The Thieves of Time

Getting old is not just about the number of years you've lived. It's also about how many times you've gotten sick.

Our body’s natural defenses against disease are comprised of many different components. Of these, there are two that stand out: our skin and our white blood cells.

Our skin provides the first and most powerful protection against disease: barrier protection. Like the wall along a country’s border or a moat around a castle, our skin prevents invading pathogens from getting inside in the first place. And if it doesn’t get inside, it can’t do any damage.

Simple as that.

However some things do manage to get inside. No matter how well we try to tape over the inevitable holes in our barrier skin with condoms, masks, goggles, etc. And there are always enemies lurking within us against which we must protect ourselves and against which the skin can provide no protection — enemies such as cancer.

For all those we have white blood cells. White blood cells come in a dizzying array of types, if not colors (they are all “white” after all), with each type specializing in a specific function from “eating” bacteria to manufacturing antibodies to creating immune memory to killing our own infected cells.

It’s really not necessary to obsess over which specific type of white blood cell. What’s necessary is to know they’re all white blood cells.

And that they all come from the same place (bone marrow) and that we are all born with a fixed number of them.

The latter is not literally true as we continue to manufacture white blood cells in our marrow into early adulthood. But the amount we manufacture drops off precipitously after about age 20 so that by the time one reaches their early thirties it can safely be said that they’ve got all the white blood cells, brain cells and eggs that they’re ever going to have.

Critical to understanding why we die is understanding that we have a fixed amount of biological material with which to fight off death. And that the more rapidly we deplete that biological material (white blood cells), the more rapidly we approach our own death.

It is as comforting as it is fashionable to think of the immune system as akin to a muscle: something that needs to be “exercised” or it will atrophy. Nothing could be further from the truth. The immune system is like your car’s gasoline tank (or battery) — the more you use it, the less there is of it left.

Our immune system is constantly fighting the enemy from within: cancer. Each of us has likely “had cancer” hundreds or thousands of times in our lifetime and will never even know, because our immune system eliminated the cancerous cells before they got a running start.

Every time your immune system kills a cancer cell, every time it fights off a nasty head cold, every time it prevents a cut finger from being infected, it uses up some of your limited number of white blood cells.

Your immune system doesn’t get stronger every time you use it. It gets weaker every time you use it.

Infections Cast a Long Shadow

If the depletion of white blood cells with successive immune responses wasn’t bad enough news, we’ve got some more for you. Not only do we have fewer and fewer white blood cells available to fight disease as time goes on, but the ones we do have left become less and less capable.

A big part of the immune system’s response to new threats is being able to expand its population by amplifying those clones of cells whose molecular competence (antibodies or receptors) is most suited for the threat at hand. This proliferative capability slowly degrades over time, as part of a complex process called immunosenescence — a linguistic stone’s throw from immune system dementia and senility.

Many infectious diseases, such as COVID, herpes and Lyme disease take up residence within the body, and it has been shown that chronic infectious diseases accelerate this process of immunosenescence. In fact, researchers now think that chronic infection and inflammation is a significant contributor to aging as a whole.

And not all aging happens gracefully — for our immune cells, there is a point at which they go from being powerful warriors against disease to turncoats for the other side. And when they do, things can get really ugly. We call this “autoimmune” disease. Auto meaning “self.” Immune meaning our immune system. Autoimmune disease is disease self-inflicted on the immune system by the immune system itself. It’s well established at this point that infectious diseases are a major trigger for autoimmunity. Many autoimmune diseases are serious and often life-threatening health conditions — diabetes, rheumatoid arthritis, multiple sclerosis, irritable bowel disease, to name a few.

Infectious diseases are also a major driver of cancer- it is now thought that slightly more than 20% of all cancers can be linked to prior infections. Many of these infections are with diseases that are a minor annoyance (mono, genital warts) or uncomfortable but not life-threatening (ulcers in the stomach).

In recent years, we have come to realize that many chronic health conditions are the consequence of infections, both acute and chronic. Viral encephalitis leads to an increased risk of dementia, months or even years later, a bout of mono (caused by Epstein-Barr virus) gifts you a 32-fold higher risk of Multiple Sclerosis that can take up to a decade to show up. HIV and Dengue are known to have autoimmune consequences that can linger for years, and other viruses have been reported to act as triggers for diabetes. The list of chronic diseases linked to infectious causes is a long one, and it keeps growing every day.

The elephant in the room for this, of course, is the infectious disease that has been raging around the world for the past four years, which most people can expect to get once or twice a year, if they don’t take precautions. A single bout of COVID — even a mild one — can leave you with a five-fold increased risk of strokes and pulmonary embolisms, and a twelve-fold increased risk of heart attacks and heart failure, in the year following the infection. Studies have found that the risk of new-onset diabetes jumps dramatically in the first months following even a mild bout of covid, and a mild bout of covid similarly dramatically lowers people’s performance on tests of cognitive ability. Long covid is a syndrome of debilitating conditions that affects millions of people worldwide, and continues to grow as a problem.

What of the health effects of covid that manifest 10 years later? 20 years later? No one knows. What of the prospects for recovery of long covid patients? Again, no one knows. But if the original SARS provides us with any hints, the future is not likely to be rosy— a clinician who treated SARS survivors for fifteen years had this to say of them:

“The Long SARS patients were ordinary people, with no predisposing factors, who nearly drowned under a tsunami of severe illness and ongoing sequelae. This impression was echoed by almost everyone who came in contact with them. They had more of my empathy and sympathy than did any other patient group in my professional life… I will point out that clinically none of our 50 patients got their old life back with time and treatment.”

The implications of this for the health and life expectancy of our youngest generation are sobering. Right now we tolerate the repeated infection of children with a pathogen (SARS-CoV-2) whose long term-consequences, worrying as they are, are still not fully visible on the basis that acute infection in children with SARS-CoV-2 is almost always asymptomatic or “mild.”

If the mildness of the acute symptoms causes you comfort, it should not. Acute infection with HIV is usually asymptomatic as well. And then you die of Kaposi’s Sarcoma a decade later.

Avoidance of Responsibility

But what does all this have to do with getting old? It has everything to do with it.

In an earlier piece, we showed how the attribution of cause of death came from a need to discern death from homicide vs. death from so-called “natural causes.” In other words, the reason for determining cause of death was limited to determining whether or not the death was the result of a crime.

Deaths from “natural causes” were a specific class of deaths understood to never be the result of a crime. Thus the more causes of death that could be lumped into the “natural causes” category, the less humans themselves had to worry about being responsible for the death. The less humans themselves had to worry about being held accountable for a crime.

In fact the terms “dementia” and “senile” are catch-all terms used on death certificates to indicate that no specific reason for death could be determined except it was noticed that the person who died was old. The coroner, physician, or medical examiner certifying the cause of death was either too lazy or too incompetent (or both) to actually spend the time trying to figure out why the person died. Instead they knew they could get away with pencil-whipping the death certificate by just saying the person died because “dementia” — i.e. they died because they were old.

Nowhere is this better reflected than in the abhorrent statistical card trick of “age-adjusting.” Age-adjusting deaths is a process by which you discount death the older the individual who dies is — usually compared to an arbitrary reference population.

If you have ever seen a population pyramid it works like this. A reference population is chosen — the reference population giving the percentage of people by age. Then a population pyramid is created of the population of people dying from a given cause. A percentage of the number of dead is assigned for every age bracket. So if only old people die (and it’s usually only old people) then the percentage of the dead in old people is very high.

If your reference population doesn’t have very many old people in it, it becomes simple to conclude that your reference population isn’t at much risk of dying from whatever the old people died from. So you multiply the percentage of old people in the dead population by the percent of old people in your reference population to come up with an “age adjusted” rate of death in your reference population.

Think of it like this: If ten people in a nursing home die that’s not the same thing as ten people in a university dormitory dying because the ten people who died in the nursing home were older than the ten people in the university dormitory. So we “age adjust” the ten in the nursing home and come up with a new figure that only one “young person equivalent” died, when age adjusted to our reference population of university dormitory residents.

And the one “young person equivalent” dying is less than ten old people dying so we’re all good.

No reason to look into or even care WHY the old people died. They died because they were old. If they were young, like our reference population, only one would have died.

Old people dying is normal. It's called senility. It’s inevitable.

This distills into the concept of inevitability and the use of the concept of inevitability as a defense against responsibility. Time is inevitable and if death is time then death is inevitable and it’s nobody’s fault.

But that’s not how it is.

“Hey, man, can I borrow your car? I’m just going to the grocery store”

Imagine you lent your car, with a full tank of gas, to your friend understanding that he was only going to use it for a short trip to the grocery store and back. You don’t use your car much and the tank is always full. Being a nice person you said “sure — it’s got plenty of gas so don’t worry about it.”

A week after your friend used your car, you get in it (again, you don’t drive much) and you notice the gas gauge is on empty. WTF? You call your friend and say “what the hell, dude? There’s no gas in my car. How far did you drive it?”

And your friend says “Of course there’s no gas in the car. I borrowed it a week ago. It’s much older now. I’m not responsible for using your gas, it’s just old and dead.”

If you wouldn’t buy that argument then you shouldn’t buy the argument that people die just because they’re old. Instead you should understand that they died because they or someone else used up their immune system.

Someone else? How can someone else use up your immune system?

Easy. They can expose you to diseases they are carrying. They can force you to work in places contaminated with pathogens. They can sell you houses with high radon levels. They can pour you a glass of dirty water. They can refuse to ventilate school classrooms.

They can tell you masks are unnecessary. No only for yourself but especially for your children.

Every time they do that they are moving either yourself or your children or both closer to death. They are giving you Alzheimer’s. They are causing your dementia. They are inflicting chronic disease on you. They are reducing your ability to fight off the cancers within.

They are doing it, not Father Time.

They are responsible. They are committing a crime.

The Devil’s Bargain

Our intention with this series is to provide you, the reader, the tools necessary to interpret and understand life in a pandemic. We hope that with this installment you will understand that whenever public health, a politician, a media outlet, etc. casts death and disease as “inevitable” they are instead conducting an exercise in the avoidance of their responsibility for death.

Death and disease are not inevitable. Death and disease come because of the challenges our immune systems face and a very large percentage of those challenges are entirely man-made.

Whether it’s denigrating transmission control like studies finding that masks don’t work (pro tip: they do, very well) or that ventilation has a negative cost/benefit ratio (pro tip: it doesn’t). Or flooding the zone with bullshit such as arbitrary distinctions between dying “from” something vs. “with” it (more on that in the next installment).

Or out-and-out discounting death simply because the clock has moved forward (old people who have already lived long enough).

Understand that whenever people advocate to relax transmission control measures, what they are actually saying is that you can take off that mask, you can send your child to in-person school in unventilated classrooms, you can pack yourself into a bar so long as you are willing to pay for those freedoms with a shorter and unhealthier life — either for you or your children.

This is a choice. It is a Devil’s Bargain where you are being offered relief of acute inconveniences today at the cost of chronic disease and death tomorrow.

This is not inevitable. This is a choice that public health, that politicians and the media are handing to you. And it is a choice you get to make now.

Take off the masks, go to work and school, urgently return to normal? You can have all those things. But there is no free lunch. If you choose those things being offered today, you will pay for them with a shorter, unhealthier life for you and your children down the road.

When you make that choice, consider that while the United States generally has very poor health outcomes compared to its peer nations — there is one area in which the United States is particularly awful and that is in the treatment, management and avoidance of chronic disease. The United States would rather spend $10K today on healthcare to treat an infected foot than spend $8 to have bought the patient a new pair of shoes a month ago.

So consider the choice being offered you when you are promised you can take off your masks, send the kids to school and “vax and relax.” Or not vax at all because “choice.”

As for us, we know where we stand on that choice. Choosing the freedom to do nothing vs. doing something just to enjoy some immediate comfort now, for earlier death tomorrow (of yourself or your children) is never right.

In fact, it’s morally and ethically indefensible. It is a crime. It is a crime when you are offered that choice. It is a crime when you accept the offer.

And if we’ve done our job correctly here, you have more of what you need now to understand why.

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