Cold, Flu, and Yes, Coronavirus

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Because of its omnipresence in the news, Coronavirus is on everyone’s mind.  The daily messaging about the disease can be fear-inducing, especially for those who are checking their devices every hour to see the stats of where and how quickly coronavirus is spreading.

But maybe we should all step back off the ledge and get educated before panicking.  As of this writing, the CDC reports 15 total confirmed reports detected in the United States; 12 of which are travel related, and 3 of which resulted from person-to-person spread. There are an additional 47 cases among those repatriated to the U.S. via State-Department chartered flights.  See CDC Coronavirus statistics. This pales in comparison to the number of people with confirmed influenza (flu) sample testing which is 14,657 since the beginning of February 2020; 174,037 since September 29, 2019.  See CDC Influenza statistics. 

The common name ‘Coronavirus’ is misleading because it doesn’t really specify anything in particular. Coronaviruses (CoV) are a large family of zoonotic viruses – those that are transmitted between animals and people – that cause illness ranging from the common cold to more severe diseases.  You may remember the 2002-3 outbreak of SARS-CoV (Severe Acute Respiratory Syndrome) and the 2012 outbreak of MERS-CoV (Middle East Respiratory Syndrome) – both of which were coronaviruses.  The disease caused by the current coronavirus outbreak is called Coronavirus Disease 2019, abbreviated COVID-19.  But just calling it coronavirus is definitely more catchy.  

What’s the Difference Between Cold and Flu

Cold, Influenza and Coronavirus are all infectious respiratory illnesses caused by a virus. Let’s first breakdown the difference between cold and flu, because their symptoms are so similar that they often get confused.  The main difference is that cold is milder than flu, and the most common symptoms are stuffy or runny nose, and often a sore throat.  But the biggest difference is that flu is much more likely to result in serious, sometimes life threatening, complications, including pneumonia.  Flu also can have stuffy or runny nose and sore throat as symptoms, but much more common are body aches, chills, cough, and fever.  The CDC has a great at-a-glance comparison chart: 


Another interesting fact, or frightening depending on your outlook on life, is that currently there are 1200 flu viruses circulating in the U.S. as a result of high mutagenicity (the ability to mutate into a slightly different virus). 

Ever notice that cold and flu season always coincides with winter and wonder why?  There are a couple of reasons: people are inside more and not getting enough sun exposure so their vitamin D levels are low and when they are inside they are usually cooped up with others and breathing recirculating air.  So get outside as much as possible, even in the winter.   

COVID-19 Specifics

Symptoms of COVID-19 range from mild to moderate flu-like, and include fever, cough, shortness of breath.  However, unlike flu, the onset may not be abrupt.  The incubation period is estimated to be 2-14 days, meaning someone may not begin experiencing symptoms until up to 14 days after exposure.  This is why some travelers returning from hard hit areas are being quarantined for 14 days before being released to go home. 

The risk of getting COVID-19 is relatively low compared to some other infectious diseases. For example, one person with measles can infect 18 other people; estimates are that one person with COVID-19 can infect 2 other people, however, even at this low rate the infection can spread relatively quickly. 

Diagnosis of COVID-19 can only be confirmed with PCR sputum sample testing, so just having a fever, cough, or other respiratory symptoms is not evidence of having the disease. Get tested if you have any concerns that you may have been infected. The CDC has good advice about what measures you should take if you are sick, which would apply well to any respiratory illness.  

The people who experience the most severe symptoms, and most at risk for contracting COVID-19 are those with preexisting conditions, mainly COPD (chronic obstructive pulmonary disease), other respiratory conditions, and heart disease.  This virus preferentially infects very low in the lungs and therefore is more likely to progress to pneumonia, especially for those with COPD. It’s the progression to pneumonia that has life threatening risks for both COVID-19 and flu viral infections. For these at-risk people, their fever could be higher as well. 

Infection Prevention Strategies

Infection prevention for any virus includes all the basic self-care steps, but let’s review them just to be sure.  Getting enough sleep is critical; sleep deprivation is one of the most stress-inducing things we do to ourselves, and can have devastating effects on immune function. Many respiratory viruses, including cold, flu, and COVID-19, are spread by respiratory droplets, so sneezing into the elbow and hand-washing are the two mainstay ways to prevent transmission of infection.  Proper handwashing techniques are key – the evidence is clear, you must use warm water and soap and scrub for 20 seconds to be most effective. Avoid touching your eyes, nose and mouth with hands that are not clean. Stay at home if you are sick. If possible, avoid close contact with someone showing signs of respiratory illness. Disinfect door handles and hard surfaces including kitchen and bath fixtures and counters, device screens and keyboards, etc. Always wash your hands after touching these surfaces in public places.  Also, helping keep indoor air clean is useful – using air filters and changing the furnace filter regularly is important.

The images we see on our screens show everyone wearing masks, so how effective are they for reducing risk of infection in someone who is healthy? Probably not that effective unless you’ve been trained in sterile technique. Most people miss the fact that if you handle the mask with unclean or virus contaminated hands, the mask is now a potential source of exposure. Mask wearing is only recommended for those who are already sick with a respiratory disease and for healthcare workers. However, there is something to be said for the psychological stress relief that people get by wearing masks and seeing others wear them.  And given that chronic stress has immune suppressing effects, mask-wearing may help provide some basic level of resistance for that reason.

Nutrients and Natural Support for Immune Activity

Nutrition Therapy Institute is a school that provides comprehensive training in holistic nutrition, so naturally we are going to talk about the nutrients we should all be getting from our foods or supplements that can help improve immune function.  And I want to be clear that the effect we are looking for is to drive TH-1 and T-Reg response.  The TH-1 “arm” of the immune system includes the immune cells that are most efficacious at neutralizing foreign invaders, including viruses and bacteria.  T-Regs are T-Regulatory cells which help regulate immune balance which is necessary to prevent overactivity of other parts of the immune system that could compromise overall function.  

Key nutrients that directly meet this primary goal include vitamin A, vitamin D, and zinc.  Nutrients that are needed for their indirect influence are magnesium, B vitamins, and vitamin C.  All of these nutrients are best acquired in a whole food diet that is widely varied, including both organic plant foods and pasture-raised animal foods. 

  • Vitamin A stimulates phagocytosis (pathogen “eating” by immune cells), helps maintain natural killer cell activity (immune cells that neutralize virus-infected cells), and helps enhance T-Reg cell activity.  Reliable sources include: meats, liver, egg yolks, shellfish, and cod liver oil. Or it can be made from beta-carotene found in orange, red and yellow vegetables. 
  • Vitamin D is necessary because it stimulates T-Reg cell activity. Reliable dietary sources include: full fat dairy, cold water fish, shellfish, egg yolks, liver, cod liver oil. And of course, we have the ability to make vitamin D with adequate sun exposure. 
  • Zinc is a required co-factor for immune cell synthesis and maturation, helps enhance T-Reg cell activity, and is necessary for proper vitamin A activity. Reliable sources include: meats, shellfish (especially oysters), dairy, legumes, nuts and seeds (especially pumpkin seeds). 
  • Magnesium is a necessary co-factor for cellular energy metabolism making it critical for the energy-demanding needs of keeping the immune system properly primed. Reliable sources include: leafy green vegetables, avocados, nuts and seeds, dark chocolate, legumes, whole grains, shellfish, seaweed.
  • B vitamins are also necessary for energy metabolism and so play an essential supporting role for proper immune function. Reliable sources include: meats, liver, seafood, avocados, dairy foods, egg yolks, whole grains, legumes, nuts, seeds. 
  • Vitamin C is a powerful antioxidant and potent anti-histamine that can help mitigate runny nose, watery eyes and sneezing. Found in bell and chili peppers, cruciferous vegetables, citrus fruits, strawberries, mango and papaya, tomatoes. 

Paying close attention to microbiome balance is necessary for infectious disease prevention.  All of our mucosal membranes that line the openings to the outside have a rich microbiome populated with a wide variety of microbial life, including the nasal passages, lungs, and the genitourinary and GI tracts. This microbial flora is a key partner, intimately interacting with our innate immune system and also helps prevent pathogens from taking hold in the mucous membranes. Eating fermented foods and taking probiotic supplements is an important step in maintaining good immune function and infection prevention. And don’t forget that adequate fiber is necessary to feed the good flora – another reason to be generous in your consumption of vegetables. 

Black Elderberry

Two medicinal herbal partners that have proven use for defense against viruses are black elderberry and goldenseal.  Black elderberry (sambucus nigra) is well known to be supportive against common cold and influenza; some research shows it protects against influenza by preventing flu virus transcription.  Goldenseal (hydrastis canadensis) has been a staple anti-infectious herb in the natural medicine chest for hundreds of years. The active antiviral constituent in goldenseal is berberine. 

Be Diligent But Not Overreactive

Unless you are travelling to an international location that has a high infection rate, exposure to Coronavirus is probably not an immediate issue of concern for the majority of Americans.  Even so, the CDC says that we should all be prepared for a likely larger outbreak here in the U.S.  It is not a question of ‘if’ but ‘when’ more cases will show up here.

Given the sizeable number of circulating influenza viruses, our chance of being infected with flu is still much more likely than COVID-19.  Common sense self-care measures are important all the time, but during cold and flu season, and now during the spread of this novel coronavirus, it becomes even more prudent to be diligent about taking the time to look after ourselves by getting enough rest, fresh air and sunshine, using proper hygiene practices, and preparing nutrient dense meals packed with immune enhancing vitamins and minerals. By taking these steps, and maybe adding a few herbal antiviral powerhouses, you will be making noticeable strides in protecting yourself from infection by a wide variety of viruses. 

Here’s hoping you have an uneventful cold and flu season, and remember, spring is coming soon.

About the Author

Dianne Koehler, MNT, is the Director of Nutrition Therapy Institute.  She has been a Nutrition Therapist for twelve years and was an instructor for 10 years and Academic Dean for 2 years at NTI before becoming the Director of the school. Dianne prioritizes nutrient density of foods in everything she practices and teaches.  


Woman Touching Her Nose by Brandon Nickerson is free for use by Pexels 

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