A very corporate pandemic

There is a point of view on the current pandemic which needs to be highlighted. Simply stated, the virus is sweeping through a population whose health has been deeply compromised. Or put the other way ‘round, a population with deeply compromised health is a sitting duck for the next pandemic. And nothing that is being done at present reduces the risk of the next pandemic which can come arbitrarily soon in a further weakened population.

It is common knowledge and very well-established that in the US about 80% of the population have compromised metabolic health. What this means is that their bodies do not self-regulate in important ways. They are obese, they suffer from diabetes, from CVD, from high blood pressure: the list goes on. It is also common knowledge that these are the existing health problems that make it more likely that a coronavirus infection will be serious or fatal. Metabolic syndrome is a disregulation of the immune system and the endocrine system. These are the incredibly, impossibly complex systems that protect us from infection. There can be no substitute, no medicine, no vaccine, no supplement that can make up for these systems not working well.

We also know without any real doubt that metabolic syndrome is the result of a chronically bad diet. The fashionable thing to point the finger at is “ultraprocessed” food: food that is the result of industrial production to suit the producers, distributors, and retailers. Whether anyone can spot ultraprocessed food on the supermarket shelf in moot.[1] Readers of this blog will know that the national food guidelines in most countries are diametrically wrong, having been captured by these same corporations. Most people with metabolic syndrome cannot afford to eat fruit, or the starches on which our diet are “supposed” to be based.

Nobody wants to hear this, but we eat what we are sold. We eat Weetabix, we eat bananas, we eat pizza, we drink beverages loaded with sugar. We eat a diet that is known to cause and exacerbate metabolic syndrome. We know that Coca-Cola, to name one corporate, spend vast sums of money subverting the science. We know that the national guidelines are wrong — the current US process to refresh their guidelines has not managed to assert the evidence but remains mired in the bad science of the past.

So, this is a pandemic cooked up by western corporates, no matter where it started. If it wasn’t this pandemic it would be another one. There is no such thing as a sick population that is not vulnerable to epidemics and pandemics.[2]

Infections

I am not reading deeply into the “news” of the pandemic. The first casualty of war and all that. The best testing of a population seems to have been done in Iceland. They reported that half those testing positive for the virus were asymptomatic. It is obviously perfectly possible to have the virus and not even know. At the other end of the scale is Italy with an elderly and compromised population with a high death rate. The US will overtake the Italian death rate is my prediction. (Written at the end of March)

We need to be clear about the population arguments. The illness caused by the virus is important to its spread. It obviously needs to infect people and it needs to infect them in a way that enables it to spread between people. That is simply what it means to be a viable virus capable of creating an epidemic or pandemic. But populations differ in their underlying metabolic health status and therefore in their susceptibility to a pandemic. When the dust clears, we will be able to see which populations were relatively healthy and which were most compromised.

This will be the message that is most ignored/buried/suppressed/badmouthed. There are some knowledgeable people who are saying clearly that even at this point it is worth people changing their eating habits so that their immune and endocrine systems can resist the infection better. No-one in authority wants to know, and those in authority in these matters are highly compromised by the present state of affairs anyway. I would not take dietary advice from anyone in Public Health in the UK or in the NHS.

There is a standard comment that the pandemic is not respecter of borders or states. The pandemic will spread wherever and everywhere that it will, and it will have the most severe and sudden effects wherever population health is already poor. This will as usual be a class and economic status effect with the poor and marginalised bearing the brunt. And it will be a geographic effect with populations most undermined by the food industry most affected.

Pharmaceuticals

There is some predictable and despicable gouging going on by pharmaceutical companies. Par for the course I am afraid.

But there is a bigger scandal unfolding. The biggest money spinner for the pharmaceutical companies is statins. Statins have been pushed on the whole world to address aspects of the metabolic syndrome we are talking about. But they do not address the syndrome at all, they address a marker, cholesterol. They reduce cholesterol levels in many/most people, but they have almost no effect on all-cause mortality.

Cholesterol per se is not a problem; it is sometimes, when properly interpreted, a marker of a problem. I have classically high cholesterol, as does my wife. Statins have been forcefully recommended to us. But a much more useful marker in the same blood test is the level of triglycerides divided by the level of HDL cholesterol. When challenged about the healthy state of this ratio, medical professionals hastily back down from their recommendations.

However, the scandal is this. It turns out that cholesterol Is protective of infections of all sorts including in recent tests the coronavirus. Let’s spell that out. People have been forcefully put on statins, often against their better judgment. GP’s are given payments by the NHS to recruit people onto statins. And in doing so they have made their patients more susceptible to the pandemic. First do no harm.

So far in this argument, we have the food industry undermining the health and resilience of whole populations and the pharmaceutical industry weighing in on the wrong side of the argument, exacerbating the damage in the name of curing it. I see zero chance of anyone being accountable for the death toll directly caused by these moves. The next pandemic is being lined up even before we are out of this one.

Societal choices

Thatcher famously said there was no such thing as society, but here it is in plain view. The food choices and food policy choices we make are societal choices. It is seriously hard to shop at Sainsburys and not buy what they are trying to sell you. For example, everything is hyped up as low fat as though that was a healthy choice. I even got a substitution in an order consisting of 0% fat crème fraiche. Where exactly is the cream in that?

On the television I refuse to watch, a prominent campaigner for proper food and diet, Aseem Malhotra, when interviewed on national news about the pandemic had his plea for real food echoed as “everyone knows you should eat more fruit and veg”. But of course, what is missing is meat and eggs, not fruit and veg. These are social beliefs and they have concrete outcomes, including susceptibility of those societies to pandemics.

Which brings me to a crunch. Usually when people who understand diet and nutrition are faced with vegetarians or vegans, they just say “well those are personal choices and it is possible to get good nutrition on a vegetarian diet, it is just really hard”. But this will no longer wash. The metabolic syndrome encouraged by such diets exposes society, exposes the population, to pandemics. The individual response to a pandemic can never be enough. The virus exploits the weakness of the population as a whole.

This is public health. The policies and choices made at a national level affect the health of the population. You would think listening to these people that their job was to persuade individuals to make sensible lifestyle choices. And sensible is in their gift to define and prescribe. The pandemic for anyone who is watching and listening show the abject failure of what has been done. This is not individuals not listening to their betters, this is a system which on the evidence makes it impossible to avoid susceptibility to epidemics.

No more bullshit

The pandemic goes where it goes, infects who it infects and kills who it kills. It can’t be bought off and many strategies for restricting its spread don’t work. If you want to know who has a compromised metabolic function it will show you. Officials can spout bullshit about the science and about the evidence base of their policy and you will be able to see very clearly where they are wrong.

There is of course a political level to this argument. Some countries have political systems that allow them to tackle the challenges of the pandemic in a fairly straightforward fashion. Some countries seem unable to face up to what they need to do until it is too late. I am puzzled that the Trumps and the Johnsons and Bolsinaros come out so clearly as anti-science, as knowing better than the experts what to do next. And of course, being wrong every time. That seems to me to be a social/political malaise to mirror the pandemic in its destructiveness.

There is an underlying sense these politicians have about what messages the public can bear and what is too much. This is the territory of propaganda during a war, of keeping hearts and minds onside even if it takes outright lies to do so. But when this lying becomes simply self-serving then it is a disease not a palliative measure. A social and political system can become diseased every bit as much as a body can, and the spread of the disease gives a picture of the underlying compromised system just as the pandemic does.

There is indeed a soft-power war going on with China starting to spin narratives about it being the new world superpower eclipsing the fading USA. The figures from the pandemic of infections and deaths are being used to show who can do what it takes and who has lost the plot. This simply means that the figures are unreliable in their raw form. The UK figures seem to get re-baselined every day and I understand registering a death from the virus is far from easy.[3]

Climate change and the pandemic

Lots of people are making connections or many sorts between the pandemic and climate change. The point I want to make is that a massive storm of the sort we have seen many of recently is a mechanism for dissipating energy in the atmosphere and oceans. It happens because there is an energy build-up that will find a release path and mechanism. The pandemic is a similar release mechanism, dissipating the impact of a rampant species, humans, on the biosphere. It happens because such damage undermines the life support systems we depend upon. We would do well to study closely just what has been disturbed and damaged.

We will never predict these mechanisms is a way that would allow us to prevent them. The nature of a release mechanism is that it will find a way. Lots of people have predicted pandemics and the economic chaos that will follow, for instance in the disruption of supply chains. But these predictions are not enough to allow a reconfiguration of how we live to allow resilience. Remember that the major world economies have been on emergency life support by their central banks for the last twelve years, without any prospect of returning to “normal”. Unconventional policies can only lead to novel effects and unexpected threats. It is the integration of these supposedly separate aspects like health and macroeconomics that blindsides us.

[1] Spoiler alert: all of it.

[2] Indeed, that’s one reason that so many things seem to start with bats. Their immune systems are markedly different from ours, on account of their DNA decaying from ‘running hot’, as I understand it, which in turn means that they’re biased toward living with disease, rather than fighting it off as other species do. There are also lots and lots of bats, comprising 20% of all mammalian species. So, a sick population, prone to living with perpetual epidemics within and between their many species.

[3] In contrast, yesterday I heard from the sister of a NHS nurse that all hospital deaths of people over a certain age are now being reported as virus-related, regardless of whether they’d had a test. The figures are variously overreported and underreported, so despite the best efforts of the rationalist community to infer things from them, it’s garbage in and garbage out.