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your abstract today.

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That's asm.org/submit. I'm

0:59

Vincent Raconiello, and you're listening to

1:01

the podcast All About Viruses. Joining

1:04

me today from South

1:07

America, Daniel Griffin. Hello,

1:10

everyone. Yeah, basically, I'm about 20

1:12

miles north of Venezuela. So that's,

1:14

yeah, I'm a bit south. And

1:16

I guess we're recording this pretty

1:18

late in my time zone at

1:20

the moment. But let's get

1:22

into it, because people will be listening

1:25

to this. Well, I guess, what is

1:27

it? East Coast right after midnight, and

1:29

then everyone else adjusted accordingly. So

1:31

I'm going to start off with a quotation. I'm

1:34

having a little bit of a break, so I've been

1:36

reading the book Dune. So my quotation will come

1:38

from Frank Herbert. The

1:41

beginning of knowledge is the discovery

1:43

of something we do not understand.

1:47

And I sort of like that. It made me

1:49

think of science. It's

1:51

that humility of going into the

1:53

unknown and learning, right? I

1:55

mean, that's what I think this is all

1:57

about. So we will jump right into our.

2:00

We were a little worried,

2:02

I was a little worried, I'll share, that

2:04

we might see one of those little double

2:06

dips where RSV starts to go down and

2:08

then we see another. And so

2:10

we saw that second peak and we're

2:13

hoping in the next week

2:15

or two we really come off that

2:17

high level of RSV. So yeah, just

2:20

keep talking to people about

2:22

this. We have tools this year. We

2:25

have those two different vaccines for adults,

2:27

for pregnant individuals in

2:30

the last trimester. We've got the

2:32

Nersebumab, the passive vaccination. So just

2:34

want to point out, we will

2:37

probably lose over 10,000 adults this

2:39

winter. We

2:42

typically lose 100 to 300 children. So

2:45

if we don't use the tools, we can't get those

2:47

numbers down. I

2:49

also want to move into flu. We may

2:51

be coming off the peak and there's some

2:53

interesting studies that we've seen in the

2:56

past where once we

2:59

get past these holidays and all

3:01

the gatherings, sometimes those numbers

3:03

can come down. A little bit

3:05

of a twist and sometimes a challenge is when all the

3:07

kids go back to school, we can

3:09

again see a little bit of a

3:11

persistence. So we'll see what happens here

3:14

in the coming weeks. But flu activity

3:16

all across the country is

3:18

basically up at pretty significant levels except

3:20

somehow what's going on in Minnesota? How

3:22

are they still in the minimal level?

3:24

I don't know what's going on up

3:26

there, but most of our country, we're

3:28

seeing lots and lots of influenza. And

3:32

what about COVID? We

3:34

are still at over 2,000 deaths a week. And

3:39

I was recently on the Brian Lair show and I just want

3:41

to put this in context. The

3:43

number of folks in hospital has gone up. We've

3:45

got about 30,000 in hospital. That's

3:48

up about 10%. We've

3:50

got about 3,000 in the ICU. That's

3:52

also up about 10% from a week ago. New

3:56

deaths this last week, over 2,000. I

4:00

don't know if people remember, but at one point,

4:02

we were having 2,000 deaths a day in New

4:06

York alone back in the early

4:08

days. But

4:12

2,000 deaths a week in the entire country is still

4:14

way too many. Just start adding up those weeks and,

4:16

you know, 2,000, 4,000, 6,000, 8,000, 8 to 10,000 a

4:22

month. But I

4:24

do think, if we're looking at our

4:26

wastewater data, we do seem to

4:28

be coming off a peak here, particularly

4:31

in the Northeast. Really looks like we're heading down

4:33

and we're seeing things starting to drop in other

4:36

parts of the country. But I

4:38

will point out we're starting to drop from

4:40

this new high set point of 2,500 copies

4:44

per milliliter of sewage. All

4:47

right. I got quite a bit this week

4:50

on children COVID and other vulnerable populations as

4:52

well as long COVID. So let's get right

4:54

into it. I like to

4:56

remind people of the article, coronavirus is

4:59

bad. Comparing it to the flu is

5:01

worse by Roxanne Comsey. February of 2020.

5:04

Can you believe how quickly that came out? Well,

5:07

one of the issues with regard to

5:09

children and COVID is this minimizing of

5:12

COVID in children by comparing it

5:14

to adults. So over 1,000 children,

5:17

we estimate died of COVID here in the

5:20

US. But people say, oh,

5:22

but over a million adults. I don't think

5:24

the fact that over a million adults died

5:26

makes over 1,000 children having died of COVID

5:29

less significant, less troublesome.

5:32

Here we have the article, outcomes

5:35

of SARS-CoV-2 and seasonal viruses among

5:37

children hospitalized in Brazil in this

5:41

population-based retrospective cohort study

5:44

that included children and adolescents

5:46

hospitalized from February

5:48

2020 to February 2023 from SARS. The

5:54

investigators looked at a total of 235,000. 829

6:00

patients that are available results

6:02

of viral tests with SARS-CoV-2

6:04

predominance. And they're going

6:07

to look at competing risk survival.

6:09

And they're going to estimate the probability of

6:12

a fatal outcome. So

6:14

these are folks with acute respiratory

6:16

infections. Not all of them have

6:19

COVID, as you'll see. But

6:22

the fatal outcome for in-hospital

6:24

mortality, so this is children,

6:26

adolescents, in-hospital mortality with SARS-CoV-2,

6:28

6.5%. Co-infection,

6:32

this is something that hopefully people are

6:34

getting more used to looking for. And

6:38

no virus, 2.9%. Influenza, 2.3%.

6:42

Other viruses, 2.1%. And actually

6:44

RSV in the children

6:47

and adolescent, 1.8%. All

6:52

right, what do we do? Well,

6:54

fortunately, we have vaccines and they

6:56

work. The article COVID-19 vaccine effectiveness

6:59

among adolescents was recently

7:01

published in Pediatrics. So

7:03

these are results from a

7:05

nationwide register-based one-to-one matched cohort

7:08

conducted in Denmark, Finland, Norway,

7:10

and Sweden between May 28,

7:12

2021 and April 30, 2023

7:17

to estimate vaccine efficacy

7:19

for primary COVID-19 vaccine

7:22

two-dose schedules among adolescents

7:24

age 12 to 17 years. Cumulative

7:27

incidence of what type of

7:29

efficacy? COVID-19 related hospitalization, that

7:31

was the primary outcome. And

7:34

laboratory confirmed SARS-CoV-2 infection, that's the

7:37

secondary outcome, were compared for the

7:39

vaccinated and unvaccinated at six months

7:41

of follow-up. The study included

7:44

526,966 primary schedule vaccinated adults. Vaccine

7:51

efficacy against COVID-19 related

7:53

hospitalization was 72.6%. It's

7:57

six months of follow-up compared with

7:59

unvaccinated. Estimates were comparable

8:01

when restricting to a period of

8:04

amacron predominance and extending follow-up to

8:06

12 months. And

8:08

they have a really nice figure where you can actually

8:10

look at the different countries and

8:13

the time. So

8:15

Finland, Sweden, Denmark. So,

8:19

Daniel, you said

8:22

adults, but you meant adolescents there. Oh, did

8:24

I say it? So, yes,

8:27

adolescents. Yeah, thank you. Okay,

8:30

not only do vaccines work for kids

8:33

to protect against acute issues, but

8:35

we also have the article that I think a lot of

8:37

people hopefully will find interesting.

8:40

Vaccine effectiveness against long COVID in

8:42

children published in pediatrics.

8:45

So here, the adjusted vaccine effectiveness

8:47

within 12 months was 35% against

8:52

probable long COVID in

8:54

a retrospective cohort study that used data from

8:56

17 health systems that looked

8:58

at 1,037,936 children. I

9:04

also want to talk in the same section about the

9:06

article, socio-emotional development of

9:09

infants and toddlers during

9:11

the COVID-19 pandemic published

9:14

in JAMA Pediatrics. And

9:16

I think people may remember from the early

9:19

days, my suggestion of perhaps we should close

9:21

the bars and open the schools. Well, the

9:24

background of this study, as the

9:26

authors point out, is that the

9:28

COVID-19 pandemic and its related social

9:30

distancing negatively affected children

9:32

and families. Caregiver stress

9:35

increased, which can negatively

9:37

affect infant development and health. Children's

9:40

screen time increased, which

9:43

we have prior studies showing us associated

9:45

with poor language, problem solving

9:47

and social development, daycare and preschool

9:49

closures, along with social distancing, decreased

9:52

peer interactions for young children. And

9:54

they're going to give you links

9:57

to all the different articles supporting that.

10:00

But here, while studies suggest young

10:02

children's social emotional development was affected

10:05

during the pandemic, assessments

10:07

specifically designed to

10:10

evaluate the social emotional development

10:12

changes in screening results over

10:14

time, referrals to early

10:16

intervention have not been examined. Well,

10:18

prior to this, here

10:21

they used specific validated early

10:23

childhood development assessments and

10:25

looked at 60,171

10:29

families and found that

10:31

the pandemic contributed to delays

10:33

in young children's social emotional

10:35

development, particularly during the

10:37

first year of life. That's

10:40

surprising, right, Daniel? Yeah, I

10:42

don't think any of this is surprising. And I

10:45

think, you know, one of the things people always

10:47

talk about, oh, what can we do better? What

10:50

lessons did we learn from this pandemic? And

10:52

we're going to talk about some machine learning

10:54

looking at that next time. But

10:57

I think we really failed our children in a lot of

10:59

ways. So I think that, you know,

11:02

we need to look really closely at that and see

11:04

how we can do a better job next time. All

11:08

right, I will move on to

11:10

COVID, the early viral phase. A

11:12

little bit of a teaser, Vincent. Next

11:14

time I'm going to be discussing a

11:16

preprint out of the David Ho

11:19

Lab with Yossi. Sabo

11:22

is one of the co-authors. I've

11:25

been waiting for this to come out because I've

11:27

been aware of this data now for actually a

11:29

couple of years. You'll see Swarmy to Silence. So

11:32

now that the preprint is out, we'll talk a

11:34

little bit about viral kinetics. But

11:36

let's talk about Paxilovid. So early

11:39

viral phase, you test positive.

11:42

You meet one of the criteria for being high

11:44

risk. NIH treatment guidelines

11:46

recommend Paxilovid. And there's a really

11:48

nice news piece in the New

11:50

York Times by Danny Bloom. I

11:53

have COVID. Should I take Paxilovid? Several

11:56

good points that bear repeating when

11:59

they look at... who is a candidate,

12:01

they note that anyone 12 or older

12:03

who is considered high risk, which encompasses

12:05

a broad swath of persons, the

12:08

CDC includes conditions such

12:10

as depression, obesity, asthma,

12:13

history of smoking. They

12:16

asked Dr. Davey Smith, an infectious disease

12:18

specialist at the University of California, San

12:20

Diego, and I quote, to

12:22

be honest, pretty much if you're an adult in

12:24

the US, you can meet one of these little

12:26

marks. Anyone aged 50 or

12:29

older is also eligible for the treatment

12:31

regardless of health status. The

12:33

older you are, the higher your risk for

12:35

severe illness tends to be. And

12:39

I like this, Pax lovid is intended

12:41

for people with mild or moderate symptoms.

12:43

So my little ad is you don't

12:45

wait for someone to be severely ill.

12:47

Take it as early as possible to nip it

12:50

in the bud and prevent yourself from being so

12:52

sick said Dr. Ziad Ali-Alai,

12:54

the chief of research and development

12:56

of the Veterans Affairs of St.

12:58

Louis Healthcare System. Even

13:01

if you clearly have few symptoms or if

13:03

you've had mild symptoms with COVID before, the

13:05

disease is unpredictable and you may still want

13:07

to consider Pax lovid if you're eligible. Dr.

13:09

Smith said every time someone

13:11

gets COVID, it's basically another game of

13:14

roulette. He said, what

13:16

about Pax lovid rebound? The

13:18

Centers for Disease Control and

13:20

Prevention found no consistent association

13:22

between antiviral treatment and rebounds.

13:25

And as we have some of the CDC. Daniel the... Yes.

13:29

Sorry. No, no, go ahead. There's

13:33

also an article in the Washington

13:35

Post. Yes. By

13:37

Leanna when the under prescribing of Pax

13:40

lovid may be our biggest COVID

13:42

policy failure and that's really good

13:45

also. Okay, excellent. We should let's

13:47

can you throw a link into that for our readers?

13:49

That would be great. Yeah, I will.

13:52

All right. So we will move

13:54

on to a little

13:56

bit about cost and

13:58

access. So I

14:00

was on NPR Monday on the Brian Lehrer show

14:03

and a woman called in showing that her husband had

14:05

been charged $1,683

14:07

for a box of Paxilovit and

14:11

one of the challenges is Paxilovit is now just

14:13

like every other medicine where you go to the

14:15

pharmacy and they run your insurance and If

14:18

you have prescription coverage you end up

14:20

either paying a copay or finding out

14:22

that that this is not covered Now

14:25

there is a link to a program called Paxes

14:27

I don't know who came up with that, but

14:29

it's catchy Paxes

14:34

For those not insured or those with

14:36

Medicare or Medicaid and

14:38

we can leave in a link to Paxes But

14:41

to qualify for free Paxilovit through this program until

14:44

December 31 20 24 patients must be Uninsured

14:49

and do not have a prescription benefit

14:53

Prescription drug benefit at the time they fill

14:55

their prescription Medicare

14:57

beneficiaries Medicaid beneficiaries

14:59

and you can either go to the website,

15:02

which is this Www.

15:05

paxilovit.com/Paxes or you

15:07

can call 1-877-219-7225

15:10

because Really,

15:15

I want to see this happen. I

15:17

don't want to see someone acutely have COVID

15:19

meet criteria Be

15:21

a person who potentially can benefit and then

15:23

have this this financial wall between them and

15:25

the access to the medicine number

15:29

two remdesivir number three

15:31

mondupirivir And then

15:33

convalescent plasma for some folks such

15:36

as those immunocompromised At

15:38

risk of progression who are not eligible

15:40

for other options and Then

15:43

week number two the cytokine storm

15:46

week, right? You're feeling crummy

15:48

the first week and then you feel

15:50

crummy that second week. What is going

15:52

on that second week? This is the

15:54

early inflammatory phase the cytokine storm. A

15:57

period of time when we have studied

15:59

antivirals. The years and years and

16:01

never shown that this is a great time

16:03

to do that. Some soaks steroids at the

16:05

right time, in the right patient, at the

16:08

right dose and to wanted to spend a

16:10

little time to set few questions. Came up

16:12

here right since he made it past a

16:14

sad and your patients feeling crummy they're in

16:17

their early inflammatory face. Do we just get

16:19

everyone steroids? It'll make them feel a little

16:21

better. Better. Remember people,

16:23

after a virus or hasn't increased

16:26

risk of a post viral bacterial

16:28

infection south, we start throwing steroids.

16:30

willy nilly if we're not following

16:32

those pulse oximeter readings, If we're

16:34

not finding the highest risk, folks

16:36

were actually potentially going to harm

16:38

our patient. So be careful with

16:40

the steroids. Let's use them in

16:42

an evidence based manner. Dex.

16:45

The math his own. six know grams

16:47

a day and six days in folks

16:49

with oxygen saturation less than ninety four

16:52

percent and and I cried. Relation guidelines

16:54

recommend it for folks to end up

16:56

in the hospital. We have great recommendations

16:59

American Society of Hematology to help guide

17:01

us and on. Commoners. Support.

17:04

From. Disappear still in the first

17:06

ten days. Immune modulation. Avoid

17:09

unnecessary and a box and unproven

17:12

therapies. And as promised, I've actually

17:14

got quite a bit here. Late

17:16

phase passed on cove It and

17:19

so. Just. To put this

17:21

simply and I don't know how many

17:23

times has bears repeating task or long

17:25

covered. This. Is a thick.

17:27

It is not just in people

17:29

set up, some people have very

17:32

low serotonin levels or low cortisol

17:34

levels or evident seven laden viral

17:36

reactivation, suppers, herpes, very day or

17:39

muscle damage with bought a condo

17:41

dysfunction and a number of papers

17:44

showing ongoing immune to Sparks. So

17:46

this week the paper long cove

17:48

it manifests with see Sell. This

17:51

regulation. Inflammation and an

17:53

uncoordinated adaptive immune response to

17:55

size Curry to was published

17:57

in Nature Immunology. This paper.

18:00

Really require some time. Complicated

18:02

cars, a solid background and

18:04

immunology to fully understand or

18:06

share. Share an overview and

18:08

perhaps Vincent I can discuss

18:10

the implication Sell The authors

18:12

explain that they used to

18:14

make essays and sorority too

18:16

Deeply characterize the global and

18:18

Sars committee specific communities in

18:20

the blood of induce hustle.

18:22

it's clear, long covered and

18:24

non long covert clinical trajectory

18:26

eight months post index it

18:29

they sound that long covered

18:31

individuals exhibited. Systemic inflammation.

18:33

Immune. This regulation of his

18:35

by global differences in T

18:38

cells subset distribution implying ongoing

18:40

immune responses as well as

18:42

by sex specific perturbations inside

18:44

a Linux subsets long coveted

18:46

individuals displayed increase frequencies of

18:48

Cd for positive T self

18:50

police to migrate to inflame

18:52

tissues and exhausted Sars can

18:55

to specific Cd a positive

18:57

P self. Higher levels of

18:59

Sars can be to Etti

19:01

bodies and he miss coordination

19:03

between. Their Sars can be too

19:05

specific t and be Cel responses

19:08

their analysis suggested and improper crosstalk

19:10

between the cellular and euro adaptive

19:12

immunity and markova it which can

19:14

lead to a me in this

19:16

regulation. Inflammation. And clinical

19:19

symptoms associate with this debilitating

19:21

condition. Every figures complicated with

19:23

multiple panels and are supplemental

19:25

figures as well, But for

19:27

example, in figure one, we

19:29

see elevated P Central Memory.

19:32

T. Effective memory. Peripheral.

19:34

Teeth like you'll a helper and

19:37

sleep and flicker helper T Rags.

19:40

In. Figure two: We see increased

19:42

homing receptor expression perhaps associated

19:44

as I say, with migration

19:47

to inflamed tissue am. In

19:49

figure three, we see that Sars

19:51

can to specific city a positive

19:54

t Sell some individuals on Kobe

19:56

Praful express the exhaustion markers such

19:58

as Ctl A full. War. And.

20:01

Figure for we see this

20:03

excessive production of anti Ah

20:06

receptor binding domain antibodies and

20:08

secure fires. We.

20:11

See that in Long Cove it I'll

20:13

for his up. I'll. Five is

20:15

down so lots of differences and

20:18

is all seems to be seems

20:20

to make biological sets. But is

20:22

this data mining survey? Repeat this

20:25

Indifferent cohorts am and what are

20:27

the diagnostic or therapeutic implications. Daniel

20:30

I'm. The. Easy to

20:33

these figures. Third, Dot. Plots

20:35

Reach.is a patient right? Yes!

20:38

Is. Huge overlap between the non

20:41

cove it any. Other

20:43

popular control population, right? So yeah,

20:45

and there are some patients who

20:48

clearly have higher. of

20:51

of whatever they're looking at anti are B D

20:53

for example but then there are many patients whose

20:55

and they are be the are the same as.

20:58

In the control population self. I

21:00

don't think it's every one that having the same

21:02

issue is. this is in fact the issue. Just

21:05

sit. You know that's. One of the test things and

21:08

I think you know as a clinicians we look

21:10

at this and we wanna see two different groups

21:12

like you know like we saw with that data

21:14

to U Penn with low Sir Tony we want

21:16

to see like a whole group of people or

21:19

the people with low cortisol as we saw it

21:21

as a Mount Sinai Yell Studies We wanna see

21:23

the two groups really separate up. And I think that's

21:25

one of the challenges. Where we're starting to see

21:28

that the two groups are biologically difference

21:30

and for we're not really getting that

21:32

distinction. And yes, I actually think this

21:34

goes wrong with the line that long.

21:36

Kobe is probably a number of different

21:39

processes going on, and not every long

21:41

covered patient has the same mechanism driving

21:43

their issues. I would be very

21:45

interested to know is. The. Dots.

21:48

Are. The same patients who are similar

21:51

to the controls. And.

21:53

In each of the as says that they

21:55

do right so anti are be deeds speedy

21:57

one ctl a fourth is it always This.

22:00

Impatient that's higher or is it a

22:02

mixed bag in which case would be

22:04

very difficult to know what's going on.

22:06

Yeah I would love that too but that would

22:08

be great. Like a know they're sorta comparing your

22:10

the the blue dots to the red dots but

22:13

yeah be great as some way to turn on

22:15

like that third dimension as you know. Give us

22:17

give us a red green or something we can

22:19

see which person is which. And

22:22

and am hoping you know as we get

22:24

a better understanding of the different drivers. For

22:26

different people that's going to drive us know

22:29

someone has us serotonin have like six or

22:31

eight. I'm gonna come up with a plan

22:33

if someone has a cortisol which is in

22:35

a certain area someone as evidence of mass

22:38

cell activation are histamine driven symptoms. Or maybe

22:40

we can get a better subtlety here of

22:42

what might be a way to address each

22:45

individual said it is throwing stuff at these

22:47

debilitated people and potentially making them feel worse

22:49

at times. And. The next one

22:51

I guess I will talk about

22:54

is a couple a couple investigations

22:56

looking at vaccination to prevent long

22:58

covered and vaccination to treat log

23:00

cove it and so the first

23:03

is the article the effectiveness of

23:05

covered nineteen vaccines to prevent lol

23:07

coded symptoms Staggered covert study of

23:09

data from the Uk, Spain and

23:11

Estonia published in the Lancet for

23:14

Spear Trade Madison year The investigators

23:16

conducted a staggered cohort study I

23:18

to the starting them at different.

23:20

Times is different Cohorts am.

23:23

using. Primary care records from

23:25

the you case I'm

23:27

from Catalonia, Spain am.

23:30

From. Dystonia. Am.

23:33

And they end up finding that

23:35

compared with and vaccinated individuals overall

23:37

hazard ratios for long covert symptoms

23:39

in people vaccinated with the first

23:41

dose of any covered nineteen vaccine

23:44

ranged from zero point four nine

23:46

to seventy one. Soothing about us

23:48

at Twenty Nine fifty one percent

23:50

reduction and consistently was associated with

23:53

a reduced risk of persistent symptoms

23:55

after a cool vid insects. it.

23:58

Now I'll. Even. Thanks to some

24:00

other studies as well. Not. What about

24:03

vaccination as a therapeutic for a

24:05

long covert sammy? Discuss the pre

24:07

prince impact of covered nineteen vaccination

24:10

on symptoms and immune see on

24:12

types in vaccine. I have individuals

24:14

who upon covered. Recently posted on

24:16

Med Archives Am is a number

24:19

of August authors there. We have

24:21

Hundred Feet. Bradley of hundred Be

24:23

Bradley. Sorry about that. Connor Am

24:25

Key goes in. There are Harlan

24:28

Krumholz isn't there? I see Daniel

24:30

Griffin misspelled in their. I'm

24:32

I'm leaving the like discusses. I'll

24:35

even a a link to a thread posted

24:38

by Akiko he was socket it's in a

24:40

walks through the spread of say this was

24:42

at this was a challenging study to i'm

24:44

to enroll Forks what we were looking for

24:46

here. Miss. Participants with long

24:49

cove it who had not been

24:51

vaccinated, who had then agree to

24:53

be in the study and then

24:55

they would go ahead and they

24:57

would get a coded vaccine doses

24:59

and then later they would get

25:01

a second covered vaccine dos or

25:03

before they got their vaccinations. Are

25:05

we reflect blood saliva? They would

25:07

do a survey, get their first

25:09

dose, they do another survey, it's

25:12

second dose again blood sly The

25:14

survey and then we found out

25:16

about three months more blood saliva.

25:18

Service and to be a lot of

25:20

stuff that that gets done here. lots

25:22

of pretty multi color said years but

25:25

I'm going to jump right to figure

25:27

two of what what was really happening

25:29

as far as just symptoms when you

25:31

ask people how you doin Hey during

25:34

the two weeks, six weeks and twelve

25:36

weeks am someone we look at. Two

25:38

weeks we about forty three percent feeling

25:40

better. Six. Weeks Seventy nine percent.

25:43

Twelve Weeks. We actually lose a few

25:45

and we're down to sixty two percent.

25:47

Twenty percent, Fourteen, and Nineteen percent say

25:49

they're about the same. And this is

25:51

what I want to point out is.

25:54

At. Two weeks, seven percent were worse.

25:56

When we go to Six weeks, seven

25:58

percent were worse And. We're twelve

26:00

weeks nineteen percent were worse. So

26:03

not everyone felt better. We actually had some

26:05

people feel worse soaps when I would love

26:07

to do it. Will go a little further.

26:09

Insists his be able to tell ahead of

26:11

time. Rabbit is here we are. We're encouraging

26:13

people. You. Know hey most

26:15

people get better he sixty percent

26:17

but some people actually are feeling

26:20

worse So jumping to figure for

26:22

this is the in our analysis

26:24

as the vaccination response to immune

26:26

system changes to antibodies against a

26:28

D V and other viruses response

26:30

to covered night seemed vaccination. I'm

26:32

and you do see a little

26:35

bit of a difference for not

26:37

really we're not really seeing a

26:39

big difference here in those that

26:41

are prove those for worse. Supplementary

26:44

figure to auto everybody analysis

26:46

and I think this is

26:48

a big one that as

26:50

it is probably the second

26:52

but but several here where.

26:54

The. Idea that auto etti body

26:57

is somehow related and may

26:59

be changes and ness we

27:01

really don't see an any

27:04

changes Auto antibody levels really

27:06

stay stable what's going up

27:08

his the am this anybody

27:10

levels seen am now this

27:13

one. I liked as

27:15

it might predict responders to vaccination

27:17

am. So here we have figure

27:19

five the results of examining plasma

27:22

factors that are enriched those who

27:24

improved after vaccination versus those who

27:26

did not. So the heat map

27:28

shows that soluble i'll six receptor

27:30

elevated at baseline and after the

27:33

vaccine in those who improved in

27:35

contrast interfere a beta and the

27:37

sillier in your troth exact to

27:39

were elevated in those who did

27:41

not improve after max. Said

27:44

maybe ways for us to tell ahead of

27:47

time. I'm who's gonna who's couldn't get better

27:49

now. Plasma. Levels of

27:51

interference. Alpha to and beta

27:53

Cncs. I'll. Eleven. As.

27:56

C F stem cell Factor were

27:58

consistently higher in those. Who

28:00

did not improve after vaccination.

28:02

While soluble I'll Six receptor

28:05

was consistently higher in those

28:07

who reported health improvement after

28:09

vaccination. So. You know

28:11

this will undergo it's peer review and

28:13

will come out hopefully better than is

28:15

currently but starting to see maybe some

28:18

of the biology and hopefully helpless as

28:20

last thing I want to do is

28:22

increase someone who's debilitate by long coveted

28:24

go get a vaccination and have them

28:26

feel worse. And what we're seeing here

28:28

is that that is a risk. Why

28:30

people are feel better but some people

28:32

are worse. All right and as I

28:34

say have been finishing up every episode for quite

28:37

awhile And me to keep this when short because

28:39

we are already tell you we've got a lot

28:41

coming next next week. No

28:43

one is safe until Every one

28:45

Is safe. Were in the middle

28:47

of January, we're getting to the

28:49

end of our Microbe Tv fundraiser.

28:51

November, December, January will double your

28:53

donations up to a potential maximum

28:55

donation of twenty thousand dollars of

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Stop What You're Doing Good A

28:59

Parasite supporters.com and Click. Donate even

29:01

a small amount. Every bit helps

29:03

us continue our work. Is.

29:06

Time for your questions. For Daniel, you

29:08

can send years to Daniel at my

29:10

group.t V. Joanne Rights.

29:13

As a question, about the boosters, I've had each

29:15

vaccine that has been offered six or seven. I

29:17

can't remember em up to date. At

29:19

my last shot in October. Twenty

29:22

Twenty Three. Would. Like to get

29:24

another at the end of January, which he

29:26

four months out. Of. Seventy A

29:28

with C O P D, diabetes, heart

29:30

disease, etc. As not, had

29:33

Cozad. And. I'm hoping not to get

29:35

it. I mask indoors. My thought is I would.

29:37

Like. To keep my immune system primed as much as

29:39

possible with you think of my plants. You

29:43

makes a lot of sense. Sounds like you

29:45

been listening to Twist On You know. What

29:47

we've talked about with the vaccines is that

29:49

each time you get a booster. In.

29:51

Own call it a new vaccine called a booster,

29:53

but each time you get one of these shots

29:56

for we estimate three or four months you're gonna

29:58

get an elevated level of those eighty. It

30:00

is. You're going to get that extra level

30:02

of protection. I'm anybody's contract. That's just what

30:04

they do now as a public health policy.

30:07

I don't think we're going to be able

30:09

to convince everyone that hey in this new

30:11

world now the Cove it is with us.

30:13

You need to get a shot every four

30:16

months, but I think certain individuals will will

30:18

wanna do that. It makes sense. These are

30:20

licensed vaccines at certainly something you and your

30:22

am this you can discuss and I certainly

30:25

understand the science and the thinking behind that.

30:28

Ellen. Rights of friend of Mine who

30:31

completed the initial series of three. vaccinations,

30:34

Has contracted cove it five times

30:36

twice in the past ninety days.

30:38

As as possible. The. Meantime her

30:41

partner with whom she shares a bad has

30:43

never had it. It affects lows at once

30:45

in the past claims and made her feel

30:47

worse feel so lost her hair during a

30:50

previous insects and occasional numbness on the left

30:52

side of her face, ongoing pain in the

30:54

right calf. This time her

30:56

doctor recommended she go to urgent

30:58

care for coded vaccination despite her

31:00

debilitating fatigue and headache, Was. This

31:03

good advice. He.

31:05

The first, my heart goes out to

31:07

people like this. Unfortunately there are people

31:09

who have repeated in sections to see

31:12

this ghost or not fully recovered after

31:14

these and sanctions on it was talked

31:16

about how devastating am losing your hair

31:18

can be an and is tough right

31:20

as as we talked about that articles

31:23

and each time you get covered it's

31:25

Russian roulette. You know people who it

31:27

was a mild case a weathered the

31:29

storm. Three. Months later on take care

31:31

of them in the hospital because something about you

31:33

know maybe their genetics ah who knows what but

31:36

each time can be different so a mild case

31:38

does enough li mean the next time you get

31:40

cove it is gonna be mild as well as

31:42

some is a tough thing you know if he'll

31:45

say i to patch love it and it was

31:47

worse or what was worse Where you continue new

31:49

the has. You. Covered nitin'

31:51

out with this been without packs live in

31:54

really don't get to do that. He.

31:57

Has a challenge is an in

31:59

a Wendy? Get that next. Vaccines

32:01

are familiar. Last question, I'm a really

32:03

frustrating for folks to get cove ed

32:05

and we're recommending wait nine days before

32:08

you get that vaccine and then they

32:10

get cove it again and this sort

32:12

of wondering how to ever get that

32:14

ninety days I'm This is where we

32:16

gotta start talking about behavioral modification was

32:19

possibly going on. What are the exposures

32:21

five covered in Saxons Am is? We're

32:23

spending a little time trying to figure

32:25

out of the some way that mitigate

32:28

that exposure com and actually get vaccines.

32:30

Is that are getting boosted with the infection

32:32

and all the risks that come with that.

32:36

Laurie. Rights and this is

32:38

about access. Road. To few

32:40

days ago about my sister's difficulty getting packs.

32:43

Love it! As it turns out, he needs

32:45

to fill out an application with access. Pfizer,

32:47

Evidently subsidized the cost for eligible

32:50

patients. Hopefully others may benefit from

32:52

this information. So this is what

32:54

you also mentioned about our axon.

32:56

Thank you. And

32:58

finally, Kathleen. Rights Kathleen is a

33:00

hair stylist and Dallas, Texas. Has

33:03

been listening to Twist since twenty twenty

33:05

and is a big fan. Friend of

33:07

mine recently tested positive for covert on

33:09

December twentieth. She. Cleared or infection.

33:11

And yes, he did get to

33:14

take packs loaded. Today is January

33:16

Eleven since he tested positive again.

33:18

This. Is the fastest we infection I

33:20

have ever thought possible. I know you

33:23

can have multiple infections, however it seems

33:25

to meet this immediate green sexy may

33:27

indicate know short period of a release

33:29

immediately after and and sexton any. I'm

33:32

not a scientist, but I do have

33:34

a large load in the common sense

33:36

department. Story continues to keep my attention

33:38

in my concern. Yeah.

33:41

now this is against is the frustration

33:43

and and our what one of our

33:45

earlier he mows right about to is

33:47

some individuals not even getting then you're

33:49

thinking i just i target at least

33:51

i will get a for the next

33:53

three months well unfortunately people are getting

33:55

reinfected some folks with insane months i

33:57

get covered many get it again and

33:59

verifying it It's a reinfection

34:01

because it might even be a different variant.

34:03

So very, very frustrating.

34:07

That's Twiv weekly clinical update with

34:09

Dr. Daniel Grissom. Thank you, Daniel.

34:12

Oh, thank you. And everyone, be safe.