TWiV 637: Clearing the fog of ignorance

July 9, 2020

In this episode, approval of an Ad5 vectored SARS-CoV-2 vaccine for the military in China, description and clinical trials of a Novavax vaccine joining Operation Warp Speed, prevalence of SARS-CoV-2 in Spain, shedding and transmissibility of the virus, and listener email.

Hosts: Vincent Racaniello, Rich Condit, and Kathy Spindler

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Intro music is by Ronald Jenkees

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13 comments on “TWiV 637: Clearing the fog of ignorance

  1. Frank Jul 9, 2020

    Regarding the development of a Covid-19 vaccine, he said: “It’s so many of our children that are being vaccinated and paralysed … So when they say the way we’re going to fix covid is with a vaccine, I’m extremely cautious. That’s the mark of the beast.

    “They want to put chips inside of us, they want to do all kinds of things to make it where we can’t cross the gates of heaven.”

    West added that Covid-19 was “all about God. We need to stop doing things that make God mad.”

    Here is a new one here according the Guardian on Kanye West’s rants over COVID-19. Sadly the only way I can get away from Politics on is listen to TWIM, TWIP, and TWIN.

    Immune and TWIV yes it’s now impossible to get away from politics given that the Superpacs and the pundits on Cable news keeps dragging virologists and immunologists to respond to every conspiracy theory made by the Anti-vax lobby in relation to COVID-19 and Vaccine candidates.

    Note I will still listen to all shows including TWIV and Immune because I know it’s important that the general public to be literate in biology.

    My take here is that Kanye West wants a Pundit seat on the Cable Talk shows except we don’t even know who will get him yet until after the 2020 elections.

  2. Carol Shoshkes Reiss Jul 9, 2020

    Vincent, Rich, and Kathy: may I please inform your listeners that while CD4 Th2, CD4 Tfh, and (one effector function of) CD4 Th1 cells is to “help” and direct class switching of B cell Ab production, you have overlooked another very important activity of CD4 Th1 cells. They are just as effective as CD8 CTLs in killing virally infected cells that express the appropriate peptide on the restricting MHC molecule. They use the Fas-FasL pathway to kill virally infected cells [this is one of the 2 pathways used by CD8 and NK cells — the other is the perforin-dependent pathway].

  3. Lyle R Gesner MD Jul 9, 2020

    Hello twiv

    I have been following this pandemic since early January. I have been listening to dr John Campbell from England who called this pandemic before anyone. There is no question that IMHO the CDC completely dropped the ball. This pandemic could have been stopped at the get go if masks had been mandated. Total failure of national leadership!!! Thank godI am a physician and have been wearing a mask since January. I know through personal experience that masks work. Why didn’t the cdc advise masks. The South Koreans who went through sars and Mers knew what to do. How arrogant and stupid the cdc was to not advise this. I was unlucky enough to be admitted to my hospital for a renal stone(most unbelievable pain I have every felt) during the covid surge in NJ. I got admitted for pain control for 17 hrs in ER Hold. I was surrounded by PUI pts several who were ultimately found to be covid positive. I wore n95 mask and goggles all night(slept in this). I did not get covid and tested negative for the antibody. If this was aerosolized like TB i absolutely should have gotten it. Added to this I developed a frozen shoulder over past few months and have been going to PT 2x per week for treatment since early January. They are two two inches from my face when they work on me. They are in mask and I am in goggles and n95 masks!!!! I believe that if you follow the rules (actually wear the mask, not have it around your chin as most people do), wash hands, social distance etc, that this is actually a difficult virus to catch.

    I love what Colby college is doing. That is one smart president. All colleges and universities should follow in line. Why try and reinvent the wheel. I agree what Cornell said is ridiculous about the cost! Also, just because there is no evidenced based medicine for support of testing of college students like Colby is doing, that it is still the right thing to do! The evidence will come later.

    Ps I am new to your podcast but I love it. I guess I am a neuroradiologist who deep down has a huge fascination with immunology and virology.

    Lyle R Gesner MD

  4. Richard Cornell Jul 9, 2020

    Chicago public schools gave out a 100,000 tablets so that students could learn at home. Mayor Lightfoot was over joyed with the fact that they could replace teachers.
    Which they did. Figure that the average teachers salary is $60,000 a year and a device could cost under 200 dollars guess who will lose.
    Trump might not be a teachers favor friend, but if the schools stay close in Chicago it is the teachers union will suffer.
    This COVID-19 pandemic is a God send to the Mayor and longer she can keep the schools close the more leverage she has with the unions.
    I can see why the unions want the schools open.

  5. Laura Jul 10, 2020

    Hello TWiV Pod-stars,
    I am writing to you from Western Massachusetts where it is currently partly sunny and 91F. I must admit this is not my first time writing to you all.
    I discovered your awesome podcast in March when all of the uncertainty of SARS-CoV-2 began to muster in a vile “sequence” of calamity. I am a Medical Laboratory Scientist with no specialty accolades AKA generalist and jack of all lab departments. However, I might now informally claim the “crown” in our lab as the Covid-19 resident expert as all things Covid-19 seem to be diverted to me; it is your podcast which I have to credit for proving much of my education in this realm. The information which I have learned and relearned throughout the past few months from you all has been a lifesaver and great timesaver for me in my profession as well as my organization.
    While listening to TWiV 634, I believe a student asked a question regarding why Lymphopenia happens in Covid-19. No one could definitively answer from your panel of wealthy knowledge. A superficial answer came to me immediately upon listening. I may be completely off track, but I feel like it’s a basic concept that may be overlooked. So I will proceed to break it down! There are different types of White Blood Cells (WBCs) that react to different circumstances. As I was taught in school for my profession, lymphocytes are the WBC known to react to foreign antigens which mainly react to target viruses (and elicit certain immune response as well to create antibodies). There are several types of lymphocytes which each have specialized functions, but I will not get into all of that as it’s not completely necessary in my explanation and above my head on the topic. Lymphopenia has been documented in severe cases of SARS-CoV-2. The WBC differential via blood samples is typically the specimen to determine this condition. The blood sample from a patient with severe Covid-19 is a sample of the CIRCULATING POOL. It has been noted that in patients with Covid-19 that do not have secondary bacterial infections that BAL specimens exhibit high lymphocyte counts ( ). Additionally, we know that other organs are attacked and affected, pointing to lymphocyte infiltration (though I have not fully researched, just recalling previously-heard knowledge). In addition to the circulating pool, there is also something called the marginating pool. The marginating pool consists of WBCs in sites other than the blood. Most references indicate neutrophils migrating from the circulating pool to the marginating pool and vice versa. For listeners whom don’t have a medical background, neutrophils are a type of WBC typically activated mainly due to bacterial infections. These granulocytes contain certain enzymes which “pop a cap” in bacterial intruders to the body. Additionally, in allergic reactions, the body double times WBCs called eosinophils for activation; in parasitic infections both eosinophils and basophils may play factors. With all of that being said, the marginating pool of ALL WBCs exists. WBCs migrate to tissues, organs or other sites outside of the blood to battle foreign invaders and other vectors unknown to the individual’s immune system. Seeing as though BALs minus secondary bacterial infection in severe cases of Covid-19 result in lymphocyte infiltration of the lungs and other organs, I feel like the following generalization can be made: Lymphopenia in severe Covid-19 is caused by the extreme demand of infected tissues to attempt to clear the virus; hence recruited lymphocytes from the circulating pool move to the marginating pool in affected tissues where they lie undetected by blood specimen tests. Please correct me if I am dumbing this all down too much or not headed in the right direction. I am sure there may be other factors causing Lymphopenia in Covid-19, but this explanation seems most likely or general in my book.
    When I previously wrote to TWiV, as I mentioned, I took Vincent quite literally by sending my questions and comments to and I did not receive a message back saying that my email was returned from sender. I assumed (never a good idea for a scientist) I could email to the provided address rather than submit through your site. Am I wrong about this? I felt like my questions and comments were intriguing and relevant, so now I am redeeming my self-esteem in my head by self-admitting that my method of submission was inadequate rather than my actual submission being sub-par for TWiV response. I know that the recent responses during these times have been immense and some of my questions were left unanswered. After my two submissions, I listened intently awaiting my debut like an eager puppy, but nothing! I have been trying to salvage my ego by excusing the volume of letters even though you read so many from nonprofessionals outside the science realm. Once upon a time, not so long ago, I thought I was so tech savvy. In reality, I conclude that I must be getting old and you podcast “geezers” (I say that term with reverence and humor) apparently understand some technology much better than younger generation users such as myself. I am never really surprised when I am determined and found to be completely wrong unexpectedly as this is the essence of science. If you respond to this submission, I would gladly resubmit a shorter revised version of my previous submissions via the website link per your guidance.
    Thank you for help and knowledge to all us strugglers during these always grey, never black and white times! Confusion has been my common theme no matter how much I think I know lately. Every result medical lab professionals put out for SARS-CoV-2 specimens are somewhat questionable due to possible false negative and false positive test results for both PCR and serum antibody tests. Meanwhile, we are left to interpret so much of grey area for providers whom order the tests. In all honestly, I feel symptom-based medicine is a more accurate diagnosis than inundating labs short-staffed with tests. The ASCLS letter submitted on TWiV 637 hits my heart to the core and I was aware and fan of it many months ago. With so many amazing colleges in my great state of Massachusetts, the reality for my profession is stark! There is only 1 college which produces a bachelor degree level medical lab professional (UMASS Dartmouth). Throughout the country, it’s the same widespread case. The cost of educating us is too much for colleges nor does the pay doesn’t pan out usually to equal that of 2-year degree nurses. I highly suggest you all read that previously shared ASCLS letter thoroughly rather than skim because it’s so relevant and important to understand the crisis of what medical labs are experiencing in the USA now and in the near future, especially with this pandemic. 70% of medical doctor decisions are based off of lab analyses as the letter indicates. Medical diagnoses of patients will not be able to continue with the continuous rapid rate of decreasing graduates and retiring rate of professionals in my profession.

  6. Michael Hodges Jul 11, 2020

    Your response about CDC saying testing has not been proven to help therefore we can not recommend this intervention …. reminds me of one of my favorite papers. It involves parachuting and evidence based medicine. Check out the full paper. I have copied the abstract below. Its hilarious – except its madness. Captain Yossarian once said “Whoooo… That’s some catch, that Catch-22”.
    Michael Hodges, MD – avid listener and clinical virologist (say Hi to Chuck). Check out self replicating RNA vaccines in development.

    BMJ VOLUME 327 20–27 DECEMBER 2003
    Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials
    Gordon C S Smith, Jill P Pell

    Objectives To determine whether parachutes are effective in preventing major trauma related to gravitational challenge.
    Design Systematic review of randomised controlled trials.
    Data sources: Medline,Web of Science, Embase, and the Cochrane Library databases; appropriate internet sites and citation lists.
    Study selection: Studies showing the effects of using a parachute during free fall.
    Main outcome measure Death or major trauma, defined as an injury severity score > 15.
    Results We were unable to identify any randomised controlled trials of parachute intervention. Conclusions As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomised controlled trials. Advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational
    data. We think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute.

  7. Peter Doering Jul 11, 2020

    Dear Dr. Racaniello and the TWiV team –

    At the end of this TWiV you encouraged us to ask questions. Please forgive my ignorance but here goes…

    We all know that DNA is the “universal code of life” common to all organisms from viruses to giant redwoods. We also know that the human body is crawling with all kinds of bacteria, viruses and who knows what other microbes. And so my question is, when you take a nasal swab to sequence the DNA of a particular virus how do you separate out the G’s, C’s, T’s and A’s of the virus from the G’s, C’s, T’s and A’s of a bacteria from the G’s, C’s, T’s and A’s of my own cells?

    In other words if DNA is simply a string of G’s, C’s, T’s and A’s when you’re trying to sequence the DNA of a particular organism how do you know you’re not including the DNA of thousands of other organisms? Thank you for your time.

    • Peter Doering Jul 12, 2020

      P. S. Perhaps you could dedicate a TWiV to describing in detail the laboratory protocols used to isolate an individual strain of virus and then how you extract the DNA (or RNA) from that virus and sequence it into its individual G’s, C’s, T’s and A’s. Thank you.

  8. The question arose that touched on how a vaccine strategy is designed, and why one might seem better than another. Perhaps patent issues weigh into this. Technological capabilities and time to market could be other factors. It might be of value to have a patient attorney, or/and someone from industry on the show to discuss this?

  9. John Hurliman Jul 14, 2020

    Hello twig. I really enjoy your podcast. I know that the dairy industry has been vaccinating there cows for bovine corona for quite some time. Do we know if any dairy people have been infected with COVID or not. If not could there be an immunity response from the vaccine they use. Thanks for your great work