COVID-19 Live Q&A 03.29.2020

Definitely some people did not know that I am a medical doctor. So I'm just going to answer a few brief questions that were asked about myself personally. My name is Aaron Hartman. I'm a medical doctor. I am board certified in family medicine. I'm integrative in holistic medicine. I'm board eligible. And regenerative and metabolic medicine. I'm certified in functional medicine. I'm also a clinical researcher of a clinical research company. We've done done over 60 studies to date. So I'm really deep into the research. I've been doing that since 2010. That's kind of who I am. Some other questions people are asking generally on some of the social media were about functional medicine. I think this time, this infection, this pandemic are actually ideal for functional medicine to rise to the occasion. So what is functional medicine? Basically it's root cause analysis, not just you have an infection. Here are the approved treatments by the fda. But let's look at this holistically. For example, what are they doing in South Korea? Hey, they're looking at hydroxychloroquine with zinc. What are they doing in China? They're looking at chloroquine. What are bigger? That's the integrative aspect. And then the functional aspect would be. Okay. How do you boost your immune system? Diet? Your 80% of your immune system is in your GI eye track. So just eating differently, working on your IBS and bowel issues. So this idea of integrative functional medicine using a whole systems, whole body, something's.

Not right with the sound to.

To addressing your health needs. So that's kind of what integrated functional medicine is. And so I think we're getting ready to start.

Can you. Something's not right with the sound.

Sound.

Which one of these is.

That's.

I'm not sure. Let me pull this back in.

Sorry about this. We thought we were going to start on time and we're starting.

You started on time?

On time, yeah. So came by here. So be good on Instagram and Facebook. I was just briefly talking about. I think we're good to go. Okay. So anyway, for those who just joined us, I was briefly talking about myself and what functional medicine is and how it relates to what's going on. So what we're going to do is answer some questions that have been already posed to us on social media and then those who are with us live, if you have questions, just kind of type them in. We are able to get questions from Instagram and Facebook. If you're on a Different media. We do apologize. We're only set up currently to do live questions on Instagram and Facebook. So the first question that was posed to me was actually by a family member asking if they can get COVID 19 from groceries, from buying groceries, eating them, and not cleaning them appropriately. I think this is a great example of majoring on the minors. If you all remember that game when we were kids where someone whispers into someone's ear, and then as it goes through the room, by the time it gets to the last person, the message is totally changed. I think this is one of those examples of the message being skewed. So what do I mean by that? You know, when you look at research and they say, hey, COVID 19 can be found on cardboard 24 hours later. It can be found on metal and plastic surfaces three days later, 72 hours later. That does not correlate with infectious. So the question ultimately is not, can someone in a lab do research? Take a viral sample from cardboard, for example, which is very porous, it's got very cellulose, and actually get infection from it. And the answer is, the biggest way you get infected from this is aerosolization. And the way exposure happens with that is coughing. The particles become aerosolized and spin in air force for up to three hours. And so if you're. That's the first thing. Second thing is, if you get on hard surfaces like metal and plastic, and you touch that and touch your face or eyes, that accounts for the vast, vast majority of infections. So I'm more worried about people in grocery stores not buying the stuff that's there, but seeing them out in public without wearing their masks, without having their gloves, without washing their hands, that's the most likely exposure you're going to get. Not the boxes dropped off at your house or the groceries you buy if it makes you feel better, because there's so much static out there about. You know, if y' all remember, if you can think back to. We started doing this, the very, very first video I did was the end of January, if you can remember, in February. There's a question of whether or not on the one of the cruise ships that literally, the COVID 19 would go through air ducts and transmit throughout the cruise ship. If you all remember that, there's always going to be some extremes people are all going to. The biggest thing is what actually makes a difference? What actually gets you infected? And the answer is, you know, hand washing air droplets. So if you have to go out in public, wear your face mask, wear your gloves if you're not going. The thing with the gloves is you have to make sure you take them off and throw them away when you walk out of the building, when you leave the grocery store. One other thing to think about with infectiousness as well is that how much do you have to get exposed to? Again, it's not just if you get exposed to one virus, you'll get disease. The example I've given before is with HIV. You know, if someone has HIV and they're stuck, they have an 18 gauge needle in them, then I get a needle stick with that, I have a risk of getting HIV of 1 in 250. So it's not a 1 to 1 correlate. So infectiousness is a big deal. And infectiousness of groceries or cardboard boxes, much, much less than you being in public and not having a face mask on or being closer to six feet to people. Yes, there's some stuff that maybe it's even further six meters. But again the risk for transmission goes down drastically. So we need to major on the majors and not major on the minors. And that's one thing I've seen a lot last week is people things coming back around with hydroxychloroquine and other treatments were majoring on the minors.

Pause just for a second, let me. I'm just going to take off one of your mics. I don't think is working as well. So I'm just going to this around. Oops, sorry, sorry, everybody gotta try that.

So we had to switch a mic out real quick and we'll see if that is working.

Ask Facebook, if that's.

Ask Facebook, Facebook. Is that better?

It's gonna take a second.

Okay. And ultimately, if whatever you're doing reduces stress, stress, that's important. Actually we'll be launching probably in a week or two one of our podcasts on stress. As far as one of the pillars of functional medicine, if you're interested in that, you know, maybe sign up, take a look at that in a couple weeks. But the gist is stress is really bad and stress by itself can increase your risk for cancerous infections. So if it makes you feel better to take charge and wash your vegetables, then by all means wash them. But I don't think it's. I mean, I wash my stuff regardless, but I'm at overly concerned about it. Someone heard that taking ibuprofen can actually bring on pneumonia quickly and they want to know if Tylenol is okay. So I think that's an example of how one thing is said one place and by the time the fifth or sixth person or the fifth or sixth blog mentions it, that gets twisted a little bit that if you take ibuprofen it brings on pneumonia. That is not true. Ibuprofen does not bring on pneumonia. Suppressing your fever is suppressing your body's immune response. So if you suppress your body's immune response to infection, you're going to suppress your immune response. The people that that makes a difference in, are you really sick? Not the 80% that get sick and get better, but the 15% that get hospitalized or the 5% that are in the ICU, those are the ones that if you suppress your fever it actually increases your risk for mortality. That is dying from this Tylenol as well. The one article that people or the Canadian, it was the French minister of health basically recommended not doing ibuprofen about two weeks ago.

Backed off on the who.

Yeah. Who backed off on that. Yeah. The problem is the literature that they were using was sound that actually taking immune suppressors, taking things that suppress your body's ability to feel, make antibodies. And that's what's happening when your fever goes up. You're making these things called Cytokines from the TH1 part of your immune system that then spills over the TH2 part of the immune system. You make antibodies. So you're literally suppressing your immune system. When you do that, for most people, not a big deal. But if you're one of those sick people in the ICU and you have sepsis, taking Tylenol is associated with a decreased risk of leaving the hospital alive. So I would just say what I personally do with the fever, I'll let them run. You worry about safety wise when it gets to be about 106. So if it's 103, 104, I would not recommend taking a fever suppressant. It's really interesting to think about in the west, you know, eastern medicine, Ayurvedic medicine, traditional Thainess medicine, they don't suppress people's fever. It's this western concept that a fever. It's this western concept that the way your body was adapted and created to have a fever, fever to fight off infections and viruses is a bad thing. That's a very western idea. It's a very modern idea. Anyway. Does hydroxychloroquine with azithromycin help with COVID and how can you get yourself some. So the initial research with the azithromycin and the zinc was actually in the test tube. So the first thing is that it was not in actual patients. The initial research that was being looked at in South Korea was actually in test tubes. It was published in France. There's currently a physician in New York who says he has about 6, 6 to 700 patients of experience. The problem is that's now anecdotal experience. So it's test tube clinical experience, and he's an outpatient provider. The question is, in the hospital, what's the success rate with people in the hospital? Because of 80% of people outside the hospital who get this. If they're all going to get better anyway and you give them azithromycin and hydroxychloroquine or zinc and they get better, well, the answer is they would have gotten better anyway. The bigger question is, in the hospital, if someone gets these, do they get better? And the answer is, we don't know. We have some anecdotal evidence. My concern is that people start buying this up on the outpatient. So now all my people are asking me for me to write this for them. And then when sneeding the hospital, it's not available. So I would say this should be reserved for, for practitioners in the hospital who are having sick patients to use. If we start using this in outpatient, for the 80% of people who will not engage the healthcare system, it won't be available for the sick people in the hospital. So now a twist on that is there are natural things that act like hydroxychloroquine and chloroquine. They're called egcg, which is a green tea extract. They're called quercetin, which is a onion and apple extract. And those things, the same research that was used in South Korea to show that hydroxychloroquine increased the zinc in the cells, also showed that quercetin did the exact same thing. So I sent something out, put something out on Facebook a week or two ago. I forget now. It's been kind of crazy. I think it was two weeks ago with a list of things that boost the immune system. And one of the things on there were these ionophores, things that act like hydroxychloroquine that are natural. And guess what? If we find out four weeks, six weeks, five months from now that the hydroxychloroquine, the zither myosin was a bad idea because it can increase your risk for lethal arrhythmias called prolonged QT interval. So if you have a heart issue that you don't know about, it could potentially give you a fatal arrhythmia. So you're not going to have a side effect from onion extract or apple extract or green tea extract. So I am currently using that for myself, my family and recommending people to use that. If you want the actual protocol, it's available on Facebook.

Quercetin also helps with seasonal allergies.

Oh yeah, great point. My wife put a great point. Quercetin also is a mast cell stabilizer. So if you have seasonal allergies, I will also actually I'm taking quercetin right now personally for my seasonal allergies as well. So if you have allergy issues, a great thing to take for seasonal allergies.

Just really quickly, someone made the point that Dr. Zelenko, the guy who was using those things, was only treating patients over 60 and those with medical issues.

So just back to your saying, okay, great. So he was only doing it in people that are high risk, but outside.

Of the actual hospital.

Yeah, again, in most of those patients are going to get better regardless. Someone also asked a question about chronic inflammatory spine syndrome and should they do anything extra in regards to that? For those of you who don't know what chronic inflammatory response syndrome some people refer to as chronic mold illness or chronic Lyme or fibromyalgia or chronic fatigue. It's basically this umbrella for a lot of people with innate immune system activation that can be caused by anything as obscure as Red Tide, Pfiesteria and ciguatera to something like mold in your house, which accounts for about 80% of it. So if you have CIRS, you automatically have detoxification issues, you're going to have vitamin C deficiency issues, you're going to have connective tissue issues, deficiencies in glycine, glutamine, your collagen based amino acids like proline, lysine. So you can have a lot of nutritional needs that whoever your functional medicine practitioner you're working with is should be addressing those. So you have a lot of extra needs. Vitamin C is one of those. Quercetin. Actually a lot of my mast cell patients I will use quercetin. Something else to use. But yes, if you have crs, you're going to already have your foundational nutritional deficiencies, stress on your body, inflammation is already going to be there. And there are some concerns with cytokine storm. Well, part of CIRS is your natus immune system is activated. So your TGF beta 1, which is a cytokine is elevated. So you already have a certain amount of cytokine dysregulation so yes, you have an increased risk. Hopefully you're working with a functional medicine practitioner that can walk you through how to deal with that because you are at increased risk. So those are all the questions I had. I know before. So I'm gonna put that piece of paper down and start answering some of the questions people are asking live.

Okay. If hopefully everybody can hear me. Okay. I realize on some of the videos I sound like I'm yelling because I'm like wanting to make sure everybody hears me. So hopefully. Sorry, I have to scroll to get to the questions. Are people with seasonal allergies in any worse position in regards to COVID 19?

No. More likely to get confused with having something, but you're not more likely to get an issue. Actually, there's some interesting literature. If you have seasonal allergies, you actually might be less likely to get certain infections because that part of your immune system, the TH2 part, is up regulated. But vitamin C for your allergies, curcumin, which I didn't really mention a whole lot because it boosts glutathione, quercetin. So those are all things I'd be taking right now. And they will also help with this as well.

So I usually take an herbal supplement for my allergies and I have been unintentionally stockpiling it and we can't find it anywhere in the house. So I've just been doing the quercetin and curcumin, like little combo with some stinging nettle tincture. It's working great. Okay. Mark Hyman had mentioned that if you're overweight, you're three times more likely to die. If you get the coronavirus.

This is.

What someone feels like they read from him. I haven't seen that. But. So if someone is under 50 but 80 pounds overweight, how would.

Yeah, that is actually true. I don't know if we actually posted that article on social media, but obesity by itself, because its effect on your immune system is associated with increased mortality from COVID 19. So that is absolutely true.

Okay, does. Hold on, let me read the actual question. So a lot of people have been walking outside, but they're kind of like gathering in groups and not staying, you know, the recommended six feet apart. Since they're outside, do the particle, like, does the aerosolization still last the same length of time as it would indoors? What's your.

The short answer is we don't know because all the studies are done in a controlled environment where there's not a lot of laminar flow, not a lot of airflow. So the long answer is outside is much better. The UVA radiation from the sun is a natural disinfectant. It kills parasites, viruses, all kinds of things. We actually use it on our farm to sterilize cow feces so that the cows don't give themselves parasites. The wind actually is going to actually disperse things even better. And right now in algae season, there's actually larger particles in the air. And so the larger particles that this gets attached to, it actually falls out quicker. So I'm still going to say, you know, the six feet distancing, all that kind of stuff. But outside is much, much better. Better. I mean, you can't get any better ventilation than all the air around your body moving. And then the sun is a very, the sun is a very, very powerful antimicrobial. When you look at things like ozone, you look at things like hydrogen peroxide, they're basically creating an effect that the exact same effect that's created by the sun's radiation, UVA that actually sterilizes.

So, okay, does it help to wear a mask out in public?

Absolutely. If you go out in public, you're not wearing a mask, you're kind of sort of asking for it if you're in a store and that's where you get exposed to the aerosolized air in the store. So you should definitely wear a mask in public. I would also advise gloves. And then when you leave the store, wherever you are, you just throw the gloves away. If you don't have access to gloves, just make sure you wash your hands when you go from location to location. But right now, if you're out in public, you should be wearing a mask.

How do steroids impact the cytokine storm issue?

Steroids are used to treat cytokine storm. If someone is actually admitted to the hospital and has a thing called systemic inflammatory response syndrome or sirs, we'll use steroids in antibiotics to quell it down so they survive. The problem with steroids is that steroids as an anti inflammatory also increase your risk from infection and dying. From COVID 19 we think that might be one of the reasons why Iran's having a lot of issues with the mortality there because in that culture they use lots of methylprednisolone for anti inflammatory aches and pains. So yes, these steroids will help with SIRS, but it'll increase your risk for COVID 19 death. So if you don't need them, please don't take them. But you could use curcumin acts just like it does way so much more than prednisone or steroids. So if you're taking it for aches and pains or other non medical reasons, maybe try curcumin instead. High doses, 1,000 2,000 milligrams, up to 10,000 milligrams a day of curcumin has actually been studied to be safe. And that's a great, great. I use it with a lot of my rheumatoid as well as regular old arthritis patients, connective tissue patients, and it works really great. So if you're using it for a non medical reason, maybe switch to that because that will also boost your glutathione levels and improve liver detoxification and do all kinds of great stuff for you. Cool.

Okay. Recently heard that heating food in the Microwave may kill Covid19. Is there any truth to that? Should we be concerned about takeout food anyway, packaging concerns aside, those are kind of two questions.

Yeah, I'm not. I've noticed. See anything about microwave radiation killing COVID 19? We don't typically use radio waves for sterilization. We usually use either light, like uva, ultraviolet light. We use something, electricity to create ions. But not microwaves. The microwave does superheat the food. I'd be more concerned with the microwave actually decreasing the nutritional content of your food, making your food more inflammatory. But it's not going to. It's not going to really. The food heating would actually. The good point. I'm sorry, I'm just thinking out loud here. I'm actually. You'd be less likely to kill stuff microwaving it than you would cooking it. Because microwaving it, it's only going to heat things for a very short period of time versus if you heat it on the stovetop, you would actually be heating it for five to 10 minutes more. So if you're trying to kill the bacteria and stuff, I would probably recommend more using a stovetop or something like that. What was the second half to the question?

Sorry, Second half was should we be concerned about takeout food anyway?

The takeout, the places I've been doing takeout, there's like one person the front desk and one person the back making it. It's not 20 people, it's not a full restaurant. So I would say, I mean, should you be concerned? We should always be careful. But I would not be that concerned about it because there's the places I've been, the restaurants are doing takeouts, maybe two people. If you're talking about fast food that you still have a whole service appeal back there, then you might be more worried about it.

Okay.

Some of these questions, if I haven't thought about them before, you might see me just thinking as I'm answering them because I haven't obviously thought about every single answer to every single question.

So you kind of answered the wiping everything down question already earlier, but I think sometimes somebody came on a little bit later and just asking if you leave items outside for several days, do you still need to wipe them down? You kind of already answered that. Two other answers.

Well, you're probably talking about boxes or things being shipped to you. If they're outside for 24 hours, by definition, cardboard, you're fine. Obviously, if in the light, even better. But then I answered that before. If you go back and listen to the thing I talked about, basically spreadability and effectability on things coming from cellulose objects like cardboard, it's much the chance of spreads much, much, much less than if you're touching a non porous thing like metal.

Use the masks or should you throw them out? I'm just asking because they're difficult to.

I mean, I'm going to tell you right now we have in our medical office we have 83 employees or 80 some employees. We have a lot of employees and we do not have a new mask for every person every day. So people are reusing their masks and we actually purchased an air ozonator with a little bag. And so we'll put our masks, I personally put mine in every couple days for about an hour to the ozone to sterilize it. But I think you're okay to keep on using them because the reality is everybody is people don't have infinite supply supplies of these masks. So we're using.

Are we using another person just joined and is asking again about ibuprofen, increasing your risk of getting the virus or making it worse or taking some allergy meds. And it's in some of them.

The short answer, I answered that before. Short answer is yes, it does. If you want a longer answer, just kind of listen to this. Once we're done.

Is it better to go to the store and be in the infectious environment or do pickup in which someone else is touching all of your groceries?

It's an issue of exposure. So one person spreads this to 2.5 to 3 people. So if you're in a store where you have 20, 30, 40 people, by definition, your risk for exposure is much greater than if someone's just packing something up and giving it to you. It's Just that's right now. That's, you know, right now we're seeing. I talked about this yesterday a little bit about the spike we're seeing right now. I think part of the reason that we're seeing a spike right now is after when this all started two weeks ago, everybody went to the grocery store, everybody got in a line for two hours and got exposed. And so I think we basically just got a super inoculation and we're now seeing that spike up. It's going to take another week for us to see if the social isolation from two weeks ago will be in effect. But we're still going out in public, people are still going to stores and getting exposed. So that's the biggest issue is this to going in places where other people are.

Okay, sorry, I'm responding, I'm responding and writing to one of the questions. See the other questions.

Hold on.

There's more, but somebody asked about an N95 mask versus a KN95 mask. K as in what's the military? K?

K. There's law abbreviations. Could you, could you, could you specify that a little bit, please? There's a lot of different masks. There's level one, level three masks. So if you could specify that acronym, it'd be helpful, I think, if you have a mask using it. I mean, the reality is right now people just don't have access to masks in general. So even the sir, even the cheesy surgical masks that aren't the best.

Oh, it's a Korean mask. Oh, there's a lot of mask stuff going around. It's a little hard to keep up with different, with the different things some people are actually being with. I saw another one today, which I'm not going to mention because we haven't.

Researched it, but yeah, the N95 basically refers to particle size that's removed and then the other numbers refer to the media itself. And so not it just says Korean, the Korean. So but the N95 is just. It removes particles to a certain size and that's what you're looking for. I have a HEPA filter. Patients who've seen me in my office recently seen coronavirus air filter. It filters down to 0.3 microns. And the particles for the COVID 19 actually attached are 0.6 microns. So literally the HEPA filter I have is 0 as I'm filtering out those particles from the air. So that's where that, that in 90, the 95 part comes from is how small the particles are filtering out. And so with the Surgical masks. Yeah, they are getting some stuff out, but if you have someone else has a surgical mask, you know, let me refrain. You gotta wonder why Japan is not having as much spread as, as we are in other countries. And there's more stuff coming out about that. There's more stuff, but one of the things is there's, there's every year mask up. I don't know if you remember seeing pictures in the past where it's flu season and pretty much you'll be on a plane or a train. In Japan, everybody's got masks on. I was this past weekend, no one had a mask on. I did not see a single person with a mask on. I saw one person with gloves. In America, we just don't do a really good job of personal protection in public in general, compared to other Asian countries.

Are people with diabetes more susceptible to getting COVID 19?

You're not more susceptible to getting COVID 19. We're all going to eventually get it. 70%. You're more likely, if you get it, to have complications from it. People with diabetes, hypertension, obesity, those are the specific chronic illnesses. They are definitely, if you get it, complications, ultimately we're all going to probably get exposed. Between 70 and 80% of the population are going to get this thing. So. So make sure you're managing your diabetes as best as possible. The higher your sugars, the more likely you are to have complications. Same thing with hypertension, obesity. The larger. If your BMI is over 40, your risk for complications are much greater than if your BMI is over 30 versus 35.

So, okay, I think we got all.

Of the, got all the questions. Okay, well, thanks a lot for everybody for coming out. Hopefully this was helpful. Hopefully this information, the reason we're doing this and keep on doing this is almost, it's like our way of giving back. It's our way of contributing. And I usually don't pay a whole lot of attention to social media. I usually don't pay a whole lot of attention to newspaper articles about medicine. I usually, personally, I just do the research myself and go to PubMed and go to the original sources. It's been really interesting for me to see how literally we can have someone talk online about chloroquine using that for treating it, and someone somehow takes fishbowl cleaner, passes away from it, and then all of a sudden it's like, oh my gosh. You know, it's like, it's just amazing to see how things are being. Are being. Everything is so based on what's. What I'm looking for just, just the shock factor that people are going scared and there's been a lot of misinformation out there. So I'm hoping that this is a more level headed, more reasonable source of information. People can get their questions answered. At the same time we can all just kind of, you know, keep our head in the games and stay healthy and be safe. So with that note, if you have additional questions, you know, please feel free to push them on to social media. If you're looking for information about functional medicine, functionalmedicine.com will have a lot of resources. Food planning guides, there's even resources as far as books, reading books. If you want something to read to learn about this kind of medicine.

I got one more that just came in that I think would be worth mentioning. Just because the longer the distancing goes on, the more this type of thing could happen that people might need to know. Someone's son had an emergency appendectomy or I guess this would be any kind of emergency. Obviously he had an emergency clinic in town. He was the only patient there at the time. To another hospital, to the or and then he was discharged two and a half hours after surgery from or recovery. But they didn't tell them to self quarantine or anything based on the fact that he was in the hospital. What do you think about that? Or how should people handle it if they're in a situation where they have to be hospital or visit the hospital?

With that logic, every person who works in the hospital would have to self quarantine. At the end of the day when you get admitted to the hospital, the people you're interacting with are washing their hands, they're wearing their devices, they screen you before you came in. When you get your surgery, everybody's scrubbed down, cleaned down. So if you're just going in for a routine, not routine because everything routines closed down. But if you're going in for an emergent thing, you leave. You shouldn't have to. Obviously if you have your appendix removed, you're going to be at home for a while regardless. But you have to realize with that logic, then I would have to self quarantine every day after I come home from work and so would every person in the hospital and that's obviously not happening. So if you were to develop a fever, the incubation, the average incubation period for this is like five to seven days. If you were to develop a fever, then, hey, you know, you should probably get self quarantined, maybe get tested. If it's available in your area time, but otherwise I'll just say rest, sleep, get lots of bone broth, you know, chicken noodle soup, coconut water. Get your vitamin C. All my patients after surgery I usually have them do glutamine, vitamin C to help help with healing. Works actually good for scarring as well, but keep that immune system boosted.

I'm laughing at chicken noodle soup because we don't usually eat noodles.

Yeah, we don't eat noodle. My wife's like we don't actually do the noodle part, we just do the chick and the broth part. But most people just have the noodles in there. We just usually do other things. So with that note, thanks for coming out and we will talk with you later. If you have additional questions, keep on posting them as updates I feel are appropriate. I'll be keeping keep on making those as well and if there's anything you want to hear about, let us know as well. Otherwise, I hope you all have a great rest of your afternoon. Take care and be safe.