Kyle Allred: Dr. Seheult, as a critical care physician you’vebeen on the front line for the recent wave of COVID-1 9 hospitalizations in the United Country, and specifically in California where you work, but a primary focus of your previous videos onCOVID-1 9 has been strategies to avoid needing hospitalization. So as more and more people testpositive for COVID-1 9 or know someone that tests positive or lives with someone that tests positive, you put together a register of strategies to consider if a positive evaluation solution comes back or ifsymptoms develop. So tell us about your index, and then we’ll go through each item one by one. Dr. Seheult: Yeah, thanks, Kyle. So the purpose of this video is good, practical message for if you turn positiveor someone you know turns positive for COVID-1 9. 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 dwelling? When to go tothe hospital? What do you do if somebody is in your home that turns positive? What can you do toprevent the spread of infection within urban households? ” That’s exactly what we’re going to talk aboutright now.Kyle: So if I came tested today and a positive assessment “re coming back”, and I precisely have mild symptoms, what’s one of the first things that I can do while I’m at home? Dr. Seheult: Well, if you’re not havingreally shortness of breath, you’re probably okay. But if there’s any kind of lung tendernes orshortness of breath, it may be worthwhile investing in a machine called a pulse oximeter. This isa device that simply slips onto your paw and it mostly 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 between9 0 and 94, then you’re kind of getting into kind of a yellowish zone, if you are able to, a “caution zone.” Butif it slips less than 90, so if it’s in the 80 s in other words, then that’s more of a “red zone.”That’s where you are clearly hypoxemic and you’d probably need to go into the emergency room tobe evaluated for supplemental oxygen.If you don’t have a pulse oximeter, some of the surrogates forthis would be persistent shortness of breath or if you have cyanosis, or blue-blooded lips or tongue. Nowit’s possible to have shortness of breath and not need oxygen, but if you don’t have the abilityto measure your oxygen, your peripheral oxygen saturation, with a pulsation oximeter, then that’s thenext best thing is looking for shortness of breath and reading if you need to go to the emergencyroom. Now if you’re already on oxygen as a as a baseline, because you’ve got lung illnes, thenyou should be on your regular quantity of oxygen, and your oxygen saturation should be kind ofwhere you’re used to it being.If it starts to drop down, that would be the same sort ofsituation where it’s time to go to the hospital and are assessed, because that could be a sign oflow oxygen saturation, could be a sign that you’re getting pneumonia from COVID-1 9. Kyle: You know there’sa lot of different pulse oximeters out there that one could purchase. There’s the medical gradeones for maybe a couple hundred horses; there’s the type that you show that just go on a thumb — a really small and portable– some of those sell online for as cheap as twentydollars.How can person tell what’s a good pulsation oximeter to consider buying? Dr. Seheult: Well, they’ve actuallydone some experiments to see how accurate they were and we’ll post that in our description below. You cansee here the ones that seem to do well on at least independent evaluation. Kyle: Any other tips-off for usingit? Anything that parties should know when they’re using a portable pulsation oximeter? Dr. Seheult: Yeah, it’s justlike taking a blood pressure. So you need to be sitting down for got a couple of minutes , not doinganything exertive, and be at rest. Slip it on your finger. Don’t do the first list that sounds up.It’s got to sort of learn your pulsation a little, and so leave it about 30 seconds to adjust, and then read the number off.Kyle: What about fingernail refine? If I’m wearing hammer polish.Dr.Seheult: Yeah, so you wantto make sure that it’s reading the color of your blood, so you don’t want to have any hammer polishon the paw that you’re using it on. So that’s a good point, you want to remove the nail polishon the finger.Kyle: What if I live at high altitude, say in Santa Fe, New Mexico at 7,000 hoofs? Dr. Seheult: Yeah, soas you go up, that’s a natural intellect for your oxygen saturation to drop, so high altitude wouldbe one of those things, and you may want to have somebody who’s not at risk or having COVIDsymptoms to position it on time to kind of participate what it would be usually at that tier. If you’re upat you are familiar with 15,000 hoofs, 10,000 feet, a ordinary person’s saturation isgoing to be probably in the low-grade 90 s, high 80 s. Kyle: What is unique about COVID-1 9 and this virus, the SARS-CoV-2 virus, that moves the pulsation oximeter so relevant? Dr.Seheult: Yeah, it’s the thing that we learnedabout very early on during the pandemic in brand-new york was these “happy hypoxics.” So inother utterances, they appear penalize in every other way except for the fact that this pneumonia is reallypreventing oxygen from being diffused into the pulmonary flow, and it’s really one of thefirst indicates 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 material, so it’s a very specific thing, but for our purposes here, both are happeningat the same time. So another thing that we’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 illnes is they will bind to those spike proteins and preventthat virus from enrolling your cadres. And this of course is important because it canreduce the viral laden, and if it does so, there’s a theoretical occasion at least that it could reducethe severity of disease.So there are currently two 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 called bamlanivimab, 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 these underwent randomized restricted tests and wereshown to be effective at reducing the viral onu and also abbreviating hospitalizations, and so theniche that these remedies occupy are those patients that are not sick enough to be admittedto the hospital, but more have a positive COVID test and are at risk for progression to hospitalization.So it’s not for everybody who’s COVID positive, and so for interest of time, let’s go over the data forbamlanivimab. So the results of a phase two trial involving bamlanivimab was published in the NewEngland Journal of Medicine on October 28 th. This was a randomized placebo-controlled trial thatlooked at 467 people who were positive for COVID-1 9 and had mild to moderate symptoms and werenot sick enough to need hospitalization.So why is timing so important with monoclonal antibodies? Well, monoclonal antibodies are man-made proteins that run just like human antibodies in theimmune method, and so they’re very good at stopping the virus outside the cells. This is kind of howvaccines work; they learn your immune plan to develop antibodies that block or limit the abilityfor the virus to foul or enter your cadres, but once SARS-CoV-2 has infected the cadres, they’veactually are now in and got into enough of the cellsthat antibodies aren’t able to neutralize the virus, and it is necessary to T cells, cytotoxic T cells, which are specialized for dealing here with fouled cells. So ifmonoclonal antibodies are given late in such courses after a great deal of that virus has already opened alot of the cadres, they’re going to have limited, if any, benefit. And what they found was that on daylight 29, percentages per of patients who were hospitalized was 1.6 in the intervention group and 6.3 in theplacebo radical, and when they dug down deeper and looked at a post-hoc analysis looking at high-riskgroups — for instance parties equal to or older than the age of 65 or BMI equal to or greater than3 5 — the percentage of hospitalization was 4.2 in the intervention group and 14.6 in the placebogroup.Now as you can see here, while bamlanivimab or the other monoclonal antibodies from Regeneronare not approved for everybody with COVID-1 9, there’s still a large amount of peoplethat included in this category. Take a watch: anybody with a BMI of greater than or equal to 35, anybody larger than or equivalent to 65 years of age, anybody with diabetes, chronic kidney illnes, immunosuppressive ailment, anybody receiving immunosuppressive care, and it doesn’t endthere. Anybody greater than or equal to the age of 55 with hypertension, that’s a great deal of people, or other chronic respiratory diseases or COPD, and so you can see here that there’s a large groupof people that included in this category and so it would be important taken to ensure that if youor someone you knew fell into this category and they were COVID positive, they would beeligible for receiving this prescription if it was available in your area.Kyle: For the bamlanivimab, bamlanivimab, do you actually need to pronounce it precisely to receive the drug?[ Laughter] Dr.Seheult: Ifthey did there would be very, very few people receiving that prescription, so it’s taking methe better part of a few days to be able to say bam-lanivimabKyle: But along those lines, Ihave heard that a lot of these monoclonals are sitting on the shelves or sitting in storagerooms and not actually getting exploited. You work at two different infirmaries in southern California; are you actually treating patients with these? Dr. Seheult: Yeah, utterly. There’s a good deal of people thatdon’t know about these remedies, don’t know the niche, and it’s because their providers aren’taware of these things.Things are happening so rapidly 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 people can be aware of it. You’re absolutely right, there’s been a lot of this medication that’s been distributed, but it’s not being used. Now, thismedication is IV merely, and so it has to be infused in a facility that can monitor the patient forthe hour that it takes to infuse it, and so at one of research hospitals that I is currently working on they infusethis regularly in the emergency room, observer the patient, and then certainly they’re — because ofthe fact that they’re not going to be admitted to the hospital after the mixture is done — they’resent home.Kyle: One of the things I know that you wanted to do in this video, Dr. Seheult, was highlightthe things that we have really solid the necessary data for, preferably randomized placebo-controlled trialdata for, and then things that we have maybe less strong data for — observational data or data fromother maladies that may be similar to COVID-1 9. 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 going to go decades –even, you are familiar with, even 100 times — looking at oxygen and quantifying oxygen and knowing when we need to putpeople on oxygen, so that data’s been around for a very long time. In calls of the monoclonal antibodies, that was submitted to the FDA through an emergency use authorization, and the basis of thatapplication was a randomized, limited trouble, 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, assured trial, which is the gold standard for evidence.Now if we are speaking of some ofthe other things — for instance, supplements — that has going levels of evidence. Probably thesupplement that has the best level of indication is vitamin D. We’ve got randomized, verified trialdata in a couple of instances — one out of India with the shade study and also out of Spain withcalcifediol study, which demonstrated in a randomized, assured inquiry( albeit small-scale) that there wasdefinitely benefit in that group with COVID-1 9 that 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 inform 59, which I would encourage everybody to look at, I would stick with everything that i’ve said therein terms of preventing COVID-1 9 to be exactly the same as if you were treating COVID-1 9. And realbriefly, in revise 59, we talked about vitamin C, how there’s really not an optimal dose thatwe’re aware of.Vitamin D, on the other hand, is a different story. Initially, when I established the video, I was taking 2500 international components and I craved my elevations to be higher after I got them checked.I’m actually taking 5000 international cells a day. The Endocrinological Society is saying that theupper limits that you can take without a physician supervision is 4000 international parts 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 watching this 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 care provider first — there is some evidence out of Indiain the SHADE study where they afford 50,000 measurements orally daily for seven days, and then ramped itback down to a regular dose of approximately 4000 -5 000 components( international components ). So there is some data there in that study.At the end point, there was an increased clearance ofthe virus; there was decreased inflammatory markers. There’s ongoing tests, so we’ll find out more, exactly what the optimal dosing is, but remember not everybody can take 50,000 measurements oreven supplementary vitamin D as we’ve talked about before. There are some circumstances, like sarcoid, which that would not be the optimum thing to do so. Kyle: 50,000 parts sounds like a lot to me. That soundslike a whopping dose over seven days, but the patients in the study didn’t get toxicity onthat quantity? Dr. Seheult: No. No, in fact we’ve talked about this in our vitamin D video that we releaseda couple of weeks ago, Kyle, that goes to show that in an analysis where they looked at over 20,000 patients in the Mayo Clinic and looked at people who complemented anywhere from 0 up to 55,000 groups daily, there was only one person that had hypercalcemia from vitamin D toxicity in 20,000 patients, and as they said, it’s probably the most safe fat-soluble vitamin there is.Kyle: Are there anyother vitamins that you are able to make with vitamin D to potentially allow it to work better? Dr.Seheult: Yeah, there’s some evidence that’s rising that vitamin K2 is beneficial in facilitating with vitamin D. I wouldjust make a caution there that there is emerging evidence that this is the case, but for thoseof you who are on blood thinners, specifically Coumadin or Warfarin, apparently taking vitamin Kis going to be counterproductive to your care that you’re getting with that medication, soI would not recommend that in that situation. The other aspect that’s very helpfuland helpful if you’re go vitamin D is magnesium 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 parties got to go and do on their own, but always to discusswith their medical professionals first, compensate? Dr. Seheult: Absolutely, and the other thing I would addto is none of this is a hundred percentage protective 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, provides an opportunity to of tipping the scales in favor of you.In expressions of your immune organization, one of theother things that I mentioned back in MedCram 59 a number of months ago was that I took Quercetin, and while there is some data in ebola and other viruses that Quercetin may be beneficial, we werewaiting for studies to come out on Quercetin in SARS-CoV-2. There’s a good review of Quercetinin Natural Product Communications put out by SAGE Booklet that was published this month inDecember, and it basically goes over the prior data supplied by other viral illness and also in vitrostudies that seem to indicate that Quercetin might be beneficial. But, again, we have no randomized, placebo-controlled trial data. It seems as though the risks of Quercetin supplementation is prettylow, which performs the benefit-to-risk ratio fairly high 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-controlled trial to ameliorate the manifestations of theflu virus — not COVID-1 9 but the flu virus– and because of this and likewise the antioxidantproperties of n-acetyl cysteine and the oxidative stress belief that we see in ACE2 inhibitionthat we see in COVID-1 9, it was felt again that the benefits of do supplemental NACoutweighed the risks, peculiarly over a wintertime season, but consider scaling back or stoppingthem once this pandemic has subsided. You know, the n-acetyl cysteine was measured with influenza duringa winter season, so I don’t think we should be on n-acetyl cysteine for the rest of our lives. Ido think that supplementation with vitamin D is going to be beneficial during a wintertime season, specially if “were living” above the 35 th similarity. Kyle: Okay, well, you Dr. Seheult have four differentboard certifications that you maintain in internal medicine, critical care, um let’s see what else, pulmonary medication, and sleep medicine as well.So I remember the next thing that you wanted to talk aboutwas was sleep.Dr. Seheult: Yeah, so sleep is very important, specially now that we’re talking about peoplegetting vaccinations. So it’s not only important if you have COVID-1 9, but it’s also important ifyou’re planning on getting vaccinated because we’ve got good data that goes back many years interms of the flu vaccine that if you are getting at least seven hours of sleep prior to vaccination, the antibody response and the immune response is much more robust and better after vaccinationif you’ve had a good night’s sleep, and that too disappears along with trying, again, to prevent yourselffrom getting the infection. They did research studies where they purposelyput rhinovirus into the nasopharynx into their nose, mostly, of students, and those that had a good night’s sleep from previously when they interviewed them, hadmuch less chances of getting a coldnes and coming the virus than those that had not been.So sleepis very, very important. The interesting thing I would mention about sleep is it’s particularly the hoursof sleep early in the night. It is those hours that is associated with slow motion sleep, so the hoursof sleep before midnight are probably worth more by hour than those after midnight. So turning offelectronic designs, turning off the television , not reading your facebook page or remarks are thingsthat got to get emotionally charged. These are all things that are going to prevent you from going tosleep. It’s better to shut down at that point, go to bed, and get that slow-wave sleep. By the action, thatslow-wave sleep tribulation is associated with swelling hormone secretion, which is really, really importantin terms of longevity. Kyle: But if I’ve just tested positive for COVID-1 9, I might be a little restless, gonna be hard to get a good night’s sleep. Is there anything else, like any augments I couldtake? Anything else you’d recommend if I’m having trouble sleeping? Dr.Seheult: So we’ve talked before about theoxidative mood of COVID-1 9 and the facts of the case that the ACE2 receptors made out, and the bottom line hereis that we are seeing more and more evidence that oxidative stress is playing a significant role inthe deleterious effects of SARS-CoV-2. One of the things that would help in terms of sleep, and alsoin terms of an antioxidant, is melatonin. Now some people might notice that melatonin labours reallywell for them, other beings not so much so, but taking a supplement — maybe three to five milligramsabout an hour before bedtime of melatonin — would be beneficial in some people in terms of antioxidants, but also in in terms of helping you get to sleep and falling asleep, so that you can get the seven hours of sleep that you need. And then finally zinc, which has been talked aboutquite a bit.Still recommending it, but not larger than 40 milligrams of primal zinc per period, andbecause zinc can be complex with many different ionic complexes, such as picolinate, such as sulfate, you’ve got to look up the actual elemental zinc in each combination 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’re trying to prevent COVID-1 9 illnes or whetheror not you have it. But is there anything else that you should be doing on top of thisif you come down with manifestations of COVID-1 9? To answer this question, let’s again reviewthe course of SARS-CoV-2 infection and how it progresses. So we learned earlier today in the courseof this ailment in a article published in the Lancet in mid-February that from infection to symptomsis an incubation period of about five days, and then after symptoms develop, there’s about sevendays where these symptoms become more and more progressive, and if it leads to hospitalization, that’s when it’s going to occur at about the seventh day nearly. And so the course ofthe disease in those people who are symptomatic is they get the infection and, of those people who aresymptomatic, about 20 percent of those patients will go on to need hospitalization, ventilators in theintensive care unit, and potentially even death.But 80 percent of those patients who developsymptoms will actually get better on their own, and the reason why they to be all right on their own in theearly phase is due in part to the immune structure, and as we’ve talked about this before, there is the innateimmune system, which you see here on the left, and there’s the adaptive immune organisation whichyou see here on the right. And each of those have their own cell types. We’ve talked aboutimmunization and that “ve got a lot” to do with what we investigate there on the right with the T cells andthe B cells and plasma cadres, which make antibodies, but it’s becoming increasingly clear in theearly part of the infection — that part of the illnes where the patient is at home and he’shaving slight indications — that the members of the immune organization that’s really responsible for takingcare of this is the innate immune system, and regrettably this portion of the immune system, the innate immune method, get weaker with age. And the particular cell types that are involvedwith the innate immune plan are the monocytes and the natural executioner cadres, and one of theprimary out makes, if you are able to, of the innate immune organisation is the interferon response.It’s very important that this molecule interferon 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 even to the point of needing hospitalization. Here’sa newspaper that was published in March in the Asian Pacific Journal of Allergy and Immunology, wherethey looked at the first SARS virus and likewise MERS and other coronaviruses, and they said herevery interestingly that it was the active viral replication later upshots in a hyper productiontype one interferon response. That’s after it is squelched early and what they say here, basicallybased on all of this data, is that these facts strongly have shown that the innate immune systemresponse is crucial for disease outcome, and those prognosis endure out here was a paperthat was published by Dr.Gough, where she remembers the data and says that studies of SARS and MERSsuggest that the interferon response is delayed compared with coronaviruses that make milddisease, and with milder cases of these two coronaviruses that can cause severe disease, thepatients with severe SARS or MERS had higher viral loads and retarded interferon responses; thusit could be that the patients most susceptible to severe ailment are those that cannot mountan effective early antiviral immune response. She goes on to state that a study of 50 patientswith subjects ranging from mild to severe found that gene expression charts indicating sort 1 andtype 2 interferon responses were highest in cases with slight to moderate disease and werelow in patients with serious or critical disease. A similar divergence in character 1 interferon activitywas detected in the serum from individual patients. Patients with more severe disease had lesstype 1 interferon the actions of their blood and this is data from August of 2020, which waspublished in the esteemed journal, Science, and it testifies exactly what the doctor was talkingabout.Here we recognize the amount of interferon, which is being exuded and, compared to nodisease, we hear a large amount in slight disease and increasingly lower levels as we get morecritical, been reported that the interferon response is very, very important. Again, looking at interferonactivity, we see it being elevated in mild disease and much lower in critical canker. Also publishedin Science were two newspapers that basically asked virtually 14 percent of all of the severe COVID-1 9cases that were studied and essentially what they found was that in cases with mutations in theirability to mount an interferon response there was essentially no interferon, and they only foundthese type of cases in severe cases. In addition to providing that, they likewise determined patients with antibodiesto interferon and, again, those interferon levels were very low in these patients and onlythese patients were found in the severe category. In other paroles, there were never patients withantibodies against interferon in the mild subjects, whereas if we look at those patients that did nothave any mutants and did not have antibodies against interferon, now we understand a very largesmattering of interferon responses, and these patients were more mild.So because of all of this, it seems as though to me that any way possible that we can enhance especially the innate immuneresponse early on in the course of this canker, there is a potential for limiting progression, because of what we are seeing in terms of the signature of COVID-1 9, which is suppressionof interferon. Well if you look at the data in 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 indicated here by a Representative publication here in 2002, and what the fuck is did now was they quickened human monocytes by entire organization hyperthermia. This was 12 health volunteers, which were immersed in a 39.5 grades Celsius hot water bath to increase theirbody temperature, and what they found was that three hours after in-vivo hyperthermia, theresponse of monocytes to endotoxin was enhanced by an ex-vivo lipopolysaccharide stimulation assay.Essentially what they’re doing there is they’re giving 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 part alpha liberation and that they concluded the thermal effect offever instantly triggers monocytes, which increases their ability to respond to a bacterial challenge.And this is part of the reason why I was hesitant to treat a excitement that wasn’t above 103 Fahrenheitearly on in the course of the disease, because it seems to me as though the delirium is enhancingthat exceedingly parcel of the immune structure — the innate immune system — that’s required to put an end to theprogression of COVID-1 9, but there were more studies. In this one, investigates at the University ofToronto took seven healthy voluntaries and looked at the effect of cold water at the end of heatingand exercise.In other texts, heating them up and applying them employ, and then putting them ina cold bath to see what happens to natural assassin cadres, lytic parts, etc ., and this is exactly whatthey found: they said that this study suggests that, despite popular beliefs that cold exposurecan trigger a viral illnes, the innate constituent of the immune organization 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 cold revelation contributed significantly to a consistent and statisticallysignificant mobilization of circulating cells, an increasing number of natural gunman selectivity, andelevations in flowing IL-6 accumulations. But the real tour de force in terms ofpublications was this one named “Hyperthermia in Humans Enhances Interferon-beta Synthesis andAlters the Peripheral Lymphocyte Population.” So basically mitogen stimulation is something thatstimulates the cadres of the immune organisation as if there was a foreign invader, and what it showedwas that when they took interferon and assessed the amount of interferon that was secreted fromlymphocytes after mitogen stimulation at different body temperatures, there was a ten-fold increasein interferon response at 39 degrees celsius, and again this is the extremely molecule that is lacking aswe found out earlier in the early direction of COVID-1 9, which led to the loss me to think, was impossible that earlyon in the course of COVID-1 9, if we wish to do hyperthermia in some way, could it vary thecourse and the progression of this malady? And at first this sounded kind of far-fetched.Is it something so simple that might have such a big benefit? Well, first of all, we don’t know ifit has a big benefit, but if we looked earlier in biography, things like this have been done beforeand I ogled to the example of Dr.Julius Wagner-Jauregg, who was an Austrian psychiatrist and notedthat his patients with neurosyphilis got better when they had a fever, so he went aheadand infected them with malaria on purpose and essentially medication them of their neurosyphilissimply from the excitement of the malaria, and then he medicine them of their malaria utilizing 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 article that was published in 2013, simple immersionof the individual in a sizzling tub or arranging him in a hot locker was one of the means bywhich this was done, and I believe a lot of these techniques were forgotten because the verynext year after Dr.Wagner-Jauregg won his Nobel Prize, in 1928, we detected penicillin and opened up acompletely new door of therapeutics, and so once againI do not have randomized placebo-controlledtrial data showing that hydrotherapy is effective in treating COVID-1 9, but there seems to bebiological plausibility that it could direct, and that’s why I am interested to see randomizedcontrolled trial data being done and studies being performed to see whether or not this in fact works.What are the risks of hydrotherapy? Well you have to use hot water and so there is the potential ofburning.There’s also the potential of heating up someone’s figure 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 home; there’s no prescription that needs to bewritten; and you’re not using up resources that need to be used by somebody else. And sobecause of this, I believe that the benefits outweigh the health risks currently for hydrotherapy, and if anyone is interested in looking more into this, I will have links in the description below.Kyle: Could public also use hot and cold showers or a hot tub or a sauna if they have access tothat to get the same effect? Dr.Seheult: Yeah, perfectly. It’s just a matter of getting thetemperature up. So, for instance, their own problems with some spas at least in the United Country is thattheir peak temperature was in accordance with 104 measures Fahrenheit. That may not be enough to get the corebody temperature up. You truly 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 expressions of showers, as you’ll notice when wetalked about this back in modernize 59, taking a hot shower be accompanied by a freezing shower is a good what wecall a “tonic” or something that impedes your immune structure on sentinel procedure, looking forthings, if you actually come down with the disease. I don’t know if merely doing distinguish showersis going to be enough to really get the immune system travelling, so sauna would be great, spa wouldbe great.If you could get the temperature up hot, water bathtubs, 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 sure you’ve got a cold towel on your manager or neck, so that your intelligence is not warming up in temperature, simply the body. Do that for about 20 minutes andthen a very quick cool down at the end, and allow that to stimulate the part of the immune systemthat is hushed in COVID-1 9. Kyle: If someone assessments positive and they are not sick enough to need togo to the hospital and they’re going back home, what are some approaches that they can employto prevent other parties that they live with from going sick? Dr. Seheult: Yeah and this is the realproblem because spread happens at home. A great resemblance to use if you’re in a homeis to think about somebody who inhales in your home.If they’re on the other side of the housesmoking, you might not be able to smell the inhale, but after a long period that cigarette isgonna is, mostly, gonna infiltrate the house, and eventually you’re going to odor thatsmoke, and that’s really the practice it is with the spread of this virus. So you’ve got to thinkabout both modes of spread if you want to prevent both modes of spread, and the first state ofspread is with sizable droplets, and that’s where concealments come in. So these large-scale 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 talked about with smoking that you can be on differentsides of the house wearing a mask, but eventually the other way of that virus spreading whichis tiny little molecules which become airborne and precisely suspend in the air. The road you preventthat is by turning the breeze over, and so having a house that’s closed up with the windows closed, the doors closed, you’re not going to get the kind of air exchanges that it is necessary to, and so to reducethe amount of COVID transmission through airborne, cracking the window open, ventilating thehouse, putting in some hepa filters in your breath filtration, or even portable breeze filters aswell.Having all of these things travelling at the same time is a multi-pronged approach to preventingspread to you. Now the other thing you do is isolate that person who is positive to one place ofthe house. They can crack the windows open in that area of the chamber of representatives, have air filtration moving, maybethey’re going to have to wear some warmer garment to compensate for the windowthat’s cracked open, but again these are all things that can work together. I reflect actuallycracking the window open and getting aura exchanges and ventilation is even more important than thetime that we throw in wiping down skin-deeps. That’s actually probably not a large way that this virusis spread.Kyle: Okay, Dr.Seheult, to summarize: if I were to get a positive COVID-1 9 experiment, and I have eitherno evidences or mild symptoms, you would recommend potentially get a pulsation oximeter, checking tosee if i’m in the category of cases that might benefit from prophylactic monoclonal antibodies, you are familiar with, antibodies in advance of going sick, a variety of immune boost strategies, including vitamin D and a few cases other complements, hyperthermia if i have an opportunity to do that –whether it’s with heated towels or a hot tub or a soak or hot-cold showers or a sauna if you haveaccess to that — sleep, trying to optimize my sleep, getting at least seven hours a darknes, and thencertainly trying to prevent the spread to other parties, so isolating myself in the home to the bestof my clevernes, opening a space a few inches for ventilation, considering replacing my heating andcooling system air filters with a high efficiency filter, and I believe it’s a MERV 13 or higher thatyou really want to capture those virus molecules, 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-spirited 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-1 9 and i’m feeling sick? It’s been three or four periods, what do I do? ” And now what I’m going to do is I’m going to simply refer them to this video, becauseI feel everything that you’ve just said there there, Kyle, is everything that I’ve been tellingpeople in the last couple of months that have been calling me about “what do I do? ” This is exactlywhat I think we ought to be doing and hopefully it will start to flatten the arch in addition toeverything else that we know is helpful, including wearing concealments, outside social distancing, and all ofthose interesting thing that we need to be doing. 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