Anonamousse writes:

Dear TWIV, 

Thank you for all you are doing to bring clarity and calm in this uncertain time. Your show brings knowledge and comfort to many people.

My questions relate to the WHO and its current investigations into the first stages of the outbreak.

1.) What are the implications of virological, epidemiological and other related research being subject to political control in mainland China? Does this prevent Chinese researchers and scientists from conducting and publishing research as they wish? 

2.) Why has the WHO team been so delayed in starting their investigation? Does this make it harder to obtain evidence and data from the early days of the pandemic? 

3.) Why in your view were clinicians such as the late Dr Li Wenliang and colleagues pursued by authorities when they alerted others to the coronavirus in its first stages? And why were journalists such as Zhang Zhan jailed for reporting on the Wuhan outbreak? 

Thanks again for the knowledge and clarity you bring to the public.  

Anonamousse (like the dessert)

Adrian writes:

Haiku for you:

Smiles hidden by masks
Worn by them to protect me
Still light up their eyes

Christophe writes:

Hey Vincent,

I am the listener that did the Mice Lie, Monkeys Exaggerate etc button. 

Naturally I am a fan of Daniel and so threw this together for fun. 

Feel free to use it for whatever you like (or not). If i can think of good catch phrases or other ideas i might do a series of silhouette style designs for all of you.

Regards and all the best for 2021. Keep up the good work


Tim writes:

Hi-ho TWiVerinos,

I apologize for the rant, but this is an important letter, which is not deserving of the criticism from Steven, no matter how well intentioned.

Steven summarizes his points as:

My questions to you are then:

  • Have you considered the issues raised above, and is my concern regarding the risk of counter-productivity valid?
  • Is there data that can be used to help to provide a more granular view on relative risks for different population segments?
  • Can, and importantly, should (perhaps they shouldn’t) scientists/doctors/governments strive to deliver a more granular/detailed message about risk factors to communities?

1. Any of the anti-masker, anti-vaxer, anti-science activists will try to make these claims, but they are more than adequately addressed in the published letter, which is not remotely presented as capable of capturing the granularity of data Steven desires.

2. The researchers used the data available and made it clear that this is a limitation. This is an expected limitation of using publicly available data – it is publicly available and does not provide the granularity Steven would like.

3. In the letter, the researchers do not make any excessive claims about the information they are providing. The researchers are clear about the limitations of the information available and the conclusions drawn.

This is an important analysis of data that apparently exposes an underappreciated risk group. The criticism of the paper is due to unreasonable expectations of what can be obtained from the publicly available death data. 

We should not expect, nor encourage, researchers to find results that are not supported by the evidence.

We know from other reporting that otherwise healthy people in the 25 – 44 year old group are dying from COVID-19. That is not new. What is new is the rate of death among 25 – 44 year olds of unknown health status. Further, the authors state:

Only 38% of all-cause excess deaths in adults aged 25 to 44 years recorded during the pandemic were attributed directly to COVID-19. Although the remaining excess deaths are

unexplained, inadequate testing in this otherwise healthy demographic likely contributed. These results suggest that COVID-19–related mortality may have been underdetected in this population.  

I understand that Steven means well, but RTFM (Read The F____ Manual [Material]). There is a test and luck is the overwhelming factor, the results of this show that luck was against over 4,500 people in the otherwise healthy 25 – 44 age group. Place your bet on your luck, and the luck of your neighbors, family members, coworkers, friends, but do it wisely, recognizing that the granularity of data you would like is not available. 

Steven appears to want certainty, for which he should consult an astrologer, or a priest, or a politician. Scientists provide caveats, because science has ethical standards. This is betting lives, so I will always go with the science and try to appropriately interpret the limitations provided by the scientists. The scientists include the limitations for that reason.


Lucas writes:


I am from Brazil and, first, I want to say I love your podcasts. Since the beginning of the pandemic, I try to listen you! Congratulations for the excellent work!

Last week (January, 17) ANVISA (the Brazilian equivalent of the FDA) approved the emergencial use of Cornavac and Astozenica vaccines. And immediately we started to use Coronavac (AstraZeneca vaccines are not ready yet). Both vaccines will be produced in Brazil. 

Last podcast, I got the sensation that CoronaVac isn’t as good as Pfizer or Moderna. However, our health authorities said that, even it is not perfect, the Coronavac will be helpful to relief our hospitals, because the studies show that it can help to prevent the severe form of the disease. 

Can you talk a little bit more about the effect of coronavac on preventing the severe form of covid, please? 

I am not a scientist, I went to law school, so please try to put in simple words… 

Thank you so much,


P.S. Even with our limitations (not a rich country), Brazil has a good vaccination public system, so I think it will be interesting to keep one eye here to evaluate coronavac and AstraZeneca vaccines. 

Bethany writes:

Hello TWIV Crew,

Thanks for all you do to keep the rest of us up to date. I have declared Vincent to be my Bob Ross of The Pandemic. 

I just finished listening to Episode # 706 during which there was a discussion about vaccine tracking. When I received my first COVID vaccine I was encouraged to sign-up for V-Safe, a free monitoring and reminder system from CDC. For the first few days I received daily texts to check for symptoms. Then when the 21 days started to roll around the text started checking to see if I had received my second dose. Not perfect, but certainly helpful.

Footnote: I’m an OB/GYN provider in New Mexico and have noted a recent increase in vaccine data flowing into our EPIC-based EHR. It isn’t perfect, but an improvement over complete radio silence. 

Stay Well, 

Bethany Kolb, MD, MBA
Obstetrics and Gynecology
Presbyterian Healthcare

Hilary writes:

Best o’ TWIVers – I’ve got an appointment for my first vaccine dose in a couple of days, which makes it feel like there’s going to be a future this year. One of the things I’d most like to restore is the freedom to go out with a group of like-minded non-pod-people and look for birds together, sharing the best views through spotting scopes. 

My scope hasn’t left the closet since the California lockdown in mid-March – scopes want to be shared, and all the early publicity about sanitizing every surface seemed to say that sharing optics would surely spread the disease. (Yeah, if viruses can’t love, scopes can’t want – but they do, or at least they trigger that response in their owners. Seeing a bird in your own scope is all very well, but it ain’t really real until someone else looks down the bore, adjusts the focus, and goes “wow, lookit that!” – and the more views the better.)

So – if everyone involved is a couple of weeks past their second shot, what extra precautions would we need? Keep wearing masks? Avoid carpools? (Or drive with the windows open?) Was the sanitize-every-surface-every-time advice overdrawn? (And if not, will vaccination reduce the risk to acceptable levels?)

You’ve been an anchor to sanity for more than a hundred podcasts… but you don’t tweet and flutter about….

David writes:

Dear TVIV,

Greetings from North Central Florida where it is a very hot 17.3 ……. positivity rate. 

Our local health department’s response to this heat wave has been to reduce testing to one day per week between the hours of 8am and noon.

“Two things are infinite: the universe and human stupidity; and I’m not sure about the universe.”
–Albert Einstein

The past few episodes of TWiV have been awesome. To see well over 100 years of experience opine, debate and share is truly a pleasure to witness including the part when Briannne’s reaches out to gather additional expertise from family in real time!

I would really appreciate it if you would call a meeting of the TWIV round table to discuss, with the appropriate caveats, in a similar manner your thoughts on the mRNA vaccines possible impact on viral load and thus transmissibility from those who have been vaccinated.

Respectfully submitted.


Jennifer writes:

Dear TWIV team,

My experience with the Shingrex vaccination was extreme. First at the inoculation site, I felt like my arm had been hit by a baseball bat. Two weeks later, I developed a severe neurological reaction (pain and stinging) on the left side of my face (no hives or welts). I saw my internist and her fear was that if I had the second booster shot, the neuralgia (trigeminal?) could become permanent, therefore she strongly recommended that I NOT have the booster shot. It took over two months for the pain to subside and now, two years later, I still occasionally have a “zapp” across the left side of my face.

I don’t know if other people have had this type of reaction, but I thought I would let you know.

Thanks for all you do, the over-my-head discussions, the playful banter, and the great recommendations.



Deborah writes:

Hello Dr. Racaniello and team,

I have been listening to TWIV for a long time, and more consistently during the pandemic. 

Since the start of the pandemic I believe your team  has been stating that the virus was caught from a natural source and not lab-derived source despite the fact that Wuhan has a large virology lab. I recently saw on Twitter that the Taiwan News is saying the pandemic is due to an escape of SARS-COV-2 from the Wuhan Lab following gain of function testing that is purportedly explained in TWIV #615. 

Dr. Daszak seems to be saying the Wuhan lab found a few wild coronaviruses that would infect humanized mice, that somehow these escaped from the lab (implied by his use of the word “spillover”) and he knew prior to the interview that these would cause very dangerous and untreatable disease as had already been identified and treatment attempted in Wuhan. He is so indifferent about the spillover and I think he knows much more than he is explaining while giving his sales pitch as to why his organization needs more funding. I really do not trust him much. 

It is concerning to me that this undated interview was released in TWIV#615 on 6/4/19 actually May 19, 2020 although the Taiwan News says the interview was 12/9/19 and 3 weeks before the announcement of an outbreak. Although I appreciate all the work you do to bring current and rational information on a complex topic to us all, I do wish that the idea of the spillover or other means of escape to the outside population resulting in untreatable disease was not minimized during the interview. 


Jessie writes:
Hello, I’ll be straight forward as I know you are very busy. Could you please respond to this article about your interview and how it is being used as evidence of wuhan lab working on coronaviruses and thus linked to our pandemic. Also can you talk about the moderna and Pfizer vaccine being questioned for their allergic reactions? 

Thank you,

Jessie (I’ve watched all your 2020 lectures for my virology class, I have a degree in biology and applying to medical school)

Søren writes:

Hello TWIV gang,

It’s unseasonably warm (6˚C/42˚F) here in London right now. Dark and cloudy, occasional light rain.

In E706 “John” the retired engineer physicist argued for a “multi criteria weighted decision-making” approach to COVID mitigation. John’s approach sounds sensible, but it is dangerously wrong in one crucial respect. Infections increase exponentially. Any level of infection that your economy can tolerate will keep increasing exponentially until it cannot be ignored.

According to German research, the optimal level of COVID intervention is R=0.75. Harsher mitigations require too much effort. Weaker efforts prolong the pandemic and its damaging effects:

Deniers are correct that severe lockdowns don’t correlate with low cases, because the causality is often backwards. Governments respond to high cases and deaths with severe lockdowns. However prompt lockdowns work. It’s cheaper and easier to quickly extinguish a small fire than wait to extinguish a big fire:

Australia, New Zealand, Taiwan, Vietnam, and Thailand are not running out of “workers, food, drugs, material, water, energy, specialist technicians, computers, networks, and transportation” because they reacted too quickly or decisively. The US and UK are suffering the prolonged consequences of inadequate and delayed reaction, not overreaction.

“Pandemic vs economy” is a false choice. These interests are aligned. We need a healthy population to build a healthy economy

Jill writes:

Greetings from Tenerife, a delightful volcanic island in the Atlantic where we are enjoying our Winter with 20 degrees C and blue skies!

Could you tell me, does the new technology used in the production of the new mRNA vaccines reduce the use of laboratory animals? I’d be really interested to know as this is an important factor to me personally.

Thank you for making your lectures and podcasts so accessible.

Jill (retired dentist)

Junji writes:

Rich reminds me of my grandfather (my mother’s father). Although my grandfather was in agriculture (no formal education) he was always trying genetic improvements. I think he and friends developed a garlic variety named Lavinia (the city they were living at the time). I remember he proudly showing an orange he cultivated and the quality he achieved (in Japan they have similar stuff like a U$50 strawberry unit). And Rich and my grandfather kind of have similar biotypes. Just interesting what memories are.


Signs along Route 66
You’ve tried the ultra-violet, 
And bleach straight in your veins.
You’ve tried Aunt Ida’s potions
And hydroxycholoquine,
Ate vitamins and herbals 
til surrender flags you wave,
You likely would do just as well
Ingesting…Burma Shave.


Anthony writes:

Those claiming human DNA modified by mRNA vaccine

“There is inadequate knowledge to define either the probability of unintended events or the consequences of genetic modifications. “

# # #

I see this quote being passed around as proof of the danger of the vaccine.  Of course, the paper says no such thing.  It raised the question of horizontal transfer among viruses.



John writes:

My wife and I LOVE listening to your show/podcast about viruses,  bacteria,  human sickness and health,  and whatever you and your guest(s) are discussing.  However,  there is one aspect of the pandemic that needs more “publicity:”  I am referring to the problem of ensuring that poor people,  both in the U.S. AND especially in places like Africa,  Asia,  Latin America,  and South America  have (TIMELY) access to the vaccine.  I have heard that the industrialized nations have already purchased almost the entire available supply of the vaccine.  And the track record of health care for the poor in the U.S. leaves MUCH to be desied.  Also,  at least Pfizer is insisting on Propert Rights Protection which will enable Pfizer to continue to charge governments “full price” for its vaccine.  Considering that Pfizer received government funding for its vaccine research and development,  it seems quite unfair to expect poor couintries to buy sufficient vaccine doses to vaccinate their (entire) population if they cannot get ther doses at a reduced price or at no cost at all.

I urge you to talk about this issue because I fear that many of your listenerrs may NOT be aware of it.

Thank you.

John Jaros,  RRT,  MS,  PhD
Philadelphia,  PA

Oliver writes:

Dear TWiVers,

I’m catching up on TWiV, and I suspect someone has already clarified, but I think this is Fauci’s article in Cell that Edward’s poem was mentioning. I’m sure you all have seen this before, but were confused because the poem was talking about a paper he wrote well before the current pandemic.