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Preparing for the Fall in a Pandemic

The number of COVID-19 cases has reached over 32 million cases worldwide with almost 1 million deaths at this time as we pass the fall equinox.  In the United States cases on average have slowed and are dropping in most states. In Europe, cases are accelerating and in England numbers have climbed almost to the levels that were seen in March and April.  In France, they have surpassed their peak in March and April. Italy has not gone up as much but still they are also experiencing an increase. In response, United Kingdom will be changing rules for pubs and restaurants to close at 10 PM. The UK's Covid-19 alert level was moved up to level 4, meaning transmission is "high or rising exponentially".

To illustrate what an exponential rise means and what it looks like we can use the example of investing or monetary growth. In this illustration, which can be found on this website https://www.modern-dollar.com/blog-index/2017/6/1/a-penny-doubled-or-1000000 if you are offered a payout of $1,000,000 upfront or to wait after 30 days to have payout with a penny doubled every day for those 30 months which would you choose?  As you can see by the graph, if you chose the penny route, for the first 25-26 days you would probably have thought you made a big mistake by not taking the $1,000,000 up front. But by the end of the month you would have received $10,737,418.24 for your wager.  So you can see that not much appears to happen until the last 3-4 days of the month which is what the fear is with an exponential rise with COVID-19. The virus was likely growing quite slowly for some time and when a rise starts to be seen as in the UK, officials appropriately responded with increasing the alert level to 4.

With the flu season coming upon us and winter following there will probably be a further spike in Covid-19 cases. The World Health Organization (WHO) has acknowledged that almost 1 million have died worldwide and the fear is even if a vaccine were available today, by the time it took to inoculate and administer the vaccine to the world another 1 million may die.

The best means of decreasing both the spread and the chances of mortality are to optimize nutrition, maintain a healthy lifestyle, and following the CDC guidelines of wearing frequent hand washing, wearing a mask, and social distancing.

In a recent interview Dr. Anthony Fauci told the interviewer what he has done for himself to maintain his health during the pandemic. His suggestions echo what I have been sharing with you these past 6 months.  He stated he supplements his own diet with vitamin C and vitamin D. He recommends getting enough sleep, maintaining a healthy diet, and avoiding or alleviating stress as the three most potent ways to keep your immune system strong. 

Here is a list of the blogs covering these topics:

https://www.allfunctionalhealth.com/blog/coping-with-covid-19

https://www.allfunctionalhealth.com/blog/benefits-of-sleep

https://www.allfunctionalhealth.com/blog/boost-your-immunity

https://www.allfunctionalhealth.com/blog/mindset-is-key-to-any-crisis-or-loss

https://www.allfunctionalhealth.com/blog/immune-boosting-foods

https://www.allfunctionalhealth.com/blog/new-study-on-how-to-reduce-your-risk-for-viral-infections-and-covid-19

https://www.allfunctionalhealth.com/blog/oxidative-stress-and-glutathione

https://www.allfunctionalhealth.com/blog/recent-studies-of-vitamin-d-and-zinc-in-pandemic

https://www.allfunctionalhealth.com/blog/are-you-stressed

https://www.allfunctionalhealth.com/blog/guide-to-masks

https://www.allfunctionalhealth.com/blog/update-on-vitamin-d-and-immune-health

https://www.allfunctionalhealth.com/blog/boost-your-immune-system-to-protect-yourself-from-viral-infections

 

In addition to doing everything we’ve outlined above, there may be certain behaviors that we can do or change that may also help. I mentioned briefly about a CDC review article that suggested an association with eating out at restaurants and COVID-19 positivity. I wanted to go into a little more detail about this study.

The study was a case controlled trial, not a randomized placebo controlled study, with equal men and women and consisted mostly of people from age 18 to 59. Only 18 were older than 60 and mostly Caucasian. Most who were exposed to Covid were exposed to a family member and most almost always wore a mask.  The investigators created a chart with the adjusted odds ratio and 95% confidence intervals for community exposures associated with confirmed COVID-19 among 314 symptomatic adults greater than age 18 years in the United States from July 1st to July29th, 2020. Because there was a lot of overlap and without getting too much into statistics the only variable with both the median and confidence ratios clearly above the adjusted odds ratio of 1, or being statistically significant, were the people who ate at restaurants. While it would be nice to know if these people dined inside or outside, this information was not obtained or published.  The conclusions were that Findings from a case-control investigation of symptomatic outpatients from 11 U.S. health care facilities found that close contact with persons with known COVID-19 or going to locations that offer on-site eating and drinking options were associated with COVID-19 positivity. Adults with positive SARS-CoV-2 test results were approximately twice as likely to have reported dining at a restaurant than were those with negative SARS-CoV-2 test results. The authors further stated that eating and drinking on-site at locations that offer such options might be important risk factors associated with SARS-CoV-2 infection. Efforts to reduce possible exposures where mask use and social distancing are difficult to maintain, such as when eating and drinking, should be considered to protect customers, employees, and communities.

Another paper from Japan supports the idea that closed environments help spread COVID-19. The article is in preprint but the authors write that in the paper they “show that closed environments contribute to secondary transmission of COVID-19 and promote super spreading events. Closed environments are consistent with large-scale COVID-19 transmission events such as that of the ski chalet-associated cluster in France and the church- and hospital-associated clusters in South Korea. Our findings are also consistent with the declining incidence of COVID-19 cases in China, as gathering in closed environments was prohibited in the wake of the rapid spread of the disease. Reduction of unnecessary close contact in closed environments may help prevent large case clusters and super spreading events.” In the paper, they found that the odds that a primary case transmitted COVID-19 in a closed environment was 18.7 times greater compared to an open-air environment (95% confidence interval).

So, in preparing for this fall during a pandemic we should all be aware of probability of the spike in the number of cases and that as a citizen of our country and the world not let our guards down but to continue to follow the recommended guidelines of frequent hand washing, wearing a mask, and social distancing. We can also help ourselves individually by optimizing our immune system through lifestyle changes such as getting 7 to 8 hours of sleep, stress reduction, and getting 30 minutes of cardiovascular exercise daily. Foods containing Vitamin D, Vitamin C, Zinc, and Quercitin help boost our immune system. Supplements such as MitoMax that contain N-Acetyl cysteine and many other cofactors to optimize mitochondria, energy production, and help mitigate oxidative stress. Lastly, making prudent behavioral choices like avoiding indoor gatherings or minimize indoor eating may also decrease the risk of infection. Hopefully, with these tools we can all stay healthy this fall as we wait for more effective treatments or preventative measures like monoclonal antibodies, aeronabs, or vaccines.

Please see the blogs on www.allfunctionalhealth.com/blog if you are interested any of the topics we discussed above.  If you have comments, questions, or want to learn how functional medicine can help with improving your gut, maintaining brain health, and optimizing immune function call our office at (925) 736-9828 or email info@jeffreymarkmd.com.

For more information on supplements to boost your immune system click on this link, call our office at (925) 736-9828, or email info@jeffreymarkmd.com.

 Take Care and Stay Healthy.

 Jeffrey Mark, M.D.

Author
Jeffrey Mark, M.D. Helping clients with compassionate and comprehensive medical care for over 25 years with 4 board certifications in functional medicine, gastroenterology, internal medicine, and anti-aging/ regenerative medicine . IFMCP, ABIM Gastroenterology, NPAS Internal Medicine, ABAARM.

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