March 14, 2020
[00:00:51] About this Podcast
[00:03:50] Podcast Sponsors
[00:05:18] Part 1 with Dr. Matt Cook of BioReset Medical
[00:07:09] Dr. Cook's History with Virology
[00:09:08] A Brief History of Viral Epidemics
[00:15:02] What A “Coronavirus” Is
[00:22:33] What the Cytokine Storm Is
[00:25:27] Immunology 101
[00:33:44] Treatment Options for Viruses
[00:40:18] A Functional Medicine Approach to Wellness
[01:06:36] What Ozone Therapy Is
[01:28:30] How Exosomes Affect the Immune System
[01:44:32] Podcast Sponsors
[01:48:12] Part 2 with Drs. Dawson and Mallin of Wild Health
[01:49:58] What We Know About COVID-19 At the Time of Recording (12 March 2020)
[01:53:47] How COVID-19 Compares with Pandemics from The Past
[01:59:04] How to Improve Your Immune System
[02:14:16] What to Do If You Start to Feel Ill
[02:21:12] Specific Advice to Health Care Workers
[02:30:30] End of Podcast
Ben: On this episode of the Ben Greenfield Fitness Podcast.
Matt Cook: My prayer is that the best clinicians and scientists on the planet get together and share this information and that something good for the planet and humanity comes out of it.
Matt Dawson: This is what you were trained for, help people. That's why you decided to become a nurse, a doctor, a paramedic, a tech, or whatever other medical professional you are. We need you right now. So, be safe, be cautious, but be courageous.
Ben: Health, performance, nutrition, longevity, ancestral living, biohacking, and much more. My name is Ben Greenfield. Welcome to the show.
Hey, folks. Recently, I have been getting, for reasons you can no doubt imagine, plenty of questions about viruses and the immune system, my own approach to protect myself with my hefty amount of airplane travel that I have been embarking upon recently, including two countries such as India, for example, and what I've been up to to ensure that I stay healthy, and also what I've been up to to ensure that my family stays healthy and prepared. And I last week released an article. And if you go to BenGreenfieldFitness.com, this article will still be on the front page there, about some little-known unconventional antiviral approaches that I have been using to boost my immune system using primarily advice from functional medicine docs, precision medicine docs, groups that I am a part of, even people who are in the realms of things like Chinese herbal medicine and Ayurvedic medicine. And as a result of that, I have pieced together a pretty comprehensive protocol that I feel very comfortable with that I have been using when traveling. And I lay it all out in that article exactly what I have personally been doing to protect myself.
Now, that being said, I thought it would be interesting for you to hear some really targeted advice from two guys who I think are some of the smartest docs, especially in functional medicine and precision medicine who I know, Dr. Matthew Cook, former podcast guest, and also the doctors from Wild Health MD, Doctors Matt Dawson and Michael Mallin, also former podcast guests. Both parties were kind enough to record for us an audio laying out what they're doing with their patients and their own unique antiviral and immune system enhancing approaches. I think that if you listen to this podcast and you also go and read that article, which I will include a link to in the shownotes for this podcast, you will be well-prepared to protect both yourself and your family.
Now, everything that you are about to hear you can get access to, regarding the shownotes of course, over at BenGreenfieldFitness.com/immune20. That's BenGreenfieldFitness.com/immune20. And I will weave in any resources, any additional articles, previous podcasts with both of the guests who you were about to hear. The first person who you're going to hear from on this episode is Dr. Matt Cook. And then after that, you will hear another audio instructional from Doctors Matt Dawson and Michael Mallin. So, that all being said, we're going to dive in in just a moment.
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Alright, let's jump in. Remember, resources for everything you're about to hear are at BenGreenfieldFitness.com/immune20.
Matt Cook: Hi. My name is Dr. Matt Cook. Today, I'm going to talk about the COVID-19 viral outbreak. I'm going to talk about the history and the biology of pandemic infections, and I'm also going to talk about some approaches to staying healthy and some integrative strategies that we use in our practice for patients with wellness. I'm also going to talk about some approaches that we've used to taking care of patients with complex viral infections over many years. I'm here to educate and inform, and I don't want to recommend any particular treatment. There are many scientific trials and case studies going on all over the world. I'll be referencing some of this work. It's a rapidly evolving problem, and I think some of the research is going to be rapidly evolving, and I'm just going to be having an academic conversation pointing in direction of some small successes, and potentially some future options for care as well.
I'm going to be discussing some things that are not FDA-approved. The FDA and the FTC have a position that the only treatment right now is supportive care, although I think that based on some early evidence that's going to come out, it may be that there are some antiviral drugs that will be approved. They've sent warning letters to a number of companies, and so I just want to be explicitly clear that I'm not recommending any specific treatment, but just trying to start an intellectual conversation that is hopefully constructive.
I've been interested in viruses for 25 years. I actually did a research project in college in a virology lab and we were studying the feline immunodeficiency virus, which is a model for HIV. I ended up going into anesthesiology and I have a practice in interventional pain management, and also have a social integrative and wellness practice, and probably most well-known for doing ultrasound-guided injection into joints and the spine and doing nerve hydrodissection for peripheral nerve pain. But I had an evolving and interesting experience in functional and integrative medicine because I had a lot of patients who had chronic pain, but who also had chronic infections. The most common was Lyme, but we've had a lot of patients with a viral illness that complicated their pain. And because of this, I ended up really digging into that and getting interested in that. And so, I have a long experience of taking care of patients with viral infections on a weekly basis for years and years and have found it quite interesting as I'm going to share some of my personal experience in this space, and know that I'm speaking generally and this is a rapidly evolving scientific experiment that's going on across the world. And so, know that I'm not in a way trying to influence you to buy any product or seek out any treatment because I don't think we know quite yet what the best treatment is, but at least we can begin to talk about it.
These infections, the flu is always going around, but probably every hundred years, one will come around that's just a lot worse than the average float. The biggest one that hit the world in recent times was 100 years ago. In 1918, there was an influenza pandemic, and it was caused by H1N1 influenza virus and it absolutely swept all the way around the world. The thought is that it infected about 500 million people. It was in Europe. It included the Pacific Islands that went to the Arctic and it had a death toll that was somewhere between 17 and 50 million, but it may have been as high as 100 million people.
Now, that pandemic actually happened during World War I. And the wartime censors didn't want to scare people, and so they put their head in the sand and they didn't allow the press to report on it. And so, the only press that was able to report on it was the Spanish press, and so it became known as the Spanish flu even though it was happening all over the world. I think this is just an interesting point that I think it's important that the press is free to talk about and discuss these problems and get as much information out there so that people can make the best decisions.
So, when we look back at that epidemic from 1918, sometimes people ask, “Well, what happened? Was it some form of a perfect storm that created the possibility for that pandemic? Certainly, there may have been because the ravages of war were going on. There was large camps of sick and injured people. There were large numbers of birds and pigs and other animals in those camps. And so, it may be that there was a number of different circumstances that combine to enhance the probability of people getting and sharing an infection. However, even though that may have been a perfect storm, probably, there was also something called a cytokine storm. And I'm going to go into this a little bit later in more detail.
But the thought is is that sometimes a virus can trigger something called a cytokine storm. What that means is it triggers a very extreme activation of the immune system that causes inflammation, and that inflammation starts in one place, often in the lungs, but then it starts to spread all over the body. And it's actually the cytokine storm which can lead to something called sepsis. That is actually what does more damage than the virus. We'll talk about that. And so, there was probably a perfect storm and a cytokine storm that led to that pandemic. And we are probably looking at something similar to that now, and I will go into what I mean by that.
The 1918 pandemic, interestingly, had a predilection towards killing younger people and younger adults. And it may be that older patients had been exposed to a similar flu, the Russian flu 20 years prior to that. And so, they may have had some immune protection from it or it may be that that pandemic had a real strong predilection towards causing this extreme inflammatory immune activation and that one is the problem that affected and caused that pandemic to be affecting more younger people. This is probably going to be a similar situation although it's different and that there's a predilection in this one for the people who get most affected and the people who get affected by the cytokine storm to be a little bit older, to be immunocompromised, or to have other problems, and we'll talk a little bit about this.
Since then, we've had two other recent big viral infections that were respiratory. One was the SARS virus and one was the MERS virus, and these were both coronaviruses that were probably not quite as contagious as this one but had a higher fatality rate. So, the SARS had a 9.6% fatality rate, and I think the MERS had a 34.4% mortality rate. The current fatality rate for the COVID-19 infection is unclear, but the ranges that we've seen are between 0.6% and 3% or 4%. So, a lot of people ask me, “Well, what is this virus?” So, it's the coronavirus, and in the coronaviruses, there's a whole bunch of different ones and they cause about 25% of the flu. And this virus SARS-CoV-2 causes the illness COVID-19.
Viruses are very small, and so we with our eyes can't see a single bacteria. I heard an expression that if bacteria had eyes, they wouldn't be able to see viruses. So, viruses are really, really small and they're a protein shell with either DNA or RNA and some enzymes that replicate, so it has a genome, but it can't replicate without help. And so, what they do is they infect cells and they bind onto a cell, and then they insert them into the cell, and then what they do is actually get the cells to copy their genome, and then they turn that cell into a kind of a zombie that makes a whole bunch of viruses. Those viruses get released, and then once they get released, then they try to duplicate that process and infect other cells. This virus started in bats and then it went into pangolins as an intermediate host before coming into humans. It seems to go through the eyes and the nose and the mouth, and it causes respiratory symptoms, fever, cough, and shortness of breath. But some people can then progress onto the more dangerous complications such as ARDS shock and sepsis.
Now, by far the most important strategies are prevention. Avoid traveling to infected places, careful handwashing, and this goes especially for healthcare practitioners, avoiding touching the T-zones because our hands can pick up respiratory droplets that came off of an infected person, and then obviously, avoiding crowded areas. So, right now, most people are not going into any crowded areas at all. So, the next question, well, how is this spread? And it's not that interpersonal transmission is primarily from respiratory droplets and contact transmission, but there may be some fecal-oral transmission as well. There were some situations where there were buildings that did not have good venting and it probably is then the stool, and so there's been fecal-oral transmission in some of these buildings that didn't have good ventilation. People in different parts of the building got infected because it was able to transmit up these lines, which is kind of concerning.
I want to emphasize that the majority of cases are relatively mild, kind of a flu, and that's positive. And it's probably 80% to 85% of people are going to have mild cases, but 15% to 20% of people can have quite significant and complex problems. And so, that's why everybody's so worried about it. Fever and a dry cough are the most common presentations. Some people had shortness of breath and fatigue. Some people have had muscle pain, confusion, sore throat. Some people can have gastrointestinal symptoms, people have had diarrhea and vomiting as a presentation. And there have been a real number of people who presented without any fever.
I want to really emphasize how important, before we get into treatments, hand hygiene is and cleanliness, and even in your home and other areas, wiping down the areas around where you are and making sure everything is clean. I think it's going to be quite important. And risk management from this perspective, this could be very important. There are guidelines that are continued to be released from healthcare organizations and we're going to try to post these guidelines both from a perspective of cleaning, from a perspective of taking care of someone who's been quarantined and at home, and then from the perspective of taking care of people and clinic and hospital.
I wanted to go through a little bit about the time course. Most people are going to have a mild infection. The people who get real sick, sepsis, and one study developed a median of nine days after the illness, ARDS developed at 12 days, and cardiac injury happened at 15. I'm going to go into why this seems to affect a diffuse and broad set of organ systems. People developed acute kidney [00:20:48] ______ in 15 days and secondary infection at 17 days. I found one real interesting study that they did with macaque monkeys, who were inoculated with the SARS, COVID virus, and they found that the older monkeys had a stronger host innate response than the younger ones. And what that did is that affected how they responded to infections because they preferentially created a lot of inflammation. They had less T-cell and B-cell function and they had more cytokines, and that set them up for the cytokine storm that I'm going to go into in just a second.
I've been having a lot of people ask me, why does the flu come in the winter? And somebody told me, “Well, the flu loves winter.” In the northern hemisphere, it typically happens between November and March, but in the southern hemisphere, it happens from May to September. So, viral outbreaks typically happen in the colder months, and sometimes in the summer, things get better, but sometimes they can go from the northern hemisphere to the southern hemisphere and that may be what's going to happen here. In general, the tropics probably have much less in the way of flu infections than colder areas, and there's some evidence that even animals who are kept in a cold environment are less susceptible to viral infections.
So, let's get into it. What is a cytokine storm? This virus, the primary target is probably respiratory epithelial cells. So, these were cells that line your airway, and they are the choreographers of cytokine implication during infection. So, I told you that when virus comes in, the virus can't replicate itself without going into a cell. So, it comes in and it gets into a cell. One of these epithelial cells, the cells that line your airway. And then they recruit that cell to make a whole bunch of copies, and that's how it replicates itself. In response to that, the human body says, “Well, let's make a whole bunch of chemical messengers that will create an inflammatory response.” And the goal of that inflammatory response is to get a whole bunch of immune cells to come in to fight that infection and fight that virus.
The first thing that happens is that the pro-inflammatory cytokines are produced and they act like an alarm belt. They drive cells of your immune system to come in and then fight the infection, and then after that, acute very inflammatory response, then there are some anti-inflammatory cytokines that calm everything down. And generally, your immune cells were able to fight the virus and then everything is cool. What happens in a cytokine storm is that the inflammatory process goes out of control and it goes so far out of control that the anti-inflammatory process doesn't ever get to take effect, and we get runaway inflammation. It was all targeted to kill something, but the virus actually is not nearly as bad as the over inflammatory response that the human body had in trying to fight it. The analogy I had was imagine there was a bunch of kids and maybe a whole bunch of kids that were in a grocery store shoplifting. Well, that'll be bad, and probably, we need to do something and get them. But one thing that you could do is you call a drone strike that takes out the grocery store. That's kind of like what's happening here as an analogy.
I'm just going to give you a little bit of science, and there's a couple of names and you may be hearing some of these names in the press. There's a whole cast of characters of the inflammatory cytokines and there's a whole cast of characters of the anti-inflammatory ones. There's one called tumor necrosis factor-alpha, TNF alpha, is often maybe the first one to initiate this fire alarm and it typically will promote the generation of another one called interleukin-1. And interestingly, the fact that we have older patients who are more susceptible, some of them may have some genetic susceptibility. They may make a little bit more of these inflammatory cytokines or it may be that their immune system is somewhat weakened because of a variety of factors. And so, as a result, instead of being able to rely on their cells to come in and do what they need to do, they're relying on an inflammatory response, but that inflammatory response goes out of control.
Now, what happens in the setting of this extreme inflammation is that those cells can undergo a process called apoptosis and they can die. And then when those cells that are lining your airway tract start to die because of this inflammation, then that can cause all kinds of swelling and inflammation in the tissues where that's happening. When that causes swelling and inflammation in the tissue of the lung, we call that a pneumonia. Often when this happens, it leads to a pneumonia. And because it's systemically happening, it doesn't happen just on one side, it happens on both sides, and that can progress on to an acute lung injury or ARDS.
Now, as a mechanism of healing, the first thing that happens with inflammation is it leads to vasodilation of the blood vessels. And the reason we try to vasodilate the blood vessels is so that immune cells can start to go in and get out into the tissues where that's happening. And so, I'd like to give an example. Let's say I was walking around and I bruised my leg. Well, the first thing that would happen is I might create that inflammatory response that we're talking about. So, some cytokines come out and they create inflammation, they create swelling, they create heat, and then some immune cells come in. And what happens is when those immune cells come in, they're going to choreograph healing. And then what they do is they start to send more messages, which are anti-inflammatory, and then a coordinated response happens that calms everything down.
In the case of an acute lung injury that is progressing into ARDS, what can happen is the inflammatory mediators that were causing vasodilation to hopefully heal the lung start to get into the systemic circulation, and then they start to cause a drop in blood pressure in the whole body. And so, then this is how sepsis starts to happen. There was inflammation in the lungs, but then all of a sudden, there's inflammation everywhere in the body. And then what happens is you have somebody with very low blood pressure and they also have not enough oxygen. Because of all the swelling, the lungs can't exchange oxygen well enough. And so, now, we were having systemic collapse, and that is physiologically what's happening.
The other thing that can happen is that this virus appears to have an effect of being able to bind onto some receptors called ACE2 on the cell surface of cells and different tissues of the body. And so, there are an ability for this virus to affect the lungs, but also it can then begin to affect and infect cells in the heart and the kidney. That's why we're having a diffuse group of other problems that happen in addition to just that traditional septic physiology.
So, I'm hopefully beginning to give you the idea that a little bit of an inflammation is a good thing, but when it's out of control, it's a bad thing. We have molecules in the body and proteins and regulators that at all times are either driving inflammation up or driving inflammation down. And in general, this is the nature of life where we turn something up to initiate a healing response, and then turn it down. We go into fight-or-flight to meet an event, but then we come back and to rest and relax. And so, we're perpetually in some form of a yin yang cycle.
One of the biggest drivers of inflammation is a protein called a nuclear factor-kappa B. And it turns out that activation of it is a central thing that can lead to sepsis. It also has broadly implicated in a whole host of illnesses and medical problems that are expressions of out-of-control inflammation. In sepsis, higher levels of nuclear factor-kappa B are associated with a higher mortality rate and worse clinical outcomes. And I think that it may be that some of these older patients that we're seeing who are either immunocompromised or have other contributing factors that make them more susceptible. One of the factors, it may be that they have greater levels of NF-kappa B or that is one of the only strategies they have because something else isn't working.
Now, there's, from a septic physiology perspective, an approach to trying to inhibit NF-kappa B activation, but it's also a fairly well-known strategy that's used broadly in integrative medicine as there are a number of supplements and strategies that inhibit NF-kappa B. And so, I'm going to go into this a little bit. Now, the other side of that coin, so I've got inflammation, the other side of the inflammatory coin is a transcription factor called Nrf2, and this is the master anti-inflammatory switch. And so, we are able, physiologically in our body, to either turn up inflammation or turn it down. And so, there are going to be strategies with vitamins and things like that that can turn down NF-kappa B. There are also strategies with vitamins and things like that that can turn up Nrf2. If you want a mnemonic to remember this, I think, NF-kappa B is nuclear factor-kappa bad, and then Nrf2, I just remember that NRF is good.
So, now I'm going to go ahead and start to talk about some of the different treatment options that are out there. Now, for those with mild illnesses, I think by far the most important thing is containment. And so, avoiding other people, avoiding transmission, avoiding transmission to other family members, having great respiratory hygiene, environmental cleaning, limiting movement, limiting exposure, and staying away from other people so that you don't get infected because if we do a great job with that 80%, then we have a hope to get this contained. So, it's like by far the most important thing to think of in that category.
Then with that being said, as I go through the treatments that may be beneficial in general, could be also beneficial for these mild cases. But then in addition to those cases, there's people who have cytokine storm and septic physiology and some of the severe things we're mentioning above. So, we'll talk about some of those strategies. If this is fundamentally a model of runaway inflammation, then you begin to think, “Well, maybe something that would be anti-inflammatory.” And in Western medicine, one of our great ideas in terms of training the inflammation down is to use corticosteroids like prednisone. The good thing about corticosteroids is they are quite good at turning inflammation down. The downside is when we give them, sometimes they blunt how well the immune system works. And in the previous coronavirus outbreaks, systemic steroids were found to not give benefit and may have caused some harm. So, unfortunately, that one's probably not going to be a useful strategy for us.
And so, then the next I think most obvious and rational thing is going to be to look at the antiviral medications. I think the most exciting of these medications is there's one called remdesivir, and it's a small molecule that mimics one of the components used during the production of the replication of the virus' RNA. These are RNA viruses. And when it's incorporated, the replication of the viruses is halted and early investigations have shown some promise for remdesivir in treating MERS and SARS, which were both coronaviruses. And it also had some benefit in Ebola. And it sounds like there's a fairly broad ability for remdesivir to affect a wide different variety of coronaviruses, including the two bad ones that we've seen and a number of clinical trials looking at its use in Ebola. The other drug, there's a drug that goes by I think the brand name, Kaletras, K-A-L-E-T-R-A, and that's ritonavir and lopinavir. And this is a drug that has been used in Asia in a couple different countries to treat this infection, and it sounds like there's some early evidence that this may have some value. We don't know how effective it is. It's been just crazy in terms of the inability to get supplies and get things right now, but I was able to get a small amount of this. And so, we'll be anxiously watching to see what the results are in terms of how effective it is.
There are a number of other antivirals. And as far as I can tell, none of those are showing much effectiveness although there are some people looking to see if Tamiflu combined with potentially the ritonavir is effective, but Tamiflu all by itself, it sounds like was not. One thing that's being looked at is therapies that are anti-TNF. So, if TNF is this inflammatory cytokine that is starting the whole process, there is the idea of giving something that would decrease the TNF-alpha. I'm not aware of anything that has shown that much merit in this regard although there's a lot in that space. However, it may be that ozone therapy, which I'm going to discuss a little bit later may have an ability to lower some of the pro-inflammatory cytokines, and in particular, TNF-alpha.
So, one idea is back to this theme turn the bad guys off, TNF-alpha. And so, ozone may have some ability to do that. And then the other thing is to turn on the good guys to turn up the inhibitory cytokines that would normally come in and calm things down. One of those is something called TGF-beta and another one is called IL-10. And I'm going to foreshadow where we're going to go here a little bit, but then it turns out that ozone, which is a modality that is one of the integrative strategies that is used in some parts of the world may not only decrease NF-kappa B, but it may actually increase Nrf2. So, this kind of brings me to the idea of functional medicine. I've referenced that earlier. And so, if you said, “Well, what is functional medicine?” I think functional medicine is a system approach to looking at the whole body and diagnostically doing testing and trying to figure out how the whole body is working, and seeing if there's things that can be done to optimize each component, each system to get the whole thing working together better.
Plato said that the part can never be well unless the whole is well, and I would say that is true whether a person or society or the whole planet. I think this is an example where–what we're trying to do is improve each individual's total wellness, but then to go further to–we really have to band together to help everybody. It may be the thing to do to help everybody more than anything else. It's just going to be to make sure that people who are infected or exposed are isolated so that this stops as soon as possible. But the functional medicine idea is kind of interesting and entertaining to begin to think about because it has some useful applications for wellness in life. As an example, a typical conversation in functional medicine, if we break down the different systems, we have immunology with neurology, we have the cardiovascular system, the pulmonary system.
I'll give an example that I see a lot, which is that people will have a fairly significant problem in their gastrointestinal tract. And so, they may have bacteria living in their small intestine. That's called small intestinal bacterial overgrowth. They may have a biofilm there that has yeast in it as well. They could have mycotoxins there as well, or they could have a parasite infection in the small intestine. They could have any of those in the large intestine as well. And then that inflammation and infection can start to lead to inflammation in the wall of the intestine, and that can start to lead to leaky gut. And so, when that happens, toxins from the gut can start to get into the bloodstream and sometimes little bits of undigested food can get into the bloodstream. And then the immune system can start to have an inflammatory response that will come in and start to attack the wall of the intestine, but it can also create antibodies and allergies to foods and other problems. And then this has the effect of making the immune system somewhat dysfunctional and not work quite as well.
When I see people with real complex infections, usually there's four or five things going on. And so, if somebody comes in fairly debilitated with Lyme disease, they don't come in with–nobody that's sick comes in with a perfect gut. They all come in with a whole bunch of things going on and I generally think that that is an initiating factor that causes the immune system to get dysregulated. And then because of that, then their immune system is not working that well and that's what set them up to be susceptible to the infection in the first place, because I'll see people who've had a blood test that show they were exposed to “Lyme”, but they are totally fine and they're super successful and they have no problems at all. But then I'll see somebody else that has exactly the same testing, but from a systems perspective, they've got four or five problems. And because of that, the whole body can't work very well together, and so there's a problem.
And it's like if there was a company and the company had a problem in marketing and a little problem in strategy and a little problem in operations, that's a big problem. If all they had was just a small problem in marketing, they just bring a consultant and fix that marketing problem and then they're back to the races. But if there is problems going on systemically in the company, then what's going to have to happen is a strategic implementation of approaches to fix all of those problems because if we don't begin to, in broad terms, focus on the problems, these people don't get better.
A lot of times when I talk to people, I say, “I'm thinking like I'm a McKinsey consultant trying to go in and optimize each system.” And I think from a wellness perspective, as we sit here and try to get ourselves as well as we possibly can in anticipation of these pandemics we're sweeping through, the less toxins we put in ourselves, the healthier we get our intestines and our heart and our lung, and the more we sleep and the lower our stress, and the more we exercise and we're doing everything to get our immune system and our biology working well, then that has potential to be a long-term strategy of preventing infections. And I would say that has been borne out in my clinical experience.
And so, when we use strategies to optimize our biology, a lot of that is lifestyle modification, and a lot of that is just making great choices. But then there's some interesting things on the supplement front that can be helpful, and that'll relate to some of the biology that I've discussed as we're going through here. One of the big ones is vitamin C. So, there's some studies that have shown that vitamin C, when it was given intravenously, decrease mortality and prevent the organ system failure in patients with sepsis. Now, it makes sense and I think it's rational because I said that sepsis is runaway inflammation and vitamin C is an antioxidant. And the runaway inflammation is this overreaction to the body. The runaway inflammation is carpet-bombing the grocery store in response to some kids that were just shoplifting.
And so, in that sense, vitamin C I think has a good logic, and I know that there's some trials that are looking at using IV vitamin C to treat this infection in patients with sepsis specifically from the COVID-19 virus. I think it's also important to keep in the back of your mind. IV vitamin C is super cheap. And so, I think it's a provocative tool that could be used as an adjunct of treatment to calm inflammation down in patients with septic physiology with this problem at a low cost. And my suspicion is that the most important thing that we're going to be able to do to help people is going to be with medication. My suspicion is that if we could combine things, particularly from a cost perspective if we can combine cheap things to put in a stack along with some of the traditional therapies, it may be that we would have more success. And so, I'm real interested in the vitamin C for that reason.
The next one would be vitamin D. They've called it the pro-survival molecule and it's felt to be helpful to the immune system in states of excessive or chronic stress. It has an anti-inflammatory potential, but it may also help your cells bacteria and viruses. Now, the other side of that coin from a functional medicine perspective is that if vitamin D is low, that may lead you to higher susceptibility to problems. And vitamin D deficiency may actually be considered a risk factor for sepsis and inflammatory disorders. And so, this is one of the things that we do. We check the vitamin D levels with a blood test. And so, then the goal is to try to keep your vitamin D level in the range of 50 to 80. There can be problems if it gets too high. So, we're looking to begin to think about supplements and some of these strategies in terms of optimizing biology and finding that sweet spot of where your levels are not too high or too low.
One of the more famous supplements that people hear about that's anti-inflammatory is curcumin, which has been found to inhibit the nuclear factor-kappa B. It's been studied broadly in sepsis and in some animal models with sepsis as well. Similar to curcumin, quercetin is another supplement that also inhibits NF-kappa B and has been studied in models with sepsis as well. Since I'm doing the podcast by myself, I'll ask myself a question. Well, would taking some supplements that turn off the inflammatory pathway be prophylactically a good idea? And the answer to that question is that I don't know, but I think it's an interesting question.
I think to go back to what I was talking about before, I think the primary thing that's going to be helpful in this situation is going to be the drugs. I think number two is going to be some adjunct of things that we put in the stack, and then I'm going to wander and I'm going to go through some other ones, is, would it be helpful to layer in supplements that could begin to modulate in general the immune system or to modulate inflammation? I can tell you that that is my personal strategy I've been doing this. And so, I've been taking some curcumin and quercetin. Tyler, who works in our office and is amazing, found a product. And so, we just ordered. I took it for the first time this morning called X-Viromin. It comes from Apex Energetics. It has a whole bunch of ingredients that are designed to boost immune function and fight viral infections. And so, there's vitamin C, vitamin A, zinc, astragalus, Echinacea, maitake mushrooms. And so, a whole bunch more in there. Is that the one to take? I have no idea.
I think that there's probably hundreds and hundreds of different products in the market and I think that they would be, hopefully, supportive of the immune system from a wellness perspective, and that's how I would be thinking about these rather than I would not be thinking of them as something that would cure a big problem. And if you've ever been in an ICU or an operating room trying to take care of somebody who's septic, you will realize that it's something to face indeed and probably we're really going to need the full spectrum of Western medicine to be in a face of some of the end stages of what this illness is.
Now, another one is that we had to search high and low to get these, and I feel like I got the last bottle of it. Life extension has these enhanced zinc lozenges. And zinc is an antimicrobial product, but it helps to prevent the replication of viruses. And I really like if you can get a hold of these zinc lozenges then send me a bottle because we only have one. The first place where people get infected could be in the eyes, but mostly in the nose and the mouth. And so, maybe a droplet was on a door or it came onto your hand and then you touched your mouth. And so, we try to keep our hands away from those areas. But the nice thing about these lozenges is these lozenges are being dissolved and they're right there at the area where the virus is coming in.
Another one Tyler found is from a company called Designs for Health. And so, we just ordered this Quercetin Ascorbate. So, it's combining two things that I think have a nice rational idea. It's a vitamin C and a quercetin. And quercetin may have some specific antiviral effects in addition to its effect on NF-kappa B. And so, I think that that's quite exciting. There's problems with poor absorption, and I'll probably go into that in another podcast. One of the, probably the most famous supplements that you've heard of is glutathione, which is the master anti-inflammatory antioxidant, particularly in the liver.
There's a company called Quicksilver and they have a Liposomal Glutathione Complex. And glutathione, it turns out it will help combat the reactive oxygen species that are produced by the virus and may have a benefit on helping the inflammatory cascade. And then on top of that, glutathione may actually have some inhibitory effects on coronaviruses, and I think I do like the idea of taking the liposomal glutathione because you're putting that in your upper airway, your throat. But then we know that this infection can go into the gut and travel all the way through the intestines. And so, having some glutathione there, from our perspective, is probably beneficial from a wellness perspective. And so, could it be somewhat helpful as a prophylactic? Maybe. But once again, we just don't know, but I'm just going through some functional medicine strategies.
The next one is vitamin A. Vitamin A turns out has a whole diversity of ways that can improve immune function. In addition to improving immune function, it probably increases the lactobacillus species in a large colon, which can improve the balance of good and bad bacteria in the gut. Vitamin A is also like vitamin D. You definitely need to have some of it, but you don't have too much. But when you take them together, that can be synergistic. So, I think that's a good one to pay attention to.
Now, I'm going to interrupt. And so, my team just came in while I'm recording this. We just found some press releases that are coming out that are suggesting that chloroquine phosphate, which is an anti-malarial drug, may have some benefit. And so, experts are discussing adding that as a possible drug that may be beneficial on the treatment guidelines. So, we're going to be posting about this, but it's positive to me that that was placed on the list because it's been used for 70 years and has been used to treat people all over the world. So, I think it has a good record and a safety profile that I think is going to be helpful. And so, then like I said, these supplement things I think are helpful, but I'm thinking of them as supportive wellness things that you can do that I would wrap around good science and a good medical approach with drugs that are scientifically proven to be antiviral to this virus.
In terms of an overall wellness supplement, I would say the–Chris Shade over at Quicksilver made, he said, “If there was only one supplement I was going to take,” it would be one that he calls “The One.” It was developed to increase cellular energy production within the mitochondria. And so, it's helping your actual cells be healthier. They put in a couple of things. One is PQQ and another one is resveratrol, which are designed to turn Nrf2, the master antioxidant, switch on. And there's some other things in there. There's some adaptogens that can help you feel good and respond to stress, as well as tocotrienols from the vitamin E family, which are antioxidants.
Now, as a concept of taking care of people either, A, who were healthy, or B, who are super sick. There's a concept of trying to improve the health of the mitochondria. And so, if you don't know what mitochondria are, in every cell, there are some little tiny baby cells that are inside. They're called mitochondria, and the mitochondria are responsible for making all the energy in our body. In life, basically, the process of life is that we breathe oxygen in, and then we eat food, and then that food goes into cells, and then we burn that food, it gets broken down, sugar gets broken down, and eventually, it gets–part of the process of breaking it down happens in the cytoplasm, and then part of the process of burning it happens in the mitochondria.
And so, one general strategy is that if we can get those mitochondria to make energy more efficiently, then the cells, wherever they are, may function better. And so, the products like The One that have strategies to improve mitochondrial health we're using with a lot of patients who have complex illness. We're also using strategies to improve another molecule that can be beneficial towards driving mitochondrial health and you may have heard me talk about, which is called NAD. If you want a deep dive, I did a podcast with Joe Mercola. And right around that time, he also did a podcast with Dr. Sinclair from Harvard, who's a great thought leader in this field.
And so, our experience has been when we give patients supplementation with strategies that will improve NAD, sometimes we see their immune function go up. Now, with this one, it's extremely nuanced and I think you have to be careful, but it's been–we've had a very positive experience with it. There's a product from Quicksilver called NAD Gold that has NMN, which can drive basically the salvage cycle of recreating NAD in your body. If you see a doctor that works with the compounding pharmacy, you can actually get NAD and it can be given subcutaneously or as an IV. You can do NAD nasally. There's patches. I think it's a provocative tool for wellness because it's a molecule, it's a cofactor that drives the assembly line of biochemistry. It's actually a version of vitamin B3. But the level is decreased by 90% from age 1 to age 90.
And so, we're beginning to see that the people who are susceptible to this epidemic or pandemic are older people whose bodies may not be pushing as optimally as they can. Part of that may be general dysfunction, but I think most of it more specifically is they have other coexisting diseases. But sometimes I think underlying a complex on this, sometimes underlying a cardiac problem may be a mitochondrial problem in those cells in the heart. And so, NAD I think is a useful wellness tool. I would not in any way think of it as therapeutic for an infection, but I think it's an interesting molecule to think about from a wellness perspective.
Another vitamin that we've been working with people is an extract of olive leaf called oleuropein and it apparently has some antiviral effects broadly as a phenolic compound, and that also has some antimicrobial effects against bacteria and has been shown to be helpful to some respiratory viruses. Despite that, I would continue to think of everything in the supplement front as being designed or thematically to be from a wellness perspective, but not so much as a therapeutic. But is there a preventative role in any of those? I think that that is going to be determined over time, but I would be hopeful that there was and I'm certainly interested in it. I'm doing some of those strategies myself, and so we'll just be watching for what the data says over time.
The next therapy that I foreshadowed a little bit that I want to talk a little about is ozone therapy. Ozone therapy is interesting. It's been in clinical practice for over 100 years. It's an allotrope of oxygen and it's three oxygen molecules, and so ozone is O3. And so, when oxygen is exposed to electricity, sometimes that creates the O3 molecule. And so, if you've ever been in a lightning storm, you probably smelled it. There are generators that can generate ozone that can be used for medical use and they generate a gas that has ozone and it has concentrations that go from 0 to 100 micrograms per milliliter. And there are wide variety of ways that doctors around the world use ozone.
Nikola Tesla patented the first commercial medical ozone generator in 1896. And so, we have been quite impressed with our experience using ozone in some of the complex patients that I've seen. I think it's provocative to think about the ozone because it may have an effect of calming down some of the pro-inflammatory cytokines like TNF and interleukin-1, and there are some references for this and I'm going to try to cite these. And then it also may have the ability to upregulate Nrf2.
Interestingly, my background is anesthesia so we're always thinking about the physiology of blood, and oxygen, and pulmonary physiology. And so, ozone actually has a whole bunch of beneficial effects. If it's in the blood, it increases something called 2,3-DPG. It shifts the oxygen hemoglobin disassociation curve to the right and allows you to get more oxygen to the tissues. But most importantly, ozone is known to be antiviral, antibacterial, antiparasite, and antifungal. So, it kills a lot of the things that can come and affect us. And ozone is used broadly around the world to treat in the integrative medical space complex illnesses, particularly in the setting of Lyme disease.
So, then you may be asking yourself, “Well, what do people do with this gas that has some ozone and, let's say some oxygen?” Well, you can't breathe it into the lungs because the lungs are very sensitive to oxidation-reduction reactions and they don't have an ability to deal with that. And so, ozone is actually toxic and you can't breathe it into the lungs. However, other parts of the body like the blood has a massive buffering capacity. And then also in the colon, there's a big buffering capacity as well. And so, one way that a lot of people will do ozone therapy is that they'll actually stick a catheter into the rectum and give them an enema, but instead of doing an enema with liquid, they can do an enema with the ozone gas. And then what can happen is some of that ozone will dissolve across the wall of the colon and then get into the bloodstream. And then when it gets into the bloodstream, then it begins to have some of these beneficial effects that may affect cytokines and then may have an antimicrobial effect in the case of infections.
It turns out that there's a whole bunch of other ways that you can do ozone. So, for example, you can inject ozone subcutaneously, you can inject ozone into joints, you can take water and ozonate water with a medical device and then drink that water. And then when that water is absorbed in the small intestine, then some ozone comes with that, and so you can get some systemic ozone from water. And there's companies that make ozone generators that can make water. There's another strategy where you can bubble ozone through olive oil, and then the ozone makes ozonides that are ozonated oils, oil molecules. And those can be quite helpful for some skin infections, but there are some people who are promoting the idea of putting the ozonated olive oil in your nose because that may have some preventive strategies. In this case, which I have no idea if that would be helpful, there are machines that can bubble ozone through olive oil making it less toxic. And then there are some strategies where that can be breathed into the nose. We've had many people buy these machines and have told us that it helped them with nasal biofilms and chronic sinus infections. And so, that's another strategy.
There are some strategies where very low concentrations of ozone can go through a stethoscope and can affect the tympanic membrane, but the big guns in the ozone therapy world is that there are some strategies where ozone can be mixed with blood. And so, the oldest and most famous was something called major autohemotherapy. And what happened with that is that some blood was withdrawn into a bag from the body, and then the ozone gas was injected in and mixed with the blood, and so then the blood goes back into the body. And so, that was called major autohemotherapy. So, no gas went into the body, but the gas was mixed with blood outside the body.
There's some companies from Germany that have machines that have a vacuum and they actually pull blood out and mix the blood with the ozone and then push the blood back in. And these are regular licensed European machines. The term for this is high-dose ozone therapy because you can do that one time, or you can do that five times, or you can do that ten times. The term for doing that 10 times is called the 10 pass. If they did that five times, they call that a five pass. About 200 to 250 CCs of blood is ozonated with each pass. So, you can imagine if you did four passes, that would be about a liter of blood. And we have a fairly robust experience of seeing people with chronic infections, particularly Lyme and mold, who have done quite well with ozone therapy and both with the low dose, intermediate dose, and high dose therapy. I don't really believe in any one of those against the other ones because some people are very fragile and we tend to start very low with them and carefully, and then work our way up.
The final strategy of using ozone therapy IV is a term called ozone dialysis where blood is taken out and it's run through a dialysis filter and pumped back in. But the blood is mixed with ozone during this process. And so, this process is called ozone dialysis. We found that of everything that we've done in ozone, that's probably been the most profound modality that we found to be helpful for treating chronic infections. And our experience has been in dealing with people who have often multiple infections. Sometimes they will have Borrelia, Babesia, Bartonella. And then often they'll have high-viral levels of a couple different viruses when they come in.
And so, then we've employed all of these ozone strategies. And it was a little shocking to me coming from anesthesia to learn about these things, but I found it's the most valuable and impactful therapies that I have had in my career for dealing with these chronic infections and chronic Lyme disease in particular. But there's a very interesting theme of viral infections complicating a Lyme illness. And so, it's an interesting model to think about when we're thinking about like a viral pandemic.
Now, given that we now have a number of strategies of giving ozone, it could be just a [01:17:51] ______ or it could be an IV therapy. Then the question is how is ozone going to be helpful? What would it do theoretically for a virus? One is, and we'll have a reference, there's not a lot of reference in this, but one is that these viruses need to attach the cells and insert them into the cell to get this whole process started. There's a theory that the way that they do that is with sulfhydryl groups, and those sulfhydryl groups need to be in a reduced state for them to effectively insert themselves into a cell. It turns out that ozone has an affinity for the sulfhydryl groups and can oxidize them. And when they're in the oxidized state, then it renders them unable to be able to get into a cell. We have no idea if ozone would be helpful for this outbreak, but I think it has the possibility of being provocative and is interesting.
Number two, ozone may have some immunomodulatory effects in terms of calming down some of the inflammatory cytokines. And number three, there's a concept of oxidative preconditioning. And so, the ozone experience creates an oxidation in the body, and then the response of the body is to turn around and have an anti-inflammatory effect. And so, this anti-inflammatory effect and in turn the activation of Nrf2 and some of these other biochemical pathways may have some beneficial effects for patients. And so, it's provocative to think about ozone, A, from a treatment perspective, but also from a prophylactic perspective.
A friend of mine, Dr. Rowen, went to the Ebola outbreak number of years ago and treated a number of people–a number of doctors, actually, who had Ebola. And based on their data, the mortality rate in the people he treated was significantly lower. It was small numbers. The other thing is that after the Ebola outbreak, there's a whole bunch of complications in terms of pain and arthralgias and other things that didn't happen in his group. There was also in that experience they didn't have support from the government in terms of treating people in mass. And so, they're basically running around just trying to find people and treat them and see if they could help them, which I have to say I was kind of like super impressed by.
There was some communication in terms of letters that they gave ozone generators to some people and those people were treating some of the patients who were in the Ebola outbreak with rectal ozone. And there is a suggestion in an article that I read that the death rate in that group may have been lower by more than 20% from some other groups. And that data is super weak, but I just think it's provocative. An ozone is something, because of our experiences, I think is useful. And another thing to just wrap your head around how–like, I'm thinking about this. We see a lot of people with herpes outbreaks. So, well, if somebody has an acute herpes outbreak, we'll obviously treat them with an antiviral. But just over 10 years, my experience of treating people with complex viral outbreaks is that if we give them ozone on the first or second day, their symptoms are dramatically less than if I just gave them the antiviral.
Ozone is not even regulated by the FDA, but a lot of the medical boards in different states, United States, have a little bit of a don't-ask-don't-tell policy with regard to ozone. And I basically have found it to be so helpful than I have done it, but I've never really talked about it on podcast much, and I've never even really let anybody know that I do it. But it's been so helpful for people with chronic infections as a tool that I'm just coming out and saying it. And I think that in the future, I'm going to be teaching other clinicians about this.
Now, another category that I think is sort of the new kid and maybe the most exciting kid on the block in integrative medicine is category peptides. A peptide is a sequence of amino acids that's bigger than an amino acid, but smaller than a protein. And proteins, as you know, if you take a protein and eat it, it's going to get broken down into amino acids, and then it'll be absorbed, but you wouldn't get the effect of that protein. And that's the same thing with peptides. It's a whole bunch of amino acids and maybe 50 or 100 and so. Then if you took that peptide, it wouldn't have any effect. The most famous peptide that you've probably heard of is insulin. And insulin is a peptide. And so, since we can't take it as a pill or sublingual, we have to inject it. And you're probably aware of people that have diabetes that inject insulin.
Well, it turns out that there are hundreds and hundreds of peptides in addition to insulin that are in our body that have all kinds of different effects, and this is a rapidly emerging area of medicine that has potential to be quite beneficial. And so, some of those peptides are anti-inflammatory. One of the most famous ones in that category is something called BPC, which stands for body protection compound 157. The other famous one that you may or may not have heard of is called thymosin beta-4, which can be helpful for pain, and we've used for patients with peripheral neuropathy. But the thymus gland is one of the centers of the immune system. And there's a peptide called thymosin alpha, and it's been shown to increase the production of some cytokines, but can be quite helpful in terms of helping NK cells, which are natural killer cells, which are a critical part of the immune system to go out and attack and kill infections. And really, they're kind of like our first line of defense.
And if NK cells are appropriately working, then they're going to come in and attack that virus that's attacking us or that bacteria and mop it up. And then because of that, then we do good and the process never really gets out of control and there may be an inflammatory response, but it's self-limited. One thing thematically that I see with a lot of patients with real complex illnesses, especially people who have had complex illness for a long time and chronic infections is that they will have very low levels of NK cells. And I think that that puts them at a slightly greater reliance on using cytokines as a strategy to initiate an immune response, and it may be that that's underlying some of the susceptibility of some of the older patients to this illness.
There's another peptide that is interesting from an infectious disease perspective called LL-37 that apparently has some antiviral effects. And we've used both of these in Lyme patients and Lyme patients who have viruses, but not the coronavirus, or not this one anyways. And so, I think that long-term, some of these peptides may be very provocative and they may be helpful as part of a stack of supporting immune system function. But I still think that it's–I'm thinking holistically around a stack of things that's going to help the immune system. But in this pandemic, we're still looking for a drug.
Now, speaking of drugs, the next thing I'm going to tell you about is exosomes. And exosomes are small vesicles that are secreted by stem cells, and it turns out that a stem cell and the inventor of the stem cell came out and said he doesn't even want the word stem cell to be used anymore because he said a stem cell is not a stem cell. A stem cell is a medicinal signaling cell that sends signals to the other cells and coordinates the healing responses. One of the ways that a stem cell can communicate is by secreting different cytokines. And another way that a stem cell can communicate with other cells is to secrete small little liposomal vesicles that are full of growth factors. And those growth factors can have a variety of different effects.
I think that over the next 5 or 10 years, exosomes may be one of the most exciting and impactful tools to come onto the scene in medicine in years and years and years. I think that they will have a potential to be used in a variety of ways. There are doctors around the world who are injecting them in the joints, injecting them on nerves, nebulizing them into the lungs, and using them topically for skin. They seem to be very, very safe. Unfortunately, in 2018, there was a company that had a bad batch and there were some infections. And so, there was a very strong letter from a regulatory perspective from the FDA that came out cautioning people. And I think part of the problem is because when there's a sexy new kid on the block, then people on the marketing side start to really market a tool, and that's quite unfortunate because generally, I'm just against that, because it potentially drives people to a therapy that might not be the best therapy for them, but it was marketing-driven. And that's I think systemically a problem in our healthcare system.
But then I think it's also negative because these are quite interesting molecules. And I've talked to five or six very smart PhDs in the last couple of weeks about exosomes, and there's some evidence that they can have some antiviral effects. I've talked to a number of clinicians and scientists who've used exosomes both intravenously and nebulized to treat COPD, which is kind of like a model or ARDS, which is part of what's happening as an antecedent to sepsis in this pandemic. I am aware of some pre-clinical studies on [01:32:20] ______ stem cell exosomes as a therapy for ARDS.
And I think it is provocative and it needs to be studied more. I'm aware also that there's an ability to give these exosomes into the lungs and so they could be nebulized, they could be injected through a bronchoscope, and they have growth factors that can–they tend to be extremely anti-inflammatory. They have TGF-beta in them. And the experience is whether clinicians inject them around nerves or wherever their place, they tend to lower inflammation. And so, I'm not treating and have not seen anyone with this viral epidemic, but I do think that if there is someone taking care of people who were hospitalized, it's provocative to start a conversation with some of the nanovesicle scientists, the exosome scientists out there because there may be a role for this vesicle speed to be used as part of a strategy of calming down the acute lung injury, and pneumonia and ARDS that happens right before people get super septic.
Now, exosomes are secretions of stem cells, and so they are the way the stem cells do their healing. Now, generally, the way that exosomes are made is that stem cells are grown in a lab. And then stem cells, when they're healthy and happy, they secrete exosomes, which are these little nanovesicles that are full of growth factors. And so, there's an original article in aging and disease that came out just a couple days ago. And this was in China, and then they treated a small number of patients, seven patients I think, where they transplanted stem cells into some patients who were sick and with pneumonia in the hospital. Now, interestingly, these stem cells had the same receptor, the ACE2 that I was talking about. They don't have that. So, these were stem cells that were ACE2 negative.
Now, scientifically, it appears that this new coronavirus, what it does is it binds onto these ACE2 receptors on cell surfaces. It's going for the lungs, but once it gets into the bloodstream, then it can act and bind onto other cells that are expressing this protein. And it turns out there are cells with those receptors in the heart, which is why people can get myocardial injury from this virus, as well as an irregular heartbeat or something called an arrhythmia. There are cells that have that receptor in the kidneys and in multiple other organs, and so they can get dysfunction broadly. And so, this may be related to the pathology of sepsis that is above and beyond the typical sepsis that people experience.
Apparently, what happened with this study is that the inflammatory markers started to go down, C-reactive protein, another marker of inflammation, started to go down, and the patients ended up doing quite well. I mean, this is a tiny study and it just was received for publication at the end of February of this year. And so, then you ask yourself the question, “Well, what did these stem cells do when they were put in the body?” So, they were put in intravenously. And in stem cell medicine, one of the things that happens is that the stem cells are floating around the vein and they go up and they go into the right side of the heart and then they go to the lungs. A lot of times, those stem cells actually get stuck in the lungs.
And so, there's a conversation a lot of people have in regenerative medicine. They say, “Well, if you give people IV stem cells, they're never going to make it past the lungs because they're going to get stuck in the lungs.” So, let's say if you were trying to treat someone with dementia, there's a conversation on one side that says, “If you give the stem cells IV, they're never going to make it to the brain. They're going to get stuck in the lungs.” But it may be that that's very beneficial in this specific study. And the reason being is that when–if you remember earlier in the podcast, I was talking about–let's say I bruised my leg and there was a bunch of inflammation. The next thing that would happen is that I would have cells start to migrate out and modulate that inflammation.
And so, it may be that the stem cells are going to migrate into the tissues that are inflamed in the longest where there's an acute lung injury, and then start to try to heal that or try to modulate that inflammation. How are they going to modulate that inflammation? They may modulate it by secreting cytokines and mediators acting as medicinal signaling cells, but they may also secrete exosomes, which may also have some beneficial effects that are anti-inflammatory, as well as potentially antiviral.
I have been personally quite interested in the physiology of stem cell medicine and as a full disclosure, I actually have a company and have a long experience of using stem cells systemically, not in United States but overseas. I was quite interested when I saw this. It is obviously way too early, but I think is quite provocative as a concept. It never occurred to me to use it in a setting as grave as acute lung injury and potentially sepsis. But the fact that this trial came out and was this positive, I think it's an indication that stem cell medicine is something that we may want to think about.
I would strongly encourage people not to do umbilical cord blood or some of the regenerative things that are being offered and sold as “stem cell therapies” that I think are unproven and could do harm. And so, I think we need thoughtful leaders to help us navigate this. So, then where do we go from here? It's just going to be evolving every day. A, I think we have to learn from the past. In the past, we haven't fostered conversation. That was what happened in 1918, and there was no communication. So, I think getting communication going and getting that out there I think is important.
I think that you see I just got interrupted in my talk just to find out that something else, a new drug is working, and I think that as we watch that, I think that's going to be the primary therapy. Primary prevention is going to be isolation and preventing this from getting worse. I'm sure that there could be people who are going to be working on the vaccine side and we'll look forward to that. There was an idea that the world was for sure going to go bankrupt from polio, but then they came up with a polio vaccine. And so, I'm hopeful that technology will be helpful in overcoming this, and we have to think towards the future. Hopefully, what will happen is the side effect of that technology will have all kinds of benefits that will make us better. That would be our goal.
And so, then how do we deploy this technology and what are the appropriate stacks of things to put together? I think as you begin to now think of–there's ways to turn inflammation up and down in the body. And I brought up a couple things that could be regulators for this, but that's just the tip of the iceberg. And so, then now, it's good to know that there are supplements and my style strategies that can optimize inflammation in the body. We know that there are some provocative new kids on the block like peptides that I think are very early and may not be studied in this outbreak, but I think they're provocative and they're interesting to think about, and there is genre of helping that may be supportive to the drug-based therapies that we have and may be helpful for people who are allergic to those drugs and that don't have access to those drugs. And so, I think that's an intriguing category.
And then I would not have really anticipated this I would say a month ago, but there are some tools and strategies on the regenerative medicine side both from exosomes and stem cells that may be helpful and beneficial. And so, I guess my prayer for 2020 is that the best clinicians and scientists on the planet get together and share this information and that something good for the planet and humanity comes out of it. And so, my thoughts are with you.
Ben: Alright. Before we jump in with the second part of this podcast episode, I want to fill you in on actually kind of a cool way to increase your own heat shock protein production and enhance your immunity, and that's via the use of frequent sauna exposure. We know that heat can do everything from increased red blood cells and human growth hormone. It can be cytotoxic to many infectious cells including cancer cells. It causes a robust increase in heat shock proteins, which are fantastic for cellular resilience. We see less pain, less muscular inflammation, better skin glow from the frequent sweating effect.
And what I use to accomplish this is a morning visit to the wonderful sauna that's in my basement. It's a four-person sauna. And when it's just me in there selfishly, I can do push-ups, swing kettlebells, do flow yoga, you name it. When I have friends over, we sit in there, we burn Palo Santo and we chat and drink sparkling water and just hang out in the sauna. Rather than drinking alcohol, gather on the table, we do healthy things, then we go jump in the cold pool and it's amazing. So, what I use is the Clearlight sauna. And Clearlight saunas make near-infrared, mid-infrared, and far-infrared heat. They shield against EMF exposure. They have a lifetime warranty and they're going to give you a $500 discount off the price of any of their saunas along with free shipping, along with an extra free gift that they include with the purchase. And all you need to do to take advantage of that is go to healwithheat.com. That's healwithheat.com and use code BENGREENFIELD, and that'll get you all of the goodies along with a Clearlight sauna. The one that I use, by the way, if you want the same one I use is called the Clearlight Sanctuary.
Now, while you're in that sauna, you'll want to stay hydrated. And one of the best water websites, if you like to geek out on water and you're weird like me and you go to websites and just surf around for cool things related to water, you need to check out the Water and Wellness website. So, it is created by a former podcast guest of mine and probably the world's leading authority on all things minerals and water and water filtration. His name is Robert Slovak. And you can go to my website and search for him to hear my interview with him. He's a pioneer. He pretty much invented these countertop reverse osmosis filtration systems that you see, but he also has done things like brought in this Quinton Marine Plasma to the U.S., which has over 78 trace minerals and elements from the ocean. He's got hydrogen water tablets with extremely high PPM in terms of the amount of hydrogen that you get. I travel with those things all over the globe and a host of other really cool water filtration and water technologies on his site, Water and Wellness.
You get a 15% discount on anything from Water and Wellness. All you need to do is go to waterandwellness.com/greenfield. That's waterandwellness.com/greenfield. That'll get you access to all of the things that I personally upgrade my water with. And they have very good customer service. Everything you need is over there. And if you'd listen to my podcast with Robert Slovak, you'll really know what you're getting into when you visit their website. So, check that out at waterandwellness.com/greenfield. And then finally, remember, everything you hear in today's show you can get over at BenGreenfieldFitness.com/immune20. Alright, back to the show. We're moving on to the guys from Wild Health MD.
Matt Dawson: So, it's March 12th, the afternoon of March 12th. I think it's important to timestamp this because things are changing really quickly and we're talking today about the coronavirus COVID-19. Personally, I'm kind of tired. I was up most of the night talking to some athletes whose teammates have tested positive, some patients in New York and on the coast who potentially have the virus. And it seems like we're in a moment where things could get really bad or we could potentially contain this somewhat.
So, we want to approach this podcast in a very specific way. We want to approach it with some humility about this. We don't know what's going to happen. We do know where we are at the moment and we know what's possible, and what we can do is prepare. We're not going to try to predict anything, but we think it is time for action. So, we want to talk about this in three very specific ways. Number one, we want to talk about what do we know at the moment. Honestly, that's probably not that helpful, but it's important to note. Number two, we want to talk specifically about what you can do to protect yourself and loved ones. And number three, we want to talk specifically at the end to healthcare workers.
Mike and I split our time about 50/50 between treating patients and educating healthcare providers, and we know there are a lot to listen to this podcast, and we're going to play a big part in our success in containing this, or not, healthcare providers in general. So, we're going to tell you everything we know and give you some guidance. I do think it's important to note that you really should be listening to the CDC and the World Health Organization. I would encourage you to not be tuning into cable news as much and other sources, which may have incentives, and who don't really know what's going on on the ground, but go to those sources who you can really trust.
So, to start with what we know at this moment, Mike, what exactly is COVID-19 illness and what is the SARS-CoV-2 virus that causes it?
Mike: Yeah. Good distinction. So, COVID-19 is the illness, not the virus, it's the SARS-CoV-2 virus, which is basically a coronavirus. A coronavirus is a large family of viruses, many of which you've probably had before, Matt. They infect humans, they infect animals, and every once in a while, animal forms of the virus can sort of jump to humans. This is exactly what happened with SARS and MERS. And like SARS and MERS, COVID-19 or SARS 2 basically came from bats and is now transmissible between humans.
Matt Dawson: Yeah. And although coronaviruses are known for causing common colds, upper respiratory infections. These novel coronaviruses cause a lower respiratory infection. It's usually fever, myalgias, dry cough. The incubation period, which this is important, is usually on average about four days. It could be up to 14 days. And this is really important and challenging from a quarantine perspective because for that period of time, people could be spreading this disease and not even have symptoms. Around 20% of the patients infected progress to severe form of the illness, which can lead to ARDS, which is acute respiratory distress syndrome or cardiomyopathy. And that's why people with lung infections and heart disease are the ones at really high risk and have high mortality rates. So, let's talk about some of the epidemiology around this as well or what we do know at least at this moment.
Mike: Yeah. So, at the time of recording this podcast and in writing this down, I've had to basically cross out the number of cases and the number of deaths probably 10 times and refresh the page. For those of you that are interested in keeping up, I've been using coronavirus.jhu.edu, which is a John Hopkins interactive map, which is pretty good. Right now, there's 130,000 cases and about 4,755 deaths associated with the novel coronavirus. And it's important to note that the case fatality rate for the coronavirus, which is basically the number of people who contract the disease and then die has been reported as 3.4% by the WHO.
But if you go and look, that's pretty varied by country. So, Italy has a case fatality rate of 6%, Iran 4%, the U.S. here, we've been about 3%, and South Korea has been as low as 0.6%. The reason for that is probably all to do with the number of tests that are being performed. If you look at it, Italy hasn't been performing quite as many tests. We've been performing very, very few tests. And South Korea has been performing the most number of tests, which is probably why their case fatality rate is 0.6%. So, presumably, they're picking up more mild cases, basically. The transmissibility rate, which is important, is somewhere around 2.2, and they've been reporting about one to three. Transmissibility rate is basically the number of people that you can infect. So, the number of people you can affect with this virus is around 2.2. And that's coming from data from the first 450 patients in Wuhan.
Matt Dawson: Or not necessarily can infect, but on average —
Mike: Right. Correct.
Matt Dawson: –infect rate.
Mike: And it's also important to note that in this particular case, this virus has been worse in the elderly and quite mild in children. And we think that's probably due to some immunity that's cross over from the other coronaviruses, which we typically get when we're children. So, that immunity is lost as we become adults and we age. And when we're elderly, we're at higher of severe complications. So, that's an important aspect of this disease.
Now, I don't personally feel like any of the information that I just gave you is actually all that helpful because basically, unless you're an epidemiologist, it's just sort of relative numbers and you don't really know exactly what they mean. So, I think it's important to put this in comparison to some recent pandemics and epidemics that we've seen to see how COVID-19 compares. So, if we look at COVID-19 and we say, “Okay. There's around 130,000 total cases.” The 2009 H1N1, do you remember that, Matt? That was a big flu scare that we had in 2009. It was I think our last pandemic noted by the World Health Organization that infected, some reports say 25% of the population. The 1918 Spanish flu infected one-third of the world's population. Whereas MERS and SARS, which were epidemics, not pandemics, only infected about 2,500 and 8,400 respectively.
It's I think helpful to know how the mortality rate compares between the different infections. So, COVID-19 has got a mortality rate of, at this point, 3.4%, although we think it's likely going to be lower. A lot of experts are predicting that it'll be closer to 0.6% or 1%, which is somewhere around 10 to 20 times seasonal flu mortality. In comparison, the H1N1 virus was relatively mild. Its mortality rate was only 0.02%. So, pretty low. The 1918 Spanish flu, and this is somewhat concerning, the mortality rate for that, which is one of the worst pandemics we've ever seen, was 2.5%, which is not far off for what we're seeing with COVID-19, and I think a lot of the reason that many people are quite concerned. The group at risk for COVID-19 is definitely the elderly. Whereas with H1N1 and the Spanish flu, it was typically younger people because the elderly had previously seen those viruses. Meaning, they had had an H1N1 virus go through in somewhat previous time in their life and they developed some immunity to it. There's very little innate immunity in elderly patients at this point for COVID-19.
And then if we look at transmissibility, I think this is helpful for how likely this virus is to infect a significant amount of the world's population. Right now, the transmissibility for this virus is thought to be about 2.2. H1N1 was about 1.1 to 1.5. And Spanish flu was 1.8, which is pretty similar to the transmissibility of COVID-19. I think it's helpful to look at this data in comparison to recent history and historic pandemics because it allows us to create some comparisons. And I'll note a few of those right now.
So, COVID-19 so far has a higher mortality rate than the common flu. It's also got a higher mortality rate than H1N1 had back in 2009. COVID has a similar, slightly higher mortality rate than the 1918 Spanish flu, which killed somewhere around 50 million people. But it is less than MERS or SARS mortality rates, but obviously much bigger pandemic. And it's got a slightly higher transmissibility rate than the seasonal flu. You combine all these findings with the fact that we can barely test for the disease and have limited knowledge on who to quarantine. I mean, to be honest, Matt, I'm fairly concerned. I'm not trying to be alarmist here, but I think the question of, “Is this going to be a big deal or not?” has been answered. I think the question now is when is it going to be a big deal and what are we going to do to mitigate the damage.
Matt Dawson: Yeah. And those numbers are I think difficult for a lot of people to really interpret, but a really nice summary I recently read by an epidemiologist who I trust is that without any containment measures, this virus, in general, would double about every six days the number of cases in the world. And without any containment measure from when it started, we would be at about a million cases right now, and that by the end of April, there would have been over 250 million. So, some of the containment efforts that are happening in other countries are having an impact if you think about where we are right now compared to where we could be. But there's more we can do. And again, we're not trying to be alarmist, but these are concerning facts.
You talked about the lack of testing earlier, and there were definitely some issues with adequate testing kits early on, but it's important to note that that's changing. Both Quest and LabCorp now to the labs that we use personally, they've released and now have a private lab tests that can be used to detect the virus. It's a nasal swab. It uses PCR to search for portions of the viral genome, and it's got about a 24-hour turnaround. So, not as good as the rapid tests we have with the flu that can be done in the office, but at least more available than testing was. And this is going to be evolving over time and somewhat rapidly. We're emailing with LabCorp actually today and working on ways to send tests directly to people's houses that they can then send in, which would be really great because there would be no exposure to others, there would be no exposure to healthcare facilities. If someone didn't have the virus, then you don't really want to risk going into the emergency department and somewhere and actually catching it as well.
So, that's going to be an evolving situation, so watch. We're going to be updating our website with our testing kind of protocols and what we're finding. We're also going to be doing probably a weekly podcast with just updates in general as well on the Wild Health Podcast. But again, follow the World Health Organization and the CDC when it comes to testing and talk to your doctor to see what's available if you start to have some symptoms.
Mike: And I think we should probably talk a little bit about what you can do to prevent from getting the virus. And I think probably the most important thing is like standard hygiene. I mean, everybody's talking about this now, wash your hands, wash your hands, and that's totally true. I mean, wash your hands, don't touch your face. But I think something that's not necessarily being performed as readily as it should be is avoiding public contact. So, this concept of sort of self-quarantine. The idea of social isolation I think is really important. Traditionally, social isolation has been required by the government and it's been shown to be extremely successful. So, in the Spanish flu in 1918, there was a mandated closure basically of St. Louis. So, all public places were closed in St. Louis at the exact same time. In Philadelphia, they had a giant public gathering of about 200,000 people. And later that week, there were over 4,500 dead in Philadelphia due to the Spanish flu. While through the entire pandemic, St. Louis only lost about half of the mortality of Philadelphia.
So, we've seen this time and time again and it's this concept of what's called flattening the curve. If you create social isolation, then instead of having a big spike in case transmission and deaths, you can flatten out the curve and extend out and basically prolong the pandemic. The reason that's important is because if there's a giant spike, especially in the United States, we're going to overwhelm the healthcare system. It's almost impossible to admit patients to the hospital already. How are we going to do it in the middle of a giant pandemic? So, this concept of flattening out the curve allows the healthcare system to tolerate the influx of disease without overwhelming it, and it's a really important concept that's going to require either personal decisions to not go out and be in public, or it's going to require the government to step in and say, “Look, we're going to stop these things.”
And we've seen this happen already. I mean, just 30 minutes before we started recording this, Oregon announced that they're basically banning any public gatherings greater than 250 people for the next four weeks. The NBA just shut down the season. So, people are doing this, but I don't think–I mean, personally, it probably needed to be happening a little bit sooner and people need to be making the personal decision to do it even if their local community isn't enforcing it.
Matt Dawson: Yeah. And this flattening the curve, I think that's talked about a lot, but I don't know if people really understand. So, just to put some numbers on it, because I think that helps me understand it better, some people are estimating. They say, “What if 50% of the population get this?” Which is an estimate of a lot of a leading epidemiologist right now. Well, let's say 100 million people in the U.S., that is. If the mortality rate is 1%, that's a million deaths, but the critically ill is going to be a really high number, maybe 20%. So, that 20%, 20 million people, if we're taking care of that many critically ill people over the course of a month or two months, we're going to be completely overwhelmed, and that mortality rate is going to be higher just because we don't have the physicians, the facilities, and the supplies to take care of them.
Whereas even if we have the exact same number of people infected, but it's spread out over six to nine-month period, then we may not reach the limits of our medical capabilities. So, that's why that flattening is important. And just to be clear, this isn't the Spanish flu, but that anecdote really makes a point about these large gatherings. I do think the NBA and the other leagues are doing the right thing. And when it comes to containment, we really have to make some difficult decisions. I mean, there's economic impact to canceling the NBA season, to canceling other things, but it's time to make those tough decisions.
I mean, just for an example, we have a conference coming up with Ben and two weeks from now at the castle, and we don't feel good about gathering people together, and just in the last two hours based on the information we have, we decided we need to not gather people together. We do think it's important that we continue to get information out and educate the public and stay connected, but not physically connected. So, we're actually going to turn our conference into a virtual conference, and that's a possibility. If you're leading medical conference and you could do this virtually, do that. People are still going to get the education just not going to get the exposure.
So, our conference is going to be a virtual conference. If you're planning on attending that, we are probably going to adjust it somewhat to have a little more COVID-19 coverage, just kind of some breaking information. And how much we adjust from the genomics to that, we're going to kind of figure out over the next couple weeks. But we think other people need to be doing this as well. Don't think about just the economic impact and the impact on yourself, but this is a concerted effort we all have to make together if we really want to get on top of this. And for you personally, if you're not making decisions of whether to cancel conferences or sporting events, there's a lot of things you can do to kind of protect yourself.
There are no FDA approved treatments, so we're not going to talk about that. There are some things that may work, but really just focusing on your immunity. There's a really low-cost thing that you can do and the externalities of that are all positive. If you focus on your immunity and your health and nothing happens, then great, you're healthier. So, just basic things that feel silly to even talk about them, but we have to talk about them because they're critically important. Like eating a better diet, there's no better time to clean up your diet if you're overweight. We know in China, the mortality rate was really high, and one of the reasons people talk about is because of the really high rates of smoking. So, some people I've heard say, “Well, America is not going to be that bad because our rates of smoking aren't as bad.”
Well, we do have an incredible amount of obesity. We don't know exactly how big of a role obesity will play, but we think it's going to play a pretty big role. So, never been a better time to lose weight and get in shape. Sleep, it's kind of hard to tell people to get more sleep when there's this much worry around this, but I don't know if there's anything that's really going to have as much of an impact on your immunity than sleep. So, really focusing on that, not staying up all night reading the latest news because you're worried. That's going to make a big impact. So, try to get sleep, really optimize your sleep, work on that. If you're working from home or you have more time on your hands because things are canceled, well, design your bedroom to get better sleep. Focus on those things that you can do now because there's plenty you can do. And exercise. Exercise I think is an interesting one talking to this crowd, kind of the Ben Greenfield Fitness crowd.
I think of exercise a little bit differently. Most of you are probably already fitness fanatics and you're working out pretty hard. Personally, I have cut back my workouts. The way I'm thinking about this is the same way I would have thought about an Ironman race that I was training for. I've been training really hard, and then you taper when it comes time for the competition. I'm looking at this next month or two in this season that we're going into as a competition. I'm not going to be overreaching, I'm not going to be pushing myself because my immunity will actually be slightly lower when I'm training really hard. So, movement, staying in shape but not overdoing it will be important when you think about exercise.
Mike: And I think those are all great points, Matt. I mean, just to put a personal note on it, I mean, things that I have personally been doing are I've been increasing my green smoothies. So, making sure I get one of those in a day just for all the micronutrient content. Really focusing on sleep, making smart decisions, which I try to do anyway, but really focusing on it. And then for my exercise, I've really dialed back the hit and I'm focusing mostly on Zone 2 work because I really want the biggest immunity boost I can get, and I want as much mitochondrial biogenesis as I can get so I can really energize my immune cells.
Matt Dawson: Yeah. It's a good point you make about the smoothies, too. Personally, I have four kids. So, their morning breakfast, I'm making them smoothies now and that's a way for me to get in the vitamin C, the vitamin D, maybe the olive oil, olive leaf extract, and all those things, which they probably wouldn't take, otherwise. So, little things like that can make a difference. That's a good segue I guess to talk about some supplements that maybe helpful as well.
Mike: Yeah. I mean, I think most of the people in this audience are probably already doing the lifestyle interventions that we're discussing, but there are a few other things that you can put in your body through supplements that can potentially increase your immunity and help boost your immune system. So, let's talk about a few of these. Vitamin D, it's critical for immune system function, necessary for a genomic transcription. It's required for immune cells to create an innate response to an acute infection. There's been several large studies over 20,000 people and have shown that vitamin D levels less than 30 are associated with more regular infections.
A recent well-designed perspective study was double-blind placebo-controlled trial showed that vitamin D supplementation resulted in a 42% decrease in the incidence of influenza infection. I mean, I think if you don't know what your vitamin D level is, right now, it's probably the time to push it up a little bit. We shoot for 50 in our patients and I think you definitely wanted above 30. So, if you haven't had this tested recently, I think that there's very low risk to taking 5,000 to 10,000 IUs of vitamin D daily. But realistically, you should get your vitamin D checked stat and know exactly what it is so that you can optimize it.
Matt Dawson: Yeah. And just to be super clear, we're not saying taking vitamin D is going to prevent you getting this illness, but we're going to talk about all the little things which you could do, which there may be some benefit that don't have a high cost to them like zinc. Zinc deficiency we know is associated with immune dysfunction, including some pro-inflammatory cytokines, atrophy to thymus, reduction in T regulatory cells. So, personally, I started taking a zinc supplement, which I wasn't in the past. So, about 15 to 30 milligrams per day, depending on how much you sweat and exercise, higher doses if you're really exercising quite a bit. That's going to be one that's going to be a low-cost thing that you can do.
Mike: Another one that I just started recently is olive leaf extract. It's got antioxidant immune-enhancing properties, helps maintain a healthy balance of cytokines in the body. Cytokines are these proteins that are secreted by cells of the immune system and they act like chemical messengers. So, they basically help regulate the body's immune response and inflammatory response. There was actually a recent study in young athletes that showed a reduction in sick days and severity of illness by 28%. So, this one might not necessarily prevent infection as much although it probably does help to some degree, but it'll likely help sort of decrease the severity of the infection and the length of the infection.
Matt Dawson: Yeah. Mushroom extracts, that's another one. Anyone that knows me knows I'm a big fan of mushrooms in general. Mushroom extract can increase macrophage and a natural killer cell activity, as well as some other immune signaling, cordyceps, reishi, maitake, all those stimulate immune cells. Cordyceps, shiitake, those have some kind of protective activity against some harmful microorganisms as well. So, you can eat mushrooms, regulate, or you can just take some mixtures. There's quite a few mushroom extracts on the market. I like the Four Sigmatic mushroom extracts, Chaga, lion's mane, reishi, cordyceps. They've got a lot of really great products as well.
Mike: I know, I saw recently Ben mentioned on his Instagram that he's been taking a large dose vitamin C, which I think is extremely low risk. I think the data has been a bit mixed in the past. There are some newer studies that have come out that have suggested there is an immune boost to it. Whatever you don't use, you basically pee out. So, it's fairly cheap and I think it's extremely low risk to add that into the equation as well.
Matt Dawson: Yeah. And there's some more advanced things like peptides. We've talked about peptides quite a bit in the past. And again, these are some things that aren't as inexpensive and cheap and the things that haven't been studied this long. So, maybe a little more risk associated, but I'm going to just mention them. And again, we're not recommending anyone take these, we're not saying that it treats the virus, but to be honest, these are things that I'm doing for myself, so I feel like I should least mention them.
So, thymosin alpha, this is a peptide that stimulates the immune system and decreases inflammation. It's been shown in the lab to also inhibit viral replication. It's been used in some human clinical trials against viral infections as well. Right now, what I'm doing with this is twice-weekly dosing since there is some community spread. Another one that probably has less data on it but I should mention is LL-37. This has been shown to be effective in preventing viral attachment to sales. So, it's been used in some viral studies and there's some anecdotal reports that it works well with respiratory tract viruses. This is something that could be dosed once you have an infection.
There's one called pentosan polyphosphate. This is really an injection for joints in the past, but it's been shown to inhibit some viral absorption into sales. This is something that you do twice a week if you had signs of infection. And then Selank, which is a nootropic that I've used for our patients before, usually, actually patients with some anxiety. It has some interesting effects, but it's a variant of an immune molecule, which have been shown to reduce viral titers, viruses like influenza. So, again, these are really on the fringe and experimental, and I'm not saying this is a treatment for this, but again it's things that I am stalking and have on hand and I'm using it, and I'm ready to use if I get symptoms.
And then there's also some other supplements that we personally put together a packet of suggestions for our patients. We'll share that with Ben so he could put it on the website as well. One that I'm really following right now closely is quercetin. There was a really interesting study going on right now, a group out of Montreal. I think it was a Canadian group and they're actually doing a study in China right now that has some really interesting effects. And there's also a gist. Last night, someone sent me four brand-new papers. They're coming out from Italy actually showing quercetin's activity against several different types of viruses, potentially, this one as well. And again, these are not studies that have been peer-reviewed. They're not big studies yet, but I want to mention it. I mean, I saw these studies and I've only read two out of four so far, but it's been enough that I've actually ordered and started taking quercetin as well. I had a little bit at the house, I took some this morning, and I've ordered more because the data was really compelling to me.
Mike: Yeah. I mean, I think when you're faced with a novel virus-like this where we don't have good treatments, you're stuck sometimes on the fringe. And I think that's just the reality. I mean, in medicine, we're seeing that right now. Physicians are in ICUs who are using remdesivir, which is a drug that was created for Ebola a few years ago that previously didn't have any other real home, and finding there might be some benefit from it. So, I mean, people, even in the medical community in the most traditional setting are having to look to the French for answers here. So, I don't think that's unreasonable.
Now, what about once you do start feeling ill, what do you think that we should be telling the listeners to do? Because I'm sure a lot of them have that question. Should I get tested? Where do I go to get tested? Do I go to the ER?
Matt Dawson: Yeah. And again, we should be following CDC or World Health Organization guidelines, but I'll tell you what we're telling our patients right now. It's good to talk through the risk. So, if someone has a fever, they start feeling symptoms, what are your options? If you do go to a healthcare facility, number one, you risk infecting others. Number two, if you just have the common cold, then you risk maybe catching something. So, there are risks to going in. What are the benefits for going in? The benefit is if there is an intervention that can be done for you that couldn't be done at home, then there's the benefit.
But for most of us, honestly, those of us that are listening to this that are young and healthy, we're going to do really well. And I think most people in our situation would probably be best served at home. And that's hard to tell people though to stay at home. So, I think there's a better option, and it's really telemedicine. This is the time for telemedicine. If you're one of our patients, that's what we're doing. We're talking over the phone or video first and helping you decide when and if you should go in. So, right now, you should check with your doctor, see if they have that capability. If your doctor's office doesn't, you should ask them to. If you are a doctor's office, you should really start thinking about using this. You can always talk to patients on the phone. You can check with your legal about some of the off-the-shelf modalities that are acceptable when it comes to HIPAA compliance like FaceTime, Microsoft Teams, or some other programs that you could quickly and easily implement, but this is really a time for telemedicine to shine. I mean, is a physician exam important? Is it important to do a physical exam? It is important in general, but it's probably even more important to not spread this disease. You shouldn't go into medical care unless there's an intervention that you'll need. And if you're not sure, then talk to your doctor before going in. I think that —
Mike: Well, I mean, what are you going to get from the physical exam? I mean, you're going to get hypoxia, which is probably important, right? You're going to get crackles in the lungs from the bilateral pneumonia. And realistically, some of that stuff can be obtained remotely now. Recently, we had a conversation with Mike Stone about how he's been doing teleultrasound, looking at the lungs to diagnose viral pneumonia.
Matt Dawson: Yeah. And I mean, there's two physicians who have seen thousands of viral cases. Mike, when was the last time that your physical exam really helped you make a decision in a viral patient? I mean, it's pretty rare to be honest not to make light of it, but this is a perfect opportunity for telemedicine. Yeah. Mike Stone just told me about two patients yesterday that he did teleultrasound. These were unique cases. These patients actually had ultrasound for some reason. They had a portable device. The one they had was called a Butterfly device. And he was actually able to walk them through. It's something that plugs into your iPhone and they all [02:17:23] ______ lungs.
And there are some actual very specific findings potentially for this. And I've actually asked Mike to–we're going to do a podcast with him and release it on the Wild Health Podcast for physicians. This won't be interesting to you if you're the patient probably, but for physicians, if we talk about testing, obviously, we're talking about the swab, but there are other testings as well in China right now that seems like they're CTing a large number of patients. And there's some findings on CT, but there's massive problems with that. If we started doing that in the U.S., one, it seems like it's not really going to lead to any extra interventions when you really look at what do you do according to the findings on CT exam.
Mike: They're using it for diagnosis, which is insane to me because you're talking about all the people you'd have to run through the CT scanner and you would have to terminally clean that CT every single time, which in the United States, takes like an hour. You can't do that. That's impossible.
Matt Dawson: Exactly. And that's the problem, yeah. And we should talk about specific population, too. So, for example, if you're home and you think you have this, that's one thing. But what if your child, what if you're worried about your child having this, what should you do? I tell you, personally with four children, I'm going to be very hesitant to go in to take my kids into an office. Number one, because the severity seems to be very low in kids. They do really well with this, which is great. On the other hand, some people are saying, “Why are we closing schools? Because kids do really well at this.”
So, it's not about necessarily the kids getting sick. Some people were looking at kids as a potential vector for this. If they don't really have many symptoms, if the kids are running around, if you're taking them out and getting them checked on, they may be able to spread it to others even when they have very mild symptoms. In Kentucky, where I'm at, we've declared a state of emergency. The first case, there's diagnosed, I heard about, and the next day I found out it was a 27-year-old, and that honestly really scared me because the problem with someone that young and healthy getting it is they could be passing it along for a long time before they even know they have symptoms. So, closing the schools, keeping kids at home is probably going to be an important public health issue as well, even though you're not necessarily worried about the kid, it's what the kid does and grandma or grandpa who is then affected that we got to think about.
Mike: I think it's important to mention that while 80% of people who contract COVID-19 are going to have a mild case of it, there is a percentage that's going to have a severe case. Somewhere around 14% are going to need to be hospitalized for mild interventions like just oxygen through a nasal cannula, and up to 6% are going to have to get admitted to the ICU and are going to have real severe disease. So, while if you've got a mild case of it, sure. Social isolation and self-quarantine makes a ton of sense. If you're starting to feel severely sick though, if you're getting short of breath, if you're having any blueness in your lips or in your fingers, if the illness just feels like it's taking hold of you, you do eventually have to go in because there are interventions in the hospital that are extremely necessary. So, while we're encouraging people to self-isolate and self-quarantine, if they've got mild disease, if it is severe disease, you really do have to go in and get checked out.
Matt Dawson: Yeah. Young healthy people may not even need to get tested, but there are some people who should get tested. For example, if you are a physician or a healthcare worker and you're going to self-quarantine at home, you're probably making a tough decision. Do I go in to help? Especially if the system is kind of taxed already. And in those situations, it's probably important to do some testing, so you know whether you're better off at home not spreading it or whether you can go in and help as well. So, it's going to be an individual decision whether we test or not. But speaking of that, we probably should talk to healthcare providers for a little bit about some dos and don'ts and —
Mike: Yeah. I think that probably the first thing to remember is to have appropriate personal protective gear, and that is becoming more and more challenging because as we know, there's a nationwide shortage in N95 masks and other devices to keep providers safe in exposure environments. So, probably the first thing that every healthcare worker should do is sort of understand what their access is to appropriate masking and appropriate gowns, eyewear, and then understand how to put it on and off, what we call donning and doffing because that is the place in the past where providers have infected themselves is when they're taking off their gear after they see a patient. CDC has some great videos on this on how to adequately do this without actually getting yourself infected. It requires a second person, which sounds crazy. So, it's almost like a dance between the two providers. But this is something that you should absolutely watch before your next shift or the next time you're inpatient care.
Matt Dawson: Yeah. And I think about healthcare workers and providers in two different groups. There's the out in the community, the primary care providers, and for those people I think really focusing on telemedicine and getting good at that, and helping your patients that way is going to be critical. For those of us who are intensivists, Mike and I come from the emergency department, then for us, there are some specific things. Like Mike said, the very first thing is that protect yourself. You're no good to anyone if you don't protect yourself when you're taking care of patients. When you do get a patient in who has some of these symptoms, the number one thing is to isolate them, prevent them from getting other people infected. This is a respiratory illness. So, some things that we may not necessarily think about until it's too late, so we're going to tell you about is if someone has respiratory condition, one of the first things you do in the emergency department frequently is give them some albuterol or breathing treatment. You shouldn't be nebulizing that. If you give them a nebulized treatment, you're going to be spreading that around.
There's a study that just came out. It hasn't been peer-reviewed yet, but I just read it this morning about how this can actually be transmitted through the air and linger in the air for several hours. So, we really don't want to be spreading this in the air in emergency department. If someone needs a breathing treatment, there's good evidence, there's just an MDI. So, just an inhaler that someone would have. It's probably just as good. And it seems like these patients are progressing somewhat quickly and a lot are needing intubation. So, probably if they're going to need intubation, you may as well intubate early because once they're intubated, there's less aerosolized spread and they're not going to be spreading it around quite as much.
So, don't nebulize, use an MDI with spacer, intubate early, at the same time not too early. I mean, our system may get taxed when it comes to ventilators, but if you're an experienced clinician and you know someone's going to need to be intubated, intubate sooner rather than later. And then how you intubate, that's going to be really important. A lot of us in the emergency department, we use high flow nasal oxygen to give us a little more time, or what's called apneic oxygenation during an intubation. You really shouldn't be doing that. That's going to spread aerosolized particles.
If you are intubating as a physician, you definitely need full protective gear. You need a facemask, complete PPE, and use video laryngoscopy so that you're not right in someone's face. Then put filter on the vents and really take care to not spread this even more. And not get yourself at a high-risk situation you're going into. And Mike mentioned N95s. I would say shave your facial hair if you're a provider right now. I mean, it's going to grow back. Your N95 needs to work. I would just do that right now. It's an easy thing that you can do to protect yourself a little better.
Mike: And Matt and I have been talking to some providers on the frontlines and some of the areas of the country where things are a little more grim and there's more exposure and more cases, more mortality. And they've had some interesting insights that I thought we should share as well. Those are that a lot of these patients are presenting with a basically normal white blood cell count, which is in the number of immune cells in your serum. They're also showing that they've got a normal procalcitonin, which is another test that we use sometimes for acute bacterial infections. And they have also noticed that the patients who present initially with elevated liver function tests often are the ones that progress more quickly and end up needing to go to the ICU. So, those are potentially the patients that you need to keep a closer eye on.
They've also noticed that the progression of the illness to the severe illness seems to be happening a bit later in the course. So, somewhere around that 7 to 10-day range. So, people will often start with sort of a mild upper respiratory tract infection, progresses to a lower respiratory tract infection. Then over the course of a week, progresses to the more severe illness where they start getting the inflammation and the acute respiratory distress syndrome or the ARDS. They've also noticed that the ARDS cases are not quite as bad, and a lot of times, the patients will actually recover from the ARDS, and then it'll actually be the dilated cardiomyopathy that gets them in the end. A cardiomyopathy is where your heart stops squeezing as well, basically. So, it doesn't squeeze as well as it normally does your ejection fraction, which is an estimate of how well your heart is performing decreases severely, and then patients end up dying of basically cardiogenic shock. So, this seems to happen later in the disease course, which I think is extremely important for treatment on the frontlines.
Matt Dawson: It is important to talk about the breakdown of ages and who gets this. I'm recording this right now from a nursing home where I'm actually visiting a patient who this morning went to a doctor's appointment, and I basically told her when she got back, “Don't go to any more routine doctor appointments until this has passed. Stay in your house and unless you're really sick, don't come in.” Because the mortality rate for those that are over 80 may be 15% to 20%, especially if you have some respiratory illness and some heart conditions to go along with that. So, we really need to protect our elderly and take really extreme precautions with them because those are the ones that are most vulnerable.
Mike: I think it's also important to mention how good our current test is. And the true answer to that is we don't know. We really don't know how good the PCR test that is currently available through the CDC, LabCorp, and Quest. We don't know how well that's actually performing. It could be as low as 75% sensitive, meaning that you're 75% likely to have a positive result if you have the disease. And that's not great. So, I think it's important to remind our providers that if the clinical suspicion is high, patients may need to remain in isolation despite initial negative testing. And there might be also a false positive rate as well. So, really testing people with who you have–a fairly high pretest probability of the disease is probably important in the first place. So, there's just so much to learn right now, Matt. It's hard to give definitive answers. I don't think we have to proceed with caution in so many realms of treating this disease right now.
Matt Dawson: Yeah. And it's also important not to be just all negative with this. Just to give you a little bit of hope, there was a Hong Kong group that recently published their experience with this and they had 1,200 people come through to get testing, really high-risk folks, 43 of those were positive. But what I really liked about this study is that they use great personal protective equipment, the providers, and they had zero cases of healthcare providers catching this. So, in conclusion, I mean, I think what I would say to people is in general, be prepared. We're going to send Ben the supplement recommendations that we have for our patients. We're also going to send the peptide review that we talked about.
And our thoughts on this are going to change daily. Like I mentioned to you earlier, I've gotten four [02:29:35] ______ interviews and I only get to read two of them. So, we have an inbox full of information from colleagues [02:29:41] ______. We'll be talking to people like LabCorp about testing. So, we're going to do actually a weekly podcast going forward just kind of summarizing our findings in the near future from the frontlines what we're seeing. But again, follow the CDC, the World Health Organization. That's where you're going to get the best info. And if you're a healthcare worker, I would really like to conclude with some encouragement. The Hong Kong study, remember that, like we can make a big difference without really putting ourselves at risk if we're just prudent about this. This is what you were trained for. Obviously, just go to work, help people. That's why you decided to become a nurse, a doctor, a paramedic, a tech or whatever other medical professional you are. We need you right now, so be safe, be cautious, but be courageous. And we want to thank you all for listening.
Ben: Well, thanks for listening to today's show. You can grab all the shownotes, the resources, pretty much everything that I mentioned over at BenGreenfieldFitness.com, along with plenty of other goodies from me, including the highly helpful “Ben Recommends” page, which is a list of pretty much everything that I've ever recommended for hormone, sleep, digestion, fat loss, performance, and plenty more. Please, also, know that all the links, all the promo codes, that I mentioned during this and every episode, helped to make this podcast happen and to generate income that enables me to keep bringing you this content every single week. When you listen in, be sure to use the links in the shownotes, use the promo codes that I generate, because that helps to float this thing and keep it coming to you each and every week.
In last week's post entitled “Three Little Known, Unconventional Antiviral Approaches For Boosting Your Immune System,” I shared some tips on how to improve your immune system via fully comprehensive, novel, and alternative health strategies—strategies that often go beyond simple pharmaceutical pill-popping or conventional medicine (similar to my previous posts on issues I've personally dealt with in the past, such as MRSA, and Giardia). In that article, I dove into natural ways I've been strengthening my immune system for my hefty amount of airline travel, even in the face of recent viral outbreaks that have made me have to be even more careful and thorough in my approach.
Two friends of mine, Drs. Matthew Cook and Matthew Dawson, are true experts in the realms of functional and precision medicine, and both were kind enough to offer me their advice when it comes to boosting immunity and fighting viruses. I've included their audio in this podcast for your listening and learning pleasure.
My first guest, Dr. Matthew Cook, has been on the following podcasts:
- Killing Mold & Mycotoxins For Good, The Craziest IVs You Can Get For Energy, Fixing Knees & Back Without Surgery & Much More.
- Immortal Cells, Biohacking Pain, Killing Lyme, Stem Cell Confusion, How Ketamine Works & Much More
- What You Didn’t Know About CBD & THC, Fixing Lyme Disease, The Full Body Blood Change Reboot, Peptides 101, Hyperthermia & Much More
Dr. Cook founded BioReset Medical Corporation and, as acting President, operates a regenerative and pain medicine practice that offers leading-edge non-surgical solutions in orthopedic medicine, sports medicine, regenerative pain medicine, and stem cell medicine.
He is a board-certified anesthesiologist with over 20 years of experience in medical practice. Currently, Dr. Cook is president of California Anesthesia and medical director of the National Surgery Center, Los Gatos, CA.
In addition, he sits on the scientific advisory board of several high profile medical companies including BM Doc, FREmedica & Vasper Systems. Dr. Cook’s early career as an anesthesiologist and medical director of an outpatient surgery center that specializes in sports medicine and orthopedic procedures provided invaluable training in the skills that are needed to become a leader in the emerging fields of musculoskeletal ultrasound imaging, nerve hydrodissection, and stem cell medicine.
My second pair of guests, Drs Matt Dawson and Michael Mallin of WildHealthMD, have been on the following podcasts:
- How To Use Precision Medicine To Enhance Athletic Performance, Defy Aging, Balance Hormones, Fix The Heart & Much More.
- Why Your DNA Is Worthless (& What You Need To Focus On Instead)
- CBD & Cannabis Special Episode: How CBD Affects Hormones, Fat Loss, Athletic Performance, Sleep, Recovery & Much More
Dr. Matt Dawson is a precision medicine physician in Lexington, KY, co-host of the Wild Health Podcast, and has been obsessed with performance optimization as long as he can remember. He received scholarships to play two sports in college even with “minimal talent” because of his voracious reading and implementation of any fitness or nutritional techniques that would give him an edge. Dr. Dawson continued that obsession in medical school, and as a physician, he has won national awards for education, innovation, and leadership. He has lectured in over 20 countries and trained thousands of other physicians through live lectures, online education, two textbooks, and an educational app.
Dr. Dawson combines his training in genomics and functional medicine to give personalized, precise medical guidance. His obsession with performance optimization has morphed from, initially athletic, to now mental performance and longevity. Whether it's a professional athlete or a grandparent optimizing their mental clarity and mobility to keep up with their grandkids, Dr. Dawson is passionate about helping everyone perform at their absolute peak.
Dr. Michael Mallin is a physician in Bend, OR who is obsessed with health performance and precision medicine and is co-founder of the Wild Health Podcast. He completed medical school in South Carolina and trained in Emergency Medicine in Salt Lake City, UT where he competed in several ultramarathons and found his love for the mountains and performance.
Dr. Mallin currently practices in Bend, OR and Lexington, KY in his precision medicine clinics. He is also co-founder of the Ultrasound Podcast, an educational podcast that has taught thousands of physicians all over the world how to use ultrasound.
During this podcast, you'll discover:
Part 1 with Dr. Matt Cook of BioReset Medical
-Dr. Cook's history with virology…7:10
- Studied feline immunodeficiency virus, a model for HIV
- Anesthesiologist with an interesting approach to pain management
- Began to successfully treat patients with complex illnesses
- Many patients have viral infections, chronic illnesses with a viral overlight
-A brief history of viral epidemics…9:08
- Influenza pandemic from 1918-1920 (Spanish flu) infected over 500 million people worldwide; 17-50 million people died
- Fear of affecting morale of WWI soldiers; publicity was censored in Germany, U.S., U.K.
- The virus created an extreme inflammatory response
- Young people were especially susceptible
- SARS and MERS occurred more recently
- Both respiratory viruses
- Mortality rate from SARS was 9.6%; MERS was 34.4%
- Current mortality rate of COVID-19 is unclear right now
- Pattern of viral infections that create an exaggerated response, particularly in the lungs
- 3 categories of patients:
- 80% will get the virus and recover with no complications
- Patients with preexisting conditions are at greater risk
- Healthy patients get a viral infection, have an overreactive immune response
-What a “coronavirus” is…15:00
- Viruses are extremely small
- Cold climates are ideal for viruses; they are very rare in tropical climates
- How are viruses transmitted?
- Respiratory droplets and other bodily fluids
- Stringent approach to maintaining cleanliness for prevention and treatment
- Pneumonia, fever, cough, shortness of breath; affects both lungs
- Symptoms can be in GI tract, low white blood cell counts
- Most common symptoms: fever, dry cough, tiredness; often there are no symptoms
- Most common complication is pneumonia
- Best practices for avoiding the virus:
- Avoid traveling to infected places
- Careful hand washing
- Avoid touching T zones
- Avoid crowded areas
- Keep your living area clean
- Majority of cases are relatively mild
- Small number can have complex problems
- Common symptoms:
- Muscle pain
- Shortness of breath
-What the cytokine storm is…22:30
- Primary target is the respiratory system
- Virus can't replicate itself without getting into a cell
- Body responds by making chemical messengers to create inflammatory response to fight the virus
- Inflammatory process is out of control; doesn't take effect
- Best known inflammatory cytokine is tumor necrosis factor A (TNF-A)
- Turns on other cytokines, promote an exaggerated inflammatory response
- Factors that drive the cytokine storm:
- Nuclear factor-kappa beta (nuclear factor kappa bad)
- Block nuclear factor kappa beta, turn on NrF2 (helps modulate inflammatory response to a stress)
- Status of testing:
- Quest diagnostics will offer a test for the current viral outbreak
- Gates Foundation working on an at-home test
- How to treat influenza:
- Hand-washing is one of the greatest medical concepts of our time
- Patients with mild illnesses can self-quarantine
-Treatment options for viruses…33:45
- Most important factor is containment
- Improve your hygiene
- A great job done with the 80% of mild cases gives hope that it will be beat
- Steroids have done more harm than good in the past
- Be aware of anti-viral medications
- NAC (antiviral effects)
- Vitamin C
- Plant-derived antioxidants with antiviral effects
- Upregulate NrF2
- Ozone therapy may be an activator
-A functional medicine approach to wellness…40:18
- Plato: “The part can never be well unless the whole is well”
- Systems approach is the best way to improve immune system
- Immune system is centered in the gut
- Problems come with age because diversity in microbiome goes down
- SIBO leads to leaky gut
- Difficulties in fighting chronic illness is due to multiple systems in the body dysfunctioning
- Increasing overall wellness provides the best defense against viruses
- Effective supplements for immune system wellness:
- Vitamin C administered intravenously
- Vitamin D (pro-survival molecule) helps dampen chronic reactions
- Curcumin and quercetin has been found to inhibit kappa b
- Probiotics may balance the GI tract
- X-Viromin Apex Energetics
- Life Extensions Zinc Lozenges
- Quercetin Vitamin C combo
- Vitamin A helpful to immune system, Vitamin D offsets some of the toxicity (cod liver oil)
- Quicksilver “The One”
- Apex Energetics Turmero
- NAD Gold from Quicksilver
- Royal jelly
- Raw honey
- Oleuropein (derivative of olive leaf)
-What ozone therapy is…1:06:35
- Used by naturopaths and more and more doctors
- Nikola Tesla patented first ozone generator in 1896
- Ozone has antiviral, anti-fungal, antiparasitic effects
- Stimulates NrF2
- Decreases cytokines
- Ozone is an oxidative therapy (helpful used with anti-oxidative treatments)
- Ozone can oxidize sulfhydryl groups on the virus (may block ability of the virus to get into the cell)
- “Oxidative preconditioning”
- Pretreatment with ozone could be beneficial before exposure to a chronic infection
- How is it administered:
- Ozone generator
- Ozone enema
- Sauna treatment
- Mix with blood, reinsert into body
- Ozone dialysis
- Proponents of ozone therapy:
- Frank Schallenberger, world's foremost authority on ozone therapy
- Johann Lahodny (high dose ozone therapy)
- Robert Rowen
- Longevity ozone generators
-How exosomes affect the immune system…1:28:30
- Exosomes are the secretion of stem cells
- The person who invented the term “stem cell” changed it to “medicinal signaling cell”
- Exosomes have TGF beta
- Patients with COPD have had exosome treatments
- Can be administered via IV or nebulizer
- Trial: Stem cells grown in a lab given to patients with the current virus
Part 2 with Drs. Dawson and Mallin of Wild Health…1:48:12
-What we know about COVID-19 at the time of recording (12 March 2020)…1:50:00
- COVID-19 is the illnessnot the virus (SARS 2)
- COVID-2 is the virus
- “Coronavirus” is a family of viruses
- Lower respiratory health is affected
- Virus is spread without feeling symptoms
- Johns Hopkins Coronavirus Resource Center
- Case fatality rate reported as 3.4%; varies by country
- Transmissibility rate is the number of people you'll infect on average (2.2 currently)
- Worse on the elderly, mild on children
- The data is changing by the hour
-How COVID-19 compares with pandemics from the past…1:53:47
- 2009 H1N1 infected 25% of global population
- 1918 Spanish flu infected 1/3 of the pop.
- Mortality rate of COVID-19 is 3.4% currently; predicted to be lower
- H1N1 was very low
- Spanish flu was the highest mortality rate on record
- COVID-19 has a higher mortality rate than common flu and H1N1
- Higher mortality rate than Spanish flu currently
- It's difficult to test for COVID-19, knowledge of how to quarantine
- It's not ifit will be a big deal; it will be a big deal
- Exponential growth: Without containment measures, the virus would double every 6 days
- How to test for COVID-19
- Quest Diagnostics
- Lab Corp
- Send in tests to avoid exposure to infected people
- Watch Wild Healthwebsite for updates
-How to improve your immune system…1:59:03
- Standard hygiene
- Wash hands
- Don't touch face
- Avoid public contact (self-quarantine)
- Flatten out the curve
- Government interventions (St. Louis vs. Philadelphia with the Spanish flu)
- No approved FDA treatments currently
- No better time to clean up your diet
- Smoking and obesity is a factor for mortality
- Get more and better sleep
- Exercise without overdoing it
- Green smoothies
- Vitamin D
- Olive leaf extract
- Four Sigmatic mushroom extract
- Vitamin C
- Thymosin A
- Pentosan polysulfate
- Ceylon cinnamon
-What to do if you start to feel ill…2:14:19
- Follow CDCand WHO guidelines
- You're best served at home
- Telemedicine (phone consults)
- Don't go to the clinic unless there is a tangible benefit for doing so
- Children are not affected as severely but there is a high risk of communicating it to others (grandparents for example)
- Closing schools may be important for public health
-Specific advice to health care workers…2:21:12
- Have appropriate personal protective gear
- N95 masks
- Understand how to properly don and doff the gear
- Protect yourself first
- Isolate infected patients
- Nebulizers may spread the infection
- Understand intubation procedures
- Shave facial hair for the mask to fit
- Elderly are the most vulnerable
- We don't know how well current tests are performing
Resources from this episode:
– Wild Health website
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