@DrTedros In the US, we just experienced a 12th wave of COVlD. Biobot data suggest the 13th wave is beginning. Swiss Re suggests ≈160,000 excess deaths in the US this year. There is no reason to believe things are vastly different in the many nations that lack wastewater surveillance.
COVID Alert❗️Biobot released their 1st COVlD report in a month, and it shows levels rising in the US after the prolonged national relative "lull" in transmission.
US COVlD Update (PMC)
◾️1 in 310 Americans estimated actively infectious
◾️9 hot spots (see Alt text)
◾️Large, lingering outbreaks in Central/SE Texas & Guam
◾️Levels are stable or slowly rising
(Links in next)
There are some people who would have you believe that vaccines basically all work the same for different infections, and all have the same effect, but that's not true.
Let me explain this as simply as I can:
Disability can happen to anyone.
Chronic illness can happen to anyone.
Many people suffering from Long Covid, POTS, MCAS and other conditions were young, fit and healthy … until they weren’t.
It’s not a moral failing.
No one is immune.
Disability justice benefits everyone.
It's worth understanding that when they say "the biggest El Niño ever", they don't mean it the same way as 'biggest hurricane ever' or 'hottest heatwave ever'.
They mean the 'biggest fluctuation when compared with recent seasonal averages'.
Hmm. That's still confusing.
So it's the El Niño with the biggest ever deviation from the recent norm... but bear in mind that the *norm itself is higher than it used to be*.
So the variation is bigger.
But the baseline is bigger.
So no one really knows how big the repercussions of a huge El Niño effect will be on top of the new norm. They can model and estimate, but that's all it is.
But everything is pointing towards the effect being BIG.
I still think I haven't explained it right.
To summarise:
Good luck.
I prefer “altered brain” to “brain fog.”
“Brain fog” sounds harmless. Temporary. Like you just need a nap or another cup of coffee.
But altered brain function raises a different question:
What changed?
We have evidence of neuroinflammation. Evidence of vascular injury. Evidence of elevated inflammatory markers. Evidence of neuronal damage and structural changes in some patients.
Whether those changes are reversible, partially reversible, or permanent remains an active area of research.
But damage doesn’t become harmless simply because the brain is capable of adaptation.
An ACL tear is still an ACL tear, even if rehabilitation restores function.
A scar is still a scar, even if you learn to live with it.
The brain is no different.
Neuroplasticity is remarkable. People recover function after strokes, traumatic brain injuries, and other neurological insults every day.
But recovery is adaptation… not a time machine.
The brain doesn’t roll back the clock to the moment before the injury occurred.
Instead, it reroutes traffic around damaged roads.
That’s why I’ve said since the earliest neurological findings emerged that COVID had the potential to cause brain injury. The extent, prevalence, and permanence are still being worked out.
But the idea that a virus can injure the brain shouldn’t be controversial. Viruses have been doing that throughout human history.
The real question is not whether the brain can adapt.
The question is how much damage occurred before adaptation became necessary.
I keep seeing people saying "I don't believe the data that says there's not much Covid around, there are loads of stories of people catching it at the moment".
Yes, but you're not seeing *as many* stories of people catching it at the moment.
Yes, it's around. Low Covid does not mean No Covid.
But here in the UK *every single possible metric* is indicating that there are historically low levels. We're still doing 20k PCR tests in England each week as a base level, plus more when there are more cases. Scotland has wastewater.
Tests, cases, admissions, deaths, wastewater, positivity are all tracking at the same rates - and it's very hard to manipulate one without manipulating all of them, and there's no need to, because 99% of the population don't care what the levels are.
I buy and hand out tests to people in our local community myself. The positives on those tests track quite closely to national numbers.
Some people are then arguing that it means that tests aren't picking up cases.
Well, that doesn't make sense either, because we've just had a wave that hit kids here, and the tests picked those up fine.
The final thing is:
What does low mean?
'Low' in terms of Covid doesn't mean *none*.
There are more Covid cases confirmed at the moment each week than Measles cases... but Measles cases are 'High'.
Covid cases are *low for Covid*.
Low Covid does not mean No Covid.
It just means that it's not overwhelming healthcare right now.
Low Covid does not mean that I'm stopping masking, or stopping any other mitigations that I've had in place for six years. It just means that there's not as much around as at other times.
Which would be a particularly daft time to catch it.
This rebuttal is brilliant, detailed, compassionate, intelligent, science based, and thorough.
The precise opposite of the statement she's replying to.
Please read, share, share, and then share. And also share:
📢A new study is out from Emory University that compares the performance of all available SARS-CoV-2 / Influenza combo rapid test brands against JN.1-lineage SARS2 strains
The two main takeaways:
🧪Don’t waste your money on a more expensive brand or overthink your purchase. No single brand consistently performed better than all other tests - The lowest detected concentrations were achieved by different tests for each of the 4 viruses.
🧪It’s essential to wait until the END of the time window listed on the instructions to read the results. “We found that at low viral concentrations, many OTC tests were interpreted as negative at the start of the stated interpretation window but converted to a positive result by the end of the interpretation window.”
They looked at the 8 SARS-CoV-2 / Influenza combo rapid tests that were available in the U.S market as of fall 2025. Unfortunately, they didn’t include the Aptitude Metrix molecular combo test, or the newer 4-in-1 rapid tests that include RSV from Flowflex and iHealth, because they were not yet available at the time.
They tested the following 8 brands:
• ACON Flowflex
• iHealth
• OSANG BinaxNOW*, QuickFinder
• CorDx Tyfast
• Healgen Rapid Check*, InBios, statID, Equate, INDICAID, GenaCheck, Consult, RiteAid, ACCUBIO, healthconfirm, RapidResponse, RapidGo, Walgreens, CVS
• SEKISUI Osom
• Watmind SpeedySwab
• Wondfo WELLlife*, INDICAID, Hough, 2San
*Specific test used in this study
For the main portion of the study, to determine sensitivity, they examined the lowest concentration of virus at which each of the test brands would reliably (3 out of 3 tests) show a positive result. For H1N1, WELLlife and Osom performed the best. For H3N2, Healgen and SpeedySwab performed the best. For influenza B, Osom performed the best. And for SARS-CoV-2, Flowflex performed the best. As the authors point out, there isn’t really any sort of a clear pattern here, and the results are indicative of all tests having about equivalent capabilities.
Next, they examined whether the readability of the results changed from the start to the end of the timed viewing window listed in the test instructions. The answer was consistently “yes”. In the 2nd image, all of the solid bars were positives that were able to be read at the end of the window, but were missed at the beginning of the window. It was a major issue across all tests - but especially with SARS-CoV-2, and especially with some brands (eg. WELLife, Osom, BinaxNOW).
Analytical comparison of over-the-counter multiplex tests for influenza A, influenza B, and SARS-CoV-2: https://t.co/BvQVEYLPVS
PMC Update (Jun 1, 2026)
COVlD levels are "very low" relative to other time periods. 1 in 277 US residents are estimated actively infectious.
However, there active hot spots in the Central Appalachia Region, Guam, Franklin County (WA), & Morgan County (AL).
🧵1/5
The Xocova product website is now live, which includes safety information, prescribing information, and patient information sheets, including a look at the US packaging: https://t.co/9jQUNGPo9f
Again, despite the lack of details at this point (no timeline, pricing information, access programs, pharmacy information, etc. included in yesterday’s press release (https://t.co/GdGb0OOPcr)), this obviously represents the biggest indication so far of Shionogi’s intent to commercialize soon.
It wasn’t yet online when I checked at the time of the press release….this is the same thing that happened with the Nuvaxovid launch, I guess I’m just too fast for big pharma.
🚨💊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.