Jeremy writes:

Dear TWiV,

I listened to your clear and informative discussion with Michael Worobey in TWiV 876 about his recent preprint showing the Huanan market was the epicenter of early COVID-19 cases. He explained that the earliest discovery of a case cluster was on December 27 by Zhang Jixian, a doctor at the Hubei Provincial Hospital of Integrated Chinese and Western Medicine [1].

However, other sources have made rather different claims. At about 17 minutes into the TWiV Special with Ian Lipkin, your guest said that he first heard about the outbreak on December 15 from Lu Jiahai, a professor at Sun Yat-Sen University in Guangzhou. This is in stark contrast to the WHO report, which shows just six cases with symptom onset before this date. Lipkin has repeated this date several times since then; it would be very helpful if someone could ask him for evidence such as email records to support this claim.

Skeptics of the WHO timeline tend to cite two other media reports from March 2020. One is in the South China Morning Post, about efforts to retrospectively trace the earliest cases [2]. It states that the first identified case was from November 17 and that 27 infections by December 15 had been identified. Since this is about a retrospective study, it doesn’t corroborate or refute Lipkin’s claim. The other is about Connor Reed, a Welsh man who was living in Wuhan. He reported feeling ill on November 25, going to a hospital on December 6 where he received a pneumonia diagnosis, and receiving a retrospective COVID-19 diagnosis in January 2020 [3,4]. Unfortunately he has since died in unrelated circumstances, which makes it difficult to corroborate his story. (Of course, this is great fodder for conspiracy theorists.)

People outside China — such as Ian Lipkin and friends/family of Connor Reed — may have important records that shed light on the murky early timeline of the pandemic. A serious investigation could collect evidence and either help put to rest conspiracy theories or disprove the early timeline given in the WHO report.

Best regards,

Jeremy

[1] M. Worobey, Dissecting the early COVID-19 cases in Wuhan, https://www.science.org/doi/10.1126/science.abm4454 

[2] https://www.scmp.com/news/china/society/article/3074991/coronavirus-chinas-first-confirmed-covid-19-case-traced-back 

[3] https://www.dailymail.co.uk/news/article-8075633/First-British-victim-25-describes-coronavirus.html

[4] https://www.youtube.com/watch?v=ex3N2g6iUdw 

Sonali writes:

Hi Vincent and Brianne,

Thanks for your recent episode on IL-1/IL-1a induction post mRNA vaccination, and a big kudos to all that you and the entire TWiV team do on a weekly basis to disseminate credible scientific information. It’s not an easy task but you do it so well.

I enjoyed your musings about the potential use of anakinra (an IL-1R antagonist) in patients with severe inflammatory responses following COVID19 infection. As a rheumatologist, I have now been involved in the care of several patients who developed Multisystem Inflammatory Syndrome in Adults (MIS-A) following “mild” cases of COVID19 infection. Unfortunately, all were in young, unvaccinated patients. I thought you might be interested to know that we frequently reach for anakinra in these cases and that it has saved many of these critically ill patients in combination with high dose steroids. It is also one of our go to drugs in cases of Macrophage Activation Syndrome (which clinically resembles MIS-A in many ways due to widespread cytokine release). 

I know that Daniel frequently gets listener emails about how various immunosuppressive drugs might affect the efficacy of COVID19 vaccination. I would like to point out that the American College of Rheumatology has assembled a task force to provide guidance on this very topic. In these cases, it might be appropriate for the patient to consider holding their medications prior to and immediately after vaccination to maximize vaccine efficacy, but this decision should be made in conjunction with their physician. 

Thanks again for all you do. You’re an inspiration. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8427105/

American College of Rheumatology Guidance for COVID‐19 Vaccination in Patients With Rheumatic and Musculoskeletal Diseases: Version 2

Due to the rapidly expanding information and evolving evidence related to COVID‐19, which may lead to modification of some guidance statements over time, it is anticipated that updated versions of this article will be published, with the version number included in the title.

www.ncbi.nlm.nih.gov

Sonali J. Bracken, MD, PhD

Division of Rheumatology and Immunology

Duke University Medical Center

Jaap writes:

Dear TWIV/microbe.tv,

First, thanks for a great collection of podcasts.

A small nitpick regarding TWIV 882: while discussing IL1b processing it was mentioned that 2 signals are required for mature IL1b.

I haven’t kept up with the literature so perhaps the below references are outdated. However, I believe that while mice (most?) cells need two signals to produce matured IL1b, it is not a general requirement. Specifically, it has been shown that human monocytes can secrete processed IL1b after a single stimulation with TLR2 or TLR4 ligands (Pam3Cys: a synthetic molecule mimicking bacterial lipoprotein, and LPS a component of the cell wall of gram negative bacteria). 

Whether this is relevant in the setting of mRNA vaccinations is another matter of course.

Thanks again for all the great work,

All the best,

Jaap

Differential requirement for the activation of the inflammasome for processing and release of IL-1β in monocytes and macrophages | Blood | American Society of Hematology (ashpublications.org)

Human Monocytes Engage an Alternative Inflammasome Pathway (cell.com)

Rich writes:

Dear all,

You might be interested in this as a listener pick, as Darwin’s sketch of the tree of life has been mentioned several times (including as a tattoo?).  The notebooks had been missing from Cambridge University library for 15-20 years…

Rich

‘Stolen’ Charles Darwin notebooks left on library floor in pink gift bag – BBC News

Neva writes:

#WOMENSART (@womensart1) tweeted at 2:23 AM on Sat, Mar 26, 2022:

Elin Thomas, UK textile artist who uses embroidery, crochet and felt work to create unique work resembling petri dishes and bacteria spores #WomensArt https://t.co/mvRZVOAxUg

(https://twitter.com/womensart1/status/1507619346050433025?t=0wHjOig1_HeF_KBw27oDJg&s=03) 

Viki writes:

Being a devoted listener to microbe tv, AND, a devoted listener to https://historyofenglishpodcast.com/ , I’m guessing other microbe tv groupies might enjoy both, as I do.

Jump right in with episode 95 about the invention of the “university” and the “PHD” during the12th and 13th centuries.

Cheers, Viki