Do you ever feel like all the information that comes out related to COVID seems to change by the next week? Have you felt like it is so difficult to even know what to believe about how COVID should be managed? Should you get tested? If so, what type of test? If you have the disease, what should you be doing to help your body? Take this medication, don’t take this medication? Take this supplement, no wait, don’t take that supplement! As a physician with advanced experience in the testing and management of COVID-19, even I’ve felt these same frustrations and uncertainties. In light of that, I wanted to put together a simple, easy to understand overview on the why’s and the how’s of this terrible virus.
First thing first, how does COVID-19 spread? It spreads mainly from person to person, typically through respiratory droplets from coughing, sneezing, and likely through talking/singing. Reports show that it most commonly spreads through close contact (defined as >15 minutes at less than 6 feet away). There is also an indication it can be spread by airborne transmission, meaning droplets/particles that can linger in the air for minutes to hours, with some evidence that it can infect >6 feet away. An example of this would be if someone who is actively shedding the virus is in a poorly ventilated space and those particles can linger airborne to infect others who inhabit the space at a later time. Two other less common spreading mechanisms involve contaminated surfaces and lastly, the very infrequently reported scenario of potential spread between people and animals.
The next topic is an incredibly important one. By this point in time, there are an enormous number of testing options. They can broadly be broken down into antibody testing and diagnostic testing. The antibody testing is looking for evidence that your immune system has reacted to a specific type of threat, in this case, SARS-CoV2 (the virus that causes COVID-19 illness/disease). There are some antibody tests that just look for IgG and others that look for IgG and IgM (if IgM positive, you’ve encountered the virus more recently). For diagnostic testing, this is where the real confusion sets in. The sad reality is that many of the testing options that are available within the typical urgent care setting are incredibly inaccurate and don’t offer much value. Countless individuals have gone and spent their $150-200+ to have a test done at an urgent care and unfortunately walk out with results that are almost completely or completely useless. When you get a diagnostic test, you want to make sure it is of the highest precision, said differently, that it is going to tell you you’re positive if you’re positive and negative if you’re negative. Many of the more “rapid” options fail in their accuracy capabilities and this can lead to unnecessary quarantine, or even worse, dangerous spread to others. While PCR testing can take a bit longer to get a result, these tend to be the options that are most accurate. Another key in the type of test used is to make sure it also offers objective markers of actual amount of viral concentration present (called cycle thresholds). These are the type of tests that have been used in professional sports scenarios and they can not only make an accurate diagnosis, but they can also guide as to when it is safe to exit quarantine.
By knowing the quality of the test you’re receiving, you can potentially avoid wasting time and money, ensuring you don’t leave your visit with unreliable results.
Another important discussion is that of what to do if you get a positive test. Sadly, the only discussions in the media are related to what the pathogen (SARS-CoV2 virus) is doing. The truth is with any illness there is a host (our body) and then the pathogen (whatever is causing the disease). There is no discussion about what we can do to potentially help out and optimize our immune system. You may have read certain headlines about “take this supplement to beat COVID” or read a message board where someone is saying “I had COVID and I took this and now I’m all better”. This can serve as additional layers upon layers of confusion and leave you asking “is there any truth to be found in this mess?!?!” Well, the truth is the “best” approach doesn’t look the same for one person as compared to another. You can’t expect that the same thing that works for a friend is going to work for you.
This is where the real value of functional medicine shines. First of all, we aim to address COVID in four different stages and align treatment protocols with what the immune system typically needs during each one of those four stages. A preventative protocol doesn’t look the same as an early infection protocol. An escalating inflammation stage doesn’t look the same as someone who is deemed a “long hauler”. On top of that, individuals have different “weak spots” or deficiencies in their nutritional status, so some people need more help in one area vs. another while someone else will have completely different needs.
In summary, for COVID care, start with making sure you’re getting the highest quality type of testing (ideally a PCR with cycle thresholds). If you do have a positive test, consider partnering with a physician who is able to put together a unique, individualized care plan for you that takes into account the specific needs of your immune system. Once your body has progressed into recovery mode, your care plan should shift and in many cases, you can use repeat testing to guide the timeline to safe exit from quarantine. The more accurate the information you gather, the better the outcomes. Sign up for a COVID care consultation here.