Not so random

New research into the Spanish flu outbreak puts a medical myth to bed

Who gets ill? Anyone, says the doctor, who believes nobody is immune. Disease is blind, he argues: it afflicts the young and old, the healthy and the infirm.

WDDTY columnist Dr Sarah Myhill would disagree; she has followed a strict low-carb keto diet for many years, and she claims she hasn’t had even the mildest cold in the last 10 years or more.

She has a point. It’s estimated that up to 80 percent of all cancers are the result of poor lifestyle choices, and type 2 diabetes—the precursor of heart disease—is even described as “the lifestyle disease.” Most diseases have an inflammatory element, which is an immune reaction to poor nutrition or environmental factors, and most also start in the gut, with the microbiome of bacteria that is sensitive to almost everything we do.

Sarah is likely an exception, and we lesser mortals do get sick, but perhaps our lifestyle can at least dictate the severity. Healthy eating, exercise, good sleep and low stress combine to determine the course of many diseases, even if they don’t stop us getting ill in the first place. And what our healthy diets haven’t achieved, improved public hygiene, sanitation and housing have.

Not a controversial argument, perhaps, but it’s one doctors have not been trained to fully embrace.

They point to the Spanish flu pandemic of 1918, which infected more than 500 million people around the world. Doctors assumed then that many in the 60 million death toll must have been healthy individuals because so many people fell ill so quickly. The idea caught on quickly and was supported by the narratives from the time until it passed into the medical paradigm of the randomness of disease.

It was a chilling idea, and one that’s still with us today. It was the unspoken, subliminal undercurrent of the recent Covid-19 outbreak, for instance. Not just adults but the young, and even the very young, were encouraged to have the vaccine.

Yes, the mass vaccine rollout was purportedly done to protect the elderly and infirm, but everyone who was jabbed would be protected. In vaccines did we trust, or we thought, to misquote one of Macbeth’s witches, by pricking our thumbs, nothing evil this way comes.

But none of this is true. New research from McMaster University in Canada has discovered that the Spanish flu didn’t kill the young and healthy indiscriminately after all. Just like the Covid virus, it primarily killed the old and infirm.

The researchers examined the skeletons of 369 people who died between 1910 and 1938. Separating out those who died before the Spanish flu pandemic and those who died during it, the researchers examined the remains for lesions, indicators of stress. Those with the most lesions were also the frailest, and they were the ones who died during the 1918 pandemic.

In other words, the healthy didn’t die during the outbreak but years afterward. Those who died during the epidemic had signs of “environmental, social and nutritional stress.” They were malnourished and had poor immune responses to infection, perhaps not surprising after four years of deprivation during the Great War that had ended that year.

As lead researcher Amanda Wissler made clear, “Our circumstances, social, cultural and immunological, are all intertwined and have always shaped the life and death of people, even in the distant past.”

Yes, even as far back as the Black Death, the bubonic plague outbreak that ravaged Western Europe in the mid-1300s. Again, we’re told it was a random killer of young and old, both the healthy and infirm, but the McMasters researchers point out that its victims were more likely to have suffered “environmental, nutritional and disease stressors.”

The same was true for the Covid outbreak. Racial and institutional discrimination amplified the lethal effects of the virus, the researchers said, and it was the elderly and infirm who were the most vulnerable.

“The results of our work counter the narrative and the anecdotal accounts of the time,” said Wissler . . . and of every time before and since.

We influence the course of disease by our lifestyle choices. Full stop.

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