A webinar hosted by Dowling & Yahnke Wealth Advisors
Dowling & Yahnke Wealth Advisors hosted Dr. Chris Sidford, founder and medical director of Black Bag Global Emergency Medicine, on May 26, 2021 to provide you the most up-to-date information on the pandemic and travel.
During the webinar, Dr. Sidford addressed topics like:
The below is an audio transcript with time guides. This automatic text capture may not be 100% accurate.
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Well, hello and welcome.
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My name is Anna Diaz and I’m a principal
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and lead advisor with Dowling
and Yahnke Wealth Advisors.
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And on behalf of my teammates,
all our colleagues at Dowling and Yahnke,
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we’re so glad you joined us
for today’s conversation.
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So we’re also excited because we are
in our 30th year anniversary
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when Dale Yahnke and our co-founders
founded our firm 30 years ago.
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They were pioneers as an independent
wealth advisor and as a fiduciary.
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Today, we provide investment management
and financial planning services for over
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thirteen hundred clients,
and that’s individuals,
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families and organizations, and today
managing over five billion in assets.
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We’re also excited because this is
a really interesting conversation.
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And as our team chats,
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we love hearing what’s going
on in the lives of our clients.
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And many of you are asking questions
about returning to travel.
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We were excited to partner with Dr.
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Chris Stanford of Black Global Emergency
Medicine to talk about travel safety.
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So looking forward
to today’s conversation.
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Let me tell you a little bit about Dr.
Sidford.
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So he’s a board certified physician
in emergency emergency medicine.
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With over 30 years of health and medicine
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experience,
he practiced and cared for over
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one hundred four clients and over 150
fifty countries and locations to date,
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ranging from the mountains of Patagonia
to ships in the Labrador Sea.
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As a US naval officer, Dr.
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Sidford served as a faculty member
of the Emergency Medicine Residency
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Training Program and provided emergency
medical support for NATO troops during
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amphibious operations
in the Arctic Circle.
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So providing care in difficult and remote
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locations became
the impetus for black bag.
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It’s also exciting to share that very
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recently black bag was awarded the health
care firm award by Family Wealth Reports,
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and actually this is the third year
in a row that they’ve won this award.
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So before I turn it over to Dr.
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Sidford just a couple of housekeeping
items, so first of all, thank you.
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Many of you submitted questions when
you registered for today’s webinar.
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We did share those with Dr.
Sidford.
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So you’ll be incorporating a lot
of that into his talk today.
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However, I also will be incorporating
a Q&A session after he speaks.
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So we hope to answer additional questions.
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There is a Q&A button
at the bottom of your screen.
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Feel free to send
questions as they come up.
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And we’ll do our best to cover
as much as we can today.
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Again, we’re so glad you’re here.
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And with that, doctors in front of me.
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Turn it over to you.
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Anna, thank you very much.
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It’s a pleasure to see you again and
congratulations to you and your team.
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I know you had some great news recently
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in your neck of the woods,
so thank you very much.
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And I’m going to share the screen
now and get us started.
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So, again, thank you very much
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for that introduction and thank you,
everybody, for joining us.
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I’m going to try and share some
of the lessons that we learned as our
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organization looks after international
travelers and security teams and so on.
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And as we all know,
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it’s been a very challenging year
and there’s been a lot of really good news
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and bad news and really tough
times to get decent information.
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So I’m going to try and share what
we’ve learned in the past year.
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And and thank you again for those
of you who submitted questions.
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And we’ll get to some of those in the end.
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So just as Anna said, I did do some
emergency medicine training program
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in Boston and one of the original knife
and gun club training programs and I paid
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back a Navy scholarship
in actually San Diego.
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San Francisco
helped open up an underground nuclear,
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chemical and biological proof
hospital near Mississippi.
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And that’s part of the strange trips.
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I also got sent to the Arctic Circle
to look after NATO troops.
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And this is some of the photographs
that got me started in this line of work.
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So this is heading up after 17 hour flight
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to begin to train for the
various troops and so on.
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And this is pictures of various NATO
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leaders and commanders and all the king’s
horses and all the king’s men.
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And this is day one, kicking
off the amphibious landing.
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And this probably got me
in the first opening up.
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No matter what you plan for, you’re
going to see things you don’t expect.
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So here we are on our first amphibious day
and two things happen we did not expect.
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The first is those people down by the
beach with the red jackets and so on.
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That’s Greenpeace have decided they’ve
come all the way up to the Arctic Circle
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and straight through the landing,
which I got to say I was not expecting.
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And the second bigger issue was that those
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half tracks coming up the beach
cut to our communication lines.
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So we were sort
of essentially flying blind.
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And again, it was a sort
of eye opening experience.
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No matter how you train, things happen.
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And so you try and train to be
prepared for the unknown.
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And that’s how it got started.
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As one in ER
and then also in Black Bag.
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So I’m going to try and summarize what
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we’ve learned and I’m going to try
and present the various aspects depending
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upon some, as if you’ve
never heard some discussion.
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And some of it is if you’re
vaccinated and some if you’re not.
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And how we go forward from here.
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So the Clint Eastwood movie,
obviously The Good, Bad and the Ugly.
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The good news is that the vaccines are
incredibly effective and half of our
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the US population has gotten a single
dose and almost close to 40 percent.
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has gotten the second dose.
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And the bad news is that for whatever
reason, misinformation, fear,
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doubt whatsoever, about a third
of the people don’t plan to get one.
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And that’s going to be a really
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challenging part of moving forward to get
beyond a pandemic existence walls
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and some of the things that contribute
that are things like the various variants
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around the world, the one that’s gotten
the most attention and probably one
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of the country’s in worse shape is
India because of their variant.
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And the variants happen because as
the virus transmits from various people
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and cells and so on, it goes
through genetic variations.
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And so the variants develop
that are in some way.
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They learn to develop new ways to attack
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our cells and make us sicker and so on,
and then these become more prevalent.
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So this was probably heard of the one
that was in Britain to be one 17 and then
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the one that was
in South South Africa and so on.
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So these variants are what is keeping us
on our toes and trying to keep us as safe
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as we can while we get ready,
while we proceed.
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Just a heads up that places like
The New York Times,
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I’m assuming the L.A. Times probably does it,
too, but you can log on with your email
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and create your own window for the
various places you want to track.
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So this is San Diego and I just logged
on and think this is one of the cities.
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It’ll give you updates every day
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for cases, new cases
and changes and so and gives you some idea
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of where you are depending upon
the country that you live.
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This is one of the original pictures
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from a small diner in China at the very
beginning of the epidemic,
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and it brings home one of the points I
want people to try and remember is
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that this virus, as we all know,
is incredibly sneaky.
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This is one person,
the one circled in the yellow
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in the middle,
who over the course of a short meal ended
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up infecting half the people
in this restaurant from one person.
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Nobody had symptoms.
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There was one person infected,
had no symptoms.
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This ability is still there.
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It is greatly changed by the fact that
many of us have already been vaccinated.
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But this is what’s still out there.
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It’s unbelievable ability to infect and be
contagious for people who don’t know it.
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One of the questions we get a lot is what
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do we do, indoor outdoor dining and I’ll
try again to break this down
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into vaccinated or unvaccinated if you
were unvaccinated for whatever reason,
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whether you are, that’s a contradiction or
whether you decide you don’t want to do it
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or you’re too young to get one yet
indoor dying, in my view, is is a no no.
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There’s just no way for you to take
a mask off inside with other people.
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It’s just too, too likely for you
to get sick and get quite sick of it.
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Some of the attempts of the at the tent
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dining and so on,
unless you’re in with the very same people
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in your bubble, those are
still all very risky events.
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And I would even go so far as to say
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for those of you who are vaccinated,
if you’re vaccinated and you’re living
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with only vaccinated people and you want
to go with a group of vaccinated people
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to a small restaurant,
I think that’s still a good idea indoors.
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If you are going to a large setting,
if you have any kind of underlying
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conditions,
if you want to be safe and cautious,
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it’s not time to go indoors yet
because it’s still we still do not know
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what the various and what vaccination
does in terms of protection.
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And I’ll come back
to that a little bit then.
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Some of the super spreader events
from the fall and now even still,
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there are still some events that are
pretty serious because kids are not been
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vaccinated yet because they’re still
testing which ones are safe for children.
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Sporting events were big, scary events,
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particularly in New England
where hockey is king.
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So they had to shut down a lot
of the tournaments and so on because too
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many kids are coming home sick,
a lot of endorsing events or speaking
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events or where people can push their
voice out and their and their their song.
[00:09:21]
But unfortunately,
that carries with it also virus.
[00:09:24]
And that’s how they get spread.
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And probably the number one risk right now
is that people who go to work when they’re
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sick,
for those of you who’ve been to whatever
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type of screening at the door,
when someone does a little thermometer,
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a digital thermometer on your forehead,
those are really inaccurate.
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And by the time they screen and catch
that fever, it’s probably too late.
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Way more people getting
through that screening.
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So you really have to be diligent if you
run a business or part of business or have
[00:09:50]
coworkers, is that if they do not feel
well for any reason,
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they need to stay home until they can
confirm that they do or don’t have?
[00:10:00]
This is just, I thought,
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an interesting case from a large church,
one piano player,
[00:10:06]
and those over two days of playing this
person was an asymptomatic carrier.
[00:10:10]
And those are the number of people
who got sick from this one person.
[00:10:13]
And the green numbers are
people who were 30 meters.
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So somewhere between 40 and 50 and maybe
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as far as 70 feet away
got infected from this one person.
[00:10:23]
So, again, if you’re unvaccinated
[00:10:25]
and unmasked, the risks
are really quite serious.
[00:10:28]
Some clues that you may have heard
of or may not have heard of.
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I think we’ve all heard losing taste
or smell, which is really awful.
[00:10:34]
But there’s also something called parent
[00:10:36]
knows where you get
your smell starts to come back.
[00:10:40]
Not only do you get a smell,
but you get a bad smell for good things.
[00:10:44]
So some of your favorite foods
may smell like rotten eggs.
[00:10:48]
And these are some clues to having
bad or progressing to cold it.
[00:10:52]
And the symptoms that people get,
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you probably all have had somebody
who’s had it or known of it.
[00:10:57]
And there’s the typical fever aches,
maybe a cough short of breath or things
[00:11:02]
like headache, isolated
headache or sore throat, diarrhea.
[00:11:05]
And so those are still signs of covid.
[00:11:07]
And for people who have young children or
[00:11:09]
grandchildren, these are things that,
again, these are triggers to get covid
[00:11:13]
tests and to make sure
that that’s not what they have.
[00:11:15]
The symptoms.
[00:11:17]
You may have also all heard of long covid.
[00:11:19]
And that’s the unfortunate outcome
for people who are recovered from it.
[00:11:23]
That may have I think
there’s up to 70 symptoms.
[00:11:26]
They could have fatigue to sort
of foggy brain and ringing ears.
[00:11:30]
And this can go on for months and about
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one in seven people
who recover from covid.
[00:11:35]
So this is more sort of a reminder of why
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we want to be diligent about being
careful of getting vaccinated.
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I’m a big proponent of certain types
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of mass, and for those of you who are
unvaccinated, you all know that you still
[00:11:48]
have to wear them any time you’re
within a certain distance of people.
[00:11:51]
But even people who are vaccinated with no
underlying conditions,
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places like health care settings,
any kind of public transportation,
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if you’re going to go on a flight,
you’re going to get on a train.
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If you’re going to go visit relatives
[00:12:04]
in a nursing facility or so on,
a mask is essential.
[00:12:09]
And the mass that I recommend is difficult
to get and now they’re much easier to get
[00:12:14]
are called N-ninety fives and their
medical grade three makes a great one.
[00:12:18]
I’ll show you the next slide.
[00:12:20]
But the difference is not only does it
filter out 95 percent of particles,
[00:12:23]
but because N-ninety fives have
electrostatic layer,
[00:12:27]
it actually has a magnetized attraction
to the small viral particles.
[00:12:31]
So it’s even more effective.
[00:12:34]
There’s a couple of
things you should know.
[00:12:36]
There’s there’s certain brands that have
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graphene in it, which was
thought to be antibacterial.
[00:12:41]
The trouble with the antibacterial is
that actually that material broke off.
[00:12:44]
So people were
[00:12:47]
so careful what kind of mask you get.
[00:12:50]
The gentleman on the right has a couple
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of problems with that kind of mask. That’s a
contractors N-ninety five mask.
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So the mask itself filters very nicely.
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When he breathes in the problem,
he’s got that port,
[00:13:01]
that box in the middle,
which is actually an exhalation force when
[00:13:03]
he brings out it go straight
out and there’s no filtration.
[00:13:06]
So the mask works great for him.
[00:13:08]
It does not work great for you if you’re
next to him on an airplane or if you’re
[00:13:11]
standing next to him in line
at the grocery store.
[00:13:13]
And the other issue for those of you
that are that have beards is you’re
[00:13:17]
breaking what’s hoped to be
a nice seal against your face.
[00:13:20]
So you’re making that mask much less
[00:13:23]
efficient and the chances of breathing
in particles is much higher.
[00:13:27]
This is great if you’re doing more
[00:13:29]
compound work or spackling
or something else.
[00:13:31]
But it’s not very good in terms
of preventing the covid consumer lab.
[00:13:35]
dot com down left is one
of my favorite sites.
[00:13:39]
It’s a small yearly fee and it goes
over all sorts of natural supplements.
[00:13:43]
It has really nice reviews
on the various masks that you can get.
[00:13:48]
And my two my one favorite is the called
[00:13:51]
the the three,
and it’s the last to the top left and it’s
[00:13:55]
a full down three and very
comfortable and ninety five masked.
[00:13:59]
Whenever you buy any of these masks
N-ninety five even KN-ninety five,
[00:14:03]
you want to look for the NIOSH
that name up the top left is
[00:14:08]
the National Institute
of Occupational Safety and Health.
[00:14:11]
It means that they verified
that that mask is what it says it is.
[00:14:15]
And to at least tell, you know, what your
body is, it’s very difficult to find.
[00:14:20]
But now you can go to sites
that carry them critical supplies.
[00:14:23]
USA buries the 3M and then
GDI Medical on the right.
[00:14:28]
It’s another very nice,
nice and ninety five.
[00:14:31]
They’re both very comfortable
and very reliable.
[00:14:33]
And I think that we’re going to be
[00:14:35]
with this whole idea and so
on for several months, if not years.
[00:14:40]
So the idea that you’re traveling without
[00:14:42]
a mask is probably pretty far
off even if you’re vaccinated.
[00:14:46]
So I would suggest that you
[00:14:49]
stockpile put a box of these in your
closet or two and keep them around
[00:14:53]
for when you have to travel,
even if you’ve been vaccinated.
[00:14:56]
The L.A. linen mask down below the cloth
[00:14:59]
masks that have one or two or three layers
can be very effective.
[00:15:04]
They’re almost as good as the N-ninety five.
[00:15:06]
And this is one of the highest rated ones
[00:15:07]
displayed and it’s supposed to be
very comfortable and very effective.
[00:15:11]
I would still go with the three
and if you can get it.
[00:15:14]
But these are these are all good choices.
[00:15:17]
If you have them and you need to use them
[00:15:19]
on a regular basis, maybe health care,
health care workers in your family or
[00:15:23]
yourself or you’re volunteering,
you can actually wash that.
[00:15:26]
You need to leave them in in a standing
[00:15:28]
by themselves for five days, at which time
the virus will died off if you are
[00:15:33]
exposed, but you can
also recycle them in a
[00:15:37]
rice cooker.
The recipes are all over the Internet,
[00:15:39]
but it’s basically there with moisture
without if you put water at the bottom,
[00:15:43]
you put a towel down and put those in and
one hundred and twenty degrees for about
[00:15:47]
20 minutes so you can reuse
these mask over and over again.
[00:15:51]
And I know the CDC came out recently
[00:15:53]
and said, well, you know, in case
you don’t need to wear them anymore.
[00:15:56]
I agree that that’s probably
where we’re going to get to.
[00:15:59]
I think I’m a little premature because we
[00:16:02]
really don’t know who’s
been vaccinated, who’s not.
[00:16:05]
And there’s such a cantankerous discussion
about who can or can’t get vaccinated.
[00:16:11]
I think it was a little early to do that.
[00:16:13]
There are a couple of the products down
below with their touting a ultraviolet C
[00:16:18]
lighting that you can use as a wand
or a box of heating oil supplies.
[00:16:22]
Yes, those do work as a wand.
[00:16:24]
It doesn’t really work very well unless
this is sort of a smooth, dry surface.
[00:16:29]
So if you’re going to bring in I’ve seen
[00:16:30]
people on a plane to bring this and try
and scan their canvas seat, it doesn’t work.
[00:16:35]
And so really, those
are not that effective.
[00:16:37]
It’s still you can use a Clorox wipe
if you want to put your keys and your
[00:16:41]
phone in the box and that’s useful,
then you got to rotate them.
[00:16:45]
But most of that is a bit of hype.
[00:16:49]
Or for people who are looking for I’ve had
a number of attorneys,
[00:16:53]
I have security teams that are covering
embassies where they can’t control
[00:16:58]
who comes in and out and whether they’re
masked or vaccinated,
[00:17:01]
there are a number of systems that can
help you clean the air you are in.
[00:17:05]
And synergise is a dry
hydrogen peroxide system.
[00:17:09]
It’s the only system that I’m aware
[00:17:10]
of that’s effective in decreasing virus
in the air while people are in the room.
[00:17:15]
There are all sorts of systems that you
can turn on when you leave the office.
[00:17:18]
Let’s say you’re an attorney.
[00:17:19]
You need to do closings or you have
to have clients come in and you’re
[00:17:22]
concerned about your health or somebody
elderly or you have suppressed.
[00:17:27]
These are now in the variety of gyms,
grocery stores, hotels and so on.
[00:17:32]
The model that the left is a small one.
[00:17:34]
It’s about twelve hundred dollars.
[00:17:35]
But it’s a really nice option for comfort
or peace of mind
[00:17:39]
for you running a business or even some
clients who have a number of workers
[00:17:43]
in their house and so
on that are nervous about it.
[00:17:45]
We need to have them install these.
[00:17:50]
If you’re going to travel,
[00:17:52]
eye protection has been proven to have
been a benefit and there are different
[00:17:55]
options you can use, you can put the mask
over your face to face guard.
[00:18:00]
I’m not a big fan of those
because they’re just so cumbersome.
[00:18:03]
But there are a number of people
[00:18:04]
that you’ve flown that that will fly,
those you cannot use.
[00:18:08]
That in lieu of a mask you have to use both.
[00:18:10]
But I’m a big fan of the goggles on the
left was available on Amazon for that.
[00:18:14]
I think it’s 15 or 18 dollars.
It’s form fitting.
[00:18:17]
It’s meant to be used honestly when you’re
[00:18:18]
cutting onions,
but they’re very comfortable.
[00:18:21]
And it’s a nice sort of protection
from your eyes, particularly if you’re
[00:18:24]
on an airplane or public transportation
or even health care setting.
[00:18:30]
Couple of risk factors people might want
to know about these e-cigarettes are,
[00:18:34]
in my mind, are inviting trouble anyway,
but it does multiply your risk of getting
[00:18:39]
covid or the complications
by a factor of five.
[00:18:42]
And the other thing which you
may want to tell to your
[00:18:46]
children themselves are young males,
[00:18:48]
is that covid does increase erectile
dysfunction about six times more likely
[00:18:53]
in young patients, which is always
obviously gets their attention.
[00:18:57]
So whatever means you can
to have them be careful.
[00:19:01]
This is one of the sort
of discussions that
[00:19:04]
social distancing,
which we’ve carried around for a number
[00:19:07]
of months is six feet was
meant to be the prevention.
[00:19:10]
And I want to explain that it’s
really not a prevention.
[00:19:13]
It’s a control.
[00:19:15]
Six Feet is not the same thing.
[00:19:16]
Where you can’t get it in means as
[00:19:18]
a population, as students,
as classroom and so on.
[00:19:21]
It’s meant to slow down the spread.
It does not
[00:19:25]
stop it.
[00:19:26]
So a number of people who I’ve had
discussions with over the last year
[00:19:29]
who say what we’re indoors with six
feet away, what can be the problem?
[00:19:33]
It doesn’t work that way.
[00:19:34]
It’s meant to slow down.
[00:19:36]
And I’ll never forget,
[00:19:37]
there was a Alabama senator
who mentioned that he met friends.
[00:19:41]
And the first time he’d been what he would
said, careless outdoors, six feet away.
[00:19:47]
And one of them was contagious.
[00:19:48]
And he literally this this gentleman died.
[00:19:51]
And his last posting was we messed up.
[00:19:52]
I let my guard down.
[00:19:54]
So, again, there’s very good news about
the vaccine, but there’s still lots
[00:19:58]
of reasons to be careful
and cautious about going forward.
[00:20:03]
So in terms of testing,
no doubt everybody here has had some
[00:20:06]
experience with testing schools to work
for their own illness or traveling and so
[00:20:11]
on, and the tests that you need
to understand a little bit
[00:20:14]
PCR is to test where they that’s the one
where they put the swab of your nose.
[00:20:18]
It takes maybe one
to three days to get back.
[00:20:21]
It’s a very sensitive test.
[00:20:23]
So it tells you if you have the illness.
[00:20:25]
The trouble with this one is that, say,
for example, you got it on day one and you
[00:20:30]
may be no longer contagious
by day 10 or 14.
[00:20:34]
You may still be positive two weeks later.
[00:20:37]
So if you’ve had experience with having
[00:20:39]
this keep term positive, it it’s a marker
that you have still illness or virus.
[00:20:46]
It does not tell you whether
you’re necessarily contagious.
[00:20:49]
These are the tests that you will be asked
to get before you go back to school before
[00:20:54]
three days, before you
travel internationally.
[00:20:57]
And you’ll need to submit will come
back to how you do that and where.
[00:21:00]
But those are the tests that they
can ask because it’s very sensitive.
[00:21:04]
The antigen test is
the one that’s very rapid.
[00:21:07]
It’s not as accurate.
[00:21:08]
If it is positive, it’s means pretty
accurately that you’re contagious.
[00:21:14]
That’s very good news.
[00:21:15]
It’s what they’re using for screening when
[00:21:16]
we come back, from certain countries
and hotels and events and so on.
[00:21:20]
The bad news is it’s
not entirely accurate.
[00:21:23]
If you have symptoms, it’ll catch
about seven out of 10 people have it.
[00:21:26]
But three out of 10 people who are
[00:21:28]
contagious will still
have a negative test.
[00:21:30]
And if there’s no symptoms,
it’s actually six out of 10.
[00:21:33]
So just something to be aware of because
[00:21:36]
we’ve all heard cases either the nose one
they had the antigen test.
[00:21:40]
And obviously a number of people who got
[00:21:42]
through the screening were sick and then
it turned into a super spread event.
[00:21:46]
And they just came out recently
[00:21:47]
with the idea that people who are fully
vaccinated do not need to get tested even
[00:21:53]
if they’re exposed to known
exposure to covid.
[00:21:56]
However, if you’re a public health
[00:21:58]
employee, work in a nursing
home or someone you need to.
[00:22:01]
This is still sort of a contentious idea
[00:22:03]
is that if you’ve been fully vaccinated
and somehow exposed or have the illness
[00:22:07]
with no symptoms,
who you spread the illness.
[00:22:10]
And that’s a number of people sent
the email questions about that.
[00:22:14]
And it’s not entirely clear.
[00:22:16]
The thinking the consensus of the various
[00:22:18]
news sources I’ve looked at is that
if you have no symptoms and you can
[00:22:23]
vaccinate, you could still have the virus,
you could still spread it.
[00:22:26]
But it’s less likely if you have symptoms,
it’s much more likely that you have a high
[00:22:31]
viral load or more virus in you and more
likely that you can spread this.
[00:22:37]
And the antibody test,
[00:22:39]
some of us may have had to see if we
either had proof that we were sick
[00:22:42]
in the past so that we need that we know
whether or not we need to do or not.
[00:22:49]
It is decent in terms of determining
in some period of time whether you had
[00:22:53]
coded within six weeks
of when you were sick.
[00:22:57]
One thing it doesn’t really tell you is
[00:23:00]
antibodies translate to having antibodies.
[00:23:03]
It doesn’t translate to immunity.
[00:23:05]
So just because you have the antibodies
doesn’t mean that you’re protected.
[00:23:09]
And while I’m on that,
[00:23:10]
I also mention the issue that just because
you had covid and you have some of these
[00:23:15]
other antibodies doesn’t mean that you’re
prevented from getting disease.
[00:23:18]
So even if you have covid,
it’s always recommended you get at least
[00:23:21]
one and probably both vaccines,
the RNA, if you can.
[00:23:27]
So this is sort of this is an L.A.
nightclub that was offering in the cover
[00:23:32]
charge that they would get
a 10 minute covid engine test.
[00:23:35]
Again, just to reiterate,
if you’re vaccinated and you’re going
[00:23:38]
through this as a young,
healthy person, that’s fine.
[00:23:41]
But if you’re a little bit older,
[00:23:42]
have comorbidities and so on,
a lot of the people,
[00:23:45]
about 60 percent of the people who might
be contagious, it will catch a 30 percent.
[00:23:50]
It will not.
[00:23:51]
So there’s not an effective
screening for keeping you from safe.
[00:23:55]
It’s an effective screening
for a large population.
[00:23:58]
So we can track who does or doesn’t have
[00:24:00]
the illness, for example,
in schools and universities and so on.
[00:24:05]
A couple of things that our clients carry
and I would suggest is
[00:24:09]
that if you don’t have one,
it’s a decent household test to have.
[00:24:12]
Now, is that little O2 stat monitor
[00:24:14]
it’s about 40, 40, 50 dollars.
[00:24:16]
You just keep it charged with a USB mini
cord and you put that over your finger.
[00:24:21]
It’ll tell you what your heart rate
is and tell you how much oxygen.
[00:24:24]
And I’ve used this with clients
all over the world.
[00:24:26]
It’s a very useful bit of information,
[00:24:29]
and particularly for if we’re discussing
if, you know, you have COVID and trying
[00:24:33]
to figure out how sick you are,
the two things that have recently come out
[00:24:36]
that if your saturation drops below 92
percent, you should be around 95
[00:24:42]
or if your heart, your respiratory rate,
[00:24:44]
the number of times you reap the benefits
of the fall of twenty three,
[00:24:48]
those are both indicators
that something serious is happening.
[00:24:51]
It’s time to get to the E.R. Most of you
[00:24:53]
are probably breathing
around 12 to 16 times.
[00:24:56]
So it’s actually a big change.
[00:24:58]
If you were speaking to someone
on the phone and they were breathing
[00:25:00]
at twenty three times a minute,
you would notice it.
[00:25:03]
You could say, well, something’s wrong.
[00:25:05]
So it’s not subtle.
[00:25:06]
These are these important findings
[00:25:08]
that that there’s effects on the lungs
of the heart and it’s time to get
[00:25:11]
to the E.R. And I mentioned the no
exercise rule for some of those
[00:25:15]
who’ve never had it or may still contract
covid, even if it’s relatively
[00:25:19]
asymptomatic, it does have effects
on the heart and the lungs.
[00:25:23]
And while most of us have grown up
in the air where viruses were things you
[00:25:27]
might exercise through recovery,
it’s important that you don’t overexercise
[00:25:32]
during a covid recovered
because it does affect heart.
[00:25:36]
They did they took one hundred college
athletes who had
[00:25:39]
covid and they found with an MRI analysis
of the heart that 78 of them had
[00:25:45]
demonstrated effects, decreased
the ability of the heart to pump.
[00:25:50]
The good news is most of them recovered,
but it’s thought that while the recovery
[00:25:53]
is not a time for them to overexert
themselves and one of the comparisons
[00:25:57]
that one of the exercise physiologist made
was it’s like taking a Division One
[00:26:02]
athlete and turning them
into a Division three athlete.
[00:26:05]
It can have a very pronounced effect.
[00:26:07]
And unfortunately,
there have been some very sad stories
[00:26:09]
of professional athletes who’ve had
either really serious events or have had
[00:26:14]
a really difficult recovery
coming back from covid.
[00:26:18]
In terms of treatment, again,
I mentioned this for those of you who may
[00:26:21]
not have been vaccinated or if you have
comorbidities or you suppressed that,
[00:26:25]
you still that being sick with this is
still a possibility or you have relatives
[00:26:30]
overseas, the monoclonal antibodies
are still a fabulous treatment.
[00:26:35]
But something I would mention,
[00:26:36]
you can actually you can actually
Google this for where it is here.
[00:26:39]
There are treatment centers
that will give you supplies.
[00:26:42]
So you can Google, for example, San Diego,
and it will highlight the various
[00:26:46]
treatment centers that are giving this out
by giving this out there,
[00:26:50]
actually administering this
the appropriate patients.
[00:26:52]
And I would tell you,
[00:26:53]
it’s a fabulous treatment, but you
need to go before you get really sick.
[00:26:58]
So if you have a positive diagnosis,
[00:27:00]
it’s important that you speak to someone,
either your primary care or an infectious
[00:27:04]
disease doctor on whether you need to go
see them or call one of these centers
[00:27:07]
and ask them if you fit the criteria
because it’s very effective early on.
[00:27:12]
It’s not so effective.
[00:27:13]
Later on,
I’ll mention Luvox and Ivermectin,
[00:27:16]
because some of us, I’m sure other people
on the phone has relatives or employees
[00:27:20]
in different parts of the world
where different treatment modalities are
[00:27:24]
not available for vaccination
is actually a the SSRI.
[00:27:29]
So it’s an antidepressant.
[00:27:31]
It’s called a serotonin
uptake inhibitor.
[00:27:34]
And it actually has a remarkable benefit.
[00:27:36]
If you have an early diagnosis of covid,
[00:27:38]
it has a very good effect of keeping many
of the people who take it out
[00:27:42]
of the hospital from severe covid
and ivermectin and similar
[00:27:48]
drugs.
And I mentioned it because people who have
[00:27:52]
either got to say, for example,
in India or South America,
[00:27:54]
whether that disease is really ravaging,
these are things that they can get access
[00:27:59]
to that can help them because
the hospitals are really overrun.
[00:28:04]
So if you’re vaccinated,
it just came out with a report yesterday
[00:28:08]
about the breakthrough that thousands
of people who’ve been vaccinated both
[00:28:12]
sequenced their two weeks,
at least two weeks after the second
[00:28:15]
in the series, and they’ve
been diagnosed with covid.
[00:28:18]
So the good news is it’s about somewhere
around one hundred million,
[00:28:22]
maybe 90 million,
two hundred million who’ve been vaccinated
[00:28:25]
and they’ve documented ten thousand
breakthrough cases, which means that they’re
[00:28:30]
COVID positive there vaccinated and somewhere about
a third of them have no symptoms at all.
[00:28:35]
But those of those 10000 thousand,
about a thousand people end up being
[00:28:39]
hospitalized and two percent
of those people did die.
[00:28:43]
So it is still a serious
illness to be taken seriously.
[00:28:46]
There’s great news about vaccine.
[00:28:48]
It’s a great comfort,
but it’s not a jail free card.
[00:28:52]
But so, as you probably know,
[00:28:54]
Pfizer and Moderna are both getting approval
for the 11 to 17 year old age group.
[00:29:00]
So they hope that the teenagers will be
[00:29:02]
able now get vaccinated
and be less concerned.
[00:29:06]
There’s a lot of people that it’s sort
[00:29:07]
of speculated that young kids
and teenagers aren’t as susceptible.
[00:29:12]
They don’t get sick from this.
[00:29:13]
And while there is some truth to that,
there are unfortunately a number of rather
[00:29:17]
serious complications for children
and teenagers who get this and so on.
[00:29:23]
It is something to still
take very seriously.
[00:29:27]
A second vaccine or a vaccine of either
[00:29:29]
one of the answers have been shown
to improve long covid symptoms.
[00:29:32]
So if you know someone who’s struggling
with it and they may not think that it’s
[00:29:36]
important that they get vaccinated,
it actually does improve.
[00:29:40]
And
[00:29:42]
you may have read recently about this is
another breakthrough case where nine
[00:29:46]
of the Yankees turned positive
and they’ve all been vaccinated.
[00:29:49]
They’d all been together.
They get regular antigen testing.
[00:29:53]
Well, what happened is that it looks like
[00:29:55]
one they got the Johnson Johnson,
which is not quite as effective.
[00:29:59]
But fortunately, it seems that there were
[00:30:00]
a case that they all got positive,
but there were no real symptoms.
[00:30:05]
So it looks like that may be a relatively
[00:30:07]
safe place for us to be is if you’re
vaccinated, you turn positive.
[00:30:12]
Doesn’t seem to serve
for the majority of us.
[00:30:16]
In terms of the Olympics that some of you
[00:30:18]
are either going to as athletes,
relatives, families,
[00:30:21]
coaches or so on that have been a lot
of discussions about the safety of Japan.
[00:30:25]
Japan is struggling with a rather serious
uptick in terms of cases and mortality,
[00:30:31]
and unfortunately, they’ve only vaccinated
about four percent of the population.
[00:30:35]
So I find that a little bit surprising
[00:30:37]
given the relatively
tightly controlled society.
[00:30:40]
But that’s the case where they are now.
[00:30:42]
I’m hoping that they will surround
the Olympic village and travelers
[00:30:48]
and visitors with people who have
been vaccinated if they can.
[00:30:51]
But if it is something you’re considering,
[00:30:54]
feel free to reach out to me
in between after the presentation.
[00:30:59]
And we can discuss some of the risks
[00:31:00]
with some of the ways you might be
able to to improve your chances.
[00:31:05]
So a couple of questions that we get all
the time is if you get if you get covid
[00:31:09]
versus getting the vaccination,
which is better,
[00:31:13]
and it turns out that the vaccination is
better than improving your chances, your
[00:31:19]
immune protection than the illness.
[00:31:21]
And it’s even better that if you had told
[00:31:23]
if you go ahead and get at least one
and probably both of the vaccines
[00:31:28]
and as I mentioned earlier,
that a vaccinated person,
[00:31:31]
it looks like they can get positive,
they can get it, and it looks like they
[00:31:35]
may be able to transmit
it to someone else.
[00:31:38]
But that’s when things are trying
to figure out the most right now.
[00:31:41]
Estimate as to how long you’re protected.
[00:31:44]
It’s really not known.
[00:31:45]
There are all sorts of speculations
[00:31:46]
between six months to nine
months to maybe a year.
[00:31:50]
And that’s one of the challenges that we
[00:31:52]
come into with people who are
not going to get vaccinated.
[00:31:54]
Are we going to have these pockets
[00:31:56]
of outbreaks that are going to come where
there’s going to be a big
[00:32:00]
peaking number of cases and it’s going
to occur is maybe in six or nine months.
[00:32:04]
And now those who thought they’re
[00:32:05]
protected because
of vaccination are no longer.
[00:32:09]
A recent study from the England
in England public health system there
[00:32:14]
found that there’s some really pretty
[00:32:16]
encouraging news that a number
of the variants are protected.
[00:32:20]
We’re protected from those
parents with vaccinations.
[00:32:26]
So in your mind, there are a few people
that ask various questions about
[00:32:29]
the different
illnesses that they may have or relatives,
[00:32:32]
and I just mentioned some of the reasons
why someone may be compromised.
[00:32:37]
Steroids, cancers and so on.
[00:32:38]
Things that you may know, smoking is
a reason that you may be suppressed.
[00:32:43]
And it means that for those people who can
[00:32:45]
get the vaccine, they’re not
nearly as successful in terms
[00:32:50]
of a immunological response, particularly
the first dose is not that helpful.
[00:32:55]
And the second one is really important,
whereas someone who doesn’t have this kind
[00:32:59]
of illness may be somewhere around 60 or
80 percent with the first vaccine and up
[00:33:04]
to 90 the second someone who’s
immunocompromised may be closer to 10 or
[00:33:08]
15 percent on the first one
and maybe 50 percent on the second.
[00:33:12]
And there’s a this is one of the reasons
why it’s kind of kept with trying to be
[00:33:17]
careful about trying to wear masks and so
on, being aware of the other people
[00:33:21]
in and around you, your household,
your relatives and so on.
[00:33:26]
So in terms of traveling, some
of the things to keep in mind is that.
[00:33:31]
There’s going to be a need for some sort
of verification that you’ve either been
[00:33:35]
vaccinated or you’ve had a negative test,
and there’s lots of different people
[00:33:39]
who are putting their stake in this,
the Department of Homeland Security,
[00:33:43]
the World Health Organization, it’s not
going to be a global or national effort.
[00:33:47]
So what you’ll find is if you’re thinking
[00:33:49]
of traveling, it’s going to be
it’s going to be a combination.
[00:33:52]
It’s going to be the airline.
[00:33:53]
It’s going to be the hotel.
[00:33:54]
It may be the resort
and maybe the travel agency.
[00:33:58]
They’re all going to have different
[00:33:59]
criteria for when and what
kind of proof they require.
[00:34:03]
And some of them are digital passports.
[00:34:05]
So, for example,
the Excelsior passes by IBM
[00:34:08]
and New York State is going to use
a suit to get into public events.
[00:34:12]
The International Air Transportation
Association represents about hundred
[00:34:16]
airlines worldwide and they have
a digital health passport.
[00:34:21]
So there are different
airlines verifies one.
[00:34:23]
Even dating apps are starting
to have ways to verify your
[00:34:27]
vaccination status for dating.
[00:34:29]
And I won’t tell you that a month ago is
[00:34:32]
down in the Bahamas and you’ll
find it’s kind of a mishmash.
[00:34:36]
So everybody has a different claim.
[00:34:39]
And I would tell you that when you travel,
[00:34:41]
you want to bring up some
type of back up.
[00:34:44]
So bring literally a photocopy of your
[00:34:47]
vaccination, bring a digital passport,
and that applies even to your passport.
[00:34:52]
Bring a cup of coffee with you because
[00:34:54]
everybody seems to have a different
thing that they require.
[00:34:57]
And you don’t want to be stuck because
your app doesn’t open up for sale somehow
[00:35:02]
or it doesn’t upload
your images and so on.
[00:35:04]
So the other question I give you for those
[00:35:07]
of you who are traveling is that these
tests, they’re going to require either you
[00:35:11]
you’re going to need
a picture before you go.
[00:35:14]
We require some antigen tests
a couple of days after you get there.
[00:35:17]
And depending how long you are,
they may do them every five days
[00:35:22]
and they may require the US government
required tests for you to come back.
[00:35:26]
And all of these tests,
[00:35:28]
if you’re in certain countries,
they know they have you.
[00:35:30]
They can be a hundred fifty dollars
[00:35:31]
a test, some of them very nice, very
accurate to come to your hotel and so on.
[00:35:35]
But but it’s a it’s an expensive venture
to keep in mind if you’re thinking
[00:35:38]
of traveling, for example,
with a large family of kids.
[00:35:43]
So like I said before,
[00:35:44]
they’re not quite out of jail yet,
particularly for not vaccinating.
[00:35:47]
There’s still lots
of reasons to be careful.
[00:35:52]
Just a couple of things about where you
travel and how you do,
[00:35:54]
if you’re going to be traveling
in a in a taxi, for example,
[00:35:57]
so you don’t know the status or
the vaccination status of the driver.
[00:36:01]
I would suggest you wear a mask.
[00:36:03]
Whether you want to wear
eye protection is up to you.
[00:36:06]
But even if you’re vaccinated,
is the best way to keep a barrier between
[00:36:10]
you is to actually open
up the windows opposite.
[00:36:13]
So the passenger window in front of you
and then the person across the street.
[00:36:18]
So it creates a wind barrier between
you is the best way to travel.
[00:36:24]
In terms of traveling by plane,
[00:36:26]
I actually consider that the plane itself
is not the risky area for people
[00:36:31]
who a number of questions on where they’re
going and what countries and hotels
[00:36:35]
the risk when you’re in a plane is
probably the lowest of the trip.
[00:36:37]
The risk when you’re in the airport,
[00:36:39]
when you’re in public transportation,
because when you’re trying to get
[00:36:41]
something to eat,
probably the high risk areas.
[00:36:44]
So this is a flight that went
to Ireland early in twenty twenty.
[00:36:48]
All those seats are empty.
[00:36:50]
So those positive cases have that plane
came positive just from one person.
[00:36:55]
And this is some of the people were
[00:36:57]
wearing masks and some of them
were not wearing masks and so on.
[00:37:00]
The good news is that there is HEPA
[00:37:02]
filters, that high efficiency filters,
there’s a rapid turnover.
[00:37:05]
There depends on the airline for how
much it is, but it’s very effective.
[00:37:08]
So the rates before vaccination
[00:37:12]
with masks, when you had a middle seat
that was empty, it’s about one in eight
[00:37:16]
thousand that you would get covid
even following the protocols.
[00:37:20]
And it’s a middle seat
for folks about half that.
[00:37:23]
The good news is that because so many
[00:37:24]
people are getting vaccinated,
those right.
[00:37:26]
Those numbers will improve dramatically
until we if they do take off the mask
[00:37:31]
mandate, then it’s going
to go the other way.
[00:37:33]
It’s going to be much more serious because
[00:37:35]
now they’ll be so much more free,
the air that’s not filtered.
[00:37:39]
So some advice that I tend to tell people.
[00:37:42]
I mean, I think most people are very
[00:37:43]
careful about being clean around
the public restrooms and so on.
[00:37:46]
And that’s still the case.
[00:37:48]
It’s still the case.
[00:37:49]
Even though there’s not a high
[00:37:50]
transmission from contact surfaces,
it’s still important to clean wipe down
[00:37:55]
the trays and the buttons and things,
even the air vents that you might not
[00:37:59]
think of and keep your hand
and hand sanitizers and so on.
[00:38:03]
A couple other things.
I mean, the food isn’t very good anymore
[00:38:05]
anyway, but I would recommend
you do not eat during the day.
[00:38:09]
They bring the food in between
[00:38:11]
because that’s when everybody
has a message you want to eat.
[00:38:14]
When everybody put their mask back on,
[00:38:17]
put the vent right over your
head and leave it on full.
[00:38:20]
You have to bring extra clothing
because it gets chilly.
[00:38:22]
That’s fine.
[00:38:22]
But these are some
of the ways to help improve.
[00:38:25]
And again, this is not the risky area
when you’re thinking about the various
[00:38:29]
countries and so on,
it’s more of where you’re going and how
[00:38:32]
and what kind of location
you’re going to be.
[00:38:35]
So, again, this is the Bahamas
is one of the places we went.
[00:38:38]
So your resources, when you want to figure
[00:38:40]
out what’s required,
the U.S. embassy for that country will
[00:38:44]
have resources very specific
for what the country needs.
[00:38:47]
The other one that I’m a big fan of is
[00:38:49]
the International Air
Transportation Association.
[00:38:52]
So you can click on the country you’re
going to and you can register your name
[00:38:56]
and your email and they’ll tell
you everything that’s required.
[00:39:00]
And it’ll also send you updates up
to the trip that you’re going to.
[00:39:03]
So it’s a very useful website.
[00:39:08]
Evacuation insurance. I won’t go too deep,
[00:39:11]
but I would tell
I can’t tell you the number of events
[00:39:13]
where I’ve been asked to try and help
evacuate somebody from across the globe
[00:39:18]
who just didn’t think something
medical or traumatic would happen.
[00:39:22]
And unfortunately, they just do.
[00:39:24]
And now they’re in a foreign country.
[00:39:26]
They need the better definitive care.
[00:39:28]
There are a number of great policies
and carriers out there before COVID in the
[00:39:33]
Travel Guard International S.O.S. They’re
all great carriers, Redpoint and so on.
[00:39:38]
And again, I’m happy to speak to anybody
[00:39:40]
on here who’s trying to figure out
which carriers they want to use and why.
[00:39:44]
So my contact information will
be later on in the presentation.
[00:39:48]
But covid through a wrench in that,
[00:39:50]
because in the beginning,
when people so sick,
[00:39:52]
the evacuation policies didn’t apply
to covid, because one of the exclusion
[00:39:59]
criteria for your policy is if you put
the crew at risk, they can’t fly you.
[00:40:04]
So a number of this is one
[00:40:06]
of the companies that came out and said,
we will fly you if you’re covid positive,
[00:40:10]
because the issue you have to think about
when you’re traveling internationally is,
[00:40:13]
one, not only could you get sick with it,
but to what if they don’t let you back
[00:40:18]
in a country and you have to go
to their health care system.
[00:40:21]
And that is a real challenge to some
[00:40:23]
of the countries that going to go back a
little bit as one of the ones that does.
[00:40:27]
And you can also get,
[00:40:28]
I think is one of the few ones
you get a policy after you leave.
[00:40:31]
But again, I’m happy to discuss those
[00:40:33]
kinds of details with people
trying to make decisions about it.
[00:40:37]
And this is a good example.
[00:40:38]
Again, when I looked after
[00:40:40]
three families that rented very nice
to go to Croatia during the pandemic.
[00:40:46]
So there are ways to travel safely,
even if you’re not vaccinated,
[00:40:50]
but you have to be very careful
about the environment you control.
[00:40:53]
So in this case, it was a
large part of yacht.
[00:40:56]
And we’ve done all the screening.
[00:40:57]
We’ve done all the coverage testing,
all the current testing sites.
[00:41:01]
We’re going to be all the way up and down
[00:41:02]
the coast of Malaysia where the medical
facilities there and so on.
[00:41:06]
So this is some of the things that you
[00:41:07]
need to sort of think about
when you’re over there.
[00:41:10]
And then I’m going to share this is
[00:41:11]
the other things that happen
that just happen when you travel.
[00:41:13]
So I’m going to throw this out as a video,
and this is one of our clients in there.
[00:41:18]
And I’m warning the boy who gets
injured in this, it was perfectly fine.
[00:41:22]
But this just does raise the kind
[00:41:24]
of harrowing experiences
that you have when you travel.
[00:41:29]
So that’s him in the yellow shirt
[00:41:31]
and he takes a quick turn around
[00:41:34]
and
[00:41:36]
he’s fine.
[00:41:38]
But, you know, sometimes.
[00:41:43]
And
[00:41:49]
so, again, he’s fine,
but he did get knocked out.
[00:41:53]
He was down on the water and we now have
[00:41:55]
to figure out a way and where to go
and take him in in a foreign country where
[00:41:59]
we don’t speak the language
in the middle of a global pandemic.
[00:42:02]
For those of those of you who speak,
[00:42:04]
who are considering travel,
these are some of the things I don’t want
[00:42:07]
to scare you,
but at least need to be aware.
[00:42:09]
And that’s things like evacuation
services on in this case.
[00:42:12]
We literally I mean,
I spoke to the treating team I walked
[00:42:15]
the family through the various medical
evaluations,
[00:42:17]
some dramatic issues that that they are
because they went to a trauma center,
[00:42:22]
they took a quick look and then
they put them out in the courtyard.
[00:42:24]
Health care is very different
in different countries.
[00:42:26]
So some of the things need to you
want to think about when you travel.
[00:42:32]
[00:42:34]
and that’s it for now,
so open up the questions
[00:42:38]
and stop screen share.
[00:42:41]
Thank you, Chris,
that was very interesting and as you
[00:42:46]
as you know, we’ve had a series
of conversations through this pandemic.
[00:42:50]
We had a couple of conversations with Dr.
[00:42:52]
Erica Saphire, at the La Jolla Institute of Immunology when we were kind of into it.
[00:42:55]
And so it’s now really great to get
your perspective where we are today.
[00:42:59]
And definitely as we talk to our clients,
there’s there’s an interest and there’s
[00:43:02]
a hope that we’re getting to close
to the end of this tunnel.
[00:43:05]
We still have some somewhere to go.
[00:43:06]
And you made that clear.
[00:43:08]
We want to make sure we’re thinking
through some of these travel dynamics.
[00:43:11]
So questions have come in.
[00:43:12]
Can I pose a couple of these to here?
[00:43:15]
OK, great.
[00:43:16]
Some we’ve got two that are kind
of geographically specific.
[00:43:20]
So regarding that India variant,
[00:43:23]
and there’s a 30 to 50 percent higher
mortality rate affecting the young.
[00:43:28]
Can you share some thoughts on
[00:43:31]
how is that changing the perspective
of children being impacted by covid?
[00:43:36]
So I think it’s the the children issue is
[00:43:41]
I think it sort of reinforces the idea
that we shouldn’t ignore children because
[00:43:46]
they’re young,
because they get coronaviruses normally as
[00:43:49]
kids and because they’re young
and healthy and the complications of.
[00:43:53]
So I think it’s changing the focus
that we need to address them.
[00:43:56]
We need to do this.
[00:43:57]
Type of studies are actually already
well underway, if proven very effective.
[00:44:02]
In fact, it’s more effective
for teenagers than it is for adults.
[00:44:06]
And the studies now are going on for I
believe it’s six months to 11 years old.
[00:44:11]
So I think what it’s reinforce the idea is
[00:44:13]
that we have something to help prevent
some of the very serious complications.
[00:44:18]
They are rare.
[00:44:19]
It’s nowhere near the same
impact it is for adults.
[00:44:21]
But it is a reminder that we should not
ignore this age group,
[00:44:25]
even though I have teenagers,
even though they may want to ignore it.
[00:44:29]
Medically speaking,
there are ways to be careful about it
[00:44:31]
and conversations to have
with them about the risks.
[00:44:37]
It makes sense, makes sense.
Very good.
[00:44:41]
So we also have a couple of guests
who are intending to travel to Africa
[00:44:47]
and so later this summer and the fall,
[00:44:51]
which has also some dynamics
going on in the country.
[00:44:54]
Can you share some of your thoughts
[00:44:55]
on on specifically what’s going
on in Africa and maybe thoughts
[00:44:58]
that travelers heading that direction
should be thinking about?
[00:45:02]
Sure.
[00:45:02]
So we have a number of clients
who are traveling to Africa as well.
[00:45:05]
And I think it’s a matter of where you
going and how you’re getting there.
[00:45:10]
And I don’t mean that you have to go
incredibly high end travel,
[00:45:14]
but it’s more of a what kind
of exposure are you going to be in?
[00:45:17]
Are you going to be in small hotels?
[00:45:19]
Are you planning to go
into large public events?
[00:45:21]
Are you going to be in the bazaar
or you’re going out on safari?
[00:45:26]
And are you going to be well controlled?
[00:45:27]
Well, maintain well-established
travel organizations.
[00:45:31]
There are a number I would tell anybody
[00:45:33]
who’s going there are a number
of evacuation policies are very good.
[00:45:37]
And it’s not to say that it’s going to be
something awful,
[00:45:40]
but you want to have the idea that if
something happens,
[00:45:44]
somebody has has a reason to come
look for you or get you out of it.
[00:45:49]
Redpoint is one of the ones I use
a lot of TravelGuard like I said.
[00:45:52]
It means that you can be in safe
places where they do look into
[00:45:59]
how clean the air is or
how well they’re tested.
[00:46:01]
In terms of it,
if you’re going to get into public
[00:46:03]
markets, if you’re going to get
into places like the Congo and so on,
[00:46:06]
that a little riskier that that,
I would say would not be is a good idea.
[00:46:09]
And maybe the summer, obviously,
[00:46:11]
for a variety of reasons, not
to mention that there’s probably more
[00:46:15]
to the virus if they’re not testing as
thoroughly as they could or should.
[00:46:20]
But there’s obviously other other
issues like volcano and so on.
[00:46:23]
So
[00:46:25]
there’s risk in everywhere you go,
but you can walk through the various steps
[00:46:29]
you go and consider
the risks and the exposures.
[00:46:32]
So what kind of hotels?
What kind of staff?
[00:46:34]
And this is something there’s some very
[00:46:36]
good safari organizations that can walk
you through what they do, where and why
[00:46:41]
do they do they include things
like flying doctors and so on.
[00:46:45]
So there are ways to do it,
but there are risks.
[00:46:49]
And as I mentioned to you before we
started our session earlier is that one
[00:46:53]
of the articles, The New York Times was
speaking to epidemiologists and they
[00:46:57]
interviewed a number of epidemiologists,
the various questions of people we asked
[00:47:01]
here, what about going to this country,
about this country
[00:47:04]
and the range of what people do who are
infectious disease and epidemiologists?
[00:47:09]
It’s all this study was unbelievable from
some people said, well, of course we go.
[00:47:13]
And other people said, no way,
we’re not taking our kids on this.
[00:47:16]
So these are general advice
and it is a matter of comfort.
[00:47:20]
So that’s why I sort of look
at every step and who’s going.
[00:47:25]
I didn’t mention that.
But who in your team is at risk?
[00:47:29]
Is anybody immunocompromised?
[00:47:31]
Has everybody vaccinated?
[00:47:32]
I, quite frankly,
would not take on vaccine.
[00:47:34]
I wouldn’t go unvaccinated really.
[00:47:37]
I’m not sure I’d go anywhere
right now except maybe the Caribbean.
[00:47:40]
But even then,
you can really get into issues.
[00:47:43]
Not only can you get sick, you get
really sick and then you can’t get back.
[00:47:47]
So that’s my bottom line is
at the very least, get vaccinated.
[00:47:52]
And if you’re thinking of taking small
[00:47:53]
kids, then you need to be in a very
controlled bubble of your own.
[00:47:57]
So.
So there’s not an exposure for them.
[00:48:02]
Again, thank you.
[00:48:04]
We have also a couple of guests
[00:48:06]
who who are connected to schools
thinking about school.
[00:48:10]
And so a question like my address
addressed a few in this group.
[00:48:14]
So this particular school they’re testing
[00:48:16]
every two weeks, is that good enough
to catch someone who has the virus?
[00:48:21]
Maybe you can walk through some
[00:48:22]
of that positive results window
a little bit more.
[00:48:26]
Well, so there’s two questions
there in that question.
[00:48:30]
There’s the individual, you as a family
and you as your child is one issue.
[00:48:35]
And then there’s the bigger
issue of the school.
[00:48:38]
And so speaking for you as an individual,
[00:48:41]
you start with do we have good
are my children wearing the kind of deal?
[00:48:47]
And that’s probably the most important
handwashing and so on,
[00:48:50]
because there are a number of studies
about even not very good mass in people
[00:48:54]
who were contagious
with covid before vaccines.
[00:48:57]
The mass, a really very
effective and schools.
[00:48:59]
We’ve been very surprised
in the last year.
[00:49:01]
I personally am one of those people.
[00:49:03]
I thought there would be a terrible
[00:49:05]
outbreak of children
from going back to school.
[00:49:08]
The other risk,
and that is that the exposure to be
[00:49:10]
adults, the teachers and so on,
and that that is still a problem.
[00:49:14]
But us sending your kids back to if
they’re they’re careful about the message,
[00:49:18]
they’re careful about
their social circles.
[00:49:22]
For example, a number of the outbreaks
[00:49:24]
in universities and prep schools and so
on didn’t come from going to class.
[00:49:28]
It came from the covid parties.
[00:49:29]
It came from taking your
mask off on the weekends.
[00:49:31]
It came from breaking out of your circle,
which is understandable.
[00:49:35]
These are kids.
Those is a really challenging time
[00:49:37]
for them in terms of getting back
to the school and screening.
[00:49:42]
I mean, they can’t they can’t.
[00:49:44]
Unfortunately, if the covid testing,
if the testing were really rapid
[00:49:48]
and really inexpensive,
they could literally do it every day.
[00:49:51]
You can go to school,
but it would cost to be exposed here.
[00:49:54]
Some of the schools are actually now
[00:49:56]
testing the sewage because you can check
a suit from one dorm and screen the entire
[00:50:02]
sewage to find any
evidence of covid vaccine.
[00:50:05]
And then you go through
and check out the individuals.
[00:50:09]
So there are ways of doing larger
[00:50:10]
screening and then fine tuning
to where it may come.
[00:50:14]
We know that there is a tremendous mental
[00:50:17]
health burden for kids who do
not socially interact.
[00:50:20]
Also for adults, but also for kids.
[00:50:23]
So while honestly, I have two college kids
and both of them said
[00:50:28]
we’re not going back, this remote
learning is a terrible waste.
[00:50:31]
They’re going back in the fall.
[00:50:33]
And I think now with the
combination of vaccines.
[00:50:35]
And so I think it’s appropriate
[00:50:37]
if you have children who are younger than,
say, 18 and aren’t eligible yet,
[00:50:41]
it looks like maybe October they may be
getting, but maybe as early as September.
[00:50:46]
I think there’s ways of safely doing it
[00:50:49]
and balancing the idea that they
need to get among their friends.
[00:50:54]
We are all having discussions about
the safety of our kids and what they do,
[00:50:57]
what they do with their friends
when they take their masks off.
[00:51:01]
What happens when teenagers drink?
[00:51:03]
I mean, it’s just, you know,
[00:51:04]
it’s things we’ve all dealt with and now
they have to think of things like covid.
[00:51:08]
So it’s a complicated discussion.
[00:51:12]
It is we’re entering a new chapter
[00:51:14]
and there’s a there’s an impetus
for kids to get back in school.
[00:51:17]
And what would that look like
and what does that mean?
[00:51:20]
I’ll
[00:51:22]
send my contact out for the people who are
[00:51:23]
asking these individual questions,
if you want to chat about it in greater
[00:51:27]
detail, I’m happy to set up a call
because these are tough choices, so.
[00:51:32]
Thank you, thank you for that question,
[00:51:34]
yes, to remind us a couple of guests
who said questions,
[00:51:35]
we will also again post his contact
information at the end of the session.
[00:51:39]
So you’ll see that one more time.
[00:51:42]
So let me ask another question here.
[00:51:44]
So there are
some commentary about the impact
[00:51:49]
on the lungs for a patient so someone
could read a news article and a couple
[00:51:54]
of people did
of the X-ray image of a lung of a covered
[00:51:58]
patient and that the scars look
worse than a lifelong smoker.
[00:52:02]
Do you believe with mild to no symptoms,
[00:52:06]
covid patients have lung damages
like those who had severe symptoms.
[00:52:12]
Well, I think so, yes,
there are clearly rather pronounced
[00:52:17]
effects in relative,
relatively asymptomatic patients.
[00:52:21]
I know that I think that the severity
[00:52:25]
of the effects is somewhat comparable
to the severity of the symptoms.
[00:52:30]
So if you were somebody who was
[00:52:31]
on a ventilator, you were
in intensive care setting for weeks.
[00:52:34]
We know there was a lot of damage
to a lot of effects in your lungs.
[00:52:37]
But we also know that there was really
[00:52:39]
some rather surprising effects
or have very few symptoms.
[00:52:44]
And I would tell you from the E.R.,
when I was mentioning the saturation
[00:52:47]
that we used to have people,
they came in with a saturation in the 80s.
[00:52:53]
That was an indication in many ways either
get extra oxygen,
[00:52:56]
even consider a ventilator, be very,
very serious interventions.
[00:52:59]
Now, there are people who would come
[00:53:00]
in the door with 40 or 50 percent
readings we’ve honestly never seen.
[00:53:05]
It’s a very strange effect where things
like you have to turn a patient over,
[00:53:09]
put them on their stomach, and it’s
just such an unusual illness and so on.
[00:53:13]
So to answer your question, we know
that there are effects in the lungs.
[00:53:17]
I was just actually listening to a lecture
[00:53:19]
about things like nitrous oxide and
various other
[00:53:23]
naturopathic solutions and things that may
be considered for scarring and long term.
[00:53:28]
But the answer is yes,
there can be very pronounced scarring.
[00:53:31]
Could it be worse than smoking?
[00:53:33]
I haven’t seen that comparison made.
[00:53:36]
It would depend on the degree of smoking
[00:53:39]
and the and the how long
you’ve smoked and so on.
[00:53:42]
But they’re different.
[00:53:44]
So one is an inflammation and one
is a chemical inflammation.
[00:53:48]
So I haven’t seen it.
[00:53:49]
But I’m sure that there are unfortunately
[00:53:52]
similarities in how severe and how
much effect, how effective you may be.
[00:53:58]
OK, thank you.
Thank you.
[00:54:01]
OK, so we have
[00:54:02]
a couple of travelers who are hoping
to cruise and the next coming months or
[00:54:07]
year, how do you feel about cruises
and that particular travel?
[00:54:13]
Well, I’m not I’m not a big fan
of the cruise ship medical support.
[00:54:19]
I you know, I’ve had my.
[00:54:24]
I wouldn’t say run ins,
but I’ve certainly had patients that we’ve
[00:54:26]
dealt with and I’ve had patients who have
been sick and literally dropped off
[00:54:30]
in the port in Greece, said,
you’re too sick for us.
[00:54:33]
You’re in a hospital.
See you later.
[00:54:36]
I think it’s a large volume business.
[00:54:38]
And so in the short term,
while we’re figuring out are they ever
[00:54:43]
going to be able to say, well,
we want everybody vaccinated?
[00:54:46]
I don’t think so.
I think they’re probably one
[00:54:48]
of the industries that say
we’ll take your word for it.
[00:54:51]
I don’t want to be on that ship with.
[00:54:54]
I guarantee you people will get
[00:54:55]
the screening or no screening,
will have the illness and there will be
[00:54:58]
outbreaks, no guarantee
it’s going to happen.
[00:55:01]
What I would say is if if you’re a big fan
of it and there are some unbelievable
[00:55:05]
figures available, is that could you find
a way to find the smaller ships,
[00:55:10]
the 40 guests, 50 guests,
where they have better control
[00:55:14]
of the staff and better
control of the travelers?
[00:55:17]
If you’re if you’re a diehard traveler,
[00:55:19]
the other one is know give
it a couple of months.
[00:55:22]
If they start opening,
I believe it is the fall that they’re
[00:55:25]
planning on getting
shipped out back and see.
[00:55:29]
I wouldn’t I wouldn’t be in the first wave
travels for a couple of months,
[00:55:33]
and I hate to say it,
but we will see what the numbers.
[00:55:35]
We’ll see what cases.
We’ll see what happens.
[00:55:37]
There are too many areas in the world
[00:55:40]
that are raging
covid locations like South America,
[00:55:44]
like India and so on,
that with international travel being so
[00:55:47]
easy, it’s hard to imagine that there will
not be people who get through
[00:55:50]
the screening and be on that ship
and then like we did in the fall.
[00:55:54]
What happens if you’re on it?
[00:55:55]
How do you get off?
[00:55:57]
Because then the places where you’re going
[00:55:59]
to remember what they did with the ship,
they said, well, nobody can get off.
[00:56:02]
I can’t imagine a worse place to be than
to be stuck on a ship and then say, well,
[00:56:06]
you know, the port doesn’t want you or
the Bahamas doesn’t want you or whatever
[00:56:11]
beautiful place to visit
does not want sick patients.
[00:56:14]
That’s my caution.
[00:56:18]
OK, thank you.
[00:56:21]
So a couple more questions around
[00:56:23]
the India variant, because that’s one
that’s that’s front and center right now.
[00:56:27]
If if it does become more dominant
[00:56:29]
globally, will it be
safe to travel even with
[00:56:33]
the current vaccines?
[00:56:35]
What are your thoughts there?
[00:56:37]
Well, that’s a great question.
[00:56:38]
And that’s that’s probably the most recent
[00:56:41]
headlines is around those very,
very issues we already know.
[00:56:44]
Whereas, for example, in England,
[00:56:46]
the B 17 was that was the new kid
in the block because three,
[00:56:52]
maybe six months ago where it started
to show up in England and it was again,
[00:56:55]
oh, my gosh, it’s more transmissible,
it’s more sick and so on.
[00:56:58]
That was a big concern.
And now it looks like in the last week or
[00:57:01]
two, the Indian variant
is actually doing the same
[00:57:05]
thing the B 117 it’s now and 40
percent of the new cases in England.
[00:57:09]
The good news is so far is
[00:57:12]
that the initial studies and they just
came out in England
[00:57:15]
or Health or Ministry of Health came out
and said it looks like the vaccinations
[00:57:20]
are protective against
almost all the variants.
[00:57:24]
So the one thing we know that the variance
[00:57:26]
advantage is when I mentioned
the monoclonal antibodies that Regeneron.
[00:57:29]
So we know that those are not as effective
against the variants,
[00:57:33]
but it looks like the variants,
the vaccine so far are protective.
[00:57:37]
And I will also add to that that they’re
already Moderna I know is already working
[00:57:42]
on a booster shot
specific to the variants.
[00:57:46]
I think Pfizer may be doing the same or
[00:57:48]
they’re considering a surge
to boost your immunity.
[00:57:52]
So
[00:57:54]
a year ago I would never have imagined we
[00:57:56]
would have this many vaccine
options be disaffected.
[00:57:59]
So this really amazingly good news.
[00:58:02]
The bad news is we’re having trouble
getting it to all those who need it.
[00:58:06]
So
[00:58:07]
it’s a very good question.
[00:58:09]
I think it’s a lot of people’s
minds to see if that.
[00:58:13]
OK,
so a couple who wanted a little more
[00:58:16]
elaboration, if you could, Chris,
on the 50, 30, 20 rule you referenced
[00:58:22]
and you mentioned it to be very careful
exercising, is that the same?
[00:58:26]
Can you explain that?
I went a little unfamiliar with it so that
[00:58:32]
when you talk to yourself,
you know, you’re tired.
[00:58:35]
So what was that recommendation is is the
first week you go to 50 percent capacity.
[00:58:41]
So if you’re whatever kind of distance or
speed or so and you’re going to 50 percent
[00:58:45]
of that for a week
and the symptoms you’re looking for,
[00:58:48]
are you having chest pain
or you’re lightheaded?
[00:58:49]
Are you short of breath?
[00:58:50]
If you don’t,
you go up 30 percent the next week
[00:58:53]
and then you go to the final
20 percent, the third week.
[00:58:56]
So over the course of two weeks somewhere,
[00:58:58]
what you want to do is a progression
you don’t want to start out.
[00:59:03]
I’m sick whenever I get a cold,
I just run by marathon,
[00:59:06]
I run by six miles whatever, and I
work myself through it all semester.
[00:59:10]
And that’s actually there’s truth
to that for general viruses.
[00:59:13]
You raise your body temperature,
it helps eliminate the virus.
[00:59:15]
That’s not the case here because we’re
worried about whether you have
[00:59:19]
asymptomatic effects on your lungs or
your heart you may not know about.
[00:59:23]
And that’s where your symptoms
of shortness of breath may come in.
[00:59:27]
So sorry about rushing through that.
[00:59:28]
One of the things we’re elaborating
[00:59:30]
on that,
OK, so we have so many really appreciated
[00:59:34]
the insight on traveling on an airplane
and people have already been traveling or
[00:59:38]
they’re wanting to do
longer travel on airplanes.
[00:59:41]
And some of the data you shared
showed some interesting points about not
[00:59:44]
having people in the middle seats
and the benefit of all that.
[00:59:47]
The planes are full.
I mean, you’re saying planes are.
[00:59:50]
So
[00:59:52]
that’s what it is up to.
Exactly.
[00:59:56]
And clearly, the airlines aren’t aren’t
aren’t buying into that that benefit. But
[01:00:00]
if seats are full,
individuals are asking,
[01:00:03]
is it better to sit on a window seat or
an aisle? Is there a preference,
[01:00:07]
a recommendation you have there
if it is a pretty full flight?
[01:00:10]
So I hate to say this,
but if if you have the option,
[01:00:14]
you’d be surprised,
I would if you’re I don’t think it’s going
[01:00:17]
to make a difference
for a seat or an aisle.
[01:00:19]
I mean, I guess the aisle is maybe
[01:00:22]
more air, but then you’re also exposed
to the people walking up and down.
[01:00:26]
I haven’t seen anything documenting it.
[01:00:28]
What I would say is, if you’re going to do
[01:00:30]
something, if if I don’t know,
the airlines are crazy these days,
[01:00:34]
you can’t get a basic seat anymore without
paying 30 to 50 dollars for every flight
[01:00:39]
because you want to put your
legs two inches further.
[01:00:41]
If you add all that up,
if you’re if you’re going to go and you
[01:00:44]
have the means is think about first class
because they’re the spacing is better and
[01:00:49]
some of them have some very nice deals up
until the flight leaves,
[01:00:53]
that this is changing because obviously
the tickets are going up in every year.
[01:00:56]
But that’s that’s why I
have not seen anything.
[01:00:59]
See, just one seat to the other.
[01:01:01]
I would tell you that if you’re vaccinated
and you’re wearing a ninety five mask,
[01:01:05]
again, I’m happy to help people figure
out where, but I think you’re OK to go
[01:01:11]
if you’re not vaccinated.
[01:01:12]
I mean, I travel a couple of times about
[01:01:14]
it and but is facing was much
better than it is now so.
[01:01:20]
There’s a little bit of risk there,
[01:01:22]
again, if you go through an airport,
that’s where you wonder,
[01:01:24]
you see the people sitting
in the in the waiting room,
[01:01:26]
they’ve got the mask over the top of the
head and they’ve got their noses out.
[01:01:30]
Those are the areas where I think are
much higher risk than the actual plane.
[01:01:33]
And the big one is where do you meet?
[01:01:36]
Where do you take your
mask off is the big issue.
[01:01:38]
And some items take a mask off
first couple of times like this.
[01:01:43]
OK, OK, great.
[01:01:46]
So if you want to create a list,
a short list based on what we know today,
[01:01:51]
crest of the the no go travel place,
these are places that you would just say,
[01:01:56]
gosh, I really would not go
there at this moment in time.
[01:01:59]
Maybe you’d put India on that list,
maybe right now.
[01:02:01]
What other places would you put on that
very high concern locations?
[01:02:07]
I still think England
is a bit of an unknown.
[01:02:10]
I think Europe is a bit of unknown.
[01:02:11]
They have a couple of countries
that are really struggling.
[01:02:14]
And and
[01:02:16]
I kind of keep coming back to this.
[01:02:18]
But the issue is how how well can you
control your your entry and exit
[01:02:22]
from where you’re going
and where you’re going to be?
[01:02:24]
So if you’re on a private yacht off
the coast, you’re in good shape.
[01:02:28]
If you’re in a public hotel and you have
to go through the public hospitals,
[01:02:31]
if you get sick, if you’re
in London, then I’m not as comfortable.
[01:02:36]
I know they’re headed in a better
[01:02:37]
direction, but there are some
really serious outbreaks.
[01:02:40]
I would put India on there.
[01:02:41]
I would put I’m looking for.
[01:02:42]
But the Seychelles is not a large number,
but percentage wise, it’s having.
[01:02:48]
Terrible outbreak.
[01:02:51]
Four of the countries have have either
[01:02:53]
needed to or been rewarded with
indignation from different countries.
[01:02:57]
And I know the Seychelles, for example,
I think they got their vaccination.
[01:03:00]
I won’t say which country
because I can’t remember.
[01:03:02]
I thought it was
China Chinese version of the U.S.
[01:03:06]
and for some reason, they have not
it wasn’t very effective.
[01:03:09]
And they have a very high number
[01:03:11]
of recurrent cases in spite
of very high vaccination rate.
[01:03:15]
South America, Brazil,
I would not go to there.
[01:03:18]
There are places
in the Manaus is the country or
[01:03:23]
the county where
so many people have the illness originally
[01:03:27]
that they thought they were actually
through the through the pandemic.
[01:03:30]
There were not very many vaccinations,
but because the variants had come through
[01:03:34]
in a second wave, many of the people got
sick and they’re completely overwhelmed.
[01:03:38]
There are parts of South America,
[01:03:40]
they’re probably fine,
but I would stay away from Brazil.
[01:03:42]
And I think, again,
[01:03:45]
there are certain sites you can go into
and look at where the numbers are going.
[01:03:49]
Japan has a very,
very low vaccination rate.
[01:03:53]
Japan high on that list.
[01:03:56]
You know, New Zealand, if you can
get in, is probably very good.
[01:03:59]
Australia is better and even some of the
[01:04:03]
Southeast Asia and so on.
[01:04:06]
What happens if you get sick?
[01:04:07]
What happens if you turn positive?
Where are you?
[01:04:10]
And that’s already an issue,
medically speaking, anyway.
[01:04:13]
If you get sick or if you’re in these
[01:04:14]
countries, it’s an issue I
have for many of our clients.
[01:04:17]
If you turn into a patient,
you’re just another patient.
[01:04:20]
And and there are different priorities.
I don’t care where you fluent.
[01:04:23]
You don’t care you are because the care
[01:04:24]
they have to take care
of in front of them.
[01:04:26]
So.
[01:04:28]
Absolutely.
Mexico, by the way,
[01:04:30]
I’m going to throw Mexico out only
for a couple of different reasons.
[01:04:33]
Like I said, I do work a lot with
former Secret Service FBI teams.
[01:04:39]
Mexico is always a quandary.
[01:04:40]
And one of the reasons is you have
to consider security risk where you go.
[01:04:44]
Mexico is probably the highest
in terms of your personal risk.
[01:04:48]
And the security security teams that I
[01:04:50]
work with do not or will not go to Mexico,
mostly because they cannot one that can’t
[01:04:55]
carry a weapon usually and they
don’t trust the local police.
[01:04:59]
And I know a lot of people that go,
I have relatives that go.
[01:05:02]
It is not that reliable
and there are a lot of very random
[01:05:07]
ATM hold ups where they come point,
[01:05:10]
they take things, they take
three thousand out of your ATM.
[01:05:13]
There are ways you should figure out
who is who is screening the driver to your
[01:05:17]
resorts and even being
at high end resorts.
[01:05:19]
Mexico is a bit of a wild card
for me as well.
[01:05:24]
Thank you.
OK, that’s helpful insight for our guests.
[01:05:28]
Well, Chris, thank you
for for giving us the time on Q&A.
[01:05:31]
There was a fair amount
of questions, comments.
[01:05:32]
It’s great to go through
those to our guests.
[01:05:34]
I know we’re a little bit over on time,
but we hope that that additional
[01:05:38]
space to go through your
additional questions was helpful.
[01:05:41]
If there are additional questions
that we did not get to.
[01:05:44]
Please feel free to reach
out to your team.
[01:05:46]
We will do our best to answer them.
[01:05:48]
And then, as Chris mentioned,
he’s very willing to answer them.
[01:05:50]
And so you’ll see in just a minute or
two here the contact information for Dr.
[01:05:55]
Sidford.
[01:05:55]
And and again, he was kindly willing
to to respond to many of those questions.
[01:06:00]
Thank you to all of you for joining us.
[01:06:02]
We hope this was productive
use of your time.
[01:06:04]
We know there are some
interest of traveling.
[01:06:05]
We want to make sure where does it safely
[01:06:07]
and and as informed as possible
on behalf of our team.
[01:06:11]
We appreciate it.
[01:06:12]
And we’ll hope to see you
in our next conversation.
[01:06:14]
Thanks so much, everybody.
Thank you.
[01:06:17]
Wonderful job.
Thank you.
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