DECEMBER 2020 – COVID19 Prevention

So it looks like COVID19 is poised to roll past ’20 and right into ’21 as the ongoing headliner.  Vaccines are on the horizon and in fact ready to deploy already in some venues, but widespread distribution isn’t imminent.  Furthermore – and please don’t read this as advice against mRNA vaccines (or conspiracy theory) – the technology is relatively unproven and certainly very fast-tracked.  Again – I’m not saying the vaccine is a bad idea, and we’re counseling many of our patients to get vaccinated as soon as possible.

There are some other things though we can all be doing meanwhile – and throughout the duration of this pandemic and beyond – to reduce the risk of serious COVID19 (and related) disease.

The first is ensuring adequate Vitamin D levels.  Most of us don’t get enough sunlight at latitude 60+, and people in northern regions (especially African Americans and those with darker skin) have been consistently shown to have low Vitamin D levels.  Vitamin D levels also decrease with age generally.

This isn’t just important for bone health; increasing evidence shows that 25-hydroxy vitamin D levels greater than 50ng/mL seem to be very protective against multiple respiratory illnesses, including COVID19.  Too much Vitamin D can be harmful to the liver, but this winter we’re advising almost all of our patients to supplement with 10,000 IU of Vitamin D3 per day at least until they’re vaccinated, and probably drop back to 5,000 or less by springtime.  (This doesn’t constitute general medical advice for those we haven’t evaluated personally.)

Another thing we’re recommending to a lot of our patients is a low-dose or 81mg (or in some cases full-dose or 325mg) aspirin a day.  Turns out much of the serious and deadly effects of the virus have to do with blood clotting.  Now, there are multiple studies going on right now around the world having to do with evaluating the use of anticoagulant (blood-thinning) drugs on severe COVID19 disease in hospitalized patients, most of which aren’t targeting platelets (like aspirin does.)  And there isn’t strong evidence at present for the use of an anti-platelet medicine like aspirin; it isn’t proven.  BUT – as we’ve said to many of you before, most decisions in medicine have to do with balancing risk vs. benefit, and to MOST people, a baby aspirin a day is very low-risk.  SARS-CoV-2 infection?  Maybe not so low-risk.

Many of you know that I’ve advocated arginine and citrulline supplementation very publicly (see https://www.medpagetoday.com/infectiousdisease/covid19/85770).  Again, not general medical advice for everyone, and again, not proven.  But low-risk?  Rather.

Finally, there’s the obvious:

  1. Wear a mask.
  2. Social distance and avoid mass gatherings.
  3. Here’s one not talked about often, but I think is VERY important: avoid alcohol. For so many reasons.  Not only does it impair judgment, and not only does it come with a host of general health problems (it’s after all a universal toxin negatively affecting every tissue in the body) but it’s a significant detriment to the body’s ability to fight off infection.
  4. Along those lines, avoid simple sugars and junk food too. They don’t help the immune system one bit, and in fact are detrimental as well.
  5. Exercise and sleep well.

Stay healthy, folks!