Updates in CV: Preparing for a New Phase—Part III Emerging Treatment Options

You. It's great to be back with everybody once again. And so, as we continue talking about how do we treat this disease, what's our plan for the future? I want to continue to just talk about COVID 19 and just help us to start thinking about a little differently. Now, for those of you who don't know who I am, My name is Dr. Aaron Hartman. I am board certified in family medicine. I'm also board certified in integrative and holistic medicine, certified in functional medicine, and I'm a clinical researcher. I've been doing research for about 10 years. I've been the principal investigator for over 60 different studies and even published in Lancet. So what I want to talk about is a little bit is transitioning our thinking about COVID 19 and how we treat this. In my mind, this is the idea of functional medicine and integrative medicine coming to the common consciousness. The American people, many people aren't really quite familiar with functional medicine or integrative medicine, but basically it's individualizing care to people based on their own environment. It's repurposing medications. It's using anti parasitics like atovaquine or hydroxychloroquine to treat chronic illnesses like Lyme disease or chronic viral infections. It's using IV vitamin C for people with chronic illnesses, chronic Lyme mold related things, dysautonomia, pots, et cetera. It's using zinc to help people with prevent prostate cancer. It's all these things that's our wheelhouse. That's what we've been doing for years and years and years. And so it's kind of exciting to me and a lot of other functional practitioners to see this evolution in medicine in our country be accelerated by, by this. Not that we're excited about this disease per se, but it's now people are realizing that this kind of medicine, practicing individualized medicine, is actually out there for people to grasp. So hopefully this will help transition us to thinking more holistically as we move through the summer and into the fall. Because the chatter and the data with all these individual articles and all the news media thing is overwhelming people. And the big picture is there are things you can do that aren't complicated, that can boost your immune system. There are things you can do to help with your health, and there are things you can do to prepare yourself and your family for phase two and phase three of this illness. So what I want to do is really quickly review what these phases are. Phase 1, 2 and 3. Phase 1 is basically the pre Infection phase, when you get infected, there's a time before symptoms, in phase two. Now in phase two, that is 80% of people will not need any kind of interaction with the healthcare system whatsoever. Of this group, about 20% will go on to phase three, which is admission to the hospital, and ultimately about 5% will go into the ICU unit. So I think it helps us visualize a little better what we're trying to do with this 80% that have been successful immune system, when they get exposed to this virus, they, they suppress it. Half the people have no symptoms, they get a runny nose, they're better, fine, we're done. The 20% that need interaction with the hospital system, that's where a lot of these repurposed medications come into play. IV, vitamin C in the hospital. One of the things we're trying to do in the integrated functional medicine world is how can we get this 80% to 85%, how can we boost people's immune system before exposure, before infection, so that if exposed, maybe only 15% of people need to interact with the healthcare system, and if they do, they'll be more likely to survive. So that's kind of one of the concepts and topics of these repurposed medications of nutraceuticals, of cellular treatments, using things to treat people's cells and immune systems. That's kind of what we're talking about, and that's what more people are aware of now. So this is actually becoming common knowledge. And I want to remind us really quickly about the numbers. Australia is in the southern hemisphere and they are, appears to be getting out of this, but they're in lockdown. So as they get out of lockdown, this will start coming back up. But you have to realize they are now entering winter. So expect to hear about peaks in Australia. Same thing for New Zealand. They've done a great job. Actually, you can't see active cases in New Zealand. They've done another. They've done a great job as well with this. But again, expect peaks as they enter their fall time frame. These are active cases in the United States and we're seeing this flattening out as well, which is where we're at. And that's the reason why we're ready to reenter. That's the reason why in it makes sense to gradually and in a controlled fashion let the young, healthy people out, get that 80% out there, get them exposed so we can protect the 20%, so we can protect the vulnerable. Again, United States is above Europe in cases you all know I Like to watch this one a lot. The United States represents one third of all the world's cases. That's something to keep in mind as well as we talk about all this. Most of the action now in the world is in the United States. We, we have to realize that it's also a lot of the progress, a lot of things that are happening in research and studies are now, have now shifted to the United States. That's something else to keep in mind as well. Daily cases, again, we flattened out newly daily cases in Sweden, we've talked about them before. Switzerland, we talked about them. The United Kingdom, we've talked about them before. The goal is everything is kind of evening out in the United States. We're seeing that most cases, about one third of our cases are represented in New York as well. Again, these are all starting to calm down and ease out and prepare us for the next phase, which is reentry. And this is where we are now. Prevention, sleep, nutrition. All these things that we've talked about that we put into our survival guide, which is available on our website. Things to make you a part of that 80% and make you more likely to be a part of the asymptomatic 50% inside the 80%. All the treatment things here we're looking at, those are helping that 20%, if you engage the healthcare system, help you increase your likelihood of getting better quicker as well as increase your likelihood of not needing to be intubated. Because we know once you get intubated again, mortality is super, super high. We've talked about hydroxychloroquine and remdesivir. Let's talk about a few of these others because there are some really interesting other treatments out there. One of them people have talked about is convalescent plasma. So what is convalescent plasma? Plasma. Convalescent plasma is when someone gets sick after they've recovered, you take their blood and you filter the blood out and take out antibodies. This is very similar to the immunoglobulin shot people get to prevent hepatitis A. Some people that have a suppressed immune system will do ivig, which is a immunoglobulins that they will help boost their immune system. This is specifically looking for the antibodies for COVID 19 to give to people and the hospital. Right now this is only available in hospital trials, so it's not available to the general population. This would be for the sickest of the sick for that people in the 20%, potentially that 5% that are in the ICU that we're trying to save their lives. Now, tocilizumab is one of many, many biologics. Biologics are very interesting group of medications. They're kind of like smart bombs. They take a part of your, your immune system, that inflammation for you. Those of you who are familiar with the cytokine storm, they take certain cytokines or certain cell mediators and focus on those. Tokolizumab is one that focuses on IL6 which has been implicated in the cytokine storm and COVID 19. And then here in Richmond, Virginia, there was actually a local vascular surgeon, Dr. Brown, who did a little YouTube about his experience using it and actually sounds like it saved his life from his perspective. Thing about this is that it's one of these repurposed drugs that I talked about before, but there's only case reports on this, so we don't have any randomized trials for it to date. It is used in the EVMS protocols. That's something I put out earlier as well that they're using. And some of the intensive care units, we don't have any trials yet to date being used, but it is being used individually based on clinical expertise of those in the IC units. And it's been used for well over a month. There are multiple other repurposed drugs as well. Thimotidine is something someone asked me about recently. The idea of using these H2 blockers like famotidine as antivirals is not a new concept. Back when I was in medical school, we were using Tagmet or cimetidine, which is the first of all these actually as a antiviral for people with, with warts. If you had warts that would not get better with treatment, you could actually use cimetidine to treat those. So the idea of using famotidine to treat a virus, specifically the SARS CoV2 is not a new concept. I think the thing here is that it has to be done IV and the doses are crazy, crazy high. So this is not something that taking oral Pepcid, which is what this is, would be useful at all. They're super, super high doses that can only be given intravenously and only in the hospital setting. So someone asked me about that earlier and I'm kind of responding to their question. But again, this is, that's how that can be used. But it's not prime time for outpatient use. It's only for hospital use for the sickest of the sick. And there's no, again, no RTCs or randomized trials on this we've already talked about different nutrients, vitamin C. There's lots of interesting data on vitamin C shortening hospital stays in the icu. It's been used for acute respiratory distress syndrome in the past as well as patients with sepsis and organ failure. Usually IV doses are 3 to 6 grams. IV usually be done every 6 hours with other vitamins like magnesium and B vitamins, something mainly in the intensive care units. But the question would be maybe, just maybe, could you use it outpatient to help help boost people's immune system? Great question. We do have data about vitamin D and they're actually research articles. These are in vitro, which means in a test tube, not in vivo, which means in a real person's body, but at least in test tubes. Vitamin D has actually been shown to fight off the COVID 19 virus. So you know, get your vitamin D level checked. If it's low, bump it up to an optimal range of 60 to 80. Zinc is another nutrient that actually inhibits coronavirus in vitro. Again in test tubes works great with quercetin and other ironophores like EGCG as well as hydroxychloroquine. One of the ways hydroxychloroquine works is by getting zinc into these cells to help kill the virus. Quercetin. There's literature on quercetin actually inhibiting eboli which if you all remember that the remdesivir actually was originally used for eboli and that's kind of how we had that ready to rock and roll was because we'd studied that with that outbreak years and years ago. N acetylcysteine is another nutrient. There's lots of interesting literature on using this to fight off flu like illnesses as an antiviral. It's been used in the respiratory care world for decades to treat patients with cystic fibrosis. And there's many others that I've talked about again in our COVID 19 survival guide that's available on our website for download for anybody who wants to take a look at that. So there are many nutrients that can additionally be used. But what I think my question is, what's the role of these nutrients? I think again this is more for stage one, early stage two people that prevention. And these are things that are relatively safe to take for prevention. Again, do that with your primary care provider, your personal physician. Don't do this on your own without direct medical supervision. That's my caveat to that. And there are other immune immunity enhancing interventions, hydrothermal therapy, something was used during the first well during the Spanish influenza outbreak of 1918. That's something we've talked about in previous videos of Finnish saw therapy. You have about a 50% reduced risk for respiratory tract infections in the wintertime if you actually do sonotherapy. There's interesting literature on that. Again, we've done that before. Placenta mesenchymal cells enhanced natural killer cells sleep and nutrition if you get six hours of sleep versus eight hours of sleep a night, you have a 400% chance increased risk for complications from a viral influenza or viral lung infection. Nutrition is a super super important to enhance your immune system. So this is where integrative and functional medicine now enter regular world. These are interesting things you can do to help with your own immune system. So in the last part of this I would like to talk about some of our new understanding of the SARS CoV2 infection, what it actually does in regards to reactive oxygen species, the inflammation that related in our body and actually other things we can do to help treat this situation. If this was helpful, please share with friends and family like us on Facebook, follow us on Instagram, Feel free to visit our website. One of the things we're trying to put together is a educational series of things for patients to treat themselves, to help themselves, to take care, to educate, empower and encourage people that we're going to get through this together. We just need the right information that can be applied appropriately to each one of us. Take care and have a great day.