Dr. Patrick: You've dove into a little bit about the effects of heat stress in terms of sauna use on the immune system and lung function, respiratory tract infections, which is also very relevant now.

Dr. Seheult: Yes, exactly. So vitamin D gets me excited, talking about sleep gets me excited, but nothing gets me more excited than talking about this. This is really amazing stuff. Because I have a feeling that it could be helpful in COVID-19. It makes plausible sense. Let me tell you the evidence for that just sort of offhand. Okay.

So I said at the beginning that you've got to look at COVID-19 as a timing issue. Early on, in the disease we've got good evidence now, from immunologists, that SARS-CoV-1, SARS-CoV-2, and MERS, all three of those, they kind of act the same way in that early on in the disease, they suppress the innate immune system. So there's two parts to your immune system. There's the innate immune system that's sort of the garbage collector that goes around looking for stuff that shouldn't be there and eating it up. What are the tools of that innate immune system? Fever is a big tool of that innate immune system. Interferon, the substance called interferon, there's gamma-interferon, beta-interferon, and alpha-interferon, all of these things are the tools of that innate immune system. The other part of the immune system is the adaptive immune system, that's B cells, T cells. That's what we're using with the vaccination.

What I'm talking about is the innate immune system. And early on, this virus suppresses the body's ability to mount that response. The thing about the innate immune system is it's very robust in children. But as you get older, its efficacy diminishes with time. So that's why we see fevers all the time in pediatric populations. They get a virus, they get a fever. But we're not seeing the fever so much in the adult population, and certainly not as much as we would expect to see in SARS-CoV-2.

Now, that being said, as the virus, using various techniques, proteins, things that it does, as it suppresses that immune system, you get this low-level of viral infection that goes on for days. And then finally, the adaptive immune system kicks in and you get this cytokine explosion that ends people up in the hospital with pneumonia. So again, it's a timing issue. The question is in COVID-19, do you want to suppress the immune system or do you want to elevate the immune system? And the answer is yes. Because you want to enhance the immune system at the beginning so that it gets rid of the virus. But notice that all the things that work late, like steroids suppress the immune system. So you got to be very careful about which phase you're looking at.

Okay, so what they've done, there's a couple of papers that were published in Science about a month or two ago. They could explain 14% of all of the severe cases in their cohort, based on two findings. One was a bunch of genetic mutations that basically left the subjects hamstrung in terms of secreting and producing interferon. So interferon production is a complicated system, there's many genes involved with it. And in many points along that pathway, there were mutations that basically caused the interferon secretion levels to be nil. All of those mutations were found only in the severe COVID-19 patients. Okay? Did not find any of these in the mild patience. So again, there is some causation there, like you were talking about before with the SNPs in vitamin D.

The other one that made up about 10% was older patients that had developed antibodies to interferon. So essentially, their interferon levels, even though they're being produced, they were being inactivated. All of these patients that had antibodies against SARS, or against interferon were in the severe, non in the mild to moderate group.

So what they determined was, and other studies have borne this out, that in order to predict a mild to moderate course of the disease, you have to have an adequate interferon response early on in the course. And you wanted to have that to lead to a mild to moderate. If you did not have a good interferon response early on, that would lead to severe disease in almost all of those cases.

With that in mind, what I started to do was look at a number of things. Number one, looking at heat. So there was a number of studies, actually, that have been produced, some at the University of Toronto, some also in other centers as well, that showed that if you take human beings and heat them up in a hot water bath, 39 degrees centigrade, the purpose of this is not to kill the virus, the purpose of this is to enhance the immunity. And what they found was that they were able to, independently of these potential mutations that fever or temperature itself was able to cause a secretion in elevation in interferon, tumor necrosis factor, those sorts of things.

There's one study that they did, where they took subjects, put them in hot water baths at various degrees, so 38.5, 39, 39.5, etc. And when they took the monocytes out of their body and put them on the petri dish and exposed it at various temperatures to LPs, which is lipopolysaccharide, which is a universal activator of the immune system, that interferon levels were 10 times higher once they got up to about 39 degrees centigrade, or celsius, which is around where you start to have a fever. So lots of plausibility there.

Okay. So now what we did is I looked back in history and I thought, well, maybe if we started to heat up their bodies, maybe there could be some immunity. Think again about the fact that 80% of all symptomatic COVID-19 patients, 80% never need to go to the hospital. Why? Because their innate immune system does the job. It takes care of the virus. Twenty percent end up going to the hospital. If we could somehow increase that 80% to 85% ,90%, that would have a huge impact on the number of people that are seeking medical attention right now in the hospitals.

So I decided to look back. This is not new. Rhonda, this is not new. In fact, a Nobel Prize was awarded in 1927 on something just like this. So the doctor's name was Dr. Wagner-Jauregg, he was a Austrian psychiatrist who had, basically, an insane asylum in Austria. And at the time, there was a number of neurosyphilis patients that was in his insane asylum. And what he noticed in observation was that when they came down with a fever, their symptoms got better. So he had this idea. At the time they had the treatment for malaria, they had not discovered penicillin at this point. Penicillin is a treatment for neurosyphilis now.

So what he did was he on purpose infected these neurosyphilis patients with malaria. Sure enough, started to develop very, very high fevers, anyone who knows malaria knows that they cause very, very high fevers. And essentially, he was able to cure these patients of neurosyphilis, just based on inducing fever in these patients. He then treated them with the treatment for malaria, and these patients were cured. So in 1927, he won the Nobel Prize in Medicine for just this work.

Now, he didn't come up with this in a vacuum. Prior to this, and if you look back at history, and especially here in the United States, probably in the late 1800s, there was a man by the name of Dr. Jackson who was living in New York in the northeast, he was a physician. And looking back and studying as a physician, he had this idea that by using hydrotherapy, in other words, hot towels, hot things, by increasing the body temperature, he could improve the outcomes of a lot of his patients.

And at the time, there happened to be, this was probably around 1860s,1870s, there was an outbreak of, I forget exactly what it was, it was a respiratory disease, diphtheria. That's what it was. There was an outbreak of diphtheria. And he used this and it was very well published in New York. And there was an author at the time that was living... She was not an author at the time, but she was living at the time, by the name of Ellen White who had two children that were affected by this outbreak of diphtheria. And she carefully studied what Dr. Jackson had done. She implemented it in her own kids. And basically, it turned this epidemic into nothing to really worry about because this had become very famous... In fact, Dr. Jackson made a center for hydrotherapy, and he was treating many, many people and having great results.

Turns out later that a man by the name of John Harvey Kellogg, who you may know as the author of many breakfast cereal, went to medical school, his medical school education was funded by this lady Ellen White. And this man became a very large visionary on using natural remedies, hydrotherapy. Turns out, he built this very large sanitarium in Battle Creek, Michigan, called The Battle Creek Sanitarium where the luminaries of the time, including Franklin Delano Roosevelt, including JCPenney, Amelia Earhart, a number of these very, very well-to-do people would come to the sanitarium. And he was doing hydrotherapy where they would heat up the body and treat all sorts of diseases. Well, this spread around in the northeast.

And so we come to the time, I'm sort of bringing it to this conclusion here in 1990, and during the epidemic. So there was the flu epidemic of 1918 and 181 in the United States. Now, remember, this is before oxygen. This is before randomized placebo-controlled trials. This is before the discovery of penicillin even. There was sort of two thoughts about how to treat this pandemic or this epidemic of the flu. And as these soldiers were coming back from World War 1 and bringing the flu with them, there was a lot of Army hospitals that were treating these patients. And the thought was that it was the symptoms of the flu that was killing these patients. Well, we knew how to treat fever by giving aspirin. Aspirin had just been discovered in 1899 by the German company Bayer. And so a lot of Bayer aspirin was being used to get rid of fever, to get rid of symptoms. And we knew exactly how that went in the army camps. That was the one way of treating it. The other way of treating it was by doing what we've just been talking about, which was rest, sunlight, fresh air, and hydrotherapy. And this was the type of pattern that was being used in a number of sanitariums in the northeast of the United States.

Well, I stumbled across an article that was published in 1919 By Dr. Ruble [SP] . Now Dr. Ruble was the medical director at the Boston New England sanitarium. And what he wrote was he said, you know, this epidemic has given us a fine opportunity to see if there is a difference in terms of our therapies. He called these rational therapies. And so that's exactly what he set out to do.

And what he did was he collected the data from all of the 10 sanitariums that he knew about in the northeast of the United States, and compared them to what was going on in the sanitariums or in the army hospitals at the time. So what he did was basically say, which one is better? Is it the treatment in the army hospitals with the aspirin where we're trying to kill the fever? Or is it in the sanitariums where we're trying to basically increase the body temperature with hot towels and hot foot baths and things of that nature? And just a point, the things that they were doing in the sanitariums. There's nothing there that we couldn't do in our own homes today. I mean, we've got hot water, we've got all of these sorts of things.

So he did that. And what he found was a couple of things. Number one, he found that there was two phases. There was the early phase and the late phase, just like we have with COVID. He found the same thing with the flu. And the thing that demarcated that was exactly what we have with the COVID-19 and that is pneumonia. So the practice in the sanitarium was if anybody came down with any kind of symptoms, period, there's no need to test. You just immediately start hydrotherapy, you immediately start sunlight, you immediately start fresh air, and bed rest. That was the key for the sanitariums.

When they did that, and this was a number of about 446 subjects, only 2% of those subjects went on to develop pneumonia. Only 2%. He was able to get the data from the army hospitals. And in the army hospitals, about 20% of the camp came down with the flu. How many of those patients with the flu went on to develop pneumonia when they got aspirin, and they got all of these other things? Sixteen percent. So eight times the number of people in these army hospitals had pneumonia.

Now, when you looked at pneumonia in both the army hospitals and the sanitariums, the mortality from there was about 40% to 50%, in both. So it didn't matter. Once you had pneumonia, the damage had already been done. And so when you look at the infection fatality rate in the sanitariums, it was about 1.1%, whereas, the infection fatality rate in the army camps was about 6.4%. So it was a fraction of that.

So obviously, this is a different time. This is a different practice. This is a different disease. But it's the same immune system. And the very fact that hydrotherapy and heat can cause potentially an increase of the very thing that's lacking that we're seeing early on in the COVID-19 course gives me pause that there is biological plausibility that hydrotherapy, early on, while you're supposed to be sitting home and waiting for you to get sick enough to go to the hospital may impact and change the course of the disease so that you don't have to go to the hospital.

The reason why I find this particularly attractive is because there's no company that has to make hydrotherapy. There's no rationing of hydrotherapy. You don't have to leave your home for hydrotherapy. You practicing hydrotherapy doesn't take away the ability from somebody else to do that. All of those things are the same problems though that you have with ivermectin or hydroxy, or any other medication that might have to be produced and be distributed. This is something that everybody can do. And it's also got very, very low risk.

So I, I think, and actually, I am working currently with an institution up in Northern California called Del Mar that is looking into this. And we have actually done a pilot project with students on the campus to do hydrotherapy to see if it will... We're measuring markers, we're measuring inflammatory, it is not a randomized controlled trial in any sense. But we're trying to get more data to see if this is a plausible way of dealing with this. And, of course, this would not be affected by the viral mutations or anything like that. It's a way of teaching the immune system or revving up or enhancing the immune system to deal with an infection that is suppressing the innate immune system.