Dr Satoshi Akima, FRACP

A portrait of cellist Joshua Roman. He stands against a softly lit beige background, casting a shadow to his left. He has short, curly dark hair and is looking calmly at the camera with a neutral expression. He wears a brown leather jacket over a light-colored shirt. At the bottom of the image is a caption . Across the bottom is the headline: “After a diagnosis of long COVID, cellist Joshua Roman builds community around Immunity”, with a link indicating the article is from chicagoreader.com.

Joshua Roman, 41, is an American cellist who once practiced 10hrs a day and toured the world performing standard and original works. After getting COVID in 2021, he developed Long COVID with severe brain fog and fatigue, becoming too weak to play his instrument or even climb stairs

archive.md/Wpg33

Breaking: Spain brings masks back.

Mandatory in hospitals, primary care, and long-term care—for patients, visitors, and staff.
Strong recommendation everywhere else.
Public health moving where evidence points.

Note: Really worth upgrading to respirators.
euroweeklynews.com/2025/11/28/s...

Toshi Akima, Sydney AU. No COI #NephJC

Spain hits back: Masks are mandatory again Spain’s Ministry of Health has issued a warning over rising flu cases as winter approaches, preparing to require masks in hospitals, health centres, and elderly-care facilities…

Spain hits back: Masks are mandatory again

Spain’s Health Ministry warns of rising flu and COVID this winter and mandates masks in hospitals, primary care, long term care, and elderly facilities in high-risk areas to protect at risk people, prioritizing nursing homes and immunocompromised patients.

Multiple large natural experiments have documented Shingles vaccine is linked with ~20-25% reduced risk of dementia and Alzheimer's disease. A new report today adds to that and extends the to slowing the progression of dementia @cellcellpress.bsky.social
www.cell.com/cell/fulltex...

Minimalist white poster with a subtle crumpled-paper texture; small ‘whn.global’ logo centered at the top. A small intro line sits above a huge headline where ‘COVID’ is bright red and ‘is different.’ is black. Text: ‘Paraphrased from David Brasure’s WHN blog post, “COVID Is Different.” Read the full article at whn.global/covid-is-different. COVID is different. SARS-CoV-2 behaves differently from the viruses most of us grew up with. And treating it like “another flu” is costing people their health.’ Footer: The World Health Network is a network devoted to global compassion—working together to inspire collective action through science for a safer, healthier world.

Same white, paper-texture poster and top ‘whn.global’ logo. Large title reads ‘What makes COVID different?’ with ‘COVID’ in red, followed by a bulleted list. Text: ‘Paraphrased from David Brasure’s WHN blog post, “COVID Is Different.” Read the full article at whn.global/covid-is-different. What makes COVID different? • It can breach the blood–brain barrier • It can damage your endothelial lining and increase clot risk • It can persist in tissues • It can lower key immune cells • It may increase cancer risk • You can catch it multiple times per year These are not “normal cold virus” behaviors.’ Footer line about the World Health Network.

Same clean white poster with paper texture; ‘whn.global’ at top. Big statement line mid-page where ‘Long COVID’ appears in red and the rest in black; two short paragraphs below. Text: ‘Paraphrased from David Brasure’s WHN blog post, “COVID Is Different.” Read the full article at whn.global/covid-is-different. Long COVID is caused by SARS-CoV-2. Persistent symptoms come from real, documented damage. Not anxiety, not imagination, not “just needing rest.” Hundreds of thousands of studies show SARS-CoV-2 affects the body in ways we’re still uncovering. Just because you’ve had multiple infections and “felt fine” doesn’t mean it will stay that way.’ Footer line about the World Health Network.

Same minimalist white, paper-texture layout with ‘whn.global’ at top. A large heading ‘Here’s what you can do.’ sits above a simple bullet list; the final URL slug ‘covid-is-different’ is in red. Text: ‘Paraphrased from David Brasure’s WHN blog post, “COVID Is Different.” Read the full article at whn.global/covid-is-different. Here’s what you can do. • Improve air quality (filters, ventilation) • Wear a high-filtration mask in shared indoor air • Test when exposed or symptomatic • Stay home when sick • Use layered protections with friends, family, and workplaces Read more at whn.global/covid-is-different’ Footer line about the World Health Network.

COVID isn’t acting like the viruses most of us grew up with, and treating it like “just a cold” is putting people at real risk. David Brasure breaks down why SARS-CoV-2 is fundamentally different, how it causes long-term damage, and what we can do to protect ourselves.

December 1, 2019 : the first known case of COVID-19.
More than six years later, SARS-CoV-2 is still circulating. Its long-term effects are not “in the past.” They accumulate, quietly and often invisibly.

#WorldAIDSDay We’ve lost do many friends & relatives to AIDS. Today we remember their talent & beauty & kindness. I was honored to be Rock Hudson’s date to a Lifetime Achievement Award. A gracious & lovely gentleman. We’ve lost so many, but also made so much progress #BeKind #ReachOut 💔

<em>Journal of Internal Medicine</em> | Wiley Online Library Background The long-term risk across severity strata of people infected with SARS-CoV-2 has not yet been comprehensively described. Methods Using nationwide registries, all COVID-19 cases in Swede...

From the University of Gothenburg, over 1 million adults in Sweden were studied

Those hospitalized with COVID-19 had a nearly 2-fold higher risk of heart attack, stroke, heart failure or death even after a year

Nonhospitalized cases had no lasting risk

onlinelibrary.wiley.com/doi/10.1111/...

Fish Oil in Dialysis: A Big Catch or an Empty Net — NephJC Holy Mackerel! This week we will discuss fish oil use in maintenance hemodialysis patients. Could this be the one thing that bends the curve on CV mortality, or is it just a red herring?

Maybe the most shocking study from #KidneyWk.
🐚From the depths of the oceans to #BlueSky, we're discussing PISCES 🐟 12/2/25 9pm EST. #NephJC
Are you hooked🪝on fish oil for CV disease in ESRD, or are you throwing it back 🌊?
www.nephjc.com/news/pisces-fishoil

Lookie here American Board of Pediatrics, no matter how many times you ask me to diagnose a teenage girl with "psychogenic" anything, imma choose an organic cause.

Every. Time. You. Post. THAT. Question.

Wouldn't be surprised if it grew into a new head like in the last Japanese summer flu wave

A TTE suggests flozins have a greater renal benefit than GLP1RAs

journals.lww.com/cjasn/pages/...

Is this a useful study?

We have seen Flozin effect being ~ 40% in DM
GLP1RAs ~ 25% from FLOW

1. We should use both - it’s not an either/or situations
2. Maybe GLP1 if weight/sugars a concern …

⚠️ BREAKING:

Spain 🇪🇸 Reintroduces Mask Mandate as COVID-19 and Flu Surge Push Hospitals Toward Crisis

Yes one lesson is to allow everyone access to COVID booster shots every six months like they do in NZ

The results for Australia are a bit depressing tbh. After a start similar to NZ in 2020-21, the impact in late-2021-22 was more than twice as severe as in NZ. NZ skipped 2 big waves by keeping their quarantine going until Feb-April 2022.
🧵

I’ve added an Excess Deaths Comparison page to my analysis on that topic. Here I’m comparing the UK, Sweden, Australia and New Zealand, to June 2025.

My method projects "Expected Deaths" using a linear regression on the weekly deaths (4-week average) from a baseline of 2015-2019 deaths.
🧵

A table from the Australian Bureau of Statistics titled “Acute respiratory infection associated deaths, 2025”. At the top is the ABS logo featuring a kangaroo and emu around a shield. The table lists monthly deaths from three viruses across 2025: COVID-19, Influenza, and RSV. Months run from January to December, plus a final “All” total column. For COVID-19: deaths range from 323 in January down to 38 in October, with November and December marked “na” and a total of 2,004. For Influenza: figures range from 36 in January to a peak of 322 in July, declining to 245 in September, 59 in October, November and December are “na”, totaling 1,385. For RSV: counts are lower overall, from 18 in January rising to 118 in July, then 77 in September, 20 in October, with “na” for November and December, totaling 506. The design uses clean horizontal lines, dark text on a light background, and a centered heading above the table.

Australia: Deaths due to acute respiratory infections.

Published: 28 November 2025

🔸Registered deaths by 31 October 2025

🔹2025 - COVID: 2,004
🔹2025 - Influenza: 1,385
🔹2025 - RSV: 506

Source: www.abs.gov.au/statistics/h...

Unvaccinated infants are the second most likely group to get hospitalized for Covid after older adults. Any effort to minimize the effectiveness for kids is evil.

#VaxandRelax? Probably not
Last winter, the effectiveness of the COVID-19 vaccine (against hospitalization, adults over 60) was

42% after 2 months
32% 2-4 months
0% after 6 months

So either you go doubbletab during winter or you #MaskUp

onlinelibrary.wiley.com/doi/10.1111/...

Measles Vaccine Protection Wanes After a Decade Individuals who receive a measles-containing vaccine maintain seropositivity for a decade; however, the vaccine’s protection declines gradually thereafter.

New Lancet meta-analysis finds measles vaccine immunity wanes over time, with seropositivity dropping from ~93% within 10 yrs to ~83% at 16–22 yrs.

The authors say their findings warrant an urgent review of vaccination strategies

www.medscape.com/viewarticle/...

For the 2025-26 season our office has given 48 COVID shots vs 700 flu shots.

The bad people have already won. Nobody wants them anymore.

Twas frymblal and the autism,
Did remech & runction in the wabe.
All mimsy where the fexcectorn,
And the bicylce outgrabe.

Infographic with AI slop published in Nature Scientific Reports

"Runctitiononal features"? "Medical fymblal"? "1 Tol Line storee"? This gets worse the longer you look at it. But it's got to be good, because it was published in Nature Scientific Reports last week: www.nature.com/articles/s41... h/t @asa.tsbalans.se

Australian COVID-19 weekly stats update:

The risk estimate fell again, to 0.1% “Currently Infectious”, or 1-in-1,625. This is a fresh “all time” low (since this analysis started in late 2022).

That implies a 2% chance that someone is infectious in a group of 30.

#COVID19 #SARSCoV2 #Australia
🧵

Yes you see the occasional mask but not respirators, which are as rare as hen's’ teeth

📣 Heavy Menstrual Bleeding in Women Treated with DOACs: Results of the HEMBLED Registry ⬇️

📌 Lindhoff-Last report differences among DOACs and their influence on the intensity of sponteneous menstrual bleeding

🆓 on TH: www.thieme-connect.de/products/ejo...

#Thrombosis #DOAC #VTE #HemeSky

Adults with #AFib who drank at least one cup of caffeinated coffee daily after successful cardioversion had a lower risk of recurrence than those who abstained from coffee & caffeine.

Lead author & JAMA Associate Editor Gregory M. Marcus, MD, MAS, explains the results of the study.

🔗 ja.ma/4p14pSw

B6 toxicity victims 'vindicated' as TGA confirms it is coming off shelves — ABC News The Therapeutic Goods Administration (TGA) will crack down on vitamin B6 after a rise in toxicity cases causing life-altering nerve damage to many Australians.

TGA says some vitamin B6 will come off shelves and require prescriptions for large doses after rise in toxicity cases apple.news/A_FmyXxPATFC...

REVIEW: Death in Hamburg: Society and Politics in the Cholera Years by Richard J. Evans (1987) The Legacy of Johann Kraus Lives On

cholera in Hamburg, 1892 broke me www.panaccindex.info/p/review-dea...