Source: Johns Hopkins Coronavirus Resource Center

Omicron is the 15th letter of the Greek alphabet…and yes, the COVID-19 variant that carries its name is the 15th “variant of concern” since the Alpha variant first arrived in the US over two years ago. Delta was the only other one that got really (in)famous…but all of your favorite fraternity and sorority letters have had their named variants too.

The current surge is a massive one because Omicron is extremely contagious. And, just like previous variants, it is transmissible by asymptomatic (or pre-symptomatic) individuals for several days. That’s the main reason why it is so difficult to contain. 

Since the beginning of the pandemic, the Johns Hopkins Coronavirus Resource Center reports over 79 million confirmed cases and over 965,000 deaths related to COVID in the US. (Global numbers are over 460 million cases and 6 million deaths as of March 15, 2022.) There is not one person, one industry, or one corner of the world that has not felt the impact of this scourge.

Pandemic fatigue is real. We are all desperate to return to normal, but most of us aren’t even sure what normal even looks like anymore. It can sometimes feel like all the news is bad news…but there are several reasons to be hopeful in 2022. 

Milder Symptoms 

Many people who are exposed to Omicron will not develop any symptoms at all. For those who do develop symptoms, the onset will typically be 2-3 days after exposure and commonly include fever, headache, sore throat, sinus congestion, cough, and gastrointestinal symptoms like heartburn and diarrhea. Omicron patients are far less likely to experience the loss of smell and taste that was so common with previous variants. For most people, these symptoms are mild to moderate in intensity and resolve completely within 10 days.

Note: Although it’s true that “most” people with Omicron will have a mild/moderate illness, it’s also true that individuals who have been vaccinated and/or boosted are more likely to have a mild course and have a significantly lower risk of hospitalization and death than unvaccinated individuals. 

Less Death

The Omicron variant is now the dominant strain worldwide and in the US. It spreads much more easily than previous strains but it also causes less severe disease. This explains the phenomenon of “uncoupling” which refers to the extremely high caseloads with relatively lower levels of hospitalizations and deaths relative to previous strains. 

Better Treatment

Although Omicron is less likely to cause severe disease, there are still over 150,000 people currently hospitalized with it in the US, and over 25,000 of them are in intensive care. It’s no picnic.  But, the challenges of the last two years have led to advances and improvements in the way that we treat Covid patients, both at home and in the hospital. Antiviral medications and monoclonal antibodies are being used in an outpatient setting, and hospital and ICU care has advanced dramatically for the sickest patients.  

Risk Factors: 

Early in the pandemic, it became clear that older people and those with chronic conditions, including obesity, were at greater risk for more serious disease if they contracted COVID-19. That remains true, but new science has shown that individuals who are overweight or obese now have a new problem to worry about.  Obesity may impact the effectiveness of Covid vaccines. 

A new study suggests that lean or normal-weight individuals have a more robust antibody response after a COVID vaccine.  This may result in a shorter duration of protection and/or lower vaccine effectiveness in obese or overweight individuals. Additional studies demonstrate that elevated blood pressure and excessive abdominal fat lead to suboptimal antibody responses after vaccination.   

If you needed another reason to lose weight and get your blood pressure in control…you’ve got it.

COVID Testing:

There are two main technologies that are used to determine whether or not an individual has COVID. Both methods use a nasal or throat swab to collect the sample to be tested.  

1. Polymerase Chain Reaction (PCR): PCR is a technique that replicates tiny amounts of genetic material so that it can be detected. It is the most reliable way to diagnose COVID but PCR tests can take 24-72 hours to provide results. 
2. Rapid Antigen Test: Antigens are specific proteins on the surface of a virus that can be detected using technology and tools that are similar to the way we test for hormones in pregnancy. One line = negative. Two lines = positive. 

Both PCR and Rapid tests can be expected to remain positive for 7-10 days after initial infection. In some cases, tests may remain positive for significantly longer.  This persistent positivity has prompted the CDC and many other health authorities to modify isolation and quarantine regulations to include the days since exposure, symptom onset, or first positive test in the regulations.  

There is also a blood test that can look for antibodies that were made by the immune system in response to either infection or vaccination. Antibodies can days to weeks to develop after an infection and may remain in the blood for months after recovery. As such, antibody tests are not useful for diagnosing an active COVID infection.

COVID-19 Vaccine Update: 

The Congressional Budget Office estimates that the Federal Biomedical Research and Development Authority alone has spent over $20 billion on COVID vaccine development.  Future estimates suggest that US spending on COVID vaccine research, development, and deployment will soon reach $50 billion. 

The return on that massive investment is extremely difficult to calculate.  

Covid vaccines are different than other vaccines in both form and function. 

Let’s start with function. The first vaccine ever developed and deployed at population scale was for smallpox. That was over 200 years ago in 1798. Since then, the list of diseases that have available vaccines in the US has grown to 24 different infectious diseases…with COVID being number 25. (The number of vaccines is far greater because there are multiple vaccines for single illnesses and combinations of vaccines for multiple illnesses.) 

Up until COVID surged into our lives…it was a matter of fact that vaccines were used to prevent illness. The idea was that if you got the vaccine…you would not get the infection, nor could you pass it on to someone else. 

COVID changed that. 

Unlike our other vaccines, COVID vaccines do not reliably prevent transmission of the illness. But, they do make it less severe, less likely to result in a hospitalization, and less likely o result in death.  Those are all good things indeed…but we can all agree that preventing the infection entirely would be better. 

COVID vaccines are also different in terms of form. That is, they are new and structurally different than all of the other available vaccines. The difference is that COVID vaccines like the ones made by Pfizer and Moderna employ a technology that is based on mRNA. 

(Note:  The Johnson & Johnson COVID vaccine does not use mRNA technology…it is more similar to our more traditional vaccines that use inactivated viruses.) 

Messenger RNA (mRNA)

If you think of DNA as the original manuscript or the source code…mRNA is a bit like a screenshot that can be copied, pasted, and sent. mRNA carries genetic code from DNA inside the nucleus out to ribosomes which are where protein manufacturing occurs.  In other words, mRNA brings the blueprints to the protein factory. Messenger RNA really is a messenger molecule. 

In the case of mRNA vaccines, mRNA that was created in a laboratory provided the blueprints for the manufacture of a very specific type of protein called an antibody.  Antibodies are proteins that can bind to specific sites on a virus. When they lock on, they sound a biochemical alarm that attracts immune cells to the virus to kill it and dispose of it.  

mRNA does not enter the nucleus of a cell, and it does not alter DNA. It simply provides an instruction manual for the manufacture of an antibody that is specific to the spike protein of the coronavirus that causes COVID.  Once those antibodies are made, the mRNA from the vaccine is destroyed. 

Although mRNA vaccine technology is new and almost seems like science-fiction, there are several reasons that mRNA vaccines have an advantage: 

1. Adjuvants:  Chemical adjuvants are ingredients that are added to traditional vaccines to stimulate a stronger immune response. Because mRNA vaccines work differently than traditional vaccines, they do not require the same adjuvants, so the ingredient list is actually “cleaner” than many traditional vaccines. 
2. Preservatives:  mRNA is an unstable molecule that requires extremely cold temperatures to maintain its integrity. Those cold temperatures reduce the need for extra preservatives which are required in traditional vaccines.  

There also appears to be at least one significant disadvantage to mRNA vaccines compared to older vaccine technology…the protection that they provide does not last as long. It appears that the protection that mRNA vaccines for COVID provide “wears off” after about 6 months. And that brings us to the discussion of boosters.

The CDC currently recommends booster shots for everyone 12 years and older. Booster eligibility begins five months after getting the second dose of the Pfizer or Moderna vaccines or two months after a single dose of the Johnson & Johnson vaccine.  

In the scientific community, there is a strong consensus that boosters are useful for people over age 50. In younger individuals, and in those who have had a recent COVID infection…the question of boosters remains far from settled. 

The current data does suggest that booster shots do indeed confer additional benefit against the Omicron variant. Boosted individuals, regardless of age, have a milder illness and less risk of hospitalization and death than those who have not had the booster. But, Omicron tends to run a fairly mild course anyway…and, although the vaccines are generally safe and well-tolerated for most people, they are not risk-free.

As of March 15, 2022, there have been over 555 million doses of COVID vaccine administered in the US. (There have been over 10 billion doses administered worldwide.) That is a lot of vaccines. Given the massive scale of the COVID vaccine campaign, it’s quite clear that COVID vaccines are generally safe. But, they are not 100% safe. mRNA vaccines have been associated with:   

• • Common side effects: mRNA vaccines often cause pain, redness, and swelling in the arm where the injection was given. In the 24-48 hours after the injection, commonly reported side effects include: fatigue, headache, muscle pain, chills, fever, and nausea.
  • Lymph node swelling:  It is common for axillary (armpit) lymph nodes to become enlarged on the side where the COVID vaccine was administered. The enlargement can persist for several weeks after the vaccine. Because axillary lymph node enlargement can also occur in breast cancer, this otherwise minor side effect can strike fear in many women after the vaccine.  As a result, many experts are now recommending that women avoid unnecessary testing and delay mammograms and for one month after getting a COVID vaccine to allow time for enlarged lymph nodes to subside.
  • Anaphylaxis:  This is a severe allergic reaction that has been reported in approximately 5 people per million who receive a COVID vaccine. 

• Thrombosis with thrombocytopenia syndrome (TTS): This is a rare blood clotting disorder that has been reported after the Johnson & Johnson vaccine at a rate of 57 cases per 17 million doses. 

• • Guillain-Barré Syndrome (GBS): This is a neurological disorder that has been reported at increased rates after J&J vaccines. At present, there appears to be no increase in GBS with mRNA vaccines. 
• Myocarditis and pericarditis: Myocarditis is inflammation of the heart muscle.  Pericarditis is inflammation of the lining that surrounds the heart. Both are serious and painful, but not usually life-threatening. As of January 2022, CDC and FDA have verified 1,213 reports of myocarditis after a COVID vaccine, typically in males younger than 30 who have received an mRNA vaccine.  

It’s important to remember that over 9 billion doses of COVID vaccine have been administered globally, over 530 million doses of which have been injected into the arms of Americans. That is a lot of people.  And tragically, even if COVID (or COVID vaccines) never existed…some of those people would get sick and some of them would die.  But, COVID does exist. And so do COVID vaccines.  And some of the people who got one of those 9 billion doses COVID vaccine will get sick and die in the days to weeks afterward. Whether the vaccine was directly involved in that sickness or death is not always so easy to sort out.  

In public health, there is no such thing as zero risk.  COVID has risks. Vaccines have risks. Societal shutdowns have risks. We need to consider them all.  And then, the goal in any public health initiative should be to choose the path that leads to the lowest total risk. We call that total harm reduction. 

It is also critical to point out that the path to total harm reduction for any one individual might be different than the path for another individual. And, perhaps more importantly the path to total harm reduction for an entire country, might be different than the path for any one individual in that country. It is precisely that divergence that has led to all of the social and political drama we see playing out all around us.  

IMMUNE SUPPORT

I believe that the outcome of any infection (including COVID) can be improved with attention to the health of the immune system. This pandemic should be seen as an opportunity to shore up our defenses and improve the chances that we come out the other side in one piece. Here is a list of the most important ways that you can support your immune system:  

But first, a disclaimer:  

I’m not a virologist, immunologist, epidemiologist, or infectious disease expert.

The approach that I have always taken, and the one that still makes sense today is rooted in the idea that:  

Every infection is a RELATIONSHIP. 

It’s a relationship between an organism (in this case, a coronavirus) and a host (in this case, you.)  

The outcome of that relationship depends on factors related to both the organism AND the host. In much the same way that a cheetah catches and kills the weakest/slowest antelope in the herd…the coronavirus does the same thing. The healthy, fast antelopes at the front are more likely to be spared….it’s the ones who are at the back of the pack (older, weaker, sicker etc) who are most vulnerable. 

So…when an organism like this is in the community…it’s like the cheetah on the prowl. You need to do everything you can to stay at the front of the pack.   

Below, you’ll find my list of top ten natural approaches to keeping your immune system strong…to keep you at the front of the pack. 

But before we get to that…my second disclaimer: 

The suggestions below have not been proven as treatments for COVID-19, nor are they substitutes for the advice from your physician or local public health authority. The strategies below are reasonable and they are safe, and as such …I believe that these suggestions are worth a try.  

1) Social Distancing: I know it feels like “everything” is canceled, but I’d like to remind you that: 

• Your family is not canceled.
• You can still call your friends. 
• Your imagination still works.
• Conversations aren’t canceled.
• Music is still here. 
• Long walks are still allowed. 
• The beach, the mountains, the lakes, the rivers, the woods…still open.
• Books have been waiting for you.
• Hope is still alive.
• And…self-care is open for business. 

2) Foods To Eat: The best fuel for your immune system is a minimally-processed, plant-based, anti-inflammatory diet. That means eating foods that come from farms and fields…not factories.

•  Eat vegetables, fruit, beans, nuts, seeds, whole grains…and if you choose to eat animal products like meat, poultry, eggs, dairy, make sure that they come from healthy animals that were farmed in an organic, sustainable, regenerative way.  
• Eat lots of spices: ginger, garlic, turmeric, oregano, thyme, rosemary all have antiviral and immune-supportive properties.  
• Drink lots of green tea. It contains an immune-supportive compound called EGCG. Pro tip:  dark chocolate contains EGCG too! 

3) Foods To Avoid: 

• Avoid added sugar, high fructose corn syrup and foods or drinks that contain added sweeteners.  Honey is the sweetener of choice. 
• Avoid the unhealthy fats found fried food, and foods processed with ultra-processed “vegetable oils” 
• Minimize ultra-processed foods in general. Shelf stable foods in cans, jars etc should only have a short list of ingredients that you can read and recognize.

4)  The Three S’s:

1. Sleep: 7 hours minimum. More if you’re sick. Don’t stay up late watching the “bad news”…turn it off an hour before bed. 
2. Stress: We can’t eliminate stress, but the way we respond to it is a choice that is in our control. Uncertainty is fuel for anxiety and these are uncertain times. But remember, panic almost never helps anything. 
3. Smoking: There has never been a better time to stop smoking.

5) Physical activity:  The gym is closed. Keep your physical activity going…but keep it gentle. Super heavy exercise can depress immunity while moderate exercise improves immunity. Long walks, hikes, short runs, bike rides…try to move your body outside.

6) Water: 

• Hydration: Stay hydrated. No need to overdo it. Consider using your last sip to gargle…believe it or not, there is actually some research that suggests gargling water might decrease the risk of respiratory infection.
• Humidification: Viruses do better in dry air. Consider using a humidifier.  
• Hygiene: Yes, hand washing. For at least 15 seconds. Focus on your fingertips.

7) Vitamins and Minerals:

• Vitamin A:  Commonly used in doses of: 
  • 5,000-10,000 IU is a reasonable dose for prevention 
  • Up to 100,000 IU for three days for treatment
  • DO NOT USE  in pregnancy, nursing, or liver disease.  
• Vitamin C: 
  • 1-3 grams per day for prevention
  • up to 10,000 mg (or 10 grams) for treatment. 
  • Divide doses throughout the day to improve bowel tolerance
• Vitamin D:  Target lab test level of 40-60 
  • 2000-4000 IU daily 
• Zinc:  
  • Prevention:  15-30 mg daily, 
  • Up to 75 mg daily for treatment. 
  • Zinc acetate or gluconate in lozenges is probably best. 
  • Too much in one dose will cause nausea. Divide it up.

8) Other supplements:

• Probiotics:  There is an entire ecosystem of microorganisms that live within our bodies. When that ecosystem is healthy, we are more likely to be healthy as well. Take a high-quality probiotic daily.  

• N-Acetylcysteine (NAC): 

• • 1800mg day in divided dose for prevention.  
  • Associated with higher likelihood of asymptomatic infection   
• Quercetin:  A bioflavonoid compound found in onions. Canadian research is promising for antiviral and immune-supporting properties. 
  • 1000mg daily.  
• Monolaurin: Derived from lauric acid which is found in coconut:  300mg three times per day with food. 
• Propolis: An antimicrobial product produced by honeybees. Commonly used in throat sprays.

9) Herbal Medicines:

• Elderberry (Sambucus nigra):  One tablespoon syrup two to four times per day. Lots of discussion online about the possibility that elderberries might increase the risk of “cytokine storm” in viral infections. There is no reliable evidence that concerns me. 

• Skullcap (Scutellaria baicalensis): Has been studied in China in test tubes against Coronavirus:  Typical product in a capsule might contain 350-500mg of a fried herbal extract.  Take two of those three times daily.

• Andrographis (Andrographis paniculata):  Look for a product that contains andrographolides…shoot for 50-60mg of andrographolides per day.   

• Astragalus (Astragalus membranaceus): A famous and well-studied herbal immunomodulator.  Look for a product that contains a standardized extract and take about 2 grams, that’s 2000 mg daily.  

• Cordyceps (Cordyceps sinensis): Commonly known as the “caterpillar fungus, this is a medicinal mushroom widely known for use in lung disease. Typical doses are about one gram (1000mg) daily for prevention, and up to three grams in the case of illness. 

• Japanese Honeysuckle (Lonicera japonica): Animal studies have demonstrated an immunomodulatory effect. Often appears in Chinese formulas with Forsythia (below) and other herbs listed here.  
• Forsythia (Forsythia suspensa): A beautiful spring flowering bush and a famous Chinese herbal medicine.  Herbal formulas for lung infections often include a Forsythia extract.  

10) Be Flexible: Have you ever seen a palm tree in a hurricane? They survive the storm because they are flexible. There is a storm coming…we’re going to stay calm, take it day by day, and ride it out together. 

And now, my final disclaimer:  

The information presented here is for educational purposes only. It is not a treatment or prevention for COVID-19 or any other medical problem. It is not a substitute for medical advice from your personal physician and is not a substitute for the advice from your local, state, or federal authorities.