and good evening.

Thank you so much for watching HealthLine on PBS Fort Wayne I'm your host Mark Evans and a very interesting subject tonight something I'm sure that you've also heard about from time to time and we're talking pabout long covid syndrome.

>> We'll learn more about the virus and how it could be controlled and how you can feel better if you have it.

We have a very special guest is first time on line Dr. Kanon or C Tony Cannon Cannon Ali the gavage.

>> You got it.

All right.

Thank you.

Ding ding ding.

Give me some brownie points.

I great to have you on the show.

>> A pleasure.

And I know just from talking in the green room and also right for the show started this is going to be a very interesting conversation and we want to open up our telephone lines and the telephone number is right there on your screen.

Please call any time in the next half an hour because it is a half an hour show and we don't stop down for commercials because we are a public television.

The number is 866- (969) 27 two zero.

Get those calls coming in because the good doctor here is more than willing and anxious to answer those for you.

>> Let's go ahead and get started here.

Do you have any stats currently on the top of your mind about how many people are still dealing with covid even after they thought they were over with it and now have long covid or I mean is that a pretty common thing these days?

>> Mm hmm.

So the updated stats that I have looked at was based off a meta analysis that included about 50 studies across 22 countries that showed that from that population of approximately one point two million people that roughly six point five percent of people experienced long symptoms.

>> Now what is long covid you know you could easily say that it's anything that lasts more than four weeks after your first positive confirmation but we really don't call it true.

Lenkov, until it's more than 12 weeks or three months.

>> I say that because there's a whole separate topic we'll discuss later called post viral syndrome that can occur with any viruses.

>> But for covid we'll say specifically more than three months and in that time frame the people from that one point two million from all the studies like I said six point five percent at them they those were the people who had symptoms for more than four weeks and then of those people who had passed the three months cutoff that I just mentioned, that was 15 percent of that.

So a total of one percent.

So we'll roughly say about 100000 people in that one million population had long Kopans and I've read today because not only last month but even possibly years.

>> Is that correct?

Correct.

That is very rare by comparison most of the time another statistic I found is depending on if you have to go to the hospital or not, the average amount of time people experienced long covid symptoms if you just have an outpatient infection you don't have to be hospitalized typically around four months the symptoms last and then if you're hospitalized up to nine months beyond that is more rare.

>> But again it does happen to people as I've seen in my own clinic.

>> All right.

Well, we're going to talk about long covid syndrome but we need to talk initially about covid-19 started the whole thing and it is a virus.

>> So what exactly is a virus?

Oh, they're insidious, annoying little things.

So just like how our cells have a little body and DNA in them, viruses are actually not considered living beings.

>> So when you think of all the kingdoms of animals and how there's like all the different family groupings for crab spiders, fish oil and so forth ,viruses are completely outside of that.

>> It's considered a whole nother domain which is just the virus domain.

The reason why they're different and not considered living is because they need another living host in order to reproduce everything else that we see around us bacteria, protozoa, plants all of them can reproduce on their own capacity but it's a virus it has to infect you use your own DNA mechanics to make more of itself and so it's insidious in the fact that it actually has to get into us and replicate and that's how they keep going on and how they've kept going on since things were created on this planet.

>> Well, and since this is kind of one of your specialties is a family medicine practitioner, the layman, the person like me who gets information bits and pieces when it's force fed to me find interest in it.

>> But you're staying on top of it.

Have they gotten to the bottom of how the coronavirus actually originated?

>> There are two leading hypothesis and I do think both of them are valid just based off how some of the other viruses have occurred especially like when you think of bird flu back in I think 2009 that was a subset of influenza.

You can have things passed from actual animals to humans just-ld from primates back in the fifties.

So it is very reasonable, especially with the bat hypothesis that it could have came from an animal somewhere in China that's reasonable and then based off some suspicions could it have been lab manufactured?

I don't like to speculate on that too much but the evidence that they show I can't immediately dissuaded because I'm not a virologist.

>> But it is very possible though I'm more leaning to the bats.

But yes, I would rather people yeah but you know the truth is the truth will find out what the truth is I'm sure eventually who knows tomorrow 10 years from now who knows.

>> But anyway hopefully we will find out the we've got coronavirus covid-19 how a cold is a virus.

>> So are there any similarities there between the two even though some of the symptoms are the same?

But I mean isn't it just a whole different ballgame between the two ?

>> I actually wanted to talk about two of the more common ones which include influenza OK influenza virus and then all the cold viruses there is over a thousand viruses that can cause the cold but I specifically will say that it's the rhinovirus family, the viruses that affect our nose nose so going back to what I mentioned about viruses, they are essentially a little protein capsule kind of like how ourselves have a little membrane around them.

They're made of little proteins and then inside the proteins is some combination of single or double strands of RNA or DNA.

And if you recall from middle school DNA is what our nucleus always holds and then RNA is essentially what our DNA can make to get sent out to our to make proteins for the rest of our body so viruses can encapsulate either the it can look like the native DNA that we have or it can look like that other RNA.

Now why do I mention that?

Because of those three viruses we just mentioned coronairus influenza virus and the rhinoviruses they're all considered RNA viruses.

What that means is unlike the DNA viruses who actually have to get into our nucleus to hijack them, they can actually go a little bit past that which makes it easier for them to replicate themselves sometimes not not every single virus and every single variant but they can usually get into the bodies of our cells and just use all that native protein building processes to start making more and more viruses for themselves.

>> OK, OK, let me bring up bronchitis.

>> Is that a virus a very commonly I say because there is a bacterial bronchitis but it's most typically a viral bronchitis.

>> OK so if you have a viral bronchitis antibiotics would not help at all.

>> Not technically.

There is one common antibiotic that's prescribed often for a bronchitis known as the Zithromax and yes it has some antiinflammatory properties.

I hate admitting it but it's one of the reasons we use it for COPD patients even if they get viruses because it can cut down the inflammation they have in their lungs.

>> I don't prescribe it for bronchitis because again there's enough antibiotic resistance in the world and is it the medicine is a very good drug.

>> It now works on things related to TB and all those other very special types of bacteria.

>> I get bronchitis.

It seems like every other year or so and that's one of the first things that my physicians have prescribed is a Cythera myosin Hansbury doctor dependent.

>> Yeah and if it works and but yet you know if I have a relapse they never want to extend that.

It's like well let's just write it out.

I guess that's probably one of the best things to do just let the disease or the your symptoms right out.

>> Is that correct?

Correct because there are usually other signs if it is a bacteria that it's a bacteria typically in elevating fever you're feeling very fatigued or unwell.

>> Your oxygenation status is starting to go down.

There's red flags that I always personally look for specifically when it comes to sore throat like when someone has a viral sore throat you can tell they're feeling a little crummy versus when I've seen people with strep throat they look like they're on death's door.

>> Yeah, yeah.

And what can you do for strep throat?

A little sidebar here for regular strep throat which is bacterial antibiotics.

>> They work wonders for that.

OK, very for for viral strep throat.

>> My best friend is usually some kind of ibuprofen naproxen if you can handle I see this and then again just let it ride itself out, treat the symptoms, treat the symptoms.

Now I'm a history buff and one of the questions here I have is relating to the Spanish flu of 1918.

So how did covid-19 become like an a pandemic and how does it relate to the previous pandemics such as the Spanish flu going back to the three viruses I mentioned?

>> So how long have viruses in general been around?

It's kind of like asking how long has the first Wolf been around?

You know, we know all of its ancestors.

We know how long it's been with us but we don't quite know how it's been there.

So I kind of say the same thing with viruses.

>> Most of these viruses have probably been around for billions of years ever since life started on the planet but they didn't become prominent until they really hit pandemic level.

So for instance, one the the rhinovirus is there never pandemics.

>> They've just always been around you know, they're the common cold that's been since recorded human history.

The influenza virus has actually been they speculate has been recorded all the way to 6000 B.C.

and China based off how some of the symptoms they described in a pandemic that happened at that time.

Well, so there have been pandemics for all of these happening over and over again.

>> The coronaviruses did become popular until the nineteen twenties when they were first a bird based in virus not say that they weren't humans but it was most noticeable then and then the 1960s more often different types of Corona virus pandemics happened relating to the Spanish flu.

>> There were pandemics before that and epidemics in localized areas going as far back into the I think seventeen hundreds definitely the eighteen hundreds from what I read.

And then the Spanish flu was notable just because it was the start of having ever heard of the term Heny when they talk about like bird flu H1N1.

>> Oh yeah yeah yeah.

So that was the start of the prominent H1N1 variant of the influenza virus and it had a change in the H and stand for different parts of the virus that just make it more virulent get into your cells, stick around longer and after that happened it just blew up kind of like the coronavirus did did its damage and then has been sticking around since then and it's not always the predominant one that we have during flu season but it is one of them and that was the setting event that made it more predominant kind of like how we now have sars-cov-2 among all the other coronaviruses.

>> Yeah.

And you just hit the nail on the head there about the different varieties of the covid virus that that there are and I'm sure it's not stopped yet.

>> I'm sure it does because what what are the what do you call it?

>> They they branch off into other things.

They become more resistant.

There is a term that is skipping my mind now.

>> It is either genetic drift or genetic shift and so they do not build up resistance.

>> They actually because their little pockets of DNA and RNA they can actually just shift their whole build up around much quicker the bacteria can bacteria build up resistance by actually developing things on their bodies that either stop our medicines or change how they stick onto things?

Viruses just completely warp and that's only certain viruses .

I say that because earlier before the show started we were talking about the RSV virus.

Yes, there's a reason why the new vaccine for the RSV virus is just one because the RSV virus has not mutated significantly compared to when we've been studying it versus flu which every year is a total nightmare.

>> Yes, absolutely.

And I've got to get my RSV shot.

I'm so glad we had this discussion.

>> OK, well we have a call coming in right now and it ooks like Michelle who prefers to be offline and that's great.

That's just fine.

We'll transcribe your question for you if needed and she's asking are blood clots a symptom of Koven or VACC covid or the vaccine very touchy subject.

So there are there have been a lot of symptoms reported with the covid vaccine and I can't deny that the vaccine may not cause certain symptoms but when they compared like for instance it wasn't blood clots, it was in the cardiac inflammation.

There was a certain type of inflammation of the heart that was affecting young men and athletes who got the vaccine and when they compared to people who get the covid virus, they found that the rates of getting it from the covid virus were much, much higher than just from the vaccine.

So in a way it's me saying that yes, in very rare instances the virus can cause symptoms but you have a much higher chance of getting it from the virus itself because the viruses can cause symptoms across the board.

>> So to answer your question, Michel and thank you for that is more often or not it's the covid virus that will cause the clots.

And I've heard of only one instance personally where a vaccine was associated with an immediate clot within about a two week frame after they got it.

>> All right.

We are talking to Dr. McGavick Begovic who is a family medicine practitioner and we're talking primarily about viruses and specifically more about covid-19 and long covid.

So if you have any questions, please call the number on your screen 866- (969) 27 to zero.

>> All right, let's move on here.

So got past the comparison with the Spanish flu of 1918.

>> You touched on this rather briefly at the beginning but it is a question I'd like to know.

We talk about viruses and how they affect you.

A lot of people think you get a virus.

It's all up here and here and maybe here.

But how do viruses actually affect our bodies?

>> I wish I had a blackboard to demonstrate it but if you think of yourself as a nice little circle, the body the virus will actually attach to your cells and make a little bleb.

>> The fancy term for that is endosome.

So it's almost like it develops another bubble inside of your cell and from there it starts to inject its DNA into your it starts to inject its DNA into your DNA or it lets its RNA float around your body and it just starts replicating and from there it causes cells to burst more viruses out.

It spreads out the whole process starts to repeat itself are for as long as the human race has lived our body actually does have a pretty good immune system response to it.

>> So out of all our white blood cells we have a very specific type called lymphocytes.

>> Lymphocytes can treat a couple of different things but I always considered them very specific for viruses and so that's typically our bodies response to the infection and not your organs are affected by the virus, is that correct?

>> What organs are most non defensive I guess or which ones are going to be attack first?

>> Difficult answer because it depends on the virus.

So like for instance the rhinoviruses are typically sinus or ear nose throat based because sometimes it can cause ear irritation essentially wherever the mucus is for that affected organ system it can affected there's certain types of things like the norovirus that affect mostly our GI tract.

So unfortunately no easy answer for that.

>> It can affect just about everything.

It's very viral dependent.

covid was infamous because it got to everywhere.

OK, everywhere.

>> And what is the virus that attacks the liver?

Hepatitis hepatitis the the the hep every day I think it's specifically the viruses for hepatitis C. >> Okay well I'm going to stick with hepatitis if you don't mind please.

Okay.

All right.

Now not only physical and we do have another question coming in.

>> David, hold on just a second.

I want to go ahead and get this question out of the way.

But physical but the long term covid and just covid-9 in general can affect not only your physical self but your mental well-being.

>> Is that correct?

Correct.

Yeah.

And we're talking about brain fog and and what other happens sometimes there's three main symptoms for long covid are what I considered the systemic the neural and the respiratory.

>> So specifically it can affect your breathing patterns and if you have any need for oxygen after it, it can affect how you think that's the mental fog and then the systemic symptoms are fatigue, muscle ache, mood swings, things like that.

>> OK, all right.

Yeah.

>> All right.

Let's go to line five.

David is preferring to stay offline and he's asking how do we see Guy helping in the battle of viruses?

>> I'm actually excited for A.I.

because it can make my job a lot easier when I'm sorry I chuckled a little bit but I was trying to see what the correlation so I'm interested in this.

>> I think I mean I think I could piece a little bit together so a.i.s nice because just like if you've ever seen Chatterji generate a like a draft for a play or for a movie you look at it and you read and you're like that's a little funky, you know like the general premise there but that's a little funky.

They've been using A.I.

to do things such as read radio grammes based off what a patient's symptoms are.

They can take the symptoms, write them down in their internal memory banks and then put it on like a registry to see if it's more likely this symptom versus this it can be caused by this.

>> It's this syndrome.

It's neat because if we find some way to incorporate A.I.

to our day today, not only will it help me prognosticate or pick specific diagnoses for my patients and to see how long they'll be affected based off their symptoms, I could actually tell if someone's having viral versus bacterial infections.

>> Can't see that happening any time soon.

But yes, I could see that viruses could end up helping us.

Well, I guess that would be helpful.

>> Yeah, absolutely.

All right.

Well let's move on.

You had covid-19 struggling a little bit.

How do you know you have long term covid how's it diagnosed?

>> So first I always recommend that people have some confirmtion of having sars-cov-2 specifically it could be maybe you didn't get a test to confirm it but you had a close exposure and you had these symptoms we can say more than like more likely than not it's if this was some other like disease I would say that we could diagnose it empirically just based off like how the logic flows together.

So at least knowing you had covid or were likely exposed to covered is the first thing and then you would have the correlation of three symptoms I mentioned previously which is it could be mental fog, it could be issues breathing or it could be systemic symptoms, just fatigue and muscle aches and those will have to last more than three months for it to generally be considered long covid.

>> And what about risk factors?

Are there any age groups or is it possible one particular gender would more likely have long term covid?

>> For the first part I did not write that down because essentially if you are older, sicker, more chronic diseases smoker intravenous drug use or any anything that predisposes you to bad health will predisposed to have long covid symptoms from the little bit statistics I saw it was generally younger Caucasian women unfortunately that were more predisposed to get it.

>> Now I wonder why there's so much I can speculate on difference between the sexes for all kinds of diseases but I don't have an answer for that once.

>> OK, well maybe we will have some research done and we'll get that answer some time.

>> It would be valuable to you and everyone else as well.

All right.

So is there a specific well, I'm just going to set you up here so you can answer this question how long does a long covid syndrome last?

>> Oh, fun question.

So we were discussing it earlier before the show started .

But essentially there is there is a rough average and it's based off of first if you had an infection where you didn't have to go to the hospital what we call an outpatient infection.

So you just went home or just got to see the doctor and then an inpatient for most outpatient people who have symptoms of long covid lasting more than three months, the average amount of time is four months.

I can say specifically for myself I definitely had long covid symptoms where when I was I couldn't exercise the same I used to and it took me three and a half months before I got to my baseline and that was I had an outpatient infection for inpatient.

It can take upwards of nine months on average and then there is a very rare subset of people after that who it goes well beyond that and that is possible years even unfortunately folks with diabetes or heart disease more prone.

Yes, diabetes more so heart disease I would assume so yeah.

OK, diabetes specifically because it affects your immune system.

>> I would say that I could see that we have Anthony on the phone.

>> He is asking do mask work against viruses?

The answer is yes partially so the best mask is the ninety five it specifically made to avoid certain bacteria and viruses of a certain size masks otherwise in general you know people compare it to like if you put a tennis racket over your face like will that actually stop anything hitting it and the answer is yeah a little bit.

So I'm usually pretty good advocate of wearing masks because they will decrease your chance of catching the virus.

>> It's just not always the best way to do it.

>> Well, you know and during the covid-19 pandemic we had several shows here right here in the studio and they were our hour long and we had several guests and it was still fairly new, fairly fresh so the coronavirus can still be transmitted through the air, is that correct?

>> Correct.

Very specifically droplets so the reason why I say that is because you don't have to be spitting on people to be passing it.

They could be microscopic droplets because there's a big difference versus if you have covid versus if you have tuberculosis tuberculosis considered airborne do not to be in the same room as that person.

>> OK, and what about the hand sanitizer?

And that was a big thing.

I don't very helpful.

>> The very small subset of viruses don't respond to that and it's typically the stomach viruses those you have to do soap and water.

>> Otherwise hand sanitizer does help kill most of the respiratory viruses.

That's good to know because you know you can't believe everything you read but unfortunately yeah.

So some of those things but you did verify the positives on those and thank you for that.

The your hypothesis of the future treatment or research of the covid virus I wrote down a couple of them just based off studies that I've been reading.

>> So they're looking into different kinds of medications and some of them are very benign.

Some of them are more serious.

But just to see if there's some way to treat it and that's based off the hypothesis is is long covid more inflammation by viral persistance?

Is it more damage to the cells?

>> So they're trying all kinds of different medicines to see if that works for that.

They're trying a set of NSAIDs also known as the anti inflammatory.

>> So that's like ibuprofen.

It's not specifically ibuprofen but cousins ibuprofen they're trying there's also variants of blood thinners such as Araldo that they're trying a couple of antihistamines and I mean that's simply like Claritin, Zyrtec they're seeing if that could improve it and they're actually developing experimental molecules to see if that could potentially help.

>> Hmm.

How would that work?

I have some of those stuff they actually make Denovo just based off some like I said, I'm not virologist so it's something related to the virus that they think will work.

Yeah, the one that I've been most interested in is have you ever heard of the anti diabetes drug metformin?

>> Yes, I have.

So they have found and this is not after someone has the that after someone has covered it's before they have it they've been they've been viewing people who have been on metformin before they get covid and they've been able to show that then against a controlled population out of metformin typically has forty percent less of a viral load by the time they have the disease like fourteen days later and that they've had less covid symptoms like long lasting covid symptoms then a control group.

>> Now there's no they didn't state a mechanism as to why that works but I thought that was very promising because metformin is such a cheap drug and I personally love it.

>> OK, well and I want to bring something up to you know, during the days of covid-19 when it was all out there I mean it was a very dark time for us and many people died.

>> So what attributes to the death factor going down?

>> Would you attribute that to the vaccine both to a combination of infection and vaccine?

Because I don't deny that once you get the covid virus just like any virus you will have some degree of natural immunity and studies have shown that they can be comparable now just like with other viral infections.

I say that even if you had natural immunity you can still get the vaccination after a six month period and provide you even more benefit.

Like I've had some patients who've had shingles.

They have an episode of shingles.

>> They want to get the shingles vaccine.

If you get the shingles vaccine after having shingles it still provides you a benefit.

OK, we have thirty seconds left.

>> Doctor, if you can just let our viewers know how we can prevent getting covid-19 please get vaccinated.

>> I highly, highly recommend the vaccine.

It's one of the few ways that have been shown.

It's an even if you have covid if you get the vaccine it decreases your chance to get over it again.

And they've shown in a study of 600000 people that those who were vaccinated had symptoms less than individuals who are not vaccinated.

>> OK, well thank you very much, Dr. Ali Begovic.

>> We truly appreciate your time and you did a great job of being on the show for the first time.

>> All right.

Continued success to you so much, sir and thank you so much for watching HealthLine tonight we'll be back next Tuesday at seven thirty.

In the meantime, take care.

Good night and good