Mike writes:

Hi Dr Griffin,

I’m a healthy guy in my 40s, I’ve been vaccinated/boosted repeatedly and had COVID twice. In both instances, it wasn’t long after I was vaccinated/boosted and my symptoms were very mild, similar to allergies and I bounced back very quickly (physically).

However, after my last bout my brain has felt like Swiss cheese for months. It seems to be slowly improving. If I contract COVID again, would Paxlovid act as a prophylactic against this? The studies seem mixed, and I am not sure a doctor would even give me a prescription based on mild symptoms.

Thank you,

Mike

Patrick writes:

Hi Daniel (and Vincent),

I’ve been listening to the clinical updates ever since they started during COVID, and even though I’m not a medical professional by any means, I very much appreciate your rundown every week. So thank you.

I have a question about the way HSV is transmitted, particularly HSV-1. I’m a 33 year-old male and reasonably healthy (I would like to think). Recently, I discovered that a partner of mine had an active cold sore when they were performing oral sex, so I’m concerned about the possibility of contracting genital HSV-1.

However, I’ve also had cold sores in the past, so I know that I’m already infected with HSV-1. So is this considered a new infection in a new site? Will it reactivate my latent infection? Will my risk of transmitting HSV-1 be basically the same as it was before, or will I be permanently be a potential source of exposure to future partners even when asymptomatic? The resources I’ve found online are not clear about this specific scenario, so I would very much appreciate your thoughts on the matter.

Thanks so much in advance!

Cheers,

Patrick

Heidi writes:

Hi,

I’ve been a faithful TWIV listener since COVID and consider Dr. Griffin my go-to source for ID advice. I’m a healthy 68 year old who has had all the sar-cov-2 vaccines, the last being in 5/23. I’ve never had COVID. I’m going to Scotland in August and planned on getting the latest booster about 6 weeks before the trip. However, in April I had a rare side effect  (uveitis) to a zoledronate infusion given for osteoporosis with mildly elevated ESR and CRP. Other symptoms included unilateral headache and scalp tenderness. The uveitis was treated with prednisone eye drops for a month and all the symptoms resolved in several weeks. 

My understanding is that this type of reaction was due to release of acute-phase proteins including cytokines. My doctor recommended waiting to get any vaccines until the symptoms resolved. Is there any risk of recurrence of my inflammatory symptoms if my immune system is stimulated with another booster?

Thanks so much for all that you do.

Heidi

Mary writes:

Dear Daniel (and Vincent),

I was listening to TWiV 1114 Clinical Update and heard you, again, comment negatively about practitioners that won’t take the time to run the Liverpool COVID-19 Drug Interaction Checker so they can comfortably prescribe Paxlovid early on in the viral phase of the disease.  Each time I hear you sigh in frustration I want to leap up and down with a suggestion.  Finally I’m putting fingers to keyboard to write the following:

Please put a link to the Liverpool COVID-19 Drug Interaction Checker in the show notes.  Every episode.  Please mention frequently that anyone at risk, even I (only an accountant), can easily use it to preemptively perform the check before they even get sick.  It is easy.  I did it the first time you mentioned it.  I mean, I have to keep a list of all my medications because I can’t take a physical without my doctor going over it and asking me what dose and how often I take each one.  It was my own idea to use the checker but my doctor could have suggested it to me, and so can you. 

Even more frequently than sighing in exasperation over practitioners’ failure to use the tool, I hear you both lament failures to even prescribe Paxlovid.  If the failures are even a tiny bit due to unfamiliarity with the tool or god forbid ignorance that it exists then you are in the catbird seat to solve that roadblock.  So instead of sighing in exasperation, give them the tool and remind, remind, remind that you need to use it.  Doctor or patient, use it.  Thank you.

Warm regards,

Mary