The Viral Load
(Warning, this one is long, even for me)
On our way to visit my family in Boston a few weeks ago, Eric and I were talking through some of the things he will be discussing in his class on Environmental Physics, and I laid out an analysis for him that he was really interested in, about covid and viruses in general, and what I think will ultimately be the most astonishing discovery of the early 21st century, and the complicated reasons, and responsibilities for why we don’t understand what’s really going on.
Eric asked me to put it together, complete with links, so that he could show it to his class and generate some discussion. But perhaps someone else will find it helpful as well.
I think an important part of the way the pandemic unrolled and an important part of the reasons for why we are where we are was shaped by two, simultaneous strains of contradictory thought – one scientific and one popular.
That is, at the exact same time that scientists were developing the beginnings of a really fascinating new theory, a new popular theory about human health was also emerging. Lack of understanding of the ways these two narratives are at odds has been a real barrier to clear expression of scientific ideas, and explains part of why the covid pandemic and other issues have been so deeply politicized.
Just to be totally clear, when I say scientific thought, I don’t mean all scientists share that line of thinking – I mean that the experts in that particularly field generally agree, but as we all know, scientists are just as likely to hold popular opinions as anyone else in things they are not expert in. And scientists are just as likely as anyone else to be corrupted by opportunities for influence, money and power when science is politicized, or when science intersects with entrenched biases.
Let’s start with the science, and then move on to the question of what the popular narrative has been, to see if we can understand where we are now.
The emergence of AIDS and HIV in the 1980s really shook up a lot of assumptions about viral illness. While there had been discoveries about viral persistence on and off throughout the century, up until the 1980s most research on viruses focused on the acute phase.
HIV infection, however, upends the idea that the acute phase of illness is the critical one. HIV infection itself is an extremely mild cold or flu like illness that most people don’t even notice happening. It causes no visible damage, and people shake it right off. The fact that you’ve never met anyone who said “Yeah, I was really down with the HIV virus” in its acute phase is because most people don’t even realize they have it. The common cold causes more deaths than HIV in the acute phase.
Three years after exposure to HIV, however, a few people start getting sick, but most people are still fine. For most people, it is 7-12 years after exposure to the HIV virus before (in the era before treatment) AIDS emerged. The discovery of the link between the HIV virus and its long term, extremely severe effects was a revelation, if a horrifying one.
In the pre-treatment era, of course, when the HIV virus turned to AIDS, it was was almost universally a death sentence, as all of us my age and older remember watching friends and loved ones suffer and die. It was particularly troubling and terrifying that a sexual or medical encounter years earlier that caused virtually no symptoms could cause such suffering and death.
Because this was 40+ years ago, it is hard to remember how much this upended people’s assumptions about viral illness – while viral persistence and consequences had been known for some time – post-polio syndrome, etc… the idea of a near-universally fatal illness that presented as a cold, and then lay dormant for years was quite shocking. Even virologists were accustomed to assume that damaging illnesses FELT damaging when they happened.
Research into AIDS, along with other medical research led to finding that what HIV does actually isn’t entirely atypical of viruses. In fact, it is more common than suspected. We already knew that chicken pox could cause the shingles virus, and that the emergence of shingles was in large part due to an aging immune system that had previously kept the dormant virus in check. ME/CFS was also widely assumed to be caused by viral persistence.
In the decades that followed, though, a whole lot of new studies found a strong and long term link from various conditions, many of them immunological, to viral illness. By the early 2000s, such a link was widely understood or the most common hypothesis in many illnesses, particularly autoimmune and immunosuppressive conditions.
We learned that Epstein Barr virus causes MS, as well as being linked to other autoimmune conditions. We learned that the long-recognized higher death rate of children for several years after having measles was caused by immunosuppression created by the measles virus, and lasting for up to three years after infection.
Links between viral triggers for Type 1 diabetes in children and enteroviruses and other viruses, suggest that viral persistence in the pancreas is a trigger for the most common immune condition affecting children.
Around the same time that scientists were coming to understand HIV, German scientists isolated the HPV virus in cervical cancer cells, and hypothesized that HPV caused cancer.
Oncogenic viruses had been known since the turn of the 20th century, when a chicken virus was shown to cause leukemia in poultry, but it took until the mid-20th century for most people to understand the significance of this. The Australian HPV vaccine was the first time we have been able to vaccinate against cancer.
HIV, of course, has a tendency to promote dangerous and unusual cancers (Kaposi’s sarcoma being the most famous), and the 1980s and 1990s were a fertile period in science in understanding tumor virology and the ways that viruses like papilloma viruses, human T-cell leukemia virus and HIV were causing cancers. Recent estimates are that 20% or more of human cancers are viral in origin.
Since covid, we’ve seen an astonishing rise in unusual cancers in younger patients, and also covid is clearly linked to new onset autoimmune diseases, and to immune damage. We also know that new cancer rates are highest in populations that are unvaccinated for Covid. The sheer number of conditions with links to covid is astonishing – parkinson’s, alzheimers, type 1 diabetes, lupus, cardiomyopathy and cancer among others.
In the last few years we’ve also seen an increasing number of links between vaccination and overall better health. For example, type 1 diabetes incidence is much lower in fully vaccinated populations. Both the flu vaccine and the chicken pox or shingles vaccine are linked to lowered risk of Alzheimers disease, giving some support to the idea that Alzheimers may also be caused by viral persistence or reactivation, at least in some cases. And since lowered risk is tied to vaccination for two different viral illnesses, without a clear mechanism, that suggests that either Alzheimers can be triggered by more than one virus, or that the immune boosting effect of vaccination is uniformly helpful in protecting against Alzheimers.
Over the last forty years, it is not exaggerating to say that one of the biggest revolutions in medicine has been the growing awareness that what seem like mild and routine viral illnesses are staying in your body and causing long term problems.
Scientists aren’t sure exactly how all of this works, but there is a clear trend towards understanding that contracting routine viral illness, which seems normal and benign, may not be as benign as previously thought, and may be the root cause of more concerns that we have known. The general, emergent scientific consensus is that perhaps we should have been taking viral prevention and spread MUCH more seriously all along, and that we might see a dramatic decline in autoimmune diseases and other conditions if air cleaning, masking and other NPI interventions had been taken to reduce viral exposure.
But while some scientists know all of this and most scientists and some regular people know some of this, most of these revelations didn’t get a huge amount of public attention, and since they were released one by one, rarely was the broader issues of viral exposure addressed in the public mind. There has been NO public education campaign to help people understand that the conditions they are acquiring in later life may be linked to their exposure to routine viral illness.
What DID happen among the general public were three important things, that created a popular understanding of the world, modern medicine and our relationship to illness that in general, undermines public attempt to help people understand that the techniques used to prevent covid are also useful in other contexts.
These were widely popularly publicized, and widely disseminated, and most people knew about them. Whereas most people, if they knew any of the history above, knew little of it, and never saw it put together. I didn’t see it put together until I began to follow covid closely, and I have been a science writer for a couple of decades. I’ve still rarely seen it all written out like this, which is why I’m doing it now.
The first of these three important things was the emergence of the hygiene hypothesis. In the 1980s, a researcher named Strachan noted that allergies, asthma and eczema had lower prevalences among larger families with many children. Strachan hypothesized that this was due to greater exposure to bacterial and viral agents at an early age from siblings.
He identified the parallel decrease in infectious, fungal and bacterial agents due to vaccination and increased cleanliness, and suggested that autoimmune conditions like allergies were due to this decreased exposure in modern life.
Strachan thought the primary factor might be the transmission of viral illnesses from older siblings to younger ones at earlier ages, but later studies refined this thinking to focus on bacterial exposure.
Studies on Alpine and Baltic farms in the 1990s showed that children that were exposed to more bacteria occurring on farms, including those in raw milk and from farm animals were less likely to have allergies or asthma. They were corroborated by Finnish and other studies that showed that the important factor was microbial exposure and the microbiome in young children’s long term health.
These studies were widely and popularly disseminated among parents. For parents in the late 1990s and early 2000s, deeply worried about a rise in severe or anaphylactic food allergies in children, allergy prevention was a major concern, and so the shift from a “avoid allergens and create a more sanitized environment through chemicals” and “exposure your kids to bacteria in a natural way” was an important cultural shift, and it happened just as late Baby Boomers and Gen Xers were becoming parents, and Millenials were becoming adults.
The version of the science that most people got, as always, missed some of the nuance, but was still a big deal, and every parent knew about it. You would be hard pressed to find a parents who didn’t get SOME variation of “exposure to natural illnesses of childhood is good for you.” And there was some truth in it, which is important to acknowledge. That is, parents who learned about the hygiene hypothesis were, in fact, correctly understanding that modern chemistry might be harming their children’s health.
One problem, however, is that most Americans don’t really have a very clear scientific understanding of the differences between viruses and bacteria, and this was further confused by several things – including the fact that the original hygiene hypothesis DID include the idea that exposure to viruses might be beneficial.
Thus, a lot of people absorbed the idea that exposure to “natural” things was simply better for children than “non-natural” ones, because understanding the details required a grasp of the differences between viruses and bacteria, which unfortunately, many people in America do not have. So that’s one important factor driving popular understanding.
Also from the 1960s to the 2020s, emerged an increasing number of scientific revisions of underlying medical assumptions that had been wrong, and actively harmful, usually to women and children, and that were driven by racism, ableism, paternalism and misogynist beliefs about illness.
For example, women were routinely pressured into taking HRT, despite increased risk of cardiac and cancer issues. The natural birth movement, which arose in the 1960s in response to unresponsive, autocratic and violent methods of childbirth took on a mainstream role. The story of thalidomide stood as a cautionary example.
Women were and are currently still blamed for their own illnesses, accused of psychological problems for things that were clearly medical, and bullied by doctors, and understandably, rebelled. They rebelled particularly powerfully for their children, standing up for them with an emergent mistrust engendered by legitimately awful and unjust experiences with the medical system.
Women’s experience of medicine was and is often of disbelief, lack of support, inadequate pain relief (consider the lack of anaesthesia offered to women being inseminated just recently), attribution of everything to personal choice and weight, and often, premature death due to lack of interest in their health issues. Women of color, gay women, gender atypical women, heavy women and the disabled suffered particularly.
This was and is very real, and engendered an understandable and absolutely legitimate anger at modern medicine and its misogyny, racism and ableism. And where women might be at a loss in advocating for themselves, they often swore not to be for their children. An emergent distrust of a medical establishment that was and is, in fact, racist, sexist, paternalistic and misogynist became part of the language of mothers and parenting in general. And the fault of this lies firmly at the feet of the medical establishment, which had been alerted to these problems in the 1960s and 1970s, and left the problems entrenched.
Over almost exactly the same time period as all of this, the anti-vaccination movement emerged. Originally, its whole focus was not adult vaccination, but early vaccination of children.
In the 1970s in the UK and the 1980s in the US, the DPT shot was the focus of the early anti-vax movement, but it really took off in 1998, when autism was becoming more widely recognized and Andrew Wakefield took money from a group of parents who wanted to claim their children’s autism was a vaccine injury to find evidence on their behalf. He did, by faking it. In 2010, the Lancet removed the paper and retracted, and Wakefield was discredited and lost his medical license.
Still, the ten years of some ambiguity on autism and vaccination did a HUGE amount of damage. I can well remember how nervous I was, as a parent of a child diagnosed with autism, vaccinating Simon and Isaiah as toddlers and babies. I did so, but with a great deal of anxiety, as even early studies showed clearly that autism was better than death from childhood illness. I also argued in the first decade of the 2000s that the antivaccination movement was small enough to be largely harmless, something I now regret and believe was entirely wrong.
In the decade between the first Wakefield paper and the absolutely clear evidence (which began to come out shortly after the first Wakefield paper) that vaccines did not cause autism, the anti-vaccination movement arose, and it took a lot of its thinking and language from the hygiene hypothesis and from women’s legitimate anger at the medical establishment.
The idea that the natural immune system was better, that industrial medicine was cruel and uncaring to women and children, and that leaving things alone was better than treating them in a dubious system was a powerful strain of thought, and truly, had some merit. Unfortunately, it also was wrong and terribly dangerous. It confused the bacterial revelations of the hygiene hypothesis with an understanding of viruses, and ignored emerging science. It equated the racism, misogyny and profit-drive of the medical establishment with all medical science in error, and most of all, it attributed to vaccination effects that were actually caused by the viruses vaccines were designed to protect against.
What many people don’t remember is that Wakefield’s initial hypothesis also involved bowel health in children, and a link to now well-substantiated issues of gut bacteria in children with autism. Very early on, the anti-vaccination movement began to associate the hygiene hypothesis and autoimmunity with vaccination in exactly the wrong order. And because there was no public education campaign to help Americans understand the root causes of autoimmunity and new science, or to remediate the paternalistic elements of medicine, the quality of “truthiness” to the antivaccination movement increased.
The anti-vaccination movement, supported for profit by some men, was largely driven by women who legitimately felt that the entirel social responsibility for caring for their disabled children was thrown unfairly on them, and were angry and seeking someone to blame. They were not wrong. The social supports for disabled children in the US are execrably poor, and alongside all of this was a lack of empathy for women expected to support families, care for disabled children and do all the domestic work. No wonder they were angry, even if at the wrong thing.
And of course, the usual suspects saw economic opportunities in the desperation of parents of disabled children – and the desperation of women who wanted to be mothers to be assured their children would not be disabled. (To be absolutely clear, I’m not supportive of the ableism of anyone who think they are “entitled” to a non-disabled child, and a majority of my children have disabilities, but women did have a right to be angry about the fact that their larger community and their spouses would bear less or none of the burden.)
Those three strains of popular thought – the idea of an industrial medicine that was cruel to women and children and indifferent to their conditions, and existed mostly to sell dangerous pills and shots, the idea that vaccination was causing autism and autoimmunity, and that the solution was to go back to more natural ways of living came together to create the situation we’re in right now. And it is growing fast and noticeably worse, and more deeply politicized and that’s not just the fault of the usual suspects.
All of the above made it seem all the more natural when, as covid arose, the anti-vaccine movement began to blame the effects of covid upon the covid vaccine. The idea that “natural” immunity and “natural” health were more powerful, effective and safer than vaccination-induced immunity became very powerful, very quickly.
And that’s the fault of the Biden administration to a large degree. Many people will not like my saying this, or blaming medical science for its own misogyny, racism and ableism, but I think it is very important to hold responsible all the actors for their parts, because truly, you cannot change things without understanding what’s happening, and on the left, we have a very simplistic understanding of our current situation.
The Biden administration placed a bet and lost, and made a huge and serious mistake. We knew that early animal studies of the mRNA covid vaccines showed immune waning and risks of reinfection. That’s why the vaccines were never tested against transmission and made no claims about preventing covid. Nevertheless, the Biden administration, which presided over the 2021 vaccine roll-out in its early days wanted to believe, as many scientists did, that the covid vaccine would be sterilizing and prevent transmission. As we all know, it did not.
Part of the difficulty goes to public health initiatives that long precede Biden. We have long known that some vaccines, like MMR are sterilizing – if you get the vaccine, you will not ever get sick. Others, mostly to highly mutating viruses like influenza and coronavirus, are not sterilizing, but prior immune exposure reduces your risk of severe disease, hospitalization and death, like the flu shot.
Still, I have never seen a good public health campaign that honestly explained the benefits of flu vaccines. Which is one of the many reasons influenza vaccine uptake is extremely poor in the US – because people expect it to prevent flu, and it often doesn’t. We all know someone who once got the vaccine and got the flu and never got it again. So some of the responsibility for the failures of covid vaccine messaging goes to prior failures of public health messaging about vaccination.
The Biden administration was told early (we have the memo) that covid was a losing political issue for the Democrats and the Biden administration. Biden explicitly campaigned on restoring normalcy, which by necessity, implied ending covid. Unfortunately, the administration definitely knew that the vaccine might not actually stop covid transmission, but it chose to put all its eggs in that basket anyway. That was a huge and dangerous mistake, and involved lying to the general public – as late as fall of 2021, when breakthrough infections due to Delta were rising rapidly, Biden was still saying in public speeches if you got the vaccine, you would not get sick.
Biden clearly saw his job as restoring normalcy – which meant reopening schools, businesses and returning things to normal. That’s why he declared victory in the summer of 2021 as Delta was emerging as a global problem, in much the same reasoning that George W. Bush declared “Mission Accomplished” in Iraq long before the full effects were seen.
Since the vaccine was the only strategy that the administration had other than lying about covid being over, they pushed it hard, including with mandates. I admit, I thought at the time and think now that the mandates were a mistake, particularly in health care, where up to 5% of health care workers left the field. Biden encouraged vaccine checks for things like theater tickets and made a non-sterilizing vaccine and weak antivirals his only public health response.
But the most important part of that response is that in order to do so, in order to say that covid was over, someone needed to explain the prevalence of ongoing excess deaths, long covid and post-covid organ damage. And who did that? The anti-vaccination movement, which, infuriated by mandates, immediately attributed the effects of covid to the vaccine (Please understand, the covid vaccine DOES cause a small number of people harm, and those effects are real, they are just smaller by a lot than the causes of harm from covid itself.)
As I’ve argued for several years, the ONLY WAY that Biden could get away with ignoring the effects of covid was to allow the anti-vaccination movement to carry the water for him. Officially the CDC and the Biden administration said almost nothing about excess deaths and about post-covid organ damage. Or doctors blamed illness and death on “lockdowns” which the US never really had. But the lockdown argument never made much sense – the one that dovetailed with what a LOT of people think, including people who are not anti-vaxxers, was to blame the vaccine.
Then, add the fact that in order to reopen schools, which parents were desperate for because the social supports offered to parents, particularly women again, were appalling and inadequate, Biden had to tell families that covid infection was benign and mild in children and they mostly didn’t get it, and certainly didn’t get long covid, most parents saw no reason to risk vaccination for the children – why vaccinate against an illness your child won’t get, and if they do, it is mild? Which again, led parents who then saw their children infected with covid repeatedly and with lingering health effects, to double down on the danger of vaccination and “unnatural” things that must be causing their children’s illnesses.
Basically, the Biden administration entered into an implicit and deeply unholy alliance with the anti-vaxxers, allowing the anti-vaxxers to carry the water for the damage being done to the population by the removal of masks and failure to clean the air.
But by letting them carry that water, instead of straight out saying that covid is not mild, should not be contracted by children or adults, and causes organ damage, immune damage, new onset mental and neurological illness, brain damage and long covid, gave an enormous power to the antivax movement, which then shifted its focus from the protection of children to the idea that everyone is being damaged by vaccines, and that the damage is contagious (shedding, etc…)
This also, probably unintentionally, pushed a lot of white Moms in the direction of the Republican party, which had embraced the anti-vaccination movement and used the mandates as a club against Biden, and has driven a lot of political power into the hands of people who probably shouldn’t have it – the very fact that Robert Kennedy Jr. is running as a Democrat should give everyone pause. Because it means that the political spectrum which to a degree has always been a circle, has shifted into some much more dangerous alliances. And since much of this is being driven by women who SINCERELY believe they are protecting their children, they are not subject to lighter forms of moral suasion.
All of which is a long way of describing how we got here. At the same time that science is overwhelmingly reinforcing the idea that we should be taking more care and protecting people more from viral illness both with vaccination, and with air cleaning, and when outbreaks occur, with masking – that it isn’t JUST covid causing these life-destroying illnesses and disabilities, the population is getting more and more resistant to any kind of self-protection from viral illness, and the very powerful antivaccination movement is now driving a large chunk of the political train.
There is plenty of responsibility for this situation to go around. It is easy to target bad actors, because there are a lot of them – but it is also a problem of lack of scientific education, of the medical and pharmaceutical industries, of lack of competent public health messaging, of moral cowardice and of a refusal to truly acknowledge where we’ve gone wrong.
What arose in part from partial truths, legitimate outrage and good faith is now an entrenched and powerful political ideology, becoming more complex as we speak. And we may have missed our window to address it, in large part because we refused to be honest about covid and the covid vaccine.
We now are in the situation where solid chunks of both the crunchy left and the hard right will not accept any vaccine, and are even growing to disbelieve in viruses at all. The anti-vax movement has moved from being focused on children, to hostility to any vaccination at any age, with predictable results, including resurgence of diseases that had been defeated, public health officials like the Florida Surgeon general or RFK jr who see the opportunity to gain power through accomodation of these interests, and an increasingly powerful coalition of mostly white women who truly believe they are the only thing that stands between their children and a hostile and dangerous world.
And the truth is, they are. And they are opening the door to the biggest possible threats to their children. And when that becomes obvious, those women will not give up the ideology they developed, but will turn their rage on other targets.
Meanwhile, covid presented a remarkable opportunity. Let us not forget that in 2021, flu season was largely nonexistant, because the masks and distancing that prevented covid knocked influenza into submission. In endorsing the lockdown hypothesis of immune damage, which is garbage, the CDC and other agencies have given additional fuel to the anti-vaxxers, teaching them that if your kid doesn’t get sick all the time, you are hurting them. Which provides convenient fuel for the idea that it is normal for your immune-damaged child to get sick all the time.
We could have reduced viral spread by 80% by adding HEPA filtration to every classroom and public space. We could have reduced it even further by keeping masking available during surges of ANY illness. We could have educated people on the relationship between viral illness, viral persistence and later illness. We did not. Instead, we elected to kill millions and disable millions more for political reasons, and we now face an era of pandemics with an anti-vaccine movement that is both powerful and sincerely believed by far too many. Sharon Astyk 9/21/23