Tag: readings

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.

This video provides a short overview of coronaviruses.

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

More information on SARS-CoV-2 variants is explained here:

Late in 2020, several vaccines for SARS-CoV-2 have been developed and 3 have been approved for use in the United States (with several others being used in other countries). Vaccines generally work by teaching your immune system to create antibodies which can attack the pathogen when you come in contact with it. There are 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. Another vaccine made by J & J works by introducing another harmless virus (adenovirus) in order to bring pieces of SARS-CoV-2 to your immune system. Read more about the current vaccine research here https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/covid-19-vaccines

In 2022, vaccines have been approved for most age groups, we have had booster shots, wide-spread testing became possible, and treatments for COVID-19 have improved a lot. However, variants have continued to spread and have become more contagious and mitigation policies have mostly disappeared. We’ve understood the disease more and people continue to get sick and even die, but people and governments have mostly returned back to the lives we led before the pandemic started. People can still be more vulnerable to the disease, especially those who are immuno-compromised in some way, people who are getting treated for cancer, people living with chronic diseases, and others. An important issue for all is that a considerable percentage of people who get sick with COVID-19 can develop long-term symptoms, some debilitating. It is unfortunate that mitigation measures are no longer required and this disease is establishing itself as something we will continue to struggle with for years to come.

How does the body work?

Our bodies contain several different systems and are made up of tissues and organs. All the systems work together in a complicated way to break down foods, intake oxygen, expel waste, communicate between each other, process outside stimuli, and more.

Read a short description of what each body system does here https://www.healthline.com/human-body-maps and watch the short video below.

In particular, the cardiovascular and respiratory systems work together to get oxygen out of the atmosphere and move that oxygen to various organs and tissues. The lungs help to oxygenate the blood, the heart then pumps that blood out to the other parts of the body, and blood vessels circulate the oxygenated blood around the body, and bring carbon dioxide to the lungs to exhale.

Organic changes in the cardiovascular system can lead to heart disease – the leading cause of death for most demographic groups in the US. https://www.cdc.gov/heartdisease/facts.htm One of the most common system-wide changes is atherosclerosis, the narrowing and hardening of arteries throughout the body. This process can lead to heart attacks, pain in the chest, strokes, and other consequences. Heart attacks (myocardial infarctions) usually happen when the blood supply and oxygen are disrupted to a part of the heart and the heat cells begin to die. This tends to happen because the coronary arteries become closed off or narrow.

Similarly, strokes happen either because of a bleed in the blood vessels in the brain, or a lack of blood and thus oxygen to a part of the brain. Both strokes and heart attacks can be fatal or survivable, depending on the size of the damaged tissue.

Another leading cause of death is cancer. Cancer is a name given to several related diseases. In general, when people have cancer, some cells in their bodies divide and spread to other tissues. https://www.cancer.gov/about-cancer/understanding/what-is-cancer Cancer can happen for various reasons, but commonly it happens because of genes inherited from our parents, or exposure to toxins, infectious agents, radiation and others.

Other illicit drugs

People use other illicit drugs. We can consider the different groups of drugs based on the type of effect they have on a person or how people use them.

Depressants are drugs that act by slowing the action of the central nervous system. These include pain killers and tranquilizers, many available by prescription. Some of these drugs can be misused or abused. Another example is heroin. Some effects of depressants may be a feeling of relaxation, calmness, and drowsiness. Many of these drugs are quite addictive.

Stimulants are drugs that act by increasing the activity of the central nervous system. They can increase the heart rate and cause feelings of excitement, agitation, and alertness. Examples include nicotine, cocaine, and methamphetamine.

Anabolic steroids are synthetic versions of the hormone testosterone. Some people use them to enhance athletic performance or to get bigger muscles which is considered a misuse. However, these drugs can be dangerous to their health and have various side effects.

Inhalants are substances like solvents, aerosol sprays, and gases that people use as a psychoactive drug. Examples of products that people use are household cleaners, spray paint, markers and glue – products not intended for getting high. Overdose is possible with these types of drugs.

Club drugs are various drugs that people use that cause a change in mood, awareness and how people act. Examples include hallucinogens and MDMA (molly or Extasy).

Synthetic cannabinoids are human-made drugs that act on the same receptors in the brain as marijuana. However, they may have a more powerful effect and have not been studied as long, so they may be more dangerous.

Opioid crisis

For about 20 years, the US has been struggling with rising rates of use for particular types of drugs – opioids. These drugs interact with opioid receptors in the brain and include prescription pain medications and illegal drugs like heroin. In particular, one of the dangerous possible affects of opioid use is overdose and death.

Most states in the US are struggling with this problem. See a map with rates here – https://www.drugabuse.gov/drugs-abuse/opioids/opioid-summaries-by-state. This epidemic has evolved over time from overuse and misuse of prescription pain medication, to illicit heroic use, and the third wave of synthetic opioid use (like fentanyl).

Image shows trends of use of opiods from 1999 to 2017, including 3 distinct waves of prescription pain drugs, heroic, and synthetic opioids.
From CDC.gov
Statistics about the opioid epidemic from HHS.gov. Over 70 thousand people died from drug overdose in 2019. 1.6 million people had an opioid use disorder. 745,000 people used heroin. 10.1 million people misused prescription opioids in the past year. 1.6 million people misused prescription pain relievers for the first time. and others
From HHS.gov

There are some medications available for opioid use disorder, including milder opioids like methadone. Overdose deaths can be prevented with an opioid antagonist called naloxone. Government agencies are also working on preventing opioid addiction, limiting the use of prescription pain medications, and helping people find treatment options.

Substance abuse and substance use disorder

People can abuse drugs when they overuse them, often to the point of various negative consequences. They may start to feel withdrawal symptoms when they stop using the drug – mental, emotional or physical effects that happen because your brain has adapted to having the drug.

It is also possible to develop an addiction to substances. Addiction is a brain disease that is characterized by compulsive use and difficulties in controlling one’s behavior, despite negative consequences. Some people may exhibit tolerance to some substances as a result of use.

Differences in Marijuana Use Disorder Women: develop disorder more quickly1 more anxiety disorders2 more panic attacks2 Men: more severe disorder1 more antisocial personality disorders2 more of other substance use problems2 Prescription Pain Medicines Women are less likely to misuse or abuse prescription pain medicines. Four million women report past-year misuse. Five million men report past-year misuse.3
From NIH.gov
Treatment for Sleeping Aid Misuse Women are more likely to seek treatment for misuse of barbiturates. Fifty-five percent of past-year treatment admissions for barbiturate misuse are women. Forty-five percent of past-year treatment admissions for barbiturate misuse are men.4 Quitting Nicotine Nicotine replacement options, such as the patch or gum, are less effective for women than for men. Quit rates after 6 months on the nicotine patch were 14.7 percent for women and 20.1 percent for men.5

It is possible to treat drug abuse and addiction and there are several effective approaches. Scientists are working on innovative new ways to help people with addiction.

The American Psychological Association also recognizes one behavioral addiction – gambling disorder. While other things like compulsive buying, excess exercise, and too much internet use may not be considered addictions, they may nevertheless be distressing and cause people to feel out of control and suffer negative consequences.

Marijuana

One commonly used drug is marijuana, which consists of dried parts of the plant Cannibis sativa or Cannibis indica. The main psycho-active ingredient in this plant is THC or tetrahydrocannabinol.

Image of Cannibis plant. Created by Jennifer Martin
Taken by Jennifer Martin

Many people either smoke or use vaporizers when using this drug. People can also mix the plant into food (commonly called edibles). There are several short-term and long-term effects from the use of marijuana. Health risks include breathing problems, lower birth weight if used during pregnancy, and mental health problems.

There have been several research studies looking at medical uses for marijuana, in particular two drugs within it which are THC and CBD. The Food and Drug Administration does not currently consider marijuana to be a medicine, however, several laws around the US has made it legal to use marijuana for medical reasons. This may include managing nausea when on chemotherapy for cancer, or for treatment of epilepsy.

Some US states have also started to allow recreational marijuana use – see the map here https://www.businessinsider.com/legal-marijuana-states-2018-1. However, this drug is still considered illegal on the federal level. This puts marijuana in a strange position in terms of enforcement. If the federal government decides to enforce their laws, people in the states with legalized marijuana may be at risk. Additionally, many states still have many people serving prison sentences for marijuana offenses, even though the drug has been legalized.

As with most psychoactive drugs, people can abuse marijuana and can develop marijuana use disorder. There are behavioral treatments available.

Sexually transmitted infections (STIs)

STIs are conditions that are mainly spread from person-to-person sexual contact which can include oral, vaginal or anal intercourse, and other types of sexual contact. Prevention of STIs includes using barrier methods (condoms and dental dams), getting certain vaccines, and other behaviors. These infections are relatively common, half of all sexually active adults will get an STI by the age of 25 (according to CDC.gov) – https://www.cdc.gov/nchs/fastats/stds.htm.

There are many different STIs. Some are caused by bacteria and can be treated with antibiotics. These include chlamydia, gonorrhea, and syphilis.

Others are caused by viruses and do not have a cure, though treatments may still be available. These STIs include herpes simplex I and II, human papillomavirus (HPV), and human immunodeficiency virus (HIV). Some strains of HPV can be prevented through vaccination. HIV infection can lead to acquired immunodeficiency syndrome or AIDS if left untreated. However, people at risk for HIV infection can take a medication called Pre-exposure prophylaxis (PrEP).

There are also fungal and parasitic infections like trichomoniasis and pubic lice. These infections are treatable with special medications.

Many STIs are asymptomatic or have symptoms that are not very specific like a fever. Thus, it is important to get regular STI tests if you are sexually active. Untreated STIs can lead to pelvic inflammatory disease. Some STIs may be extra dangerous during pregnancy. Men who have sex with men have a higher risk of getting an STI.

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Contraception and birth control

When people try to prevent or space out pregnancy, they are practicing contraception or birth control. There are several broad categories of birth control. Failure of birth control is measured by what number of people who use this method nevertheless become pregnant. The more a person uses a method of birth control, the more likely failure becomes (since there are several ways to fail to use contraceptive methods correctly). See graphs in this New York Times article showing typical and perfect-use effectiveness for several methods.

Barrier methods of contraception include the condom, the internal condom, the diaphragm, the cervical cap, and the contraceptive sponge. Many of these methods may be used together with spermicide.

Hormonal methods of contraception include the birth control pills, the vaginal ring, the patch, the shot, and the implant. Some intrauterine devices also contain hormones, while one IUD has no hormones and is copper-based.

Behavioral methods include abstinence, withdrawal, and fertility awareness methods.

Surgical methods of contraception are tubal ligation and vasectomy and are usually permanent.

If a person fails to use a contraceptive method or their chosen method fails (e.g. a condom tears), there is emergency contraception, which can be used up to 5 days after. The “morning-after” pill is most effective within 24 hours of unprotected sex.

However, pregnancy can still occur even when using these contraception methods. In that case, people should consider whether they want to continue being pregnant and giving birth. They may also consider abortion. There are two main methods of getting an abortion – the abortion pill, and the in-clinic abortion. There are many limits placed on both of these medical interventions by law, including the length of the pregnancy and the reasons for abortion. This year, the Supreme Court case that kept abortion legal in all states called Roe v. Wade was overturned, and many states have already placed severe limits on this medical procedure, in some cases making it impossible for people to obtain it. This will likely lead to many unwanted pregnancies and births and may result in more difficulties for the pregnant person, including traveling out of state to obtain abortion or trying methods to perform an abortion that may not be medically safe. However, there is wide access to abortion pills and many providers can prescribe these medications early in the pregnancy using telehealth. To read more about ways to access abortion, go here https://www.wired.com/story/guide-abortion-resources-post-roe-america/.

Fertility, conception, pregnancy and birth

Fertility refers to the ability of someone to become pregnant or cause someone else to become pregnant. Some people may have trouble with becoming pregnant – this is called infertility and treatments are often available.

When sperm is present in the Fallopian tubes at the same time as an ovum (or egg), fertilization can occur. Read more about this process here – https://www.plannedparenthood.org/learn/pregnancy/how-pregnancy-happens. Home pregnancy tests are quite accurate and easily available and can often be used once a menstrual period is overdue.

Pregnancy lasts about 40 weeks from implantation and is the process of two cells which have combined (sperm and egg) becoming a full grown fetus. Read about the changes each month of pregnancy here – https://www.plannedparenthood.org/learn/pregnancy/pregnancy-month-by-month.

There are several ways to help a pregnancy be as healthy as possible. Getting appropriate prenatal care, ensuring the right nutrients, avoiding drugs, and other behaviors are important. Some pregnancies are considered high risk and there are certain conditions that can develop during pregnancy, including pre-eclampsia, gestational diabetes, and others. Finding the right healthcare provider is also important. People may go to OB/Gyn doctors or family doctors for care. Another option is a Certified Nurse Midwife. Research shows that having a person present during the birth who can support the person in labor leads to better health outcomes for parents and babies – this can include a friend, family member, or partner, or a trained doula. Read more about healthcare professionals here – https://www.parents.com/pregnancy/giving-birth/labor-support/which-birth-professional-is-right-for-you/.

Labor is the process of the fetus being born and has several stages. Labor can last a long time. There are many options for pain management which include medication, breathing techniques, moving, meditation, birthing tubs and others. Labor can result in vaginal delivery or a Cesarean section. Hear about the stages of labor here https://www.youtube.com/watch?v=samWyTjFmS8 .

Post-partum care includes healing of any incisions or tears, pain management, assistance with breastfeeding and lactation, screening for post-partum depression and/or anxiety, and making sure people don’t develop post-partum complications like blood clots, hemorrhage and others. Typically, people go for a post-partum visit with their healthcare provider within six weeks of giving birth.

Sexual identity

There are many aspects of sexual identity that are complicated and interrelated, including our biological sex, our gender identity and expression, our attractions and our behaviors.

The gender unicorn shows the complexity of gender, sex, and sexual orientation.

A purple unicorn. There are 5 sections with several arrows in each (arros read female, male, and other). The sections read: Gender identity, gender expression, physically attracted to and emotionally attracted to. The fifth section reads Sex assigned at birth with the options Female, male and other/intersex.
Source: Trans Student Educational Resources

Here is a current (though not complete) list of terms that people use in relation to sex, gender, and sexual orientation – https://transstudent.org/about/definitions/

Even something as “simple” as biological sex, or the formation of one’s genitals and gonads, is not as simple as first thought. Scientists have identified many different possibilities that don’t exist on a simple binary of male and female – https://www.scientificamerican.com/article/sex-redefined-the-idea-of-2-sexes-is-overly-simplistic1/.

Sex is different from gender and gender identity. People may express their genders in different ways and gender can be outside of the binary of masculine and feminine. However, society endorses certain gender roles and stereotypes that people may adhere to or reject. Sometimes people may feel that their gender identity does not match the biological sex they were assigned at birth – these people often identify as transgender.

Sexual orientation is how we often think about our sexual and romantic attractions. Common terms include lesbian, gay, bisexual, straight and others. Some people may not experience any sexual or romantic attractions and thus may identify as asexual or aromantic.

People who are sexual minorities may face stigma, social isolation, and lack of acceptance by family and friends. This may make them prone to more depression and anxiety, sexual assault, interpersonal violence, and suicide. There may also be legal issues of discrimination or unequal protection under the law.