who_knows_health.md 9.2 KB
Biological Reality
What did we used to think? (preamble) It has been most fascinating to see the average person react to the circumstances of the last year. Barring the original projections for massive death within the first 2 months, we all eventually came to a place of understanding wherein it could be agreed that the disease wasn't as deadly as originally thought. In fact, no matter who's numbers you look at, it's still within the same order of magnitude as anything we've already been accustomed to dealing with.
You'll find that, however, in spite of this, several factors still keep causing people to look at the potential threat of a respiratory disease quite differently.
What do people know about health?
I've long found that most people know very little about health.
They believe they get sick primarily because of an exposure event. Not only the fact of the essential aspect of pathology whereby the presence of a particular pathogen allows for the deduction that there must have been some timepoint where exposure occurred, but that the instance of being sick is tied necessarily to the particular time point which is absolutely the last time they were exposed to that pathogen. That is to say, the proliferation of a pathogen has developed to the point where symptoms of illness are present, and this circumstance is consequent to their last exposure to that pathogen in an environment.
You might take it a step further and observe when someone comments that they were not so lucky, or that another might have been lucky by not having been present at the exposure event, and realize that the reasoning is such that the exposure event dictates illness. This is a very facile view of pathologies and assumes a clean differential between opportunistic pathogens and a more classically conceived of highly infectious pathogen which is theorized to cause illness in any prospective host who happens to interact with it. Pathology and designation of opportunistic characteristics are something which are still being readily studied with far to go before they're thoroughly understood. It's not only "average laypeople" who fall into this manner of thinking, but a lot of academic development can plausibly involve study which assumes this simplistic categorization. Nevertheless, it's well known that a person who has not been sufficiently recovering from their activities, be it by poor diet and inadequate rest, will become more susceptible to illness. We would be hard pressed to differentiate between instances of illness of fatigued individuals who became ill because of a single recent exposure event and those who fell ill because of a combination of factors which allowed an opportunistic pathogen to proliferate that was otherwise affecting the host in such a manner that tissue inflammation was detected.
There is seldom a peep of a sentiment as to the complexity of how an exposure event lead to illness, with perhaps some consideration given to the state of the individual at the time of exposure, and likely less being considered during a period of proliferation. Less still concerning the metabolic state of the host, whether particular substrates were present to potentiate particular cellular interactions, whether inflammatory markers were being expressed for reasons other than the interaction with the pathogen, how these factors influence one another, and so forth.
Certainly, if it were the case that falling ill was purely dependent on whether or not you had come into contact with the pathogen, we would all become equally ill from the same degree of exposure and this would remain true at any stage of our lives. We obviously know this is not the case, however, and even the "average layperson" can realize this with very little effort:
There's a reason we talk about the vulnerable, and a reason most understand that children have a stronger immune system and are beter able to avoid falling ill. If we take our observations and understanding of the variability of vulnerability and effect, we can begin to appreciate the complexity of pathology. What is a vulnerable person? What makes them more vulnerable than a perfectly healthy child with a well-functioning immune system? You might say that person p1 with number of leukocytes n1 and number of illnesses i1, or numerate their comorbidities and weight them as though are of a like type (though you might feel under duress to abscond from discussing obesity, for fear of being called an oppressive fat-shamer by the "health at any size" crowd). Certainly, even to declare that a healthy person is a person with minimum n1 leukocytes also begs additional questions:
Do they always have this number or range of leukocytes? Is the number going to change as they age? Will the delta of leukocyte count always change in one direction? Will this behaviour aberate? To what degree? Are there cyclical patterns that can be observed over long enough periods that it no longer becomes admissible to assume a constant decline? How much is affected by circadian rhythm? Quality of rest? Nutrition? Choice and intensity of activity? How much are these factors affected by the presence of pathogens? If a sick person has even more leukocytes, are they healthier than our theoretical "healthy person"? Of course not. Does neve being exposed to a pathogen mean you have a superior number of leukocytes? Certainly not.
It's not a matter of total leukocyte count, but the degree to which you react to a pathogen, threat, perceived threat, now these reactions express themselves such as to affect the number of leukocytes, the proportion of subtypes, and so forth? We know that the number, type, proportions and behaviours of particular leukocytes vary based on the activity and circumstance of the organism.
Obviously, we know that there is a great degree of variability in the behaviour and performance of one's immune system, that it is not static, and that it does not necessarily progress in only one direction linearly along all temporal scales. Somehow, however, when data is used to discuss the threat of a virus, everyone believes that the percentages they are presented are the most meaningful manner by which to be accurately informing them of their real world susceptibility to the harms of the threat in question - just as they believed that their having gotten sick, in previous instances, had more to do with having come into contact with a particular pathogen, rather than the state of their, for example, glucocorticoid signaling
Obviously to approach health in this way is to use a very naive model of the world in order to assess the state of their health, their risk of disease, and so on, and this manner of thought should be understood to be simplistic and unrealistic.
I've seen, for example, similar problems when it comes to concern for other health issues (cholesterol and saturated fat):
They are quick to believe advice given by a healthcare professional, without stopping to consider whether or not the diagnosis they are receiving is congruent to their state of health. If their particular state of health is fine, and without symptoms, and they begin using a medication which incurs a metabolic cost, toxicological effects, and a reduction in their ability to perform at the same capacity previously enjoyed, even to the point where they now begin to develop deliterious symptoms (pain, muscle spasms, reduction in digestive capacity, reduced capacity to heal), are they really making an amendment to their health? Are they potentiating their healthy, improving their vitality and increasing their lifespan? Are these things mutually exclusive to one another, or does potentiating your health also mean increasing your life span? If your medication is reducing your vitality and worsening your biological performance, but you continue to use it under the assumption that it will increase your lifespan, then something is wrong with your model.
We can produce a placebo-controlled study on the obese, for example, where we demonstrate a measurable improvement of a metric for those using the medication. Could it be said that such a study demonstrates better outcomes for those using the medication, necessarily meaning that their life will be extended, or that they will do a better job of mitigating disease?
Similarly, in epidemiology, we might also observe that use of a particular medication is leading to improved outcomes, but it's easy to make the case that those who are using the medication are wealthier, more cognizant of health issues, or are representative of those who are more likely to make a degree of effort to improve outcomes.
Even practicing a mindset of trying to improve one's health, all things considered equal, could mean that you have fewer instances of cortisol release, greater instances wherein one experiences a better sense of wellbeing, and fewer instances of falling into a hopeless mind state.
That these things do not affect health is nonsense. You are able to affect your heart rate through stress, even that produced purely at the psychological level. (citation needed)
Average-minded perspectives on issues of health Higher Death Rate The initial expectation for a very high death rate is something that imprinted its mark on the concept of Covid and SARSCoV2.
Escaping the covid body The body of the past The body of the future