Influenza, epidemic constitutions and the COVID-19 pandemic
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Abstract
The idea of “epidemic constitutions” is attributed to Thomas Sydenham, one of the most eminent physicians of the 17th century. Regardless of the type of disease epidemic (cholera, influenza, smallpox), it aimed to explain what remains unexplained to this day: Why now? And why do some develop serious illness while others do not? In this article, I review some debates that occurred during the cholera epidemics of the 19th century, discuss the idea of telluric “epidemic constitutions”, and propose a reinterpretation, or perhaps just an updated interpretation of Thomas Sydenham's amazing insight into the cause of epidemic constitutions: a confluence between an exciting cause that was in the atmosphere and a predisposing cause that was in the bodies of the sufferers themselves . With what we have learned since then, I explain his insight as representing the process and product of our co-evolution with Influenza A viruses. I explore theoretically how this interpretation would explain differences in rates and distributions of infection, disease and mortality during epidemics, and, propose alternative explanations to the epidemiology of the early emergence of COVID-19 in China and selected countries, based on an epidemiological inquiry on the circulation of influenza viruses during the 2019-2020 influenza season across those countries. The approach brought up new questions that could only emerge from epidemiological (population-based) reasoning (what causes vulnerability?) and epidemiological studies (what was the context of influenza during the emergence of the COVID-19 pandemic?), such as: a) did Influenza B have a role in the production of vulnerability to infection by the SARS-COV2 virus? b) do the SARS-COV2 virus and the H1N1 influenza virus share some immunological attribute conductive to a same type of immune-inflammatory response among non-H1 primed individuals? Or do the sequence B-H1 and B-SARS_COV2 produce similar morbidity? Does a sequence of B – H1 – SARS-COV2 explain the severity of COVID-19 Pandemic in the US? Do the SARS-COV2 viruses and the H1N1 viruses compete in the same ecological spot? What would this mean for future developments of our immune-inflammatory landscape?
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This Zenodo record is a permanently preserved version of a Structured PREreview. You can view the complete PREreview at https://prereview.org/reviews/15557933.
Does the introduction explain the objective of the research presented in the preprint? Yes Yes, the introduction explains the objective by linking historical ideas with a modern hypothesis about how prior influenza exposure may influence vulnerability to COVID-19. However, the objective could be stated more clearly and directly. The introduction explain the objective in a way that only people in the field can understand the work, we observe that the researcher make personal remark e.g "I". We recommend that it should be paraphrased in a simple and clear statement.…This Zenodo record is a permanently preserved version of a Structured PREreview. You can view the complete PREreview at https://prereview.org/reviews/15557933.
Does the introduction explain the objective of the research presented in the preprint? Yes Yes, the introduction explains the objective by linking historical ideas with a modern hypothesis about how prior influenza exposure may influence vulnerability to COVID-19. However, the objective could be stated more clearly and directly. The introduction explain the objective in a way that only people in the field can understand the work, we observe that the researcher make personal remark e.g "I". We recommend that it should be paraphrased in a simple and clear statement.Are the methods well-suited for this research? Highly appropriate Absolutely, Epidemiological methods like cohort studies, serological tests, ecological analyses, and modeling can effectively investigate the interactions between influenza and SARS-CoV-2. They help understand population-level patterns and immune responses. However, we need to be mindful of data gaps and confounding variables, which means careful study design is key to ensuring we draw reliable conclusions.Are the conclusions supported by the data? Somewhat unsupported The conclusion does not address any data and not include data at all.Are the data presentations, including visualizations, well-suited to represent the data? Neither appropriate and clear nor inappropriate and unclear The preprint does not provide enough detailed or clearly presented data visualizations. The data presentation is limited and would benefit from clearer, more structured visuals to support the hypotheses and enhance understanding.How clearly do the authors discuss, explain, and interpret their findings and potential next steps for the research? Neither clearly nor unclearly The authors express their ideas effectively in a theoretical context, but the data supporting their findings leaves much to be desired. Their explanations are certainly thought-provoking, though they can feel a bit speculative. Additionally, the next steps for research are mentioned only in a rather general way.Is the preprint likely to advance academic knowledge? Highly likely Yes, the preprint presents a novel hypothesis that could advance academic knowledge, though it needs more empirical support.Would it benefit from language editing? Yes Yes, in other to improve clarity, precision, and readability.Would you recommend this preprint to others? Yes, but it needs to be improved The work can only be of immense valve to researchers, epidemiologists, virologists, and public health professionals who are exploring the fascinating intersection of historical epidemiology, viral co-evolution, and pandemic dynamics. It's particularly useful for those studying the relationship between influenza and COVID-19 or seeking innovative frameworks for understanding epidemic variability. However, for a general audience or anyone looking for immediate, actionable insights, the theoretical nature of the preprint might be a bit daunting. We suggest being more simplicity to more audience.Is it ready for attention from an editor, publisher or broader audience? Yes, after minor changes Absolutely, the article is almost there but just needs a few minor adjustments: 1. It needed to clarify the thesis, 2. the structure should be streamlined, and add some specific evidence for the 2019-2020 inquiry, 3. technical terms need to be simplified, highlight the novelty, and tidy up the formatting. With these tweaks, the article will be in great shape for editors, publishers, or a wider audience.Competing interests
The authors declare that they have no competing interests.
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