Has Paracetamol (Tylenol) made this pandemic much worse than it should have been?
Paracetamol Myth - Systematically suppressing fever likely carries huge consequences, enhancing and reinforcing both the pandemic hurting more people in the process
As a father of four, with a certain experience of feverish kids, I have been wanting to write about fever and paracetamol for some time now. Herein, I outline why systematic use of Paracetamol in the population is probably one of the worse health policies public health authorities could have enforced, not only for individual health, but also epidemiologically. Covid Myth Buster Series is a reader-supported publication. Please consider becoming a contributing subscriber.
The world is filled with stories whereby a policy ends up creating the complete opposite of what the intent was.
In Freakonomics, Levitt and Dubner describe the backlash of a castigating fine imposed on parents picking up their kids late at the daycare centre. Instead of incentivising them to come on time, the fine was perceived as a babysitting fee, and more parents ended up being late… In other words, some policies make things much worse and have unintended consequences. Throwing oil on the fire!
In a not-so-distant future, I am quite convinced that the systematic use of Paracetamol during the COVID pandemic will be considered as one of the biggest failings in public health History, right behind the catastrophic COVID vaccines.
Ancients used to consider fever as an indispensable ally in the fight against illness. "Fever is a mighty engine which Nature brings into the world for the conquest of her enemies."said 17th century physician, Thomas Sydenham, also known as “The English Hippocrates”. Modern-day medicine focused on comfort - over therapeutic reason - has been systematically quashing fever for some time now, particularly during this pandemic.
I understand it can be scary to see one’s child feverish, but as long as it doesn’t become overwhelming (in time or level), fever should be embraced as nature’s defence at work. If evolutionary pecking order is a sign of therapeutic priority, and thus efficacy, fever is much more important than antibodies1.
Fever, what for?
Too many view fever as a useless and painful by-product of the immune reaction, as if Evolution couldn’t have done away with such an incapacitating symptom. Let’s go back to basics here:
Fever-less people have been pruned from the evolutionary tree, only fever-prone people have survived.
Let that kick in…
Another randomised controlled trial was held during millenia and fever - despite its painfulness and discomfort - held on and won. In other words, fever has to be an indispensable strategic tool in our fight against disease and suppressing it in a systematic fashion is as idiotic and foolish as suppressing the immune system.
What does fever do that is so important?
By raising the temperature of the body and the acidity of the blood stream, fever likely acts as a systemic bomb impeding further infection and destroying all the circulating virions, putting an end to the exponential viral propagation early on. SARS-COV-2 sensitivity to temperature - as other corona viruses - is well documented2 3. So while billions of immune cells go on a door-to-door guerilla, destroying one single infected cell at a time, liberating virions into the tissues and the blood stream, fever sends a systemic blast, similar to an immunity EMP bomb4 (for those of you who remember Ocean’s 11) that kills all circulating virions. As long as T-cells haven’t destroyed all infected cells, fever is required to stop the never-ending cycle of virus replication in the body.
Fever does at least two things :
it stops further cell infection by modifying the physical structure of the spike5 with increased temperature. This change in the protein’s structure impedes proper binding to ACE-2 receptors, and therefore limits the exponential dynamic.
it blasts the liberated virions in the tissue and in the blood by raising the temperature and the acidity, maiming the virions’ capacity to infect and replicate further.
Why is stopping the propagation early so important? As I stated in numerous articles, viral propagation is exponential, an avalanche. It grows ten-fold every 36-48 hours. If we waited for antibodies to stop the propagation - which is widely believed by most scientists - the viral infection would be likely up to 4.6 million times worse (10^6.6) in terms of infected cells damage. Fever is thus an indispensable response to a propagation inside the body.
Paracetamol only makes your infection worse
Given the above, it is quite evident that stopping fever is a recipe for disaster. Most healthy people who state they have had symptoms for 6-8 days (instead of 1 or 2) are people who have taken Paracetamol. Lowering temperature - and consequently acidity - is like tying your immune system’s hands behind its back. Circulating virions are let free for some more time to propagate and infect more healthy cells. Even if T-cells cut short virion production by systematically scuttling infected cells. Any virion left untouched by lowered fever will penetrate new cells and start replicating.
Here Comfort comes at a considerable cellular cost as the viral avalanche is not brutally stopped. The fact that MDs would not understand this logic is particularly worrisome to me as it demonstrates a clear lack of knowledge of viral infection dynamics and harm…
Paracetamol fuelled and accelerated the Pandemic
Epidemiologically the consequences of the wide use of Paracetamol throughout the pandemic can only be catastrophic: higher R0, increased incidence, worse severity and inevitably higher fatality.
For one, fever is typically the most obvious symptom of illness. As such it serves the purpose of information to the host that something is wrong. Another immediate benefit of fever is that it forces the host to stay at home, and thus somewhat isolates the would-be contaminator from the rest of society. By cutting short mobility, fever is a key contributor to epidemic control. If one enables fever to be avoided altogether, mobility of hosts is considerably improved, and that in of itself can’t be good.
More importantly, generalising the use of Paracetamol means that people are infectious much longer and with a much higher viral load. Carrying viruses 4-5 days extra nearly doubles the time of contagiousness, and having higher viral load means infection efficacy will be much higher. The impact on the R0 would need to be calculated, but there’s no question it would make a considerable difference.
It is probable that Paracetamol artificially maintained a much higher R0 and greater disease severity.
If viral propagation is let loose longer in a community, the virus production would naturally be considerably larger. The incidence and the corresponding fatality rate. would evidently follow. Mathematically, increasing all aspect of an exponential of exponentials dynamics can only bring radically different outcomes. In other words, it is quite plausible that this pandemic would never have been much of anything if it weren’t for the generalised use of Paracetamol. It is also likely that without wide-use of Paracetamol, the idea of vaccinating the world would never have had much support.
A conspiracy theorist would say that this was all done on purpose. Though some Machiavellian plays are always possible, I believe a more mundane dynamic was at play. Just as abandoning the “aspiration technique” to avoid pain was generalised without appropriate analysis, the systematic use of paracetamol creeped up on our world as patient comfort became more important than health itself. Unfortunately, if our society doesn’t re-anchors itself in reality, this will continue.
So next time you or your loved ones have fever, let fever and the immune system do their work. We might end up avoiding a 2-year long nightmare thanks to you…
Antibodies typically come in very late in the process, some 10-14 days after infection
“Physicochemical properties of SARS-CoV-2 for drug targeting, virus inactivation and attenuation, vaccine formulation and quality control” by Christin Scheller et al
“Sensitivity of SARS-CoV-2 to different temperatures” by Qi Lv et al
EMP: ElectroMagnetic Pulse