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  • 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

welcome to another MedCram coronavirus update you just wanted to review the

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B1 sleep flu duration sleep deprivation efficiency deprivation

Coronavirus Epidemic Update 17: Spike in Confirmed Cases, Fighting Infections with Sleep (COVID-19)

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