Podcasts about reinfection

This week Jonathan is joined by Ron Daniels, Founder and Executive Director of UK Sepsis Trust, and Vice President of the Global Sepsis Alliance. Together, they shatter myths and amplify awareness around sepsis, and discuss how to break barriers in diagnosis and treatment. Use the following timestamps to navigate this episode: (00:00)-Introduction   (03:03)-Stepping into the world of sepsis (07:29)-Preparing for the worst in medicine   (11:10)-Dispelling common myths about sepsis (16:02)-The overuse of antibiotics (18:20)-The Sepsis Six treatment bundle (21:10)-Overcoming barriers in sepsis treatment (29:00)-Addressing resistance in education (33:12)-Raising public awareness of sepsis   (36:43)-What can we do better? (41:18)- Exciting developments in the world of sepsis (43:16)-Bringing social media into play (48:04)-Television in raising awareness (53:10)-Ron's three magic wishes

Season 2 is here! It's also episode #13 so for something spooky, let's talk about getting reinfected with the virus that changed your life forever. Today I discuss how my recent reinfection felt, how reinfection affected my Long Covid symptoms, and how I responded. I'll share how antivirals work, who they work best for, and who shouldn't take them. We'll also peruse the existing literature on reinfection and Long Covid. How did reinfection affect you? Email me at LongCovidMD@gmail.comLinks:https://www.fda.gov/media/158165/downloadhttps://www.pfizer.com/science/coronavirus/severe-covidhttps://www.covid19treatmentguidelines.nih.gov/therapies/antivirals-including-antibody-products/molnupiravir/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10454552/https://www.longcovid.org/images/Documents/Reinfections_in_Long_Covid_Survey_Report_by_Long_Covid_Support_and_Long_Covid_Kids_080922.pdfFollow me on X @doctor_zeest

News

COVID-19 cases continue to rise, and the FDA authorizes new COVID-19 boosters. AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia, JD, MPH, also discusses the latest news about the Eris (EG.5) and Pirola (BA.2.86) variants, the effects of COVID-19 reinfection, and its relationship with Long COVID. Plus, the CDC's health advisory on RSV. American Medical Association CXO Todd Unger hosts.

Few, if any, physician researchers have done more to understand the long-term impact of Covid than Dr. Ziyad Al-Aly, a professor, nephrologist, and epidemiologist along with his team at Washington University, St. Louis. Here is the transcript (with links to the audio) of our conversation that was recorded one 7 September 2023.Eric Topol (00:00):Welcome to Ground Truths, and this podcast is a special one for me. I get to meet professor Dr. Ziyad Ali for the first time, even though we've been communicating for years. So welcome, Ziyad.Ziyad Al-Aly (00:15):Well, thank you. Thank you. Thank you for having me. It's really a delight and pleasure and an honor to be with you here today. So thank you. Thank you for the invitation, and most importantly, thank you for all the stuff that you do and you've been doing over the past several years, communicating science to the whole world, especially during the pandemic and enormously grateful for all your effort.Background in Lebanon, the move to Wash U., and EpidemiologyEric Topol (00:33):Well, you're too kind and we're going to get into your work, which is more than formidable. But before I do that, because you have been a leading light in the pandemic and understanding, especially through the large veterans affairs population, the largest healthcare system in the United States, the toll of covid. But before we touch on that a bit on your background first, you're a young guy. You haven't even hit 50 yet, my goodness. Right. And you grew up in Lebanon, as I understand it, and you were already coding when you were age 14, I think, right? Pretty wild. And then perhaps the death of your father at a young age of multiple myeloma had a significant impact on your choice to go into medicine. Is that right?Ziyad Al-Aly (01:28):Yeah, that's how it is. So I grew up in Lebanon, and when I was growing up, the computer revolution at that time was happening and all of a sudden in my surroundings, there's these people who have these Commodore 64. So I decided that I wanted one. I asked my parents to get me one. They got me one. I learned coding at that age, and my passion was I thought I wanted to do then why not to do computer science. And then my dad fell ill with multiple myeloma and it was an aggressive form and he required initially a lot of chemotherapy and then subsequently hospitalizations. I do remember vividly visiting him in the hospital and then connected with the profession of medicine. I was not on that track. I didn't really, that's not all my youth. I wanted to be a coder. I wanted to be a computer scientist. I wanted to do basically work with computers all my life. That's what my passion was. And then redirected all that energy to medicine.Eric Topol (02:32):Well, you sure did it well. And you graduated from one of the top medical schools, universities at American University of Beirut, and came to St. Louis where you basically have for now 24 years or so, went on to train in medicine and nephrology and became a leading light before the pandemic. You didn't know it yet, I guess, but you were training to be a pandemic researcher because you had already made the link back in 2016, as far as I know, between these protein pump inhibitors and kidney disease later, cardiovascular disease and upper GI cancers. Can you tell us, was that your first big finding in your work in epidemiology?Ziyad Al-Aly (03:22):Yeah, we started doing epi. I started doing epidemiology or clinical epi right after fellowship, trained with mentors and subsequently developed my own groups and my own funding. And initially our initial work was in pharmaco-epidemiology. We were very, very interested in figuring out how do we leverage this big data to try to understand the long-term side effects of medication, which was really not available in clinical trials. Most clinical trials for these things track them for maybe 30 days or at most for few months. And really long-term risk profile of these medications have not been characterized previously. So we did that using big data and then subsequently discovered the world of environmental epidemiology. We also did quite a bit of work and environmental linking air pollution to non-communicable disease. And in retrospect, reflecting on that now, I sort of feel there was training ground that was training wheel out, how to really optimize our thinking, asking the right question, the right question that matters to people addressing it rigorously using data and also communicating it the wider public. And that was my training, so to speak, before the pandemic. Yeah,Eric Topol (04:37):Yeah. Well, you really made some major, I just want to point out that even though I didn't know of your work before the pandemic, it was already momentous the link between air pollution and diabetes, the link of PPIs and these various untoward organ events, serious events. So now we go into the pandemic and what you had access to with the VA massive resource, you seize the opportunity with your colleagues. Had some of this prior work already been through that data resource?Ziyad Al-Aly (05:18):Yes, yes. Our work on PPI on adverse events of medications, including proton pump inhibitors, was all using VA data. And then our work using environmental epidemiology, linking air pollution to chronic disease was also using VA data. But we linked it with NASA data with sort of satellite data from NASA that capture PM 2.5. But NASA has these wonderful satellites that if a chemical is on earth and has a chemical signature that can actually see it from space and measure its concentration. So that data is actually all available free of charge. So what we did is I went to these massive databases at NASA and link them to our VA data, and then we're able to analyze the relationship between exposure to high levels of air pollution in the United States and then subsequent disease in veterans in our database.Eric Topol (06:11):That was ingenious to bring in the NASA satellite data. Big thinker. That's what you are. So now you are confronted with the covid exposure among what millions of veterans. Of course, you have controls and you have cases and you're now seeing data that says every system is being hit here and you write, you and your colleagues wrote papers on virtually every system, no less the entire long covid. What were the surprises that you encountered when you were looking at these data?Initial Shock on Covid's Non-Pulmonary Sequelae IdentifiedZiyad Al-Aly (06:47):I remember the initial shock and our first paper when we did our first paper and there was a systematic approach looking at all organ systems. We weren't expecting that because at that time we were thinking SARS-CoV-2 is a respiratory virus. We know respiratory virus may have some post-acute sequela and maybe cardiovascular systems, but we weren't really expecting to see hits in nearly every organ system. And remember when we first got the results from what then became our nature paper, our first paper in nature around this, I doubted this. I couldn't really believe that this is really true. I looked at the association with diabetes and I told Yen, my colleague here who's really absolutely, absolutely wonderful, told him, there must be a mistake here. You made an error. There's an error in a model for sure. This is not believable. That can't be like SARS-CoV-2 and diabetes.(07:39):This is impossible. There wasn't really an arrow in my brain that sort of linking SARS-CoV-2 diabetes. I doubted it. And we went back to the model, went back to the data, rebuilt the cohort, redid the whole experiment again with controls. The same thing happened again. I still was not believing it, and it was like, end, there is something wrong here. It's weird. It's strange. This is not how these things work. Again, from medical school, from all my education, we're not trained to think that viruses, especially respiratory viruses, have these myriad effects and all these organ systems. So I doubted it for the longest time, but the results came back exactly consistent every single time the controls work, our positive control work, our negative controls work. Eventually the data is the data, then we then submitted it for a review.The Largest Healthcare System in the United StatesEric Topol (08:40):Yeah. Well, I want to emphasize this because many have tried to dismiss their data because it's average age of 60 plus and it's men and it's European ancestry and for the most part, but everything you found, I mean everything you found has been backed up by many other replications. So for example, the diabetes, particularly the Type 2 diabetes, there's now 12 independent replications and a very similar magnitude of the effect, some even more than 40% increase. So we didn't need to have more in the diabetes epidemic than we already have in the world. But it looks like Covid has contributed to that. And what do you say to the critics that say, oh, well these are old white men are studying and does it really apply long and all this multi-system organ hits to other populations given that, for example, the prototypic long covid person affected might be a woman between age 30 and 39. What's your sense about that?Ziyad Al-Aly (09:54):The way I think about it is that our data are massive. And while the average age is 60, the data, because these are literally millions of people, some cohorts are 6 million. Some of the studies that we've done, 6 million people, so the average age could be 60, but there are literally hundreds of thousands in their twenties and thirties and forties, and they're all represented in the data. And the data is obviously also controlled for age and race and sex. And I tell people this thing that they say, oh, well, your data is only 10% women, and then this is why. But 10% out of 6 million people is 600,000 women. I told a friend the other day that 600,000 women could fill six Taylor Swift stadiums. So it isn't really small. And even if we were to only analyze people in their twenties and thirties, or we could do that, we could do that.(10:44):We could easily do 300 or 400,000 people study of people from age 20 to 40. In our experience, we get more or less the same results because again, the results are adjusted for age. And then the second component of my thinking about this, and as you pointed out, the gold standard and science is reproducibility. Does this really finding reproduce in other settings? Other people are also seeing it, are able to validate it and reproduce the finding. Or this really some peculiar thing about the VA is happening only in the VA world or the VA universe. That doesn't really happen outside. And then so far, not only the findings in the pandemic, all the findings prior to the p p use and chronic kidney disease, PPI use and other side effect, all the pollution work has been reproduced to the T by Michelle Bell by Francisca Doci at Harvard to the T.(11:35):All these pollution studies have been reproduced from using Medicare data using data that's outside the VA, other data sets. And also some European friends and European collaborators reproduce the same thing. So again, the gold standard in science reproducibility, but healthy skepticism is skepticism is also healthy because we always want to challenge the finding. Is this really true? Can we bank on it? And really the most important thing inside reproducibility really is to be able to take this finding or to take the question somewhere else and then be able to reproduce the evidence that is seen in any dataset.The New 2-Year Follow-Up StudyEric Topol (12:13):Right. Well, so you have really laid out the foundation for our understanding of Long Covid. I agree with your point that there's plenty of people who are more in that prototypic age and gender. But by doing so, we have these kind of two paths. One is the symptoms of Long Covid where as you know, there's reported even a couple of hundred and some of course in clusters. And then there's these organ hits across neurologic, cardiovascular, kidney, and on and on. And you recently of course provided the two year data on that, which of course is important because as you know from your data, these are mostly, if not almost exclusively unvaccinated early in the pandemic. Could you comment about what your main findings were in two years and what you think would be the difference if this was a widely vaccinated population?Ziyad Al-Aly (13:20):Sure. In the two year studies, what we've really seen is that we, first of all, to introduce the readers or the listeners, there were two groups. We split them into two cohorts, non hospitalized and hospitalized people with covid 19 compared to controls. Now in the non hospitalized group, in both groups we assessed about 80 sequela of SARS COV to two. We've seen about 30% the risk for 30% of the SQL remain elevated at two years in the non hospitalized group, those are the people who really had mild disease that did not necessarily hospitalization yet even at two years, they remained at higher risk of about 30% of the sequela that we evaluated in that study. The risk profile for the people who were hospitalized was much more complicated or much more or less optimistic in the sense that they were about 65% of the sequela also registered at a higher risk in the covid group versus the control group.(14:25):So now it's very, very important for people to really know that this is really because we needed to do a two year study, we couldn't really enroll somebody in the study who had covid six months ago. They don't have a two year follow up. So this is a two year study. By necessity, we had to enroll people from the very first year of the pandemic, which meant that most of the people there or nearly all actually were the pre delta era, the ancestral strain or pre delta era and were non-vaccinated. So to the core of the question, how does this risk profile change with time? And my hunch is that a lot of things have changed. Obviously now we have vaccination, we have population level immunity. The virus itself has changed. We have antivirals, Paxlovid and others, but mainly Paxlovid and all of those are known to ameliorate the risk of not only acute disease but also chronic disease or the risk of Long Covid to various degrees.(15:24):But there's certainly we see in our work and other people's work, there is evidence of risk reduction in the risk of long-term sequelae or long-term consequences of SARS-CoV-2 infection. So that leads me to believe that the risk now or would be lower, but that's really a hypothesis. I don't have data to back this up. You asked me for data today for three year, I don't have it yet. We're thinking about it a lot. We're trying to work on it. I don't have it yet, but the hunch is that this is really, it's, it's lower now than a way it was.Clarifying the Role of Reinfection and Long CovidEric Topol (16:06):Right, right. No, that'll be really interesting to see. And I certainly agree with you as other studies, obviously none as large as what your data resources with the Veterans Affairs have suggested that the vaccines and boosters are providing some protection. Paxlovid, Metformin in a randomized trial, as you well know now, one of the papers of the many in top tier journals that you published was about reinfection. And this led to some confusion out there, which I hope that you'll be able to straighten out. I saw it as a dose response whereby if you have multiple re infections, the chance of you developing multiple of a long covid syndrome would be increased to some degree. Can you clarify that interpretation?Ziyad Al-Aly (16:57):This is exactly right. So a lot of people sort of interpreted it as we're trying to evaluate the risk of second infection versus the first, or whether the second infection is more mild or more severe than the first. That's not really the study question. So what we did, we sort of said that now we know a lot of people had a first infection that's already happened to these people. They cannot go back and erase it or do anything about it. They already had a first infection. What's the most important question for somebody who had a prior infection going forward? Does it matter to me or is it helpful to me to protect myself from the second infection? Right. So we designed the study and arguably designed a little bit was confusing to some people in the media. We designed the study to evaluate the risk of reinfection versus a counterfactual of no reinfection.(17:50):So basically if you have two people who have equal characteristics at baseline, everything equal, they had a first infection, one protected himself or herself from getting a second infection and the other one did not and then got a second infection. What are the outcomes in the person who did not get a second infection versus a person who got a second infection? And the results are very, very clear that a second infection or reinfection is consequential. It adds or contributes additional risks both in the acute phase, it can put even reinfection can put people in the hospital, can also result in some death that's very, very clear in our data and is very clear in other data as well and can also contribute risk of long. So I think the best interpretation for this is that for people to think that two infections are worse than one and three are worse than two, so two infections are worse than one and three are worse than two.(18:46):But we've learned a lot from this paper because I definitely agree and I've seen a lot of not the right interpretation for it. We discovered that America does not like counterfactual thinking. It's really hard to explain counterfactual thinking, but that's really what we thought about as the most important question to answer. It isn't really whether a second infection is really milder or more severe, and at first is more like if you were to do something about it, does it really help you to prevent yourself from getting a second infection or a third infection? For us to design the study to answer this specific question, we compared reinfection to no reinfection and we thought we wrote it very clearly still some headlines where, oh, these are comparing a second infection to a first infection, which that's was not our intent. We didn't really design this set this way.(19:42):As a matter of fact, we had a little bit of a hunch that it might be misinterpreted this way at the very, very last minute. In the copy editing stage, I inserted a sentence in the discussion that our results and our work should not be interpreted as a comparison of a second infection versus first, I hope the editor is not listening. I inserted this at the last minute in the copy editing stage in the limitation section to help people understand that this is not an evaluation or a competitive evaluation of the risks of the second infection versus the first, but more a second infection versus no second infection.Getting CovidEric Topol (20:21):Right, right. No, I'm so glad you clarified that because I think it's an important result and it has indeed. Everything else you've done been replicated. So now I want to ask you have, are you in Novid? Have you ever had Covid?Ziyad Al-Aly (20:38):Oh, I did have. I tried to reduce my risk and I did everything I'm supposed to do except that this June, about two months ago, I traveled and I got it while traveling. I think, I guess I was doing all the precautions that I could and I got it. I ended up having, although I'm young and I don't mind sharing, I got Pax Ovid because I got back slowly and I got over it. But that was my first, and it was only two months ago and I did my best throughout this pandemic to prevent it. But then travel is tricky because you are exposed a lot of people on the plane and it's tricky at the airport is very busy, crowded and it's very tricky. No,Eric Topol (21:27):Especially because people are not taking precautions anymore. And so you go to these crowded places with poor ventilation and very few people wear masks, and we still have all these people who are anti mask and that isn't helping either. So the next thing I was going to ask you about was you've done this remarkable work, a series of papers that have led the pandemic and in fact, you really have the only pulse on the United States data because outside of what you have in terms of all these electronic health records and longitudinal follow-up, we don't have any health system that has this capability. So we have relied on you and your team to give us these really critical readouts. What are you going to do next?Ziyad Al-Aly (22:20):We're very committed to understanding Long Covid. So we feel there is a lot of knowledge gaps that still need to be unpacked and understood, and we really, I feel committed to it. So we came to long covid because we sort of felt the voice of the patient advocacy groups at the very early phase of the pandemic saying at that time they were not so organized, but they were saying an up at pieces that we're having a problem here and somebody needs to look at it and somebody needs to evaluate it. We immersed ourselves in long covid, really inspired by the patient advocacy groups initially, and we feel connected to this. So that's, we're definitely committed to deepen our understanding of long covid. But having said that, I sort of feel that I do hope that our work inspire others that there is a lot of value in data, there are limitations. Existing data or big data is not without limitations. There are limitations in the data, but it can also unlock a lot of insights, especially in crises like the one we just experienced, the pandemic.Missed RECOVER Opportunities and Testing Treatments for Long CovidEric Topol (23:28):I think you have some extraordinary opportunities. So for example, when you found what previously was not appreciated for the data resource of the Veterans Affairs, the relationship between a medication protein pump inhibitors and kidney and cardiovascular diseases, I wonder for example, because so many people take metformin, would Metformin show protection from long covid within the Veterans' Affairs database as an example? Of course, maybe there are even some medications that are commonly used that offer a protective effect. I mean, you might be able to look at something like that because the data you have to work with in so many ways is massive and unprecedented.Ziyad Al-Aly (24:14):Well, yeah, I mean the scale of a data is really amazing. So it is really the largest integrated healthcare system in the US and it's really fully integrated. There's lab data, medication data, socio demographics, everything benefits data. Literally everything is in one place and there is opportunity to try to evaluate therapeutics effective metformin, other anti hypoglycemics, maybe GLP ones. And so there's a lot of these hypotheses that they, because the virus might reside in fat cells, there is this hypothesis that we just recently reviewed in a beautiful review in nature immunology, unlike the viral resistance hypothesis, so as a potential mechanistic pathway for long covid. So there are a lot of hypotheses around metformin and GLP one, and I think the VA environment or data environment is certainly good to test those, at least to help inform trials in this space. Now, there is already a trial on metformin, so that's done by David, but looking at it from another angle in the VA data would also, I think would add insight and would further contribute to the national conversation.Eric Topol (25:30):Right. I mean I think the Canadians, McMaster are starting a very large trial, Metformin with 5,000 participants. But I wonder if there were these drugs that are linked to mTOR and mitochondrial function enhancement, which as you said, not only was there an excellent review on the persistence of the virus in reservoirs, but also one that you know of well, bringing in the potential of mitochondrial dysfunction as a unifying theme. Now as we go forward, obviously the covid problem is not going away. We have this circulating virus in one form or another, one version, one strain or another over the years ahead. And we only know of one way to avoid long covid for sure, which is not getting covid in the first place. And at least we have some things that would help if you have Covid, like what you've already reviewed with Paxlovid. But the question is there's no treatment out there. And you have been of course helping as an advisor to the White House and WHO and the patient led collaborative. And the frustration out there is high because the big recover at NIH had over $1 billion and they have done really almost nothing in clinical trials. Imagine if you had 1 billion to work with. Can you comment about the fact that here we are, we're in September of 2023 and we don't even have one good clinical trial of a potential therapeutic.Ziyad Al-Aly (27:09):So this is enormously frustrating to me as well. It shouldZiyad Al-Aly (27:15):Yes, yes, yes. So no, we are definitely on the same page. So this is enormously frustrating to that. And three years into the pandemic, we still have, and I do remember when I see the white box that you put on your tweet and I think was recently illustrated in Fortune Magazine. There's three years into it. This is a full list of therapeutics for long covid and it's literally zero, nothing there. So it's very, very, very disappointing. And I do think that we want recover to succeed. That's really very, very important. We want recover to succeed. The patient community want also recover to succeed. And I think this really hopefully an invitation, all this what I think is a constructive criticism of recover, hopefully the recover folks will take it to heart and will sort rethink the approach and rethink the allocation of funds. In particular.(28:08):What really bothers me the most, and I've told them about this, I mean, as you know, I talked to multiple people in HHS and White House and all that. What really bothers me the most is that a lot of the money had been actually allocated to the observational arm to recover. And my argument to them is that actually we can produce the same. We actually not can we have produced all that evidence for peanuts two years ago. We need a study in JAMA to tell us that while long covid is characterized by fatigue and brain fog, I know that already, I already did that two years ago, an observational study. Well, we need interventional studies. What we need, most of the money should really be allocated to interventions, not really observational arm. And it's not too late to correct course. It's absolutely not too late to correct course. Well,Eric Topol (28:56):You're kind, but I'm afraid they've run out of money. And so I don't know they're going to get any more to do the trials, which are as very expensive to run. So it's not too late to do the trials, but unfortunately it's very hard to get the funds to support them. I thinkZiyad Al-Aly (29:14):There may be mechanisms for them to reallocate things, but also very importantly that we cannot, even if they reallocate this $1 billion to long covid, I think we need a longer term program and COVID should have a support that it should be. We argued that loco, which should have its portfolio at NIH, maybe not an institute and have a line-item funding so year there will be funds for long covid. Now we're told past F Y 25, fiscal year 25, there won't be additional funds for long covid. And that's really not how we should treat really the long-term consequences of SARS-CoV-2. And why is that the case? Why we ask why that's really will not only pay dividends to help us understand what long covid is and how to best treat it. It also can shed light into the other basket of infection associated chronic illnesses that I argue that we have ignored for a hundred years.(30:12):Again, COVID or SARS-CoV-2 is unique and it's not is unique because now we're in a pandemic and the scale of it is really big and all of that. But if you really think about it, there's actually a lot of viruses that have produced a lot of long-term effects that we've ignored their long-term consequences for a long time from the research perspective and also from clinical care. And that needs to be researched. So research on long covid or understanding along covid will help us with long covid, help us better understand the infection associated chronic illnesses. And three, also help us with pandemic preparedness. There is almost like a universal agreement that with climate change, with human encroaching on animal habitat, with human traveling so much more in the 2020 first century than in the 20th century, that the frequency of pandemics in the 21st century is likely to be higher than the frequency of pandemic in the 20th century.(31:06):So we're going to experience more pandemics in this century. We have to be prepared for them. This pandemic is not the first and unfortunately, unfortunately, it's not going to be the last. There's going to be another one in five years. In 10 years, in 20 years, we don't know. We cannot really predict these things, but it's almost certainly there're going to be one or more than one downstream and we have to be prepared for it. So I think we should not be shortsighted. I also argue that we already paid the price, the hefty price in this pandemic, more than 1.1 million deaths. We already paid the hefty price. We already paid a very, very dear price in this pandemic. Let's learn from it. Let's learn as much as possible from this pandemic. Let's learn to be able to help us for the next one.Post-Viral Syndromes Multiple Years OutEric Topol (31:47):Now having said, I want to underscore a point you made, which is it's not just this virus of SARS-CoV-2, the Myalgic Encephalomyelitis (ME/CFS) and many other viruses have led to a post-viral syndrome, which can be very debilitating. So yes, we can anticipate that not only do we have a burden that goes well beyond covid, but we may see this sort of thing of lasting debilitating impact of future pathogens. But to that mind, I want to ask you, because when I studied on the influenza 1918 and the polio epidemics, what I saw was that we saw many years later new things that had not been seen at two years or three years. So as you know, after influenza, Parkinson's showed up 15 years later and after polio, 30 years later, 40 years later, we saw the post-polio syndrome. So I hope within the Veterans Affairs you'll continue to look for things that we haven't even seen yet, which are kind of what I would say are the known unknowns that there could be further surprises to this problem. I don't know if you have a comment about that.Ziyad Al-Aly (33:09):We're cognizant of the prior observations, the historic observations that it took several, it took more than a decade for Parkinson's to show up after the flu. And there potentially could be latent effects of viruses. Things that we're not seeing now, we still don't know because obviously the whole pandemic is in its fourth year. So we don't have 10 year follow up, but we are sort of building our systems here to look at five years and look at 10 years with an eye that if there are latent effects of SARS-CoV-2 infection, we want to be able to see it and characterize it and understand it and hopefully figure out how to best prevent it and then treat it. So we're very, very cognizant of the fact that viruses, some viruses can have very latent manifestations. For example, EBV and multiple sclerosis, it doesn't show up immediately. It shows up way down the road. Epstein Barr virus and multiple sclerosis. A lot of viruses, not one, again, SARS-CoV-2 is not unique. There are a lot of viruses produce long-term conditions and they have different timing when they show up. And so we're very, very interested in this and certainly are building our data systems here to look at five years and 10 years.The Lack of Public Regard for Long CovidEric Topol (34:20):Yeah, that's perfect. I knew you would. I just wanted to make sure I touched on that with you because you don't miss a beat. Now, the problem I see still today, Ziyad, is that there's lack of regard, respect, acknowledgement for long covid despite your phenomenal work. Despite that there's 60 million people around the world and then still more as infections again are on the uprise, there's people out there saying that these are malingers, that there's no such thing. I can't even post things about Long Covid on social media like Twitter/ X because I get all this pushback that it's made up and it's a hoax and this is just unnerving because we both know people who have had, they were athletic and now they're either wheelchair or bound to bed. I mean, this can be so people are suffering. What can you say about the fact that there are these people who are trying to dismiss long covid after all the work that you have done along with so many other researchers around the world to nail this down as a very big issue?Ziyad Al-Aly (35:36):So I definitely think it's a big issue. It's really unfortunate that in the US and actually some other parts of the world, that the whole pandemic has been politicized. And it's really sad to see, I mean, not as much as you, but I get some of the pushback on Twitter. And even sometimes when we publish a paper, sometimes people find my email, I don't know how they find my email. They find my email, I get what I call them nasty grams. Really sort of a very, very unpleasant emails, very unpleasant emails. And I just delete and I don't respond. So it's really hard to understand. It's really hard to understand. But there is a lot of misinformation, a lot of disinformation, a lot of politicization of the pandemic, a lot of politicization of vaccines and their side effects. And it's almost polluting the national conversation.(36:30):And it's toxic because these things are, this is not free speech. This is actually speech that harms other people. There are people that feel disenfranchised, that feels sort of the feel that their illness is not recognized. Or some people refer to it as gaslighting condition is being gaslit by this toxic discourse. And that's really unfortunate. But I wish I have a very clear solution or very clear understanding of how to address this. It's something that baffles me. And because of some of the stuff that I experienced, I sort of classify as almost toxic. It's reallyEric Topol (37:09):Very, again, you're being kind because it's, or I mean you're not. I think it's so dreadfully toxic. It's disgusting, despicable. Now I'm disconcerted because for example, the last time we had a state of the Union address by the president, he said, the pandemic's looking good. I've never heard our president say about long covid and our other leaders in our country to acknowledge how vital this is. It's great that we had the N I H to allocate significant funds, but may be that a lot of that unfortunately has been wasted. But I think we can do much better in getting the point across that this is a really big deal, that so many people, their lives have been changed. We don't have a remedy in sight. Only a very limited number of people, as you've published, really fully recover, particularly if they've had a severe case. So I hope that in the future we will have a better consensus among the spokespeople leadership that acknowledges the breadth and depth and seriousness of this problem. So the last thing I want to ask you about is you have had a record of prolific work in this pandemic, and I want to know what your daily routine is like. Do you sleep? What do you do?Ziyad Al-Aly (38:46):We feel very committed to this. So we are really working constantly almost all the time. And definitely I do sleep and I do go to the gym and I try to maintain some healthy balance, but I also work on Saturdays to try to write papers and move things forward. We're a small team, but we feel very driven to keep moving the ball forward long. And really honestly, thanks to the patient community that has supported us from day one actually inspired us and supported us from day one. So feel very connected to this cause and feel, want to move it forward. And it's a lot. But again, kudos to my team. They're amazing and it's a small team, but they're really, really absolutely, absolutely amazing people. And you doEric Topol (39:28):A lot of kudos to you too, because you've been leading this team and you've illuminated Covid from the US standpoint, no group, no less for the world. And these studies have been one after another. Just really an extraordinary and seminal paper. So in closing, Ziyad, I want to thank you for what I consider heroic efforts. You and your team, you have lit up this whole space of covid for all of us, and it's superimposed on great work that people didn't know about that you were doing. The Washington University of St. Louis, one of the leading academic medical centers in the country and the world as well as the Veterans Administration should be so proud of you and your colleagues for this work. This is tireless work. I know every time you submit a paper and every time you go through all the peer review and the revisions and the resubmission, and then you've done it all through these years of the pandemic, and I know you'll continue as well. So thank you for this indefatigable effort, which has really been extraordinary and I look forward to keeping up with you and all the future efforts, and I know you'll be on it for years to come.Ziyad Al-Aly (40:51):Well, thank you. Thank you. Thank you for having me. And again, thanks also for all your effort in this pandemic communicating science to elevating science and communicating to the wider public now, all your wonderful, amazing, gigantic prior contributions. So thank you for your contribution to America and the world, and especially being the communicator in chief throughout this pandemic.Eric Topol (41:12):Oh, you're too kind. We'll talk again. I hope soon and great to be with you today. Thank you.Ziyad Al-Aly (41:18):Thank you.If you prefer to watch the whole convo by video, here Is the link Get full access to Ground Truths at erictopol.substack.com/subscribe

AUGUST 21 2023-CHALLENGES EVACUATING SENIORS FACE; NEW COVID-19 REINFECTION STUDY AND SAVING THE MARIAN SHRINE

May 8, the State Council's Joint Prevention and Control Mechanism held a news conference, introducing the prevention and control work after the COVID-19 pandemic no longer constituted a Public Health Emergency of International Concern.5月8日下午，国务院联防联控机制召开新闻发布会，介绍新冠疫情不再构成“国际关注的突发公共卫生事件”后防控工作有关情况。Discussions of COVID-19 re-infections were popular online recently as some netizens suffered from COVID-like symptoms after the May Day holidays, during which large gatherings and mass movements increased the risks of getting the coronavirus.近日，关于新冠疫情“二阳”的讨论在网上很流行，因为一些网民在“五一”假期间的经历大型聚集、迁徙后出现了类似新冠的症状。Officials said that the virus has kept mutating, and sporadic cases have been reported across the country with the harm of the disease still existing, officials from China's National Health Commission (NHC) said during a press conference on Monday.5月8日的新闻发布会上，国家卫生健康委员会的成员表示，新冠病毒在不断变异，全国各地都有零星的病例报告，疾病的危害仍然存在。According to Liu Qing, official of the National Bureau of Disease Control and Prevention, the recent monitoring results of nationwide fever outpatient departments show a small increase in the epidemic in some areas during the "May Day" holiday, but the number of serious cases in hospitals around the country does not increase significantly. And medical institutions are not affected. Overall, there are sporadic outbreaks of scattered infections and no large-scale epidemic nationwide.国家疾控局传染病防控司副司长刘清表示，近期，全国发热门诊监测结果显示，“五一”期间部分地区疫情出现小幅上升，但各地在院重症病例数均未出现大幅增加，医疗机构正常诊疗秩序也未受到影响。总体来看，国内疫情目前仍处于局部零星散发状态，各地医疗服务秩序正常，全国未出现规模性疫情。According to Chen Cao, a researcher from the Chinese Center for Disease Control and Prevention, with China increasing its foreign exchanges, the composition of the main epidemic strains of the COVID-19 in China is increasingly affected by international influences. The XBB variants account for 97.5% of all imported cases in late April, which is close to the global proportion.中国疾控中心病毒病所研究员陈操表示，随着我国对外交流的不断增加，我国新冠病毒主要流行株的构成也受国际影响明显增大。从监测数据看，今年4月下旬，在输入病例当中，XBB系列变异株的构成已经达到了97.5%，与全球的XBB系列变异株占比基本保持一致。According to the Chinese Center for Disease Control and Prevention, the highly transmissible XBB variant has become the dominant strain on the mainland, with its percentage among total COVID-19 infections rising from 0.2 in mid-February to 74.4 in April.据中国疾病预防控制中心称，高传染性XBB系列变异株已成为主要毒株，在本土病例中，XBB变异株的占比自今年2月份明显升高，从2月中旬的0.2%增长到了4月下旬的74.4%。According to Chen during the Monday briefing, the XBB variants have stronger transmissibility and immune escape ability than the earlier prevalent Omicron variants, but with no significant change in their pathogenicity.5月8日，新闻发布会上，陈操表示，XBB系列变异株是一种奥密克戎重组变异株，其传播力和免疫逃逸能力均强于早期流行的奥密克戎变异株，但致病力没有明显的变化。Wang Guiqiang, Director of the Department of Infectious Diseases of Peking University First Hospital, said there are many reasons for sore throat, including COVID-19, flu, and bacterial infections, so they should be treated differently. The clinical manifestations of a secondary COVID-19 infection and XBB variant infection are similar at present. It is a necessity to maintain personal hygiene, including wearing a mask, to avoid or reduce the risk of further transmission.北京大学第一医院感染疾病科主任王贵强表示，导致咽喉痛的原因有很多，包括新冠、流感以及很多细菌感染等，所以要区别对待，如果感染新冠，无论是二次感染还是新变异株导致的感染，目前看临床表现都是类似的，要做好个人卫生，包括戴口罩，避免或者减少进一步传播的风险。Pan Hongying, director of the Department of Infection at Zhejiang Provincial People's Hospital, said that it has been found in clinical practice that patients with secondary infection of COVID-19 generally have milder symptoms and fewer cases of significant sore throat. If the patient does not develop a fever, then the patient is indicated as asymptomatic or mild, then it is equally unlikely to develop a sore throat.浙江省人民医院感染科主任潘红英表示，临床中发现，二次感染新冠的患者，普遍症状较轻，出现明显咽喉痛的情况较少。若患者没有出现发烧，说明是无症状或轻症，那么也就同样不可能出现咽喉痛。In general, when sore throat due to acute pharyngitis occurs, oral antipyretic and analgesic medications can be taken and attention should be paid to daily throat protection. Patients with strong immunity can recover in 2 to 4 days. If the inflammation is more serious, it may take 1 week or more to recover, and the patient needs to seek medical examination and take antibacterial drugs and other treatments as prescribed by the doctor.一般情况下，出现急性咽炎导致的咽喉疼痛，可口服解热、镇痛的药物，注意日常护嗓。抵抗力较强的患者2~4天能自行缓解。若炎症较严重，可能需要1周或更长时间恢复，需就医检查，遵医嘱服用抗菌药物等进行治疗。Here are five ways to relieve a sore throat and protect the throat on a daily basis.日常中可以通过下面5个方法，缓解嗓子疼，保护咽喉。It is recommended that healthy male adult drink 1,700 ml of water a day and women 1,500 ml a day. Drink small amounts of water many times and never wait until you are thirsty.一定的湿度对咽部黏膜有滋润和保护作用。建议健康成年男性每天喝1700毫升水，女性每天喝1500毫升水。多次、少量喝水，千万不要等到口渴再喝。Studies have shown that saline irrigation of the mucous membranes in the throat can kill bacteria and relieve inflammation. Add a small half spoon of table salt to a bowl of warm water, wait for the salt to fully dissolve and then gargle with salt water. Hold it in your mouth for 20-30 seconds and spit it out, then rinse your mouth with water.研究表明，盐水冲洗咽喉部位的黏膜能起到杀菌、缓解炎症的作用。具体做法：在一碗温水（约250毫升）中加入小半匙食盐（一啤酒瓶盖），待食盐充分溶解后用来漱喉。口含20~30秒吐出，再用清水漱口。Inhale steam from a hot cup of water through the mouth, paying attention that the water temperature does not exceed 60℃. Doing this for twenty minutes twice a day for two to three days can greatly relieve pain and ease symptoms.口张开，以适当距离对着有热气的水杯，注意水温不要超过60℃。每天2次，每次20分钟左右，如此2~3天可以大大缓解疼痛症状。When taking throat lozenge, make sure it is contained in the base of the tongue near the throat. Do not chew or swallow directly, and avoid drinking a lot of water within half an hour. It should be noted that most of the lozenges contain iodine, which can have a good inhibitory effect on bacteria. They should be taken under the guidance of a doctor.服用润喉片时应含在舌根靠近咽喉的部位，不能直接咀嚼和吞咽，含服半小时内不要大量喝水。需要注意的是，润喉片大多含碘，对细菌能起到良好的抑制作用。应在医生指导下服用，如果咽喉没有炎症，尽量不要用润喉片。Avoid frequent exertion of throat clearing as it may cause edema of throat mucosa, acute and chronic pharyngitis and other problems.频繁用力清嗓子可能造成咽喉黏膜水肿、急慢性咽喉炎等问题。说话时放慢语速，避免长时间、大声量过度用嗓。Reinfection英/ˌriːɪnˈfekʃən/ 美/ˌriɪnˈfekʃən/n.[医]再感染Variant英/ˈveəriənt/ 美/ˈveriənt/n.变异株

Adventures of a Pus Whisperer

Episode 77 of the Long Covid Podcast is a chat with the wonderful Suzy Bolt about the fears around reinfection, or indeed infection of any kind. This is something that is a huge concern for me, and I know for many others. Suzy gives loads of really good advice - and her own experiences - around this, so I hope you're able to take as much away from it as I did. Links:360MindBodySoulThe Fern ProgrammeYouTube ChannelWorkshop on reinfection Support the show~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~The Long Covid Podcast is self-produced & self funded. If you enjoy what you hear and are able to, please Buy me a coffee or purchase a mug to help cover costs.Share the podcast, website & blog: www.LongCovidPodcast.comFacebook @LongCovidPodcastInstagram & Twitter @LongCovidPodFacebook Support GroupSubscribe to mailing listPlease get in touch with feedback and suggestions or just how you're doing - I'd love to hear from you! You can get in touch via the social media links or at LongCovidPodcast@gmail.com

In this episode, Angela Branche, MD, and Helen Y. Chu, MD, MPH, discuss the clinical presentation of respiratory syncytial virus (RSV) in adults and the importance of early detection, including:  Clinical symptoms and presentation  Complications, including exacerbations of cardiopulmonary diseasesUse of medical resources compared with other respiratory virusesDiagnostic approaches and challengesTreatment and management of RSV diseaseClinical impact of RSV awarenessFaculty:  Angela Branche, MDAssociate Professor of MedicineDivision of Infectious DiseasesDepartment of MedicineUniversity of RochesterRochester, New YorkHelen Y. Chu, MD, MPHAssociate Professor of MedicineDivision of Allergy & Infectious DiseasesUniversity of Washington  School of MedicineSeattle, WashingtonLink to full program: bit.ly/3nb25xeLink to downloadable slides:bit.ly/3TsXym5

  Vidcast:  https://youtu.be/ducLJcCo1Zo   A CoVid reinfection more than triples your risk of hospitalization and more than doubles your risk of death.   The St. Louis VA Clinical Epidemiology Center reports these sobering results after reviewing the records of 40,947 vets who experienced two or more bouts of CoVid and compared them with more than 400 thousand experiencing only one infection and more than 5 million uninfected persons.   In addition to greater risks of hospitalization and death, multiple CoVid infections increases risk of pulmonary disease 3.5 fold, cardiovascular disorders 3 fold, clotting issues 3 fold, kidney disease 3.6 fold, and gastrointestinal issues 2.5 fold.  They increase the risk of diabetes 70%, neurological disease 60%, and musculoskeletal disorders 64%.   What's this all mean?   CoVid is bad news.   https://www.nature.com/articles/s41591-022-02051-3   #CoVid #reinfection #hospitalization #death #cardiovascular #neurologic  

Our house doctor Peter Lin explains the findings of a new study that looks at what happens when people get COVID-19 more than once. The study's findings suggest that people may be worse off with every reinfection.

Reinfection Rates & What You Need to Know Episode #489 with Dr. John Molinari Dentistry has a history with infection control. It has become better and safer because of it, and we can do it again for COVID-19. And to encourage keeping your practice and patients safe, Kirk Behrendt brings in Dr. John Molinari, expert on infection control and co-author of Cottone's Practical Infection Control in Dentistry. He explains everything you need to know about reinfection rates and what you can do to keep your community healthy. Don't let your guard down against reinfection! For more advice from the expert, listen to Episode 489 of The Best Practices Show! Episode Resources: Dr. Molinari's email: johnmolinariphd@gmail.com  Subscribe to thehttps://the-best-practices-show.captivate.fm/listen ( Best Practices Show Podcast) Join thehttps://www.actdental.com/ttt ( To The Top Study Club) See ourhttps://www.eventbrite.com/cc/act-dental-live-workshops-306239 ( Live Events Schedule) here Get thehttps://www.actdental.com/magazine ( Best Practices Magazine) for Free! Write ahttps://podcasts.apple.com/us/podcast/the-best-practices-show/id1223838218 ( Review on iTunes) Main Takeaways: COVID-19 is here to stay. Vaccines alone will not prevent reinfection. Practice the proven methods of infection control. There are many more cases than what's reported. Stay positive. Advancements are being made quickly. Quotes: “[COVID-19 is] not going to go away. I hate to say that. People keep saying, ‘Well, you have a vaxxed team for influenza, and we have some of that under control.' But still, people get the flu even after they get the vaccine. And of course, a lot of people get the flu vaccine. Well, flu vaccine research started in 1940. So, we've had like 80-some-odd years of research with flu vaccines. We only have a little more than two-and-a-half years with SARS-CoV-2. And these coronaviruses do mutate a lot. They change.” (3:52—4:30) “The good news — the good news first — is that [COVID-19 Omicron] reinfections with this tend to be milder, especially if you're vaccinated. So, that's good, which is what these [vaccines] were designed to do, prevent severe illness, hospitalizations, death. But the not-so-good news is this thing continues to adapt and mutate where now we have BA.4, BA.5, which are predominant in the U.S. And they can escape our antibodies to a certain extent.” (4:37—5:05) “[COVID-19] antibodies can protect, but not like a hepatitis B immunity or a measles immunity or something like that, which is more stable. And so, you have people who could get reinfected, especially if they had a mild infection the first time where they didn't produce a lot of antibodies. This virus is really — I hate to give it a human characteristic, but it's very smart. It can adapt and change very readily. The good news is that the most recent mutations appear to present with milder infections, especially for those who are vaccinated. The unvaccinated continue to be much more severe in hospitalizations.” (5:06—5:52) “I will tell you one exciting thing that I think is on the horizon. And I don't have a crystal ball, but there are clinical trials, including in this country, on what's called a pan-coronavirus vaccine where they actually are taking antigens from different coronavirus strains, not just SARS-CoV-2, and trying to find stabilized antigens so that they can induce a broader immune response with this pan-coronavirus vaccine down the road, which will not only protect against what's out there, but will also help protect against the emerging stuff down the road.” (6:26—7:08) “One of the themes I hear is, ‘I'm really tired of this crap. We're okay. We got vaccinated. We got boosted. These are expensive. This is expensive. What can I do?' So, they're not necessarily following what they were doing during the peak of the pandemic. What they need to realize is this is part of the new infection control, just like gloves were in the ‘80s for

Dr. Aileen Marty, Infectious Disease Specialist and Professor at Florida International University, joins Bob Sirott to talk about the latest health news. Dr. Marty discussed the overlap of COVID and flu symptoms, as well as who is more likely to be re-infected with COVID.

For some people, the BA.5 situation's looking... more manageable than expected? And also, what we maybe shouldn't have said about the James Webb Telescope.

With Joe Biden's re-infection and testing positive for COVID again and again, we talk to the Cleveland Clinic's Dr. Michael Roizen about the reinfections. AND, Mike knows a few people who have had COVID, appeared to recover but lost their sense of TASTE. Can anything be done??? Plus - Does homeopathy work? What about supplements to help with the prostate?

As more and more people become infected with COVID-19, more and more people are also going to be reinfected. But there's another type of reinfection known as a rebound infection, which can happen in the days after you've recovered. The US President Joe Biden tested positive again this week for COVID-19 only a few days after he was cleared following his treatment with antiviral medication Paxlovid. So what could be going on? How common are rebound infections and could it extend to people who don't take the drugs also being reinfected?

As more and more people become infected with COVID-19, more and more people are also going to be reinfected. But there's another type of reinfection known as a rebound infection, which can happen in the days after you've recovered. The US President Joe Biden tested positive again this week for COVID-19 only a few days after he was cleared following his treatment with antiviral medication Paxlovid. So what could be going on? How common are rebound infections and could it extend to people who don't take the drugs also being reinfected?

As more and more people become infected with COVID-19, more and more people are also going to be reinfected.But there's another type of reinfection known as a rebound infection, which can happen in the days after you've recovered.The US President Joe Biden tested positive again this week for COVID-19 only a few days after he was cleared following his treatment with antiviral medication Paxlovid.So what could be going on? How common are rebound infections and could it extend to people who don't take the drugs also being reinfected?

This week, Marianna sits down with John Faragon to discuss the risk of contracting Hepatitis C or HCV for people with HIV. Why does this happen and why does it matter?  --Help us track the number of listeners our episode gets by filling out this brief form!  (https://www.e2NECA.org/?r=CVR3770)

New 3rd booster guidelines from ATAGI Omicron is changing and there are serious implications We need to ramp up preventive measures to tackle this new wave more effectively Host: Dr David Lim | Total time: 29 mins Guest: Prof Michael Toole AM, Infectious Disease Expert, Associate Principal Research Fellow, Burnet Institute; Professor, School of Public Health and Preventive Medicine, Monash University Register for our upcoming FREE WEBCAST! Every second Tuesday | 7:00pm-9:00pm AEST Click here to register now!See omnystudio.com/listener for privacy information.

Right now the subvariants of the Omicron Covid virus, BA.4 and BA.5 are responsible for the majority of new Covid cases emerging in the U.S. Medical experts are finding that people are not “immune” for quite as long after getting over Covid as they initially thought. Dr. Daniel Kuritzkes, head of the Division of Infectious Diseases at Brigham and Women's Hospital says, “Everybody is basically at risk of becoming reinfected if they had COVID more than 8 or 12 weeks ago and should be mindful of that”. Dr. Kuritzkes joined Dan to discuss.

Long Story Short with Dr. Been Episode 15: Reinfection and Risk of Long COVID and Severe Outcomes - COVID Reinfection Outcomes Are Not Good (Preprint Study) This study shows that a reinfection increases the risk of hospitalization, death and sequela regardless of the vaccination status. Let's review. DrBeen: Medical Education Online https://www.drbeen.com/ FLCCC | Front Line COVID-19 Critical Care Alliance https://covid19criticalcare.com/ URL list from Saturday, Jul. 9 2022 Outcomes of SARS-CoV-2 Reinfection | Research Square https://www.researchsquare.com/article/rs-1749502/v1 Duration of immune protection of SARS-CoV-2 natural infection against reinfection in Qatar | medRxiv https://www.medrxiv.org/content/10.1101/2022.07.06.22277306v1 Outcomes of SARS-CoV-2 Reinfection | Research Square https://www.researchsquare.com/article/rs-1749502/v1 Disclaimer: This video is not intended to provide assessment, diagnosis, treatment, or medical advice; it also does not constitute provision of healthcare services. The content provided in this video is for informational and educational purposes only. Please consult with a physician or healthcare professional regarding any medical or mental health related diagnosis or treatment. No information in this video should ever be considered as a substitute for advice from a healthcare professional. covid 19dr beenflccclong covidlong story short

New South Wales and Victoria have joined Western Australia and the A-C-T in revising its COVID-19 reinfection period from 12 weeks down to four. - New South Wales dan Victoria telah bergabung dengan Australia Barat dan A-C-T dalam merevisi periode infeksi ulang COVID-19 dari 12 minggu menjadi empat minggu.

WIOD Senior National Correspondent Rory O'Neill *Follow him on Twitter: @RadioRory. New Covid variant makes people susceptible to reinfection and Dr. Anthony Fauci recommends masking up again.

New South Wales and Victoria have joined Western Australia and the ACT in revising its COVID-19 reinfection period from 12 weeks down to four.

The government is supplying thousands of masks to school kids and staff in a bid to curb the spread of Covid. It has also revised its advice on testing for re-infections of the virus, as thousands of cases are still being reported daily. Year 4 to 7 students will be able to get 50 child size masks each. And up to 30,000 masks will be supplied to all other students and school staff. There were 7,423 cases of Covid-19 reported today and another 19 deaths of people with the virus and 411 people in hospital. Covid Response Minister Dr Ayesha Verrall talks to Lisa Owen.

In COVID-19 clinical update #120, Dr. Griffin discusses outcomes of SARS-CoV-2 reinfection, CDC recommendation for vaccines in young children, neurodevelopment outcomes in infants of mothers testing positive for COVID during pregnancy, efficacy of monoclonal antibodies and antivirals in hamsters, rebound phenomenon after PAXLOVID in high-risk persons, hospitalization for infection after PAXLOVID treatment, and risk of long COVID with different variants. Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode Reinfection outcomes (Research Square) CDC recommends vaccine for young children (CDC) Neurodevelopment outcomes in infants post-infection (JAMA) Efficacy of monoclonal antibodies/antivirals in hamsters (Nature) PAXLOVID patient eligibility screening checklist (FDA) Remdesivir fact sheet for providers (Veklury)  Bebtelovimab fact sheet for providers (FDA) PAXLOVID drug interaction checker  Rebound phenomenon after PAXLOVID in high-risk persons (IDSA) Hospitalization for infection after PAXLOVID treatment (CDC) Risk of post acute infection with different variants (the Lancet) Contribute to FIMRC fundraiser at PWB Dr. Griffin's treatment guide (pdf) Letters read on TWiV 912 Timestamps by Jolene. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to daniel@microbe.tv

A repeat encounter with Covid used to be a rarity. But now that Omicron has changed the game, expect reinfections to be the new normal.

A repeat encounter with Covid used to be a rarity. But now that Omicron has changed the game, expect reinfections to be the new normal.

Coming up today: Morgan explores the problems facing Google in Russia, and Grace tells us all about the Great Reinfection The stories we talked about this week: Welcome to the Great Reinfection https://www.wired.com/story/welcome-to-the-great-reinfection/ Google's Russian Empire Faces an Uncertain Future https://www.wired.com/story/google-russia-exit/ Music by Filip Hnizdo Produced and edited by Matt Burgess Learn more about your ad choices. Visit podcastchoices.com/adchoices

HR3 Judge Andrew Gould AZ AG Candidate Interview| John & Andy: The Great Reinfection, Uh? | 6/7/22 by John Rush

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Make your health an act of rebellion. Join The Healthy Rebellion Please Subscribe and Review: Apple Podcasts | RSS Submit your questions for the podcast here News topic du jour: Gluten-free diet can ameliorate the symptoms of non-celiac autoimmune diseases  Podcast Questions: 1. Anthony J Leonardi and Covid/Vaccine Immune Depletion and Reinfection [19:00] Kristi says: Hi Robb and Nicki, Very long time listener. Thank you so much for your show and for dipping into different topics, I love it. My question is, do you know anything about Anthony J Leonardi? He has apparently done a lot of work on and talked about some sort of immune depletion that is caused by both covid and the covid vaccines: called T-cell exhaustion. Something similar to AIDS as far as I currently understand. He has also talked about the "fraud" of the Great Barrington Declaration, I guess because of people getting severe covid reinfections. Although I have a bit of scientific background, the papers linked to me are beyond my knowledge, and the fraud claim is a bit baffling to me. I'm wondering if you have looked into this at all or know anything about either the T-cell exhaustion or the reinfections. https://www.drugtargetreview.com/news/81320/t-cell-exhaustion-may-limit-long-term-immunity-in-covid-19-patients/ https://www.science.org/doi/10.1126/sciimmunol.abe4782 https://twitter.com/fitterhappierAJ/status/1514199036319834124?s=20&t=CjqEIQspcmpJBTV3kCTBsw Thanks, Kristi Herlein   2. Early Eating Habits of 8 months - 18 months? [32:23] Getty says: Hey Robb, All the usuals, you've been super helpful and changed my life, been on and off your stuff for 8+ years.  Also, my bad if someone has asked this before over the many years. My wife and I welcomed our first born in June of 2021, breastfeeding and been introducing pureed fruits/veggies at home for the past two months.  Now we are heading into the pincer grip stage and curious on any recommendations on companies that have products that are quality for the lifestyle.  Cheerios are obviously not on the table, but the ease of something in that arena would be appreciated. Keep up the great work and been loving LMNT Getty Serenity Kids Puffs - Get 15% off your first order with code ROBBWOLF Sponsor: The Healthy Rebellion Radio is sponsored by our electrolyte company, LMNT. Proper hydration is more than just drinking water. You need electrolytes too! Check out The Healthy Rebellion Radio sponsor LMNT for grab-and-go electrolyte packets to keep you at your peak! They give you all the electrolytes want, none of the stuff you don't. Click here to get your LMNT electrolytes Transcript: You can find the transcript on the episode's blog page here https://robbwolf.com/2022/04/22/covid-immune-depletion-baby-food-remembering-brian-tait-thrr107/

At the start of the pandemic there was a lot of misinformation suggesting that we couldn't be reinfected with coronavirus more than once, but we now know that is simply not the case, and we can in fact contract Covid-19 multiple times. But why is it that some people seem susceptible to falling prey to different variants, even quite close together, while others seem to remain immune, even when they've been surrounded by people who are very unwell? The Quicky speaks to an expert epidemiologist to find out what factors determine whether you are more or less vulnerable to catching Covid-19 more than once, and if there is anything you can do to reduce your risk. CREDITS  Host: Claire Murphy With thanks to: Professor Adrian Esterman - Chair of Biostatistics and Epidemiology at the University of South Australia Producer: Claire Murphy Executive Producer: Siobhán Moran-McFarlane Audio Producer: Jacob Round Subscribe to The Quicky at... https://mamamia.com.au/the-quicky/ CONTACT US Got a topic you'd like us to cover? Send us an email at thequicky@mamamia.com.au GET IN TOUCH: Feedback? We're listening! Call the pod phone on 02 8999 9386 or email us at podcast@mamamia.com.au Mamamia acknowledges the Traditional Owners of the Land we have recorded this podcast on, the Gadigal people of the Eora Nation. We pay our respects to their Elders past and present and extend that respect to all Aboriginal and Torres Strait Islander cultures. Just by reading or listening to our content, you're helping to fund girls in schools in some of the most disadvantaged countries in the world - through our partnership with Room to Read. We're currently funding 300 girls in school every day and our aim is to get to 1,000. Find out more about Mamamia at mamamia.com.au  Support the show: https://www.mamamia.com.au/mplus/ See omnystudio.com/listener for privacy information.

If omicron can escape our vaccines, can it also escape ... itself?

Governments' directives about how and when to vaccinate people who've recovered from Covid-19 vary widely. But, according to this episode's guest, Dr. Ronen Arbel, they all say they don't have enough evidence to set firm policy. So, Arbel and his colleagues set out to collect evidence from some 150,000 patients' records in Israel who'd recovered […] The post Podcast 282: Vaccination after Covid-19 recovery prolongs natural immunity to reinfection first appeared on Clinical Conversations.

After two years of lockdowns, mask mandates, vaccines and physical distancing, Americans are more than ready to resume normal lives. But is the pandemic phase of Covid over? Steve Forbes on why Washington should remove the Covid cloud, end restrictions and declare the pandemic over.Steve Forbes shares his What's Ahead Spotlights each Tuesday, Thursday and Friday.

Natural immunity (from prior infection) was found to be 6 times stronger during the delta wave than vaccination according to this new CDC report. Let's break it down.  ➢ Eat Like Your Life Depends on it tee Shirt: https://bit.ly/3nNRsOu Use code podcast at checkout  ➢ Get the best Vitamin D and K2 Combo: http://bit.ly/vitamin-d-k-2-blend Link to show notes and video version: https://bit.ly/3Apti1P Time Stamps: 0:19 Israel reported on this six months ago  0:46 New CDC Study reporting prior infection is indeed protective  1:40 Public is losing trust in our institutions  1:54 Proof of T cell immunity from 2003  2:29 Damage has been done because we ignored this  2:52 Marty Makary, MD's thoughts 4:19 Thanks for sharing and commenting  5:50 Israel report from August 2021 7:00 October report claimed prior infection wasn't protective  8:51 Details of New Paper 9:52 New York and California  11:15 Main finding here 13:01 Important quote from CDC researcher  13:39 This image tells the story nicely  16:00 55 fold lower hospitalization rates after prior infection  17:40 Better late then never 

  Vidcast:  https://youtu.be/PiQlANr73wY   The Omicron variant was first identified in South Africa and and is fast becoming most prevalent form of CoVid there.  Discovery Health, South Africa's largest private health insurance now releases detailed information from 3.7 million participants and 211,000 CoVid test results during the first 3 weeks of their Omicron surge.   Here is what we know from their data: The 2-dose Pfizer vaccination is only 33% effective in preventing any Omicron infection compared with 80% effectiveness against earlier variants. The 2-dose Pfizer vaccination is 70% effective in preventing any Omicron hospitalization compared with 93% effectiveness against earlier variants. Vaccination protection against hospitalization similar for those 18 through 59 years, lower at 67% for those 60-69, and 60% for those 70-79. Vaccination protection against hospitalization similar for those with complicating medical conditions including diabetes and cardiovascular issues. Good News:  Omicron is 29% less likely to drive hospitalization in adults than the initial strain of CoVid. Children 51% less likely than adults to test positive for Omicron. Omicron disease is less severe in children than in adults.  Bad news Omicron is 20% more likely to drive a hospitalization in children than the initial strain of CoVid. The risk of a CoVid reinfection due to Omicron is higher than for previous variants: 73% higher for those previously infected with original strain; 60% higher for those infected with beta variant; 40% higher for those infected with Delta variant.   https://www.discovery.co.za/corporate/news-room   #CoVid #omicron #vaccination #pfizer #hospitalization #reinfection  

A huge study from South Africa has been released as a yet-to-be-peer-reviewed pre-print over the last few days.  The researchers looked at what's called immune escape from the point of view of reinfection rates in people who've been infected with the COVID-19 virus in the past year or so.

It rarely happens in the wake of a school shooting, but it's happening in Michigan: the parents of the 15-year-old accused of killing four classmates earlier this week have been charged with involuntary manslaughter -- and police are looking for them. We'll get details of the charges and ask about the chances the parents could be convicted.Here in Los Angeles, apparently being charged with committing violent smash-and-grab robberies isn't enough to keep you in jail: 14 people arrested ... have all been released.And the next time you see a cute cat video on the web, beware: it may take you down a conspiracy theory wormhole.An early characteristic of the new omicron variant: is a potentially high re-infection rate.New York City could make history next week by becoming the first city in the country to allow non-U.S. citizens to vote in local elections.And we've been hearing the warnings of Christmas tree shortages... so is the grinch going to make off with yours? To learn more about listener data and our privacy practices visit: https://www.audacyinc.com/privacy-policy Learn more about your ad choices. Visit https://podcastchoices.com/adchoices

In our first episode, we discuss how SARS-CoV-2 attacks germinal centers in lymph nodes and spleens, resulting in a weakened immune response.  Review paper from the life sciences journal Cell:  Loss of Bcl-6-Expressing T Follicular Helper Cells and Germinal Centers in COVID-19.  Hosted by John Houghton, with special guests Dr. Faz Alam, Microbiologist and graduate of the Imperial College of London, and Danny Chan, PhD candidate, Infectious Diseases, University of Chicago and President of Biotech Without Borders.  Faz and Danny are co-hosts of the YouTube Microbiology Journal Club and they also covered the same paper in their September 6, 2020 episode.

Are you still at risk of being reinfected with COVID-19 after you have already been infected? How many cases of reinfections are there and how can acupuncture help? Watch this episode for the answers to all of these questions!

In this week's live Q&A, Dr. Lindsey Leininger and Dr. Malia Jones of Dear Pandemic tackle reader questions on working the polls, reinfection, superspreading in schools, the psychology of risk, and whether it's safe to donate blood (yes it is!). --- Support this podcast: https://anchor.fm/dearpandemic/support

Show notes: In the show, The Bio Busters professors discuss the coronavirus and recent interesting medical updates! Keep the discussion and comments going on the iTunes review section, or feel free to e-mail the podcast with future show ideas and thoughts on the current show. You can find Dr. A on Twitter @DoctorDelbert and Dr. Fonner @fonner916 Music by Bahaa Naamani Email us at thebiobusters@gmail.com References: COVID-19 Reinfection: https://www.livescience.com/coronavirus-reinfection-case-confirmed-us.html COVID & Colleges https://www.insidehighered.com/news/2020/08/27/covid-19-roundup-6-percent-students-one-college-have-disease-some-data-arizona-state https://www.nytimes.com/interactive/2020/us/covid-college-cases-tracker.html Alzheimer's Blood Test https://www.sciencetimes.com/articles/26880/20200814/blood-tests-alzheimers-neuroscientists-explain.htm HIV Suppression https://www.livescience.com/hiv-elite-controllers-functional-cure.html

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Catch up on the most important news today in 2 minutes or less. Get even more news you can use with the Tech in Two newsletter. Sign up here: https://www.wired.com/tt

Coronavirus Pandemic Update- Reinfection Study and Biowarfare Experts On Coronavirus. Coronavirus Pandemic Update 42: Immunity to COVID-19 and is Reinfection Possible? https://youtu.be/q4P91VrfPGw MedCram - Medical Lectures Explained CLEARLY Coronavirus (COVID-19) Update 42 with Roger Seheult, MD of https://www.MedCram.com With medical professionals, supplies, and equipment in short supply during the coronavirus pandemic, understanding how viral antibodies and immunity works (and the possibility of reinfection) is a key concept. Dr. Seheult reviews an encouraging pre-print (non-peer-reviewed) study that showed that COVID-19 re-infection was not observed in a primate called macaques. Website LINKS from this video: https://gisanddata.maps.arcgis.com/ap... Healthlynked Tracker App: https://www.healthlynked.com/corona-v... https://era.ed.ac.uk/handle/1842/27363 https://www.medrxiv.org/content/10.11... https://www.sciencemag.org/news/2020/... https://www.biorxiv.org/content/10.11... https://www.medicalnewstoday.com/arti... https://onlinelibrary.wiley.com/doi/a... https://www.ncbiotech.org/news/biomed... Some previous videos from this series (visit MedCram.com for the full series): - Coronavirus Pandemic Update 41: Shelter In Place, FDA Investigates Hydroxychloroquine for COVID-19: https://youtu.be/hPz5KxgI_K4 - Coronavirus Pandemic Update 40: Ibuprofen and COVID-19 (are NSAIDs safe?), trials of HIV medications: https://youtu.be/dT6mHi_8V5E - Coronavirus Pandemic Update 39: Rapid COVID-19 Spread with Mild or No Symptoms, More on Treatment: https://youtu.be/AToF8O5T86s - Coronavirus Pandemic Update 38: How Hospitals & Clinics Can Prepare for COVID-19, Global Cases Surge: https://youtu.be/MoisrCTu0SY - Coronavirus Pandemic Update 37: The ACE-2 Receptor - The Doorway to COVID-19 (ACE Inhibitors & ARBs): https://youtu.be/1vZDVbqRhyM - Coronavirus Pandemic Update 36: Flatten The COVID-19 Curve, Social Distancing, Hospital Capacities: https://youtu.be/vww1nIIoqmw - Coronavirus Pandemic Update 35: New Outbreaks & Travel Restrictions, Possible COVID-19 Treatments: https://youtu.be/vE4_LsftNKM - Coronavirus Epidemic Update 34: US Cases Surge, Chloroquine & Zinc Treatment Combo, Italy Lockdown: https://youtu.be/U7F1cnWup9M - Coronavirus Epidemic Update 33: COVID-19 Medication Treatment Trials, Global Testing Remains Limited: https://youtu.be/Mm7UrZeu-74 - Coronavirus Epidemic Update 32: Important Data from South Korea, Can Zinc Help Prevent COVID-19? https://youtu.be/Eeh054-Hx1U - Coronavirus Epidemic Update 31: Mortality Rate, Cleaning Products, A More/Less Severe Virus Strain? https://youtu.be/7YI2tOoVVpk - Coronavirus Epidemic Update 30: More Global COVID-19 Outbreaks, Vitamin D May Aid Prevention: https://youtu.be/gmqgGwT6bw0 - Coronavirus Epidemic Update 29: Testing problems, mutations, COVID-19 in Washington & Iran: https://youtu.be/XjEacUyp4vY - Coronavirus Epidemic Update 28: Practical Prevention Strategies, Patient Age vs. Case Fatality Rate: https://youtu.be/quDYb_x54DM - Coronavirus Epidemic Update 27: Testing accuracy for COVID-19 (CT Scan vs. RT-PCR), California Cases and Coronavirus Los Angeles: https://youtu.be/xQwfuJgJ9lo - Novel Coronavirus Epidemic Update 26: Treatment Updates, Stock Markets, Germany & San Francisco, Pandemic? https://youtu.be/bV1CZxJ-uvU - Coronavirus Epidemic Update 25: Vaccine Developments, Italy's Response, and Mortality Rate Trends: https://youtu.be/UImSVhLLeGY - Coronavirus Epidemic Update 24: Coronavirus Infections in Italy, Transmissibility, COVID-19 Symptoms: https://youtu.be/UImSVhLLeGY - Coronavirus Epidemic Update 23: Infections in Kids & Pregnancy, South Korea, Spillover From Bats: https://youtu.be/JGhwAGiAnJo - Coronavirus Epidemic Update 22: Spread Without Symptoms, Cruise Quarantine, Asymptomatic Testing: https://youtu.be/OqpHvK0XADY - Coronavirus Epidemic Update 21: Antibodies, Case Fatality, Clinical Recommendations, 2nd Infections?: https://youtu.be/9BYaywITXYk - How Coronavirus Kills: Acute Respiratory Distress Syndrome (ARDS) & Treatment: https://youtu.be/okg7uq_HrhQ Many other videos on COVID-19 and other medical topics (ECG Interpretation, hypertension, DKA, acute kidney injury, influenza, measles, mechanical ventilation, etc.) at MedCam.com Speaker: Roger Seheult, MD Board Certified in Internal Medicine, Pulmonary Disease, Critical Care, and Sleep Medicine. Produced by Kyle Allred, PA Media Contact: Hayley@MedCram.com MedCram medical videos are for medical education and exam preparation, and NOT intended to replace recommendations from your doctor. #Coronavirus #COVID19 #SARSCoV2     Biowarfare Experts On Coronavirus (COVID19) To listen to the entire interview visit- https://youtu.be/lWOYj8hjjjM Valuetainment Biowarfare Experts On Coronavirus (COVID19)- Dr. Gerald Parker Associate Dean for Global One Health at Texas A&M and Professor Andrew S Natsios Executive Professor at The Bush School and Director of the Scowcroft Institute of International Affairs have a sit down with Patrick Bet-David about the Coronavirus Pandemic. About our guests Dr. Gerald Parker https://bit.ly/2IZPRAl Professor Andrew S. Natsios https://bit.ly/2UkWBy6 Tweet your thoughts to PBD https://www.twitter.com/patrickbetdavid Subscribe to Valuetainment for weekly videos http://bit.ly/2aPEwD4 PBD Instagram: https://www.instagram.com/patrickbetd... PBD Twitter: https://twitter.com/patrickbetdavid PBD Linkedin: https://www.linkedin.com/in/patrick-b... Intro song : “Sweet Victory” by R-Mean. Available on all digital platforms courtesy of Pentagon Records LLC Link: https://songwhip.com/album/r-mean/swe... Music selection used through agreement with Epidemic Sound http://bit.ly/2B8DxK1 Resources: White Papers: http://pandemic.tamu.edu/Publications... The Silent Threat: https://theconversation.com/the-silen... Coronavirus May Not be the Apocalypse: http://english.alarabiya.net/authors/... Foreign Aid Programs Best Defense: https://www.washingtontimes.com/news/... Weaknesses in the Global supply Chain: https://academicminute.org/2018/02/ch... To reach the Valuetainment team you can email: info@valuetainment.com     https://youtu.be/5mIwCAZug1Y Is China a Corrupt Nation? Valuetainment Pandemic experts Dr. Gerald Parker and Professor Andrew S Natsios visit the studio to talk with Patrick Bet-David. Full interview coming soon. Subscribe for weekly videos http://bit.ly/2aPEwD4 Share your thoughts with Patrick Bet-David by texting 310.340.1132 or send a tweet to https://www.twitter.com/patrickbetdavid To reach the Valuetainment team you can email: info@valuetainment.com Follow Patrick: Instagram: https://www.instagram.com/patrickbetd... Twitter: https://twitter.com/patrickbetdavid     https://youtu.be/RWISObtxjSY Coronavirus Vaccine - How Long Until It's Here? Valuetainment Pandemic experts Dr. Gerald Parker and Professor Andrew S Natsios visit the studio to talk with Patrick Bet-David. Full interview coming soon. Subscribe for weekly videos http://bit.ly/2aPEwD4 Share your thoughts with Patrick Bet-David by texting 310.340.1132 or send a tweet to https://www.twitter.com/patrickbetdavid To reach the Valuetainment team you can email: info@valuetainment.com Follow Patrick: Instagram: https://www.instagram.com/patrickbetd... Twitter: https://twitter.com/patrickbetdavid Linkedin: https://www.linkedin.com/in/patrick-b...