the figure on the manila anatomical bookmark is against a dark ink background. their body is colored in dark green-blue, with vibrant trans pride flag colors across their body diagonally, the white at their lower abdomen. Their face is drawn in extreme concern. A speech bubble shows them asking, "is there a less invasive option?" a drawing of a disembodied white coat,with jagged edges and allmost glitch-like shaking lines is before them. The white coat also has a speech bubble, and replies, "this is the less invasive option."
This is not medical advice, this is a summary of things I have read from various studies, journalists, and newsletters, and what I try to prioritize for myself. I send this to loved ones who accept my offer for it when they or someone they know gets infected, and I figured I should make it more broadly accessible.
Ways to Lower Your Risk of Long Covid &
Lower The Severity of A Reinfection’s Worsening Your Long Covid
Medicines, Vitamins, and Supplements
Increase Vitamin D ASAP and sustain it for at least a month. It’s a reserve vitamin so you can’t cram it all in 2 days, and should not. It is possible to have too much Vitamins A & D, so please be mindful of dosing.
Increase Iron ASAP and sustain it, similarly to above.
Zinc, like Vitamin D, is key to our immune system’s functioning & signaling. Zinc can help boost underactive immune features, calm overactive immune features, and reduce inflammation. Additionally, studies have found Zinc levels are significantly reduced during Covid infection, and reduced in relationship to severity of infection, so it makes sense to combat this.
H1 Antihistamines have preliminary research to support them decreasing LC risk and SIGNIFICANT research supporting them as treatments in Covid-19 infections, plus ways to lower your Covid infection risk overall. All H1 antihistamines have shown in vitro benefits, however the ones I’ve seen most studied in humans are cetirizine/zyrtec, ebastine, azelastine, and loratadine. Most trials in humans used modern antihistamines, which I agree with. I do not generally suggest any first generation antihistamines including Dramamine, Benadryl, NyQuil, or their generic versions unless you have a medical reason for choosing them & their adverse anticholinergic effects. H1 antihistamines are typically available without a prescription in the US.
A recent study from Germany found a Nasal H1 Antihistamine, Azelastine Nasal Spray reduced covid infections by 69% (nice). More research is needed, but a 2x a day dose of Azelastine, or 3x a day dose of German Azelastine is extrapolated to be beneficial from a long covid precaution perspective, similarly to other H1 medications above. This is typically available without a prescription, and is inexpensive in the US.
H2 Antihistamines, especially Famotidine/Pepcid, reduce both symptom severity and viral load, leading to an earlier resolution of infection. These are available without a prescription in the US, and typically inexpensive.
Paxlovid is less effective at decreasing Long Covid risk in the acute phase, but does have other benefits, even if started late. It is additionally showing progress as part of a combination therapy. Stock up on mints and cough drops though.
Magnesium, Vitamin C and other immune-boosters can be very beneficial IF you are not autoimmune/don’t have other relevant considerations.
If you are on trans masculine HRT or similar medications please continue. Men & NB people with similar levels of hormones have lower risk and sometimes lower symptom burden than women & NB folks with similar hormone levels. We aren’t sure why yet.
Other OTC items which might help lower the viral load or otherwise make the acute infection less impactful:
A mouth wash containing PVP-I [povidone-iodine] or CPC [cetylpyridinium chloride]. This can be used multiple times a day.
Green tea (ECGC)
Hibiscus tea (ACE2)
Antioxidants and omega-3 fatty acids (including flaxseed oil, fish oil) help remove oxidative stress, which is helpful in both acute Covid (infection and replication causes OS) and in multiple forms of Long Covid. I’ve read . Antioxidants are vitamins A, C, E, Selenium (Se), and Zinc (Zn). Vitamin A is possible to overdo, so please be mindful of dosing.
Transmission Precautions (how to protect people you live with, etc):
COVID is most often transmitted via the air, not droplets like we thought early in the pandemic. As such:
Fresh air will be your easiest and most effective option, assuming climate safety. Even a slightly open window will be MUCH better than closed windows.
Masks are extremely effective, especially when both parties wear them. Respirators (aka a mask with a safety rating such as N95, KN95, KF94, P2, FFP2, DS) are best, but anything is better than none. Try to get as good of a seal as you can/minimize air leaks.
Air filtering with HEPA filters is great if you have access and funds. Try to make sure the filter(s) you use are sufficient for the square footage of the space. Earlier variants had a filter goal of 6 air changes per hour (ACH), but anything is better than nothing, especially when combined with opened windows, etc. If the filters are insufficient for the square footage/meterage or ACH, place them for largest impact: for example close to the sick person, in areas with poor ventilation, or areas of high social contact.
If HEPA filters are too expensive or unavailable, try to make a Corsi-Rosenthal Box (a DIY air filter alternative using MERV13+ filters and a box fan, free directions abound online). Same strategies as above.
Last home air filter precaution: most climate control systems have a filter, and if that filter is already or can easily be changed to a MERV13+ filter, that will be an additional help.
If you must run errands/go to work/etc, please prioritize one of the rated respirators above. Try to do curbside or other distanced, outdoor pickup options where available.
There are nasal precaution options including the aforementioned OTC H1 Antihistamine Azelastine and Profi Spray (which is highly effective, but their science was measured with nasal swab application, not spray).
It doesn’t take a lot: We have stopped the acute spread of Covid in our home two times (that we know of!–the real number is probably much higher) by using only a couple strategically placed HEPAs and window cracking.
If you feel any sustained exhaustion or fatigue, please rest and do not push yourself for at least two-three months after infection, including physical and mental exertion. A lot of us long haulers had an inkling early on that something was off but we pushed ourselves to be “back to normal” and that caused immense lasting harm. It might sound like a long time now, but a few months is a short time in comparison to the rest of your life. Trust me.
I wish I had read this earlier: Indefinitely Ill – Post-Covid Fatigue
Pacing is the most helpful tool I have found for my health, and has been practiced by people with post-viral illness for a long time.
Intro to pacing: ME Action’s Stop Rest Pace
Scheduling breaks with reminder alerts is how I do it, and by having specific things I look forward to about downtime (slowed audiobooks, a nature soundscape, etc). Some people are better at remembering on their own.
Lastly, I recommend using a symptom tracker even for initial infection (and that couple month period after). Hopefully before too long there won’t be many symptoms to track and things’ll be mostly a-ok, and it won’t be needed, but the way covid makes the brain all squiggly, IMO tracking symptoms is super important for understanding what your body needs to have your best chance at maintaining your current health!
The app Visible is popular in some LC communities, but a journal or calendar is a-ok too. It helps to check in with your body and see how much feels safe to do and what to prioritize. (Visible is free for symptom tracking and I recommend the free version short-term. If you end up needing long term pacing help and want to include the paid wearable, though here’s my coupon code: https://join.makevisible.com/68284299c4dc3e )
**Thank you for taking care of yourself and your communities. We need all the precautions, kindness, and care we can get right now.**Additional Covid Safety info from someone else’s patreon: https://www.patreon.com/posts/huge-free-covid-86871700
the figure on the bookmark is silhouetted in outline vs the shape of a house, outlined in red and filled with purpley blue textures. the head of the figure, angled to the side, is attacked from all angles with dark rough textures of inky depths with red/rust particles, and purple angular lines pointing inwards, and breaking past the lines of the house. the figure stands on a square of purple ink as well, which balances the composition