I am a practicing physician, board certified in Anesthesiology and Internal Medicine with Certificate of Special Qualifications in Critical Care. My interests include the effects of lifestyle on health and health care policy.
There is great overlap in symptoms and physiology of Long Covid and ME/CFS (Myalgic Encephalitis/Chronic Fatigue Syndrome.
Both are marked by Brain Fog, Cognitive Impairment, Post Exertional Malaise, with similar findings on studies of the immune system and the neuro-endocrine system in these conditions.
Here is a picture of organ involvement with CFS:
And here is a picture of Long Covid.
Do you notice the similarities and overlap?
The theories/clinical findings of studies regarding both have overlap:
Low Dose Naltrexone has been studied for many chronic ailments in small studies. Since this is available in generic form there are no big profits to be made by the pharmaceutical industry so do not expect large studies with this medication. (I wish NIH would get on the ball and fund studies of this and other interventions utilizing nutraceuticals such as Rhodiola).
Here is a very hopeful study with regards to Long Covid and Low Dose Naltrexone.
Recovery from symptoms, activities of daily living, energy level, pain, concentration, sleep quality and mood ALL IMPROVED!
If this were a patented drug it would be a BLOCKBUSTER for a pharmaceutical company.
And since Chronic Fatigue Syndrome represents a major portion of Long Covid patients, pathophysiology AND symptoms, here is a study of an adaptogen called Rhodiola (a plant nutraceutical in the category of ADAPTOGEN).
Look at the amazing improvement in major components of CFS/ME which represent the major complaints of many patients with Long Covid.
Post Exertional Malaise, Concentration, Memory and Sleep ALL IMPROVED by more than 50% within eight weeks.
But this is an over the counter supplement, so again, no big profits for big pharma.
You will note the diversity of clinical applications for Low Dose Naltrexone including autoimmune disease (one possible mechanism of long Covid), neuro-inflammation (another probable mechanism of Long Covid and ME-CFS).
In the context of the COVID 19 pandemic I will close with the usual summary.
Exercise, especially out of doors in a green space, supports the immune system
Get some sunshine and make sure you have adequate Vitamin D levels. Supplement with Vitamin D3 to get your levels above 30 ng/ml, >40ng/ml arguably better.
Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.
Eliminate refined-inflammatory “vegetable oils” from your diet, instead eat healthy fat.
Clean up your home environment and minimize your family’s exposure to environmental toxins by following recommendations at EWG.org with regards to household products, personal care products, and organic foods. (https://www.ewg.org/)
Drink water filtered through a high quality system that eliminates most environmental toxins.
If you are eligible for vaccination, consider protecting yourself and your neighbor with a few jabs. Age > 50 and/or risk factors (Diabetes, pre-diabetes, insulin resistance, hypertension, obesity, heart disease, COPD, asthma, cancer treatment, immune suppression) suggests benefit from a booster. Risk for complications of boosters in adolescents, especially males, without risk factors, may equal benefit. Previous infection with Covid can be considered as protective as a booster. Discuss risk vs benefits with your doctor.
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.
SARS CoV-2 virus is spread by aerosols. These aerosols contain many viruses carried in a tiny amount of liquid from a person’s mouth and nose as they breath, talk, sing, or yell. Yelling, singing, coughing, sneezing produce more aerosol than breathing. Risk of transmission in a room depends on duration of exposure (time in the room), amount of ventilation, # of individuals carrying the virus present and their activity . A 5 micron aerosol can stay suspended in air for 30 minutes indoors.
HEPA filters (High Efficiency Powered Air-filters) can dramatically reduce the number of aerosols in a room. This includes not only virus carrying aerosols but also small particulate pollutants, both of which impact the health and safety of children and adults in classrooms, meeting rooms and businesses.
HEPA filters range in price from $150 to $800 or more depending on quality, efficiency and how quiet they run. They have been tested in classrooms and hospitals.
In the hospital setting they have dramatically decreased COVID Virus.
To determine how the filters stand up to real-world conditions, Navapurkar and his co-authors installed them in two fully occupied COVID-19 wards — a general ward and an ICU. The team chose high-efficiency particulate air (HEPA) filters, which blow air through a fine mesh that catches extremely small particles. The researchers collected air samples from the wards during a week when the air filters were switched on and two weeks when they were turned off.
In the general ward, the team found SARS-CoV-2 particles in the air when the filter was off but not when it was on. Surprisingly, the team didn’t find many viral particles in the air of the ICU ward, even when the filter there was off. The authors suggest several possible reasons for this, including slower viral replication at later stages of the disease3. As a result, the team says that measures to remove the virus from the air might be more important in general wards than in ICUs.
An Engineering professor and Dean at UC Davis, Richard Corsi, tweeted the design of an inexpensive homemade air filter providing the equivalent aerosol clearing capacity as an expensive manufactured HEPA filter. A colleague in Texas built one with simple components from a hardware store. The result was called the Corsi-Rosenthal box.
Made with four MERV 13 Airfilters, a box fan , duct tape and cardboard.
Dr. Corsi is an expert in the engineering of HVAC systems. He has researched methods to improve indoor air quality and published many scientific studies involving the interaction between pollutants and indoor materials. He estimates that the cost of a home-made Corsi-Rosenthal box is $4.50 per year per student to build and run based on average class size in the US. These are easily made with simple components and instructions available on-line. In fact if you search YouTube you will find many short videos on how to build these in 20 minutes. Their construction and use could easily be a classroom activity.
Here is a picture of the Corsi-Rosenthal box from Wikipedia:
One box can help to improve the air quality in an average size classroom, offering the equivalent of 7 to 8 air changes an hour.
These boxes would not only benefit health by decreasing circulating virus containing aerosols but also filtering out indoor pollutants that come from latex paint, carpet fibers, cleaning chemicals, air fresheners, fire retardants on furniture and clothing, which all release volatile organic compounds (VOCs) that cause lung damage, increase risk of asthma and autoimmune disease. So why have these not been widely used in our schools, homes, and businesses?
Why has the CDC not recommended this simple and inexpensive highly effective risk reduction approach? If widely implemented soon after Drs. Corsi and Rosenthal invented and advocated it’s use, it would have prevented many infections and allayed some of the fear and anxiety of teachers, students and parents. As the flu season approaches, and with the added risk of a triple threat presented by RSV, Influenza, and Covid, all transmitted by aerosol, now would be a great time to build some for your home, business, office or your chidren’s school classrooms.
In the context of the COVID 19 pandemic I will close with the usual summary.
Exercise, especially out of doors in a green space, supports the immune system
Get some sunshine and make sure you have adequate Vitamin D levels. Supplement with Vitamin D3 to get your levels above 30 ng/ml, >40ng/ml arguably better.
Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.
Eliminate refined-inflammatory “vegetable oils” from your diet, instead eat healthy fat.
Clean up your home environment and minimize your family’s exposure to environmental toxins by following recommendations at EWG.org with regards to household products, personal care products, and organic foods. (https://www.ewg.org/)
Drink water filtered through a high quality system that eliminates most environmental toxins.
If you are eligible for vaccination, consider protecting yourself and your neighbor with a few jabs. Age > 50 and/or risk factors (Diabetes, pre-diabetes, insulin resistance, hypertension, obesity, heart disease, COPD, asthma, cancer treatment, immune suppression) suggests benefit from a booster. Risk for complications of boosters in adolescents, especially males, without risk factors, may equal benefit. Previous infection with Covid can be considered as protective as a booster. Discuss risk vs benefits with your doctor.
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.
Vax skeptics continue to claim that deaths and side-effects of the vaccine have been under-reported and the risk-benefit ratio of vaccines has been under-estimated. Many claim that the vaccine has produced more harm than good.
I do not agree.
Recently a UK cardiologist has been interviewed in the social media, claiming to have published in a “peer-reviewed journal” the dangers of vaccinations. But the media-hyped reports of his “peer-reviewed” paper have failed to report scientific debunking of his claims.
You can enjoy the debunk here.
this is worth the time.
Dr. Seheult, a quadruple boarded physician, produces on-line medical education and reviews for the lay public on many medical issues including COVID-19, vaccinations, and misinformation. He discusses excess mortality (deaths higher than expected based on historical seasonal variations) in a superb video here.
Very much worth a watch.
Summary:
During the pandemic, excess death spikes correlated with surges in Covid-19 infections not with vaccination.
Potential causes include Covid infections, decreased cancer screening and treatment, hesitancy to seek necessary medical care (emergency rooms and office visits), overburdened hospital and out-patient care because of Covid infections (limited ICU beds, hospital beds, primary care visits, etc.). With limited resources including staff, ICU beds, hospital beds, and primary care, when these resources are filled by Covid surges, patients with other needs do not get the usual care they deserve. Likewise, many patients avoid seeking medical care out of fear.
Other contributing factors likely include social isolation, depression, lack of exercise, lack of sunshine, disturbed sleep, pandemic anxiety, pandemic related stress all of which increase risk of acute and long-Covid as well as other medical problems.
In the context of the COVID 19 pandemic I will close with the usual summary.
Exercise, especially out of doors in a green space, supports the immune system
Get some sunshine and make sure you have adequate Vitamin D levels. Supplement with Vitamin D3 to get your levels above 30 ng/ml, >40ng/ml arguably better.
Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.
Eliminate refined-inflammatory “vegetable oils” from your diet, instead eat healthy fat.
Clean up your home environment and minimize your family’s exposure to environmental toxins by following recommendations at EWG.org with regards to household products, personal care products, and organic foods. (https://www.ewg.org/)
Drink water filtered through a high quality system that eliminates most environmental toxins.
If you are eligible for vaccination, consider protecting yourself and your neighbor with a few jabs. Age > 50 and/or risk factors (diabetes, pre-diabetes, insulin resistance, hypertension, heart disease, COPD, obesity, immune suppression, asthma) suggests benefit from a booster. Risk for complications of boosters in adolescents, especially healthy males, without risk factors, may equal benefits. Previous infection with Covid can be considered as protective as a booster. Discuss risk vs benefit with your physician.
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.
An excellent article recently published in the Atlantic was so well written that I have cut and pasted important snippets to help create this post. The review confirms many findings uncovered in my reading of several scientific publications.
20 to 30 percent of patients report brain fog three months after their initial infection, as do 65to85 percent of the long-haulers who stay sick for much longer.
Of long COVID’s many possible symptoms, brain fog “is by far one of the most disabling and destructive,”
It is more profound than the clouded thinking that accompanies hangovers, stress, or fatigue.
It is almost always a disorder of “executive function”—the set of mental abilities that includes:
focusing attention,
holding information in mind, and
blocking out distractions.
Patients state they often lose focus mid-sentence.
Difficulty with simple tasks impairs activities of daily living.
“I couldn’t unload a dishwasher, because identifying an object, remembering where it should go, and putting it there was too complicated.”
The memories are there, but with impaired executive function, the brain neither chooses the important things to store nor retrieves that information efficiently.
Most people with brain fog are not so severely affected, and gradually improve with time. But even when people recover enough to work, they can struggle with minds that are less nimble than before.
“I’ve had surgeons who can’t go back to surgery, because they need their executive function,” Monica Verduzco-Gutierrez, a rehabilitation specialist at UT Health San Antonio.
That specific constellation of problems also befalls many people living with HIV, epileptics after seizures, cancer patients experiencing so-called chemo brain, and people with several complex chronic illnesses such as fibromyalgia.
People with brain fog also excel at hiding it: to protect their jobs when still able to work, or to protect their reputation, or out of embarrassment.
“I know my value in many people’s eyes will be diminished by knowing that I have these cognitive challenges.”
Individuals with previously above average cognitive ability often test “normal” but suffer significant loss compared to their prior ability.
A team of British researchers analyzed data from the UK Biobank study. The findings revealed structural changes in the brain with loss of tissue on MRI scans that correlates with symptoms.
They found that even mild infections can slightly shrink the brain and reduce the thickness of its neuron-rich gray matter. At their worst, these changes were comparable to a decade of aging.
They were especially pronounced in areas such as the parahippocampal gyrus, which is important for encoding and retrieving memories, and the orbitofrontal cortex, which is important for executive function.
In most cases the virus probably harms the brain without directly infecting it.
Inflammatory chemicals can travel from the lungs to the brain, where they disrupt cells called microglia (immune cells in the brain).
In their presence, the hippocampus—a region crucial for memory—produces fewer fresh neurons, while many existing neurons lose their insulating coats (demyelination), so electric signals now course along these cells more slowly.
These are the same changes seen in cancer patients with “chemo fog”.
Neuro-inflammation is “probably the most common way” that COVID results in brain fog, but that there are likely many such routes, such as reactivation of dormant viruses such as Epstein-Barr virus, which has been linked to conditions including ME/CFS and multiple sclerosis.
These problems can be exacerbated or mitigated by factors such as sleep and rest, which explains why many people with brain fog have good days and bad days.
Although other respiratory viruses can wreak inflammatory havoc on the brain, SARS-CoV-2 does so more potentlythan influenza.
For adults following SARS CoV-2 infection:
risks of cognitive deficit (known as brain fog), dementia, psychotic disorders, and epilepsy or seizures were still increased at the end of the 2-year follow-up period.
For children following SARS CoV-2 infection:
in the 6 months after SARS-CoV-2 infection, children were not at an increased risk of mood (HR 1·02 [95% CI 0·94–1·10) or anxiety (1·00 [0·94–1·06]) disorders, but did have an increased risk of cognitive deficit, insomnia, intracranial haemorrhage, ischaemic stroke, nerve, nerve root, and plexus disorders, psychotic disorders, and epilepsy or seizures (HRs ranging from 1·20 [1·09–1·33] to 2·16 [1·46–3·19])…. Unlike adults, cognitive deficit in children had a finite risk horizon (75 days) and a finite time to equal incidence (491 days).
The fact that neurological and psychiatric outcomes were similar during the delta and omicron waves indicates that the burden on the health-care system might continue even with variants that are less severe in other respects.
There are no proven drug treatments for long-haulers.
But there is hope.
Cancer researchers have developed drugs that can calm inflamed microglia in mice and restore their cognitive abilities;
“Metformin can promote the regeneration of neural precursor cell populations and improve cognitive function in a preclinical model of cranial radiation and a pilot clinical study of children after cranial radiation and chemotherapy.”
With regard to long-haulers, better sleep, healthy eating, and other generic lifestyle changes can make the condition more tolerable. Breathing and relaxation techniques can help people through bad flare-ups; speech therapy can help those with problems finding words.
“Some people spontaneously recover back to baseline,”
The largest group of long-haulers—those whose brain fog has improved but not vanished, can “maintain a relatively normal life, but only after making serious accommodations,”
Patients struggle to make peace with how much they’ve changed and the stigma associated with it, regardless of where they end up.
People with ME/CFS learned this lesson the hard way, and fought hard to get exercise therapy, once commonly prescribed for the condition, to be removed from official guidance in the U.S. and U.K.
In summary:
Brain fog can occur even after mild or asymptomatic Covid-19.
Although many patients improve over time, many are left with disability that can range from mild to incapacitating.
Although these symptoms can occur following any viral infection, SARS CoV-2 seems to produce this with greater frequency compared to other viruses.
Chronic brain inflammation is the likely cause in many individuals.
Reactivation of Epstein Barr and/or other dormant viruses is suggested by various immune markers.
The immune signature also suggests an immune response that mimics persistent infection in the absence of live SARS CoV-2 virus.
Post exertional malaise following physical or mental exercise is a common and debilitating symptom without proven treatments. However there are guidelines that may help mitigate this devastating condition.
Exercise, especially out of doors in a green space, supports the immune system
Get some sunshine and make sure you have adequate Vitamin D levels. Supplement with Vitamin D3 to get your levels above 30 ng/ml, >40ng/ml arguably better.
Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.
Eliminate refined-inflammatory “vegetable oils” from your diet, instead eat healthy fat.
Clean up your home environment and minimize your family’s exposure to environmental toxins by following recommendations at EWG.org with regards to household products, personal care products, and organic foods. (https://www.ewg.org/)
Drink water filtered through a high quality system that eliminates most environmental toxins.
If you are eligible for vaccination, consider protecting yourself and your neighbor with a few jabs. Age > 50 and/or risk factors means clear benefit from a booster.
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.
My friend Diana Rogers, started the Global Food Justice Alliance. This organization brings unbiased science to the discussion of meat consumption as it relates to health AND the environment. As discussed previously (see regenerative agriculture posts), properly raised ruminants (beef, pork, lamb, etc.) are ecologically sound, help create soil and fight climate change, and provide important nutrient dense food for people of all ages. The anti-meat narrative in popular media presents a false and dangerous position that threatens our environment, soil conversation/creation, and health.
Regenerative sustainable agriculture (depicted on the right) , minimizes use of fossil fuel and fossil oil based fertilizer. Instead it utilizes ruminant animal waste for fertilizer, creates living soil and biologic diversity. Mono-agriculture depicted on the left, destroys soil, depletes nutrients in food, contaminates our food with pesticides, creates downstream runoff environmental degradation, and contributes to climate change. The documentary “Kiss the Ground” documents these important concerns.
In the context of the COVID 19 pandemic I will close with the usual summary.
Exercise, especially out of doors in a green space, supports the immune system
Get some sunshine and make sure you have adequate Vitamin D levels. Supplement with Vitamin D3 to get your levels above 30 ng/ml, >40ng/ml arguably better.
Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.
Eliminate refined-inflammatory “vegetable oils” from your diet, instead eat healthy fat.
Clean up your home environment and minimize your family’s exposure to environmental toxins by following recommendations at EWG.org with regards to household products, personal care products, and organic foods. (https://www.ewg.org/)
Drink water filtered through a high quality system that eliminates most environmental toxins.
If you are eligible for vaccination, consider protecting yourself and your neighbor with a few jabs. Age > 50 and/or risk factors means clear benefit from a booster.
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.
I recently gave a talk at the AHS 2022 meeting held at UCLA. You can view the video here:
This first slide gives a good overview.
The presentation covers a quick review of my presentations given last year at the PAH 2021 annual meeting (virtual) with additional information on long Covid.
Multiple nutrients acting synergistically support a balanced response to viral infections, including SARS CoV-2. Here is a picture.
The take home message is that no single nutritional intervention is likely to have significant impact with an acute infection unless all but one nutritional component is optimal. Nevertheless, there is compelling evidence that Vitamin D deficiency is rampant in the developed world and if one nutritional intervention is likely to be of benefit, Vitamin D supplementation, particularly in high risk populations, presents the most likely candidate. As usual, preventive supplementation would be preferable to rescue high dose intervention.
In a study of frail elderly hospitalized patients, regular vitamin D supplementation was associated with decreased mortality as demonstrated here. Compared to no supplementation, regular supplementation was associated with a 93% reduction in risk of death.
A study from Spain with very high dose Vitamin D in the form of Calcifediol showed significant benefit in hospitalized patients, suggesting that Vitamin D deficiency was prevalent in that population and that such a treatment intervention should be widely considered.
Calcifediol Treatment and COVID-19-Related Outcomes
The following graphic from another nutrition review article, with red additions added by myself, demonstrates the complex interaction between nutrition and the two main components of our immune system, innate immunity (immediate response) and adaptive immunity (based on immune memory). Again red highlights added by yours truely.
And here is a slide from my lecture with quotes from that article.
Yet most Americans are deficient in many of these essential nutrients as depicted here. The percentages represent the % of Americans that fall below the estimated amount required to prevent deficiency in HALF of adults (a very low standard).
The EAR is a very low bar to meet, yet many Americans fall below even that low standard.
The SARS CoV2 virus interferes with a crucial component of the the initial (innate) immune response, the production of interferon 1 and the signaling of interferon one to immune cell mediators as depicted in this graphic.
SARS CoV2 on the left is compared to Virus X on the right. On the left interferon 1 (IFN) production and signaling is blocked by the virus, interfering with an effective and controlled immune response, on the right IFN is not blocked. A cascade of events results in TOO LITTLE, TOO LATE, AND THEN TOO MUCH of an immune response, producing a cytokine storm.
Obesity, insulin and leptin resistance, also interfere with the production and signaling of interferon. The result is that people with insulin and leptin resistance (pre-diabetes, Type 2 Diabetes as well as sarcopenia) experience a double hit. First the virus itself disrupts the immune response and superimposed upon the viral effect is the effect of insulin and leptin resistance on the immune response.
SOCS: suppressor of cytokine signaling. Several recent viral studies have shown that viral genes can hijack SOCS1 to inhibit host antiviral pathways, as a strategy to evade host immunityOn the left Interferon production and signaling are normal and a successful immune response is mounted. On the right the presence of insulin and leptin resistance, associated with obesity results in an initial inadequate response and a late excessive response. TOO LITTLE, TOO LATE, THEN TOO MUCH.
Factors that can quickly impact insulin and leptin resistance include all the components of an ancestral lifestyle depicted in my website graphic. A paleolithic or ancestral diet that eliminates sugar added foods and beverages, replacing those empty calories with nutrient dense foods, exercise, adequate restorative sleep, stress reduction, avoidance of environmental toxins, social connection. All of these affect health in general, mitigate insulin and leptin resistance, and support a balanced immune response to viral infection. The circle of health depicted below is surrounded by the many deleterious aspects of modern living. Thus, a mismatch between our evolutionary biology and present day life.
Here is a slide from my lecture that lists many lifestyle factors that can impact infection with any virus, including SARS CoV-2
My lecture also included discussion of Long COVID, theories of etiology and pathophysiology which will be discussed in my next post.
For the full lecture which is about 34 minutes long, please follow the link above.
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.
I will be presenting at the next Ancestral Health Symposium, at UCLA, on August 18. The title of my talk will be:
Nutritional and Lifestyle Immunology related to Acute and Long Covid.
AHS includes talks, posters, movement sessions, workshops, and a welcome dinner.
It is a scientific conference but is generally lay-accessible.
AHS covers a wide range of topics, from diet to sleep, breathing, movement, and more — all examined through the lens of evolutionary mismatch
AHS examines various ways modern human life has diverged from how we evolved successfully for millennia and how those differences are affecting us, making us sick and unhappy.
AHS is fun and inspiring, and you’ll leave having made new friends and with new ideas about how to optimize your health
If you decide to join us, please come say hello. Tickets are available through the AHS Website, at ancestralhealth.org — [“Ancestral Health Dot Org”] — where you can also see the three-day schedule for the event, from August 18 to 20.
You can get a 10% discount using the the Eventbrite promo code “PresenterFriend”.
I just viewed an excellent video presentation from the Institute of Functional Medicine providing very useful data on COVID, particularly focusing on the Omicron variants. You can watch it here:
I will summarize the information. But first a few disclaimers.
I have not vetted all of these notes but none disagree with any reports or studies I have read
I have read many but not all of the studies that support these statements
I viewed the video with frequent pauses and replays to facilitate accurate note taking. If you view the video and find any errors please make a comment.
I had a mild case of breakthrough COVID last week and seem to have some brain-fog, feeling like the morning after working most of the night on-call in the operating room.
Many general observations on varied topics related to COVID-19
Omicron Timeline:
11/11/21 Omicron first appears,
1/15/22 Omicron is 99.5% of US cases
1/26/22 B.2 variant appears in US and Europe
2/5/22 B.2 variant 3.6% of US cases
Omicron presents with about 50 mutations, 15 on the RBD (receptor binding domain) with increased affinity for the ACE 2 receptor
Omicron has a cluster of mutations at the S1S2 Furin Cleavage Site. Furin is an enzyme that cleaves the virus to allow for entry into human cells, present in large amounts in the brain, lung and GI tract (thus omicron affecting these organs perhaps more and possibly increasing the risk in people with comorbidities “associated with Furin”.)
Some Omicron mutations are associated with a degree of immune escape, evading anti-bodies and T cells.
B2 may not be picked up by some tests (not discussed in detail)
Compared to B1, B2 is 2.5 times more transmissible in non-VAX folks.
But Vaccine effectiveness against B2 appears to be at least as good or possibly better than effectiveness against B1. (Strange but stated)
Omicron has on average a 3 day latency between infection and symptoms. It appears to replicate “70X more quickly” compared to delta with 3.5 times greater household transmission. Fortunately lung involvement is 10 times lower compared to the original “Wuhan virus”.
Prior infection with delta DOES NOT SEEM TO PROTECT AGAINST OMICRON.
Hospitalization rate with omicron 38/1000 infections vs 101/1000 infections with delta.
In hospital mortality 29% with delta vs 3% with Omicron BUT because of a dramatic increase in transmission with Omicron, daily death rate in US has been 2200 to 2900 per day during the surge, more than delta. (Greater number of infections outweighs the lower mortality rate)
A preprint study published last month looked at data from about 52,000 people infected with the omicron variant, and about 17,000 infected with delta, in southern California. Compared with patients who had the delta variant, omicron patients had a 53% reduced risk of hospitalization, a 74% reduced risk of ICU admission and a 91% reduced risk of death. The study has not yet been peer-reviewed.
Duration of infection averages 10 days. Estimates for being contagious after onset of symptoms:
5 days 1/3, 7 days 16%, 10 days 5%, therefor some practitioners are recommending isolation for 14 days after onset of symptoms.
PCR can remain positive for months after infection because of non-infectious remnants of viral RNA.
Negative antigen test after isolation is reassuring but does not guarantee patient is not contagious. The home antigen tests were not designed or studied for predicting degree of contagion, only for diagnosis.
LONG COVID can be as high as 30% of all cases, as high as 10% after mild cases.
Vaccination reduces risk of LONG COVID by about 50%.
A study published in GUT demonstrates altered GI microbiome 6 months after infection. The gut microbiome is extremely important for immune function.
One year following COVID infection (previous variants) there is a 60-70% increased risk of heart attack, stroke and congestive heart failure.
In the UK 25% of worker absenteeism is due to LONG COVID.
A Swiss study showed 98% reduction in death with VAX plus booster.
2/15/22 published study from IOWA showed that 90 minutes of exercise on the day of vaccination increased antibody levels measured 4 weeks after vaccination. Similar data are available for influenza vaccination. I reviewed data on various non COVID vaccine effectiveness relative to sleep and exercise in 2 talks given last year. This result is not surprising.
Individuals with infection from prior variants, but not vaccinated, show no effective neutralizing antibody activity against omicron. (Very worrisome, I will try to vet this one)
Omicron has 4.5 times higher re-infection rate compared to delta.
Omicron infection appears to decrease risk of infection with delta, but prior infection with delta (without vaccination) does not appear to protect against omicron.
Prior infection (before omicron) PLUS vaccination provides 76% protection against omicron infection which is about the same protection of VAX + booster, and this appears to include protection against B2 variant.
T cell immunity after infection (pre omicron) and after vaccination appears to persist and T cell activity increases with time after infection and after vaccination.
Novavax has applied for EUA with the FDA. This is a vaccine made with S-protein particles plus adjuvant (no mRNA).
“The Novavax COVID-19 vaccine, codenamed NVX-CoV2373, is a subunit COVID-19 vaccine candidate developed by Novavax and the Coalition for Epidemic Preparedness Innovations (CEPI), brand name Covovax.”
“Results from a Phase 3 clinical trial enrolling 29,960 adult volunteers in the United States and Mexico show that the investigational vaccine known as NVX-CoV2373 demonstrated 90.4% efficacy in preventing symptomatic COVID-19 disease. The candidate showed 100% protection against moderate and severe disease. In people at high risk of developing complications from COVID-19 (people 65 years or older and people under age 65 with certain comorbidities or with likely regular exposure to COVID-19), the vaccine showed 91.0% efficacy in preventing symptomatic COVID-19 disease.”
The US Army is in phase I clinical trial with a multi-valent “ferritin nanoparticle multi-faced” vaccine. This “soccer ball shaped” vaccine has 24 “faces” with multiple variant antigens. Each “face” carries a different antigen.
“The Spike Ferritin Nanoparticle platform is designed to protect against an array of SARS-CoV-2 variants and SARS-origin variants but was not tested on the Omicron variant,” Walter Reed officials said.
J&J vaccine issues:
The J&J vaccine is associated with a risk of thrombosis-thrombocytopenia (blood clots and decreased platelets). Risk: 1:100,000 doses in women age 30-50. CDC recommends against J&J vaccine unless there is a contra-indication to mRNA vaccine. 15% of these cases are fatal.
A full discussion of therapeutics (drugs) against COVID can be read at IFM.org/COVID
PAXLOVID is an oral combination of two anti-viral medications reserved for adults (age >= 18) with increased risk, given within day 3-5 of symptom onset. It decreases risk of hospitalization and death by about 70% in low-risk and 89% in high risk groups. There are many contra-indications to use including specific medications and supplements (such as Saint John’s Wort). Availability is a problem.
A recent study published in NEJM used IV Remdesivir (daily for 3 days) for early out- patient treatment in high risk patients, reduced risk of hospitalization/death by 87%. This would represent an off-label use of the drug based on a well controlled study.
Home antigen tests on average become positive 3 days after first positive PCR (nasal swab), 2 days after a positive saliva PCR.
The BiaxNOW home antigen test is 73% sensitive (27% false negative rate)
Pregnancy-COVID and vaccination:
A study of 40,000 pregnant women found no increase in pre-term birth, small for gestational age, or any other complication following vaccination during pregnancy.
But COVID infection in unvaccinated women during pregnancy is associated with increased risk for pre-term birth, still born, low birth weight, cesarean section, decreased fetal growth, maternal intubation and death.
Maternal Vaccination produces anti-Covid antibodies found in fetal cord blood at birth.
Intra-uterine demise with COVID is associated with massive placental insufficiency.
There is no data to support decreased female or male fertility following vaccination.
A study of menstrual regularity following vaccination showed < 1 day change in cycle length post vaccination, not clinically significant. Post vaccination regularity equivalent to expected variation in menstrual cycles.
Two months following COVID infection there is a decrease in male but not female fertility rate.
Multiple studies have demonstrated association between low Vitamin D status and risk for severe-critical disease and death. Association does not equal causation but there is biologic plausibility (Vitamin D is a major immune regulator) and consistently increased risk associated with low levels. A recent study demonstrated 14 times greater risk for severe-critical disease in hospitalized patients with levels <20 compared to patients with levels >40. I will update my previous discussion of Vitamin D and COVID in a future post. Spoiler alert: An intervention study with high dose Vitamin D done in Spain demonstrated improved clinical outcome.
Risk factors for poor outcome in descending order:
Age > 65
immuno-compromised state
lung disease
liver disease
kidney disease
neurologic disorders
diabetes
cardiac disease
Patients with severe disease had >= 1 risk factor
78% of patients who died had >= 4 risk factors.
“Nearly two years into the pandemic, unvaccinated Americans are still making up the majority of COVID deaths.”
“Data from the Centers for Disease Control and Prevention shows that during the first week of December — when the omicron variant began taking hold — unvaccinated people were dying at a rate of 9 per 100,000.”
“By comparison, fully vaccinated people were dying at a rate of 0.4 per 100,000, meaning unvaccinated people were 20 times more likely to die of the virus”
In the context of the COVID 19 pandemic I will close with the usual summary.
Exercise, especially out of doors in a green space, supports the immune system
Get some sunshine and make sure you have adequate Vitamin D levels. Supplement with Vitamin D3 to get your levels above 30 ng/ml, >40ng/ml arguably better.
Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.
Eliminate refined-inflammatory “vegetable oils” from your diet, instead eat healthy fat.
Clean up your home environment and minimize your family’s exposure to environmental toxins by following recommendations at EWG.org with regards to household products, personal care products, and organic foods. (https://www.ewg.org/)
Drink water filtered through a high quality system that eliminates most environmental toxins.
If you are eligible for vaccination, consider protecting yourself and your neighbor with a few jabs. Age > 50 and/or risk factors means clear benefit from a booster.
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.
Again, another biased article claims to demonstrate the dangers of red meat. There are so many problems with the author’s analysis and conclusions it is hard to know where to begin. Rather than go through the nitty gritty here, just head on over to this analysis to read another debunking of the same litany of bad science.
Exercise, especially out of doors in a green space, supports the immune system
Get some sunshine and make sure you have adequate Vitamin D levels. Supplement with Vitamin D3 to get your levels above 30 ng/ml. (read this Open Letter)
Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.
Eliminate refined-inflammatory “vegetable oils” from your diet, instead eat healthy fat.
Clean up your home environment and minimize your family’s exposure to environmental toxins by following recommendations at EWG.org with regards to household products, personal care products, and organic foods. (https://www.ewg.org/)
If you are eligible for vaccination, consider protecting yourself and your neighbor with a few jabs.
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.
Today I listened to Dr. Bruce Patterson discuss his research on Long-Covid.
Bruce Patterson was director of a virology lab at Stanford before establishing Incelldx, a biotech firm in the area of virus diagnostics. Bruce was interviewed today (second half of the program) on The People’s Pharmacy (NPR). The transcript and podcast will be available tomorrow at PeoplesPharmacy.com (show #1273)
Utilizing AI and data from over 10,000 patients, Incelldx has developed diagnostic tools to characterize the immune system dysregulation associated with long covid. According to Dr. Patterson’s research, Long-Covid involves “non-classical monocytes” that are reacting to remnant virus proteins (not RNA or DNA), producing a vascular inflammatory process. That was the missing link. Researchers were looking for RNA, but the problem appears to be in the monocyte reaction to remnant viral proteins that stimulate these specialized monocytes, producing a chronic vasculitis.
Here is a link to the Long Covid clinical program based upon this research.
The program involves immune testing by Incelldx and based on the results, treatment recommendations are made.
So far 2 drugs repurposed for long-Covid appear effective when used in combination.
A CCR5 antagonist (maraviroc) which has been used to treat HIV and a Statin medication which blocks binding of the monocytes to artery walls.
According to Dr. Patterson, Long Covid in many patients is a vascular inflammatory process, mediated by non-classical monocytes which are activated by viral remnant proteins.
Dr. Patterson has seen many patients respond to this drug combination. He uses an old, early statin drug (pravastatin) which has a low side effect profile compared to the more commonly used atorvastatin (which gave me severe myopathy, notorious for that problem but understated by drug company reports).
This is cutting edge, most physicians, even in university settings, are not aware of this diagnostic/therapeutic approach.
This is still considered experimental but appears to be very promising.
In the context of the COVID 19 pandemic I will close with the usual summary.
Exercise, especially out of doors in a green space, supports the immune system
Get some sunshine and make sure you have adequate Vitamin D levels. Supplement with Vitamin D3 to get your levels above 30 ng/ml. (read this Open Letter)
Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.
Eliminate refined-inflammatory “vegetable oils” from your diet, instead eat healthy fat.
Clean up your home environment and minimize your family’s exposure to environmental toxins by following recommendations at EWG.org with regards to household products, personal care products, and organic foods. (https://www.ewg.org/)
If you are over age 12 and eligible for vaccination, consider protecting yourself and your neighbor with vaccination.
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.
Practical Evolutionary Health 