What if you get COVID-19
Hello again,
I am writing because Covid-19 is coming closer to home with Mason county having 25 confirmed cases, Fredericksburg has had 5, and I see that Main Street Fredericksburg is bustling again. Are you like me, wondering if you are going to get the virus, and what you could do in advance of that?

Several new developments are noteworthy.

  • Very good news about easier and accurate antigen testing is on the horizon ... almost: Studies suggest that the virus begins being shed by day 3 after exposure and can go on to day 23 after exposure. However, after 14 days of the illness, contagiousness has already likely stopped. Getting tested has not at times been readily accessible, requiring a doctor's order, etc. So how do you know when to test and the best way to go about that? Now available in the northeastern states is an antigen test that is done from home. Using saliva, this test is as accurate as the other best test already available, which is the naso-pharyngeal swab test for the viral antigen. Finding the antigen confirms the presence of the virus RNA. This viral RNA is known to linger several days beyond the last date that a person is contagious. But with this test, if positive, at least there is a confirmation that the illness a person is having is Covid-19. The site that this at-home saliva test is ordered from is https://www.vaulthealth.com/covid. The cost is $150. But I have just tried to order this to have one available, and they are saying it is not yet being shipped to Texas. So we wait, and see what else develops. Rapid blood tests are available at some hospitals. For now, the local hospital is still where to go for testing - with a doctor's order.

  • Mixed news: there are antibody tests available which, if positive, show that a person has immunity developing. This is helpful. The problem comes if the result is negative. Only about 90% of patients who definitely had Covid will test positive. So, the antibody testing accuracy is not perfect. The numbers of available options on antibody testing that have not gone through the normal FDA certification is part of the problem as they have variable false positive and false negative rates. Local public policy and your doctor's opinion weigh in for deciding if someone can return to work, etc., and the use of antibody tests may be part of that decision. Knowing the timeline of exposure and length of illness and having had a positive RNA antigen test seem like the biggest help to me. How do you improve your chances of having an antibody test be positive, thus helpful? The antibody testing should not be done before having Covid for at least 7 days, and better yet 14 days as the sensitivity continues to go up by the 14th day of the illness. So, if you decide to get this test, just wait until you think you've had Covid for at least 7 days, and preferably 14. If positive, your doctor may say you are okay to return to "life." If not, being retested after some interval seems the best option.

  • The Institute of Functional Medicine is posting good resources, two of which are are here: General prevention and early treatment information go here

  • More specific information on various nutraceuticals that have a place in the prevention and treatment: go here

  • As mentioned in those two links, there is help. Patients who do badly have an "up-regulated inflammasome" which is common in people with chronic illness such as diabetics, hypertensive and obese patients. Studies are saying that adequate dietary potassium may help. So sweet potatoes, avocados and bananas are great sources of potassium.

  • Another development is that a nearly ketogenic diet is helping people have milder cases of Covid. The reason is complicated:) If you are a bit nerdy like I am, it has to do with the Omega 3 balance a person has.

  • I am taking several things personally designed to prevent viral invasion and to modulate my immune system. I am considering adding more because I have become aware of a correlation between a test that Great Plains Lab does called Pla2 or phospholipase A2 which, if elevated, indicates the possibility of having a rougher go should you get Covid. The data have come from testing done in cell culture in the lab, not in human trials, yet. However, in this study, if phospholipase A2 is inhibited, the viral replication is diminished. I am having my patients get that test done. And if positive we will do supplementation to specifically reduce that level...for a long time.

  • Other testing to discern if you are challenged in your own immune system are your white blood cell count on a simple CBC - needs to normal, not low. And CRP, a marker of general inflammation, if elevated, portends trouble if you are infected with Covid-19.

  • In my first email on Covid-19 readiness, found here in a document called Limiting Covid, I mentioned that folks should not be taking things such as oregano or caprylic acid for killing mold as it also weakens the microbiome. Just a further general word about nutraceuticals you might be taking.

  • There is a difference between the various supplements to strengthen an immune system that I mentioned for prevention in the last email, and the anti-viral agents available if you are infected which I did not emphasize. In prevention, the concept is to stimulate the immune system. Once infected, though, the biggest risk is the ARDS, the respiratory distress, that can set in from an "upregulated inflammasome." If a person gets Covid, and is deteriorating with shortness of breath, thinking its time to go to the hospital, further stimulating the immune system further is not desirable. At that point it is best to stop certain ones of the supplements you might be taking. Elderberry is an example, echinacea is another, mushrooms, another. Possibly vitamin D, especially if not balanced by Vitamin A.

  • Right now, supplements with antiviral capability are in short supply. I even had trouble getting good quality vitamin C. Zinc lozenges, astragalus, andrographis - all hard to find. Propolis is still available. I have a little bit on hand. Anyway, those are general thoughts for you on antiviral helps that don't stimulate the immune system.

I know this may have been a bit complicated. Sorry about that.

I am available for short virtual appointments as you try to plan your own regimen of protection/prevention against Covid-19. Adjustments to your supplement regimen would be the focus and possibly discerning a timeline of exposure/infection/testing, etc. Just email us or call the office at the number below to set those up.

More later, and stay well!

Dr. E
Suzanne Ellison MD