Uncertainty continues to be a part of trying to understand the strain of coronavirus, (SARS-CoV-2) causing the disease, (COVID-19). There has been much speculation, interpretation, rumour and opinion, but still relatively few certain facts.
Human beings are understandably disturbed by uncertainty and, as we have discussed before, this tends to activate the fight or flight part of our old, more primitive brain. The more understanding we have about a situation, the more prepared we feel to deal with it. However, as we have also seen in the last few months, human beings are extremely adaptable animals. Most of us have understood the need for social, (I prefer the term physical, as we are a sociable animal and can maintain social contact albeit at a distance or online) distancing, to limit transmission of the disease. This not only slows spread so that health services are not overwhelmed, but also protects the more vulnerable. We are learning to be together apart.
Most initial medical consultations are now online and we at The Natural Practice have experience of online consultations, as Dr David Owen has outlined in his piece in this newsletter.
I have been fortunate to be involved with discussion with my fellow, medical professionals and medical homeopaths, both locally and worldwide. I have therefore drawn together a summary of what we do know about the virus.
Although our hospitals remain a vital part of the medical response, it is clear that much of the real battle against the virus will be fought in the community and in primary care.
Much of the planning and modelling was based on worse case scenarios, but this too has not been as simple as first thought. We have managed the capacity problems well so far and there is in fact plenty of capacity freed up via public health management and the challenge now is to manage not only SARS Cov-2, but also the rest of the health service activity which has, up to now, been largely paused. There are still patients with ongoing health needs such as cancers, diabetes, asthma and mental health needs that must also be cared for.
The understanding of the disease SARS-CoV-2 causes is still evolving but is understood to be much more than a viral pneumonia. We understand it more now as an inflammatory process, or pneumonitis (pneum = lungs, itis=inflammation). It also seems to cause a profound drop in blood oxygen levels, for which ventilation is not always the right answer, but for which nursing the patient in a prone, or face down, position may help, and also a state where the blood clots more easily, (hypercoagulable state causing clots or thromboses), which can cause strokes, kidney and further lung and other organ damage.
I speak to many of my patients about the background of inflammation that underlies most, if not all, of our chronic diseases - diabetes, heart disease, stroke, arthritis, (another “ itis” but this time of the joints, or arthroses). This and the support that we may be able to give our bodies to defend against inflammation, by our food and nutritional intake, is addressed elsewhere in this newsletter, by Ruth Taylor, Nutritional Therapist at The Natural Practice. There was an article in the British Medical Journal just last week about this very subject, and I find that my conventional medical colleagues are at last starting to embrace this issue and appreciate just how important diet and nutrition are as the building blocks to support health.
I have also been trying to understand more about the risks associated with COVID-19 from conversation with my colleagues. Most of us struggle with a personal interpretation of risk. It is a very personal interpretation as what is important to one person may be less important to another, depending on whether you are a risk taker or not. One explanation that I found particularly helpful was that the risk of dying if you contract COVID-19 is the same as your age-related risk of dying in the next 1 year. This is a figure that is readily available and is published regularly from an ongoing statistical analysis. SARS-CoV-2 can be lethal but brings your annual “lethality” for the age you are right into the immediate aftermath of developing COVID-19.
Whatever your perception of risk - look after yourselves, eat, exercise and sleep well and spend time addressing your emotional well being with whatever you can enjoy safely.