Dearest Community Members and All,
I hope this blog entry finds you well during these challenging times. As you are undoubtedly aware, humanity as a whole is facing an unprecedented challenge from a microscopic threat known as the coronavirus or COVID-19. As we know from our history, a time of crisis is also a time of opportunity. In this new era of social distancing and with the worldwide spread of this virus, we have a chance for the first time in our collective history to all truly be in this together. No matter what age, race, ethnicity, socioeconomic background, or any other part of your identity, we are all either directly or indirectly at risk by this virus and by the broad implications of its existence. From school closings to businesses to seemingly draconian shifts in our daily life by national closures and shelter in place policies, we are effected by this. We are all facing on a global scale something no one could have anticipated or predicted just a few weeks ago.
I would humbly offer that one of the lessons we are learning is that we are truly all one and part of one interconnected global community, in the best and the worst of times. Not recognizing our interdependence has led to restrictive policies and politics of division that have long separated us from collectively achieving our best potential and experiencing all the gifts of life in a socially just world. So, as we panic and fear the worst, let us also recognize how our fates are ultimately tied together as one human race. Our survival depends on our unified learning and sharing of knowledge, resources and perspectives to better understand and appreciate where each of us is coming from.
If knowledge is truly power then right now many of us feel powerless as our experts are still lacking all the knowledge there is to fight and prevent this life-threatening condition. In terms of the science of the virus, we as physicians and medical professionals are daily humbled by what we see and what we learn. We know that the virus can be spread through personal contact primarily through droplets and to a much lesser extent from infected surfaces. We know that it spreads much more rapidly than the flu or other viruses and while the exact mortality rate is not determined, it appears to be more deadly in its present forms. While conditions vary depending on where we are, it is clear that social distancing is the new norm. We must accept our temporary discomfort for long term success to save lives and save our society at large.
What Do I Do?
As a family medicine physician trained in public health, I highly recommend that we all turn to our public health experts for guidance on what makes the most sense. In the U.S., the CDC along with aligned city, state and other public health departments are our best source for information. Globally the World Health Organization has a great resource page for all. Based on my read of the current reality that will continue to change, I recommend we avoid unnecessary travel outside of the house and limit this to needed trips to the grocery store, pharmacy and financial institutions. I agree with our experts who have suggested for those of us who are not living in a part of the world that is temporarily shut down to act as if we could potentially be carriers of the virus and that for the time being we should all strive to #stayhome.
Thankfully, we are in a much better condition to conduct life virtually than we ever have been before. Think to yourself, for those of you who remember, what it would have been like if this had happened 20 years ago or even just 10 years ago?
How would we get information to everyone so quickly? How would we continue to stay connected without these communication tools? While inconvenient and temporarily detrimental to business, many aspects of life can still remain in through virtual connections. Many communities have engaged in video conferencing and novel ways to stay connected.
WHAT CAN I DO TO AVOID INFECTION AND RECOVER WELL IF SICK?
The best thing we can do is avoid others outside of our household in person as much as possible in order to avoid coming into contact with the virus. This is truly the best strategy to prevent it. Other than that, we must follow all of the guidance of the CDC.
If despite our best efforts to #stayhome and minimize contact by following the guidelines we still get infected, we know that the healthier you are prior to getting the infection the better off you are in terms of fighting it off and recovering from it without significant harm. So, the healthier you are going in determines how well you do coming out.
In terms of our immunity and preventing COVID-19 infection, I recommend the following at this time based on available evidence and will update as new knowledge comes to our attention:
1) As mentioned in the CDC guideline, wash your hands! Think Coronatime Hamster or whatever image you like to remind yourself, 20 seconds or more with plenty of bubbles to clean those hands! And keep your social distance while maintaining your connection with others through technology.
2) Get adequate sleep, research has shown that shorter sleep duration increases the risk for viral infections most notably cold notably cold viruses. Adequate sleep also maintains adequate melatonin levels which we are learning may play a role in the severity of coronavirus infections. While sleep is the best way to get this, in some cases, depending on you health history and conditions, you may also benefit from supplementing melatonin at bedtime.
3) As difficult as it may to achieve, reducing stress will also enhance immunity and help us resist this virus. Stress levels are directly associated with higher levels of pro-inflammatory cytokines in the body. These molecules increase our risk for infections and worsen our ability to fight them off. Remember, being acutely stressed or angry can lower your immune system for a number of hours while laughing can raise it. The Andrew Weil Center for Integrative Medicine has some great resources for stress reduction on their Integrative Approaches to Covid-19 site.
Another way to lower stress and enhance your immune system is to connect with that which is most meaningful in life for you and your own sense of purpose. This would include investing time in your most important personal relationships with loved ones and close friends, in person or virtually as it were. Try stress reduction apps, stay connected at least virtually with friends and family, and consider personal mind body practices like yoga, tai chi or meditation to lower your stress level. Time for reflection and prayer or meditation may be more important than ever these days to adjust our perspective and recognize the gift of health and life that we all enjoy every day.
4) In using food as medicine, avoid processed foods as usual and try to eat more plants. Increase your consumption of fruits and vegetables. Antioxidants in plants are protective from both chronic diseases and acute infections, the more the better.
5) Exercise is medicine. Even though we are trapped in our homes with all the precautions we have to take, now is the time to do things we never got to before like sit ups, push ups and home exercise programs. Youtube can be helpful for this as well as anything that gets you active, even just going for a walk when you can or simple activities at home. Exercise builds immunity and strengthens our ability to resist disease, as we age muscle mass declines but being active allows us to retain adequate muscle to stay healthy.
6) Consider a zinc supplement, usually as little as 15 mg a day again depending on your health condition as discussed with your doctor. What we are learning now is that coronavirus penetrance into our cells and the severity of the infection itself can both potentially be diminished with the antioxidant activity of zinc.
7) Vitamin C has been shown to decrease incidence, severity and duration of cold virus infections and incidence of pneumonia, usually a minimum of 1 gram a day will help keep the doctor away.
In an effort to help as much as I can personally, I will continue to send updates as we learn more and also be available for online telemedicine consultations via secure zoom video conferencing internationally. Please feel free to message me through this website to learn more and ask me any health related questions you may have join our community to get updates with new articles and upcoming IGlive and FBlive events.
Wishing you and your entire family all the best in health as we strive to not only survive, but also to thrive in as many ways as possible in this challenge of our times together.
Dr. Shad (Farshad Fani Marvasti, MD, MPH) is a Stanford-trained medical doctor, associate professor in academic medicine, speaker, and author with expertise in nutrition and culinary medicine, wellness, public health and prevention.
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