Covid for Individuals April 2020

So much of what is written on the internet about Covid-19 focuses on the macro scale. Health care systems, country wide lockdowns, multi-country scientific collaboration. I haven’t seen much about what to do if you or someone in your household gets sick with it. Because we are learning so quickly about the disease and the impacts it has, there is a lot of current and past science that can be applied to answer this question. Consider this the individual’s guide to treating your own or an immediate family member’s mild covid experience. I am not a doctor, but I do have the ability to read and understand the relevant literature, and I will cite all claims.

Covid-19 is experienced in up to five stages. The first is asymptomatic, where you have been infected but have not developed symptoms. Each subsequent stage is an escalation of the prior stage. Each stage requires different treatment, hence the benefit of viewing it through stages.

Malaysia was the first to identify (roughly) the stages of progression and disease severity in Covid-19. The stages are: positive but asymptomatic (one), positive but with mild symptoms (two), positive with shortness of breath, hypoxia or other pneumonia-like symptoms (three), positive and requiring external oxygen (four), and pneumonia or severe oxygen desaturation requiring intubation (five) 1. The latter two (stages four and five) require hospitalization and treatment from experienced doctors and respiratory therapists, that’s outside our scope. If you have trouble breathing, you should call Public Health and make a plan to go to the hospital.

The other three stages are more interesting to me, and the focus of this writing. Roughly 95% or more of cases (depending on how good your surveillance is) never get past stage three. It turns out there are things you can do to reduce the likelihood that you progress to the more acute stages. Here are some of the things currently being studied or which have already been studied, which can improve your state and symptoms, in some cases quite significantly. The sooner these things are acted upon, in theory, the more time your body has to win the battle.

Proning

The most critical strategy for treating phase two and three covid-19 is proning. It means laying down on your stomach, chilling. It works because it allows your lungs to bring more oxygen in (more available volume) and it reduces the effort required. A field study (doctors trying stuff) looked at 50 patients in Brooklyn 5. The range for their oxygen saturation when they arrived was between 69% and 85%, which is strangely low (you would expect people to be unable to talk or function). Laying on their stomach for five minutes brought them up to 94% on average. In younger people, this is often all that is needed, 75% of them improved condition wise and maintained it by staying on their stomach most of the time. In any other condition, you would put someone that low on a ventilator, but 75% of the time, especially effective for younger patients, you just have them lie on their stomach. A similar strategy is used by cyclists after mountain riding. Which gives more credibility to the assumption that covid-19 is viral altitude sickness.

Isolation

It’s important if you start to have Covid-19 symptoms to isolate from the people you live with. Much of the spread in China, Italy and other places where we have more longstanding contact tracing programs suggests that four out of five cases are spread among close contacts. The longer you can delay (or avoid entirely) someone else in the household getting sick, the easier it will be to maintain the functioning of the house. Isolation (ideally) means a dedicated bedroom and bathroom for the sick person to use for the duration of their symptoms. If you have to interact with them, make sure the sick person is wearing a mask and that you are doing your best hygiene wise. The worst part of Covid-19 tends to be week two, when your body is struggling to keep up with its oxygen needs. So if you can avoid multiple people experiencing the second week at the same time, you make it easier for others to contribute their support.

Saffron

As we learn more about the pathology for covid-19 infections, it becomes clear one of the impacts is a breakdown of the effectiveness of diffusion of oxygen between lung alveoli and blood capillaries. Basically, the air enters your lungs and has to be “exchanged” with red blood cells, getting CO2 out and putting oxygen in. It appears that this process is hindered by covid-19, which is a process called diffusion. There are no pharmaceuticals available right now that increase the effectiveness of diffusion. Saffron (the food) has been shown to improve the diffusion process in the body. No studies have looked at whether this applies to covid patients.

Zinc

Zinc is being used along with antivirals chloroquine and hydroxychloroquine for the treatment of Covid-19. Patients are given 200mg of Zinc (a lot) along with the medications, and a preprint study 2 found that zinc leads to better outcomes than the antivirals alone. Zinc acts on the virus in a way that makes it much harder to spread. It can’t treat or cure the existing presence of the virus, but it can make it harder for the virus to spread, giving your body more time to fight it. Zinc is an inexpensive, over the counter supplement and could be effective, especially in the early stages, at slowing down the spread of the virus. Worth having pill and lozenge form on hand. The pill because the presence of zinc in the blood could enable slower spread, and the lozenge because in the first and second stage of Covid-19 the viral load is mostly in your throat.

Black Tea

There are many potential food and drink “cures” for colds and flus out there. In the case of coronaviruses however, only one has something with proven scientific efficacy. Oddly, Black Tea contains an organic compound abbreviated as TF3 3. It turns out that in all coronaviruses (SARS, MERS, the four common colds and Covid-19), TF3 can inhibit or neutralize the virus by acting on the pathway it uses to spread. Sort of like a milder antiviral effect. It’s not studied specifically whether drinking Black Tea is an effective treatment for this coronavirus, rather it’s found that in the quantities contained in Black Tea, it would theoretically be effective. Given the viral load starts in your throat, that Black Tea is cheap and delicious, this is another scientifically supported option that you could use in the first stages to slow spread and support your body.

Nitric Oxide

One of the things Black Tea happens to do is increase nitric oxide content in your blood. Many other things (from Viagara’s active ingredient, to beets) do the same. And similar to the other things we have talked about, it turns out that high blood NO content inhibits the spread of Covid-19 4. There are various dietary sources, with varied levels of effectiveness, that contribute to a similar effect: zinc (hello again), B12, B6, beets, Black Tea and Vitamin C. A study found that high altitude populations (tibetans) have up to 10x the concentration of nitric oxide in their blood. So again the theory holds that it is critical for adapting to altitude sickness.

Oxygen

Covid-19, contrary to early indications, is primarily a disease that attacks blood hemoglobins. The goal of that system is to spread oxygen to your tissue. Rather than destroying your lungs, which leads to less oxygen, it destroys the distribution mechanism for oxygen, which stresses out your entire body (and eventually your lungs too as they try to compensate). When milder case patients receive air rich in oxygen, it tends to improve their condition, because it gives your lungs an unfair advantage (artificially oxygen rich air so that you can compensate for the lack of distribution cells). This improved distribution ability allows your body to catch up in the fight against the virus itself, slowing or preventing further desaturation of the blood oxygen levels. If you are going to take oxygen at home, you should have an SpO2 monitor ($50-100 on Amazon) so that you can see what your blood oxygen content is while you’re taking the oxygen. Taking oxygen would come from an oxygen concentrator ($500-1000 on Amazon). It is possible that if people got oxygen as soon as they stopped having 95%+ saturation of oxygen in their blood, the outcomes of Covid-19 patients would be much better, because the body would be much less stressed. If you wait until you cannot oxygenate your blood to go and get care, it doesn’t help as much because your blood is already starved for oxygen regardless of the state of your lungs. Covid-19 presents like HAPE, which is a pulmonary condition experienced by high altitude climbers. So rather than being like a flu or viral pneumonia, it’s more like viral altitude sickness.

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