The IndieSAGE group conjure up images of clever witches and wizards sitting around the Griffindor common room plotting against the inept bureaucracy of the Ministry of Magic. This week, we got to talk a member of the group, top virologist Stephen Griffin. Although we had a hugely wide ranging interview, for the purposes of the podcast we concentrated on bringing you his area of expertise when it comes to Long Covid and the SARS_Cov2 virus itself. We talked about the drugs available and to treat acute Covid that could be used to treat long Covid and the merits of Paxlovid and other antivirals.

As Griffin explains, “If there is a low level virus infection, logic dictates that using an antiviral to suppress that virus is a good idea of course. That's a no brainer, and I can completely understand what people are saying, but it's not as straightforward as you might think, unfortunately. This is it is because antivirals are not eliminatory drugs. They are suppressive drugs. So if your virus, let's say the scenario is that in long Covid, you've got this very, very low level persistent infection in a tissue in tissue x, that's still stimulating your immune system, which is making you feel unwell and it's giving metabolic problems and neurological problems. Because your immune system misfiring is a bad thing. If you suppress that virus transiently with a five or 10, or even 20 day course of antivirals, whatever, then yes, you probably may start to feel better again, but the minute that's taken away, they might come back. And the reason for that is that this virus is persisting at such a low level - is that obviously our immune response isn't able to mop it up. It's not able to kill that cell for whatever reason that the virus is lingering in. So there is almost no point giving antivirals apart for an improvement in symptoms, because you're never going to get rid of it. It will come back.”

There is a theory that Long Covid sufferers fall into two camps, one where viral persistence is the cause and antivirals, reinfection or the vaccine can help the body rid those pesky remnants, and then there is the other camps where the virus has triggered and autoimmune malfunction and dealing with that, like all autoimmune diseases, is far more complicated.