Wherever you live in the world, government advice is to stay at home and do nothing during this time of pandemic. However, there’s actually rather a lot that you can do for yourself and your family from home.

• Find related articles, information and videos in our Covid Zone

Our newest video in our Covid-19 series takes you through 4 main areas where your own actions can have significant impact to reduce your risk and susceptibility.

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Be empowered: you are not without hope

As Adam Kucharski, associate professor at the London School of Hygiene & Tropical Medicine explains in his serendipitously-timed book, The Rules of Contagion: Why Things Spread – and Why They Stop (Wellcome, 2020), there are 4 key factors that drive the reproduction number (R₀ value). This is the all-important (but also problematic) statistic that tells you how many people a single infected person is likely to infect. Estimate from different studies vary greatly, ranging from around 1.5 to as high as 5, with more common estimates ranging from 2 to 3.5. If the value remains above 1, spread of the virus through the global population will likely continue – but as with all novel viruses, the R₀ value will decline with time as our immune systems adjust to its presence.

Dr Anthony Fauci and colleagues from the National Institute of Allergy and Infectious Diseases at the National Institutes of Health in the USA, leading the scientific strategy stateside, propose an R₀ of 2.2. He also proposes a true case rate fatality that might be considerably lower than 1%. He suggests this might put Covid-19 on par with severe seasonal influenza which has a fatality rate of around 0.1%.

The components feeding into an R₀ value are several:

• Duration of infection (i.e. how long are you spreading and shedding virus)
• Opportunity (i.e. where do you go)
• Transmission probability (i.e. what’s the chance of you passing on infection), and
• Susceptibility (i.e. your underlying susceptibility).

Current government advice so far addresses the first three of these, but not susceptibility. This is likely because of the high level of individuality between us all that governs our personal susceptibility. From genes, to gender to our diets, lifestyles and the drugs we’ve been prescribed. With this kind of variation, it's hard to issue one-size-fits all public health messages.

With this dearth of information are anxious fearful, disempowered citizens who don’t realise that there are powerful self-care options to help reduce personal susceptibility and enhance underlying health - even if you fall into one of more of the very vulnerable groups.

Breaking down susceptibility

We’ve spoken in previous articles and videos in our Covid-19 zone about how stress, a bad diet and a lack of exercise negatively impacts your immune system at a time when you most need it to bring its A-game. This week we bring you key information emerging from the scientific pandemic literature about susceptibility. You’re not likely to hear this information on the news any time soon and you certainly aren’t likely to hear that there’s anything you can do about reducing your susceptibility.

In short, the data are pointing to men being more susceptible than women. As vaccine researchers have long-known, men don’t mount as strong an immune response. That's likely an evolutionary adaptation because men, unlike women, are not gifted with all the DNA (in their sperm) for their potential progeny at birth. In a detailed study on critically ill patients in UK intensive care units, 70% of the 775 patients involved were found to be men. While some studies from China showed a very similar tendency for severely ill patients to be mainly men (Lancet study, BMJ study) there are other studies that show a more equal distribution of men and women, such as a large study of Covid-19 patients in China, involving 1590, published in the European Respiratory Journal.

Those with hypertension and cardiovascular disease also fall into this highly susceptible category. As do those with metabolic dysregulation resulting in type 2 diabetes, obesity, metabolic syndrome and cardiometabolic syndrome. In our review of 11 key studies(* see below) looking at the relationship between underlying conditions and susceptibility, 4 diseases among patients are consistently the most common among those with the most severe symptoms, including death. These are cardiovascular disease, hypertension, diabetes (the majority of which are overweight or obese) and chronic respiratory disease. In relation to body weight, a UK study found that 72% of patients (n = 775) had a body mass index (BMI) in excess of 25.

All of these groups have one thing in common: they all suffer systemic inflammation. 

Age is also a very important factor, because there is a functional decline in the immune system. But this isn’t limited to your chronological age. Your metabolic and biological age is ultimately what’s important as it reflects your epigenetic clock and the true state of your health. Based on the existing studies that have included reference to age, it is clear that older people - those over 50 - are considerably more susceptible than younger people. For example, the previously mentioned UK study (n =775) found a mean age of 60 years old, whilst an Italian study that included a hot spot of people in care homes, had a mean age of 78.5. While all studies clearly point to the inherent resilience of children to Covid-19, there are other studies that do include significant numbers of younger people, such as a Chinese study, with a median age of 41. While it is too early to conclusively explain such variations, it seems likely that when younger people are affected, there are one or more factors expressed by those individuals that likely make them both more susceptible to the virus, as well as to chronic diseases as they age. There has been much made of the fact that those with a history of lung or respiratory diseases are also highly vulnerable.

The connection between all these high-risk susceptible groups is inflammation - which is the insidious underlying driver of nearly all chronic diseases, but which can also be very positively impacted by diet and lifestyle changes. Critically, those who suffer severe disease from Covid-19 are, in effect, hyper-inflamed, so any effort to reduce inflammation is likely very helpful.

How we can reduce our susceptibility?

Our latest video in our Covid-19 series walks you through four areas that contribute to your personal susceptibility: genes, physiology, behaviour and environment, but that are also highly modifiable by different methods of self-care.

Genes

Our genes contain our genetic code, our book of life, which also determines how our immune systems will function in response to external and internal triggers. However, even if you’ve been dealt a poor hand of genetic cards, our immune systems’ function can be improved, but it may take a bit more work with more specific dedication. Immune resilience is greatly supported by eating a balanced and healthy diet, getting ample good quality sleep, exercising daily and managing stress. Whether you are male or female, please remember that while our genes load the gun, it’s our environment that pulls the trigger, because our gene expression (how our genes interact with their environment), ultimately determines our level of health and resilience.

Physiology

There is plenty of rapidly emerging data that demonstrates that our underlying physiological state has a big bearing on the Covid-19 disease process. This in turn influences whether we might express severe, moderate, minor or even no symptoms of the infection. During this time of potential exposure when you want your immune function to be at its optimal, make a concerted effort to eliminate all added sugars and highly refined, starchy carbs from your diet. Reducing the amount of circulating sugar in your system and moving to a keto-adapted diet, as per ANH’s Food4Health guide will promote metabolic flexibility and help you start burning fats for energy, rather than sugars. We’re aware that through stress, anxiety, fear and also boredom, many are comfort eating all the wrong types of foods at the moment. However, increasing your level of healthy fats as you cut out starchy carbs and sugar will help you handle cravings and reach satiation more quickly.

Behaviour

The impact of our behaviours on risk and susceptibility go a lot further than handwashing and social distancing, which are also about our role as transmitters of Covid-19 to others. Behaviours such as smoking, drinking too much alcohol, getting less than 6-8 hours of quality sleep a night, letting your stress get on top of you and exposing yourself to lots of chemicals via processed foods, household cleaners and personal care products, can all impact your body’s ability to mount an effective immune response. Add to this a lack of activity and movement, time spent outdoors and also time for self-reflection/’me time’ and you can further compromise your health. If you can get outside, do - the benefits are not all psychological and emotional, nature brings us into contact with an array of beneficial microbes that support and assist our own microbiome, which is essential and integral to immune function.

Environment

In a health sense, the word environment refers to everything to which we’re exposed, including the food we eat, the air we breathe, the water and fluids we drink, the products we put on our skin and the spaces around us, both in and outside our homes. Added together, these factors all have big impacts on your health and the way your immune system functions. Your immune system is your primary defence against the virus – and for most people, it works incredibly well most of the time. So well, that most of the time you’re not even aware of how many pathogens you’re being protected against.

Six top tips for an immune A-game

1. Optimise our diets. Our Food4Health guide points you in the direction of a dietary and lifestyle approach that’s both anti-inflammatory and one that helps you develop metabolic flexibility
2. Fill any dietary gaps with key supplements. Based on data from dietary and nutrient surveys, many people have inadequate vitamin D, vitamin A, zinc and magnesium status. Vitamin C is also key when it comes to protection against viruses.
3. Drink hot fluids like herbal, immunity-enhancing teas throughout the day. Hot drinks help to wash any virus particles caught on the mucosal surfaces of your mouth into your stomach acid and if herbal, also provide resources to help support your immune system.
4. Stay calm and manage your stress with techniques that work for you because anxiety is your immune system’s enemy. From meditation and mindfulness, to exercise and activity, to family time or more self-reflective re-evaluation of your life, lock down provides us a rare opportunity to stop and recalibrate. Try breathing techniques, yoga or meditation to give yourself peace of mind, get yourself grounded in nature, practice living in the moment and not the future. Rest, rejuvenate, find things to laugh about and explore some apps to help e.g. HRV or heart rate variability; meditation; sleep
5. Get outdoors if you can. Luckily for us in the UK we’re still allowed to exercise outdoors once a day. Make the most of that time and take time to smell the roses…
6. Cut the chemicals! This recalibration time is perfect for reducing the number of harmful chemicals around you. Think household cleaners, garden products and personal care products like skin and hair care and make up. You don’t need to fill your house with harsh disinfectants and anti-bacterials at this time - simple soap and water is enough to kill the virus. So too is coconut oil mixed with a few drops of Lugol’s Iodine solution (tip: gently melt the coconut oil, add the iodine, mix and put into a clean jar to solidify again) used on hands instead of harsh sanitisers. Lastly, remember that processed and ultra-processed foods are usually loaded with non-nutritive nasties like additives, preservatives and colouring.

*11 key studies:

Study 1
Study 2
Study 3
Study 4
Study 5
Study 6
Study 7
Study 8
Study 9
Study 10
Study 11