Let’s focus on you, because: “it is more important to know what sort of person has the disease, than what sort of disease the person has.” 

This 42-year-old gentleman was very unwell with severe lethargy following a Covid-19 infection in May.  Routine blood cell counts showed anaemia with low haemoglobin at 115, MCV low at 78.6, white cell count low at 3.12, neutrophils low at 1.22, and lymphocytes low 1.05.  Fasting blood sugar was high at 6.4, suggestive of pre-diabetes.  Haemoglobin A1C (HbA1C) was high at 45, diagnostic of diabetes.  A genetic test confirmed a compound MTHFR variant of 677 and 1298.

He was overweight with high BMI at 28.7 and a waist-to-hip ratio of 0.97.  I put him on Paleo diet, with intermittent fasting, and commenced Berberine to sensitise his cells to the action of insulin, B vitamins to help energy production, and iron to optimise the electron transport chain.

On returning to the clinic three months later, he had lost nearly two stone in weight and his blood sugar had normalised with HbA1C down to 35, and fasting blood sugar had plummeted to 5.1.  He had regained his full energy and pursued a normal healthy life.

(Type 2 diabetes causes insulin resistance, which means that the body does not respond well to insulin, the hormone that opens the gate for sugar to be burned to energise us.  Sugar will instead accumulate in the blood to coat and damage immune proteins and cells.  This can be easily diagnosed with a simple test for raised HbAIC.  Putting the patient on an appropriate dietary regime and supporting them with food supplements helps them recover, achieve ideal body weight and reclaim their immune system to prevent further infection.)

Simple interventions with weight loss and appropriate diet, together with vitamin support, have helped this patient recover completely to normal health, definitely preventing future infection.

It gives us all hope.  But let us return to the second wave………. Is this truly a second wave of Covid-19 or is there another explanation?

Let’s look at what has happened.  There is an increase in the number of new cases reported on a daily basis in the UK and globally.  However, the mortality rate in UK intensive care units is lower in the second wave than in the first, and the 28-day survival rates are also better.  The increase in the number of patients admitted to hospital has reached half of the spring peak.

One interpretation of the above data is that this increase in new cases is due to an increase in testing, because this is a condition where 80% to 90% of cases usually stay asymptomatic.

Infected patients now receive a lower dose of the coronavirus, and a smaller viral load produces less severe symptoms.  Perhaps the virus has mutated to become less virulent.

Maybe we are seeing less severe cases in the second wave due to the herd immunity gained during the first wave.  The use of dexamethasone (steroid) in the UK may have reduced inflammation and calmed down overreactive immune systems.

Doctors and other healthcare staff now have more experience in dealing with Covid-19 resulting in improvement in clinical decisions.

Worse in winter?

Whether this is a second wave or not, what can we expect the future to bring?  The mortality rate in UK intensive care units is at present lower, but cases are expected to soar in winter.  But Covid-19 is a new virus, and we don’t know if cases and mortality will increase as the weather gets cooler, like with the flu (influenza) virus.

However, a study does suggest that Covid-19 may be more severe in the cold winter months, indicating a 18% drop in mortality for every 1°C rise in temperature.  The study reported that, as UK temperature rose, mortality dropped and general outcomes improved.  Also, less severe disease and lower mortality was observed in the warm countries of Africa as compared with the colder climes of Europe.

With shorter days and less sunshine, people are lower in vitamin D, which plays a major role in insulin production.  So, lower vitamin D means low immunity and poor glucose processing.  The impact is compounded by the Halloween/Firework Night/Christmas party season, where there is more sugar, alcohol and junk food consumption.

The World Health Organisation has reported a low Covid-19 mortality rate of between 0.26 and 0.46%.  Covid-19 does not feature in the top 10 killers in the UK.  Average age of Covid-19 death in the UK is 82.  There is evidence that Covid-19 transmission was decreasing throughout October.

What did we learn from the first wave?

We learned that we need to flatten the peak of the epidemic for the NHS to cope, so that they can provide adequate treatment and reduce mortality.  The first wave was curbed by a national lockdown.

This time, there is no change in prevention strategies – 2-metre social distancing, wash your hands with soap and water, disinfect your hands with alcohol gel.  There is no effective drug treatment, only supportive interventions.  There is as yet no vaccine.

High risks groups were identified as the over-70s and those with chronic health conditions.  Is there any development in that knowledge?

We know that people in possession of ACE receptor variant are at high-risk of Covid-19, because the variant allows the virus easy entrance into their cells.  Also, at risk are people with high plasmin levels, such as those with obesity, diabetes, high blood pressure, heart disease, chronic kidney disease, and chronic obstructive pulmonary disease (COPD).  High plasmin facilitates the entrance of the virus into the cells.

An overreactive immune system is also a risk.  The genetic variant of IL-6 is associated with cytokine storms in the lung, resulting in ADRS and respiratory failure.  (There is the possibility of using pharmaceutical agents such as low naltrexone (LDN) to calm down the immune system.)

What makes Covid-19 infectious?

For infection to happen, the virus has to enter the cells, and then hijack the cell’s resources to multiply and take over.  The virus enters the cells mainly through the ACE receptor in the lungs and blood vessels in the following way: the virus binds the ACE receptor by the lateral projection – capsid or S protein; it then cleaves the S protein subunit in order to enter and infect the cell, using plasmin, an enzyme in blood.

As I have said, plasmin is exceptionally high in those with obesity, high blood pressure, diabetes, heart disease, chronic kidney disease, and chronic obstructive pulmonary disease (COPD), making them at high risk of Covid-19.  This makes plasmin a primary therapeutic target.

The unique challenge of Covid-19

Covid-19 is unique in having Furin cleavage, made up of four amino acids, two of them Arginine.  This means that Covid-19 is new, with no close relatives in the viral kingdom.  The nearest relatives share only 37% nucleic acid sequence.  The Furin cleavage makes Covid-19 highly infectious and likely to result in poor clinical outcomes.

This 45-year-old lady presented with severe post-Covid-19 infection in March, complicated by severe fatigue (PVFS), her energy level plummeting to 2 out of 10.  Routine blood tests showed Hb normal at 130, WBC 4.62, normal neutrophil at 3.04, but low lymphocytes at 1.04, B12 was low at 192, Fe normal at 19.5, thyroid function was within the normal range with TSH at 2.57, vitamin D 106.  She ate a good, balanced diet and had been on multivitamins.  Hence, her B12 deficiency was likely to be related to gluten intolerance, which was confirmed in her genetic test.

I asked her GP to administer B12 injections and I prescribed B complex tablets.  Gluten can damage the stomach lining and impair the absorption of B12.  The other B vitamins can be absorbed through the gut.  The patient reported back to the clinic eight weeks later with good energy levels at 7 out of 10, and a normal serum B12 at 549.

Further testing revealed very high oestrogen, low progesterone; however, DHEA and testosterone were within the normal range.  Also, all cortisol specimens were within normal range.  So, I prescribed interventions to support the detoxification of oestrogen and progesterone to reinstate hormonal balance.

This confirms that simple tests like blood counts, thyroid and sex hormone profiles, can help to set up a personalised management plan to support a person who suffers a severe Covid-19 infection with complications.  These interventions not only prevent further Covid-19 infections, but also reassure the patient that they are safe to pursue a normal life.

Neutropenia (low neutrophil) and lymphopenia (low lymphocytes) are common among cancer patients, particularly after chemo or radiotherapy.  This puts the patient at high risk of serious infection.  These patients are usually admitted to hospital as the matter of urgency for potent intravenous antibiotic combinations.

Supplements that can support the high-risk groups are vitamin B, C, D, Zinc, Selenium Quercetin, EGCG (green tea), Elderberry.

Studies confirmed the beneficial effect of vitamin C in acute cases and prevention of Covid-19 infection.  It is an antioxidant, a free radical scavenger, giving it an anti-inflammatory effect.  Human beings cannot make vitamin C, so it has to be supplied in food or as supplements.  Against Covid-19, it has been found to be effective in the management of the acute respiratory distress syndrome (ARDS) and vascular injury.

Don’t live in fear: build your castle

Yes, please, my friends, build up the castle that is your body and its health.  But, in doing so, do we adopt the germ theory or the terrain theory?  This goes all the way back to the 19th century debate between Louis Pasteur’s germ theory and Antoine Bechamp’s terrain theory.

The first states that germs are the cause of disease and we need to kill them and keep them at bay to stay healthy.  This approach helped to produce antibiotics.  The terrain theory views germs as our partners in this world and says that we should not worry about them but focus instead on keeping ourselves in a healthy balance, ready to defend ourselves when necessary.

Both theories are important, because, whilst I strongly advocate keeping ourselves healthy, I also recognise that we need medicines when our bodies are not in the best shape to defend themselves.

Hippocrates states that “it is more important to know what sort of person has a disease than to know what sort of disease a person has”.

With so many different Covid-19 experiences being reported, I would love to hear your Coronavirus story.  Please feel free to share it with us if you can, and I will be delighted to respond if I feel I can help.  We all of course recognise that, in sharing our thoughts, we may well be helping others to reach a successful conclusion to their Covid-19 journey.  Thank you!