To Our Dear Spring Center patients:
Please know that you are all in our thoughts and we will continue to do all that we can to educate, inform and keep you safe.
This is a quickly evolving situation. It is my intention to continue to communicate with all of you via email and blogs to keep you up to date with as much vital information as possible. For those of you who still have questions and concerns, please contact the office to schedule an appointment so we can discuss your unique situation. I do have appointment availability.
We have now transitioned to telemedicine and this is both very exciting and helpful for all of us. We are using a HIPPA compliant platform called Doxy.me. It is simple and even fun to use. Ideally you can use a computer, laptop or tablet to provide the video. See previous email for details how to use. I strongly encourage all patients to use the video platform. I have realized that seeing each of your faces is vital for me to be able to continue to provide the best, most personalized care possible.
If folks have questions they would like to see me answer for the benefit of all, please let the office know either in a phone message or email and I will make sure to provide adequate answers in subsequent blogs.
What does novel corona virus or COVID19 mean?
Novel, refers to the fact that this strain is genetically and immunologically unique and new to the human population. No one has any immunity to it. And this is why it is such a big threat.
Why is handwashing SO important?
Fortunately, the COVID19 virus structure possesses an outer envelope which is made up of a lipid-protein. The RNA (the genetic information) resides inside this outer layer. Soap is both hydrophilic (water-loving) and lipophilic (fat-loving). This dual structure is what makes soap extremely efficient in killing the virus. When soap comes into contact with the virus, it pulls the virus envelope apart, much like it does with oils, render the virus incapable of replicating. The key to the hand washing, however, is time. We must scrub for at least 20 seconds, giving the soap time to disintegrate the envelop of the virus. Don’t forget your fingertips, where we are more likely to harbor the virus. And be sure to not contaminate yourself turning off the tap. Use a paper towel or tissue to turn off the water.
The virus is also susceptible to being broken down by alcohol-based hand sanitizers, made from ethanol, propanol and isopropanol, but they must be at least 60% and you need to wait until they are completely dry. Alcohol in the hand sanitizer denature the proteins destroying the envelope. Other non-alcohol sanitizers like chlorhexidine and benzalkonium chloride are also available, but are less effective against viruses.
Does heat kill COVID19? If so, would sauna help?
There are no sauna studies with COVID19 yet, however, there are many benefits of sauna for those who have access to one in their home now. Regular sauna use is associated with a decrease in all cause mortality, a decrease in pneumonia risk, and has been shown to cut the incidence of the common cold in half.
It appears that both temperature and humidity play a role. The MERS-CoV (Middle Eastern coronavirus) died at 132 degrees F at 25 minutes and in 1 minute if the temperature was 149 degrees F. No killing was observed at 77 degrees F. The Corona virus can live up to 28 days at 39 degree F, but they are inactivated at 20% humidity.
Dried virus on surfaces is viable for 5 days at least at our usual temperatures of 72-77 degrees and 40-50% humidity typical of California weather and air-conditioned environments. However, viruses quickly die at higher temperatures like 100 degrees F and 95% humidity, typical of some tropical countries.
It does appear that a sauna would be hot enough to kill the coronavirus. Traditional saunas are generally in the range of 150-175 degrees F. Infrared saunas use a lower temperature of 120-140 degrees F. These temperatures will kill coronaviruses on surfaces or on someone’s belongings or skin. So, great to use if you have been exposed to the coronavirus.
However, once infected and the virus is in the lungs, sauna will not kill the virus and should not be used to “treat” COVID19. If you do use a sauna, just be sure to stay well hydrated.
Can I safely use Ibuprofen? Do I need to use only Tylenol?
People have historically used both ibuprofen and Tylenol for fever and pain reduction when sick with viral infections. The French Minister Olivier Veran, a physician, tweeted last week that anti-inflammatory medications like ibuprofen “could be a factor in aggravating the infection,” encouraging patients to take acetaminophen, which is found in Tylenol, for a fever instead.
Although its safety is still being studied, for now, the world’s leading scientists at the World Health Organization WHO clearly announced on March 19th that it does “not recommend against the use of ibuprofen” because it is “not aware of reports of any negative effects, beyond the usual ones that limit its use in certain populations.”
I find Ibuprofen more effective as a pain medicine, particularly for the muscle aches that accompany fever. We do also have a variety of herbal anti-inflammatories available.
What about my blood pressure medicine? The controversy of ACE inhibitors and Angiotensin Receptor Blockers (ARBs)
The SARs COV2 infection attaches to a human cell with its S protein via the ACE2 receptor on the cell membrane and the virus enters the cell. From animal data, we know that ACEI and ARB medications can increase the numbers of ACE2 receptors on the cell, potentially making more entry point for the virus to enter the cell. Observationally, there appears a higher mortality in patients with a history of hypertension. There was a small cohort study out of China that suggested worse symptoms of the virus in patients on these medications.
However, based on physiology which involves a cascade of conversions, it does appear that ARBs may be protective leading to a reduction in inflammation by preventing the virus from docking on the ACE2 receptor site. The MedCram video on the topic is enlightening for those who have an interest.
This is a summary statement coming out of the American College of Cardiology-
” there is conflicting evidence on whether ACE, ARB, and ARNI are helpful or harmful in patients infected with COVID-19. Stopping treatment has negative health implication, and medications switching during a pandemic may create unwanted distractions from more urgent issues. As such, we recommend continued treatment of hypertension and heart failure as consistent with existing guidelines, to include ACEi/ARB/ARNI as appropriate for each patient, leaving patients on their usual antihypertension and heart failure therapies, and only holding antihypertensives in the setting of sepsis with hypotension.”
At this point we will maintain patients on their current medication regimes.
Now in stock:
Vitamin C options
We now have several Vitamin C options.
Ortho Molecular Buffered C – 2 capsules provide 700mg of vitamin C, plus smaller amounts of calcium, magnesium and potassium to protect the GI tract. Vitamin C supports the immune system by providing antioxidants, and this product also promotes Collagen Formation to Maintain Healthy Ligaments, Tendons and Joints. $19.95 for 90 count.
Ortho Molecular C-FLav – 1 cap contains 400mg of Vitamin C plus bioflavonoids including, Quercetin, Hibiscus Flowers, and Rutin. This product is good to help maintain normal inflammation and antioxidant status and is good for healthy blood vessels. May be a better choice for those who can’t tolerate high doses of Vitamin C or who need more anti-inflammatory support. $27.50 for 60 caps
Metagenics Ultra Potent-C® 1000. Each capsule contains 1000mg of Vitamin C, providing all the benefits associated with Vitamin C for antioxidants and immune support. This is also buffered to protect the gastrointestinal system. $42.50 for 90 caps
Immune Support – alternatives for Transfer Factor Multi-Immune
Metagenics Immucore – The foundation of this formula is a concentrated blend of mushroom extracts combined with buffered Vit C, Vit D, zinc and selenium. This is great for upregulated TH1 side of the immune system for fighting viruses. However, this should not be taken by those with autoimmune conditions. $ 44.29 for 90 caps. The dose is 1 cap daily for prevention.
In addition to our usual Ultrabiotic, Ultrabiotic 100 and Corebiotic, we now have available
Metagenics UltraFlora® BiomePro – 1 cap provides 105 billion CFU organisms clinically-studied probiotic strains to support gastrointestinal health, immune health and respiratory health. Does not require refrigeration. $ 69.95 for 30 caps
Metagenics UltraFlora Immune Booster – 1 cap provides a shelf-stable targeted Probiotic Support for Healthy Nasal, Sinus & Respiratory Function. $37.50 — 30 caps
Closing thoughts for today
There are many aspects of life that are on hold now as we are required to Shelter In Place as much as possible. However, I do think that it is important to maintain or even improve many aspects of our lives. We may now have time to rest, relax and reflect on our lives, where things are going and what is truly important. I encourage you all to take this moment to breathe and consider what it is that you want for your life. This virus has thrust upon many of us a pause in the chaotic busy-ness that is the tone of most of our lives, mine included. We have the opportunity to reflect not only on our own lives, but also the bigger context of humanity and its relationship to the natural world. This is considered a novel virus, meaning, although there are a number of corona virus strains that commonly infect humans, this one is “brand new” to humans. There is speculation that the virus “jumped” or mutated to humans through contact with or ingestion by the Chinese. Alternatively, there is concerning evidence that this virus with its infectious spike S protein was bio-engineered in Wuhan’s Bio-level 4 Laboratory and it escaped, unleashing the pandemic we are now experiencing. Which origin story is actually true may never come to the full light of day. And how we manage the current crisis is not dependent on where it has come from. In either scenario, this virus is born from a wild imbalance between human and nature, whether from neglect, from greed or intention malevolence. The human perception that the resources of this world are for us alone without consideration to the future, and to the environment are short-sighted. We drive to dominate, to manipulate nature and bend it to our will. So I encourage you all to consider how can you, can we as a society become more in tune with not just ourselves but also, with our Mother Earth.
Kelly McCann and The Spring Center Staff
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