What Can I Do to Take Care of Myself in this Pandemic?

I was talking with my hair-cutting person this morning and she asked me what I thought was going to happen with “this COVID thing, because I don’t want to wear a mask forever.” She’s a wizard with hair and a very successful small-business person with ten employees in her hair/nail/skin salon. Her business was shut down for several months, which was very painful to her and her employees, and she’s been resistant to and resentful of wearing masks.

We talked about corona viruses being a big family of viruses, most are not that bothersome, causing colds or no symptoms at all. But viruses are constantly mutating, that’s what they do, so every once in a while, a virus manages to put together a series of mutations that make it more easily transmitted, or more able to cause serious damage to the host. And, sometimes, a virus is able to pull off both.

SARS was caused by a corona virus that was much more deadly than the cold-causing cousins, about ten percent fatality rate, but the Asian countries were able to contain it for several reasons. Its human-to-human spread was not that efficient, most people were not contagious until they had symptoms, and Asia responded with very vigorous case identification, quarantine, and contact tracing. MERS is caused by a corona virus with about a 30% fatality rate, but, again, it is spread to humans from camels, most of us don’t relate well to camels, and the human-to-human spread just doesn’t work very well.

Then along came SARS-CoV-2. This virus has it all. Its human-to-human spread is very efficient, happening through contaminated surfaces, air-born particles, and aerosols. It doesn’t seem to take a large number of viruses to cause an infection, and people can be contagious without having any symptoms. Its mortality rate is still not fully known because we don’t have a really good handle on how many people are actually dying from it (the numerator) or how many people have the infection (with or without symptoms) (the denominator). But we know that the death rate is higher than influenza and lower than SARS.

Also, a virus is usually more deadly when a population has not seen it before. We talked about the example of small pox. In Europe, it had about a ten percent fatality rate but when it was introduced to Native Americans, it initially had around a ninety percent fatality rate. So, right now, every human immune system is a newbie to this virus. After it’s been around for a few years, it probably won’t be as deadly, partly because those who are susceptible to it will have already died or survived their first infection, and partly because our immune systems will figure it out.

We talked about how there has never been a vaccine successful against a corona virus and there may be a biological reason for this. Corona viruses initially infect the cells that form the surface of your moist mucous membranes. These cells are primarily protected from infection by secretory IgA antibodies. These are not your body’s memory antibodies. They usually fade away in four to six months if they are not being continuously activated. Many kinds of food reactions are IgA mediated. That is why avoiding your reactive foods for eight to ten months usually resolves your food reactions.

But this means that if a vaccine was to be effective, it would have to stimulate IgA against SARS-Cov-2, but you would have to repeat the vaccine two to three times a year. Now, the drug companies would love this, but this is not very practical on a global scale. There are some novel strategies being tried for COVID vaccines, but only time will tell if they pan out.

We may get effective drug treatments for COVID infections. Heparin and platelet deactivators seem promising. A British company has just finished a trial using interferon beta, a specific cytokine, that looks very promising as a COVID treatment. And we may still find specific anti-virals that work, similar to flumantadine for influenza, acyclovir for herpes, or antiretrovirals for AIDS.

Just in case superman won’t show up to save us, clearly the best long-term strategy is to get on the other side of this pandemic by building herd immunity. But…we need to do this slowly, so that the healthcare and deathcare systems don’t get overloaded. In Texas, they are having to park refrigerator trucks outside the hospitals to store the dead bodies because the morgues are all full. In the hospitals, the medical staffs are maxed out and burning out.

We need to be smart about this. We talked about how the virus can hang in the air for hours. How, when you breathe in, most of the air that you breathe comes in around the edges of your mask, not filtered through your mask. So, in a sense, people who claim that wearing a mask won’t protect you, they are right. But when you breathe out, the mask catches a very high percentage of the droplets and aerosols that you exhale, so that they are not hanging around in the air for others to breathe in. But it doesn’t do this if it is not also covering your nose. So wearing your mask below your nose is like wearing your underwear below your penis. (And for those of you who don’t have penises, you get the picture.) Only much more deadly.

So that’s why we all have to work together. One contagious person, not wearing a mask, walking through a room, can contaminate that whole room for hours, potentially infecting all the others in the room who are wearing a mask. If we can decrease the amount of virus hanging around in the air and settling out on surfaces, we can decrease the spread of the virus. Wearing a mask or not is not a political issue, it is a compassion issue. You do it because you care about people who may be susceptible to the serious effects of COVID. You do it so that everyone who needs a ventilator will have one, so that people don’t have to stay in the emergency room for days waiting for a bed in the hospital.

There may be no way around reaching herd immunity without ten to fifteen million American deaths (to date, about one percent of Americans have tested positive for COVID and we have at least 150,000 deaths, so do the math. Herd immunity may be attained with fewer deaths than that because I believe there are a lot more people who have had COVID already than have tested positive for it). But, if we slow the spread, we may get a treatment or vaccine before that many people get infected, and we can make sure that people can get the medical care that they need in a timely fashion.

And, if everyone did their part to slow the spread of the virus, we could safely open many segments of the economy. So, from that perspective, people who are resisting wearing their masks, who are inconsistent with them, who are not following the advice about social gatherings and such are the people who are responsible for keeping the economy shut down.

She also asked if there was anything people could do to take care of themselves if they got COVID. When I answered her, she said that it was too bad that we weren’t talking about these things more. That is what prompted me to write this blog post. So here is what I told her.

SARS-CoV-2 seems to cause serious problems through two mechanisms: oxidative damage and increased blood clotting. Autopsy studies of people who have died of COVID have been very surprising. People who the ICU doctors thought had inflammation in their hearts based on their clinical picture didn’t have any inflammation in their hearts: their heart muscle was full of hundreds of little blood clots. When the ICU doctors thought a person was having inflammation in their brains due to their clinical picture, their brains didn’t have inflammation, they were full of little blood clots. And over twenty five percent of autopsies showed clots in the deep veins in their legs and pulmonary emboli from them.

So, putting this all together, this is what I recommend:

·         For protection against oxidative damage

o   NAC (N-acetylcysteine) 600 mg three to four times a day

o   Vit C at least 50mg/kg/day (three to five grams per day for most people)

o   Vit E as mixed tocopherols 400 IU per day

o   Selenium 200-400 micrograms per day (not to exceed 800 micrograms/day)

·         For protection against increased clotting, to help calm down your platelets

o   Fish oil, at least one tablespoon (15 ml) per day

o   Vitamin C as above

o   Aspirin 84 mg/day: that’s one baby aspirin or one quarter of an adult aspirin per day

·         As a prevention for infection, in addition to hand washing, keeping your hands out of your eyes, nose and mouth, wearing a mask, and social distancing

o   Zinc may slow viral replication if it can get into the cells. Zinc picolinate 15-30 mg/day

o   Quercetin one to two capsules per day may help drive the zinc into the cells

o   Take these two any time you plan to go out into the world

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No matter what our political persuasion, let’s all work together to beat this virus.

Stay healthy out there!