Ask Dr. Drew - Ask Dr. Drew - Coronavirus Answers w/ Dr. Gounder, Kati Morton & Scott Adams - Episode 11

Episode Date: March 18, 2020

Dr. Drew Pinsky answers your top Coronavirus questions LIVE on a special episode of Ask Dr. Drew, with guests Dr. Celine Gounder (infectious diseases specialist) and Kati Morton (Licensed Marriage & Family Therapist), along with surprise guests Scott Adams (Dilbert / Loserthink) and Greg Gutfeld (FOX’s The Greg Gutfeld Show). Missed the live show? Get an alert next time Dr. Drew is taking calls: http://drdrew.tv Ask Dr. Drew is produced by Kaleb Nation (@KalebNation) and Susan Pinsky (@FirstLadyOfLove). THE SHOW: For over 30 years, Dr. Drew Pinsky has taken calls from all corners of the globe, answering thousands of questions from teens and young adults. To millions, he is a beacon of truth, integrity, fairness, and common sense. Now, after decades of hosting Loveline and multiple hit TV shows – including Celebrity Rehab, Teen Mom OG, Lifechangers, and more – Dr. Drew is opening his phone lines to the world by streaming LIVE from his home studio in California. On Ask Dr. Drew, no question is too extreme or embarrassing because the Dr. has heard it all. Don’t hold in your deepest, darkest questions any longer. Ask Dr. Drew and get real answers today. Learn more about your ad choices. Visit megaphone.fm/adchoices

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please contact Connex Ontario at 1-866-531-2600 to speak to an advisor free of charge. BetMGM operates pursuant to an operating agreement with iGaming Ontario. Our laws as it pertains to substances are draconian and bizarre. Psychopaths start this way. He was an alcoholic because of social media and pornography, PTSD, love addiction, fentaconian and bizarre. Psychopaths start this way. He was an alcoholic because of social media and pornography, PTSD, love addiction. Fentanyl and heroin, ridiculous. I'm a doctor for.

Where the hell you think I learned that? I'm just saying, you go to treatment before you kill people. I am a clinician. I observe things about these chemicals. Let's just deal with what's real. We used to get these calls on Loveline all the time. Educate adolescents and to prevent and to treat.

If you have trouble, you can't stop and you want to help stop it, I can help. I got a lot to say. I got a lot more to say. Dr. Drew, there we go. Thank you guys for being here. We're going to take your calls in just a minute. We've got three great guests lined up in just a moment. I'm going to bring our friend Scott Adams in here.

We have infectious disease expert, Celine Gounder, and then we have Katie Morton, a psychologist who's going to help us deal with the fallout of all this. But right now, let's go to Scott Adams. Scott, are you there? I'm here. There you are. Thank you for joining us.

I appreciate it. I loved your Periscope today. And for people that don't know Scott Adams, you can follow him at Scott Adams Says. You can see it right there on the screen. And he does a 7 a.m. Periscope. And I don't know how you maintain this, Scott. Seven days a week. How do you do it?

Mostly because I like it. I actually look forward to it. If it were work, I'd only do it a lot less. Fair enough. But yeah, I enjoy it as much as the people who were following me, apparently. So let's start with the press conference that was just held. Did you have a chance to see that by any chance? No, but I did hear third party or secondhand that the president just sort of did his thing

and got off the stage, which I've been hoping he would adopt that model. Because the less we hear from him on the details, the more confident we're going to be. We just want to hear everything's going to be good. We got money. We're paying attention. It's the top priority. You know, president stuff. Yeah.

As you say, get him off the field quick. Right. Yeah. And, you know, the thing we want is to know that the right people are on the job. And he's in messaging and i'm not sure his personality is perfectly suited to this very specific you know unique task but boy once we get past this and we've got a we've got to recharge the economy that is who you want you you want the you want the the cheerleader then now getting past this is something that you and

i both know is going to happen but everyone is so worked up even just while i was before the mics were heating up here i'm getting texts from people who are losing their minds with panic i mean it's just raining down on me all day and that has been my concern all along here is trying to navigate between freaking people out and doing what we need to do to squash this thing. And I feel like, and I, and what I saw coming and what's, what's circling on the internet with me is me telling the press to shut up because I could see the panic coming and that's what disturbed me. And now we're here. Uh, do I, I'm having trouble navigating this. In other words, the panic is motivating good behavior that I'd like to see people engage in, which is social distancing and stay at home and avoid all the good things I want them to do.

But I don't want them freaking out so badly that they're going beyond the recommendations of the CDC. Yeah, you know, I think Dr. Fauci hit exactly the right balance there. And basically, he said that a little bit of panic is going to help us. And I agree with that totally. Now, given that everybody handles stress differently, and we're all in different situations, the only way probably you're going to get enough productive panic, you know, the good kind where people go out and do what they need to do, is if 10% of the world is panicked. I don't know that there's any solution in the emergency world where you can't scare the panics off 10% to get the rest of the people to do what

they need to do. Let me give you two observations that concern me. One is every phone in Los Angeles got a text from the mayor yesterday telling them to stock up on food. And guess what happened? There was a run on the stores. There was violence. It was just a nightmare. And it still is to this day. That's the kind of shit that's bothering me. That's on one side. On the other, I have worked with Dr. Fauci since the AIDS epidemic. I used to bring him down to my residency of lectures, and he has been my guiding light in infectious disease ever since. I mean, he is, I just tell everybody, just listen to what he tells you.

He will tell you exactly what you need to do. Don't need to do more. You can do more if you want, but you don't need to. Just listen to him and do what he tells you. But I'm now remembering in the middle of the AIDS epidemic, he started using rhetoric to try to use panic to motivate. I forgot about this chapter until I started seeing him do it today. And so it just concerns me with the local people going over the top that he

also needs to be clear with his messages and not induce too much panic. Yeah. I didn't hear what he said today. Did he have some language that was more extreme than what he said before? He said today, he reiterated, it's going to get worse. It's going to get worse, going to get worse. But he doesn't say, and we're going to get this thing. He just goes, things are going to get really bad.

He's got to also say, and we're on it. We make the changes we're telling you to make. We're going to be fine. He never puts the disclaimer at the end. And apparently there are a bunch of guidelines coming out tomorrow that I don't know what they're going to be, but I'm imagining it's more about staying home. Yeah.

And the thing we have to remember is we're all in different situations. So if the government says, you know, you should think about staying home, I'm staying home. And if I can reduce my contacts to zero and survive, in know, you should think about staying home, I'm staying home. And if I can reduce my contacts to zero and survive, in the short term, I might do it if I can do it. But there are people who just can't do it. So I've been looking at this as sort of a math problem, and maybe somebody can

help me with it. So you've got this virus that has some kind of exponential for growth, right? Is it 4x or something like that? And therefore, there's some kind of exponential for growth, right? Is it 4X or something like that? Yeah, maybe. And therefore, there is some number of average contacts that we have that can be reduced to a smaller average. And that's the way I'm thinking about it is the math. I'm actually thinking about my experience. I say, okay, in a normal day,

would I have whatever the number is, 25 contacts. If I take that down to five, have I beaten the virality? Is that the math? Yes. 25 to five contacts? It's exactly the way to think about this. And I don't know the numbers off the top of my head, but 25 to five is a massive reduction.

And this is why I get upset when yesterday on the front page of the New York Times, they reiterate the doomsday data which is mathematical modeling based on no changes in our behaviors we have had massive changes in our behaviors and this is this is why i kept telling everybody to shut up in the beginning i knew we would change behavior i knew i've been in epidemics i know how we adjust and we don't have to panic we just do what we're told and things will be fine. But they continue to fan the flames of panic unnecessarily rather than putting your model up there and going, hey, the average person has at least cut their contacts in half.

My goodness, what's that going to do to the curve? Let's look at that math. They don't even offer it. Yeah. The other thing that we do wrong, people are not good at comparing things and predicting things. We're just dreadful at that. So it's always a mistake to do a straight line prediction. That's what you're saying. A prediction that says nothing changes when there's a 100% chance that everything will change. So that's the first thing. The other is you have to look at the

solution, which I believe is sort of at a flat line now because we're in gathering information, we're learning, we're A-B testing accidentally and intentionally. But when we get our weapons, and right now it's a weapon search, humanity is scouring the earth to find a chemical, a drug a drug to process the system yeah and we're not armed yet you know we're running away and doing defensive retreats exactly as we should yep at this phase oh man we have the smartest people in the universe well i won't say universe in the world solar system yeah in our yeah right i think solar system is a good bet yeah and i remind people that we've never had a situation where the smartest most capable people in the entire globe were this

well trained and focused at the same time at the same problem with almost unlimited resources and if that doesn't get the job done well it will it will get the job done. It will get the job done. Yeah. And it's already happening. There are 100 studies underway, literally 100, on different treatment modalities that are looking promising. So something's going to break through. And pretty soon. Within a few weeks.

All the things that we think are sort of inflexible problems, like, well, there's no way to get a vaccine before 18 months. Well, not in a world where everything changes and it's emergency and all of the risk management is completely changed. Certainly, we're going to see situations where people have, at the very least, a right to try. Now, my understanding, Dr. Zhu, is that there are at least three substances, chemicals, medicines that already have good results anecdotally. You mentioned chloroquine today in your piece, and we've known that for about five days. There was some activity in terms of interrupting the inflammatory cascade that some people get into with this thing.

I've also heard anecdotes about some antivirals that have been used with HIV and Ebola and combinations that are looking good and anecdotally extreme responses, but again, only anecdotally at this point. So let me ask you this. Maybe you can't answer this in a public way, but are any of those things which we know about, couldn't you take them at the same time? Yes, people are doing that.

People are doing that. Right. But we don't know. But right now, I just heard a report from Italy, and it's really interesting. I've got a full, I can tell you everything that's going on there from this one report I heard from a pulmonologist, an intensivist there that gave a one-hour presentation to everyone in the American Medical Association. And he was saying, look, we know how to do supportive care well.

We can get people through this thing. We don't know what harm we might do just yet, so let's not jump onto these treatments until we have some good data, which I thought was a reasonable thing to say. But that balance could also change. Yep, soon. Soon. Yeah, very soon, like tomorrow easily yeah yeah so yeah and by the way other countries i tried say what am i telling what what are you telling

people with kids in terms of um how much contact they could or should have because some of this is just social and parenting it's not medical you just have to find a way to get on top of them right i found that i found the saying that the the government is requiring a six foot you know distance kind of kills all their hope of having a normal play date right right so i found that that's effective but would what would you say to the model of yeah we don't want you to be a hermit for a month right but you could only have one one friend you can go to their house so they can come to your house how do you feel about that i feel i think that's fine i have no problem with that i where i have problems and where i'm worried is in preschools which haven't been closed yet that that's like i don't know quite what to do

with that um because it's the cdc is not right i'm generally trying to stay with the cdc specific recommendations they've not recommended those closures so all the school closures have been because the CDC is not, I'm generally trying to stay with the CDC specific recommendations. They've not recommended those closures. So all the school closures have been above and beyond what the CDC recommendations. Now tomorrow things could change because they're coming out with more stuff, but it hasn't included the childcare

and the preschools and stuff. And that doesn't make any sense to me that you'd close the middle school age kids down who can self, you know, can practice social distancing and the little kids who are all over each other with all kinds of secretions you leave them you leave them in groups that doesn't make sense to me in terms of play dates i i'm i'm fine do proper assessments you know look very carefully to everybody teach kids about

hand washing and let them have little play dates it. It's fine. All right. And where are we different? I saw you mention, and I heard other people. Here's where we're different. Well, the first thing, one thing we're different on and one thing I want you to help me with. So the first one I want to start you with to help me with. I have been using other epidemics to not compare to this epidemic, right? i'm not saying this is like the flu epidemic

this is like the h1 epidemic what i what i've been trying to do is get people to realize that they have been through epidemics and been just fine with it not freaked out good not even done anything in most of the cases i mean they don't remember the 2009 pandemic they don't care that there've been 24 million influenza cases this year, but I'm using them not to say, oh, the corona is going to be like the flu. I'm not saying that at all. What I'm saying is contextualize it. Look how we've gotten through previous pandemics to try to calm yourself down and be more systematic. Is that inappropriate? Is that getting lost somewhere?

Is that an appropriate kind of analogy to make? No, I think that's perfectly good the way you do it. The problem is the way the less informed people do it, which is, well, that last one was no big deal. Right. Why do I have to do social distancing? I didn't do it last time. Right.

So that's where all the problem is. We're just dreadful at comparing things. And the other thing I like to tell people is that they're confusing. And I don't think you can say this enough. People are confusing their individual risk with a system risk. Right. Meaning, you know, the odds of somebody having a car accident today is 100%. The odds of you having a car accident so small you're not worrying about it when you

you get your car and drive nowhere because there's no place to go that's another story yeah the risk of dying of corona right now is 0.000012 for a given individual uh and that and it's probably less than that if you're under 70 right the uh the death rate in South Korea, if I'm remembering right, was 0.1 for under 60, 0.1. It's the same as the flu. Now, over 70, it was 8.5%. So you have to, this is a nefarious virus, which is why we're taking it so seriously.

All right, well, so here's something that's scaring me, and I want you to talk me out of it. Okay. Maybe we can help talk each other out of stuff. Yes, good. That's what I like. So all the experts are saying what you're saying, which is it's affecting the old,

and it's almost perfectly linear except for underlying conditions people. But at the same time, I'm receiving massive individual DMs and tweets from somebody who says, I know a guy who's 30, he's 40. It took him out. Yeah. So here's the deal. The H1N1, the 2009 pandemic, primarily killed 40 to 60-year-olds. That was the risk group, 40 to 60.

And again, no one knows that. It killed 500,000 people and infected 1 billion, 1 billion with knows that. It killed 500,000 people and infected 1 billion, 1 billion with a B, and killed 500,000, mostly 40 to six-year-olds. What we're saying here is not that no 30-year-olds

are going to die. Some 30-year-olds can die of this thing. And we're trying to figure out what the specifics of those individuals that get into complications, when they defy the odds of the younger populations. We think there's got to be something a little different about their physiology.

We're trying to figure that out because they are such outliers. But it does happen. Happens to children, happens to middle-aged people, but it's unusual. So for those seeing the same thing I'm seeing, the experts, correct me if I'm wrong, but the experts are not saying that at this point not saying that they're not saying that the flu is now and all ages equal risk right kind of thing no they're still saying it's an old person of primary risk yes but my guess is that these individual anecdotal reports are either people who do have an underlying condition and didn't know it.

Well, not necessarily. Yes, yes, yes, and. The and is the first case in Italy was a 35-year-old male. The first case on a ventilator. The first one that got their attention. So it's going to affect young people. It just does. But it was almost all old people after that.

And there may be some kind of a genetic connection do you think we're going to have a correct massive genetic uh deep dive on the data to say all right here's everybody's genes here's everybody's outcomes well you know if you got this gene you better run you're getting to some very interesting territory i was reading a lot of really good science this morning on the use of angiotensin-converting enzyme inhibitor antihypertensive and the sister group called ARBs. I was reading about that too. You might have been. It wouldn't come across your desk quite the way it does mine.

Can you spell that for us too? ACE inhibitor ARBs. These are blood pressure medicine. I'm on an ARB. And at first, a bunch of anecdotes were circulated that somehow because the virus binds at one, it's kind of a complicated thing, but what's on the surface of the cells of the lung is part of the blood pressure system that the ACE and the ARB interfere with. And as a result, more of that protein binding site was showing up, they thought,

on the surface of the lungs with people on these medications. So a very quick panic ensued, which was that, oh my God, you got to get off these medicines. That's going to make things worse. Now, it looks like there's a secondary phenomenon that the binding site has to be consumed or brought in by the lung cells. And on ARBs particularly, and ACE inhibitors, the virus can bind but can't get in, doesn't get drawn in the way it does without these medicines. So it's actually today looking like ACE inhibitors and ARB might be protective against the infection. Really interesting, right? Wow. Very interesting.

Fog of war. Fog of war stuff, yes. This is how science works. It fits and starts. And don't take any of this as axiom yet. We all know we're in the fog of war for sure, which is the other piece. Go ahead. Finish. What did you say is this well this is a perfect example of you know as the smartest people in the world are you know sharing this information at the speed of light literally on the internet we're we're we're kind of flatlining saying we got nothing we got nothing we got

nothing but when we get something yeah something's going to happen fast. Yes. You framed that today in your periscope as the exponential growth of the virus is going to meet the exponential growth of our knowledge and skill. Exactly. Yep. So here's the other thing I want to share with you. You have been talking a lot about ventilator shortages, right? And if you watch the press conference that was just on with the vice president he he secretary azar addresses that very specifically i i don't know if it will assuage your anxieties the way he addresses it but i was fine with it and and here's what what i i

want to say and you tell me if i'm helping you which is that you're basing your fear about the ventilator shortage and bed shortage on what you're reading about healthcare and what could happen and what might happen. And I'm basing my confidence that we're going to be fine with those resources on my 35 years of experience of working with hospitals and talking to hospitals now what they're preparing to do. And I think that's where you and I differ. That's why I feel confident because I have so much experience with hospitals flexing and getting ready for this stuff

and doing what they need to do. Go ahead. Give me the idea, the level of, let's say, ramping up they could do in the time that we have. Could they, let's say, triple their capacity of ventilators? Yes, they could. Well, let's think think about it here's something you haven't thought of because you're not in the hospital

world uh every surgical suite every surgical center in the country has a ventilator in every room when you do surgery you put people on ventilators that's going to be i keep my my guess hundreds of thousands of ventilator instantly available if we just say sorry no surgeries we're going to use the surgical suites as icus the use surgery centers wheel them across the street to the hospital we're using them there we have a massive increase so subtracting out the operations that you really do have to do their life of course of course of course but but that's what italy did this is what italy did and this is why they're stabilizing they flexed up with essentially using all the surgical ventilators and then they had enough ventilators to deal with what

they were dealing with it took them some doing to kind of come to that realization and to be able to flex it but then they did and then the military has thousands of ventilators on hand that they can call upon in a very short order. So I don't worry about the ventilator thing because I think we're going to flatten the curve. And I think we can flex by literally hundreds of thousands if we need to pretty quickly. So I think we're way closer to agreeing on this than maybe it seemed. Because getting back to the right amount of panic yeah the right amount of panic is what makes that so solvable yeah because you

know we're we're sort of at it so um and joel pollack did some uh investigation of american manufacturers of ventilators and called one of the one of the bigger ones in this country and said, yeah, a lot of people are calling, but I don't have any orders. Right. And as soon as I heard that, I thought, yeah, okay. It can't be that critical. I saw you, I saw you say that too. And that's when I thought, oh, we'll flex, we'll flex with the surgery centers,

but I'm telling you who's going to make the orders is the, is the military. The military is going to make the first orders for ventilators. Cause it's going to be a, a pool that they're going to have on hand that they're going to be able to flex up and down for hospitals as needed. There's one thing I thought of this morning, and this is the last thing I want you to help me with, which is I have this feeling that politicians have begun to use, not just politicians but people certainly on the internet as well have begun to use their i don't know how to frame this their the the rigor of their response to this epidemic as the new virtual virtue signaling like we in california we're going

to close schools oh no no we're going to close everything we're going to it's like it's a virtue signal now because i know here's where i noticed that we have 12 step meetings are all closed down too and i'm trying to help the mutual aid societies to sort of break into smaller groups and what you get back is oh thank you you're going to kill people it's like no we're following the cdc guidelines we're not going to kill people and we're trying to keep people who are drug addicts alive frankly and the virtue signal is oh're not going to kill people. We're trying to keep people who are drug addicts alive, frankly. And the virtue signal is, oh, you're going to kill people. You want people to die. And I think the politicians have adopted some of this too. You think? Well, there's a funny thing happening with the risk management equation here. If you close things too early, you're going to be okay if you're the guy who closed that you know

the gal who closed it too late and and smart people say that that is confirmed it was too late you can't recover from that so i think people are just looking at their own risk management here but but i i get what you're saying you're thinking as a corporate guy i'm thinking as a clinician where it's a risk benefit analysis right how many drug addicts are going to spiral out because they can't get to meetings versus how many people are going to infect it at a meeting of 35 people i would argue that the meeting is a much better bet than not having the meeting do you agree and just and don't hold hands when you say the prayer and keep three feet apart and blah blah blah and blah, and that's all you got to do. Yeah, and while you're preaching to the choir on the risk of the addicts,

certainly the addicts are always on the edge. And there's nothing like a big news situation like this to push people a little further. So I'm with you that we have to keep really clean about what the odds are in all these situations and so and so risk benefit again the same thing is true with the economy right and with jobs like people's lives are going to be up ended by what we're doing here and i'm glad the government is thinking about supporting people that was what scared me they were going to leave people flapping out on their

own but it looks like our government is going to step up on behalf of people. And the risk benefit analysis, again, I'm not saying that you put jobs ahead of lives. I am not saying that. I'm saying that there's a navigation. There's a sweet spot. If we get it right, we will do, let's say, optimal with the infection and won't overdo on the economic side. And that's the sweet spot. That's what we have to hit, no?

Yeah. Do you think we're heading toward a sort of a strategy where we have to get enough people infected so that when we're making those decisions about, oh, do I avoid a group of five people? That doesn't make sense unless you're really trying to stop it completely. And I don't know that anybody smart says that that's possible.

I agree with you. So given that we're smoothing the curve, flattening the curve, and by the way, that's one of the most brilliant pieces of communication that we've seen on this. People really get that. You see the graph and you say, say oh if you flatten that that then things can work out so so i think that's brilliant um and slowing it down is the way you should think about it not stopping it that's a different process yeah yeah and and some of us are going to get this thing and just prepare yourself and you're going to be okay and if you you know part of i'm looking forward to the recommendations that the CDC puts out tomorrow because people are getting confused what to do if I have a fever, what to do if I have a cough, when do I go where, how do I get tested?

And there's a little bit of chaos still flying around that we can also smooth out and reduce the risk of people running into emergency rooms and either A, exposing everybody in the ER to what you got, or B, you getting exposed to what they got, which is not optimal. That is sort of, to me right now, where the problem exists. Yeah. Do you think that we have massively more people who may have been infected mildly and that it's possible that there's some hidden immunity in the United States? The answer is at least 50-50 that that's true. I can't, it's, my wife is convinced that she and I had coronavirus. We were exposed to a friend who had a terrible, Susan's convinced she had it.

I did. Who got it from that region of China, came in, we immediately got sick. It was a bizarre illness, knocked us off our feet, but no fever. So I'm like, no fever. Oh, we don't don't know that well i don't think i had fever and uh and then it resolved and whatever and we didn't get anybody else sick we didn't i was i was joking at the time it was with a christmas time i said hey we got coronavirus and now i'm beginning to think

it's possible but there there definitely will be as you well know a lot of people that will test positive that will have nominal or minimal symptoms there will be a lot of people that test positive that don't expect to test positive i would say but whether or not it's been flying around here for a while really i'm i'm gonna say okay i'm gonna say 60 40 yes just just on the other side of 50 50 what do you think yeah yeah i'm feeling very close to 60 40 as well because you know i'm not like a a human computer but when i'm looking at what we're doing to stop the spread and then how successful it seems to be in in some places i think to myself it doesn't feel like it should be that successful. It feels like there's a hidden hand that's giving us a little boost. And maybe we're better at it

than we think. Maybe I'm bad at math. But maybe we have some immunity out there. I think that's not a bad bet. But secondly, our behavior is changing massively. I mean, we have changed our behavior. I've never seen anything like this. And again, not to compare with the flu, but to bring the flu back into the conversation again, I hope some of these practices will translate into the next flu season. And I hope you will get your damn flu shot next year because you can interfere with that every year epidemic

by same practices, not isolating, but washing your hands, being careful, getting your flu vaccines. I wish, I hope that message doesn't get lost in all this. Hey, Drew. Yeah. Greg Gutfeld wants to call in, but he says he'd rather listen to you guys. We'll tell Greg to call in. We have our lines are full, but Dr. Celine Gounder is on the line. Yes. And I don't know if you got, if Scott wants to hang on or. Well, let's, I think Scott would like to talk to Greg, or Greg would like to call in. Want to try to get Greg real quick?

I know. Okay, let me try. Greg always has lots of good questions for Scott. We can actually keep Scott on with the infection specialists. I don't want to keep Scott learning, but let's do it with Greg, and then we'll have a little doctor-to-doctor geek off after that. Oh, that's so funny.

Okay. You don't want my medical opinions if you if you want i i just don't want to i don't want to you know yeah i'm happy to have you as long as you you i know you know you're probably busy it's but let's get i know greg would love a chance to uh talk with you so i i don't want to deprive greg of his chance to talk to you well while we're waiting for this let me uh give you a little thought. Sometimes it helps to just think of things differently, you know, turn off the news once in a while and think of something else. But, you know, I often talk about our reality being a simulation.

And this feels like, if you believe that we're a simulation, this feels a lot like a software update. I like that. I like that. And not without its costs. You know, every software update ruins something and fixes something. But we're going to end up with some new features when this is done, to your earlier point about permanent habits.

But I would guess that maybe the fate of online education will change permanently. I think that maybe telehealth will start to be practiced across state borders because why the hell was that not already a thing? Yeah, well, because it takes a while for people to adopt stuff, and now we're pushing the adoption, right? So you're absolutely correct. So it feels like a software update that's going to improve our healthcare accidentally. It's going to prove it's accidentally. It's going to improve.

It's certainly going to change how we think about immigration. I don't know. You can argue with that. It'll be an improvement, but it'll be different. And I was saying earlier on my own periscope that what is the psychological effect of bringing in your prepping and your food just to be ready? You're just being cautious. You're not panicked. And then you realize that the border is open and it's a global epidemic.

Can you keep your food? I mean, those are the thoughts you're going to have, which is, yeah, everything's fine as long as the population stays about what it is. But if that increases suddenly, where's my food? Now, it's not really a rational thing because you shouldn't be afraid of you know immigration during this they're just unrelated things for all practical purposes but your mental process is going to bring that in yeah yeah just automatically yeah it changes things yeah is uh greg available susan is he ready we're lining him up now he's getting lined up here because uh greg gutfeld of Greg Gutfeld, of course, from The Greg Gutfeld Show.

On Saturday evenings, I think it's 10 o'clock. He's going to have to tell me. And he also has a podcast. Reminder, Scott Adams. You can follow him at Scott Adams Says. And he has his Periscope every morning at 7 a.m. And his Periscope is my therapy because he reframes things and calms things and uh i appreciate that when sometimes things seem very difficult to understand scott uh looks through the prism of uh

what should we say motivation uh persuasion and and cognition would that be accurate yeah yeah different filters on life and persuasion you. One of the things I often refer to when it looks like there are problems coming is what I call the Adam's Law of slow-moving disasters. Yeah. an unbroken record of defeating gigantic problems. Well, you're all going to run out of food. Surprise. We figured out how to farm better. You're going to run out of oil. Well, surprise. We got solar. We got fracking.

So we're really good at this if we have time. So this whole coronavirus comes down to an information problem and a timing problem, if you think about it. If we had perfect information about people, we wouldn't have a problem already. You just ah it's you back up yeah so information and timing so i think we have done the right thing to delay it the whole flattening the curve thing closing the borders etc and i think that has bought us enough, given that this isn't normal and the smartest people in the world are focusing on it. And I'm suspicious that, I'm not good at predicting, so don't take this as any sort of gospel, but that the South Korean experience, I think we will exceed that.

I think South Korea did a good job in shutting things down and flattening the curve, so to speak. And although we're going to have a spike in the short term because of all the testing, I think we're going to do a better job. What do you say, Scott? I absolutely agree with that because we're similarly capable, but we had more time. And we're spread out more. We're spread out more too, right? Oh, yeah, way more. We may be less compliant as a people because americans are

famously you know i'll i'll take this coronavirus i'm going bowling you know don't tell me what to do america so we're a little bit we got that working against us there's no doubt about it i mean you know to be fair it's also our greatest virtue it's our greatest strength really is that we're like that but it's going to work against us a little bit. Speaking of bowling, I brought Greg Gutfeld back from his bowling league. Greg, you there? I'm here.

I'm here to just say that it's very healthy and good that you two people are out there publicly talking about this stuff. I think it's great and I have healthy and good that you two people are out there publicly talking about this stuff that's uh i think it's great and i have an observation and i think a question or maybe it's just an observation but for the last couple years or forever the entertainment industry has been telling us all of these awful things that are going to happen and how bad americans are and they make these movies

about the apocalypse in which everybody's destroying each other and there's only one guy left and everybody else is zombies and all this other stuff there's never any movie about people actually helping each other out which is obvious because it wouldn't sell any tickets but there is i'm noticing a tremendous gulf between what we are being fed through the media and through the entertainment and how humans really are and that we underestimate or we don't even estimate the power of positive thinking, the power of sacrifice and just doing the right thing because we've been trained to believe that when bad things happen, everything falls apart. Is that right? Well, it's accentuated by what we can measure.

The things you measure are the things that you end up treating as the most serious. So if you get X number of people dying and infected, we keep seeing those statistics. But what's the measurement for how much ingenuity is forming? What's the measurement for how much smarter we are than one week ago what's the measurement for how we've changed our behavior you can't put a put a number on that so we get fixated on the the bad news because we got numbers x number dead so that that also is driving us crazy and then the fact that there's just repetition just pure repetition uh i just have to turn off my devices every now and then

once an hour i have to just turn them off yeah greg i completely agree with you and in fact i would argue don't watch anything in the short term here except comedies just just clear your palate exactly because because those are stories what's that but my sister my sister and they watch contagion but why are you doing that why do you need to go an outdoor contagion to your bedroom contagion it doesn't it doesn't make we watch the tape why are you doing that it's no sense anyway I have a recommendation. Given that humor is my field. George Carlin.

Go to YouTube, the whole bunch of clips of George Carlin, and just listen to them. Because there's something about him in particular, because he's smart and sort of fatalistic, and he has sort of a gallows humor about everything. It really made me feel good. Like it just put me in a whole different mind and I started laughing and stuff. So try him. Good advice.

And if that fails, go watch old episodes of Love Boat. There's no way you'll escape from that. There you go. All right. I'll leave you two. All right, Greg, listen. I don't want to take any more time. No, no, no.

But listen, Greg. Bigger brain. No, no, no, Greg, Greg, Greg. I know how you love to talk to Scott, and so I wanted to give you a chance if you have any other questions for him. And I'm wondering, are you getting a sense

of what you're going to be talking about this week on the show? You know, I'm wondering, honestly, if we have a show because of the distancing thing. I'm like going like, how do you do hair and makeup? I'm not going on air you do hair and makeup?

I'm not going on air without my hair and makeup. I don't need people to see me the way I'm actually. You know what I mean? I've seen it. I've seen it, Greg. I know exactly what you're talking about. Greg, I'm glad that you're taking this. Legitimate.

Think about all the people that are telling you to stay six feet apart they're getting people young people to pat out of them so close to their faces I love that terrible so I don't know it'll be a lot of it I'm hoping I have a show no audience yeah no audience for sure no audience

alright that's it you're out Greg's outreg out thanks doctor okay bye-bye dr juke can i ask one more question that you can maybe talk about with your other guests i'm confused about the value of testing i have a suspicion that we're putting maybe too much um absolutely much hope in the test absolutely and that is what I'm going to talk to the doctor about. People are getting, they are, the press, this is the stuff that makes me crazy because the journalists have no business in the conversation even about testing.

The original rollout, the system that Fauci was talking about that was in place was a diagnostic system. So doctors that have a high probability case can confirm a diagnosis. That is different than a screening instrument, both in terms of what the test is and how you implement the test. And a screening test is different than universal testing.

And each of those things have different goals, different reasons for rolling out, different timeframes when you would roll that out. I would agree that the testing has been choppy, but I don't think it's affected anything. I think we've done exactly what we should do. And this new screening representation is going to give us the information we need. And one day they may ask for universal testing, but that's up to the people that are working out the models. Don't second guess what they're up to with these instruments and the systems. So in terms of the public worrying, I've been feeling that the lack of testing wasn't that

big a deal relative to all the other things that are a big deal. And it's going to be online pretty soon. Right. It didn't affect anything in terms of what it was designed to do, which was to help doctors make a diagnosis. But because it wasn't designed to screen, it looked like we were behind. We needed to put in a screening system, which now we've done. And yeah, I wish we had it immediately, but it's not how medicine works. It doesn't work like that. It's pretty quick. Very quick. It's pretty darn quick. Very quick. Very quick. And so, yeah, in a perfect system, we would have had both at the snap of a finger.

That's not the world we live in. That's not how it works. And so I don't think it's affected anything is my point. If anything, if we had screening, I'll tell you what, if we had screening, if anything, it might reduce the recommendations coming out of the CDC because we might find out it's not as widespread as we thought. You know what I mean? And you could adjust your behaviors in a more conservative way. I don't know. All right, Scott, thank you so much. Really always a privilege. And we'll look for you tomorrow morning, seven o'clock to assuage your anxieties further. Thank you, Dr. Chu.

Scott Adams, everybody. At Scott Adams Says and the Periscope at 7 a.m. tomorrow morning. Now, I want to bring in Dr. Celine Gounder, who also has a podcast. It is American Diagnosis, a podcast about health and social justice. Season one covered youth and mental health. Season two, the opioid overdose epidemic. Season three, gun violence in America. Another podcast is Epidemic with Dr. Celine Gounder and former Ebola czar Ron Klain. Dr. Gounder, thank you for joining us. Sure.

And just so you know, CNN, I recently signed as a medical analyst, they have closed their hair and makeup. Good. That's good. I apologize for the, everyone's going to have to do their own hair and makeup. So good. Exactly. That's exactly what's going to happen.

So let's start with the testing uh do you think that the choppy rollout of testing has affected how we respond to this epidemic or do you see it the way i just represented it uh i don't know that i totally agree with you drew um i do think it has been an issue um you know it it does so i mean there are different ways in which you can think about it. So there's in the hospital setting, how careful do you have to be in terms of infection control with a patient? And there really are resource utilization issues there. So hold on. I'm going to say, I want to, whenever I hear something, you say that I know exactly what you mean, but I know the listeners won't know what you mean.

What you're saying is if you put everybody on isolation who might have the virus, you're going to exhaust resources, right? Right. What I was going to say is at Bellevue, we have a special pathogens unit, but we don't have rooms in that unit for every single person who might come in with flu-like symptoms. So you need to have a way to figure out, okay, these are the people that actually need to be in those rooms. These people don't. So I think that's a really critical place that we need to be using this. Also in terms of infection control and emergency rooms, if somebody's known to be infected, you want to get them out of that emergency room and into a isolation room as soon as possible. I feel like ERs are our greatest risk right now. Don't you? I mean, because people are going to

start pouring in there and some of them are either going to get infected by going to the ER or infect others by going to the ER. I'm very concerned about that flow right now. Yeah, I 100% agree. That's actually where I think the highest risk is going to be, because that's where we won't know, right? Somebody comes in and we won't know, are you sick with coronavirus or not? Or the other people sitting in the waiting room. Yeah, you won't know the waiting room could be filled with or without, or could be flu and you can get influenza or God knows what. You know, I think this is another place where the testing is really essential. And it needs to be testing that's not health facilities.

And this is part of what's being discussed. If you listen to the press conference earlier today, they are finally going to be rolling out these community-based testing sites so that it's not coming into the doctor's office and into the hospital. You have a different place to go for testing. So some of that's going to be drive-through and there are going to be other models. You know, another key piece that's going to come out within the next two weeks is going to be home-based testing. So you have these telemedicine companies, pretty cool actually,

where you'll be able through your smartphone or through the web, you fill out your personal data. They'll ask you some screening questions. You know, do you have these symptoms? Have you had these risk factors? And then if you're extremely high risk, you'll be told, you know what, call 911, just go to the hospital. You're clearly very sick.

If you're very, if you have no risk factors, you have no symptoms, they'll say, you know what, sorry, like this is not an appropriate test for you. But if you're somewhere in between, those platforms are gonna be great because what they'll do is they'll express mail you a test kit, you self-collect, you express mail it back. Again, you're not sending all these people to the emergency room to help spread infection.

And then you'll get help. Yeah. Are you worried about the overutilization of that? Because I think lots – I mean, I'm watching what happened in New Mexico where they had some drive-thrus. There was hundreds of cars, people waiting in line. I thought, oh, boy, not all those people need to be tested. Well, and that's why they're going to implement it with the screening questions to figure out who to target it to, at least in the beginning when there is not going to be enough testing for

every single one of the 350 million Americans. You're going to have to make some decisions about that. I hope they educate up front why it's important to be truthful and why these tests need to be used in certain settings and not others. Cause I I'm fearful of the overutilization unless we get to the point where we want universal screening and then that's a different story. Yeah, no, I mean, I do agree that. And how do you figure out how to target, um, to the people who need it most? I mean, that's, uh, there it's going to be complicated yeah yeah so uh the couple of things i want to get into very not even quickly they're big topics one is i know you're not in the on the west coast you're you're in texas is that right selena is that no new york city new york city so

you know kind of what i'm talking about we have 60 000 homeless people here in southern cal in los angeles alone that are in concentrated environments that are immunocompromised that have no sanitation and are so mentally affected by their illnesses i don't expect them to come to care early because they're paranoid and agitated and we're not by law allowed to touch them in this city that's the situation we're in now. I'm just worried about there being a massive outbreak in the homeless population. I agree with you completely. And that's also a population that over time has aged and has a lot of chronic medical conditions. So that group, super high risk people who are incarcerated, prisons and jails, super high risk. In Italy, they had some prison riots around this. I mean, there's so many issues around that that could be very scary. Any advice for what we do to mitigate the homeless exposure

or response should a little outbreak occur? I don't know what to do. I can't think of anything other than get them housed in residential facilities, which they should be in already, but I'll listen to what you think. Yeah. I mean, I think that would be the answer, but how quickly can we do that now? You know, I just don't see, yeah, I am very concerned about that group. I wonder why, particularly my governor doesn't, in his having created an emergency,

you know, this is now technically an emergency in the state of California, wave aside all the regulation that makes it impossible to build these residential programs. We could have 20,000 beds in six months. I guarantee it. If you just wave stuff aside. And I don't know why that's not happening. But anyway, the other thing is, what are you hearing about novel treatments? I've heard a lot of rumors. What are you hearing? The one drug that seems to have the most promise is remdesivir, which is antiviral being developed by Gilead. That's one I'm most hopeful about. I heard you guys talking about ACE inhibitors earlier.

There is actually some data that ACE inhibitors could actually be harmful. We don't know. But that was the original data. And then they started looking at it and it looks the opposite now, that it's maybe protective because, well, the harmful idea was that it was an expression of this ACE2 alpha or something, receptor site, and that they were overexpressed in somebody on an ACE inhibitor. But it turned out it's never internalized by the cell, even though it's overexpressed in somebody on an ACE inhibitor, but it turned out it's never internalized by the

cell, even though it's overexpressed on the surface, that it blocks the internalization that occurs normally, apparently. Again, the science got very complicated. I scanned it this morning, but it looked like good science to me, what I saw. So I wonder if, we don't know. We're going to see, that's going to be- We don't know. I think it's too early to say. Yeah. And other than remdesivir, anything about chloroquine and zinc I'm hearing rumors and other sort of anti-inflammatory? Yeah, I'm hearing about that. I've seen some data on indomethacin, which is an older anti-inflammatory. Crazy. But no slam dunks yet.

And the Redesivir, I've heard anecdotes of marked response with that, right? At least I've heard that, like a couple of anecdotes. What's the downside to that medicine? I also heard the Italian doctor saying, look, we do supportive care well. Let's do what we do well. Let's not expose people to things where we don't understand the harm. What is the downside to Rindesivir? I mean, I think this is actually a great question in that when we talk about why is it going to take so long to get vaccine approved and then talking about remdesivir, there's a big difference, right? Remdesivir you're giving to somebody who's sick and very often critically ill. And frankly, in that situation, I think

compassionate use makes a lot of sense. It's not like we're talking about giving it to the general population, which is what we would do with the vaccine. So I think the thresholds are very different and how much you need to study to say, okay, this is safe is very different. And let's go back to vaccine. What's your, what are your predictions on that? Well, Moderna, which has one of the experimental candidate vaccines, they are starting to enroll for a phase one trial in Seattle, you know, but then it's going to take a while. So I think the Fauci estimates of 18 months to get through one, you know, phase one, two, and three are quite

realistic. Even if you're going on fast forward warp speed, it's going to take at least that long. So we are going to have to implement non-pharmaceutical interventions, you know, the social distancing stuff over the coming year until we do have a vaccine available. Is there a world where some other country fast tracks phase three trials differently than we do, and then we can benefit from that research? Well, it's a great question. So let's say China develops a vaccine. Maybe they don't even do a phase three. Maybe they just say, you know what, this looks effective enough. We're just going to vaccinate everybody. And then I think that is going to create some interesting questions for us ethically. What do we do? You know, maybe we have the option.

Do some people say, well, you know what? I don't care that this hasn't been fully vetted scientifically. I still want this. You know, what do you say to that? I don't have a good answer to that. It's interesting because there could be real risk. There could be real risk. I mean, you could trigger all kinds of weird autoimmune who knows what, right? And, you know, for example, some vaccines can actually make the disease worse. You know, there's been some issues with dengue vaccine, for example. So you don't want something that could actually potentiate even worse disease. So, yeah, I mean, I think those are going to be really difficult questions.

How do you feel we're doing with this one? Do you feel like we got this epidemic, pandemic? I think the next two weeks will really be telling. Yeah. I can't imagine with the massive changes in our behavior and the rapid improvements in our therapeutics, I can't imagine that we're not going to see a significant benefit on the epidemiology curve. I hope you're right.

I mean, I do hope that people really take this seriously. But I can tell you, in New York City, people are still walking around and acting like nothing's really out of the ordinary. Not everybody, but there are still enough of those people. I am concerned. And I am also concerned that we didn't clamp down on all of this soon enough. We didn't hit the brakes soon enough. And, you know, we'll have a better sense what's been happening in terms of transmission in about two weeks time, because that's sort of that incubation period. So we'll, we'll know, you know, and we'll also have more screening data by then too.

So that will, that will tell, uh, do you have any concerns about, uh, ventilator availability? I do. Um, I mean, even now, and I've worked in multiple hospitals across the country, whenever you're transferring somebody into the ICU, there's, they're almost always at capacity and there's always a conversation. Okay. So if this person needs to go in, who's going to come out and are we sure this person needs to go in? So if we're already having those conversations at baseline, and then you add this, you know, in New York city, I can quote you quote you i pulled up some of the data we have somewhere between i guess these are hospital beds but somewhere between 1200 and 3000 open hospital beds and the estimates are that within about seven days we could you know after

what what's the date today today is the 14 15th. Yeah. Yeah. So in about seven plus days, you know, we could be hitting capacity in terms of hospital beds. You know, I heard you mentioning earlier in terms of, you know, surgical suites and trying to use those ventilators and the anesthesiologists who normally man those. I think that would certainly be helpful. You know, there's been discussion of getting the military involved. I think that would certainly be helpful. I still am very, I don't know. I still am worried that's not going to be enough capacity.

I mean, they're good, smart people are worrying about it as well, and they're preparing. And I know the military is gearing up. The only issue is I haven't heard about manufacturing gearing up to meet a demand beyond what the military has available, which is interesting. Maybe they're waiting to see these next five to seven days, too, before they really crank that up. I don't know. I still feel like we're going to be okay with this thing because everywhere I go, the behavioral changes are so, so massive. Even though there are still people walking around, I understand, but we've only been asked to maintain social distancing, right? We haven't been told not to walk around.

Yeah. I think there are also still the people who have no choice but to go out because that's their livelihood and they have no other way. And, you know, we have a lot of those people in New York City, the people who deliver your food, the nannies, the, I mean, which I honestly think people should just pay their nannies to stay home at this point. But there's just a lot of people who do those jobs. You know, the person who's taking out our trash, the person who's delivering your mail, et cetera. And those things are not stopping. Do you want to take some calls from people? They have some sort of very specific questions about their own risks. Do you mind? Yeah, I have about five minutes. All right. Let's get one or two in here. This is interesting. Let's try this. This is

Will, who's a young person. Will, go right ahead. Hey, Drew. Quick question for you. I am 27, of course. I'm not in the range of any severe danger. But my main concern is the kind of bronchial lung damage that could occur as a result of pneumonia. And also, what would be the latency we could see from this virus if the apparent symptoms go away? And my second question I just came up with is, why isn't something like Valtrex, something along those lines, or Tamiflu being implemented as kind of a safety measure,

I guess, first right off the bat? Would that be applicable? Okay, we'll take both your questions in order. First, the question about sequelae, pulmonary sequelae of the infection. Well, we certainly do see scarring after a severe viral pneumonia, but I think that would be proportional to how bad the disease was in you. So if you have a very mild case, I wouldn't anticipate that you would have much in the way in terms of long-term effects. Also, this virus is weird in that it's more parenchymal than interstitial.

It causes hypoxemia without affecting lung compliance. Can you spell that for us, Dr. True? In other words, it's affecting the air sac's ability to exchange oxygen without making the lung stiff, right? And that's a weird thing. That's a new thing that this virus does. Would you agree? Yep. Yep. So yeah, it's hard to anticipate exactly how this is going to play out. But I think as a young, healthy person, if you do not have a severe illness with this, I wouldn't be too worried about long-term consequences. Right. I agree with that. And sometimes the other consequences really are about being in prolonged critical care or having secondary infections and God knows what other organs are affected, that kind of thing. I'm hearing occasional-

Well, and to that point, actually, we have not seen much in the way of secondary bacterial infections with this, which is also different from influenza. So that's good. That's good. That is good. Very, very weird. Very weird virus. I wonder what we're going to learn about as time goes on. All right, let me try to get one more in here before I let you go. Okay. And by the way, he had a part two of his question. I'll just quickly answer. People have looked at oseltamivir, which is Tamiflu. It doesn't really seem to be effective for this. I don't know that I've seen acyclovir or Valtrex used, but I would not anticipate those would have activity.

But he was saying for prevention, like we use Tamiflu for family contacts. Is there any studies being done that way? I have not seen that. I've only seen the treatment studies, and that does not seem to be helpful in treatment. Yeah, that makes sense. This is Grace. Grace, go right ahead. Oh, hi, Dr. Drew.

Hi, Grace. And this is in regard to what you said about the ARBs and ACEs. I'm on Benicar. I also take metoprolol. I'm 55, by the way, and I have proxismal AFib and develop also high blood pressure. And I did see that information

about the ACEs possibly, you know, actually doing more harm. So that information that you had, was that like up, like very new? I don't know how, I heard this on Dr. Rufia's podcast. It was this morning and it was very good science what I was reading. But even they said at the end of the article, it's all preliminary. Until it can be reproduced multiple article, it's all preliminary. Until it can be reproduced multiple times, we don't know. So in terms of changing your medicine, Grace,

that's your question. Let's each of us answer that. I would say do not change your medicine. Dr. Gounder, what would you say? Yeah, I would agree. I think right now the data is conflicting. It's too early. We don't have the numbers. I would not make any changes based on that we have thus far. Right. I think my five minutes is up. I really appreciate you spending time with us, Dr. Gounder. Where do you want people to go? You can send them to epidemic.fm, which is the website for the podcast, which also you

can find links to other things that are useful there. But we will be releasing at least once a week with information, sort of instead of the daily blow by blow, sort of backing up a little bit and thinking about big picture issues around this. So hopefully that'll also be calming and reflective. Such as, give me some examples.

Well, we had Craig Spencer spencer on last week so that was the physician who was infected with ebola we talked a little bit about you know how healthcare providers are thinking about their own risk of infection what's your duty to care for patients when there's an epidemic spreading and you're not sure what it might mean for you and your family interesting um yeah so those kinds of questions yeah big not just big picture but big questions big questions yeah philosophical ethical questions too yeah all right well thank you we will look for you there great thanks so much dr drew you take care of yourself thank you you too so uh i want to get to a couple of your calls before we bring in our psychologist.

Do I have time to do that, guys, or should I bring you guys? Where did Producer Susan go? It's all you, honey bun. Okay, so we have Katie Morton ready to go. We're going to bring her in in just a second. She's an author. She can help you answer some questions. Mental health expert.

A lot of them are sort of very specific medical infectious disease questions. I'm going to kind of get through these. Angela, I see you have hypertension and diabetes, but they're both under control. You're 65. You would be considered in a risk category, so you have to be very, very careful. I have made the point repeatedly that in this country, diabetics and hypertensives are typically under control, so their risk is nominal. But you add that to being 65, and I would adjust your behavior accordingly as someone in a risk category. Larry, you're 67 at Lake Tahoe. You went skiing yesterday. He noticed that he was not the only one out. Is the governor doing enough by asking people to stay home? Yes, yes.

I don't want, it's not like you're going to contact somebody on the ski slope, right? You're okay to go out and go skiing. When you get into the locker area, that's when you have to do social distancing and get out of there really quick. Wash your hands like crazy. Look forward to the CDC guidelines that are coming out tomorrow. Let's see what they say tomorrow. I am a little disturbed by local and state excesses that aren't backed up by the CDC

recommendations. So let's see what the CDC says tomorrow. What if you're healthy? Are you just more worried about catching it or? Or spreading it. Or spreading it. There's two things. I mean, we have a responsibility to each other not to spread this thing. And who wants this thing?

I don't want it. And we talked earlier with this, when we were talking to Scott Adams, that there are people in the young age groups that will get seriously ill from this too. You don't want to take that risk if you can avoid it. If this is Tony, I'm going to take, actually, yeah, let me talk to Tony real quick, and then we'll bring in Katie Morton. Also, Kelly has a great question at the very bottom. On the bottom of the- Not dealing with her sobriety. Yeah, I want to get to that. So, Tony, go ahead.

Hi, Dr. Drew. I'm coming because with the closures of, for instance, elementary schools for a couple weeks, a lot of us are going to be taking care of family members. And I'm wondering what's realistic in the sense of keeping a kid at home 24-7. I mean, is it okay to take them to the store if you have to go to the store? What are your views on that? Again, I just say fall back on the CDC recommendations. They are not telling you to stay home entirely. And remember, kids are at very low risk. Not no risk, but very low risk of this thing.

We have learned that kids have some risk, even though that's unusual. So having them, you know, you've got to take kids out and teach them about hand washing and use Clorox wipes everywhere and keep a good eye on them. I know it's hard when kids are getting involved in stuff and grocery stores are environments where everybody's going, right? Everyone's getting in there and touching things. So you have to be very, very careful. But I just, I think the excesses are going to end up creating more trouble in the long run. So you've got to pace yourself out. I mean, if you're going to keep your kid with you for the next two weeks, I mean, Producer Susan, you've spoken about how you would feel

if our kids were that age. I would lose my mind. Right. And they'd all want to go to Disneyland, and that's cool. Exactly. Yeah, and so you've got to pace yourself a little bit and be realistic. And then watch tomorrow, Tony. This is what I'm encouraging everybody to do.

The CDC is coming out with what they're calling specific guidelines tomorrow. And I'm betting they're going to break down recommendations to very specific situations like yours and let's see what they say. So let's wait till tomorrow and read those recommendations. Okay. Okay. Thank you. You bet, Tony. Thank you so much. I think you're going to be fine though. Hey Drew, look at your phone. I texted you a question by somebody. I know. Okay. I don't know if you want to read it.

I know. Let's bring in Katie Morton. She's author and mental health expert. She is a licensed MFT. And Katie, welcome. Hi. Thanks for having me. Are you having the same thing I'm having with people freaking out and calling you all day

long about their anxiety related to this final outbreak? Yes. And I'm having to talk. out and calling you all day long about their anxiety related to this. And I'm having to talk to people off the ledge all day long. And it's, this is one of the, this is where I've been very bothered by all this, which is we have unnecessary panic and anxiety that we just do. My, my approach and can you tell me if this is yours too, which is I'm telling people just do what you're supposed to do.

These people whose responsibility is to get us through this know what they're doing, follow their direction, and we will be fine. What do you think? Yes, I agree. I think the thing that's causing the panic, that feeling of panic where people are stocking up on toilet paper and you know raiding costcos it's just crazy how about the fact that your mayor to text you everybody in the city goes stock up on food right now it's like what of course my patients are going to be hospitalized as a result of that it's just too much our system's overwhelmed we go into like fight or flight but we don't really have a action to take you know we're not like running from a bear or like oh we're safe yeah we're it's like a virus and we

don't really understand it and there's all this misinformation social media is not the best place always to get this kind of content you know the cdc is a great resource you should go back to that yeah yeah i and it i mean i'll even admit if i spend too much time on social media or watching the news i get ramped up. I can feel myself getting more and more worried. I have trouble going to sleep at night. I start doubting my judgment. I start questioning what I'm thinking.

It is the madness of crowds. I mean, I would urge everyone, read the book, Extraordinary Popular Delusions and the Madness of Crowds. We're in it. We're in the middle of one of these things. We are. And it's sort of okay because the behaviors we're manifesting are good for the viral outbreak, bad for our mental health and the economy. And there should be a balance we can get right here. Yeah, and that's why it's important for people to do what they can.

If you feel like you're in that state of freeze where you're just terrified and you question your judgment, like I'm not sleeping very well either. You know, that's when you try to take some action. Like maybe if cleaning your house makes you feel better or distracting, watching a funny movie. Like earlier, I think it was Greg was saying how his sister was watching Contagion. Like let's not increase the symptoms

that we're already having by, you know, putting ourselves in front of that kind of content. But it is, let's not increase the symptoms that we're already having by, you know, putting ourselves in front of that kind of content. But it is, let's acknowledge that it is a normal human impulse to scratch an itch, right? We do that. We reenact traumas. We go over things. We make things worse. And let's reverse that. Oh.

Exactly. Yeah, I was on Netflix earlier and it said one of the number two trending was the movie outbreak oh no of course it is it should be bridesmaid or something like that it should be something to laugh at or nikki glazer's stand-up special let's do that oh yeah anything anything other than yeah scratching that itch and also the thing that i think is the most difficult especially for my community i hear a lot is like this isolation that they're feeling, especially if you live alone. That's why it's important. We have tools, right? We have Skype.

We have Google Hangouts. We have live streams. Like connect with people still because that is really through research. We know the antidote for all this panic. It's the only thing that can really calm us down. And so, you know, connect with your loved ones. Give your mom or your grandma a call. And, you know, it'll help soothe your system a little bit. I'm just confident. I'm, and that's what's missing out there. At least that's what's the media's not doing. They're undermining

confidence. And I am confident in the people that do these things. And even Dr. Gounder, who was worrying about ventilator and the ICU beds, that kind of stuff. Yeah. Yeah. She should be worried about it because that's her job is to worry about these things and then adjust and then flex and create the capacity as the surge occurs. I'm going to bet that we get a surge somewhere. And that's going to create so much panic because the press will make optimum craziness out of that and so look forward to that uh i predicted that they would use the word pandemic to freak us all out and i will just remind everybody that pandemic is just a technical word that means new virus widespread that's what it means we had one 10 years ago you don't even remember it so you've all lived through a couple of pandemics and you don't even remember them so don't let that word

freak you out. Now, I'm not comparing this outbreak to those outbreaks because this one has some unique challenges. I get that. But, man, I just, I feel that's what I get upset about every day is how the stuff I see on TV is designed to make people crazy, make people upset. Yeah, it's, they're like like we talk about being contagious the virus is contagious but so is fear and panic and it's like we're spiraling with each other and i really think that people should be more responsible with how with their language around it yes because that's what's causing the chaos at the grocery store and the language you know

toilet paper people can't even Avoid words like staggering and incredible. Hey, Mike from, where are you from? Immune Town? Union Town. Tell me where you got that CDC recommendation for canceling events of 50 people or more, because California has already done that, and I'm wondering if that's why we did that in California. If the CDC is announcing that now, that seems a little premature because they were going to announce everything tomorrow. We'll see. Katie, anything else that you're

thinking about that you're not seeing people talk about in social media or on media generally that you wish people would as it pertains to all this? I mean, the main thing really, and I think we're going to grant on this, is just always check your facts, check your sources. Don't read a meme and take it as fact or truth. A tweet is not research-based. So the more that we can make that a priority, I think the less panic we'll feel. And I really think the connection with people will calm us all down.

Well, you know, I've noticed the connection thing has actually gone rather well, that people have been sort of, hang on, here's somebody has a mental health question. I'm going to get to her in a second, but that people have done a really good job of re-entrenching with people they care about and, you know, using their emotional resources. I think it's a good thing, some of it. So let's talk to Bethany here. Bethany, go ahead. Yes, I was wondering what this means for the mental health community going to therapy and how is that going to change with the therapy offices and people that struggle with panic disorders

that rely on going to the doctor for medication and therapy offices? That's a great question. Katie, you're hearing from your peers. I'm going to put you on hold there, Bethany. Thank you for the question. Katie? Yeah, I mean, what I've been hearing is that people were trying to see patients as long as they could, but at this point, we feel like it's kind of irresponsible.

Really? So Skype sessions. Oh at this point, we feel like it's kind of irresponsible. Really? So Skype sessions. Oh, Skype sessions. I see. But I mean, it's not like you're having a group. I mean, you're just one individual practitioner with one patient. And again, as long as you're six feet apart, that is still the recommendations with the CDC. The worry that I heard was, I mean, I share an office.

So there's like four other clinicians in the suite that I share. And with that amount of people coming through every day we know that it can live on things people were very concerned we were wiping things down um but i think if if we feel it's appropriate because there are some people who prefer to be i understand like in office there's something about that that makes it so much you know yes better for's really better therapy. But we have so many resources to connect outside of the actual office space, and so a lot of people have been doing that. So let's leave it on be sensible. I also just got an email from a guy named Duke Roomley who sends me a lot of –

he's from Sober AF Entertainment, and he has a daily international 12-step open meeting every morning at 9.30 a.m. Eastern. Yeah. So I think he's at like soberaf.com or something like that. But I still, that's good. And I'm sure there's lots of things like that. Oh, there are lots of them.

There are lots of mutual aid stuff online. But I still think some people need a little group. In person. Yeah. I mean, 10, 15 people, that's a meeting, you know, break them up into small groups. That's fine. You're not, you're not being told you can't do that. Now, when you get there, don't hug, don't hold hands. When you say the sobriety prayer, you know, that that's just be sensible again. Let's, let's see. And it's, unfortunately,

I don't know what the CDC is going to be issuing tomorrow morning. They say it's going to be a lot of new information. So we'll see tomorrow. And it may be a mandate that we do not go to these things. Yeah, we'll have to wait and see. Yeah, just follow their direction. Kelly, what's up? Hi, Dr. Drew. Kate, love you guys.

Never dialed in like this before. I guess my question is twofold. Really struggling with sobriety right now also ed um hoarding food uh having all that food in the house um just dealing with i'm two months sober and seeing all the memes online about like hoarding wine i i'm really struggling guys so if any advice you could give me, I would truly appreciate, and I think talking to sober friends, they're kind of in the same position as well. So stay with us. I'm not going to put you on hold, but you need to interact with you a little

bit. So Katie, go ahead. Yeah, I mean, eating disorders are my specialty, and you're not alone. I've been hearing this a lot it's true it's hard for my patients who um under eat to have to go get more food it's hard for my patients who overeat to have all of that food in their house my main recommendation is connect with other people in the same spot so you can vent a little bit about it and use your tools when you have that urge i always direct my clients to use what i call like an impulse log so my impulse is to overeat or undereat. What's the feeling that I'm feeling?

Is that panic? You know, you have tools that have helped you in the past. And now is the time we really have to lean on those and lean on our connection with other people, you know, who are in recovery as well. I would say too. Sorry. Go ahead. What I did in the past, I would go on a walk or go to the gym and i if i

can't do that like like sorry it's just um what can i do if my coping mechanisms are removed with warrant but removed um i mean my friends but i don don't want to be too intrusive because they're going on through their circumstances right now. So anything that you guys can say, I would appreciate. Also, I am seeing people on Restream from, it looks like Periscope, telling me that the CDC has come out with that recommendation of 50 or more to be avoided. Okay. That's what we will do. Wouldn't it be better to just go to the gym and catch the virus and completely lose your mind?

Well, that's what they're doing in England. They actually have a policy of trying to get 60% herd immunity up, but the rest of the world is going, dude, that's going to create all these people that are going to come infect us. So I, again, I just do what the CDC says, but Katie, I'll let you answer her. Yeah. I was just going to say going for a walk. I don't think that's something you can't still incorporate. Maybe it's going earlier in the day so that it's not so packed. I mean, that's all something that, you know, we can still integrate.

Or if it's something you do online, like I usually attend yoga classes, but my yoga studio is closed. And so I've been doing them through YouTube. So there can be ways for you to still kind of get that energy out in a healthy way. So Kelly, you know, one of the things that I'm looking for in response to this whole thing is that we all come out of this with some skills and information, sort of a new normal, let's say. And I'm wondering if this is an opportunity for you to lean in a little bit and to really lean into your anxiety a little bit. That's one of the ways to get over anxiety is to own it and go, this is an asset in certain ways. I'm a compulsive person. I get things done and I worry about stuff. That makes sure that I'm on top of things and I'm going to use that worry to do exactly what

I'm supposed to do and I'm going to be fine. But in order to adopt that kind of positive outlook, I think you need to have other people around because they help you regulate. And of course, in your sobriety, I mean, that's a big thing is keeping other people, you know, call your sponsor to make those contacts. But let's not look at this as something you can't get through. Let's look at it more as an opportunity for you to get some skills and resources out of it. How about that? That's what I've really trying to lead in um really trying so i would say to anybody else that's been making me feel so much better just

like texting somebody that i know is going through the same thing um provides a bit of relief um again two months over my yoga studio closes That was the place that I was like, really felt was like a refuge. I guess leaning into, I'm controlling as much as I can. I guess. Well, here, here's, I didn't hear, Kelly, let me interrupt you. Kelly, let me interrupt you. There's a piece of your history I didn't hear when you first told me was that you're only two months sober. And two months sober is a very, very fragile time. I get that. And so I would even, I get it.

And I think that's what you're really contending with right now is the fragility of early sobriety. And so I would say double down on connectivity, just like Katie was saying, really reach out, you know, meetings, meetings, meetings, sober people, stay with the winners. And again, that then becomes a way of managing this in a healthy way. Okay. Okay. I will definitely do that, sir.

Thank you. You got this. You got this. The other thing is getting the food. Like, how do I just deal with like, oh, I have an abundance of food to not lean into the binging tendencies when, oh, I'm not drinking, but I'm eating. I guess that's my big story. I'll let Katie answer that. My response would be to, everything's managed the same.

The recommendation is the same for all these feelings and impulses. I agree with Dr. Drew on that. And that's kind of like the impulse logs. Like when that comes through, you have to figure out why you're having that urge, what's triggering it, what's the feeling. Is there something I can do that's been useful in the past to help me manage that feeling?

It could be connection. It could be going for a walk. It could be any of those things. Yeah, I know it's hard, but you got this. You have the tools. We just have to pull them out of our tool belt and use them. And let's not kid ourselves. Two months into sobriety, that's tough.

It's hard. It's tough. But there are a lot of people who know that and are there to support you. So unfortunately, in a different time, I'd be putting you out to three meetings a day. Now you're going to have to find stuff online like crazy. Yeah, go online. Yeah. Sober a F E.com. Um, so let me see if I can get one more call in here. And also just so people know there's a, the crisis text line is available. Um, I know that that's not always best for everybody texting, but seven, four, one, seven, four, one is the number. So

if you're feeling on edge, if you're worried, you're about to do something impulsive and stupid, maybe that impulse can be delayed a little bit and you can shoot a text out that just says help. That's reaching out. That's the key. Sean, you're asking, I'm not going to take your call, but you're asking if you're obese,

that you're at any special risk. And not unless you have some risk, because if you're truly obese, risk. And not unless you're, you have some risk because if you're truly obese, your pulmonary reserve is restricted. And that is an issue, but it's not a specific risk category as of yet, unless you're over 60, then we have a problem.

And you are 33. So you should be okay. Again, provided it's not massive obesity. Asthma, again, is the same. What would be the difference between, sorry, just because I'm sure people have this question, what's the difference between regular obesity and massive obesity? Well, or morbid obesity, it's called. I'd have to look up the formal definition, but morbid obesity, let's look it up real quick so I don't speak out of turn. Morbid obesity, define.

Okay. Yeah, 100 pounds. That's what I was was going to say 100 pounds over ideal body weight so yeah and and i people argue about that definition i mean it's enough to cause restriction of your lungs that's the key thing that you can't take a deep inspiration because there's such weight on your chest or underneath your diaphragm uh that's why I worry about its effect on pulmonary function. Well, Katie, let me wrap it up. I, as always, appreciate you contributing. Where can people find you? I have a YouTube channel, just youtube.com forward slash Katie Morton.

I just released a video all about what we're talking about in more detail. So if you want to go down that rabbit hole with me, you can learn about your stress response and how to soothe it. Yes. And I think, would you agree with me that maybe turning away from the press is a good idea? Don't watch the social media and the press. That's the greatest source of this panic that I know of right now. Agreed. 100%. I mean, again, when you said watch your language, that gets all my stuff going because that's what I have seen for the last month. A language that is gets all my stuff going because that's that's what i have seen for the last month a language that is dangerous and it's hurting people i'm not saying that we shouldn't take it seriously that the cdc is overreact i'm saying you go beyond the cdc recommendations

you use language beyond what they're using at the cdc you are inciting this you're you're dangerous you're dangerous you're going to incite panic and you're going to hurt people who um are much like the people we've been talking to for the last 15 minutes so well we have to think about the greater good not just getting clicks and views you know so it's just frustrating just yeah limit your amount of intake uh so i'm looking at the U S let me look at the U S Stata right now. It's three, two, four,

four cases, 62 deaths. We're still in pretty good shape right here. And the next two weeks will tell us a lot more sort of where we are and what we can expect. And I think it's going to go pretty well. I just think it is. Katie,

thank you so much. I want to say farewell to you and we'll look for you at your YouTube channel. Thanks for having me. You betcha. I want to say thank you to Caleb Nation for risking coming out in this. Appreciate it very much. Susan. I'm alive. Great job. Susan, anything else you want to get into here

before I wrap things up? Everybody loves it. It sounded really good today. Okay, good. New microphone from Blue Mic. Yeah, this microphone is crazy good. And these headphones too. Yeah, Blue Mic. Blue Microphone, we'll tell you more about them at a future podcast and whatnot. We may be back tomorrow with Rob Schneider on Dose of Dr. Drew.

Yeah, Rob Schneider is red hot. He's very concerned about the excesses in the media. And it's really bugging him. And so he wants to come on and talk about it. And I'm all about that. I think we need to, we need to balance. We need to balance what's out there with what is and what we need to do and what our responses should be both emotionally and otherwise.

Ask Dr. Drew is produced by Caleb nation and Susan Penske. Today's call screener is Lindsay K Floyd. Thanks for subscribing to the podcast. If you have a question, go to drdrew.tv, that is D-R-D-R-E-W.TV and sign up to receive an alert next time I am taking calls. No spam, just quick alerts when I'm streaming live. Also, you can text your question to me right now at 984-237-3739.

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