DR. PAUL KASENENE: The COVID-19 pandemic: What you can do to keep your immunity strong, stay healthy and protect yourself (Part II)

KAMPALA – I recently decided to write out a four-part series on COVID-19 to help provide some insights into this new viral pandemic that we honestly are all still trying to fully understand. I hope they will stimulate us to start our own quest for more information that can shape our own decisions and responses to COVID-19.

Like I mentioned in the first article, many people are living in fear and are very anxious about COVID-19 because of what we read and see in the news. We are even more afraid because there is a narrative that, Africa with weaker health systems is likely to have a disaster on our hands sooner rather than later. Honestly, I can’t say this is true. Over the two months in which we have had COVID-19 in Africa, for whatever reason, we have had a much better impact than Europe, and other areas had in their first two months. We have fewer deaths and fewer people becoming critically ill. This is our story. We are not Europe, and we don’t always have to have the worst of everything. Because of this, we need to have our own measured and well thought through strategy to keep us safe, but one that takes into account the long- and short-term health, social and economic consequences of our actions. And like our president rightly said, we should not simply copy what the western countries do.

In this second part of the series, I would like to shift the focus to what each of us can do to keep our bodies healthy and specifically to keep our immunity strong so that we can have the best chance against COVID-19. Before I get into that, I hope you realise that no one can win this battle on their own. We must all come together and collectively do what is best for everyone. Even if the impact of COVID-19 is better in Africa, we still have the virus amongst us. We, therefore, all have a responsibility not only to keep ourselves safe but everyone else too. You may not be in the vulnerable group (the people above 65 years of age and those with pre-existing conditions like diabetes and cancer) and so may be less likely to have a critical disease or even die if infected. Still, we can all transmit the virus to the vulnerable. Take into consideration that some people can be infected and spread the virus without showing any symptoms. Remember too that the virus does not spread, we spread the virus.

Unselfish behaviour change by everyone, as our president said, is probably the best way to keep this virus at bay. The simple things like washing your hands frequently, maintaining safe distances from others, practising cough etiquette, avoiding non-essential movement and staying home if you are unwell or have any respiratory symptoms are the most essential things in bringing COVID-19 under control. That way mass lockdowns and restrictions will not be necessary, and we can all continue with our lives, albeit with caution. Let us teach this to our children and all the youth who sometimes don’t realise how important this can be and who sometimes feel invincible. Children could eventually help accelerate any spread of COVID-19 by picking it up from each other and spreading it older people. It may also be a good idea to avoid visiting or checking on our older or ill parents or grandparents very often to avoid unnecessary contact.

We need to get the people to genuinely understand the problem at hand and how we can all play our part to solve it. Forcing people to change behaviour has never been successful. We will need to have buy-in from the community who can then take a lead role in sharing the message of prevention. It is also essential that this message comes from people that our family and community members can trust. This a time for responsible leadership, not one to try and push an agenda, criticise the government or score point by politicians.  Because right now there are so many people who believe that this is a disease for “the whites” or “the rich” and such sentiments and beliefs don’t have impactful behaviour change and can lead to even more restrictions and lockdowns. Frankly, lockdowns are meant only to slow the spread and “flatten the curve”. We cannot stay in lockdown forever, even if it an effective measure. Eventually, we will all have to come out of our homes. When we do, unless we all change our behaviour, do what is best to keep each other safe and more importantly keep our immunity strong, we shall always be more at risk for COVID 19, no matter if the risk is lower in Africa than elsewhere.

So, what can we do to keep ourselves healthy and our immunity strong?

I would like to share seven things we can all do to keep our immunity strong. Before I do, I want to highlight something important. It is known that those with a chronic or underlying problem like diabetes, chronic lung disease or heart disease are almost ten times more likely to die if they get infected. Those who are obese and who have weaker immune systems are also more at risk. So I must begin by explaining that we must try and help people overcome these chronic diseases and not only discuss boosting immunity. Why do we have so much chronic disease? Because of something called inflammation. Inflammation is the body’s natural response to injury or damage to tissue. It is a process that involves swelling, pain and heat. But, continuous damage to body tissue leads to chronic inflammation which then damages tissue and causes disease. Many of the chronic health problems today are caused mostly by inflammation but also oxidation as well. Conditions like cancer, heart disease, diabetes, asthma, arthritis, autoimmune disease, immune deficiency and even some forms of obesity are driven by chronic inflammation.

Why do I dwell on inflammation and not just the chronic disease? Well, it is inflammation in the lungs, when affected by COVID-19 that ultimately leads to death. If you already have chronic inflammation in your body then you are going to have a low chance of survival. The virus quickly devastates a body riddled with chronic inflammation. So we must boost immunity and also rid the body of inflammation. The combination of inflammation and low immunity is a fatal combination. That is what we see in most of the older people dying from COVID-19.

In functional medicine, we believe that to help people with chronic disease there are two important things to focus on.

1. Identify and address the dysfunction as well as the cause of the dysfunction making someone unwell. We do not support the idea of merely treating the symptom of the problem. In most of these pre-existing conditions (like high blood pressure and diabetes) that increase the risk for death of COVID-19, a lot of the care people get focusses on treating the symptoms (the high pressure and the high sugar levels), without addressing the dysfunction and the cause of the dysfunction. Take note that symptoms often serve to warn of an underlying problem and are not the problem in themselves. Removing the symptoms with drugs is like removing the light bulb in your dashboard that serves to warn you of an underlying engine problem. There are many genetic, environmental and lifestyle factors that cause disease, but in most cases, the underlying dysfunction is inflammation. We also know for sure that most inflammation is caused and worsened by the food we eat, nutrient deficiencies, toxins, stress, lack of physical activity and even the medication we take for chronic diseases. We want to change the way we think of illness from treating symptoms and disease to addressing the underlying dysfunction (usually inflammation) and the root cause of the dysfunction. We want to change our approach from one where we need medicine to stay alive to one where we use food and a healthy lifestyle to stay alive.
2. Improve the body’s natural resilience to fight disease and support the body to use its inbuilt healing mechanisms to heal itself. This includes boosting our natural defence mechanism (the immune system) that is designed to fight foreign pathogens like viruses and to dampen any unnecessary inflammation. The body has a homeostatic mechanism that always seeks to restore balance. We can support this mechanism with minimal use of pharmaceutical medications, which should be used only as a last resort, when natural methods fail or in emergencies. This is what I would like to share next.

Even if you are elderly or have a chronic condition, the good news is that within about one to two weeks of changing your diet and lifestyle, you will see improvements to your health that will significantly reduce your risk for death from COVID-19. I have seen people who have struggled with type 2 diabetes for years, see their sugar levels return to normal in only a few days. Wherever you are in the world lets use the next few days to ramp up our health. I want to caution you though, not to stop your medication or change your treatment plan without medical guidance. Take a step by step approach, and when you see your health improve, then you can make necessary changes, under guidance.

Now, more than ever, it is essential that everyone makes their health a priority and takes measures to boost their health. Fortunately, there are several things we can do to support our body’s immune response and to reduce inflammation at the same time. Here are seven things that we can all start doing right now to protect ourselves from chronic disease and COVID-19.

1. Keep yourself well hydrated.

The most essential nutrient our body requires is water. The human body is almost 70 percent water. Most functions in our cells occur in the water-rich cytoplasm. Not having enough water in our system can lead to malfunction or dysfunction of cells, including those of our immune system. For our body to work well, we all need to be well hydrated. To ensure you are getting enough water, aim to drink at least two litres of water each day. Or more accurately estimate your bodies daily water requirements in litres by dividing your weight in Kg by 30.  Children should also drink lots of water and aim to drink up to six glasses a day. Remember to drink throughout the day, not all at once. Drink 500mls (or two glasses) of water first thing in the morning, half an hour before meals and  two hours after meals. Have an additional glass before bedtime. The best temperature of water is lukewarm. Take note too that our bodies function best in an alkaline environment. Once in awhile, add two teaspoons of sodium bicarbonate to your water to make it alkaline. Adding lemon to your water also helps to keep your water healthy.

2. Keep your respiratory system healthy.

Regularly gargling warm water with salt and apple cider vinegar can help to keep your respiratory tract healthy and more resilient to inflammation. Avoid white table salt and use healthier salt like Himalayan and sea salt. Do this twice a day in the morning and before bed. It will also have far-reaching benefits to your respiratory health in general.

3. Eat a healthy diet.

We are what we eat. What we eat has the power to be our best ally or our worst enemy. Eating a healthy diet will determine how strong your immune system is. Many deaths from infections are often not due to the infection itself, but the body’s inability to fight it. So during this time, we need to eat a diet high in health-promoting and immune-boosting nutrients and low in high calorie and proinflammatory substances. I don’t think there has ever been a better time for sugar, refined food and junk food detox. Here are the foods we should avoid.

1. Sugar and foodstuffs high in sugar like soda, sweets, lollipops and ice cream. Sugar is a known immune suppressor. Did you know that within 30 minutes of taking sugar, the function of your cells that fight viruses (the lymphocytes) is significantly suppressed, and this effect can last for up to 5 hours? If you consume sugar regularly, your body could be chronically immune suppressed.
2. Food rich in refined carbohydrates including foods made from refined wheat like white bread, chapati, cake, mandazi, pasta and biscuits. Other foods made from refined grains like cornflakes, and posho should also be avoided. I appreciate that we have to be mindful of what is available to us during such a time, but where you can choose, please avoid these foods
3. Deep-fried foods such as chips, crisps, fried chicken and other such foods. Deep frying produces polyaromatic hydrocarbons (PAHs) that cause significant inflammation in the body, something we don’t want in this time.
4. Processed meat like sausages bacon, ham and frankfurters
5. It has been shown that consuming large amounts of alcohol can have immediate suppressive effects on your immune system. Alcohol is known to increase susceptibility to infections. There may be a temptation to drink more alcohol at this time, but I think it is a period to drink much less alcohol. The safe limit is a maximum of two drinks per day and no more than six drinks a week. I think we should half this in this time of COVID-19. A drink can be estimated as 350mls of beer, 150mls of wine and 50mls of whisky or spirits. Please note, alcohol does not fight COVID-19 in any way. That is a myth.

Well, what should we eat then? Simply eat a diet high in vegetables, fruits, nuts, seeds, avocado, legumes with mild to moderate amounts of whole grains, high fibre starch and limited amounts of organic animal food.  Aim to eat 50 percent of your food from vegetables and fruits and aim to eat animal foods no more than twice a week. Eating healthy food can be a subject for a whole book and if you would like to get a more in-depth understanding into eating healthy, be on the lookout for my book “Eat Your Way to Wellness” that will be out in a few weeks. However, regarding keeping our immune system strong, I encourage you to eat the following foods regularly,

1. Garlic and Onions. These bulb vegetables are high in sulphur compounds and have some of the most potent immune-boosting and anti-viral effects known. Use these as often as you can.
2. Cruciferous vegetables that include cabbage, sukuma wiki (collards), broccoli, kale, and cauliflower have compounds that are known to improve immunity, fight cancer and even dampen inflammation. Eat at least one of these daily.
3. Mushrooms, especially the cordyceps variety, are immune powerhouses. These are some of natures most powerful immune-boosting and anti-inflammatory foods.
4. Anti-inflammatory and immune-boosting herbs including turmeric, ginger, cinnamon, oregano and rosemary. These should be added to all your food and soups. I also encourage you to get a combination of ginger, garlic, turmeric, cinnamon and blend them with lemon and honey for a health concentrate drink that you should have daily. Read more on how to make this.
5. Orange foods such as pumpkin, carrots, orange sweet potatoes that are high in immune-enhancing carotenoids.
6. Colourful fruits of all types. Aim to have four servings a day. A serving can be estimated using the size of your fist. Fruits high in vitamin C such as guavas, mangoes, oranges and citrus fruits
7. Seeds including chia, flax, pumpkin and sesame
8. Nuts including almonds, cashews and other edible nuts
   1. Foods high in healthy fats like avocado
   2. Green tea and in particular matcha green tea that is high in detoxifying and immune-boosting catechins. Please drink lots of matcha tea at this time.

If you can learn to make healthy drinks and smoothies, it may be easier to get many of these into your diet in their most natural state without having to cook them which reduces on their nutritional value. Read my article on making health drinks to get more guidance on this on my website blog.

4. Know the nutrients that boost immune health.

Certain nutrients are very essential for our immunity. The most important are the minerals selenium and zinc, Vitamin C and D as well as Omega 3 fats. In particular selenium has been shown to play a key role in your body’s defence against disease. A deficiency in these will negatively impact our immune systems to function. I urge you to take the time to learn the foods that are high in these substances. However, if you need to give your immune system a boost, and I encourage you to consider taking a supplement that can provide the following nutrients

1. Selenium – 100 – 200 micrograms a day (This is probably the most important of all for your immunity)
2. Vitamin C high dose – 2 to 4 grams a day
3. Zinc – 30 mg a day
4. Omega 3s – 1 to 2 grams a day
5. Vitamin D – about 5,000 i.u

I also encourage you to get some supplements that have powerful anti-inflammatory compounds. The three I recommend are curcumin (the active ingredient of turmeric), Cannabidiol (CBD oil) which is one of the most powerful compounds from the hemp plant (a member of the cannabis family) and catechins from green tea and in particular matcha tea. Please get in touch if you need more guidance in this area.

5. Get regular physical activity

Being active is extremely important in keeping your immune system healthy. Aim to get at least two hours a week of moderate exercise. While exercise may not come naturally to all of us, we can all learn to get more and more active gradually. If doing longer sessions proves challenging, try breaking it down into smaller chunks of 7 to 10 minutes. Your mind may find that more manageable. Then increase by 3 to 5 minutes each week until you can make 20 to 30 minutes in one session. Keep it simple. Whether it is skipping, running on the spot or dancing what is essential is to get your heart rate up and your blood circulating more. If it is important, you will find the time. Think about this quote. “People who think they have no time for exercise will sooner or later have to find time for illness” – Edward Stanley

6. Get enough rest

Without adequate sleep, it is impossible to expect our immune system to function well. Sleep is the time when detoxification, healing and restoration are at their peak. Rest is one of the most important things for your immune health. In fact, some research showed that adults who slept less than six hours a night were four times more likely to get a cold than adults who slept more than seven hours. We should never sacrifice our sleep. Aim to get 7 to 8 hours each night and try to go to bed as early as you can. The earlier you sleep, the healthier you will be. The best time is usually before 10 pm.

7. Reduce anxiety and stress

This time can be one of high anxiety for many. There is, of course, the worry of what will happen next regarding our work, plans and financial situation, but there is a lot of anxiety too that comes from fear about this new virus. Will I get the virus? Will I lose loved ones? What is going to happen to us? When will normal life resume? And then perhaps there is also increased pressure from having to juggle work at home, increased demands from children, spouse and family. Fear, worry and stress produce emotions that make our brains produce chemicals that can reduce our immunity significantly. That is why it is said that stress and worry increase risk for diseases that affect immunity like cancer and autoimmune disease. But on top this, the fear that COVID-19 could kill once infected can trigger what we call the nocebo effect. This is opposite of the placebo effect. The nocebo effect usually occurs when a patient is told that a procedure or disease could have a negative outcome, which then negatively impacts the outcome purely because of the power of suggestion. It is already thought that this nocebo effect is already causing much more harm globally in regard to COVID-19. We, therefore, need to find ways to stay calm, reduce anxiety and manage stress. Here are some suggestions

1. Stay informed to be aware of what is going on but avoid being overinformed. Many news stories and headlines can inappropriately catastrophise the situation and cause fear and anxiety. Try and avoid getting information about this pandemic more than once a day and avoid getting information from the news or social media.
2. Keep your focus on what you can control and not what you have no control over. When anxiety creeps in deliberately change your attention to what is important to you and what you can control
3. Practice gratitude. Saying and feeling thank you has a very powerful impact on your physical body. It will reduce the tension in your body but will also stimulate the release of feel-good, stress relief and immune-boosting chemicals. Even with all the uncertainty and the potential and existing challenges arising from this pandemic, there is still a lot to be grateful for. Take 5 minutes twice daily, close your eyes and feel the gratitude for all that is well, including still being alive.
4. Practice deep breathing. Breathing is the only system that can be controlled voluntarily by your conscious choice as well as involuntarily by the subconscious mind. Breathing is, therefore, the bridge between body and mind. When you see yourself, or someone else unintentionally take a deep breath, that is a message from the body to the mind to calm down. If we learn to voluntarily take deep breaths we can influence our mind to remain calm while removing tension from the body. Aim to take 15 deep breaths twice daily. First thing in the morning and last thing before bed. Keep this simple. One way to do this is to lie on your back with your knees bent, feet on the floor and hands on your belly. Take a long deep breath in through the nose to the count of 5, hold the breath to the count of 3, and let out a long deep breath through the mouth or nose to the count of 5. As you inhale, feel your belly expand into your hands and as you exhale feel your belly drop back towards the floor. Or follow any breathing technique you know. Deep breathing also greatly enhances our immune system.

If we follow these guidelines, I am pretty sure we will see a significant improvement in our health and will enhance our bodies immune system. Please make time to read more around some of the areas where I have given brief information or feel free to write in and ask for more guidance.

We may not have much control over what everyone else does and how the virus spreads; we do have a lot of power and choice over our actions. Making choices that will keep you healthy and boost your immune system will probably be the wisest thing you can do. With most experts suggesting that up to 60% of the world’s population will eventually be infected with COVID-19, your best bet is ensuring that your body is best suited to fight it off in the unfortunate event that anyone gets infected. People experience anywhere from mild to extreme symptoms. And an essential factor that will determine this will be your immune response to the virus.

One of the questions I have received a lot is whether we really need a vaccine, and even if they are safe. I have been asked about whether 5G networks have anything to do with coronavirus. In my next part of this series, I will focus on answering such questions that a source of debate and contention. If you have a question you would like answered; please do let me know. Until then, stay safe, boost your immunity and work to protect all the vulnerable people around you. If you need any clarification, please get in touch.

The writer, Dr. Paul Kasenene, is a qualified medical doctor specialising in Nutritional, Functional and Lifestyle Medicine.