Bringing the Second COVID-19 Wave Under Control

Bringing the Second COVID-19 Wave Under Control

  • August 7, 2020

While Japan’s coronavirus epidemic appeared to have subsided, it is now roaring back with a vengeance. We asked leading immunologist Miyasaka Masayuki about the extent of the epidemic, his predictions for the future, and what he thinks should be done.

Where Japan Stands

INTERVIEWER  Tokyo and Osaka are seeing record numbers of coronavirus cases. What is your take on the current situation?

MIYASAKA MASAYUKI  There’s no question that we are seeing an uptick in cases. Without knowing the type of virus involved, we can refer to the current outbreak as either a continuation of the first wave, or the beginning of the second wave. The increase in infections has been concentrated in specific entertainment districts, including Tokyo’s Shinjuku and Ikebukuro and Osaka’s Minami, along with their surroundings. These areas harbored a very high number of COVID-19 carriers, and people who frequented these areas have unwittingly taken the virus back to their homes and workplaces, causing it to spread steadily through their communities.

The current spike in infections is by no means restricted to a small geographical area, either—we’re beginning to see outbreaks in surrounding areas as well. And it’s only a matter of time before this outbreak will no longer restricted to young people. While I thought people had learned the lessons of the first wave of infection, some have not, and continue to frequent entertainment districts. That is the problem.

INTERVIEWER  We were told the second wave would not arrive until autumn or winter. It appears to have hit much earlier than expected.

MIYASAKA  Those estimates were merely individual opinions. A lot of people thought the virus’s vulnerability to heat and UV light would keep it at bay in summer, so the second wave would not hit until autumn. While many believed this theory, in the United States we have seen significant outbreaks in summer, in places like Florida.

INTERVIEWER  How is the current outbreak different from the first wave?

MIYASAKA  The circumstances are different this time. The received wisdom, which invoked the concept of herd immunity, held that when a virus-naïve population is exposed to a novel virus, a given percentage of individuals will contract it. Nishiura Hiroshi from Hokkaidō University said that as none of us has immunity to COVID-19, up to 60 percent of the population in Japan could contract the virus. I disagree with his assessment, however.

Immunity levels vary significantly amongst the population, meaning that those with compromised immune systems will contract COVID-19 before their healthier counterparts. The chances of becoming infected after exposure to a given amount of virus are not the same for everyone—those with a high resistance to infection will remain uninfected, eventually halting the spread of infection. Another factor is the public’s knowledge about the virus. During an outbreak, people will maintain social distancing. The theoretical statement that every individual infected goes onto infect 2.5 others assumes no preventative measures are taken—if the population observes social distancing, infections will stop. R0—the basic reproduction number, pronounced “R-nought” or “R-zero”—is actually around 1.25 in Osaka, meaning that if just 20 percent of the population develops immunity, the spread of the virus will be stopped. R0 is approaching 1.25 in Tokyo as well. In other words, we are approaching a state in which the virus is no longer spreading.

Antibodies Are Not Everything

INTERVIEWER Can you briefly explain how immunity works?

MIYASAKA  People talk as if immunity is all about antibodies. There is a theory that the spread of COVID-19 will be stopped when 60% of the population develops immunity. However, this assumes that antibodies are the only things capable of conferring immunity. In fact, exposure to a given amount of COVID-19 will never result in 60 percent of a population becoming infected. Even in Wuhan, the percentage of the population that contracted the virus was no more than 20 percent.

The human immune system is comprised of two layers. The first line of defense is our innate immunity—think of soldiers guarding a gate—which attempts to repel all invaders. If our innate immunity is compromised, our acquired immunity kicks in in the form of lymphocytes. T helper cells, which perform the role of controllers, respond to the infection by instructing B lymphocytes to produce antibodies, which in turn attack the virus. The other avenue of defense involves helper cells creating cytotoxic T lymphocytes, or “killers,” that completely destroy infected cells. While antibodies are only able to kill viruses outside cells, these killer lymphocytes are able to kill viruses inside cells. You need both antibodies and killer lymphocytes to reliably defeat a virus.

INTERVIEWER  So it isn’t just the antibodies—the “soldiers at the gate” are also important.

MIYASAKA  People ignore the fact that some people are able to shake a virus they don’t have antibodies for with their natural immunity alone. Antibody seroprevalence is not the same as the infection rate. In other words, if your innate immunity is robust, you don’t have much to worry about.

It’s likely that the antibodies our bodies make in response to COVID-19 infection will only last for around six months. If this is indeed the case, it will be impossible to attain herd immunity. However, immunity is a two-pronged defense: Some individuals are able to defeat the virus using their innate immunity alone. People shouldn’t get too hung up on antibody seroprevalence rates.

The Risk of an Exponential Spike

INTERVIEWER  Cases are currently on the rise. Do you think the increase can be halted, or could we see a runaway number of cases?

MIYASAKA  While the true number of infections is definitely higher than the number of positive PCR results, I believe the rate of infection will eventually dwindle. That is, we will not see an exponential increase in cases. During the initial wave of infection, we were able to stop the virus from spreading further by restricting our movements by 65 percent. As long as people maintain social distancing, avoid the three Cs, namely closed spaces, crowded places, and close-contact settings, and impose reasonable restrictions on their behavior, we will definitely be able to slow down the spread of the virus. However, if there is not enough testing, we get undetected clusters of infection, and the virus spreads rapidly through the community, as has been the case in Western nations, the epidemic will know no end. Fortunately, the prevalence of the virus in Japan is far lower than in the West.

INTERVIEWER  And yet levels of infection are now higher than the initial peak.

MIYASAKA  The statistics seem worrying if you only focus on the number of infections, but Japan’s prevalence of infection and morbidity rates are far lower than in Western nations. It should be noted, however, that the prediction that the second wave of infection would be only minor has proved to be untrue. While it initially looked like we had defeated the epidemic, this was only the picture on the surface. In reality, there were clusters of infection in Shinjuku, Ikebukuro, and Minami that we didn’t know about. These combined with community contact to create the second wave. By testing exhaustively and reducing cases in these areas, potential causes of infection can be reduced.

What We Should Do

INTERVIEWER  Budget restrictions mean that that it’s more or less impossible to demand that businesses close down. Is enough being done?

MIYASAKA  If each and every one of us can be alert, rather than waiting for local bodies to issue alerts, there is no need to panic. The problem is that people forget to be alert and go out carousing in bars. People will not catch the virus if they follow the rules.

INTERVIEWER  Does a state of emergency need to be declared?

MIYASAKA  No. Declaring a state of emergency does have some value because it forces people to moderate their behavior. However, issuing another state of emergency now would have grave consequences for the economy. Now is not the time to declare an emergency. As long as individuals remain alert, the virus will not spread that easily.

INTERVIEWER  The government has chosen the present time to launch its “Go To” travel campaign, although it has excluded Tokyo and its residents from participation. Should we be worried?

MIYASAKA  We have known all along that increased movement by the population would result in the virus being passed on again. Increased movement due to the campaign might or might not increase infections, although as long as travelers modify their behavior as required, the virus will not be passed on so easily. There is no need to order businesses or schools to close, with the exception of a few special industries, as long as individuals remain alert.

INTERVIEWER  Many more people are working from home now. Is remote working an effective strategy for fighting COVID-19?

MIYASAKA  Working from home obviously helps prevent the spread of infection, although just because you take the train to work does not automatically mean you will catch coronavirus. When we speak, a mist of droplets is propagated 2 meters from our mouths, but this volume can be cut by 90 percent by wearing a mask. While the micro droplets that waft out from the sides of our nose and mouth linger in the air for 10 to 15 minutes, they can be dispersed with fans and removed with ventilation. Packed trains are obviously not good, but people don’t need to be overly worried just because their train is a little full. Avoiding rush hour is also an effective strategy. The worst thing is to become so risk-averse that you can’t do anything.

Why Random Testing Won’t Work

INTERVIEWER  So a primary cause of the continuation of this epidemic is entertainment districts, and that if countermeasures are taken people can carry on as normal?

MIYASAKA  Effectively, yes. By no means do I believe entertainment districts are the only places people are becoming infected, though, as we know the virus has spread to surrounding areas as well. However, as long as we all observe social distancing, wear masks, and take precautions, the virus will not spread any further. Then it just becomes a matter of testing exhaustively in places with a high concentration of cases.

INTERVIEWER  I guess we need to increase PCR testing so that we can identify places with high concentrations of the virus.

MIYASAKA  Far too few PCR tests are being performed. Capacity needs to be boosted by a factor of ten or twenty. That said, sentinel, or random, testing will not achieve anything. In Tokyo, for instance, Shinjuku, Ikebukuro, and the surrounding areas need to be tested extensively. We need to make much more use of PCR testing to determine routes of transmission. I’m not saying we need to test everyone—rather, that we have to make a concerted effort in areas where it’s warranted. PCR testing is the most important part of that approach.

A PCR test is like a snapshot. You might be negative today, but that’s not to say you won’t be positive tomorrow. Because COVID-19 has a five-day incubation period, a negative PCR test result does not guarantee you are not infected. We need to perform frequent, exhaustive testing of those populations that need to be tested. Many people in Shinjuku started interacting with others again after a negative test result, only to later find that they were positive. It is therefore important to perform testing frequently. It is impossible to test everyone in the population.

As I have been saying all along, rather than relying on PCR testing, we need to make more use of faster, cheaper methods of detecting viral antigens. Tests can be performed on saliva samples, removing the risk of catching the virus at the test facility. While the saliva antigen test is slightly less sensitive than the PCR method, it does have the advantage of being more sensitive to individuals who shed larger amounts of virus. Frequent, repeated viral antigen screening is a much more useful way to prevent the spread of the virus than one-off PCR testing.

The Benefits of Vaccination

INTERVIEWER  There is still no vaccine or drug that can fight SARS-CoV-2. Is there a way of boosting our immunity to defend against COVID-19?

MIYASAKA  It may be possible for people to eliminate the virus by leveraging their innate immunity. Recent studies show that innate immunity can be trained. We often hear about BCG, a bovine pathogen that also protects humans from tuberculosis. BCG boosts your innate immunity by training it, thereby making your acquired immunity more easily triggered. A look at data from several dozen countries shows a clear trend to lower tuberculosis mortality and morbidity in countries that have embarked on widespread administration of BCG. There are, of course, exceptions. However, the amount of BCG that can be produced for pediatric vaccines is limited, and the vaccine is not produced for adult use.

In Japan, those in their fifties and sixties have gone over 30 years without a vaccination. Conversely, young children are immunized with nearly ten different vaccines, resulting in very low morbidity rates. Children are vaccinated annually, each time stimulating their innate and acquired immunity. This may explain the low incidence of COVID-19 in children and young people. Senior citizens, on the other hand, have not received an immunological challenge since they were last vaccinated decades earlier, and therefore their trained immunity is no longer effective. If senior citizens are happy to endure the inconvenience of being revaccinated against streptococcus pneumonia and influenza, they may receive unexpected benefits.

Differences Between Asia and the West

INTERVIEWER  Why are there far fewer infections and deaths in Japan and other parts of Asia than there are in the West?

MIYASAKA  There are many factors involved. Genes are part of it, as is the lack of kissing, hugging, and shaking hands in our culture, and the practice of removing one’s shoes indoors. But there’s something else that makes Asians less likely to be infected. BCG is part of the story, but it’s not everything.

One factor is region-specific infections. There are four varieties of nasal cold virus in the common human coronavirus family, which appear in frequent outbreaks in Japanese schools. Around 15 percent of common colds are caused by a common human coronavirus. It is possible that exposure to these viruses for some reason makes you less susceptible to COVID-19. Exposure to region-specific infections boosts your innate immunity, and to an extent stimulates acquired immunity as well. A strain specific to Asia would explain the disparity, although at the moment we don’t know if such a strain exists.

(Originally published in Japanese. Banner photo: Shinjuku Mayor Yoshizumi Ken’ichi, second from left, patrols host clubs in the city’s Kabukichō entertainment district. © Jiji.)

Nancy Pelosi's ill-advised boost for Big Pot

Nancy Pelosi’s ill-advised boost for Big Pot

  • August 7, 2020

When asked recently how a legislative measure allowing the marijuana ­industry access to banking was germane to our nation’s ­response to the COVID-19 pandemic, Nancy Pelosi said that weed is “a therapy that has been proven successful.”

Come again? The House speaker’s claims were dangerous and flat-out incorrect.

As a former Obama administration drug-policy appointee, I was stung by her words. A host of reputable organizations, including the National Institute on Drug Abuse and the American Lung Association, have concluded that marijuana users are among the groups of people more likely to develop a severe case of COVID-19.

Dr. Nora Volkow, director of NIDA, stated in a blog post that “because it attacks the lungs, the coronavirus that causes COVID-19 could be an especially serious threat to those who smoke tobacco or marijuana or who vape.”

Early on in the pandemic, viral memes made the rounds claiming that marijuana was a cure for COVID-19. Former NFL player-turned-pot-profiteer Kyle Turley has repeated this claim all over Twitter as he promotes his new line of cannabinoid and pot shop in Las Vegas.

In response, the Food and Drug Administration has been working overtime sending warning letters to Turley and other pot peddlers making false claims about marijuana’s efficacy as a coronavirus cure. A quick glance at the data shows why.

Marijuana smoke is known to damage lungs and has been found to contain many of the same harmful components as tobacco smoke. Evidence also suggests that it leads to the development of chronic bronchitis. Plus, marijuana use can potentially increase the risk of infections such as pneumonia, a common illness found in severe, often-fatal COVID-19 infections.

“OK, just eat edibles,” Big Pot’s cheerleaders retort. Not so fast.

Research has shown that THC, the psychoactive ingredient in marijuana, is an immunosuppressant. When it comes to fighting ­viral infections like the novel coronavirus, your immune system creates proteins that work to ­destroy the virus. THC inhibits the body’s ability to create these proteins, rendering it more susceptible to infection. This can ­result in more severe symptoms or a rougher recovery.

Marijuana is associated with a wide array of other harms. Before they encourage pot use and boost the industry that profits from it, lawmakers might consider the ­increased risk of severe mental ­issues such as schizophrenia, psychosis, anxiety, depression and suicidal thoughts. Those 1980s ­anti-drug ads may have been a tad overwrought, but a large and growing body of scientific evidence suggests they weren’t wide of the mark.

Let’s be honest: Pelosi’s weed provision had little to do with Americans’ health — and everything to do with pot shops getting access to the federal financial system. Big Pot has suggested that the lack of banking capabilities makes the industry a “cash-only” operation vulnerable to crime.

Nonsense. In reality, law enforcers have testified that most robberies of marijuana storefronts were aimed at procuring large amounts of the marijuana products for resale on the thriving black markets — not cash stowed away in heavy-duty safes.

Furthermore, undercover video from top pot shops in Denver shows many of these establishments accept card payment through workarounds.

Instead of working to grant the marijuana industry access to the banking system and blindly parroting industry rhetoric that has warranted repeated warnings from the FDA, our leaders on Capitol Hill must focus on mitigating the fallout of this pandemic.

The push for pot normalization is nothing more than an attempt to open up the marijuana industry to major investment firms, hedge funds, pension funds and established corporations, such as Big Tobacco. As former House Speaker and pot champion John Boehner says, such firms are keen to dive “headfirst into cannabis.”

Who would have thought boosting Big Pot would unite Boehner with his Democratic successor, Pelosi? They’re both wrong.

Kevin Sabet is a former three-time White House senior drug-policy adviser, serving the Clinton, Bush and Obama administrations. He serves as president of Smart Approaches to Marijuana.

Nepali couple in a garden

North Akron Immigrant Families Hit by Coronavirus Get Help from BRAVE Project

  • August 6, 2020

The spread of Coronavirus has been more pervasive in some regions than others.

In Akron, the north side of town has experienced greater spread than anywhere in the city. North Akron is the city’s international neighborhood, housing immigrants and refugees from Nepal, Bhutan, Iraq, Afghanistan, the Congo and many others. But one group is working to keep the virus in check.

Take a drive through the heart of North Hill and you’ll find Nepali restaurants, Asian boutiques, Mexican grocers and Italian eateries.

Immigrants contribute much to Akron’s economy. They are also at greater risk than most for exposure to coronavirus.

“They do work in places of business where they are on the front lines, they’re more likely to take public transportation where they’re also exposed to potential COVID,” said  Elaine Tso, executive director of the nonprofit Asian Services in Action.

Currently, Asian residents make up the largest immigrant population in the city, with many living in North Akron, zip code 44310. Summit County Public Health data shows that, at more than 500, North Akron has twice as many COVID-19 cases as any other neighborhood. And 68 percent of those who tested positive are Asian.

“A lot of people just want to jump to conclusions that they don’t know better,” said Katie Beck, who runs the North Akron Community Development Corp. and the Exchange House.

But Beck says that’s not  true – immigrants have been aware from the beginning about the dangers of the virus.

“Many of them do exactly what they’re supposed to do,” said Summit County Public Health Commissioner Donna Skoda. “It’s just any time you’re in a close environment you’re going to increase your risk.”

And, Akron immigrants often live in close, multigenerational households, Beck said.

“Some of them only have one or two workers making incomes to provide for everyone, so it’s not like they can quit or stop working,” she said.

Caring for extended family is an ethos that’s been passed to the younger generation, who Beck calls “culture brokers.”

“So they’re constantly navigating the world for their families,” she said. “They’re answering calls, they’re 

reading legal documents they’re translating in doctor’s offices.”

The BRAVE Project, which stands for Bhutanese Response Assistance Volunteer Effort, exemplifies these values. It was launched in Columbus early in the pandemic by young Bhutanese immigrants affiliated with the nonprofit group the Bhutanese Community of Central Ohio.

Graduate student Sudar Shan Pyakurel, heads up BRAVE Columbus and oversees chapters that have opened in other cities, including one in Akron.

“It’s a tremendous amount of work and a tremendous amount of commitment these young community leaders, and students and volunteers have shown for responding to the COVID crisis,” he said.

The idea for BRAVE was to bring clarity about the virus, and to deliver food and supplies to immigrant families’ doors, Pyakurel said.

“People were so overwhelmed. There was so much information they didn’t know what to do and what not to do,” he said.

Pyakurel‘s team also designed training for the BRAVE chapters so volunteers know exactly how to help families affected by COVID-19.

“We have to educate them, we have to give them orientation on what COVID is, what they need to do, what they don’t need to do, and also provide them with groceries, supplies and medical counseling at the same time,” he said.

University of Akron engineering student Moni Kumar Bhattarai heads up Brave Akron. His teams take every precaution to stay safe when dropping off groceries and other supplies outside, he said.  

“We get into the car and call them on the phone and we tell them ‘we’ve got something outside so you guys can come out and pick it up,’” he said. “So we don’t talk to them directly.”

Along with food and Tylenol, BRAVE also delivers natural health supplies.

“Ginger and lemon,” Bhattarai said. “It boosts the immune system, so we buy them that.”

Bhattarai’s team stays busy, rounding up volunteers and gathering donated supplies to help as many families as possible.

“So far 28 families are recovered and 12 to 13 are still in quarantine right now,” he said.

This dedication to helping the immigrant community is no surprise to the Exchange House’s Katie Beck, who works with immigrants daily.

“The young people in their community are just so passionate and so ready to help whoever they can,” she said. “They saw this model in Columbus and they heard about other cities doing it and they wanted to step up and help.”

In keeping with that spirit, Bhattarai‘s team is ready to help more people.

“This is not just for Nepalis,” he said.  “We have resources. We can help other communities.”

BRAVE Akron is currently running a fundraiser to buy food and supplies.

For more information, or to volunteer, contact BRAVE Akron through its Facebook page. For assistance for those affected by the virus, call the BRAVE helpline at 234-738-5598 or 234-706-9892

S.I. rapper launches fresh juice business amid coronavirus outbreak

S.I. rapper launches fresh juice business amid coronavirus outbreak

  • August 6, 2020

STATEN ISLAND, N.Y. — Caitlin Hawkins, known as Prema777 in the music world, needed to find a way to make a living when the coronavirus (COVID-19) forced a global lockdown.

Soon after the New Springville resident learned how the virus was affecting those with underlying health conditions, Hawkins, who is the mother of a 1-year-old son and is pregnant with her second child, said she wanted to come up with a way to keep people healthy.

And with her music on hold due to the health crisis, she said was looking for a way to earn money.

That’s when Hawkins — known for her poetic and melodic style of rap music, and her latest album, “Take Flight,” recorded at the North Shore studio House of Dreams in Clifton — created imunaTea, a fresh juice delivery service.

“I call it imunaTea because I started it with the intent of helping people build their immune system through the pandemic. …My intention is to build something for myself and my family by helping others and giving back to the community. Health is wealth and should be affordable and accessible for everyone,” said Hawkins, who has formerly worked in the hospitality industry as a server and bartender.


While music is her first outlet for creativity, she said her new business is also one that allows her to create something that can help others.

“Music is my therapy and first love. … I love rapping and I love performing ….Music has gotten me through challenging times and always inspires me to reinvent. I heal and help through music, and now it’s just about expanding that same concept through my juicing creativity,” said Hawkins.

“When you take care of yourself, you feel good. And when you help other people, it’s inspiring. That’s what I get from my music; I want to help people. Ultimately, my goal is to send a message to people to give them hope,” she added.

With a second child due in October, Hawkins said she wants to take the time to set a “good intention,” and build a business for which she could be proud.

“I’m a mother and business women who always wants to be busy,” she said. “I want to show my children that you have to work during hard times…. Plus, the business was one I could do with my son. I could put a mask on and use hand sanitizer, and put him in the car and make my deliveries.”


Hawkins said she focuses on three main juices:

Energy-boosting shot: Made of a turmeric, ginger, orange and black pepper. “Turmeric has an immense amount of healing properties in it. It’s an anti-inflammatory. It fights diseases,” Hawkins explained. “These shots make you feel fresh and are great to start your day.”

Boost juice: A beverage made of orange, lemon, carrot, green apple, turmeric and ginger. “This is a tasty drink to make you feel good and to boost your immune system,” said Hawkins. “It’s like a super fresh orange juice with a little bit of earthiness to it.”

Teatox: “This is a green juice,” she said, noting it’s made of greens, cucumber, honeydew, green apple and Greek yogurt.


Hawkins said her long-term goal is to build an “imunaTea community.”

“I’d like to create a space that inspires success stories in exchange for free knowledge on holistic and homeopathy remedies. Anyone and everyone will be welcome to join,” she said.





New Businesses in Focus is a weekly column that relates the stories of new Staten Island businesses owners.

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10 Ways To Boost Your Immune System In Times Of COVID-19, According To SHA Wellness Clinic

10 Ways To Boost Your Immune System In Times Of COVID-19, According To SHA Wellness Clinic

  • August 6, 2020

Set on Spain’s Costa Blanca, SHA Wellness Clinic is one of the world’s premier wellness destinations. This health resort has been known to attract everyone from elite athletes, to Hollywood celebrities and Victoria’s Secret models, as well as assorted oligarchs and billionaires. They come to lose weight, detox, or participate in SHA’s Healthy Aging program. Others want to reset their minds and bodies, adopt new healthy habits, or simply get away from it all. 

Devised by wellness guru Alfredo Bataller, the immensely successful SHA method is based on a holistic approach to wellness that combines the latest advances in Western medicine and progressive natural therapies, with a particular focus on healthy, balanced nutrition and exercise.

Since reopening in July, SHA has introduced a series of new services specially designed for the COVID-19 era. Immunotherapy and lymphocyte profile consultations have been added to all bookings to assess the state of the guest’s immune system, while a new immune system strengthening pack has also been developed. A comprehensive “SHA insurance” covers medical and related expenses in the event of positive COVID-19 test on arrival. 

So, how can we apply the SHA method to our everyday lives to give our immune systems an extra boost in times of COVID-19? Here are some tips from Alfredo Bataller and his team of experts at SHA Wellness Clinic:

1. Choose seasonal fruit and vegetables

Alfredo Bataller, founder of SHA Wellness Clinic: A balanced diet that includes plenty of fruit and vegetables, vitamin C and antioxidants helps reinforce the immune system and prevent disease. It’s highly recommended to choose fruit and vegetables that are in season to ensure that they are as fresh and nutritious as possible.

2. Enjoy immune-boosting superfoods

Melanie Waxman, healthy nutrition expert: To keep the immune system in perfect working order, we should enjoy a diet based on fresh food that helps to maintain the balance of the intestinal microbiota. It should include whole grains, beans, seaweed (spirulina), nuts, seeds, green leafy vegetables, such as kale, onions, garlic, leeks and asparagus, and fruit, such as apples.

3. Take moderate exercise

Luis Ganso, personal trainer: Moderate exercise, such as 30 minutes of fast-paced walking, has been shown to improve the function of the immune system. This type of exercise strengthens our respiratory capacity, mobilizing antibodies and white blood cells to circulate more quickly, and detect and neutralize external attacks. Meanwhile, raising the body temperature helps to prevent the development of infection.

4. Exercise outdoors if possible…

Alfredo Bataller: It’s always a good idea to spend some time during the day walking outdoors—preferably in nature. Spending time outdoors is important for breathing fresh air and absorbing the vitamin D provided by the sun, which is so crucial to support calcium absorption and the proper functioning of the immune system.

5. …Even when you don’t feel like it

Alfredo Bataller: Exercise is always good, even if we may have lost motivation during lockdown or if we feel tired or low on energy. Exercise strengthens the immune system and makes our bodies secrete “happy” hormones, or endorphins, while reducing the level of the stress hormone, cortisol. Stress is harmful to the body, and, having less of it actually strengthens the immune system.

6. Use deep breathing to stimulate lymph flow

Rachel Rose, body and mind expert and yoga coach: Stable mental health is basic to managing stress, which, in turn, impacts the immune system. Lymphocytes are found in lymph nodes and organs, and in the blood. Lymph nodes are the body’s first line of defense against disease. Breathing is directly related to lymph flow, and lymph flow is directly related to immunity. 

The diaphragm muscle, located between the lungs and the abdomen moves down when we inhale and up when we exhale. This movement causes a series of pressure differences that generate movement in the body. Lymph flow, or the mechanism that transports the lymph containing our infection-fighting white blood cells throughout the body, is one of the most crucial movements supported by deep breathing. 

7. Get enough rest

Alfredo Bataller: Getting quality sleep is essential to reinforcing our immune system, while not getting enough sleep can cause our immunity to decline, making us more prone to infectious diseases. Adults should sleep at least seven to eight hours a day.

8. Rethink breakfast

Maria Romeralo, healthy nutrition expert: When we start the day with sugary coffee and a pastry, we instantly feel good and full of energy. However, after a while, our energy levels drop and our bodies demand more sugar. This is why it’s important to avoid refined sugar, artificial sweeteners and honey at breakfast. 

At SHA, we serve miso soup for breakfast. Miso soup is a great source of protein, vitamins, minerals and enzymes. You can make it even richer by adding wakame seaweed, onions, tofu, carrots or pumpkin. It’s a wonderful way to cleanse the body while providing quality nutrients. Miso is a fermented food and therefore a source of probiotics that also help strengthen our immune systems.

9. Keep in touch with friends and family

Alfredo Bataller: Confinement can lead to loneliness, sedentariness and depression, all of which are detrimental to the proper functioning of the immune system. Contact with our loved ones helps calm the mind, enables us to cope with the stress of these uncertain times, and also reduces the risk of obesity and alcohol and tobacco abuse.

10. Look for lasting lifestyle change, not quick fixes 

Melanie Waxman, healthy nutrition expert: It’s important to transition to a healthy lifestyle gradually, with a view to maintaining it long term. At SHA, we give our guests the necessary tools to start leading that lifestyle once they leave: healthy cooking classes, yoga classes, outdoor exercise, nutrition and medical advice on everything from quitting smoking, to sleeping, and strengthening the cognition. Once back in their routine, they’re encouraged to adopt these activities until they become habits.

Post COVID-19 care: Home-cooked food rich in protein and calories key for boosting immunity in recovering coronavirus patients

Post COVID-19 care: Home-cooked food rich in protein and calories key for boosting immunity in recovering coronavirus patients

  • August 6, 2020

A protein-rich diet can help repair damaged body tissues, make up for the muscle loss that occurred while the infection lasted, and boost the immune system too.

If disease — any disease — is taxing on the body and depletes it of nutrition and immunity, then your recovery period should largely focus on replenishing these through a proper diet. This is true for COVID-19 infection, particularly because studies have shown that even mild symptoms of it can cause damage to the heart, lungs and brain.

Why diet matters

The UK’s National Health Service (NHS) recommends that those who’re recovering from COVID-19 need more building blocks (like proteins) to repair their bodies and more vitamins and minerals to help the process along. Such a recovery diet would not only help you get your strength back but also boost your immune system and keep other infections at bay until you’re fully back on your feet.

“Your diet, nutrition and fluid intake are of great importance when you’ve had COVID-19,” says Akanksha Mishra, a nutrition and wellness expert associated with myUpchar. “This infection is likely to reduce your appetite, and affect your ability to taste and swallow. So, your post COVID-19 diet should keep all these factors as well as your nutritional needs in mind.” The following are the most important things you must do to meet your nutritional needs during the post COVID-19 recovery period.

1. Get protein

A protein-rich diet can help repair damaged body tissues, make up for the muscle loss that occurred while the infection lasted, and boost the immune system too. Protein is also one of the best sources of energy out there and eating enough of it can help you overcome post-disease weakness. Mishra recommends including a portion of protein-rich foods, like pulses, legumes, peanuts, milk, yoghurt, cheese, soy, eggs, fish and chicken, in each meal. Your overall intake of protein should be between 75-100grams per day.

2. Choose nutrient-dense foods

Having COVID-19, or any other infection for that matter means that your immune system has taken quite the beating. Replenishing the vitamins, minerals and antioxidants your body needs is, therefore, an integral part of your recovery diet. Include plenty of fresh and seasonal fruits and veggies, as well as nuts and seeds in your diet, and have five to seven servings of them every day. While this can provide for your requirement of most vitamins, minerals, polyphenolic compounds and phytochemicals, you’ll also need to get 15-20 minutes of sunlight every day for vitamin D.

3. Don’t neglect calories

Sure, a low-cal diet is great for when you’re trying to lose weight, but you want the exact opposite after suffering from COVID-19 infection. More calories mean more energy to fight off the infection and the ability to recover faster. So include calorie-dense foods in your diet but make sure they’re healthy carbs and not empty ones. Opt for whole grains, potatoes, bread, pasta, rice, milk, avocados, jaggery and roasted chana.

4. Stay hydrated

Your body would have lost a lot of fluids due to the infection and fever, so you should get plenty of them to speed up your recovery. Drink eight to ten glasses of water every day and include soups, broths, herbal teas, kadha, non-caffeinated drinks, etc. in your diet.

5. Stay safe

COVID-19 can affect your sense of taste and smell, and that can put you off food. Getting over the infection may also give you a sense of security and you might feel like getting a taste of foods from your favourite joints. However, your safety and recovery should be your only priority now, so stick with fresh, simple, home-cooked meals which are prepared in sanitary conditions.

For more information, read our article on Diet for COVID-19 patients.

Health articles in Firstpost are written by, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.Recovery Guidelines for COVID-19 patients.

Boosting immune system a potential treatment strategy for COVID

Boosting immune system a potential treatment strategy for COVID

  • August 5, 2020

As the COVID-19 pandemic continues to claim lives around the world, much research has focused on the immune system’s role in patients who become seriously ill. A popular theory has it that the immune system gets so revved up fighting the virus that, after several days, it produces a so-called cytokine storm that results in potentially fatal organ damage, particularly to the lungs.

But new findings from a team of researchers led by scientists at Washington University School of Medicine in St. Louis point to another theory and suggest that patients become ill because their immune systems can’t do enough to protect them from the virus, landing them in intensive care units. They suggest that boosting immunity could be a potential treatment strategy for COVID-19.

Such a strategy has been proposed in two recently published papers, one published online in JAMA Network Open and the other published online in the journal JCI Insight.

“People around the world have been treating patients seriously ill with COVID-19 using drugs that do very different things,” said senior investigator Richard S. Hotchkiss, MD, professor of anesthesiology, of medicine and of surgery. “Some drugs tamp down the immune response, while others enhance it. Everybody seems to be throwing the kitchen sink at the illness. It may be true that some people die from a hyperinflammatory response, but it appears more likely to us that if you block the immune system too much, you’re not going to be able to control the virus.”

The Washington University researchers have been investigating a similar approach in treating sepsis, a potentially fatal condition that also involves patients who simultaneously seem to have overactive and weakened immune systems.

Hotchkiss points to autopsy studies performed by other groups showing large amounts of coronavirus present in the organs of people who died from COVID-19, suggesting that their immune systems were not working well enough to fight the virus. His colleague, Kenneth E. Remy, MD, the JCI Insight study’s first author, compares efforts to inhibit the immune system to fixing a flat tire by letting more air out.

“But when we actually looked closely at these patients, we found that their tires, so to speak, were underinflated or immune-suppressed,” said Remy, assistant professor of pediatrics, of medicine and of anesthesiology at Washington University. “To go and poke holes in them with anti-inflammatory drugs because you think they are hyperinflated or hyperinflamed will only make the suppression and the disease worse.”

After gathering blood samples from 20 COVID-19 patients at Barnes-Jewish Hospital and Missouri Baptist Medical Center in St. Louis, the researchers employed a test to measure the activity of immune cells in the blood. They compared the blood of those patients to 26 hospitalized sepsis patients and 18 others who were very sick but had neither sepsis nor COVID-19.

They found that the COVID-19 patients often had far fewer circulating immune cells than is typical. Further, the immune cells that were present did not secrete normal levels of cytokines – the molecules many have proposed as a cause of organ damage and death in COVID-19 patients.

Instead of trying to fight the infection by further interfering with the production of cytokines, they tried a strategy that has been successful in previous studies they have conducted in sepsis patients.

Hotchkiss and Remy collaborated with researchers in a small study conducted in seriously ill COVID-19 patients who were hospitalized in Belgium. In that study, which was reported on in the JAMA Network Open paper, the COVID-19 patients were treated with a substance called interleukin-7 (IL-7), a cytokine that is required for the healthy development of immune cells.

In those patients, the researchers found that IL-7 helped restore balance to the immune system by increasing the number of immune cells and helping those cells make more cytokines to fight infection.

The research did not demonstrate, however, that treatment with IL-7 improved mortality in COVID-19 patients.

“This was a compassionate trial and not a randomized, controlled trial of IL-7,” Remy explained. “We were attempting to learn whether we could get these immune cells working again – and we could – as well as whether we could do it without causing harmful effects in these very sick patients – and there were none. As this was an observational study involving a small number of patients who already were on ventilators, it wasn’t really designed to evaluate IL-7’s impact on mortality.”

Studies focused on boosting immunity and improving outcomes among the sickest COVID-19 patients are just getting underway in Europe, and similar trials are starting in the U.S., including at Washington University.

Hotchkiss said that finding ways to boost the immune response should help not only in COVID-19 patients but when the next pandemic arises.

“We should have been geared up and more ready when this pathogen appeared,” he said. “But what Ken and I and our colleagues are working on now is finding ways to boost the immune system that may help people during future pandemics. We think if we can make our immune systems stronger, we’ll be better able to fight off this coronavirus, as well as other viral and bacterial pathogens that may be unleashed in the future.”

Moderna is pricing coronavirus vaccine at $32 to $37 per dose for some customers

Moderna is pricing coronavirus vaccine at $32 to $37 per dose for some customers

  • August 5, 2020

Moderna is charging between $32 to $37 per dose for its coronavirus vaccine for some customers, under cheaper “pandemic pricing,” the company said Wednesday.

The Cambridge, Massachusetts-based company is currently in discussion for larger volume agreements that will have a lower price, Moderna CEO Stephane Bancel said on a conference call discussing the company’s second-quarter financial results. 

“We are working with governments around the world and others to ensure a vaccine is accessible regardless of ability to pay,” he said. “We’re currently in a pandemic as defined by WHO. At Moderna, like many experts, we believe the virus is not going away and there will be a need to vaccinate people or give them a boost for many years to come.”

Moderna defines a small order of its vaccine as “in the millions,” he said. The price Moderna is charging for small orders is higher than the $19.50 per dose agreed to by U.S. drugmaker Pfizer and German biotech BioNTech in a deal with the U.S. government.

Bancel said the vaccine will be priced “well-below value” during the pandemic period. After the virus is under control and considered endemic, the pricing will follow traditional market pricing in line with other commercial vaccines, he said. 

“We’ll work with the market,” Bancel said.

The comments came after the company reported a fivefold increase in second-quarter revenue.

Moderna said it has begun talks with multiple countries to supply its potential coronavirus vaccine, called mRNA-1273, and has already received about $400 million in deposits as of July 31. Last week, the company started a phase three trial testing how safe and effective it is on 30,000 people with results expected as early as October. The company said it expects to complete enrollment for its phase three trial in September.

Moderna’s experimental vaccine, which is being developed with the help of the National Institutes of Health, contains genetic material called messenger RNA, or mRNA, which scientists hope provokes the immune system to fight the virus. 

The company received $483 million from the Biomedical Advanced Research and Development Authority in April to support its vaccine development. Last month, it announced it received an additional $472 million from the U.S. government. 

Earlier Wednesday, Moderna reported a fivefold increase in second-quarter revenue primarily on its coronavirus vaccine work. Revenue jumped to $66.4 million during the quarter, more than five times the $13.1 million it took in during the same period last year.

Novavax Coronavirus Vaccine Candidate is Safe, Produces Immune Response | Health News

Novavax Coronavirus Vaccine Candidate is Safe, Produces Immune Response | Health News

  • August 5, 2020

A third U.S. company has released results from a study indicating that its potential coronavirus vaccine is safe and sparks an immune response.

Novavax Inc. released results from Phase 1 of its study showing that two doses of its COVID-19 vaccine candidate, NVX-CoV2373, elicited an immune response in 100% of the study’s participants. The volunteers developed neutralizing antibodies at levels four times higher on average than antibodies developed by people who had contracted the coronavirus and recovered, according to the results.

Cartoons on the Coronavirus

Neutralizing antibodies are antibodies that fight off the virus that causes COVID-19. The vaccine was given to participants with and without an adjuvant, a component to boost the immune system. The doses with the adjuvant induced a response from T-cells, a type of immune cell.

Three U.S. companies now have promising vaccine results: Moderna, Pfizer and Novavax. Novavax announced in July that it had been awarded $1.6 billion from the federal government program Operation Warp Speed to develop a coronavirus vaccine.

The potential vaccine was well tolerated in the study’s participants, which included 131 healthy adults aged 18 to 59. Reported side effects included tenderness and pain near the injection site. Headache, fatigue and muscle aches were also reported less-frequent side effects, the company said.

No Grade 3, severe or significant, adverse side effects were reported.

Data from Phase 1 has been submitted for peer review to a scientific journal but hasn’t been reviewed by independent experts or published yet.

Novavax reports promising early trial results of COVID-19 vaccine

Novavax reports promising early trial results of COVID-19 vaccine – World

  • August 5, 2020

US biotech company Novavax on Tuesday announced its experimental COVID-19 vaccine elicited a robust immune response, producing more antibodies than are present in recovered patients, and with generally tolerable side-effects in its early-stage trial.

The company was given $1.6 billion by the US government last month to develop and fund the drug under Operation Warp Speed — but in terms of timeline it is behind other firms including Moderna and AstraZeneca which have entered the final stages of their trials.

It reported in a press release that the phase one stage of its placebo-controlled trial involved 131 healthy adults aged 18-59 and two dose groups of five and 25 micrograms.

Side effects included soreness at the site of injection, headache, fatigue and muscle pain. These were classified as mild to moderate, and none were severe.

After the first dose, all subjects who got the vaccine developed antibodies that block SARS-CoV-2’s “spike protein,” which it uses to latch on to human cells.

Most also developed “neutralizing antibodies” which are more potent and prevent viruses from infecting cells.

After a second dose given 28 days later, all participants had the more powerful neutralizing antibodies.

Novavax reported that the lower dose performed comparably with the higher dose, which is important when it comes to mass production and because lower doses generally elicit fewer side effects.

Antibodies are infection-fighting proteins made by the immune system. 

Another part of the immune response comes in the form of T cells, types of white blood cells that have the capability to kill infected cells and which are increasingly thought to play an important role against COVID-19.

Novavax said it looked for these cells in a subset of participants and found they were present.

The trial was supported by funding from the Coalition for Epidemic Preparedness Innovations (CEPI) and was conducted at two sites in  Australia.

Novavax has not yet shared the detailed findings but said it was submitting the research for publication in a peer-reviewed journal and to medical preprint site 

The final stage Phase 3 trial of its vaccine, called NVX-CoV2373, is set to take place this fall.

The Maryland-based company grows synthesized pieces of the SARS-CoV-2’s “spike protein,” which triggers an immune response, inside insect cells in order to help scale up production.

It also uses an “adjuvant,” a compound that boosts the production of neutralizing antibodies.

The company says the drug, which is a liquid formulation, can be stored at two degrees celsius to eight degrees celsius, refrigerator temperature.

In the spring, the company said it had proven the efficacy of a seasonal flu vaccine it had developed using the same technology.

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