Why science?
I find myself existing in an enormously fascinating and enormously complicated universe. I want to align my understanding of all that complexity with its objective reality, and nobody’s come up with a better way to do that than the scientific method.
Why this book?
Everybody is familiar with colds and everybody hates them but, after a couple of decades in infectious disease research, I realised I didn’t know much about them. The only people who do are the unsung few who research them. Yet if you mention colds in a bus stop queue, you’ll hear plenty of very firmly held opinions on how to avoid them and how to treat them.
I wanted to take a deep dive into the last century of cold research to find out what we really know about colds and how we came to know it. I also wanted to know how much bus stop wisdom – if I may put it that way – is supported by evidence and how much is not.
All of which led me to write Sneeze.
Many years ago, there used to be talk of ‘a cure for the common cold’ - leaving aside immunisation (which is prevention rather than cure), was this just a pipe dream?
That was indeed many years ago, before colds were understood as a class of diseases rather than a single disease. We now know that colds can be caused by over 200 very different viruses, so there’s never going to be a single antiviral agent that clobbers all of them.
An alternative approach is to suppress the symptoms. The common feature of colds is that whichever virus causes the infection, the grottiness is caused by an overstimulated inflammatory response that does nothing to tackle the virus. Pharmacies sell several over-the-counter remedies that suppress that inflammation – and a lot more that don’t – although none that are anywhere near good enough to be called a cure.
That those remedies do anything at all suggests that at some point, someone might come up with a way to suppress the symptoms so effectively that we could call it a cure. It’s a nice idea but it’s unlikely to happen any time soon.
Right now, a cure is a theoretical possibility that may be realised in the future. It’s a little more than a pipe dream – but only a little.
What’s next?
The research groups that focused on colds have all closed now, so I expect cold research to progress more slowly than it has over much of the last half-century. Having said that, there’s still a lot of ongoing research on the big bad three cold viruses that are most likely to cause serious complications: influenza, COVID-19 and RSV. A lot of the findings will apply to colds caused by other viruses.
What’s exciting you at the moment?
There are a couple of research areas that look particularly exciting.
One is the relationship between colds and long-term debilitation. The research is mostly driven by ‘long Covid’, which affected around two million people in Britain alone at the last count, but it’s opened the door to a broader understanding of cold viruses as a trigger for chronic fatigue syndromes. We’re some way from that research leading to effective treatments but at least there’s movement toward them.
The other is the resurgent interest in ‘air hygiene’, which is the idea that we should be able to breathe the air of our shared indoor spaces without getting infected. It’s led to some practical approaches to achieving that through ventilation and filtration, which offer a way to reshape our shared environment so we spend less time being ill. Who doesn’t want that?
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