welcome to another MedCram coronavirus update you just wanted to review the
Stars Cove e2 is the name of the virus in kovat 19 is the name of the illness
that the virus is causing and that's an important distinction because up to this
point the criteria for a confirmed case has been looking at the RNA using PCR
technique and test kits specifically for this virus and what they're noticing of
course is that they don't have enough kits to test everybody and so as a
result of that and this has been a major push they're in Wuhan China is to look
at something that is not as specific but is much easier much more rapidly able to
make that assessment and that's it looking at the illness and parts of the
illness the characteristics of the illness is an infiltrate on chest x-ray
or CT scan so these lung scans have been central in making the determination of
whether or not we're dealing with the virus so again moving from something
that's very specific but takes a long time to make a diagnosis couple of days
to confirm it versus something that's very quick but not as specific in other
words you may catch other things in there but given the fact that there's an
epidemic the chances of that happening are pretty low and the key here is that
it's very fast so it looks like today they made that switch and as a result of
that we're seeing a lot bigger in numbers let's go to the numbers 60,000
now total confirmed cases 1369 total deaths total recovered is 6061 about
four times the number of deaths have totally recovered and we'll show that in
a little bit what that looks like here's the world a meter website huge jump in
cases and that's because of the change in the definition not much probably as
change in terms of the reality on the ground as we've been saying before this
numbers probably been under estimating but it's been systematically under
estimating and now we've gone from apples to oranges where this is probably
closer to the true number because now we're looking at lung scans still
there's probably a lot of people that haven't come into the hospital there
could be many people outside of this testing parameter that we're not picking
up let's keep looking here in terms of daily cases worldwide huge jump in the
total number of cases now another graph we've been looking at here recently is
the total cases excluding mainland China so what are things looking like and
actually because we're not overwhelmed with the number of cases right total
cases only 517 we can be very careful and we can do those RNA tests that are
very specific and again here some of the smallest numbers to date as of February
12th we'll keep watching those numbers as they go okay I want to follow up a
little bit more on some of the things that we were talking about before and
that is what we can do in terms of our immunity and I want to be clear about
this some of the things that we've been talking about in terms of sleep in the
last videos if you haven't watched this is that we don't have any randomised
trials for specifically coronavirus everything we're going to be talking
about has to do with what evidence do we have in terms of viruses in general or
immunity I want that to be clear what we're looking at here is a
methodological way of going through all of the risk factors in trying to reduce
our risks in this kind of a situation or in this situation we don't have
medications or vaccines and so what is it that we can do to reduce and minimize
the risk of becoming infected and if we are infected of surviving an infection
so one of the easy things we talked about is sleep and we made the point
last time that by sleeping more that actually improves the immune system but
we've got to realize that not everybody sleeps well right some people have
insomnia the other thing that people don't realize is that if your body's not
ready to go to sleep and you try to go to sleep and go in bed what's gonna
happen is you're not gonna be able to sleep and they're gonna get anxiety
because you can't sleep then you're gonna associate that with the bedroom
and when you walk into the bedroom you're gonna get more anxious I'm not
gonna leave all of you hanging here there are things that we can do for
people who can sleep people who have insomnia there's many other things that
can happen when you're trying to sleep including obstructive sleep apnea
there's people that can't sleep because of medical problems and I'll try to
address all of those however remember that each
person is an individual and we're not here to give out medical advice so all
of this needs to be reviewed with your personal physicians but there are some
guidelines there are some things that you can do that are going to help and
we'll be happy to go over some of those things in general so I wanted to review
another paper that was put out to study by van coder basically what they did was
they took some healthy men and on average they're around 23 years of age
and there were some criteria that they had to have number one no influenza
vaccine in the previous three years and all of them had to have a specific sleep
routine in other words they normally went to bed between 11:00 p.m. and 1:00
a.m. they typically woke up between 7:00 and 9:00 a.m. and their total sleep time
was around 8 hours plus or minus 30 minutes there were about 25 of these men
and they split them up into two groups the first group which had 11 was the
intervention group and these are the ones that were prevented from sleeping
and then there was another group of about 14 that were the control group
they did something very interesting those eleven in the sleep deprivation
group were only allowed to sleep for four hours and they did this for six
nights whereas the control group were allowed to sleep for the eight hours for
those same six nights then after those six nights of only four hours sleep per
night then they were allowed to sleep for 12 hours to recover and they did
that for seven nights here of course they were allowed to sleep again for the
eight hours for the same seven nights what they did was they took measurements
of antibody titers and they did it just before they were given an immunization
so I'm gonna right here when they were given immunization was on the fourth
night so right here fourth night
of minimal sleep and this was an immunization against the flu vaccine
okay so flu vaccine given there and flu vaccine given the same point over here
and what they measured was at this point right here what was the antibody titer
to the flu vaccine and they also measured again ten days later and then
they measured again 21 to 30 days later so they wanted to see what the effect
was of sleep deprivation on the body's ability to make antibodies against in
this case the flu vaccine basically a challenge immunologically to the
patient's immune system so even though the patient's had never had a flu shot
before as we mentioned in the previous three years they did have antibodies
against the flu because of course people have had the flu in the past and so
there was no statistical significant difference here between these two so
there was no difference and over here on the sleep deprivation side it was point
zero seven and I'm rounding it off and over here on the control side it was
point zero nine so there was no statistical significant difference now
after the immunization these people here were sleep deprived these people here
were not sleep deprived and so the question is what was the difference here
at this points even though remember now this is 10 days in they had the ability
of recovering some of their sleep even at 12 hours so the four days into
recovery sleep how much would it be well the titer here in the sleep
deprivation group was point five zero whereas the titer over here on this side
was 1.15 it was over twice the amount now when they looked at it after about
21 to 30 days after they had gone both back to a regular sleep schedule again
there was no difference in terms of antibody titer so what they discovered
was that sleep deprivation could reduce the body's ability to fight off the flu
as measured by antibodies but that difference seemed to go away after a
period of 21 to 30 days but please remember that they also stopped the
sleep deprivation that they were doing so the question is what would happen is
someone had chronic sleep deprivation okay let's look at in another study this
one was by Cohen at all in this one this is a bigger study they took a hundred
and fifty three patients and they were aged 21 to 55 years of age and they
asked them about the previous 14 days of sleep and they looked at two things they
looked at sleep duration how long were they sleeping for and they looked at
sleep efficiency and then they put in rhinovirus one of the viruses that cause
the common cold and they dropped in with nasal drops into their nostrils these
drops in to infect them okay so we know exactly how much duration they sleep
their efficiency and we're taking a hundred and fifty three of them and
basically inducing a cold they monitored them for five days and they looked at
the results of it two sets of results the first one had to do with a duration
remember we looked at the duration and we looked at efficiency let's talk about
duration first they were able to divide them into two categories those that had
less than seven hours of sleep and those that had greater than or equal to eight
hours of sleep in total those that had less than seven hours of sleep were
anywhere between one point one eight and 7.30 times the likelihood of having cold
symptoms and on average that was two point nine four so in other words based
on the duration of sleep if you had less than seven hours you were on average two
point nine four times more likely to develop a cold when exposed to the same
exposure than those who slept for greater than eight hours there was
another category and that was efficiency now efficiency sleep efficiency is
simply the amount of time that you are asleep divided by the amount of time
that you are in bed and they divided that into two categories those that were
asleep greater 98% of the time versus those that were
less than 92% of the time and what they found was that those that slept less
than 92% of the time were 5.5 times the likelihood of getting the cold and that
was a range of 2.0 eight to fourteen 0.48 meaning that it's not just how long
you sleep but with efficiency you sleep with as well now when you're looking at
statistics they noted that it was just these things duration and efficiency
that made the difference when they look for confounders things that did not
predict this pre-challenge antibodies did not predict it demographics the
season of the year the BMI the socioeconomic status and their health or
lifestyle none of those things affected whether or not they got the cold but the
strong predictor was duration and the efficiency of sleep so I believe that
even though these two studies are not specifically testing the 2019
coronavirus I do believe that they do have some appropriate information for us
in dealing with what is it that we can do right now in terms of protecting
ourselves from the virus and realize that it's not a hundred percent you can
still get the virus even though you sleep well just like some of these
people got the cold even though they did sleep but it was less likely so the
purpose of these last couple of updates was to show you the importance of sleep
now the question is is well what can I do to make my sleep better and I think
that's what we're going to attack in the next couple of videos is what is it that
you can do personally if you have such and such a problem let's say you have
difficulty falling asleep let's say you have difficulty staying asleep what are
the things that you can do that are fairly simple and effective in making
your sleep better let's talk about those and also update the news and the numbers
as we go through this epidemic thanks for joining us
you