Andrew, PhD, MPH, CPH

#Keepmasksinhealthcare. PhD health services & public health Northwestern. Frmr: PennMedicine, VA, Harvard, MA HHS Alum:Columbia, Cornell. tweets: my own opinion

[Andrew, PhD, MPH, CPH @AWangMPH]

This is great news!

[Biff #SARSisAirborne 🍉 @Biff234523]

🚨💊HUGE news: @US_FDA has finally granted approval to @ShionogiUS’s Xocova (Ensitrelvir), a 2nd-generation antiviral targeting SARS-CoV-2.

The approval is for the indication of “post-exposure prophylaxis of COVID-19 following contact with an individual who has COVID-19”. However, just like with any drug, it can obviously also be used off-label (e.g. treatment of both acute COVID or Long COVID).

In Japan, Xocova received Emergency Use Authorization for the treatment of acute COVID all the way back in November 2022, received full approval in March 2024, and an expansion to include post-exposure prophylaxis in March 2026.

The post-exposure prophylaxis indications are based on the SCORPIO-PEP trial (https://t.co/Dxv0lhS2CM), where Xocova reduced the incidence of COVID-19 after household exposure by 67%, from 9.0% down to 2.9%.

Mechanically, Xocova is the same class of drug as Paxlovid - a 3C-like protease inhibitor that inhibits viral replication. From our best understanding, Xocova is probably slightly more potent than Paxlovid, but the more definitive advantage is that it comes with less side effects and less drug interactions (which are caused by the Ritonavir component of Paxlovid, added to boost the concentration of the actual antiviral, Nirmatrelvir).

Xocova should be useful for lowering viral load during an acute infection, especially if taken within a couple or days of symptom onset, which may help shorten the duration of acute symptoms. Will it do anything to prevent long-term damage or the development of Long COVID? Almost certainly not, just like Paxlovid, but I’d be more inclined to tell people that it’s worth trying if we’re no longer dealing with the side effect profile of Paxlovid.

Where it makes the most sense to use Xocova, just like with Paxlovid, is as a component of polytherapy for Long COVID driven by viral persistence. The big issue there, however, is that you need a longer course of these antivirals than most physicians are willing to prescribe and/or most insurance companies are willing to cover. And they’re generally not very effective as a monotherapy, you need to pair these oral antivirals with other therapies for better coverage and tissue penetration (eg. monoclonal antibodies and Nuvaxovid, and potentially even a 2nd antiviral like Remdesivir).

All in all, this is a very important and long overdue approval. It’s not a game-changing silver bullet, and notably, nobody should really be expecting to use or rely on Xocova in a way that they wouldn’t be open to using or relying on Paxlovid in the present. But there are plenty of applications for it, and Xocova should absolutely be seen as another Swiss cheese layer / tool in the toolbox for COVID conscious community members and any allied medical providers.

[Andrew, PhD, MPH, CPH @AWangMPH]

#LongCovid only ends when infections are stopped.

[Monica Verduzco-Gutierrez, MD @MVGutierrezMD]

New JAMA Network Open study:

📊 Long COVID prevalence estimated at ~16%
🏥 58 U.S. hospitals
🤖 AI-based EHR phenotyping
⚠️ Diagnosis codes alone missed many cases

The burden of #LongCOVID is likely much larger than initial data suggest.

https://t.co/uqyJoejzDb

[Andrew, PhD, MPH, CPH @AWangMPH]

This is not a goody goody story but a story that is a serious warning that even after abandoning public health, dangers will rear its ugly head back at haters, and public health will return as the knight in shining armor. https://t.co/ErUnnROvsM

[Andrew, PhD, MPH, CPH @AWangMPH]

@JenniShengMD I live in chicago and saw all of the asco advertisements!

[Andrew, PhD, MPH, CPH @AWangMPH]

@JenniShengMD welcome to chicago! will you be here thru the week?

[Andrew, PhD, MPH, CPH @AWangMPH]

Pancreatic cancer is probably the most serious and deadly types of cancer. An effective treatment is needed!

[Eric Topol @EricTopol]

There hasn't previously been a treatment vs pancreatic cancer this successful. Striking improved (a > doubling) survival results @NEJM and @ASCO today with daraxonrasib, which also became available via an FDA approved early access program and began shipping to physicians this week @RevMedicines
https://t.co/e04jqJMPw0

[Andrew, PhD, MPH, CPH @AWangMPH]

@uTobian no one is dying from covid vaccines. stop lying.

[Andrew, PhD, MPH, CPH @AWangMPH]

@VirusesImmunity @keylas3 @PutrinoLab Thank you for your ongoing work in this area!

[Andrew, PhD, MPH, CPH @AWangMPH]

@KennyCarmody Covid vaccine injuries are very rare but is a serious matter. Creating a diagnosis covid doesn't make sense for it. Instead, focus on validating and ensuring that truly happens needs to be first.

[Andrew, PhD, MPH, CPH @AWangMPH]

@SenRonJohnson covid vaccines remain important tools. what tools are available are left that work that you support? natural immunity fails to stop infections.

[charlos @loscharlos]

“Given that nearly everyone in the US is believed to have had COVID, the 16% rate extrapolated to the approximately 340 million people in the country would mean that roughly 54 million Americans developed #LongCovid.

An HHS spokesperson did not respond to a request for comment.”

[Public Health Action Network @pubhealthaction]

As part of #WorldMaskWeek, this Thursday, May 28th, we'll co-host a free Zoom discussion with @AirSupportBox all about mask blocs: what they do, how they get masks and tests and other items to distribute, how you can find one near you, and how you can start one in your area.

[Andrew, PhD, MPH, CPH @AWangMPH]

@RWMaloneMD shame
on
you.
a basic public health measure
should be celebrated.

[Andrew, PhD, MPH, CPH @AWangMPH]

A basic public health measure that should be celebrated during this weekend of memorial day honoring those whom have fallen

[Public Health Action Network @pubhealthaction]

World Mask Week is here! #WorldMaskWeek is a global event for talking about masking, sharing pictures about masking, and helping those who may have stopped masking come back to it without shame or judgement.

[Dr. Jennifer Irwin @drjenirwin]

“Hantavirus outbreak shows we haven’t learned the lesson of SARS-1 or COVID-19” https://t.co/SxYa2roUZU

[Andrew, PhD, MPH, CPH @AWangMPH]

Covid is low and may it keep lowering!

[People's CDC @PeoplesCDC]

This is the People’s CDC bi-weekly update for May 4, 2026! This Weather Report from the People’s CDC sheds light on the ongoing COVID pandemic and other public health crises in the United States.

[People's CDC @PeoplesCDC]

Support our colleagues in Illinois to protect the right to mask by tomorrow, May 12th! Kiki's Law (SB3340) was passed in the IL senate and now it is under consideration by the IL House.

[Andrew, PhD, MPH, CPH @AWangMPH]

@FmrRepMTG He is a good and faithful servant.

[Andrew, PhD, MPH, CPH @AWangMPH]

@ianmSC stop lying.

[Andrew, PhD, MPH, CPH @AWangMPH]

This is truly alarming. How many other people in medicine does this? many.