If you happen to feel like talking about it, two nasal spray vaccines for COVID-19 have just been approved (or given emergency authorization in one case), in China and India.

Expand full comment
Oct 17, 2022·edited Oct 17, 2022

So there's Emmanuel the emu, an internet celebrity, and the farm he's on got hit by bird flu, and they're trying to nurse him back to health and I'm watching a lot of hand wringing about how terrible it is that she's not masked around the bird.

It looks like yeah, cuddling the bird isn't the greatest idea, but they have quarantined the farm for 150 days and no one's allowed on it and theu',re certainly aware they're at some risk.

From what I just read above, it looks like care in washing and disinfecting is important, but being breathed on by a bird is far secondary?



Expand full comment

I expect you'll be writing about this, but what do you think about the EUA for the new omicron-specific boosters without any human data? I don't expect they do new human trials for every annual flu vaccine update, but then I also don't know how analogous that situation is.

I guess what I'm wondering is, how norm-breaking is this action, and how justified is it to break norms in a situation like this? We aren't losing thousands of people a day to COVID-19 in the USA anymore, and there doesn't seem to be any more than a (reasonable, educated) guess that the new boosters are going to be significantly more effective at preventing infections, hospitalizations, or deaths than the current ones.

I don't think I'd hesitate to get it, but I can easily imagine a situation where it turns out to have an increased risk of side effects (still very, very low) and little to no increase in protection. Perhaps human trials take too much time and it's likely to have mutated again if we wait for them?

Expand full comment

Thanks for writing the piece on LongCovid!

Did you see the new pre-print about LongCovid from Prof Akiko Iwasaki? It seems that cortisol might be one of the drivers. The levels of cortisol were uniformly low among the people with Long Covid.

Could you write an explanatory piece on this, and what´s your take on this study?

"Distinguishing features of Long COVID identified through immune profiling"


Expand full comment
Aug 29, 2022·edited Aug 29, 2022

I wish EBV had been one of the viruses you mentioned as being associated with long-term illness. The crippling fatigue an unlucky few suffer from that monster is unfathomable. I was sick for almost three years and have had several relapses since, so when I hear people talk about long covid, brain fog, fatigue, etc... I know EXACTLY what they mean. And it's real as hell.

Expand full comment

I'm surprised you didn't mention shingles. As you say, though, there are so many post-viral diseases to choose from.

I personally would mention HPV, which has a post-acute syndrome of extremely deadly cancer in women (and far less often in men).

Expand full comment