Coronavirus Conversations - Day 20: Considering Masks and Hydroxychloroquine Revisited

Well, hello everyone. Dr. David Perlmutter here. Can you believe it? We're at update number 20, but I guess, you know, it's going to be a large number when this is all said and done. It's going to be a great time when, when we're not doing this update anymore. So what are some of the developments past couple days? Well, I don't want to review the numbers. I think we're all quite aware of that. Had some interesting announcements. We learned from Dr. Deborah Birx. She is the White House coronavirus media outreach person, and she said something I think that was very startling for a lot of people yesterday. She said that we can expect between 100,000 and 200,000 deaths related to this coronavirus. But I want to just characterize that. She said that, that, that would be if, quote, we do things perfectly, end quote. That means that is under the best circumstances, we're going to have 100,000 to 200,000 deaths from this event. Let's do some math. There are 340 million Americans, right? If 50% of us get it, What is that, 170 million people? And if the death rate is 1%, that's about 1.7 million. We want that rate to go down and we can do that by changing our behavior. Are there some exciting things that we're hearing a lot right now with reference to treatment, in other words, being offensive? Yes, there are. We have just learned more about this combination therapy, the hydroxychloroquine, Chloroquine with azithromycin, which many of you know by the name of Zithromax, that you get in a Z-Pak. And in one very small study that was published, a collaborative study between China and researchers at Yale, just published, was determined that in fact at day 6 following infection, that 100% of the people taking the combination of those 2 drugs were virus-free. Again, it was a very small study. Taking just hydroxychloroquine in and of itself was associated with a 57% chance of being virus-free, and just placebo, or rather control people not taking the medications, 12.5% of those individuals were not shedding virus at day 6. So this sounds really exciting. I'm feeling excited about it, but here's what I want everyone to consider, and that is that we all shouldn't be jumping on the bandwagon if these drugs become available, and likely they will. They're not, they're not too exotic. I mean, there's Zithromax everywhere, and hydroxychloroquine is a drug commonly used for autoimmune conditions, for example lupus, so it's out there. But We've got to consider that this would not be, if it's proven effective, something that we should all do. And why would I say that? Because there can be some significant issues associated with either of these medications, and who knows what might happen if they were given in concert. We know, for example, that azithromycin, Zithromax, is associated with liver issues, kidney issues. Headache, nausea, diarrhea, things that may in fact, the latter 3, be associated with the actual infection itself. We know that hydroxychloroquine can be associated with heart rhythm abnormalities. I talked about that yesterday, but also vision loss, which is permanent. The heart rhythm issues may resolve when you stop taking the medication, but the change in vision, the visual loss, is a permanent event. So we should think about this in terms of the idea that everybody who thinks that they have it or has been proven to have coronavirus should absolutely jump on this hydroxychloroquine and azithromycin protocol. Is it being used? Yes, it is. Is it being used in hospitals? Yes, it is. And we also know that the antiviral medicine remdesivir is being used quite aggressively now. in trials using it for what we call— the company has given extended access to it. So no longer are they limited to just compassionate use, meaning only when somebody looks like they're just not going to pull through are they using this remdesivir. They've widened the scope now and using it in hospitalized patients who have a better chance at living. So there's some great things on the horizon that we're looking at, and we're hoping to see new developments as this research continues, along with lots of other developments. More research being done now in this amplification of various antibodies, monoclonal amplification ideas as well. So the idea of plasma transfer from a convalescent individual Looking like that may prove helpful as well, but let this play out a little bit. Just do your best right now to keep yourself healthy, keep yourself isolated while the experts are able to tease out what's working, what doesn't work. Then if that works, buys us even more time such that we can then be ready for a vaccine should that be available soon. I wanted to talk about the idea of mandatory quarantine or restriction of availability to go out and do things. It's being talked about in various urban centers around the country, and many local governments and even state governments are instituting much more aggressive isolation procedures. I think that's good. The consideration that's being raised has been, well, do people in rural environments need to have this level of isolation? And here's why my answer is yes. The likelihood of underlying medical issues which would be— pave the way for a bad outcome with coronavirus is much more likely in rural environments than in urban environments. For example, obesity in an urban environment is seen in about 29%, according to 2019 data. 29% obesity in the urban environment, 34% obesity in the rural environment, in rural America. More obesity. And along with obesity, which is an independent risk factor for more complications from this infection, but along with obesity rides things like diabetes and coronary artery disease and other Chronic degenerative conditions that also amplify risk for having a bad outcome. So that is my logic behind thinking that isolation mandated even in rural environments is a good idea. I get that it's bad for business, but we've got to think about what we can do on the front end. And let this thing calm down so that then we can all resume our lives. People can get back to work if we do the right thing on the front end. It's why I posted that quote from Thoreau earlier today that is on Facebook, because it's all about postponing this gratification, not thinking about tomorrow, but letting it ride out for just a few extra weeks. Now, we're told today that perhaps masks are a good idea. I don't know if you're going to lose me on this, but I did post on Facebook down below. If you look right down below, there should be an image, and I want you to— if you double-click on that, you might lose my audio. I don't know. Maybe— you know what, why doesn't somebody double-click on that image right now and then let me know if in fact I can walk through this. Okay, Gary, I see you're asking mask. Yes or no? We're gonna, we're gonna cover that right now. I just want to know, somebody please let me know if you're able to double-click on that image, amplify it, and then— all right, well, we're gonna go through this image now. I will send you a link in a moment to where this comes from, and let me just post that for you right now. Back to Facebook, and here is a link. Okay, so it's a big question. I am going to tell you that I'm in favor of masks, and here's why. Masks do a lot of things. One of the main things that wearing a mask will do for you is it will keep you from touching your mouth and your nose, and that is so fundamentally important. We all do it. We do it when we're not thinking about it and don't know where our hands have been. What doorknobs we may have touched. Who knows what else we may have come into contact with. And— oh, I was just about to do it. But anyway, that is— had I been wearing a mask, then that wouldn't have happened. I would have thought about it. Actually, gloves can help do the same thing, keep you from touching your face. We're going to talk about this in a little bit more detail in a moment. I would say that I think masks are a good idea, but provided that we don't compromise our ability of healthcare practitioners to get masks who are treating patients with COVID-19. So we want to make sure that they get masks first, but once there are enough masks to go around, I think it's really a reasonable idea. Let's look at some of the data. Well, if you're able to open the image, and I'm going to scroll down to see if somebody told me they are or they are not, Video feed stops when I scroll down. Okay, sorry about that. Well, when you get a chance to look at the image, don't scroll down or you'll lose the video feed. You'll see that in the countries that are not wearing masks, the trajectory of new cases is a lot more aggressive. Countries that aren't using masks like Germany, France, Iran, Switzerland, United States, United Kingdom, Norway, Belgium, and even Italy. When you look at countries that are using masks right now, their curves are much less aggressive, much more horizontal. Countries like South Korea, Japan, Singapore, and Hong Kong. But to be fair, those countries are doing other things as well. South Korea has had a huge testing program and stringent case isolation efforts. When we were told that we have done the same number of tests that South Korea has done, that was a true statement in terms of the number of tests that we had done. But the point is that the population of the United States is 6 times that of South Korea. So in reality, on a per capita basis, when that statement was made, we weren't actually— we were doing 1/6 the number of per capita of testing. Now that number has come up. Strong social norms around obedience and mask wearing. That is what is reported. Strict quarantine rules and contact tracing, which would be a very important thing to do. Kind of out of control here at this point to make that happen. Very low rate of increase. They did very early school closures, quarantine, and community responses. So yes, there's more to the story of do we or don't we wear a mask that I think, you know, there are many variables here that need to be considered. But I think when we look at the countries that are using masks, by and large, what we are seeing is a flattening of the curve, if you will. So if we don't look at the number of deaths per country, but rather the death rate per 1 million population, it's a far better way of determining if countries are ahead of the curve or not. Italy, while they have 12,000, 12,500 deaths, if you look at the death rate per 1 million people, that's an important, perhaps better metric in terms of our discussion. They have 206 Deaths per 1 million population. Taiwan has 0.2 deaths per 1 million population. Very important difference. Spain has 177 deaths per 1 million population. Japan, 0.4 deaths in one— per 1 million population. South Korea, 3 deaths per 1 million population. So This is another indication that mask wearing is part of a good program, in my opinion. We are now seeing that messaging coming from our government is changing, which I think is a good thing. It's being responsive and now looks like it's trending towards the wearing of masks. Again, provided this is Does not create a shortcoming for healthcare practitioners. Why would we make the recommendation to wear masks? Why would mask wearing be associated with lower COVID-19 deaths? Well, we know that spreading the particles from an infected individual would certainly be one way. When that person is coughing or sneezing, if he or she is Wearing a mask, that is a good thing. These N95 masks are able to reduce that spread, and that's very important. And please recognize that as many as 40% of people that are infected may not know it. They may casually cough or sneeze and be spreading viral particles, but they don't know it. So therefore, if these individuals are wearing a mask, that would be really helpful. So it's not necessarily to protect that individual, but to protect other people. We also know that masks can protect ourselves from inhaling particles from the outside, and that is a way that we can protect ourselves. And as I mentioned earlier, a mask is a super handy way to reduce your touching of your face, as are gloves. Hopefully, if you're wearing gloves to pick up your takeout or whatever, you're not going to be touching your face with those gloves. So I think very important to think about this as it relates to wearing a mask. Now, I don't know where you get a mask. I know you can order them online. They're extremely exorbitant in price. Perhaps you can ask your dentist or healthcare practice— other healthcare practitioner. if they have a source of a mask for you. But I think that when we see the images from countries that have flattened their curves and everyone's wearing a mask, might be something that we consider emulating. All right, let me get back to our feed and let me see if— let's talk. So Mary Schmidt is asking about gloves. I wear gloves if I have to go to the grocery store, and I dispose of them before I get into the car. I don't handle— I don't bring the gloves into the car. I throw them away. Then I use hand sanitizer. I don't want to touch the steering wheel or anything inside the car with these now contaminated gloves. So that's when I wear gloves. You know, you can keep your gloves, throw them in a paper bag in the back of your car, and then when you get home, put them in bleach solution if you are limited in terms of the number of gloves that you have access to. Who can even find masks? Good question. I'm hopeful that we're going to see masks soon become available to us, and we'll see how that plays out. Would hyperbaric oxygen help with the symptoms? I think possibly, but you know, I Hyperbarics is something you can only do for, let's say, 90 minutes at a time in terms of oxygenation of your body. So it's nothing I think that will be— that would be available for anyone. How do you open the image? I think if you just double-click on the Facebook image down below me, you could see what I'm talking about. But don't do it right now. What I would prefer that you do is simply go to the link. Why don't I post it again? And just take a look at the link I just posted, and then you can have all the data yourself. And homemade masks— I think that homemade masks are actually better than nothing. They may have some ability to reduce your inhalation of these things that people are coughing, these particles. So I think that there is some demonstration that they may work. I actually saw one idea of using vacuum cleaner bags to make a homemade mask. Don't know how effective it is, but we know that vacuum cleaner bags are really tight weave and are designed to, to, you know, catch dust. So maybe that's a good idea. Yeah, can we make a mask out of a scarf? It is somewhat effective. Okay, I'm gonna take a couple more questions. If you're on a PC, open a different— use another browser. You can do it on a Mac too, by the way, and then look at the image. Or just go to the— just double-click on the link and it should take you there while you'll still hear my audio. Okay. Yes, the CDC says that a scarf bandana does offer protection. Look, doctors in hospitals are using scarf bandanas, are using homemade masks, and I would say that, you know, there is some evidence that that is effective. Okay, I'm going to take a couple more questions. Why didn't H1N1 get that much attention? I think that, you know, people seem to be again wondering why Why do you think that the various flus are not— didn't get attention? Why does the seasonal flu— doesn't get the attention that we are seeing with COVID-19? And after all, as somebody told me today, there have only been north of 3,000 deaths associated with COVID-19 and, you know, 40,000 to 60,000 deaths every year from the common influenza. Well, When we see 3,500 deaths, that's right now. You know, we're seeing 500 and 600 deaths a day. That's unlike what we would see with influenza. So the infectivity of COVID-19 is much more aggressive. The death rate is as much as 10 times greater. I wish that weren't true. I really wish that weren't true. And I really wish that this were the same as the common influenza. You know, we wouldn't be fearful in terms of going out and having contact with other people. So this is a global event, and I think that what we see nations doing in response to COVID-19 is in response to how aggressive and threatening this is. Okay. All right. Let me see if there's any other questions. A lot of people asking about homemade masks Again, I think that if you don't have an N95, a homemade mask would be a good idea. Should I wear a mask when I go out to walk the dog or to grocery shop? I don't think when you're out walking the dog or going out for a walk or walking yourself that you need to have a mask if you're staying away from people and they're staying away from you. Some people don't get the social distancing memo And will tend to come closer to you, you know, you need to back up. At the grocery store, it's sort of a different story because then there is much more of a likelihood, I think, of touching something that may be contaminated and then touching your face. So wearing a mask at the grocery store in that situation makes a heck of a lot more sense. It's why I wear gloves to the grocery store. At the very least, moving forward, I will likely wear a mask to the grocery store. I brought it last time, but there was nobody in the grocery store except for me and one other person, so I thought we were okay. But if there are a bunch of people in the grocery store shopping, you bet I'm going to wear a mask. Anything is better than nothing. Glasses instead of contacts. Interesting thought. I wear either sunglasses or safety glasses from my garage that I use when I'm drilling or using power tools when I'm opening packages. Why do I do that? Because I don't want popping something open, something's wet, particles to become airborne, get into my eyes, or— and I don't— strangely enough, I try not to inhale while I'm doing that part where you pop open the cardboard. Is that over the top? Probably, but I'm a bit over the top. And I'm the first to admit that. So let me take a couple more questions. Okay. If wearing gloves, would it be a good idea to wear hand sanitizer and then reuse them? I think while you're out and about, to put some hand sanitizer on your gloves is good. But remember, when you grab the bottle of the hand sanitizer to put it on your gloves, you contaminating the bottle of hand sanitizer, so make sure that you sanitize that before you put it back in your pocket. Got it? When you get home, I think it's probably best to dunk— put the gloves in a solution, in a bucket of 5 parts water, 1 part Clorox, or if you're using Lysol. Is this airborne? I think that the balance of data indicates That's right. So that indicates that yes, it can be airborne. You know, we are hearing a lot that you've got to limit your exposure to groups of 10 or less, and in my opinion, I tend not to agree with that, and here's why. I'm not really sure that it's the number of people that are in your group that really matters the most. You could be in a group of one other person, in other words, a group of 2, and And that could be problematic if that person is infected and is in close contact with you. At the same time, you could be in a group of 200 people spread out over a football field, and as long as people are maintaining their social distancing, that might be less of a threat. The airborne idea, I think, that was just raised is important as it might relate to, for example, an elevator. I think an elevator is a risky proposition Why? Because people in the elevator are in very close proximity to each other. People are pushing buttons without gloves, without hand sanitizers, and if indeed this virus can remain airborne for a period of time, who knows who coughed or sneezed in the elevator as the door opens and you get in and there's nobody there. So I think, what would you do? Well, you might want to leave the Door open, put your foot in the way, let it air out for a little bit, or maybe spray something. I don't know what you might consider to be good, a good thought there, but I'd like you to at least consider that jumping right into an elevator that had 8 people just get out may not be a good thing to do. Can a mask become a trap for bacteria and viruses? Absolutely, Anna. That is certainly a possibility. So we get to the question then of how do we then sterilize the mask? And in reviewing the data, there are multiple ideas from steam to chlorine to Lysol, you name it, and nothing has been found to be 100% effective or also not associated with damaging the mask and making the mask less So again, we are in the better than nothing kind of conversation. Does heat kill the virus? Hot water, hot air? The answer is yes. I don't know what microwaving does aside from heating things. Does microwave in and of itself help? I don't know the answer to that. Does iodine supplement help? I don't know, Nina, specifically about iodine, but I have seen some publications Just this morning about oral iodine. In fact, using something called Lugol solution, L-U-G-O-L apostrophe S, named I guess after Lugol, that that might be an effective way of sterilizing the mouth, though it may stain your mouth. Hi Jerry, great to see you. Great. So let me look at a couple more of these questions. How long do I think before this virus peaks? Tough question. I think I'm going to throw it back at you and I would say it really depends on what we do. Some estimates indicate that mid-June is what we should expect if we basically continue on what we are doing. The idea of flattening the curve is kind of pushing the peak down the road a little bit But lowering the peak as well. That's what that is all about. When you look at the countries I mentioned earlier in our face mask discussion, countries like China and South Korea, Japan, Singapore, and Hong Kong, what we see is that their efforts are flattening the curve— wearing masks, social distancing, quarantining, etc. I don't think it's going to happen 2 weeks from now. which is what some people have talked about. I think that is unfortunately overly optimistic, but we're hoping to see the effects as we've seen now in Washington and possibly even in New York, seeing the effects of our behaviors or the behaviors of the individuals that live there. And that answers the question from Joan Wetzel, are we having Any impact so far on flattening the curve? By and large, we are not. There are plenty of people who are as yet not taking this as seriously as they should. One individual said, if I get this coronavirus, I'm going to be fine. With all due respect, that's not the point. The point is, if you get coronavirus, how am I going to be? This is, you know, called empathy. And younger people likely will do better. Older people who are in contact with younger people will have to accept the risk that is imparted on them from the behaviors of younger people. What about changing clothes when you come back from being out, from come back store versus walk outside? Again, I think walking outside is relatively safe. I don't think having your shoes on in the house from walking outside is necessary. Necessarily a good idea, not just for this situation but in general. I think if you're going to go to a store where you might be rubbing against a counter, bumping into the cart, that it would be a good idea to shed that clothing and wash it in hot water and dry it in hot water as well. And so, yeah, so the real question then becomes And I'll raise it— than these various surfaces like plastic and metal and even cardboard. And the indication is that the virus can remain infective on surfaces like plastic for as much as 36 hours, cardboard as long as 48 hours— rather, plastic as much as 72 hours, rather, and cardboard 48 hours. So something to think about when that package that you've been waiting for arrives on your front porch and you think you're going to go out and open it up may well be something to think twice about, about doing. Any benefits of zinc and vitamin C supplements? We know that zinc and vitamin C and vitamin D have good science behind them in terms of other viruses. Is there specific evidence this time around with respect to coronavirus? There is not. I am taking supplemental zinc, 50 milligrams a day. I'm taking 5,000 IU of D3 each day because of some of its effects in terms of amplifying what are called antimicrobial peptides. And again, it would be super easy to conduct— to get this data. Simply take blood samples from people who are in the hospital versus those who are sent home from the emergency room. And look at their vitamin D levels. Who does well? Who does poorly based on vitamin D level? Based on zinc level? I think things that help calm inflammation, the inflammatory pathway called NRF2, like broccoli sprouts, kale, cruciferous vegetables, turmeric, and coffee are good ideas in this situation. Again, there is no quotable study for me to impart. Okay. So I don't think that's going to be of any part to you, though I did post a study looking at the possibility of curcumin, turmeric, as it relates to the so-called cytokine storm. I would indicate, however, that the levels that need to be achieved in translating the animal research to humans would require an intravenous dosage of curcumin. So Okay, somebody mentioning Dave Asprey recommends something as part of his— yeah, and so go to my interview with him from 2 days ago. I'm sure he's posted it by now. Kimberly Madero, me too, I even spray my shoes. As do I. I spray the bottom of my shoes because, you know, when people are going down your street or bike riding and whatever, people spit, they, you know, they do all kinds of stuff and So therefore, that could— you could be contaminating your bottom of your shoes. Leave them outside. Okay. I'm a volunteer at hospice and I was told I should bring my own mask. It would be great, Melissa, if that mask were made available to you. Can we get the virus twice? Denise Barnes asks. That is the home run question, isn't it? I know plenty of people who Right. There are people who have now been diagnosed who are on the mend, and the question is, can they get it again? We don't know the answer to that yet. And that question has a bigger context in that if we harvest their blood and spin off the plasma and use that to treat other people, which has been done since 1918, would that be effective? And I— my sense is that the answer is Yes. But I don't know that to be sure. We're seeing, you know, a lot of people are getting it and then ultimately going back to work. What did we talk about yesterday? We talked about the fact that you can test negative for this virus once you are feeling better and without a fever. You can have the nasopharyngeal swab done and it can test negative, but you can still revert back to being positive in terms of shedding the virus once again. We talked about that data yesterday. We talked about how you can shed this virus even though your nasopharynx is testing negative, but you can still shed the virus in your fecal material. In other words, contaminate the bathroom at home, contaminate the toilet, contaminate the sink. I think that's extremely Extremely valuable information. Okay. Well, listen, everybody. I am very excited that we're getting the 30,000, 40,000, 50,000 people who are tuning into these each day when we post them. That makes me want to continue, and I will continue. If you have a chance, look at The 700 Club on Christian Broadcast Network. where I spent quite a bit of time today explaining some of the things that we're working our way through right now. I'll be back tomorrow and give you an update. So thanks for watching. Until then, do your best to stay healthy. Bye-bye.