Lisa and David write:

Here in Chattanooga, Tennessee it is fair and 75 degrees tonight.

In TWIV episode 648 you indicated that a program on back to school with COVD-19 was in the works.  My husband and I are surgeons and when the schools were shut down and the hospital discontinued elective surgery, we busied ourselves helping our community and our hospitals get the supplies they needed.  We designed a gown of which hundreds of thousands have been made, helped design disposable biodegradable face shields which are in use throughout the country including NYC, and decided the bigger task at hand was helping laypeople mitigate risk as they returned to work.

We started an advisory group with the plan of mitigating COVID-19 in the workplace and to have a plan to deal with the workforce contracting COVID-19.  We now participate in medical panels for universities, businesses ranging from a few employees to large companies with tens of thousands in the workforce, city task forces, county task forces, and local schools, learning from each experience and increasing our fund of knowledge through regular reading and, of course, regular TWIVing.  For us, TWIV is like journal club and Daniel Griffin’s weekly spot is like a good M&M!

We have been fundamental in the reopening plans for one county school system, two large private schools, and one major midwestern university.  Having interacted with the school boards, headmasters, principals, athletic directors, school nurses, high school sports state governance committees, and teachers, we have a large fund of experience that can contribute to your episode of “Back to School with COVID-19”.  

All of the schools that we have counseled have a strong, on-campus testing plan.  We do not believe that you can return to school with successful, regular attendance without testing.  As a matter of fact, Vincent stated that schools would never be able to put the equipment in and get the lab certificates to allow testing–these schools did just that!  They got a CLIA certificate, procured rapid testing equipment, and one school even has its own rt-PCR run by a Ph.D. virologist (she can do 450 tests a day).  The university with whom we are involved is using saliva-based rt-PCR testing with 24 hour turnaround.

See, Vincent?  It can be done if you put your mind to it!  Let us on the show–we’d love to share our community’s experience.

We will continue to listen with our TWIV hoodies and tshirts on regardless.

Most sincerely,

Lisa A. Smith, MD, and W. David Bruce, MD

Lisa A. Smith, MD• Medical Director, Return to Work
Chattanooga, TN

Tom writes: (for Daniel)

Dear TWIV,

My father was infected with SARS-CoV-2 at the end of May and had a relatively mild second week before suffering an AFIB episode the beginning of the third week. He was hospitalized and had an initial positive PCR and two days later tested negative. During the fourth week he had a cardioversion procedure which put the heart back in sinus rhythm. This week it was discovered that he was again in AFIB. He was again hospitalized and given a second successful cardio version procedure.  My question is: What is the current understanding of The relationship between AFIB and COVID-19, and what course of treatment has been successful on an evidence or observational standpoint?

All the best, Tom

Dana writes (for Daniel):


I am a pediatrician in Ft. Myers, FL, writing to you on behalf of my group, Physicians’ Primary Care of Southwest Florida. School here is starting Aug 31, and we want to have criteria for patients returning to school after mild viral symptoms. We feel that with mild viral symptoms, resolution of fever, AND a negative rapid antigen test, the child could be deemed non-infectious and be cleared to return to school, rather than waiting out the 10 day quarantine every time there is a runny nose, which would keep many children out of school and parents out of work. 

Based on the information you have provided on your podcasts, even though the sensitivity of rapid tests is not perfect, it probably detects those children who are likely to transmit infection well enough to be used  as a screening tool to send children back to school. 

I’m guessing every pediatric group and every school district is going to be faced with this exact challenge once school reopens, and it would be great to have national guidelines based on science. We would love to know your thoughts. Thank you so much in advance, and for all the excellent informative podcasts. 


Dr. Dana D. Crater, MD

Physicians Primary Care, Pediatrics

Michael writes:

Hello Professors at TWIV!

My name is Michael and my son is a graduate student at the University of Illinois at Urbana-Champaign.  I’ve been recently listening to your podcasts and was very pleased to hear you mention the work going on at U of I with their new saliva based test and the protocols put in place for students.  My son participated in the testing trials over the summer and was very impressed with the ease of testing and the quick turnaround of results (within 24 hrs).  The twice per week testing protocol is very welcome news to us parents and I’m hoping other schools follow suit. 

I’m forwarding a couple of announcements to you as the test they developed just received FDA emergency approval and is now being considered for broader use here within the state. 

Please keep up the good work and stay safe.


Margaret writes:

School Nurse from MA reaching out… 1st, I love your podcast.  You are all so, so brilliant.  I understand a solid 50% lol.

My question is about last week’s show -talking about testing in the tri state, the 50 rapid testing sites…  that’s a spit test right? 

As a district, we’ve been quoted $50.00/person testing with the Broad Institute to test all kids/staff 1x = 200K.  Are there other options I can introduce to my admin team?  Any advice or where to go would be extremely helpful.  Thanks for your help!  Stay well!!


Meg Jensen, M.Ed, BSN, RN 
School Nurse
Peabody Concord Middle School

Leigh writes:

Dear TWiV Maestros,

A microbiologist friend of mine shared with me your podcast a few weeks ago and I am now officially hooked.

I am but a humble cartoonist with a huge knowledge gap on the subject of virology but I feel by listening to a group of experts that gap is slowly but surely filling up.

On a professional note I had never drawn a virus until the current pandemic and doubt not many other cartoonists had either but it has provided some real inspiration during a time when we can all use more laughs.

I’ve attached some pandemically-inspired gags*. Hope you enjoy them!

Be sure to laugh a lot…I hear it’s good for the immune system. (Though this claim has not been verified by the FDA.)

Cheers and thanks to you all!

Leigh Rubin

P.S. If you re looking for some more laughs I invite you all to a live virtual event hosted by

the Deadline Club/New York City chapter of the Society of Professional Journalists on August 25.

(It’s free and worth every penny!) Yes, there will be more virus cartoons during the event.

For details see:

*Viruses in petri dish appear larger for comedic affect.