[Craic] Why COVID-19 Disproportionately Affects the Elderly

[Cedric Stevenson]

Art, thanks...interesting article. I have for some time been taking vitamin
D3  at a dosage of 1000 IU/day. I gather that 1000 IU = 25mcg. How does
this relate to the dosage units in the article?

Cedric

On Sun, Jun 14, 2020, 1:02 PM Arthur Blomme, <art at integralshift.ca> wrote:

> I pasted the whole article because of the problems Dr. Mercola is having
> with censorship on the Internet.
> Why COVID-19 Disproportionately Affects the Elderly Story at-a-glance
>
>    - While the mortality rate for COVID-19 varies around the world, one
>    trend is clear: The infection disproportionately affects the elderly, with
>    those over the age of 75 making up the bulk of the deaths
>    - Adults over 65 years of age represent 80% of hospitalizations and
>    have a 23-fold greater risk of death than those under 65
>    - In addition to age, underlying health conditions are primary risk
>    factors that raise your risk of death from COVID-19
>    - More than 80% of deaths have occurred in nursing homes, assisted
>    living facilities and live-in rehab centers. More than 90% of such
>    residents have at least one chronic disease and more than 70% have two
>    conditions
>    - Additional factors that make the elderly more susceptible to dying
>    is an aging immune system, excessive calorie intake and epigenetic changes
>    that occur with age, specifically the dysregulation of the epigenome and
>    changes in glycosylation
>
> While the mortality rate for COVID-191 varies around the world (in large
> part due to variations in testing), one trend is clear: The infection
> disproportionately affects the elderly, with those over the age of 75
> making up the bulk of the deaths.
> COVID-19 Outcomes Tied to Age
>
> Looking at provisional data2 from the U.S. Centers for Disease Control
> and Prevention, you can see a clear and dramatic increase in deaths for
> each older age group.
>
> For young people, especially children, the risk of death is negligible.
> (Even so, more elderly die from pneumonia that is unrelated to COVID-19.
> The statistics separate out COVID-19 cases, pneumonia only, and pneumonia
> with concurrent COVID-19 infection.3)
>
> The exact same age-dependent trend is seen in other countries, four
> examples of which are included in the OurWorldInData.org’s graph below.4
> As noted in a May 29, 2020, review5 in the journal Aging, “Adults over 65
> years of age represent 80% of hospitalizations and have a 23-fold greater
> risk of death than those under 65.”
> [image: coronavirus case fatality by age]
>
> Below is a graph created by the Minnesota Department of Health, published
> by Twin Cities Pioneer Press6 June 1, 2020, showing the same kind of
> age-dependent mortality curve.
> [image: minnesota covid 19 deaths by age group] Underlying Conditions Are
> a Primary Risk Factor
>
> In addition to age, underlying health conditions (so-called comorbidities)
> are a primary risk factor that raises your risk of death from COVID-19. Not
> surprisingly, the elderly tend to have more underlying conditions. Very few
> people who have no underlying health conditions at all end up dying from
> this infection.
>
> Below is an Our World in Data graph showing the breakdown of comorbidities
> found in Chinese patients, as of February 11, 2020.7
> [image: coronavirus early stage]
>
> Another graph from the Minnesota Department of Health, (again, published
> by Twin Cities Pioneer Press8) reveals a different picture of prevailing
> comorbidities, yet the trend itself is clear: A vast majority of those who
> die have underlying conditions that make them more susceptible to severe
> infection and death.
> [image: pre existing conditions fatal coronavirus]
>
> In the case of Minnesota, 97% of COVID-19-related deaths have occurred in
> those “already fighting serious illness before they were infected.“9 The
> average age of those who have died is 82. Meanwhile, the medial age of
> Minnesotans with known COVID-19 infection is 42.
>
> Just like in other areas, more than 80% of deaths occurred in nursing
> homes
> <https://articles.mercola.com/sites/articles/archive/2020/05/07/nursing-homes-covid-19-risks.aspx>,
> assisted living facilities and live-in rehab centers, and there are logical
> reasons for this. More than 90% of residents of these centers have at least
> one chronic disease and more than 70% have two conditions, which in turn
> can weaken their immune systems.10 They also live in close quarters and
> share staff, which facilitates the spread of pathogens.
>
> Italy and certain states in the U.S. — most notably New York, which has
> the highest COVID-19 death rate in the world — made the grave error of
> sending COVID-19 infected patients into nursing homes.
>
> In light of what we currently know about the transmission, this was one of
> the most catastrophic and negligent government decisions that likely caused
> far more deaths than the lockdown prevented.
>
> Rather than calling for the total lockdown of healthy and low-risk
> populations, why did health and government officials not simply call for
> the protection and isolation of the elderly?
>
> Nursing home residents and workers account for about one-third of all
> COVID-19 deaths in the U.S., and up to 20% of hospitalized COVID-19
> patients actually caught it in the hospital while being treated for another
> ailment.
>
> According to a May 15, 2020, report by the University of Michigan,11
> nursing home residents and workers account for about one-third of all
> COVID-19 deaths in the U.S. Another report12 in The Guardian has pointed
> out that up to 20% of hospitalized COVID-19 patients actually caught it in
> the hospital while being treated for another ailment.
>
> If 20% of people catch the disease at the hospital and 33% of deaths
> happen in nursing homes, just how much of the entire disease burden is a
> result of the health care system alone?
> Advertisement
> ------------------------------
> Biological Differences Help Explain Age-Related Morbidity
>
> According to the outstanding May 29, 2020, review by David Sinclair on the
> molecular biology of COVID-1913 mentioned earlier, “Comorbidities such as
> cardiovascular disease, diabetes and obesity increase the chances of fatal
> disease, but they alone do not explain why age is an independent risk
> factor.”
>
> If that’s so, then what else might account for the radical discrepancy in
> mortality? In his excellent review, Sinclair discusses the “molecular
> differences between young, middle-aged and older people that may explain
> why COVID-19 is a mild illness in some but life-threatening in others.” If
> you have any interest in this topic I would strongly recommend reading this
> paper.
>
> Importantly, Sinclair points out that inhibiting the virus is not enough
> in and of itself. One must also restore the patient’s ability to fight the
> infection and upregulate their immune responses to avoid an overreaction.
> This is done by many strategies I have previously discussed such as
> exercise, time-restricted eating and NAD+ optimization
> <https://articles.mercola.com/sites/articles/archive/2019/10/20/regenerative-medicine-benefits.aspx>
> .
> The Aging Immune System
>
> Topping the list of additional factors that make the elderly more
> susceptible to dying is an aging immune system — both the innate and
> adaptive arms. As noted by Sinclair:14
>
> *“For the immune system to effectively suppress then eliminate SARS-CoV-2,
> it must perform four main tasks: 1) recognize, 2) alert, 3) destroy and 4)
> clear. Each of these mechanisms are known to be dysfunctional and
> increasingly heterogeneous in older people.” *
>
> During aging, your immune system undergoes a gradual decline in function
> known as immunosenescence, which inhibits your body’s ability to recognize,
> alert and clear pathogens. Aging also increases systemic inflammation,
> known as inflammaging, thanks to an overactive yet ineffective alert
> system. According to Sinclair:
>
> “*An abundance of recent data describing the pathology and molecular
> changes in COVID-19 patients points to both immunosenescence and
> inflammaging as major drivers of the high mortality rates in older
> patients.*
>
> *The inability of [alveolar macrophages] AMs in older individuals to
> recognize viral particles and convert to a pro-inflammatory state likely
> accelerates COVID-19 in its early stages, whereas in its advanced stages,
> AMs are likely to be responsible for the excessive lung damage.”*
>
> Sinclair also addresses the impact an aging innate immune system has on
> vaccination efficacy, noting that:
>
> *“In the aged, immune responses to vaccination are also often weak or
> defective whereas autoimmunity increases. Therefore, in designing vaccines
> against SARS-CoV-2, it will be important to consider that older people may
> not respond as well to vaccines as young people.”*
>
> Vascular Inflammation Is a Risk Factor
>
> While we have all heard of the cytokine storm, what is even more
> predictive of death is an increase in the fibrin degradation product
> D-dimer that is released from blood clots in the microvasculature and is
> highly predictive of disseminated intravascular coagulation (DIC). The
> elderly have naturally higher levels of D-dimer, which appears to be a “key
> indicator for the severity of late-stage COVID-19,” the Sinclair states.15
>
> In the elderly, elevated levels are thought to be due to higher basal
> levels of vascular inflammation associated with cardiovascular disease, and
> this, the authors say, “could predispose patients to severe COVID-19.”
> Similarly, the elderly tend to have higher levels of NLRP3 inflammasomes,
> which appear to be a key culprit involved in cytokine storms. According to
> Sinclair:
>
> *“In older individuals, NLRP3 may be poised for hyperactivation by
> SARS-CoV-2 antigens. NLRP3 activity is under the direct control of sirtuin
> 2 (SIRT2), a member of the NAD+-dependent sirtuin family of deacetylases. *
>
> *During aging, NAD+ levels decline, reducing the activity of the sirtuins.
> Old mice … have decreased glucose tolerance and increased insulin
> resistance. This decline, exacerbated by COVID-19, might promote
> hyperactivation of NLRP3 and the trigger [for] cytokine storms in COVID-19
> patients.”*
>
> Higher NAD+ Level May Be Protective
>
> Importantly, he points out that maintaining optimal NAD+ levels may
> therefore alleviate COVID-19 symptoms. This theory is further supported by
> recent data showing “SARS-CoV-2 proteins … deplete NAD+,” and the fact that
> NAD+ precursors are known to inhibit inflammation.
>
> Helpful strategies to achieve that include taking NAD precursors such as
> nontimed-release niacin, lowering your sugar intake (as excess blood
> glucose lowers NAD+), cyclical nutritional ketosis, and/or taking glycine
> or collagen
> <https://articles.mercola.com/sites/articles/archive/2019/02/04/what-is-nadph-and-nox.aspx>.
>
> Other Factors at Play
>
> Other factors that predispose the elderly to severe infection and death
> include epigenetic changes that occur with age, specifically:
>
>    - The dysregulation of the epigenome
>    - Excessive calorie intake
>    - Changes in glycosylation (the enzymatic process by which glycans, a
>    type of carbohydrate, are covalently attached to proteins or fats on the
>    cell surface or in the bloodstream)
>
> Sinclair points out that metformin, a glucose-lowering drug that inhibits
> the mTOR pathway, “has been suggested as a possible drug to combat severe
> SARS-CoV-2 infection in older people.”
>
> Metformin also has antiviral effects and helps improve mitochondrial
> metabolism, decrease inflammatory cytokines, decrease cellular senescence
> and protect against genomic instability, Sinclair notes.
>
> The following illustrations from his review16 summarize the biological
> mechanisms that determine your COVID-19 susceptibility and subsequent risk
> of death.
> [image: covid-19 susceptibility] [image: covid-19 fatality risk] Vitamin
> D Is a Simple Strategy That Can Save Lives
>
> The elderly also tend to have low vitamin D levels, and vitamin D
> deficiency is another trend that several researchers have now identified as
> an underlying factor that significantly impacts COVID-19 severity and
> mortality. I discuss this in “Vitamin D Is Directly Correlated to
> COVID-19 Outcome
> <https://articles.mercola.com/sites/articles/archive/2020/05/08/vitamin-d-level-correlated-to-covid19-outcomes.aspx>
> .”
>
> The following graph is from a May 18, 2020, letter17 to the Federal
> Chancellor of Germany, Angela Merkel, from retired biochemist Bernd Glauner
> and Lorenz Borsche, in which they highlight studies18 showing a clear
> correlation between COVID-19 mortality and vitamin D levels.
> [image: correlation covid 19 death rate]
>
> It’s important to note that experts are already warning SARS-CoV-2 may
> reemerge in the fall when temperatures and humidity levels drop, thereby
> increasing the virus’ transmissibility.
>
> To improve your immune function and lower your risk of viral infections,
> you’ll want to raise your vitamin D to a level between 60 nanograms per
> milliliter (ng/mL) and 80 ng/mL by fall. In Europe, the measurements you’re
> looking for are 150 nanomoles per liter (nmol/L) and 200 nmol/L. Optimizing
> your vitamin D is particularly important if you are older or have darker
> skin.
>
> One of the easiest and most cost-effective ways of measuring your vitamin
> D level is to participate in the GrassrootsHealth’s
> <https://www.grassrootshealth.net/> personalized nutrition project, which
> includes a vitamin D testing kit
> <https://shop.mercola.com/product/1090/vitamin-d-test-kit-for-consumer-sponsored-research>,
> either alone or in combination with the omega-3 test
> <https://shop.mercola.com/product/2124/vitamin-d-omega-3-test-kit-for-consumer-sponsored-research>.
> This is done in the convenience of your home.
>
> To make sure your vitamin D level and immune system function are
> optimized, follow these three steps:
>
> *1. Measure your vitamin D level — *Once you know what your blood level
> is, you can assess the dose needed to maintain or improve your level. The
> easiest way to raise your level is by getting regular, safe sun exposure,
> but if you’re very dark-skinned, you may need to spend about 1.5 hours a
> day in the sun to have any noticeable effect.
>
> Those with very light skin may only need 15 minutes a day, which is far
> easier to achieve. Still, they too will typically struggle to maintain
> ideal levels during the winter. So, depending on your situation, you may
> need to use an oral vitamin D3 supplement. The next question then becomes,
> how much do you need?
>
> *2. Assess your individualized vitamin D dosage — *To do that, you can
> either use the chart below, or use GrassrootsHealth’s Vitamin D*calculator
> <https://www.grassrootshealth.net/project/dcalculator/>. To convert ng/mL
> into the European measurement (nmol/L), simply multiply the ng/mL
> measurement by 2.5. To calculate how much vitamin D you may be getting from
> regular sun exposure in addition to your supplemental intake, consider
> using the DMinder app.19
> [image: Vitamin D - Serum Level]
>
> *3. Retest in three to six months — *Lastly, you’ll need to remeasure
> your vitamin D level in three to six months, to evaluate how your sun
> exposure and/or supplement dose is working for you.
>
> Not only will optimizing your vitamin D be an important strategy for you
> and your family, but it would be really helpful to start thinking about
> your community as well. I am in the process of writing an even more
> comprehensive and detailed report on vitamin D in the prevention of
> COVID-19 and I hope to enlist ALL of you to talk to your friends and family
> and get them on board to get their vitamin levels optimized.
>
> If you can, speak to pastors in churches with large congregations of
> people of color and help them start a program getting people on vitamin D,
> and if you have a family member or know anyone who is in an assisted living
> facility, meet with the director of the program and encourage them to get
> everyone tested or at least start them on vitamin D.
> _______________________________________________
> craic mailing list
> craic at lists.integralshift.ca
> http://lists.integralshift.ca/listinfo.cgi/craic-integralshift.ca
>
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://lists.integralshift.ca/pipermail/craic-integralshift.ca/attachments/20200615/fded0342/attachment-0001.html>