CoV Weekend Update 05.24.2020

Just a summary based on a few changes this past week that I think are important that I want to share with everybody. The first is an update for the CDC guidelines as far as the recommendations for outdoor exposure. The second is an article published in Lancet about vitamin D. I've already put a link out there for the CDC updates and the vitamin D update will be put out later on. So I want to start with the CDC update. So basically, the CDC stated that this past week that they've changed a few things and they're now recommending when people go outside. Basically, the idea is that you can't really get this out. You can't really get COVID 19 being outdoors. And so they recommend going outside controlled environments, social distancing. But in that situation, there's not a really big concern for spread. They also talk about the idea that this is spread mainly person to person. That's something we've been talking about for a little bit. So it's really important. And what I want to do is kind of explain that a little bit because the whole masking question intertwines with this. And the idea comes into, like, how do you actually get the disease? You have to get a certain amount of viruns or viral particles to actually get infected. And so it's not just one particle. It's not one particle that's floating in the air and you walk by where someone else was there an hour ago, you actually have to get a fairly substantial exposure. Now, if you get a large exposure, you can have a very robust infection. So we already know from some healthcare workers that were using nebulizers with sick COVID patients who got big exposures, they got really sick really fast. So you have to get a certain amount of exposure to get sick. If you get a really large exposure, you can get really sick really quickly. And that's where masking kind of comes in, kind of weaves into this really nicely that if you have a mask and you're coughing and you're sick, that you're not actually going to put out as many particles. And if you're wearing a mask and someone else around you is coughing, you're not going to get exposed to as many particles. So these are not absolute concepts or constructs, but they're relative. The relative risk for getting this infection outdoors is very small. How small? There's been maybe two cases in China of patients actually transmitting this that have been documented to be transmitting this in public. So the CDC recognized that this past week. They said, look, social outdoor, outdoor places Parks, recreation, beaches are okay if you're social distancing. And again, if you're outside, UV light kills this. The wind will move the viral particles. It's just very low risk to get out. Outside where you get this is enclosed environments, subways, indoor buildings, etc. So they kind of made a change with their recommendation, basically acknowledging what the research has shown over the last six to eight weeks, that you can't really get this outdoors. Is it possible? Sure, it's possible. Is it probable? No, it's not. And that's where I think some of the discussion is just confusing with the masks. Masks do decrease your risk for infection. They do not eliminate it 100%. If you're outdoors, your risk for exposure is very, very minimal. Could it happen? Possibly. Sure. Is it probable? No, it's not. It's so improbable that, you know, I'm not that worried about my parents being outside in a park, in a beach. So that's the first update. The whole article is actually available on Facebook if you want to go there and look at that to see the whole thing. Second article, a Lancet article about vitamin D. And so there's all this discussion about evidence. You know, there's not evidence, there's not randomized placebo controlled double blind trials to say XYZ works. There's only one RTC to say one thing actually helps with COVID 19 and that is with shoot remdesivir. Sorry, I had a brain fart there. The antiviral remdesivir. That is true. But this article from Lancet that was published this past week about doing RCT without actually doing an rct, and the reality is with randomized controlled trial, these costs tens and tens of millions of dollars. And no one's gonna pay tens of millions of dollars to say, take vitamin D, you know, so that's the reality. But anyway, the Lancet reviewed multiple different countries. They looked at some stuff from England, they looked at stuff from Europe and they quoted stats like, for example, if you take D, you can lower your risk for complications from COVID 19 up to 400%. And I published an art, posted an article probably maybe a couple weeks ago looking at some Indonesian data that if you had low vitamin d in the ICU in Indonesia, that you had about a 10.14 increased fold increased risk for dying from COVID 19 if you actually had low D levels. So this Lancet article very nicely summarized that data, nicely summarized the progression from different countries. There's really kind of interesting, some of Their speculations. The Lancet, for those of you who don't know what Lancet is, It's England's, the UK's version of the New England Journal of Medicine. So when people talk about the most prestigious medical journals in the English speaking countries in the world, they're usually referring to the top two are usually Lancet and New England Journal of Medicine. And the JAMA is usually third in that category. This is a very prestigious journal. So sorry for that. So. But the point is that I'm sorry, I lost my train of thought because of that background noise. What was that saying? So shoot, that totally messed me up. Lancet. My wife played this thing in the background. It totally threw me off something at the Lancet. It was me. Yeah, shoot. Those are the most prestigious terms. Most prestigious. But there's a point to that.

You were gonna tell about this to help.

Yeah, Study. That really threw me off. Totally threw me off. Wow. Sorry. Sorry about that. The point was how prestigious the D. But that's about as good as you get as far as. Without doing the actual study for what the lancet is putting out there. Oh yeah, this is the point. The point also is. Well, they looked at disparities between. This is what I was saying before I lost my train of thought. They're looking at Scandinavian, different countries because we see a difference in vitamin D. Like it was much more severe in Italy and in Spain versus other countries and you tend to see the disease worse in countries further north versus south. Now they think that was probably related to the vitamin D levels, except for Spain and Italy. For some reason those two countries have a large population of individuals with low vitamin D. And then when you look at some of the Scandinavian countries that have not been hit very hard, they actually have elevated for Germany, for example, Scandinavia. But Germany was one of the countries they talked about. They actually fortify their food with vitamin D. So the speculation was some of the inter country differences actually are probably related to vitamin D, which is really quite kind of interesting. And they also looked at ethnic differences between Caucasians and other races and how their vitamin D levels vary greatly. So a great summary article. But the reason I've been talking about D a lot the last couple weeks and the reason is I'm making such a big deal about this because we're not really going to get any more high quality evidence for a single nutrient than this. At the same time, we have lots of evidence for C&NAC, zinc and quercetin and a whole host of other nutrients. And so the point is that, you know, we don't know if you combine these things together, what the additive effect is. And so we're going to continue to get more information that's going to talk about nutrients. I just want to keep in mind there are things you can do to boost your immune system. So I think those are the two big things. This past week, I'm not going to be doing as many posts I've been doing the past just because I feel like things are slowing down a little bit. If something does pop up that I feel is useful, I will summarize it. Everybody can feel free to post questions on social media for things that they want me to look at as I'm continuing to read things. But hopefully, please share it. One of the things that we've noticed as well on social media is a lot of things related to COVID 19 are actually being dropped from different forms of social media. So if you feel like this is helpful, the best way for this to get out there is for you to share it with your friends or family, people you feel to be useful. I did a little post this past weekend and it was really interesting how, how, how much it was boosted because it was mentioning the, it was actually linked to the, the cdc. So the point is that I don't want to get too much in that, but I think by now most people realize there's a lot of surveillance going on social media in regards to COVID 19. If you want to search it, there's actually was a YouTube video talking about that interviewing the head of one of the major social media outlets and how they're trying to keep information safe out there. So the point is, if you feel like this is helpful and useful, please share it because that's really the only way good information is going to be, is going to get around. So hope you have a great Memorial Day weekend. Have a question? Yeah. Oh, okay.

Question someone asked on your last post why you recommended gloves and masks if you're in the grocery store.

Someone asked. So, okay, great question. This is a live. But I didn't realize people would be actually watching while I do it live. So. Great. That's a great, great question. Great question. So the question was this on why my last post that I recommend wearing gloves and using a mask if you're in a grocery store. The way this is spread is person to person. Okay. So the mask is helping to diminish the particles in the air when you're walking around, you're close to someone. So again, it's the idea of quantity of Exposure. The other thing with gloves is the second way you get the high risk areas, like someone in close proximity is talking, breathing, et cetera. The second thing is if someone coughs on a surface, breathes on a surface, and you touch that surface and then touch your face. So with gloves, one, you're a lot less likely to touch your face and rub your face. The second thing is that when you leave the grocery store, wherever you're at, and you take those gloves off, then you're kind of done. One of the things with a lot of these hand sanitizers people are having at grocery stores. I got my hair cut today and they made me do like a little hand gel stuff that is not the same as washing your hands. And so people conflate a gel as being equally efficacious as washing your hands. And it's not. So the glove kind of helps take that out of the, out of the picture. The reality is if you're a high risk individual, you want to minimize your risk for exposure to viral particles, basically. So that's the reason I recommend those two recommendations, which are pretty standard. There's nothing special about those.

Do you think people use gloves properly when they're out in public?

Do I think people use gloves? I know, I realize that, yeah. I don't think people are using gloves or a mask appropriately when I'm out in public. People are wearing them over their mouths, not over their noses. They're not the little bendy things of your nose, they're not bending those. Just when you put a mask on, whether it's N95 or whatever, they have the little metal thing over your nose, you're supposed to bend it to conform your face. People aren't doing that with the gloves themselves. People aren't wearing them appropriately. So the point is even a poorly worn mask is better than nothing if you're a high risk individual. If you're a low risk individual, the reason you're wearing it is to prevent you spreading virus if you're part of the 50% that don't get symptoms and can be asymptomatic. So any other questions? Like mom, while we're here? That's from yesterday. Okay. Okay. My wife will see if there's any other my. Okay, cool. Awesome. So anyway, again, I think the big thing, those are two big things. And share this information if you feel like it's helpful. And again, if there's questions, please post them. That'll help me kind of know what people are wondering. And that's also helpful to me. Because what kind of opened my eyes to the COVID 19 back in January, mid January, people started asking me questions about it and I started looking into it. And so that's the reason why we were an early adopter, so to speak, and did Our first post January 30th was because people were asking. So please continue to ask. Take care of a grand.