TWiV 1142: Clinical update with Dr. Daniel Griffin

[@JunJieOng-d4o]

Thank you for making the trip to Singapore (and to Taiwan). And recording the show with Vincent at 5am local time just speaks about the commitment and dedication you give to the show. Bravo!

[@DudeFun-yi7nu]

In a world filled with ego-centered know-it-all doctors, your humble approach to sticking to the data is so comforting and reassuring. We thank you.

[@Ramiiam]

Data? There is a lot of data on mRNA vaccine risks being ignored here.

[@redhen689]

@@RamiiamThe vaccines are still much safer than actually catching the virus.

[@ryanburgoon7354]

The drs lean left....

[@razerginn]

Only smart people lean left​@@ryanburgoon7354

[@WillNewcomb]

Always so grateful for your reviews of recent studies and latest recommendations. Many blessings.

[@pambp5978]

Thanks for your dedication. It is always important.

[@ehfik]

dr. griffin is such a treasure. thank you!

[@WillNewcomb]

What was it like in the early days in your country? I've been living in China as a retired Brit since 2014. I cannot recall when I first heard about SARS-CoV2, but I do remember it being talked about in the second week in January. My wife recounted how horrified she was on hearing the the Wuhan administration had planned a major mass gathering/celebration of 1,000s of officials around the 3rd week in Jan. Shortly afterwards the central govt took over in Wuhan and the city was isolated on 23 January; zero flights, zero trains, road blocks. We had family members return from Wuhan just hours before the blockade. It was the time of the Spring Festival/Chinese New Year and we went out for a big family meal out. Somehow we got a limited supply of surgical masks but pharmacies had already run out. It wasn't until at least two weeks later that supplies became more available, being distributed to residents in the local major park. Changsha, being 300km S of Wuhan experienced recommended restrictions but no lockdowns. Things were already quiet because of the national holiday when most small businesses closed down for a couple of weeks. All supermarkets remaining open required temperature testing and mask wearing. All residential blocks likewise and banned non-residents from visiting, and some roadblocks were imposed where other existing security facilities were lacking. At that time my wife's parents lived in their home in the middle of the city. My wife traveled by bus to them everyday to cook for them. Normally buses came every minute or so. She often had to wait 30 minutes for one to come, and then it was empty. While I recognise that early on there was secrecy and Li Wen Liang, opthamologist who's social media post leaked the SARS-like illness to the world, was threatened and silenced by the police, my experience is that China was taking it bloody seriously. When I reflect on what happened elsewhere, my country UK for example, I despair. The Prime Minister failed to attend 5 emergency meetings of COBRA in Jan/Feb and did F.A. to restrict the spread of the disease or even impose sensible NPIs to help protect people. I remember the professor of global public health in Edinburgh Devi Sridhar Tweeted that immediate action HAD to be taken even if it meant an over-reaction. That was dated 26 January. The effing govt did nothing. And of course, later on on 20 September the SAGE advisory group insisted that emergency action be taken immediately to stem the growing 2nd wave, and were totally ignored for months. Later analysis of samples taken found that the first occurance of Alpha was found on....20 September. The UK had in fact infected the whole world with the latest variant because of a laissez faire govt. And I suspect, most other govts across the globe weren't much better. Yes, SARS-CoV2 started in China but almost every country has been involved in helping it because they ALL failed to take responsibility within their own regions. It's been a world-wide failure.

[@georgesibley7152]

you were lucky, transport in Wuhan was stopped and only those with exemptions could move around. Those of us on the outskirts fared worse for the gates were locked and there was no access to shops, while people in Wuhan proper had food deliveries those of us on the outskirts did not until a few weeks had passed. After a few days we were allowed out of the building to go the gates where outside people were selling vegetables at twice to three times the normal price and which were of questionable quality, It took some time before people were "arrested" and allowed on certain days to go to the supermarket whose shelves tended to be empty. Even then only 1 person per household was allowed out. Masks were mandatory and people who did not wear them even to hang ut washing were taken to places where for a full day they were instructed on wearing masks. as for secrecy, it was on Wuhan tv and all hospitals and clinics in Wuhan and the surrounding area were fully informed of the problem. as was the WHO though during the time of the local party jamboree The local government did pressurise the local CHC to minimise the outbreak, which resulted In Information not being forwarded as promptly to the Nationa CHC, Even worse they printed out free tickets to visit Wuhan and held a big party during this short time. Given that in Wuhan, there were already 2 variants of Covid by November 2019 then the alpha variant would have popped up elsewhere. Though the first alpha variant was indeed found in Kent in December 2020.. to be fair this was a new disease and how to contain it and treat it was unknown at the time. what matters is that lessons were learned and strategies have been developed fr future epidemics.

[@robinirons541]

Blaming the UK is far fetched and stupid . No one collapsed on the streets of the UK like we saw in China. No one in the UK was sealed in their homes like the communist freedom freaks did in China.

[@circa1890]

In the Pacific NW of the US here.. I started reading of it on my science sites which were surprisingly encouraging news such as that it wasn't traveling person to person nor airborne. By January 13th, I read of the infected tourist who had not visited the Wuhan Market, then 2x accounts of asymptomatic spread a few days later, then multiple reports out of Chinese hospitals indicating that it was airborne. Within minutes on Jan 19th I read that China said it was "preventable and controllable" and the next article showed a photo of a train station with thousands of people going home for the festival .. I knew that was the end. I woke up at 4am on Jan 20th and wrote to WHO, CDC, and NIAID asking when they were going to start curtailing travel and that we most likely were heading for an imminent pandemic and to act fast. On Jan 21st, bought a large pack of reusable viral N95s, a pulse oximeter, a thermometer, two canisters of lysol wipes, gloves and bleach. Warned whoever would listen which turned out to be quite a few. We started testing and tracking for it at my research institution and perfected the testing then started designing at home tests. One lab in my building built an open source platform for real time tracking of viral evolution. One month of hell working diligently .. knowing what was coming but unable to stop it. My institution had us WFH as of March 3rd. We were told to leave that day and act like you're not coming back. Though some of us were coming in to continue the testing, etc. masked in N95s. I know that the pandemic is not over. I know that this disease creates potential vascular disorders, long covid, and the dropping of 3-9 IQ points with each infection, in essense, brain damage. I know that it's not readily acknowledged since "the world must go on" but I do wonder what this world will look like in 20 years. -still a Novid, for now..

[@georgesibley7152]

@@circa1890 the science at the time was that restricting international travel would not be effective and that there was little evidence that it would help. The uSA had strongly preached this line when they refused to prevent people going abroad during the H!N1 outbreak. I do not remember China saying it was preventable and controllable. If anything Doctors in Wuhan and the medical research team that was set up in December though otherwise. The Mayor and his fellow politicians tried to downplay it but the WHO and the medics knew otherwise. what they did not know was how it was spread, the scientists and doctors did not wish to jump to conclusions as Dr Zhi later stated in an interview, They feared it would cause greater panic. It was not until later a patient IN Shenzen who had never been to Wuhan contracted it that they realised how it was passed. (Although the patient had to been to Wuhan the family had). However, the medical notes as opposed to the press release by the WHO stressed that precautions against the possibility should be taken from the start. New year then was Jan 25th so most people would not have gone home then, although there were hundreds of thousands of commuters on a daily basis. Crowds in Wuhan railway stations are normal , though a few days before Chinese new year they are exceptional standing room only.

[@circa1890]

@@georgesibley7152 What was known by Jan 14th was that someone had it who had not gone to the market (Journal Science). The C-CDC said at this time that it was a "limited outbreak" and that it "might be over." It was on the 19th, (BBC) where it said that China is still "preventable and controllable" and that there have been no cases of person to person transmission (something we already knew was happening). Two days later, they changed their stance. I remember a photo at a train station, with a myriad of people on Sunday the 19th, with the caption saying the beginning of travel for the Lunar New Year had started. By this point there was no way to stop the pandemic from happening with travel restrictions but to mitigate the spread so that the world could prepare (like we were setting up at our research institution). Testing, tracking, understanding method of spread, etc. These are all extremely important at the beginning .. It was an unmitigated disaster of public health. We were ineffectual then, and sadly, we will be with the next pandemic. Very few learned from that experience.

[@Logotic]

Early days: I became aware of covid sometime in early January 2020. I'm old enough to remember the swine flu panic of the 70s and thought this was likely something similar, so I booked a flight to Berlin in March. Come March, of course, I found myself not in Berlin, but in the frozen food section of Whole Foods, staring at the only thing left, a single box of frozen sliced rhubarb. My niece, a CC nurse like her mother, had sent us a picture of the gear she had to wear to take care of covid patients. Neither she nor my sister talked much about their most awful experiences until later. I still tear up with pride at their courage. It was around this time I started listening to TWIV and to John Campbell, who had not yet gone insane. And that's about what I remember.

[@Henry-fk7cq]

Campbell is criminally irtesponsible and KZbin IS COMPLIICIT. Take him down. Antiscience teacher!

[@redhen689]

@@Logotic I worked as a respiratory therapist. I remember those days well. It was so scary and I lost several friends due to their beliefs in all those bizarre conspiracy theories. It was a crazy time.

[@tonaruch8623]

How generous for Dr Griffin to speak with us in the wee hours of the morning before sunrise! You can see the sun rising light through his window

[@iashakezula]

Thank you for the update Dr Griffin. I got sick with Covid from my husband around mid July who didn’t even check himself 😡 when he started feeling sick. I got Paxlovid on day 2 of symptoms onset. That bronchitis symptoms took over 4 weeks to go away.On the second week , the rapid test was turning negative while my husband who didn’t take the PAXlovid was very positive even towards the end on the second week and third week My work hospital, UCLA, scheduled the staff vaccinations of the flu and Covid vaccine will be on Nov 1. So I should be able to get it. So far I didn’t get sick with the Flu or colds. I still wear my mask at indoor crowded areas.

[@WillNewcomb]

As a totally unqualified layperson I realise it's all too easy to criticise experts. But I'm absolutely horrified by the stories two of your correspondents recount about the misunderstandings about the effectiveness of Paxlovid. If this were a rare disease that very few had come across I could understand how easy it might be to be misinformed, but this has been going on for 4.5 years and has killed 1.2m people in the USA, one of the highest fatality rates in an industrialised country. If these doctors are so misinformed about something that has been extensively studied, it really begs the question about how much they really know about their speciality in general. Doctors: put your house in order!!!

[@kristivice5537]

I am so grateful for your work. Thank you.

[@judyjones7300]

I LOVE this podcast . As an insurance based primary care doc it has guided me through this pandemic and beyond. Cannot thank you enough . Also wanted to report on something that just happened to me . I have covid for the second time - last time was February 2024- so my United healthcare coverage is not going to fill my new Paxlovid prescription until NOVEMBER 11th!!! Sometimes so hard to work under the capitalism of health care. My primary care doctor called them back and was first directed to the 5 day prior with - he then explained the urgency and now is waiting to hear from a one day prior with which HE has to call back later today in the middle of a typically 18-20 patient day… Daniel do you still consult with United Healthcare? I am 64 yo with some cardiac issues. Wondering how this is possible to withhold Paxlovid and to pay out of pocket in this country is approx $1400 . Discouraged

[@quincymedex]

Always love your podcasts. I love the discussion of science and evidence based medicine. Thx from ID / PM provider in Florida.

[@aishahnazirdeen5858]

Both my elderly parents took Paxvclovid when they had Covid and it really worked like a wonder drug!Their symptoms resolved faster compared to mine (i didnt take the paxclovid due to the restrictions for young people in Malaysia). Big thanks to both of you for your amazing dedication. Mindblowing and keeps me motivated as a young clinical microbiologist!

[@crystaldragonwoman]

Amazingly my friends tell me there is no use of Paxlovid in Holland including… one person’s doctor never heard of it ….

[@Dominatrix97]

28:00 wait, have I heard that correctly? 40% efficacy against hospitalisation one month after vaccination?!? Really, really disappointing.

[@redhen689]

40% is still better than 0%. It’s similar to the effectiveness of the flu vaccine.

[@radmehrabdolahi1346]

That’s against or compared to baseline immunity. So the new vaccinate be those already vaccinated. So 40% better than baseline

[@Bete-Bete-Bete]

Or are repeated infections harming people’s immune system so that they aren’t having a good response. You left that out.

[@Turtledove2009]

A very good point. Hopefully there will be studies that can shed light on this question.

[@Tabitha_K]

Accessing treatment with Paxlovid in the UK is near impossible. Just saying…

[@robinirons541]

Because the NHS is not funded by big pharmaceutical companies. The treatment for people on the NHS web site for people falling ill with covid is to treat symptoms as you would any dose of flu or a cold..

[@donnamunro2090]

Hey, they read my letter!!

[@garyanderson5446]

Thanks!

[@Cajeput]

I took part in the Astra Zenica Supernova trial for Sipabivart but its gone very quiet about its authorisation. Do you know anything? There was talk about it not covering F456L mutation.

[@traianliviudanciu8665]

In 2020 I worked like MD emergency on ambulance. At some Covid19 hypoxic patients a finger drop of blood indicate hiperglicemia,and drop of blood put on a cold glass agglutinate before coagulate. If I used warmed oxigen mix at body temperature at that patients , oxigen saturation increased more rapidly. Maybe some IgM antibody was ,,cold agglutinine,, or cryoglobuline?

[@traianliviudanciu8665]

At microscop erytocite agregate even anticoagulants was present but not at body temperature. Maybe before using oxigenoterapy not warmed can use conjunctival test for ,,cold agglutinine,, ?(Harders test)

[@zachthayer]

Dr.griffin u may...A+

[@AJFish-rm6cv]

Talk around town tells me mpox is respiratory. Maybe not *as* respiratory as COVID, but it's not just fomites.

[@danielasuncion9991]

Maybe variants can be named like hurricanes: Adaline, Adaline-4 instead of J.1.1 or P.P.3.4.4. etc.

[@Logotic]

They, or at least twitter, tried naming them after monsters. It was very silly.

[@danielasuncion9991]

@@Logotic Confusing for the public; it doesn't have to be: Canis lupus. Many people may be unfamiliar with this term. But, everybody knows what a WOLF is! 😃

[@bethmendoza1847]

I had covid back in January 2024. How long do I wait to get the vaccine?

[@StefaanNijs]

How lovely it would be if not only some comments get published.

[@Sceince01]

@@StefaanNijs that would be awesome . It will highlight your very dumbness even more and not truncate our ability to prove you wrong about absolute bs that you post

[@WillNewcomb]

Frequency for updated vaccination: I heard elsewhere that the official (?) recommendations were being reduced to 2 months.

[@Turtledove2009]

2 months! Wow, what does that say about the efficacy of our current vaccines!

[@mariaveresova8169]

I'm wondering what is the effect of these multiple boosters on the immune system over such short period of time?

[@christopherrobinson7541]

Research beekeepers.

[@JoonaTuhkanen-z7i]

Immune to strokes after tgis

[@lyellbrown9766]

Apparently there’s a brand-new mRNA vaccine trial for lung cancer begun in the UK. “Talking about mRNA”

[@redhen689]

@@lyellbrown9766 interesting. I’ll have to look into it.

[@redhen689]

@@lyellbrown9766 wow, there are trials being run for pancreatic cancer, breast cancer, brain cancer, etc. “mRNA cancer vaccines have emerged as a promising novel approach to cancer immunotherapy, offering high specificity, better efficacy, and fewer side effects compared to traditional treatments. Multiple therapeutic mRNA cancer vaccines are being evaluated in preclinical and clinical trials, with promising early-phase results. However, the development of these vaccines faces various challenges, such as tumor heterogeneity, an immunosuppressive tumor microenvironment, and practical obstacles like vaccine administration methods and evaluation systems for clinical application.”

[@TrivettTurner]

What about the icup variant?

[@traianliviudanciu8665]

At some hypoxic Covid19 patients using warmed oxigen mix at body temperature can increase rapidly oxigen saturation. Why ?

[@traianliviudanciu8665]

At that patients erytocite have tendency to agregate at low blood temperature.( can see that at microscop)

[@traianliviudanciu8665]

At some hypoxic Covid19 patients at microscop I see that erytocite agregate at room temperature,but not at body temperature

[@traianliviudanciu8665]

Maybe high level of some IgM antibody increase tendency of erytocite to agregate at low blood temperature ?

[@redhen689]

We usually heat and humidify high-flow oxygen. Do you have more information? Where did you hear this?

[@traianliviudanciu8665]

@@redhen689 when I heat at 36C oxigen mix , oximetry value increased more rapidly

[@JoonaTuhkanen-z7i]

97 106 happiarvo ja syke

[@JoonaTuhkanen-z7i]

Miks on prosentin laskenu

[@Bete-Bete-Bete]

Yes, you will see respiratory spread of Mpox. The same nonsense as what everyone said about SARS-Cov-2 not being airborne initially.

[@Turtledove2009]

Thank you for this comment.

[@christopherrobinson7541]

Mpox was first reported in 1970. So far the evidence is that there is no aerosol or droplet transmission.

[@robinirons541]

Most cases are sexually transmitted. Wearing a condom is better than a mask.

[@Bete-Bete-Bete]

There goes Vincent minimizing mpox virulence already. Did you enjoy telling people to send their sick children to class so they could infect each other and get long Covid?

[@Logotic]

Dude. Breathe in. Breathe out. Breathe in. Breathe out. Step outside and look at flowers. Everything's going to be okay. 🐱

[@brendanmay9585]

​@@Logoticit's a legitimate criticism.

[@georgesibley7152]

when did Vincent ever tell parents to send a sick child to school? As for downplaying mpox virulence all he is doing is pointing out reality, all experts agree that Mpox is not readily transmissible.. It relies on close physical contact - usually prolonged - to pass from person to person, or animal to person.

[@traianliviudanciu8665]

Historicaly ,atenuated virus vaccination was more immunogenic and effective comparativ with inactivated. Maybe m RNA vaccination mimic atenuated virus vaccination ?

[@traianliviudanciu8665]

Did liposomes with mRNA blood spread ? Can liposomes with mRNA transfect vesel endothelial cells ? Can decrease risk of blood spread of liposomes with mRNA ? How ?

[@traianliviudanciu8665]

If injected muscle is not used some hours after vaccination,risk of blood spread theoretically decrease.

[@traianliviudanciu8665]

If forearm is suport sustain like after shoulder trauma, deltoid muscle did not contract.

[@wortelsorbet]

My country did everything to try and infect me with the new virus. Life changing indeed.

[@beckyconstantinides2546]

What country are you from? What did they do?

[@wortelsorbet]

The Netherlands. It went for a herd immunity approach by trying to infect everyone under 45 years.

[@JoonaTuhkanen-z7i]

Ai jauheliha juttu

[@traianliviudanciu8665]

If SARS COV2 better replicate at lower tissue temperature, maybe must avoid use of antipiretics ? even fever increase oxigen consumption,

[@brendanmay9585]

It is standard of care to avoid anti-pyretics unless the fever is too high.

[@traianliviudanciu8665]

At TWiV Nr 659 at min29 german virologist Christian Drosten indicate that to replicate SARS COV2 in different tissues must decrease incubator temperature to 34C

[@traianliviudanciu8665]

@@brendanmay9585 in 2020 was used paracetamol at Covid19 patients

[@brendanmay9585]

@@traianliviudanciu8665 I don't dispute that. But this channel has talked about the proper use of anti-pyretics on many occasions.