COVID-19 Update 03.18.2020

Sunday. So I've just been thinking through a lot of stuff. I've been reading a lot of research I've been doing, and tonight's just more of like a brief overview. We've had a lot more people start following us in the last week. And so a lot of things I've talked about since beginning of February, a lot of people aren't aware about. Please look at the last videos we've done, a lot of numbers, a lot of information. Please look at the social media resources that put out there. A lot of those have data and information about studies. I put a newsletter out today, so if you're not signed for that, please sign up for it. So this is basically a brief overview. So pretty much everybody who's, you know, hopped on board can be called to date, plus or minus one. Things we're starting to add in is some question and answer sessions and we've been getting literally hundreds of questions on social media and it's become so much we can't answer them all. So we're trying to do is condense what people are asking, have a little bit of Q and A time at the end of this tonight and when I do the lives, but also probably be doing once or twice a week just answering the questions people are putting out there. I know there's a lot of misinformation out there. There's a lot of misinterpreted information out there. So the hope is this, this will inform people, help you make right decisions. It'll empower you that there is something you can do about this. It's not just simply waiting until the next government, you know, mandate or whatever happens. You can actually take charge of things and take care of yourself, take care of your families. This is actually an opportunity for us to step back from society and culture. A time to rest, a time to sleep, a time to eat real food. A time not to be running around and focus on ourselves and our families. And that's kind of how we're taking it with our family. But you have to be informed. You have to know what's going on. So just gonna do a quick overview. You know, back in January when we started following this, a lot of numbers were questionable as far as what was going on. People started asking me questions and that's what led to me to start researching this so I can give people some actionable, actionable data. What we saw, though, in December when this started in China was basically non communication with the outbreak in China and the rest of the world. So there's about a four to six week lag, most people say four week lag between the identification of this new SARS COV2 virus that now we know as COVID19 is the disease. During that time, China became a cedar, so to speak, for other countries and this spread to South Korea. Now the difference between what South Korea did and what China did, South Korea very quickly started testing massive, massive amounts. So you look at some of the literature on the number of mortality in South Korea, you don't see the numbers as high as other countries. And one of the reasons for that is that they've tested so many much that if the number on the bottom is really high from tests, the number on top, when you divide things out for death rates, the percentage becomes a lot lower. And that's kind of what's happened in South Korea. One of the things you'll hear a lot about is flattening the curve. And initially the curve was skyrocketing in China, but after about eight to 12 weeks we've seen it flattened off. And literally since the end of December, sorry, end of February till now, there's only been between 3 to 4,000 new cases in China. They literally have shut down as of today, all of their hospitals, they built all the hospitals. They, you know, I think it was six, maybe they threw up. They're all closed now. They've actually been able to contain it. So same thing with South Korea. They've actually, through isolation, through advanced lots of testing, through isolation, distancing and quarantine, they've been able to control this. And so it went from there to Iran. Iran is a very interesting case because we don't really have good information for Iran. We have video, we have solid images of what appear to be mass burial sites, but we just don't have reliable data from Iran, just like initially we didn't have reliable data from China. There is some speculation that we're not getting the full, the full story of things going on in China right now. But the fact that they've actually closed down those hospitals, they've changed their focus from treating disease to now blame shifting, that that's very strong, that they've actually got things under wraps regardless of what other some of the suspicions are out there. And so after it spread to Iran, it then went to Italy, which is what's going on right now. Now there's a lot of interesting things about the Italian case. First, Italy has the oldest population in Europe and as most people know by now, this is spread very easily among the elderly. And they get it Pretty, pretty bad off. The other thing is Italy has a large trans generational household system. What that means is grandkids are in the houses with parents, grandparents, so it's the perfect setup for vector spreading. The other thing about Italy is their population is mostly major, major areas and they travel a lot and the country is relatively small. So it's basically a perfect, perfect environment for rapid spread. From Italy it's gone through Europe again, China to Iran, China to Italy, then Italy through the rest of Europe. And we've gotten some seeding from China. Now one of the things we did very quickly on the front end of things about a month or so ago is we closed travel to China. What we did not know at that point in time is that we were getting spread from Italy. It takes about incubation, as most people know by now, is three to 14 days. There's been speculation as far as longer, but most people develop symptoms within five to seven days, which is one of the reasons why England made the recommendation for a 7 day quarantine initially. They've changed that recently, however, but the point is that it takes about that long for cases to pick up. And so the result was that there's some spreading going on even with Italy, to the rest of Europe. Every country in Europe is doing things differently. And this is very instructive to us to see how Germany, who, they've had 12,000 cases but only 28 deaths. So that's a great question there. Why has Germany had so many cases and so few deaths? To me, that's actually very, very reassuring. Something else that's very reassuring is the fact that in the United States we probably have over. Well, the lowest estimate is 50,000 cases in the United States right now, probably closer to 100,000, which puts our mortality rate closer to 0.7 to 1%, which is, you know, still pretty high, but not as bad as the South Korean or the Chinese rates. And so right now we're seeing the United States become the current epicenter is England, I'm sorry, Europe. And we're seeing it basically start to spread throughout the United States. One way to think about the United States, it's almost like it's like Europe, you have your Washington state, you have your New York City, which is having a big uptick right now. But the biggest thing to do is pay attention to your local, local area. I'm in Virginia and so I'm paying attention to my local department of Health to see what's going on in Richmond, the Virginia state. But we've what we're seeing finally is the uptick. Now one of the things I've been talking about over the last two weeks is eventually we're going to see a huge up spike as we test. Several days ago they talked about putting out about 1.4 million test kits throughout the United States and starting to do lots of testing. In my area in Richmond, we have not started any mass testing kind of yet. The only places and here you can be tested or in the hospital if you're getting admitted, every place will be a little different. But most places are following the CDC guidelines in the United States, which is hospital based testing, you have to be sick. There are some drive through test sites that are opening up and that's actually very reassuring because I feel like we need a big. We didn't know how many people are out there. And that's one of the things that South Korea did really, really well is they tested extensively and once they tested people and had positive cases, they basically isolated the people that are positive. If you were sick, they quarantined you and everybody did social isolation. So that combination of testing, finding who had it and saying you're out of the public picture. Then people who are sick and got hospitalized quarantine them and everybody else doing social isolation. South Korea did a great, great job of keeping this from taking up a lot. And that's what we're trying to do here. That's the reason we're shutting everything down. It's not because we're expecting mass deaths which are what people are worried about. I'm hopeful that the German data and the South Korean data are more accurate. And if we do indeed have 50 to 100,000 cases, we're going to see the mortality rates not quite as high. But one thing I've been saying since beginning of February on is we just don't know because we this virus that as far as know did not exist before December. So literally this is something that didn't exist four months ago. And we're learning so much. You know, one that one of the things I'm seeing a lot of our experts out there talking about this and the people that I'm reading at the research I'm looking at basically the only expert. There are no really experts, just people that are focusing on this and studying on it. We'll have experts in two or three years. Right now we're all students of this thing. So the new epicenter currently is Europe. Denmark has done some interesting things. Where Denmark initially was just isolating the elderly population, they've now Done mass isolation. Same thing in England. Everybody's basically adopting, isolating people with cases, quarantine those, testing people in isolating, quarantine those who are sick, and social distancing, which is probably the best way to stop this in the track. Now, there's been some question out there. How does this spread? According to some, Angela Merkel in Germany, she's expecting maybe 80% of Germans to get this. In England, they're expecting probably 70% of people to get this. The question is, when do we get it? Do we all get it once? Over the period of six to eight weeks? And which is the concern? That's the mass hospitalizations, or is it spread over two to three seasons? That's what happened with H1N1 that came out. A lot of people got sick, got concerned. It became a routine part of the routine vaccination. And now no one really talks a whole lot about it as much because it's in the routine vaccine and most of us have already been exposed to it. So what we're trying to do now is slow this till summertime. These RNA coronaviruses typically slow breeding. When it's warmer, it's more moist. That's one of the reasons we think we're not seeing a huge uptick tick in the more moderate climates. And so we're trying to push it off, slow it down as much as possible so we can spread this off, let it burn out a little bit. In the summertime, if 25 to 30% of us get sick, we become the roadblock, so to speak, for everybody else. And when it comes back in the fall, we have a buffer population that's not going to spread it. So if the current R naught, which is how many people you spread this to. So if I get sick, I can spread to 2.5 people. Well, if one of every three people is immune, that becomes a buffer. That's one person who. That's one of those 2.5 people to three people that get exposed who can't spread it. And so every time there's a new outbreak, we get more buffers until the point in time where not as many people are getting this. Typically, for influenza, in any given environment, about 25% of the population in a local area get the flu. Most people don't very infectious. But what happens is when you always have these things cycling out, there's always a buffer population so that you don't have massive numbers of people getting that particular illness. The thing that's unique about the COVID 19 or the SARS COV 2 is that this is totally novel. No one's seen this before, so no one has immunity. So we're trying to get people immunity, spread it out through isolation, realizing that it's already here. And again, we will see a big uptick probably in the next two to four weeks. England is expecting to hit their peak in 10 to 14 weeks. So we don't know here. I'm just using their information. So I'll say 10 weeks. Let's see. So what that means is we haven't even started yet. Actually, we're at the beginning of everything. We've already seen a massive uptick in the last day with our numbers and expect that just to continue to go up. This is a good thing. This means that the people who are getting hospitalized and dying from it are all getting tested in the hospitals. So as the number of people that are walking, the walking will get tested. That's very, very encouraging. So the mantra is test, isolate, quarantine, and social distancing. And that's what we're doing right now. The best thing you can do for yourself and your fellow Americans, for your classmates, whatever is, is the social isolation. Hopefully we'll have enough test centers up that once we can start testing, if you feel you're sick, you've got a fever, you're cold, you've got a respiratory tract infection, you can get tested. And if positive, you can then self isolate and then or self quarantine. And then obviously the people that are in the hospital will be taken care of there, and that will hopefully break this whole cycle. But that's what they did in South Korea and that's what we're trying to do here. So what are things you can do for yourself? Well, the first one I want to mention is social distancing. The second thing is testing, which we're still waiting on that hopefully there'll be a place close to you soon. There's not one here in Richmond. There is in York, Virginia, that I know of. Walmart's made some talks. Cleveland Clinic has started one. There's several hospital systems that are starting that. But again, something you have to look at in your local environment because every place is going to be different, and that's what's different about or what's going on in America as well as, say, France. Literally the president of France, Marcon, can say, mandate something. They're literally using the military right now to help control this. That's something here in the United States with states. The states kind of control the federal government is A blanket. But the state's enacting things. That's where just staying in touch with what's going on in your local environment. So social distancing, testing, the next thing is boosting your immune system. Now, there's been some debate out there. I've heard a lot of. I've heard several people say there's no data on this and no data on that. I just want to talk about data real quick because all data is not the same. When people tend to refer to data in the scientific world and they say there's no data, they're usually referring to randomized placebo controlled trials. Those take years and years to put it together. Typically between bench research and when you have a drug that's approved for an indication like COVID 19 or whatever, usually it's 15 to 20 years before that becomes a standard of care. So when people use this term, no data and they say they're referring to our randomized placebo controlled trials. Yes, there's absolutely no data on that because this has literally only been around for four months. When I refer to data, I'm referring to bench research on sars, for example, which is another coronavirus. I'm referring to laboratory cell culture research from China and South Korea, referring to literature on vitamin D and how to boost your immune system with tuberculosis and other influenza like illnesses. Okay, there's now somebody posted it. Okay. Someone just posted my wife to show me a thing that now there's now COVID 19 testing here in central Virginia. That'll be posted. That's fresh right now. You're seeing it live. Isn't this great? Isn't social media great? We can learn stuff as it's literally popping out and you sell it live here. Now we can test. Five hours ago. It's five. Five hours late. Five hours ago. Oh, this is. This is killing me. Five hours. Wow. I was behind the times. But so when I talked about research, I'm talking about, you know, bench research, clinical. I am talking about some population research like for example, with vitamin D and tuberculosis influenza outbreaks. I'm referring to some bench research using zinc and culture to actually block the spread of coronavirus from cell to cell. And so that's what you have to be careful when people say there's no evidence or, you know, X, Y, Z. I heard one expert talk about, you know, the only thing that there was any Data on with COVID 19 was, was using vitamin D. And the next thing he literally said was he did not have a full nutritional evaluation. So it's kind of hard to to say. There's no literature about something that I actually have never been tested for myself. The other thing about it is that all apples are not the same and we're not comparing apples to apples when we talk about that. So, for example, on the website I put things out there with vitamin C nac. We've been using N acetylcysteine for respiratory tract infections since I was in Medical School in 1996 for people with cystic fibrosis, for example. I use it with my patients with pulmonary fibrosis as well. So there is data in literature. But the biggest thing that I want to focus on, the immune boosting things, is these are all really safe. The worst thing that happens if you get too much vitamin C is diarrhea. The worst thing that happens if you get too much NAC is gas and bloating. So you want to boost your immune system. Now, one thing I did talk on the previous podcast is the most important thing for boosting your immune system is sleep. That's it. Sleep. Getting that eight hours of sleep a night. And now with most of us being off, except for the. Well, I'm still working because I'm a healthcare, I'm a doctor, and we're still. People have to keep open ups, factory workers, a lot of people are still out there. But sleep is a big thing. Diet has always been important for your immune system. Half of all chronic disease in our country can directly be related to eating processed foods. My second and third podcasts that are available on itunes actually talk about diet, nutrition, how it boosts your immune system. We've known about that for a long, long time. So this is a time for those of you who want to do the new thing, Your new Year's resolution, start fresh, start new. Work on your diet, work on your lifestyle, sleep. Work on relationships, family relationships, marital relationships. Spend time with your kids. This is actually the time that we're kind of maybe being forced to do the things we've always wanted to do but been too busy to do. Now we've got a little more time. Stress reduction is a huge, huge thing for your immune system. Chronic stress can increase your risk for chronic infections. I've seen people with shingles, I've seen people with pneumonias from flu from just not sleeping and stress. So work on boosting your immune system. Diet, exercise, sleep, the immune boosters. And on our website we have lots of resources for these things you can start doing at home. Meal plans, you can download and start doing things at home. But this is a time, in my opinion, for us to kind of reflect on our lives, to be informed, to be aware, know what's going on. But use this as a time to better yourself and get prepared. Because right now the reality is most likely you have not been exposed yet. And so get ready because you will be exposed. Whether this outbreak, whether one the fall. And this will probably be like H1N1, H2N3, H3N1, and all the other flu like things that will kind of keep on going back around. Those are my quick thoughts for today. There will be a few questions. Can you speak to how you use clinical. Okay, how do I. So one question was, how do I use my clinical expertise to make recommendations?

Since we don't have randomized.

Since we don't have randomized, double since we don't have the data, how do I use my clinical expertise? Well, first of all, you know, anything that boosts your immune system is a good thing regardless. Okay? So that's the standard recommendation I also make in the past done a lot of research on nutritional deficiencies and chronic diseases, autoimmune diseases, and ultimately the effect of a viral infection. The COVID 19 is actually an immune dysregulation. If you're young and you get it, you tend to have this acute respiratory distress syndrome, which is an immune dysregulation. If you have immune suppression, you get a secondary pneumonia. And so ultimately 80% of people get exposed to this are going to be fine because their immune system is working well. So a lot of the clinical expertise is looking at other things I've used in other disease conditions, other infections, chronic monitor, chronic Lyme, people who've had immune immune system suppressed. Some of my cancer patients who have low natural killer cell counts related to the underlying cancer, what boosts that so they can actually have a better chance of surviving their cancer. So it's kind of literally 20 years of clinical experience and then you kind of hone it in to something like this. And that's kind of where I get my personal. That's where the advantage of being a, you know, working with a clinician who has a lot of experience but also reads a lot. I mean, the best you can learn from books, but the, the best source to learn from is seeing patients and seeing lots of them. So. So my. We're adjusting a few things here. If you're moving Instagram pooped out. Okay, so if there's any questions out there, I'll answer one or two. Otherwise, our plan is to try to keep people up to date, this is like the last. Okay. My wife told me I would go answer questions. This is the last general thing I'll keep on doing, like, what I was doing before, while I was just updating from time to time. This is more for people who haven't.

This was the only questions. Presumptive positive or whatever.

I mean, if someone's in my office. Well, in. In office, in a workspace, like, if someone thinks.

If someone thinks a co worker might be positive for this, what should they do? Like, and they've been exposed.

Well, if you've been. Well, you can't. You have to. You have to find out. You can't just assume every person. This is. We're still in flu season. Allergy season here in Richmond's acting up. Someone has a cough who feels kind of cruddy. If you assume all those people have this, then basically probably 20% of the population right now in our area is going to be, you know, positive. So, you know, if someone's acting cruddy, you know, talk with them, have your boss talk with them. They should. If you have a fever and you have a cough, then most likely you have to assume they need to be out of the workplace. If you've been exposed, the best thing you can do is boost your immune system. If everybody. And that's one of the reasons why we're doing this whole mass self isolation is so all the people that got this initial exposure can pull away. They can see who's sick, keep them out of the system, get them tested and get people back to work. And that's kind of the reasons why we're doing this. So. And we'll see how it works. So there's no other questions. We'll call it a night.

Okay. There is a question.

There's a question.

Somebody. Instagram is really not doing very well, I think for. It's just really glitching out on Instagram. I'm not sure what happened.

Instagram's having issues for some reason. Instagram always has issues.

Let me end Instagram real quick, sorry, Facebook and the other ones and see if we can get them back because there's a bunch of people who.

So every other Instagram has glitched out. We're trying to get back with them so they can answer questions and then we'll. Sorry, we're gonna end at 9:30. We're ending two minutes at 9:30. I need my sleep because I'm kind of tired. So. Actually, some patients were asking me today if I was tired, and I'm Kind of like, man, if I look that bad, then I need to get some rest. Actually, I guess my wife said a few people were worried about me too on social media. So that means I need to get to. I need to be in bed by 10. And you all should too be. If you're in the eastern time zone, you should be in bed in time to get a good night's good eight hours rest.

Okay. You can just tell Instagram that you were just chatting.

I was just chatting on Instagram, Yeah.

Trying to get Instagram back, guys. So if anybody seeing this, they're not on yet, but.

Okay.

All right. So the. There was one question which was just, is it okay to take NAC with Singular and Zyrtec?

Yes, it is okay to take NAC with Singular and Zyrtec.

Do you want to explain what it is again?

So N. Acetylcysteine, known as nac. Some people may have heard it as mucomist. It's the prom. It's the bio body's rate limiting amino acid for boosting glutathione. Glutathione is the primary extracellular. I'm sorry, it's the primary intracellular antioxidant in your body. So it basically helps fight infections, has antiviral activity. If you had cystic fibrosis, when I was doing my training in 1996, we would actually give people cystic fibrosis, which have chronic terrible lung infections. They would inhale it to help fight off infections. I also have patients with pulmonary fibrosis who use it for the same thing. So I've been using it orally for my, you know, my chronic patients with respiratory issues with really great, great results and some really interesting literature that it has antiviral activity as well as helps decrease your risk for upper respiratory tract infections. So that's one of the reasons why I'm recommending that. There was an actually interesting article looking at NAC with it's coronavirus activity, not COVID 19, but another coronavirus, like a typical coronavirus. So that's what NAC is.

When. If someone presents with a pneumonia, is there a way for them to tell the difference between the cause of it? Like if it's from influenza or COVID 19 or.

Well, pneumonia is a general term. You can have viral pneumonia and you can have bacterial pneumonia. And so I'm assuming referring to bacteria, viral pneumonia, which is both lungs, you can't really tell what's causing that. If it's flu, the flu strip will be positive if you get them in time. If it's more than three days, you might not the way. If someone's sick enough to be admitted in the hospital, that's how you're gonna figure out if it's COVID 19. Most people with viral pneumonias get better, but without the test, there's really no way to chill. Right now what's happening is they're basically testing for viral flu and a bunch of other things and strep and chest X rays and blood count, everything's fine. Then they're presumptively assuming it's a coronavirus COVID 19. And if the patient does not need to be hospitalized, they're just going home and self quarantining. That's not the best way to do it, but that's what we got right now. But as of five hours ago, we do have a test center in central Virginia. So actually I'd recommend that person getting tested. We need data. We need people that have not just feel cruddy and aching of allergies. We need people that actually have a respiratory tract infection with a fever to get tested so we can actually get good data on how prevalent this is. So with that, you can keep on asking questions on social media. What we'll try to do is compile those and answer those probably on another session. They'll be just me answering questions. They'll be live as well. And so if there's other questions to answer, we'll answer those. But stay safe. Find a good source of information you trust, stick with it, be encouraged, don't. There's a lot of. This would be really. This is a life changing event for us. No one alive that I know of has ever seen this before. Unless you're. You have to be like 110 or 11 to even remember it. So we just got to take this with stride. There's gonna be a lot of sacrifice on everybody's part. A lot of personal sacrifice, monetary sacrifice. We have to have to come together to analysts, help each other out. But don't become dismayed. We've gone through hard times before. We'll get through this. It's just we're at the beginning of it and people are getting really excited. One of. I was talking to someone who is, you know, his daughter was concerned he's gonna get sick and die at work. And I just kind of felt sorry for that child that she was actually worried enough about her parents. So we just need to support our kids, support our families, support each other, stay informed, know what's going on, and we'll get through this. It's where it's gonna be. It's gonna be interesting. But we will. We will. This, too will. Will pass. Have a great night.

I'm popping on really quickly. I'm hoping I can get in the camera. This is. I'm his wife, and for the Instagram people who got cut off sort of in the middle, he didn't really say anything. He was more just talking while we try to get you back on. But in case anybody missed anything, there's also going to be links on YouTube or you can go over to Facebook, and hopefully the whole thing will be there. So just in case anybody is like, I missed part of. That's. That's it. Hi.

Have a great night.