Eric Delwart writes:
Hi Vincent
As you’ve reported there Is definitely SARS CoV 2 RNA in plasma from some Covid-19 patients. Blood donors must be afebrile. Whether those who develop fever a few days post donation were viremic at time of donation is the subject of ongoing studies in the Bay Area and Seattle area.
Blood banks are also gearing up to measure SarsCoV2 antibodies prevalence across entire country to finally measure rate of asymptomatic infections and get more accurate case fatality rate.
Plasmapheresis is also being started on recovered Covid19 patients who are RNA negative to see if their plasma has therapeutic value.
There are also pathogen inactivating methods used for some blood transfusion products that kill all infectious agents by cross linking their nucleic acids.
Many viruses have impacted transfusion safety namely HIV/HBV/HCV/WNV/ZKV and the system is geared to detect and exclude contaminated donations using highly sensitive PCR and TMA nucleic acid tests.
There is a blood shortage due to absence of blood drives in closed high schools and companies. Going out to donate blood is allowed (and safe) for quarantined people looking to contribute to their local blood bank.
Thanks for ramping up TWIV.
Eric Delwart
Vitalant Research Institute
Francesco writes:
Hi Folks,
Thank you for your important work.
A reputable, private, medical clinic here in Hong Kong is offering “tests on blood that look for evidence of antibodies which suggest current (IGM) or previous (IGG) infection.”
I have two questions:
1) Can this type of test clearly differentiate between current and previous infections–i.e. if I have had the disease, and have fully recovered, will it be clear from this type of test that I no longer have the disease?
2) I received the following comment on the above COVID-19 test from a doctor who is unrelated to the clinic offering the test: “with virus mutation, having antibodies to one strain and thus having immunity to it, wouldn’t mean that you are immune to another strain.” Putting aside the question of the type/duration of immunity for this pandemic, is the comment about different strains and different antibodies correct? I thought the mutations in SARS-CoV-2 were just markers, without any significance to COVID-19?
Thank you for your help,
Francesco
20C (68F), 94% humidity, cloudy with rain patches
Renee writes:
I listened to “Shelter in Place” on the way to work this morning. You mentioned the email about gas pumps and I think you implied that the social media alarm (which I haven’t seen) about getting covid from gas pumps is incorrect. This is something I’ve thought about, and use a hand wipe on my hands after pumping gas as a precaution. You didn’t follow up but it seemed like you were implying this isn’t something to worry about. Did I misunderstand? Thanks for your podcast, it’s fascinating. Much more interesting than accounting!
Renee
Arthur writes:
Hi folks,
I was curious as to whether anyone has investigated if people with any antibodies against SARS-CoV (classic SARS!) have any protection against this current outbreak of CoV2?
Also, I wondered if anyone on the team has any thoughts/opinions about the possibilities of using glutamine analogues (namely ketoamides) to block the action of the M-pro on the viral polyprotein? there’s a paper here discussing it https://pubs.acs.org/doi/10.1021/acs.jmedchem.9b01828 whilst I appreciate this is far from being in clinics, the possibility of a pan-coronavirus treatment is intriguing.
Thanks
Arthur in Oxford
Eric writes:
Hi Vincent and the whole TWIV team,
For context, I’m a complete layman who has over the last few weeks chain-smoked the recent TWIV episodes and Virology 101 2020 lecture series and think I’m in love with viruses now!
I had a question – hypothetically, if previous exposure to other Coronaviruses such as the 2 common cold ones confers an immune response to SARS-COV-2, would it be an option to proactively infect the population with these common cold Coronaviruses as an alternate path to slowing the rate of COVID-19 cases with something that unlike a newly developed vaccine has been actively circulating among the population anyway and thus is a “known entity” unlike a new vaccine?
Also, has something like that been done in the past other than with smallpox/cowpox?
Thank you again for making so much informative content available to the general public – you guys are fantastic!
Greetings from Australia
Eric
May I remain anonymous [MIRA writes:].
I’ve listened to TWIV and even as a layman I’ve learned a lot about viruses so I thank you for your wonderful information. You reviewed the length of time that Covid-19 can remain active on different surfaces. In reference to copper, which appears to quickly extinguish the virus, I wonder if a copper insert in a mask could increase its effectiveness. From what I understand there’s a big question as to whether a surgical mask protects the wearer. I have a roll of flexible copper intended for use on a grill for barbecuing. I cut a piece of it to fit between two masks used by construction workers to see if it’s possible to breathe through it. It is but I have no idea how protective it might be. If it were, perhaps masks could be designed to incorporate a thin layer of copper. What do you think?
Kristen writes:
I know you’ve been getting questions about PPE so the information on PPE standards may be useful.
Regards,
Kristen Keteles, Ph.D.
Toxicologist
She sent:
A contact at NIST recently shared with me that ASTM has made over 20 of their standards OA that relate to medical masks, gowns, gloves, hand sanitizers, and other PPE and medical equipment.
https://www.astm.org/COVID-19/
They are attempting to get this information out to everyone who needs it so please share with others.
Thanks,
Margaret Phillips
Assistant Professor of Library Science
Purdue University Libraries and School of Information Studies
AnMin writes:
Dear TWIV
New listener here, I am not a microbiologist but like most of your new listener I started listening due to covid 19.
Anyway, I was practicing Russian on Duolingo and I noticed I was shooting tiny droplets of spit toward the screen (which almost never happens when I give voice command in my Chinese accented English) Which made me wonder: do some languages produce more fine aerosol than others?
Could this in part explain a few percentage difference in Coronavirus transmission between different countries?
IWPTRA writes:
In TWiV #592, at about 32:20, Ori Lieberman says: “And you actually legally in New York state cannot be removed from a ventilator to give that ventilator to someone else.”
Is that really 100% true? Someone showed me the following document which describes guidelines for making decisions about whether to continue ventilator treatment precisely in order to give them to others who are more likely to survive (basically; see, for example, page 61, section C “Step 3: Periodic Assessments for Continued Ventilator Use (Time Trials)”):
https://www.health.ny.gov/regulations/task_force/reports_publications/docs/ventilator_guidelines.pdf
This document is interesting for other reasons as well. It is all about pandemic preparedness!
Thank you for the great show.
I would prefer to remain anonymous.
PS in a previous episode you struggled with the term “Nerfed”. Someone looked it up and got a bad definition (“reconfigured”). It means “weakened” or “softened” – like the soft foam bullets of toy Nerf guns, Nerf footballs, etc. The opposite of Nerfed is “buffed” – made stronger. Clearly an attenuated virus is Nerfed. Presumably there are also buffed viruses, yes?
Scott writes:
Dear Twiv team,
In the last episode there was some lively discussion around whether the dose of viral inoculum could influence clinical outcomes and maybe explain higher fatality rates in healthcare workers who are exposed to Covid-19 patients. I have lots of friends who work in healthcare and I’m getting worried about them.
I can’t comment on SARS-CoV2 specifically, but in our work with bacterial and viral pathogens of fish we see clear relationships between challenge dose and mortality rate for most of the agents we work with. I think Vincent’s explanation in which higher doses of inoculum overwhelm the host immune system makes perfect sense. However, I had also wondered if repeated exposure to virus from multiple patients could mean that healthcare workers are being inoculated with a wider range of genetic variants of the virus, which would make it harder for their own adaptive response to keep up. Since each infected patient is effectively a genetically and immunologically unique culture vessel, the virus they shed represents the escape mutants that survived the particular circumstances of their immune response. I wonder if there is any evidence in the sequence data that we have so far to indicate variation in antigenic components of the virus?
Keep up the great work. I’ve been listening to Twiv for years but it has now become my most trusted source of information about the SARS-CoV2 pandemic. I hope you’re all staying out of trouble in the US. We had our first Covid-19 death here in Tasmania this morning, and the state government is moving to progressively tighter levels of restriction on movement and social gatherings. Luckily we had a phone directory delivered to our house last week, so we’ll have a backup for when our toilet paper supply runs out.
Regards,
Scott
Tasmania
Research Microbiologist
Andrew writes:
Dear TWIV,
Where do you think new infections are coming from during lockdowns like the one in Italy? Is it just the people still at work? Or is it more scattered? Do we have any data on this? This seems like a critical question to me.
Thanks,
-Andrew
Trevor writes:
Dear TWiV,
First, I’d like to say you’re all doing an outstanding job and providing a great public service that more people should be made aware of.
I just finished listening to TWiV 595, and a question was asked about how hospitals are determining when it is ok to discharge Covid patients. I am not a clinician, so I cannot speak for any hospital or health department policy; however, I did find these links from the CDC outlining suggested protocols for infected healthcare professionals and hospitalized Covid-19 patients.
https://www.cdc.gov/coronavirus/2019-ncov/healthcare-facilities/hcp-return-work.html
https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-hospitalized-patients.html
They appear to recommend a similar strategy to what was mentioned for Chinese patients (2 negative RT-qPCR, resolution of symptoms), and a non-test based approach (fever/symptom free for 72 hours). There are additional restrictions recommended for healthcare professionals returning to work in the 14 days post infection (face masks, avoiding susceptible individuals). I would love to hear from practitioners as I think it would be interesting to see what protocols are in place/being followed in different areas.
As testing availability is a current concern, what are everyone’s thoughts about individuals released based on resolution of symptoms? RNA can obviously still be detected for many days to weeks, but have any groups attempted cultures from sputum or feces?
I’m a graduate student at the University of Tennessee where I study herpesviruses (it’s 64F and overcast in Knoxville, for the record). I enjoy listening and learning from the fount of knowledge that is the TWiV team.
Stay safe and keep up the amazing work,
Trevor
Victoria writes:
I am currently working in China at an international school for 5th through 10th grade students. I am a United States citizen and have two questions.
1. I have been watching the current model language from the Presidential Press Briefing. Tony Fauci and Deborah Birx stated models have projected 100,000 to 200,000 deaths in the United States. I think this is projected to occur by June 2020. With the current number of deaths in the United States being 2,400 and 33,903 deaths worldwide, it seems 100,000 to 200,000 deaths by June in the U.S. is way too high. Can you comment on your thoughts and explain the model process?
2. What are the current guidelines for mask effectiveness? From cloth masks, medical masks to N95 masks.
Thank you.
Katie writes:
Hi Vincent and team,
Thank you for the informative podcast! If remember correctly from past episodes, you all were skeptical that the severity of COVID-19 disease in otherwise healthy young people could be explained by the infectious dose. If I have that right, could you explain more about why the amount of infecting virus would not be an important factor? I have a PhD in Immunology and when I infect mice with influenza I have to be very careful when diluting the virus because 40 PFU will make the mice sick but all should recover. Any slight change in the amount of virus, by just 5 or 10 PFU, will mean the mice don’t get sick at all or all of them die.
I am totally ready to believe that pipetting virus in saline into an anesthetized mouse’s nostril is not the same as someone coughing in someone else’s face, but I’d be interested to hear more. Thank you!
Katie
David writes:
Could you please comment on the possible use of BiPAP and even CPAP machines in conjunction with airtight scuba masks to assist the respiration of compromised COVID-19 positive patients? If effective and safe, it could be a significantly less invasive approach that, when we are running out of ventilators, might prove to be remarkably helpful as an alternative to the traditional ventilation methods. I realize that this isn’t exactly a virology question, but it is pertinent to the virology-related crisis we currently face. And if beneficial this could save many lives.
Stories to the positive:
https://www.mirror.co.uk/news/world-news/coronavirus-incredible-hack-turning-scuba-21746459
Article to the negative:
(This article does not seem to consider the possibility of an airtight mask, but scuba masks are airtight or their makers will soon be out of business!)
Thanks!
—
David Crank, DDS
North Carolina
Matt writes:
Hello Group,
As a former critical care paramedic I do have a basic understanding of the body and medicine. Please know as a medic, you guys with MDs, DOs, and PhDs are my heroes. Im only sad I was too stupid to be a doctor and was only a medic.
During my years on the streets I was like other medics and thought I was invincible and thus smoked, ate like shit, had wildly high uncontrolled BP, and ate NSAIDs like candy to keep working. A year and a half ago I had an AKI [acute kidney injury and other medical issues] due to ACEI [angiotensin converting enzyme inhibitor], diuretic, and NSAIDS. I found out I was born with one kidney. I lucked out and went from a GFR of 13 to 70s-low 80s on ACEI post AKI with stage II CKD by creatnine and microalbumin. I am a diabetic with an A1C of 8.4 a year and a half ago to 4.8 last month. I am [now] diet controlled for everything! My BP is 120s-130/70s-80. My only meds are Ramipril and Pravachol. I quit smoking. I am 40.
I heard your last show with Dr. Griffin. I was wondering if you guys knew about how pre-existing patients that are overall doing good, on few meds, and are diet controlled for everything faring if they get infected? I am proud of my lifestyle turn around and am loving life after I left the street. I just never learned anything to your level and have forgotten a lot in the 3 years after I left the street. Can you give those of us who are the “ok stable” guidance on how terrified we should be? I understand disease affects everyone differently, but I was wondering if you have heard how the “ok stable” are doing.
Thank you for teaching us.
Matt
Vincent writes:
A comment about the number of deaths in Wuhan you guys talk about in TWiV 595. The question one should ask is what is the normal number of deaths in a 19 million city in the winter months (three months of cumulative deaths) and what would the number of deaths be if the hospital system is not available for non-COVID-19 patients. The premise of the news article
is based on the picture
(http://photos.caixin.com/2020-03-26/101534542_6.html#picture) of a
funeral home ordering thousands of urns.
Thanks for the very informative podcasts.
Charlie writes:
Dear TWiV,
I have really enjoyed listening to your podcast after discovering it in February. I wanted to provide some clinical context to a discussion of treating fever in hospitalized patients in episode 594. I am a surgical resident with fellowship training in critical care and I am also a master’s degree student in a clinical epidemiology program. I work frequently in cardiac surgical intensive care units (ICUs), which often includes patients with acute respiratory distress syndrome (ARDS) and those on extra-corporeal life support (ECLS) for severe respiratory infections.
Fever, typically defined as >101.5 F (or 100.5 F in immune compromised patients) is treated aggressively in patients with severe respiratory failure for several reasons. First, fever increases cellular metabolism which results in increased CO2 production. In order to maintain an appropriate arterial pH, this excess CO2 production must be removed through respiration by increasing the minute ventilation of the lungs (tidal volume per breath multiplied by respiratory rate). In patients with ARDS, interventions that increase minute ventilation (i.e. increased respiratory rate or increased tidal volume) also increases mechanical force on the lungs, which contributes to ventilator-induced lung injury (VILI). Specifically, a key feature of treating patients with ARDS is to utilize low-tidal volume ventilation, below levels that would be seen in a spontaneously breathing person. In addition, interventions to compensate for increased CO2 production often come at the expense of decreased ability to oxygenate the blood. Therefore, treatment of fever, along with other strategies, contributes to a more “lung protective” ventilation, a key tenet of ARDS treatment.
Second, treatment of fever has also been shown to decrease vasopressor (infusions of medications that increase blood pressure) requirements in patients with septic shock (which is often caused by severe respiratory infections and coexists with ARDS). This is in part through decreasing cutaneous vasodilation that results from the body’s attempt to cool itself.
Third, treatment of fever in patients with known or suspected infection has not been shown to have a deleterious effect on ICU length of stay or mortality.
If you are interested, I have attached several references related to my above comments.
Thank you again for your interesting, timely and informative podcast. I would be happy to answer any additional questions that you have or provide any clarification about my comments.
Best,
Charlie
Franciszek writes:
Hi Twiv,
I’m writing to you from Poland, it’s 1°C (33°F) at this late hour which is 11:30 p.m.
My friend Iwona*, who recommended your podcast to me, listens to you for a couple of years, so she’s an expert on virology, but now everyone is 🙂
I have a proposal to estimate a level of magnitude of closed cases.
Let’s assume that actual mortality rate is 1%, there are now about 2400 deaths in USA. So if we divide it by 1% we get 240,000, which would be the number of closed cases. It would correspond with a total cumulative number of cases from about 2 weeks ago.
I know this estimation may be flawed in many ways, but is there something to it? May these numbers be close to truth?
Keep up the good work and be healthy 🙂
Franciszek
*pronouced “eevona” ;p
John writes:
Hi, TWiVers.
Thanks for all the episodes lately offering real information about SARS-CoV-2 and COVID-19. As a doctor (but not that kind, or that kind, but in math), my response to just about anything new is to learn as much as I can about it, and you’ve been a great help, along with using Dr. Racaniello’s lecture series as a crash course.
My curiosity was piqued by something in TWiV 595 (apologies if I misremember or otherwise mangle any of the details). Dr. Griffin mentioned something about a drug that moderates a particular part of the cytokine response, IL-6, which may be maladaptive in this case and lead to overreaction and worse disease. I’m wondering if different people might have different levels of this response naturally, and this may have something to do with different disease courses.
This question was further motivated by recent conversations with my partner, a former primary-school teacher and mother of two. She would, of course, deal with a generous share of viral infections, and has a very good sense of what it feels like when her body is fighting one off, but in her whole life she has almost never gotten a fever. Further, when she’s had sprains she’s never noticed warmth or redness, and was mildly surprised at the idea that those would normally accompany such an injury.
Again, in my (totally amateurish) mental model of such things, this might suggest that some people’s immune responses don’t overreact the same way while still being strong enough to fight off the infection, and this might play a role in determining the severity of the resulting disease.
Of course, this wouldn’t lead directly to any new therapy or different behavior, so I’m mostly curious about whether I’m understanding these issues more or less correctly, or if I’m wildly off-base. As was stated in another recent TWiV, physicists should stick to physics, and that probably goes even more strongly for mathematicians.
Keep up the good work!
—
John
Portia writes:
New listener here! I’m asking this question in retrospect, but maybe some clear guidance will help someone else.
My boyfriend and I don’t live together, and at the same time as our jobs shut down, he had a slight cough. We are both in our early thirties, living in Upstate NY in the capital region where there is likely community spread, but the numbers of confirmed cases are still fairly low. We’d been practicing social distancing, however we really wanted to see each other. After 11 days, his cough abated and because he didn’t have any other symptoms and never had a fever, we felt confident(ish) in spending some time together. Are we being incredibly foolish by increasing our risk of infection? I was unable to find any guidance about this online at the time.
TL;DR: Am I being irresponsible by expanding my social distance bubble to include my boyfriend who does not live with me if we’re both practicing social distancing from everyone else?
I’ll update you if either of us develop symptoms so we can be a cautionary tale, but so far, so good.
“Stay healthy,”
Portia
Mike writes:
Hi Guys –
Love the podcast – on the last episode you discussed PPE sterilization technology. You may have heard about this by now, but Battelle labs in Ohio has developed machines that can sterilize 80,000 N95 masks per day. Currently pushing on FDA to approve use.
Keep up the great work!
Mike
Crystal writes:
On episode TWiV 595, you brought up 3D printing and how would that work for face shields. Here’s what’s going on in the SF Bay Area at a local maker studio:
https://www.makernexus.com/covid1
wiki on the design
http://makernexuswiki.com/index.php?title=3D_printed_face_shields
and a bit more details on their FB group.
https://www.facebook.com/groups/1999239440316643/
Brian writes:
During university I worked at a fairly low rent motel and we would use ozone machines in our smoking rooms to reduce the smell after a heavy smoker. There were SIGNIFICANT safety warnings and precautions when using it…..no one in the room while it’s running or for x(?) hours afterwards.
Hadn’t thought about those in years.
Take care,
Brian
Southwestern Ontario
Sevrin writes:
Hello TWiV, this is Sevrin from Iran
I’m a master student in virology and I proudly translate highlights of your podcasts on my Instagram page.
I wanted to know about herd immunity regarding SARS-COV2. What percentage of a society should contract the virus in order to gain herd immunity, to your assumption ?
With best Regards
Tom writes:
Hello,
I did my my undergraduate degree in microbiology, and my graduate work in pathobiology, before becoming a patent attorney (FYI, I want to go back to the lab). I love science, and absolutely love biology with all that is unknown,. I only wish the public understood that your podcast was the top of the heap (I tell everyone), the best of the best of the absolute best!
Imagine (and it is now a reality) a podcast that interviews a senior ranking physician (and “only” an MD/PhD) who is actually treating COVID-19 patients!! I wish you, and him the very best. I have great gratitude for all who dedicate themselves to searching for the truth and putting themselves on the front line. I am asking a huge favor here. My daughter (Arabella) has wanted to be an infectious disease doctor for at least the past three years. She just (March 25th) turned 17 (and listens to TWIV). She was unable to have her birthday sleepover with her friends because of SARS-CoV-2. Would you please give her some ideas to inspire her about her future career? She just the other day did a virtual tour of Johns Hopkins (no more in person tours), and loves it! I have told her this current situation is an opportunity that should inspire us all to contemplate how we can make the world a better place.
BTW Where is Ori? Such a great person… really rooting for him to finish his MD/PhD, then he can be more than “only a medical student”. Loved Vincent’s statement we are only who we are. Please be well, and stay well. Snowing here in Maine… 0 C and snowing.
All the Best, Tom
Jody writes:
Hi team TWiV,
It’s 50F and sunny out here in Seattle, where our highly competent and science-loving governor Jay Inslee (you know, the guy the current American president likes to call a snake) yesterday welcomed army doctors to the facility attached to the Seahawks stadium, which they are in the process of converting into a field hospital for non-covid-19 patients. I tossed in a photo for you so you can see what a press conference featuring political, public health, and military leaders practicing and promoting social distancing looks like:
The interview with Ian Lipkin was wonderful; how generous of him to share his vast experience, knowledge, and recommendations even while suffering through an active infection. Based on his and many other experts’ recent guidance re: wearing masks and gloves whenever they need to go out into a public space like a grocery store, could you please discuss how people might reuse masks they currently have? Say if someone — be they a member of the general public (who may or may not be infected) or a healthcare worker — has a total of 3 to 5 surgical masks or N95s, could they set up numbered brown paper lunch bags and cycle through the masks (carefully removing them using gloves to deposit them into the bag) on a 3-5 day rotation? Would that be enough time for any virus in respiratory droplets that may have been deposited on the masks to be inactivated? Apologies if inactivated is the wrong word, I’m pretty sure Vincent wouldn’t want me to say “killed.”
Thanks and stay safe!
Jody
Aaron writes:
Thank you so much for what you are doing! As soon as this was really making the rounds in the science/skeptic forums, I knew it wouldn’t be long until you guys started covering it and it is impossible to put into words the value you have given on this subject.
I’m writing to you from Oahu, Hawaii, where it is around 80 degrees as normal. Despite our leaders and health department doing almost nothing for the past two months to keep this bug from spreading and despite that as a tourist destination we have had piles and piles of the most at risk visitors, we are only just now starting our climb.
We and New Zealand have really been waiting for the other shoe to drop as we both have had travellers with Covid 19 from the very start of this outbreak, had not taken sane measures until this last week, and yet so far have been relatively OK. It feels like a very bad karmic lottery that we will be paying soon. Finally we have entered a quarantine a few days ago and are around 150 cases as I write this.
An article was posted about food safety and I wanted your take on it:
A lot of us have been very worried about fecal-oral and wondering why there hasn’t been as far as I can tell reports of mass exposures due to food. Here, you can watch unmasked, ungloved workers spooning food onto plate lunches, with both cold and hot items, and I would think that was pretty much chucking grenades into gunpowder store rooms.
The article makes it sound like it would be very difficult to get the virus from eating it.
However we are constantly told to wash our hands and be excessively careful about touching our faces and such. At the old JREF forum (James Randi Educational Foundation) some were suggesting that getting it into your respiratory system was the biggie, so dirty hands would put it in your nose or eyes and get to your lungs. I would assume that some amount going into your mouth would do the same thing.
What do you think?
As someone with pretty severe IBS I was horrified to hear of many cases with no fever or other symptoms aside from GI symptoms that from what I assume would be indistinguishable from my daily struggles with IBS. Wouldn’t these be caused by something you ate?
In the extreme end, how dangerous would it be to lick a surface with the virus on it?
This all seems very confusing and contradictory.
P.S. Kudos to Dr Lipkin, those were BIG brass ones he sported for the sake of humanity. What a hero!
Brian writes:
(17C/62F and beautiful in Southwestern Ontario)
On the most recent Twiv, it was mentioned that fruit/veggie soap washes, while they may be inferior to cold water rinses, they weren’t harmful.
While most folks would rinse their produce well with water after using soap, some may not and soap can cling to the pores of various items. If you look at the MSDSheets for dish soap there are GI symptoms after ingestion of soap that may mimic some early COVID19 symptoms (mild to severe nausea, vomiting).
So, the public health messaging usually avoids soap washes for fruits and veggies — at least here in Canada (at least regular dish soap…there are expensive benign washes commercially available, though not much evidence they are effective)
Thank you so much for the increased frequency, this podcast is a God-send.
Cheers.
Brian Caldwell
Southwestern Ontario, Canada.
Isabel writes:
Hi there,
First of all i want to thank you for all the good work you’re doing.
I’ve been listening to the show and there is a question i can’t find an answer for. We are watching Chinese authorities deciding that life can go back to normal on the first affected areas. If the quarantine was effective on stopping the infection to progress wouldn’t it also shorten the collective immunity? What is preventing it to start spreading all over again?
Best wishes,
Isabel
Lisbon- Portugal 🇵🇹
Anonymous writes:
I am a paramedic and Emergency Department nurse. I have been an off-again/on-again follower of the show for a few years now. The information about SARS Cov 2 has been invaluable to me and has helped me greatly with these patients. Having a primary source of information from you and your colleagues has helped balance the confused and haphazard response I see first hand from my systems administration and from my local, state and federal officials.
Quick note from the field: My state is right in the middle in terms of number of confirmed cases nationwide. We have enjoyed less patients in the ED over the last two weeks but they are beginning to creep up. We have had several positive cases and those numbers climb every day results come back. Currently, the tests are averaging 8-10 days for turnaround. Everything you are hearing about shortages of PPE, ventilators, staff etc is coming to life in my department at an agonizingly slow pace. The worst part is that It seems to me we have had so much time to prepare and make space and utilize existing supplies of PPE to contain and isolate suspect cases but were so undecided as how serious to take this it is now too late and can only react.
I was in the military many years ago and was a part of the US Marine Corps Chemical, Biological, Incident Response Force. The training and information that we went through in the 2000s always lead me to believe that we were ready when this happened. It seemed we took it seriously and the nation as a whole had a response plan that would be in place as a global pandemic was all but certain to happen at some point. It deepens my anxiety today knowing that simply wasn’t true and that our civilization is still so fragile and ruled by utter complacency.
Thanks from all the healthcare professionals for your research and the way you deliver the information in a professional and responsible way.
Annie writes:
Dear TWIV,
I am Annie from Taiwan. It’s 19 degree C (66 degree F), dark and chill outside after showers yesterday. I am a returned listener who wrote in for patent discussion few years ago. When COVID-19 started in January (still named as Wuhan pneumonia then), I was really happy that TWIV provides a scientific perspective for the people who are tired being bombarded by overwhelming anxious news and rumours circulating on social media.
I am writing to update status from Taiwan. We have 298 confirmed cases, 2 died until March 29, 2020 (Taiwan CDC https://www.cdc.gov.tw/En; hope won’t raise up too much when you come to my letter). The initial cases were mainly import from Asia, along with family and friends gathering. The landscape shifted to younger generation came back from the EU and the US in the last few weeks due to working or study abroad.
The government banned surgical mask export from January 24, and people started hoarding all kinds of masks, 75% alcohol, detergent of disinfection. We have also been through the chaos of hoarding food and toilet paper, and finally people calm down. The Digital Minister and the IT team set up the system connecting the health insurance and everyone can buy 3 surgical masks per week with less than 1 USD at pharmacy or via pre-booking on-line system. There are lots of clips reminding personal hygiene, wash your hands (which might contribute to the decreasing of influenza spreading (statistic result https://nidss.cdc.gov.tw/en/), quarantine with multiple languages played on almost all TV channels and media platforms. Minister of TFDA and the team hold press meeting every single day since January on TV and live stream, and social media accounts automatically update status. The restriction for traveling gradually changed to Grade 3 Warning to all the world. Compulsory quarantine for 14 days is required for people come from oversea. People start working from home or in different area, and body temperature checkpoints are set at the entries of buildings. I work in a pharmaceutical company and we notice the enrolment rate were quite low recently in Taiwan and the US. (FDA guideline for clinical trials:
I remember one case of Taiwan in the early stage was using different typing (L and S types?) to differentiate whether the subject is more likely to be infected by the local strain or by the stain from overseas. Will this only apply at the early stage and it’s no longer applicable after pandemic? Thank you for your time and be safe!
Annie
Matt writes:
Hey gang,
Can any of you explain to us in the lower rungs of healthcare the pharmodynamics of how an anti parasitic and an antibiotic work on a virus?
Matt
Noelle writes:
Hi Vincent and other TWIV members!
It is -2 C (28 F) and cloudy in Calgary, Alberta. I was introduced to TWIV by my boyfriend who is a microbiologist and an avid listener from pre CoVid. I am a Registered Nurse currently working in the Cardiac Intensive Care Unit, soon to be back up ICU for Covid positive ventilated patients. I am wondering what are your thoughts on frontline health care workers leaving the family home for the duration of this crisis? I am concerned about potential exposure of myself and consequently those I live with, but also worry about how long this will go on for and how long that separation would be for. I trust my own practice of using PPE and trust the protocols and procedures used to protect staff, but admittedly worry given the impending shortage and constantly changing guidelines.
Thank you for hosting such an informative podcast for scientists and non scientists, I recommend it to all my coworkers!
Thanks,
Noelle
Megan writes:
Thanks for all that you do, love your work always, but especially at the moment.
See this link which is designed to show kids how to effectively wash their hands, made by my friend, the talented Rina Fu.
Cheers, and stay healthy,
Megan
Megan Lloyd (PhD)
University of Western Australia