I don’t have good news: Covid-19 is the new normal.

But isn’t Covid-19 a death sentence?

No, it isn’t.

Early in the epidemic, the CDC estimated that 1.4 million people in the US might die. At this writing (mid-June 2020) the estimate is 110,000 people have died. Very recently the Physicians for Informed Consent published a fact sheet about what that actually means and showed that the death rate is at the same level as a bad seasonal flu. (Physicians for Informed Consent, 2020)

In fact, the expectation is that recurring Covid-19 outbreaks will be very much like recurring flu outbreaks. In March 2020, Anthony Fauci (head of the NIH and a prominent figure in Covid-19 news) wrote in the New England Journal of Medicine that the Covid-19 death rate “may ultimately be more akin to those of a severe seasonal influenza.” (Fauci et al., 2020) In other words, what you have to prepare yourself for is flu season and Covid season.

But until that day, the current outbreak still needs to be brought under control with a continuation of masks and gloves and and handwashing and social distancing and economic travail for the indeterminate future.

Is that what to expect for future Covid seasons? Episodes of masks and gloves and social distancing and hand washing and economic shutdowns in perpetuity? Possibly.

What we’re told is that a vaccine is just around the corner, a vaccine that will eliminate the virus. But then you might have also heard (if you were listening carefully) that it will take some time to develop the vaccine (realistically years) and you might also have heard that there’s no guarantee that the vaccine will be safe or effective and even if effective might not have a permanent immunological effect (which is supposed to be the big payoff).

Are there alternatives? Yes. Are they being explored by public health agencies? No.

So let’s start at the beginning.

Covid-19 is caused by a virus—specifically, a variant of the SARS-COV-2 virus. This type of virus attacks the respiratory system of mammals. When you die from Covid-19, you die because your respiratory system fails. In order to die you first have to be exposed to someone who has the virus.

Some, even most people are not exposed. That’s what the masks, etc. are for: those isolation practices keep the virus away from you and also keep the virus in and on you from getting to other people. But if you are exposed, you won’t die unless you’re infected with the virus—which means the virus has to make it from an already infected person into your respiratory system.

Some, even most people who are exposed don’t get infected. But if you do get infected, you won’t die unless your body responds to the infection with symptoms such as a dry cough or fever.

Some, even most people who are infected don’t develop symptoms. However, this particular virus both a long gestation period and the capacity to be asymptomatic—so that someone could be infected and infectious with showing symptoms. But if you do develop symptoms, you won’t die unless your body responds so strongly to the infection that it’s overwhelmed. Symptoms are not the action of the virus, they’re the action of your body trying to get rid of the virus. Put another way, you die because in the course of trying to kill the virus, your body kills you.

Most people who develop symptoms don’t die. Most people recover. And it seems that people who recover have an immunity to the virus—the jury is still out on how long the immunity lasts.

To avoid death by Covid-19, first avoid exposure. But if exposed, avoid infection. If infected, avoid developing symptoms. And if symptomatic, avoid letting the symptoms get so bad that they kill you.

How is it that some people tumble down this cascade yet most do not? Because their immunity works. If exposed, their immunity prevents infection. If infected, their immunity prevents symptoms. If symptoms emerge, their immunity prevents those symptoms from becoming lethal.

Public health is focused on eliminating exposures and preventing infection. Masks and gloves and social distancing and handwashing and etc. And a vaccine.

Historically, how closely associated with the introduction of a vaccine is the decrease in the corresponding infectious disease? For the most part, its not. The declines in the classic infectious diseases, including polio, all began well in advance of vaccines. What initiated the decline was better hygiene, better sanitation, better nutrition, better working conditions, and isolation of the sick from the well. (Humphries and Bystrianyk, 2015)

The equivalent actions you can take (and that public health institutions should be taking) consist of support for your immunity, food that is non-toxic and nutrient dense, and rest, recovery, and environmental stress reduction.

One of the many things gone wrong in the public health response to Covid-19 is the failure to support those whose body is least able to respond to a Covid-19 infection. That could have been done with the huge amount of money made available for stopping Covid-19 but instead was allocated almost entirely to developing a vaccine. You don’t have much control of that process, but you do over how you support your immunity, the food eat, and the rest you take. (Berman and Fawcett, 2009)

The cascade from exposure to death is not the same for everyone. If the ultimate effect of public health is to prevent death and disability from Covid-19, shouldn’t public health agencies act to protect those most likely to die? People older that 65 account for 90% of Covid-19 deaths. In all ages, people with compromised immunity and chronic disease such as diabetes, heart disease, and lung disease are more likely to die. Environmentally, the death rate varies considerably between cities: one estimate is that the rate in New York City is 4 times that in Los Angeles. No estimates are available for rural, exurban, and suburban places or small cities and towns. And as I’m sure you’re aware, people of color and people of lower income and people suffering from discrimination are more likely to fall down the cascade. So in addition to immunity, nutrition, and rest add place as a catchall for environmental exposures and social stressors that affect the likelihood of death by Covid-19.

I want to pause and take special note of the assault on immunity by a variety of environmental exposures. Over some you have considerable control: tobacco smoke; agricultural chemical drift; urban air; noise; toxic chemicals in personal care products, furniture, bedding, clothing; microwave radiation (cell- and smartphones, iPads, wi-fi, and their infrastructure). (Ketcham, 2020; Pall, 2018)

Is it just age that puts old people at greater risk or is it something else? You would be right to think immediately of the prevalence of overmedication and under- and malnourishment among the elderly. You also might think of the consequences of overmedication and under/malnutrition on the intestinal microbiome of old people as an integral part of their immunity. A recent study found that subjects with a particular microbiome profile were more likely to be infected with Covid-19—but only if they were over 60. (Gou et al., 2020)

Viruses—including disease-causing viruses—are part of your intestinal and other microbiomes (such as skin and the organs of breath). The organisms of those microbiomes include fungi, archaea, protozoans, and worms as well as bacteria and viruses. These organisms comprise an ecology that, among other things, controls or contributes to controlling the population of each member organism, including pathogens. It’s really a third element of your immune response.

You have an adaptive immune response, which produces antibodies that recognize and destroy pathogens based on a previous exposure to the pathogen. You have an innate immune response to foreign organisms that might be pathogens by creating an inhospitable environment (through processes such as inflammation and fever), by creating agents that directly attack those foreign organisms (for example, the host of cytokines), and by stimulating an adaptive immune response that remembers how to neutralize that foreign organism. And you have microbiomes all over your body (not just in your gut) that act to control the population of potentially harmful organisms and stimulate your innate immune response. In fact, it’s being found that many organisms that are ordinarily associated with disease (such as poliovirus) can have beneficial effects—when they are part of a healthy microbiome ecology. (Pfeiffer and Virgin, 2016)

This new understanding of the microbiome has emerged in the last two decades. It brings into question the linear thinking that shows up in the progression from exposure to infection to disease to death and even the dominance of the germ theory of disease. This new understanding raises questions about overzealous hygiene—for example, the observation that children raised in rural environments have more robust immunity than urban children. It even raises thoughts that exposure to a pathogen under appropriate conditions might be good for your immunity. It reminds me of the common practice when I was growing up of gathering all the children in an extended family into one house when one child came down with measles or other childhood disease.

Although the science that surrounds the intestinal microbiome is the most developed, every function in your body has its own microbiome—your respiratory function, for example, from your nose to your lungs has its own. As you might know, overly aggressive hygiene with the use of antibiotics and antiseptics disrupts the diversity of your microbiome and therefore its capacity to neutralize pathogenic organisms. (Patel, 2015)

Public health that focuses on developing a vaccine has many problems. (Fisher, 2020) One of these problems, emphasized by the new understanding of the microbiome, is that starting at adaptive immunity leaps over the natural progression of immune responses. The results are short-lived and ineffective. What your body wants to do on its own is first control infection through your microbiome, then call on your innate immune response, which then leads to an adaptive immune response.

For example, adjuvants contained in vaccines are designed to provoke an innate immune response that will lead to the creation of antibodies. But often as a consequence the adjuvant overstimulates the innate response and causes an acute reaction (such as fever or allergy) or a chronic allergic reaction (such as asthma). As another example, booster shots are a common part of vaccination protocols—which simply means that the vaccine is ineffective at causing a permanent immune response—unlike that commonly found with naturally acquired immunity. (Obukhanych, 2012; Thaiss et al., 2016)

Just within its own narrowly focused scientific universe, public health institutions in the new normal of Covid-19 should pay far more attention to naturally acquired immunity—for example, making sure that vulnerable populations such as the elderly or the immunocompromised are well-nourished, well-rested, and their immunity well-protected. Public health institutions need to broaden their scientific horizons to incorporate science such as what I’ve just described regarding microbiomes. They and the political institutions within which public health operates need to broaden the political horizons to incorporate that science as well. I’m not holding my breath.

At least one implication of microbiome science is that the Covid-19 virus will inevitably be incorporated into your microbiome where it will become part of your microbial ecology. And that would be done by public health institutions devoting the appropriate level of resources to preventing people, especially those who are vulnerable, from tumbling down the cascade from exposure to death by (repeat after me) providing immune support and protection, safe and healthy food, the means to rest and reduce stress, and a safe place to live (environmentally and socially).

After the Covid-19 is brought under control, will you have to contend with other exotic pathogens like the Covid-19 virus? Almost certainly.

There’s been a discussion about the Covid-19 virus’s origin. For the purpose of controlling the current outbreak, the origin story is not particularly relevant. But it is very relevant to what we can expect in the future. I’m sorry, once again, but it is not good news.

There’s agreement that the virus is a descendant of a coronavirus found in bats. Coronavirus is a type found in mammals’ respiratory systems. Because a virus can infect one type of animal does not mean it can infect another—because it can infect a bat does not mean it can infect a human. A virus’s life plan consists of invading a cell, highjacking the cell’s biology to make copies of itself, and then have all those copies released into their immediate environment (typically by bursting out) to invade other cells. If for some reason there are no suitable cells available, a virus can go into a suspended state and wait until a suitable host comes along.

In order to jump from one species to another, it must have the biology to invade the new host’s cell—otherwise, the virus doesn’t do anything and the new host’s biology either destroys it, neutralizes it, or incorporates it into a microbiome ecology.

It’s generally accepted that the Covid-19 virus made the jump in Wuhan, China. One Covid-19 origin story says that the virus made the jump from bat to human with some other species as an intermediate (such as a species of snake) that is sold as food in the so-called wet meat market in Wuhan. This is the natural zoonotic origin story—“zoonotic” meaning a human pathogen that originates in another animal.

The other Covid-19 origin story says that the virus made the jump in the lab of China’s biosafety program at Wuhan where the bat virus was (still is) under study—which means genetically manipulated to understand the pathogenic biology of the virus in order to better prepare for a pandemic. Call this the artificial zoonotic origin story.

When Covid-19 first appeared, the consensus leaned toward the natural zoonotic narrative. It continues to be the dominant narrative in the mainstream media. What it mistakenly focuses on is the human practice of eating exotic meat from the wild, calling to mind unhygienic food and food preparation. However, that’s not the problem. The problem is human practices that simplify food producing ecologies—whether in the wild by disrupting ecologies, reducing biodiversity, and thereby impairing the capacity of those ecologies to keep pathogens in check or in civilization through monoculture and simplifying the ecologies upon which industrial agriculture builds (also reducing the biodiversity and thereby impairing the capacity of those ecologies to keep pathogens in check).

Remember the discussion about human microbiomes and their role in controlling pathogenic organisms? The same is true for both ecologies in your body and ecologies on the land. It’s important to know that ecologies on the land include their own microbiomes—so that, for instance, the antiseptics found in hand sanitizers simplify soil microbiomes and so affect the resilience of plants against diseases.

This is captured nicely in the book title Big Farms Make Big Flu: Dispatches on Infectious Disease, Agribusiness, and the Nature of Science by epidemiologist Rob Wallace. (Wallace, 2016, 2020) The upshot is that as food production ecologies are simplified, more pathogens of all kinds will jump species and as a consequence more pandemics of formerly exotic and inconsequential microbes will emerge.

The other Covid-19 origin story is an artificial zoonotic narrative—specifically, the story of a virus cooked up in a lab and accidentally released. As I mentioned, Wuhan is the location of China’s biosafety research laboratory. When Covid-19 became a prominent issue, the Chinese government and the lead coronavirus researcher vigorously argued that an escape wasn’t possible. The evidence seemed to bear this out. But as time has passed, the natural zoonotic story has become increasingly implausible. For example, the crucial intermediate species that links bat virus to human virus has yet to be identified. (Latham and Wilson, 2020)

In addition, despite protests to the contrary, the Wuhan lab is almost certainly doing the kind of research intended to produce exactly a Covid-19 virus. Further, the security of the lab has been questioned from both within and outside the lab itself. The likelihood of an accidental escape is plausible not because it’s China. The United States is building the equivalent of the Wuhan lab in Manhattan, Kansas under the auspices of the Department of Homeland Security, which reported to Congress that the chance of a catastrophic accidental release over 50 years was 70%. The National Research Council found that the report grossly underestimated the risk and grossly overestimated the safety measures proposed for the new facility.

A US agency investigation of accidental release of organisms from the highest level biohazard labs in the US over the six years between 2009 and 2015 found 749 incidents. A significant number of those incidents were not reported initially but were only discovered in the course of investigating another incident.

Both the natural and artificial zoonotic narratives are plausible. Both are about how ecological disruption by humans causes a virus (or other pathogen) to jump from wild animals to humans. Going forward what matters is that both sources will almost certainly create public health hazards. So even if Covid-19 eventually dies out and does not become a recurring event, other pathogens will almost certainly emerge. An estimated 60% of emerging infectious disease is expected to be naturally zoonotic. (Robbins, 2015) No estimate is available for how many are expected to be artificially zoonotic.

It’s a frightening future. Some of the fright is entirely justified; some is cooked up intentionally or unintentionally to achieve public health, public relation, and public order goals. But frightening is not hopeless. You have the power to protect yourself: take care of and protect your immunity (including your microbiome), eat well, rest, live in a safe place, and don’t let the soup of fear cooked up by infectious disease panics disable you.(Berman and Fawcett, 2016; Fawcett, 2016)

Bibliography

• Berman, L., and Fawcett, J. (2009). Boosting Immunity. Your Own Health And Fitness. http://www.yourownhealthandfitness.org/Download/20090818.mp3
• Berman, L., and Fawcett, J. (2016). Fear. Your Own Health And Fitness. http://www.yourownhealthandfitness.org/Download/20160705.mp3
• Fauci, A., Lane, H., and Redfield, R. (2020). Covid-19–navigating the uncharted. N Engl J Med.
• Fawcett, J. (2016). Fear. Health Bites. http://www.yourownhealthandfitness.org/?p=15783
• Fisher, B. L. (2020). How Fear of a Virus Changed Our World. The Vaccine Reaction. https://www.nvic.org/NVIC-Vaccine-News/June-2020/How-Fear-of-a-Virus-Changed-Our-World.aspx
• Gou, W., Fu, Y., Yue, L., et al. (2020). Gut microbiota may underlie the predisposition of healthy individuals to COVID-19. medRxiv. https://www.medrxiv.org/content/10.1101/2020.04.22.20076091v1
• Humphries, S., and Bystrianyk, R. (2015). Dissolving Illusions: Disease, Vaccines, and the Forgotten History. http://www.drsuzanne.net/
• Ketcham, C. (2020). Is 5G Going to Kill Us All? The New Republic. https://newrepublic.com/article/157603/5g-going-kill-us-all
• Latham, J., and Wilson, A. (2020). The Case Is Building That COVID-19 Had a Lab Origin. Independent Science News. https://www.independentsciencenews.org/health/the-case-is-building-that-covid-19-had-a-lab-origin/
• Obukhanych, T. (2012). The Vaccine Illusion: How Vaccination Compromises Our Natural Immunity and What We Can Do To Regain Our Health.
• Pall, M. (2018). 5G: Great risk for EU, U.S. and International Health! Compelling Evidence for Eight Distinct Types of Great Harm Caused by Electromagnetic Field (EMF) Exposures and the Mechanism that Causes Them. http://www.yourownhealthandfitness.org/Download/Pall EU-EMF2018-6-11US3.pdf
• Patel, R. (2015). The Microbes In Your Home Could Save Your Life. Popular Science. https://www.popsci.com/bugged/
• Pfeiffer, J. K., and Virgin, H. W. (2016). Transkingdom control of viral infection and immunity in the mammalian intestine. Science. https://science.sciencemag.org/content/351/6270/aad5872
• Physicians for Informed Consent. (2020). SARS-CoV-2 COVID-19: Assessing Infection Severity. Physicians for Informed Consent. https://physiciansforinformedconsent.org/wp-content/uploads/2020/06/PIC-COVID-19-Disease-Information-Statement.pdf
• Robbins, J. (2015). The Ecology of Disease. The New York Times. https://www.nytimes.com/2012/07/15/sunday-review/the-ecology-of-disease
• Thaiss, C. A., Zmora, N., Levy, M., et al. (2016). The microbiome and innate immunity. Nature. https://www.nature.com/articles/nature18847
• Wallace, R. (2016). Big Farms Make Big Flu: Dispatches on Infectious Disease, Agribusiness, and the Nature of Science. New York: Monthly Review Press.
• Wallace, R. (2020). We Need to Connect the 2019-nCoV Coronavirus to Agriculture. Independent Science News. https://www.independentsciencenews.org/health/we-need-to-connect-the-2019-ncov-coronavirus-and-agriculture/

What do you know about health? What do you know about how to stay in good health? About how to get back to good health? About preventing the onset of ill health?

The 20th Century philosopher Ludwig Wittgenstein observed that most of what someone knows comes from what he or she has been told by someone else. Not really a theory of knowledge. More like a portrait.

And, of course, it’s important to remember that what those people you heard it from know comes from what they were told by yet someone else. These include the experts upon whom you rely.

A friend was recently diagnosed with cancer. The doctors encouraged her to start chemotherapy. They said that people who took this particular course of chemotherapy had a 60% survival rate whereas those who did not had only a 30% survival rate. She took them at their word. But she’s also consulting with three alternative physicians, including an energy healer. All of which consists of knowing what you know by having someone tell you.

Not a bad thing, just how we know most of the things we know. Even her doctors. Chances are good that her oncologists didn’t do the research that came up with those survival rates or chemotherapy methods or cancer diagnostics. Someone told them.

What was true for the doctors and became true for my friend is that what they (and she) know makes sense given what else they know. What they know has as much (or even more) to do with how they fit together what they know into something like a portrait of that makes sense to them.

You likely know the work of the Renaissance artist Giuseppe Arcimboldo. He’s famous for painting portraits using fruits, vegetables, books, and other objects as the elements of a face. Each portrait is recognizable as a human face because it’s made coherent by him in his selection and placement of each piece of fruit, vegetable, or other object, and by the viewer in how he or she recognizes the face in what might otherwise be a jumble of vegetables.

The portraits are more than a collection of objects. By Arcimboldo’s art, the vegetables hang together as a portrait. And we do some of the work in making sense of it as a face.

That’s more about how we know things about health than it is about what we know and what sense we make of it. Start changing the individual vegetables and you’ll get a different face. Change one thing you know, get a different picture of your health. For example, what if you knew not only that 60% of people treated with chemotherapy survive but also that an alternative cancer treatment based on features of the immune system also resulted in a 60% survival rate? If that were the only thing that was added to the portrait, would you choose a different course of action?

And that, of course, is the key question: would you do something different?

Because there’s no simple answer to that question, I want to start with an historical perspective based on the book Dissolving Illusions: Disease, Vaccines, and the Forgotten History by Suzanne Humphries and Roman Bystrianyk.

At the beginning of the 19th Century, vaccination against smallpox was promoted in England and Wales. The physician Edward Jenner is credited with conducting the first experiments on children in the late 18th Century. He became a primary expert and chief promoter of the practice.

By the mid-19th Century, vaccination against smallpox was both heavily promoted and widely accepted as a medical practice. However, smallpox epidemics still erupted, even among vaccinated populations, sometimes especially among vaccinated populations; vaccinated people died from other diseases transmitted by the vaccine; and, contrary to the experts, sometimes vaccinated people often contracted smallpox earlier and with worse symptoms than unvaccinated people.

In response, local governments and the national government passed laws for compulsory vaccination, particularly of children. Parents could be punished by fines and jail for preventing their children from being vaccinated.

By the 1870s, vaccination rates for children were over 90%. Yet smallpox outbreaks occurred at regular intervals. In 1873, when vaccination was at its highest, so was the death rate from smallpox. Popular resistance increased. In 1885 what was called the Great Demonstration occurred in city of Leicester. The city government was replaced. The new government stopped compulsory vaccination and proceeded to implement what was called the Leicester Method—consisting of quarantining smallpox patients and disinfecting their homes. The vaccination rate dropped to near zero, yet the smallpox death rate was the same as that for the nation as a whole.

In Leicester vaccination made no difference in controlling smallpox outbreaks nor in reducing smallpox deaths.

Medical experts and government authorities ignored Leicester’s success and continued to promote and enforce smallpox vaccination. The narrative we’ve inherited is that the decline in smallpox deaths that occurred in the late 19th Century resulted from the medical intervention of vaccines. It is hailed as a great triumph of science over superstition. It is held up in the narrative of public health as proof that state intervention is a proven method for ensuring the prevention of disease through the application of science.

More generally, experts promote the narrative that medical interventions, principally vaccination and antibiotics, supported by the power of the state, were the principal cause for the dramatic decline of infectious disease from the late 19th to the mid-20th Century. It’s what everyone knows. And it’s likely not true.

I don’t intend for this to be a diatribe on the dodgy science and history of vaccination. What I do intend is to illustrate the power of social forces in creating a narrative of what you know about health and how you come to know it.

One social force is the role played by experts in creating and maintaining the dominant ideology of health—which has to do with how and why experts become sources of knowledge and how and why you take them to be sources of knowledge. Just because Edward Jenner promoted himself as the smallpox vaccine expert it didn’t follow that he would be successful at promoting the practice. It was his social class and his status among physicians, themselves of elevated status, and so on that created the cadre of smallpox experts that then used their status to affect government policy and action.

A second social force is the role of the state or other social authority in enforcing the dominant ideology of health—which has to do with the state as the social force that maintains social stability by sanctioning some knowledge and discouraging other knowledge—with force when necessary. Smallpox epidemics are of necessity socially disruptive. Governments needed a solution that was socially acceptable. Jenner and vaccination were socially acceptable. The Leicester Method was not.

A third social force is the capacity of civilians (that would be you and me) to make their own sense of what’s coming from experts and social authorities and acting on that knowledge—and when necessary, taking things into their own hands. The people of Leicester rebelled and organized. They were not alone in rebelling, but they were alone in successfully organizing.

A final social force is the power of commerce, something not on display in dealing with 19th Century smallpox outbreaks. Unlike today,there were no large pharmaceutical companies busily working to shape the science and politics of disease treatment, control, and prevention.

Instead of pursuing those issues, right now I want to discuss the dominant idea that vaccination eliminated smallpox. That victory claimed by conventional medicine extends to the other infectious diseases rampant before the late 19th Century when their dramatic decline began, ending in the mid-20th Century. The narrative is that vaccination and antibiotics marked a victory of science over disease.

An article written 40 years ago titled “The Questionable Contribution of Medical Measures to the Decline of Mortality in the United States in the Twentieth Century” looked carefully at the data on death rates from major infectious diseases: tuberculosis, scarlet fever, influenza, pneumonia, diptheria, whooping cough, measles, smallpox, typhoid fever, and polio. It’s clear by just looking at the data and comparing it to when the vaccine or antibiotic for each disease began that the declines in deaths from every single infectious disease began well beforehand.

In other words, medical practices might have contributed to reducing the health risks of a particular disease, but the reductions had already started—which suggests other causes. And those would be changes to people’s social and physical environments: increased incomes and standards of living, improved nutrition through safer food supplies, clean water, and sanitary waste disposal. These came about through labor movements, public health movements, and social justice movements.

The relative contribution of medical practices to the reduction in death rates from all infectious disease was less than 40%. Deaths from tuberculosis and pneumonia were most significantly affected by the introduction of antibiotics (contributing 28%), whereas deaths from whooping cough, measles, and polio by vaccination contributed little (a total for all three of less than 3%).

The point here is not that medical practices were entirely ineffective, but that they were not the heroes of the story. The heroes were public health and environmental health from labor and social reform activism.

To take an even wider perspective, the dominant ideology of what you know about health is that medical interventions generally have been responsible for the dramatic improvements in life expectancy over the last 150 years. That ideology has made “health care” synonymous with “medical care.”

Daniel Engster’s article “The Social Determinants of Health, Care Ethics, and Just Health Care” examines research on increased life expectancy in the 20th Century. People now live 30 years longer than they did in 1900. But only about 5 years of the increase, that is about one -sixth, can be attributed to medical interventions.

There’s more. Only 10% of preventable premature deaths in the United States results from a lack of medical care. Based on Medicare and Medicaid data, people living in areas with high rates of spending on medical care and high utilization rates of medical care do not live longer nor do they have better health generally than people living in low spending, low utilization areas.

On the contrary, a study in Winnipeg Manitoba found that health actually improved during a decade in which hospital access was restricted and hospital spending decreased.

Yet other researchers looked at health outcomes for the wealthy as compared to health outcomes for the very poor. They projected what would happen if medical care was entirely denied to the wealthy while medical care for the poor was made free and without restrictions. What they found was that even in this extreme case of reverse disparity in access to medical care, the wealthy with no access would still live four years longer than the poor with unlimited access.

So there’s more than ample reason to doubt that medical care is health care. That medicine is the health colossus astride the world. That it is medicine to which you must turn for what you know about health. What you know about how to stay in good health. To recover your health. To prevent ill health.

The history and research I’ve discussed suggests that you should principally turn to your social and physical environments for what you know about health and its maintenance, recovery, and promotion. Knowing what you can from medicine might help. Sometimes it might help critically. But always in the context of your social and physical environment.

Before leaving the topic of mortality, permit me to tell you about something called iatrogenic mortality. Iatrogenic deaths are the third ranking cause of death after cancer and heart disease. Iatrogenic mortality consists of deaths due to medical mistakes. In other words, along with all those medical miracles come medical risks—and not the expected risk that a medicine might not work for a particular person, that some unexpected reaction kills the patient. Iatrogenic mortality is death from a medicine or procedure or circumstance that’s already known to be lethal. It’s giving a patient the wrong drug. It is dying from methicillin resistant Staphylococcus aureus (MRSA) contracted in a hospital.

As for iatrogenic mortality ranking number three, I remind you that cancer and heart disease became significant killers only in the 20th Century. In my opinion, they are environmental illnesses. What medicine has succeeded in doing is not curing them but turning them into chronic diseases by discovering ways to keep the machinery of the body going.

So if what you know about health is a portrait, it should principally consist of what you know about your social and physical environment. What I’m suggesting is not that health care should be organized along the lines of Black Lives Matter or Occupy Wall Street or Sea Shepard. I’m saying that Black Lives Matter, Occupy Wall Street, and Sea Shepard are health care.

On the other hand, the dominant ideology of health care is a portrait of engineered medical technologies designed to solve discrete problems that afflict your body—but has little to do with you. It is a portrait of technologies brought to you by one business or another. It is a portrait of magic and miracles.

Don’t count on the so-called progressive media to keep you well-informed. I recently heard the host of a daily program syndicated on the Pacifica Network use the phrase “vaccine deniers” during an interview about climate change. She was making a point about climate deniers who, allegedly like people who do not want their children to be vaccinated, ignore the science.

That’s the dominant ideology: vaccines are a miracle; nothing bad ever happens; the government, protecting our health and safety, should force vaccine deniers to do what’s right—for the sake of the children. It’s clear to me whose ignoring the science—certainly the science that doesn’t conform to the dominant ideology of health as medicine.

It’s interesting to note that in the first half of the 20th Century, the involuntary sterilization of people deemed defective was legally sanctioned based on existing policies for mass vaccination.

In their book, Humphries and Bystrianyk discuss therapies for infectious diseases that were actively ignored during the 19th Century. These include what would come to be understood as vitamin deficiencies resulting from malnutrition. They also included what we would now call natural remedies such as cinnamon, jicama, fruit juices, apple cider vinegar, cod liver oil, and colloidal silver.

What you know about health is what makes sense to you. What makes sense is the face that emerges from the portrait composed of the vegetables of what you know. And it’s not just the vegetables, it’s what you bring to them and their arrangement. It seems obvious to me that what needs to dominate that portrait is the vegetables of social and environmental justice.

For example, the Zika virus has the CDC worked up. President Obama has asked for $1.9 billion. A good chunk of that is for developing a vaccine, which will be manufactured and sold by a pharmaceutical company. Funds will also be used to prevent the spread of the mosquitoes that carry the virus. Two methods are being examined: spraying infested areas with pesticides and releasing genetically modified mosquitoes into the environment so that the insects don’t breed successfully. Both of those solutions are products of profit-making enterprises.

Just talking about this issue has drawn our attention to one kind of science while ignoring another. We don’t see or hear headlines about microencephaly, let alone pesticide induced microencephaly. What we see and hear are headlines about the Zika virus.

That’s created a nice panic both in government and among people in general. There are reports of women showing up in emergency rooms fearing for their reproductive health because they were bitten by a mosquito. Given the information at their disposal, it’s a perfectly rational concern.

But is the information frightening those women helpful or even accurate?

The Zika virus and its clinical symptoms have been known for 70 years. It’s related to the Dengue fever virus and so has the potential to cause neurological problems. So it’s no joke. On the other hand, clinically less than 1 in 5 cases manifests with overt symptoms. That means that for five people infected with Zika, only one will show any signs at all.

But the health issue is not the virus itself but the effect of a Zika infection on pregnant women who give birth to children having the microencephaly birth defect—that is, the baby’s head is unnaturally small and with that comes neurological problems.

So the health problem isn’t the virus’s usual clinical, flu-like symptoms—previously characterized as relatively harmless. It’s the unexpected occurrence of a particular birth defect associated with infection by the virus.

This association between Zika virus infections and microencephaly birth defects has only bee seen in a specific region of Brazil. It is a region where a particular kind of pesticide called Pyriproxyfen was sprayed the year before the cases of microencephaly showed up. In early 2016 a group of Brazilian and Argentinian doctors calling themselves Physicians in the Crop Sprayed Villages described it as a pesticide problem. They’ve been ignored.

Subsequently, researchers reported in the New England Journal of Medicine that cases of Zika infection in Colombia were not associated with cases of microencephaly in any greater numbers than for uninfected women. In other words, while there were cases of microencephaly, there was no association with Zika infection. They’ve been ignored.

Finally, an independent research group called the New England Complex Systems Institute recently examined the science and concluded that the Zika virus was not the cause of the microencephaly outbreak in Brazil. They’ve been ignored.

At least ignored by the CDC. The World Health Organization has not yet committed to the Zika theory of microencephaly—which is somewhat odd in itself, as typically global health organizations take the lead of the CDC. However, the World Health Organization isn’t giving much credit to the alternative theory that it is pesticides that have created the outbreak.

Pyriproxyfen, the pesticide used in Brazil that has been implicated, is designed to disrupt mosquito development, causing mosquito birth defects. Microencephaly is a birth defect that results from the disrupted development of a human fetus. Is this really that hard to believe?

Apparently so. The CDC committed early to the Zika theory—half of the $1.9 billion President Obama asked for was to be spent on further study of the link between the virus and the birth defect. The other half was for developing a vaccine. It was only two months after submitting this request that the CDC announced definitively that Zika was the cause. The basis was an article in the New England Journal of Medicine written by four CDC employees.

The funding issue is currently stalled for partisan political reasons, the Zika train has left the station. The government as well as the media (including the progressive media) are on board. The US government has declared as state of emergency in Puerto Rico. Health officials are citing widespread health effects, including cases Guillain-Barre syndrome “linked to the Zika virus” according to the Associated Press.

But no cases of microencephaly.

In Florida, Miami is spraying pesticides to kill mosquitoes that might carry the Zika virus, tourists are being warned about the dangers of mosquito bites, and in Key West the pest control district wants to release male mosquitoes that have been genetically modified to pass on a gene to their offspring that will make them sterile. This latter technology is the product of a five year development project by a biotech company. The people of Key West are fighting back.

Remember how I spoke about the social forces that maintain the dominant ideology of health as medicine? On one side sanctioned experts, the state, and commerce. On another side are experts who are ignored by that first bunch—and you. Here they are on display again. That’s something important you should know about your health.

What frightens you? Climate change? Losing your sight? Genetically modified organisms? Chemicals in products that might harm you? That might harm your children? Donald Trump? Hillary Clinton? Terrorists? The National Security Agency? Your mother? A loud, unexpected noise? Mentally ill people getting their hands on guns? Continue reading →

Soon after the Paris agreements on climate change were signed, The Guardian carried an opinion piece titled “There is a new form of climate denialism to look out for—so don’t celebrate yet” (Oreskes, 2015). What’s being denied is the possibility that the goals of the agreement can be met using a 100% renewable energy resource strategy—the explicit implication of which is that nuclear energy is a necessity in order to prevent the world from going to hell in a climatic hand basket. Continue reading →

Feeling helpless is not the same as being helpless.

Some time ago, I came across a study in Science magazine that describes how feeling a lack of control affects the decisions you make. A new study by the same researchers develops these results. Continue reading →

Research published in the journal Genetics reports on “the gene responsible for traits involved with diabetes.” That news might lead you to believe that we can now predict who will need treatment for diabetes, how to treat those people, and maybe even how to prevent those people from developing diabetes in the first place. Continue reading →

The American Chemical Society maintains the most comprehensive database of commercial chemicals in the United States. Fifteen thousand new chemicals are registered to the database not every year, not every month, not every week, but every day: 15,000 per day Continue reading →

As I’m sure you know, the Ebola virus is rampaging through Equatorial West Africa. In a report scheduled for release next week, the CDC estimates that half a million people will have been infected by the end of January 2015. What’s scary about Ebola is that of those half million people, 83% will die—and it will be a terrible death—that’s 415,000 dead. To date the toll has been in the thousands. Continue reading →

Ecover, maker of environmentally sensitive cleaning products, has gotten into trouble. It and a number of other makers of so-called green cleaning products have replaced the palm oil they use in their products with an oil produced by algae. Continue reading →

Aldehydes are a class of potently toxic biochemicals. You might recognize the name from a notorious family member: formaldehyde. Aldehydes have been difficult to study because they are very reactive and therefore don’t hang around long enough to be examined. Nevertheless, it would be reasonable to assume that the extreme reactivity of aldehydes spells bad news from human and environmental health. Continue reading →