Living in a COVID World 🦠

We find ourselves in the midst of a new COVID wave, and these are the ways I continue to reduce risk and stay informed in 2023.

I don’t know about you, but my feeds have been lit up with people testing positive for COVID over the past week. Some for the first time, others for the third…fourth….fifth times.

But you might find yourself asking, “Why is Dani writing about COVID”? I am not, by any measure, an expert on infectious diseases. And I have no desire for you to view me as one! But COVID impacts both our work and wellness, and therefore is a relevant topic for this little space!

Not only can an infection knock us off our game for a solid 3-10 days (woof!), with lingering symptoms that can impact our productivity, such as brain fog and fatigue, but as I’ll explain below, each subsequent infection can increase our risk of severe neurological diseases.

The New Variant

The current wave is being caused by a new variant…and perhaps a combination of poor weather + a lot of people packed into cinemas (gosh darnit, Barbenheimer!).

The newest variant is Omicron EG 5.1, which is known as “Eris.” Back on July 1, 3.3 people out of every 100,000 had COVID – but that has now jumped significantly, with 7.2 having it as of July 29 (source). Presumably, this number is still rising and could position us for a larger wave as Autumn progresses.

This new variant, Eris, presents differently, with a fever no longer being the main symptom:

Update (9/5/2023) - As August came to a close, there was yet another variant worth watching, BA 2.86 (AKA Pirola). Because testing, surveillance, and sequencing are drastically reduced across the globe, it’s difficult at this time to say which symptoms are coming from which variant. However, a lot of people who are currently being infected are experiencing more gastrointestinal issues than with previous strains:

One of the opinions I see most often about COVID that is really dangerous is, “I’ve already had COVID, no big deal.” That’s dangerous because research shows that your risk of long-term effects (such as diabetes, blood clots, and chronic fatigue) increases with each infection (source and source).

There’s also an increased risk of neurological issues. This Danish study analyzed over 1 million health records and found that “patients who tested positive for COVID were more likely to be diagnosed with Alzheimer’s, Parkinson’s, and strokes.”

Of the 919,731 patients that tested for COVID-19, they found that the 43,375 who tested positive had a 3.5 times increased risk of being diagnosed with Alzheimer’s disease, 2.6 times with Parkinson’s disease, 2.7 times with stroke and a 4.8 times increased risk of bleeding in the brain. (source)

Something that makes people dismiss that information is the fact that being infected with influenza carries a similar risk increase for these neurological diseases. But rather than feeling comforted by the fact that a “common” virus such as influenza also carries that risk, we need to be alarmed that both of these circulating viruses can lead to long-term, debilitating, and deadly health outcomes.

This means we should absolutely still be doing what we can to avoid subsequent infections.

I had COVID for the first time last summer, and although my goal is, of course, to never get it again, I’m under no illusion that it will be my last battle with that beast. All governments have basically quit talking about it, there are no masking requirements anywhere, and finding accurate information is far from easy.

We’re at a point where we need to learn to live with COVID while managing our personal risk in a logical, healthy way.

So, three+ years later, what measures am I taking to protect myself, and what resources do I use to stay informed? I’m gonna tell ya. But first, I want to say that I think this is highly personal and that each of us have different levels of risk as well as health concerns. I hope this is helpful, but encourage you to consider your own situation and make decisions for yourself.

The Obvious Stuff

While it’s not much fun (and probably not a popular opinion), I’m still in the mindset of avoiding high-risk activities as much as possible. We choose restaurants and bars with outdoor seating or avoid them altogether. Overall, I’d say I go indoors at a bar or restaurant or participate in an indoor activity twice a month or less.

If I’m traveling, I mask! Mostly because I have no desire to land in Italy and spend my entire ten-day vacation with COVID or anything else, for that matter. By masking in crowded spaces, I can reduce the risk of getting sick on vacation, and that’s worth the minor inconvenience to me.

And I am, of course, up-to-date on vaccinations and boosters. As long as I avoid infection, I’ll seek out another booster this fall (likely in early October). If I get infected, I’ll seek a booster six months later. Evidence does show that being vaccinated helps reduce long-term risks.

I’ve also stuck to being pretty consistent with hand-washing. The simple stuff is important!

Wellness for COVID

There are people out there who are more than willing to sell you on special “immune boosting diets” and supplements….but one of the most important things we can do for our immune system is get enough sleep.

So although I’ve always been a #Sleepevangelist, I take it even more seriously now, as I know it’s one of the most important ways I can support my body in avoiding another COVID infection.

Sleep is when our body restores our “natural killer cells”. These are the “secret service agents” of our immune system that identify unwanted elements and eliminate them.

We’re exposed to all kinds of viruses and threats every day. Having a “full supply” of these Natural Killer Cells makes you that person who “never gets sick.” Your body can fight things off.

But if you aren’t sleeping enough — you are running around without your full team of “secret service agents.”

If you’ve ever gotten sick during finals week, a music festival, when caring for a newborn, or other high-stress times in your life when you weren’t getting enough sleep…this probably makes perfect sense to you!

If this info is new to you, I recommend this TEDtalk. I’ve shared it in my weekly newsletter before — it’s one of my favorites! It’s 20 minutes long, but fast forward to 9:50 for the “Sleep and Immune Health” section:

As he explains, in a study where they restricted participants’ sleep by just ONE HOUR, participants saw a 70% DROP IN NATURAL KILLER CELL ACTIVITY, leading to a “concerning state of immune deficiency.”

And so, without droning on about this for too long — one way I try to support my immune system is to prioritize sleep. I remind myself that you can’t “catch up” on sleep. Good sleep requires consistency. I stick to a regular sleep/wake schedule (even on weekends), keep my room dark and cool, and make a to-do list at the end of each day to reduce stress or anxiety that might interrupt my sleep.

But once you understand Natural Killer Cells (NK cells) and the important roll they play in your health, you can’t *unsee* the research showing how a COVID infection damages them. I could only include a snippet of this thread, but click on the image to read the entire thing on Twitter:

A cell that “makes antibodies to fight infections, attacks foreign cells, cancer cells, and cells infected with a vrius, and helps fight tumor cells” seems pretty important to our overall health — especially our longterm health and ability to avoid debilitating or terminal illnesses. This might also be part of why some people who have had multiple COVID infections now seem to have severely compromized immune systems (less NK cells = less ability to fight off *any* virus). For me, I’ll do what I can to avoid repeat infections until we know more about how to avoid or treat the worst outcomes.

Other Simple Wellness Practices:

💨I optimize airflow! Air filtration and increased airflow are one of the best ways to reduce transmission. Whenever possible, I opt for outdoor activities. But it not possible, I’ll open windows, sit near a door, put on a fan, etc.

💦I stay hydrated! This is important for overall health, and if we fall sick, it’s important that our body is already hydrated. Being properly hydrated helps thin out all fluids in your body, including snot and mucus. So being hydrated can also help alleviate symptoms when you are sick.

🤧I blow my nose and gargle! Our body is smart, and our nose is lined with tiny hair called cilia. These tiny hairs can help trap particles before they enter our body. My dad is a biologist, and early in the pandemic he suggested that blowing your nose and gargling when you return home could help remove particles that your body has already trapped before they dislodge and make their way further into your system. To me, this always just made basic sense, and was a simple thing I could do. I do it as regularly a I can. As far as gargling…I’m not sure if it makes any difference, but I like the idea of cleaning out both airways when possible. Take this or leave it!

🌈I eat colorfully! An easy way to make sure you’re getting a lot of vitamins and minerals in your diet is to eat colorful meals. “Eating the rainbow”, if you will. I do my best to make the majority of my meals as colorful as possible.

👶🏻I don’t have kids. I’d be remiss if I didn’t mention that being a caregiver (or living in any communal setting!) can make this all a lot more difficult, and I want you to know that I recognize that. I have pretty full control over what I’m exposed to, and your exposure is increased with each person in your household. Being a caregiver also means you aren’t always in control over your sleep schedule. (FWIW, I currently get up with Walter (my dog with cancer) 1-2 times per night. Nightime warriors, unite!)

👃🏻 Corsi Rosenthal Box: If I was working in an office or had kids in school, I would absolutely consider making a Corsi Rosenthal Box. These are an effective air filtration system that can be made in about 5 minutes with affordable supplies you can buy at your local hardware store. If your child is repeatedly bringing COVID (or any other virus!) home from school, or you’re in a crowded office all day, building/donating/using devices like this can make a huge difference. Worth noting that if you suffer from allergies, having one of these in your home can also be a tremendous help. Here’s an easy-to-follow video tutorial:

Masking in Daily Life

I know I might be simplifying this in a way that is possibly annoying….but this is just how my brain works.

On average, we breathe in and out around 24,000 times per day or roughly 1,000 breaths per hour.

Each of those is an opportunity to get infected.

To me, it’s all a numbers game, and the numbers will be different for each of us.

I look at my day and think about which “breaths” are going to be the most high-risk, which ones are zero risk, and which ones are worth the risk.

I take 24,000 breaths per day, but 8,000 of them are when I’m working (alone, from home) and 8,000 of them are while I’m sleeping…so I’m left with about 8 hours (or 8,000 breaths) that might be moderate to high risk for exposure. I do what I can to reduce that by masking, being outdoors, increasing ventilation, distance, or avoidance.

As an example, during those “8,000 breaths,” lets say that I:

• Attend a 1-hour workout class

• Go to the grocery store

• Meet a friend for coffee or lunch

• Ride on public transit (bus or train)

I mask 100% of the time when going to workout classes. I have not been to one without a mask since COVID emerged. To me, these are high-risk situations. 20+ people in a small room with limited ventilation who are all breathing heavily and expelling more respiratory particles does increase your risk of exposure. So, it makes sense to me that I mask during this time.

When it comes to the grocery store, I try going early in the morning when the store is mostly empty. In that situation, I don’t mask. If I have to run an errand at a peak time, I’ll mask if the store is busy.

Same with public transit. I’ll try to avoid peak times, but mask if it’s busy. Typically, I’ll choose lower-risk modes such as biking or walking when possible.

And things like lunch or coffee dates are often when I will try to reduce the risk by choosing a place with outdoor seating or good ventilation or trying to go at an off-peak time.

Please note that TYPE of mask makes a huge difference in the protection it offers to you and others. While any mask is better than nothing, cloth masks and surgical masks are less protective than fitted respirators such as N95s or KF94s.

FWIW: I prefer KF94 masks. I find that they are smaller than N95s, so they fit my face better, and I like the way they fold and mold to the face. You can order them on Amazon.

Resources I Like

I think it can be easy to get overwhelmed when it comes to COVID information, and it can also be hard to tell what’s reliable. These are the two resources I rely on the most.

Your Local Epidemiologist

Dr. Katelyn Jetelina has a masters in Public Health and a PhD in Epidemiology and Biostatistics. You can subscribe to her Substack, where she publishes the latest COVID news regularly. All of her content is free, although you can upgrade to paid to support her work.

I also enjoy following her on Instagram, where she often creates simple graphics that summarize her latest Substack post. These are great ways to stay informed.

your_local_epidemiologist

A post shared by @your_local_epidemiologist

The Osterholm Update

Dr. Michael Osterholm is the head of CIDRAP (Center for Infectious Disease Research and Policy) at the University of Minnesota. He publishes a weekly podcast called The Osterholm Update, in which he breaks down the latest COVID news.

He has a very conversational tone and speaks to the average person. I like having something I can just hit “play” on and listen to while getting ready or taking a walk. He is also doing a lot of coverage on long-COVID.

You can listen here, or wherever you get podcasts.

Let Them Eat Plague

If you want to do a real deep dive on the failure of government responses, this article “Let Them Eat Plague” is a great place to start.

How To Talk To Your Loved Ones About COVID

It can be hard to remain vigilant about COVID if you feel like most people in your life have “moved on”. This Google Document is maintained by a group organizers and organizes information in one place. It identifies some of the best methods for approachign difficult conversations, how to have productive conversations about COVID, dispell myths, and try to find common ground. You can access it here.

💬 So where are you at with COVID, dear reader? Have you totally tuned it out? Tossed up your hands? Still masking 100% of the time? Just doing what you can? If there’s one thing I know, it’s that this community is smart as hell, so I’d love to hear from you — especially any resources you recommend!