Covid has been found in the brains and organs of Long Covid sufferers at autopsy while not being found in their blood in PCR testing. Bhupesh Prusty recently found in an autopsy of 4 ME/CFS sufferers they had HHV-6 in their brain and spine and 3 of the 4 also had EBV too where 28 controls did not. The DOD just last year also linked Multiple Sclerosis to EBV. There is growing evidence that many viruses stick with us in cells, are not found in the blood and can lead to severe chronic illnesses later in life.
A lot of microbiome research is leading to particular bacteria in or missing from the gut being correlated with various diseases like diabetes and obesity and almost all chronic diseases have a corresponding microbiome adjustment. We don't know yet know if there is a cause here or its just correlated but its a potential diagnostic that shows long before more serious symptoms and could potentially be used diagnostically one day. Or it might be these shifts are causal and we need to find a way to restore gut function that works well and reliably.
The fundamental idea is becoming mainstream in research with significant labs working on this for Long Covid, ME/CFS as well as EDS across the globe. Its not a fringe idea in research looking at long neglected diseases and the more they look the more they find evidence for it. Its not something the vast majority of doctors would have any knowledge on today, most would consider it ridiculous despite thousands of papers on this topic with growing evidence for the fundamental idea of ongoing infections causing increasing problems.
“the vast majority of doctors would have any knowledge on today, most would consider it ridiculous despite thousands of papers on this topic with growing evidence”
Are doctors, as a group, becoming stupider? I’m not trying to troll by asking that question. I legitimately feel, as a patient of a large HMO, that the doctors I interact with aren’t very bright, making frequent mistakes about stuff they could google as quickly as they give out wrong information, but instead confidently insist upon something they’re misremembering or have never learned correctly in the first place. It feels like the profession has been optimizing for the wrong things: quick recall of a breadth of information rather than a scientific orientation towards the work. Perhaps I’m just seeing downstream effects of the reform of health economics in the last decade. Perhaps it’s elite overproduction. In any case reading the featured article, I’m just not at all optimistic about current medical practices experiencing any sort of kuhnian paradigm shift. They can’t even get the basics right, and seem prone to extreme group think bordering on religiosity.
I don’t think they’re getting stupider. They’re what they’ve always been…a source of conventional wisdom. When conventional wisdom said bloodletting was good for health, they bled their patients. When mercury was considered a medicine, they administered it. When hacking off limbs was considered the best way to fight infections, their toolkit included bone saws. When electroshock therapy was considered a treatment for mental illness, they shocked the hell out of their patients. I’m sure that one day we’ll look at chemotherapy and radiation as barbaric practices representative of our ignorance of how easy it is to deal with cancer.
Scientists/researchers advance the state of our medical knowledge and doctors, over subsequent generations, absorb what they find and practices slowly change. But there’s always a lag. What we need to get past is the notion that doctors are some font of truth when it comes to medical information. They are, largely, a snapshot of what was conventionally believed at the time they graduated med school. We don’t have a system that effectively updates their knowledge or keeps them in the loop for cutting-edge research. They do learn a set of first principles that can help them reason about novel situations better than a lay person, but only if the right answer is one that follows from those principles as opposed to being counterintuitive.
It’s the nature of being a practitioner rather than a researcher.
> We don’t have a system that effectively updates their knowledge or keeps them in the loop for cutting-edge research
That's not true... generally, in order to practice doctors must be licensed, and in order to keep their license they must have annual continuing education. Generally accomplished by attending conferences where the latest research results are presented.
The required continuing education is pretty limited. It may cover new treatment strategies, drugs, etc. but not cutting-edge research unless the physician seeks that out. In emergency medicine (where I have some friends), continuing education doesn't include new procedures. Some of my friends have had much more senior docs ask to be taught a new procedure or technique that didn't exist when they were in residency. Many older docs don't seek out new knowledge (no one is forcing them to), and end up just doing what they've always done. The continuing education system does exist, but it's far from perfect.
These threads always have lots of people jumping on doctors and their decisions/callousness/lack-of-reason/missing up-to-date-into/etc.etc.etc. My wife is a physician (OBGYN) at a major city hospital that primarily serves a very poor population. I'd like to share her schedule, and see if you think what kind of care you could perform under these circumstances, or how up-to-date you could stay in field:
Monday - Friday
- Wake up at 4:30 AM
- Get to hospital by 5AM to start rounding on patients
- Sometimes work inpatient all day sometimes clinic thrown in, but usually not done working until 7 PM, without even a 15 min break or a chance to eat a meal (15 hour day)
- Come home and do about an hour of notes, 16 hour work day
- At least once per week, wake up in the middle of the night to deliver a patient who asked for that kind of continuity of care. 24 hour work day
Saturday:
- Wake up around 5am to be in by 6am to start the day
- Work inpatient, usually without time for a 15min break for food, until 10AM SUNDAY (28-30 hours shift)
Repeat 49 weeks/year (days of 24/hr shift can vary and she usually gets one weekend off/month). Her average time at the hospital last year was 96 hours/week. She is not a resident.
How much confidence do you have that you'd be able to stay up-to-date in your field, or make recommendations that aren't ultra-standard, with this kind of schedule?
I don't see how your wife's unreasonable work schedule is supposed to make me feel better about the poor quality of health care I receive. If anything, it makes me question her judgement more, that's just not healthy. How are unhealthy people supposed to educate people on health?
In the UK medical professionals are doing the sensible thing, and leaving the profession. I'm sure most of them would much rather stay, but they're making the rational choice as individuals.
That's not the best choice for patients as a group though.
There's a serious under-staffing, under-pay and conditions crisis.
It's always her choice. And I'm not being flip. Only individuals making good decisions will change this situation. My wife is also a physician and she has thoughtfully opted out of the "rat race." It's good for her, good for her institution, and good for the populations she serves.
They have very little power in most primary care specialties. The expectation from hospitals is you will work this hard or they won’t hire you. Hospitals are more than happy to just dump more hours onto their over-exhausted doctors rather than hire new ones who ask for fewer hours. The expectation from other doctors is you will work this hard because if you don’t, someone else will have to pick up the slack. Also, most of them sign as part of their contract basically “I’ll show up outside of contracted time if it is necessary for patient safety”, turns out this is like 50% of the time because they’re so understaffed
Doctors have invested huge sums of time, money, and effort into getting the qualifications needed to perform their jobs, and there are few alternative jobs they can transition into if they are given a bad deal.
If you don't even know about these organisations then you're not really qualified to talk about what doctors should or shouldn't be doing or what power they do or don't have.
How do you know they haven't? Just because things aren't perfect doesn't mean things can't be better than they were previously, the NHS has been around for 70 years after all.
My point was not at all to make you feel better. It was to explain a systematic reason why doctors underperform and empathize with their position instead of blaming them personally.
To be clear, I was not meaning to blame and sincerely apologize that my comment may have come across that way. Your comment was very helpful in conveying why, ceteris peribus, the perception of doctors may be diminishing. They are too overworked to excel beyond the standard of care, and even consistently meeting the standard of care is a tall order.
But that’s what I was trying to suggest by saying that it seems the medical field, as a whole, seems to be optimizing for the wrong thing, viz. quantity over quality. As others note, there are clearly economic forces at play, and maybe too much constraint on the supply side. And it’s not clear to me that any reasonable discussion is occurring with respect to that. And so I reiterate my pessimism that we’ll somehow get from where we at currently, to a brighter future brought about by a kuhnian revolution as hinted at in the original article. We need to fix what’s broken before adding new features, to put it in software terms.
> Sometimes work inpatient all day sometimes clinic thrown in, but usually not done working until 7 PM, without even a 15 min break or a chance to eat a meal (15 hour day)
Honestly, that makes me agree with the parent comment that the medical profession must be getting stupider to not let a doctor take a break or eat a meal on a 15 hour day.
No, it's so the administrative staff can become further bloated as parasites upon the host of the actually productive doctors, and so the shareholders can take whatever breadcrumbs the administrative staff leaves behind.
Doctor pay-per-hour-worked varies a lot by specialty. My wife gets $270k/yr on her current contract after max bonuses and paying for malpractice insurance. That comes out to about $60/hr. this is in a mid col city in the USA.
That’s in no way bad money, but per hour worked PAs and many nurses make more than that. When I worked IT support I was paid close to that. It doesn’t at all seem worth the pain.
AMA membership by physicians have dropped from 75% in the 1950's to about 15% a few years ago. Doctors are actually not that great at advocacy which is the main reason why counter-AMA organizations don't exist imo.
A large chunk of their membership is just medical students and residents but thats primarily because they offer good savings to them like study materials.
Which lobbying organization is that? If you're referring to the AMA then you're wrong. They have actually been lobbying Congress to increase the number of physicians by funding more residency slots.
but to your point, studies have shown that handoffs kill patients. if you've got 18 people on a floor, each shift you hand off to has a statistically significant chance of screwing up one of them. So if there are 3 shift changes a day there are potentially 3 might-screw-you-up-bad rolls of the dice.
putting people on 12- or 24-hour sifts is crazy, but the sleep deprivation kills less than the shift change mistakes.
There are definitely capitalistic hospital business incentives at play here, but there is more than just that. Medicine is a notoriously supply-side gated field, and intentionally so by all practitioners. It’s one of the main drivers of the sky high pay white coats get access to after all the hoop jumping.
Speaking for the US, as it has a notorious track record for inefficiencies in its medicinal industry: the USA is getting older (aging population needing more care) with the cost of medical school higher than ever. With this, the production of doctors is unlikely to increase at a pace necessary to maintain levels of care uniformly across the board (for example, rural vs city medicine capabilities vary massively based on region).
Most hospitals attempt to use technology to squeeze more out of their doctors, as getting more doctors isn’t cheap (because there aren’t enough of them). Hospitals can’t do much to solve the doctor production shortage - that involves legislative changes and the American Medical Association (lobbying arm).
The capitalistic effects will compound all of this - but not so much in what you may be describing. If we don’t resolve things, in the medium-term future years we can see a bifurcation in medicine as we see in criminal defense law - the wealthy will have great access to world class healthcare, paid at an extreme premium, and everyone else will be out of luck. (Some would say we are already here there or rapidly approaching this state).
Worse yet, experienced people in these professions tend to defend the insane schedules, which I take for some sort of hazing ritual / Stockholm syndrome.
No confidence at all, I wish doctors didn’t make so many mistakes and I wish doctors weren’t being ritualistically tortured. The fact that we get both just speaks to the incredible dysfunction of it all.
Reading the replies to your comment is so grim. I think, more than anything, I'm floored by the level of arrogance that permeates seemingly every conversation on HN lately. I'm spending less time here than I have in years because watching the culture of curiosity die just makes me sad.
Anyway, thank you for taking the time to share this.
It is required by the hospital. I have made her promise me we will try finding a better work-life balance hospital within a few years, but it’s hard to apply to new places with this kind of schedule
I think patients are getting smarter, and conditions for doctors are worse causing some intelligent people to choose different fields. That said, I recently went through a major illness and interacted with many medical professionals. My first hand experience/anecdata is that doctors are just like every other professional. Some are good, some are mediocre. Some are so consumed by hubris they believe the public is always wrong, and
Some are willing to talk things through and keep an open mind about everything, even if it is ridiculous.
The best thing we could do for healthcare is to remove the idea that "doctor knows best." While it is important for doctors to feel confident, and to teach the public to avoid snakeoil, it just places unreal expectations on these people. If patients took more accountability for their own health, then we could loosen some of the malpractice laws, and doctors insurance premiums would go down, and that would in turn cause rates to go down. But that was a bit of a tangent from my point that doctors are just people, maybe with an average intelligence that is slightly above the population at large, but still just people.
To make life and death decisions for people requires you have hubris and faith in yourself. I can't imagine what would happen to my hypercritical/overthinking self if I was a doctor making life and death choices, some resulting in death, for people for 10 years. I had a hard enough time when I did medical software, working 80 hour weeks to get a new release out the door because it was going to positively impact people's lives and a delay meant X people's lives wouldn't be improved, and I took that on as me failing those people who I didn't help every day the release didn't go out.
To make life and death decisions for people requires you have hubris and faith in yourself.
Sure, but outside of surgeons and the ER, most doctors are not making life or death decisions all too often. Your average family medicine doctor should always be presenting multiple options for care, and be honest with the patient and themselves that they may be wrong about the diagnosis. I know some people dislike so-called weasel words, but doctors should be using them regularly.
I think as the pool of knowledge balloons exponentially in size it becomes nearly impossible for a doctor to be familiar with all of it, so their only choice is to deeply specialize in one field and limit the breadth of patients they can treat (also becoming less knowledgeable about anything unrelated to their field), or they must be incredibly general and have only surface level knowledge of everything. 100 years ago a few years of study could teach you nearly everything there was to know in the medical field at the time. The expanding pool of knowledge also makes it harder to determine which knowledge is actually helpful to take in.
I think this is an area where technology can help. The best primary care providers I've had have been the ones who aren't afraid to look things up as we're talking about them. I think better tools to aggregate the cutting edge of medical knowledge would help greatly.
Very much agree. I hope language models make a big dent in the problem. Many other places tech can move the needle as well, like imaging and diagnostics.
They're not becoming stupider, the culture of following protocols rather than understanding is a pre-scientific one. It certainly has benefits- predictable consistency, limited liability for doctors. Unfortunately, Dr. House style deep thinking in widely available medicine is legally impossible, and only a tiny percentage of the population is able to think that way.
I think this quote really sums up this issue, and it's history:
Knowledge isn’t a commodity, especially not a fungible commodity, as the medical business sees it. Consciousness and culture are part of the life process. It is exactly the commoditization of medical knowledge that makes it dangerous, and generally stupid. Doctors buy their knowledge, and then resell it over and over; it’s valuable as a commodity, so its value has to be protected by the equivalent of a copyright, the system of laws establishing the profession. Without its special status, its worthlessness would be quickly demonstrated. When A.C. Guyton wrote his textbook of medical physiology (the most widely used text in the world) in the 1950s, it was trash; as it was studied and applied by generations of physicians, it was still trash. The most compliant patients who bought their treatment from the most authoritative, Guytonesque, doctors were buying their own disability and death.
Each time you learn something, your consciousness becomes something different, and the questions you ask will be different; you don’t know what the next appropriate question will be when you haven’t assimilated the earlier answers. Until you see something as the answer to an urgent question, you can’t see that it has any value. The unexpected can’t be a commodity. When people buy professional knowledge they get what they pay for, a commodity in a system that sustains ignorance.
All told I had a pretty fun time trying to self-diagnose myself, and I did a better job diagnosing myself than the docs I saw. I firmly believe that the only reason I’m not on disability and unemployed is because I took my diagnosis and treatment into my own hands.
That said, if I had to do that 20x per day with only 20 minutes allotted per patient, I can’t imagine I’d be very good at diagnosis either.
I just wish I could find a doctor that was open minded, and would discuss things. I have a PhD and do research in a medically related field, and will deeply read all of the scientific literature about any conditions I have, yet I still get the "just shut up and do what I say- your google search is not equivalent to my medical degree" treatment. I would like to be engaged by the doctor as a sort of collaborator on my medical issues, rather than be treated like an infant.
My feeling is they are hiding behind the "I'm the expert here" thing because they are actually self conscious about how little they know, and are worried it will show if they engage in a discussion.
This is my great frustration. They are trained to detect “narcissistic” patients, and having seen some of those training videos, I now understand that their treatment of patients who try and reference the literature is guided by that training. I have to pretend to be stupid and find weird “people hacks” because I can’t just come out and say, “here is a recent meta analysis in nejm that says x. Could you read that sometime in the next few weeks and see if it applies?” Often it’s not even recent research but common knowledge you can find in bio 101 textbooks or Wikipedia. But asking questions the wrong way, you can come across as “thinking you know more than the clinician” (you do!) so you have engage in bizarre kabuki theater and feign ignorance hoping they feel the urge to revisit their textbooks, or google it.
I had my first real foray into the US healthcare system in 2022. I went to three orthopedic surgeons and a neurologist, and none of them diagnosed me correctly. I was having nerve pain in my hands, and they all jumped on “carpal tunnel syndrome”, however none mentioned or even tested me for Thoracic Outlet Syndrome, which is what I actually have. Three doctors.
One of them, who was the shoulder specialist ironically (he should have nailed the diagnosis as TOS), looked at my hand X-Rays, said there is no arthritis, then did a test on me to that I said hurt, and then diagnosed me with arthritis. I’m 27. It borders on malpractice and at the very least should be considered gross negligence.
And they were all in a big hurry. I had to stop all of them on their way out of the examination room to ask my questions!
I’ve been a patient dealing with a chronic condition for about four years now. IMO you had a pretty good experience relative to the norm. It’s not uncommon for it to take years to get a proper diagnosis for chronic conditions.
It’s because I spent a tens of hours doing research. I’m sure it would take me a lot longer if I had to specialist-hop until I found someone familiar with TOS
I’ve done a lot of research on TOS and my findings are that TOS is A) very difficult to diagnose even with diagnostic imaging and B) considered much less-common than Carpal Tunnel Syndrome, Cubital Tunnel Syndrome, and Tendonitis.
I’ll add that all three ortho docs did those “provocative tests” for CTS, like bending my wrists, and NONE made my symptoms worse. This alone should have been an indicator that the nerve impingement was happening closer to the spine. Meanwhile, the provocative tests for TOS almost immediately and drastically worsened my symptoms.
Sorry about your experiences, that must have been incredibly frustrating. I guess I'm surprised that it took that many doctors to figure it out because it is taught pretty early in medical education. I remember practicing Adsons Test as a first year med student (not diagnostic in any way, but just to emphasize that TOS is taught early).
Sort of like how I would be surprised if I interviewed a developer who didn't know what an array was.
To be clear, I haven’t been formally diagnosed, but after 3 docs I give up. There’s really no point anyway unless I’m looking to get it treated surgically. Even then, people say it’s hard to get a vascular surgeon to do surgery for TOS. They really want you to exhaust physical therapy thoroughly. It’s very hard work. Way harder than programming. And it’s taken several months to see significant improvement- BUT I am improving.
None of the surgeons or neurologist did Eden’s or Adson’s or any other TOS test. I didn’t learn about TOS until the third doc, but she immediately dismissed it because “TOS is very rare” and “it would have shown on the nerve conduction study”- though the NCS wasn’t done above my elbow, and anyway studies out there say NCS only shows nerve damage, not so much nerve impingement.
I googled my symptoms for months, and only found TOS after exhausting literally every other nerve impingement disorder from the hand to the spine. Google results are very prejudiced to carpal tunnel syndrome and tendinitis.
I’d heard stories from people who would go to various doctors and say they were all quacks. I always thought “hey, these guys went to MEDICAL SCHOOL, what do you know about any of this stuff?”, but now I’m more in their camp.
Anyway… Good posture is very important fellas! Having ergonomic everything doesn’t matter if your posture is poor.
I don't think so, I think there's a combination of things that are happening that makes their jobs more difficult and a lot of macro changes happening in the world as well as just bad expectations that we have as patients. I am not in the medical field, this is simply my layman's interpretation of what is going on.
1. Doctors are not the same are researchers in many or most cases. They are more akin to technicians than scientists. In the same way I wouldn't expect my electrician to meaningfully innovate the way that he hooks up my house to the power grid or I wouldn't expect my plumber to fundamentally shift my city's sewer system to better serve my individual house that simply isn't their job as front line folks administering care.
2. I think we are massively overlooking simply the breadth and depth of the changes in the world and how that affects their profession. We are exposed to a staggering and exponentially increasing amount of chemicals, environmental toxins, pollutants, foods, and their patients come from a variety of different ethnic backgrounds and live in wildly different environments with wildly different lifestyles. I have to imagine 100 years ago if you were a doctor in say Ireland, you mostly knew what your patients did for work, what they ate, they all lived in roughly the same area, etc. The variables of health were simply much less.
3. The same time the amount of diseases / disorders / etc. that we've identified has grown exponentially. When the field of things that it could be even if that was an incomplete list (obviously) it was much easier to give a broad diagnosis than a specific one. This has improved treatment to be sure but also demanded specialization so any one doctor having all the answers gets less likely over time.
4. Lastly it's just financial pressures. Markets and especially insurance is part of this but I think in general as globalization has continued to accelerate and resources are being distributed more and more in some sense (and concentrated in other senses) you have to take a holistic view. You say doctors used to be "better" but better where? If all the doctors are in a handful of countries with most of the resources that sub group of people will yes get better care but what about everyone else?
Hospitals and some practices run their medical professionals on long shifts, often back to back, and on skeleton crews. They're profiting at the expense of the quality of care they're providing by spreading doctors, nurses, etc as thin as they possible can.
Viral infections sticking around has been known about for a very long time. Chronic infection of Hepatitis C for example occurs in about 80% of those infected and it can be asymptomatic for years while causing liver etc damage.
This includes many viral infections that the general public don’t realize stick around: “The causative agent for shingles is the varicella zoster virus (VZV) – a double-stranded DNA virus related to the herpes simplex virus. Most individuals are infected with this virus as children which causes an episode of chickenpox. The immune system eventually eliminates the virus from most locations, but it remains dormant (or latent) in the ganglia adjacent to the spinal cord (called the dorsal root ganglion) or the trigeminal ganglion in the base of the skull.”https://en.wikipedia.org/wiki/Shingles
Typhoid marry is a famous example of this behavior occasionally extending to viruses that generally get cleared from the body.
In my experience doctors are horrendous at statistics and have no idea how often they should be seeing rare conditions. The “think horses not zebras” mentality that’s drummed into them has blinded them to the herds of zebras galavanting around them.
Right, "horses not zebras" means "if it has four hooves and a mane check if it's a horse first", not "your patient definitely doesn't have a rare condition". I know so many with chronic conditions that were brushed off by doctors or misdiagnosed that only got the right diagnosis later when their conditions worsened.
This process of most doctors is: 'gather up available data/symptoms/test results from this patient, then compare against medical research to see which diagnoses fit and which is most likely'.
Since the process is so mechanical and so stats-driven, I think statistical computer models or even AI would do a much better job of it than your average doctor.
But due to the medical field being slow to utilize new methods, we don't see any of that yet, and the end result is far more people get false diagnoses than would otherwise. We can accept a human making a poor judgement sometimes, but we do not accept a machine doing the same, even if it's right more of the time.
Unfortunately, in medicine, there is evidence that just because a computer program is better then a Dr at diagnosing a patient is no guarantee it will be used. The classic example here was the MYCIN expert system developed in the 1970s. MYCIN was shown to outperform infectious disease experts by 1979 in a blind testing:
>... Eight independent evaluators with special expertise in the management of meningitis compared MYCIN's choice of antimicrobials with the choices of nine human prescribers for ten test cases of meningitis. MYCIN received an acceptability rating of 65% by the evaluators; the corresponding ratings for acceptability of the regimen prescribed by the five faculty specialists ranged from 42.5% to 62.5%. The system never failed to cover a treatable pathogen while demonstrating efficiency in minimizing the number of antimicrobials prescribed.
There are a lot of examples of these "expert systems" in medicine that seem to do well in research, but fail in other ways. We're seeing some of these failures again these days with ML models in medicine, especially bridging the gap between the proof-of-concept and production systems.
A lot of those efforts were based around expert systems and failed for many of the same reasons many other expert systems suffered from.
I would suggest that a lot of medical questions are now answered by Dr. Google which implicitly does a lot of behavioral modeling / statistics in their machine learning and is already very successful.
H. Pylori has been around for 20 years, hundreds of papers written on it. My wife went in and the doctor said - huh, I haven't seen that before I need to go look up how to treat it, I'll be right back.
That is, of course, after we did our own GI-MAP and took it to a doctor, not that a doctor would EVER suggest doing that. A naturopath? Yes they do it as a standard.
Standard doctors are operating on 1960's textbooks.
Best doc I ever had was a naturopath. Unfortunately, he tired of dealing with insurance companies and moved to a retainer model with a limited number of patients. Why was he so much better than any other doc I've had? 1) he listened. Appointments were at least 45 minutes. Sometimes over an hour. When I go to an MD I'm lucky to get 10 minutes. 2) He tested. Annual blood tests were extensive (and, yes, could be expensive because of those insurance companies not wanting to cover a lot of stuff) 3) As he listened he was on his laptop pulling up relevant papers ("I was just reading a paper on this topic that came out a couple weeks ago") He'd print out the paper for you and highlight the relevant passages 4) He was interested - by that I mean, I never got the idea he was just going through the motions. He loved this stuff and nerded out on it.
Yeah I am not in this tier of wealth but being in tech / working with VCs I rub elbows with it. They consistently suggest to get a concierge doctor and its so great because they have a small number of patients and they actually listen to them and help them get whatever medicine needs, read studies on their conditions and recommend like niche and newer treatments / drugs. It sounds great but you know I can't afford a 3k a month retainer. The medical system once again seems to work incredibly well if you have means but that sort of expense is even outside the realm of most 1%ers.
The common denominator here seems to be caseload. Lower caseload, lower hours per week, lower burnout, more focus time, more deep thinking. Sound familiar to anyone in software?
Doctors are required to keep getting recertification based on current practices, they can’t just regurgitate outdated information.
General practitioners refer people to specialists because nobody can keep up with every bit of new research out there. A doctor looking something unusual up isn’t a sign of incompetence but rather best practices.
I am not saying they have to be completely up to date, just that they must keep up with many advancements because they can fail these tests.
That said you can read up on all the latest research for a condition because you don’t care about all the other research. Doctors can’t get away with such a limited focus.
I mostly see specialists and even there they’re consistently out of date. I get that not everyone can be a top tier researcher and many doctors have a business to run, but once we reach the limit of their knowledge I’d much rather hear “I don’t know” than “that’s all anyone knows.” Doctors to me are a minor inconvenience to prescription medication.
You're speaking my language. My wife and I have self diagnosed and fixed a shit-ton of ailments. Most of it with natural supplements, but occasionally we'll get the pharma stuff.
I'd like to ask what GI-MAP provider you used. Based on what you said it seems like you were able to get tested without needing a provider to order the test. I've had gut issues for a while and I'm surprised this has never come up.
DirectLabs is a reseller that has a physician on staff that approves your GI Map. So contact direct labs, order the kit, poop and vial it, drop it in the mail, wait 15-20 days. PDF of your results will be in your DirectLabs account online.
Everybody has been aware of hepatitis C, herpes, and chicken pox becoming shingles for decades. I'm pretty sure this discussion is about viruses that we generally don't think of as chronic.
Double checking, by ‘EDS’ that wasn’t a typo and you meant Ehlers Danlos Syndrome? I’ve been beating the drum for underdaignosed EDS for a long time. It’s insane how prevent it is in so many statistics and yet doctors still think it’s super rare. I think a huge number of Long Covid people have EDS, way more than the general population, they’re highly disposed to it. It would make sense that a treatment for EDS would help LongCovid and visa versa.
> we need to find a way to restore gut function that works well and reliably.
Microbiota engraftment from faecal transplants _is_ reliable - it brings along a raft of bacteriophages that clear a niche for the incoming colonies - unlike just slinging some probiotics down your neck and hoping some survive.
Ig. It be worth to add that total dental care costs in US are more than $160bln / year (which isn't much less than cancer spending) and my guess would be that 95% of that costs are caused by chronic infections.
This is precisely why I still wear an N95 mask outside of our household - we need decades to learn about a meaningful part of the damage SARS-CoV-2 does to us. A lot of people still consider this to be a form of the seasonal flu, but it's a totally different thing, and the excess deaths are just an early indication that we should be more careful with it. Some blame vaccines for them, it's an acceptable hypothesis, of course, but I doubt it's only that. Having a reinfection every other month is not something we get with the flu!
Not really unless we have decent antivirals and knowledge - I got used to it. Out of 4 people in my household, 2 had it only once this summer (BA.4 or BA.5) - it was contracted outside on a sunny August day and from a large distance - 20-30 feet from our neighbor, but my son and I wore masks at home and didn't catch it (I trust PCR tests, we've had several).
People do stupid things! I observe and wonder how can call us intelligent species! For example, I see the following scenarios:
- only some people in a family wear masks in a closed space.
- people wear a mask inside but take it off to eat or sometimes talk to others.
- people talk in each other face outside, but wear masks inside.
- people wear surgical masks without any certification (such as ASTM) and wear the same masks for days (you can tell from how dirty their masks are) - not only they are not protected from COVID-19, but they can bring bacteria, fungi, and microplastics straight into their lungs!
I do not participate in circuses - if I do something, I do it properly, and in a meaningful way! XBB.1.5 is as contagious as measles, i.e. it's the most infectious virus known to science! And new variants could go beyond the r0 of measles soon (r0 has only being going up so far)! You cannot act the same way as this is the flu with a much lower basic reproductive number, which is very-well studied, has decent antivirals, yet still kills a lot of people and costs trillion dollars to the global economy each year!
there are literally no peer reviewed scientific study demonstrating the pathology of "long covid". In fact, there aren't really any knowledge that there is such as thing as "long covid" in the way we traditionally define diseases
Google long covid ncbi for a long list of papers. I don’t know what you mean with your no true Scotsman fallacy, there’s definitely something and quite a lot of research establishing what.
I'd suggest just sharing a good paper. Asking somebody where they got their information that something doesn't exist is pointless. You could say the same thing to somebody who doesn't believe unicorns exist; better to just show them a unicorn.
I did, in suggesting a google search which results in many papers, the question being "you said this doesn't exist, here are many examples, why don't they count according to you?" which is mostly rhetorical because it seems I'm replying to someone whose sources are politicized medical information but I left room for real information if it existed. (perhaps an actual expert has an opinion on the corpus of existing research being inadequate I'm not aware of, I don't think this is true but I'm ready to be wrong)
In addition to the others that have already been listed here, there's recent research pointing to elevated levels of both ANG-1 and P-SEL[1], a combination of elevated cytokines and lowered cortisol levels[2], and changes in mitochondrial proteins from neurons[3].
Biomarkers by nature can be extremely difficult to track down.
Max exertion test for post exertional malaise (PEM), Immunoassays, red blood cell plasticity in small capillaries, nano-needle salt stress test, calcium channel dysfunction test, and there are probably a few more that I’m probably forgetting.
These test are all highly accurate and can easily distinguish between those who have ME/CFS/LongCovid and those who don’t.
Edit: I did forget some; retina capillary test, ACE-2 auto antibodies (though not sure about the accuracy for this one). Then there is also the metabolic assays that are so full of distinctive differences that the issue is determining the important ones.
The same people that have a revolving door to big pharma? The same people that told you you couldn't get infected by covid after a vaccine? The same people that told you an unsealed cloth mask would help?
Boy are you gullible, you really should start looking into studies and the data rather than the con men that you "trust".
The majority of long covid is fake though. It will be suffered by the same hypochondriacs that had gluten intollerance last decade and dust allergies before that. You are are that the definition of long covid is along the lines of "anything that can't be explained that happened after a covid infection" absolute horseshit propagandized by the media. Show me some biomarkers and I'll start paying attention.
How do you know they're hypochondriacs? Are there studies showing long-COVID patients to be hypochondriacs? Or are you a doctor who has examined lots of patients who turn out to be hypochondriacs?
For pretending that covid is something other than a moderately bad flu, in order to push pretty much untested mRNA shots onto the population, the vast majority of whom didn't need it.
Is it this month that the clinical trials end? I will be very curious to see what happens then, as the EUA will end, and thus pharmas liability shield is gone. Will the bullshit be forgotten about? Biden just extended the "emergency", so maybe not.
Covid, one of the worse diseases that humanity has ever known, is "a moderately bad flu"? Do you realize that it has killed more people in these two years than TB, malaria, most individual cancers, AIDS, and on and on - and this based only on the officially confirmed cases, and despite absolutely unprecedented prevention measures virtually everywhere in the world? If we look at increased mortality, or if we extrapolate what happened early in China or Italy, it would have probably easily beaten the original AIDS epidemic, perhaps even the Spanish Flu.
And to prevent the tiresome "died with Covid, not of it" idiocy, that applies to each and every disease death number. There is no such thing as "dying of a disease" that is separate from "dying with a disease", apart perhaps from cases of violent deaths, such as "shot in the head while infected with Covid" (which are obviously an entirely insignificant minority).
What’s worst is a bit relative, I’d prefer covid to hiv obviously.
What made covid bad was how transmissible it was, everyone got it more or less.
Once you actually got it though it was about as severe as a flu, in the neighborhood of a bad flu, particularly notable for the age-based outcomes that were very much correlated to age. Plenty of flu variants actually effect young people strongly whereas covid was very much “older is worse”.
In one sense covid was way worse than any old flu after 1918, in the other sense covid is somewhere between an average and bad flu. Your values might determine which is more important to you.
If you were young covid was no big deal, if you were old it was terrifying. This was an odd situation for many diseases.
And you have to be honest covid cases and cause of death are counted differently. There are lots of infections which just aren’t tested which would otherwise have much bigger “cause of death” numbers.
I’m not a denier at all, the problem is facts get distorted to match people’s personal views and often the things you argue against aren’t entirely wrong, if distorted.
Absolute nonsense. 99.97% survival rate for under 70s.
Here is the impact compared to other pandemics, completely insignificant. If it weren't for forced masks and the hysteria imposed by governments it would be completely unnoticeable.
For pharma, to get a clinical trial for free. For authoritarian politicians to trial run social credit systems (vaccine based this time around) and tracking systems. Plenty of money to and power to be grabbed by those in positions to benefit from them. For big tech, to force people to stay in their homes and thus on their platforms. For those without any spiritual aspect to their existence, a chance to virtue signal, to force their ideals on everyone else.~~
I didn't follow the link above, but some prominent and respected scientists put lectures on YouTube so I don't think the platform is a bad source per se.
This and the evidence of gut-microbes influencing behavior tells me that we’ve likely been focusing too much on genetic causes of many diseases. We have guests in our bodies interacting with our digestion, immune, and central nervous systems. They have an effect.
> Educating people on these topics and getting more doctors to offer the necessary blood and stool tests to rule out pathogenic causes before commencing psychiatric treatment could potentially help millions of people.
Are there even accurate tests for many of these? Take long Covid as a modern challenge. Most people already have antibodies of some kind and a fraction still struggle with mental challenges post infection that repurposed SSRIs can significantly help with. Just the other day there was even an article about people being overprescribed SSRIs.
If I were to summarize the article in a few words it would be:
Stress caused by pathogens can lead to chronic illness.
You can say the same about most stresses in life too though and their similar correlations as made in this article.
This is fascinating and in particular this article called out EBV infection and the link to anxiety. I developed a rough EBV infection in college and a few years later I developed generalized anxiety disorder and panic attacks. At this point they're mostly under control with lifestyle changes however that they call out this link is really enlightening. I hope that more research looks into this sort of thing and makes these connections because it seems like it could be a huge benefit to folks. It feels like a lot of the interventions with mental health tend to be a bit of a sledge hammer generalist approach so looking at the root causes of the "why" I think could power a much more holistic view of things.
I didn’t find this to be “shock media”, and the culmination of the article isn’t “you’re all wrong”, but “we should start a foundation to examine this in more detail”.
Basically: “here’s my idea that might sound crazy, but there might be some reasons to explore it in more depth”.
The attitude that “it goes against the grain so I won’t even consider it” seems problematic though when the subject is one that we still know very little about.
Assuming for a moment that there’s something worth exploring here, how would you reframe the content?
Apply this response to a group raising concerns about the safety of asbestos and seeking funding for research to validate or debunk those concerns.
People fear disease because of its impact on wellbeing and life expectancy.
Not all fear is warranted or healthy, but fear also drives action and is an evolutionary advantage. There’s a good reason to stop smoking, because one hopes to avoid a painful death via lung cancer.
“Lock your doors, or risk invasion and bodily harm by local street gangs” is an appeal to fear, and sound advice depending on your neighborhood.
Fear can obviously be weaponized/misused, but not all fear-based arguments are inherently so.
With all of that said, I didn’t really see fear mongering in this article. Instead, potentially sobering thoughts.
> I didn’t really see fear mongering in this article
The article starts with:
> Endemic Pathogens are Making You Crazy and Then Killing You. Nobody warned you about them, but they’re destroying your mind and they’re everywhere.
Maybe we have significantly different perspectives on fear mongering, but that’s archetypal fear mongering in my book. The article then goes on to summarise a number of fringe scientific theories that are not substantially supported by evidence, including linking autism to vaccines. The article then concludes with a call to action to help philanthropically fund the industry in which the author works as a venture capitalist (and don’t see any disclosure about this conflict of interest in the article).
If the article left you feeling soberly thoughtful, then perhaps you could make a donation to the author’s next funding round. But from my perspective “be afraid, give me money” seems like a perfectly reasonable summary.
Many viruses have been linked to singular inflammatory diseases, making it hard to attribute any one virus to a specific disease.
Coxsackievirus B4, Herpesvirus 6, Enteroviruses, and Cytomegalovirus have all been linked to type 1 diabetes and pancreatic failure.
EBV, however, has been identified as a strong precursor for MS. Due to difficulty in conducting studies on viruses, research in this area has been limited, but recent interest in auto-immune disorders caused by COVID has led to renewed funding.
mRNA-based vaccines are also being tested for auto-immune diseases thought to have viral causes.
HSV 1 is neurodegnerative? First I heard of that, and considering that it affects the majority of the population whether they know it or not, I find this to be quite unlikely to be a serious problem.
You have to understand that this virus lays dormant in your spine before re-emerging up to years later as another outbreak in the skin. It's the same with herpes zoster (chickenpox) re-emerging years later when your immune system has its guard down in middle to old age as shingles.
Its most severe central neurological manifestation is herpes encephalitis.
The author is Riva Tez (https://twitter.com/rivatez). She first posted this on her blog, hosted on ghost.io, but she abandoned that personal blog. She then contributed her article on this new website that collects such articles. The new website does not show the author's name when you read an article. You have to look into the article index to view the her name as the author of the article.
Never heard of this term. What is „shock media“? I also fail to see what part of this blogpost qualifies as „fear mongering“. What am I missing? Is „You will die“ a shocking message, or does induce fear? I thought it is just true.
Sensationalizing fear by presenting existing niche knowledge as an elevated concern for day to day living. This is why it's sometimes referred to as fear-mongering.
eg: Did you know how lethal drinking water can be? Simply drinking water has killed plenty of people in modern times. Click here to know more.
Shock media, like most phrases, is an amalgamation of ideas. In this case, "Shock Jock" and Media. The implication is that it's not purely click-bait and the point of the media is not purely informational.
It's as bad as you think: pompous and reads like we're all idiots and the author is that one guy at the high school party who was fixated on being the "smartest guy" in the room.
Edit: Dead blog link.
There was an excellent meta-study about Schizophrenia triggered by a trifecta of genetics, pathogens, and stress-related immunosuppression posted on HN last month [0].
i would pay for a service that reads in articles with low quality, clickbait headlines that are designed to elicit fear and anxiety, and only recommend ones to me that are likely to actually impact my life.
as of now, i just assume most of these are not a big deal and written in bad faith and ignore then entirely, but i’d prefer not to miss important information if there’s an actionable change i should make in my life, and i would really prefer to be able to read interesting content without being bombarded by garbage.
"i would pay for a service that reads in articles with low quality, clickbait headlines [...], and only recommend ones [...] to actually impact my life"
i've paid for publications like NY times and wapo for a bit, they are not too my tastes. too many opinionated stories in the vein of "how you should feel about X topic", too many misrepresentations of reality. an example would be during covid wapo ran a front page story about young people filling up mount sinai with severe covid cases, where doctors saw clots forming right in front of their eyes, etc. nothing about relative risk in that story, it was just emotional horror, i'm not interested in that.
NEJM is a lot more broad than what i would want to see, i'm not really interested in keeping tabs on the entire field of medicine. i just want to hear about what affects me- "a pandemic is sweeping the world" or "RSV cases that affect your child's age group are sharply on the rise" are examples.
what i want is specific which is why i would be willing to pay for a service that accommodates it
There’s not really an actionable change, long term low grade disease after infection is just a thing which is getting increased attention from researchers.
I'm always cautious about pieces like this, but still thought some of what they wrote to be interesting to think about, whether or not it's likely to be true. This is an area that we still know very little about.
With that said, I find the author’s argument for epistemological anarchism overly simplistic.
Yes, many big breakthroughs came from discarding mainstream schools of thought. But the era in which those discoveries occurred was an era where many of our ideas about the world were fundamentally wrong. As knowledge increases and our models of the world improve, such anarchism becomes harder and harder to distinguish from quackery.
I suspect the author would point out that we might still be fundamentally wrong, but there is plenty of evidence to show that at least in some categories, we’re getting more things right than we used to. Whether the subject at hand is one of those areas is certainly debatable.
The point I can concede is that we still know so little about mental health and the impact of biology on mental health, that this may still be a discipline that needs some of that anarchism.
Recent studies linking gut bacteria to wellbeing at least hint at some potential legitimacy.
I think a huge issue we have is that we are now at a point where we know a lot. We even know there's some causation here between latent infections and plenty of neurodegenerative disorders.
However, as the author pointed out, it's super hard to study. And with all the problems of the world, the ones that are almost impossible to study don't get studied.
But the question is if we need these studies anyway. Maybe some of the latent infections don't cause as many issues as others, but we've gathered enough knowledge at this point that we should suspect all of them.
A much better point is the one about vaccines. HPV is a prime example. It is already reducing cancer rates for boys and girls (one of the few cases where medicine ignored men - to much detriment, because a whole generation of boys could have been vaccinated already and they get cancer and spread it, too).
We should put funding into getting rid of as many of these latent infections as possible. We desperately need Epstein-Barr, HSV-1, HSV-2, and Herpes Zoster vaccines.
Making vaccines isn't anarchism to overthrow the medical establishment. Instead the problem is how funding gets allocated because the proof we have is less strong, but looking at all of the latent infections, the proof is plenty, we don't need those hard-to-do studies. Instead we need to start fighting these disease.
I find the idea that we no longer live in "an era where many of our ideas about the world [are] fundamentally wrong" quite amusing. It's not even been twenty years since the UK's leading medical institutions were thoroughly convinced that vaccines caused autism. Not through epistemological anarchism, but through good ol' numbers fudging, conclusion skewing and mass media induced panic, in serious-looking, play-by-the-numbers-seeming research papers.
The way you tell "epistemologically anarchist theories" from quackery is the same way you tell any other theories from quackery: you test them.
I find that idea quite amusing as well, and as I pointed out, there are areas, including the subject at hand, that we know very little about. Hell, much of medicine probably still falls under this umbrella.
I did not mean to imply that we no longer live in a world where many ideas are wrong, just a world where we’ve gotten a hell of a lot more right than the era in question. My issue was more with the claim that the success of “epistemological anarchism” of the past was a sufficient reason to justify it presently, with no acknowledgement of the major shift in the landscape that has occurred as a result of those breakthroughs and continuing progress.
I say all of this while still finding the ideas presented to be interesting, especially in light of others emerging research.
I just think the anarchism angle didn’t help the content much.
In areas that are sufficiently understood, such deviations should become increasingly rare. That doesn’t mean there is no room for this - there certainly is!
> The way you tell "epistemologically anarchist theories" from quackery is the same way you tell any other theories from quackery: you test them.
The problem here is not one of testing, but convincing someone that an idea is worth the $$$ required to carry out that testing.
It’s impossible to test every form of quackery, which puts the modern “anarchist” in a difficult position.
These are musings about the challenges presented, not conclusions about the state of things.
What do you think is causing the massive increase in autism seen in the US over the last few decades? I did buy the "better diagnosis" line, until I saw how much it had risen by. It's one in 50 in the US. It's lower in Europe (as are the number of vaccines administered to children). Not saying vaccines are the cause, but better diagnosis doesn't cut it for me.
>
What do you think is causing the massive increase in autism seen in the US over the last few decades?
Tonnes of reasons. Parents being older before having children, spending your life surrounded by biologically active plastics (Hello, BPA, and its yet-to-be-banned cousins), changes in diet, Jupiter being in retrograde, etc, etc, etc.
Any one of them, even the wild-ass nonsense ones seem more plausible to me than one fraudulent study written by a doctor who wrote it in order to... Sell autism testing kits and litigation.
You should put less trust in proven, shameless liars, who have a simple explanation for all that ails you, that they will sell you a cure for.
The rates are significantly greater in the US than in Europe. (As are the number of vaccines on the schedule). Given that, you should be able to eliminate some of the reasons you suspect and be able to narrow it down. Any chance you can do that?
Or do you just have a religious faith that it is anything but the vaccines, (the same as we see with the current excess deaths being anything but the covid vaccines).
Doing a cross-continental medical comparison and blaming only one factor, among many, many others, that doesn't even differ very much does not remotely pass the sniff test for a study.
It's not religious faith, but you're going to need a lot more than a shoddy argument.
The argument, by the way, is so shoddy (by failing to be rigorous about both diagnosis methodology, and of differences in environment) that we could trivially use it to conclude that vaccines actually reduce incidences of autism, if we look at America as the undertreated high-autism, under-vaccinated baseline, and at Europe as the properly treated gold-standard... But I don't think that's what you're interested in exploring, no?
There may be a reason why this question attracts so many frauds, quacks, and fools. I postulate: the people who run well-made studies, that we can actually draw meaningful conclusions from aren't finding the answers that the frauds, quacks and fools like.
The phrasing of this question seems meant to imply that because one explanation doesn't satisfy you (better diagnosis), it must be the other (vaccines). This sets up a false dichotomy, though--there's no reason it would have to be one or the other.
We know vaccines aren't the cause, because large-scale studies have been done that show that autism rates aren't higher in vaccinated children. This leaves us with basically every other possible cause, including not just better diagnostics (I personally find that explanation highly plausible), but also changes in nutrition, effects of some sort of virus, pollution, microplastics and everything else under the sun that's changed in the last decades.
You don't know that at all.
There were no studies involving all the shots that kids in the US are getting together these days. You are in denial if you don't consider the correlation a possibility. Best take another booster and trust the $cience. Safe and effective.
(Did you have any idea other than "anything but the vaccines"?)
> There were no studies involving all the shots that kids in the US are getting together these days.
It's been decades; the kids are the study. Also, they're no longer kids. Do people who have taken the vaccines report higher rates of autism? It would be relatively simple to check for that.
> Did you have any idea other than "anything but the vaccines"?
Increased awareness of autism, increased medical attention on kids at large, increased medicalization of societal deviance, less socialization, less parental time, environmental factors (more CO2, more exposure to pollutants, more exposure to forever chemicals), dietary factors (more sugar, more carbs, more fat, microplastics), derived factors from any of the above (more screen time, earlier occurence of obesity and diabetes, higher prevalence and normalization of societal deviance).
All of those are as likely as vaccines; which is to say, extremely unlikely. We can test for them. Or we can keep testing this one thing we've already tested for, over and over, until as statistically expected, a study eventually happens to agree with your preconceptions about vaccines, proving the all-encompassing conspiracy of $cienti$t$ and $tati$tic$ and error margin$, and plunging us into another two decades of unvaccinated idiocy.
>People who catch toxoplasmosis often have no symptoms. If they do, they may experience an acute infection of mild flu-like symptoms. Think about how many times you’ve had a cold or mild flu, perhaps one of those times it was actually from a pathogen such as Toxoplasma. After entering your system, the toxoplasmosis infection then enters a dormant phase, during which bradyzoites (slow, multiplying cell forms) create clusters within a cyst that become permanently lodged in your muscle and brain tissues. Toxoplasma gondii is occasionally also found expressed in conditions around the eyes, the lining of the lungs and also the heart.
Don't worry, it alone will make you sick and will not add a single day to your life. Instead, seek the Kingdom of God and His righteousness. Matthew 6:25-33
While doing that go outside get fresh air, exercise and sunshine. Also, take some Vitamin D.
> Contemporary society champions neuro-diversity and makes it taboo to consider that our psychological issues could have a biological causation. Telling someone that their mental health issues could come from pathogen exposure demeans their experience in individualistic societies.
This is quite a presumption! The advocates of neurodiversity that I’ve seen care less about where these things come from, and more about how they are thought of in society. So what if it’s caused by a pathogen?
When a virus has a pretty much universal presence in the body, isn't it part of the microbiome rather than just an infection? There are certainly negative effects on some people, but could there be a symbiosis here with positive benefits?
Thank you for this very high quality article and initiative to finally take psychiatry seriously and address all the amount of harm and invalid coercion that fuels the unnecessary suffering of millions.
Yes, some connections are there, but not enough to draw these conclusions.
There's no need for funding a new foundation (run by neophytes?). The funding system for health and infectious diseases in particular is pretty good in terms of funneling money to researchers with actual prospects of advancing what we know.
Here's the thing: once you're old, or your immune system is compromised (inactive or over-active), the bevy of mechanisms to Keep Things Going itself fails, and then it's mostly a matter of time. Because failures can happen for so many reasons and in so many ways, findings in this context will always be promising, rarely definitive, and almost never helpful.
Take EBV and MS. Epidemiologically, EBV is highly prevalent - say 95+% of adults show antibodies, and the rest are likely just not producing enough to detect. So the recent VA study had to start from a base of millions to find a few hundred case/controls and a risk factor of ~37X, with only one patient who developed MS not having demonstrated EBV antibodies. Then analytically, e.g., folks at Stanford have found an EBV antibody that also binds to a protein at the foot of the myelin. Thus, we seem to have a perfect exemplar of auto-immune molecular mimickry.
Case closed? Well, you're not going to get rid of EBV soon (a vaccine from ~2000 was abandoned, but Moderna is trialing another). Also, there are many lines of evidence that neurodegeneration starts before the myelin-attacking flares (and the myelin protein at issue is not normally exposed to antibodies). So while the auto-immunity may be excessive and amplify the problem, it's only responding to the neurodegeneration. But we already knew that because even the B-cell ablating therapies for MS only delay disability.
So while there's more science behind this discussion than the typical anti-vaxxer's, it's one of the areas that has the highest ratios of valid, narrow findings to actionable medicine: auto-immunity, gut microbiomes, neuropathic pain, etc. Whenever the problems are systemic, you get some benefit from a system reset or dampening (colon cleanses, inflammation reduction), but that's a bit like rebooting the system as a cure for the blue screen.
Fear-mongering at it's best. The article's main intent is to scare into thinking that genetic problems are because of the cold that you had when you were little so that you might send money their way for "a new philanthropic foundation to focus on the intersection of neuroscience, psychiatry and immunology." 90% of the article is superstion warning you that infertility is because you've been sick for decades and just don't know it, and 10% is asking for money. The only inkling of anything helpful is at the very end, when they recommend vitamin D supplements.
The herpesviruses like EBV and CMV have been with the human race for at least as long as we've been humans and pretty much infect everyone, which begs the question of how much we've adapted to them. I sometimes wonder if it wouldn't be worse if we eliminated them all from everyone. Clearly if you're one of the people who wind up with MS though you'd prefer to have EBV gone from yourself.
As I have had 3 occurrences of mononucleosis from EBV, the last of which had me feeling fine at noon on one day, feeling like flu 6 hours later out of the blue, and then literally bedridden, in significant pain, and unable to work for 27 days(around 20 days with high fever), count me also among those who would really prefer to not have EBV gone from myself.
A lot of microbiome research is leading to particular bacteria in or missing from the gut being correlated with various diseases like diabetes and obesity and almost all chronic diseases have a corresponding microbiome adjustment. We don't know yet know if there is a cause here or its just correlated but its a potential diagnostic that shows long before more serious symptoms and could potentially be used diagnostically one day. Or it might be these shifts are causal and we need to find a way to restore gut function that works well and reliably.
The fundamental idea is becoming mainstream in research with significant labs working on this for Long Covid, ME/CFS as well as EDS across the globe. Its not a fringe idea in research looking at long neglected diseases and the more they look the more they find evidence for it. Its not something the vast majority of doctors would have any knowledge on today, most would consider it ridiculous despite thousands of papers on this topic with growing evidence for the fundamental idea of ongoing infections causing increasing problems.