UPDATE – Saturday March 21, 2020:
Check back in regularly for more updates. We will be updating this guide with BIG UPDATES as they become available. The rest of this extensive guide is also staying up to date.
COVID-19 first symptoms may be STOMACH ACHE, bloating, or diarrhea… and not necessarily a cough.
Although COVID-19 is a respiratory virus (as we’ll discuss on the next page), new research is suggesting that nearly HALF of all COVID-19 infected individuals experience stomach ache as a primary symptom.
Practical Insight: If you have a multi-day persistent stomach ache… that may be early signs of COVID-19 infection. Self-quarantine. Stay hydrated. Take your temperature. Monitor for cough progression. If symptoms persist for 2+ days, call your doctor/get tested.
Confirmed cases in the USA are “Rising Faster Than Any Other Country” (read full story here).
Here’s the graph:
The cases effectively doubled in 1 day (18 to 19th). We may see something similar today.
This massive rise in cases is likely due to 1) the fact that the USA has been pitiful on testing over the past few weeks and we’re just seeing the cases that were previously infected…. 2) COVID19 is also very contagious (R0 of ~2; if you don’t know what that means yet… read this guide).
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Background Questions (Virus Transmission, Symptoms, & More):
What is SARS-CoV-2? How does it infect the body?
- Shortness of breath
- Headache, malaise, loss of appetite.
- Can also cause rash, GI upset, and night sweats.
In mild cases, the virus will run its course and resolve on its own.
But if the Coronavirus infection progresses to a critical level, it causes pneumonia and uncontrolled inflammation which results in:
- Severe swelling and accumulation of fluid in the lungs.
- Damage to the membranes where gas is exchanged in your lungs (the alveolar-capillary barrier).
- This can eventually lead to Severe Acute Respiratory Syndrome (SARS).
- Can lead to a secondary infection with bacteria (pneumococcus /staph aureus).
The disease spreads via droplets in the air. The droplets can enter a person from those who cough and sneeze and the “spray” from the droplets enter the mouth, nose, or eyes of others.
The disease process SARS-CoV-2 causes is called COVID-19. We will use the generally accepted “COVID-19” term throughout this document for simplicity.
COVID-19 is in the Coronavirus family as it has “spike” proteins on its surface that give it its characteristic shape. COVID-19 uses these “spikes” to infects cells through ACE-2 receptors that are found in lung and intestinal cells primarily.
Where did COVID-19 come from?
This is how previous coronavirus outbreaks have emerged, with humans contracting the virus after direct exposure to civets (SARS) and camels (MERS).
The researchers proposed bats as the most likely reservoir for SARS-CoV-2 as it is very similar to a bat coronavirus. There are no documented cases of direct bat-human transmission, however, suggesting that an intermediate host was likely involved between bats and humans.”
In the other proposed scenario, a non-pathogenic version of the virus jumped from an animal host into humans and then evolved to its current pathogenic state within the human population. For instance, some coronaviruses from pangolins, armadillo-like mammals found in Asia and Africa, have an RBD structure very similar to that of SARS-CoV-2.
A coronavirus from a pangolin could possibly have been transmitted to a human, either directly or through an intermediary host such as civets or ferrets.
How quickly do symptoms develop? What are the most common symptoms? And what are the common symptom progressions?
- 4-5 days of high fever → 50% of time things can progress to pneumonitis (inflammation of the lung surface) → which can lead to SARS (whole lung inflammation).
The median incubation period was estimated to be 5.1 days (95% CI, 4.5 to 5.8 days), and 97.5% of those who develop symptoms will do so within 11.5 days (CI, 8.2 to 15.6 days) of infection. These estimates imply that, under conservative assumptions, 101 out of every 10,000 cases (99th percentile, 482) will develop symptoms after 14 days of active monitoring or quarantine.
How contagious is Covid 19? How does it compare to the seasonal flu?
- The term “R0” tells you the average number of people who will catch a disease from one infected person.
- If R0 equals 1, each existing infection causes one new infection. The disease will stay alive and stable, but there won’t be an outbreak or an epidemic.
- If R0 is more than 1, each existing infection causes more than one new infection. The disease will spread between people, and there may be an outbreak or epidemic.
- If R0 is less than 1, each existing infection causes less than one new infection. In this case, the disease will decline and eventually die out.
- Swine Flu (1918 – 50 million deaths) R0: 1.4 – 2.8
- Swine Flu (2009) R0: 1.4 and 1.6
- Seasonal Flu: 1.4
- The WHO says the R0 is between 1.4 and 2.5, meaning every infected person will, on average, infect about two more people. A team of researchers in China calculated the R0 as between 2.24 and 3.58 (bioRxiv 2020, DOI: 10.1101/2020.01.23.916395).
- Measles R0: 12 to 18 (things could be worse)
- Practically speaking, coming into any close contact, even within 60 seconds of an infected person is enough to spread it.
Can I transmit COVID-19 if I have no symptoms?
How long does Covid19 live on surfaces?
I see all the media hype and hysteria and I get that it’s pretty contagious… but how dangerous is it really?
About 13.8% report severe illness, meaning they have shortness of breath, or require supplemental oxygen, and about 4.7% are critical, meaning they face respiratory failure, multi-organ failure or septic shock. The data thus far suggests that only around 2.3% of people infected with COVID-19 die from the virus (we’ll cover this more later).
People who are older or have underlying health conditions seem to be most at risk of having severe disease or complications. While there's no need to panic, people should take steps to prepare and protect themselves and others from the new coronavirus.
What factors increase your risk of having more serious complications from COVID-19?
- High blood pressure (Hypertension)
- Heart Disease
- Kidney disease
You will hear the term “comorbidities” when people are mentioning these conditions; it means the simultaneous presence of multiple disease conditions.
A new Italian study reports a high prevalence of hypertension amongst those who died. It is hard to know what to make of those raw rates as the patients who died were also quite older. The prevalence of Hypertension in those who died (76%) was higher than diabetes (36%), heart disease (33%) and CKD (18%).
Being over 65 is a risk factor… although (as we’ll see later) … young people can get it too.
Can I get it even if I have a “strong” immune system?
How is Covid 19 spread? What is the transmission process?
Between people who are in close contact with one another (within about 6 feet) [airborne]
Through respiratory droplets produced when an infected person coughs or sneezes.
These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.
Why do Children get affected less? Is that true?
Yes. However, more recent studies suggest children are as likely as adults to become infected. In a study reported March 5, researchers analyzed data from more than 1,500 people in Shenzhen, and found that children potentially exposed to the virus were just as likely to become infected as adults were, according to Nature News. Regardless of age, about 7% to 8% of contacts of COVID-19 cases later tested positive for the virus.
One theory why children appear to be less affected with COVID-19 is that their lung cells may express less ACE2 and have fewer ACE2 receptor binding sites to allow SARS-CoV-2 to invade. ACE2 is increased by some medications, including ibuprofen, which led some to conclude that ibuprofen may be dangerous if you have SARS-CoV-2 infection.
Another theory is that children (especially those under 10) have 10x more melatonin production than older adults. Melatonin plays a large role in suppressing the severe inflammatory response to COVID-19.
Are men more likely to get Covid 19 than women?
This may have to do with hormonal factors of the fact that women have stronger immune systems (less cancer; more auto-immune)
Do you get immunity after being infected?
The Chinese scientists coined the terms the “L” and “S” strains. “S” seems to be the older and weaker version of the virus. Chinese researchers suggest that the L strain is more “aggressive”, either transmitting more easily or replicating faster inside the body.
Can the virus cause infection if exposed to my eyes?
Are there multiple strains of Covid? Can it mutate?
Based on how the virus replicates, it can mutate fairly easily; this could make the virus LESS or MORE deadly.
Do face masks help prevent COVID?
N95 respirator masks can prevent COVID.
What is social distancing and why does it matter?
“Mitigation requires heavy social distancing. People need to stop hanging out to drop the transmission rate (R), from the R=~2–3 that the virus follows without measures, to below 1, so that it eventually dies out.”
What does “flattening the curve” mean?
We need to weigh balancing these measures with the economics of keeping people at home.
What is the fatality rate of Covid? What’s the mortality rate? And what’s the difference?
This figure could be an overstatement, because mild cases of the disease are less likely to be diagnosed. Or it could be an understatement, because many patients have already been diagnosed with the virus but have not yet recovered (and may still die).
Mortality represents the number of deaths per unit of population (100,000 now generally used and indicated) which population consists of the sick and the well, thus:
Mortality = deaths (for a given illness)/unit of population (100,000 sick and well)
Conservatively, the mortality rate of COVID-19 is 1% – 1.5% (10-15x more deadly as the flu which has a 0.1 % mortality rate)… but data varies by country.
These numbers can be scary at scale… if 1 billion people get COVID (and we say mortality is 2%), then that would be 20,000,000 theoretical deaths.
Where can I see the virus spreading map and updates?
Does heat affect the virus?
Summer may be good for slowing the spread.
Are “young” people safe?
How much testing is happening?
USA as of 3/19/2020 – around 45,000 tests (equivalent to 5 tests per million)
Where can I get tested?
Drive-in centers popping up in all states now: https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/testing-in-us.html
Can my pets get sick?
Pets probably can’t transmit to humans. One dog in China contracted a ‘low-level infection’ from its owner, who has a confirmed case of COVID-19, meaning dogs may be vulnerable to picking up the virus from people, according to The South China Morning Post.
The infected Pomeranian has not fallen ill or shown symptoms of disease, and no evidence suggests that the animal could infect humans. Several dogs and cats tested positive for a similar virus, SARS-CoV, during an outbreak in 2003, animal health expert Vanessa Barrs of City University told the Post.
‘Previous experience with SARS suggests that cats and dogs will not become sick or transmit the virus to humans,’ she said. ‘Importantly, there was no evidence of viral transmission from pet dogs or cats to humans.’” Read more here.
What to do if myself (or family member) get sick:
- Self quarantine
- Bed rest
- Hydration / fluids
- Simple but adequate nutrition – including the following supplements:
- Zinc: 50mg per day
- Vitamin C oral (to bowel tolerance… “until you have diarrhea)
- Melatonin: 1-5mg
- Vitamin D: 5,000 IU
- Monitor temperature, weight, blood pressure, pulse
- Monitor Pulse Ox (to watch for hypoxemia – low oxygen in blood)
- Normal levels are 95-100 on a pulse ox
- Breathe through nose as best as you can.
- Contact your doctor if experiencing shortness of breath/ trouble breathing at night.
What happens if my child has a fever? Should fever be treated?
Take a deep breath, and remind yourself that fever is helping your child get better faster and also be less contagious to others. But, you do NOT have to just sit idly by while your child suffers. Read more from Dr. Elise Song, MD | Pediatrician (see her blog here).
Keeping a fever in control by the use of hydrotherapy using a tepid bath with sponging or immersion in water lower than the temperature of the body (85–90 degrees Fahrenheit, or 29.4–32.2 degrees Celsius).
This works just fine in most situations. Report to fever lowering medications and seek medical attention only when there is difficulty in keeping the beneficial fever in a safe range.
There are cases when fever needs to be addressed (prolonged fever greater than 104).
Should I use advil, tylenol, or NSAIDs to treat pain or fever?
NSAIDS may increase susceptibility to virus? There is conflicting opinion. France says yes. WHO says no.
NSAIDS lower glutathione – one of our bodies’ KEY natural antioxidants (see this). Most chronic disease processes are associated with low glutathione levels.
Lowering fever may make you feel better, but can actually prolong the illness.
Therapies (Medications, Supplements, Exercise, Food, & More)
What is the timeline on COVID-19 Vaccine? How are vaccines developed?
Monoclonal antibody vaccine: https://www.biorxiv.org/content/10.1101/2020.03.11.987958v1.full
“Neutralizing antibodies can alter the course of infection in the infected host supporting virus clearance or protect an uninfected host that is exposed to the virus4. Hence, this antibody offers the potential to prevent and/or treat COVID-19, and possibly also other future emerging diseases in humans caused by viruses from the Sarbecovirus subgenus.”
Human trials are beginning now, which is crazy fast (read more here).
According to this interview with Vaccine Researcher Dr. Offit who developed a vaccine for the Rotavirus, most vaccines take 10-20+ years to develop. See full interview here.
Promising therapy: what is plasma antibody therapy?
“We give plasma derived from blood taken from coronavirus patients who have recovered, and injecting that into other patients in an attempt to potentially jumpstart their own immune response.
To do so, we collect the blood, concentrate that and have the ability, once it’s pathogen-free, that is virus-free, be able to give that to other patients and the immunoglobulins, the immune response could potentially provide a benefit to patients.”
Promising therapy: anti-malarial drugs… chloroquine and hydroxychloroquine (Plaquenil)?
The main anti-malarial drugs being tested are hydroxychloroquine (Plaquenil) and chloroquine.
Research on Chloroquine on COVID 19: https://pubmed.ncbi.nlm.nih.gov/32150618.
How do these drugs: it seems to alter the pH inside cells not allowing them to become acidic due to the process through which COVID replicates.
These drugs seem to be effective:
- 36 patients were enrolled in the trial, including 16 infected controls and 20 treated patients. The test group was given 600 mg daily of Plaquenil, which is on the WHO’s List of Essential Medicines and has been used for malaria, rheumatoid arthritis, and lupus.
- At day three, the study reported, 50 percent of the treated group turned from positive to negative for the COVID virus.
- By day six, 70 percent tested negative.
- As intriguing, of the 20 test patients, six who were treated with both Plaquenil and the antibiotic azithromycin did even better, the team reported. Five of the six, or 83 percent, tested negative at day three. All six, 100 percent, tested negative at day six.
- Meantime, the control patients largely stayed sick longer. On days three and six, just 6.3 percent and 12.5 percent, respectively, tested negative. The research paper did not include how they were alternatively treated.
They are not without side effects (drug-induced psychosis): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2552796/
Promising therapy: HIV drugs (lopinavir, ritonavir and remdesivir)?
But our own cells also rely on enzymes that transcribe DNA, so it is much harder to inhibit such enzymes without harming our own cells. Because coronaviruses use RNA-dependent enzymes, an antiviral such as remdesivir has a good chance of working against them.”
Is there any truth to the Chicken Soup is good?
Many viruses (like Coronaviruses) and common “sniffles-causing” Rhinoviruses reproduce better at lower temperatures… the vapor from soup may interfere from them.
Don’t use blow dryers up your nose 🙂 https://www.snopes.com/fact-check/hair-dryer-coronavirus/
What other helpful things do you suggest?
- Wim Hoff Breathing Exercises: https://www.youtube.com/watch?v=nzCaZQqAs9I
- This is great for your immune system and mental wellbeing.
- For Men: https://www.fitfatherproject.com/get-free-workout
- For Women: https://fitmotherproject.com/get-free-fmjs
Is Vitamin D3 helpful?
Take it daily. Or, if you’re healthy, get sunshine (the best form).
Is Zinc helpful?
50mg daily. Zinc gluconate. This supports your immune system
Is Vitamin C helpful?
There is a longstanding history of Vitamin C’s role in the immune system:
- Vitamin C, also known as ascorbic acid, is a powerful antioxidant. Vitamin C has long been known to boost immune function, but early studies are finding that high dose vitamin C might actually be able to reverse the effects of the Coronavirus.
High doses of vitamin C is speculated to mitigate the massive inflammation and subsequent respiratory failure seen in Coronavirus infection by:
- Suppressing the dramatic inflammatory response in the lungs
- Preventing the accumulation of immune cells in the lungs
- Minimizing the release of cytokines
- Slowing down the reproduction and spread of the virus within the body
- Giving the immune system a much-needed boost
Essentially, the focus of this nutraceutical treatment is to flood the body with compounds that enhance and balance the body’s natural immune reaction. Our bodies’ Vitamin C usage increases in the presence of an infection/immune system demand.
How much to take: Orally, 1000mg 1x/day is a fine starting point. If you’re feeling symptoms, increase Vitamin C intake (500-1000mg) every few hours to until you have loose stools.
Promising Therapy: Vitamin C IVs
Summary of high-dose C therapy IVs: Those treated with High Dose IV Vit. C: Patients were given:
- 10 – 20 grams all recovered; no one died, 3 – 5 days shorter hospital stay.
- One patient in critical condition was given 50 g of Vit C. over a period of 4 hours; this brought a patient who was deteriorating rapidly back to wellness.
Is Melatonin helpful?
How? Melatonin blocks a main inflammatory mediator that can get you super sick (an inflammasome called: NLRP3). This is one reason that children under 9 rarely present with severe symptoms, as they have 10x the peak melatonin levels as older adults.
Dose: 1mg/day; can use up to 20mg safely. That said, more is not necessarily better.
What about ACE-2 Blocking medications? Doesn’t COVID enter via the ACE-2 receptor?
This is intended to halt – or at the very least slow down – the virus’s ability to attach and enter the body.
While prescription angiotensin blockers include drugs like Cozaar or Diovan, there are some natural compounds that exert angiotensin-receptor blocking effects such as:
- Vitamin C
- Vitamin B6
- Coenzyme Q10
- Gamma linoleic acid/dihomo-gamma-linoleic acid (GLA)
Read more about natural ACE inhibitors: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3989080/
The use of angiotensin-receptor blockers in the treatment of Coronavirus is still in the very early stages and will require significantly more research to reveal it’s true
Potential therapy: use of mushrooms
Mushrooms are very strong immune modulators and help fight and prevent viruses.
Look into getting a blended mushroom supplement with these key mushrooms.
Other Interesting Stuff & Closing Notes:
Is the virus affected by the sun’s cycle?
Our current solar minimum cycle makes it more likely that viruses will spread.
We are currently entering a solar minimum phase: https://www.weather.gov/news/190504-sun-activity-in-solar-cycle
Maxima in the sunspot cycle are characterised by high daily sunspot numbers, frequent solar flares, coronal discharges and X-ray emission. High fluxes of X-rays reach the Earth’s upper atmosphere but are almost totally absorbed by the lower atmosphere.
A more important property of a sunspot maximum is that the interplanetary magnetic field near the Earth remains high, being generated and maintained by the flow of electrons from the sun. As such the Earth would be effectively shielded from the ingress of charged dust grains as well as galactic cosmic ray protons.
It is to sunspot minima that we must turn to seek a possible explanation of the onset of pandemics. Sunspot minima are characterised by a weakening of the interplanetary magnetic field near the Earth, which allows for the entry of Galactic Cosmic Rays (GCRs) as well as electrically charged bacteria and viruses to the Earth.
When GCRs collide with the atmosphere they produce a cascade of secondary particles including neutrons and muons that continue to penetrate the atmosphere.”
Does having gotten the Flu Vaccine make me more susceptible to getting Coronavirus?
Read this on viral interference: https://www.ncbi.nlm.nih.gov/pubmed/31607599
Should we have seen this coming?
Should we have seen this coming? Maybe.
Read more here: https://hub.jhu.edu/2019/11/06/event-201-health-security/
How is this affecting the health care system?
Decrease in HIPPA laws and doctors practicing across state lines.
What is the most important thing we can do?
- Slow the spread.
- Stay connected to one another.
- Spread positivity and service.
- Fear is more contagious than anything.
South Korea’s Treatment Guidelines:
- If patients are young, healthy, and have mild symptoms without underlying conditions, doctors can observe them without antiviral treatment;
- If more than 10 days have passed since the onset of the illness and the symptoms are mild, physicians do not have to start an antiviral medication;
- However, if patients are old or have underlying conditions with serious symptoms, physicians should consider an antiviral treatment. If they decide to use the antiviral therapy, they should start the administration as soon as possible:… chloroquine 500mg orally per day.
- As chloroquine is not available in Korea, doctors could consider hydroxychloroquine 400mg orally per day (Hydroxychloroquine is an analog of chloroquine used against malaria, autoimmune disorders, etc. It is widely available as well).
- The treatment is suitable for 7 – 10 days, which can be shortened or extended depending on clinical progress.
Treatment Guidelines from China:
- Treatment for mild cases includes bed rest, supportive treatments, and maintenance of caloric intake. Pay attention to fluid and electrolyte balance and maintain homeostasis. Closely monitor the patient's vitals and oxygen saturation.
- As indicated by clinical presentations, monitor the hematology panel, routine urinalysis, CRP, biochemistry (liver enzymes, cardiac enzymes, kidney function), coagulation, arterial blood gas analysis, chest radiography, and so on. Cytokines can be tested, if possible.
- Administer effective oxygenation measures promptly, including nasal catheter, oxygen mask, and high flow nasal cannula. If conditions allow, a hydrogen-oxygen gas mix (H2/O2: 66.6%/33.3%) may be used for breathing.
- Antiviral therapies:
- … chloroquine phosphate (adult 18-65 years old weighing more than 50kg: 500mg twice daily for 7 days; bodyweight less than 50kg: 500mg twice daily for day 1 and 2, 500mg once daily for day 3 through 7) …
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God Bless, -Dr. A + The Fit Father and Fit Mother Project Teams
Dr. Anthony holds dual degrees in Nutrition & Neuroscience from the University Of Pennsylvania, a Doctorate in Naturopathic Medicine, and is also a national champion bodybuilder.
After watching his own Dad lose his health and pass away at the young age of 42, Dr. Anthony founded The Fit Father Project & Fit Mother Project to help busy Moms and Dads get and stay permanently healthy for their families.
I’d recommend you read the program overview letter for our Fit Father 30-Day Program (FF30X).
Inside FF30X, you'll receive:
- The simple & delicious Fit Father Meal Plan
- The metabolism boosting Fit Father 30X Workout (under 90 min/week
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*Please know that weight loss results & health changes/improvements vary from individual to individual; you may not achieve similar results. Always consult with your doctor before making health decisions. This is not medical advice – simply very well-researched info on Covid-19.