General Health

Back to School #covidstyle

As a long-anticipated return to school is upon us, many of my patients are asking me about COVID prevention. In this post, I will review some must-do items and I will also cover what I am doing for my own three children who will be returning to in-person school after a year and a half.

IF YOU ONLY DO TWO THINGS…

  1. Be vaccinated and get your kids vaccinated when they are eligible. Even if you or your child has a low risk of experiencing severe covid symptoms, the only way to stop this virus is to stop it from propagating. Each instance of replication (when it makes copies of itself) is an opportunity for mutations to occur. Any mutation can result in a more infectious or more deadly variant. The only way to reduce the chance of variants is to stop the spread. As my kids and I rap: We gotta stop the replication | Don’t want another mutation | So please get your vaccination | And you can end the propagation | Then we will have a celebration!
  2. Wear masks when indoors. There are so many reasons for this (see above). But mostly, with emerging hyper infectious variants, we must work even harder to reduce the spread. In schools, this is especially important. Kids under 12 are still waiting to get vaccinated and those tweens/teens who are eligible may or may not be vaccinated. Even if they are vaccinated, we know that they can still spread disease. We also know that tweens and teens are very susceptible to peer pressure. Having a rule around masking helps avoid any room for confusion and will reduce missed school days or school closures due to COVID exposures.

If you want to do some other things…

Acknowledging that the above two recommendations are backed by rigorous science, I will share with you what I will be doing for my children. This information is also scientifically backed, but there are not that many studies on free interventions (like nasal saline) and certainly not that many studies on a relatively new infection like COVID.

Nasal preparations and throat gargles. Another key fact about COVID is that the more virus you are exposed to, the worse your infection may be. Like masking, rinsing viral particles out of your nose and throat may reduce the load of virus your body sees. I have always been a fan of saline in the nose (loosens up mucous, helps wash out pollens) and more recently saltwater gargles (after years of hearing my parents tell me to do them, finally someone studied it and it turns out my parents were right). The nose and the throat have been long ignored in the United States. Around the world, it is part of the daily routine to rinse your nose and throat, and we are starting to adopt these rituals here as well. The options for rinsing your nose and throat are plain water, salt water or iodine preparations. For school this year, I will be using nasal iodine preparations for my kids. Iodine is a common antiseptic safely used around the world. I purchased mine on amazon. I have my kids lay flat with their chins tilted up while I instill one drop at the base of each nostril. Then they breathe a few breaths; when they tell me they feel the liquid going back into their noses, I pinch their nostrils together and let them get up. I will be doing this daily when they return from school. Some studies suggest it may be prudent to do it prior to exposure (so before school, daily). Personally, I don’t think I can add that to my morning routine.

For gargling, salt water is known to help break up the mucous and some proteases and these actions make your throat less inviting to infectious particles. Iodine rinses are probably even more effective. Iodine prevents viruses from attaching to cell surfaces. Again, these are done safely in many countries, and they are sometimes used pre- and post- anesthesia. However, I have not been able to easily find an over-the-counter iodine rinse (it is available, I hear, in Canada). For now, I will be sticking to an over-the-counter nasal iodine preparation and salty saltwater gargles (as warm and as salty as your child will tolerate).

Please note that there are certain conditions in which iodine is not recommended (e.g., allergic reaction, iodine-related therapies).

Handwashing. Handwashing is always good. Even if COVID is not readily spread through surface contact, other common cold viruses and gastrointestinal viruses are just waiting for you to let your guard down. Getting sick is no fun but getting sick now is just plain confusing. Should I stay home? Should I get tested? Should my kids stay home if her sibling is sick? Better to be hypervigilant for the time being. Shower your kids when they get home and remind them to wash hands and avoid face-touching (masks do help with this!). When handwashing is not available, hand sanitizers are fine. One day we will go back to eating dirt, but for now, I am on germophobe mode.

Good sleep routines. Lowering physical and emotional stress keeps our immune systems on point and adequate sleep is practically magical in lowering stress on the body.  Maintaining a sleep routine that varies minimally, less than an hour (even on weekends!), keeps your immune system optimized for infectious and non-infectious disease prevention. That’s right, immune cells that fight cancer and COVID work better when well rested.   

Supplements. I have not given my kids any supplements during this pandemic. When it comes to supplements and immune-boosting, I reference some adult studies that show zinc and elderberry to reduce length of symptoms for colds and flus. For kids taking zinc, I make up a dose between 5-15 mg a day. Adult studies use 20-30 mg a day. Too much zinc can upset the stomach (Do not use nasal zinc! It can result in permanent loss of smell.). For elderberry, there are now several preparations to choose from, most with pediatric dosing. I always recommend buying your supplements from reputable sources or stores that vet their vendors since supplements, like foods, do not undergo any approval before being put on the shelf.

Meanwhile, eating a variety of real foods (not factory processed) is another way of unlocking your body’s immune powers.

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