Can You Stave Off A Cold With Willpower?

cwick (Chadwick Matlin, deputy editor): :sniffle: Maggie, Anna and Christie, I’ve gathered you all to discuss the kind of question that could change EVERYTHING (and one well-timed for flu season): When I know it’s really important for me not to be sick for a day or two (say, if there’s an election coming), can I stop myself from feeling sick? Does my mind really have power over my matter? Is my brain that dope?

You’re not doctors, but in my book, you’re close enough: journalists who talk to doctors. So tell me: Do I have the power???

slackbot: I’m sorry you aren’t feeling well. There is Advil and Tylenol in the cabinet in front of Nate’s office/Vanessa’s desk.

cwick: Readers, that’s an auto-response triggered every time one of us says “sick” anywhere in our chat app. But if you ever need an Advil in the FiveThirtyEight office, now you know where to find it.

christie (Christie Aschwanden, lead writer for science): Hi, Chad! I love it when an editor sends writers off to get an answer to his personal medical problem.

maggiekb (Maggie Koerth-Baker, senior science writer): I get where he’s coming from, though. This is a pretty common belief. I mean, my super skeptic engineer husband is convinced that he saved all his illnesses for the end of the semester in college. Last test done. And then the deluge.

cwick: I suffered through a 102-degree fever the day after my wedding. I don’t think anything you say will convince me that I WASN’T holding it at bay the whole weekend.

christie: Because I like you, Chad, I asked a few experts. I have a few pet theories myself. But first, the expert opinion: “Sorry. No evidence of the willpower effect!” That’s according to Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

anna (Anna Maria Barry-Jester, senior reporter): Was that a “no evidence for or against” the willpower effect, Christie?

christie: I think he meant there was no evidence that there is a willpower effect.

And Marc Lipsitch, an epidemiologist at Harvard, said the same thing that several others did: “I don’t know of any research one way or another about these things.”

anna: (Thank you for that prescient answer to my at-that-point unasked question, Mr. Lipsitch.)

christie: One of my theories: It’s all about attention and focus. When you’re stressed about something else or hyperfocused on getting through finals week or meeting a deadline or getting out a grant proposal, all of your attention is going to that other task. When you get through it, you have more attention to pay to your symptoms, and you can kind of bask in them. So it’s not that you’re not sick (while you’re supposedly holding it off), it’s just that you’re in denial or you’re ignoring the symptoms.

anna: I can buy that (though I assume you’re talking about mild colds here).

christie: Yeah, I’m talking about the usual winter crud. Not the kind of illness that you can’t possibly ignore, like a heart attack.

anna: The one interesting thing I found was some research about colds and placebo. But before we get to that, there seems to be very little research on warding off illness altogether or delaying it and a lot more on reducing symptoms or shortening how long you are sick. Part of the problem there is that mild colds come and go, making them difficult to study.

christie: Good point, Anna. And that’s also what makes placebos so good at treating them.

anna: But a study from 2011 really intrigued me. It’s one study and it’s small … It looked at echinacea, an herbaceous flower commonly used to treat colds (the National Institutes of Health says some preparations may potentially treat colds, but the evidence is weak). The study essentially found that people who believed in the power of echinacea and were given a placebo pill had shorter colds (by a lot, 2.5 days!) than those who didn’t believe. Placebo: It’s a hell of a drug.

christie: If you take the placebo when you are feeling your worst, which is usually the low point no matter what, then what is really just the illness’s natural course appears like an effective treatment. (When it’s at its worst, it can only get better.)

anna: What about my favorite cold placebo, vitamins in the form of a fizzy additive to water? I take that before I get on a plane. Or ride the NYC subway.

christie: Oh, the fizzy vitamin water? People love those! And they’re a great placebo. But … a Cochrane review found that vitamin C did not reduce the incidence of colds and that “trials of high doses of vitamin C administered therapeutically, starting after the onset of symptoms, showed no consistent effect on the duration or severity of common cold symptoms.”

anna: Oh, I know that there isn’t particularly convincing evidence about the effect of vitamin C on colds. It is literally my favorite placebo, not pharmaceutical. The placebo effect is real.

christie: I wonder how they measured the duration of the cold in the echinacea study. Because if it’s derived from a self-reported “how do you feel?” question, there’s a lot of wiggle room. If you expect to feel better, you might in fact rate yourself as feeling better. Because how you feel is a rating of your experience. It’s open to suggestion.

anna: “Duration was defined as total time elapsed from enrollment until the last time answering yes to the question, ‘Do you think you still have a cold?’” I think that’s part of why that study intrigued me, Christie. Because it suggested that how people felt depended on whether they thought the treatment could work. I don’t see why that couldn’t in theory translate to keeping a cold at bay, as well.

christie: Agree, Anna. How we actually feel is a conglomeration of a lot of things, which include how we expect to feel.

cwick: So are we really talking about two different questions: Can I stop myself from feeling sick for a bit? (No, you dummy.) Can I make myself feel better once I am sick? (Maybe if you truly believe.)

maggiekb: I’m going to add one more question here, Chad. Instead of asking whether you can hold off your illness until your stressful life events are done, what about the question of whether stressful life events make you sick. And the answer to that, kind of surprisingly, is … well … maybe … yeah.

There’s a line of research — enough individual research papers to make a meta-analysis — that suggests stressful life events can make you more susceptible to things like the common cold.

christie: That’s a good point, Maggie. And that leads me to another theory: When you’re stressed about that thing in your life, you may be more susceptible to illnesses. You may be skimping on sleep, not eating well, drinking too much, skipping exercise, etc. The illness just catches up to you.

maggiekb: The studies on this are super interesting because they actually involve getting these sample groups of people, doing inventories about their stressful life events, and then exposing them all to cold virus intentionally. So for instance, in one 2012 study, the people who reported stress and stressful life events were twice as likely to get sick.

cwick: Wait, what does purposeful exposure to cold virus look like? Do I get misted? Do I get slobbered on? Does someone wipe their snotty hand on my face?

anna: In the nose, Chad.

cwick: 👃!!!!

christie: In one study, Chad, they gave nasal drops containing rhinovirus. Turns out, people who were sleep deprived were most likely to get sick.

maggiekb: Misting in some of these studies. Swabbing in others.

cwick: My nose is twitching just thinking about it.

anna: Which is to say, don’t pick your nose after riding the subway.

christie: And don’t touch your nose, eyes or mouth ever during flu season if you want to stay well. Seriously, good hygiene practices are your very best defense. Wash your hands with soap and water. Don’t cough on people (or get coughed on).

maggiekb: It’s not just cold/flu, either. There are some papers that show connections between stress and worse outcomes for HIV/AIDS. Including higher levels of virus in the bloodstream, an increased risk of picking up other infections, and increased risk of death.

I’m kind of fascinated now by this researcher at Carnegie Mellon who has basically made it his life’s work to figure out WHY stress is able to increase your risk of contracting a communicable disease. And you guys are going to love this … he’s the American Psychosomatic Society’s 2018 distinguished scientist.

christie: Wow, there’s an American Psychosomatic Society?

anna: Pardon, what?

cwick: Cheap joke: They dreamed it into reality

maggiekb: Anyway, his theory is that the receptors that bind to stress hormones can become resistant to those hormones. The more resistance, the worse your body is at suppressing inflammation. The more chronic inflammation, the worse things work … in terms of preventing illness.

anna: Chad, you really just want to know if you can will yourself into not getting sick, right? Do you care at all about what you can do to make that sickness … shorter, less … sick?

cwick: IDK, once I am sick, I sort of revel in complaining about it. If you shorten my colds, what would I have to talk about?

christie: Go ahead and joke, Chad, but I think we should be careful about stigmatizing the connection between mind and body health.

maggiekb: It’s not hokum. At least not completely.

christie: The mind is a crucial part of the body, so it’s not surprising that one’s psychological state of being can affect physical symptoms. Instead of joking that it’s “all in their heads,” we might be better off trying to harness this connection.

anna: Related: A recent New York Times magazine story delves into the new science of placebo and after reading it, it’s hard not to feel like a whole new era of treatment could be upon us. But it means completely revamping how we think about things like placebo.

christie: You know where this is leading, right, Chad? To my perpetual mantra: It’s complicated, and science is hard.

cwick: When will science get easier?

christie: Never! Sorry.

cwick: Lame.

Will The Midterms Decide Who Runs In 2020?

Welcome to FiveThirtyEight’s weekly politics chat. The transcript below has been lightly edited.


sarahf (Sarah Frostenson, politics editor): It is now 21 DAYS UNTIL THE MIDTERMS!! And while voters will mainly be deciding who controls Congress, they’ll also maybe be deciding what kind of Democrat should run in 2020. For instance, if Democrats don’t take back the House, does that mean a Joe Biden run in the 2020 Democratic primary is more likely? Or if there is a blue wave and Democrats gain 60+ seats, does that make the road easier for a more progressive Democrat like Sen. Kamala Harris?

clare.malone (Clare Malone, senior political writer): Man, if the Democrats lose the House, I think there will be some straight-up PANIC.

natesilver (Nate Silver, editor in chief): There would be, although one could ask whether it was warranted or not.

clare.malone: I don’t think Joe Biden needs them to lose the House to prove he’s a good candidate. He could just point to Democratic Senate losses, maybe?

Assuming that Democrats lose in a couple of red states, a candidate like Biden could say, “Look, I will make inroads in a place like that.”

But I’m interested in Nate’s House take.

natesilver: I mean, to a first approximation I think a lot of this stuff is silly.

Here’s why:

As David says, there isn’t much of a pattern for how midterms affect the next presidential election.

Certainly. it will affect Democrats’ attitude, but how much that attitudinal change affects 2020, and whether that is helpful or hurtful to Democrats, is pretty up in the air, IMO.

clare.malone: Right — I mean was just about to say, proof aside (proof! facts!), I think candidates and party apparatchiks always use a loss to motivate their constituents.

That attitudinal thing can be pretty powerful in a primary campaign. See: Bernie Sanders.

natesilver: I’m skeptical that Biden could use Senate losses to justify the need for more conservative candidates … if Democrats also win the House.

We’ll see, though. There are some pretty wacky scenarios that are within the realm of possibility, like Democrats winning 35 House seats but losing four Senate seats.

clare.malone: I think people’s minds are on the Senate right now, though. And the Republican majority there does lie in smaller states and regions that Democrats have gradually lost over the past couple of decades.

It’s not an absurd argument to make in 2019.

perry (Perry Bacon Jr., senior writer): I think Biden has to decide if he wants to run or not. He was kind of confused about whether to run in 2016. And based on what he’s been saying, he doesn’t seem to know now either. I think a really strong push to draft him might encourage him to get in the running. And I think Democrats not winning the House (assuming that they lose the Senate too) will get more people to encourage him to run. Biden would be an important figure if he got in the race, in large part because others in this more “centrist” lane might not run if he is in.

clare.malone: I don’t think Biden is a Mario Cuomo: I think he’ll get in the race. I’m not sure how much he’ll toy with people up until the very end.

natesilver: Are people’s expectations that Democrats will win the Senate? If so, people aren’t paying much attention (certainly not paying much attention to our forecast).

clare.malone: I don’t know. I don’t think people expect that. I guess you hear “blue wave” bandied about and you could make assumptions.

sarahf: And it wasn’t always so dire in the Senate either — it wasn’t until early October that Democrats’ odds worsened dramatically.

But OK, let’s set aside what could happen in the Senate for a moment and assume that there is a huge blue wave in the House and even in some key gubernatorial races like Stacey Abrams’s, in Georgia, and Andrew Gillum’s, in Florida.

It doesn’t mean Democrats win in 2020, but doesn’t it change the playing field of candidates in the Democratic primary? Or would Sens. Harris, Elizabeth Warren and Cory Booker run no matter what?

clare.malone: I think Gillum or Abrams wins would be huge. It would challenge some norms about what sorts of candidates win in states where you need to win over moderates or Republican-leaning independents.

natesilver: Gov. Scott Walker losing his re-election bid in Wisconsin might have some interesting narrative implications too, although not in the same way that Gillum and Abrams do.

perry: I’m interested in Abrams’s and Gillum’s gubernatorial bids and Rep. Beto O’Rourke’s Texas Senate run because they are all making the case that it is a better strategy to try to amp up the base to get greater minority and youth turnout rather than trying to win over swing voters. If they do significantly better in their states than more moderate candidates from previous years, I think that would buttress Democrats like Warren and Harris, who are more likely to run more decidedly liberal campaigns.

But the Midwest is interesting, as Nate is hinting at. The Democrats are doing well in the Midwest with a bunch of candidates who are kind of bland and fairly centrist-friendly. The South and the Midwest are, of course, very different regions, too.

natesilver: I guess I’ve just never dealt with an election before where you’d get the sort of split verdict like the one we’re predicting, where Democrats win the House and do pretty darn well in gubernatorial races but fall short –– and possibly even lose seats –– in the Senate. And some of the high-profile toss-up races could also go in different directions. Maybe Gillum wins in Florida but Abrams loses in Georgia, for example.

In that case, there would be a sort of battle-of-narrative-interpretations over the midterms.

sarahf: As our colleague Geoffrey Skelley wrote, the last time the Senate and House moved in opposite directions during a midterm was in 1982, during under Ronald Reagan’s presidency.

Part of that was because Reagan had a pretty bad approval rating, in the low 40s … which isn’t too far off from where President Trump’s sits now.

natesilver: And I guess 1982 was interpreted as being pretty bad for Reagan? I was 4 years old then, so I don’t remember. 😉

sarahf: But we could get a really weird coalition of Democrats with competing priorities in 2019 if they do take back the House.

And that could make finding a general-election candidate that appeals to both the more moderate and more progressive wings of the party … challenging.

clare.malone: I guess this is why so many people in the post-2016 party were enamored of the Sanders economic message.

It gets to the progressive heart of things while trying to avoid the touchy culture stuff.

But, of course, Democrats have to figure out the Trump factor. Trump will inevitably drag culture wars stuff into a campaign.

perry: Sens. Tammy Baldwin, Sherrod Brown, Bob Casey and Amy Klobuchar are likely to win in the Midwest, an important region of the country for Democrats electorally — and some of that group could win easily. Post-election, we will be able to see the counties in Minnesota where Trump won in 2016 but that Klobuchar carried in 2018 — and I think there may be a lot of them. Plus, that’s the kind of thing she could talk about if she decides to run for president.

clare.malone: Right. But none of those senators have the buzz factor in this shadow primary that we’re in right now.

Nor the fundraising.

But that could change post-November.

sarahf: Speaking of fundraising …

What do we make of all the 💰💰💰 pouring into O’Rourke’s campaign?

Why aren’t more Democratic supporters funding races where the Democratic candidate actually stands a chance of winning?

natesilver: Oh no, you’re going to trigger me, Sarah.

The O’Rourke fundraising narrative is so fucking dumb.

Democrats are raising huge amounts of money EVERYWHERE.

EVERYWHERE.

clare.malone: We spend a lot of time here on numbers, but I always think of people reacting to politicians they really like in almost pheromone-tinged ways. People are irrational actors when it comes to politics — it’s why they vote by party even when the party positions do a 180 (see, ahem, the post-2016 GOP on trade, Russia, and so on.)

perry: In terms of O’Rourke, I was surprised the majority of the money came from Texas, according to his campaign. So it was not just coastal elites who liked seeing a white man delivering Black Lives Matter talking points. Houston, Austin and Dallas all have plenty of Democrats, but they are not Los Angeles, Washington, D.C., or New York. That also pushes back on the idea that he is somehow taking money away from other close races around the country.

clare.malone: Democrats see inspirational stuff in O’Rourke’s response to the NFL kneeling issue and the incident where a black man was shot and killed in his own home.

They like that he’s saying this stuff in Texas.

They also really dislike Ted Cruz.

perry: I think this kind of small-dollar fundraising is a real talent and shows real political appeal. It is what made Howard Dean, Barack Obama and Bernie Sanders such viable candidates.

clare.malone: O’Rourke’s also gotten a lot of media buzz, so people know his name, unlike, say, Sen. Joe Donnelly (running for re-election in Indiana) or former Gov. Phil Bredesen (running for Senate in Tennessee).

So they send O’Rourke money!

natesilver: Texas is also a big state with a lot of wealth, and Democrats there haven’t had a lot to donate to in a while.

perry: I can’t tell if O’Rourke should run for president if he loses the Senate race. But he should definitely think about it.

Hard.

clare.malone: I mean, the thing about O’Rourke running in 2020 is that he’s proved he can fundraise and he’s still young(-ish), but he’s been in Congress awhile, which is an asset. People can’t call him too inexperienced the way they could with, say, failed Missouri Senate candidate Jason Kander.

perry: But I’m not sure how the midterms affect the political outsiders like lawyer Michael Avenatti, billionaire Tom Steyer and former New York Mayor Michael Bloomberg. That is the one group I’m probably the most curious about. I feel like I know who the main established candidates are — the senator and governor types like Warren, Booker or Montana Gov. Steve Bullock. I suspect the more it seems like Democrats are in crisis, the more these outsiders have a rationale to run.

sarahf: Bloomberg did just re-register as a Democrat.

clare.malone: Real question: Does Avenatti actually want to run or does he just like the attention?

I don’t think he really wants to run.

natesilver: I think Avenatti’s chances are overrated because people are overcompensating for their failure to see Trump last time.

natesilver: He massively, massively, massively fucked up in the Kavanaugh thing.

He’s polling at 1 percent.

I don’t think his chances are zero … I just think he’s one from a long list of long shot possibilities.

clare.malone: POLLS!

Bloomberg’s flirtations feel so off for this political moment with the Democrats.

perry: I think Avenatti, Bloomberg and Steyer would love to be president, so if there is demand for their candidacies, they will be more than eager to jump in. But whether there’s demand for their candidacies is going to depend on whether Democrats need a savior.

sarahf: I guess what I’m trying to wrap my head around is: Under what scenario does it make sense for these outsider candidates to run?

perry: If Democrats lose the House and Senate.

natesilver: Make sense for them or make sense for Democrats?

perry: It makes sense for them.

natesilver: If Avenatti thinks it will help to sell more books and put him on TV even more, he’ll run.

If he thinks it will damage his brand in the long term, maybe not.

perry: Yes, Avenatti may just want the fame.

clare.malone: Right.

Steyer and Bloomberg are more interesting because they actually have $$$$.

perry: Bloomberg endorsed Hillary Clinton in 2016. Maybe he feels like he should just run.

He tried to be a team player, and it didn’t work.

sarahf: No matter the national environment for Democrats?

clare.malone: E G O

perry: I think a lot of these candidates are more responsive to, say, “Morning Joe” than FiveThirtyEight.

I will be watching what “Morning Joe” says the day after the election.

sarahf: OK, so, what happens in 2018 means nothing for 2020 … but in a world where they are related, what are you looking for on election night to give you clues about 2020?

perry: I’m looking for results that will create narratives that make it easier for people to run — or not run. I assume Klobuchar wants to be president. Does she win her Senate election by so much that she convinces herself (and others) that she is the electable candidate Democrats want?

Or do Democrats do poorly enough in swing states that people who are too centrist for the party’s activist crowd (e.g., Biden, Bloomberg or Colorado Gov. John Hickenlooper) convince themselves and others that they are the solution?

Maybe O’Rourke, Abrams and Gillum do so well that it’s clear Democrats should try to grow the base and focus on swing voters less. Or they do terribly — and the message is that Democrats should be thinking about the center more.

natesilver: Again, it depends a lot on what happens (obviously). If Democrats sweep both chambers, or lose both chambers, there are some pretty clear takeaways. Otherwise, I’m not sure that the midterms will affect people’s behavior that much. I do think the Abrams and Gillum gubernatorial races are important, though. Plus, there’s the fact that Democrats have nominated an awful lot of women. And if women do well, it could (perhaps quite correctly!) lead to a narrative that Democratic candidates should look more like the party they’re representing, which is to say diverse and mostly female.

perry: I think I might view the 2018 election results less as telling us important information about 2020 and more as data points that will be spun by self-interested people into rationales for what they already wanted to do anyway.

clare.malone: I guess I’m mostly focusing on what kinds of women turn out to vote for Democrats in this election. I want to see whether there’s elevated turnout in communities we don’t usually see elevated turnout in, particularly with women. There are a huge number of female candidates potentially on the Democratic docket for 2020, and Warren, for example, has already made an interesting ad about running as an angry women in the age of Trump. What I’m saying here is that I’m eager to see what the zeigtgeisty take away from Nov. 6 will be, in addition to what stories “Good Morning America” is running vs. “Morning Joe” (as a proxy for what Americans who aren’t microscopically interested in politics will take away from the election).

sarahf: Indeed. And I’ll be looking for FiveThirtyEight’s 🔥 takes as well.