Michael Abrahams | Multipronged approach to COVID-19 management

In Jamaica we are at the tail end of the third COVID-19 spike. Restrictions are gradually being eased as we try to approach living as we did before the pandemic. But the threat of COVID-19 still looms large. As we speak, some countries are experiencing a fourth wave, in some instances even more severe than previous spikes.

Billions of people have been fully vaccinated on the planet, but the infection refuses to go away, even in some heavily vaccinated regions. So, we must acknowledge a painful truth: there is no single or simple solution to this global malady. In order to fight COVID-19 effectively, a multipronged approach must be utilised.

VACCINATION REMAINS KEY TOOL

Vaccination remains a key tool in fighting COVID-19. When someone is vaccinated, their bodies produce antibodies against SARS-CoV-2, the virus that causes COVID-19. Therefore, if they are exposed to the virus, their bodies are already in a state to fight it. Indeed, data show that vaccinated individuals have a lower risk of contracting COVID-19 than the unvaccinated.

Unfortunately, being vaccinated does not mean you cannot get COVID-19. Vaccinated people can get breakthrough infections. However, research has shown that if the vaccinated do contract COVID-19, their risk of severe illness, need for oxygen, hospitalisation, and death are reduced. Also, infected vaccinated people tend to clear the virus quicker from their bodies than the unvaccinated, and are therefore likely to be infectious for a shorter period of time. They are also less likely to develop long-COVID, which is the persistence of symptoms for a protracted time.

HEALTHY LIFESTYLE

In order to be protected against COVID-19, we must make our bodies hostile environments for SARS-CoV-2. Vaccines help in this regard by stimulating our bodies to produce antibodies to attack the virus. However, reliance on vaccines alone is unwise. No vaccine ever created has 100 per cent efficacy, including the ones developed for COVID-19. So, it would be a good idea to do all we can to prepare our bodies to fight the virus.

The importance of a healthy lifestyle cannot be overstated. The people at highest risk of death are older adults and those with underlying illnesses and comorbidities. We cannot change our ages, but we can adjust our lifestyles to strengthen our immune systems and enable our bodies to be more resistant to the deleterious effects of the virus. So, we should try to eat as healthy a diet as possible. We should decrease consumption of sugar, salt, processed food and red meat, and increase our consumption of fruits and vegetables, if we are not already doing so.

The use of certain vitamin and other supplements is also to be encouraged. For example, research has shown that vitamin D deficiency increases the risk of severe morbidity if COVID-19 is contracted. Vitamin D deficiency is common in people of colour, and the majority of Jamaicans are of black African descent, so vitamin D supplementation is a great idea. Vitamin C and zinc are also important for the immune system. Certain foods such a turmeric also exhibit anti-inflammatory activity, and increasing the consumption of these may be beneficial. We need to drink enough water to be adequately hydrated, minimise our consumption of alcohol, and try to quit smoking.

Several studies have shown that obesity is a huge risk factor for severe illness if COVID-19 is contracted. In fact, even if someone is not obese but has increased abdominal wall fat (belly fat), the likelihood of severe disease is increased. So, it would benefit those who are overweight or have increased abdominal wall fat, to do all they can to lose the excess weight by a combination of dietary changes and exercise.

And speaking of exercise, there is data to support exercise as a tool to fight COVID-19. A recent study involving 48,400 patients, and published in the British Journal of Sports Medicine, found physical inactivity to be associated with a higher risk for severe COVID-19. Getting enough relaxation and sleep, and managing stress effectively, are also important for the body and its immune system. Some studies have also found that gargling regularly with some mouthwashes, such as Listerine or chlorhexidine, may also be of value. And it goes without saying that if you have chronic medical conditions, you should do your best to keep them under control.

PUBLIC HEALTH MEASURES

It is important to not let your guard down and to still be vigilant. Wear a mask when around others and avoid large gatherings, especially indoors. Wash or sanitise your hands regularly and properly. Cover your mouth when you cough. Sneeze into your sleeve. When you blow your nose, dispose of the used tissue promptly and cleanse your hands thoroughly. And when indoors, try to have the rooms you are in as well ventilated as possible.

EARLY INTERVENTION

One of the main causes of severe illness and death from COVID-19 is seeking help late. We must all be acquainted with the symptoms of COVID-19 and seek medical attention promptly, should these symptoms occur.

And if COVID-19 is diagnosed, once in isolation, early treatment is a must. Even if you have mild symptoms, you should be managed and be in touch with a physician. A thermometer should be used to check your temperature, and a pulse oximeter (a small instrument that is placed on your finger) to monitor the oxygen level in your blood.

There are various regimes and protocols used in early treatment. Monoclonal antibodies are very effective. Some studies have found drugs and medications such as aspirin, ivermectin, fluvoxamine, budesonide and menthol crystal steam inhalation to be of value, as well as supplements, including vitamin D3, vitamin C, zinc, melatonin, turmeric, N-acetylcysteine and thymoquinone (black seed oil). If you get COVID-19, please do not self-medicate. Rather, discuss your options with a doctor.

None of these interventions, by themselves, is guaranteed to keep you COVID-19 free. However, using a combination of all the above ought to give you a great chance of kicking the virus to the curb.

Michael Abrahams is an obstetrician and gynaecologist, social commentator, and human-rights advocate. Send feedback to columns@gleanerjm.com and michabe_1999@hotmail.com, or follow him on Twitter @mikeyabrahams.