DDP Newsletter – May, 2020, Vol. XXXVI, No. 3
Many people’s lives are dominated these days by concerns about the coronavirus pandemic. Many refuse to go anywhere if not absolutely necessary. Some “quarantine” or disinfect their groceries, and shower and wash their clothing after doing an errand. Are the masks, “social distancing,” and obsessive-compulsive behaviors necessary—or protective? Evidence for benefit from the drastic measures is nonexistent to thin. There are many unknowns, but some observations can be made:
If there is coronavirus in the vicinity, you have some on you. In an unpublished experiment, a harmless chemical compound resembling material found in viral coats was radioactively tagged and applied near the mouth or on the palm of two “spreaders.” They carried on normal social interactions with several test subjects who were doing library research—talking, looking at papers, etc. The subjects washed their hands frequently. At the end of several hours, all had radioactively tagged material on face, hands, and clothing.
Viruses rain from the sky. Even in pristine environments, the downward flux of viruses ranges from (0.26)(109) to >(7)(109) per square meter per day. Bacteria and viruses can remain viable after long-distance atmospheric transport, consistent with the wide dispersal of microbes across distant ecosystems. They constitute an important part of the world’s ecology (https://tinyurl.com/ya4dtwv9).
Animals survive because all, even invertebrates, have an innate immune system that removes potential pathogens. If a pathogen penetrates the first line of defense, higher animals activate the adaptive immune system that generates antibodies and killer T-cells. This system “remembers” previous attacks and can mobilize more quickly against subsequent attacks. Whether an infection develops depends on the pathogen, the degree of exposure, and the terrain—the host resistance. All the current official measures focus on decreasing exposure—awaiting the “warp-speed” vaccine.
What “social” distance is safe? WHO’s 3 ft? CDC’s 6 ft? San Francisco’s proposed 10 ft (which would mean that people generally could not eat or drink anything together)? The concentration of droplets decreases by an inverse square law, disregarding those that fall to the ground. So, at 3 ft the concentration would be 1/9 that at 1 ft; at 6 ft, 1/36; at 10 ft, 1/100. If the source is not infected or the recipient is immune, it makes no difference. If a person coughs into an air current, being 10 ft downstream might not be far enough. And what is an infective dose? That is unknown. The rules are arbitrary.
If masks are correctly used—often they are not—they will decrease the amount of virus that is transmitted. Virions are much smaller than the openings in masks, even N95 masks, but are attached to droplets that are trapped. But air leaks around the edges. Also, one needs eye protection; tears wash viruses that contact the conjunctiva right into the upper airway. Masks are not themselves without risk. An N95 mask worn for hours can decrease blood oxygenation by 20%, causing or worsening headaches, or even causing loss of consciousness. Hypoxia can inhibit CD4+ T-lymphocytes, immune cells that fight viral infections (https://tinyurl.com/y9cw9dky). Even a surgical mask can decrease a surgeon’s hemoglobin saturation and increase the pulse rate after the first hour (https://tinyurl.com/y9m62wvq). Compensatory shallow hyperventilation can lead to acid-base disturbances (https://tinyurl.com/y935oxqt).
Viruses can be cultured from surfaces for varying lengths of time, but they deteriorate rapidly. Will touching a doorknob then rubbing your eye make you sick? Or will it stimulate a protective immune response? We are in the realm of speculation.
Will staying home protect you? Gov. Andrew Cuomo is “shocked” that 66% of new hospitalizations appear to have been among people “largely sheltering at home” (tinyurl.com/ybknju2n). Perhaps with young adults who were kicked out of college dorms?
What if a person could effectively be kept in solitary confinement? Aside from the psychological effects, what would happen upon re-exposure to outside microbes? Lacking frequent small exposures to prevalent organisms, with a consequent immune stimulus, would a person be more likely to become ill? I know of no studies.
BOLSTERING IMMUNITY
Social media giants have been censoring posts they declare to be “harmful misinformation”—anything that the World Health Organization (WHO) does not like. This includes nutritional information. There are many claims, some dubious and apparently designed to sell expensive supplements. But the immune system indisputably requires nutrients that are likely to be deficient.
Vitamin D is essential for defending against respiratory infections. In an Indonesian study, nearly half the COVID-19 patients with insufficient or deficient Vitamin D levels died.
Only 16 of 388 patients (4.2 percent) with normal levels died. When adjusted for age, sex, and co-morbidity, Vitamin D-deficient patients were 10 times more likely to die than patients with normal levels (>30 ng/ml). Most Americans are likely to have insufficient vitamin D, especially in winter or when confined indoors; even an avid golfer in sunny Arizona had low levels. Persons with dark skin require more sun exposure (perhaps contributing to higher mortality in blacks). How much is enough? Some suggest 20 minutes of sunlight with a lot of skin exposed each day, or 5,000 IU (or even more) of vitamin D3 supplements. There can be toxicity; blood levels should be measured.
Zinc is needed to fight viral infections. One mechanism is inhibition of RNA-dependent RNA polymerase, which is essential to the replication of coronaviruses and several other viruses. Hydroxychloroquine and other ionophores such as quercetin and elderberry facilitate zinc entry into the cell—and hydroxychloroquine is far more likely to be effective if zinc is added. Zinc, like vitamin C, may be depleted in fighting viral infections. Repletion is urgent if the patient develops tinnitus, depression, or smell and taste disorders. Beef and poultry are good sources; meat shortages would worsen dietary deficiencies.
Resources:
Summaries of research articles January-Apr 20: https://tinyurl.com/y98644dk
Articles concerning hydroxychloroquine prophylaxis: https://tinyurl.com/y8wp8j8s
Frequently updated commentary and recommendations, especially on zinc: https://tinyurl.com/y7292vve
“A Perspective on SARS-CoV-2, the Most Dangerous Virus in History,” by Jane M. Orient, https://jpands.org/vol25no2/orient.pdf
AAPS News, March, April, May, June 2020: https://aapsonline.org/category/newsletters/ Articles curated by the Association of American Physicians and Surgeons (AAPS): bit.ly/coronavirusarticles