In 2021, the National Institutes of Health (NIH) launched its ambitious nearly  $2 billion RECOVER Initiative, dedicated to finding the root causes of and possible treatments for Long Covid.

Solve played a critical role in securing the preliminary $1.25 billion in funding for the program, and Solve representatives continue to serve on many advisory, authorship, and oversight committees for RECOVER.  

RECOVER has published nearly 80 papers and collected millions of data points with more work still underway, but only recently has responded to public pressure to focus on therapeutics and treatments. The launch of RECOVER-Treating Long COVID (RECOVER – TLC), a new program to develop and initiate additional Long Covid clinical trials, is backed by $500 million to find new ways to treat patients with Long Covid.

In September, the NIH held a three-day workshop at its campus in Bethesda, Maryland, to discuss the path forward for RECOVER-TLC. In this blog series, we’re summarizing the workshop in its entirety. 

Read our coverage of Day 1 here.

RECOVER-TLC: DAY 2

HOW DO WE PRIORITIZE LONG COVID INTERVENTIONS TO TEST IN CLINICAL TRIALS AND HOW DO WE DESIGN THESE TRIALS?

Patients with Long Covid and their healthcare providers share their experiences

The second day of the workshop began with 10 participants sharing their experiences as patients with Long Covid or ME/CFS or as health care providers specializing in these diseases.

Patients Jermaine Greaves, Josh Porter, Rivka Solomon, and Ezra Spier movingly described how the medical system (and society in general) ignored them and how these diseases weakened them, drained their finances, and isolated them.

But participants also described the joy of being a part of the vibrant and committed patient community. Many participants said they were hopeful and resolute. Dr. Sevda Sarikaya—a mother of a young girl with Long Covid—said that although she understands progress takes time, we must act with urgency. She said these diseases are devastating our communities (especially our children) and will bring increasing devastation if we continue to lack cures.

Dr. Svetlana Blitshteyn—director of a clinic treating hundreds of patients with Long Covid—said she most desperately wants more pharmacological options, more choices of drugs to try for treating patients. She said diet and exercise help but a few of her patients; but drugs help a great many. 

Getting the most out of clinical trials already underway or soon to start

Panelists then discussed current clinical trials on Long Covid. 

Dr. Kanecia Zimmerman, from Duke University’s medical school, talked about the RECOVER clinical trials underway. These are RECOVER-NEURO (focusing on treating cognitive dysfunction); RECOVER-VITAL (viral persistence, inflammation, and coagulation); RECOVER-AUTONOMIC (POTS); RECOVER-SLEEP; and RECOVER-ENERGIZE (cardiopulmonary rehabilitation and pacing).

For the two clinical trials for which enrollment is now closed (NEURO and VITAL), researchers have already hit important milestones (some ahead of schedule) and have every confidence that these trials will yield valuable knowledge that directly helps patients.

These first two trials have established a strong infrastructure for all later RECOVER trials to use—standardized protocols; strong relationships between patients, study teams, and community organizations; and regular meetings at many levels to move quickly and to address speedbumps along the way.

Already, RECOVER expects the NEURO trial to show that cognitive training and noninvasive brain stimulation helps patients with Long Covid–associated cognitive dysfunction and that these treatments may help certain subgroups of patients more than others. And they expect the VITAL trial to show how patients respond to different doses of Paxlovid, how patients may respond differently to Paxlovid over time, and which symptoms improve the most after taking Paxlovid.

Critically, researchers expect both trials to uncover valuable biomarkers that predict outcomes for patients. For example, they expect the RECOVER-VITAL trial to show that the levels of viral antigens are biomarkers that predict which patients will respond to Paxlovid and which will not.

The three trials still recruiting patients are those testing treatments for POTS (intravenous immunoglobulin, ivabradine, coordinator-led non-pharmaceutical care); treatments for poor sleep (soriamfetol, modafinil, melatonin, bright-light); and treatments for fatigue (cardiopulmonary rehabilitation, structured pacing).

Dr. Zimmerman shared a guiding principle of the RECOVER trials—to be as pragmatic as possible. This means appreciating that patients taking part in these trials are already taking lots of medicines and can’t just stop medicines to participate in a trial. This also means giving patients the choice to get some non-pharmaceutical interventions in the convenience of patients’ own homes, since many patients cannot easily travel to clinics. But the early results about the engagement of patients in RECOVER trials are impressive—about 8 in 10 people in these trials have taken part in optional visits and activities. This shows that patients are deeply committed to helping the trials succeed.

Dr. Upi Singh from the University of Iowa’s medical school then discussed other completed or ongoing Long Covid clinical trials (aside from RECOVER). She focused on the earliest clinical trial on Paxlovid for patients with Long Covid—the STOP-PASC trial. When this trial was developed and launched in 2022, we knew much less about how to categorize patients.

Back then, many patients had no documented testing, and we had even fewer hints about useful biomarkers than we have now. We also knew less about which symptoms to study or how Paxlovid might interact with other medications dangerously. Many patients were getting vaccinated or reinfected with SARS-CoV-2 in 2022, further complicating outcomes.

Although STOP-PASC was an essential, pioneering study launched during the pandemic, patient communities were understandably frustrated with how long things were taking.

The STOP-PASC trial found that Paxlovid helped patients no more than did placebo. But this first trial paved the way for other, more detailed trials on Paxlovid and other interventions. For example, the trial produced some critical information. It showed that patients may safely take Paxlovid for 15 days and revealed which drugs patients should not take when taking Paxlovid. The STOP-PASC trial also showed how to effectively conduct complex protocols on Long Covid and how to keep patients with Long Covid engaged throughout trials.

Finally, the STOP-PASC trial produced an immense and detailed data set that researchers continue to mine for valuable biomarkers. Dr. Singh detailed all these challenges and successes from an insider’s point of view, being one of the leaders at Stanford of the STOP-PASC study.

Dr. Singh ended by reviewing newer clinical trials on both pharmacological interventions (like a trial on high-dose coenzyme Q10 and several others on Paxlovid) and non-pharmacologic interventions for a wide range of symptoms involving diverse organ systems. Echoing discussions from the day before, Dr. Singh emphasized that future trials must find biomarkers that objectively predict disease outcomes and patients’ responses to treatment. With such biomarkers, we would be less reliant on patient experiences, which are more subjective and sometimes difficult to interpret.

Dr. Singh also said we must carefully balance future studies; we must design some trials to explore new interventions, and others to get interventions approved by the Food and Drug Administration (FDA).

After these morning presentations came a lively open discussion.

Dr. Liz Worthey, a Solve Ramsay Research Grant winner, asked Dr. Singh whether the STOP-PASC team had reanalyzed their data to tell whether Paxlovid can help key subsets of patients (although it did not help participants in the study overall). Specifically, Dr. Worthey was curious about genetic data; could Paxlovid especially help individuals with certain genetic makeups.  Other participants agreed; using these valuable data to find patient subgroups would critical.

Some panelists noted that such studies are already underway. Dr. Singh took a moment to point out that these clinical trials exist along a continuum—trials don’t necessarily succeed or fail at once; rather, trials can lead to better trials or be reconsidered down the line with the benefit of better tools or deeper insights. A key challenge is securing enough funding to continue analyzing STOP-PASC samples, she said. 

Participants also wanted to know more about how RECOVER was making it easier for patients to take part in trials. One patient advocate said patients may hesitate to enroll in the RECOVER-AUTONOMIC trial (which seeks treatments for patients with POTS) because patients must exercise to participate, and exercising is a serious challenge if you have post-exertional malaise.

To take part in the AUTONOMIC trial, patients must also travel to clinical sites every week for intravenous immunoglobulin treatments, which is also taxing. The patient advocate suggested changing these requirements to help patients participate. For example, after having the first few intravenous immunoglobulin infusions at clinical sites, patients might have later infusions at home.

Other participants noted that some trials are now more decentralized in this way. For example, one of the RECOVER trials (SLEEP ) is fully remote, and another (VITAL) has optional visits. A Yale trial on Paxlovid is fully decentralized: in that trial, researchers go to patients’ homes to give treatments and to collect samples. However, people also noted that to give some treatments and to collect some samples (e.g., gut or lymph node samples), procedures are done more safely and more productively in clinics than in homes. 

One participant raised the interesting question of whether declaring Long Covid as a public health emergency could unlock powerful assets, with which we may more quickly find treatments and cures. For example, when the pandemic emergency order was in place, doctors in one state could treat patients in other states. This was a blessing for many patients from rural areas. And with fewer restrictions, agencies might adapt to patient needs more nimbly. Some panelists agreed this was a promising idea, but also noted that the Secretary of Health decides on public health emergencies and that budgeting might be an issue. 

Choosing the most promising interventions to test. 

Later that morning, participants discussed how to best select and prioritize interventions for testing in Long Covid clinical trials. 

Dr. Julia Vogel began by overviewing the tough choices we must make for clinical trials. (Dr. Vogel is a prominent Long Covid researcher at the Scripps Research Institute and a patient with Long Covid.) She said the first thing we must ask is what we may reasonably accomplish with the funds at hand. Patients with Long Covid may have any combination of over 200 symptoms. And for each symptom, we have many interventions to try.

With unlimited funds, we could recruit enough patients to evaluate how many interventions (and combinations of interventions) affect many symptoms. But with limited funds, we must strategically choose. On the one hand, we could focus on a few key interventions and symptoms, rigorously testing these with enough patients to sensitively detect benefits. On the other hand, we could cast a wide net, testing many interventions and symptoms. However, casting a wide net means using fewer patients for each intervention and thus being less able to detect meaningful changes. Dr. Vogel offered her personal option—to use our limited funds to explore more possible treatment (accepting that we’d be less able to detect benefits for any given treatment).

Dr. Vogel also suggested how to further prioritize research with limited funds. First, clinical trials should seek interventions to cure the disease more than interventions to manage symptoms. She quoted Larry Page (co-founder of Google) in saying “If you set an ambitious goal and miss it, you’ll still achieve something remarkable.” She also recommended letting patients decide for themselves how much risk they want to take with interventions and how much reward they hope to get.

And we should evaluate both brand-new interventions and old ones already used for patients with other diseases (which we may repurpose for patients with Long Covid). Clinical trials should especially test combinations of older interventions, some prescribed for specific comorbidities (like POTS, ME/CFS, craniocervical instability) and others available over the counter (antihistamines, magnesium, famotidine). Finally, Dr. Vogel recommended that we move quickly, even if we don’t have all the answers at this moment.

Cure ID—an intervention registry for difficult-to-treat diseases

Next, Dr. Heather Stone spoke about CURE ID, a web-based tool designed by the FDA and the NIH for showing which interventions to prioritize by using real-world experiences of patients with difficult-to-treat diseases. (CURE ID is not only for patients with Long Covid, but also for patients with other difficult-to-treat diseases. The program just recently expanded to include Long Covid, which most certainly meets the criteria of being difficult to treat.)

Dr. Stone explained that because we have no approved treatments for patients with Long Covid and because new drugs take time and money, patients with Long Covid and healthcare providers are right in trying to repurpose drugs already developed for other diseases. However, because patients and health care providers try these other drugs informally (not in controlled settings of clinical trials), we haven’t adequately tracked which repurposed drugs work for Long Covid and, therefore, which to test more rigorously in clinical trials. CURE ID, a registry for interventions, is turning out to be a fantastic solution to this problem.

Through the CURE ID portal, participants can share their informal experiences with treatments and learn what happened with other patients trying the same (or other) treatments. The app and website are easy to use. For example, participants can quickly see the top ten best drugs for a symptom (as ranked by patient feedback). Participants can also dig deeper into case reports to learn details about what patients had to say. Almost 3,000 participants have registered to describe their experiences on the CURE ID platform, and almost 4,000 people visit the CURE ID website every month.

CURE ID is filling a critical role in launching new clinical trials. Through CURE ID, researchers can download patient electronic health records (with patients’ permission) to find even more useful details, like drug doses and treatment durations. They can also find which drug combinations are most effective and which patient populations respond to treatments best. CURE ID is no substitute for clinical trials in telling whether an intervention will help patients, but it is immensely valuable for prioritizing FDA-approved interventions for Long Covid clinical trials.

Dr. Stone gave a special shout-out to Solve M.E. and to other partners instrumental in helping the FDA and NIH to develop CURE ID.

Lessons from a monumental earlier effort—the ACTIV Initiative

Next, Dr. Timothy Buchman from Emory University spoke about his experience as part of ACTIV (Accelerating COVID-19 Therapeutic Interventions and Vaccines), a partnership among government agencies, private companies, and nonprofit groups that formed in 2020 in response to the pandemic. ACTIV was launched to coordinate efforts for quickly developing treatments and vaccines for patients. As a group leader, Dr. Buchman fast-tracked the most promising interventions for further testing. He explained how his team prioritized candidates, what they could have done better, and what they did well.

His team started with over 800 candidate interventions recommended by doctors, researchers, and “anyone and everyone who might have a good idea.” Dr. Buchman’s team had to figure out which interventions to test and which to set aside for the moment, and they needed to work fast.

The team started by putting interventions into separate groups. Some were “silver-bullet” interventions, like antivirals and monoclonal antibodies. Others managed the immune response.

After categorizing the interventions, the team weeded out ones already being tested in other clinical trials—there was no time to simply repeat work already being done by others. The team also asked how much clinical data was available for interventions (prioritizing interventions for which more was known), and whether the interventions could be made at high scale (prioritizing those that could). They whittled their list from 800 candidates to 37; and of those, 6 proved effective for treating patients.

Reviewing this enormous undertaking, Dr. Buchman noted things (some out of his control) that slowed his team and things they could have done differently to move more quickly.

• They could have better coordinated with other groups (in other countries or in the US) that were doing this work. Dr. Buchman’s team sometimes spent a lot of time advancing a particular class of intervention, only to find that some other group had already made headway into that same class.
• Sometimes a better intervention (for example, barticitnib plus remdesivir) took longer to develop than a not-as-great intervention (barticitnib alone). But backtracking to understand when this was happening took time.
• Because ACTIV was managing multiple critical issues at once (not only prioritizing interventions, but also quickly evaluating vaccines, developing animal models and experimental assays, and boosting clinical trials), other teams were not always ready to act when Dr. Buchman’s team were ready with recommendations.
• The team was perhaps too concerned with finding silver-bullet interventions (like antivirals and neutralizing antibodies) or complicated interventions, and not concerned enough with quickly showing what didn’t work. Showing what doesn’t work is also valuable because resources can then be used elsewhere. For example, although the team’s list had many silver bullets early on, the final list mostly had drugs that manage the immune response. Dr. Buchman said that had his team more quickly shown which candidates didn’t work, clinical trials might have more quickly turned to other options.
• Decentralizing clinical trials sooner might have let them repurpose approved drugs more quickly.

But Dr. Buchman noted resounding successes of ACTIV that RECOVER-TLC should emulate. Most noteworthy, he said, is ACTIV is an extraordinary example of what can be achieved by a “coalition of the willing.” The government, private, and nonprofit groups that formed the initiative realized they were dealing with an existential threat—the COVID-19 pandemic. Taking up this spirit of partnership would be a valuable thing for the RECOVER-TLC initiative.

During the second open discussion of Tuesday morning, Ms. Meighan Stone, a patient advocate from the Long Covid Campaign, spoke about what frustrated patients, what they wanted most urgently, and what they most appreciated. One frustration was that the interventions discussed so far at the workshop were the same ones people have discussed for years, like Paxlovid, exercise, and cognitive behavioral therapy. (Especially frustrating were video game–based interventions, she said.)

Patients want newer, more complex options, especially over-the-counter interventions, which they can easily get. And patients want more forums—like this workshop—to talk with NIH people, researchers, and doctors. Ms. Stone said the RECOVER collective must better manage its portfolio of intervention candidates and must give more money to these incredible researchers so they can launch more nimble studies testing newer interventions. 

But Ms. Stone said we’ve a lot to be happy about; some groups are doing it right. Ms. Stone especially praised the CURE ID treatment registry for doing such an excellent job engaging patients, saying other groups should “do it the way CURE ID does it.” She also highlighted groups turning small investments into meaningful results: PolyBio (which has limited funds but still does great work) and the Patient-Led Research Collaborative (which raised and used $5 million to produce important results). Finally, Ms. Stone said we have the right leaders at the NIH, who are reducing bureaucracy to speed progress.

Key challenges with designing RECOVER-TLC clinical trials

The afternoon sessions of the second day discussed challenges facing RECOVER-TLC—challenges with recruiting patients from different populations, challenges with designing clinical trials, challenges with choosing what to measure to tell whether interventions work, and challenges with clinical trials of children and teens. 

Recruiting patients from certain communities is difficult. Dr. Sally Hodder (from West Virginia University) began by speaking about challenges in recruiting patients with Long Covid for clinical trials. Key challenges include patients not knowing about Long Covid (or not knowing they have Long Covid); patients living in remote areas with no easy access to clinical trials; patients not having access to the internet or other media to engage in clinical trials remotely; patients not having health care providers who help them enroll in trials; and patients not wanting to enroll in clinical trials for fear of being stigmatized for having Long Covid. 

Dr. Hodden also described patients whom the RECOVER-TLC trials should especially look to involve. These include patients who are more likely to develop Long Covid, like women, older patients, patients who had severe COVID symptoms, patients with other health conditions, low-income patients, and unvaccinated patients. Other high-priority patients are those often underdiagnosed as having Long Covid and those unfairly represented in earlier clinical trials. RECOVER trials should also focus on recruiting children and teens because health care providers especially underdiagnose or undertreat young people with Long Covid.

To help recruit high-priority patients, trials should use customized ways to contact patients from different communities. Because at least half the population (and as many as seven in ten people) use smartphones or other digital devices, clinical trials can reach many people (even those in remote areas) through digital channels.

Future trials might also include community health workers who visit disabled patients with Long Covid in patients’ homes; this would help more disabled patients take part in trials. Participants stressed that although we have no way to treat or cure patients, we must keep recruiting them for trials. Long Covid will not go away, and we need to be using the right language when talking about this disease to design effective clinical trials. 

During the open discussion, participants also spoke about how lack of diagnoses and treatments causes substantial stress on patients. Many clinicians are not trained to help patients with Long Covid and are unaware that their neglect traumatizes patients. This “toxic stress” degrades physical health, even at the molecular level. Participants described how the effects of toxic stress on patients with Long Covid are like its effects on patients with HIV/AIDS during the early days of the AIDS pandemic. But just as greater attention and care from health care workers reduced toxic stress among patients with HIV/AIDS, so should they help patients with Long Covid moving forward. 

Special problems with designing Long Covid clinical trials.

Next, Dr. Priscilla Hsue, from the University of California, Los Angeles, led a panel discussion about challenges with designing clinical trials on Long Covid and things to do better. A key challenge in designing these clinical trials is that patients may have any number of diverse symptoms. Patients may also have varying severities of symptoms, different disease subtypes, or other diseases or comorbidities alongside Long Covid (for example, pre-pandemic ME/CFS or pre-pandemic POTS). This heterogeneity complicates clinical trial designs. For example, if an intervention works for only some symptoms or some groups of patients, then the intervention can seem useless in a clinical trial that enrolls patients with other symptoms or from other subgroups.  

Dr. Hsue described ways to improve clinical trials on Long Covid. First, patients should help design studies. Patients can best say the main symptoms to target. An attendee pointed out that researchers sometimes think if patients help design studies, then progress will be slow.  Actually, having patients help makes things go faster.

Clinical trials should also account for whether patients have other conditions and in fact must include these patients. Several participants brought up the need to recruit transgender patients, for whom Long Covid rates are exceptionally high. And although excluding patients with other conditions may make cohorts more homogenous (and easier to work with), this would also leave out many patients likely to develop more severe forms of disease, said Lauren Stiles, from Dysautonomia International.

Finally, clinical trials should test drugs used by patients with other infection-associated chronic diseases (like Ampligen, used by patients with ME/CFS) and should better measure symptoms common among infection-associated chronic conditions. In this way, we may apply results of Long Covid clinical trials to help patients with ME/CFS, POTS, and other related diseases.

Panelists also discussed some successful Long Covid clinical trials, like the REVERSE–Long Covid trial, studying barticitnib. Several of the key people who designed the REVERSE–Long Covid trial were themselves patients with Long Covid (including #MEAction’s Jamie Seltzer, who was a panelist at the workshop).

In that study, patients and researchers tracked how well they were collaborating by using patient-led research scorecards. These scorecards evaluate how equally power is shared between patients and partners; how much patients are involved in all stages of the project (including designing the study); how much accommodation is made for patients’ burden (for example, whether patients are compensated for their time); and how much the research group can and wants to substantially work with patients.

Dr. Tom Patterson, from the University of Texas at San Antonio, shared how his ACTIV team had much success by using a master agreement for all clinical sites. With a master agreement, his team could rapidly pivot from one site to another and quickly complete four trials in a little over a year. They could share results quickly. And if a drug didn’t work, they didn’t discard the drug outright. Instead, they tried other combinations with that drug (for example, by using another drug alongside the first one).

Choosing what to measure in clinical trials is not easy. Next, Dr. Alison Cohen, from the University of California, San Francisco, spoke about how clinical trials usually measure effects of Long Covid interventions and about challenges with deciding what else to measure. Clinical trials on Long Covid have measured symptoms like post-exertional malaise, cognitive function, and orthostatic imbalance, as well as overall physical health. Participants emphasized that among these, measuring post-exertional malaise is most critical. Dr. Cohen said that clinical trials must focus on the most important symptoms (from among the many ones possible).

We must measure the symptoms that patients care about the most, and we must know how to measure these symptoms quickly and reliably. Our measurements should help us decide policies for helping patients with Long Covid.  

Dr. Cohen said that we can choose the right things to measure only if we include more patients with diverse symptoms, especially those with severe symptoms. This is challenging because we must reach patients too sick to leave their homes. We must also protect these patients and ensure they feel safe at study sites; for example, by having people use masks and be tested for SARS-CoV-2 infection when at clinical sites. Measuring post-exertional malaise is also challenging. We have ways to measure this main symptom (for example, by using questionnaires), but clinical trials often do not consider post-exertional malaise.

In fact, several participants commented how post-exertional malaise was hardly mentioned at the workshop. Measuring post-exertional malaise is also difficult because patients with post-exertional malaise are less likely to participate in clinical trials if they must travel to study sites. Dr. Geng, from Stanford University, also noted that not everyone will agree on what is most important to measure because patients and researchers have diverse perspectives.  

But Dr. Geng and other participants agreed that we have an important asset to help choose what to measure in Long Covid interventional trials—years of research on other difficult-to-assess disorders, like ME/CFS, headache, and pain. Like for Long Covid, we have no objective way to measure severity or improvement with these diseases. But, over time, researchers found useful things to measure.  

Dr. Seth Lederman, chief executive officer from Tonix Pharmaceuticals, advocated measuring “patient global impression of change.” Interventional clinical trials on pain or headache already use this metric, which is useful for focusing on patients. Patient global impression of change automatically balances how patients consider risks (for adverse effects) and potentials (for benefits).

Dr. Lederman suggested that global impression of change could become for Long Covid research what “progression free survival” is for cancer research—a primary measure that pharmaceutical companies use to develop interventions; and the FDA, to approve these interventions. Dr. Davenport added that we already have at hand other good things to measure for Long Covid trials, like blood flow to the brain, cardiovascular reactions, mobility, and physical and cognitive functioning. 

 Pediatric trials 

Next, Dr. Melissa Stockton (from Columbia University) spoke about challenges unique to clinical trials on children with Long Covid. Millions of children have Long Covid in the US (more than the number of children with epilepsy or the number of children diagnosed with cancer each year). But we have too few Long Covid clinical trials focusing on children, and we cannot assume that Long Covid affects children just as it affects adults. The RECOVER-Pediatric trial found that Long Covid symptoms differ among young children, teenagers, and adults. And symptoms in young children and teenagers can be serious, affecting nearly all organ systems. 

 Dr. Stockwell said that we must launch more clinical trials focused on finding biomarkers, subgroups, and treatments for young patients with Long Covid. Dr. Roberta Debiasi (Children’s National) agreed, saying that the immune system of children differs from that of adults. And Dr. Gail Pearson (NIH) said that years of NIH research shows that how medicines work in children may substantially differ from how they work in adults. The only way to tell whether an intervention helps children as it helps adults is by including young people in interventional trials. Because the NIH’s policy is for new clinical trials to include children when appropriate, Dr. Stockwell recommended that the existing RECOVER trials add young patients now. 

Participants agreed that many families are eager to take part in clinical trials focused on children with Long Covid. Already, the RECOVER-Pediatric study has over 2,000 children who probably have Long Covid and who are ready to take part in studies. Researchers have collected high-quality clinical and molecular data from participants in this large and diverse cohort, enrolled from over 100 sites across the country.  

During an online seminar a week earlier, the RECOVER-Pediatrics group further discussed challenges unique to clinical trials of children with Long Covid and their initial findings. The Solve Science Spotlight series includes a summary of that webinar here.