Anonymous writes:

Hi TWIV team

I thought you would be interested in this ad5 vectored vaccine that includes nucleocapsid in addition to spike. The ad5 backbone has been in cancer patients and has been modified to evade anti ad5 antibodies.  They just started phase I (I was injected yesterday with the low dose) and they will be tracking T cell responses (!)  in addition to the antibody response. 

Thanks for all you do to spread good science!

Mike writes:

Greetings to my favorite support group. When listening to episode 674, Rich mentioned Alan Alda’s ‘Clear + Vivid’. Did you know he played Dr. Robert Gallo in the movie “And the Band Played On’? Wonderful movie about the emergence of HIV and the politics that ensued. Get him on the show! Love all of you!



Michael writes:

I am a psychiatrist working with the homeless mentally ill. It surprises me that we don’t have many patients in our crowded group housing locations don’t some down with Covid-19. It seems like it should sweep through the community because they are not keeping good social distancing, etc. So I wonder if antipsychotic medications, or on the other hand, methamphetamines, are somewhat protective ;-).

Also, as someone who has spent a lot of time hanging out with Tibetans particularly in the 80s, I remember finding out that Robert Thurman’s daughter is an actress.

Love the podcast.
Michael Essex, MD

Pat writes:

Hello Twivers,

I want to start by thanking you all for providing such a delightful source of accurate scientific information, not just about this current pandemic but all kinds of great info on viruses, research and science in general. 

I am fervently hoping this “spills over” to the general public and inspires more understanding of what Science is and does.

The links below have me concerned that ADE is underplayed with SARS-CoV-2, both in the instance of reinfection and possibly after vaccination.

I would be interested in your discussion on both these articles

Now to the irony:

How is it that the same people that deny the scientific guidance provided by the scientists and doctors at CDC, FDA …..immediately turn to the scientists and doctors when they become ill from Covid19 , shouldn’t they be asking the politicians, conspiracy tweeters etc for treatment ??


PS I listen to the end of each podcast!!

Trump: “Do as I say, not as I do”


Carolyn writes:

I find this very worrisome.  I know we have to wait and see but….


Christie writes:

Hello TWiV Crew,

I’ve become such a huge fan in the last few months, it’s gotten so my schedule revolves around new TWiV drops! I’m a former high school science teacher and organic chemistry PhD dropout living in Colorado Springs where it is sunny and 57 F this afternoon, although it will be 10 F and snowing by the weekend.

Episode 673 (Wake up and smell the pandemic) really struck a chord with me. In 2011 I developed a sort-of obscure respiratory condition, which among other things causes me to grow a whole lot of polyps in my nasal passages and sinuses. As is typical for people with my condition, I had surgery to clear them out and within a few months they all grew back. One of the hallmark symptoms of the disease is anosmia. For 8 years I couldn’t smell ANYTHING or breathe  through my nose. When you all were discussing your experiences with loss of smell and taste I wanted to raise my hand like an overeager student – “Ooh, ooh! Pick me, pick me!” As you can imagine, it’s no fun not being able to smell or taste. I used a lot more salt than a normal person and chose foods more based on texture than flavor. Not being able to smell can sometimes be dangerous (you can’t smell a fire or a gas leak), often can be sad (you can’t smell the pies baking at Thanksgiving), and occasionally be a blessing (both of my boys went through their stinky adolescence and I got to miss smelling it). When the pandemic started and the loss of smell emerged as an early symptom, I was so glad that I can smell again so that I might be able to have that early warning of getting infected. Not that I even go anywhere, I’m not messing around with this virus!

I’m doing much better since about a year ago, as I’ve found a “miracle drug” made by… drumroll please… Regeneron! Yep, it’s a monoclonal antibody that is helping to balance my screwed-up inflammatory responses. I’ve been frustrated lately as my friends and usual news sources, who I generally appreciate for their well-deserved criticism of this administration, have been so quick to malign the president’s experimental Covid treatment. It feels like they’re putting it in the same category as hydroxychloroquine or that oleander nonsense. I understand having a healthy skepticism, especially now, but I’ve felt the need to defend Regeneron as a legitimate company doing legitimate science. You all know that, of course.

Finally, at the end of the episode, Vincent mentioned one of my very favorite books from my childhood: The Twenty-One Balloons. I treasure the copy that my mother read when she was a child and then read to me. It’s a fun and fantastical story with a lot of “science” that isn’t really science, and full of imagination. Now I’m going to have to dig it out and read it again!

Thank you all for letting us into your “clubhouse.”  I so enjoy the thoughtful discussion, reasoned arguments, and camaraderie you all share.



Owen writes:

When I sorted the site by Tot Cases/1M population, I noticed that 20 of the 24 states with the highest COVID-19 case rates and the 17 states with the highest case rates were all states that Trump won in 2016.  I found this is an interesting correlation and suggestive that a state’s political affiliation might affect your likelihood of  contracting COVID-19.


Lisa writes:

Dear All,

Driving to the Tennessee State Girls’ Volleyball tournament, the weather is 85 degrees and sunny.  The tournament is spread out over more locations this year with limited tickets to dedensify the crowds, mandatory masks except for the athletes who are actually playing and the referees, and touchfree entry using your cell phone.  The finals are today, and we are hoping for a win!  

Our private schools continue surveillance testing using saliva and rtPCR with same day turnaround and report the cycle threshold.  We remain at less than 1% and those students are isolated and contact traced. Due to mitigation practices including regular testing, both schools’ football teams were able to play their annual grudge match (it has been played 86 times since 1908). The game was moved to the college football stadium to allow a well-spaced crowd, health checks were performed for entry, and masks were required for all except the athletes. Moving forward, we have created protocols for receiving new international students for boarding next semester, based on what we have learned since August.  With appropriate quarantine and entry testing the schools can offer them in-person education on the controlled campus environment. We are working toward lowering risk for winter sports.

Some good news–the gowns that Lisa designed now have a new milestone:  the company producing them has secured a contract with the Department of Defense and they will become part of the national stockpile.  You may recall that the original design, created after seeing the nurses wearing trash bags in New York, makes a few, key cuts in any surgical drape so you could turn it into a gown.  The design lends itself to rapid manufacture and will now become part of our nation’s resources.

Working toward the goal Dickson set for us, Purdue is doing well.  Football will start this weekend with outdoor viewing of the games as large gatherings are prohibited, and athletes are tested per their protocols.  Purdue has a combined surveillance and symptomatic testing positivity of 2.36% and Big “Q” (where the whole house is quarantined because everyone is mixing and no one can sort it out) doesn’t happen so much anymore as the congregate living students have embraced mitigation strategies.  (We call it “little q” when the houses follow the recommendations of masking in common areas and other strategies to allow for selective quarantine of a few exposed individuals instead.)  We have been using a scoring system for symptoms that can be found on the dashboard with our campus health center statistics here: and will tally the results at Thanksgiving and share them. The students will go to online class to finish out the semester.

Protect Purdue Covid-19 Testing DashboardWATCH: Eric Barker, dean of the College of Pharmacy and member of the Protect Purdue Implementation Team, discusses Purdue’s pre-arrival student testing on the TODAY Show.. How were the students who tested positive cleared to come to campus? Students who tested positive for COVID-19 during our pre-arrival testing were required to stay home and away from campus until they completed a 10-day …

An unanticipated finding:  25% of infected dorm students discovered by surveillance testing are new members of the Greek organizations that had the lowest adherence to recommendations. We will be able to advise incoming students as they embrace college life of this data.  Still, we have no in-class transmission and attribute spread of disease to social activities and combat that spread with education and testing. 

Our clients with One to One Health continue to keep their businesses running, using TeTrIs principles. Overcoming “coronafatigue” is the biggest challenge for them.  We are preparing for the winter with flu shots and continued layers of good practices. We are fortunate to work with people who always want to stay one step ahead of what’s coming next.  

We both sit on the county mayor’s pandemic advisory board and continue to appreciate the many sides of the coronavirus response. We, along with three other physicians (two infectious disease docs like Daniel and a hospitalist), advise leaders in hotel management, tourism, county schools, the chamber of commerce, building contractors…a whole group comes together weekly in an effort to keep the kids in school, the parents at work, and the economy growing all while keeping infection down. Our public support of the county mask mandate is seen as critical, and we hold regular press conferences demonstrating the downward trend that continues since the mask mandate was passed. We have included a link to the latest tourism video.  Although you said you don’t want to travel during this pandemic, seeing this commercial will change your mind and have you hopping in your car! 

Finally, the future with One to One Health:  Lisa’s perception of the pandemic from the surgeon’s standpoint is one of a mass casualty:  a slow-moving, rolling disaster where resources are at times overwhelmed in places.  Trauma systems have evolved to review and report their findings after mass casualty events to allow all cities to learn from their experiences.  It’s time for everyone to share pandemic data in this fashion as an “interim review”.  We have looked back at our efforts in April and May when we were keeping factories and businesses going and taken what we did right (masks!), what we did wrong (hygiene theatre), and what we wish we did (had a shorter lockdown and directed resources to public education).  We are now helping organizations as outside, objective consultants to improve their response.  

Our goal remains to inspire others as you have said, especially surgeons with trauma experience, to lead in their communities as our surgical perspective remains a valuable one in this slow-moving mass casualty called the SARS-CoV-2 pandemic. It is easy to look back and identify problems.  It is constructive to use that knowledge to change what we are doing for the better.  It is not useful to use words like “idiots” or “failure of leadership” as not everyone’s perspective is the same as the Monday morning quarterback.

Listening this week to the physician, Megan, from Montana, I want to tell her that her experience isn’t unique.  It is important to continue to do the right thing, to advise the community as best you can. Not every colleague, committee, or client follows the advice we give. We just keep doing what we feel is right (and scientifically accurate), and we feel like we have made a difference.  We think that TWiV does, too, and we are glad you are in this with us.  Keep it positive, stay healthy, and, see, it can be done!

Lisa Smith and David Bruce

P.S.  I know that was a huge email, but this warrants mention.  We’ve begun a weekly newsletter and a COVID-19 response webpage.  Our committees and clients receive it well as we are reporting the science in terms that nonscientists can understand.  Here is the link:

Sal writes:

Dear TWIVerati,

Firstly Thank you!! I’ve been a “ listen to the end“-er of TWIV and associated podcasts since early Jan (right back when you were not sure this would be “the one”).

I’m emailing you from the Tree Cathedral in Milton Keynes England, where it’s 13 degrees and sunny with a good smattering of Autumn colours.

Thank you so much for your Pain review (TWIV 674). As a person with chronic Neuropathic pain I was delighted. What a potential gift to humanity if this one small benefit came out of the Pandemic. All current Neuropathic analgesia has significant sedating and similar side effects so a completely new pathway is very exciting, but leads to my question… I went from excited to worried. If it’s elements of the spike makeup that is the active element of analgesia, would spike based vaccines render any breakthrough  ineffective? I’m sure it’s a dumb question, I understand much more about Nerve conduction studies than viruses! Also there are loads of specialist support groups for the various diseases and injuries leading to chronic neuropathic pain so researchers shout out to or others, we are a naturalistic worldwide experiment cohort being infected right now!

Second ask… you wondered how many Vincent Racaniello’s there are… I think I may be the only Sally-ann Rodbourne in the world, certainly Google can’t find another. Does anyone in the TWIViverse know of a namesake, or also think they have a unique name?

ddd: I am the only Dickson Despommier as far as I can tell

Then an offer: Transcribing and/or summarizing your podcasts is important but too much for one. How about a citizen science style team effort? I’d be happy to organize it if other TWIV listeners wanted to join in. A few dozen of us and we could do it reliably and quickly, a few hundred and we could even tackle the back catalogue! Tell Vincent if you’re in?!

Finally we know your views on this so don’t need to review them; but in case you haven’t heard a team from Imperial College London are very serious about human challenge studies. My reading is that they’ve yet to finalize the ethical approval but I may be wrong as their press briefings have been very strong.

Thank you again

Yours in science and constant learning
Sally-ann Rodbourne
“Another email has ended!”