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Let the Sunshine in

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Sunlight is not a cure for coronavirus, but it does have other benefits for mind and body.

Credit…Juan Arredondo for The New York Times

Deciding whether to head outdoors or to stay at home has never before felt so fraught, as many of us continue the weigh the benefits of getting some fresh air versus the risks of getting sick. For many, however, the enticements of a spring day are too powerful to resist.

“Yesterday it was raining and we felt kind of sorry for ourselves, but it’s hard to feel sorry for yourself on a sunny day like today,” said Nancy Penman, a resident of Manhattan’s Upper West Side.

Ms. Penman was one of many who were maintaining a safe distance between themselves and others while they walked in Riverside Park on a recent afternoon. “I hope they don’t close the parks,” she said. “We need our sun. I’ve heard it boosts the immune system.”

Ms. Penman may have a point. “There is now limited but convincing evidence that moderate sunlight exposure is capable of modulating the immune system and improving health,” said Daniel González Maglio, a professor at the University of Buenos Aires and researcher in the growing field of photo-immunology.

A daily dose of sunlight won’t fend off or cure coronavirus, though researchers continue to explore the effects that warmer weather and ultraviolet rays might have on the virus. But scientists are finding that exposure to the sun has numerous other benefits that may be especially important now — including helping to elevate mood, to improve the quality of our sleep and to strengthen the body’s innate defenses against a variety of pathogens.

The impact of sunlight on human health would not have been news for our ancestors, said the British researcher Richard Hobday, author of “The Healing Sun: Sunlight and Health in the 21st Century.”

“Hippocrates, the father of medicine, said that if you have a city that is properly oriented toward the sun you don’t have so many diseases in it,” Dr. Hobday noted. “Throughout history and all over the world, sunlight has been worshiped for its health-giving properties and used as a medicine.”

These ancient beliefs received scientific validation in the early 20th century, when sunlight was employed to kill tuberculosis bacteria and to treat the deficiency disease, rickets. Inspired by sun advocates like the pioneering nurse Florence Nightingale, hospitals and sanitariums were designed with large east-facing windows and skylights to maximize sun exposure for their patients.

During the Spanish flu pandemic of 1918-19, patients who were treated in overflow tent hospitals and regularly taken out in the sun when they were in recovery had lower death rates than those who were left indoors in dark and poorly ventilated wards, Dr. Hobday reported in a study published in the American Journal of Public Health.

Enthusiasm for sunlight as medicine waned after antibiotics began to be widely used during the 1930s, but it has recently revived, as evidence mounts for the complex role that vitamin D — sometimes called the sunshine vitamin, because the skin creates it when exposed to sunlight — plays in human biology.

Over half of Americans do not produce enough vitamin D, a result of spending some 90 percent of our time indoors, according to Dr. Michael Holick, a professor of medicine at Boston University. And that’s a problem, he says, because too little vitamin D can weaken our body’s ability to fight off infections.

While the mechanisms of its action are still not fully understood, a study published last year by Dr. Holick and colleagues reported that vitamin D boosts the expression of hundreds of genes that are thought to help regulate immune function.

Dr. Holick recommends to many of his patients that they take supplements of vitamin D. Overweight people, he says, may need extra high doses. But consult your doctor before doing so, since high doses can cause kidney problems and other complications.

Dr. JoAnn Manson, the chief of preventive medicine at Brigham and Women’s Hospital in Boston and a Harvard professor, says that the jury is still out on optimal levels of vitamin D, though some people might benefit from supplements “to hedge their bets.”

“The best approach is to have a heart-healthy diet and get the nutrients from foods,” Dr. Manson said, and to spend time outdoors in the fresh air and sunlight. “Being physically active outdoors helps people to maintain proper weight, reduces the risk of diabetes and heart disease, benefits bone health, lowers stress and improves emotional well-being. The list of benefits from physical activity is extensive.” Moreover, sun exposure enables the skin to create nitric oxide, which lowers blood pressure and improves cardiovascular health, Dr. Manson said.

But the fact that a little sunlight is good for health does not mean that a lot is better. “Too much exposure suppresses the ability of the human immune system to efficiently detect and attack malignant cells,” which can increase the risk of skin cancer, Dr. Maglio cautioned.

To gauge how long one can safely remain in the sun at different latitudes, seasons and times of day, Dr. Holick helped develop a free app called D Minder Pro that tracks the amount of vitamin D that your body is getting from exposure to the sun and warns you when you are staying outdoors too long.

Exposure to daylight is also critical for accurately setting our internal circadian clock, which in turn regulates sleep and waking, said Mariana Figueiro, the director of the Lighting Research Center at Rensselaer Polytechnic Institute in Troy, N.Y.

Without adequate light, we can go into a kind of permanent jet lag, Dr. Figueiro explained, where we get more easily irritated and depressed, our immune function is suppressed and our overall health may deteriorate.

Not everyone will be able to get outside now, or feel safe doing so. Those who remain indoors may have to take some extra steps to be exposed to the light that they need to remain healthy.

“If possible, work facing a window, especially in the morning hours, and avoid working in your basement,” Dr. Figueiro advised. “If you have one table lamp in the living room, you might want to increase that number to get the amount of light you need to stimulate the circadian system.” You don’t need special bulbs, she says, since ordinary incandescent lighting emits the wavelengths of light that we need to help set our biological clocks.

While exposure to morning light helps us to get a good night’s sleep later on, in the evening it has the opposite effect. “Turn off and dim your lights two hours prior to bedtime, because that is when your body starts producing melatonin, which is telling your body that it is night and time to go to sleep,” Dr. Figueiro said.

She also recommends taking a daily 15 to 45 minute walk when possible, while being careful to maintain adequate social distance between yourself and others, since outdoor light, even on a cloudy day, is far brighter and more biologically potent than indoor light.

Scientists also continue to explore whether sunlight might fight the coronavirus directly, as it does for other viruses. Paul Dabisch, an aerobiology specialist with the Department of Homeland Security, together with several colleagues, published a paper in November that found that flu viruses are rapidly inactivated when exposed to the UV radiation in sunlight.

“This is the first study to show that simulated sunlight will greatly decrease the infectivity of influenza virus contained in aerosol particles,” he said.

These results might partly explain why flu transmission is lower during the summer, when people spend more time outdoors in the sun. “It may be due to a combination of the fact that sunlight actually degrades the virus, and also that vitamin D has been shown to be effective in fending off infections,” Dr. Dabisch said. His team and others are currently conducting research to determine whether sunlight also destroys the Covid-19 virus, or mitigates its effects.

While few scientists believe that the sun will prove to be a magic bullet against the pandemic, medical research already amply demonstrates that exposure to sunlight can help to make us happier and healthier at a time when we are in need of both.

  • Updated April 11, 2020

    • When will this end?

      This is a difficult question, because a lot depends on how well the virus is contained. A better question might be: “How will we know when to reopen the country?” In an American Enterprise Institute report, Scott Gottlieb, Caitlin Rivers, Mark B. McClellan, Lauren Silvis and Crystal Watson staked out four goal posts for recovery: Hospitals in the state must be able to safely treat all patients requiring hospitalization, without resorting to crisis standards of care; the state needs to be able to at least test everyone who has symptoms; the state is able to conduct monitoring of confirmed cases and contacts; and there must be a sustained reduction in cases for at least 14 days.

    • How can I help?

      The Times Neediest Cases Fund has started a special campaign to help those who have been affected, which accepts donations here. Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities. More than 30,000 coronavirus-related GoFundMe fund-raisers have started in the past few weeks. (The sheer number of fund-raisers means more of them are likely to fail to meet their goal, though.)

    • What should I do if I feel sick?

      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

    • Should I wear a mask?

      The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

    • How do I get tested?

      If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.

    • How does coronavirus spread?

      It seems to spread very easily from person to person, especially in homes, hospitals and other confined spaces. The pathogen can be carried on tiny respiratory droplets that fall as they are coughed or sneezed out. It may also be transmitted when we touch a contaminated surface and then touch our face.

    • Is there a vaccine yet?

      No. Clinical trials are underway in the United States, China and Europe. But American officials and pharmaceutical executives have said that a vaccine remains at least 12 to 18 months away.

    • What makes this outbreak so different?

      Unlike the flu, there is no known treatment or vaccine, and little is known about this particular virus so far. It seems to be more lethal than the flu, but the numbers are still uncertain. And it hits the elderly and those with underlying conditions — not just those with respiratory diseases — particularly hard.

    • What if somebody in my family gets sick?

      If the family member doesn’t need hospitalization and can be cared for at home, you should help him or her with basic needs and monitor the symptoms, while also keeping as much distance as possible, according to guidelines issued by the C.D.C. If there’s space, the sick family member should stay in a separate room and use a separate bathroom. If masks are available, both the sick person and the caregiver should wear them when the caregiver enters the room. Make sure not to share any dishes or other household items and to regularly clean surfaces like counters, doorknobs, toilets and tables. Don’t forget to wash your hands frequently.

    • Should I stock up on groceries?

      Plan two weeks of meals if possible. But people should not hoard food or supplies. Despite the empty shelves, the supply chain remains strong. And remember to wipe the handle of the grocery cart with a disinfecting wipe and wash your hands as soon as you get home.

    • Can I go to the park?

      Yes, but make sure you keep six feet of distance between you and people who don’t live in your home. Even if you just hang out in a park, rather than go for a jog or a walk, getting some fresh air, and hopefully sunshine, is a good idea.

    • Should I pull my money from the markets?

      That’s not a good idea. Even if you’re retired, having a balanced portfolio of stocks and bonds so that your money keeps up with inflation, or even grows, makes sense. But retirees may want to think about having enough cash set aside for a year’s worth of living expenses and big payments needed over the next five years.

    • What should I do with my 401(k)?

      Watching your balance go up and down can be scary. You may be wondering if you should decrease your contributions — don’t! If your employer matches any part of your contributions, make sure you’re at least saving as much as you can to get that “free money.”


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