Nicki Murff Goedecke

    As the COVID-19 pandemic sweeps the globe, discussions surrounding the immune system are especially prominent. It’s important to note that due to the novel nature of coronavirus disease COVID-19, new information surrounding transmission, infection, and immunity to the disease is being uncovered almost every day, and much is still unknown about the details of the disease.

    While vaccines are being researched and developed, there is no specific medicine that can prevent or treat COVID-19(1), and it’s unclear whether those who have recovered from COVID-19 will have any immunity to reinfection from the coronavirus.(2) Even still, a strong, healthy immune system is better equipped to fight off any disease; taking steps to teach how to support immune system functioning during this time is wise.

    1. Infection Prevention

    The first and most obvious step to preventing the spread of a disease is to follow CDC recommendations(3) for handwashing; using antibacterial gels to clean hands; avoiding touching one’s face, eyes, nose, and mouth; and practicing social distancing.

    These measures are crucial for flattening the curve(4) of the COVID-19 spread, which can prevent hospitals and their resources from being overloaded, and are also helpful in avoiding contracting the virus or transmitting it to others.

    For hospital staff and any healthcare personnel, this means personal protective equipment (PPE) and how to properly wear it is a must. Unfortunately, many suppliers (including Pocket Nurse) are currently experiencing low or no stock on PPE items. Luckily, there are some ways that to help local health centers deal with the shortage, as many are accepting equipment donations.(5)

    2. Nutrition

    A healthy diet is a foundational component of a healthy lifestyle and immune system. In particular, gut health can be key. According to a 2012 study on Gut Microbes, “The gut microbiota that resides in the gastrointestinal tract provides essential health benefits to its host, particularly by regulating immune homeostasis.”(6) Teach students and patients they can improve gut health by incorporating probiotics and prebiotics into their diet, eating whole grains and leafy greens, and limiting sugar intake.(7,8,9)

    To boost overall nutrition, everyone can aim to make meals at home using fresh ingredients rather than processed and packaged foods. If there is a concern about the availability of healthy ingredients or one wants to limit trips to the grocery store, try cooking with frozen and canned vegetables, as they can still provide the needed nutrients . Instruct on the use of hand hygiene before and after grocery trips.(10)

    3. Staying Active

    Exercise can be beneficial for the immune system(11), and staying active while social distancing can stave off feelings of restlessness.

    Where state and local mandates allow, people should spend time outside to get fresh air and sunlight while remaining active, respecting social distancing protocols. Spending time outside when it is sunny is important, as Vitamin D is produced when the skin is exposed to UV B rays, and can increase immunity.(12) To stay active indoors, people can follow exercise videos online; also, local gyms may be offering virtual classes.

    4. Getting Quality Sleep

    According to Eric J. Olson, M.D., from the Mayo Clinic:

    “Lack of sleep can affect your immune system. Studies show that people who don’t get quality sleep or enough sleep are more likely to get sick after being exposed to a virus…Lack of sleep can also affect how fast you recover if you do get sick.”(13)

    Advice for getting better sleep include:

    • Making sure the room is completely dark
    • Using white noise devices
    • Unplugging from electronics, especially phones and computers, at least an hour before bedtime
    • If these methods don’t help, talking to a healthcare provider may be called for

    5. Reduce Stress

    While acute stress (like the kind one has before a job interview or big exam) doesn’t necessarily affect the immune system, chronic stress can negatively impact the body’s ability to fight off disease and can lead to a host of immune-related conditions.(14, 15)

    In order to mitigate chronic stress, healthcare providers, educators, and students can consider engaging in practices like yoga, meditation, and deep breathing techniques during this time. Additionally, seeking out support groups and counseling via telehealth can help. Anxiety related to the pandemic is valid, and people are allowed to feel concern in regard to this unprecedented time. Look to trusted sources for information and updates about the virus, and consider the advice from the World Health Organization (WHO) on their posters, “Coping with stress during the 2019-nCoV outbreak” and, “Helping children cope with stress during the 2019-nCoV outbreak.”(16)

    6. Vitamins and Supplements

    Now may be a good time to consider adding certain vitamins and supplements to a daily routine, especially if one is concerned about getting all the vitamins and minerals needed from food intake alone. Vitamins C, D, A, E and more have been shown to support the immune system, as well as certain minerals like iron and zinc.(7) Seek advice from a primary care provider before incorporating new vitamins and supplements into a diet.

    Going Forward

    In addition to the above, now would be a good time to quit cigarette smoking, as it can wreak havoc on the immune system and organ function.(17)

    A healthy, well-functioning immune system is associated with the overall health of the body it lives in. Dr. Fatima Cody Standard, an obesity medicine physician at Massachusetts General Hospital, says, “It’s important to recognize the things that are most supportive of a good immune system are a healthy lifestyle.”(18)

    People with an autoimmune condition should seek out additional ways to protect themselves.(19) If one thinks he/she may have symptoms of COVID-19 (including cough, fever, and tiredness)20 they should reach out to their healthcare providers by phone for an evaluation and for advice on what to do next.

    Sources:

    1. Source: World Health Organization.
    2. Source: From CDC.gov: “The immune response, including duration of immunity, to SARS-CoV-2 infection is not yet understood. Patients with MERS-CoV are unlikely to be re-infected shortly after they recover, but it is not yet known whether similar immune protection will be observed for patients with COVID-19.” Additionally, this article from NPR News.
    3. See the CDC guidelines for infection prevention here: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fprepare%2Fprevention.html
    4. This simulation by the Washington Post illustrates how infectious diseases can spread and what it means to “flatten the curve”: https://www.washingtonpost.com/graphics/2020/world/corona-simulator/
    5. How you can donate to local health centers: https://www.wsj.com/articles/how-you-can-donate-protective-equipment-to-help-hospitals-fight-coronavirus-11585323638
    6. Study on Gut Microbes and Immunity: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337124/
    7. Diet advice for gut health: https://health.clevelandclinic.org/eat-these-foods-to-boost-your-immune-system/
    8. Sugar and Gut Health: https://www.pbs.org/wgbh/nova/article/sugar-keeps-good-microbes-at-bay/
    9. Study on gut health and diet: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5470704/
    10. Tips for grocery shopping during the pandemic: https://www.consumerreports.org/food-shopping/how-to-protect-yourself-from-coronavirus-when-grocery-shopping/
    11. Exercise and the immune system: https://www.irishnews.com/lifestyle/2020/04/02/news/a-quick-guide-on-how-to-make-sure-your-immune-system-is-kept-fighting-fit-1885307/
    12. Study on Vitamin D and the Immune System: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3166406/
    13. Sleep and the Immune System, from The Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/insomnia/expert-answers/lack-of-sleep/faq-20057757
    14. Study on stress and the immune system: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361287/
    15. Stress and the immune system, from the Cleveland Clinic: https://health.clevelandclinic.org/what-happens-when-your-immune-system-gets-stressed-out/
    16. Ways to cope with Covid19 stress, from the WHO: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public
    17. Study on smoking and the immune system: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3580564/
    18. Healthy immune systems are found in healthy bodies: https://health.usnews.com/wellness/slideshows/ways-to-boost-your-immune-system?slide=2
    19. Extra ways to protect yourself, autoimmune: https://health.usnews.com/conditions/articles/immuncompromised-and-coronavirus-how-to-protect-yourself
    20. Symptoms of covid 19: https://www.who.int/news-room/q-a-detail/q-a-coronaviruses#:~:text=symptoms

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