By now we’ve all heard and read about the current Coronavirus (SARS-CoV2) and the 2019 disease (COVID-19) that has infected about 2 million people thus far. [1] Every news and media outlet seems to be discussing this ever-changing topic sparking numerous debates, anxiety, and even fear across the globe. As the world scientists intensely search for a solution to this increasing pandemic, many governments are taking protective measures by shutting down schools, social gatherings, restricting travel and placing their communities on hold.

Numerous sites post precautionary steps to minimize risk exposure, including:

• thoroughly and frequently washing hands with soap;
• not touching face and rubbing eyes;
• staying home, and going out in public to only pick groceries and other essentials;
• maintaining social distancing (2 meters (~6.5 feet));
• practice cough etiquette and wearing a mask if showing symptoms;

Now, the overwhelming majority of information out there discusses the recommendations such as above in order to avoid getting coronavirus in the first place. But, very few details talk about what happens when you DO get the virus, which many of us will. In this article, we’ll take a closer look at the coronavirus, current statistics and suggestions on how to cope with the infection.

Please be advised, that this article (or any other article on this blog) is not a medical advice, and in no way intended as such. Seek medical assistance when exhibiting symptoms associated with COVID-19 or any other pathogen-like infection.

What is the Coronavirus?

Coronaviruses (CoVs) is a large family of viruses found in a variety of mammals and birds. There are hundreds of these viruses divided into four groups: alpha, beta, gamma and delta. The alpha and beta mostly reside in mammals, gamma infects birds, and delta can infect both. [2,14] The name coronavirus comes from Latin word corona, meaning crown or halo, which referenced to sugary type proteins found on top of virus’ lipid based outer envelope. The envelope covers a structural protein shell that protects and houses genetic material (in form of ribonucleic acids [RNA]) that decodes information for the virus to copy itself.

There are six zoonotic coronaviruses meaning that they can spread from animals to humans. Four of these coronaviruses cause flu type symptoms, while the other two can pose complications and linked to fatalities. [3] The two dangerous strains are called severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV). [3] For instance, SARS outbreak of 2002-2003 believed to originate in bats that transmitted to humans through civet cats. MERS outbreak of 2012-2015 also suspected to come from bats and passed to dromedary camel as an incubation animal before infecting people. [4]

The disease from this novel coronavirus is referred to as COrona VIrus Disease 2019 or COVID-19 for short. This virus was first reported in Wuhan, China in 2019 but scientists are still trying to trace the exact origin of COVID-19. It is beta type coronavirus and is very similar to the original SARS virus of 2002 outbreak. The viral genome sequencing of this novel coronavirus-19 had over 96% identity to the bat CoV suggesting the same ancestor and the name SARS-CoV2. [5,6,14]

SARS-CoV2 Infection and Incubation

SARS-CoV2 situation is rapidly unfolding, and so is the research of this expanding disease. Like other respiratory infections, coronaviruses can spread from person-to-person through droplets of saliva or discharges from the nose when coughing or sneezing. [7,8] The good news is that the droplets are too heavy to float in the air, and fall quickly onto floor and surfaces. The bad news, COVID-19 virus can survive in the air for several hours and live on certain surfaces (like metal/plastic) between 2 to 3 days. [9] So, keeping distance from others and always washing hands before touching our faces is a great practice to minimize the risk.

COVID-19 Symptoms

COVID-19 virus appears to be highly transmissible and infected can pass on the virus to others before showing symptoms. [10] These symptoms include: [11]

• fever;
• fatigue;
• dry cough;

As well as:

• body aches;
• congestion;
• runny nose;
• sore throat; and
• diarrhea.

Small percentage of population including elderly, people with pre-existing chronic conditions (ie: diabetes, high blood pressure, CVD, etc) and compromised immunity are at higher risk of developing complications to the COVID-19 and becoming seriously ill. Symptoms that may lead to possible complications may be:

• high fever;
• shortness of breath;
• difficulty breathing;
• chest pains.

COVID-19 Transmission Process

SARS-CoV2 must infect living cells to reproduce. Once inside the body, SARS-CoV2 attaches to our cells in the nose, mouth, throat and lungs. Its crown-like surface spikes used to connect to human cell receptor called angiotensin-converting enzyme 2 (ACE2), the same receptor used by the original SARS virus of 2002. [13] This works like a lock and key where the cell takes the SARS-CoV2 inside. Once inside, the viral envelope opens up releasing the genetic material which hijacks cellular machinery to make copies and assemble more COVID-19 viruses. Eventually the new viruses move out of the host cell, killing it in the process.

The symptoms discussed before can last anywhere between 2 to 11 days. [12] This long period makes SARS-CoV2 highly contagious, as the host showing mild or no symptoms can unknowingly infect others. Due to high infection rate that rapidly spreading over the globe, the World Health Organization (WHO) declared the novel 2019 Coronavirus a pandemic. To limit the rate of transmission many health organizations (including WHO) recommend social distancing (6 feet or 1.8 meters) and a 14 day quarantine for people showing symptoms. [7,8] The 2 meter (6 – 6.5 feet) is the safe distance for any airborne droplets to fall down on floor/surfaces rather onto another person’s facial and respiratory openings.

COVID-19 Stats

The statistical data continuously changes as this virus keeps on spreading. The variance in numbers (eg: death rate, infection rate, length of symptoms, etc) can be explained due to different calculating methods completed at different times of this pandemic and in different parts of the world. Thus far, here are some statistics:

• COVID-19 is a beta type coronavirus that binds to ACE2 receptor in humans; [13-15]

• It causes respiratory problems and is primarily spreads in people through water droplets by coughing or sneezing; [7,8,15,17]

• Average incubation (infection showing symptoms) of COVID-19 is 5-6 days, [12,15] but some reports show times up to 24 days; [15-17]

• Infection rate of COVID-19 varies greatly (depending on time and place of pandemic). The R0 (basic reproduction number) shows contagiousness of the virus. The averages for SARS-CoV2 RO move between 2.2 to 2.79, meaning every infected person will go and infect 2 to 3 other people, and so on; [15-16]

• Great majority of people (82%) will have mild symptoms when infected with COVID-19 and will recover without hospitalization; [15]

• Children don’t seem to be affected by COVID-19. Cases in children are rare with mild symptoms come to about 2.4% of total reported cases (aged under 19 years old). [15] Study of 425 COVID-19 patient found no cases under 15 years of age [16,17], and infected infants (under one years old) experienced mild symptoms without the need for intensive care; [15]

• Elderly (60+ years old), and people with compromised immunity or chronic diseases are in higher risk for developing severe complications from contracting COVID-19; [11,15-17]

• This virus is not without fatalities, and just as the infection rate, varies greatly. As the data continues to pour in, the average fatality rate appears to be between 0.7% to 3%. Fatal cases are predominantly elderly patients (80+ years old) and patients with preexisting conditions (such as cardiovascular disease, diabetes, chronic respiratory disease, etc); [14-15,17]

Immune Response to COVID-19

The continuous data on our immune response to SARS-CoV2 is coming back in waves and likely will continue so for some time. However, here’s what the laboratory results show thus far:

• Most patients show lower counts of numerous types of blood cells, including lymphocytes (Natural Killer cells, B cells and T cells). [14] B cells fight many pathogens (bacteria, viruses, etc) through production of antibodies, T cells produce signalling proteins cytokines which direct immune response towards infected cells and pathogens, while NK cells identify infected cells initiating a destruction process; [18]

• Patient’s immune system responds with inflammation through the increase of common inflammatory markers (like NF-kB, TNF-alpha, IL-6 and IL-10). Complications in patients raise levels of many other inflammatory factors (including IL-2, IL-7, IL-10, IP-10, MCP-1 and MIP-1alpha); [14]

• Majority of people will experience flu-like symptoms, lasting from several to 14 days. However, some may develop complications including pneumonia (moderate to severe form), acute respiratory distress syndrome (ARDS) and even sepsis requiring hospitalization and critical care. [14-17]

• Viral infection often activates many mediating and signalling molecules which at times can over-excite immune response. The infected cells signal for help may instigate a very large immune response often referred to as cytokine storm. [19] This was seen in SARS and Bird flu (H5N1) where the immune system doesn’t function properly resulting in over response. [20,21].

• COVID-19 is no different which infects mucus lining of the respiratory tract first before moving down trachea producing an overwhelming inflammatory response in form of a cytokine storm. The main marker here being IL-6 [17] showing in lung tissue damage. [14]

10 Suggestions to Ride Out the COVID-19 Storm

SARS-CoV2 statistics vary greatly from country to country, and region to region. Because of this rapidly developing data, it is difficult to predict the exact infection and fatalities for COVID-19 pandemic. [22-25]

If you’re experiencing high fever, difficulty breathing and/or chest pain, contact a health professional and follow their direction. Anyone with preexisting conditions should speak to their doctor, discuss possible concerns and a plan of action if infected.

The suggestions below would apply to mild symptoms discussed in this article. Such symptoms may overlap with flu or allergy reaction that display a respiratory inflammation. Recommendations focus on addressing mild physical symptoms while focusing on healthy habits and body energy. If these suggestions look like “home remedies” it’s because they are. The reason being as we’ll likely be confined at home while experiencing such symptoms.

1. Keep Common Essentials Handy

These include:

• Kleenex or any other tissue paper;
• Cough medicine of your choice;
• Vapour rubs (Vicks VapoRub, Tiger Balm, Bengay or other like ointments);
• Saline spray for nose sinus rinse;
• Salt water for gargling.

Salt shown to have an antiviral effect capable of reducing severity and sick period of the flu. One study identified a viral sample that causes common cold to made up of rhinovirus (56%), coronaviruses (31%), influenza A, enterovirus, parainfluenza virus type3 (PIV-3) and human metapneurmovirus (HMPV). [26] Using salt water solution to gargle and flush nasal passages three times per day significantly reduced duration of the cold by two days. Viral replication (also known as shedding) and transmission was also reduced by a third. [26] Salt solution is a convenient remedy that is simple to use and quick to prepare.

Cough and vapour rubs are common options to alleviate congestion symptoms.  With a 115+ year history including a major factor in the last 1918 flu pandemic, Vicks is the remedy marketed by Proctor & Gamble. [27] Mountains of Vicks research showcase symptom relief benefits in all age groups, much of which is financed by P&G. [28] This doesn’t necessary mean that results are incorrect, however reading the fine print clarifies possible draw backs and helps you decide whether this product is for you. For example, don’t place such ointments under noses of young children (under 2 years of age) as they may develop nasal inflammation further restricting airways. [27,29]

2. Shower and Breathe-in Steam

Steam baths have extensive history in numerous cultures including the ancient Romans (thermae), Finns (sauna), Russians (banya), Swedes (bastu), Turks (hamman) and Americans (sweat lodge). [31] Such traditions carry numerous health benefits that increase circulation, lower body inflammation, fight free radicals and reduce oxidative stress. [32] Cellular changes lead to improvements in nervous, cardiovascular and endocrine systems,[32,33] while reducing risk for chronic and respiratory tract diseases like pneumonia. [34]

Now, if you don’t have a steam or sauna room handy, a hot shower or simply inhaling steam can also help. Inflamed trachea results from mucus build up resulting in deep and continuous cough, wheezing or even shortness of breath. [30] Breathing steam from hot shower or leaning over a pot of hot water while draping a towel over head several times a day can loosen up the mucus build up and produce symptom relief. Also adding a drop or two of an essential oil (like eucalyptus) can further help in opening up clogged airways. In general steam inhalation can help with many sinus symptoms like headaches and reduce the use of over the counter medication. [35]

3. Tylenol vs Advil

In the mist of COVID-19 pandemic, it’s easy to assume that anyone with a cough, fever, sore throat or even muscle pain may be infected with the novel coronavirus. Common non-steroidal anti-inflammatory drugs (NSAIDs) containing ibuprofen (Advil, Motrin), naproxen (Aleve) and acetaminophen (Tylenol) are popular over the counter medications often used during the cold and allergy season to reduce various symptoms. However, recent reports raised concerns that ibuprofen type products (Advil) can worsen the effects and cause complications in COVID-19 cases. [36]

Social media ran with stories of ibuprofen’s potential side-effects and by mid March 2020 several government agencies (like World Health Organization) and France’s Minister of Health were issuing cautions against such products. On the other hand, National Institute of Allergy and Infection Diseases (NIAID) issued a statement of “no evidence of ibuprofen increasing risk or serious complication in COVID-19 cases”. [37]

As novel coronavirus keeps on spreading, so does the science of its mechanism. Ibuprofen concerns emerged as to:

1. process which all NSAIDs work, and
2. method that SARS-CoV2 enters the human cell using ACE2 protein receptor. [37]

Like other NSAIDs, ibuprofen reduces inflammation by inhibiting mechanism which produces prostaglandins (molecules that predominantly cause inflammation). The argument is that ibuprofen may “dampen” immune response by lowering prostaglandin levels and extending disease. However, all NSAIDs more or less effect this mechanism, not just ibuprofen. [37,38]

The other argument is that COVID-19 uses ACE2 protein to connect and gain entry to human cell, and some reports suspect that ibuprofen can increase the production of human connective enzyme (ACE2). [39] This “interesting” statement is not cited by the authors in a letter-article which was not peer reviewed. [39] In fact, we couldn’t really find any direct correlation between ibuprofen and ACE2 up-regulation, and all recent papers point to a single animal study on diabetic rats. [40] The study designed around ibuprofen’s compounding effect on chronic disease (diabetes), the animals were fed 40mg/kg daily doses of ibuprofen for 8 weeks resulting in cardiac fibrosis (thickening of the heart muscle and valve). [40] Now, this study was never replicated in humans. And, the doses used on small animals are about 1.7 times greater than maximum daily dose of six Extra strength Advil caplets (400 mg each) taken by 100 kg person. So, even though this study is interesting, it is not very relevant or conclusive in ibuprofen causality of COVID-19 progression and/or complication. At this time, there is no evidence to support this claim. [38] To air at the side of caution, have some Tylenol handy, and if doubt, always speak to a doctor.

4. Honey is Back on the Menu

Honey has been used as food and medicine since the ancient times. Made by honeybees from nectar of various flowers, honey is mainly sugar (fructose, glucose, maltose and sucrose) with trace amounts of several vitamins and minerals. [41] But, where honey stands apart is in numerous phytonutrients possessing powerful antioxidants, anti-inflammatory, antiseptic and anti-microbial properties. [41] The antioxidant content varies by the type of flowers bees visit, but these active compounds (like phenolic acids) make honey especially acidic dehydrating numerous bacterial strains and stopping their replication. [42] For instance, buckwheat honey increases antioxidant levels in our blood, [43], while manuka variety shown to be effective against various viruses (influenza), fungi and parasites. [44]

Spoonful of honey can soothe the sore throat and can even be more effective than common cough medication (diphenhydramine). [45] Add honey to warm lemon water or have it with tea. Diluted honey carries the same health properties and is more enjoyable. An old folk tradition is to combine tea with lemon and honey for a greater benefit.

5. Zinc Anyone?

The second most abundant mineral (after Iron [Fe]), zinc is an essential element which plays important roles within growth and development, expression of our DNA, and hundreds of enzymatic and messaging reactions. [46] It is vital in cellular building and development, function and regulation of the immune cells. [46,47]

Current estimate puts 2,000+ various transcription factors depend on zinc. These include the complex highways of inflammatory proteins responsible for production, maturation and activation of various immune responses (white blood cells). [47] As far as viral infections go, research is not consistent, with some showing that zinc supplementation can reduce cold-like symptoms and speed up the duration of infection. [46,48-49] Inconsistency could be when studying the “common cold” which encompasses variety of viruses (predominantly rhinovirus), which share similar infections periods and symptoms as coronaviruses or influenza. [48,49] However, zinc is a very important element for overall health and wellbeing which will help maintain our systems to ward off various  pathogens.

6. Get Your Vita-bet on with A, B, C and D

Vitamins are organic compounds which required for specific physiological function. Our body needs 13 vitamins: 4 fat soluble (A, D, E, K) and 9 water soluble (C + B complex). [61] Like many minerals, vitamins control and partake in many biochemical processes within every body system. Some vitamins like C and E also double up as potent antioxidants which control free radical population and reduce oxidative stress. Oxidative stress taxes the body and has been linked to chronic inflammation and numerous diseases. Vitamins (C and E) speed up the immune response against infection including viruses. [50]

Supplementing vitamin C can reduce the length of your cold, and even help with complications such as pneumonia. [50] When given intravenously, vitamin C has even greater effect on combatting infection from invading viruses, sepsis and acute respiratory distress syndrome (ARDS). [51] Vitamin E is a potent antioxidant which scavenges free radicals. [52] Besides being a mighty cell protector, vitamin E also enhances immune response that increases body’s resistance to all infections. [52] Some studies point to vitamin E as possible preventative measure of respiratory complications, reducing pneumonia (even in elderly smokers) between 69 to 72%. [53]

Vitamin D is made in our skin from exposure to sunlight and is an important part to our general health and protection against disease and infection. It’s essential in the immune response by increasing immune cells (monocytes, macrophages and lymphocytes [T and B cells]) while reducing inflammation. Vitamin D promotes autophagy (internal process of braking down non-functioning cells, enzymes, etc) which also increases antibacterial response. [54,58] Vitamin D can prevent acute respiratory infections and improve asthma symptoms. [55] After made in the skin, vitamin D is activated in the liver prior to body-wide distribution. The active vitamin D works as a natural antibiotic in the respiratory tract, destroying invading viruses, bacteria and other aerial pathogens. [55,56] The anti-inflammatory effect of vitamin D can also reduce cytokine storms, often seen in respiratory complications such as pneumonia, that mitigates immune response and destroying bacteria and viruses responsible. [56] This mechanism is especially interesting in current COVID-19 studies. [57]

Vitamin A is made and stored in the liver from two common precursors that we eat from diet. It is best known for its role in vision and overall eye health while being a potent antioxidant. However, vitamin A has many other benefits. It is important to health and upkeep of many structural tissues (skin, eyes, heart, lungs, intestines) [59] including influencing growth, maturation and activation of various immune cells (NK cells, macrophages, white blood cells). [60] Vitamin A and D appear to have an inverse relationship, controlling each other’s levels and activity. [58,60]

Vitamin B is actually class of 8 different compounds (B1, B2, B3, B5, B6, B7, B9, B12) that engages in wide range of biochemical activity. They are big participants in digestive process and conversion of materials to energy, maintaining optimal organ (ie: brain) function, constructing genetic materials and numerous specialized cells (red blood cells, hair, skin, nerve cells). [60] B6, B9 and B12 have also shown important in all parts of the immune response. [60,61] B6 – pyridoxine appears especially vital in enhancing activation of immune cells, including in critically ill patients. [60]

7. Load up on Polyphenols

Polyphenols are naturally occurring compounds in plants. They are mighty antioxidants which not only fight free radicals and oxidative stress but also numerous chronic diseases through their potent anti-inflammatory, anti-bacterial and anti-mutagenic properties. [62,63] Polyphenol’s popularity and usage is soaring higher than ever, due to their application by some countries during the current COVID-19 pandemic. In China, hospital doctors have been prescribing combination of Western and traditional Chinese medicines as part of the therapy to treat COVID-19 patients. [15,64]

For instance, Shufeng Jiedu Capsule (SFJDC) is a traditional Chinese medicine used to treat acute upper respiratory tract and lung infections including conditions such as pneumonia. [64] For over 30 years, SFJDC has been used for its anti-inflammatory, antiviral and antibacterial properties. [65] The 8 herbs that make up SFJDC contain over 27 active ingredient predominantly made up of polyphenol subgroups like flavonoids, stilbenes and lignans among others. [66] Active ingredients like resveratrol, emodin, rhein, quercetin, rutin, kaempferol, anthraquinone, hastatoside, verbenalin, forsythoside A, phillyrin, liquiritigenin and liquiritin among others fill up the list of SFJDC. [65,66]. Together, they effectively control key inflammatory factors (NF-kB) and signalling pathways (MAPK/ERK, PI3K-mTOR) leading to reduced inflammation, improved immune response and reduction of infection. [63-66].

The same active compounds in SFJDC has also been identified in variety of fruits, vegetables, spices and herbs. The father of modern medicine Hippocrates often quoted saying, “Let food be your medicine, and medicine be your food”. Polyphenols from plants affect key factors (such as IL-1beta, IL-6, TNF-alpha) in overall inflammation response leading to improvements of various chronic and metabolic diseases. [62-63,69] And, spices have the highest concentration of many of these potent polyphenols and much more. [67,68] For example, active ingredient of star anise shikimic acid used to produce antiviral vaccine Oseltamivir (also known as Tamilflu, a drug used to treat H5N1 bird flu). [70]

Besides, potent antioxidants, plants have a full micronutrient profile consisting of elements and minerals necessary for all of metabolic activity and optimum health. So, have some salad, fruit salad or both. If fatigue like symptoms leave little energy for prepping meals, simply throw some greens and fruits into the blender, add some spices and herbs, blend and enjoy the goodness.

8. Tea for Me

While on the topic of polyphenols, teas offer a great option for getting some active ingredients in an easy and simple way. Tea is a good source of polyphenols, particularly flavonoids. The main polyphenols in tea catechins offer numerous health benefits for digestive tract and organ functions, and have been used to treat many acute and chronic infections. [71] Research shows catechins combat variety of viruses and other pathogens, and regular consumption of teas (green variety) lowers the risk of developing virus related colds altogether. [72] So, keep it interesting with some tea. There are many delicious and flavourful options available but, always opt for ones with whole ingredients without added flavours and sugars. The warm liquid soothes the throat and comforts the body while reducing symptoms of viral based infections. As always, adding some spices and herbs to the mix, will further enhance the flavour and health benefits.

9. Stay Hydrated

Humans are made up of about 65% water as it is vital to our life and wellbeing. Water occupies our every cell and is used in all main biochemical and energy driven processes. Viral infections increase immune response with inflammation resulting in symptoms like fever. This raises our metabolism resulting in water loss. If we forget to replenish liquids, we may run the danger of mild dehydration which affects all body functions including the ability to fight off infections. [73] There are no direct studies showing whether viral infections indeed cause us to lose more water [74] however, numerous government health agencies advise to keep up our fluid intake during sickness period. [75]

So, water, 100% orange juice, coconut water or electrolyte type of drinks are all good options while battling flu-like symptoms. Chicken noodle and bone broths offer even greater nutrient content while providing plenty of liquids.

10. Catch some Zzz’s

The last but not least is rest. Not only extra rest minimizes the spread of viruses to others, but it also speeds up the recovery process. In fact sleep and immunity are closely related. During rest, especially sleep, the body is fully engaged in fighting the infection and diverts many of its energy into immune efforts. [76]

On the other side, poor sleep habits makes us more vulnerable to viral infection. Little sleep reduces functionality of several immune cells (T cells) that recognize and destroy viral-infected cells. [77] Other parts of the innate (initial) immunity are also negatively impacted by inadequate rest increasing the risk of infection. [78] This includes less inflammation, as certain parts of sleep are either interrupted or not achieved resulting in reduction of numerous inflammatory cytokines. [78] Therefore, take some time, relax and get some sleep.

Final Thoughts

The novel coronavirus (SARS-CoV2) is a class of highly contagious pathogens which causes COVID-19 disease and has been deemed a pandemic. First reported in mainland China, COVID-19 has since moved across the globe infecting over 2 million people thus far. Majority of cases showed mild symptoms of fever, sore throats, and fatigue, but elderly and immune compromised individuals are at a greater risk for developing complications (such as pneumonia) to COVID-19.

To minimize infection rate, social distancing and personal hygiene is greatly encouraged. People who believe to have contracted SARS-CoV2 should speak with their doctor and seek medical attention. For overlapping flu-like symptoms, it is advised to stay home and self isolate. While at home, some recommendations discussed in this article will serve as a good foundation to fuel the body with nutrients and rest enhancing an immune response.

If you’re experiencing high fever, difficulty breathing and/or chest pain, contact a health professional and follow their direction. Anyone with preexisting conditions should speak to their doctor, discuss possible concerns and a plan of action if infected.

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