Front Lines of COVID-19 with Dr Jeff Gusky
Today's episode is also a video interview. So look it up on youtube dot com slash. Eric Hunley if you WanNa see that and my life streams joined by Professor James Fallon. He is a gentleman who discovered that he was a psychopath when he studied his own brain scan and next week the livestream will feature not one not two not three but four body language experts Chase Hughes Mark Bodin Scott Rouse and Greg Hartley. They're all part of the behavior panel and they'll all be on at once to answer any and all body language questions you might have now today. This is Dr Jeff Guskey. He is a front line. Er Doc who's dealing with covid nineteen and quite seriously. This episode May Save lives and with that present. Dr Jeff Guskey is Eric and this is unstructured or we have dynamic informal conversations with some amazing people today were joined by an actual er doctor so we can stop speculating for about ten minutes about what's going on in the world and maybe get some real information. This is Dr Jeff Guskey. He is a board certified doctor. National Geographic photographer saw so an explorer. And the Gentlemen Obviously Never Sleep or sleeps at all. How are you doing today? Doctors Guskey so glad to be with you. I hope you're safe and your audience is safe. I think everybody is Kinda hoping to be too. And truthfully I speaking for myself. I'm uncertain everything is really really uncertain in the world right now. What's going on my day job? Which haven't had to go into except to go pick up a couple of things here and there. Now they have three cases that have just popped up. So we're all a little jittery with this whole coronavirus Byron one to bring you on to talk about what is going on and you had a really strong message I heard with. It's the weather stupid. So let's start. It's the weather stupid. It's the weather stupid. So here's here's the meaning of that. You remember James Carville. The it's the economy stupid and everyone knew what he was talking about. And this is where this is during Bill Clinton's time yeah or the. Where's the beat which is another election so this is the this? This is kind of the mantra of hope during the Kobe. Era Because it goes right to the core of what the problem is that no one's looking at right now and if we do we're going to be much safer Levy start by saying that we have to always cling to sober realistic expectation. Started out the shutdown with with one singular mission which was that we avoid catastrophic death and collapse of the healthcare system. And we've achieved in. Everyone should really feel good about the sacrifices and the team working the and they unselfishness that they have all done to To get to this point but the initial goal has crept into fear and uncertainty and this this constant haranguing of all of us with asking us to do things that are not very scientific that are kind of winging it that are that are challenging whether we can trust our of the goal posts being moved. I guess it'd be the question. I think I think what's happened is that it's all become politicized because I hate to say it. But there is a cottage industry in in provoking ragent. Fear many of the large media companies Their business plan is basically keeping people in constant a constant state of post traumatic stress breaking news breaking news breaking news breaking news on. It's constantly keeping people on the edge of of fear uncertainty anger rage. Everything's become very politicized and politics needs to stay out of medicine in the Er there's never any writer left black or white gay or straight rich or poor educated or uneducated religious or non-religious. It's just human. You can walk into any. Er It's the same way and and people are a real there there's no PC and PC is dangerous. Pc and political manipulation were covert is very dangerous We need to insist upon clarity in terms of science behind the things were being asked to do and that's not happening right now billing presses right now I say that right precipices expressive this precipice. Thank you and do we open to. We not open. So I put out to Mike Group for the unstructured podcasts on facebook and I said Hey can I get some questions from everybody and they delivered so far. Start off with masks Damascus. Bents actually do anything with Vince. They're slowly masset like events in the site. Oh okay let's go back to where the masks started it would. Initially the surgeon general said don't wear masks for the general public that they don't work and he he I think he was factual now. There are reasons to wear masks. And I'll get into that but but let's go through the issue with mask as I see. These are all my personal opinions. It's what I believe. It's not political. I'm just trying to to help. People understand the science behind masks so we start out with surgical masks. Where do they come from? They come from surgeons in the operating room. Where you're you're trying to protect a patient who is lying on the operating table with open wound from getting infected when a surgeon like cough. And let's say that surgeon has bronchitis or were strep throat or something jer infectious that could get into the wound and cause a surgical infection so the surgical masks work reasonably well protecting the others from an individual. Who Sick but they don't protect you from others. The air comes right in the idea that that a surgical mask is going to protect you from anybody is a myth the facial coverings look so many people. I mean frame this at a positive light because you have to look at the the way that people have responded to this request that came all the sudden out of the clear blue and people have been so unselfish and noble in in trying to help others and socially responsible. We cannot say enough good about that but from a science standpoint in my view the the virus is so small it goes right through surgical masks and face cloths and all of these very creative ways. That people were covering their faces. Now Okay so so now. Let's go to the end. Ninety five the end ninety five mask is supposed to protect you from others. It does kind of what is end ninety five mean. It means that that masks win. It's worn properly. And when it is in in good shape you can't reuse them over and over and over you can read some song but it has to be in working condition. It will filter out ninety five percent of particles above three hundred nanometers. Forgive me for being picking up. Please go ahead. I'm a nerd. So three hundred nanometers above. Yes what's is the viruses. It's it's sixty two hundred forty nanometer. It's smaller than the particle size. The lower limit of the particles that the and Bible filter out now there is a circumstance where the mass help in that that some of the particles especially when someone coughs that's covid will be encapsulated in a micro droplet and those are larger than the three hundred meter limit and they will likely be filter out. But if it's a a just a viral particles floating in in the indoor drier. Air. You're ninety five is is not even going to protect you completely requires an n one hundred which is almost impossible to get right now so in my view the masks are important for healthcare providers or people in nursing homes or people people who are in indoor spaces where there may be cove exposure. Another application where you might consider an ninety five is if you're getting on an airplane although airplane air though there's some problems with it. There are a lot of good things about airplane. Air as well that that people are not talking about and that I think make us much safer in in in that air because of the turnover and the hippo filters so you have to look at mask social distancing and then the most important thing that no one's talking about that the risk of covert is very very different indoors versus outdoors and the irony of it. All is that we live ninety percent of the time indoors and now one hundred percent of the time indoors For many of us. Because we've been asked to shelter in place and guess where the danger it's indoor the hotspot the best hope that we have and and it's important in dealing with the emotions of of this covert marathon. That were is that we prevent society from having catastrophic viral outbreaks that lead to massive loss of life and collapse of the healthcare system in other words that we flatten the curve. If we do that that's the best we can hope for. We cannot get rid of the virus until a vaccine or the virus burns out in so when we hear the news with these outbreaks. That are going to be happening. They get used to it. Any of US can get Kobe. And and the good news is that most of us will do just fine. It's about ten. Fifteen percent were the The bad things happen. Think about this for years. We've lived with flu. And No one other to do social distancing to the handwashing the not shaking hands. And so all that we're doing now is having a strong impact on lowering the transmission rate with Kobe but somber are still going to get it. So let's talk about. Let's let's talk about the weather. So why is it the weather stupid? Let's start with relative humidity so if you get a chart of Wuhan relative humidity it looks like Florida. It's about seventy five to eighty percent twelve months a year. Here's the big surprise. Is that when you look at this other metric of humidity? Which is not relative humidity. It's it's a little bit related but mostly not. It's not something you as you're at home. It's not something reported on the Weather Service but they can report it. My mission is to get them to report. It's another geeky metric and if you WANNA learn about it very quickly go to. Google and type in humidity helps fight flu. And there's a brilliant sixty seconds science podcasts. From Scientific American from two thousand and nine. This data has been around for a long time. That says we've been looking at the wrong metric to understand indoor airborne spread of viral disease. And so it's this other geeky metric so when you look at Wuhan for that metric. Oh my God it was. The indoor air in Wuhan was bone dry when a small viral outbreak exploded into a massive viral catastrophe. And then you look at New York and you look at Detroit and you look at even New Orleans. It's the last place people would think that a viral problem related to dangerously dry. Indoor air would would lead to a viral bomb but tragically when you look at the two peak days of Mardi Gras this year. There was some weather pattern. It may have been a cold front or something that came in and it changed the normally humid weather into dangerously dry indoor air and that's why the bomb went off in New Orleans. You've also mentioned meat packing plants. I believe that they have very dry. Error because of the air conditioning xactly. Because and and so if you look at the common thread behind every single outbreak I believe it's it's that you have high population density indoors plus virus plus dangerously dry indoor air. Okay now let's talk about why. The weather affects the indoor. So when you this metric which is a measure of the amount of water in the air it has been. It's not relative humidity. It's something else. And so that metric actually correlates very well with indoor air because buildings breed even high rises that are field off. That seem almost medically sealed. They are connected to the outdoors and so when the outdoor humidity amount of water in the air drops low it affects the indoor air. And then when you couple that with wintertime where you have the heat on and it really drives it out. Washington state where the first outbreak occurred. You look at win. The in that nursing home win the viral bomb went off and go back about twelve or fourteen days there. They Weather System. That came through a made the ordinarily very humid air dry. I think it was actually even in the middle of the night. You can have what I call red days or or even read hours until the part of going back to the the mindset of what we're dealing with heart of watch on lives are turned. Upside down is because we were fighting a war against an enemy that we cannot see and we have to make invisible danger visible right now. It's critical and that's why I'm pushing hard for one of the big weather services and I've really tried to reach Byron Allen at the weather channel. I haven't heard back also accuweather also. Ibm which owns the weather. Underground any one of those sources could overnight prove that dangerously dry. Indoor air was a product or a component of every single viral bomb. That went off. And when I'm talking about with Barack Obama's you have a small outbreak that in indoors. That suddenly is it becomes a massive barrel. Catastrophe and so the worst places are nursing homes. Because in those places you have people who are very old with coq with prem- orbiting I'm sorry pre morbid conditions with co morbidity and and so they're extremely vulnerable they physiology of aging makes us more vulnerable to Kobe. And then when you add the CO morbidity it makes those people extremely vulnerable and so that's why you have nursing homes and long hair long term care facilities prisons and meat packing plants as the places. Were we see most of the of the terrible catastrophes happening that makes sense and I think somebody had released that an extremely high percentage of the deaths in New York all had co morbidity of some kind. Bi Tension Diabetes Obesity. They had something going talk about New York so New York is an absolute tragedy in that you know. The officials were almost arrogantly saying. Don't worry about it. We've got everything under control go. You know do live your normal life. All the while. Their city was being seeded with people coming from the hot spots in Europe and it was tragic. Would it New York look like when you look at the the dangerously dry indoor air it was probably by my estimate perhaps twice as dangerous as Wuhan that dry that's one secondly you have high population density in high rises? And there's some question in my mind that in in some of the spaces that you may have central heating. They have passed the virus from one level to the next the next and then third you have inner city poverty and and the the the tragedies amongst minorities in particular African Americans have been attributed to the the the well-known health disparities in inner city. Poor whether it's high blood pressure obesity or a chronic heart disease or smoking. Or you know. It's a whole panoply of of conditions. But there's something new and I'm going to share it with your audience and it is not in the news yet and I think we actually released a press release on Sunday. I just happened to stumble on this on Friday. We're looking at a physician's update on Cova and it's very hard to understand. It's it's very technical but in a nutshell it was the first time that there was data showing that the that tragic disparities of of death and bad outcomes with African Americans with blacks is not just from inner city poverty. It turns out that there is a genetic vulnerability that also is tied to this news about children. That is starting to come out. Who are experiencing death for multi organ failure and yesterday. There was a a headline that went all over the world. Fast related to men having a vulnerability related to an enzyme and all three of these situations or link there it turns out that the virus attacks what's called an NGO attention to receptor and that it puts that that receptor out of business. Basically in that receptor is very important because it keeps other receptors from going haywire when we think of cancer what is cancer it's were cells go haywire will there's another form of Haywire involving The immune system and chemicals that are produced in the body that attack our Oregon's and they're called super oxidises and they attack the blood set the blood vessels and they produce intense vascular thrombosis in blood. Clots all over the place and and it. It is a nightmare scenario. And and this is the re I'm really upset. I've had a great deal and I still have a great deal of respect for the medical doctors that are working tirelessly to help us through this crisis. But I feel now that it's become politicized and why is it that an Er doc who is on the? Who's afraid unlike a basic scientist? I'm not in a research lab but but I could put this together and why in the hell have not the doctors that are leading this. Put this together long ago. Because had we known about the link with dangerously dry indoor air to Wuhan Hotspot Sense. I believe we I believe we could have avoided the shutdown of America and save tens of thousands of lives and now that we have this story emerging about children that are that are dying from multiple organ failure and the vulnerability that explains why african-american death rates are significantly higher. They ghost it's actually Similar pathway to the problem of high blood pressure that is operatives genetic vulnerability in African Americans and so we need to go into overdrive. Just like we did with ventilators in. Pp Six weeks ago on a word time footing to get indoor air. What I call green to get indoor air safe because we're only five months away from flu season and when that happens it's we're going to be lulled because now and then we're going to. We're going to have a CMIH RESPITE. And it's because of the weather because as you go from spring to summer you have more green days than read and and it makes the indoor air relatively safer but but that's going to flip back into danger in in the fall and there are inner city poor. There are people in nursing homes. There are meat packing plants prisons. You know there are so many places. They're all the businesses that that have closed that could reopen if people feel safe by knowing the danger of dry. Indoor Air has been mitigated. And it's so easy to do so let me use Florida as an example. So we've heard about the fantastic success of the Florida governor in Florida. Health officials and all the courageous were radiance. Who did such a great job? They were proactive. In testing people going into nursing homes and in being very very careful about limiting the most or access to the most vulnerable patients and the projections about a nightmare scenario apocalypse in Florida because of all the elderly turned out to be just the opposite and they had the lowest death rates among elderly. Have you heard about that? I have not but that's about to hear good to hear. Yeah it's an amazing success story but I believe that a lot of it and not to discredit the governor or the courageous people in Florida at all but because they did great. But it's also the weather because Florida has ambient weather outdoors that makes the indoor air naturally more safe against Cova even with air conditioning. It's safer and I believe that a significant reason why Cova deaths have been less in Florida is because the indoor air is safer in a natural way. So how is it that we can create safety everywhere we can? I come up with. A parrot called humidity saves lives which is a simple plan to keep us safe. And it it. I begins with making invisible danger visible second. It's making that invisible dangerous safe by adding water to the air. We breathe indoors until indoor humidity is fifty to sixty percent round the clock until the crisis pat relatives. That's what we can measure. That's where that's a starting point. But but the the part one of the humidity saves lives is actually a new vital sign of viral safety. Which I want to see on every weather report every day around the clock around the world. And it's where they report this Kiki metric that can actually forecast ahead of time read air or dangerously dry indoor air in time for us to do something about allergy index or UV index index heat index allergy index. It gives people advanced warning viral danger indoors in time to make their home safe. And so what a difference that will be for all of us in terms of elevating our morale in our sense of pope in our sense of identifying the The enemy that we're fighting just by having the viral safety index on the weather report because the there are three things that happen when when the air is in that fifty to sixty percent range one involves person to person spread. So it's so simple and it's not new science there's an abundance of science. It's been out for years. The physics of Of Dry Indoor air enables viral particles to travel all the way across the room linger for hours in Moist Air. It's almost like social distancing on steroids. It's like a firewall that prevents the virus from going very far. Because there's friction. And there's there's a resistance to blow when you have moist. It's an invisible protective barrier against Kobe when you have moist water in the air that's in the rain to fifty to sixty percent relative humidity indoors. I want to clarify though before we go to deepen because I still WANNA know. Don't you still need to social distance even if you have the protective barrier? That doesn't mean he should be leaning on each other in the bar necessarily right okay. Well okay this is. This is where science you know. We've been spending all of this time. Fighting over. Testing mass test is is actually in my view dangerous and same with with all the promises about about tracing and treatment testing brace treatment. It's like a mantra that keep hearing on television by politicians who who are getting they're politicizing healthcare in in my view in a dangerous way. So let's go back to your various question. We don't know the answer. I know that first of all I know for sure that viral outbreaks outdoors. I in fact. I have not heard a single outbreak becoming a bomb outdoors because outdoor air is much different than indoor air dilutes. Sunlight that that makes the viruses non-viable very quickly and the physics of air outside or just totally different. So whoever came up with this six foot number I feel like they pulled it out of their hat. I don't know if there's really good science that I you know. In which people being arrested we have fights breaking out. We have so much tension over this six foot number now indoors in dangerously dry indoor air six foot mate may not be enough. If it's dry if the air is green it may be plenty. I don't know we need rapidly to look at the science of humidity that is in the fifty to sixty percent range or in terms of this metric it should be above ten grams per meter cube. That's the amount of water in the air to the I mean. Ideally tend to thirteen fourteen in that range. But you that we shouldn't treat even if the air let's say does magically get to that level. Everybody pays attention to does it. We still publish it practice a little bit of hygiene just in case. Oh definitely hand washing and and until this crisis is past. Probably not a good idea to shake hands in terms of the distancing. You know this. There's utter paranoia and fear now because we've all been indoctrinated with the idea that there's something magic about six feet. Here's why I believe. Mass testing is dangerous in the backdrop is that we've all been cooped up. You know we want to feel safe. And we want to feel a degree of certainty about about our lives about the future about you know the places that we are working and shopping living. We've been told that mass testing is going to make us safe that for example returning to work. You know the everybody needs tested. I don't get it I just personally. Don't get it because You can. All attest means is that you're negative. At the time the test was done. Could you be infected an hour later? Yes could you be infected the next day yes? So when people have all of this pent-up desire to have their lives back to feel certainty and safety and they get a a normal test. They're going to think okay now. I've got the good housekeeping seal of approval to go hug grandma and it's human nature that you know three or four days after the test you're going to say oh you're going to rationalize. I'm fine and you're going to be affectionate towards you know a person that you love who is at risk and that is going to potentially give. Cova to somebody that you love and it's because of the. The misunderstanding about mass testing now targeted testing is extremely important. I have a view that every person going into a nursing home whether it's healthcare workers or visitors or plumbers or whoever should be tested every time they go in at least every day I heard about New York saying twice a week. I don't get that. I think it should be every day that people go into a nursing home. They should be tested. I think that frontline healthcare workers need to be frequently tested bus drivers anybody working in enclosed spaces where you're around a lot of people where you could be exposed and then you could turn the a symptomatic expose others. You need to be tested frequently if you'RE A on a navy ship or if you're in a meat packing plant though situations you need to be tested but but that those situations are very specific scenarios where people were in indoor air at risk. Those are not the ordinary work situation. We have to reset our expectations around. What's real we have to go back to where we shut down the country to avoid catastrophic death in class of the healthcare system in realize that that is the best that we can do. We're not going to eradicate the virus. Well down to move four because I have a lot of questions that I wanna hit and some of these I think are very important. Actionable steps are questions that people have and you can. Hopefully answer are all right. Let's start off with. How much of a risk is getting packages slash food? Things like that delivered and is it risky. Is it not risky? And then what do people do about it? Should they how she decamped decontaminate it? Okay so I don't know the exact answer and you know there was a New York Times article. That I felt was was really irresponsible that was talking about viruses lasting seventy two hours on cardboard or something like that. You know the the first of all. Let's get clear about the difference between viruses and bacteria viruses do not live they bacteria or living organisms. They metabolize they they oxygenated a excrete waste products viruses are just a piece of RN. A with a coat they don't live. So what you need to know or the question you need to ask is how long will viral particle be infective in sunlight quickly Nature in moist air. They quickly or relatively quickly nature. They they don't last very long in moist air. You know we go out to a GROCERY STORE. We touch something we come into our homes. And now we're worried about contaminating the sacred space that we live in. And that's that is eerie unnerving that that the very place where you you feel safe. You're now worried about this hidden enemy attacking you so that you can't see and it's driving people nuts. I think people should just do good handwashing common sense. You know when you come home. Wash your hands and by the way you don't need to have pure L. or antibacterial soap. Even though that's what I used to be honest but like it's it's not these are bacteria they don't live plane. Soap and water is what you need so I want to say something. That's GONNA sound really like I'm lying. A Toll Cova. I did not know how to wash my hands. So this person said we'll wait a minute. That sounds that sounds unbelievable because you have done surgery well surgery we have a brush you know we we have routine that we go through okay. You're not washing. Your hands with surgeons brush neither am I and so because of covid. A in a medical podcast. I learned there seven steps and it's brilliant. So here's the first step. You go like this flat surface water palms of your hand. Then you go like this between your fingers. We're fingers and actually I do one over as well. Okay okay like that. That's step to two then. The third step is this from behind case. One other Palm to back of the hand. Yeah that's three okay. Third step is our four step is also two parts. It's your fingertips you go like this and then you go I out. You're turning a doorknob into your palm. Yeah exactly and that's your fingertips fifth. Steppers your knuckles okay. Rubbing Nasr on your palm. Yeah six step is your thumbs. Can you go all the way down like that up and down the yeah all the way to the base and then the seven step is your wrist? Go like that okay. Just and that's it. That's that's the Kobe hand wash and I thought it was so smart when I saw this and I. That's what I do now every time when I come in but Just Place Open Water. The virus code for all of its of its infectiousness. It has vulnerabilities. I want to continue. My wife is a library director and she gets books that are returned. What should she do about those? Just leave him sit for a day and they'll be good. I don't think I don't I don't have the answer and I don't think that we're gonNA drive each all of us crazy if we if we have to worry about imagining hidden virus everywhere it's GonNa make everyone OCD and we're you know people are. It's already causing so much problems in terms of mental health and suicides depression. And Look you cannot just elevate the air US good handwashing social distancing and I think that by and large. You're GONNA be fine. What are you doing yourself in your peers to keep yourself safe since you're right in the middle of it okay? So now. We're going to go into some controversy. I would. I saw the study on hydroxy chloroquine early on within day the famous French infectious disease doctor. That was seeing these amazing results in terms of our clearance when he combined hydroxy. Clark win and Zithromax if I you know I wonder why Zithromax it's an antibacterial but apparently it has antiviral properties as well. Unfortunately that medicine has been so politicized and I believe that it's criminal the way that that doctors that look at this you know are so angry at that. Studt it was. I think it was a hit job intentionally because the doctor that apparently did the study never took care of a Cova patient. He's a research ophthalmologist. Which study was the so-called? Be a study that against hydroxy chloroquine. They didn't publish dosages. They were just so many things wrong with it. They were they. Were looking at people who are already in of chrome storm and in a very end stage state and saying well. It didn't work well. Nothing would work at that point now. We have brim disappear which gives us some hope but the point is that hydroxy chloroquine has been around about seventy years. Hens and tens and tens of millions of people have taken it millions of people every year as anti malaria prophylaxis as a medication for lupus or rheumatoid arthritis the rheumatologist to my knowledge who've used it for decades and decades they the many of them report never having a significant complication. They don't do. Ekg theoretically it can prolong the q t interval and which is not a heart attack. But it's something I won't go into. But it's there are a lot of things that theoretically can prolong the tea interval but in terms of of of the way that that drug has been used successfully mass populations it has a very well established safety profile. And so I can tell you a story. I've a very dear friend who is a CARDIOTHORACIC surgeon whose wife has lupus and has been on that drug for years. How did she feel when all of sudden the news is reporting that People Hydroxy Cora Cohen is getting heart attacks? It was totally irresponsible and frightening people who need that drug for Lupus and rheumatoid and for Anti Malarial. You know a lot of my colleagues. Take it when we go into. Malaria prone regions soldiers. It's a very common drug soldiers. We AT PHNOM ERA soldiers. So go back to your question. What am I doing is I I got on hydroxy chloroquine zithromax and most of the Er docs of the front line. Docs in intensive care units that I know of did the same okay and they just don't talk about it because it's so political now. I don't know I just know what they did and what I did and and and it's criminal that I'm sorry to use that. It's a very strong word but politicians need to stay the hell out of medicine right or left. You know. We need to try to do the right thing. We're at war against a an invisible enemy and in were you do things differently if something might health and it won't hurt you go for it because you fight the battle with the tools that you have. It makes total sense. Some for one of the questions I had is. When do we know that we should check ourselves out? And one thing that I heard is blood. Oxygen monitors could be useful. Okay okay. Let's talk about that so when I did this zoom session two sessions actually for NAT. Go colleagues around the world on Thursday and we had to do to. Because you're a lot of people in different time zones and so the only what I told it was the only time I would recommend buying a pulse. Ox is if you're let's say out in the middle of nowhere eight hours from the closest healthcare working out in the field and you feel like you're getting sick or you you've been around someone that turns out to have and you want to know when you need to seek medical care when you go drive that eight hours through the Bush in order to get healthcare. Well then you know the pulse ox makes sense. Oh by the way let me before I forget there is a Yale. Healthcare has a protocol online about hydroxy. Clark guess what their first line drug is for their impatience. It's Hydroxy Clark when this is Yale Yell and that was may I. Last time I looked at it so bays ago it was there. It was their first line drug for hospitalized patients who were meeting and what made me think of it was when you're asking about the oxygen level so if you have. Kobe does something really strange. With a certain segment or certain cohort of the patients. Get it and it causes the oxygen levels to drop in a way that we've never seen before and so people can have oxygen levels in the low eighties. Or even the mid seventies and ordinarily they would become a toaster delirious and they start to have organ profusion problems and these people are using their organs. And they're talking to you. You know the the science behind this is not clear but if you are out in the field and you feel like you have it and what I told my my colleagues is if you start to go down into the eighties like the Mid Eighties. Then drive in and get healthcare. Or if you're let's say ninety and you exercise in your in your pulse ox Up Your pulse ox similar drops by three points when you're exerting yourself that would be another criteria but otherwise I would not buy a pulse ox because you're just gonNA drive yourself crazy. Don't try to play doctor because it's covert is way more complicated than than you can figure out by looking at the Internet. It is a complex disease and most of the people that you know that right now there is no official treatment except for Ram disappear on an emergency authorization. Only so is a medicine for people who are really really sick in an ICU. Or in a hospital. Who makes the? I can't think it's Gilead. Is that a government funded medicine. Our I don't I don't I don't know the details but I know the Gilead has received a lot of praise for pulling all the stops and getting you know produced and giving a lot of away and so that's what I don't know the controversial mix or is it just another thing that has any FDA approval to my knowledge right now and it's just for really really sick patients. It's not something that you know you you. There is no other treatment for Cova. D- right now except for things that are off label like hydroxy chloroquine and Zithromax. And by the way that Dr Finished I think in about eleven hundred patients several weeks ago put together a non randomized study but I think he had almost ninety two percent rate of viral clearance while it was pretty remarkable numbers there were seven or eight deaths and I think one complication out of eleven hundred patients so it was very good numbers and I think there are other studies that are there undoubtedly that are coming out now but but you have to be very careful in what you're hearing in the news It there is a lot of misinformation with numbers with statiscal. That's a question I had actually that there is some question of there's over inflated numbers about all the out there all over the map and it's a lot of it is designed to create fear and panic in my view and it's irresponsible so some people would say the only number we can count on. Is the death number. Okay at least in the United States where we have fairly accurate reporting of deaths but even in the US that number as we're discovering can be higher. A lot of states have politicized it and and doctors are being pressured to write cove on the death certificate. When it's maybe Kobe but it's probably a heart attack or something like that was a question to somebody. Came in with a brain aneurysm but also at Kobe. What would be the cause yeah? They're blaming it on Kobe. I said and it's it's politicized and it's unfortunate. That's not always happening. But I understand that it's happening it. That's that's an example where politics has intervened with medicine. And it's giving US numbers. They're also under reporting with people in nursing homes or homeless or New People. Dying at home they may not be accurately reporting those as as Cova Desk. So it's not as tight as we want it to be and and then in terms of these numbers about recovery and how many people what percent have it and death rates? We can't trust those numbers because we don't know what the denominator is. How many people actually have Kobe? What what we kind of assume I think personally. I believe this is the case. Is that way more. People have had it. Then we know that's hope is an. That's actually a good thing. The more people who have had the better though so that goes into another area of uncertainty. Because we don't know right now whether having antibodies protects you from another covert attack okay and our reports of people who have anti the I G G antibody Release the GM antibody who are still shedding virus. So it's it's a you know the the the In fact the FDA took the antibody tests off the market or the they require requiring them to now be certified because there were so many scams and so many tests that that cropped up out of nowhere out of Control. You know that we're that were being highly commercial taking advantage of people. You didn't know what the numbers meant. They weren't standardized so now the has kind of put the Kabosh on that and they're restarting that whole program and so in terms of Let me just go through at least as of last Thursday. I haven't checked since but this Cova thing for doctors is the same everyone else. We all feel like the ground is shifting. What was true. Yesterday is not true today. In many cases we've never seen anything like it so the ordinary public should know that doctors are going to the same sense of dread or walking quicksand. Yeah like everything's changing but when you accept that and in fact I wanNA say something that I love. Just it's very calming. When the power of the modern world disappears. All we have left is each other and that really. That's what we can count on is each other and we see that in such an amazing way. We see incredible altruism. That's what we count on right now. Is each other other human beings helping other human beings complete strangers risking their lives to save the lives of complete strangers and that is the most remarkable beautiful fingers. This bashed reservoir of human decency and goodness that lies just beneath the surface and it erupts like a volcano. We don't even know it's there until a crisis and then we see you know what our country is made of and it's never about race or about gay straight or rich for any of these jobs. It's just human beings helping human beings. Actually you know what that is a perfect perfect message to wrap on. I just love India non hope like that so I'm hopeful and please be hopeful and please write your state and local and national leaders and tell them it's the weather stupid Dr Jeff Guskey. Thank you so much people can find you at Jeff. Guskey DOT COM. Yes they can also go on youtube and posting. There's I have a show at the Smithsonian show at the Smithsonian National Museum of African American History and Culture. They can learn about that on on Youtube. Also posting a lot on linked doing a lot of interviews and I'm pushing bit the viral safety index on every weather report and to get indoor air safe as fast as possible is trying to make it happen there my Eric. It's an honor to be with you. Thank you so much for to Nina. I hope you enjoy that and got serious value out of that episode. I know that I did not want to encourage you again to please check out the live streams on the Youtube Channel. Youtube dot com slash Eric. Only and if you want to have something to do this weekend my friend Brett Allen has a conference he's put on called book your dream guest and I will be speaking. You can find it. I've put together a little pretty link at UNSTRUCTURED POD DOT com slash book. And that will take you to the facebook group which you can join and that will show you the conference when it comes live. It's completely free. There's a lot of great people who will be there and I hope to see you there too. Thanks so much.