Hi Vincent and crew.
I’ve been enjoying your podcast for over 3 years now so thanks for the excellent COVID coverage. Still haven’t got the virus yet, somehow, 23 yo male with 4 shots and regular N95 masking.
I’d like to share a different virus-related story that happened to me just 2 days ago.
Recently, a random dog that was being walked by a little girl licked/touched my right jacket’s sleeve for a second in Valencia, Spain. This prompted my rabies anxiety to go up by a thousand points. I was going to eat when that happened, so I cleaned my hands and sleeve with hand sanitizer, ate, and had a bit of a panic.
According to WHO guidelines this is a Category I exposure “Touching or feeding animals, licks on intact skin, contact of intact skin with secretions or excretions of rabid animal or person”, so its “not regarded as exposure, therefore no PEP required”.
I won’t be getting the shots after all. This doesn’t quite put my mind at ease, as health anxiety with “what ifs” kicks in, but I’m staying rational. The guidelines are there for a reason.
Thankfully and surprising fact, Peninsular Spain has had no cases of dog-induced rabies since 1978, with only one imported dog rabies case in 45 years. This speaks greatly of the work that Virologists, Veterinarians, and the Spanish Government have done over the last decades.
I was also very sad to learn that the indication for potentially exposed dogs to rabies with no vaccine is mandatory euthanization.
I loved your 1918 influenza episode with Jeffery Taubenberger.
You guys are awesome, keep the virology up!
Dear TWiV experts,
Thank you so much for all the knowledge you have shared over the course of the Covid pandemic, when I, like so many others, found you. I’ve learned so much that is enlightening, and recommended your podcasts on Covid origins to all my Chinese politics specialist friends. I also have found Dr. Griffin’s clinical updates personally invaluable – knowing what to ask for when.
I am writing you from Beijing China, where I have been since the end of October. I’ve basically experienced it all – Zero Covid, the end of Zero Covid, quarantine, the mass testing regime, getting Covid in China, and recovering and now being out and about with a society, at least in Beijing, that is pretty much through the wave. I thought I’d share a little of my experience with you.
Firstly, quarantine started with a quarantine hotel, where one was literally confined to a room for 10 days. Three times a day someone would leave a tray of food outside my door, knock and run away. I would see a fully PPE clad worker hurrying down the hall as I retrieved my tray. Most days a health worker (no idea what qualifications) would come to give me a Covid test. At the airport there had been both a nasal (very deep) and throat test, and that double procedure was repeated on day 7, but otherwise it was a throat swab. On day 7 they also swabbed various places in my room that I would have touched – doorknobs and the like – to test for Covid. I came back to my computer and found my track pad wet – they had apparently swabbed it.
After getting out of quarantine in Shanghai I took the train to Beijing, showing both my Shanghai and Beijing health code apps on my phone. There is no national system. Every province (or centrally-managed city) has their own. I then was free for an evening, and even went out to dinner, before the system caught up with the fact that I had been in Shanghai, where there were already new cases emerging. That’s when I started to understand how local the system really was. The message (called a pop-up by everyone) on my phone said that if I had been in an area with Covid, which apparently my quarantine hotel was in such a city district, I needed to test for 3 days. But the local district government in Beijing decided I should quarantine for 7 days. Many, many people said that was not correct. Various people tried to point out to them on my behalf that I hadn’t really been in the district, but in a quarantine hotel with absolutely no contact with anyone, but to no avail. I was put in quarantine again – but not a special hotel. This time I was just put on a quarantine floor of a regular hotel. I wasn’t supposed to leave my room, except to go get my daily Covid test. These were administered out on the street by a car that would drive up to test all the people who had pop-ups at a designated time. So I would leave, then come back. I didn’t want to get reported to the district, so I complied.
Once out of quarantine for the second time I found a city where everyone was super cautious. Covid cases were increasing, and everyone was afraid of getting locked down or worse, getting sent to a fever hospital. So restaurants were open, but empty, and people were basically staying home or going to the office. But they weren’t really wearing masks. They would put them on to go through gates and building entries, where guards checked. But they would take them off once in the office. And most Chinese offices are communal. The lab I work in had about 20 people. The university dining halls were also open – so lots of people together – and students, faculty and staff all eat in dining halls. Even retirees who live around campus will eat there.
The university had its own extra health code in addition to the city one. It had its own definition of contact, which was broader than the official government one. Localities, companies, universities were all free to add extra requirements. As a result, all through November various of my colleagues were not allowed on campus because of a “secondary contact,” i.e. near someone who was near someone who got Covid, even though they were completely free to be elsewhere in the city, go to restaurants, supermarkets etc.
At some point in November schools went back to online. We also were required to test daily – it had been every 2-3 days. Between people who had to stay home to watch their kids, and people who had contacts with others and had to stay away from the office, by November 24 (yes, Thanksgiving) I was the only one in the office! By this point everyone was warning each other not to test for Covid, because there were so many cases that the pooled tests would come out positive. The university also said that no nonpermanent staff could come on campus, as they increased restrictions in the face of increasing numbers of cases.
So I wasn’t on campus when the demonstrations occurred. Afterwards, they said students could leave, but for those on campus, most restrictions remained. Less than half the students went home, because I assume a lot of them wouldn’t have the internet connections they needed to study on line or any place to study.
That late November/early December period was one where there was a sense of impending lockdown. Lots of housing developments were under lockdown, but not mine. And people were doing anything they could to avoid getting stuck in a fever hospital. Mostly they stopped taking Covid tests. If you don’t go in anywhere you can avoid it, and home delivery of everything is everywhere.
Around Dec. 7, when they lifted restrictions I was allowed to go back on campus – but I still needed to take Covid tests (my fulltime colleagues didn’t). That’s when I experienced what had happened to the Covid testing system. The Chinese were using pooled tests – they would put 10 samples together (it was called “10 mix 1” in Chinese, so I know it was 10 – at least in Beijing), and then if anyone is positive they retest the 10. That works fine when there are very few positives, but collapses when any 10 will have 1 positive. Starting December 8, I went through this pooled positive followed by needing to retest twice in a row. But given that this was happening everywhere, the whole system was slowed down. It took over a day to get the first notification – from first test to final clearance the first time took 4 days and the second time almost 3. If I had been positive, I could have infected half the city by then. The last Covid test after these two pooled positives I convinced the guy to give me an individual test.
After that I got Covid. I was in the big office that seated 20, plus extra space, with one colleague. I had a mask on. He didn’t. The HVAC was on, and the windows were open. He came down with Covid the next day. I got it the following day.
At that point I had had 4 mRNA shots, plus had had Covid in August. Every expat I know here who got mRNAs overseas has gotten Covid. And so have most Chinese I know. But most of them have done fine. The ones who haven’t have all been elderly.
That gets me to the vaccine issue. There are several studies from Hong Kong suggesting that if people had their full 3 Chinese vaccine series they did fine – avoiding severe disease and death. I know there is a Singapore study that still shows mRNAs did better – but that was with 4 or more shots, and that is hard to imagine here. So the issue is that many elderly aren’t fully vaccinated. You ask why and what the politics are. Firstly, confining someone to a home and actually forcing something into their body are perceived differently. Secondly, a lot of the issue was doctors advising elderly with any health issues – cancer, heart disease, etc. – that they were too weak for the vaccine. Thirdly, the elderly felt safe – they often really liked the Zero Covid policy and assumed it kept them safe. Fourthly, a lot of folks didn’t think the vaccines worked. The western deprecation of Chinese vaccines did seep through. But the Chinese propaganda against western vaccines also had blowback against all vaccines (kind of like how antivax has spread from Covid to measles in the US). And then there is the weird response to the low reactogenicity of the Chinese vaccine – it doesn’t make you sick like an mRNA. That should be a good thing, except it had many people doubting they got more than saline. The low elderly vaccination rate was an urban phenomenon – rural rates are higher. I can’t say for certain why, but I suspect it is a population distribution question – many rural villages have only the very young and the very old, as the 20-40 age population goes to urban centers to work. Thus, if local health offices were given a percentage quota of what they were supposed to vaccinate, they couldn’t meet it without convincing the elderly in rural areas. But in cities they could reach their quotas with working age folks. And the initial priority was on working age population, because there was no immediate threat and they were seen as the more likely vectors during some future outbreak. So there definitely was a problem. But I’m not convinced it was an mRNA problem.
The real problem once the outbreak began was its speed, its intensity, and the lack of Paxlovid. Initially there was almost none, despite the fact that Pfizer had signed a deal with a local company to produce it – seems like that never went anywhere. Then they started importing some, but I’ve seen numbers like 620,000, and the estimate that I saw was they would need 130 million. Needless to say, it became a hot item, and people in the know in Beijing were buying it in advance to have in case their parents got sick.
I personally know of several people who lost elderly relatives. And I’m hearing that the death rates among retirees at the university are much higher than usual.
Beijing has become a city divided by health. For most people, including me, they’ve had the disease, recovered and are now back out and about. Restaurants are not full, but there are many more people eating at them than was true back in November. Traffic is back to getting jammed in the day – something I did not see through all of November and early December. But there is this other reality of people that are sick and in hospital. I’m not sure how crowded they are this week – certainly were last week. I just heard from a friend whose parents in Wuxi (near Shanghai) just went to the hospital (oxygen level fine thank goodness), and it is so busy there that they went at 4 am. Shanghai is definitely a week or two behind Beijing in this wave. Some other cities like Chongqing and Baoding were probably ahead of it.
The bottom line that I’m trying to describe is that once it became an omicron winter the previous testing and isolation system simply collapsed. If they had tried to open last summer, they might have been able to do a gradual opening, but in the winter they didn’t stand a chance – with Zero Covid the disease was already everywhere. Because the most fundamental thing to realize is there was no behavior change when they dropped the policy on December 7 – people weren’t going out before, and they didn’t go out after. That is they didn’t go out until after they got sick. Now they are out and about because they feel safe.
As for all the propaganda about omicron being mild – I think that is mostly a ham-handed way to try to get the public not to be terrified of getting the disease. And for most people here it has been mild to moderate. I do know a lot of people who were only sick for 1-3 days – mostly vaccinated folks under 60 years, even some older vaccinated folks. Of course, this is because this disease is wildly variable.
I’ll also say that a lot of the public was very skeptical of government propaganda. I have been asked so many times if it really is true that 1 million people died in the US. The government has pushed that line so hard that people just assume it is propaganda.
It is also the case that people had all kinds of ways of avoiding lockdown and avoiding getting sent to fever clinics. I have met a number of people who moved from one place to another when they got wind of an impending lockdown. I also have a friend who discovered the sensors put on his door to keep him from leaving his house had no batteries. A lot of the system was run by local residents committees, who are retirees in housing developments. They liked Zero Covid, because it made them feel safe, but they also weren’t exactly professionals. And starting in late November residents would start demanding documentation from the local CDC that there actually was supposed to be a lockdown – another thing that slowed the process. All of this is to say Zero Covid wasn’t keeping cases at Zero – they were rising rapidly, and the system collapsed because of omicron.
I hope you find my tale somewhat interesting. I think it feels quite different on the ground.
Assistant Professor of Political Science
Thank you and your amazing team of scientists and friends for providing me and thousands of other listeners with so much listening pleasure! Sometimes the information is over our heads, but we’re always learning and appreciate all you have done for us these past years since COVID reached our shores. Today you said that you believe the listeners learn from and appreciate the friendly banter, and you were correct! The back and forth between you, your co-hosts Brianne, Kathy, Dickson, Alan and Rich create an amazing forum for learning complicated and vital concepts. I’m a recently retired pediatric nurse who just LOVES listening and learning about scientific research. Sidebar conversations make it all very entertaining and memorable. Having guests like Paul Offitt and Carl Zimmer on the show reminds us we have much to learn, things are never stagnant or boring in science. I rarely watch, but thank goodness for your podcasts which can be accessed anywhere and everywhere.
Finally if you have fond memories of trips to the Horn and Hardart Automat in NYC, you can watch a wonderful documentary on HBOMax (maybe also YouTube, I’m not sure) created by Lisa Hurwitz about these amazing food emporiums that existed in a different lifetime in NY and Philadelphia, that many of us of a certain age remember so well. Plus the documentary is hosted by Mel Brooks who sings and jokes in praise of eating creamed spinach in Manhattan so many years ago.
Happy and Healthy New Year to all!
(In thanks for all you do, I sent a donation via credit card and purchased several items at vaccinated.us for holiday gifts.)
Cherry Hill, NJ
First, thank you for your podcast!
Second, I was listening with interest to your episode: “TWiV 973: Crouching virus, hidden triggers with Felicia Goodrum.”
If I understand correctly, cytomegalovirus (“CMV”) is widely dispersed throughout the body by way of infection, and a large part of immune function may be tamping down what could be a cytokine cascade or, at the very least, a serious immune reaction to the widespread infection by the virus.
My question is this: Could aging or at least a portion of aging actually be due to the body no longer being able to restrain the immune system from attacking CMV-infected bodily tissues?
In other words, is aging largely or even primarily simply an immunopathological disease that is triggered by inadequate tamping down of a robust immune response to CMV-infected cells?
Perhaps this could explain age related symptoms like deterioration of joints, disintegration of cartilage, fibrotic changes in lungs, recession of gums, or even some dementia. Perhaps these are manifestations of a slowly deteriorating check on the immune system in its quest to deal with CMV-infected cells. A quest that necessarily eventually destroys or seriously harms the body because the CMV-infected cells will be injured and/or destroyed by the immune system.
Again my thanks for TWIV!
Hi Vincent and the TWIW team!
I just learned the plural of anecdote. It’s obviously not data, but anecdata!
Hi TWIV team:
I live in the Pacific Northwest. My best friend recently contracted COVID and called her doctor to ask about getting Paxlovid. She was offered the drug but at the same time discouraged. She was told that if she wanted Pax she should “know” that taking Pax would make her more susceptible to it in the future. To me, this comment suggests that PAX weakens the immune system. I had never heard this, and I think it is ridiculous and reckless.
Please comment on this comment provided by a medical professional to a sick client.
Dear TWiV Team,
First, like many other listeners, I want to thank you for the invaluable work you do in science communication. I have been an avid listener since mid 2018, when a colleague of mine who is a chemical engineer recommended your podcast. Needless to say, during the pandemic your program became an essential listen, because not only did it keep me sane and well-informed, so that my wife and I could make informed and intelligent decisions about our health risks, but it also turned me into a sort of “guide” for some friends and family who were inundated with alarmist news and misinformation. I was even able to manage my elderly mother’s pandemic strategy from thousands of miles away, all thanks to your advice and clear statement of the facts as you knew them at the time.
I write to suggest a “listener pick”, which is right up TWiV’s alley. My colleague Andrew Wehrman just published The Contagion of Liberty: The Politics of Smallpox in the American Revolution, with Johns Hopkins UP. The book explores the emergence of the scientific “discovery” of inoculation for smallpox in the West, and its confluence with growing political concerns in the early years of the US Republic. It explores the details of how the origins of inoculation were whitewashed, so that that it would be more “acceptable” to white colonists. It also documents how prominent American figures, such as Benjamin Franklin, became some of the strongest advocates for inoculation, thereby making it an American “discovery”. It is not a dry academic book, but rather an engrossing read that sheds new light into the history of public health politics in the US. It really is worth reading.
Again, my sincerest thanks for all you guys do. By now, I am so used to your voices and quirks, that I feel like I am listening to a group of trustworthy friends. Keep up the good work.
Roberto Mendoza-Farías, Ph.D.
Associate Professor | History, World Languages, and Cultures Department
Pearce 305 | Central Michigan University