what we’re seeing now is that the immune system can go into overdrive, where certain immune cells trigger sepsis-like illness, sometimes in milder or chronic ways. long covid and related conditions seem like part of that same spectrum of immune dysfunction.
the nih recover autopsy studies are also finding viral persistence in multiple organs, with more results coming soon
https://recovercovid.org/pathobiology
i work on multiple NIH RECOVER efforts on this topic and post long covid research on x, and honestly the picture is both fascinating and pretty grim
https://x.com/atranscendedman
It’s tough to get a clear picture, but if you’ve been following the research closely, it’s obvious that there are better long-term candidates in the pipeline.
Project Next-Gen is highly data-driven, and the most promising candidates are rising to the top as some are already near Phase 3.
Redirecting funding toward these options isn’t as drastic as it may seem. In fact, it makes sense if we want the best outcomes.
I don’t really see where and how this is more promising than mRNA. My (very cursory) understanding was also that mRNA based vaccines can go far beyond just COVID and into all manner of promising options such as curing some of the viruses that cause the common cold entirely.
curing some of the viruses that cause the common cold entirely.
This was this kind of crazy hype from back in 2021/2022 that has helped fuel the backlash against MRNA vaccines. There has been nothing happening on the common cold virus with MRNA vaccines. In retrospect, it seems like CEOs pumping the stock price with wild promises.
> There has been nothing happening on the common cold virus with MRNA vaccines. In retrospect, it seems like CEOs pumping the stock price with wild promises.
So not true. There are numerous candidates for pan-flu and pan-coronavirus vaccines. mRNA and other vehicles.
If there are indeed better candidates why not compare the results of those candidates in field? Backing a hope versus a working solution with all your chips means that even if these end up being better the decision was still deeply wrong and we got lucky. Just abysmal risk mismangement.
Look, it’s not that BARDA is throwing science out the window in favor of some wishful thinking. It’s that they’re looking beyond what works now and toward what might work better, not just for today’s virus, but for the ones waiting in the wings.
Oral vaccines, nasal sprays, multi-antigen, multi-receptor approaches, these aren’t just buzzwords. They aim at mucosal immunity, they aim at T-cells, they aim at the places our current tools often miss. And when you learn that SARS-CoV-2 can persist in the body long after the sniffles are gone(i.e. Long COVID/MIS-C), you realize we need more than just antibodies.
So you trust RFK Jr at his word then when he lies right to your face? Because even if you honestly believe there are better long term candidates in the pipeline you would have to be immensely disingenuous to believe anything he says.
Yes, and this thread is very specifically about what the HHS is doing and what RFK Jr is saying. Where he is again, specifically, winding down mRNA vaccine development, redirecting funding and cancelling grants even if they contain a whiff of the word 'mRNA'. The 'messenger' in this case holds a loaded gun and has no qualms about using it to kill science he doesn't like.
A shift in the science doesn't translate into cancelled research contracts and abrupt termination of further research. This is RFK, not a shift in the science.
Not against researching other candidates as well. But mRNA has a proven track record and extending it to other diseases is a promising track.
You can fund research in those other areas without cutting mRNA. Sure it'll cost more $ but there's plenty of that - ffs we're spending $150 billion _more_ on "border security".
> Which after 5 years we have better science supporting how to combat them long term.
bird flu, not sure; but as for covid no other method has anywhere near the large scale data supporting it since mRNA was the only one deployed to millions. Do I don't really agree that we have "better science" that shows other methods are more effective.
there are a number of computational/modeling studies suggesting paxlovid needs to be given for at least 7+ days to slow the viral load and prevent rebound.
Pfizer did a preliminary study(the FDA asked them) and quietly published their results on the topic. their data implies a second treatment might shorten the overall duration of the infection consistent with the studies i allude to above. but you probably haven't heard about this news!
The Paxlovid dosing guidelines probably need to be changed, but given the current climate and cost it's unlikely to ever happen.
Similarly, the initial two-shot vaccine guidelines probably needed more time in between the doses for more effectiveness, but that's what was tested so that's the official recommendation.
agreed on changing guidelines, disagree its unlikely to happen.
the study is done and just needs to be formally published. then recommendations can "officially" change although the science has been clear about this for quite some time now with this specific drug.
other antivirals dont have this problem because they are actually effective for 10+ days even if you take it for 5 days (Ensitrelvir).
there's countless candidates in the pipeline as well for vaccines, antivirals, and monoclonal antibodies. as they keep getting better, the guidelines will shift slowly but surely.
I believe Science would benefit from a different approach to reporting, as Derek’s analysis over the past four years has been consistently lacking.
A responsible science reporter should present the full body of evidence rather than drawing conclusions from a single study.
Currently, a 900-person study is exploring Paxlovid’s potential for three clusters of Long COVID patients using a novel ultra-sensitive single-molecule assay. While many question its effectiveness in short treatment durations, there is reason to believe it could have extended benefits, similar to treatments for hepatitis C or feline coronavirus infections.
Having read and shared thousands of studies on SARS-CoV-2 and Long COVID, I find it irresponsible to dismiss a drug based on a single study, especially when broader research suggests that access to antivirals may reduce the risk of developing Long COVID, even among vaccinated individuals.
New antivirals are awaiting FDA approval, and an updated version of Paxlovid is in development. Derek’s analysis is not only misleading but also incorrect, and it would be best if he reconsidered the reach of his words.
In the Pipeline is an “editorially independent blog,” [1] so I’m not sure that it’s fair to criticize Science or Derek Lowe for the “reporting.”
I’m a big fan of Derek’s blog. And I think his comments about long COVID at the end of the post are enough to convince me to ask for Paxlovid if/when I get COVID again (I’ve taken Paxlovid before).
1. Science magazine's association with his recurring "editorially independent blog". I've been a subscriber for many years and have never enjoyed it personally.
2. His opinion on this topic in general. The drug lived up to the hype even beating some international antivirals on efficacy terms.
Today's science is a bit further ahead still. For example, Pfizer will publish acute 10d data soon? which already has preliminary data showing faster symptom resolution and less rebound.
NIH/Yale/Karolinska will publish their 25d/15d/15d Long COVID Paxlovid studies to see what phenotypes may benefit from extended durations.
Your comment does not cite any scientific evidence that contradicts the assertions in the article. The study you mention is ongoing and small. For comparison, one of the articles cited involves 280k patients with 35k treated.
If you're going to call an analysis incorrect, you should should say what's wrong with it.
With a comment this strong, I think you should disclose a little more of your own background / stance on the subject. Have you written a self-published book on Long Covid? (It looks like yes, but tl;dr.) My sympathies if you have suffered it.
background: 4 years of long covid, work on nih efforts to cure it, and i don’t want anyone to suffer like millions of us do. so i share reliable info with the world.
note: paxlovid is a first-generation drug. in 2025, derek should follow more science rather than zeroing in on one study or griping about the taste when it can prevent your life from flipping upside down with long covid. he has literally written on the next version of it as well.
many elderly patients who are only vaccinated still develop long covid and are often dismissed due to their age. nobody deserves that when an antiviral is available until next-gen vaccine 2b trials finish soon and more treatment options hit the usa market later this year.
Did this happen after a known infection of some sort? Does it run in your family? These questions may be important to know the answers to until science gets more tests over the counter as they are fairly close already.
Many viruses are linked to cancers, MS, Parkinson’s, Alzheimer’s, T1D and so on. Research is finding that some of these viruses may actually be low grade infections or left over viral proteins causing constant immune dysfunction.
People who claimed they never got SARS-CoV-2 for example were tested with a novel ultra sensitive single molecule assay and found that 99.9% of individuals samples were indeed asymptomatically infected.
Here’s an earlier version of this claim showing 95%.
Some of these individuals later went on to develop Long COVID. They are using this assay in an antiviral trial to see if it reduces the amount of SCV2 proteins this assay can detect.
there’s some great new research out of the university of virginia looking into this https://www.science.org/doi/10.1126/science.adq2509
mis-c and the adult versions are rare but real, and there’s early promise with a treatment called larazotide https://www.science.org/doi/10.1126/scitranslmed.adu4284
the nih recover autopsy studies are also finding viral persistence in multiple organs, with more results coming soon https://recovercovid.org/pathobiology
i work on multiple NIH RECOVER efforts on this topic and post long covid research on x, and honestly the picture is both fascinating and pretty grim https://x.com/atranscendedman