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What Comes Next? And Some Immunology

Updated: Mar 14

Well it hit the fan in the US yesterday. This is serious, but overreacting doesn't help anybody. This is not a sprint, this is a marathon. It is natural to overshoot our responses, and find the equilibrium later. People need to chill out. A piece of sage advice. Only look at the news/media for no more than 1 hour per day. It is over whelming. It is all consuming. And to be honest, it hurts your ability to fight off this bug (more on that later)


Importantly, if this response works, people will think we over reacted.


So one of the things I am trying to do is make you prepared for what may come. So if it does become a reality it wont catch you by surprise.


What comes next?

So here's the thing. This virus is here to stay. It is likely to become the 5th coronavirus that circulates in humans (yes, we already have 4 of them, and they are responsible for 25% of all colds). As another example of new diseases in humans, measles jumped from cattle to humans about 2000 years ago and is still causing us grief. Pathogens jumping from animals to humans is not uncommon.


This virus is here to stay. The expectation is that 30-60% of the world's population will be infected with the virus in the coming 12-18 months. Breath. When it gets to that stage, the level of community immunity will slow the virus's spread down to something much more manageable.


So the chances are that you, someone in your household, or a friend is going to get infected this year. But you, your family, your friends want to be the last ones infected. Every extra day you can put it off, the more we learn, new treatments will be developed, outcomes will be better. We must slow down the rate of spread.


The science isn't there yet, but there is a chance that this will be seasonal, like influenza. Virus-laden respiratory droplets don't survive as long in higher temperatures, higher humidity, and UV exposure. We don't know whether this is true for this coronavirus, but if so, we would expect community spread to slow down in the USA around the end of April. But, we would then expect things to get much worse in Australia and other south hemisphere countries.


But if seasonality is involved in this infection, we then have to expect a 2nd wave of infection in the US toward the end of the year (November). This is exactly what happened in the 1918 Spanish flu pandemic, the first year it circulated through communities it was a "mild" (relatively speaking) infection, the second season/year it was devastating. Clearly, medical technology is much better than 100 years ago, and outcomes for this virus will be better, but I want you to get the idea in your head that this is a marathon not a sprint.


You are making plans for the next 2 weeks based on fear and the unknown (we all are), but the reality is the new normal will look much different for many months.


While infections in your area are low, remember "common things happen commonly". that fever is likely not a coronavirus infection.


Immunity


We are only 12 weeks into understanding this virus. So there are so many unknowns, but we do have the knowledge from SARS (another coronavirus) to draw knowledge from. Once you get infected with SARS you become immune to SARS reinfection for at least 2-3 years. With this new coronavirus, we are seeing that people recovering from infection have developed strong IgG antibody titers to outer envelope proteins of the virus. This is good news, and gives hope that a vaccine, when developed, may be effective in providing protection. It also means that you can't be reinfected with the virus for quite some time. There is/was a lot of speculation and misinformation about this point, with "recovered" people still shedding virus for ~month after discharge, but the science appears to be settling toward infection and recovery leads to immunity.


I may get some hate mail from this next section


You can not boost your immune system! There is no magic supplement you can take that will enhance your immunity. Anybody telling you otherwise is wrong.


I have seen some seriously bad advice being given, like:

  • Flush water up your nose: Please don't, that damages mucus membranes making it easier for the virus to get in!

  • High dose vitamin C: Please don't, that can leading to severe diarrhea and again damage mucous membranes.

  • Colloidal silver: yeah, no... just no.

I could go on and on, but the people pushing these things online are snake oil salesmen, friends pushing it online may be well intentioned, but they are wrong. Remember, lots of things kill viruses in a dish, but have zero pharmacological value when put in a person



I'd also like to point out, that it appears most severe cases of illness due to this virus is due to an overreaction of your immune system (ARDS). If immune boosters are a thing (which they are not), do you really want to risk over stimulating the immune system and sending you or your loved one into Acute Respiratory Distress Syndrome? think about it....


So what can you do?


Eat well. You can't boost your immunity through food or supplements, but you certainly can suppress your immune system by eating poorly. Fresh fruits and vegetables. Well balanced meals.


Get outside: the US is in winter, many of us don't get enough sunlight to meet our vitamin D needs. Get outside and get some sun.


Exercise: don't start doing anything crazy that you don't normally do, but go for a walk with your kids. Kick a ball around. You don't need to lock yourself away. Please note: there is zero evidence that the virus can be spread in sweat.


Reduce stress: I don't care whether it‘s from yoga, going to the gym, reading a book, cutting off social media, prayer.... it doesn't matter. Stress suppresses immunity, a lot! Find a way to lower your stress burden and your body will thank you for it.


Get sleep: Just getting 1 hour less of sleep a night reduces immunity by about 20%.


I will leave it at that today. Be nice. People are scared. Nothing big has happened in the last 24hrs. Everything up until now (except for the terrible government response), was completely predictable.


Please find ways to

  • Support the needy in the community

  • Support our healthcare workers

  • Support our small businesses



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