Outline Structure

Section 1: Setting the theme-relationship between Immune system & Covid

● Immune System- Top-level view of how it is working?
● Talk about how sleep affects the Immune system. The detrimental impact
of Sleep on the Immune system
Section 2: Factor for poor Immune system
Evidence of Sleep & Covid- References over Sleep & Immunity from Harvard,
Nature, Ted talks etc
Talk about any literature about covid & Immune system- (Evidence suggest
people had a more likely impact on covid through the immune system)
● Three significant factors highlighting the importance of the Immune system
1. Sleep
2. Diet
3. Stress level
Section 3: Piece of advice as Self Help
What can I do as a reader to restart or rewind our system?
Reduce my stress levels
● Take better sleep
● Off-Screen Time
● Meditation
● Better Diet
Closing Note
For Individual- Evidence-based action points leading to self-care and better health
care
For Policymakers- Call to action for better health reform as another aspect in
reforming NPI (Non-pharmaceutical Interventions)
References to check:
1. Harvard study:
● Crucial ways you can support a healthy immune system
● Sleep and Health | Need Sleep
2. PubMed Study- The Sleep-Immune Crosstalk in Health and Disease
3. Sleep Foundation- Sleep & Immunity: Can a Lack of Sleep Make You Sick?
4. Ted talk by Matt Walker
https://www.ted.com/talks/
matt_walker_how_sleep_can_improve_your_immunity?language=en#t-
137262

Section 1: Setting the theme-relationship between Immune system & Covid

·

Immune System- Top level view of how it is working?

Each human body is unique and the immune system plays an important
role. The development of science and technology helped us to understand
how the immune system functions within our bodies. The immune system
plays a vital role in protecting our bodies from any foreign attack. The
pandemic emerging in 2019 and effectively shutting down the entire world.
Led to excessive use of technology, exposure to screens, constantly
checking media news, and developing unhealthy food habits to fight stress
and anxiety.

One of the articles talked about how the black death 1 swept through
Europe in 1347. It was known to be one of the deadliest disease outbreaks
in human history leading to the deaths of between a third and half of
Europeans. With evidence around, historical researchers could believe that
“famine in northern Europe, before the plague came ashore, may have
weakened the population there and set the stage for its devastation”
 Does the question arise as to how it may have weakened the population?
What factors may have arisen that affected those times? There was a
constant fear, anxiety about the future, lack of support systems around and
what else? To understand this lets’, go a little further within our human
systems and try to explore many other supporting factors.

As we understand our body's defense mechanism, we get closer to how our

Immune system works2.

It has two main parts:

● The innate immune system- It is inherited and is active from the moment
we are born
● The adaptive immune system- This is developed with the help of the innate
system once exposed to microbes or chemicals released by microbes. Our
bodies start producing cells(antibodies) as a self-defense mechanism. These
antibodies are developed by cells called B lymphocytes after the body has
been exposed to the invader. These antibodies stay in our bodies. It can
take several days for antibodies to develop. But after the first exposure, the
immune system will recognize the invader and defend against it. The
acquired immune system changes throughout our life as it gets exposed to
different invaders.

Now the question arises that if our bodies are so well designed what leads
our bodies to become weakened and unable to protect their own defence
mechanism?

If we consider our systems as a whole and not segregated as different

sections, we may be able to see through the interconnectedness of illness
vs wellness.

Effect of sleep on the Immune system

Scientist Matt walker exclaimed “there’s a very intimate association between our
sleep health and our immune health” and he further explained through research
groups how having a sound sleep can impact our immune system. He concluded
that “when it comes to our immune system, we should perhaps think of sleep as
one of the best health insurance policies”3

Covid impacting sleep- A major effect on one’s overall health

With Covid 19 wave 1, a whole lot of people went into a gloomy state, uncertain
of what lay ahead in the future. Wave 2 brought further challenges, with more
fear and anxiety building up. There was worldwide dilemma over vaccination/
vaccination side effects/ failure. The higher mortality rate in wave 2 was indeed
worrisome. Earlier wave 1 made people adjust from office life to online life, huge
challenges with people with families and small spaces, erratic time management
over work vis-a-vis personal life. With uncertainty emerging the majority of the
population suffered from sleepless nights and disturbed sleep.
The Lancet article stated how sleep problem appeared more commonly during
the pandemic time and was associated with higher levels of psychological
distress.11 People during wave 2 started showing clear signs of anxiety, fears, and
lower motivation to work or engage in any activity. With quarantine fatigue and
loss of social connection, there was a higher increase in screen time for everyone
from kids to the elderly.
Research connected with sleep and mobile screen time
One of the studies conducted on the Chinese population showed that “After
adjustment of the gender, age, body mass index, demographics, and lifestyle
factors, more than 3 hours of TV viewing and 4 hours of computer usage or
mobile phone usage was associated with 85% (95% CI 1.04-1.87; P=.008), 72%
(95% CI 1.01-2.92; P=.045), and 53% (95% CI 1.06-2.22; P=.03) greater odds of
having poor sleep quality (PSQI score>5), respectively.” 4
Sleep- An antidote for good health during COVID times
Sleep is the recharging switch for every living being to revive and set back to their
higher energy level. We human beings are designed based on the circadian
rhythm of the human body. Our system automatically shuts when in the dark.
There are some more scientific reasons for the biochemical mechanism working
within the body.
The human body is the highest intelligent species created on this earth. We,
humans, have minds which think logically. We are able to rationally choose
factors ,which help in one's survival. With Covid 19 impacting the entire world, it
has made the entire medical fraternity question knowledge over wisdom and
science over spirituality. A small virus not only created havoc worldwide but
questioned the intelligence of nature. Are we humans still entirely at the mercy of
medicine or do we have some innate ability to fight to survive? Evolution taught
us many lessons. Science played a bigger role in many aspects of human
civilization to develop. However, the question remains: Are our natural instincts
weakened and suppressed because of excessive use of technology and gadgets?
One of the research articles also highlighted the importance of sleep during Covid
times. A research paper published in Springer on the importance of sleep for
health and well-being amidst the COVID-19 pandemic mentions that “sleep which
occupies nearly one-third of our life should get more emphasis for attaining better
immunity” 5
In fact, Arianna Huffington, the author of sleep revolution in one of her talks at
Google mentioned “how sleep is something that is non-negotiable”. 6

Factors responsible for poor immune system

Apart from sleep as one of the key influencers impacting the immune system,
there are several other factors that result in poor immune systems such as diet
and lower stress levels.

Research shows how food acts as a natural source of immunomodulation 7. For

our system to function efficiently: we need the right source of food, and
nourishment to support our immune system. There is evidence of how poorly
managed dietary habits alter the immune system. 8 Thus, dietary choices impact
the functioning of immune systems by suppressing immune responses and further
enhancing the vulnerability to diseases.

Understanding the effect of acute to chronic stressors on the immune system in

adaptive and maladaptive manners9. Research shows that “While acute activation
of the immune system in response to threat is homeostatically regulated by
neuroendocrine mechanisms, chronic activation of the immune system arising
from persistent stress exposure can contribute to an allostatic load with an
inflammatory diathesis that has been implicated in the pathophysiology of mood
and anxiety disorders” 10
Section 3: Piece of advice as Self Help
Understanding how the pandemic has affected the lives of each individual,
however, the question still arises how are we individuals going to cope with the
post-pandemic world out there? Will there be more government support in terms
of better health systems or employer-friendly work guidelines so that employees
are able to effectively and efficiently manage and bring back normality to their
lives, or more community support for individuals to succeed in overall well-being?
What measures can an individual take for better self-care and be able to cope
with the current challenges and situations?
It is important to remind ourselves and question our priorities based on our
learning from pandemics. Some of the ways to bring self-care into action.
References:

1. https://news.harvard.edu/gazette/story/2016/01/did-famine-worsen-the-
black-death/
2. https://www.hopkinsmedicine.org/health/conditions-and-diseases/the-
immune-system

3. Ted talk by Matt Walker

https://www.ted.com/talks/
matt_walker_how_sleep_can_improve_your_immunity?language=en#t-137262

4. Relationships Between the Usage of Televisions, Computers, and Mobile

Phones and the Quality of Sleep in a Chinese Population: Community-Based Cross-
Sectional Study

5. Importance of Sleep for Health and Wellbeing Amidst COVID-19 Pandemic

6. https://www.youtube.com/watch?v=TLBiVgkESM0

7. https://www.sciencedirect.com/science/article/pii/S0023643822000895

8. Foolchand A, Ghazi T, Chuturgoon AA. Malnutrition and Dietary Habits Alter the
Immune System Which May Consequently Influence SARS-CoV-2 Virulence: A
Review. International Journal of Molecular Sciences. 2022; 23(5):2654.
https://doi.org/10.3390/ijms23052654

9. Ravi, M., Miller, A. H., & Michopoulos, V. (2021). The Immunology of Stress and
the Impact of Inflammation on the Brain and Behavior. BJPsych advances,
27(Suppl 3), 158–165. https://doi.org/10.1192/bja.2020.82

10. McEwen BS. Central effects of stress hormones in health and disease:
Understanding the protective and damaging effects of stress and stress
mediators. European journal of pharmacology. 2008; 583(2–3): 174–85.
11.https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00196-
6/fulltext