New study in JAMA: azelastine antihistamine nasal spray reduced occurrence of COVID19 and common cold by 67% in a placebo-controlled (but small) study.

Azelastine in the US is sold OTC as Astepro, just $10 at CVS (with coupon). Note it's not the more common steroid nasal spray Azelastine is generic now, and this was an academic study. Little interest by companies to test off-patent drugs. It was done in Germany (zero interest by US to do COVID-19 research now)

Trial was n=450 split into azelastine and placebo groups. That's large by academic standards

People have been asking about the SARSCoV2 (COVID19) vaccine outlook so I'll summarize as best as I can. But overall, the current situation is chaotic and in constant flux, and if FDA is trying to apply consistent criteria then they haven't shown it yet Right now there are 4 vaccines from 3 companies covering 2 technologies with FDA approval in some form or other. The approvals are for different age ranges and risk categories. In addition each August or September new formulations have to be reapproved, kind of like influenza.

In case you think cameras can detect cars or people ahead of them through the glare of the sun, or that AI has learned to react to ambiguous situations with the, well, intelligence of humans, read this It's a frightening and sad story (a grandmother was killed) and I'm surprised to find out about it only now.

There's clear evidence from the Tesla's own cameras that no kind of image processing can beat glare (and that FSD lacks all sense of caution)
bloomberg.com/features/2025-…

FDA has granted regular approval to the Novavax vaccine. What does this mean? A lot of things, all good.

1- It proves Novavax has met efficacy and safety criteria to merit approval outside of the emergency use situation. Novavax is safer than the RNA vaccines, but ironically the RNA vaccines received full approval earlier than Novavax. That meant Novavax was the only COVID vaccine which vaccine skeptics could incorrectly claim was not safe enough to receive regular approval.

"Novavax had 1.7 systemic symptoms compared with 2.8 in Pfizer recipients. In total, 43.8% of Pfizer vaccinees reported at least one symptom of moderate or higher grade, compared with 24.2% of Novavax"

@RobertKennedyJr in case you didn't know. It's also more broadly protective. This is the 2nd controlled study to show about half the side effects rate for Novavax vs Pfizer.

Of the 3 covid vaccines, Novavax is the only one still on EUA. Happens it's the smallest of the 3 companies and hasn't hired ex-FDA staffers.

Article below.
cidrap.umn.edu/covid-19/novav…

Our NIH grant to discover coronavirus antiviral meds was terminated today.

With this grant, we had developed a better SARSCoV2 inhibitor than Paxlovid, and we recently discovered an improved drug that looks better than Pfizer's own second-generation inhibitor. This is part of a complete elimination of COVID19-related research, including on long COVID.

The rationale given is that the pandemic is over.

In reality, people are dying of COVID at several times the rate of flu, and still getting long COVID.

arstechnica.com/health/2025/03…

I wish sane writers like David Wallace-Wells (and real scientists) had more influence instead of those with an axe to grind or a conflict of interest to protect. Even within @nytimes, he was given a second-fiddle seat. But he keeps his facts, and perspective, straight. Link: nytimes.com/2025/02/26/opi…

Yet another study that shows that Novavax-induced Abs clear virus from the upper respiratory tract better than RNA vax-induced Abs.

https://twitter.com/Daniel_E_Park/status/1835096031291179011

Novavax beats Moderna, which (transiently) induces higher levels of neutralizing Abs. As I've said before, Abs are much more than neutralization. Ab effector functions do most of the clearing, and Novavax seems particularly good at that.

Flew in from Asia today to learn the exciting news that Novavax's JN.1 booster has been approved!

So happy that the delay relative to RNA vaccines is less than a week. People will finally have a choice of RNA vs protein vaccines this fall.

What are the differences?

https://twitter.com/Novavax/status/1829612945338482755

I made this graphic to show how different vaccine types work (back in 2021).

We can just look at line 1 (protein vax like Novavax) and line 3 (RNA vax).

In protein vax, antigen-presenting cells take up the antigen to activate B cells and Thelper cells....

Basically Pelosi figured out Donilon was the one feeding Biden hopium-spiked poll results, and leaked it out.

Once it was proven that there really was bad info in the inner circle, that gave everyone else confidence in their own eyes. The emperor really was naked.

https://twitter.com/ezraklein/status/1814045611072889273

“Put Donilon on the phone,” Ms. Pelosi told the president, referring to Mike Donilon, the president’s longtime aide, according to people familiar with the exchange, which was reported earlier by CNN. “Show me what polls.”

Go Nancy!

nytimes.com/2024/07/18/us/…

Biden has COVID-19 again. He had first symptoms today, positive test today, and first Paxlovid dose today.

As the early Paxlovid will limit immunostimulation by virus, I predict he will suffer rebound again, unless he gets 10-day course, or he is given a strain-matched vaccine. Biden's DO does not seem to follow the science. The rate of rebound is 26% if started within the first 2 days of symptoms or positive test.

Sure, FDA and CDC and Pfizer still claim it's less than 3% and no different than no-Paxlovid, but it fools nobody

https://x.com/michaelzlin/status/1810528032849031584

The question is when Biden's inner circle (all 4 of them) will tell him the truths:

That he's dropping in most polls.

That 2/3 of Democrats prefer a different nominee.

That he looks low-energy and confused in recent appearances, and the contrast with Trump keeps getting wider. Citations. Dropping in most polls: "New Democratic-funded polling shows Biden losing ground to Trump in key states"
cnn.com/politics/live-…

I intuited that early start of Paxlovid blunts immunity, allowing viral rebound once drug ended. I thus predicted both Joe and Jill Biden's rebounds (before they occurred), as they started Pax on day of symptoms.

A math model now supports the intuition:
nature.com/articles/s4146… "The model identifies that earlier initiation and shorter treatment duration are key predictors of post-treatment rebound."

The model shows that early therapy reduces the number of infected cells secreting innate immune signals (IFNs) that then activate antibody production.

"Short- and long-term neuropsychiatric outcomes in long COVID in South Korea and Japan"

Higher recorded rates of cognitive deficit (2.7x), insomnia (2.4x), anxiety (2.2x), mood disorder (1.9x), and stroke (2.0x) in the year after COVID-19 infection.

nature.com/articles/s4156…
Big caveat: Retrospective association study, so major possibility of reporting bias. People who recently got COVID may be more likely to seek care and diagnosis for any new health problem. The study tries to control for this but there's no way really to eliminate it entirely.

Documents for the June 5 FDA VRBPAC meeting are out.

Advisors will be asked to answer the question "For the 2024-2025 Formula of COVID-19 vaccines in the U.S., does the committee recommend a monovalent JN.1-lineage vaccine composition?"

fda.gov/advisory-commi… Documents now include company presentations. Meeting has started and love video link is below

youtube.com/live/weaKQiFk_…

The summer wave is starting in the Bay Area. Several people I know have gotten sick and SARSCoV2 wastewater is back to high levels, higher than the winter 2020-2021 wave and almost halfway up to 2021-2022 Omicron. Looks like we'll have Dec-Jan (tightly synchronized by holiday gatherings and cold weather) and a looser June-August (spread by vacation gatherings, travel, and maybe some Southern to Northern hemisphere transfer) each year

Pleased to report, at long last, the publication of ML2006a4, our SARS-CoV-2 protease inhibitor for COVID-19, in @ScienceTM.

Compared to nirmatrelvir, the inhibitor in Paxlovid, ML2006a4 binds more tightly and has greater antiviral activity in vivo.

science.org/doi/10.1126/sc… @ScienceTM This paper tells the origin story of nirmatrelvir and ML2006a4 (they are brothers) and reveals why these two drugs work so well.

It also explains the chemical basis for ML2006a4's superior activity, which goes back to a deliberate decision we made back in 2000.

So much for viruses evolving to less pathogenicity.

As I've said before, we might expect viruses to become more transmissible, e.g. by replicating faster or suppressing immunity. That's not less pathogenic.

A new report shows recent variants suppress innate immunity more.

https://twitter.com/NaturePortfolio/status/1749188642449260549

There are a lot of plots, but the general gist is that BA.4/5 infection in cells generates less IFN and other innate immunity cytokines than earlier BA.1/2, and BA.4/5 shows less gain from innate immunity suppression by a drug (ruxolinitib) (because it suppressed it already)

Actually a person who could have sparked COVID19, accidentally or not, has been ID'ed in the open for a long time.

The name is Zhou Yusen. Evidence?
1. He filed a patent for SARS2 vax in 2/2020, when others only knew of SARS2 from 1/2020
2. He died from a rooftop fall in 5/2020

https://twitter.com/harishseshadri2/status/1685139352240914432

Those facts are not disputed, but somehow not widely discussed.

The theory isn't mine. It is described in detail by former Assistant Secretary for Preparedness and Response at the US Department of Health, Dr Robert Kadlec, above and more recently below

skynews.com.au/australia-news…

Just published: Another useful difference between Novavax over RNA vaccines has just been discovered.

3x RNA vaccines induce IgG4 antibodies, which clear antigens poorly and is associated with immunotolerance.

By contrast, 3x Novavax does not induce IgG4.

https://twitter.com/vipintukur/status/1748321694962315644

IgG3 antibodies bind Fc receptors on phagocytic cells like macrophages so that viral particles bound to them will be ingested and destroyed. This antibody-dependent phagocytosis (ADP) is a crucial part of the immune response to viruses...

The full DEFUSE proposal on gain-of-function experiments on bat coronaviruses is available, and I'd say it's quite shocking. It does not lay out a plan to create SARSCoV2, but does propose to identify and culture natural sarbecoviruses with the ability to infect human cells. A 🧵 There are threads interpreting the DEFUSE proposal as intending on making SARSCoV2. A careful read shows that is not the case. However the intention was to identify natural viruses with features that would help them infect cells. So it may be not much of a difference functionally