TWiV explains that a recent report suggesting that the SARS-CoV-2 spike protein inhibits V(D)J recombination in vitro would not impact immunity after infection or vaccination, and describes the isolation of remdesivir resistant mutants in cells in culture, and the emergence of amino acid changes in the spike protein identical to those in variants of concern, in the absence of immune selection.

In COVID-19 clinical update #88, Dr. Griffin covers vaccine protection among US veterans, absence of long COVID in vaccinated who are infected, single dose of REGEN-COV monoclonal antibody cocktail provides long term protection, and Pfizer protease inhibitor Paxlovid is 89% effective in preventing hospitalization or death.

In COVID-19 clinical update #87, Dr. Griffin reviews PCR cycle threshold and RNA copy number, rapid antigen tests, hospitalization rate after infection or vaccination, allergies and vaccination, community transmission and viral RNA load, early treatment with sotrovimab, meta-analysis of tocilizumab treatment, antibiotic overuse, and guidelines on the use of anticoagulation for thromboprophylaxis.

In COVID-19 clinical update #86, Dr. Griffin discusses virologic features of infection in children, antibody tests should not be used to asses level of protection, test-to-stay programs in schools, FDA authorizes Moderna boosters, results of TOGETHER trial for fluvoxamine, statins and 28 day mortality, and cognitive function in patients.

Rich reviews the history of smallpox and the discovery of variola viral genomes in ancient DNA from human remains throughout Northern Europe, which pushes back the earliest date of smallpox virus infection to ~600–1050 CE, overlapping the Viking Age.

A TWiV trio reveal the isolation of novel paramyxoviruses from rodents and bats in Arizona, and isolation of naive B cells from seronegative donors that produce germline encoded antibodies which engage the receptor binding domain of SARS-CoV-2, variants of concern, and related sarbecoviruses from bats.