FOR IMMEDIATE RELEASE Orthomolecular Medicine News Service, January 10, 2026

The Pathogen-Response Time Gap

Nutritional Immunity as the Missing Foundation of Pandemic Preparedness

Richard Z. Cheng, MD, PhD, Robert Smith, PhD, Thomas E. Levy, MD, JD

OMNS Editor's Note

This commentary reflects an Integrative Orthomolecular Medicine perspective and is intended to advance biological understanding of pandemic resilience rather than engage in policy advocacy.

Executive Summary

Pandemics cause their greatest harm during the early interval between the emergence of a novel pathogen and the successful development and deployment of effective pathogen-specific medical interventions. This unavoidable biological interval-the pathogen-response time gap-represents the central vulnerability of modern epidemic control.

During this early and most lethal phase, no targeted therapies exist that can meaningfully alter outcomes at the population level. Disease severity and survival are therefore determined primarily by host biological resilience, especially the functional integrity of innate immune defenses.

Nutritional Immunity, as articulated within Integrative Orthomolecular Medicine (IOM), directly addresses this vulnerability. By supporting immune energetics, redox balance, and inflammatory regulation through adequate micronutrient availability, Nutritional Immunity strengthens host defenses precisely when no pathogen-specific tools yet exist.

Micronutrients such as vitamin C, vitamin D, zinc, magnesium, and selenium are not optional supplements but essential, rate-limiting cofactors for immune function. Ensuring their adequacy is a foundational requirement for pandemic preparedness.

A Debate That Reveals a Missing Layer in Pandemic Preparedness

In late 2025, NIH Director Jay Bhattacharya and his Principal Deputy Director Matthew J. Memoli published an essay titled "NIH Directors: The World Needs a New Pandemic Playbook" arguing that aspects of the traditional pandemic preparedness paradigm - including pathogen cataloging and high-risk laboratory work - are flawed and potentially dangerous, and that future strategies must place greater emphasis on fundamental population health and resilience. City Journal

In early 2026, Seth Berkley, a veteran infectious-disease epidemiologist and former CEO of the International AIDS Vaccine Initiative, responded in Science with a commentary titled "Magical thinking will not prevent future pandemics or improve public health." Berkley cautioned that abandoning evidence-informed infectious disease strategies in favor of oversimplified approaches would not make populations safer and that neglecting foundational preparedness systems would leave societies less resilient to future threats. Science

Despite their differences, both ignore the inevitable vulnerability period-the early phase of pathogen emergence when outcomes are determined by host resilience alone.

This interval-the pathogen-response time gap-is where pandemics are decided and where Nutritional Immunity is indispensable.

The Pathogen-Response Time Gap: A Structural Limitation

Pathogen-specific therapeutic and preventive technologies share a fundamental and non-negotiable constraint: they cannot exist until a pathogen has already emerged, been identified, characterized, and targeted.

By definition, pathogen-specific interventions require:

• Pathogen detection and sequencing
• Target identification
• Development and testing
• Manufacturing and distribution
• Clinical uptake
• Biological response time

Even under ideal conditions, this process unfolds over weeks to months. During that interval, populations remain biologically exposed.

This is not a technological failure.
It is a category limitation rooted in biology.

Why Speed Cannot Eliminate the Biological Time Gap

Advances in biotechnology, accelerated regulatory pathways, and global manufacturing capacity have shortened development timelines. However, biology cannot be compressed to zero.

Even the most rapidly developed pathogen-specific intervention:

• Emerges only after widespread exposure has occurred
• Requires time to exert meaningful clinical effects
• Offers no benefit to individuals already experiencing severe disease

Thus, a window of maximal vulnerability is inevitable-precisely when:

• Health systems are overwhelmed
• Mortality curves steepen
• Public anxiety peaks
• Host biological reserves are tested

Pandemic preparedness strategies that do not explicitly address this window remain biologically incomplete.

The Biology of Early Vulnerability: Why Outcomes Differ So Widely

One of the most striking features of pandemics is the extreme heterogeneity of outcomes. Individuals with similar exposure may experience trajectories ranging from asymptomatic infection to multi-organ failure and death.

This variability cannot be explained by pathogens alone.

Modern immunology demonstrates that immune function is metabolically constrained. Effective immune responses depend on:

• Adequate cellular ATP production
• Intact mitochondrial function
• Robust redox buffering capacity
• Sufficient micronutrient availability

Chronic metabolic disease-obesity, insulin resistance, hypertension, and micronutrient deficiency-impairs each of these systems. Pandemics therefore function as stress tests of biological reserves, revealing vulnerabilities long before targeted interventions can exert meaningful impact.

Innate vs. Adaptive Immunity: The Biology of Early Pandemic Vulnerability

The human immune system operates through two interdependent but temporally distinct arms.

Innate immunity provides rapid, non-specific defense. It responds within hours of pathogen exposure through epithelial barriers, neutrophils, macrophages, natural killer cells, interferon signaling, and inflammatory containment. It requires no prior exposure or immune memory.

Adaptive immunity, by contrast, is highly specific and long-lasting. It depends on antigen recognition, clonal expansion, and immune maturation-a process that unfolds over days to weeks.

During the early phase of a novel pandemic, only innate immunity is immediately available.

Consequently, early survival is determined primarily by the functional integrity of innate immune defenses-systems that are profoundly dependent on metabolic capacity, redox balance, and micronutrient sufficiency.

Nutritional Immunity: Addressing Early Pandemic Vulnerability

Neither technological acceleration nor institutional optimization can eliminate the pathogen-response time gap. What can be addressed is host biological readiness, which is fundamentally a biochemical and nutritional property, not a technological one.

Nutritional Immunity focuses on strengthening immune competence during the period when no pathogen-specific tools yet exist. Effective interventions during this interval must be:

• Pathogen-agnostic
• Immediately deployable
• Safe and well-characterized
• Affordable and scalable
• Biologically grounded

Orthomolecular strategies-particularly adequate provision of vitamin C, vitamin D, zinc, magnesium, and selenium-meet these criteria by supporting fundamental immune biochemistry rather than targeting specific pathogens.

Vitamin C as a Prototype of Nutritional Immunity

Vitamin C illustrates the principles of Nutritional Immunity clearly.

Severe infections consistently produce:

• Rapid depletion of plasma and intracellular vitamin C
• Increased oxidative stress
• Dysregulated inflammatory signaling

Vitamin C is essential for:

• Neutrophil and macrophage function
• Interferon signaling
• Endothelial integrity
• Regulation of cytokine cascades

Clinical and experimental evidence supports its role in pneumonia, sepsis, acute respiratory distress syndrome, and severe viral illness. These effects are not pathogen-specific; they reflect universal biochemical requirements of immune defense under stress.

High-dose oral and intravenous vitamin C demonstrate favorable safety profiles and biological plausibility as early supportive interventions when no targeted therapies exist.

A Hierarchy of Immune Defense: Timing Determines Relevance

Pandemic resilience operates across multiple biological layers:

1. Immediate, non-specific host defense (Innate Immunity)
   • Nutritional status
   • Redox capacity
   • Metabolic resilience
2. Delayed, pathogen-specific responses
   • Adaptive immune maturation
   • Antibody and T-cell responses
3. Technology-dependent interventions
   • Pharmaceuticals
   • Pathogen-specific immune technologies
   • Targeted biologics

Neglecting the first layer leaves populations exposed precisely when protection is most urgently needed.

Conclusion

The central vulnerability of epidemic control is not a lack of scientific sophistication, but the biological interval between pathogen emergence and effective targeted intervention.

During this interval, outcomes are determined primarily by host resilience-not technology.

Nutritional Immunity addresses this Achilles' heel by strengthening immune function through immediate, pathogen-agnostic biological support. This approach reflects a foundational reality that conventional epidemic strategies systematically overlook.

Pandemics will continue to emerge. Whether they become catastrophes depends not only on what we develop technologically, but on the biological reserves of the populations they confront.

Key References (Selected)

1. Bhattacharya J, Memoli MJ. NIH Directors: The World Needs a New Pandemic Playbook. City Journal. November 2025. https://www.city-journal.org/article/nih-jay-bhattacharya-covid-pandemic-lab

2. Berkley S. Magical thinking will not prevent future pandemics or improve public health. Science. 2026. https://www.science.org/doi/10.1126/science.aee2611

3. O'Neill LAJ, Kishton RJ, Rathmell J. A guide to immunometabolism for immunologists. Nature Reviews Immunology. 2016;16:553-565. https://pubmed.ncbi.nlm.nih.gov/27396447/

4. Buck MD, Sowell RT, Kaech SM, Pearce EL. Metabolic instruction of immunity. Cell. 2017;169:570-586. https://pubmed.ncbi.nlm.nih.gov/28475890/

5. Hotamisligil GS. Inflammation and metabolic disorders. Nature. 2006;444:860-867. https://pubmed.ncbi.nlm.nih.gov/17167474/

6. Carr AC, Maggini S. Vitamin C and immune function. Nutrients. 2017;9:1211. https://www.mdpi.com/2072-6643/9/11/1211

7. Calder PC, Carr AC, Gombart AF, Eggersdorfer M. Optimal nutritional status for immune function. Nutrients. 2020;12:1181. https://www.mdpi.com/2072-6643/12/4/1181

8. Marik PE, Khangoora V, Rivera R, Hooper MH, Catravas J. Hydrocortisone, vitamin C, and thiamine in septic shock. Chest. 2017;151:1229-1238. https://pubmed.ncbi.nlm.nih.gov/27940189/

9. Cheng RZ. Protected Group Immunity, Not a Vaccine, Is the Way to Stop the COVID-19 Pandemic. Orthomolecular Medicine News Service. 2020;16(27). https://orthomolecular.org/resources/omns/v16n27.shtml

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