Mrs Pullthrough

Sydney.Oz Registered Nurse,wife, mum of three, love my cats and my ranch. Crazily Covid cautious! Dragging myself through this nightmare.

[Reality Check Marker @RealCheckMarker]

Gut SARS persistence.
Unfortunately, there's experienced physicians like Dr. Henrich who are finally starting to see the evidence of SARS persistence right before their eyes - and they still don't grasp why SARS is more damaging than HIV.
#LongCOVID is #AirborneAIDS so #WearN95

[Mrs Pullthrough @MrsP2019]

@Scoobie8657 @TheTrueJasonM Yep

[Mrs Pullthrough @MrsP2019]

@alvaro_maestro May I ask .... where would you choose? Bear in mind that quiet, few people, is the priority.

[Mrs Pullthrough @MrsP2019]

@Miss_Rosen Touché. Killer way to put it! Strong. I always say this when questioned re mask....."I likE my T cells"... Blank looks, of course. Don't care.

[Mrs Pullthrough @MrsP2019]

@SaltyBitch_52 Looks stunning natural now! Never dye it again is what I think 😊

[Mrs Pullthrough @MrsP2019]

@StevePhillipsMD Why would perfectly fit, healthy marathon running, marathon swimming brothers in their 60's suddenly, develop heart conditions in the last 2 years? Both AF+ one new onset BP, the other aortic root enlargement & aneurism, followed by sudden death? SarsCv2 not mentioned in consult.

[Mrs Pullthrough @MrsP2019]

@The_Exit_Code My God. So true. I'm looking at 40 years. Of trying, hoping. One grandchild sorted it. The envy, the mocking( but she has 5!) Behavioural patterns finally hitting home. A sister, no less. No. No more. A one year old. It's over.

[tim ritchie @timritchie]

Sunrise approaches behind me as a cool breeze ripples the inky waters of Sydney Harbour. On a clear winter’s day, a couple of icons pose for the shot.

[Jame Abraham, MD, FACP @jamecancerdoc]

Absolutely practice changing!! One of the most stunning developments in the treatment of patients with metastatic pancreatic cancer !! It is one of the rare moments in oncology which you will always remember ! Like the imatinib, trastuzumab presentations @ASCO #ASCO26 @OncoAlert

[Aswin John Solomon MD @DrAswinSolomon]

As an oncologist, whenever I hear the words “advanced pancreatic cancer” and “survival nearly doubled”, I pay attention.

Pancreatic cancer has historically been one of the most difficult cancers to treat because it combines several challenges:

• late diagnosis
• aggressive biology
• early metastasis
• dense stromal barriers
• and profound immune suppression

That is why even incremental improvements matter enormously in this disease.

A treatment that nearly doubles overall survival is not just a statistical achievement.

For patients and families, it can mean:
• more birthdays
• more anniversaries
• more time with children and grandchildren
• and, importantly, more opportunity for future therapies to emerge

However, one lesson oncology teaches repeatedly is that the details matter.

Before declaring a breakthrough, we need to understand:

• What was the control group?
• How many patients were studied?
• What was the absolute survival gain?
• Which patients benefited most?
• What were the toxicities?
• Can the results be reproduced?

Many promising therapies generate excitement in early reports but must still survive rigorous validation in larger studies.

That said, the broader trend is encouraging.

Pancreatic cancer research is no longer standing still. We are seeing advances in:

• immunotherapy combinations
• personalized vaccines
• targeted therapies
• stromal modulation
• metabolic targeting
• liquid biopsy detection
• and precision medicine approaches

For decades, pancreatic cancer was viewed as one of oncology’s most stubborn adversaries.

Today, we are beginning to see cracks in that wall.

The most important message is not that we have already won the battle.

It is that for the first time in a long time, we are finding new ways to fight it.

[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.

[The Exit Code @The_Exit_Code]

A narcissist’s envy is recognizable in their need to diminish you. Not to beat you in competition. But to make you smaller. To prove that what you have is not actually valuable. The diminishment is the goal.

[Mrs Pullthrough @MrsP2019]

@JamesThrot “According to Matthew…”…😆 sad part is,people happily do. They will read every word a game programmer says on Covid, as long as he is saying what they want to hear. “Down the pub” talk is very comforting here in Oz 🙄

[Dara in Chains @DarainChains]

@DrPatrick told everyone three years ago this virus goes deep into the bone marrow. Watch him try to explain how everyone is at risk.
https://t.co/R5qduEj4mR

[Jess @MeetJess]

Oh hi 👋🏻

Have you met @fitterhappierAJ ??

In case you haven’t, he’s been warning us about this exact thing …

[Trish Orwen @trishorwen]

@GreeneWendy First-wavers are dying, though I’m guessing no one is counting them.
But a look at excess mortality shows that starting in 2020, numbers started increasing.

https://t.co/YAruTm68ug

[Mike Hoerger, PhD MSCR MBA @michael_hoerger]

So, remember that when headlines state mortality has returned to pre-pandemic levels. Instead, listen to the multi-billion dollar actuaries whose livelihoods rely on precise estimates and suggest substantial excess mortality will persist a long time.
12/end

[Reality Check Marker @RealCheckMarker]

@trishorwen "The Canadian Press had a serious pension shortfall, which was, in 2010, valued at $34.4 million."
Pension fund shortfalls are on the rise. Pension funds are often tied to insurance market. What is one way to fix pension imbalances due to Baby Boomers?
#FlattenTheBoomers

[Reality Check Marker @RealCheckMarker]

@trishorwen What truly complicates this situation is that it is occurring in Canada, where Canada's primary news media outlets were sold to Power Corp., the largest Canadian insurance conglomerate.
https://t.co/1iw6pMQeFO

[Reality Check Marker @RealCheckMarker]

@trishorwen While the medical community remembers the mid-1990s for the scientific advent of Highly Active Antiretroviral Therapy (HAART), the systemic shift in institutional attitudes was driven heavily by legal liability. It was lawyers who solved AIDS pandemic.
https://t.co/OGhtDJhWUX