The current state of viruses

A few stories on the ongoing virus mania including China's COVID surge, a possible non-tripledemic, and problems with junk science and scientific reporting.

There’s been a lot I’ve intended to cover, including more on the microbiome and the intersection of viral infection and microbiome alterations. However, most stories get away from me because of the research needed to cover such stories.

While I continue to do research, here I’ll provide a glimpse into some of the current reports from the mainstream media and provide some perspective. Of note, we’ll take a look at the goings on in China with respect to COVID, how there may not be a looming “tripledemic”, and why we should be careful of assuming that all science is good science.

The Ramifications of Zero COVID in China

Right now China is easing their COVID restrictions amidst weeks of protests, initiated by an apartment fire in which firefighters could not reach the fire due to COVID street restrictions, causing a delayed response and many casualties.

As such, China is experiencing a massive wave of COVID and reports are suggesting that hospitals are filling to the brim, leaving many people having to wait for medical care or even many patients receiving treatment outside of the hospitals in their own cars.

This is in start contrast to the first images that came from China during the initial onset of the pandemic, showing pop-up hospitals being constructed in a matter of days, enforcing this notion that China was taking COVID seriously and was well-prepared for the viral onslaught.

Of course, it appears that many of China’s actions were performative, and that much of the policies were a masquerade of the appearance of having things under control while hiding many of the actual COVID numbers and silencing any voices who dissenting on China’s handling of the virus.

In such times of fear, other countries acted under a need of having to do something, even if such actions have not been properly assessed as being effective.

So in an ironic sense, it was China who proposed a hypothesis on how to deal with COVID, with the rest of the world having to reproduce said hypothesis, only with horrible and contradictory results. The world peer reviewed China’s actions, and something was clearly wrong with their data, only the reproduction of said hypothesis have caused downstream global economic and social turmoil.

But now China is dealing with its own mess of problems. It’s been reported that China’s vaccination rate is strikingly low among the elderly. Barring any general criticisms of COVID vaccines, as well as questions on China’s numbers not being accurate, what this means is that much of China’s population are likely to be immunologically naïve to SARS-COV2, meaning that they have no immunity due to lockdowns that dampened any exposure to the virus.

It’s another reason why lockdowns never made much sense, as all it served to do was create a dam with ever rising level of harm. The longer the dam stayed in place, the worse off the downstream effects will be once the dam is removed or breaks. We may be experiencing that now in what could be immunity debt due to a gap in immunity from lack of exposure to pathogens over the nearly 3 years.

As such, policies that hold off the inevitable rather than encourage an antifragile populace will leave many people worse off.

Right now China is in a precarious situation due to many of the actions they subjugated the rest of the world to live under.

In another ironic turn of events, it’s been reported that Pfizer has cemented plans to sell PAXLOVID to China in order to help deal with their current COVID situation. The deal seems to have been in place since earlier this year, although with cases rising it seems as if the deal has been revisited and expedited.

So as China deals with the ramifications of their lockdown policies, the rest of the world can now look on and see the failures of a Zero COVID policy.

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A non-tripledemic on the horizon?

Most reporting over the past few months have touted a possible phenomenon called a “tripledemic”, in which the flu, RSV, and SARS-COV2 will all coalesce into one timeframe and hit us all at the same time creating hospital surges and illness.

I’ve entertained the idea of a tripledemic before, but mostly under the idea that if such an event were to occur it would be due to immunity debt and the lack of robust, trained immune system making people far more vulnerable to infections.

However, the term tripledemic, much like many terms used now, is ambiguous and somewhat inconsistent. As a production of the media, tripledemic is rather ill-defined, as it doesn’t quite explain what the timeframe of a triplemedic should be, or what exactly it should look like outside of different viruses intermingling among the population. One floating idea just seems to suggest all 3 viruses should see a surge around a similar time, although the categorization of what infection one gets can be ambiguous.

As Peter from All Facts Matter noted, this event isn’t anything new, as most viruses have always intermingled with one another under the category of flu-like illness, which contains a ton of other viruses such as rhinoviruses and adenoviruses as well as the ones that have been included under the category of “tripledemic”.

It doesn’t help that many of these viruses present with very similar symptoms as one another, so as far as symptomatology goes one can’t differentiate one virus from another upon first glance.

However, given the hypochondriac-like culture we are living in we should also consider the fact that many minor illnesses, which would otherwise never be met with much fanfare, may now be presented as being far more severe than in prior years.

I remember a point in which coworkers would come to work with a massive coughing fit, but still appear for days. Only now if one were to even show a sign of a sniffle they may be sent home and told to take many COVID tests.

And even with that said, most people wouldn’t care to differentiate one virus from another. If they were sick, they just considered it the cold or flu and stayed home. It’s only now where the tallying of what virus one has is becoming far more meticulous, and the data becoming far more scrutinized.

The epidemiological data for waves of viruses is likely to have always been noisy, and the same is likely occurring here where many respiratory infections may be lumped together under the umbrella term of flu-like illness.

And rather than provide people with information on good nutrition, sleep, exercise, and awareness of mental health that will help deal with all manners of viruses, the narrative only continues to provide short-sighted, limited information such as continuous masking, antiviral treatments, and vaccination as the only viable methods of dealing with the virus.

So on one hand, we may look at the information and wonder whether a tripledemic is coming. On another hand, we may wonder if it’s worth any consideration, given that many of these viruses present with the same symptoms anyways, and the data collection is already rather messy.

Instead, it may be important to do things that make one resistant to all forms of infection, such as eating right, exercising, supplementing if necessary, and doing things to reduce one’s stress.

And above all, making time to see friends and loved ones, rather than living in constant fear of whatever may or may not be coming.

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As an aside, some of the rebuttal to the tripledemic narrative has been a concept called viral interference, in which a wave and widespread infection with one virus may dampen the ability for another virus to take hold in a given population.

An example of this includes an article in Science published a few weeks ago, which cites data from France and Sweden suggesting that rhinovirus waves may curtail proceeding flu virus waves.

Part of this is owed to a class of antiviral proteins named interferons.

During a viral infection interferons are released from the body which can provide a wide array of defenses by acting as immunomodulatory agents and activate various immunological pathways. It’s been suggested that one viral infection will lead to the release of interferons, and it’s this release of interferons that may dampen the infection from subsequent viral exposures. In essence, the immune system has been activated to prevent any proceeding infection, and so a population that experiences a wave of one virus may not see any proceeding virus gain a foothold.

Given how interesting the idea of viral interference is I tried doing some research and hoped to assess this phenomenon further. Unfortunately, it was shelved and was going to be looked at some point in the future.

With that being said, a word of caution is needed in decoding this interferon response given a few things that I've seen.

Note that many viruses have evolved mechanisms to obfuscate the interferon response, either by eluding such responses or even dampening the body’s ability to activate such a series of events. Viruses may also utilize the interferon cascade to aid in their own pathogenesis¹.

There’s also the fact that interferons are a rather broad category. Some interferons may aid in the antiviral response while others may worsen symptoms.

Interestingly, not all viruses produce the same interferon response, and not all viruses are susceptible to the interferon response produced by prior infections². This would mean that not only is the timing of infections critical to the interferon response, but the order of exposure to viruses is likely to play a role in viral interference as well.

Given that RSV and flu infections are on the rise, one may argue whether prior SARS-COV2 infections followed by these viruses are creating the perfect match for viral interference, or whether there is a mismatch or more to the story than just interferons.

The Omicron variants being an infection of the upper respiratory tract may help with some of this interferon response, as the localization may attenuate the ability for other upper respiratory viruses to talk hold in such regions, but more research would be needed to see if that is the case. It also requires a distinct examination of which individuals got what infection and when, and the ensuing interferon response, rather than population-wide correlations.

In any case, there’s been arguments made that the RSV wave is on the decline, and research may find out how much this viral interference/interferon response played into the tripledemic (or lack thereof).

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The Problems with Junk Science

Recently, a study³ came out suggesting that the unvaccinated were more likely to get into car accidents compared to vaccinated individuals.

Igor Chudov covered the study recently, and apparently so did Dr. John Campbell.

I didn’t cover the story since several people already had, and of course reading the title of various headlines such as the one above should cause one’s eyes to roll indefinitely.

But given it’s various flaws I’ll just point out a few issues, and why such junk science is constantly perpetuated.

Click on the image for a link to the study. Also, note that the study uses this phrase “vaccine hesitancy” quite often. It’s been adopted into several works, and yet I find it very hard to argue that those of us who didn’t get vaccinated are suffering from “vaccine hesitancy”, so to speak.

The study has all sorts of problems in methodology, and is really an example of junk science being touted out to fit a narrative.

For one, the researchers categorized driving accidents to include those who were either a driver, passenger, or even a pedestrian, rather than just the driver who would be responsible for…the driving (emphasis mine):

We identified serious traffic crashes during the subsequent month based on emergency care throughout the region (178 individual hospitals).45 This definition reflected incidents sending a patient to an emergency department as a driver, passenger, or pedestrian (codes V00-V69).46 Additional crash characteristics included time (morning, afternoon, night), day (weekend, weekday), ambulance involvement (yes, no), and triage severity score (higher, lower).47 In each case we also determined whether the patient was admitted (yes, no) and final status (dead, alive).45,46,48, 49, 50

On this alone the study should be met with severe scrutiny, since we have no way of knowing who among the participants were actual drivers. As we’ll see, this discrepancy doesn’t work in the researchers favor of attempting to correlate vaccination status, accident rate, and reckless behavior together.

But of course, that’s not the only problem. The researchers make note that the group who tended to have lower vaccinations were in younger drivers (emphasis mine):

The largest relative differences were that those who had not received a COVID vaccine were more likely to be younger, living in a rural area, and below the middle socioeconomic quintile. Those who had not received a vaccine also were more likely to have a diagnosis of alcohol misuse or depression and less likely to have a diagnosis of sleep apnea, diabetes, cancer, or dementia. About 4% had a past COVID diagnosis, with no major imbalance between the 2 groups.

Right then, one should immediately raise concerns over cause and effect mismatching.

At the point that researchers noted that younger people were more likely to not be vaccinated, they should have realized that it’s likely the young age that is the variable here, and not vaccination.

This is especially made true as the researchers attempt to tie driving accidents and vaccination status to reckless behavior, which again may be better explained based on the age of participants:

Our research agrees with past studies about psychology contributing to traffic risks.53,54 One of the earliest studies evaluated taxi drivers and observed a 7-times greater frequency of personality disorders among those with multiple crashes compared with those with no crashes.55 A study of young drivers identified a near doubling of crash incidents associated with an aggressive personality pattern.56 A psychometric analysis of motorcycle riders found that personal temperament was the largest predictor of crash involvement.57 The weaknesses of past studies include small sample sizes, fallible self-report, cross-sectional designs, low outcome counts, and narrow generalizability.58,59 We are aware of no past study testing COVID vaccination and traffic risks.

This is a prime example of a study pulling a slight of hand, in which the study presents one narrative but buries the lede. Here the researchers make comments about psychology contributing to driving risk (i.e. reckless, antisocial behavior), and even makes mention of a study related to young drivers and reckless behavior. So shouldn’t such an assessment lead to hesitancy in the conclusions made by the researchers?

This is a problem with studies that attempt to find any tenuous association between variables.

It’s also why a breakdown such as the one done by researchers can be entirely misleading, since it may infer that the vaccines are somehow intrinsically tied to the below factors:

From Redelmeier, et al. The above list categorizes participants based on different demographics, such as age, gender, and medical condition, and compared the risks of accidents between vaccinated individuals to those who were unvaccinated. There’s many issues with this categorization because such categorizations may mislead people to infer that vaccinations are somehow related to the above medical conditions, and subsequently driving accidents in some way.

In any given case, the above breakdown really serves as additional distraction, as the researchers have no way of tying driving accidents and vaccination to the variables listed above without taking great leaps in assumptions.

This is why reports associating vaccination and reductions in all cause mortality are absurd, since it would insinuate that vaccines would somehow reduce cancer deaths, car accident deaths, and other causes of deaths without examining what features between vaccinated and unvaccinated groups may be the reason (if such a relationship was actually true).

And so such a study where highly tenuous correlations are made only serve as part of a broader issue of junk science, which doesn’t add much to the discourse but rather is done in some vein attempt to promote a narrative.

I will state though, that scientific endeavors may sometimes result in junk science. Many researchers may not know what results they will come across until many months and several experiments down the line, having to unfortunately come to terms with the idea that their results did not bear anything fruitful. And in some cases, a researcher may scrap together whatever results they have to try to put something out, which sometimes may be the case with such studies on tenuous correlations.

However, as I have covered recently this issue can appear rather commonplace.

Here’s a few studies I have noted recently where there have been a few improper associations and conclusions made:

• A new study on Long COVID doesn't actually look at Long COVID

  • To be fair to the researchers, the crux of their study wasn’t entirely on Long COVID. However, some have interpreted this article as suggesting that it somehow discredited Long COVID. Instead, I argue that the methodologies used make it impossible to determine who has Long COVID or who even has viral persistence.

• The NEJM wants to bring back masking school children

  • This is an assessment of a study published by NEJM in which the researchers suggested that school districts that continued to mask and lower infection rates compared to other school districts which removed masks. I point out that the use of “trend” here is probably improper, given that the increase in infection doesn’t show a trend that can be related to masking policies, but rather shows a correlation between vaccination status of children and infection rate. This doesn’t point to immune dysfunction being a factor, but points more to the fact that infection rates and behavioral factors may have contributed to increase in infections in the weeks following mask removal. More importantly, the study was part of a growing trend of voices trying to bring back masking, suggesting a more political motive in the reporting of this study rather than a scientific one.

• More COVID infections, more death?

  • This article looked at a widely spread study which suggested that more COVID infections were related to increased risk of worse outcomes. Again, when looking at the data I argued that the information, as noted in the Supplementary Material, actually points to those with more infections having poorer health overall. Therefore, it’s likely that those with poorer health may see repeat COVID infections, and it’s likely the poorer health that also puts them at risk of worse outcomes.

The point in outlining these posts above is to remind people that plenty of studies out there are flawed. Rather than argue that studies are flawed in general, it’s important to point out what aspects of a study are worth criticizing.

It’s also a reminder to not fall into the temptation of arguing based on group dynamics. We tend to immediately dismiss studies that go against ingroup narratives while citing studies that support such narratives.

Rather, it’s important to scrutinize all studies and see where the flaws may lie. Don’t be outright dismissive or supportive without understanding why to dismiss a study.

This is a serious problem in mainstream reporting, which tends to take studies at face value without examining the study in great detail. Because of this, many reporters do nothing but tout the remarks made by the researchers, rush to report, and move onto the next study to not critically asses.

Remember, it’s far more important to read studies than it is to report on studies. In any given case, we should be reading more in general anyways!

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1. Fensterl, V., Chattopadhyay, S., & Sen, G. C. (2015). No Love Lost Between Viruses and Interferons. Annual review of virology, 2(1), 549–572. https://doi.org/10.1146/annurev-virology-100114-055249

2. Essaidi-Laziosi, M., Geiser, J., Huang, S., Constant, S., Kaiser, L., & Tapparel, C. (2020). Interferon-Dependent and Respiratory Virus-Specific Interference in Dual Infections of Airway Epithelia. Scientific reports, 10(1), 10246. https://doi.org/10.1038/s41598-020-66748-6

3. Redelmeier, D. A., Wang, J., & Thiruchelvam, D. (2022). COVID Vaccine Hesitancy and Risk of a Traffic Crash. The American journal of medicine, S0002-9343(22)00822-1. Advance online publication. https://doi.org/10.1016/j.amjmed.2022.11.002