Thoughts… 03-13-2020 –
Dear Patients of MaxWell Clinic,
This is the 3-12-2020 update to my prior comments (included) on the ongoing developments of COVID-19. If you missed my first info and want ongoing updates please click here to register for my mailing list.
In this missive I will share my thoughts on the virus, the spread, and WHAT TO DO NOW and WHAT TO DO IF INFECTED. These are my opinions, to you my patients. I will mention many lifestyle, behavioral, dietary, and supplementary suggestions to combat this very new threat. Do not become stressed reading this that you must do everything I have stated. This is my best and most complete reasoned response. If you need guidance, please call us at the clinic. We will set up a time to talk to a provider and make certain recommendations are appropriate for you, but given the urgency of this matter I felt this was the best way to get the most information out the quickest.
You may not know this, but I actually started my medical career as a virus and vaccine researcher and have been keeping up with the very challenging developments since this outbreak started. There is much mis-information present on the internet and social media and I see too many individuals that are spreading either needless panic or harmful reassurance. We need to meet this challenge head-on with science and good information.
If you think you may have coronavirus or even just have a cold, cough, or fever – DO NOT COME TO THE MaxWell Clinic – CALL US and we will set up a telephone or video visit. We can direct you to next steps and want to be a great support to you, but our strength at our clinic is to create chronic health. MaxWell Clinic is a Sanctuary for the non-acutely ill. We take care of many sick people that continue to need our support for things other than the Coronavirus.
Acute viral illness is a threat to those individuals that come to the clinic to have other conditions treated, as we must continue to do. We can care for you via phone or video visit, but please if you think you may be acutely ill. DO NOT COME TO THE MAXWELL CLINIC – CALL US instead!
Ok… now that I made that clear….
Here are the facts as I see them having digested much information from the WHO, CDC, National Governments, Infectious Disease and Epidemiology experts, Independent researchers, and physicians I know in countries that are most affected (China, South Korea & Italy).
COVID-19…is the disease that results from being infected by the SARS-CoV-2 virus. This virus emerged from human-animal contact in October or November 2019. It mutates about every 2 weeks, so there are many variants of the virus at this time – some variants have changed how the virus behaves. So when we talk about this virus and the disease it causes as one thing, we are already wrong – it is a moving target. The good news is that mutations that affect function almost always make a virus weaker, not more dangerous, but we cannot count on that. The part of the name that is SARS means “Severe Acute Respiratory Syndrome” CoV stands for “Coronavirus” and 19 is for 2019 – when this virus was first identified.
COVID-19…. is caught mostly from breathing in droplets that have been sneezed or coughed into the air by someone infected by the virus. It can also be caught by touching surfaces that have been contaminated by the virus and then touching one’s mouth, nose, or eyes. The surfaces where these droplets land are infectious for up to a week.
COVID-19… can cause Severe Acute Respiratory Syndrome via making the lungs leaky, inflamed, rusty, and metabolically exhausted – more on that later in this description.
COVID-19…is Highly Contagious causing an average of 2 to 3 new infections from every person infected (Influenza has a transmission rate of 1.2 new infections from every person infected.) This makes the spread exponential
COVID-19… disease usually starts with a fever, fatigue and dry cough which may last for a week (often with sore throat, muscle aches, rash and/or headache) until loss of appetite and/or shortness of breath begins which may lead to pneumonia or acute respiratory distress syndrome causing a need for supplemental oxygen, or even intubation and mechanical ventilation in the ICU.
COVID-19… early symptoms look a lot like Influenza and we are still in the tail end of influenza season so this has caused quite a bit of needless panic.
COVID-19…. Tests have been woefully poor in quality and difficult to get – therefore every cough and sniffle is held suspect and people are either not taking them seriously enough or needlessly isolating. There will be movies and much investigative journalism made about the mis-management of this early response by our leaders in government and the CDC, including the prior cutting of funding for our departments that are responsible for such preparedness. Just having early testing could have made the current panic so much less. Examine this current data – South Korea has tested nearly a quarter of a million people in the time it has taken us to test just over 8,000. It is a failure of monumental proportions. When testing does become available – it should be drive-through testing where if you expect you may have been exposed or have the illness you should drive through a station and have a health care worker in full Protective Equipment do your test, or do it from home. Again, DO NOT COME TO THE CLINIC for testing for this problem.
COVID-19… is Dangerous for the Elderly, Previously ill, and the Unhealthy with a risk of death as a result of infection ranging from 0.2% to 20% depending upon the source population studied and the constraints and the author’s experience. By these numbers it would be anywhere from 3x to 200x more lethal than the flu because influenza has a death risk of 0.1%. I think the best data (when we finally have comprehensive testing data to find out just how many mild cases there are) will reveal a risk of death of 0.4% to 3% risk of death after infection which is still 4x to 30x greater risk of death than the flu.
COVID-19… disease at this time (what is likely early in spread) has killed
4285 5093 5400 5794 people with another 4987 5210 4805 4815 in critical condition currently. [From the time of my first-draft to my final this is what changed in <90 hrs with most of these coming from the exponential rise in Iran and Italy – two of the countries with early spread] Yet, compare that to an estimated 291,000 to 646,000 people that die from the seasonal flu every year across the globe. We can all hope this virus will be something we looked back on and felt fortunate it was not worse than it was. But I don’t allow myself wishful thinking when it comes to my patient’s health.
COVID-19… is generally a mild illness in children under 10 and many youngsters have few to zero symptoms – but they can still spread the virus.
COVID-19…. infections result in 80% of cases being mild or asymptomatic (without symptoms), 15% are severe infections which require oxygen and 5% are critical infections, requiring ventilation.
COVID-19… persons exposed to a person with the virus that end up being infected will not begin to display symptoms until
- 3 days afterwards at the earliest
- 5 days on average
- 97.5% will have symptoms occur within 11 days
- 99% will have up symptoms occur within 14 days
- AND a full 1% of those exposed won’t develop initial symptoms until more than 14 days after initial exposure.
COVID-19…. after an individual gets over the symptoms of the disease the average time an individual continues to shed the virus is 20 days and the longest duration of viral shedding recorded in survivors was 37 days. We do not know if those individuals were still sources of infection that long, but the point is that feeling well does not make a person safe to then go back out into the community until lack of ongoing viral production and release from that person is documented by testing.
COVID-19… is NOT a bioengineered weapon or man-made. The virus came from lots of humans living in very close proximity to lots of animals sold for food (as happens in the Chinese markets) – these conditions make such disease emergence almost a certainty. This will not be the last of such viruses, and even after reading this description please know this could be much worse with other virus candidates such as Avian Flu which can have a >60% mortality if it crossed over into humans.
In short, COVID-19 is sneaky, dangerous, persistent, and preys on the weak.
Remember my point above – “…causes Severe Acute Respiratory Syndrome via making the lungs leaky, inflamed, congested, rusty, and metabolically exhausted.”
Lets take up that last point first… the virus preys on the weak, the unhealthy, the toxic, the immune-compromised, the inflamed. Individuals with Obesity, Heart Disease, Dementia, Lung Disease, Seasonal Allergies,toxic mold exposure, Cancer, Autoimmune Disease, or who are already battling other illnesses such as Lyme, co-infections, or chronic viral infections are more susceptible. Children – who have massive resilience – are much less susceptible to fatal illness. What does this teach us???
THE MOST IMPORTANT THING FOR SURVIVAL of COVID-19 IS YOUR OVERALL HEALTH!!!!!
Yes, that was a lot of CAPS. But I mean it. All too many people are focusing upon the virus, when it is the host that is the most important determinant of the outcomes of an infection. The mechanism of fatal infection is something called ARDS – Acute Respiratory Distress Syndrome and it is caused by a “cytokine storm” which is a burst of inflammation-signalling molecules being released in the lungs causing the membranes in the lungs to become permeable (leaky) which causes build-up of proteins in fluid in the lungs (congestion). Inflammation largely works by the body making bleach and hydrogen peroxide-like molecules to chemically burn (rust) nearby molecules. We call this process oxidative stress and it is present in most all individuals that have chronic illness that raises one’s susceptibility to death from SARS-CoV-19. Inflammation is a good thing in the right place and time as it is what protects us as well so focusing the immune-inflammatory response is important.
So… Rampant over-inflammation and oxidative stress is the mechanism of lung injury in the most ill… AND… over-inflammation and oxidative stress is the common denominator of the toxic, the weak, the unhealthy, and the immune compromised. Steroids – which are a potent anti-inflammatory – have been rationally used in the treatment of COVID-19. In our efforts to help our immune system function I think we are forgetting something very important – we must be attending to our inflammation/oxidative system PROACTIVELY if we are to have the best chance against this virus. We must keep our oxidative stress down because that causes inflammation.
Let’s be clear, we do not have anywhere near the data we desire to have to know the effectiveness of specific interventions (other than isolation) to impact this specific virus. I am giving you my best reasoned and most comprehensive approach to a very challenging novel situation. Please do not mistake my comments for diagnosing and treating disease, but rather I am making suggestions to support the body in a way that I think may be most helpful. Nutraceuticals play a large role in my recommendations because it is clear they can act on underlying mechanisms of RNA-virus-infections and are generally safe – because they are essentially concentrated foods.
So, how can we possibly battle over-inflammation and oxidative stress? Well, if you have been a patient at MaxWell Clinic for any period of time we have likely discussed this for your individual case, but in general I suggest this:
Plan of action FOR PREVENTION…
Common Sense stuff is common sense because it works. So…get lots of sleep! Sleep is anti-inflammatory, decreases oxidative stress and enables your immune system to be at it’s best.
As you avoid other humans that may be contagious…. get sunlight, put your feet on the grass, enjoy the outdoors, play frisbee golf, visit a state park, call friends, watch funny movies, encourage others, contribute to the good in the world as you can. This can be a time of transformation for the good in your life!
There is no harm in eating an anti-inflammatory diet. Do this if you can. This would ideally be gluten and dairy free, high in color-rich vegetables, high in olive oil, lots of garlic, onions, rosemary, curry, berries, green tea, coconut oil (contains monolaurin), healthy fats such as avocados and olives, nuts, cold-water fish and avoiding sugar, and trans-fats. And hey, enjoy some 80% or darker chocolate as a treat! This diet can be supported by use of the medical food Inflamacool™ (2 scoops once a day). It contains many of the health, immune and anti-oxidative ingredients listed below in meaningful doses. If those food stuffs are out of your reach, do not panic, just eat as well as you can. 🙂
DO NOT Intermittent fast as it can increase the intensity of the cytokine storm. Remember, it is not the virus, but the body’s aggressive response to the virus that causes the damage. Water fasting and intermittent fasting may be useful in the treatment of many conditions when trying to increase the cytokine response (like cancer or bacterial infection), but not in this case. Good old 3 meals a day with snacks is better in this situation.
Increase your intake of Omega-3 fish oils. I am currently recommending approximately 3 grams a day to prevent inflammation. Make sure to take a high-quality Fish Oil that is pure and tested for toxins and heavy metals, like Creating Health’s OmegaClean™ MonoMax™ 1300EC – 3 capsules a day.
Eat fermented vegetables, kombucha, or active culture non-dairy yogurts or use a potent probiotic such as FloraFoundation™ SB or FloraMax 70 one a day. A healthy gut barrier decreases the contribution of LPS (lipopolysaccharide) to worsening the cytokine storm.
Eat lots of brightly colored vegetables to contribute fiber and phytonutrients to the diet to support a healthy gut bacterial population. I use a green drink of several flavors to support this called Green-NRG.
Strongly consider taking a supplement to increase the production of glutathione in your cells by activating NRF-2 pathways. The foundation I think most everybody should take is NRF-2 Catalyst (just 1 capsule a day for the relatively healthy) which contains highly validated and pure forms of Curcumin extracts, Sulphoraphane, Green Tea extracts, and Pterostilbine which not only increase anti-oxidative effects but turn on part of our clean-defense system called LL-37. If however one already has high oxidative stress due to chronic illness or even pre-diabetes, I would recommend bigger guns for this process and that would be OncoDetox™ ES – 2 capsules twice a day. This is the mac-daddy of stimulating NRF-2 and is very helpful for supporting lung health in my experience. This material comes from Johns Hopkins research and is of the highest quality.
Vitamin D3 – 2000 to 10,000 IU/day (enough to maintain a blood level of 50-80) – super important for immune support. D3-5,000
Vitamin C – 3 grams a day – also very helpful for immune and antioxidant support. It is important to bring Vitamin C in all day long – Have either a small serving of citrus fruit or take 1 capsule of Creating Health C Complex 6 times a day. The C-Complex formulation contains synergistic bioflavonoids that usually accompany vitamin C. Our bodies require more vitamin C when we are ill, and we can’t make it on our own.
Consider supplementing with NAC – an antioxidant defense system that specifically supports lung disease, as well as an important detoxifier that makes Glutathione. NAC 600 mg – take 1 three times a day.
Mushrooms – eat a lot of lightly cooked mushrooms, and/or take Medicinal Mushrooms – both are well-validated to support the immune system’s flexibility and targeting capacity. Mushrooms and particular yeast extracts contain specific beta-glucans that are highly supportive to a strong immune system. During the threat of viral challenge all members of my household take ImmuFlex 3-6™ one capsule a day, or Urgen-C™ 1 capsule twice a day (this has vitamin C and olive leaf extract as well).
Supplement with Zinc Glycinate, 20 mg, 1 twice a day.
And along with all this – do your best to shift your stress! Be mindful of how you can de-stress. Deep Breathe. Pray. Meditate. Exercise gratitude. Play games. Watch movies. Write a letter of appreciation to those in your life who have made a difference – it will help your immune system and theirs!!
And finally – something that is hard to say: It is your choice to see this time as a tragedy or an opportunity. It is time to say the things that should be said. To forgive. To make plans for how our world can be a better place in the future. It is time to think about what is really important and to sink into that. Very few of us will die from this virus – but all of us will be affected. How you are affected is in large part up to you. This is said with much love from your doctor. 🙂
I, as many others do, hope that this pandemic will be reasonably contained, BUT I personally do not think it will be. Humans have never seen this bat-associated virus before and have no specific immune defense against it.
Tremendous worldwide efforts are being made to understand the molecular and clinical virology of this virus. Unbelievable molecular knowledge about the genomics, structure, and virulence of this virus has already been achieved. BUT, there will be NO drugs or vaccines available this year to protect us or limit the infection within us. Only symptomatic support is available.
What to do if infected:
If you develop acute Illness, please DO NOT COME TO THE CLINIC – but CALL US and we will arrange a phone or video visit to guide you. In addition the following list include some of what we may recommend:
Go back to the PREVENTION list and make certain you are doing those things. Especially the steps to decrease oxidative stress (consider Oncodetox ES high-dose) and over-inflammation.
How COVID kills is the lungs filling up with fluid due to inflammation induced leaky-lung. While there is no human data, there is mouse data that diosmin, a specific extract from the sweet orange peel that is successfully utilized to treat hemorrhoids, varicose veins, and leg swelling (leaky inflamed vein problems) had benefit protecting mouse lungs from an infectious-agent induced acute lung injury. Vein Sustain™ is the very diosmin used in the study and the usual dose is 1 capsule twice a day.
ElderOlive (OlivDefense) – 2 capsules once a day while symptoms are present. This compound has 3 components that are useful against viral illness. Our family uses this at the first sign of a viral-like illness. Elderberry has antiviral activity against many viruses and is also immune-boosting, anti-inflammatory, and has antioxidant activity also the specific green-tea extracts and theanine in the formula increase the number of gamma-delta-T cells which on one hand protect the body from infection, and on the other hand limit cytokine release. Win-Win!
Bo-D-Zyme™ proteolytic enzyme is a compound that we use a lot when there is an acute injury as it helps break down damaged tissue so that it does not continue to cause inflammation. It is remarkable stuff. I would have acutely ill folks at the first sign of shortness of breath or congestion start to take 3 capsules 3 times a day on an empty stomach. The empty stomach part is important here as we want these enzymes to not digest your food better (they will do that too) but get absorbed and have effect body-wide.
Vitamin C – Increase to HIGH DOSE oral (6 grams/day) – have a half-serving of citrus fruit or take 2 capsules of C Complex™ 6 times a day. The C-Complex formulation contains synergistic bioflavonoids that usually accompany vitamin C.
Zinc – Zinc Glycinate – Increase to take 2 capsules twice a day with food for no longer than 1 month.
NAC – NAC 600 mg – increase to 2 capsules three times a day on an empty stomach – this may give you some flatulence, but is very safe.
Zinc lozenges. These lozenges have been proven to be effective in blocking coronavirus (and most other viruses) from multiplying in your throat and nasopharynx. Use as directed several times each day when you begin to feel ANY “cold-like” symptoms beginning. It is best to lie down and let the lozenge dissolve in the back of your throat and nasopharynx. Cold-Eeze lozenges is one brand available, but there are other brands available.
Use a neti pot to rinse out your nose with salt-water – this can be very comforting and it removes mucous which may be irritating the surface of the nostril. If you don’t tolerate using a neti pot, saline nasal sprays containing Xylitol can be comforting as well.
viResolve (Viragraphis) is a complex mixture of Andrographis, Isatis and Licorice – this formula has been helpful to improve recovery from upper respiratory viral infection, and help support overall energy. In my opinion, for coronavirus, this would be something to use in the recovery phase after the most severe part of the illness has passed.
For any supplements that are listed but do not have a hyperlink, please call our office at (615) 370-0091 for assistance.
PLEASE CONSULT WITH A PHYSICIAN IF YOU ARE PREGNANT BEFORE USING ANY OF THESE SUGGESTIONS.
A hopeful note… When China saw the explosive growth of the spread of COVID-19, they shut down the city of Wuhan in the province of Hubei on January 24th. NO TRAVEL IN OR OUT of the city! It took until Feb 5th for the viral spread to stop increasing and it has dramatically declined since that time. This is VERY HOPEFUL!! But it requires drastic action.
This graph suggests that this disease outbreak is controllable. We’re at a critical junction right now, but we can still mitigate this substantially.
TIPS ON HOW TO LIVE…. FOR PREVENTION and slowing/stopping this viral spread….
1) Avoid crowds and exposure to individuals that may be infected. This means practicing “social distancing”, such as limiting attendance at events with large groups of people. This is to “flatten the curve” of the rate of infection in the population as China has been able to do. Work from home if you can.
2) Stay HOME if you are feeling ill!
3) Take your temperature daily, if you develop a fever, self-isolate and call the clinic (do not come to the clinic)!
4) Do Not Touch your hands to your Mouth, Nose or Eyes! Make a game with your co-workers or family that every time somebody catches you touching your face you put a quarter in a jar – the person that touches the least gets the jar at the end of the day!!
5) NO HANDSHAKING! Use a slight bow, elbow bump, or even hugs where you are not breathing on the other individual, etc.
6) Either do not touch or use ONLY your knuckle to touch light switches, elevator buttons, etc.. Lift the gasoline dispenser with a paper towel or use a disposable glove. Open doors with your closed fist or hip – do not grasp the handle with your hand, unless there is no other way to open the door. This is especially important on bathroom and post office/commercial doors.
7) Use disinfectant wipes at the stores when they are available, including wiping the handle and child seat in grocery carts.
8) Wash your hands with soap for 10-20 seconds and/or use a greater than 60% alcohol-based hand sanitizer whenever you return home from ANY activity that involves locations where other people have been. In the wake of coronavirus, I have changed my position on hand-sanitizers and think the benefit of viral inactivation is worth the risk to the microbiome and tissue permeability at the present time.
9) If possible, cough or sneeze into a disposable tissue and discard. Use your elbow only if you have to. The clothing on your elbow will contain infectious virus that can be passed on for up to a week or more!
10) Begin some preparations in anticipation of social distancing or supply chain shortages, such as ensuring you have sufficient supplies of prescription medicines and ensuring you have about a 2 week supply of food and other necessary household goods.
11) With these preparations in mind, it is important to not panic buy. Panic buying unnecessarily increases strain on supply chains and can make it difficult to ensure that everyone is able to get supplies that they need.
12) Help your neighbors that may be less-prepared or less-able to prepare. This time can pull us apart or bring us together. It is our choice.
So, How Worried should you REALLY BE??
I am recommending caution at this time – especially until we have testing to help us know who is infected and who is not. Taking action is not the same as panicking or adding to the mass hysteria that is un-useful. Take action by being more loving, caring, compassionate. Reject fear and be present. Be proactive by continuing to educate yourself, come back to this page for updates, and focus on your overall health as both your short and long-term strategy.
With much Love,
David H. Haase, MD
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