Coronavirus (Covid-19) Update

Over the past several weeks there has been a huge emphasis placed on COVID-19 and its impact on the world. After scouring resources and speaking with people ranging from researchers & epidemiologists to public health experts and health care professionals, our Bonita Springs FL and Fort Myers FL chiropractors felt it important to address the issue.
There are 3 COVID considerations as we see it:
- Epidemiologic Concerns - deals with the incidence, distribution and control of diseases
- Immunological Concerns - branch of biology that covers the study of immune systems
- Preparatory Measures - Involves proactive pursuit of solutions while collaborating health professionals
Let me start by saying that all three are of equal importance and each consideration carries its own concerns. As with most complex problems, we believe that COVID-19 requires a multifaceted approach in order to achieve true resolution. Most Epidemiologic Concerns rest with slowing the transmission of the Coronavirus also known as "flattening the curve", in part, to prevent an unsustainable load to our health care infrastructure. This is probably the single greatest threat to our community, as it would strain healthcare resources along with healthcare personnel, negatively impacting our ability to provide care for true life threatening conditions or complications that members of our community may face. The primary reason testing and quarantine measures are being discussed is to address these epidemiologic concerns.
While COVID-19 has not proved to be a major problem in healthy populations, it is proving to be a challenge to those whose immune system is compromised. This very fact warrants attention and action because no life is expendable. So as we receive updates and or instructions keep in mind that every recommendation is not just for us, it is to benefit ALL of us. The Immunological Concerns rest with limiting exposure to those who are at greater risk for having complications and how to effectively support them, should they become ill. Currently the CDC still says that there is "No specific treatment for COVID-19 is currently available. Clinical management includes prompt implementation of recommended infection prevention and control measures and supportive management of complications, including advanced organ support if indicated". Furthermore, "corticosteroids should be avoided, because of the potential for prolonging viral replication as observed in MERS-CoV patients, unless indicated for other reasons." Yes, there has been a lot of communication regarding rushing a vaccine to market. Our concern is that steps, designed to test safety for humans, are being skipped in the interest of time for a virus that the CDC still believes that "Most will be able to recover from at home".
This means that the best course of action still rests with strengthening our immune systems if we are not ill and supporting it if we are, to give us the best opportunity to recover. Therefore the next logical question is what Preparatory Measures should be taken to stack the odds in our favor.
What Measures Can You Take to Protect Yourself?
1. Exercise Good Manners: Most of the recommendations coming from every health related agency in the world fall underneath this category. All of which should be things that we exercise on a regular basis already.
- Wash your hands frequently for at least 20 seconds
- If you cough or sneeze please do so into a tissue and then discard
- Avoid touching your face, in particular your eyes and nose
- Sanitize surfaces regularly
2. Consider Supplementing with Vitamin C & Vitamin D: Both Vitamin C and D have been shown to have a favorable impact on the immune system along with having antiviral properties. It would be an excellent idea to have your Vitamin D levels tested by a healthcare professional and potentially supplement those levels.
3. Load your diet with Anti-Viral Foods & Eliminate Sugar Intake: Sugar suppresses immune function so leave the twinkies alone please. Listed below are few different foods that have been shown through research to have antiviral properties.
- Garlic
- Turmeric
- Echinacea
- Peppermint
- And many more… Google is your friend and at the bottom of this page are links to resources to get you started.
4. Get Adequate Sleep: Getting continuous sleep, in particular REM sleep has also been shown to positively impact immune modulators. So in times of high stress, it remains extremely important to carve out time to ensure adequate sleep is acquired.
5. See Your Local Chiropractor: As you can see, from the non-inclusive list above, there are several things that can be done proactively to ensure that your immune system is strong or to strengthen it in the event that it is compromised. Chiropractic has been shown through research to positively impact key immune compounds that are key to fighting off and protecting against bacteria and viruses. Check out the links below highlighting their link to immune compounds, IgG and IgA.
Our hope is that after we recover as a community there is a new found value on proactively keeping our defense(immune) system high.
What Measures Are We Taking?
Our stance and the decisions that we are making as a result of COVID-19 are not out of fear but in respect of our responsibility as a health professional in the State of Florida and empathy for the community that we serve.
- All disinfectants that are being used by our office are shown on List N which is a list of appropriate disinfectants compiled by the Environmental Protection Agency (EPA).
- We had the entire office sanitized over the weekend and will continue doing each night in preparation for the next day.
- All of our team have access to hand sanitizer with at least 70% alcohol, which is being used regularly.
- Tables, chairs and equipment are being sanitized regularly.
- If you are immunocompromised and would like to make special arrangements to be seen we will accommodate you. Also if you are at-risk and are in need of anything from errands to supplies, please let us know as we are making provisions to help there as well!
- Ruben Manuel Luciano Colunga Biancatelli, Max Berrill & Paul E. Marik (2020) The antiviral properties of vitamin C, Expert Review of Anti-infective Therapy, 18:2, 99-101, DOI: 10.1080/14787210.2020.1706483
- Kim Y, Kim H, Bae S, et al. (2013) Vitamin C Is an Essential Factor on the Anti-viral Immune Responses through the Production of Interferon-α/β at the Initial Stage of Influenza A Virus (H3N2) Infection. Immune Netw. 2013;13(2):70-74. doi:10.4110/in.2013.13.2.70
- Carr AC, Maggini S. Vitamin C and Immune Function. Nutrients. 2017;9(11):1211. Published 2017 Nov 3. doi:10.3390/nu9111211
- Mariangela Rondanelli , Alessandra Miccono,et al. (2018)
- Self-Care for Common Colds: The Pivotal Role of Vitamin D, Vitamin C, Zinc, and Echinacea in Three Main Immune Interactive Clusters (Physical Barriers, Innate and Adaptive Immunity) Involved during an Episode of Common Colds-Practical Advice on Dosages and on the Time to Take These Nutrients/Botanicals in order to Prevent or Treat Common Colds Hindawi Evidence-Based Complementary and Alternative Medicine Volume 2018, Article ID 5813095, 36 pages
- Beard JA, Bearden A, Striker R. Vitamin D and the anti-viral state. J Clin Virol. 2011;50(3):194-200. doi:10.1016/j.jcv.2010.12.006
- Austin B. Bigley, Forrest L. Baker, Guillaume Spielmann and R. J. Simpson, Aging Immunity and the Impact of Physical Exercise, Handbook of Immunosenescence, 10.1007/978-3-319-99375-1_165, (2823-2879), (2019).
- Pierre Olivier Lang, MD, MPH, PhD and Richard Aspinall, DSc, FRCP (Edin), FRCPath (2017) Vitamin D Status and the Host Resistance to Infections: What It Is Currently (Not) Understood Clinical Therapeutics/Volume 39, Number 5, 2017
- Salvatore Chirumbolo, PhD ; Geir Bjørklund ; Andrea Sboarina, PhD and Antonio Vella, PhD (2017) Review The Role of Vitamin D in the Immune System as a Pro-survival Molecule Clinical Therapeutics/Volume 39, Number 5, 2017
- Yamshchikov AV, Desai NS, Blumberg HM, Ziegler TR, Tangpricha V. Vitamin D for treatment and prevention of infectious diseases: a systematic review of randomized controlled trials. Endocr Pract. 2009;15(5):438-449. doi:10.4158/EP09101.ORR
- Teymoori-Rad M, Shokri F, Salimi V, Marashi SM. The interplay between vitamin D and viral infections. Rev Med Virol. 2019;29(2):e2032. doi:10.1002/rmv.2032
- Yu S, Zhang G, Jin LH. A high-sugar diet affects cellular and humoral immune responses in Drosophila. Exp Cell Res. 2018;368(2):215-224. doi:10.1016/j.yexcr.2018.04.032
- The common fruit fly, Drosophila melanogaster, is a well studied and highly tractable genetic model organism for understanding molecular mechanisms of human diseases. Many basic biological, physiological, and neurological properties are conserved between mammals and D. Pandey, Udai Bhan, and Charles D Nichols. "Human disease models in Drosophila melanogaster and the role of the fly in therapeutic drug discovery." Pharmacological reviews vol. 63,2 (2011): 411-36. doi:10.1124/pr.110.003293
- The benefits of garlic to health have been proclaimed for centuries; however, only recently have Allium sativum and its derivatives been proposed as promising candidates for maintaining the homeostasis of the immune system. Arreola, Rodrigo et al. "Immunomodulation and anti-inflammatory effects of garlic compounds." Journal of immunology research vol. 2015 (2015): 401630. doi:10.1155/2015/401630
- Garlic (Allium sativum) has been used for centuries as a prophylactic and therapeutic medicinal agent. Importantly, garlic has been suggested to have both cancer-preventive potential as well as significant enhancing effects on the immune system. Schäfer, Georgia, and Catherine H Kaschula. "The immunomodulation and anti-inflammatory effects of garlic organosulfur compounds in cancer chemoprevention." Anti-cancer agents in medicinal chemistry vol. 14,2 (2014): 233-40. doi:10.2174/18715206113136660370
- Nantz MP, Rowe CA, Muller CE, Creasy RA, Stanilka JM, Percival SS. Supplementation with aged garlic extract improves both NK and γδ-T cell function and reduces the severity of cold and flu symptoms: a randomized, double-blind, placebo-controlled nutrition intervention. Clin Nutr. 2012;31(3):337-344. doi:10.1016/j.clnu.2011.11.019
- Aged Garlic Extract Modifies Human Immunity Percival SS. Aged Garlic Extract Modifies Human Immunity. J Nutr. 2016;146(2):433S-436S. doi:10.3945/jn.115.210427
- Traditionally known for its an antiinflammatory effects, curcumin has been shown in the last two decades to be a potent immunomodulatory agent that can modulate the activation of T cells, B cells, macrophages, neutrophils, natural killer cells, and dendritic cells. Interestingly, however, curcumin at low doses can also enhance antibody responses. Jagetia GC, Aggarwal BB. "Spicing up" of the immune system by curcumin. J Clin Immunol. 2007;27(1):19-35. doi:10.1007/s10875-006-9066-7
- Catanzaro, Michele et al. "Immunomodulators Inspired by Nature: A Review on Curcumin and Echinacea." Molecules (Basel, Switzerland) vol. 23,11 2778. 26 Oct. 2018, doi:10.3390/molecules23112778
- Nutrients that have been demonstrated (in either animal or human studies) to be required for the immune system to function efficiently include essential amino acids, the essential fatty acid linoleic acid, vitamin A, folic acid, vitamin B6, vitamin B12, vitamin C, vitamin E, Zn, Cu, Fe and Se. Practically all forms of immunity may be affected by deficiencies in one or more of these nutrients. Animal and human studies have demonstrated that adding the deficient nutrient back to the diet can restore immune function and resistance to infection. Calder PC, Kew S. The immune system: a target for functional foods?. Br J Nutr. 2002;88 Suppl 2:S165-S177. doi:10.1079/BJN2002682
- Recent studies have revealed that preparations derived from certain species and plant parts, but not all of them, possess potent antiviral activities, at non-cytotoxic concentrations, particularly against membrane-containing viruses. Thus all strains of human and avian influenza viruses tested (including a Tamiflu-resistant strain), as well as herpes simplex virus, respiratory syncytial virus, and rhinoviruses, were very sensitive to a standardized Echinacea purpurea preparation. Hudson, James, and Selvarani Vimalanathan. "Echinacea-A Source of Potent Antivirals for Respiratory Virus Infections." Pharmaceuticals vol. 4,7 1019-1031. 13 Jul. 2011, doi:10.3390/ph4071019
- Echinacea has a wide range of pharmacological activities. Besides its common function as a supportive therapy in the treatment of the common cold and upper respiratory tract infections, in which it reduces the duration and/or the severity of the symptoms,1,2 it has been shown to possess palliative effects on wound damage,3inflammation,3,4 and tumor growth.5 Zhai, Zili et al. "Enhancement of innate and adaptive immune functions by multiple Echinacea species." Journal of medicinal food vol. 10,3 (2007): 423-34. doi:10.1089/jmf.2006.257
- At the moment, only few effective antiviral drugs are available for the treatment of viral diseases [121]. ... There are several reports showed that various peppermint extracts has significant antiviral activities [123-126]. It seems, pepperminthelps to immune system and protect the body from viruses[127-137]. Masomeh L, Narges M, Hassan R, Hadi A (2017) Peppermint and Its Functionality: A Review. Arch Clin Microbiol. Vol. 8 No. 4:54. doi:10.4172/1989-8436.100054
- The production of interleukin-2 -induced immunoglobulin G and immunoglobulin M was significantly increased in cultures from subjects treated with spinal manipulation. At 20 min post-manipulation, immunoglobulin G synthesis was significantly elevated in subjects who received manipulation with cavitation, relative to that in cultures from subjects who received manipulation without cavitation and venipuncture alone. At 2 hr post-treatment, immunoglobulin M synthesis was significantly elevated in subjects who received manipulation with cavitation relative to the venipuncture group. Teodorczyk-Injeyan, Julita A et al. "Interleukin 2-regulated in vitro antibody production following a single spinal manipulative treatment in normal subjects." Chiropractic & osteopathy vol. 18 26. 8 Sep. 2010, doi:10.1186/1746-1340-18-26
- Analysis of variance revealed that the experimental group displayed a statistically significant greater increase in postintervention sIgA levels than the control group Results suggest that OMT may then have therapeutic preventive and protective effects on both healthy and hospitalized patients, especially those experiencing high levels of emotional or physiological stress and those at higher risk of acquiring upper respiratory tract infections. Secretory immunoglobulin A (sIgA, also referred to as salivary IgA) is the major immunoglobulin secreted by the mucosal system1 and is found in saliva, intestinal fluids, bronchoalveolar lavage fluid, and other mucosal fluids.2Secretory IgA provides protection from pathogenic organisms by preventing attachment, replication, and colonization of such organisms.1,3 Gregory Saggio, DO; Salvatore Docimo, DO; Jennifer Pilc, DO; Jennifer Norton, DO, RN; and Wolfgang Gilliar, DO The Journal of the American Osteopathic Association, March 2011, Vol. 111, 143-147.
