JULY 2020

WEDNESDAY 1 JULY

Both S and Z were offered jobs today! S got an academic post in the University of Graz, and Z got a job in a company back home in Warsaw. Great to see them both developing their careers. As it should be, but I’ll be sad to see them go. The lab turns over. I think I’ve probably had six sets of people over the years. Several have gone on to academic posts all over the world – in the USA, Australia, the UK and Ireland. I counted – 18 of them now have their own labs, which is great. And some of them are in the media talking about COVID-19. Paul Moynagh, Annie Curtis, Beth Brint and Clíona Ní Cheallaigh all worked with me. Tell that to the haters!

Gave another Zoom talk tonight at the Royal Irish Academy. It’s so important to have learned societies like the RIA, who host properly moderated discussions and events – not like Twitter or people shouting through megaphones at anti-mask rallies. Shame on those who use social media to vilify others (not talking about myself there, you understand!).

THURSDAY 2 JULY

Another incredible day on this COVID-19 journey. Good Lord, my life is so different now. Intense but also just surreal and ‘out there’. On the Dart I counted 6 out of 15 people who were wearing masks. Not good enough, but better than before.

Sometimes I think the show should be called Pandemic with Pat. Informed our listeners that all evidence now suggests that COVID-19 jumped from a bat or a pangolin into a human. Like its relatives SARS and MERS, it began in another species, mutated slightly and then jumped into us. The mutation made us acceptable as a host. But because it’s a brand-new virus, our immune systems have never seen it before, and so as a population we have a low level of protection. For each person we have to mount a fresh defence against this new pathogen. Younger people, and healthy people without other diseases in general, can mostly fight it off thanks to our adaptive immune system. But for the vulnerable, which mainly means older people, or those with lower immunity, it can wreak havoc.

So will it happen again? It might, but it’s impossible to predict. Science doesn’t always have the answer, but strives to find it. There are 1,400 different pathogens known to infect humans, of which 20 per cent are viruses. Many have jumped from other species – as much as 70 per cent. HIV jumped from monkeys. H5N1 flu virus jumped from geese. There may be as many as 700,000 other coronaviruses in animals. Scientists are trying to track them all, to stop all this happening again. A ‘Global Immunological Observatory’ is being set up and even involves collecting bat guano to look for viruses. Brings whole new meaning to the phrase ‘bat-shit crazy’.

A huge delegation came to the Biomedical Science Institute in Trinity today. Minister for Health Simon Harris, the Director of Science Foundation Ireland and the CEO of AIB all in my lab. The opening of the COVID-19 Research Centre was announced. My colleagues Kingston Mills and Aideen Long had done a great job at pulling it all together. And now here we are. It’s great that TCD and Ireland can play its part in this fight against the biggest public health crisis in 100 years.

Then in the evening I took part in the ‘Provost’s Salon’. This is a discussion hosted by the Provost, and supporters of Trinity are invited to attend. An amazing list of attendees were on the call tonight. The Earl of Iveagh took part. He has been a great supporter of Trinity over the years, and he asked some very interesting questions. As did the managing director of Microsoft Ireland, Cathriona Hallahan. I spoke for around 20 minutes and then the deluge of questions came in. As with everyone else that I speak to, there is such an appetite for information. The people invited may well help us in various ways, and I look forward to further engagement.

A remarkable day, really.

SATURDAY 4 JULY

A nice, relaxed day. Tony Holohan announced that he is stepping down as Chief Medical Officer to spend time with his family. It’s widely known that his wife is suffering from cancer. It’s a tough time for him. The whole country feels for him, and there has been huge support. People are pressing for him to be given the Freedom of Dublin. Irish people can be so decent. It’s something I am especially proud of.

SUNDAY 5 JULY

Got a spread in the Sunday Independent comparing COVID-19 to the movie Jaws. Quint is the front-line healthcare workers who risk their lives. The mayor represents the business people, trying to open the beaches to save the summer and yet the shark is still out there. Hooper is Tony Holohan, coming up against business: ‘Like to get your name in National Geographic, wouldn’t you, Hooper?’ The article makes a point, I hope.

MONDAY 6 JULY

First signs of the virus mutating. There have been at least 1,300 separate strains coming into the UK. Changes are in the spike protein. There’s hope that these won’t affect the virus too much but still, we don’t know.

I’m currently getting around 15 emails a day with questions and try and answer them all. For example, choir leaders are worried about not being able to get together. Choirs are so important for communities and for people’s well-being. And yet this virus likes nothing better than a choir in which to spread. All I can advise them to do is to sing outdoors, keep as much social distance as possible and if at all possible, wear a visor or even a mask. It’s so difficult. I would love to tell them all will be well soon.

Others who have contacted me recently are people in rowing clubs, hockey clubs, teachers, mixed martial-arts instructors, worried parents and grandparents and even driving instructors. Here are some of the things I’ve been asked:

I am desperate to hug my lovely grandchild. What’s your advice?

image

Answer: it’s OK to have a quick hug outdoors, wearing a mask.

I am a film director, and we are about to start shooting a movie. I want to use a smoke machine. Will that be safe?

image

Answer: probably, but outdoors

I have had a child by IVF. I was put on the immunosuppressant dexamethasone during the procedure. I want to have another child, but they are refusing me the drug because they say it will suppress my immune system and I might catch COVID-19. What should I do?

image

Answer: talk to your GP.

I am a separated father of a 15-year-old girl. She lives with her mother. Every year for her birthday I drive her into town and we go to a lovely restaurant and I buy her a nice present. Her mother won’t let me this year because she’s scared I might infect her. What should I do?

image

Answer: have a test. If negative, drive her into town in your car with the windows fully open, blaring loud music, wearing masks.

I am a convenor of the University of the Third Age. Many of us are over 70. The women really want to go to their hairdressers. They are frightened as they might infect their families. What should we do?

image

Answer: it’s OK to go to the hairdresser as long as they are following all the guidelines. Spend a short time there and wash your hands when you get home.

Response: You have no idea how happy you have made so many women today!

image

I am a music teacher. I know singing isn’t allowed but would it be OK for the children to hum and use body percussion instead of instruments?

image

Answer: I don’t know. But if it’s outdoors and with good distancing and for a short time this should be fine.

My grandson was recently taken into care, as sadly my daughter couldn’t look after him because of depression. The foster mother is refusing to allow my grandson to visit me as she says he might get infected and bring the infection back to her as she is in a vulnerable group. Can you please email me to say children aren’t a major source of infection, as I want to show that to the judge who is examining this case.

image

Answer: I sent her an email confirming that children are not a major source of infection and she got back to me to say my email helped ‘carry the day’.

And then some questions I couldn’t really answer:

If I carry a jam jar to spit in discreetly when I need to, will that lower my risk of catching COVID-19?

image

I’ve noticed the wearing of flip-flops and sandals is on the increase. Might droplets land on people’s feet and then their feet are a source of infection? I think I’ll stick to my wellies in Ireland for now.

image

Do you think wearing a snorkel might protect me from infection?

image

I think I caught COVID-19. I took a slime extract from snails in my garden and drank one spoonful. The COVID-19 was gone in three weeks. What do you think?

image

As well as questions, the nasty comments:

When the rest of the Irish people find out you have been lying through your crooked mouth, they might like to do more than send you an email, so good luck with that, professor. Must be worrying that Fauci is being thrown under a bus. Who knows who might be next?

image

What does it feel like to be a brain-dead moron?

image

But far more nice than nasty ones, like these:

Hi Luke. I am a plumber in my 60s. Worked for years in the rough end of the business: drainage, sewage. Worked on oil rigs. Never caught a cold or flu in my life. And listening to you, I know why. I’ve a great immune system! Much appreciate your wise words. Maith thú!

image

I’m a huge fan. Would you sign one of your old T-shirts and send it to me?

image

Here is a picture of an echinops [globe thistle]. Isn’t it just like COVID-19? Please keep up the good work!

image

And from the Irish ambassador to Argentina:

Please keep informing us of COVID-19. I’m sending you information on inhaled ibuprofen, which I know you have a strong interest in, which has great potential and is undergoing clinical trials.

image

And from the CEO of Laya Healthcare:

Keep up the tremendous work! We need you.

TUESDAY 7 JULY

It struck me this morning. The way this virus has changed my working life is substantial. No travel – I miss that. I also miss giving talks and meeting fellow scientists to thrash out ideas. I wonder, will that affect progress? And I hate Zoom drinks. Awkward silences. Boring stories. And all this media – massive.

Stevie got his results today – a first! So proud of my lad. How will COVID-19 affect him and his generation? We all need to look out for them. We went to Rasam in Glasthule to celebrate. It’s always been a favourite of Stevie’s. They had screens up everywhere and the waiters wore masks. The front-of-house guy recognised me: ‘You’re the virus guy!’ Lovely atmosphere and lovely food. Good to mark the occasion for my great lad.

WEDNESDAY 8 JULY

Downloaded the new COVID Tracker app today. It’s good! Over 700,000 other people also downloaded it. This should surely help. You can check in and find out if you’re a close contact with someone who has been infected. It will need compliance. Let’s see if it works out.

MONDAY 13 JULY

Didn’t do much over the weekend. Reading a super book called Around the World in 80 Trains. Some of them sound brilliant – across the US in sleeper trains, or the bullet trains in Japan. It’s like forbidden fruit, given that we can’t travel. Do people in prison read books on things they can no longer do? It’s like we’re all in prison these days.

Exciting developments for the Pfizer/BioNTech vaccine. Pfizer are a huge vaccine manufacturer, so it makes sense for them to partner with BioNTech. They have said they will report their big trial by the end of the year.

Every time I am in the Newstalk studios, Cormac, the sound engineer, asks me, ‘Any sign of the vaccine?’ I can’t wait for the day when there is one – not least because it will stop him asking! Pfizer have said they are seeing an excellent antibody response. Meanwhile, Novavax have received $1.6 billion from the US government as part of ‘Operation Warpspeed’, by which many companies are being supported in their efforts to get a vaccine as soon as possible: 190 vaccines are currently being tested, and at least 263 treatments for people in hospital. The FDA are mandating a minimum of 50 per cent efficacy for any vaccine, which seems achievable. As ever, it won’t be for want of trying, and I have full faith that at least some of these will succeed.

Watched University Challenge with the family. Stevie and Sam are getting questions ahead of me. How dare they? Also watched CNN late into the night. It’s become a habit: I flick all the way up the channels until I get to it. Wolf Blitzer, Erin Burnett. I’m awestruck at the way Erin asks a question and then listens intently, slowly blinking. What’s happening in the USA is atrocious. Cases climbing everywhere, followed by hospitalisations and deaths. Where’s Levitt now? What is wrong with Trump and the administration? Why won’t they listen to Tony Fauci? He spoke about death threats to him and his family. He gets it much worse than me! He has security to protect him. And all he does is talk about data and science. Some country.

TUESDAY 14 JULY

More optimism about Roche. Waxes and wanes. Realised today that trip after trip has been cancelled in the past month: Rhode Island, Boston, Melbourne, Taipei …

WEDNESDAY 15 JULY

Big meeting in the lab about the data on COVID-19 coming from Belgium and Holland. Our potential treatment, itaconate, protects human lung cells from being injured by COVID-19. Our first real data! It’s a good feeling. Need to egg them along. This can be tricky with collaborators, as they can drag their heels and be more into their own projects.

Meeting outside Zambrero’s, the coffee shop near our building. Ann and Ger from Tallaght Hospital showed us lots of data from COVID-19 patients. They, like other labs, are seeing a big increase in various inflammatory markers. We are keen to measure our favourite marker, IL-18.

Finished the day speaking at a Zoom conference on the consequences of COVID-19 for people who are on immunosuppressants for diseases like rheumatoid arthritis. The bottom line is not to worry but to take all the precautions.

What struck me today is how this virus has touched every single part of our lives – birth, childhood, school, sport, music, jobs, hobbies, friendships, weddings and, as I saw the other day, even people trying to get pregnant. I challenged people in the lab today to name a single part of their lives not affected by it and they couldn’t.

The Taoiseach (who is now Micheál Martin) said that further easing of restrictions will now not go ahead until 10 August. I wonder why? I guess the trend in the numbers is changing. He emphasised a few things: face coverings must be worn in all shops; wet pubs will stay closed; a maximum of four households can gather but there can be no more than 50 people gathering indoors. It’s not exactly easy to follow, but I guess there is some relief. I picked up a sense that there is fear of another lockdown being needed. How will we all cope if that is indeed the case?

An anxious mother emailed me about her son, who has had Kawasaki Syndrome. She is worried about him catching COVID-19. I linked her up with my Cedars-Sinai friend, Moshe, and he got back to her quickly to reassure her. She was amazed that I had managed to link her with a world expert so quickly. Moshe is a sound person.

THURSDAY 16 JULY

COVID-19 patients have a lot of clots in their lungs, I explained to Pat this morning. The disease is increasingly being seen as a coagulopathy. This means that the virus provokes clotting and that can then damage the tissues, cutting off oxygen. We discussed ‘happy hypoxia’, a feature of COVID-19, which makes it different from other respiratory diseases. Usually people who have low blood oxygen feel faint and pass out – that is not the case with COVID-19, where they feel normal even though blood oxygen is low. Another mystery of COVID-19. Low oxygen normally leads to high carbon dioxide in the blood because the exchange between oxygen and carbon dioxide when you breathe in isn’t happening. This is what causes unconsciousness. It doesn’t appear to be happening with COVID-19, hence the happy hypoxia. It could be caused by tiny blood clots, which means less blood going through the lungs and so less oxygen being taken up from the blood. This got a big reaction from the listeners, with lots of questions coming in.

FRIDAY 17 JULY

Klaxon horns needed. Got a text at 6.10 a.m. from Manus, chair of Inflazome, scheduling an emergency board call at 12 noon. Oooh!

Then – the call. Roche are now very keen. They came in with a new offer two days ago. They are prepared to spend huge money on clinical trials on all the big inflammatory diseases, neurodegenerative diseases, respiratory diseases and beyond. I mean, wow. Just imagine if it works in even one of these! I can’t quite believe it is happening

Manus asked us to vote on the current deal and we all said ‘yes’. He then congratulated me for getting this whole thing started. To see a science project through to this point (a major offer from a big pharma with the real prospect of helping patients) is a massive milestone. Oh my.

Went for lunch in Dunne and Crescenzi with old college mates Jock and Peadar. Was so beside myself, but had to show restraint. Partly because it might still fall through. Told them we were close but not quite there yet. I’ve been telling them this for years, but they certainly picked up on my excitement. We had two bottles of wine.

Went back to the lab walking on air. It’s a strange feeling to be nearly there: I can see the top of Everest but there are still a few yards to go and we could still slip. A mixture of joy and fear. I’ll bet some language has a word for it. Tenterhooks? What are tenterhooks, anyway?

On the way home I went for a walk along the seafront at Newtownsmith. High as a kite, I put in my AirPods and played ‘Lily the Pink’ by The Scaffold. ‘For she invented, medicinal compound.’ All the blue, yellow, red and green lights twinkled that bit brighter. I felt like I was in a Van Gogh painting.

SUNDAY 19 JULY

Went over to Sam’s friend Gav’s house for his 21st. In the garden, all very nice. But then a surprise: his mother had ordered a kiss-o-gram. She was somewhat raunchy, to say the least. It made for a memorable birthday for poor old Gav!

MONDAY 20 JULY

That Monday morning feeling … the comedown. As Tommy Tiernan says, ‘the tide comes in, and the tide goes out’. It certainly went out this morning. Must be the contrast. Last week was so hectic, and then my brain ramped down for the weekend. New week, brain has to ramp up again.

Several antibody therapies are in development and Eli Lilly’s one looks especially interesting. Their antibody is a cocktail that can mask the spike protein and stop the virus from getting into the lungs. This is a really good plan B if the vaccines prove problematic. Much more expensive to make, though.

TUESDAY 21 JULY

Alex’s paper got accepted today!

Alan English, Editor of the Sunday Independent, has said I should submit three of my pieces for this year’s journalism awards. I’d sent him five and he said they were all great. I need to decide among ‘A nation holds its breath’, ‘Health versus economics’, ‘The Covid shark is still out there’ and ‘Face masks are key to halting coronavirus’. I’ll have a think about it.

WEDNESDAY 22 JULY

Wrote a piece on vaccines for the Sunday Independent, getting the people ready. Imagine if the vaccine comes sooner than we thought. Joy to the world ahead of Christmas.

Acting Chief Medical Officer Ronan Glynn made some worrying noises this evening at NPHET’s press conference. They are seeing outbreaks in various places where people gather – building sites, supermarkets, fast-food places. Could this be the start of another spike? Oh, I hope not. Imagine another lockdown. How will people cope with that?

The government has also published a list of ‘green countries’. People coming in from them don’t have to quarantine for 14 days because the viral count is low in them. They include Malta, Finland and, perhaps surprisingly, Italy. It will be renewed every two weeks. It all seems a bit half-baked to me. Surely numbers will keep changing? And countries like New Zealand just banned travel and have mandatory quarantine from any country. Could we not think about that? Seems too much to contemplate or organise, because we’re in the EU, where there is free travel, and because of the border with the North. I can hear the virus laughing. Still, at least it means some travel can happen between countries.

THURSDAY 23 JULY

A fantastic session with Pat today. Eimear said she still can’t get over the reaction. We spoke about possible endgames. Vaccination will be key. Incidence of ‘long’ COVID grows. This is defined as having persistent symptoms after COVID-19 infection. The symptoms include fatigue, problems breathing during exertion, aches and pains and difficulty concentrating. Other viruses can have similar effects in post-viral fatigue syndrome. Some studies are reporting one third of people will have such symptoms, which can go on for months.

And an amazing statistic – at one point 90 per cent of all children in the world were kept out of school. That has to have long-term consequences. Got the feeling that we’ll be living with the consequences of COVID-19 for a long time. In Germany they are looking for volunteers to attend a rock concert next month – the pop singer Tim Bendzko (never heard of him) will perform. They will track people in various ways to predict how likely it is that a virus would spread. Can’t see it working, but at least it’s a gig!

FRIDAY 24 JULY

Today was tough enough. Not clear why. Just a day when it all seems more difficult. A film crew came in to do some filming, but it went on too long, and I had to skip a meeting. That bugged me.

Alex Whelan gave a talk on Zoom. I told the lab that he was my old lecturer and mentor. It was in his lectures that I first heard of IL-1, the cytokine that became the subject of my PhD and is the target for NLRP3, so Alex deserves some credit for Inflazome! He has some interesting, if slightly wacky, ideas. I encouraged him to send his idea to Nature Reviews Immunology, one of the world’s leading immunology journals, and that I would tell them to look at it. It was so good to see him, if only on screen. He is in his 80s and still burning bright.

A lot of economic news today. The government approved a €7.4 billion support package, which will cover what is now known as the PUP – the Pandemic Unemployment Payment. Hundreds of thousands of people are on this. It’s essential to keep people going, and if it wasn’t paid it would lead to a breakdown in social order. They also announced over €300 million for schools, to allow them to reopen. At last, a substantial investment in education! Class sizes are likely to drop, which is something for which educators have been pressing for decades. It’s essential that schools reopen. Everyone is agreed on that.

SATURDAY 25 JULY

Shopping in Glasthule with Stevie. Queued outside Noel Kavanagh’s butchers in the sun. Funny how feeling the sun on your face makes you relax. Good chat to Noel, who as usual slagged me off about The Metabollix. Deep down he’s a fan, I know.

MONDAY 27 JULY

Pfizer/BioNTech and Moderna announced today that they have begun recruiting thousands and thousands of people into late-phase clinical trials for their vaccines. Remarkable progress over the past few months. We can hope. They both use RNA technology. This means using RNA as the recipe to make the spike protein from the virus. It’s injected into the body wrapped up in a fatty bag, and then goes into cells, where the recipe is read off and the spike protein is made. The immune system then reacts to the spike protein, making lots of antibodies. No vaccine using that technology has ever been approved. Risky, but it could be brilliant. I’m sure they have a strong reason to try RNA as an approach.

Some of the symptoms of COVID are well known: most people are familiar with a loss of smell and taste, suggesting that nerves are being damaged in the nose and tongue. But some symptoms are not as well known, like ‘COVID toe’, where a toe will become inflamed, like chilblains. Still not at all clear why or how that’s happening.

TUESDAY 28 JULY

Kept awake by Inflazome matters last night – a rare occurrence for me. Complexities of the deal with Roche were on my mind. Spoke to Manus early this morning and he assured me all was well. It’s getting closer and closer. Tantalisingly closer.

WEDNESDAY 29 JULY

Had a magical afternoon. Stevie came in by boat again and picked me up. We had a scoot around on the Liffey and then tied off beside a coffee place near the Beckett Bridge. I told him the latest on the Roche deal. We dropped by my lab and then headed home by sea. It was a lovely evening with a fair few boats out. Slight chop, but we like that. Felt like the luckiest guy alive … (waiting for the trouble to arrive, as John Cooper Clarke would have it).

THURSDAY 30 JULY

Interesting evening! Took part in a cocktail-tasting session with Oisin Davis. All the stuff was sent over: glasses, shaker, mixers and of course the various cocktail ingredients – vodka, champagne … I was the ‘celebrity’ guest, FFS, but the others were nurses from various hospitals. Connected by Zoom and then Oisin began showing us how to mix. It was great craic. I gave some to Marg, as there were two helpings in each. It was a lovely session and the nurses enjoyed it too! Can’t beat a little bit of what you fancy. Oisin said it was a way of keeping his business going, as he’s involved in the promotion of Irish spirits and mixers. There was even an elderflower cordial using elderflowers from County Wicklow.

I stayed up for a bit more and went over to Brian’s. Enda and Colm, two of the Metabollix medics, were there. Enda told us about his time in St James’s at the height of the COVID-19 attack, and how they had managed pretty well, although he got infected himself. He said he felt bad about this, as it was him who was training the nurses how to use PPE! Just shows you how easy it is for our healthcare workers to get infected. He seemed in good form. Medical rivalry couldn’t stop Brian from winding Enda up: ‘Sure the ICU is empty now!’ Brian had actually gone back into medicine for a few months to help with A & E, and overall, he said it was actually pretty quiet, but the risk of being overwhelmed was always there. The hospitals really have performed very well overall. Strange times indeed.

FRIDAY 31 JULY

Sam told me about some of the haters coming at me on social media. It kind of disturbs me to know that he sees that kind of thing. I needn’t have worried. ‘Dad,’ he said, ‘this means you’ve made it!’

So, July ends. Big Inflazome action. Quiet in hospitals – here’s hoping it’s not another calm before the storm. Surely in the next couple of months this will start to resolve, because of all the hard work going on in trying to control spread? Pfizer and Moderna recruiting hugely. Onwards.