What if we tolerated diseases?
knowablemagazine.org
knowablemagazine.org
We are already doing this, no?
Every time we take medication that lowers our fever during an infection (antipyretic ), we trade a bit of immune response for a much more comfortable illness.
The other aspect of this is that carrying more pathogen, for longer, increases the chance that you will infect others.
Or that it could do more damage, depending on the type of infection. For example, HPV os though to only lead to cancer for those who have a persistent infection for a few years.
You cause damage to your body through inflammation. You invoke deleterious pathways that normally sit idle.
Getting sick primes the immune system for defense, but it is also damaging to healthspan.
The Hayflick limit really isn't relevant here.
My personal theory is that fever arose as a specific mechanism against specific pathogen that humanity encountered some time in the past. Probably very lethal. The only people who survived were ones that were getting fever when encountering large number of various antigens. That pathogen I think is long gone and most human pathogens are completely not influenced by the fever. But the mechanism largely remained.
Or perhaps fever works against bacteria so if you keep yourself isolated when you are having viral disease it's useless, but if you still contact people when virally ill maybe fever protects you from secondary bacterial infection to some degree.
Fever, I suspect, is the body trying to exceed the operating temperature range of the pathogen to either kill or impede it.
I don't know if there has been any research on this that either confirms my genius theory or disproves my rambling uninformed delusion.
The body also does not go into fever mode for every kind of infection so I personally think that it's quite adapted to only "fevering" for the right kinds of pathogens, as in: yes it does still help/do something but there can of course be "imposters" that make you go into fever mode without it helping much.
Some people get fever that goes way too high and kills the host if we didn't have Ibuprofen and the like (or herbal remedies to the same effect). If none of those were available, the genes affecting this would naturally die out/become less prevalent. Which is along the lines of the article that "letting diseases run their course" might be beneficial in that sense.
There's no evidence of this tradeoff.
Maybe this is a selfish thought, but moving towards tolerating diseases objectively increases risk for people like me who can't tolerate diseases to the same extent as others, and others tolerating them more increases the odds that I'll catch them, so this isn't a medical advancement I'm particularly excited about.
If you want to argue over details that make little difference though, I'd recommend using the term "splitting hairs" instead.
'kind unkind'
'known unknown' (unless your Donald Rumsfeld)
'seen unseen'
etc.
I feel like writing quote-on-quote takes away the ability of non-native speakers to search for and learn the basis of the idiom. I really don't see how it would be more understandable than just typing "quote".
They aren't proposing increasing asymptomatic disease, they're discussing trying to reduce damage done to individuals.
Which 100% sounds like the right approach to take and I don't consider this immoral or wrong or anything, just unfortunate.
However, for those that have a weak immune response and also don't or can't get this new tolerance treatment, it would be a net negative, on that I can agree.
I guess this is a very Dutch thing, but usually the GP here sends you home with the advise to take some rest, an antipyretic and call again if it gets worse or it doesn't go away after a week.
Still, interesting read - good this is thought and discussed about.
Yep!
I’ll save you all the rant about opioids.
Analgesia is pretty weird.
Especially because I already do the paracetamol & wait myself before I go to the GP to begin with, but at least my current GP understands that.
The time is that you send a kid at school until they "have temperature". Before that they sneeze, cough, whatever, together with the rest of the pupils. Eventually everyone gets ill and the general immunity increases.
When they are are ill it is paracetamol. It used to be also antibiotics, now an increasing number of GP do tests before.
EDIT: following up on comments, please note that I am neither the Ministry of Health, nor the Ministry of Education - just relying the status in France. And a parent who suffered of this first-hand.
This is not a good thing - repeated infections with the same virus only cause damage. Then they infect parents or grandparents. Especially now that covid is about, and life expectancy has fallen across the world by several years.
Schools could install air purifiers for a few hundred bucks per room and greatly reduce infections
PS: a lot of responses perpetuate the urban legends about immunity. So I thought I would respond here:
1 - getting many infections as a child does not keep you safe when you are a pensioner. Immunity does not last the rest of your life.
Most vaccines need to be refreshed every 10 years. The proper term is Immunological memory, and is a complicated subject I don't fully grasp. That's why we had booster shots for COVID, immunity from it disappears quickly.
2 - getting infected is not consequence free. Just because you gully recovered does not mean you have no lasting damage. Serious infections cause microscopic damage in your organs. That damages is patched by connecting tissue / scar tissue. That tissue is not functional - if it patches a kidney, that kidney is less capable. You don't need to get Ebola to suffer damage - even a serious case of flu takes a toll.
3 - many immunities are worthless - for example the flu mutates every year, and if you want immunity from it, in UK we do flu vaccines. So if you want immunity from it, take every vaccine when it's offered. But if you got a vaccine 3 years ago, chances are that particular mutation will not reoccur in your life, and it offers no particular benefit ever again.
4 - pathogen load is a thing - you don't need to fall ill to generate immunity. When you are walking about, your body is getting tiny amount of pathogens - and most of the time the quantity is too small to get you sick, but your immune system deals with them. You do not get infected because someone sneezed 20 miles downwind and you inhaled 1 virus particle. Schools / kindergartens with poor ventilation create pathogen hot-tubs with unnaturally high pathogen loads. This is like an infection hot boxing. We know ventilation is terrible because often have CO2 concentration in excess of 2000. There is nothing natural about this, cavemen did not encounter such conditions. Improving ventilation reduces how many pathogens are floating in the air, even if the same number of kids are sneezing.
Bottomn line is, immune system is not like a dog that you train once, and it's also dangerous because you can get allergies or autoimmune diseases.
There is no evidence that subjecting people to excessive number of infection by creating disease petri-dish conditions in school has any benefit.
Also Kurzgesagt has many videos on immune system: https://youtu.be/M-K7mxdN62M
That may be true for teenagers and up and perhaps more crowded workplaces or university halls. But I think you are greatly underestimating how nasty and excessively touchy most kindergarten and primary school kids are, that really is not fixable with just HEPA filters. Kids will always be a bio-hazard agglomerate of disease vectors it is kind of unavoidable when you put them all together.
Or not, if immunisation was achieved, like it usually does. If you would keep the kids at home, everytime they have to sneeze, then the schools would be pretty empty in winter, general education level drops further and everyone will get sick again anyway, the first time they interact with other people outside their home, as they let their immune system without work.
The situation in the kindergarten was and is quite horrible after covid. All the diseases they did not get, while in lockdown - they got now and concentrated (that means, now it slowly seems to be moving towards normality).
So air purifiers might still be useful, but I think it is an illusion to think to be able to prevent all or most diseases. Sure, some very dangerous strains are to be taken with caution and if a lockdown would be really necessary, so be it. But infections are just a normal thing. Especially for children. This way they train their immune system step by step. So removing that step will be actually dangerous later on as there are quite some diseases that are quite mild for children, but deadly for adults, if they did not catch it as a child.
Not all diseases behave like that, and all should be treated differently. Really you should just do public health, and have statistics, and let those make the decisions instead of doing policy by omission, or deciding by intuition.
I don't think this is evidence that getting sick as a nurse in daycare is good for you. This only evidences that people adapt to an repeat infection and environment with pathogens.
The comparison should be made against a person that never had to go to daycare and never had to get sick there -> would they be more or less healthy.
I am not an immunologist of-course, but everything I read indicates that this conventional wisdom is build on misunderstanding of the immune system .
Isn't it also the case that lowered exposure to general pathogens, also decreases general tolerance and resistance to them, leading to more complications down the line? Thus living in a clinically scrubbed environment can also be equally as harmful, which could also be part of the aftermath of 2020?
This is of course anecdotal, but personally I never had such a bad influenza as after that period of severe isolation, when I finally started meeting people again. And the same is true for many of my colleges, one of which contracted Asthma due to the severity of the disease. This was regular influenza after isolation, and not Corona, btw.
I expanded my reply, but why would it be a good thing? Think about it - 'getting ill is good for you' is a counter-intuitive claim, and the only reason you are asking me for proof, is that you have gotten used to accepting this urban legend.
This is not 'natural infections' -> there is no natural situation where you stuff 30 monkeys in a box with poor ventilation and raise CO2 concentration to 2000 ppm, so that the few sick monkeys can achieve really high concentration of pathogens.
I think the idea that it is 'good' is civilisational copium. It's like when people claimed that sending kids into coal mines builds character.
Sorry, "getting ill is good for you" is not what I meant to convey. Instead, what I wrote is that lowered exposure to general pathogens, also decreases general tolerance and resistance to them. This means that it's very likely detrimental to live in "clinically" clean and filtered environments, as it is also detrimental to live in isolation for too long.
The most extreme example of this are all the natives who got sick and died as the conquistadors arrived in South America. They died because they had no prior exposure, and thus no defense against, the pathogens that the Europeans unknowingly brought with them. Thus I'm fairly sure that it's trivial to prove that prolonged isolation will also lower your tolerance for common influenza pathogens. I don't know this, of course, but I'm sure an experiment where both yours and my claim were tested would be very interesting to read!
They pick their nose, touch everything, lick their hands, put things in their mouths, etc.
Unless you’re willing to put them in a plastic bubble until they are adults and stop doing that, they’re going to get sick.
And in practice, this would be a really bad idea, because the moment you open that plastic bubble, all the pathogens that are constantly in the air anyway, will hit them bad, as they are totally unprepared for it.
One of the theories why children put everything in their mouth, is exactly to expose them to world of microorganisms early on, so they can get used to it, while their immune system is developing.
It’s very obvious. You’re citing a popsci video while accusing others of falling prey to urban legends, and declining to offer references to the people asking for them.
Let me be unequivocal: all the points you’ve made are inaccurate (except #2), because you lack this fundamental understanding of the difference between adaptive and innate immunity, and the value of paratope diversity.
“Getting sick” (i.e. an infection reaching the point where it causes clinical symptoms) is crucial for the development of the adaptive immune response, whereby the body tries “randomized” antibody structures until it develops new ones that can bind to an antigen. Having a broad range of antibodies developed through this process, called somatic hypermutation, is important because your body uses prior antibodies it’s developed as starting points for developing targets against new antigens, so even for rapidly evolving targets like the flu, exposure to previous strains still can help stack the odds in the body’s favor.
Ditch the youtube, and instead find a good literature review on immunology (e.g. https://doi.org/10.1016/j.vaccine.2010.07.022). Please stop blowing uninformed hot air.
At the moment my faith in Schools, very rigid institutions, to adapt and properly consider risks to children is essentially zero.
Genuine question: what defines “excessive”? The way you put this seems to bury the actual question at hand, which determining what level of illness policy, sanitation, etc. is too much?
That said, a better understanding might allow the linked pathogen/prey relationship between diseases and their host populations to be broken - as we have done with smallpox?
Isn't there a strong correlation between birth rate & child mortality? Most rich societies have slowed down their birth rate in large part because you don't need 5 kids in order to ensure 1 makes it to adulthood.
If we tolerated disease, we would probably increase birth rates to compensate for the spike in child mortality.
We could also make rising children less of an obstacle. If you build the infrastructure around rising children so that rising 2 children is not a full-time job, then parents would get more children.
If population declines, maybe housing will get cheaper, but our current system directs unhealthy amount of cash into houaing market and inflates it beyong it's natural state.
But it doesn't, housing prices have. roughly doubled in UK for example since 2008, and wages have fallen.c
If you measure housing cost is multiples of income, they have grown massively in the past 70 years. If the price of chicken went up as much as price of housing over the same period, a chicken would cost like $55 or smth
The multiple of my mortgage to income is higher than for my parents, but I'm still left with more spending power left over, because my lending is cheaper, the LTV higher, and not all the other costs have increased at a similar rate.
Overall, despite a higher proportion of my income going to housing, I'm far better off than my parents were at my age.
And low interest rates didn't last, now they are back up in Europe, so people with large mortgages are not having to make huge repayments and will be making them for the next 30 years.
generally speaking we have more capital tied up in housing than we do in productive economy. This is inefficient deployment of capital and is not economically healthy.
Meanwhile, in the UK where I am now, there is plenty of empty housing at lower cost.
What there is a lack of is housing people want to pay for where they want to pay for it, because many - not all - can afford to be picky.
That's not to say it wouldn't be a tremendous benefit to society to drive down house prices, because it would, but the housing market is elastic:
People can, and have (and many still do), lived in far more cramped conditions, and do when they can't afford to pay more.E.g. house shares and the like.
The actual problem of high prices is a level of inequality that means a subset struggle more. But that is insufficient to explain e.g. fertility rates across the board when the overall wealth is at it is.
Considering my original example, if you look at indications of disposable income in Norway, you'll see people e.g. taking far more holidays abroad, far more have holiday homes, etc. despite spending more on housing.
Overall wealth is through the roof and you see it everywhere. And yet fertility rates are not.
This is also consistent with the development we see everywhere in the world. It's played out in country after country, and is an effect that plays out over many decades.
https://www.economist.com/europe/2023/02/16/why-there-are-so...
It's more about the idea that someone can be healthy, even if they carry a pathogen.
The article is about research into non-immune system based adaptive systems of the body that reduce disease susceptibility - i.e why some animals and people can tolerate higher bacterial or viral loads without dying then others, and can we develop drugs which enhance these effects or augment them (i.e. giving glucose support to malaria infected rats which arr experiencing an overactive drop in glucose production due to natural responses to effects of malaria).
It's about therapeutic agents to boost survivability without looking directly at pathogen kill paths - it is admittedly weirdly titled.
If you'd please review https://news.ycombinator.com/newsguidelines.html and stick to the rules when posting here, we'd appreciate it. One of them is "Edit out swipes", and there's even another about this specific case:
"Please don't comment on whether someone read an article. "Did you even read the article? It mentions that" can be shortened to "The article mentions that.""
I know that's popular among some political groups, but it is still inhuman.
All of this stacks the deck against the majority of Americans.
Is it any wonder our bodies cannot fight off disease naturally?
When you also add in that we have an absurd fear of illness and death, our behaviors get more and more neurotic, which then adds to the stress, which then further compromises our health.
You need to prove that we could previously. The various plagues and epidemics (Athens, Antonine, and Black to namea few) are excellent proof that returning to unprocessed food won't much help.
> When you also add in that we have an absurd fear of illness and death
The Momento Mori rose in response to the Black Plague, so that's not new either.
Followed by surgery like gastric bypass which is largely ineffective long-term, but of course they don't track it long term. People return to old habits, and the body tries to adapt, but now with newly crippled digestive system.
"Everything in moderation" is something we've not learned yet, as a culture.
Lots of plastic surgery is done to restore features. I think that practice does far more good than harm.
Here's an example of a study if you're interested [1]!
The neutralizing antibodies aren't durable, so protection against infection and mild illness wanes, but the T-cells that protect against hospitalization and death are likely permanent.
Isn't that just the definition of a vaccine?
"A vaccine is a biological preparation that provides active acquired immunity to a particular infectious or malignant disease." ... "The agent stimulates the body's immune system to recognize the agent as a threat, destroy it, and to further recognize and destroy any of the microorganisms associated with that agent that it may encounter in the future."
Not that we should even give up the search for more truth, at least, that's one of my mantras.
Looks to me like you are reacting to the title instead of the article
I expected the standard anti-medicine fare from the title, but got neat biological investigation/hacking instead. That was an interesting read
We take it for granted, we believe that we have the right to exist. At every turn we're trying to defeat death and illness. Trying to defeat nature's (and the planet's) mechanisms of a form of population control.
Then on the other hand, we sort of complain about overpopulation.
Don't get me wrong, I don't want to see people die, but on the other hand I fully understand that we must die. Me must get ill.
Those are not mutually compatible
Well, unless you take some esoteric interpretation where one can be absolved from the immediate implications of what they think are the most desirable states for the universe
If one considers it necessary for people to die, one wants people to die. It's part of the whole considering death necessary