Dr Griffin is something else! He could easily stay in the comfort of the USA, but: he is such a committed professional, he spreads his expertise - in person - globally. A true example of an outstanding human being.
Doctors are not telling their patients about Evusheld. And even discouraging patients when they ask. Mine initially did not want me to get it as she thought it was unproven and potentially dangerous. Some people are told they don't qualify when they actually do. I thought my town would run out of its tiny dose allocation quickly but it did not due to lack of awareness and/or hesitancy. I think it's probably the same story with Paxlovid. As it was with monoclonals initially. Doctors in my town were giving steroids and antibiotics long after monoclonals came out. This is sad. People are dying unnecessarily. Why are doctors still not educated about COVID treatments? It's been 2 years. There is no excuse.
Evusheld has had a 12 to 30 fold reduction in neutralizing activity for Omicron. It still does something, but…yeah. The non-placebo arm also had ~3x higher chance of adverse cardiac events than placebo, could be stochastic but still not great. The letter is JAMA “Tixagevimab and Cilgavimab (Evusheld) for Pre-Exposure Prophylaxis of COVID-19” Monoclonal and polyclonals, and even convalescent serum got hit pretty hard by Omicron.
@@minRef it is apparently more effective against the BA.2 variant per the latest FDA guidelines. This will be the dominant variant soon. Though they did have to double the dose. I'll be getting the double dose next week. With being on high dose prednisone and Rituximab, I will take any extra protection I can get. The risk of cardiac events compared to the risk of serious long term damage to my body or death from COVID means I feel that Evusheld is worth getting. Though I agree it's far from perfect and there is no guarantee its protection will hold up against future variants. Plus, I would love more data on how it actually holds up against BA.2 in reality. I'll continue to mask and be cautious after getting it.
I LOVE Daniel's Clinical updates. As a desperate Long Hauler, I used to watch anything and everything Covid related. TWIV is one of the few podcasts that withstood the test of time, and I continue to watch it religiously.
Invaluable. I eagerly await Daniel’s weekly updates and am also carefully following Vincent and friends other weekly programs. Thank you so very much. Cheers, Will
Southern Brasil states have started public school classes on Feb 24th with students in our classrooms, after a six month trial, all teachers, cleaning staff and students wearing masks. We have done well vaccinating children and teens, but there are religious influences which block our brilliant Public Health Service so far, it has been done by SUS offering free government late vaccines and assistance , some teams come to outskirts economically deprived community schools to vaccinate . Now there is a new order by governors and Mayors freeing the use of masks in the open spaces in our schools. As Winter is coming, we, principals, teachers , parents of vaccinated kids and teens are very much worried. Thank you very much for the clear, honest and precious scientific information. teacher of 4th to 9th graders in a municipal school in Porto Alegre, Rio Grande do Sul State, border with Uruguay and Argentina.
I'm not sure what is going on in the US. When I/we say "it's mild" it's our experience of it, not the US. But we had our BA.2 come in early, and our CFR is around 0.1%-0.2%, that's flu level, not 5-20x higher than flu like it used to be, and our hospitals are able to cope (at least for now) running business as usual. Our positivity rate peaked at insane 75%. We may be differentiating between "with" and "from" Covid (not sure if this is reflected in ourworldindata) where our incident rate was about 50%. Assume this is not done for the US, even applying it ourselves brings the CFR down from current 2.24% to 1.12% which is still insane. I'm not sure we can though, because usmortality site still reports +30% excess deaths from all causes for hard hit Arizona - even well into 2022. If it was just a reporting issue I'd expect to see a significant decrease in absolute mortality from prognosis. So yeah, what he hell is going on?
@UCrhCKcaDlGDG50nVLLNMTOA I agree you can't get an "accurate" R0 simply by measuring, now that vast populations aren't exactly naive to this anymore. But since R0 for various variants has been *estimated* I'm sure there exist some mathematical model to do so by plugging in statistical data, taking mitigation efforts, previous exposure, and immunization levels into account. Rt will vary with all of those, whereas R0 should be relatively static. At least in one episode I got the impression R0 and Rt was completely mixed up, and thus senseless. Whereever delta hit, it quickly became dominant, and struck way harder without any change in mitigation efforts. A bunch of Asian countries ended up struggling like crazy with delta where they were able to keep Rt
@@gottagowork What is their R0? Smallpox has an R0 of 3 Polio has an R0 of 4-6 Mumps has an R0 of 10-12 Chickenpox has an R0 of 10-12 (Varicella) Pertussis has an R0 of 15-17 Measles has an R0 of 16-18 “The (relatively) good news is that SARS-Cov2 is much less transmissible than measles.” Source: Vaccines Today. Your R0 numbers for the SARS-Cov2 variants are reasonable but keep in mind that they apply to “naïve” populations that are not implementing measures to prevent spread, i.e. the first introduction of the virus. You mentioned this too. Delta and Omicron would never have had such high R0 numbers in practice since vaccination rates and natural immunity rates were already quite high before their arrival, at least in richer countries. Your point about measles seems wrong as the quote above notes. TWIV and others have mentioned several times that Delta and Omicron have the same intrinsic spread rate among the “naïve”. Omicron just appears to spread faster since the current vaccines and natural immunity don’t completely prevent Omicron infection among those who already have prior immunity. Maybe Omicron spreads a touch faster since its symptoms are highly mucosal, not hidden in the lungs as much. Delta is able to evade antibodies better than Alpha so perhaps a smaller starting amount of inoculum can cause equivalent cell damage but I had not heard that it was more pathogenic than the other variants - my understanding is all the variants are approximately equally pathogenic, but their spread rates do vary under different circumstances. In vaccinated people the virus mutates to be able to evade antibodies so that it can infect other vaccinated people. In unvaccinated people, the virus mutates to be more infectious since speed of infection is more advantageous. That's really the only difference among variants.
@@gottagowork hello. I think the behavioural explanation is accurate. Like you said, “Japan had do to shut down to stay ahead” … this implies that there would be even more infections once society opened again, because once vaccinated, people are less likely to wear masks and more likely to socialise … which means more spread. I understood that Ro was a measure of the population when unvaccinated ….
The backbone of a virus is its overall molecular structure, and helps us to determine possible ancestors. The variant named Delta (21A or B.1.617.2) has the backbone of B.1.617 (predominantly in India), B.1 (origin: Northern Italian outbreak early in 2020), B (first to be discovered - Dec 24 2019) and A (root of the pandemic). The backbone of SARS-CoV-2 is not derived from any previously used virus backbone, (controversially) ruling out laboratory manipulation as a potential origin for SARS-CoV-2.
Stop moving the goalpost. My people back in Argentina used lVM by the boatload for prophylaxis and they found it wasn't useful so they gave up by spring of 2021.
In the “dreaded Hamster” model with Omicron the upper respiratory tract and bronchioles were more affected than the lungs . Some contend this the reason 0-4 are more affected having smaller airways .
Why did John Campbell say there were 2 peer-reviewed studies that showed that IVM was beneficial for treating C19??! My bias wants it to not be true...
I have donated. Floating Doctors. I ask for context on COVID-19 deaths. 80% over 65, total excess deaths 125,000 per year in USA. Looks like CDC reduced COVID children deaths to less than 800 out of 10s of millions
I am a bit confused. Did Dr Griffin admonish us to follow the data about IVM and to follow the truth when he has not yet seen the data himself and felt qualified to comment based on a WSJ article? Now, Dr Griffin likely has parasitic experience with IVM so that gives him some ‘Cred’ but if he has not put IVM through trials himself and if he is practicing ‘selection bias’ based on what studies he reviews and reports he is not being quite forthright. Appreciate the voice and perspective from TWIV, especially clinical updates but encouraging a more forthright (positive and negatives) about IVM and ‘established’ low cost treatments that ‘May’ be beneficial for prophylaxis and/or early treatment.
His closing comments in that topic seemed quite definitive and clearly the WSJ article happens to ‘agree’ with his own perspective. Has he presented a balanced view on the topic by presenting credible studies that are different than his own perspective?
Oh and if he ‘tags out’ some studies for ‘flaws’ does he look for flaws in the studies that agree with him and tag out ‘ageement’ studies for flaws also?
When he does discuss the data in the future, I would like an explanation as to why a trial of under 1,400 participants is now sufficient when it was previously stated on TWIV that a trial would need at least 4,000 participants to be sufficiently powered.
Yes Salik. he didn’t mention that! I also thought he thought this report was good news I.e ivermectin didn’t help relieve symptoms. Later on he reported the worst countries for xcessive deaths both total and per capital, but failed even a solitary mention of which countries did best.
@@deborahfreedman333 People went bananas over a study that showed _in vitro_ that there is an antiviral effect at a dosage that would be beyond fatal if scaled up. They're just anti-science lunatics at this point-- most of them believe HIV is a condition brought on by AZT. You can't reason with them.
Ivermectin reminds me of the Athanasius v. Arian culture wars in Byzantium. Two large camps. Dominance and banishment at stake. Lots o hype. Equal or consubstantial? Eternal or limited? Who cares? Follow the , $.
If paxlovid is sitting unused, and assuming cases are increasingly likely to increase, can we get a near term EUA for prophylaxis (weekly dose?) using Paxlovid?
But wouldn't that lead to faster resistance? Resistance is going to be a problem no matter what with drugs like Paxlovid but opening it up for lots of people to use it for prophylactic purposes seems like it would speed the development of resistance.
Personally I expect Paxlovid is not likely to cause resistance. It is a combination of 2 different drugs which makes ‘total resistance’ less likely. But also, Paxlovid’s method of action is likely to remain effective even for different variants, much like is reported by some for Ivermectin.
Should a vaccinated/boosted (no co-morbidities)66 year old start paxlovid in the initial phase of mild Covid- or should the paxlovid be saved for Un-vaccinated.
Conclusive statements about "scientific research" WITHOUT any scientific evidence. You guys are full of it. Why didn't you either state the results or at least wait to make your unsubstantiated claims until you actually could back up your claims WITH THE DATA.
@@susanmcdonald9088 To provide balance to those who mindlessly believe some of the crap published by such eminent scientists. I've watched Vincent and his cohorts since Covid hit early 2020 and witnessed numerous claims that have since proved wrong.
Dr Griffin is something else! He could easily stay in the comfort of the USA, but: he is such a committed professional, he spreads his expertise - in person - globally. A true example of an outstanding human being.
Doctors are not telling their patients about Evusheld. And even discouraging patients when they ask. Mine initially did not want me to get it as she thought it was unproven and potentially dangerous. Some people are told they don't qualify when they actually do. I thought my town would run out of its tiny dose allocation quickly but it did not due to lack of awareness and/or hesitancy. I think it's probably the same story with Paxlovid. As it was with monoclonals initially. Doctors in my town were giving steroids and antibiotics long after monoclonals came out. This is sad. People are dying unnecessarily. Why are doctors still not educated about COVID treatments? It's been 2 years. There is no excuse.
Evusheld has had a 12 to 30 fold reduction in neutralizing activity for Omicron. It still does something, but…yeah. The non-placebo arm also had ~3x higher chance of adverse cardiac events than placebo, could be stochastic but still not great.
The letter is JAMA “Tixagevimab and Cilgavimab (Evusheld) for Pre-Exposure Prophylaxis of COVID-19”
Monoclonal and polyclonals, and even convalescent serum got hit pretty hard by Omicron.
@@minRef it is apparently more effective against the BA.2 variant per the latest FDA guidelines. This will be the dominant variant soon. Though they did have to double the dose. I'll be getting the double dose next week. With being on high dose prednisone and Rituximab, I will take any extra protection I can get. The risk of cardiac events compared to the risk of serious long term damage to my body or death from COVID means I feel that Evusheld is worth getting. Though I agree it's far from perfect and there is no guarantee its protection will hold up against future variants. Plus, I would love more data on how it actually holds up against BA.2 in reality. I'll continue to mask and be cautious after getting it.
I LOVE Daniel's Clinical updates. As a desperate Long Hauler, I used to watch anything and everything Covid related. TWIV is one of the few podcasts that withstood the test of time, and I continue to watch it religiously.
Wishing you a total recovery soon.
So sorry.
Thank you Dr Griffin. It’s good to have a reliable source of information in these times.
@@lamel1781 There was a recent meta analysis that showed that it was not helpful.
Thank you Dr Griffin 🙂👍
Thanks again for the clinical update.
Invaluable. I eagerly await Daniel’s weekly updates and am also carefully following Vincent and friends other weekly programs. Thank you so very much. Cheers, Will
I donated, and it was matched. Thank you so much for helping us stay informed and for all you do.
Dr. Griffin, your updates have been truly valuable. Happy to donate to parasites without borders in return!
Thank you for your updates
Thankyou so much great to hear the latest update 👍
Southern Brasil states have started public school classes on Feb 24th with students in our classrooms, after a six month trial, all teachers, cleaning staff and students wearing masks. We have done well vaccinating children and teens, but there are religious influences which block our brilliant Public Health Service so far, it has been done by SUS offering free government late vaccines and assistance , some teams come to outskirts economically deprived community schools to vaccinate . Now there is a new order by governors and Mayors freeing the use of masks in the open spaces in our schools. As Winter is coming, we, principals, teachers , parents of vaccinated kids and teens are very much worried.
Thank you very much for the clear, honest and precious scientific information. teacher of 4th to 9th graders in a municipal school in Porto Alegre, Rio Grande do Sul State, border with Uruguay and Argentina.
Anyone know of any studies of the risk of long covid when vaxxed and boosted?
BA-2 seems to be quite transmissable, to me. Also Omicron seemed to have caused many deaths in USA.
I'm not sure what is going on in the US. When I/we say "it's mild" it's our experience of it, not the US. But we had our BA.2 come in early, and our CFR is around 0.1%-0.2%, that's flu level, not 5-20x higher than flu like it used to be, and our hospitals are able to cope (at least for now) running business as usual. Our positivity rate peaked at insane 75%. We may be differentiating between "with" and "from" Covid (not sure if this is reflected in ourworldindata) where our incident rate was about 50%. Assume this is not done for the US, even applying it ourselves brings the CFR down from current 2.24% to 1.12% which is still insane. I'm not sure we can though, because usmortality site still reports +30% excess deaths from all causes for hard hit Arizona - even well into 2022. If it was just a reporting issue I'd expect to see a significant decrease in absolute mortality from prognosis. So yeah, what he hell is going on?
I ve had c-19 twice and I don’t feel like it is mild (whatever that means) but I felt less sick the 2nd time compared to the first 😷
@UCrhCKcaDlGDG50nVLLNMTOA I agree you can't get an "accurate" R0 simply by measuring, now that vast populations aren't exactly naive to this anymore. But since R0 for various variants has been *estimated* I'm sure there exist some mathematical model to do so by plugging in statistical data, taking mitigation efforts, previous exposure, and immunization levels into account. Rt will vary with all of those, whereas R0 should be relatively static. At least in one episode I got the impression R0 and Rt was completely mixed up, and thus senseless. Whereever delta hit, it quickly became dominant, and struck way harder without any change in mitigation efforts. A bunch of Asian countries ended up struggling like crazy with delta where they were able to keep Rt
@@gottagowork
What is their R0?
Smallpox has an R0 of 3
Polio has an R0 of 4-6
Mumps has an R0 of 10-12
Chickenpox has an R0 of 10-12 (Varicella)
Pertussis has an R0 of 15-17
Measles has an R0 of 16-18
“The (relatively) good news is that SARS-Cov2 is much less transmissible than measles.”
Source: Vaccines Today.
Your R0 numbers for the SARS-Cov2 variants are reasonable but keep in mind that they apply to “naïve” populations that are not implementing measures to prevent spread, i.e. the first introduction of the virus. You mentioned this too. Delta and Omicron would never have had such high R0 numbers in practice since vaccination rates and natural immunity rates were already quite high before their arrival, at least in richer countries. Your point about measles seems wrong as the quote above notes.
TWIV and others have mentioned several times that Delta and Omicron have the same intrinsic spread rate among the “naïve”. Omicron just appears to spread faster since the current vaccines and natural immunity don’t completely prevent Omicron infection among those who already have prior immunity. Maybe Omicron spreads a touch faster since its symptoms are highly mucosal, not hidden in the lungs as much. Delta is able to evade antibodies better than Alpha so perhaps a smaller starting amount of inoculum can cause equivalent cell damage but I had not heard that it was more pathogenic than the other variants - my understanding is all the variants are approximately equally pathogenic, but their spread rates do vary under different circumstances.
In vaccinated people the virus mutates to be able to evade antibodies so that it can infect other vaccinated people. In unvaccinated people, the virus mutates to be more infectious since speed of infection is more advantageous. That's really the only difference among variants.
@@gottagowork hello. I think the behavioural explanation is accurate. Like you said, “Japan had do to shut down to stay ahead” … this implies that there would be even more infections once society opened again, because once vaccinated, people are less likely to wear masks and more likely to socialise … which means more spread.
I understood that Ro was a measure of the population when unvaccinated ….
Though something was wrong, Vincent, when I didn't see this pop up at the usual time.
Thank you
Thank you! ♥️
Could someone explain what "the "backbone" of delta" means.
The backbone of a virus is its overall molecular structure, and helps us to determine possible ancestors.
The variant named Delta (21A or B.1.617.2) has the backbone of B.1.617 (predominantly in India), B.1 (origin: Northern Italian outbreak early in 2020), B (first to be discovered - Dec 24 2019) and A (root of the pandemic).
The backbone of SARS-CoV-2 is not derived from any previously used virus backbone, (controversially) ruling out laboratory manipulation as a potential origin for SARS-CoV-2.
@@gribbler1695 Thank you.
Thanks for the clinical update
How soon were the patients treated with Ivermectin? (asking for a friend)
Stop moving the goalpost. My people back in Argentina used lVM by the boatload for prophylaxis and they found it wasn't useful so they gave up by spring of 2021.
Do we know if viruses can replicate in bacteria cells too? If yes, how much do we know about the mechanism and are viruses bacteria specific?
In the “dreaded Hamster” model with Omicron the upper respiratory tract and bronchioles were more affected than the lungs .
Some contend this the reason 0-4 are more affected having smaller airways .
Day 5. Symptoms improving but still lingering low fever. Testing positive. Looks like 2 more days to clear. CDC guidance of 5 days was ridiculous.
Hello from Brugge. Travelling from SF to Brugge found most people complying with masking.
Why did John Campbell say there were 2 peer-reviewed studies that showed that IVM was beneficial for treating C19??! My bias wants it to not be true...
I have donated. Floating Doctors. I ask for context on COVID-19 deaths. 80% over 65, total excess deaths 125,000 per year in USA. Looks like CDC reduced COVID children deaths to less than 800 out of 10s of millions
I am a bit confused. Did Dr Griffin admonish us to follow the data about IVM and to follow the truth when he has not yet seen the data himself and felt qualified to comment based on a WSJ article? Now, Dr Griffin likely has parasitic experience with IVM so that gives him some ‘Cred’ but if he has not put IVM through trials himself and if he is practicing ‘selection bias’ based on what studies he reviews and reports he is not being quite forthright. Appreciate the voice and perspective from TWIV, especially clinical updates but encouraging a more forthright (positive and negatives) about IVM and ‘established’ low cost treatments that ‘May’ be beneficial for prophylaxis and/or early treatment.
He is using another straw man. Everybody knows Iver doesnt work so late as when you go into hospital.
He didn’t say it conclusively as he said he will share it. It was in the Wall Street Journal. If he didn’t say anything, that would have been odd.
His closing comments in that topic seemed quite definitive and clearly the WSJ article happens to ‘agree’ with his own perspective. Has he presented a balanced view on the topic by presenting credible studies that are different than his own perspective?
Oh and if he ‘tags out’ some studies for ‘flaws’ does he look for flaws in the studies that agree with him and tag out ‘ageement’ studies for flaws also?
When he does discuss the data in the future, I would like an explanation as to why a trial of under 1,400 participants is now sufficient when it was previously stated on TWIV that a trial would need at least 4,000 participants to be sufficiently powered.
Unclear why you omitted Fluvoxamine and Heparin from your list of treatments under discussion.
Are the positive study results not on your radar?
He has discussed anticoagulants, like heparin, in the past. Why keep repeating the same thing?
@@deborahfreedman333 but not fluvoxamine yet?
Ivermectin: One day prior to hospitalization is too late for antiviral therapy. Dose and timing are central to therapy . Here the timing is wrong.
Yes Salik. he didn’t mention that! I also thought he thought this report was good news I.e ivermectin didn’t help relieve symptoms.
Later on he reported the worst countries for xcessive deaths both total and per capital, but failed even a solitary mention of which countries did best.
Poor study anyway
Since ivermectin is an antiparisitical, not a antiviral, so what?
@@deborahfreedman333 People went bananas over a study that showed _in vitro_ that there is an antiviral effect at a dosage that would be beyond fatal if scaled up.
They're just anti-science lunatics at this point-- most of them believe HIV is a condition brought on by AZT. You can't reason with them.
Ivermectin reminds me of the Athanasius v. Arian culture wars in Byzantium. Two large camps. Dominance and banishment at stake. Lots o hype. Equal or consubstantial? Eternal or limited? Who cares? Follow the , $.
Daniel is a rockstar ! even if he speaking from the moon
If paxlovid is sitting unused, and assuming cases are increasingly likely to increase, can we get a near term EUA for prophylaxis (weekly dose?) using Paxlovid?
But wouldn't that lead to faster resistance? Resistance is going to be a problem no matter what with drugs like Paxlovid but opening it up for lots of people to use it for prophylactic purposes seems like it would speed the development of resistance.
Personally I expect Paxlovid is not likely to cause resistance. It is a combination of 2 different drugs which makes ‘total resistance’ less likely. But also, Paxlovid’s method of action is likely to remain effective even for different variants, much like is reported by some for Ivermectin.
Should a vaccinated/boosted (no co-morbidities)66 year old start paxlovid in the initial phase of mild Covid- or should the paxlovid be saved for Un-vaccinated.
Conclusive statements about "scientific research" WITHOUT any scientific evidence. You guys are full of it. Why didn't you either state the results or at least wait to make your unsubstantiated claims until you actually could back up your claims WITH THE DATA.
@@susanmcdonald9088 To provide balance to those who mindlessly believe some of the crap published by such eminent scientists.
I've watched Vincent and his cohorts since Covid hit early 2020 and witnessed numerous claims that have since proved wrong.
@@alocinotasor oh, because obviously nothing ever changes? It’s called scientific method.