I’d like to ask you three questions that we still don’t know the answer to. I’d like to know that answer because I think it would help us get to a better place.
Question 1: What is the denominator?
Whenever we have cases of an illness or a disease and it has bad outcomes, like people dying – that’s the numerator. The denominator is how many people actually had it in the first place. That would tell us if one person had it and died from it and a 100 million people had it. That’s very different than one person having it and dying from it and two people having it. Those are completely different things. One death, but over a very different denominator.
We still don’t know what the denominator is, mainly because of our lack of ability to do serology testing, which is a blood test, looking at people’s antibody response to see whether they’ve had Covid-19 and recovered. They may have had it without symptoms. Some early studies coming through just this week from the US show there is a magnitude of difference between the actual cases, through our current testing methods, and serology.
I haven’t heard a single journalist in Australia or New Zealand ask about serology or ask governments why we aren’t doing serology. I think those are questions that the public should be asking. Because without knowing what the denominator is, we don’t actually know what we’re dealing with.
Because without knowing what the denominator is, we don’t actually know what we’re dealing with.
Clearly, people are dying, and we want to avoid that. But how lethal is this? We don’t know that answer still.
Question 2: Why are we not talking about metabolic syndrome and metabolic health?
Dr Aseem Malhotra wrote about this from looking at the NHS data just earlier this week – you have up to a 10-fold increase in the chance of death if you have metabolic syndrome and its associated downstream factors of chronic disease. And that gives us a clue about probability of survival once you’ve had this, and it is around maintaining a stable blood glucose. It’s around not being insulin-resistant, not having prediabetes.
If you look back in the literature about respiratory illnesses and the ability of your immune system to respond in a favourable way, it’s all about keeping your blood glucose, your insulin and your metabolic syndrome risk factors, your blood pressure and those sorts of things, under control.
We’re also not talking about cardiorespiratory fitness as part of metabolic health. We’re used to thinking about cardiorespiratory fitness as talking about the cardio part. But cardiorespiratory fitness has a second part, it’s called respiratory fitness – this is the capability and capacity of the lungs. Exercise and being fit increases that. If you’ve got X damage to it from the disease over Y available space, compared to X damage over Z available space, you’d rather have the bigger respiratory capacity, Z. This is just not talked about at all. We’re spending billions of dollars a day. Why is this not a topic?
Going forward, why is being metabolically healthy not one of the most important things we do?
Question 3: What about vaccines?
That’s the great white hope, isn’t it? We’re going to invent a vaccine. Well, when you start to look into the literature around vaccines for coronaviruses, which is the common cold variety that this came from, there’s never been a vaccine invented. It hasn’t been possible. And even the vaccines for SARS and the like ended up doing more harm than good. So we still don’t know if we can develop one. In addition to that, people respond variably to how effective they are.
For example, the vaccines are least effective on older men, presumably because they’ve got more metabolic syndrome and more metabolic risk factors, and they have trouble producing antibodies. So influenza vaccines have about a 30% efficacy for men over 65. In other words, 70% of older men don’t respond to them.
The good news is there is some improvements in the efficacy of vaccines with nutrition.
There’s actually quite a strong literature on probiotics and its ability to develop, and even double, people’s immune response or immunity by producing antibodies to viruses. So again, metabolic health is important.
- What is the denominator? Still don’t know. Need to know. Urgent. Start asking questions about it. Look it up. Keep asking, because that’s crucial.
- Why aren’t we talking about metabolic health, for goodness sake? Nutrition and cardiorespiratory fitness in particular are crucial.
- Why are we putting all our hopes on something that doesn’t even exist and may not exist? Not saying that a vaccine can’t exist. And even if it does exist, we don’t know how well it’s going to work and how much good or harm it’s going to do.