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The Knowledge Project Podcast

Balaji Srinivasan: Exploring COVID-19 [The Knowledge Project Ep. #78 Pop-up Episode]

A special pop-up episode of The Knowledge Project exploring a timely issue.

Now available on: YouTube | Apple Podcasts | Spotify | No Transcript

Today, I welcome Balaji Srinivasan (@balajis) to the Knowledge Project.

Balaji founded a large molecular diagnostics company, taught bioinformatics at Stanford, won an MIT TR35 for his work in genomics, and holds a Ph.D. from Stanford. With so much misinformation and mass hysteria surrounding the recent coronavirus pandemic, I invited him to sit down with me because he is one of the more thought-provoking, interesting, and multi-disciplinary thinkers I know.

In this special episode, we explore the origin of Covid-19, what’s being done to contain it, (including possible second and third-order consequences,) how to find reliable information in a constant stream of sensational news headlines, and how we can thoughtfully prepare for what’s coming with a rational and level head.

You’ll also find dozens of resources and references below to complement the discussion and supplement your own study of this very important topic.

References

  • At first, the disease and virus were called the same thing early on: ncov2019 or the novel coronavirus2019. https://www.nejm.org/doi/full/10.1056/NEJMoa2001191
  • The difference between SARSCOV2 the virus and COVID19 the disease: https://www.cdc.gov/coronavirus/2019-ncov/about/grows-virus-cell-culture.html
  • Why didn’t WHO declare a pandemic? Perhaps because some governments would use that as an excuse to do mitigation without any containment.https://twitter.com/balajis/status/1237422481276796930
  • Some have actually hypothesized that obesity could be caused by an infectious agent.https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(04)01164-8/fulltext#:~:text=, https://blogs.sciencemag.org/pipeline/archives/2013/01/15/is_obesity_an_infectious_disease
  • There was phylogeny before molecular phylogenetics. “Comparative morphology, anatomy, embryology, and the fossil record were the ways to distinguish homology from analogy and thus, order organisms according to their evolutionary relatedness”. By “comparative morphology” it’s referring to things like how many legs an organism had, or how much fur. These are macroscopically visible features.https://www.pnas.org/content/109/4/1011
  • SARSCOV2 is an RNA virus https://www.symplur.com/healthcare-hashtags/sarscov2/
  • Sequence similar to SARS Virus from bats from Yunnan province http://virological.org/t/divergence-of-ncov-2019-to-closest-non-human-relative/388, https://www.ncbi.nlm.nih.gov/nuccore/MN996532
  • Huanan Seafood market, https://pubs.rsna.org/doi/full/10.1148/ryct.2020200033
  • Culture the virus https://www.the-scientist.com/news-opinion/australian-lab-cultures-new-coronavirus-as-infections-climb-67031, https://en.wikipedia.org/wiki/Viral_culture#:~:text=
  • Bats immune to viruse https://www.sciencealert.com/deadly-viruses-always-seem-to-start-off-with-bats-here-s-why-they-re-patient-zero
  • Zoonotic leap, https://www.who.int/health-topics/coronavirus
  • Eating spread the virus, https://www.npr.org/sections/goatsandsoda/2020/01/31/800975655/why-theyre-called-wet-markets-and-what-health-risks-they-might-pose
  • Huanan seafood market sells dead and live animals, https://www.npr.org/sections/goatsandsoda/2020/01/31/800975655/why-theyre-called-wet-markets-and-what-health-risks-they-might-pose
  • Immunocompromised animals at wet markets, https://www.wsj.com/articles/abolish-asias-wet-markets-where-pandemics-breed-11580168707
  • SARS 2002-2003, https://www.who.int/ith/diseases/sars/en/
  • Patient Zero, Two different definitions, First documented person and First person who began outbreak, Not the same thing, but often used ambiguously https://en.wikipedia.org/wiki/Index_case, https://www.sciencemag.org/news/2020/01/wuhan-seafood-market-may-not-be-source-novel-virus-spreading-globally
  • CDC rRT-PCR protocol, https://www.cdc.gov/coronavirus/2019-ncov/lab/rt-pcr-detection-instructions.html
  • Illumina sequencing protocol, https://www.illumina.com/content/dam/illumina-marketing/documents/products/appnotes/ngs-coronavirus-app-note-1270-2020-001.pdf
  • How you collect a swab (video), https://www.youtube.com/watch?v=mfZYAMDpGNk
  • FDA update partially allowing lab tests to go through by Feb 29, https://www.fda.gov/media/134922/download
  • Basic and effective reproduction number definitions, https://www1.health.gov.au/internet/publications/publishing.nsf/Content/mathematical-models~mathematical-models-models.htm~mathematical-models-2.2.htm
  • NCBI link to genomics data, ftp://ftp.ncbi.nlm.nih.gov/genomes/, https://www.ncbi.nlm.nih.gov/genome/viruses/
  • NCBI Genbank sequences of coronavirus, https://www.ncbi.nlm.nih.gov/genbank/sars-cov-2-seqs/
  • Possible long term effects, https://twitter.com/balajis/status/1237508931770929152
  • Doubling time of 7.4 days, https://twitter.com/balajis/status/1234612145108791297
  • Time from infected to symptoms (1-14 days), https://twitter.com/balajis/status/1234624365767032833
  • Time from symptoms to death (2-8 weeks), https://twitter.com/balajis/status/1234624365767032833
  • Real time PCR doesn’t actually finish in “real time”, it actually refers to a quantification technique, https://www.bio-rad.com/en-us/applications-technologies/what-real-time-pcr-qpcr?ID=LUSO4W8UU#1
  • Point of care diagnostics, Results within minutes rather than hours, https://www.pointofcare.abbott/us/en/about-us/benefits-of-point-of-care-testing
  • Oura ring, https://support.ouraring.com/hc/en-us/articles/360025587493-Body-Temperature
  • Diagnostic grade wearables, https://twitter.com/balajis/status/1233996418261684224
  • Iron Dome: missile defense, Have to be like this for a pandemic, surveil and then quarantine/vaccination, https://en.wikipedia.org/wiki/Iron_Dome
  • Great Biowall of China, https://twitter.com/balajis/status/1224972943991746560
  • Flu actually does appear to be airborne, https://www.medicalnewstoday.com/articles/320690, https://www.youtube.com/watch?v=ogQnSHSkQKM&feature=emb_logo
  • Why isn’t the flu? It crashed Wuhan’s healthcare system, https://twitter.com/balajis/status/1226330414404571138
  • SARSCOV2 is airborne, https://twitter.com/mattocko/status/1238092560104435714
  • Amoy Gardens: how SARS spread through fecal transmission, https://en.wikipedia.org/wiki/Amoy_Gardens
  • SF professor on spread of infectious disease via fecal transmission, https://www.nbcbayarea.com/news/local/diseased-streets/166605/
  • UW diagnostic, https://testguide.labmed.uw.edu/public/view/NCVQLT
  • NEJM first case study, using compassionate use, https://www.nejm.org/doi/full/10.1056/NEJMoa2001191?query=featured_home
  • Gilead statement, https://www.gilead.com/news-and-press/company-statements/gilead-sciences-statement-on-the-company-ongoing-response-to-the-2019-new-coronavirus
  • FDA/CDC bottleneck, https://twitter.com/balajis/status/1232724743016603648
  • CDC doing 12 tests per day, https://twitter.com/balajis/status/1232722942448033793
  • Concept of “off label marketing” to contextualize remdesivir prescription, https://www.independent.org/pdf/tir/tir_05_1_tabarrok.pdf
  • Caronia case, https://www.policymed.com/2012/12/united-states-v-caronia-a-victory-for-free-speech-vs-off-label-promotion.html
  • Right to try laws, https://righttotry.org/about-right-to-try/
  • FDA battle to regulate LDTs, http://www.fdalawblog.net/2019/10/regulation-of-laboratory-developed-tests-by-fda-time-for-the-agency-to-cease-and-desist-until-congress-enacts-legislation/#:~:text=, https://www.raps.org/news-and-articles/news-articles/2018/12/fda-leadership-calls-for-ldt-reforms, https://www.lexology.com/library/detail.aspx?g=20fa976c-8380-454b-9b4d-0e24cf2aa609, https://www.cms.gov/Regulations-and-Guidance/Legislation/CLIA

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