#96 Dr Jaime Hope discusses Coronavirus and COVID19 with Mike Domitrz

Welcome to the Mutually Amazing Podcast. This is a live episode here. So excited with today's guest. This is somebody I've known now for about 2 years. We met through a group called the Genius Network. She does amazing, incredible work. Her name is Dr. Jamie Hope. It's so weird for me to say Dr. Hope when I'm on these interviews. I'm so used to saying Jamie, but she deserves to be called Dr. Hope because that's what she does, and she's earned that title. She works in one of the busiest level 1 trauma center ERs in the United States. And in a state right now that's getting hit, a state that's one of the states starting to make some news now with coronavirus and COVID-19, and that's Michigan, and she's right outside Detroit. So she's seeing this all front and center. I don't want to waste any more time. I want to get right into this. Jamie, thank you so much. Dr. Hope, thank you so much for joining us today.

Mike, thank you so much for having me. This is, I mean, these are unprecedented times, so to have the opportunity to get to talk to people and help is such an honor. So, thank you for having me.

Absolutely, and something we are going to do a little unique for everybody watching. I love that those of you are with us because you are going to be able to ask questions. We are going to run this actually live to Facebook so we can reach as many people as possible right now. I am going to start with the following question, Dr. Hope, and that is, what do you think is the biggest misconception people have right now about COVID-19 and coronavirus?

So I'm hearing there's actually 2 big misconceptions. And what I'm hearing is, it's not a big deal in any way. And this is all ridiculous. And the other one is, we're all gonna die. This is— we're doomed. There's nothing we can do. So I'm, I'm very much hearing both ends of that misconception spectrum. And it's really fascinating.

Yeah. And so how do you respond? How do you respond to each of those? So the one who's saying, come on, this is being overblown. I personally know some people like this is, this is being overdone. Yes, it's real, but it's being overdone. What's your response to that?

Well, so, I mean, I know you intro'd me to the, you know, to the webinar that we're on, to the Facebook Group Live. I work at one of the busiest level 1 trauma centers in the country, just outside of Detroit, and Michigan is currently one of the top hotspots in the country. So, to those people who say this is not a big deal at all, I wish that you could come see what I see. I wish that you could look into these eyes of people who are gasping for breath, And hoping to survive as our resources become more and more limited. And people say, well, that's not going to happen to me, I'm young and healthy. And you're probably right, it might not get you, but the people that you touch, it can get them. And this matters. And there are finite resources, and that includes frontline staff. And so as we run out of resources, we're going to have to be making some terrible decisions. So it, it is a bigger deal. People hear the statistic, 81% of people will have no or mild symptoms, and that's great. But I'm staring down the face of the 14% of severely ill and the 5% of critically ill patients, really just wishing people would take that a little bit more seriously. They just don't have to see what I see.

Yeah. Do you think part of the reason is that when we see other things that scare us, whether it's terrorism or it's war, we see it. Like, we see the damage. Whereas the one thing where obviously there's 24/7 news coverage of this right now, but you're not actually in hospitals, right? The cameras aren't constantly showing people dying. People are hearing about it through people randomly, through Facebook, through this, or through numbers, but they're not visually seeing it. And usually we do with terrorism or war, other things that impact us or scare us. Do you think that— Which is good. We don't want the extra PTSD and the trauma and emotional trauma of seeing all the deaths. But do you think that's impacting how people are taking it or not taking it seriously?

Yeah, maybe it looks different that, you know, as people are stuck at home and getting increasingly bored, maybe they don't see it. There's some really good videos out of hospitals in Italy that show you a little bit of what this looks like. And again, you know, on this spectrum, you know, the people who are way too scared You know, we don't want to overwhelm them. But for the people who aren't scared at all, maybe just getting an understanding of what this looks like, both for them and for our society, and how this is affecting the healthcare system in so many ways. It would be very useful if people really understood the impact that this is having.

And so what can people do? You know, we've all heard the 6 feet, right, social distancing. And a lot of critics have now come out and said we use the wrong language there, because social distancing, it should be physical distancing.

Yeah, social connecting and physical distancing.

Oh, there you go. I love that, right? To connect socially, you know, through social media and all, but keep that 6 feet of distance. Washing the hands for 20 seconds every time you wash the hands. Don't touch the face if you have left your house in 2 weeks. Don't touch your face. Don't touch— is there additional things people can be doing to either strengthen themselves or to be aware or to help lessen this spreading?

Yes, and that's one of my favorite questions because, I mean, we definitely— I mean, focusing on the physical distancing, the washing your hands, the not touching your face, that's extremely important. People are so afraid that, you know, if they touch something with COVID they're going to get it. But it's not— you touch the thing and the way that it gets in is touching your face. It gets into the mucous membranes. It doesn't soak in through your hands. So those kind of messages I really feel are starting to get out there. What I think is being left behind, Mike, is, okay, so, so you're at home, you're washing your hands, you're not touching your face, or at least getting better at it. At least I know I'm trying to when I'm not at work. When I'm at work, I'm covered in gear. You can touch your face if you tried. But it's the— but then what? So what are— what is everybody supposed to do? People are stressed. There's some job insecurity. There's some financial insecurity. And people are wondering, what am I supposed to do now while I wait this out, even if they are doing all of the right things that we're asking them for? And that's one of my favorite questions that I love to answer.

So what would be those things?

So it's important to stay healthy. So the way that you can fight this for yourself, for your family, and for everybody is to, number one, develop And maintain healthy habits. So I talked about people getting nourishing food, energizing exercise, restorative sleep, stress release, and meaningful connection. Now we can't get meaningful connection in the same way that we used to, you know, meet our friends out somewhere, giving hugs, high fives, all of those things. But there are so many beautiful ways that we can stay connected. Now, A lot of people have told me over the years, you know, Dr. Hope, I don't have time to get healthy. I don't have time to exercise. Well, all of a sudden, the universe gave a lot of people a lot more time on their hands than they were expecting. So the question is, how do people want to use this time that they have? This is an opportunity. As you know, as our, you know, our mutual friend Shawn Stevenson had said, this is happening For us and not to us. Yes, this is unfortunate. Yes, there are a lot of things going on, but there are also good things that can be had. So what in this can you find is helping for you instead of happening to you? So I'm just talking about exercising, you know, the immediate complaints are, you know, I don't have the equipment, I can't go to the gym, all of those things. Of course, that's true. I'd be shocked if there were gyms that were still open, quite frankly, because that's Not appropriate in a pandemic, but that doesn't mean that you just give up and sit on your couch and watch Netflix. What it means is it's an opportunity to get creative and flex your mental muscles along with your physical muscles. There are so many free resources. You know, I mean, there have always been free YouTube videos and things like that, but even big companies like Peloton are offering their app to use 90 days for free. You don't have to put in a credit card, and I don't get a commission from Peloton. Don't believe me, I don't get anything from them. And they have non-bike, non-treadmill workouts. So I've actually started doing some of their strength and yoga workouts just for fun, just to mix up my routine and try something different since I can't get to the gym. And you don't have to literally be locked in your house. So it's okay and safe to go outside. In fact, we should. We need that sense of fresh air. We need the vitamin D. You know, in Michigan where I'm at, if it gets above 40 degrees, we're usually all outside like Heat wave.

Today was 50. You're like us, right? I'm in Wisconsin. Today was 50 and we went for a walk and, and you saw more people than normal. Of course, everybody stayed on the opposite side of the road, which is awesome, which is great. But you're right, it was like, get outside, it's too nice to be inside safely, right? They're safe.

This is tank top weather for us. This is crazy. Um, can I ask—

I want to ask a question because one thing that can happen— I noticed you used a specific language earlier. You said energizing exercise, and I think that's such an important conversation because there are people that under stress overtrain. They overwork out because they just, I need to do something, I need to do something, and they're actually exhausting and depleting their immune system. Is it correct? I believe so, at least. Is that correct?

Yes. Exercise boosts your immune system, but like anything, the poison is in the dose. Overexercising and extreme exercise can actually deplete your immune system. And that's the last thing we need right now. So if somebody's been sitting on the couch for the last 5 years, maybe this isn't the time to run a marathon today, but maybe a couch to 5K situation on an app and things like that. So the exercise should be replenishing you so you feel tired afterwards, maybe sore the next day because if you're not used to exercising, but not debilitated, not exhausted. We're not burning ourselves into the ground. Sorry about that.

I love that, and that is awesome. Are there things people can do on the spiritual side, whether that's prayer or meditation? Do you find that those are very helpful in these times, especially with all the stress happening right now? Yes.

Oh my gosh, Mike, yes. With all of this stress going on, it leaves a lot of questions. You know, why is this happening? Why now? Why me? And to sit at home and ruminate on those kinds of things and spin out on watching the negative news media, wow, that can be soul-crushing. So at this time, you know, in the same way that I talk about nourishing food and energizing exercise, we should be treating our spirit the same way. So whatever your belief system, whatever your religion, all of that is okay. It's a matter of feeling that connection to a higher purpose, a higher being, however you define that. It doesn't— I mean, there's no requirement. It's, it's a choose-your-own-adventure kind of thing, whatever fits you the most. And having some still reflective time in meditation. Mike, I'm not gonna lie, meditation is hard for me. I work in such a high-stress, high-stakes environment. And, you know, everything is go, go, go, constant stimulation. Some days we're lucky to get a bathroom break and then to just come home and shut it off. It's hard. And so if there's anybody out there who have struggled with meditation, I feel ya. It's not easy. But there are so many different forms of meditation. I was never able to do the kind where you sit still in a lotus position on a mountaintop with perfect blank thoughts for an hour. 2 seconds into it, I'm already thinking, oh no, I'm not supposed to be thinking. Oh no, that's a thought too. Oh no, I'm doing it wrong. I'm terrible at this. But for me, what I actually find meditative is to do something like go outside and go for a walk in nature. No headphones, no audiobook, no music, and just be. For me, and I'm, I'm not pretending to be an expert on meditation by any means, but for me, it's just being present in the moment. And there are so many ways that people can do that. And it gives you that That release. We need so many forms of stress release, and that's something I've worked on in many different ways over the years working in such a high-stress, high-stakes environment.

Yeah, you're the definition of a high-stress situation, so you would understand. And I think one of the things that, whether it's prayer or it's meditation, is let the stress off of yourself when you're doing it even, right? So there are— I'm fortunate that I live near water, and what I do is I get out on the water. I take my kayak out on the water And I meditate there. But like today, after about 15 minutes, I'm like, I'm done. And I used to feel guilty about that. I'm like, no, I got the 15. I got what I needed. And it's okay to just say, hey, if it's 5 minutes, it just helps freshen your mind. That's better than 0 minutes.

And even take 5 deep breaths. Anything is better than nothing. We need to let go of the guilt and shame with this. I mean, it's the same thing with Look at the language we use around food. It's a cheat day, or a guilty pleasure, or sinful food, and all these kind of negative type of connotations with food. So I'm going to go on a little mini rant here since we're all sitting at home and we— and I'm telling people, you know, eat nourishing food. So this is kind of— this is my interpretation of Michael Bernoff, who runs the Awesome Sucks community, or— oh my God, I'm just an idiot. The Average Sucks community. Oh my God, he's going to kill me. Michael, I love you. The Average Sucks community. He is awesome and he doesn't suck. He's amazing. And he talks about food in 4 ways. I break it down more, even more simple than that. If you look at anything you're eating, it is either nourishing or entertaining. Period. It's not difficult to figure out what it is. Broccoli, nourishing. Cheetos, entertainment food. And you can go on and on. So instead of all this horrible guilt and shame we tend to associate with food, I just say, look at your ratio of nourishing to entertainment food. And I say that to be a healthy person, you should be at least 70% nourishing to 30% entertaining or better. I try and stick to a 90/10 or a 95/5, you know, kind of ratio, but anything above 70%. That way, when you are enjoying your entertainment food, you can drop all those ridiculous labels and negative words and just enjoy it. When I have a brownie, there's no cheating, there's no sinful, there's no— it's just, it's enjoyment, it's bliss, it's my moment of entertainment.

And I love that. I love that concept. It makes it simple. And this, unfortunately, COVID-19, actually, if from what I understand, and you know, I'm asking you actually more than I should be saying, I want to ask, Is it true that elements of overweight, diabetes, high blood pressure actually creates a higher vulnerability of attack and mortality issues? Yeah.

No, that's actually the truth. When you hear reports that a bunch of young people are on ventilators, those aren't completely inaccurate, but a lot of those younger people are overweight. They are diabetic. of that, with that poor self-care, not getting exercise, not getting nourishing food. And so the way this virus is going at them in the same way it's going after the elderly and immunocompromised people. And it's just, it's scary to look somebody who's not that much older than me in the eyes and as they're struggling for breath and putting them on a vent. And so it matters. It's, you know, they— the whole saying, you know, the best time to plant a tree was 20 years ago. The second best time is today. The best time to get healthy was 20 years ago. The second best time is today. It is not too late.

Yeah, and I'm seeing people joke about, oh, the freshman 15, but this is the corona 15, now that I'm home and I'm putting on the weight, and you see that. What you're saying is this is now the time to be very cautious and aware of what you're eating so you are your strongest, you are your most immune strength-wise to be able to fight it off, or even if it were to happen, To be able to handle the situation.

Yes, healthier people are less likely to get it, less likely to suffer severely from it, and less likely to die from it. So when we have this unprecedented free time, and I know people are still working from home plus trying to homeschool their kids, not everybody has an abundance of free time. I certainly have the exact opposite of that. But even that little bit of time where we have the opportunity, use that time to your advantage instead of numbing out with You know, Cheez Whiz and Netflix. And so when we come out on the other end of this, you will have spent your quarantine time in this highly stressful time coming out stronger and better.

Love that. And this is a live podcast. We're doing a live podcast. So everybody watching, whether you're on Facebook, you can ask questions in the comments. I'm following that. And if you are here live actually in the podcast, which means you're on our webinar with us, there's a Q&A section at the bottom of the screen. where you can pop that up and ask a question, and I'll keep an eye on those so we can ask those of Dr. Hope throughout this. So if you have any questions right now, write them in the comments, any thoughts on Facebook, or if you're live here at the actual podcast in the webinar, use that Q&A section. What are the most common questions you're getting or concerns from people right now, Dr. Hope?

So I actually— I've been actually keeping a list because I am getting kind of the same types of questions over and over. And number one is, are we turning away other emergencies? So if, you know, say if you're having a heart attack or appendicitis or you're in a car accident, you break your leg, are we turning people away? And please know the answer is absolutely not. The emergency medicine system is still running. We are still actively and very safely taking care of all of those other emergencies. We don't expect you to stay at home until your appendix bursts. For those non-COVID patients coming in, we are taking absolutely every precaution we can to keep you safe and take care of your healthcare during this situation. So, I mean, certainly now is not the time to come in for, you know, you sprained your ankle 8 years ago. Maybe if, if you're not feeling that, maybe now is not the time to come in for kind of non-emergencies. You can do telemedicine visits with your doctor about those kind of things. But please know that if you are having a medical emergency, we can and will absolutely take care of you.

And we're—

we've been doing it forever, so we— I promise we're still prepared. We didn't forget how to take care of appendicitis in the last few weeks.

Do you think that's coming from people are hearing about people who are saying, I've got— I think I have COVID-19, I've called the hospital and they've said stay home, your temperature's not at this level yet, so when it gets here Do you think people hear stories like that and think, oh, they can't even take the people who need it, so I can't go? Is that where you think that's coming from? And if so, how do you address that?

You know, I wonder. That might actually be true because truly, we're— I mean, if people are having mild symptoms, we're not admitting them to the hospital. We're admitting people to the hospital who need oxygen and respiratory support. So they might maybe kind of extrapolate that to say, don't come in for anything. But certainly there are other emergencies that would necessitate intervention sooner than that. You know, people who are having a severe diabetic attack or things like that, that's perfectly okay. We're not going to turn those away. We're just trying to control the population of COVID because the vast majority of people can self-treat at home. But please don't take that to mean we're not treating anything because we are treating all of those things.

Yeah, that's so important for people to hear. I appreciate you stressing that. What is the difference? People hear coronavirus, And they hear COVID. We've heard COVID is when you're getting sick, but I think people get confused by that. So what is the difference in coronavirus versus COVID-19?

People are using the terms interchangeably along with the SARS-CoV-2. They're all referring to this novel virus. So let's back up a little bit. Coronavirus. A coronavirus itself, this is not a new thing. These have been around for decades. Probably since humankind. We get coronaviruses every single year along with rhinovirus, adenovirus, influenza, things like that. Most of the time, the coronaviruses cause a mild cold, like no big deal. We don't really test for it that often because we know it's not that big of a deal unless someone gets a respiratory virus panel on you in previous years and then say, oh, you have rhinovirus versus coronavirus, and the answer was, you're fine, we're doing the same thing. What's different about this one in particular, so the COVID-19 is a specific subtype of a coronavirus. In the same way, do you remember the whole swine flu thing?

Absolutely, yes. H1N1.

Okay, so all the flu viruses have an H and an N designation. So it was just that H, you know, there could be H1N2, you know, all of those different things. It was just that particular strain that was troublesome that year. So this is a particular strain Strain of a coronavirus. So, and that's, it's that specific one human bodies have never seen before. The reason that they're thinking that children are not getting as affected is kids get sick every year. I mean, I'm like, have you walked into an elementary school before this happened? It's a booger fest. Every kid's doing this and this and stuff like that. So they're getting coronavirus year after year. Maybe it's a mild sniffle, no one tests. So because they're getting similar viruses, even though it's not this exact one, there are some people saying that could be why kids aren't getting as sick from this because they kind of live in a booger fest cesspool.

Well, it's a great example of education because early on it was keep away children and old people. And then suddenly children just, you never heard about it all of a sudden. It was only focusing on old. And now we learn don't focus just on old, obviously, as you brought up. That's so important there. So when it comes to that, you said, hey, it's, it's the difference in what they're contacting. One thing that we're hearing now is that this one already mutated way quicker than other ones have mutated. Is there a threat of future or more mutations in the next few months that could keep this rolling for a while?

You know, it's possible. Viruses are amazing at mutating. It's how they stay alive and continue to infect host after host after host. A smart virus would mutate so after you get the first form, You would not be immune to the mutation and get it again. That's how the virus continues to replicate and grow. Now, I'm not a virologist. I'm not an epidemiologist. I'm just the person on the front lines taking care of them. But we have seen this with other viruses. So it's hard to say. I would love to think that we just get this one under control with, you know, all the measures that we're supposed to be doing. And now get this, I can't predict that. I'm sure that there are, you know, some smarter epidemiological folks that could probably answer that question better.

We actually have a question related to this, so we're gonna go right into this. Sarah asked, related to the conversations about the kids and the booger fest, are you saying that we over time might build more immunity to these coronaviruses, or specifically this virus, naturally by exposure? So she didn't say naturally by exposure, but I think that would— that's my interpretation of the question, just to be fair.

Yeah, so we believe most viruses, after you get it, you have some level of immunity. I can't say for sure that that's going to happen with this one, so because we just haven't had enough time to test. So we're going to start doing things like, do we have antibody testing? Can we use that convalescent serum to help other people? Will we build that kind of immunity? But generally, yes. And then the question is, will we get a different mutation and a different strain that's different enough for, for future things? I don't know. Did I answer that question? I feel like I missed a good part of it.

Yeah, no, I think you did. I think the danger would be anybody thinking that that's going to happen soon, right? That this— because we're adults, our immune systems are different than children. And so I assume it would take us much, much longer to accomplish what children naturally have. Is that right or is that wrong?

Probably. And then I would hate for somebody to extrapolate that to something like what they were doing back when I was a kid with chickenpox parties. You know, if one kid gets chickenpox, you take your kid over there and rub them on them. So you can all get it. Please don't start doing that with COVID We are not prepared for that because some people are getting much, much sicker than we thought. So now is not the time to try and get immunity. Now is the time to try and avoid it as much as possible.

Now that makes a lot of sense. All right, we said earlier, what are questions you're getting that we haven't addressed? You brought up the one— what are additional ones that you're hearing that you want to make sure get addressed?

Okay, so I get a lot of questions about how can you get this. Should I wear a mask? Should I accept deliveries? Should I bring home groceries? So let's be crystal clear on how you get the coronavirus, any type of these viruses. So as I mentioned earlier, you don't absorb it through your skin. So just touching something in and of itself, even if it's teeming with coronavirus, you don't get it that way. You don't get it until it crosses your mucous membranes, which is the portal of entry for these viruses. So now we're talking your eyes, nose, and mouth. Notice I'm not touching them. Well, if I do touch my face during this video, I promise I just cleaned my hands, so no need to harass me.

And by the way, earlier you said you were equipped up when you're on the job. I wish we could show people a picture right now, but when you say equipped up, there's not just a mask, there's a glass, like, welding section you have above the mask, right, from the pictures I saw.

When we can, it's really important for us to be in full gear because— and which actually helps round out the question really well. People say, you know, if I'm in public and someone a few feet away from me sneezes, am I going to die of the COVID And it's— yes, it is droplet. There's potential that it's airborne. That's up for a huge debate that I'm not even going to touch right now. So there are some droplets in air, but the vast, vast majority of people are not going to get it from walking through droplets. It's you're going to touch something that has a droplet on it and you're going to not realize you're doing it and then touch your eyes, touch your nose, touch your mouth. So when people ask me, should they wear a mask in public? The answer is actually yes, but you don't need an N95. You're not intubating somebody. You're not putting them on life support like we are. We need the N95 because it's spewing into our face very directly in close contact with someone with a high viral load. The reason I encourage—

I'm just pausing because you're using a term some people might not understand. Is N95 the glass wall I'm talking about versus the mask?

Oh no, that's the shield. So N95 is the one that fits right on your nose and mouth that are in extremely, extremely short supply. They're sealed around the edges so liquid can't get in under any circumstance. So kind of the painter's mask.

Great, thank you for explaining that. Appreciate that.

And then the surgical masks are the one that are just kind of the sheet across your face. Those are perfectly fine for anyone who's not doing direct patient spit contact procedures. In fact, other personnel in the hospital that are not doing those direct spit contact procedures are perfectly safe in that surgical mask. You can make your own, you can get some, I mean, you probably can't get some.

I was about to go into that. So the making their own, is there a certain protocol people need to follow if they are making their own?

No, because the point of those masks that you're wearing out in public, like I said, there's very little risk of droplet, especially if you're doing the physical distancing. And even if you do get a little droplet on there, just wash the mask. You know, make make a cute one. Make it whatever pattern and fun thing you want. Take it. You know, take it home. Take it off. Put it in the washing machine. Wash your hands. The reason that you're wearing it is because you're at the grocery store and you're not going to realize it. And then you reach and put a few things in your cart, and then you're like, "Um, what did I need to get next?" And that's where the problem happens. But you can't touch your face if you have a mask on. No, Mike. I saw a great video from I believe it was the Prime Minister of the Czech Republic that they've actually required. I would require every single citizen to wear a mask in public. That way, you know, last time I was at the grocery store, I sneezed. And now normally, I mean, you sneeze in public and people say bless you. Now people run in terror and give you dirty looks.

That's right.

But I'm a healthcare worker and I know that I've had some very high-risk exposures, even though I'm extremely careful. I was wearing a surgical mask. So I sneezed inside my mask. There was no chance of passing it to anyone else. And all of those times I was so tempted to touch my face, The mask stopped me. So it's protecting me, it's protecting you. So it's perfectly okay to wear, you know, just a regular surgical mask of any kind, any cloth you want to make. There's tons of videos out there to learn how to make one. But that way you're just keeping your mucous membranes safe in public.

Thank you. We have a very specific question here of somebody who— somebody close to them has been impacted by this. So I want to make sure I say this word for word for you. This is one of our listeners asking, Here is the question: My girlfriend was exposed on March 18th. I just found out on March 30th, and she has no symptoms. Should she quarantine, and for how long?

Okay, so on so so on the 18th, she was exposed to somebody.

She was exposed to somebody with it on March 18th. She just found out on the 30th that that person back on the 18th had it at that time. So she's just learned that. That she was exposed 12 days before, she has no symptoms, should she quarantine and for how long?

I get there's such a lag time in testing right now. Isn't that so frustrating? That's a separate issue we can talk about.

By the way, that's an important issue. Is it— what I saw on the news today, there's a 10-day lag on some tests. Like if you take the test, it could be 10 days in some states before you hear the results. Is that correct?

Oh yeah, a little interjection here about that. That's absolutely true. So if somebody has classic symptoms and we swab them, we're like, you know, for them, just assume you're positive. We'll just tell you, like, here's a gift certificate, you have it. Just assume you have it and act accordingly. Right now we believe that the incubation period is mostly between 2 and 14 days. So if we're talking, you know, 12 days from an exposure and still zero symptoms, 2 more days of self-quarantine would be appropriate. And if you remain symptom-free, then join the rest of the general public with just the physical distancing, the not face touching, and the hand washing.

So this is a good example though, because the person wasn't quarantining or self-isolating until 2 days ago when they found out about the 12 days earlier. It's a little tricky. So for 12 days they would have been walking around, right, in theory, potentially, but that would then be exposed to other people.

Absolutely. I mean, unless you're truly, truly isolated, we are still being exposed to other people in some ways. And that's why we're— and we know that 81% of people have either no symptoms or very mild symptoms. So there's this rate of asymptomatic people, so no symptoms, that are carrying this, that have it, that are passing it to others without realizing it. And that's why we just say everybody wash your hands, stop touching your face, wear a mask in public, stay physically distant away, because you might have a mild sniffle that you think is a seasonal allergy, and that potentially could be the COVID virus, and it's just not affecting you that much. So that's why we want everybody to participate in this and not just the people who are feeling sick. And it is possible, even if you do get sick, that you were sharing and shedding the virus in the few days prior to your symptoms. And so if we all join together and share the responsibility in not spreading this, that's the only way we're gonna slow this down.

Stay home, stay home, stay home. Yeah, we have another question. Absolutely. We have another question from Sarah, one of our listeners. Can you talk about the risk-benefits of using acetaminophen versus ibuprofen when people get symptoms?

Yes. So separate from the risks of the medications themselves, of course, too much of the ibuprofen can be hard on your kidneys, too much acetaminophen can be hard on your liver. So we'll separate that out and you can read the package labels for those unless you really want me to dive into that. But specific to COVID. What we're seeing is that it increases a specific receptor in our lungs called ACE2, and ibuprofen specifically can also increase that receptor. And there is a theory that that can make you more susceptible to getting this infection and to having a worse outcome because of that specific receptor, and acetaminophen does not do that. So although we haven't Specifically, not every medical institution has banned the use of ibuprofen because that theoretical risk is very real. We're just saying if at all possible, when you are doing symptom control for the muscle aches or fever, just avoid it. Just avoid it because we don't have enough data to know better and instead of taking the risk. So we're pushing people toward acetaminophen if they're looking for an over-the-counter medication. for fever control and muscle aches and just make sure that you're not overdosing because that's a medication that's easy to overdose on.

So acetaminophen, for those who aren't aware, what would be over-the-counter examples of acetaminophen?

Tylenol and paracetamol are the most common ones.

What was the— I knew Tylenol. What was the second one?

Paracetamol.

Paracetamol.

Yeah, that's, I believe, in Canada and then also in England and Australia.

Wonderful. All right, excellent. All right, so one last one. Any other last nuggets you want to make sure that our listeners and the viewers and the watchers right now know before we wrap up?

Yes. So one of the things that also that are really important to do while you're at home is when times are so stressful and we're frustrated and things like that, now is the time to connect more deeply than ever with your purpose. Not everybody can be on the front lines facing this, and quite frankly, not everybody needs to be. There are so many things that people are doing from home. You know what, I'm great at suturing. Mike, I suck at sewing. I have no idea how to do it. But all those people who are good at it are making us those hair covers. I can't go in like this. I need, I need hair covers. So people are sewing us hair covers. People are making masks. People are making food. People are taking things to neighbors. People are still working on what What can we do with all these rescue animals that need homes? People are still helping victims of human trafficking. People are creating coding software to help platforms like this have enough capability to have this many people on it all of a sudden. So you don't have to be the one putting a tube down someone's throat to be a hero. Everybody is doing something so important. I mean, the people who deserve some of the biggest shoutouts are like our environmental services team. Who are cleaning up after a patient leaves the room and doing it so carefully that that room is safe for the next person to come in, even if they don't have COVID. So everyone out there, you do something useful. And even if for some reason you're laid off on your job right now, or that's not available, you have a skill, you have a thing, something that you can bring to the world that is useful and needed right now. Yes, we're seeing stories of suffering and problems and pain, but there is so much beauty and wonder in the world. Go pick up your neighbor's sticks in their yard. You know, that's still something at a safe distance away. When you're connected to that purpose, that useful thing that you can do during all of this, it gives us a reason to get out of bed. It's a great stress release technique, and it helps us all feel so connected together in this world. You know, we're physically distant, but we are still so connected.

Yeah, one of our listeners just wrote right now, Scott, that he's creating a fundraiser in May, and I assume it's a 6-foot distance apart because it's a bike, which you could do and still keep that physical distance to fundraise and help donate. He also brought up donate blood. Now, I can imagine people are scared of that though, right? Because they're thinking, well, everybody's overwhelmed, or am I going to donate blood where they're not overwhelmed? So let's, let's go into that before we wrap up. If somebody does want to donate blood, what is the best way to do that right now?

Contact your local Red Cross and your local blood banks. Yes, we need blood. It's not that these sick COVID patients are taking up all the blood by any means. It's that, you know, we're still getting trauma patients, we're still getting bleeds. They're not taking up all the blood either. But the supply only lasts for so long before it expires. And we need a replenishment of that supply. So those places, the blood donor centers, are meticulously cleaning. So nobody gets— they don't want anyone to get sick while they're there because then nobody will donate. So I assure you, they want you to be safe. They want you to be careful. So yes, that, that is a great way to help give back. So absolutely, that's a great suggestion, Mike. Thank you.

Absolutely. I'm glad you're taking us down these roads to think about all these possibilities and alternate ways people can make a difference. It's so important. This is Dr. Jamie Hope everybody's been listening to. You are so amazing. Just again, for anybody who's listening, works in ER at a trauma— level 1 trauma center outside Detroit. She is literally on the front lines of what's happening right now. You do such amazing work, not just in ERs, but you're out there spreading a message, and your name works perfectly with your message.

Thanks.

Jamie, could you share how people can get a hold of you, your information. You have a great book. So if you could tell them about your book quickly, so if they want to learn more, get more of you, how they can do that.

Sure. And I mean, this is all pre-COVID. So the way I always looked at my career is my main job, my love is I work in emergency medicine. So I see people on the worst day of their life. And so I dedicated the other part of my career to helping people never have to end up there. And that's by teaching People how to create and sustain healthy habits. So the title of the book is called Habit That. So it's helping teach people how to create and keep those habits, not like those New Year's resolutions that we forget in 10 minutes. You know how that goes. But the real stuff. It's not the quick fix. It's not some crazy fad stuff, lose 100 pounds in 2 days or BS like that. And so, so the book is called Habit That. It's out there. And I have a Facebook group called the Habit That Tribe. So where we connect— I haven't been writing quite as much as usual lately, but in my defense, I'm working really hard.

I think, I think the work you're doing is so important. Nobody's gonna complain.

Yes. But my website and my Twitter and all those things are the same. It's Dr. Hope Health. So come find me, tweet me. I'm doing my best to keep all these messages, you know, to answer as many questions as possible. It's not, you know, other than the book, I'm not doing this professionally. I'm just doing this in my free time out of Because I care. So I'll answer absolutely as many as I can until I need to go to sleep.

Well, your passion shows, and I want to thank you. I want to thank all of our medical professionals on the front lines. Like you said, the people, even the cleaning, that they're making sure they're safe, to our nurses, to our doctors. Thank you, all of you listening right now, for what you're doing. Jamie, thank you so much for joining us tonight. I know this is going to help a lot of people. We're going to get this out on our podcast, the Mutual Amazing Podcast, so you can replay it. Anyone can by looking it up. When we launch it, I'll have it up by tomorrow. We're going to really turn this around fast so people can find this episode. It's going to be episode 96 of the Mutually Amazing Podcast. Jamie, thank you so much. You're an awesome friend. You're a brilliant doctor and just a giver. People can tell by listening to you how much you care and want to help others. Thank you so much.

Mike, thank you so much. It was a wonderful opportunity to be here. I absolutely adore you and the work that you do. It's a huge honor to be here.

Thank you very, very much. For all of our listeners, please know that we're going to be doing more live podcasts, so keep an eye on our website or my Facebook, which is facebook.com/mikespecs, and keep an eye out for when we're doing live feeds like this. You can join our podcast because we usually do at least one a week. And until then, please work on every day building mutually amazing relationships in your life. If you're stuck at home with your family, it's a great time to work on building mutually amazing relationships in your life. I'm Mike Domitrz with the Center for Respect. Our website is centerforrespect.com. Thanks, have a great week.