From Lifestyle is the Best Medicine podcast notes for episode 2, season 1.
Have you read the classic book, or seen the Walt Disney movie Old Yeller? For those who aren’t familiar with the story, its setting is 1860s rural Texas. (If you remember from the last episode, this is around the same time we were making great advances in our understanding of what pathogens were, how they made us sick, and what we could do to prevent so much sickness.) Well Old Yeller was the family dog, a fun-loving, hard-working Labrador Retriever. After a series of adventures the movie ends with Old Yeller having to defend the family against a rabid wolf. During the fight, the wolf bit Old Yeller. After becoming infected with rabies, the dog became a threat to the family and because of that threat, the family shot and killed the beloved family dog Old Yeller.
Maybe I should gave issued a spoiler alert for those of you whose parents turned off the show before that tragic scene and told you, “…And they all lived happily ever after.” But the virus that causes rabies and the many other deadly pathogens are not compliant with a “happily ever after” Hollywood story ending.
Rabies is one of many viral diseases and essentially has a 100% fatality rate. Domestic dog transmission to humans causes 99% of all rabies infections. It is a really, really bad disease. It rapidly destroys the brain and if you don’t get quick treatment, it will kill you. It is that aggressive.
So how do we defend ourselves and fight pathogens that are so aggressive?
Today, we’re going to talk about our first line of defense — reducing exposure to harmful pathogens.
In terms of the current COVID-19 pandemic, some of the things we will be discussing today are surprisingly a bit controversial. There is much current conversation on social media about how there is no need to reduce exposure. Multiple arguments are getting bounced around, some more relevant than others, but one of the most frequent arguments is that, “The body’s immune system is all we need to fight pathogens. There is no need for protective gear, medicines, vaccinations, or or behavioral changes if we simply have a strong enough immune system.”
Our emphasis will intentionally avoid any political discussion about public health policy as it is not within the scope of this podcast to discuss such things. Instead we will be looking through the lens of how it affects our health so hopefully you can make the best decisions for you personally.
How does reducing exposure help our immune system? Simply put, it makes it not have to work as hard.
If you remember from episode 1, we talked about how we actually “get sick” when exposed to any pathogen. And one of the ways we get sick is by being exposed to aggressive germs. Some pathogens are so aggressive that even the healthiest immune system would not be able to fight them off. Their aggressiveness is based on either having a high transmission rate, or by having a high fatality rate.
The rabies virus is one such pathogen. No immune system is strong enough to destroy the rabies virus without treatment. A typical treatment protocol would include a series of shots. There’s a fast-acting injection of rabies immune globulin (think pre-made antibodies) that is given as quickly as possible after being bit by an infected animal. You then receive a series of 4 vaccination injections over a 2 week period to help your body identify and fight the virus itself.
This is why rabies vaccinations for animals are mandated in most communities, which is an example of something we DO to reduce exposure to deadly pathogens.
There are many aggressive pathogens that our body simply has an extremely difficult time winning the fight.
The Ebola virus has a 50% fatality rate. Hantavirus and smallpox kills a third of those who get it.
HIV killed about 90% of those infected UNTIL WE DEVELOPED MEDICATIONS THAT have drastically reduced that figure to about 15%.
Anthrax is caused by an extremely contagious bacteria. Again, without additional treatment, the body simply cannot mount a powerful enough response to defeat the bacteria, but the bacteria that causes it is sensitive to many antimicrobial agents.
These are all examples of extremely harmful pathogens that our immune system has a hard time fighting. So because our bodies can’t win every battle, the only way to defend ourselves is to reduce our exposure to such aggressive germs.
Again, referencing back to episode 1, another way we get sick is from overloading the immune system response. For pathogens that may not be as “deadly” or aggressively harmful, if we are exposed to enough of a pathogen, even the healthiest immune system can get overloaded. This is why you can be as healthy as can be, but still end up with the flu or a simple cold. We see that happening with COVID-19. Initially we saw it was the elderly and those who had some comorbid disease process who were getting sick and being hospitalized. Now we are seeing younger people and you’ll hear many stories of even healthy people who are getting sick with COVID-19. It’s true their death rate is lower, but how do healthy people get sick?
It’s all about what we call viral load, or the amount of total viral material in someone’s blood.
The more pathogens you are exposed to, the more likely a pathogen will have a chance to infect you. If you’re exposed to a small amount of a pathogen, you have a better chance that your immune system will win the battle. But the more virus you are exposed to, the more likely you will overload the immune system and become sick.
It’s unavoidable to avoid all exposure. In a typical day, we come into contact with about 60,000 different types of germs. (Even though only about 1-2% of those are potentially dangerous). We are walking petri dishes. The human body contains as many bacteria cells as it does human cells. Now it’s true that not all pathogens are bad or will cause us harm. Most of those in the human body are there for a purpose: to synthesize vitamins, maintain digestive and immune system health, and to break down food into nutrients.
But when we’re talking about something like COVID-19, the principle stands true: the more virus you are exposed to, the more likely it will overload your immune system. I’ve heard some ask, “Why if I can eat at a restaurant without a mask on do I need to wear my mask into and out of the restaurant? This is the exact reason. Because the longer you have a mask off, the more virus you are potentially spreading if you’re sick, and the less you are potentially exposed to as you walk through a crowded and possible contaminated room. Wearing a mask for even a short time reduces your time of exposure and therefore the total amount of virus that you could have been exposed to in a contaminated area. That being said, if you are actively infected and you are at peak viral load, not wearing a mask in a drive-through when you’re at the window making your payment may not be the cause of the worker getting infected, but if that happens multiple times in a day from other infected people, it definitely increases the amount of virus the cashier is exposed to. Less exposure is always better when it comes to pathogens exposure.
What are the ways we can reduce exposure?
BEST PRACTICE #1: Watch where you go.
We can minimize our exposure to harmful pathogens by knowing about high risk locations.
Malaria is caused by a parasite that is spread by mosquito bites. Sub-Saharan Africa is the highest risk area. If untreated, it can have a 75% death rate. With treatment, that rate is reduced to 20% or lower. It is still in the top 10 leading causes of death in low-income countries.
Cholera is a bacterial disease commonly spread through contaminated water. It causes severe diarrhea and dehydration and can be fatal within hours, even in previously healthy people. Hotspots for cholera are typically areas without modern sewage and water treatment, where people live in crowded conditions.
These are examples of infectious pathogens where a “healthy immune system” is just not enough to prevent significant numbers of death by disease.
Not everyone will be traveling the world and get exposed to many of these deadly pathogens. But there are still many locations in “wealthier” countries that can present a high risk of exposure such as:
Playgrounds (Indoor & Outdoor)
Fitness Centers (Norovirus can stay on equipment for up to a month.)
Gas pumps (71% of gas pump handles are contaminated)
Offices (90% of people will go to work when sick)
Restaurants (MENUs can carry 185,000 bacteria, condiments
Places of big gatherings (concert halls, churches)
So are we to just stay in our homes and never go anywhere? This is where as part of the Meducos Method, you obtain the knowledge you need to get you to your desired healthy destination. From that knowledge, you choose what action you will take that will help you live the healthiest lifestyle.
It’s all about risk assessment. And part of that assessment is our current level of health. Someone who is in an immune-compromised state is going to be at higher risk of their immune system not fighting off a potential harmful pathogen.
So should we never go anywhere? Sometimes quarantining ourselves is the best option, but this tends to be the best option when you have a contagious infection. This reduces the likelihood that you can pass the pathogen to someone else. Staying home when you’re sick is an example of a quarantine method. In the hospital, when someone has an infection from a really contagious pathogen, patients are put in isolation rooms where even the air is from a separate source than the rest of the hospital.
Social distancing is kind of a “mini-isolation”.
Limiting close face-to-face contact reduces your exposure to vapor droplets that are dispersed when we breathe, talk, sneeze, or cough. We typically say 6 feet apart, but that number came from studies in the 1930s and 1940s and we know that some contaminated droplets can travel up to 27 feet when someone sneezes or coughs. The question is not how far can the germs travel, but how far can they travel and no longer be a threat. The smaller particles are the ones that travel the furthest, but the smaller the particles, the lower the risk.
BEST PRACTICE #2: Watch what you touch.
Some examples of this would be avoiding high risk surfaces. So if you have the knowledge that the bathroom door handle can be the most contaminated surface in a public restroom, you can alter your behavior and do something like use a spare paper towel to grab handle as you leave the restroom.
As well, if you know that your eyes, nose, and mouth are the prime entrances for pathogens and that your hands are also commonly contaminated, you can change your behavior by reducing the number of times you touch your eyes, nose, and mouth.
If you know that a deadly pathogen can be transmitted through sexual contact, you can change your behavior and use “personal protective equipment”- a condom to reduce your risk of exposure. Why? Because you understand that your immune system isn’t strong enough to fight an HIV infection by itself and that reducing your exposure to HIV is your best defense against developing AIDS.
What are some of the most contaminated surfaces in your house?
The National Science Foundation conducted a study to identify germ hot spots in the home. They tested 30 things we encounter everyday for coliform bacteria (think fecal contamination - like E.coli and salmonella). Can you guess which things are the most contaminated?
Dish sponge/rag - 77% of dish sponges and rags had coliform bacteria present and 86% had yeast/molds
68% of keyboards were contaminated
Remote control: 55%
Video game controller: 59%
Kitchen sink - 45%
Stove knobs: 27%
Toothbrush holders: 64%
Bathroom light switch: 23%
Toilet handles: only 14%
Toothbrush holders (64%) were more contaminated than toilet seats (27%)!
BEST PRACTICE #3: Watch what passes through your mouth/nose.
This included things we put in our mouths (food, water, or fingers), and things we breathe in or out. It’s not a surprise that we have extra lymphoid tissue in the back of our throats to help mount a quick response to pathogens, because this the most common route pathogens will enter.
Risk reducing behaviors include:
Handling and preparing food safely.
Drinking clean, non-contaminated water.
Avoid touching your face.
Covering your mouth and nose to help prevent pathogens from coming in, and to help you from contaminating other surfaces by what you breathe out.
BEST PRACTICE #4: Clean high risk surfaces.
This includes your hands and any other high risk surface mentioned above.
Washing hands evidence:
Meta analysis from 2008 (Basically, this is a study that reviews other studies): concluded that the most beneficial intervention is hand-hygiene education with and using soap to wash. They found it decreases gut infection illnesses by 31% and respiratory illnesses by 21%.
Education should include frequency, duration, and triggers - we know that it’s working, but can we improve it by looking at these things?
Antibacterial soap - no difference than regular soap
Alcohol-based antiseptics didn’t show a reduction in infections even though they kill a wide range of bacteria and viruses.
BEST PRACTICE #5: Wear appropriate protective equipment.
In different settings, wearing appropriate protective equipment can help reduce our exposure:
Gloves - to protect hands
Gowns/Aprons - to protect skin and clothes
Masks/Respirators - to protect mouth/nose/respiratory tract
Goggles - to protect eyes
Face shields - to protect face
It's not just about reducing exposure, but also about reducing our transmitting it to the environment where someone else can get infected. This is especially important in pathogens that you can spread before you are aware of symptoms. This is one reason why HIV is such a deadly virus. You get it and can spread it before you develop symptoms. It can take years for HIV to cause the disease AIDS, but you can start spreading the virus much sooner than that. Research shows that more than half of all HIV transmissions occur during the first few months after an individual becomes infected.
We already talked in episode 1 about how Coronavirus reproduces rapidly in the back of the nasal passages and is commonly transmitted from people before they get symptoms, or even from those who may never have any symptoms.
Knowing these things should help us determine what behaviors we adopt to reduce our personal exposure, and to reduce the likelihood that we would pass it on to someone else.
So now, the moment you’ve all been waiting for. What about masks? Do they work or is it a government conspiracy? We’ve tried to provide you with an understanding of how pathogens get transmitted and in episode 1 how they make us sick. There is common consensus among doctors and medical experts, and the scientific evidence that is available to us. I’m not going present all of the evidence here, because if from what you have heard so far about how viruses spread you aren’t convinced that reducing exposure is wise, you’ll likely not be convinced with any amount of scientific evidence. People commonly think and form opinions based on some internal belief. And beliefs are hard to change without a certain amount of willingness to be open to new information.
I will relay some facts for those of you who want to know, and to answer some of the common questions I get. I’ll present it in a true/false format.
Virus particles are small enough to penetrate through masks. True. Not all masks can stop all virus particles from passing through them. The common N95 mask can’t even do it.
The N95 mask can reduce the amount of virus that is spread. True. Even though it can’t stop all the virus particles, it stops many of them. Even if they are small. When you breathe, speak, cough, or sneeze, you don’t just expel virus particles. You expel vapor droplets that are contaminated with the virus and these droplets are quite large. Most of the virus particles are present in these droplets. It’s these droplets that we are trying to reduce exposure to and transmission from ourselves to the environment.
Cloth masks are pointless. False. While surgical masks are better designed to prevent transmission, anything that can reduce the number of droplets that are being spread will help.
Masks will prevent spreading COVID-19. False. It will reduce the amount of spreading, but there will still be some spread even with masks. Masks in and of themselves are not enough to prevent all spread.
Masks can make you sick. False. Some have theorized this, but there is no evidence of such happening. And you can look at the number of ICU beds that are filled with people from wearing masks. It’s zero.
We could go on and on, but we won’t here. Find me on social media @drwillblake and ask me any questions you might have there and I’ll try to get back to you that way.
So let’s summarize. What is the first thing we can do to help our immune system? We reduce our exposure to harmful pathogens.
This helps us from overloading the immune system and from exposing it to aggressive pathogens.
We do this by:
Being aware of our physical location and environment, and of the potential harmful pathogens that are common to that area.
Avoiding touching things that could be potentially contaminated.
Reducing the number of pathogens that enter through our airways and mouth.
Sanitize and clean our hands, and commonly contaminated surfaces.
Wear appropriate protective equipment.
Now that you have some knowledge about how to reduce exposure to you and those around you, let’s turn that knowledge into power and DO SOMETHING. Remember, this is a podcast designed to emphasize how we can use lifestyle as focus to improving our health, so we will always ask this question:
What can we DO? What is one thing that you can control that will make a difference in your life? If you are familiar with the Meducos Method, you’ll know that by taking just one small intention and through daily practice you can make enormous changes in your life.
To make it easier for you to track your progress and to keep yourself accountable, we’ve created a Personal Intention Record that you can download from the Meducos Library at https://www.meducos.com/library where you’ll also find additional tools and information to help you on your path to achieving health.
Thank you so much for joining us again. There is so much more we have to talk about so tune in to next week’s episode where we will be discussing something everyone needs to hear right now… we’ll be talking about a secret to actually flushing pathogens out of the lungs and airways. It’s really quite timely during a pandemic caused by a respiratory pathogen. You’re not going to want to miss it. So please like, share and subscribe to the podcast as it really helps us to reach more people just like you. And now that you are on your way to making Lifestyle the best medicine in your life, go share what you’re learning with someone else and together we can #SpreadHealth. Until next time, have a happy and healthy week.