The immune system, infectious illness, and COVID-19

The immune system is a complex system of tissues, cells, and organs that detects and acts against threats to your health.

The first layer of protection we have against infections is our skin – it provides a physical barrier between your organs and systems and bacteria, viruses, parasites and toxins you may encounter. We also have complex microbiomes – microorganisms that exist on our skin, in our mouths and noses, and in our guts. The microbiome can protect us from certain illnesses. Finally, there are cells generated by the immune system (white blood cells like T-cells, B-cells, macrophages and others) and proteins (antibodies, cytokines and others).

Can you boost your immune system? Because it is quite complex, scientists are still unraveling all of the connections between our lifestyles and immune function. We do know there are certain behaviors that can help protect us from disease – avoiding exposures to chemicals like tobacco smoke, washing our hands, and others – https://www.health.harvard.edu/staying-healthy/how-to-boost-your-immune-system.

Microorganisms that can make us sick are called pathogens – https://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/germs/art-20045289. Sometimes they live on and in our bodies without causing illness. Other times, they can multiply to the levels of causing disease.

SARS-CoV-2 is the virus that can cause COVID-19, the respiratory illness that is now pandemic. This is a novel virus, but it is related to other coronaviruses that sometimes cause seasonal colds, and have caused 2 other epidemics in the last two decades – SARS and MERS. Viruses are pieces of genetic material encased in a shell with binding proteins. They enter the body and invade our own cells in order to make copies of themselves. The below video gives a short explanation of how the coronavirus functions, but was made in March 2020, so does not contain up-to-date information on the pandemic.

The COVID-19 pandemic began at the end of 2019. It is a respiratory disease that has a relatively long incubation period (the period of time people don’t have symptoms even if they are infected), can spread even when people don’t have symptoms, seems to mainly spread through droplet and direct contact exposure, and can cause severe illness and death in some people. Find more detailed information here – https://www.cdc.gov/coronavirus/2019-nCoV/index.html

Late in 2020, several vaccines for SARS-CoV-2 have been developed and are in different stages of testing/approval. Vaccines generally work by signaling your immune system to create antibodies which can attack the pathogen when you come in contact with it. The two vaccines that have been approved by the FDA currently are both based on the mRNA or messenger RNA molecule. These molecules instruct your cells to make a protein on the surface of SARS-CoV-2 (the spike protein), which your immune system recognizes as a foreign body and begins to manufacture antibodies. Read more about the current vaccine research here https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/covid-19-vaccines

Medicines and drugs

A drug is a substance that causes changes in the chemical and biological processes in the body. This is a very general term, and thus, drugs can fit into several categories, both beneficial and harmful to human health.

Medicine is defined as a drug that is meant to prevent, diagnose, or treat a disease. Each country defines for itself how medicines are regulated. In the United States, the Food and Drug Administration (FDA) is responsible for regulating medications.

Some medications require prescriptions from a doctor or other healthcare professional. Others are sold to anyone from a pharmacy – https://www.fda.gov/drugs/questions-answers/prescription-drugs-and-over-counter-otc-drugs-questions-and-answers. In either case, it is important to become educated about using medications safely – know about the right indication for use, the right dosage (how much active ingredient), which active ingredients are present, the risks and benefits, and possible side effects. https://www.fda.gov/drugs/resources-you/be-active-member-your-health-care-team-brochure.

The active ingredient of the medication is the one that interacts with your body so as to treat a symptom or cause of a disease, or prevent or diagnose the disease. The main effect of the drug is this specific therapeutic effect. But most drugs come with side effects – effects that are beyond that main effect. These can be mild or severe. Be sure to read the drug package or pharmacy print-out to know what to expect.

Medications can also be brand-name or generic. Generic medications are those have been developed once the active ingredient is no longer protected by a patent. This generally means that generic medications are cheaper than the brand name alternatives. https://www.fda.gov/drugs/questions-answers/generic-drugs-questions-answers

Drugs can have interactions with other drugs, with dietary supplements, and even with food. These can amplify the main effects or side effects, cancel each other out, or cause unwanted effects. They can also change how the drug is absorbed, metabolized (or broken down) and excreted out of the body. Read more here – https://www.fda.gov/consumers/consumer-updates/avoiding-drug-interactions. It is important to tell the doctor or pharmacist what medications (whether over the counter, or even herbal) you use regularly, to avoid interactions.

Drug are administered into the body in several ways, including orally, through injection, by inhalation and other means. https://www.merckmanuals.com/home/drugs/administration-and-kinetics-of-drugs/drug-administration

It is possible to abuse over-the-counter and prescription medications. People may also misuse these types of medications, which means using them for a purpose other than the main effect.

Reliable health information

In order to make educated and wise decisions about healthcare and health products and services, we must be able to get good information. With the Internet, there has never been more freely available information. But not all of that information is correct. Nevertheless, most of us reach for Dr. Google when we have a health question. How can we get the best information out there?

First, you should be skeptical of news pieces about health, especially if it’s something that sounds too good to be true. Read more or listen here – https://www.wnycstudios.org/story/breaking-news-consumers-handbook-health-news-edition.

Second, you can always ask your doctor what source of health information they recommend. Nowadays, many doctor’s offices have a way for you to email your doctor for quick questions and answers, if you don’t have a face-to-face appointment coming up.

Look things up on search engines using these tools.

Infographic on how to google more effectively. Use keywords like report, search in a particular site, use quotes around a phrase to search for it. Use Google Scholar or your library for scientific papers.

If you want to quickly see if a website has been reviewed and certified by experts, you can do a custom search here at Health on the Net –
https://www.hon.ch/en/search.html or install a browser extension to see which sites are certified or not
https://www.hon.ch/en/tools.html#honcodeextension.

Finally, consider these questions – who pays for this site? Do they provide evidence, and if so, what kind? How recent is the information? Read more here – https://www.mlanet.org/page/find-good-health-information.

Health insurance

You may have had health insurance for a long time, you may be covered under your parents’ plan, you may get it through Medicaid or Medicare, or maybe you don’t have it. But what is health insurance?

Here are some of the more common terms you may find in your health insurance plan – https://www.cms.gov/CCIIO/Resources/Files/Downloads/uniform-glossary-final.pdf

Most of the time, if you can get a health insurance plan through your employer, that will be a better deal than getting it on your own. What should you look for when trying to select a plan? http://guides.wsj.com/personal-finance/insurance/how-to-shop-for-health-insurance/. Consider a few things as well – do you have a known chronic condition? What is your budget for healthcare? Are you generally healthy and don’t visit the doctor often?

You may be eligible for a plan through Medicaid or Medicare (if you are over 65 years of age).

You may also decide to shop for a plan through the marketplace established by the Affordable Care Act – the New York State marketplace is here. Some information for young adults and about the essential plan can be found on the site.

Healthcare costs in the US are very high, usually much too high for an individual to afford. This video explains some reasons why.

Prevention and wellness

One view of medical care is that if something is wrong, you can go to the doctor to get better. The medical definition of health is often just the absence of a particular disease.

However, there is another view of health and wellness – this is the view that sees wellness as a combination of several dimensions, and sees the interaction of the person and their environment. In this view, we not only want to cure an illness, we want to prevent it from happening if possible. This is the public health model of health.

We can think of prevention as a behavior that eliminates or lowers the chances that a disease will happen in the first place (primary), or behaviors that lead to a disease being discovered early and thus treated early (secondary).

Examples of primary prevention are vaccination, wearing condoms, putting on sunscreen and hand washing. Examples of secondary prevention are Pap smears, mammograms, and other screening tests.

Image of vaccine adminstration

Here are a few more ideas for preventing disease – https://www.nih.gov/health-information/disease-prevention-toolkit.

Complementary and Alternative medicine

We already know the definition of conventional healthcare. Anything that falls outside the realm of conventional care is considered to be complementary or alternative care. You may also see the term integrative health. Read about the differences here – https://nccih.nih.gov/health/integrative-health.

There are several types of complementary or CAM approaches.

Natural products includes various products like herbs, dietary supplements, probiotics and so on. These tend to be the most common CAM practices that people try.

Mind and body practices include things like yoga, meditation, massage, chiropractic practices and so on.

Some CAM practices can be considered their own medical system. Examples include Traditional Chinese Medicine, Ayurveda, homeopathy and others. These systems have their own philosophies about what causes health and disease, often incorporating a belief in some kind of vital force like qi, and will likely contain a large number of different types of treatments. These systems are often considered holistic, because they think of the person as inextricable linked to a vital force that connects them to the environment, and because the body, mind and spirit are closely connected.

Traditional Chinese Medicine includes practices like acupuncture, massage, herbal remedies, and several other components.

Ayurvedic medicine is one of the oldest systems of medicine still practiced in the world. It came from India and contains several practices like yoga, meditation, herbal and natural products, diet and so on.

Homeopathy is a holistic system which was developed in Germany about 200 years ago. Treatments mainly consist of highly diluted remedies.

Before you decide to use any of these practices, consider whether they are safe for you to use and whether they are effective – https://nccih.nih.gov/health/safety and https://nccih.nih.gov/health/decisions/consideringcam.htm.

Make the most of your healthcare visit

You’ve decided to go see a doctor or other healthcare provider. Maybe it’s just time for a check-up. Maybe you are not feeling well. Whatever the reason, here are some ideas to make the most out of your visit.

Think about your reason for the visit, prepare ahead of time, try to focus on what brought you in – https://www.npr.org/2019/07/03/738497630/how-to-get-the-best-from-your-doctor.

Learn how to ask questions! Sometimes the visits are short, and you forget to ask something you wanted to know about. Try to write down your questions before the visit so that doesn’t happen. Some sample questions are here – https://www.ahrq.gov/patients-consumers/patient-involvement/ask-your-doctor/index.html.

If you are nervous about something, it may be helpful to bring someone with you to the visit. Having two sets of ears can help you to remember some of the important things your doctor may tell you. You can also take notes during your visit, especially if you are getting a prescription, the doctor is sending you for a test or procedure, or they tell you something unfamiliar.

As a patient, you have certain rights. In general, you have the right to get medical care if you need it, and to refuse specific kinds of care. You have the right to an informed decision – that is, your healthcare providers should tell you your diagnosis, the risks and benefits of possible treatments, and the success rate of a treatment if there is a known one. You have the right to privacy of your medical information and the right to view your medical records.

What makes a good doctor?

We all have to seek professional healthcare sometime. But how do we find a healthcare provider we really like and trust?

Think about a good experience you’ve had at the doctor’s office, urgent care, or hospital. What stood out to you as a good quality for your healthcare provider?

Think of a bad experience. What did you find frustrating? What would you change, if you could?

Find some more ideas here – https://www.npr.org/sections/health-shots/2019/07/08/739039046/how-to-pick-a-doctor-or-break-up-with-one

Conventional medical care

Conventional medical and health care are also called allopathic or Western medicine. This is in contrast with complementary, alternative, or integrative health approaches. Most of the healthcare you have probably gotten in the United States is this type of care – the kind where doctors, nurses and other affiliated medical professionals provide the care.

This type of care generally concerns itself with diagnosing, preventing and treating disease. Disease or illness in this system of care is thought to stem from organic changes in the body, like atherosclerosis, or from exposure to pathogens like bacteria and viruses.

The people who provide conventional care are medical doctors who hold MD or DO degrees, nurses (who may have a bachelor’s or master’s degree and who are licensed as RNs or NPs), physical therapists, and various other allied medical professionals. Examples include emergency medical technicians (EMTs), respiratory therapists, dentists, podiatrists, optometrists, and others.

Most medical doctors hold the MD (medical doctor) degree, and some may also have a DO or Doctor of Osteopathy degree. They attend accredited medical schools for several years, then have periods of residency and internship, and some may choose to specialize further. Doctors who provide general every-day medical care are usually those who studied internal medicine or family medicine. They may be known as general practitioners or primary care providers. They can see people for common complaints like respiratory infections, and well-care (check-ups that may include blood laboratories, blood pressure screenings, vaccines, and other prevention and routine care). They can order screening tests, blood work, medical imaging like X-rays or MRIs, and other diagnostic tools, and can prescribe medications. Doctors offices may also have Nurse Practitioners (NP) or Physician Assistants (PA) provide this kind of care under the supervision of the doctor.

Doctors who choose to specialize spend several more years working in a particular area of medicine. This can be based on a particular body system, like cardiology or neurology, a kind of patient, like pediatrics or gynecology/obstetrics, or particular type of disease, like oncology (specializing in cancers). Usually, a primary care provider may refer their patient to a specialist if they require more than routine every-day care.

Conventional care is also found in hospitals, urgent care centers, and rehabilitation centers. Here, many allied health professionals may be present to help doctors provide care.

When should you seek emergency care and when should you go to an urgent care center? Generally, you should go to the emergency room a life-threatening condition (heart attack), sudden serious changes like shortness of breath, numbness or paralysis, or serious/severe conditions like trauma, severe cuts or burns, severe allergic reactions and so on. Urgent care is for times when you need care right away and may not be able to see your primary provider quickly – things like respiratory infections, earaches, etc.

Exercise safely

It is important to prevent injuries when you exercise. There are traumatic injuries that can happen suddenly and overuse injuries that happen from repetitive motions. As a first line of treatment for overuse injuries, you can try RICE – rest, ice, compression and elevation. However, it is important that you see a healthcare professional as well, to make sure nothing serious is going on.

Wear comfortable shoes – https://www.webmd.com/fitness-exercise/features/how-choose-athletic-shoes#1.

Learn how to exercise correctly – https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/weight-training/art-20045842?p=1 .

Wear a helmet or other protective gear when riding a bike, skateboard, roller blades and other activities that can result in injuries. Wear the safety clip attached to treadmills – they will stop the machine if you get too far from the safety bar.

Stay safe when exercising in hot weather – https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/exercise/art-20048167.

Make sure to drink enough water before, during, and after exercise. You probably don’t need to increase your protein intake unless you decide to become a body builder. However, eating or drinking a small amount of protein-rich foods can be helpful with muscle recovery. Make sure you are eating enough carbohydrates for energy.

If you decide to use dietary supplements to enhance performance, first read this https://ods.od.nih.gov/factsheets/ExerciseAndAthleticPerformance-HealthProfessional/. Know that dietary supplements may not always work as you expect, so consider carefully. Using medications like anabolic steroids or human growth hormone to enhance performance is unwise and may lead to health problems.