I was wondering about that with the hantavirus, whereby if it's got a higher fatality rate then it's less likely to be easily transmitted.
Is that like a general rule, or pure bunk? (I'd probably assume the answer 'depends').
Is that like a general rule, or pure bunk? (I'd probably assume the answer 'depends').
I understand the jury is still out on whether a virus can be considered "alive" but, like us, it is capable of replicating itself and mutating. In that sense, it benefits from the same evolution strategies as more complex beings: a strain that gets its host very sick very quickly gets a lower chance to spread to a new host and multiply.
This creates an evolutionary advantage for strains of that virus that are less aggressive or at least develop the worst symptoms more slowly and more covertly.
That allowed for a deadly disease that's somewhat hard to spread (mostly just through sex) to ultimately go on a rampage.
So without concern for the humans with HIV* there an argument to be made that treating symptoms without curing made it spread more?
*obviously, this is just hypothetical. It’s important to care about the life of those with HIV. No banish them all to something like a leper-colony. Although it explains the logic for those at the time they existed better than a religious one did.
The treatments we have now also decrease the risk of spread significantly.
It's a bit like the chickenpox. Once infected, you always have chickenpox ready to burst out in the future as shingles. But for the most part, it's dormant and you aren't infectious.
HIV treatment does the same. It doesn't clear your body of HIV, but it does decrease the HIV load to such low levels that it can be undetectable. That, in turn, decreases the likelihood you'll spread it.
The modern treatment regime was developed around 2010. That is, about 15 years.
I'd argue that with the timeline of the disease that's not recent. What's become more recent is the mass availability of treatment and the significantly reduced cost of treatment.
Compare this with HIV, which can be rendered untransmittable with modern treatments, which is primarily a sexually transmitted disease, which has pre- and post-exposure treatments. It's simply not very efficient/effective to exile millions of people with a lifelong latent infection and little risk of transmission.
The instinct towards ostracism of those who are perceived as unclean is some pretty primordial lizard brain shit which was a great rule of thumb two thousand years ago, along with wearing garments made of only one kind of material. It's actually actively harmful to the process of stopping infection. It leads to fear, distrust, and reduced reporting, hindering the medical system's ability to reach the people who most need to be reached, and encouraging the spread of superstition and suspicion of pre- and post-exposure treatments. In both diseases, the actual infection risk is modest compared to an airborne virus like COVID.
[1] https://journals.lww.com/jphmp/Abstract/2022/03000/Estimatin...
[2] https://pubmed.ncbi.nlm.nih.gov/34189844/
[3] https://pmc.ncbi.nlm.nih.gov/articles/PMC4252165/
[4] https://pmc.ncbi.nlm.nih.gov/articles/PMC7875361/
[5] https://academic.oup.com/cid/article/73/10/1849/6168541?logi...
No, because HIV treatment is about killing the virus, and we don't have any that only treats the symptoms.
But there is an argument like that for the flu and colds.
I remember way back in med school in the mid-70s our infectious disease professor asking this same question, in a philosophical as much as a mechanistic sense.
The most successful strategy is to make a virus that spreads fast, with few visible symptoms until the late stages of the disease. A deadly virus, early will just cause borders to be locked and the international research community to swarm on a cure.
https://en.wikipedia.org/wiki/Myxomatosis#Australia
there are ways to escape the dynamic, such as latency of deleterious symptoms