If you haven’t already come down with coronavirus, you’re probably wondering what your chances are of a.) contracting it, and b.) becoming seriously ill or, God forbid, dying from complications.

I wonder that too, so I’ve been digging in the research to find answers. Here’s what I found.

Update on Coronavirus facts worldwide as of Tuesday, April 7, 2020:

• Currently, 1,363,303 people in the world are confirmed infected (95% mild cases)

• Over 290,000 have recovered.

• 76,403 people have died.

Among people 50-69 years:

• 20-30% are hospitalized

• Death rate is 1-3% depending on country

Among people 70-85 years:

• 30%-55% are hospitalized

• Death rate ranges from 4-10% world wide

Read details on coronavirus from the World Health Organization here.

According to this interesting article, which attempts to outline the reasons for increased risk with advancing age, the older we are, the more likely we are to both contract and become ill with coronavirus, as you can see in the above numbers.

But, those with underlying medical conditions such as hypertension, diabetes, and heart and lung disease are at higher risk for serious illness and death.

WE ARE ALL AT RISK. IF OVER 50, THE RISK INCREASES WITH EVERY DECADE OF LIFE. We cannot afford be complacent because we think we’re healthy with “no underlying medical conditions.” At any age!

Being female

Being female gives us a bit of a leg up. Women do contract coronavirus, and can become seriously ill and die, but men are affected more often in almost every country reporting male vs female statistics. Reports from Italy state that men become sick and die almost twice the rate of women in that country.

We’re not yet sure about numbers in the US and the UK, as they haven’t reported their stats to reflect gender differences of those contracting the virus or those dying, according to Global Health 50/50, a London-based research institute promoting gender equality in health care around the world, which is collating and keeping track of gender disparities in COVID-19 - the disease caused by coronavirus. However, we assume that trends will be similar, once the data are collected and/or published.

Overwhelmingly, in the countries that report gender information on those who have died of COVID-19, males outnumber women. Here in Bermuda, where I live, we have 39 cases (population approximately 64,000), 6 in hospital, and have had 2 deaths. Gender breakdown of the hospitalized patients has not been provided, but of the infected cases, men out-number women; the average age of hospitalized patients is 74.

So, it appears that being female helps, but our risk isn’t zero.

Why are women advantaged? It’s too early to tell for sure, but theories such as ‘more male smokers,’ ‘men longer before seeking medical attention,’ and ‘women may be protected by estrogen’ have been postulated.

What if you’re female and suffer from ‘underlying medical conditions’ - such as hypertension, diabetes, heart and lung disease, or cancer?

The exact answer to this question is difficult to uncover, as gender differentiation is often not made. But the assumption is that women with underlying medical conditions who fall ill with coronavirus will also run a greater risk of ICU admission and death.

Over 50, female, and healthy

Well, first of all, what does ‘healthy’ really mean? Does it simply mean being free of a medical diagnosis? Not taking medications? Looking and feeling okay?

I’m intrigued by this question, especially when we see news reports of young people “fit and well” who succumbed to the virus for no apparent reason. How healthy were they…really?

What was their diet like, did they exercise, how did they sleep, how stressed were they, did they smoke or vape, what was their fasting insulin level, were they anaemic, what was their Vitamin D level, and magnesium? and zinc? How healthy was their gut?

How healthy was their IMMUNE SYSTEM?

More important details, such as a genetic link, may come to light at some point in the future, but at the moment, it’s a mystery. One thing is certain, SOMETHING IS AMISS - in both the sick, elderly population and in the seemingly well, younger people who are dying in greater and greater numbers as COVID-19 marches around the globe.

In terms of the odds of coming down with COVID-19, we are all humans and it is a novel virus and a very contagious one, meaning we are all at risk of getting it. In fact, it’s been suggested that 80% of the population of the US and UK will be exposed to coronavirus before this pandemic is over.

Who will shrug it off and who will get seriously ill? This is a question that haunts us all.

What makes a person vulnerable to infection?

Genetics

A French study looking at a number of variables in population immunity found that genes express unique, individualized responses to bacterial and viral exposures. That means you and I may respond differently to the same infection based on our inherited immunity. One of us may not show symptoms to something like coronavirus, and one of us may fall.

Age and Gender

The same study looked at different age groups and both genders and noted differing immune responses based on age and sex. In this case, older men are falling victim most often.

Infection History

Again, in the French study above, people who had been previously infected with certain viruses were left more susceptible to infections. That could be any of us.

Chronic Inflammation (Lifestyle)

We now know that people with conditions like diabetes, heart disease, high blood pressure, chronic lung conditions and cancer get sick and die from coronavirus at a much higher rate than the rest of the population. All of these diseases have a common denominator: inflammation.

Aging, in and of itself, is underpinned by “inflammaging,” the low-grade, creeping, whole-body inflammatory state that happens over years of wear and tear. And…some would argue…neglect.

Chronic inflammation, which starts with the immune system, disrupts blood glucose metabolism, increasing levels of both glucose and insulin, which further disrupts the immune system’s response to pathogens in a vicious cycle scenario. The more inflammation, the higher the glucose level, the higher the insulin response, and the higher the inflammation levels.

How does chronic inflammation increase your risk of complications of COVID-19? Think of chronic, low-level inflammation as smouldering embers, gradually eating away and damaging cells, tissues and organs little by little, over time. It also disrupts the vital communication between immune cells, slowing down the response to infection, in some cases, over-reacting in others.

If a person ALREADY has elevated levels of inflammation in the body, then contracts COVID-19 and becomes ill, he or she will be at higher risk for the cytokine (immune cell) storm that makes it such a challenge to recover from the illness. An already weak and damaged heart and lungs makes it nearly impossible.

The end stages of severe COVID-19 are pneumonia, anaemia, and heart and lung failure caused by an over-reaction of the immune system called 'the cytokine storm’ - which is basically an inappropriate out-pouring of anti-inflammatory cells as a reaction to the coronavirus infection. So, you can see how a person who had borderline metabolic, heart and lung function at baseline would go downhill rapidly and require intensive care support.

Current reasoning is that some unlucky souls may have had 2 or more factors that contributed to them becoming suddenly, critically ill with coronavirus: unfavourable genes, male gender, advanced age, and/or chronic inflammation and a weakened immune system. Or all of the above.

You can now picture the perfect storm.

Sources of inflammation in seemingly healthy people:

• Obesity - especially belly fat (fat cells are little factories of inflammation!)

• Diet high in sugar, refined carbohydrates (junk food), and industrial seed oils (used as preservatives in processed food)

• Nutrient deficiencies - particularly magnesium, Vitamins D and K, omega-3 fatty acids and fibre

• Physical inactivity/sedentary lifestyle

• Insomnia or unrestorative sleep

• Chronic stress

• Depression

• Smoking/vaping (among it’s other dangers, smoking affected gene expression in the French study above, and not in a good way)

• Environmental toxins - air, water, food

• Electromagnetic fields (EMFs) - high frequency wireless technology, currently under study

How do you know if you have chronic inflammation even if you’re considered healthy?

• Constant fatigue and insomnia

• Persistent aches and pains

• Depression, anxiety , moodiness

• Gastrointestinal symptoms like constipation, diarrhea, and acid reflux

• Weight gain, especially belly fat

• Rashes, hives, acne

• Frequent infections, colds, flus

• Your doctor may order blood tests such as complete blood count, ferritin and uric acid levels, C-reactive protein, interleukin-6, or fibrinogen levels. But I can tell you from clinical experience, many a patient has come into my office with all the symptoms and signs of chronic inflammation, and the tests have been normal. Plus, it may not be easy to get your physician to order these tests at the moment. You don’t need them. Listen to your body.

Sisters over 50! Here’s how to tip the COVID-19 odds in your favour:

To summarize - we know that we may be at increased risk of nasty complications of COVID-19, when and if we catch it, simply because of our age over 50. We may also be at risk because of our inherited, individual genetic make-up, but we are protected somewhat by our female gender. Finally, we may or may not be at risk depending on our personal health status and how much inflammation has built up over the years, which translates to how well our immune system will be able to handle the virus.

Confusing? Let’s break it down.

• Age and gender - we can’t do much about either. They are what they are and we’ll have to take the good with the bad (wink).

• Work with your genes - It’s true, we’re born with a set of genes that are passed down from our parents and are unique to us as individuals. But OUR GENES ARE NOT OUR DESTINY! This exciting idea comes from the study of epigenetics, which is revealing new information all the time about the myriad ways we can TURN ON our good genes and TURN OFF our bad genes by the lifestyle choices we make. So the best thing you can do to reduce your anxiety about having a genetic risk for COVID-19 complications or anything else (breast cancer and Alzheimer’s spring to mind) is to clean your genes. Get this awesome book to show you how!

• Reduce systemic inflammation - start now, it’s never too late. Reducing your body’s inflammation load crosses over with cleaning your genes! The very same anti-inflammatory lifestyle choices you make to support your immune system will be the same ones that will nurture your genes. It’s a win-win-win. Check out past posts here and here where I detail all the steps for leading an anti-inflammatory lifestyle, with a focus on gut health where it all begins. Of prime importance is cutting sugar and removing highly processed industrial seed oils from your diet - as these foods are pro-inflammatory.

• Continue to protect yourself from exposure - I know you know all of this:

  • WASH YOUR HANDS OFTEN with soap and water, for at least 20 seconds, or use hand sanitizer containing at least 70% ethyl alcohol

  • Avoid sick people

  • Avoid dense crowds or crowded places - this is a moot point, as most of us are sheltering now

  • Wear a face covering or mask when out or as recommended by your health authority

  • Avoid touching your face, mouth, nose, eyes

  • Obey your local government’s guidelines and recommendations about staying home, social distancing, lock-downs and closures.

  • US Centers for Disease Control (CDC) is recommending the following to prevent spread of COVID-19/Coronavirus: self-observation and self-monitoring for symptoms such as fever, cough, difficulty breathing, and self-isolation for 14 days if you have travelled. If you are sick, or think you may have been exposed to influenza or coronavirus, stay at home and call your doctor’s office for guidance.

You are at increased risk because of your age, yes.

But, if you follow these guidelines, you can rest assured that you are doing ALL YOU CAN to both protect yourself from exposure to coronavirus, and to build a shield by reducing systemic inflammation and strengthening your immunity.

Stay well and stay vibrant!

*Here’s an AMAZING resource website for information on functional medicine (nutrition and lifestyle) approaches to COVID-19 from one of my gurus and Director of Functional Medicine for the Cleveland Clinic in Cleveland, Ohio, DR MARK HYMAN: www.drhyman.com/c19