We present a guide prepared by an expert immunologist collaborating with our Institute, Dr. Maciej Hałasa from the Pomeranian Medical University in Szczecin. He has developed guidelines on how to act in the face of the threat of coronavirus infection.
The development of current events surrounding the SARS-CoV-2 coronavirus pandemic has become so rapid that at times it is difficult to follow in detail. Scientific research findings regarding the virus are published in online journals within days of data collection, and are read by us sometimes immediately upon appearing on the web.
Unconventional steps, or measures not used for a very long time, are being undertaken—both shaping the operation of healthcare systems and regulating the functioning of entire societies. All these actions are the result of concerted efforts aimed at curbing, or at least substantially slowing, the course of the epidemic.
Such dynamism fosters unprecedented mood swings, both across whole societies and within each of us individually. Dread alternating with an excessive sense that there is no real danger leaves many individuals feeling utterly disoriented. Can one write something reassuring today without instilling an excessive and unfounded sense of certainty in readers? I shall try…
WHY DO THE YOUNG AND HEALTHY HAVE THE BEST CHANCE OF EXPERIENCING A SARS-COV-2 CORONAVIRUS INFECTION IN A MILD OR EVEN UNNOTICED MANNER?
Mounting evidence indicates that the vast majority of people who have had infectious contact with the coronavirus will not fall ill symptomatically, or will experience very mild symptoms of upper respiratory tract irritation and systemic flu-like illness features (muscle ache, fever, etc.). Only individuals over the age of sixty, and younger people suffering from serious chronic underlying conditions, face a significantly elevated risk of severe COVID-19 illness.
WHAT ACCOUNTS FOR SUCH DIFFERENCES IN THE DEGREE OF RISK ASSOCIATED WITH THE INFECTION?
To understand this, one must trace how the stages of an infection by a droplet-transmitted virus unfold, attacking primarily the epithelial cells of mucous membranes:
- the virus attacks us through a very specific gateway of infection: epithelial cells of the oral cavity mucous membrane that carry on their surface the appropriate structures (for SARS-CoV-2, this is angiotensin-converting enzyme 2, ACE2) serving as receptors for the virus,
- upon entering the cell, the virus incorporates its genetic material and compels it to produce new viral copies – at this stage, the body's immune system has its first opportunity to encounter the virus, initiating the process known as the primary immune response, which typically requires around 7 days to develop effective specific immunity,
- when, typically after several days, the new copies of the virus are ready, the host cell ruptures,
and the newly formed, far more numerous viruses are released to attack new cells – restarting the cycle of replicating subsequent viral copies, - when a sufficient quantity of viruses is produced in the oral cavity as a result of one or more such replication cycles, and the immune system fails to halt this progression, they can begin to penetrate deeper into the lower respiratory tract and the gastrointestinal tract – in the lungs, substantial numbers of receptors (ACE2) for the virus are found on certain epithelial cells lining pulmonary alveoli (type 2 pneumocytes).
As shown by the above overview of COVID-19 disease development stages, the viral infection process—or more specifically, the development of the illness caused by it—is not a binary, on-off phenomenon like a light switch on a wall. Before clinical symptoms appear, we actually have a considerable window of opportunity to subtly modify the course of this process, which ultimately can prevent the infection from escalating into a full-blown, severe clinical syndrome. Because forecasts from certain specialists indicate a likely scenario in which a substantial proportion of our population will become infected, the recommendations—or rather suggestions—presented below may be useful to each of US.
To increase our chances in the war against the SARS-CoV-2 virus, both as a society and as individuals, EVERY ONE of us should assume a share of responsibility for the fate of ALL of us.
How, then, should we proceed? We should focus on three fundamental stages into which our actions can be divided:
STAGE A – PREPARING THE BODY FOR ENCOUNTERING THE VIRUS
STAGE B – INFECTION PREVENTION
STAGE C – DELAYING DISEASE PROGRESSION
It must be emphasized that Stage C is intimately linked to and directly stems from the effective execution of actions in Stage A. Each of these stages can be broken down into several complementary, though at times independent, measures.
STAGE A.
This point can only be implemented if we still have the time and capability to do so, and essentially consists of maintaining the body's immunity at the highest possible level. This is inextricably linked to maintaining optimal overall physical condition, supported by:
- Proper rest, preferably active, (e.g., gymnastics by an open window, air temperature permitting), breathing exercises, etc.
- Adequate sleep, at least 7–8 hours per day, and more if feasible. It is essential to avoid sleepless nights and staying up late, whether due to work patterns or pursuit of entertainment (video games, late-night movie sessions).
- Proper nutrition, which means not only providing adequate energy (calories—which, while avoiding excess, is also crucial), but also ALL essential nutritional components. Avoiding restrictive dietary regimens (elimination diets, very low-calorie diets, vegetarianism, etc.) not required by medical indications is a vital step toward preserving proper immune function.
- Stress management and cultivating positive emotions, as the link between immune status and good mood/optimistic mindset has been established beyond doubt. Although difficult to pinpoint entirely through conventional scientific mechanisms, for some reason immunity “loves a smile”!
- Avoiding stimulants, especially high-proof alcohol and cigarettes, including e-cigarettes that generate artificial “vapor” based on propylene glycol (also an alcohol), as they dehydrate mucous membranes and undermine high bodily immunity.
- Controlled supplementation with selected vitamins and micronutrients, but only very moderately and ideally under the supervision of an experienced physician or dietitian. This can moderately help correct deficiencies and enhance immune markers, as immune cells require certain micronutrients for their proper development. Any supplementation is best preceded, where possible, by laboratory tests confirming a deficiency. However, using micronutrients or vitamins in “megadoses” makes no scientific sense, as it can disrupt the delicate balance essential to immune function. Furthermore, overloading the body with unnaturally large doses can strain vital organs, as seen with kidneys or intestines following massive doses of vitamin C. Instead, focus on regular, natural intake of these nutrients through a balanced, complete diet.
- Use of colostrum, which is the only known natural supplement engineered by nature SPECIFICALLY to modulate the immune system. It was created so that a newborn nourished by it could acquire the capacity for defensive response against all possible infectious agents, including viruses, as swiftly and comprehensively as possible. Adults—and especially the elderly—likewise derive significant benefits from colostrum in the form of improved immune system effectiveness. Dozens of scientific studies over recent decades have provided evidence for these actions of colostrum, which contains approximately 250 bioactive components.
What is the purpose of the actions in this preparatory stage of fighting the virus? Their aim is to prepare us for the most crucial race in this disease: the race between the replicating virus and our lymphocytes' ability to effectively neutralize it. If we accomplish this in time, we will pass through the illness without serious health consequences. We acquire specific immunity (just like after a vaccine), and from that point onward, we should no longer be susceptible to infection by this virus.
Remember that for the virus to successfully attack the lungs, it must reach a certain critical mass. This occurs through the production of new copies within the upper respiratory tract epithelium. Here, one important thing must be clarified: the rate of new viral copy production depends on the initial infectious viral load. If our mucous membranes came into contact with a small number of viruses, only a few cells are infected in the initial phase, and consequently, relatively few new viral particles are released following their replication cycle inside them. Still not enough to successfully infect the lungs. Neighboring cells in the upper respiratory tract are then infected, but this time their number is greater, because the first replication cycle multiplied the viral count. Before the number of viral copies reaches a magnitude sufficient to infect the lungs, a certain number of these replication cycles must take place, each taking several days. During this window, we have the opportunity to mount an immunization process and develop an effective specific immune response, which should halt the infection. Such a bodily response is only possible under conditions of having sufficiently effective immune mechanisms—in other words, robust immunity.
Unfortunately, an infection resulting from a large initial viral dose can look quite different. In that case, because a large number of cells are infected from the start, the time required for replication to produce an overwhelmingly large number of copies can be substantially shortened. If this takes less than 5–7 days—the timeframe required for the full development of a primary immune response—even a person with reasonably good baseline immunity may not manage to develop effective defenses in time to prevent viral involvement of the lungs. This is why raising the level of immunity to the HIGHEST POSSIBLE level is so vital.
STAGE B.
This stage of protection against severe outcomes of infection is the most widely promoted measure aimed at avoiding disease, although as many epidemiologists suggest, this infection will likely affect a very large portion of society. Implementing this stage should consist of:
- Avoiding contact risk with viruses by every citizen, which is expressed through individual application of rigorous hygiene standards and compliance with state directives and continually updated sanitary-epidemiological regulations. This point is widely known and, hopefully, observed in solidarity by everyone.
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Keeping mucous membranes in optimal condition, which can help repel a viral attack even if the virus enters our mouth or nose. Mucous membranes must remain coated at all times with mucus, which prevents epithelial cells from drying out and, above all, shields epithelial cells from direct contact with potentially infectious agents. Mucus possesses protective properties for mucosa due to its viscosity, but also because its constituent factors (including secretory IgA antibodies, if we are properly immunized) effectively destroy bacteria, viruses, and other microorganisms. Maintaining the mucosal coating in the upper respiratory tract is particularly challenging during winter months due to the drying effect of air heated by radiators. This is especially relevant in bedrooms, where air drying can be mitigated by placing a clean, damp towel on the radiator. Another cause of excessive mucosal drying is inadequate body hydration, as well as mouth breathing when the nose is congested.
ATTENTION! MYTH. On this occasion, one widespread myth emerging in the context of the coronavirus epidemic must be debunked: alcohol, preferably high-proof, kills viruses, so drinking it prevents disease. This is untrue insofar as internal “disinfection” cannot produce positive results, because before viruses are effectively killed, one will cause severe self-harm. Alcohol severely dehydrates and even damages mucous membranes, which can pave the way for even more effective penetration of the virus into epithelial cells.
- Applying the highest protection standards by healthcare workers, who, being exposed to exceptionally high viral challenge doses, can succumb to severe infections even if they are in full health and have an intact immune system. Unfortunately, the demanding nature of their work—especially under conditions of critical necessity to save the lives of others—frequently causes such physical exhaustion that even an average viral dose can lead to a severe course of COVID-19.
- Complete isolation of the elderly (over 70 years of age) and individuals suffering from chronic illnesses that impair immune capacity, respiratory, or cardiovascular systems. Only in this way can we substantially decrease the likelihood of infection in these individuals, who most frequently suffer a very severe course of infection with a high risk of fatality. Their isolation should continue until the virus recedes from the population. Because these individuals are of retirement age, their absence from the labor market does not disrupt state operations. Meanwhile, younger citizens bear the responsibility of delivering everything necessary for their sustenance, while strictly adhering to quarantine protocols.
Because from the perspective of society, slowing down the rate of epidemic spread will give the healthcare system the chance to gradually provide care to all those most critically affected by this infection, without the risk of hospital overcrowding.
Whereas from the perspective of individual personal protection, avoiding exposure to a large initial infectious viral dose reduces the risk of severe disease.
STAGE C
The success of this stage relies directly on the effective implementation of the measures described earlier. Delaying disease progression results from the effectiveness of Stage B, which reduces the infectious challenge dose and affords the opportunity to develop specific immunity. In turn, the development of an effective specific immune response depends heavily on how successful our actions were under Stage A. Specific immunity initially slows viral replication and ultimately resolves the illness. However, to preserve and even bolster one's chances of winning the fight against the virus, each infected individual, immediately upon detecting the first symptoms of infection, should:
- Cease all non-essential activity, including professional work, but also “leisure activities.” One should definitely not attempt to push through infection-related malaise by maintaining normal or even heightened activity. Every calorie saved by entering a state of rest is utilized by the immune system to combat the infection! The best way to successfully pull through an infection is to remain in bed.
- Provide the body with sufficient calories and building blocks for synthesizing new proteins. During an infection, our immune system requires not only immense amounts of energy, but also building material for producing new immune cells (leukocytes) as well as antibodies. The best time-tested method for delivering both energy and building material is consuming BROTH (rosół) during an infection! This extract of meat and vegetables, rich in lipids and amino acids, is an appealing meal option that can be tolerated even by a sick person lacking appetite. It is also exceptionally easy to digest and absorb, further enhancing its value.
- Maintain the proper condition of mucous membranes, which primarily means staying hydrated (drinking fluids) and preserving ambient humidity. Clearing nasal passages also helps prevent drying of the mouth and throat.
- Consider initiating colostrum supplementation, because in addition to its immunomodulatory properties that help the immune system achieve readiness to repel the virus sooner and more effectively, colostrum itself possesses direct antiviral properties, as shown in studies with various viruses, including HIV. Colostrum taken within the first hours of a flu-like infection significantly alleviates and shortens its duration.
It must be emphasized that the preventive strategies outlined in Stages A–C apply not only to SARS-CoV-2 infection, but to all viral infections transmitted via respiratory droplets.
Because the new coronavirus infection will most likely not spare the majority of us, we must prepare for it in the best possible way.
We must endure as best we can until the emergence within the population of a sufficiently large pool of individuals who have gained specific immunity through recovery from the infection causes the virus to recede from the population and ends the epidemic.
Therefore, the better we care for our individual immunity, the more effectively we protect ourselves against a severe disease course, and the more efficiently we facilitate the overcoming of the epidemic.
Author: Dr. Maciej Hałasa
Maciej Hałasa, MD, PhD, graduated from the Faculty of Medicine at the Pomeranian Medical Academy in Szczecin (1979–1985). From 1990 to 1994, he pursued postgraduate studies in immunology at the University of Alberta in Edmonton, Canada. Since 1994, he has worked at PAM (now PUM – Pomeranian Medical University) in the Department of General Pathology, and subsequently in the Department of Human Nutrition and Metabolomics. In 1997, he defended his doctoral dissertation at PAM on “Apoptosis and proliferation at various stages of peripheral blood lymphocyte maturity.” In addition to core scientific activities (including pioneering research in harvesting pluripotent very small embryonic-like stem cells [VSEL] and intestinal barrier permeability issues) and academic teaching (immunology, pathophysiology), he focuses on practical issues relating to immunity, immune disorders, and methods for regulating and enhancing its function. His primary clinical interest lies in chronic and recurrent inflammation, particularly of the respiratory tract. In recent years, his work has focused primarily on gut immune system function, its link to immune dysregulation and allergy development, and opportunities for its natural regulation (including colostrum and probiotics). These subjects have been the focus of dozens of lectures delivered across Poland in recent years.
