at how a specific type of MICROCLOTS may be associated with LONG COVID pathology...

1/many This thread will have three things:
- Takeaways of this study
- Breakdown of the method they developed
- How these findings connect with other known patterns

This is a study that looks at some rugged little blood clots that come courtesy of the SARS-CoV-2 spike protein.

2/

My thoughts on this new finding? AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA

"The consumption of BW [bottled water] is associated with heightened risk for certain health conditions," such as:
- hypertension (+5% increased risk)
- diabetes (+9%)
- GI ulcers (+21%)
- kidney stones (+17%)

1/10 This was a very large cross-sectional study that looked at a national population, conducted by Italy's census agency. They controlled for covariates including socioeconomic status, age, and gender, then clustered and stratified the population as appropriate.

Solid methods!

2/10

New interdisciplinary review was published on current Long COVID science, with a roadmap for science and policy!

It is written in plain language, so it's worth a read on its own, but I just want to pull out some highlights about what WE DO KNOW into a single thread...

1/many This is definitely the definition for Long COVID I'll be explicitly using from now on: Long COVID is "the constellation of post-acute and long-term health effects caused by SARS-CoV-2 infection."

2/

Can't believe I missed this!

This review/commentary piece makes one thing extremely clear: We do not yet have ANY STRONG EVIDENCE about how SARS-CoV-2 infection affects PREGNANCY.

The limited evidence shows there IS harm, which may be MITIGATED by vaccination.

Thread...
1/ What is the takeaway? There are three:

- Unanswered questions remain about the effect of SARS-CoV-2 on pregnancy.
- Evidence shows congenital anomalies MAY be associated with COVID.
- Evidence shows vaccination provides "protection from such anomalies."

2/

THIS IS BIG. WOW. New paper in PLOS Pathogens has findings about:
- the effect of the SARS-CoV-2 spike protein on cardiac cells (and mitochondrial dysfunction!),
- a treatment to be investigated, and
- how this is NOT caused by mRNA vaccines!

Buckle up, we're diving in...

1/ [This paper is an uncorrected proof; it's been peer-reviewed, but not copyedited yet.]

A bit of background: syncytia (sin-sih-sha) are giant cells with multiple nuclei that form from the fusion of multiple cells. Viral infections are a common cause of syncytia.

2/

New preprint on the PATHOGENICITY of H5N1 was published yesterday, and... it's not good news, but it's definitely not *terrible* news either!

The delayed, lackluster response to the current outbreak remains DEEPLY concerning.

Here's a summary for a general audience!

1/many

They test three H5N1 isolates. I'll refer to them as:

- Texas: Isolated from worker at Texas dairy farm (A/Texas/37/2024)
- Bovine: Isolated from dairy cow (A/bovine/Ohio/B24OSU-342/2024)
- Vietnam: Isolated from fatal 2004 human infection in Vietnam (A/Vietnam/1203/2004)

2/

This isn't a major paper, but it's an interesting jumping-off point for three different topics:

- Accuracy of RATs—in practice
- Understanding what descriptive (incl. Bayesian) statistics mean
- HOW rapid tests work

Here's a thread written for a general audience!

1/ This study was conducted from January 2020 to June 2021 using admission screening swabs from 556 oncology patients at a single hospital in Jerusalem.

The patients in this study were swabbed for both PCR and RAT, allowing for comparison of the detection ability.

2/

Let me start by saying AAAAAAAAAAAAAAAAAAAAAA.

Turns out SARS-CoV-2 RAPIDLY infects the NERVOUS SYSTEM long BEFORE it even enters the bloodstream.

These findings have huge implications! Here's an analysis of the study, written for a general audience. (Sorry in advance!)

1/many Overall, it's pretty extensive: They examined the productivity of neuronal infection in multiple animal models and multiple neuronal cell cultures, and found productive neuronal infection across the board.

It's also a long one, but we'll pick up the pace as we go!

2/

Big picture, these findings are bad for EVERYBODY, but ESPECIALLY for those still clinging to the fantasy of "natural immunity."

The takeaway? It's unclear if ANYONE has strong immunity to COVID infection!

Here's a deep analysis thread, written for a general audience!

1/many The paper is fairly complex, but the takeaways are pretty straightforward, so I'll start with the highlights!

Method is robust, data collection was EXTENSIVE: It's a longitudinal study (follows the same individuals over time) with regular nasal swabs and blood draws!

2/

This preprint seems HUGE: It has CONCRETE DIAGNOSTIC CRITERIA for a specific subtype of LC!

The novel disease identified here is named "SARS-CoV-2 Persistent Intestinal* Epithelial Syndrome (SPIES)"!

Gastrointestinal LC has a new name! Thread, for a general audience...

1/20 I love this preprint because, not only does it make a specific subtype of LC into a tangible medical artifact, but it also identifies the way in which SPIES differs from similar conditions, like IBS!

2/

FIRST: This paper DOES NOT HAVE CLINICAL VALUE. It is NOT about treatment!

With that out of the way: WOW, WOW, WOOOW.

"After six years, 44.1% of the [ME/CFS patients treated with cyclophosphamide] scored an SF-36 PF of at least 70, and 17.6% of at least 90..."

Summary ⬇️

1/13 The clinical trials (conducted last decade) were based on the hypothesis that a subset of ME/CFS patients are experiencing an autoimmune condition; this study is the six-year follow-up!

The interesting result here is the impact of cyclophosphamide (from the CycloME trial)

2/

An interesting re-analysis was published today: "Remdesivir treatment does not reduce viral titers in patients with COVID-19"

Basically, remdesivir has no impact on *viral load* in acute COVID!

Here's a summary of the findings—and controversy—for a general audience!

1/12 Initially, remdesivir received emergency FDA approval because in one NIH-sponsored trial, the remdesivir group recovered quicker than the control group. That's ALL.

It was trialed because it does seem to be a great drug in cell cultures in the lab!

2/