Acute and Chronic COVID-19 Infection

Immunological Arguments For Social Taking Distancing Seriously.

March 14, 2020

From Dr. Ahvie Herskowitz

In 1985, the Immunology lab I led at the John Hopkins University published a series of review articles that suggested that the wide range of early and late immune responses to a virus in mice are genetically mediated. The conclusion section stated: “Our model emphasizes that the diversity of patterns may represent an individual’s genetic predisposition to both direct and indirect viral induced injury and the subsequent development of autoimmunity.”

This work was performed in the Immunology and Molecular Biology Department in the School of Public Health, later to become the Bloomberg School. If you read the full article, you can substitute the word “myocarditis” for “ARDS or lung failure” in the case of our current coronavirus pandemic.


The reason this is important for this pandemic:

  1. We have multiple strategies in place for primary prevention — hand washing, social distancing, wearing gloves outdoors, taking vitamins/supplements and keeping our diets healthy, sleeping well, reducing stress and avoiding alcohol — these reduce our risk of getting infected. Since the science of viral infections (whether influenza or our other epidemic of Lyme disease) teaches us, once infected a person cannot predict how their immune response genes will regulate their acute response to any given new virus. This is why small handfuls of 40-something year old patients, who are extremely fit and healthy, have succumbed to COVID-19; this is also why, small numbers of patients have died from direct viral mediated heart damage leading to heart failure (and not from respiratory failure). Different patterns of responses are always to be anticipated, and most are not predictable.
  2. But, that is not all. We know that many more people infected will remain asymptomatic, and asymptomatic persons drive community spread. So, is my risk from COVID19 over after I get infected and survive the first 2 months?

  3. The answer is no! The end of the virus incubation period may not be the end of organ injury, in that delayed autoimmunity will happen in a significant subset of persons, whether they were initially symptomatic or asymptomatic, way beyond the period that the virus is still infectious.

With this said, the way one avoids infection and modulates their immune response early has long lasting impact. The use of all the adaptogenic and immune modulating practices bolded above, as well as many others, will down regulate a long-term, chronic stress response. This chronic stress response invites post-viral autoimmune conditions to develop (thyroid, heart, GI tract and liver). Our primary prevention strategies for reducing risk of infection, therefore also support reducing our risk of post-viral autoimmune disorders after we get infected and “recover” — whether we were asymptomatic or experienced symptoms in early phases, since our continued immune responses can ultimately lead to post-viral autoimmuity, avoiding the infection is where the smart money is.

Social distancing is the most important tool we have now, and why I am grateful to the tech industry in the SF Bay area, and in particular in SF, for encouraging many of their workers to stay and work at home. Perhaps this will save us from what was surely an inevitable lockdown like in Italy, Spain and France, and probably next in NYC.


There are many natural options available for combating COVID-19 that I have described earlier. The following is what my staff and I do to keep our immune system optimized and in prevention mode.

  • While NOT approved by the FDA as an anti-viral therapy, My staff and I use IV (intravenous) Ozone for its anti-microbial and immune modulatory effects — using a cocktail of ozone with UV light, Glutathione and Vit C IV to prevent and/or combat infections including viruses. Also Vit D IM (intramascular) injections are useful to immediately raise Vit D levels. (There are as of yet, no data from China on the efficacy of IV Vit C with the COVID-19.)
  • To heighten your surveillance system, one key element is keeping your Vitamin D levels up. My personal preference is to keep my Vit D levels at 80-100 of 80-100. This often takes 5,000-10,000-20,000 IU (International Units) orally per day for the next several weeks.
  • My staff and I also use Sovereign Silver, (10 ppm colloidal silver preparations), which cannot accumulate in tissue. We use the oral spray 3 times a day into the throat and the oral solution 1 tspn, swish for 30 seconds.

Please call the office at by phone at (415) 345-0099 or by email at if you are interested in any of the above IV options. Please note that the IV suite will book up quickly as the vaccines are not going to come in time to help during this years’ epidemic.

Dr. Ahvie Herskowitz

About Ahvie Herskowitz, MD

Dr. Herskowitz’s extensive training includes a medical degree from The Albert Einstein College of Medicine, residencies in Anatomic Pathology and Internal Medicine, and Fellowship training in Cardiology at The Johns Hopkins Medical Center. During his 12 years at Johns Hopkins, he became Associate Professor of Medicine and Immunology and Molecular Microbiology and led a research team in the study of molecular and immunological mechanisms of inflammation, autoimmunity, ischemia, heart transplantation rejection and congestive heart failure.

Dr. Herskowitz’s latest academic appointment was as Clinical Professor of Medicine at UC San Francisco. To learn more about Dr. Herskowitz, you can read it bio here.


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