COVID-19: An Ounce of Prevention is Worth a Pound of Cure
Hey, Folks! Just reminding you that there’s a pandemic out there, and this virus is doing what all viruses need to do to survive: mutating. And, if we’re going to get through this, we’ll need to channel the ethos of those Mutant Ninja Turtles. So, what’s going on? There are several variants working the globe: From the United Kingdom we have B.1.1.7, South Africa’s version is 1.351, and Brazil has P.1. Not very fancy names, but all seem to spread easier than SARS-CoV-2, the one for which vaccines have been developed. Some new coronavirus variants may have evolved in the United States, too. We’ll call these homegrown variants. Now, before you start freaking out, keep in mind that virus mutation is a natural occurrence and is totally expected. This was one reason why we needed to keep it contained; and if I’ve said it once, I’ve said it a thousand times to Gabbi (the only mammal who really listens to me in my garret): be smarter than an ultramicroscopic, invisible to the naked eye, non-cellular particle! You already know the drill: wear a mask, socially distance, wash your hands, stay home if you can, and limit contact with other people until the vast majority of us are vaccinated and we achieve herd immunity. You can also call it community immunity, but our actions this past year showed that we humans behave a lot more like a herd than a community. Enough of that. Let’s focus on other things we’ve learned, such as treatments that work and don’t work, and what we can do to boost our own immunity. Note that I’m giving the CliffsNotes version here.
This drug is used to treat malaria and some auto-immune diseases. It is not a recommended treatment for COVID-19, and it doesn’t reduce deaths in hospitalized patients with the disease. Don’t combine it with bleach, either.
This drug is used to treat parasitic infections. The drug manufacturer, Merck, has issued a statement stating that there is “no scientific basis for a potential therapeutic effect against COVID-19 from pre-clinical studies; no meaningful evidence for clinical activity or clinical efficacy in patients with COVID-19 disease; and a concerning lack of safety data in the majority of studies.” The National Institute of Health (NIH) has also issued a statement stating that there is insufficient evidence to use this drug as a treatment for COVID-19. If you are a dog owner, you’re likely quite familiar with ivermectin because it’s the active ingredient in the once-per-month heartworm prevention medication. Use it for worms, not viruses.
This treatment involves taking the plasma (fluid part of blood) that contains the antibodies from a patient who has recovered from COVID-19 disease. Using antibody-filled plasma is actually a very old practice: in 1901 the Nobel Prize in Physiology or Medicine was given to Emil von Behring for treating diphtheria patients using this therapy. The therapy is approved by the FDA because it may lessen the severity of the disease or shorten its duration. The jury is still out.
Vitamin C is a water-soluble vitamin that has been touted for decades as THE vitamin to boost the immune response; and the biggest champion of vitamin C was two-time Nobel Prize winner, Dr. Linus Pauling. Vitamin C is important for our body’s optimal functioning (just as having adequate amounts of all nutrients is), and among its many roles is dampening inflammation and moderating the immune response. Here’s a fun factoid about this vitamin: most animals can make it; humans and guinea pigs cannot. It may be a likely candidate as supplemental treatment in the COVID-19 medicine bag.
Vitamin D is a fat-soluble vitamin that’s important for calcium absorption. Without vitamin D, calcium can’t make its way into our body to build strong bones and teeth. This vitamin has a few forms, we get it in foods, and we make some naturally by exposing our skin to sunlight. But at temperatures hovering around freezing, you probably aren’t exposing your skin to much sunshine. Moreover, vitamin D is a hot research topic. Some research shows a link between decreased vitamin D level and increased risk of COVID-19 infection, others show no link, and others show that decreased vitamin D level is associated with the cytokine storm. Cytokines are chemicals released by specific immune cells that act on other cells. The cytokine storm is an overzealous response to fighting a viral infection. When we have an infection, our body reacts with cytokines, but we need just the right amount. We need more research on vitamin D and COVID-19. That’s okay, because that’s how science works.
Melatonin is a hormone secreted by this tiny structure deep within the brain called the pineal gland. Melatonin regulates our sleep-wake (and reproductive) cycles. You’re probably familiar with it as a supplement for inducing sleep. It may also be another pill in the COVID-19 prevention medicine cabinet as some research from the Cleveland Clinic showed melatonin usage may help prevent infection. Melatonin is also used for cancer prevention and treatment.
Like vitamins D and C, zinc is a micronutrient that the body needs for overall health. However, there are currently no recommendations for using it to treat COVID-19.
Dexamethasone is a steroid drug that reduces lung inflammation. It is given either by mouth (orally) or through a vein (IV; intravenously). When given to COVID-19 patients who were receiving oxygen alone or through mechanical ventilation, it reduced mortality.
The antiviral medication, remdesivir, is the only drug approved by the FDA to treat COVID-19. It is given intravenously. When compared against placebo in adults hospitalized with COVID-19 and respiratory infection, recovery time was shortened.
Pralatrexate is a chemotherapy drug used for treating lymphoma, a type of cancer. It is given intravenously. Lab experiments show pralatrexate inhibits coronavirus replication and appears to be better than remdesivir.
Yes, get the vaccines! They ready the immune system so that when you encounter the actual virus, you'll be able to fight it off. Many people are reporting that the second dose in the two-dose series is worse than the first. This is a common immune system reaction, and clinical trials predicted this. When you get the second dose, the immune system has been primed to recognize it and mount a stronger response. It's better to feel crummy for a day than to have the disease or its long-term consequences.
While there is still much that isn't known about sleep, from an immunological perspective, it is known that good things happen to body cells when we sleep. Sleep seems to strengthen our immune response while sleep deprivation hampers our immune response. During sleep, cytokines (remember them?) are released; conversely, sleep deprivation leads to decreased antibody production. The “perfect” number of hours per night needed varies; but research suggests 7-8 hours for adults, 9-10 hours for teens, and 10 or more for grade-schoolers. Pre-pandemic studies in some school districts showed that when the school day started later and students got more sleep, both grades and attendance improved. Puberty and circadian rhythms are the reason. Long-term sleep deprivation increases the risk for obesity, cardiovascular disease, diabetes, and infectious diseases (hello, coronavirus).
While it is known that we get lots of benefits from exercise, such as decreasing cardiovascular disease risk, it's not entirely clear what role exercise plays in the immune response. We know that exercise decreases stress hormones (those chemicals that dampen the immune system); and aerobic exercise clears the lungs and enhances cardiorespiratory responses. Physical activity makes us feel better, and that's enough to keep doing it.
The Great Outdoors
In addition to eating well, getting plenty of sleep, and exercising, just being outdoors has therapeutic effects. As little as two hours per week of spending time in nature boosts immune cells. You don’t have to do much other than walking around outside, taking in the sights, smells, sounds, and other stimuli of being outdoors. The Japanese call it “shinrin-yoku,” which means forest bathing. It’s a practice that has been around for quite some time and is making the news-waves right now because it’s good preventive medicine. Research shows that it has both physiological and psychological benefits like lowering cortisol (stress hormone) levels, pulse, and blood pressure. Moreover, it increases parasympathetic (rest-and-digest) activity and decreases sympathetic (fight-or-flight) activity.
While it might be cold, we know the benefits of getting outside, breathing fresh air, and connecting with our natural world. Good ole nature therapy. Time for magic mushrooms, er, forest medicine.
[Photos Courtesy of Mike Nath and Kelsey Lindsley]