Oyinka Adeogun, M.D.
Family Medicine / Lifestyle Medicine
Mark Sandoval, M.D.
Emergency Medicine / Lifestyle Medicine
Basic Information
COVID-19 (Coronavirus Disease 2019) is an illness caused by a novel coronavirus now called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), formerly called 2019-nCoV. It was first identified amid an outbreak of respiratory illness cases in Wuhan City, Hubei Province, China. It was initially reported to the World Health Organization (WHO) on December 31, 2019. On January 30, 2020, the outbreak was declared a Public Health Emergency of International Concern. And on March 11, 2020, the WHO made the assessment that COVID-19 can be characterized as a pandemic.[1]
It is spread from person-to-person mainly through respiratory droplets between persons within about 6 feet of each other, and from contact with infected surfaces or objects. People are most contagious when sick, but spread is possible before people show symptoms. The virus causing COVID-19 spreads easily, is very contagious, and is sustainable in the community (community spread). This means people have been infected with the virus in an area, including some who are not sure how or where they became infected.[2]
Symptoms may appear 2 to 14 days after exposure and may include, but not limited to fever, cough, and shortness of breath.[3]Other symptoms include fatigue, sputum production, muscle or joint pain, sore throat, headache, and chills.[4]
After analyzing almost 45,000 cases of COVID-19 in China, it was found that 80.9% of identified cases were mild, 13.8% of identified cases were severe, and 4.7% of identified cases were critical.[5] Approximately 2.3% of those identified with COVID-19 died as a result of the infection.[6] These numbers do not take into account those who contracted the virus but were not tested for it because their cases were mild. This means that there may be more people with mild cases and fewer with severe and critical infections than are represented in these numbers. Those who are at greater risk for severe complications are those who are elderly, and those who have other illnesses, such as heart disease, diabetes, and lung disease.[7]
Of the critical cases, 49% died from the infection. And of those with pre-existing illnesses, 10.5% of those with cardiovascular disease, 7.3% with diabetes, 6.3% with chronic lung diseases, 6% with hypertension, and 5.6% with cancer died from the COVID-19 infection.[8] And by age group, 14.8% of 80+ year-olds, 8% of those in their 70’s 3.6% of those in their 60’s, 1.3% of those in their 50’s, 0.4% of those in their 40’s, 0.2% of those from 10-39 years old, a 0% of those below 10 years of age died from the COVID-19 infection.[9]
What is the good news? The good news is that 80% of cases are mild, the younger you are the less critical the infection is, the main response for someone suspected of having COVID-19 is isolation, and there are things that you can do to prevent serious complications from the illness. Why is isolation good news? It indicates that the immune system is able to successfully deal with the infection in the majority of cases.
So, what can you do to help in this crisis?
First of all, we recognize that health is a consequence of obedience to God’s laws (both moral and physical – Exodus 15:26), and disease/illness is a consequence of sin, which is disobedience to God’s laws (1 John 3:4). We also recognize that the power to truly heal from illness/disease comes from God. The following measures we will discuss are ways that we can cooperate with God (and His laws), and we do so, not trusting in the measures themselves, but in the God who alone can heal. It is of vital importance that we abide in the Vine (Christ) and remain in a prayerful, connected relationship with Him. That is our true protection and hope. These methods mentioned next are simply our way of expressing, through actions, our trust in God to be our protector and healer. Read Psalm 91 for great encouragement in these difficult times.
Basic Protective Measures
- Wash your hands frequently with soap and water or thoroughly clean your hands with an alcohol-based hand rub. This kills viruses that may be on your hands.
- Maintain at least 6 feet distance between yourself and anyone who is coughing or sneezing. If too close, you can breathe in the respiratory droplets which could contain COVID-19 and infect yourself.
- Avoid touching your eyes, nose and mouth with your hands. The hands touch many surfaces and can pick up viruses. If contaminated, the virus is transferred to your hands and then to your eyes, nose and mouth and make you sick.
- Practice respiratory hygiene by covering your mouth and nose with your bent elbow or a tissue when you cough or sneeze, then dispose of the used tissue immediately. This protects the people around you from viruses like cold, flu and COVID-19.
- If you have a fever, cough, and/or difficulty breathing, call your doctor or local medical clinic, then follow the directions given. Calling in advance will allow your health care provider to quickly direct you to the right health facility. This will also protect you and help prevent spread of viruses and other infections.
- Stay informed and follow advice given by your healthcare provider, your national and local public health authority or your employer on how to protect yourself and others from COVID-19. National and local authorities will have the most up to date information on whether COVID-19 is spreading in your area. They are best placed to advise on what people in your area should be doing to protect themselves.[10]
Protective Measures for Recent Travelers
If you have recently (past 14 days) visited areas where COVID-19 is spreading,
- Follow the guidance outlined above.
- Stay at home if you begin to fell unwell, even with mild symptoms such as headache and/or slight runny nose, until you recover. Avoiding contact with others and visits to medical facilities will allow these facilities to operate more effectively and help protect you and others from possible COVID-19 and other viruses.
- If you develop a fever, cough and difficulty breathing, seek medical advice promptly as this may be due to a respiratory infection or other serious condition. Call in advance and tell your provider of any recent travel or contact with travelers. Calling in advance will allow your health care provider to quickly direct you to the right health facility. This will also help to prevent possible spread of COVID-19 and other viruses.
- If you must go anywhere while having these symptoms, do wear a mask. This protects the people around you from getting sick. Do not touch the exterior of the mask.
- Wash your hands often.[11]
Additional Measures of Prevention and Immune System Boosting for Everyone
- Exercise regularly – the more physically fit that you are, the more likely you can prevent the development of an infection, and the better you can deal with the infection if you contract it. [12] Begin your exercise routine right away so you can have the greatest fitness before you are exposed to the virus.
- Eat an immune-promoting diet – this is a diet that promotes the best immune function, which includes foods with lots of anti-oxidants, and avoids excess sugars, fats, and highly-processed foods. More specifically, this diet promotes the consumption of fruits, vegetables, legumes, whole grains, nuts/seeds, and herbs, and would avoid the use of processed carbohydrates, sweeteners, artificial foods, fried foods, animal products and byproducts (the COVID-19 virus has 89% nucleotide identity with bat SARS-like-CoVZXC21, and thus thought to have come from bats[13]), and other high-fat foods.[14]
- Maintain optimum vitamin D levels – through daily sunshine exposure and Vitamin D3 supplementation. This enhances immune function.[15] The target is a vitamin D blood level between 60 and 75. The virus is sensitive to ultraviolet rays from sunlight and heat,[16] so let as much sunlight into every space you occupy.
- Fresh Air – all cases of known COVID-19 transmission have been in confined spaces. Keep windows open with a constant flow of fresh air through your home or workspace and spend much time outdoors.
- Take daily contrast showers – with your shower, alternate between hot and cold, beginning with hot and ending with cold. The hot cycle should be longer than the cold, and should not be too vigorous for you or your health condition. You should feel invigorated and refreshed after the contrast shower. If you have heart disease, are elderly, or have balance issues, be very mild in the change in temperature between the hot and cold (limit it to what you can tolerate well), and consider using a shower chair during your shower.
- Rest – those who are well-rested are better able to fight or resist infections. One of the complications of chronic sleep-deprivation is that it causes immune suppression,[17] thus increasing the susceptibility to infections. So, get to bed early and rest at least 7-9 hours each night.
- Maintain a good attitude – thoughts, whether positive or negative have direct effects on our immune system.[18] Those who are happy, joyful, confident, loving, compassionate, etc. are better able to resist infection than those who are depressed, insecure, suffering from guilt, revengeful, and self-focused. Therefore, a strong relationship with God and trust in His love has a significant impact upon immune function and susceptibility to infection.
- N-Acetyl Cysteine (NAC) – a study of adults showed that of those taking 600mg of NAC twice daily for 6 months, only 25% had symptoms when they were infected with an influenza virus, whereas 79% of those receiving a placebo had symptoms when they were infected.[19]
- The following items have been shown to have some anti-microbial, anti-viral, or anti-infectious properties:
- American Ginseng – avoid in pregnancy, 200-400mg twice daily [20]
- Siberian Ginseng – insufficient evidence to recommend for children or pregnancy, don’t take for longer than 2 months, 400mg 3 times daily [21]
- Panax Ginseng – (Asian Ginseng), don’t use more than 6 months, avoid in children and pregnancy, 200mg daily [22])
- Andrographis – (Indian Echinacea), avoid in pregnancy, 200mg daily [23]
- Thuja – (cedar leaf oil), avoid in pregnancy and lactation, 18-36mg 3 time daily, for 2 weeks [24]
- Wild Indigo [25]
- Echinacea – 800mg 3 times daily for prevention, up to 5 times daily with symptoms [26]
- Elderberry – only use the ripe fruit, dosage not specified [27]
- Umckaloabo – (African geranium), insufficient info for pregnancy/lactation, dose not specified [28]
- Zinc – prevention – about 20-25mg/day; treatment – up to 75mg/day for less than 1 week [29]
- Probiotics – at least 1 billion CFU’s (colony forming units) daily. The higher the CFU’s and the more bacterial species included, the better. Don’t take indefinitely [30]
Early Treatment
If you begin to feel ill in any way (sore throat, headache, body aches, fever, chills, etc.), we have found by experience that the following treatments can be helpful in averting the illness if you treat it early enough:
- Take a contrast shower – be a bit vigorous with 5-7 exchanges of hot & cold, while still taking precautions as mentioned above.
- Take a hot foot bath – get water as hot as you can tolerate it (no more than 103°F if you are diabetic or have circulatory problems in your legs, and avoid entirely if you have a new blood clot in your legs, have very poor circulation, or open wounds on your feet/legs) and wrap up in a blanket while your feet are in the hot water. Keep the water hot during the 20-30-minute treatment. Drink water frequently during the treatment.
- Take a hot bath – get in a hot bath, keep your head cool with a washcloth and ice water, and work up a good sweat for 15 to 20 minutes. If you have health conditions that would make it difficult or dangerous for you to run or jog, don’t do this treatment, as it will make your heart pump like it would for a jog.
In our experience, of these treatments, they can help cut the progression of symptoms if you can do them right after you start having symptoms. After each of these treatments, rest in bed under the covers for an hour, drinking water frequently as you sweat.
If Symptoms Persist or Progress
There are simple things you can do to help alleviate the symptoms that you have and shorten the period of illness or any complications.
- Rest: a prominent component of the successful treatment of patients in the Spanish Flu pandemic was the early initiation of total bedrest. Once an individual started to be ill, they were isolated, put on bedrest, and kept on bedrest until 2-3 days after their fevers resolved. Those who adhered to this plan were less likely to develop pneumonia as a complication of the Spanish Flu and more likely to survive.[31]
- Hot and cold applications: Hot and cold fomentations (see https://www.ucheepines.org/fomentations/ for more information) to the chest with a hot foot bath were a regular part of the successful treatment regimen of Spanish Flu in the 1918/1919 influenza pandemic.[32] With a heating pad under the upper back, start with wet cloths (fomentation pads, wet towels, hyrdocollator, moist heating pad, etc.) that are hot, but not burning hot, protected by a dry towel, and place over the chest for 3-5 minutes. Then rub the chest with ice water (washcloth or hand towel) for 30 seconds. Go back and forth between the hot and cold for 5-7 exchanges for a treatment, all the time keeping the heating pad on the upper back and the feet in a basin of hot water that can hold enough water to put both feet in it up to the ankles (see https://www.ucheepines.org/hot-foot-bath/ for more information). Repeat 1-3 times daily as needed.
- Give plenty of water or rehydration solutions to drink during the illness and treatments, as the patient will likely be sweating and losing extra fluids through the sweat. They need to remain well hydrated throughout their illness.
- Sweating: It is capable of eliminating many salts, drugs, toxins, and even some viruses[33]. Be certain to drink enough water. The sweating can be done in a bathtub with hot water. Be certain to keep the head cool, or you may feel weak and dizzy after treatment is over.
- Onion poultice: In our experience of treating respiratory infections, we have found onion poultices to be helpful in decreasing cough and sputum production in cases of lower respiratory infections. Blend ½ of a medium-sized onion in a blender with just enough water to make a paste. Spread it on a paper towel like the onion is the sandwich filler and the paper towel is the bread, so you have paper towel on the outside with the onion on the inside. Place it on the chest and then wrap it with plastic food wrap and secure it in place. Cover with a tight t-shirt and then a flannel or thick sweater and leave on overnight. Remove and wash off in the morning.
- Nature’s Penicillin: Another treatment that we have found helpful is what we call Nature’s Penicillin. Blend 1 orange, 1 grapefruit, 2 lemons, 3 cloves of garlic, and ½ of a large onion in a blender with enough water to just be able to blend it. Add 3 drops of peppermint oil and mix in. Drink 1 cup throughout the day.
- If your symptoms continue to worsen, contact your local healthcare facility and alert them to your situation and seek care according to their directions.
Recovery Phase
When you begin to improve (no more fevers, symptoms are going away, etc.), make sure that you do not become active too quickly. We recommend that you:
- Rest – continue with bed rest for 2-3 days after your last fever, or as many days after the fever is resolved as you had the fever. You want to make sure that you recover well and do not progress to pneumonia, as was the case with a number of the sufferers of the Spanish Flu pandemic. And after you are up and about, make sure you get to bed early each day.
- Contrast Shower – continue with contrast showers (3-5 exchanges each treatment) on a daily basis.
- Limit the amount of work that you do if you are tired, weak, or fatigued. Again, you want to avoid secondary infections or other complications by avoiding becoming too active too quickly.
- Spend a lot of time outdoors in the fresh air and sunshine, but with appropriate clothing for the climate (covering your trunk, shoulders, arms, and legs evenly and sufficiently to avoid chilling).
- Keep in a cheerful state of mind. The impact of your thoughts and attitudes on illness is great, so maintain that cheerful state of mind.
Summary
It is our prayer that you fare well in this pandemic and reveal to the world that the health message we have had for over a hundred years is effective even in pandemic situations. Keep in good faith, trusting in your heavenly Father and His great mercy, while at the same time cooperating with Him in keeping yourself in the best health possible. Be a source of help and encouragement to your neighbors and community. Let us pull together as a people, under Christ, to meet this emergency in the faith and strength of Jesus.
Helpful links:https://www.ucheepines.org/fomentations/https://www.ucheepines.org/hot-foot-bath/https://www.ucheepines.org/full-body-pack-blanket-pack-for-fever-treatment/https://www.ucheepines.org/the-immune-system-how-to-strengthen-it/https://www.ucheepines.org/sinus-treatment-2/https://www.ucheepines.org/full-body-pack-blanket-pack-for-fever-treatment/
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[1]https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen
[2] https://www.cdc.gov/coronavirus/2019-ncov/prepare/transmission.html
[3] https://www.cdc.gov/coronavirus/2019-ncov/about/symptoms.html
[4] https://ourworldindata.org/coronavirus
[5] http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9a9b-fea8db1a8f51
[6] https://ourworldindata.org/coronavirus
[7] https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/high-risk-complications.html
[8] https://www.marketwatch.com/story/coronavirus-fatality-rates-vary-wildly-depending-on-age-gender-and-medical-history-some-patients-fare-much-worse-than-others-2020-02-26
[9] https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/
[10] Coronavirus disease 2019. (2020, March 02). Retrieved from WHO website: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public
[11] https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public
[12] Campbell JP, Turner TE. Debunking the Myth of Exercise-Induced Immune Suppression: Redefining the Impact of Exercise on Immunological Health Across the Lifespan. Front Immunol. 2018; 9: 648.
[13] Cascella M, Rajnik M, Cuomo A, et al. Features, Evaluation and Treatment Coronavirus (COVID-19) [Updated 2020 Mar 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554776/
[14] Percival SS. Nutrition and Immunity: Balancing Diet and Immune Function. Nutrition Today. 2011; 46: 12-17.
[15] Preiti B, et. al. Vitamin D and Immune Function. Nutrients 2013, 5(7), 2502-2521.
[16] Cascella M, Rajnik M, Cuomo A, et al. Features, Evaluation and Treatment Coronavirus (COVID-19) [Updated 2020 Mar 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554776/
[17] Maurovich-Horvat E.1, Pollmächer T.2, Šonka K. The Effects of Sleep and Sleep Deprivation on Metabolic, Endocrine and Immune Parameter. Prague Medical Report / Vol. 109 (2008) No. 4, p. 275–28. Accessed 03/14/2020.