Coronavirus Conversations - Day 14: Monoclonal Antibody Therapy and Treatment by Summer?

Well, hi everybody. Nice to see you all, as if I could really see you. But it's episode 14, update 14 coronavirus, and I'm gonna post something for you right now so you'll have it. And we're gonna first jump into the news, see what is exciting, what we've learned, and most importantly, what we can do with that information. Interesting, I met somebody today and his comment to me was really interesting. He said, you know, I don't know why this is such a big deal. I mean, I'm in good shape. If I get it, I'm going to be fine. Yeah, maybe you will be, but you know, the point is that we're all in it together and some people are absolutely going to be fine. And later in our time together today, we're going to explore why this is such a big deal in comparison to influenza. Every time we get together, somebody says, you know, this is just like the flu. Why the big deal? In fact, the death rate from flu seems to be higher. I'm going to tell you later on in our time together today why this is actually a lot more of an issue. So just posted something. What do you know? I'm the first person to post. And this is an interesting journal preproof, meaning this has been submitted for journal publication, but it is not yet in a peer-reviewed journal. Now what does that mean? Generally there is a time lag between when you submit a journal article and it goes through the process of peer review and then editorial review as well for content continuity, etc. So typically it takes months to get a good study— rather a study published in a good journal. So this has not been reviewed, but I'm going to talk to you about it anyway. And the title of the study that we are talking about today is SARS-CoV-2 turned positive in a discharged patient with COVID-19 arouses concern regarding the present standard for discharge. So here's what happened. This is a 54-year-old man who began feeling fatigue and mild myalgias or muscle pain. And on January 20th, he began to have a fever of 37.5 degrees centigrade, that's 101.3 degrees Fahrenheit. So he went to a clinic and underwent an evaluation. He had a chest CT scan that showed what's called ground glass appearance. You know, if glass isn't clear, it's been eroded, like in the beach, you see it looks sort of opaque. That's the classic chest CAT scan appearance that you see in diagnosing COVID-19. His diagnosis was confirmed with a throat swab, which is like we are using here, nasal— nasopharyngeal swab, tested positive. He then was admitted. He developed what's called mild to moderate dyspnea, which means shortness of breath. His temperature went up to 38.3. And he had worsening of his chest CT scan appearance. So here's a man diagnosed, goes into the hospital, is deteriorating. So now they put him on oxygen at a rate of 5 liters per minute. That's a fair amount of O2. And he also took some what were called antiviral drugs. They didn't specify which ones they were, but it states symptoms weren't improved at all. This is happening in China. This is a report from China. He was then isolated and ultimately, interestingly, he was given chloroquine. Now you've heard quite a bit of talk about hydroxychloroquine and chloroquine, an antimalarial drug. Well, you know what? It looks like it's being used in China. Is there evidence that it works? I'm not sure. It must be or they wouldn't have used it or maybe it was just, you know, he was part of a trial. It wasn't disclosed. Nonetheless, he improved. He was discharged. He underwent— he had no more fever. He had the typical throat swab test for coronavirus that proved negative. He went home and then ultimately— but he was home and isolated. He came back for follow-up and again tested positive. So that tells us something very interesting. People, as I talked about yesterday, people testing negative and then testing positive. And how often is that happening? We don't know. What is their status when they are tested positive in terms of infectivity? Well, isn't that the most important question we could be asking? But I think it is interesting to think through this. Because it may tell us several things. We know that the testing has what is called false negatives, meaning some people can have the coronavirus test and they have it, and yet the test is negative. So maybe he was tested, had a false negative, but he actually was still positive. Maybe the technique for sampling him wasn't done appropriately, or maybe the antiviral drugs, which were not specified, that he was taking Might have had an effect on the testing that he received. Very interesting information. I will look for comments. Seeing a lot of comments from people around the world. Toronto, hello. Germany, hello. Let me move to our second interesting story. And this is playing upon— well, not— they didn't play upon it, but it amplifies something that we've talked about before. We talked about this type of treatment being thought of as being possibly something that may help And scientists at the Defense Advanced Research Projects Agency— so this is the Defense Department— are working to develop a therapeutic approach against SARS-CoV-2 using what are called monoclonal antibodies. These are antibodies that are raised in the body against the virus, amplifying those antibodies and using them as a treatment. I'll read from the article and I'll send you the link to it. Actually, let me do that first. So sorry, send you the link right now. And here it is. Okay, a U.S. military research program that seeks a new way to boost the body's immunity against viruses. So this is an established treatment for other viruses, could change how governments and militaries prepare for pandemics, and might even arrive soon enough To help with COVID-19 outbreak. DARPA's Pandemic Protection Platform isn't looking to create a vaccine to use to amplify your immune system, but rather— because they say that may take weeks to take effect in the body— rather, the goal is to identify specific, what are called monoclonal antibodies, antibodies our body produces against things like viruses. That the body naturally produces when it encounters a virus. Gee, I just said that. And then trick the body into producing the one that guards against a specific illness that could serve as a temporary, months-long shield that can protect the individual from the pathogen until a vaccine can be brought online. But these antibodies take a long time to find and discover. There's a long pipeline in the biomedical world to identify and test them and really understand these antibodies, says Dr. Amy Jenkins, who manages the program at DARPA. So again, the idea of amplifying antibodies and then giving them to an individual to help that person fight the disease, sort of something along the lines of what we've talked about before, where we actually take antibodies in the form of plasma from a person who is convalescing and who's had coronavirus and then administer that to other people. Now that we are seeing that some of the people who test negative may actually ultimately test positive, it certainly makes us think twice about the idea of harvesting plasma from people and administering it to others as a way of treating them. I want to give you what I find to be a terrific resource, and that is the New England Journal of Medicine now has a dedicated site area where they are collecting really the best research that is around in the world and making that available to each and every one of us. That's the— it's the www.nejm.org post that I just posted for you. And they— when you go there, you'll see an interesting article that I reviewed today. I think it was published today, and it's called Fair Allocation of Scarce Medical Resources in the Time of COVID-19. Now, what this article addresses is what are the ways that doctors are going to be able to allocate scarce resources like masks, like beds, Like ICU beds and ventilators. What are they going to do? Governor Cuomo in New York today talked about a kind of an innovative idea because, as you know, the, the worst issue happens to be that not enough ventilators are likely going to be available to keep people breathing when they are having a tough go with coronavirus. So he discussed what was proposed to him, and that is that people actually share a ventilator, that the air coming out of the ventilator with oxygen, extra oxygen usually mixed in, is split into 2 tubes that go into 2 patients. Well, you're going to be sharing a breathing machine with somebody, but you know what? It might be better than nothing. And it's a very novel idea. But kudos for being creative at a time like this. So interesting to think about that. Now I want to address this issue of scarce resources, and in the article there is a comparison chart. I'd like you to take a look at that. Look at the link I just sent. There's a comparison chart looking at various metrics of influenza versus COVID-19. Now, looking at moderate to severe cases of influenza, 64,000 for moderate and 64,000 for severe. And looking at COVID-19, moderate is considered 16,000 and severe the same, 64,000. So no real difference there. Let's talk about the number of outpatients For the influenza with severe, those numbers, I'm sorry, were million. I didn't mean to say thousand. I apologize. So the number of outpatients globally, rather in the U.S., sorry. This is the United States, our population over 300 million. So this is looking at severe. The number of outpatients influenza severe would be 32 million and severe severe COVID-19, 12.8 million. Well, you might say, gee whiz, the number of severe patients with influenza is projected to be less than COVID-19. This is now where it gets interesting. The number of hospitalized patients with severe disease, influenza in America, 3.8 million, COVID-19 number of hospitalized patients, Severe disease, 5.1 million. A big disparity. The number of patients admitted to the intensive care unit, United States, severe influenza, 1.2 million, COVID-19, 3.8 million. So a very large multiple of the 1.2 million, 3.8 million with COVID-19. That is, again, The number of patients admitted to the ICU. That's why there is so much concern about not being able to care for these individuals. The number of deaths projected from— for severe influenza is 510,000, and for severe COVID-19, 1.9 million in the United States. Now, There is an exciting new therapy or intervention that has been shown to be effective across the globe, and I want to talk to you about that right now. This is breaking news. When we look at countries that have now gotten this under control, it's so exciting. We've talked about this for the past couple of days that it looks like the rates are coming down in mainland China and in South Korea and to some degree in Japan. Wow. What have they done? Well, what they've done is they've really imposed some very strict restrictions on people being out and interacting with each other. It is working. It's been demonstrated. We see what this is showing. We're seeing the evidence right before our very eyes. how these countries are gaining a foothold on COVID-19. It's a very, very important lesson. It is a test that is in progress and we're already seeing preliminary results. The most powerful intervention we can do to stem the tide of COVID-19 spread is to socially isolate. We see it working now in various countries. Around the globe. So keep that in mind when we are told to, or people want to convince us that we should just go on with our lives and keep interacting with each other and not worry about our close proximity to other people. Yeah, we see how that's working out. It's not working out very well. We do see success now in the world in countries that are limiting contact. So with that said, hello Evan. Evan, great to, great to see that you've joined, and I'll say hi to your mom. Let me take some questions from everybody. Great, great. Just a lot of people just saying hi. Do I agree that COVID may last for 12 to 16 months? It may be indefinite. You know, we're learning that, you know, this may be a recurrent seasonal event. So that means that we've got to, you know, recognize that when we hear news that there might be a vaccine, it might be a year to 18 months out. Well, it's that, that time will come. And if we have a vaccine in a year, if this is a recurrent event, then that becomes very, very valuable. Nice to see you again. Thank you for— okay. Anyway, yes. All right. I'm looking for questions. I'm loving the comments from everybody and from— hello, South Africa. I see that rates are increasing there. I'm hoping that you'll put into play what we've been talking about. Okay. This is a great question. Veronica Berry. If a family member has been exposed to a confirmed case, what do we do at home? Excellent question. Here's what we've learned, what we've presented over the past several sessions together, is that person needs to be isolated, number one. Number 2, understand that there is the concern of shared air sources. So if you have the opportunity to close the air vents in that person's room and open a window, that might be something to consider. Measuring the air for the virus in a hospital setting has proven negative, but what they did show was 2 other things that I think are important. Number one, that the air vents were contaminated with virus, and number two, that the bathroom was contaminated. So we do seem to see some pretty powerful evidence that there is fecal shedding of coronavirus, which is not surprising. When we know that the binding sites on the gastrointestinal system cells do support binding of the virus. So if that person is isolated in a bedroom, that person might be able to get outside if there's a different exit, but I would say that person certainly needs to not touch anything if they're going to need to walk through the house and go outside. That doorknob needs to be sterilized. That person needs to make that trip when nobody else is nearby, go back into his or her room, and, you know, deliver meals to that person, and it can work out really well. I'd say that likely 14 days is what you need to do. That's about 96% likely of that person not manifesting the disease. The fly in the ointment, though, unfortunately, is that people can get the virus and have no symptoms whatsoever. Meaning that this idea of when we were screening people at the airports coming in by taking their temperature, that only would prove positive in about half the cases, meaning half of the people coming in who could have carried the virus would not have had a fever. Kind of a long answer for that question, but I think some important points. I think I have the virus, but my temperature is always 97. I have chills My temperature goes between 97 and normal. I would love to be tested, but no fever. Yeah, in an ideal world, you could be tested. You could have a cold, you could have a rhinovirus, you could have influenza, but you could have coronavirus as well and not have a fever. You can have— it's— you can pick and choose. Well, you can't, but the virus can pick and choose how it manifests in each and every one of us, and certainly you could be without a fever or afebrile. 3 people I know in their 60s and a 75-year-old tested positive, recovering couple at home and single woman assisted living in Issaquah. Yeah, I mean, that's, that's great, and that is not unexpected. Most 60 people, 60 And even 75 are going to recover and probably not need hospitalization. It's those, you know, those 10% that we worry about that get severe disease, or even 20%, generally the 20% of the population that gets severe disease. So those are the ones that we worry about. When I say the 10%, those are the 75-year-olds, percentage that actually may succumb to having this infection. I was wondering if you or Dave Asprey would be doing a cast. Tomorrow. Who knew? We're recording tomorrow. I don't know when Dave is going to publish that, but we're gonna do a— we're gonna do a Zoom video, and then I think we're gonna do an Instagram video thing as well for, I think, an hour and a half is scheduled. Ontario is quite strict. Yes, how encouraging it is that the City of Toronto has 50 million masks stored away, like, you know, for a time like this. Okay, hi from Toronto. I'll take a couple more questions and then gonna have to go, got things to do. Thank you for the daily updates. I'm very, very appreciative that you guys are paying attention and like these, I'll continue to do them. Okay, what is your take on black elderberry? We've really covered that quite a bit. The research on elderberry does show that it does have efficacy as it relates to the common cold, a rhinovirus, in terms of shortening the symptomatic period. The post that we put up the other day shows that there is a huge disparity between in various products in terms of how much actual elderberry extract is contained in various products. I can't imagine necessarily it would harm, so there you go. Would Mucinex help? I would think it may very well. We hear some good things about Mucinex. I've never actually tried it. My go-to, not to be brand-specific, but I will be, is Vicks NyQuil. Certainly it's about as far from a natural supplement as you can imagine. It has about a million ingredients and I can't pronounce half of them, but you know what, it works for me. So there you go. I've been on hydroxychloroquine for several years to treat autoimmune disease. We know that it's used in rheumatoid arthritis, as a matter of fact. Evidence might help prevent COVID-19 or reducing chance of needing to be hospitalized. Don't know the answer. So we really need data on hydroxychloroquine to be able to answer that question. We know it's being studied and also interestingly heard today that doctors are writing prescriptions for themselves to hoard hydroxychloroquine. That was on CNN in their news feed. Okay, John Stark, thanks for the update. Okay, advise people not to fast would be disastrous if we go from pandemic to famine. Not sure what that means. I would say, Judith, that if you're not sick and you have your doctor's approval, fasting is a way to perhaps augment your immune system. So something to think about against something to discuss with your healthcare practitioner. I enjoyed fasting with whoever of this group fasted with us. I think it was Sunday. We fasted until Monday evening, and we know that that might be beneficial, a low-grade stress to our bodies, hormesis, to augment immune function. The other thing that I discussed in, I think, episode 8 perhaps, was a nutritional supplement called Fisetin, F-I-S-E-T-I-N, a flavonoid compound that does show some senolytic activity, meaning it does tend to help us rid our bodies of senescent or old, poorly functioning immune cells. How effective it is, I don't know. That is one of the supplements that I am taking right now. You can buy it online. There are many brands. Hello to North Carolina. Okay, let me take a couple more questions and then I'm going to need to sign off. I would want to tell you all, please feel free to share these Facebook interviews with others if you think that they're helpful. I see that a lot of that is happening and I appreciate that. Hi David, would you explain why someone has corona with no symptoms? Is it due to a more robust immune system? Likely. I would say that they're keeping it in check. We certainly know that that happens more with younger people. So Rob, and I know you as Robbie from the day, it's a very good question. It really kind of feeds back to what I just mentioned about fisetin, and that is trying to reestablish a more youthful immune system by using that supplement. Fisetin may work also by fasting, but also making sure that you're paying attention to sleep and getting outside, experiencing nature, all the things we talked about in the Brainwash book, all those things that are good to help you Also importantly, distance yourself from impulsivity and self-centeredness. That's part of the brain that gets locked— you get locked into when there's high levels of inflammation, as in not eating well, not getting enough sleep, and all those things. So it's really now so important to pay attention to our lifestyle choices. And hey, you know what you might do that you might enjoy, especially you, Rob, I'm talking because I remember by your garage you used to have a little planter there and you used to plant vegetables and things because you were going to be a farmer, as I recall. And so I would say that that's a good thing to do. Go online, buy some seeds, get some dirt, and grow something. It'd make you feel good. Are babies at risk? Interestingly, while we saw a report of a 12-year-old having severe disease, actually being into an intensive care unit. Kids are doing exceedingly well with respect to having coronavirus. Game changer, sense of smell. Yes, James Myers brings that up. It is something that was brought up just yesterday, that loss of sense of smell— Sanjay Gupta brought that to our attention— might be an early indication Okay, asthma. Not sure what the question is, but if you're on a corticosteroid inhaler, recall what we talked about, I think it was yesterday, that the time that you revert back to negative in terms of your COVID testing can be significantly prolonged if you're on steroids, according to a recent study that we, I think, reviewed yesterday. Yeah, I think so. Yesterday. Western Colorado, hello. And you know, it's, it's all great if you guys want to go back and forth and ask each other questions, and I'm gonna look through and just take a couple more, and then I'm gonna need to sign off. Just hearing Jennifer Nichols saying a 7-month-old in South Carolina was diagnosed. Yeah, I mean, I think we're gonna see this, but You know, it's certainly very rare. A lot of people have subclinical glucose-6-phosphate dehydrogenase deficiency, or gene Mitros G6PD, most common enzymatic deficiency in the world. Oh, okay. And don't know if— and the chloroquine would be contraindicated. That's a good thing to look up. I think it might be, and I think people who have G6PD deficiency probably already, or they should by now, have a list of the various drugs that they would be at risk for taking or increase their risk by taking because of glucose-6-phosphate dehydrogenase deficiency. That sounds like I'm saying a lot, but if you have G6PD, then you know what I'm talking about. Okay, well, let me take one last question from Eric Miller. What was the supplement name again? It is Fisetin. F as in Frank or Foxtrot, Indigo, Sierra, Echo, Tango, Indigo, November. For those of you who know the phonetic alphabet. Oh, How I Love Summer by Susan M. Gilbert. Though May did bring her deepest gray and June did bring her gloom, I woke this morn in a glorious way to sunshine in my room. Quick, get up, it's time to rise. Greet the day, I started to cry, for today it has begun. It's finally here, the summer sun. Feel her warmth. See my garden grow, taste the sweetest fruits, watch the butterflies flow, hear the squirrels chatter and my orioles swoon till evening comes with the summer moon. It seems like I've waited such a very long time, longing for the light of your rays of sunshine. So please stay a while, bring your long lazy days I'll cherish each blue day and ride every wave. Oh, how I love summer and all her songs. Happy summer to all, and may it be long. And I'm going to just say that in closing that, you know, there is the sense that perhaps summer and heat may be helpful. We don't know yet. We'll find out soon enough. Thank you all. I'll hope to connect with you tomorrow, but I may take an afternoon off. So if you don't see me on one particular day, it doesn't mean anything. Just means I took a day off, but I'll try to be here tomorrow. Bye for now.