Let’s assume that most of us will get infected by the coronavirus COVID-19 over the coming months. If so, relying on our own immune system to see us through is going to be quite literally the barrier between life and death (with maybe a helping hand from healthcare). Let’s take a look at what you need to know, why and how you can prepare your body for an attack.
Why does it matter how healthy I am at the moment?
At Melio, we go on about health(y) care - the products and services that can help you stay healthy for as long as possible. The coronavirus is a clear demonstration of why this matters. The numbers coming out of China clearly show that if you suffer from conditions such as cardiovascular disease, diabetes, or hypertension, you have a considerably higher risk of dying from the coronavirus infection than those who don’t.
Data from the WHO/China Joint Mission report on COVID-19, published on February 23rd, 2020.
Right, you’ve convinced me that I need to take better care of myself in preparation for getting sick, what should I do?
Stating the obvious, but do what you can to avoid catching the virus!
This means washing your hands properly - there are loads of videos on Youtube on how to do this properly. It’s worth spending 5 minutes of your life to learn how to do this. You may think you know this stuff already, but you’re probably doing it wrong...
Check your Vitamin D levels.
There are estimates suggesting that as much as 70 - 80% of people worldwide suffer from vitamin D deficiency, which in turn increases the risks of many infectious diseases like respiratory tract infections, influenza and pneumonia. Vitamin D is a critical component of a well functioning immune system, and a number of studies in the past have shown a benefit of vitamin D supplementation for preventing respiratory tract infections. But for this intervention to be effective, it should be done continuously, before the respiratory tract infection starts. If your levels are low, look at increasing sun exposure (outdoor exercise can help on more than one front!) and eat vitamin D rich foods such as salmon, sardines, eggs and mushrooms.
You could also boost your levels using a supplement, but it is worth checking your levels before using supplements to avoid Vitamin D toxicity (too high levels of vitamin D), a rare but potentially serious condition resulting in a buildup of calcium in your blood. You can retest around 8 weeks later to see if your results improve. In addition to detecting vitamin D deficiency, a nutrient blood test can also identify other major deficiencies that can harm the immune system. Nutrient deficiency treatment is vital to health, even more so until a COVID-19 vaccine or treatment is available.
Get your blood sugar under control.
Even if you don’t have diabetes, it may be worth checking to see whether or not you are prediabetic (higher than normal fasting blood glucose can indicate you are on the path to Type II Diabetes) and implement lifestyle changes before it becomes more serious. If you are diabetic, try to control blood sugar levels tightly and avoid too much hyperglycemia (high blood sugar). High blood sugar is thought to cause dysfunction of the immune system and it’s well known that diabetics are more susceptible to infections.
If you’re smoking, quit!
Yes, you’ve heard it before, but smokers are at increased risk of a wide range of infections, both increasing the likelihood of catching infections and the severity of the disease if you do get it. It has been suggested that the higher coronavirus death rate among men compared to women in China (fatality rate of 2.8% for men compared to 1.7% for women) could be due to smoking being more common among Chinese men. And remember that passive smoke exposure also increases disease risk, so by helping yourself you are also helping those around you.
Overall, the bad effects of stress on health is probably the best-established link between lifestyle and the immune system. People who are stressed for long periods of time suffer worse from viral infections, take longer to heal wounds, and respond less well to vaccination. Take the opportunity to work from home. There are many ways to relax, but the only two with any evidence on their effect on the immune system are tai chi and mindfulness. That said, the level of evidence is weak and so the best advice is to do more of the things you find relaxing. Not deep, but there you go.
Don’t get us wrong, the coronavirus outbreak is no laughing matter. But a research study has shown that people with diabetes who watched comedy films with hospital staff experienced increased activity of their immune system genes. Again, the evidence isn’t overwhelming, but it’s been interesting to watch the comedy and camaraderie coming out on Wechat (Chinese messaging service) as people have been quarantined in their homes. Worth a try.
We are slaves to our body clocks. Light helps guide the rhythm of our bodies biochemistry and this holds true for the immune system too. In fact, many illnesses follow a rhythm of when symptoms are more likely to occur depending on the time of day or night. The time of day that a vaccine is given or the strength of the immune response can vary depending on the time of day it’s administered or picked up. In general, our immune system is stronger during our natural rest time, at night. When mice are given simulated repeated jet-lag tumours grow and their survival from cancer is decreased. Let’s not even discuss night shift workers. The point is that if you’re expecting to be hit by an illness having an active well-functioning immune system is vital and this requires high-quality sleep.
Get physically active
Those who are sedentary have a higher risk of getting any virus which can cause an upper respiratory tract infection (including coronavirus), compared to those who engage in regular moderate aerobic physical activity. However, the benefit of physical activity is shown to reduce if very high intensity exercise is done. Importantly, if you are feeling under the weather, it is best to avoid exercise, as this can increase your risk of becoming more unwell.
The Nieman J-curve
Buy the book ‘The Beautiful Cure’, by Daniel M. Davis. Relax and learn just how amazing your immune system really is.
One caveat with all of the above data. The overall mortality (death) rate is argued to be lower than that seen in China. Some argue the natural experiment, the quarantined Diamond Princess cruise ship held off the Japanese coast, shows that the mortality rate is much lower than the one seen in China. Whichever number turns out to be nearer the truth, the outcome is the same: figure out how to stay healthy!
We hope this goes some way towards taking positive action to ensure you are as healthy as possible should you become infected with coronavirus, or indeed any virus. It’s important to monitor your health over time to ensure that your body functions well - you never know when it might be tested. To learn more about what you can do, visit meliohealth.com or listen to our podcast 'What Does Good Look Like?'’ on major podcast players.
Daniel M. Davis, The Beautiful Cure, 2018
Hayashi, T., et al., Laughter up-regulates the genes related to NK cell activity in diabetes, Biomedical Research 28, 281-5 (2007)
Nieman et al (2010). Upper respiratory tract infection is reduced in physically fit and active adults. Br J Sports Med. Sep; 45(12):987-92