My training is as an er doctor and i did emergency medicine for 13 years and started an urgent care practice in new york about six years ago. Our bread and butter has always episodic,ems that are utis and things i did not require the hospital. When thetioned quickly pandemic hit new york. Fires a lot of learning by , and we strapped on our boots and jumped into helping because thats what was necessary. We have treated over 10,000 patients in the past couple of months. From the real difficult times in march, to the much more calm time. Its been an interesting journey, definitely the highlight of my medical career. We were one of the first practices to provide testing on a widescale level in new york. Creative and we got testing available. While many people were unable to get tested, we had Health Care Providers and we were testing people frequently. For was really a godsend people who were told that you should be working in the icu. We worked with people who needed to be healthy on the front line. Additionally, thousands of other people who were available who may be did not need to go to the preventingut just unnecessary volume in the Critical Care setting, it really was an incredible time for us. And luckily the worst of it seems like it has passed. Has been an evolution. Host you yourself were infected at one point . Yeah, so before we knew about covid in the United States, we were treating people with flulike illnesses that were testing negative for the flu and i can remember patients looking at me and saying do you think that this is that coronavirus . I had to say i cant tell you, i dont know. We werent even directed to wear masks. Even during flu season, we get vaccinated and we treat people with the usual precautions. Wearing ppe was not the standard. To, iably got ill prior had heard about corona, obviously, as some of the news was making the forefront and i thought well, its the flu. I want to get it and just to be done and get back to work and help people. I had no idea the extent of the illness. I was sick for a total of about 16 days. The first week was bad, the second week hit and it was really bad. I checked myself into the er and i had bilateral pneumonia. Im healthy, i have no medical problems and i went from doing everything that i had been used to, working out, working, doing normal things to laying in bed and being really scared because having pneumonia on both sides can lead to complications and certainly all the respiratory symptoms everyone was reporting was very scary. Luckily, did not have to be in the hospital, was able to take care of myself. But i had a father who was sick who came down with covid and ended up in the icu and was intimated on a ventilator. He subsequently recovered, but you can imagine the gamut of things happening with the practice trying to help out in maintaining good standards, my own illness, my families illness. In the heart of the pandemic in march, when new york was getting hit, it was pretty tough times, i would say, personally and professionally. Like i said, learned so much. Theres not a textbook that we could reference or journals to read about. It was really trial, seeing patients, communicating with other doctors through social media or consultations. Just chatting with people. A really unique experience as a professional to be learning by basically being on the front lines and sticking your neck out and learning from personal experience. Is here. Jake deutsch to talk about that unique personal experience and answer your questions about it and what he saw in manhattan at the cure urgent care and talk about the spicy seeing around the country right now. Phone lines are flipped regionally. Eastern or central time zones, 202 7488000. Mountain and pacific, 202 7488001. A special line for those have experience with covid19, either personally or a Family Member, 202 7488002. Jake deutsch is with us until the bottom of the hour this morning. Im going to show viewers this chart from the wall street journal today about the surge in coronavirus cases, tracking how long it took the u. S. To reach its first million cases. It took 95 days to rack up that many in the United States and then 43 days later we hit our second million cases and then the 28 days later we hit third million cases in the United States. What is your biggest worry right now as we watch the spikes around the country . Aret it feels like we losing control to some degree. Having seen new york go through the worst of it, i dont wish that on any other country or city in the country. So thats scary. As the resources become overwhelmed, it gets really, really dangerous. Remember, back in march, we didnt have ppe or ventilators. We didnt have enough hospital staff to take care of it. If we get into those situations in other parts of the country, we really are going to be moving backwards and it is only going to precipitate greater numbers of cases and a spiral that could be quite out of control. Thats the part that really worries me. We have seen that using ppe works. We have seen that social distancing works in new york. The other day we reported zero deaths for the First Time Since the pandemic started. Thats real progress. We have to learn from that information. Ithave to take it and apply to other parts of the country and its scary that it doesnt seem that things are working moving in the right direction. Its been a huge slide of cases. Somebody needs to pay attention. We all need to be vigilant. Its an individual problem. If we are not being told on the greater level what we need to do, Everybody Needs to take action individually, thats my belief. Host who is the best person to deliver that message, to try to get the country to learn the lessons of what you went through in march and april . Has this become too political . Do you think that doctors need to be out there more talking about the experience, like you are doing . Guest absolutely. If it doesnt affect you, it just doesnt resonate. Seeing someone who was in new york three months ago has no bearing when you are in anothers eight and you are trying to justify that you need to get act to work or that you want to gather with friends and family. Having a connection that is personal is whats going to make a difference. We need to keep reminding people that this is whats out there and this is whats happening. Of course, our leaders should be the people guiding the ship here. Really believe that using, influencing people who are young and relatable to the people who are getting sick and spreading the virus, thats a key element. If we can get people to connect with the individuals at risk, potentially a symptom medicare he or, this younger demographic, thats a real key tactic that we could use to help prevent the ongoing surge that we are seeing. Its not the elderly people who are staying home and being vigilant. Its the people who may not even really realize they are sick, and they are spreading virus inadvertently. For the majority of the time in new york, we have seen people with asymptomatic infections. It just goes to show you how pervasive the virus is and where it lies dormant. With Antibody Testing we learned that 15 to 31 of the population never had symptoms, eventually that will carry on through the rest of the country and if you see one third of the population without symptoms, we dont to do what we need to do, we will continue to see these surges and that, going back to your question, is what scares me. Think youruch do you fellow doctors want to be spokespeople right now the Politics Around this . Is that what they went into the field for . To help or is it to help people . How much are you encouraging them to step up and dontout more . Guest i think any physician went into medicine to deal with the political side of this pandemic. But when there is a necessity to step in, thats our duty. This or any other health crisis, our job is to protect, to heal, to do no harm. If it means that we have to take a political voice, im all for that. Unfortunately, our voices are so small. There are not a lot of physicians with flat that can communicate in an effective way to get the message out there. And like i was saying, who wants to listen to a doctor when you are in your 20s and you just want to be with your friends. Thats not really connecting area press conferences are not getting the message out there. There are people still suffering and getting sick. We have to be strategic about how we are using this. All the physicians that are now dealing with these issues need to relate the reality of it and give information that will allow to connect. That will get people to wake up. Like i said, unless there is a connection, its difficult to get people to understand how this can be. Lets get to some callers for dr. Jake deutsch. Susan is up first out of massachusetts, on the line for those who have had experience with covid19. Go ahead. Taking myank you for call. Im an lpn and longterm care and i tested positive in mid april. Luckily, i had an o2 sat machine and was able to monitor my own condition. Somewhere in the middle of my infection i o2 sats went down to 82 and i was having pain breathing in. So, i called my doctor, who i never spoke to this whole time. I got a nurse at the Doctors Office and i said my stat is 82 and she said whoa. I set of not calling to impress you, im calling because i need guidance, i think i need to be seen, there is something wrong. She didnt do anything, didnt pass it along, never got a call back. The next day my condition persisted and i thought im not going to just sit back, im going to fight, theres something wrong, i know there is. I still had the pain. She said go to urgent air. I went to urgent care and luckily saw a Nurse Practitioner there who did a d dimer test on me and it came back elevated and i end up being diagnosed with a pulmonary embolism and they started me on anticoagulant. But all this time, the whole time i have been sick or anything, i have never seen an md or my pcp. I have only seen Nurse Practitioners. Im so grateful to the one at urgent care who thought to give me a d dimer test. This was a silent thing. I could have been one of the statistics and it makes me angry. Right now primary care is not working for the patients. My doctor was actually working at another urgent care intermittently, so i never got to see her and even when i go back my followup, it wont include a cat scan to see if the clot is gone. It wont include seeing my md. I just feel like im being seen by Nurse Practitioners and thats great, i know there are a lot of great ones out there, but should i be upset that i havent seen a doctor or a pulmonologist or anything . I dont want to be a jerk about it guest i think you make, yeah, a great point about advocating for yourself. During the pandemic, unfortunately, standards of care have deviated from what we would like to have happened in terms of availability, followup, and just what we would normally practice. Your intuition was 100 correct. When things dont seem right, you have to react on it. Just because someone tells you not to worry, that is where our responsibility and taking whatns to continue, thats i advocate for for patients and it is what i tell doctors, too. If thats if something doesnt add up, dont dismiss it as something simply unusual, continue to follow the symptoms. As far as seeing a physician versus midlevel Nurse Practitioners, im a big advocate or nurse were midlevel. Many are very excellent. Patients that come into the practice and sometimes they say they want to see a doctor and they say by july, you may see someone who just graduated versus a midlevel who has 10 years of er experience. There are nuances to understanding what it means, but i think it is about advocating for yourself if it is working out, to see your doctor. Congratulations for taking the effort to do what you knew was right. That is such an important message. During covid we have seen people staying home because they are afraid of the hospital and other illnesses are still happening at a normal rate. Appendicitis, strokes, general illnesses like your thyroid being out of whack. That is where it is important to understand that still need to be maintaining our good health and following the clues that there may be something greater going on. Certainly with respiratory problems, when things are not normal, you have to react. Im glad that you got the care that you needed, definitely pulmonologist. A having started anticoagulants in the face of covid requires that you see someone who is expert in dealing with lungs and lung functions. Host most are comfortable taking their own temperatures. As a society, do you think we comfortable become with monitoring our own oxygen saturation levels . Guest it seems like the inevitable next step, i have seen devices that measure respiratory rates. I went out to dinner in new york yesterday and they check our temperature before going in. Thats the standard in the parts of the world that are ahead of us. Yes, i think that these devices are going to become our mainstay. Going to bes is what we do for a long time. Everybody should have a thermometer in their household. I still talk to people who said they havent had a chance to get one. Time to make sure. If you have the ability to get a pox a pulse oximeter. They are inexpensive, some of them you can buy online, 30 to 50. Not necessarily the most sensitive ones, but at least an idea to Say Something is not right here. I applaud the patient to notice that there pulse oximeter went from 90 to 80 and saw a big change and recognized they needed to take action. Michael is in madison, wisconsin, good, you are on with dr. Deutsch. Caller i would like you to comment on the following, talking about pulse oximeters, covid is a disease of the blood that attacks the hemoglobin, separates excuse me, it ionizes the iron and separates and thatemoglobin causes the hypoxia, because when the blood gets to the lungs in those damaged cells, it cannot accept oxygen. Its the reason hydroxychloroquine works and the same reason it works for malaria is because malaria also attacks hemoglobin and the hydroxychloroquine gets into the cell and prevents it from happening. That is why you have sometimes dramatic overnight success because after a few hours of taking hydroxychloroquine, some patients, their iron is restored and they can breathe right away. Host i will let dr. Deutsch a jump in on that. Guest you touch on the hot topic of using hydroxychloroquine as a therapy for covid. Early on there were studies that suggest it was effective. Subsequent further studies didnt show it to be as effective as we had thought. When i wasecause sick, that is what was being recommended in the medical literature. Theres a cascade of information that happens cascade of inflammation that happens in the lung tissue. Not being able to get oxygen to go through the lung tissue is what causes the lack of oxygen in the blood. Whether there is a cascade of other inflammatory processes that affects vascular constriction, affecting other cardiovascular output, is to be determined. And im certainly not a physiologist. But we did think that hydroxychloroquine was going to be a panacea and it doesnt appear to be that way. Unfortunately, nothing has proven to be an absolute treatment we can rely on and that is where we are really stuck, not having any great leaps forward in how to treat this. I appreciate your inquiry. I think that there is a lot of complexity to the situation. Host wild and wonderful on twitter asks guest well, you know, med school has been competitive for years. A lot of the crisis, financial, medical like covid, have proven that doctors are invaluable. Matteris paramount no what is happening. We can always use more providers. Not just physicians, but physician assistants, Nurse Practitioners, nurses, all the other skilled professionals who are a part of the process. Respiratory therapists, medical assistance. Even the people who are administrators in the hospital are critical. If we can continue to allow andle to get into medicine make it a more successful option for people, for their career choices, thats fantastic. Last year at nyu we saw them eliminate tuition practically to make it easier for doctors to get to their university. I think that there is going to be a great change in education and our focus on how to get people, to provide health care, certainly to make them, i think that is one of the things we will see in the future but we need health care now. We cannot overwhelm the system now. Thinking about what could happen in five years as people train, thats fantastic, but we need to make sure the resources that we have now are not being overwhelmed as we continue to fight this disease and make sure that the number of cases dont increase at an exponential rate. Host about 15 minutes left with clinicaldeutsch, director and founder of urgent care in new york city. 202 7488000 eastern and central, 202 7488001 202 7488002 mountain 202 7488001 mountain and pacific time zones. If you have had covid had or had with it, experience with it, 202 7488002. Thomas, good morning. Caller i was wondering, has with, tested mouthwash you know, stopping the spread . Cough, sneeze, they spread the virus. Would the mouthwash kill the germs in the mouth . Well, mouthwash is not antiviral. Certainly you will reduce some of the bacteria by using god good hygiene like mouthwash. But that is a fix i would not put my energy in. I would work on masks. We have seen that using masks works. I can speak to my own practice. We see about 4500 patients a mask a month and since we started using ppe measures like masks and washing hands more thoroughly, isolation with distancing amongst patients, we have not seen one Employee Work in the practice get sick, provider, medical assistant, or support staff. Thats what works. Thats why we are seeing success in the parts of the country that are using masks in a widespread level. Interesting thought, but nothing i know that has been proven to work. Lets focus on what we do know works, Wearing Masks can make the difference. We all have to be a part of the process. Its not a violation of your civil rights. Its about a healthcare initiative. We want to make sure that your family is healthy and that we will not overwhelm the medical system, that we get this under control. The simple process of wearing a mask is effective towards that. Host when a patient comes any comes in with a severe case of covid, whats the treatment at your facility that is standard . Guest in general or in terms of keeping everyone protected around them . Host how do you treat them in general . Guest we basically assess the patient by looking at vital signs, taking a history, just like any other intake problem. But for covid we are trying to understand if the patient is able to take care of themselves or if there is a need for a higher level of care. Oxygenation is one of those key factors. Other comorbid problems, are they ill with lung problems, diabetes, kidney problems . What does that look like if we send them home with complications . Certainly, just understanding how they are functioning. If people are able to do their normal activities like eating and drinking with normal factors checking out, then we are able togenerally direct them homecare. In the evaluation process we are obviously testing them and doing xrays whenever necessary. Homehen the position going of going home, we had in whether or not they need additional support, asthma medication to help breathe. But i have to tell you, this is really encouraging, in new york city, where we have seen a great decline in a number of cases, we are not seeing people as ill as they were in march. In march we saw a high number of people that work very ill with pneumonia, who we were sending home because there wasnt capacity in the Critical Care environment. Now we have a high number of people who are mildly symptomatic or asymptomatic. There has been a shift as we got things under control of less severe illness. Another highlight that we should be thinking about in other parts of the country is getting this under control so that we can see a similar shift. I would expect that to be the case. But if we let things go wildly and arent doing what we know is effective, theres a potential that we will see high numbers of very sick patients in other parts of the country. Virginia, riverside, california, good morning. Caller i will try to make this brief. My grandson was an emergency, got ella month and a half ago. Did diagnosed with corona. They did send him home and i had to keep him isolated for a minimum of 14 days. My question is, when he was released to the instructions stated that after the 14 days within 24 hours he had to have two tests showing negative. Himdoctor, when we spoke to , said that that was absolutely not even necessary now. Im 76 and i was concerned about my welfare as well and was speaking to his doctor. 22 years old, he has hsp, its a kidney disease. He has had the pneumonia. Hospitalized when he was younger. Myself, as well. I was asking what your opinion is on this. Guest it sounds like they are trying to be overly cautious, which is never a bad thing. Trying to figure out if it has turned negative after what we consider an adequate amount of time of isolation. Thats where thats coming from, get a negative test, make sure there is no longer virus in the body. The difficult part is that sometimes the test can pick up virus for up to four weeks. We have seen cases where people test positive over a long time, even though we believe that you are no longer infectious after two weeks, which is why we recommend the two week quarantine, but the test is very sensitive and just reproduces small pieces of virus and it may be an inactive piece of virus that was nicked up and at four weeks may still be tested positive. I agree with being cautious, we should all be more cautious than not. Certainly with your situation in your history, being more cautious is more favorable than being less careful. Getting another test that tested negative will give you a Greater Peace of mind that the virus is no longer in his body, but it may take longer than two weeks and maybe your doctor says it is not necessary because of that beay, but you still want to cautious about what this means to you. Its not just your friends. Everyone around you, heading to the grocery store, touching something, touching the mask, taking it off to have something to drink in public, someone nearby is coughing. There are so many fact is where we need to continue to be vigilant and getting tested is the. Of the key. Is the key. We need testing on a wide scale. Test toto continue to find these infections because the high number of asymptomatic people make it very difficult to continue to contain where the itsreak is spreading at greatest numbers and testing is not painful. I have demonstrated on my videos and social media that testing is simple if done correctly but i see a number of people afraid to get tested because they are afraid that it is painful. That is so unfortunate, considering the circumstances of virus spreading. Getdvice, have them retested in two weeks and if it is still testing positive, peter in repeat it in another 10 to teen days. 10 to 14 days. You dont want to rush because your Family Member may test positive. Host where can people find those videos . Guest go to my instagram, look for dr. Jake deutsch. Sometimes they get buried in the other stuff. Social media is a great for people to understand, you know, what to expect when it comes to pandemic treatment. I have always tried to advocate that this is something that we need to be a part of and using tools like social media can be very helpful. People should understand what to expect, where can i go to get it, how long will the result take . We are seeing a lot of parts of the country suffering from long delays and for testing and that can be a critical factor, to. Being a informed consumer, whether it is ox gin levels getting low or knowing what the test is like and where to go, i would advocate for that for everyone with individual health care. Host time for a couple more phone calls. Gary, east on zwick. Caller you made my day East Brunswick. Caller you made my day. Im 82 and im a professional and Clinical Researcher, not a physician. The reason you made my day, i want to give a compliment to the leadership of the Mount Sinai Medical Center under dr. Ken dennis chauncey, as well as dr. David mueller for what they have done with this virus and the medical care they have provided to me. I also want to give thanks to ken langone for what they are doing. Finally, i dont have the virus but i went to my Urgent Care Center in East Brunswick and the doctors there did the nasal test and guess what . Hey did the antibody im not a physician. I got a couple of graduate degrees. I spent 40 years in Clinical Research. Im the editor of a text book on Clinical Research in the farmers on in the pharmaceutical industry and amazon has trip it triple the price of the book. I was a founder in 1984 of the journal Clinical Research practices. , thereading the book now great influenza of 1918 by john berry. You are doing great work. Guest thank you. Caller the problem is the Political Leadership of this country. Thats the problem. Caller you are the voice of america that Everybody Needs to hear. We are not done with this and everybody that is a part of this process and is fighting needs to be recognized. I think we have lost that focus. You know, great kudos to all the physicians in new york. I serve at mount sinai, have villages there, i work with the doctors at nyu. Every level of health care involved here, people putting their lives on the line, people care more about the better because then politics. The rest of the country needs to understand that dont want this to get worse. We want to continue to have this improvement and Everyone Needs to continue to do their part. You bring a tear to my eye because we have lost perspective on what some in this pandemic. It has become political, about peoples choices not to protect themselves and we all need to be on the same page to get to the solution and make progress. For dr. Jakell deutsch, this is brandy. Go ahead. Hader my experience was i to basically i had to take care of myself at home. But one of the things i felt really helped me was eating a lot of antiviral food. I ate a lot of garlic, i had my zinc with a zinc supplement. Drinking a lot of tea and lemon balm. My symptoms lasted for about a week. I want to encourage people to actually eat more food that is and stopped eating foods that feed viruses, like eggs and dairy. I want to encourage people to do that. I really feel like it helped me to come back combat the virus. Are absolutely right, our digestive system plays a great park in immunity and some of the things that you mentioned, particularly zinc, are believed to have a Critical Role in the process, subduing what we can to improve our immunity with Natural Resources is something im a great advocate for. Absolutely, people need to be taking care of themselves yonder just taking something for the fever. Good diet, vitamins and supplements that are immune supportive, i absolutely agree with. Certainly, listening to your symptoms. Im glad that that worked out for you and im a great advocate for Something Like that that is easy for our health. Host dr. Jake deutsch, founder of cure urgent care in manhattan. Please talk to us again. Guest my pleasure, President Trump will discuss business deregulation. Watch live at 4 00 eastern on cspan, online, or listen with the free cspan radio app. Treasury secretary, steven mnuchin, appears before the House Small Business Committee on oversight of the Small Business administration and department of treasury Pandemic Program friday at 10 30 a. M. Eastern on cspan. William barrnth, appears before the House Judiciary Committee general oversight hearing on the Justice Department on tuesday, july 28. Watch live coverage friday at 10 30 a. M. Eastern on cspan. Watch anytime on cspan. Org, or listen on the free cspan radio app. The u. S. House and Senate Return on monday to resume legislative business following their state work period over the fourth of july holiday. The u. S. House considers the 2021 authorization act with votes expected as 11 30 a. M. Eastern. The senate convenes at 3 00 p. M. , resuming debate on the nomination of russell vought. The senate limited debate and advanced his nomination on a artyline phot of 7744 7744. Education secretary, betsy devos, talked about some of the challenges in the Education System due to the covid19 pandemic. This event was hosted by the georgia Public Policy foundation