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[00:00:01]

That pot Kenny show on Newstalk. Professor Luca Neal, professor of biochemistry at Trinity College in Dublin, good morning. Good morning. Now, we've got a number of topics today. First of all, as the children are back at school, the question is how vulnerable are they to covid-19? What does the science say?

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Well, yeah, this is this morning of all time. Of course, parents will be worried about their kids going back to school, I guess. But a huge study yet again. You know, lots of work going on. But the final definitive study in a way, lots and lots of kids across 138 hospitals that these are children who had been hospitalized. So there were slightly more severe. I guess they all did very well, 99 percent recovered fully.

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The median age was four point six, 35 percent were under 12. But it's a really detailed study in this consortium. So, again, it's good news for children. I guess they do very, very well. But this disease, it kind of confirms this. This is a disease of older people, as we knew anyway. But science has to keep confirming this. So we're very happy to see this big confirmation. The children handle the virus extremely well.

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Yeah.

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So these are the children who actually ended up in hospital. I mean, there are countless others who obviously had a mild dose or were asymptomatic. So we're looking at this study at the sickest of children who contracted covid-19. And the good news is that that small fraction of the total children, it's a tiny, tiny fraction of that one percent who suffer severe consequences.

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Yeah, kind of point one percent. Some number like that of total children who get infected end up having severe disease. So, again, it really is good. And the good thing is we kind of know why. I mean, again, the scientists are wondering why are children so protected? And they've got two things going for them. One is what's called their innate immune system is very strong that we all have innate immunity. It's built into us in a way.

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Kids are already strong when they make these things called interferons, which block the virus and they make more than older people. And the second one about the intriguing idea we discussed before, which is still a work in progress, if you've had a cold, will that protect you? And children have more colds than adults. And there's a hint, more data coming out on this, that having a cold, you might get antibodies and T cells to the cold virus and they protect you against the sars-cov-2 viruses.

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Remember this word, heterozygous protection. So that's holding up at the moment that maybe the cold might give you a little bit of protection. And that may be another reason, I guess, because children might have a lot more colds than adults, obviously, you know, yeah, we talked about that heterozygous protection before.

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And I was suggesting that GP's not every medical, but GP's, particularly in their surgeries, who come across the common cold coronavirus again and again and again every year, year in, year out, they might have it. And you suggested that teachers, particularly older teachers with a lot of experience who come across the same sort of thing in the classroom year in, year out, that they might have this heterozygous protection. Is anyone doing any science on this?

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Well, absolutely. This first came out about three months ago, it seems like years ago. The first science on this about three months ago. They are finding these people who had colds that seemed to have had to have blood on nearby cells in their blood to protect against the virus. And it begins then. And lots of people now are studying this in great detail, trying to see if it's true. And obviously, science is a work in progress and they want to try and confirm this.

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But it's looking reasonable to me, actually. There's more evidence to support that notion. And you're right, teachers may have a built in, not not all of them. It'll be like any biological thing. There'll be a range of responses, but there's a chance that teachers will be in that group as well, having had colds that might give them a bit of protection against the virus.

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I remember Fergus Finlay saying on radio and one of the programs, and he's a member of the board of the HSC, that one of the talking points within the Hajazi is whether or not when and covid-19 erupted in nursing homes, that GPS, who, you know, are not resident of the homes but go in and out, that they could have been a vector, not to point the finger at anybody at all because who's to know?

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But if you happen to be a doctor who's got this heterozygous protection and maybe you get it, but you're asymptomatic, but it doesn't affect you because such as your immunity, that you could unknowingly, you know, be passing it on to other people simply because you are protected.

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Yeah, but that's the big question. What does protection mean? And, you know, the other big debate is, can you get reinfected that that's going on? There's another three or four cases now of people who have been infected and then one or two of those did have slightly more severe disease. So going to be arraigned here in the puppy like every biological thing, but be a range across the population. And you could have some GPS who are fully protected and they don't get a viral load in them.

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Their body clears the virus very, very quickly. Some might have a bit more virus and then they might be infectious. I guess that's one of the big unknowns. But it's a really very much a work in progress. And, of course, in my opinion, this is so important because if we can show that, you know, prior infection protects a bit or gives rise to less disease, if we can show that the common cold might give it a little bit of protection, this bodes extremely well for a vaccine because that was the vaccine is a souped up version of that, you see.

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Yeah.

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The only thing that breaks down the theory that I advanced is that older people have lived longer and have had more colds. Well, other lives.

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Well, there's no doubt. But the other question is they're not getting as many colds, older people at. Someone has hypothesized this, that older people in nursing homes get less colds than if they're in the general public. So on the previous remember, the protection might only last a year. They are six months since that length of time. So they might have had a cold a year before.

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And then if that goes away, you see, and then they're not protected. But that could be another reason why older people are more vulnerable. They haven't had colds in the past year or so. And again, very much a hypothesis and a work in progress.

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So that could be one reason why people in nursing homes were slightly more susceptible at that age old argument, which is the more vulnerable of the genders, the males or the females. On covid-19, there's now evidence that men and women are affected differently. They are now.

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This, again, is a superb study of someone I know. And in Yale, Akihiko, it was Sarki. She's one of the world's most famous immunologist. She's really up there with the stars. You know, she just had a big nature paper last the week before last night. The Nature paper is the the gold standard for us. And she does a very systematic analysis comparing men and women. And again, it confirms what people saw early on.

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Men are much more severely affected than women. Men die more than women of this disease and they have a more difficult course. And that's been confirmed, of course, now across many studies, and she's gone into their immune system. So why would men be less able to fight this virus? And she measured the viral load in them, their antibodies, the cytokines. These are all words that trip off our tongues. Now, the T cells you see and love the man have a lot more of two particular cytokines Iola annihilated and the more monocytes.

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And she thinks that's why they're getting sicker, because those particular cytokines can cause damage. And the monocytes cell type called them on a side that we work on in my lab. Actually that can be a very inflammatory cell. Now the females. But guess what? They're better at his T cells. So the females are a lot more T cells, more sustained as they got older people. Older women have more T cells than older men. And that really is an important study part because it might tell us now how to intervene, you see.

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And then again, if you block by block, isolate or limit the monocytes that might save those men. So we see it as a really important study.

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Now, the next topic we have this morning is not about 1918 on that famous flu pandemic, but there was one in the 19th century, the late 19th century.

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And there's a question about, well, this is striking.

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So so there was a of a flu pandemic in 1889. And it's the first big pandemic that was covered by the media because the press were just getting going at that time, you know, and all the newspapers, all the anxiety, the flu or the Russian flu, it killed a million people. Now, the Earth's population was a fifth of what it is today. So that was a lot of people died, maybe even double that, they think.

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But a lot of people died of this. In some cities, half the people died. And it's well documented, you see, and it began in Central Asia, a city called Bukhara. Within 70 days, it had spread all around the world because travel in 1889 was lots of trains and stuff and, you know, managed to spread all over the world. And the big mystery was what caused it. And of course, they thought it was a flu virus like other pandemics.

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And they thought it was an influenza, a subtype, too, they thought. But there wasn't good evidence for that. And literally three weeks ago they think of as a coronavirus. So this may have been the last at least documented big pandemic from a coronavirus like sars-cov-2 Sakalys. What's happening now is scientists are digging into the history books to see what we can learn from this pandemic, as it could well have been caused by another coronavirus. That would be a lot like sars-cov-2.

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Everyone who was alive in 1989 is dead. So how do they actually go back? There's no blood.

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They can examine this, you know, no physical evidence, if you like, of what was there. Yeah, they're not exhuming people.

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They're not. It's very clever genomics, detective work. So they have all these coronaviruses today and they compare it to the ancestor. Was it? It's a very complicated way to do things. But these geneticists are very clever fellows and they can look at the rate of change of the the genes in coronavirus and track them back to an ancestor. And the ancestor was 1890. So there was definitely a coronavirus in circulation in the world. Exactly. And that's a bit of a correlation, obviously, because, as you say, we can't take blood or anything.

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But that's the second. The good thing is if they got reproduced by a lab in Denmark, the two different groups are now saying there's evidence that the 1889 pandemic was caused by an ancestral coronavirus, the ones that are kicking around today. It began with SARS, but once they had the SARS genome sequence, they could then begin to trace the lineage of that, you know, and then track it back to 1890. So the evidence is genetic, I guess.

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Yeah. How many people died? What was the rate at the end when the pandemic finally subsided? What was the percentage death rate? Now we have much better weapons at our disposal. We may have a vaccine before the pandemic finally finishes. We certainly have better therapeutics than they would have had in 1889.

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But if worse comes to worse, what would be the death rate based on that pandemic?

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Yeah, about four point three percent was the infection fatality rate, which is not that dissimilar to the sars-cov-2, which is a bit slightly higher than flu. So it's around. About the same as sars-cov-2, and that gives you a clue Cicconi, but the disease was very similar. I mean, it began to peak day four or five after infection. People were dying week for four and a week, four to five after infection. That's similar as well.

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So a lot of sort of clinical characteristics were overlapping with this and a big infection rate. So, for example, Vienna, I got to Vienna eventually, one and a half million people a year and a half the people in that city got infected and became immune. I mean, the other thing that was that they've sort of said from this sort of herd immunity was achieved because remember, this virus was that run all over the world. It's a bit like if we let this virus covid-19 run by what happened and herd immunity was eventually achieve, the ah number was two point one, for example.

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And again, that's in the same kind of range, you know. So overall, the characteristics are quite similar to sars-cov-2. But again, the idea here is that that you will see immunity build up on the population. That's why it went away. So it looks as if this is our hope, isn't it, that covered will, you know, see some immunity building up. So there are a lot of similarities between the two. But again, the death rate was very similar.

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You know, overall, on balance, you know, it's great because you can you can look at all the newspapers in all the cities began reporting it. It got to America within 70 days from starting in Russia. And the Russian American thing is interesting because, you know, the Russians and the Americans were discussing it between them. Business there was locked lockdown to some extent. Businesses closed. They spoke about butchers and bakers going out of business. So when you read it, you think, good lord, you know, his history repeats itself.

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Now, look, there's so many stories knocking around at this one. We got a press release from Oakland Nursing Home who say they're the first to pilot a new covid-19 health passport. And they're talking about using a 15 minute test and then they construct a kind of a health passport. It's developed by an Irish based group called Roku or O Kikuyu.

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And the Roku part of it is a kind of a digital thing. But the nursing home thing, they're using some technology to do a 15 minute test.

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This is an amazing development for many ways. I mean, I read this and I said this is superb because this will be a 50 minute test. I'm wondering, is it a saliva test? I'm guessing it might be a saliva test.

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Roku, I looked up their press release when I saw this thing and they say and they are not discriminating against any one test or another. You can use any test you like and feeding into their platform, which is this health passport. So it's you know, there's no development there in terms of the testing. That's up to other scientific companies to develop the test site. But they built it into this health passport in some way.

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Yeah, another 15 minutes or so fast. I'm guessing it's a saliva test. It doesn't say it. And the thing that might tell us, but this looks superb to me, but I come doing with a dog is the head of that nursing home. I think Cloyne near when I go on my holidays, to be honest, I'm going to recline. And he wants to test all the residents and all the staff repeatedly. And this is exactly the thing to do, because you can imagine if you're testing people two or three times a week, they're spitting into a tube.

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It's very easy to do. You test for the virus. You can test for what's called the antigen. That's another thing you can do about a protein in the virus much quicker. You see, and this is a superb development and there's a pilot study. So keep it again. We're keeping our fingers crossed that this pilot study works out that this should come into every single nursing home in the state. It should also go to every school in the state and every university test, test, test the famous mantra, because then we get to hunt the virus.

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Remember, they got to hunt the virus down. It's like an animal got to hunt it. And this testing is the way to hunt it and see the swab.

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Yeah, even if you don't get 100 percent from the saliva test or whatever, if you get a reasonable level of detection, you are kind of hunting it.

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You're isolating the virus if you might escape and you might have an outbreak. But by and large, you're keeping the thing under control.

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Even if you get 60, 70 percent success of this, you're hunting it down, aren't you? And you're having the risks of whatever it might be just by having that level of of detection in the system. And some of these tests might be 90 percent. That's still a pretty good number overall. And you will begin to see you isolate the people who are positive. It's fantastic. I think it's especially relevant to schools as well as back to school today.

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If there was regular testing and they call this surveillance monitoring, you just test randomly. And the test is so straightforward. If it is saliva package, remember that the swab is a bit of an ordeal. You need health care professional to do it. This is just spit in the tube and test to see if the virus is there. So I think this is a fantastic development.

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You two are still not talking about Sweden's great success in dealing with this virus. That's Paul and me. We, Paul must have missed a few of the best.

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That was right in the sense that we began kicking Sweden, didn't we, because there was a high death rate. And remember that high that those numbers are still there. Those people died in Sweden compared to Denmark. The long game. I mean, Sweden is now doing extremely well. And we're going to see what happens next. I suppose so. It's not. No, we did. We did. We did give Sweden a bit of a shout out recently.

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And in many ways, we've all become like Sweden in a sense. So I never see what's going to happen in all our countries if teachers.

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And doctors and kids might be protected then how are so many hospital staff getting the virus? You think they would have the same protection and dealing with all the public coughing and sneezing on them during the winter flu season?

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Well, they're going to get a range now. Clearly, if you have a massive dose of virus going into you, that will overwhelm the protection you have because the protection of it might differ. But remember, the immune system is very variable between people. It's not it's not a plus minus. So if if you've had a recently had a mild cold that may not protect you from a massive dose of virus, you see. So sadly, the health care is the reason why the health care professionals get infected as they're getting exposed to huge amounts of virus, you see, so so their immune systems aren't.

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But we were talking about the GP surgery, where every 10 minutes you have a new person coming in governance and sneezing at you, which is different to the experience that they would have in general hospitals. And of course, when they're dealing with some people who obviously have the flu, they might even be wearing a mask in. So dealing with that patient and someone else is asking, could you ask what is opinion? Is a face brackets for under masks that's commonly teacher in Galway.

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What is that?

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I haven't heard of that actually here. I'm not sure. Is that a way to hold it in place? Maybe to hold the visor?

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I mean, the mask has got to be completely tight against your nose and your under your chin and so on for it to be effective. Someone else wanting to know the question we've had so many times worth answering again. Does the mask give you any protection?

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The wearer from covid-19, we know the mantra, my mask protects you, your mask protects me. But does the mask itself protect the wearer in any way?

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This has been the curse of the mask debate from the start, because obviously all the early detractors were saying masks are no good because they don't protect you and in fact, the limited evidence that you're going to be protected so that now across the board 95, the PPE clearly protects you because that's in hospitals.

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They wear those the regular cotton mask that we're all wearing. Now, that doesn't give you a huge amount of protection, but you're protecting someone else. That's why everybody has to wear a mask.

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And that's the the the mantra that we've been seeing some of the observations about. Kaylani, please ask Glueck, why isn't covered rampant when our youth are partying like we saw in Kilani? I've been on top of each other all summer, yet we're all caught up about them going back to school and college. I just don't get it.

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Well, this is really this is a great question. I mean, what we think is happening. But again, it's a work in progress. One reason why older people aren't getting infected is that observing all the rules because they're very conscious of wearing masks and washing hands and limiting crowds. So they're being protected by those measures. Young people aren't doing as much of that. They're getting infected, but they're hardly no symptoms, you see, and they're very mild disease, but they aren't spreading it to the older people, we hope, because the older people are adopting all the measures.

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And that's a good thing, you know, so you will see a difference between young people and other people. As we just discussed earlier, many young people get infected and don't have any symptoms at all. So they're still partying in the face of having infection on board.

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Good news on kids on their immunity, which we talked about earlier. Do they not therefore need a vaccine?

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What do you think, Luke? That's a question from Ronnie.

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Well, there's still a risk of infection in kids, remember? And remember, the kids will get infected and they might spread it. So that's why we need a vaccine to protect them, you see, because obviously and remember, ultimately, the idea with any vaccine part is everybody gets vaccinated. And then when young babies are born, they are naive to the virus and they vaccinate them to protect them, you know, just in case they pick out a small number, will get sick, of course, with this virus.

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The reason why you want to vaccinate children is to stop them spreading it to older people. That's the main reason.

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That's the next question from a listener. And he figures on children infecting parents. That's an awful lot.

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I mean, a huge amount of studies on that. And, you know, it depends on the study you look at. Children can in fact, adults, there's no question under tens are probably less infectious than over tens. That's that's one thing that's emerging. And the teens seem to be more infectious. That could be because they've picked up more virus with each other, because they socialize more. But we just have to be careful that children can spread it to older people.

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And this one, the selfish actions of the crowds in County Kerry must have all wet. Republicans outraged today and people wonder why the pubs are closed, some steven and fingerless, but this one from a Kelani man. Most of the people on Saturday night were down from Dublin. I refused several them service in the restaurant where I work earlier in the evening, but they got the drink somewhere.

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They did. Yeah, they did. So I don't know what how we can answer that, but it does mean that last night on the trains back or on the buses or whatever, they'll all be spreading whatever they have, in fact, to each other.

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Joanna says, would really appreciate if you could ask Luke about washing uniforms, spraying down school bags, pencil cases, cetera, when they get home from school. Should they be having a shower when they come in? That's from Joanna.

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No, I don't think you need to be overzealous there. I mean, I think as long as the school is keeping its hygiene levels up, you know, and then kids are in school and hopefully, you know, following all the guidelines, of course, you'd want to wash the uniform as usual every week, but I wouldn't be doing anything over the top there necessarily. Hand hygiene is critical for the kids, remember as well all the time. So, I mean, we know the virus doesn't really live.

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I mean, the evidence at the moment that, by the way, is that catching it off a surface is a lot less than catching it from human to human contact anyway. So there is a risk. Of course there is, but it's not high enough to be overdoing it on that front.

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Yeah, some someone's just text me about what went on in Kilani that the dogs in the street and know which pub it was selling take out pints at the guy that you know this the owner of this establishment. Why isn't he being outed like Phil Hogan was outed? Well, that's a good question, which maybe we can address later on in the program. And I'm a covid long hauler and like many long haulers, very good immune system before this never got cold.

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Wondering, could there be a link in terms of what you mentioned about the cold virus protection?

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Well, the debate, but if you look at the scientific world at the moment, is shifting towards long haulers because that's becoming more and more evident as the physicians study their patients more and more. And we hear from GP's. I mean, the long haul here is a real feature here and now. That's a concern, isn't it? And the question is, can we help? The doctors want to help those Long Islanders? Can they come up with ways to treat the maybe or.

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So that's a big issue. Now, one reason to get rid of the virus? Well, not necessarily because remember, the death rates are almost flatlining as amazing people as we know the hospitals, it's the long haul is our big focus now because you don't want to catch this virus is a risk. You're going to become a long haul or you want to know more about that. So and the truth is, we still don't know why. But I mean, some people think that could be the reservoir of virus in the body that keeps reemerging.

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And that's why you feel sick for weeks on end. At worst, it's triggering some kind of what's called an autoimmune reaction. And other viruses do that. By the way, the virus wakes up the immune system, and that begins now to kind of affect you. And four months ahead, even though the virus is gone, your immune system is still burning away, causing these symptoms.

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And this is a really active area of research. First off, as a listener, I support restrictions. Rickover, 19. However, I also feel very sorry for the young people are getting slated for drinking indoors, understandably, and also being out of doors, having a bit of crack there, 18 years of age. I have the life of Riley at 18 out dancing seven nights a week. These kids were robbed of a normal leaving cert, graduating from secondary school, meeting up with friends.

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Can't go out and cut loose. Give them a break. The holier than thou crew that never had their freedom taken from them in their own youth. The mental health of these young adults is important and is as critical an issue as covid-19 in my opinion. That's from Ashlynn in Cork.

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That's not a bad point. But now remember, it's the worst scenario. 18, 19, 20 are programmed to get out there, you know, socialize as part of your development. It's like when you're a six or seven to don't to ride a bike. It's almost as natural, isn't it? As natural as that. So so how do we stop these 18 to 22 year olds doing it when they're absolutely biologically Darwinian programming to get out there, make friends, have a peer group, meet a partner, hopefully your program to do that?

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So I have a certain amount of sympathy with that viewpoint. Now, again, you've got to make them aware that they're at risk of spreading it to vulnerable people. How we manage to control that part is the question, really.

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You know, can you ask about someone with an allergy or intolerance to eggs and the flu injection?

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Well, yes, I think there is some evidence for that because obviously the flu is grown in eggs. It's just a very kind of very primitive technology they still use for the flu vaccine. And I think I think it's what's called a contraindication, actually. If you have an allergy to egg products, you shouldn't be getting the flu, I think.

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But you want to check with your GP on that one as someone else wants the definition of a covered long holer.

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That's a fantastic question. I mean, there's no doubt there now defining those symptoms and they're different from what other viruses do. This, as people may know, if you had the flu, you might feel rotten, by the way. But in the 1889 pandemic, they reported long haulers, they said, where people were weakened for some time after it. So, again, it seems to be a feature of coronaviruses. So, I mean, again, you've got things like brain fog.

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You can't concentrate as one feature fatigue muscle, like they're the three main ones. And that can go on for weeks and weeks and weeks. And walking up the stairs, you might get a bit breathless when you actually have your normal exercise regimen. You can't quite do it. So certainly the lungs are still a little bit damaged, you see, and then beyond it gets worse. I mean, the worry notepad is and again, they're not to frighten people, but there are studies now on effects on the serious of the heart, possibly on the brain that are more troublesome, again, that be the rarer end of the spectrum.

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But these this symptomology is being looked at very, very. Closely, could you ask Luke if it would be useful to talk about cases as a percentage of tests, we are testing more.

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Are all countries testing equally? If a country wants to look better, they can just test less.

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That's from Mag's in Donegal, who's a huge fan of your work.

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This is the Donald Trump scenario was a really worrying, if I can use the word New York Times piece. Did you see it over the weekend? The test is highly sensitive, really picks up a tiny, tiny amount of virus. And there's one study claiming that even if you get a positive hypocenter, people may test positive and aren't infectious, you know?

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Now, that's a work in the CDC you're looking at closely, because that means even though there's a number of cases coming up every night, a good percentage of those people are not going to be infectious. And yet they're being locked down for two weeks, you see. So that's a really sensitive test. So that's really an important question to ask about the number of cases. And we may end up with a situation where I would stop reporting the number of cases because it might it might be not useful.

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What you really want to report, of course, is people in hospital, people in ICU deaths, and then this long haul rate that be a useful thing to begin to get a handle on.

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You see, as opposed to just the number of X number of cases putting on your immunology hat, if you're getting chemo and radiation, can you get the flu vaccination? Will it work?

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I think they do get the flu to those people on chemo because, again, there's a risk of you catching the flu if you're if you're on those sorts of drugs, you see. So I don't think there's a there's a reason not to have the flu vaccine if you're on chemo, for instance. But again, see, the GP's are needed here because they know the exact you know, the drug regimen each person is on. But I'm pretty sure there are vulnerable groups and they'll be given the vaccine to the vaccine that has this thing called an adjuvant, which boosts the immune response against it.

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So even though you're on and I mean like a chemo regimen, that adjuvant will break through that immunosuppression, hopefully, and allow the vaccine to work. OK, so you better get the flu vaccine if you're on chemo and or radiation.

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Luke O'Neil, professor of biochemistry at Trinity College in Dublin. Thank you very much for joining us.

[00:26:27]

All right. You top it off and up to bat you. No, I never go to bed to 30 now. I'm not even tired.

[00:26:36]

I promise I'll make it easy on yourself, John, and just let her stay up. No, we said we're getting back to the usual routine. Looks like I have to be the bad guy again.

[00:26:47]

Five more minutes, please.

[00:26:50]

Remember what we agreed about a routine. You can finish watching that tomorrow.

[00:26:54]

It takes a hero to be the bad guy. Healthy routines start with sleep to get bedtime time back on track and start your kids on the way to a healthier life for more ways to start. Does it make a start that I brought to you if I say for the HSC and Healthy Ireland?