Can we stop a future pandemic? Dr. Michael Greger M.D explains what’s next.

by birtanpublished on August 17, 2020

"Can We Stop a Future Pandemic?" Hello, everyone, and welcome to the next episode of the Disclosure podcast. I hope you're all doing well, and I also hope you enjoyed the last episode of Dr. Melanie Joy, and that you enjoyed the discussion and conversation we had about communication and effective advocacy and what they can look like in terms of how we speak to others, both non-vegans as well as vegans as well. So I hope you liked that one. In this week's episode I'm speaking with

Dr. Michael Greger, and I'm just going to do a little introduction to Michael Greger before we cut into the actual video itself. But before I do the introduction, just a little bit of housekeeping at the beginning to say, firstly, if you like the podcast and you've listened to the podcast before and you've enjoyed doing so, then please do leave a review. It does mean the world to me and I really appreciate it.

I like reading them, I like hearing what you guys think and seeing your feedback about the discussions I've had and the conversations that have been taking place. And also if you enjoyed the Disclosure podcast, I also do a monthly Disclosure podcast Q&A for my patrons. So it's a Patreon-only podcast edition. And so if you sign up to my Patreon, you can support the activism that I do, and you also get access to this Q&A

Where my patrons ask me questions and I hopefully give insightful and thoughtful responses back to those questions. And we also have a Discourse service where we chat about different issues. Obviously, we've been talking a lot about what's happening right now, which is the pandemic, and share a list of articles and resources surrounding exactly what's been happening. Let's get into the podcast,

And I'll just do a little introduction for Michael Greger because a lot of us will know who Dr. Michael Greger is from Nutrition Facts and from his work as a physician, focusing on solving the epidemic of chronic disease through lifestyle changes, particularly plant-based diets. So a little brief overview of Dr. Greger. So he's a physician and a New York Times best-selling author, as well as an internationally recognized

Speaker on nutrition, food safety, and public health issues. A founding member and fellow of the American College of Lifestyle Medicine, Dr. Greger is licensed as a general practitioner, specializing in clinical nutrition. He's a graduate of the Cornell University School of Agriculture and Tufts University School of Medicine.

In 2017, Dr. Greger was honored with the ACLM Lifestyle Medicine Trailblazer award and became a diplomat of the American Board of Lifestyle Medicine. Now I'm sure a lot of you have heard of his books. He's got a few books, How Not to Die. But actually one thing that many of you maybe don't know, what I didn't know this until the pandemic, was that Dr. Greger was actually

The former director of Public Health and Animal Agriculture for HSI, it's the Humane Society International. And a lot of his work when he was working for HSI was about infectious disease, so things like Mad Cow disease, but also bird flu and swine flu. And in fact he wrote a book back in 2006 called Bird Flu: A Virus of Our Own Hatching.

And so in this week's podcast episode we're going to talk about the links between using animals and infectious disease, and also talk about the problems related with bird flu and why that could potentially be the next pandemic. Something we'd been scared of before, but actually looking forward, something we should continue to be scared of unless we make radical changes in the way that we all live as a species. I hope you enjoy this week's episode

And I'll cut right into it now. Well, hi, Dr. Greger. Thank you so much for joining me on today's podcast. I greatly appreciate it, and thank you for all of the work you've been doing recently in spreading the message about pandemics, and also encouraging people to kind of think beyond just what we're told, I suppose,

About where these pandemics start and originate from, and so, yeah, thank you for joining me. Happy to be here. Excellent. And so the infamous kind of speech you did maybe, what, 12, 13 years ago now is that kind of prophetic, almost conference you did where you were talking about pandemics and ways to prevent pandemics.

And since you've done that talk, there's been two pandemics. Of course, we're currently in one. Are you surprised that there's been two pandemics in the past decade? Does that come as a shock to you? Well, you know, predicting that there's going to be another pandemic is like predicting the sun's going to come up the next day. I mean, it's always "when," never "if."

But then the next question is how bad? Have we got off lucky last time with the 2009 swine flu pandemic? It was only a Category 1 pandemic, only about a half million people died. But what we learned from that pandemic for the first time is that flu viruses can jump directly from pigs into the human population, circulate throughout the world.

We may not be so lucky next time. Yeah, absolutely. And so with the current pandemic, it's obviously been traced or likely it's been traced back to the meat market in Wuhan. Now I was in the US a couple of years ago and I came across these kind of live animal markets in Brooklyn; there's also some in Texas when I was there. What was the likelihood of something similar originating

From one of these live animal markets in somewhere like the US? Yeah, you know, I'm glad you brought that up because it's easy for us kind of xenophobic Westerners to kind of poo-poo these back alley wet markets in Asia. But, for example, the last pandemic was largely made in the USA from industrial pork production facilities in the United States. And there are these live bird markets, particularly in the Northeast,

Also California here in the States, that had concerning outbreaks of these H7 viruses, which have infected people. There was a New Yorker infected in 2003. Then in 2015, shelter cats across New York became infected with this bird flu virus that was found on those live animal markets. One of the veterinarians, one of the shelter workers also got infected. So this is a human-adapted virus. Has not yet acquired the necessary mutations

To transmit human-to-human effectively, which would trigger the next pandemic. But certainly live markets anywhere—Asia, the United States, Europe, anywhere else— are risk factors and they should all be shut down. I think it's important to realize that even now in China, when supposedly these live markets are shut down— no, they just shut down the raising of wildlife meat.

So the wildlife trade for fur, still on-going. Wildlife trade for traditional Chinese medicines, still on-going. Can still raise these animals, slaughter these animals, sell these animals, but just not for meat. And all farm animals are exempted. In fact they even went in changed the definition of like frogs and turtles to livestock, to farm animals so they could continue to market them.

And so there's still these massive live bird markets, in which case— at some of these markets you can actually sample bird flu viruses straight out of the air, so even walking through one of these markets could be dangerous. And the same thing was found at fairs here in the United States with swine flu viruses.

There's so much virus being excreted by these animals, it just gets in the air. Causes people to get sick. And the more people that get sick, the more animals get sick, the more kind of pandemic spins at the roulette wheel is just locking in the right mutations to then finally spread into the human population. So we really need to recognize that how we treat animals

Can have global public health implications. Yeah, I mean, one of the things that shocked me is after this current pandemic started, I was going—just typing into Google "swine flu" or "avian flu" and just go on news that was just in the past week or past few weeks, and it's all the time. There's been outbreaks of a new—I think it was H5N6 strain in Germany of bird flu.

And it just happens all the time, everywhere. And I suppose the one thing that—I mean, I know that you're concerned about some things that you've spoken about before is one of these strains may be mutating into something that's similar to H5N1 in terms of the fatality rates. So kind of combining like a highly infectious strain of avian influenza with a highly, you know, a high fatality rate

Strain of avian influenza. Yeah, so there's an important parallel here with Coronaviruses. Until 2002, we thought all coronaviruses could do was cause the common cold, so we knew they were transmissible from person to person, but they just caused the sniffles. Then, boom, 2002, SARS emerges from these wet markets.

These civit cats being raised in Guangdong province in south China, and all of a sudden spreads around the world to over 20 countries. Infects about 8,000 people, 800 of which die, so it's about a 10% mortality rate. All of a sudden coronaviruses could be deadly. We had no idea. And then the thought is, well, wait a second.

If it can be transmissible and deadly, well, then, there's no reason that this class of coronaviruses couldn't then trigger a global pandemic. And we got another warning call in 2012 with the emergence of MERS, linked to intensive camel farming in the Middle East— another deadly coronavirus disease, killed about 1 in 3.

We kept having warning sign after warning sign, but of course, we didn't listen. And in fact wildlife markets were shut down after SARS in China, but poorly enforced, rapidly reopened, and civit cats were back on the menu within months. And so similarly the current wildlife ban in China is still only set to be temporary with these whopping loopholes. If we don't permanently change the way we interact with animals,

Then we are just going to look at more and more pandemics coming down the pike. I mean we are in an unprecedented era in human history. We've had dozens of newly emerging and re-emerging diseases, most of which come from animals. You know the AIDS virus, blamed on the bush meat trade in Africa and killing chimpanzees. We have SARS and COVID-19 from the wildlife trade, these live animal markets.

We have swine flu, Mad Cow, when we started these cannibalistic feeding practices. But, you know, the deadliest plague in history was a bird flu virus that emerged from the trenches in World War I to kill 50 million people in the pandemic of 1918. But from a virus standpoint, we have those same trench warfare conditions today in every industrial chicken shed,

In every industrial egg operation: confined, crowded, stressed, but by the billions, not just millions. And now, as you said, we have viruses H5N1, H7N9 that could kill millions around the globe if they lock in those necessary mutations. Right now the CDC considers H7N9, which rose to ascendance in 2013, killing about 40% of the people it infected, as our gravest pandemic risk.

A recently released threat scenario suggesting millions of Americans could die with an H7N9 pandemic. And so the silver lining here of COVID-19 is that hopefully the world will wake up and look around after, you know, millions of lives lost, billions locked down, trillions of dollars lost around the world, finally sit down and take very seriously what those of us in this movement have been saying forever, and that is we need

To accelerate the movement towards plant-based milks, plant-based meats, plant-based egg products, not just for human health for chronic disease sake, not just for global warming. Global health is taking a whole other view now. Now there's pandemic risk as well. And so we just need to move away towards healthier products, heathier for ourselves, healthier for future generations, and healthier in terms

Of reducing the risk of pandemic infectious disease. Yeah, absolutely. I mean, it really this kind of—it's the key to solving so many of the world's current issues. It's just simply changing our lifestyles and how we use animals. One thing that I think scares me about the 1918 pandemic is that the fatality rate was only between 2 to 3%. But if we're

Talking about a strain of avian influenza that has a 40% fatality rate, I mean, the amount of damage that that could cause is almost unimaginable. And we think about the social upheaval that's happening right now because of COVID-19, but imagine if the same virus right now was killing 40% of the people and was completely non-discriminatory; it wasn't just people with underlying

Health conditions or of a certain age. It was anyone, of any age, 40%. I mean, society would collapse. Yeah, I mean I'm so glad you brought that up. COVID-19 is just a dress rehearsal. Look, doctors are still showing up. The food is still being restocked on grocery store shelves. The internet may be slow, but it's still on.

The electricity is still on. We're still getting clean drinking water. All of that can go away if even suffering like 25% of the workforce out. And so, right, there's no reason—in fact the World Health Organization actually convened a panel of experts to ask the question: well, wait a second. Would a virus, like H5N1, H7N9, necessarily have to ratchet down its lethality, it's flip-of-the-coin human lethality down

In a pandemic situation, because the worst pandemic in history was only 2% with the last bird flu virus jumping the species barrier. And the answer was "not necessarily." In other words, the nightmare scenario that you just described. So here in the States, 60 million Americans get the flu. Imagine if it turned deadly. So even here in the US, probably the worst-case

Scenario estimates for COVID-19: half a million American deaths; that's like 1 in 3,000 people. What if instead it was 10 times worse, 20 times worse: 1 in 15 dead; 1 in 6 dead, 25 times worse. I mean that's why it's so critical, and that's why, one, I mean, can't emphasize enough the risk that the world is taking,

And you know, it may— hopefully won't come to this, but we don't tend to shore up the levees until after a disaster, and it may take a pandemic that wipes out millions of people before the world realizes the true cost of cheap chicken. Exactly. I think the most scary thing is, isn't it, we hope that we listen to what the world's telling us and what these infectious diseases

Should be able to teach us. But I guess the risk is that we just go back to business as usual when it dissipates. Why do you think it's not something that our governments do take more seriously when the risk is so catastrophic? I mean, apart from climate change, the United Nations says it's the second biggest risk to human health.

So why don't we take it more seriously as a risk? Well, because there are very important monied interests involved. So, for example, here in the States we continue to feed millions of pounds of medically important antibiotics to farm animals by the truckload, something that every single human health organization on the planet is allied against. You say, wait a second, if every public health

Group on the planet says it's not a good idea to be feeding these critically important drugs to animals just to fatten them faster for slaughter, then why hasn't it been done? Because they're going up against two of the most powerful industries: the pharmaceutical industry that sells all these drugs, and Big Ag, the animal agriculture industries.

They have so much power hold, so much a stranglehold over our political system that even things that are just so slam-dunk common sense, scientific consensus, people are dying, are being consistently ignored. But again, there's the silver lining with COVID-19: hopefully we'll get a pandemic that's just bad enough that people will pay attention so that an even worse pandemic can be prevented

In the future, but, of course, not bad enough. I mean, the minimum amount of suffering that will actual get us to prevent an even larger amount of suffering later on. I mean that is the hope, isn't it? I think one of the risks is that potential of people, as we say, employing the almost xenophobic tendency of just accusing the Chinese culture of being the problem, and overlooking the fact that industrialized agriculture

Anywhere across the world plays a part in these pandemic risks. I suppose if we don't change, the transfer pandemic, it's not really an "if," it's always going to be a "when," right? Like as long as we do what we— I mean obviously the industrialization of agriculture isn't the only risk potential, but it's one of the biggest drivers in risk potential.

And so, I guess, if we don't change, then it will always be a matter of when: when the next one happens, how bad will it be, as opposed to— otherwise we're just playing that fingers crossed game, aren't we, hoping that it never happens, but of course mathematically it always must do at some point if we don't change. And it's getting worse and worse.

Never before have we seen flu viruses, one of the few viruses capable of infecting literally billions of people within a matter of months; never have we seen a flu virus with an Ebola-like lethality, 50%. There are strains of Ebola that only kill 50%. That's what we're facing with some of these bird flus, and there's no biological reason that they couldn't trigger a pandemic.

Even the coronaviruses, again, MERS, 1 in 3 have died who got it; SARS, 1 in 10. Currently with COVID-19, probably we're looking at about a 0.5% case fatality rate. I mean, that's why it could just be so much worse, as devastating—and not to underplay how devastating COVID-19 is, but I mean it could get so much worse. And so that, I think, is the message that public health professionals have been shouting from the rooftops for decades. We need to get out there.

The American Public Health Association, the largest and oldest association of public health professionals in the world, has called for a moratorium on factory farming for more than 20 years. The Pew Commission on Industrial Animal Production, the same thing. We've got to ban some of these practices, like gestation crates and battery cages with crammed animals together.

You know, when we overcrowd animals in these cramped, filthy, football-size cages to lie beak-to-beak or snout-to-snout atop their own waste, it's just a breeding ground for disease, right? The sheer number of animals, the overcrowding, the stress crippling their immune systems, the ammonia from all the decomposing waste burning their lungs, the lack of fresh air, the lack of sunlight.

I mean, put all these factors together, you know, the kind of perfect storm environment for the emergence and spread of these so-called super strains of influenza. These factory farms are a public health menace, but it may not be enough just to, you know, tinker around the edges and change some of these worst practices. Maybe we really need to shift entirely away from animal agriculture entirely.

And there is hope on the horizon. No longer are these plant-based meats just kind of a niche market for vegetarians. Now some of the biggest meat processors in the world—Tyson, Perdue, Smithfield— the biggest pork producer in the world just released an entirely plant-based line of products. Look, they are just in the business of making money.

They can make as much money selling plant-based meat than any other kind of protein; they'll do that. I mean, that I see is the glimmer of hope on the horizon is that there may be a market solution to this after all. And cultivated meat another possibility. And cultivated meat another possibility. Growing meat from muscle cells in the lab; you don't have to worry about

Fecal pathogens like salmonella, E. coli, if you're making meat without the guts. You don't have to worry about respiratory viruses when you're making meat without the lungs. Now I'm not saying these are healthy personal choices, right? Meat is meat, but from a pandemic risk standpoint, zero risk. Yep. And I think the thing that probably surprises a lot of people is, I mean,

We're in something called the Age of the Plague now, right, because of industrialized agriculture. But before the 1970s, a lot of people were talking about how we've kind of gone past infectious, really like the post-infectious disease era. You know, we've eradicated smallpox and we didn't need to worry about it anymore. And then because of our own doing and our own gluttony for these products

And for cheap products, we've created potentially the worst era of infectious disease as ever existed, just as we thought we'd come out of it. Yeah, just when we thought we concurred infectious disease, we thought it was going to be a very dull field, right. Unprecedented emergence. Now it's not just animal agriculture. Deforestation has also brought some of these, like Rift Valley fever,

The Lassa virus, some of which are boosted by the bush meat trade, like Ebola in Central Africa. There's a number of South American hemorrhagic fever viruses that come when we are clear-cutting the forest down there. Livestock can then act as amplifying vessels for tic-borne diseases, mosquito-borne diseases to take these primate viruses

And spread them in the human populations. You know, antibiotic use also plays a role in the emergence of these new emerging diseases that we can no longer treat with our armamentarium of antibiotics. But what all these factors share is that these are changes in the kind of human-animal interface. You know, animals were domesticated 10,000 years ago, but never before

Did we see these kinds of changes that we're seeing today, and unfortunately, we're suffering the consequences. That's why we really need to shift gears and move away towards healthier production. You suggested, you said about we domesticated animals such a long time ago, but I think I remember it was you who was saying about how we could trace back the origins of, say, influenza to the domestication of ducks.

Oh, absolutely. Again, no, no, I know. It's really important to realize, bird flu viruses have existed harmlessly for millions of years, harmless to both birds and people. Very important to understand. In aquatic birds the viruses perfectly adapted, in what's called total evolutionary stasis, harmless, but when thrown into a new environment, land-based birds like chickens,

Which you can get at these live animal markets, then it quickly has to start mutating to adapt to its new host. Because chickens aren't paddling around in the pond, this intestinal bug has to spread to the lungs, become an air-borne virus. So it goes into chickens as an aquatic virus, but comes out as the flu. As it adapts to terrestrial birds, it also adapts to terrestrial mammals

Such as ourselves. And so until birds were domesticated, waterfowl were domesticated, there was no influenza. We never had measles until we domesticated livestock. We never had tuberculosis. Many of the greatest plagues in history came from when we bridled these animals. I mean how common could the common cold be if there's just

Some wild ungulates out on the plain, but when they were blocked and bridled, close to human contact, they can jump species and rapidly adapt. However, that was the first age of disease, and then came the Industrial Revolution, and then there were chronic diseases that really took the forefront. It's what I've been working on for about the last decade of my life, you know,

Heart disease, the epidemics of obesity and high blood pressure, which are also tied ironically to eating the same diet, and putting us at higher risk for infectious diseases like COVID-19. Now we're in the third age, with the submerging and re-emerging infections, again also tied to agriculture. So it's the food! You have to go back and think what we can do to prevent these in the future.

You know, now in the age of commercial, global airline travel, a virus can get out of our grasp within a matter of days, so we really have to prevent these diseases in the first place. Yep, exactly. And so you're writing a new book at the moment, is that correct? It will be out May 26th, How to Survive a Pandemic. I'm really excited to be able to use my infectious diseases expertise,

Which I stopped working on about 10 years ago because no one seemed to care about the threat of a pandemic, but that's changed now. And so I can use my infectious disease background to talk about pandemic survival and prevention. So have you seen in the 10 years or so that we've been just talking about, have you seen a change in the conversation? Is there more of a discussion surrounding

Whether or not animal farming should simply be eradicated, as opposed to preventative, because obviously we talk about biosecurity a lot, but biosecurity in and of itself is never going to be a good deterrent from these pandemic starts or even just these outbreaks from starting. So have you seen conversations changing? Yeah, biosecurity in industrial animal production is wishful thinking.

There are massive inputs and outputs inherent to industrial poultry production or pork production: water, feed, waste provide roots for introduction, release of the virus. High-volume ventilation fans are required to keep these hundreds of thousands of birds cooped up, and blow aerosolized dust, dander, viral particles out into the surrounding countryside. You can pick up swine flu viruses a mile downwind, outside of these facilities.

Look, you can't keep flies out of a factory farm; they've been found to carry influenza virus. It's really just wishful thinking. And so we really, we just have to not present the virus with this all-you-can-eat buffet of 45 billion new viral hosts, feathered viral hosts every year, another billion curly-tailed test tubes every year.

The only reason that these animals exist to get infected is because we make it that way, and if we were to stop doing it, we would dramatically reduce our risk. So do you think that in terms of the conversation, that conversation is moving forward to then kind of like government officials? So it hasn't in terms of pandemics.

I mean it certainly has in terms of human health. There's just been an explosion in the interest of plant-based protein these days. I mean look at the dairy case. I mean there are massive dairy giants here in the States declaring bankruptcy because now there's this constellation of new consumer choices. If you provide consumers with a better product, they're going to buy it.

And so, yes, you could pass regulations to stop feeding slaughterhouse waste to cattle to reduce the risk of Mad Cow disease, or, you know, you can just provide people with healthy alternatives. You don't have to worry about contaminated cattle brains in your oat milk. So you're an advocate of changing the consumer and changing

Peoples' mentalities then? Do you think that's an effective way of by-passing the problem in the future? And look, and this is the same thing we're talking with these exotic animal markets in Asia. People are not going to stop eating rhino horns and tiger bones and pangolin scales and bats. All the laws in the world aren't going to do that because there will be thriving black market trade,

Which may be even harder to keep tabs on. And so it's all about changing the consumers' mindset. And there's been tremendous changes. Like, for example, shark fin soup used to be a very popular dish, but a number of groups, conservation groups worked very hard to change the mindset of people,

And all of a sudden shark fin soup went from this really prestigious thing that you serve at weddings, to all of a sudden like you carry a stigma. And so all the laws in the world to protect sharks aren't going to matter if there's that demand out there. And so to stop the supply, we need to stop the demand. And so let's make products that are so delicious, that are just so cheap,

Convenient, delicious that it's just like they just beat out the competition, no problem. That's a nice way, I think it's a nice way for us to maybe round up what we've been talking about, so I know you're incredibly busy. And I suppose one of the final questions: I guess there's a sense of irony, isn't there, with the Wuhan meat markets, when you'd think that the intermediary host might have been a pangolin. And one of the reasons

The pangolin was in the market was because the scales are used for kind of like herbal medicine. And so there's the irony of people who are going in there for the medicine, and what they got is one of the worst infectious diseases that's ever plagued humanity in that sense. And so there is definitely an irony in the way that we're all living, because it's also about people going into supermarkets

And stockpiling bacon and chicken. So I think changing mindsets, those delicious products have to be the way. And I sincerely hope that maybe after this outbreak we do learn our lesson, but I guess it's up to people like yourself and hopefully myself to keep spreading that and hopefully we can influence consumers to make better choices for themselves and for everyone, including the animals and the planet as well.

Thank you, Dr. Greger. Absolutely. So happy to help. I mean this is really—I mean in terms of timing, there was already this surge of interest, and hopefully this will just kind of take it over the top. The kind of selfish concern about themselves, their families, their communities will then translate into at least trying

Some of these products, and then incorporating into their daily lives as they get better and better and cheaper and cheaper. And we will shift this away and knock off a number of global crises, all at the end of our fork. Absolutely. And if I may make one recommendation to your listeners is on Nutrition Facts, on your You Tube channel, you recently re-uploaded

The talk you did a decade or so ago about how to prevent pandemics, and it's definitely worth watching, although it's a challenging listen, when we consider what we're going through now. But there is that moment at the end where you predicted the toilet paper crisis, didn't you? And this brings a smile to everyone's face

In this sweet ironic potential way, but yeah, excellent. There's a whole month-long series of videos coming up on Nutrition Facts about the current pandemic and what we can do to prevent the ones in the future. So, yeah, stay tuned. Excellent. Well, thank you so much, Dr. Greger, and thank you for all of your work as well, and your inspiration.

I appreciate you very much for that. Keep up the good work yourself. Thank you, all right.

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