The Neverending Endemic Pandemic

Human Biomonitoring for Enhanced Immunity!

“Is it still the President’s goal to defeat the virus…or is he coming around to accepting that the virus is going to be a part of life from here forward, that it’s going to become endemic?” Question to Jen Psaki — White House Press Briefing January 6, 2022.

It’s hard to envision the glistening shoreline when you are being pounded full frontal by the surging waves of a global “tsunami” but a public health movement was launched in the Journal of the American Medical Association on Thursday, January 6, 2022 by six “rogue”advisors to President Biden. In a three part statement the public health experts concede the goal is not to eradicate COVID-19 but to accept -as national strategy — the “new normal” of life with COVID as even the fully vaccinated are being infected by the latest wave of the omicron mutation.

“The US needs a comprehensive, digital, real-time, integrated data infrastructure for public health. As Omicron has reemphasized, the US is operating with imprecise estimates of disease spread, limited genomic surveillance, projections based on select reporting sites and data from other countries that may not be generalizable. These shortcomings are threatening lives and societal function.” [https://jamanetwork.com/journals/jama/newonline]

The bottom line is that it’s not going away, Folks! It will never be the same again and there’s no going back home to “the way we were.” The War on Covid in San Francisco…like the War on Drugs in the Tenderloin, will fail if the strategy is the eradication of the public health threat rather than rebuilding the public health response and societal safety net.

Successive tidal waves pack a punch and in “The City by the Bay” where 81% of residents are fully vaccinated and 54% have received boosters, the strain on hospitals and the 911 system by non-emergent calls is being felt as teachers threaten sick outs demanding districts enact strict COVID — 19 precautions. San Francisco’s COVID-19 case rate tripled from 91 cases to over 273 by Christmas of 2021 after detecting the first case of Omicron in the U.S on December 1st. [sf.gov/news.get-your-booster-now-omicron-variant-spreads-sfdph-supports-drop-ins-boosters-tests-recommends]

“The total reported last week was the highest of the pandemic.” New York Times Interactive

According to the New York Times updates as of January 9, 2022 San Francisco County cases were “extremely high” with a total of 78,152 cases and 690 deaths. The daily average of new reported cases was 1,461…up by 263%! [https://www.nytimes.com/interactive/2021/us/san-francisco-california-covid-cases.amp.html]

The CDC continues to find severe illness, hospitalization and death from Covid 19 rare among those who are fully vaccinated and boosted but urges those over 65 or with a weakened immune system or underlying health conditions to take precautions to prevent contracting infection by new variants.

The World Health Organization declared on January 7, 2022 that the omicron variant is not “mild” and issued a warning of a “tsunami” of COVID cases.

According to SFGOV, as of December 27, 2021 an average of 829 San Franciscans a day are contracting COVID — 19, “raising the prospect that frontline workers could become infected and temporarily unable to work, impacting SF’s delivery of essential services.” [https://sfgov/information/new-data-shows-next-several-weeks-critical-beating-back-covid-19-surge-and-protecting]

“This biggest surge yet is taxing our cities in new ways, even more so than delta, Director of Health Dr. Grant Colfax said. The new omicron variant is forcing us to learn to manage and live among COVID while keeping our hospitals and clinics, schools, businesses and many other essential services operating.” [https://www.governing.com/now/once-nearly-covid-free-hundreds-of-sf-workers-quarantined?_amp=true]

To make matters worse, Bloomberg News reported on Saturday, January 8, 2022 that Leondios Kostrikis — Professor of Biological Sciences at the University of Cyprus has discovered “Deltacron” — a coronavirus strain that combines the more deadly delta variant with the highly transmissible omicron variant. Kostrikis and his team detected 25 cases of infection due to this ominous COVID — 19 variant in which omicron genetic signatures are detected within the delta genome. Statistical analysis shows Deltacron incidence was higher in patients who required hospitalization. [https://www.bloomberg.com/news/articles/2022–01–08/cyprus-finds-covid-19-infections-that-combine-delta-and-omicron?sref=ctSjKj2N]

The Politicalization of Natural Immunity

In crudest terms, when you have immunity to a viral infection it means your body recognizes it as a “foreign invader” and is able to fight it off. Terms like natural and acquired immunity have been tossed around for the last two years with increasingly more “nebulous” meaning. In pre-COVID basic epidemiology, natural immunity was defined as resistance to reinfection by a virus due to a heightened immune response triggered by the prior infection. In the pre-COVID era it was presumed the virus would ultimately be extinguished when it ran out of people to infect.

Natural immunity is not be enough to reduce hospitalization and death from exposure to a more virulent or transmissible strain and “real”experts agree natural immunity is not as potent as acquired immunity through vaccination — and that both wane over time leading to risk of reinfection. Natural immunity can decay within 90 days of being infected by COVID-19 while acquired immunity through vaccines like Moderna can last for well over six months.

Traditional arguments hold that populations eventually reach heightened immunity against COVID — 19 severe disease, hospitalization or death through a combination of natural and acquired immunity through vaccination. This is called “herd immunity” or endemicity. Many experts predicted COVID — 19 will ultimately smolder and become endemic with episodic and seasonal flares...like the flu and common cold. They foretell of a future of human/virus symbiosis in which the pandemic does not end and the virus does not disappear but “enough people will gain immune protection from vaccination and natural infection such that there will be less transmission and COVID — 19 — related hospitalization and death, even as the virus continues to circulate.” [https://www.hsph.harvard.edu/news/features/what-will-it-be-like-when-covid-19-becomes-endemic/]

But in the words of ER doctor Hilary Fairbrother, “The idea of natural immunity is not really panning out with this virus.” Part of the problem is that COVID — 19 has so many mutations that vary in transmissibility and severity. As the U.S. averages over 500,000 new cases a day even experts question whether herd immunity can be achieved. While the omicron variant is still able to evade the protection of a three dose vaccine regimen, those reinfected have a milder disease. [https://finance.yahoo.com/amphtml/news/omicron-natural-immunity-doctor-161847721.html]

Another major part of the problem is the role partisan politics plays in acknowledging the limitations of natural versus acquired immunity in a quixotic quest to eradicate the virus...and keep Wall Street rolling. An issue that is highly politicalized and bipartisan. President Biden doubled down last week on his plan to “Beat COVID — 19” and publically disagreed with six top advisors saying “I don’t think COVID is here to stay.”

Meanwhile, Republican lawmakers in Indiana and Wisconsin added natural immunity clauses to vaccine exemption bills that allow businesses to accept proof of natural immunity instead of vaccination or coronavirus testing. The Supreme Court will hear arguments on lawsuits challenging Biden’s vaccine mandate for all businesses with over 100 employees

Train Like An Athlete! -Enhanced Immunity Through Human Biomonitoring

“Many professional and Olympic-level athlete settings comprise comprehensive sports medicine and sports science support services, with an objective of:(1) achieving the highest possible level of performance with the lowest number of days lost to injury or illness and (2) a duty to care to protect athletes from long term negative health consequences of their sport. This includes the use of biomarkers to assess the efficacy of training interventions, inform nutritional strategies and assess the capacity to tolerate training loads.” [Blood Biomarker Profiling and Monitoring for High-Performance Physiology and Nutrition — https://link.springer.com/article/10.1007/s40279–019–01158-x.

I would like to offer my educated “two cents”about the role of “enhanced immunity” with support from a body of medical research little known to the public at large. There is a wealth of information being stockpiled in the sports performance arena about the role of human biomonitoring and biometric tracking systems to promote an enhanced and augmented nutritional, physiological and immune response in elite, high functioning athletes. The fundamental determinants of disease expression are nature and nurture…genetic and controllable environmental influences. In my opinion the best approach to optimizing your natural resilience and immunity during a neverending global pandemic is to TRAIN LIKE AN ATHLETE!

Like a fine tuned automobile, “Top Tier” fuel equates to “Top Tier” performance for the human biomechanical machine. ATHLETE is a consortium of researchers from the US and 11 European countries in partnership with 22 public and private research groups designed to understand and prevent health effects from environmental hazards starting from the earliest stages of life. The human exposome studies the myriad of environmental exposures ( urban, chemical, dietary, lifestyle and social) accrued in our lifetimes to improve health and create a shift toward a more comprehensive and holistic approach. ATHLETE is a project of the European Human Exposome Network — the worlds largest research collaboration studying the impacts of environment exposure on human health.

One of the most common applications of biomonitoring in elite athletes is to evaluate nutrient status and the ability to manage lactate build up in muscle that limits performance. Salivary tests for the stress hormone cortisol are performed coupled with strategies for feedback loop control through relaxation methods. The Hunters Point Community Biomonitoring Program urinary screening detects the status of essential nutrient elements including iron, copper, calcium, magnesium, potassium, selenium, sulfur and zinc that are required for physical strength, muscular endurance and to optimize immune and thyroid function.

In biomarker profiling and monitoring for high performance physiology and nutrition, Pedlar et al detail the routine use of human biomarker monitoring in professional and high performance testing as a source of “robust research evidence” to identify iron, vitamin or energy deficiency, oxidative stress and inflammation and the status of red blood cells. Serial monitoring can be used to optimize nutritional and immune status and build the capacity to tolerate a high training load.

Vitamins, nutrients and foods statistically linked to improved athletic performance include iron, probiotics, Vitamin D, creatine, caffeine and select minerals.

Biomonitoring research on elite athletes has yielded findings to support the essential role of sulfur in cartilage and collagen synthesis, growth, metabolic processes, defense and detoxification. Sulfur is present in all cells and a shortage of sulfur is linked to physical fatigue, muscle injury and loss of lung elasticity.

Additionally, there is a bounty of research on the healing and restorative role of sleep. According to doctors working with Olympians and the National Collegiate Athletic Association, sleep is one of the most important training habits for mental and physical health. LeBron James averages 12 hours of sleep nightly and takes a nap before each game. Adequate sleep enhances immune function, reduces risk of upper respiratory tract infections and risk of injury. Muscle injury repair, growth, alertness, stamina and cognitive function are enhanced by the universal human requirement for sleep.

The training habits of elite athletes can serve as models of success and beacons of inspiration when examining optimum diets, training schedules and techniques used to optimize peak performance and physical conditioning.

Gratitude

I am so “over” reacting like a lab rat in a maze of confusion to the latest surge of the most recently mutated “flavor of the month” COVID — 19 variant and the secondary fallout and contradictory health messages!

Instead, I enjoy wearing my mask…it is my closest friend. It keeps my face warm in the cold of winter and rebreathing carbon dioxide helps reduce the neverending anxiety triggered by life in a global pandemic.

I have learned to enjoy and appreciate physical distancing. I was never comfortable having strangers come up to me to pet my dog and ask if I am dating.

Whether it be by blessing or design, I am most grateful that I can say neither I nor any member of my immediate family has tested positive for or been diagnosed with any COVID — 19 infection in the two years of the everlasting pandemic and I credit it to a safe environment and healthy nutrition. In the words of Hippocrates, “ Let food be thy medicine and medicine be thy food.”

Life in the New Normal

“Without a strategic plan for the “new normal” with endemic COVID — 19, more people in the U.S. will unnecessarily experience morbidity and mortality, health inequalities will widen, and trillions will be lost from the U.S. economy,” wrote Dr. Ezekiel Emanuel, Dr. Michael Osterholm and Dr. Celine Gounder — members of Biden’s COVID-19 Transition Advisory Board in 2020. The public health experts wrote in JAMA that rather than “living in a perpetual state of emergency,” the public should coexist with the virus by mitigating outbreaks and practice “humility” in contending with an enduring endemic neverending pandemic. [https://www.voanews.com/amp/former-biden-health-officials-urge-new-approach-to-fighting-covid/6385939.html]

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Founder, Director, PI - HP Biomonitoring/ Founding Chair- Radiological Committee Hunters Point Shipyard RAB 2001, Former Attending MD VA Toxic Registry & SFDPH

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Ahimsa Porter Sumchai MD

Founder, Director, PI - HP Biomonitoring/ Founding Chair- Radiological Committee Hunters Point Shipyard RAB 2001, Former Attending MD VA Toxic Registry & SFDPH