Just how much damage does the COVID-19 virus inflict on the human body? Some describe it as a multi-system cluster bomb, because it can attack the whole body. What is affected is not only the lungs; the virus is at war with the body entire immune system, and virtually every organ can be involved. The weakest point is breached most easily, so each patient clinical symptoms differ slightly—this is due to individual variation.
Relatively speaking, however, the virus is not without its focus: its lethal and long-term effects concentrate mainly on the cardiovascular and cerebrovascular systems. This is because, whether it is the original early strain or the later variants, they all bind to angiotensin-converting enzyme 2 (ACE2) in the host.ACE2 plays important roles in regulating blood pressure, fluid balance, inflammation, cell proliferation, hypertrophy and fibrosis. So the virus mainly attacks the body blood vessels and capillaries, readily forming thrombi, which cause a great many patients to die of complications such as cerebral thrombosis, myocardial infarction and diabetes.Metaphorically, Omicron makes our blood coagulate. It is called a cold-blooded killer because when Omicron impairs the patient circulation, the body instinctively feels very cold. In this respect, Omicron shares something with the original strain and other variants: having observed this disease for three years, the chief complaints of patients I have seen over those three years basically all begin with aversion to cold and body pain—the principal symptoms of what TCM calls the cold-damage (shanghan) syndrome.The various COVID-19 variants share this pathogenic feature: regardless of the season or region in which a patient falls ill, the initial presentation is essentially the same. Symptoms in reinfected patients differ from those in first-time infections, but we still lack sufficient data on that; over the coming year I expect to have the chance to observe the clinical features of reinfection.That young children show no obvious early symptoms is because early symptoms in infants are not easily noticed by the children themselves or their families. By the time most children are noticed, the disease has already reached its middle or late stage, which means that some children are in danger as soon as symptoms appear.Traditional Chinese medicine has long described pediatrics as the "silent department," because infants cannot, like adults, promptly and actively report changes in their bodies; during inquiry, a child chief complaint is also hard for a doctor to rely on, since children cannot accurately remember and describe their bodily sensations and signs. This is also why critical illness arises in pediatrics. So if parents show signs of infection, they should act decisively and immediately take corresponding sweating measures to protect the child, rather than waiting for symptoms to appear before acting.Even the blood vessels of COVID-19 recoverees are strongly affected. Research data released by the United States this February showed that, compared with uninfected people, COVID-19 patients within one year of recovery had about a 63% higher risk of a series of potentially fatal cardiovascular events—abnormal heart rhythm, inflammation, thrombosis, stroke, heart attack, heart failure.Omicron attack on the lungs is far weaker than that of the original virus and earlier variants; the now-circulating Omicron strains attack the upper respiratory tract, but this is not fatal. So pneumonia is no longer the main cause of death in Omicron—it accounts for only a small fraction of Omicron deaths—while the cardiovascular and cerebrovascular system has become the system most affected by Omicron.Recently, China National Health Commission stated at a press conference that China currently only counts deaths caused by pneumonia. This follows the practice of the early pandemic and is endorsed by the World Health Organization. But it omits a large number of Omicron deaths and fails to warn the public to take precautions.Countries such as Singapore currently use the same statistical method as China, counting only pneumonia deaths, which is why Singapore death statistics are also very low. In the United States, anyone who dies after COVID-19 infection—whether from pneumonia or from virus-triggered complications—is counted as a COVID death; in the United Kingdom and New Zealand, anyone who dies within 28 days of a positive COVID test is counted as a COVID death. In fact, the true case fatality rates across countries are quite close, but differing statistical methods produce very different final figures.At present, for middle-aged and elderly people, the main causes of death from Omicron are cardiovascular and cerebrovascular disease and complications such as diabetes; younger patients more often die of Omicron-triggered sudden cardiac death. In addition, patients with impaired immunity—such as those with kidney disease or advanced cancer—also die readily from Omicron.We know that in medicine many diseases result from the combined action of multiple factors; so for the great majority of those who die after Omicron infection, Omicron merely aggravates pre-existing problems in their bodies rather than being the single cause of death—and we should not blame everything on Omicron.Most decedents already had underlying diseases such as hypertension, diabetes, tumors and chronic kidney disease before contracting Omicron. They may also have had one or more of the following: living in bitterly cold and/or high-altitude regions, a salty diet, a smoking history, sleep disorders, overwork, and so on.A note here: although medicine sets the hypertension threshold for ordinary adults at a systolic pressure of 140 mmHg and above and/or a diastolic pressure above 90 mmHg, in fact, compared with people with blood pressure below 110/75 mmHg, those at 120–129/80–84 mmHg have a doubled risk of cardiovascular disease. The higher the blood pressure, the higher the cardiovascular risk; those above 180/110 mmHg have up to a tenfold increase.So it is not only people with a medically diagnosed hypertension who face cardiovascular risk; those with high-normal blood pressure also face it. Keeping blood pressure as low as possible can lower the risk of death after Omicron infection.Why young people drop dead from Omicron is mostly related to overwork. A minority are also related to family genetics—those with a family history of hypertension and/or heart disease may be more prone to sudden death after Omicron infection.In cold seasons and at higher altitudes, residents are more prone to chronic diseases such as hypertension and heart disease, and cardiovascular and cerebrovascular events rise sharply in winter. That the north was hit harder than the south in this wave, and that northern patients are harder to treat than southern ones, is related to northern China colder climate and higher altitude.Ordinary residents can take the following measures to help lower the case fatality of Omicron.First, keep the diet as light as possible and strictly control salt intake; limit salt to 1.5–2 g per person per day, and you must also count hidden salt, such as the salt in soy sauce and dried noodles.Second, keep warm and avoid heat. Extreme cold and extreme heat both raise blood pressure and more easily trigger stroke and sudden cardiac death; keeping warm in winter and cooling down in summer can both lower the risk of death after Omicron infection.Third, drink water in moderation. Moderate hydration lowers blood viscosity and counteracts thrombosis. But "moderate" here absolutely does not mean drinking over five liters a day as some celebrities preach—that is very dangerous and excessive water intake will damage the kidneys. A normal adult needs only 1–1.5 liters a day; middle-aged and elderly people should drink more hot water to promote circulation.Fourth, pay close attention to changes in your body; acting early in infection is most effective. Most people at the onset have aversion to cold and body pain, and some also have fatigue. Taking various sweating-promoting measures promptly at the onset—detailed in my article "If You Have Caught COVID-19, Try This Method"—need not be repeated here.The key to that method is heat therapy by every available means (foot soaks, blowing hot air from a hairdryer onto the body or into the bedding, using an electric blanket, drinking hot water, drinking ginger-scallion tea, etc.) to induce sweating. It promotes circulation and lowers the risk of thrombosis. It works for the common cold as well, so whether it is an ordinary cold or Omicron, you can apply it immediately without waiting for test results.Fifth, eat more foods that protect blood vessels. Vitamin C in vegetables and fruits clears vascular inflammation; vitamin E in vegetable oils protects vessels; apigenin in Umbelliferae vegetables such as celery also protects the cardiovascular and cerebrovascular system. Eating more of these foods in daily life helps somewhat in lowering the risk of death from cardiovascular and cerebrovascular disease.Sixth, exercise more while uninfected (no strenuous exercise after infection). Studies show that people who exercise regularly recover faster after illness and have lower mortality and lower rates of sequelae, because regular exercise—especially aerobic exercise—is particularly important for protecting the cardiovascular system.Seventh, dispel tension. People in a cheerful mood are less prone to cardiovascular and cerebrovascular disease; life should be as rich and varied as possible, and you should not spend every day scrolling through COVID news on a screen. That only amplifies anxiety and is very bad for recovery after infection.Eighth, keep regular hours, eat regularly, and ensure adequate sleep.Beyond that, avoid prolonged sitting and standing, and avoid straining on the toilet or holding urine, as all these can raise blood pressure. Smoking, drinking, eating pickled foods, drinking strong tea and coffee, and staying up late also raise blood pressure; quit them if you can.Omicron and future variants of COVID-19 will coexist with us for a long time. It is both a human misfortune and a wake-up call from nature about the very business of survival. People with a healthy lifestyle will be better able to fight the virus; if our lifestyle is unhealthy, Omicron is far from the only thing that can kill us.