How have our immune systems changed during coronavirus? Doctors weigh in

Our day-to-day realities look a lot different than they did a few months ago. The nature of living through a pandemic, with a virus that has no cure and no vaccine, has meant that everyone has had to change their habits, routines, and realities. Many of us are getting less sunlight and less exercise than we’re used to. We’re eating worse, stressing more, spending increased time on our phones (my screen time has doubled in the last two months), and missing out on physical touch and interaction with others. So what does all of that mean for our bodies—and especially our immune systems?

It might not be all that bad, says Dr. Lucy Bruijn, a family physician with Methodist Medical Group in Memphis, TN. If you’re an introvert who found going to the office every day stressful and are enjoying working at home, she notes that you might actually be better off. The same is true if you’re sleeping more than usual because you don’t have to get up early and commute. “Our immune systems are so individualized and depend on individual characteristics and external factors,” says Dr. Bruijn. “But it’s fair to acknowledge that our immune systems are under stress due to the rapid changes in our daily lives brought on by this pandemic.”

While some may be basking in extra free time and sleep, many people are under extended stress as they balance job(s), financial issues, and family responsibilities in an ongoing crisis—and long-term stress isn’t good for our immune systems. While there are no studies yet that measure the relationship between the long-term effects of this current quarantine on our immune system, the general guidance from medical experts I talked to for this article was clear: Our immune systems might not be thriving right now, and that’s okay. Here’s what’s happening and how we can better take care of ourselves.

Overall, our immune systems are influenced by lifestyle factors that might be taking a hit right now.

Our immune system, like our overall health, does best when we give it what it needs—like nutritious foods, plenty of sleep, and exercise, to start. “Lifestyle factors…play a major role in the response of our immune system in fighting any pathogen, whether it’s the coronavirus, influenza, or even the common cold,” says Dr. Daryl Gioffre, a chiropractor and nutritionist and the author of Get Off Your Acid.

So if your day-to-day routine includes more alcohol, more processed foods, and less sleep than usual, that’s not ideal. You could be “driving up inflammation and lowering your immune system’s ability to fight any foreign invaders,” says Dr. Gioffre.

Ideally, you’d use this time to invest in factors that strengthen your body and mind. Dr. Gioffre suggests “reconnecting with loved ones, catching up on projects you put on the back burner, and making better choices to move towards a healthier lifestyle.” Working out regularly; getting fresh air, if possible; sleeping well; eating a balanced diet; and managing stress will keep your immune system strong.

We’re not getting enough exposure to normal bacteria because of stepped-up hygiene practices.

When going about our normal lives—browsing clothing at a store, eating a meal at a restaurant, using public transportation—we’re constantly exposed to bacteria and viruses. That’s usually a good thing, explains naturopath Dr. Mary Shackelton of Holistica Integrative Care in Boulder, Colorado, as those bacteria and viruses “may not produce any illness but help to keep our immune systems ‘awake’ and up-regulated,” she says. “When we see viruses and bacteria out in the world in our normal lives, our immune system is busy making antibodies to these exposures. This is a type of fitness for our immune response. By sheltering in place, we are not getting these normal exposures,” says Dr. Shackelton.

It’s the same reason that kids who go to daycare get fewer colds in elementary school: Their immune systems are exposed early on and they build up immunity.

To help keep your immune system functioning, Dr. Shackelton recommends washing your hands with soap on a regular basis versus spraying them down with hand sanitizer every few seconds. She also suggests “eating for your microbiome,” or eating plenty of fruits, veggies, and fermented foods to “help feed the thousands of beneficial bacteria in your gut microbiome that are helpful as a first line of immune defense.”

Sheltering in place might be keeping us from getting enough vitamin D to maintain our immune systems.

When was the last time you got a solid dose of sunshine? If you’re missing out on time spent outside, your immune system may be suffering, says Dr. Michael Smith, internist and author of The Supplement Pyramid. “Vitamin D is known as the sunshine vitamin because when our skin is exposed to sunlight, it makes vitamin D from cholesterol,” says Dr. Smith. “And vitamin D plays a significant role in regulating the immune system. High vitamin D levels are associated with a decreased risk of seasonal viral infection and acute respiratory infection,” says Dr. Smith.

Beyond helping your immune system, adequate exposure to sunlight can boost your mood and regulate your circadian rhythm to help foster a healthy sleep-wake cycle, says Dr. Bruijn.

If you can get outside, do so at least three times a week for at least 15 minutes to pump up your vitamin D levels. If you have darker skin, you may need to spend more time (up to 30 minutes) to get the same benefits. However, if you’re unable to get outside safely, consider taking a vitamin D supplement.

Some stress is good, but too much COVID-19 stress can lead to increased inflammation

“Some degree of stress is actually healthy because it helps us keep moving through life,” says Dr. Bruijn. “Cortisol, a stress hormone, is usually anti-inflammatory and helps us with our immune response.” But in a pandemic, where we’re experiencing constant high levels of stress, our bodies release more cortisol, which, according to Dr. Bruijn, “can lead to a weakened immune response. Our bodies, when exposed to too much stress (aka cortisol), can become pro-inflammatory with increased production of certain molecules called inflammatory cytokines, which can lead to increased risk of infections and other diseases such as cancer and heart disease over time.”

So what can you do about it? “It’s hard to tell yourself not to stress when things are stressful. This alone can lead to more stress,” says Dr. Rand McClain of Regenerative & Sports Medicine in Santa Monica, CA. He suggests making a list of things that you enjoy—like music, movies, people, activities—and try to engage in at least one thing from the list every day. “Accepting what cannot be controlled and being proactive with what can be is helping to support your immune system.”

This changed reality is impacting every aspect of your life, including how your immune system is functioning. While everyday choices add up—like eating a balanced diet, getting whatever exercise you can, and sleeping well—don’t beat yourself up if you’re struggling to do so regularly. All you can do is take it one day at a time.