We have new information from the Chinese data and other resources on the behavior of the virus, and options fro protection from the corona virus that will help us understand the disease better and how to handle it. After the huge epidemic that started in Wuhan, China, the thousands of people who contracted the virus and the deaths of so many of their population, the Chinese now understand the behavior of the Covid 19 virus better than anywhere in the world. We can thank them for doing autopsies on those who died and had the virus and the results that these pathology evaluations have provided. The Italian experience has also given us great incite into this viral pandemic.

Of those who contract the disease, if all goes well with appropriate medical care and good health, around 98% of patients survive the disease, but around 2% suffer such severe respiratory problems that they die, unable to recover from the disease primarily due to the lung problems the disease causes. If they survive the acute episode, lung problems tend to be worse by days 10 to 13 of the illness, and resolution of the radiological signs and the symptoms by after 14 days.[1a

Thus, there is HOPE. Even if you get the virus, there’s a good chance that you will survive, assuming you are healthy and do protective actions that improve your chances. We will discuss many of the actions that you can do to help you survive the coronavirus infection.

Symptoms of Coronavirus

Due to the prominent lung involvement, the most common symptoms following infection by the virus that will give you a clue that you might be getting the viral illness are fever, cough, and shortness of breath. Other symptoms of the virus include sore throat, chills, diarrhea, vomiting, muscle aches, malaise, abdominal pain, and a severe headache.

If you just have a scratchy throat and no fever, or you feel a little achy, most likely you don’t have the corona virus and it could be something else, such as a cold, flu, allergies, etc. For those who have been prescribed the Coronavirus combo protocol of hydroxychloroquine[2] and azithromycin, you should depend more on the more common symptoms listed above before you start taking the meds.

Of note, there are few interactions of the use of these two medications. One rare interaction problem could be development of arrhythmias in around 0.35%[3] of those who took this combo. Since the incidence of death from coronavirus is up to 4%, the risk: benefit ratio favors use of the two meds. In other words, it most likely won’t hurt you, but could benefit you markedly.

Lung Changes from Coronavirus Infection

The viral illness, when symptomatic, is characterized by obstruction of the lung pathways (the bronchi) with thick mucous that thickens and may obstruct the airways. With obstructed airways, you get poor ability to breath in oxygen and exhale carbon dioxide, and when severe results in asphyxiation with subsequent cardiac failure and death in those 2%-4% who progress.

In order to treat these lung problems, one must open the airways to give medications that could help this problem. However, this may take a few days, and may require support in the ICU with respirators. Acute respiratory distress syndrome (ARDS) may occur,[1] which is a very severe pulmonary condition with a very high death rate, resulting in worsening inflammation to the lungs and a poorer prognosis.[4]

What You Can Do if You Get the Corona Virus

The Chinese experience has suggested that there are potentially 10 modifiable actions that you can do to help you fight the infection. These have not been verified as being effective, but the Chinese feel these actions work. They are relatively safe things you can do, so it’s advisable to do them, whether you are trying to prevent the disease or you see signs of the viral illness.

  1. Drink lots of hot liquids: These can include beverages such as coffee, teas, hot soups, warm water, etc. Consider taking sips of these every 20 minutes if you have symptoms of the disease. Doing so may regularly wash any virus particles that may be in your mouth down into your stomach where the acid in the stomach gastric juices can neutralize (kill) the virus. Transmission of the virus through the mouth is probably the most common route.
  2. Gargle with an antiseptic in warm water. Consider using a mixture of half a lemon, ½ to 1 teaspoon of vinegar or salt in a glass of warm water.
  3. Wash your hands regular, and thoroughly, especially after touching surfaces that may have been contaminated with the virus. As a general rule, that could be anybody’s hands, mouth, or even inanimate surfaces. Wash with any soap that produces a foam, and wash for 20 seconds.
  4. Shower with soap and hot/warm water every day. Every morning is fine, but ideally, when you get home after being on the street or outside your house, you should avoid sitting down anywhere and go straight to take a shower immediately after you get home with lots of soap and water.
  5. Wash your clothes daily. If you cannot wash your clothes daily, hang them in direct sunlight which also neutralizes the virus.
  6. Wash all surfaces regularly, especially metallic surfaces. The virus may remain viable on metallic surfaces for up to 9 days. If you touch these in a public area, wash your hands with soap and water and don’t touch you face, especially your eyes, nose and mouth. Regularly clean handles, rails and door handles in your house. Note that anti-bacterial solutions will not work. This is not a bacterium; it is a virus. You must use a dilute solution of Clorox. In 1 liter of water (around one quart), add 10 cc (around 1/3rd ounce or 2 teaspoonfuls) of bleach (5.25% sodium hypochlorite), or a 1:100 bleach:water solution.[5] Use a sprayer bottle and let it sit for a few minutes before you wipe it off.
  7. Don’t smoke! This really decreases your immune system and ruins your lungs making it easier for the virus to produce its nasty and deadly effects on your lungs. Smoking is a death wish, not only for this virus, but for other causes of death.
  8. Eat plenty of vegetables and some fruit. These have many immune-boosting ingredients that improve your bodies’ ability to fight off infections. Mix them, and do lots of colors, not just green, but red, yellow, and purple.
  9. Avoid getting the flu or a bad cold. This increases your risks of lung inflammation before you even get the virus. How do you avoid these? We recommend you decrease any type of severe temperature shifts or other stress on your body. When temperatures go down (or up) rapidly, this can reduce your resistance. The viruses that you’ve already been exposed to may be in your body already, but you don’t have symptoms because your good immune system fights them back. However, when your resistance is low, i.e. your immune system is shocked from the stresses and its efficiency is not so good, these viruses lurking within you tend to multiply rapidly because your weakened immune system can’t fight them off, so you get the colds and viral conditions even though you can’t even remember being exposed to anyone with them. Thus, keep your immune system maxed up by avoiding stresses, including large temperature shifts and other stresses to your body.
  10. If you feel symptoms of viral infections, attack it immediately. If you have a sore throat or raspy throat, use the above methods to reduce the potential viral load into your lungs. The virus can enter your body primarily through your mouth, and it appears to stay in your mouth for 3-4 days before it passes into your lungs. Thus, the warm water sips regularly and the antiseptic gargles are good things to do to avoid you getting a severe case of the coronavirus. Avoid cold drinks, especially cold sugary drinks.

Other Actions You Can Do

We also recommend that you take supplements that are immune boosters. Boosting your immune system to more efficient levels may enable you to fight off the virus better. These supplements include Zinc, vitamin C, curcumin, resveratrol, green tea extract, quercetin, and omega 3 fish oils. These may all boost your immune system. Make sure you maintain high levels of vitamin D, so take around 5,000 u per day. Note that we have all these great quality products at our office at the correct dose if you would like to purchase them from us.

Along with these products are peptides that boost your immunity. These are nature’s natural signaling compounds that tell the cells of your body to be more efficient. In the case of the peptides for the coronavirus, called the Thymosin’s, they activate your immune cells to be more active against invaders to your body, such as viruses, including the corona virus. Read more about these on this blog.

Another option for protection is to prescribe two medications: Hydroxychloroquine (or chloroquine) and azithromycin for around 5 days if you get the symptoms of the viral condition (noted above). Presently, the lab test for the coronavirus takes around 5 days to come back. In the meantime, you may become quite ill. This combination may decrease the severity of the viral illness through multiple pathways and has been shown to work anecdotally. You would essentially start and finish the course of treatment before you would even know if the coronavirus lab test was positive or negative. If you waited for the test, the severity of the illness could become much worse.

We offer office visits and telemedicine visits/consults to discuss these options. There are side effects from these medications that must be discussed before prescribing them and we need to see if you are a candidate for use of them. If you’re interested, call use to book a consultation. Understand that all these options are not approved treatments by the FDA. Per FDA requirements, we must tell you that the statements we use for usage of supplements, or any modalities not approved by the FDA, are not intended to say they prevent, diagnose, treat, or cure any disease.

Social Distancing Concepts

There are a lot of people who are critical of President Trump’s and the CDC’s recommendations of social distancing. Anyone who thinks that this social distancing is not necessary and is creating great havoc in our society obviously does not have a grasp of the situation. This contrary thought is very damaging to the nation and potentially very harmful to others and to those who say this.

The purpose of Social distancing is to prevent the rapid spread of the virus. If there is one thing that we can learn from the Italian and Wuhan experiences of the rapid invasion of the coronavirus throughout their countries it is this: we must prevent the rapid spread of the virus, which will happen (for sure) if we just allow everyday life to occur, people to gather closely, planes to fly to and from where ever, and business with close contacts to occur like always. By limiting all this, it allows the spread of the disease to occur slowly, to slowly utilize and hopefully have enough of the great medical resources available for all of us who need them without overwhelming the system.

None of us have any immunity to this virus and it is very contagious. Most likely almost all of us will get the disease sooner or later. However, if allowed to spread rapidly, we would see thousands of cases of the coronavirus illness rapidly, which will overwhelm our medical system. Anywhere from 10% to 20% of people who contract the virus will require respiratory support and treatment in ICU’s with respirators. There’s not enough of these available if a huge number of people get the viral disease at the same time.

Thus, there would be some people with serious lung complications from the virus (as discussed above) who will be left out and will not have access to these wonderful medical modalities, such as respirators. The consequence of this is that they have more chance of dying. And this is what happened with the Italian situation. Their mortality rates went up to 8%, while most endemic areas with adequate resources and social distancing concepts in place have mortality rates much less, around 2% to 4%.

Bottom-line, President Trump and the CDC are saving the lives of thousands of people in the United States. This is prevention, and we don’t always see the effects of prevention since the ones who would have gotten the severe disease, didn’t, so it’s not too apparent. We have to look at the studies to get the right answers. And the Italian and Wuhan situations are proof that without social distancing the results are much more devastating than with it.

Granted, this social distancing is causing tremendous economic turmoil: people are losing jobs, the stock market is tanking, there may be a terrible global recession. But what if it were your mother or father who didn’t get that respirator or ICU bed? You can see how important this concept it.

You’ll get another job in time, the market will bounce back eventually, the recession will also bounce back eventually. But you won’t get your parents back if they die of the virus, which could be more likely if all of the US didn’t take this very drastic position.

Conclusion

In conclusion, there are many lung changes that occur in people infected with the coronavirus. If extreme, admission to ICU and respirator support are necessary, for severe lung conditions can develop such as ARDS. These can result in death, although the majority of people who contract the virus survive.

There are many actions that you can take to help prevent yourself from getting the coronavirus, and there are protective options that could potentially help you, although not approved by the FDA. The concept of social distancing is perhaps the best action we all can presently do to prevent the overwhelming spread of the virus that would also overwhelm our medical system and result in not having enough facilities for those severely ill, which most likely would subsequently and markedly increase the death rate from the disease.

If you would like to discuss your options more thoroughly and get some of these modalities, call and make an appointment for a consultation. We do offer telemedicine consults to allow for further social distancing to be maintained.

References:

[1] Lai, CC, et al.  Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Internat. Journ of Antimicrobial Agents. 55(3), march 2020, 105924. doi.org/10.1016/j.ijantimicag.2020.105924

[1a] Pan, F. et al. Time Course of Lung Changes On Chest CT During Recovery From 2019 Novel Coronavirus (COVID-19) Pneumonia. Radiology, Feb 13 2020https://doi.org/10.1148/radiol.2020200370

[2] Specific Antiviral Therapy in the Clinical Management of Acute Respiratory Infection with SARS-CoV-2 (COVID-19). Link

[3] Sbaih N, et al. Potentially Serious Drug Interactions Resulting From the Pretravel Health Encounter, Open Forum Infectious Diseases, Volume 5, Issue 11, November 2018, ofy266, https://doi.org/10.1093/ofid/ofy266

[4] Xu Z, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. The Lancet Respiratory Medicine.February 18, 2020.  DOI:https://doi.org/10.1016/S2213-2600(20)30076-X

[5] The Use of Bleach. https://www.info.gov.hk/info/sars/en/useofbleach.htm

https://www.ncbi.nlm.nih.gov/books/NBK214356/