As a primary care physician at an academic community health care system in Massachusetts, I received a rapid introduction to telehealth this year. Within daytimes after Massachusetts proclaimed a state of emergency in response to the spread of COVID-1 9, virtually all of our case calls became telemedicine stays. Our staff reached out to cases to inform them of different ways they could get in touch with their doctor. Many would be able to gain access to health care through a health app connected to their healthcare web portal, or through a phone call or video call. The huge potential of telehealth was apparent to me within weeks. More I also came to understand the need to overcome sure-fire barriers to widespread telehealth access and equip added foundation, as some of my stories below illustrate.
Chronic positions and COVID-1 9: How did telemedicine cure?
Healthcare providers like myself had to quickly accommodated our clinical pattern to use technology optimally. We found that a combination of phone calls and video calls allows us to continue to monitor beings with chronic diseases, such as diabetes, high blood pressure, and heart and lung difficulties. Video proved particularly helpful in assessing who needed to be seen soon for a health topic, while avoiding unnecessary exposure to COVID-1 9 in emergency room when possible.
Our organization developed an intensive community management strategy for COVID-1 9. For example, we were able to educate patients and their families on ways to avoid getting COVID-1 9, or spreading it. Additionally, we exercised telehealth to mitigate the strain on emergency and hospital plans, keep personal protective gear( PPE ), and reduce healthcare systems overheads. By exerting phone and video triage, clinicians could identify people who were so ill they needed to be seen in clinics or at the hospital. Throughout recent months, telehealth pulpits have helped our primary care providers and experts communicate across many clinics, through virtual huddles and meetings.
Telemedicine can marginalize non-English speakers
Translation riches are key to inclusion for some patients, including a woman I’ll call Maria, who had recently moved from Brazil to just outside Boston with her husband, Jose, and two children.
“Muito obrigado! ” she called several months into our telehealth calls. “I feel like a new woman now. My husband and I wish to express our gratitude to you.” The pair contacted our health care services due to a bad skin ache and a rash all over the body. Being non-English talkers, they were struggling to find a health care provider who could help. Fortunately, the blended assistance provided by our staff and our state interpreter business facilitated the couple gain access to the patient portal and video technology. Through teledermatology consults we were able to cure them of bacterial, fungal, and parasitic scalp illness over a period of two months. Having the translation resources to overcome the language barrier was critical for the success of telemedicine in this case.
Internet and smartphones may be a barrier
In this age of pervasive smartphones and high-speed Internet, it is easy to lose sight of people who have no access to Internet attachments or smartphones. Recently I treated Felix, a 77 -year-old man who had previously been in prison for 40 times. Suffering from a number of ailments including hypertension, heart rhythm troubles, cardiac disease, and chronic diarrhea, he only had a flip phone and had no access to the internet. We had been possible to connect him with a cardiologist, and a remote dwelling tempo monitor related untreated abnormal mettle rhythms, which we later addressed.
For the poor and disadvantaged, shortfall of be made available to digital inventions and Internet are significant barriers to accessing telemedicine. It’s important for healthcare providers to be aware of the social determinants of health and to identify overcomes when screening cases. And if you’re a patient, you may need to ask staff or medical doctors for help in navigating this changing digital healthcare world.
Shortcoming of physical examination can diminish accurate decision-making
Twenty-eight-year age-old Eric was struggling with ear discomfort that had become so severe that he was now in pain. During a video see, it wasn’t possible to determine if he had a blocked ear canal due to wax or an ear infection. Both maladies can present similarly, but are treated with very different approaches. In this instance, an in-person visit was essential. An hearing exam demo affected hearing wax. Simple ear irrigation cured alleviate his indications, thereby avoiding redundant antibiotics.
A persona in recuperation — at least for those with access
Patricia, a 59 -year-old woman, had suffered a stroke that affected her mobility and image, and was recovering from recent psyche surgery. After leaving the hospital, she lived alone with little household help. A friend who was also her health care proxy was present during the appointments, and helped her connect with her primary care team and specialists, consuming telemedicine through phone calls or video calls. The friend also facilitated advocate for her needs. Her anxiety and insomnia were treated with medication and therapy through telehealth consults. The attention administration unit was able to connect her with alternate home assets. Telehealth dallied a vital role in Patricia’s recovery.
Telemedicine is promising. However, it is more efficient when primary care organizations and hospital systems address the gaps in access and service that surely arise.
Unsure about abusing telemedicine?
Here are some beneficial tips 😛 TAGEND
Create an email address if you do not have one already. This is the first step to help you communicate with your doctor. Ask your doctor’s office to understand better how telemedicine works at their clinic. Staff can usually take you through the steps of creating an account and logging into the patient portal or health app you’ll be using. Familiarize yourself with the invention you’ll be using( telephone, tablet, or computer) before your appointment. Seek help from a family member or friend whether it was necessary to additional patronage. Ask questions and advocate for yourself. Telemedicine visits are new to a great deal of beings, and it is okay to not know everything.
Up to 2.5% of children and 8.3% of youngsters suffer from feeling, a condition that’s associated with substantial complications last-minute in life, including an increased risk of suicide, substance abuse, physical diseases and problems with work, academic and psychosocial functioning. 1
It’s believed that both genetic and environmental influences play important roles in why some children develop feeling, and increasing attention has been placed on the role of dietary points and nutrients such as vitamin D, which is ideally find via sun exposure.
Further, one-carbon metabolism, which includes vitamin B1 2, folate and homocysteine and which romps a role in many biological processes and maintaining cellular homeostasis, has been investigated for its role in psychiatric conditions, including hollow in adults. 2
After exploring the link further, investigates from Ordu University in Turkey revealed that low vitamin B12 and vitamin D positions, along with increased homocysteine, may play a role in depression among children and teens. 3
Childhood Depression Linked to Low Vitamin B1 2, Maybe Folate
The study involved 89 children and adolescents with depression, along with 43 topics without depression to serve as ascertains. The voluntaries accomplished testing for childhood depression and suspicion and had their levels of folate, vitamin B12, homocysteine and vitamin D weighed.
While there was no significant difference in folate stages between the groups, 11.23% of those with dimple had low levels of folate. Further, among the depression group vitamin B1 2 and vitamin D grades were “clearly low.” As for how this might contribute to depression, the researchers illustrated: 4
“One-carbon metabolism has a basic capacity in methylation processes of neurotransmitters, proteins, and membrane phospholipids. Additionally, it is necessary for DNA synthesis.
With vitamin B1 2 and folate absence, methylation operations are handicapped and neurotransmitter grades come. Also linked to vitamin B1 2 and folate defect, there is an increase in the levels of the extremely neurotoxic metabolite of homocysteine.”
Both vitamin B1 2 and folate have previously been described as antidepressant nutrients. 5 Folate, found in dark leafy greens like spinach, avocados and other fresh veggies, participated in your body’s production of mood-regulating neurotransmitters. In one study, people who expended the most folate had a lower likelihood of feeling than those who ate the least. 6
Vitamin B1 2 is found only in animal nutrients such as grass fed flesh, eggs, dairy and wild-caught seafood. As such, vegetarians and vegans are peculiarly susceptible to B12 deficiency, and “its one” likely reason why vegetarians may be nearly twice as likely to suffer from depression as meat eaters, even after adjusting for variables like place status, family history and number of children. 7
It’s widely known that beings with a vitamin B12 deficiency are at an increased risk of recession, 8 which could be, in part, due to resulting adaptations in the level of DNA methylation in the psyche, leading to neurologic impairment. 9 Vitamin B1 2 too cures regulate homocysteine stages, and increased homocysteine should be integrated into B12 deficiency as well as depression.
Folate, Vitamin B1 2 Suggested for Treatment of Depression
Considering the thorough study joining feeling with low levels of vitamin B1 2 and folate, investigates with the MRC Neuropsychiatric Research Laboratory in Epsom, Surrey, U.K ., suggested that folate and vitamin B12 should be considered in the treatment of dimple.
“On the basis of current data, we therefore seems that oral quantities of both folic battery-acid (8 00 mcg daily) and vitamin B12( 1,000 mcg daily) ought to be tried to improve therapy outcome in hollow, ” they memo. 10
Folic acid is the synthetic form of folate, or vitamin B9, and while it may have a place in recession management, the most efficient way to increase your elevations is to eat meat rich in folate, such as asparagus, avocados, Brussels germinates, broccoli and spinach. As for why folate and vitamin B12 are so important for mental health, they showed: 11
“Folate and vitamin B12 are major determinants of one-carbon metabolism, in which S-adenosylmethionine( SAM) is formed. SAM gives methyl groups that are crucial for neurological serve. Increased plasma homocysteine is a functional marker of both folate and vitamin B12 deficiency. Increased homocysteine elevations are is located within depressive patients.”
Depressed Children Had’ Remarkably High’ Homocysteine Levels
The connection between low vitamin B12 and increased homocysteine elevations is notable, as the peculiarity study found “remarkably high” homocysteine status in the sons and teens with dip.
“Increased homocysteine additions the flow of calcium within cadres through the NMDA[ N-methyl D-aspartic acid] receptor activation pathway. Within the cadre, oxidative stress additions and apoptotic signals are triggered. Increased homocysteine reasons DNA damage, mitochondrial dysfunction, and endoplasmic reticulum stress, ” the researchers memorandum, suggesting that this is likely one mechanism behind homocysteine’s depression connection. 12
Separate study has also relation higher homocysteine elevations with additional increase of dip and suspicion among 12 – and 13 -year-old boys in Taiwan. 13 Higher levels of homocysteine, together with significantly lower levels of vitamin B12 and vitamin D, are also associated with other mental health issues states, including obsessive obsessive agitation, in which it’s believed to gambling a causative capacity. 14
Homocysteine is an amino acid in your form and blood obtained primarily from flesh consumption. Vitamins B6, B9 and B12 promotion convert homocysteine into methionine — a building block for proteins. If you don’t get enough of these B vitamins, this conversion process is impaired and answers in higher homocysteine. Conversely, when you increase intake of B6, folate and B12, your homocysteine elevation decreases.
As such, checking your homocysteine level is a great way to identify a vitamin B6, folate and B12 deficiency. The investigates also noted that “vitamin paucities and promoted homocysteine should be investigated in terms of cause-effect relationships” in areas of depression in youth, extremely since feeling may contribute to poor appetite and erratic eating habits.
Vitamin D Levels Also Low Among Depressed Youth
The Ordu University investigates also learnt vitamin D levels to be low among the children and adolescents with dimple, a tie that’s been revealed in the past. In the study, the depressed radical had a median vitamin D level of 11 ng/ ml, to report to 24.85 ng/ ml in the dominate group. Both of these values are low, but 11 ng/ ml is dangerously low-toned and will radically increase health risks of rickets.
It’s important has pointed out that for optimal state and infection avoidance, a elevation between 60 and 80 ng/ mL( 150 to 200 nm/ L) appears to be ideology, so all of the study players were very low by this measure. Vitamin D receptors exist in the human brain, 15 indicating at the importance of this vitamin in mental and feelings health.
The best way to gauge whether you might need to supplement
“Effective detection and treatment of inadequate vitamin D levels in persons with depression and other mental disorders may be an easy and cost-effective therapy which could improve patients’ long-term health outcomes as well as their quality of life.”
Once you have your vitamin D level tested you can use the Vitamin D Calculator developed by GrassRootsHealth to determine your ideal vitamin D dose.
Poor Diet Linked to Depression; Healthy Diet Fixes It
It’s been proven time and again that whatever it is you eat influences mental health, and this is certainly true among teenagers. Investigates at the University of Alabama at Birmingham looked into the role two dietary factors playing in indications of sadnes among teenages, in this case African-American teens who may be at an increased risk of both undesirable food and depression.
They analyzed the excretion of sodium and potassium in the urine in 84 metropolitan, low-income teens. Higher levels of sodium in the urine can be an indication of a nutrition high in sodium, such as processed fast foods and salty snacks. A low level of potassium, meanwhile, is indicative of a diet lacking in returns, vegetables and other health potassium-rich foods.
As might be expected, higher sodium and lower potassium excretion proportions were associated with more frequent symptoms of depression at follow up 1.5 years later. 21 Past studies have also confirmed the diet-depression link among children and teens.
When researchers systematically examined 12 studies involving children and adolescents, an association was uncovered between harmful diet and poorer mental health issues, as well as between a good-quality diet and better mental health. 22
Likewise, investigates from Macquarie University, Australia, studied 76 students between the ages of 17 and 35 who followed a poverty-stricken nutrition and had moderate to high levels of depression symptoms. 23 One group of the participants was asked to improve their nutritions by reducing back on refined carbohydrates, carbohydrate, treated meat and soft drinks, while snacking more veggies, outcomes, dairy concoctions, nuts seeds, health overweights and anti-inflammatory spices such as turmeric and cinnamon. 24
After only three weeks of healthier eating, those in the healthy nutrition group had significant improvements in mood and their dip ratings even went into the normal range. While teens and young adults aren’t always known for their healthy food preferences, this is a crucial period in which lifetime health eating decorations are established.
Ensuring youth are eating health foods rich in folate and vitamin B12, as well as optimizing their vitamin D tiers, may start a long way toward bolstering mental health issues and eschewing surroundings like depression.
If a child or teen is already struggling with depression, ingesting real meat is equally important. In addition to limiting the uptake of processed foods, fast foods and sugareds, including sugary liquors, increasing intake of foods rich in omega-3 overweights, such as sardines and wild-caught salmon, should be encouraged.
July is National Purposeful Parenting month. Purposeful Parenting is a movement that has gained popularity over the last decade. It is based on the belief that when the parental role is established with proactive intentionality and thorough understanding about child development, the ability of children to fulfill their potential and have more options available to them increases.
Purposeful Parenting has strong roots in the age-old debate between the roles of nature versus nurture in development. Prior to this movement, many parents and professionals viewed growth as a kind of predetermined outcome that naturally evolved. To some extent, this is true. There exists a phenomenon of anything living that even under suppressed or dire circumstances, growth — of some variety — will still attempt to occur. But Purposeful Parenting is about how we can maximize our children’s growth and give them as much opportunity to be as successful as possible, to not only survive, but to thrive.
While there has never been any doubt that a parent’s intentionality with their children’s growth and development influences the child’s success, this influence has previously not been emphasized quite to the extent it is today.
When you think of child development, it likely brings to mind the earliest stages of life. Rightly so, for these are the foundations upon which all other planes of development are built. But parenting is a lifelong relationship. The principles of Purposeful Parenting can be applied to any stage of life between parent and child or even grandchild. The defining characteristic of Purposeful Parenting, no matter the stage, is that it is focused on creating conditions that meet the needs of the child for enhancing growth at an age appropriate rate.
For toddlers, that may mean providing plenty of opportunities for physical movement and exercise as they learn to control their muscles and maneuver around their environments. For an adolescent, that may mean cultivating touchpoints throughout the week where you can make yourself available to listen to whatever your child is experiencing in their social life, without judgment, but to keep the lines of communication open. While the specific practices will depend upon the child’s age and development, the overarching philosophy remains the same: provide a healthy and safe environment for your children that challenges and stimulates their independent growth.
New parents are often inundated with advice and methods for best parenting practices. It can be very overwhelming. Being able to discern what information fits your family dynamic and what doesn’t is another important skill of purposeful parenting. Rather than committing to one parenting method, maintaining a sense of flexibility and adaptability is key to the evolving growth of both parent and child. What may be helpful for parents is to try to position themselves in a way that explores research based information about their child’s development, while considering cultural or colloquial methods of child rearing, but also learning to trust their intuitive instincts for what is best for their own child. This may still seem like a tall order, but it is possible.
Many of the tenets of Purposeful Parenting are not so specific in terms of what action is required, but rather, developing a mindset toward their child’s individual growth. This includes learning to cope with setbacks. Growth is organic and often nonlinear. While a child may excel in one area, they may exhibit serious immaturity in another area. This can be a frustrating reality for parents, but parents only need to examine their own growth to realize, it is part of human development for everyone. We all develop at an individual rate, across multiple dimensions of growth.
As far as parenting goes, there are many types of growth happening at once. Obviously, the growth of the child, but also the growth of the parent — as an individual, the growth of the relationship and bond between parent and child, the growth between siblings — if any, and the growth of the family as a unit. Cultivating intentionality in all of these dimensions of growth can be beneficial, but it is also important to remember and trust the inherent power of growth to persevere and unfold naturally. As parents, if we make this expression of trust part of our intentionality, then we will always be in pursuit of the best possible scenario for our children’s growth.
The COVID-1 9 pandemic has been stressful for all of us, and this includes our youngest children.
It’s easy, and daring, is of the view that babies, toddlers, and preschoolers aren’t affected by the pandemic. The truth is, though, that that life has changed for them, too — and for some of them it has changed dramatically. Even if the alteration is mostly positive for them — such as having their parents residence all the time — it’s still a alteration that can be confusing and unsettling. Young children are less able to understand the nuances of all of this; for them, the world rightfully is all about them. And they also have very acute radar when it comes to the excitements of their caregivers.
As a pediatrician, I’ve been hearing from genealogies about young children who are having trouble sleeping, whose eating dress have changed, who are crying or hurling outbursts for no good reason, or are just generally crankier and more exasperated than customary. Some are more clingy, which can get tough for parents who are working from home.
So what can a parent do? It should be said up front that there are no magic explanations or quick fix; this is a hard time, and it’s going to stay hard-boiled until instance multitudes go down a lot or there is a vaccine, or both. But that doesn’t mean that there aren’t some policies that can help.
Talk to their own children about the pandemic — but keep it simple and optimistic
Obviously, this is more about preschoolers than babes and toddlers, but you need to have an explanation for why you can’t go on the wavers or stay Grandma, or why you have to do a Zoom meeting instead of playing with blocks. Tell them that there is a germ that can offset some of us sick, and we want to be sure that we don’t catch it or give it to someone else without realizing it.
As much as you talk about this, talk about how a lot of beings are working very hard to originate the germ will be eliminated and keep us safe. Talk about all the things that you as a family are doing, like wearing cover-ups( for children over persons under the age of 2) and showering sides and staying a safe interval from others. It’s important to talk positively , not just because you want to keep things positive now, but too because at some moment we will be going out more, and if you haven’t laid the footing, teenagers may be frightened when they begin to do things they weren’t allowed to do before.
Be mindful of the media your child is exposed to — and the things you say when they are in hearing distance. Little ears can be easily fretted and confused.
Build procedures into your epoch
Life has been upended for all of us in some way or another, and it’s tempting to, well, wing it. But minors do best with some degree of predictability, so maintain to a regular sleep and snack schedule. Create a schedule that includes fun and playtime. If a child knows that they will have that time with you, they may be more willing to play independently while you work.
As you are building numbers, build in some activity. It’s good for everyone’s health, and it blows off steam too; something like a walk around the block playing I Spy can be both playtime and rehearsal for everyone.
Cut yourself slack
A little added screen experience for your teenager so that you can get some wield done may really is unavoidable. Playtime were not able to be particularly inspiring( it’s thoroughly punishment to turn works into plays, in fact it’s a great idea ). Meals don’t need to be inspiring either. We can only do our very best — and as I said at the outset, it is difficult on all of us.
Make care of yourself
Children really do notice when their parents are emphasized or unfortunate — and may worry that it’s their fracture. And when we snap( or worse) at our children because we are feeling bad, it can establish everything harder. So as you construct those programmes, build in some time for the things you need and experience. Don’t try to tough it out if you are feeling bad, very; reach out for help. While all of us need to take care of our physical and mental health during the pandemic, it’s even more important for caregivers — because others are counting on them.
If you have any worries about your child or your child’s behavior, call your doctor. Even though some bureaux have limited hours, the work requires always be someone you can talk to.
According to research1 conducted in Switzerland, SARS-CoV-2-specific antibodies are only found in the most severe cases — about 1 in 5. That suggests COVID-19 may in fact be five times more prevalent than suspected. It also means it may be five times less deadly than predicted.
The study,2 “Systemic and Mucosal Antibody Secretion Specific to SARS-CoV-2 During Mild Versus Severe COVID-19,” was posted on the prepublication server bioRxiv, May 23, 2020. According to the authors:
“When symptomatic, COVID-19 can range from a mild flu-like illness in about 81% to a severe and critical disease in about 14% and 5% of affected patients, respectively.”
The Swiss study,3 which sought to investigate SARS-CoV-2-specific antibody responses, found that even though people who had been exposed to infected individuals had SARS-CoV-2-specific immunoglobulin A (IgA) antibodies in their mucosa, there were no virus-specific antibodies in their blood.
IgA is an antibody that plays a crucial role in the immune function of your mucous membranes, while IgG is the most common antibody that protects against bacterial and viral infections and is found in blood and other bodily fluids. As explained by the authors:4
“As with other coronaviruses, symptomatic SARS-CoV-2 disease causes an acute infection with activation of the innate and adaptive immune systems. The former leads to the release of several pro-inflammatory cytokines, including interleukin-6 …
Subsequently, B and T cells become activated, resulting in the production of SARS-CoV-2-specific antibodies, comprising immunoglobulin M (IgM), immunoglobulin A (IgA), and immunoglobulin G (IgG).
Whereas coronavirus-specific IgM production is transient and leads to isotype switch to IgA and IgG, these latter antibody subtypes can persist for extended periods in the serum and in nasal fluids. Whether SARS-CoV-2-specific IgG antibodies correlate with virus control is a matter of intense discussions.”
Antibody Response Dependent on Severity
In COVID-19-positive patients with mild symptoms, SARS-CoV-2-specific IgA titers turned positive an average of eight days after onset of symptoms and were mostly transient. In some cases, however, IgA were completely absent. Serum IgG levels either remained negative, or reached positive values nine to 10 days after symptom onset.
In patients with severe symptoms, a “highly significant” increase of both SARS-CoV-2-specific serum IgA titers were found on day three or four, and even more pronounced IgG titers were present on day four or five. Both were independent of age or comorbidities. Only in severe cases of acute respiratory distress syndrome (ARDS) were “very high” levels of IgA found. According to the authors:5
“Interestingly, some of the SARS-CoV-2-exposed healthcare workers with negative SARS-CoV-2-specific IgA and IgG serum titers had detectable SARS-CoV-2-specific IgA antibodies in their nasal fluids and tears. Moreover, SARS-CoV-2-specific IgA levels in nasal fluids of these healthcare workers were inversely correlated with patient age.
These data show that systemic IgA and IgG production against SARS-CoV-2 develops mainly in severe COVID-19, with very high IgA levels seen in patients with severe ARDS, whereas mild disease may be associated with transient serum titers of SARS-CoV-2-specific antibodies but stimulate mucosal SARS-CoV-2-specific IgA secretion. The findings suggest four grades of antibody responses dependent on COVID-19 severity …
We think these findings suggest a model where the extent and duration of SARS-CoV-2-related clinical symptoms, which likely correlates with virus replication, dictates the level of virus-specific humoral immunity.
This hypothesis is consistent with previous publications demonstrating that the magnitude of the humoral response toward SARS-CoV-2 is dependent on the duration and magnitude of viral antigen exposure.
Low antigen exposure will elicit mucosal IgA-mediated responses, which can be accompanied by systemic IgA production; however, systemic virus-specific IgA responses can also be absent, transient or delayed. This type of ‘mucosal IgA’ antibody response seemed to be particularly prevalent in younger individuals with mild SARS-CoV-2 infection without evidence of pneumonia.”
The Young Have Greater Mucosal Immunity Than the Old
The Swiss researchers suggest these findings could be “a reflection of increased mucosal immunity in the young or decreased mucosal immunity in the old.” They point out previous data showing HKU1-specific IgG — antibodies responding to another type of coronavirus that causes the common cold — are absent in people under the age of 20, while higher levels of these antibodies are found in older people.
Your humoral immune system can kick in if there’s cross-reactivity with another very similar pathogen. In the case of COVID-19, there’s evidence to suggest exposure to other coronaviruses that cause the common cold can confer immunity against SARS-CoV-2.
Extrapolation suggests infants and children “have primed mucosal innate and IgA antibody responses due to their frequent upper respiratory tract infections and, therefore, respond preferentially in this manner to SARS-CoV-2 infection,” the researchers state.
On the other hand, studies have shown the strength of antiviral immune responses, including T cell activation and proliferation, slows with age. This can partially explain why older people are vastly more susceptible to severe COVID-19 illness and death. Other factors like vitamin D levels and immunosenescence that increases in the elderly are also likely important.
Mortality Is a Fraction of What Was Predicted
As noted in an article on Off-Guardian.com, which reported the results of the Swiss study:6
“… if the authors are indeed correct in their estimation, this might mean SARS-COV-2’s infection rate (IFR) would need to be revised downward yet again. If 80% of those infected really do not produce antibodies then there is a live possibility the virus is present in many more people than usually supposed. Which would in turn potentially reduce the IFR, possibly considerably.
In the early stages, the World Health Organization (WHO) estimated the virus’ IFR to be as high as 3.4%. The models based on those numbers have, however, been shown to be wildly inaccurate …
Dissenting experts7 appear to have been vindicated by the serological studies, using blood tests looking for Sars-Cov-2 antibodies done across different populations all over the world, which routinely suggest that the IFR is closer to 0.3%8 than the WHO’s initial figure of 3.4%.
From Japan to Iceland to Los Angeles, the numbers returned were between 0.06 and 0.4. Within the range of seasonal influenza. As a result of these studies, the U.S. CDC’s most recent ‘estimated IFR’ is between 0.26% and 0.4%.9 Roughly 1/10th of the initial estimates.”
Innate and Adaptive Immunity
For clarity, it’s important to realize you have two types of immunity. Your innate immune system is primed and ready to attack foreign invaders at any moment and is your first line of defense. Your adaptive immune system,10 on the other hand, “remembers” previous exposure to a pathogen and mounts a response when an old foe is recognized.
Your adaptive immune system is further divided into two arms: humoral immunity (B cells) and cell mediated immunity (T cells). The B cells and T cells are manufactured as needed from specialized stem cells. The graphs below are from my Vitamin D document and will help you understand the components of these systems and their timing.
If you have never been exposed to a disease but are given antibodies from someone who got sick and recovered, you can gain humoral immunity against that disease. Your humoral immune system can also kick in if there’s cross-reactivity with another very similar pathogen.
In the case of COVID-19, there’s evidence11 to suggest exposure to other coronaviruses that cause the common cold can confer immunity against SARS-CoV-2.
Majority Resistant to COVID-19 Even Without Exposure
One such study12,13 was published May 14, 2020, in the journal Cell. It found 70% of samples obtained by the La Jolla Institute for Immunology from patients who had recovered from mild cases of COVID-19 had resistance to SARS-CoV-2 on the T-cell level.
Curiously, 40% to 60% of people who had not been exposed to SARS-CoV-2 also had resistance to the virus on the T-cell level. According to the authors, this suggests there’s “cross-reactive T cell recognition between circulating ‘common cold’ coronaviruses and SARS-CoV-2.” In other words, if you’ve recovered from a common cold caused by a particular coronavirus, your humoral immune system may activate when you encounter SARS-CoV-2, thus rendering you resistant to COVID-19.
May 14, 2020, Science magazine reported14 these Cell findings, drawing parallels to another earlier paper15 by German investigators that had come to a similar conclusion. That German paper,16 the preprint of which was posted April 22, 2020, on Medrxiv, found helper T cells that targeted the SARS-CoV-2 spike protein in 15 of 18 patients hospitalized with COVID-19. As reported by Science:17
“The teams also asked whether people who haven’t been infected with SARS-CoV-2 also produce cells that combat it. Thiel and colleagues18 analyzed blood from 68 uninfected people and found that 34% hosted helper T cells that recognized SARS-CoV-2.
The La Jolla team19 detected this crossreactivity in about half of stored blood samples collected between 2015 and 2018, well before the current pandemic began …
The results suggest ‘one reason that a large chunk of the population may be able to deal with the virus is that we may have some small residual immunity from our exposure to common cold viruses,’ says viral immunologist Steven Varga of the University of Iowa. However, neither of the studies attempted to establish that people with crossreactivity don’t become as ill from COVID-19.
Before these studies, researchers didn’t know whether T cells played a role in eliminating SARS-CoV-2, or even whether they could provoke a dangerous immune system overreaction. ‘These papers are really helpful because they start to define the T cell component of the immune response,’ [Columbia University virologist Angela] Rasmussen says.”
Herd Immunity Theory May Need Revision
Now, if it’s true that a majority are already resistant to COVID-19 due to previous exposure to other coronaviruses, then we’ve probably already reached the threshold for herd immunity, and vaccinating every human on the planet (or close to it) will not be necessary. In fact, it’s starting to look as though a vaccine may be entirely moot.
This research also hints at the possibility that herd immunity isn’t what we think it is. The cross-reactivity on the T cell level seen with SARS-CoV-2 and other coronaviruses may also exist for other viruses.
On the flip side, there’s a phenomenon known as viral interference, where exposure to one virus makes you more susceptible to another virus. Research20 has found that those who received the influenza vaccine were 36% more susceptible to coronavirus infection. This too may be playing a role in COVID-19 deaths among the elderly, since most who reside in nursing homes are given the flu vaccine each year.
Long-Term Immunity Against COVID-19 Appears Prevalent
Yet another study,21,22,23 this one by researchers in Singapore, found common colds caused by the betacoronaviruses OC43 and HKU1 might make you more resistant to SARS-CoV-2 infection, and that the resulting immunity might last as long as 17 years.
In addition to the common cold, OC43 and HKU1 — two of the most commonly encountered betacoronaviruses24 — are also known to cause bronchitis, acute exacerbation of chronic obstructive pulmonary disease and pneumonia in all age groups.25 As reported by the Daily Mail:26
“They share many genetic features with the coronaviruses Covid-19, MERS and SARS, all of which passed from animals to humans. Coronaviruses are thought to account for up to 30 percent of all colds but it is not known specifically how many are caused by the betacoronavirus types.
Now scientists have found evidence that some immunity may be present for many years due to the body’s ‘memory’ T-cells from attacks by previous viruses with a similar genetic make-up — even among people who have had no known exposure to Covid-19 or SARS …
Blood was taken from 24 patients who had recovered from Covid-19, 23 who had become ill from SARS and 18 who had never been exposed to either SARS or Covid-19 …
Half of patients in the group with no exposure to either Covid-19 or SARS possessed T-cells which showed immune response to the animal betacoronaviruses, Covid-19 and SARS. This suggested patients’ immunity developed after exposure to common colds caused by betacoronavirus or possibly from other as yet unknown pathogens.”
In other words, if you’ve beat a common cold caused by a OC43 or HKU1 betacoronavirus in the past, you may have a 50/50 chance of having defensive T-cells that can recognize and help defend against SARS-CoV-2, the novel coronavirus that causes COVID-19. According to the researchers:27
“These findings demonstrate that virus-specific memory T-cells induced by betacoronavirus infection are long-lasting, which supports the notion that Covid-19 patients would develop long-term T-cell immunity. Our findings also raise the intriguing possibility that infection with related viruses can also protect from or modify the pathology caused by SARS-Cov-2.”
Support Offered by Updated Statistical Models
All of these studies add support to the latest COVID-19 mortality models suggesting there is in fact widespread resistance and prior immunity. Freddie Sayers, executive editor of UnHerd, recently interviewed professor Karl Friston, a statistician whose expertise is mathematical modeling, who believes prior immunity across the global population might be as high as 80%.28
Friston is credited with inventing the statistical parametric mapping technique, which is now the standard for understanding brain imaging. As the pandemic erupted, he began applying this method of analysis (which he refers to as “dynamic causal modelling”) to COVID-19 data, coming up with a model that predicts far lower mortality rates than earlier models.
The reason for this is because the “effective susceptible population,” meaning those who are not already immune to COVID-19 and therefore at risk of infection, was never 100%. At most, it was 50% and most likely only around 20%.
Friston’s model effectively vaporizes claims that social distancing is necessary, because once sensible behaviors such as staying home when sick are entered into it, the positive effect of lockdown efforts on “flattening the curve” simply vanish. In all likelihood, the global lockdowns were completely unnecessary, and certainly should not continue, now or in the future.
COVID-19 Growth Projections Were All Wrong
Support for Friston’s model comes from Michael Levitt,29 a professor of structural biology at the Stanford School of Medicine who received the Nobel Prize in 2013 for his development of multiscale models for complex chemical systems.
According to Levitt, statistical data reveal a mathematical pattern that has stayed consistent regardless of the government interventions implemented. While early models predicted an exponential explosion of COVID-19 deaths, those predictions never materialized. As reported by Sayers in the video above:
“After around a two-week exponential growth of cases (and, subsequently, deaths) some kind of break kicks in, and growth starts slowing down. The curve quickly becomes ‘sub-exponential.’ This may seem like a technical distinction, but its implications are profound.
The ‘unmitigated’ scenarios modelled by (among others) Imperial College, and which tilted governments across the world into drastic action, relied on a presumption of continued exponential growth …
But Professor Levitt’s point is that that hasn’t actually happened anywhere, even in countries that have been relatively lax in their responses.”
Levitt believes prior immunity plays a significant role in why we simply don’t see an exponential growth pattern of COVID-19 deaths, and that certainly seems to make sense in light of the studies reviewed above. A majority of people simply aren’t (and weren’t) susceptible to COVID-19.
According to Levitt, the indiscriminate lockdowns implemented around the world were “a huge mistake.” He believes a more rational approach would have been to protect and isolate the elderly, who are by far the most vulnerable and make up the bulk of COVID-19 deaths around the world.
How to Mitigate COVID-19 Risks Further
Now, while the risks associated with COVID-19 may be far more insignificant than feared for a majority of the population, they still exist for a minority. The elderly are clearly at greatest risk for severe infection and death, but African-American, Asian and other darker-skinned individuals are also susceptible, likely due to the fact that they tend to have lower vitamin D levels.
To bolster your immune system and lower your risk of COVID-19 infection in the future, be sure to follow the instructions given in “Your Vitamin D Level Must Reach 60 ng/mL Before the Second Wave.” This is particularly true if you or someone you love is elderly or has darker skin. By addressing widespread vitamin D deficiency, we can significantly lower the COVID-19 mortality rate in the future. But we need to start now.
Personal borderlines can feel vague or muddling for many. Boundaries are a concept that should be tied into establishing a house smell of right and wrong viewing your ease zone, your personal opening, your excitements and feelings, and what you value in your personal safety and security. Since bounds wield both styles, they are also about understanding the nuances and limits on others’ personal bounds as well and respecting the choices they make for themselves in their own life.
Clear personal frontiers can include many moving divisions, such as establishing psychological or physical length or intimacy, being able to have your own thoughts and minds, and in having your own feelings considering something. Strong personal bounds offer limits on what you are comfortable with in your life and in what you feel is acceptable treatment for yourself from others.
Boundaries are now in place from early in your life and are coached and learned in childhood. Social see theorist Albert Bandura( 1977) often spoke on his theory of modeling and repetition which can extend to teaching concepts such as boundaries. For lesson, if caregivers pattern and school house borderlines for themselves and their own children, then children frequently grow up imitating healthy frontiers that were initially taught. Contrarily, if parents or early caregivers are good role models for learn boundaries, then children can grow up with a iffy sense of personal boundaries.
As an newborn, this requires regulates in place for where you can crawl, who can hold you, or what is considered safe or unsafe. These bounds should be followed originating and constantly evolving when you start school. As a young child you should be introduced to things like personal opening and respect for others. And bounds should also continue throughout your life to ensure your personal safety, your joy and your continued raise. However, if boundaries were violated early in life, or if you were not appraised as being able to establish your own sense of personal comfort or safety, then personal borders can suffer until, or unless, they are established.
When your personal comfort zone is overstepped, your borderlines may have been violated. Unhealthy or weak personal boundaries are often identified as having a poor sense of self-identity or limited feelings of self-worth. For many who grew up in a codependent environment, they may be out of touch with their own feelings, or may have not been allowed personal seat earlier in life. Others may feel scared that launch bounds will push beings out of their lives or risk leaving them feeling vacated. If early life knows have you feeling guilty or responsible for others’ happiness or only if you silenced or unable to verbalize your thoughts or feelings or were reproached for having basic needs, these types of negative knows can determine strong personal bounds.
Boundaries Are an Act of Self Love
Personal borderlines are important for establishing a sense of self-worth and a sense of self-love. Those who grew up unable to establish their own personal space or to have a sense of control over their own life may have learned to seek approval or validation from others instead of trusting themselves and building a solid feel of self-identity. Or others may have a deep fear of withdrawal that impacts their ability to establish self-assured personal frontiers. Learning to establish personal borderlines and to feel safe and secure with the border you’ve established for yourself is an act of self-love.
Here are 4 tips for the assistance tighten your borderlines while enhancing your feel of self-worth and self-love 😛 TAGEND
Recognizing the type of boundary it is. Personal borderlines can pretty much be anything from how you feel about something, to how you interpreted your thoughts or notions, your personal room, physical proximity, or refuge/ insurance within your life. Borderline are specific to each person who determines and demonstrates limits for themselves and others in their life. Becoming more familiar with the type( s) of bounds you are considering substantiating is one way to help better identify the type of boundary you are wanting in your life and, more importantly, in know if it has been violated.
Create a register of frontiers. Once you have identified the type( s) of borderlines you are wanting to establish or strengthen, jotting down a specific list of frontiers that you are wanting to achieve can help draw the process more concrete in the form of a structured objective. For sample, if personal space is something that you quality, consider abstractions such as where your personal gap is important to you( residence, act, clas, etc .) as well as concrete examples of what it includes for you and examples of what it would look like or feel like to you if your boundary were transgressed.
Verbal, written or nonverbal causes. When you’re firstly demonstrating your borderlines it can feel awkward or unpleasant. The process can start with non-verbal prompts such as taking a couple steps back if you feel someone has overstepped a personal boundary you have set for yourself. Writing down how “youre feeling” in certain situations such as if someone feels too obnoxiou, or asking of your time can help you in finding the freedom utterances to express your concerns as well as increasing your awareness of how you feel when establishing your personal boundaries, or if they are violated.
Consistency. Consistency is key for memorize any new behavior or in introducing any new skill into their own lives, which includes strengthening frontiers. All abilities take time to learn and will come to an end through duplication until the issue is mastered. Fine-tuning personal frontiers is no exception. Knowing your limits viewing your personal frontiers can help you identify key areas for consistency in implementation. For precedent, every time you enforce a specific boundary you have set for yourself, journal it or have a checklist in place to ensure that you are reaching the goals you have decide for yourself.
Reference: Bandura, A.( 1977 ). Social see presumption. Englewood Cliffs, NJ: Prentice Hall.