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Decoding the COVID19 Vaccine

December 2020 heralded the release of the COVID19 vaccine. It was created at an unprecedented speed after a clinical trial demonstrated its efficacy. The vaccine was shown to be 95% effective in protecting humans against the COVID19 virus.  

Many in the public are skeptical about this vaccine.  I would like to offer some basic knowledge to assist in clarifying any confusion you might have about how this vaccine works to protect against the COVID19 virus.

First, a recap of the immune system and how vaccines work:

When a foreign protein (antigen) enters our body, our innate immune system is the first to respond. This part of our immune system consists of ‘foot soldiers’ on the front lines that see the enemy and run towards it to destroy it.  These foot soldiers are billions of Natural Killer (NK) cells, whose job is to attack any foreign antigen that is considered a threat to the body.  These are released into the bloodstream by the liver, which find and kill the foreign antigen through a process called phagocytosis.  This antigen could be a virus, a bacteria or a cancer cell.  After killing it, parts of the antigen are carried on the surface of these cells and presented to the adaptive immune system, where a type of B-cell called plasma cells to manufacture antibodies against the specific parts of the antigen presented to them. This takes a few days to occur after the antigen first enters the body. Another category of B-cells called memory cells, memorize the configuration of the antigen that the antibodies are made against, and lay waiting in case the same antigen invades again.  If the antigen enters the body, the memory cells stimulate antibody production which destroys the antigen and protects the body from invasion.  

Antibodies are Y shaped proteins whose tips are shaped to fit a precise antigen, like a lock and key.  Antibodies bind to precise antigens they are created against, forming antigen-antibody complexes.  The reaction is called an antigen-antibody reaction.  This reaction draws white cells towards the complex whose job is to phagocytose and destroy these complexes. During immune reactions, cytokines are released by white cells, necessary to signal more cells for assistance in defending the body. The side effects of cytokines include inflammation, fever and fatigue, and when too many cytokines are released, they can cause high fever and tissue damage.

The same antigen-antibody reaction described above occurs after a vaccine is administered.  A vaccine contains an antigen or parts of it that are injected into the body to stimulate the production of antibodies, in this case, against the COVID19 virus.

Many vaccines are made from the actual virus or bacteria. This introduces the infectious particle itself into the body.  The virus or bacteria is typically weakened or attenuated  before it is injected.   For example, the influenza vaccine contains the influenza virus (which causes the flu), in an attenuated state. This is why some people can actually get the flu after being vaccinated, especially if their immune system is weakened by an illness or an unhealthy lifestyle.  

The COVID19 vaccine is different from a vaccine that contains an infectious particle in a fundamental way.  It does not contain an attenuated COVID virus. Instead, the antigen injected into the body is a strand of the genetic code of the COVID19 virus, the part of its blueprint for the spike protein, which sticks out from its capsule.  The spike protein contains the docking mechanism needed by the COVID19 virus to engage with the surface of cells (receptors) to enter them. The antigen in this vaccine, a messenger RNA that codes for its spike protein was synthesized in the laboratory by copying the genetic sequence from COVID19, then surrounded by a lipid or fat layer creating a lipid nanoparticle. This lipid layer helps it merge with the lipid layer of the cells in our body for easy entry of the messenger RNA into the cell. Our cells then use the RNA to manufacture the spike protein of the virus.  Once the spike protein is manufactured, our cells recognize it as foreign and mount an antibody response against it. This takes about 2 to 3 days after vaccination. Antibodies generated destroy the spike protein, memory cells are created, and if the COVID19 virus enters our body after vaccination, the immune system will recognize the spike protein on the COVID19 capsule as the foreign antigen it has seen before (from the vaccine) and create antibodies against it.  The antibodies will attack the spike protein and destroy it, preventing the entry of the virus into our cells. The mRNA present in the vaccine is short-lived, never enters our cell’s nucleus containing our DNA, and completely degrades within a few days. It does not become a permanent part of our DNA.

Since no infectious particles are used in this vaccine, its side effects are relatively mild. These include soreness at the vaccination site and a mild cytokine reaction described earlier, with fatigue and possibly a low-grade fever that lasts for a couple of days. The mild cytokine reaction is an indication of an antigen-antibody reaction confirming the presence of antibodies made against the spike protein after vaccination.  The COVID19 vaccine is administered in two doses delivered 3 weeks apart.  After the first vaccine, a booster is given 3 weeks later, which amplifies the antibody response, ensuring greater protection against COVID19. 

So far three companies have manufactured the COVID19 vaccine, Pfizer, Moderna and Oxford (AstraZeneca-Oxford). Both the Pfizer and Moderna vaccine are available in the U.S.

In the clinical trial conducted by Pfizer and Moderna, 95% of participants developed immunity against COVID19 after vaccination.  The clinical trial was quite large and the phase 3 trial  included over 43,000 subjects, 45% of whom were 56 – 85 years of age, from diverse backgrounds.  So far, the COVID19 vaccine shows great promise with few side effects.

We know that in patients infected with COVID19, antibodies last about 6 months or longer post-infection, and reinfection can occur after even being infected after this period of time.  It is not clear how long the antibodies produced after vaccination will have a protective effect.  It is still too early to tell. 

Another concern for researchers has been a question about the efficacy of the vaccine if the COVID19 virus mutates in a way that makes the vaccine ineffective. Remember, antibodies are specific for specific antigens, in this case, the spike protein of the virus.  If the virus mutates after people are vaccinated, completely changing the composition of the spike protein, the antibodies won’t work to neutralize the mutated antigen. 

The COVID19 virus has gone through two mutations per month since it entered the human population a year ago.  This is a known phenomenon among viruses.  When a virus jumps from animal to human, as in the case with this virus, it mutates to become more stable in its human host to spread more effectively. 

If today’s COVID19 virus is compared to the original one originating in Wuhan in December 2019, it has undergone 25 mutations in the past year! So far, one mutation of potential concern relative to the vaccine, is that of the docking apparatus of the spike protein.  This has been called the N501 mutation

As we now know, all three vaccines released so far stimulate the immune system to attack the spike protein of the virus.  The good news is, one area of mutation on the virus may not impact the efficacy of the vaccine, because once vaccinated, the body learns to attack many parts of the spike protein, so if one or two parts mutate, other parts are still rendered ineffective by antibody attack.  

Once enough people are vaccinated, will SARS-CoV-2 mutate in a way to avoid being rendered ineffective by the vaccine?  

It is too soon to tell. 

Our antibody response is only as strong as the health of our body.  Our lifestyle choices have a direct impact on our immune system.  We have ample evidence about what choices support our immune response and what choices weaken it.  A diet high in sugar, saturated fat, alcohol and the lack of exercise will not mount a strong immune response.  A low vitamin D and Vitamin B level also negatively impact the strength of our immune response. 

I am very impressed by the technology engaged in the production of this vaccine to create an effective antibody response with few side effects. I am hopeful that this will assist in reducing deaths from COVID19.

As promising as this vaccine is, it does not prevent transmission of COVID19, so please continue to use a mask, observe social distancing of 6 feet or greater, and continue to hand wash and use hand-sanitizer.  

Our health is our greatest asset, and 2020 has been a year that has illuminated the power of our lifestyle choices.  In fact, they can make a difference between life and death.  It is up to us to support the health of our body and I ask that make this a priority in 2021.

For more information on gaining knowledge to promote health, visit https://rosekumarmd.com/webinars/.  Her learning platform will inform you with evidence-based information about how to transform your health.

Dr. Kumar’s integrative Internal Medicine practice focuses on disease prevention and reversal.  For an in-person or remote appointment, call 262-695-5311.  

©January2021 Kalpana (Rose) M. Kumar M.D., CEO and Medical Director, The Ommani Center for Integrative Medicine, Pewaukee, WI. www.ommanicenter.com   Author of 2nd Edition – Becoming Real: ReclaimingYour Health in Midlife 2014, Medial Press. She is currently accepting new patients-call 262.695.5311 for an appointment.  During this time of COVID19 pandemic, she is offering both telephonic or in-person appointments for those people free of symptoms. 

 

Can Our Choices Save Us From COVID19?

As time passes, and the coronavirus continues to spread with a rising death toll, we must ask ourselves, what do we need to learn during this pandemic?  Any event with this level of magnitude arrives as a lesson for humanity.  To gain insight, will require us to apply self-reflection, critical thinking, and a large measure of common sense to learn what we need for transformation to take hold.  Time and time again, we have learned that sometimes the best solutions for complex problems are simple ones.  This pandemic has brought many feelings to the fore. For many, it has triggered fear, confusion and helplessness.  For others, conflicting belief systems, different sides of politics, whether or not to wear masks has taken precedence, and yet underneath the varied amplifications that this pandemic has triggered, it has affected a much needed global reset to evaluate what is truly important and meaningful in life.  

For the Medical community, this time has brought much to the fore.  Now more than ever, it is critical to follow enduring scientific evidence and to fortify Medicine’s fundamental foundational principles. Medical evidence is not a belief system. Belief has no place in health care.  As physicians, we are taught to distill and interpret evidence, and we must practice evidence-based medicine and educate our patients to promote their health and well-being.  This is sacred work and requires diligence, discernment, and a sustained effort.  It also requires sacrifice.  As physicians, we have a responsibility to ‘sacrifice’ public opinion for what has been shown to be true.  It also requires flexibility, so we can amend our ideas of evidence-based ‘truth’ when new evidence uncovers the limitations of previously held theories. 

Healthcare today is faced with many problems.  We have repeatedly heard how broken our healthcare system is and why it needs to transform.  I would like to add my personal experience to this opinion.

Over the past few decades, the intention of corporate medicine shifted from patient care to profit, altering its emphasis from caring for patients to viewing patients as ‘consumers’ and commodities.  Understanding that the business of medicine is necessary for this system’s survival, using patients and physicians to make money at the cost of care and choosing treatments that offer greater profit margin in lieu of safer and more effective methods, has eroded the public’s trust of the current healthcare system.  Insurance companies have added yet another layer to the corporate model, withholding payments for promised services to patients, as well as withholding payment for services rendered by physicians.  Nearly two decades ago, this shift witnessed a movement of physicians from private practice to hospital employment. The price they paid was grave.  Unbeknownst to them, they were required to sacrifice their integrity of practice for corporate profit.  This was the root cause of the loss of trust patients suffered towards healthcare.  Today, this distrust has a great impact on the manner in which the public is responding to health care’s representation of the COVID pandemic.

Once broken, trust is difficult to restore without a radical transformation in behavior.  Without trust, public opinion about medical issues replaces scientific evidence, causing potentially harmful theorizing and decision making to take hold.  Left to their belief systems that are influenced by fear, public opinion cannot provide the needed protection when medical evidence is cast aside.  In fact, it can be dangerous for both personal and collective health. 

Since the pandemic began, I have been appalled at medical proclamations about COVID19 which are released to the public without rigorous auditing known as peer review.  Once reviewed, the vast majority of the unaudited conclusions have been retracted, further shaking public trust.  During a pandemic, the global collective is in fear and looking for ways to stay healthy and heal quickly, if infected.  But the health care system, rife with decades of fundamental conflicts of interest, has not been able to lead the way with scientific integrity during this infectious disease crisis, after decades of business practices that have been out of alignment with its essential mission.  The lack of public trust in Medicine, from this context, is understandable, and no surprise given the lengthy history of its money track.  What I believe we are experiencing are the symptoms resulting from the deep-rooted illness that has infected health care for decades – its emphasis on profit at the cost of care.  

As one who walked away from corporate medicine with its inflated salary and golden handcuffs decades ago, I vowed to practice from the integrity of the scientific method in which I was trained and which was also based in the sanctity of the doctor-patient relationship and a high standard-of-care. Believe it or not, Medicine once practiced from this platform. It has been difficult in many ways to run a solo practice from this essential platform but the meaning I derived from this form of practice more than offsets the challenges it presents. 

I have observed how corporate medicine has handled the COVID pandemic.  I am appalled by the lack of support the system has provided for physicians who are risking their lives to save their patients.  We all know the dangers they have been subjected to due to a shortage of PPE, safe practice environments, and the threats towards them restricting their freedom to voice fear and anger resulting from the injustice with which they are being treated. This is in the hospital environment, but what about the community?  We have not heard en masse, the importance of preventive measures which have gone virtually ignored during the COVID pandemic.  Decades of medical evidence shows that supplements such as Vitamin D, broad-spectrum probiotics, zinc, healthy lifestyle choices, and stress reduction are vitally important as antivirals and immune enhancers.  Instead, these have been ignored in favor of conventional methods of treatment, with emphasis on treatments for the hospitalized, the promise of a vaccine, and means of preventing death.  This emphasis has created fear and confusion without instruction or guidance in choices people can make to subvert the mechanism of Sars-CoV-2 assisting people to improve their health and their prognosis if infected.  

 

Where do we go from here? How do we assist our communities to stay healthy? The threat of comorbidities is a prognostic indicator so we must educate our communities to make healthier choices that not only prevent them but also reverse them.  Now more than ever, we must apply what we know to present healthier choices to our patients and communities. Overwhelming evidence has shown that our choices do matter and can make a difference between health and illness, life, and death.

 

COVID-19 is a virus whose course is directly impacted by lifestyle choices. It is old news that our immune systems’ capacity to fight infection is directly impacted by these choices.  Recently, researchers have shown that the body’s T cell response is an important indicator of the severity of infection.  In fact, this is the direction in which vaccine research may be headed.  T cells not only assist B cells in antibody production, but they also have a direct destructive effect on viruses. The strength of the T cells response is directly impacted by our lifestyle choices.  In fact, these choices can also reverse (or create) comorbidities. Prior to a disease manifesting, how we choose to eat and live impacts the function of all of our body systems. Our choices can lead to an illness, and if altered, can result in health. When we state that the elderly have a poorer prognosis when infected, we fail to mention that the elderly are generally low in vitamin D, which impacts prognosis from COVID and other infections.  The elderly who exercise, eat a plant-based diet, have an adequate level of Vitamin D, have a much better prognosis than those who don’t.   It has been shown in the elderly that 6 weeks of exercise and a plant-based diet can enhance immune response. We also know that alcohol depresses (innate) immunity, and disturbs sleep. A plant-based diet enhances immunity and promotes good sleep, zinc has antiviral activity,  and daily food choices impact our health.

We must stop making generalizations about age groups and be more precise and empowering in our instructions to society and also mention how choices as simple as those mentioned above impact prognosis.  Making general statements by the medical system leaves a society with fear and helplessness, which is irresponsible on the part of the medical system. We must focus on evidence-based means of assisting our patients so they can be empowered to make the needed adjustments in their lifestyles to improve outcomes and restore health.  When facilitated in this way, our communities can become healthy once again.  

I believe now is the time when education of this nature and magnitude can save millions of lives. Uncovering the mechanism of a virus is only as valuable as our ability to understand how to subvert its survival in our body.  We know enough about the immune system to be able to understand how to do this, and a shift in our choices will not only repair our personal and collective epidemic of comorbidities but will even alter the trajectory of morbidity and mortality from COVID.  Occam’s razor, an idea used in medicine means, “All things being equal, the simplest solution tends to be the best one.”

 

In the final analysis, the simplest solution to COVID may be a matter of choice.  Our choices do matter and we must bring consciousness to them not just to survive this pandemic, but to evolve towards a healthier future.  Maybe the cure for COVID19 indeed is consciousness.  Maybe this pandemic is a call for us to gain insight and choose wisely.  Maybe if we applied consciousness to promote health, it can be a means for us to be unified beneath our differences of opinion rather than polarized and divided.  Our choices always matter and informed and conscious ones can truly save us.

 

 ©Aug 2020 Kalpana (Rose) M. Kumar M.D., CEO and Medical Director, The Ommani Center For Integrative Medicine, Pewaukee, WI. www.ommanicenter.com Author of 2nd Edition – Becoming Real: Reclaiming Your Health in Midlife 2014, Medial Press. She is currently accepting new patients-call 262.695.5311 for an appointment. During this time of COVID19 pandemic, she is offering both telephonic or in-person appointments for those people free of symptoms.

 

Your Lifestyle Can Make a Difference Between Life or Death with COVID-19

Our world is no longer the same since the beginning of 2020. The wave of affected people around the world with COVID-19, a novel Coronavirus, SARS-CoV-2, whose first cases were revealed in December 2019 in Wuhan China, has created an unprecedented shake-up of every aspect of our reality. COVID-19 is highly infectious, contagious and transmissible. It lives on surfaces for days and can be transmitted through the oral and fecal-oral route. In addition, if you carry the virus, even in the absence of symptoms, you can transmit it to another person. If you cough or sneeze, you can transmit it through droplets of saliva sprayed into your mouth or nasal passages if you are in close proximity to a carrier. Coronavirus can also be transmitted through the fecal-oral route if your child is a carrier, as the virus is spread through fecal shedding.

How does the COVID-19 virus cause the damage it does? The virus itself, which is round with spike-like projections docks on ACE2 cell receptors present in the lower lungs and small intestines. Once it has docked, its membrane merges with the cell membrane and it enters the cell. Once inside, the virus needs an acidic environment to engage the cell’s DNA to manufacture its RNA and replicate itself. The liver produces ‘antigen-presenting’ cells to illuminate the virus so the immune system can attack it. At this initial stage, you may experience mild symptoms of cough, fever, nasal congestion, runny nose, sore throat, loss of smell or taste or diarrhea or loose stools, as the immune system attacks the locations the virus has docked. Early on in the infection, this reaction can reduce the replication of the virus as the immune system attacks it. If your liver is compromised, the immune system does not attack the virus during the early stage of infection. In addition, if the immune system is weak or compromised as is commonly present in the elderly or immunosuppressed patients, and the virus is also not killed off early, which allows it to multiply rapidly. This increases the viral load in the body. When the immune system attacks this high viral load, its response is amplified causing severe tissue damage. This response is known as a ‘cytokine storm’. This is the reaction that causes shortness of breath due to damaged lung tissue often requiring hospitalization and ventilator support. This carries a much higher risk of morbidity and mortality.

There has not been much published about the importance of lifestyle to potentially prevent and reduce the intensity of COVID-19 infection, likely due to the current focus on crisis management of infected patients. Lifestyle choices are of critical importance since there is so much you can do in a relatively short time to maximize your ability to fight this virus and mitigate serious damage to your body.

  • Remember, COVID-19 needs an acidic environment to replicate. The best way to alkalize your body and increase its pH is by eating a Whole Food Plant-Based Diet. The standard American diet is high in animal protein and dairy, both acidify the system creating a lower pH. This creates optimal conditions for viral replication.
  • If your liver is compromised due to alcohol consumption or fatty liver, it will be slow to assist the immune system in reducing viral load early in the infection process. The best way to assist the liver in its immune support function is to discontinue alcohol and eat lots of greens, which cleanses the liver and optimizes its function. A Whole Food Plant-Based Diet combined with daily aerobic exercise will reduce abdominal fat and begin reversing fatty liver and also assist a liver that is sluggish from alcohol use. The liver is highly regenerative so once you begin making lifestyle changes, it will respond rapidly, which will optimize its immune support function.
  • The COVID-19 virus favors a cool and dry environment that air passages provide, and does not fare well in moist heat conditions. Inhaling steam with a steam tent or a home sauna or hot shower and using a warm mist humidifier while sleeping is highly beneficial for moisturizing and warming the nasal passages to create an unfavorable environment for the virus.
  • Aerobic exercise is extremely important to reboot the liver’s ability to provide support to the immune system and optimize detoxification and antioxidant production. 20 minutes of aerobic exercise per day is the minimum amount that should be done (of course, after clearance from your physician).
  • Reduce inflammation. This is best accomplished with a Whole Food Plant-Based Whole Food Plant-Based Diet. If your inflammatory platform is healthy and your body is not inflamed, the damage to your tissues from an amplified inflammatory response to COVID-19 can be reduced.
  • Seven to eight hours of sleep at night is highly important to increase regeneration and reduce inflammation. Deep sleep relaxes the body and neutralizes stress hormones which are inflammatory and immunosuppressive.
  • Supplements to boost and support your immunity may be helpful. There have been no studies thus far on the beneficial effects of supplements for preventing COVID-19 but using what we have learned are the beneficial effects of specific supplements may assist in recovery if you are infected. They should by no means provide a (false)sense of security or act as a substitute for advice you need to seek from your physician in case you have symptoms of COVID-19.

Supplements cannot prevent you from getting infected by the Coronavirus, but the supplements listed below have been shown to support the body in viral defense:

  • Zinc 20 mg per day has been shown to reduce viral replication  in vitro studies. Although has no evidence for COVID-19, it may hypothetically assist in reducing viral replication and is safe to take in small doses.
  • Vitamin C 2000 mg per day (if you have kidney stones, check with your doctor before taking this) is a potent anti-oxidant which assists the body in anti-viral activity.
  • Vitamin D3 2000 to 5000 IU per day has been shown to assist in immune support (be sure and get your blood level checked before taking more than 2000 IU per day in case you have a normal 25 OH-Vitamin D level. Vitamin D is a fat-soluble vitamin and can be toxic if taken unmonitored in high doses.)
  • A broad-spectrum probiotic is key in keeping the gut microbiome and immune system healthy and the general immune system from being chronically activated. An effective probiotic should have 5 strains of Lactobacillus and 5 of Bifidum to populate both the small and large intestine. Since one of the docking sites of the virus is the ACE2 receptors in the small intestine, fortifying the small intestinal microbiome can be of assistance. To ensure that your probiotic is temperature stable, it is better to get one that does not need refrigeration.
  • An immune support supplement shown to modulate immune response and assist in glutathione activation may also be helpful. In my practice, I have observed this assist hundreds of my patients in reducing inflammatory flares of their rheumatologic diseases.

While on a Whole Food Plant-Based Diet, make sure you eat a variety of deeply colored fruits and vegetables. The color indicates the antioxidants present in the food which supports many different body functions including cancer-fighting properties. Add lentils and beans if you can tolerate them (best cooked from scratch rather than from a can). These increase Nitric Oxide in the body which increases blood flow and oxygenation to the tissues. This creates an unfavorable environment for viral replication.

A note about Hydroxychloroquine and Azithromycin:

Hydroxychloroquine is an anti-malarial pharmaceutical agent as well as a commonly prescribed drug for Rheumatoid Arthritis, Systemic Lupus Erythematosus, and Porphyria Cunea Tarda. For rheumatologic conditions, it is prescribed at much lower doses for chronic conditions than it would be in an acute setting. An article was published in France touting the benefits of using HCQ and Azithromycin for severe cases of COVID-19 but this study was anecdotal and did not meet the criteria for a clinical trial. Moreover, the side effects of HCQ range from dizziness, nausea, vomiting and retinal damage causing blindness and this medication should not be taken unless proven to be safe and effective for COVID-19.

The combination of HCQ and Azithromycin can cause a fatal arrhythmia called Torsade the Pointe at any age, but especially in people with cardiac rhythm issues and underlying heart disease.

There have been no large clinical trials to prove the safety or efficacy of these medications for COVID-19 yet physicians are prescribing them prophylactically and pharmacists are promoting them as well. This is very dangerous in light of public panic and fear regarding COVID-19.

The public should be aware that taking pharmaceuticals that have only anecdotal evidence can lead to a tsunami of unknown harm. In fact, we do not even know what doses, if any, are effective for prophylaxis or treatment of COVID-19 infection. We must wait for the results of clinical trials. The scientific method has always had the responsibility to keep the public safe from harm by studying the effects of pharmaceutical agents through the rigor of clinical trials. The combination of HCQ and azithromycin is advised for compassionate use at this time in serious cases.

Because of the potential for assistance by HCQ, the public requests for it of their physicians have generated a shortage for patients who need them for their ongoing rheumatologic conditions.

My advice is to steer clear until we have more definitive data on the efficacy and safety of any medication to treat Coronavirus infection.

Of interest are two of the mechanisms of action of Hydroxychloroquine. It increases the pH of the cell while reducing inflammation. Why not begin doing this yourself with a Whole Food Plant-Based Diet and all the evidence-based lifestyle suggestions listed above. You may have neglected to start this before now, but now is a great time to start given the COVID-19 pandemic. You will notice a difference in about a week as your body responds quickly to positive changes you make in case you contract COVID-19, you will increase your chances of having only a mild case of it.

If you feel you have any sinus or respiratory symptoms, please contact your primary care physician first and begin your triage there. Please do not self-medicate without first speaking to your PCP while we are in this Pandemic. Do not go to your Emergency Room or Urgent Care Center if you have these symptoms as you could inadvertently transmit the virus to others or become infected by others.

If you feel you have any sinus, respiratory or digestive symptoms, such as:

  • fever greater than 100.4
  • sore throat
  • runny nose
  • cough
  • shortness of breath
  • Diarrhea or loose stools

Please contact your Primary care physician for further advice.

The best preventive measures so far are to wash your hands frequently and engage in social distancing and abide by the shelter-in-place orders from your state. Our goal is to ‘flatten the curve’ of COVID-19 to arrest transmission and to reduce the spread of this virus.

For CDC guidelines and updates, please visit the CDC website . For Dr. Kumar’s videos on COVID-19, please visit Youtube.

For The Ommani Center’s COVID-19 protocol, please visit www.ommanicenter.com