The COVID-19 pandemic has lifted a number of bioscience concepts from academic obscurity into everyday awareness. One erstwhile arcane concept is “flattening the curve” to avoid a steep spike of infection so that we do not overwhelm society’s capacity to deal with the cases that require medical attention. Another now familiar notion, that of “herd immunity”, postulates that once enough people are not susceptible to a pathogen, the infection rates drop, and the disease peters out. Flattening the curve is the immediate priority while herd immunity is needed to minimise long term impact.

At the time of writing (late April 2020), the measures taken around the world to restrict movement and person to person contact appear to be helping to flatten the curve, but these restrictions cannot be maintained indefinitely. Once the world comes out of lockdown, there is the very real risk of second and subsequent COVID-19 waves. One way to minimise the impacts of these waves is to adopt lifestyle practices that can help to strengthen peoples' immune systems to minimise infectious disease severity.

The practice Julie and I have adopted comprises of an integrated approach encompassing seven interlinked pillars of a healthy lifestyle:

1. A Wholefood Plant-Rich Diet
2. Frequent Movement
3. Sound Sleep
4. Effective Breathing
5. Psycho-Social Health
6. A Healthy Environment
7. Personal Empowerment

​
I will introduce this approach in this article and list some of the practices I undertake to optimise my health. For a more personalised, practical, and in-depth understanding you can sign up for one of our participatory workshops or take part in one-one or small group coaching. 
​
This and other articles that address SARS-CoV-2 and immune function are based on the logical assumption that improved immune function will help to limit the severity of infection from this particular virus. However, this cannot be definitively concluded until there is targeted research to confirm this underlying assumption.
​
What we do know is those that suffer certain pre-existing conditions are much most vulnerable to COVID-19 than those who do not. A CDC report published in late March stated that 94% of all the people who have died from COVID-19 in the US to date had an underlying chronic condition such as type 2 diabetes, hypertension, cardiovascular disease, chronic lung disease, and obesity (CDCMMWR, 2020). The equivalent figure in Italy was 99% (COVID-19 Surveillance Group, 2020). The lifestyle interventions outlined in this article have been shown to prevent, arrest and even reverse the chronic conditions that serve as coronavirus welcoming mats.

The following diverse and consistent evidence base indicates that a whole food plant-rich diet is optimal for human health:

• Epidemiological studies of dietary pattern and health outcomes, e.g. studies on Seventh Day Adventists adopting a range of dietary journeys from omnivore to vegan and stations in between (Le and Sabaté, 2014) and studies of the world’s longest lived and healthiest populations – the “Blue Zones” (Buettner, 2010).
• Studies of human physiology and evolutionary biology that indicate that humans are primarily herbivorous animals (Mills, 2018; Warinner, 2013).
• Mechanistic studies looking at the impact of diet on physiology and biochemistry (Miller et al., 2009).
• The impact of dietary-based interventions on health markers, such as the cardiovascular disease (Ornish et al., 1990), prostate cancer (Ornish et al., 2005) and obesity, heart disease and diabetes (Wright et al., 2017).

​There is insufficient evidence to assert that a wholefood vegan diet is any healthier than a regime that  incorporates small quantities of animal products 1-3 times per week. This is why we use the term ‘plant rich’ rather than plant based. Our approach is summarised in the New Paradigm Health Wholefood Plant-Rich Diet Plate derived from the work of Fuhrman (Fuhrman, 2011), Popper and Merzer (Popper and Merzer, 2013), and Davis and Melina (Davis and Melina, 2014).

The categories can be broken down as follows:

• Sliver - Avoid: processed meat, non-organic animal products, GMO products, non-organic wheat products.
• 8% - Limit: Alcohol, eggs, dairy, red meat, poultry, fish, oil, sugar, processed food.
• 35% - Vegetables (30-50%): e.g. Kale, cabbage, broccoli, spinach, squash, peppers, onions, garlic, carrots, lettuce, cucumber, tomatoes.
• 20% - Fruits (10-30%): e.g. berries, apples, oranges, peaches, grapes, pears, bananas.
• 20% - Legumes (10-30%): e.g. Kidney beans, black beans, chickpeas, peas, lentils, soybeans, peanuts.
• 8% Nuts & Seeds (5-20%): e.g. Chia seeds, flax seeds, pumpkin seeds, walnuts, cashews.
• 30% - Starches (20-60%): e.g. whole wheat, brown rice, quinoa, potatoes, sweet potatoes.

​For an excellent summary of the power of plants to contribute to a healthy immune system, I recommend you read the article by Ocean Robbins - Smart Immunity: How Diet and Lifestyle Can Help You Stay Healthy in the Time of COVID-19. Robbins uses Joel Fuhrman’s handy acronym G-BOMBS to introduce the power of healthy foods to positively influence your immune system. G-BOMBS stands for greens, beans, onions, mushrooms, berries, and seeds. But remember, the power in the individual foods is manifested in the dietary pattern of which they are a part. There is little benefit in eating flax seed (ground not whole) for its omega-3s while guzzling down gallons of Coca Cola and binging on greasy kebabs. Superfoods are no longer super if they are part of a dietary pattern that minimises nutritional kryptonite. 

​Julie and I eat a wholefood vegan diet with no added sugar or wheat products and very little oil. We eat organic as far as possible.

​As might be evident, I prefer to get my nutrition from whole foods rather than from pills. Whole foods contain a complex of macro and micronutrients in a form our bodies are designed to absorb (Campbell and Jacobson, 2014). A focus on individual nutrients reflects a reductionist mindset prevalent in both the conventional and complementary health spheres. That being said, there can be instances when taking individual nutrients or other supplements is justified and an individualised regime may be required. Being a vegan, I take vitamin B12 (1,000 mcg, 3 times per week). B12 is produced by microbes that live in the environment and are ingested by animals. I also regularly take vitamin D (1,000 IU per day from October – April), quercetin (500 mg once per day) for gut health, and an algae-based source of omega 3 DHA (400 mg per day). At the first sign of an infection I take vitamin C to bowel tolerance and zinc (50mg per day).

​Our bodies are mostly water, so it is vital that we keep properly hydrated. According to a review study (albeit funded by the bottled water industry) there is evidence that not drinking enough may be associated with falls and fractures, heat stroke, heart disease, lung disorders, kidney disease, kidney stones, bladder and colon cancer, urinary tract infections, constipation, dry mouth, cavities, decreased immune function and cataract formation (Jéquier and Constant, 2010). Here are some tips to maintain proper hydration

• Most people should take in 2-4l water/day including beverages. Your urine should be a light yellow colour. Ideal intake varies a lot depending on factors such as how energetic you are, temperature, humidity, etc. Those doing endurance activities in the heat can sometimes take in over 8l water/day.
• Drink water first thing: You can lose a lot of water at night especially if you are a nose breather.
• Drink water when thirsty: Thirst is a signal.
• Avoid soft drinks, ‘sports drinks’, energy drinks and fruit juice: Most are full of sugar, often contain caffeine and a variety of low level toxins.
• Drink water to compensate for alcohol: Most people know this but most of us don’t do it.
• Filter your water. Pure water is best but filtered tap water is often better for you than bottled water. And cheaper and better for the planet.

​I drink about 2.5 litres of liquid in an average day, about 1.5 litres is water and 1 litre is black tea and herbal teas. I drink a glass of red wine 3-5 times per week. 

​Eating is, of course, essential but it is nonetheless a stressor. This is evidenced by the fact that a large proportion of our immune system is contained in our digestive tract. Fasting can help to improve immune system function for a number of reasons including the following: inflammation of the digestive tract is reduced due to elimination of allergenic food (Salloum, 1999); normalised blood sugar levels, and enhanced immune cell activity (Hiramoto et al., 2008).

​Julie and I do regular short fasts of 18-24 hours, and quarterly 5-day fasts. While we are enthusiastic devotees of fasting, it cannot be overstated that for optimal benefits fasting must be part of a lifestyle that includes a healthy diet. Without this combination, we are prone to falling in the “detoxification trap” – indulging in periodic cleanouts, only to return to a toxic lifestyle. Such an approaches is akin to yo-yo dieting, high intensity exercise in an otherwise sedentary life, and the superfood and junk food combo outlined above. 

The oft-repeated mantra for good health – “eat less and exercise more” is quantitatively correct, but tells you nothing about the quality of what you are putting in your mouth, nor what you should be doing in terms of exercise. I prefer to focus on the word “movement” which encompasses both formal exercise and other types of movement. Paying attention to exercise alone may imply that all your body needs is short bursts of activity to offset long periods of sloth.

Unsurprisingly, researchers have found that the energy used in non-exercise activities dwarf the energy used in formal exercise for the vast majority of people (Shook, 2016).

A focus on movement encourages us to consider the importance of all of the physical activities we do throughout the day. Aboriginal people never formerly exercise but they are tremendously physically fit. Without the accoutrements of civilisation such as cars, dishwashers and home shopping delivery, aboriginal people, of necessity, have developed a daily movement regime in nature involving activities that are aerobic (talking pace), anaerobic (getting out of breath), mobility-related, and involve lifting heavy weights. We need to engineer a similar regime but one that is compatible with modern life.
That’s where OTMs (“Opportunities to move”) come in (Segar, 2015). What you focus on expands and awareness of the value of OTMs alerts us to the daily decisions that we (normally unconsciously) make about whether or not to move and how. Should I cycle or drive to work? Should I impersonate a circling vulture and always look for the closest parking spot or park further away? How can I reach for an object in a way that improves my range of movement? should I do yoga poses while the kettle is boiling, or should I slouch on the couch? Should I fidget at my desk or stay immobile? etc., etc.

But labour saving devices do exist and most of us are unlikely to embrace aboriginal living, so OTMs though necessary, may not be sufficient to maximise, strength, stamina, speed and flexibility; so most people need to do some formal exercise. The fact is that the best exercise for you is the exercise you will actually do, but here I want to single out the value of weight training in particular.

A great many people, especially women, are reluctant to use heavy weights (defined as a load that is close to your maximum) because they don’t want to “look like Arnold Schwarzenegger”. This is not a risk for most of us, men or women. Arnie and his ilk are “genetically gifted”, and spend hours working out. What I am advocating is within the reach of ordinary people.

Weightlifting helps to build bone density which decreases as you age. The higher the bone density, the less risk there is for fractures from falls. Fractures are a major cause of incapacity for the elderly and they are correlated with vulnerability to a range of morbidities. Weightlifting also improves flexibility as well as strength, so if you fall you have a better chance of breaking that fall and not fracturing. Weightlifting also helps to generate mitochondria – the body’s battery packs. More mitochondria equates to improved cardiovascular fitness.

The great news is that you can get the benefits of a strength-based conditioning from weight training for less than an hour a week using methods pioneered by Doug McGuff and John Little (McGuff and Little, 2009).

Exercise is a classic example of hormesis, or “good stress” – something that challenges the body which over-compensates and gets stronger (Mattson, 2008). A hormetic response is induced by pushing the body outside its comfort zone just enough. However, too much stress can overstretch the body’s capacity resulting in long-term breakdown.
​​
The relationship between exercise and immune system function appears to be subject to a j-shaped curve indicative of hormesis or the “Goldilocks effect” – not too much, not too little, but just right. So, engaging in moderate activity may enhance immune function above sedentary levels, while excessive amounts of prolonged, high-intensity exercise may impair immune function (Gleeson, 2007). The definition of “moderate” or “excessive” will vary according to the individual. 

​There is sound scientific evidence to support something that we have known intuitively all along – that getting out in nature is good for our health. Japanese scientists have studied the effect of “forest bathing” (visits to a forest for relaxation and recreation) on immune function compared to the equivalent activity levels in a city location (Li et al., 2008). The investigators found that the forest bathers exhibited a significant rise in immune cell number and function and a significantly decreased concentrations of adrenaline. In contrast, the “city bathers” showed no changes. The changes have been partly attributed to phytoncides (wood essential oils), released from trees. Phytoncides were detected in forest air, but there were only trace levels in the city. 

​My movement regime is daily OTMs with lots of fidgeting, daily 1-2 walks with the dogs, 20 minute weights sessions twice per week, 1-3 cycles at below aerobic threshold (roughly defined as "talking pace") per week, and ad hoc 10-20 minute yoga sessions. The exercise component of my movement regime takes an average of one hour per day.

​The invention of artificial light and a number of other developments have wreaked havoc on our sleep patterns. Most adults need 7-9 hours’ sleep per day but the average Briton gets only about six and a half hours (The Sleep Council, 2013). This is a huge issue and the importance of sound sleep for optimal health cannot be overstated. Specifically, there is a lot of peer reviewed literature demonstrating that sleep has a powerful effect on your immune response to viruses (Besedovsky et al., 2012; Cohen et al., 2009; Dimitrov et al., 2019).

Peoples’ sleep-related issues can be complex, and some people will need individualised support, but the following basic sleep hygiene tips can help in many cases:

• Stick to a sleep schedule. You cannot fully compensate for lack of midweek sleep with weekends of binge sleeping.
• Unwind before bedtime through calming rituals like reading, relaxing conversation, meditation, a bath or sauna, or listening to relaxing music.
• Use an alarm clock – to tell you to get ready for bed. Don’t use one to get you up except as a transitional measure to regularise waking up times, or on the odd occasion when you need to get up especially early. If you do need an alarm, do what you can to avoid the snooze button.
• A healthy diet can improve sleep (St-Onge et al., 2016).
• Being physically active increases sleep quantity and quality especially in the middle and old ages, but strenuous exercise less than 2-3 hours before bed is not advisable.
• A hot bath before bedtime can help sleep.
• Don’t stay in bed if you cannot sleep. If you do not sleep within twenty minutes or so, do something relaxing that does not involve screens until you are tired. Otherwise your anxiety about failing to get asleep may make it harder to fall asleep.
• Turn your bedroom into a sleep sanctuary
  • Keep your room cool
  • Keep your room dark
  • Remove phones, TVs, laptops, tablets
  • Have a comfortable bed with clean sheets, create an uncluttered environment, add a few houseplants to improve indoor air quality, add an essential oil burner and burn oils such as lavender and jasmine, create an alter if you are so inclined. However, be careful about burning incense as many incense sticks contain toxic chemicals
• Avoid certain things and curfew others
  • Nicotine – avoid
  • Caffeine – avoid or curfew
  • Alcohol - avoid or curfew
  • Large meals and drinks - curfew
  • Screen time – curfew. Minimise watching the news or other programmes that are likely to stimulate adrenaline production.
  • Work – curfew.

​I sleep 7 to 8 hours most days and go to bed at about ten o'clock most evenings. We follow the sleep hygiene tips outlined above, but do not always keep to the screen curfew before bedtime. However, if we do watch TV close to bedtime, we will be wearing our funky yellow-tinted specs which block blue (‘daytime’) light – it’s one of life’s little compromises. 

​It is estimated that we take more than seventeen thousand breaths a day, usually without even being  aware of a single one. Becoming more aware of our breathing and harnessing this awareness on a regular basis can be immensely therapeutic. There are endless breathing techniques, notably from the yogic tradition, but here I will focus on three easy to learn practices that can help us to step back from life’s daily dramas.  

This simple technique can be used anywhere, anytime and anyplace and is a great instant stress reliever (Davidji, 2017). It comprises of one or more rounds of breathing in for a count of four, holding your breath for a count of four, breathing out for a count of four, and holding your breath for a count of four. Repeat as necessary. 

​For more details, see my article: Cultivating Stillness: Control, Alt, Delete for your Bodymind.

Developed in Russia by Prof. Konstantin Buteyko, the Buteyko Method comprises of reduced-volume breathing and breath holding. It has been shown to be effective for the management of asthma, with people able to substantially reduce medication with no deterioration in their asthma control, although no studies have demonstrated objective changes in lung function (Rosalba, 2008). The technique emphasises nasal breathing which is is likely to increase nitric oxide (NO) levels. NO influences many physiological processes including bronchodilation, vasodilatation, tissue permeability, immune response, oxygen transport, neurotransmission, insulin sensitivity, memory, mood, and learning.

​For a practical demonstration of Buteyko breathing, check out the video below.

This system has been developed by the eponymous Wim “the Iceman” Hof – a Dutch eccentric with the look of a leprechaun, the enthusiasm of a young child, and the delivery of a stand-up comedian. His achievements include setting world records for the length of time for swimming under ice, and the fastest half-marathon ran barefoot on ice and snow. He has reached the top of Mount Kilimanjaro in two days wearing only shorts and shoes, and he ran a full marathon in the searing heat of the Namib Desert without water – thus proving his resilience at both ends of the thermometer. A wee word of warning: Wim Hof has been doing this stuff for many years. I am recounting his feats as a testimony to the power of the body-mind, not as an encouragement to others to attempt to emulate or surpass Wim, unless they build up gradually and have full medical backup.

The Wim Hof Method (WHM) comprises of three pillars: breathing, cold exposure and meditation. Here we focus on “Wim Hof breathing”. Drawing heavily on yoga practices, notably Tummo or Chandali Yoga, Wim Hof breathing comprises of cycles of hyperventilation followed by breath holding (hypoventilation) which helps us to resist the cold (Carney and Hof, 2017). The method has been subject to scientific scrutiny in which the investigators found that trained group were better able to fight off infection than an untrained control group (Kox et al., 2014).  The essence of the method is very simple to learn from the free miniclass available on Wim Hof’s website.

Before exercising I use Wim Hof’s 11 minute guided breathing session (from the video below) as a way to increase my energy levels. For the rest of my day I use nasal breathing with periodic Buteyko exercises and sixteen second breaths as necessary.

There are many kinds of stress, but they all boil down to physical, chemical, or psychosocial stimuli that are present in too high a dose, too low a dose, or are stimuli that are too new for the body-mind to absorb. Novel compounds such as synthetic pesticides and plastics come into this category as do substances such as mercury and asbestos, which occur naturally but to which we would not have been regularly exposed during our evolutionary history. The body is constantly subjected to stresses, for example, air and water pollutants, potentially stressful events, processed foods, and electromagnetic radiation. But we have mechanisms to deal with stresses/toxins including a well-functioning immune system. The capacity of the body to deal with stresses/toxins can be compared with a bucket. As long as there is capacity in the bucket the body does not become diseased, but if there is more stress/toxicity than the bucket can hold a disease will emerge. Disease emerges once a threshold is crossed.
​
In common parlance, people use the term stress to refer to psychosocial stress - anything that translates into a perceived threat to our social status, social esteem, respect, and/or acceptance within a group; threat to our self-worth; or a threat that we feel we have no control over. There is a plethora of literature on the effects of psychosocial stress on the immune system and its effects on a diverse range of chronic and infectious disease processes and outcomes (Campos-Rodríguez et al., 2013).
​
Rather than attempting to summarise the vast literature, I will outline some simple practices that can help to manage psychosocial stress – a daily gratitude practice, Emotional Freedom Techniques (EFT or Tapping) and mediation. One valuable stress management modality - mindful breathing is summarised above. 

Humans are hard-wired to pay attention to threats. This has had survival value for much of our existence as a species, and it still has to some extent. In ancient times it would not have been to your benefit to admire the graceful feline form of sabretooth tiger which sought you out for its supper. Rather, you needed to focus on its bad intentions and turn tail as fast as possible, or hurl a spear into the space between its eyeballs. And in modern times, the best attitude to that unexpected email with news of your inheritance from your lost late uncle Eustice is to distrust and delete rather than trust and transact. So “negativity” is necessary, but it can lead to chronic stress if it perpetually casts a shadow over the positive side of the coin.

There is a great deal of evidence that a daily gratitude practice has powerful physical and psychological benefits (Emmons, 2008). And, the more we focus on what we are grateful for the more we find things to be grateful for. What you focus on expands.

Julie and I have a simple morning and evening gratitude practice in which we alternately state three things that we are grateful for. They can be large things such as the beautiful planet on which we live, or everyday experiences such as having a nice walk with dogs.
​
Despite its apparent simplicity, it is possible to mess up a gratitude practice and I speak from experience. When we started the ritual in April 2013, I only focused on overtly positive things but steered clear of the silver linings that hide in every cloud. This engendered denial and frustration. I write about this experience in the article How I messed up my daily gratitude practice - Walking the tightrope between expressing appreciation and kidding ourselves. 

Thanks to my wife Julie, who is a Certified EFT Practitioner, I learned the basics of tapping and, have been using EFT for some time when I felt emotional blockages, large or small. Tapping your fingers on acupuncture points on the face and body calms the amygdala (the part of your brain that triggers your fight or flight response) and helps energy to flow freely throughout the body. Tapping has been shown to provide effective relief for a myriad of issues such as anxiety, depression, obesity, high blood pressure and chronic pain.

The classic EFT process involves tapping nine acupuncture points in turn and saying (aloud or to yourself) “even though I have this problem” [insert problem here], “I love and accept myself.” Following this ‘set up statement’, you come to name the problem, explore its root cause and find your own solutions while you are in a resourceful state, rather than sitting or lying passively. Tapping can be done on your own, but it is better to work with a qualified therapist if you are a beginner or have complex issues to deal with. Tapping is easier to conceive of when watched rather than read about so I recommend that you consult the short YouTube video linked to below for a clearer idea of what it is all about and how to do it.

​Meditation has moved from the margins to the mainstream in recent years. Like breathing practices, there are diverse approaches to meditation. Many of us who have been brought up in the west struggle with meditation. This is not surprising given the nature of our upbringings with a focus on logic and the material world. I am by no means a meditation master but find the following technique I call decoupling your trains of thought to be useful. This technique was introduced to me by Neuro-linguistic programming (NLP) expert, life coach and “head fixer” Ali Campbell. I call it Decoupling Runaway Trains of Thought. 

Ali describes this form of meditation “for people who suck at enlightenment!” as the single most powerful exercise he has done to improve his life. That statement certainly made me sit up and listen as it comes from a man who has a deep understanding of a rich smorgasbord of life-changing techniques. Below is a summary of this simple but very powerful exercise. 

• First find a reasonably quiet place. 
• Set a timer for five, ten or fifteen minutes. 
• Close your eyes if it is safe to do so. 
• Allow a thought to come to you as it surely will. Acknowledge it as a thought about a thing. For example, oh there’s a thought about washing the dishes, do not attach any meaning to this thought – there is nothing you can do about the situation at this time.
• Let this thought go, and another thought will come to mind. 
• Acknowledge this thought as a thought about a thing and let it go. 
• Keep with this process until your time is up.

​When you first start doing this you will probably find that the thoughts come thick and fast. Ali Campbell likens it to a dam bursting and unleashing a torrent of thoughts. But over time you will find that the thoughts flow more slowly, as if you are sitting by a riverbank observing the thoughts gently flowing by. 
 
In addition to our daily morning and evening gratitude practices, Julie and I meditate every morning for about ten minutes.

​Nobody lives in a vacuum and we are all influenced by the environment in which we live. So the link between environment and health should be self-evident, yet it is often ignored. In this section I introduce the topic of toxins found in our indoor and outdoor environment and explore the benefits of hot and cold exposure for the immune system.

Many a substance has followed a familiar journey from being labelled as harmless to being declared to be toxic, via what I have named “The Schopenhauer Sequence”, after Arthur Schopenhauer’s famous quote on the nature of truth. The sequence from ridiculous to self-evident via opposition has been repeated time and again for a long and growing list of substances, which have transitioned from apparently benign to being banned, restricted, heavily taxed, or plastered in health warnings. Substances that have completed the sequence include lead, asbestos, DDT, PCBs, BPA, and of course tobacco. Some are in still in the violently opposed state. These include mercury in dentistry; aluminium in cookware, antacids, antiperspirant and vaccines; and glyphosate in pretty much everything we eat and drink (Myers et al., 2016). Currently in the ridicule stage, with a mix of violent opposition thrown in for good measure, is electro-magnetic radiation, in particular 5G (Davis, 2019).

The above discussion refers to individual substances, but in the real world pollutants are likely to act synergistically, but synergies are almost never tested for. With hundreds of new chemicals being added to the environment every year, this testing gap is to be expected.

In the absence of adequate testing, examination of synergies, and long term monitoring, we are all unwitting participants in an uncontrolled natural experiment. Because so much stuff is being introduced at once it is very difficult to unravel cause and effect. In such circumstances I rely upon the precautionary principle – “guilty until proven innocent”. The precautionary principle states that when human activities may lead to unacceptable harm to humans or the environment that is scientifically plausible but uncertain, actions shall be taken to avoid or diminish that harm. What this means for me in practical terms is that I will let the Schopenhauer Sequence play out, but in the meantime, I will use natural personal care and cleaning products, filter my drinking and washing water, eat organic food as far as possible, and use a wired Internet connection. 

As discussed earlier, we can tolerate a bit of toxicity and according to the toxic bucket or total load model of disease, disease emerges when our exposure to toxins exceeds our ability to mitigate this exposure. The lifestyle strategies outlined in this article are designed both to minimise exposure and to mitigate toxicity, a central component of which is optimising our immune system.

For centuries, hot and cold treatments have been advocated for health, hygiene, social, and spiritual purposes. The potential for health benefits of heat and cold is congruent with the principle of hormesis. One of the most studied modalities is sauna bathing (Hussain and Cohen, 2018).  Numerous beneficial effects have been suggested, including a reduction in the risk of developing certain chronic or acute respiratory illnesses (Kunutsor et al., 2017).
​
Another simple hot-cold treatment is a contrast shower in which you flip between hot and cold. A hot to cold shower is one of the pillars of the Wim Hof Method. Most people will be able to gradually adapt to longer periods of cold, but anybody with heart disease should exercise caution regarding cold exposure. It is advisable for this group to consult their doctor if contemplating cold baths, open water swims in winter, contrast showers or similar practices. 

I meditate in our homemade near infrared sauna for about ten minutes every day and have a contrast shower of two sets of one-minute hot, one-minute cold. I know it could be a bit longer, but I don’t want to waste water!

​The healthy living approach we promote at New Paradigm Health is one that is based on personal empowerment – where each individual develops their own set of lifestyle practices that facilitate optimal health in a manner that is congruent with their unique nature and circumstances. These practices must be based on an understanding of their fundamental human needs and a knowledge of where their personal power lies. Without these foundations, people are prone to be blown off course by events, trends and the well-intentioned and sometimes not so well intentioned opinions and advice of others. 

Tony Robbins’ six human needs framework provides a simple, powerful and intuitive framework for assessing our dispositions. I have used this framework to understand my own aptitudes and those of the people I work with as part of a strengths-based approach to personal and organisational development.
Tony Robbins has built on the work of John Burton and Abraham Maslow to develop human needs psychology. In essence, Robbins believes that everybody’s actions are driven by the need to fulfil one or more of six basic human needs. By definition, these are needs that we all share, but everybody is unique, so we do not value all our needs equally. Different people will emphasise different needs and this emphasis often shifts as we go through life.

The six fundamental human needs are as follows:

1. Certainty – that things will unfold as imagined.
2. Uncertainty – that life will serve up its share of variety.
3. Significance – the sense of being special or unique.
4. Love and connection – the feeling of togetherness or intimacy.
5. Growth – the feeling that we are making progress.
6. Contribution – that we are part of something bigger than ourselves.

I unpack these each of these needs in my article - Why we Think and Act the Way we Do: The Six Fundamental Human Needs as the Basis for our Unique Dispositions.
Understanding our human needs helps us to know which needs we habitually meet, which needs are not being met, which needs we want more of, and conflicts and trade-offs between meeting some needs at the expense of others. This understanding also helps us in our relationships of all kinds as we become less judgemental by acquiring a fuller understanding of the factors that motivate other people’s aptitudes, attitudes and actions.
​
You can assess your human needs with this online test devised by Chloe Madanes who has worked extensively with Tony Robbins to advance the thinking in the field. The results include detailed information on how your primary need and top two needs can serve you or hold you back.

​I love the Serenity Prayer – or at least the three lines which I know, as made famous by Alcoholics Anonymous:

​Grant me the serenity to accept the things I cannot change
The courage to change the things I can
And the wisdom to know the difference

In terms of understanding your place in the world, it is critical to know what circumstances are under your control, what circumstances you can directly influence, and what circumstances you can neither control or influence despite the fact that they are cause for concern. 

This model can be visualised in terms of circles of control influence and interest. Only one person stands in the circle of control – yourself. However, you do have some influence on others with whom you interact, just as they have influence on you. Finally, there are others whom you cannot directly influence whose actions may give you cause for concern. This is a concept used in the Outcome Mapping system for project planning, monitoring and evaluation – a system I find very useful and use extensively in my work.

In terms of living in alignment with your values, it is advisable to place most effort in the spheres of control and influence where you are best placed to make a difference. Of course, as is clear from its name, you are still interested in the sphere of interest/concern, but your ability to directly affect change in this sphere, at least in the short term, is limited.

Knowing where you stand helps to provide you with the certainty you need to face life’s challenges regardless of how much influence you may or may not have on others and in the face of concern about a world that does align with your deepest held values. Most people do not have the power to reverse the endless stream of doom and gloom that is the 24-hour news media, nor to affect entrenched power structures in the immediate term; but they do have considerable power over what they put in and on their bodies, what they put their bodies into, and what they put their bodies through. Being the change you want to see in the world is powerful and helps to displace fear with focus. 

As a football fan, I dutifully tune in to BBC’s Match of the Day most Saturdays or Sundays. The Sunday edition features a segment called ‘Too Good Too Bad’, in which the presenters showcase both the sublime and the ridiculous moments from the weekend’s matches. In its humorous way, this item holds up a mirror to life which conjures up its fair share of wonder goals, super saves, and goal line clearances; as well as own-goals, red cards, and shirt pulling. In the current crisis, it would be easy to focus on the dark side, but it's been very clear that many people have also discovered some treasures buried in the unwanted gift that is the COVID-19 pandemic. I’ve identified the good and bad possibilities in the following eight categories: respect for nature; our environmental footprint; the power of microbes; health consciousness; the Internet; data; solidarity; and global citizenship.

​In this blog, I examine the potential for both positive and negative outcomes for what has been dubbed the Post-Pandemic Planet. 

😊 Animal exploitation comes under the spotlight
Unless you have been living under a rock, it's pretty clear that most of our infectious diseases are of animal origin. Most sensible commentators would agree that our patterns of animal exploitation is a major contributor to the rise of emerging infectious diseases.

Most of the attention has being focused on bushmeat, the trade in wild animal species, and (to a lesser extent) the loss of biodiversity. However, there has also been a degree of focus on the barbaric animal factories that provide billions of opportunities for pathogen mutation, multiplication and species hopping. There is a great deal of momentum for the closure of the notorious Chinese wet markets, but if animal factories escape scrutiny much of the potential for further pandemics will remain. 
          
☹ People become ‘nature-phobic’
Several animal species have been implicated in the genesis of the novel coronavirus, with the role of bats in particular being highlighted. Bats already have a reputation for being sinister creatures among some communities, and the issue of disease transmission may be used as a proverbial bat with which to bat the bats. THIS EPIDEMIC HAS NOT BEEN CAUSED BY BATS.
​
Another risk is that people may become scared to venture out of nature, seeing it as a repository of disease and other threats to life and limb. This is rarely the case, and a life spent cooped up in the ‘great indoors’ is a much greater threat to our mental and physical health. 

😊 We reduce humanity’s environmental footprint
The shutdowns and slowdowns enforced by the COVID-19 epidemic have acted as a planetary detox with pollution levels radically falling, wildlife reclaiming lost habitats and bird songs being heard above the constant cacophony created by man and his machines. Perhaps taking things a little too far, wild goats have famously taken to the streets of Llandudno in Wales! Of course, all of this is only a temporary reprieve, but it may provide the impetus for a concerted move towards a world in which we live with more respect for our Mother - Nature.

☹ We rapidly return to business as usual and act as if nothing happened
Business as usual has been responsible for the current crisis, as well as a panoply of interlinked existential threats, notably climate change, mass extinction, land, sea and air pollution, and the chronic disease epidemic. Many people who have been feeling deprived under lockdown may blindly rush into a post-lockdown hedonistic rebound binge in the desire to make up for what they perceive to be lost time. That is understandable, all but the most monastic among us need a little hedonism from time to time. However, the danger is that we will be happy to return to our comfort zone even though, deep down, we all know that the habits that got us into this mess cannot be sustained.

😊 The world wakes up to the power of microbes
The bulk of the attention on microbes in recent times has been focused on their power to destroy. But the truth is that the vast majority of microbes are beneficial at best and neutral at worst. They are the little things that run our world - they fertilise our soil, power the earth's weather, and facilitate the breakdown of waste material among many other functions. They are the precursors to mitochondria (cellular ‘battery packs’) which are essential to multicellular life. In fact, in terms of numbers of genes, we are more microbial than mammalian. The trillions of microbes that live in or on our body are essential to our biochemistry and physiology.  The rapid evolution of a new virus to which we have minimal acquired immunity has highlighted the importance of looking after the beneficial bacteria microbes that provide us with general protection against perturbations, at both the personal and planetary levels.

☹ We escalate the unwinnable war on microbes
In the words of late and great Edwin Starr “(War) h'uh Yeah! (What is it good for?) Absolutely (nothin’) uh-huh”. Wars, particularly those waged against hidden enemies with a huge potential for replication, tend to fuel the very thing that they are fighting against. The so-called War on Terror is a notable example. 

That is not to say that there have been no positive developments in the management of microbes. Hygiene, antibiotics and vaccines in particular have been provided notable breakthroughs. But in the words of Abraham Maslow “when the only tool you have is a hammer you tend to see everything as a nail”. A mentality that the “Only good microbe is a dead microbe” is ultimately counter-productive. This has been vividly illustrated by the rise of antibiotic resistance due to their overuse and misuse. A move towards excessive hygiene and the carpet bombing of microbes will likely usher in an accelerated rise in superbugs in an evolutionary arms race that humanity cannot possibly win. There are trillions more microbes than men and they replicate thousands of times faster than us.

😊 Health consciousness is on the rise
As most people know, the coronavirus is not even-handed in its impacts, with those with pre-existing conditions being at greatest risk. The major emphasis has been on the vulnerability of the elderly, a vulnerability that is compounded by the fact that most elderly people in most countries suffer from a range of chronic diseases - obesity, asthma, heart disease, high blood pressure, type 2 diabetes, and others. The best defence against a specific infectious disease is not getting it the first place. The second best defence, and the best defence against all diseases, is having a strong immune system, which comes from leading a healthy lifestyle. This observation will come as little consolation to those who already suffer chronic ill health. However, a healthy diet and other positive lifestyle interventions such as good sleep hygiene, frequent movement and a psychosocial stress management can bolster the immune system. Studies have shown that changes can be rapid. So, there's a lot that people can do to resist the current and future coronavirus waves, as well as any other existing and emerging diseases that come our way.   
​
☹ People place their faith in magic bullets
We all know that prevention is better than cure but, as a species we seem to invest more of our collective resources and ingenuity in cure rather than prevention – the firefighter is a hero while the building inspector is a petty bureaucrat. There are no Hollywood movies lionising building inspectors, nor best-selling calendars featuring a phalanx of half-naked building inspectors flexing their bulging building inspector biceps... you get the point!

I have worked for much of my professional life in ecosystem restoration and I know first-hand how time-consuming and expensive it is to restore a habitat compared with protecting it from destruction in the first place. The truth is you need to start from where you are standing and a coordinated response to disease management requires a hierarchical approach that embraces prevention, early detection and rapid response, eradication and disease management. But the thrust of the debate around the long term management of COVID-19 has emphasised finding the cure in the shape of the vaccine and not in managing the ecosystem to minimise the chances of future pandemics. It must be borne in mind that the development of a safe and effective vaccine is not a given. Despite great efforts there are no vaccines for AIDS and malaria, nor are there vaccines for SARS and MERS, which are both corona viruses. 

😊 We increasingly tap into the power of the Internet
Coronavirus may be the event that accelerates the already growing trend of virtual meetings, online learning and working from home, all of which are great for society’s carbon footprint. And the potential of the Internet goes beyond the world of work with virtual parties, meetups, and quizzes connecting loved ones across different parts of the globe; with virtual workouts, telemedicine, and even virtual dating springing up as the world locks down. When a door closes, a window opens. The work-arounds in the face the crisis have helped to usher many people into the digital age, with the less tech savvy learning to host teleconferences, share screens and take online courses. The crisis is bringing social and economic dislocations in its wake, but the Internet has been a balm to ease the pain.

☹ Face to face contact continues to erode
Humans are social creatures and there is no substitute for meeting people in the flesh. I have some work colleagues that I have never met face to face, and the relationships are never as close as they are with those whom I've actually met. Virtual tourism is all very well, but it is not a substitute for that total immersion experience that is the real thing. A danger is that institutions will restrict personal interactions as a means of cutting costs, in the same way as many organisations no longer accept payment through old fashioned means. This lack of alternatives may further disenfranchise the old, the mentally and physically vulnerable and the poor who do not have untrammelled access to the digital world. Working from home may further extend the reach of the gig economy with further nefarious consequences for the lowest paid.

😊 Big data helps solve global problems
​Some of the countries and territories that are dealing most effectively with the crisis have been those who have harnessed the power of technology to acquire, analyse and act upon data gathered on spatial and temporal patterns of disease transmission. The use of the GPS capabilities of mobile phones has facilitated contact tracing and a targeted approach to self-isolation in the early phase of epidemic, allowing for efficient management. These types of approaches have great potential to usher in an expansion of “citizen science”, in which people log events such as the presence of protected wildlife, pests and diseases, or pollution incidences. This information is sent to a hub and the data can be then be used to inform management decisions. And grass roots initiatives of this kind go beyond science. Mobile phones are allowing poor people in Africa to exchange information to assist them in all areas of their life from banking to agriculture to healthcare.

☹ Big Brother is watching you
It is easy to see how big data, information sharing, and connectivity can be abused. People are generally amenable to accepting limits on their privacy and other freedoms in times of crisis. But the danger is that we will be thrust into an Orwellian world in which authorities justify surveillance on the pretext of a perpetual crisis.  It is easy to imagine a situation in which authoritarian leaders justify a raft of measures imposed until further notice that curtail civil liberties, freedom of assembly, and sovereignty over our bodies. Lest we think this is overly an overly paranoid prognosis, we are already in a situation where global players such as Google, Facebook and Amazon hold vast amounts of information on our purchases, preferences and aspirations. This information is not always used for altruistic reasons. 

😊 Solidarity in the face of a common foe
A crisis can bring out the best in people because of the solidarity that comes to the fore in times of warfare. During lockdown neighbours have started to look out for the more vulnerable in the community with tangible gestures such as cooking, cleaning, shopping, and keeping up a semblance of social contact by regularly chatting on the phone. Events to bolster the community spirit include (socially distanced) sing songs, virtual parties and, in UK, the weekly clap for NHS workers. And most people have shown fortitude in terms of high levels of adherence to restrictions laid down for the common good. There has been a lot of publicity over those who have broken the rules, but most people have been compliant once the denial phase had passed. It helps greatly when leaders make personal gestures of solidarity, such as the New Zealand Prime Minister, Jacinda Ardern, who, along with her ministers and public service chief executives, has taken a 20% pay cut.

☹ The blame game takes centre stage
It is an instinctual and common response to find somebody or something to blame when things go wrong. For many millennia bad things were attributed to the wrath of the gods. The modern equivalents are more diverse and include the aforementioned bats, the Chinese, the WHO, the patriarchy, the young, the old, the middle aged. This scapegoating has culminated in a variety of conspiracy theories claiming that the epidemic has been deliberately engineered for a variety of fiendish purposes. My own personal conspiracy theory is it was “The Sun Wot Did It” in an effort to deny Liverpool FC their first English League title in thirty years!

It is true that every effect must have a cause and it is important to understand the causes of this pandemic if one is to prevent or manage the effects of this and future comparable events. So a sober process of reflection is required but demonising “the other” will not help the process of healing.

For those who don’t know, the Sun is a trashy British tabloid newspaper which falsely criticised Liverpool fans in the wake of the 96 deaths in the Hillsborough Stadium disaster in 1989. The Sun is part of Rupert Murdoch’s global media empire. I am not pointing any fingers, but if there was a conspiracy, Murdoch would surely be a prime candidate for conspirator in chief!

😊 We think globally and act locally
The COVID-19 pandemic vividly illustrates that we live in an intimately connected world, for better and for worse. What goes on in Wuhan does not necessarily stay in Wuhan. Disease epidemics are a global problem and management needs to take place at all scales from the local to the global. There has been a lot of leadership at the global level and unprecedented scientific collaboration in terms of data sharing, the formation of multinational, and multidisciplinary teams, and the free dissemination of scientific publications. This level of international collaboration has the potential to resolve global social, economic, political and environmental problems through a collaborative and evidence-based approach. At the same time, the pandemic has highlighted our global dependencies such as the West‘s reliance on ‘just in time’ supplies of generic drugs and other medical equipment from China and India. These levels of dependency need to be examined if local and national responses are to be more robust.
​
☹ We think locally and act xenophobically
As outlined above, people like to play the blame game and while there are many people who are happy to collaborate internationally there are others who are rushing to pull up the metaphorical drawbridge. The USA, which was the world leader during the 2014 Ebola crisis, has adopted an insular approach that appears have to placed sabre rattling above science. The UK also initially appeared to ignore the scientific consensus in its plan to promote the development of herd immunity. Fortunately, though a little late in the day, the UK fell in line with the best scientific evidence and ditched its plan to let nature take its course. However, a “me first” approach has been in evidence throughout the crisis, as reflected by the hoarding of food and other household goods. I hope that global solidarity in the face of a common threat will symbolise the post-coronavirus world, but I fear that the enduring symbol may be an empty supermarket shelf where the toilet rolls used to be.

The future, like the past and present, will be a mixture of the good and the bad. The real world is messy after all, and human nature will always encompass good and bad impulses. This Native American story eloquently encapsulates this reality:
An old Cherokee is teaching his grandson about life:
“A fight is going on inside me,” he said to the boy.
“It is a terrible fight and it is between two wolves. One is evil–he is anger, envy, sorrow, regret, greed, arrogance, self-pity, guilt, resentment, inferiority, lies, false pride, superiority, and ego.”
He continued, “The other is good – he is joy, peace, love, hope, serenity, humility, kindness, benevolence, empathy, generosity, truth, compassion, and faith. The same fight is going on inside you – and inside every other person, too.”
The grandson thought about it for a minute and then asked his grandfather: “Which wolf will win?”
The old Cherokee simply replied, “The one you feed.”

​There are some really useful maps and charts that help us to make sense of the patterns of coronavirus occurrence and severity. The most familiar are variations on the theme used by the WHO in their daily Situation Reports. There is also the excellent COVID-19 Dashboard from the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU), and I love the COVID-19 GIFs from World Mapper. The map below, used in an excellent Newsweek article, is representative of the typical maps we see every day. They provide useful summaries but do not capture the patterns as they unfold over time. 

However, I wanted a one-stop shop - something that represented the daily progress of the pandemic over the planet, but I could not find anything that fitted the bill. The WHO maps could not, because they have used different scales throughout the infestation. They have also represented totals in terms of numbers per country rather than incidences per capita. This can exaggerate the relative severity of the situation in large and/or populous countries (notably India and Russia). This is a bit like saying India with a total GDP of $US2,800 billion is a richer country than Ireland whose GDP is $US381 billion.

So I decided to make the charts I was looking for. I also added a ‘thermometer’ to keep track of seven-day mortality as a way of gauging the effectiveness of disease management efforts at the global scale. Some people have asked why the red column on the left sometimes go down. That's because it represents the total numbers of deaths from COVID-19 during the previous seven days. When this figure drops consistently it will show us that we are really getting on top of the pandemic at the global scale.

I have used reported deaths rather than incidences as death represents the ultimate hard endpoint, and the reported incidences data strongly reflects the intensity of testing. At the time of writing (mid-April 2020) Germany, for example, has a higher number of COVID-19 cases than UK but a lower level of mortality. All this being said, it needs to be recognised that there are still great imperfections in the data on causes of death, as countries vary hugely in their detection and reporting capacity.

​Here is my first offering. 

​Below are a few of my take home observations based on this time series.

• January and February were ‘lost months’ for early COVID-19 action in Europe and USA, when decision-makers may have been lulled into a false sense of security by the (predictable) slow growth in cases in the early phase of exponential growth.
• There appears to be a relationship between climate and COVID-19 severity, with both warmer and cooler parts of the world having relatively lower mortality – the ‘viral Goldilocks effect.’ However, the climate-mortality link is far from proven, and other factors also come into play. Economic development levels appear to be important if we compare the relatively higher mortality figures of Australia and some South American countries with those for many parts of sub-Saharan Africa. Higher levels of economic development may be associated with other factors such as increased travel and more hours spent in air conditioned environments.
• At the time of writing (13 April), COVID-19 deaths are rising globally at an alarming rate, and we will need to maintain our individual and collective efforts if we are to minimise future mortality increases.

 ​I will update these videos every month. Here is the second offering. In addition to charting the trajectory of the pandemic, I ​explores some of the possible reasons for the observed patterns - climate/UV, smoking, air pollution, mobility patterns, age distribution, management practices, and dubious data.

Although not doing everything I want, the best mapping resource I have found for COVID-19 and a variety of other topics is from Our World in Data. With thousands of free, open access and open source  charts covering a range of topics including health, education, and the environment, it is a goldmine. They present the COVID-19 data in useful and interactive ways not seen on other websites. 

All free: open access and open source. An example chart is shown below.