Weird Medicine: The Podcast - 399 - COVID-19 Update #4

Episode Date: March 19, 2020

Nothing but listener questions, some news on chloroquine and hydroxychloroquine as possible treatments for COVID-19, a guy with ED, and a terribly rendered song because we suck SO bad PLEASE VISIT: stuff.doctorsteve.com (for all your online shopping needs!) withings.com/steve (for the best fitness wearables on Earth!) Feals.com/fluid (get 50% off your 1st subscription shipment of CBD!) TRIPP.COM offer code DRSTEVE (relax and get 20% off!) simplyherbals.net (While it lasts!) noom.doctorsteve.com (lose weight, gain you-know-what) tweakedaudio.com offer code “FLUID” (best CS anywhere) premium.doctorsteve.com (all this can be yours!)   Learn more about your ad choices. Visit podcastchoices.com/adchoices

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I've got Tobolabovir stripping from my nose. I've got the leprosy of the heartbound, exacerbating my infectable woes. I want to take my brain out and blast it with the wave, an ultrasonic, ecographic, and a pulsating shave. I want a magic pill. All my ailments, the health equivalent is citizen cane.

And if I don't get it now in the tablet, I think I'm doomed, then I'll have to go insane. I want to requiem for my heart. disease. So I'm paging Dr. Steve. It's weird medicine, the first and still only uncensored medical show in the history of broadcast radio now a podcast.

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take everything your grain of salt, don't act on anything you hear on this show without talking over with your doctor, nurse practitioner, physician, assistant, pharmacist, chiropractor, acupuncrust, yoga master, uh, Stacy Deloche, physical therapist, clinical laboratory scientist, registered dietitian or whatever. All right, very good. All right. All right. Shut up. Shut up. All right. So, yeah, Dr. Scott, good to see you. Uh, don't forget, feels.com slash flu. That's F-E-A-L-S. com slash fluid. It's really the easiest way, Dr. Scott, to get CBD oil that's, you know, broad spectrum and of known strength. Right. Delivered right to your house.

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N-O-O-M. It sounds like I'm capitalizing on this. I don't really, I'm trying to make it somewhat lighthearted. It's hard to do. Anyway, and check out Dr. Scott's website at simply herbal.net. Yeah. Kind of been talking about nothing but SARS. OV-2, the virus that causes COVID-19, and I was on Sid and Bernie the other day.

I've been on the phone with the air traffic controllers of a very large and busy air traffic controller unit, and I've been answering questions here, a couple other places as well on Twitter. So I think what else is there to talk about right now? Not much. So one of the things that I've been talking about, and then I've got a craplode of questions that you all called in, that's all we're going to do today, is answer your questions and try to get everybody up to speed. But I have two sort of news stories. And I'm going to do a video of this as soon as I can get to it.

This is the shittiest vacation ever. I'm just telling you, I'm supposed to be at St. Pete Beach of the Don Cesar, sipping some. damn alcoholic beverage in my bathing suit on the Gulf of Mexico. And instead, I had to work all week, which, I mean, you know, it's all about me. And I'm sitting here doing this with Dr. Scott. This was not what I was expecting to be doing halfway through my vacation. But anyway, so, you know, looking at the silver lining, I'm saving a crap load of money. I did get all my miles back.

The hotel gave me money back. and I'm going to save it up and blow it out my ass when this is all over whenever that is. All right. So, a couple of things. China has,

the curve of their data has leveled out significantly at about 80,000 cases. Now, I have people say, well, how can we believe? You know, we don't have any choice right now. Now, if it turns out

they're telling us fibs, hopefully they're not telling us fibs, then we'll have to have something else to say about it. But they've cut off at around 80,000 cases, and they get one or two every day, but it's nothing like it was. It was growing exponentially at one point. So 80,000 cases,

if they can hold it down to that, is 0.00,000. 0.08 percent of their population. If you multiply that times our population of 329 million people, you end up with about 25,000 cases. We're at 36. Well, I have it right here. Hang on. I'll tell you exactly where we are as of this morning. Now, we are recording this on March 18th at 452 p.m. That may actually matter, right? Yes. So United States of America had 35. 500 cases. Now, that had doubled from the day before where we had 1,600. So we're seeing that could have something to do with reporting as well. But if we see doubling for a while, then we'll see

this sort of geometric progression. And then hopefully as we continue to isolate ourselves and follow the rules, this thing will even out. And if it does, at about 0.0008% of the population, We're looking at about 25,000 cases, and 850, give or take, deaths, which every one of those is tragic. Yes. That's a lot. But it's a whole lot different than 1.8 million if 60 million people in this country get this virus as they did in the influenza pandemic of 2009. Now, that influenza only had about 0.1 percent mortality. This has 3 percent when we think we're not sure.

But let's say it is 3%, it's a number that's been bandied about, then it's 30 times more lethal than influenza. That's the problem. So you get all these people, you know, at spring break and they're all young, they're in their 20s, their risk of dying is about 0.2%. They're like, yo, you know, dude, you know, we're safe. Yeah, okay. So you might be, and then transmitting this all over through the crowd. to your great-grandmother. And then you take it home, well, okay, I get it.

I'm old. I'm an asshole, right? So my life doesn't matter as much as yours. But even if you had that asinine attitude about it, what's going to happen is if we overwhelm the medical system, then when those 20-somethings get a urinary tract infection or appendicitis or they break their leg, there will be nowhere for them to go. So it is still in their interest, even though they're at low risk. to social distance and try to flatten out this curve somewhat. In that vein, I'm looking at a white paper. Now, this is not a peer-reviewed publication, not a double-wide placebo control study,

but this is in consultation with Stanford University School of Medicine, UAB School of Medicine, and the National Academy of Science Research, is presented by James Tadero from Columbia, Maryland. And the title is an effective treatment for coronavirus, parentheses, COVID-19. And we've been talking about this. I talked about this on Sid and Bernie as well. Recent guidelines from South Korea and China report that chloroquine is an effective antiviral therapeutic treatment against coronavirus disease 2019.

The use of chloroquine tablets is showing favorable outcomes in humans infected with coronavirus, including faster time to recovery and shorter hospital stays. They've been given this to the sickest. U.S. CDC research shows that chloroquine also has a strong potential as a prophylactic. And not that kind of prophylactic, Dr. Scott, as a preventative measure against coronavirus. And this is in the lab, while we wait for a vaccine to be developed. Chloroquine is an inexpensive, globally available drug that has been in widespread human use since 1945 against malaria, autoimmune, and various other conditions. Now, there is a version of this called hydroxychloroquine, which is also known as Plaquinell.

That's even better tolerated than chloroquine is. It says the U.S. CDC and World Health Organization have not published treatment measures against coronavirus diseases. medical centers are starting to have issues with traditional protocols, treatments, and ideally a preventative measure are needed. So they're working on this drug remdesivir, which we've talked about on this show. It's in phase three trials. We have a vaccine that's in phase one trials. I'm trying to get Greg Poland on the phone to be on the show. He is one of the nation's top vaccineologist.

He's very busy right now. But he was my mentor in residency. He's the smartest person I've ever met in my life. And he thought I was one of the smartest people he'd ever met. So we had a mutual admiration society. He just knew a bunch of dumb people. Everybody around him was dumb compared to him. But anyway, he's at Mayo, and I'm trying to get him on the phone so we could talk about this vaccine.

Because my proposal is, let's skip phase two. We have a vaccine that's in phase one right now, which means you give it to a few people to make sure it's not killing people. Right. and not causing damage. You've got to watch them for a little while. Then phase two, you give it to about 100, 150 people, and then you see if it works. And then if it's not killing people and it seems to work, then you do a much larger trial, which is a phase three trial where you can give it to a couple thousand people.

Then phase four trials are post-marketing trials. That's actually after you brought it to market. And I keep hearing people say a year, it's going to be a year, it's going to be a year. I think we could accelerate that in a situation. like this. If the 40 people that they gave it to in phase one, you know, were not harmed, we go straight to phase three because we know how vaccines work. Right. And then we see if it works and if it does, then we can just roll this thing out and then just hope for the best. Yeah, let it rip, yep. Yeah, and just let it rip. Exactly right, Dr. Scott. Okay, according to the

research that was reported in clinical trials arena. Data from chloroquine studies showed certain curative effect and fairly good efficacy. Patients treated with chloroquine demonstrated a better drop in fever. Improvement in lung CT images required a shorter time to recover compared to parallel groups. The percentage of patients with negative viral nucleic acid test was also higher with the anti-malarial drug. Chloroquine has so far showed no obvious, serious adverse reactions in more than 100 participants in the trials. Clorcan was selected after several screening rounds of thousands of existing drugs. It's undergoing further trials in more than 10 hospitals in Beijing, Guadong Province, and

Hunan Province. Now, there's, you know, they're, and they're looking at it in other places, too. So if, you know, if I got this and ended up in the hospital, I pretty much demand some Claquine. Some Claquine. Did you do Plaquino? I would do Plaquino. Right on.

Yeah. Because that's pretty readily available anyway. Yes. It's dirt cheap too. It's 60 tablets for 25 bucks. And it'd be just a short course of using it anyway. I don't want to get too excited about this. But if this pans out and we can, while we're waiting for a vaccine,

we can put people on the front lines on prophylactic chloroquine to decrease the number of cases of health care providers. And we can keep people out of the hospital, maybe or off the ventilator, then, and this is a very polyanish view, but if we could do that, if it were possible with this medication or some other medication, then the risk to the health care system collapsing decreases by orders of magnitude. In which case, yeah, if you're at low risk for this, you just go about your business. we'll just treat the ones that get sick. And, but we are light years away from that, but I just, people are losing hope out there, particularly the service, the people in the service industries.

Yeah, they're being crushed. By the way, if you go to a restaurant and you can afford it, double tip, triple tip, if you go to, if your local restaurant is just doing takeout only tip them anyway, you know, a lot of times when you do takeout, You give 10%. This lady at, I was at Perkins, and her son is a friend of my sons. And she was just saying, I don't know how I'm going to pay the rent.

So, you know, I was going to just give her a hundee. And then I figured, well, I mean, she's pretty hot. So she's got to think I'm, you know, I want something in return. So I didn't do that. But I gave her 100% tip. You phoned up. I gave her 100% tip. That's good.

The bill was 60 bucks and I gave her $60. So, you know, if you can afford it, I mean, we're all going to take a hit financially. Those of us that are taking maybe less of a hit because our jobs, for example, my job is ramping up during this time. But then try to help those people out. Right. There was a guy outside the restaurant that I go to, and he was asking for, you know, do you have 50 cents or something like that? And I'm like, oh, here we go. You know, here's somebody that's already hurting from this thing.

And I went into the liquor store, which is next door to this place, and I got some change. And I came out, I gave him four bucks. He was like, oh, damn, dude, thanks. And he went running in the liquor store. So, you know, hell. He's buying some pure grain to wash his hands. Yeah, yeah, yeah. It's his money at that point.

But I was like, oh, well, shit. I just enabled somebody doing something naughty. But anyway. All right. So the chloroquine stuff, let's not rush the pharmacies to get chloroquine and hoard it, but it's looking promising, and I would love to see an end of this damn thing. Yes, me too. So, but continue with your social distancing, please. Yes.

And if you get sick or you've been exposed to a nose case, a nose case, well, there are nose cases, unknown case, you got to isolate yourself. Absolutely essential. In this day of Grubhub and stuff, though, you know, it's a little easier to do. Yep. All right. You want to answer some questions? Yeah, let's do it. Number one thing.

Don't take advice from some asshole on the radio. All right. Let's see here. Uh-oh. Of course. Looks like my computer's got, oh, there we go. Hi, Dr. Steve. For weeks you've been saying that only people who have the coronavirus.

virus should be wearing masks and if you don't have it you shouldn't you have not said once why yes i have don't have it you shouldn't wear a mask doesn't it make sense that if the shit's out there and you're breathing it in if you're wearing a mask and you don't have it you wouldn't get it right why are you telling the people who don't have it i'm not wearing this but you keep saying this and don't tell us why oh no okay yeah no That's a great question. This is context-driven. What I'm talking about is people running around going to the store wearing a face mask.

If you're social distancing yourself from people the way you should be, you know, if I see a line, you know, I back up six feet and stay out of there, the stuff isn't really floating in the air. It is the primary mode of transmission appears to be droplets. Now, you can cite that study that showed that they, that. coronavirus was viable in the air for up to three hours. That was under an experimental protocol where they put it in a nebulizer, shot it into the air, and then tried to isolate it from the air in an enclosed environment. And what they have shown, though, is even, you know, you hear this thing, it can live for nine days on surfaces.

Being present and being infectious are two different things. And what they are showing is exponential decline in viral particles over those nine days. So it's not like you cough a lugy onto a table. And then nine days later, there's the same trillion particles that you laid out. And then all of a sudden they disappear. You know, they decline at a very rapid rate. So it becomes less and less able to cause illness over time. Now, face masks.

Oh, that's my kid. Hang on. They're freaking out a little bit just because they can't go out. Liam, you're on weird medicine. Yes. I'll tell you that. Okay, buddy. You know, none of my family ever wants to be on the radio.

I've tried to get the kids up here. I don't even think that we're on the radio. I know. Well, Liam's been on here. He did the, Are You Smarter Than Big Joe? thing, which was on the podcast, which if you haven't heard it and you want some light listening, I can maybe put it back up again. It was pretty funny.

It was funny. Because she's good at mod applying. And by God, everybody knows eight times eight is 16. Steve. Steve. So, anyway. All right. So face masks.

So, yes, if you're in an enclosed room with someone. First off, there's a face mask shortage right now. Right. Okay. So to just walk around on the street wearing a face mask, this will really do nothing unless somebody coughs right in your face, which I guess is possible. But even then, you know, we have to wear those N95 face masks, which have a higher filtration ratio than, say, the regular surgical masks that you buy over the counter. So if you're likely to be in close contact with someone you know is infected, and you shouldn't be, But let's say you're at home and you're caring for somebody, a mask definitely cuts the chance of the disease being passed on. So this is context-driven. I was really just talking about people just slapping masks on thinking they're doing something. Hand-washing and keeping your hands out of your face.

Now, I have also said that there are people who are not ill who should wear a face mask. And these are people who cannot keep their stupid fingers out of their mouth. I had a meeting with my boss today. and she was biting her fingernails the whole time. Oh, for goodness, thanks. I reached over and grabbed her hand. I said, you've got to stop that. And then she did it again.

And then it became a joke, you know, and she just couldn't stop. I said, you need to wear a mask. Because if you can't stop touching your face or putting your fingers in your mouth or in your nose or licking. She did that thing where she was, she licked her finger to turn a page, too. I mean, she did everything. Then you need to wear a face mask, but it doesn't have to be a surgical mask. It could be an old t-shirt that you wrap around. Just anything, yeah, sock, anything that would just keep you from touching your face.

Well, and I think the thing you said to mainly is, you know, when you see doctors' offices and hospitals running low on the gear, they need that are on the front lines protecting us and putting their lives up there, that's another, that's a huge issue. Yeah, yeah, yeah, yeah. Yeah, so could it conceivably decrease your chances by some small fraction of a percent if you're on the bus or something, maybe, but really it's their face masks protect against disease when you're in close contact with somebody. And even then, they're not perfect. All right.

Excellent question, though. Good question. Hey, Dr. Steve, chloroquine phosphate, you say it better, treated for malaria. Oh, okay. Chloroquine. That could be something to. Yeah, yeah, yeah. We already answered that.

Sorry, dude. Yeah, chloroquine is showing some promise. I'm looking forward to more data before we can definitively say we need to be doing this on everybody. But the data is coming. We will have it in the next few weeks, really. We'll have preliminary data in the first few weeks. Go ahead. What were you going to say?

No, no. And I was going to say, the great news is it's a medication has been around for a long time. Yep. You know, it's not like it's a brand new thing. We don't know anything about it. We don't want people rushing out to get it when they don't need it. particularly because there are people with immune disorders that need this stuff. And there is a limited supply of it.

So if everybody rushes out like they did with Cipro, when the anthrax scare hit, yeah, there was a shortage of Cipro for a while. We don't want a shortage of this stuff. We want people to be able to have it if they're sick. What comes in mind when you picture the perfect roommate? One who comes when you call, one who doesn't forget to lock the doors, maybe one who doesn't seal your milk, just a little bit at a time hoping that you won't notice. At Apartments.com, they understand that when it comes to roommates, a pet can be your best bet.

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You know it on Twitter. I'm a big fan of yours. regarding COVID-19. Is it you or Hugh? Let it hear. Okay. Well, after now we're talking tonight, is it possible to have the flu and COVID-19 at the same time? And does having the flu first increase or does it really affect your chances of COVID-19 taking on more serious symptoms?

Okay, so... Another good question. Excellent question. I'm going to give him one of these. Give yourself a bill. A big bill. Golly, I'm going to have to compress the crap out of this episode. The influenza can induce inflammation in the lungs, which then can make them more susceptible to super infections by things like staff.

So people who get influenza and then get bacterial pneumonia afterward will have Staphylococcal pneumonia often. and it's bad, but we have antibiotics for it. There's only, I did some research on this. I could only find one case of concurrent influenza and coronavirus at the same time. That person was pretty sick. Pretty sick, yeah. But, so yes, it's possible. Unlikely.

We used to, when we first heard about interferon, what we sort of were taught was that if you had one viral infection, that it protected you against other viral infection. infections for some time afterward because your body released this stuff called interferon. And I don't know if that, it was ever born out to be true. So, yeah, you want to avoid influenza the same way you're avoiding this. You know, stay away from people who are sick. If you're sick, stay home, wash your hands with soap and water. Dr. Hoplin, when he was in there, said sing happy birthday while you're washing your hands with soap and

water. Soap and water is better than alcohol gel, but alcohol gel is pretty damn good. Yep. Okay. Of course, you can't find any anywhere. Hey, Dr. Steve. I'm sitting on a toilet, but mostly just because it's the only place I can avoid my kids since they're home from school now. Question, what happens if China underestimated by 10 to 20 times the amount of cases? they're reporting. Sure. What does that mean for us?

Well, what if aliens, you know, came to Earth? You know, I mean, it's a hypothetical question. They're here now. Yeah. So let's say that they underestimated it by 10 to 20 times. Which is possible if they didn't have enough tests. Sure. And so, but what that tells us is those 10 to 20 times, let's say it was 20 times more.

They got better. Yeah, they were asymptomatic. Yeah. So, and people have brought this up. If we have a large, group of asymptomatic individuals. We're going to be answering a question about this in a minute. We'll do the numbers.

If we had a large group of asymptomatic individuals that never go, then that's going to increase that denominator. Yes. When we're trying to figure out how many people, what percentage of people are dying from this. So if you have three people out of a hundred dying from this, that's three percent, right? But what if it's really a thousand? Right.

What if a thousand people had it and you have those three, but we only knew it. about 100 because they were the ones we knew about because they were the ones that got sick. Exactly. Then you're talking about a 0.3% mortality rate, which is a hell of a lot more reassuring to be perfectly honest. Yep, I agree.

All right. Hey, Dr. Steve. It's Paul from New Jersey. Hey, Paul. Just trying to figure out some of this corona business. Me too. So I saw some talking head on Fox News. A guy from Johns Hopkins says

they can use plasma from recovered coronavirus patients to somehow cure people infected sounds weird that that fluid would be helpful and it said they said they could only use it to cure two people

right sound incredibly complicated do have anything on this I do and that's another give yourself a bill question it's not complicated When you get an illness, like a viral illness, let's just say, for example, COVID-19, when you clear that, the way that you clear it is your body generates antibodies against the stupid-ass virus and generally to the spike protein, you know, if you've looked at a COVID or SARS-C-O-V-2 virus on the electron microscope, it's got these little spikes on the outside. And that's what attaches to the angiotensin receptors, and then the membranes merge, and then the thing bloops its RNA into your cell and starts making copies of itself.

It comes with an instruction manual, a error-checking protein. It's crazy, this thing. This thing is really tricky because if you try to induce an error in there with a drug, it just goes, nope, and moves on to the next one or repairs the error. It's crazy. It's almost, you know, so... Alien-like. Yeah. So it's...

Where the fuck was I? What was that? Oh, the plasma. Yeah. So you make these antibodies. Your body makes them. Right. Now, once you've cleared the thing,

those antibodies will circulate for some time. So you donate blood, spin it down, take the plasma out, put the red blood cells back in if you want to or just keep them. And then you can use that plasma as medication for somebody else. So you could, if you injected somebody who had a really serious case, they would have pre-made antibodies that would stop the infection for a long enough time that their body could then turn around and make antibodies that they need to complete the clearing of the virus. And they're right, when you take that out, you know, really, you're only going to get enough for maybe one or two people. That's the problem with this. It's not scalable.

You know, if we end up needing 20,000 doses of this and we only had 5,000 recover, well, we're going to fall short. So it'd be better to have a medication. But, you know, if you had somebody local that had cleared this thing and you had someone that was critically ill and nothing else was working, you could absolutely try that. Yeah. Turns out that there's this thing called cytokine storm, too. And cytokine storm is when you have. so much inflammation in your body, and these white blood cells are releasing these cytokines, which are inflammatory proteins, and they can, you know, cause inflammation in other parts of the body

and cause multi-organ failure. There are actually some anti-inflammatory medications that you can use. They're recommending right now, not ibuprofen, although I'm waiting to see the data. Yeah, I heard that too. Well, my buddy, Greg Poland, in Medscape, was interviewed. viewed, and he said that he didn't see any evidence that this was real. But there were, you know, so we'll see. I've never heard this guy ever say anything wrong before.

So I'm hoping he's right, because I'd much rather use ibuprofen than Tylenol, particularly if I want to have a drink. Sure. But there are some other medications that you can use when you have this cytokine thing, and they call it hyperinflamation. and there's this medication called anachina or anachrona, anachina, anachinra. And they've used it in sepsis for hyperinflation, and it's been pretty effective. So I'm just hoping that the infectious disease guys remember this stuff

if this happens to somebody out there. Because if you start to see multi-organ failure, it may not be from the virus. It may be from the body's response to the virus. And that will be in extremely rare cases. But they're showing the cytokane storms are in the lungs with these COVID. Sure. The deep lungs, that's the problem. It's causing those, the, that soticon storm.

So, yes, you can use plasma, but it's not scalable. And that's why it's not being pushed. But it would be definitely an effective intervention. Now, if we can teach bacteria or white blood cells, for example, to, make these in culture to make these antibodies. We can do these things called monoclonal

antibodies. One of the ways that they do that is to take plasma cells that make antibodies. Merge them with rat or mouse cancer cells that they continually reproduce and then you

call out the ones that aren't making the antibody that you want. So you take the antigen and you throw it in there and they start making antibodies to it, right? And you find the ones that are making effective antibodies, and then you put those in culture, and then you just grow the shit out of them. So they're just making these antibodies. So you could make a monoclonal antibody to this virus possibly and use that as medication

as well. We use monoclonal antibodies in cancer care now, all kinds of stuff. You know, so it's any, if you see a medication that is advertised with the letters MAB at the end, then that's a monoclonal animality. Right. Yep. Okay. Great question. Well.

Jenkins, I had a question for the podcast about if you think ordering food on apps like seamless. and Grubhub and making delivery guys come out and give them to you if that's unethical. Now, I wonder what he means if. Is it unethical because they can get it from us or is it unethical because they could give it to us? Now, Grubhub and those other delivery things have said that they've got a policy to make sure that people are staying home if they're sick. And, you know, it's always, I mean, there's so many ways that stuff, you know, that you could conceive it'll be get infected. But really, droplets remains the primary way that people are getting sick from this. And if you're careful, you know, if you touch something that's been touched by somebody

else washing your hands or wiping it down with some sort of antiseptic wipe or soap and water is really an effective way to neutralize that. Now, I fantasized about what would happen because I'm on the front lines. I'm going to see the sickest of the sick being doing. doing what I do. If I come down with this, what I would do is, you know, if I order food from Grubhub, I would say, you know, COVID-19 leave the medication on the front stoop and just walk away, you know. Because it tells you when they're there, so I just wait until they leave and go out and get it. It's not like I can walk out in the air and somehow transmit it to my neighbors.

That's not how this works. So food delivery is a good thing. And I would tip the shit out of them, too, by the way. If they're bringing people food in the middle of this, tip the hell out of that. All right. So I'm guessing that's what he meant. Mm-hmm. Okay.

Is Rast fit here? Okay. You're asking, leave some questions about the coronavirus. All right. Well, I've been begging some pretty filthy, nasty horrors for the last, I don't know, two years. I want to know if that's going to help with my immunity against COVID-19. Thank you. Only if one of them had it.

Only one of them had it. Well, they can't all be gems. Okay, let's try another one here. Oh. Hello, Dr. Steve. Hello. I have a question as far as communicability of the sickness. Sure.

How quick. After coming in contact. contact with someone, could you be infected and spread the sickness? Is it a day? Is it 15 days? Just wondering as far as being around someone who comes near someone else. Yeah, I'm with you. Who is confirmed to have disease.

Okay. Well, if you've been around someone close contact with someone confirmed to have the disease, you need to be isolated for 14 days. And the reason for that is 97% of people who contract the SARS-COV-2 virus, aka COVID-19 disease, show symptoms within 11 and a half days of exposure. The average incubation is around five days, and that's what we know right now. For a lot of people, the symptoms start as mild. The symptoms and maybe get worse over a few days.

Sometimes they don't. Some people have unbelievably mild disease. The way it's transmitted is person to person through close contact or from droplets that are scattered when the person sneezes or cough. So you've got to anywhere from a six foot to 15 foot radius, but it's an inverse square rule. Dr. Scott, you remember the inverse square rule from, you know, that things decrease the square or the distance if they're spherical? No. Yeah, okay, like light. Yeah, I believe you.

Light intensity, gravity, decreases as the square of the distance. Okay, gotcha. So if it's 100, 100 units at 10 feet, it will be, you know, whatever. And 100 units, 1 foot. It'll be less than that. By the square root. Anyway. But, yeah, as the square of the distance increase, as the distance increases, the stuff decreases by the square of the distance.

That's what I've been trying to say. Got you, got. And that's not perfect in a cough because it's not perfectly spherical, but it's pretty close gradient. You know, you're going to get the most particles right in somebody's face, and then as you get farther and farther away. So because things are present doesn't mean that they're going to infect you necessarily. Okay. You know, they say, although it's much less common, there's a possibility that someone's infected with the coronavirus can transmit the virus, even though they're not showing symptoms. but it is felt right now that they're most contagious when they're showing symptoms.

Now here we go. I didn't bring any water up here. This is not COVID-19. This is what we call... Bradford-Pertree season. Vocal. I have vocal cord dysfunction. I really need to see a speech therapist because this will happen to me when I talk for a long time

and then my throat clams up, which is not. not good for a radio person. No. And then it clears up and then I'm fine like it is now. You can also possibly contract this through fomite transmission. And I think everybody who listens to this show long enough knows what fomite transmission is. That's where somebody hawks a lugie onto a table, walks away, someone else touches the table where the infected, infective particles are. and then stick their finger into their nose.

More likely, that would be on a door handle. You know, someone sneezed into their hand, and then they grab a door handle. And then if you're going in the bathroom, of course, you should be coming out, having washed your hands and not touch the door handle on the way out. And if there is a handle there,

use a paper towel when you're on your way out and throw it on the floor just to teach them a lesson if there isn't a receptacle right there next to the door, because there should be. And that's just standard protocol at this point is put a receptacle next to the door so that people who don't want to touch your filthy door handle don't have to, and they can throw the paper towel on their way out. So just make sure that if you touch a bathroom door handle,

if there's no way around it, that you don't touch your hand, or, I mean, your face, particularly, but your other hand or any, other part of your body until you've washed your hands. And I think it's, and I, if I'm going to piss and I'm going to touch my male membership with a hand that just touched the door, I'm going to wash my hands before and after. Yeah, good point. Okay. What are you going to say?

And plus, too, this, they've shown this virus is susceptible to to heat and UV light too. So, you know, enclosed, you know, cool rooms where a lot of people are, it's going to be a lot more dangerous. Yeah. Yeah. Yeah. and stainless steel. It's the most longest living.

But, yeah, and I'm just looking here. The best way to prevent yourself from contracting it is to wash your hands off and use soap and water for at least 20 seconds. And there you go. Other ways to protect yourself include stay six feet away from anyone who seems sick and avoid large groups of people. I'm staying six feet away from people even if they seem totally fine. Yes.

Don't touch your face. Don't share personal items with others. That's gross anyway. Wipe down high-touch surfaces like doorknobs, keyboards, and stair rails in your home with household cleaners or a diluted bleach solution. If you can get, you know, chlorox wipes, which is really hard to get. But if you have them, if you work in the hospital, I'm doing my keyboard and my phone and my mouse every single day. Yes, multiple times a day. And wash your hands or use a hand sanitizer after touching surfaces like elevator ATM buttons.

Yeah. And stay home and call your doctor if you start having respiratory issues. your symptoms are consistent with those of COVID-19, which would be fever, dry cough, and maybe shortness of breath. Now, this is allergy season, so that sucks. Yep. You know, how do you know if your dry cough is coming from your post-nasal drip or your COVID-19, and the presence of fever is usually the differentiating factor?

All right. Great questions. Hey, Dr. Steve. I finally clued in. This is a guy from Twitter that obviously doesn't understand what the fuck's going on. Yeah, okay, so he kept saying, what time exactly should I call in? And it was obviously

he didn't realize it was a voicemail, so I said, you know, 4-57 call in right then he did call in and got confused, and then he called back and realized it was a voice mail. Anyway, I'll just read the question for you so you can use it. Okay. Hey, Dr. Steve, eventually, wouldn't it be

prudent to simply just test everyone for exposure to? Knowing whether or not you have or had it could go a long way to your personal planning and response. And for example, you know, back in the 80s when parents used to get their kids sick with chicken pox rather than, you know, getting them the vaccine. What do you think? Yeah, well, back in the day, they didn't have the vaccine.

So that was the back in it. You know, I'm pretty much pro vaccine, Dr. Scott. I am not a fan of the chickenpox vaccine. That's something we've talked about multiple times on this show, just because I'm not 100% sure what we're going to. going to do with a bunch of 40-year-olds who didn't get their booster and no longer have immunity to chicken pox, and now they're getting chicken pox as adults. Yeah, it's a very mild disease with very few serious, although there are some. There are some, yeah.

Serious consequences are getting it when you're a kid, but it's a lot more serious disease when you get it as an adult. So I am, so, you know, I'm not just some just say yes to all vaccine type person, but hell, rabies, diphtheria, pertussis, measles, mumps, rubella, COVID-19, hell yeah, influenza, universal vaccine, all in favor of that. So testing strategies then, yes, a perfect strategy would be to test everybody in the United States,

anyone that showed, and this is for active disease, anyone that showed positive, we'd just isolate them immediately. And that way we would catch some asymptomatic people. We wouldn't catch everybody because there would be some people that have been exposed that are not yet shedding virus. But we would be, you know, just two or three half lives of that and we would have this thing pretty much licked. That requires a test that is basically infinite in supply and infinite in or perfect in its sensitivity and perfect in its specificity. In other words, it doesn't miss any cases.

And it doesn't give to people that don't say that some people have it that didn't have it, okay? Yeah. So, yeah, no false negatives and no false positives. Right. It pretty much would have to be a pretty perfect test. So, you know. So in the absence of that, we are right now testing people who are symptomatic that show a high or moderately high pre-test probability. of having a positive test.

So these are people who have symptoms and have been in contact with somebody or people who have gotten really sick that have symptoms or people who have come from an area where it's prevalent and they have symptoms. But you're right. We're missing all those asymptomatic people

and it's going to be really hard to extrapolate how big this is out there. You know, if there's a huge amount of people, people that are just asymptomatic, that's great, but it'd be good to know. Yeah, it would be. Okay. So it's a problem. Now, people say, well, if you give me, they missed up, the WHO test, as Dr. Hoplin said,

the one that was originally came out with was somewhat insensitive, that he had a supposedly, according to him, a significant fraction of false negative test, or, yeah, false negative tests. In other words, people that showed up negative, but were actually positive. And the CDC found that unacceptable, and that's why they wanted to do their own test, but it did induce a delay and somewhat of a shortage. Now, there's another kind of test. That's a test called a polymerase chain reaction where you're taking a snot from somebody's nose and mouth, putting it in a reagent, and then amplifying the DNA that you find in there, or RNA in this case. And so you get these fragments of RNA and you amplify them and you can then detect, you know, the COVID-19 virus. That's how they're doing it.

They're not detecting the virus directly. They're detecting its genetic material. Now, what if someone's cleared it, but they're still excreting chopped up viruses? They will still have a positive test. So that may explain some of these people that have had a positive test, then a negative test, and then they test them again and they're positive again. It doesn't mean they're contagious or that they're actually infected anymore. They're just still excreting viral RNA. Gotcha.

Okay. Now, the other kind of test, so that's the test for the virus itself, is an antibody test. Because that was the other thing this guy asked, which was a great question. I'll give him one of these. Give yourself a bill. Is how do you tell if you already had it? If you're not excreting and you've already cleared it, you're going to have a negative polymerase chain reaction. But you'll have a positive antibody test.

So there are two kinds of antibodies. There's IGM and IGG, and there is a test out there. It's in Europe right now. I hasn't been approved here yet. That's a quick test you can do in your office. And the IGM looks at current or recent infection. So when you get a current infection, you produce immunoglobin M. And then as the infection clears, the body produces immunoglobin G or IGG.

So IGM. So IGM shows current or recent infections. IGG shows remote infections. Right. And if this thing is specific enough for the SARS-COV-2 virus, then you can tell if someone's had this already, which would be nice to know. Sure.

And that test is dirt cheap. You can get two of them for 70 bucks, and they were just selling them online in England. Yep. So that's something that will be coming here, I'm quite sure. Sure. And then when we start doing those, and they're dirt cheap and they're sensitive, you can use that as a screening test. Then we'll get a much better idea of the number of asymptomatic individuals and a much better idea of what the death rate of this thing is or the mortality rate.

Right. All right. Hey, Dr. Steve, this is Mike from New Jersey. I've got a question regarding ED. Oh, well, I mean, you know, that's the thing. even during a pandemic, a guy's got to worry about his erections. Yes. I mean, for real.

Yes. I've told the story about the brain dead guy that, you know, was able to get an erection and actually gave a sperm sample. So, yeah. I'm 62. I'm six foot. I'm 220 pounds. I've just lost about 20 pounds through dieting. Good job.

On five milligrams of ramapril, five milligrams of amylodepine, and 40 milligrams of estorbostatin. I do have three stents, which are almost 10 years. old. And I can't use Viagra successfully, but I'm curious as to why I have ED when I don't use it. I don't think at my age that should be the case. I see what his question is. He says he can't use it successfully. I'm not sure what he means by that. If you're not on nitric glycerin or there are some other, you know. I thought he said he could use it successfully. I thought he said he couldn't. Why it didn't have? Oh, wait. Okay. If he doesn't use it. But I'm curious as to why I have it, which are almost 10 years old. And I can't use Viagra successful.

I can use it. I think. A different question. So he's asking, why does he have ED? Well, hell, why does anybody have it? Every down by that age. Well, now, Dr. Scott, he's... 99.

Okay, not everybody. Not even 100%. It's not, no, it's not even close. But because atherosclerotic cardiovascular disease is a blood vessel disease and erectile dysfunction is a blood flow disease. So when you've got

trouble with hardening, or, you know, this is just sort of a lay term, hardening of the arteries, then you're going to end up with issues with blood flow. Sure. And issues with blood flow means erectile dysfunction. So the other thing, though, I would get,

you know, not worth doing is get your testosterone check. Testosterone checks. What if your testosterone's low, then you will be chasing this thing for some time, and really the answer is right there in front of you. So a significant fraction, 90%, 85% of men that have low testosterone,

never know it because they're never diagnosed. So get that check. All right, what else you want to do, Dr. Scott? Play a little. You want to play a song? Play a song. Now, this song has nothing to do with what's going on in the world. It just happens to be a song that we really like.

So don't freak out when you hear the words. No. Yeah, thanks always. Go to Dr. Scott. We can't forget Rob Sprantz, Bob Kelly, Greg Hughes, Anthony Coomia, Jim Norton, Travis Teb. You know what? I'll do it with the music, and then we'll just play the song at the end so you can, if you don't want to listen to us, this is horrible. Scott's got this electric mandolin, it won't stay in tune, and we've just played this once.

And a voice that doesn't stay in tune anymore. Yeah, so anyway, so don't worry about it. But it's... Tune off. What else are we going to do? We just... We're quarantining. We can't forget Rob Sprantz, Bob Kelly, Greg Hughes, Anthony Cummie.

Jim Norton, Travis Teft, Louis Johnson, Paul Offcharski, Eric Nagel, Roland Campos, Sam Roberts, Pat Duffy, Dennis Falcone, Ron Bennington, and Fizz Watley, whose early support of this show has never gone unappreciated. By the way, Sam had this tweet. This was awful. He said, hey, I was always a member of the Yang Gang, and I see Trump's going to give everybody a thousand bucks. I'm already filling up my Amazon cart.

And I said, yeah, when I get mine, I'm going to be donate. it to the school lunch program for kids that don't get school lunches when school is out and also to the local service industry folks so that they can feed their kids but I'm glad you found something on Amazon that you would like and then you know I was just shitting on him

I mean I love Sam and he was there when I stuck my finger in Pat Duffy's butt so he's been there from the very beginning of my relationship with that channel so I was really just messing with him but he got shit on so bad. And then people said I sounded cunty or sounded like a douchebag.

So anyway, and I'm using the C word in the way that the British use it. Right. It just means, you know. And not a vulgar way. A funny bloke. Right, okay. All right.

Go to our website at dr.steve.com for schedules and podcasts and other crap. Until next time, check your stupid nuts for lumps. Quit smoking, get off your asses and get some exercise. We'll see you in one week for the next edition of Weird Medicine. Wash your hands. and self-isolate. Quit being jackasses.

Tread on. I'm coming up on me to hold you undue. I'm coming up on me to show you wrong. To know you is hard we wonder. To know you all wrong we want. Really too late to call so be waiting For morning to wake me, Oh, they're going to know me as hard

Going mad is hard No wrong Every occasion I'll be when you're born Every occasion once more is call the funeral every occasion of being ready for the funeral every occasion of one million

a few I'm coming up only to show you down fill I'm coming up to bowl to show wrong

to know the outside the wrong hanging to know to know you are all wrong we wonder

we wonder ready for the funeral every occasion once more is called the funeral every occasion of i'll be ready for a few every occasion of one million days of you. Hey, perfect. I don't think we'll... We'll have to quit a day job, Stewie.

I don't think we'll get a copyright violation on that one. It's so far from the original. They'll never recognize it. That's right. That's right. We'll see you next week. Everybody stay healthy. Take care.

All right.