Andrew writes:

86th Street and 3rd avenue: Where peptidase meets thirst

“…the spot where, allegedly, the papaya drink was born: the corner of Eighty-Sixth Street and Third Avenue Papaya King.”

“Signs touted papaya’s superlative health benefits: “Nature’s own revitalizer!” “Vitamin packed, health giving!!”

Alas, randomized trials are lacking

Best regards,


Andrew Farb, M.D.
Chief Medical Officer, Office of Cardiovascular Devices (OHT-2) and a loyal podcast listener
Center for Devices and Radiological Health (CDRH)
U.S. Food and Drug Administration

Neil writes:

We’ve seen an enormous number of infections at pork processing plants (slaughterhouses) and while we have seen cats, mink and even a tiger test positive for SARS-CoV-2. Aren’t pig’s ACE-2 receptors nearly identical to humans?

David writes:


My new friends at TWIV
You have helped me live
And experience a smart life
Every week during this pandemic

so lucky am I
and lots of others
to hear such
intelligent discussion

has this medium
made all of us somehow”
I do think that this is true.

 I am just a doc
A cancer doc
Who rarely thought about virus
Until the last months

I don’t still quite understand
The endemic EBV, HPV, and VZV
And probably many others 

I knew that I needed
to learn more about virus
and then I found TWIV

 lots of Comfort in hearing
thoughtfulness from all of you
very nice to be learning lots again

 So smart and inquisitive you are
Vincent is the leader

 He is a new-day Socrates
And with his questions
i hear his kind style
He brings out the best in all

The youngest of the group
A smile so sweet
and with deep interest insight and spirit
Drew,   .edu is a rhyme in itself

No need to smile
Never dour or sour
Lots of experience and perception
Of what really matters

 He understands that there is a difference
Between what we can do
versus what we should do

 Kathy is sometimes quiet
But when she speaks
Her ideas are profound
Each moment that I listen, I wait for her insight

 So here I am
In central Massachusetts

 New virtual friends and colleagues
I am very thankful for your TWIV project

 We will survive.

Dora writes:

I signed up some time ago for the Novavax vaccine trial. Today they called and screened me.

The call center agent had no answers to a single one of my questions and said they’d be answered at my first visit, for which I’d allegedly be paid $150 even if the answers to my questions led me to immediately walk out the door. I didn’t even know whether to believe it.

It turned out they couldn’t have answered my questions.  

One question involved where I’d be tested for covid if I became sick and where I’d be expected to get treatment.  I never got any answer at all to this, not even we don’t have the answer.  This is an obvious confounding factor.  If they need to diagnose it, then I may need to ride my bike 8 miles in the winter with a high fever or trouble breathing.  If they go by my doctor’s diagnosis, my doctor couldn’t diagnose a boil on his butt.   If it happens to test positive by the time the doctor’s office and the lab mess it up, cowabunga.

Now I asked what if you don’t know if you’ve already had coronavirus, since I don’t – and it only matters if you’ve ever had a positive test.  I think that I and most people I know had covid in March.

Second, and most important.  The trial is for five years.  A vaccine should be available to high risk people like myself in 2-3 months.  I asked if they’ll give everyone a shot at that point, or all high risk people a shot at that point, or even tell us if we actually got the vaccine at that point.  I pointed out that not only would I go get the vaccine if I hadn’t already had it, or couldn’t determine if I’d already had it, but so would many people.   I was told we are free to leave the study whenever we want!  After two or three months?   They’ve not learned anything yet!   I also pointed out in my email to them, that less scrupulous people will get the vaccine elsewhere and not tell them.   

They’d gain the most valid information by vaccinating all of us at that point and then following us. If a third of people who were vaccinated subsequently get covid, they’ll know it works about as well as the flu vaccine.  

I was told they have no idea.  

In my mind this must mean this study is not being well or ethnically run.  For certain any results after the date when people can get the vaccine if they want to won’t mean a whole lot !



Anthony writes:

Hello Twiv

Shouldn’t Dr. Fauci be advocating for a RECOVERY-style randomized study to assess, head-to-head, the efficacy of Pfizer and Moderna vaccines? (And any others?)  If not, how come?

Wouldn’t such a randomized study be advantageous, especially for medical front-line workers, and in prisons, and in nursing homes at this point in time?

Brendan writes:

Dear TWiV team,

After listening to the last few episodes and mentions of vaccine distribution, I found myself wondering whether we are thinking correctly about how we classify most “vulnerable.” As has been emphasized in recent episodes, especially when referring to the long term COVID and morbidity associated with clotting, should we be thinking of the demographic of potential patients with valuable life-years first in addition to frontline workers? This idea of vaccinating immobile and less mobile elderly individuals may save lives, but as you have discussed, life doesn’t exist in a dichotomy of “recovered’ and “deceased.” The morbidity of those in between can be the most significant aspect to this pandemic. I was wondering if you could address whether vaccinating the general population first (along with healthcare workers) makes more sense as a top priority, since they have the potential of going from household to household, group to group, keeping viral prevalence high and prolonging the pandemic more than elderly person in a nursing home. It seems to me that the ambulatory person walking and traveling around town has the potential of a much higher R-naught than most. I don’t mean to minimize protecting the elderly, but the people who still support the economy, provide childcare and care for their families, and make up the bulk of spreading infection may be the most important in getting us out of this mess and keeping the long term consequences minimized. 

Thanks for this great podcast. This is my favorite connection to the medical world, since I’m a former MD and miss great knowledgeable discussions.

Longtime listener,


Dr. Brandon Finnorn
Finnorn Illustrations, LLC

ddd: In addition to health care workers, I think we need to protect the groups with the highest rate of mortality – the elderly, ethnic groups that are at high risk of dying, and those with underlying health risks. 

Junji writes:

And I thought in Computer Science we have lots of acronyms …

“Follicular Dendritic Cells Adhere to Fibronectin and Laminin Fibers ViaTheir Respective Receptors”

Wayne writes:

Japan enacts law to make coronavirus vaccines free to residents – Japan Today

Dr. Vincent,

Hope all is well…TWiV is truly a bright light in this morose world!

Vaccinations in Japan will be free to all!


Wayne G
Wakayama JP/Bozeman MT

Tony writes:

Dear Truthers, 

In TWIV 687 and other podcasts you have said you are preaching to the choir. Please don’t take this as a criticism as I love the show but the reason you have this problem is because you are “mere” scientists and not social media influencers. In order to get the truth out I have a plan. You will hate it but it should work and that is all that counts right now. I think you should have another show called TWIM (This Week In Moronology). Invite conspiracy theorists / anti vaxxers as guests. Then you can rip them to bits with science fact and not science fiction. This would attract far more listeners and subscribers and you could easily go viral. Many people would then go on and listen to your regular stuff. Yes it would be a gimmick to some extent and not so cosy for you guys but this is a war that must be won to save lives. I picked the name TWIM as a joke and you could choose something less confrontational. 



Ken writes:

Dear TWIV,

The temperature in Chicago is now 28°F/-2°C. My son attends the University of Illinois at Urbana-Champaign, the same university which implemented a twice a week mandatory saliva test for all students, faculty and staff who were on campus. U of I has a cumulative test data website here which allows you to view and download information such as number of cases, case positivity rate, and number of tests run. At this point there have been 4195 cases discovered from this testing, which has started July 6, with the daily number of tests ramping up around August 17.

My main question is if any of you are aware of any data collection which utilizes these test results to see if there’s any reinfection within any of the 4195 cases?  This type of mandatory testing provides a great opportunity to see if there’s any reinfections, and if so, what the timing, severity and frequency would be. Aside from the U of I, there should be data from the Saliva Direct Test developed for the NBA bubble, Covid testing for the NHL bubble, and non-bubbled MLB & NFL. Obviously this data should be anonymized, but a great opportunity exists to shed some light on the questions related to reinfection.

One additional request; the next time Kate Rubins comes on the show, please ask her to let us know the temperature outside the space station.

Thank you,