Allergy and COVID-19

Symptoms of flu, cold, and allergy are quite similar to those of COVID-19, so with every cough and sneeze, people wonder whether they have been infected with the coronavirus. Allergies normally cause symptoms such as runny nose and sinus but generally do not result in fever, as is mostly seen with COVID-19 or flu.

Bangladesh is a developing country with 150 million population. About 20% to 25% of population is suffering from different types of allergic disorder. They suffer almost all year round from different kinds of symptoms. 

Allergy vs COVID 19:

COVID-19 is a highly contagious and viral disease which can spread via air, respiratory droplets, or close personal contact. The symptom onset is around 2-14 days after exposure to the virus. Allergies on the other hand is a non-contagious hypersensitive reaction to the immune system when one is exposed to their trigger or allergen such as pollen, dust, mold, etc. Allergy symptoms are usually more localized, ranging from mild to severe, and can occur seasonally or be present year-long.

For instance, a patient with COVID-19 may have a fever, body aches, chills, a sore throat, weakness, and respiratory symptoms, while someone with allergies will be more likely to have the symptoms centered on the eyes, nose, and throat, and they usually don’t have a fever. Furthermore, in cases of allergy, symptoms improve when administering antihistamines but this does not help patients with COVID-19.

Although some coronavirus symptoms are similar to allergies, there are many variations. The image below from the CDC compares symptoms caused by allergies and COVID-19.

Some key points to differentiate allergies from COVID-19:

People often suffering from allergies have a personal history of allergy from allergens like food, pollen, dust, etc, and other atopic diseases. They may also have had previous similar allergy attacks or have a family history of atopy or allergy. COVID-19 is an extremely viral and contagious virus that can spread from person to person without any personal history. 

Allergies typically make people itchy which is not a symptom for COVID-19. People with allergies may also have asthma which can cause coughing, breathlessness, chest pain and tightness, and wheezing. Even though most are similar symptoms, COVID-19 typically does not develop wheezing.

Allergy symptoms can be treated with allergy medication like antihistamines and steroids. On the other hand, there is yet no proven medication or vaccine that can cure COVID-19.  

Some study shows the clinical course of COVID in allergic patients is associated with a worsening of allergies, for example, exacerbation of asthma. Even so, a clear understanding of COVID-19 infection in allergic patients compared to non-allergic patients is limited, and more clinical evidence is needed.

CDC recommends wearing masks as masks also offer some protection against seasonal allergies because they can prevent some larger particles from being inhaled. Discard your masks after each use, particularly if you suffer from seasonal allergies, because the covering may carry particles such as pollen.

The best way to prevent or treat allergy symptoms is to avoid the allergen. On the other hand, the best way to prevent COVID 19 infection is wearing masks, washing hands for at least 20 seconds, and maintaining social distancing. Finally, anyone who has any illness or symptoms must make sure to quarantine at home to avoid spreading the germs.

What You Need to Know About the Flu and How to Stay Safe This Season

Flu season is right around the corner and this year we are facing it amidst the COVID-19 pandemic. The flu may not be seen as the same kind of threat as COVID-19 but for some, it can be just as deadly and up to 650,000 people around the world succumb to it every year. Preventing the flu is always important, but it is especially crucial now when we are already fighting COVID-19. 

The flu has very similar symptoms to COVID-19 such as fever, nasal congestion, headaches, and severe muscle weakness and tiredness. This may lead to an increased number of unnecessary hospital admissions due to the fear of getting COVID-19. Fortunately, the same measures that help prevent the spread of the COVID-19 can also help prevent spread of the flu – washing hands often with soap and warm water for at least 20 seconds or using an alcohol-based hand sanitizer, avoiding touching our face, eyes, nose, and mouth with unwashed hands.  

When the novel coronavirus was discovered, almost immediately, the global public health and pharmaceutical communities started working on a vaccine as it is the best way to overcome any public health emergency. Unfortunately, vaccine development does take time, and even once the vaccine is developed, it will take time for it to be manufactured and distributed globally. In the case of the flu, we have both the time and foresight to prepare ourselves, and fortunately, we already have a vaccine to prevent this disease from deepening the losses we have suffered.

The best way for us to fight the flu is by getting the flu vaccine before the winter season starts. While the flu vaccine won’t protect us from developing COVID-19, it will reduce the chances of getting the flu and strengthen our immune system. There are four human coronaviruses – 229E, NL63, OC43 and HKU1 that account for about 15% of common colds in humans. Adults may be infected with one of these on average every 2-3 years, such that there could be a degree of pre-existing cross-reactive immunity to SARS-CoV-2 antigens in these people. It is possible that those susceptible to developing severe COVID-19 disease might benefit from the flu vaccination. 

Even if the vaccine doesn’t guarantee complete prevention from the flu, it can decrease the chances of us experiencing severe symptoms, and people older than six months can and should get the vaccine. Here are a few facts to know about the flu vaccine:

  • It decreases the risk of getting the flu.  
  • It does not increase the risk of getting COVID-19 and might be even be beneficial especially for those at risk for developing severe COVID-19.
  • It decreases the burden on frontline healthcare workers such as our doctors and nurses, who are already overstretched taking care of COVID patients by reducing the number of people who will get the flu and require hospital admission. 
  • The flu strain changes every year so researchers work to evaluate which strains are the ones that are most likely to affect the population and so if you were vaccinated last year, it does not mean you will be protected this year.
  • The best time to get the flu vaccine is before winter around September or October.

With the flu season now only a few weeks away, we must prepare for the challenges it will bring for us and our community. You can get your flu vaccine shot at Praava or talk to your family doctor via video consultation if you think you are showing symptoms of the flu. Stay informed and stay healthy this flu season.

Food for our mood: our ‘second brain’ in the gut

As the COVID-19 pandemic stretches on, the bad news is that the disruption in our daily lives, relationships, and workplaces is taking a mental toll. We are all faced with different manifestations of mental challenges such as increased irritability, emotional exhaustion, exacerbation of pre-existing conditions, poor concentration, and poor sleep.

The good news is that stress and feelings associated with it are not a sign of weakness, but a normal reaction to difficult times and can be managed. We can adopt several ways to improve our mood and cope with stress. One solution, well documented and backed by research, is to maintain a nutritious, well-balanced diet that can improve brain function, shore up immunity, lower blood pressure, improve circulation and reduce toxins from the body.

When we speak of diet and health, we usually think of it as prevention for illnesses such as heart diseases, diabetes, cancer, obesity, and so on. We rarely and consciously relate diet with our mood. But food has a major impact on our everyday mood changes. Specific nutrients play a very important role in reducing the levels of cortisol, adrenalin, and the stress chemicals in our body that activate fight and flight response. The nutrients such as complex carbohydrates, proteins, iron, vitamin B and C, magnesium, selenium, and omega 3 fatty acids play a very specific and significant role in helping improve our mood and reducing stress levels.

Fuel for the body and mind – how does it work?

The major constituents of our usual diet – proteins (e.g. meat, fish, eggs, pulses, beans), carbohydrates (e.g. rice, potatoes, bread, pasta), and fats (e.g. cooking oil, ghee, butter) serve not only as an energy source but as precursors to a variety of neuro-active substances.

When we do not take enough nutrient-rich foods, our body may lack vital vitamins and minerals, often affecting our energy, mood, and brain function. Several nutritional deficiencies, such as vitamin B9 (folate), B12, and zinc can cause symptoms of depression and dementia such as low mood, fatigue, cognitive decline, and irritability.

The brain is an organ with very high metabolic and nutrient demands. On average, the brain consumes 20% of a person’s daily caloric intake, approximately 400 calories per day. It is composed of 60% fat and contains high concentrations of cholesterol and polyunsaturated fatty acids (PUFAs) such as omega-3s.

Our brains need an adequate supply of energy that is needed to help us concentrate and focus. This energy comes from glucose in our blood. We get that glucose from the carbohydrates – mainly bread, rice, potatoes, sugars, cereals also from fruits, vegetables, and lactose in milk.

Regular meals containing carbohydrate ensures we have enough glucose in our blood. It is important to ensure we are eating healthy sources of complex carbohydrates such as whole grains, vegetables, fruits, legumes, and low-fat dairy.

Another name to keep in mind is serotoninthe chemical messenger in the brain that controls various body functions including appetite, body temperature, libido, and mood. Serotonin is made with a part of protein from the diet (tryptophan) and the more carbohydrate-rich food we consume, the higher amount of serotonin that may find its way to our brain.

Serotonin is considered to be the brain’s natural ‘feel good’ chemical and appetite suppressant. Complex carbohydrates take a longer time to get digested and, therefore, keep a person calm for a longer time. Complex carbohydrates also stabilize blood sugar levels.

Why do we crave sweets?                                            

The concept is not to have a lot of sugar to improve our mood but to have an adequate amount of complex carbohydrates to ensure a normal level of glucose for the brain.

By adequate amount we mean, about 130 grams/day of carbohydrate is required to supply the energy demands of the brain (e.g 1 slice of bread = 15 grams of carbohydrate, 100 grams of cooked rice = 30 grams of carbohydrates).

So, there is no need to have excess or refined sugar (added sugar from cakes, biscuits, pastries, fruit juices) from processed foods. Research indicates a diet high in sugar is linked to lower levels of brain-derived neurotrophic factor (BDNF) without which our brain is unable to learn new things and form new memories. BDNF is low in people suffering from diabetes and also pre-diabetes. Lower levels of BDNF is also linked to depression and dementia.

Obesity is linked to chronic consumption of added sugar because obesity reduces the activity of anorexigenic oxytocin system which is responsible for ‘telling’ us when to stop eating or not to overeat.

Certain vitamin and mineral deficiencies affect brain function and mood

Iron: Iron deficiency anemia leads to lethargy and weakness. Adequate iron can be obtained from red meat, poultry, and fish, beans and pulses, fortified cereals. Avoiding tea and coffee with meals may also be helpful.

Omega 3 fatty acids: The brain needs omega 3 fatty acids for the formation of healthy nerve cells. Research shows they are associated with a lower risk of depression. Sources of omega 3 fatty acids can be oily fish, nuts, and seeds like flax and chia seeds, walnuts, soybean, and canola oil.

All vitamin Bs: Deficiencies impact the nervous system and lead to stress-related symptoms such as irritability, lethargy, and depression. B vitamins maintain regular blood sugar levels, keeps energy, and mood stable. B3 (Niacin) deficiencies may lead to disorientation and depression. B5 (pantothenic acid) improves coping mechanisms. B9 (folate) relieves stress, anxiety, panic, and even depression. B12 (cobalamin) eases mood changes. Sources include yeast, meat, poultry, legumes, kidney beans, wholemeal bread, broccoli, Brussels sprouts, dark green cabbage, peanuts, peas, egg yolks, and green leafy vegetables.

Vitamin C: Both emotional and physical stress depletes vitamin C status in the body and reduces its resistance to infection and disease. Vitamin C supports adrenal glands allowing quicker recovery and lower fatigue levels. Rich sources include guava, pepper (capsicum), oranges, lemon, strawberries, tomato, papaya, and broccoli.

Magnesium: Stimulation of stress hormone from both physical and psychological stress increases magnesium depletion from the heart and other vital organs increasing dietary requirements for magnesium. Research indicates magnesium reduces stress and anxiety and improves the quality of sleep. Green leafy vegetables, such as spinach, legumes, nuts, seeds, and whole grains include magnesium.

Zinc: Depression and zinc are related as it activates neurotransmitters signaling pathway in the gut which regulates brain functions like appetite, sleep, neurogenesis, cognitive function, and mood. Oysters, red meat, poultry, chickpeas, and nuts (cashew and almonds) are excellent sources of zinc.

There is a strong link between our diet and mood, but it is specific to each individual and compounded by specific health issues. But one message is clear, by keeping an eye on what we eat we can stop emotional eating from stress and choose healthier alternatives.

This article was published in The Daily Star authored by Tazreen Yusuf Mallick, Praava Health’s Nutritionist. She also worked in the NHS, United Kingdom as a registered clinical dietician.

COVID-19: Message from Praava Health Chairman & Founder Sylvana Sinha

Across the world and at home in Bangladesh, as the global pandemic of the novel coronavirus continues to evolve, these are uncertain times. We at Praava Health want to share with you a personal message from our Founder & Chairman, Sylvana Q. Sinha. Ms. Sinha shares some important information on the COVID-19 pandemic, how the virus spreads and means of prevention, how Praava is caring for you and your loved ones, and above all, being good to ourselves and staying calm as we brave through this together.

To avoid coronavirus, wash your hands often with soap and warm water for at least 20 seconds, or use an alcohol-based hand sanitizer. Avoid touching your face, eyes, nose, and mouth with unwashed hands. Practice social distancing, which is deliberately increasing the physical space between you and others to avoid contracting or spreading illness. Staying at least 3 feet away from other people lessens your chances of catching COVID-19.

If you think you need to be tested, directly contact the government lab IEDCR at 01937000011, 01937110011, 01927711784, 01927711785. Government-approved hospitals for suspected coronavirus patients are Kuwait Bangladesh Friendship Government Hospital (Uttara, Dhaka), Bangladesh Railway General Hospital (Kamlapur, Dhaka), Dhaka Mahanagar General Hospital (Motijheel, Dhaka), Mirpur Maternity Hospital (Mirpur, Dhaka), Kamrangirchar 31 Bed Hospital (Lalbagh, Dhaka), Aminbazar 20-bed Hospital (Savar), Jinjira 20-bed Hospital (Keraniganj), Sajida Foundation Hospital (Jurayn, Dhaka), Dhaka Medical College and Hospital, Sheikh Rasel Gastro Liver Institute & Hospital (Mohakhali, Dhaka), and National Institute of Diseases of the Chest and Hospital (NIDCH).