ISSAQUAH, WASH. – Maybe the time has come to quit fretting over Covid-19 – the latest disease nature has produced to limit a human population that has been exploding since about the time of Christ – and accept that nature is losing again despite our own, modern efforts to speed our demise.
Here on the outskirts of liberal, green, wealthy, motor-vehicle-0verrun, always-in-a-hurry Seattle, one cannot ignore how good a job we have been doing to design cities to shorten people’s lives.
And yet, on a global scale, the population of homo sapiens somehow continues to explode.
There were an estimated 190 million people on the planet when we started officially counting the years on the Christian human calendar. Now, 2,022 years later, Our World in Data puts the estimate at 7.9 billion – a more than 40-fold increase.
And despite the arrival of the new, Covid-19 causing SARS-CoV-2 virus near the end of 2019, human births exceeded human deaths by more than two to one in both 2020 and 2021.
The nearly 140 million new humans added to the population in the latter year actually topped the number of all homo sapiens living on the planet for the first 299,000 years of the species’ existence. Those 140 million babies added to the global population in 2021 exceeded the entire number of people present in North America up until 1916.
An ecologist would look at the “recruitment” here – the ratio of births to deaths – and consider us a possibly still too productive species. But then ecologists worry about the ecological carrying capacity that limited the size of our population for about the first 290,000 years of our existence.
Only about 10,000 years ago began the Neolithic revolution, or what one might now call the first agricultural revolution, in the so-called “Fertile Crescent” of the Middle East. The transition of the human species from hunter-gatherers to farmers spread to most of the lands around the Mediterranean Sea over the course of the next 2,000 or 3,000 years while agriculture began to evolve independently among humans in China and South America as well.
A series of agricultural revolutions would follow to push the human population of the globe ever higher with the biggest of these – the Green Revolution – coming but 60 years ago.
“The developing world witnessed an extraordinary period of food crop productivity growth over the past 50 years, despite increasing land scarcity and rising land values,” economist Prabhu Pingali observed in 2012 paper published by the Proceeding of the National Academy of Sciences of the U.S. “Although populations had more than doubled, the production of cereal crops tripled during this period, with only a 30 percent increase in land area cultivated. Dire predictions of a Malthusian famine were belied, and much of the developing world was able to overcome its chronic food deficits.”
The Green Revolution ended the fears published in the 1968 best-selling book “The Population Bomb” which predicted that “in the 1970s, hundreds of millions of people will starve to death in spite of any crash programs embarked upon now.”
The SARS-CoV-2 pandemic, whether one goes by the “official” World Health Organization (WHO) count of nearly 6.2 million dead of this date, or the nearly three-times higher total of 18.2 million estimated in a peer-reviewed paper published in The Lancet last month, has killed a tiny fraction of the “hundreds of millions” once predicted to die of starvation.
Death by laziness
We amazingly continue to flourish as a species despite our willingness to ignore 300,000 years of evolution in an effort to kill ourselves with sloth, often by design, because it is so easy.
There is at the moment much fretting about how, as the Associated Press reported, “2021 was the deadliest year in U.S. history” with Noreen Goldman, a Princeton University researcher, declaring “mammoth” the loss of two years of life expectancy for Americans born today.
The pandemic is, of course, blamed but in reality about all it did was accelerate a U.S trend that began five years ago as Americans, and many in the Western World, became increasingly addicted to what has been termed the “sedentary lifestyle.”
With no pandemic to blame in 2018, the U.S. Centers for Disease Control (CDC) pointed the finger at suicides and drug overdoses for the fact that for “the second time in three years, the average life expectancy in the United States has actually gone down.”
But those weren’t the big killers in 2018; heart disease and cancer were as they have been for years. As a cause of death then and now, heart disease and cancer dwarf all other forms of death. And the CDC’s 2018 death tally didn’t count how many people with those diseases were being kept alive by modern medicine while teetering on the edge of death.
It’s pretty obvious now that when the SARS-CoV-2 virus came along, modern medicine couldn’t hold the line, and a Covid-19 killed a lot of them. The U.S. was hit especially hard.
“At the country level, the highest numbers of cumulative excess deaths due to COVID-19 were estimated in India (4.07 million, the USA (1.13 million), Russia (1.07 million), Mexico 798 000), Brazil (792 000), Indonesia (736 000), and Pakistan (664 000),” the Lancet study
The study also noted “the magnitude of disease burden might have changed for many causes of death during the pandemic period due to both direct effects of lockdowns and the resulting economic turmoil. To correctly divide excess deaths into those directly due to SARS-CoV-2 infection and those associated with changes in other diseases and injuries, multiple drivers of change in mortality since the onset of the pandemic need to be considered.”
Data limitations to date have largely prevented such an examination.
Where data is available, the authors of the study wrote, the picture remains confusing as it is likely to remain for some time. Much of the data is in conflict.
“Some excess mortality might be attributable to reductions in health-care use across a number of causes; however, the effect of reduced health-care use on health outcomes is difficult to prove…demonstrated increases in cause-specific mortality from reduced health-care use do not have a generalized pattern in the countries with data released to date (and) the effect of changes in health-care use on excess mortality might also be greater in later years, rather than in 2020 or 2021,” the study says. “Even hypothesized decreases in injury-related deaths might be in doubt, as the U.S. National Traffic (sic) and Safety Board has reported that road traffic deaths increased in 2020 in many U.S. states despite decreases in transport mobility. There is convincing evidence that rates of anxiety and depression increased during the pandemic period, which might lead to increases in deaths from suicide. However, to date, evidence of increased suicide mortality is scarce apart from in Japan, where reported suicide deaths increased during the pandemic.
“Deaths from some chronic conditions such as ischaemic heart disease or chronic respiratory disease decreased in particular months of 2020, most notably in May and June in Europe,” the authors wrote, “(but) these decreases might have occurred because frail individuals who died from COVID-19 earlier in the year might otherwise have died from these chronic conditions.
Among the few things that are clear these days, however, are that healthy T cells, the body’s natural first line of defense against infection, are important to surviving Covid-19, and the disease is predominately killing older people in whom T cell performance fades.
“Increasing evidence now supports a potential (T-cell) role in both preventing initial infection and, more importantly, limiting the extent of disease following infection,” the latest peer-reviewed study on the subject concluded.
The authors of that study published in Nature Immunology in February traced T cell immunity in the “evolution of jawed vertebrates” back to a “common ancestor around 500 million years ago. This underlines the critical importance of cellular immunity for multicellular organisms, and therefore it should be no surprise that cellular immunity is critical in the control of a new virus such as SARS-CoV-2.”
T cells are known to naturally decline with age in a process called immunosenescence. This is all part of nature’s plot to see that we all die eventually.
But T cells appear to decline faster in those who are inactive. Think of it as nature’s way to get rid of the laziest members of a species that evolved to be always on the move chasing down its next meal and even after the Neolithic Revolution had to work its fingers to the bone to survive.
A group of Polish scientists reported in a peer-reviewed study published in BMC Geriatrics in 2021 that they had “demonstrated that major features of immunosenescence were driven by lifestyle exercise. Physical activity sustained throughout life enhances the immune system by increasing the percentage of naïve T lymphocyte population….”
Researchers in the United Kingdom early in the pandemic looked at walking speed as a general indicator of fitness among 412,596 middle-aged UK Biobank participants and discovered that the slow walkers among them were almost four times more likely to die if infected with Covid-19 than the fast walkers.
“Fast walkers have been shown to generally have good cardiovascular and heart health, making them more resilient to external stressors, including viral infection but this hypothesis has not yet been established for infectious disease,” lead researcher Tom Yates from the National Institute for Health Research Leicester Biomedical Research Center at the University of Leicester told Science Daily at the time.
Since then the evidence to support the hypothesis that “good cardiovascular and heart health” is protective against infectious disease has only grown. The latest study issued just days ago by the European Congress of Clinical Microbiology & Infectious Diseases looked at the medical records of almost 1 million English adults and concluded those destined for heart attack or stroke, often due to a lack of exercise, are also at much greater risk from Covid-19 in the here and now.
The study “suggests that people with elevated risk of developing a stroke or heart attack over the next 10 years (but without existing cardiovascular disease) who contract COVID-19, are nearly three times as likely to be hospitalized and require treatment in intensive care, and six times as likely to die from COVID-19, compared to those at low cardiovascular risk,” The American Association for the Advancement of Science reported.
“The researchers say the findings emphasize the importance of COVID-19 vaccination and investing in strategies to improve cardiovascular health that could reduce the severity of COVID-19 across the population.”
Despite all the whining about anti-vaxxers in the U.S., the country is doing a better job of getting people vaccinated than it is in improving cardiovascular health, a much better job. And it shows in the Covid-19 death numbers.
Consider the difference between the death toll in Italy, where people still walk a lot, and the U.S., where they don’t. In Italy, according to the numbers compiled by Statista, 86 percent of the Covid-19 dead are age 70 or older, and only 4 percent are under the age of 60.
CDC numbers would put the U.S. median five to 10 years younger, and the proportion of Americans under age 60 who are dying is way higher. The CDC doesn’t count deaths under age 65, but deaths under age 50 among for 7 percent of all deaths and another 19 percent of the dead are clustered in the 50 to 65 age group.
If even half of that group is under 60, the percentage of Americans under age 60 dead of Covid-19 would climb to 16 or 17 percent – about four times the rate in Italy.
Correlation is not causation, but it is certainly in this case an indication of a problem, a problem public health experts in this country have been warning about since shortly after the data started coming in from the now long-running Framingham Heart Study began in 1948.
Killing by design
The Framingham researchers found, simply put, that Americans eat too much and move too little and as a result too often die early as a result. The country has been largely ignoring the warning for decades.
It slaps one in the face here in a nicely designed Seattle suburb with winding streets lined with sidewalks and well-thought-out green spaces where people can exercise if they so chose.
Some do. Most don’t.
Meanwhile, the kind of exercise that might get them moving has been wholly overlooked. From the in-law’s house in which I’m staying to the nearest QFC grocery in a small mall with other amenities, it would be about a 10-minute walk if one could walk directly there.
That’s a little less time than it takes to drive given those winding streets. stop signs, traffic lights and traffic. Who knows how many people might walk rather than drive to the store to grab a few items on a sunny spring day if walking was a reasonable option.
But it’s not. The few walkways that connect the cul-de-sacs in the subdivision take one on a convoluted route to a gravel trail along Issaquah Creek that finally leads one to the QFC. What could be a 10-minute walk becomes a 30-minute walk.
Not a lot of people are going to spend an hour coming and going from the grocery store when they can make the trip in less than half the time in the family car. Even with gas at $5 per gallon here, they’re going to eat the cost to save the time.
And this is in the better-designed part of the community.
When I tried to walk the dog to Lake Sammamish, we ran into a maze of older subdivisions where no one even thought about sidewalks or right-of-ways for walkers. They were cut by busy roads with narrow shoulders, no sidewalks, speeding drivers and dead-end streets.
None of this is unique. The suburbs that have sprawled out around all American cities since the 1960s were designed for automobiles, not people, and they continue to be designed for automobiles, not people.
This was a growing problem before the arrival of television and the internet, which enticed Americans into sitting more and more and more. Researchers with the National Center for Chronic Disease Prevention and Health Promotion and the CDC found Americans sitting almost six hours per day in 2018 and warned that “high levels of sedentary behavior and physical inactivity increase the risk of premature mortality and several chronic diseases.”
And then along came Covid-19 to kill a bunch of them.
Some countries have taken note. The United Kingdom is investing £2 billion (about $2.6 billion) in infrastructure to get more people moving on foot and on bicycles. The French are radically restricting automobiles in significant parts of Paris. The Dutch and the Danes have always been a little cycle crazy and the Swedes aren’t far behind.
And in the U.S., at least judging from the traffic-jammed freeways once again plaguing the Seattle area, the thinking seems to be “you’re not getting me out of my motor vehicle and off the road until you pry my cold, dead fingers from the steering wheel.”
Unfortunately, as of late, there have been the appearance of a lot of cold, dead fingers, but nobody seems to be paying much attention to that either.