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What do you want to know about Covid-19?

This Won't Hurt A Bit podcast.

March 23

In this episode, Dr. Jessica Mason, Dr. Melvis Herbert, and, well, just Dave, cut through the Corona craziness and bring you the latest in COVID-19 news, medical science, and cocktail recipes. Wash your hands, grab your headphones, and enjoy.

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Oh, wait a second.

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Where? Doctors. What? Who? Brace yourself. Hey, ladies Newman. Boys and girls. I'm Dr Mel Hope. Next.

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I'm Dr JJ estimation. It was so good, You guys. I was such a good job.

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And I'm I'm just Dave killing medical show about everything that's fun and interesting and educational for the non physician in your life. Okay, wait. Do this. What are we doing? This this this first discus hailing from boys and girls. Just when you thought we'd gone forever. We're back. We're back. It's this one hurt a bit. I'm here with Jess and Dave. I know.

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Wait, not Mel.

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We forgot how to do this.

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I can't see we're doing this remotely because, you know, we're all hunkering down during this pandemic. So obviously this one hope it is back. And we're doing a special pandemic addition because, you know, we're in the thick of it right now. Jess is literally on the front lines, seeing patients. We are a medical company most of the time, so we've been very, very busy talking to the docks. Talking to the nurse is getting them up to speed with all this stuff. But we thought that you were out there. L listeners should also be hearing from people like Jess and myself from the experts about what is this thing? So let me give you a quick summary. This pandemic started probably in China.

The first case appears to have occurred about in November. It is probably one of these situations where in these markets you have bets and seabirds and chickens, and they're all in this sort of very closed area and humans as well. And then you've got a mutation and, um, you get this covert 19 bars So it is now spread throughout the world on a pandemic is defined as something that is infectious, is lethal and is across the world. So we're now at that point to the time stamp. This is March 20th here in the United States. We had out first case that we know about on generally 14th. And now if you're watching the news you see in New York, they're having an explosion of cases. So can I ask just a question. Just, uh, what is covert 19? Because my understanding is that it's a Corona virus and that causes a cold. So what are we worried

2:24
What is Covid 19?

It is the disease caused by this particular Corona virus. Covid-19 stands for Corona virus Disease 2019. It is like a cold but is particularly deadly compared to all the other types of corona viruses.



about. So Cove in 19 is the disease caused by this particular Corona virus, which, in case you're nerdy and really interested in virology. It's SARS. Cov two. That's the official name for this virus. It's really similar to the stars. I don't know what you call it stars one virus outbreak that happened several years ago, which was also a Corona virus. Now, if you get sick with this virus than we call that disease Covad 19 which is Corona virus Disease 2019. That's where that name comes from. And let me answer the second part of your question. You said that Well, what if I get Corona virus? Isn't it like a cold?

And, you know, sort of other Corona Viruses do cause symptoms like a common cold, and they're not very deadly. But this one is different, and that's why it's getting all this special attention, because it is particularly deadly compared to all the other types of Corona viruses that you're probably exposed

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to all the time. And I should say, for the record, the reason that just knows so much about this is that we have this online medical textbook of reference for clinicians throughout the world and just wrote the chapter with Young Covert 19 0 that's right.

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I helped. Yeah, you help just a little bit, as in, we co

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authored it. That's right. So we have been scaring literally all of the literature as it comes out every single day. And there's a lot, lots of preliminary reports from across the world and now reports from the United States. So we come to you with a significant amount of knowledge on this because we are reading everything. So just you are seeing these patients in the months that apartment on the front lines one of the symptoms of these people have.

4:0

Okay, so the most common symptoms fever. But that's not saying that everyone's gonna get fever. Only about half of people are gonna have a fever, cough, shortness of breath. Sometimes they're coughing up, hacking up some Flem. You might have a sore throat, but really the key ones that we keep honing in on our cough, fever and shortness

4:22

of breath. What's interesting is that we just added to get some reports two days ago that a lot of people from China we're also having G. I symptoms. We think of these viruses is mostly causing respiratory stuff like a coffin, the snoozing and the Maybe you get pneumonia, but a lot of these people had anorexia.

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Anorexia is loss of appetite.

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Thank you. You're welcome. Some had vomiting, some even had diarrhea.

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So and we don't want to cause a mass hysteria and people running out buying more toilet paper. But just know that that potentially is another symptom. These G I symptoms So we wanted to do was really gather here with Dave and let Dave be the voice of the people and fire questions at us, Dave, because we want, you know, I feel like there's a lot of hysteria coming from the media and it's constantly reporting death tolls and how bad everything is. And everyone's wearing these crazy space suits. But maybe not the key information that's being relayed that people want to know about. So you are the voice of the people.

5:21

Okay, so I mean, you had a good little explanation of what Corona viruses, but this is the first time I've ever heard the word Corona virus. Are there other types of Corona virus, or is this just brand new out to kill us,

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What other coronaviruses are there?

There are about four viruses in that family of coronaviruses that causes the common cold. They are pretty common, and it's not uncommon for the virus to actually undergo a little bit of mutation and change.



there's about, Ah, I don't know how many current bosses. There's a lot of Corona viruses, the common cold. There's about four viruses in that family that causes the common cold. So it's It's actually pretty common, and it's not uncommon for the virus to actually undergo a little bit of mutation and change. So maybe what's happened here is you've got a common cold virus that got stuck with a bet virus and maybe with some other virus, and then it mutated and became a common cold blood virus. But way worse. So there's lots and lots of these out there.

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Is there a type of Corona virus then that we will would have heard of before, like a common

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name Or it's really just the common cold. Like Mel said, there's a lot of things that fit under that umbrella. But the one that you probably heard of is SARS and Mirza, which is Middle East respiratory syndrome. Those are the other examples of Corona viruses that have mutated into something much more

6:31
How do you get SARS-CoV-2 ?

Most people would get it through their nose and throat. So somebody is sick, and they sneeze or cough, and all that virus gets fired into the air. And this is a virus that sort of lives in the little droplets that you spray out and floats around.

Now, this virus is also probably also present in blood, and it might actually might also be present in your poopy.

Mostly though you would get it through respiratory droplets. So if you also sneeze onto a surface, then all of that fluid from your disgusting upper airway goes under the surface. So if some other unfortunate person comes by, and puts their hand on on that surface and then rubs their eye or sucks their thumb or whatever it is, then they can get the virus too.

It's more infectious than flu, but it's much less infectious than something like measles. If you have measles and you go in a room with like 10 people just by breathing, the measles virus goes up in the air and it stays there for ever, and it's very infectious and you'll infect like seven out of 10 people. This one is much less infectious in that, and that's good. So you can get it from other people.



deadly. And what does How does this virus infect you? How does it How do you get it? Because people are saying it's living on surfaces, um, through people coughing on me Ah, breathing the same air you breathe. What's what's the main way you get the Corona virus?

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Well, you just explained it.

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That's great that now you get it every way.

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Well, with the way you get this is now is that if somebody has this, then they could be shitting the virus, mostly in their up railway, so through their nose and throat and stuff, So then they sneeze with a cough, and all that virus that's up in that upper airway gets fired into the air. And this is a virus that sort of lives in the little droplets that you spray out and floats around. So we have few coffin somebody's face or sneeze on somebody, and they breathe that in. Then the virus can get into them and then start replicating and that person, and then they can spread it on from there. Now, this virus is also probably present in blood. We haven't seen any blood spread. It actually might also be present in your poopy so potentially you could get it if you put it on the ground and then ate it somebody came along or something

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like that. Wait. I would have it already, though, if I poop to make my poop,

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it's true. Somebody have to eat your poop, but it's mostly It's mostly this thing called respiratory droplets. So if you also sneeze onto a surface, then all of that fluid from your disgusting upper airway goes under the surface. And the virus is living in those little droplets and can probably live there for a few days. So if some other unfortunate person comes by, puts their hand on your keyboard that you sneezed on and then rubs their eye or sucks their thumb or whatever it is, then they can get the virus that way as well. The good news about this, so it's very infectious. It's more infectious than flu, but it's much less infectious than something like measles. If you have measles and you go in a room with like 10 people just by breathing, the measles virus goes up in the air and it stays there for ever, and it's very infectious and you'll infect like seven out of 10 people. This one is much less infectious in that,

and that's good. So you can get it from other people. But if you just sort of stand six feet away, wipe things down, wash your hands really well, you're much less likely

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What is fecal-oral transmission?

Fecal-oral transmission is a real thing, and that's how a lot of diseases get transmitted because someone goes to poop, and then a tiny microscopic amount of that poop ends up on their fingers. They don't wash their hands well enough, then prepare food, someone else eats that food, and now you're eating microscopic amounts of poop. Then you're getting infected that way!



to get it. Mel, you joke about pooping on the ground and someone eating it. But fecal oral transmission is a really thing, and that's how a lot of diseases get transmitted because someone does poop, and then a tiny microscopic amount of that poop when they wipe their butt is on their fingers. They don't wash their hands well enough. They prepare food. Someone else eats that food, and now you're eating microscopic amounts of poop. And then you're getting infected that way. And we don't really know how much of a role that plays in this particular Corona virus, but potentially that's a motive transmission

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as well. Wash your hands. You're disgusting.

9:16

So going back to what you said is the virus can live on different surfaces. That's Ah lot of concern people have on online and, um, just people I talk thio like going out and getting my mail from the mailbox. Could the virus live on a letter that has been addressed to me and was sent to me next day, not don't take three days to get to me. It took

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next day. I understand the concern with that because one of the things that came out in this report that you're referring to is how long it can live on cardboard. And so it was like, Oh my God, it's coming in the mail. Um, so remember that these numbers that you're hearing so we're what's being quoted is from one particular study where they basically just swapping things and checking to see if viral particles are there and how many of them. So it's saying like, Oh, in the air, the virus is probably for several hours, but on various surfaces, it's probably there for many hours and potentially a few days. But remember that this is decreasing at an exponential rate. So if someone with Corona virus sneezes on the table and I swab the table, there's gonna be a lot of viral particles, and in a few hours they're still gonna be a lot. But it's decreasing rapidly over time because that those viruses they can't just live on a table forever. They need human cells in order to replicate their DNA or there are in a

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rather. So if this table was made out of skin, that would be a problem.

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Well, they would need to be live cells that it gets into.

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This was a living skin table.

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We don't have a skin table discussing, but yeah, this is This is decreasing with time. So even though that report might say something that sounds scary like, Oh, the virus is still there tomorrow morning it's still there, but in way fewer numbers. And is that Are those numbers enough to actually make you sick? So what that really translates to in real life is less clear.

11:6

Yeah, I think people could get really hysterical better. So it's the good news is that Cobb would wasn't as good as just sort of like plain surface. And remember also that the cardboard the stuff that's coming to you in the mail is also often it takes a few days and it'll die. Or it's sitting out in the sunlight, a zit getting, transporting, putting under trucks and maybe that sunlight is affecting in his will, so I wouldn't freak out too much. It's theoretically possible, but it's extremely unlikely. It's much more likely you're going to get this, not from cardboard. You're much, much more likely to get it from somebody who's sick and sneezing, and they're right next to you. So social isolation spreading yourself apart from people can really protect you. I think you know, worrying about whether Amazon is gonna send your little Corona virus in the mail. I don't think it's

11:55
Could someone cough and pass the virus onto me?

Yeah, that's exactly the concern, and that's why right now the recommendation is social distancing. Stay away from people. Don't go out to the store unless you really need to.



that being out in order to that with prime. So there is a real fear. Then if I'm walking around Target and somebody coughs and creates a cloud and I walk through that cough cloud, I could I could swallow it or get in my eyes. And the next day I got Corona

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virus. Yeah, that's exactly the concern. And that's why right now the recommendation is social distancing. Stay away from people. Don't go out to the store unless you really need Thio, because who knows what you're being exposed to and someone who sneezes. Maybe the otherwise feel well. So they thought I'd be fine to go out to the grocery store and they sneeze, and then you walk through that sneeze cloud or cough cloud and then you contract the virus, and you wouldn't even know yourself for a few days because it takes several days before you actually start to feel symptoms.

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Right? Let's talk about symptoms. What? What am I going to feel in the first few days or day of have of getting Corona virus? How do I differentiate that between a cold or the flu?

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Well, it feels and looks like a cold or flu because it is it's just another sort of cold like virus. Eso it x very much the same. You're gonna have aches and pains and you're gonna have some sniffles, and then you're gonna have some sneezing and coughing, and maybe you're gonna get some of these G I symptoms. Your tummy is not going to feel very good, but it looks just like them, and that's the problem. Just might be a great doctor, but she can't really look at you and say that is a cold virus or that is a flu bars or that is the covert virus. Um, because they all look very similar. And so what happens is this gets more and more prevalent. Is that everybody probably half the population will eventually end up getting this and there's no good way to tell them apart so you can do some testing. But during this epidemic, you just have to assume if you have a cold, it's probably the bad one.

13:39
When should we get tested for Covid19 ?

If you do not have symptoms, you should not go testing. There's nothing to test.

If you feel symptoms, but you otherwise feel like you're doing okay and you are not feeling really ill from this, just stay home and stay away from other people.

An at risk person should probably get tested because a positive response would really gonna change what you would do and what the advice that your doctor would give to you.

But, if you are not at risk, and the result is positive, we would not do anything differently than with any other virus like this. Drink fluids, stay home, watch some Netflix.



So okay, testing. Should I be tested pre symptoms or once I start to get symptoms, should I be tested? And even if I got tested, what did even matter? If I knew if I had it or not, would it change any kind of treatment?

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That's a really good question. Good series of questions. The first question was, If I don't have symptoms, should I get tested? You know you should not. There's there's nothing to test. Even if you did have it, I don't even know if that test would be positive. Would that test come back and be anything reliable? Probably not,

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because it hasn't multiplied enough into my system to show up on any kind of swab,

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right? Right, So there's no point. If you have no symptoms, you feel well. There's no point in being tested if you have symptoms. This is this is now a bit controversial, you know, at what point should you go in for testing? I would say that if you feel symptoms, but you otherwise feel like you're doing okay. Like this just kind of feels like a cold. You're not feeling, like, really, really ill from this. Just stay home.

You know, like you said, what's the point of going out and getting a test? It may change things for some people, but for the majority of people, just continue to stay home and stay away from people. If you, you know, are a person who has let me call you an at risk person, someone who has an immune system disorder. Ah, like you're a cancer patient on chemotherapy would be the obvious one. Or maybe you are a diabetic or you are an older person or you are pregnant. Not you, Dave. But someone is pregnant. An at risk person should probably get tested because that's really gonna change things in terms of what you do and what the advice is that your doctor would give to you. You had 1/3 question?

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Well, no, I said just if it wouldn't change anything if I did find out what the treatment

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be any different? Oh, treatment. That's a great topic, Mel. Why don't you start us off talking about? How do How do we treat Corona virus?

15:32

We don't. Unfortunately, there is no proven therapy for this virus yet. And so this goes back to the testing thing. Well, if I get a test and I'm positive, what do we do differently for the vast majority people? You don't do anything differently. You just have to sort of suffered out. Stay at home, drink your fluids and do those normal things, and watch Netflix and and it will run its course and then you'll have anybody's against it. So there is no specific therapy, and that's a problem, because for the vast majority of people, it's just gonna act like a cold or flu. And you're gonna feel bad for,

you know, some days, maybe a couple of weeks, and then you'll get better. But some people get really, really sick with. It's mostly the elderly, mostly those people with other sort of medical problems. But there isn't any specific treatment right now. We're looking desperately for treatments for those people, and you hear about lots of them in the news. But currently there's no specific therapy to make this shorter toe shorten the course of this there's no vaccine that's probably at least a year away. So again, with the testing, if the test is positive tonight, that can't really do anything.

For the vast majority people, testing is probably not a big deal. The reason it's good to do a lot of test during an epidemic is just to sort of find out where it is and to learn a little bit about it. But you can't do anything specific about this thing yet. At least we don't know if there's anything we can do with

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try and find

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something because these old people really get very sick sometimes. And we need to find something to help. Um, while we're waiting for a vaccine, but we haven't found anything

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yet, so that's what I'm hearing, that the test would only be helpful because if I knew I had it, then I could stay away from people that are more susceptible and would have worse symptoms than

17:19

I would write. And another factor in all of this is how available is the test right now

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available? Is it cause, like Corey apparently did it over a weekend like tested everybody in a weekend?

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Um, so it's becoming more and more available. Luckily, we're not completely dependent on just the testing from county health departments of the government testing that is, you know, a portion of the testing. But fortunately, some private companies have really ramped up their production and their ability to run tests. And so we're now able to run more tests but still not meeting the total demand in the in the population. If everyone in the country who had cold symptoms wanted to get a test, there's no way we could accommodate all of that. So you know, it's it's a good question. Should I go for a test? You know, at what point do I go? So to summarize,

I would say if you were one of those at risk persons, you should get tested. Or if you're someone who takes care of an at risk person, you should get tested because it changes how we advise you in terms of your home isolation. And if you are like, really feeling sick, like not just cold symptoms, but you're feeling like you really are struggling to catch your breath and your coughing really hard, and you're feeling very, very fatigued and your pulse is fast. These air concerning signs and symptoms that you might actually need to be admitted to the hospital

18:43
Why are we holding off on testing everyone?

While the tests are not yet widely available, we want to preserve the tests for healthcare workers who need them first. Normal people can stay at home and rest, but doctors and nurses (at el) have to know for sure if they have gotten sick, as they are the ones treating others.



or the other reason that we don't want everybody to get tested until we really do have enough tests for everybody is because people like Jess really need to have access to the test. So if she's got a little runny nose and it's just a normal cold, that's okay for her to go to work and she can wash your hands and you know I'm not spread her cold around. But if she's got this one, if she's got Covert 19 she should really stay at home because she's looking after sick people in the hospital and she can infect them. So for health care workers, it's really important that they have access to the test first and other sort of celebrity groups and celebrities in Indiana.

19:19

Thanks, it's important. Tom Hanks has his test delivered to

19:22

his hotel in Tom Hanks tweets. It's news. Well, Tom

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is different. I mean, he's very, very

19:28

good movies. He's a national treasure, e i e. I want him to be well,

19:35

I don't think of myself not at all. Now the reason that I let's say I'm just a normal lay person and I'm just hanging out at home and I've got the symptoms. The reason that I would want a test, even though I probably don't really need a test right now is I just want to know if I got it so that okay, I've got it and I survived. Thank you. That means I've probably got anybody's and I'm not gonna get it again. And I'm gonna be okay, So I'd want to know if that horrible flu like cold thing that I had was this bad one of the nice survived. But that's not a good enough reason yet. The good news is that home testing should be available soon ish. So if they can really ramp up production, you won't have to go in and potentially infect a health care worker or somebody else. And you might be able to do this test at home in the future. I don't know exactly when that's gonna come out, but that would be something that would be pretty cool. So I feel bad,

but I don't need to go to the hospital. And I did a home test and it was like a pregnancy test that came up blew. Mel, you've got the virus. Congratulations, Ray. That's negative. Yeah, but that's probably, ah, ways off.

20:38

There's a lot of good other questions. Follow up questions, toe everything you guys were talking about, that people are scared and myths floating around, and hopefully we'll get those by the, like, the end of the show. But I kind of want to just ask the big broad questions first. Um, another question I have is what are you actually dying of when you get Corona virus? Like like with the flu? I don't die of quote unquote the flu. I die of dehydration or something

21:6
What is killing Covid-19 patients?

Viral pneumonia is the most common reason why patients are dying from this virus. Respiratory failure (ARDS) is a really hard problem to fix.



else. Yeah, so this corona virus causes a viral pneumonia. So just like any other kind of pneumonia, this is the most common reason why people are dying. It causes a very bad type of pneumonia where a bunch of fluid goes into your lungs and puts you into basically a respiratory failure in a small subset of patients is not, you know, everyone but people are actually dying. That's what's going on. And also other organ systems are failing, so they might go into kidney failure. They might go into heart failure. But it's primarily a respiratory failure because of all this fluid that's leaking into the lungs and then you can't breathe. And even if we have ventilators and all of this amazing technology, Thio do our best to try to keep you alive. It can be really hard to to push air and get oxygen into your lungs when it's working against all this, you know, fluid in the lungs.

21:59

Would the flu do that, too? Is that how people die from

22:2

the flu? Yes, people can die from the flu for similar reasons, but this Corona virus is thought to cause a lot more of this. This syndrome, which, if anyone's curious, it's acute respiratory distress syndrome a R D s if anyone's curious and wants to look that up. But that's that's the syndrome that we're talking about was always kind of leaking and fluids rushing into

22:21

the lungs. Okay, so on on that topic, how deadly is the Corona virus? Because you see really like a number swaying all over the place, depending on country, depending on culture, depending on age. So what's how bad is this compared to flu?

22:38

This is actually we know a little bit. We're learning more every day, but it's certainly much more deadly than flu, and that's the problem with this thing. It's actually a little more infectious than flu, so it's easier to catch and it's more deadly, so it sort of a double whammy. It appears if you look at the data from China and other places that about 1 to 2% of people who get this might die now, it might be less than that when we finally finish up testing everybody because we tend to test right now, just the people who are sickest. So once we do allow testing, maybe it's gonna be less than that. But you do see these numbers that are a little bit concerning from Italy, where it's much higher than that. There are places like in Germany, where it appears to be much lower than that and South Korea as well. But it's somewhere around.

Let's say you know, 1 to 2% which would put it about 5 to 10 to 20 times more deadly than flew and flew kills, you know, 10 2030 40,000 people a year here just in the United States. Now the good news, if you can call it good news, is that it's mostly affects the elderly. So if you're over the age of 75 85 if you've got other lung diseases or kidney diseases or renal disease that tend to occur in older people, that's the group that it seems to be most deadly. And that's obviously a tragedy, but a far worse tragedy if it killed young people and it's not killing the kids. I don't think we have still had any deaths in anybody under the age of nine, so it's mostly really harming the only. But I should say, for the record, 100,000 times,

anybody can catch this and you can certainly spread it. And there are some young people that will get very sick from this. And relatively young people can even die from this. So don't be thinking young people that you're completely immune. You can get it, you can spread it, and you can certainly get super super

24:28

sick from it. Yeah, I think young people can feel this false sense of confidence like I'm fine. I'm gonna go out and continue to live my life. Well, you are the contagion. You are the person who is gonna go out and infect your grand parents and someone else's grand parents. And just remember, even if you feel well, that doesn't mean that you don't necessarily have it. And you can't be spreading it to other people who could get very sick and

24:50

die. Okay, let's say I get Corona virus. How infectious, m I before I start really getting sick and then after I'm all better, am I still infectious like a week afterwards?

25:3

Well, there's a lot of speculation, and no one really knows for sure. But I could tell you this when you get the virus. You aren't gonna have symptoms for those first few days while you're incubating the virus while to replicating inside of you. And on average, that goes on for about five days before you start to show symptoms. But sometimes it goes on for two weeks before you start to show symptoms, and in all that time leading up to you having symptoms, it's unclear how many of those days you actually could be spreading it to other people. You probably can be. It's very, very likely and there's there's some reports showing that that is happening, but I don't think that that's probably the peak time of when you are the most infectious. It's probably when you're coughing and sneezing, because then you're exploding all your viral particles all around the room and to other people, so that's probably when you're the most infectious.

And then once you start to recover, you're probably still shutting some of that virus. So if you're still coughing, sneezing, breathing, you're probably still infectious. But probably not quite as infectious is when you are the peak of your symptoms. And again, a lot of this is speculation. Why

26:6

is it going after the Italians? What's what's up with the Italians?

26:10

That is super interesting question, and it's really not clear. So the mortality in Italy right now and they're right in the midst of it there, about a week or two ahead of us in the United States. So they're having a huge outbreak in one particular air of Italy, which is a very wealthy heir of Italy, and the immortality appears to be very, very high, like, you know, nearly 10 times higher than in Germany, for example, and it's not clear is just cause they haven't done enough tests yet. Maybe there's many more people infected that doing fine. Is it because Italy tends to have a pretty old population? There's a lot of people over the age of 65. Is it because there's a lot of smokers in Italy?

Is it just that Italians have a gene, which makes it easier for the bug to get in? I don't know, and we won't know until this little thing plays itself out. And we have a

26:56

better idea. So what? What what about other pre existing conditions? Like I have a friend who's got really bad asthma and he got that asthma because of his wife thinking when he was a teenager he had really awful pneumonia. And now I guess this asthma's may be a side effect from that scarring or that past problem. So he's really worried that he might be more susceptible to Corona virus or maybe not more susceptible. But if he got it, it would it would hurt him more than the average person. Is that their truth

27:29

there? Well, I don't know how much validity there is in the connection that your friend is making between pneumonia and the passengers.

27:34

That's the first problem.

27:35

That's one problem there. But aside from that, let's just the root of the question. Here is certain people are going to get more sick because they have underlying lung conditions or other conditions. And that's true. Anyone who has baseline bad lung function is gonna have a harder time fighting this, and it's gonna be more likely to get more sick. I think with with something like asthma, that's a huge spectrum. I mean, some people have asthma, and they're really just fine. And occasionally, you know, they run a little bit of exercise and they use their inhaler and then they feel fine. That's very mild, someone who's on steroids all the time.

We're frequently and, you know, dependent on lots of medications for their asthma is much more severe. That's a very different situation. I'd be more worried about that person, and there's a few other groups that we are worried about. So underlying lung diseases one but underlying heart disease. And that could be anything, you know, heart failure, past heart attacks or elevated blood pressure. If you have hypertension, that's looks like it's associated with more severe illness. And diabetes is another one that looks like it's associated with more severe illness.

28:36
What is the effect of steroids on the Covid19 virus?

If you're on steroids all the time, doctors would consider you to be immunosuppressed, and you would be at risk.



Was there a connection with steroids? And

28:39

there there is so so a couple things with the steroids. First of all, if you're on steroids all the time, we consider you to be immuno suppressed. You're

28:47

in that capsule reason

28:48

I'm on it. Yeah. So you're in that category of patients were more concerned about your own at risk person on the other thing. That steroids kind of come up in the in. This discussion of Corona virus is because it was it's been looked at. Do steroids potentially help or hurt someone who has the disease, and it looks like they hurt. Um, And so if you have it, then you would not be in general, we wouldn't be treating you with steroids.

29:11

Okay? How how is Corona virus any different this outbreak any different than some of the ones we experienced in the past, like swine flu and bird flu. And Zeke, any bull I mean, these all seem to be just a serious diseases and viruses. How come Corona virus is basically crushing the economy and making us all like

29:33

holed up in our house is it's different in that, its first of all, much more deadly than flu. So that's first thing, so it's gonna kill a lot more people. It's more infectious than flu, even an aggressive flu season. This appears to be more infectious than even really aggressive flu and sort of the H one n one, which was about 10 years ago. It's more infections that's more deadly than that. The good news is, it's less deadly than Ebola. So a bowler is bad, because if you get it, you're gonna die lots of the time. Fortunately, Ebola isn't as infectious,

so it's harder to catch it. You have to really have to have more exposure to sort of blood and secretions than just sort of sneezing. So ah, it's less deadly than SARS. But you probably heard about sellers a number of years ago. It was really bad, but SARS wasn't as infectious. And is this? So SARS killed a lot of health care workers, and it killed a lot of close contacts of people, but it wasn't as spreadable, is it? So this is sort of ah, not quite a perfect storm. But it is a bad storm because it's very infectious and it's very high mortality, particularly in the elderly population.

So overall, it's much worse than any of those things. It'll end up killing many more people than any of those things that you know that this is a lot like the Spanish flu of 1918 and that was a flu virus, which is a little different. But it was very similar. It was pretty infectious and pretty deadly, and so it killed lots and lots of people. But it's not the perfect storm. The perfect storm is the one you see in all the movies, right? It's in the movies. It's a virus that's super infectious. You just like walking around and you catch it and super deadly and turns you into a zombie every time This isn't that bed,

31:18

it's like it'll be it'll be Ebola that became contagious through air. That would be the worst case, and

31:26

that is the thing that, like public health people are most concerned about. And this is sort of as bad as this is. This is actually an opportunity, a dry run, as it were for what could be much worse. If this was much more deadly and much more infectious, which potentially could happen, it could just be devastating. And so this is our opportunity, although it's terrible right now to get this right toe, learn how to do this well, to do social distancing, to get the health care system back up on its feet and have enough masks and gloves for people because this could have been much worse.

32:0

Yes, so social distancing. We've said this already. Can you give me a good definition of what social distancing is and how it's social distancing, different than being quarantined or the quote unquote shelter in place or the stay at home? How does what are the differences between all those terms?

32:19
What is social distancing?

An attempt to stay away from mass gatherings and lots of people so we can limit the spread and the rate of the spread of the virus.



Think of social distancing is an overall concept that we're gonna avoid. Mass gatherings were gonna avoid highly trafficked public places. There's a lot of techniques within social distancing, but social distancing is the idea. Stay away from mass gatherings and lots of people so we can limit the spread and the rate of the spread of the virus and then multiple tactics within social distancing. Right? So, um, shelter in place, for example, that's basically stay at home and don't go out unless it's really an essential thing that you have to do or if you work at a job where you have to keep coming to work, like your health care provider or firefighter pharmacist something like that. So there's multiple different tactics for maintaining social distancing, like the six feet rule right? Trying, If you're gonna go out, try to stay six feet away from people whenever possible. It's another tactic of social distancing

33:12

and that the amount of social distancing and just the sort of distance really depends on the bar. So because this is a pretty, you know, contagious virus, but it's carried on droplets. If you're about six or eight feet from somebody and they're not trying to sneeze on your spit on you, that's usually enough distance for the virus to Not for you not to not catch the virus. If this was a virus, which was much more contagious, that just sort of was able to float in the air like something like measles. The appropriate social distance might be something more like 50 feet to really stay away from people because they're viruses sort of hanging around and all around the air near them. So six feet is sort of like the number we're using for this because it's in droplets and you're seeing what all of this is about. All of this social distancing and getting people to stay at home and doing all this stuff is all about this concept of flattening the curve. Have you heard of flattening the curve day?

34:8

Oh, yeah, that's that's everywhere. That's that's the new hashtag.

34:12

So just tell us what flattening the curve is all about because we're flattening it for huge is.

34:19

So if you can imagine a bell curve with a steep rise, are you imagining that? Yeah. Okay,

34:24

So like a giant pointy pimple?

34:27

Exactly right? And so, if that's the rate of cases overtime, then this curve that were kind of expecting is a sharp rise in the number of cases of Corona virus in a short amount of time. And that's concerning because there's only so many hospital beds and doctors and nurses, and I see you beds and ventilators. So if we get that sharp rise in a short amount of time, it's very quickly gonna peek over. The available resource is that we have to take care of the whole population of sick

34:56
What does that mean to 'flatten the curve' of infection?

Instead of getting a really sharp influx of newly infected patients, we are trying to slow down the spread in a more predictable, manageable way.



people. It's just going to get so pointy that it's gonna explode. A puss. Sure,

35:1
What does that mean to 'flatten the curve' of infection?

Instead of getting a really sharp influx of newly infected patients, we are trying to slow down the spread in a more predictable, manageable way.



So what we want to do is flatten the curve, which means we want that rate of spread to slow down. So instead of a really sharp increase, it's gonna be a much more gradual Rolling Hill, right? It's gonna spread that out over a longer period of time. Now we're still expecting there to be a lot of cases. But if it doesn't rise way above the theater Mount of Resource is that we have available, then we can actually take care of people as they get sick and come to us. So that's the idea that we're flattening out the curve from a sharp rise to a much more gradual, slower rise over a greater amount of time.

35:36

So flattening the curve, basically we're just trying to build in Maur time for resource is 22

35:42

combat for resource is for hopefully we can develop a vaccine now that's gonna take some time, but you know, treatments that we can discover and try a test out and make sure that they're safe, but anything that we can do to prolong the amount of time before tons of people get sick. So that way we can deploy treatments, vaccines and have enough resource to take care of people. How

36:5

come we don't have any kind of vaccine for this? It seems like every year they can create made up flu vaccines for the anticipated flew for that year. I just like like, Oh, it's gonna be this flu this year. I'm gonna take a guess, and I'm gonna make a vaccine for it. Um, and they just seem to do this on a regular basis. So much so that it's like, free. You just walk in and somebody will give you a vaccine. But with Corona virus, if it's already been out there, it just seems like this is the first time anyone's discovered in. Now we have to create, create something that's never been created before. Why is that?

36:42

Well, use advances. You're in question with that. You know, the flu, they're they're pretty good at looking what strains of flu around. And then they sort of try and guess what's gonna be the predominant type of flu for that year. and then they start making the vaccine. And so that's why sometimes with flu season, they get a really good vaccine, which protects you almost completely. And other times it's not as good. So it's a lot about sort of testing what flu is out there and looking in the Southern Hemisphere, and because they have a different season than arson and then trying to guess what's gonna be the flu for the next season and start making the vaccine beforehand. And they're generally pretty good at it, although it's not perfect. But as you said,

this is a brand new virus. This is like a common cold virus, sure, but it's got little pieces of D N A from bets and other things in there, which we've never seen before, so they have to start the process from ground zero. They have to try and create a vaccine, and then that's one part of it. Then you've gotta test the vaccine and make sure it doesn't produce more harm than good. And then you gotta test it in a large group of people, and then you've got to make the vaccine. Then you've got to distribute the vaccine and then you got to get it to everybody in that process, As good as we've gotten at making vaccines over the last sort of 75 years, that process takes probably at least a year from when you start to when it's actually deployable ad in the world and maybe as long as 18 months. So when you hear people very powerful people saying, we're gonna have a great vaccine in just a few months, it's not gonna happen. You need at least about a year to

38:13

get it done. Although what's very interesting is how fast the science is moving. There has already been testing in human subjects on a vaccine that happened just a few days ago, which I believe was within it was either 60 or 65 days from when the Chinese shared the genome with us. So it's already it's already being tested. It needs time to do lots of trials and safety checks before everyone starts getting it and then mass production, of course. So that's what takes time. But I would say it's moving at lightning speed and it's amazing how fast it's happening.

38:47

Yeah, the the keys, that testing part and then creating enough of it and deploying it. There was a vaccine a number of years ago, which was for kids for diarrhea, and it looked great and it was wonderful. And then we started giving it to kids. And then it turned out that had had this side effect where the kids basically intestines would swallow their intestines and they had to take it off the market. So we don't know. Um, you don't know that there couldn't be some side effects from the vaccine. So you have to do this testing you have to do to the plant. But it is impressive. It used to be back in the day. It would take years and years and years to get a vaccine. But by the use of super computers and modeling and all this new techniques, the fact that you could potentially get one out there to the world in a year is stunning

39:30

as pretty amazing. Yeah. So, Jess, at the hospital pre Corona virus. What? What's the difference then? And now, in terms of seeing patients and and your personal protection of seeing those patients

39:49

okay, from my perspective or the patient perspective, both. Okay. Well, um I think we're being very cautious as the people providing care because we don't want to be sick, even if we're not having symptoms to be potentially spreading the virus to other people. So we're being very, very cautious. Now, if you are the patient and you're coming into the emergency department, which, by the way, you don't need to come to the emergency department. We're not your only source of testing. You should come to us if you think you're having an emergency. Ah,

and if someone else can run a test for you and you think you're having symptoms of Corona virus and aren't sure if you need to test contact your primary care doctor, they might be able to run the test. County health might be able to run the test. Urgent cares or also emergency departments. But we don't want influx of people who are just showing up saying I got a sniff. Lee knows, and I think I want to test. But if you do come to the emergency department, say you got a cough fever, maybe you're a little short of breath and you show up to the E. R. It's gonna be different at every single hospital. I can tell you right now how it's working today, and that might be totally different tomorrow. But before you even make it into the door, you're gonna be greeted by a nurse who's gonna do an initial triage assessment.

So they're gonna ask you some questions, ask you about your symptoms. And right now, depending on the risk factors you have, have you been exposed to someone who has Corona virus or been to an area where they have multiple cases right now? Fortunately, in President, we don't have a lot of cases, So we're still screening this way. And if you say yes to those questions, you're not coming into the E. R. We have a tent set up, and so you're gonna be brought over to a tent and brought in as a patient. And all of the healthcare personnel who are going to interact with you are all going to be very cautious because again, we don't want to get it and then spread it to a bunch of people who are immuno compromised in our at risk persons. So we're going to be wearing the full garb we're gonna

41:37

bring you guys are dressed up like in the HAZ mat outfit. Like when you found when they found E. T. And

41:42

not the space suit. Uh, like what people wore during the Ebola outbreak. But we're gonna be wearing gowns. Okay? We're gonna be wearing gloves, um, face masks that seal tightly around, and many of us are wearing eye shields and sometimes goggles that seal around our face. So we're going pretty cautious in terms of how we're going to try to protect ourselves. And there's also a question of How long can we sustain that? Because what what do we do when that supplies runs out? So we're trying to protect ourselves the best we can kind of put all the people together. Not like you're sitting right next to each other. We're maintaining several feet of distance trying to maintain that six feet distance between people. It is a very big tent. Yeah,

and then you may not even see a doctor in person. I'm a call from, like, an iPad and doesn't roll up. It

42:30

does. Look on a robot.

42:31

I don't like, sit there with a road control. A nurse will roll up the iPad right up to the chair where you're sitting and then I'll interact with you that way. This is, of course, in someone who looks pretty well, if you look sick, you have vital signs that are not normal like a fast heart rate or you're breathing too fast. Your oxygen is too low. You're not going in the tent, you're coming into the E r. And we're gonna put you in an isolation room and do a full in person assessment there. But in many cases, we're able to do these assessments over Justin iPad, um, and send see the quote unquote see the patient and discharge them from the tent. So they're never even coming into the e r, potentially infecting a whole lobby full of people who could get really, really sick.

43:10

What are the dangers to pregnant women and kids? Because you hear these kind of stories that kids might not even feel the effects of it.

43:17

Mel, answer the question about pregnant patients, and maybe you could answer the pediatric question in pregnant patients. There's very, very limited information to guide us right now, and so I think, is the medical community were being very cautious and protective over our pregnant patients. There's one study that looked at a small number of pregnant women who got Corona virus while they were pregnant and delivered babies, and they had good outcomes and the babies had good outcomes, and it wasn't found to be in the breast milk. But that was testing six people's breast milk so we can't make big conclusions over just looking at what happened with six people, right? We can look at what happened with SARS and murders, and that was actually very concerning what happened to pregnant patients in terms of the mother and the outcomes with the babies. And so I'm considering pregnant patients to be one of those at risk persons. Multiple persons are at risk in that case, and they should be very cautious about who you're being exposed to, and if you get it should be very closely monitored by your obstetrician.

44:16

And when it comes to kids as a set before, the good news is that kids don't get as sick as old Lee patients. We've had no deaths under the age of nine yet, although that you know, in a huge outbreak that still might occur. But it looks like kids of protective. It's not clear why it might be some of the infectious disease. People think that maybe because kids are so covered with CO Vered, like kids are so covered in Corona virus all the time giving it to each other, sneezing on each other, that may have made that they've got lots of protection. Whatever it is, the younger kids seem to be okay. That doesn't mean they can't spread it. We don't really have a lot of information about that yet. Um, and then depends on what you define as a kid.

Certainly there are people that are over the age of nine that have died, so it's not completely protected. But EJ, you get older and older and over gets worse and worse and worse. But, um, the little kids seem to be pretty protected for reasons that are unclear. Um,

45:20

I think we covered a lot. Um, should we just start shooting off questions

45:24

like, Yeah, I think there's a lot of myths that are out there. A lot of good questions came to us on social media. Give us

45:31

some of those, Dave. Yeah, I'll just start shooting them at you. okay. Handling money safe? Not

45:36

safe. I would say. If you don't need to use money, don't Paperless would be better. I think you know, it's probably not a big deal that used to be used to be that, like a dollar note would be handled by, like, 15 people in one day. And if one person was sneezing a lover, then that might be a problem. It's probably We used less and less money now anyway. But if you don't need to use it and you can sort of do tap to pay with your phone, I would do that. But I wouldn't be too worried about it. The key thing is, if you're going to go into the world during a pandemic like this,

the virus is gonna be out there. It's gonna be on some service is it's gonna be on some money. It's gonna be on some places, and that's why you hear over and over again. The single best thing you can do is after you go out and you live your life and do some things and go to the grocery. When you come home, wash your hands really will wash him really well because you may have picked up some Boris along the way

46:24

and bring some hand sanitizer with you. If you if I was touching money, I'd be sanitizing my hands. And if I had a job where if I was still working and touching money all the time, I would either be wearing gloves or frequently using hand sanitizer, and it's amazing how hard it is to not touch your face. Oh, yeah, that's why the other advice is Try not to touch your face because you touch something and then you scratch an itch. And before you know what, you've just transplanted the virus from the dollar bill

46:47

right on your and I haven't thought about the whole entire time. But now that you said, don't scratch your face I want to do is grab my face and claw

46:53

at it. Is that funny? May minutes. I feel bad that she has this made, but there's like some Department of Health Person was giving the spiel and saying really great things and don't touch your face. And then she licks her finger and turns the page like No, but that was sort of a reminder that he is somebody telling you not to do it. And they did it. It's so hard.

47:15

Can I get Corona virus and give it to my pet? Or come my pet, get Corona virus from someone else and then give it to me? No, that even if it's like even a step pet, If my dog licked the face of some friend of mine who had it And then my dog ran over to me and I didn't know about it and the dog licked my

47:35

face like, Ooh, poo cheap.

47:37

Would I

47:38

then get it? Maybe, Maybe, But so the way I interpreted your question is, if I get it and then could I give it to my dog and my dog gets sick, and then he gives it to someone else, and and that's it doesn't go through

47:48

dogs. Okay, well, forget about that dog. Getting sick just carries

47:51

it to me. It could carry it. Protects, um, sneezes on your dog's fur and blast corona virus all over little our little Dougie. And then you pet the dog and then touch your face. Yeah, theoretically, you could get it that way. Okay, Right. Just like any other object or surface Yeah. And in medicine, we call that a foe Might. The phone might is anything that could potentially have pathogens land on it and then get transmitted to someone else. So my keyboard is a foe. Might. My white coat was a faux might. My dog might be a foe,

48:22

might. And if your pet is a bet that has this Karan of ours and it bites you, Yeah, your pet could give

48:28

it to you. Don't need

48:29

it. Actually, one of the theories right now is that the bat had the disease, then pooped on something

48:34

and angular

48:35

and an eater who then, look, I infected. And then it was the ant eater that was eaten. So there's some other animal that's involved in. No one really knows

48:43

right now, but not my dog. Poor little

48:46

Dougie. Can I go to the gym? Still know there's a lot of metal surfaces and sweaty people. The gym? Is this, like a good idea? No. I feel like it's not

48:54

a good idea. This is not a good idea. Yeah, you got a lot of people that a breathing really hard and sweating and in coughing and touching service is this is not a good day to go to the gym. This is your excuse to stay home, get fat and

49:7

watch Netflix. I don't make excuses. What's up with the masks? Why is everyone buying like construction masks? And because from what I understand, the little white mask you buy when you go up in the attic so don't breathe in fiberglass isn't gonna help against viruses.

49:22

Okay, so those masks the construction massacre for us, that's sort of a sort of equivalent to like a surgical face mask. The ones that don't have a perfect tight seal around the face. These are actually designed to be worn by someone who is sick so that when they sneeze or talk, they don't spray viral particles everywhere else. So it's basically protecting the people around the person wearing the mask. And so because of this, that's the way the mask is designed, right? If you if you're wearing the mask and you take a deep breath in air is gonna get sucked in from all around the sides of it, you're still gonna be breathing the error in the environment. And so because of this, people are, you know, saying stop hoarding mass. Stop buying them.

All you're doing is preventing healthcare personnel from being from having access to the masks. But I do want to say one other thing about the masks. It's not like they're useless, right? I mean, I wear a mask on shift cancer patients on chemotherapy. Often times will come in wearing a mask. Of course, it does provide you some protection. It's not going to be foolproof. It's not designed for that purpose. But of course it's going to give you some protection. And I think that's why people are running out and buying them like there is some validity to that, so it might give you some protection. But if you're doing the things that are being recommended right now, you're doing hand washing your staying home.

You're not going out to public gatherings, then you don't need the mask. I need the mask. The people working in the E. R. And in the hospitals we need the masks. We need to put them on sick people. We need to wear them, were walking around the hospital. So stop buying. Stop hoarding that. And also please stop hoarding

50:54

toilet paper. Why toilet paper? I don't know. You know, I thought

50:59

my thinking

51:0

What hind behind the toilet paper craze was that when we did the influenza episode, we asked people that weren't doctors and or in the medical field and everyone, most people, not everyone. Most people thought that when you get the flu, you get diarrhea and throw up. And I'm thinking that people are thinking like, oh, Corona virus. Kind of like the flu. But worse, which means worst diarrhea. I'm gonna buy TP.

51:27

Yeah, it's ah, Humans are very interesting. You know, there's plenty of production of toilet paper, even during, like, outbreaks of diarrhea. If people didn't hold it, there'd be plenty of it. But what happens is when somebody goes and takes enough toilet paper for a year and then another person, another person, there's not enough for everybody else. So stop holding. Just stop it,

51:49

Okay? Yeah, Worse comes to worst. We just go back to what we used to do before toilet paper was using old Sears catalogs.

51:55

Exactly. Sticks, twigs

51:58

think Sears is closed,

52:0

so Oh, no, wait. One thing I've heard recently is about blood types. How some blood types might be more susceptible than others. This this sounds really strange.

52:25

Yeah, I saw that as well in the news, and I think there's a couple of interesting phenomena at play here, so this is a very scary time. It's a very potentially deadly virus, and the medical community, I think, is doing anything that we can to try to identify any risk factor for who could get more sick with Corona virus. So information is being shared, and normally it wouldn't be shared this rapidly. It would go through pure review, and it would be very scrutinized before being released and published. But right now, since it's such a scary time, lots of data is being released

53:0

unvetted. Oh, no.

53:1

And when you look at massive amounts of data in hindsight, it's very easy to reach conclusions that are potentially wrong. Like if I said, Hey, I want to look at all the patients who have had heart attacks in the last year, and then I'm gonna look at how many of them like to wear hats and how many of them prefer chicken over beef and just like a bunch of kind of random data points, you will find associations between liking to wear hats

53:28

and before the drink water, get Corona virus

53:31

right. You're gonna find associations and whether or not those are true and valid and one causes the other who

53:38

knows? Great. So the medical community has turned into Facebook.

53:41

We'll see. Facebook is the other problem here because we have this desperation for information, and that's amplified by social media and by media hysteria in general. And so we latch onto these ideas like blood type. Who knows of blood type is a real thing or not Right? Who knows

53:59

if there's any material thing

54:0

that our blood, our blood types? But who knows if this has any effect on your severity of Corona virus, right? It might not, but you know, that's just the example here. But it's easy for the media to latch on to that and then start blasting it out to everyone and putting a bunch of fear in people about something you can't even

54:16

control about drinking of that. What about ibuprofen? That's like the one people are getting freaked out about.

54:21

Yes. Oh, there's things I'd be perfect thing is one of those examples of the media is sort of taking something and running with it. So there is, in theory, there could be a problem with ibuprofen because of the thing that it does to your lungs and this receptors in there. And that's how the virus gets in. But the official statement right now by the W. H. O. The official statement is that you don't have to avoid it. Having said that, if you've got a fever and you're feeling sick and you've got muscle aches and pains and you've got two bottles of an algae six and anti pirate IX anti fever medicines in front of you and one of them is Tylenol, and one of them is ibuprofen right now, I'd take the Tyler old things being equal, so it's probable that the ibuprofen isn't bad. But if you've got a choice, I would just take acetaminophen or Panadol what have you whichever country you're in rather than the ibuprofen until we get more

55:15

information. And by the same token, if you twist your ankle and now your ankle hurts, I would take the ibuprofen, because why use up the acetaminophen or Tylenol when we might want to save that for later? You might want to have that on hand. So if it's something else and you have the choice, go for the ibuprofen.

55:32

It seems instead of toilet paper, people should be buying day quill in my quill and Vicks vapor rub.

55:37

Let's not fuel the fire here. There's our You know, this this

55:42

is Earl Grey Tea, lots of

55:44

honey. There's already a shortage, and they're already rationing acetaminophen in some countries in Europe because of this. This ah, you know, potentially false information.

55:53

Speaking of which, what about this chloral Quinn stuff? This, like magic bullet of Ah, that could just eradicate Corona virus.

56:2

Yeah, that's a really important one to talk about. So, Chloe Quinn is your classical used for malaria issues, much less now because the malaria got smart and got resistant to it. And so this is a little complicated, but the summary is we don't know. We'd love to believe that Clark Kent is gonna help us fight this virus, but we don't know. So if you take sort of the Corona virus and you put it in a test, you and you put some clothes on in there, looks like the cork, and we'll make that virus not work very Well, so theoretically, that would be good. But he is the big concern. We've had other viruses. And there's this great one called chikungunya is a great example. It's this crazy votes with crazy name. And the same thing happened with that virus. So you put the chicken goon

56:43

Navarro. Sounds like something you jumped at, right, Chicken? I don't know that chicken

56:47

goon. Yeah, I'll have the chicken. Good. So you put that virus in a in a vial, and then you put some clothes on in there, and it looked like the same thing. It reduced the virus, like replicating and doing the things that viruses like to do. So they started giving it to patients with the disease, and it made them worse, Not better. So we gotta be really careful. We have to sort of study this, and it is getting studied now, and hopefully we'll have some data soon that if you're sick, some patients gonna get Clark on and others aren't,

and we might have some idea, but there is no good evidence right now as to whether it's helpful. And it really makes me anxious that it, you know, it could be bad for you. We just don't know. So don't just go taken, Clark. One of the people, I guess, or a already tryingto to use. This is perf Alexis and stuff. We don't know if it's gonna work. And Clark and itself, You gotta be careful. That's a little dangerous. If you take too much of it can give you heart problems. And if you've got a kid in the house, this is one of those medications that a very small amount in a child can be devastating can be terrible. So enough of the chloroform

57:47

already. Yeah, it sounds. Sounds like just have a gin and tonic. Wasn't Jenna tonics what they gave soldiers in World War from malaria?

57:54

It's right. It had a little bit like that.

57:57

Dave was actually coming up with a cocktail recipe for a Corona virus. Tell us what your cocktail recipe is a,

58:3

uh, some part of gin, some part tonic water and some part of elderberry syrup or liqueur with a twist of lemon garnishes. Yeah, because elderberry is another one of those things that's running around the Internet because it has anti viral properties or or it could be bad. It could like take away some of your immune system. I'm not sure what I heard. I saw it somewhere,

58:32

but it falls into the category of like, Oh, maybe it's like Econ, Atia and other things that kind of fight viruses, eggs, ink. And you know, who knows if there's any validity to that, either. But I can't hurt. I like it in the cocktail. I like the idea of a gin and tonic with some elderberry syrup and maybe like 11 twist or something, you know, like a little or zest lemon zest in there.

58:53

I heard a good one yesterday. A friend of mine said, Well, I been seeing these ads for these copper things that you shove into your nose because the cop that kills the virus And so should I do that, Mike? Well, actually, it is true. If you take the virus and drop it on copper versus on stainless steel, for example, it will kill the virus in about four hours on copper, and it can live on stainless steel and plastic and stuff for maybe a few days. So the problem with that is you have to leave that couple thing in your nose for at least four hours.

59:23

I heard that's gonna t take two pennies and shove it up your nose and take a selfie and post it. You will definitely prevent Corona virus. So please, we'll do that.

59:33

There was also another crazy one about it was posted in some gyms and stuff that since there's no test, what you have to do is you have to take a take a deep breath in, and if you can hold your breath for 10 minutes, 10 seconds, you don't have Corona virus. That's the most ridiculous.

59:46

That's there's another. There's a lot of kind of false stuff going around the Internet. Things like drink warm water instead of cold water.

59:52

One was if I have a dry throat, that the virus will fly into my mouth and hang out there for a little bit. But if I'm constantly drinking water, if the virus flies in my mouth, I will immediately wash it down into the despair of my hydrochloric acid type ass stomach acid. And we'll just just destroy

60:12

It Sounds like a nice idea,

60:14

but now you know how many calories in Corona virus? Um, what about if Corona viruses on food. If somebody is making food and they and they have come a virus in the cough under your food, can I put hot sauce on my food and kill that corona virus? I mean, think about it.

60:34

Think about think about

60:35

the question, because I almost think it could work. If the hot sauce was made with white distilled

60:43

vinegar, it will only work if you mix that hot sauce with some elderberry syrup and tonic water.

60:51

Okay, what about the big debate between hand washing and hand sanitizer? Which one's the most effective?

60:59

They're probably both equally effective if you're doing good hand washing and, for that matter, if you're doing good spreading of the hand sanitizer around your hands. But hand washing is more important when you think your hands are actually soiled with something. So let's say you got a little poop on your hand or something. Uh, hand sanitizer is not gonna be as good as washing and laddering with soap and water. So if you think you're just, you know, you touch something that someone else may have touched hand sanitizers just good. Also, that hand sanitizer kind of builds up a film on your hands over time, and eventually you just gotta wash that stuff off.

61:32

What is the highest temperature which the virus can survive?

61:36

Donna, I think where that question is going is that other Corona viruses and flu's tend to be seasonal, in part because in the hot weather they die fast. Eight. So that if you do have it and you sneeze and it's a hot day and a lot of ultraviolet light, then it dies much quicker than when it's cold in the winter. Eso, we're hoping, hoping that this Corona virus will show that same thing. So when we get into the hot summer months here in the Northern Hemisphere that maybe the infectivity will go down and that will help us flat in the curve. But we don't know yet exactly for this virus, because sometimes have actually been flu outbreaks during the summer months. So it's not a guarantee. But I'm hoping I'm hoping that when the sun comes out, it gets warm that this will go away and give us more time to get a vaccine.

62:21

Is it? Is it, um, bringing home fruits and vegetables from the grocery store? Should we be concerned about Corona virus on that, and and should we wash our fruits and vegetables? Just saying this. I think I know the answer To work out of this. A current of Iris, you should be washing your fruits and vegetables.

62:40

Yeah, you should wash your fruits and vegetables all the time. Um, if you're really worried, I mean, let's say you get a pair at the grocery store and someone sneezed on it, Um, or someone pooped and didn't wash their hands. Touched it. You know, who knows if you get it that way? Um, you buy that pair, you bring it home. Good idea to wash. It just said it may be made by the one that's not the most ripe. Maybe buy one that needs a couple days and just sit it out on your counter and let it sit there and let things die on its

63:6

surface. Yeah, I think I'm more worried about E. Coli than I am about Colonel.

63:10

That's probably way more likely to get

63:13

E. Coli o. Is there something? Have you heard anything about these strains? Like there's an L strain in an s strain of the Corona

63:20

virus? If so, the thing with these viruses is that they change. So, yeah, there's already probably four different types, and they're not really different than they seem to be acting about the same. But these viruses, you know, they're getting spread from person to another person to another person, and there's like each person doesn't have one copy of the virus. Each person has billions of copies of the virus, so it's replicating and replicating and getting past the people you're getting past the people. And so it's mutating. The good news is that most of the time when these viruses goes through these mutations, they actually usually become less virulent, less deadly,

less bad, then getting worse. But it's it's possible that they get worse, but most of the time is that they get less worse over time. We know from this virus from the original reports in Wuhan it was way more deadly in its first form and then when you passed it to somebody else, so if you actually got up from wherever it came from in those first few days, two weeks, it looks like it was much more deadly initially than it is now, So this appears to be following that same thing, but these do change all the time. That's also the problem with them is that even if you develop a vaccine, or even if you get infected, it's possible that in a few years, if this thing is still hanging around, it might change enough so that that vaccine doesn't work or the fact that you got it before may not be 100% protective. It might be a little bit protective, but not completely so. These little viruses are always changing. That's the problem.

64:47

Can I get the flu at the same time?

64:50

That's a good question. Yeah, so the flu does not protect you against grown a virus. Uh, but I understand where where the question is coming from because a lot of people are doing a test for influenza and saying, Ha, it's influenza. Therefore, you probably don't also have Corona virus, because what are the odds of having two things when

65:10

exact That is my whole theory behind walking down a dark alley? If I am going to walk through a dark alley, I say I am going to be the mugger. If I see somebody, I'm going to mug him. And then I'm free to walk through down the alley because two muggers can't exist in the same place

65:25

at the same time. Very unlikely that two muggers try to mug each other. So but but similar idea here, right? What are the odds that you have both diseases at the same time? That's just that's just unlikely. It seems, however, this data is changing pretty quickly. Initially, we thought that that was really, really uncommon to have both, but new reports are coming out saying like Maybe that's not as uncommon as we thought. Maybe if you have influenza, we should still also be testing you for Corona virus. And that's highly dependent on where you are regionally and your health department and who's seen you? So it's so right now, no one really knows. The answer is that it's probably highly dependent on where you are.

66:3

How long can we expect to be living like this? When is it gonna end?

66:7

That's a tough question, because it would've been easy to tell you if they did nothing. So if you just sort of let this virus go, you could ask the smart epidemiologist with their smart computers and they'll say this would be over in two months for most people, but then there would be millions of people dead. So what we're doing with this flattening the curve is trying to spread this out, and dis depends on how effective that is as to how long this is gonna go. But it'll be months, I think, months where here in the United States, where will be trying to do this, flattening the curve thing. Then the other thing that can happen is is Okay, so you do this for a couple of months and the cases go right down and you have been overwhelmed the hospitals. And then you start to say to people like how you can start going back to work and do your normal things, and then the virus takes off again because not everybody's infected. And not everybody has an immune reaction to it yet.

So sometimes it's not actually flattening the curve. People in there talking about flattening the roller coaster so you flatten it now, get it under control, let people go back to work. But if it starts to pop up in some place here or there, you might have to do it again. Probably not as bad as the first time and probably much more regional. Little might pop up in places where it didn't take off. So expect this is gonna go for a while. This is gonna be a few months and, you know, isn't gonna be completely over until we can get a vaccine or something. Because it might become part of slick with seasonal flu. We don't know yet. We might have a little bit of this Corona virus every year.

67:28

I like this kind of this last question here. What? As you know, Joe Citizen, can I do to help with all this? Is there anything I can do to help hospitals with supplies? Can I donate money? What can I do for businesses? I was thinking, like buy gift cards to businesses toe help them while through there through this time like welcome. What can I D'oh.

67:49

The most important thing you can do right now is to follow the sort of social distancing guidelines, stay home as much as possible, or at least stay away from other people as much as possible. Let's flatten that curve. Let's slow down the rate of infections that people are getting really take that seriously. The course. We don't want to overrun the health care system. We do want to spread this out over time so that we can find vaccines and therapies that might helpful, be helpful. That's the most important thing. You know, the economy has taken a huge hit, and there's not much you can do as an individual for that. But if you've got a favorite restaurant and stuff and they're still letting you do home delivery, then that's a great thing to do. Make sure that you tip well and get some of the food that way. People have asked me,

Actually, is that safe, though? Let's say that it's got made by somebody that had current virus on their hands, and then they handed me the plastic thing. So you it's unlikely and cooked food and stuff that the virus is gonna survive on that. But the plastic bag that they put it in if they sneeze on their hands and then they you've got that plastic bag so you might wanna wipe damn just sort of the covering of of the plastic bag or whatever the food comes in just for a little bit of extra senator to be extra sanitary, and you can take the food out of the containers and then wash your hands before you eat. That might reduce your risk as well, but it seems that the risk from home delivering stuff is probably pretty low.

69:11

Or you could consider buying a gift card. I mean, if you're in really the fortunate position that your income is not being affected by all of this, then whatever you can do to step up and help other people because the economy is going to get hit, it already is hit so hard, and it's gonna be really devastating. So if you have a favorite restaurant, maybe you want to buy a gift card and then you can go back and use that at a later date. Anything that you can do to help keep other people afloat from the normal routine that you're deviating from. I think it's

69:40

helpful. I heard a wonderful story, and this probably more like this, that of a couple elderly and actually quite well off. And they went to their local restaurant and they got the take out and they left a $10,000 to I said, This $10,000 tip is for all the people that work here, and we hope that it helps. And I'm like, That's a nice story.

70:0

Wow, I will kind of throw out like what we're doing. Um, I'm not going to the gym anymore, But we also didn't stop paying my personal trainer. She's still going to get a check from us at the end of the month, no matter how how long this goes on for, because it's built into our budget and she really depends on that

70:19

income. And we're trying to do that for our housekeepers and anyone else that that's sort of relying on us for some steady income.

70:26

Yeah, that's great. We, ah, same thing. L because of the work that we do. We're not very affected by this right now because we do virtual sort of education, and that's what everybody needs right now. So we still have good income, and we're doing the same thing. There's some people that sort of come and clean the studios and all that stuff, and we just paying them. So don't worry. We'll clean it ourselves. You stay home and we'll still pay, said if you're in that really fortunate position, that's really

70:50

helpful. So what do we talk about here? We talked all about Corona virus and remember that this is all true. As of today, information is changing really, really rapidly. We're learning new things all the time. Ah, we're probably at the beginning of our bell curve here in the United States. And we're trying to flatten out that curve by doing things like social distancing, keeping in mind that for most people, this is not gonna be a severe illness, but for small subset of the population, it will be, and it will be deadly. And we're trying to do our part to save lives. So stay home. Try to prevent the spread of illness because you might have it even if you're feeling pretty well and might spread it to other people and get them sick. So stay tuned. We'll try to get you some more updates on Corona virus. As things change,

71:35

wash your hands, stay away from people, don't even have eyes on each other. No bet.

71:40

And finally, the one thing I think is on everybody's mind right now is will there be more. This won't hurt a bit. Episodes after this,

71:48

it took a pandemic to

71:50

get us back up. I know it took a zombie apocalypse like record a show.

71:54

Yeah, we're gonna come back to this one. Had a bit. We've really been missing it with being super busy and then a pan Tamika goods. And it's crazy, Jess. And I in particular gonna be really busy for the next few months. Just seeing patients and me sort of doing the education around this stuff once that slow down. We really want to get back to this one. Hope it because, you know, it's the greatest podcast I'm told. Greatest podcast in the history podcasts that we're gonna be back. We're coming back. This'll one heard of it is a production of fool Abou Incorporated, produced by Bill Connor. The information you here on this one hood of it should not be taken as actual medical advice. If you have actual medical questions about actual medical things, you should see an actual medical practitioner even though we are actually doctors were not your actual doctor. So be sensible and keep it real.

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