Immunity & Covid-19 with Dr. Wang on KXFM

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Dr. Anita discusses the process by which this coronavirus attacks the body via ACE2 receptors, and makes an interesting analogy that easily explains the process and what we can do to reduce our risk. She regularly discusses important health topics with Ed Steinfeld on KXFM Radio.

Highlights from previous interviews

Ed Steinfeld:
Welcome to the program. It’s the Mornings with Ed Show and Dr. Anita Wang, an Emergency Medicine MD and integrative medicine practitioner here in town has been doing amazing work. She started doing it because there were many patients that she had cared for in the emergency department had requested her help longer term. She’s spent over 30 years as an ER doctor, previously at UCLA Medical Center, Eisenhower Medical Center, and St. Mary’s Medical Center. Dr. Wang has a litany, a long list of accomplishments. She was also the team lead in the Beijing 2003 SARS outbreak. So she knows a lot about what we’re about to cover this morning. We welcome to the program, Dr. Anita Wang. Thank you for being here this morning.

Dr. Wang:
Thank you for having me. It’s truly an honor.

Ed Steinfeld:
Well, let me tell you that if ever we needed to talk to an expert, it is today. It is this very moment in time. And if, if I may just get right into it. You do amazing work here in town with wellness. A lot of covid-19 patients who recover, continue to struggle with symptoms after recovery. What’s the importance of a resilient immune system in recovery? And are we as Americans short circuiting ourselves with our fast food society that we live in?

Dr. Wang:
National data has listed 12% of us as healthy, an appalling small percentage. And it’s really called the “hidden hunger” in this country because we have you know, we have abundance here. Jean Mayer of Tufts University set out to eliminate malnutrition in the United States. That was 50 years ago. He is credited for dramatically improving our country’s food and nutrition policy to reduce hunger among low-income Americans, including successes like the expansion of Food Stamps, expansion of the National School Lunch Program, etc. Unfortunately as a result we have gotten much less nutritious food. So our food may be nutrient dense but not nutrient rich.

People are also eating things that are empty calories, so they are not nutrient rich. As a result we have obesity among individuals, but also these very large people who are malnourished. When you are malnourished in this country, you don’t necessarily have a disease for example. We know that if you don’t have enough vitamin C, you end up having scurvy, right? We’re not talking at that level. It’s called a clinical deficiency where your cells are not getting what they need and nutrients to work efficiently and effectively, and to have a strong immune system — to be immune resilient.

Our bodies are constantly battling infections and viruses all the time. There are 8 to 10 nutrients that are really most important for fighting infections. And they do it by three different mechanisms. One of those ways is by direct effects against the protein. We talked previously about how this coronavirus enters the body and then through the ACE2 receptor, which is the repair site. And if you ever heard me talk about it, I talk about the your body being the highway and the Cal-trans on the highway (from the 4/23 Interview) and the ACE2 is their repair site, which is a normal healthy process.

And then I talk about how they, the little white T-cells, the white trucks, that come in, then the pavers come in, but they’re kind of warped. If they’re warped, they’re not great at paving, right? Your body’s not going to repair that site. They can’t quite smooth out that site. Right? So that’s the nutrient deficient product. They got some food and they go, “Oh my gosh, there’s no zinc in there!” When there’s no zinc in there, then it can’t actually bind to the protein in that site. So they can’t really move that area out without the zinc. The zinc, for example, inhibits the virus from being able to use your protein at that site to replicate. If you don’t have enough zinc, the virus can get in.

Now also, quercetin, found in broccoli and onions, and also blocks the protein and the ACE2 receptor sites. So that’s one only one mechanism.

The other mechanism is that these 8 to 10 nutrients actually help to improve your ability to kill off pathogens so the immune system works more efficiently.

And then the third effect is that these nutrients dampen these inflammatory responses. So the repair sites where the repairmen are working are blowing off steam and smoke and all that — that’s normal inflammation. When you have enough nutrients, your body can dampen that inflammation down. In unhealthy bodies, we see the cytokine storm where the immune system is producing too many inflammatory signals, sometimes leading to organ failure and death.

Ed Steinfeld:
And inflammation is as big an obstacle as we have here. Right?

Dr. Wang:
That’s what I believe. And this is where you’ll see the difference between conventional medicine and functional medicine. I’m not bashing one or the other. I practice both and I think that you need them in conjunction.

In health, I think that many people are seeking the answer, right? I always like to compare it to traveling (which we can’t do right now, sorry). If you look at traveling and you’re deciding where you’re going to go, some people say, “I’m just going to go down to the next city.” Some people think, “I’m going to go around the world.” Each person asks themselves: how am I going to get there?

And so then you’re going to decide: I’m going to walk there. I’m going to take a plane. I’m going to take a bike. I’m going to swim there. I’m going to take a boat. Different methods. How long are you going to go, how far you’re going to go. Those are the ways that you can travel. Well in medicine and health, there are many different practitioners and many philosophies of medicine. You’ve got your acupuncturist, you have your Chinese herbalist, you have your holistic, naturopath. You have your functional medicine, you have your conventional medicine. I think each and every one of them is valid, but they have to go with the way that you want, how you want to attain your health. And conventional medicine has slowly recognized inflammation, whereas functional medicine has recognized inflammation as a measure of health for over 30 years.

Functional medicine recognizes that a certain amount of inflammation is a normal, natural process. But when it becomes too much, it becomes deleterious to your body. And when you have someone who is obese because too many fat cells, as I was always used to go back to my Caltrans, when they’re digging up and throwing out those extra large pieces, the jackhammer guy is really getting in there. And then that little paver guy who’s a little warped and they go work on the extra fat cells — they’re in there churning out inflammation in the process constantly. So that’s where you’re going to see that.

So that’s why with Covid, you’re seeing most of the people with severe reactions to it with obesity because they have a lot of inflammation. And when you have too much inflammation it is causing a lot of problems and causing the cytokine storm especially in the lungs, so you kind of drown in your own mucus. There’s just too much going on in there.

In the body’s recovery phase — I want people to have a lot of hope because we’re all going out and getting back — it takes only a few months to change your metabolic cellular strength. So you can have immune resilience. And that’s what we want. I want your immune system to be able to combat anything it encounters.

And so that’s why you hear about Covid all over the board. “No, I just had a little runny nose. I didn’t have much,” against others who are succumbing to it. So it depends on how resilient your immune system is to fight this off. You can change that by changing your diet. So if you’re a Big Gulp drinker and you eat a lot of pastries in the morning and you know, pasta at night and there’s no colorful fruits and vegetables on your plate, you may be more at risk.

Ed Steinfeld:
Now, before I ask you the next question, let me ask you about supplements. So let’s say, let’s say I’m looking to get more zinc. Should I take a supplement or am I better off eating some type of green food or something that would give me zinc in my food? Where, where, how, how will, how will it serve me best to take my zinc?

Dr. Wang:
I have a simple one-liner: test, don’t guess. I don’t know how balanced your diet is. I don’t know how well your gut is absorbing. I don’t know if your microbiome is working well, so we’d have to dive into everything. It depends on where you are getting your food, how nutrient rich those foods are. But it’s generally, I think, best to get it from your foods. If you have good quality food and you eat a diverse group of foods, you should be able to get it in your food. But so to be able to know, you need to test, right? I recommend all my patients test once a year. We check all those micronutrient levels, we check to see how well you’re detoxifying, and how well you’re absorbing. Any one of those factors can throw the entire balance off.

So my pescatarians because they’re more at risk at collecting mercury, we’ll always try to stay on top of that. And my vegetarians’ creatine is going to be down, so they’re going to need to have supplements on that because there’s no plant source for that and we need that amino acid and they can’t get that. So they have to have to supplement.

Then there’s genetic defects, the mutations that you have. And when you know if you have a poor methylation and you can’t do that last detoxification pathway, which is a methylation, you’re going to need a supplement for that in that specific supplement. (DNA methylation is an example of one of the many mechanisms of epigenetics. Epigenetics refers to inheritable changes in your DNA that don’t change the actual DNA sequence, which means these changes are potentially reversible.) So there are certain ones, and if you, once you’ve tested, you’ll know certain supplements which you have to take. And then you may choose to take certain supplements if you’ve been eating poorly and know you aren’t getting through diet alone.

The bottom line is that the best way is to find out for your particular body what it is that you specifically need.

Ed Steinfeld:
In your best estimate is 12 to 18 months for a vaccine just wishful thinking? Is it possible that we don’t discover a vaccine at all for this?

Dr. Wang:
I think that is yes to both of those. I’m more hopeful because we’re so far more advanced than with SARS because it took them from 2003 until 2007 just to get through phase one vetting. So we’ve already gone through phase one and now we’re into this phase two. But I think that there’s a lot of questions about how safe it is and how effective it’s going to be. And if they can do it and they want to turn around that rapidly, I just don’t know that we can actually do that.

I think the better advice to people is not to rely on, medicines and vaccines and hospitals and doctors alone, but to rely on taking care of your body and being resilient and let your body do what it can do naturally and you need to fortify it.

And that’s an easy fix. Eat colorful food. Eat herbs. Eat vegetables. Eat fruits. Lower your sugar count content. Don’t eat so many empty wheat products — cakes and cookies and breads and pastas and pieces and things. And I’m not saying that you can’t eat those things because certainly I still eat them, but I think that you have to be modest and you have to be able to know where your body is and, and you can change.

When you look at conventional medicine, when they take a morbidly obese person and they do a gastric bypass, they don’t lose that weight overnight, but in a few months their diabetes goes away. Why is that? Because they can’t eat as much of the bad stuff. They’re starting to eat good stuff. They’re monitoring their nutrition and they’re making sure what they get in there because they can’t eat as much. So they’re being watched closely and their diabetes goes away in a few months. Well, that’s the same thing that we can do if we just change our habits here.

Ed Steinfeld:
Thank you for the very clear and coherent view there. As I walk around, I find myself getting upset when I don’t see someone wearing a mask. Are masks are our future for the next year or so. Do you think, do you think that’s the answer for right now?

Dr. Wang:
Well, I think there’s going to be a new normal and I think that people need to understand that any time that there has been a major pandemic of the things that have extended lives and have prolonged life it’s not been our modern medicine, modern medicine has extended our lives maybe three years. But back on when we lived up to 40, it was sanitation, public health. So public health is what has prolonged our lives where we had sanitation. We cleaned, we paved the streets, we made sewers, we made clean water, right? So it is public health and what this pandemic has shown, which has been my pet peeve for many years because every flu season is my pet peeve. We do not have a good respiratory etiquette in this country and we and we are a very strong dynamic.

We’re a can-do country and we work until we drop dead and we will share our germs with our coworkers. In one study, 35% of people who were sick went to work. What about when we’re not in a pandemic? I think a lot more people will go to work when they go, when they’re sick. And I think that the thing that we need to change is our respiratory etiquette. That is the next public health thing that has come about. And if that means face masks, then we need to do face masks. We need to be supportive. If you say “I’ve got a cold and I need to work remotely, I’m going to come to the meeting today through a remote,” I think we should allow that to happen.

So there’s a lot of changes and I think it’s going to have to happen because the respiratory illnesses don’t go away. We just don’t care that on an average year, 40 to 60,000 people die of the flu. And I think as of April 4th, it was, Oh, 62,000 and now is probably, it’s been, I heard an unknown, you know, estimated to be 80,000 of the flu. But because the flu was not overwhelming the healthcare system, no one batted an eye. For me as an ER doctor, every flu season, we are overwhelmed. People are coming in droves and there’s nothing that we can do with them. We tell them, go home, hydrate, take your Tylenol, you know, wait it out. And then the sicker ones we admit. It’s the same thing that’s happening. But with Covid, this may be the next common cold that causes people who have morbid comorbidities to succumb to that. Right?

We need to take care of each other. So if you have a respiratory illness but you feel well, you wear a mask if you go out. Or if you wear a mask because this person has low immunity. Or this person is taking care of their 90 year old person, or this person has a child at home with cancer. And they need to be healthy. So we need to just be compassionate and empathetic that people are wearing masks

Ed Steinfeld:
And we really need to re-educate ourselves on respiratory etiquette — etiquette manners, as you say.

Dr. Wang:
Yes, to have respiratory etiquette. So you’re going to make sure you sneeze into your arm. If you think you have something, let’s not shun people when they wear them. Also if everybody’s wearing a mask, we may get some of that herd immunity effect. I think we need to be more open about it and be more accepting of it, be more empathetic to people and understand who are they taking care of, what’s the story behind that mask.

Ed Steinfeld:
Thanks for giving us great information and clear data. They’re just fantastic analogies. I want to talk briefly about the work you’re doing here in town. We spoke a little bit about your work in strengthening the immune system and making sure that our immune systems are strong. I want to talk about some of the groundbreaking work that you’ve been doing in the field of incontinence and a lot of us don’t think about that. But you have been doing some groundbreaking work in the field of incontinence. Can you tell us about it?

Dr. Wang:
Yes. Well, you know, I see people at their worst in the emergency room and many people will come in and they’re always there and no one speaks about it and they don’t really go to their doctors. And talk about it. A really small percentage of women and men will even mention this. This is just like a hidden embarrassment about this. They’re leaking or they’re afraid that they smell or anything. And I see that in the ER and the ER a lot and they say, Oh, sorry, I didn’t, I didn’t have my change of clothes or I didn’t get to change his pad and I’m leaking. And the worst thing that I also see is prolapse rectums and prolapse uterus. You know, I have to reduce those and put them back in. When you have, your pelvic muscles are so weak, they can’t hold your internal organs.

And you know, people think about having a strong bicep, but nobody’s really thinking about the pelvic floor, right? So the pelvic floor muscles, they’ve gotta be strengthened. We talk about the kegels and doing those. But truthfully, how often do you really do that though? You know, everybody thinks about it for a little bit. But as you have a strong pelvic muscles, you know, you’re going to have enjoyments in your your sex life, which everyone should continue to having on even up in the up years. And when you have a strong pelvic floor that you are going to be able to enjoy and enjoy that part of your life, quality of life and having a strong pelvic floor.

There’s either in conventional medicines you have either by medications to reduce the urgency to go or it was by surgery, by supporting those things that have fallen by putting mesh and lifting them up. But now there is this new technology. It’s only a three week treatment, twice a week called Emsella. In each treatment, you do the equivalent of 11,000 kegels in 28 minutes. And what it essentially is this just the muscle building and the pelvic floor muscles that you don’t contract and you utilize constantly and it builds them up.

One of the side effects is you know, better quality sex. It may also help with erectile dysfunction, as a side effect because some of that is muscle contraction, right? But stress incontinence, which is actually when you cough and sneeze go running, you leak when you have to get up in the middle of the night, you have to constantly get up. I have my patients, who come in because they say they get up every two hours. “I’m not getting any sleep cause I’m up every two hours.” Afterwards, they say, “Thank you. I’m sleeping through the night. I went to bed at 10. I got up at seven. I slept through the night.” They are so happy. People are able to finish the round of golf now because they don’t have to keep stopping for bathroom breaks. They say, “I can finish a movie.” These types of things you don’t always think about: incontinence could ruin your sleep.

Ed Steinfeld:
It can actually affect the rest of your health by not getting enough sleep. It’s just a never ending circle.

So you’re involved in something called face masks for all here in Laguna. What, what exactly are you doing with them?

Ed Steinfeld:
Okay. Dr Anita Wang, I can’t tell you how grateful I am. I know you’re busy and I appreciate your time. I know it’s valuable.

If you need to contact Dr. Wang, it’s info@AnitaWangMD.com. Dr. Wang, thank you so much for your time with us today.

Dr. Wang:
Thank you for having me. It was my pleasure.

Ed Steinfeld:
We’ll look forward to talking to you down the road. Thank you very much.

Dr. Wang:
There is a project that’s going on called FaceMasks4All and I’ve joined with other businesses here locally to get a face mask to every residents of Laguna beach so that they would have a good quality clean mask that they can use. And hopefully we can also avoid the stigma and change that stigma of it and get everyone a mask that they can use.

Dr. Wang on KXFM Radio

Listen to KXFM Radio Mornings with Ed to hear Laguna DJ favorite Ed Steinfeld speak with Dr. Anita Wang, MD, about her ER experience dealing with COVID and how she feels that now can actually be an ideal time for individuals to take control of their health in a whole body, holistic way.

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