Current Events



                             June 24, 2020:​
COVID-19:  What we know.  What we don't (yet) know.  What we can do to protect each other.

It first appeared half a world away, in east central China, in a city called Wuhan, a city most of us had never heard of before.  The first reported case appeared in late December, barely 6 months ago.  From there it spread.  Rapidly.  Like wildfire.  The first true pandemic in a century.

The cause?  A tiny little virus, mysterious and deadly, that had never before been seen on this planet.

Based on the initial reported symptoms, the virus was quickly given an appropriate name:  SARS-CoV-2, for Severe Acute Respiratory Syndrome Coronavirus-2.  And, as we all now well know, the disease it causes was also given a name:  COVID-19 (CO for corona, VI for virus, D for disease, 19 for 2019).

COVID-19 has, very literally, changed our lives.  And it has done so almost overnight, and in ways we never could have imagined a few short months ago.

So this piece is about COVID-19

But before I go any further let me say this:  I am not an expert in infectious disease, virology, or the history of pandemics.  There are a lot of very smart people - physicians, researchers, and academics - directly involved in the day to day battle against COVID-19 and/or deeply involved in COVID-19 research, who have a much keener and deeper understanding of the rapidly growing tomes of information we're learning about this novel virus.  What I'm offering here are some highlights that I hope you'll find helpful.

So, first:  What do we know now that we didn't know, or didn't know as well, a few months ago?
  • For starters, the manifestations of this virus are far more unpredictable and varied than we first suspected.  At first glance COVID-19 appeared to cause respiratory problems.  In larger urban areas like New York, Emergency Departments were swamped by folks with rapidly progressive shortness of breath, and hospital ICUs were clamoring for respirators to meet the demand.
  • Now we know that COVID-19 is far more than just a respiratory bug.  It can trigger blood clots and strokes.  It can cause kidney failure.  It can even directly damage myocardial cells (the cells that make up the muscles of the heart).
  • In still others, COVID-19 appears to cause nothing bad at all.  Many people breeze through their encounter with COVID-19 without even knowing they have it, completely asymptomatic.
  • Why the difference?  Why is COVID-19 fatal for some and relatively harmless for others?  That's not entirely clear; not yet, at least.  That said, we've learned more than a little about the "how", the specific mechanism that gets triggered that makes COVID-19 deadly dangerous.  And that "how" appears to involve inflammation.  When COVID-19 kills, it does so by triggering the immune system to produce a severe inflammatory response, causing a major overproduction of dangerous chemical messengers called cytokines.  If that inflammatory response involves the lungs, the end result is respiratory failure.  If that inflammation primarily involves the kidneys, the kidneys shut down.  If that inflammatory response attacks the myocardial cells, we see heart problems.
  • Children:  In the early days, it appeared as though children weren't really being affected by COVID-19, or, if they were, their symptoms were transient and relatively minimal, like many adults.  Now, we know more and we know better.  In some children, we're seeing that same overwhelming and deadly inflammatory response evident in some adults.  In fact, we're seeing it with such increased frequency that we now have a name for it:  Pediatric Severe Inflammatory Response Syndrome.  The bottom line:  Kids, too, are affected by COVID-19.
  • Adolescents and young adults, too, are being affected and dying.  Where initially it was the elderly that were being hit the hardest, now we're seeing more and more younger adults and even adolescents hospitalized, and being placed on ICU ventilators, and dying.  No one is immune.
  • When it first appeared, many were comparing COVID-19 to the flu.  And, while there are similarities, one huge difference has clearly emerged.  While influenza has historically demonstrated a mortality rate of about 0.1% (1 person dying for every 1,000 cases of the flu), COVID-19 is far more deadly, with a US mortality rate somewhere in the range of 4-6% (4-6 people dying for every 100 cases of COVID-19).  Far more deadly, indeed!
Next:  What do we not (yet) know?
  • Lots.  Tons.  We really don't know much at all.  Our understanding of SARS-CoV-2 and COVID-19 is still in its' infancy.  Does that make this a silly question?  I don't think so.  I believe it's an important question because it helps us identify and spell out what it is that we really need to understand, those particular pieces of information that would help us know how to move forward better, more wisely, more knowledgably.
  • Here's a few of the most important "what we don't know" items that we desperately need to know:
    • We don't know if someone who contracts COVID-19 from one person, either symptomatically or not, can get re-infected some time later by someone else.
    • We don't know whether or not COVID-19, like a number of other viruses, has the potential to cause long-term health problems months or even years following recovery from the initial exposure/infection.
    • We don't know whether or not COVID-19, once suppressed following initial infection, can reactivate (like, for example, Chicken Pox in childhood reactivating as Shingles many years later).
    • We don't know to what degree COVID-19 specific antibodies provide protection against re-exposure or possible reactivation.  Is there a threshold antibody level that offers protection?  We don't know, not yet, at least.
    • We don't know how to treat the virus.  And, when we do find an effective treatment, we won't know for a long time if there are long-term side effects or potential downsides to that treatment.
    • We don't know whether or not we can come up with a safe and effective vaccine for the virus.  Historically, our track record is mixed.
Finally:  Where do we go from here?
  • Start by recognizing that we're all in this for the long haul.  COVID-19 is not going away anytime soon.  Pandemics, I've learned, historically come in waves, and we should probably anticipate the same of this one.
  • Next, make peace with social distancing and face masks:  A few months ago, we didn't know whether or not these simple measures would help slow the spread of COVID-19.  Now, thanks to a growing number of studies, we know better.  These measures do help.  Period.  End of discussion.  So, when in public, be smart.  Wear a mask.  Not just to protect yourself, but those around you as well.
  • Because viral particles can remain active on hard surfaces for several hours, clean those surfaces frequently.  And you don't have to use anything fancy, either.  While alcohol and bleach are great, soap and water are very effective, too.
  • Stay informed.  Listen to the experts.  Frustratingly, like so many other aspects of our society today, COVID-19 has become politicized, an increasingly polarizing point of contention that divides us.  While I constantly hear two very different voices and viewpoints coming from the media today, the same is not true of the medical community.  There we see almost universal agreement.   The vast majority of physicians and health care experts agree on how best to proceed.  Cautiously.  Socially distanced.  With protection.
  • Do what you can to boost your immune system:
    • Get at least 7 hours of sleep, as the immune system rejuvenates and restores itself in deep sleep.
    • Eat a healthy, low-carb, "REAL FOOD" diet.  Processed foods and foods high in carbohydrates are inflammatory.
    • Supplements can help, too.  Zinc, for example, has long been known to be very important to supporting immune function.  Better yet, recent studies appear to show that Zinc blocks replication of the COVID-19 virus.  Studies also support the use of Vitamin D to minimize not only the risk and severity of infection.  (Be careful, though.  Supplements should be used with caution.  Some require blood testing to monitor for safety.
And most of all, Keep Calm & Carry On!

Dr E

COVID-19 Update:  March, 2020:
​
​Our office is open:
Our office continues to be open during regular business hours:  Mondays, Tuesdays, Thursdays and Fridays from 8:30 am - 5:00 pm, and Wednesdays from 8:30 am - 4:30 pm.  We have always taken pride in the cleanliness of our office facility, but in light of the current situation, we have intensified our cleaning and sanitation regimen.  A foundational piece of functional medicine is the prevention of illness, and in this time of increased risk, we are working continuously to keep all public surfaces as germ-free as possible.

In addition, we are utilizing social distancing of 6 feet between individuals within our office  You will note, specifically, our request that you remain 6 feet away from our front desk (this area is marked for your convenience), as well as in seating arrangements when interacting with our staff.  We also ask that you wear a mask while you are in our office.

And during these extraordinary circumstances, if you prefer to not leave your home, we will provide phone appointments.  Just let our staff know if you prefer a phone appointment, and they will assist you in making those arrangements.

We are also able to ship supplements directly to you if you prefer to not come in to the office.  Simply call us at 317-863-5888 and our staff will be happy to assist you.

What you can do to help build your immune system:
These specific supplements and recommended doses are for your protection; in case of infection, doses can be higher for some of these:
  • Reacted Zinc or Zinc Supreme - one daily
  • NK Stim - one-twice daily (may increase to two - three times daily for infection)
  • Transfer Factor MultiImmune - one-twice daily
  • Whole Mune - one daily
  • IgG Protect - one-twice daily (increase to two-twice daily for infection)
  • SBI Protect - one-twice daily (increase to two-twice daily for infection)
  • Turiva - one daily
  • Viracid - one-twice daily
  • Sinatrol - one-twice daily
  • Immutone Plus - one-twice daily
In addition, please remember these behavioral interventions that we are all strongly urged to follow:
  • Avoid gatherings of more than 10 people.
  • Minimize public transportation.  Postpone and/or cancel travel plans if at all possible.
  • Wash your hands frequently throughout the day.  When soap & water is unavailable, use hand sanitizer, preferably one that contains 60-70% alcohol.
  • Avoid touching your face as much as possible.  Virus particles can be picked up from any surface, so touching your face increases your risk of infection.
  • Make sleep a priority.  Aim for 7-8 hours a night.  Your immune system generates & strengthens while you sleep.
  • If you're not currently taking one, start a probiotic.  If you're already taking one, consider increasing the dose.
  • Optimize your Vitamin C & D status.  Low levels of Vitamin C &D increase your risk of infection.
As always, please feel free to call us if you have questions before your next appointment.  We are here, willing to help in any way that we can.

​Stay calm and carry on!

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