Vantage Point: Illness and health in the COVID era

Jul 01, 2023

In this, the fourth year of the COVID era, we need to remember there are always viruses and other bad bugs circulating. Avoiding them is mainly a matter of luck. And isolation.

Doctors here and around the country were surprised, after 2020, that few patients were reporting colds and flu in those socially lonely days. Now, we have payback. Dr. Leana Win, a Washington Post health columnist, tells us, “Unfortunately, there probably isn’t much to do. Your immune system is catching up, and you’re getting the viruses you previously avoided.”

Mark G. Epstein

This spring, for the second time in recent years, I was hit by a nasty bronchitis, which is like a cold on steroids. Both times, I was down for weeks. Fortunately, my bocce team captain had her own history of bronchitis and gave me a pass, week after week.

I was reminded that for most viruses, there’s very little modern medical science can do for us. Paxlovid for COVID is a notable exception. We’re on our own to get better. There’s rest, fluid and food: nothing magical.

Yet, we’re always looking for a magical cure or some special advantage. That can explain the epidemic of “biohacking,” the perhaps desperate search for innovative medical solutions. The Wall Street Journal, surveying some of its rich and highly educated readership, noted biohacking’s “extremely wide spectrum of tools and interventions.” Whether it’s an expensive infrared sauna or a frugal cold shower, there’s always something trending on the health front.

The Berkeley restaurateur Alice Waters famously wrote, “We are what we eat.” Most St. Helenans I know eat for pleasure, which fits neatly with a local population focused on wine. Just a few eat for health. Food as medicine is controversial since, as a highly regarded nutritionist once advised me, we react individually and uniquely to what we eat.

As with most aspects of healthy living, food is complex. For decades, we were told not to eat eggs. Researchers now know that dietary cholesterol (in eggs) is vastly less important than cholesterol-related factors circulating in our blood. Popcorn, if it’s not drowned in butter and salt, is actually good for us. And while watermelon may rank high on a glycemic index of sugar, it’s mostly water. We would have to gorge big-time on watermelon to get a sugar rush.

If you want a spirited conversation, talk to people about how much water they drink. Anecdotally, it seems that St. Helenans are looking at water more and more as a health food. A pal at the gym carries around a gallon jug and drains it several times a day. Others tell me they start drinking water as soon as they climb out of bed and continue to do so until they return to their bed at night.

If you’re mathematically inclined, there are many formulas to determine how much water you “should” drink. A popular one is to drink daily, in ounces, half your body weight. For me, around 150 pounds, that means more than nine glasses of water a day. That’s a goal I rarely reach.

But opinion is not universal. A sports medicine doctor told The New York Times, “You can achieve, and exceed, your daily fluid requirements of beverages and high moisture foods without drinking a single glass of water.” What that shows is that we can always find some expert to support whatever we’re inclined to do.

The burden falls on us individually to stay informed. There is an unpleasant and potentially dangerous virus called respiratory syncytial virus. The good news is that there’s a RSV vaccine now available for those 60 and over. But I thought it was intriguing that some St. Helenans whom I know pay a lot for their medical care were ignorant of this effective new medical tool.

One problem is that this vaccine may not appear in doctor’s offices. I found it by appointment at the Safeway on Trancas Street in Napa. The appointment was easy to get, the pharmacy staff was efficient and helpful, and the store gave me a discount coupon on whatever groceries I might buy while there.

The downside was a day and a half of the classic “flu-like symptoms” that hit me. Was the cost of feeling lousy balanced by the future benefit of the vaccine? For me, it was.

The average age of St. Helenans appears to be getting older, perhaps reflecting the assets needed to live here. So it’s nice to know that our hospital’s ER was recently credentialled for geriatric emergency care.

Yet the best available biohack may be to try to live our lives so we can stay far away from the emergency room.

Mark G. Epstein moved to St. Helena from the East Coast early this century after a career in international business.

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