iiinova — where your digital self keeps evolving

Ezra S @ezra.zone · 13/07/2026

this is my body on (cancer) drugs

screenshot of my garmin wearable app showing a sleep score graph. the sleep score is 20, quality is poor, and duration is 3 hours and 36 minutes. the graph shows that I was awake for most of the night.

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Ezra S @ezra.zone · 25/02/2026

“But I got COVID and was fine!”

Image from Wikipedia article about survivorship bias showing bullet locations on an airplane

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Ezra S @ezra.zone · 05/02/2026

There will never be fewer reasons to get off Substack.

Screenshot of email from "Substack Standards & Enforcement":

Hello,

I’m reaching out to let you know about a security incident that resulted in the email address from your Substack account being shared without your permission.

I’m incredibly sorry this happened. We take our responsibility to protect your data and your privacy seriously, and we came up short here.

What happened. On February 3rd, we identified evidence of a problem with our systems that allowed an unauthorized third party to access limited user data without permission, including email addresses, phone numbers, and other internal metadata. This data was accessed in October 2025. Importantly, credit card numbers, passwords, and financial information were not accessed.

What we are doing. We have fixed the problem with our system that allowed this to happen. We are conducting a full investigation, and are taking steps to improve our systems and processes to prevent this type of issue from happening in the future.

What you can do. We do not have evidence that this information is being misused, but we encourage you to take extra caution with any emails you receive that may be suspicious.

This sucks. I'm sorry. We will work very hard to make sure it does not happen again.

- Chris Best, CEO of Substack

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Ezra S @ezra.zone · 14/12/2025

What if we kissed at the credit card exclusive promotional comedy show

Screenshot of iOS notification from the BILT rewards app that says:

Final spots: Comedy in SF
Join us Monday for a member-exclusive show at Punch Line SF. Two drinks included. Tap to book!

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Ezra S @ezra.zone · 26/09/2025

how did i celebrate? by doing a study visit last week with the amazing UCSF LIINC team, which has been studying Long COVID since April 2020. if you are in the bay area and have ever gotten COVID, they (and we) need your help. learn more and sign up for the study here: liincstudy.org

me, a white man in my late 30s with a mustache and smirk, standing in front of UCSF Pride Hall at San Francisco General Hospital prior to a study visit

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Ezra S @ezra.zone · 09/09/2025

I'm sorry but how is this okay? This is Kaiser Permanente. We can't go out of network and get reimbursed. It's the middle of a massive wave in Northern California.

Screenshot of Kaiser website that says:

Vaccine updates
Flu shots will be available starting September 8. Kaiser Permanente is reviewing the FDA's approval of the 2025-26 COVID-19 vaccine and awaiting CDC guidance. COVID-19 vaccines are expected in mid-September. Please check back for eligibility and details.

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Ezra S @ezra.zone · 15/08/2025

Google, never change

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Ezra S @ezra.zone · 14/08/2025

Oh! And late-breaking news via the other site, the clinical trial of Anktiva at UCSF is starting soon. cssifm.org

Tweet from (sigh) Pat Soon-Shiong: "Trial of Bioshield to explore treatment of Long Covid is open!! Please enquire via this form at http://cssifm.org and our team will respond to the many requests for Bioshield #anktiva #longcovid"

Image showing screenshot of website with "Long COVID Clinical Trial" heading and "CSSIFM Clinical Trial Inquiry" section

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Ezra S @ezra.zone · 09/08/2025

Wow someone on my vanity plates chat found @samgavin.com

Photo through a car windshield showing the Nevada car license plate “NOCHILL”

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Ezra S @ezra.zone · 05/06/2025

related to this – I got an indoor air quality monitor a while back, and when I turn my filter on I watch the numbers go down almost immediately. PM2.5 was over 40 when I woke up, now it's at zero.

graph of pm2.5 measurements at my desk in the last 24 hours, showing early morning spikes that quickly go down to 0.

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Ezra S @ezra.zone · 16/05/2025

In fact here's the slide in question, as well as one of the follow-up slides

Slide showing:
Why Didn't It Work?

Wrong drug:
• Maybe AER002 did not have the activity we needed or the dose was wrong
• Maybe virus had already escaped
• Maybe participants had "mixed" reservoirs from exposure after August 2022

Wrong participants:
• Maybe we did not enroll anyone with viral persistence
• Maybe participants were too far from initial infection (most data for 3-12 months)

Wrong approach:
• Maybe we treated people too late (>2
years after infection causing Long COVID
• Maybe a single dose is ineffective and a multi-dosing strategy is needed
• Maybe a combination approach is needed (either targeting virus or immune system)

Wrong hypothesis:
• Maybe viral persistence is simply not a cause of Long COVID

Slide showing:

Where Do We Go From Here?: My Thoughts

• While clinical trials targeting viral persistence to date have been negative, I do not think that we should abandon pursuit of this line of investigation

• The next round of trials targeting viral persistence will need to be more nuanced and selective:

• Confirmation of SCV2 persistence as eligibility criterion → need biomarker development to support this (VIPER program)
• Specific phenotypes associated with persistence
• New approaches
• Modern monoclonals
• Monoclonal + antiviral (including non-Pl antivirals): some anecdotes, targeting virus from multiple angles may be of benefit
• Monoclonal + therapeutic vaccine: based on case reports, experience in HIV
• We should be testing other (non-persistence) hypotheses in parallel

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Ezra S @ezra.zone · 13/05/2025

we need to get him working on long covid

screen capture from s2 e4 of The Rehearsal: nathan fielder, in a suit, sits down at a table in a replica congressional hearing room, with a placard with his name in front of him.

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Ezra S @ezra.zone · 07/04/2025

Another week, another study visit.

Me, wearing a 3M VFlex mask, in front of UCSF Pride Hall

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Ezra S @ezra.zone · 03/03/2025

there was a time in my life when I thought this was a big blood draw. now it's just a Monday.

A phlebotomy setup with coband, gauze, and alcohol wipe. A green test tube rack holds 8 large purple-capped vacutainers, one small purple-capped vacutainer, two black-and-red medium vacutainers, and one yellow medium vacutainer.

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Ezra S @ezra.zone · 20/02/2025

I'd like to read a longform article about what it's like to work at a company that uses the entire Zoom product suite

screenshot of Zoom UI showing a variety of features offered. This includes:
Chat
Docs
Whiteboards
Workflows
Clips
Notes
Mail
Surveys
Apps
Contacts

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Ezra S @ezra.zone · 30/01/2025

friends, THIS IS HOW IT IS DONE s/o to @onholliday.bsky.social, an amazing tattooer and friend in Portland, Oregon!

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Ezra S @ezra.zone · 12/01/2025

your last saved meme is your moral philosophy @lauren.rotatingsandwiches.com

lauren@rotatingsandwiches.com post:

i made a little meme about going the farmers market

aggravated meme person on left is carrying a “Choose Gratitude” tote and saying I NEED TO GET THE LONG EGGPLANTS

smiling meme person on right is drinking a hot beverage and saying “I like enjoying the vibe”

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Ezra S @ezra.zone · 08/01/2025

The impact of one person, in the right place, can be extraordinary. Amazing work, @bhanlon15.bsky.social. From: www.mdpi.com/2673-8112/5/...

Screenshot of linked paper with the following text:

"My involvement began in this RECOVER initiative after an article was published on Oct 20, 2021, in “UIC Today for the Illinois RECOVER Initiative” [3]. Dr. Jerry A. Krishnan was the Principal Investigator for this RECOVER adult HUB at the University of Illinois Hospital and Health Sciences System. In November of 2021, after reading this article about the launch of the Illinois HUB, Billy Hanlon, a Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), and Long COVID activist from Minneapolis contacted me as he had read several research articles I had written on ME/CFS, and he asked if I was connected with this Illinois HUB. I said I was not, and Billy then contacted Dr. Krishnan and encouraged him to involve me with this Illinois HUB. After several meetings with Billy and Dr. Krishnan, I was asked to serve as an ME/CFS expert for the University of Illinois RECOVER Hub. As part of my activities over the next few years, I presented several webinars and workshops to Dr. Krishnan’s RECOVER staff on diagnostics and case definitions for ME/CFS [4]."

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Ezra S @ezra.zone · 31/12/2024

hello which of you are going to get me the minions router? www.amazon.com/Davolink-Min...

product image of a wifi router shaped like a minion

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Ezra S @ezra.zone · 26/12/2024

how your email finds me

a fluffy, old shih tzu with tongue sticking out sleeping on a wooden floor. or is it a mop? we'll never know

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Ezra S @ezra.zone · 21/12/2024

the pathologist seems to seething with passive aggressive rage about the missing core biopsy. (the doc tried three extra times to get them one. i ended up with three extra holes in my hip. what are you gonna do?)

Screenshot of lab report that says:

FINAL DIAGNOSIS
Peripheral blood smear and bone marrow, right posterior iliac crest, aspirate smears and clot:
- Cellular marrow with progressive trilineage hematopoiesis and blasts less than 5%; see comment.
COMMENT:
Aspirates are abundantly cellular and demonstrate progressive trilineage hematopoiesis with a slight decrease in the myeloid to erythroid ratio
(1-2:1), no significant dysplasia, and no increase in blasts (~1%).
Due to the lack of a core biopsy, cellularity for age cannot be determined; however, the clot contains cellular spicules which demonstrate 30-40% cellularity. Concurrent UCS flow cytometry (IM24-4413) showed no increase in myeloid blasts (1% of total events) and no evidence of a lymphoproliferative disorder. Clinical correlation is recommended.
The following stains (COVID19, CD138, kappa, lambda) was performed and evaluated at UCSF on block Al and the results are reported in the microscopic description.

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Ezra S @ezra.zone · 19/12/2024

Who else got a sick equifax payout today?

screenshot of message:
Your Additional Settlement Payment
$7.44

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Ezra S @ezra.zone · 14/12/2024

One other nice thing about this team is they really try to provide participants with whatever clinical testing results they can (though the most exciting test results are all locked up in the research lab). Here's my flow cytometry!

Screenshot of test results with the following text:

FINAL DIAGNOSIS
1. No increase in myeloid blasts (blasts are 1% of total events); see comment.
2. No evidence of a lymphoproliferative disorder; see comment.
COMMENT:
No immunophenotypically abnormal cell population identified.
Lymphoid gate (bright CD45, low side scatter): 19% of total events
-B-cells: 13% of gated events
Expressed: CD19, CD20, CD22
Kappa:lambda ratio: 1.4:1
No co-expression of CD5, CD10, CD34
- T-cells: 58% of gated events
Expressed CD2, CD3, CD5, variable CD7, and either CD4 or CD8
CD4:CD8 ratio: 1:1
No loss of a pan-T-cell antigen
- NK-cells: 29% of gated events
Expressed CD2, CD7
Subsets co-expressed CD16, CD56, and/or CD57
Blast gate (intermediate CD45, low-to-moderate side scatter):
- Myeloid blasts: 1% of total events
Expressed CD13, weak CD33, CD34, CD38, weak CD71, CD117, HLA-DR No co-expression of CD14, CD15, CD16, CD64, CD123, lymphoid antigens
Normal immunophenotype
- Hematogones: 1.5% of total events
Expressed CD10, CD19, variable CD20, variable CD34, bright CD38, HLA-DR
Normal immunophenotype
Myeloid events:
- Granulocytes (intermediate CD45, moderate-to-high side scatter):
Expressed CD13, CD15, CD33
Normal immunophenotype
- Monocytes (bright CD45, moderate side scatter):
Expressed weak CD4, CD11b, CD13, CD14, weak CD15, CD33, CD64
Normal immunophenotype

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Ezra S @ezra.zone · 18/11/2024

blue sky is done. it's just one big art deco chamber

screenshot of classic art deco style design, a gold pillar in the middle with sweeping gold rays coming out

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Ezra S @ezra.zone · 17/11/2024

Also, I really like that the website proudly shows its Patient-Led Research Scorecard. This is a tool that @patientled.bsky.social developed to evaluate research projects based on how deeply they collaborated with patients. More of this, please! cdn.prod.website-files.com/65981d7bb4de...

Screenshot of REVERSE-LC website showing Patient Led Scorecard evaluation, with most grades in the +2 "Ideal" category and a few in the +1 "Great" category.

Text reads:
"The Reverse-LC Study’s
Patient-Led Research Scorecard

Our trial was graded by leaders at the Patient-Led Research Collaborative (PLRC) (Hannah Davis, Gina Assaf), ME-Action (Jaime Seltzer), and National Academy of Medicine Long COVID testifier (Kelly Sealey).

This scorecard was created by Patient-Led Research Collaborative.

The figure shows the high degree of collaboration between the physician-scientists and patient-researchers with not only lived experience of the illness, but also experience with the research process, participatory design, patient engagement, and study design.

We are grateful for the input from so many who shared their wisdom and advice to make this NIH-funded trial the best it can be. Reverse-LC is a campaign of human service and scientific discovery."

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Ezra S @ezra.zone · 31/10/2024

What are you for Halloween? I'm my broken immune system

yours truly wearing sunglasses and a t-shirt of an [18F]FAraG PET/CT scan showing widespread T-cell activation throughout my body

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Ezra S @ezra.zone · 26/03/2024

The filters let you choose the kinds of trials you’re most interested in. Only want to see trials that are testing interventions? Just check the box.

Screenshot of longcovidstudies.net filter options

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Ezra S @ezra.zone · 05/08/2023

Read a take, got angry, wrote the letter, got it published in the Boston Globe www.bostonglobe.com/2023/08/05/opin…

Letter to the editor titled "Long COVID has destroyed my life" published in the Boston Globe. Text contained in skeet thread

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Ezra S @ezra.zone · 24/07/2023

twitter.com/RMac18/status/168353972… 'The co. is projecting the X logo in the cafeteria and changed conference room names to words and phrases with the letter X in them. Those new names include “eXposure,” “eXult” and “s3Xy."'