Features
Boosting immune system to fight Covid-19: Is it possible?
By Saman Gunatilake
Emeritus Professor of Medicine
University of Sri Jayewardenepura
Immune boosting is a trending topic these days with the COVID-19 pandemic. The concept of “immune boosting” is scientifically misleading and often used to market unproven products and therapies. There is no current evidence that any product or practice will contribute to enhanced “immune boosting” protection against COVID-19. This lack of evidence has not stopped wellness gurus with vested interests, and commercial entities from propagating notions of boosting immunity. Internet and popular press are flooded with messages of this nature resulting in an abundance of misinformation circulating online. The public is increasingly going online for health information and questions persist around the kinds of inaccurate information the public is absorbing and the impacts it may be having on health-related decisions and actions.
What are Immunity Boosters?
Immunity boosters are products which claim to be able to support your immune system so you aren’t as likely to get sick. Additionally, if you do get sick, taking the supplements will make your illness pass faster. There is no scientific and clinical evidence in humans to support claims of ‘immunity boosting’ foods and other products which supposedly enhance immunity. The body has its own immune system which fights against viral and bacterial invaders. With a normal immune system, we are capable of protecting ourselves against most infections but with certain situations the infection manages to overcome our immune system and cause serious disease and even death. The current Covid 19 pandemic is such a situation. We are in the grip of a spike in infection with over 1000 cases per day seen during the last few days. Total deaths from the pandemic in our country is nearing 700 and the total cases up to now amounts to around 111,800.
With no scientifically established cure for Covid-19 yet and the available recommended treatments limited to severe cases and being not so effective, recovery in most cases has largely been reliant on the human body’s natural defence, the immune system. Fighting the infection by boosting our immune systems had been the buzzword since the beginning of the pandemic. This has led to many misconceptions, misinforming and misleading the public. Improving the diet, taking vitamins and herbal products, lifestyle changes are proposed as ways of doing this. As a result, the market has been flooded with an array of products that claim to boost one’s immunity.
One of the common misconceptions is that high doses vitamin supplements and other minerals and nutrients boost one’s immunity. Ayurvedic concoctions, fruit juices, vitamin pills, zinc tablets have flooded the market with an array of products that claim to boost one’s immunity. Promoters of these products indicate that the body’s natural defences can be strengthened or enhanced by the consumption of certain foods, herbal products or the use of specific products.
Is there robust scientific evidence to support these claims for immune system boosting? The answer is no. Immunology experts believe that there is no way for healthy adults to improve their immunity through foods or other products. The immune system is very complex and these claims about boosting immunity are irrational and unscientific.
The Immune System
The immune system is activated by things that enter the body that the body doesn’t recognise as its own such as bacteria, viruses or even particles that cause allergy, like food, drugs and pollen. Most pathogens have a surface protein on them that the immune system recognizes as foreign. These are called antigens. Then the immune system sets in motion a complex process that fights the invader – this is the immune response.
There are two kinds of immune responses in the human body. The innate immune response is the first to kick in and is common among all animals. It is non-specific and immune cells mount an immediate attack on antigens. The response is subsequently replaced by the adaptive immune response, which tailors defences based on the kind of pathogen that is being encountered. The innate immune response consists of white blood cells like neutrophils, macrophages, and monocytes, while the adaptive response involves Lymphocytes -T cells and B cells, as well as antibodies produced by these cells as a specific response to the invader’s antigens. Stimulated immune systems release chemical proteins known as pro-inflammatory cytokines in large numbers, which can cause soreness and pain. So boosting immunity may lead to unwanted inflammations causing swelling, redness and pain locally and fever and other organ damage.
The Internet searchers will find that the myth of “boosting immunity” is extremely pervasive. Of the approaches that claimed to boost immunity, the top ones were diet, fruit, vitamins, antioxidants, probiotics, minerals. Interestingly, vaccines, the only proven method that enhances our immune response to an infection is ranked very low. One of the biggest misconceptions is that consuming more vitamins than required helps the immune system. It has been proven, time and again, that mega-doses of Vitamin C or of any kind of vitamin are not effective on the body at all. Another misconception is that zinc tablets can play a role in mitigating Covid-19. However, this isn’t backed by evidence either.
Zinc is not an immunity booster. It is an essential mineral for the body which is a ‘cofactor’ for a large number of proteins and enzymes. A cofactor is a non-protein chemical compound or metallic ion that is required for an enzyme’s activity as a catalyst. Like zinc, vitamin C is also a cofactor, and is important for the body to function. So, if you have a deficiency of these essential micronutrients, you will face a problem. But, if a person does not have any such deficiency, an excess amount of these taken does not improve one’s chances of fighting off a virus. Vitamin C and Zinc deficiencies are very rare unless someone is starving or following an extreme diet depleted of nutrients. Iron and Iodine deficiencies are seen in communities and more than immune deficiency they cause other problems.
An extremely active immune system, can also be problematic. In severe Covid-19 cases, the body launches an aggressive immune response resulting in the release of a large amount of pro-inflammatory proteins. This is known as a cytokine storm and is one of the common causes of death in Covid-19 patients. A cytokine storm occurs when the body’s immune system goes into an overdrive, killing healthy cells and causing organ failures. Several research studies suggest that the cytokine storm causes lung injury and multi-organ failure. So, if this is the case boosting the immune system in a Covid patient is not a wise thing to do.
Market interests add to the myth
The truth is natural immunity in normal people cannot be improved. There are immunocompromised individuals with a poor immunity who are susceptible to infections due to certain illnesses, and how can they stay safe from this highly infectious virus that spreads rapidly? The most effective way is by keeping our communities safe.
We can do this by attending to the public hygiene of the population exposed to the infection. Providing safe drinking water, providing clean air, providing adequate nutrition — are ways of keeping the people healthy and strong to fight any infections. There are parts of our country fortunately not as bad in India, without access to these basic health requirements. Achieving social distancing in these communities that live in overcrowded households is impossible.
This background, and a new infection with no treatment, led to various interested parties with good and bad intentions in promoting the myth of immune boosting. They have become self-proclaimed experts exploiting this crisis, putting forth all kinds of miraculous non allopathic substitutions. As allopathic medications to be approved, a rigorous procedure has to be observed, they resorted to the easier approach of promoting quick remedies in traditional and herbal products. Unproven ‘natural’ remedies came to the fore in our country in this background where people felt helpless. The vaccine, the only proven way of boosting the immunity of an individual and the population against a specific disease was not available around this time.
There are added dangers in such situations. There may be a lot of drug-drug interactions. If people are consuming allopathic medicines, and then also start consuming these medicinal herbs, the components of the herb will interact with the drug resulting in unknown complications. These unapproved medications can have toxic effects on your kidney, liver and other organs.
Even during the Spanish Flu pandemic in 1918 companies jumped in on the opportunity to hail themselves as immunity boosting drug producers. However, no products were ever proven to be effective in improving immune responses.
Maintaining a normal immune system
A poor immune system is seen in people with certain ailments. Some are born with defects in their immune system and they are known as immunodeficiencies. People with chronic illnesses like diabetes and auto immune disorders are also vulnerable to catch illnesses easily as their immune systems are weak. People on immunosuppressant medications like steroids and cancer drugs also have a weakened immune system and easily catch infections and develop serious complications easily.
Lifestyle is key for keeping your immune system normal and ready to act with an adequate response when necessary. For now, there are no scientifically proven direct links between lifestyle, exercise and enhanced immune function. Researchers are exploring the effects of diet, exercise and stress on the immune response. There are indeed processes that do affect our immune cells and improve their responses. The best one of them, perhaps, is exercise. Many studies have shown that moderate exercise of less than 60 minutes can improve the circulation of anti-inflammatory cytokines, neutrophils, natural killer cells, T cells and B cells. This can work effectively — not for combating diseases at a specific point in time, but to combat stress hormones in general, which can suppress immune cell function. Extremely high intensity exercise leads to a short duration of compromised immunity, increasing risk for disease in this time period. This is one of the reasons marathon runners or professional sports persons tend to catch a fever or cold in the days following a sporting event. Regular exercise is known to improve cardiovascular health, lowers blood pressure, helps control body weight. Therefore, adopting general healthy-living strategies make sense since they are likely to have other proven health benefits. But whether they help to boost the immune system is a controversial issue with no proven answers.
The immune system can also be compromised by many lifestyle habits such as smoking, which is known to affect T and B cells, among a host of other parameters. Diseases like diabetes by themselves result in compromised immune systems. This is why diabetic patients are particularly susceptible to infections. Obesity is another condition with a weak immune system as it predisposes to the development of other illnesses like diabetes and hypertension. There appears to be a connection between poor nutrition and immunity and this is a problem especially in the elderly. Poor nutrition can lead to micronutrient malnutrition, in which a person becomes deficient in some essential vitamins and trace minerals. Deficiency of these can result in a poor immune response to infections. Older people tend to eat less and often have less variety in their food. In them dietary supplements may have some beneficial effects and they should discuss this with their doctors. Taking mega doses of vitamins do not help and can even be harmful.
Every part of your body, including your immune system that fights against infections function better when protected from unwanted damage and bolstered by healthy-living styles. These are – not smoking, taking a diet high in fruit and fibre, exercising regularly, maintaining a healthy weight, avoiding alcohol or consuming in moderation, getting adequate sleep, washing hands regularly, developing good food habits, minimizing stress.
However, there currently exists no evidence of any consumable foods or products being able to induce an improvement in immune function. Although some preparations have been found to alter some components of the immune system, so far there is no evidence that they actually boost your immunity to the point where you are protected against infection. The only scientifically proven way to boost immunity, the immune system, and an immune response is through vaccinations. Vaccines prime your immune system to fight off infections before they take hold in your body.
So, where do we stand today? Vaccines to boost our immunity against Covid, prevention of spread and catching infection by proper wearing of masks, washing hands and maintaining social distance. These are the scientifically proven methods and others appear to be market-driven myths.
Features
Trump’s tariffs, AKD’s gazette and Sri Lanka’s diplomatic slumber
“We are rather respectable in Colombo. We go to bed fairly early, and we remain there till morning. “
According to Sri Lanka’s diplomatic folklore, the late S.W. R. D. Bandaranaike uttered these words while explaining the reasons for Sri Lanka’s abstention on the UN resolution condemning the Soviet invasion of Hungary. Apparently, SWRD’s foreign ministry officials were asleep at home when the diplomatic cable seeking instructions was received from New York. In those days, there were no cell phones, Internet, or even fax or telex machines. The diplomatic cables were sent through post offices. Decoding them was a slow and time-consuming process. Thus, the government could not provide appropriate instructions to our mission in New York in time, and the Sri Lankan delegation abstained on that sensitive UN vote.
Sri Lanka’s Absence from Section 301 Consultations
But then, how does one explain Sri Lanka’s absence from the crucial bilateral consultation held in Washington by the Office of the United States Trade Representative (USTR) during March-April on “Forced Labour” under the Section 301 of the US Trade Act of 1974? Didn’t our foreign and trade ministries send appropriate instructions to Washington in time? Even if the instructions from the foreign ministry were transmitted to our embassy in Washington by pigeon carriers, there was enough time for Sri Lanka to participate in those meetings.
In March, the USTR initiated these 301 investigations on 60 trading partners, and invited all of them for confidential consultations. Out of the 60, 46 participated in these consultations. Sri Lanka was not one of them. Other countries that didn’t participate in these consultations included China, Russia, and Venezuela! In addition to that, the Section 301 Committee conducted a public hearing with interested parties on April 28 and 29. Washington-based diplomats, representatives from few trade ministries as well as representatives from many foreign trade associations and chambers participated in these hearings. Sri Lanka was once again conspicuously absent.
As a result, when the USTR published the proposed forced labour tariffs on June 2nd, Sri Lanka ended up with a 12.5% duty. Pakistani and Indonesian diplomats participated in these consultations and took appropriate follow-up measures, and managed to enter the 10% duty category. As even a threat of a modest tariff hike could disrupt supply chains and reduce competitiveness, particularly in an industry such as garments, I discussed this issue on 15 June and underscored the importance of Sri Lanka’s participation at the next hearing, which was scheduled to be held from July 7th .
Awakening from Diplomatic Slumber and AKD’s Gazette
Fortunately, Sri Lanka finally awoke from weeks of diplomatic slumber, and Ambassador Mahinda Samarasinghe participated in the public hearing on 9 July, and promised, “…. · We have agreed to the text in our negotiations with the USTR on forced labour, …. The gazette as we speak is being printed and I’m getting the gazette tomorrow morning, and the gazette will be shared with USTR as I get it“.
As promised, President Anura Kumara Dissanayake issued a gazette on 10 July banning the imports of goods produced by forced labour. These new regulations are very similar to what Pakistan and Indonesia enacted in April, after their consultations with USTR in March. Why couldn’t we do it in April? Why did we wait till the very last minute?
Challenges ahead
“War is too important to be left to generals alone,” is a famous saying attributed to former French Premier Georges Clemenceau. Similarly, monitoring our main markets is too important to be left to diplomats alone. The United States is the largest single-country market for Sri Lanka. Therefore, Sri Lankan trade chambers and associations should become more proactive in these markets and participate in these events. For example, the chairman of the Pakistani apparel exporters association participated in the April hearings. Similarly, representatives from the Indian Agricultural and Processed Food Products Export Development Authority, the Federation of Indian Chambers of Commerce and Industry, the Confederation of Indian Industry, and Reliance Industries also participated in July hearings. At an event where each speaker is given only five minutes (strictly enforced), having a number of speakers from a country is an advantage. The presence of industry representatives in these kinds of events also help them understand the market dynamics and the future challenges. This is important, particularly because there will be many more challenges with Trump’s tariffs.
With the gazette issued on 10 July, Sri Lanka has imposed a prohibition on the importation of goods produced with forced labour. Now, the challenge will be to effectively enforce the prohibition. And what are the goods produced with forced labour? The USTR list only focuses on aluminum, cotton, electronics, lithium-ion batteries, rice, and tobacco. However, according to the U.S. Department of Labour, the list is much longer. Hence, this list may change continuously during the next two years and tariffs may fluctuate once again.
So, this is definitely not the time to slumber.
(The writer, a retired public servant, can be reached at senadhiragomi@gmail.com)
by Gomi Senadhira ✍️
Features
Tales of Mystery and Suspense 10 Casino for Sale
After the overwhelming grotesquerie of J K Rowling’s latest Cormoran Strike novel (written, I should have noted, as the others were, under the pseudonym Robert Galbraith), I thought I should return to the world of fun, and also a much shorter description since this thriller moves quickly without the layers of detail that Rowling engages in.
I then move to the second comic thriller by Caryl Brahms and S J Simon. This, their second story to feature Vladimir Stroganoff and Adam Quill, was Casino for Sale, as lunatic a romp as the first, though without the emphasis on the ballet that characterized A Bullet in the Ballet.
This one begins with the impresario Stroganoff buying a casino cheap from Baron Sam de Rabinovich, only to find that it was a rundown place, not the grand casino of La Bazouche, a resort on the Frenc+h Riviera, as he had initially thought. The grand one belonged to Lord Buttonhooke, and Stroganoff could not compete, until he thought of bringing the Ballet Stroganoff to the casino – which of course leads to Buttonhooke deciding to have ballet performances in his Casino too.
Stroganoff invites Quill to visit him, which Quill decides to do since he has left Scotland Yard, having come into a legacy. No one believes this, and he has to face questions as to what he did to have been sacked, with sympathy for having been found out.
The day he arrives in La Bazouche there is a murder, of a vitriolic critic called Citrolo, in Stroganoff’s office. He had been going to write a damning review of the opening night of the ballet and Stroganoff, when he realizes Citrolo cannot be swayed, drugs him and dictates the review himself to the papers. He leaves Citrolo sleeping and finds him shot the next morning, whereupon he decides to muddy the waters and leave a suicide note and lots of other murder weapons. So much overkill, as it were, of course ensures that he is arrested.
But the excitable French detective who makes the arrest follows up his suggestion that Buttonhooke was also involved, and so the two casino owners find themselves in cells next door to each other, with the detective Gustave quite happy to provide creature comforts for a fee.
Quill decides he must investigate, and finds Gustave most cooperative, since he has a laid back attitude to work. So it is Quill that finds a notebook which makes it clear Citrolo is an accomplished blackmailer, and that there are lots of possible murderers, including Stroganoff’s croupier, who was crooked, Rabinovich, who was now working for Buttonhooke, a confidence trickster called Kurt Kukumber, whose prospectus for a dud gold mine was found in the office and Prince Alexis Artishok who was engaged in a deal to buy diamonds from the ballerina Dyra Dyrakova.
Stroganoff had been trying to get Dyrakova to dance for him, but having done so previously she had refused. But then to Stroganoff’s chagrin she agreed to dance for Buttonhooke. The clearly crooked Artishok had told Buttonhooke’s mistress Sadie Souse, who was not very bright, that Dyrakova possessed diamonds she was willing to sell cheap, and Sadie was determined to have them.
Quill meanwhile finds out that there was a secret passage to Stroganoff’s office, the obvious solution to what had begun as a locked room mystery, and that this was known by almost everyone apart from Stroganoff himself. And then Rabinovich is murdered, just after Gustave had released his two original suspects, leading him to blame Quill for having insisted on that and thus allowing them to kill again.
Soon afterwards Dyrakova arrives, and the town is full of posters announcing that she will appear in the casinos, elaborate posters for either one, since Stroganoff is determined that she will dance for him, and if she does not come willingly, he has devised a scheme to make her do so unwillingly. So, though Buttonhooke has her taken off to his yacht immediately she arrives at the station, Quill along with Arenskaya gets her into a launch and to Stroganoff’s casino, where she performs to tumultuous applause, not knowing for whom she is dancing.
When Quill asked her about the diamonds, she said she had sold them long ago, and that gave Quill the solution to the mystery. Rabinovich had known about this, and Artishok had killed him to prevent Sadie learning it from him, he had killed Citrolo who had recognized him for an accomplished card sharper, not a Russian prince at all. But before he is arrested, he gets away in a boat, and the police launch that pursues him is on the point of catching him up when it runs out of petrol.
Again, lots of excitement, and entertaining references – Gustave grows marrows – and if not quite as brilliant as its predecessor, Casino was certainly a delightful read.
Features
The challenge of being positive about SAARC
It was a few years back that a former President of Sri Lanka took it on himself to pronounce SAARC ‘dead’. Since then there have been other sections of Sri Lankan opinion that have joined the critics of SAARC and taken the solemn stance that SAARC has indeed died what may be called a natural death.
Their fatalism is understandable. SAARC has failed to meet at heads of government or state level for the past several years to take the SAARC process notably forward. Regional cooperation has more or less been only an appealing idea. No substantive concrete projects have taken off to make the idea a hard reality. ‘Inner paralysis’ seems to be SAARC’s lot. Hence the fatalism in these circles.
However, being one of the worst cash-strapped regions of the world and a teemingly populated one with people virtually left to their devices, what choices do the ‘SAARC Eight’ have other than to try their best to band together and continue with their cooperation efforts, however small they may be?
There is no escaping the mounting debt trap for many of these countries and bankrupt Sri Lanka is a glaring example, but ‘throwing in the towel’ and abandoning themselves entirely to the diktats of the strongest economies and their agencies will prove a ‘living death’ for many countries in the SAARC fold.
The gains may be meagre but giving-up on SAARC cooperation in full would prove self-defeating for the organization and South Asia. Right now, the collective intention ought to be to salvage what the region could from the tenuous cooperative efforts. Moreover, such initiatives could go some distance to generate a degree of goodwill among the Eight and help in sustaining a dialogue process.
Given this backdrop it proved ‘a stich in time’ for the Regional Centre for Strategic Studies (RCSS), Colombo, to recently host the SAARC Secretary General Ambassador Md. Golam Sarwar to a round table discussion on the unifying potential of SAARC and its future possibilities, besides other related issue areas.
Held on June 24th and moderated by RCSS Executive Director and former ambassador Ravinatha Aryasinha, the forum brought together a vibrant, wide ranging audience comprising academicians, diplomats, senior public servants, civil society activists and many others. Following the presentation by Ambassador Golam Sarwar titled, ‘Reigniting SAARC: Achievements, Challenges and the Way Ahead’, a lively Q&A followed.
The above forum could be described as an act of lighting the proverbial ‘candle’ rather than ‘cursing the darkness.’ It surely is a ‘darkness’ that could be seen as daunting considering that the region’s pivotal powers, India and Pakistan, are failing to act in a spirit of accord but are engaged in bitter finger-pointing on a number of questions of vital importance to SAARC.
On the other hand, what is the rest of the region doing to bring the above sides together? It is disappointing that to date the rest of SAARC has failed to launch a major diplomatic drive to bring peace between the feuding regional heavyweights. It needs to act without delay and establish its earnestness and this effort would need to prove SAARC’s staying power in the unfolding months and even years.
In assessing SAARC’s seeming failure local opinion in particular has failed to factor in what could be described as weak leadership. Since Sheikh Mujibur Rahman of Bangladesh, the founding father of SAARC, the region has failed to produce a visionary leader who could advance the SAARC cause with charisma and drive.
Among other reasons, weak leadership accounts considerably for the faltering and stuttering status, as it were, of SAARC. Badly needed are leaders who could go the extra mile, think less of narrow national interests and work diligently towards the collective well being of the region but SAARC’s millions of ordinary people have been made to wait in vain for leaders of such stature. Instead, they have been burdened with politicians who seem to be relishing the apparently moribund state of SAARC.
Looking back, it could be said that it was the dynamic leadership factor that led to the launching of the Non-Aligned Movement and for its sustenance for a few decades. True, it could be seen in some quarters that NAM is no more, but as in the case of SAARC, the former too has been unfortunate to be burdened over the years with politicians who lack the vision and drive to unflaggingly advance the fortunes of the South. NAM and SAARC lack the dynamism and vision of leaders of the stature of Jawaharlal Nehru, for example, to give them the required guidance and intellectual depth.
The reasons are complex for there not being among us currently political leaders with the vision and the steadfast commitment to advance the legitimate interests of the South. However, it could be stated with conviction that the majority of Southern leaders have too easily caved in to the demands of the global North and its financial agencies.
These leaders have failed to see, for instance, that the largely market economy oriented Northern governments would not view with favour a centrist economic model that attaches priority to the interests of the dis-empowered publics of the South. This realization ought to have dawned on the current government in Sri Lanka, for instance, some while ago but it has no choice but to abide by IMF dictates since economic survival at present is unthinkable without the latter’s succour.
Accordingly for SAARC this should be the time for some soul-searching. Priority needs to be attached to ending the feuding between India and Pakistan since at present the material fortunes of the region hinge largely on these regional giants giving peaceful relations among them a try. This is no easy challenge to meet but some daring, visionary diplomacy needs to take hold among the rest of SAARC.
There is some sense in SAARC bringing the peoples of the region together through programs that address their best collective interests. A meeting of minds among SAARC nations could enable SAARC and its agencies to build a region-wide people’s movement for progressive political and economic change that could in turn lead to the region’s political leaders sensitizing themselves more to the neglected needs of their publics.
However, the time is ‘now’ for the initiation of these progressive changes and the voice of SAARC well wishers would need to drown out those of their critics.
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