Alan writes:

I am a gastroenterologist in the New York area and wish to thank Drs. Griffin, Racaniello, and the TWIV  for their valuable service.  I have the following question:

If a fully vaccinated patient who was in a high risk group (age > 65 or medical co-morbidities) developed an early COVID infection, would you recommend the monoclonal antibody treatment?  Would the level of the patient’s COVID antibody level obtained at the time of infection make a difference in deciding the treatment?

I realize that there may not be any randomized trials for this type of situation at the present.  However, clinicians frequently have to make decisions in the absence of good data or good studies.

As a side note, your program is so interesting that I went through the Columbia Virology organized by Dr. Racaniello and also purchased the textbook.  While not a clinical book, the molecular biology of viruses is fascinating.

Best wishes,

Alan Rosman, MD
Associate Professor of Medicine
Mount Sinai School of Medicine

Linda writes:

Hi there:

Thanks for your very informative podcasts, and for making yourself available to answer email questions. 

I wanted to understand the role of the at home rapid antigen test for the vaccinated person following exposure to a covid positive vaccinated individual. 

Currently, as I understand the NY rules, no quarantine or testing is required for the vaccinated person that has been exposed.  I find that a tad concerning and wanted to protect my family (no one in a high risk category) and friends following such an exposure and so have been wearing a mask at home, and limiting my exposures to others for what will be 7 days (timing of my choice based upon my own review of the current debates).   I’m not sure what the magic number of days should be, particularly as I go on this frolick of my own since no one is telling me I have to do anything (other than wear a mask indoors).  I feel like there is a role for the at home antigen test in this setting, and considered doing it at days 3, and then 6.  

I just really don’t know what is the reasonable approach following close exposure to a covid positive vaccinated individual.  Can you explain if the at home antigen test plays a useful role in this context? 

Thanks so much!

Linda

Gabriel writes:

Dear Dr. Griffin 

A friend of mine suffers from  Bruton’s agamaglobulinemia and many medical doctors in Ecuador do not recommend any covid-19 vaccine for him.  I am a microbiologist and I have carried out research in immunology and although I understand that he couldn’t produce antibodies, the T cell responses should be fine. I don’t see any potential risks of him getting vaccinated.  I would appreciate your opinion about whether he should receive the vaccine and what kind of vaccine will be better for him. I also would like to thank you for all your clinical updates, although I am not a medical doctor but  I love to learn more about this disease. 

Sincerely 

Gabriel 

Abby writes:

Hi Daniel.

Peds NY here. 

My daughter was 17yrs in early March 2020 when I brought Covid home from the peds clinic.

She had very mild illness, fit rugby player. 

She is STILL  having GI issues. And neuro sx

She had signif tachycardia, fatigue, brain fog, depression, couldn’t eat, lost 20lbs. N/V/D

We need more parents to learn about long Covid. Many docs are still saying ‘it’s mild in kids’ and they are just as at fault not vaccinating their own kids!!!

We had a reporter write up her story. We need to educate about low risk of vaccines (which media loves) VS real risk for kids (which is getting little traction)

Dr Abby Siegel 

PS-millions of kids w this around the world.