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