How Contagious is Covid-19?

Covid-19 has put fear in the hearts of everyone as the numbers go up. Test kits are now more readily available, so medical professionals are testing and identifying more and more individuals with the illness.

Contagiousness of Covid-19

What we need to remember is that though highly contagious like the flu virus influenza, this virus in particular is a relatively weak one. It is an enveloped virus; it has a fatty acid coating that is easily destroyed simply by washing hands, which degrades the outer coating and kills the virus. Typically, enveloped viruses may last only several days, unlike non-enveloped viruses such as the “stomach bug” norovirus, which can last for months on a surface. A recent study found that this coronavirus (SARS-CoV-2) which causes the Covid-19 disease was detectable in aerosols for up to three hours in laboratory conditions, up to four hours on copper, up to 24 hours on cardboard and up to two to three days on plastic and stainless steel.

Spray Items to Disinfect

Surfaces of clothes, shoes, and personal items all have the potential of carrying the virus. When bringing home any items from outside, it may be a good idea to first disinfect surfaces potentially exposed to the virus. This includes delivery packages, grocery store non-perishables, even the bottoms of shoes. To make a homemade disinfectant, fill a spray bottle with 70% isopropyl alcohol, or prepare a bleach solution by mixing 4 teaspoons bleach per quart of water. Asymptotic individuals 19 and under may spread the virus about 9% for about 2 weeks.(23)

The Intensity of the Covid-19 Outbreak

Scientists use R0 (pronounced “R naught”) – the reproduction number – to measure the contagiousness or transmissibility of an infectious disease. Many scientific groups estimate Covid-19’s R0 to be around 1.5-3.5, though many unknown factors make projecting the future number of cases very uncertain. An R0 of 3 means one person will infect three others. (24) During the last pandemic in 2009, Influenza A/H1N1 had a median R0 of less than 2 (25), and was lower in areas where mitigation strategies were in place. Therefore, social distancing and hand washing play an important role in virus spread.

ACE2 Receptors, Inflammation, and Coronavirus

Scientists have found that coronavirus 2 (SARS-CoV-2) enters the body by the ACE2 receptor site. This Angiotensin Converting Enzyme 2 (ACE2) is an enzyme attached to the outer surface of cells in the lungs, arteries, heart, kidney, and intestines. This explains why the young are less vulnerable and the chronic disease and elderly are more vulnerable. As one ages or has more chronic disease or overall inflammation, the body develops more ACE2 receptor sites which are integral in the repair and protection of the body. The more receptor sites one has, the more targets for the virus to enter the body. Therefore keeping down inflammation and keeping our bodies as healthy as possible is one effective way to protect oneself.

Covid-19 in Italy

Covid-19 hit Italy’s population especially hard. Aside from the country’s delay in taking action by two weeks, they have an older population, and many of its citizens are smokers. These two biological factors mean these individuals have higher inflammation, which means more ACE2 receptors, which the Covid-19 coronavirus targets. As a result, it is prudent to combat inflammation, which is what I focus on in my patients.

How to Fight Inflammation

Some ingredients I recommend to fight inflammation, support, and up regulate the immune system are: elderberry, garlic, turmeric, olive leaf extract, vitamin D, zinc, selenium, N-Acetyl Cysteine, vitamin C, probiotic, beta carotene, and more.

How much of these micronutrients does my body need?

Our bodies function optimally – thus protect us from infection – when our micronutrients are balanced. The best way to know if we are balanced is to measure and test. These lab tests, measured by blood or stool sample, will show if the body is deficient and needs correction. Once cold and flu season hits we will be able to support the immune system by reducing our inflammation and consuming supportive supplements.

These diagnostic tests also show us IF we really need certain supplements. For example, Vitamin C can prevent homeosis, which is protective of the mitochondria and therefore not helpful. But if you have a viral illness, Vitamin C may help with lowering the oxidative stress that comes with having a viral illness. In the case of functional medicine, testing takes the guesswork out of all the supposedly beneficial nutrients out there, so patients waste less energy and money buying supplements that their bodies don’t need (or worse yet, could be harmful).

My personal approach to Managing Inflammation

If I decide to have sweets, I know it will cause some inflammation and imbalance of my gut microbiome. I will start Biocidin to make sure I have not weakened my system, get the inflammation under control, and get my gut back in balance and make my immune system strong. I also make sure I follow my 4 steps to a healthy lifestyle: food, mood, move, and rest.

Children’s health

For my sons, I make sure they eat enough fruits, vegetables and probiotics. I change up the probiotics according to need. Starting in September (the beginning of the school year) and throughout cold and flu season, I have them on vitamin D due to its critical role in enhancing immunity against viral acute respiratory infections. (26) Zinc also supports the immune function, reduces morbidity and mortality, and shortens recovery from acute health problems. (27) Lastly, when the boys were younger, I used to sprinkle their food with brewer’s yeast, a form of beta-glucan. Beta-glucans are sugars that are found in the cell walls of bacteria, fungi, yeasts, algae, lichens, and plants, such as oats and barley. Used as medicine for the treatment of many chronic conditions like high cholesterol, diabetes, high blood pressure, and cancer, beta-glucans can also be taken orally to boost the immune system.

Supplements to Balance Health

Now I use the following supplements to support my boys and my personal immune system. Every human body is different, so please consult your functional medicine practitioner first.

Other Potent Viruses

Are you aware that from October 1, 2019 to March 7, 2020 there has been between 31M and 51M cases of H1N1 and 22,000-55,000 deaths? Back in 2009 when H1N1 was the pandemic there were 43-83 million cases and 8,868-18,306 deaths and affected the young. We must remember there will be another pandemic. We must keep our bodies as healthy as possible.

Promoting New Social Etiquette Norms

The next new virus is not a complete unknown. It is like a new baby: we just don’t know if this new baby will be the next Einstein — or Frankenstein. We must establish and adhere to a new standard of social etiquette when one has a virus, old or new. We must have the social support to be able to self isolate or wear a mask in public and not be shamed. We have all given little Johnny medication to reduce the fever and send him to school. Wouldn’t it be nice if the school had an infirmary for sick children to isolate themselves? I would love to see our workplaces support parents taking off work or to work from home when ill.

In the workplace

I’d also love to see companies remove incentives from going into work sick.  Some companies give bonuses for showing up to work even when employees are ill.

Other social norms honor individuals who work even though they are sick. That has to change.

Unfortunately there are also cases where I give a time-off work note to individuals who are sick, but since they live paycheck to paycheck they say they have to go to work. These are your fast food chain and restaurant employees, so their decisions may have a dramatic impact on your personal health.

Practical steps

If you are a family that shares your illness, that spreads from one another, you may want to rethink your hygiene protocol. Some steps to do at all times is to protect yourself, especially if you have someone in your household with a weak immune system.

During this critical time, my multi-generational family follows these measures in our home, as we have elderly grandparents living with us.

Covid-19 for Children vs. Grandparents

If a child gets sick, they most likely will recover and have mild symptoms. On the other hand, Grandmother may become very ill, and even possibly succumb to it.

Physical Protection from Covid-19

When one member of the family unit goes out to work, buy groceries etc., that person must practice physical distancing: keep 6-10 feet from another person, do not touch surfaces, wear a mask or scarf around the nose and mouth if they are going to be closer than 6 feet, wash hands immediately or wear gloves and remove, and do not touch the face. When returning home, they should wash hands, disinfect masks, clothing, and all items entering the home. I personally follow this protocol when I return from the emergency department.

More Covid-19 Protection Tips

Is it worth it?

I ask my patients this question when they are deciding whether they should adopt these seemingly extreme methods of protecting one’s health: which would you regret more — putting in extra effort in not making others ill, or becoming the epicenter of a breakout because you chose not to practice physical distancing?

Silver lining

I am hearing more and more stories of the community coming together to help each other and to protect each other.

Maybe this pandemic is what it takes to make people be aware, and to remember that the next pandemic will come eventually. Just as we prepare for earthquakes, tornados or hurricanes, we should prepare ourselves for other super viruses.

Please take a deep breath, use your sauna or hot showers, eat your fruits and vegetables, move, and sleep well. If you have any questions or healthcare needs, ask me via virtual appointments.

Embrace the adventure of life.

Let’s learn to care for ourselves and be prepared for the number of things that threaten our health.

In Health,

References

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4519035/
2. https://www.evolutamente.it/covid-19-pneumonia-inflammasomes-the-melatonin-connection/
3. https://www.rndsystems.com/resources/articles/ace-2-sars-receptor-identified
4. https://www.ncbi.nlm.nih.gov/pubmed/32129518
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3989080/
6. https://clinicaltrials.gov/ct2/show/NCT04264533
7. https://www.sciencedirect.com/science/article/pii/S0033062020300372fbclid=IwAR0UMWXFiQvxpIBxCOvg8zpFQLBgq8zTUmI5LOc-HDd0G32SzeBbcv9cFz0#bb0070
8. https://f1000research.com/articles/9-72
9. https://www.jci.org/articles/view/138003
10. https://www.sciencedirect.com/science/article/pii/S1876034116300181
11. https://www.ncbi.nlm.nih.gov/pubmed/32150618/
12. https://www.sciencedirect.com/science/article/pii/S0924857920300820
13. https://www.ncbi.nlm.nih.gov/pubmed/25108173
14. https://www.nih.gov/news-events/news-releases/new-coronavirus-stable-hours-surfaces
15. https://www.cdc.gov/coronavirus/2019-ncov/prepare/cleaning-disinfection.html
16. https://www.healthleadersmedia.com/nursing/covid-19-epa-releases-list-registered-disinfectants
17. https://www.weforum.org/agenda/2020/03/coronavirus-covid-19-mers-sars-experts/
18. http://www.infectioncontroltoday.com/covid-19/focus-surface-disinfection-when-fighting-covid-19
19. https://www.nationalgeographic.com/science/2020/03/why-soap-preferable-bleach-fight-against-
20. coronavirus/
21. https://www.ecowatch.com/how-good-gut-health-can-boost-your-immune-system-1882013643.html
22. https://www.hopkinsmedicine.org/research/advancements-in-research/fundamentals/in-depth/the-
23. gut-where-bacteria-and-immune-system-meet
24. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337124/
25. https://wwwnc.cdc.gov/eid/article/26/6/20-0452_article
26. https://labblog.uofmhealth.org/rounds/how-scientists-quantify-intensity-of-an-outbreak-like-covid-19
27. https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-14-480
28. https://www.bmj.com/content/356/bmj.i6583
29. https://www.cdc.gov/coronavirus/2019-ncov/about/symptoms.html
30. http://orthomolecular.org/resources/omns/v16n11.shtml

Research on Xymogen Immunotix

1. Pelton R, LaValle JB, Hawkins EB, et al. Drug-Induced Nutrient Depletion Handbook. 2nd ed. Hudson, OH: LexiComp, Inc. 20011. Tian J, Ma J, Wang S, et al. Increased expression of mGITRL on D2SC/1 cells by particulate β-glucan impairs the suppressive effect of CD4(+)CD25(+) regulatory T cells and enhances the effector T cell proliferation. Cell Immunol. 2011 May 10;270(2):183-7. [PMID: 21636079]
2. Feldman S, Schwartz HI, Kalman DS, et al. Randomized phase II clinical trials of Wellmune WGP® for immune support during cold and flu season. J Appl Res. 2009 March-June;9(1&2):30-42. http://jrnlappliedresearch.com/articles/ Vol9Iss1/FeldmanVol9No1.pdf. Accessed September 9, 2011.
3. Driscoll M, Hansen R, Ding C, et al. Therapeutic potential of various beta-glucan sources in conjunction with anti-tumor monoclonal antibody in cancer therapy. Cancer Biol Ther. 2009 Feb;8(3):218-25. [PMID: 19106638]
4. Liang, J., D. et al. Enhanced clearance of a multiple antibiotic-resistant Staphylococcus aureus in rats treated with PGG-glucan is associated with increased leukocyte counts and increased neutrophil oxidative burst activity. Int J Immunopharmacol. 1998 Nov;20(11):595-614. [PMID: 9848393]
5. Vetvicka V. Glucan-immunostimulant, adjuvant, potential drug. World J Clin Oncol. 2011 Feb 10;2(2):115-9. [PMID: 21603320]
6. Vetvicka V, Terayama K, Mandeville R, et al. Pilot study: orally-administered yeast ß1,3-glucan prophylactically protects against anthrax infection and cancer in mice. JANA. 2002;5(2):5-9. Reprint. http://www.ana-jana.org/Journal/ journals/JANAVol52.pdf. Accessed August 21.
7. Natural Standard Database http://naturalstandard.com. Accessed July 23, 2011.
8. Yan J, Allendorf DJ, Brandley B. Yeast whole glucan particle (WGP) beta-glucan in conjunction with antitumour monoclonal antibodies to treat cancer. Expert Opin. Biol Ther. 2005 May;5(5):691-702. [PMID: 15934844]
9. Qi C, Cai Y, Gunn L, et al. Differential pathways regulating innate and adaptive antitumor immune responses by particulate and soluble yeast-derived ß-glucans. Blood. 2011 Jun 23;117(25):6825-36. [PMID: 21531981]
10. Pelizon AC, Kaneno R, Soares AM, et al. Immunomodulatory activities associated with beta-glucan derived from Saccharomyces cerevisiae. Physiol Res. 2005;54(5):557-64. [PMID: 16238470]
11. Tsikitis V, Albina J, Reichner J. Beta-glucan affects leukocyte navigation in a complex chemotactic ingredient. Surgery. 2004 Aug;136(2):384-9. [PMID: 15300205]
12. Senoglu N, Yuzbasioglu MF, Aral M, et al. Protective effects of N-acetylcysteine and beta-glucan pretreatment on oxidative stress in cecal ligation and puncture model of sepsis. J Invest Surg. 2008 Sep-Oct;21(5):237-43. [PMID: 19160131]
13. Turnbull, JL, Patchen ML, Scadden DT. The polysaccharide, PGGglucan, enhances human myelopoiesis by direct action independent of and additive to early-acting cytokines. Acta Haematol. 1999;102(2):66-71. [PMID: 10529508]

Research on Xymogen Immunotix

1. Tian J, Ma J, Wang S, et al. Increased expression of mGITRL on D2SC/1 cells by particulate β-glucan impairs the suppressive effect of CD4(+)CD25(+) regulatory T cells and enhances the effector T cell proliferation. Cell Immunol. 2011 May 10;270(2):183-7. [PMID: 21636079]
2. Feldman S, Schwartz HI, Kalman DS, et al. Randomized phase II clinical trials of Wellmune WGP® for immune support during cold and flu season. J Appl Res. 2009 March-June;9(1&2):30-42. http://jrnlappliedresearch.com/articles/ Vol9Iss1/FeldmanVol9No1.pdf. Accessed September 9, 2011.
3. Driscoll M, Hansen R, Ding C, et al. Therapeutic potential of various beta-glucan sources in conjunction with anti-tumor monoclonal antibody in cancer therapy. Cancer Biol Ther. 2009 Feb;8(3):218-25. [PMID: 19106638]
4. Liang, J., D. et al. Enhanced clearance of a multiple antibiotic-resistant Staphylococcus aureus in rats treated with PGG-glucan is associated with increased leukocyte counts and increased neutrophil oxidative burst activity. Int J Immunopharmacol. 1998 Nov;20(11):595-614. [PMID: 9848393]
5. Vetvicka V. Glucan-immunostimulant, adjuvant, potential drug. World J Clin Oncol. 2011 Feb 10;2(2):115-9. [PMID: 21603320]
6. Vetvicka V, Terayama K, Mandeville R, et al. Pilot study: orally-administered yeast ß1,3-glucan prophylactically protects against anthrax infection and cancer in mice. JANA. 2002;5(2):5-9. Reprint. http://www.ana-jana.org/Journal/ journals/JANAVol52.pdf. Accessed August 21.
7. Natural Standard Database http://naturalstandard.com. Accessed July 23, 2011.
8. Yan J, Allendorf DJ, Brandley B. Yeast whole glucan particle (WGP) beta-glucan in conjunction with antitumour monoclonal antibodies to treat cancer. Expert Opin. Biol Ther. 2005 May;5(5):691-702. [PMID: 15934844]
9. Qi C, Cai Y, Gunn L, et al. Differential pathways regulating innate and adaptive antitumor immune responses by particulate and soluble yeast-derived ß-glucans. Blood. 2011 Jun 23;117(25):6825-36. [PMID: 21531981]
10. Pelizon AC, Kaneno R, Soares AM, et al. Immunomodulatory activities associated with beta-glucan derived from Saccharomyces cerevisiae. Physiol Res. 2005;54(5):557-64. [PMID: 16238470]
11. Tsikitis V, Albina J, Reichner J. Beta-glucan affects leukocyte navigation in a complex chemotactic ingredient. Surgery. 2004 Aug;136(2):384-9. [PMID: 15300205]
12. Senoglu N, Yuzbasioglu MF, Aral M, et al. Protective effects of N-acetylcysteine and beta-glucan pretreatment on oxidative stress in cecal ligation and puncture model of sepsis. J Invest Surg. 2008 Sep-Oct;21(5):237-43. [PMID: 19160131]
13. Turnbull, JL, Patchen ML, Scadden DT. The polysaccharide, PGGglucan, enhances human myelopoiesis by direct action independent of and additive to early-acting cytokines. Acta Haematol. 1999;102(2):66-71. [PMID: 10529508]
14. Kournikakis B, Mandeville R, Brousseau P, et al. Anthrax-protective effects of yeast beta 1,3 glucans Med Gen Med. 2003 Mar 21;5(1):1. [PMID:12827062]

Reference Xymogen Viragraphis

1. Natural Standard Database. Andrographis. http://www.naturalstandard.com/ databases/herbssupplements/all/andrographis.asp. Accessed January 30, 2013.
2. Akbar S. Andrographis paniculata: a review of pharmacological activities and clinical effects. Altern Med Rev. 2011 Mar;16(1):66-77. [PMID: 21438648]
3. Abu-Ghefreh AA, Canatan H, Ezeamuzie CI. In vitro and in vivo anti-inflammatory effects of andrographolide. Int Immunopharmacol. 2009 Mar;9(3):313-8. [PMID: 19110075]
4. Sheeja K, Shihab PK, Kuttan G. Antioxidant and anti-inflammatory activities of the plant Andrographis paniculata Nees. Immunopharmacol Immunotoxicol. 2006;28(1):129-40. [PMID: 16684672]
5. Cáceres DD, Hancke JL, Burgos RA, et al. Use of visual analogue scale measurements (VAS) to assess the effectiveness of standardized Andrographis paniculata extract SHA-10 in reducing the symptoms of common cold. A randomized double-blind placebo controlled study. Phytomedicine. 1999 Oct;6:217-23. [PMID: 10589439]
6. Kumar RA, Sridevi K, Kumar NV, et al. Anticancer and immunostimulatory compounds from Andrographis paniculata. J Ethnopharmacol. 2004 Jun;92(2- 3):291-5. [PMID: 15138014]
7. Rajagopal S, Kumar RA, Deevi DS, et al. Andrographolide, a potential cancer therapeutic agent isolated from Andrographis paniculata. J Exp Ther Oncol. 2003 May-Jun;3(3):147-58. [PMID: 14641821]
8. Calabrese C, Berman SH, Babish JG, et al. A phase I trial of andrographolide in HIV positive patients and normal volunteers. Phytother Res. 2000 Aug;14(5):333-8. [PMID: 10925397]
9. Bothiraja C, Pawar AP, Shende VS, et al. Acute and subacute toxicity study of andrographolide bioactive in rodents: Evidence for the medicinal use as an alternative medicine. Comparative Clinical Pathology. June 2012. doi:10.1007/s00580-012-1539-x.
10. 10.Natural Standard Database. Licorice. http://www.naturalstandard.com/ databases/herbssupplements/licorice.asp?#undefined. Accessed February 4, 2013.
11. 11.Fiore C, Eisen M, Krausse R, et al. Antiviral effects of Glycyrrhiza species. Phytother Res. 2008 Feb;22(2):141-8. [PMID: 17886224]
12. 12.Cinatl J, Morgenstern B, Bauer G, et al. Glycyrrhizin, an active component of liquorice roots, and replication of SARS-associated coronavirus. Lancet. 2003 Jun 14;361(9374):2045-6. [PMID: 12814717]
13. 13.Krinsky DL, LaValle JB, Hawkins EB, et al. Natural Therapeutics Pocket Guide. 2nd ed. Hudson, OH: Lexi-Comp; 2003.
14. 14.Isbrucker RA, Burdock GA. Risk and safety assessment on the consumption of Licorice root (Glycyrrhiza sp.), its extract and powder as a food ingredient, with emphasis on the pharmacology and toxicology of glycyrrhizin. Regul Toxicol Pharmacol. 2006 Dec;46(3):167-92. Review. [PMID: 16884839]
15. 15.Xu YM, Lu PC. Experimental studies on immunostimulatory effects of the Isatis indigotica polysaccharide [in Chinese]. Zhong Xi Yi Jie He Za Zhi. 1991 Jun;11(6):357-9, 325-6. [PMID: 1889106]
16. 16.Molina P, Tárraga A, Gonzalez-Tejero A, et al. Inhibition of leukocyte functions by the alkaloid isaindigotone from Isatis indigotica and some new synthetic derivatives. J Nat Prod. 2001 Oct;64(10):1297-300. [PMID: 11678654]

References Xymogen Xcellent A

1. Vitamin A. In: Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press; 2001:82-161. https://www.nap.edu/read/10026/ chapter/6 Accessed August 29, 2019.
2. Green HN, Mellanby E. Vitamin A as an anti-infective agent. Br Med J. 1928 Oct 20;2(3537):691-6. [PMID: 20774205]
3. Blomhoff HK, Smeland EB, Erikstein B, et al. Vitamin A is a key regulator for cell growth, cytokine production, and differentiation in normal B cells. J Biol Chem. 1992 Nov 25;267(33):23988-92. [PMID: 1429735]
4. Brown CC, Noelle RJ. Seeing through the dark: new insights into the immune regulatory functions of vitamin A. Eur J Immunol. 2015 May;45(5):1287-95. [PMID: 25808452]
5. Semba RD. Vitamin A, immunity, and infection. Clin Infect Dis. 1994 Sep;19(3):489-99. [PMID: 7811869]
6. Huang Z, Liu Y, Qi G, et al. Role of vitamin A in the immune system. J Clin Med. 2018 Sep;7(9): 258. [PMID: 30200565]
7. Lu L, Lan Q, Li Z, et al. Critical role of all-trans retinoic acid in stabilizing human natural regulatory T cells under inflammatory conditions. Proc Natl Acad Sci USA. 2014 Aug19;111(33):E3432-40. [PMID: 25099355]
8. Stephensen CB. Vitamin A, infection, and immune function. Annu Rev Nutr. 2001;21:167-92. [PMID: 11375434]
9. McCullough FS, Northrop-Clewes CA, Thurnham DI. The effect of vitamin A on epithelial integrity. Proc Nutr Soc. 1999 May;58(2):289-93. [PMID: 10466169]
10. Oliveira LM, Teixeira FME, Sato MN. Impact of retinoic acid on immune cells and inflammatory diseases. Mediators Inflamm. 2018 Aug 9;2018:3067126.
    [PMID: 30158832]
11. de Medeiros PHQS, Pinto DV, de Almeida JZ, et al. Modulation of intestinal immune and barrier functions by vitamin A: implications for current understanding of malnutrition and enteric infections in children. Nutrients. 2018 Aug 21;10(9):1128. [PMID: 30134532]
12. Wicke C, Halliday B, Allen D, et al. Effects of steroids and retinoids on wound healing. Arch Surg. 2000 Nov;135(11):1265-70. [PMID: 11074878]
13. Polcz ME, Barbul A. The role of vitamin A in wound healing. Nutr Clin Pract. 2019 Aug 7. [PMID: 31389093]
14. Conaway HH, Henning P, Lerner UH. Vitamin A metabolism, action, and role in skeletal homeostasis. Endocr Rev. 2013 Dec;34(6):766-97. [PMID: 23720297]
15. Wu AM, Huang CQ, Lin ZK, et al. The relationship between vitamin A and risk of fracture: meta-analysis of prospective studies. J Bone Miner Res. 2014 Sep;29(9):2032-9. [PMID: 24700407]