“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. Read the rest of this entry »
The state of ‘being’, sought by all and yet when obtained, is generally all too temporary, is that of ‘happiness’. How are you in its pursuit and attainment?
In the 2020 World Happiness Report the authors note that in the face of a pandemic where the social fabric is not strong enough to support co-operative action on the required scale, then fear, disappointment and anger add to the happiness costs of a disaster. There are few people that have not experienced these costs over the last few months. (Practical, safe solutions are described at the end!) Read the rest of this entry »
In the late 1650’s, the French polymath and renowned scientist Blaise Pascal, having undergone a religious experience that transformed him into something of a zealot, suggested the following logical strategy regarding belief in God: If there is a God, then believing in him will ensure you an eternity of bliss, while not believing in him could earn you an eternal sentence to misery.
On the other hand, if there is no God, believing in him anyway will cost you very little, and not believing in him will mean nothing in the non-existent after life. Therefore, the only sensible bet is to believe in God. This has come to be known as Pascal’s Wager.
The wager has a surprising number of applications beyond concerns for a comfortable afterlife. There are many things for which the value of believing something or not can be utilised as a ‘cost-versus-likely-benefit’ wager, often without regard to the actual truth of the matter.
Since science does not profess to have a final truth, and in many areas freely admits its incomplete knowledge, Pascal’s wager can provide a useful method of deciding between two alternatives. In this article it is the validity of the Sars-Cov-2 virus as a causative agent of global illness and the benefit or not of two of the most common non-pharmacological strategies and lifestyle proposals for its related management. Read the rest of this entry »
As is typical at the beginning of a New Year, there are numerous opportunities and encouragements to engage with life affirming, changing, or accelerating lifestyle related programmes.
Yet for most of us right now, we instead must manage several unwanted challenges, changes in lifestyle and family life brought upon us by the SARS-Cov-2 virus and its current variants. Read the rest of this entry »
As we come to the end of a very different year, it is common practice to look back on events. Obviously the Sars-Cov-2 virus has featured heavily so let’s do a quick review:
Based on collated data from research and observational studies since Feb 2020 it is well understood that the SARS-CoV-2 virus spreads most efficiently among unmasked adult speakers who spend time together in close, unventilated indoor spaces. More so, if when in that space, they insist on talking to each other!
It is also clear that the virus can spread through nonverbal activities. Sneezing and coughing produce virus-encased globs of spittle, and even heavy breathing, especially during a run or vigorous activity, can spray aerosolised droplets that can linger in the air before slipping inside a person’s nose or mouth. Read the rest of this entry »
As we progress towards a staged release of constraint on movement, interaction and social engagement, there are quite naturally discussions about the potential impact and risk of increased exposure.
Mortality rates have dominated discussions, so far, the global death toll of Covid-19 is estimated at 1.4m. Deaths are now running at a little under 10,000 a day or about 3.5m a year. If this were maintained, cumulative deaths over the first two years might reach close to 5m, or just over 0.06 per cent of the global population. To put this in context, the Spanish flu, which emerged in 1918, lasted 26 months and cost somewhere between 17m and 100m lives, or between 1 and 6 per cent of the then global population. However, as feedback from infected people who survive builds, there is a growing appreciation for the impact of post infectious morbidity, duration and intensity.
Substantial long-term morbidity is at least possible, as the Sars Cov-2 virus enters pulmonary and brain tissue and causes cardiac dysfunction. Read the rest of this entry »
On the 9th November 2020 promising results from a vaccine candidate against Covid-19 were announced by Pfizer and its partner, the German company, BioNTech. They stated that their candidate vaccine (BNT162b2 (modRNA)) was “more than 90 percent effective in preventing Covid-19 in participants”.
Whilst there have been substantive funds poured into vaccine development in the UK, EU and USA, Pfizer were quick to clarify that they funded the research with their partner independent of governments’ support. In July, Pfizer negotiated a $1.95 billion deal with the US government’s Operation Warp Speed, the multiagency effort to rush a vaccine to market, to deliver 100 million doses of the vaccine. The arrangement is an advance-purchase agreement, meaning that the company will not be paid until they deliver the vaccines. Delivery itself appears to be a significant challenge as the Pfizer vaccine needs to be kept at minus 70 degrees Celsius (-94 F) or below.
A week later, the 16th November, Moderna presented similarly promising preliminary results. Moderna recruited 30,000 volunteers across the United States to participate in its trial. A quarter of the participants are 65 years or older. White people make up 63 percent of the volunteers; 20 percent are Hispanic; 10 percent are Black; and 4 percent are Asian Americans. The United States government provided $1 billion in support for the design and testing of the Moderna vaccine and an additional $1.5 billion in exchange for 100 million doses if the vaccine proved to be safe and effective. They have proposed that theirs requires less stringent temperature controls.
Data is thin on the duration of benefit and the effects in differing age groups and safety are a way off being clarified. Encouragingly, the Pfizer trial has not reported to date any severe “adverse events” in the 43,500 trial participants, Moderna has yet to release their findings. While most vaccine-associated severe reactions occur shortly after vaccination, it will be important that trial participants and those vaccinated following licensures are closely followed to ensure that the benefits of receiving the vaccine outweigh any risks.
Importantly, the data released by Pfizer on November the 9th and Moderna on the 16th were delivered in news releases, not a peer-reviewed medical journal. It is not conclusive evidence that the vaccines are safe and effective, and the initial finding of more than 90+ percent efficacy could change as the trials go on.
BioNTech and Moderna have purposed a technology that has never been approved for use in people until now. They take genetic material called messenger RNA and inject it into muscle cells, which treat it like instructions for building a protein, a protein found on the surface of the coronavirus. The proteins then modulate innate and adaptive immunogenicity and are believed to confer long-lasting protection against the virus.
Ten other vaccine makers are also conducting big Phase 3 trials, including efforts in Australia, Britain, China, India and Russia. More than 50 other candidates are in earlier stages of testing.
Phase 2 preliminary results data published in the Lancet on the 18th November 2020 on the single blind Oxford ChAdOx1 nCov-2019 vaccine study shows that it triggers a robust immune response in healthy adults aged 56-69 and people over 70.
Whilst further data needs to be examined, it appears to be a developing narrative, that the immune system responds to at least three triggers – non vaccine expose, vaccine trigger via lipid particle mRNA generation of immunity and adenovirus-vectored vaccine which contains a pathogen-specific transgene.
ChAdOx1 nCoV-19 is a replication-defective chimpanzee adenovirus-vectored vaccine expressing the full-length SARS-CoV-2 spike glycoprotein gene (GenBank accession number MN908947).
In a move to shore up public confidence around the novel development of the vaccine, and after criticism from outside researchers, Pfizer and other companies took the unusual step of releasing their trial blueprints, known as protocols, revealing typically secret details about how it was evaluating its vaccine. Public confidence in the drug companies’ findings and regulators rigour and independence will be critical in persuading populations to consider the merits and get vaccinated.
Pharmaceutical companies have had their reputations severely damaged due to multiple failures of policy (fraud) as well as medicines. Quite understandably there is anxiety about the proposed vaccination of billions of people. Albeit, initial >90% efficacy outcomes are likely to persuade people far more than the anticipated 40-50%.
There is precedent for a greater type of transparency. The large Recovery trial run by the University of Oxford, which helped determine that the steroid dexamethasone reduces deaths in patients with Covid-19, has published its trial protocol and statistical analysis plans, helping clinicians and the public understand the assistance it offers.
Nutrients and Immunity
What we can be relatively clear about, is that Immunity is a multifaceted phenomenon. The concept of the herd immunity threshold, which refers to the fraction of the population that needs to be immune to prevent an ongoing epidemic spread of an infection, has been a major focus of research and extensive discussion since the early days of the SARS-CoV-2 pandemic.
The herd immunity threshold is reached when an infected individual infects fewer than one other person, on average. For a novel infection for which there is no pre-existing immunity, herd immunity can be generated either through infection with the pathogen or through vaccination. The primary mechanisms for developing resistance and immune memory relies on the development of antibodies and T cells with existing viral familiarity and related cytotoxicity.
Although much remains to be understood regarding the immune response to SARS-CoV-2, and how vaccine-induced protective immunity may differ from natural immunity owing to the immune-evasion strategies of the virus, an improved understanding of the natural immune response will be instrumental in developing effective vaccine and therapeutic strategies. One of which we can easily integrate into our clinical care, namely the provision of adequate nutrients required to offer both natural and vaccine induced immune development, and safely.
Adequate and appropriate nutrition is required for all cells to function optimally and this includes the cells in the immune system. An “activated” immune system further increases the demand for energy during periods of infection, with greater basal energy expenditure during fever for example. Thus, ‘optimal nutrition’ for the best immunological outcomes should be nutrition and supplementation, which supports the functions of immune cells allowing them to initiate effective responses against pathogens but also to resolve the response rapidly when necessary and to avoid any underlying chronic inflammation.
The immune system’s demands for energy and nutrients can be met from exogenous sources i.e. the diet, or if dietary sources are inadequate, from endogenous sources such as body stores. Some micronutrients and dietary components have very specific roles in the development and maintenance of an effective immune system throughout the life course or in reducing chronic inflammation and can also be supplemented exogenously.
Healthy eating, exercise, sleep, stress management, vitamins, minerals, fatty acids, and other natural agents can help mitigate the seriousness of diseases and health conditions, and even protect and save lives. The distinction that needs to be made, though, is what good nutrition, lifestyle and supplements cannot do is to stop a virus or bacteria from infecting people but is an “essential component” of outcome determination.
In terms of determining nutrients that confer a benefit on vaccination (including those approved for Covid-19) it is necessary to draw on prior work, as there are no current vaccines to test against. As may be expected Vit D status has an impact on tolerisation, and may be of particular importance for older people. Zinc, A and E deficiencies have been noted to diminish benefits from vaccination in younger patients. Further work shows that Vitamin C, B vitamins, Copper, Selenium, Iron, Probiotics and EFAs are all required to ensure best response patterns to infection and vaccination.
To Vaccinate or Not
The WHO recognises that vaccine hesitancy is a global challenge, and is nothing new. As we are likely to be asked to consider multiple vaccine candidates in a short time frame, this uncertainty it is going to create natural barriers to public acceptance.
Where we are presently, is that whilst there are many factors yet to be qualified regarding immune generation via a vaccine, a healthy and adequate nutrient status is a clinical benefit not a risk. If you have family or friends looking to receive a vaccine, the message is clear, there is a better outcome from efficiency and reduction of risk in those people with suitable micronutrient status than in those without.
Microbes are big news, bigger than any other health related story for decades including Aids and Ebola. The Coronavirus (Sars-Cov-2 and Microbe No 1) has dominated popular, political, and scientific discourse for months.
The related pandemic as defined by the WHO on the 11 March 2020 is also challenging our bodies and minds in obvious and hidden ways. For, while protecting ourselves from unwanted exposure to the Sars-Cov-2 virus and limiting risk of infection, some people have begun to fear all microbes, regardless that many are beneficial for human health.
Humans, as we already know face rising rates of allergies, food intolerances, inflammation, auto-immune diseases, metabolic disorders and gut-brain conditions – negative health trends that are already entrenched in most societies and linked to a changing relationship with our various microbiomes and diet. Read the rest of this entry »
“Our ability to mitigate disease emergence is undermined by our poor understanding of the diversity and ecology of viral threats.”
Whilst the burden of non-communicable disease (NCD) dominates health and disease globally, its progress through the population is slow, providing opportunity to intervene, reverse and restore health in many cases.
Infectious disease rarely provides such a time related opportunity and depending on a variety of factors can induce rapid local, national or as we have all seen international responses, that we would never see regarding NCDs. For most of us, witnessing the political, economic and societal strains brought about by this recent event can promulgate anxiety, and varying opinions. Yet zoonotic infections on a global scale have been predicted for many years by infectious disease specialists (which has included Disease X), but mostly ignored by governments and the public. Read the rest of this entry »
The challenge for everyone either resisting or managing a SARS-CoV-2 related infection appears to centre around the ability to determine the validity of the data sets used, and those that are available.
Most people, until the last few months, have had very little personal experience with the use of testing for infectious diseases. Until the last few months in the UK most people were dealing with the adverse consequences of non-infectious diseases, the ones that dominated global health news until just recently.
Infectious disease specialists it seems were wheeled out for short term fearful and nerve-wracking infectious agents such as Ebola and SARS, but then disappeared to their labs or areas of investigation. Read the rest of this entry »