The history of the flu/American Journal of Public Health, Peter Doshi

The SARS-CoV-2 virus is surging again, something that was predictable given the way its evolution seems to be tracking that of the Spanish flu, and much of the U.S. medical community is singing the same, old tune of masking and vaccination.

The majority of American physicians appear to believe in all of this, but you have to wonder if they believe in evolution.

Or is it all just about the money?

How else can one explain the willingness to overlook the development of the human immune system over the millennium,  the links between physical fitness and the maintenance of that immune system in a species that developed on the run, and the biggest misinformation campaign of the pandemic, the one that pitched the idea that Covid-19, the disease caused by the SARS-CoV-2 virus, is an equal-opportunity killer.

It wasn’t, and it isn’t.

The disease is primarily a threat to the old and the unfit. And for them, the Covid-19 vaccines could be a lifesaver or at least a life extender.

For the young and fit it’s a different matter unless the medical community is now in the business of prescribing drugs to people might not need them solely to increase profits.

Look at the data.

Listen to the science

As of today, the IU.S. Centers for Disease Control reports 77 percent of the Covid-19 dead were age 65 or older. 

Meanwhile, just shy of 95 percent of the dead are over the age of 50, and it would be very interesting to know the biological ages versus the chronological ages of those in the 50 to 65 age group.

Why?

Because of what we’ve learned since the pandemic began about the importance of naive T cells, those that haven’t been preprogrammed to fight a known disease; the nature of our own immunosenescence; and the connections of both to exercise.

Not to mention what we knew before the pandemic about the “sedentary lifestyle” paving the way toward frailty, and what we later learned about the connection between frailty and Covid-19 deaths. 

More than a decade before the pandemic began, the American Council of Sports Medicine saw this coming and launched a nonprofit initiative to promote the idea “Exercise is Medicine.”

The pitch never really caught on. Most Americans seem unaware of the idea today, and if polled many, if not most, would probably confess they’d rather take a drug to solve any problem than take to exercise.

Exercise is a vaccine

It’s too bad the Sports Medicine Council didn’t rebrand its campaign as  “Exercise is a Vaccine” once the pandemic began because that is what exercise most clearly parallels now. It isn’t a cure-all, but it is a game changer.

Just like the Covid-19 vaccines.

They won’t necessarily stop the SARS-CoV-2 vaccine from infecting someone, but they will increase the odds a Covid-19 infection proves “asymptomatic,” and if you never develop the symptoms, you’ll never know you were infected.

They won’t ensure the SARS-CoV-2 virus stays asymptomatic either, but the odds are very good they will reduce the severity of those symptoms if Covid-19 takes hold.

And, of course, the vaccines can’t guarantee you won’t die from Covid-19, but they will significantly up your odds of survival.

Exercise has been shown to work in much the same way against Covid-19 and a whole lot more.

The value against Covid has been known since the very first year of the pandemic when researchers in the United Kingdom combed through the medical records of more than 400,000 people on file in that nation’s Biobank and discovered “slow walkers” had a two-and-a-half to four-times greater chance of being killed by Covid-19 than “fast walkers.”

The difference in the odds was largely tied to weight. Overweight fast walkers had better odds of survival than slow walkers of any weight, but healthy-weight fast walkers had the best chances of survival.

Weight in this case, however, might simply be another indicator of increased fitness.  Suffice it to say, you won’t find many serious, overweight marathon runners because they run a lot in training.

You have to exercise a lot to get in shape for a marathon, and, as with most things in the world of medicine, the benefits of exercise appear dose-related.

More is good up to….

A peer-reviewed study published in the journal Circulation two years after the Biobank study reported that regular exercise up to a total of 600 minutes of “vigorous” activity per week significantly reduced all-cause mortality.

“The nearly maximal benefit on mortality reduction was observed among individuals who reported approximately 150 to 300 minutes per week of long-term, leisure-time vigorous physical activity (or) 300 to 600 minutes per week of long-term, leisure-time moderate physical activity, or an equivalent combination of both,” the study said. 

Six hundred minutes – 10 hours – of exercise per week is a lot, but there are people who get that much and more. When on a quest to run a sub-3 hour marathon in my younger years, I was regularly running 12 hours or more per week to get in 100 to 120 miles, and between biking, hiking and some light jogging, I still get in eight hours or more per week.

The Circulation study found exercise is a Covidesque vaccine against a whole lot of deadly diseases, starting with cardiovascular disease (CVD or heart disease), still the nation’s number one killer, and a wide variety of cancers, which are collectively the nation’s number two killer.

And researchers seem to every day be finding more diseases against which exercise is protective.

Dementia is the latest. A peer-reviewed study published in Alzheimer’s & Dementia, the Journal of Alzheimer’s Association, this month reported that “conservatively, one in 15 cases of dementia may be attributable to physical inactivity, defined by any criteria.

Upon reading that sentence, middle-aged children with any idea of the difficulty of caring for aging parents with dementia ought to be thinking “get grandpa a bike.”

You can invest in a Towwhee, if necessary, to give him a boost in getting into shape until he can ride easily on his own power, or get him a Class 1 e-bike to help him keep up. Same for grandma.

Dementia, fortunately, tends to show up very late in life while a host of other diseases start to manifest themselves after age 50, although the CDC data for 2020 did show heart disease and cancers now rank number four and five as causes of death for Americans under the age of 45.

Covid-19 was sixth in that age group. It was blamed for 8,900 deaths, or about 48 percent of the 16,700 deaths from cancer and about 49 percent of the 17,300 deaths from heart disease, which is normally thought to kill old people.

Homicides killed more than twice as many people – 18,800 – under age 45 than did Covid-19, and suicide claimed the lives of 22,400, slightly more than two and a half times more than Covid-19.

And they weren’t even the big killer. That was “unintentional injury.”

Unintentional injuries – those things we like to call “accidents” even when they’re not – killed 80,200 at work, home or play. That was more than nine times the number of deaths from Covid-19.

“In the first half of life, more Americans die from injuries and violence – such as motor vehicle crashes, suicide, or homicides – than from any other cause, including cancer, HIV, or the flu,” the CDC reported.

Flu deaths reached nearly 3,000 in 2009, a bad year for flu, but they vary considerably from year to year. Covid-19 deaths too have varied by year, and they were higher than for the flu with the second-year deaths from the disease for the under 45s rising to 26,000 before falling back to 8,800 in 2022.

The death rate for the group most threatened – the cohort aged 35 to 44 –  fell from 16 per 100,000 in 2020  to 11.9 per 100,000 in 2022, according to the CDC report.

Old in middle-age

As with those aged 50 to 65, there is no telling what the biological ages of 21st-century Americans in the 35 to 44 age class.

Immuonsense, the natural decay of the immune system, is generally thought to start not long after puberty, but the rate at which it progresses is most often dictated by lifestyle choices.

A group of researchers from Singapore, writing in Seminars in Immunpathology in 2020 went so far as to argue that “immunosenescence is not age-dependent.”

“Though this phenomenon is often seen in aged individuals, it is also possible in younger adults as it could be ‘accelerated immunosenescence’, especially for T cells,” they wrote. 

“The concept of ‘accelerated biological aging’ is also shown in two studies that compared biological age and chronological age in an individual, and they were able to show that individuals that have older ‘biological age,’ as compared with chronological age, exhibit cognitive decline, looked older, self-reported worse health, and measured lifespan (mortality) and health span (frailty).”

All of these things play into who does or doesn’t die from Covid-19 and still do. This is pretty obvious in the data. U.S. Covid-19 death rates for all age groups under age 35 are about half to much less than half of that for the aforementioned 35 to 44 group.

For those ages five to 14, the 2021 rate was 0.5 per 100,000.

That’s about a fifth of the rate for motor vehicle accident deaths involving children of the same ages, according to data from the National Safety Council.

And yet it’s not uncommon to see parents texting while driving around with a car full of kids even though the American Automobile Association (AAA) has concluded this and other forms of distracted driving killed an average of nine people per day in the U.S. in 2021.

Americans are really bad at risk assessment. Some of the same parents who adamantly insist everyone get their kids vaccinated against Covid-19 often drive like idiots with kids in the car.

And doctors who should know what works best against Covid-19 and what doesn’t appear fixated on masks and vaccines.

There’s nothing inherently wrong with this. The vaccines help some people a lot, some people a little, and don’t matter much for others.

If the odds of dying are 0.5 in 100,000 and you increase them by 100 percent to 1 in 100,000, you haven’t changed much. In the first case, the individual odds of survival are 99.995 percent. In the latter, they’ve fallen to  99.99 percent.

The problem with fixating on masks and medicines is that it encourages Americans to ignore the bigger problem of fitness, or more accurately the lack thereof, rippling through society. The CDC now calculates inactivity is linked to one in 10 premature deaths in this country and costs the economy $117 billion. 

Its all too common companion – obesity – is now so bad that military leaders are worried about being able to field the army of tomorrow.

According to the Department of Defense, 31 percent of those ages 17 to 24 were simply too heavy to enlist in 2016, and the obesity problem hasn’t gotten any better for the service branches that need to find about 130,000 people a year to fill uniforms.

Neither masks nor medicines are going to solve these problems, and in the case of the former, there’s no real evidence they do much more than help fuel the country’s culture war. A thorough Cochrane review concluded that “wearing masks in the community probably makes little or no difference” and called for more research to determine whether the final answer was the “little” or “no.” 

The vaccines, on the other hand, have been shown to work, but they don’t stop the spread of the disease as was once promised. And there are legitimate questions as to how much fit and healthy young Americans need them.

Then again, the percentage of Americans who qualify as fit and healthy appears to be declining year to year.