Patients frequently ask me what works best in specific medical situations that relate to medications, devices, nutrients and activity. Now that we have COVID-19 the specific questions have increased with the general question, “What do I need to do to be healthy and protect myself?” The following are my thoughts based on 40 years of practicing medicine.
The mask debate. Masks protect us and others. Not all are made the same. Surgical type masks, the blue ones with elastic ear straps, have been used for years in surgery to protect the patient from bacteria spread from the surgery personnel to the patient on the table in the surgery suite. They are used also by medical personnel in rooms with immunocompromised individuals to protect the patient.
Medical personnel also wear surgical type masks to protect themselves from infected patients.
With COVID, the goal is not to spread the virus if you have it and also to protect yourself from the spread by others. The tighter the mask fits to the face the less likely spreading occurs and also that you will be protected by breathing filtered air thru the mask and not from around it.
The N95 mask is designed so it fits to the face better and with a bigger pocket for the nose but may be harder to breathe through. Homemade masks and face coverings are definitely better than nothing to protect you and others. Using some sort of face covering is important to reduce spread so choosing the one that you can tolerate and will use is so important. Try the different types for fit and tolerance.
I’m seeing face shields being worn without masks. Shields were designed to protect health care workers from the direct contact of body fluids to the eyes and face. They are meant to be worn with a mask.
Wearing the shield without a face covering only prevents direct contact of particles from a cough or sneeze by others around you. You are unprotected with your next breath, as you breathe in the expelled respiratory particles from around the shield that are still suspended in the air. When you cough or sneeze you spread the expelled particles to the shield and the particles are directed down and out into the air, clothing and surfaces below the shield.
Overall, not much protection either from you spreading particles or receiving particles. Wearing one does remind the wearer of COVID-19 and the need to distance.
Keeping a strong immune system. Supporting your immune system is important. Zinc suppresses viruses from multiplying as well as the amino acid Lysine. Vitamin D is also reported to be a protective nutrient. In my practice many patients are severely Vitamin D deficient when I first see them and measure their blood level. Proper guidance by a health professional is helpful in determining what level of supplementation is right for you.
Which are the best tests? Testing can be confusing. The nasal swab, PCR for COVID-19, looks for the virus being present by detecting its specific genetic material. This tells us the virus is present in the nasal cavity and is capable of being spread to other people. True illness occurs when that person has symptoms such as fever, chills, cough, aching and fatigue.
Antibody testing looks for your immune response to the virus. IgM antibodies may be present within a few days of exposure, showing an acute exposure situation. IgG antibodies form after days to weeks after the virus contacts your body and show prior exposure or infection and may indicate some immunity to the virus has developed. IgA antibodies indicated a mucus membrane immune defense response to the virus and generally is seen early on like IgM.
Antigen testing looks for specific proteins on the surface of the virus indicating virus is present. Just like IgM positive you may or may not have symptoms when positive. Results that are obtained quickly are the most helpful in the symptomatic patient.
How testing and treatment all ties together. In medical treatment of a disease early detection and treatment is useful in decreasing the severity of the medical problem. In my experience the same is true with COVID-19. Testing to confirm infection with results obtained within one to two days is important in symptomatic patients to begin early treatment. The longer the time the virus has to multiply before treatment the greater the infective load the ill individual’s immune system has to overcome.
Early treatment in infections generally provides a better outcome. The recent study from Henry, hydroxychloroquine, cut the death by 50 percent. Seeking medical help early when symptoms occur is important in improving the individual’s outcome and recovery.
Dr. Alfred Johnson, D.O. is a physician practicing in Richardson, specializing in internal medicine, environmental medicine and chronic disease. For more information, visit johnsonmedicalassociates.com or call 972-479-0400.