TWiV 698: COVID-19 clinical update #42 with Dr. Daniel Griffin

December 26, 2020

Daniel Griffin provides his weekly clinical report on COVID-19, including his own experience with vaccination, guidelines for vaccine distribution, reasons for under-utilization of monoclonal antibody therapy, and much more.

Hosts: Daniel Griffin and Vincent Racaniello

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Intro music is by Ronald Jenkees

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5 comments on “TWiV 698: COVID-19 clinical update #42 with Dr. Daniel Griffin

  1. Johnye Ballenger Dec 29, 2020

    For Dr. Griffin:
    Trusting you remain well and side effect free from the Moderna vaccine you received. I was given Pfizer’s vaccine yesterday (12/28/2020). It was 99.4% painless and so far so good.

    My question is about descriptive terms for antibodies (Ab). I understand “neutralizing” Ab as being protective Ab because their binding to SARS-CoV-2 does not allow the virus to enter the cell and begin replication of it’s viral genome. Correct? However, what is meant by “sterilizing Ab”? I have not been able to find a good definition or clear explanation of its what, where, how or when, or the relationship to/with neutralizing Ab.

    An explanatory model (I’ve made this up.) is to think about sterilizing Ab as another name for Ab produced by memory B cells. But, do neutralizing and sterilizing Ab exist co-temporaneouusly and function simultaneously or neutralizing Ab come and go and then sterilizing Ab appear? Are there other descriptive terms for antibodies based on their functions (much like the alphabet soup for RNAs?). I don’t mean the 5 classes of Ab, but does class shifting have anything to do with sterilizing Ab?

    Dr. Griffin, thank you for your steady, science infused, committed work, teaching, clinical care and inspiring ethic for colleagues. It is a privilege to listen and watch as the standards for best practices and evidence based care and treatment of COVID19 patients is created.

    I sleep better knowing you are a voice knowledge and reason at “the table”, and that the world’s Virologist, Prof Racaniello, insures your voice and others are publicly heard and broadcast broadly.

    Take rest prn, both of you — doctor’s orders.

  2. Catherine Cotter Dec 29, 2020

    Dear TWiV team,
    I was a casual listener before the pandemic turned me into a hard core fanatic and I now listen to every show, and have been sampling the other shows when I get the chance. Thank you so much for all the hard work you put in creating these podcasts. I made sure to contribute for the first time and plan to do so on a regular basis. You have been an amazing resource to me and I recommend these podcasts to all my friends and family. I am just a pox-virologist who had little knowledge of coronaviruses before this began but have now been educated along with the rest of the science community and world (with a lot of help from you). I listened to the recent clinical update #42 with despair at the truth of Dr. Griffin’s analysis. I am a transplant to the US from England and have been a little horrified by the handling of the pandemic in the UK (we have had our own different horror story in the US of course). The initial response was slow to lock down, but at least when they did it was more of an actual lock down than we experienced here, and they did ramp up testing and surveillance. Unfortunately, after reopening they were very slow to encourage masking, and I sense it is mainly done when required (on public transport etc.) and not as a matter of fact as more people have come to do here (at least in my immediate area in Gaithersburg, MD). There has been a lot of pressure to keep shops, restaurants and bars open. I do sympathize with people working in those industries, but England is not a place that is conducive to outdoor eating much of the time. My brother-in-law recently had a cluster of 12 people infected at his work where they were inside without consistent masking or distancing (thankfully he quarantined and was not infected). My parents have probably eaten at more restaurants since this started than they did in the 3 years prior to this. So long as they see some plexiglass they think everything is safe. Schools have remained open for the most part though it is not clear there is much spread from there (at least from the younger children). I was talking to my sister today who was concerned schools may not reopen after the holidays with the latest surge. This conversation was after she returned from the gym where they were giving out mince pies! “Spaced out so you could take one without getting too close to someone else”. My brother-in-law was just leaving to take my nephew to a restaurant as they were tired of eating at home. This is in the face of the largest numbers of cases they have ever seen, and with the NHS under tremendous strain. I am sure it is possible the new variant could be more transmissible, but this increase in numbers is also easily explained by the holidays and winter leading more people to gather indoors. I never felt the measures put in place over summer were adequate, but I think school holidays and warmer weather led everyone to a false sense of security. Now I am just crossing my fingers my parents manage to get the vaccine before they get the virus. It looks like more shutdowns will dampen their restaurant habits for a while so I will take some comfort in that.
    Keep up the good work and thank you again for all of your hard work.

  3. Janet Dec 30, 2020

    Re new variants affecting spike- analysis of PCR S dropout samples, presumably including Kent variant:
    https://www.medrxiv.org/content/10.1101/2020.12.24.20248834v1.full.pdf
    ‘when conservatively inferring relative viral load from Ct values, approximately 35% of S-dropout samples had high viral loads between 10 and 10,000-fold greater than 1 x 106, compared to 10% of S-positive samples’

    I think the relative half-assedness of people’s NPIs has stayed more or less the same throughout, bar the Real Lockdowns there were initially.
    We are encouraged in UK Tory press to think of the upsides (£600m savings on pensions). Heartless, heartless and ignorant.

    I am intrigued there is more common lupus and Covid 19 severity for African descendents- are they related?
    systematic review of epidemiological studies here:
    https://pubmed.ncbi.nlm.nih.gov/28968809/

  4. Laura Jan 5, 2021

    For Dr Griffin,
    I am a hospital pharmacist in San Francisco, California. I’ve recently received my first dose of the Pfizer-BioNTech vaccine (yay!). I have been regularly testing for SARS-CoV2, about every 1-2 weeks. Is this still necessary after vaccination? Knowing that we don’t have the data regarding vaccine efficacy against transmission, I’m not sure how to proceed to protect the other members of my household.
    Thank you for your very informative clinical summaries. They are so useful to my colleagues and me.
    Wishing you all the best in the days ahead.

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