COVID-19 Lessons

Dear One,

In recent conversations with good friends—smart and worldly friends—I realized how uncertain and scared many of them are about the COVID-19 pandemic. More than I expected.

Like, what it is. How it affects us—really. Why we are responding as we are. What we can do to protect ourselves and others. How we safely move forward with our lives.

I’ve heard remarks like, “I didn’t think we’d ever be able to safely come out without a vaccine.” “If the governor says it’s okay to go back to work, then it must be true.” “Well, the CDC says …”

And worse, I’ve heard harsh judgments of others’ behavior—shaming people for not wearing masks (we’ll talk about this in a bit) or for having a different perspective.

I’ve also observed intensely fearful behavior. Like the woman who leaps off the path in the woods we share from time to time, pulling up her mask (her bare hands touching the front of it), turning her face away from me in obvious fear, and not replying to my friendly greetings.

It all reminds me that there’s so much misinformation and incomplete information out there about just about every aspect of the COVID-19 pandemic. It makes people needlessly scared about their futures.

And it makes sense, right? Most of us aren’t physicians or scientists who can wade through the scientific literature to make sense out of it. And we’ve had no strong, knowledgeable, trustworthy leadership to guide us.

Dang straight people are scared and uncertain.

Since we’re all adults in the room here, I won’t try to dumb this down or make it seem simple when it’s not. Immunity and resilience are complicated. And it appears the novel coronavirus and the illness known as COVID-19 are complicated as well.

But we’re wired for uncertainty and complexity. True, they make us squirm. No doubt about it. But we’re brave. We’re resourceful. We can keep love in our hearts. We can do this.

Why We’re Social Distancing

What we’re witnessing in the COVID-19 pandemic is a collision between a novel, highly virulent coronavirus and an increasingly physically vulnerable global society.

The sheer numbers of severely ill have overwhelmed acute care facilities and hospitals worldwide, exploiting shortages of resources, hospital beds, and medications.

Healthcare workers on the leading edges of the pandemic are exhausted, overworked, and traumatized.

And there have been countless deaths due to COVID-19 in addition to non-COVID-19 acute illnesses that may have been prevented if resources had been readily available.

This is why we’ve been asked to “flatten the curve” of the rising tide of identified COVID-19 illnesses and deaths: to allow healthcare resources and workers to re-equilibrate to manage the needs of the sick.

These measures include:

  • Social distancing.
  • Frequent and aggressive handwashing.
  • Quarantine for suspected or proven coronavirus infection.

Special Word on Wearing Masks in Public

More recently, we have been asked to wear cotton masks while in public, in addition to maintaining distance, though there is a marked paucity of scientific data to support this practice.

I bring this up because there’s been a disturbing trend of publicly shaming those who choose not to wear masks, though adhere to the key aspects of social distancing and barrier protection.

There is evidence that wearing cloth masks may actually increasethe risk of viral transmission from a large randomized controlled trial in which penetration of cloth masks by viral particles was almost 97% (compared to medical masks—44%). The measured outcomes of the study had to do with viral transmission to the mask wearer, not those they came in contact with, but revealed the ease with which viruses get through the masks during the wearing period.

In addition, a 2020 review of the protective value of masks showed a slight, statistically insignificant protection associated with wearing masks in the community, and modest protection against viral transmission from an infected household member.

Mask wearing without scientific support has been compared to using a parachute when jumping out of a plane—not something we’d study for obvious reasons.

But even parachutes don’t work when we don’t use them correctly. And they’re designed to protect the jumper, not the bystander. I cringed the other day when a delivery person hopped up on my porch with a package, while pulling up the mask he’d been wearing on his neck. No gloves, dirty packages, exposure to countless households. Yikes. Masks and parachutes? Apples and oranges.

As we come out of our homes to spend more time in closer contact, particularly with folks who may be at increased risk for becoming gravely ill, it makes sense to use masks as part of an intensive barrier protection strategy as long as they are used correctly (more on this in a bit).

The End-Goal of Social Distancing

The specific end-goal of social distancing is ill-defined but is about reducing the number of people becoming sick right now to allow medical resources to recover.

Social distancing is not about getting past the pandemic to a time when we’re all safe from getting sick. While it may protect all of us to some extent short term, that’s not the overarching purpose.

For the vast majority of us, the harm of staying in lock down outweighs the harm of becoming sick for many reasons.

The estimates that 80% of us exposed to the Sars-CoV-2 virus thought responsible for COVID-19 will be asymptomatic or have only mild illness is reassuring.

And as many as 68% of us need to become immune to the novel coronavirus before we see a sustained decline in the numbers becoming sick outside of social distancing.

But don’t let this scare you–read on!

Why the Virus, by Itself, Is Not the Enemy

I’ve talked about this before, but it’s so important, it’s worth retelling.

There is a dominant social narrative of “the virus is the enemy” that is powerfully influencing peoples’ responses to the pandemic and conversations in the news and social media.

This isn’t completely wrong. But it’s not right either.

What I want you to know is this: The enemy is not the virus.

The true “enemy” is the virus-host-terrain relationship. In this relationship, we are the host. And the terrain is our health.

Our health is based on the gene-environment relationship we’ve created through our lifestyle choices and the condition of the environments we live in.

See—it’s not simple. It’s not a simple matter of “we’re under attack by this enemy that we must protect ourselves from.”

Simple is easy to wrap our minds around. But it doesn’t give us hope, does it? Truth is, there’s a lot we can do to take control of this relationship.

Determinants of Whether We Get Sick from a Virus

Becoming sick has to do with the relationship between the virus and the host-terrain in which it lands.

We are the host and our health is the terrain, right?

How much harm a virus causes us depends on two main factors:

  • The tenacity and adaptability of the virus.
  • The tenacity and adaptability of the host because of its terrain.

These tenacity and adaptability factors vary from one virus to the next, as well as one host to the next. This is why many viruses don’t make people sick, and in the face of really nasty, tenacious viruses, some people get sick and other don’t.

The virus, like all living organisms, wants to survive and thrive. Whether it can, depends on us—on our terrain.

Will the terrain the virus lands on be hospitable to the virus, allowing it to invade and replicate widely, setting off a nuclear bomb-level illness to create the most damage as it survives and thrives?

Or will the terrain (us) have robust boundaries, a deep supply of energy and resources to defend itself, the ability to mount an appropriate immune response, and the capacity to recover, repair, and heal itself?

The latter scenario is what immune resilience looks like. A healthy terrain in an inhospitable (to the virus) host.

Make sense?

Who is Vulnerable to COVID-19?

Truth? We all are.

We live in unprecedented times for our planet and global community. We’ve been collectively driving massive and unsustainable levels of:

  • consumerism and resource consumption,
  • carbon emissions,
  • pollution (industrial, pesticides, plastics),
  • nutrient-poor, processed diets,
  • sedentary lifestyles, and
  • pharmaceutical-based disease-focused healthcare.

The result? Devastating loss of resilience that has made us all increasingly vulnerable to dysfunction and disease.

Even those among us with robust self-care practices and excellent health are challenged by increasingly toxic and nutrient-depleted environments.

But clearly there is a spectrum of vulnerability.

Statistics from this pandemic show an increase in severe disease and death in the elderly and those with at least one pre-existing chronic illness, such as obesity, hypertension, and diabetes.

These conditions are all associated with dangerous levels of inflammation, nutrient-depletion, and immune dysfunction. They are likely factors that play strongly in loss of immune resilience and viral illness susceptibility.

The hopeful news is these conditions are all modifiable.

What Should We Do Next?

Social Distancing

First, follow guidance regarding social distancing, but let the data drive your behavior. If you live in a state that’s opened up but not reached its peak for COVID-19 incidence and deaths, stay home anyway.

Once we’ve dropped down the other side of the curve, get back out into the world. Continue to wash your hands diligently. And, please, if you’re sick, stay home! Not only do we not want your COVID-19, we don’t want your common cold or flu either.

Wearing Masks in Public

If you choose to wear a mask while social distancing, use it correctly to increase the probability that it will actually function as you’re asking it to—to reduce the chances that you, as a potential asymptomatic carrier, are transmitting the virus to others.

With this purpose in mind, it makes sense to wear a mask in a correct manner when in close contact with the general public (whose health status you don’t know) or when in the presence of those who may be at increased risk of severe illness.

Remember, the mask is not to protect you. There is data suggesting they may increase your own risk of contracting a viral illness due to the length of use, the ability of viruses to move through the fabric, and exposure of your unprotected eyes to viral aerosols.

If you can’t follow these guidelines, then don’t bother—you may be increasing the chances of infecting others.

  • Place it snuggly over your mouth and nose when you enter a public domain or are in contact with someone at increased risk for more severe disease.
  • Touch only the straps and DO NOT TOUCH THE MASK, or any part of your face, while you’re wearing it.
  • Follow social distancing and hand washing protocols while you’re using them.
  • Use them one time only, then wash them in hot soapy water.
  • If you are symptomatic, do not go into public even with the mask on—stay home.

Increase Personal Resilience Through Self-Care

We’ve talked about this extensively before. We all need to let the COVID-19 pandemic energize our efforts to create beautiful energy, adaptability, and strength through self-care. This is a powerful point of control over our resilience in the face of COVID-19 and all other health challenges that come our way.

Self-care practices bolster our terrain, so we become an inhospitable host to this virus and all future viruses.

Our gene-environment-lifestyle terrain will favor us, not the virus.

Love Our Planet

In the early days of the COVID-19 global lockdown, there were marked measurable decreases observed worldwide in air pollution and greenhouse gas emissions because of reduced fossil fuel driven transportation, electricity generation, and industrial consumer goods production.

I found this so encouraging: our planet can heal.

These planetary problems directly challenge our personal biology and immune resilience through depletion of critical protective nutrients, widespread damage to our cells and tissues, and upregulation of destructive inflammation.

While the magnitude of these changes cannot be sustained when the lockdowns are lifted, they demonstrate how quickly we can create positive modifications—and reduce our personal and collective risk—in our environment when we behave differently.

We can all contribute to planetary healing in painless, low cost ways:

  • Stop using all single-use plastic, household toxic chemicals, and lawn/garden pesticides and herbicides.
  • Conserve energy use.
  • Remediate toxic buildings.
  • Use only organic foods and pasture-raised meats.
  • Avoid consumption of “fast” foods.

Last Words: Stay Soft

We need one another now more than ever. With all of our differences, we have more in common than we ever realized.

We all want to survive. We want to thrive. We want to live the purpose for which we were born.

But sometimes we get scared and lost. This makes us forget who we really are and who others are.

How can we come together even with the people who are the most difficult for us?

We soften. Soften our judgments. Soften our stories. Soften our expectations. Soften our worries and defensiveness.

Only when we soften can we feel. Only when we feel can we know ourselves and know others—and find our commonalities. We’re all just humans doing our best.

Thanks for listening and I’d love to hear from you!

How are you doing?




C Raina MacIntyre, et al. A cluster randomized trial of cloth masks compared with medical masks in healthcare workers.BMJ. 2015.

Julii Suzanne Brainard, et al. Facemasks and similar barriers to prevent respiratory illness such as COVID-19: A rapid systematic review. MedRxiv. 2020.

Karyn Shanks MD. COVID-19: How to Protect Your Whole Self in a Global Pandemic. 2020.

Karyn Shanks MD. How to Create Resilience: Adaptability, Energy, and Strength for Life. 2020.

Karyn Shanks MD


Karyn Shanks, MD, is a physician who lives and practices in Iowa City. Her work is inspired by the revolutionary science of Functional Medicine, body-mind wisdom, and the transformational journeys of thousands of clients over her twenty-eight year career. She believes that the bones of healing are in what we do for ourselves.

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