Is COVID an acute illness or a chronic illness?
Our body has lots of habits, both in illness and in health. Some of those patterns are predictable and quite protective. For example, if we unintentionally eat spoiled food our body will work hard to clear it out (with vomiting or diarrhea). Similarly, if we breathe in a lot of dust we sneeze, cough and get watery eyes, all ways to move something out of the body. If our immune system needs to be active against an infection we mount a fever. These kind of responses mean that for most acute illnesses there are a variety of predictable patterns, and that we can dependably work to find ways to support the body in its protective tasks.
An important caveat about how we approach these acute illnesses is whether we are trying to stop a process—such as mainly working to remove all of the symptoms—or whether we are guiding and stimulating the body to move through to a healthy resolution. We might ask: should we suppress a fever, or help the body better accomplish its own goals for increasing warmth? Should we stop a cough, or find treatments that help move mucus out of the lungs? Anthroposophic medicine works primarily towards those second goals, working with, not against, the body’s protective patterns. This approach has been shown to significantly reduce the amount of antibiotics that needs to be given for a variety of acute illnesses.
Want to start thinking that way? Well, as we head into another fall and winter season, revisit the blog post from a couple years ago about “Support for Working through Flu (treatments which should help with coronavirus, too).”
Another way is to build a new relationship to fever. Anthroposophic colleagues have developed a very helpful app for your smartphone called “Fever Friend” which gives guidance about how to take care of a child with fever. When should you be worried? When do you need to reduce the fever? When should you seek medical attention? This app gives you clear indications so that you can feel more prepared and empowered, and walks you through the whole process in about three minutes.
If we go back to the question about acute versus chronic illnesses, we can say that there are good, predictable tools and treatments for acute illnesses that work for a broad range of people and have shown their efficacy over multiple generations (anthroposophic medicine is now more than 100 years old!).
Now when we come to chronic illness, things are quite different. We again encounter “habits” of our body, but they are not necessarily part of a healthy response. We might find that our blood pressure tends to be too high, or we get a nagging bronchitis every time we catch a cold, or a migraine if we don’t get enough sleep. We recognize there are predictable ways that our body gets out of balance, which may at first just appear when we are over-tired or stressed but then become a recurrent problem. In anthroposophic medicine the goal for chronic disease is really to try to shift and change an illness pattern, in a way to learn a new habit. In order for that to happen, treatments and tools need to be very individualized. We might be able to control a pattern from the outside, stop or suppress symptoms, but to really make a lasting change we must participate in our own healing process. It’s an important and meaningful process, which is a little bit different every time.
Back to our original question: is COVID an acute illness or a chronic illness? The answer is: “yes.” It seems more and more to be both. COVID is not like other kinds of acute illnesses where you pretty well know what the symptoms and the course will be, even though it can have some classic symptoms like fever, congestion or cough. How this illness shows up in one person or another is quite variable. Also, a large number of people have lingering symptoms—a study this week from Scotland showed that 42% of people who had symptomatic infections were still not fully recovered 18 months later. And the lingering symptoms are quite individual. In my own practice, it seems that lingering symptoms often relate to sleeping “patterns” of illness that we’ve already been carrying for some time. The most common patterns seen in the study were “pain or discomfort, shortness of breath, cognitive impairment, and mental health problems.” But recent experience also shows that there can be persistent GI symptoms, a dry cough that won’t go away, exercise intolerance with imbalanced circulation, or simply an overall feeling of being dysregulated.
To meet the challenges of the present time we:
· need information to share with each other that will help guide us through the acute part of an illness
· while also creating space to look at things in a very individual way.
Good thing that we have two eyes and two ears, so that (hopefully) we can work to hold both views at the same time, or at least regularly alternate back and forth between them.
More information about well-established anthroposophic treatments for COVID can be found here. Please share this with others who are open and looking for these kinds of approaches. Especially share the fever friend app—let’s work to create a new culture around fever! Let’s make sure that as a community we are really learning and changing and able to take new steps, and that out of challenge of the last several years new wisdom can be won.
Be well,
Dr. Blanning