Unfortunately, given the politicization of the virus on both sides, COVID-19 misinformation is rampant. I find myself recommending that people ignore much of what is in the media, and sadly even the medical establishment experts. Instead, my focus is simply on what the research shows, along with a dollop of common sense.
1. How Contagious Is the Virus?
Only 12 percent of people in households with somebody with positive COVID-19 came down with the virus. Only 2 percent of other contacts.1 Although fomite spread (touching objects with the virus on it) plays some role, it is considered to be modest. Most spread is likely by inhalation.
2. How Is the Virus Spread: Finding the Balance Between Caution and Fear
Basically, if a large amount of the virus builds up in the air in an enclosed space, and you spend over about 20 minutes inhaling it, that appears to be the main risk. This suggests that the risk of catching the virus outdoors is low, as the size of the atmosphere is very large, and breezes tend to blow the virus away and dissipate it. The main risk seems to be indoors. There was very little increase in the virus associated with large outdoor gatherings, much as they have been politicized. The media is currently focusing on the cluster around the president and the Rose Garden gathering. But much if not most of this event occurred indoors at receptions before and after.
So personally, if I am going out on the walking trail, or in general outside, I do not wear a mask. Especially if not in groups of people. If I am indoors, such as in stores or restaurants, then I do. Unfortunately eating in restaurants is a significant risk, especially as people are not wearing masks. I recommend that people find restaurants that have outdoor seating or do carry out.
Social distancing is also reasonable, but the research is suggesting that spread is predominantly aerosol rather than droplet.2 This means that the 6-foot distancing may have modest (although still reasonable) benefits.
This data is important so people can make decisions based on common sense and science instead of the media fear mongering. The latter is resulting in people excessively socially isolating themselves and staying indoors. This has contributed to:3
A. Forty-one percent of the population having at least one adverse mental or behavioral health condition; 31 percent reported symptoms of anxiety or depressive disorder; and 26 percent reported symptoms of a trauma- and stressor-related disorder related to the pandemic.
B. The prevalence of symptoms of anxiety disorder alone was roughly three times that reported in the second quarter of 2019.
C. In addition, roughly 13 percent have started or increased the use of drugs or alcohol
D. Suicidal ideation has doubled. With approximately 50,000 U.S. suicide deaths yearly pre-COVID, this is an important health care consideration.
Basically, the cost of excessive fear is very high. It also results in “COVID fatigue,” where people start abandoning helpful common-sense measures such as wearing masks inside in public areas. By limiting their outdoor activities unnecessarily, this also is contributing to vitamin D deficiency, a major risk factor for worsened outcomes. From a public health perspective, what makes most sense to me, in addition to teaching people good basic common sense and safety precautions, is to dramatically increase testing and contact tracing.
So accurate information and perspective are power. The media’s focus, unfortunately, is to sensationalize things. As health care providers, it is our responsibility to give people accurate information. Including:
A. COVID is not the plague. The plague killed one half of the population in Europe. The Spanish Flu killed 3 percent of the population. As of the time of writing this article, COVID-19 has killed about one in 1,500 Americans. Although this may change if we see the second wave. So the large number of deaths are very important, but accurate perspective is warranted.
B. Estimates are that 2.7 percent of the population have been infected. This is likely an underestimate, as more than 40 percent of people who get the virus are asymptomatic4 and therefore don’t get tested. Dr. Anthony Fauci, director of the National Institutes of Allergy and Infectious Diseases, has also estimated that the virus kills about 0.6 percent of people who are infected,5 mostly the elderly that are at high risk.
C. A large meta-analysis by Meyerowitz-Katz has found that children have a very low risk of death—about five out of every 100,000 children infected have died. But this rises to 60 of 100,000 by age 40; 680 of 100,000 by age 60; and 8,000 of 100,000 by age 80.6 The risk of death in people under 40 years of age who catch the virus at less than .06 percent.
Basically, the above and the research overall suggests that most people who catch the virus have no or mild symptoms. This makes the key question, “How do we guide those we treat, so they stay low risk. To help them sail through the virus if they do get it?”
3. How to Keep COVID Infections Mild and Safe: An Ounce of Prevention
Unfortunately, with the pharmaceutical industry being one of their major advertisers, the news media is focusing on expensive treatments from their advertisers, and essentially ignoring or attacking those things that are low cost. This is not surprising.
Consider this. In speaking with major magazine publishers and editors, they have shared with me that many of their pharmaceutical advertising contracts come with clauses, such as “there shall be nothing positive written about natural therapies in that issue of the magazine.” If you wonder why major national magazines routinely misrepresent research on natural remedies, picture how some people train dogs.
If the dog does what you want, they get a snack (e.g. a bacon bit). The media has been well-trained, using pharmaceutical advertising as “bacon bits.” Write something negative about natural remedies, get a bacon bit. Avoid reporting on the toxicity of advertiser’s treatments, get a bacon bit. Write something positive about Remdesivir (Gilead is the third largest pharmaceutical advertiser) get a bacon bit. Report on the research on natural treatments helping COVID? No bacon bits for you!
Basically, the research is suggesting that simple nutritional optimization may be the most powerful defense to keep the virus mild and the population safe. Here are the key things that I recommend:
A. Zinc is poison to this virus and decreases its reproduction. I recommend 15 mg a day, after first taking about 50 mg a day for one month to optimize zinc stores. At first sign of symptoms I increase to 50 mg a day for another month. The rationale for this is given in several reviews.7-8
In a new study of people hospitalized with COVID, low zinc levels were associated with a 2.3 fold increased risk of death compared to those with optimal zinc levels.9 B. Low vitamin D levels have also been associated with much more severe clinical outcomes in numerous studies. In fact, Dr. Fauci has noted that he himself takes vitamin D and considers vitamin C reasonable for the virus.10 In addition, optimized vitamin D levels are associated with a 77 percent lower risk of developing COVID.11 The critical role of vitamin D levels being associated with milder disease has been confirmed in numerous studies.12 For those who would like, here is a short review by a Harvard professor giving some of the rationale.13 Since she wrote this, numerous other studies have been published supporting the importance of vitamin D. Which also raises concerns about vitamin D deficiency from the “shelter-in-place” recommendations keeping people indoors, as vitamin D is the “sunshine vitamin.”
C. Low vitamin K is also associated with more severe disease, possibly by increasing the risk of thromboembolic complications.14 I recommend 100 µg daily.
D. Of course other nutrients such as vitamin C also likely play a significant role. I recommend 500 mg a day for prevention, increasing to four times a day at first sign of symptoms.
All of the above can easily be found in a good multivitamin. I do recommend this for all the adults I treat.
So, it is obvious that there is a remarkable amount that the people you treat can do to stay safe. Unfortunately, in contrast to expensive medications being proposed, there is no financial or political lobby to our media or medical establishment for these low-cost natural tools. In fact, there is quite a bit of resistance.
In addition, people should be sure to optimize sleep and stay hydrated. Poor sleep is associated with immune dysfunction in numerous studies and IgA antibodies require a moist surface to function optimally.
4. Persistent Post COVID Symptoms: “Long-haulers Syndrome”
Approximately, 55 percent of symptomatically infected people are still having severe fatigue and other symptoms after 10 weeks. And the likelihood of this is not dependent on how severe the illness was.
My suspicion is that about 15 percent of people who get the virus will develop long-term post-viral CFS (chronic fatigue syndrome) and fibromyalgia. This is discussed in an excellent article by U.S. News & World Report where I was quoted.15
My published placebo-controlled RCT (randomized control trial) showed that 91 percent of people with CFS and fibromyalgia, including those with post-viral fatigue, improve with SHINE (addressing Sleep, Hormones, Infections, Nutrition and Exercise as able; p<.0001 vs placebo).16 Effective treatment of these conditions is discussed in detail in the new edition of my book From Fatigued to Fantastic (Penguin/Avery; September 2020). For those treating these conditions, I am happy to send you free treatment tools which dramatically simplify care. You can email me for these at
[email protected].
5. What Treatments Are Most Likely to be Helpful if People get Symptoms?
Although the research is not yet conclusive, I think if one is hospitalized it is reasonable to consider dexamethasone and in more severe cases Remdesivir. But this latter treatment will get the lion’s share of positive media attention because the company is a major media advertiser.
But there are things people can do on their own at the first sign of infection that are powerfully effective. Even much more so than the expensive medications. Here are a few examples. I would not start these unless I came down with symptoms of the virus, but would begin them while waiting for the test results:
A. Take Pepcid (famotidine) 40 mg twice a day. We have been discussing the immune benefits of this family of medications in viral infections such as mono for decades. So, it is not surprising to see as much as a 58 to 73 percent lower death rate in people hospitalized with COVID-19 who are given these.17
B. Do NOT use acid blockers such as Nexium or Prilosec. These are associated with a 2 to 3 fold increased risk of getting the virus.18
C. Take melatonin 5 mg four times a day.19
D. Consider Plaquenil 400 mg twice a day for one day and then 200 mg twice a day for five days at first sign of symptoms. It’s best given with the zinc 50 mg daily. Yes, the research is still suggesting that this is safe and effective. But because this medication became politicized, the media, and even many in the medical establishment, have grotesquely misrepresented the data. Basically, a few studies were designed where the people were given insanely high doses known to be toxic, instead of the safe dosing I and most other experts have been recommending. And then, unsurprisingly, these toxic doses were toxic. Then the media focused on them.
What the research is actually showing? Most studies have shown a marked decrease in the risk of both catching the virus, and its severity, with treatment. But the studies did not have enough people in them to have statistical significance. So they were misrepresented as being negative. Because there are so many study references showing this, I am simply giving a Newsweek article by Yale professor discussing this issue.20
Meanwhile, a new Yale and UCLA (University of California, Los Angeles) meta-analysis of randomized placebo-controlled studies showed that early hydroxychloroquine use was associated with a 24 percent reduction in COVID-19 infection, hospitalization or death (P=.025) when given in the first two to four days of symptoms. With minimal toxicity.21 I have seen little reporting on this study in the media, but it has not yet gone through complete peer review. Having reviewed the study myself, it is well done and reflects what the preponderance of the data shows.
E. Optimizing nutritional and natural support as above, along with sleep and hydration.
My opinion? It’s an acceptable time for people, especially those at low risk, to consider getting on with their lives. While using basic common-sense precautions and tools discussed above. And, when they feel safe in doing so.
COVID-19 requires common sense. Not fear. I recommend that people turn the media off and look to the science!
References:
1. https://wwwnc.cdc.gov/eid/article/26/10/20-1315_article.
2. COVID-19 Data Dives: Why Arguments Against SARS-CoV-2 Aerosol Transmission Don’t Hold Water – Medscape – Jul 30, 2020. www.medscape.com/viewarticle/934837.
3. www.cdc.gov/mmwr/volumes/69/wr/mm6932a1.htm?s_cid=mm6932a1_x
4. Fauci: ‘About 40%-45% of Infections Are Asymptomatic’ – MEDSCAPE – Sep 11, 2020.
5. What Changing Death Rates Tell Us About COVID-19 – MEDSCAPE – Sep 02, 2020. www.medscape.com/viewarticle/936754.
6. ibid – www.medscape.com/viewarticle/936754#vp_3.
7. https://pubmed.ncbi.nlm.nih.gov/32512490/.
8. https://pubmed.ncbi.nlm.nih.gov/32458149/.
9. Güerri-Fernández R, et al. Abstract 00177. Lower baseline zinc levels are associated with poorer outcome in COVID-19. ECCVID 2020. 23-25 September 2020. www.medscape.com/viewarticle/938793?src=mkm_covid_update_201009_mscpedit_&uac=326215CX&impID=2612171&faf=1.
10. www.instagram.com/p/CE7tWzinTI8/ (at the 32-33 minute mark).
11. Meltzer DO, Best TJ, Zhang H, Vokes T, Arora V, Solway J. Association of Vitamin D Status and Other Clinical Characteristics With COVID-19 Test Results. JAMA Netw Open. 2020;3(9):e2019722. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2770157.
12. www.naturalmedicinejournal.com/journal/2020-08/vitamin-d-levels-associated-covid-19-infection-risk.
13. JoAnn E. Manson. Does Vitamin D Protect Against COVID-19? – MEDSCAPE – May 11, 2020. www.medscape.com/viewarticle/930152.
14. Anton S M ,et al. Reduced vitamin K status as a potentially modifiable risk factor of severe COVID-19, Clinical Infectious Diseases, ciaa1258, https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1258/5898121.
15. https://health.usnews.com/conditions/coronavirus-and-your-health/what-are-the-long-term-effects-of-covid-19.
16. Teitelbaum JE, Bird B, Greenfield RM, et al., “Effective Treatment of CFS and FMS: A Randomized, Double-Blind Placebo Controlled Study,” Journal of Chronic Fatigue Syndrome Vol. 8, No. 2, 2001. PP3-28. www.tandfonline.com/doi/abs/10.1300/J092v08n02_02.
17. Freedberg DE, et al. Famotidine Use Is Associated with Improved Clinical Outcomes. Gastroenterology 2020;159:1129–1131. www.gastrojournal.org/article/S0016-5085(20)34706-5/pdf.
18. www.medscape.com/viewarticle/934332.
19. https://pubmed.ncbi.nlm.nih.gov/32347747/.
20. =www.newsweek.com/key-defeating-covid-19-already-exists-we-need-start-using-it-opinion-1519535.
21. Ladapo, JA, McKinnon JE, McCullough PA, Risch H.Randomized Controlled Trials of Early Ambulatory Hydroxychloroquine in the Prevention of COVID-19 Infection, Hospitalization, and Death: Meta-Analysis. medRxiv 2020.09.30.20204693; https://bit.ly/2SlHEeE.
A recognized authority on chronic fatigue syndrome (CFS) and fibromyalgia, Dr. Jacob Teitelbaum is medical director of the Fibromyalgia and Fatigue Centers nationally, and does phone consultations with CFS/fibromyalgia patients worldwide. He is the author of the popular iPhone application “Cures A-Z,” and author of the best-selling book From Fatigued to Fantastic! (3rd revised edition, Avery/Penguin Group) and Pain Free 1-2-3—A Proven Program for Eliminating Chronic Pain Now (McGraw-Hill). His newest book is Beat Sugar Addiction NOW! (Fairwinds Press; 2010). Dr. Teitelbaum does frequent media appearances, including Good Morning America, CNN, Fox News Channel, the Dr. Oz Show and Oprah & Friends.
