Lainie writes:
Hello TWIV Panel,
I have been listening to TWIV regularly since my mother and father-in-law recommended you this Spring. I am a physician assistant in Knoxville, TN. I specialize in primary care and infectious disease, primarily serving individuals living with HIV.
TWIV is my one and only source for evidenced based information concerning SARS-CoV-2. I recommend you to friends, patients, and colleagues. Thank you for all you do!
A few TWIVs ago someone commented that the fact that Dr. Daniel Griffin has not acquired a SARS-CoV-2 infection this far into the pandemic is “remarkable”. Now, I presume that part of his good fortune has to do with his judicious use of PPE, just as another panelist remarked during your show. So here is my question:
How concerned should health care professionals be about SARS-CoV-2 exposures at work provided we have adequate supplies of PPE and are donning and doffing our PPE appropriately? I probably do not need to ask this, but is there any reliable data available to support the answer you provide? I am fortunate that my office quickly transitioned to doing a lot of our appointments via telehealth, but as the pandemic continues to evolve I’ve been seeing more and more patients in the office. I feel reasonably safe since the patients are all masked, I’m wearing the appropriate PPE, and our office has instituted other safeguards concerning cleaning, disinfecting, social distancing, etc. But I am interested in hearing your opinion on this matter.
I have another question. I tried to sign up for a vaccine trial based out of Vanderbilt recently, but was rejected because I am currently breastfeeding my 1 year old daughter. I hope to continue breastfeeding her for the next 6-12 months so she can benefit from my antibodies. This makes me wonder if any of the SARS-CoV-2 vaccines will be approved for breastfeeding moms. Thoughts?
Warm Regards,
Elaine Heine PA-C
Associate Medical Director
Choice Health Network
Jason writes:
Dear TWiV Team,
You are truly awesome. I love the show and recommend all my friends listen to you. I also just received an order from Cafe Press of TWiV merchandise. Rosh Hashana is approaching and it is traditional to say a blessing (shehecheyanu) as part of celebrating the holiday. On the second night it is traditional also to wear something new as an additional reason for saying the shehecheyanu blessing. I can think of no better clothing to say the shehecheyanu blessing over this year than my TWiV gear. I will also note that according to Jewish law one only says the shehecheyanu blessing over important garments. I did not ask my Rabbi but in my opinion the TWiV gear qualifies.
I am writing specifically with a question for Dr. Griffin. I know you have discussed the issue with false positives in a place with relatively low prevalence of COVID-19 such as New York. Last week, there was a question from someone who wanted to visit an elderly father after the person’s mother passed. Dr. Griffin spoke about the possibility of getting a rapid test right before the visit. Would you speak about any danger there would be about a false negative on the test? Is that less of a concern in a place like NY where there is currently a relatively low prevalence? I presume you were recommending a test that would return very quick results and the visit should happen in a period of time as close to the test as possible? Is there any evidence on the interval of time from a person being infected to the person showing up as PCR positive?
Thank you so much for such an amazing podcast. Please listeners, support TWiV!
Sincerely,
Jason
Tony writes:
Thank you to Dr. Griffin for his weekly updates and, during episode 663 in particular, his rundown on vaccine trials. Am I correct to assume that if someone enrolls in a trial, that person would be prevented from getting a different vaccine (let’s say, one that’s been approved while the person’s trial is ongoing), 1) to preserve the validity of her trial participation and 2) because of possible negative interactions between the two vaccines? Could taking one vaccine possibly make a different vaccine ineffective? Is this something a person should consider before participating in a trial?
Thanks for all you do from an interested and fascinated layman,
Tony
Leah writes:
Dear TWIV Superstars,
While I love hearing all the lovely haikus people submit, I think I’m better suited to contribute an irreverent limerick! So, here you go:
There once was an anti-masker,
Who was also an anti-vaccer.
He got Covid-19 and was never more seen!
And nobody missed the damned bastard!
Believe it or not, I’m actually a compassionate person and I certainly don’t wish Covid-19 or any other disease on anyone regardless of their personal persuasions. Nevertheless, in this crazy time, you’ve got to find a laugh where you can, right?
Thanks for keeping me and so many others well informed!
Stay Grumpy,
Leah from Oak Ridge
Perry writes:
Sheffield, 9 Sep 2020
Hi TWiV Team,
Hello from a 17 degree C Sheffield in UK.
Very good news: in what I believe is possibly the first country leader announcement, UK PM Boris Johnson announced on live national press conference, 9 Sep 2020 (https://youtu.be/kzOnmQvU2CU), UK strategy is to have daily mass rapid testing, perhaps by saliva.
Someone in UK government is listening to Michael Mina!
Admittedly this is some months away, the technology is coming along but not quite there yet.
In the meantime we are limiting gatherings to 6 people with some exemptions.
Keep on TWiVing!
Thank you.
Best regards,
Perry
Martin writes:
Hi,
This may be of interest.
I hold no brief for these companies and I know absolutely nothing about them, but three companies in Wallonia (the southern, French-speaking part of Belgium) claim to have developed a new rapid test that may be of interest to you. It seems to test for past infection, so may not be relevant to the needs of the educational sector, but I don’t feel qualified to judge that.
https://unisensor.be/en/news/45_covid-19-new-rapid-test-marks-a-world-first
Keep up the good work!
Martin (Brussels)
Rob writes:
Hello people of TWiV,
I am Rob from Maryland and it’s hot. I wanted to start with one of the more existential questions that has emerged to me during this pandemic….
How do you keep your glasses from fogging up when wearing a mask???
I started looking for answers regarding this in March and I have tried all the crackpot suggestions; shaving cream, regular soap, dishwashing detergent. I have tried breathing sideways, breathing downward, putting the mask tightly around my nose and under the glasses. It’s all BS! I have to take my glasses off every time I go inside somewhere. I am not blind or anything, but it is really annoying.
Secondly, I was devastated when I got an email from JAMA saying they were declining to include a comment I made on a paper they published a few days ago on their website. The paper is about vitamin D status and COVID-19 test results.
Some of the issues I pointed out:
- COVID-19 is not tested for or transmitted, it is the disease caused by the virus, SARS-COV-2, which is tested for and is transmitted. How can a scientist mess this up in the title of the paper?
- There have been tons of studies that have reached the conclusion that vitamin D “MAY” have some association with infection rate and/or disease outcome, but not a single randomized controlled trial to prove anything. Why make a big deal about another study that suggests an association, but proves nothing?
- The study uses previous vitamin D levels from “sometime within the past year” to determine what category the subjects should fall into: “likely deficient”, “likely sufficient”, or “unknown”. With that rock-solid science, shouldn’t they all be in the “unknown” category?
- Saying, “These findings appear to support a role of vitamin D status in COVID-19 risk”, seems like quite a stretch when you look at the actual study. They just assume that everyone acts the same in attempt to control for vitamin D level? Vitamin D level was the only difference in these 489 people? There’s no difference between Bob the biker that went to Sturgis and the RNC and a Labor Day party, versus Vinny the rackinyeller that stays home?
But what do I know? I am just a computer science graduate student and as we all know, if your profession has the word science in it, you’re no scientist. Anyway, I was just annoyed seeing people make a big deal about this, as if we found a cure or something. Nothing against JAMA, they seem to be well-organized and well-managed. I am still uncertain as to why they declined to include my comment though. Was it formatting? Could they highlight my work? Was it because I labeled my primary affiliation “Common Sense” and my primary source “TWiV”? Who knows…
Love what you guys do. I randomly saw Vincent on a Twitch stream back around March talking about the virus. He sounded like he knew what he was talking about, so I searched around and eventually found TWiV. I have been listening ever since and I am very appreciative of you all and everyone you have on. Thanks and stay safe.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2770157
John writes:
Hello TWIV band
I would like to present my perspective on the vaccine debate from TWIV 660
First the science on vaccine risk. Let’s look at the science of the 1976 flu vaccine. The vaccination campaign of 45 million doses was associated with 450 cases of Guillain-Barre syndrome resulting in 25 deaths. On average 1 in every 100,000 patients experienced this complication, and less than 1 per million died.
A complication of this magnitude is unfortunate, but since the vaccine benefit is usually estimated at 40,000 flu averted deaths per year for a 60% coverage, the benefit exceeds the risk by more than 1000 to 1.
Moreover, It is unlikely any phase 3 trial of 30,000 subjects would identify a complication with a rate of 1:100,000 no matter how prolonged.
A trial with clear early statistical evidence of efficacy, is statistically unlikely to be negative in later stages.
I would conclude:
1. Vaccines have been very safe, and the ratio of benefit to risk only increases with a more dangerous pathogen such as SARS-cov-2
2. Adverse effects, particularly those with characteristic features such as Guillain-Barre are easily identified and elicit disproportionate anxiety based more on fear of the unknown, than on real danger.
3. With vaccines, like all preventative medicine, their benefit manifests by the absence of disease, and invites the conclusion they were unneeded.
4. Public confidence is low in part by failure to communicate a consistent message regarding true vaccine value.
5. There is a substantial anti-vaccination movement in our country. These are not evil people, but they are not likely to support any vaccine program no matter how well performed. We should not make their conversion our goal.
6. I am a physician out there fighting the good fight, and I am hoping the miasma of misinformation on SARS Cov-2 vaccine does not prevent my timely vaccination. None of us wants to be a martyr to our unconscious biases.
Yvonne writes:
https://www.cdc.gov/flu/prevent/adjuvant.htm
Hi TWIV,
Dense smoke and 78F! (California)
These (go to link) are the adjuvanted flu vaccines licensed in the U. S.
Thanks so much for TWIV!
Yvonne
Point Richmond, CA
Bob writes:
Wow, TWIV 660 gave me pause, a little late, as both my wife and I (and two different neighbors) are on the Moderna phase 3 trial. (I think I got the placebo, but the second shot will tell the tale). Dr. Griffin has me worried now… but I knew the job was dangerous when I took it.
I agree with all the comments you all made about how bad it was for the CDC to have tried to cover for Trump’s magical thinking, but I think it could be bad no matter what happens. If he tries to push a vaccine early, and the grownups resist, then the election happens and (we hope) Trump loses, then in December, or worse January, right after the inauguration, the data does show that the vaccine is OK, it is going to look politically motivated in reverse, causing a whole section of the population to distrust the CDC and FDA even more, right when we will be trying to convince them that they need to get vaccinated.
I for one no longer want to live in interesting times.
Love the podcast!
Bob
Mark writes:
Dear TWiVers
Despite Vincent’s best attempts to alienate me in previous grumpy emails (he called me “mean”!!!), I still enjoy TWiV greatly. It helps that I found a Chrome extension that translates “grumpy” to “tolerable”. Only affects Vincent, strangely.
I’m a medical practitioner of 37 years experience in Australia. It’s 18°C and sunny today in Sydney, with a high chance of bushfires through the summer.
The attached PDF of Australia’s premier newspaper to doctors, Australian Doctor, will probably interest you. It is distributed free ONLY to Australia’s 50K registered medicos, which is why I had to create a PDF for you to access.
An Australian Gastroenterologist, Tom Borody, claims to have developed a “triple therapy” to effectively “cure” COVID-19. Ivermectin, doxycycline and zinc picolinate. I await details of his regimen, access to which requires that I phone a pharmacy in his suburb near his Centre for Digestive Diseases (CDD.com.au).
Before you laugh and discard it, I do note that Borody is the doctor who invented “triple therapy” for gastric ulcers (helicobacter research in Australia was new at that time), and pioneered “fecal matter transfer” (FMT) for C. difficile worldwide. He is no dummy. He has met with two US Presidents (a feat that has been radically devalued in the past four years!), and lectures in the US regularly. I am unsure of the provenance of his professorial title.
I listened to your TWiV with your expert on ivermectin ( I forget her name, but she was TWiVerific), and it seemed to be a drug effective only at concentrations unachievable in real life. Orders of magnitude higher than the FDA approved dose.
I’d appreciate your thoughts on the claims, and whether publishing this to the wider medical profession is sensible or potentially dangerous.
Cheers and continue in appropriate grumpiness to set the SARS CoV2 agenda.
Mark
Dr Mark Donohoe
Mosman Integrative Medicine
He sent: https://drive.google.com/file/d/1_jzdcILQcz-bXTmwHkKIaFsCi2v2-zvy/view?usp=sharing
Tim writes:
Hey TWIV team,
I have the opportunity to sign up for a COVID19 vaccine trial that is starting soon in Germany. I don’t have all the information about it yet but I am excited to hear the upcoming episode about it. I like listening to the podcast because you get to hear some positive news about it all rather than all the negative stuff on the news.
I was wondering what happens if you are in a trial and a successful vaccine is released. As a healthy 20-something I don’t feel as at risk as others might, and I realise I wouldn’t get the vaccine first anyway. But if the trial is 12 – 14 months long does this mean you could end up with a placebo/ineffective dose and not be allowed to get a proven vaccine because you are participating in a trial? Maybe this is too optimistic in terms of perspective on a vaccine being released?
I look forward to hearing the episode to see what else I should be considering!
Thank you!
Best wishes,
Tim
Sam writes:
Hi Twiv Team,
Wanted to say thx for supplying the general public with a good analysis of publications coming from researchers in the realm of virology. It’s not always perfect but 99% is spot on. I’ve come to trust the analysis from your team which is big because I’ve been a big skeptic since I was age 13. When the FDA ran its first series of closed door sessions that led to the reclassification of OxyContin that led to the opioid crisis, I stopped trusting the government at face value. That led me on the journey set off by one of the best pieces of advice my father gave me. “If you want to master a subject you have to read all the footnotes.”
Since that time, I’ve always delved into the source materials of any news article’s science. Purely on semantics I’ve seen time and time again journalists twisting words or just plain out right misunderstanding the research printed in a science publication. Although I’m still a novice with only a thousand or so readings under my belt over the past two decades, I always wished there was an outlet that would quickly summarize the publications I’d come across. Especially ones that I could trust as unbiased, or at least one I could trust with a non-facetious bias. You are that dream come true. Thx for all that you do.
A Fan,
Sam
P.s. -been a fan B.M.M. (Before Michael Mina), please don’t let the new celebrity grow any big heads, lol.
LOL
Richard writes:
Dear Team TWiV,
Today, Labor Day, TWIV showed up on my Google News feed!
Could be AI, but I think it’s that you guys are great. Keep up being the most reliable source on virology, in general, and things COVID, in particular.
Please pass it along that I have been using the other Racanyellism, “that’s excessive!”, relating to some of the protective protocols for COVID transmission and the heat in Southern California (121F in the San Fernando Valley Yesterday)
Rich
Richard Schoenbaum, DDS
Culver City, CA
John writes:
A sense of humor at NCBI? (otherwise how on Earth (or beyond) did this wind up there?)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7358766/
3.2. Detailed analysis of COVID-19 epidemic
We now analyze all reliable genetic, epidemiological and geophysical and astrophysical data. This leads to the alternate hypothesis that COVID-19 arrived via a meteorite, a presumed relatively fragile and loose carbonaceous meteorite, that struck North East China on October 11, 2019. This is at odds with the main stream expert “Infectious Disease” opinion of traditional person-to-person spread of an infectious endemic disease such as, for example, Cholera (Vibrio cholerae).
—
John
Joseph writes:
Dear TWiV:
I am an old imunoglobulin savy researcher who has made many polyclonal antisera and used them to identify proteins in my research.
I listen to all TWiV podcasts and I have a question over a point that Christian Drosten made.
He suggested that COVID-19 virus may be coated with immunoglobulin secretion in the nose and expel such preheated virus when they sneeze.
In that case it brings up for me the question of IgA, which I have heard nothing about in any past discussion by anyone.
Is there any rationale by which IgA, which in my ancient reading were often associated with secretion from eye, mouth and nose, could be a strategic help in fighting COVID-19.
Keep TWiving.
Joe,
-·. .· ·. .><((((º>·. .· ·. .><((((º>·. .· ·. .><((((º> .··.· >=- =º}}}}}><
Joseph G. Kunkel, Emeritus Professor
Biology Department
UMass Amherst
Silvia writes:
Dear TWIV team,
As field service personnel for lab diagnostics companies such as Abbott and now Euroimmun, I’ve been following your terrific podcasts for quite a while – long before Covid-19.
However, now I dare to make a comment regarding Christian Drosten‘s answer to your question „what does Germany do differently“ – because he forgot (or took for granted, which it is) to mention a very important aspect :
although it definitely is not perfect at all, we do have a truly SOCIAL healthcare system in which EVERYBODY can receive medical care if they wish to, even people who don’t have money to pay into it at all.
That overall makes a big difference from the US – the place which my husband (a parasitologist working for the state of Bavaria) and I so much love to travel to but which scares us more each time, because the even widening gap between poor and rich is so cruel and so many people are poor although they are working so hard.
Of course this is no direct influence on the pandemic, but as Corona does in so many ways: it reveals what has been bad already, anyway.
Why can’t one of these countless billionaires in the US start off some true „Obama care“ or at least found a company health insurance fund ?!? This would help everybody in your country.
Warmest regards and thank you so much for your unique podcasts, Silvia
… from a small village close to the Austrian border which unfortunately was (and our county still is) one of the hottest hotspots in Germany and whose beloved neighbour (71, f, very small pension) could survive a heavy Corona infection in March due to full access to medical care at no charge
Willie writes:
Dear Communicators of Science (true scientific method followers who talk and share info),
I heard this on Rachel Maddow, msnbc, last night, 20200916, –
6 million dead in the USA from SARS-CoV-2 if the current, do-nothing, ‘herd immunity’ followed.
Do calculation estimates on death rates from covid-19 include re-infections OR just initial exposure?
thank you very much, everyone at twiv tv,
for all you do to share vital, life-saving, scientific research news on ‘da corona’ pandemic
(even tho most of us may have a 6th grader’s vocab, thanks for using and explaining proper terms)
Willie in Dallas, TX
Ruth writes:
Hello, Twivvers
One item discussed was that a person should receive the vaccine against SARS-COV 2 with all doses of the series being the same product, and how that should be tracked.
Having worked for over 20 years in pediatrics, I am familiar with my state’s vaccine database. I believe that most states have a similar system, so we already have something in place to track which vaccine a person was given.
We had the same issue when the first HPV vaccines became available, from two different manufacturers, with the recommendation that you complete the series with the same product for all doses.
Perhaps this has already been brought to your attention by another faithful listener.
Thanks for your informative and entertaining podcasts.
Ruth