Disclaimer: This is coming to you from fellow patients offering an educated opinion and is not medical advice. I am citing pubmed or similar professional resources whenever possible. I inject a bit of my own commentary at points – take this as you will. Please consider working with a doctor when you feel is appropriate.
The following are some things that are wise in our opinion and experience.
1: Know this is a rapidly evolving situation and things can and will be learned and change. Study what is happening in other countries, outside the US or even in Washington state to see what is actually happening and the statistics of what is happening in the real world. Look at data from John Hopkins, WHO and the CDC for guidance.
2: Getting a good night’s sleep! Do your best to wind down at night and get to bed at a good time.
“Sleep and the circadian system exert a strong regulatory influence on immune functions. Investigations of the normal sleep–wake cycle showed that immune parameters like numbers of undifferentiated naïve T cells and the production of pro-inflammatory cytokines exhibit peaks during early nocturnal sleep whereas circulating numbers of immune cells with immediate effector functions, like cytotoxic natural killer cells, as well as anti-inflammatory cytokine activity peak during daytime wakefulness. Although it is difficult to entirely dissect the influence of sleep from that of the circadian rhythm, comparisons of the effects of nocturnal sleep with those of 24-h periods of wakefulness suggest that sleep facilitates the extravasation of T cells and their possible redistribution to lymph nodes. Moreover, such studies revealed a selectively enhancing influence of sleep on cytokines promoting the interaction between antigen presenting cells and T helper cells, like interleukin-12. Sleep on the night after experimental vaccinations against hepatitis A produced a strong and persistent increase in the number of antigen-specific Th cells and antibody titres. Together these findings indicate a specific role of sleep in the formation of immunological memory. This role appears to be associated in particular with the stage of slow wave sleep and the accompanying pro-inflammatory endocrine milieu that is hallmarked by high growth hormone and prolactin levels and low cortisol and catecholamine concentrations. “
3: Wear blue light blocking glasses starting around sundown. Limit or avoid electronics at night. Sleep in a dark room. Get out into sunlight during the day, watching the sunset can be valuable.
” Mammals receive light information through the eyes, which perform two major functions: image forming vision to see objects and non-image forming adaptation of physiology and behavior to light. Cone and rod photoreceptors form images and send the information via retinal ganglion cells to the brain for image reconstruction. In contrast, nonimage-forming photoresponses vary widely from adjustment of pupil diameter to adaptation of the circadian clock. nonimage-forming responses are mediated by retinal ganglion cells expressing the photopigment melanopsin. Melanopsin-expressing cells constitute 1–2% of retinal ganglion cells in the adult mammalian retina, are intrinsically photosensitive, and integrate photic information from rods and cones to control nonimage-forming adaptation. Action spectra of ipRGCs and of melanopsin photopigment peak around 480 nm blue light. Understanding melanopsin function lets us recognize considerable physiological effects of blue light, which is increasingly important in our modern society that uses light-emitting diode. Misalignment of circadian rhythmicity is observed in numerous conditions, including aging, and is thought to be involved in the development of age-related disorders, such as depression, diabetes, hypertension, obesity, and cancer. The appropriate regulation of circadian rhythmicity by proper lighting is therefore essential. This perspective introduces the potential risks of excessive blue light for human health through circadian rhythm disruption and sleep deprivation. Knowing the positive and negative aspects, this study claims the importance of being exposed to light at optimal times and intensities during the day, based on the concept of the circadian clock, ultimately to improve quality of life to have a healthy and longer life. “
3: Don’t panic, but use common sense and prepare. Do not hoard.
4: If you are at higher risk, the CDC states:
” Get Ready for COVID-19 Now
- Have supplies on hand
- Contact your healthcare provider to ask about obtaining extra necessary medications to have on hand in case there is an outbreak of COVID-19 in your community and you need to stay home for a prolonged period of time.
- If you cannot get extra medications, consider using mail-order for medications.
- Be sure you have over-the-counter medicines and medical supplies (tissues, etc.) to treat fever and other symptoms. Most people will be able to recover from COVID-19 at home.
- Have enough household items and groceries on hand so that you will be prepared to stay at home for a period of time.
- Take everyday precautions
- Avoid close contact with people who are sick
- Take everyday preventive actions
- Clean your hands often
- Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing, or having been in a public place.
- If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.
- To the extent possible, avoid touching high-touch surfaces in public places – elevator buttons, door handles, handrails, handshaking with people, etc. Use a tissue or your sleeve to cover your hand or finger if you must touch something.
- Wash your hands after touching surfaces in public places.
- Avoid touching your face, nose, eyes, etc.
- Clean and disinfect your home to remove germs: practice routine cleaning of frequently touched surfaces (for example: tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks & cell phones)
- Avoid crowds, especially in poorly ventilated spaces. Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings with little air circulation if there are people in the crowd who are sick.
- Avoid all non-essential travel including plane trips, and especially avoid embarking on cruise ships.
- If COVID-19 is spreading in your community, take extra measures to put distance between yourself and other people to further reduce your risk of being exposed to this new virus.
- Stay home as much as possible.
- Consider ways of getting food brought to your house through family, social, or commercial networks
- Stay home as much as possible.
- Have a plan for if you get sick:
- Consult with your health care provider for more information about monitoring your health for symptoms suggestive of COVID-19.
- Stay in touch with others by phone or email. You may need to ask for help from friends, family, neighbors, community health workers, etc. if you become sick.
- Determine who can provide you with care if your caregiver gets sick
Watch for symptoms and emergency warning signs
- Pay attention for potential COVID-19 symptoms including, fever, cough, and shortness of breath. If you feel like you are developing symptoms, call your doctor.
- If you develop emergency warning signs for COVID-19 get medical attention immediately. In adults, emergency warning signs*:
- Difficulty breathing or shortness of breath
- Persistent pain or pressure in the chest
- New confusion or inability to arouse
- Bluish lips or face
*This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning.”
5: As mentioned above form the CDC; It may be a very wise choice to obtain extra prescription meds and important supplements as soon as possible.
6: Practice meditation or other self-relaxation methods to help reduce stress.
7: Avoid non-critical travel such as vacations. Now do I think you can still go out to walk at a park or similar, I suspect that is totally fine and even good for us to be outdoors. But going into crowded places like planes seems to be very unwise at this point.
8: Science is finding that fresh air and sunlight may have a positive effect.
” In the past, hospitals were designed with south-facing glazing, cross-ventilation and high ceilings because fresh air and sunlight were thought to reduce infection risk. Historical and recent studies suggest that natural ventilation offers protection from transmission of airborne pathogens. Particle size, dispersal characteristics and transmission risk require more work to justify infection control practices concerning airborne pathogens. Sunlight boosts resistance to infection, with older studies suggesting potential roles for surface decontamination. “
9: Supplements that have research showing there may be benefit to using:
Zinc – Extrapolating from how it is helpful for colds, zinc is a tool to strongly consider. I like Zinc Carnosine as it’s easy on the stomach, but it’s a low dose compared to others.
“The mean common cold duration was 33% (95% CI 21% to 45%) shorter for the zinc groups of the seven included trials. Three trials that used lozenges composed of zinc acetate found that colds were shortened by 40% and four trials that used zinc gluconate by 28%. The difference between the two salts was not significant: 12 percentage points (95% CI: −12 to + 36). Five trials used zinc doses of 80–92 mg/day, common cold duration was reduced by 33%, and two trials used zinc doses of 192–207 mg/day and found an effect of 35%. The difference between the high-dose and low-dose zinc trials was not significant: 2 percentage points (95% CI: −29 to + 32)”
“Zinc is a required mineral for the proper functioning of the immune system. It helps in the formation and development of immune cells such as natural killer cells and neutrophils. Studies have shown that zinc shortens the duration of the common cold and flu. Zinc can be found in pumpkin seeds, legumes, nuts, and animal proteins. “
Selenium (and potentially Vitamin E as well) – There is some evidence to support that good levels of these may play an important role in the response to viruses.
I’ve seen wise sources suggest a RBC selenium test be considered prior to much supplementation. Some have theorized that many food sources of selenium are lower than they once were due to modern farming. Studies on brazil nuts for example support this claim.
“Recent work has demonstrated that deficiencies in either Se or vitamin E result in increased viral pathogenicity and altered immune responses. Furthermore, deficiencies in either Se or vitamin E results in specific viral mutations, changing relatively benign viruses into virulent ones.”
Beta Glucan – An interesting agent that shows a good response in trials. Cost can be a downside especially with the well recognized brands like transfer point. There is some debate with experts as to if this might make an autoimmune attack worse for those with autoimmunity – there does not seem to be solid science one way or the other.
“We found that a 2-week oral feeding with glucan mixture significantly reduced the effects of influenza infection in total mortality. Our study was focused on phagocytosis, cytokine levels, antibody response and cytotoxicity assay.”
If you have autoimmune disease you may want to read this link and make an informed choice:
Vitamin D – Numerous studies support that good vitamin D levels are supportive of a healthy response to infection, such at the one below;
“However, vitamin D also has an important “non-classic” influence on the body’s immune system by modulating the innate and adaptive immune system, influencing the production of important endogenous antimicrobial peptides such as cathelicidin, and regulating the inflammatory cascade. Multiple epidemiological studies in adults and children have demonstrated that vitamin D deficiency is associated with increased risk and greater severity of infection, particularly of the respiratory tract. Although the exact mechanisms by which vitamin D may improve immune responses to infection continue to be evaluated, vitamin D supplementation trials of prevention and adjunct therapy for infection are underway. Given its influence on the immune system and inflammatory cascade, vitamin D may have an important future role in the prevention and treatment of infection.”
Having a REASONABLE amount of food and supplies at home seems very wise. I now strongly suspect people have been hoarding as I’ve witnessed multiple local stores selling out of many items. I suggest getting a hold of what you need, but don’t go crazy with buying so much that others can’t get what they need.
There are numerous studies and indications that disruption to our circadian rhythm affect our health on multiple levels. Focusing on good sleep and good light exposure (no blue light at night) seems very wise in my experience and has generally been backed by science.
Few among us could argue that focusing on a good quality diet isn’t helpful. The science seems to support that home cooked meals are associated with a lower BMI for one thing and there are a huge correlations between higher BMI and poorer health outcomes. It’s never too late to make positive changes.
“More frequent consumption of home cooked meals was associated with greater likelihood of having normal range BMI and normal percentage body fat.”
”Those consuming home cooked meals more than five times, compared with less than three times per week, were 28% less likely to have overweight BMI (99% CI 8 to 43%), and 24% less likely to have excess percentage body fat (99% CI 5 to 40%).”
“Diet and food supplements exert a great impact on gut microbial composition and its variability through time.”
“Interaction between food and gut microbiota is also finely tuned by our circadian clock. The disruption of the physiological circadian rhythm increases the likelihood of a gut dysbiosis, possibly contributing to the pathogenesis of several metabolic and inflammatory diseases, including diabetes, inflammatory bowel diseases, and even cancer”
Gut Health – I’m using a prebiotic called ISOThrive right now. It can be used with other prebiotics as well. It’s well researched and some studies point that it may aid in functions related to the immune system.
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