Update From WNF on COVID-19

It is important to follow the advice of your local Ministry of Health during any outbreak.

Key Points

  • The Coronavirus disease 2019 (COVID-19) originating in Wuhan, China was first identified in early January.
  • There is not enough information yet to determine the incubation period, the rate of infection or the initial source of the virus.
  • If you have travelled to China (or another significantly affected area) in the last two weeks, or if you have been in contact with someone who has and fell unwell, call your local health authorities. Do NOT go to your naturopathic
  • practitioner, walk-in clinic or hospital if you suspect that you have the COVID-2019 as you risk spreading it to others.
  • If you suspect that you may have the COVID-2019 contact your state/territory / provincial health unit or communicable disease branch for advice on how to proceed.


Background

The family of  coronaviruses were first discovered in the 1960s. What these viruses have in common and what they are named for are the crown-like spikes on their surface. There are seven coronaviruses that can affect humans.(1)
It is currently believed that COVID-2019 has a genetic make-up that is about 70% similar to the SARS-CoV.(1) As a point of comparison, during the eight month that SARS (severe acute respiratory syndrome) was active it was responsible for just over 8,000 known infections and 774 deaths. As of February 15th, 2020 (roughly six weeks since COVID-2019 was first identified) twenty-four countries have confirmed cases of COVID-2019 and there are over 49,000 confirmed cases (505 outside of China) and 1,381 deaths (only 2 outside of China). Here is a link to the countries that have confirmed cases.(2) Here is a link to the WHO COVID-2019 Updates.


Symptoms
There are four types of  common coronaviruses (229E, NL63, OC43 and HKU1) that are associated with the common cold that affects most individuals at some time in their life. The typical coronavirus infection is short-lived with symptoms such as a runny nose, headache, cough, sore throat, fever and a general feeling of being unwell. In compromised individuals, the elderly, the young and those with a compromised immune system or other severe health issues, the common coronaviruses can cause bronchitis or pneumonia.(1)

The COVID-2019 is a new strain. It often begins as a common cold with fever, lethargy, cough and difficulty breathing. Additional symptoms may include sore throat, nasal congestion and swollen adenoids. In some people, especially those that are compromised, it can rapidly cause respiratory symptoms including viral pneumonia. The rapid progression is what makes individuals very ill and can cause death.


Transmission
Human coronaviruses are commonly spread from direct contact between an infected person to others through:(1)

  • the air by coughing and sneezing
  • close personal contact, such as touching or shaking handstouching an object or surface with the virus on it, then touching your mouth, nose, or eyes before washing your hands
  • rarely, is fecal contamination a mode of transmission

Travellers returning from China or other areas affected by a potentially deadly coronavirus should monitor themselves for symptoms of respiratory ailments for 14 days. Anyone who develops a fever, cough or breathing difficulties within two weeks of travelling to Wuhan or its neighbouring provinces should isolate themselves and seek a medical assessment."


Prevention
The following steps may be beneficial for preventing risk of most infections. Please note that there currently are no recognized treatments to prevent or treat COVID-2019.

  • Hygiene: Wash your hands often with soap and water. Always wash your hands before preparing food and before eating. Avoid touching your eyes, nose, or mouth with unwashed hands.
  • Coughhygiene: Cover your mouth and nose with a tissue when you cough or sneeze, then throw the tissue in the trash and wash your hands. If you don’t have a tissue, it is better to cough into your shirt sleeve; not your hands and always wash your hands after coughing or sneezing.(3)
  •  Food hygiene: Ensure that you use a different cutting board for meat and vegetables. Clean your cutting boards well. Avoid sharing water, food,or products (glasses, cutlery, hygiene products) with someone who has arespiratory infection.
  • Clean surfaces: Whether grocery shopping, flying or exposed to something new, clean and disinfect all objects and surfaces that you touch.
  • Avoidance: Avoid close contact with people who are sick. If you have a cold or flu stay home to limit your risk of spreading the infection to other and to support the healing process. Avoid large crowds when the risk is high. If you choose to weara mask, choose a mask that covers both your nose and mouth.

Health Promotion
Naturopathic care recognizes the importance of both decreasing exposure and addressing individual susceptibility as a way of promoting overall health. The following guidelines may be beneficial in supporting overall health. For specific recommendations it is important to work with your naturopathic practitioner or medically trained health care practitioner.


  • Stay hydrated: Ensure adequate hydration, especially if there are signs of dehydration to assist the body in fighting infections.
  • Clean balanced diet: Limit known food intolerances; ensure balanced nutrition including lean protein, vegetables and whole grains; and limit foods that contributeto mucous (such as excess bread, dairy, yeast and bananas).(4) Limit processed food and foods high in salt and sugar.(5)
  • Spices: Many warming spices have anti-microbial and anti-viral properties.Spices such as garlic, ginger, thyme, oregano and sage are easily added to teas and food dishes.
  • Sleep: Ensure adequate sleep. When you have symptoms of a cold or flu it is common to require more sleep.(6)
  • Stress Management: Reduce and manage stress. Positive relationships are associated with a stronger immunity and overall health.(7)
  • Indoor pollutants: Address indoor pollutants such as mould as they can worsen lung related illnesses.(8, 9)
  • Avoid smoking: Smoking and exposure to second-hand smoke can increase your susceptibility of lung-related illnesses.(10)
  • Exercise: Moderate exercise enhances immune function and lowers the risk of respiratory infections. Intensive exercise can suppress normal immune reactions and is best avoided if unwell.(11)

It is important to follow the advice of your local Ministry of Health during any outbreak.


Diagnosis

Clinical criteria include fever or history of fever (≥38 ºC) and acute respiratory infection (sudden onset of respiratory infection at least one of shortness of  breath, cough or sore throat).


Or


Severe acute respiratory infection requiring admission to hospital with clinical or radiological evidence of pneumonia or acute respiratory distress syndrome (i.e., even if no evidence of a fever).


Please note that the information above may change as more information is available on this virus. To stay up-to-date on the COVID-2019 and other coronaviruses please check out the Centre for Disease Control at: https://www.cdc.gov/coronavirus/index.html or your local Ministry of Health.


References
1 Center for Disease Control. 2020. Novel coronavirus 2019, Wuhan, China. www.cdc.gov
2 CDC – Confirmed locations: https://www.cdc.gov/coronavirus/2019-ncov/locations-confirmedcases.html#locations
3. Effectiveness of cough etiquette maneuvers in disrupting the chain of transmission of infectious respiratory diseases: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3846148/#B15
4. Effect of fruit and vegetable consumption on immune function in older people: a randomized controlled trial: https://academic.oup.com/ajcn/article/96/6/1429/4571488
5. Ullah M, Akhtar M, Hussain F, Imran M. 2015. Efects of sugar, salt, and distilled water on white blood cells and platelet cells. J Tumor.  4(1):354-358.http://www.ghrnet.org/index.php/JT/article/view/1340/1795
6. Sleep and Immune Function: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3256323/
7. Indoor Air Quality and Health: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707925/
8. Anger, stress, dysregulation produces wear and tear on the lung https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2104758/
9. Air pollutants and early origins of respiratory diseases: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6033955/
10. The Health Consequences of Smoking: https://www.ncbi.nlm.nih.gov/books/NBK294322/
11. Casteleijn, D., & Finney-Brown, T., (2014). Respiratory Infections and Immune Insufficiency. In J. Sarris & J. Wardle (Ed’s), Clinical Naturopathy: An Evidenced Based Guide to Practice (pp. 159-182) Elsevier, Sydney.

Contributors:
Dr. Iva Lloyd, BCPP, ND – President of the World Naturopathic Federation (WNF)
Dr. Paul Saunders, PhD, ND – Research Committee, WNF
Tina Hausser, naturopath, Heilpraktiker – 1st Vice-President, WNF
David Casteleijn, BHSc(Naturopathy), MHSc (Herbal Medicine), RN, MNHAA – Secretary WNF