Case-demic

We’ve been inundated with public health messages instilling fear and panic, threatening another lockdown, more mandatory wearing of masks and even night curfews, because of “soaring cases”........ 

Firstly, what is a case?

The correct use of the term, represents someone with severe symptoms, severe enough to be admitted to hospital. However what the media and Govt are dramatically calling a case, the numbers spooling across our TV screens don’t fit this criteria at all. 

What these figures represent is the result of a positive PCR swab test - irrespective if that person has severe symptoms. It’s important to know what a PCR test is: The polymerase chain reaction (PCR) is a technique for copying a piece of DNA (a billion-fold). Once a sample has been collected, in this case by swab, the laboratory extracts nucleic acid “extraction” or “purification” to obtain DNA and RNA. A positive PCR result doesn’t prove that a replicating (also called infectious) virus is present. It proves that its genetic material – the RNA – is present. The PCR result is therefore a surrogate indicator of the presence of the infectious virus -  this is really important to understand. I’m not saying the test is invalid, the point I’m trying to make is, the narrative we are being given is that cases are escalating, and rapidly. But the narrative is a) not using the correct terminology of a case and b) a positive PCR test doesn't prove infection, and it therefore it is not a diagnosis of a “case” in the true sense of the word ”severe enough to be admitted to hospital”. 

So, how many are in hospital? The number of beds in England occupied by “confirmed  Covid 19 patients” in the entire UK (published on 10th Sept 2020) is only 0.5% of patients (again, to be clear, of the total number currently in hospital), compare this to the inflammatory figures that spool across our TV screens.  I’ll leave you to mull this information over, is the narrative comparing apples with apples?

There is a solution……. OUR IMMUNE SYSTEM!!!!!! 

Cells belonging to our innate immune system are the first kids on the block, neutrophils (engulf), macrophages (an antigen presenting cell), dendritic (antigen presenting cell) and natural killer cells work to identify, engulf and clear via the lymph to the adaptive immune system - where T and B cells can create memory cells effector T cells and antibodies respectively. 

This diagram displays what happens in the lymph nodes when we contract an infection: - antigen presenting cells present fragments of the pathogen to T and B cells, B cells can also recognise antigen directly. Of all the T and B cells in the lymph node, a few will have receptors that recognise the pathogen being presented. The successful presentation triggers colonel expansion - growing a new army, the B cells turn into plasma cells that make antibodies. The newly cloned effector T cells hone back to the tissue where the infection came from, promoting the resistant macrophages to kill said pathogen as well as killing the pathogen themselves using chemicals. This feed forward cycle is driven by cytokines, some of which are responsible for that unwell feeling, like a temperature, chills, muscle pain when you we get the flu.  

This a very simplistic explanation - but the vitally important takeaway is this -  if the innate immune system is downregulated or suppressed -  your immunity is compromised - big time!

What drives down our innate immune system (Th1) response, that will predispose an individual to have a poor, undesirable immune response? 

1. Age

The immune system’s repertoire of immune cells, especially memory cells depletes with age.  Immunosenescence refers to the gradual deterioration of the immune system brought on by ageing. Immunosenescence involves both the host's capacity to respond to infections and the development of long-term immune memory - which is vital for remembering the virus a second time round, or even elements of the virus, even if it’s mutated. 

The British Society of Immunology states “This helps explain why around 50 per cent of deaths from the disease (COVID-19) have occurred in people over 80, and 40 per cent in people aged 60 to 79”.

2. Chronic Inflammation 

As my diagram here illustrates, lifestyle factors alone cause a rise in unrelenting inflammation. If your inflammatory burden is this close to threshold, the neutrophils of the innate immune system can’t cope with this level of burden and the clearing system fails, which results in necrotic tissue formation, neutrophils spilling their contents a cytokine storm and your immune system starts to fail due to the overwhelm.

 3. Stress chemistry (cortisol)

High/constant levels of cortisol and steroid use causes apoptosis (cells death) of innate immune cells. A particular cytokine that is released in response to stress chemistry is Il6. 

The British Society of Immunology states“Easy-to-access biomarkers would be extremely helpful to identify patients who may be at risk of developing severe symptoms. This would allow us to provide early support to prevent them getting worse. Trials are underway of one promising immune system biomarker, called interleukin-6, which may reveal which patients are at risk of an overly energetic and damaging immune response”.

Can you see where I’m heading …... diet and lifestyle factors here are not just the elephant in the room, there is a bloody gigantic herd of them staring us in the face! 

The Covid epidemic peaked in April - and best estimates show that 80% of us dealt with it, as I’ve described above, many without knowing, some felt symptoms, some did feel pretty awful -  but recovered (as happens with a bad case of the flu) due to some form of  T cell and mucosal immunity positive action. The virus did hit the remaining 20% with compromised immunity and co-morbidity hard, and sadly we saw the majority of deaths in this group. 

I am not belittling or disrespecting families’ loss of loved ones - but while the number of new confirmed "cases" (acknowledging that this term is not being used correctly) of coronavirus has been rising (simply because we are testing more), deaths have continued to fall from July into August and September, daily deaths averaging 10, and on the day of writing, 11th Sept, was 6.  

So to review, we have on average 10 deaths a day (of course devastating to families that lose their loved ones) and lower hospital admissions than cancer cases and yet we are being dictated to stopping seeing friends in groups, being made to wear masks in all number of social situations, having to sit behind plastic sheeting when choosing to eat out, fanatically being asked to sanitise ours hands when going into a shop, being threatened with 10pm curfews! 

Matt Hancock urged young people not to “kill your gran” by spreading coronavirus after an increase in cases led to calls for mass testing of students. Yes, the younger age group may well be the biggest “carriers”. But we need to focus on what is the biggest cause of those when they become infected to have such poor outcomes - not shoot the preverbal messenger!  

The social & economic impact of the national lock down has been devastating with 730,000 employees falling off UK payrolls from March to July, escalating poverty and stress chemistry. The mental health impact on vulnerable individuals and younger generations being ripped out of education and forced to stay home for the many in vulnerable conditions has untolled long term mental health effects.

Threatening local lockdowns, imposing social restrictions to no more than 6 friends meeting and enforced mask wearing is not the answer! Building community immunity is, as they have done in Sweden. They went through the classic “curve” - a peak and  drop off - no lock down, no mandatory masks, schools remained open and only a total of 892 deaths with COVID being the direct cause of mortality. Spain took the most extreme form of lock down in Europe, and now has the worst second spike on the Continent, Sweden has none at all. As this paper states - "evidence from 14 randomised controlled trials of {mask} wearing showed these measures did not support a substantial effect on transmission of laboratory-confirmed influenza"! 

As I’ve discussed, there are many variables that affect progression into Dis-ease, including the population’s state of age and baseline health (lifestyle led conditions). What is clear, is that people can spread Covid-19 before symptoms appear and this virus is here, it’s not going to be eradicated.  Although Epidemic outbreaks are complex dynamical systems, the daily new cases number most generally follows a similar time evolution: after an exponential growth, infections slow and eventually decay exponentially as, whether group immunity is reached, or seasonal factors or public actions slow the virus reproduction. This behaviour has been observed for seasonal influenza, H1N1 as well as for recent coronavirus epidemics such as SARS or MERS.

Whatever distancing measures you take, short of locking the nation inside indefinitely and feeding us through our letterboxes via a tube, the virus will still spread, but more slowly. 

The only way to eliminate COVID-19 is widespread immunity, that requires a 100% safe and effective vaccine or build up immune resilience through community immunity. The longer we issue distancing measures and lockdowns, the longer this will take -  suspending human social connection in the process. 

The CDC (The Centres for Disease Control & prevention) has reported that, overall, only 6% of deaths involving Covid-19 indicate Covid-19 as the only cause mentioned. 94% of Covid-19 deaths involved one or more comorbid conditions. These conditions are nearly all diet and lifestyle driven so - is it such an insane concept to start asking questions about these individuals’ diet and lifestyle habits and build an intervention programme right here? We should consider someone’s diet and lifestyle as a “vital sign” in the same way we take blood pressure, cholesterol and blood sugar levels - and based on these prescribed medications - why not prescribe diet and lifestyle changes?

Let's positively encourage healthy "well" people to get back to life, connect and socialise - not lock ourselves away. Lets prioritise building immune resilience through diet & lifestyle interventions, build community immunity and stop breeding fear and retribution as a tactic - this is not the democracy or right of autonomy I for one recognise and I will continue to speak my truth until some degree of “life” returns! 

In health, Tanya x