El "rechazado": verdades falsas y mentiras verdaderas

 

En caso de que no lo sepas, hacer investigación científica no es fácil. Y publicar los resultados de una investigación tampoco es fácil. Como ejemplo, me gustaría comentar que un grupo prestigioso de investigadores de Dinamarca obtuvieron financiamiento para llevar a cabo una investigación muy importante acerca de los posibles beneficios de usar tapabocas, y tuvieron problemas para publicarlo por "razones políticas" (más información acerca de este estudio aquí).

Aproximadamente desde marzo de 2020, México atraviesa por uno de los periodos más oscuros de su historia. Existen muchas "opiniones" acerca de la supuesta pandemia, pero yo no estoy ni de un lado ni de otro. Me gusta pensar en mi persona como otro científico interesado en la verdad. Y como parte de este compromiso, me animé a escribir un artículo titulado "False truths and true lies about microbes, infections, and hygiene: a New Perspective in times of COVID-19" e intentar publicarlo en FEMS Microbiology Ecology como una Perspectiva. Sin embargo, el Editor Marcus Horn decidió rechazarlo porque encontró "muy pocos aspectos ecológicos" en el paper. 

La verdad, estoy en un punto de mi carrera en donde los "papers" ya no importan tanto para mi (prefiero mil veces estar en mi huerta o con mis perros que sentado frente a la computadora). Por este motivo, comparto aquí la última versión del "rechazado". Agradezco cualquier posible retroalimentación que tengas.

False truths and true lies about hygiene, microbes, and infections: a New Perspective in times of COVID-19

Jose F. Garcia-Mazcorro

General Escobedo, Nuevo Leon, Mexico

Correspondence: josegarcia_mex@hotmail.com

ABSTRACT

Viruses, Bacteria, and other microorganisms are ubiquitous on Earth and have important functions in soils, the oceans, as well as the bodies of all plants and animals. In this perspective, I expose my opinion on the relationship between hygiene, microbes, and infectious, in a context of scientific moral responsibility in times of COVID-19. It is my hope that this perspective helps illuminate the importance and relevance of the pursuit of truth among future microbial ecologists and other scientists.

  

“If you would be a real seeker after truth, it is necessary that at least once in your life you doubt, as far as possible, all things”. - Rene Descartes.

 

The pursuit of truth is a distinguished feature of true scientists. They want to know what, where, how, when, and even why. They also have, whether we like it or not, a moral responsibility to train young people to continue doing so for the rest of the days.

 

Viruses, Bacteria and other microorganisms are ancient life forms that have roamed on Earth for at least 2 billion years. They have important functions in soils, the oceans, as well as the bodies of all plants and animals. This is a prime example of a true truth. The idea that microbes have shaped the evolution of other life forms also seems to be true and well supported by science, and I agree that this notion “can be [easily] rationalized when this process is viewed from an evolutionary perspective” (Lee and Mazmanian 2010). Indeed, “anatomical structures and physiological needs have been determined in part by the microbiota”, and “the indigenous microbiota can influence the morphological and physiological characteristics of its host to such an extent that traits assumed to be the unavoidable consequences of the genetic endowment are determined in reality by the microbial environment” (Dubos et al. 1965). Despite the obvious role of microbes in the functioning of metaorganisms (Esser et al. 2018) and their surrounding environment, the question of whether microbes are dispensable for life to endure is not only valid but also vital to better understand life as an entity. Even though Louis Pasteur had suggested that “life would not long remain possible in the absence of microbes” (Pasteur 1885), this question was answered half a century ago with a suggestion that ‘yes, they are dispensable’ (Luckey 1972). This important question has remained until our days (Gilbert and Neufeld 2014) and will likely remain forever without a clear answer. Regardless of any point of view, today and in the near and far future, viruses and microbes are vital for virtually everything happening on Earth.    

 

The COVID-19 disease is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and was catalogued as a pandemic on March 11^th, 2020 by the World Health Organization (WHO). In just a few weeks, this disease brought countless economic, psychological, and social consequences to the lives of millions of people around the world. Ever since, several strategies have been implemented (or constantly suggested) throughout the world to stop an uncontrollable spike in the number of infections with SARS-CoV-2, for example, the promotion of more hygiene, social distancing, and the quasi-universal use of face masks (see Figure attached). In this perspective, I will not discuss the rightfulness of these efforts but instead will consider that this was done in a sincere effort to help improve people’s health and wellbeing. However, it is an undeniable truth that these measures, like any other measures, are accompanied by several disadvantages that, in my opinion, have not been properly discussed by the scientific community.

 

The public is, overall, massively unaware of science and the study of microbial life. In part because of this, and the strong push by the media, today the general public in Mexico and other countries is more likely than before to associate a better hygiene with lesser chances of being infected with the new coronavirus, which brings me to the topic of this perspective. Does washing hands with soap and alcohol diminish the likelihood of getting sick by COVID-19? This is apparently true according to the official narrative; however, some fragments of the public are likely to exaggerate believing that the more hygiene, the better.

 

More hygiene may decrease the chances of being infected by pathogens and some people tend to exaggerate, true. But on the other hand, is it possible that high hygiene standards have the capacity to impair the correct development of the immune system of newborns and small children? If so, to what extent? According to the WHO, hygiene refers to conditions and practices that help to maintain health and prevent the spread of diseases, and therefore the term usually relates to microbial exposure. But this is complex, for example is hygiene the level of daily exposure to all new microbes from the external environment (pathogens as well as commensals)? Or the total amount of microbes encountered by the body internally and externally each day? Or perhaps the level of exposure to potential pathogens only? (Andrew Holmes, personal communication on September 10^th, 2020).

 

The hygiene hypothesis states that early childhood exposure to microorganisms (such as host-associated microbiota and helminth parasites) protects against allergic diseases by contributing to the development of the immune system, and that a lack of exposure leads to defects in the establishment of immune tolerance. This hypothesis has been proven using animal models (Mulder et al. 2011). However, the original idea originally came from a small study from one author in one region of the world (Strachan 1989) and has been rightfully challenged with the argument that the rise of allergy and autoimmune diseases are due to “much more than rampant cleanliness” (Scudellari 2017). Some leaders in this field have actually suggested to abandon the hygiene hypothesis and move towards to a promotion of a risk assessment approach that maximize protection against pathogen exposure while allowing spread of essential microbes, particularly between family members (Bloomfield et al. 2016). These thoughts highlight the need of questioning not only whether compulsive hygiene can help against COVID-19, but also any theory proposing disadvantages of this practice, like the hygiene hypothesis.

 

The other two widely promoted strategies to help stop the spread of COVID-19 are social distancing and the use of face masks and a brief discussion of these two is also useful for this perspective. Are these strategies based on false truths or true lies? Social distancing brings stress and dissociates human relationships, accordingly to governmental institutions such as the CDC (CDC 2019) and also the literature (Kimura et al. 2020). Despite this truth, and the fact that the beneficial effects of social distancing to control the spread of respiratory viruses remains highly debatable (Ahmed et al. 2018), governments of some countries are still pushing hard to make this a ‘new normal’, particularly in work environments (Gobierno de Mexico, 2020). On the other hand, the quasi-universal use of face masks is not only very poorly supported (Radonovich et al. 2018; Bundgaard et al. 2021) but is apparently not enough to prevent contagion, with some scientists even suggesting “the recommendation to speak what is strictly necessary in confined spaces and where it is not possible to keep a healthy distance, even if a mask is used” (Olmedo and Barrientos-Gutiérrez 2020). Even though the prolonged use of face masks facilitates a “potential self-contamination that can occur” due to “favorable conditions for [mostly oral] microorganisms to amplify” (WHO 2020), some governments keep holding on the belief that everyone must wear a mask all the time, even with the imposition of laws (Periodico Oficial, Nuevo Leon, 2021). The lack of scientific publications addressing the negative health effects associated with the prolonged use of face masks is extraordinary (Swiss Policy Research, 2021) but this is related to the nature of what we do as scientists (we usually only investigate potential beneficial, not harmful, effects of a given strategy).

 

Conclusion

Viruses and microorganisms abound on Earth and have shaped the evolution of all higher life forms. Pasteur passed away believing that life would not long remain possible in the absence of microbes, but others believe that microbes are dispensable and life as an entity would endure without them, at least for a few days (of course without considering mitochondria and chloroplasts, Gilbert and Neufeld 2014). I believe that the strategies taken in some countries to stop the spread of COVID-19 oscillate dangerously between false truths and true lies. However, at least in the case of compulsive hygiene, I agree with experts in that field that this practice is not enough by itself to provoke the rise of allergy and autoimmune diseases. It is my hope that the thoughts discussed here can bring light into current and future thinking and research about hygiene, microbes, and infections. More importantly, this perspective will hopefully illuminate the importance and relevance of the pursuit of truth among the future microbial ecologists and other scientists.

 

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