The Pomp Podcast - #247: James Todaro, MD on Coronavirus, What Makes it Unique, and Potential Vaccines

Episode Date: March 20, 2020

James Todaro is the Managing Partner at Blocktown Capital and a Physician with a Medical Degree from Columbia University. In this conversation James and Anthony discuss the Coronavirus, applying existing medication to treat it, timelines for potential cures, how we can prevent it from spreading, and what to expect in the coming weeks.  =============================== LEDGER----- Ledger hardware wallets empower you to optimally secure, own and control your crypto. Visit ledger.com and give yourself peace of mind by knowing that your cryptocurrencies are safe. ~If you enjoyed this episode and want to stay updated on everything Bitcoin, blockchain, and crypto. Check out Off the Chain newsletter by visiting offthechain.substack.com and join 35,000+ other investors currently subscribed to my daily investor letter.

What's up, everyone? This is Anthony Pompliano. Most of you know me as Pomp. You're listening to Off The Chain, simply the best podcast in crypto. Let's kick this thing off. James Todaro is the managing partner of Blocktown Capital, a cryptocurrency investment fund and a physician with a medical degree from Columbia University. In this conversation, James gives us an overview of COVID-19. He explains why this is different than other viruses and flus. He walks us through the vaccine and cure process for production. And then he talks to us about a potential cure that has recently been identified. This entire conversation was super enlightening, and I learned a lot from it. I'm thankful to James. But before we get into this

episode, let's talk to one of our sponsors, Ledger. I'm going to play a recording now that they've made to tell you more about what they're doing, and then we'll get into the episode with James. I hope you enjoy it. Digital assets custody can be quite difficult to secure and hard to scale. Firms are often left with a difficult decision, having to choose between security or liquidity. At Ledger, we're obsessed that our clients' businesses succeed. That is why we decided to create a digital assets platform that would enable financial institutions and crypto firms to manage their funds without compromising on security and liquidity. Firms like Uphold, Bitstamp, Crypto.com, Indax, and Dunamu are already using Ledger Vault to operate their

business at scale while maintaining the highest standards of security to protect their clients' funds. Visit ledger.com slash vault to learn more. Control, scalability, agility, because security is not enough. Anthony Pompliano is a partner at Morgan Creek Digital. All opinions expressed by Pomp or his guests on this podcast are solely their opinions and do not reflect the opinions of Morgan Creek Digital or Morgan Creek Capital Management. You should not treat any opinion expressed by Pomp as a specific inducement to make a particular investment or follow a particular strategy, but only as an expression of his opinion. This podcast is for informational purposes only. All right, guys. Bang, bang. I'm

here with James, who's going to teach us everything we need to know about COVID-19 and potential vaccines and cures. Before we kind of jump into this conversation, I just want to kind of caution everybody. We're recording this remotely. Normally we do everything in person, but given the remote recording, the audio may be a little shaky. So just bear with us if anything happens. But James, thanks so much for joining us on Short Dose. Thanks for having me. Let's start with your background. You know, I kind of want this to be the ultimate explanation of COVID-19 vaccines and cures, but what does your knowledge base come from or kind of your training that gives you the perspective you have? Sure. So I guess I really have kind of two

backgrounds. So one is in medicine. So I graduated from medical school at Columbia University in New York back in 2014, and then went on to do ophthalmology residency. So residency in eye surgery and graduated from that in 2018. I also studied epidemiology during medical school and some research in that as well, which kind of gave me another perspective, I think, on coronavirus and this epidemic, pandemic. Parallel to that background, and what most people on Twitter and in this whole universe know me is for cryptocurrency, for Bitcoin. It was in the last year of medical school, so end of 2013, 2014, when that first wave

of people kind of got interested in it, it really caught my attention. And within a couple of weeks, it just made sense to me. sound money, scarcity, censorship resistance, Swiss bank account in your pocket, all the things that you've said many times. And then I basically divided my time where half of it was spent in residency, which that's already busy, but I also spent about 30, 40 hours a week studying cryptocurrency investing in it. And so that worked out very well in 2017, gave me the ability to actually step away from clinical medicine. So in 2018, after I finished residency, I stepped away from clinical medicine entirely to focus on cryptocurrency investments in this space.

ironically it's cryptocurrency that kind of got me back into the medicine space again now with coronavirus um the uh so i guess quick aside so blacktown capital is kind of what i've been focusing uh attention on lately that's a our gp only fund um and so that's what we've been publishing research under but with cryptocurrency we manage a lot of investments in the space and It's very volatile and it's very impacted by world events. And so when I started seeing evidence come out of Wuhan and China of this coronavirus, it really caught my attention. And I was like, is this going to come to Europe and then America? And is it going to wreck the markets and wreak havoc on my investments?

And it didn't take long for me to become convinced that there's a really good chance it would, especially when it started to seed in Europe. Um, and then, uh, and then, yeah, for the past couple of weeks, it's been a whirlwind where I feel like every single day there's a new announcement that is surprising to a lot of people. Got it. So let's start with, uh, kind of COVID-19 or coronavirus. I think everyone at this point has heard about it. Most people are, uh, being quarantined or staying at home and stay away from people

through social distancing. Give us kind of just a one minute, like what exactly is this? And why is it different than all of the other kind of seasonal things that we would see that are somewhat related? So I think from a high level, one of the big differences from coronavirus is its mortality rate. That was the big controversy back, you know, three or four weeks ago, a month ago. At first, it was this is only going to stay in China because it's not very it's it's why would it spread to anywhere else? And so what you have to look at is the R0. So that means for each person that's infected, how many people will that one person infect?

And if it's more than one, then that means this has the potential to turn into an epidemic or pandemic, because now more people are being infected than recovering. Coronavirus did. That's what first caught my attention, which makes it not different from the seasonal flu. Like that can have an R0 above one. But then that combined with this amounting evidence, especially with that ER doctor, was kind of the whistleblower on this when he died that really got my attention you can't uh that death was was prominent he was a young supposedly healthy er guy this was more fatal

than the seasonal flu you rarely see people from the seasonal flu that are young die maybe sick and then elderly people sure so the are not is one thing and to compare this to other historical because i know which i got a lot of flack for this early on in twitter when i kind of started talking about coronavirus uh in early february they were like just talk about bitcoin don't talk about this don't you what do you know about that and one of the things people kept saying is how is this different from the flu this is no different from the flu and um it was that or or i was actually so not only for the flu but the second thing of someone is is they people felt like they were being tricked again by the media in the sense that sars was supposed to be this big outbreak

that didn't really seem to amount to much ebola but the the differences with SARS which is why I realized early on this wasn't playing out that way is SARS was not very contagious before you started having symptoms so it was much easier to this is longer than a minute but it was much easier to contain because once you got sick you you stayed home and then you didn't really affect anyone else. The big difference with COVID-19 novel coronavirus is that you can be contagious while you're asymptomatic. So you don't know and you're spreading it and then you get sick a few days later, but you're already infected two, three, four people. So I'd say that's why this is different than say Ebola or SARS. And then it also combines that more fatal element than the

seasonal flu. Our bodies are not used to this virus essentially. Got it. And so before we get into what I'll call kind of the vaccine and cures component of this. A lot of what you just described, your analysis, kind of those original alerts that you saw, red flags, is all about data, right? And one of the questions I think a lot of people have is, we've got a pretty good sense of the accuracy of the deaths, right? So the aggregate number of deaths, somebody died, you can test them, did they have it, did they not, maybe before or after death. But the denominator to that mortality rate is how many people actually get infected and then how many people die. There's not a lot of testing that's gone on. So how did you, using that kind of caught your

attention in the beginning, the sort of red flags you saw, et cetera. I think that there's a lot of confidence in the death number, just given that people are actually dying. It's pretty easy to confirm that. And you can either have tested before or after death to see if they have this, But the actual number of infected, given the low amount of testing that's available, especially in the United States and in parts of Europe early on, how did you think through the accuracy of the data or kind of understand, you know, how bad is this or could we just be looking at bad data? So that's a great question. And that's still actually an important question is how many people are we actually detecting that have coronavirus? That was one of the big problems is rolling out this testing to be able to determine that. And even today, a lot of the experts on this, including myself, my opinion, is the fatality rate probably is lower than what's coming out of, say, Italy, which is 5% or so.

There's a really good chance that people with milder symptoms maybe aren't going to the hospitals to get tested or staying home. And sure, they're bedridden. It could be the worst flu of their life, but they recover. But those would all be people that lived and didn't die. So that still could be the case. I guess one thing, though, that pointed me to, kind of goes in the other direction of the mortality rate, is because this is a pandemic, the amount of cases was rapidly increasing. So back in January and early February in China, when it was still increasing, you actually had to compare the number of deaths to about the number of cases 10 days ago. Because right when you test positive or get it, you don't die.

There's a 10-day delay. So looking at that delay, when it's rapidly rising in China, it gave me an impression this mortality rate was, there was actually a fact that the other side might be higher than those numbers, but then also there were maybe undetected cases. So I kind of balanced that out and it's, you know, you just have a rough number, but it looked like there was still, there was a reasonable fatality rate, far worse than the flu. Got it. That makes sense. Okay, so now that we understand kind of what this is and the fact that the infection rate and kind of the symptomatic versus asymptomatic are all reasons why this is more concerning, let's walk through why don't we already have either a vaccine or a cure for this? Like, what's kind of the scientific explanation behind the lack of that stuff being available today? sure so you really it's it's difficult to make a vaccine for a virus that you don't know of so this is novel coronavirus it's new so you wouldn't expect us to have a vaccine for it what we can do

is isolate parts of this virus and then introduce it in cultures and form a weaker version of this virus that we can then give to people that's essentially we do it either when you get a vaccine you're getting either a dead version of the virus or a weakened version and so your body most of the time you don't even feel anything sometimes you feel a little bit under the weather and so what that does is now you don't really get sick but now you have immunity to that disease so that takes knowing the virus studying it and then coming up the vaccine that realistically we're not looking to have that until mid-2021 early 2020 would be a shock if we even are able to successfully come up with one regarding a cure for it viruses are very hard to cure so

coronavirus on a molecular biology level is a single-stranded RNA virus. So what this means is it mutates quite rapidly. So there are times when we can cure viruses. We have cured certain viruses like hepatitis C in the past with medicine, but it's notoriously hard. A lot of times what you can have is find a treatment that can work some part of the time and kind of flatten the curve in how fatal this virus can be or how much it will spread. Got it. And so what's the process? Let's start with maybe the cure first, and then we can go to the vaccine.

What's the actual process that people will go through to test and actually validate that, yes, there is something out there that can be a cure? It's a long process. So you have very early studies and cultures, and then next you have very small trials of 50 patients, and then you kind of keep rolling it up from there. The U.S. is very cautious, very regulated when it comes to studying and approving, the FDA approving medications. and that has saved the u.s in the past from certain medications being harmed like the thalidomide is a chemical is actually very toxic to pregnant women and so this was rolled out in europe but the u.s said wait hold the brakes on that and that turned out to be a good decision

in the situation of a pandemic though it kind of works against us because we don't have six months a year 18 months to be like we're going to find a vaccine or medication to treat this and go through all those proper steps, which we usually do. And so that's where, you know, I've kind of been focusing on a treatment, potential treatment that's already widely available, known safety effect profile, and something that about a million people or so globally are already on. So if this could actually cure or help reduce the symptoms or reduce the amount of people to get infected with coronavirus. That could be huge. You could expedite those trials and that process much more quickly than developing a whole brand new treatment over the next 6 to 18

months. Got it. And then is it similar process for the vaccine as it is for the cure, or is there a completely different process with different timelines and complexities? I would say a vaccine would even probably take a little bit longer um especially if you talk because now you're talking about rolling this vaccine out to a large number of people so if you're going to also start making like the flu vaccine where you're recommending just about everyone in america or in the world gets this vaccine you don't want to mess that up right whereas a treatment you can be like okay well this person's already sick we know that there is a three percent mortality rate we know that this treatment has a very favorable side effect profile potentially and so it's much

easier to prove that as opposed to rolling out something that's in healthy people um that we don't you know the side effect profile has been studied less because there's always that concern with the virus there's always that concern with the vaccine that that weakened virus could mutate into a harmful virus and then you don't want to die from the vaccine got it and i think that i saw um this is like the uh imperial college paper uh that recently came out uh their whole thing was even if you start uh identifying what you think could be a vaccine it's got that really long time frame kind of 12 to 14 months they said at the earliest um until you could confirm it and it sounds like a lot of that sort of what you're saying is

revolves around just like you can't go tell people this can save you from you know covet 19 but oh by the way there's a 20 chance it could kill you at the same time right you've got to for sure you know what's actually safe for the human. Right. The first three in medicines do no harm, right? So you don't want to introduce them to something that's going to actually be more harmful than just, you know, maybe living out the course of the disease. Got it. Okay. And so talk to us a little bit about the potential cures that you're looking at. I know that there's some encouraging, I think, reports and data that is starting to come out now as to how there may be some things that will actually cure this or at least reduce the symptoms?

Yeah, so what I've been focusing on with one of my colleagues is basically, it was about two weeks ago now, I started seeing evidence coming out in guidelines from China and South Korea about chloroquine being a potential treatment for coronavirus. And I started doing a little more digging into that. there was some mechanisms of action that showed how hydroxychloroquine or hydroxychloroquine, I'm going to kind of use them interchangeably. They're very similar drugs. I can talk about the differences in a little bit, but it has mechanisms to decrease viral replication in cells and actually eliminate that process entirely, at least in vitro.

And they studied this in the SARS version of coronavirus. And so there's already a base of in vitro studies for that. This kind of idea, which wasn't really talked about yet about chloroquine being a treatment for coronavirus, was kind of justified in my mind when I started to see the United Kingdom banned export of the active pharmaceutical ingredients in chloroquine. China did similar. They essentially announced in February, look, the priority, they brought them back to the Chinese New Year early and said, hey, look, we need you to produce hydroxychloroquine in high volume we're going to stop all exports of this and we need to prioritize wuhan in our own country to make sure that we can stop this and then in march 9th i was in contact

with pharmacies and one of the pharmacists i contacted the manufacturer of rising pharma of chloroquine and announced and told us there's a national shortage of it and so all these things in my mind was like you know basically triggered there's something big going on behind the scenes either they think chloroquine may be an effective treatment or it already potentially is an effective treatment. And so that's when I started talking about it on Twitter and to a lot of colleagues. And this is when one of my colleagues on Twitter contacted me. I said, hey, I've been studying chloroquine for a number of years. It looks like, you know, I know the mechanism of action behind this very well. I have a paper that I put together. Take a look at it and see what you

think? And I looked at it. I changed, added some clinical elements to it. I was actually already familiar with Borquin on a clinical level because one of the main side effects is vision loss. You can have, it's very rare, but you can have vision loss from it. And so I've seen a lot of patients that were on it. And so I was able to add those elements to it and more of a clinical, I guess, impression of it. And again, that's because I was an ophthalmologist. So I saw, that's why I saw those patients and we released that paper and it got a ton of attention it was retweeted by elon musk shortly thereafter and just kind of blew up from there and we were contacted by press the media uh my co-author so greg regano has now been on the war ingram show

he was on tucker carlson last night i think he's on glenn beck today as well um and it's uh you know, it's really, it's starting to become a little bit more justified. So what we have is this kind of summary of all this evidence, I think, to show that chloroquine might be an effective treatment. And then what I announced yesterday, which was we're being in contact with Didier Raul, this very famous infectious disease doctor, MD, PhD out of France. And he's been studying this for the last few weeks as a treatment for patients with coronavirus. And he had very positive the results. It was a small study, just about 36 people that stayed enrolled till the end, but it showed that the combination of hydroxychloroquine plus azithromycin. So again,

hydroxychloroquine is like chloroquine, it just actually has a safer side effect profile. So it's kind of used more often than chloroquine. But it showed a very small sample size still, but showed 100% decrease in viral load in 100% of the patients who received both hydroxychloroquine and azithromycin and so this is a small again a small sample size but very positive results regarding this treatment method and this was announced by my co-author on tucker carlson last night and it seems like donald trump reacted to that as he and his press conference today talked about he specifically talked about anti-malarial medications hydroxychloroquine how this needs to be expedited and cut through the red tape if possible to allow physicians to

make physicians feel comfortable in using this drug to treat COVID-19 positive patients. It's pretty crazy that it seems like many of these people are getting their news from television or from Twitter, but it's human nature at this point, right? A lot of this content that gets shared around, that's where people are learning from. Walk us through, what is the difference between the hydroxychloroquine, I think is how you say it, and zithromycin. What are those two things kind of at the core, right? And understanding that most of the audience isn't going to be highly scientific, but just how would you describe those? So hydroxychloroquine is really used mainly as an immunosuppressant. So it's actually used for

treatment in patients with rheumatoid arthritis or lupus. It kind of suppresses the immune system in the way to keep the body from attacking itself it also again has antiviral properties and anti-parasitic properties so it's used as a prophylactic or treatment for malaria it's very popular in in Africa azithromycin is typically known as being an antibiotic usually prescribed for bacterial infections but studies have shown that has antiviral properties so coronavirus is a virus it's not a bacteria so that's a very important difference. That's why they can't give you antibiotics for just a seasonal cold. I mean,

you could ask them, people often ask them, but it really isn't going to actually help because it's a totally different type of species. But azithromycin actually has antiviral properties in bronchial epithelial cells. And this is where coronavirus will attach and infect is a lot of the respiratory tract. And so azithromycin, it makes sense why it could help treat or be preventative, treat or prevent the coronavirus. Got it. And then when you talk about those being used in unison, is this actually like a scientific mixture, right? Meaning that you're creating one single solution by combining these two, or is this two separate either shots or however they're actually administered, they're kept separate, but you basically take them at the same time? correct so in the french study which is really the the most data we have at this time on this combination therapy it's two separate pills so you take your hydroxychloroquine and then you

take your azithromycin and so what he did for the hydroxychloroquine it was a 10-day treatment of it at 600 milligrams a day and then azithromycin was a 500 milligram loading dose the first day and and 250 milligrams for, I believe, the next four days. So oral form, separate pills, but used in tandem combination. Got it. And so where do we go from here? We've identified these two drugs that we think have the potential to be effective in treating this. We've got what I'll call kind of an initial early study that shows some encouraging results. We obviously don't have time to go through kind of the traditional process. But as you mentioned earlier, we want to make sure people are safe and actually can validate the efficacy of this. So what does that

process look like or where do we go from here? So I think what I kind of alluded to earlier, one of the interesting things about hydroxychloroquine is so many people are already on it. So you already have a million or so people. So if there is a way to analyze that data that already exists and see if any of those people are getting infected with coronavirus. And as the incidence or prevalence of coronavirus goes up, you should start to see overlap. You should start to see lupus patients or rheumatoid arthritis patients who are on hydroxychloroquine as becoming infected. And so if you were able to create a study that could analyze that group of people, and maybe it's too self-reported or some other means, then it'd be, I think,

a safe way to evaluate efficacy of this drug very quickly, as opposed to doing a controlled trial where you're a placebo and all that. Got it. And so once we get past kind of those studies, so I think of studies maybe correctly or incorrectly as the way to gather data. What are the milestones or kind of the stamps of approval? Like what does that look like? Is that the people who run the study saying, hey, stamp of approval, this works? Is there some kind of overarching, like a governing body or government organization? What does that kind of approval process look like before it can actually start being given to patients kind of on the ground? Yeah, so there's basically two different ways. So you either have to come to the FDA

with sufficient evidence to show this medication is safe and beneficial in the treatment of a specific disease. That's the, if you want to call it on-label use. So that's, you know, what the prescription is designed for, let's say. Doctors also have the option, though, to use medicines off-label, which means this is not the FDA-approved indication for it, but doctors still have the ability to prescribe medications where they think appropriate or necessary in patients that it's not the specific indication that the FDA approves. This is where things get interesting, though, Because in America, medicine is fairly litigious. So if you as a physician deviate from that standard of care and then something goes wrong,

even if that something went wrong was a small percent and that could happen to someone with an FDA approved indication, it still makes you vulnerable to a lawsuit. And traditionally, it's academic physicians or people, physicians are very comfortable experimenting with new use cases for these drugs. They will see those patients. The problem we're seeing in a pandemic is those physicians, those academic ones, they're kind of becoming overwhelmed. You have patients all over. So it's not just a very rare case of something where you're looking for a physician that will treat this thing with this off-label use.

You have physicians everywhere that are kind of stuck in this thing where do I use a certain medication off-label to treat all these coronavirus patients that are coming into my ward? or do i give them iv fluids and uh you know hope they get better and that's i think the question that a lot of physicians in the u.s are dealing with right now and so they're looking for some guidance from the fda essentially saying hey you can use which that's kind of what trump did a little bit today the fda i think backpedaled on that a little bit but he essentially said look i'm approving people for approving physicians to use the this medication hydroxychloroquine in coronavirus patients. I don't know if it's really that hard that we pass through it. I think there's still some red tape that maybe needs to go through, but that's essentially, I think,

what he's aiming at. Yeah, it's really interesting to see a lot of kind of bureaucracies and red tape in the healthcare system being almost broken down in this crisis, right? So everything from what you're talking about, kind of the acceleration or approval process to the ability for a doctor to actually uh administer health care services to a patient in a different state right a lot of telemedicine stuff etc um for those that aren't aware of how bureaucratic health care is there's a lot of rules that uh you kind of mentioned earlier make sense sometimes and other times they seem really stupid right and so it takes a crisis like this to uh kind of break some of those down and then maybe some of them get reinstated later or maybe they don't but but

It's just been fascinating to me to kind of watch this almost tennis match between here's the rules today. Well, should we keep them? Or is this kind of an emergency situation? Let's get rid of them. Yeah, exactly. You kind of take a hard look and say, wait, which of these rules are actually high yield? And which ones are just vestiges of old bureaucracy that is maybe due to lobbyists or who knows? for sure um and so to finish up here uh obviously you've got um kind of two parts of your brain right now i almost think of right you've got the the medical side and the training that you've done there and obviously the hours and hours that you've spent kind of looking at this um and starting to identify some of the potential solutions but then you also are uh an investor and you're managing

capital and things like that where's the crossover in terms of how do you see uh coronavirus and the economic impact kind of continuing over across different markets in the coming weeks and months? Yeah, so it's constantly changing, but I think you have to kind of look out for three different potential paths coming up over the next few months or years. So there's the first path where we do find a medication, a treatment, or a prophylactic that can flatten the curve, reduce the symptoms, reduce the fatality rate, or reduce the number of people that get infected. and that could buy us time until maybe vaccines develop or even until we have herd immunity and this thing in coronavirus just becomes almost like the flora of the seasonal flu and not really a big

deal the second uh path is the virus mutates a little bit so almost like h1n1 uh where it was kind of thought it was a big deal higher fatality rate and then it kind of mutated in a way where a lot of people got it so it's affected a lot of people but the mortality was actually quite low so that's why i didn't even hit the radar all that much and most people don't even know how many people are actually affected by it. And then the third path would be if the virus does not mutate, if we do not have a medication or vaccine for it, then that's scarier, obviously. And what I think you could be looking at is maybe, and this is based off China and South Korea, how the cases have stabilized. The number of new cases is dramatically dropping. Does this have to do

the warmer weather coming in and are we going to see a second wave come the fall and that's what a lot of people compare this to the spanish flu of 1918 where it had its first wave that kind of ended around june july and it wasn't until about october november the second wave came in and that's one that really wiped out a lot of people and so that's something that you're going to be looking out for is if this does settle down that's great that's fantastic but keeping a close eye for reinfections in areas um come the fall on a short-term basis um for americans look at italy we're running about 10 days behind italy so what italy is going through now will be america most likely in 10 days and this just seems so obvious to me over the past couple weeks um and so that's

why it was interesting a couple weeks ago almost no one was really talking about it was almost like a joke. And it was awkward if you were to shake someone's hand or something. Now, it's not. And if you actually just look at those stories coming out of Italy about the people living there, what that life is like, prepare for that, because that could easily be America in 10 days. And I think it's already getting very close to that. And so looking for stabilization of coronavirus, again, look at Italy. When those cases stop going up and stabilize, I think that's good news. And I think that there's hope for this stabilizing at least over the summer and then we'll have to revisit it in the fall and then i think the market so bitcoin and bitcoin cryptocurrency i think it all kind of

goes in something this massive it seems like it kind of is uh trading along with the when the economy is going down it's it's you know it's kind of asset and it goes down as well um yeah one of the things that i've heard and i don't know if it's true or not is that once you get coronavirus, you basically can't get reinfected, right? So the population itself, some portion could get infected, it goes away and comes back and could reinfect other people. But is it true that the individual itself, once you have it, you can't get it again? Or is it just too early to know whether that's accurate or not? So that's typically how viruses work. Once you get a viral infection, you can't get that really exact same viral infection.

There can be different strains of it, though. That's why you can get the flu multiple years. It's not like you get the flu once and you never get the flu again. Another strain can come out the next year, or you might get infected with a different strain even that year. They are finding, though, that patients that test negative after they've been treated later then test positive again for the virus. And so that's concerning in some ways in the thought that are they not treating patients long enough? Is this some type of reinfection? And so that data is being studied now, but I'm inclined to think that's how you get herd immunity is potentially if you get infected, you won't get it again. So that's kind of the hope, but it's not definitive at this point.

Got it. And those different strains, I think the other thing I've heard is basically when the warm weather comes, it may kind of migrate south to South America, Latin America, etc. But there could be mutations. And then when the cold weather returns later this year, North America, for example, that's where really there could be some problems. Because now you're not just talking about the coronavirus, but there could be multiple strains of this or mutations that even if you already had it, you're still susceptible to the new stuff. Yeah, exactly. I think that one thing that people argue that we're going away during the summer is increased temperature will dry out the virus in some ways. And then also the increased humidity. So it's kind of like you have this heat to the sun drying effect. But then you also have the humidity in the air, which will stop the spread of the virus, because if there's enough water particles in the air, it'll stop the viral particles from kind of, you know, projecting when you talk or sneeze or cough.

Got it. That's super interesting. Okay. And then what do you think is kind of the, if you had to guess right now, what does this look like over the next kind of six to eight weeks? Do we flatten the curve, you know, two weeks from now and, um, and kind of start moving back towards, uh, you know, everyday life? Do we stay in kind of this self-quarantined, um, you know, even someplace to shelter in place for weeks, months? Like, how do you think this plays out given the information you have today? Uh, you're going to be quarantined for at least weeks.

I would say at least a month could be a couple months, three months it kind of depends on this thesis on this thing slowing down for the summer but I think we're in for a rocky few weeks coming up and it looked like Italy was stabilizing a little bit

but then they recorded a record number of new cases yesterday and another record number looks like today so we haven't had any, there's been no evidence this is slowing down really for Italy or Europe and so that's not good news for us right now either Got it. And then what do you take in terms of China? I think today we're recording on Thursday, March 19th. It was either yesterday or today they reported no new cases. So, quote unquote, zero new cases. Can we trust the data? How do you kind of fit that data point into this whole thing?

So I'm in contact with people that have come back from China and they feel convinced that China has it under control and that that data is real. That's always been the question, though, is from the very beginning. You know, China didn't really want to announce this was the virus. You had the whistleblowers. They were originally persecuted and now praised. And so there is this always this distrust of the information from China. But South Korea has a kind of very positive results. I think Singapore has been doing a good job controlling this. and so it's possible it's also possible in the kind of social infrastructure side of things i

think in china and south korea the social distancing is maybe a lot easier or if the government recommends it or imposes it it's done much more effectively whereas in italy and the u.s you know like well you know screw that i i'm gonna go kiss whoever's cheek i want i'm gonna go to the bars and so i think that it really takes a little bit more to scare people and now people are starting to get scared where maybe they're scaling back on that a little bit but if you read a lot of the italians what they're telling americans right now is do that now don't don't wait until it gets so bad that you you know there's a curfew you can't if you're outside like in italy right now if you go outside you have to essentially have a pass or a very good evidence of a reason for

being out otherwise you get fined and the only reason you really ought to go out is to go pick up medication or to go to grocery stores yeah the other thing i just saw um literally right before we started recording uh and again so i'll caveat with i haven't had the time to look at the accuracy of it is um israel is actually implementing uh martial law um so like actual true martial law where the government uh or the military is going to enforce people staying inside curfews you know all of this kind of not essential traffic, et cetera. And so I think that we're probably far away from that, you know, in the U S for example, or other places, but, you know,

depending on people's reactions, I think that, you know, there is this overarching feeling of like, we've got to flatten that curve and kind of fight back against this. I would say there's a non-zero chance. Some version of martial law comes to the U S as well in the next two, three weeks. I mean, if, If this thing continues to spread and people aren't voluntarily isolating themselves, then it's definitely possible. It wouldn't surprise me in the next two or three weeks, which sounds crazy for Americans, especially because a lot of Americans have guns.

Well, I was explaining to somebody the other day, if you would have said four or five weeks ago, hey, the stock market is going to go down 30%. 30%. There's the possibility of martial law, you know, all these different things. People are going to look at you like you're nuts. And in a very short period of time, you know, here we are. Yeah, exactly. And I think that people could be in for a little bit more surprises the next couple of weeks. Yeah. Well, let's, let's all hope not. And hopefully we can get back to normal. Absolutely. Yep. Well, James, listen, I really appreciate you coming on, on such short notice and helping us understand this where can people find you uh online and kind of find more about what uh what you're tracking um and paying attention to uh james tadaro md is my

twitter account looks like uh joe just put it on the screen there uh that's the best way to follow i know he's quick that's where i talk about coronavirus updates uh a lot of times it's effect on the bitcoin cryptocurrency markets and that's where i talk about all my crypto insights as well awesome before i let you go i got two questions that you could ask me one uh favorite book or most important book you've ever read most important book i ever read um gosh i guess treasure island for no real reason except it was a book that was probably the first very sophisticated book that my dad read to me he read it to me when i was very very young and And it's actually funny because I felt like he was too slow.

So after he read the first maybe a few chapters of it, I actually just picked it up and read the rest of the book on my own. And so that always stands out in my mind. I love that. It's one of those things where it's not only the book, but the time of your life when you read it. That makes something important. That's pretty cool. Aliens, believer or non-believer? I think there is life somewhere out there in another universe in some way.

it isn't uh that i think that's definitely possible well just because the world's so you know kind of the galaxy's so big or some other reason i mean infinite with infinity you have an infinite number of possibilities right so you can have an infinite combinations of matter that can form humans or people or animals or life it's a fair way to view the world uh what one question you have for me to finish up dude does anyone ever call you anthony or is it always pump so uh my mother still calls me anthony um and uh my family uh they actually all call me aj uh my anthony john uh popliano is my name so they call me uh initials uh for first and middle name

but uh pretty much today if somebody calls me anthony uh it's usually followed up with by the can i call you pop or is that are we not like close enough yet um and i tell people that uh you can call me whatever you want just don't call me an asshole and we'll be good it's anthony pop whatever it all works for me all right man well it's great talking to you thanks for having me on the show yeah thanks so much james appreciate it all right have a good one hey everyone pop here if you like this episode of off the chain and want to help us take crypto to the top of the apple spotify and other podcast charts please do us a favor and rate review and subscribe to review simply go to the off the chain homepage scroll down until you see the five blank

stars taking 15 seconds to fill those stars in and leave a quick review goes a long way in helping us take the entire crypto ecosystem to the top of the charts i appreciate you listening and see you next time on off the chain