Home Survival Guide for Boosting Immunity & Weathering the Storm

Ireland’s Prime Minister Leo Varadkar recently said, “We’re asking people to come together as a nation by staying apart from each other. This is the calm before the storm.” Varadkar then paraphrased a quote from Winston Churchill that he said during World War II, “Never will so many ask so much of so few.”

If it’s any consolation, the whole world is stressed by the Coronavirus crisis, but now the U.S. is on the front lines of the battle. In the World Wars, all Americans pulled together to support our young soldiers who risked everything and sometimes made the ultimate sacrifice to save our freedom, our culture, and our people. Today, the health care providers in the emergency rooms, intensive care units, and hospital wards are the ones in the trenches, fighting this highly contagious and potentially lethal virus. What can you do to pitch in and help us win this war against COVID-19?

Your main mission is to simply take very good care of yourself and hunker down at home alone or with your small circle of people. This COVID-19 crisis has drastically altered each of our lives, and the situation still is unfolding in unpredictable ways. Nobody has a clear idea of how bad it will get, and when this nightmare will be over. Right now, we need to take it one day at a time.

Angst is inevitable. We all feel it. But, don’t let it dominate your mindset. Panic and anxiety do not help anything. Take it from astronaut Chris Hadfield when he spoke about dealing with issues that arose when he was in outer space. “There is no problem so bad you can’t make it worse.”  Today, we are dealing with another harsh and alien environment, and we need to be especially careful to not sabotage our odds of surviving this threat.

Sitting or lying around all day in front of screens while binge-watching and snacking is not the ideal approach. Nor is freaking out and being mean or inconsiderate to people, drinking heavily, using recreational drugs, or hoarding supplies. None of this is going to improve your or anyone else’s odds of getting through the COVID-19 Crisis. Neither will blaming China or adopting a “head in the sand” ostrich approach. These are counter-productive behaviors that take a bad situation and make it worse.

Ryan Holiday writes, “The single most important practice in Stoic philosophy is differentiating between what we can change and what we can’t. What we have influence over and what we do not.” If there was ever a time to focus on what we can control, and to not emotionally invest in what we can’t control, it is now.

When exposed to the Coronavirus (SARS CoV-2), some people come down with the COVID-19 infection and others don’t. Your immune system function is a major factor in determining whether you will be vulnerable or resistant to the infection. The information that follows will help you boost your immunity and stay safe. This article is a mixture of a “to-do” list, along with a “not-to-do” list, to help you as much as possible take control of your destiny so that together, we will safely navigate through these perilous times.

A Mask: Don’t Leave Home Without It

One of the simplest strategies for protecting yourself from getting COVID-19, or spreading it to others, is to wear a mask whenever you are around other people. Many people who have the virus do not have symptoms, so the best strategy is to assume everyone has COVID-19.

The mask should fit tight, so that the air you breathe goes through the fabric, not around the sides of the mask. We need to take a lesson from China, wearing a mask is a low-tech and powerful way to get this pandemic under control.

Check Your Gut

Your microbiome is the collective genetic material from all the microbes—viruses, bacteria, fungi, protozoa—that live on and inside your body. Up to 70% of your immunity arises from the interaction between the gut microbiome and white blood cells (WBCs) in the walls of your small intestine.

For example, this interaction between the gut microbes and immune system develops some WBCs that remain vigilant to any dangerous intruders, and trains other WBCs to be killer T-cells that seek out and destroy pathogens, like the Coronavirus, before they can get a foothold.

So, making sure our digestive system has a diverse and hardy mix of microbes can help to optimize our immunity. To grow a healthy garden of friendly microbes in your GI tract, you should be consuming multiple naturally fermented foods like unsweetened yogurt, sauerkraut, kimchi, kombucha, and pickles. Joan and I do this every day, but you could instead consider taking a probiotic supplement.

Pet Your Pets

These days my family and I are especially appreciative of our dogs, Frances and Coco, and our cats, Lola and Sunny. They are lifesavers for us right now. Hugs and kisses that you share with your furry family members can give you warm-fuzzies almost like those you get being physically affectionate with your human loved ones, but without the risk of transmitting COVID-19.

Dogs and cats are also great for your immunity by diversifying your microbiome and reducing stress. Our leafy green friends underfoot and overhead in our yards and neighborhoods are also particularly valuable to our well-being today. Nurturing plants and trees and working with the soil can melt stress away, lift our spirits, and also improve one’s microbiome. And, like with our pets, these plant friends won’t give you COVID-19, even if you cozy up next to them.

Vitamin D

Maintaining normal vitamin D levels can help to support a strong immune system. It’s super easy to boost your vitamin D with sunshine. Anytime the sun is at least halfway up from the horizon (or >45º from the horizon) to straight overhead (90º), the UV light in the sunshine will stimulate your skin to crank out massive amounts of vitamin D.

As little as just 15 minutes of the sun’s rays hitting your hands, face, and arms two or three times a week usually is enough to make a difference. You can also find vitamin D naturally in mushrooms and fatty fish like salmon, sardines, and herring, or fortified foods including milk and cereal.

Get Your Nutrients

Pay close attention to your diet. Higher intakes of some nutrients have been shown to strengthen the immune system and reduce susceptibility to infection. Specific nutrients that may support the immune defense system include zinc, selenium, iron, and vitamins A, C, D, E, B6, and folate.

Whole foods such as broccoli, Brussels sprouts, kale, spinach, onions, garlic, mushrooms, avocados, bell peppers, green tea, berries, and citrus fruits are good for your immunity. Cook the produce if possible, otherwise wash it thoroughly. Other nutrients like omega-3 from fish and curcumin may help to reduce excess inflammation that can occur in severe lung infections. Ideal protein foods include fish, shellfish, nuts, seeds, and legumes (beans). Products with added sugar should be avoided like the plague. These kinds of highly processed foods make you more vulnerable to diseases of all sort.

Invest in Your Relationships

This pandemic is a unique, serious stress on our relationships, but we need each other more than ever right now. Cut your family and loved ones some slack. Listen more. React less. A few of my friends and patients have texted me saying how much they appreciated me, and it made a huge difference in cheering me up and brightening my day. Now more than ever, it is very important for us to tell our loved ones, friends, neighbors, and co-workers how much we love and appreciate them. Do it safely, without hugs, kisses, handshakes, or even elbow bumps. By necessity, these days it will often be via electronics or the phone, but it’s your sincere expression of gratitude for having them in your life that they need to hear.

Be Active

Stay physically active—exercise boosts immunity. Besides, being sedentary tends to make us sad, anxious, irritable, and unhealthy. But don’t overdo the exercise either; excessive strenuous physical activity can temporarily lower resistance to infection. You won’t have access to a gym for a while, so be creative.

Put on upbeat music and dance (no touching involved). And walk, jog, bike ride, garden, scoot, etc. Just avoid coming within 6 feet of anyone else and shun groups of people that might be in crowded parks or busy sidewalks and trails. Be much more cautious than usual about injuring yourself. Now more than ever, the Emergency Room and/or hospital are to be avoided if possible.

Hydrate, Hydrate, Hydrate

Stay well hydrated. Choose mostly water, sparkling water, tea, and coffee. You should be drinking at least 64 oz. (two quarts) daily. But cut off the caffeine intake by about noon or 2 p.m. to ensure you’ll be drowsy at bedtime. Sleeping soundly is already challenging enough what with all the scary news and frightening images swirling though our minds.

ACE-inhibitors and ARBs

If you are on an angiotensin-converting enzyme inhibitor (ACE-inhibitor) such as lisinopril, ramipril, benazepril, or enalapril, or an angiotensin receptor blocker (ARB) such as losartan, valsartan, olmesartan, irbesartan, or telmisartan, you don’t need to change to another medication. These drugs are very commonly prescribed for the chronic treatment of high blood pressure or heart failure.

According to an article published April 2, 2020 in the New England Journal of Medicine, experts have concluded that neither ACE inhibitors nor ARBs are problematic for getting COVID-19 or worsening the symptoms of the infection. More research into this important issue is needed, but continue these blood pressure medications as prescribed without interruption. The ACE inhibitors in general tend to have more side effects like cough or rash than ARBs, but the two classes of medications are otherwise quite similar for lowering blood pressure and reducing cardiovascular risks.

Take Your Temperature

If you feel chilled or feverish, take your temperature. A definite fever is over 100º F. To treat the fever and body aches of COVID-19 use Tylenol or its generic, acetaminophen. Try to avoid using NSAIDs like Advil or Motrin, (generic = ibuprofen), or Aleve (generic = naproxen), or high-dose aspirin (325 mg or more).

People with pre-existing cardiovascular disease, such as those with prior coronary stents or coronary bypass surgery, previous heart attack, carotid or peripheral artery disease, should continue to take their low-dose aspirin (81 mg per day).

If you have other symptoms like night sweats, body aches, loss of taste and smell, or cough, get tested ASAP. We need to find everyone with this virus and keep them as isolated from other uninfected people for about two weeks. Saint Luke’s of Kansas City now has multiple options to test for COVID-19 with prompt turn-around time (less than 24 hours) on the results. A physician referral and appointment are needed for testing.

Wash Your Hands

This novel Coronavirus (SARS CoV-2) is highly contagious and predominantly spread via droplets, usually when an infected person coughs, sneezes, wipes their nose or eyes, and then touches a surface that you subsequently touch. So, wash your hands frequently and thoroughly after coming in contact with surfaces others might have also touched. And keep your fingers and hands away from your nose, mouth, eyes, and ears. The virus can live for up to 48 hours on common surfaces, so wash your clothes daily; and keep your home environment very clean, ideally with disinfectants and/or soap.

Don’t Smoke or Vape

Smoke from tobacco or marijuana, or fumes from vaping inflame the lungs, which increases the chances of getting a respiratory infection. Too much alcohol, even from one binge-drinking session can suppress immunity. If you drink alcohol at all, make sure to keep it to one drink a day for women, or one to two drinks per day for men. Ideally, a good general rule is to limit alcohol to not more than about 10 drinks per week.

Hang In There

We are all in this together and we need to band together, by staying apart. One easy and valuable way to do that is with phone calls and social media. Do what you can, with what you have, where you are, and we will overcome this together.

At Saint Luke’s Cardiovascular Consultants, we are doing virtual visits either via phone calls and/or video connection. We also are continuing to do cardiac testing such as nuclear stress testing, but we are prioritizing the patients who need to be tested urgently. For less acute symptoms we are deferring the echo, ECG, and stress testing until the quarantine restrictions are able to be relaxed.

The physicians at Saint Luke’s are on the cutting edge of the therapies for treating this Coronavirus pandemic. Infectious disease specialist Dr. Joseph Brewer here at Saint Luke’s is one of the most widely read and quoted experts in the U.S. on emerging therapies for treating or preventing COVID-19. Also, we will be participating in randomized controlled trials testing promising drugs for treating COVID-19 patients.

American ingenuity and grit saved the world 75 years ago when we rallied together and came up with game-changing breakthrough technologies to win WWII. I’m optimistic that America will come to the rescue this time too, but it will take some time.

In the meantime, follow this advice and have faith that we will safely navigate this storm. Some people wonder, “What’s the meaning of life?” An existential crisis like the one we are facing now makes it clear, at least to me, that our collective survival and continued progress as a species is the meaning of life.

In Good Health,

James O'Keefe, MD, FACC