COVID-19 can sometimes overwhelm young and old immune systems and in some cases can result in ‘Severe Acute Respiratory Syndrome’ pneumonia and death (CDC (2020). The risk is greater for older people who may simultaneously be dealing with cancers, heart disease, diabetes, emphysema or other health issues. As we age the immune system deteriorates (immunosenescence) which reduces the response of the adaptive immune system that needs to respond to the virus infection (Aw, Silva & Palmer, 2007; Osttan, Monti, Gueresi, et al., 2016).
Severity of disease may depend upon initial dose of the virus
In a brilliant article, How does the coronavirus behave inside a patient? We’ve counted the viral spread across peoples; now we need to count it within people, assistant professor of medicine at Columbia University and cancer physician Siddhartha Mukherjee points out that severity of the disease may be related to the initial dose of the virus. Namely, if you receive a very small dose (not too many virus particles), they will infect you; however, the body can activate its immune response to cope with the infection. The low dose exposure act similar to vaccination. If on the other hand you are exposed to a very high dose then your body is overwhelmed with the infection and is unable to respond effectively. Think of a forest fire. A small fire can easily be suppressed since there is enough time to upgrade the fire-fighting resources; however, during a fire-storm with multiple fires occurring at the same time, the fire-fighting resources are overwhelmed and there is not enough time to recruit outside fire-fighting resources.
As Mukherjee points out this dose exposure relationship with illness severity has a long history. For example, before vaccinations for childhood illnesses were available, a child who became infected at the playground usually experienced a mild form of the disease. However, the child’s siblings who were infected at home develop a much more severe form of the disease.
The child infected in the playground most likely received a relatively small dose of the virus over a short time period (viral concentration in the air is low). On the other hand, the siblings who were infected at home by their infected brother or sister received a high concentration of the virus over an extended period which initially overwhelmed their immune system. Higher virus concentration is more likely during the winter and in well insulated/sealed houses where the air is recirculated without going through HEPA or UV filters to sterilize the air. When there is no fresh air to decrease or remove the virus concentration, the risk of severity of illness may be higher.
The risk of becoming sick with COVID-19 can only occur if you are exposed to the coronavirus and the competency of your immune system.
This can be expressed in the following equation.
This equation suggests two strategies to reduce risk: reduce coronavirus load/exposure and strengthen the immune system.
What can you do to reduce the dose of virus exposure
Assume that everyone is contagious even though they may appear healthy. Research suggests that people are already contagious before developing symptoms or are asymptomatic carriers who do not get sick and thereby unknowingly spread the virus. Dutch researchers have reported that, “The proportion of pre-symptomatic transmission was 48% for Singapore and 62% for Tianjin, China (Ganyani et al, 2020). Thus, the intervention to isolate people who have symptoms of COVID-19 (fever, dry cough, etc.) most likely will miss the asymptomatic carriers who may infect the community without awareness. Only if you have been tested, do you know if you been exposed or recovered from the virus. To reduce exposure the dose of virus exposure, do the following.
- Follow the public health guidelines:
- Social distancing (physical distancing while continuing to offer social support)
- Washing your hands with soap for at least 20 seconds.
- Not touching your face to prevent microorganisms and viruses to enter the body through mucosal surfaces of the nose mouth and eyes.
- Cleaning surfaces which could have been touched by other such as door bell, door knobs, packages.
- Wearing a mask and gloves to reduce spreading the virus to others.
- Increase fresh air to reduce virus concentration. By increasing the fresh outside air circulation, you dilute the virus concentration that may be shed by an infected asymptomatic or sick person. Thus, if you are exposed to the virus, you may receive a lower dose and increase the probability that you experience a milder version of the disease. To increase fresh air (this assumes that outside air is not polluted), explore the following:
- Open the windows to allow cross ventilation through your house or work setting. One of the major reasons that the flu season spikes in the winter is that people congregate indoors to escape weather extremes. People keep their windows closed to conserve heat and reduce heating bill costs. Lack of fresh air circulation increases the viral density and risk of illness severity (Foster, 2014).
- Use an exhaust fans to ventilate a building. By continuously replacing the inside “stale” air with fresh outside air, the concentration of the virus in the air is reduced.
- Use High-efficiency particulate air(HEPA) air purifiers to filter the air within a room. These devices will filter out particles whose diameter is equal to 0.3 µ m. They will not totally filter out the virus; however, they will reduce it. Note: for even better air purification and testing visit pureairdoctor.com.
- Avoid buildings with recycled air unless the heating and air conditioning system (HAC) uses HEPA filters.
- Wear a mask to protect other people and your community. The mask will reduce the emitting of the virus by people with COVID-19 or asymptomatic carriers.
How to strengthen your immune system to fight the virus
The immune system is dynamic and many factors as well as individual differences affect its ability to fight the virus. It is possible that a 40 year-old person may have an immune systems that functions as a 70 year old, while some 70 year-olds have an immune system that function as a 40 year-old. Factors that contribute to immune competence include genetics, aging, previous virus exposure, and lifestyle (Lawton, 2020).
By taking charge of your lifestyle habits through an integrated approach, you may be able to strengthen your immune system (Alschuler et al, 2020; Lawton, 2020). The following tables, adapted from the published articles by Lawton (2020) and Alschuler et al, (2020), list some of the factors that may strengthen or weaken the immune system.
Factors that strengthen the immune system
Factors that may weaken the immune system
These factors have been superbly summarized by the World Health Organization Director General Dr. Tedros Adhanom in his presentation, Practical tips how to keep yourself safe.
Note: We don't treat any named, un-named disease condition or illness. Our job is to help the body to function better. We make no claims about the article above -- but thought you would find it an interesting read.
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ALL THE BEST – DR. KARL R.O.S. JOHNSON, DC – DIGGING DEEPER TO FIND SOLUTIONS
Ganyani, T., Kremer, C., Chen, D., Torneri, A, Faes, C., Wallinga, J., & Hensm N. (2020). Estimating the generation interval for COVID-19 based on symptom onset data doi:https://doi.org/10.1101/2020.03.05.20031815
Ostan, R., Monti, D., Gueresi, P., Bussolotto, M., Franceschi, C., & Baggio, G. (2016). Gender, aging and longevity in humans: An update of an intriguing/neglected scenario paving the way to a gender-specific medicine. Clinical Science, 130(19), 1711-1725.
Special thanks to Dr. Erik Peper for giving permission to use his blog post; Can you Reduce The Risk of Coronavirus Exposure and Optimize Your Immune System (by Erik Peper and Richard Harvey) as a guest blog on my website.