How does alcohol change immunity? 3 truths about lockdown drinking

As quarantine continues, a record number of people are getting buzzed.

From March 7 to April 11, alcohol sales surged by 26 percent in the United States. People report drinking far more frequently and earlier in the day than they did pre-pandemic.

Why people drink is largely the same as why they drank pre-pandemic: They turn to alcohol to take the edge off, socialize with friends, or pass the time. The difference is, now they have more time and more temptation. Covid-19 is testing people's relationship with alcohol. The question is will alcohol, in turn, test their ability to fight off Covid-19?

That answer, in part, comes down to how alcohol negatively affects the immune system. It's a complicated relationship, but essentially is simplified into three primary effects:

1. Alcohol can hamper innate immunity, the body's first line of defense.
2. Alcohol can leak bacteria out of the gut, which causes inflammation.
3. Alcohol can disrupt the ability of crucial immune cells to fight off infection.

Still, some experts argue the immune risks don't mean you have to quit lockdown happy hour completely. If you want to play Ina Garten and have a Cosmo, or Stanley Tucci and have a Negroni, that's fine. Some research even suggests that a few libations — 1 drink a day for women and 2 a day for men — may even boost the immune system. But that's only if you choose antioxidant-rich beer and wine.

Before you decide whether to pour a glass, it's worth understanding how alcohol influences the immune system — as well as taking the time to reflect on your own relationship with alcohol. Alcohol does affect your ability to stay healthy, but that's also dependent on how much you're drinking.

How does drinking alcohol affect health?

Dipak Sarkar, an expert on alcohol metabolism and immunity, and professor at Rutgers University, tells Inverse that he advises skipping alcohol altogether during the Covid-19 pandemic. This is because studies suggest that heavy drinking — defined as over 8 drinks per week for women and 15 per week for men — can disrupt key immune pathways, make people more susceptible to infection, and weaken the immune system.

George Koob, a behavioral psychologist and the director of the National Institute on Alcohol Abuse and Alcoholism, agrees. "Even short-term alcohol misuse affects the immune system," Koob tells Inverse.

Whenever the body detects a foreign invader, like the novel coronavirus, the immune system springs into action. The body pumps out a vast array of immune cells to fight the invader, in a process called innate immunity.

"Binge drinking will weaken the immune system’s response to Covid-19."

An army of antibodies — Another subsystem of the immune system is called adaptive immunity. This is when the body produces an army of antibodies specific to the incoming threat. This generates “immune memory," which ensures that the next time the body faces the same invader, the immune system is better equipped to take it down.

"After an episode of binge drinking, the ability of the innate immune system — the first line of defense in the body for detecting and destroying foreign invaders — to fight infections is reduced," Koob says. This makes it easier for a person to catch a virus, and get sick.

Binge drinking — defined as more than four drinks for women or five drinks for men in two hours — can also trigger a long-lasting genetic change. This can result in heightened cravings for alcohol that can lead to alcohol addiction, Sarkar explains.

It's also possible that, when a person drinks alcohol, some bacteria that's naturally in the gut can leak out, and in turn activate inflammatory cytokines from immune cells, Sarkar adds. This can increase the body’s stress levels and dampen body immune function.

Alcohol also influences the functions of the lymphoid tissue and alter the activation, secretion, and functions of crucial immune cells called lymphocytes.

Over the long term, excess drinking can cause chronic systemic inflammation and impaired ability to defend against infections, Koob says.

"It is anticipated that binge drinking will weaken the immune system’s response to Covid-19," Sarkar says.

So, should you be drinking at all?— Some research suggests no amount of alcohol is good for you, while other studies say moderate drinking may actually boost immune function more than teetotalling.

If you do choose to imbibe, it’s best to avoid binge drinking and stick to CDC Guidelines — consuming no more than one drink per day for women or up to two drinks per day for men.

"Alcohol, the drug, is the same regardless of the type of beverage," Koob says. "The important thing is the number of servings rather than the type of beverage."

Meanwhile, evidence suggests that drinking wine moderately can support a healthy gut and strengthen immune function because wine contains healthy antioxidants called polyphenols. Other studies claim the same is true for beer — but only in small amounts.

Still, the evidence is more robust for considering how much you're drinking, rather than what you're drinking. Experts suggest sticking to serving sizes and reflecting why you want that drink in the first place.

Drink responsibly— Using alcohol to cope with negative Covid-19 related feelings could place a person on a path toward developing an alcohol use disorder, Koob cautions.

"Alcohol temporarily dampens anxiety, negative emotions, and other uncomfortable feelings, but the relief is short-lived and negative emotions tend to increase when the buzz wears off," Koob says. The change in emotions a person experiences between intoxicated and being sober can also motivate drinkers to drink more frequently, Koob explains.

"In essence, using alcohol to dampen emotional misery ends up making people more miserable," he says.

The occasional quarantine cocktail isn't going to inhibit the immune system or set you on a path to alcohol misuse. But if you find yourself leaning on the bottle to get you through the day, it could be worth it to head outside for a jog — exercise is a tested method of supporting the immune system — or video chat a friend instead.

"This too shall pass," as they say.