World Health Day 2021: Covid-19 is dead, Long live Covid-21?
In medieval Europe there was a classic heralded expression upon the death of a monarch: “The King is dead, long live the King!”. This brief expression was used to not only report the most sentinel news in the lifetime of the populous but also to reassure them that there is continuity in succession, and brighter days ahead. When looking at the current data since the start of 2021, and comparing that the guidance of our government institutions and media, I feel like the parallel proclamation for our moment would be: Covid-19 is dead, Long Live Covid-21! This modern expression, unlike its 15th century counterpart, is neither fully factual nor optimistic. So on this World Health Day I am going to focus the blog into 3 Parts: Part 1, A data driven Covid status update - vaccines, variants, and where we are now; Part 2 what we got wrong over the past year so we don’t use the same playbook going forward; and Part 3, how to START the pivot from a year long focus on infectious disease to a prolonged focus on optimal health and wellness.
Part 1: Covid 2021
As many of you know at our Formula Wellness Centers we have performed Covid testing since the start of the pandemic. During each wave, in real time, we would see testing increase just as each surge started, and wane as the surge passed. This makes sense as people would come in to be tested if they had classical symptoms, or were exposed to either a close household contact or to someone with whom they recently socialized. We saw not only an increase in number of tests during surges but also an increase in the percentage of people who tested positive (the positivity rate). Thus we have been an accurate real time barometer in our local marketplace of prevalence of disease. I recount this because something incredibly unexpected happened the second week of January. Covid testing frequency didn’t fall, it plummeted. On top of that those getting tested for symptoms or exposure not only were fewer in number but our positivity rate dramatically fell as well. Could this be the vaccine in action? It may have had some small contributory effect but the vaccine in Texas had only been administered for 3 weeks with less than 1 million total doses in the entire state and absolutely no one having receiving a second dose. Where people just doing a better job of distancing, hand washing, masking then they were before? Hardly. Covid fatigue was beginning to be rampant. What could explain this then? Simply, it was the start of population based or herd immunity. Herd immunity is the holy grail concept we talked about a year ago and although everyone is now familiar with the term, its definition has been muddled by government/media messaging as to what it is and what it takes to get there. Heard immunity’s definition is NOT 80-90% of a population being vaccinated. It is enough of a population to have immunity (from wild type infection OR vaccine) for the virus to spread/reproduce at a rate well below one person passing it along to the next. We were beginning to see this before hundreds of millions of doses of vaccine have been in arms. We are definitively seeing it now. Not that it will be officially called but I believe that data will conclusively show that we are merely weeks in this country from the Covid-19 pandemic being over.
Wait, how can this be? In the news there are cities and states that after months long decline and increasing vaccination rates that are showing increasing case counts and hospitalizations. We are being told to double mask, roll back restrictions and if we let up now, we will be like France who is going back on lockdown. It is easy for all of us to be confused because the messaging this whole pandemic has been so botched that we don’t understand where the goalposts are and what terms mean anymore.
In the paragraph above I did not say that SARS-Cov-2 was gone and no one will ever be infected, hospitalized, or unfortunately, die of Covid ever again. I said the Pandemic will shortly be over. A pandemic is an epidemic that is over multiple geographic areas. Covid was an outbreak in Wuhan. It quickly became an epidemic in China, and It became a pandemic when it spread uncontrollably to Korea and Europe and then the USA. As this year long infection has raged on we lost site that the goal wasn’t eradication of the virus but walking things backward from Pandemic to medically manageable local outbreaks that we have treatment plans for. Despite the state of Texas losing mask mandates and many businesses operating at 100% capacity, case counts are not going up (and in fact continue to fall). There are however still positive cases and at risk people will still be hospitalized and unfortunately die, but that does not make a pandemic.
“Wait a minute”, you say, “I see on the news about the increase in cases of the highly infective new VARIANTS and the CDC director within the past week has warned of “Impending doom”. Yes, the health agencies and media are shouting from the roof tops that “The Variants are Coming, The variants are Coming!” I am not saying we should not be concerned over current or future mutations that lead us back to square one. These variants are indeed MORE INFECTIOUS and MORE DEADLY and if not for pre-existing combined immunity with cross protection from the original strain we would indeed be in a heap of trouble. What I am saying is that the accuracy of the worrisome claim of impending doom from “The British Variants are coming...” will go down as less accurate tale then the false schoolbook narrative of the famous ride in colonial Massachusetts (Historical note: Not only was that phrase never yelled by some lone patriot named Paul Revere but Paul was one of 5 riders that night and of the 5 he was the only rider who did not make his destination because he was turned back by the British).
What should our health agencies be shouting? Cross strain immunity for now is real and it is effective. In 5 months of the strains emergence there is statistically nearly zero cases of people being hospitalized and exactly ZERO data of someone dying of the new strains who had developed prior immunity from wild type infection or vaccination. Zero. None. Prior immunity, no matter how you get it protects you from death. This is the win that the CDC needs to be shouting from the rooftops.
Let me clear, in this separate paragraph so it is easily found. The variants are legit more infectious and if you have not had covid and you have not been vaccinated you are for the next several weeks to months MORE ART RISK of contracting covid on an individual level then at any point this past year. There are the two variants that most people have heard of (“the British, the South African/Brazilian) and now an additional double variant first found in India and making its way here. All of these variants spread easier then the original European strain so if you don’t have prior immunity maintain distancing and masking.
So if despite a preponderance of immunity, people can still get infected, and some still will die, what I am I making a big deal of the semantics of removing the term Pandemic and hopeful for continued progress to new-normalcy? The CDC, for all the combined wisdom of the scientists who work there, are so hyper-focused on the spread of infectious disease that as we get on top of this thing we need to look back and see the whole forest of human health and not just focus on this 1 year old “infectious” tree. Mental health and suicides, illicit drug and alcohol use, decreased exercise and increased sedentary lifestyles, worsening diets, people not getting cancer screenings, and later interventions in heart disease and stroke, all matter in our healthspan. As we have undoubtedly saved people from covid related death with our government interventions and restrictions, we have also worsened each of these health parameters and also lost lives. If we don’t change the messaging as the data is changing, more people will die from preventable delays in health care, and behavior/lifestyle changes that contribute to disease.
So what does the data say, circa April 7th 2021 as to how close we are to herd immunity? Let’s start with vaccine data first. Over 160 million doses of vaccine are already in the arms of American patients. The vaccines while not 100% at preventing mild covid, they are nearly 100% effective at severe disease and death. So that means within 4 weeks 160 million people wont die of covid (and if they do it will be a fluke and reportable case.). With an estimated 325 million people in the country 50% of the country will have vaccinated immunity. In and of itself that is most likely to end the hard definition of a pandemic even without accounting for wild type immunity. But when we add in antibody survey data we are pretty sure that around 120 million Americans have had the virus. That’s about 1/3 of the country. Even assuming overlap between people who got the vaccine who already had prior-covid, we are most likely within 4 weeks at 70% plus of the US population with immunity. They wont die of coronavirus. Is that enough? Most likely yes, since coronavirus does not kill everyone who gets it. It kills the elderly, the obese, the diabetics, the immune compromised and others with multiple medical diagnoses. The vaccination rate in the at risks groups is HIGHER than that of the general population. The data trends are not murky. Covid cases will continue in people who refuse to be vaccinated. But deaths from those that get vaccinated or who have had it are trending to zero.
So with that as background what is the data saying we should do right now?
Students - They should be in classrooms. The education gap between those that have support structures at home and technology and those that don’t are widening to unrepairable levels. The decreased social interaction is isolating children and worsening mental illness. Child abuse is up and not being detected. The pediatric death rate from each year’s influenza outbreak is about the same as the last 12 months of pediatric covid deaths and we don’t shut down schools for flu. The data is clear, the decision making on keeping kids out of schools this fall will go down as the second biggest mistake of the pandemic.
Masking - I’m sorry, my anti-masking friends, but the data is very clear, the less viral load that gets transmitted, NOT only results in less people getting infected but it lessens the severity of the infection for the recipient (given the same co-morbid risk factors). Transmission of high level of viral innoculum due to lack of broad masking EARLY in the pandemic was the third greatest failure of the pandemic. HOWEVER, if you have had the virus or have been vaccinated, masking is not necessary. Yes, it is possible (although EXCEPTIONALLY rare) to get Covid a second time or after vaccination, but the viral loads generated on this secondary infection are much smaller and thus the ability to infect others and to infect those to the point of them getting serious life threatening illness drops precipitously with pre-existing immunity. Which brings us to life post Vax...
Post-Vaccination lifestyle - Continuing to social distance, wearing 2 masks, avoiding friends and relatives and acting the same as prior to being fully vaccinated (which is 2 weeks after your second dose of Moderna/Pfizer or 4 weeks after J&J), simply flys in the face of all immune science in the history of ever. Disallowing freedoms post immunity not only fly in the face of historical science, it spits in the face of the current vaccine studies and now 4 months of post FDA approval real world date of over a half a billion of post vaccinated individuals who are no longer being hospitalized and spreading the virus.
Hand Washing - The data is clear. It is good to wash your hands to prevent a lot of communicable disease. However it turns out that Covid, is not one of these. Yep the gallons of hand sanitizer you have bathed in the last year has probably cut some flu and other respiratory virus transmission but transmission as fomites- picked up on surfaces by your hand then transmission to your mouth or nose, but it has not a prevented Covid transmission. Still, everyone please wash your hands, covid science or not, it’s gross when you don’t.
Going to the Gym - Do you have prior immunity? For all of the prior reasons, you have sufficient immunity and going to the gym will lower your medical risk for just about every other disease and health related illness (including recurrent covid). Don’t have immunity? We have around 9 moths of health club data and the data shows the incidence of contracting covid post gym exposure is far LESS than nearly any other indoor scenario including your own home. The only exception in the data thus far is some small clusters of outbreaks seen when an infected GYM EMPLOYEE has caused a local outbreak. Find out what your gym’s policies and protocols are for ITS employees. That is far more determinant in your risk of covid than if some other patron sweats on you.
Travel by airplane - Travel and hotels are the hardest hit industries during this pandemic. If you have prior immunity travel is safe and at this point the risk of an accident on your way to the airport is far higher then death by covid. If you are not immune? Short haul domestic flight data show incredibly low infection rates with transmission incidence and rates lower than household or restaurant transmission. Long haul international flights do have a higher incidence of covid transmission so it does make sense to take extra precautions on these types of flights.
Restaurants- if immune, not only should you eat at them but if your choice is between Uber eats and going to a restaurant you should go. Why? Social interaction is important to mental health. Restaurants have been hard hit and local restauranteurs lose significant margin to the delivery services and they need your help. Lastly, your ability to custom order healthy options (olive oil instead butter on your salmon, subbing out veggies for fries) happens easier in person. You will be healthier.
Part. 2: Hindsight is 2020 (unless you are talking about the year 2020)
Although hindsight is 2020, I fear that in this case 2020 will refer to the year and not perfect vision. If we don’t learn what we did wrong in 2020 we are going to keep repeating this mistakes going forward in the short term and even worse, when we face the next one (and there will be a next one).
I mentioned above that decisions on education and masking will go down as the second and third biggest mistakes made in national management of the pandemic. The number one mistake, which is still going on, hands down has to be a failure in messaging that crossed both political administrations. 12 months ago we needed to NOT pretend we knew everything about the virus (which we didn’t) when we were giving edicts. Now we need to stop acting like we are ignorant on transmission, risk groups, benefits of immunity and pivot our guidance based on the preponderance of the current data.
Messaging has been an abject failure. I do not believe for a second that the Renfeld from the CDC, Dr. Brix, and Dr. Fauci, believed in March 2020 that masks wouldn’t slow the spread. There was reams of data from SARS-cov-1 (aka SARS) that aerosolization is the predominant vector and that masking reduces ones chances of spreading infected aerosol. So why did they give this messaging? Although we will never know for sure, I speculate that it was due to a shortage in the national stock pile of masks. Hospitals around the country and clinics like mine, were telling our employees we don’t have enough masks to change with every patient so wear the same one all day, all week, and at some hospitals - one mask per employees per month. The paternalism of our health directorate told a white lie, “masking not important” to prevent a run on masks. Well its often said the road to hell is paved with good intentions and this messaging is a profound example. It was the first massive paternalistic misinformation/lie of the pandemic with massive implications.
What could they have done different though? They needed to save the masks for health care workers right? The way I see it they had 3 choices. Tell the truth and find some way to restrict mask purchases only to health care entities and get civilians to cloth mask in the short term. Option 2: Say nothing - say we are still looking at the data and quietly get mask production going quickly. Or Option 3: lie. They chose option 3. What is the difference if there was not enough masks to go around anyway? Plenty. There was always going to be some anti-maskers. Wearing a mask all day sucks. Being told to do it will always chafe those with libertarian values that don’t want to be told what to do by government. But we created more anti-maskers by flip flopping on guidance contrary to the scientific data. We immediately undermined credibility of those giving us guidance and interjected that lack of credibility into a hyper-partisan political world. I remember a lecture from one of my professors in medical school during our medical ethics course, whose title of the lecture was “There is no such thing as a little white lie in medicine.” Telling a patient just diagnosed with stage 4 pancreatic cancer that things aren’t that bad when they have a negligible 5 year survival does not help the patient or the family in the end. Credibility is everything and misinformation from the start doomed our response.
Despite this colossal failure at the outset, the messaging only got WORSE from there. We had the problem of “moving the goalpost messaging”. Are we 30 days to flatten the curve? Are we now extending lockdowns trying to prevent hospitals from being over run? As surges past and hospital capacity was no longer an issue, we needed to restrict lifestyles based on 7-day case count averages and positivity percentage rates ( which may have slowing, but did not stop anyone from getting the disease). Are we keeping kids out of schools despite them not being a transmission vector until we have vaccines? Now that we have vaccines do we need cases and death to be at zero or is it that 85% of Americans need to be vaccinated until we are fully back to normal?
The messaging has not changed despite a progression from a time 12 months ago when we didn’t know how to treat Covid (and we didn’t at first) to us now having a disease that we not only have decent therapeutic options for, but due to vaccination and post infection immunity have lessened the transmission vectors and made this a disease less deadly on a population basis then the seasonal flu. We need to be changing our messaging.
I wrote a long blog last month on the vax. Readers know that I think it is incredibly safe and if you did not already have covid and you are over 50 or high risk in any other way, you are not making a sound statistical decision by rejecting getting it. The risks of covid are higher than the risks from the vax. However I do strongly favor peoples ability to make their individual health decisions. Smoking and not exercising are scientifically unjustifiable things to do. But hey, it really is your choice. I am going to every day convince you in clinic and on these blogs to be your best healthful self to maximize health span through the best behaviors (including vaccination) but its on the individual to take the advice.
While I respect individual decision making, I don’t understand the messaging about the vaccines by our leadership. They are using the stick of virtue signaling: anger and shaming - “If you don’t get it you are part of the problem and killing your grandmother”. They are using a stick of “we can’t open the economy and return your lifestyle until 90% of you do this”. Yet they are taking away the carrot of known vaccine science. The data conclusive show these vaccines prevent covid related death. They markedly drop asymptotic infections and spread. The carrot should be, get the vaccine, and “you are free to move about the country, maskless”.
So if current messaging is the wrong sticks and no carrot, what really could we do? This is our first crack at messaging during a public health infectious crises so, give the government a break, right? Well, wrong actually. Just under 30 years ago another scary infectious disease was hitting our county. The HIV virus was causing a mysterious immune killing disease called AIDS in specific populations - IV drug abusers and the male homosexual community. What was our initial public health messaging response? Don’t do drugs and stop same sex activity. We shamed those that continued these practices and told people that it was their fault if they didn’t follow the mandates and subsequently got an infection. Did moral shaming work to stop the spread and save lives? Nope, not one bit. It caused polarization, people in risk groups being afraid to approach the medical community and worsening outcomes. Does shaming spring breakers in Florida by not allowing them to party on the beach (outside, great ventilation, low covid transmission risk in a low risk population) make them stop partying or does it cram 40 of them into a 200 square foot hotel room (indoors, low ventilation, high transmission risk).
When we began to change the messaging in HIV to one of education, the outcomes changed.
When you lecture someone in medicine or public health from a place of morality you lose. When you educate on risk reduction strategies you win. It doesn’t matter if its: HIV, overeating, smoking or Covid; Telling someone to change or they are a bad person doesn’t work. Teaching someone how the disease process works (viral transmission, unhealthful behaviors leading to specific disease) and then walking them from a range that takes them from zero risk (avoidance, abstinence, self-lockdown) to reduced risk (condom use, healthier food substitutions, masking) and adding in a carrot (a lifetime without anti-viral medicines, more energy/better body, more freedom in social interaction) you win the argument and change behavior.
When I am indoors and around anyone wearing a mask, I put on a mask out of respect for that person. I however do NOT think you are a jerk if you don’t. I do however think you are a jerk if you morality shame others into wearing them when they understand their own immunity status and risk tolerance, or counter-morality shame those that are wearing masks for their own protection or for following national guidance.
So white lies, morality-stick messaging and lack of clear goalposts to our freedom have compounded our response to this infectious pandemic. I think the world should focus on Texas one month after the governor’s “Neanderthal” proclamation a month ago. Not focus on the case counts and positivity rate - which is impressive but may be fortunate timing as much as anything else. I’m talking about the behavior of the Texans I see. Some are not wearing masks, but many still are. Many businesses are still requiring masking indoors, but a few (like ours) have loosened rules for patrons but not staff. What I am not seeing is anyone bullying anyone else. People are making educate decisions based upon their level of comfort. And its working because educated (adult) Americans are a lot smarter, a lot nicer, and a lot more reasonable then our experts seem to think.
Lastly on messaging and as a transition to the final Blog part, we have not been truthful about why America is in the middle of the pack in how well we did in death rate from covid. It is not because we should have locked down earlier and more severely like South Korea. its not because we have evil anti-maskers. It’s not because of president Trump or Governor Cuomo’s errant policies leading to massive death (although there are specific mistakes made by both). It’s because we as Americans are obese. We have an epidemic rate of diagnosed and undiagnosed non-insulin dependent diabetes and immune crushing insulin resistance. We have high rates of hypertension, we eat too much processed crap, we drink too many 800 calorie mocha-frappacunios and walk less then just about every nation on earth. Our healthcare system poo-poos vitamin D supplementation, and focuses on using drugs after the fact instead of advocating for preventive behaviors. I have heard NO ONE in government leadership advocate that choosing better health options during this pandemic would lead to better outcomes. The messaging has been focused on virtual signaling decisions (isolation, food delivery, sitting on a couch, not going outdoors) that lead to weaker immune systems. Our messaging and desire to take accountability is just shameful and the real unwritten story behind why America lags in Covid outcomes.
Part 3: World health day and beyond
At our health and wellness clinics our nurses and providers speak daily with hundreds of people about their diet, nutrition and exercise progress. It’s the very rare person we speak with who currently has a better health lifestyle now versus 12 months ago. The national statistics concur with our local data. Think you're alone in gaining weight this past year? The annual national survey by the American Psychological Association released last month showed that 61% of people had undesired weight change the last 12 months and 42% of people surveyed gained on average 30 pounds of weight! We had an obesity epidemic in this country prior to Covid. We just accelerated a worrisome trend line of obesity, diabetes and heart disease not by a year but by a decade.
Just shy of 600,000 people died in this country of Covid and that is an almost unimaginable infectious related tragedy. If there is an upside in that number it is all of that death was in one year and despite what impending doom you may hear from our CDC director, that number although it will continue to inch up, it is not going significantly higher. 600,000 is a lot of Americans, but 1.2 million is twice that number. 1.2 million is the number of Americans that die EACH YEAR from vascular disease or cancer.
We spent 7 trillion dollars and caused a host of secondary problems saving the lives of an estimated 1.4 million people (see the original Glasgow predictions from a year ago of predicted deaths without interventions) - once! What’s the scale and magnitude of that spend compared to annual cancer and heart disease research? We spend around 3 Billion a year on Heart disease research and 6 billion a year on cancer research. I wasn’t a math major but by my calculations it would take us 700 years of annual heart disease and cancer research spend to equal our Covid spend last year. Let the magnitude of that spend sink in for a second.
I know questioning any spend sounds cynical. We needed to spend all of that to save lives and help the economy after forced lockdowns. We all saw the constant ticker on the news of new daily deaths. Those deaths clearly week in and week out trumped the number of heart disease and cancer deaths right? Well its sort of right. When looking at weekly death rates, Covid deaths did exceed heart disease plus cancer deaths - just 2 out of the last 52 weeks. The other 50 weeks more people continued to die weekly from cancer and heart disease than Covid. We just didn’t put it on the CNN ticker. Even more problematic, some of our measures used to reduce covid death, stay at home orders, telemedicine instead of in person visits, and lack of focus on screenings, imaging and laboratory for disease prevention has lead to a staggering drop in cancer and heart disease screenings and either missed or diagnosis at later stage of disease.
I’m not bashing on spending money for covid research or relief - at Formula we took PPP funds and just like so many other small business it was a short term life saver for us to keep all of our employees hired. I’m just highlighting the magnitude of the spending to show how we all dug in together and beat a virus that killed 500,000 people once yet we day in and day out mostly ignore and relatively financially neglect one that kills twice that each and every year.
It’s time to start the mental pivot.
If your reading this (and you have had covid or opted to get the vaccine) you survived the Covid pandemic . But are you amongst the individuals who despite survival from the pandemic have accelerated your progress towards diabetes, obesity, heart disease and cancer ? Is your body composition and lab values better then the were 12 months ago or worse?
15 months ago I wrote a blog on healthy user behaviors (“Be like HUE”). No where on the list was a lifestyle of Grubhub daily/Netflix nightly and wash it all down with a bottle of wine. I have seen thousands of patients during the last twelve months. There are about 10 I can recall who are significantly healthier today then they were 12 months ago. There are certainly others who held par. But the vast majority took a giant step back.
The human body is incredible. So the most important thing to know is even if you took a year off on a journey of wellness It’s not too late to get back on. Our body can suffer tremendous insults in the short term without long term consequences. It's when those short term insults become recurring lifestyles that our body maladapts with disease, cancer and premature death.
I always say I am a nutrition first doctor because that’s what matters most. However nutrition is the single hardest of all the healthy user behaviors to change consistently. If you are ready to make that change great. If not, let's take the greatest failure of the last year - messaging, and work on it for ourselves. Are the people you are getting guidance from giving you the facts and helping you make that sustainable change? Or are you being led into a false narrative that’s its all or nothing, it has to be this diet/restriction or failure.
So where to start on your on health journey post covid. If I break down the critical components to maximizing Healthspan (see intro on my first Blog on definition of Healthspan) it is in the following categories :
1). Nutrition / Fasting
2). Exercise (Cardio, Muscle mass maintenance, Flexibility)
3). Recovery / Repair
6). Stress Reduction
7). Hormone Balance
9). Cognitive Conditioning
10). Advanced Therapies (Removing senescent cells, longevity peptides, supplements and medications)
I could and probably will write numerous blogs on what goes into each category and how to optimize it. Excluding number 10 (which you shouldn’t do before working on 1-9 anyway), Each one of these is attackable for everyone right now. What is the right post covid game-plan? This is highly individual and if anyone feels overwhelmed we are happy to do a consult/tele-consult and put together an all encompassing plan. If you just want to get started I recommend EITHER taking one category and focusing on it for the next 90 days by setting a hard, but obtainable (written down) goal and striving for it, or pick smaller improvements in multiple (no more than 3) categories that are less extreme from baseline but with the goal to try and incorporate these for a lifetime. Statistically, you are more likely to achieve success if you write a plan down, and look at it once a day. For instance has your nutrition been off? Focus on something specific like a weight target or something specific like dropping down to 50 grams of sugar a day or adding in one healthful serving of vegetables and protein per meal. The more specific the more likely for success.
Below are some starter ideas for each category:
Nutrition/Fasting - cutting sugar grams, adding in protein/vegetables to each feeding, adding in intermittent fasting (18 hour or 24 hour fast), removing processed foods.
Exercise - aging well requires all three sub specialties stated above. Are you great at one but not the other (great on cardio, poor on strength or great on strength and poor on flexibility?) Flex in one day a week on whatever you are most deficient at. Haven’t been moving much at all? Start with 10k steps a day and move on from there.
Recovery/Repair - sounds crazy but this is 100% as important as exercise. Are you using a supplement that maximizes your gains of exercise by recovering better ? If not add in essential amino acids, carnitine, or BCAAs to aid growth and repair. Already doing that? Sauna, Infrared sauna, cold plunge, cryo all activate heat shock proteins that stimulate repair and lean body mass. Go next level with that once a week.
Supplementation - the category is broad and overlaps all others but add in one supplement - cognition slipping? Train some brain supporting nootropics or NAD+. Gut health feel off? Start or switch up a probiotic and add in glutamine daily. Been stressed out? Try adrenal adaptogens like our own Stress Defense or supplements that boost serotonin like GABA, Theonine and 5HTP.
Sleep - Maybe even tougher then changing chronic nutrition but if its not good, nothing else matters. Focus on sleep hygiene - turning off blue light screens hours before bed, meditation nightly, supplementation with small dose melatonin and magnesium. Cut alcohol. Don’t keep doing the same thing and expecting different results.
Stress Reduction - Lots of overlap here but improved nutrition, exercise, adrenal adaptogens, meditation, and supplementation all help dramatically. Beyond this, socialize, interact and reach out to professionals if stress levels are high. That desire to be alone when stressed is a maladapted physiologic response. We are not animals meant to cocoon and emerge as a butterfly. We are social animals that need engagement to improve. Seek socialization and if the stress is bad seek professional health. See my blog from last august, You are not alone, and in fact you are closer to the anomaly to have less stress know then a year ago.
Hormone balance - Our hormones effect every cell in our body. If its more then one thing “feels” off its worth getting a blood test and a consult to see if they are on point. It can improve lean body mass, energy, libido, cognition...
Socialization- as mentioned under stress we are meant to interact face to face as humans. Endless Zoom calls and hibernating in our Netflix caves is not a recipe for longevity. Pick up your cell phone and make a date to meet someone in person. And if y’all are immune, take down your masks and look at each other’s faces.
Cognitive Conditioning - watching Netflix and Hulu can reduce some stress but it does not sharpen the mind. Read a book, do a crossword puzzle, learn a new skill or hobby. Accelerating rates of dementia and cognitive dysfunction are going to be the next pandemic facing baby boomers and Gen X. As bad as it will hit those generations, at least most people in these generations grew up reading books. Millineals and Gen Z’s formative years have been reading instagram and twitter. You don’t need to have a crystal ball to see a brain crisis in the making.
I know that list is long and exhausting. The government is also not going to give us 7 billion in financial support to make positive changes in our wellness even though we would all live healthier and longer lives if it did. Start with one thing. By starting with one thing you will make the next healthy thing easier. The more of these healthy user behaviors you start doing the less of the unhealthy you do. When you work out AND add a sauna after, there is less time for Netflix that evening. When you intermittent fast there are less hours of the day you are grabbing processed junk. One healthy thing leads to another. After a long year when through bad lifestyle choices we accelerated our million plus American march to heart disease and cancer on top of the half a million more deaths due to covid, isn’t it time to say, “Covid-19 is dead, long live your health and wellness”.
As Always, Stay Well