Terrain Theory vs Germ Theory

[dann]

I respectfully disagree with this portion of your comment. IMHO terrain theory puts too much of the responsibility on the individual, in the sense that it implies that if you get sick, it is your fault. Some people are born with subpar immune systems (the genetic condition SCID comes to mind), and others become immunocompromised from lymphoma or other diseases. It also ignores the fact that new pathogens appear and old ones evolve. However, I would agree that terrain theory can appear reasonable on the surface. Nor do I disagree with the proposition that good nutrition and exercise are important components of good health.

It's a little more complicated than that, and it's important when people divide themselves and others into two groups: those with strong and those with weak immune systems. For instance when they are talking about COVID-19: 'I have a strong immune system, so I've got nothing to fear. I see no need to get vaccinated.'
You may have a pretty good immune system until you run into that new infectious disease that your otherwise strong immune system just doesn't handle very well even though it was able to tackle all the others. And unfortunately, that isn't something that you know until you run into it.

There are also immune systems that are so 'strong' that they react to innocuous stuff that would be harmless if it weren't for the (too) strong reaction to something that isn't even a pathogen, but may nevertheless kill them because of the immune response: Anaphylaxis (Wikipedia).

Sometimes COVID-19 may kill you, not because your immune system is too weak, but because its reaction to the infection is too strong:
Cytokine storm (Wikipedia).

 

[Chris_Halkides]

dann,

You make some valid points, but you did not directly address the issue that I hoped to raise; my phrase "subpar immune system" is vague enough to be unintentionally misleading. One type of SCID (severe combined immunodeficiency disease, a.k.a. boy-in-the-bubble-disease, from a television movie) is a genetic deficiency in the enzyme (deoxy)adenosine deaminase. Because of this hereditary deficiency, deoxyadenosine triphosphate (dATP) is found at higher concentration inside the cell than normal, and it binds to a regulatory site on the enzyme ribonucleotide reductase, the enzyme which produces the four critical precursors for the synthesis of DNA. When dATP inhibits ribonucleotide reductase, the slowdown of DNA synthesis prevents the rapid proliferation of specific cells needed for the adaptive immune response. My point is that one cannot reasonably blame a person who has SCID and who gets sick from an infection for poor lifestyle (diet, exercise, etc.) choices. I recall a rant from Del Bigtree about Covid-19 along these lines, but I don't remember where I read it. If a person suffers from SCID, the fault is in their stars.

 

[Chris_Halkides]

At Science-based Medicine David Gorski wrote, "You can see where I’m going with this in the age of COVID-19 and why pandemic deniers and minimizers might be attracted to the 19th century ideas of the “terrain” being more important than the “microbe,” namely for the same reason that antivaxxers so frequently lapse into germ theory denial and invoke Béchamp and/or Bernard. (Examples include Kelly Brogan and Andrew Wakefield) After all, if SARS-CoV-2 is not the “main” cause of COVID-19 and severe illness, then all those public health interventions, such as masking, “lockdowns,” and vaccines become superfluous and unnecessary, if not actively harmful. I’ll discuss this aspect more near the end of this post. I’ll also prime you by suggesting that, even if you’ve never heard of Claude Bernard, Antoine Béchamp, or “terrain theory” before, I bet you’ve encountered these ideas being invoked by quacks, antivaxxers, antimaskers, and anti-“lockdown” activists."