35 Burst results for "Respiratory Distress"
Fauci: 'Close the bars, keep the schools open' to mitigate community spread
"Dire dire warnings warnings advising advising against against Thanksgiving Thanksgiving gatherings. gatherings. We We also also saw saw record record breaking breaking travel, travel, and and today we expect to break another record as millions of Americans are making their way home. This is just a snapshot of some of the nation's busiest airports this morning, but it is not just those lines at the airport that air causing fear. It is the images of these shocking lines across the country. Americans lined up for food. With the vaccine not widely available until next year. Businesses remain shuttered and more than 20 million people are claiming unemployment benefits. Dr Anthony Fauci is standing by, but first we wanted to take a closer look. There's critical moment and those struggling in the long shadow of the pandemic. We still have months of This battle ahead of US President elect Joe Biden, warning that the fight against Cove it is far from over. We have to try to slow the growth of this farmers. We all went to the doctors and the nurses and other frontline workers. It's about 2 30 in the morning. I just got home from work last March, when this all began, we talked to emergency room. Doctor Aaron Beaumont. All of the sudden we just got overwhelmed Ambulance after ambulance with Hypoxic patients people in respiratory distress. Dr. Beaumont, who works in the Boston area, has grown tragically used to the toll of this pandemic, but is bracing for a post holiday crush of patients at one of the constants that we've had throughout this pandemic since the beginning. Is the component of stress and fear that the health care workers in the front line providers are experiencing every single day or tired of this. We're exhausted, but the pandemic strange extend far beyond the halls of hospitals, months of economic hardship marking the start of the holiday season. That need evident across the country. Cars backed up for miles, people standing in line for hours, even in the rain just to get food. food. You You know, know, I'm I'm thinking thinking he's he's trying trying to to provide provide for for my my family family right right now now Networking Networking hunger hunger in in this this country country at at a a new new high high one one out out of of every every eight eight Americans say they sometimes don't have enough food to eat. For households with Children. It's one in six. I've never witnessed the system being more strange than it is right now just miles from my own home in Virginia Long lines here where they've seen a 45% increase in the family's coming for food executive director Charlie Main worries it could get worse. It can get very difficult at times watching These lines getting longer and longer. What do you expect in the coming months when county support federal support drops off, our families will come to us and even greater numbers, and that's my biggest fear. And you know we have to serve. All of those people were committed to serving everybody who comes to our doors. Joining me now now Live Live is is the the director director of of the National the National Institute Institute of Allergy of Allergy and and Infectious Infectious Diseases, Diseases, Dr Dr Anthony Anthony Fauci. Fauci. Dr Dr Fauci. Fauci. Welcome Welcome back back to to this this week. week. Today Today could could be be the the busiest busiest travel travel day day in in the country the country since since the the start start of the of pandemic, the pandemic, even even though though you you and and other other public public health health leaders leaders have have made made appeal appeal after after appeal appeal for for people people to stay to stay put. put. And And distance distance as as much much as as possible. possible. When When you you watch watch these these scenes, scenes, what what do you do think? you think? And And what what else else can can you you possibly possibly say say to to them? them? Well, Well, I mean, I mean, the the travel travel that that has has been been done done has has been been done done right right now now is is people people go go back? back? We want We want to to urge urge them. them. If they've If they've been been in situations in situations outside outside of of the the family family setting setting in in which which they they really really don't don't know know the level the level of of exposure exposure to to be be really really careful careful when when you you either either return return from from the place the place that that you you went. went. Other Other people people come come back back into into your your house. house. That you've That you've really really got got to understand to understand the importance the importance of of trying trying to to prevent prevent further further spread spread and and further further surge surge that that maybe maybe when when you you go go back back to to where where you you came came from, from, if if it's it's possible possible to to quarantine quarantine yourself yourself for for a a period period of time, of time, or or even even get get tested tested to to make make sure sure That you're That you're not not bringing bringing infection infection back back to to another another place place being being another another home home or or another another family. family. Having Having said said that that we we have have to to be be careful careful now now because because they're they're almost almost certainly certainly is is going going to be to be an an uptick uptick because because of of what what has has happened happened with with the travel. the travel. We We understand. understand. The importance The importance of of family family is getting is getting together together and and it's it's just just something something that that we we have have to to deal deal with with that that we we likely likely will will have have an an increase increase in in cases cases as as we we get get into into the the colder colder weeks. weeks. Of the Of the winter. winter. And And as as we we approach approach the Christmas the Christmas season, season, please please don't don't forget forget the the standard standard public public health health measures measures that that we we talk talk about about The reason The reason I I say say that that a a moth moth and and and and almost almost plead plead with with people people is is that that we we do do know know That it That it does does work. work. Countries Countries that that have have mitigated mitigated have have turned turned around around the surge. the surge. States States that that have have mitigated mitigated have have had had a a turnaround turnaround of the of the inflection inflection of of the the curb. curb. So So it it does does work. work. And And as as we've we've just just heard, heard, help help is is on on the the way way Vaccines Vaccines a a really really right right on on the the horizon. horizon. Will Will be be having having vaccines vaccines available available for for the the higher higher priority priority people people towards towards the the middle middle and and end end of of December December and and as as we we get get into into January January and and February, February, so so everyone everyone is is totally totally empathetic. empathetic. About About the the fatigue fatigue that that everyone everyone is is feeling. feeling. But But if we if we can can hang hang in in there, there, hang hang in in there there a a bit bit longer longer and and do do the fundamental the fundamental things things wearing wearing of of mask mask uniformly uniformly avoiding avoiding crowds crowds and and congregate congregate settings, settings, keeping keeping physical physical distance distance washing washing your your hands. hands. They They seem seem simple simple in in the the enormity enormity of of the problem. the problem. That we're That we're facing, facing, But But they they do do make make a a difference. difference. Dr. Dr. Fauci Fauci pleaded pleaded before before the the beginning. beginning. Yeah, Yeah, Doc Doc Doctor Doctor Fauci. Fauci. You You have have said said that that again again and and again again and and again. again. We We saw saw all all those those people people traveling. traveling. So So you you know know what's what's coming. coming. And And with with Christmas Christmas just just around around the corner, the corner, do do you you think think will will be be under under the the same same restrictions restrictions that that you you recommended? recommended? On Thanksgiving On Thanksgiving going going into into Christmas. Christmas. You You know, know, Martha, Martha, I I can't can't see see how how we're we're not not gonna gonna have have the the same same thing thing because because when when you you have have the the kind kind of inflection of inflection that that we we have, have, it it doesn't doesn't all of all of a sudden a sudden turn turn around around like like that. that. So So clearly, clearly, in in the the next next few few weeks, weeks, we're we're gonna gonna have have the the same same sort sort of thing. of thing. And And perhaps perhaps even even two two or or three three weeks weeks down down the the line, line, Martha, Martha, we we may may see see a a surge surge upon upon a a surge. surge. You You know, we know, we don't don't want want to frighten to frighten people. people. But But that's that's just just the the reality. reality. We We said said that that these these things things would would happen. happen. As we As we got got into into the the cold cold weather, weather, and and as as we we began began traveling, traveling, and and they've they've happened, happened, it's it's gonna gonna happen happen again. again. So So I I cannot cannot see see all all of of a a sudden sudden a a relax relax ation ation of of the kinds the kinds of of recommendations recommendations or or restrictions restrictions because because we're we're getting getting into into colder colder weather weather and and enough enough in in even even larger larger holiday holiday season season as as people people travel travel to to come come back back and and forth. forth. For Christmas, For Christmas, so so I I don't don't see see a a relax relax ation ation of of the kind the kind of of recommendations recommendations and and restrictions restrictions that that we've we've made. made. And And Dr Dr Factually. Factually. The Supreme The Supreme Court Court on on Wednesday Wednesday struck struck down down New New York's York's Covad Covad restrictions restrictions on on religious religious gatherings gatherings in in the state. the state. How How concerned concerned are you are you about about legal legal challenges challenges to to pandemic pandemic restrictions restrictions going going forward? forward? Well, Well, I I mean, mean, they they happened, happened, Martha. Martha. There's There's nothing nothing I I could could do about do about it. it. I I just just keep keep saying saying that that when when people people ask ask me me for for Opinions Opinions of of specific specific things things rather rather than than make make a a comment comment on on a a specific specific things. things. I I could could just just say say it it doesn't doesn't matter matter who who you you are are where where you you are, are, when when you have you have congregate congregate settings, settings, particularly particularly indoors. indoors. When When people people are not are not wearing wearing masks, masks, that that is is a a considerable considerable risk risk for for acquisition acquisition and and spread spread of of infection, infection, no no matter matter what what the circumstances the circumstances that that is is a a risk. risk. And And you you said said there there should should be more be more regular regular testing testing available available for for asymptomatic asymptomatic people. people. How How soon soon do do you think you think before before Americans Americans could could have have inexpensive inexpensive home home tests? tests? And And why why haven't haven't they they so so far? far? Well, Well, I I hope hope it's it's sooner sooner rather rather than than later, later, Martha. Martha. I mean I mean they they obviously obviously we've we've done done better better in in testing testing than than we we did did early early on on in the in beginning. the beginning. But you're But you're talking talking about about different different kinds kinds and and different different motivations motivations and and different different objectives objectives of of testing. testing. If If you're you're trying trying to find to find out out if if a a person person is is infected infected either either for for contact contact tracing tracing or or what what have have you you then then you you want want a a highly highly sensitive sensitive test test that that might might take take a a day day or or two two to to get get a a result result back. back. When When you're you're trying trying to find to find out out what what the the extent extent of of the community the community spread spread is is that that is is driven driven very very clearly, clearly, at at least least in in part part by by asymptomatic asymptomatic spread, spread, so so we we need need to to know know the extent the extent of of the the asymptomatic. asymptomatic. The only The only way way you you know know that that is is what what you you just just asked asked for. for. And I And I would would like like to to have have seen seen it it already. already. And And I hope I hope that that we we get get it soon. it soon. Rapid, Rapid, sensitive, sensitive, specific specific home home testing testing even even one one that that you you might might not not even even need need a a prescription prescription for for so so that that people people can can have have within within their their own own power power to to know know whether whether or or not not it it is is in in his his highly highly sensitive sensitive is is the the other, other, but but it it is is very very helpful, helpful, particularly particularly if if you you do do it it over over and and over over again. again. I hope I hope we we get get that that soon. soon. And And Dr Dr Fauci Fauci in New in York New York City City Public Public school school shut shut down down again again earlier earlier this this month. month. I I know know your your default default position position is is that that you'd you'd like like to to see see the the skull skull schools schools open. open. But But how how do do you you make make that that happen? happen? And And how how would would you you advise advise the the incoming incoming Biden Biden administration administration on on getting getting a a sort sort of unified of unified response? response? Well, Well, you you know, know, Martha, Martha, that's that's a a good good question. question. We get We get asked asked that all that all the the time. time. You You know, we know, we say say it it not not being being facetiously facetiously as as a a sound sound bite bite or anything, or anything, but but you you know, know, Closed Closed the boss the boss and and keep keep the the school's school's open open is is what what we really we really say. say. Obviously, Obviously, you you don't don't have have one one size size fits fits all. all. But But as as I I said said in in the past, the past, and and as as you you accurately accurately quoted quoted me me The default The default position position should should be be to to try try his his best best this this possible possible within within reason reason to keep to keep the the Children Children in school in school to to get get them them back back to school. to school. The The best best way way to to ensure ensure the the safety safety of of the Children the Children in school in school is is to to get get the community the community level level of of spread spread low. low. So So if if you you mitigate mitigate the things the things that that you you know, know, are are causing causing spread spread In a In a very, very, very very profound profound way way in in a a robust robust way. way. If If you you bring bring that that down, down, you you will will then then indirectly indirectly and and ultimately ultimately protect protect the Children the Children in the in school the school because because the the community community level level is is determined determined how how things things go go across across the the board. board. So my So my feeling feeling would would be the be the same same thing. thing. If If you you look look at at the the data, data, the spread the spread among among Children Children and and from from Children Children is is not not really really very very big big at at all, all, not not like like one one would would have have suspected. suspected. So So let's let's try try to to get get the the kids kids back. back. But But let's let's try try to to mitigate mitigate the the things things that that maintain maintain and and and and just just push push the the kind kind of community of community spread spread that that we're we're trying trying to avoid. to avoid. And And those those other other things things that that you you know know well, well, the the bars bars the the restaurants restaurants where where you have you have capacity capacity seating seating indoors indoors without without masks. masks. Those Those of of the things the things that that drive drive the the community community spread, spread, not not the the schools schools and and and and Dr Dr fracture. fracture. You You talked talked about about the the vaccine vaccine and and the availability the availability of of the the vaccine. vaccine. The government The government Can't Can't force force everyone everyone to take to take the vaccine. the vaccine. So So what what about about schools? schools? Companies? Companies? Employers? Employers? Can Can they they mandate mandate of vaccine of vaccine like like in in other other vaccines? vaccines? You You know know any any individual individual group group command command eight eight vaccines vaccines in in certain certain ways, ways, Martha, Martha, It's It's not. not. I I believe believe going going to come to come centrally. centrally. I I don't don't want want to get to get ahead ahead of of the game the game there, there, but but I I doubt doubt that. that. That would That would happen. happen. For For example, example, right right now, now, myself. myself. I I mean, mean, I'm I'm at at the the NIH NIH Clinical Clinical Center. Center. I'm I'm a a physician. physician. I I see see patients. patients. I I have have to to get get the the influenza influenza vaccine vaccine or or I'm I'm not not gonna gonna be able be able to see to see patients, patients, so so individual individual units units be be they they hospitals hospitals or or other other organizations. organizations. Can't Can't do do that. that. It's It's within within their their right right to to say. say. If If you you want want to work to work with with us, us, you're you're gonna gonna have have to to get get a vaccine. a vaccine. But But that's that's not not going going to be, to be, I I believe, believe, essentially essentially mandated mandated process process and and Dr Dr Factory. Factory. There There are are concerns concerns about about the the anti anti vaccination vaccination movement movement and and infectious infectious to to see see disease disease specialists specialists in Boston, in Boston, telling telling the Boston the Boston Globe Globe the same the same energy energy that that was was placed placed into into development development and and distribution distribution of a of a Corona Corona virus. virus. Vaccine Vaccine should should have have been been placed placed in in messaging messaging and and community community engagement. engagement. Do you Do you agree agree with with that? that? Oh, Oh, absolutely. absolutely. We We have have to to engage engage the the community. community. Martha Martha B. B. Because Because we we do do have have a a degree degree of of anti anti vax vax to to begin begin with. with. But But then then there's there's skepticism skepticism about about this this vaccine. vaccine. So So we've we've got got to be to be able able to to get get out out there there get get community community people people who who the the community community trust trust to show to show two two things. things. The process The process of of the the development development of of this this vaccine vaccine has has been been one one that that has has been been scientifically scientifically sound sound safety safety has has not not been been compromised. compromised. Scientific Scientific integrity integrity has has not not been been compromised compromised and and the process the process Of determining Of determining whether whether it it works. works. Whether Whether it's it's safe safe and and effective, effective, has has been been independent independent by by independent independent bodies bodies and and transparent. transparent. We've We've got got to get to get the the community community the broad the broad community community of of the United the United States States to to see see that that and and appreciate appreciate that. that. And And how how could could be be we'd we'd be sure be sure there there won't won't be prolonged be prolonged side side effects effects from from this this vaccine. vaccine. Well, Well, you you know, know, Martin, Martin, the one the one thing thing you've you've got got to admit to admit that that in in any any intervention, intervention, there there might might be be a side a side effect. effect. The The history history of of vaccine vaccine ology ology that that we we know know for for decades decades and and decades. decades. Is that Is that when when you you talk talk about about prolonged prolonged side side effects effects that's that's very very rare rare and and the side the side effects effects that that occurred occurred that that are beyond are beyond the immediate the immediate pain pain in in the the arm arm and and the fever the fever and and things things like like that. that. Generally Generally occur occur when when you look you look at at like like 95% 95% of the of time the time between between maybe maybe 30 30 and and 45 45 days, days, which which is is the the exact exact reason reason why why the the FDA FDA said said that that they they would would not not want want Tonto Tonto issue issue and and you you a a or or approve approve anyway anyway and and emergency emergency use use organization organization until until 60 60 days days after after half half of of the the people people in in a a trial trial Have Have gone gone from from their their last last dose. dose. So So already, already, the the FDA FDA has has baked baked into into the the process, process, a a safety safety mechanism mechanism to to make make sure sure that that you you have have historically historically overwhelming overwhelming chance chance that that you're you're not not gonna gonna have have a a very very late late effect. effect. Having Having said said that that also, also, you you don't don't just just forget forget about about it. Once it. Once the the trial trial is is over, over, you you have have one one or or two two years years of of the the trial trial follow follow up. up. In In addition addition to to post post trial trial follow follow up up So that's So that's something something that that is is very, very, very very high high priority priority is is the the immediate immediate intermediate intermediate and and long long term term safety safety of of these these vaccines. vaccines. It's It's not not something something that's that's being being disregarded. disregarded.
Self-Advocacy Through Storytelling with Katie Vigos, RN
"Welcome back to the moment everybody I am speaking with Katie Vigo's today she is a registered nurse and founder of the empowered birth project. I'm so excited to speak with you today we've had a few technical difficulties in hopefully those stay at bay now but yeah, welcome to the woman. I'm so glad we finally got you on. Thank you so much for having me. I'm excited for our conversation you work in Icu Poe right now correct yes. That's right. Critical Care is still my primary specialty the moment. Love that when did you know you want it to be a nurse led you to this field? I've always been interested in anatomy and physiology as a kid I found the human body to. Be. So fascinating and I was just drawn to those sciences and when I was a senior in high school my offered a free course to become certified as a CNA nursing assistant, and so I immediately saw Kinda, this golden opportunity to get certified to start working in this field that I'd always been interested in. So I took a class and then got my first job working in skilled nursing facility and I've pretty much never stopped. I love. That's the thing that's basically the road I talk to you like I. Well, I knew I wanted to be a nurse but like as soon as I could take that scene a course I did that a great way to get started. A it definitely will introduce you to to see if you can handle being around that much bodily fluid. That will particular job was like probably the most backbreaking Labor I've ever done in my life. Yeah. Yeah. All have only gone up hill from there their gotten better from there that was so hard. I was too young and inexperienced to even know any better I was just excited to be working in. You know getting started with my career yeah. One hundred percent I mean I started working on a med surge floor and I literally never been in more pain in my life than when I would come home from working. At. A shift there. I have so much respect for MED surge nurses. I S honestly think it's harder in many ways that what to do in critical care respect for floor nursing same same I ended up in the Nikki I've had enough of adults like I can't. I can't move them. No, it's. It's physically, very challenging. Mentally emotionally, spiritually challenging job it requires like our whole being so he has. Yes people. Yeah. What is life and free since the pandemic started with working still being in the ICU I it's you know it's been a roller coaster I at the time that Kobe really started to hit the United States where we went on lockdown here. In California, I was on a full time loan to cardiovascular is you which was a challenging assignment, but I took it because I wanted you know some fulltime work for a few months and I was just a few weeks instead assignment and starting to feel a little bit more comfortable, and because I was per diem and because all almost all elective non emergent surgeries completely stopped onus unindicted unit was way overstaffed and they're like, well we. Don't need you any more sorry and I was like, okay. So I lost that Gig and then I had been working in outpatient surgery as well with a facility for three years and back completely shut down. So ironically I was kind of gearing up in those early weeks. I'm like all right here we go. Like I've been training my whole life for this and I was it just didn't play out the way I expected a now a sudden I'm worried about you know getting enough work as I in pandemic. And there are a lot of reasons for that that you know I'm sure you're aware of many people listening are aware of, but you know the per diem crowd got hit hard and everything just shifted around so quickly and then it was like travel nurses coming in, you know my co workers are you know leaving and getting work elsewhere because they can't Get at our hospital and it just felt so chaotic and uncertain, and I have had also been working for the private sector for the last eight or nine years here in Los Angeles Oh come on a lot of pride in doing her thing and so I'm really networked into that field as well here and so I was able to just hustle in. Find some private work and just like piecing everything together like a lot of us per diem nurses are good at doing you know. Yeah. So I was able to get through you know kind of those early months and then things started to pick up again at my hospital and so now that I'm able to work more kind of back mostly full in the ICU again, doing some a private work as well and aside it's it's changed everything I mean regardless of where we work like. Especially, at first like the policies and procedures were just changing daily, you know as mere figuring out the best ways to protect ourselves, screen all of our patients and everything, and so that was overwhelming to keep up with, and for example, I was floated to. Telemetry one day at a unit I. Believe once before come on shift and I have a patient who is like in basically in respiratory distress did not like the level of a rapid response per se. But like he's on iphone as will Kanye like eighty percent like fifty liters or something like that, and you know he has tech Nick and all this stuff and I'm just like, are we going to test this guy for covert like your and? where's PP P now, as I kinda, don't want to go in the room unless I have that, and then I really had to advocate for myself and be like you know, let's test this guy that was before my hus-, my husband's testing everybody. But like those early weeks were really stressful that way because there are so many unknowns and it was it was scary to walk into work which previously was familiar and comfortable to me is an experienced nurse and two now just feel. So on edge
"respiratory distress" Discussed on Free Game Just Listen
"And they are both classified as narcotic on it'll just in these these are very high for codependence addiction and they are they. Both can cause respiratory distress and death when taken in high doses or combined with a substances such as alcohol or fennel. So how do you approach someone who is using? Definitely you know. You don't rush them and do not start yelling at them. If you find out from someone that your loved one is using, you know what I mean I mean approach them and give them some sort of power and ask, Hey, can I talk to you? You know what I mean on I guarantee you this person is struggling and they're hurting you know and I can tell you right now after studies that I have that I have done and help that I was saved for things that I was struggling with. You know it all begins from As a kid, you know what I mean. So so me growing up you know there's something that I did wrong you know I definitely was dishonest. mean. Be Dishonest to get things way you know what I mean. So so kids nowadays you know what I mean. They'll ask you like, Hey, can I have a certain amount of money to go do this to go to a movie? But are they really using this money to go to a movie or? To go do this please so. As the kid is young, find out what they're doing who they're hanging out with you know. You know there's a saying from from when I was younger that said, you, you are your friends are. Honestly. True. If your friends using, you'll be using too. But right now that's the matter at hand is is just not the whole using part is the fact that you know some some of our kids are using appeal that they can never come back from. You know. So it's very serious right now in our community and. The education that we're lacking is just it's not rape we need to be educated in this. We need to save our kids at the end of the day. That's what it comes down to. You know. Our children should be sheltered to a certain extent. Talk to your kids find out what their with your passion her boat make sure you're pushing them and support them you know. You have to be a friend as well as appearing Also, how do we help these struggling? Individuals right now like I said, please talk to them. You know what? I mean. trust me like I said, they wake up every morning praying to God. You know what I mean to blacken destruct from their hearts and their lives you know. So they can continue on and being normal nobody wants to struggle like that. Our people need to be sent to treatment centers. These centers are from Don upon with in our communities and I know it. But honestly, the only way you could save any of our children are in that are in substance abuse is to get them to get these toxins out of their bodies and at least to be away for thirty days or so or even you know that gives them time and hope you of becoming clean. So I would love can all come together? And maybe even maybe open it islamic-based. Center, to help our. People. I'm honestly offer the 'cause whatever works. I'm telling you the best way to help anybody that struggling right now is to send them to treatment. And if you don't think that's rate than please let's come together and build eight. Islamic treatment. Centre. For the people. Please, we need to help our people and like I said, talk to your kids. I hope this podcast helps on on addiction and mental health If you have any questions, please contact me on Snapchat Sammy Buns S..
DACA recipients on the front lines of fighting the coronavirus
"This spring court could decide as early as tomorrow the future of the deferred action for childhood arrivals policy daca that's the Obama era program that protects immigrants who came to this country illegally when they were kids in two thousand and seventeen the trump administration tried to rescind daca arguing that Obama illegally created it now it is up to the Supreme Court more than ninety percent of daca recipients are students or they are working some of them are the health care workers on the front lines in the cold nineteen pandemic are co host David Greene talked to two nurses who are dealing with the emotional toll of saving lives while also waiting to find out the fate of their own status in this country your status twenty nine year old Estefania betting korma CS an ER nurse in Vancouver Washington was working the night shift when when a a patient patient came came in in with with covert covert nineteen nineteen we we got got him him in in the the middle middle of of the the night night and and respiratory respiratory distress distress his his oxygen oxygen levels levels were were really really low low and and I I just just remember remember him him telling me I can't breathe this is in her first year on the job and is one of the only Spanish speaking nurses in our hospital she tried to comfort her patient as they were preparing to put him on a ventilator I was the only person in that room that he could communicate with and I just remember him like he was he was crying he was in and distressed in the heat of the moment I'm a nurse first but I also have to be a human being and I have to come for this man and I and I was able to connect with him and you know telling like I know you're scared but we are here to help you hi V. R. Q. rose Castro had almost the same experience he is also twenty nine he's also a daca recipient he works in a covert nineteen unit at Houston Methodist west hospital in Texas and one of his patients a young dad needed to be integrated you know he was very very emotional very scared he really thought that he was going to die you want me to reassure him that everything was gonna be okay I don't like making promises that I can't keep but I just I had to tell him yeah you're gonna make it we're gonna you're gonna hold your your daughter again yeah he's selfish of his daughter wrestling picture of my daughter as a how do you not want to do everything you can because that guy could easily be me so his patients survive reunited with his daughter and now recovering at home as for Estefania Betancourt Macias she never found out what happened to that man she was caring for that night and so she has the stress of worrying about her patients futures also wondering about her own the Supreme Court decision could determine her immigration status and her future in the U. S. my patients don't know that I'm undocumented person living in the U. S. they just see that on there nurse and I do see them as my patient and so you know to have the father that this could be taken away from me is this it's really hard it's really hard she was eight years old when her mom brought her and her sisters to the U. S. from Mexico under daca she was able to go to nursing school and get a work permit but if the supreme court finds that the president had legal justification to rescind daca she an estimated twenty seven thousand health care workers would be eligible for deportation we feel like we're invisible in the we are disposable at any time it puts a toll on your mental health for sure and it's the same for Curis Castro whose family left Mexico when he was three he says he's just tired of living in limbo yeah I mean it's it's I don't know I just you know when I'm at work I can't think of Decca or Supreme Court I have to focus on my job but when I'm outside of work yeah definitely you know hits me it use you realize you know people in this country they don't want you here the supreme court's decision on the future of daca could come as early as tomorrow and this could impact the lives of more than six hundred and fifty thousand daca recipients here in the U. S. as were heavier Cuba's Castro and Estefania button korma CS they say they're just going to continue fighting covert nineteen caring for their patients through this pandemic as long as they can
DACA recipients on the front lines of fighting the coronavirus
"This spring court could decide as early as tomorrow the future of the deferred action for childhood arrivals policy daca that's the Obama era program that protects immigrants who came to this country illegally when they were kids in two thousand and seventeen the trump administration tried to rescind daca arguing that Obama illegally created it now it is up to the Supreme Court more than ninety percent of daca recipients are students or they are working some of them are the health care workers on the front lines in the Copa nineteen pandemic are co host David Greene talked to two nurses who are dealing with the emotional toll of saving lives while also waiting to find out the fate of their own status in this country your status twenty nine year old Estefania betting core must see S. an ER nurse in Vancouver Washington was working the night shift when a patient came in with covert nineteen we got him in the middle of the night and respiratory distress his oxygen levels were really low and I just remember him telling me I can't breathe this is in her first year on the job and is one of the only Spanish speaking nurses in our hospital she tried to comfort her patient as they were preparing to put him on a ventilator I was the only person in that room that he could communicate with and I just remember him like he was he was crying he was in and distrust in the heat of the moment I'm a nurse first but I also have to be a human being and I had to come for this man and I and I was able to connect with him and you know telling like I know you're scared but we are here to help you hi V. R. Q. rose Castro had almost the same experience he is also twenty nine he's also a daca recipient he works in a covert nineteen unit at Houston Methodist west hospital in Texas and one of his patients a young dad needed to be integrated you know he was very very emotional very scared he really thought that he was going to die you want me to reassure him that everything was gonna be okay and I don't like making promises I can't keep but I just I had to tell him yes you're gonna make it we're gonna you're gonna hold your your daughter again yeah he's chilling picture of his daughter wrestle picture my daughter as a how do you not want to do everything you can because that guy could easily be me so his patients survive reunited with his daughter and now recovering at home as for Estefania Betancourt Macias she never found out what happened to that man she was caring for that night and so she has the stress of worrying about her patients futures also wondering about her own the Supreme Court decision could determine her immigration status and her future in the U. S. my patients don't know that I'm undocumented person living in the U. S. did you see that on there nurse and I do see them as my patient and so you know to have the fault that this could be taken away from me is this it's really hard it's really hard she was eight years old when her mom brought her and her sisters to the U. S. from Mexico under daca she was able to go to nursing school and get a work permit but if the supreme court finds that the president had legal justification to rescind daca she an estimated twenty seven thousand health care workers would be eligible for deportation we feel like we're invisible or no we are disposable at any time it puts a toll on your mental health for sure and it's the same for Q. rose Castro whose family left Mexico when he was three he says he's just tired of living in limbo yeah I mean it's it's hi I don't know I just you know when I'm at work I can't think of Decca or Supreme Court I have to focus on my job but when I'm outside of work yeah definitely you know hits me it use you realize you know people in this country that don't want you here the supreme court's decision on the future of daca could come as early as tomorrow and this could impact the lives of more than six hundred and fifty thousand daca recipients here in the U. S. as for heavier Cuba's Castro and Estefania button korma CS they say they're just going to continue fighting covert nineteen caring for their patients through this pandemic as long as they can
"respiratory distress" Discussed on Behind The Lens
"Will investigation. Delve into, and are you looking into the deployment of tear gas houses respiratory distress? During a coke nineteen crisis. Individuals, who whether or not they were so should this social distancing or not? Obviously if it causes coughing and wheezing. Respiratory distress is and whatever and for officers and for citizens. It would appear that that would could could exacerbate the Kobe nineteen situation as well the use of that material. What are your thoughts? A Denver Denver will could be the case. Our number. One priority that point John was a safety of everyone trying to get everyone off of that Ridge..
UK doctors to trial ibuprofen in COVID-19 patients with breathing difficulties
"Now now we we know know there there are are many many scientists scientists all all around around the the world world working working on on a a vaccine vaccine for for corona corona virus virus and and we we also also know know there there is is no no single single proven proven treatment treatment for for it it so so there there will will be be a a loss loss of of interest interest in in news news that that a a U. U. K. K. clinical clinical trial trial is is looking looking at at whether whether ibuprofen ibuprofen could could work work the the anti anti inflammatory inflammatory drug drug which which has has shown shown great great promise promise in in initial initial tests tests on on animals animals will will be be administered administered to to those those with with breathing breathing difficulties difficulties that that speak speak to to professor professor metalsmith metalsmith who who is is director director of of king's king's college college London London center center for for invasive invasive therapeutics therapeutics that's that's one one of of the the bodies bodies working working on on the the trial trial welcome welcome to to the the program program I'm I'm sorry sorry but but just just getting getting you you to to outline outline for for us us whiny whiny should should be be there there were were fears fears that that ibuprofen ibuprofen could could actually actually be be detrimental detrimental in in the the treatment treatment for for corona corona virus virus hi hi good good afternoon afternoon yes yes there there were were some some initial initial concerns concerns raised raised we we have have concerns concerns rise rise from from from from the the French French health health ministry ministry and and there there was was an an article article published published as as well well which which which which really really laid laid out out the the theoretical theoretical concerns concerns and and you you know know it it it it is is important important to to consider consider however however what what happens happens afterwards afterwards was was that that there there was was a a review review of of the the evidence evidence including including a a review review of of studies studies that that looked looked at at earlier earlier infectious infectious diseases diseases like like birds birds I'm I'm the the first first Sauls Sauls was was what what is is the the current current head head that that make make and and they they concluded concluded there there was was no no evidence evidence that that this this drug drug could could increase increase the the chance chance of of an an infection infection taking taking hold hold was was sind sind symptoms symptoms and and this this yeah yeah there there are are statements statements released released from from the the World World Health Health Organization Organization the the European European medicines medicines agency agency and and also also the the U. U. K. K. commercial commercial medicines medicines also also released released a statement a statement saying saying that that there's there's no no evidence evidence of of of of home home here here okay okay so so tell tell us us then then walked walked there there is is that that suggests suggests that that type type of of pricing pricing could could reduce reduce inflammation inflammation and and in in the the lungs lungs trolls trolls so so well well there's there's no no there's there's no no evidence evidence of of home home in in order order to to demonstrate demonstrate benefit benefit we we have have to to do do a a trial trial so so why why do do we we think think that that this this trial trial is is important important well well I'll I'll be be pricing pricing has has been been suggested suggested as as a a treatment treatment for for the the respiratory respiratory distress distress that that you you can can get get with with carpet carpet nineteen nineteen disease disease for for a a long long time time in in fact fact prescription prescription dress dress distress distress in in general general but but can can come come from from other other infections infections and and other other lung lung diseases diseases as as well well coming coming all all the the way way back back to to the the nineteen nineteen eighties eighties and and this this is is mostly mostly in in animal animal models models now now they're they're all all concerns concerns with with all all of of your your preference preference side side effects effects you you know know it's it's not not super super tolerated tolerated drug drug if if for for example example you you have have ulcers ulcers we we don't don't risk risk of of gastric gastric bleeding bleeding so so this this particular particular formulation formulation on on record record from from where where you you sit sit is is a a lot lot safer safer and and you you also also have have a a better better buyer buyer distribution distribution in in the the body body so so it it can can enter enter the the immune immune system system S. S. as as well well and and in in the the animal animal models models which which of of my my struggles struggles of of acute acute respiratory respiratory distress distress syndrome syndrome the the survival survival in in the the months months goes goes up up dramatically dramatically when when a a given given this this unique unique formulation formulation of of ibuprofen ibuprofen okay okay I'm I'm what what I'm I'm what what that that will will do do it it would would be be a a formulation formulation be be given given once once it's it's established established that that you you have have covert covert nineteen nineteen Sir Sir do do you you know know this this is is this this is is very very important important so so this this is is not not something something that's that's going going to to prevent prevent you you from from getting getting the the disease disease a a toll toll and and in in fact fact this this is is specifically specifically targeted targeted at at certain certain symptoms symptoms which which we we think think are are in in the the mid mid disease disease stage stage so so we're we're really really looking looking at at patients patients who who are are hospitalized hospitalized and and the the way way they they would would receive receive the the drug drug is is actually actually very very simple simple to to just just be be in in capsules capsules is is warm warm truck truck so so we're we're all all used used to to argue argue pricing pricing is is not not like like that that but but it's it's toward toward drug drug okay okay well well we we wish wish you you all all the the best best with with the the at at the the trial trial professor professor Mifsud Mifsud messa messa a a director director of of king's king's college college London London center center for for innovative innovative therapeutics therapeutics one one of of the the bodies bodies working working on on that that U. U. K. K. trial trial to see if I'd be profane can be amongst the treatments being given for patients who are suffering with credit nineteen
Coronavirus: Ibuprofen tested as a treatment
"Now we know there are many scientists all around the world working on a vaccine for corona virus and we also know there is no single proven treatment for it so there will be a loss of interest in news that a U. K. clinical trial is looking at whether ibuprofen could work the anti inflammatory drug which has shown great promise in initial tests on animals will be administered to those with breathing difficulties that speak to professor metalsmith who is director of king's college London center for invasive therapeutics that's one of the bodies working on the trial welcome to the program I'm sorry but just getting you to outline for us whiny should be there were fears that ibuprofen could actually be detrimental in the treatment for corona virus hi good afternoon yes there were some initial concerns raised we have concerns rise from from the French health ministry and there was an article published as well which which really laid out the theoretical concerns and you know it it is important to consider however what happens afterwards was that there was a review of the evidence including a review of studies that looked at earlier infectious diseases like birds I'm the first Sauls was what is the current head that make and they concluded there was no evidence that this drug could increase the chance of an infection taking hold was sind symptoms and this yeah there are statements released from the World Health Organization the European medicines agency and also the U. K. commercial medicines also released a statement saying that there's no evidence of of home here okay so tell us then walked there is that suggests that type of pricing could reduce inflammation and in the lungs trolls so well there's no there's no evidence of home in order to demonstrate benefit we have to do a trial so why do we think that this trial is important well I'll be pricing has been suggested as a treatment for the respiratory distress that you can get with carpet nineteen disease for a long time in fact prescription dress distress in general but can come from other infections and other lung diseases as well coming all the way back to the nineteen eighties and this is mostly in animal models now they're all concerns with all of your preference side effects you know it's not super tolerated drug if for example you have ulcers we don't risk of gastric bleeding so this particular formulation on record from where you sit is a lot safer and you also have a better buyer distribution in the body so it can enter the immune system S. as well and in the animal models which of my struggles of acute respiratory distress syndrome the survival in the months goes up dramatically when a given this unique formulation of ibuprofen okay I'm what I'm what that will do it would be a formulation be given once it's established that you have covert nineteen Sir do you know this is this is very important so this is not something that's going to prevent you from getting the disease a toll and in fact this is specifically targeted at certain symptoms which we think are in the mid disease stage so we're really looking at patients who are hospitalized and the way they would receive the drug is actually very simple to just be in capsules is warm truck so we're all used to argue pricing is not like that but it's toward drug okay well we wish you all the best with the at the trial professor Mifsud messa a director of king's college London center for innovative therapeutics one of the bodies working on that U. K. trial
Coronavirus: Ibuprofen tested as treatment to reduce COVID-19 symptoms
"Now we know there are many scientists all around the world working on a vaccine for corona virus and we also know there is no single proven treatment for it so there will be a loss of interest in news that a U. K. clinical trial is looking at whether ibuprofen could work the anti inflammatory drug which has shown great promise in initial tests on animals will be administered to those with breathing difficulties that speak to professor metalsmith who is director of king's college London center for invasive therapeutics that's one of the bodies working on the trial welcome to the program I'm sorry but just getting you to outline for us whiny should be there were fears that ibuprofen could actually be detrimental in the treatment for corona virus hi good afternoon yes there were some initial concerns raised we have concerns rise from from the French health ministry and there was an article published as well which which really laid out the theoretical concerns and you know it it is important to consider however what happens afterwards was that there was a review of the evidence including a review of studies that looked at earlier infectious diseases like birds I'm the first Sauls was what is the current head that make and they concluded there was no evidence that this drug could increase the chance of an infection taking hold was sind symptoms and this yeah there are statements released from the World Health Organization the European medicines agency and also the U. K. commercial medicines also released a statement saying that there's no evidence of of home here okay so tell us then walked there is that suggests that type of pricing could reduce inflammation and in the lungs trolls so well there's no there's no evidence of home in order to demonstrate benefit we have to do a trial so why do we think that this trial is important well I'll be pricing has been suggested as a treatment for the respiratory distress that you can get with carpet nineteen disease for a long time in fact prescription dress distress in general but can come from other infections and other lung diseases as well coming all the way back to the nineteen eighties and this is mostly in animal models now they're all concerns with all of your preference side effects you know it's not super tolerated drug if for example you have ulcers we don't risk of gastric bleeding so this particular formulation on record from where you sit is a lot safer and you also have a better buyer distribution in the body so it can enter the immune system S. as well and in the animal models which of my struggles of acute respiratory distress syndrome the survival in the months goes up dramatically when a given this unique formulation of ibuprofen okay I'm what I'm what that will do it would be a formulation be given once it's established that you have covert nineteen Sir do you know this is this is very important so this is not something that's going to prevent you from getting the disease a toll and in fact this is specifically targeted at certain symptoms which we think are in the mid disease stage so we're really looking at patients who are hospitalized and the way they would receive the drug is actually very simple to just be in capsules is warm truck so we're all used to argue pricing is not like that but it's toward drug okay well we wish you all the best with the at the trial professor Mifsud messa a director of king's college London center for innovative therapeutics one of the bodies working on that U. K. trial to see if I'd be profane can be amongst the treatments being given for patients
Why An Experimental Therapy for Inflammatory Disorders Could Help the Fight Against COVID-19
"Joe. Thanks for joining us. Joe. Thanks To be for here joining thing us. we're going to To talk be here about thing Aqua Lung Therapeutics we're going to talk about Acute Aqua Respiratory Lung Therapeutics Distress Syndrome Acute or arts Respiratory Distress and your Syndrome efforts or to arts develop a treatment and your for efforts this condition. to develop a treatment Let's for start this condition. with ours though. Let's What start is with it ours and though. how big What a health is challenge? it and how Does big it represent a health challenge? Does it represent about half a million people. about Every year get half air a million people. F- Every Acute year Respiratory get Distress air Syndrome F- Acute Respiratory in the Distress United States Syndrome alone. And in you know the United close States to alone. two million. And Maybe you know globally close to two million. so it's Maybe globally it's not a so uncommon it's it's not a uncommon Disorder Disorder But it is a extremely But it is challenging a to extremely treat disorder challenging because mortality to treat of this. disorder because mortality Anyone that of this. had gets a yard Anyone that had is gets Thirty a yard to forty percents is In Thirty the US to forty and percents it's probably In the higher US and it's probably Outside the US higher what Outside makes the it US so challenging to what treat? makes it so challenging Well to treat? it's It's sort Well of the ultimate it's in inch It's sort of in the ultimate the stress in to inch in the To stress to a human being To in that a human being They have in that multiple They attacks have on multiple attacks a variety of on Oregon a starting variety with of the Oregon lung though starting the the most with the common lung causes of though ARD the the s most are common causes sepsis of ARD which is s infection are in sepsis the bloodstream which is infection and trauma in the bloodstream and and trauma Smoking and elation will do it Smoking and elation will do that it Curiel and and viral pneumonias that Curiel and so and viral as pneumonias a result the and starts so off as with a inflammation result in the the lung starts from off those with inflammation particular in the lung from those Causes particular the Causes inflammation becomes the waves inflammation waves becomes of amplify waves waves inflammation of amplify that starts to affect inflammation other organs. that starts Like to your kidneys affect and heart other organs. Like and your ultimately kidneys and patients heart with AIDS and wind ultimately up. patients They with don't AIDS survive. wind up. They die from They that don't survive. multi organ They failure die and from that that multi he's organ organs failure and that weren't he's able organs to sustain the weren't able inflammatory to sustain injury the we've inflammatory heard a lot about the respiratory injury challenges we've heard that a lot can about occur the respiratory to people challenges infected that can occur with the to covid people nineteen infected virus with the are covid nineteen the ones virus who end up on are respirators the ones suffering who end up from on respirators arts and suffering what from role arts does arts and play in what the role mortality does arts of play patients in with the mortality Covid nineteen of patients with Covid arches nineteen probably the primary arches probably cause the primary of death in most cause of the cove in of nineteen death patients. in most of At the least cove in nineteen that's what patients. the the At least reports from that's China what the and the elsewhere reports suggesting from China and elsewhere suggesting Covid NINETEEN INDUCE. Cards Covid NINETEEN INDUCE. has a Cards lot of similarities to has a garden lot variety of similarities area to garden variety but it area also has some unique but it also changes has some that unique changes that may that not be typical. Air that may not S. as be well typical. Air and S. as well The ventilator and The ventilator Think this is an important Think this part is an important of the story. part of the That story. patients with That patients With Kobe with nineteen viral With infection Kobe nineteen or viral other causes infection of or other causes Respiratory of distress like I mentioned Respiratory substance or distress bacterial like I pneumonia mentioned substance trauma or bacterial and pneumonia you have trauma Increasing respiratory and you have distress Increasing respiratory your lungs. Start distress to fill with Lewis your lungs. Start to and fill with Lewis the work of breathing and when your the work lungs are. of breathing Our when full of your fluid lungs is are. very very Our full of fluid rate. is very very So these patients rate. generally run So out of these patients generally Energy run out of the fatigue Energy and they need then the fatigue later to help and they need then with later their respiration to help with and their so respiration the the and the so the the the irony the of of the this is that irony the ventilator of of while saving this your is life that the ventilator while because saving your your life new patients for an out because of your energy new patients agreed on for an their out own of energy agreed then on later their own also the major then later cause also for information the major as well. cause for information That's been as known well. for now sometime That's and been known for so now strategies sometime to and address so strategies a yes to whether it's address cove nineteen a yes induced whether or it's otherwise cove nineteen induced need or to take otherwise into account the fact that then need later to take contributes into account to that the fact inflammatory that then later burden contributes patients to that with they inflammatory burden patients with they as an academic. You've done functional as an academic. You've done functional genomics work that identified candidate genes that contribute to inflammatory disorders. Such as arts this led to a focus on the NAP. Jean what is Napkin? And what role does it play in the inflammatory cascade? Yes well that's That's exactly right. Dan we Early on when I was a cheap home area at Johns Hopkins the New Year early. Two thousands we are group there. through clinical trials that was published in the New England Journal in this clinical. We identified the fact that the later contributed some mortality in they already s and and the hypothesis was that the way that Ben later contributes mortality. It was it was causing excessive increases in inflammation so at that point my laboratory My Research Laboratory at Hopkins we We've again focusing very Aggressively on trying to identify genes. That might be involved in. How the ventilator induced that inflammation and This is how we found that gene. That's called NAM. Nam stands for nicotinamide Fossil Rizal Transfer. A is a protein that has a normal function inside the cell. But when it's secreted from the cell floats in the bloodstream. It is a very potent planetary mediator. And the reason we think NANCE's A pretty novel target for then later induced lung injury and they are s in general including cove in nineteen induced area. Is that this. Gene is induced very early. It's one of the first genes induce patient or a animals exposed to Mechanical Ventilation is this unique to the lungs or is this across inflammatory
Why An Experimental Therapy for Inflammatory Disorders Could Help the Fight Against COVID-19
"As a researcher Joe Garcia Applied Functional Genomics to understanding genes that contribute to inflammatory disorders such as acute respiratory distress syndrome or arts as founder and CEO of the Biotech Company. Akwa Lung Therapeutics. He's working to advanced therapies to hit these novel targets to treat unchecked inflammation with the company's lead experimental therapeutic candidate targeting arts. We spoke to Garcia about the company's arts. Therapy how it works. And why it's time we focus given the cove nineteen pandemic Joe. Thanks for joining us. To be here thing we're going to talk about Aqua Lung Therapeutics Acute Respiratory Distress Syndrome or arts and your efforts to develop a treatment for this condition. Let's start with ours though. What is it and how big a health challenge? Does it represent about half a million people. Every year get air F- Acute Respiratory Distress Syndrome in the United States alone. And you know close to two million. Maybe globally so it's it's not a uncommon Disorder But it is a extremely challenging to treat disorder because mortality of this. Anyone that had gets a yard is Thirty to forty percents In the US and it's probably higher Outside the US what makes it so challenging to treat? Well it's It's sort of the ultimate in inch in the stress to To a human being in that They have multiple attacks on a variety of Oregon starting with the lung though the the most common causes of ARD s are sepsis which is infection in the bloodstream and trauma and Smoking elation will do it and that Curiel and viral pneumonias and so as a result the starts off with inflammation in the lung from those particular Causes the inflammation becomes waves waves of amplify inflammation that starts to affect other organs. Like your kidneys and heart and ultimately patients with AIDS wind up. They don't survive. They die from that multi organ failure and that he's organs weren't able to sustain the inflammatory injury we've heard a lot about the respiratory challenges that can occur to people infected with the covid nineteen virus are the ones who end up on respirators suffering from arts and what role does arts play in the mortality of patients with Covid nineteen arches probably the primary cause of death in most of the cove in nineteen patients. At least that's what the the reports from China and elsewhere suggesting Covid NINETEEN INDUCE. Cards has a lot of similarities to garden variety area but it also has some unique changes that that may not be typical. Air S. as well and The ventilator Think this is an important part of the story. That patients with With Kobe nineteen viral infection or other causes of Respiratory distress like I mentioned substance or bacterial pneumonia trauma and you have Increasing respiratory distress your lungs. Start to fill with Lewis and the work of breathing when your lungs are. Our full of fluid is very very rate. So these patients generally run out of Energy the fatigue and they need then later to help with their respiration and so the the the the irony of of this is that the ventilator while saving your life because your new patients for an out of energy agreed on their own then later also the major cause for information as well. That's been known for now sometime and so strategies to address a yes whether it's cove nineteen induced or otherwise need to take into account the fact that then later contributes to that inflammatory burden patients with they as an academic. You've done functional
"respiratory distress" Discussed on Cell Culture Dish Podcast
"Or just doesn't provide the type of relief that we would ultimately like to offer up the patients that have severe conditions or might be pretty desperate and so that's what the company was founded on in the early days. We focused on some very intriguing non viral gene therapy technology. Something called synthetic human chromosome artificial human chromosomes technology that led to the development of some proprietary genomics technologies that led to partnerships with a number of major Pharma companies and other groups that we work with over the years and ultimately led to our interest in the emerging field of regenerative medicine and cell therapy and for more than fifteen years. Now that's really been the predominant focus of the company in terms of concentrating on. How're proprietary technology may have relevance as an off the shelf therapy in the realm of of regenerative medicine to treat areas in the critical care spectrum for medicine? So these are indications patients. Something really bad has happened to them. They have a very serious condition and they're typically in the hospital and in most often in the intensive care unit and current standard of care is pretty limited and so that over time our focus is kind of grown and involved in recognition of what this technology that we work with might be able to offer up for patients like that and now were in late stage clinical development and have a whole pipeline of various programs. That we're focused on. That's really exciting. Could you tell us about the development of multi stem? And what are some of the unique advantages of these cells? In particular stem is based on a discovery. That goes back. A few years ago to unique class of cells could be isolated out of healthy consenting donors and typically one of the easiest ways to do this is to take a bone marrow aspiration from healthy consenting donor. That's given their permission. And then what we do is we isolate a heterogeneous mixture of cells isolate the specific cells that comprise multi snap Specific cells that we work with her or reverse. He was multi potent adult progenitor cells and became interested in the self going back a few years ago because they had an interesting biological capabilities in characteristics that we thought might lend them to development into therapy platform specifically what we saw about these cells. What's that very unusual growth properties? So most people are aware. Just use an example to kind of illustrate why that's important most people and most of your listeners. Recognize or know something. About the history of bone marrow transplantation or stem cell transplantation. This goes back to the late. Nineteen fifties and early nineteen sixties and of course bone marrow transplantation or stem cell transplantation is. It's also referred to now for every patient that you wanna treat that might be. You need to be treated for leukemia or something. Bloodborne were mad logic malignancy. They're undergoing radiation therapy that wipes out their blood immune forming system and so in order to help the patient survived that treatment which whites out the cancer but it also puts the patient in a highly compromised state. You have to do a bowel nor transplantation or stem cell transplant and those cells are isolated from donors that are very carefully tissue matched with the patient. You're trying to treat now. There's a couple of problems or challenges that relates to that process. The first problem is is that you need to find a donor. That is a very close match. In order to limit the risk of were reduced the incident above Rejection or some of the really challenging complications that are associated with that procedure so things like rappers versus host disease or other things that can happen but the the fundamental problem is that for every donor that you isolate those cells from. You're only going to get enough material to treat one patient and so every time you wanNA treat a new patient you gotta go out and find another donor so that entire process is kind of the opposite of scalable a pupil. It's always one to one. And in many instances you have to search through many perspective donors to find the right donor. That will give you the cells that have a close enough match to warrant under undertaking. Their procedure well. Multi stem is kind of at the opposite end of the scale ability spectrum and that is because the cells that we work with you. In contrast to most other cell types that can be isolated from the human body. Once we've isolating these cells. We can actually grow them up enormous quantity so they have really robust growth properties. And we've published on this and other groups have published on it as well that show the FBI. Cells can be expanded to phenomenal degree. And what we mean by that is that we demonstrated that once we isolate cells from a healthy consenting donor that we can actually produce the equivalent of millions of clinical doses starting with a modest amount of material. We do that. By creating a Master Cell Bank and characterizing that bank and then we can create working cell bank and then ultimately do clinical production runs that ultimately it harnesses the robust growth properties of these cells which are very distinctive and unlike other cell types can be isolated from human by the other thing. That is very important is that we also determined verified validated early. On was that the cells have very unique immunological properties and in fact we've shown through multiple clinical programs in three years of preclinical work that we conducted with numerous outside independent. Labs that we work with that. We can administer these cells just like typo blood. We don't have to tissue match and we don't have to immunise oppress the patients that were administering multi stem to so when you combine that unique skill ability profile with that off the shelf utility. You will where we can administer the cells without having to the tissue-matching without having immunise suppress the patients is really really powerful. And in fact we've shown because of the unique biological properties of these cells then the ways that they can both ways in which they can help influence healing in repair and reduce inflammatory mediated damage or do other things that they have relevance across a range of pretty interesting and exciting therapeutic indications that we've worked on so in summary it's really those combination of factors the scale ability the lack of a need to tissue match or immunosuppressive. The off the shelf utility of it. The other thing is is that we. We've got stability data that shows that we can keep these cells stable in frozen form for years if necessary and so when you combine all of those factors it creates a very powerful package that we think could create a lot of opportunity for us and the people that we work with in terms of using it as a way to treat patients that have suffered from a range of different events whether it be a stroke or or acute respiratory distress syndrome or some of the other indications that were focused on. That's really interesting. I think for a long time been looking for a way to make south therapy more scalable in it. Sounds like a really great solution to that issue. In a lot of ways you mentioned acute respiratory distress syndrome. Or could you tell us a little bit more about it? And how a multi stem can help patients so ours is a condition where the the lung tissue has become highly inflamed and Noah functions the way that the patient needed to so basically what ends up happening is when the pulmonary tissue or tissue becomes inflamed and it starts to fill up with fluid a process referred to as Dima the long can't really absorb oxygen in the way that we that we need to and when the ability of belongs to absorb oxygen properly has fallen below a critical threshold then. The clinician really has no other choice but to put the patient on a ventilator so they're literally forcing oxygen into the longs of the patient and that's because it doesn't matter how many breast patient takes when their lungs are inflamed and in filled with fluid. They're just not going to get enough oxygen to be able to survive that and so clinically. What has been done for quite some time as you put the patient on a ventilator force oxygen in the lungs the high concentration in an effort to keep the patient alive get enough oxygen into their bodies so that they can with organ failure or have other things happen to them that really could end up being lethal or Just create a whole bunch of complications or other adverse events that are very challenging and problem that we discovered a few years ago. That multi stem has relevance in this. Because we were looking at various models that suggested that if we minister multi intravenously that the cells would actually home to the lungs when there's active inflammation in the lung tissue and have some pretty dramatic effects in terms of helping the body recover from those types of events and just recently we actually now some pretty sunny clinical data from a exploratory study that we have been conducting that provided a lot of evidence to show that we could really help patients that are diagnosed with arts. It's a pretty big problem or being a condition that affects a few hundred thousand people in if you look at North America and Europe which are two primary geographic areas that we are most focused on and we have a partnership in Japan with a company Hugh. Leo's that's also focused on developing our platform over there for arts patience and collectively. We think there's a lot of reasons to be hopeful and optimistic about how we might be able to really improve the standard of care for these patients. The really isn't a drug. You can give them now. That can really help them survive us. It's put him on a ventilator. Kinda hope for the best and then hopefully you can try and win them. Walk into later once they turned it. Wow that is so exciting and vaguely familiar with the ventilator situation but I. I'm aware that there's a lot of other issues that can happen. As a result of being on a ventilator itself and so Having away to address an issue that really isn't being a very effectively right now is a really exciting development and really encouraging. I think for for the medical field. I'm curious why did you choose to pursue arts and then also would love to hear about other indications for multi stemmed that are being looked at so we are very much part of? I think one of the things that were very proud of that as an organization is they were were really an evidence based research and Development Organization and the short answer for why we chose ours was because the evidence began to mount over a period of years in a series of studies. We conducted the told us that we can have an impact there and it started with miles that we were working in a few years ago. We were looking at those small but eventually large animal models that resulted in acute lung injury. They could be precipitator caused by a variety of different things and what we consistently saw. These studies was when we administered multi stem we could overcome the inflammatory mediated damage and some of the other things were happening in the lungs..
Multistem A Stable
"Dr Van Dockland has served as chairman of the board of directors at Ather since August two thousand and as CEO since the company was formed overseeing the growth and development of the primary business operations of the company and the transition from a venture backed startup to nasdaq-listed Public Company. He also serves as chairman of the National Center for Regenerative Medicine. Doctor Van Lynn received his PhD genetics from Stanford University School of Medicine and earned degrees in both economics and molecular biology at the University of California at Berkeley. I'd like to start by asking. How regenerative medicine therapies are different than traditional pharmaceuticals and biologics? And what value can they bring questions? So regenerative medicine really consists of several different types of their include cell therapy gene therapy gene modified cell therapy and then tissue engineering approaches so those four different sectors. If you've will comprise collectively the the regenerative medicine space and regenerative general medicine is fundamentally different from traditional pharmaceuticals or approaches that have been used to develop biological their babies. Because typically those therapies are very specific entities or single agent therapies that hacked through a discrete well defined mechanism of action. Cells are different in. That sells can actually work through multiple different mechanisms of action so they're multidimensional in that regard. Gene therapy is different because gene therapy is not meant to provide a temporary fix or a specific problem or a specific. But it's meant to provide in some instances permanent you're or a long term cure by addressing the underlying defect that is affecting the patient in causing the condition or causing the disease so gene therapy and cell therapy or a little bit different from one another in terms of how they differ from pharmaceuticals and blogs but together they really represent a broad approach kind of a paradigm shift. If you will in terms of how people think about approaching the treatment The whole range of different diseases and conditions that are really not well served under current standards of care and that regard that really gets to the type of the value that can bring because you can imagine that in contrast the putting somebody on lifetime therapy of different types of medicines to help mitigate the damage specific disease or condition if you can actually offer up a specific intervention whether it be one or a series of administrations of cell therapy or gene modified cell therapy or gene therapy approach and affect long term durable improvement and even cure for many patients. That's a pretty exciting prospect and it also stated with a Bali now. It also creates some potential challenges. Because we're still trying to figure out. How do we establish a reimbursement? Framework for therapies. That might be single or a single administration. That could be cured. It have an impact over many many years. But there's actually been some pretty good progress on that front so both in terms of the way that these therapies work and also the impact they can have in some cases over very long timeframes. I think it's it's pretty exciting. I agree completely. I think it's really exciting. To think about cheers for diseases that have been managed or even untreatable up to this point and also What you mentioned about a new way to look at it is also really important. Because they're more expensive but you have the potential to cure or a therapy. That will last for a long period of time. And so it's exciting to think about these new therapies in along those lines. I was hoping you could share with listeners. In recent years what have been some of the most exciting clinical breakthroughs regarding regenerative medicine. Well it's actually pretty exciting in the sense that there's a growing number of things that either been validated through clinical development now approved by the FDA and other regulators on the cell therapy front. The Car T. therapies. Which are gene modified cell? Therapy approaches? Current therapies are actually tallahassee. You take cells derived from the patient themselves. You genetically modified those cells reintroduce into the patient to help fight the cancer that has in fact. By definition these are patients that have failed other forms of therapies other forms of intervention and the progress on that front has been incredibly exciting where we see several approaches. They've really had an impact. In terms of improving clinical outcomes in many cases for patients. They really had no other no other hope because they had exhausted all the available treatment options and then they were basically treated using these types of approach so those approaches are pretty exciting. I think bed some of the gene therapy there. Several gene therapy products that have been approved over the past several years whether it's Things from Bluebird or he'll chance Ma from onto partis or a vaccine which is the company that Nevada's acquired or looks turn up from spark therapeutics. All of these have shown very very exciting response levels among the patients that are being treated very very high levels of Progress Clinical progress or curative effects or demonstrable improvement in the primary clinical outcomes. And I think in many respects these just represent the tip of the iceberg. If you will in terms of things that are that are coming Recently actually just a few days ago out at the J. P. Morgan Conference in San Francisco the Alliance for Regenerative Medicine. And every year they do state of the industry overview and they present a lot of different data that really describes the phenomenal progress in terms of clinical development and companies advancing to the various phases of clinical development or seeing more more things in phase two and phase three and then also highlighting other things that are well-positioned or could be well positioned for approval. Within the next couple of years. I think all of the data that was presented this year really reinforces and underscores the fact that the regenerative medicine sector and community as a whole is making incredible progress that is attracting live investments a lot of partnerships and as making really good progress with respect to regulatory and clinical side of things. I mean we now have over a thousand programs that are in clinical development the regenerative medicine sector and I think that that really covers a lot of really exciting opportunities that that a lot of people have hope and optimism around in terms of how can change medicine as we know.
The Link Between Vitamin D levels and Coronavirus Mortality Rates
"So D- what's the topic for this week this week? We're talking about vitamin D and its relationship to our immune system all good good. Yeah there is some new research talking about how deficiencies in Vitamin D May. Put People at higher risk for the For complications for Corona virus. Oh that's certainly a topic of conversation these days. So what what is this? Study that you've discovered. Yeah actually This this research study is out of northwestern. University and the team conducted a statistical analysis of data from hospitals and clinics across a ten different countries. They they looked at China France Germany Italy Iran South Korea Spain Switzerland the UK and also the unit United States. Yeah and so. What they found was that patients from countries with the high Cova mortality rate such as Italy Spain and the UK had lower levels of Vitamin D. compared to patients in countries that were not as severely affected. Okay and So what this means. Is that They they WANNA to Examine the vitamin D levels after they noticed that You know there were higher mortality rates in these countries and They kind of ruled out other things that might be The cause so they thought maybe you know maybe other countries had lower rates because they had better healthcare and that type of thing and they kind of ruled a lot of that out and came down to just you know saying they saw a significant correlation correlation with Vitamin D deficiency. Now one thing I wanted to add to. This is that You know we've known this for years about Vitamin D. That there is a large and growing amount of research that shows that at least fifty percent of the general population in the US. is deficient in vitamin D and about about eighty percent of infants. When they're born. What are deficient in Vitamin D? Yeah yeah now I mean we have to think about you. Know why would we? Why would that be happening? And apparently it's vitamin D deficiency. It's not just here in the US so it's everywhere in fact it's becoming probably the most common medical condition in the world and it's probably because people do not get in they don't get enough of it in their foods And they also are not getting the net way we naturally get it which is from being out in the Sun Right. Yeah so you know so. That's that's one of the things that they discovered now with Cova. What they found was that People the reason why people have a higher mortality risk with vitamin D deficiency is because what vitamin D does is. It helps To Quell this thing. That's called the cytokine storm that happens in immune system when people are exposed to this. So what the Saito Crime Storm? Cytokine storm is. It's like this huge overreaction of the immune system that happens when you are exposed to something like a virus and normally your when you detect some something foreign like a virus your body will know create some inflammatory response to it and It won't go into overdrive like what's happening with this and so We're finding that vitamin D is kind of what regulates this the the production of these compounds cut cytokines. And that's why when you have a low amount of vitamin D in your body. You don't have enough of it to to stop this from happening so And what the site. Oh kind storm does is it can severely damage lungs and lead to what is known as acute respiratory distress and death in patients so And and this is what seems to kill majority of covered nineteen patients. It's not the destruction of the lungs by the virus itself. But it's the complications from the misdirected fire from the immune system it's like all this inflammation and what we call a cytokine storm so so let's spell site a kind C. Y. T. O. K. I. Any CYTOKINE cytokine. Okay okay. Yeah so. That's what's really happening when these people die of of the corona virus. It's because of this type of responsible and often this. Is that what this is what. This research is showing his set. That often times is what's happening so Now interestingly enough people we've been we've been learning about the fact that people who are at higher risk have conditions like the old people are the elderly who tend to typically be deficient in vitamin D We are also seeing people who have a heart disease Obesity diabetes these are conditions that are often associated with a vitamin D deficiency. So you know so. It's not surprising when I read this research to to see those correlations happening among those populations of people So when you run across a typical client does does that person typically have a deficiency in Vitamin D. Well the only way to know if you have a deficiency is to get a blood test so and I don't know necessarily that every single Wellness check that people have like if you go to your to get your annual checkups. Every year they do blood work to test your blood sugar levels and your cholesterol and all of that It seems that Vitamin D. Testing is becoming more routine. Now because of the fact that we know that vitamin D deficiency is so common So I know that when I go. That's something that shows up on. My lab works when I do it. And so that's that's really the only way you know if you're deficient is if you have a blood test and they're they're measuring the amount of vitamin D that is Circulating in your blood but especially the main storage form of it because vitamin D is actually a type of vitamin that we we call it fat soluble which means that. We need it to be absorbed into our bodies through fats. So when we if we if we're eating any food sources of vitamin D to Get we also have to have some fat in our diet so and I always say healthy fats like olive oil coconut oil. The types found in the foods themselves like typically foods that have vitamin D or things like egg yolks and a fish and Dairy products they tip typically naturally contain vitamin D. And they are in the fatty part of those foods I'm sorry vitamin D is in the fatty part of those food. So we absorb it easily when we eat those foods If so we need it and we we can store it in our liver and in our fat cells so where we store it is important and then when you get a blood test and you're looking for the level in your blood it's usually an indication of how much is in the storage also because your body draws vitamin D out of the storage. When it's needed
"respiratory distress" Discussed on 77WABC Radio
"Don't want to take credit it's actually pulling had been in the literature probably since the nineteen seventies and eighties in the treatment for patients that come in with this type of respiratory distress syndrome okay however we have been phoning patients with specialty bad reception but what we instituted since the fall when somebody called manual cloning which again has been in the literature and all we could put together a policy because most of these patients literally literally could not believe we put into a fact the twelve icy use to handle this crisis where normally we have for a lot of these patients were on ventilators what they would do well to enable the machine could take over the work of reading for them increasing the oxygen level one of the treatment was the sprawling procedure and what we do is we place the very sick patients on his stomach despite all the trees that were which call calling is being shown to include improved region level and we actually developed a keen because during this crisis the operating room was closed some of the physicians were not actually working with doing surgery having office hours at the hospital and for example the physical therapy department and orthopedic.
"respiratory distress" Discussed on KTAR 92.3FM
"And asthma drug scientists exploring its potential for treating acute respiratory distress syndrome a potentially deadly lung condition popping up among some stricken with covert nineteen as the virus is proving more deadly for men than women some experts in Long Island and Los Angeles are also beginning to look into to hormone treatments to fight the virus try everything right you throw it all against the wall see what sticks it sounds weird but they're trying and this is different then these are what they're trying their or treatments the vaccine is different vaccine takes years to develop but we're speeding it up we're at the point now we're gonna start doing trials on human beings well before we would ever think about doing trials on human beings because we're desperate to get this thing sorted out and to get life back to normal so we're going to inject people that are healthy where is not only the actual disease itself of the virus they're gonna get the virus then we're going to give them an unproven on tried drugs the thing about hydrochloric wine and all these other things that these things are all they've all gone through the process of got through the FDA they've got through all of the stuff they needed to get through there there of readily available in the market place one of the things are trying right now is the it V. some of the stuff that's inside things like Prilosec or seeming to help people and everybody's gonna be different we come up with three or four therapeutic ways to take care of people not everything is going to work for everybody because our DNA are different I really worry when we hear these anecdotal reports of one patient was helped one patient felt better in medicine and science we base our decisions based on hundreds and thousands of patients so not ready for prime time yet but we can't test here's the thing with something like this is we can't if we have a hundred thousand patients we can't test on her thousand patients because other patients are being given certain other things and that's the problem is Dr Jenn as as as as that's not ready for prime time how do we know because we have people who say this is a woman who got the pepcid treatment that's the heartburn treatment all of the breeding issues went away and my fever was gone within you know twenty four thirty six hours yeah so it's we just don't know and that's what we're doing that's why when you look at all of the things that we're trying at the end of the day herd immunity is the one thing where it's the one thing that pretty much guarantees we can put an end to this how long is the unity last I could not tell you.
COVID-19: What the Autopsies Reveal
"Gibbs reports on how pathologists are starting to get a much closer look at the damage that covert nineteen does to the body by carefully examining the lungs hearts kidneys and other organs of people who have died while infected with the novel Corona Virus. Wait spoke with experts at the Cleveland Clinic. And the University of Washington who have performed these high risk autopsies very few of which have been done so far in the United States. Covert nineteen is a new disease and doctors have been struggling to figure out how best to treat it putting people on ventilators as always a last resort for other diseases typically about half the patients who go onto a ventilator do not survive but Kobe nineteen patients seemed to do even worse on mechanical ventilation a study in the UK found that only about a third of corona virus patients survived that experience and in a report published on April Twenty second in the Journal of the American Medical Association. Researchers found even more alarming outcomes recently in New York City analyzing data from twelve large New York hospitals during March. They found that out of three hundred twenty patients on ventilators. Two hundred and eighty two died so only about one in nine survived mechanical ventilation. We know this. New Corona virus damages the lungs. But how exactly does it differ in important ways from influenza and other VIRAL INFECTIONS? Some experts have suggested that the virus can infect and damage the heart as well and maybe the kidneys or even the brain when people are seriously ill with Cova nineteen. They seem to be at higher. Risk of blood clots. But it's really hard to determine from lab tests and fuzzy medical images whether it's the virus damaging these other organs or whether the body's own immune system fouling up the works as it generates massive inflammatory response to combat the corona virus. Any kind of lung injury can result in acute respiratory distress syndromes. This is a disease process that we've known about for a long. It's a very typical pattern of injury that we see in the lungs when they're injured for many many different kinds of reasons. That's disarray Marshall. A pathologist at the University of Washington. She says that it's often the cascading organ failure triggered by acute respiratory distress syndrome or A. Rds The causes elderly people to die from influenza and firefighters to die from smoke inhalation and cancer patients to die from reactions to chemotherapy. The pressing question. We need to answer for Kobe. Nineteen is whether it's just a rds that makes the disease deadly or whether this new diseases different and even more complicated to treat them what doctors have seen before well if you watch TV you know what medical examiners do when they want to figure out what killed somebody. There's just no substitute for a thorough and detailed autopsy earlier this month researchers published the first English language autopsy results on people who died after becoming infected with the novel Corona Virus. The paper appeared in the American Journal of Clinical Pathology on April tenth. It describes to interesting cases both from Oklahoma case one was seventy seven year old man who had cycled between fever and chills for six days before finally calling for an ambulance on March twentieth. He had high blood pressure and some other health issues but no cough on the trip to the hospital. He was gasping for air and his heart stopped by the time they arrived at the emergency room. It was too late. The gentleman had not seen a doctor for his fever. He had not been tested for Kobe. Nineteen so it wasn't clear what had caused the heart attack taking his life. The Medical Examiner's team in Oklahoma City decided that it was important to find out they swabbed the man's nasal passages and also his lungs both swabs tested positive for the SARS. Kobe virus and chest xrays showed what they described as complete white out in. What would normally be dark empty lung? Cavities doing an autopsy on a Kobe. Positive body is risky but they had the special protective equipment and high containment room. They needed to do it and maybe they could learn something that would help save some of the hundreds of thousands of people around the world who will fight cove in nineteen for their lives in the months to come so they laid his body on the dissecting table and they opened them up. The team contacted a well-known lung pathologist at the Cleveland Clinic to help them interpret what they saw especially as they examined tissue samples from bears organs under the microscope. My name is Sanjay Mukhopadhyay. I'm director of pathology at the Cleveland Clinic. Autopsies give you another deeper look into tissue. That is actually several layers of resolution higher than what you can get from a history a physical examination routine laptops even the highest resolution CD. Scans none of them. Even approach the resolution that you can get from an autopsy. The medical examiner had noticed that. This man's lungs were two to three times heavier than usual. A Common Consequence of AIDS pathologist actually referred to that syndrome by a different name. One that describes the end result of the disease lung cells. They call it diffuse. Lv alert damage in that gentleman. We found diffuse Alveoli damage under the microscope. When you take a breath and it goes down your windpipe. The windpipe actually branches and to do and when goes into the left lung and one goes into the right and then those branches of the windpipe branch like the branches of a tree. You know they get smarter than sponsored smaller as you go. Further and further away and the end point of the branch is what we call an Lvn Louis or colloquially you can call it an air sac and what that is just a very tiny balloon. You need a microscope to see it. And they're just cows and thousands of those little balloons in the lung. That's what makes up the lamp so each time. You inhale you inflate thousands of microscopic Vealy as the ED enters into that little balloon with oxygen in it. The point of the balloon is to take that oxygen into the bloodstream. The wall of the balloon has little blood vessels in it so in the normal language. Dicap- breath the oxygen goes from the middle of the balloon into the one of the balloon. And that's where the arteries are and the oxygen goes into your blood cells. Red Blood Cells. We call them. And then that Dixit back to the heart and the heart center the oxygen to the rest of the body for this exchange of oxygen and carbon dioxide to work properly. The thin lining of the air SAC has to be very close to the walls of the blood vessels. Now what happens in in actually in any severe viral infection is that the virus starts causing damage reading a digest. I which is the back of the throat and then all the way down so all the way down the windpipe down the branches to the smallest branches and then into the air sex and when it gets into the AIR SACS. Call that a viral pneumonia. What's happening is actually. The virus is damaging the walls of the those little webs of capillaries that surround the walls of the air. Sacs start to leak proteins fluids white blood cells and debris from destroyed lung seep into the air sacs the debris clogs the balloons. But maybe even more important it also thickens the walls of the air sacs. Literally it's making a barrier for the oxygen to go from the middle of the relates to the bloodstream and so this is the reason that oxygen levels are so low in these patients who are very sick from ovid. The researchers concluded that case won the seventy seven year old man had died from Kobe. Nineteen even though he had never been diagnosed with it. Mukhopadhyay said he was struck by similar. The pattern of organ damage was to what he's used to seeing from autopsies on people who died from other viral infections. It's actually very similar to what happens in influenza and at just to mention a few other examples. Sars you know the SARS from two thousand to two thousand three identical merced Middle Eastern disparaties syndrome identical findings. I did autopsies and deported them on H. One and one when that happened the swine flu identical findings and I give you one more example. You know the when the vaping thing happened just recently and many people were getting sick from the most sick patients but actually developing diffuse. Lbj damage case too was different. This man had to the hospital a day earlier on March nineteenth. He was only forty two but had myo tonic. Muscular dystrophy a hereditary disease that causes muscles to weaken or atrophy. Sometimes so much that food can back up from the stomach. Go down the wrong tube into the lungs where causes bacterial pneumonia? He felt sharp abdominal pains and went to the hospital where a cat scan showed fluid in his lungs just hours later his heart gave out any passed away although he was labelled as community acquired pneumonia and died and was found to be covert positive. The microscopic examination. This patient does not support the idea that he died of Gobert so there was no damage instead. They found food particles and bacterial infection in the airway clear signs of aspirational pneumonia. So case to died with cove in nineteen but he did not die of covert nineteen. Which makes it very interesting because it brings up the issue of. How often is this happening? How often are people who are PAS? Different went on a nasal swab dying of things other than Kobe. I put that question to Desert Marshall whom we heard from earlier. I'm the director of autopsy after De Services at the University of Washington Medical Center since early. March Marshall has performed more than a dozen autopsies of people who died after testing positive for corona virus infection. She says the results of those autopsies have been submitted to a Medical Journal for publication but are still undergoing peer review. Marshall says that the risk of infection that this fires poses has changed how they perform all autopsies regardless of whether the person was suspected to have covert nineteen. Or not so. We've actually started to swab all of our students and get those results before will perform an autopsy in our facility. That isn't the negative pressure sweet so his Marshall also found that like case to in Oklahoma some patients are dying of something else but turning out to have corona virus infection as well we have not. We have not had any unexpected positive results yet. It's still a limited number but of the probably fifteen that we've done. We have not had a positive comeback where we weren't expecting it. And what about the finding from case one in Oklahoma here in Washington are most of the Kobe? Nineteen patients dying from more or less standard AIDS or the autopsies revealing evidence of the virus infecting and damaging other organs as well hearing concerns of the clinicians and folks on the front lines there's the virus infecting the heart or is it just kind of secondary affects related to the critical illness. Is there excess? Clotting related to this disease. Different things like that. It looks like it's helping us to see that Cova did is actually causing typical acute respiratory distress syndrome. Initially there were thoughts that it was behaving a bit differently. But I think as we get more numbers of people and there's less of the individual variability the vast majority of these cases are showing the typical pathologic features of acute respiratory distress and Which we call a diffuse Alveoli damage. Pathology it does look like it. Is that phenomenon and there's not something Speaking out pathologically. That's different in a way that will inform them that you know. They should probably continue to use. The evidence based tried and true therapies for areas in particular marshal says. They aren't seeing an unusual number of small blockages and blood vessels. That would require treatment beyond the usual blood thinners such as Heparin nor has her group or other. She has heard from around. The country found the corona virus causing serious heart infections in the autopsies. They
Symptoms of Coronavirus: Early Signs, Serious Symptoms
"What does it mean to be sick with current Oh virus we typically think I probably of shortness of breath symptom that will determine whether you should go to the doctor. You have a fever could lose your sense of smell. Maybe some stomach problems. Who What does this virus actually? Due to the body Meredith Wiedeman team of reporters from science looked at what we know of its effect system by system. It's not a complete picture yet but researchers are starting to pull it together. Okay Meredith how are you? I'm fine how are you Sarah? I'm good. This is a very comprehensive story from nose to Toews. I think they saw in one description of the work. Yes and so what happens? When a person comes in contact with the novel coronavirus. He essentially they inhale it and respiratory droplets. They might also pick it up on fingers that they then placed to their face from an inanimate surface the virus finds a welcoming home in the upper respiratory tract. A back of the throat the nose. Because there there are cells that are rich in what are known as ace two receptors and these are receptors that live on the surface of some cells and that the virus needs in order to get into those cells. We don't know the numbers but some people are just gonNA clear the infection and move on with their lives. Right they are. They're going to either be a symptomatic not even being aware they are infected and they can be very infectious in this stage or they might feel crummy they might have Malays. They might have aches fever. That really within a week or so start to recover ordered. They might go into a more serious phase of the disease. This is when the virus makes its way into the lower respiratory tract. That's right if your immune system can't beat back the virus while except in your nose and throat then the risk goes up of marching down your windpipe and into what we call the respiratory tree. The whole system of Airways that leads to the far reaches of the lung. And that's where the virus again finds a welcoming home because the tiny air sacs called Alveoli where oxygen exchange occurs with the blood also adds an abundance of these ace to receptors on their cell surfaces. And this is a problem because if the immune system goes on the attack these tiny spaces in the lungs you can get really serious problems. Sure it becomes what we know as pneumonia and ammonia simply as lung inflammation. This particular virus can cause a really rip roaring lung inflammation but these patients may have in quotes. Mild the MONJA. Although I don't think anyone has described how they feel as mildly affected or they may turn a severe sharp corner where they begin a rapid downhill. Slide into what we know is acute respiratory distress syndrome where. There's just a raging pneumonia and on their chest xrays or C. T. Scans you're GonNa see white where you should have seen black. Lack representing air in an white. Is this whole inflammatory? Response trying to beat back the virus but doing damage itself. Alveoli walls breakdown either can be clots in the little tiny blood vessels that supply the OBVIO- light nurse. Just a real STU real mess and when people deteriorate very seriously enough deny one thing that researchers are trying to understand is how serious is this immune response and would intervening at that point. Be Helpful for patients. If you have just a regular immune response and you start giving immune suppressing drugs your disarming your your Mahameed in a minority of gravely. Ill patients the immune system goes into this really damaging hyper immune state. Call that a cytokine storm when levels of certain chemical signals and the blood. Go absolutely off the charts and in the end what happens is the immune cells of the body began attacking healthy tissues and you can get widespread kwoh-ting you get the blood. Vessels leaking blood pressure plummeting. It's a catastrophe for the whole body. So in efforts to combat that out of Control Immune response they are deploying drugs that go after specific ones of these chemical signaling molecules known as cytokines and just to be clear here. Most of what we're going to be talking about is for severely affected patients people who are in the ICU people who are coming into the ER. So let's turn to the heart and blood vessels meredith. This is something surprisingly being seen in maybe twenty percent of patients. Yes it's clear that the heart and blood vessels are a target for Kovic and just how unwise still being sorted out. Let one paper in. Jama cardiology found heart damage in nearly twenty percent of more than four hundred patients who were hospitalized for the disease in. Wuhan another found forty four percent of patients in an ICU. There had abnormal heart rhythms. And then there's also an increased tendency to blood clotting that in a Dutch. Icu nearly forty percent of patients had blood. That was clotting abnormally. These are extremely problematic issues and people. That are already very sick from pneumonia. What has been seen happening to people's hearts there seems to be heart inflammation and it's possible because the heart lining and the blood vessel lining just like the cells in the lungs and the nose is rich in these ace two receptors again. They're the viruses port of entry into into cells. So the cells could be. It's possible that they're being in the heart. And the vessels directly inflamed. It's possible there at the lack of oxygen. Getting through because of the problems in the lung is doing additional damage to her vessels could be that a societal kind storm releasing all these inflammatory molecules again and sells remember they attack normal healthy tissue and that can include the linings of blood vessels so there are these multiplex of potential causes that may indeed vary between patients as to what's causing let. But it's clear that there's cardiac and vessel damage in a significant number of severely. Ill patients let's take a turn now to the brain. This is something that we've seen some scary reports on actually of inflammation in the brain and we've also seen law sense of smell in corona virus. Patients is that something that's related to the brain it might be that's not been established but there is a direct connection from so-called olfactory neurons. The ones that light you smell running from the nose up to. It's called the olfactory bulb which connects to the brain as one of our sources. Put It as a nice sounding feary who I have to go and prove that it actually extends to the brain but there are more general brain effects. That don't trace back to loss of sense of smell for one thing. The bloods increased tendency to clot can put patients at risk of having strokes. There's also a problem in that. A lot of these folks developed kidney failure that in itself can cause delirium and problems for the brain in addition there can also be a quote unquote sympathetic storm. It's sort of an overreaction of the nervous system that somewhat analogous to the site of kinds storm and that's common after traumatic brain injury some people with Cova nineteen can lose consciousness. So there's just a whole panoply of potential brain symptoms another symptom that I'd heard of before reading this story and I haven't heard most of this. Was that people can have symptoms in their gut. They can have diarrhea. They can have upset stomach. Does this mean that you know the virus pieces of the virus are surviving digestion? Yes apparently it does. And one of the suggestions is that patients are swallowing their own respiratory secretions and that the virus is carried live and somehow survives the acid environment in the stomach to land in the small intestine which is again replete. With these ace two receptors. An so virus can establish. Wow a robust infection. There that's it's thought what's leading to diarrhea nausea and other problems in perhaps on average about twenty percent of patients across studies. I WANNA take a step back here and just talk about how all these different systems being affected kind of expand the pool of people who have pre existing conditions that would make corona virus infection. Really dangerous for them. Can you talk a little bit about that? Sure so since we were just talking about kidney disease in the kidneys. That's one of the organ systems. Where if you have a pre existing kidney disease that gives you basically a handicap when you start this race with this new virus than we think of something like diabetes harms the kidneys. So if you start with a lower baseline of kidney function these chronic kidney patients with pre existing kidney disease are at seriously greater risk of developing acute kidney injury during the infection in the same way diseases that affect the blood vessels will also put patients at higher risk. High blood pressure diabetes again congestive heart failure all these kinds of pre-existing disease just make patients that much more vulnerable. Should they become infected? So how is research like this? It's so preliminary. Were really just beginning to understand the progression of this infection. How will this help with interventions or treatments? I think it will certainly offer clues and sign posts. There will be new discoveries that hopefully will lead to highly effective drugs but we have already a good deal of information that points the way to either existing drugs or targets for drugs now being developed knowing for instance the outline of a site a kind storm which is something that can be triggered by other viral infections or bacterial infections. We have a starting place with that. We have these drugs already being deployed and other inflammatory states like rheumatoid arthritis that you can then say well. If they're beating back a certain site assign one of these out of Control Chemical Messengers in arthritis may be they will also be back some piece of the cytokine storm. That's going on in these severely ill patients and so you have such drugs being deployed in clinical trials. What we know about the ace two receptor and it's detailed protein. Structure has been defined by a couple of new important papers hopefully will give us new unique targets to actually prevent binding there. Which would be terrific. Yeah so what? Was it like trying to report on this? Big Mix of peer reviewed preprinted small clinical studies firsthand reports. Those kinds of things was very challenging. Every scientist and physician we interviewed really added the caveat. This is science on the fly. Our knowledge today may be completely eclipsed a month from now or what we're thinking about how this diseases is acting may be proven wrong within three weeks. This is obviously an ongoing endeavor to understand how the disease progresses what conditions set you up for getting extra sick and then you know the mechanisms that are happening at the cellular level. Where is the best information going to come from? Do you think. Is this something where people need to set up. These robust studies that you described. Are they doing that now? Yes in fact. They are doing it but hampered by the fact that they're trying to at the same time in many cases take care of desperately ill. Patients cleverly does the analogy goes trying to build the plane. While you're flying at this information is going to be constrained or imperfect because of the situation. It doesn't mean it's not going to be important.
Are Ventilators Actually Helping?
"We've focused on ventilators on this podcast. Because they seem to be the prime medical intervention we have at the moment but more troubling data has come out about how effective ventilators are to affect covert outcomes at all a new blood. Clotting complication is worrying another look at New Zealand where they're so successful against the disease. Their goal is now to eradicate it and a snapshot at the realities of Testing through the lens of one small Texas town. The numbers are all over the place this morning. Iran reported the lowest number of daily new infections and month and new infections in Russia fell for the second day in a row though. There are some who questioned the veracity of official numbers from those states. Meanwhile the number of cases and deaths in Germany and Spain jumped overnight cases in Germany increased by two thousand three hundred fifty two to total of one hundred. Forty eight thousand forty six and deaths increased by two hundred fifteen to five thousand ninety. Four Spain saw an increase of diagnosed cases from two hundred eight thousand three hundred eighty nine to two hundred thirteen thousand twenty four. While the number of deaths there was up by four hundred forty from the day earlier all that said across the board in more places we continue to see numbers plateauing up by a little somedays down by a little some days but there's no consistency in either direction. I E no run of down days in a row suggesting the curve has been broken and no run of up days in a row suggesting new sustained outbreaks new data. From New York's largest hospital system shows that eighty eight percents of Corona Virus. Patients who were placed on ventilators did not survive. Meanwhile doctors are seeing a mysterious complication involving blood clots showing up in many fatal. Cova nineteen cases quoting the Washington Post. A paper published in the Journal. Jama about New York. State's largest health system suggests a reality that like so much else about the novel. Corona virus confounds our early expectations. Researchers found that twenty percent of all those hospitalized died a finding that similar to the percentage who perish in normal times among those who are admitted for respiratory distress. But the numbers diverge more for the critically ill put on ventilators eighty eight percents of the three hundred twenty. Cova nineteen patients on ventilators. Who were trapped in the study died that compares with the roughly eighty percent of patients who died on ventilators before the pandemic according to previous studies and with the roughly fifty percent death rate some critical care doctors had optimistically hoped when the first cases were diagnosed and quotes in other words based on that data being put on a ventilator essentially saves no lives beyond what would have been expected suggesting that ventilators are ineffective in reversing cove in nineteen outcomes quoting again. The paper also found that of those who died. Fifty seven percent had hypertension forty one percent were obese and thirty four percent had diabetes which is consistent with risk factors listed by the Centers for Disease Control and prevention noticeably. Absent from the top of the list was asthma. As doctors and researchers have learned more about Kobe nineteen the less it seems that asthma plays a dominant role in outcomes. One other surprising findings from the study. Was that seventy percent of the patients. Sick enough to be admitted to the hospital did not have a fever. Fever is currently listed as the top symptom of Kovic nineteen by the CDC and for weeks many testing centers for the virus turned away patients if they did not have one. Davidson said that as a result of those findings north well is encouraging people with underlying health conditions such as hypertension and diabetes who are potentially exposed to the virus and who might not have a fever to consult with a doctor sooner rather than later and quotes.
"respiratory distress" Discussed on Newsradio 700 WLW
"Adult respiratory distress syndrome otherwise known as cards may be an entirely different animal something we've never seen before according to Dr did check part of the pandemic task force working group and the attending physician that one of the medical centers in New York City and he says in ards patients when we take X. rays of the lungs after they've been ventilated their lungs improve not show with most of the covert nineteen patients we're treating the wrong disease he says this is not your classical adult respiratory distress syndrome there were using a false paradigm to treat cove in nineteen ninety I think continue we do use mis guided trip it's going to lead to a tremendous amount of suffering in a very short time Mary sent several radiologists suggested the serial radiographs of Kovin patients resembles the pattern of a premature infant respiratory type of shipment yeah R. D. S. rather than a R. D. S. maybe we should start to view the coded to patients as suffering from a similar path ology to the infant RDS an attempt successful interventions that we use in children okay there's several different studies as of late saying that it appears the vents are doing more damage you're doing more harm than they are good but all right final time out returning to on America's trucking network losing the house was.
Gilead's Remdesivir Efficacy Still Uncertain! Is Stemline Therapeutics a Buy?
"So I'm glad to be back and I have a great show for you all today. We have some real spicy stuff to get into. Some of them have commented on twitter. But yet it's it should be good so I'm GONNA start off today by talking about some biotech news. Some little updates that we got some press releases and then a follow up by talking about Gillian ads at Rim decively data. We're going to touch a little bit. On the New England Journal. Medicine study that they published followed up by a report that was provided by our friends at Stat News. So that's going to be good and then the final topic. I WanNa talk about is stem line. So you know. One benefit of being in this volatile environment is that there are buying opportunities right now and one that I do see is a company called stem line. So we're GONNA talk about them and why think thereby right now so with that? Let's get to some of the news that we saw this week and first thing I wanted to touch on his after sys mostly because I just talked about them in the last video but we saw actually in the last couple of weeks that the FDA has authorized after says to initiate a pivotal clinical evaluating multi stem cell therapy in patients with Cova nineteen with induced acute respiratory distress syndrome. So some of the stuff that I talked about in my previous video was that I wasn't sure if the face to that. They're currently undergoing with their collaborator. In Japan was going to be a pivotal study. And it looks like it will be for the Japanese system and then this study that they're launching that they launched in the last couple of weeks is going to be the pivotal study for them domestically here in the United States so the primary endpoint is ventilator. Free Days Through Day. Twenty eight and they're beginning to open sites this quarter so I'm not sure exactly what that means in terms of when we can expect data. I would think maybe late Q. Three probably in Q. Four we'd see some data for this which could be a big boost for the company. Also what we learned in at the risk of opening another can of a drama this company they announce a public offering a twenty two million shares at two dollars and twenty five cents for about fifty million dollars in proceeds. I did say that I was expecting them to announce another offering and that is what we saw earlier than I expected. I really thought that they were GonNa wait until maybe later in the year to do this but while the songs doing okay I guess it's a it's an opportunity to do so so with another fifteen million dollars in cash. This should give them another six months or so and you know if they do see some good data from this pivotal study it would likely boost the stock quite a bit more before they have to go ahead and raise money again. So that's after says. I'm still saying on the sidelines. I'm still not super confident. In that data we originally with their phase one so I have no real sense on whether or not I think the date is GonNa be positive but I hope it is that this can get rolled out and it can actually start helping patients that have covert nineteen and areas going to move quickly to immunogenetics which is a company that kind of fell off my radar ticker symbol. Is I m you? They have a compound called says a to Mab Guven Akin and yes. I did practice. That's all I can say. A properly for metastatic triple negative breast cancer and I kind of talked about is the potential for this drug. It's it's a unique formulation so that they can really target the cancer cells and hit them with this tailored that is toxic to all sales. But because it's tethered to something that specifically targets cancer cells it would primarily affect them and kill them so the primary indication they're looking for is triple negative breast cancer and they had done in a sense study to confirm their previous face through results and there was some concern with safety but the sense that he was actually stopped for compelling efficacy. So that's great news for them the PDF date is June. Second of this year. And we'll see if the FDA is going to go ahead and approve the drug so that they can search treating metastatic triple negative breast cancer patients. They have a plan readout for your cancer in the second half of twenty twenty and they're also still enrolling patients for positive her two negative medicine breast cancer so I think that that trial read out is going to be particularly important for the company. And I'M GONNA keep them on my radar and pay a little bit better attention because I think that if they do see positive data there. The company has a a much larger patient population. Go after so Yeah so it's good for them and hopefully they'll see a positive result at the PDF eight anime. Keep an eye out for that trial moving on. I WanNa talk a little bit about Amarin. Because they had their earnings report while ago and what we learned is that they're cute. One Twenty twenty revenue beat estimates at one hundred and fifty million dollars and I had said previously that. I thought their estimates were sandbagged in anticipation of better results. And that is what happened but unfortunately none of this matters because they do not have pan protection in the United States given the ruling that we heard a little while ago so regarding to the appeal and the generics the CEO is not expecting at risk launches. But they are willing to file an injunction. I've talked about that in the past. This is not new news but they did also say that. In the event of an appeal loss Amarin would be willing to launch a brand engineering version. So this is an interesting strategy in order to allow them to maintain market share in the space because if they launch a generic version immediately. You know by the time another generic comes to the stage Amazon's already going to generic Kinda solidifies their position in the markets. There's not going to be really an advantage to patients taking a another third party. Generic other than Amazon's now the only issue with this is that the generic price is going to have to be competitive with the other companies. That launched generics as well. So in this way they're gonNA lower the amount of total revenue. Get but there's a lot of uncertainty in the company. I'm still not sure what I'm GonNa do with my shares. The stock has bounced back a little bit. But you know if they don't win appeal I assume they're gonNA see further downside until we actually start to see the kinds of numbers that start coming in given the new pricing of generic version of Amarin. So we'll see we'll keep you posted on what I do. I'm tempted to buy a little bit more and lower my cost basis by I'm I don't feel great about that either. So we'll see all right. Let's talk about Gilead. Everybody so first thing I want to touch on with Gilead is this New England Journal. Medicine studied that they released regarding the compassionate use of Rendez severe for patients with severe cove. In nineteen so Gillian been at the forefront of the media when it comes to this rendez severe drug that they're hoping to get approved and they initially had rendez severe offered only as compassionate use for patients as is still undergoing phase. Three trials right now so some people who are really severe severely affected by cove nineteen could apply to to take severe and what they did is they published a study with fifty three patients who had taken it under this program and really it wasn't a placebo controlled trial so for me. There's no real conclusion to be drawn. They said that a majority of patients were discharged. But because there's nothing to compare it to doesn't really mean much Another thing that's worth complaining about for the studies that they didn't even measuring viral load. So we don't even know if patients that were taking Severe head lowered viral loads in. You know we could figure that out by comparing baseline to treat a data. But they didn't do that so it's Kinda left in the dark here. The company itself has terminated a study in China with severe patients because of low enrollment. And they're awaiting the publication of these data to announce in-depth review the result. So that's one thing that we can also look forward to see is the data that we're getting from this low enrollment patient population in China. And they are doing a mild to moderate disease study in China. So that's still ongoing. Takes been seeing on twitter. Pretty disappointing a lot of people complaining that the New England Journal of Medicine shouldn't publish the study given that it was you know. There's a conflict of interest and there's no placebo and you're not new to academia. You know it's a cartel. The big name journals really only published stuff. That's like really hot off the press type thing. So of course there's huge problems with this study and Gillian's not even shy to mention them in the discussion so they clearly outlined limitations of the study. And everybody that I've seen on twitter isn't really taking that into consideration they think Gilead just willfully blind to the fact that there's no control. Obviously they know that. And if you want to throw the New England Journal Medicine under the bus or publishing this year but throw the entire institution appear review under the bus. It's a horribly flawed system as somebody. Who's coming from academia? I've seen this all the time you know. These journals are a cartel that gate keep science. So that unless you know people or your science is so particularly compelling that they'd be willing to publish it but if you WanNa talk about the academic system and publishing. Let's have that conversation but to call out this study in particular is being. The true hope written the true problem in the world of publishing. This is not the one for you
Chicago researcher says helmet ventilators can ease short supply
"At first when testing increased the number of positive coping nineteen cases was doubling every other day now the numbers are doubling every four days what does that mean for difference in the number of people impacted by covert nineteen currently we have nearly seven thousand cases if that number doubled the way it had been every two days we would sort of one hundred twelve thousand cases in ten days but at the new rate a doubling every four days would leave us with fifty six thousand cases roughly cutting the spread in half I think really the amazing response or and in collective effort by everyone is going to go a long way as we continue to battle this ventilators are the number one tool for the sickest patients to battle this virus they force air into people's lungs after cover nineteen causes so much damage it's nearly impossible to brief but ventilators are in short supply now one Chicago researcher says he has another idea helmets they not only help patients they cut down the risk of infection for health care workers normally we put a tube in the trachea an endotracheal tube and that process is called endotracheal intubation and mechanical ventilation it's a highly invasive therapy and one associated with poor outcomes that's why university of Chicago medicine doctor John Kress is hoping to harness helmet for the sickest cobit nineteen patients this does have the potential to make an important Dante inspired by space travel built in Texas Chris Austin showed us the helmet he makes in his garage reflects the both weekend and they are looking for storage or what have you yeah this material the models strong it's very resilient it won't tear it won't leak there are twenty to thirty of the helmets in use right now at university of Chicago medicine you can actually connected to the source of oxygen from the wall right in the hospital and no ventilator at all so it simply pressurized system of oxygen enriched air that inflates the helmet and also inflates your lines in the patient breeze spontaneously begets in red stocks engine so that saves a validator for non people who are sicker and might need it that's particularly important to us we start to worry about I guess what I would call the unthinkable which is we have too many patients and we don't have enough ventilators to take care of all of them the devices can be sterilized and reused they connect to the hospital direct source of oxygen so a steady flow at higher pressure compared to a standard mask fills the helmet and ultimately reaches deep into the lungs no tuber ventilator need higher pressures can be effective in many patients that have called the nineteen because the severity of the injury to the lungs is such that higher pressures are needed and a better seal not the mouth but around the neck protect healthcare workers from infected patients when you have a R. D. S. acute respiratory distress syndrome which is what the copay patients have you have some limits because the amount of pressure that defeat gas source must generate is beyond what the mask can handle so you have leaking around the mask effect across study the helmets back in twenty sixteen he found the device helps sixty percent of patients with acute respiratory distress syndrome R. A. R. D. S. avoid intubation that number appears to be lower in Khalid nineteen patients closer to thirty percent still statistically significant as ventilators are in short supply that's clinically relevant because we could save thirty percent of patients from needing to be anticipated not only does that and give the patient a better chance for a good outcome as staying off the ventilator it will translate into you having a better outcome but it also saves thirty percent of the ventilators for somebody else the sky's
Leading lung expert John F. Murray dies of coronavirus-related complications
"A prominent doctor in California dies and as USA today reports its because of Kobe nineteen Dr John Murray who spent decades studying and treating acute respiratory distress syndrome died at the age of ninety three from that very illness caused by coronavirus this syndrome is often the cause of death among those hospitalized by a crew of a
"respiratory distress" Discussed on Newsradio 970 WFLA
"R. your examine sent to an isolation ward as doctors wait for the results of a test for the coronavirus the administer a CT scanner lawns which reveals telltale ground glass opacities fuzzy spots caused by fluid accumulating where the immune system battle is the most intense not only have you got covert nineteen but it's led to a kind of intense and dangerous the mall you called acute respiratory distress syndrome or ards with all the regular beds already occupied by the many covert nineteen suffers you're given a cot in the room alongside five other patients doctors put you on an intravenous drip to supply your body with nutrients and fluids as well as anti viral medicine within a day of your arrival you condition deteriorates you throw up for several days and start to loosen it your heart rate slows the fifty beats a minute when a patient in the next room dies doctors take the ventilator he was gonna put you on it by the time the nurse threads the endotracheal tube down your throat you're only half conscious of the sensation of its snaking deeper and deeper toward your lungs you just live there as she places tape over your mouth to keep the tube in place you're crashing your immune system has flung itself into a cytokine storm and overdrive of such intensity that it no longer is fighting just a viral infection but the body's own cells as well white blood cell stormy alongs destroying tissue fluid fills the tiny and the Laura sacks that normally lead blood absorb oxygen effectively you're drowning even with the ventilator pumping oxygen enriched air into your lungs that's not the worst of the intensity of the immune response is such that under its onslaught organs throughout the body is shutting down a process known as multiple organ dysfunction goes the more the story here when your liver fails it's unable to produce tie unable to process toxins your fluttering on the age of life and death now that you've slipped into mods your odds are fifty fifty or remorse lying on your card you have here the doctors hook you up to extra core extracorporeal membrane oxygenation machine this will take over the work of your heart and longs and hopefully keep you alive until your body can find its way back to equilibrium and then you're flooded with overwhelming sense of calm you sense that you've reached the the the the nadir all of your struggle but worst of the danger is over but the viral attack is beating your body's immune system will pull back and you'll begin the slow painstaking journey to full recovery some weeks from now the doctors will remove the tube from the.
Here's what this US coronavirus survivor in Seattle learned when she was sick
"This next story this segment you gonna listen to hear folks should give you hope I mean you hear nothing but dire news bad news all this woman we have on the line now this nice lady Elizabeth Snyder she's from Seattle she has a doctorate in bio engineering and she survived the coronavirus Elizabeth good morning to you hi good morning Bernie and said it's great the package what is the I love New York City and I I want to come back in now that the flights are cheap and I recovered I have immunity maybe I'll be there in the near future I like a lot you got a great attitude I know I don't even know if you have a muted I've heard of examples of people getting it twice I hate to bring it down but in your case you're very very upbeat you survive the coronavirus tell us about your deal tell us about how you first became aware that you actually had this virus yeah that's a great question so I actually initially when I got sick I thought I just had a nasty flu like symptoms Burberry and line with what you would get if you came down with the flu and I initially did not think I have a corona virus because I had no cost they had no shortness of breath I had no respiratory distress or any respiratory issues those really only when I started chatting with a group of friends of mine who all got sick at the exact same time three days after attending a party that we started to get a little suspicious and many of my friends went to the doctor I myself did not go because I was recovering on my own and I think that I thought I had the flu my friends have gone to the doctor and the doctors just tested for flu it came back negative we're all getting a little bit frustrated enough that police one of my friends found that there was a local research study here in Seattle called the Seattle to study and it's a joint collaboration between university of Washington Seattle children's and perhaps they were just testing for the flu as part of a study on community transmission of influenza but they recently started testing for coronavirus so we also spent ten ten naval quads simple to just kind of you know cross our fingers and hope for the best we were curious to know if we had current virus but we weren't you know particularly sure we had it and sure enough I got a call this past Saturday on March seventh from the research coordinator with the study saying my sample tested positive Lizabeth Snyder thirty seven years old live now in Seattle Washington had the virus corona and does doing much better today survived of course I thought was kind of cute when I read the story of how much a list that you know your symptoms subsided by the time you found out you had corona you'll you're not at your work you're actually getting better already so when you found out you how do you like I don't know it's kind of cool I'll be like probably site depicts permit yes that's correct I would say at first I was a little shocked because as I mentioned I just thought that I had the flu and perfectly honest if I hadn't been tested that what I would have thought and yes when I got the call on Saturday I was feeling better I was upbeat and the sun came out in Seattle I was enjoying my Saturday in fact I was planning to have a friend over that evening to play board games so yeah I was a little shocked but I was not scared I didn't panic I wasn't worried because as I said at that point I had pretty much you're covered I did kind of think it was pretty cool in a way because at that point I knew there weren't that many people in the United States that had contracted it and as you mentioned at the beginning of the segment I do have a PhD in bioengineering I did molecular biology research in college and graduate school and I work for a biotechnology company here in Seattle so I think from an intellectual curiosity perspective I thought it was kind of interesting so a Lisbon Snyder from Seattle again a doctorate in bio engineering of course Washington state one of the highest the highest number of cases of coronavirus and Lizabeth to tell us about for example how many days you suffered from this coronavirus and how big did it get while you're going through it so I fell down thank and found that I was feeling unwell on it you pay it was Tuesday February twenty fifth there's actually three days after that okay that party that I mentioned in the evening my temperature spike two hundred and three so that was a little alarming I can't remember the last time in my adult life I've had a hundred to three degree fever so I thought queen and it was the most severe apart from that however I just had a headache I had intense body aches I had a lot of fatigue I started feeling a little bit contracted and these are all symptoms of a common cold or you know and nasty flu and I did not have any respiratory symptoms as I mentioned earlier I didn't have a cost I didn't have shortness of breath I didn't have any chest tightness so thankfully the next day after I started feeling sick my fever came down to a hundred and one they just add did self care and I took over the counter medications and drink a lot of water I would say that the entire duration of my illness was about eight days and that's when I immediately one evening I was watching television and I automatically kind of felt this sort of like fog you know that you get all over your body and in your head when your steak it's a sort of listed and I felt my energy package back to normal well you know to be honest here you fall in the category of people who what you want those what you're supposed to thirty seven years old eighty I I I gather you're in good shape having had a bunch of medical history issues before so it's not shocking that you will have this for seven or eight days and your okay I think what what people are going to say is I hate it when grateful Isabel Schneider but you know my uncle's eighty and he just had a heart attack or his lungs aren't good and then she's going to make it sound like it was kind of cool I got it is not that big a deal but I know you're on record saying listen listen I was okay that doesn't mean that other people shouldn't take the proper precautions that's correct you know one of the takeaways but I have from this experience is that the symptoms are varied and just because you don't have you know cost and shortness of breath and chest tightness doesn't mean that it's not coded nineteen and so you know I think at this point right now the best thing that we can do in the community is anyone who is experiencing any of these terms and please try and stay home from work train arrange something with your employer if you have limited time or if you can work from home in please do so by yourself for fourteen days because there are people in our community who are elderly and your no fault of their own have you no underlying health condition or someone who's a concert you know or you know have had major surgery and they're the most vulnerable but I would say that you know I think as this thing progresses we're gonna find more and more people coming out as testing positive people like myself who who have recovered so it remains to be seen how quote unquote deadliest viruses compared to influence that but you know I think that this whole experience should remind us that this is not something that we should practice just in a time of crisis like right now at the cove in nineteen outbreak this is something we should practice all year long when you get sick or even a
"respiratory distress" Discussed on Ten Minute Medic
"Welcome to the ten minutes host Dr Bill Young before we beginning presentation. I WanNa take a moment to thank you for taking the time to listen to this. PODCAST is over the publication of this episode. We have over three hundred fifty followers and in two thousand thousand in nineteen just a little more than thirty two thousand downloads. That is awesome and I just want to say thank you. I'd also like to know what topics makes. You liked it here in twenty twenty. Please visit our facebook. Page the ten minute medic- let us know what you would like to hear in this. The final podcast two thousand and nineteen. We'll take a look at the recognition respiratory distress and failure respiratory distress encompasses both breathing too fast as walls too slow to maintain retain life. It's important to paramedic be able to recognize entreat both simple and complex admirable respiratory conditions in infants and children children as we stated earlier podcasts positive responsibilities treatments is often quite dramatic. It's quite common that a good outcome is seen after a risk where risks I would not so much a cardiac arrest. You will improve the chances of Rauch by being able to identify early at your assessment respiratory distress in the pediatric patient Shen and aggressively treated briefly review. The physiology of Vittori System Immolation about the adults and the pediatric patient is an active process. Ross both intercostal muscles and the diaphragm contract thereby lowering the pressure inside the lungs somewhere between three to five millimeters of mercury because of this lower pressure is compared to the outside atmospheric pressure. Air Rochas in gas exchange takes place in the which are covered by multiple strands of capillaries is because the gas in the Alveoli Lawrence high oxygen and according to the law of Diffusion Ostra will move out of the lungs and attached to the hemoglobin ago because of blood capillaries is high in carbon dioxide. The reversal happened with that. Carbon Dioxide is expelled to the air when the patient sales The metabolic rate pediatric patients is about fifty percent higher than that of an adult as a result. Pasha can have a much more rapid onset in the pediatric the education then the adult four are still nations present. According to the American Heart Association axios defined as a decreased arterial oxygen saturation zachery detected by pulse luxury or direct measurement of oxygen saturation in an arterial blood gas sample in our assessment of patients as we. Julie consider how `bout exist the pulse. Ox is less than ninety four percent. Now all we're looking at issues of Pasha. We must know the difference between how Park Samia Tastes. You have parts you as we said earlier. How does having a pulse ox? Symmetry of less than ninety four percent tissue have actually occurs when a particular region the body where it could be the body as a whole does not have an adequate oxygen supply. It's important to remember that is not the same thing as tissue hypoxia you nor does have always lead to tissue partial one. Good example of this is the patient who has a chronic condition with the amount of oxygen in the blood is low over a long period of time such as may be seen in the adult. COPD patient body may respond with a condition known as polycythemia. Yeah this is an increase of red blood cells help to maintain the oxygen content of the body by an increase in the amount of hemoglobin available. Let's take a look at hyper Arbia or an increase in the amount of carbon dioxide in the body. It's important to remember that when your patients hydrocarbon. The dilatory process is inadequate. It's also important to remember that. Carbon Dioxide is not a bad guy here just a byproduct of metabolise. Let's like everything else in life though too much. Carbon Dioxide can lead to robs any increase carbon dioxide will increase as doses. In your patient the most common bodily reaction to this is an increased respiratory rate the increased rate and depth occurs in attempt to blow off the excess carbon dioxide. After a while the child becomes so fatigued with this effort of breathing that he begins become sleepy at this point respiratory failure is just a few moments away with potential for respiratory arrest being very high a decrease in the patients love of consciousness. Office is an important symptom that clues you into an inadequate Villa Tori effort. The pediatric patients often go from being very anxious and educated to becoming. I mean very quiet sleepy. And just a few moments other symptoms that may occur with this condition include nasal flaring as wells retraction of the intercostal muscles there is a difference between respiratory distress and respiratory failure respiratory distress is often marked by an increased breathing rate as well as a greater effort in work. Breathe new your patient. Restaurants air comes about as those compensatory make noodles began to fail. Lead to inadequate oxygenation inadequate ventilation In respiratory distress your patient may be agitated Wallin failure. They may become very lethargic and sleepy the pediatric patient Ristori failures often preceded by respiratory distress. But not is important to keep this amount. When you're assessing the chop some of the symptoms of respiratory distress included an increased respiratory rate diminish bristles especially in the distant ally an increased heart rate a low pulse ox and the potential for cyanosis? Now keep in mind that cyanosis lakeside. And she should not wait. Until its appearance. Before you begin to take your patients nations respiratory status very seriously signs of respiratory failure include extreme tech in cardiac followed by Brand Cardi. Your patient may exhibit dangerously usually low pulse ox symmetry level. You'll often see them begin to Bob Their head or act as if they're going to sleep this point they're becoming exhausted new must act quickly quickly respiratory failures life reading state that requires aggressive intervision. The part of the paramedic or else it will deteriorate cardiac arrest as we discussed earlier. Aggressive intervention on your part is needed to prevent the child from Progressive Cardiac arrest if the child is conscious and responsive allowing them him to determine their position of comfort will help ensure by narrowing the child's not able to maintain their own airway. Use the head Tilt Chin lift. Open it in the event of of a potential spinal cord injury you should use the jaw thrust maneuver keep in mind that just method of opening the airways difficult to maintain for long periods of time. Do the strain to places is on your failures from pushing the jaw forward. Consider the use of an advanced airway curse there is in the airway suction it until it's clear important that you remember a couple of things about sectioning. I when you're applying such thing you're decreasing the amount of air available to the patient. The normal circumstances this would not lead the major problem. But you're dealing with child so this is anything but normal secondly prolonged section and can lead to braddock harding for child who's teetering between green risk for distress and failure bread at Kearney could be disastrous provide oxygen. And make sure it's possible that it's humidifier humidifier oxygen. It'll help decrease the inflammation in the bronchial tree as well. As break-up secretions found. They're making it easier for the child to cough up use the Bravo. Dial later.
"respiratory distress" Discussed on WTRH
"World it's just early early on i don't know if it's not nineteen thirties or forties but it's it's a musical and you've got the word legal i n you've got the ten man who's scared by the way you gotta scarecrow scarecrow now he's supposed to scare off like birds and stuff but the scarecrow scared and they are just frightened and they're going to the land of oz or going to see they want to see the wizard of oz because he's supposed to be able to do all kinds of things this is a made up story but the point is here they are they're fearful and there's this booming boys this low voice and it's the wizard of oz but dorothy little dog toto goes behind the curtain can somehow pulls back the per the the curtain little tiny guy little man and he's trying to scare these zoo scare everybody and he scares dorothy and the scarecrow and the tin man and the cowardly lion and all i see is it's a bluff it's a bluff to their emotions and they realize this just a little man behind the curtain i want to pose to you this a panic attack an anxiety attack is a bluff to your emotions it feels as real as anything could be so in order for you to stop a an anxiety attack what i'm wanting you to understand is you're gonna i tape a real deep breath let me tell you why you do this when you first began to experience this shallow rapid breathing that is called hyperventilation hyper prevent rapid breathing and that reduces carbon dioxide in your blood and you need the not not monoxide is not carbon monoxide that's that that kills people carbon dioxide is you need to take deep breaths and therefore that will reduce the light headedness the dizziness the tingling of extremities meaning like in your hands or feet it's it's if you you can feel faint and many people feel like there is called respiratory distress it's like that's why i said they can feel they're gonna die they don't know what to do and so so all the more they start breathing rapidly not just you take a deep deep breath and you can you can literally quote a particular scripture pluck deep breath when i am afraid i will trust in you then deep.
"respiratory distress" Discussed on KQED Radio
"Iron get to the transfer and and then the rest will take care of itself that is correct those correct so i never years back he were scratching your head saying how do we do this threatened you do yes indeed or i was actually in 1995 working as in the fall in just a and before hospital and in a frolic gist is but a kidney doctor and the idea of good to me that juding the process of dialysis as we are removing the toxins from the body via off also infusing into these patience molecules like bicarbonate lake calcium sweat heart when don't we infuse iron these patients lose item with every dialysis session and therefore at hard that if i could put item into the dod solution then it will slowly go across the di lies a membrane and then i wanted to have an item that were directly bind to transfer unfortunately all the item compounds there are currently in use are these large globules of far of iron it has thousands of item fetig oxide adams or molecules in the central core surrounded by a shell of carbohydrate and the idea of the carbohydrate shall is to bring the item from coming indicted contact the cells because item can be potentially very toxic so these laws globules are insoluble and they cannot be added to the dialysis solution the won't transfer across the dalai's remembering because they are too big so to go back to the old history from the 1800s and indeed the scientists in 1800s they wanted to infuse item intravenously into the patients who cannot tolerate or an item and they're law patients who cannot tolerate or alarm they have guess went to stylists side effects cetera so first this started infusing these islands horse like for example on a scoreboard it but these source will fall apart in the circulation and the free item will be very toxic and it would cause respiratory distress and the blood pressure will go down and many patients in fact died because of these.
"respiratory distress" Discussed on WREK
"Intravenous item formulations that are used these item carbohydrate complexes because a carbohydrate can 'cause he's got a traffic reactions and a full access because the body reacts to the the the carbohydrate and the patients kindle upper respiratory distress the hypertension they'll look pressure goes down into the abboud senda they have a cardiovascular collapse and many patients in fact die from these reactions because this compound try fetig does not have any carbohydrate or sugar moity therefore it has negligible risk of for an awful access and in fact we have administer no more than hundred fifty thousand doses of traffic and heroin had a single instance of four and a full access so that appears to be a major advantage of for this drug also that are other benefits in terms of for the intravenous item as i mentioned before guts sequestered in these scavengers system of the body the macrophages but traffic is able to overcome dysfunctional out in deficiency so these patients with inflammation lake cancer patients patients with kidney disease the amid enough item in the body was not getting to transfer and and that is or functional in deficiency and try fetig is the only item compound delivered directly into the circulation that is able to overcome this functional item deficiency without causing a dishwasher adam overload and as you realize item can be highly toxic this high body has these mechanisms to prevent too much item getting into the body and that's exactly what happens in with intravenous hiram uh the traditional intravenous asylum that it causes this dishwater overloads which can be potentially very harmful and that is avoided by the use of traffic it this is such a great story in so many ways one is that you went back centuries see what what's going on most of.
"respiratory distress" Discussed on WREK
"Transfer and and then the rest will take care of itself that is correct that is correct so i never years back he were scratching your head thingy hata we do this through idea yes indeed uh i was actually in 1995 working as an affront logist a afford hospital and in a frolic gist is a kidney doctor and the idea of good to me that during the process of dial assists as we are removing the toxins from the body via gulf also infusing into these patients molecules like by carbon it like calcium sweat heart when don't we infuse iram these patients lose item with every goddesses session and therefore at harm that too if i could put item into the dod solution then it was slowly go across the dialyzers membrane and then i wanted to heaven item that were directly bind to transfer unfortunately all the item compounds there are currently in use are these large globules of of iron it has thousands of item fetig oxide adams or molecules in the central core surrounded by a shell of carbohydrates and the idea of the carbohydrate shall is to prevent the item from coming indicted contact with the cells because item can be potentially toxic so these large globules are insoluble and they cannot be added to the dollar's solution the won't transferred across the dalai's remembering because they are too big so act go back to the old history from the 1800s and indeed the scientists in 1800s they wanted to infuse aydin intravenously into the patients who cannot tolerate or allied them and their laura patients who cannot tolerate or allow them they have guessed went to of side effects at cetera so first this started infusing these items hordes lake for example idleness orbit but these swords will fall apart in the circulation and the free items will be very toxic and it would cause respiratory distress and the blood pressure will go down and many patients in fact died because of these.
"respiratory distress" Discussed on 850 WFTL
"Issues going on over there to us were we took that information our command center at our chief nur an officer who happen to be manning the command center who the evening took it upon herself to walk across the street to really you know what's going on here you know we have a couple of patients such as came in with elevated temperatures in other word were getting they don't have airconditioning so when she walked across the street and began serving area on the on the first floor and realized the staff were buried and act it looked like they were in distress in the patients were were awarded in areas of the first four with fans and they just you know didn't appear well and at that point in a took a lot of courage you know it's not our facility uh she came out of our facility over over to somebody else's facility unfed we're gonna empty this place out we're gonna everybody safety and it wasn't until you know fire rescue unit started to arrive and our stop start going through the hawks the living facility room to room where we realize how how grave the situation was an you know when you open the door and there's a a patient bear that's no longer living that another one and then other patients and respiratory distress of it it's what have become um just reflexive and that we had over fifty of our staff numbers over there to pulling people out of rooms and bring them out front in trying to get them to areas of safety and and one of the things that we do in a mass casualty is is really trial label patients green yellow red and black which prioritises cared at a sick expasion patients the ones that are green that aren't sick but nevertheless need to be taken somewhere safe can can wait but we know those red patients we had to get to safety and a lot of them we took immediately across emergency department i believe there were thirty nine patients vashem or transported over to our eur directly from a nursing home with stretchers.
"respiratory distress" Discussed on KOMO
"Shooting and our partner station kxly reports shirts and sweatshirts with the hordes freeman stronger flying off the shelves greg burnett she's the owner of brunette sportswear which is donated the money raised to a college fund has been overwhelming fire are sop has pretty much been onsite down since we started doing these cell so far they've raised more than ten thousand dollars in the middle of this the parents of a freeman high highschool freshman are talking about the nightmare that a stranger put them through last week after finding out about that shooting that part of the story from comost carleen johnson news of an active shooter at freeman high school sent a wave of panic through every parent steve's to ritz daughter is a freshman it freeman he had nearly an hour drive to get to school how do i get from chinni need to freeman and three seconds on the way there he got a call from his wife said their daughter was okay but moments later came another call his wife could barely speak and said a friend of their daughters had sent a said she was in respiratory distress and not breathing immediately lent to paramedics him and my daughters and respiratory distress having received any information about this it was another few minutes sewer tells kxly felt like hours before his fears were relieves i glanced over football field i sr turns out his daughters friend had not sent the tax she has a new number at whoever has the old member decided it was a good idea to make that cruel prank the stewards contacted the sheriff's office but were told that being malicious was not against the law carleen johnson komo news komo news time seven thirty three garbage juice that's what in environmental acid caused the toxic waste it says a landfills been pouring into a fish supporting trip if you terry of the nisqually river short from comost corwin hake the suit filed by the puget sound keeper alliance alleges the l r i landfill and graham has been discharging unacceptable levels of pc bees lead arsenic and.
"respiratory distress" Discussed on KELO
"The budget up from a time the survivors transported and treated for respiratory distress dehydration and heat related issues fps else's they were providing power to part of the facility whether it was cool enough could be the issue loved ones gathering to get any information they could i was just happy to see muscles it just what voice what's the my eyes correspondent robin simmons on thursday president trump traveled to florida for a first hand look the steve kastenbaum has that story the president came to southwest florida with malania trump and vice president pence their first stop was in fort myers where he was briefed on the response of recovery by florida's under along with representatives of federal and local agencies macos every day president trump acknowledged how hard the coast guard in others have been working both here added in texas in recent weeks want to thank everybody i don't wanna see it next week he then flew over homes stillflooded in naples before landing at a distribution in staging area where he and the first lady handed out sandwiches to storm survivors thank you so much for you off very much while he did ask people how they were doing many of the conversation centred on their support for him glove these people and we're going to be back with you to help the president vowed to make sure that their needs are met i just wanna tell you we are there for you one hundred percent elsewhere around florida the cleanup continue down trees seemed to be on every street it every community of southeast florida in the miami area boss worked his chainsaw while his brother had a marshall was behind the wheel of a construction vehicle dragging large trees from where they fell they're family has been doing this for sixty years they've seen a lot of storms in that time larry said earlier was one of the worst four just if if there's awful if if this all kenneth was dripping with sweat after working under the hot sun for morning until nightfall idea with one now they'll be doing this for weeks to tell casted down in miami correspondent steve kastenbaum and this is westwood one news the weekend review squadron leader i'm a dead now holdings green.
"respiratory distress" Discussed on KKAT
"Rallied now you know this morning on chaos info and you're in case of oh country out the san francisco bay area i talked with a lot of people who are at this rally give me your experience of thanks for calling the savage nation well thank you bring out remain nice talk to i you know i got there that's appointed time which is around to o'clock a little after it and i think dude missed the first violence i got just in on the taylor but i didn't realize i think i've always thought but it was contained and you have the right up close to to see that the fight occurring and i saw the important all day and who in my opinion has of the last two to have to proportion waiting to be filed this matchup two per hundreds of millions of dollars per the and the university for healing to allow this whole exercise who freedom move assembly and of of speech and the thirty agent so i'm well that's a good one now could you that's the guy that was really bloodied correct no i was thinking of the old man who was on the ground suffering respiratory to difficulties because you know yes no it looked like at first when i saw the video of that i thought he was having a heart attack well that that's that's the shirt of that may have with the with the with a respiratory distress we just didn't have that should be you want to it should be on a t shirt with a legend could we think democrats who because then right the through the tragedy in and i was fifty peter going i didn't go overlooked producer of by this but i have a i think we did to approach this year what is the legal approach at the somebody when you put berkeley of university our owner of all that we should just sit back in a couple all because people are going to get hit in the pocket book really hard if we really take it seriously number one bigger stick should have that never universities have a have an obligation to support freedom of pressure people say you'll see for conduct of business and they're not and if they you do the thing.
"respiratory distress" Discussed on WLOB
"You were at the berkeley rallied now you know this morning okay us a photo and you're in case of oh country out the san francisco bay area i talked with a lot of people who are at this rally give me your experience of thanks for calling the savage nation well thank you for having me nice talk to you yeah i got there that's appointed time which is around to o'clock a little after and i think do missed the first violence i got to get on the taylor but i didn't realize i thought we saw but it was contained a new had the right up close to a to super replied occurred and i saw the a portion of old man who in my opinion has a loss to the the proportion waiting to be filed this matchup super hundreds of millions of dollars per look at the university for healing to allow peaceful exercise who freedom move assembly and over of that speech and thirty a should so i'm glad that's a good one now could you that's the guy that was really bloodied correct no i want to give you all down who was on the ground suffering respiratory the difficulties because you know yes no it looked like at first when i saw the video of that i thought he was having a heart attack well that that's that's the shirt of that may have with the with the with a respiratory distress with his hat that should be you want to prep should be on a t shirt with a legend could we thank democrats religious because the right to the tragedy in and i was fifty people room and i didn't go overlooked producer of others but i have a i think we did two approaches here oh what is illegal approach to so many wins the titties but berkeley at the university are formidable do we should just sit back in the couple all because people are going to get hit in the pocket booker very hard if we really take it seriously number one the drastic should have been it never universities have a have an obligation to support freedom of pressure peaceful st you'll see if conduct a business and they're not and if they do you do the things we can.