Kerry writes:
Daniel: I really appreciate your extremely helpful TWIV commentaries, from the quotes to the emails. I’ve treated over 1500 Covid patients in our telephone clinic in Southern California through the nightmare of last winter and now the dawn of a post pandemic world.
But Covid is still here, of course, in our unvaccinated patients, many high risk for severe disease. We embraced the one effective preventive treatment, monoclonal antibodies, and I’m thrilled to have personally arranged for this for over 40 patients in the last 2 months, and TWIV has been very helpful.
Despite the wonderful decrease in case numbers in the community (from over 1000 new patients a days in January to an average of 15 per day in our organization), but there are still about 2-3 high risk patients per day who are eligible for mAbs. Our medical system is now dealing with ‘the 4th wave’ of huge numbers of non-Covid patients now feeling safe to come in for care, leading to bigger access problems than ever. This has required reprioritizing resources and the future closing of our mAb infusion clinic, with referral of our high risk patients to community sites. The problem is that we haven’t found any. The HHS and Regeneron websites have extensive lists of ‘Regen-COV infusion sites’ but every one of them in our area have ceased operation; county and state funding appears to be drying up; and there don’t seem to be any alternatives for patients in the community.
Have you found a similar problem in your area? Are there any national effort to allow continued treatment with the one highly effective, evidence based, and safe preventive Covid treatment? I anticipate that Covid will remain with us as long as misinformation and lack of confidence in science persists, which is unfortunately forever, so a long term plan to provide mAb treatment to all who require it seems essential.
I’m interested in your thoughts. Thanks for all you do!
Kerry Litman MD, CPPS, Family Medicine
– Physician Lead for Patient and Family Centered Care
– Physician Lead, eAutopsy Study
– SBC Covid Tele-Clinic
Southern California Permanente Medical Group
– Assistant Professor, Clinical Sciences
Kaiser Permanente Bernard J. Tyson School Of Medicine
Darcy writes:
Hi Daniel,
huge fan of TWIV and your weekly casts – it feels like we get honest information without bias or monetary incentive which is not easy to find in this pandemic. Firstly, I am not an anti-vaxxer btw but have a genuine question I am finding it difficult getting answers to and would respect your opinion, which might also help many others as evidenced by similar experiences I’ve read in arrhythmia forums. I had my first jab- AZ as I had a prior history of anaphylaxis to contrast agent used during an mri scan, whilst initially ok I had an arrhythmia bad enough to need the A&E (ER) and had several since taking me there since, each time discharged with no insights into why. Whilst I had a history of palpitations and some arrhythmia whilst ill previously with a benign adrenal tumour, I had not had anything significant for years. Could be entirely coincidental that it happened within 5 days of my first jab.
I am awaiting a variety of tests to see what might be going on but in the meantime, I keep getting contacted re my second and now overdue AZ jab. In the A&E a doc told me not to get the second one until I’d had some cardio investigations but with the Delta variant and pressure from social and familial sources to be fully vaccinated, I wonder if you can comment on your experiences regarding arrhythmias and covid vaccination and whether a second jab could exacerbate arrhythmia symptoms.
Many thanks and even if you don’t get round to replying I wish you all the best and applaud everything you do for us in this most difficult of times,
Darcy
Ken writes:
Dear Dr Griffin
I’ve just watched a presentation where several medical doctors have hypothesized , based on clinical studies, that long haul Covid is caused by presence of non classical monocytes containing S1 protein fragments, located on or near epithelial cells of blood vessels. These cells apparently engender various inflammatory conditions in the vascular system presenting as common symptoms of long haul Covid. The doctors have also presented evidence from their own practice that the use of Statins and Ivermectin have benefited patients by presumably shutting down the over active monocytes or somehow blocks the effect of residual S1 within the monocytes themselves.
I am not a doctor or scientist and not positioned to evaluate their claims, but would love to hear your thoughts on this hypothesis.
Thank you
Ken
Ps I had long haul Covid myself after infection in November 2020 and had a clearing of symptoms after the first dose of Moderna in April.
Danielle writes:
Hi Dr Daniel,
Thank you for the work you’re doing on the TWIV podcast and information dissemination.
Like many people who received the J&J vaccine in early April, I have been extremely worried about the efficacy and protection provided. Especially given that I live with a high risk individual who got 2 Pfizer doses. Honestly, I regret that I listened to the CDC advice to get whatever vaccine was available. For your reference I am a healthy 57 year old woman.
Based on data I had read on clinical studies of heterogenous vaccine trials in the UK and Spain, I decided last week to get 1 dose of Pfizer vaccine.
I listed to your podcast this week #69 and your answer to a listener who got 2 dose Sputnik vaccine and now must get 2 more doses in Canada of an approved vaccine and you seemed to indicate it would be safe to get 2 additional doses of an mRNA vaccine.
My question for you is whether it is safe to go ahead and get the 2nd Pfizer vaccine or whether I would be subjecting my immune system to “too much immune stimulation”?
Thank you in advance for any articles you can suggest on whether this regimen would be safe.