Written by: Gregory Howard, MD is a Lifestyle Medicine physician who practices preventive medicine as the medical director of MHP Bone Health and Lifestyle Medicine, after serving 15 years as the director of MHP Sports Medicine. He is an inaugural member of the American College of Lifestyle Medicine Board Certification class and is a member of the teaching faculty for Franciscan Family Practice Residency in Indianapolis, IN. He prioritizes teaching his patients at every office visit, engaging them as partners in their endeavor to improve longevity and quality of life.
Our communities need a fresh approach to protecting ourselves as the novel coronavirus swings back around for another approach, even as the first pass of the contagion has recently seen a resurgence. Unfortunately few, if any, prominent health officials are addressing the need for blunting or preventing the most severe problems associated with this novel coronavirus.
So together, lets take a breath and reflect on the current state of the COVID-19 pandemic, as it has affected the United States. After only 5 months of exposure to the novel coronavirus, the US has seen 3 million people infected with the novel coronavirus and we have seen the passing of 150,000 people due to this virus.
In Indiana, my state government has addressed the challenge with an aggressive early approach, which limited a great many people from being harmed by the virus. We closed schools earlier than many states and limited exposure to infections by closing non-essential businesses and recommending the use of masks when in public. In comparison to many areas of the country, we have managed to blunt the full force of the virus, although we have not “locked it down” by any stretch. Astoundingly, this is the “good news.”
The bad news: We are not done with this virus. And not every state has been nearly as aggressive as my state at trying to balance public safety and economic flexibility and those other states are now seeing their cases spike once again. We are not out of the woods by a long shot.
Furthermore, it’s reasonable to expect that as we reopen more businesses and as we begin to interact with more people, the simple fact is that we will all be increasing our exposure to this infectious agent. If we add to the above realities the fact that the flu will be coming in the next 3-6 months, we really need to take seriously the idea of making ourselves a harder target for COVID-19 to hit.
How are we to reduce the risk for being harmed by the virus if we contract it? How do we reduce the burden of disease for a contagion for which we have no cure or vaccine?
Get yourselves to Wellness Bootcamp. No kidding. How do we prepare young men and women for the rigors of military life? They spend between 8-12 weeks in basic training, depending upon the service, to become more physically fit and more informed in order to defend themselves and their teams against looming adversity. This is no different for our communities at large. We need to become harder targets for the virus to harm.
The first steps we need to take in Basic Training include the measures we already know: keep up social distancing, remember thorough hand cleansing and always wear a mask, in order to dampen the spread of disease.
The expectation of experts is that approximately 60-70 percent of the country will contract this disease if we don't develop a vaccine in a timely fashion. What are we to do if we contract it?
We need to reduce our body’s level of chronic low grade inflammation. The virus appears to be especially good at attacking people who have higher levels of inflammation; this is the same inflammation which is also the most significant cause of our most crushing chronic diseases: Obesity. Diabetes. High blood pressure. We now know that these diseases are exacerbated by inflammatory changes happening at the cellular level and this chronically destructive environment is what harms our body’s organs. It just so happens that the virus also targets these same people and it flares their inflammatory response, to the point that it can kill people.
By aggressively lowering our inflammation level, we might in turn lower the risk that the virus poses to us, while at the same time managing our chronic diseases. Truly a win-win scenario, if we’ve ever seen one.
So what are we actually going to be able to do? How can we concretely make a difference in the risk of the disease becoming fulminant and really doing damage to someone?
Answer: Use the warm weather during these summer months to effectively and aggressively alter your lifestyle to increase health and if you have been prescribed medications, take them routinely to get control of your diagnoses.
Summer is an ideal time for getting healthier. People are naturally more active in the summer months. The weather is more inviting, the days are longer, people are more likely to access fresh foods. Summer weather is also a natural suppressant for respiratory viruses in general - we just have to hope this one follows the model of other coronaviruses and influenza by diminishing in the summer months.
Furthermore, the following are recommendations Lifestyle Medicine physicians might make to patients to create concrete action steps so that we might begin to reduce our underlying inflammatory levels. They might not pertain to you personally, but they are examples of guidelines which we often recommend to patients for making lasting changes in their lifestyle. If you have questions about whether these are appropriate steps for you to take, please contact your physician and ask if they are safe for you to do.
- As a part of your diet - eat 1-2 servings of fruits & vegetables with all meals, including breakfast; eat 15g of fiber in a day as a start and build to 30g of fiber each day; limit your total window in which you eat to 8-12 hours; finally, and which might be the most difficult for many people to start making a part of their lifestyle, reduce the total amount of, or avoid, pro-inflammatory foods such prepackaged highly sweetened foods and drinks, highly processed foods and even reducing or eliminating most meats, especially highly processed meats such as lunch meats and bacon.
- Begin a daily exercise habit- start with walking 10 minutes for the first week, every day, just hard enough to make you breath harder; increase time by 5 minutes per week until reaching 30 minutes; increase speed to the point where a conversation is difficult but manageable; add 10 -15 minutes of lifting small weights or resistance bands while watching a favorite TV program. There is great evidence that 30 minutes of moderate exercise increasing longevity and reduces the underlying cause of many diseases.
- Improve your sleep - turn the phone off 30 minutes before sleep; avoid caffeine in the afternoon; take a magazine or book to bed instead of the phone; wake up at the same time every day and eat the first meal at the same time- it can improve sleep consistency. Sleep is an extremely important period of healing for the body and many of us have a great deal of trouble getting enough. Please seek medical help if this is an area in which you are struggling.
- Reduce stress - some examples might include trying “mindfulness” for 2 minutes per day the first month. Add 1-2 minutes every week until reaching 15-30 minutes per day; schedule appointments with your counselor every 2-4 weeks if helpful; pray for 5 minutes per day if followers of faith; spend time in a stress reduction hobby 15 minutes or more per day; take a mid-day mini-nap if it is feasible.
Now is our moment to make a difference.
We need to enroll ourselves in basic training to protect our health while we have the time. We need to help ourselves to physically resist the looming viral infections to come. We need to narrow the target window for COVID-19 to hit us by reducing our chronic systemic inflammation. We have a small window of opportunity to make this happen during the summer months - let’s move it or lose it my friends!