Edward Chen

“I have been infected with COVID four times and got long COVID after the first three, but not the fourth one—the only difference being that I had metformin in the acute stage of the fourth infection,” said Margaret O'Hara, a trustee of the UK charity Long Covid Support.

She asked for the drug after an earlier clinical trial of metformin among people who were overweight. “This was a miraculous result for me and I can't thank those scientists enough for making this discovery.”

nature.comCan long COVID be prevented? Two drugs finally show promiseRigorous trials suggest they reduce the risk of long-term disease after coronavirus infection.

“If someone said to me, ‘I’m really scared about long COVID,’” Sax would discuss metformin, but the risk of long COVID is low enough that he would not typically prescribe any drug for it, he said.

At least one individual credits metformin with helping them escape long COVID.

nature.comCan long COVID be prevented? Two drugs finally show promiseRigorous trials suggest they reduce the risk of long-term disease after coronavirus infection.

And the Paxlovid study suffers from high fragility, said Paul Sax, the infectious diseases chair at Brigham and Women’s Hospital in Boston, Massachusetts. “With this low sample size, all it takes is a few cases to go on one side or the other, and then you have a completely different result,” he said

(Author Nina Langeland, infectious diseases professor at the University of Bergen in Norway, said “there was little we could do to improve recruitment.”)

nature.comCan long COVID be prevented? Two drugs finally show promiseRigorous trials suggest they reduce the risk of long-term disease after coronavirus infection.

There are also physicians who are not fully swayed by the papers. Compared to Paxlovid, the “evidence base” for metformin is “far less developed,” said Ziyad Al-Aly, an epidemiologist at Washington University in St. Louis. “You would also want to see some mechanistic explanation to understand why.”

(Justin Reese, a computational biologist at Lawrence Berkeley National Laboratory in California, said “there are some ideas,” though more research is needed. Metformin suppresses mTORC1 signalling, he said, “potentially making the cell less hospitable for producing new virions.”)

nature.comCan long COVID be prevented? Two drugs finally show promiseRigorous trials suggest they reduce the risk of long-term disease after coronavirus infection.

“If I had a patient with acute COVID today,” said Wes Ely, a pulmonologist at Vanderbilt University in Nashville, Tennessee, “I’d say to them, ‘We can probably cut that [long COVID] risk in half by you taking these 36 pills—two weeks’ worth of metformin. What do you want to do?’”

And, said Myron Cohen, an infectious diseases doctor at the University of North Carolina at Chapel Hill, the new Paxlovid study “simply pushes me further over into saying to someone, ‘Unless you have a reason not to take Paxlovid, I would probably give you Paxlovid.’”

nature.comCan long COVID be prevented? Two drugs finally show promiseRigorous trials suggest they reduce the risk of long-term disease after coronavirus infection.

nature.comFertility clinics are offering young mitochondria in controversial fertility techniqueResearchers are alarmed that the procedure, which has not been rigorously studied, is advertised by clinics around the world.

A trial of 2,983 people, published last month in Clinical Infectious Diseases, found metformin reduced clinician-diagnosed long COVID at 6 months by half. A trial of 144 people, published two weeks ago in The Lancet ID, found Paxlovid reduced self-reported long COVID symptoms at 3 months by 40%.

Edward Chen reposted

Richard Van Noorden

@richvn.bsky.social

28 July

Some fertility clinics offer to furnish clients’ embryos with donated mitochondria to help treat infertility -- this hasn't been proven in rigorous clinical trials and may have safety risks. Scientists who spoke to @nature.com are alarmed. By @edwrdchen.bsky.social www.nature.com/articles/d41...

nature.comWhat it will take to stop the spiralling Ebola outbreakCases in central Africa are rising at an alarming pace, but lessons from past epidemics could help to contain the current spread of infection.

Adding testing capacity is one way to help contain the ongoing Ebola outbreak centered in the Democratic Republic of the Congo, @marilenharo.bsky.social reports for Nature's News section: www.nature.com/articles/d41...

It may be surprising that some healthcare workers are not being paid—it was for me at least. But a Western infectious diseases physician, who asked not to be named, said this is “unfortunately common the world over in low-resource settings.”

One of the first steps to countering Ebola, they said, is “pay the nurses.” Not doing so “very much undermines the response.”

“Sometimes it is very difficult to get work done with demotivated people.” He said complaints are widespread on WhatsApp groups, with themes like “we are the ones sitting at the frontline” but “people are not caring about us.”

Thanks to @marilenharo.bsky.social, Traci Watson for edits, and Rachel Fieldhouse and @ecallaway.bsky.social for flagging ideas. Graph of Ebola cases from Mariana:

Doctors report that medical staff are not regularly paid by the government, which employs them in the public health system. “We have a lot of hired staff, medical personnel, who are not even paid,” said Tony Ukety, medical director of a research center in Ituri, DRC.

The delay is a “massive organizational issue that everyone knows about,” said an epidemiologist who asked to remain anonymous. “It always come[s] too late.”

“Part of the contributing factor,” said Nicholas Enrich, who was an acting assistant administrator at USAID, “is they're not able to rely on large swaths of community health workers that had been previously funded through USAID efforts.”

Experts who've responded to Ebola outbreaks, like Megan Fotheringham, who was an office deputy director at USAID, said that contact tracing has been unusually late. “It's the first thing you start doing,” she said. Without vaccines or specific treatments, “that is your public health intervention.”

Yet, as of last Thursday, 13 days after an outbreak was declared on May 15, contact tracing had yet to start in Mongbwalu, where the outbreak probably originated, said Manuel Albela, an epidemiologist with MSF. At the time, MSF planned to begin contact tracing sometime this week.

There is also a lack of confidence in the healthcare system that is shared by some of its own workers. As of last Thursday, 11 workers at his hospital had confirmed Ebola, said Tonen-Wolyec.

One, their director of nursing, passed that morning; five were hospitalized; and five “refused” to seek care at the hospital, he said. “They really didn’t want to go there because everybody has the belief [that an] Ebola treatment center is just like [a] mortuary where people are going to die.”

The weeks- and potentially months-long delay in confirming the outbreak has allowed the virus to spread roughshod throughout hospitals, said Serge Tonen-Wolyec, an internal medicine physician at Polyclinique Citadelle in Bunia, DRC, where some of the first positive Bundibugyo samples were collected.

“My suggestion would be to close all these institutions, the health facilities here, to decontaminate them” before re-opening, he said through a French translator. “The virus has invaded all the health infrastructure within Bunia.”

Also critical is desanitizing health facilities, fully implementing contact tracing, and paying staff, experts say.

nature.comWorld’s largest forest research agency faces severe cutback by Trump administrationThe US Forest Service has proposed closing some three-quarters of its research sites in a move that has provoked widespread fear and uncertainty.

The largest forest research organization in the world, the US Forest Service's R&D branch, may lose up to 74% of its sites under a planned reorganization. Researchers on the ground and former officials shared many thoughts with Nature's News team: www.nature.com/articles/d41...

Research sites that may be shuttered are located throughout the country. Some regions and lines of research are more affected than others. One prominent example is urban ecology, which can help city parks departments decide which trees are more likely to survive in a changing climate.

A tremendous and sincere thanks to each of the scientists, foresters, and land managers who made this story happen by trusting me to report with sensitivity, nuance, and care. Thanks, too, to USFS PO. Thanks to Traci Watson and @alexwitze.bsky.social for edits and encouragement.

An internal memo distributed to R&D staff promises “forthcoming” information on another opportunity to take early retirement. “What would we lose if we lost this organization?,” a former official reminisced. “It really breaks my heart.”

Nature’s story has entirely different quotes that do not repeat the above. A former chief, two deputy chiefs, and two associate deputy chiefs comment: www.nature.com/articles/d41...

Many have described USFS as “glue” and “connective tissue” that fosters collaboration between land managers, government, academia, and others.

“My heroes are Forest Service scientists,” one academic said. “My closest colleagues are in the Forest Service,” said another. “The Forest Service was instrumental in every study that I carried out,” said a third. “We’re talking almost 40 years.”

R&D is under a hiring freeze that was started during the previous administration, in early 2024. (Even before, hiring was severely limited.) Congress has appropriated sufficient funds for R&D to hire in FY26, but the chief’s office has prohibited R&D from hiring.

The associate chief earlier floated a target of 600 employees for R&D, multiple former officials said. One added: “600 employees, really, it’s not enough to continue to serve the entire mission that we were serving. So what do you do? And the big question is, ‘What have you lost?’”

USFS as a whole has also had to face a decades-long trend of declining headcount. In the 12-year period immediately before the current administration started, USFS R&D lost a third of its employees. USFS R&D has lost a third again, in just 16 months.

(The Canadian Forest Service may soon surpass USFS R&D to become the largest forest research organization. CFS has close to 1,000 research employees.)

“The manner in which it’s been rolled out has been totally unacceptable and unprofessional and meant to inflict emotional damage,” a current USFS scientist said. “We all see it as an attempt to drive people out of the government.”