Why We Need Hope

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I hope you all had a good Thanksgiving and were as safe as possible. The COVID-19 seven-day average continues to stay over 150,000 cases per day. We’ll find out in a couple weeks how we did during the Thanksgiving holiday related to masking and social distancing. It’s difficult to be without family and friends, especially over the holidays, but the one thing we can take solace in is that this is temporary; the better we all follow the rules, the sooner we can all be together again.

It reminds me of an interview a well-known business advisor had with a prisoner of war in Viet Nam years after the war ended. He asked who did better in captivity—people who were optimistic about rescue or those who decided they would simply endure? The answer surprised him: the optimists did far worse than other POWs. The optimists would say, “We’ll be out by Christmas for sure!” Then Christmas would come and go, so they would pick the next significant event and say the same thing. The events would pass, one after another, and soon, the optimists lost all hope.

Don’t do that. One thing we have is hope. The current treatments for those who get COVID are better than six months ago, and they will be better tomorrow as we learn more about the disease. Vaccinations will start soon and while the distribution will take time, there’s hope for those who are most at risk. If we do all we can with the things we can control, there will be an end to this. We don’t know exactly when that will be, but it will happen. Until then we grind it out, we endure. We’re tougher than we think we are. Let’s prove it.

What are you prepared to do today?

        Dr. Chet

Another Path to Trained Innate Immunity

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There is one more action that may give a person a way to enhance trained innate immunity short of catching COVID-19 itself, and that’s to catch a cold. Specifically, a coronavirus cold. I read a great article in the New Scientist that I’ll summarize for you. I urge those of you who want to know more to read the paper listed below.

There are four fairly common coronavirus colds we all get at some time: OC43, HKU1, 229E, and NL63. In a study cited by the article in the New Scientist, researchers collected data from medical records of just under 16,000 patients. Of those, 875 had a documented case of coronavirus colds verified by a test; the rest of the subjects did not. Those who had a confirmed case of one of the types of coronavirus colds had milder cases of COVID-19, fewer required intensive care, and fewer had to be put on mechanical ventilation. The mortality rate was 4.8% in those who had a prior cold and 17.7% without a verified cold test.

The upside is that it seems to provide some trained immunity against COVID-19. The downside is that the immunity seems to wane over the years. I think this research is important because it shows one more way to train the immune system. It may not be practical in the real world, but if you happened to catch a simple cold in the past six months, you may have some innate immunity—if you happened to catch the correct form of the cold virus. For the rest of us, the flu shot is still the best course of action in training our immune system.

What are you prepared to do today?

        Dr. Chet

References:
1. The New Scientist. https://bit.ly/35yxbDY
2. J Clin Invest. 2020. https://doi.org/10.1172/JCI143380.

How to Train Your Immune System

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Here’s where we stand: healthcare workers in the Netherlands who got last year’s flu vaccine had fewer cases of COVID-19 than their unvaccinated counterparts. In addition, white blood cells treated with the flu vaccine, with or without the tuberculosis vaccine, demonstrated enhanced immune responses when exposed to the COVID-19 virus.

Where does this lead? It’s a quality known as trained innate immunity: exposure to one vaccine, such as the flu vaccine, will train the immune system to respond to another virus such as COVID-19. However one test-tube study does not prove it will work in the real world. Let’s look at some additional research.

The Flu Vaccine and COVID-19

Several retrospective studies have looked at the flu vaccine and COVID-19. In two studies from Italy, people over 65 who got the flu vaccination had a lower mortality rate from COVID-19. There are several more observational studies, but these studies don’t prove cause and effect.

There are problems doing clinical trials, ethical considerations being one of them; for example, if getting the flu vaccine proves to have a beneficial effect, it puts the people in the study who did not get the flu vaccination at risk. There’s also the possibility that it might have been other factors that were actually beneficial, such as lifestyle. It’s all very complicated.

Other Vaccines and COVID-19

Several studies have reported an enhanced immune response against COVID -19 after certain vaccinations. The polio- and measles-containing vaccines have been identified as stimulating the immune system and providing protection against covid-19. The bacillus Calmette-Guérin (BCG) vaccine against tuberculosis could protect against COVID-19 as well. Both have been investigated as potentially being immune-stimulating against severe upper respiratory infections. In countries where BCG is given on a regular basis, the rates of COVID-19 have remained lower than in countries that no longer use it because tuberculosis has been eradicated for the most part.

The Bottom Line

These are observational studies; there’s a lot of research to be done to find out how vaccinations for one virus can provide benefits against a completely unrelated virus. Trained immunity means immune cells are reprogrammed in some way. The “how” is important because what we may find out is that there’s another way to do it, or research may find other factors such as vitamin D status that complement the vaccinations to enhance trained immunity.

One lesson this foray into trained innate immunity has taught me is that our immune system gets weaker as we get older and must constantly be “trained.” It’s not just diet, exercise, and supplements that help our innate immunity; it seems that exposure to other viruses in the form of vaccines may help protect us against severe cases of COVID-19 and possibly other viruses as well. Right now the simplest way to do that is to get the current flu vaccination. We may not evade catching COVID-19, but having a better-trained immune system may help us avoid the most severe symptoms and possibly even death.

I got my flu vaccination and so did Paula. Talk with your physician and see if it’s right for you. Your body. Your choice. But I hope you’ll do whatever you can to put the odds in your favor.

What are you prepared to do today?

        Dr. Chet

References:
1. medRxiv preprint doi: https://doi.org/10.1101/2020.10.14.20212498
2. Nat Rev Immunol. 2020 June; 20(6): 375–388.

How Vaccines Can Affect COVID-19

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In vitro studies, more commonly called test-tube studies, are used when you want to see if there’s a relationship between cells and microorganisms. In the case of the researchers in the Netherlands, blood cells, vaccines, and the COVID-19 virus were used. While the laboratory techniques were complex, here’s what they found.

The researchers isolated peripheral blood mononuclear cells from the Buffy coat layer of cells. The Buffy contains primarily white blood cells after centrifugation. The researchers then exposed the white blood cells to the flu vaccine commonly used in the Netherlands for 24-hours. Half the samples were also exposed to the bacille Calmette-Guérin vaccine, typically used for tuberculosis. After a week, the samples were exposed to the COVID-19 virus. The objective was to see if immune system markers were increased after exposure to the virus.

The flu vaccine increased the immune capability of the white blood cells. The addition of the BCG vaccine increased the capability of the immune response. The cells were better able to make cytokines faster. If it happened in humans, the cytokines would be able to respond faster thus reducing the ability of the COVID-19 virus to replicate.

What does this all mean? I’ll finish this on Saturday.

What are you prepared to do today?

        Dr. Chet

Reference: medRxiv preprint doi: https://doi.org/10.1101/2020.10.14.20212498

The Flu Shot and COVID-19

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This week, I’m going to review a series of studies that outline a strategy that includes getting the current flu vaccination. The first study is an observational study. In my opinion, it’s the way research should begin: look for relationships between factors first, and then conduct experimental trials.

Researchers in the Netherlands used the medical records database of a large hospital to find out the answers to a couple of questions. First, of over 10,000 healthcare workers who worked there, they wanted to find out how many got the flu vaccination during the 2019–2020 flu season last fall. Then they examined how many employees got the COVID-19 infection since the pandemic began. They learned that of those who were not vaccinated, 2.23% got the COVID-19 virus; of those who got the flu vaccination, 1.33% got COVID-19. That works out to a 39% reduction in the risk of catching COVID-19 for people working in a healthcare setting if they get vaccinated for the flu.

As we know, there’s not a cause-and-effect relationship in these types of studies. But it does indicate that it’s a place to look—which is exactly what they did in the next phase of the research paper. More on Thursday.

What are you prepared to do today?

        Dr. Chet

Reference: medRxiv preprint doi: https://doi.org/10.1101/2020.10.14.20212498

Taking Charge of Your Health

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Flowers and trees have been winterized. The mulch has been spread throughout the yard. The leaves remain a continuing problem, but in short order the snow may take care of that. The one thing that I like about working in the yard is it gives me an extended opportunity to think. There are two things they have been on my mind.

Body Composition and Aging

I completely underestimated the change in body composition that occurs as we get older. I weigh about seven pounds more than I did about a year ago; the problem is that it’s all settled right around my waist. I’ve lost muscle mass in my arms, shoulders, and even my legs. From a strictly physical perspective, that’s the challenge I intend to address next. This will not be a “by the end of the year” thing because it’s going to take some time. I’ll write about how I intend to do it and then keep you posted on how it goes. Everyone is welcome to join me.

COVID-19 Isn’t Going Away

The second thing I’ve been thinking about is the COVID-19 virus. I’ve had the opportunity to read a lot of material I want to cover in upcoming memos that are not related to the pandemic. But the damage from this pandemic continues to increase, at least for the time being, and it would not be responsible for me to ignore COVID-19 all together. There’s some fascinating research that I think adds to the Swiss cheese approach in the last Memo.

Many people seem to be working themselves into a frenzy over possible state restrictions on activities and the insistence on wearing masks. Many of you know that attitude is everything. If we, as a nation, could just make up our minds that we’re going to do the best we can in each and every state, we could get through these temporary restrictions and get back to living our lives more completely than we are able to right now. If we don’t, then this is going to continue until we all decide to take things seriously.

The Bottom Line

Every morning, when I take Riley to school, we review our rules. The first rule is “Do the best you can.” It doesn’t have to be perfect. And you will make mistakes. Just do the best you can each and every day, because that’s all you can do. We review it after school on the drive home, and he gives me a thumbs up if he did his best that day. I hope we all can do the same thing in dealing with our health. The bottom line is that in all phases of our health, let’s do the best we can.

The Insider Conference Call is Wednesday evening. Do you have questions you’d like answered about supplements, weight loss, or any other topic related to health? Become an Insider today and gain the benefit of our discussion.

What are you prepared to do today?

        Dr. Chet

Swiss Cheese COVID Protection

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You’re probably thinking “First, zeptoseconds, then speeches and dancing, and now Swiss cheese? How are they related?” I’ve used the concept of discrete time intervals to make a point. Each discrete time interval of seemingly separate tasks can be put together to make up something that can be greater than each individual part—in this case, a way to control the spread of the COVID-19 virus.

The Swiss cheese concept is credited to Dr. James Reason who applied it to safety in many industries, but it fits here very well. For example, wearing a seat belt every time you drive reduces the risk of serious injury. But a specific type of collision, say hitting another vehicle from behind that doesn’t have operational brake lights, could still cause serious whiplash. In a time interval too fast for human response, a sensor sends a signal to deploy an airbag to limit injury, and there are now sensors that will automatically brake to stop the car. Different actions performed in discrete time intervals put together can make driving safer.

The Swiss cheese idea is that while there are holes in any single slice, the holes don’t extend the entire brick of cheese; any single hole will eventually get blocked. If you have enough safeguards, the combination of imperfect strategies will work together to lower your risk. I’m adding time to it to illustrate how little time it can take.

Four Steps to Keep Yourself Healthy

1. Wear a mask all the time when in public. Using my five-year-old grandson Riley as an example, it takes no more than 10 seconds to put on a mask. (He and his classmates wear masks all day in kindergarten, so don’t tell me it’s too hard to do; here’s more on masks.)

2. Social distance and spend no more than 15 minutes in any single encounter (four hours in a poorly ventilated space with strangers is just asking for trouble). A shorter time is better.

3. Clean and sanitize surfaces regularly. This may take up to 10 seconds for the surfaces we encounter frequently.

4. Wash your hands often with soap and water; sing the ABC song to make sure you scrub long enough. Or use a hand sanitizer with 70%+ alcohol, and the virus is destroyed within 30 seconds.

Any single strategy has holes, but used together, we can keep the risk for ourselves and others very low.

The Bottom Line

My point this week is to demonstrate that you have enough time to reduce the COVID risk for yourself and others. Small discrete acts can add up to a powerful strategy; doing enough of them helps put the odds in your favor. As I said before, there’s nothing to fear. Just respect the virus and act accordingly.

If you’re a U.S. citizen, make sure you vote next week. With everyone glued to the election results, including many readers in other countries, I’m sure your attention will be elsewhere so Paula and I are taking next week off. The leaves and the mulch await, and I’ll work on getting prepared for some great new ideas for the New Year.

What are you prepared to do today?

        Dr. Chet

Reference: doi: 10.1097/QMH.0b013e3182418294.

The Power of the Pause

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When talking about discrete time intervals, there are two specific examples that come to mind. As a professional speaker and a Distinguished Toastmaster, I’ve learned one of the most difficult things to do in giving a speech isn’t selecting the correct words, it’s knowing when to pause. It’s one of the most difficult techniques to learn because when you’re speaking, you think every available second needs to be full of sound. You can say more with a moment of silence than you can with a shout.

Discrete time intervals also apply to ballroom dancing, and that’s even harder to master because it can involve the entire body. A specific move in a waltz or a tango can be broken into smaller and smaller pieces. They don’t seem important individually but when they flow together, they make the simple seem elegant; a pause speaks even more loudly in the context of that flow.

The pause allows us to make the ordinary appear and sound extraordinary. While it takes a lot of practice to make the sounds or the moves appear to be seamless, once mastered it becomes a habit. Then it’s no work at all.

Where is the going? You’ll find out on Saturday.

What are you prepared to do today?

        Dr. Chet

What Is a Zeptosecond?

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In a football game on Sunday, the ball was intercepted and the defensive back started to run the ball back about 90 yards for a touchdown. Only he never made it. A wide receiver took off after him and caught him at about the 7-yard line. To watch it happen was simply amazing. He reached a speed of 22 mph.

That’s fast for a human being, but it’s a lifetime in physics. Scientists are trying to measure things in smaller blocks of time. They measured how long it took for a single particle of light to cross a single atom of hydrogen and came up with 247 zeptoseconds. A zeptosecond is a one after a decimal point followed by 20 zeros! That’s a trillionth of a billionth of a second. That’s relevant to science but not practical to us as humans.

However, time is something we should all think about. By breaking tasks into more discrete time intervals, we can focus on the individual elements that make up any task. I’ll give you a practical example in Thursday’s Memo. Until then, think about the tasks you perform and how many discrete intervals are involved in them. It will all make sense on Saturday.

What are you prepared to do today?

        Dr. Chet

Reference: DOI: 10.1126/science.abb9318.

Does Exercise Reduce COVID-19?

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I’ve written about fitness and COVID-19 before, but a recent post by a colleague got my attention. I had never been able to find any research that suggested people who are fitter would have less serious cases of COVID-19 or any upper respiratory infection for that matter. I thought maybe the scientific paper he used might provide an update. In addition, there were a couple of statements in the paper that caught me by surprise. Here’s what I found.

Exercise and Fatty Lungs

The paper suggested that if a person were overweight or obese, there could be an increase in fat cells in the lungs. As such, that could increase the available components such as fatty acids that could contribute to the cytokine storm in extreme cases of infection. I’d never heard that fat cells were found in the lungs, so I decided to dig deeper.

The paper referenced an article that talked about risk factors for severe cases of the COVID-19. They cited two studies. The first was a study on overweight diabetic rats. However, we’re not rats so we can’t assume the same applies to humans. The other article dealt only with obesity. The paper said that in a small study on humans, fat cells were found in the lung parenchyma where gas exchanges occur in the lung tissue.

I decided to check out that paper as well. It was a post-mortem examination of the lungs of normal-weight and overweight subjects who died from asthma and non-respiratory conditions. Researchers found fat cells in the cell walls of large structures greater than 6 mm in diameter but none in smaller areas. There was an increase in the fat cells and immune response cells in the fatal asthma cases in obese subjects. While interesting, it does not support the original article indicating fat cells in the lungs to any significant degree, because some obese subjects had none in their lung tissue.

Exercise and COVID-19

The rest of the paper discussed the benefits of exercise as it relates to weight loss, reducing cardiovascular disease, and improving metabolic systems, especially as related to type 2 diabetes. They talked about how every type of exercise improves the body enough to reduce comorbidities, and reducing comorbidities may lead to a better outcome if you get COVID-19.

The only misstatement was that exercise is a way to reduce a significant amount of body fat. It’s not; you also have to reduce your caloric intake to do that. But exercise can improve every organ system to respond better to challenges. That may help if one catches a severe case of COVID-19, so they got that right.

The Bottom Line

Exercise has been described this way: it would be the most prescribed medication in the world if it were in pill form. Based on this paper and the sum total of all the research on exercise and health, exercise can help you reduce your risk of a severe case of this or any virus, maybe not directly, but in helping you reduce your comorbidities. Move more and start today!

What are you prepared to do today?

        Dr. Chet

References:
1. Front. Physiol. doi.org/10.3389/fphys.2020.572718
2. Diabetes Metabolism. 2020. https://doi.org/10.1002/dmrr.3325.
3. Eur Resp J. 2019. 54:1900857; DOI: 10.1183/13993003.00857-2019