SARS-CoV-2 virus can infect cells in acid solutions where natural immunity fails to protect them.

We can measure Nitrates, Nitrites and Acid in Saliva. If Nitrates and Nitrites are too low, we can increase them with dietary supplements. If Acidity is still too great, we can further reduce it by restoring the oral acid-base buffer system.

The Saliva Nitrate Protein Defense provides protection against all current and future variants as well as the original SARS-CoV-2 virus.

Help measuring Nitrites and Acid in Saliva can be obtained from Herd Healthcare. Sign up for a Good Health Assessment at the end of this blog article.

Viruses are just a nuisance as long as they don’t get into cells of human tissues and organs. Kept out of cells in muscle, fat and nerves. Out of lungs, heart, brain, liver, pancreas and kidneys. Breathed in, swallowed or absorbed through skin or intestines into blood, lymph or tissue fluid. Stay safe from harm as long as it takes to get rid of them. Just so long as they don’t get into cells.

Normal healthy cells are strongly protected from virus entry. Blood proteins, leukocytes, T Cells and Natural Killer cells carry receptors that detect and destroy harmful invaders. There are similar defense mechanisms inside cells.

Acid-base balance in cells, tissue fluid and blood is tightly controlled. CO2 dissolved in water is a weak acid. Any change in acid-base concentration shifts more or less CO2 in and out of solution. CO2 is breathed out into the air and liquid acids and base are excreted in urine. Restoring the original acid-base balance. At slightly alkaline level with pH, potential of hydrogen, about 7.4. Neutral pH is 7.0.

Particles of SARS-CoV-2 circulate around in blood, lymph and interstitial fluid as folded proteins inside a closed envelope. To get inside cells, the virus particle must get attached. The envelope is covered with thousands of spike proteins that can attach to thousands of receptor sites. Acidity of the tissue fluid unfolds the virion envelope. Spike proteins on the virus attach to cell receptor sites and fusion begins. ¹

Protective innate antibodies inhibit fusion in proportion to acidity of tissue fluid. The viral envelope unfolds about 10% at pH 7.4 but opens completely at pH 5.5. Protective antibodies inhibit attachment completely at pH 7.4 but fail to act at pH 5.5. As a result, SARS-CoV-2 spike protein attachment to cell membranes at low pH allows up to a 3-fold increase in entry. Entry into intracellular space occurs both at the cell surface and from cytosolic vesicles. ²

Entering the host cell takes about 15 minutes. Inside the cell, the virion uses host cell functions to replicate viral molecules. Each invading virion takes over hundreds of protein actions to create about 10 infectious units. Replication cycles from entry to release of new infection units take 7 to 8 hours. The huge number of protein interactions causes many mutations which create variants among the particles released. Time from infection to symptoms is about 5 days. ³

Nitrate<->Nitrite<->Nitric Oxide-> (Oxygen Delivery)

Combinations of nitrogen and oxygen move back and forth supporting chemical oxidation and reduction. The amounts stored in these molecules determine how quickly they can be used and for how long.

Nitrates take up and release oxygen to support metabolism. Combined with sodium and potassium, they store and release energy. Amounts available control reactions for cardiovascular, neurological, renal and immunological function.

Acid-Base Balance From Metabolism

Normal cell metabolism combines proteins, fat and carbohydrates with oxygen to produce energy, CO2 and H2O. With scattered remnants of weak acids and bases. As well as electrolytes and fiber.

Sometimes metabolism gets interrupted before reactions with oxygen. Producing lactic acid as well as CO2 and energy. The result increases acidity and lowers pH. Making SARS-CoV-2 virions more able to fuse with cell membranes.

Lactic acid does not get balanced as quickly as CO2. Lactic acid is metabolized by tissues and organs all over the body. Eventually converted into energy, CO2 and H2O. In the meantime, CO2 is breathed out in the lungs. Until removing CO2 from blood increases acidity and decreases pH.

Excretion of excess acid by kidneys decreases pH of urine. Excretion of excess acid by salivary glands decreases pH of saliva.

Daily Variation Of Urine pH

Daily variations in acid-base balance of urine occur in relation to meals, physical activity and sleep. Intake of food and fluid during meals increases urine pH. ⁴

During meals, the stomach makes acid from Cl, Na, CO2 and H2O. When the acid is formed, CO2 and H2O are returned to the blood. The Cl forms acid which is secreted into the stomach. That leaves an alkaline combination of Na, CO2 and H2O which is left in the blood. The excess basic fluid in blood delivered to the kidneys is excreted in urine.

During physical activity, requirements for energy during mild exercise are matched by increased amounts of blood flow. Without any change in acid-base balance of blood. 

During sleep, decreased breathing causes a higher level of CO2 in blood leaving the lungs. As a result, the acid level in urine gradually increases during the night. A urine specimen tested in the morning is usually highly acidic. Especially a second collected specimen after fully emptying the bladder.

Daily Variation Of Saliva pH

Daily variations in acid-base balance of saliva very much follow the rate of production. During sleep, secretion of saliva is much slower than during the day. Saliva containing proteins, electrolytes and water, flows through ducts that reabsorb Cl and secrete bicarbonate. The amount of base excreted depends on rate of flow. As a result, the acidity of saliva is highest of all after several hours of sleep. ⁵

Energy for metabolism includes production of lactate. Especially with low levels of serum bicarbonate and low urine pH. Further decreasing protective effects of bicarbonate during rest.

Defense Against Viral Infection

The most obvious treatment to prevent severe illness and viral replication is initial, repeat and booster vaccination against COVID-19. Except for known diagnosed allergy to some component of a COVID-19 vaccine.

While continuing all precautions against exposure to spread of COVID-19.

Indicators of Decreased Risk of Infection and Severity of Illness:
•Morning saliva pH: at least 6.0
•Morning urine pH: at least 6.0

Conditions Increasing Risk for Infection, Vaccination Breakthrough and Severe Illness from COVID-19:
•Metabolic disease including hypertension, obesity and type 2 diabetes
•Kidney disease with metabolic acidosis and renal failure
•Lung disease with respiratory acidosis and COPD
•Autoimmune disease with chronic inflammation
•Organ transplants with medication to prevent rejection
•Cancer causing immunodeficiency

Treatment of organ dysfunction and chronic metabolic dysfunction requires correction of the underlying medical condition. As much as possible. Giving special attention to compliance with prescribed medical treatment. Including nutrition, physical activity and sleep patterns. Also, management of behavioral and psychological factors.

Services From Herd Healthcare

We will assess individual features of health to make recommendations for increasing personal safety from infection and illness.

Results of laboratory tests combined with personal information can be used to determine natural features and strength of good health protecting against infection and illness.

REFERENCES

1. Cohen FS. How Viruses Invade Cells. Biophysical Journal 2016;110(5):1028-1032.
https://doi.org/10.1016/j.bpj.2016.02.006

2. Tongqing Z, Tsybovsky Y, Olia AS, et al. Cryo-EM Structures Delineate a pH-Dependent Switch that Mediates Endosomal Positioning of SARS-CoV-2 Spike Receptor-Binding Domains. bioRxiv 2020.07.04.187989.
https://doi.org/10.1101/2020.07.04.187989

3. Bar-On YM, Flamholz A, Phillips R, Milo R (2020) Science Forum: SARS-CoV-2 (COVID-19) by the numbers eLife 9:e57309.
https://doi.org/10.7554/eLife.57309

4. Cameron M, Maalouf NM, Poindexter J, et al. The diurnal variation in urine acidification differs between normal individuals and uric acid stone formers. Kidney International 2012;81(11):1123-1130.
https://doi.org/10.1038/ki.2011.480

5. Choi J, Lyons K, Kieser J et al. Diurnal variation of intraoral pH and temperature. BDJ 2017 Open 3, 17015
https://doi.org/10.1038/bdjopen.2017.15

Not everyone exposed to COVID virus gets virus into functioning cells of lungs, heart, kidneys, muscle, fat and pancreas. Some have natural, innate full protection. Those with poor acid-base balance are poorly protected. Liable to get intracellular infection and suffer severe illness. Exercise and physical fitness restore normal acid-base balance.
 
Exercise and physical fitness also strengthen immune function. Even when immune function is weak.

Many in the US have already been infected by SARS-CoV-2. At least one-third. Of the others, probably half haven’t yet been dangerously exposed.¹

They will be. Sooner or later, everyone will be exposed. Of those not yet infected, probably half were dangerously exposed and just didn’t get infected. They were able to resist infection.

Not because they had been vaccinated against Coronavirus infection. Vaccination doesn’t prevent infection. It just prevents severe illness.

Even without symptoms of illness, people who have been infected are contagious. They expose others in close contact with them to Coronavirus infection. Any of those others who have not been vaccinated are liable to severe illness.

Not everyone exposed to SARS-CoV-2 infection gets infected. Not even when living in the same household as someone with a positive diagnosis.

Rates of transmission have been studied in 101 households in Tennessee and Wisconsin. In each household with someone newly infected, others in the household were examined and tested repeatedly for secondarily becoming infected. During 7 days of follow-up, 54% of other members became secondarily infected. 36% were symptomatic and 18% were Infected without symptoms. ²

Rates of secondary infection depended on risk factors known from other clinical studies. As shown in the figure of rates in relation to age, older household members had greater rates of secondary infection than younger members.

Other risk factors such as high blood pressure, lung disease, cardiovascular disease, diabetes, obesity, and chronic inflammatory dysfunction also increase the risk of secondary infection. Studies in other clinical trials show that about half of all people everywhere have co-morbid medical conditions that increase the likelihood of becoming infected with Coronavirus.

Apparently, many people of all ages everywhere have a natural, innate resistance to Coronavirus infection. Including all the virus variants that keep appearing. What is it that protects them?

Protection by Exercise has been studied during the COVID pandemic. Kaiser Permanente in California recorded week-by-week physical activity at outpatient health clinic visits from March 2018 to March 2020. ³

During the past 10 years, patients have been asked about their exercise. Their responses are included as vital signs in their health records. Along with body temperature, blood pressure, and pulse rate. About one-third report at least 150 minutes of moderate exercise every week. Of the others, almost one-third don’t do any exercise and the rest do less than 150 minutes.

As shown in the Figure, most of the groups with COVID infection were inconsistently active. Only 0.4% consistently exercised at least 150 minutes a week.

From January to October 2020, the clinic population of 4.7 million had about equal numbers of outpatients in each exercise group. About 2% of the total population was diagnosed with COVID-19. Those who were continuously eligible under study criteria were evaluated for risks of COVID in relation to their physical activity.

Risks of infection with COVID were much greater in those who had not been consistently active. About 3% for those who exercised less than 150 minutes a week. Less than 0.5% for those who exercised consistently at least 150 minutes a week.

Risks for severe COVID infection were much greater in those who had not been consistently active. The Figure indicates about a 20-fold increase in incidence of severe illness compared to those who had been exercising at least 150 minutes a week. Severe illness required hospitalization for 0.4% of those who had been consistently inactive. In contrast, severe illness affected only 0.02% of those who had been consistently active.

Results from other clinical studies have been similar. In addition, subjects who were older, female, belonging to minority racial or ethnic groups, were obese or had chronic health conditions were more likely to be inactive. Severity of COVID illness has always been less in subjects who consistently exercised.

Consistently, frequency and intensity of exercise are the most remarkable features discriminating between subjects at high and low risk of COVID-19 infection and severity of illness.

Energy for Action

Anything that’s alive needs energy for chemical reactions, growth, and motion. Human muscles convert chemical energy into movement with about 50% efficiency. Energy is lost in heat and CO2. Remarkably efficient considering normal body temperature is less than 100^o F. A cylinder in a car engine burns fuel at 2,800^o F. The result is about 10% fuel efficiency.

The breakdown of food releases energy. That energy is captured in smaller chemical forms and carried to places where energy is needed. Or places where it can be stored as carbohydrate or fat.

Protein Structure and Function

The chemical machines guiding action consist mostly of proteins bonded together. Called enzymes. Each enzyme acts on specific substances to break chemical bonds, rearrange them or make new bonds. More than 20,000 enzymes in a typical human cell.

The structure of proteins is more complex than a simple string of molecules. Strings are folded into 3-dimensional shapes. The folded proteins must be stable for enzymes to function correctly.

Protein folding depends on temperature and chemicals surrounding the structure. It also depends on acid-base conditions. More acidic solutions have more hydrogen positive molecules than basic solutions with more negatively charged molecules. The measure of how acidic or how basic is called pH. Which means “potential of hydrogen.” It’s a measure of how much free hydrogen carrying a positive charge is in solution.

Optimal function depends on proteins that are fully folded. Extremes of higher or lower acid-base conditions disable normal protein function.

The range of pH goes from 0 to 14. Completely acid at 0, neutral at 7 and completely alkaline at 14.

Virus Structure and Function

A virus is a core of proteins containing genetic material surrounded by a protein capsule. It can’t capture or produce energy, move or grow. It’s not alive. It can survive and multiply only by entering living cells and capturing essential materials.

Optimal function of proteins in virus particles occurs in more acidic solutions at lower pH than optimal function of proteins in host protective enzymes.

Innate Physical and Chemical Protection

Surface skin and inside membranes keep almost everything from getting inside. Cells are arranged side by side, over and under one another. Each fastened tightly to those next to it. Injury can rip them apart. Physical force, and toxic chemicals can cause injury and some places leak enough to let things inside.

Just getting inside skin and membranes is enough for poisons and toxic chemicals to cause harm. Results of those injuries have to be taken care of.

Also, getting inside is enough for infection by bacteria, fungi, parasites and worms. They start growing and spreading. They’re alive and have to be caught and killed.

Viruses that get inside into blood and tissue juice, still can’t grow and spread. Infection is not established. They need essential materials from inside cells. Floating in fluid outside cells, they can be captured and destroyed.

Cell membranes are strong and protective. Proteins join cells together. Very few chemicals just diffuse through. Proteins control movement of chemicals in and out of the cell.

Blood, tissue and most cells are slightly alkaline. Even slight change to acid has dramatic effects. Cell protection and normal cell function depend on alkaline pH. Acidic pH causes protein structure to unfold and lose normal function. ⁴

Virus infection of tissue cells depends on fusing with the cell membrane. Optimal pH for protein in a virus envelope is more acidic than protein in the host cell membrane. Alkalinity provides protection from attachment, penetration and entry of virus into cells. Once inside, the virus takes over cellular proteins that enable virus multiplication, growth and eventual destruction of the host cell.

Natural resistance to virus infection depends on maintaining a protective acid-base balance. Slightly alkaline. Host cellular protective proteins with optimal pH higher than optimal pH for invading virus particles.

Innate Immune Protection

Cells and tissue fluid contain protein receptors that recognize patterns and structures that can cause injury. Some receptors are attached to special immune cells and some are inside normal functioning cells.

These receptors bind to anything that is not natural to the tissue. Especially dangerous foreign molecular structures. They begin the process of destroying them and activating other local immune cells.

They also signal systemic activity to bring in additional protection. Some things are captured and cleared with little local effect. More damaging substances bring out full inflammatory responses.

Cellular action that creates additional inflammatory cells and substances requires energy. That energy comes from metabolism that doesn’t require oxygen. Sugar is broken down into smaller molecules releasing energy. What’s left is lactic acid. Some of the lactic acid combines with bicarbonate and some washes away in the circulation. Either way, inflammation changes the acid-base balance in tissue and blood. More acid and less bicarbonate.

Protection from COVID Infection

The virus causing COVID circulates through droplets in the air spread by coughing or sneezing. It enters through mouth, nose or eyes and spreads to the back of the throat. From there, it can reach the lungs. Also, it can be swallowed down to the stomach.

Virus particles stay on the surface until breathed out or washed away. Kept out by physical and chemical barriers of the upper airway.

Protection of Nose and Throat

Captured by cilia, virus particles are bathed in secretions. Normal acid-base balance of saliva and nasal secretions varies from pH 6 to 8. ⁵

COVID infection of nose and throat occurs when tissue fluids become acid. Acidic pH causes cell protein structure to unfold and lose normal protective function. Virus particles fuse with protein on the cell membrane, enter the cell and take over essential protein structures. Infection is completed.

Hydration affects acid-base balance of saliva and nasal secretions. Even mild dehydration reduces rates of flow and produces acid secretions. Increased rates of flow produce secretions that are less acid and more alkaline. ⁶

Drinking 6 to 8 glasses of fluid a day is commonly recommended for good health. Especially with strenuous physical activity in hot or humid weather. Even more at high altitude.

Chronic, mild dehydration is a risk factor for COVID infection of nose and throat. Especially when associated with co-morbid conditions that increase risk for severe illness from COVID. Certainly, fluid intake should be at least 6 glasses a day if pH of saliva is less than 6.0. Increasing intake of fluid could well produce secretions of saliva that are less acid and reduce risk of COVID infection. ⁷

Rates of flow also depend on general acid-base balance in circulating blood and local tissue fluid. Any acid-base shift that reduces pH in tissue fluid reduces pH of saliva and nasal secretions.

Protection of Lungs

COVID virus moves down the airway from mouth, nose and throat to the lungs. Virus particles released from cells in the nose and throat are released into the air in droplets.

Air inhaled into the lungs fills small spaces called “alveoli.” From there, CO2 moves from blood into the air that’s exhaled. Along with droplets carrying virus particles. Most droplets carried in are carried on out. But some droplets with virus join with fluid lining the air spaces.

Dissolved in tissue fluid, CO2 is a weak acid. Released into air, it leaves behind a more basic solution. Alkaline fluid with pH greater than 6.0 effectively excludes entry of virus particles.

The acid-base balance of airway lining fluid can be measured. Droplets of fluid are caught up in exhaled air. Collected and condensed, the pH has been measured. ⁸

Samples of Airway Lining Fluid were collected from 404 healthy young adults living around the University of Virginia. Individuals were excluded if they had any acute or chronic condition of any system. Median pH was 8.0. Fewer than 10% of these normal subjects had pH less than 7.4. No effect of age or sex.

Release of CO2 from fluid lining air spaces in the lungs decreases acidity and increases alkalinity. Lower levels of bicarbonate and lesser loss of CO2 increase the acidity of the fluid. Increased amounts of other acids stay in the fluid and decrease the pH.

Less than 10 percent of the total quantity of carbon dioxide carried in the blood is eliminated during passage through the lungs. Slowing the flow of air out of the air spaces decreases the amount of CO2 removed. Increased concentration of CO2 in the air slows innate action to maintain and repair cells lining the air spaces.

The combination of decreased bicarbonate, increased organic acids and decreased elimination of CO2 quickly lowers the pH. Virus particles become able to fuse with cell membranes and pass into the interior. Infection is complete.

Heart Rate Response to Injury and Infection

The innate immune system includes increasing heart rate. Protein receptors that recognize danger react and send out signals for an inflammatory response. Including signals that stimulate the brain to increase heart rate. Short-term acute or long-term chronic. Complete recovery from acute injury or infection returns all systems to normal. ^{9  10}

As a result, infection by COVID virus causes an increase in resting heart rate. Before the host has any symptoms of infection. Even before virus can be detected using a nasal swab. An alert triggered by increased heart rate forms an opportunity to isolate the newly infected host from transmitting virus to others. ¹¹

Chronic Inflammation

Injury or infection anywhere that persists keeps resting heart rate higher than normal. Sympathetic nerves from the spinal cord act to increase heart rate. The vagus nerve, running through the neck and chest acts to slow the heart. ¹²

Stimulation of the vagus nerve also acts to increase secretion of saliva. Increasing not only the amount of fluid secreted but also the amount of enzymes involved in digestion. Also, the amount of immune enzymes involved in defense of salivary cells.

The defense enzymes are mostly basic proteins which increase the pH of saliva. The normal pH of saliva is about 7.0 which is neutral. At peak flow, optimum pH is close to 8.0. Much higher than optimum pH for envelope proteins of COVID viruses.  

The effect of chronic inflammation anywhere enough to increase resting heart rate is to increase acidity of saliva. Decrease in pH of saliva below 6.0 increases the risk of COVID infection in the nose and throat.

Chronic inflammation also affects acid-base transport everywhere. Local action of immune cells without oxygen increases acidity of local tissues. Local tissue acidity decreases bicarbonate and increases organic acids in circulating blood. Acid-base transport in the kidneys adjusts the pH of circulating blood by excreting acid urine. Decrease in pH of urine below 6.0 increases the risk of COVID infection in the lungs.

Exercise Training for Preventing and Controlling COVID-19 Infection

Many clinical studies have shown that moderate intensity aerobic training strengthens the immune system. It’s safe and it works! Even one 10-minute session activates neural, endocrine, cellular, and humoral defense against infection. ^{13  14  15}

Endurance training most often used is walking, running, cycling or swimming. Intensity that increases heart rate to about 70% between resting rate and maximal heart rate. Duration between 20 and 60 minutes. Frequency 3 to 5 sessions a week. That’s a total of moderate exercise for about 150 minutes in each week.

Intensity and duration for protection of most healthy people is an average heart rate between 120 and 160 bpm for at least 20 minutes. About the most that anyone can do comfortably 3 to 5 sessions a week. Able to talk but only a few words in short sentences between breaths.

So far, the best proven protective effect of regular exercise has been a lesser number of sick days. Fewer than half as many sick days in adults with exercise training over a period of 8 to 15 weeks.

The best laboratory indicator of exercise protection has been low plasma level of c-reactive protein. Levels in normal healthy adults are <3 mg/L and safest levels are <1 mg/L. CRP is produced by the liver in response to early indicators of infection and inflammation. Its level rises rapidly to a peak in about 48 hours after onset of disease. Its concentration decreases when inflammation lessens and healing begins. ¹⁶

COVID-19 infection causes average levels of 20 to 50 mg/L. Patients with severe COVID-19 requiring hospitalization had levels more than 2-fold higher than those with mild disease. Patients who died from COVID-19 had about 10-fold higher levels of CRP than the recovered patients.

High levels of CRP in healthy adults have been measured before and after moderate exercise training. A clinical study of about 200 parents and 400 adults in their families was done in USA and Europe. About 25% of them had levels of CRP greater than 3 mg/L. Those with high levels of CRP also tended to have abnormal clinical features and other abnormal laboratory values. Many similar to individuals with hypertension, obesity, diabetes and abnormal blood lipid levels. ¹⁷

An exercise training program on cycle ergometers was conducted 3 times a week for 20 weeks. Increase in heart rate during exercise started at 55% of maximum possible during the first week and increased to 75% for the average during the last week. Maximum energy capacity increased about 18%.

Reductions in CRP only occurred in individuals with levels at baseline greater than 3 mg/L. There were no consistent associations with changes in other clinical features or laboratory values.

High levels of CRP certainly indicate high risk for severe COVID-19 illness. Whether already infected or exposed to infection. Also, moderate exercise training reduces levels of CRP in patients with comorbid conditions.

Especially evident in patients with common conditions like hypertension, lung disease, diabetes and obesity. The target of exercise training always is reducing severity of comorbid conditions.

Physical fitness also affects levels of CRP and indicators of acid-base balance. Results of exercise tests were compared with blood levels measured for 2,714 healthy young adults in the US National Health and Nutrition Examination Survey (1999-2004). Lower levels of physical fitness were associated with higher levels of acid in the blood. Also, associated with higher levels of CRP. Low levels of physical fitness had chronic inflammation along with an excess of acid in tissue and blood. ^{18  19  20}

Apparently, physical activity including less than 15 to 30 minutes a day of moderate exercise causes the same risk to health and life as smoking tobacco.

Measuring Your Good Health

Good health improves natural protection from infection. Including infection by Coronovirus-2 and variants. The strength of health-supporting protection can be evaluated by physical and laboratory tests.

Vaccines that are available provide very little protection against Coronavirus infection. They do reduce the severity of illness. At least for several months. But they do not protect against illness of all variants that continue to appear. Variants that will continue to appear as long as some people are poorly protected.

Also, protection against severity reduces but does not completely protect against transmitting infection to others.

Many people have natural features and strength of good health that reduce risk from infection. As well as risk of severe illness. Many others are in great danger of infection and illness. Almost everybody can improve their health enough to decrease risk of infection and severe illness.

Results of laboratory tests combined with personal information can be used to determine natural features and strength of good health protecting against infection and illness.

We will assess individual features of health to make recommendations for increasing personal safety from infection and illness.

References

1. Adams ML, Katz DL, Grandpre J. Population-Based Estimates of Chronic Conditions Affecting Risk for Complications from Coronavirus Disease, United States. Emerging Infectious Diseases. 2020;26(8):1831-1833. doi:10.3201/eid2608.200679 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392427/pdf/20-0679.pdf

2. Grijalva CG, Rolfes MA, Zhu Y, et al. Transmission of SARS-COV-2 Infections in Households — Tennessee and Wisconsin, April–September 2020. MMWR Morb Mortal Wkly Rep 2020;69:1631–1634. doi:10.15585/mmwr.mm6944e1
https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6944e1-H.pdf

3. Sallis R, Young DR, Tartof SY, et al. Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients. British Journal of Sports Medicine 2021;55:1099-1105
 https://bjsm.bmj.com/content/bjsports/55/19/1099.full.pdf

4.  Zhou T, Tsybovsky Y, Kwong PD. A pH-dependent switch mediates conformational masking of SARS-CoV-2 spike. bioRxiv. 2020, Jul 4.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7337388.1/

5. Baghizadeh Fini M. (2020). Oral saliva and COVID-19. Oral oncology, 108, 104821. doi:10.1016/j.oraloncology.2020.104821

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7250788/pdf/main.pdf

6. Stookey JD, Allu PKR, et al. Hypotheses about sub-optimal hydration in the weeks before coronavirus disease (COVID-19) as a risk factor for dying from COVID-19. Med Hypotheses. 2020;144:110237. doi:10.1016/j.mehy.2020.110237

https://www.sciencedirect.com/science/article/pii/S0306987720319460

7. Farshidfar N, Hamedani S. Hyposalivation as a potential risk for SARS-CoV-2 infection: Inhibitory role of saliva. Oral Dis. 2021;27 Suppl 3:750-751. doi:10.1111/odi.13375

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7267261/pdf/ODI-9999-na.pdf

8.  Paget-Brown AO, Ngamtrakulpanit L, Smith A, et al. Normative data for pH of exhaled breath condensate. Chest. 2006;129(2):426-430. doi:10.1378/chest.129.2.426

https://www.researchgate.net/publication/7297871_Normative_Data_for_pH_of_Exhaled_Breath_Condensate

9. Whelton SP, Narla V, Blaha MJ, et al. Association between resting heart rate and inflammatory biomarkers (high-sensitivity C-reactive protein, interleukin-6, and fibrinogen) (from the Multi-Ethnic Study of Atherosclerosis). Am J Cardiol. 2014;113(4):644-649. doi:10.1016/j.amjcard.2013.11.009

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4280910/pdf/nihms651029.pdf

10. Sajadieh A, Nielsen OW, Rasmussen V, et al. Increased heart rate and reduced heart-rate variability are associated with subclinical inflammation in middle-aged and elderly subjects with no apparent heart disease. Eur Heart J. 2004;25(5):363-370. doi:10.1016/j.ehj.2003.12.003

https://academic.oup.com/eurheartj/article/25/5/363/485118

11. Hirten RP, Danieletto M, Tomalin L, et al. Use of Physiological Data From a Wearable Device to Identify SARS-CoV-2 Infection and Symptoms and Predict COVID-19 Diagnosis: Observational Study. J Med Internet Res. 2021 Feb 22;23(2):e26107. doi:10.2196/26107

https://www.jmir.org/2021/2/e26107/PDF

12. Farwell WR, Taylor EN. Serum anion gap, bicarbonate and biomarkers of inflammation in healthy individuals in a national survey. CMAJ. 2010;182(2):137-141. doi:10.1503/cmaj.090329

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2817320/pdf/1820137.pdf

13. Scudiero O, Lombardo B, Brancaccio M, et al. Exercise, Immune System, Nutrition, Respiratory and Cardiovascular Diseases during COVID-19: A Complex Combination. Int J Environ Res Public Health. 2021;18(3):904. Published 2021 Jan 21. doi:10.3390/ijerph18030904

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908487/pdf/ijerph-18-00904.pdf

14. Hilde Grindvik Nielsen (May 15th 2013). Exercise and Immunity, Current Issues in Sports and Exercise Medicine, Michael Hamlin, Nick Draper and Yaso Kathiravel, IntechOpen, DOI: 10.5772/54681. Available from:

https://www.intechopen.com/chapters/44616

15. Stewart LK, Flynn MG, Campbell WW, Talbert E, et al. The influence of exercise training on inflammatory cytokines and C-reactive protein. Med Sci Sports Exerc. 2007;39(10):1714-1719. doi:10.1249/mss.0b013e31811ece1c

https://www.researchgate.net/publication/5936431_The_Influence_of_Exercise_Training_on_Inflammatory_Cytokines_and_C-Reactive_Protein

16. Martins RA, Veríssimo MT, et al. Effects of aerobic and strength-based training on metabolic health indicators in older adults. Lipids Health Dis. 2010;9:76. Published 2010 Jul 22. doi:10.1186/1476-511X-9-76

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2912308/pdf/1476-511X-9-76.pdf

17. Lakka TA, Lakka HM, Rankinen T, et al. Effect of exercise training on plasma levels of C-reactive protein in healthy adults: the HERITAGE Family Study. Eur Heart J. 2005;26(19):2018-2025. doi:10.1093/eurheartj/ehi394

https://academic.oup.com/eurheartj/article/26/19/2018/532081

18. Abramowitz MK, Hostetter TH, Melamed ML. Lower serum bicarbonate and a higher anion gap are associated with lower cardiorespiratory fitness in young adults. Kidney Int. 2012;81(10):1033-1042. doi:10.1038/ki.2011.479

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3340439/pdf/nihms346734.pdf

19.  Aeschbacher S, Schoen T, Dörig L, et al. Heart rate, heart rate variability and inflammatory biomarkers among young and healthy adults. Ann Med. 2017;49(1):32-41. doi:10.1080/07853890.2016.1226512

https://www.tandfonline.com/doi/pdf/10.1080/07853890.2016.1226512?needAccess=true

20. Farwell WR, Taylor EN. Serum anion gap, bicarbonate and biomarkers of inflammation in healthy individuals in a national survey. CMAJ. 2010;182(2):137-141. doi:10.1503/cmaj.090329

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2817320/pdf/1820137.pdf

So far, about 10% of adults in the US have been sick from COVID-19. Another 5% had infection but no symptoms. Of those with symptoms about 20% have been hospitalized for treatment.

To learn more about programs Herd Healthcare offers, our website is:
www.herdhealthcare.com

COVID-19 And Influenza

Illness with COVID-19 is much more serious than seasonal influenza.

Much greater impact. In 2019, there were about 10% of adults who were sick from influenza and 5% with no symptoms. But only 1% of those with symptoms were hospitalized.

Rates of infection with and without symptoms are about the same. But death rates for those with COVID-19 are more than 20 times higher.

Virus Mutation

Viruses are merely organic structures that can’t move or reproduce. They can’t generate energy. They have no functional capacity until they connect with materials in living cells.

Once connected inside living cells they multiply rapidly. With multiplication, constantly forming new protein, haphazard changes cause mutation. Most new molecules simply disappear. But some have new functional capacity with genes and traits that form new variants.

Virus Variants

Most of these variants are little different than the original forms. But some have traits that allow them to multiply and become dominant. Those that are successful grow and spread through living tissue. They frequently resist immune functions which controlled the original form of the virus.

The first variant associated with increased rate of spread appeared in the fall of 2020. Identified in the UK, it has been labelled UK Variant-B.1.1.7. Its most obvious effect is to increase the rate of transmission from person to person. Severity of illness and death rates have not been increased. So far, existing vaccines have provided effective protection from illness and death.

The first variant associated with a decreased immune response was detected in South Africa. It has been labelled South Africa Variant-B.1.351. It changes the shape of proteins attached on cell surfaces increasing its resistance to antibodies of existing vaccines.

Additional variants have been identified in Brazil and the United States. So far, all these variants have been found in most of the United States. Vaccines used in this country to prevent Coronavirus provide protection from all variants discovered so far. However, the continuing spread of viruses and the process of mutation eventually will produce variants that escape immunity from vaccines. Until about 70% the population is vaccinated or recovered from COVID-19, epidemic spread of the virus will continue.

We still don’t know how long immunity lasts after COVID-19 infection or vaccination. Also, we don’t know how frequently variants will appear that require booster injections or new vaccine formulations. It is possible that revaccination will be required every year or two.

This spread of Coronavirus will go on for a while. We have been expecting that vaccines will prevent and medications will cure COVID-19. Then everything would return to normal. But not everybody will get vaccinated, we don’t have any cures for this respiratory virus disease and variants will keep appearing.

We already know that public health measures do not provide complete protection from Coronavirus infection.

We do know that self-protection measures reduce prevalence and severity of Coronavirus infection. Good health habits prevent this respiratory virus disease and reduce its severity.

Innate And Adaptive Immunity

The immune response to COVID-19 infection has two components. It includes immediate cellular action followed by slower action of cells producing antibodies. Both components include hormonal and humoral agents.

The immediate response operates through white blood cells, dendritic cells and macrophages carrying pattern recognizing receptors. Detection of common chemicals, toxins and infectious agents elicits responses to destroy or isolate them. At the same time, the immediate response initiates local inflammation and signals systemic responses. This is the innate immune system. It continuously protects against damaging effects of injury, foreign substances and infectious agents.

The delayed response operates more slowly through white blood cells called B cells and T cells. Antibodies, proteins produced in B cells, are released into blood and attached onto invading cells and foreign substances. T cells directly kill cells that have been infected. Cell debris and foreign material are removed by macrophages.

Risk Factors For COVID-19

The risk factors for severe COVID-19 include comorbidities and physical inactivity. Comorbidities include hypertension, diabetes, obesity, cardiovascular disease and chronic lung disease. Physical inactivity includes complete lack of regular exercise.

Exercise Reduces Risk

General guidelines for physical activity include 150 minutes per week of moderate aerobic, endurance exercise and 2 or 3 sessions of resistance, strength training. Categories of endurance exercise include less than 10 minutes/week, 11 to 149 minutes/week and 150 minutes of exercise spent consistently week after week.

In the Kaiser Permanente Southern California health plan, patients are evaluated at every outpatient visit. About one-third of patients report less than 10 minutes/week and one-third report some exercise. Less than one-third exercise consistently at least 150 minutes/week.

Since January 2020, more than 100,000 patients with a diagnosis of COVID-19 were identified. Approximately 48,000 had at least three reports of exercise since March 2018. Exercise assessments revealed that 14% were inactive, 80% were inconsistently active and 6% consistently exercised at least 150 minutes/week.

Hospitalization for treatment of COVID-19 was required for more than 4,000. This was 8.7% of all who had at least 3 assessments of exercise before illness. Among those who had been consistently inactive, 10.5% were hospitalized and eventually discharged, 2.8% were hospitalized and admitted to an Intensive Care Unit. Another 2.4% died.

In comparison, 3.2% of those who had been consistently active were hospitalized and eventually discharged, 1% were hospitalized and admitted to an Intensive Care Unit and another 0.4% died.

More than 15% of those consistently inactive were severely ill or died from COVID-19 compared to less than 5% of those consistently active.

Range of Individual Responses

Severity of illness from COVID-19 infection varies considerably. From complete absence of symptoms to rapid progression of respiratory, cardiac and renal failure.

An outbreak of COVID-19 on a cruise ship had 18.5% of all people infected. Of these, 55% were asymptomatic, 39% were mild cases, 5% were severely diseased and 1% died. The majority of people liable to exposure were not infected. Most of those infected were asymptomatic or suffered only mild illness.

Genetic risk factors apparently affect risk. Genomic regions associated with coronavirus infection and illness have been identified. Also, large numbers of variable epigenetic features determine the strength of genetic risk.

Epigenetic features vary according to physical fitness, nutrition and psychological factors. All of which determine liability for infection and severity of illness.

Comorbidity Increase In Risk

Comorbidities of obesity, hypertension and diabetes more than double the risk of severe illness from COVID-19. Especially after 75 years of age. Nearly two-thirds of patients hospitalized with COVID-19 suffered from these conditions. There was obesity in 30%, hypertension in 26% and diabetes in 20%. Many had two or even three of these conditions.

Unfortunately, these conditions are common. In the U.S. about three quarters of adults are overweight or obese, about half have hypertension and nearly half have prediabetes or diabetes. All these are preventable.

Overeating And Insulin Resistance

These conditions are particularly affected by overeating. Consuming more than can be used or safely stored.

Within safe limits, between meals and overnight, sugar and fat can be stored in muscles, liver and subcutaneous fat. The amount that can be stored is limited by individual ability to increase fat storage. Some individuals can create enormous numbers of subcutaneous fat cells. Others are severely limited.

Chronic Inflammation

When all available fat cells are full, excess sugar and fat builds up in the blood. Increased levels in blood stimulate the pancreas to produce more and more insulin. Those increased levels of insulin force sugar and fat from blood into cells in skeletal muscle, liver, fat, pancreas, nerves and brain. The result is damage to cells from high levels of insulin, sugar and fat. Some damage is caused by excess fat and some is direct damage to cell structure and metabolism.

Damage to cells activates markers to recruit inflammatory immune cells. These cells repair and regenerate tissue cells. They get energy from fatty acids and produce lactic acid. The result is a shift in the acid-base balance of the region. Excess acid diffuses into the local circulation and eventually is cleared by kidneys into the urine.

Urine Excretion Of Acid

The result of many regions chronically inflamed is to increase the amount of acid in urine. Enough to shift the potential of hydrogen or pH of urine, Neutral balance of pH is 7.0. Increasing acidity of urine decreases pH. Increasing alkalinity increases pH.

The acid-base balance of tissue fluids, blood and urine is tightly controlled. Tissue fluids and arterial blood are slightly alkaline with a pH of 7.4. After 6 to 8 hours without eating, normal pH of urine is 6.5 to 7.5. The increase in acid excretion associated with chronic inflammation causes morning urine values less than 6.0.

C-Reactive Protein

Chronic inflammation also causes an increase in high-sensitivity C-Reactive Protein.

This protein is secreted by the liver in response to markers from damaged cells anywhere in the body. Stimulating formation of immune cells that repair and regenerate tissue.

Increased levels of this protein in blood indicate injury or infection. They also indicate inflammatory functions associated with atherosclerosis, hemorrhagic stroke and Alzheimer’s Disease.

Self-Protection From Coronavirus Infection

All along we have been expecting that vaccines will prevent COVID-19 and everything will return to what it used to be. Now we know that immunity to COVID-19 probably will have to be boosted every year or so. We also know that eventually COVID variants will require new versions of vaccine to continue preventing illness from Coronavirus infection.

Individual differences in protection from infection have been ignored. Differences in who gets infected, who gets ill, who has to be hospitalized and who won’t survive. Most people who get infected don’t even know it or don’t get seriously sick.

Most of those ill enough to be hospitalized have poor health habits. No regular exercise, overeating, poor sleeping and continuing psychological distress. Specific genetic traits also determine who might get infected but good health habits prevent their expression. Even the response to vaccination is hurt by poor health habits.

Good health habits prevent Coronavirus disease and reduce its severity.

We are pleased to share our blog articles with you, and we are always interested to hear from our readers. Our website address is: www.herdhealthcare.com

About an equal amount is paid by public funds – Medicare (20%) and Medicaid (17%). The rest of healthcare costs are paid by Donations (19%) and Out-of-pocket expenses (10%). Each year, we spend more because of poor health than we spend on the military and national security.

To learn more about programs Herd Healthcare offers, our website is:
www.herdhealthcare.com

Healthcare for Business and Industry

Employer-sponsored healthcare began during World War II. The Stabilization Act of 1942 limited wage increases. To attract new employees, US businesses used employer-sponsored health insurance. Employees didn’t have to pay taxes on sponsored healthcare and they got coverage for themselves and their families.

Other types of benefits included Life insurance, Retirement plans and Disability insurance. Medical insurance was the most popular.

Since then, employer-sponsored healthcare has increased. Initially, only large corporations were self-insured and implemented their own insurance plans. Especially in industries where employees had a high risk of injury.

Now, increasing costs of healthcare and changes in healthcare regulations have caused small and medium-sized businesses to become self-insured. Along with opportunities and incentives to reduce healthcare costs.

Designing and implementing healthcare programs for business and industry has become an industry of “Professional Employer Organizations.”

Employee Health Benefits

Most large US employers offer a health-contingent program as part of their employees’ health benefits. These support employees in making changes to health behaviors. Including changes to reduce risk for certain chronic medical conditions and manage them more effectively.

They include health screening for risk factors as well as education and coaching for cessation of tobacco use, promotion of physical activity, stress reduction, and weight management. Some programs also include chronic disease management.

Most large employers ask for personal health information. The majority use a health risk assessment (HRA) questionnaire and some use screening by a physical examination or lab test. In addition, some large employers collect information through wearable technologies. Approximately a third of large firms offer incentives to disclose health information.

A small percent also offer incentives to reduce body weight or improve blood cholesterol levels. These health-contingent wellness programs were authorized first in 2006, and later by the Affordable Care Act.

Randomized Controlled Clinical Trials

The health, economic and employment effects of education and coaching have been studied in the US. Effects of health and wellness programs in 20 worksites were compared with health, economic and employment outcomes for 20 worksites without health-contingent programs. Each group included about 4,000 employees.

Over an 18-month period, programs offered at treatment worksites included 8 sequentially delivered sessions instructed by dietitians, each of 4 to 7 weeks in duration. Approximately 35.2% of employees in the treatment worksites completed at least 1 set of education and coaching sessions.

After 18 months, 29% of employees in the untreated groups had high cholesterol, 23% had hypertension, and 43% were obese. No statistically significant differences were detected between the employees in the untreated group worksites and treatment group worksites. Also, there were no significant differences in mean medical care spending or utilization.

Data from all worksites were examined to determine absenteeism, job tenure, and performance review scores. Here again, there were no significant differences in productivity or performance between employees in the treated and untreated worksites.

Financial Incentives

In 1996, the Health Insurance Portability and Accountability Act (HIPAA), allowed financial incentives for programs of health promotion and disease prevention. Initial limit was 20% of total healthcare coverage. In 2010, the Affordable Care Act lifted the ceiling on health-contingent program incentives to 30 percent. This limit was close to $1,800 annually for an average employee-only plan.

Employers offering health and wellness programs frequently include monetary incentives to encourage participation. Surveys show incentives are associated with higher participation rates. Especially in larger firms with comprehensive programs. They have the highest participation rates. Access to a more expensive plan elicits a participation rate of 40%. Incentives structured as penalties for not participating have an even higher participation rate of 73%.

Chronic conditions are the major cause of illness, disability, and death in the United States. A RAND Wellness Programs Study showed 87% of participants in worksite wellness programs had risk factors for costly disease. Only 13% had chronic disease requiring daily management.

Savings in healthcare costs resulted from about $30 per participating employee per month. This reduction was caused almost entirely by a 30% reduction in hospital admissions among 13% of employees who had chronic conditions. Most of the reduction in hospital admissions was the result of improved disease management.

In 2010, the Affordable Care Act allowed incentives for health outcomes up to 30% of the cost of the group health plan. However, few employers offer this type of health program. In 2019, only 7% of large employers offered health-contingent wellness programs.

Coronavirus Infection, Symptoms and Severe Illness

COVID-19 is a viral infection that spreads from person to person. It surely started in animals but it spreads in people. Everywhere as fast and as far as an airplane can fly. What can we do?

We hear the most instruction about using public health and social measures. Actions by individuals, communities, governments and travel that slow down spread. What else can we do? Each of us can improve our health enough to prevent getting really sick.

The best sources of information report that about 25% of people in the US already have been infected by COVID-19. About a third of those infected didn’t even know it and another third had minor symptoms. Others became so ill they had to be hospitalized and one or two percent died.

Many of those who became seriously ill were already sick with heart disease, lung disease or diabetes. But the biggest group of seriously ill were simply overweight or obese. Especially high % body fat with visceral obesity. Something that can be prevented, recognized, measured, and corrected.

All are indicators of Subcutaneous Adipopenia and Chronic Inflammation.

All are avoidable, measurable and correctable in a corporate health program.

We are pleased to share our blog articles with you, and we are always interested to hear from our readers. Our website address is: www.herdhealthcare.com

Also, greatly increases the likelihood of infecting someone young and healthy. In fact, people with abdominal obesity or type 2 diabetes are probably the major source of COVID-19 infection in everybody else.

Let us help you improve defense against Coronavirus. You’ll be less likely to become infected and less likely to infect others.

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COVID-19 is an acute viral respiratory illness that can spread from person to person. It is caused by a coronavirus similar to others that cause acute respiratory illnesses, even including the common cold. Infection can be so mild as to cause no symptoms at all or so severe as to cause serious symptoms and even to cause death.

This coronavirus called COVID-19 is enough different from all the others that there are no vaccines to prevent illness following infection. Also, there are no medications yet proven specifically effective in treating its effects.

With no prevention or treatments, this virus has spread as an epidemic throughout the world. Here in the US, the cost of treating those infected and the cost of preventing its spread between people has been enormous. It spreads rapidly and causes more serious illness than influenza.

Every year, about 12% of the population in the US gets the flu. That is they have symptoms from infection with influenza virus. Of those with symptoms, 1 or 2% have to be hospitalized and 1 in 10 of those hospitalized don’t recover. The result is 30,000 to 50,000 deaths every year from influenza.

In the first 3 months of illness with COVID-19 in the US, 1.4 million people have suffered symptoms. More than 20% of them have had to be hospitalized and more than 80,000 have died. Deaths in just three months more than twice the total deaths caused by influenza in a whole year. We still don’t know how many there will be in 12 months! Could be 3 or 4 times more!

The cost of COVID-19 in 2020 will be enormous. Both Health Care Costs and Costs to the Economy.

Medical treatment for COVID-19 will increase Health Care Costs by about 20%. Costs to the US economy for public health measures will reduce Gross Domestic Product about 20%.

Costs of Medical Treatment for COVID-19 will be about seventy times more than annual costs for medical treatment of influenza.

Portioning costs to everybody will increase Health Care Costs by $2,400. Increase caused by Influenza will be about $350.

Loss of GDP caused by COVID-19 will be about 200 times greater than loss caused by Influenza.

Loss of GDP portioned to everybody will be an annual cost of $15,000!

COVID-19 frequently is serious and potentially deadly for anyone with abdominal obesity. That’s half of the US adult population. The other half may not even have symptoms if infected or be infectious to anyone else.

Weight reduction and moderate exercise abolish risk of severe COVID-19 for individuals with abdominal obesity and greatly decrease risk of transmission to others.

No vaccine against COVID-19 will ever substitute for recovery from abdominal obesity. Vaccines against other types of coronavirus have never been successful protecting against illness. Vaccines against influenza viruses only protect about 40% of those who have been vaccinated. Also, vaccination is required every year. Only about 50% of those who could be protected actually get vaccinated each year.

The natural defense against COVID-19 involves the immune system. This includes white blood cells circulating in blood and specialized cells in organs and tissues. Immune cells recognize normal, healthy cells. They also recognize unhealthy cells. Injury or infection causes immune cells to isolate and remove unhealthy cells.

Immune cells also recognize unhealthy conditions. They collect and multiply in unhealthy tissue. Some immune cells tear down unhealthy tissue and other immune cells clean up and restore healthy conditions.

Fat in the abdomen is recognized as unhealthy. Immune cells accumulate and multiply there, especially the tear-down cells. Eventually, immune action in abdominal fat dominates the whole immunity system. Levels of immune cells, proteins and hormones all rise above normal in blood samples and other tissues. But not enough to take care of new COVID-19 infection.

Immune cells depend on normal metabolism of sugar, fat and protein just like cells in all other systems. When overloaded with sugar and fat, they become resistant to insulin. Insulin resistance and type 2 diabetes further damage immune response to infection.

Response to COVID-19 requires rapid action by immune cells. The result of abdominal obesity and type 2 diabetes is slow onset and reduced strength of immune response.

The daily news about COVID-19 often reports that severe disease and death occur mostly in elderly people. That’s not completely true. Reports from New York are different than reports from China. In a report of 5,700 patients treated in hospitals in New York City, half the patients were less than 64 years of age.

Another feature of patients with COVID-19 in New York is the severe effect of obesity. Under 60 years of age, obese patients were twice as likely to be hospitalized as those who were not obese. In hospital, those with mild obesity were twice as likely to be admitted to Intensive Care Units. Patients under 60 years of age with severe obesity were 4 times as likely to be admitted for Intensive Care.

Obesity was not the most important risk factor for patients over 60 years of age.

We don’t yet know an effective treatment for COVID-19. It’s always possible that treatment will be found that is as miraculously effective as Penicillin for Streptococcal sore throat.

We also don’t have an effective vaccine for prevention of COVID-19. It’s always possible a vaccine will be produced that is as miraculously effective as polio vaccine for acute poliomyelitis.

We do know that normal healthy % body fat and regular routine of moderate exercise greatly increase natural resistance to all viral infections.

We can prevent severe symptoms of COVID-19 in ourselves and avoid transmission of infection to others.

We are pleased to share our blog articles with you, and we are always interested to hear from our readers. Our website address is: www.herdhealthcare.com

The natural response to infections involves immunity cells.

The metabolism of these cells is just as complicated as cells in any other system. They depend on sugar, fat and protein for energy to operate just like function in all other cells.
 
Insulin is especially important. Insulin resistance from poorly controlled diabetes damages immune function. Just like it damages function of muscle, liver, heart, brain and nerves.

Let us show you how to improve immune function. By reducing abdominal obesity and increasing physical fitness.

To learn more about programs Herd Healthcare offers, our website is:
www.herdhealthcare.com

We already know who has poor immune function. People with chronic diseases. But also, people with chronic conditions such as high blood pressure, obesity and diabetes. In fact, almost everybody could improve immune function. By improving nutritional fitness and physical fitness.

Sound familiar? That’s the way to reverse and recover from type 2 diabetes. Here we have an opportunity to avoid severe COVID-19 illness right away and prevent disability with type 2 diabetes for the rest of our life.

Truly creative insight. An Aha! moment.

The immune system is a complex network of cells that defends the body against infection. These are white blood cells circulating in blood and specialized cells located in organs and tissues.

Immunity cells recognize chemical patterns of normal, healthy cells. They also recognize molecular patterns of unhealthy cells. Damage caused by physical injury or chemical poison causes immunity cells to isolate and remove unhealthy cells.

Infections by viruses, bacteria and invading organisms also stimulate an immune response. Viruses are large molecules that get attached and rely on living cells to function and reproduce. Bacteria are complete cells that can live on their own but rely on host cells to reproduce in large numbers. Other invading organisms include single-celled organisms like malaria that can live outside the body. Other organisms include worms that have many cells and can produce eggs that mature and live a long time inside or outside the body.

Chemical patterns of many infections cause a rapid response whenever they appear.

Other infections stimulate proteins that attach to invading molecules and structures. These proteins, called antibodies, recognize invaders and attach themselves to invaders. Once attached, antibodies change chemistry and destroy infected cells. Destroyed cells and invaders are taken from the blood by scavenger immune cells. Antibody production continues for as long as it takes to get rid of invaders. After recovery from infection, antibodies remain in blood and tissue for weeks, months or years. Guarding against reinfection.

New antibody proteins are added to the network of cells and proteins that destroy infections. Any return of infection is quickly recognized and destroyed. Some antibody responses are retained for a few months or years and some are stored for response whenever some infection returns.

Overweight, obesity and type 2 diabetes damage immune response to infection. Immunity cells depend on normal metabolism of sugar, fat and protein just like cells in all other systems. When overloaded with sugar and fat, they become resistant to insulin.

Response to infection requires rapid action by immunity cells. This brings quick adjustments in metabolism stimulated by insulin. Overweight, obesity and type 2 diabetes damage response to insulin. The result is slow onset and reduced strength of immune response.

Obesity causing poor immune response to influenza was recognized during the swine flu pandemic in 2009. Response to infection was delayed, complications more severe and time to recover took longer. Also, during prolonged illness, obese patients shed more virus infecting people around them.

Fat tissue also has an oversupply of immune cells. Especially cells that destroy infection. More than cells that can control the immune response. Overweight, obesity and type 2 diabetes have more than safe numbers of immune cells even without infection. A new infection not quickly controlled can cause a runaway response. A storm of response that doesn’t get turned off. The result is more damage to lungs, blood vessels and brain by the immune response than by the new infection. If it doesn’t get turned off, the result is deadly.

Weight loss with reduced fat tissue restores immunity cells to normal.

Since 2009, we realize that preventing overweight, obesity and type 2 diabetes helps prevent severe respiratory viral disease.

We’ve known for a long time that regular mild-to-moderate exercise reduces viral respiratory infection. In 2008, more than 1000 men and women in the US were studied for 12 weeks during the fall and winter. The days of illness with viral respiratory disease were 43% less in those who exercised at least 5 days/week compared to those who didn’t exercise at all.

In many other studies, the results have been less clear. However, the amount and intensity of exercise of many studies shows a J-shaped response of duration and severity. Very high amounts of exercise appeared to be less effective than moderate amounts.

We do know that moderate exercise quickly reduces the risk of illness in overweight, obesity and type 2 diabetes. So far, studies of COVID-19 illness in China indicate that low to moderate exercise decreased mortality.

Progress detecting and treating COVID-19 has been slow. We’re not even sure that recovering from illness protects us from another infection. Another infection could be just as severe or even worse.

So far, it appears that the only way to prevent infection is to avoid contact with anyone who might be infected.

During the COVID-19 pandemic so far, 73% of patients hospitalized in New York City had obesity, type 2 diabetes or both.

We can protect ourselves from severity of illness. We can boost our immune system. By restoring and enhancing nutritional and physical fitness.

We are pleased to share our blog articles with you, and we are always interested to hear from our readers. Our website address is: www.herdhealthcare.com

If flu-like symptoms come on, anyone with diabetes should lower sugar intake, stay well-hydrated and monitor blood glucose more than usual.

Protect yourself by keeping some distance from others. Especially from others not wearing a facial mask! Wear a mask yourself. Maybe you’re infected and just don’t know it.

Let us help you protect yourself from COVID-19.

To learn more about programs Herd Healthcare offers, our website is:
www.herdhealthcare.com

Viral diseases have been infecting people for hundreds, possibly thousands of years. Probably as long as people and animals have been around each other.

Infections like influenza infect both animals and people. We’ve found medications to treat the flu, and developed vaccines to build immunity against severe disease.

Once infected, we become immune to that virus and somewhat immune to disease from similar viruses.

When an infection gradually disappears from people, infections persist and keep adapting in animals. Eventually, a variation develops that can pass from animals to people and from person to person. Then it spreads from individuals to groups then populations. Eventually spreading wherever people travel.

Respiratory coronavirus disease has existed in animals and people for more than 40 years. Several varieties cause illnesses such as the common cold. Other varieties cause influenza. During the last 40 years, we’ve developed medications to treat respiratory virus diseases in general and vaccines to prevent influenza.

In 2019, in China, a new version developed in bats and spread to people. This variety of coronaviral disease is more dangerous than the flu. It’s new. There’s nothing we’re certain is effective to treat it or protect us against it. All we can do is cut down how fast it spreads.

What we know so far is that COVID-19 spreads from each infected person to at least 2 or 3 others. We also know that 80% of infected people had only minor disease and recovered in 2 or 3 weeks. However, 20% had severe disease and 1 or 2% died.

In comparison, influenza only spreads from one infected person to fewer than 2 others. Also, it is deadly for fewer than 1 in 1,000 of those who are infected.

Influenza is particularly dangerous combined with type 2 diabetes. Severity of influenza requiring hospitalization is 6 times greater in patients with type 2 diabetes than those without diabetes. Death rates are 3 times greater.

The greatest danger from this new coronavirus disease is the severity of illness. In the US, approximately 10% of patients with COVID-19 required hospitalization, 2 and one half % required Intensive Care and 1% died. This severity of illness is more than 10 times greater than severity of influenza.

The Center for Disease Control lists diabetes as one of the chronic illnesses that increases the chance of developing serious complications of COVID-19.

Severity of this illness in China was substantially greater for patients who had type 2 diabetes than those without chronic disease. The Table shows that most of the patients admitted to hospital had either Hypertension, Diabetes or Heart disease. Approximately 20% of them had diabetes and about half of those with diabetes did not survive.

The natural response to infections involves immunity cells. These are cells located in blood, organs and tissues. The metabolism of these cells is just as complicated as cells in any other system. They depend on sugar, fat and protein for energy to operate just like function in all other cells.

Insulin is especially important. Insulin resistance from poorly controlled diabetes damages immune function. Just like it damages function of muscle, liver, heart, brain and nerves.

The time to repair the immune system is before viral infection. Repairing insulin resistance requires physical, nutritional and behavioral fitness. Health fitness takes time, planning and day-by-day action.

So far, it looks like type 2 diabetes slightly increases risk for COVID-19. What is certain is that diabetes increases its severity of illness! Insulin resistance is much, much greater than usual. If flu-like symptoms occur, any sugar or excess calories raises blood sugar levels 2 or 3 times more than usual.

We are pleased to share our blog articles with you, and we are always interested to hear from our readers. Our website address is: www.herdhealthcare.com

Let us help you protect yourself from COVID-19 and any other respiratory viral illness.

To learn more about programs Herd Healthcare offers, our website is:
www.herdhealthcare.com

COVID-19 really makes it clear that overeating and under-exercising is bad for your health. Type 2 diabetes also makes that clear. It just takes longer.

We expect about 5 to 10% new coronavirus infections every year. Less than influenza but more severe.

About 1/3 of those infected will be healthy and won’t ever have symptoms. Another 1/3, not so healthy, will have symptoms they get over in a week or two. The other 1/3 with poor health will be severely ill and have to be hospitalized. Of those who are hospitalized, about one in ten won’t recover.

Remember! Everyone will be infected eventually or successfully vaccinated.

About 5 to 10% new infections every year. May not seem much of a risk. But no one knows just when they’ll be infected. For those with poor health in the group at risk for severe illness, will it be before or after there’s successful vaccination? The problem for the group with poor health is that fully successful vaccination is a long way off.

Features of those in the group with poor health and severe risk are well known. They include older more than younger, hypertension, diabetes, obesity, other chronic diseases and poor immune function. High-risk features include abdominal obesity with hyperactive inflammation and little resistance to COVID-19.

An important feature of patients with COVID-19 in New York is the severe effect of obesity. Under 60 years of age, obese patients were twice as likely to be hospitalized as those who were not obese. In hospital, those with mild obesity were twice as likely to be admitted to Intensive Care Units. Patients under 60 years of age with severe obesity were 4 times as likely to be admitted for Intensive Care.

Abdominal visceral fat is particularly dangerous for severe COVID-19. Average maximum waist circumference for adults in the US, is 58% of height. That’s not ideal. The ideal for normal healthy men and women is less than 50%.

Measurements of 30 men and women admitted to hospital with COVID-19 showed waist circumferences 59% of height. Those so sick they needed mechanical ventilators for breathing showed waist measurements 64% of height.

Overfilled, unhealthy fat tissue secretes proteins that circulate in the blood. They not only attract immune cells they also stimulate the liver to produce protective proteins. These include C-Reactive Protein which circulates because of infection somewhere in the body.

Normal levels of C-Reactive Protein in blood are less than 3 mg/L. They can increase up to 1,000 times at sites of infection or inflammation. Elevations of 3 to 10 mg/L occur in about one third of adults in this country.

Abdominal obesity increases C-Reactive Protein. Even in people with average weight. Maximum waist circumference more than 50% of height frequently causes levels of C-Reactive Protein more than 3 mg/L.

Abdominal obesity also increases Resting Heart Rate. Maximum waist circumference more than 50% of height usually causes Resting Heart Rate more than 60 bpm.

The strong relation between Resting Heart Rate and C-Reactive Protein was studied with more than 6,000 participants from 6 communities in the US. Subjects were men and women who did not have any clinical evidence of chronic disease. They did not eat anything for 12 hours and were resting before they had an electrocardiogram. Venous blood was drawn and analyzed for level of high sensitivity C-Reactive Protein. Data from subjects with levels higher than 10 mg/L were excluded from the analysis.

As shown in the figure, an increase in Resting Heart Rate was related to an increase in C-Reactive Protein. Those with a Resting Heart Rate less than 60 bpm had levels of C-Reactive Protein less than 2 mg/L.

These results show that levels of C-Reactive Protein are related to levels of Resting Heart Rate. Both maximum waist circumference and resting heart rate are easily measured. They can be used to detect abnormal inflammation in overfilled abdominal visceral fat. Then measurement of C-Reactive Protein can be used for confirmation.

Chronic inflammation continues to destroy and clear out fat cells that are damaged. It’s a natural reaction to unhealthy conditions but it attacks host tissue. Fat cells keep building up and chronic inflammatory cells keep destroying host tissue. The immune system overreacts. That takes over and leaves natural immune function poorly prepared to protect against viral infection.

Maximum waist circumference should be less than 50% of height. Resting heart rate should be less than 60 bpm. The combination makes it extremely unlikely there is any unhealthy abdominal visceral fat. Control of abdominal obesity protects against illness from COVID-19. It reduces chronic inflammation and restores immune function. That all reduces levels of C-Reactive Protein in circulating blood.

Results from 33 clinical studies show the effect of weight reduction on C-Reactive Protein. The relation in over 2,000 men and women is summarized in this Figure. The average weight for all participants before weight loss was 190 lb and the average level of C-Reactive Protein was 4 mg/L. Combining and extending average loss down to 155 lb showed reduction in C-Reactive Protein of 50%. A weight loss of 18% reduced levels of C-Reactive Protein to safe levels under 2 mg/L.

Exercise training also reduces high blood levels of C-Reactive Protein in healthy adults. A clinical study of 652 men and women in US and Canada showed the effects of aerobic exercise training on C-Reactive Protein. Sedentary healthy adults trained on exercycles 3 times a week for 20 weeks. Before training, about 1/3 had blood levels less than 1 mg/L, about 1/3 had levels from 1 to 3 mg/L and the third group had levels more than 3 mg/L.

The main result, shown in the Figure, is that aerobic exercise by sedentary healthy adults with high levels of C-Reactive Protein reduced levels about 1 mg/L. Without any change in body weight.

Combined with reduced food intake, aerobic exercise reduces body weight and further reduces levels of C-Reactive Protein.

Overeating and Under-exercising are strong causes of poor resistance to illness from viral infection. But there are other causes. Genetic abnormalities, allergic responses and chronic illnesses. Without abdominal obesity, poor immune function still has high blood levels of C-Reactive Protein. That can be measured. But what if it hasn’t been measured.

High Resting Heart Rate gives the important signal there’s poor protection from viral infection. Resting Heart Rate more than 60 bpm. Maybe even so high as 100 bpm. Persistent high resting heart rate can be checked against levels of C-Reactive Protein.

Infection Protection from Illness happens naturally for probably half of all normal healthy adults in the US. Most of those who are not protected have abdominal obesity.

We’re all hoping there’ll be effective vaccination for everybody. Especially for those with poor health and high levels of high-sensitivity C-Reactive Protein.

That’s still a long way off. Also, vaccination may prevent illness but not prevent virus infection and transmission. And even that may only last a year or two. Influenza vaccination only protects from illness for about 6 months.

Good health is the best protection from illness. We know how to avoid overeating and increase exercising. We can help everyone do that.

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