Chronic Disease, Coronavirus, and Doctor’s Orders for Boosting Your Immunity

This post was originally published March 27, 2020. For the latest information on COVID-19, please visit the CDC .

The swift spread of the new coronavirus (COVID-19) around the world is scary for everyone, my patients at Parsley Health  included. Not just because of how fast it is appearing in new cities, and not just because of how little we know about its health impact, but also because of how helpless we feel as it approaches. It’s like watching a tidal wave in slow motion.

Advice and policies on prevention, containment, and next steps are boiled down to bullet points : wash your hands thoroughly, don’t touch your face, distance yourself from those who are sick, avoid crowds, cancel non-essential travel, and stock up in case of quarantine.

These are critical messages and lessons for communities worldwide.

Yet as we read story after story, we silently wish that an effective treatment or vaccine will be found, or that preventive measures will slow its progress before COVID-19 reaches our towns and our families.

And as we do so, we ignore a uniquely American vulnerability that COVID-19 is about to expose: we have a population that is at risk, not simply because of age, but because of the chronic diseases that affect 6 out of 10  Americans according to the CDC.

Early studies out of China show an overall COVID-19 mortality rate of around 1.4%  to3.4%  — a far cry from the flu’s usual 0.1%. And while more comprehensive research may show a much lower overall mortality rate as testing becomes more widespread and milder cases are captured, the early data is clear : the elderly and those with underlying health conditions like heart disease, diabetes, and respiratory disorders are most at risk.

These chronic conditions, along with lung disease, cancer, HIV/AIDS, autoimmune conditions like multiple sclerosis, rheumatoid arthritis, and lupus, and inflammatory conditions like asthma, compromise the immune system . They make people more vulnerable to severe illness , and more likely to require hospitalization, ventilators, and ICU stays — and that will strain our hospitals and clinics once infections spread.

So what do we do about it?

Well, there are short-term and long-term fixes — and the latter will involve fixing America’s broken primary care infrastructure. We need to get into that later.

In the most immediate term, you can take the following steps to boost your immune system.

I recommend supplementing with 5000 IUDs of Vitamin D a day. Vitamin D deficiency is associated with increased susceptibility to infection , and 35 percent of adults in the U.S. are clinically deficient in Vitamin D while an even greater number have insufficient levels.

And if you’re not already meditating, start now. Meditation has also been shown to help people with insomnia  improve their sleep , and we know that those who sleep less than seven hours a night are almost three times more likely to develop the common cold  than those that sleep over eight hours.

Finally, get moving. Any type of exercise is better than nothing at all, but a study  found that after three 30 minute sessions a week for 10 weeks of high-intensity interval training (HIIT), white blood cells called neutrophils were better able to fight off pathogens. In the study, participants did 60-second intervals of high-intensity walking separated by 60-second intervals of low intensity walking.

This is also a time to look closely at your own health to determine your risks. There are a few tests I recommend every adult gets — regardless of your age — to assess if you have an underlying chronic illness or are at greater risk of having a poorly functioning immune system.

1. Test for inflammation : hs-CRP, ANA, and ESR

These inflammatory markers measure different sources of inflammation in your body. Even mild increases are associated with a greater risk of things like cardiac events or depression. If you have elevated levels, it’s a sign that something else is going on in your body that needs to be addressed, like an autoimmune condition, infection, or cardiovascular disease.

2. Blood glucose testing: HbA1c

This test looks at your blood glucose level average over the past 90 days. Elevated levels mean your body is not processing sugar properly and indicates that you may have metabolic syndrome or Type 2 diabetes, depending on the level. 112 million Americans  have metabolic syndrome and another 34 million  have diabetes — that’s more than 1 in 3 of us who have a blood sugar disorder, primarily caused by high sugar and refined carbohydrate diets.

3. Cortisol testing

A 4-point cortisol test through saliva or urine measures your levels of the stress hormone cortisol throughout the day, which should naturally start high in the morning, some down throughout the day, and reach the lowest point around 10 pm. Cortisol levels that fall outside that pattern could be linked to high blood pressure, weight gain, and blood sugar imbalances — all things that put you more at risk for chronic diseases like heart disease, obesity, and diabetes.

These tests aren’t just needed if you’re hitting a certain age or look ill to other people walking down the street. In my practice, Parsley Health , we regularly see healthy-looking people in their late 20s and early 30s with pre-diabetes, stressed 40- and 50- year-olds with chronically high cortisol and people of all ages who have underlying, yet to be diagnosed autoimmune conditions.

While these steps alone won’t stop the spread of coronavirus, they will help shape your individual risk profile and change the trajectory of the disease if they’re picked up en masse. They’re also the first step in becoming healthier as a nation.