Now on Bluesky. Mother to twins, healthcare consultant, Former Exec Dir at ProjectN95. Opinions my own. She/her. Same handle everywhere.

Joined October 2014
409 Photos and videos
Anne Miller --moved to Bluesky retweeted
🚨💊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 (nejm.org/doi/full/10.1056/NE…), 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.
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Anne Miller --moved to Bluesky retweeted
Social Media Only: Here is a new sneak peek of the PMC COVlD Hot Spot Map. Do you think a version of our Hot Spot Map would be helpful to people seeking to avoid COVID? ⚡️🧵QUICK THREAD: 1 of 3
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Anne Miller --moved to Bluesky retweeted
Fully agree. "Close contact" describes behavior, but it does not describe how the virus gets from one person to the other. It could be through touch, inhalation of small particles in the air, or spray of large droplets.
Something I touch on repeatedly in my Airborne Infection course is that “close contact” is not a good way to describe how a virus is transmitted. It can be communicated as a risk factor for infection, but it does not say what the actual biological mechanism of transmission is.
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Anne Miller --moved to Bluesky retweeted
Clean water. Clean food. Clean air. I'm leading one of four Performer teams for the @ARPA_H BREATHE program. We're building a system that ensures clean air in buildings. We're demonstrating this in child care centers to improve health for kids and their families.
May 13
Would you knowingly drink a glass of water filled with dangerous pathogens, bacteria, and pollutants? More than a century ago, water treatment and sewer systems transformed public health and saved countless lives. But we still have not done the same for the indoor air we breathe, where Americans spend roughly 90 percent of their time. Whether it is a school, office, hospital, or home, we often have no idea if the air around us contains harmful invisible particles that could be affecting our health. ARPA-H’s BREATHE program is working to change that by building technologies and systems that can monitor indoor air quality, detect potential health threats early, and help make indoor spaces healthier and safer. On this Asthma and Allergy Awareness Month and beyond, ARPA-H is working to make cleaner indoor air a standard of modern public health. Learn more about BREATHE: arpa-h.gov/explore-funding/p… @MayoClinic @virginia_tech
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Anne Miller --moved to Bluesky retweeted
It's widely accepted that hantavirus transmits from rodent excreta to humans via inhalation of aerosolized virus, so I don't understand why we're so reluctant to acknowledge the inhalation route for human-to-human transmission. nytimes.com/2026/05/14/healt…
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Anne Miller --moved to Bluesky retweeted
I spoke about the potential for airborne transmission of hantavirus, and Josh Santarpia talked about the National Quarantine Unit. I visited it last year; it's a critical resource for the country. @virginia_tech @VTEngineering
The Andes type of the hantavirus is spread by “close contact,” but it’s unclear how much of that transmission occurs by inhaling airborne droplets or other means spklr.io/6016EzcPi
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Anne Miller --moved to Bluesky retweeted
Replying to @ABC
So: Patient zero caught an airborne virus (w/ ~30% CFR, long incubation period & asymptomatic spread) outdoors birdwatching, spread it on a poorly ventilated cruise ship & @WHO provided... dust masks?! Now @CDCgov is bringing 17 people to NE quarantine facility to just...go home?
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Anne Miller --moved to Bluesky retweeted
1/ With #Hantavirus in the news, it is worth re-visiting the most famous outbreak which was in Yosemite National Park in 2012. 10 people were infected; 5 were in the ICU and 3 died. How they got infected was the most striking part of the outbreak and can help us think about the cruise ship today.
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Anne Miller --moved to Bluesky retweeted
🚨 BREAKING: Mayo Clinic AI Detects Pancreatic Cancer Up to 3 Years Before Diagnosis in Landmark Study — A Potential Game-Changer for Early Detection
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Anne Miller --moved to Bluesky retweeted
Let me be clear: this SICKENS me. I spent YEARS writing letters to get my interpreters in America because they SAVED OUR LIVES. One of my interpreters was a 15 year old kid. One day, we were working with the Afghan police and he went stone quiet. After we left, I asked him what was wrong. He told me that the Afghan police had just threatened to cut his lips off for helping us. He was FIFTEEN. And he risked EVERYTHING for our soldiers.
Shame on us. I think of the brave Afghans that stood alongside us against the Taliban, especially those I worked with personally during my four years in command of the NATO mission there. It is incomprehensible to me that we would not bring them here to the United States, fulfilling the most fundamental obligations of trust and honor. nytimes.com/2026/04/21/world…
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Anne Miller --moved to Bluesky retweeted
RFK Jr wants to you to believe that vaccines are not safety tested Well @jakescottMD has put together a list of vaccine trials It's long...
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Anne Miller --moved to Bluesky retweeted
A multimodal AI agentic model that integrates electronic medical records, lifestyle, layers of biologic omics data to predict health outcomes and, with perturbations, "what if" scenarios a person improved lifestyle or took a medication @Cell_Metabolism sciencedirect.com/science/ar…
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Anne Miller --moved to Bluesky retweeted
mRNA vaccines are curing cancer whilst anti vaxxers want you to believe they cause cancer
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Every week I read things Walz is doing for MN — and then I look at #VT. What has #Vermont Gov Scott done lately?? Recruit health care companies to Colchester BioLabs facility. Bring in cyber security companies. Fin Services. Vermont Gov is sleepwalking us into a fiscal ditch.
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Anne Miller --moved to Bluesky retweeted
Long term follow up of a phase 1 trial of an mRNA tumor vaccine shows that 7/8 patients with pancreatic cancer, who mounted an immune response to the vaccine, are still alive 6 years later. This is breathtaking data and shows the promise of mRNA vaccines. nbcnews.com/health/cancer/pa…
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Anne Miller --moved to Bluesky retweeted
The idea vaccines cause autism was invented by Andrew Wakefield in 1998 and was so thoroughly debunked he lost his license for gross malpractice And here we are 27 years later RFK Jr and his fans dredging up the same nonsense Such a tiresome waste of time
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Anne Miller --moved to Bluesky retweeted
"Nothing worth doing comes easy." For Kristen Gallagher, that means navigating the challenges of running a small fiber mill in central Vermont, and working alongside her father. Vermont Human is produced by David Littlefield.
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Anne Miller --moved to Bluesky retweeted
Anyone in Bradford County, Florida?
Bradford County Commissioners in Florida just put the lease for a warehouse ICE detention site on the agenda for their meeting tomorrow. They added this last minute hoping it would go unnoticed. If you are in the area, turn out to speak in opposition and also email commissioners.
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Anne Miller --moved to Bluesky retweeted
Very, very sad to report that Hayam El Gamal, mother of 5 kids detained at Dilley for 10 months, has suffered a serious medical emergency due to systematic denial of medical attention by ICE. We can now share the following: For many weeks Ms. El Gamal has been concerned about a growth on her chest that has caused pain for many weeks. She has made complaints to Dilley staff and ICE repeatedly but has been denied a visit to an outside doctor. She had specifically made requests for a CT scan to identify the lump and the source of her pain. On Thursday April 8, a doctor at Dilley told her that he had put in a request for a CT scan but "higher ups" in either ICE or CoreCivic overrode his request, and so no scan was conducted. Medical records show she had been demanding help since February, at which time she said her pain had been already worsening for 8 weeks. A doctor at Dilley said the lump in her chest was merely a bone. Mid-morning on Friday April 9, Ms. El Gamal began experiencing excruciating pain which she rated an 11 out of 10. She described the pain as being stabbed through the back to the stomach. At about 11 AM central time she began pleading with officials for painkillers and medical attention. After two hours of asking for help (at around 1 PM central time) she was taken to an off-site emergency room. While there she received lab work and, finally, a CT scan. The CT scan confirmed that the lump was not a bone, but it did not reveal what the lump was. The scan also showed she has "fluid around the heart." The ER doctor recommended an ultrasound to determine what was causing the pain, but this was denied. Ms. El Gamal was told she had to go back to Dilley and was not given the ultrasound. We do not know if the lump is cancerous, all we know is that the pain is increasing, the incidents are becoming worse and worse, and she is not receiving proper diagnosis that could lead to proper treatment. After 10 months in detention, Ms. El Gamal remains in pain. We are concerned that the systematic denial of medical attention may result in her death. Her children are extremely worried about their mother, who is now their only guardian. Her five year old child has been denied the right to go to a dentist for 13 cavities. Her 16 year old son was told to take tylenol when he suffered from acute appendicitis. All of the children are suffering from depression. Please join us in demanding the El Gamal's immediate release so that she can acquire the urgent medical attention she desperately needs. This family has suffered enough.
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