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Help your immune system to pack a punch

Starting today — and continuing all this week — Dr MICHAEL MOSLEY unveils his health revolution to help you stay one step ahead of coronavirus as the lockdown eases. In exclusive extracts from his new book Covid-19, he will help you get in the best shape to fight the virus and unveil a blueprint to bolster your immune system as well as measures to keep you and your family safe. 

As many of us venture out into the world once more after so many weeks of lockdown, it can be tough to balance that heady mix of excitement to get back to some kind of normal, with an undercurrent of fear that the Covid-19 virus is still out there. 

Once we start working and socialising, even tentatively, we inevitably put ourselves at some risk. 

Social distancing and diligent handwashing will help, but if you want to increase the chances of being one of the lucky few who experience mild symptoms — or even no symptoms at all — you're going to have to ensure your immune system is working at its absolute optimum. 

If you do come into contact with the virus, a well-functioning immune system could be enough to stop its progression into your lungs, and dramatically reduce your chance of complications. 

Your immune system faces a tricky balancing act. It has to respond to threats, but not go too far

The worst Covid complications — the ones that send people to intensive care — are often caused by an immune system which initially responds ineffectively, then completely overcompensates in its attempts to control the viral invader. 

Your immune system faces a tricky balancing act. It has to respond to threats, but not go too far. 

One of the reasons older people are dying in such large numbers is because the immune system tends to become less efficient as we age. 

It fails to react when it should, then overreacts and causes extensive collateral damage. 

But the good news is there are simple lifestyle changes you can make that can not only keep your immune system in good shape, but may even turn back the clock so that it operates like the immune system of someone quite a bit younger! 

Today and all this week, in extracts from my new book Covid-19, I'll be sharing my blueprint for shoring up your defences so you are in the best shape to fight this virus. 

Your immune system is a complex army of cells that works hard on your behalf to identify and destroy any potentially dangerous invaders such as bacteria and viruses. 

A typical Covid-19 infection begins when you inhale viral particles from someone who is infected, or you pick up some particles on your fingers by touching a surface where droplets have fallen. 

If you don't wash your hands, then the next time you touch your mouth, nose or eyes, the virus gets in. 

These viral particles will, most likely, start by infecting your upper throat.

That is why one of the early signs is often a dry, persistent Covid cough. 

In 'Covid-19, What You Need To Know About The Coronavirus And The Race For The Vaccine' by Dr Michael Mosley, he tells you how to defend yourself

What makes viruses like this so dangerous is that once they get into the cells that line your throat, they hijack the mechanism of those cells to make lots more copies of themselves. 

It is like a rogue robot taking over a factory and using it to produce endless versions of itself before going off to another factory to do the same. 

Once the virus is in, the race is on between the virus, which will try to replicate as fast as possible, and your immune system, which will try to destroy it, before it can really take hold. 

The trouble is, since your body has never seen this sort of virus before, it will take time to mount an adequate immune response. 

And in some people the response will come too weakly and too late. 

People like me, who are over 60, tend to have weaker, less efficient immune systems and, initially, may be slower to mount an adequate response. 

It is shocking to see how badly an attack of Covid-19 can impact people who are obese

Then, when it comes, the response is too strong and uncoordinated, leading to extensive damage as your immune system attacks healthy cells, as well as those infected by the virus. 

Other people who are at risk are those who are significantly overweight (like Boris Johnson was) or who have pre-existing conditions such as heart disease or type 2 diabetes. 

That's partly because Covid-19 can make your blood clot, and if your blood vessels are already damaged through long-term raised blood sugar levels or too much fat in the blood, then this can put you at risk of heart attack or stroke. 

It is shocking to see how badly an attack of Covid-19 can impact people who are obese. 

One reason is the more overweight you are, the lower your lung capacity. 

So if Covid-19 attacks your lungs, then you are more likely to end up in intensive care. 

Being fit and active will promote good blood circulation and help your immune system to do its job properly

People with excess fat also tend to have a less efficient immune response, which is why adopting a healthy diet and slimming down is a key step in the right direction. 

Good sleep is important, too. It's essential for the production and release of key components of your immune system and there is strong evidence that getting a good night's rest is a great way to keep infections at bay. 

We all know that regular physical activity is good for your heart, your bones and your muscles. 

It can also improve your mood. But what I find particularly encouraging right now is evidence that just 20 minutes a day is enough to give your immune system a good workout as well. 

Being fit and active will promote good blood circulation and help your immune system to do its job properly. 

Good sleep is important, too. It's essential for the production and release of key components of your immune system

Being confined to your home should certainly not be an excuse for not exercising, and in Friday's unmissable pullout I will share with you exercise routines you can do at home. 

There's no doubt that these are horribly stressful times and we know that chronic stress has a direct and damaging effect on your immune function. 

Any increase in the stress hormone, cortisol, decreases the ability of our immune system to respond effectively to infections. 

While it's hard to avoid everyday stress altogether, all the lifestyle tips I've just described, from losing weight to becoming more active and eating a ­Mediterranean-style diet, are great ways to reduce stress. 

I'll show you how to try to strike a balance.

KNOWING THE DANGER ZONES 

When you are outside of your house, you are most likely to pick up the virus in a confined space, such as in a lift, or on public transport. 

You catch it from droplets, which come out in a fine spray when someone with the virus coughs, sings or shouts. 

You can also inhale viral particles when someone talks, particularly if you are up close and personal. 

You are much less likely to get the virus from someone you walk past on the street because your risk of infection depends on how close you are to an infected person when they cough or sneeze, and also how long you spend in their company. 

Outdoor encounters with strangers are usually brief and any virus particles will be easily damaged by exposure to ultraviolet light even on an overcast day. 

Now that we are allowed to socialise again in small groups, it's safest to do so outside because any airborne virus particles will be carried off by the breeze.

 But remain meticulous with your hand-washing all the same. 

One of the clear differences between countries that controlled the initial spread of the virus, such as China, South Korea and Taiwan, and countries that didn't was the fact that, in the former, people were actively encouraged to wear masks outdoors

WHEN SHOULD YOU WEAR A MASK? 

We are being advised to wear a face covering when using public transport, but you might want to get into the habit of wearing a simple home-made mask whenever you're in a busy public area. 

One of the clear differences between countries that controlled the initial spread of the virus, such as China, South Korea and Taiwan, and countries that didn't was the fact that, in the former, people were actively encouraged to wear masks outdoors. 

One study suggested that if 80 per cent of people wear masks that are only 60 per cent effective then that alone could stop the pandemic. 

The reason that wearing simple, homemade masks has such a big impact on transmission of the virus is not so much because they will protect the wearer (though they might, particularly if someone coughs directly in your face), but more because they will dramatically reduce the amount of droplets someone who is infected will spray around if they happen to have Covid-19 — particularly if they are asymptomatic and are infected with the virus but show no symptoms at all. 

A key superpower this virus possesses is its ability to infect your throat and turn you into a 'superspreader' long before you even realise you are infected. 

What wearing a mask out in public does is dramatically reduce that risk. 

If you have Covid-19 and cough on someone from eight inches away, wearing a cotton mask will reduce the amount of virus you transmit to that person by 36 times. 

So if you wear a mask there is a chance that you will be saving a lot of lives. 

Your mask doesn't have to be sophisticated or medical grade to be effective. 

A basic mask made out of an old T-shirt combined with a liner of kitchen paper would be good enough. 

But you will only stand the best chance of protecting yourself if you use the mask properly. 

That means making sure you wash your hands thoroughly before you put it on, then resisting all temptation to touch, fiddle with or adjust it while the mask is in place. 

As soon as you get home, first wash your hands, then carefully remove the mask and put it in the wash (ideally at 60c), and wash your hands again.

If you are out (at work or in the car), sanitise your hands before and after removing the mask, and put it in a sealed bag until you can get home to wash it. 

From filling your fridge with immunity bolstering foods to throwing open windows and regularly wiping your mobile phone, we show you how to ensure that your home remains a safe, Covid-free zone

As lockdown gradually begins to ease, we are now at increased risk of picking up the virus and bringing it into our homes, so it's never been more important to take steps to ensure your home is kept meticulously virus-free to minimise your chance of spreading infection among other members of your household. From filling your fridge with immunity bolstering foods to throwing open windows and regularly wiping your mobile phone, we show you how to ensure that your home remains a safe, Covid-free zone. 

KITCHEN 

Cleaning 

Disinfect surfaces which are touched frequently (door handles and kitchen counters). 

You can wipe down with a diluted bleachbased disinfectant, but an alcoholbased cleaner or soapy water can be as effective because soap breaks down and destroys the virus's outer shell. 

Cleaning cloths and sponges are not likely to be Covid-carriers, but they are the biggest reservoir of microbes in your whole house. So wash them in a bleach-based disinfectant. 

Shopping 

Ordering a food delivery is a safer option than going to a supermarket — but it's not entirely risk-free. 

If the person who collected your order has contaminated hands, the virus could transfer on to your food packaging. 

However, the coronavirus does not replicate outside the body, so by the time your food is delivered, it is likely to have become less infectious. 

We also have good evidence that just ten minutes in the sunshine kills most viruses on most surfaces, so you might want to leave packages in the sun for a short while.

If you do go to a supermarket, wear a mask. 

Try to avoid touching your face as you shop and, if you are driving, give your hands a wipe when you leave the shop. 

Cups & Plates 

If someone in your household becomes ill, keep a separate set of plates and cutlery for them and wash these separately. 

Washing Clothes 

The virus can survive for two to three days, indoors, on plastic and stainless steel, but it doesn't live anything like as long on porous fabric surfaces (such as clothes and furnishings). 

The holes in textiles trap the coronavirus and prevent it being transferred so easily. 

Even so, hygiene experts I've spoken to recommend washing clothes more than we normally would. 

If you are concerned you might have been in contact with an infected person, then wash your clothes at 60c. 

Be careful not to shake the clothes before putting them in the machine as this could disperse virus particles. 

Disposable masks should be binned after use, and home-made masks put in the wash after every use. 

Fridge 

Make sure to empty your fridge of tempting sugary snacks which contribute to weight gain. 

Being overweight significantly increases your risk of complications if you do get Covid-19. 

Instead, top it up with immunity-bolstering foods. 

Our favourites include red peppers, which contain three times as much vitamin C as an orange. Also try live yoghurt and oily fish.

ENTRANCE HALL 

Outdoor Clothes 

If you do a high-risk job, such as nursing, or you are a taxi driver, you might want to put a box by your front door for outdoor shoes and jackets. 

This means you can remove potentially infected outer clothing as soon as you return home. 

Post 

The virus can, theoretically, last 24 hours on cardboard, but post and packages are not considered a high-risk route of transmission. 

Ask the person delivering them to keep their distance, wash your hands after opening, and then throw packaging away. 

Mobiles 

Unlike hands — which are, hopefully, regularly washed — almost three-quarters of people have never cleaned their phone. 

A study in the Journal of Travel Medicine And Infectious Disease found that 68 per cent of mobile phones are contaminated with viruses and bacteria, including some phones that were harbouring antibiotic-resistant bugs. 

The report concluded that our mobile phones could be having a 'large and largely unacknowledged impact on spreading infection in the community'. 

Apple recommends Clorox Disinfecting Wipes, but anything that contains more than 70 per cent alcohol will be fine. Do not use water or bleach. 

Bags 

Keep your bag on your lap when using public transport. 

Wipe down your purse or wallet regularly with an alcohol-based wipe, and wash or sanitise your hands before applying lip balm or make-up on the move to avoid introducing germs that may have settled on those items into your eyes or mouth. 

Keep any food in a bag or sealed box, and wash or sanitise hands before eating. 

Although the risk of picking up or transferring the virus on a bank card is low, it's a good idea to wipe cards once a week. 

Wipe down your purse or wallet regularly with an alcohol-based wipe, and wash or sanitise your hands before applying lip balm or make-up on the move to avoid introducing germs that may have settled on those items into your eyes or mouth

Downstairs Loo 

Now we can entertain outside, there may be the need for family or friends to use the loo. 

Wipe all surfaces, including flush levers and taps, with bleach solution or disinfectant spray before guests arrive and change the hand towel. 

Do the same again when they leave, washing hand towels at 60c. There's no need to clean the loo each time it's used. 

BEDROOM 

Windows 

Open windows/doors whenever possible. Government advice says the virus is less likely to be passed on in well-ventilated buildings and outdoors. 

Now it is warmer, leave windows and doors open. 

Virus droplets quickly disperse in fresh air, and smaller particles which float in the air after an infected person has coughed or sneezed will dry more quickly if there's a breeze. 

Rubbish 

If someone in your house is ill, ask them to put any tissues or wipes in a rubbish bag and tie the top. Keep this separate from other waste for 72 hours before putting in the household waste bin.

Sweeter Dreams 

Wash sheets regularly at 60c (90c for whites). 

If someone in your house has symptoms, ask them to put dirty bed linen and towels in a bag and wait 72 hours before washing it. 

Leave clean linen outside their room. Wash hands after touching items from their room 

SITTING ROOM

TV Remotes 

Just like your mobile phone, a TV remote and gaming handsets can harbour bugs, so give them an occasional wipe with disinfectant. 

House Plants 

I love having house plants around and there is evidence that they can improve the quality of air in any room. 

There's even a hit list of top 'air cleaning' plants devised by scientists at NASA who found that house plants are not only good at absorbing carbon dioxide and releasing oxygen, but can remove volatile organic pollutants from the air, such as benzene and xylene, found in furnishings, cleaning products and air fresheners. 

English (or common) ivy, snake plants, aloe vera and broadleaf lady palms all made it onto the list. If you have breathing problems, plants are great humidity regulators for our dry, centrally heated homes. 

Whether the air is dry, or your room tends to be damp, plants help to balance out moisture levels. Humidity and good indoor air circulation have been shown to help prevent the spread of viruses.

Home Office 

Keyboards and shared laptops and tablets are a potential source of cross-infection, so give them an occasional wipe down. Use an alcohol-based wipe or a dry cloth with disinfectant spray. 

Books, Magazines & Newspapers 

The virus cannot be transmitted on newspapers, but avoid licking a finger when you turn the pages (in case you transfer virus particles that you might have picked up elsewhere into your mouth). 

Glasses of Wine 

The odd glass of wine is fine, but drinking too much will impact your immunity (alcohol abuse is connected with an increased incidence of infectious diseases). 

BATHROOM 

Washing Hands 

The key to protecting your home and your loved ones is to wash your hands thoroughly when you return from being outside. 

I'm sure you know the drill by now, but in case you don't, you should lather your hands, rubbing the backs and between fingers, 'scratching' each palm with the nails of the other hand to get soap under the nails. 

Keep going for 20 seconds (or as long as it takes to sing Happy Birthday twice). Then rinse your hands under clean running water. 

I make a point of washing my hands regularly throughout the day (after every trip to the lavatory, before cooking, before eating, and after wearing a face mask). It a good habit to get in to.

Bathroom Scales 

Weigh yourself every week so you can tell if your weight is creeping up. As well as longterm health problems, being overweight increases your risk of complications from Covid19. It's far easier to bring any dietary slips back into line if you monitor your weight. 

Shower/Bath 

The virus doesn't cling well to hair, so there's no need to wash your hair after you've been out and about, but do tie back long hair so you're less inclined to touch your face. 

Shower daily, as normal, but ensure that everyone in the house has their own towel, which is washed regularly at 60c. 

If someone in your family contracts the virus, try to confine them to their own bathroom if possible, or be vigilant about wiping all surfaces including taps and the toilet flush with a bleach solution. 

... AND OUTSIDE

Your Car 

Keep a bottle of hand sanitiser in your glove compartment for on-the-move clean-ups. 

A pack of disinfecting wipes is also handy so you can wipe the gear stick and steering wheel, door handles and any commonly used buttons when you return to the car after being out if you or a member of your family might have been in contact with the virus. 

This will stop any particles transferring from your hands to the car interior, and being potentially brought into your house with you when you get home. 

Ideally, don't share a car journey with anyone outside of your close family group unless you absolutely have to.

If you do have to travel with someone else, use a face mask and keep a window open when driving. 

According to the Office for National Statistics, security guards and taxi drivers are the workers most at risk of dying from Covid-19. It is hard to keep a safe distance in a car. 

Garden & Patio 

If you are lucky enough to have a garden, do take the opportunity to soak up some sunshine. 

Even if you are wearing suntan lotion, it is the best way to top up your vitamin D levels, which are likely to be depleted after a long winter. 

Vitamin D is important for building and regulating your immune system. 

Getting a blast of UV light in the morning is also a great way to set your circadian clock, which ensures good restorative sleep. 

Sunlight, as I mentioned before, is a great way to kill any of the virus that happens to be hanging around on packages or other surfaces, mainly because the ultraviolet end of the light spectrum breaks up its vulnerable genetic material. 

So do enjoy the sun, safely, this summer! 

But such is the demand for a Covid-19 jab that more than 100 vaccines have gone into development in record time, and several are already being tested on humans

RACE FOR A VACCINE

With a deadly new virus stalking the planet, the race for a safe, effective vaccine is like nothing ever seen before. In normal times, the process would take at least five years due to rigorous testing and regulation — 95 per cent of potential vaccines fail. 

But such is the demand for a Covid-19 jab that more than 100 vaccines have gone into development in record time, and several are already being tested on humans. 

The good news is that with so many vaccines against Covid-19 in development, and with so much money behind them, it is possible that at least one will come through the scrupulous testing required, if not by the end of 2020, certainly by 2021. 

But there are huge challenges for the laboratories to overcome. 

Some of these vaccines are quite traditional, based on the principle of using a dead or weakened strain of the virus to give the immune system advance warning so it is better prepared when it comes face to face with the actual disease. 

But other groups are going down a fascinatingly different route. 

The Imperial Approach 

Professor Robin Shattock works in the Department of Infectious Disease at Imperial College London. 

For many years he has worked on Aids, pioneering the use of drugs and passive antibodies to treat and prevent HIV transmission. 

Robin and his team began by identifying the genetic sequence of the spikes that cover the surface of the virus. 

It is these crown-like spikes which give the virus its name (corona = crown) and which make it so successful at latching on to cells in our body. 

They have created a vaccine made of genetic material which, when injected into animals, makes their cells churn out viral spikes. 

Robin and his team hope the presence of the spikes (without the virus) in the body will be enough to alert the immune system and prepare it to face a real virus covered in the same barbs. 

'The great advantage of this approach is it tricks the immune system into thinking it has seen the whole virus,' explains Robin. 

When they injected their vaccine into mice it worked even better than expected, encouraging the mice to develop antibodies to fight Covid-19 within two weeks. 

The experts are now awaiting the results of studies done in monkeys and hope to begin human trials this month. 

Other laboratories around the world are using a similar approach. One of the current leaders, a company called ­Moderna, has teamed up with the Vaccine Research Center at the National Institutes of Health in the U.S. 

They were very quick off the blocks and began a small human trial with their vaccine on March 15. Early results look promising. 

The vaccine seems to be safe (none of the volunteers suffered side-effects). 

It is also clearly having an effect, as the first eight volunteers tested were producing decent levels of antibodies which bind to viruses in the blood and stop them infecting more cells.

It is early days, but Moderna plans to hold bigger human trials this month.

Dreaming Spires To The Rescue 

Another major research group is based at Oxford University's Jenner Institute, led by Sarah Gilbert, professor of vaccinology. 

This vaccine also uses the Covid-19 spikes, to spark an immune reaction against the real virus. 

This vaccine is, however, based on a harmless common cold virus, which has been genetically modified to produce Covid-19's distinctive viral spikes.

In a 2019 study, the team showed that their genetically modified virus was safe and could induce a good immune response to MERS (Middle East Respiratory Syndrome, a deadly infection that is also caused by a coronavirus) and human trials began in Saudi Arabia last December. 

They swiftly modified their existing vaccine so it would work against Covid-19 and by March were ready to test on monkeys. 

Six were given a single shot of the Oxford vaccine and mounted a good immune response, remaining healthy after being exposed to a heavy dose of the virus. Encouraged, the Oxford group began human trials with more than 1,000 volunteers in April. 

They await confirmation that the vaccine is safe and that the volunteers produced antibodies to the virus.

Professor Gilbert is confident it will work and the group has linked up with biopharmaceutical giant AstraZeneca to prepare for the manufacture of tens of millions of doses when the trials are complete. 

What are the next steps? 

Once it has been established that a vaccine is safe (with few, or no side-effects) and triggers a good immune response, the crucial test is to see if it works. 

This is difficult because self-isolating means there is not much Covid-19 about, so they are also testing it on health workers, who are more likely to get exposed. 

They might even need to trial it in another country where the virus is more active. 

Or volunteers could be vaccinated, then deliberately exposed to Covid-19 to see if the vaccine protects them. 

To minimise the risk, they would have to be young and healthy, and at low risk of complications if they did get the virus. 

They would also have to be closely monitored and get the best possible care if something did go wrong. Ideally, drugs that could help would be to hand (many antiviral drugs are currently undergoing trials). 

Finally, volunteers could be recruited from a group likely to become exposed to the virus anyway, such as frontline medical workers. 

We already expect them to risk themselves by treating patients with Covid-19. Is this really that different? 

When I was a medical student I took part in studies when healthy volunteers were needed to test for potential side effects of new drugs. 

If I was in my 20s, I would certainly volunteer. 

How long would a vaccine last? 

Although the vaccine might not give lifelong immunity, there are good reasons to hope its effects will last for at least a year. 

A Chinese study of 176 people who got SARS, which is caused by a related coronavirus, found they maintained good levels of antibody against the virus for a couple of years, and some for up to 14 years.

5 of the best for immunity 

Green Leafy Veg (Spinach or Kale) 

A good source of iron — vital for building your red blood cells that carry oxygen in the blood to other organs in your body. It also plays a vital role in building your white cells, which are a key part of your immune system. 

Green vegetables are packed with vitamins and fibre which your gut bacteria uses to regulate your immune response. 

Peppers 

Red or yellow, these have — weight for weight — three times as much vitamin C as oranges. 

Vitamin C is an antioxidant which also plays a vital role in launching an effective immune response, plus it also helps by aiding the absorption of iron from your food. 

Brazil Nuts 

The best source of the mineral selenium. This is a powerful antioxidant, which reduces chronic inflammation and enhances immunity. 

Many Brits are low on selenium, which can put you at risk of infection. However, a handful of nuts a few times a week will give you all you need. 

Mushrooms 

Research shows that people low inlevels of vitamin D could be at more risk of Covid complications. 

We get most of our vitamin D from sunshine, but if you put any mushrooms (fresh, dried, whole or sliced) on a sunny windowsill for a few hours before eating, that will really boost their vitamin D levels. 

Salmon 

Oily fish is rich in omega-3 fatty acids that have powerful anti-inflammatory effects, which help dampen down an overactive immune response. 

If you do not like fish, then nibble on some seaweed snacks instead (fish get their omega-3 from seaweed). 

Adapted by Louise Atkinson from Covid-19, What You Need To Know About The Coronavirus And The Race For The Vaccine by Dr Michael Mosley, published by Short Books at £6.99. © 2020 Michael Mosley 

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