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.

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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

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.

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