Josh writes:

Hi Dr. Griffin,

For a high-risk individual recently infected with COVID-19, does it make sense to take multiple treatments?  My grandmother is in her 80s and a kidney transplant recipient, boosted and recently on Evusheld (thanks to TWiV).  She just tested positive for SARS-CoV-2, and her hospital, having ruled out Paxlovid, is giving her Bebtelovimab.  Would it help for her to also take Remdesivir?  It’s hard to tell whether, of the four recommended early treatments (Paxlovid, Remdesivir, Bebtelovimab, and Molnupiravir), each patient is supposed to take only one, or take as many as seem safe.

Thank you for your excellent updates which have guided my family through the last 2.5 years!


Lilian writes:

Hi Dr. Griffin,

I have heard you speak many times about NOT giving steroids in the early phase of Covid treatment and I was wondering if you could explain (in layman’s terms lol) the science behind this so to speak, and why it is not a good idea. An acquaintance has just tested positive for the second time and was definitely given steroids early the first time.  I wanted to be able to pass along your knowledge with a more detailed explanation other than to just tell them it’s not a good idea, as I know they will ask me “why?”

Thank you so much for all you and Vincent do, huge fan of TWIV!



Mary writes:

Good morning.

Please speak to when baseline LFTs, PT/INR and eGFRs are needed for 3-day Remdesivir prior to administration and whether retesting during the course is needed. Since the course is so short and it can take more than 24 hours for outpatient lab results to become available, it is likely that the timing for the second and third dose may roll around before test results are known. Was this retesting initially recommended for a longer course of Remdesivir? The PINETREE study suggests that outpatients with mild-moderate COVID-19 administered 3 day Remdesivir may not require baseline creatinine if they weigh > 48 kg. What about baseline LFTs and PT/INR? What about retesting? Any insights you have would be appreciated.

Working everyday to keep COVID-19 patients out of the ER and hospital,

Mary Sturm MD

Board certified in Emergency Medicine

Kathleen writes:

Dear Vincent and Daniel,

Thank you for all you do with TWIV and as well the clinical update. Always informative and cutting edge.

This morning I was catching up on TWIV clinical update 945 on my ride to CUIMC. Thank you for discussing the recently reported occupational exposure of the Nurse to monkeypox resulting in a monkey pox infection. As reported in the MMWR Volume 71 10/17/22, the needlestick occurred when recapping the used needle by hand before disposal. I think this might be a very good teachable moment. I can’t help myself as a clinician and safety professional, to remind – never recap a needle … if one must absolutely cover the needle prior to disposing in a sharps container, then utilize the one-handed technique.

Just my two cents when discussing the needle stick that resulted in a “Generian” pustule 4 days later. Thoughts?

Thanks for all you both do!!!

Have a nice weekend. Best, KAC

Kathleen Crowley, DrPH, MPH, PA-C
Vice President Environmental Health & Safety
COVID-19 Safety Coordinator, VP&S
Columbia University