Health, Nutrition, and Wellness
in times of COVID-19
HEALTH
• Not the absence of disease
• Physical, Mental and Emotional well-being
• PATHOGENECITY
– Potential to produce disease
• VIRULENCE
– Harmfulness of disease
• ENDEMIC
– Condition regularly found among particular people in a certain area
• EPIDEMIC
– Widespread occurrence of an infectious disease in a community at a particular time
• PANDEMIC
– Epidemic that has spread over a continent/whole world
Recent pandemics/epidemics
1918 Spanish
Flu 1/3 of world population 500-100 M infected, 50 M
death 10-20%
1957 H2N2 1-4 million
1963 H3N2 1-4 million .3%
2002 SARS 8,000 cases, 774 death 15%
2009 H1N1 1.4 billion infected 284,000 deaths 0.02%
2014 Ebola Sweat & blood; 28, 652 cases; 11, 325 deaths 40%
Common
Flu 1B; 9% of population .01%
Difference between bacteria and virus
• BACTERIA
– Single cell microorganisms (live) colonize – Sore throat, TB, UTI, Leptospirosis
• VIRUS
– Nucleic acid molecule with a protein coat and is able to multiply only within the living cells of a host
– Hepa, HIV, Rabies, Ebola, Dengue, Polio, Bird Flu, MERS, H1N1, Chicken Pox
• 10 million time more viruses on earth than stars in universe
• Bucket of ocean water has more virus than number of people on earth
How does it make people sick?
• Re-programs your cells / hijack A) Attachment
B) Entry
C) Genome replication & Gene expression D) Assembly
E) Release
Coronavirus
• A family of enveloped, non- segmented, single-stranded, positive-sense RNA viruses.
• They are the largest group of viruses belonging to the
Nidovirales order.
• Named after their corona- or crown-like surface projections that correspond to large
surface spike proteins.
• Coronaviruses are host-specific and can infect humans as well as a variety of different
animals, causing diverse clinical syndromes.
Structure
• Coronavirus virions are spherical with diameters of approximately 125 nm.
• The most prominent feature of coronaviruses is the club- shaped spike projections emanating from the surface of the virion.
• Within the envelope of the virion is the nucleocapsid.
• Coronaviruses have helically symmetrical nucleocapsids, which is uncommon among positive-sense RNA viruses, but far more common for negative-sense RNA viruses.
Coronavirus
Coronavirus
SARS-CoV 2
COVID-19 was first reported in late 2019 in Wuhan, China.
Early COVID-19 cases were linked to a live animal market in Wuhan, China, suggesting that the virus was initially transmitted from animals to humans.
Person-to-person spread occurs through contact with infected secretions, mainly via contact with large respiratory droplets.
It could also occur via contact with a surface contaminated by respiratory droplets.
SARS-CoV 2
• Incubation period is 14 days and symptoms tend to appear within 4 to 5 days of infection.
• Most people infected with the COVID-19 virus will experience mild to moderate respiratory illness and recover without
requiring special treatment.
• Older people, and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory
disease, and cancer are more likely to develop serious illness.
Current Stat (as of May 27, 2020)
• 14, 669 positive cases
• 886 deaths
Signs and Symptoms
Fever.
Dry cough.
Difficulty of breathing.
Sore throat.
Diarrhea.
Conjunctivitis.
Headache.
Loss of taste or smell.
Immune system
The Norm
ADD A FOOTER 19
Cytokine Storm
- activation of cascade that will lead to an
autoamplifying cytokine production ( B.
Chousterman, 2017) - markedly increased
levels of numerous proinflammatory
cytokines including IL-1, IL-6, IL-18, TNFα, and IFNγ ( Shulert, 2015) - acute systemic
inflammatory syndrome, or an excessive immune response, characterized by fever and multiple organ dysfunction (Porter
& Maloney, 2019)
Cytokine Storm
The cytokine release syndrome (CRS) of severe COVID-19 and Interleukin-6 receptor (IL-6R) antagonist Tocilizumab
may be the key to reduce the mortality by Zhang et all March 2020
21
Sarscov binds to the Ace II Receptor cells
Destroys the
epithelial cell leads to inc in
permeability leads to releasing of virus
Cytokine storm
ADD A FOOTER 22
Innate and
adaptive immunity is activated leading to release of
cytokines
Cytokine release
Cytokinestorminterventionintheearlystages ofCOVID-19pneumonia
By Sun et. al., March 2020
23
1. Diagnostics :
- RT-PCR- gold standard - Rapid Antibody Test
- IgM - 5-4 days of Symptoms, acute - IgG - 21 days (15-39 days), immune - for fast population survey (after 14d) - to ID asymp'c positive cases &
immune individuals
- for presymptomatic transmission:
6.7% (Japan: 1-3 days, median: 4 days)
2. Tests for Monitoring :
CBC- low WBC, low Lymphocytes, low Platelet (5x risk of severe
CoViD)
Ferritin: high
Procalcitonin: normal 3. AI or Lifetrack CoViD CT scan
- remote triaging via Chest CT scan - to isolate & prioritize testing for presumptive CoViD-19 cases
- for checking false negative RT- PCR
Patient Categorization
Administrative Order No. 2020-0013 on April 9, 2020 – New categorization of patients
SUSPECT
• A patient will be classified as “suspect” if they fall under any of the three:
1. Patient has the following symptoms:
- Fever of at least 38 degrees C - Cough
- Throat Pain
• And either of the two:
Has travel history or lives in community with local COVID-19 transmission within 14 days since start of symptoms
Had close contact with a confirmed or
probable COVID-19 case within 14 days since start of symptoms
2. Patient has the following symptoms:
- Fever - Cough
- Difficulty of Breathing
- And is any of the following:
60 years old and above
Has preexisting condition
A health worker
3. Patient experiences sudden onset of lung illness with severe symptoms of unknown origin and needs hospitalization
PROBABLE
• A person will be classified as “probable’ if
he/she was earlier tagged as a “suspect” and has the following:
- Still undetermined COVID-19 results
- Test was not done in an official laboratory with RT-PCR test (reverse transcription
polymerase chain reaction, considered the
‘gold standard” in Covid-19 testing) - Remain untested
CONFIRMED
• A person will be considered a confirmed COVID-19 case if RT-PCR testing shows positive result for coronavirus.
Clinical
• Suspect
• Probable
• Critical
Management: Palliative - Antibiotics
- Antiviral - Steroids - Dialysis - Plasma
Best Protection for COVID
1. Social distancing 2. Mask
3. Hand washing
4. Keep yourself healthy
VACCINES
• Very small amount of weak/dead germs that can cause disease
1) Sounds alarm
2) Release antibody
3) antibody attack germs
VACCINATION – act of getting a vaccine
IMMUNIZATION – process of becoming immune
VACCINE
• Undergo years of safety testing then monitoring
• Should be SAFE, PURE, POTENT, STERILE
Stages of Vaccine Development
A) Exploratory Stage
B) Pre-clinical Development C) Clinical Development
D) Regulatory Checks and Approval E) Manufacturing
F) Quality Control
Phases of Vaccine Testing
I – small group of people
II – expanded and given to people who have
characteristics similar to those whom the new vaccine is intended
III – given to thousands and tested for efficacy and safety
IV – approved and licensed
- Continuous study -
Types of Vaccine
1) Live Attenuated
- Use weakened form of germ - Longer lasting
- Not on immunocompromised
- MMR, Chicken pox, Rotavirus, Small pox
2) Inactivated
- Killed version - Need booster
- Hepa A, Flu, Polio, Rabies
Types of Vaccine
3) Sub-unit, Conjugate, Recombinant
₋ Uses specific pieces of the germ
₋ Gives strong response but can be given to immunocompromised
₋ Need booster
₋ HPV, HBV, Shingles, HiB, Menningococal
4) Toxoid
₋ Uses a toxin made by the germ that causes a disease
₋ Creates an immunity to the parts of the germ
₋ Diphtheria, Tetanus
How to stay healthy?
• Exercise
• Enough sleep
• Proper nutrition
• Limit alcohol, cigarettes
How to Strengthen Physical Body
Detox Nourish Restore Regenerate
• “If people will eat the right food they will not need medicine.”
• “Let food be thy medicine
“Hippocrates”
World Health Organization and World Food Council Nutrition
Guide During Pandemic
1) Eat a variety of food
Common Food Toxins to Avoid
A) MSG
• Frozen dinners, salty snacks, canned soup, fast food
• Neurological effect, impaired growth
B) Artificial Food Coloring
• Food dyes Blue I, Red 40, Yellow 5, Yellow 6
• Allergy, ADHD, thyroid problems
C) Sodium Nitrite
• Acts as preservative for processed meat and adds saltiness and red color
• When heated becomes nitrosamine
• Cancer risk: colon, stomach, breast, urinary bladder
Common Food Toxins to Avoid
D) High Fructose Corn Syrup
• soda, juice, candy, cereals, snacks
• Inflammation, diabetes
E) Artificial Sweetener
• Aspartame, sucralose, sacharin
• Cancer risk
F) Artificial Flavors
• Decrease blood production, cancer risk
G) Transfat
• Hydrogenated fat to increase shelf life
• Naturally occurring in meat and dairy
• Crackers, cookies, snacks, fast food, creamer, margarine, microwave popcorn
HORMONES
• Substance that stimulate specific cells or tissues into action A) Gluten
• Protein found in wheat and rye
• Highly inflammatory
• Malt, soups, cold cuts, seasonings, syrup, instant hot drinks, beer
B) Dairy
• A lot of synthetic hormones
• Milk, margarine, cheese, ice cream, cakes
C) Oils
• Canola, vegetable oil, omega 6
• Omega 3 – fish, flaxseed, chia seeds, soybean, oysters
World Health Organization and World Food Council Nutrition Guide During
Pandemic
1) Eat a variety of food
2) Eat moderate amount of fats and oils
- No transfat
- WHO proposed plan stop transfat by 2023
World Health Organization and World Food Council Nutrition
Guide During Pandemic
1) Eat a variety of food
2) Eat moderate amount of fats and oils 3) Limit salt intake
- 1 tsp a day or 5 grams
World Health Organization and World Food Council Nutrition
Guide During Pandemic
1) Eat a variety of food
2) Eat moderate amount of fats and oils 3) Limit salt intake
4) Limit sugar
5) Stay hydrated 6) Avoid alcohol
Functional Medicine Model :
- “An evolving understanding that disease is an endpoint and function is a process...The
functional medicine model for health care is concerned less with what we call the
dysfunction or disease, and more about the
dynamic processes that resulted in the person's dysfunction.”
- Jeffrey Bland, PhD
Anti-CoViD-19 Nutrition
a. Iron removing foods: alugbati, beans, legumes, purslane, fiber, cocoa
b. Iron removing supplements: Zinc, Selenium, turmeric, lipoic acid, glutathione
c. Zinc rich foods: Oysters (74mg/3oz), Sugarcane (19-49.2mg/kg), coconut meat
(2.05mg/100g), squash seeds, pumpkin seeds d. Zinc ionophores / enhancers: garlic,
onion, green tea, quercetin, tugabang
e. Antivirals : Andrographis (Mirabilos or Serpentina or Sinta), Berberine, VCO, licorice
f. Alkalinizers: avocado, banana, lemon,carrots, kulitis, papaya, broccoli, onion, melon, radish, pineapple, raisin, sprouts, cabbage, celery, squash, alugbati, nuts, garlic, spirulina, wheatgrass, malunggay
g. Avoid high iron: liver, sardines, beef h. Hot water
i. ACE2 regulator: melatonin, Vit D3, Astragalus j. Anti-inflammatory: curcumin (IL-1), quercetin (NO, TNFα,IL-6), Andrographis (IL-1β,caspase1,NLRP3)
Psychoemotional Concerns During Pandemic
• Increase in anxiety, depression, PTSD, suicide
Psychoemotional Concerns During Pandemic
• ANXIETY
– Inexplicable feeling of impending doom, or unfounded worries about numerous things or irrational fear of situation
– Excessive anxiety difficult to control with accompanying somatic symptoms causing impairment
Psychoemotional Concerns During Pandemic
• DEPRESSION
– Negative view of self, world, future – Hopelessness and helplessness
Psychoemotional Concerns During Pandemic
• POST TRAUMATIC STRESS DISORDER
– Life threatening event – Intrusive symptoms – Avoidance
– Negative emotions and thoughts – Arousal
Psychoemotional Concerns During Pandemic
• CAUSES:
– Fear
– Disrupted routine
– Lack of social contact
– Decrease physical activity
Psychoemotional Concerns During Pandemic
• HOW TO MANAGE:
– Connect with people
– Avoid too much TV, social media – Exercise
– Stick to a routine
– Acknowledge your feelings – Focus on the big picture – Get support
QUICK VIEW
• Corona virus is here to stay
• Vaccines is still year/s away – but it is coming
• Distancing, face mask, hand washing are still our best protective measures
• Best test to determine if you are not infectious / positive – 14 day quarantine with no
symptom development
• We just need to stay healthy to increase our change of surviving this pandemic
• Eat the right food, exercise, sleep early, limit alcohol, lessen fear / worry.
• This will all end.
