Jennifer writes:

Dear Dr. Griffin, 

I am an RN and Clinical Informatics Specialist in a small critical access hospital in the Midwest.  I have been listening to your TWIV updates for most of the pandemic and they have been a source of sound clinical advice and information and the thread of hope, that has kept me afloat in a sea of confusion and distrust. I am incredibly thankful to all of you who take the time and energy to produce TWIV and I will continue to be a lifelong listener and learner. (The non-Covid-19 episodes take a little more concentration and research to understand but I love them also!) 

The reason I am writing today is to ask some advice for a friend and also, my husband.  My friend (40 years old and lives in Florida) was infected with a pretty mild case of Covid-19 over a year ago and is still dealing with lingering tinnitus that is affecting her entire life.  The hardest thing for her seems to be the fact that she has days that are completely silent, and they give her hope and then out of nowhere the ringing will return and her sense of peace is crushed.  She has seen an ENT who basically told her there was nothing that could be done but gave her gabapentin and an antidepressant.  They really didn’t seem to make a difference and she felt dull and lifeless while taking them, so she stopped.  She has tried clean eating and diet for inflammation, but it hasn’t helped.  She is following the Medical Medium protocol currently hoping that alternative medicine can make a difference.  She is constantly researching and looking for answers and is miserable and afraid that it will be permanent. It affects every area of her life, marriage, job, etc.  

My husband (55 years old and lives in Illinois) also had a mild case of Covid-19 in October of 2020.  He has also had, what he describes as a low humming sound in his ears since then.  Our TV volume is always very loud, and I often must speak very loudly for him to hear and understand.  He has had various rashes that pop up for a while and then resolve as well as some “traveling” joint pain (ankles, wrists, elbows) Currently he is dealing with sciatica that is a brand-new issue as well. I realize that some of this could be related to aging, but we try to look at it as possible residual Covid-19 since some of it is so strange. We also did a complete diet cleanse to try to help with inflammation but didn’t really see any difference in his symptoms.  

I should also mention that they are both in great shape, exercise daily, within healthy BMI, vaccinated and boosted.  My husband is resigned to the idea that he will be dealing with these different issues forever, but my friend is really struggling.  Any ideas, suggestions, referrals would be greatly appreciated.  



Gayle writes:

Hello and thank you for all the fact based information you and all the people at Microbe TV share with the world!

I am a regular listener of Q & A with A & V and your weekly updates. I hear Vincent repeatedly say that he thinks the fully vaccinated should be fine without a mask as we have a high level of protection. I then hear you say that  although the risk is low the fully vaccinated can get long covid and I have seen the studies that show the likelihood of being diagnosed with diabetes or other conditions is higher for those who have had covid. Are these risks dependent on how sick you get with covid? 

So far, I have been able to avoid getting covid (to the best of my knowledge anyway), I am fully vaccinated, I am nearing 60, I am not at my ideal weight, and I have a family history that includes heart disease and diabetes. I live in an area where we have about 60% of residents 5 and up who have at least one shot. The percentage of fully vaccinated is less than 50%.

As the mask mandates fall away I am trying to decide if being fully vaccinated is enough. What are your thoughts?

Chaim writes:

What’s your criteria for when you will personally stop wearing a mask?

Gabriele writes:

Hi there!

Thank you so much for doing these weekly clinical updates. I am someone who isn’t technically in a high-risk group for severe COVID, as I am relatively young and healthy. I am a C6 quadriplegic from transverse myelitis though, but I have no other underlying health conditions and no autoimmune conditions beyond that initial monophasic idiopathic TM attack over a decade ago. Due to the damage to my spinal cord, I have impaired coughing abilities. Any respiratory infection is concerning for me, as I have a harder time clearing secretions than the average person. There are also limited data on spinal cord injury and COVID outcomes, although so far it doesn’t seem like spinal cord injury itself leads to an increased risk of severe disease. I am triple vaccinated and have avoided becoming infected so far.

My question is about Paxlovid. I know that the immune response from vaccination is superior to that of infection in terms of durability etc., but was wondering if Paxlovid interferes with the potential durability of immunity from infection if one becomes infected despite vaccination, or if it just reduces the virus’s ability to replicate in the body without having an effect on initiating a robust immune response? Just weighing options on if I happen to become infected – if starting Paxlovid makes sense even though I might not technically be high risk (but maybe I am due to weakness of cough muscles?), especially if Paxlovid might reduce the “boost” of durability of my immune response from infection. Here’s to hoping I don’t ever have to make that decision, but it’s a question I haven’t been able to find an answer to so far!

And as a side note, I also hope we start seeing more accessible or easier to use home tests! As someone with impaired hand function, it is quite difficult to squeeze little bottles of liquid into other little bottles in order to take a home test 🙂 I know home tests can be a problem for those who are blind or visually impaired as well. 

Thank you so much and I apologize for this lengthy email!