[blix]

The first recorded appendectomy is in 1880. Probably the first major study conclusively indicating adverse consequences was published in 2014.

It did hold for a long time, until it didn't because we found scientific evidence that said the opposite. Are you really so confident that no such evidence could ever be found for anything else? There is so much we don't know about the human body.

[sudosysgen]

That's really not it. There is a heavy bias that the appendix is somehow beneficial because we evolved to keep it for some reason (though it could have been just a relic).

EBV is a virus. Our immune system does whatever it can to get rid of it. It causes significant illness. There is absolutely no reason to believe it is beneficial whatsoever.

If you think it is, you can prove it. We have literally hundreds of millions of people walking around that never got EBV. Go on, and find a statistically significant way in which EBV is beneficial for them. You have the burden of proof here.

[blix]

If that bias is so strong, why did people believe the appendix was vestigial for a 100 years?

If the immue system does "whatever it can" to get rid of EBV, why is it happy to let EBV lie dormant in most people who have it?

Most of what you said can be said about bacteria too. It turns out bacteria can be helpful and blindly applying antibiotics is linked to the rise of numerous autoimmune diseases. It took quite a long time for us to figure it out.

I think the burden of proof is on the people who want to modify other people's bodies (i.e. prophylactic EBV vaccination). You can do what you want to yourself. But unless we want to repeat the mistakes of the recent past we should be ~really~ sure there is no reason the body keeps it around lying dormant. One could even say this is a larger "control group" than the one you are talking about.

Besides, correlational medical studies can't even determine if eggs and coffee are good or bad for you. If we really want to answer these questions adequately, we need better tools.

[sudosysgen]

The immune system isn't happy to let EBV dormant. EBV infects the immune system in order to lie dormant. It hides inside long-lived B-cells in a way that is impossible for your immune system to see from the outside, so there is no way to mount an efficient response at that point.

Again, we knew about side effects for antibiotics from the get-go. It's link to autoimmune diseases specifically is recent because autoimmune diseases were misunderstood. We knew that bacteria could be beneficial and necessary from before we had the first antibiotic.

If we can't tell if eggs or coffee are bad for you, it's because there just isn't a strong correlation either way, and diet studies are not very good at deriving signal.

Thankfully, simply comparing people that are and aren't infected is a much clearer signal.

Again, this isn't hard. We've been able to associate dozens of negative outcomes to EBV infection. We would be able to figure out a positive outcome.

The idea that "the body keeps it around" just completely flies in the face of reality. The fact is, the body doesn't really have a way of preventing it from staying there.

[blix]

> The idea that "the body keeps it around" just completely flies in the face of reality. The fact is, the body doesn't really have a way of preventing it from staying there.

This is a difference in semantics, not reality. The body also doesn't have a way of spontaneously ejecting the appendix. I would describe this as the body being happy to let it stay there. Of course, sometimes the body becomes unhappy with the existence of the appendix. I think the interesting question is why this happens and the proper treatment is to remove or mitigate these triggers. This is harder than removing the appendix.

We thought there were no serious consequences of antibiotics for a century. We were wrong. As someone living with autoimmune disease, I can assure you that we continue to misunderstand these diseases. I wish I could be so confident that we would never be wrong about anything else ever again. A few days ago there was an article where a virus was used to fight a bacterial infection [1]. How can you earnestly say it's impossible that any virus that makes its home in the immune system could play a role in the immune response? Proving negatives is really hard. Maybe if I saw a 10000 studies that showed no correlation for a wide range of different infections I could be convinced, but our system doesn't encourage publication of negative results so I'm not holding my breath. How many have you seen?

The problem with statistical medical studies is that in general samples are non-random (as you note in another comment) and cannot easily control for any of the 1M (lower bound) confounding variables. Our current methods here are mainly good for p-hacking publications, not uncovering causal relationships or complex effects. This is a discussion for somewhere else though probably.

[1] https://english.elpais.com/usa/2022-01-27/how-a-virus-helped...

[sudosysgen]

>We thought there were no serious consequences of antibiotics for a century.

That's not true. We knew there were serious consequences and that microbiome was important from before antibiotics were even a thing.

>The body also doesn't have a way of spontaneously ejecting the appendix. I would describe this as the body being happy to let it stay there.

It has a way of doing so over evolutionary timescales, which is not true for EBV.

>A few days ago there was an article where a virus was used to fight a bacterial infection [1].

That is a bacteriophage. It is a virus that does not infect human cells, but only bacteria. We've known about them for decades.

> How can you earnestly say it's impossible that any virus that makes its home in the immune system could play a role in the immune response? Proving negatives is really hard.

I don't need to prove a negative, you have the burden of proof. It's absolutely certain that has an impact on immune response, we know that, it's just that every single effect we have seen so far has been negative.

> The problem with statistical medical studies is that in general samples are non-random (as you note in another comment) and cannot easily control for any of the 1M (lower bound) confounding variables.

There aren't 1 million confounding variables as far as sampling for EBV. You could feasibly account for all remaining variance, or enough of it to know that it doesn't have a sufficient impact.

[blix]

> We knew there were serious consequences ...

We had some minor inklings of the microbiome, but we were not aware of serious consequences. Unless you are accusing the all the governments and medical bodies of the world of gross malpractice.

> It has a way of doing so over evolutionary timescales, which is not true for EBV.

Do you have evidence for this claim?

> That is a bacteriophage.

Do you really think nature has drawn a bright line between viruses than can affect humans and viruses that can affect bacteria? I'm not sure this lines up with reality. People are even seriously starting to talk about the "Human Virome" [1]

> I don't need to prove a negative, you have the burden of proof.

This is what they said about tobacco causing cancer and pesticides killing bees and carbon emissions causing global warming. How did that work out? I'd prefer a more proactive scientific framework than a reactive one. Maybe we could stop the next crisis before it happens.

> There aren't 1 million confounding variables as far as sampling for EBV.

There are 1M confounding factors in sampling outcomes. Not controlling for confounding variables is a great way to get weak conclusions.

[1] https://www.scientificamerican.com/article/viruses-can-help-...