How do we defend ourselves against a disease where the parameters of its transmission, pathology and mortality are all still so unclear and everchanging. To date, the best defence is infection control or as it is less favourably called quarantine. The knowledge raised from previous Corona virus’ provides us with a series of great pathways to follow, and this is evident in the governments capacity to minimise the spread of this Corona virus, Covid-19. However, it is inevitable that containment will break and transmission will broaden from origins of Wuhan province in China. So what then? Fortunately, Australia is at the forefront of vaccine development but there is no doubt that the clock is ticking on that defence avenue. Building an understanding of the virus and how to best manage the condition if contaminated will surely be the next critical piece of this ever evolving puzzle.
What do we know so far. Frequent comparisons is made to previous epidemics including the SARS virus of 2002. Covid 19 currently presents with a low pathology, i.e. it is not as aggressive or as severe compared with SARS, which had an 11% mortality rate. Having a lower mortality rate of 3%, it is more significant to those that are already immunosuppressed. It initially presents as a light upper respiratory infection, with a light fever, runny nose and cough. It may also be asymptomatic. It becomes more dangerous if it progressed into a lower respiratory condition with symptoms of shortness of breath and lower respiratory issues, resulting in pneumonia. A paper produced by The New England Journal of Medicine in January, 2020 highlights that with this lower pathogenicity of this infection, healthy infected patients may not be inclined to seek medical attention if they are unwell, instead they will continue to work, travel, potentially infecting patients who are immunocompromised.
Here in lies the problem! SARS was eventually contained by means of syndromic surveillance, isolation of patients, and quarantine of their contacts. But, it was easier to identify and less easy to ignore for the affected. So it is safe to assume, if the COVID-19 transmits efficiently (and it looks like it does), with seemingly lower pathogenicity to SARS, it could be a virus that poses a low health threat on the individual level and yet can pose a high risk on the population level. Encouraging people to self-isolate, and seek professional help at the right time is going to be a real challenge.
As a health practitioner, I am left asking myself what I can do to protect my community, family and self. After reviewing much of the data, I am confident that in addition to trying to prevent infection, taking preventative measures to build and strengthen the immune system is the obvious way to go. In natural medicine we have a firm belief that the body is a self-regulating organism. For a pathogen to really take flight in a patient, they must be have an immune system that is compromised in some way. Our management protocol would be to use natural immune modulator’s and immune stimulants, implement therapeutic diets, facilitate detoxification, and actively increase thermogenesis. Outlined below are some key nutrients and dietary modifications that I will be considering throwing in my ever changing toolkit:
So what’s in my toolkit:
1. SLEEP – The most critical immune building processes happen in our sleep, so ensuring that it isn't impacted is number 1 on my list.
2. DIET – Making these changes promptly:
· Adequate Protein for immune cell formation.
· Increase antioxidant rich foods to combat inflammation.
· Remove sugar as it is an immunosuppressant.
· Reduce caffeine as it is increases the stress response, resulting in increased inflammation.
· Reduce alcohol consumption, as it increases inflammation and impacts sleep.
3. Using NUTRICEUTICALS to build and strengthen the immune system (Please seek professional advice when supplementing):
Immune modulator and mucous membrane restorative and anti-infective agent.
Deficiencies in B vitamins has an impact on the barriers to infection and various areas of immune cell and antibody formation. Unfortunately due to our modern lifestyles this class of vitamins is easily depleted by stress, taking the oral contraceptive pill or drinking excessive alcohol are all examples.
This potent antioxidant has so many immune functions, it is hard to go past…so don’t! Stimulates immune cell production and movement, and strengthens resistance to infection.
An immune modulator, it’s direct target is the Th1 and Th2 cells, (critical in the identifying and attack of the invading pathogens). Most likely to be deficient in the Vitamin D are office workers, aged care patients, veiled women.
This mineral is important for all aspect of immune function. It contributes to the functioning of both the innate and acquired immune systems.
I like to think of these immune powerhouse as the light switch. They essentially bind to receptors on the immune cell and switch on an entire cascade of immune cell activation. Plus they have been found to stimulate immune cell development.
4. HERBS – Utilizing the vast array of herbal medicines to modulate the immune system, protect with antivirals and reduce inflammation. Some of the leading herbs include, St john’s wort, Andrographis, Echinacea, Hemidesmus and Yarrow.
5. Last and most important – SEEK MEDICAL ATTENTION
The most critical point is to self- isolate if symptoms of a respiratory infection present. Call your health care professional and discuss your options for testing and treatment support.
For the most up to date information, please refer to the following websites:
Wu, J. T., Leung, K., & Leung, G. M. (2020). Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study. The Lancet. doi:10.1016/s0140-6736(20)30260-9
Report of novel coronavirus-infected pneumonia in Wuhan City. Wuhan Municipal Health Commission, 2020 (http://wjw.wuhan.gov.cn/front/web/showDetail/2020012009077. opens in new tab).
Vincent J. Munster, Ph.D., Marion Koopmans, D.V.M., Neeltje van Doremalen, Ph.D., Debby van Riel, Ph.D., and Emmie de Wit, Ph.D. (2020) A Novel Coronavirus Emerging in China — Key Questions for Impact Assessment, The New England Journal of Medicine. Massachusetts Medical Society
Na Zhu, Ph.D., Dingyu Zhang, M.D., Wenling Wang, Ph.D., Xingwang Li, M.D., Bo Yang, M.S., Jingdong Song, Ph.D., Xiang Zhao, Ph.D., Baoying Huang, Ph.D., Weifeng Shi, Ph.D., Roujian Lu, M.D., Peihua Niu, Ph.D., Faxian Zhan, Ph.D. (2020) A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med 2020; 382:727-733 DOI: 10.1056/NEJMoa2001017
Xu, B., Kraemer, M. U. G., Xu, B., Gutierrez, B., Mekaru, S., Sewalk, K., … Kraemer, M. (2020). Open access epidemiological data from the COVID-19 outbreak. The Lancet Infectious Diseases. doi:10.1016/s1473-3099(20)30119-5
Xu, Z., Shi, L., Wang, Y., Zhang, J., Huang, L., Zhang, C., … Wang, F.-S. (2020). Pathological findings of COVID-19 associated with acute respiratory distress syndrome. The Lancet Respiratory Medicine. doi:10.1016/s2213-2600(20)30076-x