Part 1: Dr. Cook Q&A Series: Richard Rossi & JJ Virgin

 What we're doing is we're, we're podcasting, sort of it, it's ideally every day and trying to get information out there, get out there with things that you can do to protect yourself and your loved ones and your family.

You're listening to the Bio Reset Medical podcast with Dr. Matthew Cook.

The, the thing that, uh, that came out today is they, they, the, a trial that came out that looked at, uh, a dosing design and some strategies of treating, uh, COVID, uh, 19, uh, with, uh, hydroxychloroquine. And Hydroxychloroquine is the other name for it, is Plaquenil. And, uh, Plaquenil, uh, and, and Hydroxychloroquine is actually a derivative of Chloroquine and they're both anti-malarial drugs.

And, um, and so then that's, they, they've been around for a long time. Millions and millions and millions of people have used them. Uh, initially there was, uh, some, some thought, well, which one is better? Uh, the hydroxy or just the regular cor chloroquine. And it turns out, uh, it looks like the hydroxychloroquine is better for sars and it's also the one that has less side effects.

Um,

Of, uh, renal problems. And, um, I'm gonna do a follow up to this tomorrow and, uh, give you some more information on this. Uh, however, even though, uh, good job, even though it has, um, sorry, I'm doing two things at the same time. Shocking. Uh, e even though it, uh, it has some renal toxicity, I'm just reviewed a, a, a article that showed that in patients with rheumatoid arthritis who were put on hydroxychloroquine, the, the patients who got hydroxychloroquine ended up with less kidney problems.

So I'm gonna dig into this over the next 24 hours and give you information on it. The dosing, uh, that they came up with was to do a, a double. The dosing is, is 400 milligrams a day. And, uh, in, in the trial that I got, And so then what they're doing is they're doubling the dose on the first day. Now this is brand new.

We don't, we don't have as much information as we really should have in terms of being able to understand, uh, how beneficial it's gonna be a, uh, for prophylaxis and b for treatment. Um, but what's interesting is, is that what, the way that this hurts people is when it causes a cytokine storm. Do you guys un, do you guys understand that or do you want me to talk a little bit about that?

Sorry. Cytokine storm. Cy. Okay. Yeah, you should talk about it because it seems really scary. Um, sounds like there's lightning and thunder involved. Lightning and thunder. Well, we're gonna get the lightning and thunder when we get the ozone, so that will be, that'll be beneficial. Um, But so, uh, what happens is, is is that this virus comes in and attacks the epithelial cells, uh, which are the lining of your airway.

And it starts in the, the back of your throat and your nose. And then it can go down and start to attack the lining of the, basically your windpipes and your lungs. And when that happens in, it can cause a pneumonia, which would be a viral pneumonia. But then the other thing that it can do is it can cause an extreme reaction that's like an overreaction to, um, to the fact that there's a viral pneumonia.

And my analogy that I gave, that I came up with this weekend is like, imagine if there are a bunch of shoplifters, uh, in a grocery store. And then, um, we realized we needed to get those shoplifters. And so our solution was to call in a drone strike and take the grocery store out. And that's kinda like what happens when there's a cytokine storm.

And, and, and let me explain what I mean by that. When there's a cytokine storm, your immune cells start to release these chemical signals that call in the rest of your immune system to fight. And initially we start out by releasing some inflammatory ones and then we turn around, uh, once everybody shows up to the party and we then we turn, uh, we release anti-inflammatory ones.

And so life is a constant process of creating and starting inflammation, but then turning that inflammation off and then healing. What can happen sometimes is inflammation goes out of control. And when inflammation goes out of control, the one of the terms for that is called a cytokine storm. And when that happens, then we start to, uh, it starts to be get not just in your lungs, but it becomes systemic.

And so people can start to have low blood pressure and they can get a condition that's called sepsis. And then it turns out that this virus can then later on, start to attack the kidneys. And it can cause kidney failure and it can cause heart failure. And then it, and, and it, and then just the, the effect of the cytokine storm can be a, a problem.

So it turns out that hydroxychloroquine, which is sort of what we're talking about today, increases the pH of cells and in doing so, makes them a little bit resistant to the virus getting in in the first place, which is good. It also is immunomodulatory. And so there's a lot of things that we use that are immunomodulatory that can be quite helpful.

So, uh, uh, the classic thing is stem cells are modulate the immune system, so they kinda amp down the volume or the intensity on what's happening, which is why they're useful for autoimmune conditions. Uh, uh, this drug, Plaquenil has some immunomodulatory effects. Exosomes, which is, which are stem cell secretions, also have an immuno immunomodulatory effect.

And a lot of, uh, our favorite supplements, uh, may have some immunomodulatory effects. So, um, So, uh, Plaquenil, uh, may be helpful because of its immunomodulatory effects and if it can calm the immune system response down, then that may mean that people are less likely to progress on from pneumonia to sepsis and systemic, uh, problems with it.

Um, so then that's good. And then it also may block viral replication. So I think there's, there's, uh, it's quite provocative that, uh, it could be beneficial for these things. And in general the risk I think is quite low. Low. And, and I'm gonna di dive into the risk in more detail cause I only got a chance to write a few, a couple papers today just cause we've been running, uh, running all day.

But then given, given, go ahead. Richard, do you have a question? Oh, no, no. This is Tim. I had just two questions, Matt. So first of which, when you talk about sepsis and kidney failure and heart failure, like at what point, like what's the timeframe that this all happened? Oh, that's a great question. So the, um, So the, first of all, there's a pro roam when people are exposed and they don't have any symptoms.

And that may be like a month. So, so people may have been exposed and they may have no symptoms at all for, for some period of time, but more likely for like a week or two. Then once they start to have symptoms, the first symptoms that they're gonna have are probably gonna be upper respiratory in the nose and throat.

And so then imagine that is like day one. And so then what will happen after that is it can progress into chest tightness and uh, people can have, uh, pain in the chest and then they can develop a pneumonia and they can develop difficulty breathing. And so then that's gonna be in the, in the time course of three days to a week after the upper respiratory symptoms.

Then what will happen is the cytokine storm is gonna happen in one to two to three days after the pneumonia. And the cytokine storm then leads to the kidney problems and then the heart problems. And so then if the, if the upper respiratory stuff started on day one and then the chest started on day five or six, and then the, uh, pneumonia was on day eight, and then the kidney would be on day nine, and then the hardest day 11.

And I've seen different numbers on this from different places, but those are sort of ballpark, um, ballpark statements that give you a sense that you're not gonna have a sore nose and then get, um, heart, uh, heart failure. But what this, but what this does show is that if you start to have nasal symptoms and then upper respiratory symptoms, now we wanna do everything possible to, to calm the immune system down so that it doesn't go into overdrive.

Now then, given that, if you look at the data coming outta, um, Italy, the vast majority of people who had a problem had had three major medical problems. Let's, so let's say they had, uh, heart problems, lung problems, and kidney problems. And then the next group had two problems. So that'd be like heart problems and kidney problems.

And then the third group, uh, had at least one problem. So the vast majority of people who are having a lot of trouble with this have not a lot of metabolic reserve. And so then when a stress happens to them, It, it, it hits them super hard. Now, despite that, there are still young people, young healthy people who are progressing on, and I have a patient who, uh, is a friend of mine who, uh, uh, developed a very bad pneumonia and I did all of this remote, and it didn't make any sense to me in December.

And then shortly after that, he went into what sounded like a cytokine storm to me, but four or five days after that. And then eight days, eight days after the pneumonia, he went into kidney failure. And so, uh, and, and I was like, I, I'm a little embarrassed because I, I, I was talking to him through this whole thing and I was like, this is, this is crazy.

I've never seen somebody go into a, like this cytokine storm thing. And at that point, this is in December, and we didn't know about, we didn't know about, you know, the coronavirus. And so, uh, but then I woke up the other day and I was like, oh my God, he had Corona. That's what happened. And so then we're getting him tested and I'll have information about that.

And so know that people who are totally otherwise healthy can progress to this, but then also know that. Uh, I that, that the, this drug is beneficial. We're gonna go into some supplement strategies, strategies that are beneficial. We're gonna go into some ozone strategies. So there are a lot of things that we can do, and I think once we have, uh, a robust stack of things that we're doing, we're going to be able to really mitigate that risk.

Right. Hey, Matt. So, so one other question. Um, so that, and sorry, Richard, but really quickly, so the flax, I believe that's the name of it. What's the, what's the therapy for this? Like, I, is it, is it five days? Is it two weeks? Is it 30 days? Like, what are, you said, you mentioned you doubled the dose on the first day, which is very much like a Zak, and then you taper down right to the, to the standard dose.

What's the, what's the dosing on this? Yeah. Hold, so hold, hold on a second on this because I have a, Hey, while you're doing that, let me, um, let me give you the, what the University of Washington is saying. Oh, great. Um, so, you know, a lot of the cases are up there right now and I'm, I'm reading their internal documents on the algorithm for management.

Um, and what they're saying is 400 milligrams twice daily on day one, followed by 200 milligrams daily for four days. That's, that's their recommendation. The other thing that's interesting is I'm looking at the algorithm of management and basically if, if you have, if you've tested positively, For Covid 19, um, and you don't have any O two requirements and you don't have any risk factors, then they're saying symptomatic treatment only if you have any risk factors, and I can tell you what those are.

First line of defense hydroxychloroquine, if you have O two requirements, first line hydroxychloroquine, if you're on mechanical ventilation, first line hydroxychloroquine, you see the pattern there? Yes. And they're saying for how many days, Richard? Well, in with the University of Washington is currently doing is, uh, 400 for one day, sorry, 400 twice daily for one day, followed by 200 twice daily for four days.

And the other thing I wanted to, but what I wanted to ask you, Matt, is there's. There's some evidence coming out of the south of France that if you really want to supercharge this, you add a Zack in. Have you been reading anything about that? Yeah, so there's a, um, there's an article that I saw that there may be a risk of a cardiac arrhythmia if you combine a Zak with the hydroxychloroquine.

Um, and, and, and so then, and then let me say, I, I have a study that was done by Yao at all, and uh, that's obviously fresh off the press. And, uh, the title of it is in Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine in the Treatment of Severe Acute Respiratory Syndrome.

Coronavirus too. So this is a a and so this is basically what they did is they did a, a trial in test tubes, and then they used that to come up with data to derive a dosing strategy in people. And, um, what what they said is to, to do, uh, 800 milligrams on day one, which is the same thing what that Richard said, and then to do 400 milligrams a day for, for, for days two through nine.

So they, this is, they're, they're discussing a 10 day strategy here. Um, and. What I would say, uh, is, and, and so what I would say Richard is, sorry. What I would say is, is that probably my best case scenario would be if someone was exposed and had symptoms would be to do, take the hi the hydroxychloroquine in a strategy of either a four day strategy or a 10 day strategy.

And I would probably do a 10 day strategy and then I would, and then I would combine that with the nutritional support and the strategy that, like what I'm gonna talk about with JJ and everything else that we have. And then I would consider thinking about adding in things like ozone and stuff like that.

And I think people are gonna do really well with that. Good luck trying to get ozone. No one, all the options are closed. Well, that's a problem, but I, I have a solution for you on that too. All right. Okay. Um, before we get to, to, before we get to that, let me just, um, cause you're gonna have a lot of folks listening to this podcast.

Um, would the university, can everybody mute themselves for not speaking, please? Uh, I'm sorry. Okay. Bryce drank all our wine and it's a crisis, so we're dealing with that shit now. You know, it's enough that we're now in self isolation. Our child's drinking all the wine. Uh, you know, Bryce, Bryce, Bryce, Bryce.

Really? However, he is cooking all the dinners. So I'm the pastie, I'm all,

um, yeah, so lovely. So with the, um, what I'm seeing here and what I'd love to get you to comment on Matt, is, um, this is again from the standard of care out of, uh, university of Washington Medical. They're saying that most toxicities are associated with long-term use. Um, there's some minor things like dizziness, headache, loss of appetite, nausea, vomiting, no big deal there.

They're also mentioning two things I don't understand, maybe you could explain to your listeners. One is LFT abnormalities and the second is QTC prolonging effect. And they recommend check QTC if on QTC prolonging drugs. Now what does that mean? So, um, the, the, so we'll start, do you want me to start with the LFTs and then we'll qtc?

Yeah, I just wanna make sure your listeners are, you know, fully informed, right. So, uh, they're almost all drugs we take will end up going through the liver and then when through the liver, oh,

drugs will go through the liver and when they go through the liver, they'll start to be metabolized. In the process of being metabolized, that can sometimes create a little bit of toxicity for the liver. And then if that, that creates toxicity in the liver, it can cause your liver function enzymes. For liver function tests to be elevated.

And so then for drugs that have any potential to affect the liver, often, and this is particularly if somebody is gonna be on a drug for six months or a year, then we will give them that drug and then a couple weeks later we'll check their liver function tests and then make sure that they're okay.

Because if you had some elevated liver function test, then that would be a problem If you were taking a drug that was toxic to your liver and then kept taking it, uh, I think that the incidence of this is quite low, but it is still a, it's, it's still a risk. But in terms of, uh, liver toxicity, I think the overall liver toxicity for plaque is low.

That being said, um, let's say I have two people, one person's totally healthy, no issues, no problems. Let's say that they had an exposure to Covid but didn't have any symptoms. Well, because Plaquenil is so safe, I would think that it would be reasonable for that person to take Plaquenil as a prophylaxis.

But then if I was gonna do prophylaxis, I probably wouldn't necessarily require that they do the loading dose, because I'm not trying to immediately get high levels. I'm just trying to get a little bit of, a little bit in there for them. And then I'm trying to have a prophylaxis effect. Now that's option.

So that's, that's one. If you told me there was somebody who had real bad liver disease and then they, and, and they also had an exposure, we might wait on that patient. And then see how they do, and then only treat them if they had symptoms. And then also, I don't, I don't specifically know what the incidence is.

Uh, can do me a favor look up, uh, incidents of, uh, increased LFTs and plaque. So we're gonna look that up right now. Um, now then the, the next thing is, is that a lot of drugs can affect the electrical activity of the heart. And, um, the, uh, the, when, when, and the, what happens is, is the heart creates an electrical, an electrical wave goes through the heart, and as that wave goes through the heart, it causes the heart to squeeze and, and eject blood out.

And so the blood gets pumped throughout your, your whole body. Uh, there's different, uh, each wave that goes through the heart has a different name. So, uh, one wave is called the P wave, and then the rest of them are called the qr s t, so it's P Q r S T. So it's a kind alphabetical. And so then there are some drugs that can cause a delay or a lengthening in how long it takes the electrical activity to get through the heart.

And so what happens is that delay can happen anywhere between p QRS and T, but some drugs can affect what is called the qt. And so it's, that's the amount of time it takes to get from q t, and that's the time when the heart is actually squeezing. So, um, and so then you, you say, well, when is that relevant?

I would say 99% of the people that we know don't have any symptoms with that. But what will happen is, is that there are certain patients, particularly heart patients and then um, uh, particularly heart patients that may have other electrical problems. And so there are a lot of cardiac patients who have problems in terms of how electricity flows through their heart.

And those patients, if they're given a drug that delays how electricity moves through the heart, may be more susceptible to problems. And so then once again, now what we say is, oh, okay, I've got this person who's a cardiac patient who's probably one of the people who's at higher risk of a problem with covid.

But I also know that they might have. More of a side effect from one of the drug that treats it. And so then we're gonna have to make a judgment call around would it be a good idea for that patient to take this drug versus, uh, would it not? And, and that's a judgment call based on the, the incidents of it.

Now, if you gave me, uh, Richard a hundred drugs, there might be 20 or 30 or 40 of them that that could have an effect on qt It's like when you're, it's, it's a relatively common, uh, side effect. But the, the side effect is relatively uncommon and the percentage of people that have symptoms of it is probably relatively uncommon.

And this is a, a relatively, like millions of people have taken this. And so then if I was at home in quarantine, uh, on the sofa, Preparing for my virtual, uh, rave with, uh, JJ and I had symptoms, then I would de definitely. Do you have, do you have your old Elvis costume? Because that's what we want you to be in.

I just wanna know, did it make it home? Uh, it, it didn't make it to my new house, jj. Oh, I'm so sad. I don't know if we can invite you. Well, you, you, you don't know because maybe I'm gonna have a better outfit. All right, well let's hope you've got a couple days. I've got a couple days, days work on this except not delivering Prime right now, so I dunno what you do.

Ok. Well, before, so before you move on, oh, lemme, lemme answer this question. Lemme keep going for a second, Richard. So therefore, if I was on the sofa and I had symptoms, I would feel like the risk of proceeding. Uh, and, and taking this drug is pretty darn low. And so I think, I would think it's a reasonable thing to do.

I think that we're probably gonna find that it's probably a good thing to do for, for prophylaxis if you've had exposure. And so then I, like I was talking to a bunch of doctors in Canada today, and the Canadian Health Service, they're in ration state. And so, because a lot of patients need it just for autoimmune disease and other conditions, they're only giving it to people with active symptoms in a positive test.

I think that they're, my best guess is that if there's been any exposure, uh, even without a positive test, I think it's a reasonable thing to do for prophylaxis. But we're gonna, um, we're gonna figure that out. So for someone who's in magnificent shape, like, um, Tim, Richard Rossie,

you know, a Greek god, like Tim for example. Richard Rossi

when like, say he wasn't exposed, but then he started feeling a little bit iffy and then all of a sudden he started coughing. So, and then all of a sudden his wife said, get the fuck outta the house. Go over there. Wow, Tim. Not, not that that would ever happen. Never, never happened. Never. Lemme read this to, lemme read this to you, Richard.

Um, mm-hmm. So, so this is a review article on Hepatotoxicity. So hydroxychloroquine has not been associated with significant serum enzyme elevations. During therapy for rheumatological diseases. So these are unhealthy patients. Furthermore, clinical apparent liver injury from hydroxychloroquine is rare. A single case series two cases of liver failure attributed to hydroxychloroquine was published 20 years ago.

But case reports of clinically apparent liver injury have not appeared subsequently. So that means there's been millions of people that have taken this drug and there have been a couple there. There may have been a couple people that had failure, liver failure, but those were almost all with chronic use.

So that begins to make me feel like the, the risk from a liver perspective is very low. And so then if I have Greek. Um, uh, then what I would say is I would, if he, if he felt iffy, then I would take it. And so the minute you feel iffy, you do it. So it's better to start it sooner rather than later. Yes.

Because here's the thing, if you, and now this is, this is my guess based on my just clinical experience, ok? If you follow me, and I'm not gonna be exactly right, but I'm not gonna be super wrong, what happens is this goes into your nose and your upper airway and it affects the lining there. And then a few days later it goes and affects the lining in your lungs and then it kinda causes inflammation and then it gets into your bloodstream and then it affects the in your kidney.

And then after that, it gets out of there and it goes and affects the lining in your heart. So therefore if you were to feel iffy and then you started to take something that blocks the replication, makes the cells that are getting infected, somewhat resistant and may actually have a negative effect on the virus, now I'm feeling pretty darn good that I'm doing, doing a, doing something therapeutic and I'm then potentially gonna block the pulmonary thing from ever happening.

Yeah. Cause what, from everything I've heard, like it's really stopping it as quickly as possible before it starts to get down. So it gets in your, like before it gets into your crea and then gets into your lungs, right? Yes. Because if we stopped that, then you basically had a little, nothing is gonna happen bad from the fact that it was in your nose.

It's just when it gets into your lungs, that's when it can get into the bloodstream and that's when the, the horses are outta the barn. All right? Yeah. Hey Matt, make sure in the podcast you mentioned him and the Greek God he might wanna say. Right. Thank you. Thank you, Richard, for that. Well, no, cause you know, I was thinking Oregon sounds like a name of a Greek God too, you know?

Well, hello. Yeah, there you go. He said, well, that's awesome, man. And I gotta say, um, you know, I took, uh, uh, hydroxychloroquine when I went to visit Ghana, you know, it's like, no big deal. So, yeah, but here's the issue, Richard. Here's the, here's the big issue. So here's what's happening right now. If you look at this, and here's the problem is people are told, Hey, if you've got symptoms, stay home.

And if they start to get really bad, call your, so if you start to feel bad, call your doctor. But if they start to get really bad, you go to the hospital. So they're actually doing the exact opposite of what you just said to do, because by that time, they'd be in your lungs. And by that time, you're, you're really screwed, right?

Right. And, and so now this is, this is what you're saying and what's interesting, I always say, JJ, that, um, and by the way, I've gotta tell you something about you. Cause I talk about you all the time in my clinic. Um, but, uh, uh, that sounds a little creepy. I say No, it's positive. Yeah. I'm my, I'm waiting to hear what you're talking about.

So what I say is, functional medicine makes sense. It should make common sense and it would make sense that if there's a pandemic going around and there was something that could. Basically shut down the, the, the multiplication of the virus and the ability to get in through the body. It would make a lot of sense to try to start that as soon as there were any symptoms.

Right? Yeah. Now then, so then that's, that's number one. Then number two is, should you then try to take something like this? If you were exposed to someone who was positive, and so then to me, because this is such a low risk drug, I would say yes. Would I recommend that take, would, would the dosing be different than if you were, if you knew you were really like you, someone had it, you were there with them, you hugged them, you like shook hands, whatever, would you, is the prophylactic dose different than if you started to have symptoms?

I would, I wouldn't do the double dose on the first day. I would just take the pro profile. I, I would take a prophylactic test. And how many days, how many days would you do it if you just were doing it prophylactically? So then I would do it. So, so the, the guidelines from the University of Washington talked about four days.

This article that I have from Yao at all talked about a 10 day strategy. So I would, and so then, so then I just have to use my judgment based on two, two case reports. However, we know that, uh, people can be asymptomatic for somewhere between two to three or four weeks. And so then one conversation would be to prophylax for 10 days.

And then the idea would be that you did so much prophylaxis during that 10 days that there's no virus left and you could come off before you had symptoms. And so then, uh, my best guess is option A is to do 10 days and then come off, and then if you had symptoms go back on. Option B would be to say, okay, let's prophylax for maybe let's say two weeks or three weeks.

And then if you had no symptoms, you've probably, by the odds, made it through. And if you don't have any symptoms, you could consider yourself free uhhuh. And I don't think there's a right answer or wrong answer and people disagree with me. If they had good science and knew more about this, I'd be like, this is, we're gonna try to, we're gonna try to have a conversation like this every day and someone may come in tomorrow and say, I've got a great reason why it should only be four days.

Hey Matt. Um, so I was at CVS today as you know, um, dealing with challenges with getting this prescription filled. They're the one pharmacy that it was sent to, only filled two of them. I had to transfer the, a prescription to another pharmacy and they were running out. So, knowing that this medication has been around for quite some time, and it has been taken by millions of people, how quickly can the pharmaceutical companies, and I'm assuming this is, uh, generic, how quickly can they scale the production of this medication up to be able to meet the millions upon millions of people who, you know, would need it for these situations?

So, The, the good news is, is that because they've done, I think they're gonna be able to scale this up super fast. And so I predict in a couple weeks we're gonna have no problems. Now, fortunately, I patted your prescription a little bit so that with two prescriptions, if anything happened, you'd be able to have enough to cover the whole family down there.

And I did that intentionally. Um, uh, and I did that also without realizing I did. It took, by the time I read, read through all the, the information. It, it appears to me that if, if you were gonna do it for prophylaxis based on exposure, I think that the doing it for somewhere between. Four and, and 15 days is pretty reasonable.

And so there, therefore you're gonna be covered. And I wouldn't really stress about it too much. Um, I know that, uh, uh, I talked to somebody who, uh, there's a compounding pharmacy that I know that has like a couple kilos of it. And so they're charging, they're charging more than you paid at cvs, but so then know that, uh, so that we're, we have a lot of different ways to get this.

And, and then people who have prescriptions, if there is someone who's sick, you know, we may need to, and I've never said may need sharing their prescriptions.

We don't hoard anything. No, not at all. Not one. We hoarded a lot of wine. Wine. Well, and some supplements. And some you just give and give and give. We're givers. We have a lot of, I'm, what I'm saying is I'm the rea, I actually intentionally wrote your prescription a little extra just in case you would need to give it to friends.

Cause I kinda participated. But, so, so as you know, they, they, they, they took it down to 60, uh, per bottle because they were running. Yeah, it was, it was, it was getting run by the way, when I was in the pharmacy getting it filled, um, they were getting calls to get it filled, so it's already out. So it really wasn't more of a question about us here.

And thank you again for that prescription. It was more about, you know, the masses that are gonna wanna get their hands on this as this information starts to get out via your podcast and through other media outlets, you know, given. The current supply. I mean, am I right Matt? When it, if this, I mean the President Trump was talking about this from the podium today.

If this actually becomes a standard of care, holy mackerel, there's gonna have to be an enormous production, wouldn't you say? Yeah, but so then we're talking about, uh, if you said, uh, if you said no loading dose, and you said 10 days, we're talking about 20 pills a person. And so then I don't think it's gonna be that hard for them to ramp this up.

And the question is, is, and the fact that they mentioned it just, uh, gives me an idea that they probably have somebody that can ramp this up. Like when the, so this, they, they'll put this through a pill press when they make this. And so then I predict that they're gonna be able to make. They might be a