Kyle Allred Dr. Seheult as a critical care physician you’vebeen on the front lines for the recent wave ofCOVID-19 hospitalizations in the United States and specifically in California, where you work, but a primary focus of your previous videos. Oncovid-19 has been strategies to avoid needinghospitalization. So as more and more people testpositive for COVID-19 or know someone that testspositive or lives with someone that tests positive, you put together a list of strategies to considerif a positive test, result comes back or ifsymptoms, develop.
So tell us about your list: andthen we’ll go through each item, one by one, Dr
Seheult Yeah thanks Kyle, So the purpose of this video is good practical information for if you turn positiveor someone you know turns positive for COVID-19.You know. I’Ve been asked so many times, recentlybecause of the increasing numbers “. What do I do what to do if you’re staying home When to go tothe hospital? What do you do if somebody is inyour home that turns positive
What can you do? Toprevent the spread of infection within a household ?”? That’S exactly what we’re going to talk aboutright now Kyle! So if I got tested today and a positivetest came back and I just have mild symptoms, what’s one of the first things that I can dowhile I’m at home, Dr
Seheult Well, if you’re, not havingreally, shortness of breath, you’re probablyokay
But if there’s any kind of lung discomfort orshortness of breath, it may be worthwhile investingin a device called a pulse oximeter. This isa device that just slips onto your finger andit basically tells you two different things.Number one. It tells you what your pulse is your heart rate, and it also gives you somethingcalled the SPO2. That’S your oxygen saturation.Now, generally speaking, if your oxygen saturationis, 95 and above then, you’re, probably okay,
If it starts to drop down, however, at rest, between90 and 94, then you’re kind of getting into sortof a yellow zone. If you will a “ caution zone, .” Butif, it drops less than 90. So if it’s in the 80sin other words, then that’s more of a “ red zone, “, That’s where you are clearly hypoxemic and you’dprobably need to go into the emergency room, tobe evaluated for supplemental oxygen.
If you don’thave a pulse oximeter, some of the surrogates forthis would be persistent shortness of breath. Orif you have cyanosis or blue lips or tongue Nowit’s possible to have shortness of breath and notneed oxygen. But if you don’t have the abilityto measure your oxygen, your peripheral oxygensaturation with a pulse oximeter, then that’s thenext. Best thing is looking for shortness of breathand, seeing if you need to go to the emergencyroom
Now, if you’re already on oxygen as a asa baseline, because you’ve got lung disease, thenyou should be on your regular amount of oxygen and your oxygen saturation should be kind ofwhere, you’re used to it being. If it starts todrop down. That would be the same sort ofsituation. Where it’s time to go to the hospitaland be evaluated, because that could be a sign. Oflow oxygen saturation could be a sign that you’regetting pneumonia from COVID-19
Kyle, You know there’sa lot of different pulse oximeters out there thatone could purchase There’s the medical gradeones for maybe a couple hundred bucks there’sthe type, that you show that just go on a finger –, a really small and portable –. Some of those sell online for as cheap as twentydollars. How can someone tell what’s a good pulseoximeter to consider buying
Dr. Seheult Well they’ve actuallydone some tests to see how accurate they were, andwe’ll post that in our description below You, cansee here, the ones that seem to do well on at leastindependent evaluation, Kyle, Any other tips for usingit Anything that people should know when they’reusing a portable Pulse oximeter
Dr. Seheult Yeah, it’s justlike taking a blood pressure, So you need to besitting down for a couple of minutes, not doinganything exertive and be at rest Slip. It on yourfinger. Don’T take the first number that pops up
It’S got to sort of learn your pulse, a littlebit and so give it about 30 seconds to adjust and then read the number off Kyle. What about nailpolish, If I’m wearing nail polish, Dr
Seheult Yeah, so you wantto make sure that it’s reading the color of yourblood. So you don’t want to have any nail polishon the finger that you’re using it on
So that’sa good point: you want to remove the nail polishon the finger Kyle. What if I live at high altitude, sayin Santa Fe New Mexico at 7,000 feet Dr. Seheult, Yeah soas! You go up! That’S a natural reason for youroxygen saturation to drop so high altitude wouldbe. One of those things – and you may want to havesomebody who’s, not at risk or having COVIDsymptoms, to put it on just to kind of see whatit would be normally at that level. If you’re upat, you know 15,000 feet 10,000 feet a normal person’s saturation isgoing to be probably in the low 90s high 80s
Kyle, What is unique about COVID-19 and this virus, the SARS-CoV-2 virus that makes the pulseoximeter so relevant, Dr
Seheult Yeah: it’s the thing that we learnedabout very early on during the pandemic. Innew york was these “ happy, hypoxics, .”, So inother words. They look fine in every other wayexcept for the fact that this pneumonia is reallypreventing oxygen from being diffused into thepulmonary circulation, and it’s really one of thefirst signs that people are starting to progress.So. I think it’s a very sensitive tool to useis hypoxemia and it can be very valuable.
Kyle, How ishypoxemia different than hypoxia, Dr., Seheult, Okay, so hypoxemiais, specifically the lack of oxygen in the blood Hypoxia, is the lack of oxygen in the tissue. So it’s a very specific thing. Butfor our purposes here both are happeningat the same time.
So the second thing thatwe’re going to talk about is antibodies. Andthese are known as “ monoclonal antibodies.
“, So if you can imagine here, we’ve got the virus and on the virus we have these spike proteins.Well. What the monoclonal antibodies doearly on in the infection is, they will bindto those spike proteins and preventthat virus from entering your cells.And. This, of course, is important because it canreduce the viral load and if it does so, there’s atheoretical chance at least that it could reducethe severity of disease.
So there are currentlytwo companies that have come up with somemonoclonal antibodies that have gotten emergency- use authorization from the FDA, The first one isEli Lilly and the name of their antibody is calledbamlanivimab and the other company is Regeneron and Regeneron actually has two antibodies in one medication.
The first one is casirivimab and thesecond component is imdevimab Now both of theseunderwent randomized, controlled trials and wereshown to be effective at reducing the viral loadand, also reducing hospitalizations and so theniche that these medications occupy are thosepatients that are not sick enough to be admittedto the hospital. But yet have a positive COVID. Testand are at risk for progression to hospitalization, So it’s not for everybody, who’s, COVID, positive andso for interest of time. Let’S go over the data forbamlanivimab
So the results of a phase two trialinvolving bamlanivimab was published in the NewEngland Journal of Medicine on October 28th, Thiswas a randomized placebo-controlled trial thatlooked at 467. People who were positive for COVID-19and had mild to moderate symptoms and werenot sick enough to need hospitalization
So whyis timing, so important with monoclonal antibodies. Well, monoclonal antibodies are man-made proteinsthat function just like human antibodies in theimmune system and so they’re very good at stoppingthe virus outside the cells.
This is kind of howvaccines work. They teach your immune system, todevelop antibodies that block or limit the abilityfor the virus to infect or enter your cells. Butonce SARS-CoV-2 has infected the cells they’veactually come in and got into enough of the cellsthat antibodies aren’t able to neutralize the virus, and you need T cells, cytotoxic, T cells which arespecialized for dealing with infected cells, So ifmonoclonal antibodies, are given late in the courseafter. A lot of that virus has already entered alot of the cells they’re going to have limited ifany benefit.
And what they found was that, on day 29, the percentage of patients who were hospitalizedwas 1
6 in the intervention group and 6.3 in theplacebo group and when they dug down deeper andlooked at a post-hoc analysis, looking at high-riskgroups –, for instance, people equal to or older thanthe, age of 65 or BMI equal to or greater than35 –, the percentage of hospitalization was 4.2In the intervention group and 14.6 in the placebogroup Now, as you can see here, while bamlanivimabor the other monoclonal antibodies from Regeneronare, not approved for everybody with COVID-19 there’s still a large amount of peoplethat fall into this category.
Take a look: anybody with a BMI of greater than or equal to 35 anybody greater than or equal to 65 years of age. Anybody with diabetes, chronic kidney disease, immunosuppressive disease, anybody receivingimmunosuppressive treatment and it doesn’t endthere Anybody greater than or equal to the ageof 55 with hypertension, that’s a lot of people or other chronic respiratory diseases or COPD. And so you can see here that there’s a large groupof people that fall into this category and soit would be important to make sure that if youor someone you knew fell into this categoryand, they were COVID positive. They would beeligible for receiving this medication if itwas available in your area, Kyle For the bamlanivimab bamlanivimab. Do you actually need to pronounceit correctly to receive the medication [ Laughter ], Dr
Seheult Ifthey did there would be very, very fewpeople receiving that medication, so it’s taking methe better part of a few days to be able to saybam-lanivimab Kyle, But along those lines, Ihave heard that a lot of these monoclonalsare sitting on the shelves or sitting in storagerooms and Not actually getting used,
You work attwo different hospitals in southern California. Are you actually treating patients with these Dr. Seheult Yeah? Absolutely There’s a lot of people. Thatdon’T know about these medications, don’t know theniche and it’s because their providers aren’taware of these things, Things are happening. Sorapidly. That medications are becoming availableand, we just don’t know how to prescribe them.
And that’s one of the reasons why we’redoing this video Kyle is so that peoplecan be aware of it.
You’Re absolutely right, there’s been a lot of this medication that’sbeen distributed, but it’s not being used Now. Thismedication is IV only, and so it has to be infusedin a facility that can monitor the patient forthe hour that it takes to infuse it and so atone of the hospitals that I work at they infusethis regularly in the emergency room, monitor, thepatient and then obviously they’re –, because ofthe fact that they’re not going to be admittedto the hospital after the infusion is done. — they’resent, home
Kyle One of the things I know that you wantedto do in this video Dr. Seheult was highlightthe things that we have really solid data for preferably randomized, placebo-controlled, trialdata for and then things that we have maybe lessstrong data for — observational data or data fromother illnesses. That may be similar to COVID-19
So, for the first two things you’ve talked about — these monoclonal antibodies and the pulse oximeter –. How do you think the data stacksup for those two interventions – Dr. Seheult, Yeah well pulse oximetry – is almosta part of us. It’S almost part of our “ DNA “. We’Ve had multiple studies that go back decades, — even you know even 100 years, — looking at oxygen, andmeasuring oxygen and knowing when we need to putpeople on oxygen so that data’s been around for along time.
In terms of the monoclonal antibodies that was submitted to the FDA through anemergency use, authorization and the basis of thatapplication was a randomized controlled trial and the end points were met, — that hospitalizationswere reduced –. So the evidence is pretty clear and it’s good evidence and it’s a randomized controlled trial, which is the gold standardfor evidence. Now, if we talk about some ofthe other things, –, for instance, supplements — that has varying levels of evidence, Probably thesupplement. That has the best level of evidence isvitamin D. We’ve got randomized controlled trialdata in a couple of instances, — one out of Indiawith the shade study and also out of Spain withcalcifediol study, which showed in a randomized controlled trial (, albeit small, ), that there wasdefinitely benefit In that group, with COVID-19that receive vitamin D, supplementation Kyle, So speakingof vitamin D. Let’S let’s talk about that now:
Dr. Seheult Yeah. So if you look back at our update 59, which I would encourage everybody to look at, I would stick with everything that i’ve said therein terms of preventing COVID-19 to be exactly thesame as if you were treating COVID-19
And realbriefly in update 59, we talked about vitamin C how there’s really not an optimal dose thatwe’re aware of Vitamin D, on the other hand, isa different story. Initially, when I made the video I was taking 2500 international units and I wantedmy levels to be higher after I got them checked.
I’M actually taking 5000 international units a day. The Endocrinological Society is saying that theupper limits that you can take without a physiciansupervision is 4000 international units a day. So if you’ve been supplementing with vitamin D all along and you come down with, COVID continue tosupplement with vitamin D. But if you’re watchingthis video and you have not been supplementingwith vitamin D – you you probably should start.And. There is some evidence –, but you probably wouldwant to check with your primary care health careprovider first –. There is some evidence out of Indiain the SHADE study where they gave 50,000 unitsorally daily for seven days and then ramped itback down to a regular dose of approximately4000-5000 units ( international units ). So there is some data there in that study.
Atthe end point: there was an increased clearance ofthe virus. There was decreased, inflammatory markers.There’s ongoing trials, so we’ll find out more exactly what the optimal dosing is. Butremember, not everybody can take 50,000 units, oreven supplemental vitamin D. As we’ve talked aboutbefore. There are some conditions like sarcoid, which that would not be the optimum thing to do. So.Kyle 50,000 units sounds like a lot to me That soundslike a whopping dose over seven days, butthe patients in the study didn’t get toxicity, onthat dose
Dr. Seheult, No, No, in fact, we’ve talked aboutthis in our vitamin D, video that we releaseda couple of weeks ago, Kyle that showed thatin an analysis where they looked at over 20,000patients in the Mayo Clinic and looked at peoplewho, supplemented anywhere from 0 up to 55,000units daily. There was only one person that hadhypercalcemia from vitamin D toxicity in 20,000patients and, as they said, it’s probably the mostsafe fat-soluble vitamin there is Kyle. Are there anyother vitamins that you would take with vitaminD to potentially allow it to work better? Dr
Seheult Yeah there’s some evidence, that’s emerging that vitaminK2 is beneficial in helping with vitamin D. I wouldjust make a caution there that there is emergingevidence that this is the case, but for thoseof you who are on blood, thinners, specificallyCoumadin or Warfarin, obviously taking vitamin Kis going to Be counterproductive to your therapythat you’re, getting with that medication. Soi would not recommend that in that situation.The other element, that’s very helpfuland beneficial if you’re taking vitamin D ismagnesium as well – and there are some studiesthat look into that as well as dosing.Kyle, And I think it bears repeating again that none ofthese are recommendations for people to Goout and do on their own, but always to discusswith their medical professionals. First correct Dr
Seheult Absolutely – and the other thing I would addto is none of this – is a hundred percentprotective or curative, so you still have to doall of the other things that the CDC is saying like mask-wearing distancing. All of that. This is again is a way of of tipping the scales in favorof you In terms of your immune system. One of theother things that I mentioned back in MedCram 59a number of months ago, was that I took Quercetin and while there is some data in ebola and otherviruses that Quercetin may be beneficial. We werewaiting for studies to come out on Quercetin inSARS-CoV-2
There’S a good review of Quercetinin Natural Product Communications, put out bySAGE Publications that was published this month inDecember and it basically goes over the prior datain other viral infections and also in vitrostudies that seem to indicate that Quercetin mightbe beneficial. But again we have no randomized placebo-controlled trial data, It seems as thoughthe risks of Quercetin. Supplementation is prettylow, which makes the benefit-to-risk ratio fairlyhigh. If one wants to consider supplementation, withQuercetin
If we look at NAC or n-acetyl cysteine in MedCram update 59, we talked about how itwas used in a randomized placebo-controlledtrial to ameliorate the symptoms of theflu virus –, not COVID-19, but the flu virus –, and because of this, and also the antioxidantproperties of n-acetyl cysteine and The oxidativestress theory that we see in ACE2 inhibitionthat we see in COVID-19 it was felt againthat the benefits of taking supplemental NACoutweighed the risks, especially over a winterseason but consider scaling back or stoppingthem once this pandemic has subsided.
You know then-acetyl cysteine was tested with influenza duringa winter season, so I don’t think we should be onn-acetyl cysteine for the rest of our lives. Ido think that supplementation with vitamin Dis going to be beneficial during a winter season, especially if you live above the 35th parallel.Kyle. Okay, well, you Dr. Seheult, have four differentboard certifications that you maintain in internalmedicine critical care um, let’s see what else pulmonary medicine and sleep medicine as well!
So Ithink, the next thing that you wanted to talk aboutwas was sleep. Dr
Seheult Yeah, so sleep is very important, especially now that we’re talking about peoplegetting vaccinations. So it’s not only importantif. You have COVID-19, but it’s also important ifyou’re planning on getting vaccinated becausewe’ve got good data. That goes back many years, interms of the flu vaccine, that if you are gettingat least seven hours of sleep prior to vaccination, the antibody response and the immune response. Ismuch, more robust and better after vaccinationif you’ve had a good night’s sleep and that alsogoes, along with trying again to prevent yourselffrom getting the infection.They, did a study where they purposelyput rhinovirus into the nasopharynxinto, their nose basically of students and those that had a good night’s sleepfrom. Previously, when they interviewed them, hadmuch less chances of getting a cold and gettingthe virus than those that had not been
So sleepis very, very important. The other thing I wouldmention about sleep is it’s particularly the hoursof sleep early in the night. It is those hours thatis associated with slow wave sleep, so the hoursof sleep before midnight are probably worth moreby hour than those after midnight. So turning offelectronic devices turning off the television notreading, your facebook page or comments are thingsthat, get you emotionally charged. These are allthings that are going to prevent you from going tosleep.
It’S better to shut down at that point, go tobed and get that slow-wave sleep.
By the way, thatslow-wave sleep trial is associated with growthhormone secretion, which is really really importantin terms of longevity Kyle. But if I’ve just testedpositive for COVID-19, I might be a little nervous. Gon na be hard to get a good night’s sleep Isthere anything else like any supplements. I couldtake Anything else: you’d recommend if I’m havingtrouble sleeping
Dr. Seheult, So we’ve talked before about theoxidative nature of COVID-19 and the fact that theACE2 receptors taken out and the bottom line hereis that we are seeing more and more evidence, thatoxidative stress is playing a significant role: inthe deleterious effects of SARS-CoV-2.One of thethings. That would help in terms of sleep and alsoin terms of an antioxidant is melatonin
Now somepeople might notice that melatonin works reallywell for them. Other people not so much so buttaking a supplement, –, maybe three to five milligramsabout an hour before bedtime of melatonin — would bebeneficial in some people in terms of antioxidants, but also in in terms of helping you get to sleepand falling asleep so that you can getthe Seven hours of sleep that you need.And then finally zinc, which has been talked aboutquite a bit.
Still recommending it, but not greaterthan, 40 milligrams of elemental zinc per day, andbecause zinc can be complex with many differentionic compounds such as picolinate such as sulfate. You’Ve got to look up the actual elemental, zinc, ineach compound and make sure that you shouldn’tbe taking more than 40 milligrams a day.So with the exception of vitamin D. Everythingelse should be about the same, whether you’retrying to prevent COVID-19 infection or whetheror. Not you have it.
But is there anything elsethat you should be doing on top of thisif. You come down with symptoms of COVID-19 To answer this question: let’s again reviewthe course of SARS-CoV-2 infection and howit progresses. So we learned early on in the courseof this disease in a paper published in the Lancetin mid-February that from infection to symptomsis, an incubation period of about five days, andthen after symptoms, develop there’s about sevendays, where these symptoms become more and moreprogressive. And if it leads to hospitalization, that’s when it’s going to occur at about theseventh day, approximately
And so the course ofthe disease in those people who are symptomatic isthey get the infection and of those people who aresymptomatic about 20 percent of those patients will go onto need: hospitalization, ventilators in theintensive care unit and potentially evendeath, But 80 percent of those patients who developsymptoms Will actually get better on their own andthe reason why they get better on their own in theearly phase is because of the immune system and aswe’ve talked about this before there is the innateimmune system, which you see here on the left and there’s the adaptive immune system. Whichyou see here on the right And each of thosehave, their own cell types, We’ve talked aboutimmunization, and that has a lot to do with. Whatwe see there on the right with the T, cells, andthe, B cells and plasma cells which make antibodies. But it’s becoming increasingly clear in theearly part of the infection — that part of theinfection, where the patient is at home and he’shaving mild symptoms — that the part of the immunesystem – that’s really responsible for takingcare of this – is the innate immune system andunfortunately. This portion of the immune system, the innate immune system, gets weaker with age.And the particular cell types that are involvedwith. The innate immune system are the monocytesand, the natural killer cells and one of theprimary out products. If you will of the innateimmune system, is the interferon response?
It’S very important that this moleculeinterferon does exactly what it’s named to doand, that is to interfere with viral infections.What. We’Re finding out is that the SARS-CoV-2virus is interfering with the body’s interferon and that’s why it’s allowed to progress throughthat seven-day period of time and progress evento. The point of needing hospitalization Here’sa paper that was published in March in the AsianPacific Journal of Allergy and Immunology wherethey looked at the first SARS virus and also MERSand other coronaviruses, and they said herevery, interestingly, that it was the active viralreplication later results in a hyper productiontype. One interferon response:
That’S after it issuppressed early and what they say here, basicallybased on all of this data is that these factsstrongly indicate that the innate immune systemresponse is a critical factor for disease outcome, and those predictions bore out here was a paperthat was published by Dr. Gough, where she Reviewsthe data and says that studies of SARS and MERSsuggest that the interferon response is delayedcompared with coronaviruses that cause milddisease and with milder cases of these twocoronaviruses that can cause severe disease thepatients with severe SARS or MERS, had higherviral loads and delayed interferon responses. Thusit could be that the patients most susceptible tosevere disease are those that cannot mountan effective early antiviral immune response.
She goes on to state that a study of 50 patientswith cases ranging from mild to severe found thatgene expression profiles indicating type 1 andtype 2 interferon responses were highest inpatients with mild to moderate disease and werelow in patients with severe or critical disease.A, similar difference in type 1 interferon activitywas detected in the serum from the patients.Patients with more severe disease had lesstype 1 interferon activity in their bloodand. This is data from August of 2020, which waspublished in the prestigious journal Science, and it shows exactly what the doctor was. Talkingabout
Here we see the amount of interferon which is being secreted and compared to nodisease. We see a large amount in mild, diseaseand, increasingly lower levels, as we get morecritical indicating that the interferon responseis very, very important Again. Looking at interferonactivity, we see it being elevated in mild. Diseaseand much lower in critical disease
Also, publishedin Science were two papers that basicallyexplained nearly 14 percent of all of the severe COVID-19cases that were studied, and essentially what theyfound was that in patients with mutations in theirability to mount an interferon response, therewas, essentially no interferon, and they only foundthese type of patients in Severe cases In additionto that they also found patients with antibodiesto interferon and again, those interferonlevels were very low in these patients and onlythese patients were found in the severe category.In other words. There were never patients withantibodies against interferon in the mild cases, whereas if we look at those patients that did nothave any mutations and did not have antibodiesagainst interferon here, we see a very largesmattering of interferon responses and thesepatients were more mild.
So because of all of this, it seems as though to me that any way possiblethat we can enhance particularly the innate immuneresponse early on in the course of this disease. There is a potential for limiting progression because of what we are seeing in terms of thesignature of COVID-19, which is suppressionof interferon. Well, if you look at the datain terms of the innate immune system in termsof, the interferon response and in terms of fever, it’s well been studied that fever can in factenhance the interferon response as indicatedhere by a Representative publication here in 2002, and what they did here Was they stimulated humanmonocytes by whole body, hyperthermia
This was 12healthy volunteers, which were immersed in a 39.5degrees Celsius, hot water bath to increase theirbody temperature and what they found was thatthree hours after in-vivo hyperthermia theresponse of monocytes to endotoxin was enhancedby an ex-vivo lipopolysaccharide stimulation assay.Essentially. What they’re doing there is they’regiving, the body, a stimulus to tell them thatthere’s an infection, and they see what happens and what they found was that there was a greaterexpression of tumor necrosis factor, alpha releaseand, that they concluded the thermal effect offever directly activates monocytes, which increasestheir Ability to respond to a bacterial challenge.And. This is part of the reason why I was hesitantto treat a fever that wasn’t above 103 Fahrenheitearly on in the course of the disease. Becauseit seems to me as though the fever is enhancingthat very portion of the immune system. –, the innateimmune system — that’s required to put an end to theprogression of COVID-19, but there were more studies.In this one researchers at the University ofToronto took seven healthy volunteers and lookedat the effect of cold water at the end of heatingand exercise.
In other words, heating them upand, giving them exercise and then putting them ina cold bath to see what happens to natural killercells, lytic units etc. – and this is exactly whatthey found. They said that this study suggeststhat despite popular beliefs, that cold exposurecan precipitate a viral infection. The innatecomponent of the immune system is not adverselyaffected by a brief period of cold exposure. Indeed, the opposite seems to be the case. The fallin core body temperature resulting from coldexposure, led to a consistent and statisticallysignificant mobilization of circulating cells, an increase in natural killer, selectivity, andelevations in circulating IL-6 concentrations.But, the real tour de force in terms ofpublications was this one titled “ Hyperthermiain Humans Enhances Interferon-beta Synthesis andAlters. The Peripheral Lymphocyte Population
“, So basically mitogen stimulation is something thatstimulates. The cells of the immune system as ifthere was a foreign invader and what it showedwas that when they took interferon and measuredthe amount of interferon that was released fromlymphocytes after mitogen stimulation at differentbody temperatures, there was a ten-fold increasein interferon response at 39 degrees celsius andagain. This is the very molecule that is lacking, aswe found out earlier in the early course of COVID-19, which led me to think. Is it possible that earlyon in the course of COVID-19, if we were to dohyperthermia in some way, could it alter thecourse and the progression of this disease And at first this sounded kind of far-fetched.Is it something so simple that might have sucha big benefit? Well, first of all, we don’t know, ifit has a big benefit, but if we looked earlier inhistory things like this have been done. Beforeand I looked to the example of Dr
Julius Wagner-Jauregg, who was an Austrian psychiatrist and notedthat his patients with neurosyphilis, got betterwhen. They had a fever, so he went aheadand infected them with malaria on purposeand, essentially cured them of their neurosyphilissimply from the fever of the malaria and thenhe cured them of their malaria. Using the knowntechniques at the time for this
Dr. Wagner-Jauregg was awarded the Nobel Prize in Medicine in 1927 and, as you can see here, according to this, articlethat was published in 2013, simple immersionof, the individual in a hot bath or placing himin a heat cabinet was one of the means bywhich. This was done and I suspect, a lot. Ofthese techniques were forgotten because the verynext year after Dr. Wagner-Jauregg won his Nobel Prize in 1928. We discovered penicillin and opened up acompletely new door of therapeutics, and so onceagainI do not have randomized placebo-controlledtrial data showing that hydrotherapy is effectivein treating COVID-19, but there seems to bebiological plausibility that it could work and that’s why I am interested to see randomizedcontrolled trial data being Done and studies beingperformed to see whether or not this in fact works.What are the risks of hydrotherapy. Well, you haveto use hot water, and so there is the potential ofburning
There’S also the potential of heating upsomeone’s body to the point that they could havearrhythmias, although that seems to be pretty rare.Other than that, the risks seem to be prettyminimal. You don’t need to leave your house, there’s no prescription that needs to bewritten and you’re, not using up resourcesthat need to be used by somebody else And sobecause of this. I believe that the benefitsoutweigh the risks currently for hydrotherapy and if anyone is interested in looking more intothis, I will have links in the description below Kyle. Could people also use hot and cold showers, ora hot tub or a sauna if they have access tothat to get the same effect?
Dr. Seheult Yeah absolutely.It’s just a matter of getting thetemperature up So, for instance, the problem withsome spas, at least in the United States, is thattheir. Maximum temperature is set to 104 degreesFahrenheit
That may not be enough to get the corebody temperature up.
You really want to be sweating. That’S how you know that you’re getting yourcore body temperature above where it should be, and you don’t want to do it for too long — about 20 to 30 minutes, is probably good, enough.In terms of showers as you’ll notice when wetalked about this back in update 59. Taking a hotshower, followed by a cold shower is a good what wecall a “ tonic” or something that keeps your immunesystem on sentinel mode. Looking forthings, if you actually come down with the disease.I, don’t know if just doing contrast, showersis going to be enough to really get the immunesystem going so sauna would be great. Spa, wouldbe great
If you could get the temperature up hot water baths, hydrotherapy where they they use hottowels to to heat up and then cover the patient.Generally speaking, what you want to do is you wantto heat up the body comfortably so by making sureyou’ve got a cold towel on your Head or neck so that your head is not warming up in temperature, just the body
Do that for about 20 minutes andthen, a very quick cool down at the end and allowthat to stimulate the part of the immune? Systemthat is suppressed in COVID-19 Kyle. If someone testspositive – and they are not sick enough to need togo to the hospital and they’re going back home, what are some strategies that they can employto prevent other people that they live withfrom getting sick, Dr., Seheult Yeah – and this is the realproblem because spread happens at Home A great analogy to use, if you’re in a homeis, to think about somebody who smokes in yourhome
If they’re on the other side of the housesmoking, you might not be able to smell the smoke, but after a long period of time that smoke isgonna is basically gon na infiltrate the house and eventually you’re, going to smell thatsmoke, and that’s really the way it is Withthe spread of this virus, So you’ve got to thinkabout both modes of spread. If you want to preventboth modes of spread and the first mode ofspread is with large droplets and that’s wheremasks come in, So these large droplets will havethe virus in it. And, if someone’s talking to you, these droplets are going to fly across a few feet. But, on the other hand, you’ll see, as we talkedabout with smoking, that you can be on differentsides of the house wearing a mask but eventuallythe other way of that virus. Spreading whichis tiny little particles which become airborneand just suspend in the air
The way you preventthat is by turning the air over and so havinga house. That’S closed up with the windows. Closed the doors closed you’re not going to get the kindof air exchanges that you need and so to reducethe amount of COVID transmission through airborne cracking the window, open, ventilating thehouse, putting in some hepa filters in yourair, filtration or even portable air filters aswell. Having all of these things going at the sametime is a multi-pronged approach to preventingspread to you.
Now the other thing you do isisolate that person who is positive to one area ofthe house They can crack the windows open in thatarea of the house, have air filtration going maybethey’re going to have to wear some warmer clothingto compensate for the windowthat’s cracked open. But again these are all thingsthat can work together.
I think actuallycracking the window open and getting air exchangesand ventilation is even more important than thetime that we put in wiping down surfaces That’sactually, probably not a large way that this virusis spread Kyle. Okay, Dr
Seheult, to summarize, if I wereto get a positive COVID-19 test and I have eitherno symptoms or mild symptoms, you would recommendpotentially getting a pulse oximeter checking tosee. If i’m in the category of patients that mightbenefit from prophylactic monoclonal antibodies, you know antibodies in advance of getting sick. A variety of immune, boosting strategies, including vitamin D and a few other supplements hyperthermia. If i have an opportunity to do that, –, whether it’s with warm towels or a hot tub or abath or hot-cold showers or a sauna, if you haveaccess to that — sleep trying to optimize my sleep, getting at least seven hours a night and thencertainly trying to Prevent the spread to otherpeople so isolating myself in the home to the bestof, my ability opening a window, a few inches forventilation, considering replacing my heating andcooling system, air filters with a high efficiencyfilter, and I believe it’s a MERV, 13 or higher thatyou really want to capture Those virus particles and then finally, if one can afford it a portableHEPA filter unit,
Anything else that i’m missing, Dr Seheult. No, I think that that really there is the low hangingfruit part of the purpose of me. Making this video Kyle is because I get so many people asking me “ Dr. Seheult. What do I do? I’Ve got COVID-19and, i’m feeling sick
It’S been three or four days. What do I do? ?” And now what I’m going to do is I’mgoing to simply refer them to this. Video becauseI think everything that you’ve just said. Therethere Kyle is everything that I’ve been tellingpeople in the last couple of months. That havebeen calling me about “. What do I do? ?”? This is exactlywhat. I think we ought to be doing, and hopefullyit will start to flatten the curve. In addition, toeverything else that we know is helpful, includingwearing masks outside social distancing and all ofthose other things that we need to be doing.You can help support us by visiting our websiteMedCram.com subscribing to this YouTube channel and turning on alerts by clicking on that bellicon hitting the Like button leaving comments and, most importantly, sharing these videoswith friends and family
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