I highly recommend this webinar from Israel. The medical leaders there really have their act together. Possible treatments on horizon discussed around 20 minute mark.

WEBINAR FROM ISRAEL MARCH 17

The early part discusses some basics everyone can/should understand.

Some key points.

COVID 19 is an RNA virus. After entering the cell it must use it’s own enzymes to replicate and this is one place an anti-viral might work. (Block replication). DNA viruses can use the host cell’s own DNA replication enzymes/machinery.

Blocking entry into the cell is also a possibility (Chloroquine and Hydroxychloroquine) These drugs (that treat malaria) may be useful in that regard based on small studies in-vitro and in-vivo. I have several papers in my files on both relative to COVID-19 if anyone is interested.

Because RNA viruses mutate quickly, vaccine production is more difficult as compared to DNA viruses (darn!)

Singapore got things under control very quickly because they had a plan ready to go (after experiencing previous virus outbreaks). For example, they had already built a 400 bed hospital with 250 negative pressure rooms just to be used for a SARs type situation. (Large facility for a very small country). They had travel restrictions, stay at home, rapid testing, etc., all immediately in place. Public health teams were immediately dispatched to investigate all contacts and institute isolation and quarantine. Japan seems to have done very similar quick containment. The Japanese culture is also conducive to social distancing and compliance with public health recommendations (they follow rules/recommendations, including the teenagers and young adults,  unlike Americans).

Back to the Israeli Webinar.

So blocking viral entry into the cell and blocking viral replication seem to be the best targets for potential drugs. The Protease Inhibitors used to treat HIV are much less likely to be useful according to the virologist (Susan Weiss) on the webinar. I have already read a paper and editorial in NEJM demonstrating no benefit.

The fatality rate in Germany is about 1/4 that of Italy. These societies are very different. Italian households often include multiple generations, Germany less so.

The virus has hit Northern Italy (colder) much harder than Southern Italy (warmer) and we know that many viruses are temperature sensitive relative to replication/survival/epidemiology.

Also observed has been less viral activity in the Southern as compared to Northern hemispheres.

Israel has been tracking data from multiple perspectives. # cases went from 30 to 300 in one week (double every 2 days approximately, which I have discussed appears to be the case in US). They project 600 cases in 4-5 days (as of the Webinar), 4,000 cases in 2 weeks, and as many as 20,000 cases at peak which they anticipate will be late April or early May.

Israel is working on technologies for remote monitoring of isolated positive patients who are mildly symptomatic and has already converted a building into that kind of facility (US take a hint)

The webinar is an hour long and well worth the time.

I applaud the governor of California for taking decisive action for state wide stay-at-home and essential services open only. This should prevent the degree of crisis seen in the Lombardi region of Italy.

Finally, another note on improving and maintaining your immune status.

Immunity and Morality in COVID-10

There are two general aspects. We must do everything we can to support our immune system and at the same time follow an anti-inflammatory lifestyle so our immune system does not over-react to an infection producing a cytokine storm.

People who develop COVID-19 related pneumonia and progress to multi-organ failure and death follow a path led by excessive inflammation. The immune system produces various inflammatory chemicals and cascading events that are not resolved in time to save the host. The host’s own immune system response causes friendly fire damage and death. What keeps the immune system in check?

Resolvins are produced by humans to contain excessive inflammation. They are produced from the marine omega 3 fats (EPA and DHA) which are widely deficient in modern diets. That is one advantage of the anti-inflammatory diet.

The dietary approach on this website provides for a more healthy intake of  anti-inflammatory omega 3 fats relative to pro-inflammatory omega 6 fats. The latter are consumed in great quantities in the standard American diet.

But that is just one aspect of the diet that can contribute to your body being more able to handle an infection.

With regards to maintaining a properly functioning immune system a few simple lifestyle habits are essential,

1.  Avoid alcohol consumption (alcohol wreaks havoc with your immunity)
2.  Get plenty of sleep (without adequate sleep your immune system does not work well )
3.  You must follow good sleep habits
4.  Exercise, especially out of doors in a green space, supports the immune system
5.  Get some sunshine and make sure you have adequate Vitamin D levels.
6.  Eat an anti-inflammatory diet rich in micronutrients.
7.  Practice stress reduction like meditation and yoga which improves the immune system

Now would be a good time to address all of these areas to enable your body to withstand the stress of social isolation and COVID-19.

Hopefully, with warmer weather coming and most states taking the lead in stay-at-home policy (federal leadership still lacking tremendously) if independent-minded American culture can overcome our innate distaste for following rules we may see a rapid turn-around and ability to resume modest amounts of economic and social activity. But this will take very aggressive behavior changes (especially among the young) and a united-we-stand approach.

More to come so stay tuned. I will stay on top of this crisis and provide filtered and up to date information.

THIS WEBSITE PROVIDES INFORMATION FOR EDUCATIONAL PURPOSES ONLY. CONSULT YOUR HEALTH CARE PROVIDER FOR MEDICAL ADVICE.

Eat clean, drink filtered water, love, laugh, exercise outdoors in a greenspace, get some morning sunlight, block the blue light before bed, engage in meaningful work, find a sense of purpose, spend time with those you love, AND sleep well tonight.

Doctor Bob