NOTE: COVID-19 is spread in large droplets by coughing and sneezing. This means that the air will not infect you! BUT all the surfaces where these droplets land are infectious for about a week on average – everything that is associated with infected people will be contaminated and potentially infectious. The virus is on surfaces and you will not be infected unless your unprotected face is directly coughed or sneezed upon. This virus only has cell receptors for lung cells (it only infects your lungs) The only way for the virus to infect you is through your nose or mouth via your hands or an infected cough or sneeze onto or into your nose or mouth.
How is COVID-19 transmitted?
It is now clear that human-to-human transmission of COVID-19 is possible and is occurring. Transmission is mainly through respiratory droplets and close contact – similar to how influenza is spread. The CDC defines close contact as being within 6 feet or within a room or care area for a prolonged period without personal protective equipment OR having direct contact with secretions of a person with COVID-19 infection. There is some evidence that fecal-oral or blood transmission may be possible, even when COVID-19 is not detected in oral swabs (3). Investigation is underway to determine how long COVID-19 can survive on various surfaces and possibly be transmitted through “fomites” (a fancy word for objects or materials that can carry infection, such as tabletops, keyboards, clothes and utensils).
The incubation period is thought to be 2-14 days, with a median incubation period of 4 days. Patients are thought to be most contagious when they are symptomatic. However, a recent report (4) found that an asymptomatic woman who transmitted COVID-19 to 5 other people may have had an incubation time of 19 days.
What are the symptoms of COVID-19?
What is important to remember is that the majority of infected people appear to have mild infections – with mild cold-like symptoms and fever, and likely many who have no symptoms. As noted above, there are case reports of asymptomatic carriers. However, most people who contract COVID-19 do seem to develop symptoms of some sort.
Reported symptoms include:
- Fever (which may not be present in the very young or very old, or immunocompromised)
- Uncomplicated upper respiratory symptoms (Cough, sore throat, nasal congestion, malaise, headache, muscle aches)
- Difficulty breathing
- Mild pneumonia
- Severe pneumonia (the severe pneumonia caused by COVID-19 is now named severe acute respiratory infection (SARI))
- Acute Respiratory Distress Syndrome (ARDS)
- Sepsis and Septic shock
How and who do you test for COVID-19?
COVID-19 is detected by testing nasopharyngeal swabs (basically a q-tip up the nose), oropharyngeal swabs (a throat swab), and sputum for genetic material of COVID-19 by polymerase chain testing (PCR). The test kit is called the “Centers for Disease Control and Prevention (CDC) 2019-Novel Coronavirus (2019-nCoV) Real-Time Reverse Transcriptase (RT)-PCR Diagnostic Panel.” In the US, these test kits are NOT available currently through doctor’s offices, community clinics, or hospitals (i.e. I do NOT have test kits). If I were suspicious that a child or parent in my office could have COVID-19, I would send them to the public health department for testing.
Currently, the recommendations are to test patients with fever and lower respiratory symptoms (cough or shortness of breath) who have had close contact with: 1) a person with confirmed COVID-19; or 2) history of travel from affected geographic areas with 4 days of symptoms; OR anyone with severe acute lower respiratory illness that requires hospitalization and does not have another diagnosis like influenza, eve without any known source of exposure. Remember, the CDC defines close contact as being within 6 feet or within a room or care area for a prolonged period without personal protective equipment OR having direct contact with secretions of a person with COVID-19 infection.
This is the protocol that was emailed to me by my local health department (8):
How do you treat COVID-19?
There are currently no specific antiviral medications known to treat COVID-19, Treatment is supportive with rest, fluids, oxygen, and more intensive care if needed. Scientists are actively researching possible existing or new antiviral medications that may have activity against COVID-19, and vaccines that may help to prevent COVID-19. Tamiflu will not work. While these efforts are critically needed, the manufacture and testing of a new pharmaceutical agents or vaccines is likely several months to over a year in coming.
Natural Anti-Viral treatments.
HERB LIST CLIFF NOTES:
Sambucus spp: Anti-viral, antioxidant
Lomatium dissectum: Anti-viral, helps break up mucous
Grindelia spp: expectorant, reduce mucous
Astragalus spp: immune system support, anti-viral
Glycyrrhiza (Licorice root): antiviral, mucolytic, anti-inflammatory.
Saracenia purpurea: anti-viral, reduce fever, diuretic
Ligusticum porterii: Antiviral, reduce sore throats, coughs, can improve various lung ailments.
THIS IS A SHORT LIST THERE ARE MANY OTHERS
SPICE CABINET ANTIVIRALS: Oregano, Ginger, Lemon balm, Sage, Garlic, Fennel, Basil, Rosemary.
5,000IU infants; 10,000-20,000IU for children; 50,000IU for adults do this for 3 days. This improves natural killer cells response, reduces inflammation, and antiviral activity, improves epithelia integrity.
2,000-5,000IU for infants; 10,000IU children, 20,000-50,000IU adults for 10 days then reduce dosing to 25%
has been called a “pro-survival molecule.” In this review of the literature on Vitamin D and immunity (19), the authors conclude that:
“… vitamin D not only helps the immune system to be dampened during an excessive or chronic reaction (anti-inflammatory potential) but also to rapidly reach its completion or exhaustion, helping innate cells to kill bacteria or viruses. In this sense, vitamin D maintains its pivotal role as a pro-survival molecule.”
Cathelicidin produced by Vitamin D can neutralize LPS (lipopolysaccharides) that are responsible for so much of the damage that we see in sepsis, and also has antimicrobial and immunomodulatory effects. (20) Vitamin D deficiency may actually be considered a risk factor for sepsis and inflammatory disorders, so please ensure that your and your child’s vitamin D levels are optimized as I discuss below in how to protect your child.
500-1000mg 2-3x daily for children, 1000mg 3-4x daily for adults
Antioxidant properties, improve integrity of mucosal membranes.
Natural mucolytic, can be taken orally or nebulized, natural antioxidant and anti-inflammatory.
has also been found to inhibit the NF-kB pathway (23), and to improve survival and decrease cellular damage in a mouse model of sepsis
There are commonsense measures to protect yourself from COVID-19 that you should be practicing regardless of whatever virus is circulating at the moment. The only unique recommendation with COVID-19 is to avoid unnecessary contact with non-domesticated animals due to presumed animal-human transmission. Other commonsense measures to protect yourself and prevent spread of illness include:
- Wash hands frequently, especially before eating or touching your face. Washing hands with warm soap and water for at least 30 seconds is the best option. This study found that washing hands even with plain running water without soap was more effective than ethanol-based hand disinfectants at killing the Influenza A virus! (36)
- Avoid touching your eyes, nose, and mouth! Do your best to keep those little fingers away!
- Stay home when you’re sick, unless you need urgent medical attention. You may be increasing your possible exposures to COVID-19 if you don’t have it, or exposing others unnecessarily if you do.
- Cover your cough with your elbow or tissues. Teach your kids proper cough etiquette. And if you use a tissue, immediately throw it into the trash and wash your hands.
- Keep your distance. Try to stay at least 6 feet away from anyone who is obviously sick with fever and/or respiratory symptoms.
- Irrigate your nose. While we do not know if nasal irrigation makes a difference for prevention of COVID-19, I believe that one of the MOST preventive things you can do for any viral respiratory illness is to irrigate your, and your children’s, nasal passages with Xlear nasal spray at the end of every day and after any potential exposure (work, school, playgroups, plane travel, etc.). This is a saline nasal spray with xylitol and grapefruit seed extract, both of which have antimicrobial properties. You cannot overdo it, and will not get “addicted” to it. Other options for nasal irrigation are a regular saline spray, Neti pot, and other sinus rinses like Neilmed.
**Apart from regular hand washing, I believe that daily and frequent nasal irrigation is one of the MOST important things that we can do to prevent influenza and other viral respiratory infections from taking hold.** This is because after exposure to a virus, the influenza virus tries to invade and multiply in your nasal passages for at least 1-2 days before you develop any symptoms. Nasal irrigation can wash away viral particles before they have the opportunity to take hold, and thereby prevent many infections from happening in the first place!
- Load up on foods and spices with antiviral properties. These include coconut oil, raw garlic, oregano, ginger, kimchi and other fermented foods, walnut, pomegranate, green tea, apple cider vinegar, and medicinal mushrooms (shiitake, maitake, reishi, cordyceps, turkeytail).
- Eat lots of colorful fruits and vegetables. They are full of antioxidants which will destroy the free radicals that weaken our immune system and are responsible for making us feel sick when we catch a bug. Each color provides different antioxidant power – so be sure to eat a rainbow every day. If you’re kids aren’t the hugest vegetable eaters yet, give them their antioxidant dose with a smoothie packed with fruits AND veggies, use that smoothie to make jello with grass-fed gelatin or popsicles, sneak pureed vegetables into your spaghtetti sauce, soups, chilis, or whatever other way you can think of – be creative!
- Stay well-hydrated. Stick to water, coconut water, herbal teas, and bone broth. No soda or sugary drinks, please! What’s a good estimate for how much water you need at a minimum? Divide your body weight (in pounds) in half and drink that number in ounces! Do you come close?
- Drink your bone broth! Bone broth has amazing immune-supporting properties. See Amazing Bone Broth to get started easily making your own.
- Eat fermented foods. The probiotics contained in fermented foods have tremendous immune boosting powers. In fact, the fermented Korean cabbage, kimchi, was found to have significant effects in preventing and fighting the H1N1 influenza virus! Other examples of delicious fermented foods to try include sauerkraut, pickles (try “real” pickles without added vinegar like Bubbies), miso, kefir, and kombucha.
- Avoid simple sugars and processed/junk food. Did you know that your blood shows lab evidence of a lowered immune system within 30 minutes of eating simple sugars (like glucose, refined sugar, and fructose), and causes a 50% reduction in your white blood cells’ abilities to kill germs? White blood cells are our “army” cells that fight off germs. This effect is most noticeable 2 hours after ingestion, but is still present 5 hours later! Keeping blood sugar levels healthy has been shown to improve immune system activity.
- Get fresh air and moderate daily exercise. Moderate exercise can boost the production of macrophages, the kind of white blood cells that “eat” bacteria and viruses. However, intense exercise can actually temporarily decrease immune function – so don’t overdo it!
- Get adequate sleep. An increase in sleep actually increases the number of your white blood cells. On the other hand, loss of sleep even for a few hours at night, increases inflammation in our body which makes us more susceptible to catching the flu and having more severe symptoms. So make sure your whole family is getting enough zzzz’s. For tips on getting a good night’s sleep,