Coronavirus Conversations - Day 27

Well, hello everybody. Guess what? It's not 5 PM Eastern, but I have things to take care of later in the day today, so I thought I would check in with everybody right now. Just did— why am I dressed up? Just did some national television on this exact topic, and I wanted to just do an update at this point and just offer up some interesting information. I do believe that we're seeing some real positive kinds of results coming in from New York, certainly the projections from the University of Washington, both with respect to Washington State and with respect to the country in general. They are predicting perhaps less than 100,000 deaths in America. Man, oh man, we, we would take that as good news in comparison to the previous statistics of 250,000 or more. So that's great news. And I wanted to approach something today that I think bears discussion. And, you know, we've been hearing that this COVID-19 is indiscriminate, meaning it can be something that attacks the Prime Minister of Britain versus your next-door neighbor. It doesn't really— that anyone is at risk. And I think to a significant degree that's true, but what is not indiscriminate seems to be the bad outcome. And when we are seeing the statistics right now that show, for example, that in New Orleans the death rate is 7 times what we see in New York, there is something going on here that we need to pay attention to. 97% of the deaths in the state of Louisiana are seen in people with one or more underlying health condition, one or more underlying chronic disease states, including cardiovascular disease, which we know is associated with a 13% mortality, type 2 diabetes associated with an 8 to 9% risk of mortality, chronic pulmonary disease about 8%, and these are things that we call chronic conditions. Hypertension, having high blood pressure, about an 8% risk of mortality if an individual were to become infected with coronavirus. So I think that, you know, the notion that this is an indiscriminate virus in terms of who gets it, maybe that's valid. But the idea that the outcomes are indiscriminate needs to be challenged. And having said that, it is a call for those individuals who have an underlying chronic health condition to be super vigilant, extra vigilant. Don't interact with people. Recognize all of the caveats that we have issued on this podcast over the past several weeks in terms of staying away from people, in terms of washing your hands, in terms of the packages that you receive from Amazon or from whomever, and all of the things that you need to do to make darn sure that you don't catch this. And, you know, ultimately expect that 50 to 70% of us are going to experience COVID-19. That's the prediction. That means most of you watching this— well, I don't know, it's a unique population perhaps— at least let's say half of you will experience it. And you're all going to hear of your friends who got it and are now through it and feeling better. That's for sure. I've heard that a lot. But what does it mean for each and every one of you? I think you have to sit back and ask yourself how healthy you really are. Understand that there, you know, are significant risks even for people who do not have underlying health conditions. We are hearing here in America that there seems to be a significant increase in hospitalizations in so-called younger people from 20 to age 58. I guess I consider that younger. Those are younger people, and we would say, well, gee, why are people who are young and healthy having a bad experience with this? Well, young in America doesn't necessarily mean healthy. We know that younger people in America have much higher rates than other parts of the world of things like type 2 diabetes and Overweight/obesity and extreme obesity, so a BMI of 30 or greater, or extreme obesity, a BMI, body mass index, of 40 or greater. Those are considered underlying health conditions. Those rates of elevated BMI, those metrics, are certainly associated with increased risk for hospitalization, Increased risk for ICU experience and an increased risk for death. This is not news. A study that was— a letter rather, was published in the Journal of the American Medical Association 4 days ago indicated that this is a powerful risk factor for bad outcome, and that is not news. We saw that with the H1N1 experience. That was back in 2009, 2010. So we know that these are risk factors. Now, why might hypertension, coronary heart disease, diabetes, obesity all be related to increased risk for poor outcome? Well, we know at their core that these are all inflammatory disorders. We also know That these and other chronic conditions are associated with changes in the gut bacteria and therefore likely changes in regulation of our immune systems. So what do we need to do right now? This is still going to go on for months and until there is the development of a— some type of remedy and certainly in much longer term an immunization. We'll talk about what those may be in just a moment. But what we need to do right now is double down. We need to double down on our nutrition, on exercise, sleep, time that we get outdoors or reconnect to nature, gratitude, and meditation or prayer or both, because these are ways of reducing cortisol, reducing the damaging effects of the stress stress hormone cortisol, the damaging effects that it has on our gut bacteria, increasing the leakiness of our gut lining, increasing inflammation, and of course lowering our defenses. So now is the time not to bail on eating right because you're concerned, you're anxious, you're nervous, you're not sleeping well, you're feeling the stress. No, this is not the time to go to the comfort foods. You know, they're always there. They're always available, but don't do it. Eat more vegetables. Get some exercise. Maybe even fast from time to time, as we just concluded. We just did a fast yesterday. Concluded it yesterday with hundreds of you, if not thousands. I didn't count, or I don't know how I could. So these are the times that we really need to double down. We have control over inflammation, over the health of our gut bacteria, and as such. We can control our ability to get through this in a, in a better way in comparison to ending up in an ICU on a ventilator and maybe not having a good outcome. Having said that, I'd like to also indicate that we don't know what might be long-term consequences of this infection. We're now seeing reports of changes in the heart, changes in the lung, even some neurological issues that may persist once we start feeling better. So I would say that for those of you who may think, you know what, I'm— I've had about enough, I'm gonna go out and just do what I want to do, and maybe I'll get this because I want to get it and get it over with. I I don't know how that's good advice or a good plan. We don't know what, you know, our outcomes are going to be. Start feeling better and resume your life, and now you have antibodies and you're feeling protected, you are possibly taking a chance in terms of having a lifelong issue as a consequence of having experienced this infection. Now let's talk about some of The bright news, because I think there is some. The reports out of University of Washington indicate, as I mentioned earlier, that we may not experience the number of deaths that were originally projected. We are seeing that the number of new hospitalizations in New York seems to be possibly on decline. We're not yet seeing that in Europe to any great extent, although they're reporting That the rate of increase seems to be decreasing. So we may be seeing some things that are very, very favorable. On the treatment front, we're seeing a significant expansion in doctors and clinics around the world exploring plasma therapy, specifically called convalescent plasma therapy. What does that mean? It means harvesting the plasma Of a person who's recovered because that plasma contains antibodies directed against COVID-19 that can be administered to other people who are sick, who may want to prevent the illness in the first place, or at least put themselves in a position whereby they may get it, but it won't be as severe. The idea of amplifying these clones or monoclonal amplification of these antibodies is being looked at around the world as well. And I'm very favorable that this is going to be helpful in the near term because this is something already being used, monoclonal antibody therapy. And I think therefore the approval process might be something much more available to us in a number of months As opposed to having to wait 18 months or 12 to 18 months for the development of some form of vaccine. So I'm actually very, very encouraged by that. So the take-home message is right now, what do we need to do? We need to do what works. And what is working right now is keeping away from each other, keeping that social distancing idea active. Not— if you live in Georgia, my opinion, not going to the beach with a crowd of people. And, you know, I don't think there's a lot of wisdom there. We are seeing some improvements likely only because of what we are doing from a behavior perspective, because the antiviral treatments and the plasma treatments that we've just talked about are not yet in wide use. So that can't be the reason that we're seeing some things happening. Now, might it be that the weather is getting warmer? Who knows? I would take that. If hot weather is partly a reason why we're seeing perhaps some flattening of the curve, great. The hotter the better. I'm all in. We know that that might explain why influenza seems to go down, not just because of the heat, but because of the fact that people are less likely to be close to each other indoors, and that might be a seasonal social distancing type of thing that normally happens. With MERS, we saw that in Abu Dhabi it flourished even in 100 degrees outdoors. Okay, good. So I'm going to take some questions from— I've heard many people having it without a fever. That's a very good point, and that is true. We call these asymptomatic carriers. These are people without symptoms and We also talk about people who are presymptomatic who may have, who may go on to develop symptoms but not having them yet. And it's the reason that we have to challenge the idea of screening people who come off a plane or a train by simply taking their temperature and feeling like we are totally screening out people who may or may not have COVID-19. Again, based upon what you just brought up to us, you know, just checking your temperature, you could be asymptomatic, and that may be 50% of people. We talked about this at great length yesterday, looking at the statistics of people, maybe as many as 50%, able to spread this virus and don't have symptoms. These are the people you don't want to bring into your home, you don't want to have close contact with, but— We had people in our front yard yesterday. They brought their own lawn chairs and we sat there in the afternoon and had some time with them. And it was my mother-in-law's birthday. We celebrated. We were about 8 to 10 feet away from them. Then they got in their car with their lawn chairs and it was fantastic. And, you know, there's one thing to say we should be socially distanced And another to say we should be socially isolated. Not a time to be socially isolated. We need to interact with each other, but do it in a smart way. Okay, Lanny Nichols, I was sick for 3 weeks. Fever, headache, sore throat, fatigue, mild shortness of breath. I can't— I lost the question. But anyway, so you may likely have had COVID-19. Again, we see this to be a much more protracted illness in comparison to having the flu. So be ready for that. And if you don't get tested and you have something like this that goes on for quite a while, likely that is COVID-19. It's airborne. If you breathe, you are at risk. I would agree with that. I presented the data yesterday. A research study that indicated, yes, it is likely transferred in just breathing the air of another person, and certainly if that person is speaking. It's why you don't want to be close to people, and it's why wearing a mask is a good idea. You may not have an N95. You may have to make a mask or get a mask that's a surgical mask that isn't as robust in its ability to screen out the virus. Nonetheless, any mask is better than no mask, especially because of its ability to help keep you from rubbing your face. Watching from Texas, thank you. What are the neurological blank after COVID-19 issues? Cognitive impairment, memory issues, confusion, hallucinations, psychosis, and even schizophrenia have now been described. Ilsy August, gut health is key. I am totally in with you on that statement. You bet. We've been talking about that for a long, long time. It's what our book Brainwash has— not Brainwash, Brainmaker, sorry— is all about, and that is caring for your gut health, caring for your gut bacteria. Let those little guys in your gut help you with your immunity. Help you with your mood. Who knew? Let's say, as always, USA is the exception. Please be realistic. You're not an exception. Numbers in USA are going up. You bet. And I am a proud American, but I would have to say that one of the reasons that we are having such a tough time with it is that you know the health of Americans is not great. Great. I'm just speaking from data. It's what we know to be true. Published data from the World Health Organization would indicate that there are much higher rates of obesity and chronic degenerative conditions here in America in comparison to other countries. And as we talked about in the opening segment here, those are the things that are associated with poor outcome as it relates to COVID-19. That said, we know the World Health Organization data indicates that the United States ranks about 23rd in healthcare in comparison to other countries around the world. Simply a statement of fact. I am proud of my country, but this is a statement of the data. How can we explain what's happening in Sweden, where it's talked about that Sweden has the right solution, allowing social interaction, And really getting on with it. I think that we're going to see how that plays out. Maybe it's the right choice. I am open to considering that. It doesn't seem to me at this time to be the right idea, but we'll see how it plays out. It may be a good thing for their economy and their outcome. Maybe not. These are ideas that countries are choosing. some restricting more than others. We have to be open-minded and be flexible as per the quote that from Roosevelt, Franklin Roosevelt, that I talked about yesterday in our time together. Any new news about the ACE inhibitors? Again, that is a very interesting topic that the idea that this coronavirus attaches itself to the ACE2 receptor on cells, there is some sense that blocking that receptor or inhibiting the ACE2 chemistry might be worthwhile using what are called ACE2 inhibitors. That's still up in the air. We haven't really heard anything that's definitive. But let me just reiterate something that was talked about yesterday. And it gets back to this whole notion of what is this penultimate event of— in the intensive care unit that ultimately is associated with death. And it is this thing that is called the cytokine storm. It's a sudden explosive inflammatory event. Inflammation just explodes in the human body with the production of these chemicals called cytokines. That just damages organs throughout the body, the brain, the heart, the kidneys, the liver, the lungs. So this event, this cytokine storm, is characterized from a laboratory perspective by a sudden increase of one of the cytokines called IL-6, interleukin-6. Now, we've known about this interleukin-6 for quite some time. We see that it is elevated in certain autoimmune conditions like rheumatoid arthritis, and there are a couple of drugs that are out that block the way that IL-6 increases inflammation. These are drugs that are called monoclonal antibodies, and they're being used to block IL-6 in patients with rheumatoid arthritis. So there is certainly interest in giving people these medications. It's now actually being done. There are 2 trials underway giving people these drugs to block the way IL-6 does its damage in people who are in extremis or who are having significant issues in the intensive care unit with this infection. So there are ideas now. There are interventions that are being looked at to target this so-called cytokine storm. From our perspective, well, our perspective is certainly one that embraces the medications, but I reviewed in previous episodes the idea that turmeric might be effective, having that on board in the first place as a nutritional supplement. Also, high levels of the omega-3s, and certainly we want to target a pathway in the body That can help reduce IL-6. That pathway, forgive me for being technical, but maybe you'll learn, you know, maybe this is interesting to you, is called the NRF2 pathway. Many of these comments each day talk about NRF2. And let me not be so technical, but simply, if we can activate this pathway, the NRF2 pathway, that has a role in about 600 or 700 different gene pathways in the body. We can temper inflammation, we can possibly reduce interleukin-6, and that may be beneficial for calming down this cytokine storm should we get really sick. How do we activate NRF2 pathway? Well, cruciferous vegetables like broccoli and cauliflower and kale These activate it. Broccoli sprouts, because they turn into sulforaphane when we eat them, a really powerful way to activate the NRF2 pathway. One of the neat podcasts that I listen to is by somebody named Rhonda Patrick. She is all in as it relates to sulforaphane, broccoli sprouts, and how that can activate the NRF2 pathway. Exercise activates NRF2. And guess what? I'm happy to report that coffee and green tea, mostly coffee for me, does the same thing. So we want to think about great ways to activate our NRF2 pathway. Why don't you Google it, NRF2, and learn about all the things that you can be doing to activate NRF2? Okay. I kind of like doing this update in the morning. As opposed to evening. So we start doing them, although we're not going to necessarily catch our United States West Coast people at whatever time it would be. So it'd be 6:51 for you guys, but again, again, it's banked on Facebook, so there you go. Okay, let's talk about— I have Something about I'm trying to send you friend requests on Facebook is saying you can't use this feature. I, I don't know how to work with that. So sorry, folks. What are your thoughts on NAC helpful for the lungs if you are positive? I think NAC is probably a good idea to have as one of your second-tier nutritional supplements. NAC is one of the few ways you can turn on the production in your body of glutathione, an antioxidant Helping with inflammation, so having NAC on board I think is a good idea. Okay, okay. Heart problems, lungs, etc. Think oh good that was a political statement. I want to tell you all I'm I'm personally not interested in the political statements. That's not really what we do here. I don't think it brings anything helpful for us in terms of things that we can do today to remain healthy, so I choose not to go there. Okay, Angie, good to see you. I'm trying to— a lot of people sending me friend requests. Okay, a lot of people saying I'm not with that all again. Can you help us understand whether the next, say, next 2 weeks are going to be so bad and we shouldn't even go to the grocery store or pharmacy? It's difficult to say. I don't think the next 2 weeks only are going to be bad. I think the next 2 weeks are going, in addition to probably several more weeks after that, are going to be bad. I think there's going to be a lot of cases out there. I don't I don't think that there's going to be any real difference in terms of risk if you cover yourself appropriately with a mask, wearing gloves, and going through the drill. I do want to say that I don't personally have an opinion that limiting yourself to groups of 10 people or less, I don't have the opinion that that's good information. My own opinion, I'm going to share it with you. It doesn't really matter. There's nothing magic about 10 people or less in terms of being in a group. I think you can be in a group of 5 people and be at risk if you're not distancing yourself from those people. I think being with one person is a risk if that— obviously, if that person is infected, that's a risk. So I don't think it's necessarily the number of people in your group. I think it's the proximity to those people in your group that's the issue. I think, you know, if you were with 100 people and they were spread out over a football field, that wouldn't be as big of a problem as being in an elevator with 2 people who may be, face it, coughing or sneezing. So, about beta blockers, haven't seen much data on beta blockers in terms of what they might do I would say that if a person is on a beta blocker, for example, because of a heart rhythm abnormality, then that— or hypertension, then the underlying condition, the cardiac dysrhythmia or the hypertension, may certainly be a risk factor for a bad outcome. Should I be concerned? I'm blood type A. There is evidence being talked about of increased risk With blood type A in comparison to blood type O, I think that that information is probably pretty valid. Hi from Atlanta. Have you talked about quercetin if you become symptomatic? So I would say about quercetin—that's actually a good question from Kathy Morier Moriera Moriera. Quercetin. Uh, is a bioflavonoid that may actually act to increase our population of healthy immune cells. It acts as what we call a senolytic. Seno meaning old, lytic means it destroys old immune cells. There is one another flavonoid compound that is, I think, more effective. There's more science behind it. And it is called fisetin, F-I-S-E-T-I-N. And I posted some studies related to fisetin on Dr. Perlmutter, drperlmutter.com. So you can go read those. I am taking fisetin right now. I think it's a good nutritional supplement to have on board. I'm also taking vitamin D. I'm also taking zinc and taking cod liver oil every day. My doing my very best to sleep, meditating every day, doing all of the things. I do fast probably now once a week. Okay, so Lori Ezel, E-Z-E-L-L. What about handling items at the grocery store? The canned goods, produce, just about anything in the store that can be handled. This is a very, very good question. When were those shelves stocked? They might have been stocked. That morning, and they may have been stocked by somebody who has been infected with having virus on their gloved hands, on their bare hands. Who else took that item off the shelf and then put it back? I'm not saying you shouldn't buy things in a can. It's a good idea. You should be gloved. You should bring them to the checkout. They go in a plastic bag or paper bag. When they get home, what I would recommend doing is dumping them out on the floor, in the garage, or outside, and then wiping them down with a cloth that has Clorox on it or some form of bleach in a 5-to-1 ratio, 5 parts water, 1 part Clorox. You can use Lysol. You can use 70 to 75% alcohol. I've given you a list of over 150 possible things to use. That's on our site, drperlmutter.com, a list of approved products to use. Definitely want to wipe those things down, let them dry, and then you should feel safe bringing them into the house. Those gloves that you've used can be reused when you get home to put them in soapy water, wash them, but better would be to put them in a— Sterilizer. bleach solution, again, 5 parts water, 1 part bleach. If you don't have a lot of gloves at hand and you need to recycle them, by all means. I would also say that, you know, Dr. Sanjay Gupta has put out a video in terms of how to sterilize packages that you get, and I would say it's great information except for one thing. That is, if you're wiping things down with a liquid of one sort or another, and then opening boxes, etc. One missing piece of the puzzle, I think, is to make sure you have eye protection on, because if things are wet and you're going to possibly form droplets by ripping off the tape or busting open the box real quickly, you want to have eye protection on. It might just be a pair of sunglasses, totally fine. Then of course wipe them down when you're done, but make sure to protect your eyes. I also think that eye protection Glasses, sunglasses are a good idea in the grocery store as well because virus can enter your eyes. That is a portal that I think is reasonable to protect. Let's go back to some questions. Let me— how do I know you are immune? Great. So Karen Zollner, how do you know you You are immune. I was very pleased to learn yesterday that there is a powerful new screening tool that looks at both the antibodies IgM and IgG that is being made available to businesses around the country. And apparently this is valid. I got it because I'm a physician. I'm a physician. I got it as an email thinking that I could order this for my office, et cetera. And I checked with another colleague and he's well aware of it. We actually saw it talked about on CNN. So I think pretty soon we're going to see the availability not just to test us to determine if we are infected, which is what the current polymerase chain reaction study does, but to determine if we have antibodies. Why is that important? Because now we know, yes, we've likely been infected, although To say, to be truthful, there are some false positives. In other words, if you've had a previous coronavirus, then it may trigger this thing to say that you're positive. But likely this is a way, if you were suddenly quite sick and now you're feeling better, it would indicate that you just had this COVID-19 and now you have antibodies to it. Why is that important? Good for you to know. Hey, good to know. Maybe go back to work. But also because you might now be a good candidate to donate your blood so that your plasma can be harvested and used to treat other people. Folks, we are going to see that happening very, very soon. We're going to see local clinics, local hospitals sending out a call. We haven't seen much of it yet, but it will happen. And when it does, I'll call your attention to it. What is the date today? Today is April 7th. So we'll remember how we talked about it today, but they'll be calling for people who are now recovered to donate blood, and that will prove to be something that can be used for all of us who've not yet been infected, or for those of us who do get infected and become quite ill, perhaps in combination with remdesivir or other antiviral Remdesivir, we've talked about before, an antiviral being manufactured by Gilead, G-I-L-E-A-D, now being used in about 1,700 people in America in first a compassionate usage strategy for people who are really declining quickly in the intensive care unit and also now expanded to what is called expanded use. So we're going to get data From an interventional trial within about a week that is going on right now in China on this drug, Remdesivir, given intravenously. We know that Gilead has produced, I think, do I want to say 500,000? Enough to treat 500,000 people. It's given intravenously, I believe, twice a day. So they've already banked enough of this antiviral to treat half a million people. What we don't know yet is, is it going to be effective? Most of the guidance indicates that it will be, but let's wait for the study before we suddenly talk about it as being a plausible or meaningful treatment. Yes, so Michael Roca, COVID-19 causes an overreaction of the immune system and it is this inflammation that— Yes, you are exactly right. Just go back to the original part of our time together today when we talked about this, and then Ilse August talking about loss of actually no, it's Betsy Burke talking about loss of taste and smell, zinc deficiency but not functional. Anyway, I don't know your immune system will use zinc. Yes, we do know that's true. So the immune system will use zinc. I'm not certain that the loss of sense of taste and smell that may be a presenting symptom or an accompanying symptom once you are sick is necessarily because of a sudden drop in zinc, and I'll tell you why. Because some of the data indicates that, as you might expect, that the original infection involves the cilia in the nasal passages that then help transmit the— that then involve what's called the olfactory bulb that transmit the sense of smell to the brain, and also because it may involve the taste receptors in the tongue. Okay, a juice fast typically adds too much sugar. This is a report from Catherine Sansing. You know, I want to comment on that because I think it's actually an interesting comment on The idea of juicing vegetable, fruit and vegetables in general. And I think that we should talk about how you do that. You know, to go into the health food store or to make a great big tall glass of carrot juice, while that looks really good for you, you know, it's got beautiful color, etc., typically what happens is with a juicing machine that you throw out the fiber and you don't want to do that. You want to eat the fiber. Also, you know it might take however many big carrots, you know three or four or five big carrots to make a glass of vegetable juice. Why again it seems healthy, but the comment here I think is very good, and that is that's a blast of sugar. Face it, when you're drinking that carrot juice, it is sweet, and it is also generally devoid of fiber. That's not what you want to do. Better choice. is to eat the carrot. A much slower delivery of sugar, and you're going to get the fiber to nurture your gut bacteria. When I go to the health food store and I watch them making all these juices for people who then drink them down, I watch them throw the fiber in the garbage can, and that's the part that we desperately need to nurture our gut bacteria. Okay. Somebody wants me to talk about the NRF2 pathway again. Again, why don't you Google that, NRF2? I have a lot of information on drpermutter.com about the NRF2 pathway, but let me just summarize. It's a very pathway for regulating inflammation, regulating immunity, regulating the production of free radicals, these damaging chemicals that accompany inflammation. That end up destroying our tissues, killing off, you know, our— actually our immune system. So we can regulate NRF2 and enhance that pathway by exercise, by stress, by putting ourselves in a low level of stress like not eating, by eating cruciferous vegetables, drinking green tea, drinking coffee, turmeric, a powerful way of Amping up the NRF2 pathway. Okay, we've talked about vitamins. Okay, let's see. I live in a hot zone, and yes, we've seen ads for this in local hospitals. Good. I think— I don't know what you're talking about, but I'm hopeful you're talking about bringing in people for plasma donate— for blood donation to utilize their plasma. Great. So it is going to happen. And Chris Lancaster, I'll answer your question in one moment. So I think you're going to see that even in your local hospitals. And if you are an individual who has come through COVID-19 and you are now feeling well and let some days elapse, it might be a great thing to be that Samaritan. Go to your local hospital, donate your plasma if they are collecting blood. for this purpose. I think it's going to turn out to be— we'll see the science, but I think at least they can bank your plasma if the science proves that this plasma donation will be a good thing. Next question was from somebody saying, I'm on Plaquenil for an autoimmune condition. Will that help me with COVID-19? Don't know the answer to that. Plaquenil is hydroxychloroquine. That's a hot button right now because some people are saying it's worthwhile and and others are saying that it is not. We reviewed science the day before yesterday from China, a recent study that showed that in fact there was no real benefit to hydroxychloroquine in terms of how long people shed virus, improvements of their chest x-ray, and even their— until the time they became afebrile or didn't have a fever. So we're getting mixed messages on hydroxychloroquine. It is not proving to be, you know, an exciting antiviral drug as it relates to COVID-19. I wish that were the case. Keep in mind that there are some potential downsides or risks of hydroxychloroquine and also for chloroquine, including heart issues, lung, liver, and even permanent visual changes. So Always think about what are called the risk-benefit ratios. We don't know the benefits. The risks are certainly well-defined in certain populations who've been taking Plaquenil for a long time, like people with autoimmune conditions. What are the risks in people who have COVID-19? That is something that has not yet been determined. I'll take a couple more questions, questions, and then we will— Call it a day, and okay. Ah la da. Okay. I have high iron. What is this an indication of? Many things can cause high iron. You know there are certainly some diseases that people have that are associated with high iron and high ferritin levels for which. You know, you might be having blood removed every month or so. That might be the disease that you have, and I don't know necessarily, is that necessarily a risk here for a bad outcome? Let me get a couple more questions and then I will say goodbye. I'm not going to do the 5 o'clock thing today. I'm going to actually be doing something else. Hi, David. And I juice and also take psyllium husk for fiber. Yeah, I would say psyllium is interesting. It does tend to bind magnesium. That might necessarily not necessarily be a good thing, but I would say that look at more natural types of fibers like acacia, acacia gum. Baobab fruit. These are widely available in health food stores, and I think I'm going to leave it with that unless I see something that might be applicable. Okay, last question: How much zinc? Of course, check with your healthcare practitioner. I take 50 milligrams of zinc picolinate daily, and that's it for me. So everybody, thank. Thank you, Jimmy. You can sign off now, and I appreciate the time we get to spend together. I'll hope to check back with everybody tomorrow at 5 PM and take more and more of your questions. Bye for now.