Are there psychosocial ways to protect yourself from the flu? Given the stakes here, it seems irresponsible not to investigate this method of protecting our lives.
Let me state clearly a research question that I realize borders on heresy, that touches profound social and religious emotional content and can lead to heated disputes:
Hypothesis: There are psychosocial actions we can take, that we are not currently taking, that will substantially reduce morbidity and mortality from any epidemic of infectious agents, including pandemic flu.Given the emotional and controversial nature of this research question, we need to establish a framework and set of ground rules immediately, to withstand the emotional riptides that will tend to distract us or defeat us from a systematic investigation.
Item one - do we really NEED to look at this question? Aren't current precautions adequate?
No, current precautions are a good idea, but are not all we can do.
Avoiding exposure to the agent of a pandemic is close to impossible for those of us who have to work for a living, and who don't live self-sufficient lives on remote islands with everyone else we care about on the island as well, with no imported goods at all.
It is likely that the drugs on the market will be at best partially effective, if that. In any case the drugs will almost certainly only provide symptomatic relief, since it takes 6 months or longer to develop a successful vaccine. Even then, that vaccine would be very expensive and hard to obtain, unless you are very rich and very well-connected, which most of us are not.
So, regardless, we know that
- some fraction of us will end up being exposed to the infectious agent,
- some fraction of those exposed will end up being infected, and
- some fraction of those infected will die.
Classical epidemiology is concerned with reducing the first term in this equation, the odds of being exposed and infected, by use of hygiene and limiting the travel of those who are infectious.
Classic epidemiology assumes that the "susceptibility", or odds of getting sick, given that you have been exposed, is simply a fixed fact of life, a "given" that we have no control over.
That assumption is now proving to be false, which is good news! We do in fact have some control over how susceptible people are to infectious agents, given the same level of exposure. The amount of stress a person is under, for example, affects how susceptible they are. So does the degree of fatigue. Other psychological and even social factors can come into play to reduce the odds we will "get" a disease we are exposed to.
(Literature references will be forthcoming)
OK, so then we have to ask whether we are simply passive sheep, where each of us has some degree of those protective psychological and social factors as "given", or whether we can individually and / or collectively improve our odds of survival by systematically changing those psychological and social factors in our lives.
These factors almost certainly have at least components that take a long lead time to change, so this is a largely proactive question. Most of the things we can change are not things we can wait to the last minute to see if we are exposed, and then change. If we're going to decide to change them, we need to start now, so that by the time we need this beneficial protection, it has had a chance to swing into place and take root in our lives.
Let's start with a literature review of the factors that some research has shown are effective in some cases, and then I want to take an intellectual leap and generalize from those and discuss what kind of new model of human health would make those factors "obvious", and what other factors that model suggests as well. (This journey will take many posts, so let's get started.)
Where the evidence is weak or non-existent, this approach should suggest some very specific research questions that could be done to nail-down whether this effect is present or not, and if present, how strong it is.
That doesn't mean we can't start our investigation by combing historical literature, including that going back thousands of years, for any hard-won social knowledge or even allegations of this kind of effect in action.
Of course, in all of recorded history, humans have taken all kinds of steps to ward off disease, most of which involved attempting to appease various deities, or influence the gods to go somewhere else and pass over our own houses. Various methods of trying to influence the outcomes , some quite creative, are documented in the sacred writings of each religion.
The single axis or dimension that seems to be emerging from research today involves the degree of social connectivity a person has, and the direction of the effect is that higher social connectivity is very strongly associated with better outcomes and lower death rates when people are exposed to the same risk factors.
The mechanism for this effect is highly controversial. Some of the effect is surely related to the fact that people who are well connected have access to greater resources to deal with any problem. Some of the effect is undoubtedly due to a selection process, where those who are already good survivors have, among other things, made strong social connections.
In my own thinking, there should be, in principle, some very important variables related to the existence and strength of closed regulatory feedback loops between a person and other persons and groups that the person "belongs to." People might articulate this as simply having a strong or close relationship with some other person, but, mathematically, the bidirectional causal and regulatory feedback loop seems a very likely place to look for causal pathways to changes in physiology.
Cutting through all this -- does it help to have strong relationships with other people? Yes, it certainly appears to help. The number and the depth of the relationships seems to matter, as well as the nature of the relationship. Some groups we belong to, which means we are on their mailing list, and other groups we belong to, which means that very membership changes our concept of who we are and the meaning of our lives, and changes our behavior. It's far more likely that the latter kind of strong bond to a group is going to have more impact on our health than the weak bond of simply "belonging" to a list-server's list of members.
Does it help to have a support group and supportive friends? Well, yes, it does, not too surprisingly.
Does it help to love others, to love nature, and to love God? Again, measuring these variables and what they mean is a problem, but, yes, an increase in the "love" factor is clearly strongly associated with better outcomes. Again, the direction(s) of the causality is not instantly clear.
Without any additional research, cutting through all that, it appears that what helps is being well connected socially, meaning that one has an active social life and is vitally concerned with and involved in a co-nurturing and co-supportive relationship with other humans.
This type of effect is documented by, say, doctor Dean Ornish in his book "Love & Survival - 8 pathways to intimacy and health."
There are thousands of ways to try to define "love" and "intimacy", but the aspect of both that seems to me most fruitful for study is the breakdown of walls between two or more people so that a larger entity, a meta-being, is effectively created, or synthesized, or simulated or whatever it is. It is not a question of whether I am near you, or touch you, or live with you, or have sex with you -- it is a question of whether it is increasingly hard, over time to tell where you stop and I begin. Are our core identities becoming so co-mingled that we effectively have stopped being two "beings" and started being one "being" which sort of occupies two "bodies."?
I have to note at this point some research done on cells, which I think is relevant. Researchers found ( I'll get the reference) that a cell with damaged DNA, that left to itself would die, could in fact continue to live and even operate normally if it was surrounded by healthy cells that the cell in question could sort of lean on and draw support from. The cell, in fact, was capable of getting by with a little help from its friends.
Restating the hypotheses here, before taking a break in posting - we have this.
Restated hypothesis: viruses and bacteria that attempt to infiltrate and infect a human have a harder time doing that, and cause less damage and less death, if the human is part of a multi-human meta-being with strong bonds between the humans.
In other words, the hypothesis is that we can, effectively become sources of spiritual strength and buffers for each other, that translates, in a very real physiological sense, into very measurable improved medical outcomes in a variety of areas, at least one of which is increased resistance to infection and another of which is increased survival, even if infected.
These effects should be quantifiable, and observable. If they are strong enough to be socially relevant, we shoudn't even need statistics to see the effects, although we'd want to use solid statistical methods to be sure we weren't simply fooling ourselves with distorted perception from wishful thinking.
Let me state my own bias immediately -- I believe there are such effects, that they are very strong, and that we are missing a huge piece of our armor against pandemics if we don't systematically take advantage of this effect as both a personal and a national policy.
I also believe that there are technological ways to use the web and computers to help us detect, align, focus, amplify, and improve these effects by a factor of 100 or more. I'm talking here about a next generation of "social networking" tools that is less about exchanging messages with a network of friends and more about systematically deepening mutually supportive living relationships with a network of friends.
We can now find, see, and track each other, and exchange messages and thoughts and even moods planet-wide. Now, the next step, the next generation, is to utilize that level of capacity to build the next level, one of strong, real, living, vital relationships.
It is in a way a grand experiment in artificial life, or meta-life. What happens if the individual humans now figure out how to merge spiritually into larger living organisms?
Here's a thought though -- IF that kind of merging DOES have a protective effect against death from pandemics, then there will be strong evolutionary advantage to such meta-forms, and, effectively, a pruning from the world of those humans who did NOT elect to participate in such larger life forms.
In my mind, there is sufficient evidence that such an effect might occur to put some time and effort into looking at this much more closely and pondering what it means. If the coming pandemics, and there will be more than one, are evolution's "rinse cycle", what kind of humans will they be rinsing off, and what kind of humans will remain and survive after the pandemics have come and gone?
That's a question we need to be looking at with some urgency. The mortality from pandemics may not be "value-neutral."
Along those lines, and again searching recorded history for any possible examples of effects, the black plague in the middle ages in Europe was followed by the Renaissance. We can't rule out there being a causal relationship, where the plague selectively removed humans who were, in some sense, dead wood, and left humans who were, in some sense, more vital and alive. This kind of event might provide us insight into what kinds of non-neutral impacts pandemics have, or might have, or could have.
While the data's being analyzed, however, I'd suggest putting more energy into increasing your own honest and intimate social connectedness, and less energy into attempted solutions involving drugs, or involving trying to acquire so much wealth that you don't "need" other people. If humans are transitioning to a "multi-cellular" state, that ship is getting ready to leave soon, and it might be the better part of wisdom to be on it.
( Image from "divergent learner" in Second Life virtual reality world, via Flickr ).=====
afterthought -
Because LIFE is intrinsically hierarchical, and unbreakably interconnected, we'd really like to find solutions to problems that are win-win-win solutions -- that is, solutions that help EVERY level of the multi-level organism, not just one level at the expense of others.
So, for example, on the national scale, we can reject immediately proposed policies that help "labor" at the expense of "management", or that help corporations at the expense of humans, or that help corporations at the expense of the entire government. These are all win-lose type policies, and clearly sub-optimal.
An example of a win-win-win solution for example, would be something more like a Toyota, or other company that tapped into the emergent power that comes from interconnecting the workers and management and customers into a mutually-supportive network that feels each other's pain and shares's each other's successes, and otherwise has linked fates.
Not too surprisingly, very high-performance teams, and very high-quality teams, and very high productivity teams, all seem to share this quality of a merged sense of identity, shared success, and overflowing power and energy. They are typically extremely rewarding places to work, pay very high salaries and wages, have very high retention, and are simply fun to be at and something people actually look forward to going to in the morning, not someplace that one has to "go home from to get any work done." They are, in short ultra-competitive, and just as Toyota has displaced General Motors, this type of organizational structure will selectively and differentially surivive where others fail and evolve into the dominant form, regardless what one thinks of it or whatever political label one assigns to it.
It's simply a stronger evolutionary model, and it survives where other forms fail, in exactly the same way that multicellular life (such as ourselves) turns out to be a winner over single-cellular life, regardless how large and wise and wonderful said single-cell might be.
Networks of tightly collaborating agents, or computers, or people, are "unbounded upwards" and able to go where fragmented, isolated, competitive structures cannot travel. That's just the way it is.
This goes along with the idea that all "state-variables" or crucial model variables are "holons", or scale-invariant fractally symmetric shapes. Two prime examples are "health" and "wealth".
Something that actually improves "HEALTH", properly accounted for all distant and lagged effects, will be found to improve the health of EVERY level of the hierarchy. Toyota's health also translates into employee health and into national health for Japan, and spreads into health of all Toyota's supplies. Ditto Wealth.
Beware of proposed solutions or policies that emphasize the "health" or "wealth" of one group "at the expense of" others. This is typically a flawed accounting of all the lagged effects, and efforts to boost corporate productivity on the backs of and at the expense of employees will end up back-firing and making things worse. Ditto for public health -- there are not actual solutions that make employees healthy at the expense of the corporations that employ them, there are only transient states that will decay to reveal a final state worse than the first.
It makes no sense to seek other than win-win solutions. Properly accounted for, they are the best we can do.
Wade
