Michele writes:

Hello all,

I am a veterinarian in Montana and this is my second request for you to have a veterinary infectious disease or other veterinary expert on the podcast. Mostly, it is because I still think veterinarians are very interesting people! More recently, it is because the reports of spread of SARS-CoV2 to animals (and possibly from animals in the case of mink) are mounting, and we can learn more by evaluating how animals are affected. This pandemic is a perfect example of the importance of the One Health approach. One Health strives to unite human medicine with veterinary medicine, in an effort to advance both fields, particularly where zoonotic diseases are concerned. 

In cats, there was an effort in the past to vaccinate against FIP-causing coronavirus, and some studies suggest that this resulted in antibody-enhanced disease, with more cats developing FIP after vaccination. For this reason, I’m hesitant to volunteer for a SARS-CoV2 vaccine trial and will wait to see what the outcome is for COVID-19 patients. Do any of you have this same concern? 

I would also be interested to know what you think of this; what a cool program!


Lastly, I think Vincent would particularly enjoy the following link to my favorite Ted Talk. I think of this each time he gets worked up by somebody claiming that testing, tracing, or other control measures haven’t been implemented because of lack of funding or other excuses. I believe TWIV 648 had a particularly good rant that brought this to mind. 

Thanks for all you do to share valuable information. Every time I listen to a recent episode, I feel like MT is an alternate universe, compared to the reality described in the podcast. Being in Montana, we have been fortunate to be less affected by SARS-CoV2 than in most other places in the US. However, this has its own drawback in that now more people think the pandemic is either a hoax or the risk has been overblown. This is especially true because most people here don’t know an individual firsthand that has been negatively affected, other than economically. People are being less vigilant, with fewer wearing masks and more participating in high risk activities. Of course, there are also those that never believed the virus was cause for concern. I have been very surprised and disappointed to find that too many of my veterinary colleagues either feel that “We are all going to get it anyway” or it is “Just like the flu”, and so there is far less risk reduction than I believe there should be at my place of employment. I worry that it is only a matter of time before MT experiences a very abrupt shift in our epi curve and am frustrated that the general public (and those in my circle that should know better about infectious disease) are content to just to let it happen. Le Sigh

Stay grumpy, except maybe not with your colleagues. I really appreciated Vincent’s recent apology to Dickson and felt it was warranted. Maybe the new tagline should be Just Do It!

Just Do It!

Michelle the Vet

Tom writes:

Vincent, although virology is far outside my rather bottlenecked wheelhouse, I enjoy listening to TWiV now and then, especially when my brother-in-law sends me segments he thinks I might like. A good example of such was today’s discussion of far-UVC, which looks very practical and widespread-able. I wanted to send you this photo of California Sycamore (Platanus racemosa) blossoms at our house in very early spring, before covid really hit us. Maybe this photo will change the origin story of covid? Respectfully,


Doug writes:

Dear Professor Spindler,

I eagerly await TWIV new episodes and particularly enjoy your contribution. You are always very thoughtful and reasonable. I greatly appreciate your time and effort during the last 8 months. Hard to believe I have now listened to more than 80 episodes! Up early today, I already finished today’s episode.

As a busy surgeon for 25 years, I believe I have found a reliable solution to prevent glass and goggle fogging which is far less traumatic to the delicate skin around the nose and eyes. A piece of this tegaderm (which we primarily use to cover skin incisions) placed over the bridge of the nose reliably blocks vapor from fogging glasses. I found this link and was pleased to see they are reasonably inexpensive (~$0.50 Per use). Using these will also discourage fussing with adjustments of the mask. Hope you find this helpful. 

 Best wishes,

 Doug Dahl

Karen writes:

Thanks for the information – I recommend your podcast to all of my DO and PA students in my class materials.  I listened with interest to the “behind-the-ear” real estate problem. I wear glasses and earrings, which also cause issues with the mask. I suggest altering the mask elastic to go all the way around the head, rather than behind the ears. This modification works really well. Also, for dealing with glasses fogging – try body tape (the stuff that models and beauty pageant contestants use to keep the bathing suits from riding up, and the sleeveless ball gowns from slipping. It is basically 2-sided tape that will help the top of the mask seal better – no leakage.

Regards, Karen Duus

Karen M. Duus, Ph.D.
Associate Professor, Microbiology & Immunology
Basic Sciences Department
Touro University Nevada College of Osteopathic Medicine
Henderson, NV 

Paul writes:

Referring to E 665: Someone wrote in saying that they just gave up on their hearing aids in favor of mask wearing because of the lack of “real estate” behind the ears. There is a better way! You don’t have to give up your hearing aids. Use a mask that routes the elastic over the back of the head and behind the neck. I’ve been using these since the beginning. I’ve made dozens of 3-ply cloth for myself and others. Complete instructions are here:


Note that this method assumes you have a sewing machine and can use it at least as well as I can, that is, you don’t have to be all that good.

Thank you so much for TWIV. You have inspired me to “up my game” in terms of COVID-19 precautions. I thought I was doing good but you got me to do better.


Brian writes:

Dear TWiVerati,

I am not sure if you have seen this yet, but it looks like a company (hVivo) will conduct human challenge trials for SARS-CoV-2 in the UK beginning in January. I am sure you are as concerned with this as I am and I hope you will discuss it on TWiV:



Brian in Seattle

Chris writes:

Dear TWIV All Stars,

I am a recently retired radiation oncologist who discovered TWIV thanks to Episode #640 with Michael Mina. I had read his opinion piece in NY Times a few days prior Episode 640, but was unconvinced due to the sensitivity issue and the potential for false positives.  Drs. Racaniello, Condit, Spindler, and Barker’s increasing enthusiasm and agreement with his approach mirrored mine. You asked every question that I would have asked. It pains me to hear that the FDA won’t bless these public health and public protection screening tests. I also enjoyed your discussion today with Prof. David Brenner, whose work I’ve been reading in the radiobiology literature for many years. It is exciting to see people in different disciplines interact and learn from each other. 

I want to thank you so much for your efforts on behalf of us, your listeners, and for promoting science education/communication. It’s important that the public understand how scientists think, how the scientific method works, and how the best scientists are humble, how they must let go of their hypotheses if the experimental data does not bear out the explanation, and how they must be able to pivot to alternative hypotheses.

My scientific mentor once told me that the half life of scientific knowledge was 2 years. That was back in 1971 when booking it at the university library with textbooks, review and and journal articles was the way to begin to understand the landscape of the biology to make  hypotheses and design experiments. Now with the explosion of good and bad science via the internet it is no surprise that informed wisdom changes much more rapidly. 

I have two questions for you. The first relates to this paper in the Lancet e-published on 9/17/20 on an automated rapid point of care euthermic PCR assay that the British government is going to use to increase testing in the UK. I send along a pdf of the paper. From the supplemental material not in the pdf, the time for sample preparation, RNA extraction, and amplification/automatic determination is about 40 minutes with the results going into a cloud based database and then back to the patient’s EHR or smartphone. There is 100% congruence with legacy PCR assays. The engineering is elegant but the per test cost even without amortizing the non-consumable portion of the device is not going to be in the $1-10 range necessary for FREQUENT testing. So, at least to my mind, this is not going to work to open up schools and commerce. What do you think?

My second question relates to the ultimate utility of rapid, cheap, and frequent antigen testing. I listened to Professor Michael Osterholm on his own podcast and then as the Sigma Xi scientific honor society Annual Orator. He was not enthusiastic about rapid testing as an important component in decreasing the burden of  Covid-19 morbidity/mortality. His argument is that the frequent home-based testing is not going to make a big difference, say, compared to an effective vaccine, antivirals, social distancing, hygiene, and masking to open up society. Those who would use the test, the locked down “worried well” and their children, wanting to go back to work or school, already have a low infection rate. Socially disadvantaged populations won’t get sufficient access to these home based tests and this will exacerbate health inequity. Most importantly, the (large) segment of the population that is minimizing the severity of the illness is not going to take any test. I send along a NY Times article that summarizes the nay-sayer opinion. It seems to me that by requiring frequent testing prior to attending school, going to a restaurant, going to one’s essential job (food handlers, delivery people, etc) one could quickly tamp down transmission. Am I missing something?

Thank you once again for all of your work and for your sanity and knowledge.


Christopher Rose MD FASTRO

Nancy writes:

Hello my friends at TWIV,

Thank you for your podcast that educates scientists and medical personnel.  I am not a scientist but a curious retired special education professor who has a question about transmission of SARS-CoV-2 as well as other viruses.

I understand that the SARS-CoV-2 virus is transmitted in the air in either droplets or aerosol and can be found on surfaces. Thus, you had your interesting conversation about Far-UVC lights.  I have wondered for a while about the droplets/aerosols falling to the floor.  How long do the viruses last on the floor?  Do we walk on the viruses and carry them into our cars, homes, office, and into patient rooms at hospitals?  What does science say?


Keene NH