COVID-19

Please practice the following measures to do your part.

The COVID-19 virus has posed a serious threat to our community at large. Please understand that it is very important to take all measures suggested by state and local authorities and the CDC. Everyone has to do their part to keep themselves and the community at large safe.

Ageless Integrated Medicine is committed to the health and well-being of our patients and staff. At the beginning of the COVID crisis, our office quickly implemented CDC guidelines to protect us all.

Below are ways we are ensuring that our facility is safe.

We require all employees, patients and visitors to wear masks. We provide masks to those who do not have one.
We screen employees, patients and visitors as they enter our office for any symptoms. Anyone who is not feeling well is asked to stay home.
We ask patients to wait in their cars until notified by staff to enter the office. Patients are taken directly to exam rooms.
We have limited appointments available, and our waiting room remains partially closed to allow for proper social distancing.
We have posted reminders throughout our office on how patients and visitors can help stop the spread of the virus.
We clean and sanitize spaces and equipment after each patient encounter per CDC guidelines.

Thank you for your patience as we increase our capacity for appointments and re-introduce services to our practice. Your health and safety remains our top priority.

Please practice the following measures to do your part:

Avoid shaking hands when meeting people.
Maintain social distance of 6 feet from others. While interacting keep interactions to a minimum period of time.
Wash your hands with soap and water often by scrubbing your hands thoroughly for at least 20 seconds. Use hand sanitizer when washing with soap is not possible.
Cover your cough with your elbow or a tissue.
Avoid any in-person meetings unless it’s an emergency or you’re seeking medical attention.
If you are feeling sick, stay at home. Don’t go to work or school if you are a student.
The symptoms of COVID-19 can mimic the flu but there are some symptoms that can increase suspicion of COVID-19.
Many people report loss of smell and taste. Additionally, fever, cough, shortness of breath, nausea, vomiting, and diarrhea serve as other major symptoms.
If you or someone else at your house has cough or shortness of breath that gets worse, seek medical attention immediately.
If you have come in contact with someone who tested positive for COVID-19, inform your medical provider and stay home (self-quarantine) for 2 weeks.
If you or any of your family members have serious lung or heart disease, stay home and away from others.

Enhacing Your Immunity

The COVID-19 virus has shown that it is capable of mutations. Hence making a vaccine that will cure COVID-19 seems difficult to achieve. Therefore our best strategy against COVID-19 is to enhance our immunity level and avoid exposure to higher viral loads.

In addition to regular hand washing, social distancing, stopping non-essential travel, some studies show natural supplements may be effective against certain viruses.

The COVID-19 virus has been shown to trigger inflammation and release proinflammatory cytokines IL-1B and IL-18 which is responsible for ARDS (Acute Respiratory Distress Syndrome). The following strategies can reduce risk:

Adequate Sleep

Lack of sleep for less than 5 hours a night increases the risk of infectious diseases. Sleep deprivation increases CXCL9 levels, which increases accumulation of lymphocytes in tissues. Adequate sleep also ensures the secretion of melatonin, which plays a role in reducing the virulence of the coronavirus.

Stress Management

Increased psychological stress has been shown to increase pro-inflammatory cytokines such as IL-65, thereby increasing inflammation. Various strategies including meditation, breathing exercises, guided imagery, etc. reduce stress, and CRP (marker of inflammation) thereby curbing the increase in inflammatory cytokines.

Zinc

Zinc has shown to inhibit the entry of the coronavirus into the cells of the upper respiratory tract and thus reduces it’s virulence. The recommended dose is 30 mg to 40 mg a day. Some patients who take more than 40 mg can experience diarrhea.

Vegetables and Fruits

Many flavonoids have been found to reduce inflammation. At least 5 to 7 servings of vegetables and 2 to 3 servings of fruit a day can work as an anti-inflammatory diet.

Chinese skullcap
Licorice
Onions and apples
Tomatoes, nuts, and berries
Chamomile, parsley, and celery

Vitamin C

Like the flavonoids in fruits and vegetables, vitamin C inhibits inflammation in the tissues like the lungs. Vitamin C also reduces the frequency, duration, and severity of the common cold and the incidence of pneumonia. The recommended dose of vitamin C for this effect ranges from 500mg to 3000mg daily. Patients with active infection can benefit with even higher doses.

Melatonin

Melatonin has been shown to reduce inflammation in the lungs due to the COVID-19 virus. This explains why children don’t have severe symptoms like older adults. The recommended dose may vary from 3 mg to 20 mg. I personally use 20 mg a day on a preventative basis.

Vitamin D

Vitamin D has been shown to decrease the inflammatory response in patients with viral infections. Higher vitamin D levels were associated with lower death rates in patients with COVID-19 infections.

COVID-19 Time Course

This diagram shows the time course of being exposed, onset of symptoms, duration of shedding the virus, and production of antibodies

This figure outlines the likelihood that an individual patient will have a positive test result at a specific time after onset of symptoms. Day 0 is time of symptom onset.

COVID-19 Symptoms

Onset of symptoms ranges from 2 days to 3 weeks from the time of exposure.

Most individuals get no symptoms but may develop an antibody response. The majority (>90%) of people develop symptoms within 14 days. A few (about 10%) may develop symptoms later than 14 days.

Many people never develop symptoms but may still develop antibody responses. The timing and level of antibody responses in asymptomatic people is presently unknown.

Viral shedding can begin 3 to 21 days after exposure (i.e., preceding symptoms).

Shedding of the virus occurs through secretions from sneezing, spitting and coughing beginning within 3 days of exposure up to 3 weeks after resolution of symptoms. Antibody production begins within 5 days to 2 weeks of exposure.

Types of COVID-19 Testing

There are 2 main types of tests for SARS-CoV-2 / COVID-19

RT-PCR

Nasal or pharyngeal swab (detects the RNA of the virus by PCR), helps determine if an individual has an active infection and is contagious.

It does not measure the whole virus, for which viral culture is required. Therefore even though a positive RT-PCR test may not mean that a patient is contagious for practical purposes, it’s recommended to observe appropriate quarantine measures.

Alternatively, newer methods which measure CRISPR-Cas12, a gene unique to SARS CoV-2 can help distinguish COVID-19 from other closely related viruses. This test also decreases turnaround time from 4 hours (RT-PCR) to 45 minutes.

Antibody Testing

Blood test for antibodies specific to COVID-19 determines the immune response of the individual tested, especially among individuals who have no symptoms.

Serum testing is usually done for IgM and IgG antibodies.

IgM antibodies are released immediately whereas IgG antibodies are released later and confer long lasting immunity.

According to The Institute for Functional Medicine, the production of antibodies in any individual, depends on the severity of infection, presence of associated comorbidities, and how strong an individual’s immunity is.

Purpose of Testing

Transmission of SARS-CoV-2 can occur from direct contact or via airborne droplets. At our office we do the antibody testing.

SARS-CoV-2 / COVID-19 testing should be aimed at identifying:

Individuals at risk
Individuals infected with COVID-19
Individuals who have an immune response to SARS-CoV-2
From the perspective of personal and public health, testing can help to make decisions about:
Determining if an individual is contagious and needs to be quarantined
Determining an individual’s immune response after suspected or known exposure
Determining if an individual is immune and can return to work