Microbes and Beliefs

"What is all knowledge too but recordered experience, and a product of history; of which, therefore, reasoning and belief, no less than action and passion, are essential materials"

                                                       Thomas Carlyle (1795-1881)


Over the past few days, I've sat and watched all the news reports on the Covid-19 virus, the Coronavirus.  Maybe it's because I'm concerned about the vulnerability of humans to microbes but also because a former schoolmate of mine and her husband were quarantined on board the cruise ship, the Diamond Princess, stuck in Yokohama harbor in Japan.  This ship had the largest outbreak of the virus outside of mainland China.  As I watched her videos and the news reports on them, I realized the danger of a pandemic is always possible despite our well-meaning efforts to prevent that. Stuck in their cabin for almost 14 days, they were finally "rescued" by our State Department, only to  sit on a bus for hours with 300+ other passengers, 14 of whom were discovered to be positive for the virus after they left the ship.  They were all flown to military bases in the US for 14 more days of quarantine. What's sure to happen is there will be new cases and the clock of 14 days will have to re-start each time a person is discovered to be ill.  Fortunately, for some unknown reason, the virus has not seemed to infect children under age 15.  The other good news is that this virus could have a considerably lower mortality rate than influenza.  So...a good reason for all of you to still get a flu shot!

Don't get me wrong...I'm not a worry wart.  I would just like to see the best scientific minds collaborate and come forth with a sensible and rational policy.  We've done it in the past.  I have yet to see this happening.  While I don't include myself among those "minds", I 'd like to think of myself as a concerned citizen of the world based on my past experiences.

In the 1970's, when we moved to our first house in Rochester, I took our dog for a walk one Spring day and found myself on a quiet dead-end street with some historical homes.  As Rex and I got to the end of the road, there was a small cemetery, filled with old gravestones dating centuries ago, some toppled over and others barely legible.  Towards the rear of the graveyard, lined up in a row, were numerous smaller plots, all the final resting place of infants and children, all having died in 1918-1919.  It suddenly came to me that those were the years of the influenza pandemic known as Spanish Flu, with a death toll calculated as anywhere from 40-100 million people.  To be fair, back then, there was more malnourishment, overcrowding and poorer hygiene resulting in bacterial superinfection.  Much like Covid-19, that was spread from animals to humans, and, at the start, the news about it was buttoned up and kept from the public.

I grew up in the 1950's during the great polio epidemic in America.  I was, in fact, one of the first group of children to receive the Salk vaccine (while others received the placebo).  We were terrified...kept away from swimming pools and water fountains.  The "iron lung" became all too familiar in our hospital wards.  In 1952 alone, 60,000 children were infected, thousands being paralyzed and more than 3,000 dying.  Through the process of immunization, the disease is almost a remnant of the distant past.  As of 2017, the virus remains in circulation in only three countries, Afghanistan, Pakistan, and Nigeria.  With further efforts, it will hopefully be eradicated.

When I was in 7th grade in 1957, we were once again hit with the second pandemic of the century, the Asian Flu, which, eventually killed around 70,000 people in the US and 1-2 million deaths around the world.   I was unfortunate to come down with it and remember being in bed for at least a week, writhing in pain with rigor from fever and cough.  I thought, in my 12 year-old mind, that I was about to die!

This is what we were all given for Asian Flu...of course, years later, we discovered using aspirin for  influenza was linked to the deadly Reyes Syndrome!

Then, as recently as just a few years ago, we had another pandemic from the H2N3 influenza virus.  By then, we were being more proactive about protecting people with a well-match flu vaccine.  My medical practice decided to hold a "flu clinic" each evening and weekend where my colleagues and I as well as our hard-working nurses tried to immunize all our patients.  The lines were so long they extended outside the building and around the block.  We even made the front page of the local newspaper.  "When the going gets tough, the tough get going" was our rallying cry.

We've also been through the Ebola virus scare. When I was working in a college health service, a university with many foreign national students who were going back and forth to their native homes, we had to train the entire staff to "don and doff" personal protective equipment, much what you see the health care workers wearing in Asia today.  We questioned every student with fever about foreign travel, contacts, etc. before we'd even let them in our waiting room.  We had a plan...fortunately we saw no cases of this lethal virus.

So, my point is, HAVE A PLAN and put it into action in a standardized manner with evidence-based and seamless execution.  I would be remiss if I didn't mention the importance of vaccines. In my physician mind, I regard vaccines as one of the greatest discoveries of all time and stand in awe at the countless lives they have saved from death and disability.  I recognize there is skepticism, fear and junk science opposing immunization.  What I will say is that I have started to see vaccine-preventable diseases that were previously "eradicated" return to our community because of this opposition and irrational fear.  During my training, I saw kids die from some of these.  There are children in our waiting rooms who, for one reason or another, have some degree of suppression of their immune response, be it due to medications, cancers, auto-immune diseases, etc.  It is indefensible that they be put in harm's way by un-immunized patients who might carry a vaccine-preventable virus or bacteria, whether it's in the waiting room, nursery school, or, as seen in California, in an amusement park.

I know there are several cutting edge companies working on a Covid-19 vaccine but, at best, it won't be ready for another 1-1/2 years.  When this will be offered to the public is difficult to predict.  It may well be after the cycle of the virus has died out if it doesn't stick around but, in the event of a pandemic, this should be a national priority.  Funding spent for our national public health should be of more import than more nuclear weapons or a border wall.  Science has offered us the opportunity to be safer and healthier.  We should take it!