Seventeen months ago, Surfing the NASH Tsunami began as a podcast focused on how COVID-19 and the pandemic would affect NASH clinical trials. Some 90 original episodes later, we return to this subject in this conversation. Roger Green asks questions about how COVID-19 has affected clinical trial conduct in the US and other major markets and the rest of the Surfers provide answers about the current and future benefits from what we have learned managing trials in this pandemic. Keep listening to hear some potentially sobering comments on the effect Delta or a possible more potent future variant might have on patient recruitment and assignment. In the end, the four panelists all discuss one point listeners should take away from this conversation.