Yet another news article that doesn't link the damn paper.
"The hygiene hypothesis, the COVID pandemic, and consequences for the human microbiome"
> This pandemic intersects with a decades-long decline in microbial diversity and ancestral microbes due to hygiene, antibiotics, and urban living (the hygiene hypothesis). High-risk groups succumbing to COVID-19 include those with preexisting conditions, such as diabetes and obesity, which are also associated with microbiome abnormalities. Current pandemic control measures and practices will have broad, uneven, and potentially long-term effects for the human microbiome across the planet, given the implementation of physical separation, extensive hygiene, travel barriers, and other measures that influence overall microbial loss and inability for reinoculation. Although much remains uncertain or unknown about the virus and its consequences, implementing pandemic control practices could significantly affect the microbiome.
Hygiene hypothesis still seems dubious to me. The notion that hygienic lifestyles can lead to a weaker immune system or microbiome is plausible, but I'd actually be pretty surprised if it translated into worse long-term outcomes like life expectancy. Being exposed to lots of pathogens can have some pretty big downsides. We're only just beginning to understand long-term COVID symptoms and it's possible we've missed long-term symptoms of lots of pathogens. I have had chronic canker sores my whole life (cause by retrovirus) that I definitely could live without. ERVs kinda freak me out too.
Think of it this way: your body has machinery built to combat pathogens. If there are no pathogens to fight, the bar for what is considered a pathogen lowers until eventually those machines are attacking healthy tissue and can cause many issues.
Allergies, Lupus, and many others are already caused by similar mechanisms, and pushing society into ever more clean states will likely lead to more issues.
The only real cure would then be taking immune-suppresants.
Or we just need to embrace that nasty bacteria are a natural environmental feature important to our homeostasis
> a weaker immune system or microbiome is plausible
> Think of it this way: ...
OP already said it's plausible. Your image doesn't add to the evidence at all.
The truth is, we have no idea about immune and gene regulation. A lot of the simplistic understanding you learn in school is falsely making people believe the body is a "machine" we can control or even comprehend. Medicine doesn't know shit.
All we have, are some correlations with an increase in autoimmune disease, allergies and lymphoma, and increasing hygiene. Could also be microplastics or hormone disruptors, social isolation, stress, overweight, lack of sunlight, climate change... .
The immune system is insanely complex and a huge bag of innovation and legacy making many functions redundant and incredibly hard to decipher.
And some "healthy exposure" to pathogens really is a coin toss, as it may not be the contact, but surviving the sickness you benefit from. So a severe fever may slightly decrease your cancer risk, but comes at the risk of dying from, well, severe fever.
I don't think those are the only options. Once the diversity of human microbiomes are better mapped, it would seem be to pretty simple to manufacture a dose of healthy bacteria for your gut or your blood. Something that could be administered safely in a controlled dose.
That's my hypothesis for how homo sapiens goes extinct -- becoming ever more dependent on nature-shaping or external machinery to augment weakened selection pressure, but very fragile to sudden changes and always fighting fires.
I wouldn't argue that returning to hyper non hygiene would be better, but there has been a steady and remarkable rise in Autoimmune diseases, allergies, and asthma in the last few decades. Each of these conditions have long term consequences and complications. The hygiene hypothesis link to the microbiome and "training" of the immune system link is plausible and more and more research is backing it up. Moreover, given that the immune system and inflammation continue to be found to have a role in virtually every long term disease, the hygiene hypothesis should not be taken lightly. There are a variety of sources backing up my points, you can look around; just note i am NOT saying that any of the links are certain, just that the amount of evidence that does exist far surpasses the point where the hygiene hypothesis is dubious IMO, IANAD.
> The hygiene hypothesis link to the microbiome and "training" of the immune system link is plausible and more and more research is backing it up.
There is also the hypothesis that the plague epidemics caused a shift to autoimmune diseases because it needed humanity to shift to a more trigger-happy immune system.
Another factor could be the much better state of nutrition than in the old times. Malnutrition has massive negative effects on the immune response, and nutrition was pretty shaky for much of human history, so better nutrition could also cause some autoimmune issues.
Please note, i am not claiming certainty and there are studies that point against the hygiene hypothesis. I am just stating that there is a growing body of evidence for the links between household cleanliness (and use of certain household cleaning products) and microbiome disruption. And links between microbiome disruption and prevalence of disease. For the American obsession with cleanliness in the 1950's, two things: autoimmune is hard to diagnose and many suffered in silence for decades AND cleaning up a lot is distinctly different from the proliferation of chemically based cleaning products many of which containing anti bacterial ingredients. Many look at the trend of autoimmune rise starting in the 70's and 80's. Let's say you're right about the 50's cleanliness, the children born then might not have been diagnosed, the cleanliness trend started then but built up to have large effect over 20-30 years, and/or it took time for chemicals to proliferate into household daily cleaning.
I am NOT a tin foil hat wearer. I have an autoimmune disease and have researched the topic a lot. I am claiming NO certainty, just that the immune system is woefully insufficiently understood and that links with growing evidence should NOT be ignored.
It's interesting to me that urban living would be included in the hygiene hypothesis. Intuitively, I would expect all the extra contact and travel to increase exposure to microbes, compared to "everyone spends most of their time on their own farm".
Polio is a bit more complicated than that. It's usually harmless in infants; it became a major public health concern only when hygiene resulted in it being contracted later.
Epstein-Barr is similar, causing mononucleosis in teenagers but only mild symptoms in children.
Thank you for the nuance. We have trade offs we have to consider. Hygiene on balance improves health, but it has unintended consequences which we have to be aware of and need to be addressed.
There's a difference between being exposed to dirt and being exposed to viral diseases, though. Playing outside in the leaves will likely trigger healthy immune responses. Contracting COVID-19 may lead to long term health issues.
I think the hypothesis is that they aren't exposed to as many pathogens in general (due to increased sanitation/attention to cleanliness), not that the negative effects will be due to no exposure to covid (which doesn't appear very serious for infants in any case).
One of the known things is that babies who get seriously sick somewhere in their first year have a better immune system for life. So yes, failing to be exposed to viral diseases can be bad for you.
It's really a balance though. Some of those viral diseases could have permanent consequences that outweigh the benefit of a stronger immune system. For example, Polio could leave you crippled, or Mumps could leave a boy with sterility.
Do you have a link to the data for the claim about it being a serious illness that causes a better immune system? My understanding has been that exposure to a variety of pathogens and minor illnesses would be sufficient.
its standard practice in asia to wear masks if you are sick or worried about getting sick. its not standard practice to wear masks 100% of the time forever.
It's not just dirt. Traditionally people lived in close proximity to a variety of domestic animals. Most viruses originated in animals and then crossed to humans. So our immune systems evolved to cope with that exposure.
I personally doubt we need zoonotic diseases to calibrate a healthy immune response. I also believe the close association of people and animals was more salient to European populations than elsewhere, and furthermore we didn’t evolve in an environment where you could expose or be exposed to thousands of people on a regular basis. So I’m not sure I’m convinced by an anthropological argument here.
And IIRC, the hygiene hypothesis mostly has to do with autoimmune diseases and our immune systems not learning how to differentiate between serious threats and harmless exposure.
> Contracting COVID-19 may lead to long term health issues.
Uh-huh. And what percentage of people who contract have "long term health issues"? This is just more scaremongering based on self-reporting and anecdotes.
/sigh 30 seconds of Googling and you can find this from the BMJ
“Around 10% of patients who have tested positive for SARS-CoV-2 virus remain unwell beyond three weeks, and a smaller proportion for months (see box [1]).[7] This is based on the UK COVID Symptom Study, in which people enter their ongoing symptoms on a smartphone app. This percentage is lower than that cited in many published observational studies,[8][9] whose denominator populations were those admitted to hospital or attending specialist clinics. A recent US study found that only 65% of people had returned to their previous level of health 14-21 days after a positive test.[10]”
Only 10% of people with positive test results have "long term" health effects >= 3 weeks? Does that seem frighteningly out of the ordinary compared to other diseases?
When I had the flu or pneumonia in the past I could still feel effects over a month later.
a few extra weeks isn't "long term". Long term is years. How many people that got covid last march are still dealing with issues related to the illness today? My guess: an extremely tiny percentage.
> Researchers don’t understand exactly how the disease might trigger Type 1 or Type 2 diabetes, or whether the cases are temporary or permanent. But 14 percent of those with severe covid-19 developed a form of the disorder, one analysis found.
On the other hand, the "three quarters" is probably not the number that matters, since the vast majority of Covid-19 cases are not hospitalized. Looking at CDC data (https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...) it seems that roughly 6% of Covid-infected people with symptomatic illness get hospitalized; so if three quarters of those will have long-lasting symptoms then it means that if you get Covid, then your likelihood of having long-lasting symptoms is something like 4.5%.
On the other hand, while that risk is not that widespread, that still will mean millions of affected people.
Perhaps this comment is dangerous and problematic.
The idea that your ISP should be monitoring the semantic content of their customers is disturbing, and you imply that they should do something about content that, what?, they don't like? That they think is illegal? That the government tells them to report on?
This is constantly recurring debate on HN. What is the appropriate level of censorship? Who should be censoring? By what criteria is something censorable?
I emphatically disagree with the notion that ISPs should do the censoring. They should be neutral carriers of data.
In some peoples mind even questioning or being skeptical of many of the more extreme covid claims and actions is extremely dangerous. According to some “experts” we shouldn’t be allowed to research covid, look at public covid data sets, or even think very hard about it. We should, instead, have almost complete blind faith in a handful of “experts” and just roll over and do whatever they recommend.
A ton of our actions in the last 11 months have been accepted based on nothing but appeals to authority. More disturbing is how many real life people I talk with whose arguments for all our restrictions boil down to raw appeals to authority.
To be fair, some random persons datapoint wrangling can (and usually does) have large number of eyeballs than a life long trained professional with a PhD. While the data should be public and object to scrutiny (ideally by other experts in scientific community), how much insight would untrained people actually get? Apart from alternative facts and "just a flu". Many popular blog posts and opinions were proven to be flat out wrong.
If we don't trust the people dedicated to handle that kind of situations, who can we trust? I totally agree there has not been enough transparency (what panic would it cause if the scientists say "We don't know at this point. We think X Y Z, it might change completely in a month) about what we know, but I still would rather trust WHO/CDC (who have been proven incorrect multiple times) than some random forum with no credentials.
What politicians do based on these observations is a very different thing.
I still would rather trust WHO/CDC (who have been proven incorrect multiple times)
The problem is that when you use your authority to push something, and that something turns out to have been wrong or even a patronizing lie (e.g. masks, percentage of population required for herd immunity, predicted length of the pandemic), you lose all respect for your authority. See also "The Boy Who Cried Wolf."
>> what panic would it cause if the scientists say "We don't know at this point <<
this is the crux of message management; panicing people are desparate for return of predictability, anyone who provides that will have happy customers for a while.
the idea that the information in raw form that the professionals use is somehow not of public utility needs to go away. this is part one of a double punch the next being the discovery that while data was sequestered, the general populus was lied to about it. Not that that IS what is happening here, but getting caught out doing that is beyond discrediting.
its not good policy to build an abberant world view among your population that will culminate in being crushed by reality, this is why people panic in the first place, and the solution seems to be keep cycling that way so that panic is assauged by building another alternate belief that looks comfortable. its like the trope where someone is hiding/slash disposing of the body while having a conversation accross the house designed to prevent someone walking in before its all hidden away.
The OP made an unsubstantiated claim with no evidence, why can't I call that out? There are plenty of things you could catch from playing in dirt that could lead to long term health problems.
We're trying to avoid the online callout/shaming culture here because it damages the container and destroys the sense of community. Internet forums all too easily turn into a war of all against all, or at least tribe against tribe. That's not compatible with curious conversation, which is the purpose of this site.
Fortunately you can make your substantive points without breaking the site guidelines. For example, if you had simply posted your last sentence here, that wouldn't have broken the site guidelines.
how do you supposed herd immunity develops without low level exposure to viruses and organisms (which is what's in the dirt)? it's quite likely we've prolonged the pandemic by excessively curtailing exposure, which in turn dampens in vivo immune response necessary for natural herd immunity in the population.
the 1918 flu, which killed 10-20% of the infected, was worthy of that kind of avoidance response, not this virus that kills much less than 1% (and maims far fewer, contrary to your claim). the tiresome messaging (fear strangers and non-conformists; trust our "science", not theirs) of politicians and sympathetic media played this pandemic for maximum political & economic gain, not minimizing impact. it's disgusting.
Have you heard of any coronavirus variants coming out of South Korea, China, or New Zealand? No. That’s because they don’t have uncontrolled spread there, which leads to mutations due to the virus’s exposure to heterogenous immunity in the population. So uncontrolled spread doesn’t necessarily shorten the duration of the pandemic.
All of which is actually incidental to the point I was making, that the hygiene hypothesis is about exposure to dirt and pathogens that prime your immune system for healthy responses. You can have healthy exposure to dirt without exposure to whole classes of viral diseases. No one’s going to say you have to catch Ebola to solve the hygiene hypothesis, for example.
>Have you heard of any coronavirus variants coming out of South Korea, China, or New Zealand? No. That’s because they don’t have uncontrolled spread there, which leads to mutations due to the virus’s exposure to heterogenous immunity in the population.
That's one hypothesis.
Don't particular populations already have a degree of natural herd immunity to viruses which are commonly found in their proximity, compared to populations on the other side of the world who do not?
Like how Europeans brought their diseases, which they had built up immunity against, to the Americas which then decimated the indigenous populations.
Could we hypothesize that many Asians have a stronger natural immunity to covid19?
The term you’re looking for is cross-reactivity and it’s possible that populations have some cross reactivity to COVID. In fact, I’ve heard a hypothesis that the pandemic of 1890 was the predecessor of one of the common cold coronaviruses.
Regardless, New Zealand is clearly not an Asian country.
I think the idea is that not every virus is Covid or Ebola. If you oversanitize your way out of every common cold, then the more serious diseases hit harder.
mutations happen not as a response to effective defenses as implied by 'heterogenous immunity', but because the replication process is chaotic, introducing a range of defects and accidental benefits. it's a random process as likely to prolong as it is to shorten the duration, so has no persuasive power in your direction.
as for your second point, we're exposed to coronaviruses of all sorts already (viruses that have spike proteins)--the relevant class of viral disease here--and that's what's likely to have conferred mild/asymptomatic cases in the majority of the infected.
It's frightening how much censorship there is around non-consensual views on covid. Sure there are a few nutters blaming 5g masts, but there are plenty of legitimate criticisms of the way it is currently being handled. The Great Barrington Declaration has numerous signatories from well respected scientists, however it is dismissed, without any debate and lumped alongside antivaxxers and conspiracy theorists for taking the wrong view.
The great barrington declaration also doesn’t have a single scientific claim that is backed up with any research.
The top HN comment of any article with more than 10 comments on it will always almost have more content and less fluff than the great barrington declaration.
>The declaration calls for individuals at significantly lower risk of dying from COVID-19 – as well as those at higher risk who so wish – to be allowed to resume their normal lives, working normally at their usual workplaces rather than from home, socializing in bars and restaurants, and gathering at sporting and cultural events.
>The World Health Organization and numerous academic and public-health bodies have stated that the proposed strategy is dangerous, unethical, and lacks a sound scientific basis.
>It was sponsored by the American Institute for Economic Research, a libertarian think tank that is part of a Koch-funded network of organizations associated with climate change denial
Here is a challenge for you. Find out where the idea for lockdowns came from and the science behind those. (There is none - we just blindly copied an authoritarian regime).
Here is a challenge for you: participate in discussions for a whole week without changing the subject as soon as your claims are called into question. You began with the Great Barrington Declaration; you cannot simply Gish gallop on Hacker News.
I think there are plausible counterarguments, but the results in, for example, Sweden look much like France, and the results in Belarus look much like other eastern European nations (which is to say, better than western European ones). Not that either Sweden or Belarus did nothing, but it does suggest that the measures taken by most countries, did not have an enormous impact, if any. Japan did less than most countries in Europe, but their total cases and deaths per capita are <10% of any nation in Europe (which is not to say they are zero or even negligible).
Again, regardless of what you believe, on balance, of the article's implications, the phrase "utter nonsense" suggests that it is not worth thinking about, and it clearly is worth thinking about and researching, at least.
It's a misconception that all wet markets transmit disease; they are basically markets that sell fresh foods like vegetables. A portion, probably a minority, sell "exotic" animal meat, and even then "exotic" is a biased perspective.
I've always liked how when talking about Ebola in Africa people use the phrase "Bush Meat", yet when my family goes hunting it's "Wild Game". China should just rebrand these to Farmer's Markets.
There will be most likely no changes to how we used to do stuff.
I, for one, wouldn't mind screens in the shops and some protection for the cashiers. Its probably the biggest factor for spreading flu, since they are huge point of contact.
But it won't happen. The moment we beat the covid, everyone will rush to strip and burn anything that is remotely related to covid.
What makes you think that a vaccine will eradicate this disease? We have vaccines for many diseases that still exist today - influenza, varicella, etc. Even polio has proved tricky to globally eradicate, and vaccines for this have been in existence for over 50 years. The diseases that have been essentially eradicated, such as smallpox, is something that does not require vaccination on a continual/annual basis.
Covid has been mutating and spreading to other species. It is also believed that immunity is short lived, about 1 year. The virus will be endemic (if not already) in global wildlife and agricultural animal populations indefinitely. This will mean that you can't eradicate it and what yearly vaccinations will be required. This also presents the potential that new mutations will continue to emerge and that one or more will not be protected against by the vaccine.
These concerns don't even address that parts of the population will refuse to get the vaccine. Or that the vaccine does not completely protect against infection/transmission, as seen in it's effectiveness being measured as preventing severe symptoms (which is part of why you still need to wear a mask after vaccination).
Yea, it's kind of a pessimistic take, but is there strong evidence that this won't be just like the flu, where you need to vaccinate every year to keep up? Even with vaccinations and widespread coverage, it's really hard to totally eradicate a viral disease.
So far they believe all the know strains are still covered. Nobody knows if that will continue to be the case. The MRNA vaccines are targeting the spike protein, which is what gives it many of it's infectious properties. If it does mutate to change or eliminate that spike, we might get lucky and those strains won't be as serious, but nobody can predict the future.
Just an FYI, spike protein is used by virus as means of entering a healthy host's cell. Without it virus becomes like a c4 without detonation cap. More less harmless.
And it's annually, not just once and done for eradicated diseases, like smallpox. The vast majority of the population would have to take the vaccine every year. That's going to be a challenge to keep the population vaccinated.
When the average 36 year old American overestimates their chance of dying from covid by 1000x and any comment that goes against the “be scared” narrative.... when I get called “dangerous” for posting public data from state covid dashboards because my post shows this isn’t that bad, relatively speaking.... a lot of people are gonna have some serious long term mental trauma.
It seriously feels like people want to this to be the worst thing ever.
> As occurred in the spring, COVID-19 has become the leading cause of death in the United States (daily mortality rates for heart disease and cancer, which for decades have been the 2 leading causes of death, are approximately 1700 and 1600 deaths per day, respectively4).Dec 17, 2020 [0]
How do you argue with statistics? Its leading cause of death.
Depends on the methodologies used and the conclusions drawn from the numbers.
For example, the parent comment was claiming that the average 35 year old overestimates their chances of dying from covid. Your comment states that covid is the leading cause of death. I believe both statements are true. You can see some of this in a quote from the article you posted.
"In contrast, for individuals younger than age 45 years, other causes of death, such as drug overdoses, suicide, transport accidents, cancer, and homicide exceeded those from COVID-19."
And that's a third point that isn't necessarily in agreement to the others, but doesn't refute them either. It's hard to say what it would look like for that age group (<45), or any other, without the current restrictions.
Just to point it out in the age sub groups under 45 in the previously linked article, to become the leading cause of death in each one would require a 2x-15x increase in covid deaths. I'm not sure what that means for this conversation since my main point is that none of the numbers or arguments being thrown around in this comment chain directly relate to each other - there seem to be 2 or 3 separate arguments that are only tangentially related.
"A wet market (also called a public market or a traditional market) is a marketplace selling fresh meat, fish, produce, and other perishable goods as distinguished from "dry markets" that sell durable goods such as fabric and electronics"
Some of us, at least in the UK, remember the BSE ("mad cow disease") mess. That could have turned out very much worse than it did (though it was plenty bad already).
I think the issue would be with bush meat, not with markets that carry non dry goods? Wet markets on the whole seem pretty innocuous: https://www.youtube.com/watch?v=whbyuy2nHBg
The Ottawa Citizen said the paper was published in "the journal Proceedings of the National Academy of Science in the U.S." and listed one of the authors as "Brett Finlay"
> It has a heading "PERSPECTIVE" -- is that like an op-ed for science?
It depends on the publication, but may often have much more rigour than the short prose format typical in a traditional newspaper op-ed. For example it could be a multi-author piece with extensive references and figures, and is a 'perspective' in the sense that it presents an academic summary of some topic for non-specialists.
That stuck out to me too: they imply obesity and diabetes are some sort of symptom of a diminished immune system, when it can simply be explained by portion size inflation. To add insult to injury, obesity will cause an inflammation response, hampering immune systems. It's also possible obesity could be linked to overall weakened immune systems.
On the other hand, my kids are spending a ton more time playing in the dirt of the backyard than they did pre-COVID when they would hang out at friends houses. That is probably having a positive effect?
The pandemic has also had a severe impact on the mental health of many people.
Lockdowns and their consequences have been well-covered, but there also seems to be some effect on people (kids especially) that could be pre-disposed to obsessive-compulsive behaviors, with the constant stress of this looming threat causing children to start obsessively washing their hands and becoming extremely cautious not to get infected.
We will be dealing with the fallback long after life returns to "normal".
At a meta level, I’ve begun wondering if we as a society could plausibly “return to normal”. It seems to me that time only moves forward. We can’t un-experience the pandemic. It’ll be with us for a long, long time.
Is it just me or are a lot of people going overboard with hand sanitizer?
I find it odd to see people applying hand sanitizer even though they've just left home and are visiting one place. Then you see people constantly applying hand sanitizer when entering shopping complexes and visiting various stores.
Personally, I try to limit my use of hand sanitizer because I have sensitive skin. Also I'm in Australia where we don't have major outbreaks right now.
Not to throw too much water on the joke, but in fact modern urban dirt has a distinctly different microbiome than the earth we'd have traditionally lived on. Everything coevolves.
"The hygiene hypothesis, the COVID pandemic, and consequences for the human microbiome"
> This pandemic intersects with a decades-long decline in microbial diversity and ancestral microbes due to hygiene, antibiotics, and urban living (the hygiene hypothesis). High-risk groups succumbing to COVID-19 include those with preexisting conditions, such as diabetes and obesity, which are also associated with microbiome abnormalities. Current pandemic control measures and practices will have broad, uneven, and potentially long-term effects for the human microbiome across the planet, given the implementation of physical separation, extensive hygiene, travel barriers, and other measures that influence overall microbial loss and inability for reinoculation. Although much remains uncertain or unknown about the virus and its consequences, implementing pandemic control practices could significantly affect the microbiome.
https://www.pnas.org/content/118/6/e2010217118