COVID-19 Podcast: Mom Driven, Doctor Aligned & HeyMama Join Forces

Transcript

[00:00:00] Agatha: Hi!  It’s Agatha Luczo.  Welcome to “Mom Driven, Dr. Aligned”.  Dr. Alan Greene and I were just on with the HeyMama Community doing a Q&A about COVID-19.  Dr. Greene gave us such amazing advice and tips about how to deal with immunity health and how to take care of ourselves during this time. And some advice I haven’t heard anywhere else. I’m excited to bring all of the conversation to our family and friends. 

[00:00:36] Dr. Greene:  Wonderful to get to be with the HeyMama Community. I’ve gotten a bunch of questions already that we’ll dive into.  And as a pediatrician, I’m happy to say that as we’re dealing with this historic event, the COVID-19, that with the experience of the first, more than a million people known to have had it, kids are the group that have been least affected medically by the virus. They’re the least likely to get sick. And if they do get sick, the least likely for it to be serious. So there’s lots of good news and answers to the questions we got today in that regard.

[00:01:14] But this is still really important and really important to understand, to be able to communicate with your family and with your kids. So the first question that came in was, what do you recommend for wearing masks? And to answer that question, I think it’s smart to take a step back and explain just a little bit how Coronavirus works.

[00:01:37] If you understand that, it’ll help with the answers to all these questions be a little more clear. So I understand how it works. If you take a deep breath in, besides all the wonderful oxygen that you’re getting, what happens in the room right around your face as you create these invisible air currents that pull the air deep into your lungs, and if there happened to be viral particles in there, their Coronavirus, you pulled those inside of you as well.

[00:02:04] Now the Coronavirus is not alive. It can’t move, it can’t swim, it can’t crawl. It doesn’t eat, it doesn’t drink. It doesn’t breathe. It doesn’t poop. It’s just a little packet of RNA, a code, a blueprint wrapped in a membrane. It’s floating in the air in water droplets, and if you inhale and it’s there, it goes deep in your lungs.

[00:02:27] Now in the airways, it doesn’t cause a problem. It’s just a little packet of stuff that’s not a big deal, but you’ve seen pictures of it in the news. Those red spiky things, not really red, but they, they’re colored red so you can see them. Those are like keys that happen to go into the locks of certain cells in the body, receptors, and those cells are ones that have something, a receptor called the ACE-2 receptor.  You don’t have to remember the name of it, but it’s throughout the lining of the lungs as well as in the GI tract and heart, arteries and other places. That key just slips into those cells, that lock, connects there and dumps the RNA into the cell. And that’s where the problems start. Because inside the cell (even though the coronavirus can’t reproduce, it can’t eat, it can’t drink, it can’t move), our body recognizes it and starts to make the proteins that are coated in that little bit of RNA. It starts pumping out proteins and the very first protein or the big protein that it pumps out is one called replicase. It reproduces, it replicates and we start making copy after copy after copy of that virus, those cells die and open up and create a mess.

[00:03:32] And from that first time you inhale it, they start growing exponentially, the number of viruses in your body every 12 hours, and within about three days, millions of them come out every time someone coughs. So coughing is one way that the virus gets out. We now know that just singing the virus comes out because of forced air.

[00:03:52] We know that just talking, it does, not quite as far as if you’re singing or if you’re coughing, but even breathing, some of the virus particles come out. So there’s an experiment I’d like you to do today if you have a chance, and let’s get close to a mirror and just breathe under the mirror and fog it up.

[00:04:08] When you fog a mirror with your breath, what you’re seeing on the mirror are the water droplets that were inside of you that come out. And if you happen to have Coronavirus those would be filled with the viral particles. And most of the time we don’t see that fog because there’s not something for them to condense on what they’re, they’re around us all the time.

[00:04:26] Every time someone who is sick exhales, the viruses are in those water droplets and then it drifts down to the ground. And it’s like maybe from breathing maybe three feet away from you, from coughing, maybe six feet away from you and it drifts down under the ground in front of you. Or if you’re standing in a bathroom counter or on the sink in front of you, or if you’re standing in a grocery store on the shelf in front of you, and that leaves this veneer of viral particles that stay there for a little bit.

[00:04:55] So what do I recommend for wearing masks? I think masks are a fabulous idea. And there are three things that they do. The first thing is if you’re wearing a mask, it stops those water droplets from spraying out into the world into the air around you and it stops them from coating the surfaces in front of you and at your feet.

[00:05:18] So it’s very protective for those around you. So if I wear a mask and I see you, I’m protecting you. If you wear a mask and you see me, you’re protecting me. And if we all do it, transmission goes way down. It really adds to our protection for each other. The countries that have done it, it’s made a big difference.  And mechanically we know it works. 

[00:05:39] So that’s one thing. My mask protects you. There’s a second way masks work too, and that is, they do help a little bit. If you take that deep breath in and there’s a mask in front of your face, a smaller number of viral particles will get in, and it doesn’t completely eliminate that.  N95 mask eliminates 95% of them, but it does reduce it.

[00:06:01] And it also reduces the particles that get there because you’ve touched these surfaces and you touch your own face and they’re there and when you breathe in, you pull them in so you don’t touch as much when you’re wearing a face mask. Now, I do recommend wearing a mask anytime you’re in public and it’s a great thing to do.

[00:06:18] One other thing that it does, besides stopping you from spreading, besides protecting you a bit, is that it increases humidity of the air that you’re breathing, and it turns out that’s really useful too. There’s been a lot of studies looking at the transmission of COVID and it turns out it transmits most in very dry air humidity below 30%.   And in New York City, for instance, the average humidity indoors during the winter with heaters on is less than 30% where it propagates the best.

[00:06:49] It propagates the least well, at a humidity between 40 and 60%. So if your air is drier than that, you may want a humidifier. If it’s wetter than that, you may want a dehumidifier and a mask is a great way to get the right humidity for you when you’re out in public. So that’s what I recommend about masks.

[00:07:06] Next question is are homemade masks safe enough for us to use. And the answer to that is absolutely that homemade masks do help some, but they are not all created equal. It matters both the material that you use and how many layers of it there are.  A simple bandana mask with this one layer is not very effective.

[00:07:31] Even a double layer bandana mask is like an N16 and only takes out 16% of the particles. So the materials that work the best are vacuum cleaner bags, really high count pillowcases, like 600 thread count or higher. And the more layers that you do, the better. The very best ones tested had been made by quilters.

[00:07:51] The quilting fabric tends to be really good at blocking particles going through. So a quick way you can tell if you’re making a mask for yourself,  there’s lots of videos online for how to do it, but there’s not a lot of videos about how to tell how well they work. And the best thing to do is just take whatever homemade mask you’re thinking about doing and stand in front of a mirror and blow through it.

[00:08:11] And if you can fog the mirror, the water droplets are getting through. And I’ve found that if I take a tee shirt and I do the eight layers thick, I can still fog the mirror almost as well as I could without it. But I took a hand towel a little bit ago, folded it so it is eight layers thick and I can not, I can breathe through it, but I can’t fog a mirror through it.

[00:08:33] So quick and easy test. Next question. 

[00:08:36] Agatha:  All right, I will be making my masks out of hand towels.

[00:08:39] Dr. Greene:  A hand towel!  But it doesn’t need to be at N95.  It could do all those things. It can really protect other people, help you out yourself and keep it humid in there. And I see a question that came through in chat. My older kids are 13 and 11. I’m worried about the volume of technology they’re using at the moment, particularly  the13 year old is gaming, but it is a way of connecting with his friends who know, I know he’s missing a lot. Should I try to limit this? Am I allowing longterm bad behaviors to creep in? Really good question. I want to think that’s on a lot of parents’ minds right now, trying to figure out how to spend the days home and disconnected.

[00:09:18] So in normal times, when I think about screen time, I think about sort of four different categories of it. There’s not a clearcut difference, but they’re different in focus. So one of them has passive screen time where you’re sitting and watching something. One of them has interactive screen time where you are playing a game or doing something that’s engaging you to be involved.

[00:09:39] One is creativity where you’re creating something. You’re writing online or you’re painting or you’re making videos or whatever, and one is connection where you’re like, we’re doing right now connecting with each other and in the relatively normal time,  I suggest for kids to aim for an hour of passive time and an hour of interactive time and communication as much as seems good, where they’re still doing the other things they need to be doing. Homework and play and connecting with the family. During this COVID time, I think it’s very reasonable to actually have a conversation with kids and say, we’re gonna double the limits now because so much else that you would be doing is off the table and I want you to connect. So maybe two hours of passively watching something, watching a movie or whatever, maybe two hours of interactive playing and then I think connecting with friends is great. Teens and preteens really need to be social. They really need to connect with each other. So I’d be a big fan of that happening. 

[00:10:43] The next question I see is if you’re out of hand sanitizer, can I use isopropyl  70% alcohol somehow? And the answer is yes. That alcohol between 50 and 70% does work well.

[00:10:55] You can actually mix it with Aloe Vera gel, which is not sold out in as many places, and then you make your own hand sanitizer. That’s that way. But it’s worth mentioning that soap works even better. Soap and water. It destroys the membrane outside the virus, so cannot get into your cells and works very, very well.

[00:11:14] For Coronavirus, the key with hand-washing is to make sure you get all the surfaces. If you just do the normal washing motion like this, and a lot of people do, a lot of your hand could still be covered with viruses. You need to get the backs of the hands in between the fingers. You need to get the thumbs, you need to get the top part of the fingers and the fingertips.  But did you get all parts of the hands? Soap works even better than the hand sanitizer, but you can make your own alcohol between 50 and 70% is better than higher percentage alcohol. 

[00:11:46] Let’s see. Next question. What are the symptoms kids are showing with COVID-19 that are different than a cold and the symptoms that kids are showing?

[00:11:57] Go back to that story of what happens when most people have no symptoms at all for about five days after they’re already infected, and a couple of days after they’ve already got millions of particles coming out with each breath. But when they do start to have symptoms far and away, the most common symptom is a fever.

[00:12:13] And most common colds don’t have much of a fever. Number two is a dry cough and a dry cough is a little less common with that. Number three is fatigue, and you might get tired with a cold, but people tend to get more tired, some extraordinarily tired with Coronavirus. And shortness of breath. And I mentioned that the cells in the lungs and had that little ACE to lock on them, those are the cells in the lungs that make something called surfactant. It’s this liquid that bathes the lungs and helps it expand and contract in a smooth and subtle way. And when you don’t have enough of it, your lungs are stiff and you feel tight and your shortness of breath. And that’s one of the problems with Coronavirus early on is that it’s actually directly damaging the lungs.

[00:13:00] Later on, it’s the inflammation and inflammatory storm and the cytokine storm. The problem. So kids tend to get that. Kids also may have, and it’s not as many — fewer than 15% — but they may have diarrhea or nausea or vomiting with it. There are cells in the GI tract and kids are more likely than adults to get it.

[00:13:21] They may have pinkeye because sometimes some of the particles will drift into the eyes. The coronavirus is not going to get into our bodies except through our face. That’s the only way in. So if we can protect our face, and by extension our hands because we touch our face, whether we try to or not, then we can protect ourselves.

[00:13:43] They only leave our bodies through our nose and mouth and through poop. There is Coronavirus in people’s poop and that is another good reason for washing hands at home. There’s another question. We are worried about foods carrying the virus. Is there a high risk with fruits and vegetables that we buy at the grocery carrying it? How can we clean them?

[00:14:02] At UCSF, they’ve been studying this — looking to see if food transmission is an issue. So far, and there are the more than a million cases so far, nobody’s been able to demonstrate transmission through food. It does not live long on food and typically if you get sick, it’s from inhaling, not from swallowing.

[00:14:19] Because the acid bath in the stomach tends to do a pretty good job of destroying the virus by itself. So I’m not terribly worried about food. I am a little bit worried about the packaging that virus could be on there, so I would wash my hands after touching the packaging. But the food itself, I’m much less concerned about, not a major way for people to get it.

[00:14:43] Agatha: [00:14:43] Talking about packaging, should any packages that come in, do you recommend wiping it down before opening it up or bringing it into the house?

[00:14:52] Dr. Greene: There are a bunch of different ways to handle that, but I would look at any package coming into the house as potentially contaminated and there’s a lot of ways you could deal with that.

[00:15:03] One would be to open it outside or just inside the garage or somewhere else and wash your hands. Another way to do it would be to wipe the whole thing down beforehand and then deal with it, but just be thinking of it as potentially dirty. 

[00:15:14] Dr. Greene: Another interesting question is, would it have been possible for a child to have already had COVID earlier in the year, like January?

[00:15:25] That has not been reported in the U.S., but we know that it was first reported in December in China. It may have been around for a month or two months or even longer before people became aware of it. And we know that on average.14,000 people were coming from China to the U S every day in January. The travel ban went into effect February 2nd and so in 2020 before the ban, about a half a million people came from China to the U.S.during the time of the epidemic. A bunch of them came from Wuhan, which is a city bigger than New York.

[00:16:03] It would not surprise me at all if there were people that just had what they thought was a bad flu or bad respiratory infection and nobody was testing or identifying it yet and that kids have already had it. We’ll know more about that very soon when tests become available, that allow us to test if you have already had it or not.

[00:16:23] The FDA approved the first test this week for antibodies. They’ll be coming out pretty quickly.  Stanford, this Thursday and Friday tested a few thousand people as part of a research study to see if the test works and expecting it to be a live test in one to two weeks. So pretty soon we’ll be able to know who’s had it, who’s not. That will be great. If you already know you are already immune, you have a window where you could be out in public and not be at risk. 

[00:16:45] Another great question. I have heard you shouldn’t treat with Advil or ibuprofen.  Tylenol only. Is there truth to that? And maybe. So there was a rumor that went around, and particularly on Twitter, a couple of weeks ago saying that the WHO had warned against using ibuprofen. I heard about it from so many different places. The WHO subsequently put out a statement saying, we are not recommending against using ibuprofen, but there are people who do.

[00:17:20] Some of the health leaders in France and England who think that it’s a bad idea. Leaders in Italy think that it’s actually really useful in coronavirus. The answer is nobody knows for sure. It’s not been well studied. The reasoning against using it is that we know ibuprofen, if you’re using it regularly, tends to make people make more of the ACE 2 receptors, the doors that the virus gets into the lungs, and so that’s not a good thing theoretically. The reason for using it is that it stops inflammation or reduces inflammation, and that’s one of the biggest causes of damage in Coronavirus. So if I had to guess, I would say it’s probably not good to be taking it chronically when you’re exposed. Maybe even early in illness, and it probably is really useful in the second half of the illness, but my advice would be if you’re just going to do something at home, I would use Tylenol or acetaminophen for comfort and save ibuprofen for, in a conversation with a doctor, when it might be useful or targeted, but I wouldn’t immediately rule it out for sure. 

[00:18:25] Next question is, do we know how long the window is after you have it when you’re immune? And the answer is, no. It hasn’t been around long enough to know for sure.  With some of the other coronaviruses that have been around and the immunity has been tested, tend not to last real long, maybe a year, maybe for a season. We’ll know as we continue testing the community going out. 

[00:18:47] Another question is, how accurate are those antibody tests? There are a number of antibody tests that I’ve seen that are available on an emergency basis that are not very accurate. If it’s a positive test, it does not mean that it’s actually positive.  If it’s a negative test, it does not mean that it’s actually negative. They’ve been tested against the Gold Standard PCR testing and not be not that great. The new one’s coming out from Stanford, Cedar Sinai, Mayo Clinic, all look to be really accurate, but it’s going to be another couple of weeks for those.

[00:19:20] Next question, sort of a heart felt question, is it safe to still breastfeed if you get coronavirus?  I could just imagine having a young baby and needing to connect, and am I going to be more likely to get them sick if I breastfeed or not? And I can tell you that as of today, as of April 5th that the CDC has guidance for breastfeeding, as does the American College of OB GYN Obstetrics and Gynecology.

[00:19:48] But it says that breastfeeding we know is incredibly good for kids. That is great nutritionally and immunologically there things that they can’t get. We know that with most viruses, including influenza, that it’s better for kids to nurse during it because it gives them more protection than the risk of getting exposed and that with COVID out of the first more than a million cases that have been out there, it’s not been demonstrated in anybody where we’ve looked to have COVID in the breast milk and when they’ve analyzed for it, but that doesn’t mean it’s impossible.

[00:20:25] It could be there in some people, and it hasn’t been discovered yet, but it looks like the biggest risk to moms spreading it to baby is those droplets that fog the mirror and that mom wearing a mask and washing hands before picking up the baby is the biggest thing at preventing. So the recommendation is not to forbid it, not to say you have to do it, but to say that it’s a reasonable thing to do.  But the most important thing is the mask and clean hands.

[00:20:56] Another question just came in. If you are pregnant and contract the virus, will the fetus get it? And there is still a lot that’s unknown about that. We know that there are many times so far that the fetus has not gotten it. So it doesn’t mean that it’s a sure thing.

[00:21:12] There’s some babies that have had it early where it’s not quite clear if it was that they got it from early exposure or got it from pregnancy. So I don’t really know the answer to that yet, but it doesn’t seem to be a major problem at this point. 

[00:21:25] Another related question. If I get sick with COVID-19, is it safe to take care of my eight month old baby?  My husband is supporting the family now and ideally cannot pause work. And that’s sort of similar to the breastfeeding question, that the biggest risk is through the droplet spread and that wearing a mask around the baby and washing hand is wise and as much as practical being six feet away, being careful not to cough on the baby, but to cough inside the elbow.

[00:21:58] Do not want to cough on the hands and get stuff there. It’s a balancing act. The good news is that while COVID is much worse than flu in the elderly, it is, so far, better than regular flu in kids, and so I would feel you need to do what she needs to do to take care of your baby. 

[00:22:21] Another question, are there any supplements you would encourage now to help boost immunity?  I’ve heard that vitamin D and zinc have been recommended. Well, let me answer that by one other related question first, and that is, or one other related idea and that is that during this time that other respiratory viruses, colds and flus and things like that, that preventing them is more important now than ever.

[00:22:51] And here’s why. In San Francisco where there’ve been lots of people now tested for COVID that have symptoms, are already sick and have respiratory illnesses, only about 5 to 6% of them have tested positive for COVID. So more than 90% of those folks are sick with something else right now. Those are people that are scared and are worried and are having to quarantine themselves from work or family and stressful for them.

[00:23:19] Wouldn’t it be great if those people didn’t have a different virus right now? It’d be so much better for them. The health system is going crazy doing testing, these drive up tests, where people are in hazmat suits and car after car after car, and it would be so much better for the health system, not to have all these people sick without the respiratory viruses. And beyond that at Stanford, in our first checking of people, we checked for COVID and a bunch of other viruses, 22% of them who had COVID also had a cold or the flu or another respiratory virus, which makes them sicker.

[00:23:55] So, we know that vitamin D reduces other respiratory infections. In fact, some people have the idea that the reason for cold and flu season is that it’s low vitamin D season because the angle of the sun is less. We don’t make vitamin D as well when the angle of the sun is less and are indoors more often, then our vitamin D levels tend to fall and maybe that’s the reason that we get cold and flu in the winter.  To test that some doctors decided to take kids and give them for a school year, either vitamin D or a placebo capsule and just to follow them over the course of the cold and flu season. And they found the kids who had not been getting vitamin D but did start taking it, had two thirds less swab-proven influenza than the others, and it was really effective in preventing flu.

[00:24:42] And so I’m a big fan of kids getting vitamin D right now, and it may directly help with COVID as well. We know it helps the innate immune system, the part that tackles COVID, and we know that it reduces inflammation, which is a big problem in COVID.  So I would definitely suggest vitamin D. And as for zinc, we also know that zinc can decrease colds that people who get 30 milligrams of zinc when there is a cold going on daily, the cold lasts about 30% less, and that’s over multiple studies.

[00:25:13] It actually does decrease the severity and duration of a common cold. By itself, that’s a good reason to do it right now, but doesn’t help COVID, and the answer is pretty interesting. I told you, when the virus gets into our lungs and it gets into a cell, one of the first things that it does is start making copies of itself and just getting stuff called replicates and like more and more and more and more copies and zinc inhibits, powerfully inhibits, replicates.

[00:25:40] It stops it from permitting so many copies, but that is zinc inside of the cell, and just because you take a zinc supplement, doesn’t mean it gets into your blood and it gets between the cells, but it doesn’t necessarily mean it goes inside. 

[00:25:55] So a few things. One, this is a time you do not want to be zinc deficient.  If you’re not getting enough zinc in your diet, you should definitely be taking a supplement or eating the foods that have it.  Shellfish and oysters have the highest level. Crab, lobster, beef, and poultry. and pork all have zinc in it. Pumpkin seeds, Sesame seeds, cashews, beans tend to have it, but you want to get plenty of zinc in your diet or take a supplement.

[00:26:19] But the second thing is that there are four known substances that open the gate for zinc into the cells or foreign owned types of substances. So if you’re going to take zinc, that’s the stuff that you want to be taking at the same time to make the biggest difference for it. And here are the four things. One of them are a class of antimalarial drugs, chloroquine and hydroxychloroquine, and the ones that are in the news a lot right now, and maybe one of the big ways that they work their prescriptions and it drives zinc into the cells, but the other three are not prescriptions.

[00:26:52] One of them is something called quercetin. It’s a flavonol. It’s a wonderful compound that’s in red wine. A good reason to be drinking your red wine when you’re at home, not for kids. And it’s also in red onions, probably less for kids, but great for adults, since the outer part of the red, I’m going to ask the most, they’re in red grapes.

[00:27:12] They’re in berries in general. Berries are great for kids right now. They’re in apples. This is a really good time for an Apple a day with quercetin besides being helpful against respiratory infections, opens the door, zinc inside the cell where it stops the replicates. Another thing that does it is green tea.

[00:27:27] Green tea is a really useful antioxidant. It also opens the door for zinc. It’s a zinc ionophore and the last one and the most effective of all of them that have been studied is something called coQ10. And so how do we normally get coQ10 and the story of that, something that’s only been learned in the last few years.

[00:27:44] It wasn’t normally in the supplement aisle. The way we got it historically is that when you eat green leafy vegetables. In the leaves, there’s chlorophyll chloroplasts — the stuff that does photosynthesis. And when you’d adjust it and it gets into your bloodstream in the capillaries, the chlorophyll and the metabolites are still there.

[00:28:05] And if you go out in the sun, photosynthesis happens inside your skin to that spinach that you just ate or whatever, green leafy vegetable, and it probably is thought to be one of the number one ways that we make CoQ10 is through that, through eating green leafy vegetables and being outdoors about two hours later.

[00:28:25] And that among other things, coQ10 is a powerful antioxidant, but it also gets zinc into the spot where it could stop that COVID replication. So yes, on vitamin D, yes, on zinc.  If you’re going to do the zinc, I would be eating foods with quercetin or drinking green tea, or having green leafy vegetables and getting in the sun.

[00:28:42] Agatha:  Oh!  And what about probiotics? 

[00:28:44] Dr. Greene:  Yeah. Probiotics are something else that had been shown to reduce respiratory infections. They’ve also done this study in kids where half the kids had probiotics, the other half had a placebo powder, and they were mixed up in the same classroom, so they were exposed to the same stuff, and those who were getting the real probiotics had fewer respiratory infections over the course of the year.

[00:29:05] We don’t know about COVID, but this is a great time for that too. And one other I should probably mention is colostrum, which when you buy it at a supplement store, it’s the first milk of a cow loaded with immune factors that has been shown to reduce other respiratory infections, including influenza, in several studies.

[00:29:21] Another question. Sorry to go back to the technology question, but I’m having supreme guilt over it as are many people. So are you saying that if they are interacting with friends, playing games in the presence online, it should be okay during this time to be more open with it? In my case, pretty much unlimited.

[00:29:38] I would say, more open with it. Sure. That connecting with friends is a really important thing to do and that playing a game, it’s probably one of the better ways to do that, but I wouldn’t say pretty much unlimited. You want them to be connecting with family also, and relatives. And perhaps grandparents or whoever there is, you want them to be spending some time reading, some time doing some kind of crafts. You want them to be physically active. If it’s possible to get outdoors where you are.   Our physical distancing, from each other, doesn’t necessarily mean staying indoors. Being inside, it’s a great thing to do. So I would make sure that there are other things happening in life other than just video games with friends.

[00:30:18] But I would be more open with it now than other times and be explicit that it’s because of the stay at home order that this is why it’s so much more right now. And then another question, should my 10 month old be wearing a mask as well? Again, the mask is by far the most effective at preventing you spreading it out, but it does help some if you can find a little paper mask or make a little mask that the 10 month old would be comfortable with, it would add a small layer of protection.

[00:30:45] I wouldn’t stress about it if because at work, not a huge deal, but kids do love to imitate at that age, and if they like them having a mask and you having a mask and you look at each other in the mirror and point to it and that it’s a take. Sure. That’d be great. 

[00:30:58] Now, the other question, my little girl has viral induced asthma.  Should she start taking her daily inhaled steroid again? They took her off because she has been doing so well. Thank you. I think probably everybody’s heard that in adults that the ones who get sick, and are the ones with certain underlying conditions with diabetes and high blood pressure and heart disease and lung disease, chronic lung disease, and the more things that you have going on, the more likely they are to get real sick with it.

[00:31:30] There’s good news. It just came out this week a couple of days ago about asthma, and let me pull it up here and read it directly. This is from the American Academy of  Asthma, Allergy and Immunology or Allergy, Asthma and Immunology. There is no data to support the belief that asthma is a risk factor for COVID-19.

[00:31:52] Available data suggests that the rate of asthma in patients with severe COVID-19 is the same or lower than the general population. But what we can tell so far from the first more than a million folks with it is that asthma does not make it worse. And so the best thing to do for people with asthma is to treat the asthma the way that you normally would.

[00:32:12] It’s important for doctors taking care of kids with asthma to know they have asthma, but I wouldn’t start medications in somebody who is otherwise doing well just for the sake of preventing COVID. It may not help at all and could even make it worse trying to avoid steroids unless they’re really needed for something during this because it does reduce inflammation, but also reduces the immunity a bit too.

[00:32:36] Another question, what preventive care can I do? We’ve already talked about the potential of zinc and vitamin D and probiotics and colostrum, but in many ways, the basics are some of the best things. The most preventative thing we can do is avoid exposure. So being at home, avoiding unnecessary trips to the grocery store or drug store.

[00:32:57] Wearing a mask when we’re in public. Great. Hand-washing is probably the most important thing and after that, the most important thing is likely eating as much real food as possible. Less of the hyper processed stuff with added sugar and real sleep. Sleep is really helpful for the immune system. And then the other things we’ve already talked about.

[00:33:18] Another question, my son is feeling very displaced. This might be a great one for you, Agatha. My son is feeling very displaced since we’re not at home and it’s hard to explain to him why we can’t go back to New York City right now. Any advice on how to handle that or what to say? 

[00:33:34] Agatha:  Well, Bambini Fortuna we’re really big at practicing rituals, so the more that you can keep kids on a routine and the same schedule and practicing the same rituals that you do at home, the more you’ll make them feel relaxed and comfortable where they’re at.

[00:33:51] Dr. Greene:  I love that, and I love your gratitude ritual, especially just being focused on things that we’re grateful for at this time. It’s powerful. 

[00:33:59] Agatha:  Yeah. I mean, every night during dinner time, and if we do miss  it at dinner time, we make another time every day to practice gratitude.  There are studies that show that gratitude does also help boost the immune system, and it makes you a happier and more positive person. So every day we practice gratitude and take a moment to think about what we’re grateful for and appreciate life. I mean, it is an awkward time for us all right now, but you know, what we’re most grateful for is the time that we have with each other and with the family. So turning everything into a positive. And we love our bedtime rituals as well. My kids, they look forward to having the bedtime ritual and the same ritual at home every night.

[00:34:39] Dr. Greene:  I love it. And one other thing we can tap into a little bit with kids since they often want to help others. And so just explaining that people are sick in New York right now, and one of the ways we can help the most is standing away right now. And it’s something we’re doing to help others since we’ll be back there soon.

[00:34:56] Another question. Are there ways to help clean the air in your own home? Does that help with COVID and, yes, absolutely. There’s several things. HEPA filters do remove the particles from the air, including viral particles, and so I’m a big fan of HEPA filters that can cover as much of the house as you can.  HEPA filter vacuum cleaners.

[00:35:18] And when it comes to air quality and spreading viruses, NASA has been on the forefront because in the space station you really want good air quality. You don’t, you can’t just open the windows and get some fresh air inside. And by the way, I am a fan of opening the windows when it’s appropriate here.

[00:35:35] Fresh air is great. But I’m one of the things that they studied, they found a list of 10 houseplants that are good at filtering the air that are able to take 90% of the bad stuff out of the air just by being there. Back behind me is a Peace Lily, and that’s one of the 10 plants that we have in the house in order to do just that.

[00:36:01] Well, I think that’s all the questions that I see. Any other questions that folks have out there. 

[00:36:07] Agatha:  Oh, there’s another question that just came in. 

[00:36:10] Dr. Greene:  Oh, I just saw that. Yes. Is there a benefit to taking turmeric? I am a huge turmeric fan of the things in the plant kingdom that reduce inflammation and are powerful for health.  It’s right up at the top of the list and it’s something that I do at the first sign of any respiratory infection is I’ll start taking turmeric. I have not seen data specifically on COVID, but I have some on hand just in case I do develop symptoms. And real quick on the developing symptoms, the average time people get symptoms is 5.1 days after you are first exposed.

[00:36:46] Ninety-seven and a half percent of people tested have their symptoms within 11 and a half days of being exposed, and 99% have it within 14 days. So usually within 14 days, you know, the great majority of the time, but not everybody does get symptoms and some people are contagious who never have symptoms. 

[00:37:05] Another question.  How does stress impact immunity and what do you suggest to calm anxiety?   

[00:37:15] Dr. Greene:  Stress does it impact immunity.  Some of the first studies looking at that were done in medical students where they looked at medical students during the cold and flu season and tested them. They had their final exams on different dates and tested their blood before and after their final exams and looked at when they got sick and they found that right before finals when they were feeling most stressed, they had the highest stress hormones, the lowest levels of immune factors, and got sick the most.

[00:37:40] That was quite some time ago. Now, more and more data shows that stress does decrease our ability to fight things off. And this is a time that there is a lot of stress, financial stress, and COVID stress and taking-care-of-kids-who-are-bored stress. We need to find ways to relieve that.

[00:37:59] I’m a big fan of meditation. And there are several apps for folks who are not good at that. I like one in particular called Waking Up. It’s a course in meditation that is free right now in the app store during the time period of COVID. There are a number of them that are quite good. Headspace is super popular. I like Waking Up a lot.

[00:38:16] I am a big fan of hot baths with Epsom salts for relaxing. There’s been some really interesting work, by the way, showing that hot baths, saunas, and cold plunges and cold showers, do seem to have direct impact against COVID. So it could be good for stress as well as potentially for the disease.  I’m also a fan of exercise whatever form that takes. This is a great time for yoga, for making sure that you have good physical exercises every day.

[00:38:51] I hear kids at home, yay. A couple of other questions just came in real fast.  Can helpful nutrients be absorbed through the skin transdermally? The answer is absolutely yes! In fact, one of the ideas behind Bambini Fortuna is to be able to get things, including things that are rich and quercetin, in through the skin. It’s a really gentle and connecting way to do it. 

[00:39:01] Here’s then another question about what about combining magnesium and vitamin D and can that  be useful. magnesium has a lot of different uses in the body depending on the kind. It can help with sleep and muscle cramps and with relaxation. That’s one of the reasons I like Epsom salt baths and I like taking magnesium  at night for a deeper sleep. 

[00:39:32] Agatha:  And there’s also a question about how’s the best way to take turmeric.  I love taking a shot of ginger with turmeric every day. So the past few weeks I’ve been doing ginger, turmeric, and lemon shots every day just to help up the immunity. 

[00:39:49] Dr. Greene:  Yup. That’s a great way to do it. And just eating curries is good too. We use some stuff called curcumin at home, curcumin it comes from Nourish Me  and it’s something else that’s been designed specifically to get where it’s needed in the body.

[00:40:00] Agatha:  Great. 

[00:40:01] Dr. Greene:  Well, so good getting to be with you all. Look forward to connecting again in the future. This is one that we’ll all remember. We’re all in here together and hopefully we’ll end up closer as a people.

[00:40:15] Agatha:  Thank you all for tuning in and listening to our podcasts on COVID-19. This is Agatha Luczo and Dr. Allen Greene from Mom Driven.  Dr Aligned. And if there’s any other questions or topics you’d like us to cover, please let us know. We are so excited to hear from you and until next time, stay well.

For more information about seasonal allergies, sleep, and other tips for keeping kids healthy, listen to our podcast here.