COVID-19 Update 03.25.2020

Welcome back, everyone. I'd like to do another update on COVID 19. What's going on locally, nationally, internationally, as far as research, as well as give you some ideas of things you can do to help yourself and your loved ones, boost your immune system and give you some more actionable data so you can take charge of what's going on. So first and foremost, currently most of the news media right now is just focusing on the national, state and local authorities. What we're doing in response to the COVID 19, there have not been any significant updates as far as new expectations. Have been a few drug updates as we all talk about briefly. But mostly the news has been what are our leaders doing to help protect us? Basically is what's been going on the last several days. There was a new research article published looking at a vaccine called bcg. Now, some of you all may know what the BCG vaccine is. It's a vaccine that's been used overseas for decades to help prevent tuberculosis. And the way it works is it actually activates our innate immune system to fight off infections, mainly tuberculosis. An interesting research article was recently published showing that those vaccinated with this vaccine, as well as with the measles vaccine, actually have lower incidence of mortality from the COVID 19 infection. Most of this is coming from China where they actually use the BCG vaccine. This vaccine is not currently used in the United States. Multiple other studies coming out. One of my local universities is starting a russonavir drug study soon using one of the oral antiviral medications. Hopefully that study will be going. Some vaccine studies will be launched this summer. Then there's a big controversy with the chloroquine hydroxychloroquine. The Virginia Department of Health actually sent out a letter to practitioners to appropriately use that medication and not give it out indiscriminately. Some of you all may be aware of a couple who heard about the chloroquine and, you know, consumed basically fish tank cleaner and resulted in the death of one of the individuals. Be careful with what you're hearing. There's so much information flying out there. If you hear something that sounds interesting, verify with 2, 3, 4 sources. Talk with your practitioner, your personal doctor, physician. Don't just jump on the bandwagon of what the most recent thing is, because in the case of the couple out in the west, it might be lethal. Another good advertisement for you finding a good, reliable, dependable source of information is that you can refer back to. Hence I'm continuing to do these videos. So what is going on right now in our country. We've been talking about the spike that we're expected to get. There's controverting information about when we should expect the peak. There's actually a website called covidactnow.org that you can go to and you can actually look and see when your local area is expected to have their peak in Virginia according this site. It's already off actually because according to this we would have already met our peak incidence in Virginia, which we as far as hospital capacity, which we have not. But it's showing, you know, May 2nd being the peak if nothing's done currently with, with the virus as far as isolation, quarantining, etc. I'm going to, I'm still sticking with the original data that I talked about several weeks ago and that we're probably expecting a peak in our country anywhere from 8 to 11 weeks. Again, these are moving targets based on how we respond, how the quarantine, social isolation is going. Ultimately that cannot last forever. We can't cut everything down for three months. There has to be some kind of response to things. And that's what I want to talk about a little bit is our response. So numbers wise, when we think about this, something I've been quoting over and over again, about 80% of people that get this infection, we either have no symptoms whatsoever or will have a mild respiratory tract infection. About 20% of people will need to interact with the healthcare system with the doctor, get hospitalized and about 5% will go into an intensive care unit. So what we've been focusing on is slowing that peak, slowing the 20% getting exposed and needing hospital intervention. We've also been trying to increase the capacity of, of that 5%. You know, how can we make the hospital be able to take care of more individuals? Because to have a 5% load right now into the IC units would overwhelm the system. So we're trying to do is increase personal protection equipment, increase physician healthcare system. A lot of the Vanderbilt, there's an interesting thing with them actually taking their parking garage and turning it into a hospital bed area. So there's a lot of things we're trying to do to either slow the 80% getting exposed to help improve our capacity for those that are actually sick. But one thing a lot of people have not been talking about is that 20% in the middle. Why do only 20% of people get significantly, moderately to significantly ill and what can we do to bump that 20% up? Now your first question might be why is that Important. So if you can imagine 80%, if we can take the 80% of people that have no idea they're sick and increase that to 90%, okay, then the 20% of people that are really ill drops to 10%. All of a sudden we've cut in half those needing hospitalization and interventions in the healthcare system. And we're not quite sure about the 5%, but if we just decrease that by 2 or 3% then all of a sudden 3% versus 5%, we had almost a 30 to 40% increase need for intensive care units. And that's what I want to talk about right now. How can we make more people able to boost their immune system so that we have less people getting sick and needing to interact with the healthcare system? I think that's something very important to think about right now. Our governments are focusing on improving personal protection equipment, face masks. We will have to go back out in public again. And the best way to prevent spread would be through everybody getting their own ppe, which we're working on right now, extensive testing we need to test so we can find out who actually has the virus and keep them out of the public sphere. And then antibody testing, which is being working on right now. How can we find out who has had the virus already? The reality is anywhere from 100,000 to 300,000 people in our country have already had exposure and are developing immunity. If we can find out who those people are, then we know you're already immune, you know, go back to work. So that's what we're working on. The middle part I'm talking about is the 20% of people that we say are going to get sick. How can we make that number less and boost up the number that have no symptoms? And that's where it comes down to immune system age, how old you are, nutritional status. Why is it that some people get exposed and have no symptoms and and some people get exposed and die from it, you know, even young people. And that's what comes down to their people's innate and acquired immune systems or antibody production. So what I want to do is just go over some information I was looking at the last couple days in regards to this and most likely will be posting this information as well as the articles mostly will pull from PubMed as well as a NASA, NAS, National Institutes of Health. So I'm just going to walk through these briefly and these are things we can kind of think about doing to boost our immune system. Now one thing I want to think about as we go through this is the phrase food is medicine, food is medicine. And so when we talk about vitamin A, vitamin d, and why 80% of the population is D deficient, why, you know, 40 to 60% of the elderly are zinc deficient, that comes down to nutrition, food, our diet, our nutritional habits. Ultimately these boosting things of a D and all these other things I'm about to talk about come back to if you have a poor nutritional diet before something like this happens, you're playing catch up. And that's one of the goals here, is to give you some tools because this will be here for a year or two. As most of us already know, things will slow down, most likely come summertime and while the second period peak in the fall. So what are things we can start working on now? So first thing I want to talk about is vitamin A and other carotenoids. Now, vitamin A is a vitamin. It's actually a pro hormone. So it's not an actual hormone, but it looks like a hormone. It interacts with our immune system. It helps balance the two arms of our immune system, the TH1 and TH2. So that kind of comes into your cell mediated immune system and your antibody media immune system. So if you get exposed to something, your body has to eat it up, kick out the parts and create antibodies to the parts so you can boost your immune system. That's like the interaction between the two of those. Low vitamin A is associated with impairment in that handoff in that system. It's also associated with more diarrhea illnesses and overall increased susceptibility to infections, especially GI tract infections. Higher rate of complications from infections like measles and tuberculosis. Vitamin A also supports our body's phagocytes, which are cells that eat up foreign invaders. It supports them in their job. And if they do their job well, they actually kill invading cells or infected cells, that is virally infected cells and boost our immune system that way. Also, age related immune system immunosuppression is associated with low levels of vitamin A and non vitamin A carotenoids. So some of those non vitamin A carotenoids, those are astaxanthin, zeaxanthin, lycopene, lutein. These are things in your yellow, orange vegetables. Astaxanthin is something you get in krill or salmon. When you eat the orange and salmon, that's actually astaxanthin. And then vitamin A itself is a very red, red color. The standard dosing for vitamin A runs anywhere from 5,000 to 1,000 units a day. Kids, you have to dose Based on age, weight and nutritional status. Vitamin A is one of the nutrients that you can't overdose on. So be careful, be cautious, consult with your practitioner first. And something I forgot to mention at the beginning, as always, anything I recommend, this is just educational information only. You should always talk with your healthcare professional to individualize anything for yourself, including chloroquine and other things like that. You gotta make sure you're doing things the right way. Vitamin E is another fat soluble antioxidant that helps protect your cell membranes. Low vitamin E is associated with an increased risk for certain cancers. High vitamin E intake has been shown to increase the that TH1 immune system again which then later boosts your body's ability to make antibodies. It's really important in older people who have immune systems that are suppressed. There's a lot of animal studies looking at vitamin E. Improving your body's ability to clear influenza virus, herpes infection, virus, particularly from your brain. There's also some information that if you combine vitamin E with vitamin C and has an immune boosting effect, especially in the elderly. Something of note, you've heard me say that with both E and A. These are important in the elderly. And the elderly tend to have more deficiencies in A and E. Or individuals who eat lots of processed foods or processed oils. Because these two fat soluble vitamins typically come from our diet. Either plant or animal sources of oils. Depending on. Depending on your diet. Vitamin E, the starting dose typically for adults is anywhere from 200 to 400 units daily. You want to make sure you get a good mixed carotenoid. I'm sorry mixed tocopherol supplement that has your alpha beta gamma tocopherols as well as tocotrienols. And in kids again you want to base it on their weight, age and nutritional status. Most kids can about 50 to 100 units. And a lot of these nutrients for kids you can get in a basic children's multivitamin vitamin C. We've been talking a lot about vitamin C. There's a lot of information. Evidently New York is now using IV vitamin C and some of their very sick patients in the intensive care units. Vitamin C has been shown to have an immune boosting and antimicrobial effect. High doses of vitamin C can actually have antiviral and anti inflammation as well. Anti cancer effects as well. Vitamin C is one of your body's primary antioxidants and boosts glutathione levels. Vitamin C has been shown to increase your T cell response which is part of your white cell immune system as well. In combination with B cell and antibody response, vitamin C has been shown to increase your body's antibody production. There actually was a case report several years ago of a patient with ATP H1N1 who basically was dying from H1N1 from the respiratory disease. And using IVC therapy, that patient was able to recover again. That's anecdotal, but if you get enough anecdotes, it becomes standard of care eventually. There's been studies showing up to 80% response rate in a combination of vitamin C, E and selenium. And the doses for this particular study were a thousand milligrams of C, 1,000 units of E, a little higher dose, and 200 micrograms of selenium in patients with severe pneumonia. One word of caution with vitamin C, however, is that it can increase iron absorption. So if you eat vitamin C with a lot of red meat or a lot of green leafy vegetables, you can actually get iron overload. So usually when you're taking higher doses of C, you want to take them on an empty stomach. A standard dose of iron, vitamin C, is anywhere from 1,000 to 2,000 milligrams twice daily. Kids can do 200 to 500 milligrams daily. The biggest side effects from vitamin C are diarrhea, GI upset. The next combination of nutrients is actually a combination of vitamin B6, folic acid, and B12. Now, many, many nutrient deficiencies can cause different kinds of immunosuppressive disorders. I chose this grouping basically because they work really well together and there's a lot of really good data in regards to that. Vitamin C deficiency has shown to decrease white blood cell maturation, growth and antibody production. Even small insufficiencies can have a profound immune effect, especially on that th1 th2 balance I referred to a couple of times. Low levels of B12 directly correlate with lower levels of lymphocytes or white blood cells and lower antibody titers and responses to infection. And folic acid is very important for DNA replication, DNA creating RNA and messenger, your messenger system in your body, and DNA expression. So those three are very strong combination and can usually be gotten with a B complex of some sort of that has about 500 to 1,000 micrograms of B12, 400 to 800 micrograms of folic acid, and about 50 milligrams of vitamin B12. Vitamin D, we've been hearing a lot about that. Vitamin D is another. It's a vitamin that actually. It's actually a hormone. The way we named the Vitamins, you know, vitamin A was the first one discovered, B was the second, C was the third, D was the fourth. And later we found, found out that vitamin D is actually not a vitamin cell hormone that's on every cell in your body. When your blood levels of D are less than 20, your body can't actually fight off certain bacterial organisms. It's hard to fight off when your D level is less than 20. And when your D level is over 30, you actually have a decreased incidence of respiratory tract infections. And we see that seasonally. During the Spanish flu of 1918-19, we saw an increased fatality in people who had lower exposure to UVB light, that is sunlight. So the correlate was they had lower D levels and thus an increased susceptibility to Spanish influenza. We've also seen there's this thing called the cytokine storm that's been out there, floating around some news as well. And Those who have H1N1, SARS, CoV2 or other similar corona type viruses have an increased risk for the cytokine storm and vitamin D on your monocytes, which are one of your white blood cells. Those actually help mitigate or reduce the risk for cytokine storm. In conjunction with C and E, Vitamin D greatly reduces the risk of the cytokine storm in animal models as well as in studies. Retroactive observational studies looking at populations, individuals who had this cytokine storm. The starting dose is about 200 units to 500 units daily for children with D. And then based on age, anywhere from 500 to 2,000 and nutritional status. Adults usually need about 2,000 to 5,000 units daily. Let me repeat that because that was a little confusing. Adults need between two 2,000 to 5,000 units a day of vitamin D. Kids about 800 to 2,000 units a day, infants 800 units a day. And obviously if someone has low levels, they'll need more of that. Zinc is another essential nutrient for rapidly dividing cells. So cells in your GI tract, cells in your lung, anywhere you have a fast turnover. Skin zinc deficiency can be associated with poor skin, poor poor hair, chronic diarrhea, all these things. Zinc giving during a vaccine. So if you get a vaccine and you have adequate zinc levels, it actually improves your body's production of antibodies to that vaccine. Zinc deficiency also increases your risk from sepsis if you have a bacterial infection. And even mild insufficiencies of zinc can be associated with a suppression of your T helper cells, which again are part of your immune system. They're usually associated with your Innate immune system and the cells like your natural killer cells, macrophages, those cells that eat other cells and then present these to the B cells to make antibodies. That whole process requires zinc to work appropriately. Low levels of zinc are associated with inflammatory response and increased susceptibility to infections such as E. Coli as well, which is a common. Every year or two we have an outbreak of E. Coli from someone eating tainted food. So low zinc can also increase the risk for that kind of reaction as well. Adults want 30 to 50 milligrams a day of zinc. Children anywhere from 10 to 20 milligrams daily. And it's based on nutritional stats. With kids it's a lot easier to overdose, so you always want to make sure you're not overdosing children. Again, talking with your healthcare practitioner provider, testing levels to make sure they're adequate is always the best practice. Selenium is the last nutrient I want to talk about briefly. That's really important for both your innate and adaptive immune system, without which both arms of your immune system don't work properly. So if you don't have enough selenium, the part that the most basic part of your immune system, the innate, won't work appropriately and then the acquired part, which is that makes the antibodies won't work appropriately as well. So selenium is really super efficient. Deficiencies of selenium have been seen to be associated with microorganisms ability to cause more disease called pathogenicity. So you could be exposed to the same thing as I'm exposed to. If you have an adequate selenium level, you'll be less likely for that infection to create disease than if I was to get exposed to the exact same thing. A dysregulated immune response as well, and increased inflammation we see associated with lower selenium levels and in animal models, in mice, Listeria, which here in Virginia we had some issues with listeria in some of the schools this past year. Low selenium has been associated with an increased risk for severe illness from listeria. So selenium doses for adults are usually 200 to 400 micrograms daily. Children, it's based on your immune status. So cytokine storm is something we've heard a lot about. So what cytokine storm is we have this balance in our immune system between innate acquired, between cell mediated and antibody mediated immune system. And one of the things, the way these cells talk between each other are with cytokines. So cytokines are chemicals, messengers that talk between cells that regulate our immune system. And the storm is literally what sounds a storm. It just, it's overreaction. And so your body can actually kill itself through over response. You can get too much inflammation, you need some inflammation to keep yourself healthy. Not enough inflammation means you can't fight off things. And too much means you actually attack yourself. And that's what cytokine storm is. And it looks like sepsis. It looks like you have a severe infection, but it's actually not infection, it's an immune response. The more and more dysregulation you get, the more and more ill you can become. And we're now realizing that this cytokine storm, which for COVID 19 is being referred to as acute respiratory distress syndrome or ards, we're seeing that that's actually related with a lot more deaths than we originally thought. So I remember back in my training back in 2000 seeing this thing called acute respiratory ar, I'm sorry, acute inflammatory sports syndrome. We didn't quite know what it was, but now we know it actually is our immune system's overreaction to something in the environment. And so the cytochrome storm can happen more when we have deficiencies of A and D and C. It also was seen. So there's some interesting data looking at the cytochem storm with vitamins D, E, magnesium and even flavonoids. Flavonoids are those plant colors, those plant chemicals that give oranges their orange and grapes their grape color and the blues, those actually help ameliorate and regulate your bias inflammatory response to infections. So what's the point of all this? The point again is if you can begin the appropriate nutrition and boost your own immune system, then when you get exposed, maybe we can get more people, go to that 80 and make it 80, 85 or 90%. If that's the case, we can actually significantly, significantly decrease the burden on the health care system. These are things you can do. No government organization, state or local municipality can help you boost your immune system. Right now again, we're waiting to see the state's response with all the flattening of the curve stuff slowing spread and then helping keep our hospital systems from being overrun. The reality is come a year from now, about 80%, 78% of us will have been exposed to this. So we're not going to stop us from getting it, we're just going to slow it and give us time to prepare personally through boosting our own immune systems, allow localities by bumping up their ability to take care of people and then finally at a national level. How can we prevent something like this from getting our country again while we're navigating all this? Hopefully that was helpful. I will continue to put updates out there. Hopefully we're posting this and some maybe some other articles about immune system regulation for those of you all want to get more into the data and have some more reading resources while we've got some time. Anyway, take care, be safe and we'll talk to you soon.