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  • April 19, 2020
    7:15 PM
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Good evening I'm Dr Lena Lewis I'm your host and the medical director for ad business world radio I'm also a board certified obstetrician a gynecologist and it is such a pleasure to have you back with us again tonight for part 2 of our medical symposium last Sunday we investigated the relationship of novel lessons that were learned in the night 218 pandemic and sought to see if we could apply those to our current coaches 19 situation well tonight we continue that exploration and we continue to look and see of the principles that might apply historically and currently before we do that I would just want to take a couple minutes and describe to you a little bit about the host or the sponsoring entity the 7th Day Adventist Church an admin is World Radio is very happy and honored to be able to participate in sponsoring this medical symposium since its original the originator and the 7th Day Adventist Church has sought to provide holistic healing for the physical mental emotional and spiritual health to those involved and that involves a global church in the shift to with that understanding I want to invite Dr Dwayne the keys president of agonist world radio to have opening prayer for us right now thank you Dr Lee let's hear way pray together Father in Heaven is the joy that we come together to learn at this symposium I pray as we learn together on this medical medical symposium that you will bless each of our prisoners less each one listening to help us to learn to know that we can trust in you and have faith and joy in you we have nothing to fear as you told us in Psalms 23 days ago I walked through the valley of the shallow depths I will hear no evil Thank you Father for this joy and thank you for your blessings in Christ name a myth. It is and with you again now before we get started on tonight's presentation we just wanted to do a quick review again of was some of the and mazing principles that we learned last week we began to investigate novel lessons learned at particular institutions and they were referred to as sanitariums some of those principles in last week's presentation Now one thing that came out in the science was very interesting it was actually applied to our current situation to the Finnish people it was really interesting to find out that the people of Finland had not only better overall health as far as decrease risk with viral syndromes but there seems to be a relationship even with co that 19 What are those Finnish people doing that seems to be improving their overall decrease in mortality and morbidity I'm going to invite a very special friend Dr Xeno Charles Marcel dumb Jersey now thank you for joining us Dr Xeno is the current adjunct professor a woman Linda University he's an internal medicine specialist He's also served as the past Dean of Monterrey Miss Universe city and we want to ask the question again doctors you know what interesting thing is happening are taking place in Finland right now that might be affecting in a beneficial way their health thank you very much Alina and good evening to everyone. Last week we talked about the hydrothermal therapy as part of the what you may say that the treatment and the prevention of problems such as viral infections and so on so. Just to recap we need to remember that there was a historic. Issue with the pandemic of 1918 and I have some data that will be of that of what happened with the Finns things could be as simple as taking one call shows since we all don't have saunas but if you have a sauna at home or turbo or Jacuzzi you can immerse yourself and you can simulate some of the things that the Fins do you can even use Harpax to the chest and call friction to follow up as another means of doing the seam type of thing now what happened was that in Finland and also in Estonia they have the culturally ingrained practice of doing bathing in the sauna just sort of to see with where fin than a stone your are. I have on the next slide a little map there that shows the Scandinavian countries then Filon in green and Historia regularly in in a tan or light brown color Now let's see what's happening with them right no as of today you would see the graph these are all maps or graphs of what's going on all around the world but on this graph you can see we're Finland is and you see we're still in Year is and those 2 are tracking very nicely and they are at the bottom if you will effect a computer that with the others in Scandinavia next light you'll see where Denmark Sweden Norway Norway is not written there was read about Finland that's where they are so you see they don't have the same practice of sourness the way the Finns and the a stone Ians do. If we go back to the pandemic back in 1918 this is a graph looking at the study of 14 European countries and seeing the excess mortality that was associated with the Spanish flu that's the part in red if you go on I want to highlight a few things. First of all could you go you know 1st of all you would see that Finland had only 33 percent excess mortality if you compare that with Sweden next they had 74 percent excess mortality if you look at Norway that had 65 percent excess mortality and then if you look at Denmark there had 58 percent 57 percent excess mortar so again even back in the Spanish Flu time Finland came out better than the other Scandinavian countries the reason for this we believe is related to the heat that is used in the sauna and the call that locks in that heat so we have fever range thermo immuno modulation this is what happens and I'm sure Roger later on we'll talk some more about this but we have he chucked proteins that work and they affect the Inet immunity and also the adaptive immunity next like. We can see here that fever or fever range film of therapies will affect the whole cells will affect macrophages and these micro features are part of the response of the in the in the immune system next like. In this we see that again by by giving the heat treatment or by having fever we can actually moderate some of these he chopped proteins in this case we're looking at each operating 60 and you'll see on the top half of the graph these are the innate effects and the lower half of the graph is looking at the at the acquired immunity effect and on the left side in pink we see what happens when we have a high concentration of each opera $160.00 this is pro-inflammatory and as the treatments go on and the disease progresses and the amount of each opera $160.00 decreases then we have an anti-inflammatory response which we believe will be helpful to decrease the cytokine storm next. So basically it's not a panacea it's based on historic evidence and a rational scientific set of postulates and therefore should be given serious consideration part of a preventive regimen kind of a therapeutic resident and warrants for the scientific interest which. Thank you so much Dr z. Now that was very very great review you know it wasn't just hydrothermal therapy from the perspective of sun has there's different ways as you mentioned that you can actually have complex h.t. or hydrothermal therapy and you mentioned some of those that for our viewers if you didn't have a chance to watch the original presentation please go to a w r dot au Archie forward slash health and again you'll get a full review of that opportunity Thank you Dr Zino Now I want to I have another question for another one of our guest speakers Dr Eric Nelson Dr Nelson is the associate professor of surgery at the University of Tennessee Chattanooga and Dr Nelson we don't have a lot of research on hydrothermal therapy across the board in particular for coated 19 as of course it's only been with us since November or December of last year your study has you had just got approval specifically i.r.b. approval for a particular study can you tell us just a little bit about that maybe our viewers may be interested in joining me I'm sure I'd be happy to do that I've got to live that very briefly describe the the protocol that we have. As you heard in last week's impose the end there are many different ways but I hydrothermal therapy for the impatient studying with so much personal protective equipment trying to limit the resources going in and out of rooms we're using for heating pads to heat the chest for 25 minutes followed by a 12 minute walk using just the old how we're doing this about 4 times per day we decrease the fire be approval and we hope permanently enrolled I believe 3 patients and fortunately here in Tennessee we've lapped the herbs so we're not sure how many patients will be if you get into this these abilities but we're aiming to have about 1020 patients our primary outcomes are looking at length of day and doctor nation outcomes will be variant the hyper formal therapy is hopefully helpful to the patients hope it was very excited with the response to last week a symposium well over 20 physicians and 20 different centers ever written and asked for the protocol and they are looking at implementing it in their own area and of course as most of your viewers probably know there's also things Book page that has been set up for those who are interested in discussing. The new hydrothermal therapy and how it can be applied in his particular setting the again you saw my e-mail address there on the bottom of your email them at yahoo dot com If you're interested in collaborating specially if you're a physician that has the ability to carry out i.r.b. approved research we would love to cooperate in data collection. Thank you so much Dr Nelson and again you can also go to a w r o r g forward slash health and we can help connect you with Dr Nelson thank you again you know as they looked at last week this we keep talking about the pandemic from 1918 and comparison to the pandemic for Cope at night team and looking to the past for possible ideas practices how they may help us in our current situation well I'm very excited to introduce Dr Peter Lamb was a mentor to me and a great friend Dr Lamb was a cardiologist and he directs the health ministry for the 7th Day Adventist church globally now why didn't novel last and that we really explored last week that we've already touched on is hydrothermal therapy Dr Lamb and there was a section that population really had different institutions and some of them were referred to as sanitariums that were doing some very different things in 1910 perhaps some of the Army hospitals can you tell us a little bit about the differences in mortality just as review from last week in the thank you very much maybe maybe not everybody it's as we've just been. Mind that last week in school the conversation on high defendants they would be throw in the sanitarium approach to treating patients during the 1918 pandemic well since they had been to send it to infants by the co-found and then watched writing on health principles so these principles have remained the core of the last August by minute near and today the curiosity was hidden in the. Winter and long. Running to help order the war. And. Ended. And then as I mentioned are we in the proof that it has helped starting with nuclear weapon to mine your life than it was to the medical complaints around community aluminum that the advantage reported in timing when I'm sick to think and then could not quit and to be not today what are the variables what are the factors that makes it windy and apart from the obvious at from the back and alcohol having a predominantly vegetarian diet with something national that health under that name to tell to you that when than. Locked down not in the long didn't depend but all because the area can too important in remembering that can. Pretty much be made by a team with Byron mental and moon perfect and the data coming from the study along with that and then would call the member of the black box to mean one who meant to mind tonight. Or on our come from the one and influenza pandemic which showed significant. Date growing I'd been to send it to you think women in come to read conclusions in the papers you read that appeared in life and helped to educate that isolation what we talk about the doing the actual good thing of those that have them compared to well. We wrote back an inoculation who they have a group they didn't something. And they didn't hurt as well as our cabal micrograms the. Drinking or hear anything bigger than our end when we are billed for having come to. A blue boat to well how did and how do you spank to. Modify our one pound conclusion which they did what principle made of improved outcome of art treatment good thing what great thing but you knew who was behind your bit with the women that one were or were that's what cannot handle that are the greater creating not only what was done with them a good thing but you are one cold winter blue morning grey shade and we were both too and they didn't have any under the attrition 4 of those things that's what we're going to look at the mine and see if those written the available sexes and treatment. Men you can seem to despise with confidence and there's a maverick who didn't see from the p.s. because not 2400000 plus people have been infected with Corona virus 165 days look older the world wide and an 85 countries we need to look somewhat to see what the sinful really available appropriate preview could and then use to help not enough but into the long term. Thank you Dr landless that is so inspirational and again revealing what we looked at from 1918 last week and and you gave the perfect prelude for tonight's presentation because we're going to take 2 of those principles additional principles or lessons if you welcome 1900 and we're going to investigate them further to find out if any of pluck ability for us today with coke at 19 so thank you I can end up telling us interesting that and I'm sure I knew you had read his original paper and call names and. He very much to the to the various approaches but including what was talked about but I'm so excited that we're going to look at other issues which could be the South variables which decision might such a big difference Absolutely thank you again Dr Ellis and those 2 that we're going to be talking about tonight are specifically ultraviolet radiation and open space now we've been hearing oh I'm over the news just this week is there a difference between the urban and versus the rural setting and unfortunately this week we found out that although in the past the last month or so month and a half we had hoped that the rural settings within the United States wouldn't be as hit hard as some of our big cities unfortunately as we have seen the flattening of the curve in many of our large cities we've seen somewhat of a spike in some rural location so we're going to let them both at all ultraviolet radiation and open space from a historical perspective 1st and then we're going to look at it practically currently cope with 19 and with that introduction I want to welcome Dr Richard Hart Dr Hart is an internal medicine specialist He's the chief executive officer and president of the Melinda University my alma mater and my personal friend and mentor Dr Hart is going to discuss with us a little of the historical review of u.v. light or radiation open spaces and the sceptically the 1800 situation from our institutions that were practicing those things and subsequent time thank you again for joining us Dr Hart. A little easier Can You Hear Me Ok we can hear you thank you sir it's a privilege to come back on again and talk about a new aspect we often refer to as a natural remedy. In fact. Every year about this time I developed a recurrent just. It's called the fever spring fever and there seems to be an inherent need in many of us to get outside in the fresh air. Filled in the dirt to plant a garden and do all the things that God I think is in kind of entitled us to do if you look back at the early days at Loma Linda you saw many pictures of patients outside reclining on lounges taking walks and so on benefiting from both fresh air and sunlight we know that sunlight is in fact a disinfectant it kills viruses it kills many diseases so there's some inherent value in it itself but I think even more importantly the fact of being outside and being able to enable a person to enjoy the fresh air and participate in outdoor activities is very significant modern hospital designers today have tried to figure out how to capture this it often gets referred to as a healing environment as the ability to create in a hospital both space. And sunlight both recognize as somehow having an impact on the human mind the human body and creating a healing environment and so this evening as we look at some of these natural remedies we want to put an emphasis once again on 2 of those. Outdoor exercise and reading fresh air and sunlight I think both of them have things that we perhaps cannot measure in a certain scientific way but has clearly inherent value in what we do and tends to give the kind of lifestyle that makes all of us stronger. In the days of cold would we think these even have value for those who are perhaps not hospitalized intensively but have some symptoms of the diseased to be able to benefit from it so light and fresh air as well so it's a privilege for a moment of the part of this look forward to hearing the rest of the ones as they present the 1st benefits of fresh air and sunlight thank you so much Dr Hart Yes there is it's amazing how all the way back in 1900 stated they used to be able to take the patients outside and again they had a significant improvement comparative to the Army hospitals now what we're going to look at tonight for the rest of the evening as we want to look at current scientific evidence related to ultraviolet radiation or sunlight and open space or fresh air you know there's actually been a number of studies and conversation with Dr Roger swelter which needs no great introduction but we will be discussing many of these things Dr Schweller is a pulmonologist intensivist He's the assistant professor of medicine at one Melinda university and we are honored and privileged to have him here again with us tonight to discuss current up to date research related to these 2 topics again in relationship to cope at 19 for the rural and the urban patient thank you for joining us again Dr shall thank you thank you Layla So the question really is as fresh air and sunlight right what does the science say and let's get into exactly what the science says and you'll find that it's actually more interesting than you may think. And as you know we are full in endemic mode here with covert 19 which we talked about last week and as we said let's review a little bit about what we talked about because the course of the disease came out fairly early when we were in the early part of this pandemic there was a Lancet article that showed very clearly 3 phases of this disease the 1st phase before the infection the 2nd phase after infection but before going to the hospital and that could be anywhere between a week or 2 there was about a 5 day incubation period a 7 day infective course some people got worse had to go to the hospital and unfortunately the course was fairly aggressive within days of being admitted to the hospital go into the intensive care unit being on a ventilator and so we brought that down last time we said that there's 3 phases that we can intervene in these patients number one is the people pop the population and then preventing them from becoming infected and that's what we talk about social distancing and then once you are infected there's about a 20 percent chance that you would need to be hospitalized go to the hospital you need an i.c.u. bed need a ventilator and that would of course help us prevent you from dying in that case because the key point though is in phase 2 is there's this 80 percent of people who will never need to be on oxygen never need to go to the emergency room and really it's because their immune system takes care of this and so we decided to look a little bit more closely at the immune system and we noticed that there was actually 2 parts of the immune system there is the innate I mean system and the adaptive immune system early on when you're 1st born your name in system is very very powerful That's why kids have fevers when they get viral infections and as we become adults and get older that that kind of attenuates somewhat We don't have as high fever perhaps. On the flip side of it the adaptive immune system which reacts to vaccines which reacts to antigens that are presented to it that becomes more and more educated as life goes on and what we talked about last time is they're noticing that with vaccines pacifically the b.c.g. vaccine which we won't get into tonight but I urge you to look back at that video that there is some spillover So when you excite one when of the immune system you actually it's like the other. We also looked at a paper specifically looking at components of this innate immune system you can see that we've got squared there the monocytes and the natural killer cells these are key components which will be talking about again tonight in terms of the innate immune system in the reason why we focused on this was because because of a center of excellence paper that came out just this year regarding not only the 1st SARS virus and murders both of which were coronaviruses but in conjunction with what's going on right now with Copa 19 and what it showed was that there was a number of things that came out of this article and that was that there was noticeably decrease lymphocytes which was predictive in terms of mortality and not only SARS and MERS but also code 19 and that there are prediction was that cove in $1000.00 would dampen antiviral interferon responses resulting in uncontrolled viral replication and that kind of goes along with what we see in this type of infection where patients are at home they've got the virus for a long period of time before they d. compensate and it's felt that the virus is actually suppressing the immune response and they felt that the issue was with the innate I mean system and that is at 1st the suppressed and then goes into overdrive and we talked about this paragraph in this article and it says very clearly at the end these facts strongly indicate that the innate immune response is a critical factor in disease outcome and so we were left understanding that the natural killer selling them on a site part of that innate immune system was not only involved with hydrothermal therapy as we talked about last time but it will I will also see this time is involved with being outdoors fresh air sunlight and I think a be surprised to see some of the things that we're going to show you so this is no surprise to us there are many companies that have been researching this innate immune system as we talked about last time a lot of them repurpose in their technology. Cancer fighting to fight Co The 19 there was a number of companies that have done that in some cases they're simply taking medicine time will play missing time will cells from placentas and repurpose in those to make natural killer cells and infusing those into patients when they come into the hospital to help fight with the infections couple of clinical trials that are undergoing at this point and so again to summarize the early portion of this number one SARS comes to infection down regulates an 8 immunity SARS comes to is allowed to progress because the native unity is not strong enough and number 3 strengthening that innate immune system i.e. natural killer cells monocytes it cetera might prevent or stop Kovan 1000 and Strax especially during this very sensitive phase 2 where the patient is sent home from the emergency room because they're not sick enough to get into the hospital but yet they're not well enough to say that they're normal either so kind of a period of time here where we can actually make a difference so what it was that could strengthen immunity we talked about the hydrothermal therapy last time we've talked about sleep although we really haven't talked a lot about it but there's a lot that you can do there what we're going to focus in on this topic is talking about sunlight and fresh air. So let's let's take a look and see well one of the 1st things that comes to mind is some light and vitamin d. we all know about vitamin d. and I wanted to make sure that you understood exactly what was going on here vitamin d 3 as we call it is really the storage of this hormone 1st of all vitamin d. as you can see is made up of a number of chemical rings and this vitamin really is a hormone so let's not mix any or any words here this hormone is lifted saw Yuval and can go directly into the nucleus where it actually affects transcription of genes so it's a very very powerful vitamin and it can be used in a number of different ways and is used in a number of different ways for immunity vitamin d. vitamin d. 3 specifically is activated by the liver at the 25 position it gets a hydroxyl group and then finally at the kidney at the number one position the way I used to remember this in medical school is the liver has 7 lobes and 25 is 2 plus 5 equals 7 and that's how I remember that the 25 positions were the hydroxyl group goes and the number one positional of course the kidney only has one lobe and that is when it gets activated there it is in its active form and it does a whole host of things that benefits your immunity calcium all sorts of things. The key though in understanding why the sun is involved is vitamin d. 3 can only be created through 2 mechanisms number one it can only come to you from a mass of from a cholesterol derived derivative which is activated by sun in your skin to make vitamin d 3 So one way of getting it is through sunlight and that's why you need sunlight to make vitamin d 3 the other way is just ingesting it orally and so you can see here on the side that vitamin d. can be ingested or you can get it through the Sun Now obviously if you're not getting enough sunlight and you're not ingesting it you're going to be vitamin d. 3 deficient and that's where we have a lot of problems so for years they've been looking at vitamin d. and they felt that vitamin d. was one of the things that you needed to have to have a normal and good immune system to fight against things like Coke at 19 and so sometimes they would get studies that showed that there was a benefit sometimes they would get studies that show that there was no benefit and sometimes they would get studies that show that actually there was a negative benefit so what they did was something called a mega analysis where they actually went through individually with each patient and all of these studies group them together and they analyzed them and the British Medical Journal published this not too long ago and there was about 11000 people in the study and what they did was they lined up all of the studies starting here from 2009 all the way down to 2015 and what they did is they looked at seeing whether or not control versus intervention whether or not vitamin d. was helpful specifically for upper respiratory lower respiratory tract infections and you can see this very solid line is equal to 11 meaning no benefit no no different no harm. So if the blue box was on the left side of that line that indicated that vitamin d. was beneficial if the blue box was on the line it meant no difference if the blue box was on the right side of the blue line that meant that it was harmful and so what they did is they added these all up they looked at them individually and when they group them all together and looked at all 11000 they found at the end that there was a statistical significant benefit in these 11000 patients and it was to the left of the line meaning that it favored vitamin d. having a benefit. So what did they find in the study they found number one that those that had a level before supplementation of less than $25.00 minimal XP or leader had a 70 percent reduction in risk when they were put on supplementation those that had a greater than $25.00 minimal per liter had a 30 percent reduction in risk so the 1st thing that I would mention is if you think that your vitamin d. deficient you should get it checked that's the most important thing and if you are deficient you should go on supplementation Well the question is is how much supplementation should you be on while what they noted is that you should go on supplementation and that actually you don't need that much what they found that had the most that this tickle significance was those that were put on less than 20 micrograms of vitamin d. that's about $800.00 international units that was associated with the largest change the other thing that they noticed was that you should get retested after you go on supplementation to make sure that your vitamin d. levels are in the normal range the other thing that they found very interesting is that vitamin d. is not something you should take as a stat hormone Ok In other words if you feel something coming on you shouldn't pop in a bunch of vitamin d. and then nothing for a while the key was not the hair winning the race but the tortoise winning the race and what I mean by that is taking enough every single day on a regular basis was the more helpful way of taking a vitamin d. supplement than taking an enormous amount what they felt was that an enormous amount of vitamin d. would actually inhibit the the the very mechanisms but the vitamin d. it was trying to actually do and so in their conclusion they said our study reports a major new indication from item in d. supplementation the prevention of acute respiratory tract infections we also show that people who are very deficient in vitamin d. and those receiving daily or weekly supplementation without additional bolus doses. Variance particularly benefit our results add to the body of experience of evidence supporting the introduction of public health measures such as food fortification to improve Vitamin the status particularly in settings where profound vitamin d. deficiency is common and where would you see this is no accident that this was published in the British Medical Journal obviously Great Britain United Kingdom Ireland these are all countries who are very high in latitude and therefore would not be getting direct sunlight the kind of sunlight that you need to get the ultraviolet radiation to convert one form to another in form of vitamin d 3 when this was a study and I'm giving you studies here that were just published here in the last week this one was just released maybe about a week ago and this was in Dublin in Ireland and it's called Hilda and this is a this is known as the Irish longitudinal study on ageing So what did they find here they found that number 147 percent of all adults over the age of 85 are deficient in vitamin d. in winter in Ireland 27 percent of adults over 70 who are they call cocooning basically what we're all doing right now with Kovan $1000.00 are estimated to be deficient and that one in 8 adults over 50 are deficient all year around only 4 percent of men and 15 percent of women take a vitamin d. supplement and what they found was very interesting the key principal investigator of the study was Professor Rose and Kenny and listen to what she says she says we have evidence to support a role for vitamin d. in the prevention of chest infections particularly in older adults who have low levels in one study of vitamin d.. Supplementation it reduce the risk of chest infections to half that's a 50 percent reduction in those who took supplementation Zz quote she says although we do not know specifically the role of vitamin d. in coded infections given its wider implications for improving immune responses and clear evidence for bone and muscle health. Those Kooning kind of what we're doing right now and other at risk cohorts should ensure that they have an adequate intake of vitamin d. she goes and talks about Ireland but those people in Ireland obviously it's it's they have a higher latitude they don't have as much sun maybe they have more rain cover these conditions are not too unusual here in the United States and around the world people especially living in the Pacific Northwest don't have as many Sundays even if you're living in Southern California How many times a day for how many hours a day are you inside and not being exposed to on this ultraviolet radiation so I think there is definite evidence here for vitamin d. and the benefit of sunshine speaking of sunshine sunshine has obviously a wide range of wavelengths but the one that we want to focus on here is alter Violet So there's 3 different types of ultraviolet light that come through here we have kind of what the stratosphere looks like we have altered Violet a and the majority of that actually reaches Earth and we get alter Violet a light there's also alter Violet v. and we only get a small fraction of that but there is something else called ultraviolet c. and that almost never hits us because it is a limb unaided by the ozone layer and we never see ultraviolet c hitting us that is altered Violet c. is in the lowest wavelengths and therefore have the highest amount of energy you may remember that from physics. The other thing that you may recall imagine pulling up to a stop sign and somebody in a large truck who has their radio blaring loud what is it that you can hear coming through their truck into your car if the little it's a very low frequency sounds the low frequency sounds are the ones that can penetrate very deeply and ultraviolet light is no exception you can see ultraviolet a which has a longer wavelength penetrates all the way down to the surface of the earth whereas the ultraviolet see that would be the high frequency notes the higher notes it doesn't penetrate very far but this ultraviolet c. and specifically far ultraviolet c. has some benefits that we are now just discovering. You may know that ultraviolet c. light is used in the disinfection of patient rooms and in a number of other places the problem though with ultraviolet c. light in general is that it can cause problems with your skin can cause skin cancer and it can also cause cataracts and so we have to be careful with that here you can see so in using again this ultraviolet see light in the sterilization of a patient room after the patients been discharged we know obviously that skin cancers can be caused by ultraviolet radiation and that can cataracts However there was a recent article that was published in Nature a very prestigious publication that looked at something called Far u.v. see light this is not regular u.v. see light in fact u.v. see light may not even penetrate through the glass of the ball but you're trying to use this is a very very specific type something that you probably can't even buy at this point and it's very expensive to make but something that they did that was very interesting was they took this was done about 2 years ago before Kovan $1000.00 so they took h one n one influenza virus they nebulized that they put it into this aerosol exposure chamber something that very similar what would happen after someone would sneeze. Were cough and it would float around in the air and then they sucked it into this u.v. exposure area where they exposed it to this far field u.b.c. around $222.00 nanometer wavelength then they took the particles out and they actually cultured them on a dish with culture cells to see if there were culture and what they found was something very interesting here I draw your attention to these blue dots these blue dots are the nuclei of cells and you can see here in the top left hand corner when they didn't do any kind of u.v. see light you can see there's a green haze that green haze are the virus particles so the viruses are growing very fast and you can see that correlates here with 100 percent at 0 dose then they increase the dose to $8000000.00 joules per square centimeter and you can see here that there were less viral particles they increase the 2 a sorry increase that's a $1.00 here and then finally they increase the 2 Milledge Joules per square centimeter which is a very small dose but you can see here that that u.b.c. lights this light is very very weak it can only penetrate just maybe the with of one virus particle in fact it can't even penetrate the tear layer that is on the surface of your eye this is very very far this is not something that you can buy in the store as yet. But what it showed is that it could inactivate aerosolized virus particles and it does that by damaging the r.n.a. or the d.n.a. So the conclusion of the study was that they have shown for the very 1st time this about 2 years ago that very low doses of far u.v. see light not regular u.v. see light but for u.v. see light efficiently and activates airborne viruses carried by aerosols and they say for example a low dose of 2 milage Ewell's per square centimeter of $222.00 nanometer light inactivates greater than 95 percent of airborne h one n one viruses and their results indicate that far u.b.c. light is a powerful and inexpensive approach for prevention of reduction of airborne virus infections without the human health hazards inherent with conventional germicidal u.v. seal lamps if these results are confirmed in other scenarios it follows that the use of overhead very low level far u.b.c. light in public locations may represent a safe and efficient methodology for limiting of transmission and spread of airborne mediated microbial diseases and they go on to talk about public places and doctor's offices schools airports airplanes it cetera. Why isn't a big implications well this is the Pittsburgh Post Gazette asked the very same question and when they interviewed them they this is what they said the 2 roadblocks for ramping up to high capacity production of these far u.b.c. lights is f.d.a. approval However a couple of weeks ago and this was published on April 9th My best guess for both might be 9 months but we are now trying to go faster than that last month the f.d.a. issued an advisory that clears the way for use of sterilizer and disinfection devices including far u.b.c. lamps in hospitals and other pople Cal settings during the unique coronavirus pandemic and prior to formal f.d.a. approval so this is something that we might be seeing more and more of in the coming months perhaps maybe even a year and this might help in terms of getting people back and cutting down on that are nots or that transmission. Now I want to search show you something that's very important that just came out about a week ago this is from the Department of Homeland Security it is unclassified and for official use only and I want to show you what they have been saying here this is the emerging results in terms of the stability of the corona SARS 2 cold virus and what they say here in their unclassified official use only statements here is that the virus lives longer at low humidity and in the activates faster at higher humidity they also know here that the virus lives longer at low temperatures and inactivates faster as temperature increases and notice what they say here that sunlight destroys the virus quickly and that's underlined and put in a talents they say here that higher temperature and humidity of indoor environments will reduce viral contamination on surfaces faster I also go on to say that if there is no sunlight the half life in ours if the relative humidity is only 20 percent is as high as 1718 hours but you can see that when the temperature goes to 95 percent 95 degrees Fahrenheit that that quickly goes down with increased humidity so they say here that the virus is most stable at low humidity but the case faster when the relative humidity is greater than 40 percent and that the virus is less stable at higher temperatures. Again here another slide that's very important simulated solar light rapidly inactivated the virus take a look at this if you do have sunlight the solar intensity full intensity the half life is literally 2 minutes half intensity sunlight 3 minutes a quarter intensity 4 minutes and if there is no light if it is dark there is no decay it's greater than 60 minutes they said here that sunlight reduced infectious virus to undetectible levels after just 3 minutes of exposure to the solar equivalent of midday sun on a sunny day in the middle latitudes of the United States I think this is really interesting material and it shows us that the sun is very powerful creating a sterile environment when it comes to SARS too so in summary looking at sunlight we looked at sunlight or dietary supplement Taishan is extremely important when it comes to vitamin d. and has very good health benefits and we're seeing though and studies that have been doing been happening even just recently the vitamin d. is important preventing respiratory infections that far u.b.c. 222 nanometer light may allow us here in the future coming out to significantly reduce aerosolized transmission by installing them in places overhead with gatherings institution hospitals etc and that heat and humidity are the 2 enemies of covert 19 and they speed up the breakdown of SARS cover to our right that was sunlight What about fresh air fresh air what is it that we can say about fresh air it's just air correct Well let's talk a little bit about Fresh Air Now there was a study that was published here called healthy lifestyles are so sick with higher levels of per friend granting a license granting lines a and b. expressing cells and for full blood lymphocytes. And this is really interesting they took about 114 male subjects in Japan largely in Osaka and they divided them into 3 groups based on health practices good moderate or poor and they looked at cigarette smoking alcohol consumption sleeping hours working hours physical exercise etc and what they found is that those that were have good or even moderate health had more natural killer cells than those that had poor health so they decided to do some more studies about this and this is where we come up with fresh air and I found this these studies very very interesting so this study is called forest bathing I never heard of forest bathing before but forest bathing in Hants is human natural killer activity and the expression of anti cancer proteins so this was done a number of years ago they were interested in Coben 1000 but they certainly were interested in natural killer cells so what do they do they took 12 healthy men in Tokyo working at a large company with blood 3 days before and they looked at those 3 things that we just saw in the previous study m.k. activity granule liason her friend and grands I'm a and b. these are the enzymes in the natural killer cells that help kill. Cancer cells and viruses and what they did was they took them to the forests and when they got to the forest they measured something called fi decides these are aromatic compounds that are just found in the air and in the afternoon they had them walk for 2 and a half kilometers which for about 2 hours and then they said they slept there in the forest in a nice little cabin or motel then the next day they took a blood sample at 8 o'clock in the morning just like they had done before and in the morning they had him walk for 2 hours about 2.5 kilometers and in the afternoon in a different forest for about 2 hours 2.5 kilometers sounds like a very nice study well they slept again and overnight the next day they took blood samples again at the same time if locked in the morning and then they sent them home while Let's take a look and see what some of the results were so when they looked at the natural killer cells it took a baseline 3 days prior to go into the forest and then on the 2nd day there was a statistically significant increase in natural killer selectivity natural killer cell percentage and natural killer cells per my crow leader and it was even higher on the 3rd day in all of those cases all of these were statistically significant when they looked at the ends in those natural killer cells they noticed whether it was Granny liason per friend gran's I'm a or b. they all went up and they all went up statistically significantly and all of those subjects. Ok so what maybe it was that they were just getting out of their job and maybe the just the the less stress was what they needed to do that's maybe that's all they needed writes the brake and that would increase their natural killer cells Well they did another study here again it took 12 healthy men Tokyo work in a large company to do the same thing when you're in this time they actually checked your in for adrenaline to see if they were more relaxed and this time they randomized them they had a control group so the 1st group went off and did exactly the same thing that we just talked about they went to the forest and they stayed there overnight a couple of nights and they did the blood tests but the other group this time didn't go to a forest but they went to an urban center urban city about the same distance from Tokyo but instead of walking around in the forest they walked around in the city they walked around to different plates they went to a baseball stadium and and walked around and they took the some blood samples and they stayed in a hotel in the urban center and they got sent home all at the same time so then what happened let's take a look at those results Well the 1st thing that they did was they actually checked these Fido signs usually see these aromatic compounds that are circulating in the air and they noticed that in the forest bathing trip there was a high concentration of tri cycling's Alpha pine Ians beta pines these are found chemicals that are found in the trees aromatic compounds and we can see a whole list of them here none of these were detected in the city tourist trip there was one alpha pining that was around 6 as opposed to $2886.00 in the forest another one that was 17 Lyman Lyman e. and that was found at around $100.00 and the forest bathing trip so let's take a look and see what happened so we're going to talk about the forest bathers 1st so they're natural killer cell activity jumped up. By day 2 and stayed up by day 3 and what was fascinating was that even though they had come back after 2 or 3 days after 7 days after being back their natural killer selectivity was still elevated even after 7 days in fact even after 30 days it was not as elevated but it was still statistically significantly elevated compared to their baseline meaning that if they lived in the city they could potentially get the same benefit by just visiting once a week resting once a week and go into the forest for a trip. What about the city tourists absolutely no improvement in that'll kill or selectivity whatsoever in fact if you look at dates 2 and day 3 there was a huge jump in the forest bathers versus the city tourists on both days. What about those granular grannies imes in the per friends in the granite liason a and b. same thing we saw an increase here the light green being after day 2 the dark green being after day 3 This held in every case until they 7 even that day 30 there was just the distinctly significant increase what about the city tourists absolutely no statistical significant increase in any of these and any of these cut offs now they I said that they did take your unary measurements so in the forests they did have a drop in your an area adrenaline adrenaline is not good for you right it does cause health issues if you have it shows that you're under stress by day too it went from 4 and a half all the way down to below 3 and there was a statistical significant difference in the drop in your unary adrenaline in the forest bathers What about in the city absolutely no difference whatsoever in the city tourists. Ok so the next thing that they decided to ask is Ok well what is it that's actually causing these natural killer cells to go up maybe if the spite of signs these essential oils of these trees yes actually said essential oils so they decided to do another study this time they took 12 healthy medical students in Tokyo and they took blood on day one and 4 and they checked the urine and the end kicked to Vittie the granule ice and the per from the grain lies in a and b. and urinary adrenaline and they measured fight a size they also measured. They measured the 5 a side so here's day one they got up at 7 o'clock in the morning because their medical student and senior and then they went to regular work because their medical students do not get out anything right at 7 pm they were when they went to their when they went to an urban hotel and they slept at the urban hotel so in the city they did not go to the forest they were in the city but at 7 am 7 pm they started to vaporize this gnocchi stem oil which is a Japanese. Which is a Japanese plant and they went to bed 11 pm so they did it for one day it did it for 2 days they did it for 3 days and then finally they went home after that so this is the plant that they use the no I don't think it's specific to this plant this is Kenya it's a Paris of Tusa. What do they find while when they measured in the room how much fight aside levels there were there was a measurement of Alpha pining certainly statistically significant and the total So was there it was in the hotel room wouldn't be measured before never measured it before it was there so there's no question about it what happened then well when you know it natural killer cells went up statistically significantly before versus after not only natural killer cell activity but also natural killer cells percentage wise also went up and what about those enzymes that were in the cells So yes the grant the g r a the g r b the perforations all of these statistically significant went up this one was 0.08 which did not meet our usual cutoff. But it was very close it trended towards that now interestingly what about your unary adrenaline so in this case the medical students who were sleeping at the urban hotel did have a small drop but it wasn't sophistic least significant remember when they actually went to the forest there was a statistically significant drop so maybe that these poor medical students just couldn't relax at the urban hotel. So where do we go from here well this was done a number of years ago there was just a study that was published 2 years ago that looked at the same thing except over a long term they compared 94 staff members versus 110 urban staff members and what do they find in the north 94 staff members higher natural killer cells in the forest group versus the urban group and here's an interesting point in the forest group we saw that the natural killer cells and the natural killer cell percent were higher in specifically a subgroup population of the males who were a little bit overweight b.m.i. greater than $25.00 and it's interesting to me because these are exactly the same population of patients that are at risk for coke at 19 All right now what about what about in this study the thing that they actually checked was air pollution and they noticed that in the forest the sole sulfur dioxide the nitrates the night from dioxide all of these things were much lower than in the urban environments whether or not that has anything to do with it is interesting will actually come to that very shortly and here it is this is a paper that was just published last week by a group at Harvard University and the title is exposure to air pollution and coping 1000 mortality in the United States Updated April 5th 2020 and the background here was that the United States government scientists estimate that coded 1000 may kill between 100240000 Americans and so they wanted to investigate whether long term exposure to fine particulates matter otherwise known as pm 2.5 increases the risk of cold in 1000 deaths in the United States so they collected data from approximately 3000 counties in the United States representing about 98 percent of the population up until April 4th 2020 then they fit 0 inflated negative bio in the mix models using county level Cove in 1900 s. as the outcome and county level. Long term average pm 2.5 as the exposure and they adjusted by population size hospital beds number of individuals tested weather socio economic status and a whole bunch of other variables and what they found that was this they found that an increase of only one micrograms per cubic meter in pm $2.00 was associated with a 15 percent increase in the Co The death rate 95 percent confidence interval was 5 percent all the way up to 25 percent and the results are statistically significant and robust to secondary and sensitivity analysis so their conclusion was based on air quality a small increase in long term exposure to pm 2.5 leads to a large increase in Copan $1000.00 death rate with the magnitude increased 20 times that observed for pm $2.00 and all cause mortality the study results underscore the importance of continuing to enforce existing air pollution regulations to protect human health Bolger and after the code 1000 crisis and they've made their data public and you can actually go to the site and see exactly the data that they've used to come to that conclusion So in summary health healthy lifestyles may improve natural killer cell ability number 2 trips out of the city to the forest may be beneficial to our immunity through fine asides number 3 it may help those particularly affected by the virus so we talked about being male overweight and for there may be short and long term effects and then finally number 5 air pollution may lead to an increase in Copan 1000 deaths. So before I leave you I want to show you a very interesting article and publication that was given to us out of the Puget Sound area and it's called outside our doors and there's the website what they do is they go through a number of studies that were Perry view that show that having green spaces in urban centers be very very helpful one of the ones that I'll leave it before we finish there is this one this of published by Dr Roger Ulick who found that patients in the hospital which will be talking about later recovered faster and had a shorter post operative hospital stays and required lower strength pain medication fallen gallbladder surgery when their post-operative room had a scenic window view of a nature instead of a brick wall and the link between views of nature and faster recovery time is likely facilitated by reduce stress levels which promotes healing and so what I will say here is I said at the front of my slide that I didn't have anything to declare no conflicts but I do have one little conflict and that is that I live up here in a beautiful area not too far from where Dr Hart lives and I say that come up any time and enjoy the beautiful scenery of Oakland California. Leyla Thank you Dr swell that was amazing you know I I learned quite a bit just now I've believed in fresh air and sunlight for many years and I see many of the studies in the past but never put together so it's quite concisely so thank you again Dr swell at this time you know we do have several questions we've seen some research a lot of research actually does show the benefit of ultraviolet radiation and being an open spaces are fresh air but we want to know how to practically apply that everything comes down to how Ok that's great information but how do I apply it to my situation perhaps I live in an urban setting and I don't have access to the countryside perhaps I live in the countryside but regulations are such that it's making it more difficult for me or perhaps I live in a than the north of the northern latitudes and it's not as sunny as I would like well I'm going to invite my good friend doctors you know Marcel Charles Marcel up again and we're going to discuss the specifics really again specifically on the patient who is in an urban versus a rural setting How do I make practical my exposure to fresh air and sunshine doctors even thank you clearly. If this is a this is an issue of you because we've had lots of debates about living in the city versus the rural areas and the research shows that people who are living in rural areas tend to be older they tend to have more co-morbidities and therefore given the same kind of risk level same kind of exposure level to the virus they're probably more prone to having a problem. That being said we ought to pay attention to what was being presented by Roger earlier and in fact if we look at people everywhere. The same issues really apply as the basis for things avoid contact with the virus whether they're regular through others disinfect the contact points we have a virus maybe increase resistance to the viral infection and that is we have been talking about increasing your or your own immune systems ability to fight get tested if at risk and if the testing is available of course protect the most vulnerable because you don't want to spread the disease and take care of yourself holistically that is physical mental emotional social relational and also spiritual transcendence that prevention is better than cure especially when you don't have a cure then that's an issue now how do you bring outdoors indoors. We know that that in the rural areas that there are there is some protection already for for people because you're living in the outdoors because you have more center and cetera if you're living in the zones where you can get the sunshine and this effective for you. But you know open your windows if you have if you live in a place where you can open your windows even though you're in an urban setting if you can open your windows Now here is the tradeoff you're getting the sunshine coming in but you also have the pollution coming in that's that's an issue right open your drink draw the shades go on the balcony use the parks when it's when they're safe to be able to go outside rooftops even skylights in your in your home the kind that can open up that will allow the direct sunshine to come in. If you have a patio community gardens that has been shown to be very helpful for your overall health but again you have to consider social distancing etc window. Window flowers people plant flowers just outside their windows you open the window you have plants of flowers out in a box right outside the other is of course how do you get fresh air into the home again opening the windows but using plants on the inside plants flowers and even trees being planted in the oars or even having a green wall now you know all of these things sound really nice and there's some of them that are very easy to do it's easy to put plants in your home it is about flowers in your home trees and a green wall that's a different story but but it can be done using natural building materials using a hepa filter using. Air. And sofas treatments with u.v. see of course we don't have the far u.e.c. yet but this is this is a potential right pictures of outdoor scenes as we have heard and we'll hear more in a little while I'm sure and going outside to the mountains the rivers the sea sure etc You know what happens when you go outside you also get negative ions and the negative ions usually associate with the mountains the waterfalls the seashore even the beaches Ok And after a good thunderstorm that gives you some negative ions in the negative ions actually clean the air they clean the pollutants out of the air they get rid of some of those smaller particles including They get rid of viruses and morals. And pollen Ok so so this is all good stuff the negative ions Ok Next of course we're looking at urban life and the infection risk Roger just talked about that but we need to understand that it's not everybody who can who can have space in the urban setting to self Eiseley As a matter of fact the poor are more affected by this because they don't have the space they don't have private cars they use public transportation they may have jobs that that can't be performed remotely so the they tend to have to go to work before this is this is a reality. And they tend to live in areas that have higher pollution this has been shown. To a great extent already so part of the issue unfortunately has to do with poverty because poor people in any setting actually have a greater problem than people who have more means to be able to do some of the things that we're talking about about and of course the New York Times has an article looking at what's what's happening right now people moving out of the cities and going into the into the more suburban and urban and rural areas this trend is probably going to continue after the cool with $1000.00 epidemic and pandemic has passed their Xeno that was amazing you know it really did at the practical application I think is what's so important and I hope our viewers know we should never feel discouraged where we are right now we can make the best of where we are so taking some of these principles and opening our windows like we talked about even further in the morning again is a great benefit thank you again Dr Siemionow we do have a. Pretty scary. To be Brower don't you Brauer is currently the head of Health Ministry for the North American division of 7th Day Adventists she also is a dietitian and a lot of research experience now Dr Brower we were talking about how do we you know what we have social distancing and we have clear scientific evidence as far as the benefits of getting sunshine and getting outdoors and open space can you help us to rectify some of that as as a quandary. Thank you so much Dr Lila and you know we've heard a lot tonight already about the benefits of fresh air and sunshine. And getting out into the great outdoors but we also have to remember that there are cautions we are living in a pandemic time right now and some of those cautions of course we want to maintain the social distancing it's still important so when we are outdoors we are still keeping that 6 feet minimum distance between us and others and we want to avoid gathering in crowds I know that there are some regions where they are starting to open up more if they're outdoor spaces parks have been closed but they're starting to open up beaches and so forth and we're seeing hundreds of people gathering together it's very understandable and as we've heard even necessary for our health but we still want to make sure we're maintaining those healthy safe didn't see distances we want to continue to practice the standard precautions of washing our hands using sanitizer when needed. And covering our coughs and sneezes protecting ourselves protecting others using a mask when outdoors as well. But we also can think about some of the. Potential drawbacks of what we've heard too of for example over exposure to u.v. radiation we've heard and we know this that over exposure to to u.v. light can cause things such as skin cancer it can also cause other skin damage that could be precancerous we also have premature aging cataracts and eye damage is also possible with over exposure to u.v. radiation and there's also an interesting link to suppression when it comes to overexposure and so we need to remember that there's a happy medium there we want to get good sunlight but we also want to guard ourselves from getting overexposed which may do the opposite of what we're trying to achieve remember also that it's important not to make assumptions here just because we are practicing one healthy behavior that does not negate other unhealthy behaviors so this really is as doctors you know mention this is about a holistic approach to prevention and care now let's talk about the urban and rural setting as well and the World Health Organization in 2018 put out a report talking about the dangers and the particular health inequities that result in urban settings much of this is related to political and economic environment but also there are physical constructs just a coal. Part of how urban environments are built and structured and also the social environment within those settings these all lead to greater health risks for minorities and this is the importance of case for and we're talking. That 1000 because we're seeing that minority populations are hit. A disproportionately and so we need to remember this. These lead to also chronic and communicable diseases such as pulmonary diseases acute respiratory diseases because of the unhealthy environments that are in some of these urban locations and the World Health Organization is also predicting that by 2050 the urban population will double So this is something we want to think about for the future as well for long term Now if we look at what rural settings look like and this is from the Centers for Disease Control and Prevention in the u.s. we are certainly finding greater risk of death compared to urban Americans and these are 2 of the top killers in the United States and to many Western nations there's also less access to health care in this in the Porton point because yes they may be outdoor accessible to outdoors but what happens when they do get sick less access to health insurance is while they have to travel great distances to find health care but also specialty care and as we know for high risk and for severe cases coated we need specialty care there are higher rates of smoking which we are also concerned with with respiratory conditions obesity less leisure time and physical activity interesting and also racial and ethnic disparities in our rural populations so let's look at one research that was published in 2019 just last year looking at viewing nature for those who may not be able to actually get outside into nature and in this systematic review they looked at 37 different research studies that were published over the years. And they found that stimulation methods across these different studies of actual plants or foliage in the in the home or in the study space or in a hospital setting we can go to the next slide. And also those looking at still photos virtual reality scenes of nature also natural materials he used in the building and in the room construction as well and over ranging from 10 seconds to 60 minutes of exposure to the study participants they looked at a number of outcome measures looking at really a lot of sympathetic and parasympathetic activity and also brain activity and will quickly jump to the next slide here what they found was that there were a lot of positive associations across these 37 studies when you use real natural elements inside indoors so floral arrangements foliage potted plants and so forth inside the room but also photos of landscapes were also effective in having positive health benefits and there were some interesting differences related to the type of scenery. And there were also differences by age by gender and also so interesting really enough also by personality but at the bottom line here is that what we're trying to say is that indoor elements can still provide certain health benefits when outdoor experiences are limited or are not possible are not ideal and this did include research in hospital settings Dr Schwall to mention one of those research that he says well so really in conclusion what we want to encourage people ultimately is to get outside that is the education that we want to give to get outside for the optimal benefits keeping in mind all the necessary precautions but when it's not possible to get outside when it's difficult we can also bring the outdoors into the indoors as as doctors you know mentioned and we can also use photography and videography of calming and peaceful imagery to also get these health benefits and I think this is a good time to also encourage businesses and workplaces if you are closed currently What do you do how do you when you reopen How can you promote this kind of a better work condition for your employees city planning of course you know how can this be integrated into modifications or planning and then also for individuals and families what can we do for ourselves how can we make it a priority to get outside safely but also how can we bring that indoors than I would like to actually put a plug in for even having some gardens indoors container gardens that Mike or green gardens so that you're also getting a good nutrition source so that we're living hope list so thank you Dr Lila. Thank you so much Dr Angie you know that was really exciting and as you and I both have been teaching I guess you could say lifestyle holistic health for many years I know we both agree that there is a good better and best plan but we just need to make healthy changes progressive healthy changes whatever those may be whether it's as you said putting a picture in the room. Best case scenario we can get out into the natural environment now I am actually going to make a segue here we've talked about the community patient and how we can bring fresh air and sunshine or with the wealth alter violet radiation and fresh air to decrease our risk of acquiring Ovid and even in front of our immune system but what about that 20 percent that Dr Scholl's has continued to tell us about that actually make it unfortunately into the hospital how can we bring ultraviolet radiation and fresh air or open space to the hospitalized patients again I'm going to ask Dr shell to share with us briefly making practical sir for us as we think about our patients in the hospital how can we intertwine these principles what Dr Brower I think really did a great job probably better than I could do in terms of exactly the same thing so we have television screens in patients' rooms we put up videos and things of of nature that's what we do at our hospital we have a channel that we put it on and patients will see water flowing they'll see the women go in through the trees they'll see animals jumping around they have actually have a commercially made videos for this for hospitals when they can't go outside obviously in this constituent situation with coping once you know makes it very difficult because of isolation to get outside Dr Hart mentioned this at the very beginning of this symposium how hospitals are being built and you really have to have that in mind so to have a feeling environment as he said so windows open and you know we talked about Dr all riches study that showed that patients got better so what do you actually do Ok so if you care that the patient can't really open up the windows make the room bright during the day dark at night make them understand of the circadian rhythm it prevents ice use psychosis put on soothing music video of nature there's another words that you can't put the patient into nature then bring nature to the patient and that's that's really what we try to do as much as we possibly can. Thank you thank you Dr for all you know there was a study in The Journal of Public Health and I was just actually looking at it was published in 2009 and it was looking back again as we continue to make comparison to the past. Pandemic of 1900 and we compare it to our current town Demick Kogut 19 this picture and actual article it's amazing Dr Hog Day actually looks at the relationship of the then called institutions sanitariums and some other locations that actually again brought the patients outside and were able to expose them to sunshine and fresh air in comparison to some of the Army hospitals and again the results were very very exciting Now here is the actually the study for those of you who want to look at it but again we'll we'll give you that information later but as we're continuing to make practical applications I think again looking at the past we can definitely get benefits as we look to the current situation well with that I want to bring us to another aspect of the holistic approach to health we've done a lot about talking for the physical health but the physical being is not the entire being we know that we're made out the physical mental emotional and I daresay spiritual aspects of health now we've looked at the physical relationships of open space and if you well ultraviolet radiation we have a problem we have a problem with coded 1000 it's not just affecting us this is a cli it's affecting all aspects of our life financially mentally emotionally and again I daresay it's like all over the news we're hearing about people who are quite emotionally disturbed by the current situation well that is why I'm so excited to welcome our next guest Dr Neal net only a good friend and colleague of myself internal medicine specialist he's a hospital us and he's focuses a lot on mental health there as the president of Wiemar Institute Dr Neville is sharing with us how open space and ultraviolet radiation can help us holistically in our mental health. Thank you very much Lila Well fortunately even in the all the restrictions of covert 19. Government agencies have not shut down mental health center and even right now we are Institute were running depression and anxiety recovery programs with live patients who have traveled here and been allowed to travel for their mental health but actually anxiety rates have gone up considerably as you might guess as a result of covert 19 in fact some of the patients traveling here were very specific at making sure they change their planes from the East Coast to the west coast to places that had the lowest rates of coated because of the fear of contracting that even in travel and we know from medical students as well that when they have their 3 day test period not only does their anxiety go up at their innate mune system goes down considerably and so emotional health is key with neuro immunology of having a healthy immune system while u.v. radiation does produce vitamin d. in the skin and it's emphasized by u.v.b. radiation that was mentioned earlier and the efficiency of production depends upon the number of u.v.b. photons that penetrate the skin a process that can be curtailed by clothing or excess body fat This is why obesity in some degree is related to last immunity because you're able to make less vitamin d. from Sun sunscreen and the skin pigment melanin also have a role to play for most white people half hour in the summer sun in a bathing suit will initiate the release of $50000.00 units of Vitamin d. and of the circulation within 24 hours of exposure a more tanned individual with the same exposure will have 20 to 30000. Units and a person who is dark skinned will have $8.00 to $10000.00 units and so you can see the difference that pigmentation can make alter a violet radiation not only helps with vitamin d. levels but it also increases blood levels of natural opiates called endorphins and this is why sunlight actually have more benefit than just the vitamin d. aspects there's several on multiple aspects that make sunlight a superior way of getting your vitamin d. then through a supplement if at all possible Now there have been studies done regarding vitamin d. and depression this was a study in adults 18 to 65 and it was vitamin d. was found to be lower among participants who had either current depression or recurrent depression compared to controls and it was also associated with symptom severity and worse in 2 year outcomes then I study was done and college women these were undergraduate women from the Pacific Northwest and this was published recently and it showed more than one 3rd of participants had the press of symptoms even though they were considered healthy of almost half of those had vitamin d. insufficiency and depressive symptoms were actually predicted very well by the vitamin d. levels. One of the quotes of the study showed vitamin d. deficiency and insufficiency occur at high rates and healthy young women and lower vitamin d. 3 levels are related to clinically significant depressive symptoms lower levels of vitamin d. or also so say with clinically significant symptoms of depression in otherwise healthy individuals as well. Now vitamin d. has receptor there are vitamin d. receptor is distributed in brain areas as well and this of course involves emotional processing and affective disorders vitamin d. is also very important in regulating sirrah tone and synthesis via transcription all activation of trip fan hydroxyl ace to Gene and this is important in getting our trip the fan to go over in the 5 h t p and Sera tone and and as Dr Schwab mentioned earlier it impacts in a community and the production of pro-inflammatory cytokines that in turn influence mood by activating the stress response how well we respond to oxidative stress has a lot to do with our vitamin d. level and that another important area that involves sunlight as well as darkness that's very important and in fact there's been a whole article just published last week about how melatonin can help us significantly potentially would cope at 19. Is this Pinedale hormone it's a key pacesetter for many of the body circadian rhythms it also plays an important role in counteracting infection inflammation cancer and auto immunity melatonin actually suppress says ultraviolet radiation and do skin damage so if we are exposed to alter a violent light we'll have actually less skin damage if melatonin is circulating and when people are exposed to sunlight or a very bright artificial light in the morning or 480 nanometer wavelength blue light which doesn't have to be so bright if it's a $480.00 nanometer wavelength they're nocturnal melatonin production will occur sooner and they enter into sleep more easily at night. There is an advantage of early to bed early to rise and it turns out that when we are exposed to sunlight we have a much greater tendency to go into this early to better later rise mode and we're getting a nice spike in our melatonin earlier and can actually have double the output of melatonin at night the melatonin rhythm phase advancement caused by exposure to bright morning light has been a fact of against insomnia pre-menstrual syndrome and seasonal affective disorder as well and that of course Tarrytown and is augmented with light moderately high Saratoga levels result in more positive news moods and a call yet focused mental outlook seasonal affective disorder has been linked with low serotonin levels during the day as well as a phase delay in nighttime melatonin production and so if we have low Sarah town and and of course we're not going to get that nice spike of melatonin as early in the evening for a couple of reasons but mainly in skin recently has been shown to produce Saratoga and we used to thanks very tone it was only produced in the got to occur almost in self and also in the pineal gland and retina way now and now it can actually be produced in the skin and it can transform it into melatonin and also in the skin and there's many types of skin cells that express receptor is for both Sarah tone and and melatonin. Well with our modern day tendency for indoor activity and staying up well past dusk nocturnal melatonin production has been found to be typically far less than robust and Dr Russell writer who's the University of Texas Health Science Center and as a melatonin researcher says that the light we get from being outside on a summer day can be a 1000 times brighter than we're ever likely to experience indoors. As part of the problem of many people with coping 1000 they're fearful of getting out of their house period and we want to encourage them especially with this program hopefully you'll want to get outside into bright light into blue sky and to fresh air and actually start working on the outside of your home Dr writer goes on to say for this reason it's important that people who work indoors get outside periodically moreover that we all try to sleep in total darkness this can have a major impact on melatonin rhythms and can result in improvements in mood energy and sleep quality and increasing melatonin through light will improve depression interesting that melatonin pills can improve your sleep but they can actually induce apathy where forgetting it naturally will actually improve our apathy as well as our sleep but what about if you can't get that right light in the morning to set your circadian rhythm. This has been studied now using that 480 nanometer Lightbox that's a medical grade Lightbox made by Philips and there was a randomized controlled trial in which one group was given this blue light and the other were given a placebo lite a pale red light that has no known facts and as a result they found some significant differences 3 weeks after the therapy ended more people in the light therapy group were considered treatment responders meaning their depression scores had dropped by at least 50 percent and of the light therapy patients 58 percent were responders versus just 34 percent in the control group and we also noticed that if they have the Philips Lightbox their Ph they had that steeper rise in evening level melatonin which helped them for promote slape and it helped them to go to sleep earlier and their cortisol levels the stress hormone that. Pressed the immune system actually went down and the study's author a psychiatry s. mentioned I think bright light therapy definitely now deserves a place in the treatment of major depression and this is something we will do with our wintertime patients here they actually get this light therapy every morning it helps to set their body clock and they will notice that Nephi can differences in their sleep quality within a week and one of the problems of our screen a is screens actually reduce melatonin in fact a lot of people look at a reader's to read books before bedtime and this was a crossover study and interestingly the researchers found those reading on screens were less sleep in the evening took longer to fall asleep and had reduced levels of melatonin but when they cross them over and they notice something different the blue glow that is the blue light is good in the morning not so good in the evening it actually disrupts your circadian rhythm in the evening coming from candles or i Pads and they took nearly 10 minutes longer to fall asleep after reading any read or lower amounts of rapid eye movement sleep which actually helps our frontal lobe the control center of our brain later timing of their circadian clock and their next morning alertness was reduced they didn't have that energy in the in the morning and the study's author from the National Academy of Sciences said screens can have an extremely powerful factor on the body's natural sleep pattern so we would encourage you to look at screens primarily not before bedtime one of the concerns as the w.h.o. in 2013 say the average person now spends 90 percent of their time indoors that is worldwide and a recent study showed a quarter of Americans spend almost an entire 24 hours without going outside and downplay the negative health effects of. Only breathing indoor air and fact 25 percent of Americans only get outside 2 times when they're going from their house to get in their car to go to work. Or when they're going to school and of course coming back and so for many Americans that's the only time a quarter of them that they're outdoors 77 percent of Americans don't believe that raising air inside is any worse than pollution outside although the e.p.a. showed us it's $2.00 to $5.00 times more polluted inside than outside in general and humidity mold growth and adequate temperature and being in close quarters with other people are all cited risk associated with poor quality indoor and as Dr Charles Marcel mentioned negative ions are one of the secrets of this fresh air it's generated from radiant or cosmic rays in the atmosphere sunlight including u.v. light produce these negative air ions as well as lightning and sharing forces and water he mentioned the beach and waterfalls called the one artifact that are producing these negative charges to our oxygen and ions and of course plant sources like Evergreen Trees also have an effect negative oxygen concentrations exceeding a 1000 ions per cent a metre cube is what is regarded as the thresholds value for fresh air and this is something that we haven't been able to generate indoors. So much and outdoors is really better on this front at least for now although we're looking at maybe negative ion generators that could have some positive effect what have n.a.i.s. or negative ions been shown to do with mental health significant increase in performance mirror drawing rotary pursuit visual reaction time auditory your learning actually goes up with negative ions it can alleviate symptoms of seasonal affective disorder and it can improve symptoms of mood disorders comparable to anti. Present non pharmacotherapy trial in this study negative ions also of shell and effective treatment for chronic depression as well and one study were shown to help regulate Sera tone and one of the methods in which it could be working. That and to closer to interesting that studies one of 300000 adults and children and those living near more green spaces this would be parks green trees areas where you can roam maybe forests those type of things had lower rates of 15 different health conditions in the length was especially strong when it came to 2 of those conditions and that is deep ration and anxiety one of the reasons why we run a mental health program here is the 15 miles of trails in the forests that are close by and all of these evergreen trees and Denmark but this one was published more recently and this was an amazing study I've never seen a study quite like it where all of the diseases in Denmark are actually drafted by not only you know names but they kept the name out but residence where you live and they looked at the government health care disease of all those different addresses and then they imposed satellite imagery to look at the actual green spaces and it was the largest investigation of the association ever between green spaces and mental health and growing up near green spaces was associated with a lower risk of developing psychiatric illness in adulthood by anywhere from 15 percent to 55 percent depending on the specific illness for instance alcoholism was most strongly associated with lack of green space and the risk of developing learning disabilities turned out not to be associated with greenspace but depression and anxiety also were related and so this is probably the largest study and one that seems to be very much associated with the fact that mental health is improved by being outside being near green faces and getting into the green spaces and it can help us and. Multiple ways has been mentioned Leila thank you so much Dr Natalie you know you really brought the picture to us now of the physical combined with the mental emotional and the effects that green space or opens and ultraviolet radiation play on all 3 of these aspects of health but there's one other aspect to complete the circle if you will of the entire person and that spiritual feeling you know we have we have a full We have a full picture and I am so excited to welcome our final guest Dr Marc that my Dr Marfin Lee has an international speaker and he's also the special assistant to the General Conference president of the 7th Day Adventist Church Dr Finlay Can you share with us how again we're looking at this whole person from the spiritual perspective and how even things such as ultraviolet radiation and open space play a role in our spiritual wellbeing as well. Thank you Ira It's exciting to see the evidence for hydrothermal therapy the research that's been done in the area of fresh air ultraviolet rays and sunshine but one might ask the question Do we have adequate research that demonstrates that faith makes a difference in our physical mental and emotional social well being are there are studies that are evidence based that help us to understand that safety is a valuable tool a valuable resource in the restoration of health from 872 to 2010 there were about 1200 studies done in the area of religion and health state and health. When you go to 2010 from 2010 to 2020 there have been 2000 studies in this area in fact about 90 percent of all medical schools in the United States today have some kind of course in religion and health what are these studies revealing what kind of evidence are they bringing forth are people who have who have faith healthier than people who don't have faith what role does faith play in this holistic approach to health it's kind of interesting too that in 1906 World Health Organization talked about health is not simply the absence of disease but as complete physical mental and emotional coldness and that consisted that went. Up for years for decades but recently the World Health Organization has included it in their comprehensive approach to health spirituality so let me share with you very simply 3 things that the research shows us about faith and spirituality 3 things that these 2000 studies and since 2010 show us number one. Faith leads people to make better lifestyle choices when you look at open data the people that have faith that will tend to smoke less they'll tend to to have less alcohol consumption they'll tend to be less drugs harmful drugs that is. And they tend to exercise more they tend to be more conscious of their diet so one of the predictors of good health is people of faith if you look at the Blue Zones one of the places where people are living longer in the United States is low moment in Calif Gornja wine it's a 7th Day Adventists community and there are people of faith that are they are and that have deep trust in God How does faith help you to make boy better lifestyle choices says if you believe that you're created by God and that your body is the temple of God That then leads you to care for your bodies in honor respect and worship your creator so one way to say it makes a difference is that faith leads people to make better choices the 2nd thing that the research indicates is this think leads people to be more optimistic in positive about their lives because they are more optimistic positive chemical endorphins are released and the inflammation from stress is direct sided with us so there's a relationship between faith stress information people with faith tend to have less stress they don't have less information another thing about faith is when the research took a look at it that when faith leads people to be more optimistic it reduces the stress stress is one of the predictors high stress levels of hype or tension it's one of the predictors as well of the whole. The heart disease leading killer America so what does faith do 1st it leads you to make better health choices 2nd it would. Should be more optimistic and more positive there's something else faith we as people who attend church more that's pretty obvious isn't but consequently they have a better sense of community and this sense of community produces positive health outcomes let me share with you just a few studies on this here's a study that I picked up today from the University of Berkeley in Southern California it reported in 2002 the results of a 31 year study of $6500.00 adults in a meeting California and then in the study said no $31.00 you know your study the University of Berkeley of $6500.00 that's pretty significant this what it says people who attend religious services have significantly lower risk the debt compared with those who never attend or attend less frequently then this next sentence was fascinating even if you adjust for age health behaviors and respect is in another article published in the religious involvement and us adult mortality by authors Hummer Rogers namin Ellison they took a look at mortality rates and they say frequency of religious services and it was significantly associated with lower mortality risk for all population as well as for each gender and racial group again people of faith make better choices people of faith tend to be more optimistic and positive people if they statistically will of course attend church more here's an interesting $11.00 article came out said it's official if you would regularly attend church you're 29 percent likely to live longer and that was a metal analysis of dozens and dozens of studies Michael McCullough of the National Institute of Health Care in Ally's studies that covered 126000 people these studies were published in Health Psychology a journal of the American Psychological Association and he said we think this analysis pretty much establishes that this correlation of religious involvement and mortality exists. University of Texas. Did a real fascinating study they looked at people were attending church regularly people who occasionally attended church and people who never attended church this is what they discovered people who attended church regularly tended to have a life expectancy of 82 people attended occasionally tended to have a life expect and see 79 and people who attended Not at all they were not of 10 years tended to have a life expectancy of 7570 years young. 7 year less rather in their life expectancy What does this tell us what does this research tell us it tells us this that they think is not PIII in the sky by and by that faith is not some illusionary thing for people that don't quite understand their intellectual ignoramuses but to just to be honest with the data in Take all the research together human beings are physical their mental their emotional and their spiritual beings and probing the spiritual having a healthy relationship with God What is that faith is trusting God as a friend well man it's no it's believing that I'm not a speck of cosmic dust that I'm not merely skin covering bone that I'm not a genetic accident that I've been treated by God and that belief and understanding knowing that in health and in sickness in joy and in summer when I face the challenges and what the joys of life knowing that that creator is with me that release it's pasta Coke positive chemical into our friends that bring health to the entire system human beings our whole people thank you. Thank you so much Dr Fenley you know that that I cannot holistic approach to health is so important to each and every one of us and with that. I want to end by our special guest Dr Brower to come on give us a closing prayer we'll have a couple quick thoughts at the end and we'll go right into question and answer Dr Brower thank you so much Dr Lee Let's go ahead and pray together. Dear lord in heaven we've heard some really compelling evidence today that there are elements around us every single one of us in fresh air in in u.v. light that we we can use to our benefit to our health and possibly even to help us through this terrible terrible pandemic we ask for that that wisdom I pray for those who may be in decision making capacities who are listening to us who may be able to make changes whether in hospital situations in herbalists urban settings in our rural areas where there is so much disease and disability we we we pray for them and we ask for wisdom on their part and we ask for the ability and the opportunity for them to make positive changes to improve the health of the people that they serve and we thank you for that for this group who is come together and we thank you that we are not left alone but that we do have hope through this crisis we pray all this in your name Amen. Hey Mary thank you so much Dr Brower So at the end of this conclusion this is only part 2 for a 4 part series again we want to go ahead and pull up on the screen the next up climbing to lecturers again if you haven't yet registered for your continuing medical education course please go to a w r o y r g forward slash health and you can earn up to 12 hours of see any credit so next week's lecture or I should say symposium last likely is the next next Symposium is the benefits of nutrition and exercise induced and the oxidants and racial disparity in coded 19 death rates are not going to want to mess next week's lecture again as we look at the relationship of the past to the current pandemic we are like I said if you have not yet registered please make sure and do so we have Monday medical Mondays as well so that gives you 3 hours of c.n.d. credit that you are eligible for 2 hours on Sunday and one hour on Monday and that is able to be accessed again on that same website www dot org she so would slash health and you can participate live with our presentation tomorrow medical Monday at 5 pm Eastern then I want to finally introduce our final symposium of this series and that will be on masonry and we will be doing a comparative treatment analysis a proper sleep and self restraint between 1918 flu and Co but 19 again thank you for joining us we have time for just a couple questions and we want to bring our panelists back on the screen again please take the time to fill out your c.n.d. credit let your friends and family know we're learning a lot of good information he. Oh Ok Well we're ready for our 1st but then we have Dr swells Yes here it is what you want to be a listener on that exchange that because sunlight warn us about sunlight exposure that there should also I think I'm going to ask that question is. Well in that in that situation there's there's still a number of medications like doxycycline that's an antibiotic but other ones that people are on and then they go out the sun they get a sunburn very bad sunburn and some of these medications and other medications if that's the case we have to take a rational approach and say that maybe too much sun or direct sunlight is not going to be good and make sure that you supplement with vitamin d. Again check the level 1st get on the some supplement and then check it again to make sure that that you're on enough thank you thank you Dr Spock now we have another question what about using u.v. light or wall of the system light and what is being used for with Newport and that might have a high the only reason would this have any relationship for those of us who are stuck in a hospital gram doctor and that makes it Ok well I'm an internal medicine physician and not a pediatrician but in general the u.v.. Generators you know whether it be tanning beds or whether it be Billie light are not necessarily reliable in generating vitamin d. like the sun does in some cases they can other cases not so much it doesn't penetrate the skin as much as it should to be able to get the adequate vitamin d. level like I described earlier and so I would say not consistent and not reliable Thank You Thank You Thank you Natalie we have another question from Janice what level should my vitamin c. be doctor is enough. The There are multiple recommendations depending on who you read and basically you need to get it checked 1st of all and then you go from there so rather than giving you a level I would recommend you look at the and I h. is recommendations the American College of. In the chronologists they have recommendations as well and they differ from one another so I refer you to that and there's Well there is a civic number that you would recommend definite supplementation for. That will be the level of the British Medical Journal hovered around $25.00 Nana moles per liter But again this is every lab has its own just as Dr Charles yourself said every lab has its own a levels and it is as validated for its population so I guess I would agree with what he said and get it checked those lab results and if it's low have a supplement a wonderful Now doctor Guthrie writes and I saw where someone looked at countries by average vitamin d. levels and found that they correlated with clothing 1000 mortality levels please comment Dr swell to Dr Nutley have both of you go ahead Dr Ok it's perfectly possible that the problem with these associations is that they can be confounded For instance I'm sure that if you were to see people with lung cancer there's a high likelihood that they would have a cigarette lighter in their breast pocket now is that causative or is that associates of we just don't know once we do those kind of studies. Anything to add actually have well because of what we've already mentioned we know there could be an association and of course we're hoping as the summer comes about and there is more vitamin d. available for everyone to check really in the northern hemisphere that we will see a big downgrading of the activity of covert 19 for 2 reasons what sunlight does to cope with one thing and also what are you in system being able to counteract it when we were fighting Thank you Dr Siemionow is and if there were much Vitamin d. that we could take. Well theoretically there is because there is a problem that we call hypervisor mineral says d. However most of actually I have never seen it myself and we have treated many patients with vitamin d. in the past guy did of course by the levels of vitamin d. that they have and some who have treated who came in taking mega doses of vitamin d. and we still haven't seen. Hyper vitamin this is the that is not to say that it doesn't exist but it is probably something that is quite rare thank you another question just came and if heightism with therapy vitamin d. and u.v. light activate the immune system is it contradicted these principles for patients to have immunosuppression such as look this doctor shall. So so I think with lupus it's actually a hyper m universe spawns with an auto immune response I would say you have to be careful in those situations although I would say that there is some data and we covered this in the last symposium that fever actually reduces reduces the hyper immune cytokine that we see in fact there was a mouse model that we mentioned there that heats up the fever range of in a in a mouse model actually reduce the inflammation in a college and induce birth right a so I think the we may be surprised I think anything that we do in this kind of a situation we ought to answer and with doing it very carefully but there is some data that would seem to think that maybe the thinking which seems very logical may not actually be the case thank you and this is a last question for our question answer session this one is for Dr knuckly What about screens that have the option of turning off the blue light is there still an element of blue light in the screen like I read something about this my last meeting it is better to block out the blue light particularly if you're going to be using screen within an hour of going to bed there have been shown to be some benefit but still even if you have the choice of a no blue screen or reading a printed book you'll still do better reading a printed book. Thank you thank you so much to each and every one of our panelists and I just want to say thank you to all of you who took the time out of your busy schedule to spend a couple hours together as we continue to explore lessons from the past and what applications they may have for us currently as the faces of these 19 times and again we want to remind you tomorrow's medical Monday at 5 pm Eastern and next Sunday same place same time you will not want to miss out then if it's of nutrition and exercise induced antioxidants and racial disparities and coping 100 Death Race again we wish you God bless thing and health on your holistic life we'll see you next time thank you.

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