Infection is disease. That thought has been continuing to emerge in my mind as I watch the attempts by the smart few to stop mass infections. We need to understand that infection is bad, because the way the mass infection crowd get away with what they’re doing is by…/1 #COVID19
…appealing to lived experience of everyday infection, of everyday people. The colds and flus we all grew up with. (Back to them in a moment.) One thing I think needs saying is that the past century has been hugely skewed in our history of infectious disease. Antibiotics. /2
Prior to antibiotics, cut your hand in the garden, and you could be dead within a week. Everyday cuts and scratches could kill you. We were more intrinsically aware of and wary of infection. Vaccination preceded antibiotics, but together they transformed how we experience…/3
…and think about infectious disease. They illustrate an ongoing truth, that pharmaceuticals save lives, but also dull our senses. They encourage a set-and-forget mindset. As we also see in warfare, with constantly failed dreams of *the* ultimate weapon to end conflict. /4
Infectious disease is an ecological phenomenon, much more than it’s a medical phenomenon. Medicine is one ecological input to the ecosystems of microbes, of which disease pathogens and ourselves are parts. Antibiotic resistance and vaccine waning clear examples of how…/5
…the dance never ends. With that in mind, Paul Ewald’s work has always fascinated me. There are two aspects to it that are better-known, firstly his hypotheses on modulation of virulence using public health measures, based on a particular hypothesis from evolutionary theory. /6
I won’t explore that one here, evolutionary theory is a bit of a battle ground. Though I will say (having studied evolutionary theory in depth) that the idea it means ‘mutations occur randomly, and those that are most fit survive’, which passes for accepted wisdom, is…/7
…historically inaccurate, when you actually read Darwin (which few still do). It’s more a product of the modern synthesis, and has become a type of scientific slogan, a highly simplified caricature of what Darwin discovered and discussed. Upshot being, I think evolutionary…/8
…explanations have a lot more intrinsic power that can’t be tapped while we remain fixated on these caricatures of Darwin’s thought. But to get back to Ewald’s other line of thought that seems massively pertinent today, on *chronic infection*. Ewald feels, and I agree, that…/9
…our assumptions and thinking about infection are mired in our experience of acute infection. The infections that resolve themselves, or via vaccination and antibiotics. (Or *seem* to resolve, Ewald’s critical point.) Perhaps most of us now have come to think of infection…/10
…as a temporary, resolvable bump in life’s road. A medicinal view of infection. Ewald suggests that infections, even those we think of as acute, may in fact be chronic, and persist for years, if not our entire lives. We are aware of some chronic infections, HIV-1, measles…/11
…varicella-zoster, etc. But Ewald suggests many of our chronic ailments, such as cardiovascular disease, may in fact be the result of chronic infection. (Just recently we saw an example of this with MS: theconversation.com/multiple-scler…) /12
This can be both ongoing presence of the infectious pathogen in our bodies, and/or the ongoing damage caused by earlier infection. In both cases infection is a possibly permanent shift to the ecological balance between ourselves and our surroundings. (Noting that…/13
…infection also plays a positive role in evolution, in driving biological change.). Just some of the research on possibly infectious causation of atherosclerosis here: ncbi.nlm.nih.gov/books/NBK83710/ /14
The important overall point is, take infection seriously. As those who study Long Covid know, infection with Covid may have lasting, even lifelong morbidity and mortality impacts. The deliberate mass infection of entire populations currently underway fails even basic…/15
…risk management process. Infection is not the inconvenience of a cold, we don’t even know for sure that those handful of regular infections we’ve all suffered are only acute, without chronic long-term effects. Recognising that our bodies fight infection using our immune…/16
…systems isn’t a reason to welcome infection itself. It’s like saying we have guns to defend ourselves, so let’s all start shooting. The past century is unique in human history, as above, because it’s the first time we’ve thought of infection as a minor, temporary thing. /17
In evolutionary time scales, and even in the timescales of human history, infection plays out across generations, even centuries and millennia. We’re still fighting TB, malaria and polio. Early victories have to be revisited, time and again. /18
Just to finish, recent hypotheses of the causal role of influenza infection with heart disease, and how flu vaccinations can possibly mitigate against that. ‘Just like the flu’ never seemed a dumber thing to say. /end houstonmethodist.org/blog/articles/…

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More from @RageSheen

7 Dec
Elected representatives should not be determining pandemic strategy. The definition of an emergency is something that needs to be dealt with, using known effective procedures, not consulted about. We don't have politicians.../1 #auspol #covid19aus
...'balancing' whether to put out a bushfire against the needs of Harvey Norman or Qantas. The horse trading with peoples' lives, weighed up against every vested interest group politicians are associated with, is what has both created and prolonged this pandemic. /2
This is a genuine failure of democracy itself. Our ideas about it are destroying it. If you've worked in government, you'll know it's not the job of elected representatives to run anything much at all. They don't understand most of the things they decide on. /3
Read 4 tweets
5 Dec
All politics is identity politics. Dominant groups lose the visibility of their identity, they think their privilege is just ‘how things are’. They don’t have to fight for identity, so it disappears from their view. A few short thoughts on Dan’s Tweet. #auspol /1
The dominant Covid narrative in Western nations is all about inconvenience. SARS-Cov-2 is not an existential threat in their eyes, elite societies no longer recognise those. They feel themselves to be masters of the universe. That’s the (silent) collective identity. /2
Surely there’s a technology to make all this go away, so we can go back to our lives, country-hopping on planes? To ‘see’ the world, everybody else’s homes are pages from our tourist handbooks. A technology that slots neatly into customary elite lives, to minimise disruption. /3
Read 14 tweets
2 Dec
There’s something important to be understood in why for disasters like bushfires, experts lead the effort to end the disaster, every single day. But for the pandemic, politicians have crowded into the space. Short thread. /1 #auspol #COVID19Aus Image
No doubt politicians do make an appearance in bushfires, but overwhelmingly action is decided and driven by experts. You could say the scale of pandemics warrants greater political involvement, but think back to HIV in the 1980s. /2
Do you remember many big political press conferences? Me either. This pandemic has been politicised. It’s not the scale of the challenge of defeating Covid that has caused that, it’s the scale of perceived potential ‘economic’ disruption that has caused political interference. /3
Read 12 tweets
14 Nov
h/t to @RichardfromSyd1 for highlighting this one. The UK infected:

- nearly half of its babies under 1
- nearly 60% of its toddlers aged 1-4
- 81% of its children aged 5-14.

Something I want to understand. A short thread. /1 #auspol #covid19aus
Some medical professionals are very casual about child infection, manifested in a range of ways, such as saying school is more important than avoiding infection, and not agitating for even basic PH measures in these schools. Or now, demanding a level of caution…/2
…in vaccine approval for children that appears completely absent in the acceptance of mass infection of the young. Is this the old Hippocratic ‘do no harm’ thing, where as a physician you shouldn’t harm anybody by your actions? But then it’s fine to allow them to be harmed…/3
Read 6 tweets
12 Nov
Austria, one home of free-market libertarianism. When you deny the public exists, you end up reinventing it one (incarcerated) group at a time. Libertarians hate the lockdowns their own ideas cause. /1#auspol #covid19aus @YouAreLobbyLud @polioandme

bnonews.com/index.php/2021…
This ‘pandemic of the unvaccinated’ idea has always bothered me. A collective, public event - a pandemic - becomes a consumerist libertarian question of individual choice. Like shopping. This is what libertarians have done with the vaccines,…/2
…rather than use them as part of an integrated public health strategy, that recognises this is a public, collective emergency, they’ve tried to keep their fantasy world of free sovereign individuals, vaccinated or not. And now they’re going to lock up very specific…/3
Read 5 tweets
12 Nov
Looking at Israel’s data last night made me think about how we look at Covid data as being about the virus. When actually it’s much more about us, the people. These epidemiological curves show social behaviour more than virus behaviour. /1 #auspol #covid19aus Image
The virus on its own can do nothing, it uses us to spread and grow. Have Tweeted before (aeon.co/essays/how-us-…) about how our societies are now adolescent cultures, incubated in our schools. You can see that in the curves. The yo-yo of euphoria and retreat. /2
No adult grit and determination, epidemiology driven by waves of euphoria, boredom and fear. In poorer nations without this high school culture, you see similar epidemic waves. But they don’t have the same extensive public health infrastructure as we do. These are the curves…/3 Image
Read 4 tweets

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