Published 17th February 2021
“When diet is wrong, medicine is of no use; when diet is correct, medicine is of no need.”
The shift in messaging since the allocated timeline for 15m vaccinations was achieved in the UK, is a fascinating process of dialogue and development. One can imagine that numerous pressures are being experienced from scientists, physicians, economists, business owners and us as to how to look ahead and to present a changing landscape of risk analysis.
Back in the reality of what we can each do to ensure resilience in the face of exposure and or recovery from Sars-Cov-2 (and its variants) the key message is still being stifled. Non pharmaceutical interventions (NPI) remain an important part of transmission risk reduction. However, outside of the familiar refrains, relatively little, to non-existent discussions are directed towards nutrition and lifestyle imperatives. There are many explanations and accusations as to why, but the reality is probably far less menacing than some would like us to believe.
KNOWLEDGE TRANSFER CAN BE SLOW
You see, decision makers (politicians) have very little understanding about the role of the immune system and its essential requirement for the provision of core nutrients, appropriate lifestyle support and the relative safety of recommendations and their low cost of application.
As public health policy is, and must be a broad-based approach, nuance is often lost and notions such as the recommendation for the daily supplementation of vitamin D can be lost in the noise of public debate and limited attention span. This means that the education of family and friends, colleagues and patients tends to be done one at a time, and the process, much like the delivery of immune supporting practices, must take place steadily and methodically.
The impact of a global infection has meant that many people have a better understanding of the human immune system, that it has a fast-acting nonspecific element, as well as a memory-based system that both defends and retains details to mount future faster counter attacks.
A MOVING TARGET
Wild type exposure and vaccine induced exposure facilitate immune resilience and recognition, sometimes at a cost to function and with varying degrees of quality. To make matters more challenging, viruses, mutate to counteract these remarkable cells, twisting their genome into ever more contorted shapes to ensure survival. Again, and again, the new coronavirus has sloughed off small chunks of its genome, leading to changes in a viral protein that is frequently targeted by antibodies.
A GROUP OF CORONAVIRUSES THAT SHARE THE SAME INHERITED SET OF DISTINCTIVE MUTATIONS IS CALLED A VARIANT. IF ENOUGH MUTATIONS ACCUMULATE IN A LINEAGE, THE VIRUSES MAY EVOLVE CLEAR-CUT DIFFERENCES IN HOW THEY FUNCTION. THESE LINEAGES COME TO BE KNOWN AS STRAINS. COVID-19 IS CAUSED BY A CORONAVIRUS STRAIN KNOWN AS SARS-COV-2.
But your immune system is not doomed to be discombobulated by a never-ending barrage of shape-shifting variants. For every trick the virus plays, the immune system arguably has an equally impressive one. It can adjust and re-invent, restructure, and provide a more consistent resistance. But…. To do this it needs raw materials, nutrients and self-care. Understanding how to use these in the current and future management of immune capability is a knowledge base likely to free yourself from adverse exposure related outcomes.
Initial vaccine candidates are the older, more vulnerable population, individuals who are themselves likely to be nutrient deficient and experience related immune deficiencies. They need guidance, recommendations and supplementation. Others due to receive vaccination also need to ensure their nutrient status is maintained in the optimal state so that variations may be countered with quick to adapt B and T cell responses. Ignoring this simple safe point of optimisation; that vaccination or wild type exposure immune responses need nutrient availability, will serve to undermine much of the hoped-for benefits.
BIG WAVE OF INFECTION
There have been various pre-vaccination proposals regarding the development of ‘herd immunity’ in the population, with some of the more vocal/optimistic proponents appearing to favour an elderly related early demise (bordering on social eugenics) over societal respect and care. Clearly economic compressions also have a significant consequence and with the development of a vaccine plan, the previously impossible, is now being viewed as plausible. In effect there is now the discussion; what level of risk and related outcome is acceptable and manageable?
If the at-risk population, has a significant drop in infection related hospital required support, running high levels of infection may be manageable, something like that seen in the annual flu management recommendations. But what if we could add comfort and explain to the many still unaware of the opportunity for cheap safe immune support that they could be part of the long-term solution.
Many people are longing for social interaction including heading for the pub. Whilst social drinking may be attractive to many, it does the opposite of nutrient optimisation, but carries a news message of high attention! Providing a personal choice of immune enhancement message, to protect and support individual and societal responses is a public health message that needs to get ahead of the drinks, drugs, and vaccination combination.
Supplementary and complementary treatments are needed, for prevention as well as treatment of already established infection, and to cover absence, delays and intolerance of vaccines, vaccine failures, and vaccine resistant viral mutations.
POST-COVID-19 SYNDROME (FKA LONG COVID)
Outside of the acute intensive care scenario, there is the post infectious constellation of symptoms currently classed as Post Covid-19 Syndrome. It usually presents with clusters of symptoms, often overlapping, which can fluctuate and change over time and can affect any system in the body.
Like many syndromes, it comes with numerous patters of onset and recalcitrant outcomes. It’s likely that sequential pathways of immune, inflammation and oxidation are ‘re-set’ in the face of infection, and will require a functional or integrated approach to optimise the pace of recovery and recalibration of energy sapping defence production.
Pandemics are natural events that are both foreseeable and foreseen (Remember disease X, and think of Y and Z). Nonetheless, an indifferent external observer could be forgiven for thinking that, for many, this pandemic represents a wholly novel event for which there can have been no intelligent preparation or coherent planned response. In part this is due to sequential governmental disassembly of the required resource, but it is also due to a public health policy failure to create the environment to favour self-health generation. Or, if inclined towards the more conspiratorial notion, you may consider that it was all planned to be this way!
It has become obvious that the underlying health issues that lead to highest mortality in COVID patients are largely (not wholly) self-inflicted through lifestyle choices and appear at a base biological level, to be related to a failure to maintain redox homeostasis under oxidative stress conditions. In simple terms, the people most likely to experience an adverse outcome are older, eat too much (which oxidatively stresses our metabolism), do not move about enough, and maintain lifestyles that impact on redox, inflammation and immune disturbance. Billions of pounds/dollars have been spent on research discovering these truths, so why does it appear the public health messaging is unable to find a way to put what we have learned about healthy lifestyles into practice?
Looking around the world for an example of preparedness and social resilience, the small country of Bhutan is an interesting model. A tiny, poor nation best known for its guiding policy of Gross National Happiness, which balances economic development with environmental conservation and cultural values. It only recorded its first death from Covid-19 on Jan 7 2021!
This small nation has to date demonstrated that pandemic resilience, evolves from things that we do not count normally, like social capital and the willingness of society to come together for the common good. It’s possible that richer nations and others can extract some useful data from these numbers and their experiences, as well as discuss whether their ‘happiness index’ is linked to cultural and societal willingness to cooperate with the States recommendations.
As the European Food Safety Authority recognises, the vitamins A, B6, B9, B12, C and D and the minerals zinc, selenium, iron and copper are all needed for the immune system to function as it should. Research has regularly demonstrated a link between an impaired immune system and low amounts of many vitamins and minerals.
When the immune system is not properly fuelled and is impaired, this can then lead to poor vaccine and wild type infection responses. For example, a review of nine studies – together involving 2,367 people found that individuals deficient in vitamin D were less well protected against two strains of flu after having been vaccinated compared to those who had adequate vitamin D levels.
A more recent paper (preprint by the Lancet) published on the 22nd Jan 2021 shows a significant reduction in risk with patients taking Vitamin D3. The research, published by the Social Science Research Network, found Covid-19 patients given doses of Vitamin D3 were 80 per cent less likely to require ICU treatment.
This supports the conclusion of a prior pilot trial in Cordoba in which vitamin D3 led to a reduction of more than 50 per cent of ICU admission in hospitalised Covid-19 patients.
Whilst this issue of nutrient insufficiency disproportionately affects the elderly, it is not limited to older age groups. The 2019 UK National Diet and Nutrition Survey showed “a sustained worsening of the dietary intakes and chronic shortages of several of the nutrients involved in supporting the normal immune functions” across all age groups. The micronutrients people lacked included vitamins A, B12, C and D and the trace minerals zinc, selenium and copper – all of which are needed to operate in equivalence, to avoid the Bruce Ames adverse triage effect.
OPTIMISING COVID-19 VACCINE AND WILD TYPE EXPOSURE EFFICACY BY ENSURING NUTRITIONAL ADEQUACY.
Given this, an article published in the British Journal of Nutrition on the 28th Jan 2021, summarises how to optimise vaccine (and by consequence wild type exposure) efficiency with nutritional supplementation. It concludes that all those at risk of nutritional insufficiency should take a supplement containing the recommended daily allowance of nutrients important to immune function for a period of weeks before and after they receive the vaccine. People who could benefit from this include the underweight elderly, those on restricted diets, (the population of the UK who consume less than ideal intakes of fruit and vegetables)and certain BAME communities who may be at risk of vitamin D deficiency.
Essentially pretty much everyone!