From Evidence-Based Corona Medicine to Organismic Systems Corona Medicine

Authors

DOI:

https://doi.org/10.5195/pom.2023.138

Keywords:

COVID-19, Health, Holism, Linear and Nonlinear Dynamics, Reductionism

Abstract

The Covid-19 pandemic has challenged both medicine and governments as they have strived to confront the pandemic and its consequences. One major challenge is that evidence-based medicine has struggled to provide timely and necessary evidence to guide medical practice and public policy formulation. We propose an extension of evidence-based corona medicine to an organismic systems corona medicine as a multilevel conceptual framework to develop a robust concept-oriented medical system. The proposed organismic systems corona medicine could help to prevent or mitigate future pandemics by transitioning to a bifocal medicine that extends an empirical evidence-based medicine to a theory-oriented organismic systems medicine.

References

Ahmed, Imran. 2021. “Dismantling the Anti-Vaxx Industry.” Nature Medicine 27: 366–366.

https://doi.org/10.1038/s41591-021-01260-6.

Ashton, John. 2021. “Covid-19 and the Anti-Vaxxers.” Journal of the Royal Society of Medicine 114, no. 1: 42–43. https://doi.org/10.1177/0141076820986065.

Ball, Philip. 2021. “What the Covid-19 Pandemic Reveals about Science, Policy and Society.” Interface Focus 11, no. 6: 1–10. https://doi.org/10.1098/rsfs.2021.0022.

Beckmann, Jacques S. and Daniel Lew. 2016. “Reconciling Evidence-Based Medicine and Precision Medicine in the Era of Big Data: Challenges and Opportunities.” Genome Medicine 8: 1–11. https://doi.org/10.1186/s13073-016-0388-7.

Bendau, Antonia, Jens Plag, Moritz Bruno Petzold, and Andreas Ströhle. 2021. “Covid-19 Vaccine Hesitancy and Related Fears and Anxiety.” International Immunopharmacology 97: 1–5.

https://doi.org/10.1016/j.intimp.2021.107724.

Beresford, Mark J. 2010. “Medical Reductionism: Lessons from the Great Philosophers.” QJM: An International Journal of Medicine 103, no. 9: 721–724. https://doi.org/10.1093/qjmed/hcq057.

Berlin, Richard, Russell Gruen, and James Best. 2017. “Systems Medicine—Complexity Within, Simplicity Without.” Journal of Healthcare Informatics Research 1: 119–137. https://doi.org/10.1007/s41666-017-0002-9.

Bertalanffy, Ludwig von. 1968. General Systems Theory: Foundations, Developments, Applications. Revised edition. New York: Braziller.

Boodoosingh, Ramona, Lawal Olatunde Olayemi, and Filipina Amosa-Lei Sam. 2020. “Covid-19 Vaccines: Getting Anti-Vaxxers Involved in the Discussion.” World Development 136: 1–2. https://doi.org/10.1016/j.worlddev.2020.105177.

Brown, Dean G., Heike J. Wobst, Abhijeet Kapoor, Leslie A. Kenna, and Noel Southall. 2021. “Clinical Development Times for Innovative Drugs.” Nature Reviews Drug Discovery 21, no. 11: 793–794. https://doi.org/10.1038/d41573-021-00190-9.

Cairney, Paul and Adam Wellstead. 2021. “Covid-19: Effective Policymaking Depends on Trust in Experts, Politicians, and the Public.” Policy Design and Practice 4, no. 1: 1–14. https://doi.org/10.1080/25741292.2020.1837466.

Carley, Simon, Daniel Horner, Richard Body, and Kevin Mackway-Jones. 2020. “Evidence-Based Medicine and Covid-19: What to Believe and When to Change.” Emergency Medicine Journal 37, no. 9: 572–575. https://doi.org/10.1136/emermed-2020-210098.

Chou, Wen-Ying Sylvia and Alexandra Budenz. 2020. “Considering Emotion in Covid-19 Vaccine Communication: Addressing Vaccine Hesitancy and Fostering Vaccine Confidence.” Health Communication 35, no. 14: 1718–1722. https://doi.org/10.1080/10410236.2020.1838096.

Clark, Christopher H. 2021. “Ideology, Information, and Political Action Surrounding Covid-19.” In Post-Pandemic Social Studies: How Covid-19 Has Changed the World and How We Teach, edited by Wayne Journell, 81–93. New York: Teachers College Press.

Clarke, Brendan, Donald Gillies, Phyllis Illari, Federica Russo, and Jon Williamson. 2013. “The Evidence that Evidence-Based Medicine Omits.” Preventive Medicine 57, no. 6: 745–747. https://doi.org/10.1016/j.ypmed.2012.10.020.

Corning, Peter A. 2014. “Systems Theory and the Role of Synergy in the Evolution of Living Systems.” Systems Research and Behavioral Science 31, no. 2: 181–196. https://doi.org/10.1002.sres.2191.

De Simone, John. 2006. “Reductionist Inference‐Based Medicine, i.e. EBM.” Journal of Evaluation in Clinical Practice 12, no. 4: 445–449. https://doi.org/10.1111/j.1365-2753.2006.00728.x.

Douglas, Karen M. 2021. “Covid-19 Conspiracy Theories.” Group Processes & Intergroup Relations 24, no. 2: 270–275. https://doi.org/10.1177/1368430220982068.

El Bairi, Khalid, Dario Trapani, Angelica Petrillo, Cécile Le Page, Hanaa Zbakh, Bruno Daniele, Rhizlane Belbaraka, Giuseppe Curigliano, and Said Afqir. 2020. “Repurposing Anticancer Drugs for the Management of Covid-19.” European Journal of Cancer 141: 40–61. https://doi.org/10.1016%2Fj.ejca.2020.09.014.

Engel, George L. 1980. “The Clinical Application of the Biopsychosocial Model.” American Journal of Psychiatry 137, no. 5: 535–544. https://doi.org/10.1176/ajp.137.5.535.

Fairman, Kathleen A. 2022. “Pandemics, Policy, and the Power of Paradigm: Will Covid-19 Lead to a New Scientific Revolution?” Annals of Epidemiology 69: 17–23. https://doi.org/10.1016/j.annepidem.2022.02.005.

Friis, Robert H. 2018. Essentials of Environmental Health. 3rd edition. Burlington, MA: Jones & Bartlett Learning.

Fuller, Jonathan. 2021. “What Are the Covid-19 Models Modeling (Philosophically Speaking)?” History and Philosophy of the Life Sciences 43: 1–5. https://doi.org/10.1007/s40656-021-00407-5.

Greenhalgh, Trisha. 2020. “Will Covid-19 be Evidence-Based Medicine’s Nemesis?” PLoS Medicine 17, no. 6: 1–4. https://doi.org/10.1371/journal.pmed.1003266.

Greenhalgh, Trisha, David Fisman, Danielle J. Cane, Matthew Oliver, and Chandini Raina Macintyre. 2022. “Adapt or Die: How the Pandemic Made the Shift from EBM to EBM+ More Urgent.” BMJ Evidence-Based Medicine 27, no. 5: 253–260.

http://dx.doi.org/10.1136/bmjebm-2022-111952.

Greenhalgh, Trisha, Mustafa Ozbilgin, and Damien Contandriopoulos. 2021. “Orthodoxy, Illusio, and Playing the Scientific Game: A Bourdieusian Analysis of Infection Control Science in the Covid-19 Pandemic [version 3; peer review: 2 approved].” Wellcome Open Research. https://doi.org/10.12688/wellcomeopenres.16855.3.

Greenhalgh, Trisha, Manuel B. Schmid, Thomas Czypionka, Dirk Bassler, and Laurence Gruer. 2020. “Face Masks for the Public during the Covid-19 Crisis.” British Medical Journal 369: 1–4. https://doi.org/10.1136/bmj.m1435.

Guess, C. Dominik, Lauren Boyd, Kelly Perniciaro, and Ma Teresa Tuason. 2022. “The Politics of Covid-19: Differences between Blue, Purple, and Red States in Covid-19 Cases, Deaths, and Regulations.” Research Square. https://doi.org/10.21203/rs.3.rs-1392830/v1.

Guy, R. Kiplin, Robert S. DiPaola, Frank Romanelli, and Rebecca E. Dutch. 2020. “Rapid Repurposing of Drugs for Covid-19.” Science 368, no. 6493: 829–830. https://doi.org/10.1126/science.abb9332.

Harvard, Stephanie and Eric Winsberg. 2021. “Causal Inference, Moral Intuition, and Modeling in a Pandemic.” Philosophy of Medicine 2, no. 2: 1–10. https://doi.org/10.5195/pom.2021.70.

Heider, Grace M. 1977. “More about Hull and Koffka.” American Psychologist 32, no. 5: 383. https://doi.org/10.1037/0003-066X.32.5.383.a.

Hood, Leroy. 2013. “Systems Biology and P4 Medicine: Past, Present, and Future.” Rambam Maimonides Medical Journal 4, no. 2: 1–15. https://doi.org/10.5041/RMMJ.10112.

Horton, Richard and Selina Lo. 2015. “Planetary Health: A New Science for Exceptional Action.” The Lancet 386, no. 10007: 1921–1922. https://doi.org/10.1016/S0140-6736(15)61038-8.

Huber, Machteld, J. André Knottnerus, Lawrence Green, Henriëtte van der Horst, Alejandro R. Jadad, Daan Kromhout, Brian Leonard, et al. 2011. “How Should We Define Health?” British Medical Journal 343: 1–3. https://doi.org/10.1136/bmj.d4136.

Kärki, Kaisa. 2022. “Listening to Vaccine Refusers.” Medicine, Health Care and Philosophy 25, no. 1: 3–9. https://doi.org/10.1007/s11019-021-10055-y.

Kim, Jerome H., Florian Marks, and John D. Clemens. 2021. “Looking beyond Covid-19 Vaccine Phase 3 Trials.” Nature Medicine 27: 205–211.

https://doi.org/10.1038/s41591-021-01230-y.

Kotecha, Pinky, Alexander Light, Enrico Checcucci, Daniele Amparore, Cristian Fiori, Francesco Porpiglia, Prokar Dasgupta, and Oussama Elhage. 2020. “Repurposing of Drugs for Covid-19: A Systematic Review and Meta-Analysis.” MedRxiv.

https://doi.org/10.23736/S0031-0808.20.04024-0.

Leonhardt, David. 2021. “Red Covid.” New York Times, 27 September. https://www.nytimes.com/2021/09/27/briefing/covid-red-states-vaccinations.html.

Leonardi, Fabio. 2018. “The Definition of Health: Towards New Perspectives.” International Journal of Health Services 48, no. 4: 735–748. https://doi.org/10.1177/0020731418782653.

Li, Chuan-Xing, Jing Gao, Zicheng Zhang, Lu Chen, Xun Li, Meng Zhou, and Åsa M. Wheelock. 2022. “Multiomics Integration-Based Molecular Characterizations of Covid-19.” Briefings in Gioinformatics 23, no. 1: 1–17. https://doi.org/10.1093/bib/bbab485.

Li, Heidi Oi-Yee, Elena Pastukhova, Olivier Brandts-Longtin, Marcus G. Tan, and Mark G. Kirchhof. 2022. “YouTube as a Source of Misinformation on Covid-19 Vaccination: A Systematic Analysis.” BMJ Global Health 7, no. 3: 1–6. https://doi.org/10.1136/bmjgh-2021-008334.

Machingaidze, Shingai and Charles Shey Wiysonge. 2021. “Understanding Covid-19 Vaccine Hesitancy.” Nature Medicine 27: 1338–1339. https://doi.org/10.1038/s41591-021-01459-7.

Mandavilli Apoorva. 2022. “The C.D.C.’s New Challenge? Grappling with Imperfect Science.” New York Times, 17 January.

https://www.nytimes.com/2022/01/17/health/cdc-omicron-isolation-guidance.html.

Marcum, James. 2015. “Healthcare Personalism: A Prolegomenon.” European Journal for Person Centered Healthcare 3, no. 2: 228–232. http://dx.doi.org/10.5750/ejpch.v3i2.941.

———. 2020a. “Can We Handle the Truth of What Covid-19 Is Telling Us?” Animal Sentience 30, no. 17: 1–3. https://doi.org/10.51291/2377-7478.1641.

———. 2020b. From Systems Biology to Systems Medicine. New York: Nova Science.

Martinez, Miguel Angel. 2021. “Lack of Effectiveness of Repurposed Drugs for Covid-19 Treatment.” Frontiers in Immunology 12: 1–4. https://doi.org/10.3389/fimmu.2021.635371.

McDowell, Ian. 2006. Measuring Health: A Guide to Rating Scales and Questionnaires. 3rd edition. New York: Oxford University Press.

Mercuri, Mathew. 2020. “Just Follow the Science: A Government Response to a Pandemic.” Journal of Evaluation in Clinical Practice 26, no. 6: 1575–1578. https://doi.org/10.1111/jep.13491.

Mercuri, Mathew and Amiram Gafni. 2022. “(Mis)Communication of Covid‐19 Vaccine Benefits and Harms.” Journal of Evaluation in Clinical Practice 28, no. 2: 173–177. https://doi.org/10.1111./jep.13655.

Miller, James G. 1973. “The Nature of Living Systems.” Quarterly Review of Biology 48, no. 1, Part 2: 63–91. https://doi.org/10.1086/407588.

Moleman, Marjolein, Fergus Macbeth, Sietse Wieringa, Frode Forland, Beth Shaw, and Teun Zuiderent‐Jerak. 2022. “From ‘Getting Things Right’ to ‘Getting Things Right Now’: Developing Covid‐19 Guidance under Time Pressure and Knowledge Uncertainty.” Journal of Evaluation in Clinical Practice 28, no. 1: 49–56. https://doi.org/10.1111/jep.13625.

Musalek Michael. 2013. “Health, Well-Being and Beauty in Medicine.” Topoi 32, no. 2: 171–177. https://doi.org/10.1007/s11245-013-9169-8.

Northcott, Robert. 2022. “Pandemic Modeling, Good and Bad.” Philosophy of Medicine 3, no. 1: 1–20. https://doi.org/10.5195/pom.2022.79.

Nunn, Robin. 2012. “Many‐Models Medicine: Diversity as the Best Medicine.” Journal of Evaluation in Clinical Practice 18, no. 5: 974–978. https://doi.org/10.1111/j.1365-2753.2012.01903.x.

Nyabadza, Farai, Alex Broadbent, Charis Harley, Abejide Ade-Ibijola, and Ebrahim Momoniat. 2021. “Models and Muddles in the Covid-19 Pandemic.” South African Journal of Science 117, no. 9–10: 8–11. https://doi.org/10.17159/sajs.2021/9506.

Olliaro, Piero, Els Torreele, and Michel Vaillant. 2021. “Covid-19 Vaccine Efficacy and Effectiveness: The Elephant (Not) in the Room.” The Lancet Microbe 2, no. 7: e279–e280. https://doi.org/10.1016/S2666-5247(21)00069-0.

Parkkinen, Veli-Pekka, Christian Wallmann, Michael Wilde, Brendan Clarke, Phyllis Illari, Michael P. Kelly, Charles Norell, et al. 2018. Evaluating Evidence of Mechanisms in Medicine: Principles and Procedures. Cham: Springer. https://doi.org/10.1007/978-3-319-94610-8.

Pfaff, Holger and Jochen Schmitt. 2021. “The Organic Turn: Coping with Pandemic and Non-Pandemic Challenges by Integrating Evidence-, Theory-, Experience-, and Context-Based Knowledge in Advising Health Policy.” Frontiers in Public Health 9: 727427. https://doi.org/10.3389/fpubh.2021.727427.

Pummerer, Lotte, Robert Böhm, Lau Lilleholt, Kevin Winter, Ingo Zettler, and Kai Sassenberg. 2022. “Conspiracy Theories and Their Societal Effects during the Covid-19 Pandemic.” Social Psychological and Personality Science 13, no. 1: 49–59. http://dx.doi.org/10.1177/19485506211000217.

Rao, Gundu H.R. 2021. “Biomedicine in the Covid Age: Opportunities, Responses, and Challenges.” International Journal of Biomedicine 11, no. 3: 241–249. http://dx.doi.org/10.21103/Article11(3)_RA1.

Rehman, Sabi Ur, Shaheed Ur Rehman, and Hye Hyun Yoo. 2021. “Covid-19 Challenges and Its Therapeutics.” Biomedicine & Pharmacotherapy 142: 1–12. https://doi.org/10.1016/j.biopha.2021.112015.

Russo, Federica and Jon Williamson. 2007. “Interpreting Causality in the Health Sciences.” International Studies in the Philosophy of Science 21, no. 2: 157–170. https://doi.org/10.1080/02698590701498084.

Sackett, David L., William M.C. Rosenberg, J.A. Muir Gray, R. Brian Haynes, and W. Scott Richardson. 1996. “Evidence Based Medicine: What It Is and What It Isn’t.” British Medical Journal 312: 71–72. https://doi.org/10.1136/bmj.312.7023.71.

Sallam, Malik. 2021. “Covid-19 Vaccine Hesitancy Worldwide: A Concise Systematic Review of Vaccine Acceptance Rates.” Vaccines 9, no. 2: 1–14. https://doi.org/10.3390/vaccines9020160.

Shealy, C. Norman. 1979. “Holistic Medicine.” Journal of the American Medical Association 242: 1489–1490. https://doi.org/10.1001/jama.1979.03300140011006.

Simon, Jeremy R. 2021. “Covid-19 and the Problem of Clinical Knowledge.” History and Philosophy of the Life Sciences 43, no. 2: 1–5. https://doi.org/10.1007/s40656-021-00405-7.

Solomon, Miriam. 2021. “EBM or EBM+ When Evaluating Evidence for the Effectiveness of Covid-19 Therapies.” Institute for the Future of Knowledge, Philosophical Perspectives on Covid-19 Conference, Day 2, 7 July. https://www.youtube.com/watch?v=-WcBw23Jl0o.

Stevens, Alex. 2020. “Governments Cannot Just ‘Follow the Science’ on Covid-19.” Nature Human Behaviour 4: 560. https://doi.org/10.1038/s41562-020-0894-x.

Sturmberg, Joachim P. 2019. “Evidence‐Based Medicine: Not a Panacea for the Problems of a Complex Adaptive World.” Journal of Evaluation in Clinical Practice 25, no. 5: 706–716. https://doi.org/10.1111/jep.13122.

Sturmberg, Joachim, Elisabeth Paul, Wim van Damme, Valery Ridde, Garrett W. Brown, and Andreas Kalk. 2021. “The Danger of the Single Storyline Obfuscating the Complexities of Managing SARS‐CoV‐2/Covid‐19.” Journal of Evaluation in Clinical Practice 28, no. 6: 1173–1186. https://doi.org/10.1111/jep.13640.

Thyagarajan, T. and D. Kalpana. 2021. Linear and Non-Linear System Theory. Boca Raton, FL: CRC Press.

Tranquillo Joe. 2019. An Introduction to Complex Systems: Making Sense of a Changing World. Cham: Springer. https://doi.org/10.1007/978-3-030-02589-2.

Tregoning, John S., Katie E. Flight, Sophie L. Higham, Ziyin Wang, and Benjamin F. Pierce. 2021. “Progress of the Covid-19 Vaccine Effort: Viruses, Vaccines and Variants Versus Efficacy, Effectiveness and Escape.” Nature Reviews Immunology 21: 626–636. https://doi.org/10.1038/s41577-021-00592-1.

Tretter, Felix. 2019. “‘Systems Medicine’ in the View of von Bertalanffy’s ‘Organismic Biology’ and Systems Theory.” Systems Research and Behavioral Science 36, no. 3: 346–362. https://doi.org/10.1002/sres.2588.

Tretter, Felix and Angela Franz-Balsen. 2020. “Covid-19: Science, Politics, Media, and the Public: A Systemic View.” Human Ecology Review 26, no. 1: 31–46. http://dx.doi.org/10.22459/HER.26.01.2020.04.

Tretter, Felix and Henriette Löffler-Stastka. 2019. “Medical Knowledge Integration and ‘Systems Medicine’: Needs, Ambitions, Limitations and Options.” Medical Hypotheses 133: 1–8. https://doi.org/10.1016/j.mehy.2019.109386.

Tretter, Felix, Eva M.J. Peters, Joachim Sturmberg, Jeanette Bennett, Eberhard Voit, Johannes W. Dietrich, Gary Smith, et al. 2022. “Perspectives of (/Memorandum for) Systems Thinking on Covid‐19 Pandemic and Pathology.” Journal of Evaluation in Clinical Practice. Early view. https://doi.org/10.1111/jep.13772.

Tretter, Felix, Olaf Wolkenhauer, Michael Meyer-Hermann, Johannes W. Dietrich, Sara Green, James Marcum, and Wolfram Weckwerth. 2021. “The Quest for System-Theoretical Medicine in the Covid-19 Era.” Frontiers in Medicine 8: 1–13. https://doi.org/10.3389/fmed.2021.640974.

Tyagi, Arun, Sharad Garudkar, A.G. Gagare, and Amit Thopte. 2015. “Medical Uncertainty: Are We Better Off in Era of Evidence-Based Medicine?” International Journal of Medical Research & Health Sciences 4, no. 1: 208–213. http://dx.doi.org/10.5958/2319-5886.2015.00034.X.

Upshur, Ross E. 2005. “Looking for Rules in a World of Exceptions: Reflections on Evidence-Based Practice.” Perspectives in Biology and Medicine 48: 477–489. https://doi.org/10.1353/pbm.2005.0098.

Vallejos, Julio, Rodrigo Zoni, María Bangher, Silvina Villamandos, Angelina Bobadilla, Fabian Plano, Claudia Campias, et al. 2021. “Ivermectin to Prevent Hospitalizations in Patients with Covid-19 (IVERCOR-COVID19): A Randomized, Double-Blind, Placebo-Controlled Trial.” BMC Infectious Diseases 21: 1–11. https://doi.org/10.1186/s12879-021-06348-5.

Van Asselt, Marjolein and Jan Rotmans. 2002. “Uncertainty in Integrated Assessment Modelling.” Climatic Change 54, no. 1: 75–105. https://doi.org/10.1023/A:1015783803445.

Van Druten, V.P., E.A. Bartels, D. van de Mheen, E. de Vries, A.P.M. Kerckhoffs, and L.M.W. Nahar-van Venrooij. 2022. “Concepts of Health in Different Contexts: A Scoping Review.” BMC Health Services Research 22, no. 1: 1–21. https://doi.org/10.1186/s12913-022-07702-2.

Whitmee, Sarah, Andy Haines, Chris Beyrer, Frederick Boltz, Anthony G. Capon, Braulio Ferreira de Souza Dias, Alex Ezeh, et al. 2015. “Safeguarding Human Health in the Anthropocene Epoch: Report of the Rockefeller Foundation–Lancet Commission on Planetary Health.” The Lancet 386, no. 10007: 1973–2028. https://doi.org/10.1016/S0140-6736(15)60901-1.

WHO Interim Commission. 1948. Official Records of the World Health Organization No. 2. Geneva: World Health Organization. https://apps.who.int/iris/bitstream/handle/10665/85573/Official_record2_eng.pdf.

Wong, Gary, Yu-Hai Bi, Qi-Hui Wang, Xin-Wen Chen, Zhi-Gang Zhang, and Yong-Gang Yao. 2020. “Zoonotic Origins of Human Coronavirus 2019 (HCoV-19/SARS-CoV-2): Why Is This Work Important?” Zoological Research 41, no. 3: 213–219. https://doi.org/10.24272%2Fj.issn.2095-8137.2020.031.

Yong, Ed. 2020. “America Is Trapped in a Pandemic Spiral.” The Atlantic, 9 September. https://www.theatlantic.com/health/archive/2020/09/pandemic-intuition-nightmare-spiral-winter/616204/.

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2023-05-11

How to Cite

Marcum, J. A., & Tretter, F. (2023). From Evidence-Based Corona Medicine to Organismic Systems Corona Medicine. Philosophy of Medicine, 4(1). https://doi.org/10.5195/pom.2023.138

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