Your “No B.S.” Guide to COVID-19 – Dr. Russell Miller MD. [Podcast]

Johns Hopkins University COVID-19 Resource

In this episode of Sound Health, Jim sits down yet again with friend & colleague, the brilliant Dr. Russell Miller—a family medicine doctor of nearly 25 years.

Today, we’re covering the COVID-19 pandemic.

In his typical fashion, Dr. Miller tells it like it is.

He sets the facts straight when it comes to:

• The severity of COVID
• Social distancing
• Masks
• When to go to the ER
• Ways you can strengthen your immune system
• A world post-COVID

Stay informed. Stay healthy.

Transcript

DR. RUSSELL MILLER:

I have become more aware of the need for quiet time, meditative time, reflection time. And how it’s hard, sometimes we’re too connected on this—especially in my profession—there’s texts and there’s social media and there’s a pager. Yeah, I still carry a pager because on the wilds of Pennsylvania, cell service sucks… but home telephone, email, all that stuff… It’s so very hard to unplug and getting out to nature. 

I live in the area I grew up and stopping by the church where I grew up in, and it’s unlocked. There’s nobody’s there but having that space or that sense of the sacred to me, that’s my relationship through it. It’s good because it helps you put things in perspective a little bit. I think in terms, of you know, this is awful and terrible to deal with but on a long enough timeline, things change.

JIM DONOVAN:

Before we get started, I’d like to invite you to take advantage of a free resource I made for you. It’s called the Sound Health Newsletter. In it, I shared the latest research in music and health plus you’ll learn music and wellness exercises that you can use every day to feel your best. Just come visit me at donovanhealth.com to get started today. That’s donovanhealth.com.

Hey there, this is Jim Donovan. Welcome to the show. I am so glad you’re here today. We have a very special episode today about COVID-19 with my dear friend and colleague who is literally just on the podcast, Dr. Russell Miller. Dr. Miller is a family physician with special interest in behavioral health, geriatrics, Lyme disease and complementary and alternative medicine.

He’s here today to help us unravel the COVID pandemic and to give us some best practices on how we can keep ourselves and our families healthy while we’re home bound. 

Russell, thank you so much for coming on this show today. A lot has happened between the last time we got to sit down together. How are you doing today?

DR. RUSSELL MILLER:

Doing all right. Glad to be here, Jim. Thanks for asking me back.

JIM DONOVAN:

Now, how are you dealing with seeing people? Are you still in the office or what’s going on with that?

DR. RUSSELL MILLER:

Well, when this happened, started escalating in the United States back on March 6th or so, paying attention to that and the evolution of it. By the 13th of March, I started looking at how to rearrange the office to keep myself and my staff safe and my patients safe. So by the 16th of March—Monday the 16th—we started using Telehealth visits, which luckily, the government, Centers for Medicare Services CMS relaxed some of the HIPAA guidelines and regulations to allow us to use things like Facetime and Google Duo and such things to be able to connect with patients virtually rather than having them physically in the office and thereby exposing them.

So our practice has gone from 100% traditional model, if you will, in terms of people coming to the office and being seen to nearly 100%, 99+% Telehealth, where I’m evaluating people and giving them advice via video and audio synchronous to chat. It’s working out okay. It’s better than exposing everybody and hopefully, it keeps people as healthy as possible and keeps treating their other ills that are not COVID-19.

JIM DONOVAN:

Yes. Now just for people who didn’t hear the other podcast with you, you are a physician out in sort of West Central Pennsylvania in very rural area of a town called Patton, PA. Now, are there even any cases out there?

DR. RUSSELL MILLER:

We have this feeling that morality protects us from some of these things and to a degree, it does. However, I just definitively had a diagnosis of my first patient in the practice on getting results back Saturday morning actually… 20th of March. And there’s three other people who are very suspicious for it but they’re not sick enough to test because we have a lack of testing materials nationally, as well as specifically locally, of course.

And I have another 15 to 17 who are quarantined because of travel or exposure to possible, or in the case of my one patient, his whole family is quarantined because of him being positive. So it’s real, it’s here, it’s not just some urban suburban illness of bunches of people clustered together. It’s a morality as well.

JIM DONOVAN:

I think there’s so much information going out on different television stations and radio stations and what I want to try to do today is kind of cut through all the noise and just get to the important stuff. I know I appreciate that. I’m sure the audience would appreciate that. 

So what is the big deal about this particular strain of the flu, the COVID-19. Why is this so different than anything we’ve seen before?

DR. RUSSELL MILLER:

Well, it’s a false thing, really, to say that it’s a strain of the flu.

JIM DONOVAN:

Sorry.

DR. RUSSELL MILLER:

Yeah, it’s okay. Coronavirus is its own family of viruses and we’ve had other viruses from that family infect the human beings. 

We’ve had the SARS and MERS, which we had problems in the past, in the 2000s. However, this particular strain of Coronavirus has never been in the human population before. That’s why they call it a “novel” or “new virus.” And because of that, no one has immunity to it.

So there’s a concept called “herd immunity.” And it seems like it’s a huge insult to refer to a population as a “herd,” but we are animals. In our basic function as human beings, we’re mammals. And when we come together as a group of people, that constitutes basically a herd and if you don’t have immunity in that, it can travel through that herd and through that population very quickly, which is what we’re saying.

So this is a virus that has never been seen by the human population, ever before that we know of. Nobody has immunity, therefore it’s traveling from person to person very quickly and causing a significant numbers, although relatively low percentage if you play the numbers game. People getting severely ill. It has has a mortality rate of what we’re looking at right now in the United States at about 1.8% of those infected risk death. In Italy because of their elderly population, it’s touching 10%.

And that seems “Oh, that’s really low. It’s only 1.7%.” But if you consider that the population of the United States is 327 million or thereabouts, and we figure probably somewhere around 70% of people will be ill with this, that’s somewhere around 268 million people who are ill with it, and you take 1.7%…  You’re over two million people dying from it. So when you break it down to numbers and percentages, it’s really striking.

JIM DONOVAN:

Math is a pretty unforgiving thing.

DR. RUSSELL MILLER:

It is. It’s both beautiful and terrible for that reason.

JIM DONOVAN:

We keep hearing this phrase, “We’ve never seen this before.” Is that really true? I mean have we not seen things like this before?

DR. RUSSELL MILLER:

Well, yes. I guess we have to be more precise in our language. 

We have never seen this particular virus before. Have we seen things that have threatened humanity in this way? Absolutely. 

You’re sitting at pestis, which is the bacterial cause of Black Death—the plague that ravished Europe carried by rats, and something like a third of the population was killed off because of the Black Death. So some number like that. And I beg forgiveness from the historians. I don’t have the numbers on top of my head for that but yeah, we’ve seen things like this.

Smallpox. When colonists spread smallpox to the Americas, it ravaged the Aboriginal population, caused devastation because they had never seen that disease before. There was no immunity to it. So that took out entire villages and tribes of people because of it. So yeah, we have seen this sort of thing in the past. 

Measles, polio. Most recently is probably, an example would be polio in 1950s when it went through America. My parents remember that. They would’ve been in high school.

JIM DONOVAN:

Yeah, my dad had it.

DR. RUSSELL MILLER:

Your dad had it? Okay. I have several patients who have post-polio syndrome there. They use crutches. I’ve got three off the top of my head I can think of who survived polio as children—one of whom survived the “iron lung.” 

There’s all this debate about vaccine. I’m not going to really get into that about childhood vaccination thing but there’s reasons why we look for treatments like vaccines. And polio is the most recent of that magnitude of the magnitude we’re looking at now.

And then the other historical things like smallpox and measles and the Black Death, the plague, and there’s various plagues. You look back into Roman history, the Antigone plague most likely was a form of measles they think, but they’re not sure… But it pretty much probably triggered part of the fall of the Roman Empire. It’s a part of the things then and political ineptitude, but we won’t go there either.

JIM DONOVAN:

I’ve heard this phrase thrown around that every hundred years or so we get something like this. Is that an accurate thing to say or?

DR. RUSSELL MILLER:

Well, it does seem like things cycle. Part of that in this thing is … Well, something I’ve failed to mention was the Spanish influenza pandemic of the 1917, 1918. What happened with that, it started in Europe and it’s really probably spread by servicemen coming home from World War I. And yeah, it seems like, “Oh there’s some sort of cycle.” 

We have a human need, a human instinct to have a pattern to things. You should know that as being a drummer, right? The whole rhythm patterns, right?

JIM DONOVAN:

Don’t take my patterns… I’ll be very upset.

DR. RUSSELL MILLER:

I got you. So we look for patterns. Oh, the storm of the century, every hundred years some major … and to a degree, that’s probably true just because there’s advent flow of nature. And of course, nature doesn’t care how we reckon time and it doesn’t care if it’s a century or millennia but things arise just because there’s mutations and there’s changes in the environment. And life continues to change and evolve and develop and some of it’s really cool and beautiful. And some of it’s really deadly.

We want to attach time frames to things. Things happen because they happen… 

It’s less than 100 years since the polio epidemic. It’s a little over a hundred years since the Spanish influenza epidemic but the best part of humanity I believe wanting to attach significance to timeframes. And we have, you know, a century… 10, 25, 50, 75, 100 years… a millennium. We attach particular significance to anniversaries or time frames like that. Nature doesn’t care.

JIM DONOVAN:

We’re trying to make sense out of a chaotic world and now, we find ourselves—at least here in the States—maybe many of us haven’t seen this kind of chaos before. Some people that have been around a long time have seen chaos kind of like this, maybe even some worse chaos. And I think we’re all trying to make sense of “Wow, all of our systems aren’t working right now. What do we do?”

DR. RUSSELL MILLER:

Right. Yeah, I mean you clutch at straws sometimes, and I used this analogy with my wife yesterday… we were talking about things… 

Doing Telehealth the bloom is off that rose. (I think I told you that earlier when we’re setting them up.) This cool, nifty “gee-whiz” thing and it works well. It’s fine, it’s great but it’s not how I want to practice medicine.

So you start looking for things. You’re clutching at straws or you’re grabbing for whatever is floating by to keep from drowning. That’s a psychological reaction of humanity. We have to have some sort of order or some sort of reference point. And when everything starts to unravel in front of you, it’s hard to find them.

JIM DONOVAN:

It is. It’s a very interesting thing. I’ve got three kids and it’s really interesting to watch how they are reacting to it and how they’re looking to us to try to explain something that is only partially explainable. 

And what we’ve done so far here is try to get into a groove. We tried to find a new rhythm to how a day can go, where before it was like, “Let’s rush everybody to get breakfast, and out to school, and then to practices, and all of a running that we do.” And then I drive hours to work and drive hours back home. And now there’s very little motion in the house and everyone’s like looking at you. They’re like, “Now what do we do?”

DR. RUSSELL MILLER:

Yeah, it’s very disconcerting to all of a sudden all the busyness of things and we’re like, “What just happened?”

JIM DONOVAN:

Yeah.

DR. RUSSELL MILLER:

“What was that?”

JIM DONOVAN:

I took about my middle daughter Ella. She is 17. And we are going for our new groove like we just started is we go for a walk when she wakes up. And she’s the one that instigates it like, “Can we go for a walk, please?” And so we go for a walk and we walk around the park and just talk and talk and talk. 

And as we talk, I even said this to him like, “Wow, this whole situation is so nuts, but I am so glad and I get this time with you. I get to hang out with you and we even get to know each other better than we do already.” I keep looking for the gift in it. I’m lucky to be healthy right now and I need to just enjoy this moment—each moment—as they show up.

DR. RUSSELL MILLER:

Right, because time is an illusion and there is only the now.

JIM DONOVAN:

Can you tell me anything about some of the research that’s was just announced about some possible solutions to this?

DR. RUSSELL MILLER:

Right. So the biggest thing that we want is, “How do you prevent somebody from getting really sick from this?” And that’s a vaccine. 

Unfortunately, a vaccine’s 18 to 24 months in process before you can release it into general usage. And that’s because like I said it’s a novel virus. It’s new. We don’t know how it behaves. We don’t know what proteins on the viral coat is going to cause the immune system to react in such a way to help prevent or lessen an infection when you come across it after being vaccinated.

So there’s a whole lot of research and a lot of really deep science that needs to be done to get to that. 

Unfortunately, we have this concept in our heads from television and movies that in the course of a 42-minute television hour or a two-and-a-half-hour movie, they are able to come up with the solution for something that’s really not practical in the real world.

And so, it’s an 18 to 24 month … If you listen to Dr. Anthony Fauci, CDC’s infectious disease … brilliant man. He’s not lying when he says that. It takes time to develop these things. 

The other thing that I want to see is antibody testing that if somebody has had it, can we detect the antibodies that their body’s produced in such a way that we know that they have long-term, hopefully resistance to it? 

And that would help dictate who is safe to be around whom and who is safe to get a vaccine at what time. There’s a whole thing and just being able to track this to the population, know where it’s been, what is left, and are people able to fight it off.

The big thing that has been around for a couple of weeks, and to sort of taken a life of its own with a lot of misinformation, and poor science in my opinion, but may have some really good outcomes if we look at it properly is the idea of the hydroxychloroquine or Plaquenil and chloroquine.

There’s this big frenzy. There’s a small study done in a private hospital by a private scientist basically in France of 26 people and he published this paper saying that it was really great and it’s wonderful. But if you really dig into the numbers, it was like 11% helpful basically, which is really low. And so that got into the mainstream thing and people started taking chloroquine that’s used for fish ponds which caused some deaths.

So there’s a lot of misinformation. However, just yesterday it was announced that from what I can read that it’s obviously not all in the popular press yet or even the medical press or the scientific press, but a decently constructed study looking at, is this something that’s going to help dosing this? And the president had announced yesterday how many millions of doses have been brought to the United States from Germany and another country and different things.

We don’t know how well these medicines work, with the studies need to be done that’s what they’re doing. My strenuous, strenuous caution of this is not a prevention. 

Unfortunately, these medicines were used mostly for malaria. A lot of places in the world, it’s no longer useful against malaria because the malaria parasite has become resistant to it. It’s also used for autoimmune diseases like lupus. Lupus erythematosus, which is a deadly disease if it’s not treated your immune system turns against itself.

These people need these medicines. We cannot hoard them in our homes thinking that it’s going to protect us from it. We have not proven that there’s a protective element to this. What is being researched are the really sick people who may die without some sort of treatment. It may help prevent what’s called a cytokine storm—a chemical storm that is triggered by the inflammation that this virus triggers. And that’s what the research is on. So I caution people not to go out.

And some states have restricted how many prescriptions a physician can write for someone because physicians started hoarding it themselves. 

So we don’t know the science. We don’t know exactly what’s going on with this. And it does no one any good to just keep all this stuff for yourself when you don’t know if it’s going to help or not, especially in early stages. So follow the science, follow the recommendations. That’s my big thing.

Realizing too, and this is my disclaimer I guess, this is what we know now as of March 31st, 2020 at 3:45 P.M. Eastern Time. That could change drastically in hours or days, right?

JIM DONOVAN:

Yes.

DR. RUSSELL MILLER:

So that’s that’s my take on chloroquine. 

Fortunately, the concept of taking as if azithromycin has fallen out of favor in the popular press. Azithromycin is an antibacterial or an antibiotic and this is a virus. So it doesn’t have no direct effect against the virus, granted if somebody has viral pneumonia, they are more susceptible to developing a bacterial pneumonia, it may be helpful in that. But in terms of treating or preventing a virus, no, it is not. Again, another piece of misinformation that was circulating through the popular press.

JIM DONOVAN:

Thank you for that. That makes everything so much more understandable. 

I’m wondering if we can get it from that to some nuts and bolts of how we can keep ourselves as safe as possible, especially when some people might have to still go to work. There’s definitely people still going to work out there. How can they keep themselves safe? Maybe we can just talk a little bit about that.

DR. RUSSELL MILLER:

Right. The guidelines that have been published and they’ve been upgraded and changed a little bit as this has evolved. 

Sort of an aside here… So trying to set up my office and change things to Telehealth and change how we move people in the office, or not move them in the office if they do come into the office, how are we screening them, all that sort of thing is for a social or personal distancing. 

And my staff is looking at me and last Friday, yeah Friday whenever it was, it was last week sometime. They’re asking all these questions. “Well, how do you want to do this? How do you want to do that? How do you want to do this? How do you want to do it?” 

I’m coming up with answers sort of but at a certain point I’m like, “I don’t know” and they’re looking at me like I’ve lost my mind because I’m the boss. I’m supposed to know those all these stuff. I’ve got an MD.

I said, “Look, there is no book out there that says ‘Pandemics for Dummies.’ We don’t know how to do this.” which if you watch anything on television, it should be pretty obvious. We’re sort of feeling our way through this. Things that we do know if you aren’t exposed to it, you’re less likely to get it. So that’s the concept of social or actually one of our neutral friends, Beth likes the phrase “personal distancing.”

So keeping away from crowds, keeping away from congregating people, keeping away from people with whom you do not live. You and your family don’t have to practice social distancing in the same way because you’re all in the house together. You’re a family unit. Hopefully everybody’s healthy to begin with and you stay healthy that way.

JIM DONOVAN:

People in the house that are living in the house. So not my family that lives in other houses, but just my family that’s in my house, we can hug each other and all of that stuff.

DR. RUSSELL MILLER:

Right. Whatever your family is in terms of living in a house, that’s the place where you live, that’s where your mail comes, that’s where you lay your head at night to sleep, that’s where you eat meals, whatever. Even though we all have families whether blood or by found families that are extended, “Oh well, they’re healthy.” No, you should not cross houses.

I had the one patient who was ill who tested positive for COVID who’s a healthcare worker. Should have known better but he was diagnosed one Saturday. The Saturday before had gone to a party with at least 30 people. All these people have been exposed. 

Who you hang out with is who you live with. Even though you might be blood-related to somebody, you shouldn’t go to their houses. There shouldn’t be playdates. There shouldn’t be card games. There shouldn’t be movie night, unless it’s only with the people within that house. 

And when you go out, the six foot is basically based on if you sneeze how far mucus sprays, droplets spray.

JIM DONOVAN:

Yeah, you can’t control when somebody else sneezes. 

In Pennsylvania, they don’t want us to leave the house. Obviously there have to be some times when we are able to leave the house. Can you talk a little bit about that?

DR. RUSSELL MILLER:

Sure. Most valid reason of course is a medical emergency. What constitutes a medical emergency? Well, that’s where Telehealth comes in, the concept of triage. If I can talk to somebody, one of my patients who has a cough and they have lung disease and they’re like, “I’m afraid I might be getting pneumonia.” And I can triage them and hopefully they might have some equipment in their house, like a pulse ox, a major oxygenation of the blood or a blood pressure cuff or something like that, that I can eyeball them across the video. They might be able to give me some vitals and make a decision. Do they really need to go to an emergency room or can I call something in and have the pharmacy deliver it or whatever? We minimize the number of people who are out there.

Or if we decide that you need to go, it allows me then to contact the ER and say, “This person’s coming in. I think they have a COPD exacerbation. They have emphysema and we’re having a problem or pneumonia.” Precautions, or the other thing is they’re having a heart attack or a stroke and need to expedite that, so time isn’t wasted of them not getting the treatment because of the fear of this virus that’s going around.

So that’s why we want people to not flood the ERs… To really be mindful of using the medical facilities appropriately. So it’s one thing to have the sniffles, that’s not an ER visit. “Oh, I have the sniffles… I  I think I have COVID.” Well, you need to have a fever, shortness of breath, and a cough before we will even test people for COVID-19.

We don’t want to clog the ERs with people who are worried that they’re sick when they’re not sick enough to be there, because not only does that stop us from treating people who need treated for COVID-19 ,but also people who have all the other problems that can happen to human beings—like heart attacks and strokes and other infections that need the ER too. If they’re filled with the worried well, relatively well, we can’t treat them properly.

That’s where you have a relationship with hopefully with a primary care physician that you can at least talk to over the phone or talk through a Telehealth visit. Triage things a little bit. Deal with what you can outside of urgent care, emergency care, and go from there. It has to be reasonable. I mean I don’t want people having chest pain and saying, “Well, I don’t want to go to the ER because somebody else is going to need it more.” Well, no, you’re having a heart attack. You need to go to the ER.

It’s that sort of thing of just approached the utilization of emergency services more mindfully. And people seem to be doing that. I have friends who ER doctors, one guy in particular called his wife like a half hour after he got on shift in a local ER here. And she’s like, “What are you doing calling me you’re like at work?” And he’s like, “This is the first time in 15 years that I’ve walked into the ER at 7:00 A.M. and there’s been nobody in the ER. Usually there’s 30 people waiting. I feel like I’m actually treating emergencies now.”

So people are using their brains. They seem to be doing things appropriately. Part of it’s out of fear of catching something, I think, and part of it’s out of being intelligent about how you expose yourself on other people. Another thing about leaving the house too is food shopping. You need to get food, right?

JIM DONOVAN:

Yes.

DR. RUSSELL MILLER:

And again being mindful. Plan. 

Plan what you’re going to use, what you need, what’s an essential, what is nice to have versus whatever. If you have people in an area that … So for example, I’ll use myself as an example. My parents live a couple miles from me. They’re in their 80s. I do not want them going to the store. There’s my wife and myself and there’s other members of her family who are in the area. So my in-laws, brothers, and sister-in-law who live in the area.

Going to the store and giving people lists and having it planned out, that one person goes out and gets a large order and then leaves it at the doorstep of other people, lessens the number of people that are in the population circulating, lessens other people who are in a store, lessens the exposure of people.

So I’m the one who usually gets voted to do the shopping because I’m already out. I’ve already had been out and about because I am still working—I’m considered essential. And so I shop for my parents and I shop for my brother-in-law’s family and for our home. And you leave it on the porch and you don’t go in. It’s awkward and weird, but it keeps people healthy.

JIM DONOVAN:

That’s great information. We have to rethink some of the ways that we normally do things and be willing to do them differently, even though they might be awkward or it might seem rude in a normal circumstance. It’s really an act of love to be able to just sort of bite your bullet, get over the worry, and do the right thing.

DR. RUSSELL MILLER:

Absolutely, well said.

JIM DONOVAN:

Hearing a lot today about masks and actually my wife Tracy is a sewer. So she’s been sewing them for some of our friends up in New York City who have no access to anything like that. What is the controversy around the masks?

DR. RUSSELL MILLER:

If you see China or Japan, it’s part of their culture that if somebody’s sick, they’re wearing a mask, or especially with China’s pollution sometimes. But with the COVID-19 pandemic starting in those countries, you would see that a lot. In fact, it was illegal to go outside without a mask. 

My roommate from college actually lives in China. He married a Chinese woman. He and his wife and daughter live in China and his Facebook posts and emails to me about their experience is very different. But he’s saying it feels odd to not have the mask on.

In America, we did not suggest that at first up until recently actually out of a couple things. It gives us a false sense of security because this virus the way it moves, you have to have a specific mask, the N95 mask, which stops the viral particles from being inhaled. A regular mask and cotton does not do that to any significant degree if you are showered with a load of virus.

Having said that, there are only enough masks. People have hoarded masks. The people who are on the front lines—the doctors and nurses and respiratory therapists and ambulance drivers and all those people in medicine—really need those specialized masks. I don’t consider myself frontline. 

I’m the second line trying to support people by keeping people out of the ER and keeping them hopefully healthy and home away from the hospital. I don’t have those masks. I didn’t have them in my office. I didn’t have real use for them without them expiring. You have to pick and choose sometimes. 

But the hospitals need them and the people need them. So it’s not logical for somebody to be wearing that all the time. First of all, they’re very difficult to get around and if you have a breathing condition and you put one of these on and you try to walk any distance, it’s laborious because it’s so hard to breathe through these things.

Having said that, we’re rethinking the populace using masks. There’s enough of this virus around in the general population now, that people who are asymptomatic or mildly symptomatic with coughs, may prevent from spreading it because they have a mask on and they’re not coughing and droplets aren’t spraying from them as much, maybe.

JIM DONOVAN:

It’s not a guarantee but it’s like one extra step that that people can start to take.

DR. RUSSELL MILLER:

Yes. A totally healthy person, what it probably does is remind us not to touch your face and nose. There’s a mask there.

JIM DONOVAN:

And maybe to brush your teeth.

DR. RUSSELL MILLER:

And maybe yeah, because you have to experience your own breath for a while. Up close and personal but does it do enough? It does something, most likely. Is it a huge change? Probably not. 

It is not enough change to mandate that every civilian citizen, normal citizen have an N95 mask because we just don’t have them and that’s a waste of resources. Is it a significant enough change that somebody wearing it, it might help a bit? Sure. I mean it’s not going to hurt. That’s my thought.

Wearing a cotton mask that your wife has sewn… like the three-ply masks that they’re making… It’s certainly not going to hurt as long as you realize or one realizes that hand washing, hand washing, hand washing is so important. 

Not touching your mouth, nose or eyes, social distancing, personal distancing of six feet or more, those things, all of that taken together will make a difference.

JIM DONOVAN:

And this is stuff that each person here on the planet can do. We have that ability to make that choice and it’s why we’re hearing so many people from so many different places say it over and over and over again.

DR. RUSSELL MILLER:

Right, absolutely.

JIM DONOVAN:

We have a lot of places here in the states are on the lockdown. So we’re not supposed to go out other than for medical emergencies and for grocery and things like this. 

I know even here in my own house, my kids are going stir-crazy even with all the different activities that we do. I was just watching social media. I can see that people are generally taking a pretty good attitude about it but that it’s still a very challenging thing to have a new reality thrust upon you. 

In your opinion, what are some things that we can do to help ourselves first?

DR. RUSSELL MILLER:

One thing that my wife is doing too, my wife Lori—who is an absolute gem and godsend—she is like, “Okay, what do we have in the fridge? What do we have in the cupboard? Let me be creative with cooking.” And she comes up with these spectacular dishes that are really just common things, but just so tasty and delicious. We sort of most days make a little bit of an event. Set the table, open a bottle of wine. Make an event of it. And we end up sitting at the table instead of scarfing stuff down in 20 minutes or less and out the door doing something, it’s like, “Oh, we’ve been sitting here an hour and a half and watching the news and having a conversation about it.” It’s sort of cool. 

And then we built the other space a little bit and we’ll go do social media or hang out or call somebody on the phone, whatever. You do that but it’s really cool that we have this time to have sort of a little bit of a luxurious feel, even though it’s not expensive or haute cuisine sort of things but general simple things but cooked so beautifully and with love that it’s an event. So just having that event is like really cool.

JIM DONOVAN:

The ritual of that. It’s the setting the table. It’s the cooking with love. It’s the just hanging out and taking your time. I mean that’s a beautiful ritual.

DR. RUSSELL MILLER:

Right, exactly. I tell my patients often times when they’re really stressed out about all the chaos of everyday life, which has now come to a standstill. We are human “beings.” We’re not human “doings,” right? And just being together and being present to a meal with one another, it is both remarkable and heart-rending that something like this has to happen for us to remember that.

JIM DONOVAN:

And maybe for my listeners out there who don’t have somebody at home—I know there’s plenty of folks who qualify for that—an idea that I thought about was if you have a smartphone, use those apps called FaceTime or Google Hangouts and have dinner with somebody. Put them on the table with you, stand the phone up so you can see each other. And you can still have these interactions together. We just have to be a little more creative in how we think about them and how we do them.

DR. RUSSELL MILLER:

Right. One of the things we’re talking about, the holidays are always a big thing in our family and Easter is coming up, which is sort of like suspended here. But I was saying, we should all have this in our family because it’s a huge thing. We usually have like 40 people at our house for Easter Sunday brunch. Yeah, you know, just a small gathering. We’re obviously not doing that, but getting on Zoom or Hangouts or whatever and having everybody do it synchronously, I can’t pronounce it, synchronously, to do that and have it together. It’s like, “Screw you, virus. We’re still going to get together in one way or another.”

JIM DONOVAN:

That’s it. We have to–

DR. RUSSELL MILLER:

It’s somehow empowering doing that.

JIM DONOVAN:

It is something where we can take our power back by using just creative thinking. Just think about things a little bit differently than you do typically. And that’s really I think part of what is going to come of this entire situations that we are all being forced to think about things differently. And to me, that means that’s a design problem. These are creative problems. What can I do with this new situation that I couldn’t do when I was having to do my life the other way? It’s like a really interesting pause in reality.

I can see over the fence to the old reality. I can remember just a couple weeks ago getting up at that certain time and driving to these places and all the routines I had. But now I’m over this other fence, kind of looking at that going, “There’s a couple things that I could probably just do without.” And it makes me wonder, globally, how that’s going to affect some of the bigger systems. Some of the systems that aren’t working so well right now. I wonder how that affects them to be improved.

Some of the inventions that weren’t so important before, all of a sudden are the most important. And even down to … I was just at the grocery store yesterday. I had my gloves on. I had a mask on and I used to be a bus boy at a grocery store or not a busboy, sorry. One of the cart boys, the bag boys. 

I saw these guys and I looked at them and I started to well up in tears. I’m like, “Man, thank you for being here.” They’re so overlooked, and right now they’re some of the most important people because this guy, he’s like, “Man, you can’t go in the store until I totally sanitize your cart.” And he was like really caring about it and made sure every little last part of that cart was completely sanitized.

And I was like man, what a paradigm shift that is. These guys going from overlooked to critical, critical people. Or like the UPS guys or the FedEx people. Of course every nurse and doctor in the place. You know, it blows my heart open.

DR. RUSSELL MILLER:

That is just a profound sentiment of those who were invisible have become very visible, and needfully so. I mean we need to recognize that. 

I mean there’s a lot of social justice reflection that needs to happen after this, you know. And you said about what systems are going to change. I wear a couple hats, which listeners might have gathered at some point here, but one’s medicine, of course. And this has demonstrated how broken our medical system is, in my opinion. Our health care system is broken.

And I don’t believe that we can build on what we have so far. I think we really need to have a paradigm overhaul. I’m not going to get into the debate of nationalized medicine or not nationalized medicine and what is socialism, and that whole thing… But we have to stop posturing that way and actually do something constructive to make something better. We cannot go back to “B.C.”, as I call it “Before Corona” and we have–

JIM DONOVAN:

“B.C.”

DR. RUSSELL MILLER:

Yeah, “B.C.” We have to start imagining what are the best iteration of things like medicine can be, “A.C.”—“After Corona.” And it’s okay to dream and you know what, it’s okay to spend some money that’s not blowing people up. We can use money to help people rather than blow them up.

JIM DONOVAN:

Yes.

DR. RUSSELL MILLER:

And that’s an okay thing because if you don’t start paying attention about things like this, what’s going on, now what happens in terms of our poorly prepared response to this thing that we have no control over. The other system that I believe is going to change is education. 

So much is being done distance now with the kids in grade school—and I sit on the local school board. And I’ve been a champion, I hope, of changing things to customized learning of pushing kids—rather not pushing them—but rather than pushing them into a paradigm that was shaped in the late 1890s of lining everybody up in chairs and teaching the same thing and producing factory workers, of developing a different style of education.

And our one principal who’s very, very astute with us and she’s very dedicated to having us change habits that it’s going to take five to 10 years. And then Corona happened and what she was expecting to happen in five to 10 years happened in three days, after they lifted some of the restrictions on how they’re able to do things. And they’re feeling their way, but this necessity being the mother of invention, the old platitude’s true, right?

JIM DONOVAN:

I know things that can boost the immune system. Actually on our last episode we talked about some of these things.

DR. RUSSELL MILLER:

Certainly a healthy well balanced diet to maintain health, to maintain your immune system is important. Some of the naturopathic research and suggestions that are coming out from coronavirus, as always, a healthy well balanced diet. 

I said in the last podcast that I subscribed to the idea of the inflammatory theory of disease and all diseases arise from inflammation. Therefore, antioxidants are very important. 

So eat your colors. If you can healthily get fresh fruits and vegetables, especially the brightly colored ones, that helps certainly.

In terms of supplements, vitamin D helps support the immune system. There’s some research suggestions, again disclaimer, it’s “suggesting” that a regular daily dose of the regular recommended amount of zinc, which is 50 milligrams for most people may be helpful in preventing the virus from being able to penetrate as deeply into the respiratory tract. Not overly substantiated, not really going to hurt you if you take it. So those are some things that in terms of diet and supplements that you could do.

JIM DONOVAN:

Great. And with exercise, are we still talking like the 20 minutes a day get your heart rate up?

DR. RUSSELL MILLER:

I mean obviously with social distancing and the close of non-essential things… gyms are closed. So you have to become creative with your workout if you’re a gym rat—that’s as a word, right? Walks are always good. I think blending exercise with other things. So you say you and your daughter go for a walk around the neighborhood park or whatever. Doing that in nature, certainly social distancing, always being the thing, but there’s something about the fresh air and the natural world that’s very calming and very soothing. And I think is where we’re meant to be. We’re not meant to be under fluorescent lights all the time.

It helps to bring about some of that balance that people may be lacking because of being so off-kilter from society, changing in a heartbeat. In terms of exercise, not overdoing it. At a certain point, if you overexercise, your immune system diminishes. 

So the 20 minutes, half hour, three, four times a week for a good exercise probably still remains but daily, goes back to sounds like that old British novel or something. The daily constitutional of walking around the park or something to just take in the day and move. We were meant to move. We weren’t meant to sit at an office chair all the time.

JIM DONOVAN:

That’s fantastic, and I think along with that some things that I’m doing here at the house are, I’m doing tons of the deep breathing exercises. I’ve been doing these really deep belly breaths and then filling up my lungs to kind of holding my breath a little bit just to help the anxieties to go down. But also to keep my lung capacity in good shape. I get some of that from my cardio, but I do some of these exercises, especially right before bed—the real deep breathing exercises.

Of course, I’m always doing my chanting. So I do the “ohm” chants quite a bit. When I take my walks I hum the entire time, so I’m getting that good vagal nerve stimulation in there and all the benefits that come from that, that we talked about last time too. Anything else that you do?

DR. RUSSELL MILLER:

I have become more aware of the need for quiet time, meditative time, reflection time. And how it’s hard, sometimes we’re too connected on this, and especially like in my profession. There’s texts and there’s social media and there’s a pager. Yeah, I still carry a pager because on the wilds of Pennsylvania, cell service sucks. But the home telephone, email, all this stuff, and it’s so very hard to unplug and getting onto nature. I live in the area I grew up and stopping by the church where I grew up in and it’s unlocked. There’s nobody there, but having that space or that sense of the sacred to me, that’s my relationship to it.

It’s good because it helps you to put things in perspective a little bit, I think in terms of “This is awful and terrible to deal with.” But a lot on the timeline, things change. So that reflective sort of thing is important. The deep breathing, I find myself doing a lot of singing all the ’80s anthems.

JIM DONOVAN:

You actually know the ’80s.

DR. RUSSELL MILLER:

Yeah, right exactly.

JIM DONOVAN:

What are you singing? I got to know about this, so I can like, imagine it.

DR. RUSSELL MILLER:

Actually this is terrible. This is awful. It’s so terrible of me–

JIM DONOVAN:

I can’t wait to hear it.

DR. RUSSELL MILLER:

I actually made a playlist of 19 songs called “The Covid-19 Playlist” and it’s all, you know, “Don’t Stand So Close to Me” by The Police, “I Will Survive” by–

JIM DONOVAN:

Gloria Gaynor, yup.

DR. RUSSELL MILLER:

Gaynor. “I’m A Survivor” by Destiny’s Child. That’s not the ’80s of course but yeah, things like that.

JIM DONOVAN:

You’re going to have to share that playlist with me. We’re going to put that on the website. That’s that needs to happen.

DR. RUSSELL MILLER:

Yeah, whatever. “Put The Lime In The Coconut” but that’s a … And of course, I put this on in the office when we’re trying to do this whole changeover. Most of my staff are in their 20s or early 30s. They’re like, “What are you listening to?” I’m like, “It’s funny because this is how it relates to me.”

JIM DONOVAN:

They don’t get the joke at all.

DR. RUSSELL MILLER:

No, it’s okay. Made me feel very old.

JIM DONOVAN:

Russ, I really just want to thank you for taking the time out of the schedule. I know that you got people that you need to see, and I know that our audience really appreciates you and all the work that you’re doing to help keep people healthy. And so do I. 

So thank you for coming on yet again. Well, I hope that we can do this yet again, and hopefully in a happier circumstance. Anything else that you want to say to folks before we sign off?

DR. RUSSELL MILLER:

Well first of all, thank you for asking me, and I’m hoping that this is helpful to people. Again, pay attention as things evolve. 

Social distance, personal distancing, be mindful about where you’re moving and what you’re doing, and wash your filthy hands!

JIM DONOVAN:

Done and done. All right Russ, well, have a great day. Keep yourself healthy and we will see you next time.

DR. RUSSELL MILLER:

Thanks, be well.