COVID Vaccine Update and Vaccination Safety Concerns

COVID Vaccine Update and Vaccination Safety Concerns

As TV programs show clips of FedEx planes taking off from various airports delivering these all-important Covid vaccines to cities in the USA and Canada, many people remain confused regarding the safety and efficacy of receiving these vaccines. In fact, during the whole of last week, I’d say every single patient who left my office would ask, “What do you think about the Covid vaccine?” As I’m an integrative, functional medicine practitioner, many patients assumed that I’d be cautious about advising vaccines in general and possibly this vaccine specifically. Nothing could be farther from the truth. 

However, I do have a rather cautious approach to discussing anything to do with vaccines due to a rather unfortunate experience I had ten years ago. On my website I had a ‘recommended reading’ page. On the subject of autism, I’d included an article written by another doctor concerning his general views on autism causation. I was unaware that he’d included a line describing his experience with mothers of autistic children who could swear that, in their particular case, their child’s autistic features had begun around the time of the MMR vaccine. 

A blogger working for the Huffington Post had come across this other doctor’s article on my website and notified the Alberta College of Physician and Surgeons, based on this other doctor’s article, that I was an anti-vaccine doctor! Well, after many legal letters and at great cost, I eventually achieved a retraction of sorts but I was permanently scarred and extremely reluctant to say anything for or against vaccines. 

Soon after that incident, my nineteen-year-old son was diagnosed with meningococcal meningitis. He hadn’t been vaccinated against this potentially deadly disease. He presented with a mild flu-like illness but twelve hours later was in a coma in ICU, where he stayed for three days on IV antibiotics. The doctors weren’t sure whether he’d survive. Consequently, for these reasons I’m now very cautious about taking an ill-informed stance on the subject of vaccines and always attempt to explore the literature before adopting a position regarding the topic. I always encourage my patients to do the same before they adopt a particular position one way or another.

The Pfizer and Moderna Vaccines

So, what do we currently know about the Pfizer vaccine? We know that approximately 44,000 people were studied in the company’s trial and that the adverse outcomes were low, with the vaccine having approximately 95 percent efficacy. Initially published data on November 8 stated that the vaccine was 90 percent effective, which was upgraded to 95 percent on November 18. Fifty million doses of this vaccine are due to be administered in 2020 and up to 1.3 billion doses will be available in 2021, with two doses per person. This would mean approximately half a billion out of 7.6 billion people.

The second vaccine just authorized by the FDA, developed by Moderna, published their data on November 16, saying that their vaccine was 94.5 percent effective. There were ninety-five cases of infection in the study population of 30,000 patients and of those, only five had received the Moderna vaccine and had only mild symptoms. Many susceptible population groups were excluded, such as pregnant women, the very elderly, the immune compromised, and children.

Vaccine Ingredients

With regards to the medicinal ingredients of the vaccine contents, each dose of the Pfizer-BioNTech Covid-19 vaccine contains 30 mcg of a nucleoside-modified messenger RNA (modRNA) encoding the viral spike (S) glycoprotein of SARS-CoV-2.

The non-medicinal ingredients are as follows:

  • 0.43 mg of ALC-0315 = (4-hydroxybutyl)azanediyl) bis(hexane-6,1-diyl)bis(2-hexyldecanoate)
  • 0.05 mg of ALC-0159 = 2-[(polyethylene glycol)-2000]-N,N-ditetradecylacetamide
  • 0.09 mg of 1,2-Distearoyl-sn-glycero-3-phosphocholine
  • 0.2 mg of cholesterol
  • 0.07 mg of dibasic sodium phosphate dihydrate
  • 0.01 mg of monobasic potassium phosphate
  • 0.01 mg of potassium chloride
  • 0.36 mg of sodium chloride
  • 6 mg of sucrose
  • Water for injection

The diluent (0.9 percent sodium chloride Injection, USP) contributes an additional 2.16 mg sodium chloride per dose.

The Pfizer-BioNTech Covid-19 vaccine doesn’t contain preservative. The vial stoppers aren’t made with natural rubber latex. We also aren’t aware of the vaccine containing some of the usual adjuvants that are added, such as thimerosal or aluminum.

How These Vaccines Work

Both the Moderna and the Pfizer vaccines are a new type called mRNA vaccines. Previous vaccines, such as the flu vaccine and the Hep B vaccine, are entirely different types of vaccines. They contain neutralized viruses or multiple viruses, as in the case of the flu vaccine. Consequently, we can’t extrapolate the same data concerning their safety and side effects profile onto these new vaccines, although some general principles can be observed (see later). Furthermore, we have no long-term studies related to these new vaccines, only animal studies and short-term human studies.   

This vaccine works by providing genetic code in terms of computer, laboratory derived mRNA sending information to your own cells on how to temporarily, not permanently, manufacture what’s known as the spike protein, which is found on the outside of the coronavirus. Your cells receive this mRNA genetic code that’s wrapped in polyethylene glycol or PEG, and yes, that is the main ingredient found in anti-freeze, along with phospholipids from the vaccine. They then absorb it and send it to an organelle inside your cell called the ribosome that then manufactures the spike protein. Your cells then release the spike protein for which your own immune cells called T cells and B cells (antibodies) are developed, attacking these spike proteins. 

The first dose, referred to as ‘priming the immune response’, is where your immune system learns to recognise the virus and this process takes from two to three weeks. The second dose is when your immune system does the main work of building your long-term defenses against the virus. 

If you should get the Covid viral infection at a later date, your body will have readily prepared T cells and B cells that will attach to the outer covering spike proteins of the actual virus and thus neutralize it. These manufactured spike proteins won’t be permanently embedded in your DNA, at least as far as we know, and won’t be permanently turning on your immune system. Thus, the effect of the vaccine won’t be long lasting.

Some estimates calculate that the effect will only last for between six and twelve months, with the possibility existing that yearly vaccinations will be necessary. 

Many vaccines, like the measles vaccine, confer lifelong immunity, but respiratory infections like Covid-19 do not and neither will the vaccines. Naturally occurring immunity seems to start to fall off after two to three months, with the possibility of getting a second infection rising after that period, especially as the virus appears to be mutating into more virulent forms. The first known case of reinfection was noted on April 25 and the first known case of a second infection causing death was published in October 9, 2020. (1)

Potential Side Effects and Symptoms

After the first dose you’re likely to feel a little pain and minor swelling around the injection site, with some stiffness in the arm muscle that usually disappears by the next day. 

After the second injection, most of the immune defense building takes place and one may feel a flu-like illness with low-grade fever, fatigue, and chills. This only usually lasts a day and is gone by the morning. 

With the future single dose vaccines, the side effects experienced may be similar to those after the second dose vaccine as mentioned. 

If you don’t develop these side effects, it may mean that your immune system isn’t adequately primed. This has been seen in the elderly, as the competency of their immune response may wane with age, as well as with the immune-compromised. 

It’s important to note that with these symptoms, you’re not getting a mild case of Covid. This is impossible as there’s no actual virus in the vaccine. This is your immune system responding to a foreign antigen as it should by raising your metabolism and mobilizing all your immune cells to the site though a protein called the heat shock protein (HSP90). 

How the Moderna and Pfizer Vaccines Differ

There are differences between the Moderna and the Pfizer vaccines. Moderna’s vaccine encodes for the entire spike protein on the surface of the virus, whereas Pfizer’s vaccine only encodes for a part of the spike protein called the binding domain. The spike protein is what a virus uses to attach to your cells, inject its DNA, and thus turn your cells into a factory for virus replication that spreads throughout your body. As the vaccine is targeted against a small aspect of the virus and isn’t the entire virus, the risk of getting sick from the entire injected or dead vaccine is nil. The Pfizer vaccine appears to elicit a slightly stronger response than the Moderna vaccine.

The Moderna version is given twenty-eight days apart, whereas the Pfizer vaccine is administered twenty-one days apart. 

Moderna uses a different propylene glycol liposomal encapsulation and the Moderna vaccine appears to be almost 100 percent effective against long-haul chronic disease. 

Moderna is authorized for people eighteen years and older, while Pfizer’s vaccine was authorized for people ages sixteen and up.

Pfizer’s vaccine needs to be stored at ninety-four degrees below zero. After it thaws, it can be stored in a normal fridge for five days but must be used with six hours if kept at room temperature. Moderna’s vaccine still needs to be kept cold, but at a standard freezer temperature of negative four degrees. After it thaws, it can be refrigerated for thirty days.

Moderna’s vaccine’s side effects were found to be more common after the second dose. Some experts are advising that people may want to consider taking the day off work after getting the second shot.

In September 2020, Pfizer published a study in Nature (2) showing that the two doses elicited a very strong immune T and B cell immune response. Concentrations were above those seen in serum from patients who had been naturally infected with Covid-19 and then recovered. It was therefore noted that those who received the vaccine had a much stronger response than those who acquired the immunity from the infection. 

Moderna also published similar data on November 12 in the New England Journal of Medicine (3) showing that their vaccine induced a robust immune response in all their patients and protected against viral replication in lung and nose cells without evidence of harm. 

Another advantage of these mRNA vaccines is that they can be made very quickly. However, a disadvantage is that they can also break down very quickly. As a result, certain precautions need to be in place. For example, the building blocks of the mRNA have to be modified so that they’re more stable. The building blocks are coated with certain materials, such as polyethylene glycol (4) and phospholipids, so that they’re less likely to be degraded.

Mast Cell Activation and Allergic Reactions

Pfizer’s and Moderna’s Covid vaccines appear to be the only lipid nanoparticle encapsulated vaccine for use in humans. The implication is that there may be a mechanism whereby these nanoparticles can incite allergic or pseudo-allergic reactions, including activation of mast cells. (5) The question then arises whether it’s the covering of the vaccine rather than the vaccine itself that causes the mast cell reaction, hence placing individuals at risk for anaphylactic type reactions. 

Were any tests run on the nanoparticle lipid carrier to secure FDA approval? At this point, we simply aren’t sure. 

However, side effects from this method of delivery have been known for some time. (6) Conjugation of polyethylene glycols (PEGs) to proteins or drug delivery nanosystems is a widely accepted method to increase the therapeutic index of complex nano-biopharmaceuticals. Nevertheless, these drugs and agents are often immunogenic, triggering the rise of anti-drug antibodies (ADAs). 

It may be possible in the future to measure antibodies to PEG and we may be able to predict an individual’s susceptibility to adverse immune reactions to PEGylated drugs and vaccines and thereby increase their efficacy and safety.  

However, Dr. Lawrence Afrin, one of the leading theorists/clinicians in the world of mast cell activation syndrome (MCAS) has the following comment to make about the use of PEG: “Polyethylene glycol (PEG) is such a ubiquitously used excipient in such an extraordinary array of products (medications and otherwise) that I would think one would be hard-pressed to find a first-world (or, probably, second-world or third-world) patient who has not been exposed to it. Perhaps — and I wouldn’t even bet on it, so I’ll just say ‘perhaps’ — one could find members of remote tribes (Amazon, African, New Guinea, etc.) who have never been exposed, but it would be a challenging search.” (7)

The most important step in the manufacture of these vaccines is to freeze the vaccine so that all enzyme activity is stopped. This extreme freezing won’t be available in developing countries and thus the more traditional vaccines such as AstraZeneca vaccine or the Russian vaccine will be used in those areas. (8)

The AstraZeneca vaccine is much cheaper to produce and doesn’t require refrigeration. Early data published on November 23 indicated that the vaccine at full dosage produced 62 percent effectiveness but surprisingly, when only half the recommended dose was accidentally used, there was 90 percent efficacy. (9)(10)

What We Recommend

What we don’t have are any long-term results or any results regarding people with chronic autoimmune disease or those with chronic infections, like many of the patients we see at our clinic with chronic Lyme disease and/or co-infections. Therefore, we can offer some advice. 

If you’ve ever had a severe or anaphylactic allergic reaction to anything or have severely uncontrolled mast cell activation syndrome, you’re discouraged from getting this vaccine.

We do have previous data on people who have had some form of autoimmune disease and had a severe reaction or worsening of their autoimmune disease when exposed to a vaccine of any kind, for example the flu vaccine or hepatitis B vaccine. These people should be cautious before getting this vaccine. 

There’s also a slight risk, perhaps 0.1 percent, that you may trigger an autoimmune reaction or illness from the vaccine. Getting a vaccine of any kind may trigger an autoimmune disease. You have to balance the risk of autoimmune disease against the risk of dying from Covid. 

Basically, this is your individual risk and you’re the one that has to make the decision. 

Not everyone with chronic infections like Lyme disease also has autoimmune disease. In fact, the majority don’t have autoimmune features. If you have active infections or Lyme disease, and you’ve had severe worsening of your Lyme disease or co-infections from any kind of previous vaccination, you may not want to get the vaccine.

Safety and Side Effects: What We Know from Flu Vaccinations

Some people succumb to anaphylaxis and Guillain-Barre Syndrome (GBS) as a result of flu vaccinations.

Anaphylaxis is a severe life-threatening reaction to any antigen, which usually responds to an epi-pen injection, but if left untreated can lead to death. Guillain-Barre is an ascending paralysis from your legs and up your torso that can affect the respiratory centres in the brain, leading to death if left untreated. Usually, patients with this severe form are intubated for prolonged periods. 

The reported incidences by the CDC for anaphylaxis are 1.31 cases per million and one to two people will develop Guillain-Barre. 161 million Americans get the flu shot each year, thus around 210 cases of anaphylaxis are reported with a fatality of between 0.25 and 0.33 percent, the death rate being approximately one death every two to three years.(11) Around three to five percent of people with GB will die and a small number of people are permanently affected. 

Consequently, between four and fifteen people die every year and between three and four hundred suffer severe injury from the flu vaccine. However, approximately 55,000 people die every year from the flu itself, with most of the deaths occurring amongst the unvaccinated. 

It appears that Covid-19 vaccinations may have fewer side effects than flu vaccinations for the following two reasons.

  1. With the flu vaccination, more flu viruses are included as opposed to the one in Covid-19, thus having fewer potentially harmful antigens. 
  2. Although mRNA viruses haven’t been used in humans before, they contain even fewer proteins that the virus found on flu vaccines and so have less propensity to trigger an immune response altogether.

However, it’s worth noting that the total compensation paid out over the life of the USA government’s National Vaccine Injury Compensation Program (NVICP) is about $3.6 billion. The flu vaccine tops the list of the most common list of claims paid out by the NVIC for vaccine side effects. (12)

So, is the vaccine as injurious to your health as is often proclaimed? Or is it as safe as medical statistics proclaim? The subject is extremely difficult to unravel. 

We’re constantly making trade-offs between one set of statistics and the other. Many deaths occur every year from motor vehicle accidents. Approximately 39,000 deaths occur as a result of accidents in the USA every year and many more people are maimed permanently, but we all make the choice of driving to get us from A to B, knowing full well what the risks can be. 

Furthermore, we’re also aware of how diet and lifestyle play a huge role in the advent of cardiovascular disease but many choose to make no changes to their toxic food choices or lobby against the business practices of fast-food companies in order to mitigate their risks of dying of a heart attack. 

We’re therefore faced with a choice. Are we willing to make the trade-off of a few hundred people suffering long-term injury and a dozen or so dying every year from Covid-19 vaccinations in exchange for preventing a projected 500,000 or more deaths and possibly returning to normal life? Around 40 percent of the population of the United States believe it’s a bad trade-off at present, with the numbers increasing daily as radicalized right-wing and left-wing media channels and public personalities jump into the fray.

For Further Consideration

There are some further issues for consideration for those of you who wish to explore aspects of this controversial fray.

Many people are hesitant to have the vaccine as the long-term effects of these synthetic mRNA vaccines haven’t been studied in the humans. 

Animal studies using mRNA over the past twenty years have shown significant side effects, especially autoimmune disease. Hence mRNA vaccines weren’t implemented years ago because of these potential safety concerns. 

It’s important to note that all liabilities for vaccine damage have been waived for the companies producing them. 

PCR testing also has a high number of false positives.

Many people are vehemently opposed to all vaccines, not just this one, and no amount of medical reassurance and statistics will convince them otherwise. Other individuals believe that the entire Covid-19 pandemic is a hoax. Many patients are known to have denied that Covid-19 was real even as they were dying from the virus. Others have cursed the doctors who have diagnosed them and left hospitals in order to die at home. 

Many medical doctors have also adopted controversial stances. They claim that Covid-19 isn’t a real epidemic or that the Covid-19 vaccine will negatively alter your DNA. They state that the real epidemic is fear and hysteria, accelerated by corporations who gain from flawed testing, dangerous antiviral drugs, and flawed vaccines; therefore, this whole epidemic is driven by profit and hysteria. 

Others believe that the vaccine will be used as a method of population control. They think that Bill Gates is behind this epidemic so that he can make more profits from the vaccination program and that tracking chips will be embedded in people to enact some kind of population control as the world’s population increases. 

The problem that arises if between forty and fifty percent of the population are skeptical about getting the vaccine is that vaccines, no matter how effective, may not be able to turn this epidemic around. Those who get vaccinated will be temporarily protected, but approximately 128 million people who don’t get vaccinated still represent a huge part of the population that’s still susceptible to the virus. And we have no way of knowing who they are. 

Another concern is that pro-life individuals worry that the vaccine was made from the cells of aborted babies.

It’s true that traditional vaccinations use dead or altered viruses, which have to be grown in cell lines and those cell lines originated with aborted fetal cell lines. The cell lines in question did indeed originate from embryonic kidney tissue acquired from a handful of human abortions performed in the 1960, 1970, and 1980s. These cells were then grown in the laboratory multiple times for decades. 

However, no cell lines on which the viruses were grown make their way into the vaccines. The two vaccinations grown from synthetic genetic material called mRNA don’t use cell lines at all. They’re developed using genetic sequencing on computers. These mRNA vaccines are thus considered ‘ethically uncontroversial’. 

However, AstraZeneca’s vaccine is produced from a modified virus grown on cellular material that was derived from this original fetal cell line. Purists may want to consider their options with this knowledge in mind. 

Vitamin D, Vitamin C, zinc, ivermectin, and famotidine confer some immunity. I’ve previously written on this subject and will revisit it in my next blog post.  

Please make up your own mind regarding whether or not you’re going to choose to get this vaccine. 

While as a licensed physician with the Alberta College of Physicians and Surgeons I must strongly encourage you to obtain the vaccine, I’m aware and sensitive to many of the dissenting points of view.

Health Canada and the American College of Asthma, Allergy, and Immunology (ACAAI) Guidelines

The following guidelines are published by Health Canada and the ACAAI.

What’s known and reported by Health Canada is as follows: 

Health Canada has conducted a rigorous scientific review of the available scientific evidence to assess the safety, efficacy and quality of the Pfizer-BioNTech COVID-19 vaccine. No major safety concerns have been identified. Based on the current information, Health Canada has assessed that this vaccine’s benefits outweigh its risks. The side effects observed during clinical trials of Pfizer-BioNTech’s COVID-19 vaccine are similar to those experienced with other vaccines, including pain at the site of injection, body chills, feeling tired and feeling feverish. These side effects will resolve on their own and do not pose a risk to health. According to Health

Canada,(13) they have followed up on the two reports of anaphylactoid reactions to Pfizer BioNTech’s COVID-19 vaccine in the U.K. These reactions occurred on December 8, 2020.

Both individuals in the U.K. had a history of severe allergic reactions and carried adrenaline auto injectors. They both were treated and have recovered.

As vaccine roll-out begins in Canada, Canadians may be wondering about the risks of allergic reactions. In Canada, all vaccines carry a warning about the risk of serious allergic reactions, including anaphylaxis, and immunization clinics are equipped to manage these rare events.

People with allergies to any of the ingredients of the vaccine are currently cautioned against receiving it. This caution is already noted in the Canadian Product Monograph (prescribing information) for the Pfizer-BioNTech COVID-19 vaccine. (14) Health Canada has reviewed the available evidence and has concluded that the current Product Monograph and available public health guidance are appropriate, and is not recommending any changes to the product’s use at this time.

If you know you have allergies to any of the ingredients in the Pfizer-BioNTech COVID-19 vaccine, you should not receive it.

If you have experienced a serious allergic reaction to another vaccine, drug or food, you should talk to your health professional before you receive the vaccine.

Health professionals should follow guidance and recommendations related to identifying and managing serious allergic reactions following immunization. This includes ensuring that appropriate medical treatment and supervision are in place at all vaccination sites, as indicated in the Product Monograph.

The ACAAI published their guidelines on the risk of allergic reactions to the Pfizer-BioNTech Covid-19 vaccine on December 14, 2020 (15):

Allergic reactions to vaccines, in general, are rare with the incidence of anaphylaxis estimated at 1.31 in 1 million doses given. With the emergency use authorization of the Pfizer-BioNTech COVID-19 vaccine by the FDA on December 11, 2020, the ACAAI COVID-19 Vaccine Task Force recommends the following guidance for physicians and other providers related to risk of an allergic reaction on vaccination. These recommendations are based on best knowledge to date but could change at any time, pending new information and further guidance from the FDA or CDC.

  1. The Pfizer-BioNTech COVID-19 vaccine should be administered in a health care setting where anaphylaxis can be treated. All individuals must be observed for at least 20-30 minutes after injection to monitor for any adverse reaction. All anaphylactic reactions should be managed immediately with IM epinephrine as the first line treatment. 
  2. The Pfizer-BioNTech COVID-19 vaccine should not be administered to individuals with a known history of asevere allergic reaction to polyethylene glycol as it is a component of this vaccine known to cause anaphylaxis. 
  3. Data related to risk in individuals with a history of allergic reactions to previous vaccinations and/or mast cell activation syndrome/idiopathic anaphylaxis is very limited and evolving. A clinical decision to administer the Pfizer-BioNTech COVID-19 vaccine should be undertaken by the physician or other provider administering the vaccine using their professional judgment and in consultation with the patient, balancing the benefits and risks associated with taking the vaccine.
  4. Individuals with common allergies to medications, foods, inhalants, insects and latex are no more likely than the general public to have an allergic reaction to the Pfizer-BioNTech COVID-19 vaccine. Those patients should be informed of the benefits of the vaccine versus its risks.
  5. The Pfizer-BioNTech COVID-19 vaccine is not a live vaccine and can be administered to immunocompromised patients. Physicians and other providers should inform such immunocompromised patients of the possibility of a diminished immune response to the vaccine.
  6. Anyone with questions related to the risk of an allergic reaction to the Pfizer-BioNTech COVID-19 vaccine should contact their local board-certified allergist/immunologist.

References

  1. Mulder M. et al., Reinfection of Severe Acute Respiratory Syndrome Coronavirus 2 in an immunocompromised patient: A Case Report. Clinical Infectious Diseases https://doi.org/10.1093/cid/ciaa1538
  2. Sahin U, et al., Covid-19 vaccine BNT162b1 elicits human antibody and TH1 T cell responses, Nature 2020 Oct; 586 (780): 594-599.
  3. Jackson LA., An mRNA Vaccine against SARS-COV-2- Preliminary Report N Engl J Med 2020 Nov 12; 383(20): 1920-1931.
  4. Polyethylene glycol (PEG) is a petroleum-derivative compound that is made from ethylene glycol (ethane-1,2-diol), the main ingredient in antifreeze. PEG can be found in a number of other products, including skin creams and personal lubricants, and as a food additive for anti-foaming purposes. *THIS IS NOT A REFERENCE
  5. Pseudo-anaphylaxis to Polyethylene Glycol (PEG)-Coated Liposomes: Roles of Anti-PEG IgM and Complement Activation in a Porcine Model of Human Infusion Reactions – PubMed (nih.gov)
  6. https://www.sciencedirect.com/science/article/pii/S0169409X20301083
  7. Personal email correspondence
  8. Voysey M, Clemens SAC Madhi SA et al. Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK. Lancet. 2020; (published online Dec 8.) https://doi.org/10.1016/S0140-6736(20)32661-1
  9. Nanoparticles Vaccine against Infectious Diseases. Pathi R, Frontiers in Immunology 4th October 2028
  10. Vaccine Injury Table National Vaccine Injury Compensation Program. www.hrsa.gov/sites/default/files/hrsa/vaccine-compensation/vaccine-injury-table.pdf 
  11. https://healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2020/74543a-eng.php
  12. https://healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2020/74543a-eng.php
  13. American College of Allergy, Asthma, and Immunology (ACAAI) Guidance on Risk of Allergic Reactions to the Pfizer-BioNTech COVID-19 Vaccine December 14, 2020

COVID-19 Testing: What You Need To Know

As I learn more about COVID-19 and share that information with you, my community, I’m increasingly asked about testing. Time is moving on and it’s clear that one of the limitations regarding the management of this global pandemic has been testing, or more specifically the lack of testing. There are still so many questions about how widespread SARS-CoV-2 (the virus that causes COVID-19 disease) is here in Alberta, Canada, and across the globe. We know that many people carry and spread the virus without showing any symptoms or just display very mild ones, but how many people are we talking about? 

As we enter the next phase of pandemic management, as people begin to enter communities again, testing will play a key role.1 It’s incredibly important to know who’s been exposed as well as who hasn’t and therefore may still be at risk. More widespread testing will help to keep those most vulnerable, including those with pre-existing conditions safe. 

While there’s undoubtedly still a lot to learn, in this article I’ll distill for you what I know and believe, as of now. I’ll cover:

  • Some background on testing, including understanding the timeline of COVID-19 infections
  • Types of testing, including viral RNA and antibody 
  • What test results mean
  • Test accuracy
  • Next steps for testing

Background on testing: The viral timeline 

To understand testing it’s helpful to understand the timeline of COVID-19 infection. This image was compiled by the Institute for Functional Medicine and provides a helpful visual.2 It’s important to note that this timeline is based on the data that has been collected so far, and some of it hasn’t been peer-reviewed and published yet. 

As you can see, the first thing that can be detected after exposure and with the onset of symptoms is the virus itself. This is depicted by the red and purple lines in the graph. 

After the initial infection, the body begins to mount an immune response and develop antibodies. This is depicted by the orange, blue, and green lines. 

Most of the testing that’s been done so far, mainly in hospitals, has been conducted when people are symptomatic. It’s also important to note that the time between when someone’s exposed to the virus and when they begin showing symptoms is widely variable. Some will show symptoms two days later and others may not show symptoms for three weeks. Others will show no symptoms at all, or only mild ones, yet still be spreading the virus during the first couple weeks of infection.

Time Course for testing after Exposure to SARS-CoV-2
Source:  https://p.widencdn.net/n3trkt/IFM_Sars_Graph_v3

Types of testing

There are two main types of testing, namely viral and antibody. Both have their place in the timeline of events. 

The Viral RNA tests look for an active viral infection. They test for the presence of RNA (ribonucleic acid) from SARS-CoV-2. The test will be positive for someone with a current or very recent infection.3 This test can be undertaken using several methods of collection.

  • Nasopharyngeal swab – This goes into the nose about three or four inches. 
  • Oropharyngeal swab – This down the throat and is similar to a test for strep throat. 
  • Sputum – This is the thick mucus produced by the lungs during an infection. If this can be collected from a person’s coughing, it can be tested. 
  • Saliva – Saliva collection for this test works best after a cough.
  • Stool – Viral RNA can be detected in the stool after an infection.4

A positive test result doesn’t necessarily mean that you’re contagious and are ‘shedding’ the virus. In order to verify that, we’d need to culture your sample in a laboratory. However, there are issues with safety and containing the virus in a laboratory setting, so this type of testing is mostly only done in a research environment at the moment. 

Therefore, we’ll assume that a positive test means you’re contagious and that you need to quarantine for two weeks in order to protect others. It also means that you should watch for symptoms and seek medical care if needed. You can read about treatment options, including herbs and nutrients, here. Tracking positive testing is also important from a public health perspective, in order to trace the spread of the virus.  

Viral RNA testing is going to be most accurate around four to six days after symptoms appear, since this is the peak of the viral RNA production.4 If you wait too long to be tested, you might get a negative Viral RNA test, even though you were infected. This is why this testing has a high false negative rate. You need to get the timing right. If you have a negative test, but a known exposure, you’ll still need to take precautions and may need to be tested again. 

The second type of test that’s helpful is an antibody test. This is a blood test that studies your immune response to the viral exposure. Essentially, it’s looking to determine if you were exposed to SARS-CoV-2 in the past and may be particularly helpful for mild or asymptomatic cases.5 The best time to take the test is about seven days after symptoms resolve or a minimum of fifteen to twenty-one days after exposure. 

There are two main antibodies that current testing is looking at.

  • IgM – This non-specific antibody is produced as the immune system is figuring out exactly what it’s dealing with. If you look at the chart above, you’ll see that IgM rises and then fades away as more specific antibodies (IgG) are produced. 
  • IgG – This more specific antibody takes a little time to develop and then stays high for a period of time.6

This pattern that we’re seeing with SARS-CoV-2 antibodies is typical of what we see with other viruses. 

A positive test suggests that you’ve been infected and that your body mounted an immune response to the infection, whether you had severe symptoms, mild ones, or no symptoms at all. Timing matters here as well. If you test IgG antibodies too early, you might miss them because they take some time, possibly around three weeks, to develop. False positive tests are also possible as some of the tests are detecting previous exposures to other coronaviruses, such as the ones that cause the common cold.4

A negative test might mean that you still need to take precautions to prevent exposure, especially if you’re at higher risk for severe COVID-19. Because of the timeline, it’s important to note that a negative antibody test does not rule out current infection. 

As you can see, the testing is quite nuanced, which is why connecting with your healthcare team for guidance is so important. 

Understanding test accuracy

Naturally, we want a test to be accurate, to be both sensitive and specific. This will limit false positive and false negative results. 

When it comes to accuracy, sensitivity refers to how likely a test is to pick up a positive result in those that have definitely been infected, known as true positives. It’s those that have been exposed to the virus that test positive. Specificity refers to individuals that haven’t been infected by the virus that test negative, which are referred to as true negatives.7. In a perfect world we always want a test to be 100 percent sensitive and 100 percent specific, but this isn’t the case when it comes to coronavirus testing. It can also be similar for many other antibody tests. The poor test results for Lyme disease detection are a good example of this.

We’ve already seen that there are cases of false positives and negatives based on timing and other factors. For example, with a viral RNA test, the nose swab can be really unpleasant so it’s possible that an error can occur as a result of not going deep enough to collect the appropriate sample. Alternatively, there might be low sensitivity because the test picks up antibodies to another coronavirus that are connected to a previous coronavirus infection.4

You might also hear the terms positive predictive value (PPV) and negative predictive value (NPV) in discussion regarding test accuracy. These take into account sensitivity and specificity in terms of the infection rates in a specific population.7 Of course, we need more testing to determine what rates are in each area. This article in Scientific American provides a useful guideline to the testing.

If I have the antibodies, am I immune? 

A conservative answer to this question is that we don’t know for sure. Because this virus is new, we don’t know if everyone that’s exposed develops antibodies, if those antibodies truly mean immunity, and if so for how long.4

However, it’s likely that this virus acts like other viruses that we know more about. For example, for a coronavirus that causes a common cold, you get the cold, develop antibodies, and those antibodies protect you for a while. For something more severe than a cold, such as chicken pox, you can develop immunity for a lifetime. 

You may have heard stories of those that tested positive, negative, and then tested positive again sometime later. However, this is more likely to be an issue with testing methods and timing more than a case of the immune system not creating immunity.  

That being said, I do think that having positive antibodies will be a tool that’s used to help open society up and allow individuals to return to daily life with more confidence.  

Should I get tested?

While I do think that widespread testing is important for both the individual and society, the availability of testing is still quite limited. 

There are many laboratories working to address the issues of access. These include functional testing laboratories, that are frequently used by myself and my colleagues, which are now coming to the market with tests. I have some colleagues that prefer one test over another and others that are waiting for the testing to become more accurate before widely applying it to their patient population. Another factor is that testing through private laboratories is quite expensive. At some point the cost will come down and testing will become more widely available. 

In Canada, we only have access to the provincial laboratory services, whereby they’ll perform PCR testing and antibody testing provided the correct criteria are met. If a private test is requested, we’re able to use certain US-based laboratories. Diagnostic Solutions Laboratory ships their COVID test kits to Canada. They have three test options, which are nasal swab, antibody and stool. 

A German laboratory called Euroimmun AG introduced a test with 100 percent specificity, thus eliminating the chance of a false positive. It’s been approved in the USA. A full list of all the tests approved for diagnostic purposes in all countries is included here at the Center for Health Security website. The Mayo Clinic has also launched an antibody assay with a specificity of 99.3 percent when tested against normal serum. Approximately three percent of serum is IgG positive less than seven days post-symptom onset, 35 percent are IgG positive in samples collected between eight and fourteen days after symptom onset, and 100 percent are IgG positive after fourteen days of symptom onset.

We’ve learned a lot so far about SARS-CoV-2 and COVID-19, but still have plenty that we need to understand. I’ll be keeping a pulse on the new research as it becomes available and will continue these important discussions with my colleagues in order to keep you updated regarding the very latest information. My understanding of this virus is that it’s evolving day by day and although testing is relatively new, it’s still extremely important. 

As we navigate this next wave of outbreak management, testing will be key in order to understand who has active infections, who’s already been exposed, and who may still be at risk. Testing will help us to understand how the virus is spreading, answer important questions about immunity, and ultimately to save lives. My sense is that until the antibody testing can approach a specificity that’s close to 100 percent, it may be worthwhile to wait it out.  

Please don’t hesitate to reach out for support as needed. My team and I are always here for you during this challenging time. 

References: 

  1. Patel R, Babady E, Theel ES, et al. Report from the American Society for Microbiology COVID-19 International Summit, 23 March 2020: Value of Diagnostic Testing for SARS-CoV-2/COVID-19. mBio. 2020;11(2):e00722-20. Published 2020 Mar 26. Full text: https://mbio.asm.org/content/11/2/e00722-20 
  2. The Institute for Functional Medicine. The Functional Medicine Approach to COVID-19: Primer on SARS-CoV-2 Testing. https://www.ifm.org/news-insights/functional-medicine-approach-covid-19-primer-sars-cov-2-testing/ 
  3. Wölfel R, Corman VM, Guggemos W, et al. Virological assessment of hospitalized patients with COVID-2019 [published online ahead of print, 2020 Apr 1]. Nature. 2020;10.1038/s41586-020-2196-x. Abstract: https://pubmed.ncbi.nlm.nih.gov/32235945
  4. The Institute for Functional Medicine. The Functional Medicine Approach to COVID-19: Primer on SARS-CoV-2 Testing Webinar. Hosted by Dr. Patrick Hanaway with Dr. Helen Messier. April 28, 2020. 
  5. Guo L, Ren L, Yang S, et al. Profiling Early Humoral Response to Diagnose Novel Coronavirus Disease (COVID-19) [published online ahead of print, 2020 Mar 21]. Clin Infect Dis. 2020;ciaa310. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7184472/ 
  6. He-wei Jiang, Yang Li, Hai-nan Zhang, Wei Wang, Dong Men, Xiao Yang, Huan Qi, Jie Zhou, Sheng-ce Tao. Global profiling of SARS-CoV-2 specific IgG/ IgM responses of convalescents using a proteome microarray. Preprint article: https://www.medrxiv.org/content/10.1101/2020.03.20.20039495v1 
  7. Abdul Ghaaliq Lalkhen, MB ChB FRCA, Anthony McCluskey, BSc MB ChB FRCA, Clinical tests: sensitivity and specificity, Continuing Education in Anaesthesia Critical Care & Pain, Volume 8, Issue 6, December 2008, Pages 221–223, Full text: https://academic.oup.com/bjaed/article/8/6/221/406440 

Can You Reduce Your COVID-19 Risk With Lifestyle Changes?

By now, you’ve likely heard that pre-existing conditions, including heart disease and diabetes, contribute to more severe COVID-19 symptoms, complications, and even death. However, media fail to mention that heart disease and diabetes are largely lifestyle-related diseases. They develop over a long period of time as a result of poor diet choices, sedentary behavior, stress, and other daily habits.

This is good news because it means that you’re largely in control of what you eat, how you move, and other lifestyle choices you can make to take back your health and prevent disease. You can always change your habits.

By implementing diet and lifestyle changes that support your body, you strengthen the immune system, prevent chronic disease, maintain a healthy weight, and even reduce your risk of extreme COVID-19 symptoms. This provides you with better defenses against whatever viruses and other pathogens you’re exposed to in the future.

I’m here to tell you that your daily health habits are your best defense against COVID-19. Now is the best time to begin making changes, maintaining those changes, and prioritizing your health.

In this article, you’ll learn about:

  • Rates of obesity and chronic disease
  • What the research says about pre-existing conditions and COVID-19
  • Why we need to focus on preventing chronic disease
  • My top five lifestyle tips for preventing chronic disease and COVID-19

Obesity and Chronic Disease

Rates of obesity are increasing in North America and have been trending upward for several decades. Obesity is defined as a body mass index (BMI) of 30 or greater. In Canada, 30 per cent of adults are classified as obese and in the United States, it’s over 40 per cent.

Obesity is a major risk factor for chronic diseases including type-2 diabetes, heart disease, stroke, high blood pressure, cancer, and other conditions. The rates of obesity on our continent are higher than other areas hard hit by COVID-19, including Italy and China.

It’s estimated that around 8 per cent of the Canadian population over twelve years of age have been diagnosed with diabetes. That’s over 30 million people and numbers continue to increase each year. This statistic doesn’t take into account those with metabolic syndrome, pre-diabetes, or those with diabetes that haven’t been diagnosed. The true numbers are likely much more staggering!

In addition, the leading causes of death in Canada are cancer, heart disease, and stroke, making up more than 50 per cent of total annual deaths.

When I take a look at the rates of chronic disease in our country it makes me stop and think.

At the root of this pandemic there isn’t just COVID-19, but chronic metabolic disease fueling the flames of the virus.

Pre-Existing Conditions and COVID-19

Those with pre-existing conditions may need to take extra precautions for avoiding COVID-19 infections, even as public places begin to reopen. To learn more about protecting yourself from novel coronavirus infection, you can read my recent blog on the topic, 'COVID-19 How to Protect and Assess Yourself.'

Here’s a list of pre-existing conditions that may increase the severity of COVID-19:

  • Diabetes
  • Heart disease
  • Asthma
  • Chronic lung diseases, including COPD, emphysema, and cystic fibrosis
  • Chronic kidney disease, especially for those requiring dialysis
  • Obesity
  • Immunocompromised, including those with HIV, organ transplant recipients, and people undergoing cancer treatment such as chemotherapy
  • Liver disease

Although age isn’t a pre-existing condition, we do know that older individuals, especially those over 65, have a greater risk of developing more severe symptoms and are dying at higher rates from COVID-19. This may be because immune function decreases with age. However, it may also be because rates of inflammation and chronic disease tend to increase as we get older, as we practice poor habits over a longer span of time and lose protective lean body mass.

A recent study of 5700 patients in New York City that were hospitalized with COVID-19 showed that 88 per cent had at least two chronic health conditions. (1) The most common comorbidities were hypertension, obesity, and diabetes. In another New York City study, being over 65 years old and obese were found to be the greatest risk factors for hospitalization from COVID-19. (2) Obesity goes hand-in-hand with inflammation and is often a contributing factor to other comorbidities.

In another study of 187 patients with COVID-19, 27.8 per cent had heart complications, which is associated with fatal outcomes. (3) In addition, 35.3 per cent of the patients in the study had underlying heart issues, including hypertension, coronary artery disease, or cardiomyopathy, a heart muscle disease that makes it harder for the heart to pump blood.

This makes sense when we think about the link between the heart and the lungs. The lungs oxygenate the blood and the heart delivers the blood throughout the body. With COVID-19, it becomes harder to breathe, oxygen levels drop, and the heart has to pump faster. An underlying issue with the heart only makes this situation worse.

In addition, it’s important to note that diabetes is often the driver of heart disease as chronically elevated blood sugar damages the heart. A study from Wuhan, China, states that diabetes is one of the most common risk factors for death from COVID-19 and that a staggering 69 per cent of hospitalized patients had ‘non-ideal’ blood sugar levels. (4)

In another report from China, this one involving over 72,000 COVID-19 cases, those with diabetes were found to be three times more likely to die from COVID-19 when compared to overall death rates. (5) This study also reports the death rate from cardiovascular disease to be 10.5 per cent and 7.3 per cent for chronic respiratory disease, compared to a 2.3 per cent overall death rate.

I’m sure as time goes on, we’ll see more data confirming the link between COVID-19 severity and chronic disease.

A Radical Solution: Prevention

There’s a lot of talk in the media about medications, vaccines, and other treatments and while these will certainly have their place when available, the missing piece of the puzzle is prevention.

As an integrative and functional medicine doctor, I’m keenly aware that all body systems are connected and am always looking for the root cause. If one of the root causes of COVID-19 mortality is obesity and chronic disease, then let’s address what’s below the surface. The good news is that diet and lifestyle habits create health, halt disease progression, and in some cases even reverse chronic conditions. Addressing the health of the population is likely to help a huge number of people during this, and future, pandemics.

A recent article published in Obesity states: “Until further breakthroughs emerge, we should remember that modifiable lifestyle factors like diet and physical activity should not be marginalized. Decades of empirical evidence support both as key factors promoting health and wellness.” (6)

Dr. Hoffman’s Top 5 Tips for Chronic Disease and COVID-19 Prevention

  1. Adopt a whole food diet. This means ditching the processed, high-sugar, and packaged foods in favour of cooking at home. One silver lining of all the shelter in place orders has been that many people are cooking more, which is incredibly beneficial for health. In addition, focusing on eating whole food most of the time helps you to naturally achieve a healthy weight.If you have insulin resistance or diabetes, consider a low carb or keto diet to help manage blood sugar. At the Hoffman Centre for Integrative and Functional Medicine, we often see blood sugar dysregulation in its early stages and are able to course correct before it progresses to diabetes. My team and I are here to help you personalize your dietary approach for your unique needs.
  2. Move your body. Exercise helps your body and mind to function at its best, is a wonderful tool for blood sugar management, keeps you mobile as you age, and helps to prevent chronic disease. My best advice is to make exercise fun and enjoyable instead of it being a chore. The key is building movement habits into your day and week and I promise, as you move more, it will get easier and your body will naturally want to move.You can read more about my approach to exercise on my blog post, "Exercise Smarter, Not Harder: How to Optimize Your Workout for Your Brain and Body".
  3. Stress less. Stress contributes to weight gain, inflammation, and chronic disease. Tools such as movement, meditation, neurofeedback, and biofeedback are incredibly helpful to incorporate into a self-care routine. Here at Hoffman Centre, we can help you learn tools to pull your body’s nervous system out of a stressed state and into a relaxed one. When considering stress, it’s important to note that not sleeping enough and exposure to toxins cause stress in the body, along with the typical stressors that we’re familiar with.
  4. Optimize your vitamin D levels. Vitamin D is incredibly important for proper immune function and deficiency has been linked to a variety of chronic diseases. (7) Vitamin D deficiency is a very common nutrient deficiency, especially here in Canada because of our northern latitude. A recent article suggests that because of vitamin D’s role in reducing respiratory tract infections, supplementation may reduce the risk of COVID-19 infections and death. (8)
  5. Consider supplements. It takes time to move the needle on your health and while you work to put the foundational pieces of diet, movement, and stress management into place, supplements help to bridge the gap. My team and I support patients with developing personalized supplement protocols for their health concerns.In addition, supplements provide immune support, which may be of particular benefit to those at higher risk for severe COVID-19 infections. Consider vitamin D, vitamin C, zinc, probiotics, curcumin, green tea, and others. The Institute for Functional Medicine released a handout with potentially supportive supplements for both prevention and treatment of COVID-19.

When we look deeper to uncover root causes, we see that poor health and chronic disease not only affect quality of life. It also increases risk of pandemic infections. This connection is empowering because so much of what contributes to, or prevents, chronic disease is completely within our control. It truly is never too late to make changes.

If it feels overwhelming to change your daily habits to improve your health, including upgrading your nutrition and moving your body, start with one small and achievable goal. Once that first habit’s in place, work on the next. Over time, you’ll achieve sustainable lifestyle change and will notice differences in your body and how you feel. Please note that we’d love to support you here at the Hoffman Centre for Integrative and Functional Medicine, so don’t hesitate to contact us for an appointment.

References

  1. Richardson S, Hirsch JS, Narasimhan M, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area [published online ahead of print, 2020 Apr 22]. JAMA. 2020;10.1001/jama.2020.6775. Abstract: https://pubmed.ncbi.nlm.nih.gov/32320003/
  2. Petrilli CM, Jones SA, Yang J, et al. Factors associated with hospitalization and critical illness among 4103 patients with COVID-19 disease in New York City. [Preprint article] medRxiv 2020.04.08.20057794 Abstract: https://www.medrxiv.org/content/10.1101/2020.04.08.20057794v1
  3. Guo T, Fan Y, Chen M, et al. Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19). JAMA Cardiol. Published online March 27, 2020. Full text: https://jamanetwork.com/journals/jamacardiology/fullarticle/2763845
  4. Zhou J, Tan J. Diabetes patients with COVID-19 need better blood glucose management in Wuhan, China [published online ahead of print, 2020 Mar 24]. Metabolism. 2020;107:154216. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102634/
  5. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. 2020;323(13):1239–1242.Full text: https://jamanetwork.com/journals/jama/fullarticle/2762130
  6. Carter SJ, Baranauskas MN, Fly AD. Considerations for obesity, vitamin D, and physical activity amidst the COVID-19 pandemic [published online ahead of print, 2020 Apr 16]. Obesity (Silver Spring). 2020;10.1002/oby.22838. doi:10.1002/oby.22838 Abstract: https://pubmed.ncbi.nlm.nih.gov/32299148/
  7. Heaney RP. Vitamin D in health and disease. Clin J Am Soc Nephrol. 2008;3(5):1535‐1541. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4571146/
  8. Grant WB, Lahore H, McDonnell SL, et al. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients. 2020;12(4):E988. Published 2020 Apr 2. Full text: https://www.mdpi.com/2072-6643/12/4/988/htm

COVID-19 How to Protect and Assess Yourself

In the current Covid-19 Pandemic we get asked a lot of questions about the best ways on how to protect and assess yourself. We've gathered some great recommendations that we've found to be very useful and came up with a few of our own suggestions.

Most of the following recommendations come from from a video conference given by Dr. Dave Price, an ER physician. Watch this video by Dr. Dave Price, Protecting Your Family ER doctor at Cornell University.

Covid-19 A Brief Summary

What is COVID-19?

A virus from the common cold family, the coronavirus has never been seen by the human body before, hence the virulence. The virus appears to have come from an animal.

Symptoms

The most common symptoms are a fever, cough, and sore throat. The virus then travels throughout the body and goes mostly to the lungs although there can also be cardiac involvement. Patients commonly present with a cough or are just not feeling good, with a cough and mild headache. Most people just don’t feel good when they suffer from the virus. The infection can last anywhere from five to fourteen days. Those with a mild case of the disease usually feel better around the fifth day. In more severe cases, those that are more affected will become short of breath between the third and the fifth day then feel better around the seventh day.

How do we get the disease?

Coronavirus is contracted almost exclusively from moving your hands to your face. You have to have long and sustained contact with someone who has the disease. The vast majority will have a fever and aches or will be someone that is going to get the disease in the next one or two days. This virus is almost entirely transferred from your hands to your face, into the eyes, nose, or mouth. Keep your hands away from your face and you're mostly good.  Super clean hands, never touching the face. Boom.

There is some suggestion you can get the virus from aerosolization, in other words because it’s airborne. However, for this to occur you need long sustained and unprotected contact for at least fifteen to thirty minutes, in a closed room with no mask. Most people get it from touching someone with the disease or someone who is about the get the disease. Covid-19 is in your community right now. I’m not attempting to scare you, but simply empower you to take the necessary steps to protect your hand to face spread.

Follow 4 Rules to Protect Yourself

1. Become a 'hand washing fanatic'

Know where your hands are and keep them cleaned and sanitised at all times. Walk around with Purell or hand wipes. Leave your door, Purell. Open the door and then Purell. If you keep your hands clean, you dramatically reduce the risk of infection and if you combine washing your hands with not touching your face, you will NOT get this. Covid-19 is mostly contracted from sustained contact with someone who has it. However, because of the risk of slight exposure on objects, make sure that you always keep your hands clean.

2. Psychologically work at the connection between your hands and face

We touch our face thousands of times a day without thinking, whether we’re scratching, picking, rubbing, or pondering. Start to monitor yourself doing this, gamify not touching your face or wear a mask indoors to train yourself in this new behaviour.

3. You don't need a N95 medical mask

When you leave the house, wear a mask or something wrapped around your mouth and nose, to stop you touching your face. Any covering of your face is good. The mask doesn't prevent the disease but simply trains you not to touch your face. So, when you leave your house, add a mask. This will prevent transmission 99% of the time. Clean hands and not touching your face is the key. The general community has zero need for a N95 mask. If you’re in a room with a Covid-19 patient who has a risk of aerosolization, you need a N95 mask. If you’re going to the grocery store and touch the cart, just make sure that you clean the handle.

4. Distance yourself from others

Keep around three to six feet away from other people. Shrink your social circle for now. Find your small group and don't break from it. Do all other socialising digitally. We’ll need to physically distance for the next three to six months, maybe longer if we see another little spike. Become used to keeping this distance and don’t allow yourself to slip with this. You don’t need to be afraid of your neighbour. The better you are at doing this, the less likely you'll catch or transmit the infection.

And that’s it. Just four very simple rules.

The only way you will get this disease is if your hands are contaminated, you touch your face, and you stand too close to a contaminated person. You don’t need to be afraid if you go out to the grocery store. The person three to six feet away from you is not your enemy.

What Should You Do If You Have a Cold?

Behave as if you have coronavirus for two days and see what direction this takes. If in a couple of days it feels like a regular cold like all your others you’ve ever had, go back to normal life. You can have Covid-19 and stay in your house, protected and perfectly safe. If someone is immune compromised in the house, such as a very elderly individual, isolate them completely from the person that’s sick or that person needs to leave the house. The same applies if someone is known to be immune compromised after undergoing chemotherapy, for example. Touching a person or touching a contaminated surface then touching your face is what will transmit the disease.

What Should You Do If You Get the Disease?

This disease is primarily spread through home and family transmission, such as from mother to daughter, from brother to sister. If you develop a fever or other symptom, isolate yourself in the house in a separate room, with a separate bathroom if at all possible.

If the person has to come out of the room, have that sick person wear a mask and wash their hands with sanitizer before leaving the room and entering the rest of the house. The sick person should touch as little as possible, clean after themselves, and then head back to their self-isolation. Don’t have sustained contact with this person and don’t do things like repeatedly taking their temperature. However, don’t be afraid to stay at home.

The healthy person in the house should not be touching the sick person or be around the sick person whenever they can avoid it. The sick person should get through the illness within seven days but remain vigilant as their recovery relates to washing hands, wearing masks and so on for seven to ten days. Once the sick person is feeling well, they can have more contact with others. However, continue cleaning your hands and put on a mask.

If You’re Sick, When Do You Need to Go to the Hospital?

You only really need to go to the hospital if you’re short of breath. That’s the clearest indication and a steadfast rule. Don’t go to the hospital if you have a fever, body aches, a cough, or you simply think you might have Covid-19. A lot of people presenting to hospitals are being sent home to wait out the four to five days of the disease. Of all the people who get Covid-19, only 10% become short of breath and need to go to hospital. Of those, only about 10% of people turning up at the hospital that have symptoms will actually be admitted to be monitored. About 1% of those will be put on a ventilator. The overwhelming majority of people come off the ventilator seven to ten days later. Going to the hospital is not a death sentence.

Telemedicine is the best way to avoid overloading the medical services. Call in with your symptoms and heed the advice given by your health authorities. In Canada, call 811 and follow their directions. However, if you’re short of breath, head to the hospital.

Do I Need to Get Tested?

No. Let people who really need it, get tested. As testing ramps up more people will have access. If you have symptoms like the flu with the features mentioned, you probably have Covid-19. If your community is having an outbreak of the disease then you may need to be tested.

Are Kids Getting Infected with Covid-19?

There have been almost no cases of Covid-19 disease in kids between zero and fourteen years old. A few newborns are getting it, which is thought to be due to contact. Kids are not getting critically ill or dying. We’re still waiting to understand whether kids are vectors and assume for now that they are. At the moment, kids aren’t dying and kids aren’t getting sick.

Transmission

The absolute vast majority of transmissions are from droplets. When a droplet leaves an infected person, it lands and is quickly picked up by an unsuspecting person, transferring it from hands to face. Very, very little transmission occurs through the air. You would have to be very close to a person spitting or coughing and have a droplet transferred to your face. This occurs in a hospital when the patient is suctioned or a similar aerosolized procedure is done. This is where a N95 mask is needed. Most nurses use an ordinary surgery mask when in hospitals attending to Covid-19 patients.

It takes approximately two days to be symptomatic. You are infective in those two days, keep a list if you can of all the people you interact with so that you’re able to inform people if you’re in contact with someone in the two days prior to you becoming symptomatic.

Health care providers that are on the front line taking care of infected patients in a closed room and doing nasal swabs without protection are getting very sick. With the proper protection nobody is getting sick, even in working in a Covid-19 hospital ward.

Is it really safe to go on a run or a walk if you adhere to the spacing directions?

Yes, it is. Take sterilising liquid with you and wipe down anything you touch. Keep your distances. Just don't get sloppy and don't assume that other people have your diligence. Wear a mask so that you continue to train yourself not to touch your face and to communicate to other people that you're taking it seriously. Wipe everything down before you touch it and don’t touch your face. A bandana is okay if you don’t have a mask. It’s not preventing you from getting the disease, but just to prevent you from touching your face.

What if you don't have a sterilising liquid?

Coronavirus is not robust. It dies immediately upon disinfection. Use your elbows or other body parts to open and close things, then wash with soap as soon as you can.

Do I need to wipe down groceries when bringing them into the house?

It’s a reasonable idea to have the delivery person leave the goods outside your door, pick it up with gloves then wipe it down. That’s certainly reasonable but the most important part is, as stated, to wash your hands, don't touch your face. Don’t pick up the package with your bare hands. Clean your hands immediately. If picking up coffee from a Starbucks drive-through, Purell your hands or disinfect your hands after taking the cup.

It is fallacy that this only affects older people?

Yes, this is affecting everyone above approximately fourteen years old. Everybody is getting this disease even without preconditions. Older people often do worse, while men are more often infected than females. The younger you are, the less likely it will happen. The older you are, the more likely you are to get the disease.

Is it true that Ibuprofen should be avoided when feeling sick?

In practice, 90% of people will get a fever and a cough. Those who become sicker get short of breath. Those who can’t walk to the bathroom need a ventilator. They usually settle out after a day and after seven days they get off the ventilators. There’s good enough data coming out of Germany now that ibuprofen should not be used since it causes more inflammation. If you have a fever use an alternative like Tylenol. Take glutathione if you use Tylenol.

Immunity

The people who get the disease are shedding the virus one or two days before they get the disease. The stories of people getting sick again are about people that haven't fully recovered. If you've had it, and are through it, you're immune. This virus is now in circulation and as it mutates over the next few years, it will become milder and milder. Five years from now it will be just a cold.

Finally, a study in China has determined that microbiome health is a more significant factor than age when it comes to coronavirus deaths.

A Positive Outlook During the COVID-19 Outbreak

The vast majority of the world’s population that has access to any source of media outlets is currently under the collective fear-driven news cycles of an upcoming apocalypse due to the emergence and spread of the coronavirus, COVID-19.  As I write this, a CCN alert flashed across my screen stating that there were 3,000 cases of coronavirus in the United States with 62 deaths. This number was updated six hours later to 3,155 cases. No doubt by this evening, this number will be adjusted upwards, a trend that will probably increase for the foreseeable future, the exact end-point being entirely unknown.

While all due caution is absolutely imperative and all medical guidance should be strictly followed, as I stated in my other pieces regarding coronavirus, parts one and two, I couldn’t help but reflect on what appears to be an innate tendency of all living systems to trigger homeostatic mechanisms that force self-correction whenever one side of its expression become too polarized to either extreme. It appears that evolution itself has to adjust course in light of new information by self-correcting evolutionary realignments.

We know from history that disasters are often followed by tremendous gains and achievements. The extreme horrors of World War II were followed by an extraordinary period of increased economic, social, and political global growth and relatedness, rather than nationalism, which was unprecedented in history. It was the same with 9/11. Immediately following those events, murder rates plummeted, and kindness and appreciation were unleashed upon civil servants, hospitals, demolition crews, and emergency medical services. Out of control real estate, airline, and hotel prices were corrected, and there was increased dedication to global causes. The list is much more extensive but undoubtedly real, when previous issues and statistics were assessed through this lens. 

One of the greatest and most well remembered political speeches of all time was delivered at the first inauguration by Franklin D. Roosevelt as the 32nd President of the United States. At that time, the nation was at the peak of the Great Depression and the speech was heard by tens of millions of American citizens.  

“So, first of all, let me assert my firm belief that the only thing we have to fear is...fear itself — nameless, unreasoning, unjustified terror which paralyzes needed efforts to convert retreat into advance. In every dark hour of our national life a leadership of frankness and of vigor has met with that understanding and support of the people themselves, which is essential to victory. And I am convinced that you will again give that support to leadership in these critical days.”

He went on to say, “There is no unsolvable problem if we face it wisely and courageously. There are many ways in which it can be helped, but it can never be helped merely by talking about it. We must act and act quickly.”

So, while we’re currently in the grip of the downward, fear-driven spiral that’s mostly emphasizing the potential catastrophic consequences that may or may not result from CoVID-19, how can we best compensate for those fears and reflect on the potential upside of this situation? And most importantly, what can we do to mitigate this fear-driven spiral into ennui, inaction and a potential sense of hopelessness?

What follows are some compensatory ideas that are in no way meant to downplay or minimize the suffering that many people have gone through or are about to go through. However, if we’re to embrace the homeostatic principles that there are no crises without blessings and we don’t live in a one-sided world where there are only losses without gains. So, let’s examine a few potential consequences that might arise from this present situation. 

  1. Global warming. The global warming crisis seemed to be almost impossible to reign in, despite the most well-meaning attempts by a subset of global political and environmental leaders. With all kinds of global travel grinding to a halt, it’s inevitable that at least a pause to the upward tend of global warming, primarily due to the carbon footprint induced by travel, will be inevitable. When climate change experts examine this effect in months or years to come, maybe their statistics can be used to convince others of the need for a more sustained and ambitious action regarding this omnipresent threat.
  2. Exotic animal trade. China stopped the trade in wild animals for the purpose of consumption such as dogs, rodents, yaks, snakes, porcupines, and bats when the link between animals and the coronaviruses was discussed. Officials from the Chinese Center for Disease Control and Prevention said they isolated the virus taken from a seafood and wildlife market in Wuhan believed to be the source of the outbreak. The coronavirus that caused the 2003 SARS outbreak was traced to the civet cat, a wild animal considered a delicacy in parts of South China. The civet is used in the popular dragon tiger phoenix soup, which is believed by locals to help with arthritis, stimulate poor blood flow, and revive decreased libido. The movement of humans toward recognizing animals as sentient beings may be assisted, a movement initiated and kept alive by the PETA president and founder Ingrid Newkirk and written about in her best selling book, Animalkind.   
  3. Consumerism. Our western culture is an extroverted and consumer driven one. Perhaps by sitting at home for extended periods, with the stores, at least at present, bare of many types of consumer goods, we can reflect on our impulse to seek emotional consolation outside of ourselves by buying new items that we may not need. I do realize that the beast of online shopping may be unleashed but here’s hoping that the online stores may not be able transport unnecessary consumer goods due to the transport channels being slowed down. 
  4. Possibility of increased relatedness. A series of recent posts by Rebecca Arendell Franks, who along with her husband and child has now been on forced quarantine in China for over 50 days, is quite illuminating. She said that, “Our family life has never been better. Usually, one weekend is long enough before I’m ready to send each of us back to school or work. But for SEVEN weeks, we’ve been home together with very little outside influences or distraction, forced to reconnect with one another, learn how to communicate better, give each other space, slow down our pace, and be a stronger family than ever before. I encourage you to read the link regarding this at the end of this article. 
  5. Nature emerging from the technological and human encroachment upon its domain. It’s been observed in Wuhan that the sound of birds singing has been heard for the first time in a long time since the crisis began. In Wuhan, Rebecca Arendell Franks commented, “Right now, I hear birds outside my window (on the 25th floor). I used to think there weren’t really birds in Wuhan, because you rarely saw them and never heard them. I now know they were just muted and crowded out by the traffic and people. All day long now I hear birds singing. It stops me in my tracks to hear the sound of their wings.”
  6. Learning new technologies for virtual relatedness. How does ZOOM actually work and can I teach my grandfather to hook up? 
  7. Learning to cook. Maybe we can now, instead of ordering food in or going out to a restaurant, learn to cook for ourselves and make that tasty, healthy recipe that we’ve always been meaning to get around to. 
  8. Examination of our national leader’s skill set in crisis management. 
  9. Exercise. Finally, the Peloton bike or treadmill can be put to good use!
  10. Non-drug based medicine. Examination and renewed interest, along with a certain amount of respect given, of alternative methods for treating symptoms of coronavirus, and indeed other viral related illnesses such as the three studies currently underway in China on the use of IV vitamin C for the treatment of corona related pneumonia. See blog posts part one and two for further details. 
  11. Lifestyle factors. An awareness of how lifestyle factors such as diet, exercise, sleep, and stress play an extraordinary role in immune efficiency.
  12. Business awareness. Small business will become aware of cash flow issues, staffing needs, and unemployment issues.
  13. US Federal Reserve slashing interest rates. Maybe now is the time where one can afford the mortgage on a new home that seemed out of reach a few years before. Or maybe people with fixed student loan payments can borrow money at a lower rate to pay those off. 
  14. Learning to connect with others non-locally. There’s a common misconception that in order to benefit from the full experience of another human being we have to be in their physical presence. Yet if we truly love someone and see both sides, the dark and the light, of their being, we can sit quietly, hold them in our hearts, and send deep love and appreciation to them for being in our lives. It helps if we have an understanding of the Einstein-Podolsky- Rosenberg paradox (EPR paradox) in quantum physics that showed that if one particle had ever been in contact with another particle, if they were separated across the full expanse of the universe in space and time, they’d be eternally intertwined or entangled. Einstein called it “spooky action at a distance.”  

(Please note this is a very simplistic explanation for quite a complex issue.)  

A few more quick positive outlook possibilities:

  1. Increased revenues for the medical device industry.
  2. Increased revenues for the supplement industry.
  3. Increased connection to neighbours to assist with grocery runs.
  4. Appreciation for the media and their updates.
  5. Appreciation for our doctors, nurses, and miscellaneous healthcare workers and politicians for rising to the occasion and setting minute by minute guidelines
  6. Appreciation for mobile device apps, Google, Facebook, Instagram, and Twitter for keeping us informed.
  7. Appreciation and understanding of our own vulnerability.
  8.  Resetting of values and personal reflection on what is truly meaningful, including a reorganization of values and priorities.  

So, as we step back, reassessing our priorities both personally and collectively, these are a few thoughts I’ve had in these troubling and somewhat frightening times. If Nobel Prize winning chemist Ilya Prigogine is to be believed, even insentient material systems have an inherent drive to self-organization. When physical systems get pushed too “far from equilibrium” they escape this chaos by leaping into higher level states of organized order, referred to as “order out of chaos”. My challenge to all of you is, what inherent dynamic force may be at play in your life, driving you toward greater and greater wholeness, complexity, and consciousness in the midst of these very challenging times? What thoughts of this nature have come to your mind in these times?

While you contemplate having a positive outlook and these deeper thoughts, stay safe, follow your governmental and health directive guidelines, and do what you need to do to get through these times. We must attempt to move beyond the greatest fear, which is that of fear itself. 

See part one and two for specific coronavirus updates and treatment suggestions. 

Preventive and Treatment Strategies for COVID-19: Part 2

Keep Fighting Fit

It’s only common sense to keep our bodies as healthy as we can to help us to fight off all kinds of illnesses. Obviously, we’re always going to encounter germs in our daily lives but keeping our immune systems in good condition is an excellent defense strategy. 

Follow these steps: 

  • Get enough sleep, ideally seven or eight hours each night. 
  • Try to reduce stress where you can in your life. 
  • Make sure you’re on a diet that contains plenty of plant-based antioxidants, minerals and vitamins and eat healthy food to keep your body and immune system in good shape. 
  • Make sure that you always get enough exercise whenever you can to keep everything in working order. 
  • Stop consuming all sugar
  • Stop smoking or vaping immediately. 

Get some N95 facemasks before supplies are gone. 

  • An N95 respirator is a respiratory protective device designed to achieve a very close facial fit and very efficient filtration of airborne particles.
  • The ‘N95’ designation means that when subjected to careful testing, the respirator blocks at least 95% of very small (0.3 micron) test particles. If properly fitted, the filtration capabilities of N95 respirators exceed those of facemasks. However, even a properly fitted N95 respirator doesn’t completely eliminate the risk of illness or death.

N95 respirators aren’t designed for children or people with facial hair. Because a proper fit cannot be achieved on children and people with facial hair, the N95 respirator may not provide full protection.

A full list of FDA approved respirators is provided below. These might already be out of stock everywhere but put orders in regardless of the backorder. 

  • 3M™ Particulate Respirator 8612F
  • Pasture Tm F550G Respirator
  • Pasture Tm A520G Respirator

Transmission through the eye is a common vector for the aerosolized virus. One of the common transmissions is touching public items then touching your face and transmitting it through the eye. Frequent hand washing and excellent hygiene are paramount.

Drug treatments

It’s important to be aware that there are at present no antiviral treatments that are effective for the treatment of Covid-19. There are currently no vaccines available for SARS-CoV-2. The present treatment approach is for supportive care and symptom management only. If people become severely ill, vital organ function support is necessary, usually in a hospital or ICU setting. 

Here’s a link to the number of drugs that as of February 2020 were being studied for the treatment of Covid 19. . 

The CDC also has a site discussing antiviral medications for the flu here

A Chinese multicenter collaboration group suggested this malaria drug might be useful for the treatment of Covid-19 pneumonia. In another recently published paper, the use of hydroxychloroquine, 400 mg twice daily followed by a maintenance dose of 200mg twice daily for four days, was found to be more potent than chloroquine to inhibit SARS-CoV2. Hydroxychloroquine was also shown to have fewer side effects than chloroquine while still addressing the inflammatory cytokine storm induced by the virus. 

The recommended dose of chloroquine phosphate was 500mg twice daily for ten days. 

This drug is traditionally is used as an antiparasitic and has been studied for the treatment of Middle East Respiratory Syndrome (MERS) coronavirus. This drug has been shown, in test tube studies at least, to have activity against MERS-CoV and other coronaviruses. Further studies are being undertaken to determine its true efficacy. The recommended dose was 1000mg twice daily for 10 days.

A 62-year-old man who became Spain’s first coronavirus patient is believed to have made a full recovery after being treated with an HIV drug called Kaletra or lopinavir-ritonavir. Miguel Ángel Benítez was admitted to the Virgen del Rocio Hospital in Seville, where he received an antiretroviral drug, which has been used to treat HIV and AIDS for over ten years. The drug was combined with interferon beta, which is a protein that prevents cells from becoming infected and is administered to multiple sclerosis patients. Santiago Moreno, head of infectious diseases at the Ramón y Cajal hospital in Madrid, said that the “SARS-CoV-2 protease is very similar to that of HIV,” using a name that sometimes refers to the novel coronavirus.

In this February 2020 article it was discussed that “Coronavirus infection (regardless of the various types of corona virus) is primarily attacked by immune cells including mast cells (MCs), which are located in the submucosa of the respiratory tract and in the nasal cavity and represent a barrier of protection against microorganisms. Virus activate MCs which release early inflammatory chemical compounds including histamine and protease; while late activation provokes the generation of pro-inflammatory IL-1 family members including IL-1 and IL-33.” The article proposes for the first time that inflammation by coronavirus may be inhibited by anti-inflammatory cytokines belonging to the IL-1 family members. 

It may be that individuals with MCAS are at higher risk for developing the serious consequences of this infection and thus may benefit from much stricter control of the mast cell activation syndrome if infected. Nebulized cromolyn and/or glutathione or n-acetyl cysteine (NAC) and/or IV Benadryl may be extremely helpful in these conditions.

In addition to the previous suggestions, there are a number of natural substances and supplements that can be of help in lowering your risk of becoming infected with the current coronavirus. Many of these approaches are not specific treatments for the coronavirus but have been studied and referenced in the literature as having antiviral effects.

It’s common knowledge that vitamin C is good for us but there have been clinical trials in China regarding the intravenous use of vitamin C to help treat patients suffering from Covid-19. A dose of between 100 and 200 mg/kg body weight (this is equal to quite a low dose of between 7.5 and 15 grams for a 180 lb person) was given to patients intravenously for three consecutive days and was very effective. There are currently three clinical trials sponsored by the Chinese government studying vitamin C. Dr. Tom Levy and Dr. Jeanne Drisko from the integrative U.S. medical community are involved in the Chinese studies. Dr. Richard Cheng MD PhD, who has been studying IV vitamin C, is suggesting the use of oral vitamin C.  The one study can be found at the clinicaltrial.gov website. High dose vitamin C at 20 grams has been used in ICUs for some time in an attempt to reduce mortality from septic shock, in one study from 40% to 4%. However, most hospitals refuse to administer IV vitamin C for viral infections since it’s not considered standard of care. It’s quite likely that these Chinese studies will place high dose IV vitamin C therapy for viral infections a part of mainstream treatment in the future.   

In the United States, doctors who have pioneered vitamin and mineral therapies have also been studying the effects of intravenous vitamin C, with a February 2020 paper being published. “Early Large Dose Intravenous Vitamin C is the Treatment of Choice for 2019-nCov Infected Pneumonia” recommends this for the treatment for pneumonia resulting from the virus. 

A recommended minimum oral daily dose of vitamin C is 2,000mg. Twice daily dosing is recommended due to the water-soluble nature of vitamin C and the fact that it’s quickly metabolized. If one wants a liposomal formulation, certain brands do provide this option or you can make your own by adding https://klinghardtinstitute.com/one or two teaspoons of Body Bio PC (phosphatidyl choline) to 2 grams of powdered vitamin C and stirring it vigorously. Divide your dose and take twice daily. Watch for diarrhea if your dose is excessive.

This is also very important. It’s recommended that we have a minimum of 2,000 IU and a maximum of 10,000 IU per day. The usual daily dosage for vitamin D is 1000 IU per 25 pounds of body weight. It’s best to get vitamin D levels measured and to have serum levels in Canada between 150 and 200 nmol/l. People tend to have lower vitamin D levels in the fall and winter months due to fewer hours of sunlight. However, our bodies need vitamin D to support our immune system so we need to make sure that we’re getting enough of this vital ingredient. All the cells in our bodies have receptor sites but only two types are in every cell. These are thyroid hormone receptor sites, which are responsible for metabolism, and vitamin D receptor sides. This gives you some idea of the importance of vitamin D in maintaining our overall health and wellbeing. Research indicates that vitamin D may even be more effective than the flu vaccine when it comes to flu prevention. Consequently, it’s a good idea to include vitamin D in the fight against Covid-19.

It has been reported by many clinicians that high doses vitamin D of 50,000 IU over three days is highly effective in treating acute viral infections. This dosing is contraindicated in any person with lymphoid malignancies and in any patient with granulomatous diseases such as sarcoidosis, where high calcium levels are an issue. Also, a relative contraindication is pregnancy. This is by no means an approved treatment for Covid 19.   

This has been shown to be effective in fighting infections and also supports the immune system. Zinc can help to prevent coronavirus and other viruses multiplying in the throat and nasopharynx, which is the space above the soft palate at the back of the nose connecting the nose to the mouth and allowing us to breathe through our nose. When you begin to exhibit symptoms of the illness zinc capsules can be taken several times a day. The recommended dose for zinc is between 40 and 50mg per day.

This has also has some antibacterial and anti-viral properties. If you use an official product such as Argentyn 23 you have a clear idea of how much silver you are putting into your body and don’t run the risk of taking too much. If you have viral symptoms, the recommended dosage is one teaspoon seven times per day. However, this is only a short-term solution as there are side effects such as skin discoloration if silver is used for too long.

This herb has been used in traditional Chinese medicine and Ayurveda for a long time. It’s been shown that the herb’s compounds have anti-inflammatory, antiviral, and antioxidant benefits. The herb boosts the immune system and is often employed to fight cold and flu symptoms. As a result it does have a role to play in treating the latest version of coronavirus, at least in the short term. One capsule twice a day is the recommended dose of the herbal supplement if you exhibit symptoms of the virus. There are a number of referenced articles that demonstrate its effectiveness against the influenza virus, particularly with regards to respiratory symptoms. Lyme patients with active disease may have a Herxheimer reaction as it increases lymphocyte proliferation and interleukin -2. 

Another natural short-term solution if you have typical flu symptoms, such as a cough, sneezing, and a runny nose, is elderberry extract taken up to six times a day. Elderberries come from the European elder tree, which is not the same as the American Elder, Elderflower, or Dwarf Elder. People believe the extract helps with the common cold, influenza, boosts the immune system, and reduces inflammation.

Is also known as marigold and has been used as a medicinal herb for a very long time. The plant’s extracts have antiviral, antigenotoxic, and anti-inflammatory properties that can be used to treat some of the symptoms of Covid-19. 

Also known as dandelion, this can also be used as an anti-inflammatory supplement. Dandelion also has antioxidant properties and some studies indicate that it has antiviral benefits and is good for our immune system. 

This is known to be a potent antiviral, particularly in animal models infected with corona virus. Dr. Ramzi Asfour, an infectious disease physician, suggests Beekeeper’s Natural propolis spray. Propolis increases cellular immune responses and has antiviral properties. Propolis can also be dispensed in a vaporizer (available from Ki Science) and has been shown to neutralize circulating mycotoxins in the air. 

Most commonly known as skullcap, this is another flowering plant with medicinal qualities. It has been used to treat conditions such as respiratory infections and inflammation and have antibacterial, antiviral, and antioxidant properties. 

Also referred to as sweet wormwood this has been used in traditional medicine for some time and has been employed in medicines to treat malaria. There are some indications that the plant may also be used to treat some coronavirus symptoms, particularly the SARS related coronavirus.

Dr. Klinghardt, in his extremely informative PowerPoint presentation, has recommended placing calendula, licorice, scutalaria, andrographis, artemisia, and dandelion tinctures, calculated for their weekly dose, in a blender with 100mls of clean water and 14 grams of vitamin C powder. Add two tablespoons of liquid Body Bio PC phosphatidyl choline and blend for a few minutes. Put this mixture in a glass and keep in the fridge. Each day, drink one seventh of the dose.

This product contains 19 different herbs with antiviral and immune modulating effects, including licorice, skullcap, dandelion, and rosemary.

Some patients have access to peptides with immunomodulating effects. I recently returned from a peptide conference in Los Angeles and the following peptides were suggested for their antiviral and immune modulatory effects.         

  • Thymosin alpha 1 – This is the most recommended peptide for immune stimulation. This should be used as a treatment adjuvant and a prophylactic and can help with many conditions beyond viral illness. The recommended daily dose in 450mcg.
  • Thymosin beta 4 – Natural killer cells are essential for defense against tumors and virus-infected cells. The cells are activated in by ONF-Gamma. This is activated by IL-18, which TB4 upregulates. Therefore, TB4 has ben studied for many Immune related diseases. Caution is warranted with cancer patients as it can increase the growth of cancers.
  • LL 37 (cathelicidin) – This peptide has broad spectrum antiviral/microbial, fungal effects. Peptides such as LL 37 are key components of innate defenses against infection, with both microbial and host defense modulatory functions. In addition to their well documented bactericidal potential, CHDP have more recently been shown to have antiviral properties. LL 37 has ben shown to be highly effective in preventing viral attachment to cells. It’s been used in several virus studies and has been anecdotally reported to work well with respiratory tract viruses.
  • Pentosan polysulfate – Polysulfates are highly potent and selective inhibitors of the in vitro replication of HIV and other enveloped viruses such as coronavirus. The anti-viral activity of polysulfates is a result of their shielding of the positively charged sites in the V3 loop of the viral envelope glycoprotein gpl120, which inhibits viral entry into cells and allows for immune clearance. The usual dose is 2mg/kg.
  • Selank – This is a variant of the immune molecule tufstin and has potent antiviral properties in addition to its neurological effects. The antiviral characteristics of Selank were evaluated both in vitro and in vivo against the influenza virus strain H3N2 and H5N1 and the type 1 and 2 Herpes virus. It was revealed that Selank might have a prophylactic effect during influenza infection and a therapeutic effect during a herpes virus infection. It could also be helpful with Covid-19.

The Hoffman Centre Programs for cold and flu treatment

We have developed a number of potential programs for acute cold and flu treatment. While the details aren’t specific to coronavirus many of the recommendations are applicable to dealing with virus that commonly infect us in the winter months. These recommendations are in no way a substitute for quick and rapid communication with your healthcare providers and the guidelines as issued via websites (like this one), previously mentioned at the beginning of this article.

Any treatment that you decide to undertake should start at the first onset of symptoms. The following instructions are to be followed for the duration of symptoms unless otherwise stated. 

Immediately stop consuming any sugar, since this paralyzes your white blood cells, the body’s first defense against illness. Make sure you also get plenty of sleep, at least between 7.5 and 8.5 hours per night. Hot apple cider vinegar baths twice a day will help to speed up the progression of the cold and reduce your fever, potentially halving the amount of time you may have symptoms. Add two cups of apple cider vinegar to a full bath of hot water and soak for twenty minutes, remembering to fully submerge your body. If the illness has affected the chest, you can steam water over the stove, add eucalyptus drops, and breathe in the vapor for some relief from your symptoms.

Please note that this treatment program is not to be undertaken if you are pregnant or breastfeeding.

Adult Dosage (age 16 and up)

Oscillococcinum is the first supplement to take at the first sign of a cold or flu. This works better for flu like symptoms (not cold symptoms) and you simply need to follow the directions on the package.

  • Vitamin D – 50,000 IU for three days. Contraindication to use of high dose vitamin D is lymphoid malignancies, pregnancy, and granulomatous diseases such as sarcoidosis
  • Mycelized vitamin A – 100,000 IU for three days. Contraindicated in pregnancy. 
  • Vitamin C – 1 to 2g two to three times daily (titrate dose upward to bowel tolerance)
  • Astragalus Tincture – 1 dropper three times daily
  • Echinamide Anti-Cold tincture – 2ml three times daily
  • Probiomax probiotic – 1 capsule two times daily 
  • Saccharomyces Boulardii – 2 capsules twice daily
  • Garlic/allicin – 2 capsules three times daily after meals. Open the capsule in 6oz of water and let sit for two minutes before drinking.
  • Argentyn 23 colloidal silver  – 1 teaspoon three times daily in water
  • Andrographis – 2 dropperfuls twice daily in water
  • Transfer Factor Multi Immune – 2 capsules twice daily
  • DHEA – 50mg per day for two to three days will boost the immune system and fight infection. Note that this is for adults only.
  • For muscle aches take arnica and/or magnesium malate – 2 caps three times daily
  • Add anti-viral supplements such as olive leaf extract – 2 capsules three times daily, oil of oregano (brand name ADP) 2 capsules three times per day and lysine 500mg 2 capsules three times daily

IV Treatment for 3 days

  • IV vitamin C – 15 to 35g once per day. Check for G6PG enzyme deficiency first
  • Alternatively – IV Hydrogen Peroxide, once per day

Child Dosage (2 years and older)

  • Mycelized vitamin A – 10,000 IU for three days
  • Vitamin D – 10,000 IU for three days
  • Vitamin C – Between 250 and 500mg three times daily (to bowel tolerance)
  • Echinamide Anti-Cold – Between an third and a half a dropper three times daily 
  • Probiomax probiotic  – Half a capsule twice daily
  • Saccharomyces Boulardii – Half to a full capsule twice daily
  • Garlic – Half to a full capsule twice daily after meals. Open capsule in 6oz of water and let sit for two minutes before drinking. Note that it is difficult to get a child to take this.
  • Argentyn 23 colloidal silver – Half a teaspoon three times daily in water
  • Transfer Factor Multi Immune – 2 capsules daily

Maintenance and Prevention 

Remember to stop consuming any sugar immediately, since sugar paralyzes your white blood cells, which provide your body’s first defense against sickness. Make sure you get at least 7.5 to 8.5 hours of sleep each night as well. This treatment program is not for women that are pregnant or breastfeeding.

Throat Infection

  • Zinc – 30 to 50mg lozenges. The topical antimicrobial effect can be important in infections of the throat.
  • Biocidin throat spray – 2 sprays three to five times daily
  • Propolis throat spray – 5 sprays three times daily
  • Argentyn 23 throat spray- 3 sprays three times per day
  • See your doctor for a throat swab to exclude strep throat and/or mononucleosis

Nasal Irrigation

Use a Neti Pot, particular with upper respiratory infection, for three days. 

  • Place one dropper full of Nasya wash into your Neti Pot with warm water and a heaping quarter teaspoon of pure non-ionized Neti Pot Salt. 
  • Stir until salt is dissolved. 
  • Add three drops of Echinacea Anti Cold and Core Phyto Lavage to the solution. Use this to perform the nasal wash as directed by the Neti Pot instructions on the bottle.

Air Spray

  • Add a quarter teaspoon of salt to the bottom of an empty spray bottle. 
  • Add five drops of Thieves, an essential oil by Young Living, on top of the salt as this will help to dissipate it, 
  • Fill bottle with warm water. 

Now you now have an air spray that will assist in lowering counts of viruses, bacteria, and molds in the air. 

  • Spray your home, office, and other areas a couple of times a day. 
  • You can also put Thieves drops into your palms and cup your hands over your face then inhale five or six times. 
  • This will prevent you from contracting a sinus or lung infection, especially during long distance flights.

Dr. Alex Vasquez Recommendations

Dr. Alex Vasquez is an internationally recognized author, presenter, and teacher, particularly with regards to immune related disorders. He earned three doctorate degrees from fully accredited universities in the United States and has worked in various clinical facilities ranging from private boutique clinics to inpatient hospital settings. Dr. Vasquez has published 120 books, articles, letters and editorials in various magazines and peer-reviewed medical journals, including British Medical Journal, Journal of the American Medical Association, Nature Reviews Rheumatology, and Annals of the New York Academy of Sciences.

What follows are his recommendations for viral infections and are not meant to be specific treatments for any infections, particularly coronavirus. I’ve included these references for those curious patients who are always checking out protocols online.  

Antiviral

  • Powdered Glycyrrhiza Glabra – 1.5g BID for a maximum of four weeks. Works as a tea. This is a great expectorant but avoid in heart failure patients, monitor BP and potassium
  • Zinc – Between 20 and 50mg a day
  • Selenium – 400 to 600 ug per day
  • Iodoral Iodine/Iodide – 12.5mg a day for two weeks
  • Melissa officialis – Dose variable depending on formulation
  • Carica papaya leaf extract
  • Grape seed extract (see Biotics Research Bio-Cyanidins below)

Viral Anti-replication

  • SAMe – 400mg TID plus Betaine TMG 3g BID for one week
  • Methyl-Folate – 1.6mg od for one to two weeks
  • Alpha Lipoic Acid – 300 to 400mg TID plus Thiamine 100mg (or B Complex High Potency)
  • NAC – 600mg BID to TID between meals

Immunonutrition

  • Paleo-Mediterranean Diet with no refined carbohydrates 
  • Protectamin Whey Protein – 45g a day for immune dipeptides, if dairy tolerant
  • L-Glutamine powder – 9g TID between meals 
  • Vitamin A – 100,000 IU load for three to five days, then 25,000 to 50,000 IU for two weeks (not during pregnancy)
  • Vitamin D3 – 100,000 to 300,000 IU load for one dose, then 10,000 IU for ten days to increase endogenous antimicrobial peptides
  • Nordic Naturals Arctic Cod Liver Oil without vitamin D – One teaspoon TID with meals
  • Selenium – 600-800mcg/d plus 800 IU vitamin E per day
  • Melatonin – 20mg qHS
  • Ubiquinol CoQ10 – 300mg od to protect the mitochondria
  • Biotics Research KappArest – Three capsules BID as NFKB hijacked by viruses for replication
  • Biotics Research Bio-Cyanidins – One tablet BID (contains marine pine bark and grape seed extract)
  • Biotics Research UltraVir-X – One capsule TID (Red-rooted sage, Boneset, Actratylodes, Sweet Violet, Wheat Grass, Bupleurum, Astralagus, Bee Propolis, Maitake, Black Walnut, Hesperidin, Rutin)
  • Biotics Research POA-Phytolens (Cats’ Claw, Lens esculenta extract) – One capsule TID
  • Consider broad spectrum multi such as Metagenics PhytoMulti at two tablets per day (adjust dosage of Zinc and Selenium above)

Treatment and Vaccines

  • There is no vaccine currently available to combat the current coronavirus outbreak. 
  • The best advice is to protect yourself in some of the ways outlined above and avoid contact with infected individuals or locations where you might encounter potential carriers of the virus. 
  • There’s no specific antiviral treatment that’s recommended for patients with the Covid-19 virus. 
  • Those infected should receive the medical treatment required to deal with their symptoms, including care of vital organs in the most severe cases. 

In Conclusion

  • While we still don’t know everything about the current Covid-19 virus, common sense and taking precautions and preventative measures will be a great help. 
  • The feeling in the medical community is that the virus is likely to become less aggressive and less dangerous over time, as many viruses do, although this is far from certain. 
  • Many viruses adapt, mutate, and continue to live with us everyday. Time will tell if the latest threat will follow the same pattern in the coming weeks and months.

As a final note, in the current circumstances, if you’re suffering from what you’d describe as symptom similar to flu such as a cough, fever, chills, or an aching feeling in the body, please don’t visit the office. If you have an appointment we can do a phone consultation instead or even connect via zoom online. Staying at home will allow you the opportunity to recover and also reduce the likelihood that you’ll pass on the virus to others.

Resources

 Expert consensus on chloroquine phosphate for the treatment of novel coronavirus pneumonia. Zhonghua Jie He He Hu Xi Za ZHi 2020 Feb 20. 43:E019
https://www.ncbi.nlm.nih.gov/pubmed/32150618
 https://www.sciencedirect.com/science/article/pii/S1876034116300181
https://nypost.com/2020/03/05/coronavirus-patient-in-spain-reportedly-recovers-after-being-treated-with-hiv-drug/
https://www.ncbi.nlm.nih.gov/pubmed/32013309/
https://clinicaltrials.gov/ct2/show/NCT04264533
 http://orthomolecular.org/resources/omns/v16n11.shtml
 Epidemic Influenza and Vit D. https://www.ncbi.nlm.nih.gov/pubmed/16959053
 https://www.argentyn23.com/
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Dr Horowitz newsletter 
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What You Need to Know About COVID-19: Part 1

Every day brings a new update about the spread of coronavirus. There are more cases all around the world every day and naturally people are very concerned. There’s certainly not a shortage of stories in the media but is the virus as dangerous as it’s being portrayed? And is the hysteria that’s being generated potentially more damaging than the threat posed by the virus?

In Canada, you can get the very latest updates courtesy of the federal government, including the current situation in different parts of the country, the risk to Canadians, how the government is monitoring the virus, travel advice, and the symptoms, treatment, and risk factors here.

A similar range of information is available for Alberta residents here. For those of you in the U.S. you can access pertinent information here

Mass panic is certainly not going to help the situation but neither will complacency. Despite the fear being whipped up on social media and in the traditional media reports, it’s perfectly natural to be anxious about this situation. This outbreak isn’t to be casually dismissed as it is very serious and everyone needs to accept that and not be in denial. We all need to work together to get through this. We may not know everything about the coronavirus yet and vaccines, treatment and indeed cures are still some way off, but we need to determine strategies that are going to work to protect ourselves and prevent the spread of the virus. So what exactly is coronavirus?

The Virus

Coronavirus is an illness that mostly affects our respiratory system. Doctors are still learning about the virus but it is thought to primarily be airborne, which means that it can be spread from one person to another. When a person coughs or sneezes they produce what are known as respiratory droplets. These can be breathed in by other people that are nearby or left on your hands if you touch your face after coughing or sneezing. In China, the fact that the illness seems to be mainly transmitted to family members, healthcare workers and others in close contact with an infected person strongly indicates the transfer of the virus is by respiratory droplets. The droplets can also remain on objects that have been touched, such as door handles, keyboard, elevator buttons, and many other everyday items. The virus can then spread if a person comes into contact with a surface that’s been contaminated. 

It has been suggested by recent studies that asymptomatic patients are also able to transmit the infection. This means that isolation might not be as effective a weapon against the virus as was previously thought. Researchers followed viral expression through infection through throat and nasal throat swabs in a small select group of patients. The researchers discovered that there were increases in viral loads at the point when the patients became asymptomatic. Doctors in Wuhan, China, studied 425 patients that had the virus. Many of the earliest cases were linked to direct exposure to live animal and seafood markets. However, later cases were unconnected to the animal markets, reinforcing the theory that the virus is transmitted between humans. 

There are believed to be many different types of coronavirus but only 7 of them can cause disease in humans. Some of the coronaviruses that usually affect animals are also able to infect people. The diseases Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) are also caused by coronaviruses that moved to people from animals. Like MERS and SARS, COVID-19 is believed to have originated in bats. Before the illness was brought under control in 2003, SARS infected more than 8,000 people and almost 800 died. 2,465 cases of MERS have been reported since 2012 and 850 people have died. The mortality rate for SARS was around 10%, whereas for MERS the mortality rate is around 34.5%.

The coronavirus that is currently in the news is called SARS-COV-2 (formerly called 2019-nCOV). The disease that it causes has been called Coronavirus disease 2019 (Covid-19). Once someone has the virus, the symptoms can be very mild but for some people they can be very serious and endanger life. Although we’re still learning about COVID-19 it does seem to be milder in its effects than SARS or MERS, with only a 2% mortality rate. Initially, the World Health Organization (WHO) reported that the worst severe cases in China were mostly in adults over 40 years old with significant comorbidities. This means that the patient has more than one chronic medical condition. The illness also seemed to affect more men than women, although this could change as the outbreak continues. As of March 12, 2020, COVID-19 had been confirmed in more than 128,343 people, mostly in China. To date 68,324 people have recovered from the infection. By this date, the virus had caused more than 4,720 deaths and has spread to more and more countries. These websites have information on the global situation that is updated regularly. Keep in mind that an estimated 291,000 to 646,000 people die worldwide from flu every year.

Symptoms of Coronavirus

A person that has Covid-19 might not show any symptoms at all for between 2 and 12.5 days, with the average time being 5.2 days. This one can easily pass it on to others without even knowing that they are infected in the early stages. The average time from infection to symptoms appears to be 12.5 days. The pandemic worldwide appears to be doubling every 7 days and every infected person appears to infect an average of 2.2 others.

Symptoms can include:

  • Fever
  • Cough
  • Breathing difficulties and shortness of breath.

While some of the symptoms are similar to colds and flu that people suffer from throughout the year, there are important differences. With the common cold we suffer from a runny nose and there is sputum or phlegm. This is the mixture of mucus and saliva that we cough up from our lungs when we get sick. With the coronavirus there’s a dry cough but no runny nose. This may occur in a small percentage of patients (4%) but it’s thought this is because they already have some form of flu or cold symptoms.

If nasal congestion does occur with this virus, it is usually very severe. If there is an associated sore throat, it can last for three or four days. The virus might then move to the trachea and lungs, resulting in pneumonia that can last for five or six days. Breathing difficulties and a high fever are also likely at this stage of the illness. People infected might have one or more other symptoms including headaches, muscle pain and stiffness, fatigue, loss of appetite, chills and sweats, a rash, dizziness, stomach upsets, or nausea. Numbers do vary but around 90-98% of people have a fever, 80% a dry cough, and 30% have trouble breathing and extreme fatigue. Acute respiratory distress syndrome developed in about 29 % of patients infected. Even though pneumonia is involved, 80% percent of these cases are mild and the person doesn’t need to go to a hospital. About 15 % had severe infection and 5 % were critical. The Chinese CDC analysis of 44,672 patients reported that the fatality rate on healthy people with no reported comorbid conditions was 0.9%.  

In general, children, younger people, and young adults seem to get mild versions of the illness. Those at the highest risk are people aged 70 to 75 or older that have existing medical conditions such as cardiac problems or pulmonary issues such as emphysema. The virus is also more likely to affect people with weakened immune systems, kidney disease, diabetes, hepatitis B, and cancer.

Protecting Yourself

There are a number of ways that you can protect yourself from being infected by the Covid-19 virus. Many of these are things should be part of our daily routines to prevent the spread of germs and keep our bodies healthy.

  • Washing your hands regularly throughout the day with soap and warm water for at least 20 seconds each time will help to keep infection at bay. 
  • All surfaces of the hands need to be cleaned, front and back, between the fingers and under the nails. You can use an alcohol-based non-toxic hand sanitizer (60% alcohol-based) if there’s no soap and water available. However, always use soap and water rather than hand sanitizer whenever possible. 
  • Always wash your hands before eating and touching your face. This is something you may have heard quite often recently, but infection can be spread via the nose, mouth, or eyes if your hands aren’t clean. Admittedly, the virus can only survive on your hands for between and ten minutes but although that may not seem long you could touch another part of your body in that time and spread the virus. 
  • Things that are frequently touched in the home, workplace or other locations must be regularly cleaned and disinfected with wipes or cleaning sprays. The virus can survive for up to twelve hours if it falls onto a metal surface. On fabric it lives for between six and twelve hours but regular laundry detergent will destroy the virus.
  • Gargling can work to protect your throat from the virus. You can use a standard solution from the drugstore but really one made from salt in warm water is all you really need. 
  • It’s also a good idea to drink plenty of warm liquids such as tea rather than cold drinks, either with or without ice. 
  • Some people have also found bee propolis mouth spray to work well. Propolis is a substance created by bees to protect their hives against bacteria. As a spray it helps to relieve a sore throat or other mouth issues and strengthens the immune systems. It also encourages antioxidants in our bodies. Antioxidants are molecules that neutralize free radicals, which are unstable molecules cause cell damage. CAUTION: Propolis is not to be taken if you have a Honey or Bee allergy.
  • If you’re showing no symptoms and remain healthy, avoid contact with others that are sick since the virus is considered to be airborne and spreads very quickly. It’s believed that the virus can travel between six and eight feet when it’s airborne. 
  • If you are sick with the virus, avoid contact with other so that you don’t help the virus to spread. Stay away from work or school and isolate yourself at home until you can recover. 
  • If you’re coughing and sneezing, try not to do this into your hands but into the crook of your arm or use a tissue to cover your nose and mouth and ensure that tissues are safely disposed of in the garbage. 
  • If you’re sick and have no choice but to go outside your home, wear a mask that covers your nose and mouth. This will stop you from infecting others while you’re out. However, bear in mind that if you don’t already have the virus a mask this will not protect you from catching the virus from an infected person that isn’t wearing a mask.

Resources

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