Awesome, well hey everybody, if you're listening live, you might have heard us a little as I got us going, I don't know exactly when the recording started, but we are so excited to be here with you this afternoon, at least in Mountain Time, it's the afternoon, it's about 70 degrees here in Boulder, and just a gorgeous day, and I'm so excited to be with one of my favorite intellectuals, Dr. Mansour. So good afternoon and welcome, and great to have you here, Dr. It's a wonderful pleasure, thank you Dr. Karahan, and likewise, it's just such a pleasure to be with you, though not in quite a wonderful day here in Toronto, it's a blessed day, but it's kind of murky, kind of, the sunshine isn't there, and by the way, somewhere in this conversation, we're going to be talking about how important that is for us, despite self-isolation, despite quarantining, to ensure that our listeners are getting enough sunshine. I love it, I want to talk about what other people aren't talking about, because there's a ton of stuff out there, there's stress, anxiety, fear, I want to bring some positive news, I want to talk about what you can do to control, whether it's your fear and anxiety, or whether it's your health or your immune system, and I'd love just to, if you want to just give a little bit of an intro on kind of how you've been framing this whole pandemic. Sure, so, you know, I wrote a paper on this, almost actually about a month ago, and it was kind of just predictive, because at the time we weren't quite sure where we were dealing with things, and not saying that it was anything special, but one of the things I did highlight in this, looking back at it, somewhat predictive realm, was I said, you know, there are going to be a few things about this corona pandemic, back then we weren't sure if it was a pandemic or not, but there were going to be a few things. Number one, trying to keep it positive, okay? So we've got to understand the numbers, and a lot of folks don't appreciate what the numbers are, and they're getting a lot more hysterical or concerned when they read these percent mortality numbers. So the first thing I said was, not saying that this is not a dangerous virus, no, and not saying that there's a subset of the population for which this virus is going to be certainly something quite severe or could be something quite severe, but for the first thing I want to kind of point out to the listeners is this, when you read or you see that a virus is killing 2% of the population, let's just, for example, the first thing that we've got to understand is that 2% was computed based on the number of people that were positively tested, and of course those people were positively tested because for whatever reason they were either ill enough or privileged enough in some way to go to a testing center or lucky enough and be tested. My point is this, for every 100 people that are tested, such that, God forbid, two people pass away, there are 500, 200, 1,000, we actually, we know that it's significantly more number of people that were positive that do have the virus, they do have the virus, and clearly did not get to the point of severity and certainly not to the point of mortality. So just by no means diminishing or underestimating that this is something we have to control, that it is concerning, but it just puts, it just allows the population to breathe a little easier when they see 2%, but really understand that that 2% is in all likelihood an overestimation. That's the first thing that I'd like to say. Yeah, and if you don't mind, I'm going to comment really quick on that because I remember the first week I was doing virtual patients on a Wednesday, 10 patients in my day, and three of the 10 had presumptive COVID-19.  They did not get tested because they were not high-risk, or did our state recommend it. And my first thought was just like you, we knew this, but I thought, okay, that's 30% of my day. That means that about a hundredfold more than what we're seeing, probably more, but just guessing based on my little tiny snippet. And then we see Germany who's testing, testing, testing, and their percentage is about a 10-fold, at least lower, in mortality rate, but we think this virus is probably doing the same thing around the world. So totally agree with what you're saying. And initially people were asking the questions, what are the Germans doing differently to keep their mortality so low? Well, not saying that they aren't doing beneficial things, not saying that there aren't other probable health parameters, but just starting with the simple statistics that they tested more people. They confirmed more people had COVID, which we're not doing with some other countries or not, and therefore they had a much larger denominator, such that when you put the numerator of how many people, God forbid, passed away, their percentage seems so much lower. So for the listeners out there, this is a serious virus. It's more serious than the common flu, for a percent of people. For a majority of individuals, if you do get this virus, you'll probably end up with something about the severity of a flu. By the way, there are unique features of this virus, absolutely unique features, but just trying to get the message, however we frame this, that we do need to frame this so that individuals understand, there are people out there reading articles of people, God forbid, Dr. Karnaan, committing suicide because they found out they had a positive result, and they haven't even waited to understand what's gonna happen next. You know? And these, yes, they're sometimes sensationalized, one-off news pieces, but we've gotta understand the second point that I like to make, which is this. This is the first virus, mind you, that is affecting at a societal level, the way that, you know, for most of us, if we're in our mid to late teens and we're living in North America, we've not had something that shook our social consciousness like this for about a generation. And I'm even including the horrific incidences of 9-11. You know, in terms of societally, societally broad, the entire swats of society in our consciousness because of the constant newsreel, because of the constant media around this, we're getting, we're actually seeing, Dr. Karnaan, a little bit of an unwanted clinical trial playing out here. What is this clinical trial? It's that we're taking, and let me frame this to you this way. I'm gonna use this unique subset to drive home a point. What's the age group that, again, not saying they can't have severe symptoms, but clearly they're nowhere as nowhere as at risk than the older population. We know that the younger folks, not saying that some younger folks can't get ill, we'll get to that shortly, but for the most part it is clear that if we look epidemiologically, the younger population, let's say in those teens, younger teens and teens, pre-teen teens, are not getting as severe symptoms, generally speaking. Now there are gonna be some of those individuals that have pre-existing health conditions, which we can all list, whether they have autoimmune deficiencies, I should say immune deficiencies, whether they're dealing with things like diabetic cancer and they're currently on immune suppressing reagents, whether they've got an organ transplant. So they've, of course, they've got to be in immune suppressing drugs. Clearly those are unique individuals. But here's the point. In that young group, we're not focusing on them because they're not getting ill. But this young group, societally, they're not in schools, schools have closed, they're isolating at home, they're isolating at home with parents that are probably not at their best because of fears, because of financial fears, for all the right reasons, for all the right, for all the wrong right reasons, okay? And within this teenage population, societally, there are always gonna be those teenagers that are at risk for anxiety, at risk for depression. There is because of final. Right? There's a little bit of a reverb, Dr. Kanahan, can you hear me? Yes, I can. Okay, sorry. And what is happening now is this entire, what percentage, how many teenagers do you think we've got in the US? What's the number? I don't know. Whether they're 10% of the population, 15, 20% of the population, we're talking about a few million, tens of millions of teenagers, each with their own genetic predispositions for anxiety, for neurologically based for depression, and we're not addressing the concerns they're feeling from being isolated from their peers, only having access to social media. This is just one example of the, what I call ripple effect of this pandemic that we're not paying enough attention to, and granted, we have to pay attention to the acute infections for sure, but some group within the healthcare community, we must start speaking up and alerting parents, alerting our communities that look, our teenagers haven't been put through this before, and we've got to speak to them, we've got to ask how they're feeling, we've got to watch out for, are they showing those aberrant signs of anxiety, depression, they're locked in their bedrooms? That's just the first in a series of what I call ripple effects. Would you agree, Dr. Kanahan? I would totally agree, and we've looked at child at ASA score before, and the data clearly shows there's not one risk factor that's greater than childhood diverse events, which means the social isolation in the two-year-old who can't understand and the four-year-old who can't understand is significant, and we have to factor that in. In addition, community, touching, hugging, being in close contact with those that we love is shown to boost your immunity, so we're not into the fact these things are like social isolation, how they affect the immune system. And I'm not saying we should be doing things differently right now. I'm not saying go on, hug everybody you meet in the spirit, please don't get me wrong, but what I'm saying is there are other factors in the equation that we are not looking at that are equally as important, and at the end of this pandemic, we're gonna look back and we're gonna say, you know what, we did some things right, this is what we did right. We did a lot of things wrong, and this is what we did wrong, and hopefully next time we'll do better, because people are experienced in post-traumatic stress. People are experienced, the children, I have a colleague with a two-year-old daughter, she said, I don't know how to explain to my daughter why she can't play with her friends. She doesn't understand, and she just gets angry or sad, she doesn't, and there's no way to tell her what's going on. I don't understand, I mean, I don't know how to tell her why she can't hug her grandmother. Like these things are really a big deal, and those of you with children are all dealing with it, and we're not talking about that piece of this. Again, there's reasons why we're all doing what we're doing. I'm all on board, but I think that the bigger picture is, how do we reduce stress and help our immune system in that way? How do we reduce social isolation, and the fear, and the depression, and the anxiety that that creates? How do we take care of our children who may or may not understand this, or who all of a sudden are away from their college friends and completely isolated? These are real issues, and we need to have, thank goodness psychologists and those kind of therapists are still available and essential. I would highly recommend if you're concerned for your family member, for your marriage, or your children, that you get connected virtually with one of these professionals that can help you. So critical. Absolutely, and you know, here's the thing. Again, not diminishing, not please. No listener think I'm diminishing the concern and the severity that this virus can and will have for some individuals, but infections do come and go. These children, and the reason I sort of highlighted the teenage population, because there are trigger points at places and developments, such as pubescent children, that a trauma at that time, at that particular time during their development will set the stage for mood and behavior for the ability to screen and respond to other stresses. It will set the stage for the years to come. And so again, and again, usually, this is happening at the individual level, the teenager that was bullied, the teenager that was growing up in a home that had some marital strife, and you have these isolated, you know, important but isolated cases. Here, it's happening societally. It's happening across millions of children, tens of millions of children. And it's worldwide, whenever you have a fever. And it's worldwide. Right, when you have a fever. And it's being doubled down because of course it's not just turning, you know, we no longer live in a time where the family gathers around at 7 p.m. to turn on the one channel and watch it news. It's the news 10 ways, 100 ways from Sunday. And these children, think of it, they're in isolation. Most are in isolation with some type of personal social device. So now rather than human connection, it's you so beautifully pointed out. And look at the connectivity. It's not just about the mental framework. It's right back into the physiologic immune response. Yeah, exactly. Quote study after study with oxytocin, which is raised when we touch people, human touch. And so we're losing some of these pieces of our physiology by isolating. Again, not saying we should be doing anything different, but we have to take it into account. I just want to call out because I see you guys are listening, you're commenting. Jessica, nurse health coaches are here to help. Thank you. Joy Miller, wonderful professional. Thank you. Thank you guys for listening and for your comments. I just want to make sure that you know we know you're there. You're listening and please continue to comment, share your questions, share this feed with your friends. I think it's really, really important information to get out. Let's shift to solutions. Let's shift. Okay, we're in social isolation. We're not saying we should be doing anything different for now. We need to obey our government in our areas. That's 100%. But what do we do for when we are in this situation? What are some tools that we can give our listeners? So just absolutely to the solution, but I want to highlight now two things so we can compare contrast, i.e., one way of doing it versus a different way. The first thing now is quickly contextualize what happens when we're in social isolation. We're typically not getting out and about as much as we should, typically. Now, not all of us live in homes where we can have at least some degree of sunlight. There are how many of parts of our community in our apartment buildings, apartment buildings that are not getting the type of sun exposure. If you're not getting that type of sun exposure, your vitamin D levels are going down. No two ways about it.  What are we doing when we're home? We're binge watching Netflix into past our typical bedtime. So now we're throwing off our circadian rhythms. Your circadian rhythm, when you go to sleep, when you get up, the normalcy and the repetitive nature of that is also radically important in how our body responds with cortisol, which, by the way, leaps right back to our immune response. So taking that first piece and now what do we do about it? So we're home. We do the social, we are practicing social isolation. It is necessary and especially in some of our communities, but that doesn't mean that we throw our circadian rhythm out the door. It doesn't mean that we can't at least try to keep our family members, our loved ones, keep up a healthy circadian rhythm. Try to get some type of sun exposure. Try to get these things that allow your body to stay, quote, unquote, in as healthy a circadian rhythm as possible. The human body was designed to optimally work based on optimal circadian rhythms. Self-isolation quarantining, one of the first thing that goes out the window is our circadian rhythms. So Dr. Kanahan, you've forgotten more about this than I know. Please comment to the audience of how important this is and what are some of the things we can do to maintain? A, why the circadian rhythm is so important and what we can do to keep it as healthy as possible. Oh, I love this because I'm gonna tell you some things that I do, not saying that you have to do what I do here, but I found some of these things to be really, really practical. First of all, this may shock you. I have not turned on my television for over six months, period. I do not watch television. I do not watch the news. And guess what? I wake up, I'm optimistic, I'm happy, I'm not oblivious. What I do is I get my information from selective sources like the CDC, like the medical boards, like the government.  So that means, guess what? That phone doesn't control me, I control it. I go to it when I look at Facebook, I choose when, but I never get those little ding, ding, dings because I set up your immune, your number one, your immune system, it's a stress alert. Number two, it sets up a dopamine reward system. Do you know how the lotteries and the gambling in Las Vegas, Nevada, or anywhere else gets people hooked? It's a dopamine reward system. So every time you hear that ding of an alert on your phone, your mind goes, oh, I gotta check that.  And it's a reward circuit because about 10 times that you do that, something really cool is there. So that's the way to create an addiction.  You're gonna know the weather. I go outside and find out what the weather is every day. I literally do not watch the news and it's been the most best thing for my mental health ever and people are shocked because I have to run a business, I have to make decisions for employees, but I can find the information that I need from reliable sources and I control it. I don't have anything else controlling my attitude, my mood and I don't always trust the mainstream sources to give me the factual information. They're gonna pick and choose what keeps people listening. So first thing, turn off the news. Second thing, turn off the alerts on your phone. Third thing, every day, at least twice a day, get outside unless it's raining or snowing or you can't. I agree with Dr. Munser that vitamin D, if you can in your environment, go barefoot on the grass. That earth thing will actually give you access to the earth electromagnetic core which helps our physiology. It's like recharging our batteries. If you have puppies or loved ones that are in your isolation circle, be with them, spend time with them, play games with them, all of those things, as far as your sleep patterns. So men may not be the same as us women, but us women, we usually go to bed, we get up, we do a shower, hair, makeup, et cetera. During this time of isolation, if you're working from home and not doing Facebook lives or videos, you may think, you know what, I don't have to wash my hair, I don't have to shower. I'm gonna stay in my pajamas all day. You know what, I could be alone at home and never get on video. And every single day, 100% of the time, I get up at the same time, I make my coffee. I sit and meditate and sometimes read some sort of text or spiritual information in the morning. So set my day, I set my tone, same as I would if I was going to work. Then get my coffee, take my shower, I do my hair, I do my makeup. I put on my clothes yesterday, I didn't go anywhere and I wore a dress and a cute little jacket. And it was just for me. But you know what it does is it gives my mood to be feeling like I'm involved in life, I'm involved in people, I'm the same person I was. There's something a little depressing about staying in your pajamas and not washing your hair. Like for me, I kind of feel gross. And maybe I'm a little obsessive about it, but that's a piece of my happiness and my joy is the same routine. And then the other thing is if you're sitting around all day, you tend to get tired, you might take a nap and then you end up staying up late watching. I've not turned on Netflix, I haven't watched a movie. Again, you don't have to be like me, I just, I'd rather read or educate myself, but I choose to use activities like audio audible books, reading regular books, going outside, learning a new activity. A lot of my friends have learned arcs or crafts, coloring, years and years ago, I said, I don't have time for that. But the last year, as I've learned to be still, I bought a ton of coloring books and crayons and pencils. So when I need to get creative, I'll pull out my coloring books in color. Those are the kind of things that are gonna energize me during this time and to reconnect you to your purpose and your meaning. And what I've found is I've actually been more productive, more busy, more ideas, more new things for the clinic that are happening now in this time of pandemic than ever before. Dr. Kanahan, we could literally have just stopped right there just because look, what we took is we took self-isolation, we took quarantining and we just gave it two different versions. One version that is entirely depressed depressive to your immune system and depressive to your mental function as per the sloping around in the pajamas. And again, please to the listeners out there, we know that there's so many individuals dealing with financial stresses, dealing with the worry over loved ones that did go on to get quite ill. So we're not making light of the feeling of trauma over this, but it's, as Dr. Kanahan has pointed out, it's the feeling that you can have some ownership of doing something, you particularly, choices that you don't make, choices that you do make, just that empowerment. And don't think of it as just a trivial exercise because it's gonna go right back, affect your immune system, affect your stress levels, Dr. Kanahan.  I've heard about it that Netflix now they can trace or they can score the most watched movies. Do you know what's one of the most watched movies in Canada now on Netflix? Contagion. So what are people doing? They're A, messing with their circadian rhythms, staying up binge watching things, but they're watching the very things that are now repopulating in their consciousness. Fair, oh my God, the world is ending. Well, you know, there's a very clear mechanism to a post-traumatic stress. What happens is as a child, you might have not got ice cream when your sister did or some minor thing or some major thing. Some of you have experienced horrendous trauma in your childhood or early in life. I don't wanna make light of that, but what happens is these peaks on trauma, they get populated together. So we have another peak that reminds us of an old trauma. It gets tagged together so that the nervous system is like, whoa, that feels very traumatic. I'm gonna feel the same way I did when I was two or four or six or eight. And these spikes, they get populated and they get tagged. And so another trauma like this, like being quarantined or being away from family or friends or losing a job or we're all dealing with difficult situations and they get tagged to old things.  When you break that trauma cycle by saying, guess what, I still have control. I can choose to get up in the morning to shower, to put on makeup. I can choose to take a bath at night, take care of myself. I can choose to color or do something creative. I can choose to learn a new skill. I could choose to, maybe I wasn't going to the gym, but now that I'm home, I can choose to do an online workout every day and actually get myself in better physical shape than I've been before this. Like you can choose to take the opportunity. And I wanted to mention the other day, cause we keep talking about, you know, we're not making light of the situation, but here's something important. The other day I was walking, it was seven o'clock at night and it was maybe a week or so ago, there was a lot of fear. I had my headphones on, I had some fun music and I just felt like dancing. And I kind of, I was alone. I just looked around, no one was there. I'm like skipping and dancing with a little girl. And then the first second I stopped and first of all, I looked and there was no one else out there and I thought, what in the world? Why are nobody out? It's a beautiful evening at seven p.m. But the second thought was, is it okay to be full of joy? Like in this time, is it okay for me to still have joy and happiness? And all of a sudden I was struck by the fact of, is it okay for me to be happy when people are suffering? And guess what? There is room for both. We can, just because I was happy and full of joy and skipping in the evening on a beautiful night does not take away from your suffering. And it's okay for me to have happiness or for me to have sadness and for you to do the same. And I think there's almost this guilt. I felt it about, is it okay for me to have joy or us to talk about solutions and talk about joy and talk about positivity. Is it okay? We don't have to apologize, Dr. Munser, because it is okay because we can bring light and hope to those who are suffering and by us, hopefully modeling. And granted, I have days where I'm overwhelmed. I have days where I'm stressed. So I'm not all joy and bubbles, but I realized on that walk, it's okay. For me to be happy and joyful in the midst of suffering because there's so much heaviness, there's so much anxiety. We need a little bit of that infusion.  Again, could not have even that anecdote that what it means, it could have been the place we stopped. I wanna add obviously the geneticists in the room, if you think to yourself that you know what, I don't get worked up over looking at something like contagion or something else. That's not me, it doesn't bother me. Please understand that if you're in a family context and you're all indoors now, and so of course you've got this sense of nobody else, where are you gonna go? Please understand there are profound genetic precursors that indicates why one person might emotionally fixate in something. They're either to be gene, they're dopamine metabolism, rate of dopamine metabolism, rate of no adrenaline metabolism. So my point is this, underlining what is going on, we might have individuals who are saying, oh, this is not bothering me, I could look at this, I could, but others around you, your children, your spouse, your others around you, we will tend to mimic more what we see, we will tend to imbibe what others are doing around us. So even if you're not doing it for yourself because you think it's not impacting you, it can certainly, there are genetic classifiers that superbly differentiate between risks of that, as you said, linking past fears, linking past anxieties, so that now that's the whole point of PTSD. PTSD is that person now, as they were walking down, having God forbid been deployed to horrible parts of the world, they've come back to their home's town, they're walking down the street, a sirene of an ambulance goes by, nothing to have necessarily been done with them, they're safe, but that links to when the sirene was involved, when they were involved with something.  For me, my passion here is as adults, to some degree, more or less, we have the tools or we should have the tools, or at least we have more tools than our youth, our children, that are watching at how we are behaving and they're being exposed to how we behave far longer, far more than the average, they're not within the context of their normal situation of friends and connectivity and the classroom recesses and playing. We've got to be as adults more mindful of this component and as Dr. Kanahan has pointed out, there's a lot that can be done. Now, Dr. Kanahan, the second, here's what we're doing, here's how to do it right, here's how to do it wrong. So, you know, it amazed me and I looked at what was happening. What was the first thing when the panic buying started happening, when everyone said, we've got to go prepare to go lock ourselves away. I'm not speaking of the toilet paper, let's put out the side. What was disappearing from the grocery shelves? It was all of the non-perishable foods, right? So it was the pastas and the rice, it was the canned foods, chuck full of salt and preservatives and so on and so forth. So here's the other factor now. People just naturally think, and again, please, I am not scuffing that if that's what you can afford then you have to try to get some nutrition and nourishment for your family in these times for prolonged periods. But we've got to stop for a moment here, Dr. Kanahan, and remind the population, what are the two biggest comorbidities for poor outcome if you contracted COVID? Hypertension and type two diabetes. And what are the very foods we're stucking up on when we go into quarantine? Foods that are preserved with chuck fills of salt, foods that have chuck fills of processed sugar, okay? And by the way, we're at home, we're snacking when we're binge watching the Netflix. So we are creating a physiology in quarantine that is the exact physiology that leaves you ill-prepared to handle a virus. And by the way, for the majority of us, we will be able to handle the virus when we have been exposed to it. Correct. Yeah, and even more so, what I've found to be fascinating, I was teaching this week into a group of doctors, teaching on metabolic endotoxemia. Now that's a really long, fancy word to say, it's when gut bacteria leak from your gut lumen, the tube inside your gut, through a leaky gut membrane into your bloodstream. And this LPS molecule is just a coating of bacteria. And guess what? It is the number one risk factor for the things that we see that we just talked about, heart disease, diabetes, obesity, and then all kinds of mood disorders too. So insomnia, anxiety, depression, even bipolar and schizophrenia. And guess what? That LPS, when it goes into the bloodstream, it triggers the exact same cytokine cascade as we are seeing with the virus, which IL-6 and IL-8 and TNF-alpha and some of these cytokines. So this exact same, if you are dealing with leaky gut, some of my, I'm doing this for my page because I know so many of my patients and clients have gut issues and have these kinds of risk factors. And if you're eating the kinds of foods, like the processed foods, the foods full of glyphosate, like GMO based corn and soy processed products, or high sugary things, or even a lot of alcohol, or a lot of ibuprofen or NSAIDs, or all of these things that create more leaky gut, you're contributing towards that inflammatory process that is the same thing that's almost, it's priming you for if you were God forbid to get the virus, that priming would make you more at risk for a worse cytokine response. So your gut does matter, the food does matter. This might be the most important thing you can do. So what do I do and what do I recommend? I'm in the aisles where there's plenty of food, where there's leafy greens, there's fresh broccoli and Brussels sprouts and cauliflower and peppers and carrots. I'm in the fresh aisle and I'm thinking, okay in a week or two, these things are gonna go bad and they won't have food, but I'd rather have fresh, healthy food and then I freeze some of it too so that I have some things. One of the tricks that I found because I literally don't eat processed foods at all, I don't have one can in my pantry. So if we really get into trouble guys, I might need your donations because all I have is fresh and frozen, but what I learned is like, okay, smoothies, a good quality protein powder from whey or collagen or some organic pee or rice source, if you have that on hand, that saves very well. And if you throw that in a blender with leafy greens, you kale or spinach, et cetera, and then fresh blueberry, strawberries, et cetera, you can freeze all those things, even kale which typically wouldn't freeze and cook, it's awful, but if you throw it into smoothies, frozen it works. So what I did to prepare for something since I don't have any canned foods at all, is I froze kale and spinach and I froze blueberry, strawberries, bananas, all kinds of fruits. I have protein powders and I have coconut milk that's in containers that won't go bad. So I literally have, I could get by for a month or two with protein smoothies if I had to. And if you wanna avoid the canned foods, that's a great way to do it. I just found that to be an incredible, helpful way because I was like, what am I gonna do? I don't eat canned foods. Right? So again, we're faced with a situation that we do need to do what we're doing, the self-isolation, but as Dr. Conorhan has just said, the way you go, literally, there's a fork here. We can go down the, well, let's go stock up on the bread and the flour and the pasta and the, and please, I'm not decrying if you have to do some of those things, but just think about it. It's not trivial. It's going to create, and it's not for one day, guilty day, your treat day. This is not happening, not one day, not one week, not two weeks, a month, two months even. What you can do in terms of shifting the body, either positively or negatively over the course of 30 days, 40 days, we'll have ripple effects for months, if not years to come. And so again- Instead of this being like something that's happened to us, we can take back control and we can use it as an opportunity to make our lives better. So I love that. And Dr. Munzer, I love, I know we didn't talk a lot about genetics, but I know you wanted to talk a little bit about the genetics of this. So why don't you dive in a little bit in like 10 minutes or so about the genetics, and then I want to talk both of us about the sequelae that we might see afterwards. Yes. So, you know, someone asked me and I was, Jill and I were speaking before, Dr. Kahn and I were speaking before we went live. And I said, you know, look, not trying to be the, you know, on screen, optimist always, but there was a silver lining for me in this pandemic, which has been traumatic to so many, but the silver lining amongst many others that Dr. Kahn has mentioned is we as a community, as a society, we're going to be more mindful of our health now moving forward. Why? Every single one with rare exception of the individuals who go on to develop severe progression of this infection up to and including mortality, had underlining metabolic dysfunction, i.e. underlining health concerns that in and of themselves are things that we can impact, things that we can impact with healthier living, healthier lifestyle choices. So what I've been doing, Dr. Kahnhan, is I've been using this as an opportunity to remind people, not about the genetics, people keep asking them, talk to them soon, is there a genetic variation in the ACE2 gene that makes the virus more likely to enter the human cell now? And I've actually said, by the way, from an infection perspective, there does not seem to be variations in the ACE2 gene, as far as we currently know, that is allowing the virus easier or less easy entry into the human cell. And even if there were, you know what I would say? I would say that's not where you should be focusing. What you should be focusing is understanding what are your innate genetically starting, your innate tendencies to develop hypertension, cardiovascular concerns, pulmonary concerns, for the first time in your life, own that, own that and understand that you, optimizing your health, diminishing those symptomologies, aren't just going to be a healthier version of yourself. That healthier version of yourself is precisely the version that can deal with this virus in a way that, by the way, most of us, if we were healthy, we can deal with that virus. I can't say that enough. I can't. And yes, we're seeing, we are seeing media reports of that strapping young man or woman saying, I never smoked. I was a CrossFit runner and I got this virus and it laid me up in the hospital. I am not diminishing the suffering of that particular person, which here's the truth of it. Number one, those are far rarer events. And again, our media wants to find those events, as is their job. Fine. Number two, those individuals certainly may have outwardly been healthy, but did they take a moment? Did they ever understand that they were latent health concerns that they want to work? And the only way you're going to detect latent health concerns, and I'm not here to sell a genetic test, that's where genetics comes in so that you can understand what are your latent concerns? What are the symptomologies of latent concerns that you can do something about it sooner rather than later? Every single one of those things that Dr. Karahan has mentioned here about watching out, about what that leaky gut then triggers, pro-inflammatory cascades that we can do so much about if we knew our individual tendencies. So to conclude, Dr. Karahan, here what I mean is there are genetics not related surprisingly to the infection per se, but to the underlying physiology that I hope there's a wake-up call to our societies that we begin to own our health more than we've ever owned it before. Yes, gosh, I couldn't agree more with you. I just, I love that. And I love Dr. Mansour as part of the DNA company and they have some great, I know when we first talked about my genetic test, I was like, wow, this is amazing. Really, really good information. And I love it from my patients too because it helps on pathways as far as figuring out what kinds of things we're all so unique. That's part of this is we don't have a one-size-fits-all. One of our comments here from Steve, asked about, have you seen the theory of hypoxia lung inflammation? This is a whole another can of words. This is, this is. I'll tell you what, I'm writing, you know, I try to bring you the latest information. I am working on writing a very science-based article on this right now, it will be out next week. So I do believe there's some validity to this hypoxia. Bottom line is what we're seeing is very different from the classic ARDS in lung inflammation. And instead what we're seeing is we're seeing this low oxygen because the oxidation of the iron. So basically your hemoglobin is red blood cells. They're like little boats in a river carrying your oxygen around to your body. And this virus particularly likes to attach to the iron there and decouple it from that little boat. The iron is critical there for carrying the oxygen. When that iron is decoupled that iron becomes a radical oxygen or sorry, a reactive oxygen species that causes massive collateral damage around the body. And this is a really big part of the problem because what we're seeing looks a lot more like altitude sickness. And if you're any wonder, as I looked at this, a lot of the ski resorts here in Vale and Aspen, there was a huge percentage of people that got it that were at higher altitude in the beginning. And in Colorado, those cities that are higher altitude like 8, 10,000 feet are shifting their patients to lower altitude because they know they're doing better in lower altitude because they don't have to worry so much about those boats carrying the oxygen. This is a big part of it. And I think as we investigate and dig further we're gonna find out what's going on. The other thing that's very interesting is it's not so much the fluid, the inflammation that's all part of it. But what's happening, what we're thinking is happening is at the tissue level that hypoxia, the lack of oxygen is really what's causing the damage. So maybe in the future, some of our treatments will revolve around how do we get oxygen to the tissues? Because a ventilator without getting oxygen to the tissues is not gonna be the answer. So this brand new hot off the press, you haven't heard it anywhere else, but I promise you stay tuned to the page, stay tuned for the blog because I literally, I had a two hour meeting this morning with my researcher group and we are on it. You're gonna hear next week about more about this. Dr. Kanahan, I've been writing and I've been asked to write addendums to the first letter that I released, which again was somewhat very predictive of a month ago. Literally this topic was my next addendum. And so it- Love it, you and me both were there. You know literally if we share because you've nailed all of those points and again here to the viewers and listeners, the individuality with which we deal with ROS is the reactive oxygen species and what we call our redox balance and what that does to then cascade into inflammation, this is going to be key. So just so that you, all the listeners, we have hugely important and expressed genetic differences, ethnically, so different individuals, different geographies to how we deal with oxidative stressors. And when you, when those ion, those heme groups become decoupled from the erythrocytes, they're marauding very potentially dangerous ROSs, contributing ROSs, not to mention that then the decoupled erythrocytes themselves behave in a way that they shouldn't be behaving. And so we get here and this is where this virus is, you know, we've made analogies, but we meaning in the scientific community, this is where we've got to be careful the analogies we've been making to previous flu-like viruses or even previous coronaviruses.  But to understand the particulars of it is to A, understand, do we just jump in the same old, you know, is it ventilators? Is it just oxidizing the lungs when we don't realize where is the inflammation? Is it at the level, are we even getting the oxygen into the body in the first place? So whomever asked that question, brilliant question. That's right, I'm so excited to hear because I know you and I were on the cutting edge and literally this morning I was like emergency meeting, this information has to get out and I'll tell you why. Because because of this information it explains the things that I already know are likely going to help. IV vitamin C, IV vitamin C when you can keep the frequency of dose either liposomaly orally or IV at a frequent level so that intracellular level of vitamin C is high in your body, that will neutralize the free radicals of these iron oxidation. We're gonna see some relief. Surprise, surprise. Plaquenil hydroxyquinone that we've seen on the news with zinc, it's a zinc ionophore which means it allows zinc to go into the cells. Intracellular zinc is also critical for restoring homeostasis in the body. So is magnesium. So these nutrients that we've known to work now they actually make sense in light of the virus and I think I really believe if we can give the message out and the data out and build the science on this we're gonna see a shift in medicine. You guys all know what I stand for. I'm all about finding root cause and reversing disease. To me this is a really exciting opportunity if we get it right is there's some great solutions and most of them are nutrients. They're things like a glutathione raising glutathione status either oral or nebulized where you could breathe it into your lungs. They're things like hyperbaric oxygen which can push oxygen into the tissues. They're things like ozone which can also create more oxygen and kill viruses and things. And these things aren't on the nightly news. No, no. But we're gonna bring them to you. We're gonna talk about them. And I always feel like a lot of these new things if they're fairly safe and we don't yet have a 30,000 human randomized controlled trial I'm willing to try this with informed consent with patients and the data is good. The data is really strong. I've got it. Bless you for saying that Jill because here's the other silver line that I've seen. Listen viewers listeners. Is there are there snake oil charm things that really have no business being spoken about in health but they're peddled by individuals intentionally unintentionally? The answer is yes. But once and for all our societies have to wake up to the fact that there are a plethora of well-studied uses of micronutrients, vitamin C, how many times have you had the average patient Dr. Carnahan so confused with is there any real benefit to vitamin C because I always hear these articles that it's never been shown to help with this. There are meta analyses showing the benefit of vitamin C especially being used IV in this current SARS-CoV-2 infection. So just to the listener, two things. Do not be swayed by things that just really clearly are have no place in medicine. But on the other hand, also open up and open your minds and recognize that there are things that let's see how to say this carefully. There are things that are quite easily accessible that are not coming with massive price tags that are not controlled by certain agencies that also have benefit to the human body and refreshing and having leaders like Dr. Carnahan bring you this so that you know it's being vetted. This is gonna be something Dr. Carnahan that you have a responsibility of doing as you always do. I wanna add one thing, Dr. Carnahan and here I'm adding one plus one and getting four but I can't, the researcher in me the geneticist in me, I can't let this go. When we notice the strong correlation and by the way, there was a strong correlation when we look at the fatalities in places like the South, South of the US where there were by the way, fatalities that were definitely seeming to be higher than the rest of the country. What are we seeing? We're seeing obesity, we're seeing metabolic disease. We're seeing type two diabetes. One of the things we do when we look at should the way your body processes sugar your hemoglobin A1C measurement. Well, what is this? That same heme group has the ability of attracting and binding glucose over time. We're now finding out that the virus is decoupling the heme group from the erythrocytes. I'm personally asking the question, is that happening easier? Is the hemoglobin being turned into a reactive oxygen species easier in the presence of glucose? Because to me, those two things are just, they're too glaring when you see the increased risk factors for type two diabetics with poor outcome with the hypoxia. So this is something, and again, researchers aren't asking these questions because they don't think functionally. They just think, you know, and so Dr. Karna, I'll be writing some information. We probably should share our information and get something solid out there. I would love that because I know, I respect you so much as a brilliant clinician, researcher, geneticist, and let's share those. I will share your information here so you stay tuned to this page. You'll get Dr. Montser's information. Of course, you'll get my blog too. What I'm gonna try to do with the blog is write it on a level that any person who doesn't have a science background can understand. And I'm sure Dr. Montser will take a whole another level. So both of us are gonna bring you that information. And I really think it's important as this virus progresses, because what that means is there are solutions, really, really good solutions that are gonna keep you healthy and keep you out of the hospital. Dr.  I'm not sure I've contributed anything, but just being able to share this with you, share this with your audience, bring back something that is not trivially, just optimism for optimism's sake, but to really show that there's an ownership here, not trivializing things. And you know, you know what's gonna leave, after all of those, you know, science and clinical things we've spoken about, I'm gonna leave this conversation today with the anecdote that you gave about you listening to that music and feeling happy. And that discordance, that sense of, can I actually feel a degree of happiness? Can I feel happy even though there are reasons to be sad? That anecdote that you shared to your community, I hope your community that listened to this realized, A, how personalized that was, and how powerful that was, that more than anything else is what I'm gonna leave this conversation with. Thank you for sharing that with me. Oh, thank you. Thank you, thank you. And thank you everyone for listening and joining us. We had so many conversations and lots more comments than questions, but this recording will be live. You can come back and watch it. You can share it with friends. I hope that you found it really informative. And if you did, please share it because this information needs to drown out some of the negativity. And I will say this, things are changing on a moment by moment basis. So what you hear today, in a week I might say, well, guess what, this changed a little, I learned more information, but I promised to always bring you the up-to-date truth as I hear it, just like Dr. Munser. So again, it could change, but for now there is hope, there's lots of answers. Genetics do play into this because it sets your stage for how you're interacting in the environment. And if you wanna know, we'll be sure and link up with Dr. Munser's page and his company. So if you wanna know more about what he does, you can do that as well. We're actually working in our clinic on a COVID pack. I don't know if I can call it that legally, but it's basically some of the basics. So glutathione, NAC, vitamin C, zinc, some of the very probiotics, a very, very basic core stuff that all of us should be taking right now. So check that out, drjilhealth.com, my website, jilcarnihan.com. And thank you all for joining us. This was really, really fun. And Dr. Munser, thank you so much. No, thank you. A blessing to everyone who listened to this. Bye-bye. Bye-bye, take care.


It's rollover training so it simulates if the vehicle rolls over how to egress how to get out of it so before soldiers deploy and just training it's important that they get this type of training so they understand if they have a rollover or things like that overseas if they fall into water area and starts filling up it's important that soldiers know how to get out of their vehicle properly. To be honest when I first got here and seeing the it wasn't spinning too fast I'm like ah but then once I got into it uh it actually that felt like you actually feel it like when I was actually hanging I'm like oh my god I didn't really think it was going to be the serious right but it actually did uh came back really good it was a good experience so to get out of the vehicle it's actually pretty pretty hard too because you got tight spaces in these vehicles right so it's just uh you know how to get around because you got you got the gear on all this and that and you just got to help your battles too because the team work right so we just got to get out as a team how we go in as a team we get out as a team to see how you're good okay do not egress until I say it's important that they have their gear down you know ammo boxes their weapons secure with straps and all that in the vehicle so when it rolls around it doesn't hit them in the head injure people and add to the injury of what could have happened already from the roll over so the purpose of this training is to get them prepared for and they'll be coming up here doing annual training with a lot of movements there's the potential for an accident but this is one of the training requirements prior to them participating in that exercise


Hi, everyone. This is Leah Medwig, your lead course instructor here at ACT. So I want to welcome all of you to our first anatomy and physiology lesson, part one. Today, we're going to talk about the nervous system. So functions of the nervous system. So the nervous system is important for connecting the central nervous system to your organs, to your arms, and to your legs, and to your skin. It also allows the brain and the spinal cord to receive and send information from other areas of the body. So, you know, from your legs and your arms and your organs back to the brain. And it also carries a sensory and motor function to and from the central nervous system.  And then it also helps to regulate involuntary muscle functions like heartbeat and breathing. So the nervous system is classified in two different ways. So it's that there's the central nervous system that consists of the brain and the spinal cord. And this is the integration and command center. And then you have the peripheral nervous system. And the peripheral nervous system consists of 31 pairs of spinal and 12 pairs of cranial nerves. And the peripheral nervous system is what carries messages to and from the spinal cord and the brain to the rest of your body. So the central nervous system, again, of course, consists of the brain. And at its highest level, the brain can be divided into three parts. The cerebellum, the cerebrum, the cerebellum and the brainstem, which you can see here. So the cerebrum or the front of the brain consists of gray matter, the cerebral cortex and white matter at its center. The largest part of the brain, the cerebrum initiates and coordinates movement and regulates temperature. Other areas of the cerebrum enable speech, judgment, thinking and reasoning, problem solving, emotions and learning. And other functions that the cerebrum regulates relate to vision, hearing, touch and other senses. Now the cerebellum can be considered the little brain and because it's a fist-sized portion of the brain, and it's located at the back of the head, below the temporal and occipital lobes and above the brainstem, which we can see here. Its function is to coordinate voluntary muscle movements and to mean posture, balance and equilibrium. And I found this interesting that new studies are exploring the cerebellum's role in thought, emotions and social behavior, as well as its possible involvement in addictions, autism and schizophrenia. Now the brainstem is the middle of the brain and this connects the cerebrum with the spinal cord. The brainstem includes the midbrain, the pons and the medulla. Now the midbrain is a very complex structure with a range of different nuclei in neuron clusters, neural pathways and other structures. And these features facilitate various functions from hearing and movement to calculating responses and environmental changes. The midbrain also contains the area that's most affected by Parkinson's disease. The pons is the original of four of the 12 cranial nerves which enable a range of activities such as tear production, chewing, blinking, focusing, vision, balance and hearing. Also facial expression. So the name for the Latin word for bridge, the pons is the connection between the midbrain and the medulla. And then we have the medulla here and at the bottom of the brainstem, the medulla is where the brain meets the spinal cord. And the medulla is absolutely essential for survival. Functions of the medulla regulate many bodily activities including your heart rhythm, your breathing, blood flow and oxygen and carbon dioxide levels. And the medulla is also responsible for producing reflective activities such as sneezing, vomiting, coughing and swabbling. It's also important to understand lobes of the brain. The frontal lobe that you can see here is the largest of the brain. It's located in the front of the head. So right through here, the frontal lobe is involved in personality characteristics, decision making and movements. Recognition of all smell usually involves parts of the frontal lobe as well. The frontal lobe contains bronchus area, which is associated with speech ability. The parietal lobe as we can see right here is the middle part of the brain. The parietal lobe helps a person identify objects and understand spatial relationships. The parietal lobe is also involved in interpreting pain and touch in the body. The parietal lobe houses Wernicke's area, which helps the brain understand spoken language. Next, towards the back of the head, we have the occipital lobe. And the occipital lobe is the back part of the brain that is involved with vision. And then we have the temporal lobe. And the sides of the brain temporal lobes are involved in short term memory, speech, musical rhythm and some degree of smell recognition as well. And then we have the deeper structures of the brain that consists of the pituitary gland, also known as the master gland. And the pituitary gland is very important as it's what's known as the master gland, which governs functions of other glands in the body that regulate flow of hormones from the thyroid, the adrenals, ovaries and testicles. We have the hypothalamus and the hypothalamus regulates your body temperature. It helps to synchronize sleep patterns, controls hunger and thirst and also plays a role in some aspects of memory and emotion. You have the amygdala and the amygdala helps to regulate emotion and memory. And is also associated with stress and the fight or flight response when someone perceives a threat, which we'll talk about that more in another slide that's coming up. And then you have the hippocampus and that supports memory learning, navigation and perception of space. It receives information from the cerebral cortex and they play a role in Alzheimer's disease. And then we have the penile gland and this responds to light and dark and secret melatonin, which of course helps us regulate our circadian rhythms and our sleep awake cycle. The second part of the central nervous system we have is the spinal cord. Now the spinal cord is a part of the central nervous system and it consists of tightly packed column of nerve tissues that extends downwards from the brainstem through the central canal of the spine and is crucial in facilitating our daily activities. Examples of these key functions include carrying signals away from the brain, which we talked about in the beginning. The spinal cord receives signals from the brain that control movement and autonomic functions. Also, the spinal cord helps to carry information from the rest of the body, your arms or legs or organs back to the brain. And the spinal cord also transmits messages such as sensations of touch, pressure and pain. The spinal cord is also very important in reflex responses. The spinal cord also acts independently of the brain in conducting motor reflexes, which I find to be very fascinating.  I'm sure we all had a doctor do that to us at some point in time. And these functions of the spinal cord transmit the nerve impulses for movement, sensation, pressure, temperature, pain and more. I also wanted to just make a slide regarding spinal cord anatomy. So the spinal cord comprises of three parts. The cervical, which is closer to the neck, the thoracic, which is when you think about your mid back towards where your chest is and the lumbar lower region, the lower back. Three layers of tissue protect the spinal cord, the dural matter, the arachnoid matter and the pia matter, and doctors call these layers meninges. The layers are as follows. So the dural matter is the outermost layer of the spinal cord's meninges and is a tough protective coating. You also have the epidural space between the dura and the arachnoid space is the epidural space. So this is where doctors may insert a local anesthetic to reduce pain during childbirth and some surgical procedures such as those to operate on the longer and abdominal aneurysm. And then you have the arachnoid matter and the arachnoid matter is the middle layer of the spinal cord covering. And then you have the sub arachnoid space and this is located between the arachnoid matter and the pia matter. The cerebral spinal fluid is located in this space. And sometimes a doctor has to sample the cerebral spinal fluid to test for the presence of infection. So like a spinal tap such as meningitis, they can also inject a local anesthetic into this space for some surgical procedures. And then there's the pia matter. This is the layer that directly covers the spinal cord. Next, I just wanted to show a cross section of the spinal cord. So this picture represents if you would take something and you took a knife and you sliced through the spinal cord and you were looking at it like this. So the spinal cord was your hand and you flipped it up like this. This is what we would be looking at here. Key areas of a cross section of the spinal cord include gray matter, which we talked about. And the gray matter is the dark butterfly shaped region of the spinal cord made up of nerve cell bodies. There's the white matter that surrounds the gray matter in the spinal cord and contains cells coding and myelin, which makes nerve transmission occur more quickly. Nerve cells in the gray matter are not as heavily coded with myelin. We also have the posterior root.  You also have the anterior root. This is the part of the nerve that branches off from the front of the spinal column, the spinal ganglion. And this is a cluster of nerve bodies that contain sensory neurons. And then you have the spinal nerve and the posterior and anterior roots come together to create a spinal nerve. So now we're going to begin to talk about the peripheral nervous system. So remember in the beginning in the nervous system, we have the central nervous system, which contains or consists of the brain and the spinal cord, which we just talked about. And now we're going to talk about the peripheral nervous system, which is the second half of the nervous system itself. And the peripheral nervous system consists of the sensory division, which consists of nerves that carry information to the central nervous system. And then the motor division consists of nerves that carry information away from the central nervous system. Now the peripheral nervous system is then broken down into the somatic and the autonomic. So the somatic peripheral nervous system controls all the voluntary muscular systems and the process of voluntary reflex arcs. The autonomic nervous system that's part of the peripheral nervous system controls all of your vital functions. So breathing, digestion, heart rate, linking, many of all of these things, you know, we're just not consciously aware of. Back up here. Now backing all the way up, like I said, the peripheral nervous system is then broken down into the somatic and then the autonomic. Furtherly breaking down is the autonomic nervous system. Now the autonomic nervous system subdivisions include the sympathetic and the parasympathetic. And now the sympathetic is responsible for increasing activity in most systems. And this is known as your flight or fight response. So as you can see here in this visual, so your sympathetic nervous system is going to do things. So if you were being chased by a bear and you're very scared and you have that flight or fight response, so your body needs to ramp itself up to get away. So the sympathetic nervous system is going to help with that. It's going to dilate your pupils so you're able to see for you're able to see a longer distance and more and more with more depth. It has to inhibit your salivation and also relaxes your bronchi increases your heart rate.  So if you're eating food, you also it stimulates glucose released by the liver. And it stimulates that epinephrine and norepinephrine and that is what you feel when you are afraid. It's that rush of those neurotransmitters and then it also relaxes your bladder. Now the parasympathetic nervous system on the other hand or conversely is responsible for slowing the activity and all of those systems that we just talked about. So this is known as the housekeeping response. So as you can see here, the parasympathetic nervous system will constrict your pupils, stimulate salivation. It will stimulate your digestive activity and it inhibits adrenaline production. So really is what helps you calm down. So when we're talking about the nervous system, we talked about the central nervous system and then the peripheral nervous system. And so we have to talk about neurons and because neurons are all otherwise known as nerve cells.  And then also back from your body, your limbs, your organs back up to the spinal cord and back to the brain. So they're very, they're very important otherwise, you know, none of this would work without them. So there are three main parts or three main structures of the neuron. And you can see here there's the cell body, which contains genetic information. It helps to maintain the cell neuron structure provides energy to drive activities. Then you have the dendrites that you can see here coming off of the cell body. And these are fibrous roots that branch out from the cell body. They're like a teni. Dendrites receive and process signals from the axons and other neurons. And then you have the axons and an axon is a long-tailed structure. And it joins the cell body at a specialized junction junction called the axon hillock. It's also important to know that many axons are insulated with a fatty substance called myelin. And myelin helps to, helps the axons to conduct electrical signals. Now there are three types of neurons. There's sensory neurons and these help you see, they help you hear, they help you smell, they help you taste and fill things around you. You know, they're sensory neurons, so they help with your senses.   And they are the most common type of neuron. And they help to pass signals from your sensory neurons and other interneurons to motor neurons and back. So oftentimes they form complex circuits to help you react to external stimuli. So how do neurons work? So neurons work in two main ways. First is by a chemical response through chemical synapses. So in a chemical synapse, the neuron releases chemical messengers called neurotransmitters and these molecules cross the synaptic cleft and bind to other receptors and then in the other neuron and the receiving neuron and the postsynaptic ending of a dendrite. And then the neurons also work by electrical synapses. And so electrical synapses can only excite. So these synapses form when two neurons are conducted by a gap junction and this gap is much smaller than a chemical synapse and is made up of ion channels that help transmit positive electrical signals. Alright, so I hope that you all enjoyed our first anatomy and physiology lesson here. There will be more to come. Please, you know, reach out to me always with any questions that you might have. You know, if there's something that you need me to clarify for you, you know, I was happy to do that. All you have to do is send me an email. And don't forget that you can also schedule office hours with me if you need a little bit more one on one. So thanks so much, everybody. Thanks for listening and we will see you soon. Bye.


Good morning everyone. We're here at the California State Operations Center where we're looking forward to providing you a briefing about a series of storms that are going to impact broad swaths of our state in the coming days. Behind us, you're going to hear from leaders and first responders from across state government. A couple different ways to interact with us. Many of our colleagues, the media across the state are viewing this briefing today via Zoom. And so we're going to provide you an update where you're going to hear from experts on what the state is doing afterwards. We're looking forward to hearing your questions. And there's three different ways to ask questions today. We'll take questions from any reporters in the room. You may also, for those watching online, may submit a question in the chat or you may raise your hand and we'll call on you and you may ask your question live. If folks have follow-up or want to connect with any of these individual agencies, you may email media at calloes.ca.gov and we'll connect you to the responding agencies. So we're going to start today with an overview of the weather and then we're going to go into a 30,000 foot overview of what California is doing to keep folks safe. So to paint the picture of where we are today, I'd like to bring the podium Eric Shoning from the National Weather Service. Hello, everyone. A strong atmospheric river event will impact the state of California starting this evening and continuing through at least Tuesday. We're expecting significant impacts due to heavy rainfall, heavy mountain snowfall and strong gusty winds. These winds and precipitation will become widespread across the state tonight and Sunday. Areas that could be impacted include the Bay Area and Central Valley, especially on Sunday. That said, the most significant rainfall totals for this event are expected across the central and southern coastline, including the Los Angeles and San Diego metro areas. With this heavy rainfall, significant high impact flooding is likely, including the potential for flooding on many roadways, major rises or flooding on creeks, streams and rivers, mud and rockslides and debris flows. This damaging flooding will be a threat to lives and property. Please, if you come across a flooded roadway, we urge you to turn around, don't drown. In addition to the heavy rainfall, heavy snowfall will impact the mountains with significant travel impacts on many mountain passes and strong gusty winds will bring damage to many areas with tree, property and powerline damage possible. Again, the worst of this storm is expected Sunday through Tuesday with widespread flooding impacts expected across California. Please continue to pay attention to updated weather forecasts from trusted sources and listen for preparedness and action information from local officials. With that, I will hand things over to Cal OES director Nancy Ward. Good morning and thank you for joining us today. As you heard from the weather service, these next storms are going to be impactful and dangerous. And most of the damaging impacts most likely to our coastal and southern regions in the state. They pose a threat certainly to our state and they're the most dangerous natural disasters that we have killing more people from storm damages and flooding than wildfires every year. To keep California State safe, Governor Newsom has mobilized the full weight of the state government. He's activated our state operations center behind me to 24 hour operations. You will hear from my colleagues today their coordinated efforts during these storms. And but we know already that we've mobilized more than 8500 boots on the ground through Cal OES, the CHP, Cal Fire, Cal Trans, the Conservation Corps and the National Guard. More than 7 million sandbags are at the ready with water rescue teams and equipment, high water vehicles and emergency response personnel prepositioned. Sheltering supplies for almost 40,000 people stand at the ready with food, cots, blankets and water. As of today, we're also launching an expanded initiative to call almost 2 million California's that remain in harm's way in our most disaster prone areas. Modeled after a campaign, get out the vote. This effort will contact Californians at risk and will they'll receive life saving, life sustaining messages in English, Spanish, Korean, Tagalog, Vietnamese and Mandarin. Finally, as the storm system comes through the state, we encourage you all to do what you can and do your part in keeping yourselves and your loved ones safe. Stay informed by signing up for our emergency alerts, including warnings and evacuations at CalAlerts.org. Check state and local government emergency operations information through their websites and social media from trusted individuals, even meteorologists in your local news can provide information that will be extremely important to keeping you and your family safe. During high winds, avoid going outside as there are dangerous debris falling tree limbs and down power lines. High winds may lead to power outages. Keep your batteries handy for your devices. Plan for other alternative power sources as you may need them if the power goes out. Avoid non essential travel during the peak of the storm. Don't walk, swim or drive through flooded waters. Do not go around road barriers indicating flood flooded roadways. Remember, six inches of water can down an adult in that water. 12 inches of water can sweep away your vehicle and two feet of water can move an SUV or a truck. And lastly, if your local agencies ask you to evacuate, please heed their messaging. And now I'd like to welcome Karla Nemeth, director of the Department of Water Resources. Thank you, Director Ward. Good afternoon. My name is Karla Nemeth. I am the director of the California Department of Water Resources. The department provides forecasting high water notifications, technical assistance and flood fighting supplies throughout the state. The department also manages our bigger reservoir levy and flood systems in the Central Valley and Sacramento Valley. We have activated our flood operation center as of this morning at 7am. It will be activated for 24 hours a day as we move through this atmospheric river event. We do so in partnership with our colleagues at the federal government, at the National Weather Service, the U.S. Army Corps of Engineers, and all of us together update our local flood control districts and counties around any increases in forecasting or any adjustments in forecasting and what we're seeing in terms of potential flooding in the system. With the department, we forecast river levels at 100 locations throughout the state, and we produce updated forecasts every six hours. Where we are right now is providing flood fighting materials, including almost 5 million sandbags. They have been pre-positioned at 64 locations throughout the state. The department is also providing specific support in areas of potential vulnerabilities, things like what we call muscle wall, which helps our levees that were damaged in last year's storm events. It makes sure that even levees that are undergoing rehabilitation and repair work as recently as last fall, that those levees remain secure. It's important to remember that local flood control districts do patrol levees 24 hours during the day and the night to identify potential trouble locations, and they report those to our flood operation center, and that enables us to work with our federal colleagues to deploy those resources. We do have five locations in California where we anticipate rivers to meet flood stage. That includes the Russian River in Mendocino County, the Carmel River in Monterey County, the Guadalupe River in Santa Clara County, the Ventura River in Ventura County, and the San Diego River in San Diego County. So in addition to the localized flooding that will come from heavy precipitation, we are focused on making sure that these riverine systems have the flood support that they need. We are also looking at about 16 river systems that we think will reach flood monitor stage. So again, it's these six hour updates to our forecast enable us to respond in real time to the potential for changing conditions. If you are in the Central Valley or the Sacramento Valley, you may notice that our flood systems become activated. What's different this year from last year is we do have full reservoirs, and those reservoirs have already started releasing flood water to make space for incoming inflows. So you will see flood bypasses start to activate. That is the system working as intended. So with that, be safe and be smart out there. Please do stay connected to your local resources to make sure that you have the support you need to manage through these series of storms, particularly Californians in Southern California. With that, I'd like to introduce Director Kim Johnson of Health and Human Services. Thank you, Director Nemeth. Kim Johnson, Director of the California Department of Social Services. And across California Health and Human Services, we are preparing for these storms. Our team at the Department of Social Services has prepositioned assets to be able to quickly stand up shelters with our local and American Red Cross partners. The team at the California Department of Public Health is proactively engaging with healthcare partners in areas that are most likely to be impacted to ensure they can both maintain operations and have sufficient capacity. The California Health and Human Services has prioritized our work across 12 departments, including focuses on priority populations. Those who are homeless or unsheltered, older and medically vulnerable, those with disabilities both visible and invisible, and those residing in our congregate facilities are settings both medical and non-medical. We have engaged with our statewide partners to enlist a whole of Health and Human Services community to ensure that we are collectively preparing the most vulnerable in our communities for the weather ahead. I just want to give you a call to action in your own preparation that's not too late to prepare. Please visit www.chhs.ca.gov and download our template for personal emergency planning. This is especially important for those who have access and functional needs. If you are concerned about the well-being of your loved one residing in a long-term care setting, please contact the statewide Long-Term Care Ombuds Crisis Line that's available to you 24-7 at 1-800-231-4024. Again, I want to indicate that we all need help sometimes. If you just need someone to talk to, you're feeling alone, please visit CalHOPE at www.calhope.org or call us at 1-833-317-4673. This is a resource for counselors who will listen, non-judgmental support, and will guide you to additional resources as they're needed. Additionally, for our older adults, our elders, we have established a friendship line and also offer this for you for non-emergency emotional support calls at 1-888-670-1360. Each of us can do our part. As Director Ward said, check in on your neighbor, connect with the older person in your life, and offer support to the person who might need some additional and extra help. We are stronger together. And with that, I'd like to turn it over to Anna Lee Burlew, Chief Deputy Director at CalFIRE. Thank you, Director Johnson. Good morning, everyone. Thank you to our media partners for being here this morning, as well as to our state partners. Appreciate the opportunity to talk to all of you. As Director Johnson said, my name is Anna Lee Burlew, Chief Deputy Director for CalFIRE. So over the last week, CalFIRE resources have been deployed across the state, both responding to and assisting in the preparation and recovery from last week's storms and in response to this week's coming storms. We've had swiftwater rescue teams out throughout the state. An example is in San Diego County where we had two victims that we were able to rescue with our swiftwater rescue teams from vehicles that were trapped in water, in standing water. So I bring this up as a reminder to all of us that as we are going about over the next few days through these storm conditions to ensure that we are not driving our vehicles through waterways with moving or still water that potentially could leave to trap vehicles and require responders to do rescues. In addition, we've been helping our communities, especially in the San Diego area, digging out from the storm effects of last week. We've been working to prepare for the coming storm this coming weekend. Hand crews from CalFIRE in cooperation with our partners at the California National Guard, California Conservation Corps and the California Department of Corrections and Rehabilitations have been out throughout the state filling sandbags and helping deliver those sandbags to vulnerable community members. Over 15,000 sandbags have been filled by our CalFIRE hand crews. CalFIRE will continue to have resources available to respond throughout the coming days. Examples of those include five helicopters with hoist capability throughout the state, four-wheel drive fire engines and additional hand crews. So in conclusion, I ask you all to consider, is your life, the life of your loved ones or the life of our first responders worth driving in flooded waterways or not following evacuation guidance? And the answer is no. So as we are all moving through this next storm system, please be considerate of ensuring that we are all taking precautions to ensure that we are not putting our fellow responders as well as our community members at risk. And we are doing our part to ensure that we are keeping all Californians safe. Thank you. And I would like to introduce a major Matt Bevers from the California Military Department. Thanks, Director Berlu. I am Major General Matt Bevers, the Cal Guard. I think it's important to recognize the extraordinary capability and capacity that the Guard has at the ready to address a range of consequence management challenges that the state may incur. Those capabilities include high water vehicles, engineering capabilities that you saw employed last year at about this time, including aviation capabilities, general purpose forces, filling sandbags and other requirements as needed. These assets are strategically placed across the state to ensure that we can react quickly to whatever contingency wherever the state may need us. And with that, I'll be followed by Director Tavares of Caltrans. Sir. Thank you, General Bevers. I'm Tony Tavares. I'm the Director for the Department of Transportation. Thank you for this opportunity to address you this afternoon. At Caltrans, safety is our highest priority. Keeping people safe on our roadways is paramount for us. And if you don't need to be on the roadways during the storm event, we're asking you to please, please postpone any non-essential travel until after the storm passes. However, if you must travel, please slow down and reduce your speeds. Allow additional time to get to your destination. At Caltrans, we've activated all of our emergency operations centers from Sacramento to Eureka and all the way down to San Diego. Caltrans has also pre-positioned more than 4,000 women and men working around the clock with over 1,200 pieces of equipment to address situations like flooding, mud and rock debris slides, and snow removal. Our Caltrans crews along with the California Highway Patrol will be working around the clock, as I mentioned, to keep you safe. And if you see our Caltrans crews or California Highway Patrol officers on the side of the road working, please slow down or move over to another lane if you can do so safely. In addition, Caltrans may pre-emptively close roadways due to the weather situations. So we're asking you, never drive around any barricades or closed roadways. And if you encounter water on the roadways, never drive through that standing water or flowing water. As has been said already many times, turn around, don't drown. Again, turn around, don't drown. For the latest on road conditions in real-time, I'm asking you to please visit our Caltrans website at quickmap. That is one word, quickmap, or download our mobile application to your smartphone. Again, it's quickmap, one word, and that will provide you real-time roadway information. And in closing, once again, I just want to mention, if you do not need to be on the roadways during the storm event, please stay home, stay safe, postpone your non-essential travel until after the storm passes. And now I'd like to turn it back over to Cal OES. Thank you. So thank you again to the presenters for providing an overview of California's response. And now we're available to take questions from those of you participating on the Zoom. A couple different ways to answer questions. If you'd like to ask a question, you may go ahead now and raise your hand and we'll unmute you. And you may ask a question to those in the room. You may also submit a question via the chat. And so we'll give folks just a moment to do that. Hi, we have one question, Brian, that came in privately. How is California supporting San Diego from last storm on recovery, even as the next storm bears down? So the question for those of you watching online, which is, we had just had a storm in San Diego last week. How are we starting the recovery process for that while this storm begins? And I'll ask the director, Ward, to come up and address that. Since the storms of last week, Cal OES and a plethora of other agencies that you see here have been helping San Diego, not only with preliminary damage assessments for further assistance, but setting up their local assistance center, providing technical assistance and being in their emergency operations centers to help them get through all of the documentation, if you will, that has to happen to get further assistance. The preliminary damage assessment field folks have been out in the communities, assessing the damages not only of individual homes, but of businesses and public infrastructure. Those assessments are wrapping up this weekend. I do know that the county local assistance center has closed as of Wednesday, but the city's local assistance center opened up today and will run through February the 8th, and maybe continued after that, depending on how the storm goes as well. And currently there are two shelters set up. One congregate shelter with 108 folks, and there is a non-congregate shelter option for some individuals through the Red Cross that has seven folks in there as well. All right, we'll take questions from the chat. And again, if you want to ask a question live, you may raise your hand. Another question from the chat. Are there any roads in Los Angeles specifically that we should be worried about for flooding? We'll ask Director Tavares to take that one. Thank you for that question. All the roadways in Southern California throughout the state are a priority to Caltrans. This is a very large storm coming through. It's going to drop a large amount of precipitation in a very short amount of time, a slow moving storm, and therefore there is the possibility of localized flooding on some of our roadways. As mentioned, we have prepositioned many of our crews and equipment, additional temporary or portable pumping systems to be in those localized low-lying areas throughout the Los Angeles and Southern California region. And so we will be addressing any flooding situation as quickly as possible. But as I've mentioned, we may have to preemptively close lanes or the entire roadway if there is flooding and we will do our best to get that open as safely and as quickly as possible. Take the next question from the chat. We have another question asking about whether the Governor is going to activate the National Guard. So the question was if the Governor is the Governor going to activate the National Guard and we'll have General Beavers address how the Guard's already engaged and how that process works. Yeah, as I mentioned before, we have extraordinary capacity and capability across the state, which gives the Governor extraordinary decision space to ensure that that decision is made at the right time for the right reason and places the right assets to achieve the desired effects that the Governor is looking for in conjunction with all the folks that are on the podium today. So I would offer that we are ready and we are able and capable of deploying whatever assets are required to achieve the effects that we need. Thank you. Take the next question from the chat. One more question. Are we in touch with the federal government on any aid? So the question is whether California is in conversation or in touch with the federal government on potential aid and I'll ask Director Ward to come to the podium and address that. The answer is yes, we are and have been since last week's storms. The joint preliminary damage assessments in San Diego include FEMA and the U.S. Small Business Administration to make those damage assessments for residents and businesses and public infrastructure. In our state operation center, FEMA is here, other federal agencies are here, and I can tell you that I personally have a call each day with the FEMA Regional Administrator for Region 9 with an update, sharing information of what their teams are seeing, what we are seeing and providing them an update each day about additional assistance, technical assistance that we may need. Two similar questions in the chat about weather. Is there any storm activity, similar storm activity anticipated in the rest of the month and then also how do these storms compare to the atmospheric rivers of last year? So the questions for those of you who can't hear is whether there's additional storms behind this round of storms and kind of comparing and contrasting with the storms we had last year. Maybe I'll ask the weather service to come to the podium and perhaps Director Nemeth as well. Hi, so I have some good news on the additional storms front beyond Tuesday. We could see some additional showers across the state Wednesday through at least Saturday, but that said, after we get past Tuesday, the rainfall amounts are going to be significantly less than what we're seeing on the early week part of the storm. So we're not anticipating at this time any additional widespread flooding from any precipitation that falls mid to late week. Beyond that, even better news looks like we'll have a break in the storm activity through much of the middle of February. Our outlooks for the middle part of February show drier than usual conditions across the state of California. As far as how this compares to last year, obviously it's different setups whereas last year we had weeks if not months of these series of atmospheric rivers. We've had a couple of storms that have come in recently. We do have some wet ground that will enhance flooding potential, but it's not the longer term setup we had last year. That said, this individual storm has the potential for very significant impacts. So this storm could have just as big if not bigger impacts than any individual storm from last year. And again, for folks who want to ask a question, you may raise your hand in the chat or you may continue submitting them online or via direct message to us. Question on what should folks do to report serious flooding, mudslides, or debris flows if they encounter any? Is there a phone number or somewhere to help inform first responders? So the question on the chat was how can people inform first responders if they're seeing damage, severe mudslides, other impacts locally and how can they report those and maybe I'll ask the Director Ward to answer that. So for impacts that you're seeing in either your localized neighborhoods or around as you travel through your communities, certainly the non-emergency numbers through Caltrans, their numbers to inform officials of what you're seeing. We also know that local responders, local emergency personnel will be out and about. Caltrans district offices will also be out and about. So please let your local officials know through whatever means that you have non-emergency numbers that you can report the damages both at the local level and at the state level for any roads and highway information. And just as we go to the next question, maybe a point of personal privilege on reporting, tweeting, other sorts of things, putting them online. That is not a direct form of communication to the government. If you are in an emergency situation, we want to encourage you to dial 911, report it through official channels. While we are on these platforms, we're monitoring them the same as you. The fastest and best way to get help in a moment of crisis is to communicate that through official government channels, whether it's your 911 system, your non-emergency system, your local police fire department, even the state we're here, but please be thoughtful and want to get you the help you need in the fastest way possible and please follow official channels. Any additional questions? There was a compliment on the phone banking initiative, that's an impressive number, 2 million. Why is it important to be reaching out to storm impacted or prone areas? Yeah, so the question is about phone banking and reaching out to vulnerable populations. I'll talk about it at a high level and then maybe I'll ask Director Johnson just more broadly on how we support vulnerable Californians. We as a state have invested substantially in recent years about how do we keep the most vulnerable members of our communities safe. We know that individuals who may be older, may have disabilities, may speak English as a second language, are disproportionately impacted by disasters. There's no administration anywhere else in the country that's invested the way the Newsom administration has invested in protecting vulnerable populations. That's something that's come directly out of the campfire and something that we think about every single day of how do we keep the most at risk members of our community safe and disasters and the folks behind us in the State Operations Center are working 24 hours a day because we don't want to see any loss of life at all and that's a big part of the work we do to support all of our community and it shouldn't matter how much money you have in your bank account, what your address is, we want to support you and keep you safe during disaster and maybe I'll bring Director Johnson to the podium to talk a little bit more about that as well. Glad to and I'll just also mention the license settings across California, adult and senior care settings, child care settings, children's residential settings, skilled nursing facilities, both the Department of Social Services and the Department of Public Health have been proactively reaching out to all of those operators in the impacted area to ensure that they're aware of the weather events. All of those settings are required to have disaster planning and preparation in place so we're also ensuring that in our regular inspections and visits and that it's up to date and we have those opportunities to ensure evacuations can happen as they're needed. We certainly, again, if there's any relocation needed of those that are in those settings, again, want to indicate as I did earlier, there's the phone line if you're worried about your loved ones to check in on where those temporary relocations are. That's something we also post on our website so I want to offer that as well. And as it involves unsheltered populations, specifically, a lot of outreach is being conducted right now and has been over the course of the last week as it is regularly with the investments that have been made by the governor and legislature in this space to ensure that we are connecting with those who may be currently by rivers and other places of impacted areas, getting them connected to any potential sheltering and housing opportunities that we can. So, again, a very proactive effort on all of these fronts to inform and share information about keeping themselves safe. And we have time for about one more question that we'll take through the chat. As a reminder, you can reach us 24 hours a day if you have questions at media.caloes.ca.gov. There's news desk at all of the agencies you see behind us who are available for you if you want one-on-one interviews or updates on what's happening, so we'll take one final question. Just a take-home message, what should people do today to get ready ahead of tonight? So the question is, we've talked about this storm coming in. What should people do today to be ready in advance of the storm? And maybe I'll call Director Ward to the podium to kind of answer that. And close this up. Okay. So first and foremost, have an emergency plan. Ensure that your medications, your batteries, pet food, that you have all of those things at the ready should you need to evacuate. But if you are hunkering down and staying in, ensure that you, as was said earlier, that if you don't have to travel that you're not out and about during this storm. This is a very, very dangerous storm. So take care of yourselves, your loved ones. But as Director Kim Johnson mentioned too, please check on an elderly neighbor, those folks that you know that may be homebound, that may not have the resources or the understanding of what they need to do. Bring them into your homes if you can or check on them regularly. But be prepared for this storm. There's lots you can do even in the time that we have left as the storm starts to impact California this evening, that you can be to be ready and have your plans in place. And with that, thank you all for joining us today. And if there are other additional questions, as Brian said, there's always 24-7 contact with Cal OES. Thank you.