TWiV 600: SARS-CoV-2 – enter the Coronials

April 12, 2020

Daniel Griffin joins TWiV to update on the clinical situation, then we discuss a 382 nucleotide deletion in the SARS-CoV-2 genome, a scenario for emergence of the virus from a bat, followed by answers to listener email.

Hosts: Vincent Racaniello, Dickson Despommier, Alan Dove, Rich Condit, Kathy Spindler, and Brianne Barker

Guest: Daniel Griffin

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Intro music is by Ronald Jenkees.

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20 comments on “TWiV 600: SARS-CoV-2 – enter the Coronials

  1. Teepu Siddique, MD Apr 12, 2020

    The hydrochloroquine study is not properly designed. HC should be given with zinc, In vitro HC sufficiently increases intracellular Zn to inactivate the replicase (RNA dependent RNA polymerase) . This will be lost time. And patients incompletely treated. Usual incorrect application of therapy in so called evidence based medicine.

    • profvrr Apr 12, 2020

      Zinc does not efficiently enter cells when provided on its own. A zinc ionophore is needed. However clinical benefit of increased zinc for SARS-CoV-2 is unproven.

    • It’s all not clear. No one knows the mechanism of action of chloroquine in terms of its antiviral activity.
      Looking at the in vitro data on zinc and CHQ, it is doubtful that the required concentrations of both zinc and CHQ can be achieved at all, unless one goes beyond the lethal dose.

    • If the treatment you are undeservedly enthusiastic about is not being delivered the way you think it should be delivered, don’t blame the people doing the work to find out if proposed treatment is safe or if the treatment is even slightly effective. Blame yourself.

      As Dr. Daniel Griffin said in this episode:

      One of the things that was a big change when I entered medicine. We had moved from authority-based guidance, the “I’ve been doing this for 30 years and my memory suggests to me that what I’m doing is very good,” to an evidence-based approach to medicine, which is where you would really try to say, “I’m not sure. Let’s see if what we’re doing helps.” This virus, and the amount of deaths, pushed a lot of people away from Evidence-Based Medicine with the idea that we’ve just got to try stuff. What I try to point out to people is that we think that 98%, 99% of people exposed to this virus are going to be OK. When the mortality is in the single digits, your potential to do harm goes way up. If your dealing with something with a 90% mortality, I can understand the “Let’s just try stuff.” People are settling back down and remembering their oath, which is number 1 “Do no harm.” We’re starting to see people looking at studies and trying to figure out what does work, trying to be really critical of the interventions. We’re moving away from the Full Monty approach. I see these algorithms where we give the patient everything, so that when we find out what does work, you can claim that all of your patients got that that works and the nine things that did harm.

      90% of things we try end up being harmful and not helpful. Hopefully, we’re returning to a little more honesty, when we enroll people in trials and saying, “It is quite possible, and likely, that as much as this seems to make sense, it will cause more harm than good.” As we saw, people in the early attempted therapies had increased mortality. Hopefully, we are getting a little sanity back. Don’t just read the news on your iPhone and then call up the hospital and demand that your loved one get the latest therapy that you read about, independent of knowing what the dose is, the toxicity, the timing, and all the rest.

      .

  2. where to find the Timestamps by Jolene

    first part runs with wrong speed ? too fast
    45:35 – 49:11 min.
    deletion , TWiV 584 , attenuated ? ,
    49:11
    Rabadan recomb. RBD

    can’t we “cultivate” the 382nt- virus ? Pass it in human volunteers.
    Some countries are considering that “herd immunisation” strategy
    Some countries just can’t do and control social distancing.
    Catching the 382nt-virus deliberately -maybe in some schools ? –
    might be an option.
    Or could we immediately recreate that 382nt-deleted virus in a lab ?

  3. JJackson Apr 12, 2020

    Re. The injection of RNA vaccine and the recruitment or dendritic cells due to injection trauma how would this figure if you used micro needle patches discussed in a recent show?
    Thanks as always JJackson.

  4. Robert Ricketson Apr 12, 2020

    We were discussing the reinfections in Korea among convalescent individuals with reduced neutralizing antibodies. Considering what Daniel Griffin discussed on your podcast, might that be due to the use of steroids early in an intervention?

  5. Dear TWIV-ers,
    Immensely grateful for your work.
    I am a cultural anthropologist (Berkeley) and a philosopher (Paris).

    You are practicing Enlightenment in a world of opinion (doxa) and politics.
    I wrote a book–Making PCR–years ago about the early days of the biotech industry and what a collaborative activity science must be.
    All too rare in the human sciences.

    A few of us are not trying to imitate what you are doing in a different domain (we don’t have the resources) but to at least encourage people to think together.

    with deep gratitude
    PAUL RABINOW
    Professor Emeritus, UC Berkeley

  6. john noll Apr 12, 2020

    Have been listening since the new year. Appreciate your expertise, candor and humor. Just retired NP with duel MS in Adult Internal Med. and Psychiatry. Was a
    lab rat for Dr. Fauci at NIH 1976. Retired now doing clinical work for free at Homeless Shelter. Best to you all. John Noll, Indianapolis

  7. Debby Depalmer Apr 12, 2020

    I have been following not just twiv and vanices lectures I have been following others learning alot more I find virus and the human body so amazing I rather watch videos about virus and the hu.an body over a movie. I take what I learn and try to explain it to another person. Wonder if our immune system will build antibodies against the coronavirus . The other i Use the spray that the doctor in the first picture at the hospital said it starts with fluticasone propionate is this safe to use durning corona virus out break can u please let me know will the virus latch on to it????

  8. Blue Pilgrim Apr 12, 2020

    I’ve listening for a few weeks, working my though the course, and looking up terms on the web — I had a first today: I listened to a full 1/2 minute of your discussion and actually understood everything you were saying. It’s nice to know that at 72 I can still learn things, and the best thing about sars-cov-2 is I learned you exist.

    As for 5-G, yes I heard that, and all sorts of other things, but you know what you are talking about so I’ve acquired ‘heard immunity’ to the myths, rumors, and noise, and have trying to spread the links to your site, and Youtube channel around on the Sputnik news comment section. It’s a cure for the panicdemic. Thanks!! Maybe some of you could post links or comments on other such sites to spread the word?

  9. Love the podcast!

    Interesting news report: https://abc7chicago.com/health/helmets-could-prove-lifesaving-for-covid-19-patients-doctors-say/6093782/?fbclid=IwAR3oF0qeZQPLFzlFTyEyanJlPlpQIpdRTTsTIZjCWur2WGyQQDzAR8PUtj8

    CHICAGO (WLS) — Doctors at the University of Chicago are using a helmet to treat COVID-19 patients who are struggling to breathe.

    The hospital’s COVID-19 ICU is using the spacesuit-like helmet as an alternative to a ventilator.

    “It is like a hyperbaric oxygen chamber,” said UChicago Medicine Dr. Bhakti Patel.

    Dr. Patel said the hospital is using the helmet “as a strategy to prevent an intubation or a ventilator” for five patients so far.

    Two of the nation’s top pulmonary doctors, Dr. Patel and Dr. John Kress, have studied the helmets for years in Chicago. The duo found that the device helps critically ill patients breathe better without being intubated.

    The clear plastic FDA-approved helmet surrounds the patient’s head and pumps oxygen into their lungs at high pressure.

    “The way that it feels is if you go on an airplane and they pressurize the cabin,” Dr. Patel said.

    The doctors said patients who use the helmet instead of a ventilator spend less time in the ICU and have a better rate of survival.

    “They do not have to go to a nursing facility or spend time connected to a ventilator,” Dr. Patel said.

    The devices can hook up directly to the hospital’s oxygen supply.

    The helmet is sealed with an airtight collar, so the oxygen does not leak out. A filter on the end also stops the virus from spreading.

    The helmet also allows the patient to rest more easily, doctors said.

    “The most common response for people with whom it is going to work is because they can now take a breath,” Dr. Kress said.

    They aren’t stuck in bed sedated.

    “The patient can have a helmet on and get out of bed and walk,” Dr. Kress said.

    With a low supply of ventilators, the hospital is training their staff to use the helmets, preparing for what is still to come in the fight against COVID-19.

  10. Astha Apr 13, 2020

    Would love to hear your thoughts on this:

    https://www.facebook.com/WayneDupreeShow/videos/565333511002518/

    Please watch. Is it just a conspiracy theory or plausible?

  11. Michael Goodwin Apr 14, 2020

    Vincent,
    I’m a new listener to TWiV and it’s siblings eagerly awaiting each new episode and beginning to work my way through all previous ones. Thank you for the amazing discussions of the current pandemic and the inspiring guests you bring together each week. TWiV episodes have been powering me through many hours of twice daily walks and has added a deeper understanding of SARS-CoV-2 and a greater appreciation for the science that you and your guests practice every day.

    In a recent episode you mentioned the genetic drift that has been observed in the virus. I have two questions:
    – Will convalescent anti-body plasma taken from one recovered patient be effective against strains of the virus other than that of the donating patient?
    – Will clinical trials using convalescent plasma control for the various strains of the virus that are known?

  12. Which website were you referring to with the graphics illustrating how antivirals work?

  13. William Cast, M.D. May 5, 2020

    Johns Hopkins Data: Cass County, Indiana—a rural county with more elders than Indianapolis has 1/5 the cases (around 1371) with a death rate 0.15% against Indianapolis cases (Marion County 6327 cases) of 5.74%. Logansport, Cass County 2 deaths, Marion 363 deaths. The two counties are about 50 miles apart on regularly traveled roads US 31 and US 24. Question: Can the strain of SARS CoV-2 account for the difference? Poverty is 4% greater in Marion. Cass: 1/6 over age 65/Marion 1/8th over 65.

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