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TWiV Episode: Winter Viruses, Avian Flu, and COVID-19 Updates
0:00-0:31 Fundraising Drive: The podcast is running its annual fundraising drive, requesting audio/video testimonials from listeners about how the program has empowered their "inner scientist". Contributions can be made at incubator.micro.com.
0:31-0:48 Jimmy Carter Tribute: Discussion of Jimmy Carter's work on neglected tropical diseases, especially Guinea worm, emphasizing his dedication to detail and global health.
0:48-0:57 Guinea Worm Eradication: Details about the Guinea worm parasite and how its cases have drastically decreased from 3.5 million annually to only a few cases in specific regions. A filter used for water purification that was given to the speaker by Jimmy Carter is mentioned.
0:57-1:04 Winter Vomiting Disease (Norovirus): Norovirus activity is currently high with many outbreaks and hospitalizations. Soap and water are recommended for cleaning, not just alcohol-based cleaners.
1:04-1:14 Norovirus Outbreak: There are over 90 outbreaks and cruise ships are experiencing more norovirus outbreaks than in history, possibly due to less exposure to other respiratory viruses. A theory is proposed that other respiratory infections can produce interferons that protect against norovirus.
1:14-1:30 Avian Influenza (H5N1): Discussion of recent publications regarding H5N1, with the emergence of a new clade (2 344b) in 2021 and a new dairy cow infection discovered in 2024, which is now widespread across 16 states in the USA.
1:30-1:40 H5N1 Pneumonic & Human Case: A mnemonic for the two major H5N1 variants is introduced: "B for Bovine/Benign" and "D for Ducks/Deadly." A case of a 13-year-old girl in Canada with severe illness due to a direct-from-bird H5N1 infection is discussed, with three mutations potentially linked to increased virulence and human adaptation.
1:40-1:50 H5N1 Vaccines & Treatments: Current vaccine candidates can neutralize circulating strains, and current isolates are susceptible to antiviral agents. However, these are two-dose vaccines, and research into mRNA based vaccines is ongoing.
1:50-2:03 H5N1 Human Threat: Concern over H5N1 is mostly due to its widespread nature in animals and reassortment potential, and the possibility of human-to-human transmission. Despite the concern, it's noted that H5N1 has been around since 1997 and there is still no human-to-human transmission. Current antivirals and vaccines may help mitigate any threat.
2:03-2:07 Respiratory Illness Activity: A recent map shows widespread high acute respiratory illness activity, particularly in New Hampshire.
2:07-2:23 COVID vs. Flu in Hospitals: Discussion of a Swiss study showing comparable case fatality rates between healthcare-associated COVID-19 (Omicron variant, 6.2%) and Influenza A (6.1%), which highlights the severity of both diseases in hospital settings.
2:23-2:46 Impact of Healthcare Quality: It's emphasized that these numbers may be unique to the high quality of care in Switzerland, and can be different depending on local health care availability.
2:46-2:59 Influenza and RSV Activity: Influenza and RSV activity are high across the country, with New York City potentially considering mask recommendations for RSV. The podcast highlights that there is disagreement on the infectious nature of RSV with some hospitals not requiring isolation for the illness.
2:59-3:10 COVID-19 Update: Wastewater data shows an exponential rise in COVID-19 cases across the country, with levels approaching "very high" in some areas. There is a call to make all wastewater surveillance data public, including data for polio, as it's suggested that this is currently being hidden.
3:10-3:20 Polio Cases & Wastewater: There is an emphasis on making all wastewater data public (including polio), as the speakers feel the CDC is currently hiding it. They emphasize that there have been recent cases of polio detected via wastewater surveillance and an isolate found in Australia that they wish to have public awareness on.
3:20-3:31 At-Home Testing: A listener in Germany was able to buy triple tests (Flu, RSV, COVID-19) for only 2 euro, which is significantly cheaper than tests in the US. Discussion of the value of at-home testing for reducing unnecessary antibiotic use.
3:31-3:40 Clinical Impact of RSV Testing: Adding RSV to the home test kit is valuable due to providing awareness of the illness and preventing unnecessary use of antibiotics. There is a call for insurance to cover the at-home tests, since they cover PCR based tests at the Urgent Care setting.
3:40-3:52 COVID-19 Transmission Data: The current data on COVID transmission is not as strong as it was early in the pandemic, and that the information about asymptomatic transmission is not backed by strong data and may be overestimated.
3:52-3:56 COVID-19 Isolation: There is no updated data to support COVID-19 isolation strategies, as the guidelines were updated in the US due to "isolation fatigue" and not new scientific findings. The current five-day isolation is more based on public health messaging than hard science.
3:56-end Recommendations: The speaker mentions the continued importance of early intervention and treatments such as Paxlovid and Molnupiravir for COVID-19 and discusses best practices for different phases of COVID-19 infection, highlighting the use of steroids, anticoagulants and the need for continued research on long-COVID. There is also a call to donate to the podcast.
This summary includes the key topics, timestamps, and provides detailed insights into the discussion points raised during the podcast.