We thought it was just a respiratory virus but we were wrong! by Anne Chiotis

In late January, when hospitals in the United States confirmed the presence of the novel coronavirus, health workers knew to watch for precisely three symptoms: fever, cough, and shortness of breath. But as the number of infections climbed, the symptom list began to grow. Some patients lost their sense of smell and taste. Some had nausea or diarrhoea. Some had arrhythmias or even heart attacks. Some had damaged kidneys or livers. Some had headaches, blood clots, rashes, swelling, or strokes. Many had no symptoms at all.

By June, clinicians were swapping journal papers, news stories, and tweets describing more than three dozen ways that COVID-19, the disease the coronavirus causes, appears to manifest itself. Now researchers at UC San Francisco and around the world have begun taking a closer look at this dizzying array of symptoms to get at the disease’s root causes. They are learning from people inside the hospital and out; people on the brink of death and only mildly sick; people newly exposed and recovered; people young and old, Black, brown, and white. And they are beginning to piece together the story of a virus unlike any known before.

Viruses lead a curious purgatorial existence of being neither fully alive nor dead. Enveloped in a protein cloak, a virus consists almost entirely of genetic material – DNA or RNA, the blueprints for all of life. But it can’t reproduce on its own. To survive, it must break into a cell and co-opt the cell’s gene-copying machinery. 

The novel coronavirus, an RNA virus named SARS-CoV-2, has become notorious for its skill at breaking and entering human cells. Its tools of choice are the protein spikes protruding from its surface – a feature that distinguishes all coronaviruses. The spikes of SARS-CoV-2 are the crème de la crème: By the luck of the evolutionary draw, they are able to easily grab hold of protein gates on human cells known as ACE2 receptors and, like jack-knives, pry these gates open.

Spikes on the virus’s surface act like jack-knives to break and enter human cells.

If you’re exposed to SARS-CoV-2 – say, from a cough or sneeze – the virus will likely first encounter ACE2 receptors on cells in your nose or throat. But these receptors also populate your heart, gut, and other organs. There is evidence which suggests that male sex hormones such as testosterone may increase the number of ACE2 receptors that cells produce, which could help explain why SARS-CoV-2 appears to wreak greater havoc in males than females and why kids rarely get sick. The fewer ACE2 receptors, the less risk of infection, though it must be stated that this hypothesis for the disease’s gender gap is only one of several.

Once inside a few initial host cells, the virus sets them to work churning out copies of itself. Within hours, thousands of new virus particles begin bursting forth, ready to infect more cells. Although SARS-CoV-2 is less deadly than the original SARS virus, which emerged in 2002, it replicates more rapidly. Also unlike SARS, which primarily infects the lungs, SARS-CoV-2 replicates throughout the airway, including in the nose and throat, making it highly contagious – like the common cold.

SARS-CoV-2 replicates throughout the airway, making it highly contagious, similar to the common cold.

However, infection with SARS-CoV-2 usually doesn’t feel like a cold. Fewer than 20% of infected people who eventually show up at a hospital report having had a sore throat or runny nose. During the first few days of being infected, you’re more likely to have a fever, dry cough or, peculiarly, lose your sense of smell or taste.

Most likely, though, you won’t feel sick at all; 53% of those infected never have any symptoms at all; this is much higher than expected. Surveys of outbreaks in nursing homes and prisons show similar or even higher numbers. Millions of people may be spreading the virus without knowing it, making asymptomatic transmission the ‘Achilles heel’ of efforts to control the pandemic – and highlighting the importance of universal masking.

The majority of people who have COVID-19 are out in the community, and they are either asymptomatic or only mildly ill. 

True to its name, SARS-CoV-2 (which stands for severe acute respiratory syndrome coronavirus 2) is first and foremost a bad respiratory virus. If your immune system doesn’t defeat it at its landing site in your nose or throat, it will advance down your windpipe, infiltrating the cells lining your lungs’ branching air tubes. At the tubes’ ends, tiny air sacs called alveoli pass oxygen to your blood. As the virus multiplies, the alveoli may fill with fluid, shutting down this critical gas exchange. Your blood-oxygen level may drop and, typically about six days into an infection, you may start feeling short of breath.

Inevitably, a fast-replicating virus will kill or injure many of the lung cells it infects; the more cells it infects, the more ruin it will leave in its wake.

The virus’s fatality rate seems to be roughly 10 times that of the flu.

One of the weirder things about this new coronavirus is it doesn’t seem to be particularly fatal to cells. On the other hand the flu virus does kill cells. If you add it to human cells in a petri dish, the cells burst within 18 hours.  

An early analysis suggests that the immune systems of many hospitalized patients mobilize differently – and more aggressively – against SARS-CoV-2 than against influenza viruses. Their lungs are ravaged, these data suggest, not by the virus alone but by the detritus of an immunological battle gone awry. This rogue immune response could explain why, around day 11 of a COVID-19 infection, patients often develop a severe pneumonia known as acute respiratory distress syndrome, or ARDS.

Typically, people who die from COVID-19 ARDS die around day 19. Reported rates of mortality have varied widely, with the highest rates being where the pandemic has hit hardest, overwhelming hospital resources and staff. 

On the other hand, the virus behaves in ways that are still mysterious.

Some symptoms (such as fever, cough, and loss of smell) are common, whilst others (such as sore throat, pink eye, and stroke) are rare. 

Symptoms which can occur are headaches, brain fog, dizziness, delirium, and stroke. Pink eye; loss of smell or taste, runny nose, sneezing, sore throat.  Arrhythmia, weakened cardiac muscle, heart attack. Shortness of breath, lung injury;  Kidney injury; Elevated liver enzymes, nausea, stomach-ache, vomiting, diarrhoea. Fever, fatigue, muscle aches. Inflammation, blood clots, vascular injury, skin rash, numbness or swelling in feet 

Pre-existing heart disease and related conditions put people at greater risk of suffering and dying from COVID-19. Many patients who have more severe forms of the illness are obese, they are diabetic, or they are hypertensive. 

Clinicians saw patients developing heart problems – muscle weakness, inflammation, arrhythmias, even heart attacks. Many patients whose hearts acted up also had failing lungs. But others had no other symptoms or only mild ones.

It stands to reason that SARS-CoV-2 affects the heart, but it isn’t thought that SARS-CoV-2 necessarily kills heart cells outright. Rather, in the process of copying itself, the virus steals pieces of the genetic instructions that tell the heart cells how to do their job. 

It’s also possible however, that an infected person’s own immune system may do the majority of the damage in the heart, as it appears to do in the lungs. The heart probably gets infected by a lot of other viruses, and they don’t have a lethal effect.

Most symptomatic cases of COVID-19 are mild.

And it’s not just dermatologists who are adding their observations to COVID-19’s ever-expanding symptom list. Gut specialists are finding that 20% to 40% of people with the disease experience diarrhoea, nausea, or vomiting before other symptoms. If you swallow virus particles, there’s a good chance they will infect cells lining your stomach, small intestine, or colon. 

Especially disconcerting, is how long the virus seems to persist in the gut. About 50% of patients with COVID-19 have virus particles in their stools, often for weeks after their nose swabs test negative. Laboratory studies show that these particles are often still alive and can infect cells in a petri dish. Whether faecal transmission occurs between people, however, is an open question. If the answer is yes, people recovering from COVID-19 may need to stay quarantined even after they feel well, and the rest of us will need to be as meticulous about bathroom hygiene as we’ve become about hand-washing and mask-wearing.

Recently, there’s been speculation that some of COVID-19’s seemingly disparate symptoms may stem from trouble in the blood. Blood clots, for example, are showing up in cases of COVID-19 frequently enough for clinicians to take notice. 

That may be because, as growing evidence suggests, SARS-CoV-2 can infect cells in the walls of blood vessels that help regulate blood flow and coagulation, or clotting. If true, this behaviour could explain some of the virus’s weirder (and rarer) manifestations, such as heart attacks, strokes, and even “COVID toes.

Our vasculature is a contiguous system; thus injury in one area, such as blood vessels in the lungs, can set off clotting cascades that affect multiple organs. Some of that trouble likely results from inflammation triggered by the immune system; although another culprit may be the body’s hormone system that controls blood pressure and fluid balance. It is suspected that receptors may become disrupted when the virus infects cells, thus triggering coagulation and other downstream effects. 

As with any infection, how long a bout of COVID-19 lasts varies from one person to another. If you’re ill enough to need critical care, you can expect the disease to take at least a few weeks to run its course. In some cases, symptoms persist for months. For a typical milder case, though, you should feel better within a couple weeks.

At that point, the question foremost on your mind will be: Am I immune? There are now more than a dozen antibody tests on the market, but most are unreliable, and even the best tests can’t tell you whether you have enough of the right kinds of antibodies to protect you against re-infection. 

What we have in the meantime are a lot of unknowns: If you do become immune to SARS-CoV-2, when and how does that occur? Will you gain immunity from a mild or asymptomatic case, as well as a severe one? How long will that immunity last?  The answers will have huge implications for social distancing and masking and for getting the economy back up and running. 

Holistic approach to coronavirus 

Prevention of virus transmission and the subsequent development of the more serious effects of the infection are of prime importance. Present understanding of this infection is that the elderly, those with certain other medical conditions and those with impaired immunity are particularly vulnerable to the effects of the virus. 

Medical herbalists have considerable experience of using herbal and dietary interventions to support people with conditions likely to bring about a reduced resistance against viral infections. 

The novel nature of the virus causing COVID-19 infection means that research data about the likely effects of any therapeutic interventions on the epidemiology, infectivity and pathophysiology of this illness is scarce. For this reason it is not yet possible to highlight any specific herbal strategies that have been investigated. Much research is already underway, with some treatment trials based on information extrapolated from previous, but unrelated, corona virus infections. Some of these trials will include herbal elements of Traditional Chinese Medicine (TCM) which was used to manage many patients at the start of the outbreak in China. 

The World Health Organisation is registering many such trials at present. Initial information remains tentative, but there seems to be some evidence that patients who received a combination of TCM and conventional strategies may have done better than those who were offered just one type of treatment. 

Another approach being explored by the herbal community is to use our previous experience of the pharmacokinetics of plant chemistry to target key stages in the pathogenic activity of the corona virus during infection. Much of this knowledge is based on past research work done on other strains of corona virus and may, as with many conventional medical strategies, inevitably involve a degree of extrapolation as far as the current infection is concerned for the time being. The results of these studies are eagerly awaited. Meanwhile, the Institute is supportive of herbal strategies used to bring about enhanced immunity and increased resistance to infection. We would always encourage our members to integrate the herbal advice they provide with any conventional treatment or management strategies that are appropriate for their patients, and to observe the current infection control and management guidelines formulated by the Department of Health.

 

Support your immune system with a healthy lifestyle

It is irritating that, day after day and increasingly, in the heart of the pandemic, the media does not explain the functioning of our immune system. 

 

Constantly, we are invited to seek external protection that will save us: buying masks, buying hydroalcoholic gels (without specifying that these gels should not be used for several days in a row because, based on ethanol, they will eliminate the first natural immune barrier of our body: bacteria and lipid film of our skin, which is a barrier to viruses... [This is also due to the excessive use of antibacterial products in recent years, and a misunderstanding about the role of bacteria in our immunity, which our bodies become more sensitive year by year.]

The more we use these alcohol-based gels, the more permeable and epidermal sensitive are the viruses... Let's prioritise classic soap!

 

Besides social distancing and hand washing the health of our immune system is critical in fighting viruses.

Everyone has the ability to naturally strengthen their immune system in a few days (young people) or in a few weeks? This certainly would not prevent the spread of the virus, but it would strengthen our defences against it and therefore reduce the proportion of serious cases, to heal much faster at home.

Top tips:

• Get outside into nature and the sunshine as much as possible & try walking barefoot on grass
• Keep active – walk, dance, play or even do a kitchen workout.
• Connect with friends and loved ones in whatever way you can
• Get a good amount of sleep and spend some time relaxing each day
• Find a way to help others and start a gratitude practice
• Have some fun or watch funny films – laughter is good medicine.
• Yoga can be very helpful.

·       Cold showers can be really beneficial.  In a few days the level of certain T lymphocytes (killer cells) can increase dramatically.

·       Fasting strengthens the immune system in just 3 days.

·       Fear is immunosuppressant.  (However, it's the only emotion conveyed right now by the mainstream media...) a level of anxiety that weakens you daily...

·      Eat real food. Eating trash, such as industrial products, processed and refined, is the first thing that destroys our immune defences. The efficiency of our immune system closely depends on the quality of our intestinal flora (and therefore the quality of what we eat). Therefore, vegetables and fruits living, raw and in season are the best way to quickly strengthen our mineral reserves, necessary for immunity.

 

Natural Remedies & Supplements

Herbal remedies and nutritional supplements can both play a role in helping us build a healthy immune system. Herbal remedies can also be used to help alleviate symptoms and some have anti-viral properties too.

While we are not recommending these instead of routine medical care they can be used by those who are not currently in need of medical care and can possibly be used in addition to conventional treatments.

Kitchen Remedies

• Garlic and onions – are anti-viral and can help coughs
• Thyme – great for coughs
• Ginger and turmeric – anti-inflammatory and may help with muscle aches and fever
• Chilli pepper – helps flu like symptoms in multiple ways
• Fermented foods, e.g. sauerkraut, kimchi yogurt, and kefir – boost the immune system via the gut
• Herbal teas – great for keeping hydrated. If feverish try diaphoretic herbs (i.e. herbs which encourage perspiration) such as peppermint; chamomile; lemon balm & ginger

Key nutrients for the immune system

It is ideal to get all the nutrients we need from Real Foods however at times of greater stress supplementation may be beneficial. If wanting to supplement in doses above the RDA then it is advisable to seek the help of a suitably qualified practitioner.

• Vitamin A
• Vitamin D
• Vitamin C
• Glutamine  is an amino acid which is abundant in the protein collagen which is high in bones and other connective tissue. 

·       Zinc blocks viral replication and it helps stop the virus from getting in'. Vitamin D has shown 40-50 percent less respiratory disease and lower respiratory disease.'

·       Our bodies don’t store essential minerals like zinc, legumes and pumpkin seeds are rich in zinc. As for vitamin D, look for diets rich in fish, like salmon or sardines and egg yolks.

Activating your immune system

Consume this healthy tonic for an immune system boost. It’s crafted from ingredients proven to support immune system function:

• Astragalus root
• angelica root
• honey
• ginger

About the herbs

Astragalus is a prominent herb in Chinese medicine, has anti-inflammatory and antibacterial properties. Research suggests that the root can boost resistance to infection and indicate that it can regulate the body’s immune responses.

Angelica root has been used in Chinese medicine to modulate the immune system and to treat respiratory ailments and cold symptoms.

Other key ingredients

Both honey and ginger are powerful antioxidants that also have anti-inflammatory and antibacterial properties.

Honey activates the immune system and prevents cell proliferation. Controlling cell proliferation is key to stopping pesky viruses.

Ginger has anti-inflammatory effects as well and may be able to help with muscle pain.

This recipe contains only small amounts of:

• chamomile
• orange peel
• Cinnamon
• cardamom seeds

Here’s a fun fact to keep in mind, though. Pound for pound, orange peel which contains almost three times as much vitamin C as the fruit itself.

Recipe for immune-boosting bitters

Ingredients

• 1 tbsp. honey
• 1 oz. dried Astragalus root
• 1 oz. dried angelica root
• 1/2 oz. dried chamomile
• 1 tsp. dried ginger
• 1 tsp. dried orange peel
• 1 cinnamon stick
• 1 tsp. cardamom seeds
• 10 oz. alcohol (recommended: 100 proof vodka)

Directions

1. Dissolve the honey in 2 teaspoons of boiling water. Let cool.
2. Combine the honey and the next 7 ingredients in a Mason jar and pour alcohol on top.
3. Seal tightly and store the bitters in a cool, dark place.
4. Let the bitters infuse until the desired strength is reached. It’ll take about 2–4 weeks. Shake the jars regularly (about once per day).
5. When ready, strain the bitters through a muslin cheesecloth or coffee filter. Store the strained bitters in an airtight container at room temperature.

How to use it: Mix these ‘bitters’ into hot tea or take a few drops first thing when you wake up for protection during cold and flu season.

We have within us a potential defence and healing that is infinitely more powerful than any drug in the world and can be activated quickly. Our body is a real healing machine.

 

In this period when we finally have time, it's time to take an interest in our own functioning, claim our personal power, take control of our health and our future.

by Anne Chiotis, Medical Herbalist August 2020