I am asked almost daily what I think about the Coronavirus (COVID-19) pandemic. Coronaviruses are a large family of viruses that can cause illness ranging from the common cold to more severe diseases such as what we are now seeing with this current outbreak. Although I’m not a viral expert, I can offer some strategies to help prevent an infection and strategies for boosting your immune system to help ward off infection. I would also like to discuss the role of aspirin increasing the mortality rate during the “Spanish Flu” epidemic in 1918-1919.
Viral infections are bombarding us and storming the news. We are in the midst of a tragic flu season that has affected over 29 million people and caused over 16,000 deaths.  While that is devastating enough, we are also facing a global pandemic with the coronavirus. It originated in Wuhan, China and has rapidly infected over 80,000 people in at least 37 countries causing over 2600 deaths.  As of this writing, there have been 2 deaths in the United States.
Common Cold, Influenza and the Coronavirus
Currently, the risk of exposure to the flu is much greater than the exposure to the coronavirus. With that being said, the mortality rate of the flu is about 0.5%, while the rate of mortality with the coronavirus is about 2.3%. While they are not as virulent as SARS ranking in at around 10% or Ebola’s whopping 50% mortality rate, they still raise red flags and protection against them is advised. 
First, let’s talk about the common cold virus of which there are about 200 strains. We have all experienced miserable common cold symptoms of sore throat, low-grade fever, cough, and a runny nose. Most common cold viruses are transmitted by hand contact. You shake hands or touch a doorknob that has the virus on it, then you touch your nose and the virus begins to spread from there. Usually, the virus will migrate from the nose, to the sinus passages, throat, and then down into the lungs. You have probably experienced this feeling of “my head cold has now gone into my chest”.
Unlike the cold virus which is transmitted through direct contact, the influenza virus is transmitted when you inhale respiratory droplets in the air from when someone coughs or sneezes. Make sure to cover your mouth and nose if you cough or sneeze. Consider wearing a mask if you are going to be out in public. That seems to be more fashionable these days. Since the influenza virus starts in the lungs, it is transmitted from there into the bloodstream and “hits hard”. Unlike the “creeping crud” of the common cold. Influenza presents with the rather sudden development of intense muscle aches, high fever, chills, coughing, and sometimes difficulty breathing.
The vast majority of people that contact the new coronavirus will experience a mild form of illness mimicking the common cold, or they may experience a more severe case that presents like influenza. In more severe cases, the infection can cause pneumonia, acute respiratory syndrome, kidney failure, and death.
So What Can You Do to Protect Yourself?
To the extent you can, try to stay away from people who have any respiratory illness. Wash your hands frequently. Soap and water work fine, but I also recommend picking up some hand sanitizer (which currently seems to be in short supply) when you do not have access to a sink. I also suggest picking up some masks to have on hand in the event there is an outbreak and you need to be out in public.
Boost Your Immune System
Your body’s first line of defense AKA the innate immune system is comprised of immune cells including monocytes, macrophages, neutrophils, and natural killer cells that circulate in the body to identify and destroy foreign invaders. This is why individuals who have a compromised immune system from some other illness are more likely to have a more severe respiratory infection.
Rest, eat a healthy diet, reduce stress, and basically take care of yourself.
A large-scale study published in 2017 British Medical Journal suggests that taking supplemental vitamin D may help prevent acute respiratory tract infections. In our office, we have been recommending vitamin D supplementation for years, and those patients taking vitamin D seem much less likely to be coming into the office for a respiratory illness.
Additionally, there are various supplements that may boost your immune system and help your body fight the infection. Check with our office staff for specific recommendations.
Spanish Flu and Aspirin
In 1918-1919 the Spanish Flu epidemic killed 27 million people worldwide. A little-known fact is that the mortality rate was much higher in those afflicted individuals who took aspirin. Realize that aspirin had not been on the market that long. Aspirin can increase the chances of developing pulmonary edema (fluid in the lungs) and respiratory failure if taken during a viral illness. There is a rare serious condition called Reye syndrome which can be fatal, it usually affects children but occasionally can occur in adults.  Reye syndrome can affect the brain and liver causing nausea, vomiting, and neurologic symptoms. Taking aspirin during a viral infection increases the chances of getting Reye syndrome.
Bottom line – do not take aspirin if you have a viral infection, particularly in the pediatric group.
 Chapman J, Arnold JK. Reye Syndrome. [Updated 2019 Nov 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526101/