Concepts underlying the spread of disease

As a starting point, here are some underlying concepts that I think are needed for productive  policy discussions about public health and preventing the spread of disease:

 

Despite the damage and deaths being caused by CoVid-19, historically speaking it isn’t much of a pandemic.

Over the course of a half-dozen years in the mid-1300’s the Black Death killed roughly 50% of Europeans, and undetermined millions more in Africa and Asia.  In 2018 malaria infected 200 million people and killed 400,000; it has been ravaging humanity each and every year for millennia.  And then there’s smallpox: upwards of 50% of native Australians and perhaps as many as 90% of native Americans died within a year or so of the smallpox virus reaching their communities.

Even in developed societies during living memory epidemics of scarlet fever, tuberculosis, polio, measles, a succession of ever-evolving flu viruses, and AIDS have gutted communities, killing sometimes a few thousands, sometimes tens of millions.  Sewers, vaccinations, and antibiotics – the miracle legacies of Snow and Crapper, Jenner and Salk, Fleming and Hodgkin (among many others) – have made us complacent, but as CoVid-19 is demonstrating, the threat posed by ever-evolving parasites, viruses, and bacteria remains.

Scandalously, vaccinations are falling out of fashion due in large part to heavily publicized fraudulent data, disrupting the herd immunity against highly infectious diseases that should never take another life.  In many places, we have scrimped on the investment needed to maintain water treatment and sewer infrastructure in good repair.

And, probably most seriously, we have squandered the benefits of antibiotics, foolishly prescribing them for viral infections and greedily using them on factory farms to promote the growth of animals and proactively to suppress disease.  There are already a handful of so-called “super-bugs” against which we have no reliable medical defense.  Fortunately, as yet, none have had the deadly combination of being both highly lethal and highly infectious.  But sooner or later, one will evolve that will make us look at CoVid-19 in the same way that CoVid-19 has made us look at SARS.

 

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.                Making these discussions more productive

 

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