June 1, 2020
Latest numbers show that on balance COVID incidence and death is declining nationally, however, some areas are increasing. Thus, we are not out of the woods. Cases, deaths and ICU admissions are all on a downward trend which is great. We still do not have any reasonable IFR data. States are opening up and we will be watching closely for any uptick in cases locally. Humidity, higher ambient temperatures, social distancing and general precautions taken so far are likely causes for the trend.
Recap from last week. National poverty and mental stress issues are going to acutely worsen because of the unprecedented COVID19 lockdown.
Poverty is the major ingredient in the recipe for childhood disease and mental health dysfunction as poverty has always been the fastest route to an unstable environment for a child to attempt to thrive in. Unstable environments lead to negative epigenetic changes that have long lasting effects on human health. The poverty effects of COVID will be unmistakeable.
What we know: The disease effect on the youngest among us is much less than expected and appears to be in part related to the fact that children have less ACE2 receptors in the mucous membranes of their nasal passages making them significantly resistant to SARS2 viral infection and morbidity. We find ourselves with a novel infectious disease pandemic that is ravaging the population that has lived the longest, many of which have developed inflammatory diseases associated with lifestyle choices that are magnified by aging. From my perspective, every life matters, but this is a lesser of two evils as the reverse would be catastrophic for the future of our families. Death is never good when it is premature, but vastly less painful for the current demographic situation that we find ourselves in. Every elderly person that I speak with on this topic is grateful that death is claiming the elderly and not the youngest among us. I would gladly give my life for my child. It is that simple.
What is not simple is the next section.
Now we turn to the topic of poverty. The dance of economic lockdowns versus pandemic case expansion is a tightrope walk to be sure. There is a clear and present danger to continuing to suppress economic activity for the marginalized Americans without a savings safety net. The children that are living in these economically challenged households will experience hunger, parental anger, anxiety and substance abuse. Witness the alcohol sales that have skyrocketed nationally during the lockdown as alcohol was deemed essential to society. People are self medicating their stress with alcohol. When a parent uses alcohol and/or illicit drugs to quell the pandemic anxiety and anger, there will be psychological damage for the children that are exposed in the acutely stressed homes. We know from epigenetic studies of the past that these prolonged stressful events have significant long term negative effects on children.
We will need to help the children that are trapped in these negative situations as we identify them. Counseling and meditation practices are invaluable in balancing the stress response. This goes doubly so for the parents that are struggling. Meditation and prayer are critical for reducing the anxiety that can upturn the family's happiness. Think of the airplane adage, please put on your oxygen mask before applying one to your child. Take care of self and then you will be able to take care of your family.
Whether we economically weather this storm remains to be seen, however, I am a believer that we will recover as the American system has yet to fail for any prolonged period of time.
No matter where one is today on the poverty continuum, the first and most important issue is survival. For children, the inflammation is not a significant problem as it relates to COVID survival, but is as it relates to all cause disease over time and especially for mental health which is highly tied to diet, lifestyle and inflammation. Thus, the principle precursor of inflammation and health outcome shifting for children during these times is the consumption of cheap processed poor quality foods loaded with refined flour, sugar and saturated fat.
Therefore, step one in a poverty struggle is to avoid all processed foods that are loaded with these macronutrients. This is a stout intervention for your nervous and immune system's benefit. This simple change could and should be enough to tip the balance toward mental fortitude and general wellbeing for your child while they battle the mental stresses of the changes to their environment.
Step two, replace all of these foods with whole and minimally processed colorful foods primarily in the vegetable and fruit category. These foods are loaded with macro/micronutrients that are critical for mood and happiness as well as immune/ microbiome function.
Step three, if medically possible as with adults, eat only 1 to 2 meals a day and limit the consumption of all animal meat as it is expensive as a line item on your grocery bill. Take the money that is saved and apply it towards more fresh or frozen fruits and vegetables.
Step four, eat more beans and whole grains as they are cheaper but still high quality foods. Taking this approach will reduce risk, save much needed money and set one on a goal for total health revitalization for the future.
Step five, teach your children the relaxing breath and meditation. Help induce parasympathetic activity which is calming and immune enhancing. Pray together as a family for the fortitude to be at peace throughout the stress of COVID.
Step six, get outside, play and walk in nature. Talk about the beauty of the world that we live in. Children need to be outside playing - a critical need.
Step seven, talk about their fears and thoughts. Give them solid counsel while you listen to their fears. I believe that life is here while we are allowed to have it. I teach my children that everyday is a gift. Fear is only useful to encourage appropriate behavior. I do not encourage fear mongering or perseveration.
Step eight, control what you can control. Discuss with your children the root of happiness is to be content with whatever you have at every age of life. The future will hold more bounty as work returns and money is obtained but happiness is a choice.
Step nine, spend time in calming and educational endeavors. Read with your children and learn a new topic daily. Everyone benefits from learning.
Step ten, continue to maintain quality sleep hours. Adequate sleep will help keep the mind calm, rested and more prepared for stress.
Lifestyle choices have always dictated a Darwinian outcome for some if not most - children deserve the best that we have to offer and a long fruitful life,
Dr. M
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Donath Nature Immunology Article
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Wang Lancet Article
Gandhi NEJM Article
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