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Staying Healthy During a Pandemic: Choices You can Make in the Face of COVID-19


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The current pandemic sparked by the novel Coronavirus and the illness it can cause, COVID-19, has created challenges for all of us. We feel overwhelmed and exhausted, confused by the barrage of shifting data and public health recommendations. To help you navigate through this swell of information, we have gathered resources to clarify what is known about this virus along with tips to guide you and your family in making informed choices about how to stay healthy. We are not going to throw more numbers at you; rather, we'll cover:

The What, How, and Why of Coronaviruses and COVID-19

Strengthening Your Immune System:

o Diet & Nutritional Supplements

o Sleep

o Physical Activity

o Social – Emotional Wellness

Hygiene and Masking

Making an Informed Choice about Testing & Vaccination

Remember, prevention and treatment of any health condition is best done through an approach that focuses on the unique needs of each individual. We hope that you will discuss this information with your own medical providers, ideally those who are experts in taking a holistic approach to supporting your health and wellbeing-mind, body, and spirit.

The What, How, and Why of Coronaviruses and COVID-19

What is a coronavirus?

Coronavirus includes a large family of viruses that may cause illness in animals or humans. In humans, several coronaviruses are known to cause respiratory infections ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). A novel coronavirus is one that is brand new, having no prior scientific identification or documentation about its nature.

What is COVID-19?

COVID-19 is the disease caused by the recently discovered novel coronavirus. According to the World Health Organization, this Coronavirus Disease was unknown before the outbreak began in Wuhan, China in December 2019.

How does a virus work in the body?

Viruses have a molecule called a virulence factor on their surface. Virulence factor is what helps the virus attach to a host cell. COVID-19 is more powerful because it has two virulence factors --while the common cold virus has just one. COVID-19 attacks a particular protein that is found throughout the human body, but is heavily concentrated in the lungs as well as the gut, where primary symptoms appear in an infected person. Additionally, a person can show symptoms in other systems in the body. This is one reason why such a variety of symptoms have been described in people who have become ill from COVID-19.

What are the symptoms of COVID-19?

The most common symptoms of COVID-19 are:

Fever of 100.4 degrees F or higher (children might have lower fever)

Fatigue

Dry cough

Difficulty breathing

Other symptoms can include aches and pains, nasal congestion, runny nose, sore throat or diarrhea.

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How does COVID-19 spread?

Based on what has been learned from the data to date, it is believed that the disease spreads from an infected person to another person through small droplets released from the nose or mouth when a person with COVID-19 coughs, exhales, or even talks. These droplets land on objects and surfaces around the person. People then get infected by touching the objects or surfaces followed by touching their nose or mouth.

How long can the virus survive outside of the body, such as on surfaces?

Current scientific evidence indicates that the virus can remain viable in the air (aerosol) for hours and on surfaces for days. Current information of the viability of COVID-19 on surfaces:

Plastic: 2-3 days

Stainless steel: 2-3 days

Copper: 4 hours

Cardboard: 24 hours

Be aware that research information on surfaces is typically done in a lab under controlled conditions. How viable COVID-19 is in the wild is still unknown. Research suggests it can be as much as 9 days.


Who is most likely to become ill when infected with the corona virus?

First, it is important to know that:

Not everyone who becomes infected gets ill and Not everyone who has been infected and became ill has died.


Many doctors and researchers around the globe have proposed the following groups of people are most at risk to develop symptoms:


Weakened immune system. Many things can impact our immune system. Those people who are born with compromised immune function or who have a lifestyle of high stress, low sleep, poor nutrition, or auto-immune conditions seem to have a greater risk for severe illness.


Underlying medical conditions. These conditions include autoimmune disorders, compromised immunity due to other medical treatments or medications, diabetes, obesity, and heart and lung conditions.


Age. Those people who are over 60 years old seem to be at greater risk for severe illness from COVID.


What is the health risk of COVID-19 for children and young adults?

Overall, current scientific findings show that serious risk for children is minimal. Even though data among children returning to school is still evolving, epidemiologists continue to contend that for most children, the risk will continue to be minimal. For children who are obese or who have underlying health conditions there may be a higher risk for severe illness.


Strengthening Your Immune System - Naturally

What does the immune system do, exactly?

When your body comes across a bacteria or virus, a strong and healthy immune system immediately goes into action like an army marching into battle. Once the immune system launches its "attack" on the virus, the body "remembers" that particular virus and is able to respond more quickly the next time it encounters it.


What can you do to help protect your health and keep your immune system strong?

The approach of integrative and natural/holistic medicine is ideally suited to prevention and protection from infections because it focuses on strengthening the body's innate healing ability (immunity) through evidence-based interventions. This includes embracing healthy habits, such eating well, use of nutritional or herbal supplements and daily exercise.

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A Healthy Diet

Switch to a diet consisting of primarily whole foods, locally/organically grown whenever possible, and rich in a variety of natural colors and nutrients. Increase your intake of fish and/or fish oil, fruits, legumes, and vegetables and reduce or eliminate sugar, processed foods, fast foods, etc.


Add more "cruciferous" vegetables to your snacks and meals, especially broccoli, Brussel sprouts, cabbage, cauliflower, and kale, which are naturally high in indole-3- carbinol (I3C). Clinical studies show that this compound has the potential to interfere with the way many viruses reproduce.


Go easy on the alcohol. In addition to decreasing your capacity to make good decisions, alcohol has been shown to decrease function in important immune pathways.

Stay hydrated to support the cellular processes that your body relies on for building, maintaining, and repairing its systems.


Consume foods high in Vitamin C, D, A, Zinc and Omega 3.

Vitamin C: Citrus fruits, Broccoli, Brussels sprouts, cauliflower, bell peppers, spinach, cabbage, dark leafy greens, tomatoes and squash..

Vitamin D: Salmon, mushrooms, dairy

Vitamin A: Organ meats, carrots, squash

Zinc: pumpkin seeds

Omega 3: cold-water fish, seafood, flax

Nutritional & Herbal Supplements

When natural supplements are used therapeutically by holistic practitioners to treat illness, they are often dosed higher than the Recommended Dietary Allowance (RDA). This is acceptable for short periods of time. Remember, the RDA is what is recommended to prevent symptoms of deficiency in the majority of people. For example, Vitamin C deficiency can lead to a disease called scurvy. The body does not require a large amount of Vitamin C to prevent scurvy, but it does require considerably more when using the vitamin to boost immune function.


It is also important to remember there are differences between how much of a substance that children and adults need. The amount of a vitamin or supplement that a person needs also depends on how much a person consumes in food and drink each day. Finally, there are limits to how much of certain vitamins and supplements humans should consume on an on-going basis. The USDA has gathered this information and it can be found at https://www.nal.usda.gov/fnic/vitamins-and-minerals


When using natural substances, it is always a good idea to work with a holistic health practitioner who has expertise in using supplements therapeutically and for individualizing treatment to your needs.


The following nutritional and herbal supplements have been shown to help support immune function in general and in particular, for corona viruses.


Vitamin C - can boost immune function and shorten the duration of viral symptoms.

Zinc - is essential for immune function and can be helpful with initial symptoms of and can shorten the duration of viral illness. Typically given as a dissolving lozenge.

Selenium - has been shown to be helpful in supporting immune function.

Vitamin A - helps the immune system by maintaining the integrity of the mucus membranes in addition to being part of the adaptive (long term) immune response.

Vitamin D - works to decrease inflammation and support immune function.

Omega 3 fatty acids - decrease inflammation and support the immune system.

Herbs: Echinacea and Elderberry are known to stimulate and balance the part of the immune system that deals with viruses.

Probiotics protect the gut flora associated with immunity.

Sleep Soundly

Sleep is a critical part of keeping your immune system healthy as well as managing stress and a healthy body weight. Keep a sleep routine with the same bedtime and wake-time for the majority of the week. Use room darkening blinds if you work nights.

Napping during stressful times can improve memory, energy and focus.

Stay Physically Fit

Physical activity has a host of positive benefits including stress reduction; optimizing sleep; keeping the heart and lungs strong; managing a healthy body weight; improving strength, flexibility, and balance; and supporting immune function.

The minimum recommendation from the World Health Organization is 150 minutes per week of moderate intensity physical activity that is broken up into five 30-minute sessions.

"Physical activity" could include activity you perform at your job (construction work, waiting tables); a hobby (gardening); a leisure activity (fishing, golfing)

"Exercise" specifically refers to activity designed to improve one or more of the following pillars of fitness: strength, cardiovascular/aerobic, balance, flexibility.


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Maintain Social-Emotional Wellness

Social-emotional (SEL) wellness encompasses many things; we hope you'll consider some of these unique ideas that can sustain your wellbeing during this pandemic.

Recreate Your Morning Ritual. We're pretty familiar with the advice to start your day with a few minutes of meditation, gratitude journaling, or mindful movement. In addition to doing those things more often, do less of these 2 things:


1) scanning your email or news feed before your head has even lifted from your pillow.

2) Turning on the news while dressing or eating.


Moderate the amount of news and social media you consume throughout the day. Too much of this can make you feel anxious or depressed. Turn off devices by 9 PM because the blue light emitted by devices can suppress melatonin secretion and spoil your sleep. Take a "mobile/device fast" one day per week.


Create a working-from-home sanctuary space. If you're working from home, create a spot at your desk that has visual reminders of things that relax you. In another corner of your home, create a sanctuary space where you can "chill." Even if this means just walking out to your back or front porch, or opening the front door for a few minutes of fresh air--do it. Also, be sure to take a lunch break away from your workspace.


Spend time in nature. Try to spend at least 30 minutes outdoors each week (if possible, without carrying your phone). Research shows that increasing time spent in nature proportionally increases a sense of wellbeing and reduces stress.


Do Good for Others. Volunteering during a pandemic looks different: You're less likely to be hands-on at a shelter, soup kitchen, or community collection site but you can virtually mentor a student, be a homework helper, or even do virtual visits with homebound seniors or hospice patients through landline or video-chat. Animal lovers may still be able to volunteer at a shelter, manage donations/collections, or even rescue a pup or kitty.


Share your Ability: Are You Handy about the House? Volunteer in your neighborhood to help overwhelmed parents with minor home repairs.


Learn Something New. Turn on YouTube for an hour and learn to crochet, knit, or bake sourdough bread. You can even learn to play piano or guitar, or paint!



Hygiene Practices and Masking

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Wash hands frequently throughout the day using a soap and water lather for at least 20 seconds. Wash after using the bathroom; before eating; after blowing your nose, coughing, or sneezing; and after being in high-touch environments such as the mall or grocery.


Use a 70% (or higher) alcohol-based hand sanitizer.


As much as possible, avoid touching your face, rubbing your eyes, nose or mouth.


Use a tissue to cover your mouth and nose when sneezing/coughing.


If you feel unwell: Stay home and rest.

If you have a fever, cough and difficulty breathing, seek medical attention.

To clean and disinfect surfaces, use one of the following solutions and allow it to sit on the surface for one minute or longer.

62–71% alcohol

0.5% hydrogen peroxide


It is not recommended to wash your own body or foods with disinfectants containing bleach or other chemicals. It is sufficient to just use soap and water to disinfect foods and the body.


What about masks?

Some health professionals have proposed that masking helps reduce transmission of the virus by capturing droplets. Other health professionals have proposed that masking does not prevent the spread of the virus and base their conclusions on studies that have been conducted and published over the last 20 years about masks worn by surgical teams.


All we know for certain at this point is that there are certain guidelines that should be followed when wearing a mask:


Do not share masks.

Wash your mask daily and air dry for 2 days. It is a good idea to have several masks per person so that you can alternate between them.

Do not wear a mask when exercising.

Do not touch your face or mask when wearing it.

Use a small size for kids and a large size for adults.

Reserve the N-95 masks for healthcare workers.


When do you need to self-quarantine?

Self-quarantine and testing is strongly advised for anyone who believes they have been exposed to, or have symptoms of, COVID-19. The CDC regularly updates these requirements based on current data. Most states have mandates in place for those who have tested positive. Self-quarantine can range from 9-14 days.

Making Informed Choices about Testing and Vaccination

Should you get tested for COVID-19?

The current focus of testing is for individuals who are symptomatic with evidence of respiratory tract infection. People who are concerned about the virus, but have no symptoms, are encouraged to forgo testing unless it is mandated by your locality or place of work.


When a vaccine is available for COVID-19, should you get it?

To vaccinate or not is a very personal choice. It is one that should be made in consultation with your family members and your healthcare providers. Keep in mind that there is NO vaccine for the common cold (a coronavirus) nor is there a vaccine for any of the illnesses caused by other coronaviruses (SARS, MERS, etc.) This family of viruses mutate and adapt fairly quickly (the rate for each type of coronavirus varies), which is why it has been impossible to predict the appearance, infection rate, or virulence for any coronavirus.


Resources for the Reader

Documentary: Coronavirus Explained

This Netflix Series initiated filming and production in 2019, before COVID-19 became the pandemic it is today. Netflix does an excellent job explaining what coronavirus is, what strains have caused verified illnesses, why it is so difficult to develop vaccines for this family of viruses. https://www.netflix.com/title/81273378

Communities, Schools, and Workplaces - COVID-19

Guidance for where you live, work, learn, pray, and play, including community mitigation frameworks.

https://www.cdc.gov/coronavirus/2019-ncov/community/



References

CDC: Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) - United States, February 12–March 16, 2020 https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm?s_cid=mm6912e2_w

Medscape: Coronavirus Stays in Aerosols for Hours, on Surfaces for Days https://www.medscape.com/viewarticle/926929

Virology Down Under: Why does soap work so well on SARS-CoV-2? https://virologydownunder.com/why-does-soap-work-so-well-on-sars-cov-2/

Scientific American: Flattening the COVID-19 Curves https://blogs.scientificamerican.com/observations/flattening-the-covid-19-curves/

Vitamin D for COVID-19: A Case to Answer. Lancet Diabetes Endocrin. Published Online August 3, 2020 https://doi.org/10.1016/ S2213-8587(20)30268-0 https://www.thelancet.com/action/showPdf?pii=S2213-8587%2820%2930268-0


McNamara, D. "Low Vitamin D Linked to Increased COVID-19 Risk." Medscape. Published online 18 Aug 2020: https://www.medscape.com/viewarticle/934835


John Hopkins: Coronavirus, Social Distancing and Self Quarantine https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-social-distancing-and-self-quarantine


Children, Obesity & Covid-19: Risks and Recommendations for the Most Vulnerable Populations. (2020) World Obesity Live: http://s3-eu-west-1.amazonaws.com/wof-files/Webinar_3_COVID19Obesity.pdf


Alcohol Research Current Review: Alcohol and the Immune System https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590612/

Medscape: Probiotics May Be Useful Against Colds, Flu-Like Symptoms in Children https://www.medscape.com/viewarticle/707329


Shekerdemian LS, Mahmood NR, Wolfe KK, et al. "Characteristics and Outcomes of Children With Coronavirus Disease 2019 (COVID-19) Infection Admitted to US and Canadian Pediatric Intensive Care Units." JAMA Pediatr. Published online May 11, 2020. doi:10.1001/jamapediatrics.2020.1948 https://jamanetwork.com/journals/jamapediatrics/fullarticle/2766037

Evans, S. S., Repasky, E. A., & Fisher, D. T. (2015). Fever and the thermal regulation of immunity: the immune system feels the heat. Nature Reviews Immunology, 15(6), 335–349. doi: 10.1038/nri3843

Gaby, A. (2017). Nutritional medicine (2nd ed.). Concord, NH: Fritz Perlberg Publishing.

Gálvez, I., Torres-Piles, S., & Ortega-Rincón, E. (2018). Balneotherapy, Immune System, and Stress Response: A Hormetic Strategy? International Journal of Molecular Sciences, 19(6), 1687. doi: 10.3390/ijms19061687

Haluza, D., Schönbauer, R., & Cervinka, R. (2014). Green Perspectives for Public Health: A Narrative Review on the Physiological Effects of Experiencing Outdoor Nature. International Journal of Environmental Research and Public Health, 11(5), 5445–5461. doi: 10.3390/ijerph110505445

Personal Communication: Eli Camp, ND. 11 August 2020.


Medicine Talk Pro Newsletter Service Archives 2019-2020. http://www.medicinetalk.com


Carøe T. "Dubious effect of surgical masks during surgery." Ugeskrift for Laeger. 2014 Jun;176(27):V09130564. https://europepmc.org/article/med/25294675


Salassa, Tiare E. MD1; Swiontkowski, Marc F. MD1 "Surgical Attire and the Operating Room: Role in Infection Prevention." The Journal of Bone and Joint Surgery. September 3, 2014 - Volume 96 - Issue 17 - p 1485-1492 doi: 10.2106/JBJS.M.01133 https://journals.lww.com/jbjsjournal/Abstract/2014/09030/Surgical_Attire_and_the_Operating_Room__Role_in.11.aspx


Da Zhou et al., "Unmasking the surgeons: the evidence base behind the use of facemasks in surgery." Jl of Royal Society of Medicine. (2015) 108:6, 223-228.



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