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Every adult, regardless of gender, race, or creed, could potentially die from a cytokine storm. Nevertheless, unlike so many things in our lives lately, this is something which you and I can choose to prevent. 

 I’ll quote a summary explanation of cytokines here from Https://www.amboss.com/us/knowledge/Cytokines_and_eicosanoids/. Cytokines are signaling proteins that modulate immune responses, inflammation, and aid cell proliferation and differentiation. They are mainly secreted by hematopoietic cells and act in an autocrine, paracrine, or endocrine mode. They are classified into proinflammatory cytokines (interleukins 1, 6, 8, 12, and 18; interferons; and tumor necrosis factor) and anti-inflammatory cytokines (interleukins 4, 10, 11, and 13; and transforming growth factor-beta). Proinflammatory cytokines induce fever and inflammation, in response to infection or tissue injury, while anti-inflammatory cytokines suppress the immune system. Interferons are proinflammatory cytokines that are secreted by fibroblasts, leukocytes, cells infected by viruses in response to infection or neoplastic proliferation.  Since interferons have antiviral, antimicrobial, and antitumor (antiproliferative) properties, they are used in the treatment of chronic viral infections (hepatitis B and hepatitis C), tumors (leukemia, Kaposi sarcoma), and autoimmune diseases (rheumatoid arthritis, systemic sclerosis). Eicosanoids are pro-inflammatory and anti-inflammatory signaling molecules derived from arachidonic acid (AA) and include prostaglandins, leukotrienes, prostacyclins, and thromboxane A2.

Basically, you now know what physicians and medical students know of the balances necessary for the prevention of chronic illnesses and recovery from infections and injuries. A cytokine storm is a potentially fatal reaction, usually associated with high death rates during flu pandemics. It occurs, literally, when the system overreacts to an intruder, such as a virus, and all the cells responsible for the immune reaction start working in an exaggerated manner.

Here’s where you and I can come in to prevent this “storm.” The heart of these processes begins by including the polyunsaturated fatty acids (PFA) Omega-6, -3, and non-essential, -9 in our diet.  There is no adequate intake requirement for Omega-9, which is found in vegetable and seed oils, nuts, and seeds. Most importantly, you need the right balance of Omega-6 and -3 to be between 1:1 to 4:1.  Unfortunately, people on the Western diet may be consuming between 15:1 to 17:1. Omega 6 and Omega 3 are considered essential,.because the body cannot produce them; they can only come from our food.

Omega-6 fats provide energy and are found in refined sugars; corn; safflower, corn, and sunflower oils; nuts and seeds; and foods cooked in vegetable oils. Whereas, Omega-3 fats are found in fatty fish (salmon, mackerel, anchovies, sardines, arctic char, and trout), free-range and Omega-3 enriched eggs, flaxseeds, and flaxseed oil, walnuts, grass-fed dairy, and meat. So, both PFAs are important, but it is best to have at least 2 servings of fatty fish each week and have more Omega-3 fats than Omega-6 fats to have optimum heart, brain, and metabolic health. Omega-3 fats are needed for infant brain development, to reduce inflammation responsible for numerous chronic diseases, to improve bone density, to prevent asthma, in reducing depression, dementia, Parkinson’s disease, and psychosis in those at risk, to reduce weight and waist size, and to decrease liver fat, 

I hope I have either encouraged or confirmed many reasons and ways you can take control of your health, even during this pandemic. Good luck!

Thank you for reading, next blog will be on getting adequate sleep.

One thing I’m learning from doing this particular blog is that just as viruses change, so does the science about them. My original draft for this blog was biased from a source I had trusted for over a year.  However, after re-reading through the full article, “Mapping the Technological Landscapes of SARS, MERS, and SARS-Cov-2 Vaccines”;  (https://www.tandfonline.com/doi/full/10.1080/03639045.2021.10908343, my viewpoint changed. To explain, I had believed scientists had not followed Koch’s postulates in the development of vaccines, when actually with SARS-Cov-1, they had done so.

Heinrich Hermann Robert Koch is considered to be one of the founders of modern microbiology. His postulates were:

• The microorganism must be found in abundance in all organisms suffering from the disease, but not found in healthy organisms.
• The microorganism must be isolated from a diseased organism and grown in a pure culture.
• The cultured microorganism should cause disease when introduced into a healthy organism.
• The microorganism must be re-isolated from the now diseased experimental host which received the inoculation of the microorganisms and identified as identical to the original specific causative agent.

In the mapping article I referred to at the beginning of this blog, the concept of identifying a virus by the protein sequencing in its DNA began with SARS-Cov-1. Since then scientists have been struggling to find a thoroughly safe and effective vaccine, in the manner, we have been led to believe with other vaccines Continuing with this article, on February 19, 2021, there were 181 vaccines under development. Without going into the details of each, there were 10 different methods being pursued: protein subunits, non-replicating viral vector (VVnr), DNA, activated virus, RNA, replicating viral vector (VVr), virus-like particle (VLP), VVr, and antigen-presenting cell (APC), live attenuated virus, and VVnr and APC. Pfizer/BioNTech’s vaccine is based upon an mRNA encapsulated in lipid nanoparticles (LNP) and in phase III, had 4 different formats of mRNA and target antigens. Bottlenecks for those groups doing nucleic acid vaccine development are finding suitable delivery systems and the low magnitude of immune responses. Some research groups had to change course when a heightened immune response caused a cytokine storm, according to another research article.

.In the case of SARS-Cov-2, diagnosis is based solely upon a positive rtPCR (real-time polymerase chain reaction) test. An rtPCR test involves amplification cycling under a microscope seeking those SARS DNA particles. Cycling thresholds (CT) correlate with the validity of the test. A true positive test result ought to be run at 17 cycles.  A  CT of 34 or more cycles means the test is 100% useless as a measure of a true positive case. Mayo utilizes CTs from greater than 24 through to greater than 34, as a means for diagnosing and assessing for recovery. Another point is that those particles may or may not be alive. (Stand for Health Freedom has more information on PCR testing, with actions for changing the number of cases as the basis for our social restrictions.)

Now for Emergency Use Authorizations (EUAs), which began in 2004 with the Project Bioshield Act. Quoting from the FDA website:” The EUA authority allows FDA to help strengthen the nation’s public health protections against chemical, biological, radiological, and nuclear (CBRN) threats including infectious diseases, by facilitating availability and use of medical countermeasures (MCMs) needed during public health emergencies. …..when the Secretary of HHS declares that an emergency use authorization is appropriate, FDA may authorize unapproved medical products or unapproved uses of approved medical products to be used in an emergency to diagnose, treat, or prevent serious or life-threatening diseases or conditions caused by the CBRN threat agents when certain criteria are met, including there are no adequate or approved and available alternatives.”

The Public Readiness and Emergency Preparedness Act (PREP Act) gives the HHS Secretary ability to issue declarations. An HHS declaration under the PREP Act may support certain uses when it is based on one of four types of determinations of threats or potential threats by the Secretary of HHS, Homeland Security, or Defence.”.For example, In March 2020 a declaration provided liability immunity for activities related to MCMs, such as tests, drugs, and vaccines utilized against Covid-19. 

As with any medication or vaccine, there is always the potential for adverse side effects. If any U.S. resident experiences adverse side effects from a vaccine, they are encouraged to report it to the VAERS (Vaccine Adverse Event Reporting System).  A person can file an injury report on VaxxTracker.com, which is a nongovernmental adverse event tracker, or report the injury on the Children’s Health Defense website

Finally, an observational study was published on August 25, 2021 (medRxiv ), stating it found that natural immunity confers longer-lasting and stronger protection against infection, symptomatic disease, and hospitalizations caused by the Delta variant of SARS-Cov-2 compared to the BNT162b2 two-dose vaccine-induced immunity.” 

Thank you, reader.  My next blog will be on the cytokine storm.

I’m going to co-mingle this blog into vaccines and mRNA as it relates to SARS-Cov-2 because there’s a long history of both aspects leading to Pfizer and Moderna’s COVID-19 vaccines.

Records of the common cold date back to the 16^th century. Reference to symptoms and treatments for influenza can be found in Gunn’s New Family Physician, 1887 (“200^th”) edition. The common cold is considered to be mild, usually beginning with a sore throat, and lasts for a few days.  Whereas influenza is more severe with symptoms lasting up to weeks from several hundred viruses. Already familiar with the smallpox vaccine, scientists developed an influenza vaccine after the 1918 Pandemic in 1938 which was given to military personnel during World War II and the public at large in 1945.

Medical students and residents have been taught that an injection becomes a vaccine if it gives you antibody immunity to a specific virus or single bacterium. It’s a vaccine if you are protected from getting a virus or bacterial infection when you get this injection. An injection becomes a vaccine if it reduces death from that virus or bacteria, reduces hospitalizations, and reduces severe symptoms from that bacterial or viral infection. Finally, it’s considered an effective vaccination if you no longer carry the bacteria or virus, so you cannot transmit it to another person. I’m certain you can think of many vaccines which meet those 6 criteria.  So, when the COVID-19 vaccines were introduced, it only seemed natural that everyone would have the same expectations.

Operation Warp Speed was focused on reducing severe symptoms requiring hospitalization and deaths from SARS-Cov-2. Under the Emergency Use Authorization (more on EUA in next blog) the Pfizer-BioNTech COVID 19 vaccine using lipid nanoparticles and mRNA was available to individuals 16 years old and older on December 11, 2020, and approved by the FDA on August 23, 2021.

Pfizer filed the first spike protein vaccine on coronavirus in 1990. The mRNA feature of their latest vaccine is interesting because mRNA (messenger RNA) is a natural component of our immune response. RNA (ribonucleic acid) was discovered in the nucleus of cells by a Swiss chemist named Friedrich Miescler in 1838.  In the 1970’s a discovery was made of DNA’s (deoxyribonucleic acid) amino acids adenine, guanine, thymine, and cytosine sequencing which mirrored the sequences of RNA’s amino acids, (except RNA’s bases are uracil and cytosine rather than DNA’s thymine and cytosine). Whenever there is any cellular disruption, mRNA, like a spark, signals for resumed amino acid balance. (Amino acids are the building blocks for proteins.) In a sense, this natural process supports the ancient wisdom that the body wants to heal itself.

 The concept of genetically developing an mRNA to induce a “spike” protein to stimulate an immune response is brilliant and can also be disturbing with its presence. Yes, it theoretically could reduce severe symptoms requiring hospitalization and prevent deaths. However, since viruses are known to mutate, will the specificity to SARS-COV-2 be sustainable, and for what duration? Pfizer has completed Phase 3 clinical trials. What are the adverse effects of this mRNA vaccine?  Phase 4 post-market surveillance and adverse event reporting are optional.

Of further note, shortly after August 23, 2021,  CDC changed the definition for a vaccine to a preparation that is used to stimulate the body’s immune response against diseases and vaccination is for protection, thus modulating the original purposes for vaccines.

The next blog will focus on the EUA

I’m thrilled to begin my Blog with you.  I’m going to begin by asking, “Masks: to wear or not to wear?” That is the question! As you know it’s been a local and global debate.  Let’s do a deep dive into some personal protective measures which are being suggested to control the COVID-19 Pandemic.

There apparently was a scramble by WHO and the CDC here in the US, to develop a plan in 2020. Researchers from BMJ, Yale, and Cold Spring Harbor Laboratory updated a Cochrane review that included a meta-analysis of observational studies during the SARS outbreak of 2003 with other resources from October 2010 up to April 2020, later written up in medRxiv.

Elsevier accepted a research article from Sri Lanka researchers regarding the “Transmission of COVID-19 virus by droplets and aerosols: A critical review on the unresolved dichotomy” on June 10, 2020. The Elsevier COVID-19 resource center was created with free information in English and Mandarin and makes its research available in PubMed Central and other publicly funded repositories, such as the WHO COVID databases.

Finally, a study was conducted in preparation of guidelines by the WHO on the use of nonpharmaceutical interventions for pandemic influenza in nonmedical settings by a team in the School of Public Health, University of Hong Kong, Hong Kong, China. That study, and others, done by the same team can be found on the CDC website.

I’ll refer to all three of those resources in this Blog, plus information from the CDC website.

In quoting from the BMJ report, the 6 authors independently assessed the risk of bias using the Cochrane tool and extracted data and reported results with risk ratios and 95% Confidence Intervals from 15 randomized trials investigating the effect of masks in healthcare workers and the general population, with one trial of quarantine. There were none on eye protection. Compared to no masks there was no reduction of influenza-like illness (ILI) cases or influenza for masks in the general population, nor healthcare workers.  There was no difference between surgical masks and N95 respirators for ILI or influenza. The only trial testing quarantining workers with household ILI contacts found a reduction in ILI cases, but increased risk of quarantined workers contracting influenza.  These authors recommended the use of masks with other measures.

I believe the abstract from the Hong Kong team says it best in the abstract for their report: Nonpharmaceutical Measures for Pandemic Influenza in Nonhealthcare Settings- Personal Protective and Environmental Measures:

There were 3 influenza pandemics in the 20th century, and there has been 1 so far in the 21st century. Local, national, and international health authorities regularly update their plans for mitigating the next influenza pandemic in light of the latest available evidence on the effectiveness of various control measures in reducing transmission. Here, we review the evidence base on the effectiveness of nonpharmaceutical personal protective measures and environmental hygiene measures in nonhealthcare settings and discuss their potential inclusion in pandemic plans. Although mechanistic studies support the potential effect of hand hygiene or face masks, evidence from 14 randomized controlled trials of these measures did not support a substantial effect on the transmission of laboratory-confirmed influenza. We similarly found limited evidence on the effectiveness of improved hygiene and environmental cleaning. We identified several major knowledge gaps requiring further research, most fundamentally an improved characterization of the modes of person-to-person transmission.

So, at present, there is no evidence from these studies on the effectiveness of universal masking for healthy people in the community from being infected by respiratory viruses, including COVID-19. Disposable medical masks (surgical masks) were designed for single use to protect against accidental contamination of a patient’s wound, to protect the wearer against splashes or the sprays of bodily fluids, and to protect an immune-compromised patient from potential introduction of infection. After contact with any of those patients, the mask is discarded, followed by 20-seconds of handwashing and likewise, a new mask being used for the next patient situation, preceded by a 20-second handwash (named “hand hygiene” in the last resource and as directed by CDC guidelines). The Hong Kong team recognized problems arise when lacking the availability of disposable surgical masks, improper use of the mask, non-effective “respiratory etiquette” (without masks), and length of time the mask is worn.

Hand hygiene with proper use of masks is encouraged not only by the CDC but also supported by my research.  According to the CDC, hand sanitizers are not a substitute for handwashing.  In fact, sanitizers only remove certain germs, while hand washing with regular soap and running water literally wash away more germs as well as toxic chemicals.  The caveat of hand sanitizers is that they are only effective short-term until you touch something, and handwashing is effective only if done adequately after the 11 or so situations when your parent or guardian may have said, “Wash your hands.” CDC is very specific that proper handwashing is: wet hands with clean running water and apply soap, create a lather, scrub all surfaces of your hands for 20 seconds, rinse your hands with running water, and dry with a clean towel.

When it comes to surface cleaning, the Hong Kong report found no evidence that surface and object cleaning could reduce influenza transmission.  However, it does have an impact on the prevention of other infectious diseases. On April 5, 2021, the CDC stated that surface transmission of SARS-Cov-2 is considered low compared to direct contact, droplet transmission, or airborne transmission. Their case reports indicated that the virus is transmitted between people touching surfaces an ill person has recently coughed or sneezed upon, and then directly touching the mouth, nose, or eyes. Hand hygiene is a barrier to surface (“fomite”) transmission and has been associated with a lower risk of infection. Studies indicate that there is a 99% reduction of SARS-Cov-2 and other coronaviruses under normal indoor environment conditions within 3 days on common non-porous surfaces like stainless steel, plastic, and glass.

That leads me to the size of respiratory virus particles.  Generally, we know that infected people spread viral particles when they talk, breathe, cough, or sneeze. Those particles are encapsulated in globs of mucus, saliva, and water, and their fate is related to their size and aerodynamic capabilities. Large globs fall faster and are slower to evaporate than smaller globs which will linger in the air. The WHO and CDC postulate that the particles of more than 5 mcg are droplets; less than 5 mcg are aerosols, which linger in the air for a longer time. Small aerosols are more susceptible to be inhaled deep into the lung, which can cause infections in the lower respiratory tissues. Large droplets are trapped in the upper airways.

In closing, it seems that the use of any of these nonpharmaceutical interventions depends upon the situation at hand and an individual’s knowledge-based level of caution, particularly to their individual immunity and circumstances. The field of medicine is never precise because of those variabilities. Apparently from this research, the current Pandemic will not end with mask mandates. What are your thoughts on this?

My next Blog will be on mRNA vaccines.