Response to Norman Pieniazek - Slice one of the PIE

PIE studies are essential tools for understanding the limits of what we know and don't know about respiratory agents

One of our subscribers commented thoughtfully on the transmission riddle's first post. Norman Pieniazek pointed out that the review we cited indicated the presence of multiple viral agents with multiple possible modes of transmission, is just one of many such studies. 

We never intended that reference to be an exhaustive last word on this topic - we doubt there will ever be the last word, not least because new agents or their mutations are identified all the time, as the story of SARS-CoV-2 shows.

Norman pointed to a prospective cohort study by Jain and colleagues, which followed up 2,320 adults over two and half years in different parts of the US. These were individuals with radiographic signs of pneumonia, some of whom were very ill (2% died).

So what you ask, this happens all the time. Yes, true, but the interesting part comes in the body of the article. 2,259 patients had radiographic evidence of pneumonia AND sufficient specimens to test for the presence of bacteria and viruses. Onl…