General Wellness

When Covid first hit more than a year ago, the initial impression was that it would behave like a regular respiratory virus, albeit more infectious and lethal. We figured it would spread like the regular flu, by way of people mostly who are sick with obvious symptoms, and transmit thought the regular routes like sneezing and coughing. You’d get sick, cough, maybe get pneumonia and a small number of mostly elderly and immunocompromised people might die (remember that in the 2018 season, almost 70,000 Americans died from the flu). Those that recovered (the vast majority) might have a lingering cough for a few months but then that’s it. Back to normal.

We quickly learned that the SARS-Cov-2, the coronavirus which causes Covid-19, behaves, spreads and impacts the body very differently than the influenza virus, which primarily affects the lungs. Although there could be secondary organ issues with the flu, they are from chronic illness, and not from a direct effect of the influenza virus. SARS-Cov-2 directly attacks organs other than the lungs.

Covid is much worse in terms of how it spreads, through simple breathing. It is 2-3 times more infectious  (the variants are twice as infectious as the wild type now) and it can impact on just about every organ system there is. The lungs, heart, brain, skin, hair… In addition, we are finding that many people, even those with relatively minor or even asymptomatic infections, are suffering long-term, and likely permanent organ damage. For example, a recent study from Germany showed that 70% of those who survived Covid-19, even with negligible symptoms, were identified as having permanent heart damage. Another study showed that 1/3rd had permanent scarring in their lungs. Kidney damage leading to needing dialysis, pancreatic damage leading to diabetes and even brain damage.

Some of this organ disease is related to the fact that SARS-Cov-2 binds to the now well known ACE-2 receptor, found on the surface of many cells in various organs. One organ which also is impacted is the endothelium of our blood vessels. We have 60,000 miles of them in our bodies. This single layer of cells which lines our blood vessels is indeed an organ and generates compounds like nitric oxide, a gas which relaxes blood vessels. These cells do deteriorate with age making dietary sources of nitrates more and more important, but the Coronavirus destroys these cells as well. The inflammatory process which ensues leads to activation of the clotting cascade and blood clots develop. Specifically, we see micro-clots. This is one of the mechanisms leading to the varied organ damage we see in this disease and why taking a baby aspirin is helpful early in this disease. This includes some of the more esoteric symptoms like Covid-toes, related to microvascular inflammation, and even hair loss.

POST ACUTE SEQUELAE of COVID. About 30% of those who recover from Covid-19 have long lasting effects. This syndrome is now called PASC, Post Acute Sequelae of Covid. Colloquially, these patients are called “Long-Haulers”. Microvascular damage, neuropathy (nerve damage) and chronic inflammation are thought to be the 3 main causes of prolonged health problems. As mentioned above, you don’t have to have had a bad case of Covid to suffer long-term side effects. Heart problems and lung scarring has been seen in healthy young asymptomatic people.

It is important to get vaccinated, even if you had covid, especially if you have PASC symptoms. Studies show that 40% of patients report significant improvement in their symptoms after vaccination.

The bottom line is that this virus messes us up in many ways. It’s not just a cold or like the flu. It has the potential to be much, much worse, even if you were not all that sick or even asymptomatic. You DO NOT want to get it and you certainly don’t want to be the person who dies a few days before their vaccine. You also don’t want to be the one to spread it to a friend or loved-one.

Respect it. 

Protect yourself and all those around you from it. 

Get vaccinated.

Mask and distance.

Get healthy.

Stay safe and be well.

AC

Let me start off with some good news. We are getting many people vaccinated, much more than in most countries in the world. In many places, we are doing well enough that vaccinations are being opened up to younger and younger people. In addition, if you have not yet gotten vaccinated, you can still protect yourself if you remain careful and follow the MASK/DISTANCING/WASHING guidelines.

But that second point is not what is going on.

Despite a 40% increase in cases in the last week, NJ announced even more loosening of indoor dining and public space restrictions. Masks are no longer mandated. WTF??? Overall in the US, there is a 20% increase in cases in the last week.

When all this started, our numbers basically paralleled the world numbers, they just lagged by a few weeks and that is what we are seeing once again. Numbers are on the rise. Not only in Europe and South America, where it is almost as bad as it was at the peak of this pandemic, but also here in the US. In many states, there is close to a 50% increase this last week over previous weeks. In Europe, they are locking down. In the US, we are opening up???

Why is vaccination not enough? Despite having one of the best vaccine rollouts and highest rates of vaccination in the US, Michigan is having a huge surge in Covid cases, and almost 50% of them are the NEW coronavirus variant. I call it NEW because it is almost a completely different virus. The newest data shows that it is nearly twice as infectious as the original Covid virus and causes 60% more serious disease, resulting in significantly more hospitalization and death. Most concerning is that kids are just as likely to contract and transmit these variants as adults are, whereas they were less susceptible to the original virus. Kids can also get just as sick. Lastly, having suffered the original infection or having been vaccinated provides much less protection against the variants.

As far as world vaccination is concerned, there is extreme disproportionality. 80% of the world’s population only has access to 20% of the vaccine. The richest countries are monopolizing the vaccine. That’s one of the main reasons that this will not go away anytime soon. It will keep circulating and recirculating with recurring outbreaks over and over again. As the virus is allowed to survive, more and more variants will emerge and we will continue to chase our tails.

Opening up as the numbers rise? Loosening safety measures when these variants are exploding on the scene?  Does it make any sense?

The other bit of great news, it’s Spring. It is getting warmer and there is more light. Speaking of light, it remains dim at the end of the pandemic tunnel but it has not been extinguished! We can defeat it if we just remain vigilant, careful and, most importantly, patient and compassionate towards each other.

Have a great, safe holiday weekend. Celebrate safely with your families if you can. If you can’t, celebrate virtually. We’re all tired of it but we’re also all pretty good at it at this point.

Vaccinated or not, whether you had Covid-19 or not, continue to practice safety measures and remember that it is not just about you, it’s about everyone else.

MASK

DISTANCE

WASH

VENTILATE

VACCINATE

GET HEALTHY!

Stay safe and be well.

AC 🌱 ✌️