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- Hospitals in New York areswamped with COVID-19 cases.

The president's team sayscities all across the nation

had better get ready for the same surge.

But there is hope.

New treatments seem tobe making a difference.

Dr. David Perlmutter is a neurologist

and best-selling authorand he joins us now

to talk about the spread of that virus.

Doctor, it's so nice tohave you back with us again.

- Pat, always great to see you.

Thanks for having me.

- Are there any new drugs?

They're talking about this hydroxy,

well, it's a quinine kind of drug

that they use to treat malaria.

Is there any suggestion thatthat might be effective?

- As a matter of fact, there is.

There've been a couple of studies

that have recently come out,

one, in fact, published just yesterday.

This was a combination

of the malaria drug hydroxychloroquine

along with azithromycin, whichis a fairly common antibiotic

people may take when theyhave bronchitis or pneumonia.

And in fact, the results,

it was a very small study,only 20 participants,

but it looked at howlong, or rather, how many

of the people taking the drugswere virus-free at day six,

and they found that 100% ofthose who took both drugs

were virus-free at daysix, whereas the people

who were just takingthe hydroxychloroquine,

about 57% were virus-free and about 12.5%

who took neither drug were virus-free.

So it looks very, very impressive.

A lot more studies are being done now.

The issue always, Pat,

when we look at a treatmentof one form or another,

is what we call the risk benefit ratio,

and that means what are the risks involved

in a particular treatmentversus the benefits.

It looks like the benefitsare pretty profound.

This is an early, preliminary study.

But are there risks?

And indeed, there are.

We do see that, with hydroxychloroquine,

the anti-malarial drug,that there are some people

who developed rhythmdisturbances of their heart

which sometimes can be quite significant.

So we're going to need to watch that

and remember that we have to consider

that we don't want to do harm.

Beyond that, there are a cadreof anti-viral medications

that are getting a lot of attention,

and I think the most popular one right now

is one called remdesivir, madeby a company called Gilead,

and this looks actually very promising,

according to the WorldHealth Organization,

the most promising drug out there.

And indeed, just yesterday,

Brigham and Women'sHospital in Massachusetts

indicated that they havethe go ahead to study this.

It's been used for whatwe call compassionate use,

which means, when there's nothing else

that can help turn a patient around,

giving this intravenousmedication, remdesevir,

has proven really quite dramatic

in a very small number of patients.

Now, we're going to see remdesivir used

not just in compassionate use,

when people are really in extremis,

but also in what's called extended access.

So it's gonna be usedquite more aggressively

in terms of much larger populations.

This was a drug thatwas originally developed

during the Ebola outbreak

and is now basically being repurposed,

but we've got a lot of hopefor that medication as well.

- You have been famous foryour talk about the gut flora

and the immune system of the human being.

Is that a significant factor?

I mean, is our immunesystem going to help us

resist this thing, orat least recover quickly

from an onslaught of coronavirus?

- Absolutely.

What we just finishedtalking about is offense.

Medications are playing offense,

which really, right now,we don't have much of.

It's been said that the bestdefense is a good offense.

The offense hasn't shown upto play the game yet really,

but we need to work on our defense.

We need to work on our immune systems.

And as you have pointed out not just now,

but in many of our conversations,

that the gut bacteriaplay a fundamental role

in regulating our immunity.

When we look at the prevalence of COVID-19

in places like Haitiand sub-Saharan Africa

where they are not ashygienically concerned

as we are in more developed countries,

they seem to be doing better than are we,

and it might well be that,because of their lack of hygiene,

they have a more robust microbiome,

a more diverse microbiome,and are more equipped

from the gut bacteria perspective

to deal with this challenge.

We know that the underlying conditions

that people may suffer, likecoronary artery disease,

diabetes, and obesityare clearly associated

with worse outcomes,and those are situations

that are far more commonin our developed world

based upon the foods that we are eating.

- Let me ask you something else.

The Chinese are sayingeverybody should wear a mask,

that they all should.

And the CDC just put outsome guidelines moments ago

that indicates it may be something

they're suggesting for Americans.

What do you think about the concept

of everybody wearing a mask?

- Well first, let me saythat it's an indication

that our response is very dynamic,

that things change day by day.

We were hearing that, perhaps,

the economy would get backup by Easter, but now,

the president, rightfullyso, has indicated

that we may need to berestricting our movements

for a longer period of time.

So what you're seeing is this wonder

where we are changing our messaging

as we see things develop.

And, you know, the original messaging

here in the United Stateswas to not wear masks,

and I think part of that messaging

was because we recognized early on

that, if everybody was to get a mask,

that might create orexacerbate the shortage

for healthcare practitioners.

I think that there isvalue in wearing a mask.

Will it necessarily screenout all the COVID-19 virus

from you being able to breathe it?

Not necessarily, butone thing a mask will do

is keep you from touching your face.

When your hands are contaminated,

which, when you're out inpublic, is likely to happen,

the risk of you touchingyour nose or mouth

is markedly reduced ifyou're wearing a mask.

I happen to be in favor of it.

When we look at those countries

that have so-called flattened the curve,

countries like China and South Korea,

not only are they practicingsocial distancing,

but they're generally wearing masks.

I think we have to learnfrom that experience.

So I'm in favor it, providedit doesn't create a shortfall

for healthcare practitioners.

- One last question.

Do you think that curve isgonna flatten out pretty soon?

Do you have any prognostication

about how far this thing's gonna go?

- Well we heard in a couple of weeks.

With all due respect,

I think it's a bit of wishful thinking.

Much of the data indicates middle of June

that we will reach our peak.

The slope of the curve right now

in terms of increasingnumbers of people infected

and numbers of people who are dying

is really almost straight up.

The way to make this happenis by changing our behavior.

When Deborah Birx, theWhite House spokesperson

for coronavirus coordinating the effort,

indicated yesterday andthe day before yesterday

that we should expect 100,000to 200,000 Americans to die,

the part that people needto hear loud and clear

is she indicated that that isif we do everything perfectly.

Well, you know, we're not necessarily

doing everything perfectly,we are human after all,

and I think the numbersmay well be significantly

higher than that.

It's been indicated thatthe number of Americans

who are going to getinfected with coronavirus

ranges between, on the lowside, 40% of all Americans,

and on the high side, 80%.

We're a country of 330 million people.

To be conservative, let's say 50%.

That means about 170 million Americans

are going to experience this infections.

Now, the death rateseems to be coming down

as we learn more about theseso-called asymptomatic people,

so the overall deathrate might be somewhere

in the neighborhood of 1%.

That's still about 10times what we typically see

for the seasonal flu.

So if it's even .1%, we would expect

at least a million people to die

from this current experience.

We know what works, weknow what works right now,

and that is efforts to isolatepeople away from each other.

Is that going to have economic impact?

Absolutely.

But the sooner we move through this

and do the right things now,

the better chance we haveat picking our lives back up

and resuming business, et cetera.

You know, it's been said thathalfway measures work halfway.

We've gotta really be all in,

and this idea of distancingourselves from other people

in an urban environment andeven in a rural environment,

I think, is fundamentally important.

- Doctor, you've got themost insightful analyst

I know anything about.

Thank you so much for being with us.

God bless you.- Thank you, Pat.

Thank you for having me.