Cliff writes:

A blurb today in my local paper suggests that according to CDC guidelines persons with severe cases of Covid-19 disease ought to isolate for 20 days.  Over the past few podcasts Daniel Griffin suggests (as I recall) that SARS CoV-2 positive patients are recommended to isolate for 10 days from the first positive test and hospitalized patients require 2 PCR negative tests before they are released.  Would it be possible to ask him to clarify the next time he is on?  Like many people I don’t know what protocols are true or false.

Christina writes:

Dear TWIV and Dr. Griffin,

I recently dealt with my family’s first bout of cold symptoms in a pandemic and wanted to share the experience to get the perspective of Dr. Griffin on two key questions: should I have sent my kids to school and how does the common cold spread so easily?

First, a bit of background. I live in a small town in Northeastern Connecticut, which has had a relatively low prevalence of Covid-19 (27 cases since March; total

population approximately 4,200). Our public school is preschool through 8th grade with a total of 400 students. The school is open full-time with all the standard precautions in place-masks, partitions, distancing, windows and fans to increase air flow, etc.

I have two children – a kindergartener and a fourth grader. My kids woke up on the Sunday of Columbus Day weekend with congestion. I immediately realized that the sore throat that my daughter complained of three days before was not a figment of her imagination, but rather the precursor to a viral infection. My immediate thought was, “Do my kids have Covid?”

I called their pediatrician who did NOT recommend a Covid test after I described my kids’ symptoms. Basically they had a stuffy nose, post nasal drip and a productive cough. No fever, no aches, taste and smell intact, breathing normal.

In the midst of this, my daughter recalled that a classmate had been out a few days, which made me think this cold came from school. I reached out to the parent of another classmate and found out that child came down with congestion a few days before my daughter. That child had a fever at one point, so the doctor recommended a PCR test in that case.

My kids got better from the cold within 48 hours, at which time they were due to return to school. I called the school nurse to confirm that my kids didn’t need a negative Covid test to return to the classroom. She said as long as my kids didn’t have a fever, aches, shortness of breath, persistent cough or loss of taste or smell, they did not have to be tested.

So I sent my kids to school, while my husband stayed home from work with a tougher bout of this cold (I remained asymptomatic).

My question to you is… Should I have sent my kids to school without a negative Covid test? My daughter’s classmate eventually tested negative, but the results took four days to come back. Should I have had my kids tested and isolated as a family as we awaited results that could have taken four days? 

My other question is: How is the common cold spreading so easily through my daughter’s kindergarten class when they are doing so many things like masks, etc.? If the common cold can spread so easily with these measures in place, won’t Covid spread in a classrooms just as easily? 

Thank you for your time,


Gene writes:

Hi all

As I’ve said before, love the show.

Did the first patient that Dr. Griffin described on 10/8 suffer from a spontaneous retroperitoneal bleed, central access that was attempted or present that resulted in the bleed in the context of anticoagulant, spontaneous common femoral artery or vein bleeding as the culprit, or something else?



Alan writes:

Good afternoon,

I am a volunteer retired ID physician working with a local University as part of a Covid-19 response team.  We want to do frequent testing of competitive sports teams and also students with higher exposure risks.

We are looking at Abbott ID Now, Quidel systems and also the BinaxNow system. We are trying to see which system Prohealth New York is using for rapid testing and also if a concern of a false positive arises, do you repeat the same test or switch to a molecular test.

Thank you for the wonderful service you provide.

Alan Cohen, MD

Oncorhynchus writes:

TWIV – I have been listening since March when a friend turned me on to your podcast.  Like most of your emailers, I have found you to be a rock of solid information on the pandemic and I very much appreciate the public service you all are providing. So a sincere thank you to the entire team and to your guests as well.

My question is for my brother and his family.  They got antibody tests back in June and my brother, his wife and their teenage daughter all had IgG and the wife had both IgG and IgA.  They had no known exposures and only got the antibody tests because their family physician recommended it before seeing other family members (thanks to you, I knew this made no sense at the time, but that is what they did).  On follow up PCR, no one was positive. In this case it seems it would be a very low likelihood that these are four false positive results?  I should mention, the husband and wife have not been sick this year at all and the daughter had a cold in early March.  They are located in Southern California, so this would be an early case (though they say that the cold went around the school).  Other than the daughter’s brief cold in March, no sickness and no known exposures.  Occam’s Razor would seem to go with the daughter having been infected in March and the parents both having asymptomatic infections.  Fortunately, no one in their cohort became sick after they did (this episode pre-dated contact tracing and PCR test availability in Southern California). So, the question we have is whether it is risky for someone in their situation to also get a vaccine when/if it becomes available? Are the phase III trials doing Ab tests on the volunteers before hand, so we might know if there is increased risk?

Tight lines,


PS. Dickson should appreciate my screen name.

ddd: I love it! It’s the genus name for all Pacific Ocean salmon and US western slope trouts – cutthroat and rainbow. It refers to the male fish in that genus when they develop a protuberance from their lower, and sometimes upper jaw as well, during the mating season called a kype. They use their kype to bite at the vent of female salmonids, stimulating them to release their eggs so the male can then fertilize them. What do you mean, TMI. I live for this stuff!

Wednesday Fish Facts: What causes KYPE in spawing trout? - Fly Life Magazine

Art writes:

Hi Alan,

I enjoy listening to TWiV, and in your last episode (#667) you reminded me of an Air Force Reserve C130A flight that I was on (as copilot) in the mid seventies out of Niagara Falls, NY.

The day before, another flight from our 328TAS squadron had picked up a mission to fly to Brownsville, Texas and pick up some pallets of lunch-boxed screw worms that were about to hatch and transport them over to the Naval Air Station in Puerto Rico to be off loaded onto smaller planes to be dropped over cattle fields.

The screw worms had been radiated and were ready to hatch and do their thing to reduce the fly population in Puerto Rico.

The flight broke down and could not complete the mission, so the next day our crew relieved them and flew down to Brownsville, loaded the pallets and took off for Roosevelt Roads NAS, Puerto Rico.

Inside each of the hundreds of cardboard boxes with the irradiated screwworms was straw with a cup of something (dried blood and honey, as I recall) to keep the few flies that might hatch convinced to stay in the boxes, which were not sealed.

Didn’t work.

Flies started hatching en masse (they were supposed to be in Puerto Rico already) exiting the boxes, and soon we had a swarm on the flight deck and all over the cargo area.

The flight engineer suggested we turn on all air conditioning units to quiet down the flies. That helped.

So, as night closed in we had subdued flies sitting around on the windscreen and everywhere else for our hours long flight into Puerto Rico.

We made it in to land with cabin temp down to 38 degrees F and horrible smell.

At the parking ramp the customs guy came on board with bug spray going in both hands, and we exited quickly to the chow hall.

Keep up your excellent work with everyone on TWiV. I am very grateful for all your good info on the virus problems and solutions.

73 from WA1AAY, Art Nielsen, ABScB Brown, Class of 1968

Pittsford, NY

P.S. Never would have gone into the Air Force, but I got three years off from my engineer job at Kodak for bad behavior (Richard Nixon’s, not mine) when I lost the draft lottery in 1969 and enlisted for pilot training and six year active reserve duty in the Air Force before the Army could get me.

Ellen writes:

Dear TWIV,

    I am a retired science editor who loves your lengthy podcasts, which I listen to during my nightly bouts of geriatric insomnia.

    In reference to the cruelty of nature, try reading “Mother Nature Is a Wicked Old Witch,” a 1993 paper by the late evolutionary biologist George C. Williams of SUNY Stony Brook….

    Your fan,

Ellen in NYC

Megan writes:

Dear Twiv Team,

I write to you from Montana. I am a family physician at a FQHC, and I am also the local public health officer.  I am deep in the trenches of this pandemic. 

Montana has been spared the virus so far, except that we have experienced all of the shutdown stress, pandemic preparation, and anxiety. Now that we are fully exhausted, we are now seeing a surge at levels completely unprecedented before. Our Governor has been a good leader, but as we have gotten closer to the election, it has become apparent that he will not shut anything down further due to concerns for his election. He has instead encouraged local officials to work harder on mitigation. 

I will tell you that while our public health department has had overwhelming support from the entire medical community, as well as the local hospital, our larger community has been less than helpful. Our city and county leaders have not lifted a finger to help us. 

Our hospital has been overwhelmed, as they have multiple sick staff members. We have been unable to transfer patients out of our small hospital due to the burden our larger hospitals are carrying. Our hospital only can take 3 covid patients before impacting our ability to provide routine care (we only have 8500 people in our county).

My typical day includes working a full schedule in the clinic, seeing a mixture of patients in person and with telehealth. Noon hour is when I assist with swabbing at our clinic’s drive through clinic, even on my days off. Evenings are spent in contact tracing. We have had so many cases and so many contacts to trace, that there are not enough hours in the day to keep up with this or make any difference in transmission. 

The rest of the time I spend in school board and public health meetings, where i am denigrated by the public. I have been astounded at the vitriol from our community members, and my husband and I have at times been concerned for my safety. We are also strongly considering moving away. People who were previously my friends no longer speak to me. 

I have attached an article written by our mayor he intends to be read to the public at a future meeting (and for some reason vote on the statement). I have written letters to the paper and given lectures at board of health meetings trying to fight misinformation. Your podcast ensures that I stay up to date in this fight. I attach this article by our mayor as I want to show you the level of misinformation we are dealing with. I need assistance in tearing this apart. Recently our local coroner (in MT a coroner just has to have a high school degree) stated at a public meeting that masks were causing an increase in cardiac fatalities (hypoxia?). People clapped after she stated this! I do not need to tell you she presented no data. 

Is it not true that we cannot base mask effectiveness decisions on naked viral particle size? My understanding is that bare virus is wimpy and has its external case sheared apart. I think it is more important to review droplet/aerosol size that the virus is contained in. I don’t think you can discuss masks without discussing the contribution they may have to decreasing viral load. 

I have also included an article that shows that viral load may correlate to mortality. I know you have said that viral load only correlates to infectivity, but this article shows it may correlate to mortality.  I know there is another study that shows the same viral loads in asymptomatic/symptomatic people, so maybe this is not an appropriate conclusion. 

Lastly, I would encourage you to read “The Death of Expertise”. This book has helped me understand this misinformation pandemic. It has also given me the gumption as an expert to fight this misinformation. 

One thing to keep in mind–physicians would speak out more I believe, but in a small town, they do not want to lose patients, which are our primary source of income. If they make a statement that is scientifically based, but perceived as politically biased, they will lose patients. I myself know for certain that I have lost patients simply by being the public health officer. 

Thanks for listening! Megan Evans, MD FAAFP

Research article: 

Pujadas, et al. SARS-CoV-2 viral load predicts Covid-19 mortality. Lancet, volume8, issue9, E70, 9/1/2020, published 8/6/2020. 

Gerard writes:

Dear TWiV

Greetings from Nottingham, where it’s mainly cloudy with an expected high of 52F. Thank you for your podcast, which has helped to keep me sane since March. Time has politicised Covid 19 in the UK as well, so your careful adherence to the yellow brick road of common sense is very welcome. It applies equally well in the UK. I found Daniel Griffin’s careful, evidence-based explanation of Donald Trump’s experience particularly enlightening. Maybe if the President were to listen to it, J wouldn’t stand for jackass.

Today, Nottingham has become the city with the highest SARS-CoV-2 infection rate in the UK, with 689.1 cases per 100,000 people in the past week. Cause for alarm and a call to action, surely. Our government’s reaction is to say, “we’ll decide what to do on Monday.” Today is Thursday. Four days of doing nothing different means four more days of increased infection rates. Local government has urged us to shelter in place, but can’t unilaterally close schools, bars and non-essential businesses.

Our own jackass and his minions have spoken glibly of playing whack-a-mole with SARS-CoV-2. The mole appears to be winning.

Just a couple of other things if I may.

I was delighted that Vincent chose Adam Neely’s Girl from Ipanema as a pick of the week. It’s a really interesting video and Adam is great. Adam’s latest video of children’s songs is just a joy. This video astonished me.

I appreciate there may be reasons for not broadcasting this, but Daniel Griffin mentioned that Parasites without Borders is supporting microbeTV until the end of November. I haven’t heard you mention it on TWiV and I’m worried that you’re not maximising every dollar. In the UK we are brought up to believe this is an unAmerican activity, like diffidence and bad teeth.

Stay thoughtful, stay reasonable, stay grumpy.

Stay healthy