No, there is no Framingham Virus Study, but there should be. However, there is a Framingham Heart Study (FHS), a long-running cohort longitudinal study of all the factors related to heart disease. The FHS has greatly increased our knowledge of heart disease, and therefore it is one of the best healthcare research investments ever made. A similar long-term study of viral impact could greatly increase our knowledge of how viruses attack and infect their hosts.
In 1948 Congress authorized a cohort study of heart disease. Framingham, Massachusetts was chosen as the study’s location. At the time Framingham was a small town on the outskirts of the Boston metropolitan area. The researchers selected 5,209 voluntary adult town residents who were not diagnosed with heart disease, cancer or diabetes to be the initial sample in the study. They were given complete physicals and laboratory analyses, and their lifestyle choices were thoroughly surveyed. The researchers were able to correlate their behavior patterns and choices with their physical and medical outcomes.
For example, they established that increased smoking led to increased risk of heart disease. This information has been gathered every three to five years from the same town residents. Additionally, in the succeeding 72 years the children, grandchildren and great-grandchildren of the original participants have been added to the study. In 1994 a new cohort of residents was added to the study, reflecting Framingham’s increasing ethnic diversity, and in the 2000s genetic research related to heart disease was added to the data collection procedures.
Before the FHS it was generally believed that heart disease was an inevitable result of aging. FHS results showed that, although aging is a factor in heart disease, certain behavioral choices, such as smoking, obesity and lack of exercise have a major impact on onset and severity of heart disease. In general, results from the FHS show that the choices people make or do not make over extended periods of time are causes of the various forms of heart disease.
Could a similar longitudinal cohort study give us information about the causes of viral infection? Perhaps not, because viruses will attempt to infect any available host, regardless of who they are or the choices they have made. But it does seem that both the onset and the severity of viral infection is somewhat dependent on the choices people make.
For example, in the current pandemic it appears that people living in higher density, more urbanized areas are more vulnerable to infection than people living in rural areas. If the choices people make can affect who gets viral infections, then a long-term study in a chosen location could greatly expand our viral knowledge by answering the following questions.
Do established health maintenance protocols, such as exercise, weight control, a healthy diet, and stress management increase immunity and thereby reduce viral infections and severity? How much does density in living, working and entertainment environments increase the risk of infection, and do the health protocols mentioned in the first question reduce the risk even in these high-density environments?
Does previous infection by other types of viruses, such as chicken pox, herpes, and influenza, have any affect on immunity to newer viruses, such as the SARS/Corona viruses? How much does outdoor temperature have to do with the aggressiveness of viruses? That is, are people actually safer from infection in warmer weather, or do they just not show symptoms in warmer weather?
I’m sure that there are many additional questions that experts could ask, and all the questions could be more completely answered in a long-term study like FHS. One of the most disheartening discoveries stemming from the current pandemic is how little we know about our ancient enemy, viruses, here at the beginning of the 21st Century.
As a global society we have not taken the destructive power of viruses seriously enough. Initiating and maintaining the Framingham Heart Study was a sign that we took heart disease seriously and did something about it. We need to apply the same seriousness to understanding and defeating viruses.
Image by Gerd Altmann from Pixabay