Dr Anne Truong, Webinar, Episode 4, Be Resilient & Healthy During COVID-19, 04-09-2020

Okay, so we are on.

Okay.

We are on live. Okay. So welcome everyone on a nice beautiful Thursday evening. Thank you for joining us. We have Dr. John McLaughlin joining us today. We'll be talking about meditation and I renamed the webinar to be more resilient, healthy during this COVID 19. It's a lot of COVID 19 information going on but I wanted to focus more on the positive. So we'll start with just a couple of quotes and then I will have Dr. McLaughlin take over and then I will do the end. And then we really want this to be interactive and have some. Any questions, anybody that may have some questions later on. I want to start with the quote that says the struggles we endure today will be the good old days. We laugh about tomorrow. So sometimes we focus on what the present is. But what should we focus on is what it's going to be in the future. So I really like this quote. So those of you will see this slide many, many times. And I added on to it, but I added meditation to this is ways to boost your immunity and meditation, it relaxes you but it also does great things for breathing as well. And that's one of the reason why I asked Dr. McLaughlin to join us today is to help us with ways that we can help ourselves. That we can protect our lungs and be resilient and be able to boost our immunity. So Let me introduce Dr. McLaughlin. John has been involved in meditation and contemplative practices since his late teens. He started with TM which are Transcendental meditation and currently practices in non dualistic tradition. John is a co founder of the Yoga foundation of Fredericksburg which is a nonprofit organization which offers yoga, mindfulness and wellness workshop with a focus on underserved in our community. He teaches mindfulness based stress reduction and MBSR after having finished his teacher training with the founder John Cabot Zinn at the University of Massachusetts. He has a strong science background, having trained as an MD and now combines his passion for the body with that of the mind and spirit. So please welcome Dr. McLaughlin. I don't have any slides for you, so I will just kind of leave it at this and. And it's all yours.

All right, great. Well, thanks Dr. Chuang for inviting me to speak here. Am I not able to see the participants, Ann?

No, no, not at this point. I guess I'm the only one that can do it right now. Yeah, but they can hear you.

Okay, good. It's always nicer to see a face behind. So as Ann mentioned, I have been practicing meditation for A long time. And it really has been so vital for my health and well being for many, many years. So much so that I teach a meditation class, Mindfulness based stress Reduction, for the past six years or so in Fredericksburg. And the heart of mindfulness based stress reduction is meditation. So I only have 20 minutes here. It's not a long time, but I'd like to dive into meditation for a little bit. And I'd like to speak about meditation for a little bit. But more importantly, I would like you to get a little taste of it. So we will actually do a short guided sitting meditation just so you can get a feel of what meditation is. So as many of you know, I'm sure meditation has been around for thousands of years, practiced by millions of people. And many spiritual and wisdom and faith traditions have meditation as a core of their practice. And now it's prevalent in the west here. And in the past, probably 15, 20 years or so, it's been studied by many scientists in the West. And so now we're starting to develop some very real data on meditation and the benefits of meditation, which I'm sure many of you are familiar with. But basically what meditation is, it's changing gears, it's shifting into a different mode. Because if you think about it right now, and probably for 90% of your waking hours, where is your attention? And it's usually up here in the head. It's up here in your mental realms and the conceptual realms. We usually direct our attention at our thoughts. And this tends to run most of our lives for most of the waking hours. And the only time it really turns off is when we go to sleep at night. And what meditation is practice of redirection, your attention. Instead of having the attention up here, we drop our attention down into the body. And that has an interesting effect on your physiology of the body. It has an effect on your psychology. It feels good when we do that. And what I'd like to do right now is just for a moment, just see what happens right now when we take our attention and let it sink down into the body. Just find a nice comfortable posture and imagine that your attention and your awareness is sinking and dropping down into your body. And you can also imagine that you're gathering your attention. You're collecting your attention from the mind, from the past, from the future, from worries, and you're just breathing it in and down into your pelvis. So just notice what happens when you do that. And what we're doing is we're just, instead of thinking and meditating, we're just feeling, we're switching modes, we're changing gears just for a little bit. And now we're just going to feel the breath as it comes into your body, drops down into the pelvis. So imagine that your breath is like liquid oxygen and it's going in your nose and it's going all the way into your pelvic bowl and it fills up the pelvic bowl just like it was last, fills from the bottom up. Just see if you can feel the breath going into the body and filling the pelvic bowl just like it was liquid oxygen. As you do this, you may notice that the breath becomes a little deeper, a little slower, a little smoother. You may also notice that there's a release of the tension in some of the muscles in your body, maybe in the shoulders. Maybe you feel your shoulders drop down a bit. Maybe you feel any tension in your belly just kind of releasing as the breath enters the belly and the abdomen expands on the in breath. And so there's no right way to feel. But we're just trying to really feel what we feel instead of think about what we feel. We're directly feeling having a more visceral experience of the body, a more direct and concrete experience of the body. And that's different than thinking about the body. We're directly experiencing it. We're inhabiting, fully inhabiting the body with our attention, with our awareness. And as you do this, you may notice that thoughts arise spontaneously. And when that happens, just notice the thoughts. Just leave them alone, Try to follow them, don't pursue them, don't go back up into your head. Don't even try to push them away. Just redirect your attention back down into the body. Let it sink, let it settle, let it fall into the body. See if you can feel your heart beating. There's a lot of physiologic changes that are likely occurring in your body right now as you just redirect your attention into the direct experience, the visceral feel of the body. Your stress hormones are likely falling right now. Your heart rate is slowing down, your blood pressure is decreasing. Your body responds to this just by redirecting your attention to a more visceral, concrete sense of the body. And you may notice that the mind tends to settle down when the body is settled. When the nervous system is soothed and the whole body is settled into itself, the mind settles down as well. It's like the mind now has a place to rest. The mind is constantly looking for satisfaction and entertainment. But now it's found a place to rest in the body. And isn't it amazing that just by redirecting our attention into something else besides our thoughts and the mental realms, just by dropping it down into the body, that it can have such a powerful effect? Maybe you feel this effect in the short time we've been doing this, but maybe you don't. But I can safely say that if you're really directing your attention on the feeling, on the felt sense of the body, it's just a matter of time before you will start to feel the physiologic and even the psychologic changes that occur once we do that. And so what we're doing is we're counteracting the flight response, the flight or fight and freeze response. And instead, by coming in to the body, by redirecting our attention into the body, we activate the sympathetic or the parasympathetic nervous system. And we activate what's called the reflex response, the relaxation response. So the opposite of fight and flight is the relaxation response. And that's what we're doing. We're activating that response. When we redirect our attention into the physical sensations, into the breath and in our brains right now, there's likely a shift in where the activity of your brain is occurring. Normally, when we're thinking, we activate what's called the default mode network, which is in the frontal lobe, in the medial aspect. But when we start feeling the body instead of thinking, we activate what's called the lateral neural networks, which is a different part of the brain becomes activated. And it turns out that in this phase of the lateral networks, also called the experiencing mode, this phase and the brain and the body is restorative. This is a phase where the body is healing itself. The cells are repairing themselves. It's a restorative. It's also called the rest and digest phase. And it feels good because it is good. It's good for your physiology. It's good for your psychology. The body naturally wants to go here, to restore itself. This is what we do when we go to sleep every night. We just set up the conditions of sleep by lying still, by deactivating the mind and just feeling the body. And the body knows how to do this. The body knows how to rest deeply. And this is what we're doing. We're just allowing the body to do what it knows how to do, which is deeply rest and relax and repose. There's a saying that I love by a Tibetan monk. The body at peace with itself is more precious than the rarest Gem Cherish is yours this one time. In just a moment, I'm going to ring the singing bell and we're going to come back into our cognitive states and shift gears again and go back into thinking mode, which is fine, but just see if you can keep a little bit of your attention on the breath, on the body. See if you can just keep like a tether of your attention down in your pelvis and see how that changes your experience. Instead of all your awareness going up, instead of into your brain and into your mind, into your mental activity, just keep 10% of your awareness and your attention on the physical, visceral experience of having a body it. And then when you're ready, just opening your eyes and. Ann, do I have a few minutes to.

Yep, you can take as long as you want. I'm sure we laugh right now.

I hope everybody got a little taste of that and how it completely changes your experience and not just your physical experience, but your mental experience and maybe even how you feel in your heart. You know, it's hard to have anxiety at the same time as having a body that's completely at peace with itself. It's hard to be angry when the body is completely at peace with itself. It's hard to be lost in worry and fear and planning and loneliness, all the things that are so prevalent nowadays. And depression. It's hard to be lost in all those states, mental states, if your body is perfectly at peace with itself. So with meditation, I always start with relaxing the body on a deep, deep level, just as we did right here by activating the parasympathetic nervous system, the part of our nervous system that slows everything down. And the breath is a great way to do that. Redirecting our attention into the body sensations a great way to do that as well. So every meditation session starts with deactivating the sympathetic nervous system, the fight and flight response, and activating the relaxation response. And that's just the beginning. Once you're able to relax the body, the mind settles down, then you have the ability to see what's really going on in your mental state. Because the most difficult thing right now in this crisis that we have, is these mental states of anxiety, of fear, of loneliness, depression, of worry. Unless you have the virus right now and have an illness of some sort right now, chances are that is your biggest issue right now. That is our biggest problem right now, is the mental states that this crisis has evoked within us. So meditation can optimize our state of mind. And when our mind is optimized and our mind is relaxed and the body's relaxed. That's where resilience comes from, that's where stress resilience resides, is when we can tap into the resources within our body and learn the skill of how to deeply relax the body. The mind follows suit. And you may notice that you start getting less annoyed with things, you start getting less angry, less depressed. You're able to be with experiences, develop a greater capacity to be with something that previously was difficult, but now your body is relaxed, you're a little less perturbable. Your mind and your body is much more able and has a greater capacity to handle difficult experiences, whatever they may be. But it starts with the body. Because if we don't learn the skill of how to relax the body, it's going to be hard, very, very hard to get out of our depression, to get out of our anxiety, to get out of our loneliness and fear. It's going to be very difficult. So that's why it's so important. And this is what we, what I teach in mindfulness based stress reduction is to learn the most precious skill of how to deeply, deeply relax the body. And everything will follow suit from that point on. So I hope this is some benefit to you. I hope you're able to get a little taste of what it is to deeply come into the body, fully inhabit the body, because it is our greatest resource. And I encourage you to just micro moments, micro meditations multiple times a day, just take a few breaths. Whenever you remember, take those few deep breaths into the pelvis. One of my favorite things to do is to whenever I'm waiting, I just come into the body. I feel the breath, I feel my feet on the floor, I feel my spine, and I just fully drop into physical sensations, the felt sense of my body. And when I do that, my body immediately responds. And if I'm waiting at the store, if I'm waiting for my computer to boot up, if I'm on the phone and it's ringing, I'm waiting for somebody to answer. Whenever I get the sense that I'm waiting for something to happen, that's when I take those micro meditation moments and just feel a couple of breaths as I'm waiting for something. And if you think of it, we wait a lot these days. And so that gives us a lot of opportunities to practice micro meditations. Waiting at a red light, that's a great way to come into the body. Just by feeling the breath. And imagine that you're collecting all your attention, all your awareness as you Breathe in and it's going down, sinks into the pelvis and just, just takes a couple of breaths. 30 seconds or so or a minute is even better before you start noticing that your body responds to this. So in the interest of time I'll pass it over to Ann. But thank you all for your attention.

Well, thank you John. That was wonderful. I felt so relaxed that I was actually about to fall asleep. It's interesting. Yeah. Really? Was I in? About halfway into it? I was. If I had a bed right now, I probably would be lying down to sleep. That was incredible because I was, you know, pretty adrenaline up before this. So thank you for that. And I want to let you know that when I asked Dr. McLaughlin to do this, he didn't hesitate at all to, to come and help us with this. And I know how this turbulent time and high fear and anxiety how you all feel. And I felt that meditation was something that will be a useful tool. Even you never meditate before. It doesn't mean that you can't. And this is really today if you haven't meditated before. It's the first time I've done a few of them on the app that I've used and I've always appreciated that and I've actually been doing it every day. So I'm a big proponent of that and probably have to come and take one of your class one day. Where do you teach?

So I teach at the yoga studio downtown Fredericksburg. Yoga foundation of Fredericksburg.

And where is that? In Carolina.

It's right near University of Mary Washington, right downtown. But of course now we are not teaching here anymore. So I'm actually offering a donation based MBSR course on Zoom starting the 20th, April 20th. So if anyone is interested, it's an eight week. MBSR is an eight week course. We meet for two hours once a week on Monday nights from 6pm to 8pm and I'll do a live stream MBSR class. There's usually about 20 participants in the class. It's a combination of learning, meditation, of body awareness, practices of breath work and a couple of kind of re perceiving practices that we do.

And where is anybody interested to go sign up for that?

So Yoga foundation has a website. We just changed the name but if you search Yoga foundation of Fredericksburg and you'll find our website on Google. If you just search that and you can sign up on our website. I don't know the name offhand because we changed it.

But if we just Google Yoga foundation of Fredericksburg, your class will come up Somewhere on the website there will come up.

Yes, yeah, it's on the website. Yes.

And look for mbsr.

MBSR based stress reduction. Yeah.

Okay. And you're gonna be live streaming this, so it won't be in person.

Correct, It'll be live streaming, not in person until things change.

Right, right. But definitely this is something we can do virtual. That's awesome. I will look into that. So I will. And then I'll put that in the chat as well. So thank you for being with us today. So I will just make my part brief and then we'll be open for questions. All right, very good. I'm gonna. All right, so again, the different sources that I look at for just an update on COVID 19 and some new updates that I found is through the Virginia Department of Health, the cdc, NIH and clinical trials and evidence based medical literature as of this is actually this morning, but the Data is reported 9pm yesterday. So in Virginia we've had 33,000 that has been tested and 4,000 is positive out of the 33,000. So you know, you look at that, that's actually a very, very good number. It's definitely. It's about 10. Is that 10%? Yeah, it's about 10%, right? Yes, yeah, yeah, it's about 10%. 10% there. So that's good. 10% of positive cases. Out of, out of everyone tested, the most you see is in our Prince William, Arlington, Loudoun county and Alexandria. Our region is the Rappahannock region. And currently you see more in Stafford at 54 and followed by Spotsylvania at 36, followed by Fredericksburg and 10 King George at 13 and Caroline 4. So out of those 4,000 positive cases you have hospitalization of 865 the confirmed cases. However, 627 additional to this number is also in the hospital, but they're tested pending. Now if someone is have symptoms and is suspected of having COVID 19, the doctor take a nasal swipe and send that to the lab. However, it takes about seven to 10 days for the result to come back. So the patient could be in the hospital like this group here, but the test is pending. So I'm gonna. I count these two here and those are the 1296 right here. So out of those 1296, 469 to about a third of them are in ICU. All right, and of those people in ICU two 85 out of 469 is on the ventilator. And the ventilator is a machine that help you breathe so this number is about 10%. This number, I mean, right here, it's about 20% of this number here. So out of four, out of everyone that is tested positive In Virginia, about 20% will be hospitalized, which is actually in accordance with national and international numbers. So that means that 80% of patient doesn't need hospitalization and that they have mild symptoms. And then out of those 1300, about a third is hospitalized and about maybe a little more than half of the one that is in ICU actually on the ventilator. So overall, it's actually good numbers. And these numbers somewhat correspond with national numbers as well. So interestingly, in Virginia, you have about 2,700 ventilators available and only 26% are in use, which is really good news. That means that in Virginia right now we have not maxed out our capacity and would ventilator use at this time. So far, as of today, there's 109 deaths out of 33 positive cases. I mean, test. I'm sorry, out of 4,000 positive cases right there. And so the death localization is in central Virginia, northern, eastern, southwest and Northwest. And the hospitals right now are experiencing low protective equipment, personal protective equipment, which is the gloves, the mask shield, the mask and the gowns, supplies. And they're expecting to get low in about the next 72 hours. So most cases actually are never counted. That's why I want to show this, because out of the 33,000 that was tested, there's a lot more that have symptoms that are not tested. So those numbers probably catches these numbers right here from the symptoms, but doesn't catch these. So there are probably many, many more individuals that have COVID 19 that has not been tested because they have mild symptoms or they just don't know they even have it, because 25% of people that are tested are really asymptomatic, meaning they don't have symptoms. So keep that number in mind. As of today, I looked this up on the Virginia Department of Health numbers, and these are distribution of age groups. And 65% of the total cases are under 60 years of age. So the myth that only older patient can get COVID 19, that's not true at all. Even younger group get COVID 19, but the older patient over 60 with comorbid symptoms of lung and heart issues will have more severe disease. So I wanted to show that. And national and international numbers shows that actually male is more. There's more, about 60% of male. But interestingly, in Virginia, there's less male that are positive than in female. But you also wonder whether you know more males are coming out with symptoms at all or they're just not coming out getting tested. They just have the symptoms and just kind of live with it. So these are people that are tested as well. And the race distribution is really not accurate because 51% is not reported at this time. And this is where are we on the flattening the curve. I wanted to show this number because where are we now? As in Virginia, this is a five day average. So we're peaking and peaking and we're right here and it looks like we're climbing still and we haven't reached our peak yet at this time. And you want to look for where most of the data shows. You want to look at where the state has 150 cases and from there it's about 20 to 30 days. So at this time it looks like probably around the beginning to 30 days that you're probably gonna see the downturn at this point. So 20 day, 20, 30 days, probably the end of April you're gonna see the downturn where we are on the curve. So you hear flattening the curve. I put this up multiple times because I've been asked this a lot, is that why are we doing all the social distancing and stay at home orders? Just because we're trying to decrease the enormous number of individual going to the hospital all at once. So if we don't do any of those social distancing or isolation or quarantine and respiratory hygiene, we will have everybody going to the hospital and then we will at the hospital will not take care of everyone and we will have death that can be prevented. So over here the same number as the numbers as infection. It's just we're trying to control the number of people of individual going to the hospital. So where are we right now? We're still on the curve right now and looks like in Virginia we're under healthcare capacity at this point. Again, clinical presentation, what I did mention before that fever, cough, shortness of breath and body ache. And also now we start to see symptoms of headache, sore throat and also a stomach upset of nausea and vomiting and diarrhea. Again, 80% of cases that are symptomatic are non severe, 20% is severe and about 5% goes to ICU. That's what we're seeing in Virginia right now. So if you have symptoms and you want to be tested, you can go to Better Med Urgent Care. They are located on Plank Road and you can go online to make an appointment and they actually test you right at curbside. You don't even have to get out of your car. And it's covered by insurance. And you don't have insurance. I believe it's about $200. All right, what's the definition of some critical infrastructure workers? Those are federal, state and local law enforcement, 911 call centers employees, fusion center employees, hazardous material responders from the government in the private sector, janitorial staff and other custodial staff workers, including contract vendors and food, agriculture, critical manufacturing information, IT transportation, energy and government facility. This is something new that the CDC just came out, I believe, a couple of days ago. It's interim guidance for implementing safety practices for critical infrastructure workers who may have had exposure to person of interest. So for instance, if you work in any of these facilities here, and you are considered essential, if you are exposed to somebody that has Suspected or confirmed COVID 19, a few weeks ago, you were asked to stay home for 14 days and quarantine, isolate yourself. But now that has changed. So that means exposure mean that you are within six feet of the individual or in the household contact. And the time frame is 48 hours before the individual becomes symptomatic. Not you, but the person that is confirmed COVID 19. So you can go to work, but you should take your daily temperature check before work. And daily when you're not working. Your temperature should be under 100. Wear a mask for 14 days after the last exposure, which is from this time, continue to do social distancing at work and at home for 14 days. Disinfect and clean workplaces. Do not share headsets or object near the mouth or nose with anyone. And of course, do not share food or utensils. So this has changed a lot. Before you have to stay home. Now you don't have to stay home. You just have to monitor symptoms. So just a few things as a reminder, transmission of COVID 19 is still from respiratory droplets. And that individual can shed the virus 48 hours before they even have symptoms. And what's so different about SARS CoV2, which is the new virus that's just causing COVID19, is that it shed more in the beginning of the infection than at the end versus flu. Flu sheds the flu. Shedding of the virus is more when they're very sick or at the end versus in the beginning. So that's why the virus is so infectious that it has a high viral load the beginning of the incubation period. And that's when it also can be without symptoms or asymptomatic now the droplets in the back of the throat can become aerosol and hang in the air for about two to three hours after the infected individual leave. So this can be a problem when you're in enclosed space like in the plane trains or in a conference room with little ventilation. Again, person to person spread is droplet is the primary and that occurs when people are in close contact within six feet of each other. Now the droplets can be on inanimate objects such as plastics and steel. And so the main thing is that the spread can be possible when before individual shows symptoms. All right, so statewide 44% of those diagnosed with COVID 19 are under 50. But there are people testing positive and I show you those numbers already. And this is very important, that individual own biology has more to do with how sick he or she becomes than the virus itself. Or that healthcare workers who are exposed to more the virus than others might develop more severe cases. So what this means is that you are more Predisposed to get SARS cov2 if you have high blood pressure, heart disease, insulin resistance, type 2 diabetes and also obesity. And the healthcare workers are more susceptible because they are exposed to more higher viral loads as well. So this is something new that I just learned, I want to share is that if you use a disinfectant to clean your house, you can go on this website here, you can take a picture of this, this website, the EPA website, to see if that disinfectant is effective for SARS CoV2. Now, not all disinfectant is effective. It will tell you on here how long it kills the virus for and what surface can you use it for. So check this website out, it's very informative. Again, you want to take a picture of this because what this is from the sources FDA and CDC and it shows how long the virus can be on the surface. However, the virus can be dead. That doesn't mean the virus are alive. The virus is essentially just 30,000 nucleic acid surrounded by a protein shell. And the shell can be broken easily by just soap and water and so on metal surfaces. It can stay there for five days, but doesn't mean that the virus may be alive. But it's RNA is detected, so there's a big difference there. And glass, it can be up to five days as well. Ceramics, such as dishes, pottery and mugs, up to five days. And paper, this is interesting. I took out paper in my office. Now it can stay up to five days. Wood, wood furniture and decking, four days. Plastic, like milk bottles. Bus Seat, elevator button. Two to three days stainless steel like the refrigerator pots and pans. Two to three days cardboard like shipping boxes of one day aluminum such as soda can, tin foil and water bottle. Two to eight hours coins about four hours. And this is good news. Food and water doesn't seem to spread through food at this point. So masks, please mask up. John, are you wearing masks at work when you're in radiology? Are you guys doing that at all?

Yes, we are.

Yep. Wonderful. So this is me and my staff and. And why do I. I'm a big proponent of masks because it means that individual with COVID 19 can be infectious. And that individual does not know that they're infectious. That that's why you need to wear. To protect. To protect yourself and to protect the community. In Asia, everyone wear a mask. It's a crowd psychology and protection. And it's also protect each other and protect your community. If you're sick, you have the mask on. It creates, it takes out the stigma. Wearing one is removed. China Hong Kong Credit the universal mask wearing as part of their flattening the curve. And it's encouraging because about a week and a half ago when I was going grocery shopping, hardly anyone was wearing a mask. And a friend of mine said that she wore a mask and she was treated as if she was a leopard. Nobody wanted to come near her. And I went grocery shopping about three days ago and about half of the people wore a mask and nobody treated me as a leopard either. So I think that this is becoming more of an awareness mask can also signal it's not business as usual. And it can be solidarity to bring infection under control. If everyone in the community wears a mask, it could decrease transmission. Surgical masks protect a bit more than nothing at all. But we don't have enough surgical masks for everyone. I have my office. We have to order it from Amazon, the usual place we order it from Henry Schein McGuff. They don't have it and that goes to the hospital. I understand that if we run out the one we have, we'll just wear a cloth mask. But the cloth mask is better than none at all. So the mask isn't to protect you from getting sick. Although there's some protection, but because some is better than nothing. But it's more to protect you from others who are infected. A study looking at flu suggest wearing a mask actually can reduce spread by 50%. So just. I did this last week but I wanted to reiterate it again that. So this is the cloth mask. This is a surgical Mask you see surgeon wear, a lot of us wear. And this is the N95 mask. But when you actually wear this mask, it's very hard to breathe. So if a person, if the person wears it, this is an infected individual. So when this infected individual cough, when you've initially cough, the small droplet that near to the face are very small, but the bigger droplets are the one that travels about three feet and those are the one that's going to contact you. So this is a study that looked at this. And if you wear a cloth mask, if somebody coughed, an infected person cough, 100 particles, only 33 particles will get through to the mask if you wear a cloth mask and only 25 particle will get through the mask. So that's not a lot of difference between the cloth and the surgical mask. And then only one particle get through the N95 mask. So this protects you a lot from an infected person that cough or sneeze. And then this here, if you're sick and you wear the mask and if you cough there, 90, 90 particles will leak through to other individual and 50 particles will leak through if you wear the surgical mask and 30 particles leak through if you wear the N95 mask. So you see on here that if you're sick, you shouldn't be going outside, period. But if you need to, please wear a mask because even though it shows that it's not 100%, there's some protection. It's better than nothing. So the mask is really protect you from individuals that are sick that don't know that they're sick. So the CDC actually recommends wearing a mask on April 2, which just a few days ago, and for non healthcare workers, they recommend you wear cloth masks and for the surgical and N95 for healthcare workers. So I just saw the study and it said, is it safe to eat? Is it safe to eat takeout food? Not under is it safe to eat takeout food? Well, yes. Food hasn't been shown to be transmitted an entry point for the coronavirus. And this is a study that looked at that in New England Journal of Medicine. Remember I said that it can be on cardboard up to 24 hours. So the recommendation, if you order a food delivery, take a few minutes to create a safe food environment where the food arrives by cleaning any surfaces I touch. So have one area on the counter that's dirty, one area that's clean. Pay and tip very well. The person who deliver your food and pay them in advance or through an app, let the driver leave the food at your doorstep. Wait until the driver is at least six feet away before picking up your food and remove the food from the takeout bag and the container and dispose of the recyclable and recycle them appropriately after disposing of packaging because the packaging actually you want to dispose of because there could be viral particles on the cardboard packaging. Wash your hands for 20 seconds with soap and water. Wipe your counters and other surfaces where you unpack the food and try to order in bulk with your neighbors so you can divide the multiple trip that the delivery person may have to make do. And then you have to get your food out and then leave it six feet away so your neighbors can get their food as well. So when will this all end? Well, I get as much information as I can from what this is again an evolving picture and it probably changed probably an hour from now is testing need to be all for everyone for those that are infected, those are not infected and and we need to know who is immune. We have a blood test now to find out who has antibodies against SARS CoV2. We need to do effective social distancing. But in order to do everything down flattening the curve, we need to have enough PPE for all healthcare personnel, at least in Virginia we know right now that we have enough ICU beds and ventilator but we need to have this in regions like that is hard hit like in New York and New Jersey and in Washington and we didn't have enough ICU staff at this point. And when new cases and deaths are declining, you'll see the downturn of the curve. And we're looking at probably, you know, kind of churning around the end of April, but that couldn't change. However, you're looking at about a two or three month window. The virus is the clock. So it depends on the kinetic of the outbreak. It depends on the region. Like for instance, you know, New York may be going on a downturn faster than other regions in the country and we'll see some pockets of disease outbreak that require longer social distancing and quarantining measures and other pockets as well. Now everybody said well let's get rid of this and move on with our life. Well, we're not going to get rid of the virus because the coronavirus is part of the coronavirus family which is part of the flu. And so we will be able to control the number of infection. It will be here like the flu, it may be seasonal and it will come back. But by that time we'll have vaccine, we'll have Treatments and we'll have herd immunity. So the whole point is that we need to develop herd immunity and we'll need to come up with the vaccine, which will probably take about a year to a year and a half. So what can you do to help is ensuring the public is aware of the seriousness of COVID 19 and have a high degree of population and solidarity and discipline to do social distancing, cough etiquette and coughing, hygiene and community engagement and acceptance of stringent social distancing measures. So that way we can all protect our community. It is our moral responsibility. Donate blood at the American Red Cross if you can. I heard that they need blood at this time. Send food care packages to your health care workers and donate your PPE if you have them. Order food locally. Support your small businesses and take care of yourself. And this is a picture from Ashley Mary Washington. Not all heroes wear cape. Some wear scrub. And this is a picture of the ER staff at Spotsylvania Regional. I asked for a picture of Mary Washington that's pending at this time. So these are our heroes that are in the front line and I pray for them every day. So there is an antibody test that I alluded to earlier that looked at your blood that take one drop of your blood, you put in this machine that's on the counter and it can tell you immediately whether you have antibodies for SARS CoV2. The negative result however, do not rule out an infection because the antibody might not have enough time to form or the virus could have a minor mutation that may not have appear. However, false positive can occur due to cross reactivity with other antibodies from previous infections such as the flu and so forth. So if you're negative and with symptoms you need to check again. If you're positive, confirm with the the nasal swab kit right now in at I believe right now the Mayo Clinic is looking at doing a blood transfusion of plasma with from patient that has had COVID 19 and they have the antibodies for this and to see if this can help individuals that have severe symptoms. So you can use this crisis right now being at home and the time that you have to get healthy and to protect yourself and your loved ones. This is very important. I'm starting to see this come out more and more as I'm looking at the studies that we see more preponderance of severe cases in individual young and old who have these commonalities. Diabetes, type 2 obesity, high blood pressure, insulin resistance and heart disease. So by modifying these conditions here, you can decrease in systemic inflammation And I describe inflammation as like fire in your body that predispose you to have a lower immunity. And thus if you have a lower immunity, then you're more susceptible to infection. So if you decrease your inflammation by controlling factors that predispose it to this, you'll raise your body reserve to fight any infection. And I think for the next few episodes I like to kind of focus on measures on how to decrease this with some of our special guests. So acts of kindness and compassion in the community. One more tacos. And now have a program that deliver free lunch to nearly 40 elderly residents now. And they deliver lunch to the hospital staff at all three of the hospitals and standalone hospital facility. Fredericksburg Cupcakes, Italian Station and Orofino, which are all located downtown, are contributing to some of the food as well as well as a local girl Scout troop who drop off dozens of girl scout cookies. My favorite. So please take care of your healthcare workers who are our heroes. So I like to end with the quote, yesterday is history, tomorrow is a mystery, today is a gift of God, which is why we call it the present. So it's now time for questions and I will try to unmute our participant attendees and see if you all have any. Okay, here it is. Allow to talk. You are now on mute. And so you all unmuted. Does anybody have a question? Don't be shy. Does anybody have a question? So John, can you talk a little bit about how meditation can help with respiratory reserve?

Respiratory reserve, huh? I'm not sure about that. But more importantly, it helps the immune system.

Okay, how so how does it help with the immune system?

Well, it turns out that the cytokine response is less robust with meditation. Which big component of this disease is this cytokine storm where the body produces a lot of cytokines which are actually causing more problems than they're healthy. And there's, there's data to show that with meditation, MBSR specifically that your antibody response to a vaccination is about double to triple what a non meditator's response is. Ah, that's, that's clearly been shown. So somehow meditation just optimizes the immune system.

Oh wow, that's interesting. I've always heard about that. What about nitrous oxide? How does that play into the immune system?

Yeah, well I know with meditation that meditators, long term meditators, breathe at a slower rate than non meditators and so that's going to affect your nitrous oxide just by the slowing of the breath. And studies have shown that the Optimal rate of breath is six breaths per minute.

Oh, wow.

Not 12, which is the average of most people, but about six breaths per minute. And I do that myself when I go to sleep at night, I take a breath. So six breaths a minute is 10 seconds of breath in and out. So what I do is I breathe in for four and exhale for six, and that's 10 seconds. So I do that six times in one minute. And it's the exhalation that actually activates the parasympathetic nervous system escalation. That's the reason why I go four in inspiration and six out expiration.

And how long do you do that for?

Till I fall asleep.

So when you need to calm yourself down, you should lower your breath rate to about six a minute, not 12aminute, which we are always taught in med school to be normal respiratory rate.

Right, Right.

Yeah.

It turns out that most people hyperventilate, blowing off CO2. It affects your nitrous oxide rate, and it's not as good for your immune system.

Right, right. Okay, so I unmuted people, but it seems like we have a lot of background noise there. So let me see if anybody have anything under chat at this time?

That was my chat, and I sent you the chat for the website.

I saw that. Yeah, that was great. Yeah. Okay, great. So I. Does anybody have any questions or anything? No. Yeah, I unmuted people and I think they're. But I asked some questions. Do you have anything you wanted to raise up at all, John? Oh, good, My bone is too cold. No.

Except to point out that this. This is the time to prioritize our health and wellness, to really focus and concentrate on those things that we do that really help our system. Mind, body, complex. And, you know, most of us have the time to do this now, but most of us are at home, even though kids still have more time to really prioritize our health and wellness.

Right. No, absolutely. Well, thank you. I don't see anybody in the chat or anything like that. Well, thank you for being here with us. And I can't think of anything else. I'm so relaxed from all the meditation. I can't think of anything else.

Well, meditation is like birth control. You got to take it every day.

Or else it doesn't work. Right. That's a good analogy. Well, thank you for being with me today. It was very informative. And I'll show to make sure to share that website. And so, everyone, thank you for coming by to spend your whole hour with us. And we'll be back again next Thursday at same time and we'll have another guest. Maybe we'll have John come back to do lead another meditation, but I'm afraid I'm gonna fall asleep next time again. Well, thank you, John.

Thank you.

Take care.

Take care. You too. Goodbye.