What immunocompromised people want you to know

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While many people in the U.S. have abandoned COVID-19 mitigations like vaccines and masking, the virus remains dangerous for everyone, and some groups face higher risks than others. Immunocompromised people—whose immune systems don’t work as well as they should due to health conditions or medications—are more vulnerable to infection and severe symptoms from the virus. 

Public Good News spoke with three immunocompromised people about the steps they take to protect themselves and what they want others to know about caring for each other.

[Editor’s note: The contents of these interviews have been condensed for length.]

PGN: What measures have you been taking to protect yourself since the COVID-19 pandemic began?

Tatum Spears, Virginia

From less than a year old, I had serious, chronic infections and have missed huge chunks of my life. In 2020, I quit my public job, and I have not worked publicly since. 

I have a degree in vocal performance and have been singing my whole life, but I haven’t performed publicly since 2019. I feel like a bird without wings. I had to stop traveling. Since no one wears a mask anymore, I can’t go to the movies or social outings or any party.

All my friends live in my phone now. It’s a community of people—a lot of them are immunocompromised or disabled in some way. 

There are a good portion of them who just take COVID-19 seriously and want to protect their health, who feel the existential abandonment and the burden of all of this. It’s really isolating having to step back from any sort of social life. I have to assess my risk every single time I leave the house.

Gwendolyn Alyse Bishop, Washington 

I was hit by a car when I was very young. I woke up from surgery, and doctors told me I had lost almost all of my spleen. So, I was always the sickest kid in my school.

When COVID-19 hit, I started working from home. At first, I wore cloth masks. I didn’t really learn about KN95 masks until right around the time that COVID-19 disabled me. [Editor’s note: N95 and KN95 masks have been shown to be significantly more effective at preventing the transmission of viral particles than cloth masks.]

I actually don’t get out much anymore because I am disabled by long COVID now, but when I do leave, I wear a respirator in all shared air spaces. My roommate and I have HEPA filters going in every room.

And then we test. I have a Pluslife testing dock, and so we keep a weekly testing schedule with that and then test if there are any symptoms. I got reinfected [with COVID-19] last winter, and a Pluslife test helped me catch it early and get Paxlovid. [Editor’s note: Pluslife is a brand of an at-home COVID-19 nucleic acid amplification test, which has been shown to be significantly more effective at detecting COVID-19 than at-home antigen rapid tests.]

Abby Mahler, California

I have lupus, and in 2016, I started taking the drug hydroxychloroquine, which is an immunomodulator. I’m not as immunocompromised as some people, but I certainly don’t have a normal immune system, which has resulted in long-term infections like C. diff.

I started masking early. My roommates and I prioritize going outside. We don’t remove our masks inside in public places. 

We are in a pod with one other household, and the pod has agreements on the way that we interact with public space. So, we will only unmask with people who have tested ahead of time. We use Metrix, an at-home nucleic acid amplification test.

While it’s not easy and it’s not the life that we had prior to COVID-19’s existence, it is a life that has provided us quite a lot of freedom, in the sense that we are not sick all the time. We are conscientiously making decisions that allow us to have a nice time without a monkey on our backs, which is freeing.

PGN: What do you want people who are not immunocompromised to know?

T.S.: Don’t be afraid to be the only person in a room wearing a mask. Your own health is worth it. And you have to realize how callous [people who don’t wear a mask are] by existing in spaces and breathing [their] air [on immunocompromised people].

People think that vaccines are magic, but vaccines alone are not enough. I would encourage people to look at the Swiss cheese model of risk assessment. 

Each slice of Swiss cheese has holes in it in different places, and each layer represents a layer of virus mitigation. One layer is vaccines. Another layer is masks. Then there’s staying home when you’re sick and testing.

G.A.B.: I wish people were masking. I wish people understood how likely it is that they are also now immunocompromised and vulnerable because of the widespread immune dysregulation that COVID-19 is causing. [Editor’s note: Research shows that COVID-19 infections may cause long-term harm to the immune system in some people.]

I want people to be invested in being good community members, and part of that is understanding that COVID-19 hits the poorest the hardest—gig workers, underpaid employees, frontline service workers, people who were already disabled or immunocompromised. 

If people want to be good community members, they not only need to protect immunocompromised and disabled people by wearing a mask when they leave their homes, but they also need to actually start taking care of their community members and participating in mutual aid. [Editor’s note: Mutual aid is the exchange of resources and services within a community, such as people sharing extra N95 masks.]

I spend pretty much all of my time working on LongCOVIDAidBot, which promotes mutual aid for people who have been harmed by COVID-19.

A.M.: An important thing to think about when you’re not disabled is that it becomes a state of being for all people, if they’re lucky. You will become disabled, or you will die. 

It is a privilege, in my opinion, to become disabled because I can learn different ways of living my life. And being able to see yourself as a body that changes over time, I hope, opens up a way of looking at your body as the porous reality that it is. 

Some people think of themselves as being willing to make concessions or change their behavior when immunocompromised people are around, but you don’t always know when someone is immunocompromised. 

So, if you’re not willing to change the way that you think about yourself as a person who is susceptible [to illness], then you should change the way that you consider other people around you. Wearing a mask—at the very least in public indoor spaces—means considering the unknown realities of all the people who are interacting with that space.

This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • New News From The Centenarian Blue Zones

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    From Blue To Green…

    We sometimes write about supercentenarians, which word is usually used in academia to refer to people who are not merely over 100 years of age, but over 110 years. These people can be found in many countries, but places where they have been found to be most populous (as a percentage of the local population) have earned the moniker “Blue Zones”—of which Okinawa and Sardinia are probably the most famous, but there are others too.

    This is in contrast to, for example “Red Zones”, a term often used for areas where a particular disease is endemic, or areas where a disease is “merely” epidemic, but particularly rife at present.

    In any case, back to the Blue Zones, where people live the longest and healthiest—because the latter part is important too! See also:

    • Lifespan: how long we live
    • Healthspan: how long we stay healthy (portmanteau of “healthy lifespan”)

    Most of our readers don’t live in a Blue Zone (in fact, many live in a COVID Red Zone, a diabetes Red Zone, and a heart disease Red Zone), but that doesn’t mean we can’t all take tips from the Blue Zones and apply them, for example:

    You may be wondering… How much good will this do me? And, we do have an answer for that:

    When All’s Said And Done, How Likely Are You To Live To 100?

    Now that we’re all caught-up…

    The news from the Blues

    A team of researchers did a big review of observational studies of centenarians and near-centenarians (aged 95+). Why include the near-centenarians, you ask? Well, most of the studies are also longitudinal, and if we’re doing an observational study of the impact of lifestyle factors on a 100-year-old, it’s helpful to know what they’ve been doing recently. Hence nudging the younger-end cutoff a little lower, so as to not begin each study with fresh-faced 100-year-olds whom we know nothing about.

    Looking at thousands of centenarians (and near-centenarians, but also including some supercentenarians, up the age of 118), the researchers got a lot of very valuable data, far more than we have room to go into here (do check out the paper at the bottom of this article, if you have time; it’s a treasure trove of data), but one of the key summary findings was a short list of four factors they found contributed the most to extreme longevity:

    1. A diverse diet with low salt intake: in particular, a wide variety of plant diversity, including protein-rich legumes, though fish featured prominently also. On average they got 57% and 65% of their energy intake from carbohydrates, 12% to 32% from protein, and 27% to 31% from fat. As for salt, they averaged 1.6g of sodium per day, which is well within the WHO’s recommendation of averaging under 2g of sodium per day. As a matter of interest, centenarians in Okinawa itself averaged 1.1g of sodium per day.
    2. Low medication use: obviously there may be a degree of non-causal association here, i.e. the same people who just happened to be healthier and therefore lived longer, correspondingly took fewer medications—they took fewer medications because they were healthier; they weren’t necessarily healthier because they took fewer medications. That said, overmedication can be a big problem, especially in places with a profit motive like the US, and can increase the risk of harmful drug interactions, and side effects that then need more medications to treat the side effects, as well as direct iatrogenic damage (i.e. this drug treats your condition, but as the cost of harming you in some other way). Naturally, sometimes we really do need meds, but it’s a good reminder to do a meds review with one’s doctor once in a while, and see if everything’s still of benefit.
    3. Getting good sleep: not shocking, and this one’s not exactly news. But what may be shocking is that 68% of centenarians reported consistently getting enough good-quality sleep. To put that into perspective, only 35% of 10almonds readers reported regularly getting sleep in the 7–9 hours range.
    4. Rural living environment: more than 75% of the centenarians and near-centenarians lived in rural areas. This is not usually something touted as a Blue Zones thing on lists of Blue zones things, but this review strongly highlighted it as very relevant. In the category of things that are more obvious once it’s pointed out, though, this isn’t necessarily such a difference between “country folk” and “city folk”, so much as the ability to regularly be in green spaces has well-established health benefits physically, mentally, and both combined (such as: neurologically).

    See: The health benefits of the great outdoors: A systematic review and meta-analysis of greenspace exposure and health outcomes

    And showing that yes, even parks in cities make a significant difference:

    The association of green space, tree canopy and parks with life expectancy in neighborhoods of Los Angeles

    Want to know more?

    You can read the study in full here:

    A systematic review of diet and medication use among centenarians and near-centenarians worldwide

    Take care!

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  • Nutrivore – by Dr. Sarah Ballantyne

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    The core idea of this book is that foods can be assigned a numerical value according to their total nutritional value, and that this number can be used to guide a person’s diet such that we will eat, in aggregate, a diet that is more nutritious. So far, so simple.

    What Dr. Ballantyne also does, besides explaining and illustrating this system (there are chapters explaining the calculation system, and appendices with values), is also going over what to consider important and what we can let slide, and what things we might need more of to address a wide assortment of potential health concerns. And yes, this is definitely a “positive diet” approach, i.e. it focuses on what to add in, not what to cut out.

    The premise of the “positive diet” approach is simple, by the way: if we get a full set of good nutrients, we will be satisfied and not crave unhealthy food.

    She also offers a lot of helpful “rules of thumb”, and provides a variety of cheat-sheets and suchlike to make things as easy as possible.

    There’s also a recipes section! Though, it’s not huge and it’s probably not necessary, but it’s just one more “she’s thinking of everything” element.

    Bottom line: if you’d like a single-volume “Bible of” nutrition-made-easy, this is a very usable tome.

    Click here to check out Nutrivore, and start filling up your diet!

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  • Barley Malt Flour vs chickpea flour – Which is Healthier?

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    Our Verdict

    When comparing barley malt flour to chickpea flour, we picked the chickpea.

    Why?

    First, some notes:

    About chickpea flour: this is also called besan flour, gram flour, and garbanzo bean flour; they are all literally the same thing by different names, and are all flour made from ground chickpeas.

    About barley malt flour: barley is a true grain, and does contain gluten. We’re not going to factor that into today’s decision, but if you are avoiding gluten, avoid barley. As for “malt”; malting grains means putting them in an environment (with appropriate temperature and humidity) that they can begin germination, and then drying them with hot air to stop the germination process from continuing, so that we still have grains to make flour out of, and not little green sprouting plants. It improves the nutritional qualities and, subjectively, the flavor.

    To avoid repetition, we’re just going to write “barley” instead of “barley malt” now, but it’s still malted.

    Now, let’s begin:

    Looking at the macros first, chickpea flour has 2x the protein and also more fiber, while barley flour has more carbs. An easy win for chickpea flour.

    In the category of vitamins, chickpea flour has more of vitamins A, B1, B5, B9, E, and K, while barley flour has more of vitamins B2, B3, B6, and C. A modest 6:4 victory for chickpea flour.

    When it comes to minerals, things are much more one-sided; chickpea flour has more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and zinc, while barley flour has more selenium. An overwhelming win for chickpea flour.

    Adding up these three wins for chickpea flour makes for a convincing story in favor of using that where reasonably possible as a flour! It has a slight nutty taste, so you might not want to use it in everything, but it is good for a lot of things.

    Want to learn more?

    You might like to read:

    Take care!

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    Quick show of hands, who here practices yoga in some fashion, but does not necessarily always look Instagrammable while doing it? Yep, same here.

    This book is a surprisingly practical introduction to yoga for newcomers, and inspirational motivator for those of us who feel like we should do more.

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    Bottom line: whether for yourself or as a gift for a loved one (or both!) this is a very charming introduction to (or refresher of) yoga.

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  • Blood-Sugar Balancing Beetroot Cutlets

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    These beetroot cutlets are meaty and proteinous and fibrous and even have a healthy collection of fats, making these much better for your heart and blood than an animal-based equivalent.

    You will need

    • 1 can kidney beans, drained and rinsed (or 1 cup same, cooked, drained, and rinsed)
    • ½ cup chopped roasted or steamed beetroot, blotted dry
    • ½ cup chopped walnuts (if allergic, substitute with ¼ cup pumpkin seeds)
    • ½ cup cooked (ideally: mixed) grains of your choice (if you need gluten-free, there are plenty of gluten-free grains and pseudocereals)
    • ¼ cup finely chopped onion
    • ¼ bulb garlic, minced or crushed
    • 2 tbsp nutritional yeast
    • 2 tbsp ground flaxseeds
    • 2 tbsp ground chia seeds
    • 2 tsp tomato purée
    • 1 tsp black pepper
    • ½ tsp white miso paste
    • ½ tsp smoked paprika
    • ½ tsp cayenne pepper
    • ¼ tsp MSG or ½ tsp low-sodium salt

    Method

    (we suggest you read everything at least once before doing anything)

    1) Combine the beetroot, beans, walnuts, grains, and onion in a food processor, and process until a coarse even mixture.

    2) Add the remaining ingredients and process to mix thoroughly.

    3) Transfer the mixture to a clean work surface and divide into six balls. If the structural integrity is not good (i.e. too soft), add a little more of any or all of these ingredients: chopped walnuts, ground flax, ground chia, nutritional yeast.

    4) Press the balls firmly into cutlets, and refrigerate for at least 1 hour, but longer is even better if you have the time. Alternatively, if you’d like to freeze them for later use, then this is the point at which to do that.

    5) Preheat the oven to 375℉ / 190℃.

    6) Roast the cutlets on a baking tray lined with baking paper, for about 30 minutes, turning over carefully with a spatula halfway through. They should be firm when done; if they’re not, give them a little longer.

    7) Serve hot, for example on a bed of greens and with a drizzle of aged balsamic vinegar.

    Enjoy!

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    Take care!

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  • Paving The Way To Good Health

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    This is Dr. Michelle Tollefson. She’s a gynecologist, and a menopause and lifestyle medicine expert. She’s also a breast cancer survivor, and, indeed, thriver.

    So, what does she want us to know?

    A Multivector Approach To Health

    There’s a joke that goes: a man is trapped in a flooding area, and as the floodwaters rise, he gets worried and begins to pray, but he is interrupted when some people come by on a raft and offer him to go with them. He looks at the rickety raft and says “No, you go on, God will spare me”. He returns to his prayer, and is further interrupted by a boat and finally a helicopter, and each time he gives the same response. He drowns, and in the afterlife he asks God “why didn’t you spare me from the flood?”, and God replies “I sent a raft, a boat, and a helicopter; what more did you want?!”

    People can be a bit the same when it comes to different approaches to cancer and other serious illness. They are offered chemotherapy and say “No, thank you, eating fruit will spare me”.

    Now, this is not to trivialize those who decline aggressive cancer treatments for other reasons such as “I am old and would rather not go through that; I’d rather have a shorter life without chemo than a longer life with it”—for many people that’s a valid choice.

    But it is to say: lifestyle medicine is, mostly, complementary medicine.

    It can be very powerful! It can make the difference between life and death! Especially when it comes to things like cancer, diabetes, heart disease, etc.

    But it’s not a reason to decline powerful medical treatments if/when those are appropriate. For example, in Dr. Tollefson’s case…

    Synergistic health

    Dr. Tollefson, herself a lifestyle medicine practitioner and gynecologist (and having thus done thousands of clinical breast exams for other people, screening for breast cancer), says she owes her breast cancer survival to two things, or rather two categories of things:

    1. a whole-food, plant predominant diet, daily physical activity, prioritizing sleep, minimizing stress, and a strong social network
    2. a bilateral mastectomy, 16 rounds of chemotherapy, removal of her ovaries, and several reconstructive surgeries

    Now, one may wonder: if the first thing is so good, why need the second?

    Or on the flipside: if the second thing was necessary, what was the point of the first?

    And the answer she gives is: the first thing was the reason she was able to make it through the second thing.

    And on the next level: the second thing was the reason she’s still around to talk about the first thing.

    In other words: she couldn’t have done it with just one or the other.

    A lot of medicine in general, and lifestyle medicine in particular, is like this. If we note that such-and-such a thing decreases our risk of cancer mortality by 4%, that’s a small decrease, but it can add up (and compound!) if it’s surrounded by other things that also each decrease the risk by 12%, 8%, 15%, and so on.

    Nor is this only confined to cancer, nor only to the positives.

    Let’s take cardiovascular disease: if a person smokes, drinks, eats red meat, stresses, and has a wild sleep schedule, you can imagine those risk factors add up and compound.

    If this person and another with a heart-healthy lifestyle both have a stroke (it can happen to anyone, even if it’s less likely in this case), and both need treatment, then two things are true:

    • They are both still going to need treatment (medicines, and possibly a thrombectomy)
    • The second person is most likely to recover, and most likely to recover more quickly and easily

    The second person can be said to have paved the way to their recovery, with their lifestyle.

    Which is really important, because a lot of people think “what’s the point in living so healthily if [disease] strikes anyway?” and the answer is:

    A very large portion of your recovery is predicated on how you lived your life before The Bad Thing™ happened, and that can be the difference between bouncing back quickly and a long struggle back to health.

    Or the difference between a long struggle back to health, or a short struggle followed by rapid decline and death.

    In short:

    Play the odds, improve your chances with lifestyle medicine. Enjoy those cancer-fighting fruits:

    Top 8 Fruits That Prevent & Kill Cancer

    …but also, get your various bits checked when appropriate; we know, mammograms and prostate checks etc are not usually the highlight of most people’s days, but they save lives. And if it turns out you need serious medical interventions, consider them seriously.

    And, by all means, enjoy mood-boosting nutraceuticals such as:

    12 Foods That Fight Depression & Anxiety

    …but also recognize that sometimes, your brain might have an ongoing biochemical problem that a tablespoon of pumpkin seeds isn’t going to fix.

    And absolutely, you can make lifestyle adjustments to reduce the risks associated with menopause, for example:

    Menopause, & How Lifestyle Continues To Matter “Postmenopause”

    …but also be aware that if the problem is “not enough estrogen”, sometimes to solution is “take estrogen”.

    And so on.

    Want to know Dr. Tollefson’s lifestyle recommendations?

    Most of them will not be a surprise to you, and we mentioned some of them above (a whole-food, plant predominant diet, daily physical activity, prioritizing sleep, minimizing stress, and a strong social network), but for more specific recommendations, including numbers etc, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Take care!

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