Yana writes:
Dear Vincent and Co. at the TWiV,
First of all – thank you very much for your expert discussion of the topics related to the Covid19.
I started listening to your podcast in the end of March and was greatly rewarded by a deeper understanding of our common burden of the pandemic. I am an enthusiastic supporter!
I have several questions related to dentistry, as I am a practicing dentist.
Aerosol danger and mitigation.
Most dental procedures create additional aerosol.
1. How likely is Covid19 virus transmission via aerosol? How long does the virus sustain itself in a transmissible form in the aerosol?
2. What are the possible methods of mitigation with regard to patient -to – patient transmission in the dental office?
3. Can you comment on the effectiveness of 1% Hydrogen Peroxide pre-rinse to reduce oral viral load?
4. Can you comment on the effectiveness of commercial air purifiers with respect to aerosol mitigation?
5. Can you comment on adequate PPE for the doctors and staff in the dental office?
6. Have there been known incidents of transmission via dental office?
Thank you for your help,
With warm regards,
Yana Nedvetsky, D.D.S.,
Clinical Assistant Professor
Department of Orthodontics
University of Illinois School of Dentistry
Nicolas writes:
Dear Twiv team!
I thoroughly enjoy listening to your podcast, which has become my main source for information on the pandemic.
I´m a molecular and cellular biologist and was really interested by your discussions on how to conclusively dismiss that SARS-CoV-2 came from a human laboratory in an easy-to-understand language.
Roughly speaking, a 96.2% identity between RaTG13 and SARS-CoV-2, still means that there are over 1000 differences between these viruses (3.8% of a ca.30kb genome), so you would have to really know what you were doing to make 1000 changes to a virus and not mess it up completely! Whoever did this (hypothetically) must be light-years ahead of the best virologists in the world!
Also, please have a look at this paper I found on biorxiv:
https://www.biorxiv.org/content/10.1101/2020.04.20.052019v1
They study the synonymous mutations between the bat RaTG13 virus,
the pangolin virus and SARS-CoV-2.
As you mentioned in your discussion, if you were to design a deadly coronavirus in the lab, you wouldn´t bother including synonymous mutations, as they would make your work harder and wouldn´t have any effect.
The authors also identify that there are non-synonymous mutations in the SARS-CoV-2 genome that are actually predicted to reduce fitness. Would you include those, if you were designing this?
As a bonus, they also kill the idea that this was a virus that was cultured in a lab for years and acquired these mutations spontaneously, as they show that the last common ancestor between SARS-CoV-2 and the bat and pangolin viruses was upwards of 30 years ago!
So the bottomline for non-specialists could be:
1. There are over a thousand changes between SARS-Cov-2 and the closest coronavirus we know of. Many do nothing, some actually make the virus worse at infecting people, and some presumably make it better. Although we can technically recreate the genome of SARS-CoV-2 in a lab, no human being would be capable of designing this without messing it up.
2. The virus did not evolve these 1000 changes through culturing in a lab, because this would take over 30 years, and in the 1980s we had no idea that there were coronaviruses in bats that could infect humans.
All the best
Nicolas
Prof. Dr Nicolas C Hoch
Laboratório de Estabilidade Genômica
Sala 1011 ou Lab 1020, bloco 10 inferior
Dept. Bioquimica – IQ/USP
São Paulo
Brasil
Megan writes:
Hi TWiV team,
I’m listening to 610 and had to pause and write some of my own plain language summaries for your listener’s questions. I worked on a fish virus that no one cared about while getting my PhD and now work in medical writing. Part of my job that I love is writing stuff for non-scientists. (Read/modify it if you feel I’ve got this correct)
Here goes:
We know the new coronavirus was not made in a lab because we don’t have the ability to design viruses out of the blue. Viruses are made of chains of thousands of amino acids, think of them like the parts of a Lego kit that have different shapes. If you swap out too many pieces of that kit, the end design doesn’t look like what you’d hoped for. Virologists can alter viruses, but with our current knowledge, creating one this different is like grabbing random Legos out of a bucket and trying to build something while blindfolded.
Second, the new coronavirus doesn’t change like the flu. We know this because the flu and COVID19 are different types of viruses. Viruses’ types are determined by how they store their genetic information. The flu has its genetic materials in a puzzle-like fashion, with interchangeable pieces. Each year different combinations are spread around and thus we need a new flu shot to match the combinations in production. Coronaviruses on the other hand, only keep all of their genetic information in a single piece, and thus cannot swap the information like the flu virus.
Happy to do more if you need me to put things down to middle school levels.
Thanks for being awesome!
-Megan
P.S. shout out to my Dad who now complains that I’m “interrupting TWiV time” every time there’s a new episode.
Aubrey writes:
Hello TWIV,
I just wanted to relay my gratitude for all the time and effort you all make to keep all of us informed. I am just a housewife with no medical background but your show has taught me so much about the current pandemic. I now understand so much about virus origin, spillover, transmission, spike receptors, immunity, and vaccines and valid fact vs fiction of concerning virology. You have done a great service to all of us and I appreciate it very much.
I have a question specifically for Dr. Condit. I live in Killeen, about 50 miles from Austin. I was sick in January and many of my symptoms make it seem quite possible that I may have had a mild case of Covid 19. I did not have to go to a doctor and didn’t have the means to either way. Is anyone doing prior case antibody testing in our area that might want to test my blood for research purposes. I would love to be helpful to science in this way if possible and I could go to Austin if need be to do this.
Thanks for everything,
Aubrey
Troy writes:
Hey guys,
A family member of mine just recently sent me a documentary called “Plandemic” and it is self labelled as uncovering “the hidden agenda behind Covid-19”. I have linked the website below. This is an obvious attempt at pushing an anti-vax message by using the fear of the current outbreak, but I believe this is going to get some decent traction in the general public. Could you guys provide your opinions on it? I am also curious on what you guys might know about the interviewee, Judy Mikovits. I have briefly been researching her, but I haven’t found anything obvious like with Andrew Wakefield besides her arrest.
I also want to thank you guys for providing constant and helpful information on the current pandemic. This podcast is the reason that I could immediately identify the incorrect information in the video (there is a lot of it), and you guys have given me the ability to help my family members during this situation as well.
Nick writes:
Hey All,
Can you please address the ‘documentary’ Plandemic that gained traction on YouTube and social media recently before being taken down? Do any of you know of Judy Mikovits and her prior work? I am an optometrist and have seen TWO colleagues share this nonsense. Any light you can share so that I can intelligently discuss this with them would be much appreciated. Looks like she started off promisingly enough then took a dive down the anti-vax route and is claiming that SARS CoV-2 is “caused by a bad strain of flu vaccine that was circulating between 2013 and 2015” Can you all address this or are you all part of the ‘DEEP STATE’! wink wink. Thanks and keep fighting the good fight!
Nick
Sarah writes:
Dear TWiV,
I love your podcast! I received my Ph.D. from the University of Rochester studying the reverse transcriptase of HIV-1 and its great to stay in the loop with current Virology news.
Recently many of my family members and friends (some in medical positions) have asked me about the credentials of Judy Mikovits and or Dr. Anthony Fauci due to a large volume of YouTube videos coming out around her past research, anti-vaccination and government corruption.
I remember having a very large lab discussion when her XMRV CFS Science paper was retracted back in 2011. It doesn’t seem this event or the following 10 or so papers that were unable to corroborate her findings is common knowledge. I’ve been doing my best to illustrate that unlike Dr. Anthony Fauci, she is not held in high regard within the Virology community.
I was wondering if you could talk more about this during your podcast?
Best,
Sarah Van Cor-Hosmer
Data Scientist
Digital First Media
Anthony writes:
Good point by point rebuttal of Mikovits by the website “Think Big”
The anti-vaxx agenda of ‘The Plandemic’
The anti-vaxx agenda of ‘The Plandemic’A new documentary, “The Plandemic,” states that it is uncovering a global cabal trying to implement forced vacci… |
1. Anti-vaccination agenda
The film opens with Mikovits’ new book, Plague of Corruption, published by Skyhorse Publishing. This house has skin in the anti-vaxx game. The house’s founder and publisher, Tony Lyons, said in 2004 that “my main focus in the publishing field has become books about autism and the connection between autism and vaccines.” Skyhorse has published two of discredited physician Andrew Wakefield’s anti-vaxx books. (Note: my last book was published by Carrel, a division of Skyhorse. I was not aware of the anti-vaxx connection until after it was published.) Mikovits’ co-author, Kent Heckenlively, is a known anti-vaxxer and a founding editor of the anti-vaxx website, Age of Autism. The book’s foreword was written by Robert F. Kennedy, a leader in the anti-vaxx movement. So when Mikovits states in “The Plandemic” that she takes no issue with vaccinations, she sure hangs around plenty of people that do.
2. The flu vaccine linked to coronavirus
Mikovits links COVID-19 with the flu vaccine based on a January 2020 study of Department of Defense personnel. Indeed, getting the flu vaccine appeared to result in an increased risk of being infected with a coronavirus. The problem: the coronavirus studied was the common cold, not COVID-19. This study was also based on one flu season. A previous, larger study covering six flu seasons found no such association. In the film you’re led to believe that getting a flu vaccine increases your risk of getting COVID-19. There’s no evidence of that.
3. The ongoing debate over hydroxychloroquine
Mikovits expresses consternation that the anti-malarial drug, hydroxychloroquine, is not being used more. She states that it’s been on the WHO Model Lists of Essential Medicines for 70 years. Almost: it was approved for medical use in America in 1955. While it has been successfully used to treat malaria, lupus, and rheumatoid arthritis, evidence of its efficacy in treating COVID-19 is conflicting. This does not mean that it might not work in combination with other drugs. The way the film is edited, however, makes it appear that Fauci is stating that evidence of hydroxychloroquine’s efficacy is anecdotal in regards to any usage. His clip, specific to COVID-19, is right after Mikovits’ citation of the WHO list. In this case, Fauci is right: evidence of hydroxychloroquine’s efficacy in treating COVID-19 is, to date, anecdotal. The film then flashes to a doctor berating Fauci’s assessment. He then angrily asks Fauci if he’s going to clinically test a vaccine. Considering over 70 are in various phases of clinical trials around the world, the answer is likely yes, but the film makes it seem the opposite.
4. The Bakersfield doctors
Here they are again. Dr. Dan Erickson and Dr. Artin Massihi, the team that runs an urgent care center in Bakersfield, were forceful in their assessment that sheltering in place is nonsense. Their videos were taken off of social media for spreading misinformation, yet that makes perfect fodder for “The Plandemic.” To be fair, in one clip they make a good point: humans needs to be exposed to bacteria. Our immune systems require exposure. In normal times, we’ve gone overboard with antibacterial soap. Kids need dirt.
The problem is that this point is conflated with sheltering at home. What we’re avoiding is not bacteria, but overwhelming our health care system. Sure, a large percentage of those infected with COVID-19 are asymptomatic. Doctors are still trying to understand why that is. We’re protecting vulnerable populations whose immune systems cannot handle it as well as doctors and nurses. The film’s editing is disingenuous. It makes it appear that if we only got a little COVID, we’d all be alright. The debate over herd immunity is a separate conversation. The short-term solution is sheltering at home. It’s not about taking away our freedom. It’s buying researchers and hospitals time. These doctors should know better.
5. Shady Montage
The film claims that we’re being driven to hate one another by our media outlets. That is a debatable but important point. Social media is certainly polarizing. We know that. This claim is made over a montage featuring Alex Jones (who recently contemplated cannibalism) and Sean Hannity (a leading voice for the sheltering at home protest movement) alongside comedians Trevor Noah and John Oliver. Sure, the latter are politically liberal. But since when is cannibalism a conservative principle? This montage makes you feel as if all media is flawed. The implication is that you can only turn to films like “The Plandemic” for the truth. In criticizing the “us versus them” mentality, the filmmakers are trying to win viewers over to “their” side.
6. Cult Dog Whistling
The company behind this film made its mark by distributing and marketing the documentary based on the book, “The Secret.” Barbara Ehrenreich said it best when stating that the self-help techniques inside this book—”ask, believe, receive”—promotes a failure to engage with reality while promoting political complacency. The author, Rhonda Byrne, tows a very old myth: You’re the only reason that you’re in the shape you’re in. If you’re having problems, that’s on you. You’re not asking hard enough. “The Plandemic” relies on a tried and tested cult technique: the world is toxic, but we have the answers. This is indicated when Mikovits says, “Hopefully this is the wake-up call for all America to realize this makes no sense and we win because it will take down this whole program.” You’re either with us or against us. The same mostly white and affluent demographic targeted by Byrne makes up a large portion of the anti-vaccination movement. Magical thinking is easy when you’re not poor or oppressed.
7. Surprise outbreak
The clip ends with Fauci speaking at a 2017 commencement address. He states there is no doubt there will be a surprise outbreak due to a pandemic. This theatrical ending implies that he’s been in on this the whole time (wink, wink). But let’s consider a 2007 review by a team of scientists in Hong Kong:
“Coronaviruses are well known to undergo genetic recombination, which may lead to new genotypes and outbreaks. The presence of a large reservoir of SARS-CoV-like viruses in horseshoe bats, together with the culture of eating exotic mammals in southern China, is a time bomb. The possibility of the re-emergence of SARS and other novel viruses from animals or laboratories and therefore the need for preparedness should not be ignored.”
Obama warned of a potential pandemic too. In fact, a lot of researchers have been sounding the alarm. This Larry Brilliant interview from 2017 is rather timely today. That does not fit the anti-Fauci rhetoric Mikovits is banking her career on, however. Every agenda has a target. While “The Plandemic” says the goal is our freedom, the reality is anything but.
— Derek Beres
Johnye writes:
Dearest All,
TWiV 610.
Prof Ervin’s letter reminded me of a quote most commonly attributed to Jonathan Swift (Gulliver’s Travels).
“You cannot reason someone out of something he or she was not reasoned into.”
Practically speaking, at this time the presumption is that
SARS-CoV-2 is ubiquitous. It doesn’t matter whether its origin was in vivo and found in bats or in vitro and made in a test tube, it exists and is here.
Conspiracy theories, in my opinion, are fiction and a distraction from the work at hand: thinking ahead and finding solutions. You are either part of the solution to this pandemic or dead weight and, ipso facto, become part of the problem.
Wonderful emails and food for thought.
“A luta continua. The struggle continues.” Amilcar Cabral, 1924-1973.
Maintain the best of health.
Johnye
Boston 12 C, cloudy, a chance of rain.
Paul writes:
Twiv-ers (free citizens of the Republic of Science and Enlightenment).
Aristotle argued that any free citizen who did not experience thumos (ranging from anger to grumpiness) when encountering injustice was not virtuous. It was basically a duty of a citizen to be grumpy. If not you were acting (rationally and emotionally) as a slave.
Of course I understand that these words carried a different meaning 2500 years ago.
His point still stands.
Keep up the good work,
Stay grumpy
Paul Rabinow
Professor of Anthropology Emeritus
UC Berkeley
Andreas writes:
I do find it a bit uninformed to say that Sweden has done nothing. Sweden is actually doing more or less what you asked for in the show. Try to keep infection at a rate where the health care system can cope with the ones who get ill, and at the same time not let the country totally grind to a stand still. Will not write a long story about the situation here, but that’s the plan. High death rates have mainly been connected to senior homes and home care which has been a failure, and is probably connected to how that care has been organized and the non existing stocks of ppe.
Schools haven’t been closed (secondary and university has been only online the last month) and yet there are no deaths in people under 30, so I guess your discussion about opening schools has some backing.
Well anyway, thanks for a very interesting podcast 🙂
Best Regards
Andreas
Mats writes:
Hi TWIW!
Thank you for an excellent pod. I have learnt a lot from listening. I’m a plant biochemist by training and I thoroughly enjoy listening and learning. However, I did get ever so slightly offended by a comment in the last episode (TWIW episode 610). A comment was made to the effect of that Sweden is doing nothing about the corona pandemic and just waiting to see how many die. This is just not true, we are actually doing quite a lot in Sweden. Just not as much and not the exact same things as some of our neighbors.
The government has prohibited any public gatherings exceeding 50 people. All universities has moved more or less completely to online teaching. High school grade 10-12 has also moved to online teaching. Everyone who can work from home is encouraged to do so. Elementary schools and day care centers remain open.
The Public Health Agency has daily press briefings about the situation and they always repeat the same recommendations:
- If you are sick (ever so slightly) – stay home
- Avoid unnecessary travels
- Flatten the curve to not overburden the health system
- Protect the vulnerable
In spite of most businesses remaining open, trains, buses and most other services still available most people are doing a lot voluntarily. Travel during the Easter weekend fell by 90% compared to last year. Restaurants have closed every second table and all have information about keeping distance. Stores have installed plastic screens in front of the cashier and tape markings on the floor to mark the proper distance while standing in line. In my workplace, a university department, more than 90% of the staff are working from home. Most people I know and myself avoid visiting older relatives.
The Public Health Agency is not currently encouraging the use of masks in public. For this they cite a lack of evidence. The agency also tone down the role for pre- or asymptomatic spread.
So how is it going? So far we have about 3000 deaths and about 25 000 reported cases with a steady pace of 500 new cases reported per day (has been stable since early April). However, the public health agency has calculated that the real number of cases is likely to be approximately 75 times the reported number. Testing has not been widespread, so far focused to only people sick enough to seek care. Based on random sampling for SARS-COV2 a few weeks ago in the capital Stockholm and a few recent serological surveys the Public Health Agency has calculated that about 30% of the population in Stockholm will have had the infection by the end of next week. Our hospital system is strained but so far not overwhelmed. We had ~500 ICU beds available in March, this has now been doubled. There is no shortage of equipment, but the staff is working incredibly hard of course. This far there has always been 20 % free capacity in the ICUs. Of those discharged from ICU, about 80 % has survived. A large proportion of the deaths so far has happened in nursing homes.
The strategy, albeit not ever clearly stated, seems to be to let the epidemic run its course but at a pace that the health system can keep up with. The capital seems to be well underway….
Best regards from the west coast of Sweden!
Mats
Sheri writes:
Hi there,
I’m a longtime listener, but with the onset of coronavirus, I became semi-obsessed with TWIV. I live in Brooklyn and spent three weeks knocked flat by COVID-19. I passed the time in bed with a marathon of Microbe-TV podcasts. The first thing I did when I got better was hug my children then contribute to your Patreon!
Here’s my question: Now that it seems clear asymptomatic COVID-19 was circulating in early February, has anyone re-examined respiratory virus outbreaks on college campuses right after students returned from winter break? My daughter is a freshman at Cornell. She was diagnosed with an upper respiratory infection (not flu) the first week of February. Fever of 104, chest pain, coughing. It lasted 4-5 days. The same virus ripped through the dorms — tons of kids got sick, some being taken out on stretchers. This would coincide with international students from China (including Wuhan) and Europe returning to school. I know other campuses experienced similar waves of disease. Wondering if this cohort of kids might make an interesting antibody study — esp. as colleges discuss reopening in the fall.
Thank you for all you are doing to educate we laypeople. I share your links widely.
Sheri Holman
p.s. I’m a writer and my second novel was about the 1832 outbreak of cholera morbus in Sunderland, England — and the fruitlessness of quarantine!
Paul writes:
Hi,
In response to how you can tell…….
Know what a bird looks like?
Know what a plane looks like?
How close can humans get to making a plane look like a bird?
From far away, sure, maybe we can.
Up close the difference is obvious.
Do I even need to explain what this is in response to?
Thanks for the great shows!
You all are the best!
Paul
Anthony writes:
“Coronaviruses can remain infectious for long periods in water and pasteurized settled sewage, suggesting contaminated water is a potential vehicle for human exposure if aerosols are generated. “
https://www.ncbi.nlm.nih.gov/pubmed/19246070
# # #
Subject to drying and UV, SARS CoV 2 probably won’t make it across the street much less across the Pacific. Water contaminated with sewage can reach the clouds via droplets on the wind and/or waterspouts. In clouds, viruses can be in a wet, cold, UV protected environment. I don’t know how far clouds travel.
Cats will drink rainwater.
FWIW
Anthony Olszewski
Margaret writes:
Dear TWIV,
I listen to 4 hours a week and fully understand about 30 minutes per week, so there’s that. I have been getting the impression, however, that this would not be the case: Multiple strains of SARS-CoV-2 cause starkly different pathology and clinical outcomes.
This article–I think from USA Today, though I see it popping up in a lot of local newspapers–says the clinical outcomes between San Francisco and New York are stark. One doctor in San Francisco claims 80% of patients on ventilators in New York died, whereas only 2 [out of ?] at his hospital died. He believes this may be explained by two different strains of SARS-CoV-2, one in San Francisco, and a different one in New York.
It’s rumble time in the Ervin family.
My sisters say: What do you think about that, huh? You think we can’t read or something? You think you’re so great, huh? Take that to your TWIV buddies. We’ve got scientists too. We can read too. What about these scientists. These seem like some good scientists:
Alan W. Zuckerberg San Francisco General Hospital, Professor of Laboratory Medicine allegedly said, “That could explain why we’re seeing such different outcomes between San Francisco and New York City.”
Greg Poland, Director of the Mayo Clinic’s Vaccine Research Group allegedly said, “Everyone talks about the SARS-CoV-2 virus as if it’s one thing. It may be more of a problem.”
I think those quotes are likely taken out of context. Who knows. This is science journalism. This is what you’re up against.
Yours,
Margaret
Ben writes:
Dear TWiV,
I ran across a study this morning which followed a number of COVID-19 patients over time with both rtPCR and serological testing:
“Different longitudinal patterns of nucleic acid and serology testing results based on disease severity of COVID-19 patients.” DOI: 10.1080/22221751.2020.1756699
Of course the sample size is tiny and nobody wants to jump to conclusions, but what would it mean if most asymptomatic COVID-19 carriers never seroconvert? Is there an adaptive immune response going on even if it is never revealed through rising levels of antibodies? Or could some people clear the virus strictly with an innate immune response (though one so subtle that they never notice it)? Or else could some people become permanent vectors of active, transmissible virus? And finally, if the information that is accumulating about asymptomatic carriers turns out to be reliable (ie. there are lots of them, they can actively shed live virus, and (now) they may be hard to identify except through a program of regularly repeated PCR tests) then at what point do we throw up our hands and embrace the notion that, absent a vaccine, curtailing the exposure of the general populace is logistically impossible?
I’ll be interested to hear your answers. Many thanks for your informative podcasts!
Ben
Greg writes:
Dear TWIV crew,
In TWIV 606, one of you warned about the harmful nature of UVC light. I wonder if you would comment on far-UVC light which David Brenner at Columbia U says is safe for humans but inactivates the virus.
https://news.columbia.edu/ultraviolet-technology-virus-covid-19-UV-light
He envisions far-UVC lamps in public places to reduce the spread.
Thanks for your efforts to educate me and others.
best regards,
Gregory
Champaign, IL
Steven writes:
Hi all the way from Scotland!
I have a friend to says that COVID19 has not been identified and asked me to send him the evidence of how they identified it. I said he sounds David Icke!
Can you help please?
David writes:
Dear TWIV team,
I’m one of your new COVID-19 listeners. I’m just a family practice doctor from Detroit, but I have really appreciated a reliable source for coronavirus related science, especially in podcast form, since that’s my favorite way to keep up to date. Thanks for what you are doing!
My question is about racial disparities in infection rates and outcomes. I work at a community health center in Detroit, so I am well aware of the impact of socioeconomic factors and racism on health disparities, and I agree with your analysis that this is probably driving the disparities we are seeing in COVID-19 outcomes. Still, I can’t help wondering if there might be genetic variation in the expression of the ACE2 protein that could play a role. I don’t know the science behind it, but in clinical practice and guidelines, doctors are well aware that ACE inhibitors don’t work as well in African Americans. Might this be because of differences in the ACE2 protein or its expression levels, and if so, could such differences affect infection risk and outcomes? Are you aware of anyone looking at this?
Thanks, and keep up the good work!
David
Trey writes:
I would like to submit two questions to the folks on TWiV.
If this is not the correct way to do this please let me know.
I have listened to multiple podcasts that had interviewed doctors on the front line of this pandemic.
I have noticed that there is some variation in the treatment regimens.
Hypothetically, if you had a patient (with COVID-19 and not doing well) and you had 20 doctors offer their own recommendation, would you get 20 different courses of treatment?
How much of medicine is art, and how much is science? What I am trying to understand is, what do doctors use as selection criteria, to try something different?
Besides publishing in medical journals, do doctors (in high case load areas) have a way to communicate their experiences with treatment to other doctors across the country?
Yes, I know phone calls are an option. Imagine you are a doctor in BFE and encounter you first case of COV-19. You use all of the tools you know and the patient is getting worse.
“Who ya gonna call?”…
I really enjoy your podcast. There are times when y’all get a little deep and I don’t understand the details.
It is those podcasts that I learn the most.
Hang in there….
Trey
Victor writes:
I heard and read many times your argument that we could have had pan-coronavirus antivirals if only we tried hard enough since the “original” SARS outbreak.
I am totally with you, but there is one thing that really worries me:
At least with COVID-19, these antivirals will have to be presumably taken early in the course of infection, when there is a chance to significantly reduce viral replication. You discussed just that last time with Daniel Griffin about Remdesevir.
But that means they would have to be prescribed basically prophylactically (let’s hope those would be antivirals would not require IV administration).
So that would mean they would probably have to be widely prescribed, or it would have little to no effect. But that in turn would mean the selective pressure for coronaviruses to evolve some sort of resistance to these antivirals, and we in essence help emerge MRSA-like untreatable strains of these viruses.
I admit I make it excessively dramatic. There are probably ways around this – combination drugs attacking multiple pathways of virus replication cycle would probably be more safe.
But I would love to hear your opinion on that.
And a couple of little things: while reading scientific literature I notice more and more the term ‘RNA load’ instead of ‘viral load’ when describing PCR results. Is it TWiV influence? ))
And just a funny co-incidence this morning. I was listening to the talk by Susan Weiss that you linked from TWiV episode with her while I was training on a bike trainer. It was rather hard to follow. But when it ended, the youtube AI chose to play as the next video nothing else but ‘What is a virus’ lecture by Vincent, fresh from 2020 course. Apparently it sensed my confusion and recommended I started with basics))
Thanks for your wonderful podcasts
Victor,
Moscow
Brigitte writes:
Dear TWiV,
In Switzerland, our government, similar to some others, has proposed a three-phase easing of restrictions. Each phase seems to be contingent on how the previous phase goes (in terms of keeping new daily cases of infection from going up). My question is how will we be able to interpret the number of positive cases per day if testing capabilities are expanded at the same time? If there is indeed a large number of asymptomatic people, the number of new cases will increase with more testing. If this is the case, will the only option to monitor the phasing be dependent on hospital admission rate rather than population wide testing results? Considering the lag-time between infection and onset of symptoms and hospitalization, using rate of hospitalization seems largely inadequate in helping us to avoid a second wave. What are your thoughts? (assuming we never achieve population-wide reliable antibody testing for COVID…to really understand what has been going on past and present).
Thank you for providing the world with a reliable source of consolidated, digested and unadulterated science on COVID-19.
Brigitte