TWiV 932: Clinical update with Dr. Daniel Griffin

September 3, 2022

In his weekly clinical update Dr. Griffin discusses vaccine effectiveness against influenza illness in children, clinical manifestations of infection with poliovirus, spike protein-independent attenuation of SARS-CoV-2 Omicron variant in laboratory mice, concordance of SARS-CoV-2 results in self-collected nasal swabs vs swabs collected by health care workers in children and adolescents, probable animal-to-human transmission of SARS-CoV-2 causing a pet shop-related outbreak, laboratory-confirmed COVID-19–associated hospitalizations among adults during BA.2 variant, SARS-CoV-2 specific T-cells and antibodies, Nirmatrelvir use and outcomes during the Omicron surge, real-world effectiveness of early Molnupiravir or Nirmatrelvir–ritonavir in hospitalized patients, and distinguishing features of long COVID.

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Intro music is by Ronald Jenkees

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7 comments on “TWiV 932: Clinical update with Dr. Daniel Griffin

  1. Jim Frank Sep 3, 2022

    Daniel mentioned this article but it didn’t get into the show notes, and it is a good one.
    “Unexplained post-acute infection syndromes” in Nature Medicine
    Thanks for all that you do,

  2. I’m not sure how people actually talk about the disease, but is it still necessary to remind the listeners that monkey pox is not a gay or African disease? Maybe mentioning it just feeds the negative narrative and one should not mention the distinction at all? Surely TWiV listeners are above that.

    Did Daniel really say that vaccinated people are just as likely to die? I fear that’s what makes people hesitant or even refusing the vaccines (“If they don’t help anyway, why bother?”).

    The clinical (or sometimes cynical 🙂 ) updates might be targeted at clinicians, but I bet the majority of regular TWiV listeners tune in too and I have the feeling – at least that’s how I experience it – that throwing a bunch of statistics at the audience is not very helpful. People cannot handle many numbers in quick succession very well. Comparing three drugs with ten different numbers of three different factors where it is not very clear what exactly they express, is very hard to digest. It would be easier to just tell “substance X has effectiveness Y” or “drug X is better than drug Y” or “people should get the vaccine because it showed positive outcomes of X% in trials”. I think people can handle those kind of information better and can also pass them on to others better. But if clinicians really are the main target audience here, then I guess we “normalos” just have to suck it up? 🙂

  3. Ian Light Sep 4, 2022

    Of the 241 patients over 50 who received two vaccines not three or four as it was between January 2001 to
    April 2001 how many received the monoclonals as did President Trump receive in October 2020 when he contracted Covid 19 ?
    Of the Four Double Vaccinated under 50 who died did they have severe co morbidity?

    • Elizabeth Hovey Sep 11, 2022

      Can you clarify what your question is? “…over 50 who received two vaccines not three or four” – Maybe a word or punctuation is missing. You make two references to 2001, which seems early even for SARS-COV-I. I hope you restate your question, because I am curious, but I hope also that you check out the published article of the study you care about, because Dr. Griffin would be looking up the answers for you to be sure, and you might find more context that helps you at the same time. Good luck.

  4. Kimona Sep 5, 2022

    Dear Dr. Daniel – regarding the Lancet article on “Real-world effectiveness of molnupiravir….”, I was surprised at what seems like ‘better’ results in support of molnupiravir use, than the 30% reduced hospitalization and/or death that was originally ascribed to it; and even though “all cause mortality” seems less with Paxlovid, the monupiravir indicated less progression to mechanical ventilation and oxygen requirement. Realizing that this is a retrospective study with all its potential skewing, and that these are patients that were deemed sick enough to be in a hospital setting – yet still a 1:1 propensity score matching should somewhat validate the findings. I have up until now been quite hesitant to choose molnupiravir, unless neither of paxlovid, remdesivir, or bebtelovimab are agreeable/available – considering their comparative >85% effectiveness at reduced hospitalization/death. Full disclosure – I abhor statistics and am not sure how to compare “hazard ratio” with “relative risk reduction”.
    If an elderly is being admitted within the first 5 days of a SARS-CoV-2 infection/illness (not requiring oxygen) – then remdesivir is an easy choice if Paxlovid is contraindicated. But for a Covid+ elderly in the out-patient setting, I would love having some data showing better than the 30% risk reduction for molnupiravir. Do you feel the Lancet article is indicating this? Would love your thoughts! Many thanks for all you do.

  5. Patti Sep 5, 2022

    Dr. Griffin – at 70 years old – is it possible to get a polio shot now or is that not recommended?

    • Elizabeth Hovey Sep 11, 2022

      I was so impressed to notice last week Dr. Griffin’s treatment guide! I have often heard it summarized, and attempted to commit it to laywoman’s memory. The challenge of relocating the right moments to share with friends I embraced many times. So finding this handy accessible version exists is fantastic!

      So much the better that the treatment guide it is here in Epitope 932, because it looks (at this writing) like #934’s extensive and, as ever, helpful links to information just happen to not include an activated link to the guide.