MY: What should we do to keep our immune systems strong and build our internal resilience? Why is this important?

Dr. Kaley Bourgeois: Never underestimate the importance of basics when it comes to building your immune system. Whenever able, schedule out time for 8 hours of sleep per night, meal prep to include vegetables and fruit, and prioritize stress-reducing activities.

Lack of sleep disrupts your stress hormone levels, which can suppress your immune system and make you more vulnerable to infection. Even if you struggle with insomnia, resting with your eyes shut is better than getting up and doing work in the middle of the night. For general stress reduction, consider participating in at-home yoga, or downloading a meditation app on your smartphone such as Headspace.

Eating nutrient-dense foods like leafy greens and fresh or frozen fruit supplies your immune system with necessary vitamins and minerals. The fiber content will also help to stabilize your blood sugar, which helps to balance those pesky stress hormones. Even if your appetite is low, eat a small fiber and protein-rich snack every 4 hours. A handful of almonds is always a great option!

MY: Are some types of exercise better than others right now? Why?

KB: Gyms and fitness centers around the country may be closed for social distancing, but that does not mean you need to be sedentary. Remember, exercise strengthens your immune system and helps to reduce stress.

Most exercise is good exercise at this time, but do ease into anything high intensity so that you are less likely to sustain an injury. A trip to urgent care or the ER is best to be avoided right now. If you are in an area allowing outdoor recreation, go walking or take a jog. Cycling is safer now with less traffic on the roads.

My personal favorite is a virtual run with friends. You can call each other at a mid-way point, and share challenges on running apps such as Nike Run Club.

MY: Do you recommend any specific supplements or foods for people to stay healthy right now?

KB: Right now is the perfect time to supplement nutrients you aren’t getting enough of via diet. Vitamin D3 is a great example because low levels make you susceptible to infections and many of us are deficient. Make sure you are getting at least 2,000 iu (50mcg) every day if you don’t know what your blood level is. Many of us need more than that, but speak with your physician first.

I also recommend taking 15mg of zinc daily and 200mcg of selenium to most of my patients. Both of these give our immune system a boost. Did you know that you can get your full dose of selenium per day by eating 3 Brazil nuts?

In addition to Brazil nuts, here are some other great foods which support your immune response: Garlic, fresh ginger, turmeric, red bell peppers (they have more vitamin C than an orange!), leafy greens and antioxidant-rich berries.

MY: Where can people get the best information about this virus as it changes and spreads?

KB: There is a lot of misinformation circulating, so for general information about COVID-19, I recommend following cdc.gov for updates about infection rates and community resources.

If you have more personal questions about COVID-19, like many of my patients do, please ask your doctor for resources or schedule a telemedicine visit. Your local doctor will know even more about local testing availability, your health and your vulnerability to infection.

MY: Do you have any tips for maintaining positive mental health at this time?

KB: Connection is key! Please protect yourself and others via social distancing, but reach out to friends and family for weekly video chats. You can find an online fitness or yoga class to follow together while you're both on an app.

Have kids or quarantined with a niece or nephew? How about you help them to write letters to family and friends? Reach out to friends with children who might want to be a penpal. Write letters to your friends as well.

This would also be a great time to try a new, relaxing craft at home. Consider ordering at-home painting kits or see if local craft businesses are selling supplies. If these aren’t available, order basics online to try out knitting or jewelry making and follow a tutorial on YouTube.

MY: Can you tell us a bit about the rationale for social distancing and why it's effective?

KB: COVID-19 spreads through droplets, which can travel up to 6 feet. By limiting interactions with those outside your immediate family and standing at least 6 feet apart from coworkers and strangers, you can help to decrease the spread of this infection. The slower COVID-19 spreads, the more time we have to adequately equip hospitals and identify treatments.

MY: What preconceived notions do people have about COVID-19 that are false?

KB: There is a lot we still don’t know about COVID-19 and some false information circulating. Key things that we DO know right now:

1. It is primarily spread through droplets. Droplets (think coughing, sneezing) are heavy and settle on surfaces rather than staying afloat. COVID-19 is not classified as an airborne disease at this time. However, it is possible that smaller, aerosolized particles (like miniature droplets) may stay afloat for longer periods of time.

2. Flu Vaccine does not protect you against COVID-19. Getting the flu vaccine will not decrease your risk for coronavirus infection. If your doctor asks you to get vaccinated, it is for flu and flu alone.

3. Cloth & disposable masks can decrease droplet exposure. Without question, individuals infected with COVID-19 and healthcare providers who are frequently exposed should wear masks. The general population can benefit from wearing masks, as well. Many of us will be infected without ever knowing it, which means we can spread the virus quickly if we are not wearing a mask to block our own droplets. 

4. Young adults & children are still at risk. Older individuals and those with chronic diseases are considered more vulnerable to severe illness from COVID-19, but children and younger adults can still become infected, contagious, and severely ill.

5. Certain medications appear promising for the severely ill. Doctors are trying a variety of medications for COVID-19 patients with severe respiratory illness. Hydroxychloroquine (a Malaria drug) and Favipiravir (an experimental Ebola drug) are at the top of this list. We do not know enough yet to say that these will be widely effective, and both of these medications can be dangerous if used incorrectly. Another promising treatment is Vitamin C IV infusions. This is one of my favorite therapies and appears to be benefiting COVID-19 patients. 

MY: We're social distancing and doing all we can to stay healthy, but if we happen to get sick, what steps should we take or what do you recommend?

KB: If you develop a fever or dry cough, please stay home, self-quarantine from friends and family as much as possible, and contact your doctor for a telemedicine visit. Most infected individuals will only have mild-to-moderate illness, meaning they can recover at home with rest and time.

It can be very unclear what qualifies as moderate versus severe, so it is very important that you have a conversation with your doctor about when to call 911 or drive to an ER. Contact your doctor and outline a plan for yourself.