Top Five Tips on Staying Healthy Amidst the COVID-19 Pandemic

COVID-19: The disease that sparked a worldwide catastrophe. With over 13 million confirmed cases and 504,000 deaths. In a modern world, nobody could have predicted this. Fighting this war blind-folded with no cure or vaccine in sight. We have lost so many lives. Are we destined down this path? What can we do to make ourselves better?

If we believe that tomorrow will be better, then we can bear all the hardships we are facing today. Our top priority above all else should be our health. This should be our own goal and our own pursuit.

We are in the midst of one of the deadliest pandemic in human history. Who could have imagined a mutated coronavirus can trigger a near-apocalyptic event? Healthcare systems have fallen, unable to accommodate a swarm of COVID-19 patients.

An unseen enemy—a virus 60 nanometers small has caused all this chaos. The novel coronavirus is an adversary the whole world is facing right now. Will it just fade and go away? Not without natural immunity and a proven vaccine.

The upshot is the coronavirus mutate very rapidly, hence It has a high potential for natural evolution. Coronavirus, unfortunately, compassed to a global extent and severity that it has taken on catastrophic proportions. At a time and age when we thought we can control everything, no less.

Corona is a Latin word for “crown” to describe the spike proteins these families of viruses are dependent to hijack our cells. Coronaviruses are a large family of zoonotic viruses that cause flu like symptoms ranging from the fever, cough, colds and difficulty of breathing in severe cases.

As a doctor specializing in Internal Medicine, I would admit not taking too much attention in “flu” per se. Being an acute illness, most of the cough, fever and other symptoms would subside within 5 days. Diagnosing “systemic viral infection” left and right has always been some sort of a routine for us doctors.

Then in 2004, the first SARS coronavirus or SARS-CoV 1 broke out. The first global outbreak of the century, swept through 29 territories with 8,094 confirmed cases and claimed 774 lives with a fatality rate of 9.6%.

“SARS has shook the world”, needless to say, as It caused tremendous social, political and economic disruptions in many countries. SARS-CoV 1 was a prelude…a herald to an even bigger monster, the SARS-CoV 2. This we have come to know as COVID-19.

In the first few months since the pandemic, doctors (me including), hoped that COVID-19 would just go away. Similar to the first coronavirus epidemic when the human chains appear to have been broken everywhere in the world. At the back of my mind, I thought COVID-19 was all sensationalized by the media. It couldn’t be that worse. THE WHOLE WORLD will not be wearing masks. Thousands of people will not die from this disease. I was wrong.

Even after centuries, Charles Darwin was still right on cue given our current situation. With that, I give you the Top Five Hot Tips on Staying Healthy Amidst the COVID-19 Pandemic.

HOT TIP # 1: Avoid getting sick by taking the precautions

Prevention is better than cure, so to speak. As of this writing, there is no silver bullet or cure for the novel coronavirus. We have to come up with means to protect ourselves physically.

In my opinion, there is no “plan B” on containing the spread of this contagion. We have to follow the necessary interventions in order to prevent the spread of infection.

Science-based preventive measures for COVID-19 includes to following:

Wearing Masks

Decrease transmission risk by 85%-- the type of mask could also be another factor

Proper Handwashing/Hand hygiene

Decrease transmission risk by 80% (maybe even more, if combined with alcohol and  hand sanitizers)

Physical distancing of at least 3 ft.     

Decrease transmission risk by 80%

Wearing Face Shield

Decrease transmission risk by 78%

I can’t stress this enough because transmission is when the virus spreads. Any surface that we touch be it doorknobs, elevator buttons, any metal or plastic, grocery items, coins - you name it- can be potential fomites. These are objects an infected person has touched after a simple cough or sneeze. If you are fond of touching our mouth, nose, or eyes after a brush with fomites, then boom! You could get infected too. Frequent hand hygiene nowadays, should be synonymous to surviving the pandemic, or breathing even.

The “new normal” is built on the idea that in order for us to decrease the risk of getting sick with COVID-19, we have to take action on decreasing the virus’ means of transmission. That is all there is. That could mean giving up some of the things we enjoy most. No more mass gatherings, no more dine-ins, no more watching movies in the cinema and no more gym time for now (P.S. I hated that last part).

As much as we wanted to go out and celebrate our freedom, let us not forget the COVID-19 airborne threat. The WHO finally released statements that the SARS-CoV 2 virus could stay in the air for 8 hours. EIGHT FULL HOURS-- And we needed to breathe air at least 15 times per minute (give or take).

When we can catch a disease simply from breathing, these are called airborne diseases. The coronavirus disease 2019 can spread when infected people cough, sneeze, or talk, spewing nasal and throat secretions into the air. The virus takes flight through aerosolized air droplets then hangs long enough landing on other people or surfaces.

It serves to highlight that being in an enclosed space and sharing the same air for a prolonged period increases your chances of exposure and infection. The virus, if we are not careful, takes up residence inside us. It’s pretty much an endgame after that if a person has a weak immune system.

The lesson is we need to wear facemasks in public places. Not because we’d be penalized if we don’t, but more so, our lives and the lives of other people depend on it. Unless we get tested (COVID RT-PCR swab test), we honestly do not know if we are walking around as an asymptomatic Covid-19 carrier. That means not feeling sick; no fever, cough or any flu-like symptoms. But…. very capable of spreading the virus. This is the very reason that we should wear the masks properly covering our nose and mouth, then snugly fitted on the chin (figure 1A).

Figure 1A. The proper way to wear a facemask during exposure

The world is dealing with a virus that mutates very rapidly, hence has a high potential for natural evolution.

As if the current situation weren't dire enough, some experts from the Center of Disease Control (CDC), cautioned that coronavirus could become a cyclical event. Much like the flu season which usually starts in the month of march then peaks in October.

As terrifying as it may seem, we should be prepared for the inevitability of a repeated cycle—a pandemic that has a sharp rise in the number of cases (and number of deaths) then goes down after a few months only to cycle back for another wave the following year. This has been the dictum of every flu season, a second virus strain follows the first wave. Wait, has second wave already hit other countries? This early? It’s the natural evolution of this virus that scares me.

The point here is this: prevention is so much better than healing because it saves the labor of being sick. So wear your masks(properly), wash your hands (properly) and observe physical distancing. These are the precautions we should follow by heart in order to survive this pandemic.

HOT TIP # 2: Eating the right foods A.K.A. “Pinggang Pinoy”

Pinggang pinoy is a simple, easy-to-understand food guide that remind us how our meals should look like each day. Unfortunately, with most of us resorting to fast foods, we have forgotten all about it.

The ultimate food plate encourages Filipinos to eat less salty, fried, fatty, and sugar-rich foods to prevent chronic diseases. Eating too much is not healthy either. I know, I know…most people say that a balanced nutrition is somehow like walking a tight rope. There is a certain limit to taking calories per day as maintenance. There are good carbs on the left and bad carbs on the right. We all can say that following a certain diet is difficult. But should it be?

Figure 1B. A simple diagram for pinggang pinoy

GO(carbohydrates). GROW(protein). GLOW(fruits and vegetables). Let’s take a kiddie chart for reference.

Are you still with me?

Pinggang pinoy is a plate with all the good stuff for us to stay healthy. Take go foods for example, I would pick rice and oats which are excellent sources of iron. Why? Because Iron strengthens the immune system. Rice and oats just happens to have plenty of it.

Iron is a fundamental element and a nutrient necessary in creating white blood cells – our body’s very own army against any type of infection.

If a person has iron deficiency, one of the common health consequences would be anemia or low red blood cell count. The immune system depends on a lineage of blood cells as well, namely the white blood cells. This can probably link an underperforming immune system and iron deficiency.

For glow foods, my pick would be cruciferous or “cross- bearing” vegetables. Cauliflower, cabbage, spinach and broccoli belong to this group just to name a few.

Cruciferous vegetables are rich in folate, vitamin C, E, K and fiber. They are also rich in phytonutrients, plant based compounds that help reduce inflammation. If eating green, leafy vegetables will make you frown, this will motivate you in adding cruciferous vegetables in your diet: antiviral effects of glucosinolates. These chemicals are responsible for the aroma and flavor in these plants.

Grow foods on the other hand, includes meat from pork, beef, turkey, chicken, fish and shellfish. They have one interesting (and essential) trace element for a healthy body: selenium.

Selenium is a powerful antioxidant that fights oxidative stress and helps defend our body against viral infections. Selenium is also proven to boost the immune system. It turns out that our individual immunity has become a precious resource at these uncertain times of COVID-19 pandemic.

Everyday news, even our social media feeds, reminds us how hopelessly outgunned we are from the COVID 19 pandemic. It has turned the world upside down. But we can ease ourselves that a lot of people have recovered from the disease as well. A big factor on making the big leap to recovery is a healthy body and strong immune system.

Hot Tip #3: Positive mindset leads to good immune response

Positivity is a choice, so we should train our mind to see the good in everything. There may be more to it than just “think positive”. Let’s explore the science behind it.

When the coronavirus that causes COVID-19 first started to spread, virtually nobody was immune. With no resistance whatsoever, the virus easily spread one continent after another.

There is currently no cure. The antiviral drug, remdesivir, can reduce the mortality rate, but it is no magic bullet either. The novel coronavirus is an enemy that can’t be seen by the naked eye. Scientists believe a vaccine could be available in the fall of 2021 or maybe longer.

The past two paragraphs say negative things about the pandemic, right? Would you feel down about it and does this directly affect our overall health?

Numerous studies have demonstrated the intimate relationship between mental and physical health. A wealth of evidence in the past decade has shown that positive emotions enhance the immune functions. Negative emotions on the other hand, suppress them.

Some researchers have proposed that just like emotional responses, our immune response allows us to adjust to our ever-changing environment and that the two are linked.

Stressed out? Depressed? These are common and yet normal emotions at these trying times. Psychologists in the field of "psychoneuroimmunology" have shown that state of mind affects one's state of health.

The stress of any duration or situation that happens in real life, causes all aspects of immunity to go downhill as well. So in effect, long-term stress and too much emotional wear and tear, can ravage the immune system and in turn, damages our health.

Hot Tip #4: Workout and work wonders on your health

The fact is, exercise can make us healthy in a holistic kind of way. Exercise can lower your risk of getting sick. Exercise can reduce stress and release endorphins or the “happiness hormones”. The list goes on with benefits abound, but what’s the catch?

We have to pick the right exercise and we have to do it regularly in order to reap all its benefits.

Exercise activates our body’s fight or flight response, the sympathetic nervous system-- a pathway that increases heart rate, blood pressure, and breathing rate. That’s why we feel as if our heart is coming out of our chest when we exert an effort to workout.

The whole beauty of exercise is the release of hormones epinephrine and norepinephrine into the bloodstream. This enhances our body’s immune defense system as vital immune cells are circulated better to the areas where they need to be -- in the skin, lungs, gastrointestinal tract. Every time we inhale, touch or ingest viruses from the environment, our immune cells or soldiers should be in those battlefield—fast. Hormones released from physical exercise can help the immune cells respond faster, stronger. Time is of the essence when our body is dealing with a very tough, virulent, and I would even dare say, “smart” virus.

So why is exercise so important during the pandemic? For what used to be reasons for working out is plain and simple weight loss or “fitting in those jeans”. Now, more than ever, it is a matter of survival. This is because moderate exercise has beneficial effect on the immune function. Meaning, there is a compelling link between physical activity and the body’s defense system.

Being active can help us fight off infection. Physically active lifestyle reduces the incidence of communicable (bacterial and viral infections) diseases, implying that immune competency is enhanced by regular exercise bouts. Studies show that physically active people have a 40-50% reduction in the number of days they’re ill with acute respiratory infections.

COVID-19 is…. an acute respiratory infection. I am not saying that exercise excludes us from getting infected. Even fit people, athletes even, have gotten the disease. But regular exercise, specifically moderate aerobic exercise, improves our immune system. This consequently improves our health in leaps and bounds.

Hot Tip # 5: SLEEP is the golden chain that ties health and bodies together

This pandemic-riddled world has sometimes cost us our sleep. Like you, I wanted so badly for this nightmare to end.

I do confess of having less sleep or a decent night’s rest the past two months thinking too much of COVID-19. These thoughts were running through my head:

“Did I disinfect my hands enough to not bring the virus on our home and to my family?”

“Did I just bump with a COVID carrier back in the market?”

“Could one of my patients be a COVID suspect?”

The psychological stress brought about by the COVID-19 situation did not help.

Most people are still reeling from their loses. This could lead to confusion or worse, depression.

My piece of advice? If things seem out of your control and you cannot think of a solution, stop worrying. Stay positive and keep trying. Here is a beautiful bible excerpt from 2 Corinthians 12:10: “When you’ve done everything that you can do, that’s when God will step in and do what you can’t do.” Repeat those words of wisdom over and over again in your head. Trust me, you can sleep better at night.

Sleep just happens to be very important for our immune system to function properly. If we lack sleep, this would diminish our immune system’s ability to prevent viruses from entering and spreading throughout the body. Being vulnerable to viruses is the last thing we need right now as coronavirus rears its ugly head.

Sleep and immunity have bidirectional link. Sleep is considered an important modulator of the immune response. Studies have shown that the blood levels of monocytes, T cells, and Natural Killer T cells follow a clear circadian rhythm regarding the sleep-wake cycle.

Overall health and a full, robust Immune system is the key to this pandemic. The world needs a lot of healing right now as many countries still has rising numbers of COVID-19 cases and even death rates. We will just have to hope for the best.

But individually, the human immune system heals. We should focus everything we can get our hands on; every aspect of boosting our immunity.

Don M. Tinasas

Don M. Tinasas