In his weekly clinical update, Dr. Griffin informs us about the World Health Organization research and development plan to combat endemic pathogens including hepatitis C virus, RSV and dengue virus, another case of mpox in Britian, the Marburg virus outbreak in Rwanda, before reviewing the recent statistics on SARS-CoV-2 infection, the WasterwaterScan dashboard, if there is a benefit to additional COVID vaccinations after the initial series, ISDA guideline for using anti-SARS-CoV-2 monoclonal antibody therapy for prophylaxis, where to find PEMGARDA, a reminder of how and when to use steroids to treat COVID-19, if and how do severe secondary bacterial infections develop following SARS-CoV-2 infection, and if COVID-19 associates with a risk of autoimmune and autoinflammatory connective tissue disorders.
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Links for this episode
- Is the WHO the world’s NIH: endemic pathogens initiative (eBioMedicine)
- Another two cases of mpox in Britian (Reuters)
- How to stop Marburg virus (Rwanda Biomedical Centre)
- Marburg Virus fact sheet (Rwanda Biomedical Centre)
- Influenza weekly surveillance report: cliff notes (CDC FluView)
- RSV NETwork (CDC RSV)
- Respiratory virus activity (CDC Respiratory Illnesses)
- COVID-19 deaths (CDC)
- COVID-19 national and regional trends (CDC)
- Waste water scan for 11 pathogens (WastewaterSCan)
- COVID-19 variant tracker (CDC)
- SARS-CoV-2 genomes galore (Nextstrain)
- Symptom reduction after additional vaccine dose during Omicron (OFID)
- IDSA Guideline update for SARS-CoV-2 monoclonal antibody pemivibart pre-exposure prophylaxis (CID)
- Where to get pemgarda (Pemgarda)
- EUA for the pre-exposure prophylaxis of COVID-19 (INVIYD)
- Fusion center near you….if in NY (Prime Fusions)
- CDC Quarantine guidelines (CDC)
- NIH COVID-19 treatment guidelines (NIH)
- Infectious Disease Society guidelines for treatment and management (ID Society)
- Drug interaction checker (University of Liverpool)
- Molnupiravir safety and efficacy (JMV)
- Convalescent plasma recommendation for immunocompromised (ID Society)
- What to do when sick with a respiratory virus (CDC)
- When your healthcare provider is infected/exposed with SARS-CoV-2 (CDC)
- Managing healthcare staffing shortages (CDC)
- Steroids, dexamethasone at the right time (OFID)
- Anticoagulation guidelines (hematology.org)
- Secondary bacterial infection follows COVID-19 (Nature Communications)
- Daniel Griffin’s evidence-based medical practices for long COVID (OFID)
- Autoimmune and autoinflammatory connective tissue disorders following COVID-19 (JAMA Dermatology)
- Letters read on TWiV 1164
- Dr. Griffin’s COVID treatment summary (pdf)
- Timestamps by Jolene. Thanks!
Intro music is by Ronald Jenkees
Send your questions for Dr. Griffin to daniel@microbe.tv
The post TWiV 1164: Clinical update with Dr. Daniel Griffin first appeared on This Week in Virology.
1-42min H5N1 then Bunyavirus
no discussion at all about the potential dangers !
How likely can it be abused ? How much would the disclosed information help
?
How likely are lab-escapes ?
You can’t really decide this issue by leaving those questions aside.
Ron Fouchier suggests that prepandemic vaccine makes no sense since, we
don’t know H5N1
will be the next pandemic strain (else it would)
But even if the likelyhood is only 1%, (or 10% ?) wouldn’t that justify to
produce
prepandemic H5N1-vaccine in masses ?
Somewhere there must be a percentage threshold where we would change our
mind (by logic),
so where is that threshold ? I’d really like to here some subjective
expert-thresholds here,
and I think it’s important to discuss this. But all that I get since 2005
are “noone knows” s !
So, should I trust those scientists on their responsible judgement ?
When they are just _ignoring_ the important questions and trying to avoid
speaking about them ?!
And the NSABB, did they evaluate those questions ? noone knows ….
“it is really important to publish everything”. Really Vincent? So, if I happen to discover how to synthesize in the kitchen a deadly and transmissible virus that can wipe out the civilization, then I should just go and publish it, right?
Yes, really, everything should be published. Think about your scenario (assuming it could ever happen – very unlikely, especially in a kitchen). If a terrorist makes such a deadly virus, they are not going to publish it of course. A bona fide scientist would not undertake to make such a virus. If one were made accidentally, it should be published so we can study it and know how to deal with it. Keep it secret and nobody wins.
you are obviously in conflict with the longstanding policy of your country
here.
In fact, I’m not aware of any considerable political movement in USA,
now or in the past, that would have supported this attitude.
It has always been the strategy to keep such things secret, just see
the current discussions about Iranian nukes.
I’m a scientist – we want science to be published. Most scientists I know support this attitude. Secrecy in science benefits no one.
I know. I’d been fighting against secrecy in science as well (e.g.
GISAID)
But you can’t decide this issue by just ignoring the counterarguments.
We have to estimate the magnitude of the threat, there is no way around
it.It can’t be independent from that estimate.I haven’t even made up my mind yet, how could I,I have no access to the details. But the way how this is being handled worries me. Compare with swineflu 1976.
Vincent,
I am afraid bona fide scientists just did that. The virus might not be so nasty yet (we really don’t know it), and the place to synthesize it might still need to be something more sophisticated than a kitchen, but those are technical details that a rough state or wealthy terrorist group probably can get around with the cues already given by those studies and a few more twisting.
Let me clarify something first: I am all for freedom of speech and I do think that science, art, innovation and business thrills when governments, restrictions, prejudices, etc are not meddling in these areas. But I do believe that all fields of human enterprise should be limited by some constraints that are reasonably agreed upon by the society – and science should not be an exception to this rule. It is easy to find examples to support this (so let me give you another one: imagine that an English scientist during WWII discovered a means of making radars inoperative. Should he/she, following your categorical affirmation, publish it leaving England without one of its more critical defenses against the Nazis? Eventually the enemies would probably discover such technique by themselves, but the advantage given by the time edge can be critical – both at that time against Hitler, and nowadays against similar dangerous jerks that are around)
But to be honest, I don’t even think the discussion on whether the H5N1 papers should be published or not is relevant any longer. I think that what has been done is already irreversible. My concern now is that we have a whole new situation (perhaps not so new, but made more prominent now), which is that we now live in a world where epidemics can no longer come only from wildlife, or from our contact with domestic animals, or from natural mutations in circulating pathogens. Now there is another real source of potentially devastating pathogens that can spread in few weeks around the globe and for which no vaccines or medicines could be developed and distributed on time.
I think this is a new situation for which governments and scientists have to be very aware of, and need to urgently start up setting up multilateral talks, collaborations and mechanisms for being as much prepared as possible. This is a really, really serious matter.
I wonder if a reputable journal would publish kitchen-science, not done in an academic or industrial laboratory. When I say it is important to publish everything, I am talking about science done in traditional venues. done properly and well controlled. I don’t believe kitchen science would qualify.
depends on the result, not the room.The kitchen is just less
likely to find a result, but when it does, it should be published,IMO.
Provided it passes scientific and NSABB reviews.
After all it’s the public that funds the research by taxes, and the
public doesn’t care from where it gets the results.
What if this whole H5N1 episode was not let out to the public at all? All discussions regarding the Fouchier experiment should have been kept within the NSABB and other concerned Health organizations and a suitable decision made within these closed walls. Anyways the media and public don’t play much role in the final decision to publish the work or not.