Diabetics Surviving COVID-19 with Deepak Malhotra

[00:00:00] Rob Howe: What's going on ladies and gentlemen? It's your host Rob Howe. We are here in the summer of 2020 at the time of publishing. This story is particularly relevant to today's events and that is why it's such a shame that it took me so long to publish it. What you're going to hear was recorded on April 16th, 2020, during the early days of COVID-19 lockdown. It features a patient that was introduced to me by the Integrated Diabetes Services team. And shout out to Catherine Jentz, who is their intern, who introduced me to some awesome patients from Integrated Diabetes Services, some of whom we've already featured and some that are more to come on the podcast, all who are around the world doing things with diabetes. One of those patients, Deepak Malhotra, who you're going to meet on this episode, lives in Dubai. He and I had some scheduling conflicts, which is pretty normal of international interviews. Balancing busy schedules takes a lot of time and coordination when eight plus time zones are involved. And our original interview was going to be in March. And during our scheduling mix-up, Deepak actually contracted COVID-19. And he walks through that in this interview. So this interview's title changed, and we talk a little bit about the sort of synchronicity for the reason that this moment has happened and kind of everything happens for a reason type chats. Deepak is a survivor of COVID-19, so that is one thing I want to make sure to get out of the way. And he goes into how people in Dubai are living, particularly people with diabetes, are living and being treated before coronavirus as needed and sort of the lockdown that they have there as well. So this is Diabetics Surviving COVID-19 with Deepak Malhotra. I'll get it right to the interview. I do want to say, though, I have not edited the interview for medical accuracy, so I do my best to not make any medical claims or recommendations on this show, even revolving diabetes, because I am not a doctor. But if you need more information on how people with diabetes can continue to fight against coronavirus and protect yourselves against coronavirus, please visit coronavirusdiabetes.org, presented by Beyond Type 1 and the JDRF Alliance. So with that, I'll get back to the episode. Please enjoy this conversation with Deepak Malhotra. Welcome back to another episode of the Diabetics Doing Things podcast. We are telling the amazing stories of people with diabetes from all across the world. And my very special guest today, calling from, you know, the key part of that phrase is from across the world, calling me from Dubai, Deepak Malhotra. Welcome to the show. Hi, how are you? I'm doing great. and uh you know i i mentioned this to you before we got on the got on the recording but if you if you believe that everything happens for a reason this episode is for you because you and i were supposed to talk maybe six weeks ago uh and you know with scheduling conflicts i couldn't really make that work and then we had to reschedule again uh but since then you've had a pretty eventful last few weeks if uh i guess that's the understatement of the century absolutely yeah so

[00:03:03] Deepak Malhotra: I think the first thing we had to grapple with was the time zones between us. I think we're about nine, ten hours difference. But having overcome that, on the early March, I started feeling a bit unwell. I started feeling quite fatigued. Interestingly, in February, between the 19th and 23rd, I was in Madrid. I went to the ATTD conference. and that was a great experience as a person with diabetes came back to Dubai didn't really have what I would say the classic COVID symptoms you know I didn't have fever I didn't have a sore throat I didn't have a cough I didn't have breathlessness but I knew something wasn't right and I guess as a diabetic we're quite sensitive to these things we can tell we and so when our blood sugars aren't in sync, particularly with all the kit that we have. And that prompted me to go and see my doctor and say, look, I think I might have this virus. Can I get a test? Can you get me checked out? And she said, look, unfortunately, you don't meet the requirements. I cannot test you. I said, okay, fair enough. I also did with my mum, who's 74, who's had cancer, who's a type 2 diabetic and has high blood pressure. So she's a high risk person. So I was actually more worried about her than anything else. And we live together as a family here in Dubai with my wife and young kids. So I then a few days after that went to the hospital and said, look, I really I really still not feeling well. Can you please test me? I have been traveling. I was in Madrid. Interestingly, in the end of Feb, I was in Delhi for one night and in my hotel, one person was diagnosed with COVID. so potentially there's a link there can you please um test me they agreed to test me which is great now in Dubai at that time once they tested me they say you have to stay until you get your result so they they came in a room I was in quarantine I thought okay fair enough I didn't think I had it because I didn't have the classic symptoms so in the end they they they kept me in and I went on the Friday, I think it was Friday the 13th. And then on the 14th night, Saturday, I got a call at 1-2 in the morning in my room saying, unfortunately, you've been positive. I thought, wow. I was a bit shocked. I didn't expect it. So then it was like too late to call my family. I called some of my colleagues in the UK because they needed to know because I was in contact with them. My biggest fear was, have I given it to anyone else at that time? And then I was also thinking, well, what's going to happen to me? How bad is this going to be? But on the latter, I was quite hopeful. I thought, well, I haven't had the symptoms that badly so far. Hopefully, I'll be all right. And I was also told, moved by the hospital to a negative airflow room within the hospital. And basically said, until you have two negative tests in a row, you can't leave it. So you can't leave your room. This is a legal restriction in the UAE, which in my view, again, is quite sensible. So I was diagnosed, moving to another room, had to start thinking about how many of my things, my medicine, my food, my clothes, contacting people, telling people. And the next day, I literally, you may have read from the article I sent you in the UAE newspaper, having to phone about 20 people that you've been through, been with in the last 40 days and say, hey, dude, how you doing? Yeah, I'm fine. I may have infected you. Not the easiest conversation.

[00:06:41] Rob Howe: And I imagine, too, that just carries with it some, you know, just personal feelings of, you know, personal emotions and, you know, fear. Do you remember any, you know, of those 20 people, has anybody tested positive or has it also, you know, affected them in any way?

[00:06:58] Deepak Malhotra: No, they haven't. So the good, so firstly, good thing about Dubai, immediately have been diagnosed. The Dubai Health Authority contacted me, which is like the government authority here. And they arranged my family to be tested immediately and my colleagues to be tested immediately, which is great. And then they asked for the contact trace and they asked for details of all the people who I've been in touch with, name, number, whatever. And they also had the right to get tested. They wanted to. And like, you know, the UK, US and other countries, there's no real shortage of testing here. So, you know, people got tested and fortunately, everyone came negative. And I put it down to one thing. I'm no doctor. I'm no expert. But because I didn't have a cough, because I wasn't sneezing, and because I had really good hygiene at that time, because we were worried about COVID at that time, I don't think I gave it to anyone because of that. And I think that's probably the theory, because it's quite weird how no one got it from me.

[00:07:57] Rob Howe: Well, and I think it's interesting, too. It's a good, you know, shifting gears a little bit to your own symptoms. It seems like you are, for the most part, asymptomatic, which is what we hear from people who have and test positive for COVID, but don't have the cough, fever, classic symptoms that you hear about.

[00:08:15] Deepak Malhotra: I wouldn't say asymptomatic because if you look, I read a study coming out of China saying 40% of people had fatigue and 40% roughly people had sputum. And I had sputum and I had fatigue. I wouldn't say, I wouldn't say it's asymptomatic, but I would say I had, didn't have the classic symptoms. So I, you read 78% of people, whatever, supposed to have fever. Well, I didn't have fever. I didn't have the other symptoms. And again, I put that down to some extent, my diabetes being well controlled.

[00:08:46] Rob Howe: So yeah, let's talk about that a bit. As a person with diabetes, obviously, we've read a lot of the literature that's been put out by the World Health Organization in the United States. We have the Center for Disease Control, and they put people with diabetes in the high risk group. but, you know, at, you know, subsequent information has come out saying, you know, people who are have their diabetes in control and, you know, are otherwise, you know, healthy, you know, by, by normal standards are at less of a risk. And really they just have the same risk as a regular person, you know, regarding COVID. And as I see, those of you listening, you can't see, but Deepak just took a hit of a Afreza. So obviously your lungs are feeling good. So, as we breathe in that insulin. So for you, when you first were diagnosed, what were your immediate thoughts as a person with diabetes, testing positive for COVID? And then how did your diabetes respond throughout the time you were in quarantine and even just going through the day-to-day with the virus?

[00:09:48] Deepak Malhotra: So I think the impact of the diabetes was very apparent prior to me going to get tested, which prompted me to get tested because I knew there was something wrong with me. I would go to the gym, I'd come back, I'd fall asleep, I'd be really tired, and I'd have quite elevated blood sugars. And I thought, you know, there's something in me, there's something wrong. So as a person with diabetes, I guess the fear is when you're diagnosed is, am I going to be more serious because I'm quote unquote immunocompromised, point one, and how am I going to control my sugars? So let's talk about the latter. I'm very lucky that I'm on the loop system. Thanks to Gary, Gary Scheiner and his team who got me set up on this. And the loop system enables you to put in this temp basal. I've been 150% at the time. And it enabled me to automate the increased delivery of insulin that the virus promoted. So I think, you know, I was, I would probably say, because I was in a room, I was static. That has some impact on having an elevated basal. And then I always had an elevated basal because I had the virus. I would say the beginning time in hospital, 70 to 80% increase in basal. And then you'd interestingly see it tail off. And that's our own unique thing as a diabetic to know when you're getting better, you can see your insulin coming back to normal. because you can see the virus is kind of going out of your system, which also corresponded to me being tested negative at that time. So, you know, loop is great. CGM is great. The pump is great. All linked up with the temp basal feature. Kind of got on with it, which was brilliant. And again, coming back to the point about diabetics and the risk of COVID, look, we all have the equivalent risk of catching it. It's what impact it has on you. and and I think what my personal experience shows if you're a well-controlled type 1 diabetic you should be as good and who's otherwise healthy because you know there's no point being well-controlled having other issues but you know I'm generally quite fit and healthy that I think made the symptoms much less severe than they could have been. So you credit even

[00:12:07] Rob Howe: you know the preparation that you were doing and the way that you're managing your diabetes and your overall health beforehand as instrumental in you being able to overcome COVID and fight off the symptoms and those types of things?

[00:12:21] Deepak Malhotra: Absolutely fundamental. Because at the end of the day, it all comes down to your health and your ability to fight off these infections. If I didn't have this control, which I have in terms of HbA1c, time in range, et cetera, I think I would have been probably a lot worse.

[00:12:41] Rob Howe: And have you, I know that, you know, Catherine has introduced us from Dr. Gary's practice and she's made a number of introductions to me beforehand, you know, before this COVID piece and, you know, our original interview would have been more along the lines of how has your relationship with Dr. Gary and your, you know, commitment to technology and to overall health, you know, played a part in, you know, managing your diabetes. And we would tell that story. But, you know, how much now like that story would have changed dramatically. Right. Like the the things that you were doing beforehand allowed you to be more comfortable, to be more responsive, to be able to physically fight off the COVID-19 virus. And, you know, there's really no way to quantify how important that is. Right. You weren't necessarily doing that because of COVID-19. You were doing that for overall health. And as a result, you were able to overcome the virus relatively, I would say relatively easily, yes?

[00:13:43] Deepak Malhotra: Yeah, you have your challenges and struggles. I was very fatigued. I was unwell. I was tired. And then even after I came out, I had a bit of a relapse. So I took some time off work because I was very tired, very fatigued. But again, it could have been a lot worse. And going back to Dr. Gary, I went to see him in May 18 with my wife. We went over to Philly from all the way from Dubai because he kind of felt a bit lost with diabetes. I went through a lot of challenges, had a number of issues, particularly around sight issues and other things. And, you know, I think I always see the U.S. as the leading center for tech and ideas and innovation. So going to meet Gary was a massive eye opener. And on the back of that, I went to go to Taking Control of Your Diabetes conference, which I heard about. Yeah. Because Gary mentioned, I got to know Dr. Edelman, who's a great guy. So through Dr. Gary and then Jenny, who was one of his team, I got to learn about Afreza. I got to learn about Lou. I got to learn about the Taking Control of Your Diabetes conference. So all of that kind of followed from there was life-changing in terms of my diabetes. And now I'm pretty much, you know, I'm a looper with Afreza. I don't think you can get more cuts in edge, I guess, in terms of, you know, diabetes and that type 1 in terms of control, the care. With an HbA1c of, you know, 6.0, 6.1 time in range about, I mean, sorry, standard deviation about 1.5. So it's very, and I live life, you know, I travel, I train, I don't travel anymore because I'm locked down. But, you know, I do everything. So I put a lot of credit down to Dr. Gary and his team, and then following that Dr. Edelman as well.

[00:15:29] Rob Howe: Yeah, I think it's really interesting. I'd love to know, you mentioned the U.S. sort of being on the cutting edge of technology and innovation, especially around diabetes care. What was your, before coming to the U.S. in 2018, what was your diagnosis story? Give us the, what was your life with diabetes like prior to meeting with Dr. Gary and with Jenny and their team? What prompted you to make that change and really seek that out?

[00:15:55] Deepak Malhotra: I felt it was quite stressful. I could control my diabetes, but I felt quite stressed all the time with it. And I didn't feel I had the tools to deal with that. So I think seeing Dr. Gary and his team opened my eyes to get the tools to deal with that.

[00:16:15] Rob Howe: Yeah, I think it's something that's really interesting, I think, for a lot of my listeners. when I have guests on from overseas. And obviously, you're a well-traveled man, so you understand that every place is different. Every country's got a different healthcare system, a different way that they do things. And with that comes a sense of differences around diabetes management, around technology discussions. What would you say your diabetes management and your diabetes knowledge was like in the UAE prior to coming to Philadelphia in 2018?

[00:16:49] Deepak Malhotra: so even while i was living in the ua i i i moved to the ua from the uk um or of indian origin i was born in in the uk and i i lived most of my life in the uk so my treatment even once i moved here was pretty much in the uk because for type ones bear in mind the ua is a small place dubai is a small place um there is there is limited in terms of the depth of care uh but i think there's quite good type 1 care for pediatrics but for adult type 1 there isn't a huge amount of specialism here so because i'm in london a lot anyway i get my treatment in the uk but so my benchmark i would say is more the uk than the uae um but i would say the the the uk well you know i have a very good doctor in the uk who's a great guy um but i think the adoption of technology which ultimately is the game-changing now in diabetes. It's all about tech. It's far more advanced in the US than in the UK. And even the tools available, I think. Like Afreza is not available in the UK. Right. Loop, yes, is there. But if you compare the number of loopers in the UK to the US, it's a different level. So I would say... And the UK is an NHS-based system. It's a government-based system. So, again, it's great in some way, but there's limitations in other ways. So, I don't know if you know, I mean, I think only 25% of people in the UK, I mean, don't quote me, but you may need to check this figure yourself, have CGMS. Right. That's startling. So, the US is generally, you know, I know there's challenges with the health system in the US in terms of how it's set up and devised, but in terms of tech and usage of tech, it's light years.

[00:18:36] Rob Howe: Right. I think, you know, it kind of blurs the lines of like healthcare and then free market economy where there's still, you know, innovation and, you know, entrepreneurs and people who are making these amazing tech developments. But then access becomes the issue across the board. Right. So it seems like. Economics, isn't it? It is. It's, you know, it's really it's economics. It's it really comes down to like there really isn't a system that I could point to and say this. this is exactly the way it should be. I think there's stories in the UK about people, uh, who are struggling. There's the stories in the, of Canada, people who are struggling, there's obviously the U S people struggling. So there's, uh, I can't point to a perfect system, but there's certainly ones that work, uh, you know, differently, like you said. So, um, it's cool to see how community is a factor as well. Um, and you know, for those listening, don't quote me on this either, but I read a study at the ADA conference, the scientific sessions in 2018 that mentions that people who are involved in diabetes blogs, social media, the online community have better A1C outcomes a hundred percent of the time than people who are not. And so, you know, just to hear you talking about not only getting in touch with Dr. Gary and going over to the U S but also attending the TCOYD, taking control of your diabetes conference, meeting other people, being exposed to the community, the Loop community, the Afreza community, and learning about diabetes technology and the impact that can have on your management and your life. And like you said, just your stress level. It's huge. And just taking that one step further.

[00:20:09] Deepak Malhotra: So I then through Loop got onto Facebook. I don't have a Facebook account, but I only used it for Loop. And then the Loop Facebook thing was amazing. And Dr. Edelman told me about the ATTD conference in Madrid, which is maybe where I actually got COVID, who knows. And I went there and we had a lupus event. And so that was phenomenal where you had 30 very highly motivated diabetics all with the same issue and use of tech as you in the same room. And we had a night out together and we're on, we have a WhatsApp group and a Facebook group and it's fantastic. So that That is great. Yeah, that's certainly been an eye over that.

[00:20:53] Rob Howe: Yeah, I think just the, it's hard to explain to somebody who has not opted into that type of community how impactful it can be. Even if it's just meeting up with a group of people who have knowledge or have been doing something longer. I imagine that loop group at ATTD in Madrid was eye-opening for just the knowledge share and the tips, the hacks, the way that people live their life around that technology.

[00:21:22] Deepak Malhotra: Absolutely. Katie, who set one of the people behind all of it, she was there. There were some type 1 endos who were loopers who were there. Quite phenomenal. Quite phenomenal.

[00:21:33] Rob Howe: So let's shift gears a little bit. But what's life like in the UAE right now at home for you? You're obviously calling from your home, and we had talked a little bit about this before we jumped on the recording. But for those people who are in the U.S. right now, where maybe they're in a big city like New York, and they're fully on lockdown, or maybe they're in a rural area and things aren't as strict, what is life like in Dubai right now?

[00:22:00] Deepak Malhotra: In terms of lockdown, very strict. you can't leave the house without getting a permit which you have to apply for online you can only leave the house to get food and if you do you have to go alone and you have to wear a mask and gloves or you can go to the pharmacy again on your own or you have to go for a medical appointment and the only other example is if you're one of the prescribed professions or employment works where you're able to go out to work with a doctor or construction or whatever it may be so pretty much you're at home but I'm fine. I don't mind it at all. I quite like it being, I've never had this much time with my kids before. Um, you know, the weather's great. Sit in the garden. It's nice and warm. You know, you work from home, you spend half lunch as a family, dinner as a family, barbecue is great. I don't, I don't mind it at all.

[00:22:48] Rob Howe: Yeah. I'm kind of in the same boat. I've spent a lot more time at home, uh, work, work wise. It seems like, you know, at least 90% of the productivity we're able to get just working from home, at least in my case. And I get to spend more time with my fiance and I, and yeah, we have dinner together every night. That's just a, it's a different, it's, it's a different rhythm, but I'm enjoying it. I think I've seen a lot of people and there's a lot of jokes online about spending too much time with family, spending the, you know, getting on each other's nerves or, you know, little ticks or whatever, but I haven't experienced that yet. So, and I don't anticipate that I will. So it's been a nice change of pace. Absolutely. And I think the world is rebooting.

[00:23:32] Deepak Malhotra: Everyone was going at such a fast pace and I consider myself guilty of that as well. So to not travel, to not commute, to be at home, to be with family, to be healthy with food and everything else, you know, you're not eating out, you're not eating crap, is great. And I think we're back to kind of grasp, we're back to basics. And let's hope this can, obviously it's horrendous what's happening out there, but let's hope that positive continues. And we will benefit in that

[00:24:01] Rob Howe: way. Yeah, I think I'm in the same boat. I'm starting to see, you know, I think at first I was clouded and felt a heavy weight of what was going on in the world. And obviously it's tragic. I mean, as of today, we're more than 22,000 Americans have died from COVID-19, which is just a terrible tragedy. But I agree with you. I think that there are some positives. We start to realize, you know, 70% or so of the U.S. economy GDP is spent on consumer goods, things that we don't necessarily need always. So, you know, really getting down to essentials, health, food, exercise, time with family. And I certainly miss traveling. That's a part of my life that I really like as well. And I, as well, you know, I kind of echo your sentiments as well. I'm certainly guilty of trying to do too much and trying to go too far and kind of stretching myself a bit. So it's been nice to be kind of grounded, really just sit in my house and be here with my family. So yeah, I mean, hopefully we can take some positive things. I think the environment impact, the impact on the environment, at least in the U S for sure is being positively impacted. The air is fresh.

[00:25:10] Deepak Malhotra: I mean, you look at it in someone like Delhi, which is a very, very polluted city, pretty much polluted city in the world. And you look at pictures from there and it's amazing, as clear as anything. And so Delhi is breathing again. So there's some cities in the world where mankind has really hammered them. And, you know, you're getting such beautiful environmental results now.

[00:25:34] Rob Howe: Yeah. You know, even still, obviously here is not quite as strict as it is in UAE. so people are still allowed to walk around. And even though they've encouraged everyone to wear masks and gloves, you'll see some people running, walking their kids outside, walking their dogs, more people outside just recreationally than I've ever seen. I'll look outside my window now.

[00:25:56] Deepak Malhotra: And I cannot see. There's one person there I can see. I can see two people who probably shouldn't even be out there. That's it. You know, you can't, you can't even go out for a wall kit. So, um,

[00:26:14] Rob Howe: and I think there are advantages to, you know, uh, having those discussions, uh, with, with my fiance and, or with my business partner and such is like in America, we, and we talked a little bit about this before one of our, you know, great traits is our stubbornness and our kind of bucking the system and pushing back. And, um, you know, and that sparks innovation in a lot of ways, but at times like this, I don't think it serves us very well because I think there are people who are putting themselves at unnecessary risks. And, you know, part of our part of our problem is, you know, controlling the spread of this of this virus. And we're, you know, in some places not doing a great job of that and, you know, suffering the consequences. So, you know, in some places like UAE, where the lockdown is a little bit stricter and there's a little bit more oversight on that, I think we're starting to see better results in terms of flattening the curve of COVID and obviously you yourself having been through as on a first person basis, you know, or I'm sure seeing that. Absolutely. So, you know, hopefully, you know, the rest of the world can take a cue from the countries like UAE who are doing a really nice job and minimizing the impact.

[00:27:21] Deepak Malhotra: India has got a really strict lockdown. And if in a country like India, if they didn't do it, you'd have millions of people who would die. now it's not perfect how they're dealing with it but you have to countries like that you have to be strict you have to you know otherwise they don't have the resources so you know fingers crossed but you know particularly in some of the more developing countries they can deal with it and they're being very strict so i think the developing countries know they're not strict it's the consequences are dire they can't just print money and uh right trillions into the market. It doesn't work by that for these guys. No, it doesn't. Let's talk a little bit about

[00:28:00] Rob Howe: just general sentiment for people with diabetes or listening to this. As a person who has diabetes, is well-controlled, has lived through COVID-19, for someone who's out there worried about the virus or is experiencing a lot of anxiety or fear, what would you tell them about your experience?

[00:28:21] Deepak Malhotra: i think look um clearly you want to try and avoid getting it so take whatever steps you can in terms of hygiene and social distancing and everything else like anyone would and that's the first thing i think if you do that your probability of getting it is low now one should also do everything one can excuse me to bulk up the immune system so eating healthily uh exercising and doing all the resting and doing all the other things that count for good help. And manage your sugars. Stick to basics. If you stick to basics, you probably won't get it. And if you do get it, you'll probably be able to manage it. And then it's very simple. And then that's what I would say to anyone. Then it's in God's hands.

[00:29:08] Rob Howe: Right. And I think it comes down to almost the way you approach anything, right? Like if you're prepared and you do everything that you can to avoid it and give yourself the best chance, then, you know, I think that your outcomes ultimately can be very positive.

[00:29:22] Deepak Malhotra: Absolutely. So use the tools, I think, use your tools like Loop and other things as much as you can, because if you do get it, your ability to deal with this or any other illness are much

[00:29:33] Rob Howe: better as well. Yeah, I agree. I think it's interesting, like, early on, the comparison of COVID-19 was to the flu. And especially for people with diabetes is yes, if you get the flu, you experience elevated sugars. If nausea presents problems for hypos and hyperglycemic incidents. And it's similar to COVID-19 in that way. But people with blood sugars that are in range and good diabetes control do not struggle with the flu as much as those who are on the other side of

[00:30:07] Deepak Malhotra: spectrum. So that's the thing. I don't really get the flu. I do have the flu jab anyway. And, and the impact of the COVID was, was like I said, 50, 60 percent on the basal. So it wasn't that dramatic, but I guess if someone's hit badly, then I guess it would be a lot more dramatic.

[00:30:22] Rob Howe: Sure. I think it's just like any virus. It is. And so, you know, as you are kind of, I'm now in this position to be one of the unofficial spokespeople of living through COVID as a person with diabetes. I believe there's at least two other folks that I've seen podcast interviews with who have type 1. And interestingly enough, all of them are from other countries outside the U.S., which I think is an interesting component.

[00:30:54] Deepak Malhotra: Maybe it's because we get tested more.

[00:30:56] Rob Howe: That too. And I think I always take metrics, because in the US, there's a lot of information control, because I believe, and this is a hot take for me. I usually don't get in too much to this on the podcast, but it's an election year. So the government is doing whatever they can to minimize unemployment, minimize the number of cases, minimize the number of deaths. That's politics anywhere in the world. Yeah.

[00:31:23] Deepak Malhotra: Of course. So look, the testing thing is interesting because, you know, if you look at someone like Germany, Germany had a huge number of tests and look at the number of deaths in Germany. Look at Korea. Look at the UAE. 20 plus deaths, not that many deaths. Huge 600,000 tests testing for a population of 10 million. So countries like the UK and the US, which are way behind the curve in terms of testing. Again, it's not a political statement. It's just a matter of fact. you don't know there's so many people going to be sitting there with this spreading it around and that's unfortunate there's not much you can do about that it's the system it's not people's fault so that's probably why you've had it from people in other countries because from the UK for example unless you're seriously ill and you're in hospital you can't get tested until very recently I think they've just changed the matrix so you won't know

[00:32:19] Rob Howe: yeah and I think there's a lot of people in the US that are probably the same thing. You just feel under the weather or they're asymptomatic. They don't even know that they have it and they get over it and move on and they're not necessarily part of the whole number.

[00:32:34] Deepak Malhotra: With a mass testing now, I think for diabetics as well, I think it's very important. I got through this okay, but some people wouldn't. For those who are immunocompromised, having mass testing is is critical and the sooner that can happen whether it's uk us or timbuktu the better and it's critical for people at risk because until the vaccine's found this thing's going to be around for a while and um because then you then the casting that then the thing is going to be well can you test for having the antibody right so there's a lot of work this is a few there's a long

[00:33:10] Rob Howe: stories to go yeah yeah i think we're really only at at the beginning like you said early doors early doors early doors so you know i i think the idea and you know as i have conversations with friends or i read things in the media you know there's this sense of like hey okay great we're flattening the curve or whatever the whatever the narrative might be we're going to get back to normal soon i just think that that's short-sighted uh i think that our new normal is going to be uh slow uh it's slow to roll out and you know there's still a lot of people who are at risk and And a lot of work that has to go on in time, unfortunately, that has to take place before a vaccine is approved and before we'll be able to be back.

[00:33:50] Deepak Malhotra: Tell you one interesting thing I saw today in the papers that they're talking like football matches in England. They're not going to be with crowds probably for 12 to 18 months. And things like that. I mean, that's quite fun. Mass gatherings, fundamental. And one sad thing for us as diabetics is a lot of the new tech and the new things that have been developed with trials and everything, all of that's on hold. I remember going to the ATTD conference and looking at all these new things that were amazing and very interesting for me, all these trials are going to be on hold. We're going to be impacted in so many ways. We can't even fathom at this stage.

[00:34:26] Rob Howe: Yeah, I think it's one of those things where, you know, as a kid, you're going through world history and you're reading about plagues and wars and depressions and things like this. and I think now we're looking at one of those. If we kind of take a step back and look above and take a higher viewpoint, we're just at the beginning of a world-changing, culture-altering event. And the fallout is going to be very different. And like you said, football matches, I think the NBA is my favorite sport. And I imagine they'll probably play the NBA finals and NBA playoffs in like a practice gym with nobody in it. And that'll just be the new reality for a while. It'll be very, very, very interesting.

[00:35:07] Deepak Malhotra: And just you were talking about the new reality. I think for diabetics now, it gives us the opportunity to, you know, because this could go on for quite a while, is say, okay, if your control is not even great now, just work on it. You're at home as well. You've been in a routine. You've got every opportunity now to get your control smart. Use the tools you've got. Keep your control good. And if, God forbid, this hits you, then you'll be well-placed to deal with it. So that's my advice. Do your exercise, rest, get your control good, and you can fight this if it actually comes. Because most people are going to probably get it. Until it comes to vaccine, most people are going to probably get it. That's what they say.

[00:35:59] Rob Howe: Yeah. So I think, you know, you, you bring up a great point, like whatever you can do today to get ready for that, that preparation can serve you really well long-term. So, um, well, Deepak, I appreciate you taking the time this evening on your, on your end. Uh, and, uh, you know, for helping coordinate, uh, with, with Sharon and getting this, uh, on the books, uh, I'm grateful that we were both able to reschedule this to a time that you had a little bit different perspective than the first time we would have gotten together. And I'd love to check in back with you in a few weeks and just see how things are doing over there. But yeah, I just want to extend gratitude from me here in the United States. And it's great to meet you. Please reach out at any time if you have any breaking news. I feel like you've been unofficially named one of the COVID spokespeople for people with diabetes.

[00:36:50] Deepak Malhotra: That's why I did my video diaries. I don't know if you saw the video diaries. did you see my daily video diary? you got that didn't you?

[00:36:56] Rob Howe: yeah Sharon shared that with me

[00:36:58] Deepak Malhotra: yeah yeah great yeah so you got those article the video diaries it's a time in history you know and so yeah you want to look back at this in years to come and think okay wow this is something quite a landmark and if by doing this podcast I can help other people with the condition then be delighted to

[00:37:21] Rob Howe: well that brings me to my last question I know you have a Facebook just for the purpose of your Facebook groups is there a place online where you think people who are listening if they want to reach out would be a good place to do that

[00:37:33] Deepak Malhotra: yeah I think if you're via your website or your podcast if anyone reaches out to you then connect me with them on email or something

[00:37:39] Rob Howe: great I'm happy to do that

[00:37:40] Deepak Malhotra: delighted to help anyone

[00:37:43] Rob Howe: great well Deepak thank you so much again and you know we'll talk again soon