Coronavirus Conversations - Day 33: Talking About Coronavirus Testing, including Antibody Testing

Well, hello everybody. I will say good morning because it is morning, and I'm going to talk today a little bit about testing. I think, you know, that's certainly the talk of the town right now. What does it actually mean? What are the types of tests that are out there? And what are the implications for the tests that we have available for us? So first, let's just break it down. There are 2 main types of tests that we see being used. The first type was the original test, the nasopharyngeal swab, We call that a molecular test. Why? Because it actually tests for the genetic molecules, if you will, of the virus itself. It's a marker, a test of is the virus present and active in that person's body right now. And that has proven very valuable in terms of tracking, in terms of understanding who is infected and therefore who is infectious, who could transmit the disease. And we see that in various countries that have been aggressive in employing widespread testing of this type, that their numbers have improved greatly. South Korea, for example, comes to mind. Super aggressive in terms of testing, in terms of quarantining those individuals who proved to be positive in terms of the testing, and it worked out to be profoundly effective. So there's a direct relationship then between how widespread testing is and the control that countries are able to execute over the spread of the virus. So it's been estimated that we are currently doing in the United States approximately 150,000 tests on a daily basis. Harvard research recently indicated that in order for us to gain control and to really start to have a meaningful impact on the numbers, We have to triple the number of tests somewhere around 500,000 tests each day. Please understand, however, that it is not just the testing itself that is important, but— let's just see, make sure this is working. Okay. It is not just the testing itself that matters, but what do you do with the data? What do you do with the information? When a person tests positive, that individual needs to be isolated. And that means we have to keep that person away from others so he or she can't spread the virus to other people. That's acting on the information. So there's 2 steps involved here. Number one, increasing the amount of testing that we are doing, and hopefully that will happen. And number two, then acting on the information. That has to happen as well. What we are seeing in America right now is a huge polarization between people who want to continue the quarantine and people who want to get back to work. And I would say that this doesn't have to be a mutually exclusive consideration. We don't want the virus to spread and more people to get sick and more people to die. You know, we already have 40,000 Americans that have perished from this virus. And at the same time, we have to understand That this is taking a huge toll on our economy. And it's not just the economy, but understand that about 22 million Americans have filed for unemployment in the past 1 month. That is a health threat in and of itself. It doesn't mean that we have to either choose one or the other. With testing, we can do the right thing in terms of controlling the spread of the virus And at the same time, figure out a way that allows people to return to work once they've been tested. And this leads to our second type of testing, and that is called serological testing or blood testing. And it's really a very different approach to looking at this virus. What this type of testing does is it doesn't measure whether the virus is present or not. It actually measures whether the person's body has developed antibodies against the virus itself in an ideal world. It measures the— what are called antibodies IgM and IgG. I'll explain those in just a moment. But again, it's not measuring whether that person is infectious anymore. In other words, is the virus present? It is measuring Antibodies, and that's really quite different because in an ideal world, if you show positive on the antibodies, it means number one, that you've been exposed to COVID-19, and number two, that you are likely immune to getting it again. Now, it doesn't mean 100% that you're immune from getting it again. That's very important. But I think that by and large, it's pretty good. It's a pretty good indicator. That you may well be immune. We discussed in episode, I believe, 32 of our update, the fact that now about 2% of individuals who were tested negative on 2 occasions for the virus are now testing positive again in a study of about 300 individuals in South Korea. So that might mean that the virus can reactivate. It might mean that— they have been re-exposed and were able to contract the virus again, we don't know. But by and large, there are now these tests that measure serology, measure antibodies, immunoglobulins, measure your basically immunity against the virus. Again, please understand that by no means is this 100%. Now, there can be false positives. And we talked about that earlier, meaning this test says you're immune, but actually it's picking up, it's reading these antibodies from being previously exposed to a coronavirus. This isn't our first coronavirus. We've known about coronaviruses since the mid-1960s, and many of us have been exposed to one or another of these coronaviruses over time. Typically, the infection is mild, has been in the past, not like we have now. So that said, one of the reasons that you can test positive on the new tests that are very widely available, or at least becoming so—40 of them have been approved by the FDA—one of the reasons you can test positive and have a what's called false positive test is previous exposure to a coronavirus. And the test sort of thinks that— it reads it as being positive for COVID-19, meaning you end up thinking you're immune and you might not be. So be aware of that. These tests are not 100% accurate, but it's pretty much the best that we have going. So that said, we need to ramp up our ability to test people, and that will allow us In the shorter term to get people back to work, get our economy back on its feet. The idea of just saying things are open, everybody go back to work, hope for the best, we're going to end up in a situation where there'll be higher transmission of this virus and it's going to set us back in terms of time. What happened in 1918 I think is very instructive. There was an initial wave of an influenza, Spanish flu, Though it didn't come from Spain. Nonetheless, there was an initial wave and then it started to taper off a little bit because people were isolating themselves, etc. And then people decided that they had had enough and then the second wave was actually worse than the first wave. We don't— you know, here we are in 2020. We have technology that can prevent that from happening and it is called testing. Got to test. Interesting how the state of Maryland was just able to acquire some testing kits from South Korea, recognizing how important testing really is. Now, you're going to see your local doctor's office have the serological test, the testing available for antibodies, and in fact, you might even see that you might have the ability to to order these kits online. So I think that by and large they're going to be effective, but take it, you know, with the consideration of the things we've just talked about, that they may be false positive and therefore people may think that they are immune and nonetheless may not be, but it's the best we have. In an ideal world, we could go to our local pharmacy and pick up over-the-shelf, rather off-the-shelf testing Much like blood sugar testing, much like pregnancy testing, and go home and test ourselves and determine what is our status. That would be ideal, and hopefully that's where we're going to go. That would be the absolute game changer as it relates to this situation. Then you know who can come over, who cannot. Then you know who's safe to go back to work, and that's what we need to develop. And so I think that's in the works. We just have to take a deep breath and wait for that to happen. We know that there is a point-of-contact test that's being put out by Abbott Pharmaceuticals, and this is a throat swab test for the virus, giving results while you're at the testing station in 5 minutes. So you don't have to wait 5 to 7 days. You know right away what your next course of action is. If you test positive, you drive home, you let everybody know, and you self-isolate. In an ideal world, you would then test 14 days later and determine now if you have the antibodies. Let's talk for a moment before I answer questions about those antibodies. You get the test and it's either negative, saying you don't have antibodies, therefore you're not immune, unless it's a false negative. Or you do have antibodies and there are 2 types, IgM and IgG. Now these antibodies trigger at a different rate. The acute antibody that flares really high when you're first exposed to this virus or a bacteria or other virus, whatever, this is called IgM and it peaks out very early. So if you have an IgM spike or indication on your test, But you don't have IgG, it means that you've been exposed, likely, but you don't have long-term immunity yet. You really want to have the IgG turn positive, and that's an indication, likely— I say that a lot— that you now have long-term immunity. So let's be clear. You go out, you go to your doctor's office, maybe you order the kit for your home, You get 2 responses, IgM and IgG. IgM is the acute response. IgG, that's what you're looking for. That means longer-term immunity, likely. It may not be permanent, that's for sure. It may not hold you for next year's round of coronavirus, if in fact there is one. But it is an indication that right now, as we go through this and as we wait for further testing to take place and development of better testing, It means likely that you're in pretty darn good shape. So I hope that clarifies this whole— a lot of these questions on testing. I'm happy to look some more at your questions now moving forward. I see that there are an awful lot of you following this today, so let's talk about— Hi, David. Some of these questions. Okay, here we go. CDC's failed coronavirus testing. We're there's a link there. David Zamenhof. Yes, that indeed happened. The CDC had some issues with some of the tests that they received in terms of not handling them appropriately. They weren't you know nothing's perfect and no one is perfect. But I think people are trying. I think CD is certainly trying to do their best. Hello from Sydney, evening time there. Interestingly, why I don't know this is the case, but our second highest country is Australia. Our second highest city that views these podcasts each day is Melbourne, Australia, second only to New York. Okay, I wouldn't take those tests. Nope. All right, I don't, you know, I don't see a risk for taking the test. I mean, I understand why some individuals are fearful of immunizations of one form or another, but to have your blood drawn or to have a throat swab, I think, is going to provide you good information. I think it's valuable, but everyone Everyone is entitled to an opinion. That's what's good about that. Something about IgG and IgM are specific. Yes, that's what these tests are all about. We develop IgM and IgG to a variety of infectious agents to which we are exposed. We know that we can develop almost lifelong immunity to some things to which we are exposed. exposed. But, and so we don't know how long our immunity will last as it relates to this. And results in actual herd immunity? Yes, the more people that are immune, develop antibodies, the larger is our pool of what we call herd immunity. And once we get past a point of where we're transmitting, the risk of transmission of someone infected to another person is less than 1, then we're in really good shape. Then we are in a situation where the virus is no longer able to continue to spread aggressively in our population. Okay, a lot of people are saying, well said, etc. I don't know what that refers to. How does NRF2 help prevent the coronavirus? It probably doesn't do a lot, and I'll explain for all of you what NRF2 is. NRF2 is a pathway. It is. In our bodies that balances immune system, therefore may have a role in, in, in terms of our response to this virus. But also NRF2 has a huge role to play, and this is important, please listen closely, in inflammation. We know that chronic inflammation is what characterizes things like diabetes, coronary artery disease, All kinds of chronic degenerative conditions, even obesity. That said, guess what? Those conditions are associated with worse outcome as it relates to this type of infection, COVID-19. Nrf2 reduces inflammation and therefore may play a role perhaps in limiting the inflammation that's associated with bad outcome If you catch this virus. So how might you activate the NRF2 pathway? Lots of things: aerobic exercise, cruciferous vegetables, supplemental sulforaphane, which you can get from, from growing your own and chewing broccoli sprouts or kale sprouts, cruciferous vegetables as I mentioned, green tea. And one of my favorite approaches to activating this pathway is Coffee. So this is a way of activating a very powerful pathway in your body that helps balance immunity and reduce inflammation, and also may be effective—not saying it's been proven—by reducing free radicals by turning on your body's ability to make its own antioxidants. So that's important. It's one of the reasons that using turmeric in your cooking or even as a supplement is an anti-inflammatory. Anti-inflammatory approach. Turmeric, guess what, activates this NRF2 pathway. So for all of you who are watching this, think about NRF2, Google it, learn about it, because you're one step ahead of the next guy because you know about this, and therefore you know about the value of those lifestyle choices I've just described in amplifying this NRF2 pathway. 80% of infected never develop symptoms. I haven't heard 80%. The highest number I have heard from a study out of Iceland was 50%, but I will tell you, even if it's 20%, it's a, it's a concern because people who are infected and show no symptoms oftentimes are playing a key role in spreading the disease. This is what differentiates COVID-19 from other of our epidemic concerns in the past and even the flu. Very few people who got the flu and were able to transmit it had no symptoms. Obviously, some had very few symptoms, but that's what's so stealthy and worrisome about COVID-19 is the fact that there are a large number of people out there who can transmit the virus And don't have symptoms. Now I want to talk about something else I think that is very important. Right now we're seeing a lot of talk about the fact that the number of new cases is not increasing finally in the United States. I want to look at that statement and look at the numbers and maybe add a little bit of discussion here because we're hearing that, well, it's— we're safe now, we've reached the peak. Let's go back. Let us relax, you know, our efforts to isolate ourselves because the number of new cases is not increasing. Well, how do we determine the number of new cases, the number of confirmed cases? We determine that number based upon testing, right? People who test positive, that number gets added into the total of new cases per day, per week, Etc. And that's how we are able to say, well, that there's not a lot of new cases going on. Well, keep in mind that for the past week to 10 days, the number of tests that we have done here in America has not increased. So think about that. If you don't increase the number of tests, you're not going to increase the number of positives, and therefore the number of people who test positive will not increase. The number of people who test positive will likely increase as we increase the number of tests that we do, and I'm very hopeful that we will do that. So again, keep in mind when people are talking about, hey, look, the number of positive— the number of people who test positive isn't increasing, great! That reflects the fact that the number of tests we're doing is also not increasing. So keep in mind That figure, I think a more valid figure would be the number of deaths that are occurring because you don't need a test for that. That's pretty straightforward. The only part of that story that we're not able to enter into the metric has to do with people who die at home, for example, who were not necessarily diagnosed with COVID-19 but did die at home from this infection. What is your opinion of doctors comparing COVID-19 to high altitude sickness? That is Emily Taveras. Excellent question, Emily. There are some aspects of what goes on with COVID-19 when people are sick with it in the hospital that are similar to what we see with high altitude sickness. And that's why there's been some discussion of using the very medication that's used in high altitude sickness Which is called Diamox or acetazolamide in terms of treatment. But when people become very ill with COVID-19 and are hospitalized and on a ventilator, doctors are able to control their rate of respiration and do things like increase the rate of respiration to blow off more carbon dioxide, and that allows better oxygenation and delivery of oxygenation or oxygen to the from the blood to the patient. So it's actually a very interesting question. Let me take a few more questions and then we'll move on. I have been activating NRF2 for over 8 years, says Cheryl Gomez-Reyes. Yes, we all activate the NRF2 pathway to some degree. It may be something you want to consider is increasing activation of NRF2. We've been talking about that for the past 12 years and Because it's not just inflammation in the context of COVID-19 that is important, it's chronic inflammation in the context of what causes most deaths on the planet, and that are these chronic degenerative conditions like diabetes, like chronic inflammation that leads to coronary artery disease and even cancer. So I would say that activating NRF2 pathway is something we should be looking at. In general as well, Andrea Schenkes talks about turmeric and Nrf2. You bet. We've been talking about turmeric for quite some time, and in fact, the science that talks about turmeric in terms of putting out the fire in our bodies goes back thousands of years to the Vedic texts. Turmeric is used in Ayurvedic medicine to calm inflammation. Okay. Here we go. What blood test tells you about your grades of inflammation? That's a very good question. Let me spend some time on this because I think it's actually very important. There are various markers of inflammation that you could get. I mean, you're not going to go to your doctor right now to have these done. That will give you a sense as to the level of inflammation in your body. But I will tell you, these are things like C-reactive protein, tumor necrosis factor alpha. That is not done commonly but can be done, and even more sophisticated genetic tests that tell you your risk for increased inflammation in your body. I just had one genetic test that showed me that a couple of pathways that increase inflammation are increased in my body, meaning do things for me that help balance in my inflammatory pathways. Very important. But I will tell you, in addition, Because you're not going out of your house to your doctor's office right now to get tests for inflammation, let me tell you about some what we call surrogate markers for inflammation in your body. Number 1, your blood sugar. Yes, having higher blood sugar relates to having higher markers of inflammation. Number 2, your body weight. Having higher amounts of body fat translates to higher levels of inflammation in your body. Number 3, not getting enough restorative sleep is associated with higher levels of inflammation in your body. So while you can't go to your doctor and get a blood test for inflammation that she or he may want to do for you, thinking about your blood sugar if you're diabetic, thinking about your amount of body fat, thinking about how well you're sleeping, all play a role Determining the set point of inflammation in your body. And what might you do then to reduce inflammation? Go on a lower-carb diet, maybe even go on a ketogenic diet after you check with your healthcare provider. Do your very best to get a better night's sleep. That's very important. And, you know, now might be a good time to think about, you know, better control of blood sugar and also losing some weight if This is something you're able to think about right now. Okay, let me take a couple more questions. Randy Roven Kessler, this is a great question. Why aren't politicians and the media telling people to reduce inflammation through nutrition, reducing stress, and exercise? Gosh, it's a rhetorical question, obviously. And the, the point is, and I think where you're going with this, is that we control the levels of inflammation in our bodies. It's just what I was talking about. When we get our body weight under control, we get our blood sugar under control by eating less sugar, less refined carbohydrates, less ultra-processed foods, welcome healthful fat back to the table. These are all ways that we can lower our blood sugar, therefore lower our body weight. And lower inflammation as well. So that's public health. That's what needs to happen and moving forward. What a wonderful question, and thank you so much for asking that. Okay, let me just get a couple more questions, then I'll say goodbye for now. Here's a question about ozone therapy. So ozone therapy is a technique in which your blood comes out through a vein, goes through a machine that treats This blood with ozone, and then is reinstituted into your body. It's been something that's been quite popularized in Europe for quite a long time in treating infections and possibly even in treating cancer. I can't say that I've been overwhelmed with the data on ozone therapy, at least that which comes from the United States, the the research. And while I've seen some indication that it may be effective. With respect to COVID-19, I haven't seen anything that would let me communicate to you right now this morning that would indicate that this is necessarily a viable treatment. But I will tell you that I'm going to keep an eye on it because it's not hugely technology— technologically challenging, and there are some offices around the country that do it. I'm not ruling it out, and we'll see where we go. Ventilation isn't working. People are dying from the ventilation treatment. With all due respect, I would say that ventilatory support, you know, the whole talk about we need ventilators, putting people on a ventilator is saving lives, but it is not terrific in terms of turning this around. To some degree, I would, I guess, agree With that comment in that it isn't saving a lot of people. It looks like about 70% of people, or even more, go on a ventilator end up not surviving. And it's not because, in my opinion, they went on the ventilator. It's because they were so sick that they required the ventilatory support. But about 20 to 30% of people who go on a ventilator end up surviving. Coming off the ventilator and going home. So that is the discussion there. Let me take one more question, and then I said there's a lot of posts today about this NRF2 pathway. I would say read about it online. If you go to my site, drperlmutter.com, drperlmutter.com, I've written blogs about NRF2 for a long, long time supporting the use of Turmeric, supporting cruciferous vegetables, supporting exercise, and even supporting green tea and coffee. Okay, waist measurements are indicators of inflammation. Correct. Waist measurements are a good indication of risk long-term for cognitive decline and brain shrinkage as well. Many of you know I've done actually some videos on that, looking at the peer-reviewed data from the journal Neurology. Neurology, for example, that talks about. Okay, everybody, let me see if there's one last question that we can talk about and address, and we'll take the question from Lisa. I guess it's Geis G E I S. What about intermittent fasting? Does it reduce inflammation? I'm an advocate of intermittent fasting, and as many of you know, we've done two of them already on the program. We've had hundreds of people that have joined us for a 24-hour fast, and I am very much in the camp that believes that intermittent fasting is a stress for our bodies in a good way. We call this hormesis. When stress does a good thing, we say that's a hormetic response. And I think that intermittent fasting can reduce inflammation. Can help us rid our bodies of immune cells that may be what we call senescent or older and not functioning as well. And having said that, later today I'll be interviewing Dr. Jeffrey Bland on this exact topic, on what we can do to rid ourselves of defective or senescent immune cells, how we can reconstitute a more robust, youthful immune system. And how that might work to our advantage in terms of this current pandemic, COVID-19. We wonder why it is that younger people are doing better, and it might very well have to do with the fact that younger people have a more effective, a more youthful, as you would expect, immune system, that their immune cells are working better. And this will be the topic of our discussion today. We're going to do that recording today and try to post that interview really as soon as we possibly can. Well, that's all I've got for now, everyone. Thank you so very, very much for joining. Love you all, and be safe, be healthy, and I will talk to you very, very soon. Thank you.