Weird Medicine: The Podcast - 411 - Face Mask Madness and Goober Peas

Episode Date: June 19, 2020

Dr Steve and Tacie discuss dexamethasone in COVID-19, face mask stats, why air dryers stink, vacation season in a pandemic, and more. PLEASE VISIT: stuff.doctorsteve.com (for all your online shopping needs!) Feals.com/fluid (get 50% off your 1st subscription shipment of CBD!) 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've got diphtheria, crushing my esophagus. I've got Zabular Fibing from my nose. I've got the leprosy of the heart valve, exacerbating my infectable woes. I want to take my brain now, blasted with the wave and ultrasonic. Geographic and a pulsating shave I want to magic pills All my ailments The health equivalent of citizens Cain And if I don't get it now in the tablet

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Now a podcast, I'm Dr. Steve With my wife Tacey the apple of my children and the mother of my eye. Wait, is that right? No. Tacey, the most excellent serving wench, according to all the Renfair folks. Hello, Tase. Oh, I do not like the Renfair reference. Hello, Steve. This is a show for people who would never listen to a medical show on the radio or the Internet. If you have a question, you're embarrassed to take to a regular medical provider. Or if you can't... Oh, goodness. I'm already dying. If you can't find an answer anywhere else, give us a call at 347-7-6-6-6-7.

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Check it out even though he's not here because he's a good little feller. I don't want people to think that we go to Renfares all the time. Not me. You. We went to, what? We went to two. And that was because it was a. across the street from where we lived in a very sleepy town, and that was the most exciting

thing that happened every year. And those were fun, but I would go to a Renfair again if we could wear Star Trek uniforms and just kind of show up. That would be super cool. That's sort of the cliched nerd thing to do. Not that going to a Renfair isn't nerdy enough, but to be the Uber ticket to the next level is to put on a Star Trek uniform and pretend that. that you have beamed down to a primitive planet. You know, what... That is effing clever. Funny about these rent fairs are how people that are pirates, like, lived by this code, and they are who they...

Actually are. Yeah. I mean, they are pirates, and their character is so strong, and you can't get them out of it, and there's, like, a hierarchy of pirates, and that is insane. Didn't we... We went to some pirate... We went to a pirate... party was it a party it wasn't a wedding that was not my friend that was your friend but they were

going to have a pirate wedding somebody was in that thing right um i don't know yeah it was that was um can we say who it was well was double vasectomy turd yeah it was him and and and his ex right yes yes so they would dress up as pirates and go oh pretty pretty young maiden and all this But they would live it. Yeah. Like, not even just act it. Without the raping and the plundering and the murder and stuff. They didn't do any of that.

I mean, it was bizarre. I don't know what's a point. And, you know, that's your friend. That has, I, no. Yeah. That was a wasted Saturday night. Is that mean? That's mean.

No, it was, yeah, it wasn't fun. No, it wasn't fun. It was terrible. One thing we did get out of that, though, and I think this may have been related, was there was a, an actor named Bobby Funk I think and I think he may have been part of that but he came here and read

all of a pantagruel and Okay, nerd, nerd, nerd, nerd, nerd. Okay, so we got nothing out of it. Well, wait a minute now. This was freaking hilarious. Now, I'm doing this on the fly so I don't know if I can get to it fast enough.

You know, guys, I didn't know what I was marrying when I married. He seemed normal. Gargantua and Pantagra. I did not. You knew I was not. No, I did not know the extent, Steve. And I'm sitting in the middle of the extent of your weirdness. Wait a minute. Thank God it's on the third floor and I don't have to see it. You'll like this, though. I'm sure. Okay, here we are. Yeah. Okay, let's just skip into it. It's only eight minutes long. I'll just skip into the middle of it. Oh, we're in for a treat, guys. Because I'm sure you'll find a delight. After the Switzer's fashion.

Afterwards, in dunging behind a bush, I found a march cat. Stop it. And with it, I wiped my breach. But her claws were so sharp. Okay, so this guy took a dump in the bushes and then picked up a wild animal to wipe his ass with. Why didn't he just say he took a dump in the bushes? Well, he did.

He said I was dumping in the bushes. Yeah, in some foreign weird freak language. Hang on. And they fetched away all the skin of my tail with a vengeance. Now I wish St. Anthony's fire burn the bumgut of the goldsmith. Wait, we've got to get back to that. And of her that wore them. This hurt I cured by wiping myself with a page's cap.

That's ladies' radio. Lazy, not ladies. Lazy radio, my friends. Lazy, lazy, lazy radio. Wait, wait. he took a dump in the bush. Excerated, oh, my perony.

Oh, wait, okay, here it is. Now I wish St. Anthony's fire burned the bumgut of the goldsmith. So you're telling me this guy came to our house? Yeah, he was sitting where you are. Oh, that's nice. This hurt I cured by wiping myself with a page's cap, garnished with a feather

after the scriptures fashion. Okay, that's enough. Afterwards, in dunging behind a bush. Okay, in dunging behind a bush. I get that, I get that, but it would be just easier if you just said. I found a March cat, which is basically a hair. Oh, God. With it, I wiped my breech.

Okay, so he wiped his ass with this March hair after dunging in the bush. But her claws were so sharp that they scratched and exascerated all my perony. Meanwhile, these people work at the Wind Dixie. Didn't know. Not that that's bad because they have a job, but they're, they're bagging your groceries. Oh, well, some of them, I'm sure. I mean, there are people from almost like. This guy was a professor at a local university.

Yeah, which local university? Well, that doesn't matter. Exactly. I'm not going to say it. You're afraid to say it. If you would like to hear the whole story of Rabilis, Gargantua and Pantagruil. Oh, yes. Simply go to Dr. Steve.com on the upper right corner, put in Gargantua.

That's G-A-R-G-R-G-R-G. A-N-T-U-A, and it's eight minutes and 48 seconds. It's quite delight. Oh, I'm sure it is. Meanwhile, I'm going to have the locks changed. We're moving. All right. So you brought up something last time about surgical masks.

Yes, and people saying that they're not healthy. And I'm seeing this all over Facebook, that how they're more dangerous than they help and how the cloth ones especially aren't helpful. So one of the things that you said was that your friends were saying that you were re-breathing your carbon dioxide. And we talked about square breathing and where sometimes breathing carbon dioxide is a good thing. But they were saying that this was a bad thing. And you wouldn't want to do it unintentionally to excess. So I did do some research. And I found preliminary report on surgical mask induced deoxygenation during major surgery. Actually, you may have found this and set this to me. Somebody did.

No, it wasn't me. Okay. And this was... Not your bitch anymore. What? Nothing. Okay, so this was from the Department of Nursing and Health Services in Ankara, Turkey. And this is a study called preliminary report on surgical masks induced deoxygenation during major surgery. Now, these are surgical masks.

So this study was undertaken to evaluate whether the surgeons, oxygen, saturation was affected by surgical mask or not. That's not good writing, by the way. You just say whether it was affected by the surgical mask. You don't have to say or not that's redundant during major operations. Okay. So that's my editorial. You know, I'm a journal editor.

I edit a national medical journal and I have a journalism degree, so I see things like that. Well, thank you for that. You're welcome. Repeated measures. Oh, do you want to know how to, if it's ITS or IT. apostrophe s sure it's weird because you think the possessive if you would say tacy's i don't know nut sack that would be t a c i e apostrophe s right so if you're going to say it's um it's a book you would think it would be i t apostrophe s but it's not i t apostrophe s is only used

when it's it is i t s is the possessive of it isn't that weird yes that's weird yes that's weird There you go. So if you want to say that is its book, you would say ITS. You know, if you were talking about double vasectomy tod or something. Okay. Repeated measures, longitudinal and prospective observational study was performed on 53 surgeons using a pulse oxymeter pre and postoperatively. So basically what they did was they put a pulse oxymetry machine that just gives you the saturation of oxygen,

a normal person's, you know, between 94 and 100. and did it before surgery and then right after surgery when they were taking off their masks, they repeated it again. Our study revealed a decrease in the oxygen saturation and a slight increase in pulse rate compared to preoperative values in all surgeon groups. The decrease was more prominent in surgeons aged over 35. So they said this could be due to the facial mask or operational stress because they did this all on people who were operating.

How about you just put it on people for the same amount of time that aren't operating? Let them sit and read a book and then test it. That would be another way to see. Or like we talked about those poor people who work in the grocery stores who are wearing those mass eight straight hours. Yep. So let's see what the actual results were. So there was some decrease. Okay.

When pre-operational and post-operational pulse rates were compared, okay, let me see, let me see, come on. I'm doing this kind of a little bit on the fly. Okay, let's look at the oxygen saturation. That's what we're really interested in. In group of surgeons who did not wear masks during primary care operations with duration of less than 30 minutes, pre-operational saturation values were 97.6, while post-operational values decreased to 96.3. Wait, are they saying for people who are doing surgery who did not wear masks? What surgeons are not wearing masks? Okay.

When the pre-operational and post-operational pulse rates were compared. Okay, that's bullshit. I don't care about that. There was not any statistically significant difference between peak pre-control and post-control values of pulse rates and oxygen saturations of the same surgeons without face masks while not performing surgery. So they at least compared it to people before and after some period of time. Okay, so oxygenation saturation of hemoglobin decreased significantly after the operations in both age groups. Post-operational decrease was more prominent in surgeons over 35. So it was some piss small amount, okay?

And there was no, you know, it wasn't clinically significant. and it was just statistically significant by the numbers. But that's why we have all these buffers. So, yeah, it did seem to affect oxygenation. They didn't test for carbon dioxide. That's another study. I couldn't find anything on that. So there is some effect of wearing a mask.

It doesn't seem to be clinically significant. For example, you can have a clinically significant effect without a, I'm sorry, statistically significant effect. without a clinically significant effect. So we did, years and years ago, somebody called in and said it's having anal sex affect your ability to be continent of stool. And there was actually some studies that were done on people where they compared it to people who had not had anal sex. And they also did pre before and after monometry where you stick a balloon up somebody's ass and have them squeeze. okay, with their ass muscles, doing like a kegel maneuver.

And they found that the people who had more anal sex had a more lax canal in that they couldn't squeeze the monometer as tight as the people who had never had it. However, it did not affect their ability to hold in their stool one bit. So it was statistically significant, but not clinically significant. You know, you can detect a difference, but it didn't mean anything. Okay. Okay. So that's what this is.

Yeah, it's miserable. Yeah. But we've got to wear them. I mean... Well, we have a question about that. Let's take a question about it, and then we'll talk about it whether we need to wear face masks or not. All right. If I can get this to come up.

Hey, Dr. Steve. It's Taylor, formerly of Vendigas. Hey, Taylor. I was calling mainly having a question about the psychology behind people not wearing masks. Yeah. I'm out on vacation in South Carolina right now, and the vast majority of people, especially men, are not wearing masks, and it's kind of troubling, and I don't know if it's contributing to the mass spikes of cases where I'm at. So I was just kind of wondering what would you had to say about that without politicizing it. Yeah.

No, hey, I appreciate that, too. He's not making a political comment because there's this equation and it's politics plus medicine equals politics. You know, it just takes the medicine out of it. It's just all politics when you inject politics into it. So let's just speak from pure science. we are seeing resurgences in some places. They're not all southern states. A lot of southern states, though.

Well, they are, you know, pinning it on the southern states, but let's just look at the... Arizona's bad. I know that. Is that a southern state? No. Yeah, right. Okay. So...

Smart ass. No, no, no, no. I'm asking, is that considered Southern? Jesus Christ. Mm-hmm. Okay. So the ones that have... Okay, Safari is not liking this web page.

South Carolina is a big one. I'm looking at RT Live, because what I want to look at is states that have the most number of people that are getting infected from other people. Number one, right now, Oklahoma at 1.1, Florida, Arizona, Arkansas, Missouri, Utah, not a southern state. Vermont, 1.04, Oregon, Alabama, Texas. these are all the ones that are greater than one, Mississippi, Idaho, Arkansas, Nevada, Washington, South Carolina, Louisiana, and Georgia. So Georgia is actually right at one. So if you have an RT, we talked about this last time, that is the real-life number of cases that each person is infecting, if they're infected themselves, on average. So one person may do 10, but you may have nine people who don't infect anybody and it works out to one.

So if you have an RT of one, meaning one person gives it to one person, well, if you have 1,600 cases, they will infect 1,600 people. So you will have a constant number of cases in those places, and you'll see a sort of a straight line, right? Then if you have the RT of less than one, you should see declining numbers of cases. Hawaii is the winner on that with an RT of 0.73. Give them one of these. And New York, Massachusetts, and New Jersey. Give yourself a bill. Are the next three with a RTs of 0.8, 1, and 0.81, respectively.

So all the ones that I mentioned before are all have this larger RT. So it's a little less than half the number of states. And some of these things are specific to small areas, too. Like if you have two or three nursing homes where you get a whole bunch of cases, you'll have a big spike in cases, but it's still relatively safe to go to the grocery store, you know. So you have to take all of that stuff into account. Tennessee, by the way, is just dipped below 1 to 0.99.

So I'm give us one of these But we are going to South Carolina in less than two weeks Yay, I guess And they're having some spikes, particularly in Charleston County, which is where we're going. So there you go. But we are going to go there, and we are going to self-isolate. Oh, that sounds like an awesome vacation.

It will be because we can self-isolate on the beach. Oh, that's true. Yay. Well, anyway, so he's, He's asking about all these face masses. So this is sort of the preamble that there are spikes in cases. And there are some places are getting ready to lock down. If you remember, the phased opening has built into it the ability to reverse phases if you meet certain criteria.

So you can advance in phases, you know, from phase one to phase two to phase three. if you meet those criteria. New York is on parr to do that. But it also said, you know, if things go in the wrong direction, if you start having escalating cases because you've gone through this phase, you can back up and go to the phase before. So we're going to have to do this in certain places from time to time. We're going to think places that may have opened up may have to lock back down for a period of time.

I think Memphis had to lock back down. Did they? They switched phases. And it's perfectly okay to do that even on a local basis if you can get away with it, if you have a localized hotspot. Until we have a medication, as we've been talking about, that we can just give to people who have it and they don't go to the hospital and they don't die, then this thing's over. And then we can let natural herd immunity kick in or until we get a vaccine, which is artificial herd immunity.

Okay, so we can open up, but we're going to have times when we're going to have to lock back down again. So anyway, so Taylor from Indy Ghost, and you can follow them on the members of the band that are still playing together. Cody Gilmer, who's been seen on this show from time to time, particularly before the lockdown. And Taylor, who is, was their incredible drummer, who is no longer with them. And he's, you know, working with his dad in middle Tennessee. Anyway, what he's asking is what the hell is going on with the face mask and why aren't people wearing them? I think people aren't wearing them because they're sick and tired of wearing them. Yes, everybody wants to pretend like this is over because enough is enough and it's just not over.

That's the psychology of it. Exactly. Now, it's over in New Zealand. They don't have a single case. So they're going back to normal right now until they get. letting people into the country? I don't know the answer to that. And when they do, and if they get a hotspot, hopefully it'll be one case and they'll lock everybody down and they'll do contact tracing so that everybody else can kind of go back to work. But if they get a hot spot

and they can't control it, they'll have to lock down again until they don't have any cases again. It's like living in a dream, isn't it? This is all so bizarre. Or a movie called Contagion, which is what that was about, which damn Steven Soderberg and whoever wrote that, They pretty much nailed a lot of this stuff. There's a few things that are goofy compared to what's really happening, but it was an amazing film, which also had a happy ending, I mean, kind of. I don't remember the year. Well, they got through it, you know.

Through science, they figured out what to do, which is where we're going to be. So if you're getting despondent, I think that they had a happy ending, if I remember correctly. It also showed how the virus formed, too. If you remember, it was like a bat bit a pig, and then the guy slaughtered the pig and wiped his hands on his... Oh, I don't remember that either. That was the very... Well, I just... Spoiler alert. This movie only came out 15 years ago.

But that's the very end of the movie. It shows how the thing happened. So anyway, this is from the Lancet, and this is an article called Physical Distancing, Face masks, and Eye Protection to prevent transmission of COVID-19. It says our search identified 172 observational studies across 16 countries and six continents. So what they did was a meta-analysis, which is where you take a bunch of little studies and mush all the data together and then try to do statistics on the data that's there and see if you can get statistically significant results out of it. There were no randomized control trials because really kind of how would you do that? There were 44 relevant comparative studies in health care and non-health care settings.

And it was 25,000 patients. So transmission of viruses was lower with physical distancing of one meter or more. Okay. So that's, you know, three feet. We say six compared with a distance of less than one meter. And protection was increased as distance was lengthened. Change in a relative risk was two per meter. So that's a big deal.

Face mask use could result in a large reduction of risk infection with stronger association with the better face masks compared with disposable surgical masks or similar, you know, reusable cotton or something. But eye protection was also associated with less infection. Now, that's health care related infection. But so the overwhelming data that we have is. that face masks will prevent infection. Now, not 100%. And you're right when you've got a porous face mask that's not going to prevent all these viral particles, but it will prevent droplets, which is what we're really talking about. So they did a study where they had a guy that had COVID-19. They had him cough onto a, you know, a viral transport medium, and then had him cough with and without a mask. and there was a significant decrease in the number of viral particles that were transmitted when he coughed in the mask. I mean, with the mask on, it wasn't 100%.

But when we've got, let's say we could just decrease it by 10%. If you got 2 million cases and you decrease transmission by 10%, that's 200,000 that we could have prevented if everybody had worn a mask. So that's a lot of people. So in the beginning, they said, don't wear a mask. That's because we had less than 100 cases in this country. And then as it became more widespread, even though 2 million is still, you've got a country of 350 million people, it's still a small number. But when you have more people, mask wearing makes more sense.

Well, you know, we got an email from one of our listeners, and he brought up a good point how people aren't taking this seriously. And part of it is because, well, it's only been 116,000 deaths. and, you know, people feel like it's been a long time, but in reality, it has not. Right. It has not been a long time. We locked down March 15th, so March, April, May, June. So we're into 90 days. It feels like a terrible, terribly long amount of time.

But when you're talking about that death rate. I don't want to leave my, go ahead and talk. I mean, when you have that death rate in just that small amount of time, that, that, that, That really is significant, and it's not over. And also, nobody ever talks about the tremendously long amounts of time that people are in the hospital recovery. Oh, yeah. I mean, if you are sick with this and you get sick, you're in for a month. Some of those studies we were talking about where they were using, and we'll talk about dexamethazone, but using some of the newer drugs on these people, they've been in the hospital 55 days.

Mm-hmm. And all of this occurred, this death rate of 116,000, these terribly long hospital stays, all of this has occurred during a lockdown of which we're not in anymore. Yeah. Yeah. And that's scary. And he is also from South Carolina, and he says that mask use is random. And then when people go on vacation to where he lives, they're like, woo-hoo. Yeah, woo-hoo, I'm on vacation. I'm not wearing a mask. This doesn't exist because I'm on vacation. I mean, it just doesn't work that way. So, I mean, that's a great point. So we will be wearing masks when we go out. And the other thing... We are not going out to eat. Maybe once.

Right, which is going to, you know, it hurts the economy because we usually dump a ton of money. A ton of money. But I'm an excellent chef and I'm going to be cooking for everybody. That's evident by my weight. You look fantastic. Shut up. But I was concerned about going to the grocery store. I was going to have to go at 6 in the morning to avoid all the knuckleheads because I am at increased risk because of my age and I have hypertension, although I am on an angiotensin receptor blocker, which a new study, by the way, I'm just going to throw this out, showed a decreased risk of dying if you're on that.

Oh, that's good. Also, decreased risk of dying if you're O positive, which I also am. Well, I like to hear that. Those two things will even out. Decreased risk doesn't mean immune. Just on a different subject, we still have not given blood. We need to do that. Oh, you're right.

Yeah. Yeah, we've been very naughty about that. We promised that we would do that. And we haven't done it. So let's make sure we do it. I'd like to. So I found there's this thing called Instacart. And a lot of places you go on vacation will have this.

And what it is is it's a short-term grocery delivery program where you can sign up and then just order groceries online and have them delivered to you. And so that's what we're going to be doing. But did you call and verify how far in advance you need to. And they did say two hours because I know. It's right on the website. It says two hours lead time. I know a lot of places now because of what's going on. The lead time is more like two days.

No, this has been since, I mean, And this website's been updated since COVID-19. Okay. So, yeah, I think we're good. Okay. Yeah. You say so. Well, and if it is two days, I mean, I go to the grocery store here.

I can, you know, brave it. I just put on a mask and wash my hands when I come out, which is what I do when I go to the grocery store here. But I'm just, this sitting in our house and then I guess we get to go to the beach. That's pretty cool. But half of our vacation was going out. And eating at least. Well, it's just going to be different this year. It's just going to be different.

We're going to have friends down there. Well, and I'm driving my car, and if I get fed up with you guys, I'm just going to get my car and come home. That's right. And ladies, it's on. Well, are we taking, I know our son wants to take his car. And I thought we would take my car because. Yeah. Well, well, okay, nobody on the radio gives a shit.

Can we please stop bullshitting and get to the question? I'm sorry. This is something we do need to say that. God damn, this is about as boring as sex with my wife. I mean, you know, this... You never heard of a single fucking medical question. What the fuck, man? Yeah.

Look, I never promised... Your show was better when you had medical questions. AIDS. Okay. I never promised that I would bring a good medical, medical show to you guys. I'm just sitting here because he won't let anybody else come in the house right now. right now effem nobody's coming in people did find it by the way your fitfo show that's what we need to give to them okay okay never mind i'm telling you fitfo is fabulous and beautiful people enjoy me

beeping out your f words because you're you're employed and fitfo is so useful yeah though in everyday life that's right snafu and fitfo you look at your kids and they've got problems to say i don't know fitfo got a snafu fitfo yeah all right dex Methasone proves first live-saving drug. I'm not 100% sure that that's right, but that's okay. I guess what they're saying is remdesivir has shortened recovery time, but has not yet had enough robust data to show that it's actually saving lives. So this is a cheap and widely available drug, and by the way, we've been using it from day one

that can help to save the lives of patients seriously ill with coronavirus, a low-dose steroid treatment. Dexamethosone is a major breakthrough in the fight against the deadly virus. These are experts in the UK. This drug is part of the world's biggest trial testing existing treatments to see if they also work for coronavirus, which is a great thing. Look, you could invent a drug to treat this. Remdesivir has kind of already been around, but it hasn't been approved for use. But if you have something that's off the shelf, that's why people were so excited originally about hydroxychloroquine, because it was cheap, safe, and if it was effective, it was already out there. You could just go buy it.

You know, we can write anything off-label we want to. Once a drug is on the market, we can write it for anything we want to write it for. So it doesn't have to be written for its original indication. So gabapentin is a good example of that. Gabapentin is a drug that was originally marketed as an anti-seizure medication that is now used exclusively for as an adjuvant pain medication or for what we call neuropathic pain, pain from damaged nerves. Didn't a lot of people get in trouble with the whole gabapentin thing, though? What do you mean?

Like as far as it being marketed for things that it wasn't indicated for? Yeah, oh, I'm sure. Probably. Okay. Well, manufacturers reps cannot, if it's a branded drug and they're out there selling it, they can't say, oh, by the way, it's off-label, but you can use this for neuropathy. They would get in trouble for that because they can only market, as you know, to the indication that the FDA is approved. But physicians and other licensed health care providers were writing it for neuropathic pain because there were studies out there that showed it it just wasn't indicated for that. So we could write it for anything we want to.

Now it has the indication. I'm thinking of there's some other drugs on the market that are the same way. Because, you know, drugs have effects. Most of the time, they're not specific to the thing. We just write it for the thing that they seem to be effective for. For example, aspirin is pretty good if you sprain your ankle, as long as you're not a kid. Don't give aspirin to kids because of the potential.

Rye syndrome. But forgetting about that, aspirin is good for a sprained ankle, but it also prevents heart attack and stroke in some people. Now, those are two wildly different things. So aspirin just has this set of effects, and then we use those to our advantage. It also has the effect of increasing GI bleeding, but that's an adverse effect. But they're just all effects. Some of them we think are beneficial and some are not beneficial. So we're always looking for things that are off the shelf that we can pull off the shelf and give to people without them having to go through phase one, phase two, phase three trials, because we've talked about take forever.

Forever. Forever. So dexamethosone decreased the risk of death by 33% for patients already on the ventilator. That's a big deal. For those on oxygen, it cut deaths by a fifth. So you can see that it's more effective later in the disease because of why. Do you know why? We may not have talked about this so much since you've been here.

You remember the term cytokine storm? No. Okay. So that's okay. So people who get this novel virus that the human body has never seen before and it gets in there, It creates inflammation. The body wants to go kill it. And sometimes the body overshoots.

And I talked about cytokine storm on my situation report on the laugh button YouTube channel. And it was probably the first or second one. So just go back and look at that. Skip over the statistics part because that's, or if you want to laugh about something, you can watch the statistics part. But each one of those has a little didactic on some topic of interest to COVID. COVID-19. But anyway, so when the immune system overshoots, it starts attacking, all this inflammation starts affecting other organs. So the kidneys can be involved. The blood vessels can get involved. And now you've got inflammation of the inner lining of the blood vessels that can cause thrombosis and blood clots. And that's what causes that COVID toes. The lining of the lung. Certainly you get that inflamed. And now all of a sudden you can't transmit oxygen. oxygen from the outside to the inside, you've got a real problem.

So that's why dexamethosone doesn't work so well early in the disease because these people don't have that overwhelming immune response going on because that's what we're trying to turn off because the people who get so sick, that may be the thing that kills them is their own immune system is killing them. Therefore, Tocelizumab, which is a monoclonal antibody that decreases inflammation in the body by attacking or blocking this thing called interleukin-6. Don't worry about that. But it's a really expensive anti-inflammatory.

Well, dexamethosone dirt cheap. We use it all the time for all kinds of things in the hospital. What was its brand name? Do you know? Decadron. Oh, okay. Yeah, okay. The UK government has 200,000 doses of the drug in its stockpile.

I just want to see if anything else was in here. about 19 out of 20 patients with coronavirus recover without ever being admitted in the hospital. That's right. This is just for the sickest of the sick. Of those who are admitted, most also recover, but some need oxygen or mechanical ventilation. And then these high risk patients who end up on the ventilator, the ones that seem to be in the help the most. So, all right. All right.

What do you think of that? I think that's pretty awesome. Well, I hope it's helpful. What is? We're increasing our toolbox. of things for people who are really, really sick with this thing. What would be nice to have, though, as I've advocated, is something that will keep them out of the hospital in the first place. And on that, I am hanging my hopes on Favapiravir, which the Russian government just approved

for use in Russia for mild to moderate disease. So we'll see. They'll have some data here pretty soon. And we'll have U.S. data on Favapyrivere in mild to moderate disease. It's sometime in early to mid-July. And if that proves to be as effective as some of the early studies showed, then we'll have it on the market probably by August. And if it works to keep enough people out of the hospital,

we may be able to just go back to normal anyway. Oh, I would love to go back. Do you know it's been 13 weeks? Yeah. Yeah. That's crazy. Yeah. So there you go.

All right. 13 weeks of WebExes. I like it, though. There's some things I like about this. I like the fact that we've been able to do telemedicine. We've been advocating for that for years. That's a great advantage for so many patients. I don't see us going back to no telemedicine.

You know, I think that's going to be part of our practice and that'll be good. Instead of, you know, sometimes you still have to do a home visit because you want to see the home environment. But if someone can't come in, You just do it. You know, I use an app called doxy.m. It's 35 bucks a month. I send them a SMS message. They click on it, and then we're talking face to face.

They can show me, oh, I've got this wound on my leg. You know, they can show me stuff like that. It's really neat. It is really nice. And, yeah, it's good. And it's HIPAA compliant. So unlike Facebook and, say, Zoom, what people can just burst in, apparently, do your Zoom meeting?

But you really can't, you can't replace that human-to-human interaction. People like to be touched. For a lot of people right now who are stuck inside and have been stuck inside for so long, I mean, that, that's needed. Yeah. So I know. There was a study once that showed that if people are touched in the office, just even a hand on the shoulder, they come out feeling better than if they weren't touched in the same sort of context.

Yeah, exactly. So, yeah, that you can't do. Although, now, they have a virtual reality sheath now. Oh, my God. Why do you know what I'm going to say? I don't know. I don't need to know. Okay.

Yeah, and it's a virtual girlfriend. Do you have one? What's her name? No, I do not. Is it Sally? No, it would be Tacey. It would be Tacey. Mm-hmm.

Because I only ever think of you, Tase. All right. So, anyway. So that's one way that you can get touch into the day. Hey, Dr. Steve, it's Albert from Albuquerque, Jan. How are you today? Good, man. How are you?

Great. Great. Good. More importantly, how's Tasey today? Ooh. She's doing okay. Wonderful. She's drinking.

Happy wife leads to a happy life. You're right, Matthew wife. I blew that. Anyways, question today is really an opinion question. Yeah. Just driving down the road, I stopped at a little convenience store, went to the bathroom, and washed my hands. allegedly, but they had air dryers.

Yes. High speed, high-v-lossed the air dryers. Yep. I'm not comfortable using these things. Let's talk about this. I'm concerned about this also. I've lost air, in my opinion, I could be wrong, has got to be atomizing water particulates either off. Water particulates.

How about fecal matter? I'm so interested in this, and I'm glad that he brought this up because I read that you know, they have those, the shittiest. hand dryers ever. Yeah, I'll have to bleep that out. We can't say any trade names, but anyway, at fast food restaurants. Well, I didn't know that. That's okay, I know you don't know.

They are. They're the, okay, I apologize. No, it's fine. No, no. But they're the worst. Like, you stick your hands, and it's like for no good reason, so then you wipe your hands on your shirt and you get out. And that's what you do.

And so, anyway, but they are stopping that, and they're going to paper towels now. Excellent. And I read that that was part of this whole COVID thing. Good. Good. Well, have you ever heard of a toilet plume taste? No. Toilet plume is when fecal bacteria shoots into the air when you have a lidless toilet and it flushes.

So if you leave your toilet seat up and you flush it and you just, you know, moved your bowels in which we call defecation in the medical field, because we have to have a different word for everything, it causes a toilet plume and there's fecal bacteria. Now, we live with fecal bacteria for the most part. You know, we evolved to live with fecal bacteria. I imagine it's everywhere. But there is a reason why where we eat and breathe is as far away from where we defecate and micturate, which is what we call urination. You know, the avoiding of the bladder. It's as far away as you can get and still be on the torso. And even then, we made this stalk.

and put a head on it to get it even farther away. The only way it could be any farther away is if our nose and our mouth was on the top of our head, which I've seen comic books where the aliens had that. But, you know, this seems to be a functional way to exist. But there's a reason for that because you don't want to get fecal stuff into your oral stuff any more than you have to. So having that toilet plume is pretty nasty. but there was a study that was done and what they did was they examined plates

that were exposed to 30 seconds of a hair dryer compared to those just left in regular feces-filled air in a bathroom and the air-blasted plates carried 18 to 60 colonies of bacteria on average whereas two minutes' exposure to the bathroom air left fewer than one colony on average.

Well, what about those really fancy ones that you just stick your hand. I was going to say the brand name. That's okay. I think you can say the brand name on that. Where you stick your hands down and up and down and up. But they're still sucking in air from

where these toilet plumes are and then depositing it right onto your hands. Well, the really crappy blowers, I mean, just don't waste anybody's time. They're just on the wall for decoration. Yeah. The inside of the dryer nozzles themselves, they cultured those had

minimal bacterial levels. So it was really sucking it in from the air. And they looked at 36 bathrooms at a facility of the Unidiversity Connecticut School of Medicine. And so there you go. Oh, and what they did was

there was a lab down the hall produced the spores of this bacillus subtilus. And the spores were the strain called PS533. And they found that those strains made up about 5% of the bacteria found on the air blasted place. So you can't keep this stuff in one place.

Okay. You know, those researchers were coming in and carrying it with them. They're harmless, so they're not worried about it being under a hood. So, like, if you live in New York and you have a really small bathroom, and your toilet is next to your sink. Yes. You've got to keep that toothbrush covered. Just close the lid when you flush it. Oh, that's another idea.

These are lidless, because most of these bathrooms have lidless toilets. I'm so excited about our bidet, by the way. Oh, yeah. Yeah. Our good friend Robert Kelly recommended a bidet, and so we got, what is it, Tushy. Something. I don't know. It was the cheaper one because we didn't have the electrical outlet next to our toilet.

Right. Some of the fancy ones require hot water and an electrical. Which sounds wonderful. It does sound wonderful. The next house, if we ever build a house. Which we won't. Which we won't. But if we did in our dream in the future, we would make sure that there's hot water next to the toilet and electricity.

And, well, shit, if we're going to do that, taste, we should just have them build in a bidet when we build the house. Exactly. Well, I'm stupid. My thought process. Anyway, so what my friend Catherine told me today was she now keeps a roll of paper towels in her car with her. And when she goes into a rest stop, knowing that they have those blowers, she just doesn't use it. And she uses the paper towels that she brings in with it. That's a great idea.

Yeah. If you can get the paper towels. Yeah. Yeah. Yeah. Yeah. Well, we could get those really expensive vegan paper towels. You remember those?

Oh, I bought a couple of those when we were desperate. No, they were terrible. They really were terrible. They were better than nothing. But they were like $3. Roll? Yeah. Yep.

Bacterian bathrooms will come from feces, which can be aerosolized in toilets, especially lidless toilets. So there you go. All right. So thank you for that question. That's an excellent question. So they're nasty, don't use them? Yeah. They're nasty.

You have a lidless. You're better off with your shirt. Hey, Dr. D. Randy from Austin. Amen. If you have lidless toilets in the bathroom or it's a public bathroom where you can't trust people to put down the lid. This whole time I thought you've been saying littlest.

And I didn't know what you mean. Oh, no, I'm sorry. And ones without lids. Okay. Lidless toilets. Or you can't trust people to put the lid down. And air blowers don't use the air blower. You could use the toilet paper to wipe your hands.

Oh, that's just, and then it becomes, it gets in little pieces. If you get a big enough glob of it, you can do it. Oh. All right. Okay. Okay. And probably somebody listening to us has. as, you know, stock in an airblower factory or something, you know, turn it into, you know, air tunnel testing or something or an opportunity to do something else.

Yes, an opportunity. So you remember last time we were talking about oral myiasis? Yes. Somebody sent me an exchange from their text messages. They were explaining something about COVID-19. They were saying, until there's a vaccine, adequate treatment are no longer a spread in the community. You need to wear a mask. And this person texted back, what does that mean?

And the person put Google oral myiasis, Google image it. And then there's a pause. And you see this person texts them back. It just says, you son of a bitch. And then he went, what? Very innocently. And the person texted back, I'm going to punch you in the dick when I see you. So I warned you all, do not Google Oral Myiasis.

I'm going to give you another one not to Google image today. I was on Dudley and Bob this week, which I really like them. They're in Austin, Texas, and I think that they're syndicated as well. And for Terrestrial Radio, they're pretty darn good. And Dudley and Bob, Dale Dudley, emails me every once in a while I go on there. And they asked me what's the second worst death that I've ever witnessed. And I told them it was a thing called Fornier Gangrene, and do not Google image that. Forniere gangrene, it's necrotizing fasciitis.

In other words, a bacterial infection of the tissue planes of the genitalia. I'm Googling it right now. And apparently in the news, Harvey Weinstein was supposed to have had this, which resulted in some disfigurement of his genitalia. But he survived. 20% of people do not survive. So do not Google image Fornier, F-O-R-N-I-E-R, or F-O-U-R-N-I-E-R gangrene. Do not Google image that. Thank you.

There's really not that many good pictures on it. Are there not? No. Okay. Well, if you had the junk, the kind of junk, because it's mostly males that get it, male diabetics, particularly, you might feel differently about it. It's really horrible. You're listening to Weird Medicine.

Well, anyway, we'll have a show next week. Yep. And then we will have Cliff Andrews. And I can't remember his. It used to be WM. The intern. It may still be. It might be WM. Cliff or something like that.

I'll make sure to put it on the website at some point. But he's going to be doing a series of best. us while we're on vacation. He's going to do best of for serious exam and then one for the laugh button as well. Okay. And so we'll kind of go COVID free for a few weeks, but then we'll come roaring back talking about our trip. And if I even stay down there for the whole thing, if people are acting stupid, you know, I'm in a high risk group. So, but we'll, you know, if I can shelter in place here, you're right, I should be able to shelter in place. there. And that's what I plan on doing, Steve, is sheltering in place. We're going to save a

bunch of money on food. We'll have good fish down there. Maybe we could go fishing with Cap Mike, though. Yeah, I think we probably need to set that up as early as we can. If you ever go down to that area and you want to go fishing with somebody, check out avidangling.com. I think that's right. Let's check that out and make sure that's right. I thought it's avid angler. No, it's avid angling. That much I know, but let me see if it's avid angling. angling.com. And if not, just go to Facebook and Google avidangling. Tell him Dr. Steve sent you.

Captain Mike is the, yeah, there he is. Okay, yep, avidangling.com, avidangling fishing charters, even has shirts. Captain Mike is awesome. He's our buddy. He really, he's really a member of the family. He still charges us. Well, of course. But no, and that's fine.

But he gives us a good deal. I think, and he does stuff with us that I don't know if he does just for everybody. He probably doesn't want me to say all the things that he does with us. But he is fantastic. He's great with kids. That's why we started using him because I called around. I said, look, I've got a three-year-old who wants to go and a four-year-old. And really, quantity is more than quality.

And they just want to catch a lot of fish. And a couple of the people are like, well, I just don't. You know, I don't know if a three-year-old should go on something like this. And Mike was like, yeah, bring him along. If he doesn't like fishing, the three-year-old, it can just play in the bait well. And that's exactly what Beck did. He got in the bait well and was goofing around with all the little shrimp and stuff that were in there, basically the whole time. But Liam caught a million fish.

Yeah. He's wonderful. And we've seen him every time. And now we take he and his wife, and they've had a kid. and, you know, we were there for all the girlfriends before the wife and all that stuff. And, you know, he's just a wonderful person. He let us spring our dog on the boat one time. And we found a big fish hook in his tail about six months later.

How did that happen? It wasn't in his skin. It was just in his fur. He was a labradoodle and he was furry. And he had been washed and bathed and dried. every three weeks for the whole six months and I just found it

when he was laying in bed with me one day it was the craziest thing that had nothing to do with Captain Mike no it didn't it didn't but the point is he's so awesome

if you have a well-behaved awesome dog you can bring your well-behaved awesome dog and you're well-behaved awesome dog and he's got a new boat and he just we can't say enough great things

about him so please and if you're well you go down to say Dr. Steve sent it. So not that it'll do us any good, but he'll be tickled to know that some of our listeners came down there. Yeah, he would be. All right. I guess that's it, Tase. You got anything else?

Nope. I got nothing for you. All right. Well, we can't forget Rob Sprantz, Bob Kelly, Greg, Hughes, Anthony Coomia, Jim Norton, Travis Teff, Lewis Johnson, Paul Offcharsky, Eric Nagel Rowan, Campos, Sam Roberts, Pat Duffy, Dennis Falcone, Matt from the Syndicate, aka Matt Kleinschmidt, Ron Bennington and Fez Watley, whose support of this show has never gone unappreciated. I'll 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 to our listeners whose voicemail and topic ideas make this job very easy. Indeed, go to our website at Dr. Steve.com for schedules and podcasts and other crap. Until next time, check your stupid nuts for lumps. Quit smoking, get off your asses and get some exercise. We'll see you in one week. Wear your mask.

Yeah, wash your hands and wear your mask for the next edition. Don't use dryers. Of weird medicine, don't use dryer. Okay. See you later. Thank you. Hello. Well, I didn't know what she was doing the part. Well, we sit down here and all. Everything's really good down to here. Well, they got that old crony bar.

bar? Yeah, well, I ain't never, I don't know about that, but old Otis's got them crony drink things. He said he got them from Dr. Carson's Madison. Well, they

sell them up at Ernie's Market, you know. Yeah. So he's got he told him we need to drink all six of them at one time, so. Hold, Ernie, he gave me some credit

last week, because I couldn't I didn't have enough to pay for the goober peas I bought. Well, he gave me some credit, too. He's a good, and I tell you. Well, I ate them gober peas, and then I vomicked. Well, he'll tell him, man, I bet he gave you some more credit. Well, I have to go to old Doc Carson get me some liniment, don't you know? He's a miracle worker.

He is. I think old Doc Carson is getting his limit. it down there at Ernie, so that's all right, so he's a good. He is a good, and I'll tell you. Yeah. Well, thank you.

Well, you have a good. Yeah, I hope you do, too. You have you a good, and I'll talk to you later. Tell the bird he made outy. Well, I'll do it. Oh, my homie stole my chair again of that old pest. Well, that old was soar's old popcorn.

And hey, where is they sit now? It'll be really mad. Yeah, well, she'll get her someday, I'll tell you that. Well, it ain't no good still in that chair one where she's just sitting on it hit. As you reap, so shall you sow goober peas, my old Paul used to say. Well, that's right. Well, I tell the Otis, he'll go down there.

Them's words to live by, I'll tell you. That's right. All right. He said he was going to nail it down to the porch, but I said, well, he can't rock. You can't rock. No.

He did that, so. But he said it was better to getting stalled. I don't want it to get stalled again. You know, you got stalled again. I'll say you later. Okay.

Okay, bye.