Weird Medicine: The Podcast - 405 - Hives, Blood Donation, and Herd Immunity

Episode Date: April 30, 2020

Dr Steve and Tacie discuss vaccine candidates, new covid-19 medications, hives, and explore herd immunity math. Fun! PLEASE VISIT: stuff.doctorsteve.com (for all your online shopping needs!) simplyherbals.net (While it lasts!) noom.doctorsteve.com (lose weight, gain you-know-what) premium.doctorsteve.com (all this can be yours!) DEEPDISCOUNT.COM!  (new sponsor!) 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've got diphtheria, yo-ho-ho-ho-ho-ho-yo. I've got diphtheria. I've got diphtheria of my esophagus. I've got sublovibes stripping from my nose. I've got the leprosy of the heart valve, exacerbating my impetable wounds. I want to take my brain out and blasted with the way. an ultrasonic, agographic, and a pulsating shave. I want a magic pill for all my ailments, the health equivalent of 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 a requiem for my 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. I'm Dr. Steve with my little friend, my wife Tacey. Hello, everybody. This is a show for people who would never listen to a medical show on the radio or the Internet. If you've got a question, you're embarrassed to take to your regular medical provider. If you can't find an answer anywhere else, give us a call at 347-76-6-4-3-23.

That's 347 Poohhead. Visit our website at Dr. Steve.com for podcast, medical news and stuff you can buy or go to our merchandise store at CafePress.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 the show. Without talking over with your doctor, nurse practitioner, physician assistant, pharmacist, chiropractor, acupuncturist, yoga master, physical therapist, clinical laboratory scientist, registered dietitian or whatever. All right, very good.

Don't forget to go to stuff. dot, dot, dr. steve.com. For all your Amazon needs, we've got a COVID-19. survival section in there as well, although it's pretty sparsely populated. I've been seeing hand sanitizer and toilet paper and stuff sort of reemerging in the grocery store, so that's good. Yeah. They even had it at the drugstore the other day.

They had all kinds of toilet paper. And people weren't mob and I'm trying to get it. So I think most people have gotten to the point where it's like, how much toilet paper do I actually need? Yeah. I think it's still a good idea to get a bidet, though. Yes. Let's do that.

We'll work on that. I think we should. I think we should. All right, very good. So stuff. dot, dr.steve.com. You can buy bidays there, too. Tweakeda audio.com offer code fluid for 33% off the best earbuds on the market for the price and the best customer service anywhere.

And they also have a wireless earbud now that's currently on sale that looks really cool. It looks just like, well, it looks similar to the Apple ones, but it's, you know, like, fraction of the price. Oh, cool. Check out tweakeda Audio.com and use offer code fluid. And if you want to attain your ideal body weight, which I

am I have struggled over the last little bit, but my counselor and I have a new plan, newm. dot, dr.steve.com. And the great thing about Noom is I know that if I

get a little bit out of whack, I can get right back where I was before. And that's the brilliance of So I've been doing it now, oh, my gosh, we're going on our second year now, right? Yeah, you are. Noom, n-O-O-M dot, dr.steve.com. It's not a diet. It's a psychology program for you to change your relationship with food and lose weight.

And I hit my ideal body weight. And because of social distancing and nothing else to do, I've kind of goofed up a little bit, but I'm ready to get back on the program 100%. So no points. You can only do it for three months if you want to. If you have a success at the end of three months, you don't have to go beyond that. So in that respect, it's very different than something like Weight Watches or one of these other things. And then check out Dr. Scott's website at simplyerbils.net.

That's simplyerbils.net. If you want archives of all these shows, we have those for sale as well. You get a 32-gigabyte thumb drive and only 17 gigs of, of, data so you get some extra capacity plus you get over what 400 and some shows now so um you just go to dr steve.com and the link is on there is that how many shows you've done now 400 yeah that just for riot cast we've done way more than those for you know we did them before riot cast we did podcasts on our own and i think some of those are included maybe not and those may not be included as well. If you want those too, let me know.

We can work something out. I've got something here that I'm supposed to read. It says, Hey, Dr. Steve, I dropped you a line five years ago. Wanted you to know I'm still tuned in, still living my youthful dreams of being a doctor vicariously through the show. I am tragically

now an accountant. No, there's nothing tragic about that. Thank you for being a calm voice of reason in ugh. These trying and unprecedented times. That's his Urg, not mine. Your buddy from across the pond, Carl.

We need to get Carl on the line so we can talk to him about our new favorite stupid reality show, which is Love Island, UK. Love Island, UK. 36 episodes of your genius. You know what we should do. And they're not terrible people. It's not a shit show like that. No, no, no. I care about everybody on that show.

It's insane. I don't know why. Well, the funny thing about British TV is, okay, they do a show like The Office, six episodes. Some of those other shows that we've watched, you know, the BBC shows that are on Netflix that we love, and there might be six to eight episodes, and they're done. But the reality TV, this thing's 35 episodes. And then somebody told me, season four has 54 episodes. So, Ian Sterling is a UK comedian.

He's hilarious. And they just say the most ridiculous things about these people. He's sort of the voiceover, like the Greek chorus. You know, it's really what the purpose he's playing is he's the Greek chorus commenting about what's going on on the screen. And, yeah, I actually care about these people. It's funny. And they make me laugh. And we've just had so much fun.

fun watching this idiocy. And it's mind-numbing. Mind-numbing. Exactly what you need at this time. Yes. Love Island, UK. So, you know, there's a Love Island, Australia, and there's five other seasons of this thing. I don't know if I can do it. But it is certainly more entertaining than the American version was. Certainly. By far. And I love the accents and trying to figure out who's got a northern accent and who's got a southern accent. all this kind of stuff. It's neat. But anyway.

All right. Well, we probably should do a show. So I got a call from Dr. Scott today saying, well, let's do radio today. And it feels weird having, like thinking about having somebody come over. It's only been, what, six weeks, seven weeks now? Seven. Has it been seven? For me, why didn't you let him come over to do radio?

Well, because I said we'd do it at three. and we're doing it at noon. Oh, okay. Maybe he can come over and play music, but it just feels weird having somebody over. Now, you've had somebody over. Yes. To do your charitable work,

which was packing lunches for kids, right? Yes. Which is awesome. I'll give you one of these. Oops. Thank you, everyone. Thank you. Thank you so much.

A sustained one. Wait, what did she say? Can you please stop bullshitting and get to the questions? Okay, sorry. I'm trying to butter my wife up because, you know, later on, you never know what might happen, right, honey? Yeah, you're exactly right, Steve. Nothing like quarantine love. Oh, yeah.

Ooh, that's a band name. Is it really? Yeah, I think so. Someone asked me about some virus protocol. and it's like, oh, that's a good band name. No. Virus protocol. Oh, it's not.

Well, for my kind of band. Neither is the band that you have. What, Super Android 23? You don't like that? No, that's not a good band. You don't like Super. No, it's pretty funny, though. Well, that's for my, that's for doing electronic music.

I figure it's apropos. We even have a guy that did a logo for us for Super Android 23. It's a guy named Martin, and he did an anime version of the Dr. Steve logo with me with this sword, and I'm sure there's a name for it. And I've just done this big slashing motion, and then there's just guts and blood everywhere. Well, that's nice. Yeah. So I just wanted to let everybody know if they hear heavy breathing, we brought the dogs up here. Yeah, I remember one time we had, back when we had Ozzy, he came up to do the show with me once, and he was panting.

So I would make a statement, I'd say, well, what do you think, Ozzy? And then you dear, that was pretty stupid and funny. He was a good doggy. All right. Yeah, don't forget to check out Dr. Scott's website at simplyerbils.net. He will be back next week. Lady Diagnosis is on furlough, so maybe we'll just do a regular show next week. Oh.

Am I off the hook? No. Well, no. You need to be here. I think you're probably on the hook for the duration until you go back to work and you can't record anymore. For real. You know, people really like having you on here. Well, thank you, everyone.

And I like it, too. It's the only time I tell people it's the only time I can get you to laugh at my jokes because you're being polite because we're on the radio. exactly exactly very good good for you you didn't take you didn't take the bait all right so let's talk about a couple of things there's a new drug that has been around for a little bit but just came on my radar screen as a potential to end this effing thing we've talked a little bit about what it's going to take to end this is either herd immunity which we're going to talk about We've got a question about herd immunity today, and we're going to calculate. We're going to do some math, so get your calculators out.

We are, so we either need herd immunity, which would require everybody, a certain percentage of people actually getting this and being immune to it or a vaccine. Or we need a drug that keeps people out of the hospital and keeps them from dying. If we have that and we have ample supply and it's affordable, which, by the way, even if it's not affordable, I'll guarantee them tea, it'll be less than $2 trillion to treat the people we need to treat. So I would certainly conceive of the government paying for this just to get the economy back on track. Because $2 trillion, that's an F load of money. F loan. That's been spent already on this.

So I would petition the federal government. Look, if it's going to cost, let's say, $100 billion to treat everyone to keep them out of the hospital, that we need to treat symptomatic people and keep them out of the hospital, I say let the government pay for it. Be worth it. It's a deal rather than have another one of these trillion-dollar stimulus plans. Well, anyway, there's this company, Fuji Film. They make film.

And, you know, the film industry is kind of tanked with digital stuff. So these companies have had to diversify. Fujifilm got into making drugs. And there's an antiviral drug called a fevipyrivere. Fabapyrivere taste. Remember that name. They're in phase three clinical trials. This is not like this.

malarkey we've been talking about, well, we treated 300 people and they all got better kind of trial. These are phase three clinical trials, meaning you've got thousands of people being treated. Remdesivir are also in phase three clinical trials. And this was a drug that was developed for influenza, but it looks like it might be a decent drug for SARS-COV-2, the virus that causes COVID-19. Now, I'm looking to these, there's not been any adverse reactions in human trials so far. And there was some good data on this as well that showed patients in controlled, small

controlled trials got better at a rate that was greater than. and people who were not being treated. So I'm very interested in seeing phase three data come out on this. And if this, rather than remdesivir, because right now remdesivir is that nucleotide analog. So we talked about it last time that looks like part of the RNA molecule. So when this stupid virus is trying to make copies of its genetic material, it stops, it inserts this chemical. in there instead of the chemical that it's looking for because it's too stupid to tell the difference, and then it stops it from producing it.

So if we can stop this viral RNA from being reproduced, then you've got no virus. You've got no disease. But it's IV only right now. So this phava pyruvere, my understanding is it's an oral medication. So if we can treat people early and keep it. them out of the hospital, keep them from dying, just get it down to influenza numbers even, then we can all go back to work the next day. What about Fomodidine?

Why, isn't that interesting? Yeah. Plenty of that to go around. Yeah, there's all kinds of Fomotidine to go around. Fomodidine is a H2 blocker, histamine blocker, that is used for reducing gastric acid in people with acid reflux. and before the advent of proton pump inhibitors, it was, you know, H2 blockers were the go-to for people with all kinds of

peptic ulcer disease and peptic diseases of increased acid. And there is a clinical trial going on now to look at Fomododidine to see if it, in addition to blocking histamine receptors, could it also block the ACE receptor or some other factor that COVID-19, the virus that causes COVID-19 needs? This is in no means in an endorsement. I've seen zero data. I just know it's being studied. There are also 629 other clinical trials going on right now.

Some of them, including traditional Chinese medicine. You know, they're just throwing anything off. the shelf that we already have that we can throw at this so we can find something that works and that's great you don't have to spend all the time doing phase one phase two phase three trials because let's just say let's postulate that drug X is something that we use to treat gout for example and it's already approved by the FDA it's gone through all its phases of testing they've gone through phase four post marketing testing the whole thing It's acknowledged as safe and effective for gout. And that's what's indicated for. But we find out this is the panacea we've been looking for for COVID-19. We can prescribe it tomorrow as long as there's enough supply because the way that the rules work is that I can write, as a licensed provider, I can write any drug for any indication that I want, as long as it's a law.

It's been approved by the FDA for some indication. So that's why gabapentin, for example. Gabapentin was a drug that was initially approved for seizures. We never use it for seizures. We use it for diabetic neuropathy and neuropathy from chemotherapy and stuff, you know, pain that arises from damaged nerves. Two similar but different things, and we wrote an off label for, ages until they finally got the indication for neuropathic pain.

And you go, well, why would a stomach medicine work? Well, okay, it's not a stomach medicine. It's a molecule that has a specific effect on receptors that are critical to the production of acid in the stomach. But is aspirin a stroke prevention drug or is aspirin a drug to treat pain in rheumatoid arthritis. It does both things, you know. So none of these drugs are really, you know, stomach medicines or rheumatoid arthritis medicines or they just are molecules that have effects that have beneficial effects on the things that we're looking for. Does that make sense?

Yeah. Okay. For once. Yes, absolutely. Thank you. Thank you. Thank you very much. Well, I'll give myself one of the years. Give yourself a bill. Good job, Steve. Yeah. I made sense and and didn't shit the bed. But so, yeah, so if the H2 blockers prove to be effective, that's great. Don't go hoard them now. There's no evidence that I know of that they're going to do anything for you, but they're being studied. You're listening to Weird Medicine. Hey, Tacey, so what do you think about Deep Discount?

You know, I love Deep Discount. I love the multitude of choices they have. and all the genres. I mean, it's just, if you want it, they've got it. Yeah, let's take a minute to talk about them. They're a new sponsor to the show. It's deepdiscount.com. They're a great site to buy movies, TV shows, music, and much, much more at really great prices.

We're talking classics from back in the day, hard to find titles, and new ones, too. It's crazy. I just saw the movie The Assistant that's got Ruth from Ozark, our buddy from Ozark. I love her. Her movie is out at Deep Discount. Came out yesterday. And I don't even think it's hit the theaters yet. Yeah, I'm not sure.

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You know what you can get? What? Poldark. Oh, gosh. Pol dark is the best. Pol dark is the best. It was a BBC show that we got, or it was one of those masterpiece theater shows. Always good. And we had finished, I think, Downton Abbey because we're old. and we wanted something else that was like it and so we looked at Poldark we watched one episode and we were totally hooked

totally hooked the guy goes away to war and comes back and everything's changed all of his life is all screwed up and it's how he sort of tries to put it all back together over five seasons I got my friends all hooked on it fifth season it was okay

but the first four unbelievably great loved it and there's one on there that you like too I like Killing Eve. It's on there. Yes. You have to watch Killing Eve. I thought, oh, really again, but no, she's awesome in this. I've never been a fan of hers until this show, and now I'm a fan.

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support our sponsor own your passion check out Deepdiscount.com, that's deepdiscount.com. Thanks, Deep Discount. Thank you, Deep Discount. You're listening to Weird Medicine. I was reading something about COVID toes.

I don't know anything about that. What are COVID toes? They're just, when your toes look really gross and purpley and black, and the dermatologist said they kind of linked it to the coronavirus. Okay, so I'm going to have to do some, you stumped the, I'm going to give you one of these. Give yourself a bill.

COVID toes. I'm going to have to read up on that. There, let me see. Let me see if I've got anything here. That's very interesting. Newer symptoms that have been emerging. Okay, this is from Cleveland Clinic.org. Go to show how people can react to infections in different ways. Some of these

symptoms actually aren't new in the realm of viral infections. They're quite common for people to get rashes when they're battling infections, especially viral respiratory ones. And let me see, COVID toes are just another way that the body can respond to a viral infection. It's a different form of manifestations, still not very clear what causes it. One pattern of COVID toes that people reporting is red lesions. typically on the souls. Okay, so there are other viruses that cause red lesions on the palms of the hands and the soles of the feet.

It's possible that's a skin reaction caused by small clog or microclots and the blood vessels found in the toes. Yeah, yeah. So, yeah, they've seen this before in ICU patients with sepsis or people on life support. That's very interesting. I'll look into that and have something for you next week. Okay. I'll look into that more closely.

Also, I was reading about seemingly very healthy young people who get the coronavirus having strokes. Yeah, yeah. So there, not a lot is known about this. We're seeing some people having large vessel strokes as a presenting feature of COVID-19. this is a vast, vast, vast minority of people. There was an article in the New England Journal of Medicine that reported five cases of strokes in patients younger than 50, and SARS-COV-2 infection was diagnosed in all five patients.

And there was a retrospective study of data from COVID-19, outbreak in China showed that the incidence of stroke among hospitalized patients was approximately 5%. And the youngest patient in that series was 55. So we don't know the ideology of this. It could be these people were at risk for stroke because we see, you know, in a month's time you might see in a city the size of New York about one stroke a month or something in a young person. and they're seeing, you know, three or four. So there is some association with an increase. It could have something to do with just the total body inflammation and other co-factors

that are causing increased clotting. And maybe these people had risk factors that we weren't aware of, you know. Yeah. Were they smokers? Did they have glucose intolerance? Other things like that. We will know more about this as time goes on so that we can have. try to demonstrate, hey, who's at risk for having a stroke when this happens?

And it may be people who are already at risk because some young people are at risk. Yes. You know, if you smoke and you take the birth control pill, and you're, particularly if you're over 35, you're at increased risk of having a stroke, even 35, 36 years old, you know. So don't do that. Don't smoke. First off, don't smoke. Don't smoke.

But Tacey and I used to both smoke. We loved it. Loved it. Loved every minute of it. It hurt my feelings when I quit smoking. I still dream that I smoke. I do too. I had a dream just the other day where I said, oh, F it, I don't care about my weight.

I don't care about anything. And I smoked two packs of cigarettes. And then halfway through the second pack, I was like, wait a minute, I quit smoking. And I totally forgot. I woke up in a cold chill thinking that I had actually smoked a pack of cigarettes. And I was like, thank God, that was a dream. So if I can get the enjoyment out of smoking from dreaming about it, that's fine with me. Why do I never have dreams about sex, ever?

And if I do, if I start having sex in a dream, I immediately wake up. But I can smoke two packs of cigarettes, no problem. I'm sorry. That's a bummer for you. Do you have sex dreams? Sometimes. Really? Yes.

Who's railing you in these dreams? You know, I haven't had one in a very long time, so I don't remember being, who was railing me. It's mostly just many people at once. Many people at one? For real? No. Like, oh, what was the Roman, the Roman emperor's wife that had all the same? Centurians have sex with her.

I'm trying to think it wasn't Filipino, it wasn't Justinia. I don't remember. Well, anyway, let's talk about vaccines just for a second. We'll go from dream state gangbanging to vaccines. The pharmaceutical giant Pfizer said Tuesday a new coronavirus vaccine could be tested as early as next week with the potential for emergency use by fall. So there's a company called Moderna that's got their vaccine in phase one trials right now. Pfizer has not started phase one, but it looks like they're getting ready to. And they think because they're a huge pharmaceutical giant that they'll be able to accelerate these phases.

They may be able to do that. My concern, of course, is you don't know about efficacy. In other words, does it prevent people from getting the virus until you've treated thousands of people? I mean, how are you going to do it? Right now, it's still less than 1% of people in this country have been infected that we know of. Those are known cases. The asymptomatic may be higher. But you're going to have to treat a whole crap load of people to show that that small percentage of people didn't get the virus that otherwise would have.

you know so five percent let's say it's five percent so if you have a hundred people that would only be five cases well okay so let's say you you give the vaccine to 100 people and you only had three cases well did you really show anything is that statistically significant that you had you prevented two cases of COVID-19 in that cohort of 100 people so now you need a thousand people. Instead of five people, it's 50. And, well, you had 36. Well, is that enough to vaccinate everybody and let everybody go back to work? So accelerating these phases may not be the best idea. Also, there's the specter of adverse effects that could be rare, but could be serious, like in influenza vaccines, we have the specter of Guillaume Barre syndrome, which is

a progressive paralysis that starts in the feet, works its way up the body to the knees, to the hips. If it gets up to the respiratory muscles, you'd stop breathing. It doesn't always get up that high, and then it ascends, and then it descends again, and eventually goes away, and And sometimes you're left with deficit, sometimes not. But if that's one in a million people, then if we vaccinate 300 million people, you'd figure you'd have 300 cases. You won't find that in a series of 1,000 people or even 10,000. So accelerating these phases, I get the desire to have a vaccine by fall. That'd be six months from now.

That'd be awesome. so we can have our, you know, New Year's Rock and Eve with Ryan Seacrest. We have to have that. So, but that's the issue. So Oxford has one, and they may be able to accelerate their phases because they've already done the early phase looking at a different coronavirus. So they have a vaccine that was set for a different coronavirus. and they did all the testing on it. And they said, well, hell, let's try it on these monkeys.

So they did it with COVID-19 on five monkeys. And then this is what you can do to monkeys. You can't do to people. Inoculated them with COVID-19, and they didn't get it. So it looked really good in Reese's monkeys. So Reese's monkeys always luck out. They get the good medicine before we do. They also get the, you know, the crappy medicine before we do.

but they may be able to accelerate this. And theirs uses, it's kind of a unique vaccine in that it's live attenuated vaccine, which means that they take an attenuated virus, inject their genetic material into this common cold virus. And then it becomes a neutralized virus that you can't spread into people, but you would generate immunity against the COVID-19 virus, which is SARS-C-O-V-2. And if you develop a robust immunity to this, this would be a way for us to get hurt immunity really quickly. Okay. All right?

Yes. People keep texting me. I'm sorry. That's okay. I know you're looking at your phone, so I'm just sort of monologue. That's okay. It's work stuff, though. I have to pay attention.

Yeah. So what they're going to do in human trials, they're going to give 550 people the vaccine, another 550 the placebo, and then they'll just, by God, see. What they should do is do this to people who are really at risk for getting it, which would be frontline folks like, you know, police officers who are at high risk, emergency medical personnel, EMTs, and those folks, and people working in. COVID units and emergency room workers, nurses, MDs, PAs, and nurse practitioners. All right? Yes. Okay. I'm sorry.

No, it's fine. It's fine. Who is it? Who's texting you? Work people. Okay. Tell them to just shut up. Customers.

All right. Here we go. I shake my beard off. Oh, wait. It's been the first time and we'll get back to that question. Dr. Steve, it's Jim from New Jersey. I have a question about how 60% herd immunity is supposed to work. I understand how 99% of measles vaccinated kids can protect the other 1% but he's never going to get it. But how it is having 40% of people, you know, unprotected from coronavirus help them.

This is such a great question. And it all has to do with the math. So the math behind herd immunity. community. Can you just tell them that you'll get back to them later? I'm sorry. I'm really sorry. I'm just messing with you. Okay. Is it something, I mean, are you getting laid off or something? No, no. It's not people I work with. It's people I work for. Okay. Okay, well, that you better pay attention to them. It's fine. Okay, now I know. So I'll just monologue, and if you can... No, I'm ready. I'm done. Okay. If you can, if you're engaged, fine. If not, it's totally fine. I'm engaged. I apologize.

No, please don't apologize. I appreciate you being here, so I'm not just here by myself. I know the audience appreciates it, too, so thank you. They may not today. No, they do. They like it. Okay, so herd immunity, it's not just a number for each virus. Okay, so it has to do with this thing called the critical fraction.

Now, the critical fraction works this way. you know, you want to have enough people immune to protect people who are not immune, right? And that's because the individual who's not immune is less likely to come in contact with a diseased individual since most people will not become infected. So to calculate this critical fraction, we've got to use this thing called the reproduction number. And that tells us how many people, one infected person will infect, okay? So he brought up measles. Well, you've got to have 90x percent. Well, we're going to calculate that in a minute.

Measles has a reproductive number of 12, meaning one person will give 12 people measles. It is insanely contagious. Okay. So there's a formula for this. Yeah, go ahead. So this herd immunity, like nobody wants to get it, but enough people have to get it so that we can acquire herd immunity. That's right. Either through a vaccine.

But then we don't want anybody to get it. Either through, well, but we can attain herd immunity with a vaccine. That's how we do it with measles. Okay, got it. And so when you have a population of people that are not vaccinated and they all live together in communities, then that's when you see these outbreaks of measles. and it just, like wildfire. So the reproductive number for measles is 12. The formula is the needed fraction for herd immunity is one minus, one over the reproductive number.

So for measles, the fraction that is needed to have to be immune to provide herd immunity is 1 minus 1 over 12. So 1 over 12, 1 divided by 12. I used to be able to do that in my head, but is 0.08333. Okay? So 1 minus that is 0.92666, or, you know, 0.92. So 92% of people have to be immune, have to have immunization.

to measles to provide herd immunity, which is why we have to vaccinate freaking everybody. And when you fall under that number, now these measles cases can start coming back. Okay. Now, what's the RO for COVID-19? Well, it's like 2.2. Okay. So it's much less contagious than measles. So let's do 1 divided by 2.2.

We could get Echo to do this, but we'll just do this myself, is 0.45, and 1 minus that is 0.545. So 55% of people have to be immune to COVID-19 to provide herd immunity. Okay. So I'm going to give myself one of these. Give yourself a BEL. Thank you. So where are we right now? We're less than 1% that we know of.

Okay. And even at the high estimates is around 6%. There's that Miami study that showed that, well, we think about 6% of the community has been exposed to this and has IgG antibodies. And we don't even know if they're truly immune. We just don't know. And that doesn't mean they're not. Evidence, I mean, absence of evidence is not evidence of absence. Okay. So we just don't know. But we let's presume that they are. So six. So that's a long way from 55%. So we're going to have to vaccinate, you know, the majority of the population before we can knock this thing down just through herd immunity. Okay. How's that? Sounds good. Okay. Did you have another question?

No. Okay. All right. Very good. Well, let's try this one. I'm a question. I recently donated blood for the first time. and I'm interested in starting to do it more often.

But I was just wondering if you could speak to the positive and also negative if there are any effects of your body losing, you know, a pint of blood in a relatively quickly amount of time. Just wondering, you know, what it does to the body. I've read that it can actually be beneficial. Yeah, and beneficial to other people. So let me give you one of these for donating blood. That's a great question.

You know, I've never donated blood. I've always been scared. Really? Yes. You've never donated blood? You've never donated. I know. I need to.

Yeah, I used to donate all the time. And when I was in college, I donated because at the blood place, I always got the same moment. She was just unbelievably hot. And she was Swedish or something, and I would go in there just to see her and give blood. And she would give me props because, oh, you give blood so often. But that was really the only reason. When she quit, I quit. So it was purely, you know, sort of read the fountainhead, I was sort of pulling an iron rand where I was being altruistic, but there was, it was because I wanted something for myself.

Oh, that doesn't matter. So you want to, but donating blood is truly altruistic, if you believe in altruism, which I actually do. And I think it's a good thing to do. some benefits for yourself. So if you want to look at it from the objectivist standpoint and where it's just purely selfish, you can reduce harmful iron stores if you're one of those people that is getting ready to transition into hemachromatosis. That's one in every 200 people. So if you get a thousand people who donate five of them will get benefit from depleting their iron stores a bit because they have an abnormal increase in their iron stores.

So that only helps one in 200 people. For everybody else, blood donation can reduce the risk of heart attacks and strokes. There was a study in the Journal of the American Medical Association that showed that people in your age group, Tase, the very young, had fewer heart attacks and strokes when they donated. blood every six months. Why would that be? Who the hell knows? It doesn't matter. But it was a significant difference from people who didn't donate blood. And it was 88% lower risk of heart attacks than those that did not donate in the age group of 43 to 61. Do they care how much alcohol is in your system? No, I don't even know that they look at that. Maybe they do. Is someone who's involved in a blood bank.

I know they screen for drugs, so they probably do screen for alcohol. They do a blood screening, too, to look for things like blood-borne illnesses, and anemia. So those are good things, too. You get free blood test out of it. Just don't go drunk. That would be stupid. You can also maybe reduce your risk of cancer. There's this idea that iron increases free radical damage in the body, and there are some studies, these aren't perfect studies, that show that consistent blood donation was associated with lower risks of liver, lung, colon, and throat cancers, and they think it's due to the reduction in oxidative stress when iron is released from the bloodstream.

Now, there was a study in the journal of the National Cancer Institute. They followed 1,200 people split into groups of two over the course of four and a half years. And one group reduced their iron stores via blood transfusions twice a year. I'm reading now from St. Mary's Medical Center's website. And the second group did not make any changes. The results of the study showed that the group of blood donors had lower iron levels and lower risk of cancer and overall mortality. Well, crap, I'm going to go donate blood tomorrow. Let's do it.

You know, I really have wanted to always do that, but I'm a little chicken. I wouldn't do it by myself. Well, I'll do it with you. Okay. You can burn 650 calories per one pint of blood, by the way. Let's do it every day. It's not a weight loss plan, but you do do that. And like I said, you do get the free blood analysis, and you can look at other people who aren't donating blood and just go, hmm.

And they will tell you what blood type you are, I'm assuming. That is correct. although that's not useful. You can have that tattooed on your chest, and even then they will not use that to transfuse blood to you. They will always test it every time just to make sure. You make a mistake with that.

You can kill somebody. All right? Gotcha. All right. Well. I see. I got a quick question for you. Oh, wait, I heard your name. there. So let me run that back.

We run it back. Hey, Dr. Steve and Pacey. Got a quick question for you. Ladies and gentlemen, Stacey Deloge, everyone, lest we not acknowledge him. It's Stacey Deloge. Hey, Stacey, what question you got for us this week? Well, if that's dumb-ass questions, it pops up my head from time to tap. No, he has great questions.

You know, by breaking out in hives, you know, from a bee sting or poison amity or something. What are hives? Is it a your body's reaction? like, oh, shit, something wrong, or is your body trying to expel something? Or anyway, what is what's going on that? Thank you. Yeah, so the medical term for hives is Yurtakaria. And this results from a release of a bunch of different things that are called vasoactive substances.

And some of those are histamine. So you've heard of histamine because even if you haven't, We take antihistamines when we have an allergic reaction like Benadryl or Allegra or those, you know, fixophenidine. And there are some other things like Brady Kinen and this other, you know, this other thing called calicrane. But these are all released from these things called mast cells and basophils. And they're in the skin and they are released when you're exposed to certain. allergens. And when those things are released, they cause capillaries and the little venules to dilate.

And when they dilate, you get an influx to those tissues of fluid and redness and what we call in duration because now you've got fluid in a space that before there wasn't any, it's got to go somewhere so you get raised welt. So you get this red raised welt. And it's just those, when you get those and they come and go and they are intensely itchy for the most part, those are called hives. And that is a thing that we call a type 1 hypersensitivity reaction, which are the sort of immediate hypersensitivity reactions. Now, if you get it so bad that your lips start to swell, we will call that. angioedema. And if you get it so bad that you start having contraction of the airways and

you're wheezing and you start to lose your ability to transmit oxygen from the outside to the inside, then we would call that anaphylaxis. And in those cases, you need a very powerful vasoconstrictor, and we'll use an epipen or epinephrine. And I've seen it. That is one of the most amazing things to watch in medicine is when someone comes in with an anaphylactic reaction and you give them just this tiny dose like, you know, point three of epinephrine under the skin and just goes away. It's the coolest thing. And that's a very grateful patient, by the way. Yeah, I bet. I bet. So, yeah. So if you have swelling of the face, lips, or tongue, and you've have a known allergy to something, that is a medical emergency, get to the emergency

right then, or the emergency room right then. If you have an EpiPen, that would be an indication to use it. Strider is the sound of air passing through the tracheas. So, uh, uh, that's sort of strider. And wheezing is the sound of air trying to pass through narrowing airways in the lungs. and any kind of respiratory distress, somebody's turning blue. These are all medical emergencies. And just giving them mouth to mouth is hard to do because they've got these really high airway pressures.

So the EpiPen is the key, and it is life-saving, which is why everybody was pissed off when EpiPens got marked up. Would you Google real quick just the price of an EpiPen right now? Yeah, you know, there's that new version of EpiPen. Oh, yeah? And it's supposed to be cheaper, and the pen's. talks to you. Oh, really? What is that? I don't know. I need to know about that. I'm showing my ignorance because I don't practice primary care anymore. The one thing about this show is it allows me to keep up with some of this stuff, and that's sort of slipped under my radio. I sort of remember

hearing something about it. But anyway, so let me see if there's anything else with, yeah, go ahead. Between $127 and $160. Ooh, sometimes as high as $267. This is something everyone needs to know. It's really, drug prices can really fluctuate from pharmacy to pharmacy. So if you don't like how much it costs at one place, then you need to go. And there's a really great website called Good RX, and it'll tell you how much it is at certain. pharmacies, how much anything is.

And also, if you don't like the cost of your branded medication, you can go to the name of the drug. It's usually their website, which is usually the name of the drug. I'm going to give you one of these because we've talked about this on the show before, and this is really important. And get a coupon, and you can save a ton of money. And a lot of times the money that you save from the coupon, that money will go towards your deductible.

Yeah. So you're killing two birds with one stone. And, of course, you know, Part D patients can't use them. That's a shame. And I've never quite understood why Medicare would not want their patients to be able to use coupons that would allow them to save money on their copay. I don't know. But it's by law.

It is. But why? I don't, you know, some of these things that sort of these arcane rules with Medicare particularly, when you do. delve into it, there's some sense to be made from it. But this, I don't understand. I don't understand that. I don't understand that either. But yeah, if you are not a Medicare or otherwise governmentally insured person, for example, I just went to epipen.com. The first thing that comes up is access and savings program. So you can get an EpiPen savings card, provides you up to $300 in saving for each

EpiPen 2Pack. So they're willing to basically pay for your co-pay a lot of times. So there are other drugs. If they're branded drugs, Tacey is 100% right. Go to the drugname.com

and see if they've got a coupon. And if that drug company is too dumb to make it that simple, then just Google the drug name and put coupon after it. And a lot of times you'll get some of these things come up. All right.

It's really important to know. And often it will be less expensive to do it that way than getting the generic. And the pharmacists like it because sometimes they lose money on the generics and they make money doing it this way. So, you know, we want to keep them in business. I get it. It's a big business. And, you know, it's about money. And but in the end, you're going to be really interested in what's the least painful on your pocketbook or your wallet.

Did you say pharmacists, I thought pharmacists were always incentivized to use generics? I've talked to our pharmacist, and he said that there are a significant number of generics they lose money on. Or, you know, if they've got a $4 drug, how much they go make off of that? Yeah. You know, so if you have a, let's say, a cholesterol drug that costs $4. Now, that's less of a drain on the system. No question about that. That just means we eventually need to change the system, but that's another thing.

So let's say they have a 50% markup. Well, they make $2 off of that, whereas if you have a prescription drug card for the branded version of that drug, you get the benefits of a branded drug, and there are some, and the pharmacist makes more money off of that. I'm looking up the competition for an EpiPen, and it seems like alternatives include Adrenoclick and OVQ. And the maker of Adrenoclick offers a cheaper generic version of its injector pan. So there are options to the EpiPen. Yeah, if you need this, check-in to that. Talk to your health care provider. But often they will be like me not clued into all this stuff.

The person that will be clued into this is going to be your pharmacist. And our pharmacist, yeah, he may have a vested interest in getting certain things a certain way, but he'll fill whatever's right for the patient. And if your pharmacist won't talk to you and they're just too busy all the time, don't go there, go somewhere else. You'll get better service. It makes all the difference in the world. I agree. I agree with that.

Yeah, 100%. Find a pharmacy where, you know, it's like cheers. You want to go somewhere where everybody knows. your name. And some of the big ones we've had, I won't name, you know, some of the big chains, I felt very comfortable in there because they knew us. And I thought that they had our best interest at heart. But we go to a place now that is part of a corporation, but it's just one or two pharmacists in there in a very small space. And I feel really good. good that they have our best interest.

The service is far better than a big chain that we used to go to. Right, right. But you can find good service at big chains too. You know, you just got to, you want to make yourself known. All right. Let's see what else we've got here. Okay. Yeah, we can do this one.

Yes. How are you, Dr. Steve? Good. How are you doing me? I'd like to know if there is a good. difference in the ability to contact or contract COVID-19, depending on your blood type. As I heard on one TV show where a New York doctor was saying, if you had type O blood, positive, that is, you were less likely to get COVID.

Do you remember when that was going around, Steve? Yep. That was a big topic of conversation. Yep. Yep, so I do. And we talked about it. By the way, let me give you a resource that you all can check out if you have time. Go to YouTube and just search for a laugh button, L-A-U-G-H button.

It's kind of a weird place to be putting serious COVID-19 situation reports. But that's where our situation reports reside. And the very first one, I did an in-depth analysis. analysis or discussion. It wasn't really a – well, I did analyze the data, too, on this particular question. And where this came from was that in China there was an association between your blood type and your infection status. Not how bad you're going to do and not how many people died. but when they went and looked at 1,000 people who were infected with the virus,

there was a slight preponderance in blood type A and a slight decrease in blood type O compared to the general population. And when I say slight, it was pretty slight, but it was less than 28% increase. Okay. and A, B, A, I'm sorry, B, A, and O, I'm sorry, B, and A, B, and A, B were not affected. And I've got graphs on there and all kinds of stuff. They don't know what this means. Presumably, there's some co-factor that has something to do with blood type. It may not have anything to do with those antigens themselves.

It may be something that accompanies those folks genetically. but there was this slight preponderance of type A and slight decrease in type O. So what that means, though, is there's not a single case of COVID-19 in a blood type A person where you could say, well, they got it because they were blood type A, not one. And there's no person who's blood type O, which I am, that didn't get it, that you could say, Well, they didn't get it because they're blood type O because the numbers are, it's just too small of an effect. It's just more statistically interesting than anything else.

Could it be exploitable in the future? Maybe if we can figure out what the association really is. But that's it. Type O people are not invulnerable and type A people are not doomed. Okay. Thanks always go to my delightful wife, Tacey. You're welcome. enjoy doing this with you, and in a way, although I miss Dr. Scott and other folks that we've

had in here, it's going to suck when we go back to the regular way of doing things. Well, maybe I can do guest appearances. It would be awesome. I know you're going to have to go back to work at some point, and you won't be able to have the time to do this. But I will really miss it when you're not here. I've got to be honest with you. Well, good.

Thank you. Thank you for doing this. And we can't forget Rob Sprantz. Well, we can forget Rob. But don't forget Bob Kelly. Greg Hughes, Anthony Coomia, Jim Norton, Travis Teft, Lewis Johnson, Paul Off Charsky, Eric Nagel, Roland Campos, Sam Roberts, Pat Duffy, Dennis Falcone,

Matt from the Syndicate, Ron Bennington, and Fez Watley, who's supported this show, has never gone unappreciated. Listen to our SiriusXM show on the Faction Talk Channel, SiriusXM 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 go 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. And until next time, check your stupid nuts for lumps, wash your hands, quit smoking, get off your asses and get some exercise. We'll see you in one week for the next edition of Weird Medicine. Goodbye, everybody. Thanks, Tais. You're again. You know what I'm going to be.