COVID 19 FAQ’s

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Greetings world of wellness community!

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As we work our way through this COVID-19 pandemic, I get lots of questions about “What can I do?” I wanted to answer some of those questions here.

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Question #1, “Is there something I can take?”

While the studies aren’t perfect, there is a growing body of evidence that points to vitamin D deficiency as being a contributor to severity and mortality with COVID-19 infection. I recommend for all of my patients that you take a multivitamin unless your diet is pristine. However, even if you do have an excellent diet, multivitamin supplementation is probably a great idea right now. Please be sure that your multivitamin also has vitamin D in it. But, what I don’t want you to do is take a multivitamin with vitamin D and an additional vitamin D supplementation. Vitamin D is one of those vitamins that is stored in the fat and can cause toxicity if too much is taken over time. Vitamin D poisoning is a real thing that we do sometimes see in the emergency department because of people who are exuberant about taking multivitamins. So like anything good, too much can be bad.

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You might ask, “Well, shouldn’t I go out in the sun?” The answer to that is “yes!” Obviously you want to do that with due caution and sun block as appropriate. For those of you with much lighter skin, the best time to go out is after 3 PM or before 10 AM. Going out between 10 AM and 3 PM is a good way to guarantee sunburn here in Southern California. Some people think that sun block prevents the conversion of the vitamin D you generally take into the active form. However, this has never been shown in practice to be true, and it is extremely important that you prevent sunburn. Just remember that if you’re out in public and within 6 feet of anybody else who is not from your household, you do need to be wearing a mask.

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Another supplement that may be helpful, and certainly won’t be harmful, is making sure you’re getting zinc supplementation. This is also included in most multivitamins. The evidence for zinc supplementation isn’t as good as for vitamin D, but it may shorten the course or severity of any case you might get. Again, this is usually contained in a simple multivitamin and that is all you need. Do not take more than that, as zinc can be toxic in higher doses.

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Question #2, “Do masks actually protect me from the virus?”

Great question! The answer is, “it depends.” The cloth masks that many are wearing actually don’t protect you, the wearer, from the virus. So now, you’re wondering why I keep insisting that you should wear masks. The reason is, that although the mask doesn’t protect you the wearer it does protect others from you. This virus is airborne. When you talk, sneeze, sing or cough, you can spread viral particles from your mouth, and your lungs, to other people. Let’s say in the supermarket you are talking to your 4-year-old and telling them not to touch everything. As you do that, perhaps more loudly than usual, particles come out of your lungs into your mouth and out into the air. They will stay suspended in the air for at least a few minutes if not longer. If somebody else comes along and walks through that air they will be breathing in whatever was in your lungs and your airway.

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There are quite a few people walking around who are infected with COVID-19 but don’t know it. Anybody walking through that virus-particle laden air can pick up the virus. You could easily be one of the people who is infected with COVID-19 and doesn’t know it. The mask helps trap some of those virus-containing water droplets coming out of your mouth, and also keeps them from traveling as far. The masks essentially keep your respiratory droplets from being vaporized into the air. This protects anyone who is near you, as well as anyone who comes by later. If we can get even 70% of the population to wear masks; within 5 to 6 months we could actually cut the transmission of the virus down to nearly 0. If we can get 90% of the population to wear masks, it would take less than a month to reduce the transmission to just within household units and another month or two to eliminate it entirely.

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To protect yourself from the virus the only option are respirators. The lowest level of these respirators is the N95 respirators that we wear in the hospital to protect ourselves from patients that we know, or suspect, have the virus. I wear one with every patient, since there are so many who are asymptomatic. There are N100 respirators that keep out pretty much everything, and you may see these on the news when hospital personnel come out looking like gigantic ants. The highest level is something called a PAPR– which stands for positive air pressure respirator. This is a device that we will wear that actually pushes the air out of our general face vicinity into the circulating environment. These, although they do protect the wearer 100%, they do not protect anyone else. My preferred protection scheme is to wear an N95 mask covered by a surgical mask, covered again by a face shield. This is because many of the N95 masks we are getting are actually not medical grade, and have a little vent that pushes out air which may be virus laden. I want to protect my patients from my own air so I cover that with a surgical mask covered again by the face shield which protects both of us.

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Now, you might be asking yourself, “Wait, should I wear a face shield?” If you are going to get up close and personal with other people like say, if you’re a teacher, the answer is “yes!” The face shield protects you both from those spewing respiratory particles.

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Question #3, “What should I do if I want to fly?”

You want to do what, now? Can you not fly? Perhaps you can drive? Look, if you must fly, understand that that is probably the highest risk environment you could be in. Hundreds of people will be packed into a plane which has constantly recirculating and contained air. Even if everybody wears a mask, if somebody on that plane has COVID-19 they’re going to spread it. The only recommendation I can make for that is to make sure you’re wearing some form of respirator, covered by a mask covered by a face shield. But really, unless you absolutely have to, just don’t.

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I hope you found this update helpful. Please keep those questions coming!