How Much Should You ‘Expose’ Yourself During This Pandemic
By: Jonathan Adrian
Tags: Healthcare, Health, Science, Medicine, Coronavirus

How Much Should You ‘Expose’ Yourself During This Pandemic

Striking the delicate balance between staying-at-home and basking in the outdoors

Photo by Sara Bertoni

We are just a couple months shy of the 1-year mark since the first case of Covid-19 was reported. During these past months, human understanding of the disease and how the virus operates has changed dramatically, but much of research is still inconclusive — owing partly to the fact that it’s nearly impossible for science to prove anything in such a short period of time — leaving us with a laundry list of “expert” advice and protocol, most of which is leading to massive public confusion, some even contradictory in nature.

One of the hottest areas of debate of late is on the argument of how much “exposure” can be considered safe. I say the word “exposure” blatantly because truth be told, everyone lives their lives everyday with a certain level of exposure risk depending on how they operate. There is no such thing as one hundred percent protection, even if you wash your house down with antiseptic and wear hazmat suits to commute — the odd chance of coming into contact with viral particles looms wherever you go. Exposure is all around us and therefore an inevitable part of pandemic life. Each exposure strata comes with their own unintended consequences, as we’ll explore in the following paragraphs.

This sizzling discourse on the topic of “exposure” is based on the understanding that the world’s economy rotates around the pre-pandemic lifestyle, where humans bustle down crowded theme parks, commute like sardines in a can, and crowd nightclubs and bars like elephant seals during the winter. Returning to what we considered normal would dramatically improve the world’s economy and quality of life, especially in low-income nations and poverty-stricken communities, where recession is synonymous to the idea of doomsday. The obvious downside to this is seeing the risk of exposure skyrocket, taking the number of cases up with it.

On the flip side, relinquishing the pre-pandemic lifestyle (i.e working from home) would certainly slow down the turning of our global economy’s wheels — at least until we figure out a way to get around this quandary — but it would also significantly reduce the risk of exposure and hence curb the spread of SARS-CoV2.

Most people tend to resonate with the latter, since it buys time for researchers to push more effort for prevention methods (i.e vaccinations), but there is a growing herd of desperate radicals willing to surrender safety and give option 1 a trial run. They argue that if herd immunity is what humanity is aiming for, shouldn’t they just get it over with quickly and expose themselves to the virus now — like parents traditionally would with chickenpox parties?

While some healthcare experts agree in the basic logic and potential appeal of the idea, based on the disease pattern that we have observed within the year, it’s a bad idea for two main reasons, you could kill yourself or your loved ones, and you could overwhelm the healthcare system.

Fellow physician Dr. Keith Armitage, who specialises in infectious diseases, said the number of deaths in the US would be exponentially higher if more people took this approach. It’s true that the percentage of people who die would be comparatively low (~1%), but the United States has nearly 330 million people. One percent of 330 million is 3.3 million. “I think to get to 80 percent herd immunity could lead to more than a million deaths in the United States,” Armitage said.

To further supplement the counterargument for this viewpoint is that scientists are still not sure how long the antibodies acquired through infection will last. There has been a body of largely contradicting evidence on this, after following patients who were exposed to SARS-CoV2 and have recovered, checking in regularly to test for the antibody levels in their system. An early study showed that immunoglobulin levels declined rapidly after weeks, another one demonstrated the decline later at 3–4 months. These findings show that reinfection after contracting Covid-19 is possible, even though other experts argue however that the mechanism behind antibody preservation may be more complex than that, reflecting a less dire reality.

Paediatrician Dr. Amy Edwards says that efforts to manage the pandemic has never been about stopping Coronavirus. It’s a wave we will all eventually ride out. “This was never about stopping coronavirus”, she says, “what this was about was making sure we had enough hospital capacity to keep coronavirus from overwhelming us.”

And this premise led to the birth of potentially harmful advice that if practiced under misguided interpretation, can lead to damaging repercussions. 3 words: Stay. At. Home.

Staying at home is not bad advice, in fact, it’s necessary to curb infection rates. It is, however, riddled with associations — such as long days in bed or in front of screens — that can actually prove detrimental to health.

Houses with poor ventilation can actually serve as fertile breeding grounds for respiratory infections, if not those caused by the novel Coronavirus, then by other offending pathogens such as bacteria and fungi — pathogens we know are easily killed under sunlight and adequate ventilation. The worst-case scenario is having a Covid-19 infection on top of a bacterial focus already brewing in your lungs — something called a superinfection — which can dramatically decrease your survival odds.

Staying at home does not always mean staying indoors, but that’s how I think the general public mostly perceives it. This is particularly true for apartment and flat residents, who find it a constant challenge to place themselves in an open area sans the fear of bumping into someone else. Sunlight exposure is absolutely vital in our fight against the Coronavirus. A handful of journals and research papers, including those published before the advent of Covid-19 have demonstrated the anti-inflammatory potential of sun-acquired vitamin D.

Vitamin D can be fortified in food sources or be activated in our body with the aid of UV light from the sun and works in a myriad of ways within the human body. Vitamin D helps regulate multiple organ functions on a cellular level, such as maintaining bone health, supplementing macronutrient absorption, and modulating the immune system.

A 2012 paper demonstrated that vitamin D can modulate the innate and adaptive immune response by synthesizing active metabolites that can aid in cellular signaling function after researchers discovered vitamin D receptors being expressed on the surface of immune cells.

In addition to immune system modulation, deficiency in vitamin D has also been observed in patients with depression. Scientists have yet to pinpoint the exact causality, but it is thought to be a combination of vitamin D’s direct effects, sunlight exposure, age, and a well-balanced diet — all of which can alter the levels of vitamin D in our body and affect mood as well. But behind all the uncertainty, Medscape argues that vitamin D may be low-hanging fruit in managing this pandemic. While you shouldn’t mindlessly load up with vitamin D, 10–30 minutes of morning sunlight exposure and a good diet is generally a good practice to ensure adequate levels in your body.

Staying at home can also encourage a sedentary lifestyle, which isn’t good for you on so many levels. Mindful exercise does not only lead to improved immune system functioning, it also regulates the cardiovascular system and prevents dangerous clots from clogging up your arteries, especially if you have a pre-existing health condition such as hypertension. It is therefore just as crucial for you to pay attention to your physical activity during the pandemic.

Research has proven time and time again that regular exercise improves general health (including your immune system) and mood. It’s important to stay active during times like these, and unless you’re one of those folks living in a mansion with an indoor gym, it’s difficult to consistently get a good workout in at home. WHO recommends exercising outside to rake in the additional benefits from sunlight and fresh air, and even advocates a no-mask policy during outdoor exercise so long as physical distancing is practiced.

Staying at home can also indirectly encourage longer screen times, which can be detrimental for long-term eye health, especially in children. Optometrist Jonathan Andrews says that “prolonged near work and decreased outdoor activities can increase myopic progression in children.”

Fellow optometrist Glenn Steele sustains a similar opinion. “For an adult with eye strain, we will most of the time get up and move around. Children will push on through that,” Steele said. “Now with the pandemic, all kids have for communication is through screens. I think there are things beyond eye strain that we have to watch out for, one of which is helping kids regulate when do they take breaks. It’s important for parents to help kids learn to take breaks for the future of their vision.”

But added screen time does not just pose risks against eye strain and myopia, blue and violet light emitted from most modern gadgets can alter Circadian rhythms and disrupt sleep, which is when our body recuperates and does the lion’s share of cellular and tissue repair.

Steele advices taking frequent breaks when viewing screens (20 seconds for every 20 minutes), ensure appropriate distancing (1 feet for mobile devices, 2 feet for laptops, and 10 feet for TVs), designating curfew for screen use, and encouraging physical activity and time spent outdoors.

Spending a portion of your day outside of the home can actually provide benefits that bound better than staying within the confines of your living room — a message I’m hoping to deliver to the most radical and hardcore stay-at-home advocates. Your advice and practices could in fact be damaging not only to yourself but your entire household.

That being said, I’m not advocating mindless public excursions. It’s already hard enough to navigate and sift through all the misinformation circulating in the air, and so I understand how easily people can be discombobulated by difficult-to-understand advice. That being said, I invite readers to treat advice with common sense and only practice those formulated on the grounds of a sound scientific basis.

As with how things are currently going, it’s good to always keep yourself physically distanced from one another in public (> 1 meter), avoid crowds, wear masks, and uphold good hygiene practices.

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