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.

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.