Author Archives: Eric

About Eric

Immunologist and Infectious Diseases Research Scientist by day, ultra runner and mountain adventurer in my spare time. Blogging about whatever comes up in life.

Olympic National Park: Hurricane Ridge to Sol Duc

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Olympic National Park was founded in 1938, connecting the coastline to the temperate rainforest to the glacier lined high peaks of the Olympic peninsula. With over 900,000 acres of land and 600miles of trails, selecting a single day’s worth to visit as part of my National Parks project was a tall task. After combing through maps, talking to people with more experience in the park, I settled on connecting the sweeping alpine views of Hurricane Ridge to the deep forest of the Sol Duc valley. After a year of dealing with a chronic injury and rehabbing my way back to mostly functional, I decided to give the 39mi route a go, even though I was greatly undertrained, so the wheels started turning…

Sunrise from Hurricane Ridge in Olympic National Park

After landing in Seattle, I stocked up on supplies, grabbed my rental car, and headed straight to the Olympic Peninsula to meet up with my friend Jason, who had graciously (and excitedly) agreed to join for the long day ahead. We dropped a car shuttle at the bustling Sol Duc trailhead and headed back to Port Angeles to pack our gear and rest up for the long run. Sunday morning (8/25/24) we followed the Hurricane Ridge Rd to it’s end, parked our car, shouldered our packs and off we went. The clouds were swirling in the valleys below as the sun’s early morning glow illuminated the mountains, the whole scene felt very apt for a PNW adventure. We chatted as we cruised along the paved path to it’s end near Hurricane Hill, where our 5000ft descent to the Elwha River began.

Alpine ridge running along Hurricane Ridge.

The first several miles of alpine tundra cruised by as we descended down the endless switchbacks into the dense forest below. Soft forest dirt, swooping switchbacks, calm and quiet trails, about as serene as we could have imagined. After about 1:45 we reached the decommissioned Elwha River Rd. In 2012 the Elwha River project began, removing the two dams along the river, returning the river back to its original channel, allowing the salmon to swim upstream, the silt to flow downstream and the valley to heal. With only foot traffic and bike traffic allowed, the 6.5mi on the road was incredibly quiet and pleasant as we quickly made our way to our next destination, Olympic Hot Springs.

Gline Canyon Dam, decommissioned in 2014.
Soaking our legs in Olympic Hot Springs.

Olympic Hot Springs was long used by the Klallam Tribe, who introduced the first Europeans to the springs in 1907. A resort was then built to service the growing number of tourists visiting the area but was finally closed in 1966. This formerly busy hiking destination has now become quiet since the Elwha River project began in 2012, which turned the 1.5mi approach, into an 11mi haul. We stopped for quick soak in one of the toasty hot springs before continuing our 4500ft climb to Appleton Pass, it felt really nice to get our shoes off for a bit. Several miles after leaving the Hot Springs the trail finally kicked up as we pushed towards the pass. As we climbed over the pass, the trail changed from open grassland and tundra to deep dark forest as we descended into the fog that enshrouded the Western peninsula temperate rainforest.

Lush green forest on the way to Appleton Pass.
Land of big trees along the Sol Duc river.

Back down we went to the Sol Duc river 2000ft below. Rain and dew dripped off the trees and bushes, while the spongy duff underfoot sunk with each footstep. From the Sol Duc river we climbed steadily back to Heart Lake, which marked the transition back into the alpine. It also marked the furthest I’d run in over a year (>29mi), since Cascade Crest 2023. Low clouds danced around the ridgelines, enveloping the surroundings mountains and lakes, only to just as suddenly part and reveal their secrets. Most of our run along the High Divide trail was in the clouds, a bit of a bummer as we were hoping for views, but enjoyable in its own right.

Climbing up towards Heart Lake as the clouds drop in.
Seven Lakes Basin in Olympic National Park.

After a short wrong turn near Bogachiel Peak, we started our descent towards Deer Lake. As we descended the clouds began to part, and we got one final glimpse of the surrounding mountains before dropping back into the dense forest below. Now 32mi and 10:30 in to our day, my lack of training was starting to show. My legs were shelled, I was totally exhausted and it took all my remaining strength to just stay upright as we descended the rocky trail back to the Sol Duc River. We kept plodding along down, down, down, finally reaching the bridge across Sol Duc Falls. It was this spot 20 years ago, in a rainstorm, where I first fell in love with Olympic National Park. The calming thundering of the water, the beautiful contrast of the water, greenery and black rocks and the liveliness of the surrounding rain forest.

High Divide trail in Olympic National Park. A+ trail running.
Sol Duc Falls in Olympic National Park.

We jogged the last 1/2mi back to the trailhead, soaking in the soft smooth trail through the rain forest, finally reaching the Sol Duc trailhead 39.9mi and 12h30min after we’d left the cars at Hurricane Ridge. I was elated to have been able to complete the adventure after such a challenging year, but at the same time utterly shelled after pushing my body further than it was trained for. The traverse had provided everything I could have hoped for from the day, even though we’d barely scratched the surface of what Olympic National Park has to offer. Olympic doesn’t have the hype of it’s more well known brothers and sisters (it’s 10th on the visitation list), but it has all the majesty, beauty and diversity to inspire endless wonder.

Jade Lake in the Alpine Lakes Wilderness (not Olympic National Park)

Kings Canyon National Park Ultra, 8/23/2020

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Erika, Adler and Flan crossing the river on the way to Echo Lake from Lake Sabrina.
Erika, Adler and Flan crossing the river on the way to Echo Lake from Lake Sabrina.

I grew up backpacking the deep canyons and rivers of Kings Canyon National Park, then later in life honed my mountaineering skills and scrambling head on the high peaks of the Range of Light. The remove alpine meadows, rugged peaks, crystal blue lakes and abundance of lonely places are all reasons that Kings Canyon National Park holds a special place in my heart. From the John Muir Trail to Mt Whitney, there are numerous well known landmarks that draw outdoor enthusiasts to the area, and rightfully so. In all of my exploring, one area that had eluded me was the infamous but remote valley of Ionian Basin. A high alpine granite playground, guarded by the hulking figures of the Black Giant, Charybdis, the Three Sirens, Scylla and Mt Gottard, containing numerous crystal blue alpine lakes and seen only by a handful of eyes each year, it’s a destination only for the most dedicated, hardy and adventurous. A place I’d only seen from the summit of Mt Solomon in 2004 while hiking the John Muir Trail.

Early morning light on Lake Sabrina.
Sierras we have arrived. Taking in the early morning light enroute to Kings Canyon NP.

With the Covid pandemic raging throughout the US, Flannery, Adler, Erika and I decided to plan a trip to the California mountains to explore a little not too far from home nature. The wheels went in motion to do some trail running, hot spring exploring, Whoa Nellie chowing, capped by two epic runs in Kings Canyon NP and the Yosemite NP High Country, ticking off two of my National Park Ultra Marathon project runs. I was excited to share a little of my former backyard and old stomping grounds with several of my best friends and craving a little new adventure. After quickly getting settled in to our Eastern Sierras campground outside of Bishop the night before our Kings Canyon adventure, we began to pour over maps for the proposed route.
Flan and Adler: “So how much of this route is off trail?”
Me: “Maybe 50%? It’s all fine.”
Flan: “Wait, what?”
Woops, I guess I had underplayed the amount of off trail navigation, talus and challenging terrain the run would entail, a lesson we’d all be learning the next day.

The beautiful reflection of Echo Lake with the SE ridge of Mt Wallace in the background.

We started out at sunrise from our car at the North Lake Trailhead, jogging the road across to Lake Sabrina, then on up the trail towards Echo Lake. The early morning light was hazy with all the smoke hanging in the air, but the scenery was stunning, and our spirits were running incredibly high. Our trail started to thin out as we neared Echo Lake, one of the most stunning turquoise blue granite lined lakes I’ve ever seen. From Echo Lake the fun began, with a loose talus scramble up to the elusive Echo Col, we missed the correct notch on our first try, getting cliffed out, but found easier passage through the cliff bands and down towards the JMT. Our route from Echo Col down to the JMT was some of the loosest and most heinous talus I’ve encountered, and the group was not too pleased (understandably so). Finally we stepped off the alpine tundra and back on to the well constructed trail of the JMT, now deep within the heart of Kings Canyon…. But our adventure was only beginning.

Navigating the complex landscape below Echo Col (back Right) on our way to the JMT.

With a realization that the day was already quickly passing by, the travel had been tough and slow, the other three opted to follow the JMT directly over to Evolution Basin and Darwin Canyon, while I made a mad dash from the JMT southward up and over the divide and into Ionian Basin. We bid our farewells for the moment, and I powered up the hill as the others took a dip in the icy water of Helen Lake. As I crested the western saddle of the Black Giant and descended the talus into Ionian Basin I was greeted by a dozen beautiful shimmering alpine lakes and the imposing North face of Charybdis. I rocked hopped across the talus West through the basin towards the low point on the Goddard Divide that would drop me back to Wanda Lake. As I climbed away from Lake 11592 towards the saddle, taking in the expansively stunning views, dark clouds began to roll over head…. then a clap of thunder…. all of it way to close for comfort.

Looking back at Helen Lake as I climb towards Ionian Basin.
Ionian Basin in all it’s glory with Charybdis and The Three Sisters guarding it’s entrance.

I put my head down and began to power up towards the saddle, cresting just in time to see the sky explode behind me as bolts of lightning hit the peaks directly across Ionian Basin, oh shit, must go faster, must go faster. The rain began to fall, thunder rolled overhead, and I was still miles from any significant amount of tree cover and safety. My heart raced and all the hairs on my arm stood on end as I raced down the now rain-soaked talus towards Wanda Lake. When I reached the lake shore at 11400ft, a bolt of lightning struck the ridge behind me and pea sized hail began to fall. I ducked under the nearest large boulder, which only provided marginal protection from the elements in the mostly barren landscape surrounding Muir Pass. Outside of my attempt on the Colorado 14ers in 2015, it was the most terrified I’ve been in the outdoors in my entire life. I donned all my clothing, rain jacket, rain pants and beanie, then crouched down under the small overhang, praying that it would provide me enough protection from the massive storm raging directly overhead.

I sat wondering if this was going to be the day where my hubris got the better of me, how long was I going to be stuck under this rock, praying that my friends (who were ahead of me down valley) were faring better than I was, and that I’d get to see them again later that day. Finally, after what seemed like hours (probably was 40-50min) the storm passed on down Evolution Basin, and dissipated North as it cleared Mt Darwin. In it’s wake it had left everything coated in two inches of hail, my teeth chattering but an immense amount of gratitude that I had survived the ordeal. I jogged down the hail and rain soaked trail into Evolution Basin, one of the crown jewels of the John Muir Trail. At last I reached the climbers trail turn off into Darwin Basin that would take me to Lamarck Col, and eventually back to the car.

Flan’s view and Adler’s “Unhappy with Eric” face as they ride out the storm.
I was stuck in this landscape for almost an hour as the storm raged. It’s aftermath, clear skies and hail strewn boulder fields.

The challenging terrain, emotional distress of the storm and the long day were already wearing on me, but I soldiered onward with a single purpose, to get it done. As I rounded the first lake in Darwin Canyon I saw three figures on the far side of the lake: it was Adler, Flannery and Erika and we all let out cries of joy at seeing each other and being reunited after so many hours and the harrowing ordeal we’d all endured. They too had gotten ravaged by the storm and had been forced to hide under a few boulders for an hour as it passed directly overhead. We slogged our way up canyon, finally hitting the final 1300ft climb to Lamarck Col. By this point we were all pretty toasted, and it took all of our strength to navigate our way through the boulders upward to the pass. We crested the pass just as the sun’s final rays were illuminating the Western sky, and took that moment to express a little gratitude for the beauty of where we were and what we had experienced, despite the hardships of the day.

Sapphire Lake along the JMT in the heart of Evolution Basin.
Sunset from the top of Lamarck Col looking back into Darwin Basin. What an epic day, and what an epic journey.

We descended down the endless gravel and sand towards North Lake, finally collapsing at our car, 16hours after we had started. We were all exhausted, starving but ecstatic to be done running for the day. The day had been anything by smooth, but we had all come out of it, learning more about ourselves, our friends and with a profound respect for the unforgiving power of Mother Nature. Because along with her beauty, comes a sometimes uncontrollable fury that reminds us all, we are not in control and we are but guests in her amazing landscape. Kings Canyon still holds an incredibly special place in my heart, a place filled with so many wonderful memories, stunning vistas and unforgettable experiences at all levels. Being able to share it with my friends meant a lot, though I think we all could have done with a little less death talus and without the violent thunderstorm that soaked and shook us all. Kings Canyon National Park Ultra Run, 33mi, 8600ft vertical gain, 15h17min. From Lake Sabrina, over Echo Col, over Muir Pass, into Ionian Basin, through Evolution Basin, into Darwin Basin over Lamarck Col and back down.
Strava Segment #1
Strava Segment #2

Great Sand Dunes NP Ultra, 5/1/21

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Nestled along the Western edge of the Sangre de Cristo Mt range is a wind-swept area of the San Luis Valley where the winds push the sand from Medano Creek into towering dunes.

Medano Creek in full flow in May at Great Sand Dunes NP.

Who knows what a pulse flow is? Unless you’ve been to Great Sand Dunes in the spring/early summer you’ve probably never heard of this term. A pulse flow is a phenomenon that happens when the river flowing through the dunes, dams itself up with sand, eventually breaking those dams, so you get pulses of increased flow (or mini floods) working their way down stream in a wave like pattern.

Great Sand Dunes National Park was established as a National Monument in 1932, and upgraded to a National Park in 2004 to protect the unique sand dunes forming at the base of the Sangre de Cristo Mts as Medano Creek flowed down. This ecosystem brings in a variety of flora and fauna not typically seen together and creating 500ft tall sand dunes! Most people come to this National Park to play in the river, climb the dunes and some to sandboard down. Very few get to experience the heart of the dunes or the mountains surrounding them. When I hatches the plan to do a Great Sand Dunes crossing (7mi of sand), I got lots of “Hell No” from friends, but not my friend Ben. Ben loves anything novel, and this sure was going to be a novel experience.

Sunrise over Great Sand Dunes NP with the Sangre de Cristos in the background.

We set out just before sunrise, hopping across the sandy shallows of Medano Creek and on up Star Dune, the tallest in the park at 741ft. We quickly found if one stuck to the ridges and valleys the sand was actually not bad to walk on. As we crested the high dunes, the first rays of sun were lighting up the sky above the Sangres, leaving us far below in shadow. We cruised across the dune tops and through the massive valleys, slowly making our way North to the Sand Ramp trail. We made quick time across the dunes (3h for 7mi), reaching the ‘trail’, which was really more of a sandy path. We jogged/walked back to the Medano Pass 4×4 Rd, where Ben and I would part ways. After dumping a pound of sand out of our shoes, I continued up to Medano Pass, while Ben headed back to the visitor center.

Ben traversing the dune tops in the morning sunlight.
Sand dunes and snowy mountain tops.

The road was smooth and went by quickly until about 500ft from the pass, where I started to hit patchy snow. Small at first, but they slowly grew bigger and deeper as I neared the pass. I reached the top of Medano Pass without too much difficulty, marked only by a sign describing the early pioneer’s efforts to get over the pass. It was early enough in the year that no cars were allowed up to the pass, so I had a quiet run down back to the Sand Ramp trail. From there it was the final grind back around the East side of the dunes, with a quick stop at the overlook to take in the immensity of the dunes. Then on back to the visitor center for a dip in the creek and a soda.

Making our way across the Sand Ramp ‘trail’.
Medano Pass Rd, climbing high into the Sangre de Cristo Mts. The source of Medano Creek and all the sand that makes up the dunes.

29mi and 4300ft later I pushed through the reeds growing along Medano Creek, arriving back at the beach party, closing my loop. I found the rest of our gang hanging out in Medano Creek: building sandcastles, dams and splashing in the water. It’s truly the closest thing Colorado gets to a beach day, and it’s such a unique way to experience it. I wouldn’t classify the Sand Dunes as a great running destination, but it is a unique place, especially in the late spring/early summer when the water flows and the days are warm. If you’re feeling bold, wander beyond the first 1/2mi into the heart of the dunes where you’ll have the park almost entirely to yourself. I promise you won’t be disappointed.

Reminder…sand dunes can move and cover the trail and bury signage.
View of the Sand Dunes from viewpoint near the end of the run.

Capitol Reef Ultra, 3/27/21

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Capitol Reef from near Torrey with the Henry Mts in the background.
Capitol Reef from near Torrey with the Henry Mts in the background.

Utah has 5 National Parks, each encompassing a unique and amazing landscape. Of those 5, Capitol Reef definitely gets the least attention, and so many people are missing out. Take the slot canyons and washes of Zion, throw in a few arches and the cherry on top is the amazing geology of the 100mi long Waterpocket fold and you’ve got a slickrock wonderland, full of hidden passages and deep and narrow canyons. Capitol Reef National Park may not have just one thing that wows people or that draws tourist from around the world, but spend a little time there and you’ll start to unravel the mystery and magic that makes this National Park so spectacular.

The heart of Capitol Reef in the middle of all the canyons.

I started my Capitol Reef NP run from the Visitor Center along Sulphur Creek, jogging South along the park road, across the Fremont River and starting up the Cohab Canyon trail. The trail quickly climbs along the cliffside, breaking a gap in the wall the trail enters a high canyon cutting into the heart of the reef. My first destination was Hickman Bridge, a well known natural bridge the trail passes right under. Looping back to Cohab Canyon, I quickly turned off onto Fryingpan Trail, climbing up to the top of the reef. The Fryingpan Trail undulates along the top of the reefs, rims of the slot canyons and across the top of the reef. Eventually dropping down to the iconic Cassidy Arch and into Grand Wash.

Hickman Bridge in Capitol Reef NP.
Views along the Frying Pan Trail in Capitol Reef.

Grand Wash’s massive walls rise hundreds of feet above the 20ft wash, terminating at the Fremont River. After a quick water and food resupply at the road crossing, I setup for the first technical obstacle, the ford of the Fremont River into Spring Canyon. The water was very chilly, about thigh deep and moving with some speed. Once across I bushwacked my way into Spring Canyon, and started the slow ascent up the 25mile long Spring Canyon. Trapped deep within the canyon, with no easy exit for 10mi, it’s a very quiet and isolated place in the heart of Capitol Reef, only a few miles from the park road. Soaring white and red sandstone walls, massive spires, narrow slot canyons and lots of hidden nooks. The canyon finally opens up after 10mi near Chimney Rock Canyon, and the trail splits up and over Chimney Rock, which offers fantastic views of the back side of Capitol Reef and towards the Aquarius Plateau.

Grand Wash far below, driveable to the Cassidy Arch TH, then foot traffic only beyond that.
Spring Canyon’s long twisting hallways are seldom visited, but easily accessed from several sides.
The view from Chimney Rock back down towards Spring Canyon.

At the Chimney Rock TH my route crossed the highway, and the next section of the Capitol Reef adventure loop began, descending into Sulphur Creek. Sulphur Creek is carved by a cold water natural spring, deep into the eroding mudstone. After passing through the wide portion of the upper canyon, the creek bottom begins to narrow and takes on a more slot like appearance. As the canyon slots up, the options for travel become fewer, and one finds themselves splashing alongside the creek and scrambling on the cliff edges. All of a sudden I rounded a corner and came face to face with the swim, a 8-10ft wide, 50ft long chest deep pool. I undressed, packed all my gear into my drybag and waded into the chilly water. I cruised through and back into the sunshine, redressed and continued down the narrow fluted heart of Sulphur Creek Canyon. After climbing down the final small waterfall the canyon widens back out and terminates back at the Visitor Center.

Entering the narrows of Sulphur Creek. The water starts out avoidable…for a bit.
The final obstacle in Sulphur Creek, a short 4ft downclimb around this waterfall.

30mi and 7h later, I’d completed my ultramarathon loop of the Central Capitol Reef region. A fantastic mix of trail running, adventure, solitude and stunning scenery. With short car shuttles one could easily break the run into three distinct pieces. The Visitor Center to Grand Wash, Grand Wash through Spring Creek to Chimney Rock TH, and Chimney Rock TH through Sulphur Creek. Each section offers a unique, yet stunning view of Capitol Reef’s beauty; the lonely canyons, massive arches/bridges, sculpted walls, and intricate uplift of the reef formation.

After going for a little swim through the narrows of Sulphur Creek. The water is chest deep and chilly.

2022 Hardrock 100; Acceptance

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The best crew and some of the best humans around.

Going into the 2022 Hardrock 100 I had grand aspirations and goals (which included a sub-30h finish). The quick answer is things went about as well as it could have, but not as well a I dreamed it would. I’ve always set big goals for myself, many of them born out of insufficiency and insecurities from past lives; You’re too slow, you’re not strong enough, you’re too short, too awkward, not smart enough…
Every person who steps foot on the line at Hardrock has dealt with their own challenges to get there and most likely still carries some of those challenges through the race and life in general. To claim we are all equal is a lie, we all are unique and none of us will ever have the same experience and that’s perfectly ok. Something I’ve struggled with for a long time is the idea that if I worked hard enough I could achieve some of the lofty aspirations, maybe not Killian level, but pretty high. 16 years after I started ultrarunning, I’m finally accepting that’s just not the case. To be clear, I’m not looking for a pity party, but rather through a recognition of my own weaknesses (and also my strengths), I can become the best version of that self and achieve whatever my personal limits may be.

Pre-race nervous shakeout and relaxation up at Hematite Lake with Jason.

Ok, back to Hardrock. Last year (2021) I went into the race determined to push hard and really find my potential, and a new level of success (time and place). What ended up happening was out running my capabilities early and suffering through the last 1/3 of the experience. 2022 brought a much different approach, listen to my body, be grateful for every experience (good and bad) and to enjoy a much as possible. In the past what’s done me in is running to others expectations, trying to keep up with others (not myself) and not fully listening to my body. The biggest challenge was admitting that my airways and lungs are my weak point and will always limit what I can do, especially at high altitude. This is not new (Nolans, past Hardrocks, 24h 14ers, Elks and others), but it’s been a hard thing to admit that it’s not something I can train past or “overcome”. I’ve found ways to cope and build other strengths; getting faster downhill, increasing overall fitness, running longer and slower, but none of these will ever remove this weak link of mine.

Cresting the Putnam Divide early in the race, mm10.
The infamous Island Lake near Grant Swamp Pass, always a worthwhile visit.

I slept terribly the week before the race (another temporary challenge) and work stresses had me a bit out of sorts, not the best way to start a super hard 100mi race. But I was promised to spend a long weekend running around some is the most beautiful mountains, with a crew of great friends, I was lucky indeed. The first climb went by smoothly, as I focused on just taking in as much of the experience as possible, soon finding myself in the familiar position of leap-frogging with Darcy. Maggie soon caught up to us not too much later and the three of us would spend the next 30miles leap frogging back and forth (them on the ups, me on the downs). Every time I rolled through an Aid Station the friendly faces would provide a boost, finally getting to see my crew in Telluride (mm28). The stoke was high, I was still feeling great and just doing my own thing. As we (Darcy, Maggie and I) left Telluride a big storm dropped in and pummeled us with rain and hail for 45min, but it was fine, we were below treeline and safe, just moist. The ominous skies still threatened as we approached Kroger’s Canteen. A couple of perogies, some coke and off down to Ouray I went. I was finding my own rhythm, playing to my strengths, listening to my body and just letting the miles roll by. Ouray was a wild circus full of energy. Tons of friends, spectators and confused tourist everywhere. For the first time at Hardrock I left an Aid Station without a pacer, focusing just on myself and the mountain experience I was seeking. Darkness fell as I led a group of us up and over Engineer Pass and down into Animas Forks. The aid station was a bit of a mess and I almost ran right by my crew without either of us realizing it. After a quick change into my nighttime gear, Jason and I were off to Handies, my white whale.

Nearing the summit of Virginius Pass, just after one thunderstorm had passed over, right before another one was about to hit.
Crew stop and refeul in Ouray before heading up to Engineer Pass.

As we headed up the Grouse saddle the work stress and lack of sleep were catching up with me and I’d spend the next 5h a walking zombie. My lungs strained in the cold air and I knew if I didn’t slow I was at risk of damaging the rest of my race, so upwards we crawled. After much bitching and moaning on my part (Jason was great) we made it to Burroughs AS where Jesus greeted us with open arms (no I want hallucinating yet). I kept trudging forward at what felt like a slow crawl, picked up Gwen at Sherman, then slowly staggered my sleepy way to sunrise at the pole creek divide. As the sun illuminated the surrounding mountains, my spirits began to lift. Gwen commented that she knew I was back when I made some very juvenile comment that only a 12yo would make, oops. So we ran (some) and walked (a bunch), enjoying what was a mostly lovely day. I probably groaned a bit when we hit the precipitous descent into Cunningham, but that meant only 1 AS left! I did my best to keep things fun at our last crew exchange, but I was just a wee bit tired, so who knows how well that came off. Bailee and I set off at a slow trudge up Dives/Little Giant, trying to keep my breathing in check (and not set off my asthma), but also wanting to get done. As we crested the top, I took one last look back at Green Mt and finally let myself believe I was going to get it done.

Full moon rising as Jason and I make our way over Handies Peak at 14000ft.
Down into Maggie we go, endless wildflowers all around and Day 2 sunshine.
Still kinda smiling and kinda having fun, final climb up and over Dives/Little Giant, almost done!

Whatever pain and fatigue I felt didn’t matter, all I had to do was will my way downhill to the finish. We ran as fast as I could down the technical descent, taking a few walk breaks to catch my breath. We stomped through the river and hit the final few miles into town, running into Jefferson along the way. I ran as hard as my lungs would allow, but with two miles to go I was sent into a coughing fit, diaphragm spasms and promptly threw up. This was the first time that’s ever happened during a race. Once I stopped coughing I felt fine, so we jogged it in. As we cruised through town we were greeted by many familiar faces, including my crew. It felt really good to kiss the rock for the 3rd time, but it felt even better to be in good spirits (despite puking) and to have enjoyed the experience (for the most part).

Finish line vibes.

The rest of the day was spent on a quick nap, cheering on the multitude of friends finishing that afternoon/evening and eating all the food I could find (burrito, 2x burgers, cookies, soup, etc). My training had succeeded, my legs held up (my legs are never my limiting factor at elevation), and other than my 5h sleepy stretch so had my energy levels. I’ve learned that no matter how hard I train, at Hardrock I can’t outrun my lungs, so sub-30h may never be in the cards for me, and I’m ok with that. I had a great run with my good friends, and that is really what I wanted most out of the experience. Sure it would be awesome to run faster, but after 34:38, 33:52 and 33:10 finishes I’ve accepted this is who I am. On to other new adventures, different races and to enjoy crewing my friends at Hardrock in future years, where I get to eat all the food, take a few naps and not run 100miles of that crazy course all at once.
Big thanks to Vfuel for supporting my training and my Hardrock adventure, all the Rocky Mountain Runners for the training miles shared and my friends and crew for dragging my sometimes grumpy ass around the San Juans yet again.

Omicron and Endemicity? 1/24/22

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The question I’ve received many times is what does Omicron mean for the end of the pandemic and the future of the vaccinated? The short answer is, anyone who tells you they know what is going to happen, when things will end or what the future holds is lying. While there are definitely signs of what the future of Omicron and the pandemic (maybe turning endemic) hold, Nature does not listen to our whims and there are biologically and epidemiologically still several paths we could travel down. The following blog is a departure from many of my previous writings in that it’s mostly my opinions and thoughts on these topics, lots of hypothesis, many of which are far from proven, but are still none the less backed up by scientific evidence and general biological principles. Welcome to the inner wanderings of my mind…..

Omicron Spread and Vaccines:
I’ll start by diving into why is Omicron spreading so fast, how might it be different and what does it mean for the future of the vaccine programs. The Omicron variant was first detected in South Africa in November 2021 (though the variant could have originate elsewhere), and what made it so unusual and worrisome was it contained 53 (!) mutations from the original founder strain, an extremely high number for a coronavirus. Hypothesis are currently that this virus must have evolved on it’s own in a long term reservoir (either immunocompromised host or animal) separate from Beta or Delta because it doesn’t closely resemble those two variants, but these are just hypothesis at the moment. What makes Omicron so successful is that these mutations appear to allow it to more efficiently bind to and enter human cells of the upper airway. This combined with the evidence that several of the mutations also interfere with the binding of some antibodies created by the vaccines (and previous infections), mean that our barrier to preventing initial infection with Omicron are torn down a bit more, but our protection is not lost!
So while vaccine detractors will point to vaccinated people becoming infected (which is true), there is a lot of real world evidence coming out that if you received a Covid vaccine (booster even better) you’re MUCH less likely to suffer severe disease or be hospitalized, which after all is what worries us the most. Part of the reason for this is that even though your immune defenses can’t prevent the initial infection, there appears to be enough cross-reactivity between existing immunity and Omicron that the body gets a jump start on fighting the infection, and as such has a much easier time controlling the disease. I attribute my current case of Omicron being mild to these advantages (in addition to being young-ish and healthy). We also have the good fortune that Omicron appears to not cause as severe disease (on average) when compared to Delta. A current working hypothesis is that what makes Omicron more infectious, may also mean it doesn’t damage the pulmonary tissue as much. After all, a virus’s main goal is to replicate and spread, and a dead host is not useful for spreading a virus. Successful viruses infect a host efficiently, replicate quickly and allow that host to spread the virus to other hosts. This is exactly what Omicron appears to be doing, and what also brings us to the next topic, Endemicity.

Endemicity?
The hope has always been we get to a place through vaccination, medications and natural immunity where we can live in more of a steady state with SARS-CoV-2. What this would include is the virus being a normal part of life, circulating within the population, not causing massive outbreaks, overflowing hospitals, killing hundreds of thousands and infecting millions each month. Obviously we’re not there yet as we still see massive numbers of new infections each day, a lot of hospitalizations and far too many dying (as of 1/24, >1000/day US). But what people are starting to allow themselves to talk about with Omicron is the potential that with how fast Omicron is spreading and the more widespread availability of vaccines, that maybe moving from the current pandemic to SARS-CoV-2 being endemic is possible.

For this to happen, enough people would have to be immune and/or refractory to severe infection that the virus is no longer a concern for most people (or our hospital system). The current variant, being less severe (on average) and far less severe (on average) in vaccinated individuals does look like it could push us in that direction. The trouble with proclaiming the end of the pandemic pre-maturely is that no one can tell you for certain that as the virus infects hundreds of millions more people in it’s push to endemicity, it won’t mutate again to become more severe/deadly. While the idea that there aren’t direct biological evolutionary pressures pushing the virus to be more effective at killing the host…mutations can be random and don’t always follow that path. But if Omicron continues on it’s current path (BIG IF) and infects much of the population in the coming months then maybe the number of new infections in each outbreak will greatly dwindle, our hospitals won’t overflow with severely ill patients and maybe we can move forward with thinking of SARS-CoV-2 as just another cold virus…..just maybe.
Our work is still not done, hundreds of millions will still get infected in the coming months/year and many will die sadly. Our job right now is to arm ourselves with as many tools to fight the virus as possible (vaccinate the world, stay healthy, wear a mask to reduce exposure, keep researching new medications) and to protect those who are still at the highest risk of severe infection.

Eric is an Immunologist and Infectious Diseases Scientist based in Boulder, CO. The thoughts in this blog are his own and are by no means proclamations of certainty, but rather musings and hypothesizing.

Sciencing the shit outta stuff, that’s how we do it.

Canyonlands Island in the Sky Ultra, 1/2/21

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Sunrise from the Island in the Sky in Canyonlands, 1/2/21.

Better late than never? It’s been a whirlwind of a year and 8 months later I’m finally catching up on my early year projects. Winter motivation is often a hard thing to inspire, but the desert has definitely been my oasis in this department. Adler, Owen and I headed to Utah for New Years. After a couple of cold days in Central Utah exploring Capitol Reef (the next blog to come!) we made our way back to Moab for the next installment of the National Park Ultra series, Canyonlands Island in the Sky.

Canyonlands is divided into three distinct districts by the Colorado and Green Rivers; Island in the Sky to the North, Needles to the SE and The Maze to the SW. When I started my project to run an ultra in every National Park I decided that some parks just require more than one run, because one really can’t experience each unique landscape without dividing them up, and Canyonlands is a prime example. The Needles consists of a desertscape chopped up by giant rock fins and  slickrock canyons, The Maze is just that, a maze of narrow slots and deep chasms that carve up the landscape while The Island in the Sky consists of a high plateau guarded on all sides by imposing walls, dropping thousands of feet down to the rivers below. All three can seem impenetrable at first glance, but improbable breaks in the canyons allow one to move across the complex landscape.

Adler cruising around the White Rim Rd in Canyonlands, 1/2/21.

The most well known feature of the Island in the Sky district is the White Rim Road, this 71mile road follows the White Rim sandstone formation as it circles the Island in the Sky, 1500ft below the plateau and 1000ft above the Green and Colorado Rivers. I started my morning at the Murphy Hogback trailhead at sunrise jogging the paved road North as it traversed it’s way through the park. I passed the jam packed Mesa Arch TH and onward to the Lathrop TH where I met Adler and Owen (7mi in).

Descending down the Lathrop Trail into the depths of Canyonlands.

From there we began our descent down one of the improbable trails that switchbacked down the cliff bands into the depths of Canyonlands, 1500ft below. Across this ledge, down this seam, over this talus rock fall and finally down the rim of a small slot to the White Rim. The cool winter air was delightful to run in and we had this region of the park all to ourselves. We hit the White Rim Rd (mm13), bid Owen farewell (as he headed back up to the car), and took off CW on our journey. The White Rim is mostly very cruisy jeep road, trapped between the towering Chinle/Wingate/Navajo sandstone walls above and the Cedar Mesa sandstone below. When you run/ride/drive the road you truly get a sense of the immensity that is Canyonlands, and the isolation that one can find in it’s depths. We continued on the road past the Airport Tower, Washer Woman tower and several immense canyons to our left that dropped to the Colorado River, still miles away. At mm24 we intersected the Gooseberry trail, our only easy bail exit (ie trail) from the canyon. We were still feeling great so forged onward with the long looping traverse around Grand View Point at the head of the Island in the Sky.

A dusting of snow coats Canyonlands, Adler and Owen lead the way.
Monument Basin Canyonlands.

A few snack breaks, one floss break above Monument Basin and lots of photo-ops later we finally turned the corner and began to head back North towards Murphy Wash (mm35). The miles were starting to wear on both Adler and I, so we settled into a mixture of fast hiking and jogging, finally reaching our turn back up to the Rim. This run is what I describe as a ‘Pay Later’ run, as with only 5miles to go we had a long sandy wash and 1400ft to climb back to our finish line. The sand felt like cement to our tired legs, but when we finally reached the steep cliff-bands that marked our final ascent back to the rim the hiking actually felt really good after all the flat runnable miles. As we climbed our way up through the different layers of sandstone the views started to expand and the late afternoon light lit up the walls with a reddish/orange glow. We hit the top of the climb right as the sun started it’s descent below the horizon, what a way to end an amazing day in the canyons.

Looking down from the White Rim towards the Colorado River far far below.
25mi of White Rim Rd done, back up the Murphy Trail we go!

After a quick high five we booked it back to town to eat every single thing we could get our hands on (9h12min and 43.69mi of running makes one hungry!). On the surface the desert may not have the diversity or grandeur of the mountains, but look a little closer and she just might reveal her secrets to you. The Island in the Sky district is a wonderful example of the diversity of Canyonlands; juniper forest on the high plateau, massive sandstone cliffs, arid slicrkrock and two rivers that create an impassable oasis far below. So many sections of this park are nearly inaccessible to all but the most dedicated, and that’s what makes it so special, you earn what you get, and nothing is easily given up. Huge thanks to Adler and Owen for sharing this adventure with me, Vfuel for powering me through yet another 9h unsupported adventure and to being healthy enough to challenge the body in such spectacular ways. Strava Track.

Hiking the way up the Murphy Trail back to the top!
Sunset from Island in the Sky looking towards the Lasals. Winter in the desert is beautiful.

Life in the Vaccine World, 4/26/21

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Well, it’s now been over a year since the US went into it’s first set of shelter in place/stay at home orders at the beginning of the Covid-19 Pandemic. And while there is hope moving forward, there is still a lot of unknown and I’ve received a lot of questions about what this new ‘reality’ means. Specifically about what it means to be vaccinated both now and in the future and what risk does the virus and vaccine pose to those who are still unvaccinated? Note that unlike some of my previous posts this one will contain a lot of opinion and speculation, as it’s dealing with unknown topics. I will try to be clear of when I’m giving my thoughts vs providing evidence from research and data as always, and if you disagree that’s perfectly fine (All I ask is you use evidence to support your claims).

First off, the discussion about the vaccines. Currently in the US there are three vaccines that have been given Emergency Use Authorization, meaning they have been approved for distribution in a regulated manner, pending constant review of safety and efficacy data. As with all medicines, if any issues or uncertainty arise the FDA has the authority to modify their status and reassess the situation. So far the Moderna and Pfizer vaccines have had no major issues with vaccination (that have warranted a pause), just the usual side effects that recipients experience (sore arm, fatigue, headaches, fever, etc). For the Johnson and Johnson and AstraZeneca (not given EUA) adenovirus vaccines this is a different story. As of this writing on 4/23/21 both of these vaccines are being investigated for rare adverse event blood clots (US FDA, see link below). These rare blood clots have occurred both in the US and Europe and at the time of this writing one hypothesis is, in rare cases autoantibodies are created causing platelet aggregation and a medical issue known as Cerebral venous sinus thrombosis. The Johnson and Johnson vaccine has been released from it’s temporary hold in the US (as of 4/23/21), after a thorough review of the cases and data by the FDA and CDC, and is again being distributed. This is sign of the system working, when ANY issue arose the vaccine was paused and investigated, the risk was found to be extremely low and medical providers have been notified how to identify and treat the rare cases of clotting (Yale Medicine 2021). Note that the rare cases of blood clots in the US have occurred in 8 out of nearly 6.8million J&J vaccinated people in the US (I received my J&J on 3/22), making them very very rare (0.00012% of those receiving the vaccine). In fact, the frequency of these cases of vaccine induced blood clots is approximately 10x lower than occurs with natural Covid-19 disease (Taquet et al 2021) and is also a rare adverse event for many other widely utilized medications (like contraceptives, Aleve, Ibuprofen and Viagra), meaning while it’s something to be aware of, it’s not unusual for medicines. So while the vaccine is far safer and less risky than natural Covid-19 disease, for women between the ages of 16-50yo (primary affected group) it’s something to consider and one may opt to receive the Pfizer or Moderna vaccinations instead while these events are being further reviewed and understood. An additional note, that while the blood clots can be life threatening, if the signs/symptoms are identified they are treatable, so if you receive the J&J vaccine keep an eye out for severe headaches, severe abdominal pain, shortness of breath within 6-14days of your vaccination.


With that out of the way, I now wanted to dive into the topic of “I’m vaccinated, now what does that mean for our lives?” From an efficacy standpoint, once you are two weeks out from receiving your vaccination(s) you are much less likely to become infected, but this does not mean it’s impossible. The CDC recently released the first set of data discussing the breakthrough cases, these are cases of Covid-19 in previously vaccinated individuals. The case count as of 4/20/21 was 7,157 individuals over the 4months of vaccination (over 100million people vaccinated) with 498(7%) cases of hospitalization and 88(1%) deaths (CDC Stats). While this is unfortunate, it was NOT unexpected as the vaccines were shown to be 70-95% effective at REDUCING infection in the clinical trials, meaning sadly not everyone is fully immune from potential infections. This is due to insufficient immune building or receiving a viral inoculum that overwhelms the immune system (happy to answer direct PMs about this complicated topic). The good thing is, 7,157 breakthrough cases in the US is actually a fairly small number when you consider that in the month of April >1.2million new people have become infected already and >14,000 people died this month (CDC Covid Data Tracker), so again, the vaccinate have a GREATLY reduces the chance of becoming infected.

Now on to a much more complicated topic, what a vaccine means for our daily lives, interactions and opening up society. First off, a lot of this decision will be based on an individuals risk tolerance and personal decision making, as such I’m going to do my best to refrain from telling you what you should or shouldn’t do, and instead provide each individual things to consider while they go through their daily lives. I’ll first go into what it means to be vaccinated, then speculate on how some of the new mutations might affect the future.

As discussed above, once you are fully vaccinated your risk of becoming infected dramatically drops. Meaning, you are far less likely to both carry the virus and to become infected (CDC MMWR 4/2/21). The converse of this is there is a small possibility that a vaccinated individual becomes infected (especially from an unvaccinated person) and can spread the virus. Now this doesn’t mean you have to keep yourself shut inside forever, but it does mean there is still a low level of risk out there. Situations that would pose the highest risk are any that put you in contact with large numbers of people, indoors in close proximity (yes bars and restaurants), unmasked for extended durations. Thus there are plenty of things that create much less risk in your life but still allow you to connect with others and socialize. Just consider who and how long you’re interacting with people, hopefully from known social circles. So just remember, each person you interact with and are in close contact with, whether you know them or not, becomes part of your social circle, and connects to others in your social circle (think of a giant spiderweb). Based on my personal risk tolerance I won’t be going to any bars, clubs, indoor concerts and will be minimizing indoor restaurant dining for now.

As of this writing the strains discovered in Italy 2020 and UK 2020 are the predominant strains circulating in the US, but there are newer strains discovered in South Africa, Brazil and India containing mutations that reduce the vaccines effectiveness (note they DO NOT render vaccines ineffective). Even with that, the vaccines appear to reduce severity and symptoms of the new viral strains, thus offering some protection. No one can predict the exact future, but here are a few things to watch for as the pandemic moves forward. While the virus still spreads at an uncontrolled rate worldwide, mutations will continue to accumulate, many unproductive, though some will lead to changes that are beneficial for the virus. As such I expect there to be a new vaccine booster shot that becomes available in 2021/2022 to address some of these changes, scientist from Moderna are already testing one of these (NIH 2021). So while it is fantastic news that the US is nearing half the population having received at least 1 shot, until we can vaccinate a large proportion of the world this virus will continue to spread and mutate. Locally, vaccines will dramatically slow the spread, reduce the hospital burden and save tens of thousands (or maybe hundreds of thousands) of lives but vaccinating the US alone won’t bring things fully back to normal. Since SARS-CoV-2 has a proof-reading enzyme the virus doesn’t mutate as fast as others (thankfully), so once the viral spread no longer becomes globally uncontrolled the mutations will slow and eventually cease. Again, this is just a hypothesis, but is one of the long-term goals of the global pandemic response. Combined with the potential of discovering additional live saving therapeutics, these are the tools that will help us move into a healthier future. Again, this last paragraph is all speculation and there are innumerable factors that could easily swing us off this trajectory or dramatically change the course of the pandemic response. No one knows the future, all we can do as Scientists and society as a whole is be aware of the most likely future directions and plan as best we can to deal with those challenges.

References:
CDC Stats. COVID-19 Breakthrough Case Investigations and Reporting. 4/20/21. https://www.cdc.gov/vaccines/covid-19/health-departments/breakthrough-cases.html
CDC Covid Data Tracker. 4/23/21. https://covid.cdc.gov/covid-data-tracker/#trends_dailytrendscases
CDC MMWR 4/2/21. Interim Estimates of Vaccine Effectiveness of BNT162b2 and mRNA-1273 COVID-19 Vaccines in Preventing SARS-CoV-2 Infection Among Health Care Personnel, First Responders, and Other Essential and Frontline Workers. CDC MMWR 4/2/21. 70(13):495-500.
FDA. FDA and CDC Lift Recommended Pause on Johnson & Johnson (Janssen) COVID-19 Vaccine Use Following Thorough Safety Review. https://www.fda.gov/news-events/press-announcements/fda-and-cdc-lift-recommended-pause-johnson-johnson-janssen-covid-19-vaccine-use-following-thorough
NIH. NIH clinical trial evaluating Moderna COVID-19 variant vaccine begins. 3/31/21, https://www.nih.gov/news-events/news-releases/nih-clinical-trial-evaluating-moderna-covid-19-variant-vaccine-begins’
Taquet M et al. Cerebral venous thrombosis: a retrospective cohort study of 513,284 confirmed COVID-19 cases and a comparison with 489,871 people receiving a COVID-19 mRNA vaccine. Oxford University, 2021.
Yale Medicine. The Johnson & Johnson Vaccine and Blood Clots: What You Need to Know. 4/23/21. https://www.yalemedicine.org/news/the-covid-vaccine-blood-clots

Catching Up with Covid, 11/12/20

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Topics:
Vaccines
Therapeutics
Reinfection and Immunity
Children and Schools
Looking Forward

Well, a lot has happened since I last wrote a Covid related piece, and a lot of important things have come to light very recently. In the past six months those of us in the United States have endured several waves of outbreak, and currently as of this writing we’re in the middle of the worst outbreak since the initial outbreak in April/May (Nov 11th, 2020; 144,000 New Cases, 65,000 hospitalized patients and 1400 New Deaths, John’s Hopkins data). There are many possible reasons for this proliferation in infections, but it’s not specific to a political party, demographic or portion of the country. Rather than argue about that, I’ll simply say, it doesn’t seem like people are acting responsibly and we’re going to pay the price, as death rates always lag a few weeks behind infections.

In the following paragraphs I’ll outline a lot of what has happened with the development of the SARS-CoV-2 Vaccines (including immunity, data, side effects, and timelines), what we’ve learned about the virus and how we’re treating it with new therapeutics, what the data tells us about how safe schools are and lastly some additional important notes about transmission. Note that this write-up is based on the information known as of 11/11/20, and I’m sure in the weeks following a lot of new information will come out. So let’s dive right in to the topic on almost everybody’s mind….are the vaccines going to work, when will they be approved and how long before ‘I’ can be vaccinated?

SARS-CoV-2 Vaccine Development and Trials:

The big headline on 11/9/20 was that interim data on the Pfizer/BioNTech’s vaccine “BNT162b2” shows 90% efficacy in preventing SARS-CoV-2 infection. Before we jump to too many conclusions, let’s take a step back and talk about how we got where we are and what we know. Since the release of the first genetic sequences of SARS-CoV-2 way back in January 2020 (10 months ago!) the scientific community has been working at a feverish pace to learn everything we possibly can about the novel coronavirus, turning out a mountain of research that would normally take a decade, in just a year’s time. A search for scientific articles containing “Covid” on pubmed.ncbi.nlm.nih.gov/ returns 68,494 hits! On top of this, many of the biggest Biotech companies in the world have dedicated huge proportions of their of their staff (often working lots of overtime) to the single task of solving this public health crisis, so believe me when I say this has been a truly unprecedented time for Science.

Vaccines against SARS-CoV-2 have progressed along timelines never seen before, partially because of this massive effort by the scientific community to execute multiple steps in the pipeline simultaneously, building off previous research on SARS-CoV and utilizing advances in vaccine development discovered in recent years. But questions remain, will the vaccine work, what kind of immunity is possible against SARS-CoV-2 and how long will it last? A lot of research has focused on assessing two major pieces of the human memory immune response to viruses; Bcells/Antibodies and Tcells. Most people have heard of antibodies (and the Bcells that produce them), and while most of the literature has shown that moderate to severe cases of Covid-19 lead to strong neutralizing antibody responses (Long April 2020), the durability (how long they last) is still open for debate and seems to depend on the severity of the disease experienced (Long June 2020). Thankfully the other arm of the memory immune response (CD4+ and CD8+ Tcells) seems to be far more robust and durable, and many studies have shown strong levels of anti-viral activity in a wide array of Covid-19 patients, even those who become seronegative (negative for antibodies) (Sekine June 2020, Le Bert July 2020, Grifoni June 2020). So this brings us back to vaccines, and a growing mountain of evidence that a well designed vaccine that leads to a robust immune response can subsequently lead to immunity against Covid-19.

There are currently 10 vaccines in Phase 3 clinical trials (raps.org), this is the final Phase of testing in which a large number of patients are vaccinated with the aim of looking at how effective the test vaccine is at preventing SARS-CoV-2 infection compared to a placebo control. Each trial is set to vaccinate upwards of 60,000 of people and won’t close down until a certain number of people become infected (doesn’t matter if they’re placebo or test vaccine). The threshold for the Pfizer trial is set at 164 infections, and the trial currently sits at 94 positive Covid cases, meaning they’re targeting another 70 positive Covid infections in the study before they close down and analyze all the data (though this could happen sooner). Early data from Phase 1&2 Trials of the successful vaccine candidates have shown a strong and consistent induction of the immune system, with SARS-CoV-2 specific antibody titers and SARS-CoV-2 reactive CD4+ Tcell levels being as high or better than those found in patients who have recovered from natural Covid-19 disease (Folegatti July 2020, Anderson Sept 2020, Sahin Sept 2020, Walsh Oct 2020). While the long term efficacy (>1year) of these responses is not known at this time, these trials are set to follow patients out for 2 years post-vaccination, and so far early returns (3-4months post-vaccination) are all promising that the vaccines create durable responses that will last for at least some time (TBD).

So we might have an approved vaccine before the end of the year (maybe even several), what next? Well thankfully for the general public many of these companies have already started building production capacity and scaling up production, banking on a successful Phase 3 trial (a big gamble). This means that if/when their vaccine is approved they are ready to start shipping vials almost immediately. Both the Pfizer/BioNTech and Moderna vaccines are mRNA vaccines, a relatively new technology that is MUCH faster to produce than traditional protein based vaccines. Problem is, there are some 7.5billion people to vaccinate, and initial estimates from Pfizer are to have enough vaccine for 50million doses (25million people) this year, that’s not a lot when distributed around the world. The WHO has a plan to evenly distribute the vaccine across all countries, but it remains to be seen if wealthier nations allow this to happen (WHO.INT/). Here in the US a team led by the Army have already worked out a supply chain and distribution plan to the different states, and then it’s up to each state to create a prioritization plan on who gets vaccinated first. Here in Colorado a rough draft of this plan has already been submitted to the CDC for approval, check this link for the full draft.
Skip to page 22-23 if you want to see the tiered priority list of who will be vaccinated first. In short the higher risk professions and people will be given first priority, even then estimates are that Colorado will receive 100,000 doses in the first shipment, enough to vaccinate 50,000 people, only a portion of those in Tier 1A. For those of you in the healthy general public, expect to wait until next Spring/Summer to get vaccinated (these timelines are still very fuzzy).

So whenever your turn comes up, there is a big question of what to expect from this vaccine. First off, there might be several choices available, and it remains to be seen if they all have similar efficacy and longevity. Second, there are different kinds of vaccines (mRNA, whole inactivated, subunit vaccines, hybrid vectors, etc) (Krammer Sept 2020). We don’t yet know how they stack up against each other, so I won’t elaborate any more at this time on them, but welcome questions about the different types if anybody has them. None of these vaccines are using live replication competent virus, so they do NOT cause infection. Two things to note about the vaccines in full disclosure, it’s not going to be as convenient or as comfortable as other vaccines we’re given in a more routine manner. This is part of what was sacrificed to make these timelines possible. Note, this DOES NOT in any way mean safety corners were cut or that regulatory steps were skipped, but rather it means that the comfort and patient experience isn’t quite as clean or easy. Many patients receiving the two dose vaccine regimen (Oxford, Moderna, Pfizer) report mild to moderate flu like symptoms within 24hours of administration; fever, fatigue, headache, etc. The symptoms are reported to go away within 24hours and are indicative of the body mounting a very strong immune response against a very strong vaccine, a good thing! Just be prepared to take a day off after receiving the vaccine, because there’s a good chance it’ll knock you on your ass (very short term).

Therapeutics

Other big news that came out this week was that Eli Lilly’s monoclonal antibody therapy against Covid-19 was given Emergency Use Authorization, though it is only being prescribed to elderly and high-risk patients, but at no charge (per US Government). Thankfully this is one of several therapeutics that have been shown to be efficacious in reducing the severity of Covid-19. Therapeutics can be divided up into those that act during the early stages of infection aimed at reducing the viral load and those acting during the later stages of infection that aim to minimize the damage caused by the immune response. In the former are anti-viral drugs such as Remdesivir (Gilead) (Spinner Aug 2020), monoclonal antibodies like Bamlanivimab (Eli Lilly) and REGN-COV2 (Regeneron, still in Phase 3) and a host of other anti-virals and biotherapeutics progressing through clinical trials. Convalescent plasma, while initially promising and helpful for some patients, is becoming less commonly used due to the inconsistent levels of neutralizing antibodies in donor patients (Agarwal Oct 2020). All of these treatments have been shown to be most efficacious when administered during the early stages of infection, before the disease reaches critical levels. Once the infection becomes more severe, requiring hospitalization, most of the therapeutics above have been shown to have minimal impact on the cytokine storm induced pathology, but this is when dexamethasone comes into play. A corticosteroid first approve in 1958, it acts as an immunosuppressant to help control the body’s over-reactive immune response to the virus that causes much of the late stage disease pathology, keeping many patients off ventilators (Tomazini Sept 2020). While none of these therapies are cures they have been instrumental in helping save some patients and in reducing the overall mortality rate. THIS is what the lockdowns did, they bought the Medical and Scientific community time to catch-up so that we could save more lives, though we still have a long way to go.

Reinfection and Immunity (Update)

Another big question that has arisen recently is about the potential for long term immunity and reinfection, the latter was recently proven by several case studies in Nevada, Hong Kong, Belgium and Ecuador (Iwasaki Nov 2020). First let’s start with what’s been learned about the immune response (for a more details on the immunology/virology, see my previous post). SARS-CoV-2 is a fairly sinister virus, in addition to asymptomatic/pre-symptomatic spread, the immune responses caused by it are quite variable. In many asymptomatic and mild cases the levels of neutralizing antibodies and length of seropositivity were shown to wane quite rapidly (Long June 2020), while those who had more severe disease had longer lasting humoral responses. Thankfully as I briefly introduced above, Tcell immunity seems to be more consistent across all infected patients (Sekine June 2020) and plays a major role in the memory response to the virus. Research has also shown that some people who have been previously infected by other coronaviruses have cross reactive memory responses to SARS-CoV-2 (Sette Aug 2020, Mateus Aug 2020), and that children may harbor higher levels of these cross reactive antibodies, a potential reason they are more resistant to Covid-19 (Ng Nov 2020). Preliminary data from one paper also showed that immune priming using the seasonal influenza vaccine can help promote immune responses to SARS-CoV-2. This is very preliminary lab data, and IS NOT inducing specific responses, but rather just an immune priming effect, similar to an adjuvant (Debisarun Oct 2020). This cross reactivity from other coronaviruses and immune priming from the flu shot DO NOT confer immunity, but may be part of the reason some people have more mild disease than others, though these hypothesis are still under investigation.

But if the body creates all these immune responses (some durable), how are people getting reinfected? Unfortunately for the handful of confirmed case studies we (Scientist) don’t know the exact answer. It’s possible the individual immune response was incomplete and thus proper memory cells were not created or maybe they were infected with such a high dose the memory response was overwhelmed? Thankfully, while viral sequencing of the Nevada case showed two separate viruses during the first and second infection, the mutations in their genomes did not appear to affect the antigenic sites the body recognizes; in short, mutation does not seem to be the reason for reinfection. Now, before you spin yourself into a frenzy, we’re talking about less than a dozen confirmed cases worldwide. If reinfection were a major issue (right now) we’d be seeing thousands of cases, not a handful, and these outliers were inevitable. So for now there is no need to panic about this topic, though it remains to be seen how long (beyond 1 year) immunity lasts and how stable the virus will be long term. So far due to proof-reading enzymes in the virus, and lack of selective pressures the virus seems to be fairly stable (Romano May 2020). Research on both these topics is ongoing, and as we get further out from the initial outbreak more will come to light.

Children and Schools

Now on to something a little more contentious, what role do children and schools play in the spread of the virus and is it safe to open up schools? I’ve spoken with many parents and teachers about this, and have heard stories on both sides; inability to work when kids are home, forcing a 6yo to do 5h/day of zoom (horrible), trying to educate one’s kids while working from home, teachers being given inadequate PPE to setup safe environments, teachers being guilted into working because if they don’t they’re responsible for our kids failing and on and on. It’s a terrible situation all around, so rather than focus on the politics, I’ll try to focus more on the research about how infectious are children and whether or not schools cause outbreaks.

By now most people are aware that children (0-19) rarely get severe disease and their risk of dying is very low. But the role of those under the age of 19 in spreading the virus is not so simple. Younger children (<4 or <6 in some papers) do not seem to be very strong vectors for Covid-19, meaning they are less likely to be infected and to transmit the infection to others. Older children (6-13) on the other hand were far more likely to become infected and transmit the virus, while young adults (14-19) experienced similar disease progression to people in their 20s (Goldstein July 2020). Though one study out of Duke did find that children of all ages (0-19) had similar nasopharyngeal viral loads (Hurst Sept 2020), but did not relate this back to infectious spread. So for children the story is more complicated because there does seem to be age related variability in regards to symptoms, though they can still become infected and transmit the virus in many instances.

Now the big question, what do the case studies from schools that have reopened show about the potential for Covid-19 outbreaks in schools? Unfortunately the answer again isn’t completely clear, partially because schools are reopening with a variety of mitigation measures, different levels of community spread and with different plans for testing, isolating and tracking outbreaks. Case studies out of Germany and Australia concluded that transmission within schools was fairly low IF community spread of the virus remained low AND rapid testing and contact tracing protocols were followed (Ehrhardt Aug 2020, Macartney Aug 2020). In both of these case the schools were running at reduced capacity, and following rigorous cleaning protocols, physical distancing and mask policies in some instances. Another case study out of Luxembourg found that during a community outbreak, secondary infections were transmitted throughout schools, though no large super-spreader events occurred in the schools (due to tracking and tracing programs) (Mossong Oct 2020). Overall the literature seems to agree that school related outbreaks are far more common in secondary and University level facilities (Goldstein July 2020), and while outbreaks do happen in younger children they do not seem to spread as rapidly. Measures such as reduced class sizes, physical distancing, rigorous cleaning, hand washing, mask wearing and testing and contact tracing will help limit any potential outbreaks. Though all of this is also contingent upon the level of community spread, and no study has tested or recommended reopening schools during larger and uncontrolled community outbreaks (like what’s happening in the US right now). The State of Colorado tracks all our larger outbreaks that are associated with a single facility/school, and if you look at the data you’ll notice many schools listed, but also many other businesses, events and gatherings.

Final Notes and Looking Forward

While there is a ton of promising data about vaccines, therapeutics, mitigation measures that help us control the spread, we are far from done with the pandemic. With cases, hospitalizations and deaths spiking all across the United States things are promising to get worse before they get better. Winter will bring the confounding issues of people being stuck indoors more often, influenza returning to the Northern Hemisphere (get your flu shot!) and the holidays (which promise to see lots of people traveling). If you have to travel I’d highly recommend you read my earlier post about navigating airlines, and be aware of the risks you are taking (United has fully booked flights right now, every seat). While airlines have been shown to not be high risk by themselves (Freedman Sept 2020), several outbreaks, including a large one on an Irish airline (59 cases), should be stark reminders of what can happen when people let their guard down (Murphy Oct 2020). Pandemic responses are not just about each person protecting themselves, but about all of us protecting those around us as well. Boulder County just went back into ‘Safer at Home: Level Orange‘, heavily restricting gatherings (2 households/10 people max) and further restricting other events and businesses. While we in the Scientific/Medical community are Catching up with Covid, it appears Covid is catching up with the general public….it’ll be a race to see who comes out on top.

Citations:
Agarwal et al, Convalescent plasma in the management of moderate covid-19 in adults in India: open label phase II multicenter randomized controlled trial (PLACID Trial). BMJ, Oct 22, 2020.
Anderson et al, Safety and Immunogenicity of SARS-CoV-2 mRNA-1273 Vaccine in Older Adults. NEJM, September 29, 2020.
Eli Lilly, Lilly’s neutralizing antibody bamlanivimab (LY-CoV555) receives FDA emergency use. Press Release, 11/11/20.
Debisarun et al, The effect of influenza vaccination on trained immunity: impact on COVID-19. medRxiv pre-print. October 16, 2020.
Ehrhardt et al, Transmission of SARS-CoV-2 in children aged 0 to 19 years in childcare facilities and schools after their reopening in May 2020, Germany. Eurosurveillance, September 10, 2020.
Folegatti et al, Safety and immunogenicity o ChAdOx1 nCoV-19 vaccine against SARS-CoV-2: a preliminary report of a phase 1/2, single blind, randomized controlled trial. Lancet, Vol 396: 467-478. July 20, 2020.
Freedman et al, In-Flight transmission of SARS-CoV-2: a review of the attack rates and available data on the efficacy of face masks. Journal of Travel Medicine, 1-7. September 18, 2020.
Goldstein et al, On the effect of age on the transmission of SARS-CoV-2 in households, schools and the community. medRxiv pre-print, July 26, 2020.
Grifoni et al, Targets of T Cell Responses to SARS-CoV-2 Coronavirus in Humans with COVID-19 Disease and Unexposed Individuals. Cell, 181; 1489-1501. June 25, 2020.
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Hurst et al, SARS-CoV-2 Infections Among Children in the Biospecimen from Respiratory Virus-Exposed Kids. medRxiv pre-print, September 1, 2020.
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Mossong et al, SARS-CoV-2 transmission in educational settings an early summer epidemic wave in Luxembourg. Pre-print, October 2020.
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24hours of 14ers; Revisiting the Past

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Seven years ago a crazy idea was hatched out of an online discussion on 14ers.com, how many 14,000ft peaks was it possible to climb in 24hours, and what would be the optimal linkup? I love 14ers, and I love logistical challenges, so I set out working some variations and timing, scouted a few lines and put some wheels in motion. I made my first go at the linkup in July 2013 as a training run leading up to UTMB, ultimately bowing out after tagging Sherman in 18h37min, for a total of 9 summits. At the time it was a good first effort, but I felt that I had a left a lot more potential out there and that 12 was feasible on a good day. Since 2013 several others have improved upon my original 9 summits, pushing the number to 11 summits in 22h, though still no one had crossed the 12 peak threshold.

Smokey views from the Mt Evans Rd, 9/18/20.

After a summer of running around the mountains, I was searching for a little inspiration, something to cap the summer and add a little extra motivation to the weird race-less Covid year it’s been. The opportunity presented itself, so I worked the schedules, lined up a driver and was set to go. Friday morning at 430a my friend Misti picked me up and we headed out for the Mt Evans Rd, the starting point for the journey. At 6:11am on 9/18/20 I clicked the watch and started jogging up the Rd to Mt Evans. It was cool and breezy, smoke hanging in the air from all the wildfires, but on I ran. I hit summit lake at 1:10 and busted up the NE slope to the summit (1:43). For some reason I thought I was behind schedule so I cranked my way across the Sawtooth, gasping as I scampered around the snow on Bierstadt, hitting the summit in 2:38. Even though it was a Friday it was a bit of a cluster, so I wasted no time and hammered down the trail, passing dozens upon dozens of onlookers, not even registering their comments or questions, reaching the Guanella Pass Rd, and eventually 11000ft at 3:25 (10min ahead of schedule).

Headed across the Sawtooth to Mt Bierstadt.
Finally a bit of downhill after dodging the crowds atop Mt Bierstadt.

I jumped in the car, and Misti promptly took off for Stevens Gulch as I packed my water, food and gear for the next leg of the journey. The word of the day was ‘efficient’. We pulled up to the Stevens Gulch TH, I jumped out, poles in hand and headed straight onto the trail for Torreys Peak. I dug into the trail, and found a steady rhythm up and over Torreys (5:31) and over to Grays (5:55). Thankfully the trail wasn’t too busy and CFI has done some great work, allowing me to cruise at a quick pace back down to the car where Misti had a cup o’noodle waiting and off we bounced down the Stevens Gulch Rd, next stop Quandary!

Headed up Torreys and Grays Peak.

We had a good rhythm going, I’d stuff my pack with food, water and gear, eat something solid and do some recovery work on my legs while we drove. After a short nap we navigated our way onto the Blue Lakes Rd on the South side of Quandary Peak, where I again hopped out of the car at 11200ft, intent on making quick work out of the dirt road section. I soon crested the dam at Blue Lake, and struck off on the climbers trail headed for Cristo Couloir. My semi-secret shortcut and little known fact that it’s only 2mi from 11200ft to the summit of Quandary via Cristo (1mi gaining 2300ft!). I’ve always been good at digging my poles in and just grinding out slow vert, so that’s what I did. Reaching the summit of Quandary Peak at 9:06 (1:24 from the car) to cloudy cool skies with only one other person in site. I made quick work of the steep loose descent, getting back to the car in 37min (9:43)! Then began the frantic recovery and repacking effort before we hit the Kite Lake Rd, this would be the shortest turn around, and with a long loop of the DeCaLiBron to come.

Looking down Cristo Couloir on my way up Quandary.

Misti dropped me at 11100ft on the Kite Lake Rd at 10:07 (4:45pm) and I began the long slog up to Kite Lake and Mt Democrat. After 10hours I wasn’t feeling as spry but I just kept grinding away, for the first time starting to struggle a bit on the uphills, reaching the summit of Mt Democrat at 11:52 (1:45 from the car), slower than I’d hoped for, but still on pace overall. I made decent time over to Mt Lincoln (12:48), spurred on by a bitter cold wind that froze my fingertips. Soon after I crested Mt Bross as the evening light faded into blackness, I paused long enough to take in the fact that I’d had the entire DeCaLiBron to myself, a rare occurrence. The darkness made the rocky descent far tougher than I’d expected, and I rolled back to the car at 14:13. For the first time all day I was a bit beat up, and was looking forward to the long drive over to Missouri Gulch, a chance to rest and recharge before the long night ahead. I refueled and napped as Misti drove, and before I knew it we were bumping down the Winfield Rd, screeching to a halt because we’d flow right by the trailhead!

Cold and windy sunset run up Mt Lincoln, all by my lonesome.

After a quick double check of my gear and food stores I bid Misti farewell and set off into the darkness. I put on some music and just focused on strong and solid movement upwards. I was hitting my splits as I neared treeline, but I could feel the strain in my breathing. As I began to climb the endless switchbacks to Mt Belford I knew I was in for a challenging night. My lungs felt congested and I couldn’t seem to get a full breath, forcing me to take breaks far more often that I wanted just to catch my breath. The switchbacks seemed to drag on forever, made worse by the lingering snow and ice that further slowed progress. At this point I was feeling very demoralized, moving as fast as I could muster, reaching the summit of Belford in 2:31 from the trailhead (18:16). It was dark, cold and I was struggling mentally to stay motivated.

Final bit of light fading away on the Rocky Mountains.

I pushed on to Oxford, once again forced to dodge a bunch of awkward snow and ice blocking the trail, reaching Oxford in 0:47 (19:03), far slower than what I know I’m capable of. On the summit of Oxford I did some fuzzy math, realizing that at my current pace it was gonna be tough to break the current FKT of 11 summits in 22h. When I’d started up from the trailhead 11 summits seemed almost a certainty and 12 seemed very reasonable, but now I was struggling to fathom climbing 11 in the allotted time. As I descended back to Elkhead Pass I was able to talk myself out of the funk….you know these routes, there’s still time on the clock, so keep pushing forward until you run out of time, nothing is certain.

The grind up Missouri felt like death, but I pushed on as hard as I could. 13000ft…..13200ft….13500ft….. dodging a few more snow patches, and not happy to see that my scree shortcuts down the SW face of Missouri was blocked by drifted snow from the prior week’s storm, so I’d have to go around the long way. At last I crested the summit of Missouri Mt, summit #11 at 21:00, giving me an hour to traverse the ridge and drop 3000ft to Clohesy Lake, a task that felt nearly impossible at the moment, but still off I went.

The glory of sleep deprivation and the excitement of endurance events…nap time.

I pushed across Missouri’s NW ridge as fast as I could move in the dark, the whole things is a blur in my memory. I finally turned West and began to drop, astonished to find that the popularity of Nolans had hacked a real trail into the ridge (when I began scouting 13 years ago, no trail existed). This gave me a fighting chance, because descending 2800ft on a steep rough trail in 40min was definitely within the realm of possibility! I charged downhill as fast as my legs and lungs would allow, sliding out now and again, but losing elevation in a hurry. At last I dropped out of the upper basin and began descending to Clohesy Lake. The final mile of trail seemed to take forever, but as I neared 11200ft I turned my path straight down the tundra to the lake, collapsing on the edge of Clohesy Lake at 10991ft at 4:01am on 9/19/20, 21hours and 50min after starting my journey on the Mt Evans Rd the previous day. There had been so much doubt and uncertainty the previous 4hours that I’d actually make it to this point that I was relieved, excited, exhausted and beat to shit. The only thing left to do was trudge my way out of the mountains and back down to the Winfield Rd.

Since I don’t own a jeep this meant walking/yogging a slow 3mi back down the jeep road in the coldest part of the night. After wading through the river (twice) I walked up to Lana (my Rav4) and woke Misti to give her the good news… I’d done it, though barely. I’d set out the ultimate goal to climb 12 14ers in 24hours, and while I’d fallen short of that goal, I’d still managed to climb 11 summits and just squeeze in under the previous FKT by 10min, covering 22,300ft of gain and 48.7mi. It may not have been a perfect day; with all the physical struggles and the additional challenges added by the smoke and snow, but it had been one hell of a journey through the mountains. I’d over come the persevered despite the mental struggles and uncertainty, trusting in the process rather than giving in to the doubts. Though that 12th summit still lingers….Mt Huron, I’m coming for you.