Whether we like it or not, whether we want to admit it or not, we are in the midst of a pandemic. I didn’t say “middle” of a pandemic, because no one knows how far we are through this thing. Will it end come warmer weather like the flu? Some experts say no, that this pandemic could last months, maybe into next year. Some think it is just a bad version of the flu. I suppose that is true, depending on how you define “bad.” For some, it’s a mild respiratory illness with a fever and cough. For others, it’s an all-out assault on their lungs culminating in death. Imagine what it must be like for hospital staff to witness that, helpless to save them because they don't have the means or enough resources. Imagine the families who lose a loved one. Let’s try to minimize that outcome. Let’s all do our part to "flatten the curve."
Bronze Level – the basics:
Avoid groups of people, especially large groups. However, even a group of two or three can be a problem depending on the previous activities of the other group members.
Avoid people who are sick. If you help someone who is sick, and we all should when possible, try to maintain as much distance as possible. If you can avoid entering their home, do so. Drop off supplies at the door. If you do have close exposure to the sick, avoid the healthy who are at high risk. You can shed the virus for days before you have any symptoms.
If you have to go out in public, try to avoid touching common surfaces as much as possible, things like door handles and grocery carts. Use sanitary wipes when possible.
Avoid touching your face, especially your nose, mouth and eyes until you have washed thoroughly.
Wash your hands properly and often. Soap and water work better than hand sanitizers and hand sanitizers work better than nothing. When using soap and water, apply the soap, lather up, wash your hands with that lather for almost the entire 20 seconds, and rinse. Be sure to get under your nails.
If you cough or sneeze, cover your mouth with a tissue and immediately discard it, or use your bent elbow. Wash your elbow or the clothing you are wearing as soon as possible.
If you are sick, or even think you might be, stay home!
Don't be a hoarder. There will be enough for everyone if everyone just takes enough for their immediate needs.
Silver Level – stepping it up:
Get adequate sleep. Most people need 8-9 hours.
Eat a diet of fresh veggies and fruit, quality protein, whole grains, and healthy fats. Drink plenty of water. Avoid refined sugar and processed foods. Skip the alcohol.
Get moving! Exercise supports the immune system. A walk outside, away from people, is a great way to get out of the house during this time.
Work on reducing your stress level. Stress negatively impacts your immune system. Find ways to have fun.
Humidify your air. Viruses don’t like humidity.
Stop or at least decrease smoking.
If you are at a higher risk due to an underlying condition, continue working with your physician on that condition.
Gold Level – going all out:
There are many evidence-based approaches to enhance immunity and avoid viral and bacterial infections. Below are some of my favorites.
Elderberry
Licorice root
Echinacea
Astragalus
Goldenseal
Oregon Grape
Mushrooms
Vitamin A
Vitamin C
Vitamin D
Zinc
Selenium
NAC
Probiotics
For high risk patients, and those who do get sick, additional support may be needed depending on their individual condition and circumstances.
Finally, for the reading pleasure of those of you who like to geek out on studies... (Much of this research gathering was done by Heather Zwickey PhD)
Beard JA, Bearden A, Striker R. Vitamin D and the anti-viral state. J Clin Virol. 2011;50(3):194-200. doi:10.1016/j.jcv.2010.12.006
Besedovsky, Luciana, Tanja Lange, and Jan Born. “Sleep and immune function.” Pflügers Archiv-European Journal of Physiology 463.1 (2012): 121–137.
Bryant, Penelope A., John Trinder, and Nigel Curtis. “Sick and tired: does sleep have a vital role in the immune system?” Nature Reviews Immunology 4.6 (2004): 457–467.
Cecil CE, Davis JM, Cech NB, Laster SM. Inhibition of H1N1 influenza A virus growth and induction of inflammatory mediators by the isoquinoline alkaloid berberine and extracts of goldenseal (Hydrastis canadensis). Int Immunopharmacol. 2011;11(11):1706-1714. doi:10.1016/j.intimp.2011.06.002
Emamian, Mohammad Hassan, Ali Mohammad Hassani, and Mansooreh Fateh. “Respiratory tract infections and its preventive measures among Hajj pilgrims, 2010: a nested case control study.” International journal of preventive medicine 4.9 (2013): 1030.
Hawkins J, Baker C, Cherry L, Dunne E. Black elderberry (Sambucus nigra) supplementation effectively treats upper respiratory symptoms: A meta-analysis of randomized, controlled clinical trials. Complement Ther Med. 2019;42:361-365. doi:10.1016/j.ctim.2018.12.004
Hsieh H-L, Liu S-H, Chen Y-L, Huang C-Y, Wu S-J. Astragaloside IV suppresses inflammatory response via suppression of NF-κB, and MAPK signaling in human bronchial epithelial cells. Arch Physiol Biochem. February 2020:1-10. doi:10.1080/13813455.2020.1727525
Jamshaid F, Dai J, Yang LX. New Development of Novel Berberine Derivatives against Bacteria. Mini Rev Med Chem. January 2020. doi:10.2174/1389557520666200103115124
Javadi B, Sahebkar A. Natural products with anti-inflammatory and immunomodulatory activities against autoimmune myocarditis. Pharmacol Res. 2017;124:34-42. doi:10.1016/j.phrs.2017.07.022
Kim TS, Kang BY, Cho D, Kim SH. Induction of interleukin-12 production in mouse macrophages by berberine, a benzodioxoloquinolizine alkaloid, deviates CD4+ T cells from a Th2 to a Th1 response. Immunology. 2003;109(3):407-414. doi:10.1046/j.1365-2567.2003.01673.x
Kudo, Eriko, et al. “Low ambient humidity impairs barrier function and innate resistance against influenza infection.” Proceedings of the National Academy of Sciences 116.22 (2019): 10905–10910
Li X, Qu L, Dong Y, et al. A Review of Recent Research Progress on the Astragalus Genus. Molecules. 2014;19(11):18850-18880. doi:10.3390/molecules191118850
MacGregor, Rob Roy. “Alcohol and immune defense.” Jama256.11 (1986): 1474–1479.
Noti, John D., et al. “High humidity leads to loss of infectious influenza virus from simulated coughs.” PloS one 8.2 (2013).
Ouyang, Yanli, et al. “Suppression of human IL-1β, IL-2, IFN-γ, and TNF-α production by cigarette smoke extracts.” Journal of Allergy and Clinical Immunology 106.2 (2000): 280–287.
Qin X, Guo BT, Wan B, et al. Regulation of Th1 and Th17 cell differentiation and amelioration of experimental autoimmune encephalomyelitis by natural product compound berberine. J Immunol Baltim Md 1950. 2010;185(3):1855-1863. doi:10.4049/jimmunol.0903853
Schapowal A, Klein P, Johnston SL. Echinacea reduces the risk of recurrent respiratory tract infections and complications: a meta-analysis of randomized controlled trials. Adv Ther. 2015;32(3):187-200. doi:10.1007/s12325-015-0194-4
Vimalanathan S, Schoop R, Suter A, Hudson J. Prevention of influenza virus induced bacterial superinfection by standardized Echinacea purpurea, via regulation of surface receptor expression in human bronchial epithelial cells. Virus Res. 2017;233:51-59. doi:10.1016/j.virusres.2017.03.006
Yan Y-Q, Fu Y-J, Wu S, et al. Anti-influenza activity of berberine improves prognosis by reducing viral replication in mice. Phytother Res. 2018;32(12):2560-2567. doi:10.1002/ptr.6196
Zakay-Rones, Z., et al. “Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections.” Journal of International Medical Research 32.2 (2004): 132–140.
Immune Modulation From Five Major Mushrooms: Application to Integrative Oncology. - PubMed - NCBI. https://www-ncbi-nlm-nih-gov.liboff.ohsu.edu/pubmed/26770080.
Antiviral activities of various water and methanol soluble substances isolated from Ganoderma lucidum. - PubMed - NCBI. https://www-ncbi-nlm-nih-gov.liboff.ohsu.edu/pubmed/10624872.
The cytokine storm of severe influenza and development of immunomodulatory therapy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4711683/.