By Zaheer Shah for Minder
After coming on the Minder podcast/Instagram live session a week ago, I have been flooded with messages and questions about COVID-19. So the nice folks at Minder and I worked on an article for the community tab giving some clarity on a few things before the podcast comes out. We hope that this article brings you benefit and ease.
Living in the age of a pandemic is not easy. Worrying about the coronavirus can sometimes feel as hazardous as actually being infected by it. Predictably, under such circumstances, many will appear from the woodwork to offer various forms of snake oil to help reduce our likelihood of becoming infected.
I also want to emphasize that the cornerstones of our response to this pandemic remain the same: social distancing and prompt testing. I am aware that testing has been a challenge because of an insufficiency of test kits. I fear the delay in aggressive testing will have severe consequences for those most vulnerable in our society to this pandemic: the elderly and those with certain pre-existing conditions like diabetes, hypertension, and lung disease. Social distancing, too, in some circles appears to be controversial. One of the well-known Christian colleges in America has refused to practice social distancing and has chosen instead to continue operating the school as if we were not in the age of the pandemic driven by a virus that is transmitted via respiratory droplets from person-to-person. I fear that such a cavalier attitude too will have horrible consequences for those most vulnerable in our society. But have no fear, here are some tips for you:
The first lifestyle change that I recommend is the use of a cool mist humidifier. I recommend that each of us have a cool mist humidifier by our bedside so that it blows an arc of mist over the air that we breathe all night long. The benefit of such humidity is that it moisturizes the membranes of the upper respiratory tract. And moist mucous membranes are a potent defense against the attachment of both viruses and bacteria to the upper airway. Recall, that in the vast majority of instances, the coronavirus responsible for Covid 19 initially attaches to the mucous membranes that line the nares and other parts of the upper respiratory tract. Dry mucous membranes are far more vulnerable to such an attachment. So a cool mist humidifier is a simple, low cost intervention that can play a significant role in the first line of defense against such viruses: moist mucous membranes.
Long, hot, steamy showers every morning. Let the steam percolate up into the nares and the upper airway. Allow it to free bundles of mucus that may have trapped bacteria and viruses from the previous day and overnight and then take a small amount of warm water and inhale it into each nare and while holding the other nare closed, blow it right back out. Such nasal hygiene after a steamy shower can be a simple, mechanical method to expel extra mucus as well as any attached virus and bacteria out of the upper respiratory tract.
Understand the term aspiration. Aspiration is when you breathe foreign objects into your airways. Normally, when we swallow our orals accretions, or for that matter, food, there is a controlled swallowing reflex that ensures that the secretions and/or food particles entered directly into the esophagus and on the way down to the stomach. However, for a variety of reasons, on occasion, secretions or food particles can inadvertently enter the “wrong tube”, otherwise known as the trachea and thereby allow access to our lower respiratory tract. The virus responsible for Covid 19 has a manifest purpose of attempting to get into the lower respiratory tract. The principal method by which it attempts to do so relies on the likelihood of aspiration by its human host. So now that we understand what aspiration is and why this virus needs it’s human host to experience aspiration, the lifestyle change that I recommend is to avoid the use of sedatives. Sedatives can include opioids, benzodiazepines, and even antihistamines. Why? Because sedatives increase the likelihood of an impaired swallowing reflex which can result in a higher incidence of aspiration.
I recommend (since testing for Covid 19 has been problematic in most parts of the country), is the use of multiple pillows or a recliner to keep the head at about 45° if you are experiencing significant post nasal drip. Such recumbency may reduce the likelihood of inadvertent aspiration and as we know, it’s such aspiration that in most cases results in the more serious form of Covid 19.
Understanding the medical term known as the marginal pool. Just like our military has an active component as well as a reserve component, our immune system also has an active component that resides within our bloodstream and a reserve component known as the marginal pool that resides in our lymphatic system. During the age of a pandemic, our immune system must be optimized. Regular, vigorous exercise is a simple way to activate the marginal pool and push the reserve immune system out of the lymphatics and into our bloodstream where it can boost the overall immune function.
So in summary, the FIVE lifestyle changes to make in the age of Covid 19 are:
(1) Cool Mist Humidifier
(2) Steamy Shower and nasal irrigation
(3) Avoid unnecessary sedatives
(4) Sleep with multiple pillows or in a recliner ( when suffering significant post nasal drip)
(5) Daily, vigorous exercise
Best of luck and stay safe!
Zaheer A. Shah, MD (@the gutsymd).
Board Certified, Internal Medicine
Disclaimer: These lifestyle changes will not prevent COVID-19 and are meant only as ways to better your health and current living conditions.
