What is Health?

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At the February 26, 2020, CDC’s Advisory Committee on Immunization Practices (ACIP) discussion on an Ebola vaccine and its use in healthy people, this question arose: what is meant by healthy1?

I’ve wondered about that when reading clinical trials that use “healthy” controls. The question arose again, for me, when I heard that many people on a multitude of pharmaceutical drugs consider themselves healthy, or that some will claim good health for themselves or their child, yet have chronic conditions like asthma, eczema, allergies, anxiety, etc.

Have decades of pharmaceutical advertising convinced us that relieving, perhaps even hiding, symptoms with a drug means we are well?  We have forgotten that symptoms from illness can represent the body’s attempts to adjust to a threat. Now, we hear advice to take Tylenol to lower a fever; yet fever is what activates many aspects of the immune system.2 Inflammation is also part of the immune response that occurs when we have a cut or sprain. It is part of the healing process.

Just because we can shut off the symptoms, is that health?  Is health simply an absence of symptoms?

The COVID-19 pandemic has further confused the definition of health in my mind.  As David M. Brady said in “COVID-19 and SARS-CoV-2 Testing Overview” (Townsend Letter. June 2020), “…a high percentage of people who carry the virus show no clinical symptoms.”  By all reports, over 80% of people infected with the virus experience mild or no symptoms at all. So, are they healthy or sick?

The World Health Organization says that health is “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”3 Complete well-being is a high threshold. It can change from one minute to the next.  Might another (perhaps better?) definition of health be “a wholistic state of adapting and thriving in the face of challenges”?


Jule Klotter

References

  1. ACIP February 2020 – Welcome and Ebola Vaccine. (at 1 hr 45 min mark).  YouTube.com. March 13, 2020.
  2. Evans SS, Repasky EA, Fisher DT. Fever and the Thermal Regulation of Immunity: the immune system feels the heat. Nat Rev Immunol. June 2015;15(6):335-349.
  3. World Health Organization. Constitution. https://www.who.int/about/who-we-are/constitution