DR A ANSWERS COVID & IMMUNITY QUESTIONS

Good day and welcome to Medicine and Health with Dr. Paul Anderson. That's me, I am Dr. Paul. And today, if you're listening live, this would be November 4th, 2021. And we have some things today in this sort of Q&A session that may be very, you know, date, time and date dependent because 'Cause we're gonna talk a little bit about COVID and some other stuff. So in case you're wondering, it's early November 2021. So if you're listening in the future, all bets may be off. But I got a lot of feedback and questions, et cetera, from people who were curious about some updates, also had some sort of, I think, follow-up type of questions about some of the immune things that we've talked about in the past, et cetera. So I thought this would be a good opportunity to take a look at what the questions were. We can go back over them, maybe take a fresh look at the information, et cetera. So one of the things that I wanted to do, so I didn't want this to be all about COVID and pandemics, but obviously we have done a lot of shows on that and get a lot of questions about it as well. But one of the questions that came up, because I did that series of 3 updates around the Delta variant, kind of where it was going and all that, um, and people realized, you know, we— that was sort of reporting as it was happening. And we, we were, if you recall, looking at a lot of the UK data as far as how Delta went for them, because it was there earlier than it was in North America. And their You know, medical and social structure is similar to ours in North America, so we felt that would be a good barometer to look at. Well, what do we know now that we're, you know, weeks and weeks and weeks away from all of that? So the first question I thought I would tackle is what happened with Delta? What happened with the surge in Delta and things that we were told to be concerned about, like children, etc.? Well, Um, what happened in the US was largely what, you know, most of us who were— who had been looking at, uh, the United Kingdom and their sort of trajectory with Delta happened, pretty much what happened here. So what a lot of us were saying back then is if it's like the UK, Delta is more transmissible but apparently less pathogenic, less dangerous, and so you're going to get a bigger transmission curve on a broader group of people, meaning younger people than before, et cetera. And in doing that, you're going to have this initial surge of numbers that are going to go way up and you're going to have more, you know, previously not as commonly hospitalized people get hospitalized, like little children. And people who maybe, you know, would have, you know, missed on the first go-around, younger folks. So that kind of came to pass. That was sort of the thing. It's more transmissible, it's less deadly, so we get more cases. And so initially you had a lot of reporting going on, some of which was shown to be inaccurate, which happens early on and stuff. But you had a lot of initial reporting that, oh my God, that, you know, the hospitals are now full of children and there's no room for children and all this stuff. And while in certain local instances that would very much be true, what most of us were saying who were trying to model based on what had already happened was, you know, that will happen because it's infecting younger people. And if you get sick younger people, which there are, then you're going to wind up with more of them in the hospital. And that happened. But then What we also said is it's going to sort of go to a broader group and kind of spread, and then the numbers will dampen down. Now, for instance, in India, which is another place where Delta hit earlier, you know, they went from something on the order of 400,000 cases a day, kind of at the peak-ish, you know, almost half a million, down to, you know, under 40,000. And I believe even lower. So, those sort of things did kind of come to pass with Delta. Now, are we still having a Delta kind of wave and surge? Are there other variants all along the way and all of that? Well, we're still dealing with the easy transmission of Delta, et cetera. And now what we're starting to see is something being characterized as Delta Plus. And so it's kind of on the heels of the initial Delta surge and what's going on with that, et cetera. So the next question kind of leads into some other deeper types of questions. So I'll try and kind of cluster these together here. So with respect to, you know, the, the pandemic as it is, Delta and Delta Plus, but overall the pandemic and, and humanity moving forward, you know, are there any people modeling a trajectory for that? Well, what I think we have to come to grips with is, uh, when you get a new updated version of an old virus into humans or any other population, that virus is now going to be part of, of the human virome, okay? Meaning we're going to encounter it either seasonally or periodically, etc. Some viruses are a little easier to contain. And easier to know when they're, you know, starting off and all of that. And so things get isolated better, like SARS-CoV-1, the original SARS. SARS-CoV-2, on the other hand, has this very disparate, you know, very individualized experience when each person gets it. And a lot of people don't know they're sick for a while and they're spreading the virus. And so that's how a virus like SARS-CoV-2 can kind of keep going. Now, what most people that I've listened to, either that, you know, used to work for CDC or someplace where they, you know, they study these things, is the idea of SARS-CoV-2 being extinguished and going away is that's not likely to happen. That's just not part of our future. It's going to become something like, you know, the annual variations of cold and flu that go around in the world. And so you— there will never be a time probably where you're not going to deal with SARS-CoV-2. Will it be at pandemic levels? No, it'll be, you know, a lot like the influenza pandemic of 100 years ago was an actual pandemic, and then it tapered off, and then that strain of the flu comes up periodically, etc. So what most people are modeling is that we're going to go from this pandemic waves to endemic waves, to then just a recirculating part of our viral challenge that we get to. Now, if you look at that and you look at, well, okay, we're trying to model on, say, the UK with Delta, what was going to happen here? Pretty much what a lot of us were saying is big bloom, more people infected, more people in the hospital, then it's going to kind of go away. That's basically what's going on. So then what's going on now with Delta Plus that we're seeing and herd immunity and all of that? Well, one of the things that you want to keep in mind with global immunity, if you want to call it herd immunity, etc., just the immunity of the human population in this case to something, is to consider that you have 2 groups of immune triggers generally. Okay. So the idea of herd immunity is once you have a new infectious agent, in the beginning you don't have any resistance because no one's really had it. And then it starts to mutate, which again is what viruses do, and we get variants and all that stuff. But as it churns its way through the population, eventually you build up bigger and bigger amounts of immunity for it. And so in modern times, there's 2 ways to build up immunity. So one is sort of the old standby, which is past exposure or past infection. And we've done other programs on past infection. And so you can go back and you can look at COVID T and B cell immunity on my YouTube channel if you want. But let me just kind of go through it real quick here, because past infection has a 2-track triggering of immune memory. So if I get infected with something, I am going to have certain cells that are gonna take a sampling of that infectious material or the cells that are in or some combination thereof, and they're gonna present that as an antigen, as a potential bad guy to my immune system. And then my immune system is going to go through its 2 main phases, being the cell-mediated side, the T cell side, like T like Thomas, cell-mediated immunity. And that's where I'm gonna make some actual cells that are killer T cells that go and kill this particular antigen material. And then I'm gonna make on my B cell side, the antibody or humoral immunity side, I'm gonna make antibodies. So instead of killer T cells, I'm gonna go in and make antibodies. Now, if we just look at one side or the other, what we see is in most of the research that we have durable immunity, but some of the studies that only looked at, say, the antibody immunity, humoral immunity, became concerning with what they were reporting, saying, well, in some people the antibodies stay high, some people the antibodies go down. But then some other follow-up studies were done around that, around T cells and COVID, that showed that even if your antibodies, memory antibodies, went down, your T-cell memory— because there's a whole branch of T-cells that are for memory purposes— stayed high. And the cool thing about the way that the immune system works is that either a B-cell memory response or a T-cell memory response can reactivate the other side. So if I'm weak here, I can have a response here and reactivate my memory response on the weak side. And so We do need to keep in mind that to the best science that we have that's looking at both T and B cell activity, if you have had COVID of any type, you're very likely to have immunity that is persistent. Now, you also can get immunity through immunization, hence the name. One of the things that's been happening, especially since Delta, Is this idea of breakthrough infection. So let's just first take— okay, herd immunity is I get the mass of people who've either had the virus, have been exposed and developed immune response, or, you know, had some artificial immune response like a vaccine. And the bigger that population gets, then the less people are likely to get it out here, even in the non-herd immune setting. But with Delta and then Delta Plus, one of the things that we've seen happening is not only more people and younger people being infected with COVID-19, but also breakthrough infections, which are, okay, I had my immunizations. Let's say for the sake of argument, you know, person had 2 Pfizer, 2 Moderna, or whatever. And they're supposed to be good to go. Okay, then what happens is the person gets exposed to COVID, usually Delta, Delta Plus, something like that, and they wind up developing COVID. And you think, well, how does that happen? Because they're immunized against this viral agent. Well, one of the things that we're seeing, especially with the more transmissible strains like Delta, is it's easier for more transmissible strain to get around through the population? Well, according to— again, these are usually virologists who used to work at CDC or work at CDC, so try and kind of go to as many source experts as possible for this sort of thing. But what they generally say about these breakthrough infections is if you think about the way that those immunizations, the ones we have right now, okay, uh, you know, like Moderna, Pfizer, AstraZeneca, those guys, they're— they create a response. Uh, we have injected them— this direct sort of paraphrasing of one of what one of the CDC people said— you inject it into the person, uh, so it doesn't go through the respiratory system like a lot of these viruses do. Well, what happens then is you inject it into the person, it creates an immune response in the Ig, the the antibody side, IgM and then IgG for memory. M is more acute, and you turn it into IgG for memory. Well, IgG and IgM are great then when you get exposed to it, except the initial response you have in your respiratory system is not IgM or G generally, it's IgA like Alice. And so if I haven't developed any IgA, I am not going to block it when it comes in. So I'm going to get exposed to COVID, let's say Delta or Delta Plus or whatever, Epsilon, and I'm immunized. It's going to go in here where the IgA is supposed to be protecting. It's going to fulminate in my respiratory system. And you recall the, you know, after one of the breakouts, they were looking— CDC looked at, you know, swabbing people with and without vaccine, and they're just about the same amount of viral load. Um, And so then I get it even though I'm vaccinated, and it takes my body, you know, a while to recognize that the infection is there and then to create an IgM and an IgG response against it. So there's a delay. So that's what you see with the breakthrough infection. So the people, in my experience in our community, I'm, you know, kind of monitoring a bunch of people with breakthrough infections, and, um, it's, it's like, you know, it's like regular COVID. There's, there's a, a very big gradient of what happens. Some people it's the classic loose smell or taste, and they're fatigued and achy, and they're better around a week. Some people are 2 or 3 weeks into a pretty bad sore throat and a cough and more like cold and flu symptoms. But the delay there in, I'm immunized, but I still got the disease, is that the triggers that my immune system have from the immunization take time to catch up to a respiratory transmitted disease, which SARS-CoV-2 generally is. So that's the idea behind a breakthrough infection. So will that person then be more immune? Yes. Generally, you know, if you get somebody who has a breakthrough infection and they've already been immunized, then they develop all of, you know, their native immune response, they probably have a a very rigorous sort of immune response in the future. But one of the things that most of the people looking at modeling and looking at other places, you know, like Israel or the UK— these are all kind of on news stories you can go hunting for— but if you're looking at, you know, this pattern, this idea of breakthrough COVID infection in the already immunized population is happening everywhere where they've done immunizations, basically. So this is not just the United States or Canada, for example. Now, some other things to consider then is, so is there, is there a benefit? There's kind of 2 follow-ups to this. One is, is there a benefit then if I'm already immunized and then I'm already going to, you know, maybe get a breakthrough infection? What am I doing here? Is there a benefit there? And then the second question really is, okay, so how reliable are the numbers that we look at? As we look at, okay, native immunity is worth this much and vaccine immunity worth this much, et cetera. Well, To the first question, when you're looking at breakthrough infections and is that going to keep going on, etc., based on what we're seeing everywhere else in the world, probably so. What a lot of people choose to do is then go back to environmental controls like masking and all that business. Is a breakthrough infection as bad as a regular COVID infection if you not immunized? We have some data that shows yes, some experiential data shows maybe, maybe not. A lot of it depends on who you are and how sick you got. Like I said, I've seen breakthrough infections be days to 1 week, and I've seen them go on for 3 weeks with pretty severe symptoms. It's very dependent on the person. Now, generally speaking, are you less likely to go to the hospital with a breakthrough infection? Yeah, you're less likely to be hospitalized with, with a post-vaccine breakthrough infection. If you've already had COVID, you are also very unlikely to need to be hospitalized as well. So in that case, kind of both sides are about the same. In regard to numbers, and, and, you know, this kind of goes to some things I've seen, you know, people on, on social media like to kind of ping pong back and forth I would say idea sharing. Usually it's one person talking out and the other person kind of talking out and neither listening to each other. But you see things shared, you know, about, well, natural immunity is a complete myth. Okay, so I saw this shared by someone, and there was one paper, and the paper did a review, and it looked at very particular parts of immune memory and not other parts of immune memory. And if you look look at it that way, you could say, oh yeah, nobody would ever have natural immunity to anything. But to then take that paper that's somewhat skewed, it's giving you an outcome that they were aiming for, that doesn't match other papers, it's a little bit of a stretch to say, well, see, there is no natural immunity, it doesn't last. You can't base statements on that just on you know, one paper that was set up to give you a particular answer, although people are doing it. So, um, I do want to be clear that, you know, natural immunity, if you've already had COVID, is generally pretty strong. Now, the other follow-up then is, what about boosters, or boosters for people who have natural immunity, etc.? Um, and can we trust those numbers? Well, one of the people I saw reporting said, well, if you already had COVID and you get a single booster, You'll have super immunity. Well, maybe, you know, maybe not. Um, what appears is if you're stacking immune triggers and you have— let's see, you've already been immunized, then you got COVID, so you have breakthrough COVID on top of your immunization— those people probably do have some, you know, very robust sorts of immunity. Same on the side of the person who already had COVID. Is adding another layer, you know, by doing a booster shot or an added shot onto a post-COVID patient, is that going to help them? Early data again say, yeah, you're stacking immune support and immune triggering. Can we extrapolate that to say that's going to last forever, it's always going to be true as we get new numbers? No. And the reason I say that is there's a lot of people throwing around numbers. Oh, this is X percent effective, and this is X, you know, percent side effects and all this stuff. The numbers are so early. It's really nice to see numbers, but you need to remember that they change over time. So I was just reading earlier before I came on to do this, and, you know, there was a therapeutic that had been reported to be You know, super, you know, helpful, like in the high 90 percentile. And then they were showing, you know, well, after we've done, you know, a few more million of these, it's not quite 95, it's down to 72%. And that's not to say that's not still on the winning side of a therapeutic, but— It's to say that if we just went with the early numbers and said, see, it's 98% effective, Those aren't going to stay real forever. That's how numbers are. The more we have to put in, the more we have to put into the massive data that you look at, usually the more realistic the numbers get over time. And so while it's nice to speculate and we can look at things and look at trends, I don't think that we can use the data that we have right now to say it's, you know, this is for sure, you know, always going to perform at this level. For example, so another question that was asked that was I think related because we've also talked about what you know are the things you can take for your immune system to you know make it perform at a good level, etc. And so someone wrote in a question said, "I've been taking zinc, vitamin A, D, and K, vitamin C." for, for 14 months now. Is there any danger with that? Um, and I, I suppose, I mean, starting very early on, you know, I did a number of podcasts on nutrients for immunity and herbs and other stuff. And, uh, you know, many, many other people have. So a lot of people sort of, you know, some people already taking the same, you know, that stuff. Uh, some people sort of looked and they'd never really taken supplements before, so they went out and they just bought this list and and start taking it. I did a newsletter which you can get on my website, dranow.com, D-R-A-N-O-W dot com, on immune supportive nutrients and research behind that and stuff. But this is a really good, I think, safety and follow-up question, which is— this is something we talked about almost 2 years ago now. It's hard to believe. But And that is that there is a difference if you're using nutrients to support your immunity beyond your diet. So if you're eating things, that's, that's fine, that's diet stuff. But if you're taking supplements, a pill that has vitamin A or D or whatever in it, there's a difference between doing something for a couple of months to help you over cold and flu season and doing something every day for 1 year, 2 years. 10 years, etc. So the difference is you can safely usually get away with higher doses of things for a short period of time. And what I tended to say in those early days of, you know, 2020, we're doing all these programs about immune support and can you really support your immune system, what nutrients might do it, etc. What I used to tell people was, look, you know, for 1, 2, 3, 4 months, all of these doses are going to be fine because your, you know, your body is going to have purpose for them, etc. And if it's a water-soluble, uh, item, you know, you'll probably equilibrate and pee out what you don't need. But there are some things like fat-soluble nutrients and certain minerals that might imbalance other minerals that would be really good to take a fresh look at. And so in this person's case, uh, Zinc, vitamins A, D, and K, and then vitamin C. So kind of what a lot of people were talking about for immune health. And so let's break down a couple of things. Well, vitamin C is the easiest one. We talked a lot about this. Vitamin C is water soluble. If you split the doses up throughout the day, you can probably absorb, you know, anywhere from, you know, 1,500 to 2,000 milligrams on the low end if you split it up to You know, 10,000 milligrams or more. And some people, especially if they're sick, you don't want to take it all at once because vitamin C can give you diarrhea. And generally, that's how you know you've taken enough vitamin C, is your bowels get loose, and you just back off. So vitamin C is fairly simple. It's not really going to hurt anything. Zinc is a good one to take early on, but remember what most of us were saying, uh, over time was If you're going to take zinc for a while, you should probably take it as part of a trace mineral product. And so what I tended to do even through the early days of COVID instead of just giving people zinc, is to have them steer them towards a trace mineral product and use the trace mineral product to get their zinc, but also to get other balancing minerals. The big one you have to be concerned about with zinc long term if you're not taking it as copper Now, if your copper levels were already high, sometimes doctors will actually give you zinc to lower your, your body copper levels. But what if your copper was not high? Well, copper and zinc have this balancing relationship. And so, um, usually if you look at a multi-mineral, you may have 30 to 50 milligrams of zinc and then 1 or 2 milligrams of copper. So it's a tiny amount of copper. But long term, if you've just been chugging down zinc and taking zinc, this would be a good time to switch over to a multi-mineral that's got, you know, somewhere between 30 and 60 milligrams of zinc per dose. That might be 2 or 3 pills, but, but also has a few milligrams of copper because long-term you do want them both. Short-term, not such a big deal. Then vitamin A, D, and K. Now, these are not water-soluble. These are fat-soluble vitamins. And the fat-solubles are vitamin A, D, E, and K. This person is taking all except vitamin E, so vitamin A, D, and K. Now, early on, probably vitamin D got the most attention, and a lot of us talked about vitamin D. And certainly now there's research to show the lower your vitamin D levels are, the worse you're going to do in the hospital with COVID and all this other business. Um, one of the things that we talked about was, again, long-term vitamin D and vitamin K both fat soluble, work better together. Now, a lot of people early on were just doing, you know, higher doses of vitamin D, 20,000, 50,000 IUs, maybe more. And I kind of said the same thing with that as I did with zinc. Vitamin D being fat soluble is something that you're going to want to get tested and measured. And usually when you get your levels up, you can then lower your dose to keep them where they're at. So again, for the first, you know, 1, 2, 3, 4, 5 months or so, high doses of vitamin D, probably great during cold and flu season. Long term, you want to get it checked. And what I recommend taking is now easy, pretty easy to find, are supplements that have vitamin D and K2 in them. Vitamin K2, because vitamin D and K long term work together in the balance of calcification in your body and a number of other maintenance projects that they work on. Now, what about vitamin A? Now, vitamin A has 2 potential forms, although one is really the only vitamin A. But vitamin A, remember, is broken-down carotenoids. So like you've heard of beta-carotene, probably. Carotenoids are the, like, the things in carrots and other stuff like that, are these long double-length vitamin A molecules. So like a beta-carotene or other carotenoids are 2 vitamin As put together, and then you go eat them, they go into your body, and then your body has certain enzymes that will break the carotenoid in half and give you 2 units of vitamin A. Does it break all of them? No. And are some people slow genetically at breaking those things? Yes, there are some genes that that, you know, can slow you down there, etc. But let's say you're not getting it through carotenoids, so you're not eating, say, sweet potatoes or, you know, carrots or other stuff like that, but you're getting a fat-soluble vitamin A. That— those are retinoids. Okay, so carotenoids, water-soluble. Retinoids, fat-soluble. So the fat-soluble form of vitamin A are the retinoids, and you'll see it— the, the the drug or the supplement will start with RET for retinoid. Retinyl palmitate, retinyl acetate, you know, other forms of retinol are what you see there. So again, vitamin A is one of those things that you can become toxic with if you take too much because it's fat soluble. But just like we said with everything else, early in a cold and flu season, or if you're getting acutely ill, we give people extra for short periods of time. Now, vitamin A is a little harder to test accurately than vitamin D. But what we tend to recommend with people is if they're doing it for longer than, say, 4 to 6 months and they're taking vitamin A, you should really work with somebody who can monitor your liver functions. May want to do periodic vitamin A testing, although, like I say, for disease purposes, that, that has limited value, but you can do some of that. But also just somebody who's maybe going to take a look at everything overall. So if you're taking a lot of fat-soluble nutrients, A, D, E, or K— in this person's case, A, D, and K— and then you're taking imbalanced minerals like just zinc alone, yeah, you're probably going to want to check in with somebody and have that looked at. So I think that was a really good, you know, follow-up question because, gosh, you know, we're, we're really not that far away from, uh, coming up on 2 years, uh, with all this. And there's been a lot of people who have talked a lot about nutrients and a lot of people taking nutrients. But again, over time, what you want to move towards is balance. Now let's say you get, you know, a cold, or, you know, you get COVID, or you get any other acute problem. If you're working with somebody who who can help you with nutritional augmentation, what they're usually going to do is when you're acutely ill, they're going to raise these levels and have you take more during the acute illness and then back off over time. That's kind of the normal way that's done. Here we've had people trying to do, say, prevention or whatever, you know, for 16 months, 18 months, whatever it is now. you can get people into trouble sort of imbalancing things. So yes, you know, take a look at things, work with folks who know what they're doing. If you're going to do a lot of especially fat-soluble nutrients long-term, get things looked at and you should be fine. But to you specifically, who's just been on zinc, AD, and K, and then vitamin C, like I say, vitamin C, no big deal. But the zinc, switch that over to a multi-mineral that's got some copper in it, and then vitamin A, D, and K, you know, at least back off on the dose or work with somebody who can guide you there. Now, had another question, and sorry, I've got more than one pile with questions here, so I'll make sure I ask them in the right order or answer them in the right order. Yeah, so somebody, um, uh, somebody recently, uh, was doing— it was a physician— they were doing a talk and they were talking about, okay, there's, there's technically a difference between the disease that we call COVID-19 and its inciting infectious trigger being SARS-CoV-2, the virus, right? And somebody watched this and said, could you elaborate on that? Because I got that they were saying, you know, the disease may have more facets and all that, but I thought, you know, this is a viral disease and the virus that we want to, you know, blame on COVID-19 is SARS-CoV-2, as we call it now. Why would there be a difference in SARS-CoV-2 infection and then COVID-19 as a disease? Well, that is an excellent question, and so thank you for asking. And also, it's illustrated in something we all have known about for decades at this point that you can think of, and that is the difference between the disease AIDS, acquired immune deficiency syndrome, and an HIV infection. Okay, as you probably know, there are a lot of people who are HIV positive but they don't have AIDS, the disease. So there are instances where we have infection and disease sort of having 2 different trajectories. Now, in the case of HIV and AIDS, there's a determination made when your CD4 T cells reach a certain point, uh, in suppression, because that's what the HIV infection does. And then you start to have clinical manifestations of opportunistic infections and all manner of other problems that it is called acquired immune deficiency syndrome. Okay, so you're going from an infection that causes a problem to then picking up other disease states that go into the syndrome. What this doctor, uh, who this person listened to was trying to get at is what they see in their practice is very similar, where you have the inciting infection with SARS-CoV-2, but then you have this big thing called the disease of COVID-19. So what in the world does that mean? Well, If you look, there are constellations of factors that make COVID-19, the disease, less of a problem or more of a problem. Okay, the way to think about that is if you have a SARS-CoV-2 infection and you give it to somebody who is otherwise healthy doesn't have any silent clotting problems, their hormonal system is balanced, they don't have a lot of other infectious or immunologic problems, etc., you are more likely— not 100% guaranteed— but more likely to have a low level of disease state in, in their COVID-19 disease experience. If you take SARS-CoV-2 and you put that into somebody who is weaker on many or all of those counts, so they have prior infectious disease that might be silent, they have some immune abnormalities, they maybe have some of these other population study-based things like, you know, low vitamin D and diabetes and other stuff like that, etc., etc., their COVID-19 experience may be very big and robust and not very good. And so I do think it's a good way to think of it and look at it. And so the next follow-up that it was either that person or somebody right next to them, uh, asked was, well, all right, uh, I get, you know, okay, we trigger it with this virus over here, SARS-CoV-2, but then the disease can be a few things or a whole bunch of things put together. When you look at cases that don't go well, what are the whole bunch of things? So what are the worst things to have in there? Well, there's a number of things. The first thing would be any clotting problem, because the SARS-CoV-2 infection changes your clotting quite handily. And with it interacting with the ACE receptors, which are not, you know, not just in particular places, they're in, you know, very blood vessel dense areas, etc. you can have more problems. So any clotting issue that you do or don't know you have— a lot of people have genetic clotting problems that don't know it, and that can be more of a problem. The next thing that I see, which is universal in any research done about COVID-19 where they, where they track this, is 100% of research where they looked for co-infections— so more than just SARS-CoV-2— they find them. And the sicker you are, The more infections you're likely to have. Now, people will often say, how could you have infections that you don't know you have? That doesn't make any sense. Well, what you need to keep in mind is there are a lot of infections that a healthy, especially adult, can be exposed to. They can harbor small amounts, but maybe their immune system Kind of has it marginalized. There's a lot of viruses like this, etc. There's also some atypical lung bacteria that, you know, during cold flu season, people are coughing all over each other. And if you're sick, you tend to manifest it. If you're not sick, your immune system tends to take care of it. So a lot of us have these things sitting around that have not been a problem for us, or maybe haven't been a problem for years. When you light up Your immune system. And the immune system now is, um, you know, on edge and it's fighting the SARS-CoV-2 and all this stuff. A lot of these latent resident viruses and bacteria will look around and say, well, no one's minding the store. They'll start to be opportunistic and replicate, which is what they do. So, co-infections are massive, huge. Now there's also, if you unfortunately had some infections when you went into it, or you had an immune disrupting either disease process, drug strategy, or whatever. So you already have autoimmunity, or you already have chronic infections, or you're a diabetic with lowered immunity. Yeah. or you're on immune-modulating drugs that decrease your immunity to certain chronic infectious things, you are going to have not only SARS-CoV-2, but you're going to have a whole bunch of other infections, and those will often be what kill you if they're not addressed. So, co-infections. So clotting problems and co-infections are probably 2 of the worst things. Along with clotting problems, I would put in any Prior, you know, cardiovascular disease, so bad valves, heart failure, other things that disrupt the flow. And then, you know, when you get down below that, the next layer of things that we see with people is that their hormonal system, their endocrine system gets all out of balance, and that's natural with your, you know, with any bad infection. But if you have the SARS-CoV-2 part and then co-infections and some of these other problems, you're now— your immune system is battling a community instead of just one infectious thing. And so your endocrine system is having to respond to a much bigger immune response. So when you think of that, you could see that, you know, while there certainly are people who are otherwise seemingly healthy who get very sick or even die, that generally speaking, The infection is one piece of a very big puzzle that is COVID-19 that leads you to the disease called COVID-19. This is why then— and we just have a couple of minutes left— but this is why when you're looking at post-COVID illness, we often have to go back in and assess the patient and say, what of these areas is either not addressed enough or we didn't look at or Or whatever. And so generally speaking, what we will do is we'll go and we'll take a look at all their hormone levels and see if those have shifted back to normal. Often they are not. That has to be addressed. We will look at infections that may still be there. So we'll often check for typical and atypical lung infections, some of the chronic virus and other bacteria, and take a look at what's going on there. We'll also look and make sure that something, you know, bad like a hemolytic strep wasn't, you know, reactivated or reanimated during the illness. We'll check on, you know, their inflammatory markers and clotting status like D-dimer and CRP and their clotting numbers, etc., and kind of base treatment on how bad that's going. Then any other thing which might include diet and sleep habits and all manner of other things that may go on there. Well, I'm Dr. Paul Anderson, and it looks like we're just about out of time for today. Today has been a topic of catch-up on COVID-19 questions, immune questions, And I tried to keep them all related to the immune system and COVID-19, but there's some really great questions that people did send in. So if you're watching this on Facebook Live, thank you. You can look over and subscribe and check in to get notifications from CTR Radio. If you're listening on one of the pod burners, thank you. Keep us on your favorites. And if you're listening on YouTube, please like, share, and subscribe. Dr. Paul Anderson for Medicine Health with Dr. Paul Anderson, and you can find all my links and all of this other stuff we talk about at dranow.com. D-R-A-N-O-W dot com. D-R-A-N-O-W dot com. All right, everyone, thank you very much, and I'll see you on the radio in a week.