The Human Variable 

The CYNAERA Primary Chronic Trigger (PCT) framework embeds PEM as a probability-weighted conversion event inside a prevalence model that accounts for viral exposure, environmental load, climate volatility, and recovery suppression. Modeled remission rises from historical 12–18 percent toward 35–50 percent under PEM-aware, terrain-timed designs, with early-intervention subsets reaching 42–60 percent in best-case conditions.

Infection-associated chronic conditions (IACCs) describe a single clinical terrain that appears under many labels—Long COVID, ME/CFS, POTS, MCAS, hEDS overlap, and post-infectious states following EBV, H1N1, Lyme, and Ebola. Triggers differ; downstream biology converges. Across cohorts, patients show immune dysregulation, autonomic instability, mitochondrial hypometabolism, mast-cell mediator sensitivity, connective-tissue fragility, and chronic neuroinflammation.

The Socioeconomic Phenotype Index (SPI™) represents a paradigm shift in how health science conceptualizes the role of socioeconomic status. For decades, poverty, access barriers, and discrimination have been categorized as “social determinants of health” (SDOH). While this framing acknowledges their impact, it relegates them to the periphery of medical science. SPI™ reframes these determinants as phenotypes — measurable biological terrains that directly influence disease o

The CYNAERA Primary Chronic Trigger (PCT) framework embeds PEM as a probability-weighted conversion event inside a prevalence model that accounts for viral exposure, environmental load, climate volatility, and recovery suppression. Modeled remission rises from historical 12–18 percent toward 35–50 percent under PEM-aware, terrain-timed designs, with early-intervention subsets reaching 42–60 percent in best-case conditions.

This white paper argues that MCS and MCAS are vantage points on a shared hypersensitivity terrain, proposing a new classification, Multi-Chemical and Environmental Hypersensitivity Disorders (MCEHD), that unites them, honors patient ingenuity, and formalizes my frameworks.

VitalGuard™ is CYNAERA’s flagship environmental risk engine for infection-associated chronic conditions (IACCs) such as Long COVID, ME/CFS, POTS, MCAS, and Chronic Lyme. It transforms real-time atmospheric and environmental inputs into predictive flare scores that can inform FEMA incident operations, NIH-funded clinical trials, and CDC-aligned public health programs.

The CYNAERA ESA (Emergency Stabilization Authorization) framework presents a solution. During a declared emergency, ESA enables states and FEMA to pre-authorize qualified clinics to operate as temporary micro-ERs and reimburse those services as emergency protective measures. Critically, ESA does not require new legislation. It strategically aligns existing authorities under the Stafford Act for federal disaster declarations, FEMA Public Assistance Category B for emergency pro

 After adjusting for significant comorbidity and overlap, we estimate that 65–75 million unique individuals in the United States live with one or more IACCs. This includes approximately 20–25 million individuals with multiple co-occurring conditions. The revised estimates reveal a dramatic undercount across all conditions, particularly for post-viral and neuroimmune syndromes.

Using a multi-model estimation approach, we project that 8–12 million Americans may be experiencing chronic health impacts following vaccination, with 40–50 percent facing functional disability. The associated annual economic burden ranges from $100 to $500 billion. We propose that the adoption of immune-informed readiness protocols could prevent up to 1.6 million cases annually, saving $20–40 billion per year.

The CYNAERA ME/CFS Individualized Regimen Engine™ is an educational modeling framework that simulates phased strategies for ME/CFS care. Built on CYNAERA’s ecosystem of validated modules — including Treatment Archetypes, Phenotyping Framework, Pathophysiology Drivers, and the Path of Remission Model — the Regimen Engine demonstrates how individualized patient care can be systematically structured.

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is profoundly sensitive to environmental stressors. Pollutants such as polycyclic aromatic hydrocarbons (PAHs), particulate matter (PM₂.₅, PM₁₀), nitrogen dioxide (NO₂), ground-level ozone (O₃), sulfur dioxide (SO₂), and volatile organic compounds (VOCs), combined with weather triggers like heat, cold, barometric pressure swings, mold, humidity, and pollen, drive flares that push patients into cycles of severe disabi

CYNAERA has the first clinical intelligence system designed to simulate and stratify patient response across the full complexity of infection-associated chronic conditions (IACCs) such as ME/CFS, Long COVID, POTS, MCAS, EDS, Lyme, CRPS, and related syndromes. Unlike traditional models that flatten patients into crude categories, CYNAERA builds individualized profiles across 11 stratification axes and integrates them with six mechanistic phenotyping domains.