Coronavirus Epidemic Update 18: Cellphone Tracking, Increase in Hospitalizations, More Sleep Tips

Coronavirus Epidemic Update 18: Cellphone Tracking, Increase in Hospitalizations, More Sleep Tips

February 21, 2020 56 By Kailee Schamberger


welcome to another MedCram coronavirus
update let’s take a look at the numbers since the updated criteria for the
diagnosis has gone to just a lung scan and a clinical history consistent with
coronavirus 64,000 436 total deaths 1383 total recovered is six thousand eight
hundred eighty six about five times the total deaths is the total recovered
let’s take a look at the world of meter and we can see here total cases outside
of China have kind of remained constant because there hasn’t been that
redefinition causing a slew of new cases let’s take a look at see what’s going on
inside China or total cases overall if we look down here at new cases there’s
been a dramatic drop in the number of new cases probably because there was a
number of cases that were reclassified we’ll have to watch this and see how
things go now remember what we’re talking about these total cases is based
on the number of people presenting to hospitals that can get work done on them
based on some reports that we’ve been seeing especially out in New York Times
there’s been a crackdown and a rounding up of people and holding them in
quarantine and not getting the medical treatment that they need some people of
course too scared to go and not wanting to get treatment and so it’s unclear
exactly how many people are not being counted here but it’s apparent that this
is still being under counted in terms of total deaths there has been a jump and
that doesn’t seem to be cooling off anytime soon unfortunately for the same reason why the total number
of cases may be underestimated the total deaths may be underestimated as well on
the worldA meter latest updates for February 14 we see that there’s a report
from Hebei province for yesterday that there was four thousand eight hundred
and twenty three new cases including three thousand and ninety five that were
clinically diagnosed we can see here that the testing was just kind of under
estimating those chronically a hundred and sixteen new deaths and eight
clinically diagnosed so we can see that the clinical diagnosis addition to the
count is greatly influencing the number of new cases whereas it’s not affecting
the number of deaths as much total human of cases we can see here that five
thousand three hundred and eighty four were clinically diagnosed we talked
about that what’s interesting here is that thirty six thousand are currently
hospitalized that’s an incredible amount of people that are hospitalized and you
can see here that seventy three percent so the vast majority of them are in mild
condition whereas eight thousand are in serious condition and about four point
six percent are in critical condition there’s a number of people that are
undergoing medical observation because of either their contact or other
symptoms that they may have two new cases in Japan one of them being a
surgeon at a hospital who developed a fever and in still continue to work as
usual and saw patients for three days so that’s probably gonna have to be
followed up on as well okay I want to discuss three things today I want to
talk about the New England Journal of Medicine article that actually we
referenced back at the end of January want to talk about cell phones in China
and I also want to talk just briefly about sleep and circadian rhythms and
some more reading so first of all let’s talk about the New England Journal of
Medicine so there was this article that was published in the New England Journal
talking about a visitor from Wuhan China who visited in Germany for a business
meeting and it was reported in the New England Journal of Medicine that this
woman who came over was asymptomatic and when she flew back to China she
developed symptoms of fever and the symptoms of the corona virus had later
tested positive and when they test heard her friends that were at the business
meeting in Germany they had already become sick
and then got better and they tested positive for coronavirus and it was
touted at that time that this was evidence that coronavirus could be
spread even though the patients were asymptomatic well as it turns out
there’s been a correction on this new in Journal of Medicine case and we’ll post
a link in the description what they found out was that before they printed
they had not actually reached out to this index case from China and discussed
with her if she actually had symptoms they reported that she was asymptomatic
but in reality she actually was symptomatic in fact she was taking
medications to suppress a fever and was having very mild symptoms but was having
them nevertheless so what does this mean does this mean that coronavirus does not
shed when the patient is asymptomatic no there’s still people that believe that
and they may be correct all it means is that you can’t use this New England
Journal of Medicine case to support that theory so I think that’s an important
distinction that needs to be made and it tells us that we’ve got to be careful in
this world of rapid information that we get it right before we spread the
information because spreading false information can have consequences the
other thing I want to mention with cell phones we will link to a article also in
The New York Times about what they are doing right now in China in terms of
cell phone use of course in China they have three cell phone providers that are
run by the government and wherever you go of course that phone is GPS right so
if you go to any particular province it’s gonna keep track of that on the
phone well what they’ve currently worked out through these phone companies is if
you text a particular number to them it will show on the phone right in front of
you exactly which provinces in China you have been in in the last two weeks one
month however they want to do it and they just list it and so what’s going on
now is people are coming in to various places to various checkpoints the
customs agents the military personnel who are enforcing these banned
are actually asking people as they come off to text on their phone exactly this
number and up there will pop where they have been in the last month or so and of
course if Luhan is on there or specific province that Wuhan is in pops up there
in some cases not letting them go and they’re redirecting them so I thought
I’d make you aware of that the last thing I want to talk about real quickly
is circadian rhythms now there’s been a lot of questions and what I’m really
trying to do is balance how much we talk about the virus and how much we talked
about sleep and this is the reason why I’m really gung-ho here about sleep
number one is according to the studies that we’ve talked about in our last
updates you can prevent getting the cold with sleeping appropriately up to five
times imagine if I could tell you that if you took this pill
you could reduce the chances of you getting the corona virus by 80% that
would be an amazing way of curtailing the arnott’s or the spread factor of
corona virus and that’s what we’re seeing
not necessarily the corona virus but in Rhino virus and so I think this is
actually significant enough in a discussion of what we can do practically
so in that vein of things there’s been a lot of comments specifically about some
things that I wanted to talk about shift workers circadian rhythm lights and
insomnia first of all shift workers I know there’s a lot of health care
workers that work night shift so that’s like going in at 7 p.m. and getting home
at 7 a.m. or 6 p.m. to 6 a.m. etc here’s the key about shift workers if you’re
gonna do shift work it’s better to always do shift work and not go back
between day and night that’s number one so stay at same shifts the reason why
this is important is because of the second thing we’re going to talk about
and that is your circadian rhythm if you don’t do that you confuse your body
circadian rhythm number two is make sure that your nights
are days and that your days are nights in other words if you’re going to be up
at night make sure that it is bright where you work at night it’s also very
helpful sometimes to take naps when you’re working if your job allows for
that even a 15 to 20 Neb can be very restful number three if
you’re a shift worker and you get home make sure you go to sleep right away as
soon as you get home don’t go out shopping don’t do the kids laundry don’t
go work outside go to sleep and make sure that the room is dark to make sure
that the curtains are sealed make sure the window is sealed you are working
different shift from what the rest of the world is doing but you still need
your sleep and so what you need to do is get your
circadian rhythm on a completely different cycle and that way you’re
gonna get your sleep the problem occurs is when you want to be one way on the
weekends and the other way during the week that doesn’t work so number four
continue your routine on the weekend I’m gonna put a link into the American
Academy of Sleep Medicine website that gives very very good tips on not only
shift workers but people who have other issues with their sleep so the other
thing I want to talk about affects all of us is circadian rhythm and light so
there’s two cycles that have to be in perfect harmony in your body for you to
get the great night’s sleep number one is the homeostatic and this is just a
funny word that tells you basically as you are awake more and more and more you
start to become increasingly more and more and more sleepy as you sleep more
and more you start to become more and more and more rested it’s just like
eating and hunger the more you eat the less hungry you are the longer you go
without eating the more hungry you are and that’s pretty easy to understand but
there is a bedtime that we have and there’s a wake time that we have and so
the other one is circadian and this is what happens when you go on a jet plane
and go to a different time zone and you get off there’s a certain circadian
rhythm that occurs and when both of these are combined together the perfect
thing happens is you are asleep until the morning and then you wake up and
then you are awake until the evening and then you go to sleep and what makes you
go to sleep all of a sudden which makes you get tired around ten o’clock
normally or 11 o’clock normally is the combination of the drive to go to sleep
and the drive to stay awake finally goes away and both of those combined for you
to go to sleep the is that the circadian rhythm can be
shifted either to the left advanced or to the right
delayed and what is it that can shift circadian rhythm it’s light and this is
the thing that is the bane of our existence as people who look at
electronic equipment whether it’s coming from a TV screen a cell phone whether
it’s coming from the lights in our house all of those things at that time of the
night when we should be going to bed especially blue light is going to delay
your circadian rhythm so that you become tired later and later and later and so
what happens is you stay up later and later and later and you don’t feel tired
until later and later and later but you still have to get up in the morning to
beat the traffic to get into work which starts at 8:00 or 9:00 or whatever it
starts and so that squeezes the amount of time that you have to go to bed and
to get the sleep so by eliminating light at night the light that causes this
delay in your circadian rhythm is particularly from blue light but bright
light exposure at the beginning of your day when you’re starting to get up in
the morning has the opposite effect and it can actually advance your circadian
rhythm so what I tell my patients is that if they have a situation where
they’re going to bed very very late because they don’t feel sleepy until
they go to bed very late and they love to sleep until eight or nine or ten kind
of like my teenager what they need to do is advance their circadian rhythms so
what I tell them to do make sure that they’re exposing their eyes to nice
bright lights around 7:00 or 8:00 in the morning and to avoid light exposure late
in the evening let’s talk really briefly about insomnia so some people have an
issue with going to bed and for those of you who have a separate room where your
bed is as compared to other parts of your house this works but many many
people have this situation where they feel tired they’re in the kitchen and as
soon as they go into the bedroom now they are wide awake they can’t go to
sleep and they become very concerned about their insomnia and there’s a
number of issues going on here it has to do with classical conditioning
things like Pavlov’s dogs that you may have heard of in experiments and the
situation is that you’ve got your bedroom and there are things in your
bedroom that you have associated with insomnia and so that comes to your mind
as soon as you go into the bedroom and you can’t sleep because you see these
things that you’ve associated with yourself in your brain for many many
times that you can’t sleep when you’re in this bedroom and it’s sort of like a
performance anxiety and it’s because you’ve associated that bedroom with your
inability to perform and the performance that you need to do in that bedroom is
sleep so what do you do if you cannot sleep in your bed you should leave your
bedroom and go to another part of the house and associate that other part of
the house with inability to sleep we want your bedroom to be associated with
you sleeping so in the same vein if it’s possible and you have insomnia you need
to toss out other things in that bedroom that aren’t there for sleep so in other
words if you have a TV in your bedroom you should get rid of it if you read in
your bedroom if you work in your bedroom you should get rid of it essentially
there’s only two things you should be doing in that bedroom and one of them is
sleeping so that when you go into that bedroom you are going to associate that
very very strongly with sleep and you’re going to eliminate the feeling of
performance anxiety because you’re not going to be associating that bedroom
with inability to sleep because you will be getting out of bed and going to
another part of the house until you are ready to go back to sleep the reason why
people get this is because they watch videos like mine and they get the wrong
impression they say ah I must go to sleep earlier I must get more sleep and
so they go to bed earlier when the circadian rhythm is not ready for them
to go to sleep or they say I’m gonna sleep in this morning even though it’s
nine ten o’clock and it’s time for them to get up and their circadian rhythm is
saying get up but they stay in bed and they can’t sleep and when they can’t
sleep they become more anxious and when they become more anxious they associate
that with the bedroom and that causes the issues so if this sounds interesting
to you I want to direct you to our website med cram comm where there is a
free course on insomnia that I’ve recorded previously and you’ll find a
lot of other courses that will be very helpful in explaining chronic
illnesses and medical conditions next week I will be at a medical conference
but I hope to continue the updates next week so thanks for joining us