The Human Variable 

Traditional medicine isolates diagnoses by organ or specialty. CYNAERA’s terrain logic views the body as an interdependent system where immune, endocrine, and autonomic signals co-determine stability. The Playbook applies three key insights from the Primary Chronic Trigger (PCT) Blueprint. Chronic illness begins with temporal ignition, an event that tips an unstable terrain. Chronicity persists when recovery conditions (RC) remain incomplete.

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