I just wanted to write and thank all of you for this podcast. While appropriately fearful of the COVID virus as a 70+ person I had also been missing the exciting science that always comes with these events.
As a very young med tech working at the city hospital with physicians from the Fox Chase cancer Institute I did Hepatitis B agar gel diffusion tests, though at that time it had not yet been identified as the Hepatitis B virus. Using a double blind study we tested pints of blood intended for transfusion. A drop of serum from the donor unit tested against the antigen serum looking for lines of identity when there was an antigen antibody reaction. The study was quickly interrupted when all of the transfusions from units of blood with lines of identity caused hepatitis. Heady stuff for a 20 year old.
In the 80’s I had a ringside seat for HIV as I worked in the Red Cross blood program as a Lab Director. We all learned Immunology as we muddled our way thru that crisis. You think the Covid testing is problematic; you should have seen the lack of specificity that came with the early HIV Elisa tests. Deferring blood donors with a positive ELISA test but negative Western Blot ranks right up there with the all time difficult conversations you can have with a volunteer blood donor. Despite all the headaches that this virus caused, the advances that were made in understanding the immune system were truly amazing.
By the time I retired a few years ago my experience included testing for the transfusion transmitted infectious agents HTLV-1, Hepatitis C, Zika, West Nile. I thought I’d seen it all until COVID came along. Finally to my question, Is the COVID-Sars 2 a transfusion transmitted disease? If you discussed this I haven’t heard it.
Again many thanks for this excellent podcast! Stay well TWIVers! Kathy
I’ve been seeing a growing number of stories about COVID19 patients who have not fully recovered from their illness and are suffering from debilitating fatigue, brain fog and muscle pain such as discussed in the article on “long haulers” in the Atlantic below.
What are your thoughts on this and do you know of these symptoms lingering in any of the patients you have treated?
Thanks so much,
Are Slaughterhouses a special zone of Corona Virus spread?
Perhaps you can answer that once I describe the slaughterhouse environment.
I have had the misfortune of working in both cattle and poultry facilities.
In cattle processing, the intake of live animals has dung and water hosed everywhere. Very humid at the input end. Once the animals are killed and bled, they move to a refrigerated butchering area. The air here is less than 5C and gets quite dry. Air is recirculated by the refrigeration equipment, as cooling outside air down costs energy.
Poultry are first steamed to remove feathers, this area is very high humidity (And the worst smelling area too). Once gutted, the bird carcases move to refrigerated areas for cutting and packing. In the Boning-Rooms, workers stand shoulder to shoulder over conveyor tables. Most areas will be hosed down several times a day to wash away blood and guts.
So there is water everywhere, some cold dry air, and everyone is covered in blood.
What do you guys think?
The smell from my visits will never leave my memory, and no doubt a component in my choice of a vegetarian diet.
Thank you so much for all you do.
As an elderly severe asthmatic I have been a regular listener ever since mid-March at about the time of my last ski trip. Skiing is therapy for me, but not if I have to share a gondola or an unventilated bathroom during a pandemic. I’m doing my best to learn how to stay safe and ski again, and you are a tremendous help.
I’m inspired to write by your TWiV 631 responses to the letters asking about the environmental conditions inside a meat packing plant and inside nursing homes and how these conditions might contribute to disease. You were wondering what all the variables might be that result in illness where many people work together. I have suffered severe illness several times in my life where building environmental conditions led to viral illness and asthma attacks, and I have what I believe is an informed opinion. I’m also a CPA with many years working in the energy industry and some exposure to energy conservation.
The conditions mentioned by the letter writers are enclosed spaces that need to be either heated (nursing homes in a cool climate) or chilled (meat packing plants) and temperatures maintained at a significant differential from outside.. Heating and cooling are expensive. Many building maintenance operators in my experience focus on these costs to the detriment of providing good ventilation or air filtering.
Over the months I’ve been listening to your wonderful show I have heard expert opinion that lack of ventilation in enclosed spaces allows for spread of virus via expired droplets during talking, etc. I suspect that the economics of building maintenance combined with unusual temperature-control requirements could be leading to the outbreaks in meat-packing, fruit-packing (I live in the same state as Yakima), and nursing homes on account of poor ventilation. I think you were on the right track, but if you want to find a common environmental condition that leads to outbreaks – my proposal is look at the need to control temperature.
Keep up the good work!
Japan! here ALL restaurants and cell phone stores as well as sporting goods stores check the temps of incoming customers, require masks and a hand sanitizer before entry. Restaurants are all set up for serious physical
social distancing. Once at your table you may remove your mask. Cell phone stores require an appointment and maintain physical distance. When speaking with a representative…masks remain on and there is a clear barrier of plastic sheeting separating the customer and rep.
Hand sanitizing is mandatory everywhere here.
People employed in the adult entertainment industry are checked at least 3 times a week. (The adult entertainment industry is legal here)!
Masks are worn by every one all the time…and folks line up patiently and physically distance while doing so.
Thus we have a low infection rate. Taiwan and South Korea have the same requirements as Japan. Japan is not a “huggy” culture…Japan is respectful and considerate but physical distance is a cultural trait.
I am a TWiV addict and pass on to folks here what I learn from your great podcast!
I was struck by the letter that compared Vincent to Alan Alda. The real dead ringer is Marc Maron. Attached is a brief skit: https://www.youtube.com/watch?v=PdgrEGFu44E
Have followed virology since doing pandemic training at a multi-county health center in response to the avian flu scare.
-Greg- in Wyoming- where “physical distancing” is an art form
Two styles of arse mask are generally available – boxer and brief.
The brief is preferred as it tends to offer a closer fit and is therefore most effective.
As with face masks, their efficacy is dependent on proper use, however there are some who habitually flout proper procedure. Builders and plumbers are two noticeable groups.
Love the podcast, and keep up the good work.
For the 4 year old :
(begins at 5:14) https://youtu.be/Nbmr_eM2DnQ
On the topic of risk infographics :
Thank you for all the work that you and the team do!
— aja (like the steely dan album)
I love your show probably because I’m as nerdy as you are when it comes to virology and immunology.
I’m the head of R&D at a Swedish company called Mabtech
We are a bunch of nerdy immunologist who have been working with optimization of High throughput T and B cell assays for over 30 years.
We have been working hard since February and have now launched SARS-CoV-2 specific T and B cell assays ( both for memory cells and antibody secreting cells)
As well as a bridging ELISA in the regular ELISA format which can be used by any lab.
T cell assays are not that hard.
You draw 8 ml blood in a CPT tube , centrifuge 20 min , then you have your PBMCs which you put together with peptide pool into a ELISpot or FluoroSpot plate, incubate overnight and develop. From the same tube you get plasma for your ELISA.
Cells can also be frozen and analyzed at a later time point .
These assays have been used for 20 years by vaccine companies for high throughput analysis of vaccine induced T- cell responses. They are also used in cancer research , autoimmunity, transplantation and study of natural immune responses to various pathogens.
Keep up the great work with the show!
If you want I would be happy to be a guest on the show.
All the best
Hello Twivinistas! Greetings from St. Louis, where it is currently 29C/84F and dewpoint 20C — relatively dry for this area.
Happy Birthday to Rich! Ignore the folks that suggest that this podcast might be too “Talksey” (or whatever) — that is what makes TWiV a rich, enjoyable experience.
Regarding your listener mail from TWiV 631, the Scandanavian transplant Picornovirologist said that the Fahrenheit scale is non-linear — incorrect! It’s just as linear as Celsius. And, as a person who started out in Chemical Engineering, but decided on straight Chemistry (because ChE was too mired in English units), I still wrestle with Celsius. All the other SI units I understand and can internalize, but Celsius makes no real sense for practical purposes. Scientific purposes, yes — how warm is it outside? No.
Here is an excellent explanation from the recently deceased Brion Toss — master ship rigger and great practial DIYer. The Fahrenheit scale makes much more sense for how we experience the world, so for our environments it’s quite practical. For doing calorimetry in the lab, Celsius is fine.
Thank you for all that you’re doing — it’s so nice to have a voice of scientific reason in this miasma of antithink. I’m a relatively new listener to TWiV, but have learned much in the last month or two!
From a mere Chemist, who has a newfound fascination with all things virology.
Dear Team TWiV,
I’m a Ph.D. in theoretical physics, and when that career went now hereswitched to IT. I’m also an avid cyclist, so allow me to comment on two questions and answers from TWiV631.
Reverse engineering is indeed taking a program, and from that generating source code that would, when compiled, produce the original program. But it goes further than that, it also includes trying to understand from the generated code what the purpose of the program is, and what it uses. To take the unavoidable example of a computer virus, you want to try to find out whether it would destroy your hard drive, encrypt your data, send out spam emails, or let your computer be part of a botnet involved in a dDoS attack on some government agency, to just a few nasty possibilities. You also want to know how the virus would gain access to your computer, and how it would be able to grab hold of the computer resources to do its nefarious work.
So John’s question would be, could you from the genome of SARS-CoV-2 tell how it would infect a cell, how it would replicate, and what the effects on the cell and the infected would be?
As for Dean’s question with regards to cycling, group rides are more a social event rather than a competition, and exertion levels tend to be lower than in a race, so the number of droplets ought to be (fairly) low. When you ride on a bicycle, you create a zone of lower air pressure behind your back. When riding alone, air will be rushing in from all four sides (top, bottom, left and right) to level the pressure difference, leading to some turbulence. When riding in a group, the rider behind you will fill that area of low pressure with his body, reducing the amount of air rushing in, and reducing turbulence. The rule is, the closer, the bigger this reducing effect. A quick search on this yielded a paper studying this effect by means of computational fluid dynamics and verifying the results in a wind tunnel (Blocken et al., Computers & Fluids 71, 435-445 (2013)). So increasing the distance to 6 feet would actually increase the chance of hitting a droplet rather than reducing it.
And if you’re concerned about catching too many droplets, you can always don a snoodie, and pull that over your nose and mouth.
Hello! it is 29c and mostly cloudy here in the suburbs of Salt Lake City. I noted that it felt a big muggy, so I checked my phone- 33%. Yeah, not much to complain about here.
I have a question about lifestyle interventions, but first, I’d like to address the question on TWIV 631 about group cycling. This has actually been looked at, a few months ago, in a Belgian-Dutch study (see link). It has some great visualizations, and seems to be pretty well-done. It’s a bummer for Dean (who asked the question) and I, that group cycling rides or hockey with my buds may be off the table for quite a while.
I became a professional armchair virologist on March 16, 2020, with no previous experience. The gym I was working at was closing that day, which was spent for me driving home from Low-Carb Denver 2020 (the Costco in Eagle, CO still had some toilet paper in stock!). The room full of extremely smart doctors, nurses, and fellow nutrition coaches were all nerding out the most over a study (mouse study, to be fair) that compared mice infected with influenza, and how diets would affect their outcomes. “They showed that mice fed a ketogenic diet and infected with the influenza virus had a higher survival rate than mice on a high-carb normal diet. Specifically, the researchers found that the ketogenic diet triggered the release of gamma delta T cells, immune system cells that produce mucus in the cell linings of the lung — while the high-carbohydrate diet did not.” (Linked below)
Anecdotally, most people in the room noted that since eating a low-carb or ketogenic diet, they rarely get sick anymore. That is also consistent with myself, and the people I work with. But when we look at who COVID-19 is impacting the most, and seeing that nearly every comorbidity for a negative outcome is metabolic in nature, and, in my humble opinion, avoidable and reversible, why are we not looking at this more closely? We know that only 12% of the people in this country are considered “metabolically healthy”. (Linked below). This seems like high time for us to address this.
I’m curious to know if you are thinking about which lifestyle factors can help the general populations the most? What things do you recommend? My thoughts would be that proper nutrition, exercise, stress reduction, and sunlight would all be pretty high up on my list, but I’d love your thoughts!
Thank you for your podcast!! I love the science you share, and I love all of your collective willingness to learn new things and stand corrected! It’s sad to contrast your work to the absolute vacuum of science in the nutrition world. It’s quite startling when you look into it. Did you know there is an entire non-profit that was started in 2015 whose main goal is to make the US dietary guidelines to simply be based on science, which they are not, and have not been since they first came out, in 1980? Can’t make that stuff up. (Linked below)
Cheers! Thank you for all you do.
I love the podcast. It’s sunny here in Wales (28 deg C) with a risk of thunderstorms later in the day.
With regard to the German meat packing plant C-19 outbreak there was also a similar case in Northwales. https://www.bbc.co.uk/news/uk-wales-politics-53152362
200 confirmed cases in a chicken factory. It’s seems very similar to the North Rhine-Westphalia outbreak which seemed to be linked to overcrowded working and living conditions for the mainly migrant working community.
Wales has been very cautious in its devolved healthcare strategy, in essence copying England’s policy but with a 3 week delay in implementing compared to England. Testing has been low and sporadic with an even lower rate of antibody testing.
How will we know when we reach herd immunity?
Kind regards / Cofion cynnes,
I’ve been listening since the start of the pandemic, and will continue to do so after we come out of the other side of it. I really appreciate your podcast, I’m just a Police Officer so a lot of it’s over my head, but my knowledge in this field has increased ten fold in the time I’ve been listening.
I heard on episode 631 your wish for a rapid antigen PCR test is paramount and wanted to highlight to you the work of Avacta Group in the UK, partnered with Cytiva (formerly GE Healthcare Life Sciences) is currently doing, in an attempt to bring a rapid saliva test that gives results within ten minutes to market. Their aim is to be best in class and so far the results suggest the same. Clearly if this is achieved, it’ll be absolutely game changing.
I’ve copied a link for your interest. Thank you
I am a hospital and school based speech-language pathologist in the suburbs of Salt Lake City, Utah where it’s expected to be a sunny and high of 93 Fahrenheit (33.9 Celsius). I love all the knowledge I get from your podcast, which I started listening to in March.
We in Utah were relatively unscathed by SARS-COV-2 from March to end of May, so It seems like most people have only felt the economic toll around here. Because of this, mask wearing/non-wearing has become more of a political statement than a common sense practice. Our numbers have been skyrocketing over the first few weeks of June and it’s a little scary.
My main point of writing is to ask about playing basketball…
I have 13 year old twin boys who are very serious (you might say obsessed) about basketball. My husband coaches them as well. They are diligently working on trying to make the high school team and practiced their little hearts out all spring at home when the spring leagues were cancelled. Recently, a few leagues have started up again for the kids at the higher competitive level. They are limiting spectators to 10 per team (or none at all based on venue), encouraging masks (spectators at all times and players before and after games), temperature/symptom checking, and passing around hand sanitizer.
I was very hesitant to participate in this league, but I was outnumbered and it’s happening whether I like it or not.
In my mind, there’s nothing that can be done about players and refs potentially spreading virus to each other during game play. However, I remember a few weeks ago you had a dental professor discuss using a hydrogen peroxide rinse periodically during dental procedures to temporarily reduce viral load in the mouth. Would having players and refs swish H2O2 before games (and maybe at half time) be an effective option for reducing spread between players during game play?
I would love any research articles available to send to those running the league if you have them.
Mark H. writes:
Dear TWIV, Mark again (the first Mark from 629, not the 2nd or the 3rd).
I’m just* a doctoral candidate whose research investigates antimicrobial peptides using Drosophila. Unfortunately my education in invertebrate innate immunity fails me when it comes to immunological memory, but your podcast has been fantastic to get my feet wet and I’m watching Vincent’s Virology lectures on YouTube.
On 629, Dickson mentioned two versions of the polio vaccine, one you inject vs. swallow. The injectable vaccine trains your systemic immune memory, but despite having trained immunity, your gut is still naïve? So you get infected, but not sick.
How does that work!? I’m having a difficult time reconciling what is meant by this comment. Is the implication that epithelial cells in the gut have a mechanism of trained immunity independent of systemic immune memory? Any insight would be greatly appreciated.
p.s. Dear fellow Mark who asked about innate immunity clearing the virus on episode 629, great related question!
There are murmurs of the possibility of antiviral immune memory in fruit flies, that are even trans-generational, but this is in its infancy. I’m thinking of results by Carla Saleh’s lab (she’s great by the way) where her lab shows that complementary viral DNA is detectable in offspring of parents infected with an RNA virus. I saw her speak about this and she’s following up now. A possible explanation is retrotransposition of virus into the genome which ends up inherited, but alternately some plasmid-like mechanism in the microbiome or something even weirder could explain.
A quote from the abstract:
“We further showed that information of infection by RNA viruses acquired orally leaves a trace under a DNA form, which confers protection against future reinfection by the same virus. Together, this work presents evidence of clearance and immune priming for RNA viruses in insects and challenges the current view of antiviral immunity in insects.”
Love the car talk of virology! I am a former microbiology lab person (before and during the early days of HIV) who migrated to research medical informatics (the sanitation engineer equivalent of saying computer nerd) I ended up the last 20 years managing research databases for a Comprehensive Cancer Center.
I am mostly retired, still consulting on a few systems that leave me with access to all the medical databases. I have been tracking SARS-CoV-2 with everything my idle hands could manage. I discovered you guys who sound just like the folks I worked with 20 years ago.
So my question is about fallback strategies of control. I live in NC, a red state with a blue governor. The results have been predictably mixed. I first despaired over testing, then despaired that we could ever catch up with contact tracing. Then my data geek kicked in and I saw that over half of fatalities are in “congregant facilities” (nursing, retirement homes etc). Would not a reasonable fall back strategy be to circle the wagons around these facilities, with testing, first second and third level tracing of employee contacts etc until the vaccine(s) comes? Would love to hear your thoughts.
PS. The recent clinical roundup changed my data models significantly. Besides the younger demographic currently adding new cases, I think that the steroids, proning and anticoagulants will reduce fatalities during the next wave or whatever we call it. It will be a wave of illnesses and not deaths. I fear how this will play out in the press.
Earlier you had a podcast where the Ebola virus was discussed. I had to send you a picture of my tree top looking eerily similar to the iconic slide photo of the virus. Something to lighten up the day.
Thanks for your wonderful podcast. It is my go to source for factual information.
Dear Twiv team,
Thank you for such a wonderful and informative podcast.
I am a paramedic by profession and this pandemic caught me working offshore with a crew of 53 on an 89m 4 deck marine vessel, back in February (though not yet called pandemic then).
Last week of February, I began searching for the best methods for controlling spread of infection on board, as I wasn’t convinced (to say the least) that hand-washing supplemented by coughing into an elbow and sneezing into a tissue (as advocated for by maritime companies) were adequate means to curb spread of infection onboard a closed air-conditioned vessel where physical distancing is impossible in most cases, especially given previous examples from cruise liners and their rates of infection.
Long story short, despite initial WHO, NHS and CDC discouraging this, face mask wearing was an educated guess at that point that I took after reviewing various articles written in the aftermath of SARS outbreak in 2003, supplemented by my past exposure to the social practice of face mask wearing in Japan, that contrary to what I found many believe, is in fact an act of consideration towards the healthy, by those who wear a mask when sick.
I have already implemented this with my crew when arriving with ‘post travel sniffles’ in the past.
When finding it difficult to source ‘single use masks’ I began hunting for some worthwhile study of fabric grade masks, I have attached the article below for your critical view (best I could find):
While not perfect, it was useful in guiding the choice of fabric made masks and I hope you can benefit from it too.
For completing the picture of mask wearing as proactive measure in attempt to curb the spread of infection, a very helpful piece was published in the NEJM:
The ‘replicable virus’ analysis, by the German group, you looked into on your TWIV episode 601 ‘Das coronavirus’:
Topped by the groups indication of the week long period of ‘replicable virus shedding’ in mildly symptomatic patients and later the other studies that confirmed transmission of infection from pre-symptomatic hosts have all been invaluable in putting together a plan.
I guess I wish people would stop making mask wearing a political issue and would make the mental link between use of condoms to prevent STD spread (hosts definitely not always symptomatic) and the use of face masks in preventing the spread of a respiratory borne illness (hosts as now very clear, definitely not always symptomatic in the case of COVID19).
Stay healthy, so we can all enjoy more of this unique fountain of knowledge!
I have an IgG and IgM deficiency. I infuse subcutaneously with antibodies every other week. I am 72 and in reasonably good health. I have not had an infection (including colds) since infusing for the past five years. (I used to experience bronchitis four or five times a year previously.)
I live in North Florida near Tallahassee in a county that currently has had 42 cases. I have been very prudent about physical
social distancing and masking. Two questions: What, if any, impact would the infusions have on the severity of COVID-19? As I get new shipments of the antibodies for infusion, what are the chances I may get doses which include SARS-CoV-2 antibodies?
I listen to TWIV frequently and understand about 33% but nonetheless enjoy the discussions.
Hi all of you TWiV’ers:
This COVID-19 lockdown has forced me to learn more than I ever wanted to know about viruses; thank you TWiV!
My background isn’t biology, but electrical engineering and computer science; I also did a brief stint with the U.S. Public Health Service many decades ago working on kitchen microwave oven leaks and computer analyses of radioactive milk.
TWiV has provided many of us non-biologists with incredibly helpful and accurate information during this ‘information drought’ about coronaviruses. However, I have a serious bone to pick with TWiV’ers regarding government surveillance via smartphone apps and ‘contact tracing’.
You talk about wanting to take politics out of public health. You wonder why people don’t trust their governments to provide services like ‘contact tracing’ and ‘safe vaccinations’. Here’s are a few perfect examples of why that trust doesn’t exist:
1. Tuskegee Study of Untreated Syphilis, 1932-72.
2. University of Cincinnati Radiation Experiments, 1960-71.
3. Edward Snowden revealed in 2013 the extent of secret unconstitutional spying by the U.S. Government on ordinary American citizens.
4. The Obama-Biden re-election campaign slogan in 2012 was “Osama Bin Laden is dead, and General Motors is alive”. Obama and Biden’s 2011 pre-election stunt to kill bin Laden had a gigantic cost in destroying trust in public health workers (and also in destroying public health workers themselves!) around the world. Obama and Biden themselves must personally accept much of the blame for the world-wide anti-vaxx movement, and for many future polio deaths.
“The distrust sowed … could conceivably postpone polio eradication for 20 years”
“But the operation that led to [Bin Laden’s] death may yet kill hundreds of thousands [or perhaps millions] more.”
“the violation of trust [in public health workers] threatens to set back global public health efforts by decades”
“Two months later gunmen killed 10 polio workers in Nigeria”
Scientific American Volume 308, Issue 5
How the CIA’s Fake Vaccination Campaign Endangers Us All
The U.S. was wrong to use health workers to target Osama bin Laden
Sam Washburn Apr 16, 2013
Henry Baker, PhD (MIT BSEE’69; MIT SMEE’73; MIT PhD’78, Computer Science)
–a skeptical Democrat in Santa Barbara, CA
P.S. (“6 degrees of separation”) My family & Dr. Albert Sabin’s family knew each other; we all went to the same schools while growing up in Cincinnati, Ohio in the 1960’s.
P.P.S. to fellow rower Rich Condit: I’m the 2019 World Indoor Rowing Champion in the 70-74 age group.
Hi, TWIV team. I am a retired pediatrician and a recent convert to your show, which I love listening to; I look forward to each new episode. I learn something new every time!
On a couple of recent shows, you have discussed the question of why children seem less susceptible than adults to infection with SarsCoV2. Last month, JAMA (Journal of the American Medical Association) published an article and accompanying editorial suggesting that young children have fewer ACE2 receptors in their nasal epithelium than do adults, and that this might be a partial explanation for their apparent resistance to infection. I thought you’d find it interesting and might even discuss it on a future show. I’d like to hear your take on the idea. Here is a link:
Keep up the great work of educating so many of us! And thanks.
Hello TWIV folks, thanks for all your work, especially as of late!
With regard to the questions/claims about lower transmission during warmer weather months and the current spike in warm weather states here in the US, I wonder if air conditioning might be related.
I currently live near Boston where we are closed up in the winter and open-window and outside in the summer, but I grew up in Florida where it’s just the opposite.
Summer is the the time of year when Floridians tend to cluster inside sharing the same conditioned air.
It might be a small effect compared to the overall transmission wave, but it would be interesting if a correlation (or not) could be teased out somehow.
Hello Twiv Meisters,
On this episode both Vincent and Rich agreed that far down the road COVID-19 would be similar to the flu in that
a yearly vaccine would be the norm. However, you both also agreed (I think) that the best would be if no vaccine were
My question is – were you suggesting that 1 – the virus would disappear ( probably not I would think )
2 – that herd immunity of 70% of the world’s population being infected would prevent the virus from
becoming a lifelong scourge.
Thanks for keeping me updated on all things viral.