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When should fever be treated? Evolution has the answer

When should fever be treated? Evolution has the answer

Force of nature: understanding the deepest logic of evolution and putting it into practice Owen D. Jones W. W. Norton (2026) From antimicrobial resistance and vaccines to drug design and even policymaking, evolution is fundamental to many aspects of our lives. However, Darwinian thinking is too often neglected. In Force of natureBiologist and jurist Owen

Force of nature: understanding the deepest logic of evolution and putting it into practice Owen D. Jones W. W. Norton (2026)

From antimicrobial resistance and vaccines to drug design and even policymaking, evolution is fundamental to many aspects of our lives. However, Darwinian thinking is too often neglected.

In Force of natureBiologist and jurist Owen Jones argues convincingly that understanding how evolution by natural selection works can inform humans’ interactions with their environment and with each other, and that a poor understanding can create problems. He cites case studies from various fields, including medicine, agriculture, and law, to support his position.

An example he uses is antimicrobial resistance, one of the most pressing problems in the field of medicine. The overuse of antibiotics and antimicrobial chemicals by humans is unintentionally creating the circumstances in which antibiotic resistance can evolve. However, when people with tuberculosis stop taking antibiotics before the bacteria have been eradicated from their body, they are unconsciously promoting microbe resistance to antibiotics. But it is possible to predict and prevent resistance by considering how such behaviors select for the evolution of resistance.

Natural selection also offers new ways to understand cancer. Mathematical models can predict how tumor cells will behave when exposed to targeted therapies, which eliminate cells that express specific proteins. But eliminating those cells can reduce competitive pressure on others, allowing them to grow unhindered and causing the cancer to come back.

Many researchers once thought that this process, known as competitive release, would mean that targeted cancer therapy would probably not work in the long term.1. But mathematical oncologist Robert Gatenby and his colleagues have shown that it is possible to balance this dynamic. Killing just enough cells to stop tumor growth and leaving the rest intact can prevent the formation of a resistant population and allow people to live with cancer much longer than they would otherwise.2. Similarly, in agriculture, strategies informed by evolution can improve crop yields by avoiding pest and weed control measures that select for organisms with resistance.

Evolutionary arms races

But there are cracks in Jones’s argument. Take, for example, his discussion of fever. He cites the work of evolutionary biologist Paul Ewald that describes increased body temperature as a natural response to infection that is important for recovery. Like Ewald, he suggests that people should not use ibuprofen or other fever reducers and should instead let the body respond the way it evolved, if it is safe to do so.

The problem with this argument is that the story is more complicated, something even Ewald acknowledges. His 1994 book The evolution of infectious diseases He observed that many germs evolve to grow well in febrile conditions. And viruses and bacteria evolve much faster than animal immune systems, although there is a perpetual arms race between them.

Rather than adopting a general rule about when to treat fever, medical researchers would do better to identify which germs grow well in febrile conditions and which do not, so doctors can select the best interventions. If genomic markers indicate that a virus or bacteria is likely to grow in the presence of fever, medications should be taken to reduce people’s temperature; Otherwise, the fever should be allowed to run its course.

A top-down view of a festive dining table set for six people with empty white plates, yellow napkins and various plates including salad, bread, cold cuts and fruit. Hands of six people reach out to serve or hold glasses of orange juice and red wine.

Eating ultra-processed foods has been shown to increase the risk of cancer.Credit: Sergii Gnatiuk/Getty

I have worked with Ewald to discuss how natural selection affects arms races between hosts and their pathogens.3. Sometimes medical interventions perpetuate these competitive relationships, as is the case with multidrug-resistant tuberculosis. And sometimes, as in the case of vaccine use, treatment can completely end the competition between the pathogen and the host.

Therefore, what matters is the relationship between the host and the pathogen, not the characteristics of either. If clinicians understand this relationship, they will be able to use specific interventions appropriately. At the demographic level, effective interventions can end the arms race. Smallpox is a good example: vaccination helped eradicate this disease in the wild.

Social competence

Next, Jones discusses how insights from evolutionary theory can be used to understand and improve laws and other human systems. Combining his legal and scientific background, he describes the concordance of some legal principles across cultures (such as those that punish murder and theft) and argues that this is evidence that evolution has shaped human history. Brains are the product of evolutionary forces and laws are the product of brains. Consequently, the laws that societies tend to agree on have indirect evolutionary roots.

Understanding how evolution shapes behavior, Jones says, can inform how governments adapt their policies and interventions to prevent deaths. For example, he cites studies showing that stepchildren who live with a male parent who is not related to them are much more likely to die than children who live with their biological fathers. The evolutionary reasons for these findings are clear: stepparents simply will not invest as much in children who are not related to them. It suggests, therefore, that institutions conduct a cost-benefit analysis between reducing the risks faced by stepchildren at the population level and preventing the stigmatization of stepfathers.

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