COVID-19 LIVE UPDATE: Should we PANIC?

It’s Friday, June 26, welcome to the “ZDoggMD Show” and I’m your host, ZDogg, as they say in Canada. Hey, guys, dude, what, panic, the end of the world? Hello, you wanna hear my rant on this from today. I did a live show on Instagram which I don’t do that often. But I was completely frontally disinhibited for that one, dropped all the F-bombs. This one is gonna be a version of that, that is my second draft with no cursing so you can share it with people with delicate sensibilities like your mom. And the idea here is to take the stuff that I ranted about in that broadcast, which I highly recommend you check out on the ZDoggMD Instagram, it’ll roll over to IGTV so you can watch the whole thing.

I think it’s like 20, 30, 40 minutes, something. But I interviewed, we can do split screen on Instagram, and I interviewed a woman who suffers with generalized anxiety disorder and this whole COVID thing has thrown her life for a loop and she actually just tunes into the show to get rational thought, right? Instead of the social contagion of fear and panic. So that’s what I’m gonna share with you today. Let’s talk about where we are with COVID-19. And welcome everyone, Kathleen and DJ and Krista, we’re streaming live on youtube, but we’ll ultimately put this up on, sorry, Live on Facebook, I get to too many platforms. Ultimately, we’ll put this up on YouTube afterwards.

So well, surprise. Case numbers are blowing up in the US. Surprise, surprise, surprise, but who’s not surprised? Pretty much any scientist because three weeks ago, four weeks ago, we started opening up again Memorial Day, George Floyd protests, economy opening up, people behaving like they did before this whole thing happened, especially young people, and mathematically and probabilistically, we’re seeing what people were predicting then, ah, including myself, although I will say at the time, I was hedging and saying, you know, there’s a part of me, it thinks that the summer is gonna cool this thing down because of the warming temperatures in the US, the idea that people are getting out more and that there’s gonna be less indoor interaction. Well, I failed to think about the bars and the young people and didn’t foresee the protests coming and that sort of thing.

So I was completely wrong in that random prediction. But who wasn’t wrong is pretty much every scientist and any rationalist. You’re going to start seeing more cases because people are mingling again. Why did we do an aggressive shelter-in-place lockdown? Well, because we didn’t know what was going on. The thing was looking like it was gonna exponentially spread. We were looking at countries like Italy and countries like New York City, and going, oh, crap! The goal here is to cool this thing down, flatten the curve. Remember that whole thing from like two weeks ago? And allow us to catch up with PPE, with the medical technology and know how and learning that allows us to treat this more effectively, and to have the ICU beds available for what we know happens, which is a good portion, good portion meaning anywhere from you know, it depends on how old you are, right?

But let’s say, 10% of people end up getting hospitalized, if they’re in a high risk category, a middle number like that, they’re gonna end up in the hospital and a good number of those are going to need ICU care. So just by a sheer numbers game, imagine the worst influenza season ever and multiply it by like four or five. And that’s what you have, right? So you have to be ready for that. So bending the curve means sheltering in place, putting the brakes on the spread, because we weren’t entirely sure even how this thing is spreading. Is it mostly on surfaces? Is it respiratory, is it aerosolized? Is it large droplets, nobody knew. So that wasn’t the wrong thing to do. But in the process of doing that, we learned a few things, we learned that, yes, shelter in place actually works. So it will bend the curve. We talked about, well, what’s the point of it though?

Okay, and we learned a little bit more about how to treat this thing, you don’t need to intubate everybody. Maybe drugs like Dexamethasone are showing promise for reducing mortality during the cytokine storm phase of the illness. So we’ve been learning and improving in the care, right? The early days in New York were just a storm of madness, although not the conspiracy level madness, that nurse Aaron is talking about who, uh, don’t even get me started on that. But so quite a bit was learned, but the one other thing that we were trying to do is to spread the infections out over longer periods so we could handle it, hopefully, buy us time to make a vaccine, hopefully, buy us time to protect our most vulnerable so the elderly people with chronic disease, and see kind of learn more, get more information. So what did we learn? We learn that it seems like this thing transmits mostly in an airborne way, airborne meaning droplets, and maybe even in some aerosolized.

So Michael Osterholm who’s a very prominent epidemiologist, almost an epididy-menta-stologist, which is basically a urologist. Out of Minneapolis, Minnesota says, he’s actually concerned it is more aerosolized and so even regular old masks aren’t gonna help, you need N95s. But the thing that we’re learning is, our experience in hospital settings is this thing doesn’t spread in hospitals, if everyone wears procedural masks, meaning basically surgical masks, and there’s an experience at Stanford right here down the road, washes hands, does social distancing as much as they can in the hospital and reports, tests and quarantines when they have symptoms of any kind that could be respiratory in nature, knowing full well that there are a lot of people that are asymptomatic.

If you do those things, you will reduce the spread, right? And that’s not even taking into account shutting down businesses, shutting down schools, doing all the other aggressive stuff. Well, now okay, now we’re opening up. What are we doing with this learning? People are going out in the world, they’re going back into bars and restaurants. Many of them are not wearing masks, many of them are not social distancing. Now, I’ve been a skeptic of masks, cloth masks, from the beginning because I worry that the general public doesn’t know how to use them, is touching their face, is using them incorrectly and is giving themselves a false sense of security, which Osterholm agrees with, where you’re getting too close to people thinking that you’re fully protected. You’re behind some kind of forcefield but you’re not.

And then you have the ding dongs actually wearing gloves incorrectly which adds insult to injury. So there was concern, especially on my part about these mask edicts from CDC, especially the reversal of mask edicts, so there’s miscommunication. We learn that you need to be clear in your communication and give reasons for why you’re doing what you’re doing. Otherwise, the population will revolt, and I think that’s what we’re seeing. What we saw and what we’ve learned is that the economy is devastated by a shelter-in-place order. And it’s not not just the economy at large, it’s the most vulnerable segments of our economy, who happened also to be those population groups that are most at risk from COVID-19.

And so it’s a double whammy. Now throw in the end of school, meaning taking kids out of school, putting them at home with parents now who are either out of work or can’t work because they have kids at home and they can’t afford childcare. And what are you going to do? You’re going to end up with a toxic stew of economic collapse, social and cultural destruction, which is what we’re seeing, instability in the very fabric of society, along with massive economic disaster hurting regressively poor people and minorities more. So then what do you have? You have unemployed young people out in the world that it’s gonna create an absolute chaos.

So we learned that you cannot continue a shelter-in-place indefinitely. We learned that closing the schools has huge, huge costs, in terms of children’s lives, they are missing education, especially poor and minority students who rely on school for meals, rely on school to get out of the house and for childcare for their parents, especially if it’s a single parent household, and are often getting out of the house. And this goes across the board from abusive situations. They’re only respite, they’re learning to socialize they’re learning, period. And we’ve taken that away. So why did we do all that? To bend the curve so we could learn, we could develop a vaccine if we can, we could get better medical care and we could protect our most vulnerable. Okay, did we do that? We definitely bent the curve, at least in states that really were aggressive about it.

But then we said, okay, this is is working, we’re realizing the costs are too high, let’s open back up. Now what’s gonna happen? You’re going to see an increase in infections. Now let’s even take masses out of the picture for a second because I want to just focus on increase in infections. Now we see Texas, Houston getting overwhelmed, beds being full, Arizona getting overwhelmed, beds being full, whereas before, what was happening with hospitals, they were freaking empty, empty to a fault. People were avoiding care, which by the way, between you and me is a good thing for most people. Because most of the care, probably 50% of what we do is unnecessary, harmful, and causes adverse iatrogenic, meaning us closed effects.

And so taking that out of the picture is great but the people who actually need the colon cancer screening, the other sort of treatments, especially people on the margins, again, this disease is vicious to our most vulnerable populations. This is going to perpetuate the exact injustice that people are marching in the streets about and potentially spreading COVID to the same populations. It’s absolutely unfair. But nobody said the universe was a fair place. And nobody said that disasters don’t happen. This is a disaster, so what do you do? Do you panic? Do you shut down life as we know it? Do you continue to hide in your house? Do you continue to provoke mental illness and anxiety in people that are already on the margins and already have those tendencies or diseases and make them incapacitated, which we’re seeing? Do you continue to promote suicides, substance abuse, domestic abuse, and the general collapse of societal fabric?

Well, you got to ask those questions. Or do we say, you know what, the cases are gonna increase. We better staff up our hospitals that have been decimated financially, because they’re run on a model that’s dumb, which is you get paid to do things to people and when people don’t show up for you to do things to, the hospitals fall apart. They’re losing money hand over fist, the average primary care practice in this country is losing $67,000 a year in revenue because people aren’t coming in. That’s a broken model, if it’s so fragile, that a pandemic, which it should be there to treat means it doesn’t get paid. What are we doing wrong, guys?

We ought to be paid to keep people healthy. And I’ve been talking about this for years. So now we have a system that’s super fragile. So what should we do, we should spin it up, right? Correctly incentivize the right care, staff it up, provide the PPE and the protections and the processes that our people need to take care of the inevitable surge that’s gonna come, this thing hasn’t gone away. That’s magical thinking, sometimes I’m guilty of it. Sometimes I’m like, you know what? There’s a small part of me that thinks that the summer will make this better. Well, it hasn’t, so now I have to change my thinking and go, okay, it’s not going away, it’s with us. Maybe a vaccine will work, maybe it won’t. Maybe there isn’t durable immunity, which means it’s gonna be with us, which means we better adapt. So what does that mean? Okay, does it mean keeping the school, let’s talk about schools for a second? Does it mean keeping the schools closed in the fall?

Okay, now, there are two camps on this, and I’m gonna tell you clearly what camp I’m in, open the dang schools, open the schools. We are causing, and now I’m editorializing fully, but there’s some evidence here. We are causing more harm to our children than this pandemic will ever do by keeping schools closed. So how do you do that, open the dang schools, teachers who are at high risk, you need to have some provisions for them. Maybe the children need to be asked to mask if they can, but remember, these are children, so good luck with that. You try to social distance, maybe you stagger them, but boy, I’ll tell you, two days on, two days off, that’s not gonna work. That’s gonna create untold hardship economically on parents and on children. So figure out a way to make it work.

Now if that means we have to fund teachers better, maybe we need to do something with that $3.2 trillion of printed money that we printed for this pandemic, instead of throwing it at big medical corporations that don’t need the bailout or are just using it to build more wings named after some douche. Let’s be completely honest, right? Bailing out big companies is a no. We use it to fund education, to fund actual prevention in those communities, community health workers that can actually do outreach to vulnerable communities and education to vulnerable communities. We put it into good education of our public about, okay, so first of all, let’s open the schools, period, period. That’s what I say, and it’s not selfish from my end because I’m upper middle class to lower upper class, I’m liking the 1.5%. I can afford to hire someone to teach my kids.

It still sucks, it’s still not socializing them. We still don’t like it, but I can deal with it. Can a single mother who’s struggling to make ends meet deal with closed schools because some politician decides they want to extend the school closure because some public health officials said, well, that’s the safest thing to do? We don’t know what the safest thing is to do for children as vectors of this disease. I talk to several pediatricians and several experts on this and no one knows. We know that kids don’t get infected that much. We think that they probably spread it less than they would spread influenza or stomach flus which rip through schools and come home. We know they’re less likely, vastly less likely to be hospitalized and die.

Is there risk, sure, there’s risk crossing the street to take your kid to school, there’s risk driving them to school, there’s risk on the bus, we take those risks. We don’t shut down the fabric of our society because of fear and a culture of safetyism. Safetyism says, we do everything possible to keep our children safe from anything, no matter what the cost, no matter creating a fragile generation of children that crumble at the slightest adversity, that look to their authority figures to keep them safe from words, from words that hurt them. I’m triggered, I need to save space, shut that comedian up. Don’t let that person say that on Twitter. Do not let that speaker come to my campus and say something that frightens and offends me. My feelings are more important than any discourse. In this world, we have one way to deal with conflict. And that’s talking about it. What happens when you take that one way away with a fragile generation that can’t handle themselves? The only thing left is violent conflict. Is that what we want? We need to get back to discourse in this country, which means put the kids in school, let them hash stuff out.

The pediatricians don’t know. There’s this multi system inflammatory syndrome of children. It’s so rare as to be a rounding error on the dangers that face children. But you know what’s not rare? Domestic abuse, poor education, huge socio economic variations and outcomes for children, and yet we’re making that worse. Throw the money into education, figure out a way to do it safely and get to work. And I’ll tell you, I bet our teachers would stand up and go, I’m tired of doing Zoom learning ’cause it doesn’t work. Zoom is garbage, you guys, except for people that are very introverted and shy. So I’ll make that caveat. For anyone else who’s trying to read facial expressions, trying to work body language, trying to socialize, Zoom is exhausting. It’s exhausting, demoralizing and dehumanizing until the technology gets so good that we’re able to virtually be in that room with other human beings and see their facial expressions, read their body language and smell the sweat coming off them. That’s how we evolved, we’re human fricking beings. And we have not prepared for what we’ve been thrown into yet. So we have to address that. All right, so open the schools.

Okay, next, masking. You guys know that I’m a skeptic of public masking for all the reasons I’ve talked about in other shows. But I’m gonna tell you right now, I wear a mask in public, I wear a mask to the store, my family wears masks. Do you know why? Because the culture around me here in the Bay Area, acknowledges and demands that, which means that, what is culture? Culture is an adaptation of a group of people that they found helps them live better. And it’s always evolving, and it’s always appropriating from adjacent cultures, finding the best things that work and applying it to that population. So I hate the term cultural appropriation, what is that? It’s called growing, evolving, learning. Everybody takes from everybody else. And as long as you’re not attacking that culture, take it and do something beautiful with it for the people that it’s gonna benefit. But that’s a whole another discussion.

So and of course, I’m a little biased because I do rap videos, parody rap videos. So that being said, the culture here is put a mask on not to protect yourself but to protect others. Now, that is not the culture everywhere. In fact, it’s not the culture in the White House. So in the White House, the promotion of culture is don’t wear a mask ’cause A, you’re not a man, B, you don’t like Trump if you wear a mask. And listen, there are three ways to deal with this pandemic and masks are one of those ways. Way one is shelter-in-place forever until we wreck the economy and we all die of loneliness, substance abuse, depression, anxiety and suicide. Option three is let the thing rip through the population at its full potential, no masking, no social distancing, go about your job, overwhelm the hospitals, ration care, figure out which person gets a ventilator or not, burn it through until we get herd immunity in a few months and we’re done. We’ve lost a few, maybe a million people, maybe 500,000 people, we don’t know, right? ‘Cause no one’s model’s made any sense.

Okay, that’s that, by the way, that option would never actually work in real life. Do you know why? ‘Cause humans adapt to what they see. For the last few weeks, they have not seen COVID. Now they’re seeing it again. So what do you think is gonna happen when grandma’s sick in the ICU, when it rips through your own family or a family of someone you love? You’re gonna start social distancing and wearing masks and washing your hands again. That is an autoregulation of human society. So option three is a kind of a pipe dream. It’s never gonna happen that you’re just gonna let it rip through ’cause people will autoregulate. But that’s another option, and what’s option two? Open up the economy, open up the schools. Continue to silence the crap out of this disease. Which is, it’s unfair. It’s unfair, we have this disease, it sucks. 2020 is a mess, it’s unfair, life is unfair. This is a capricious universe that can throw everything, whether you believe in God, whether you’re an atheist, it doesn’t matter, the universe throws challenges at you, and this is one of them. This is nothing in the grand scheme of history.

It’s nothing, it’s a rounding error on 1918 Spanish flu. It’s a rounding error on the plague. So science the crap out of it because those are the tools we have now that those buttholes didn’t have. Then work on a vaccine, work on treatments, work on understanding how it spread. But number next, everybody who goes out and mingles with other people for a period of time needs to wear some kind of mask. Preferably, we should ramp up procedural surgical masks, because they’re gonna be more effective than the cloth garbage masks people are wearing and misusing, do extensive public health campaigns on how to wear these masks and use them. And here’s the secret sauce. Stop shaming people who oppose this. And I’ll tell you why, they have reasons to oppose this that aren’t that they wanna kill your grandma. Many people are up your face with a mask. You’re a young person, you can’t flirt, you can’t socialize, you can’t read cues, you can’t understand people. It’s another thing you have to remember leaving the house. It feels constricting on how you’re breathing.

By the way, there’s no physical harm that comes from this thing. Some people have PTSD and claustrophobia and that kind of thing, that’s different. But anyone who says that it’s dropping your oxygen levels and doing this and that, unless you’re very, very ill, that’s nonsense, but it does have a psychological effect. And if you deny that and you attack people and you shame them, they are going to entrench and then you’re going to have a problem which we already have, especially when you have the leadership in the country modeling the same behavior. So and honestly I’m part and parcel of this, I’m saying, look, if you wear a mask in a car, what the hell’s wrong with you?

Now some people wear masks and cars because they don’t wanna on and off them every time. Right, but so it may be time to just quit the shaming and just understand, okay, there’s a reason that’s supposed. Now, if you’re uncomfortable with them coming near you or your child or your elderly mother, then you have every right to say, I’m sorry, could you please keep your distance? And this happened to me the other day, right? And the idea is, you can ask nicely and say, I’m worried about the safety of my family, please don’t, and over time the culture will start to shift. Now, why do I even think this is important? Because if everybody, for the most part, wore masks, I suspect what we would see is what we see in hospital settings, which is a real bending of the spread, it would slow down, at which point we would then have the time to try to make a vaccine do the other stuff.

Now this is assuming that those things are possible. If they aren’t, eventually, you’re only gonna have to mask people around people that are vulnerable or who are vulnerable themselves. But the truth is, what does this allow us? It allows us to open the economy, go back in restaurants, maybe you take the mask off, but the servers have masks and you space out is the best you can do. More outdoor stuff, getting outside where the spread is less likely to happen because you have good ventilation, sunlight, wind all of that. And remember, because it’s a critical dose of virus that you need, it’s not just like, on one single virus got in my nose so this mask can’t work because air is coming out of this side. Or what if it gets in my eye?

These masks useless, I’m just not gonna wear them. Listen, dude, and I had to really think about this a lot over a long time to really come to peace with this as an intervention because it’s so antithetical to kind of our culture in America. Don’t tell me what to do, right? But the truth is, if you’re even lowering that viral load by a bit, you may never reach the threshold that makes you very ill, you may get a threshold where you have no symptoms, but you develop antibodies, you may reach a threshold where you don’t even get infected, you may reach a sub-critical threshold. And so every little thing helps, social distancing, reporting when you’re sick and getting tested and quarantining yourself, contact tracing and aggressive following of cases and wearing masks to lower the spread, especially to other people.

If we’re able to do that, we can start to get back to a degree of normalcy that doesn’t overwhelm our hospitals. ‘Cause that’s really the gold standard. We don’t wanna overwhelm the hospital because that means people die that wouldn’t have died normally, people who were just having a heart attack or a stroke or something they can’t get care because the hospital’s a disaster area. Does that make sense at all? I think this is just straight, as rational as I can be about it in this moment. And you guys know my thinking evolves as we get more information, as do the public health officials. This idea that public health officials are getting death threats and all that is a sign of the cultural disruption that we’ve engaged in here in this grand experiment that we’ve been doing, it’s time to sit down, try to be as, and look, some people will say Americans can’t do that. There’s too much dumbness in the world. I’m actually an optimist that when push comes to shove, we’ll do as much of the right thing as we can. As long as it’s not destroying us.

Some people would rather die of COVID then suffer through what we’ve been through. And you know what, I get it, it sucks. It sucks, especially when we have a disease that maybe has a point 0.5% mortality. You know, so it’s like your absolute risk of dying of it. This is for the people with panic disorder, with anxiety, with fear around this. Your absolute risk of dying of COVID is tiny. It’s still really, really tiny. Even though COVID is rising internationally as the number one cause of death and all of this, that doesn’t matter, it’s still unlikely to die from it on average. So take a breath, we can put on our rational thinker because our fear-based elephant can calm down. Stop watching the news, stop losing yourself in these stories, and just kind of think about it, wear a mask. And listen, I’m talking to you, bro, ’cause you and I are on the same page, masks are dumb, they don’t look cool, they’re constricting.

We shouldn’t have to do it. I don’t like people telling me what to do. But you know what? I’m willing to bite the bullet on this one just like wear I seatbelt because it’s the law, and it actually saves lives even though I don’t like it ’cause it’s constricting. I’ll do this until we don’t have to do it because I want the world to be better. I want my life to be better, and I want others to be safe. All those things, any one of those things is enough to put a mask on. Alright guys, so that’s really what I wanted to talk about. And as a doctor, look, I could air on the full side of like, we need to do everything possible to bend the curve. I’m not like that because I’m also a rationalist and I live in this world. So there’s a balance which we’ve talked about. Alright guys, there’s lots of other videos that we’ve done about balancing the three buckets in this pandemic, about why America screwed up COVID so bad up to this point. There’s lots of different videos. I love it if you became a supporter of the show on Facebook, on YouTube, we have a supporter tribe there too. If you followed us on Instagram, that’d be awesome ’cause we do a lot of fun different stuff on Instagram, including live rants and funny memes that we steal from other people and don’t credit, and I love you guys, and we are out. Stay well and stay woke, peace.