​They say Get Your Vaccines, and do it right now. The media and public health authorities these days are encouraging us to go in for both our flu vaccine and our bivalent covid booster at the same time. Last night's news reported that you CAN get both vaccines at the same time with little increase in minor side effects, and no increase in major adverse effects. This is true. You CAN.

What they did not address is SHOULD you. Public health authorities want you to get both vaccines at once because they fear that if you only get one, you won't be back for the second one. Their motivation is about convenience (for them and for you), and enhancing (numbers) coverage in the population. But for the individual there are more concerns.

You are not a number. You probably want to know how well YOU will be protected by a vaccine. You will not see news or magazines reporting about the relative efficacy of vaccines with different dosing schemes. Odds are there hasn't been a double blind placebo control study asking exactly that question.

There are things we do know. For example, we know that getting sick with two diseases at the same time makes you less able to fight either one. Getting vaccinated with two vaccines at the same time does the same thing. It’s a two-front war. We know that the standard advice about getting a vaccine is to delay it until you are not sick. When your immune system has to fight two adversaries at once it does not fight as well. You will muster a stronger and longer immune response if you only get one vaccine at a time.

Public health authorities think that the public is not able to understand and act on information this complex. I think otherwise. I think you are smart enough to do it. Here's the plan. (This applies unless you have a contraindication, which you should discuss with your doctor.)  Get one of the two vaccines ASAP. On the day you get that vaccine, put a reminder on your calendar to get the other one in one month’s time. What that reminder comes up, go get the other one ASAP. That is how you do it. Prove them wrong.

(Image text below is a screenshot from the CDC.)

The WHO chief says AVOID "endgame" talk about Covid
https://apnews.com/article/coronavirus-pandemic-health-pandemics-united-nations-world-health-organization-d500f7942d0c920912261b30ab8bfd66

New Phase Initiated by Omicron
nytimes.com/live/2022/01/24/world/omicron-covid-vaccine-tests


Recently I became acquainted with a virologist here in PDX who, working at OHSU, helped develop an antibody test for covid. The test he developed has not gained wide usage. 

The virus makes 20+ proteins for which our bodies make antibodies, but the vaccines contain only the spike protein. What this means is that we can tell if people have had the virus, or if they have just had the vaccine. IMO this would be useful information at the population level.

It is still possible for us to know how many people have had the virus. Many people have probably had it but didn't know because they were asymptomatic. Many others have probably had it but don't know because testing wasn't available--especially early in the pandemic. Of course there are pockets of population who still haven't been exposed--but Omicron is reaching many of them. We will not have a good sense of the immunity level of humans on earth until we know the proportion who've had the disease.

Tracking the proportion who've had the vaccine is easier. I have a vaccination card that shows that I've had 3 jabs so far. For me it was mandatory because I work in healthcare. It was also a no-brainer because I'm old and fat enough that covid posed a significant risk, whereas the vaccine poses a miniscule risk.  Sure, it's uncomfortable and unpleasant to deal with the symptoms after vaccination.  I have some tricks for minimizing that.  But basically I agree with the vaccine pushers that getting the vast majority of us stuck makes good sense.

Infection does confer a higher level of immunity than the vaccine. This is because the virus makes those 20+ proteins and our immune systems recognize all of them. The vaccine only contains one protein, the spike. When you've had the virus, your body knows 19 more ways to recognize the virus than if you've just had the vaccine.

Our bodies have T-cells that remember viral proteins that they have met, and go on attack whenever the virus is in us. T-cell immunity is different from antibodies. T-cells last 10-20 years after an infection. B-cells make antibodies and some of them stick around a long time too. "Memory" B-cells live for years and make antibodies for an infection for about 6 months, then they go on break. They are still there to make more antibodies if needed.

Years after vaccination you still have memory B-cells that can resume antibody production, and T-cells that can go on the attack. Unless. Unless you are immune compromised somehow. Unless you get measles, which actually KILLS memory B-cells. This is why I recommend that most people get the MMR vaccine too. It protects you from the damages done by measles, which are more than most people realize.

The nugget here is that the immune system is complicated and managing a pandemic is even more complicated. The public messaging is simplistic. Public health officials are trying to get everyone to take the jab. This is for the benefit of the population; we do it for each other. What I wish that public health as an institution would do for us is invest in antibody testing AND some ways of evaluating immune function so that we can move forward and leave this pandemic era behind.

The world will never be the same again. Those of us who've lived through this pandemic are changed. So many people are dead. Some near to me. Some far away. Wearing a mask is hard. Being isolated from people is hard. But in spite of this we are resilient and we who have survived so far have a good chance of continuing to survive. Let us unite in caring for each other, in being decent to each other.

Let us plan ahead for the possibility of another pandemic in our lifetimes. The increasing density of humans on the planet increases the odds of pandemics. The crowding of our food animals also increases the odds. Rather than pretending that the conditions for pandemic-making are the same as they were in the past, we need to collectively recognize the reality of our situation and do our best to be prepared. It is never over.

Hello friends.  That was a nice long break from posting.  It isn't that nothing is happening on the Covid front, I just got busy with work and posting fell by the wayside.  But right now a snow storm is settling over my home and I anticipate being trapped here for a few days, so I'll have time to put down a few thoughts.

Age x Obesity + Degree of Infection => Aerosols Released
https://www.pnas.org/content/118/8/e2021830118
The equation above oversimplifies, but it captures the gist of the findings.  Basically there are a few people who are superspreaders, and the scientists are starting to understand who and why.  In their words "exhaled aerosol particles vary between subjects by three orders of magnitude, with exhaled respiratory droplet number increasing with degree of COVID-19 infection and elevated BMI-years.  What this means to us is that it is still reasonable to keep staying away from most people, keep wearing masks, and find a way to lose weight if you've gotten fat.  I've got friends who've had great success with Noom, and others who swear by the Ketogenic diet or the Whole 30.  But there is no doubt that obesity is a huge risk factor for bad outcomes and also for being a superspreader.

KIDS CAN TRANSMIT COVID AFTER ALL---AND PRETTY WELL
https://www.princeton.edu/news/2020/09/30/largest-covid-19-contact-tracing-study-date-finds-children-key-spread-evidence
Remember how they were saying that children don't transmit the virus, so it's OK to send your kids to school?  Well that appears to have been wrong.  Best protect your kids from exposures so that they don't bring it home to you.

VACCINE TRACKER
https://www.raps.org/news-and-articles/news-articles/2020/3/covid-19-vaccine-tracker
Been dorking out about all the vaccines under development?  Yeah lots of people are.  Not me, so much, I'm just working and waiting.  My take on vaccination: we're going to want it, but we also don't want it to hurt us, so it's worth waiting.  If you end up getting a vaccine that works really well, great.  If you get a vaccine that kinda halfway works, get another one the next time you have a chance.  Do what you can to improve your immune response to the vaccine.  A future email newsletter will be about this subject.

MOST CONTAGIOUS STRAINS COME TO DOMINATE
https://todayspractitioner.com/covid-19/coronavirus-genetic-mutation-may-mean-it-is-more-contagious/#.X701_6pKjNZ
Lots of mutations have appeared in COVID-19 the ​ones that make it more contagious are a big advantage for the virus, meaning that more and more of the cases are the most highly contagious strains.  Which means that mask wearing is even more important, and during our current spike staying completely away from others may be of ultimate importance.  The study was done in Houston, TX: https://mbio.asm.org/content/11/6/e02707-20.

THE CURRENT SURGE IS WORSE THAN ANYTHING BEFORE
https://www.npr.org/sections/health-shots/2020/11/13/934566781/the-pandemic-this-week-8-things-to-know-about-the-surge
This article is 11 days old already but it documents how fast the case rate accelerated in the first half of November.  An increased case rate is inevitably followed by increased hospitalizations and deaths.  During this time when so many people have the virus, there is nothing you can do except stay away from people.  Even your dearest friends and relatives can give you the virus, or you can give it to them.  So take some time to hibernate, meditate, read books, and otherwise entertain yourself at home.  Don't even go shopping if you don't have to.  This situation could last all winter if lots of people ignore this advice, but you don't have to be the one dying or killing your dearest people.  Being a homebody is not the end of the world.  It's easier to be free when you are alive.

DO WE WANT RAPID ANTIGEN TESTING HERE?  YES.
https://www.nature.com/articles/d41586-020-02661-2
These tests are quick and inexpensive, and help us detect people who have enough virus on board to be contagious.  While it is true that they won't detect very low level infections, they will give us a good clue as to who should be allowed to go to the grocery store, or work.  The CDC was wrong when they said only symptomatic people should be tested.  To control a pandemic that has so many asymptomatic cases you need to test everybody.  The goal is to keep people who are contagious from sharing air (or bathrooms) with others.  So yes, get the $5 test that's ready in minutes, and use it to decide whether or not you should quarantine yourself.  Push your employer and your local governments to get behind wide distribution of this simple technology. It will definitely help.

​

NEW REVIEW OF MANY STUDIES ABOUT COVID ANTIBODIES
​https://www.nature.com/articles/s41467-020-18450-4

Released 2 days ago, this synthesis review shows that immunity to SARS-COV2 behaves in a normal way.  When a person has been quite sick and survived, they will likely have high antibody levels for that particular sickness--for a little while.  These are the people from whom you might wish to get convalescent plasma, because it's probably full of antibodies that could help.  But these antibodies ramp down pretty quickly once you clear the sickness.  A person who had the virus months ago will not have as many antibodies in their plasma as a person who just cleared it last week.  This is why there aren't studies to prove that convalescent plasma is a good treatment: it depends on the person's immune response and on the timing. 

IgM is the first kind of antibody your body makes, and appears about a week into an illness.  After that your body switches over to making IgG antibodies.  The fact that IgM antibodies decrease after the illness is NORMAL.  The IgG antibodies that are made next are the keepers.  They keep being made, but at lower and lower levels if you aren't still fighting the same virus.  This is also NORMAL.  Your body does the same thing for ever flu it ever encounters.  The fact that your body KEEPS making antibodies has to do with its MEMORY.  The immune system has cells called Memory B Cells--the ones that know how to make antibodies for a specific condition--they are your body's memory.  As long as your memory B cells survive, your body has a blueprint of how to make more B cells that can more antibodies to fight that remembered infection--in other words, it can respond faster.  

Memory B cells can live a long time but eventually they die.  The rate at which they die varies by age and lifestyle and also by what other infections you get.  One really good reason to get vaccinated against Measles is that getting measles infection can kill your memory B cells, making you MORE susceptible to things that you've had before.  And that stinks.  I hope that you are vaccinated for measles (the MMR is available if you aren't) and that you also get vaccinated for the flu this year, because it's good to protect your lungs. 

As for the COVID vaccine, we're likely to have a lot of options with varying efficacy that are available to most of us next year.  I don't know for sure what will come out, but I will say that for myself I will try to get one vaccine/year, hopefully different kinds each year, to help my body build up resistance by exposure to lots of different parts of the virus.  For those who are worried about adverse effects from vaccines, let me just say that they really are rare, a lot more rare than the diseases. Also you can also minimize your risk of adverse effects to vaccines by improving your ability to detoxify your body.  I can help with that for sure.  Spring and fall are good times for a deeper detox!

EUROPEANS + FERMENTED VEGGIES = RESIST VIRUS BETTER
https://www.news-medical.net/news/20200708/Study-links-fermented-vegetable-consumption-to-low-COVID-19-mortality.aspx
Basically if your gut is healthy your immune system will work better and you will be less susceptible to dying of the virus.  Eating fermented foods is a quick and easy way to assure that your gut has a steady supply of beneficial bacteria.

​

"MILD" WRONGLY DEFINED AS NOT NEEDING HOSPITALIZATION
https://www.nature.com/articles/d41586-020-02335-z
People who don't get hospitalized don't get medical follow-up either. We all know that some seek hospital care more willingly than others.  Some of us refuse to go to the hospital; we know it is full of antibiotic-resistant infections and stressed-out doctors and staff. I had a pneumonia that could have been Covid but I did not go to the hospital; I self-treated at home. My pneumonia was not "mild". I thought about going in. Many people who've survived the virus at home are having longterm after-effects. This author is absolutely right that we need a better way of categorizing and tracking the cases that did not result in hospitalization.

THE KIND OF MASK YOU USE MATTERS
https://www.sfchronicle.com/bayarea/article/Does-your-coronavirus-mask-work-New-study-15473251.php
I've noticed that many police, highway patrol and fire department personnel are using what I would call "neck gaiters" for masks.  These are a single thin layer of polyester with some lycra for stretch. They drag the thing up over their mouths and noses when in close proximity with others. This kind of" mask" doesn't stay up well. Thin layers of fabric may stop large droplets but they are definitely not catching the aerosols which have turned out to be a major route of infection. Public servants who are in direct contact with the public should be wearing quality masks. Well, everybody should, but "should" doesn't get very far in America.

OVER 900 HEALTHCARE WORKERS HAVE DIED OF COVID
https://khn.org/news/exclusive-over-900-health-workers-have-died-of-covid-19-and-the-toll-is-rising/
POC's dominate the count and you can see from the photos that many victims of all colors are obese.  To reduce this grim outcome perhaps we should use front line workers who have fewer risk factors. Smokers shouldn't be on the front lines. People with hypertension, obesity, diabetes or a heart condition could (and should) be exempted from front line work. There's a great emphasis on PPE (personal protective equipment) and it is important, but the healthcare worker's baseline level of health and resilience is just as important.  People with immune compromise of any origin should not be expected to work with COVID patients. Period. There are so many obese nurses! They should not be put in this position. I heard on a podcast yesterday that 70% of our BMI is due to genetics: no point in punishing people for being heavy. We should evaluate the immune sufficiency of healthcare providers and place them accordingly. Those on the front lines of the pandemic should have top notch immune systems--and be most likely to survive the virus with minimal negative effects. Yes, I know there's a shortage, but seriously sending all these fine people to their deaths trying to help others?  This is murder.

ABOUT 10% OF COVID VICTIMS HAVE PROBLEMS AFTER 3 WEEKS
https://www.bmj.com/content/370/bmj.m3026
We're just starting to collect information about the after-effects of this virus but for a lot of people recovery is extremely slow.  This report has some excellent resources (links) for patients who are having trouble after they are supposed to have "recovered".  The list of possible lingering symptoms is long, and you are not malingering if you have chest pain or "lung burn" and would like to get some help.

A GREAT TIME TO QUIT SMOKING: EVEN YOUTH HIGH RISK IF SMOKE
https://www.jahonline.org/article/S1054-139X(20)30399-2/fulltext
Vaping is not protective. Using it just once in a while is not protective.  Inhaling smoke at all increases your risk, even if you're young. There has never been a better time to quit and quit for good.

One thing that has become increasingly apparent is that this pandemic virus is deadly to those who are already weakened by life, and harmless to many who are young and strong.  There are many possible explanations to this phenomenon, and I want to share with you my thoughts on why.

Very young children for the most part don't get the infection at all.  This is likely because their mucosal immunity is strong.  Mucosal immunity is the defenses that live in our noses, throats, and intestine, specifically defensin, cryptidin, and secretory IgA.  There are antibodies called IgA in our saliva.  These things are capable of disposing of a virus before it even gets started infecting our cells.  Most American adults don't have strong mucosal immunity, but in children it is highly effective.  "Secretory IgA can be measured directly in stool, saliva, and breast milk to assess the degree of mucosal immunity," but in modern medicine this parameter is rarely if ever measured.  It is however possible to make it stronger in adults, by the way that we live.

Older children and young adults can be infected and carry the virus but they are less likely to get badly sick.  This is at least in part because the T-cells of their immune system are strong and active and can find the virus and kill it, and because they have lower levels of inflammation so they don't go into cytokine storm.

Middle aged adults are starting to have more chronic health problems, and this is what makes a person susceptible to a very bad case of the virus.  Being obese is one of the worst risk factors.  In the news they talk a lot about heart conditions and diabetes, but these things are strongly linked to obesity.  Obese people have higher levels of inflammation throughout the body, including in the liver which clogged with fat, and the brain which responds by getting depressed. Obesity also impairs the immune system, reducing mucosal immunity as well as the T-cell response and letting the virus get a foothold and grow.

Older adults most often have an assortment of health conditions.  The ones who've gotten overweight or obese are unlikely to survive when they get the virus.  The ones that are lean and active might survive, like the 100 year old veteran in Portland who got it and came out topside.

The lesson from these patterns is clear.  If you are declining into the diseases of abundance which are so common in America, you are at risk.  Being medicated for your high blood pressure and excessive blood sugar will not save you.  If you maintain a healthy body weight and exercise vigorously you are less at risk.  Covid-19 is a lifestyle disease, it is sorting us out by our most basic level of health.

If you would like to work on your basic health, nobody is better suited to help you than a naturopathic doctor.  Conventional physicians are too busy fulfilling the requirements of their network and insurances to really study on diet and lifestyle.  They want to do what we do, but they can't, not in a 15 minute visit.  Changing your diet and lifestyle and increasing your base health, is a gradual process.  You can start today by cutting out some sugar and moving your body just a little bit more.  Good luck!! 

If you'd like a health assessment and tips on how to improve your particular situation, feel free to touch base with me.  I'll ask you to do a diet diary (you can download the form on the bring page in this website) first so I know what you eat.  I'll want a full list of the medications you take, and the supplements.  Then we can talk on the old fashioned telephone.

Covidly: another place to watch the numbers, hover to see more
​https://covidly.com/

Inoculating Dose Matters: Bigger Exposure-->Faster Onset, Worse Disease
https://www.nytimes.com/2020/04/01/opinion/coronavirus-viral-dose.html​

The CDC comes around: wear a mask in public 4/3
https://www.nytimes.com/2020/04/03/world/coronavirus-news-updates.html

The WHO lists bogus labs and recommends no cures 3/31
https://www.who.int/docs/default-source/essential-medicines/drug-alerts20/no3-2020-falsified-mp-forcovid-en.pdf

Turmeric/Curcuma longa May Reduce Cytokine Storm
https://info.bioticsresearch.com/researchforum/curcumins-influence-on-cytokine-storm

CDC on How to Care for someone at Home
https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/care-for-someone.html

If you get sick enough to need a Ventilator, you're probably a goner
https://www.npr.org/sections/health-shots/2020/04/02/826105278/ventilators-are-no-panacea-for-critically-ill-covid-19-patients

Foolishness: Letting Religious People Gather in Groups during Pandemic
https://www.npr.org/sections/coronavirus-live-updates/2020/04/01/825667542/states-consider-whether-religious-services-qualify-as-essential

Viral Shedding Continues Long Time after Illness Resolves
https://nypost.com/2020/03/30/coronavirus-patients-could-still-be-contagious-after-symptoms-resolve-study/

Dead Bodies in the Streets: Ecuador's Dark Ages
https://www.cbsnews.com/news/ecuador-bodies-streets-guayaquil-coronavirus-covid-19/

This Report Suggests that Oregon has Flattened the Curve
https://govsite-assets.s3.amazonaws.com/8arHLJI7QrqywZlmFH1X_Oregon-COVID-19-Projections-2020-03-30.pdf

Mushrooms and Oats for Immune Modulation
https://blog.designsforhealth.com/node/1219

A Different Perspective: DeGrowth and Direct Democracy
https://theecologist.org/2020/apr/03/coronavirus-and-degrowth

Mortality Rates Grim Among Elders
https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm?s_cid=mm6912e2_w

​Your Home May Not Be Private
https://www.myidcare.com/articles/single/even-sheltering-at-home-were-not-alone
​