Could space be the best medicine for COVID-19?
Earlier today a SpaceX Falcon 9 rocket blasted-off to the International Space Station (ISS) with two American astronauts on board, Doug Hurley and Bob Behnken, who will live and work there for a few months as part of Expedition 63.
Why is exploring space so important to understanding our health on Earth—including COVID-19?
“The ISS is a laboratory and our astronauts perform experiments every day to study how the body adapts in space,” says Dr. Saralyn Mark, who served as a Senior Medical Advisor to NASA for 18 years and led two decadal reviews to study the effects of sex and gender on adaptation to space. “The human body adapts very quickly and very dramatically to space—every single system changes; cardiovascular, muscular skeletal, neurosensory, immunological, even the reproductive system and behavioural health.”
That’s similar to COVID-19, which appears to impact every single system in the body. “It’s forcing us to take a multi-system evaluation, just as we do when we look at health in space,” says Mark.
Astronauts and microgravity
She cites how the human body adapts to microgravity; it quickly loses bone mass—as much as 3-5% in just a month—just as hospitalised patients often do. A loss of bone mass means a loss of muscle mass, which means rehabilitation for astronauts after they return from space. “What we’ve learned from space has correlates for how we take care of patients who become extremely debilitated, and certainly with COVID-19, patients can be,” said Mark.
Astronauts’ bodies change quickly in space. “The body changes in space—fluid flows from the legs to the brain—and some astronauts experience space adaptation neurosensory syndrome,” said Mark.
That’s also known as “space sickness.” It can mean visual impairment and a loss of smell and taste, which is generally more severe in male astronauts.
Space medicine and gender differences
That’s similar to COVID-19, where sex and gender differences also haven’t gone unnoticed; men are twice as likely to die from COVID-19, across all age groups, compared to women. “There are a whole variety of biological and behavioural reasons for that—women tend to be more resistant to infection, and when they are affected they tend to mount very robust responses,” said Mark, who founded iGIANT (which stands for “impact of gender and sex on innovation and novel technologies”), a non-profit accelerator for gendered innovation. “We’re studying sex differences in space with regard to the immune system.”
Astronauts and PPE
There’s another, connected issue; personal protective equipment (PPE), which has been a big issue during the COVID-19 crisis. Just as spacesuits don’t fit female astronauts well, PPE doesn’t fit female health care workers well, which could be why 73% of the 9,000 healthcare workers infected in the U.S. are women.
Astronauts and isolation
Another example of how the experience of astronauts can help the fight against COVID-19 is isolation and extended separation. After all, astronauts are isolated from their family members and their loved ones for months at a time. “There are important lessons to be gleaned from the space program on how you maintain connection to your loved ones from a distance,” said Mark. Assessing how people cope with isolation, how they interact, their mood, their sleep patterns—it’s all live research in space medicine.
Space medicine and vaccines
Mark also mentions research into vaccines on the ISS. “Space allows you to grow cells in three dimensions because of microgravity and that may play a role in vaccine development,” she explains. “Space is an incredible platform for studying cell growth.”
Space medicine and telehealth
Another correlate between the ISS and COVID-19 is telemedicine/telehealth/remote diagnosis. It’s all the rage now, but it’s been going on at NASA since human spaceflight began. “When Neil Armstrong landed on the surface of the Moon he had a very fast heart rate—it was a very dramatic example of how the health of astronauts has been monitored from afar since the beginning of the space program,” said Mark. “That was the genesis of telehealth.”
NASA’s ‘Twins Study’
NASA’s famous “Twins Study,” published in 2019, discovered that extended spaceflight affects the human gut microbiome. The subjects were Scott Kelly, the first American astronaut to spend nearly one full year in space from 2015 through 2016, and his identical twin brother, retired astronaut Mark Kelly, who acted as the baseline for observation on Earth.
Scott Kelly experienced a shift in the ratio of two major categories of bacteria in his gut microbiome, probably caused by microgravity. Gut health affects digestion, metabolism and immunity. More recently, changes in the microbiome have been linked to changes in bones, muscles and the brain. “We cannot send humans to Mars without knowing how spaceflight affects the body, including the microbes traveling with humans to Mars,” said Northwestern University’s Fred W. Turek, who led the microbiome study. “And we need to know sooner rather than later. The plan is to send people to Mars in 2035, so we cannot wait until 2033 to gain this information.”
If today’s launch is a step forward into a new era of human spaceflight, that’s only going to be a good thing for human health. “I hope that as we democratize space and everyone can have an opportunity to experience space travel that there will be an enhanced interest in the benefits of space exploration even for our lives on Earth,” said Mark.
“The SpaceX launch is a monumental step in that direction.”
Wishing you clear skies and wide eyes.