There are few things which have the power to cause this degree of global panic — the type that rocks the foundations of trade and travel, causes shortages of supplies, and creates sudden urges to hoard massive amounts of toilet paper. Aside from large, rare events such as impending world war, or an inbound asteroid, the most frequent cause of these enormous waves of panic come from a microscopic source. A virus.

We’ve all had to deal with a virus at some point in our life. In fact, you’ve certainly been infected with a coronavirus – maybe even more than once a year. Certain strains of coronavirus infect so regularly, we’ve dubbed it ‘the common cold’. These cases fall into more of a nuisance or inconvenience spectrum, with mild to moderate symptoms like runny nose, congestion, mild fever, etc. However, other strains have the ability to cause severe symptoms and even death.

The biological directive for any virus – whether it’s the common cold, influenza, Ebola, or HIV, is to replicate as fast and as far as possible, and they do whatever is necessary in the quest for global domination. Viruses have an innate ability to spread rapidly, mutate quickly, and easily pass between hosts – even between species.

Humans, as social creatures, provide an easy pathway to facilitate the spread of viruses. We are often in close proximity to dozens if not hundreds of different people. We greet each other with handshakes or hugs. We share spaces for working, eating, commuting, entertaining, congregating, and shopping - the perfect distribution network for an up and coming virus.

Serious coronavirus episodes are not new. They were the cause of the Spanish Influenza pandemic in 1918, and more recently, SARS (severe acute respiratory syndrome) and MERS (Middle Eastern respiratory syndrome).

The Spanish Influenza was caused by a strain of coronavirus known as H1N1 (the same strain responsible for Influenza A and the Swine Flu pandemic of 2009), and is considered the most deadly infection in history, with an astounding 500 million cases world-wide and an estimated death toll between 17 and 50 million. That’s a mortality rate between 5 and 10%. The distribution of this virus was increased exponentially due to the first World War, as infected soldiers returned home.

SARS infected eight thousand eighty-nine people with seven hundred seventy-four deaths: about 10% mortality. There were significantly fewer cases of MERS – around eight hundred seventy-three in 2014-2015, but had a much higher mortality rate of around 39%. By way of comparison, the seasonal flu (both A and B strains) infects an estimated 1 billion people per year with between two hundred and ninety one thousand to six hundred and forty six thousand deaths per year, resulting in a 0.1% mortality rate.

The Novel Coronavirus which causes Covid-19 is closely related to SARS, and both share a common characteristic with MERS: They are Zoonotic, which means they are able to mutate and cross species barriers that normally prevent such transmission. For example, SARS was transmitted from bats to cats and then to humans, MERS was transferred from bats to camel to human, and the genesis of Covid-19 is thought to be from bat to pangolin to human.

It’s the ability to mutate quickly, and jump from species to species that make these strains of viruses so concerning, dangerous, and difficult to treat. As the virus spreads, isolated instances can quickly become epidemics, and unchecked, can result in a global pandemic. Such is the case for the Novel Coronavirus and the Covid-19 infection, causing entire countries to go into isolation, disrupting business, travel, and education, and reshaping the way we live.

What is Covid-19?

This infection is caused by a strain of virus known as coronavirus. It’s called coronavirus because the spikes that surround the virus, are topped with blunted shapes that resemble a crown. As mentioned previously, coronavirus strains have been responsible for a slew of serious episodic events throughout history. However, this particular strain was never known to humans before December, 2019. Since its emergence, Covid-19 has infected more than one hundred seventy-three thousand people, killed over seven thousand and has an estimated mortality rate of 3.4%.

It’s important to note that the majority of people who will be infected by the virus will only suffer mild symptoms, and some will show no symptoms at all. We know that infected but asymptomatic people are able to spread the virus just like people with active illness. The percentage of people who experience serious, severe, or extreme symptoms is big, around 15-20%. The potential for severe symptoms and asymptomatic spread are the 2 factors which make this virus so concerning.

Consider if 80% of infected individuals develop the typical flu symptoms of low grade fever and cough, they may not realize they’re carriers of Covid-19, and continue to spread it. Another compounding factor to consider is the incubation period, which averages 5-14 days – that means some people are walking around shedding virus for 2 weeks before developing symptoms.

Without a history to refer to, it’s difficult to predict how this virus will behave, accounting for the shifting estimates in cases, and for the change in projected death rate, which was originally calculated to be around 2%. This is in sharp contrast to the seasonal flu which has been around consistently enough over the decades to allow scientists to study, understand and create somewhat effective means of prevention.

As scientists around the world scramble to better understand Covid-19, the conservative estimate of a timeline for an effective vaccine is 12-18 months. While that will undoubtedly assist in containing and controlling the virus in the future, it’s little comfort to us today, as we can watch in real-time as the virus spreads and the number of infected and death toll rises.

How is it spread?

Similar to other coronavirus strains, Covid-19 is spread through coughing, sneezing, physical contact with infected persons, or from surfaces which have been exposed to respiratory droplets from an infected individual.

The spread of any infection is calculated using a method called ‘R naught’ or R0 which predicts how contagious it is. For example measles has a R0 factor of 11-18. This means a single person infected with measles could infect between 11 and 18 additional people. Each of those infected individuals could then go on to infect another 11-18. You get it- fast and furious.

To further illustrate, Ebola has an R0 factor of 2, so each infection can potentially cause 2 more. The seasonal flu comes in around 1.3 on the R0 scale, and Covid-19 is sitting at 2 to just over 3, making it more contagious than the seasonal flu and Ebola.

During the early phases of Covid-19 infection, the virus is in a ‘shedding’ stage, meaning it’s producing high levels of viral particles (nearly 1,000 times more than during SARS), which are shed from the body during coughing and sneezing. This shedding decreases around 5 days after symptoms appear, and even though they believe the transmission rate is greatly reduced after 10 days, a person will still test positive with a throat swab 10-11 days after symptoms. Interestingly, scientists were unable to grow viruses from swabs taken after day 8 of the illness. Negative test, positive for infection. Scary.

Remember the 80% of people with mild or no symptoms? Some may never get tested, or some may get tested later in the illness (after day 8), and not realize they have been infectious for days before. This is where contagiousness projections explode, and why the number of infections keeps rising. As of right now, there are close to 4500 cases in the United States. If each of those people unknowingly infect 2 to 3 people in a day, the number of infections grows exponentially.

Who is at risk?

Because there are no vaccines for this virus, everyone who is exposed to Covid-19 has the potential to be infected.

The population most at risk for severe-extreme symptoms or death are people 60-80 years old, or younger people who have existing conditions which have weakened their immune systems.

So far, there have been no deaths for children up to 9 years old.

What are the symptoms?

  • Fever over 100.4º
  • Dry cough
  • Shortness of breath – this is probably the symptom that separates coronavirus from influenza
  • Chills
  • Body aches
  • Rare cases include vomiting or diarrhea.

Symptoms can be mild or severe, and may lead to pneumonia.

If you think you may be infected, you should contact your doctor’s office for screening. Everyone should be observing the 6ft social distancing rule and washing their hands with soap and water regularly, and trying not to touch their face.

If you are infected get plenty of rest, and fluids. If you are having difficulty breathing, you need to contact your hospital or physician. Avoid public places where you may infect others.

What can I do to prevent infection?

The recommendations to prevent infection are similar to other communicable illnesses.

  • Wash your hands with soap and water regularly – this is actually more effective than hand sanitizer at killing the virus.
  • Drink plenty of fluids
  • Social distancing
  • Avoid personal contact, like hugging, handshakes, etc.
  • There’s no need to purchase every bottle of hand sanitizer. If you are at low risk of getting sick, buy a single bottle and leave a supply for those who may be at higher risk.

How can functional medicine help?

Because this is a new strain of infection, there are no studies to look to for guidance on how to prevent and treat it. Having said that, we have a wealth of data on preventing and treating other viral infections and conditions that stress our immune system.

For those of you that know me, you know that I love signaling peptides. There are several peptides with immune support or modulating properties that I recommend to patients for both prevention and treatment of infection. The most powerful tool in this class is a peptide called Thymosin Alpha 1. TA1 was approved by the FDA under the orphan program in 2013 as a drug called Zadaxin. Thymosin alpha 1 is secreted by the thymus gland. It stimulates T cell production, assists in the development of B cells to plasma cells, and is important for antibody production. Thymosin alpha 1 actually directly suppresses viral replication. It also increases viral antigenic expression making viruses more susceptible to immune system destruction. TA1 has an excellent safety profile and can even be used in children. For preventing infection and immune system support, this peptide is typically given twice weekly in a subcutaneous injection. We dose it more aggressively for patients if they have active illness.

My other immune modulating peptide of choice is called Selank. Selank is a nootropic peptide that is typically used for anxiety. It has many other cool effects in the body, one of which is antiviral activity. It directly and indirectly supports immune system function and has been studied for both prevention and treatment of many viral infections. Selank is administered in a nasal spray once daily so needles needed with this:

In addition to peptides, there are many dietary supplements that we know strengthen and support the immune system. Vitamin D, vitamin C, andrographis, zinc, omega-3, probiotics and cannabidiol or CBD oil are all excellent options.

Lastly, we know that umbilical cord derived stem cells have powerful immune modulating properties for both prevention and treatment of infection. Stem cells help our old cells to behave young again. When it comes to infections, stem cells help our immune system to see and attack invading viruses and bacteria more effectively. There are now actually case reports of patients with coronavirus who have improved with stem cell injections.

In closing, I want to say that my number one objective here is to provide as much functional medicine information as possible about preventing and treating illnesses - whether they are caused by autoimmune disorders, hormone imbalance, or as in this case, viral infections.

The goal of functional medicine is improving overall health and well being and we will strive to continue providing that service.

Resources and References

Peptide Therapy for Covid-19 Resources

Case Studies of Stem Cell use in Covid-19

References

 

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