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