COVID-19 & Ways to Prevent Infection

Women Wearing Mask During COVID-19 Outbreak
A DISEASE LIKE WE HAVE NEVER SEEN
 
I asked my Dad who is 86 and my Mom, age 78 (and a retired superstar nurse), if they have ever seen anything like what we are experiencing. They answered with a resounding, "NEVER"! Why is this disease different when there are many types of human coronaviruses including some that commonly cause mild flu-like symptoms, like shortness of breath and cough? This new disease (COVID-19) is an infectious disease caused by a new virus. Because this is a new virus and our immune systems have never been exposed to it, we haven't built up the anti-bodies to defend ourselves.
 
In COVID-19, 'CO' stands for 'corona,' 'VI' for 'virus,' and 'D' for disease. Formerly, this disease was referred to as “2019 novel coronavirus” or “2019-nCoV”. People of all ages can be infected by COVID-19. Older adults and people with pre-existing medical conditions (such as asthma, diabetes, heart disease) appear to be more vulnerable to becoming severely ill with the virus. In fact, the highest number of deaths caused by this disease have been to older adults in long-term care facilities because the virus can spread so rapidly with individuals exposed who already are immuno-compromised. 
 
I was shocked two weeks ago when I read Stanford University (among others) had halted live classes. But now it appears they acted swiftly in the best interest of the students, faculty, administration, and employees to limit exposure. Young people are not immune to this disease as the number of cases in the United States of young adults contracting the virus and being hospitalized has grown exponentially in the past week and placing a large burden on our health care system. World Health Organization and health officials advise people of all ages to take steps to protect themselves from the virus, for example by following good hand hygiene and good respiratory hygiene.
 
 
When contracted, COVID-19 causes respiratory illness (flu-like symptoms) like coughing, fever and difficulty breathing. In more severe cases the infection can cause pneumonia, severe acute respiratory syndrome, and even death. Symptoms would appear 2-14 days after exposure so the virus can lay dormant in someone for up to 2 weeks and be spread unknowingly to others who think the carrier is not infected. Due to this incubation period, infection control folks think the health care system will be most burdened in the next few weeks to months as more cases are exposed and more testing is conducted.  Thus the response has been to self quarantine and close most places that typically have large gatherings like sporting events, schools and churches. 
 
HOW IT SPREADS
 
Just like other respiratory infections, the illness transfers from person to person in respiratory droplets of bodily fluid such as mucus or saliva. When an infected person sneezes or coughs, the germs disperse into the air and onto surrounding surfaces. Droplets from coughs and sneezes can travel several feet and stay suspended in the air for up to 10 minutes (5), increasing the likelihood of infection for anyone who comes into direct contact with a sick person or contaminated surface area.
 
Amazingly, these germs are resilient and can last a long time on surfaces. According to the Center for Disease Control (CDC), the COVID-19 virus can last up to...

Prevention is the key and there are simple things you can do to help keep yourself and others healthy and preventing COVID-19 disease and severe illness:

Besides these recommendations, to me it makes sense to keep our own immune system as highly functioning as possible. Just because we get exposed to the bugs doesn't mean we have to get sick. We are exposed to germs and disease every day but unless we are compromised, we fight of disease contraction. Having a highly functioning immune system helps immensely. Proper rest, controlling stress, exercising, good nutrition and hydration, among other modalities, like Red Light Therapy, Infrared Sauna, and vitamin injections all contribute to a healthy immune system. We have all of these modalities available at Body Lounge at your disposal if you are in the Dallas or North Texas Area.  I am so doing telemedicine consults when needed.  

PHYSICALLY BLOCKING THE BUGS

Not allowing the germs to get into our system would help us not contract the illness. Ideally, we would all wear a respirator and facemask when in public but that is not reasonable.
 
 
There have been questions regarding the use of surgical face masks to help protect against COVID-19 disease by using a mask to cover the nose and mouth.  It makes sense to physically block the virus from getting into our respiratory system by using a mask and why you will see people wearing them on planes and in high traffic areas. The health department has recommended people who are already unwell should wear masks to avoid passing on the virus but most masks are too loose to be effective and do not prevent people from touching their eyes (which can allow the germs to get into your body thru the mucous membranes) (1). Even medical-grade masks can offer a false sense of security. In the US, the Center for Disease Control's surgeon general has urged the public not to buy masks, warning masks will not help against the spread of the illness and will take away vital resources from health care professionals who are treating infected individuals (6). 
 
Currently, the CDC is making these recommendations regarding mask use:
In addition to wearing a mask when recommended, we should also use our own innate defense mechanisms.  Breathing thru our nose and avoiding breathing thru our mouth (plus keeping our immune system up) could be the best defense we have to fight COVID-19 and other germs threatening our immune system.  Not just during this pandemic but for future prevention of illness as well.
 
HOW IS NASAL BREATHING PROTECTIVE?
 
Scientists have highlighted the importance of nasal breathing in preventing the spread of infections. The nose provides a natural filter for dangerous pathogens. The small hairs and conchae of the nose filter, warm and humidify air on the way into the body. Unlike nasal breathing, mouth breathing does not improve the air quality (filtration, moisten or warm) prior to air reaching our lungs. In fact, breathing thru our mouth leaves our mouth and lungs dry, closing our bronchioles and reducing the exchange of air with the blood.  Breathing thru the mouth allows any pathogen unrestricted access to our lungs, thus the ability for the pathogen to replicate and leaving us susceptible to disease. 
 
 
In addition to improving air quality, an important molecule called Nitric Oxide (NO) is created in the nose and upper lung when we nasal breathe. The existence of NO in exhaled air was first discovered in 1991(8). NO is an air molecule which is produced in the paranasal sinuses – a group of four air-filled spaces that surround the nasal cavity. Studies have demonstrated almost all nasal NO originates in the upper airways, with only minor production from the lower respiratory tract and lungs. By breathing through the nose, we harness various properties of NO including its pathogen-killing powers (8). In 1999, Lundberg and Weitzberg discovered NO reduces or eliminates the growth of various pathogens, including viruses. Ultimately, NO in the nasal airways plus nasal filtration represents an important first line of defense against infection. NO is also understood to be a vasodilator, meaning NO plays a role in opening blood vessels in the lungs so oxygen can be properly absorbed from the air.
 
Although COVID-19 is a new disease and no direct research is currently available about its development, studies have been published on similar illnesses. One 2005 paper reported nitric oxide (NO) inhibits the replication cycle of SARS (Severe Acute Respiratory Syndrome Coronavirus) (7). In lab tests using Vero E6 cells, researchers discovered NO has an antiviral effect. It appears, NO inhibits the replication of the virus during early stages of infection. Their research also demonstrated NO inhibits viral protein and RNA synthesis – essential stages of viral reproduction in SARS.
 
In 2009, the scientists responsible for the research into the SARS virus, stated, “NO is involved in local host defense of the upper airways.” The research, which also used isolated laboratory cells, suggests while it is unclear whether NO acts directly on microorganisms or if it works in combination with other components to produce its toxic impact, NO may help to keep the sinuses sterile. Interestingly, the study found that NO inhibits the replication of SARS in two distinct ways (9). 
 
A 2013 study called 'Evidence for the Cure of Flu through Nose Breathing' supports nasal breathing, stating that nasal breathing is helpful for patients with flu (6). The paper explains nasal NO is harnessed during nose breathing, and since NO has been proven to destroy influenza viruses and inhibiting the early stages of their replication cycle, NO can kill the flu virus and therefore provide a “cure” (8). This is consistent with findings from 1999 and 2000 studies demonstrating NO has “opposing effects” (6) on viral infections including flu and pneumonia and NO inhibits the replication of a variety of viruses. 
 
Everyone should learn to nasal breathe even when this pandemic is over to help protect our bodies from infection.  Research into the human rhinovirus (HRV), or the common cold, concluded humans produce more NO in response to HRV infection, theorizing NO plays a key role in viral clearance (7). Other studies have found when individuals have limited NO, they are more at risk for respiratory infections. 
 
PREVENTION MEASURES
 
Much of the advice around eliminating COVID-19 focuses on hygiene practices such as frequent and thorough hand washing, self-isolating and catching sneezes in the crook of the elbow. Nasal breathing has demonstrated to be the bodies primary defense to airborne viruses and breathing through the nose can support the body’s natural resistance to infection.  Breathing thru the nose in addition to exercising, eating well, getting enough sleep, meditating, praying, and being grateful can all assist in getting us thru these trying times. Isolate. Wash your hands regularly. Keep your hands away from your face. We will be through this before we know it. 
 
If you need help learning how to nasal breath, I did a short video on our YouTube Channel. For more information on the COVID-19 virus and recommendations, go to the Center For Disease Control Website and your local health officials website. Here is Dallas Counties Health and Human Services Website for my local peeps. 
 
REFERENCES:
 
1. https://www.worldometers.info/coronavirus/
 
2. https://www.aljazeera.com/news/2020/01/coronavirus-spread-protect-200130115539072.html
 
3. https://www.nytimes.com/article/prepare-for-coronavirus.html – link-31d0f886
 
4. https://jvi.asm.org/content/79/3/1966
 
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1745376/pdf/v054p00947.pdf
 
6. https://www.ncbi.nlm.nih.gov/pubmed/19800091
 
7. https://www.researchgate.net/publication/311509644_Evidence_for_the_cure_of_flu_through_nose_breathing
Author
Dr. Ed hanging out in his 'cave' Ed Le Cara, DC, PhD, MBA, ATC, CSCS Co-Owner and lead clinician, Dr. Ed (as he is affectionately known in the clinic) is a board certified sports medicine and rehabilitation expert who has over 20 years experience helping people live a healthy and active lifestyle. He is a blend of manual therapist, strength and conditioning coach, athletic trainer, and researcher which provides a rare perspective on healthy living. While wrestling in college, Ed tore 3 out of 4 ligaments in his knee and rehabilitated (without surgery) with the guidance from his chiropractor, his athletic trainer and his college strength and conditioning coach. This rehabilitation experience helps bring a unique, empathetic and caring perspective when individuals need guidance overcoming their own ailments, limitations or injuries. Instead of needing to go to multiple professionals, you get all in one making Body Lounge Park Cities a one-stop shop for helping you pursue optimal health thru nutrition and an active lifestyle. Dr. Ed works with patients from 8 years old on.

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