Coronavirus Conversations - Day 21

All right, good evening, tribe. Michelle Norris here. I'm so happy to come to you tonight and bring you one of my favorite speakers from Paleo FX. Dr. Perlmutter probably talks about my favorite topic, and one of the reasons that it's my favorite topic, the brain, is that I recently, Keith and I both found out recently, that we are both APOE3/4. And this is a gene SNP for early onset Alzheimer's. And so there's an APOE, you can either be APOE 3/4 or 4/4. And both of these have a slightly higher risk of getting Alzheimer's than the average person. So one of the things that I love about him coming to PillFX is that I get to learn really great ways to really enhance my brain health. I have 2 grandmothers that both died of Alzheimer's. And so I definitely wanna do all the things that I can to keep from getting that. So I've loved having Dr. Perlmutter come to Pill Effects to discuss all the brain stuff that he knows, and I am really honored to bring him to you tonight for us to really talk about what's happening right now with COVID-19 and how your brain health affects your immunity. And so Dr. Perlmutter is a 5-time New York Times bestselling author. He is a board-certified neurologist, and he— hold on, sorry, I've got my stuff all in the wrong place. That's okay. He serves on the board of directors and is a fellow of the American College of Nutrition. I'm really honored to have you here tonight, Dr. Perlmutter.

Well, Michelle, I'm thrilled. I know we were going to be together in Austin, but, you know, the world threw us a bit of a curveball, and we're making lemonade.

Amen. Amen. So why don't we jump right into it? Because I know we've got a lot of stuff to cover and want to make sure that we make the most of the time here. Let's talk about first, obviously, the paleo diet. How does the paleo diet and the way that you eat and your nutrition play a role in your immunity and how this could help you with regard to COVID-19?

Well, first of all, I think that one of the important concepts here is that our first line of defense is our gut bacteria. Our microbiome is there standing ready to protect us. And, you know, as it relates to this COVID-19 situation, it's been said in the past, as it relates to football, that your best defense is a good offense. We don't yet have a meaningful offense. We don't really have any weapons as yet, although we'll hopefully have time to talk about what's being developed. But we have to work on D. We have to work on our defense, and that's our immune systems. And we really understand that the gut bacteria, and its metabolites, and its genetics, play important roles in balancing our immune system and allowing us to have a robust defence, and also in limiting inflammation. And I think that becomes very important as we recognise that moving along in terms of symptoms with COVID-19, that inflammation around day 10 can be a turning point either in one direction or the other. We call that the cytokine storm, and I think we'll have some time later on to talk about that. But when we value the gut bacteria, we, I think, are really valuing our input into immune competence. And I think you're saying here on the crawler underneath the screen, resiliency become hard to kill. And that's where it begins, with our gut bacteria. Even today, I mean, I created a video, somehow I'll try to post it, I'm not sure how to do that.

I'm going to post it right here in the comments, and everyone that's watching If you're watching, please, if you have a question for Dr. Perlmutter, put it in the comments and I'll be sure to bring it up.

Oh, there it is. Good. So that's a video that I created that really talks about some of these interesting observations. Why is it there's such an incredibly low rate of infection in Haiti and in sub-Saharan Africa? And, you know, my belief is that these are people with very good, very diverse, very strong microbiomes. Why? Because they haven't lived in a very hygienically sanitised environment their whole lives. And I learned that many years ago when I went to Haiti a couple of days after a major earthquake, and we were operating on patients in the most primitive of conditions and then using a UNICEF tent for recovery after doing, you know, aggressive amputations, etc. We didn't have any infections. So immunity to me seemed really kind of related to the fact that these individuals had challenged their immune systems their whole lives. They had a lot of parasites, they had a lot of helminths or worms. And we call this concept the hygiene hypothesis, whereby early life exposure to challenges, germs if you will, may actually build a more robust immune system. Having said that, we know that the Westernization of our diet, the adoption of a diet that's high in sugar, processed carbs, ultra-processed foods, and devoid of foods that are high in fibre, quality meat and animal products, if that's your choice, and catering to ourselves with things like acid-blocking drugs and nonsteroidal anti-inflammatories, These are important touchpoints that have a huge role to play in terms of the health and functionality of the gut bacteria. And let me remind the viewers that the gut bacteria plays a central role in immune function, which is why we are getting together tonight to talk about what is our best defense. So, in moving forward then, we need to ask ourselves, what are the best dietary recommendations for a more robust and functional immune system. And it starts with the gut bacteria, meaning a diet that's very rich in fiber and especially what we call prebiotic fiber. That means fiber derived from garlic, onions, leeks, Mexican yam, Jerusalem artichoke, broccoli. Most fibrous vegetables contain some prebiotic fiber.

Mm-hmm.

And even adding prebiotic fiber as a supplement that you can buy Online or at the health food store. I like to take a supplement that's derived from what's called acacia gum. That's the tree in Africa that you see providing shade for the giraffe in the middle of the, of the noonday sun. It secretes a resin or gum that is made into a wonderful prebiotic fiber that's well tolerated.

Mm-hmm.

But again, thinking about how our modern-day lives challenge the functionality of the gut bacteria is very important. Chlorinated water, medications like I've mentioned, overusage of antibiotics, residual antibiotics in some of the factory food that we eat. So these are all important considerations. Beyond food, even lifestyle can threaten the health of the microbiome and certainly challenges our immune system. For example, stress. Stress is a powerful downregulator, or a negative effector of immunity. And, you know, that is something we've got to steer away from right now. And that means, yeah, get your news a couple of times each day, learn what's happening in your communities, learn the latest recommendations from governmental agencies, and then turn it off. The idea of staying glued to the tube day in and day out does nothing more than fan the flames of stress And that is really poison for your first line of defense, your immune system. So turn it off. Spend your day doing things that are constructive, that involve exposure to nature, that involve meditation and exercise and preparing your food. There's no reason that we can't get back to growing a victory garden. We're going to be in this for a long time. So going online and buying some seeds and planting them, You'll probably harvest some vegetables in a couple of months. And guess what? We're still gonna be vigorously involved in this in a couple of months. So it's gonna be a long event. We've gotta pace ourselves for the marathon, not for the short sprint. Mm-hmm. So I think that where paleo factors into this is it's really catering to the best expression of our genome. That's what this is all about. Instead of challenging our genome with signals for which it is unaccustomed, to supply to our genome signaling that allows good gene expression to maintain balanced immunity, to maintain a balanced inflammatory response when challenged. And our bodies want that to happen. Our genome wants that to happen. It has been refined over millions of years to allow that to happen. Suddenly, when we have confronted our genomes with these maladaptive signaling pathways by the foods that we're eating, by staying up too late at night, by not exercising, then the expression of our genomes is compromised and our ability of our genome and microbiome to respond to a challenge like we're seeing now is compromised as well. It is exactly the reason that we are seeing such bad outcomes from people who have sent bad signals to their genomes by virtue of the foods that they have eaten. Now, they know that they've sent these bad signals to their genomes because now these are individuals with chronic issues like diabetes, coronary artery disease, and even obesity. That happens when we don't send the right signal to our genomes. We live a life that is counter to the principles of paleo. So that explains then why the individuals who have underlying disease have such a worse response to this challenge that is presented by COVID-19.

Right, so my understanding is that for every 1 signal that your brain sends to your gut, your gut actually sends 6 up to the brain. Is that correct?

I don't think it would be at all possible to determine which signals are going which way, because many of the signals, obviously, that the brain is sending to the gut are electrical, but they are hormonal as well. And certainly many of the signals from the gut are similarly electrical through the nerve plexuses, the vagus nerve that goes in both directions, but also chemicals made by the bacteria, the short-chain fatty acids, these so-called neurotransmitters, The small molecules, etc. So there's— there are multiple types of signaling pathways going on between the gut and the brain, and the brain and the gut, and I think it'd be very, with all due respect, difficult to quantify a ratio.

No problem, and that was just something that I had heard, so I was going to ask that question and get clarification around that.

You did ask that question, that's okay.

Yeah, so I do want to know, so what is taking care of our brain and helping with building our immunity? How do we— how do we do that? What What are the things besides what we eat? What are the other things that we can do?

Well, right now we're in a situation where our lives virtually depend upon our decision-making. Do we decide to say, what the hell, I'm going out, hanging out with people, and, you know, take my chances? Or do I decide not just what's best for myself but also best for all of those for whom I I will be interacting, with whom I'll be interacting, including older individuals, including people with underlying conditions. So it's all about decision-making, and we have 2 important areas in the brain that are involved with decision-making. We have one area which is a primitive area called the amygdala, and that is an area that subserves things like impulsive, self-centered, fear-based, and us versus them kind of decisions. Now, that is in contrast to a more advanced part of the brain called the prefrontal cortex that sits up here behind the forehead. And that is the part of the brain that's involved in forward planning, forward thinking, thinking of the consequences of our choices, thinking of the consequences of our choices not just for ourselves, but how that might play out for other people. In other words, empathy. And we live then in this balance between short-term impulsivity and long-term appropriate planning. It's clear that many of our lifestyle choices will influence which part of the brain is leveraged most as it relates to our decision-making. We can virtually choose how we make our decisions, which part of the brain do we use. If we don't get enough sleep, if we eat pro-inflammatory foods, If we're not exercising, if we're not expressing gratitude, if we're not exposing to nature, these things tend to lock us in to the amygdala, to a more primitive type of decision-making that's impulsive, that thinks about today or at most tomorrow, that doesn't really recognize implications of our choices long-term. It's like mom and dad decided to leave to go away for the weekend and left their teenage kids in charge of the house along with 20 of their closest friends. That's not going to work out really well. The adults right now especially need to be brought back into the room to help with the decision-making processes. So what do we do? And this is all in our new book, Brainwashed. This is what I was planning to present in Paleo FX in Austin. But anyway, We're presenting it now, so there you go.

Here we are.

So what do we do? And I think, you know, we have a 10-day program that looks at all of the things that we can do, uh, that we present in Brainwashed for bringing us back into connection. In other words, fighting off what we describe as disconnection syndrome. But you know what, it's not necessary that we have to do all of these things. If we can get our foot in the door and make better decisions, then the next round of decisions will be better as it relates to making better lifestyle choices. For some people, it might be as simple as getting a good night's sleep.

Mm-hmm.

We know that when you do not have a good restorative night's sleep, your amygdala, your impulsive, self-centered fear, us versus them part of the brain, is lit up, increased in its activity, by around 60%. So just to get started, concentrating on a good night's sleep is really fundamental. A low inflammatory diet, as I described earlier, contact with nature, either getting outside or even growing something inside an herb garden, or even photographs of nature all work to help reduce stress levels, to help reduce inflammation and help with our decision-making process. Keeping a gratitude journal, for example, also a powerful thing that we can do. And I think certainly one of the most powerful tools that we have to calm down the amygdala and allow us to be more thoughtful in our decision-making are things like meditation and prayer. Who knew?

I can tell you who knew— lots of Christians. Definitely something that has been part of my life and part of my journey is Definitely lots of prayer. I know one— the other part of that is, of course, too, is that all of these things also help downregulate your central nervous system, which most of us are in fight-or-flight right now constantly and constantly kicking up all those stress hormones that also— my understanding is they also decrease your immunity as well, or they can downgrade your immunity.

Yeah, I think not central nervous system. I think you're probably talking about the sympathetic nervous system. That is— has been called the fight or flight.

Yeah,

that's the direct superhighway into the amygdala. So people with, you know, their sympathetic nervous systems lit up are functioning from the amygdala. And, um, we all go there once in a while, and it's, it's reining that in, uh, that, uh, really is a skill that you can develop. I talk, uh, in Brainwash about an experience I had in Costco where somebody was, uh, giving me a hard time about the fact that my wife— we were standing in line, she had gone to get a few extra things, she does that. We're still in line, we weren't even at the checkout yet, and the guy behind her just laid into me. And, you know, truthfully, I was fine with that. I'm not fine, but I took a deep breath and centered and didn't listen to him. But the part that got me was he started to verbally abuse my wife. I, I— that was too much for me. But fortunately, I re— I, I know this anatomy, I know the physiology. And I said, my amygdala is lit up right now. I'm about to do something that's not good, thinking of the long-term consequences. So I reined it in, took a deep breath, count to 10, whatever you need to do, and moved on. And, you know, I think there's some advice there because we're going to have some very big challenges moving forward. This whole experience with coronavirus has only just begun. We're in the opening credits right now. The movie hasn't even started. And it's very, very important right now for people to rein it in and to realize we have to make important long-term decisions. It was just decided today that Florida needs to be in lockdown, which Is a wonderful decision. Is that a hardship for people with businesses? Absolutely. But it is the way long-term to get them back to work sooner than later. If you don't do it now, if people are still allowed to go to the beaches and do all the things that they were doing, it's going to protract this and make it a much more challenging thing to come out of. So it's about making decisions with Bringing online the prefrontal cortex and thinking about the future. Looks like we've got all kinds of questions. When you're done, you let me know. We'll scroll through these.

It's funny because one of the jokes that we have is that somebody has to be the prefrontal cortex in the room at all times somewhere.

That's right. Not to say there's not a time for the amygdala. The amygdala is what allows you, when you're backing out of your driveway and looking at the rearview camera, When there's suddenly a kid on a tricycle, you don't have to think about the long-term consequences of lifting up your foot off the accelerator and putting it onto the brake. No, you instantaneously hit the brake, and then you realize what in the heck just happened. Oh, how did that happen? That's, you know, reflexive. That's the amygdala kicking in, and it saved somebody's life. Right. So that's the upside of acting By impulse, impulse power. So, but we don't want to make those kinds of decisions as it relates to lifestyle and food choices especially.

Right. Okay, so we have a question. Do you think we need to be keto and fast 16+ hours to boost immune system if we are already metabolically healthy? I know prolonged fasting 16+ hours can cause downstream effects for women.

I think it's a very excellent question. We do a Facebook Live at 5:00 PM Eastern every day. And on Sunday of last week, we did a 24-hour fast with thousands of people because what we're trying to do, there are many, many things, you know, we're talking about insulin sensitivity and glucose levels, you name it. But the real mission there was to augment immune function. So is 24 hours enough? I think some, People would say you need at least 36 hours. I know that's what Dr. Peter Attia has said, but I think there there may well be benefits even for a 24-hour fast in terms of enhancing the ability of our bodies to rid themselves of somewhat compromised immune cells and allow younger, more functional immune cells to to repopulate. Having said that, this is a science called senolytics. Seno meaning old, lytic meaning getting rid of or lysis. And there are actually some nutritional supplements that are purportedly able to do that. One of them is called fisetin, F-I-S-E-T-I-N, available online, many brands out there, and it is derived from strawberries. I take that myself. I take 500 milligrams each day, and it just might be something that's worthwhile. Having said that, Michelle, Let me go through just a couple of ideas as it relates to nutritional supplements, 'cause I think people are wanting to know that. We talked about prebiotic fiber and a very good probiotic. I take a 90 billion probiotic each day. But also, I think having good levels of vitamin D is important, whatever the dosage is that a person requires. I vary between 5,000 and 10,000 IU of D3 daily. Okay. I'm also taking 50 milligrams of zinc and a sulforaphane supplement, along with lots of good DHA-rich omega-3 in the form of cod liver oil. In addition, I take a multivitamin and a methylated B vitamin because I have— as you mentioned earlier, you have some genetic predispositions. I have what's called MTHFR, so I take a methylated B vitamin. And so that's the core of the things that I'm taking.

I hear you. Okay, well, I'm gonna try— I will come back and put all of that stuff into the comments in a little bit for all of you. I did put the fisetin derived from strawberries in there. And so tell us about your daily COVID-19 updates that are on your Facebook page.

Well, most days, every once in a while I take a day off, as I did today because I was spending this time with you. But we do a 5 PM Eastern live interactive. I do the news first. I talk about latest developments in drug research, vaccine research, what are the latest recommendations in terms of wearing a mask, for example. Is that a good idea or not? And, you know, and so I do this every day and it's interactive and we have 40,000, 50,000 views one day. I can't figure out why we had 114,000. I didn't— I don't think I spoke about anything that was really different, but I guess maybe, uh, there was nothing else on TV at the time. Who knows? But, uh, you know what, I'm gonna try something, if I may, and that is I'm gonna try a screen share.

Mm-hmm.

Uh, share screen. Good. Uh, see if this is working. Are you seeing my screen right now?

Nope, hold on, let me pull it in. It should— did you— you did the thing at the bottom where it says—

I did.

Okay, let me see.

I think it's sharing. Maybe somebody can comment.

I don't see it because usually I get this— it's pulled into the stream, so I connected into the stream and it's not coming by.

And my entire screen. Here we go. All right, well, I am going to try to share. I don't know if it's working. Somebody should probably tell us if it's working. Now I'll try application window. Ah, here we are. Share. Beautiful. Tell me if that— is that sharing now?

Yep, it is.

Great. So this is an interesting report out of— that came out of— from Worldometer, which is where I get a lot of information. It's actually derived from Johns Hopkins. And this is an interesting graph that looks at the rate of increase, daily increase of coronavirus infections in comparison of countries using masks and countries not using masks. And if you look at the no-mask countries, by and large, you see Spain, the US, Switzerland, the United Kingdom, their rates of increase are pretty steep. When you look at the countries over here on the right that are using masks, like South Korea, Japan, Singapore, and Hong Kong, you see a much more flattened slope of the line. To be fair, South Korea, huge testing programs, stringent case isolation. Japan, strong social norms around obedience and mask wearing. They've always done that. Singapore, strict quarantine rules, et cetera. But I think there are actually several important reasons that we should consider, if I may, that mask wearing should be something that we should consider. And I think, you know, that's certainly been a big question these days. Should we wear a mask or not? And I think the big argument that I would put forward against mask wearing would be that if it's going to take masks away because of short supply from healthcare providers, then I can understand that. But if they are available, I think it's a good idea for 3 reasons. Number one, if you are an asymptomatic carrier—

Right.

In other words, you don't know that you're shedding the virus right now, wearing a mask is a good thing. Number 2, if somebody is coughing or sneezing around you and you have a good mask, an N95 mask, it will protect you. And even if you don't, if you have a mask that's made out of People are making them out of vacuum cleaner bags. They'll all protect you to some degree. But I think the third idea about wearing masks people really aren't talking about, but they should, is that a mask will remind you not to touch your face.

Yeah.

If you go to touch your face, you won't because you'll touch the mask. And I think that's actually very valuable because I would submit that's probably one of the biggest issues in terms of transmission, that we pick up virus from contaminated surfaces and then we touch our eyes, our nose, or our mouth. And, you know, it does bring up an interesting idea, and that is that this virus remains transmissible on surfaces for quite some time. Cardboard, for example, for as long as 48 hours. Now, that package may have left Amazon 3 days ago, but it was handled 15 minutes ago by the delivery person to your home. That individual may be wearing gloves and may be handling a lot of different packages and doorknobs and doorbells and you name it. So I think first consider that it may be a source of virus and leave it outside for a day or 2. And if you have porch pirates in your neighbourhood, And you need to bring it in, then spray it with a solution of 1 part bleach to 5 parts water, and then put it in the garage. And don't be in such a hurry to open it up so fast. Even the mail you have to think about. So getting those packages into your home quickly is something we should avoid. And by all means, don't open stuff in the kitchen. Create a routine whereby things are quarantined before they come into your home. Great, so I guess we take some more questions, or what, Michelle, whatever you'd like to do.

I am— I'm going to look and see what we've got. We've got a lot of people like putting people's names to come on board. I just put that 1 part bleach, 5 parts water to disinfect packages that are delivered.

Yeah, there are a lot of things that we can use. Lysol works, alcohol works as long as it's greater than 70%, which means not vodka, which is maximum I saw was 80 proof. That's only 40% alcohol. But, you know, remember there was something called 151 back in the day, and that's still around. That's by definition a 75% alcohol. So there are a lot of things out there that we can use. And I want to emphasize that really this idea of washing our hands with soap is absolutely dialed in. Why? Because the virus is enveloped in fat. It's a fat bilayer with protein. And we know that soap disrupts fat. That's why we use dishwashing liquid to cut the grease. So the idea of scrubbing your hands, washing your hands for 20 seconds with a lot of foamy soap is a good thing. And I frankly think that's a good idea for vegetables as well. Today we received some organic cucumbers, radishes. I don't think we got tomatoes today, but they would be certainly able to do this. And I scrub them in the garage in a bucket of soapy water and then let them dry. And I don't feel any concern about bringing them into the house. Same thing with tomatoes. So think about that. You know, you really, you wanna be eating vegetables if you're gonna try to keep your microbiome healthy. So there are safe ways to go about that.

Okay, someone's asking, does eucalyptus work as a disinfectant?

I don't know if if it is. I published a list of 150 disinfectants on I think day two of our coronavirus update, so that will be on David Perlmutter MD on Facebook. And we I published it. And actually, you know where you can find it? We have a whole coronavirus section on David Perlmutter MD. No, I'm sorry. Dr. Perlmutter dot com. D R Perlmutter. Maybe you can type that in. Just go to the coronavirus section. Every study that I mentioned is there in its full form, including a resource for all of the commercially available products that work as a way of rendering the virus inert. Right. We don't want to say killing the virus. The virus isn't actually alive, so it's not about killing it. It's about rendering it unable to infect.

Awesome. So, and that's something I guess that I didn't realize until just now, that a virus isn't actually alive. So really interesting because, you know, there's lots of people that are always talking about killing virus.

Well, I mean, I guess it is a bit of semantics, but, you know, to be alive, an organism has to metabolize and it has to reproduce. And truthfully, the virus is unable to reproduce. It reproduces itself when it injects its genetic material into the host cell and hijacks various types of genetic transcription information or mechanisms within our cells that then make more viruses. But it in and of itself, 2 viruses don't get together and make babies. It doesn't work that way.

Okay, cool. Well then, Let's see, uh, someone says, I understand the bleach solution is not effective after 24 hours, so it needs to be made up every 24 hours. Is that true?

Uh, it does tend to off-gas. If you have it in a closed container like a pump sprayer, you're better off. But if you're mixing a bleach solution in a bucket, chlorine will off-gas. I mean, anybody who has jumped into a pool that just had the chlorine added, you know, you, you can smell it, eyes burn. But come back the next day, everything seems a lot better. So chlorine does off-gas unless you have it in a sealed container. Good point.

Okay, great. And then, so what are some other suggestions you have during this time to just sustain optimal health?

I think it's time to double down on all of the things that we know are good for us, that we We don't want to find the time for exercise. We want to make the time for exercise. We want to find the time for meditation. We need to partition that off because these are the techniques, the lifestyle choices, the food choices, etc., that we know— you know, we've been talking about this for years— that they're very important for our general health. Now we need them more than ever. And I think There is a tendency amongst some people when they're in a stressful situation to eat more comfort— comforting foods, to kind of bail on the exercise and lock into being fed just fear-provoking information. Mm-hmm. So I think now is the time to double down. When you recognize that the people who are having the worst time in terms of survival are those with chronic underlying conditions, It means inflammatory conditions. We're talking about coronary artery disease and diabetes and the rest of the inflammatory conditions that are, according to the World Health Organization, the number one cause of death on our planet. And they are, along with being older, the number one cause of— number one associated cause of death as it relates to COVID-19. Now, we cannot change our chronological age. I'm 65. If you look at the charts, you know, I'm about a 10% risk of dying from— 8 to 10% risk of dying if I get COVID. That's like 1 in 10. Yowzer. So I can't turn back the chronological time clock, but I can turn back my biological time clock by doing the things that, gosh, we've talked about at Paleo FX for years and years, and really making myself and your viewers, making themselves younger in terms of immune function, in terms of adaptability and response. It is, you know, something to consider that suddenly when the virus came to America, we were dumbfounded because there were so many 20 to 56-year-olds ending up in the hospital. And that was very challenging because, you know, the statement was made, I can't imagine why this is happening in America to these younger people because they're, you know, they're young and healthy. Well, the reality is America's youth, by and large, are not young. They're young, but they're not healthy in comparison to other countries. Right. We have high rates of obesity, high rates of type 2 diabetes in younger people these days. I'm not pointing fingers. I'm simply stating the facts from the CDC. Mm-hmm. We know that overall obesity rates in America are really high, that, you know, obesity rates are around 32% in rural America and about 27% in urban America. That's obesity. That's just not overweight. That's, you know, a very high body mass index. Recent reports indicate that if your body mass index is greater than 40, you have a dramatic increased risk of dying from this experience. So in many ways, our lifestyle choices have sort of set the stage for what we are seeing now in terms of who's doing well and who's not doing well.

I saw that a lot of the numbers, there were also, it was a high number of As

you would expect. I mean, this coronavirus attaches to the ACE2 inhibitor— ACE2 receptor, which is represented in 2 places primarily: in the lungs and in the gastrointestinal system, which, you know, explains why it is such an aggressive pneumonia when it happens and how patients can very quickly go into adult respiratory distress syndrome and Which is often a fatal event. Right. You know, 70 to 80% of people who go on a ventilator die. So yeah, it's great that we're having this call for ventilators, but understand that, you know, these people are very, very sick by the time they are put on a ventilator, and, you know, only 20 to 30% of people survive. And in addition, which is complicating the issue, is typically before COVID-19, a person in an intensive care unit having been in an accident or having had a heart attack or a stroke, whatever it may be, the average time on a ventilator was 3 to 4 days. Now we're seeing people on ventilators for somewhere between 11 and 21 days. And, you know, what that means is these ventilators are really been used for a long time. So, you know, it's very, very, very aggressive and very protracted as well.

Okay, we had a question. If you buy produce and keep it in a spare fridge for 2 to 3 days, is it safe to just rinse it off like normal before using?

Well, I would rinse it before you put it in the refrigerator. I think the last thing you'd want to do is to put contaminated anything in the refrigerator. So, or freezer for that matter. I mean, you know, think about it. What does a virologist do with his or her specimens? They put them into the deep freeze because they want to study them in a month or a year. So you don't want to put anything that's potentially contaminated in the refrigerator or, or the freezer. These things need to be taken care of first, uh, as best you can, and then put them in, um, wherever you're going to put them. Uh, I enjoy, uh, oat milk. Okay. With my morning coffee. And when I get that, that gets a spray from the Clorox solution in the driveway, and then it's hosed off, dried off, and put in the refrigerator. You can do the same thing with milk. If you buy eggs, understand they're coming in a cardboard container that might have been stocked on the shelf that morning, so you need to be suspicious of that. My recommendation is that when eggs come to your home, you take them out of the cardboard container and then you wash them and put them into a bowl, or save the cardboard container from last time and then just when you're out of eggs, you put— you recycle it. So there you go. But cardboard is very suspicious. Plastic, as much as 3 days, can contain infective viral material. So we need to think about that. Yeah. Your Amazon package arrives on your front porch and it's cardboard, but the tape that seals it is plastic. And am I sounding germophobic? I sure hope so.

Okay. So one person wanted a little bit of clarification. If it's not alive, why do people say that it lives on the surfaces of anything that is not our body? Please, please answer this.

Again, it's nomenclature and semantics. It's not actually a living organism. It doesn't reproduce on itself, and it doesn't metabolize. It doesn't use fuel for energy. It's basically RNA or genetic material in an envelope, and it's, it's just breathtaking in its precision and its stealthiness. It gets into the body, attaches to a specific receptor, and then injects its genetic material into the cell and then hijacks our reproduction aspects within our cell that allows it to make more of itself to create its new envelope, and then it's extruded. I mean, it's, it's, it's, it's beyond science fiction.

Well, I have one question because one of the things that I heard a lot of people talking about is the concern that, okay, once we get through the COVID-19, is that we— one of the things that we need to be concerned about is the mutations of the virus. How does that happen? How is— how does a virus mutate?

This virus, like any virus, like a flu virus, for example, wants to do everything it can to survive. And it's always mutating. Many of those mutations happen and lead to a virus that's not able to continue on, that doesn't have the ability to replicate. In fact, perhaps most of those mutations are useless. But every once in a while, a mutation happens. For example, a mutation that causes this virus to make us want to cough. Why do we cough when we get this virus or a cold or influenza? Because that somehow allowed that virus to spread. It's— no pun intended— it's absolutely breathtaking to consider that this is constantly happening. Now, the concern about this coronavirus mutating is much as our concern has always been about the influenza mutation, that we have influenza every year, and there are 2 things that really tend to mutate. There's hexosaminidase, there's, there's an H and something called neuraminidase. There's an H and an N, and they can spin the dials between number 1, number 2, etc. When we happen to get the H1N1 mutation, that seemed to be a lot more aggressive, so that was a concern. You can— looks like you will develop an immunity if you get COVID-19 against this specific strain of COVID-19, but if it mutates and comes around again next year, you may just be at risk just all over again. Right. So, you know, the idea of creating a vaccine a year to 18 months from now is interesting, but it may well be that by the time that vaccine comes out and is available, that we've got a new player, you know, a new sheriff on the block. And so that's, you know, what we've been trying to do all these years— not myself, but researchers have been trying to develop a flu vaccine every year. And it's all— it's only a guess. They try to develop a flu vaccine based upon what they think it's going to mutate to and hope that it's effective. And the reality is, most of the time, the flu vaccine is wrong. It's about, you know, last year I think it was about 30% effective because we don't know which flu is going to appear next year, nor did we know, uh, you know, that this coronavirus would appear. However, you know, people have been talking about this possibility. And I'll tell you that the death rate from coronavirus right now happens to be pretty darn low in comparison to SARS, which was at 10%, and MERS, which was at 20%. Mm-hmm. So this is, you know, comparatively quite low, but it's highly infective, far more infective than the common flu. flu and far more lethal by a factor of around 10-fold in comparison to the common flu, which has a mortality rate of about 0.1%.

Um, hang on, I have somebody that just asked a question. My daughter started having trouble breathing, tightness in chest, couldn't get a full breath, no fever, stuffy nose. Is that how corona is displaying itself in children? Doctor prescribed an inhaler and steroid but didn't test her.

Uh, you know, today, uh, I would say that it, uh, I would be highly suspicious that that is coronavirus these days in America. I, I would say almost, um, a, um, coronavirus until proven otherwise. Could she have the flu? Yes, she could. Could she have a, a cold? Of course she could. But I would say that child or anyone should probably be treated in such a way in terms of isolation as if she or he has it. I don't know if it's a he or she. Probably. But— and I would watch that person extremely closely because what can happen is things could be— things can go downhill very, very quickly. And, you know, It looks as if it says the doctor prescribed an inhaler and a steroid but didn't test her. It might well be that the doctor couldn't test her. Most of the information we're hearing from emergency rooms is that people seem to do worse, at least adults, when they've been receiving steroids. So one of the letters, emails from a colleague in emergency room was, by all means, tell outlying doctors in clinics to hold back on the steroids for the time being. So I don't know if this person actually saw this physician, and in which case his or her analysis I'm sure is important, but these days I'd be very, very concerned.

Yeah, and then this one, if a member of the family gets COVID-19, how do we take care of the rest of the family to protect them?

The person needs to be isolated, and that means in a room by him or herself. And, you know, the question becomes, if this is a home with central air conditioning, is there a risk if that air is piped out into the, you know, main air conditioning and then piped into other rooms? Most of the research that has come out of China, even sampling the air in hospital wards where there are virus patients indicates that the level in the air is almost undetectable, but they were able to find virus on the air conditioning grates and filters and things like that. So I'd say, first of all, shut the air conditioner off or the vents to that room and open the window if at all possible. Recognise that that individual may well be infectious for many, many days, well after symptoms have abated. We're now seeing reports out of China, 2 of them actually, indicating that people, even when their throat swabs and nasopharyngeal swabs are negative twice in a 2-day period, which is the standard for saying you're no longer shedding virus, that there's still virus being shed in the stool. In other words, contaminating the bathroom, contaminating the toilet and the sink. So recognize that shedding virus through fecal means is another potential vector for infecting other people.

Oh yeah, I did, I remember reading about that. That's so super interesting. It's such an interesting time to be alive. Let's see, let me see if I've got one more question here. I do echocardiography in the clinic where I work. They gave us an N95 mask, only one mask. Is there a way to clean the mask? For example, spraying it with 99% alcohol?

The answer is unfortunately, you know, I've reviewed all of the techniques that have been described from using Clorox to alcohol to microwaving, steaming, and they all work to some degree, but they compromise the mask by increasing its permeability or by reducing its ability to bind things that the N95 is able to do, like viruses. So it would be better than nothing, but it's a tough call. It's a very tough call. Again, it's better than nothing. Even a bandana is better than nothing.

Mm-hmm.

But that's why we're looking for resources for more masks. 50% of the N95s on the planet are made in China. China is doing a great job in supplying most of the world with their manufactured masks. So we need to reestablish our relationship and stop blaming countries and people and government people for doing this or not doing that. And recognize it's not going to help us to point fingers that somebody should have done something or did do something or didn't. That's not going to help move the ball down the field. We've got to forget that stuff and just communicate with each other and listen to other people's opinions and formulate new ideas and move forward. And I would like to say one other thing, and that is that you're seeing a lot of changing messaging from, like, the CDC and from the president, etc., and I would welcome that. I would say that the The fact that the messaging changes is likely a good thing because it means we're being dynamic and we're being responsive to new information instead of locking in our heels and saying it's this way, end of story. So when now there's a change, for example, in the recommendation for using a mask, but we told you before you shouldn't use a mask, now we're telling you you should use a mask. Okay. Suck it up. We're going to move forward because it looks like maybe the epidemiology shows us that mask wearing might be a good idea. So I would say embrace the idea that the recommendations may change over time.

Well, and this is the other thing. This is something that I've really appreciated about the— particularly the speakers that come to Paleo FX. No one's really tied to a dogma. And this is the thing. None of this right now This is all new, it's all novel, it's all coming to it. They're trying to do the best that they can and do these studies and figure things out as fast as they can, but at the end of the day, they're trying to make the best decisions as they can and as possible with the information they currently have. But know that the information that they have will change by tomorrow, and that means the recommendation may change by tomorrow.

That's right, and we're in a very dynamic situation. and learning new things every day and learning things that are not working and some things that are working. And that's good. That's, you know, we've always in America been good at that, of really responding to these challenges. So again, I would just say, in my opinion, that we should welcome the fact that some of the messaging that we are getting from governmental organizations changes. And that is a demonstration of dynamism, and I'm very appreciative of that. Now, you know, having said that, we are, we're seeing some nice developments in the treatment realm. There is an antiviral called remdesivir, remdesivir made by a company called Gilead, and Brigham and Women's Hospital just yesterday announced that they have had approval to study this remdesivir in 600 patients. The company is also opening it up to use for extended usage. We know that, or extended access, it was approved for compassionate use. Compassionate use means that I'm standing at the bedside, nothing that I can do is going to help a patient, we've got this remdesivir, let's give it a shot. And it's been used in that context and has actually proven effective in a small number of patients, the utilisation now is going to be expanded. We know that this is an intravenous injection that the World Health Organisation indicates is the most promising antiviral out there, was originally developed for treatment of Ebola. So there are some good things happening. The combination of hydroxychloroquine with azithromycin, or Z-Pak, if you will, has also, in a very small study of 20 individuals, proven quite dramatic in terms of ridding the body of virus, which allows the body to heal and certainly would reduce transmissibility of that virus. So, you know, those studies are just getting underway. There is a lot of work being done looking at the idea of using what is called convalescent plasma, meaning A person has coronavirus, they fully recover, harvest their blood, take the plasma, which contains antibodies, specific antibodies against this particular virus, and use that to treat patients who are very ill, or even perhaps extend that to individuals in a prophylactic way to prevent them from, you know, from having a bad outcome.

Yeah. So it's interesting because I'm actually I've ordered the IgG tests for COVID-19 because we actually believe that, um, we know that we were exposed for sure because there we were exposed to a person that did test positive for COVID-19 several weeks ago. And so, but we think that Keith actually may have had this at the, um, end of January, beginning of February, before it really became a big thing here.

Before it became popular.

Yeah, yeah, before it became popular.

We were the early adopters.

But it was really weird because Keith doesn't, you know, he just doesn't get sick. And it took him down for a number of days, and he only had a fever, and he only had it like cough. And so we just assumed that it was some kind of weird viral flu kind of thing, whatever. But anyway, so we are getting tested for that. And so my, my thought process was definitely if I find out that I, we def— he definitely had it where I was exposed and neither one of us currently has it, that we would go and give plasma to be able to support being able to give antibodies to those that are actually sick.

Absolutely. You know, that this was done in 1918 for the Spanish flu, for example, and did demonstrate about a 23% reduction in mortality. I mean, their technology to pull this off back then must have been challenging, So we can do better now, but I think it's certainly, you know, I know Israel is deeply involved in doing this right now, and I think it's something we should think of. Don't take anything off the table, but at the same time, recognise that we have to think of the risks of the treatment. For example, hydroxychloroquine is not risk-free. It can cause cardiac rhythm disorder, and— also cause vision— visual change, which is permanent, that doesn't resolve. And then the azithromycin is also associated with liver damage, kidney damage, gastrointestinal issues in and of itself, and interacts quite negatively with around 62 other drugs, which are listed on various websites. So it's not as if everyone's going to start dishing out the hydroxychloroquine and the azithromycin and hope for the best. So we have to think that You know, there are— we have to think of risk-benefit ratio.

Right, I agree, I completely agree. And it's interesting because my son and I both are allergic to AZith, so that would definitely— if I ended up with it, that it would be a way that I definitely didn't go down that road.

Yeah, I mean, it's not for everybody. So I think right now isolation is the key if you don't want to get it. You Right. You go through the drill. Sterilize your packages. You wear gloves and a mask if you go to the grocery store. I don't want to get this, but if I did, I was thinking about it today because a friend rode down the street on his bike and he said they were— they had it, their whole family had it. It was a bit rough. Now they're out there and living the life. They don't have to be worried about getting it. And I thought, gee, if only we could be assured that it would be somewhat mild and And then I could, you know, go to work in a hospital and not worry.

Right. Oh man, interesting times for sure. I really appreciate you coming on tonight. I want to be like really respectful of your time. I appreciate you've spent about an hour with us. And tell me, I wanted to ask you, you are doing a— you're gonna be launching Science of Prevention in September, on September 9th. Can you tell us a little bit Sure. So

Science of Prevention deals with Alzheimer's, and I think in your setup today you'd mentioned that. And it really is getting out the information that our lifestyle choices affect our brain's destiny. I mean, people know that exercise is good for the heart, and we can have stronger bones if we do weight-bearing exercise, and ketogenic diet is effective in reducing our risk for high blood sugar and a treatment for diabetes. But you know what, there are a lot of things that we can do to reduce our risk for Alzheimer's disease, a disease for which there is no treatment. So that's what that's all about. We've assembled a team of world-class researchers and clinicians. I think you had Dr. Dale Bredesen scheduled to present, or he may have presented already. He did.

Yeah, he was scheduled to present.

Yeah, and, you know, a brilliant researcher at UCLA. And, you know, these individuals all came, showed up, and we recorded them, and they imparted some just breathtaking information. So September should be a good time when this current issue has settled down and we can begin to focus on other health-related issues.

Yeah, I will be happy for that. I will definitely be happy for that. So thank you so much for coming on. Y'all, if you are watching on replay, please put your questions in the comments and then we will get you the information to be able to go over. And actually, I think the link might already be there. Dr. Perlmutter usually does a daily Facebook Live on his page.

David Perlmutter, David Perlmutter, MD on Facebook.

And I think that link is in the top of the comments. You can find that, and then if you're watching in replay, please just hashtag replay. And if you know somebody that this information could help, we really would appreciate it if you would share it with them. Because right now, I think having really great information is so key for keeping ourselves out of that fear and being having knowledge and just knowing how to to move forward and not not be. In a fear-based, because like Dr. Perlmutter said, this actually will reduce your immune system, and you don't want that, not now. Thank you guys so much. Thank you, Dr. Perlmutter, for coming on.

Thank you, Michelle. Thank you for having me.

So appreciate you. You guys, I will see you tomorrow morning. I will be with Hal Elrod, the author of Miracle Morning, and you won't want to miss that. Join me then. Thank you. Have a great night.