Pandemic Resiliency: A Precision Plan

A Precision Plan is a personalized, data-driven and outcome-based plan to optimize one’s health. During a pandemic, “optimizing healthspan” includes a plan for optimal Pandemic Resiliency. Though up to 50-70% of Americans are expected to contract SARS CoV2, Prevention of infection is the goal until we get to vaccination or “herd immunity.” 70-90% of Americans will need to have recovered from the virus for the USA to achieve “herd immunity.” If you can be in the 10-30% of those who never get infected, you can enjoy the inevitable roaring 20s of this century with less complication from this historic pandemic. 

When you study human behaviors during the 1918 Pandemic and the 1968 Pandemic, you will learn from history. Mistrust of government and public health officials is typical during Pandemics. Riots are more common during a Pandemic, too. It is common to be stressed, angry, confused and frustrated about the situation. A smart strategy is to focus on what is within your control…much of what you see on the news and on social media is not in your control. 

Here are some facts about the virus with two strategies to optimize your Pandemic Resiliency Plan. 

Fact: SARS CoV2 is a Novel virus. Novel viruses warrant great concern… humans have NO immunity to a novel virus. Novel viruses can decimate populations if the novel virus has a high lethality and the population is native to the virus. SARS CoV2 is a novel virus. The Case Fatality Rate (CFR) for the virus ranges based on your age and health status. The chances of surviving the infection are highest when our healthcare system is not overwhelmed, too. This is why we hope to “flatten the curve,” hospital systems have better outcomes when we can avoid surges of cases. 

For reference, This is a crude (but still useful link) to assess your current risk of hospitalization or death from infection with the SARS CoV2 virus. You will see that your risk of hospitalization and death from infection is low if you do not have diabetes, high blood pressure, obesity, heart disease or other underlying conditions. Most healthy, young people in their 20s-30s have a risk of hospitalization that is less than 2.5% Can you think of other infections or diseases that correlate with a 2.5% risk of hospitalization for a young, healthy adult in the next year?  The goal for every client of Precision Medical Care is to prevent or delay the onset of a chronic disease that put you at increased risk of complication from infection with the virus. Certainly, the goal is also to reduce one’s risk of complication or hospitalization from acute disease and infection. This article summarizes some reported complications from infection of recovered patients,  (You can click on the “Table” link in the “Results” section to see a graphic).  Because this is a novel virus, we are just beginning to learn the downstream complications of surviving this infection.

1. Desired Outcome: 

Avoid infection of a Novel Virus during a Pandemic. 

Plan: Because SARS CoV2 is infectious to you when you are in contact with asymptomatic or pre-symptomatic people, it is wise to assume everyone you are in contact with is positive for the infection. Follow the CDC guidelines

 I recommend modifying your pandemic precautions based on your community’s infection rate. Follow the data. ( The reported numbers from your public health department are often reflective of community infection one week ago, especially when there are surges of cases.  When cases are going up, infection rates rise at a non-linear rate. 

Track the rates of community transmission in your area. Your local public health department should have tools for tracking positive infection rates per zip code. Modify your masking and distancing precautions based on this data to lessen your personal risk of infection. Communities that have the virus “under control” are defined by the WHO (World Health Organization) as declining for 14 days with a goal of keeping the infection rate less than 5% (ideally as low as possible). 

Pandemic Resiliency Plan recommendations. A data-driven approach:

If rates in your community exceed 10% AND/OR  you are immune-compromised, consider a household lockdown. Only leave the house for reasons that are essential and work from home.  If you are an essential worker, follow aggressive distancing and masking precautions. Masking with  an N95 mask or surgical mask with face shield is best in this scenario.  

When community rates of infection exceed 5% but are less than 10%, still consider a household lockdown. Defer any social outings or personal grooming appointments. Follow aggressive distancing precautions while masking.

When infection rates in your community are above 3% but less than 5%, Remember, masks help to reduce the transmission of the virus significantly but distancing is the smartest strategy.  Selectively distance from those who are choosing to take on high-risk behaviors. Consider the travel history of those you are planning to see for social outings: have they traveled to a hotspot in the last two weeks? If so, SELECTIVELY DISTANCE from them.

If rates are going down consistently in your community, make appointments for routine healthcare, preventive screening, dental appointments, personal grooming appointments. 

When rate of infection in your community is less than 3%, Continue masking and distancing. Remember the concept of SELECTIVE distance: triage the risk behaviors and travel history of others before making plans with them. If you are considering vacation or elective travel, consider the infection risk of your travel destination and take appropriate precautions. Avoid traveling to areas that have a higher risk of infection than your community.

2. Desired Outcome:

Avoid Hospitalization if infected with a Novel Virus during a Pandemic.

Plan: Optimize personal health

This plan is consistent with the goals of the practice:

  • Reduce inflammation and glycation in your body 
  • Improve immune function by lowering stress, improving sleep and “optimizing” biomarkers of health that regulate immune function
  • Lower your body’s percentage of body fat, especially visceral fat