David writes:

Hi Daniel and Vincent,

Writing for a friend 🤔. Patient had B cell lymphoma in 2020 and was treated by standard therapy, including B cell depletion with rituximab. He’s been immunized several times but never seroconverted. He caught Covid in April and responded well to Paxlovid but relapsed a month later and is virus positive, has fever, pulmonary complications, and is hospitalized on remdesivir and supplemental oxygen. Any comments or recommendations for dealing with what looks like persistent viral replication? Since Evusheld is no longer useful, is convalescent plasma recommended? Is it possible to ever completely eradicate viral replication without an immune response?

Love your show!


Roland writes:

Hello Dr Griffin,

Firstly, I’ve been listening to the weekly clinical update since the start and wanted to thank Dr Griffin and the team for their immense contribution, a lot of comfort in a turbulent time.

I am a 49 yo male with no pre-existing conditions who is currently on day 3 of Covid-19 infection (first time and triple vaccinated) and last night began a nasty cough.

Coughs tend to persist with me my physician has recommended Symbicort Rapihaler, but I have heard you say over and over to never use steroids in the first week

Can you please give me your thoughts on whether Symbicort Rapihaler qualifies as Steroid and should be avoided? (if so how long do I wait?)

Unsure If you answer emails, or just read out on your show, but would appreciate your thoughts if you  have time.



Jeff writres:


As always, many thanks for all you do. I am a practicing pediatrician in Connecticut. Many families and patients are reluctant to undergo testing for COVID because of the strict 5 day isolation rule. Missing work and school for what seems mild viral symptoms is something people are increasingly uninterested in doing. The logic seems to be, don’t ask a question when you’d rather not know the answer. My question for you is this: given our current state of affairs, how relevant now is the data that led to the 5 day isolation recommendation? Will there be a time when we can treat COVID-19 more like we do other viral respiratory infections? (stay home when you have a fever, return to work/school when you’re feeling better, plus maybe wear a mask if you’re symptomatic) I no longer recall the specifics that led to that recommendation, but back then we were dealing with other variants in an environment of lower vaccine and infection derived immunity. If the community seroprevalence is high enough to change vaccine recommendations, might it also be high enough at some point to modify how we approach the risk posed by patients who might be contagious? From what I can see, the strict 5 day protocol is making it harder for us to know how much COVID-19 is actually out there.



Deborah writes:

I’m 71. My husband is 79. We’re both relatively healthy. We’ve gotten all our Covid vaccines, including Moderna and Pfizer shots. Neither of us has had the disease. For my first booster I was given a full Moderna dose b/c I have both ulcerative and microscopic colitis, and that’s what the doctor wanted to do. The second boosters were the Moderna. The last (fifth vaccines) for both of us was the bivalent Pfizer booster. 

Here’s my question. If the lastest bivalent vaccine doesn’t protect against the current iteration of Covid 19 (and I suppose the ones that will soon follow), why get it? Why not just protect ourselves as we’ve been doing, with masking, being cautious and asking friends and family to test before they come by( no one has had a problem with this). Is there a downside to NOT getting this newest bivalent booster at our ages? 

Thanks for your answers.