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Travis Christofferson has written three books on metabolic health optimization. His third and latest one is “Ketones, The Fourth Fuel: Warburg to Krebs to Veech, the 250 Year Journey to Find the Fountain of Youth.”
Interestingly, optimizing your metabolic health appears to be an effective way to mitigate the severity of a COVID-19 infection. The reason for this is because when you're metabolically flexible, you're not insulin resistant, and insulin resistance and diabetes are significant risk factors.
The ketogenic diet was a standard of care in the 1920s for pediatric epilepsy, but once antiseizure drugs came out in the '30s, it was shelved and eventually forgotten. Fasting encountered the same fate. As noted by Christofferson, therapeutic fasting was huge in the '60s, yet the benefits of this strategy eventually fell by the wayside of medical history as the low-fat movement took hold.
“[Nutritional ketosis] made this remarkable resurgence by the year 2000, and people began to recognize that ketones were essentially a fourth fuel, and had these incredible therapeutic side effects,” Christofferson says.
Today, as we face epidemic levels of insulin resistance and its associated health effects, including diabetes, heart disease and increased vulnerability to viral infections, nutritional ketosis could not be more pertinent.
The four fuels are carbohydrates, fats, proteins and ketones. Carbs and fats are the two primary ones. Proteins are primarily used as building blocks, but they can also be broken down and be burned as fuel. They just cannot be stored for anything other than emergency starvation fuel.
Protein can also be converted back into glucose through gluconeogenic pathways. When you fast, protein can be used as an alternative fuel, but the ideal fuel is ketones. Christofferson explains the metabolic difference between carbohydrates, fats and ketones as follows:
“For some reason, life chose glucose as a primary fuel. Carbohydrates all enter the same sort of glycolytic pathway and get burned or processed through 10 enzymatic steps into Acetyl-CoA, which enters the Krebs cycle. It then spins off substrates that feed into the electron transport chain to generate energy.
How we burn fat is very dependent on insulin. So, when you're eating a lot of carbohydrates, when you're releasing insulin throughout the day, you're essentially shutting down fat processing and turning on the lipogenesis, which is fat building, and it all centers on insulin.
So, when insulin is high, it shuts down the process of fat burning, which is beta-oxidation. When insulin is low during a state of fasting or a ketogenic diet, it turns on beta-oxidation. So, fats will come in and get processed. What makes fats unique, and this doesn't get talked about a lot, is that they're extraordinarily energetic. There's tons of energy imbued in that fuel source.
So, the body really has to come up with a way to process it without blowing up the mitochondria. The way it does this is, some of the fat is processed through Complex II of the electron transport chain, which tones down or dampens the energy within fat so it can be processed without exploding the mitochondria.
Then the Acetyl-CoA enters the Krebs cycle and just goes through normal metabolism. The important point is that fat burning gets turned off by too much carbohydrate. When you enter this state of ketosis, fat burning gets turned on, and when beta-oxidation occurs, when we're burning fats, it is tethered to the process of generating ketones.
So, low insulin tells adipose cells (fat cells) to release triglycerides, stored body fat, that enters the circulation that goes into the cells, and then beta-oxidation begins. Within the liver — this is the central part of ketosis — liver hepatocytes are the manufacturing line for ketone bodies.
As beta-oxidation is ramped up, oxaloacetate, the last metabolite of the Krebs cycle, is being pulled out to generate glucose, because the body has to maintain a baseline level of glucose. The Acetyl-CoA cannot combine with the last substrate of the Krebs cycle, so it builds up in hepatocytes.
And then there's an enzyme waiting for this massive buildup of Acetyl-CoA. This enzyme begins to transfer that into acetoacetate, which then gets converted to beta-hydroxybutyrate, which now enters the bloodstream as a fourth fuel, a preferred fuel, and an extraordinarily efficient fuel. So, that's the metabolic difference between these three fuel sources.”
The problem is that with today's standard American diet, most people never reach this state of fat burning and ketosis. They’re constantly feeding their bodies carbohydrates, and in this high-insulin state, they simply cannot burn fat. Over time, it wears out your metabolic machinery, resulting in insulin resistance and weight gain.
As explained by Christofferson, glucose is a very rigid planar molecule, and when in your blood, it damages your epithelial cells, nerves and just about everything else. For this reason, your body has to get rid of it quickly. The insulin tells your cells to take up the glucose to lower the glucose level in your blood.
It then tells the cells to process it by turning on the last step of glycolysis, the pyruvate dehydrogenase complex, so that the glucose can be processed. When those two “machineries” wear out, you develop insulin resistance. What this means is your cells no longer respond well to insulin, and as a consequence your blood glucose remains elevated.
You’re also burning less fuel, which diminishes all metabolic processes. This is in context to a state of insulin resistance: Less glucose is able to enter the Krebs cycle and ATP production slows. For example, the efficiency by which your body makes antioxidants and neurotransmitters decreases. The beautiful thing about ketone metabolism is it completely bypasses all this pathology. It doesn't depend on insulin pathways.
So, when you're generating ketones and your blood ketone levels go up, the ketone enters the cell through a model carboxylic acid transport protein. Even without a rise in insulin, the cells are efficiently fueled.
Ketones also do not need pyruvate dehydrogenase complex. Instead, ketones go directly into the Krebs cycle. So, all of a sudden, diminished metabolic pathways spring back to life and you’re able to generate energy, antioxidants and all the rest. Your brain also gets the fuel it needs for optimal function.
Ketones have a number of specific benefits. For starters, they’re thermodynamically and metabolically efficient, meaning they burn cleaner than glucose, thus creating far less free radical damage and inflammation in your body. Christofferson explains:
“Beta-hydroxybutyrate is a metabolically superior fuel. It's thermodynamically imbued with more energy per two carbon unit than glucose. So that sets the stage. When you burn it, it widens this gap in the electron transport chain between Complex I and the Coenzyme Q couple.
The electron transport chain, what it does is, when you burn fuel, the electrons are stripped through, and they go through a series of complexes in the electron transport chain. When it does this, it injects a proton into the inner mitochondrial membrane space. That gradient of protons then generates ATP.
Beta-hydroxybutyrate widens this gap … There's more energy … to capture. One thing that does is, it supercharges our metabolism.
When Veech and Krebs were studying these four metabolic hubs, these coenzyme couples, where ATP is one of them, that drive all metabolism, they realized that if there was a way to increase the energetic potential of all these nucleotide coenzymes, it could therapeutically have immense benefit for metabolism.
They just didn't know a way to do this. When Veech merged with Cahill and began studying this, they realized that beta-hydroxy did exactly this. It was metabolically imbued with the ability to increase the amount of energy in ATP, NADP, NADPH and Acetyl-CoA.
Then you look at what that does … for example, the manufacturing of internal antioxidants … is dependent on the charge of NADPH. Under ketosis, that charge is dramatically increased. So, we're able to process free radicals much, much better.”
The concept of NADPH is profoundly important and not widely appreciated. It’s probably every bit as important as NAD+, especially with respect to recharging endogenous intracellular antioxidants. As explained by Christofferson, the only thing that determines the antioxidant status of a cell is the redox ratio of NADPH, and the only known way to change that redox ratio is through burning beta-hydroxybutyrate.
There’s a pervasive belief that you can diminish free radicals simply by consuming antioxidants, but that has never actually been proven. As noted by Christofferson:
“Krebs wrote Linus Pauling about this, saying, ‘You don't understand what you're talking about with regard to Vitamin C.’ The example I try to give in the book about this is, all these antioxidants … have to be recycled by NADPH. So, the NADPH ratio alone is dictating the way all these antioxidants work.
If you eat antioxidants, it's just like having a full grocery store. There are 10 cash registers, and there's 10 checkers. The rate limiting step in how fast people get checked out is the 10 cash registers. If you add 20 cashiers, it doesn't help. Those 10 cash registers are the thing that determine how many people in the grocery store get checked out.
It's the same thing with antioxidants. You can eat antioxidants and add to the pool of intracellular antioxidants, but they're not being recycled any faster. So that’s a huge misconception about how antioxidants work. When you shift to ketosis, there's profound therapeutic consequences with regard to antioxidants production.”
Christofferson cites research showing that when you give mice ketone esters after dosing them with radiation, the chromosomal damage incurred is reduced by 50%, compared to mice fed a normal carbohydrate diet. He believes taking ketone esters is therefore advisable when getting X-rays or when flying, for example. Ketone esters may also help counteract the normal ravages of aging.
“One of the theories that's stood the test of time is the Harmon free radical theory of aging, which is that we really do produce a lot of, just endogenous free radicals, just by normal metabolism. And that has always been considered the proximal cause of aging, because it's the main damaging event within the cell,” he says.
“One of the ways to mitigate this constant endogenous free radical production is through ketosis, keto metabolism, beta-hydroxybutyrate. It slows the production of free radicals …
Beta-hydroxybutyrate metabolism in ketosis will also dramatically increase the levels of NAD in our bodies … So, exogenous NAD precursors, ketogenic diets, fasting or ketone supplements are ways to really slow this pernicious process of epigenetic aging.”
Beta-hydroxybutyrate also activates FOXO3a, which is perhaps one of the most important pathways for antiaging. FOXO3a in turn changes the expression of hundreds of other genes.
Some of those genes regulate internal antioxidant production such as catalase and superoxide dismutase. These are not like traditional antioxidants that have to be recycled by NADPH. They operate by traditional ketolysis, where superoxide is changed into hydrogen peroxide and then water.
Christofferson also reviews how ketone esters can improve athletic performance and recovery:
“Another good real world application of this is Tour de France riders. They discovered ketone esters back about 2012 … The reason they're so important is, by the third week of this grueling bike race, the primary reason you're not recovering is because you're generating so many free radicals by this massive intake of oxygen and exercise.
When they take this ketone ester, they say they have an unprecedented ability to recover, and it's because it's blunting this free radical generation and massively increasing their ability to cope with all these free radicals that are damaging tissues and grinding them down as this race occurs.”
There’s also some data suggesting ketone esters can be beneficial for certain health conditions.
“In somebody that's showing the beginning signs of dementia or Alzheimer's, the [ketone] esters are able to increase levels of beta-hydroxybutyrate to druglike levels. You get these enhanced pleiotropic effects of ketone esters.
Another effect … is it inhibits NLRP3 inflammasome, the initial complex that kicks off inflammation. So, beta-hydroxybutyrate at higher levels can suppress inflammation. [It can also] act as an epigenetic reprogrammer. It inhibits HDAC proteins, which are proteins that install the tags on histones, to change the genetic expression.
The initial data show that people in the throes of some disease process may benefit more from an ester than somebody that's healthy and just looking for enhanced quality of life. That being said, it's a natural compound, it's a fuel source. It's really eating food, in a way.
If you are exercising a lot, or about to have an X-ray or flying, I think a ketone ester is a perfectly reasonable thing to take for that … But nobody suggests it's a replacement for the most important strategies, which are a good diet, exercise and fasting — those kind of global intrinsic ketone-producing [strategies].”
Another therapeutic option is to use MCT oil, as this type of fat lends itself readily to ketone production. I consume about 6 ounces of caprylic acid a day, as I require many calories due to my daily exercise. I need at least 3,500 to 4,000 calories a day. I get more than 1,000 calories a day from MCT oils, which works out well for me as I obtain the metabolic benefits discussed here.
MCT oil is also far less expensive than ketone esters. That said, 6 ounces is far more than most people would be able to tolerate. To start, begin taking 1 teaspoon and work your way up from there. Be careful to take them with loads of other fats and don’t take more than 4 tablespoons at once — otherwise you will likely get nauseous.
“MCTs are a hack to get into ketosis [as] they bypass these control pathways,” Christofferson explains. “Typically, you have to have low insulin, which releases triglycerides, which then get processed in hepatocytes to beta-hydroxybutyrate.
MCT oils go directly into the cell and force this production, because they radically increase the amount of Acetyl-CoA. That then creates beta-hydroxybutyrate. They even cross the blood-brain barrier, which most fatty acids don't.
So, neurons will directly produce ketones in the brain. One of the main pathologies of Alzheimer’s is insulin resistance in the brain. So, your brain is starving of energy. It can't process glucose. MCT oils will go directly into the brain. Or they'll produce ketones in the blood, go directly in the brain, bypass all that pathology and fill that energetic gap.”
While many believe it’s best to remain in nutritional ketosis continuously and indefinitely, I strongly disagree with such advice. I believe it can be highly counterproductive to remain on a continuously low-carb diet.
While it’s important to remain on a low-carb diet until you are metabolically flexible and insulin sensitive, which can take months or even years for some really heavy people, once you reach that state, you’ll want to increase your carbohydrate level (depending on your exercise level) to 100 or 150 grams once or twice a week, especially around the times you're exercising.
Doing so will actually further improve your metabolic flexibility, as you want to have the ability to seamlessly switch between burning fat and glucose. As mentioned, glucose is the universal fuel, so we have to be able to use that. We just don't want to use it all the time. Christofferson agrees, saying:
“You need to remember; your body is in a continual state of … breaking down [or] repair. If you're constantly breaking down, you don't give your body the chance to repair, to be anabolic.
Glucose raises insulin, and insulin is — if you're in a high-insulin state all the time — a terrible thing. But it's also an anabolic hormone that kicks off IGF-1 and all these antibiotic pathways, for repair.
So, I think … the most optimal strategy will be one of cycling, going back and forth. I think that probably mimics what our ancestors went through. We probably had times of deprivation. In the winter, there were very few carbohydrates or none. And then, in times of abundance, when there was plenty of carbohydrates, it was a time to repair and regenerate.
I think that in the end, that strategy will be exactly the correct one. And we don't know — even an occasional fast may be enough for people that are generally healthy.”
Lastly, optimizing your metabolic health through nutritional ketosis, which is best done through time-restricted eating and a cyclical ketogenic diet, will help you move forward with greater confidence and less fear in this post-COVID world. As noted by Christofferson:
“Looking at the data, and what this virus is doing, it's a no-brainer. Health officials talk about these proactive measures of social distancing and mask wearing, but it just doesn't seem like the one thing that's staring us in the face is ever addressed, which is metabolic dysfunction.
We could have said, ‘One way you can potentially mitigate the severity of the disease is by eating right; starting doing these things and come out strong.’ But that message has not been delivered …
[Metabolic dysfunction] was a crisis before the virus. It was there, and we failed [to address it]. The virus exposed that [failure], and we still have to really address that publicly.
It really shows the profound biases in human thinking, and the way we react to problems, without doing full cost accounting. When you do a dispassionate look at the full cost accounting of the economic dislocations of lockdowns versus what we're getting out of that, with the virus, it's disproportionate. We’ve got to find a way to balance that reasonably.
This virus disproportionately kills older people. What it costs per 80-year-old is over $1 million, using full cost accounting, and if you could take that $1 million, you could save hundreds of lives of younger people. So, I think our response is, in a way, absurd, and just doesn't look into the problem in the right way.
The take-home point for me is, look at health care and how we parse up and spend enormous amounts of money on each disease and make almost no progress, year after year.
We have this basically free, intrinsically installed health care therapy [i.e., ketones] installed in every one of us … It's really empowering, and that's what I want the take-home message to be: how potent this is, and how readily available. You can access it at any time you're ready.”
To learn more, be sure to pick up a copy of Christofferson’s book “Ketones, The Fourth Fuel: Warburg to Krebs to Veech, the 250 Year Journey to Find the Fountain of Youth.” This really is the information you need right now, so the timing of the publication of this book couldn’t be more appropriate.
In the interview, Christofferson also reviews some of the history of the key doctors and scientists responsible for identifying and understanding ketone metabolism — including Otto Warburg, Hans Adolf Krebs, George Cahill and Richard Veech — so for more details, be sure to listen to the interview.
Dr. Mercola Interviews the Experts
This article is part of a weekly series in which Dr. Mercola interviews various experts on a variety of health issues. To see more expert interviews, click here.
In this interview, retired Army combat veteran Erin Marie Olszewski, a nurse who for several months treated COVID-19 patients at the Elmhurst Hospital Center, a public hospital in Queens, New York — the epicenter of the pandemic in the U.S.
She has now written a book, "Undercover Epicenter Nurse: How Fraud, Negligence, and Greed Led to Unnecessary Deaths at Elmhurst Hospital,"1 which details her experiences.
Olszewski was born in Michigan and raised in a small Wisconsin town and joined the military at 17. When 9/11 happened, she was in basic training. "I was only 18 years old so I grew up pretty quickly," she says.
Altogether, she was stationed in Iraq for just over a year. Upon her return to the U.S., she worked at the Special Operations Command in Tampa, Florida, before leaving the military and going into nursing. Just a bit over 20 years ago, July 2000, I read a study by Dr. Barbara Starfield2 published in JAMA. It contained stats that identified physicians as the third leading cause of death.
I created that headline in July 2000, which took off as a meme and spread across the world. In a shocking follow-up to Starfield’s article, in 2012 her husband wrote a disturbing article in the Archives of Internal Medicine3 about her death, pointing to a drug she was taking as a possible contributor to it.
“Specialization, fragmentation, drug-orientation and profit-seeking help make American medical care the most expensive in the world, but not the safest or most effective,” Dr. Neil A. Holtzman wrote. "The lessons from Barbara’s death should be put in the perspective of the millions who cannot afford even basic services in our expensive system and suffer as a result.”
As if that's not egregious enough, newer death statistics reveal the situation has only gotten worse over the years, and Olszewski's experience during the COVID-19 pandemic demonstrates just how much more dangerous medicine has become.
"I did go into this profession to help people … [but] it did not take me long to realize that we're literally just pumping our patients full of medications. Most of my job was morning meds, afternoon meds, night meds ... [and] tests.
I've always had a passion for more of a natural approach to health and it was devastating to me to realize that I wasn't really helping these patients, I was contributing to the problem," Olszewski says.
"I always had that mindset as a nurse: How can I get these patients to look through these meds and talk to the doctors and advocate for them to get them off of all this?
I would hit a lot of roadblocks and so I ended up going to work at a private practice where doctors were more concerned about not so much profit, but the people. I always continued along those lines. Fast forward to this year, we were essentially laid off from our jobs.
In Florida, we did it right. We didn't ban any of the alternative treatments. They left it up to individual hospitals to make up their own minds, so that's why we were very successful, whereas New York was not."
As the COVID-19 pandemic progressed, New York, being a hotspot, was in desperate need for skilled nurses, so Olszewski ended up volunteering and went to work at Elmhurst in April 2020. "It was still extremely packed in these hospitals with pretty much every single person on a ventilator," she says.
Curiously, when she got there, she was told she'd have to wait days for her assignment. Normally, in times of war, you're expected to immediately get to work. This was the first red flag suggesting all was not as it seemed. Some of the nurses had waited in hotel rooms for 18 days before they received their assignments.
"Why weren't they utilizing their resources, complaining that they didn't have enough help when [there were] … 1,000, 2,000 nurses sitting around in New York waiting for an assignment? That was very confusing to me. If indeed this was essentially a war zone, people are literally dying left and right, why aren't they utilizing us?
I finally did get an assignment and they put me at Elmhurst Hospital … I got there and literally it took me one shift — 12 hours — to realize that this is absolute chaos, and not because we didn't have enough staff.
We were well staffed. It was because nobody cared. I literally felt like I was living in the twilight zone. And, just knowing what I know about our system anyway on a good day, this was just absolute negligence."
Clearly, when you go into the hospital, you are at great risk of medical mistakes that can accidentally kill you, and Olszewski's experience highlights one of the key problems: willful gross negligence. This is why it's so crucial to make sure you have an advocate with you around the clock who can speak for you, ask questions and ensure you're getting the appropriate treatment.
Due to COVID-19 infection concerns, family members were excluded from the process here. They simply weren't allowed in. To me, that was probably why so much of this abuse was able to occur. Olszewski agrees, saying:
"That's exactly right. On top of that, they created a liability-free environment. So now you have a liability-free environment where everybody knows that no matter what they do, they're not going to get in trouble for it. We have no family around putting us in check …
You've got doctors and nurses that, at that point, just didn't care because everybody was going to die anyway so what's the point? And then you have everybody on a ventilator. So, these patients can't even speak for themselves. They're at the hands of whoever is taking care of them.
How do you sit by and allow this to happen? I don't know how so many people knowingly knew this was going on and just chose to remain quiet. It's just really sad."
By the time Olszewski started working at Elmhurst in April, doctors around the world, including the U.S., had already started raising questions about the routine use of mechanical ventilation for COVID-19 patients. Within weeks, many started arguing that it appeared to be doing more harm than good.
That certainly proved accurate at Elmhurst. In a four-week period, Olszewski only witnessed one patient put on mechanical ventilation who survived, and that's because the sedation didn't quite take and he ended up extubating himself. The sad tragedy is he didn't have any medical indications warranting him being placed on a ventilator to begin with.
Essentially, being put on a vent is the kiss of death and, according to Olszewski, the staff at Elmhurst were aware of that. So, within her first week, Olszewski spoke to an attorney and began secretly videotaping her findings and interactions with the staff at Elmhurst. This was necessary so that the public would believe her story. She explains:
"Like I said, it didn't take me more than a shift to realize what was going on. I got back to my hotel room and just broke down in tears … I couldn't even believe it. I have a lot of nurse friends and I asked them to hop on a Zoom call with me and I just let it all out.
One of them is a nurse practitioner, and she ended up kind of being my proxy. She did a live video and it went pretty viral … She got gaslighted by everybody. She had death threats. Everyone said she was making it up.
So, I had contacted an attorney after a few days of seeing what was going on with her, just trying to get my message out. And I'm like, 'Listen. No one's going to believe what's happening here because they don't believe her … The only way the public is ever going to be able to take this seriously and believe what I'm saying … is with actual video.'
I had already tried to go up the chain of command and everybody would just tell you, 'Just be quiet or you're gone.' You were considered a troublemaker if you tried to advocate for your patients, and you were pretty much shunned … There were nurses sent home prior to me getting there, for doing the same things …
Ethics essentially just went out the window. My attorney actually ended up getting me a pair of spy glasses in order to videotape and they fit in with the rest of the PPE so it was never really questioned …
It was pretty terrifying, but at the same time I'm going in there, looking at my patients like, 'You know what? You guys deserve justice. This should have never happened, and I hope history never repeats itself ever again.' That was the mission.
People need to know the truth and those that thought this was OK need to be held accountable for these actions. In our profession, we're supposed to be there for the patients. We're supposed to act with integrity and compassion and none of that was happening."
As a general rule, nurses, who are in the trenches day in and day out, are far more knowledgeable about the practical details to optimize patient care than most physicians, who may understand the science better but typically fail to appreciate critical implementation variables.
Nurses who are in the trenches day in and day out typically know what works and what doesn't. I can remember many times during my own medical residency where nurses would correct decisions that, if implemented, could have harmed the patient.
So, skilled nursing staff are really crucial components that help keep patients safe. Unfortunately, in this case, nurses were routinely overruled and ignored. According to Olszewski, she had many conversations with her coworkers, all of whom said the same thing. They just couldn't believe what was happening.
"I actually recorded a lot of those conversations too just because I didn't want people to think it was just me," she says. "Really, everybody thought 'This is not OK.' But everybody was afraid to say something … There are a lot of upset people and they try to hurt you and silence you in any way that they can."
Olszewski was ultimately fired from Elmhurst for speaking out about the conditions there. There are also petitions to remove her nursing license. That, it seems, is a commonly used way to silence the opposition these days. Olszewski vows to fight to keep her license.
Making matters worse, many of the doctors treating COVID-19 patients at Elmhurst were first-year residents, many of whom had never interacted with patients before. According to Olszewski, many had "zero bedside manner" and approached their patients as little more than "something to practice on." "There were not many of them that really had compassion for these lives," she says.
Typically, private hospitals do not have medical residents treating patients, and if they do, they're strictly supervised. Elmhurst Hospital, however, is a training hospital, and according to Olszewski, residents had virtually no supervision at all. "I very rarely saw an attending, so it was the residents running these floors," she says. Worse, the residents were not leaning on the expertise of the nursing staff.
"We couldn't even leave our patient's room because [the residents] would come in and dial the ventilators, they'd mess with our drips. We had to lock our pumps because they would just come in and change it. That's unheard of on a normal day. Physicians never touch our pumps or ventilators without letting us know."
When asked why residents would behave so inappropriately, Olszewski replies:
"A lot of ego, a lot of, 'They're going to die anyway so we just want to experiment and see what works and what doesn't.' There were a lot of errors being made and unnecessarily causing a lot of death. And I can't explain it. Like I said, [you had a] liability-free environment … [and] these residents weren't being monitored by the attending doctors …"
The refusal to segregate infected patients from noninfected ones also undoubtedly worsened the situation, placing lives at risk. In a perfect scenario, infected patients would have been isolated in negative pressure rooms, since the normal ventilation system can circulate the virus throughput the hospital.
Still, by rooming infected and noninfected patients together, you virtually ensure the disease will spread to noninfected patients being treated for other health conditions.
Nurses also were not changing their personal protective equipment (PPE) between patients. The same PPE was worn all day long. Elmhurst didn't even have regulations requiring fresh PPE between patients or when going from one room to the next.
Perhaps most egregious, COVID-negative patients were listed and treated as confirmed positive, and some were even placed on mechanical ventilation. One of them was a male patient admitted for high blood glucose, which is easily remedied and under no circumstance would require ventilation. Olszewski tells the story:
"They ended up giving him a lot of different psych drugs which, ultimately, just kept that blood sugar going up and up. And, instead of treating that, they ventilated him.
They put him on our COVID ICU floor, which is unheard of. And he's anxious, so they have him tied down to the bed in restraints, which makes anybody even more anxious. You can't have any family in there, there's a bunch of nurses telling you to be quiet. Anyone's going to fight in that type of situation. You're terrified to be there in the first place …
I was in there just trying to hold his hand, talk to him, calm him down, and one of the residents comes in saying 'If you don't calm down, we're going to have to put a tube down you to help you breathe.' I was just like, 'What are you doing? He doesn't need that.' Within five minutes of my leaving for the end of my shift, he was on a ventilator. That right there, that's just negligence."
The same medical fellow also refused to allow another patient to be resuscitated, even though he did not have a do-not-resuscitate (DNR) order. A fellow is someone who has completed their formal medical training, graduated medical school, internship, and residency, and is doing a sub specialty in some discipline of medicine. So, you'd expect a fellow to act more responsibly than that.
"At that point, nobody really cared anymore," Olszewski says. The doctors expected all patients to die anyway, and there was no liability for anything that was being done or not done. Unfortunately, there was a clear financial incentive for treating noninfected patients as COVID-19 patients, and placing them all on mechanical ventilation. As explained by Olszewski:
"They essentially turned Elmhurst into an all-COVID hospital … If they were going to admit somebody, they were either COVID positive or they were awaiting their test results. So, they would be admitted as 'COVID rule-out' and the hospital would still get the kickback. It was $13,000 to admit a patient to the floor.
Some of these people, like the one that was unnecessarily vented, he could have gone to the Navy ship Comfort, knowing he was negative for COVID-19. They knew that. But they still admitted him, got the $13,000 and then ventilated him for another $39,000. This was happening consistently.
There's no reason these patients had to be packed in like sardines when we had external resources that weren't being utilized. So why? … Maybe it was the financial incentive … That's just people just not caring and putting profit over these patients."
While Olszewski has been largely ostracized by her nursing colleagues, most of whom likely fear losing their jobs if they openly side with her, the death rate at Elmhurst plummeted after Olszewski's undercover videos started making the rounds on social media.
Her hour-long interview in the "Perspectives on the Pandemic" series, which has 1.4 million views,4 was released to the public June 9, 2020. Daily death rates in New York City hospitals dropped dramatically after that.5
"I personally think that this has had an impact on the deaths in New York because after that video went out and they were outed on their treatment protocols, the death rate plummeted,” Olszewski says.
I think they're a lot more cautious about who they're admitting to these hospitals and how many people are being put on the ventilators [now]. In early April when I got there, I questioned a doctor that I also recorded and he admitted that not one patient had been successfully extubated.
So, by the time I got there, every single patient on a ventilator died. And they refused to try any alternative treatments even though we know a lot of alternative treatments existed. Their excuse was that they didn't work. And my question was, 'Listen, if you know the ventilators aren't working, then why not try [the alternatives]?'"
The tragedy is that hydroxychloroquine with zinc likely would have made a significant difference if routinely used in the early stages of disease, and in suspected cases. It clearly was helpful in Florida, where some doctors have been using it.
Quercetin also works similarly to hydroxychloroquine. Both drive zinc into the cell, and quercetin, being a supplement, doesn't require a prescription and also has other effects, such as SIRT2 activation and decreasing inflammation, which actually make it a better choice. However, like hydroxychloroquine, quercetin must also be used with zinc — and administered very early in the course of the illness.
Still, considering asymptomatic patients were being roomed with those who had confirmed COVID-19, either of these options could have protected many of these patients. It's really incomprehensible that a treatment has been so badly maligned, to the point that pharmacy boards have refused to fill prescriptions for a drug that's been on the market for more than six decades.
"I think every patient has a right to try multiple different alternatives," Olszewski says. "High-dose IV vitamin C [has also] successfully treated patients in Asia and some people in New York when [the pandemic] first started. Why are these alternative treatments being frowned upon?
Has this caused even more deaths? Honestly, government shouldn't ever get involved in the doctor-patient relationship. People should be able to have a choice and the freedom to be able to have these alternative treatments available to them if they can save their life.
Autonomy and patient rights are just gone … Patients deserve to be treated like humans, and politics and profit should never be placed above human life, ever."
One of the most effective treatments to date in the hospital setting appears to be the MATH+ protocol, which includes high-dose vitamin C, steroids, thiamine and heparin. It has protocols both for early intervention and late-stage disease.
However, I plan on posting an update to the nebulized hydrogen peroxide video as I have modified the recommendation. I've had a number of people use it with very severe disease and recovered from the symptoms in a matter of hours. I had no idea this treatment was so effective.
Fortunately, since Olszewski started speaking out, others have braved the backlash and spoken out about medical mismanagement as well. One of them is featured in the video below. Warning though the video is very emotional and the nurse uses some understandable profane language.
On the downside, physicians at Elmhurst who were responsible for implementing orders that led to patients' deaths may or may not be held liable for their actions.
"There are some clauses in that order that gross negligence is liable," Olszewski says. "Families are coming forward and many of them are very upset, so maybe, hopefully, there will be a federal investigation and there will be accountability for these actions. I feel there should be."
To learn more about what went on at Elmhurst, be sure to pick up a copy of "Undercover Epicenter Nurse: How Fraud, Negligence, and Greed Led to Unnecessary Deaths at Elmhurst Hospital," slated for release August 18, 2020.
