Weird Medicine: The Podcast - 400 - My Wife Hates COVID

Episode Date: March 26, 2020

In isolation, Dr Steve and his wife Tacie discuss life without friends (bad) or extended family (not so bad). Chloroquine, Hydroxychlorquine, Remdesivir and others are discussed. Hilarity ensues. We totally missed that this was our 400th episode. Whee. 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) premium.doctorsteve.com (all this can be yours!) Learn more about your ad choices. Visit podcastchoices.com/adchoices

You're listening to Weird Medicine with Dr. Steve on the Riotcast Network, riotcast.com. I need some touch in the garretem. I've got diphtheria crushing my esophagus. I've got Tobolivir from my nose. I've got the leprosy of the heart valve, exacerbating my incredible 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 of Citizen Kane. 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 a requiem for my disease. So I'm aging Dr. Steve. It's weird medicine, the first and still-only uncensored medical show in the History Broadcast Radio. Now a podcast. I'm Dr. Steve with my little pal, Tacey. Hello.

Hello, it's my wife. Hello, Steve. We're in social isolation together. Yes, we are. No one else is allowed in the studio, so here you are. Thanks for being here. You are welcome. This is, give you something to do.

Yes, thank you very much. This is a show for people who never listen to a medical show on the radio or the internet. You've got a question you're embarrassed to take to a regular medical provider. Can't find an answer anywhere else. Give us a call at 347-76-4-3-23. That's 347. Take it away, taste. Poo-hand.

Excellent. Is that right? That's right. Look at me. Visit our website at Dr. Steve.com for podcast, medical news and stuff you can buy or go to our merchandise store at cafe press.com slash weird medicine. Most importantly, we are not your medical providers. Take everything you hear with a grain of salt. Don't act on anything you hear on this show without talking over with your doctor, nurse practitioner, physician, physician, assistant, pharmacist, chiropractor, acupunctur, yoga master, physical therapist, clinical laboratory scientist, Stacy Deloche, registered dietician or whatever.

All right, very good. All right, very good. I just want to remind everyone, even unless you need toilet paper, go to stuff. Dot, Dr. Steve.com, stuff.com for all your Amazon needs. It's just a page where you can go through and you can, once you get there, you can scroll down and look at all the different things we've talked about, vitamin supplements that have actually have data behind them, those kinds of things. And those are few and far between, by the way. or you can click straight through and go to Amazon do your shopping there.

So please use that. It really makes a big difference for us. Use what I've used to get to my ideal body weight. Noom. Noom. Dot, Dr.steve.com. What else you got to do?

You're in social isolation right now. You might as well get your weight down. Or you could just eat. That's what I've chosen to do. Well, to taste, I'm trying to plug noam. Dot, Dr. Steve. I know. And you guys, he has done so well.

with Noom, it's ridiculous, and now he weighs a significant amount less than I do. I'm so glad you said that, and not me, because if I said that, you wouldn't speak to me for a month, so thank you for that. The truth hurts. Well, we're truth-telling now. All of a sudden, it's awesome. I like it. Maybe this social isolation thing isn't so bad after all.

Yes, it is. Because I got some other truth to show you later, if you know what I mean. Noom. Dot, Dr. Steve.com. You get two weeks free and then you get 20% off if you decide to do it. It's a psychology app and it's not a diet. You know, I did Noom and I lost 20 pounds and I did really great on it. And then I gave up on it and gained 20 pounds back.

So it's a really good program. I can. Yeah, you've to continue to do it. Just like you have to do it. But it's not like Weight Watch. where you're committed to paying for it month in and month out and getting the calculator and the points and all that stuff, you just have to decide you're going to change your habits

and your psychology about food. And, yeah, it clicked a little better with me than it did for you. No, it clicked great for me. I just got, we had a, my company had a layoff, and that's all it took. And I got really stressed out. I understand. Yeah, which is why I'm eating so much now. It's just stress.

Yeah. Yeah. Well, yeah, I think everybody's doing that. I mean, what else is there to do? Noom does talk to you about that. And every time I eat bad, I know I'm doing wrong because of Noon, but I'm not doing anything about it. So Noom is awesome. Fair enough. And Noom talks about making choices, too, and you can make your own choices on that. I want you guys to go to withings.com slash Steve. I was told earlier that the link was not working. whittings.com slash Steve for the absolutely the coolest connected health care stuff, scales, blood pressure, and you think it's dumb. Wait till the middle of the show we're going to talk about our whithing scale. It's quite stunningly awesome.

And check out Dr. Scott's herbal malarkey at simplyherbils.net. Well, anyway, what have we got this week? Oh, what's going to? Is there anything interesting going on in the news? Let's talk, we'll do a little bit of COVID-19 news. Steve? Yes. I'm basically here, so you can explain COVID-19 to morons and give us your take.

Okay. And COVID-19 for dummies is what I want for me. Okay, sounds good. So when we go through this stuff, if I say something that would not necessarily make, you know, resonate with the lay person, let me know. Okay, I will. So the cases in the United States, as of today, which we're recording this on March 25th, and it's going to record or, you know, air this Saturday in some places, but other places at other times, depending on whether they're listening on demand or wherever, we had in the United States 42,164 cases. Now, that is 0.128% of the population, which did cross that threshold that I was hoping we could keep things down to, which was China's percent of the population, which is 0.005. Now, I don't know how much testing they're doing in China.

One of the issues with this is these are cumulative cases as they test people and test more and more people as we're ramping up. testing in the United States. We're going to catch a lot of cases that we didn't know we had because there are going to be a lot of asymptomatic people that are going to have positive tests or people that may have been sick last January that show up with a positive test. They get thrown into this pod as well. But, Steve, are we testing people who are asymptomatic here? I mean, it seems... We're starting to.

All I've been hearing is how we are so far behind on testing. Yeah. And so we have no idea how bad it really... really is. And that China was really good at that and they ended up in a world of hurt. And so I don't know how good they were at testing because I'll be honest with you, a lot of the people that are included in their numbers are people that never got tested that they just presumed were COVID-19. So as of this week or next, we'll have the quick tests for the offices that will be a single drop of blood, and you can tell if you've got the antibodies to it.

So let's talk about antibody tests compared to the tests that they're doing right now. Right now, they're sticking a swab deep down into your nose, and they're trying to pick up viral particles. And what they're detecting is the genetic material of the virus, which is RNA in this case. These are RNA viruses. And they put it in this machine called a polymerase chain reaction machine. And what it basically does is read the RNA that's in the sample and amplify it. So now it becomes detectable.

And then when you detect it, you say, yeah, okay, this is a positive case. There's another way to determine whether someone's been exposed to this. It doesn't tell you if they're infectious or not, but is to test to see whether their body has produced antibodies to this. And there are two kinds of antibodies. One type is IGM, and that's the immediate antibiotic. that your body produces, and if that is positive, it shows recent or current infection. It takes about four days from when you were infected with the virus to show IGM antibodies. Yes.

But if you took the test on Monday, and you tested negative, it does not mean that you do not have it. Right. You have to take, that's right. You can't do these things in a vacuum. You've got to take clinical, you know, put a little bit of clinical information in there. If a person's been completely isolated from everyone else in the world, let's just say, hypothetically, you had someone in a box and there was in no way that a virus could get in or out, and you tested them after being in that box for 14 days and they did not have IGM antibodies, then that person, you could very safely say they have not been exposed to the virus. everyone else when they do those tests you're right there's a four-day lag so if you don't know and you think and you suspect that it's a pulse negative what you do is repeated anytime you get an unexpected

result you want to repeat the test so you could repeat it a week later and then you could at least say if a week later their iGM is negative that the original test was truly negative now you can't say that one was because maybe they got exposed two days ago you know what i mean so um What I think this test is going to be really good for is determining how many people had resolved infections that had no idea that they even had it. And that is the second antibody, which is the IgG antibody. Immunoglobulin-Globin G is produced. That's sort of the immune memory. And the body produces these proteins to fight off things in case they ever see it again.

And that should prevent you from being reinfected by the same. strain of the same virus. And you can detect those in this, too. So what if we just got 328 million of these tests and just tested everybody, particularly when this thing is over, and see how many of those people tested positive for resolve that didn't even know they had it? So what that would do, that would do a couple of things. Let's do a hypothetical. You've got this disease, and there's 100 cases and three of them died. So the percent of of people, the percentage of the mortality would be what in that case, Tays? I don't do math.

V3%. Oh, okay. Right? Okay. So, but what if there was an asymptomatic population that was 10 times that 100? Okay, so there was really a thousand cases and three of them died. Then the mortality percent would be 0.3. What if there's 10,000?

Then it would be 0.03. You see where I'm going with this? Yes. So if we tested everyone in the United States, hypothetically, and found out how many cases we actually had, because that denominator is going to grow, and that will take the fatality rate of this disease down significantly. That makes sense? So it started at 3%. It's down to about 1% in the United States, 1 to 1.5%. And we think as we continue to test, that, yes, you will see the case numbers increasing.

that's not necessarily a bad thing, particularly if most of those people are healthy and do okay. Okay. All right. That makes sense? Yes. All right. Yesterday, the number of new cases in the United States actually decreased, but you can't go on just one day's worth of data. You've got to look at trends because, you know, maybe there was a delay in key punching these numbers in at the CDC.

You know, it could happen. So we'll keep an eye on that. I am doing a weekly COVID-19 situation report on YouTube. And if you just put in YouTube, The Laugh button, which I know sounds crazy, why would there be a COVID report on a channel called The Laugh button? But the laugh button owns Riotcast, and that's the network that our podcast is on. And we are basically simulcasting podcasts and Sirius XM shows right now. now just because of the importance of the information that we're getting out there.

But if you go there, it's video, and I've got graphs and videos, and I'm going to start making fun of some people saying some ridiculous things and panic-mongering and stuff like that. Okay. You good? I'm good. Okay. Are you? You know, I don't know.

Do you want to get into that right now? Yeah, sure. Yeah, let's talk about it because people are having a hard time with this, and you're one of them. I mean, I usually put about... And I don't mean that in any pejorative sense. I mean, I'm one of them, too. No, I know. I mean, I usually put about 500 miles on my car.

I am lucky and fortunate enough to be paid to sit at home in front of my computer. Yeah, some people have been able to take their work home, and it's the service folks that we're really concerned about the most. Yes, yes. And however, I really don't have anything to do. so boredom is um leads to lots of worry um i had an online therapy appointment yesterday and i had no idea how scared i really was and i basically cried the whole hour i'm terrified i'm terrified of you being out in it all the time i'm terrified of the kids getting it because um apparently it's not as easy on them as originally thought well yeah let me dispel some fears on that

So our kids are both under 19. Kids 10 to 19 years old have a 0.2% chance of dying from this. And that was in China. So, yeah, it can be hard on kids. There's no question about that. But the hypothesis, just throw this hypothesis out, is that kids don't express the receptors in their lungs like adults do. So the COVID-19 virus attaches.

to an angiotensin receptor in the body. And nobody needs to worry about what it is. Just remember the name, the angiotensin receptor. And there are blood pressure medicines, like I'm on, called angiotensin receptor blockers that, you know, help me keep my blood pressure down very nicely. You know, I'm usually 110 over 70 all the time. But one of the things that the body does when you take those things is upregulate those receptors because the body's thinking, wait a minute, I don't have enough receptors.

need to make more. And so there's a hypothesis that people like me are actually making more receptors for this virus to latch on to, but that little kids, particularly those under 10, don't make these receptors in any quantities whatsoever, and that's why they can just shrug this thing off. Okay. So, yeah, 0.2% mortality is translating to, you know, what was that, 90.8% that nothing will happen. sewage is 2% sewage in 98% water so this is even more than that

this is 98 point I'm sorry 99.8% odds that if our kids get this they will be totally fine okay so that makes me feel better I worry so much about all the people we know who are in the service industry you know boredom leads to to just worry and idle minds

and all that stuff and I'm not sleeping, and I know I'm not the only one out there who feels the same way. This is just a lot harder than, well, I never thought about anything like this happening before, so I can't even say it's a lot harder than what I thought it would be because. It's been 100 years since the last big one. Yes, exactly. We had a pandemic in 2009. Nobody even paid attention to it other than those listeners of ours who either ended up

on the ventilator or died from it. I don't know if you remember Barry the Blade, but, you know, he died from the H1N1 that year. And he was the guy that started the trucker duty bit on this show where we'd have truckers calling in, telling us about other truckers that they knew, certainly not them, but, you know, that would take dumps and bag, in Walmart bags and throw out the window and stuff. And those are the people who are saving us right now. That's right. Yes.

Thank you to our trucker friends who are, listening to this right now, who are bringing stuff to us, bring us more toilet paper. Yes, you really suck at the toilet paper. It's not their fault. I know, I know. I keep reading. There's no shortage of toilet paper. We're making plenty.

Well, where in the hell is it? Amazon, I wish Amazon at least would go, you can back order it. We'll just send it to you when it comes. But instead, it's just not available, not available, not available. You can buy toilet paper from China. And, you know, who God knows what it's like compared to the toilet paper we're used to. I am installing, I'm telling you Tase, I'm making this declaration for our home. I'm installing badees in all four toilets of our house.

I've been meaning to talk to you about that. And I typically wouldn't think that I'm a bidet person, but I think we should do that. Guys, we spent a dollar per roll on some toilet paper at Amazon. And I just think that's – I think it's – I think it's – price gouging. I know Amazon is trying to keep people from price, but come on, a dollar, a roll. Was that a lot? I mean, I don't...

I believe it's a lot. For 24 rolls paying like 25 bucks, I think that's actually, I think that's about right. It seems high, but, you know, a roll a toilet paper, your mother uses a whole roll a day.

I don't know what the hell she's doing because I got into it, but, you know, I was like, what the hell are you doing with all that toilet paper. I just imagine her just, she's like, well, Steve, I want to be clean. It's like, well, we all. As opposed to everyone else. Right. As opposed to everyone. Exactly. As opposed. Yeah, I don't want to be clean. But I don't know that just wadding up a whole roll and cramming it up your ass crack is going to, you know, do anything toward cleanliness. But anyway, but I have seen rolls of toilet paper for like $35 on like auction sites and stuff.

like a single roll of toilet paper. Now, those people, come on. I think it's just really scary to see how quick things can really go to shit. When you can't find things like toilet paper, and who would have thought that that would have been the thing people go after? But my therapist said, people feel like they have to do something. And in this case, with this situation, they felt like they needed to go get some toilet paper. And so that's why we don't have any.

If you had told me a month ago that a month in the future, there would be a shortage of toilet paper and Plaquinell, I would have laughed you. I mean, I would have thought you insane. Who would have ever? You can't make this stuff up. No, you really can't. Plaquinell, one of the most innocuous drugs, been around forever. I mean, I learned about it in medical school. Hydroxychloroquine for the people who are listening.

It's one of the drugs that has been proposed. as a potential um ameliorating uh force in this um in this thing and we're going to talk a little bit about all the different drugs that are being well hell why don't i talk about it right now the uh world health organization because i'm not done bitching just yet okay okay okay and so and then then you have to worry about all all the elderly people in your life um because they need stuff too yep and um they get out and they get it and then they're just goners. Well, okay, 15% of them are. Okay, that's still pretty scary. I agree. I agree. Those are odds where you wouldn't necessarily take all your life savings and take them to Vegas and bet everything. But an 85%, if I'm 80, and I get this,

I still have an 85% chance of surviving. And that's without any of these new medications. That's without, you know, that's before all of this. Okay. And that data, again, were primarily from China because they're ahead of the curve on, as far as we are. You know, this started much earlier there. So an 85 percent, still the overwhelming odds are that those people will get better. As I've reiterated from the beginning, most people will not get this, and most that do will not die. Go ahead. Okay.

That's good. Another concern I have is the shortage of PPE. I've never heard you specifically talk about it, but it's all over, you know, all of my little news sites that I read. And, of course, Facebook, which is one of my news sites that I read. And so I worry about that. And these homemade masks people are making, are they useful? Okay. These are, I'm going to give you one of these.

Give yourself a bill. Well, duh. I'm just kidding. I'm sorry I'm being so bitchy guys, but... No, that's why I mind you on here. Okay. And you and I are going to be doing the show for the foreseeable futures. Oh, great, guys.

Yay. So back in the day, and when I say back in the day, I mean, you know, two weeks ago, when we were on rounds, we would have our medical students and our residents and maybe one of a pharmacist and a chaplain. And if we went into a room on a patient that was in isolation, we would all put on a gown and gloves. And if they were on droplet precautions, which would be people who had pulmonary infectious disease like influenza, you'd put on a mask. And all of us would trapes into the room, and maybe one of us would touch the patient, everybody else just kind of, you know, looking at the floor, looking at the ceiling, and then you walk back out and everybody takes those off. So that would be six sets of PPEs, personal protection. equipment, used and wasted, basically.

Five of them would be basically wasted. Now we're not doing any of that. Students are banned, well, now they're banned from the hospital, but at first they were just banned from going into rooms that required PPE. One of the other things that they're doing is they're saying, if you have an area that it, where vancomycin, that's your old buddy, David. 24-7, my friend. If you're in an area where vancomycin-resistant enteroccus or metacillin-resistant staph aureus, MRSA, is endemic, you no longer need to wear PPEs in those rooms, because we never wore it to protect us.

We wore it to protect the person in the next room who we were going to see next. Well, if it's everywhere anyway, and the dirty little secret is, we test patients when they come in. They never test doctors and nurses and PAs and nurse practitioners and, you know, everybody else, physical therapists. We're probably all colonized as well. And if that's the case, why use PPEs for those? Just use standard precautions. So they've relaxed the rules on using PPEs in rooms where people don't have influenza, tuberculosis, or COVID. COVID-19, which actually I think is a good thing.

So let's get back to the shortage of it. Do you feel like we have one? In some places, there's definitely a shortage, New York being one of them. Okay. And that may roll out from there to other places. So we've got a hot spot on the East Coast and then a hot spot on the West Coast. And then, you know, if we don't hunker down and socially isolate, then you're going to see those shortages rolling toward the middle of the country until they meet in the middle.

Which leads me to my next question regarding... She's not doing this... She doesn't have her written down unless she's doing this from her head. She's very good. You're very... Oh, you did write. Never mind. Which leads me to my next question.

These are things, you know, I have listened to some of your other podcasts and they're a little bit over my head. Oh, they are not. Well, I guess I just get bored and do other stuff. But, I mean, so anyway, you know, they're saying in New York that it's really hard to find one or two patients in the ER that doesn't have it. Okay. And they're calling it absolutely staggering. And see, I told you his phone rings all the time. If that one rings again, I'm going to have to pause.

Okay, that's fine. Okay. Do you anticipate all of America ending up this way eventually, or is that just because? they're so condensed like will we see that here where we're more spread out and far or what is your what are your thoughts on it everybody asks me yeah what your thoughts are on this and and to be honest with you i don't i don't know and i know so i guess what's your if you can what is your bottom line thought yeah on on on this whole thing um sure no i think it's it's an excellent question, and one of the reasons why we're so concerned is because even though

most people are going to do very well with this, let's say mortality is 1%. And that would mean the hospitalization rate would probably be around 5%. Okay? So 20% of people who are hospitalized will die from it. Let's just say that that's, and that's going to be ballpark. Let's look at the pandemic of 2009. 60 million people in the United States got that virus. 60 million people. Okay. Out of those, 300,000 were hospitalized. 15,000 people died. So the percentage of people that died was like 0.025%. So it was really low. It was a very contagious virus, but it didn't kill very many people. Relatively speaking, I mean, listen, Every one of those 15,000 was tragedy. One of them being our friend, Barry the Blade.

Another one, almost, you know, Richard David Smith, the third, the owner of hyperphysics, because he ended up on the ventilator with it. So, and, you know, every death is tragic. No question about that. Well, 2020 flu. 50 million people have gotten it so far. We've had 50,000 deaths, 710,000 hospitalizations. So that's a death rate of 0.1%.

So if this thing is 1%, right, that's 10 times more than that. So let's just extrapolate those numbers. So you're talking 500,000 deaths, 7 million hospitalizations. Well, we only have 100,000 ICU beds, and they've got other people in them. You know, there's other people in those beds right now that don't have COVID-19. So the concern is that this would overwhelm if it all happened at once, because that was England's strategy. And we've got a phone call about that in a second. England's strategy, you know, it was strategy to let everybody get it and let the chips fall where they may.

But then they realized that that was not an effective strategy because although, yes, you would build up herd immunity, you would get a lot more people sick and it would just overwhelm the medical system. So now you've got a medical system. that's overwhelmed. Well, what if you get appendicitis? Or if you get, I don't know, scarlet fever and there's no place to put you in the hospital. Now all of a sudden people are, you know, having serious illnesses, even death from things that we could easily treat normally so that this whole thing dominoes down until it dies down and it would be a nightmare. So that's what we're trying to avoid. So what do I think is going to happen is what I'm hoping is what happened in China.

where 0.005% of the population got it. Instead of 50,000, what is 50,000 out of 325? Let's see. Echo, what's 50 divided by 325? 50 divided by 325 is 0.1538. 0.1. So, wait. So 15%, right?

Is that right? Yeah, I don't know. Okay, yeah. Yeah, so 15%. So instead of 15%, which is what we're looking at with influenza, if we could get it down to less than 1%, then we can handle this thing. You know, if the number of cases are one, if this thing is 10 times more lethal, if we can keep the cases down to less than 10% of the influenza cases, you see, then we can handle it because we can handle the influx of flu cases. So right now we're at 0.0, what did I say, 0.0 something percent. I've lost my paper, but anyway, it's way less than 1%.

Okay. If we can keep it there. Okay. So we just don't need to overload the medical system. That's right. With other things. And, okay, so I understand that. And I guess that's the bottom line.

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It's incredible. I mean, it's the greatest thing, and I'm going to turn around and buy their blood pressure cuff, too. We need that. I have a great blood pressure cuff, but to have something that can track. my blood pressure and then I can send it to my primary care provider. Come on. They have other stuff, too. I've just started to explore their website. If you want to take control of your weight or add muscle and lose fat, a Withings smart scale can help. At every way in, you get weight, full body composition, weight trend, and even a local weather report. In fact, Tom's guide recently named

Withing's Body Plus the best overall smart scale of 2020. Get 25% off the body plus composition, Wi-Fi Smart Scale at Wittings.com slash Steve. That's W-I-T-H-I-N-G-S dot com slash Steve. You're listening to Weird Medicine. I've also been worried about ventilator triage. Yep. I mean, these are things that, you know, if you can't sleep between like midnight and four, that you think about.

Yeah, you start thinking about these things. Yeah, yeah, yeah. And how we just don't have enough. Well, let's, we've got a phone call about that. Let me, let me get the Ronnie B. disclaimer first. Number one thing. Don't take advice from some asshole on the radio. Let's, uh, there's, I've got a question just about that.

Okay. So you don't have to carry all the weight. Yeah, Dr. Steve, I have a question. I have a CPAP machine. Just wondering if that would, uh, hear a lot about the shortage of ventilator. I wondered if that was sort of on the same line. Thanks,

that's a great question. So he's wondering if he could maybe, I'm guessing being altruistic, donate his CPAP machine if somebody needs it now. So CPAP stands for continuous positive airway pressure. So it just provides pressure.

And so it blows in and you build up to a certain pressure and then that's where it holds. There are other machines called bi-pap machines. Now, bi-pap pressures are bi-level positive airway pressure machines where the pressure on an inhalation is greater than the pressure when you're exhaling. So there's still CPAP in there, but when you're inhaling, you're getting the extra pressure or extra flow. So now a bi-pat machine would most likely be more effective for somebody with respiratory failure than just a pure CPAP

machine. So when we got someone on the ventilator, we're always, before we take them off the ventilator, put them on CPAP, put them on continuous positive airway pressure, see if they can handle it, and then take them off. But if they're not ready, they'll start breathing fast and their heart rate will go up. So CPAP alone isn't as effective. But now, people who have bi-pat machines, if we run out of those, I would be happy to donate mine. I've just got complex sleep at me. I can go a week or two weeks or a month without wearing it. I went for 62 years without wearing it. And if those things would help. So if we get really desperate for the people that have the lower level respiratory failure, you can keep them

going on BIPAP for some time. I also understand that some of the industries are repurposing their factories to make ventilators. And a ventilator doesn't have to be the $100,000 machine that we have in these in these hospitals right now they can make cheap and dirty ones and when I say cheap and dirty meaning they don't have all the bells and whistles but they would still work great and heck we've got tons of cuirass ventilation machines those are the old school iron lungs they're now made out of plastic and you can wear them but that could help for people with borderline respiratory failure as well so I yes it will be an issue and I'm hoping you You know, we have ventilators in every operating suite, too, and we're not doing elective operations right now so that we could repurpose some of those as well.

So we'll be able, if we can just slow this thing down so that the flow is nice and even and not, you know, heavy. You know the difference between light flow and heavy flow, right, taste? Yeah, I sure do, Steve. Heavy flow is not good, so we want nice light flow. We want a nice menopausal flow, perimenopausal flow, okay, of patients. If we can do that, we can keep the death rate down, and we can keep from overwhelming the medical system. And having to make those types of who's going to live or die decisions. We have never done that in this country.

We have such abundant medical supplies. and access to care, despite what a lot of people think. You can still, it doesn't matter if you have no insurance or if you owe the government a million dollars, you can still go to the emergency room and get, you know, care for your heart attack and get treated and get catheterized and all that stuff. They'll just settle up with you later. But you will, we've never in this country used this thing called the principle of distributive justice. And distributive justice talks about. distributing resources to the people for whom it will do the most good.

Because the problem is, who's making that decision? Who's the most good? Is it some politician? Is that person's life where, you know, we shouldn't be making those kinds of decisions? So, you know, if you've got a 90-year-old with stage 4 cancer and they want CPR and you do CPR on them and they end up in a coma and they're on a ventilator for three weeks, it's just done. No one has that conversation that says this shouldn't happen. We may talk to people about, you know, this patient may not want this,

and it's okay to withdraw treatment if you're in a futile situation. That's not the same thing. But you're right to be in a position where now we have to say, wait a minute, we're going to save your life, but not yours. That's a position we never want to be in. And one more, one more bitch point. Yep. I'd also like to say that I am praying for every family who has,

teenagers in the house we have I got my no it's not funny I got my children up or you did today at 1 30 and that's the earliest no I got them up at 8 o'clock and they when I came home after between doing my interdisciplinary team meeting and going to another meeting they were still they were yet a bit yes yes so they may have rolled over at 8 So, and I, although am in a house full of two teenagers, I'm, you know, I just, somebody has got to talk to me at some point. So that is why I'm so grateful that Steve is at home, because it is really hard to be hunkered down. Yeah, it is. So, you know, what are things people can do?

You know, Netflix and Hulu has been nothing but awesome for us. That flicks and Hulu. Absolutely. Give yourself a bill. They've got to be doing big numbers right now. And I'm looking forward to nine months from now seeing this increase in childbirth that's going to happen. And as people are stuck together and they got, well, we got nothing else to do. We might as well do it, Myrtle Jane.

And what else? But what can people do, Tase? What do you think? you know i don't know i being being paid to work from home i i typically stare at my computer all day so that at least i'm somewhat earning my paycheck i have a little bit of things to do but it's just it's not a lot and um face-timing has really helped there's a lot of people who and i would have never face-timed anybody a week ago she's been the face-time queen that's there's no A lot of people still have not caught on to that, but it's just so good to see other people's faces, whether they've showered or not.

I do think showering and getting ready every day is important. It kind of brings some sense of normalcy to your life. I think establishing a schedule. As far as having the answer, I don't. And I would like to have some suggestions as well. If you all have suggestions for my wife, it would make my life better and by making her life better. If you have some ideas, I've got one for people, if you've got a nerd friend that's stuck in the house, particularly if they're quarantined, by a monoculus go, they're like 110 bucks, it's virtual reality. You can even set up scenarios where you're outside or you're in a museum and you're walking around and doing other things like that.

that. I think virtual reality would be something for the people that have it and can afford it would be something that would help. That trip app that we talked about, you know, Nina Reeves from t-R-I-P-P-com, check that out. If you've got a, if you have a virtual reality setup or Oculus Go or Oculus Quest, that's a great way to get yourself out of your head for a few minutes, and I played a new ninja game last night, taste that, you know, you need to try. I would love to come home and see you just bisecting some fools playing the ninja game with the virtual reality machine. I also think exercise.

I mean, I know that's important, but I am not in the damn mood right now. Yeah, yeah. Just that's the last thing I want to do, but it's the first thing I need to do. And so I understand that too. Let's talk about the new WHO trial real quick. Okay. If you want to know what people are doing about this, the World Health Organization started a new trial called Solidarity, and that would be Solidar Nostchuk in Polish, for anybody that was alive during the 80s. They are going to be looking at a series of medications.

One of them, remdesivir, that's the one that we've. been hearing about. This is, they tested it remdesivir during the Ebola outbreak. It didn't show anything, but it did show some benefit at my alma mater at University of North Carolina Chapel Hill in test tube and animal studies that could inhibit coronaviruses that cause SARS and MERS. So there's been the first COVID-19 patient diagnosed in the United States, which was a young man in Son, God, how do you pronounce that?

Snohomish County in Washington. I was given Remdesivir when his condition got bad and he improved the next day. Now, that's just anecdotal evidence. That's not evidence, okay, but didn't hurt him. So they're doing phase three trials, which means there's thousands of people getting this stuff. We should have preliminary results within two weeks to a month because the phase three trial's been going on for a while.

So I'm hoping that we'll get something really. interesting there. They're also decided because of the President of the United States, to be honest with you, and pressure from other people, they added chloroquine and hydroxychloroquine to that arm. There was one recent trial that was rather disappointing when it came to use of chloroquine. It was a very small study, and they were very sick people, yes. Okay, so this chloroquine and hydroxychloroquine? Yes. Okay, so what are the differences? I mean, not chemically, but like brand name or... Gotcha. Chloroquine is a medication that has been used in the past for malaria prevention.

So you would go to a malarial endemic area and start taking chloroquine. Okay. When you take it every day, day in and day out, there can be some significant adverse effects. People had weird dreams and had neurologic things, deposition of chloroquine on the cornea, stuff like that. Then they developed hydroxychloroquine, which is chemically almost identical.

There's one hydroxyl group on it that's different. And it turns out that it's pretty useful in things like lupus and rheumatoid arthritis. So that's plaquineal? That is plaque. Okay, okay. You have, you know somebody that's on Plaquinell. I know somebody. I mean, I've prescribed Plaquinell for decades now.

And it's, people take it every day and it's very well tolerated. So this sort of fear mongering where there was a study, it said, well, one person died from drinking the drug that Trump is propone, you know. And what it was was they drank. Fish tank? Aquarium cleaner. Yes. And they got a lethal dose. of chloroquine. And it says on it not for human consumption. So listen, y'all, we talk about this all the

time. No home brew science on this one, okay, as far as taking drugs is concerned. We want to do all this stuff under a doctor's supervision or, you know, a medical provider, NPPA, M, you know, D, O, whatever. But anyway, so they're going to look at chloroquine. I did not see that they were going to try it in concert with a zithromycin, which was the French study. If you recall, the French study looked at both chloroquine and azithromycin together and hydroxychloroquine by itself. And what they claimed, and this is a very small study, was that there was a dramatic decline in viral shedding in the people that use hydroxychloroquine with azithromycin. And then the other set of drugs is ratonavir, lopinivir, which is an HIV. drug that interrupts

RNA replication. They published a small study in New England Journal of Medicine that showed very little, well, no effect. But so many of the people in that study died that they think that they

only gave it to people who were so sick that nothing was going to help them. So we're going to try administering that a little earlier and maybe that'll get us a better benefit. And then the last leg of that one is going to be the rotonavir, lopinavir with interferon beta. And interferon beta is just a molecule that's involved in regulating inflammation. A lot of the people

who die from this have a thing called cytokine storm. And that's just a sign of what we call hyperinflamation. So when the body attacks these viruses, the white blood cells come out in force and go get the hell out of here, and then they will release these inflammatory factors called cytokines, and those will go everywhere in the body. And if you release too many of them, some of them will end up in the kidneys and cause inflammation there, and then the kidneys shut down in the liver, and the liver shuts down. Because there's no reason for these people who just can't breathe to get multi-organ failure.

And one of the things that's posited is that maybe that interferon will help with that. cytokine storm, or perhaps hydroxychloroquine could help with that, and there are other anti-inflammatory drugs that could be used that are not steroids and not ibuprofen. They're in a separate class altogether, and that may be able to prevent that cytokine storm. So even if the people got that sick, they could give them these medications and just wait till their body healed and their breathing got better and get them off the ventilator, the rough part of that is that could take six weeks. That's what I was going to ask you.

So all of this will be, we'll be rearing to go and open back up by Easter, right? Well, okay. So look, the worst thing that any of us can do, and I mean all of us, and that means everybody in government or anywhere else has started to politicize this thing. I know, I know. So you can set goals. Hey, we would like this sector to be back moving again. That's my goal. that's not necessarily saying, hey, that's what we're going to do because, you know, Anthony Fauci said,

hey, all this stuff is flexible. We just got to see how it is. But we can set gold. I'd love for this thing to be over in two weeks. If we get a treatment that can reduce the duration of this disease by half and reduce hospitalizations by 90 percent, this thing kind of will be over at that point. But we've got to have that data. And I'm not anywhere saying that we've got that or we're called.

close to it. But if we get that, that's what it's going to take for this to be over. That or just huge herd immunity, you know. It seems very unlikely to me that some drug will be proven well enough to be a cure by that time. I mean, it just. Well, the Remdesivir trial's been going on for some time. Okay. And then you're, but you're right, though. I mean, I don't want to be, I would love to go out and have dinner at Easter or have. I mean, my God, I hate to to say this, but have my family over at Easter. No, that's the one plus side to this, is we don't have to mess with your family. So, I mean, yeah, I mean.

There's a silver line of neighborhood, I'm curious, Steve. And, um. But, yeah, I think that is extremely ambitious and may not be real world in any sense, but it's good to have goals. We need to have some hope that we can get through this because even the 1918 pandemic eventually ended. It had three waves. It had a wave in the spring, no, in the winter, and then I think in the spring and then in the fall again, or it was either that, or it was spring, fall, and winter. And, you know, it just kept hitting harder and harder.

We need to be able to respond to these kinds of situations and viruses much faster. Of course, back then, they barely knew what a virus was. They didn't know what hit them. And we've got so much more technology and so much more ability. I mean, it used to take 17 years to produce a virus. We're going to have one in under a year for this. And they actually synthesized the vaccine particles within the first couple of weeks, and that's outstanding. One thing my therapist, here's a little free therapy for everybody.

Okay. He said, you know, just what if everything turns out okay? You've got to be hopeful and to know that we're going to come out of this. If this isn't the end of the world, and you've got to hold on to that. Well, the roaring 20s came out of the pandemic of 1918. Of course, stuff after the roaring 20s wasn't so great, aka the Depression, but our economy isn't like that now. So I don't see that happening.

And so we just got to get through this. And the easiest, quickest way to get through it right now until we have the tools to treat it or prevent it with the vaccine or medication is to stay apart from each other. And for those of us that are introverts, that's actually kind of a good thing. I'm kind of glad a lot of my meetings have been canceled. But I hate that MoGFest got canceled. But what are you going to do? What are you going to do?

You don't hate that, I know. No, that's the one thing you get to do for fun. I hate that what was the other thing we were going to do, got canceled? Oh, creeps with kids. with kids. I hate that. We were going to see Ronnie B., Rich Voss, Jim Florentine, and Bobby Kelly in Atlanta at the weekend of Easter, and that was going to be our excuse to not be here and have to deal with your mother and her issues.

But now we have another excuse. So, you know, the Lord provides taste. He does. There's a lot of things that I have been praying about. And this virus kind of has answered those prayers. But I just was hoping that things would, you know, come about in a different way. But, you know. Well, you want to do a non-COVID question real quick? Sure. Let's do one.

We've got about two minutes left. Okay. He's going to have to do a extraction from my bone marrow. Hey, Dr. Steve, it's my calling back. I just left a rambling message. Hopefully, you'll have fun of it. it on the radio or delete it, whatever you prefer. Again, I'm pulling back.

I have blood work done. My primary referred me to a hematologist, oncologist, who indicated I might have polycythia vera. Okay. He did say that I do have polycythemia vera, and he differentiated it

between that and polycythemia ubravera, which is the blood cancer. Well. Tests he did on my blood shows I do not have the rheumavir of blood cancer, but he said to be 100% sure, he's going to have to do a extraction from my bone marrow to find out. Okay. He also indicated perhaps my elevated counts are coming from my testosterone.

Okay, yeah, we got about a minute left. So this guy's on testosterone, and he has elevated red blood cells. We call that polycythemia. That just means the elevated red blood cells. There is polycythemia vera. That's a stem cell disorder that's characterized as a malignancy, neoplastic bone marrow disorder. And its most prominent feature is elevated red blood cell count. So the way to differentiate between the two of those, one, stop the testosterone because, yes, testosterone and smoking, being in an area where there's a lot of carbon monoxide, all those things will raise your red blood cell count.

But if you want to know if you've got the polycythemia vera, which is the neoplasm, then you've got to do a bone marrow. To do that, they numb up a place over your ass bone, basically, right, you know, just a lateral to your spine, and they take some fluid out and look at it under the microscope. You know, some of the signs and symptoms of polycythemia vera are impaired oxygen delivery. You'd think that they'd have better oxygen delivery, right? because they've got more red blood cells, but they just got too many. And too many of anything is not necessarily a good thing. So they cause sludging of the blood, which leads to headaches, dizziness, Virgo,

sometimes ringing in the ear, sometimes changes in vision and stuff like that. Even if they're prone to it, they can get chest pain, you know, true angina, because it's actually clogging up some of the smaller arteries going into the heart sometime. What we call intermittent claudication. Clotication is when people have pain when they're walking, right? And then they get their legs cramp up because they can't get enough blood supply to them. A lot of times, 75% of people at least will have an enlarged spleen in that case. If you've got testosterone that's just increasing your blood counts, you're not going to have that.

They may have enlarged liver and high blood pressure and stuff like that. So if your hemoglobin is greater than 16 in men or your hematocrit is greater than 49% in men. So do you know what the hematicrit is, Tays? No, sir. I do not. Okay. So the hematocrit is the percentage of blood that's actually red blood cells. So what you do is you have this little tube and you spin the blood down.

And then the old school way to do it was just measure it. And you would measure the height of the total column. let's say it was 10 inches. And then if the height of the column of red blood cells was 4.5 inches, then it was 45%, right? Sure. Oh, Jesus. There's a limit, Steve.

Everybody has a limit. All right. So anyway, so that's what they're looking for, is an elevated hematicrit, meaning that you've got a plethora of red blood cells. And one of the things they can do for this is just do phlebotomy. They'll just take red blood cells out. You've got to throw them away, though, because they come from a malignant process.

But, you know, this isn't like having some sort of cancer. I mean, sometimes they'll do what we call cytoreductive therapy, which is medication to just kill off some of those cell lines. They'll do that in people who are at really high risk for clotting and stuff like that. if they have painful spleen, they will remove the spleen sometimes, because when you're an adult, you can get away with that. But most of the time, treatment consists of just drawing off blood. There's also a medication called hydroxyurea, and that's used as a cytoreductive agent,

and there are lots of other alternatives as well. And the hematologist will be the one that will walk you through all of that. Okay. All right. You got anything else to plug? No, I don't. Well, we can't forget, Rob Sprats, Bob Kelly, Greg Hughes, Anthony Coomia, Jim Norton, Matt at the Syndicate,

Travis Teft, Lewis Johnson, Paul Offcharski, Eric Nagel, Roland Campo, Sam Roberts, Pat Duffy, Dennis Falcone, Ron Bennington, and the great Fez Watley, who is having a birthday this week, whose early support of this show has never gone on appreciated. Listen to our Sirius XM show on the Faction Talk channels, Sirius XM Channel 103, Saturdays at 8 p.m. Eastern, Sunday at 5 p.m. Eastern on demand and other times at Jim McClure's pleasure. Many thanks to our listeners whose voicemail and topic ideas make this job very easy. 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, get some exercise, wash your hands. We'll see you in one week for the next edition of Weird Medicine. Thank you, guys. Oh, yeah. Bye, Tase. Bye, Steve.