Vaccination Nation

 

“What made eradication possible was a really good vaccine and political support. There was a real incentive to do it. You don’t ask a cow if it wants to be vaccinated. You just do it.”
— Ron DeHaven, former CEO of the American Veterinary Medical Association, speaking about the eradication of rinderpest, a cattle disease related to the measles virus.

Rinderpest and smallpox are the only two infectious diseases that have been eradicated around the world. Smallpox is the only disease to be eradicated that infects only people. Eradication of other infectious diseases, like COVID-19 for one, is unlikely because there are alternate hosts in the animal population, and while it may be feasible to vaccinate domesticated animals such as cows to the point of herd immunity, it is unrealistic to think the same can be done for wild animals.


Ruins of 19th-Century Smallpox Hospital - Roosevelt Island - New York City - USA - 01 (41147019525)
Ruins of the Smallpox Hospital built in the 19th century on Roosevelt Island in New York City. Photo by Flickr user Adam Jones.

Cows have another favorable trait in reaching herd immunity besides being easily available for their shots, which is that they don’t subscribe to bizarre, illogical, and unscientific conspiracy theories egging them on to refuse vaccinations, if that was a possibility for them. Rinderpest, like its cousin infecting humans, the measles virus, is among the most contagious diseases on the planet, and the more contagious a disease is, the higher the percentage of a susceptible population must be vaccinated in order to achieve herd immunity. For measles and rinderpest, that’s over 90 percent.

Smallpox is – was – in the middle of the scale as far as its contagious qualities, but among the deadliest at around 30 percent fatalities. Influenza, with notable exceptions throughout history, such as the 1918-19 Spanish Flu outbreak, is at the lower end of the scale for both contagiousness and deadliness. COVID-19, like the other Severe Acute Respiratory Syndrome (SARS) viruses to which it’s related, is higher up the scale for contagiousness than the annual flu, but it is nowhere near as deadly as smallpox, though deadliness as always is strongly affected by a victim’s socioeconomic circumstances. The poor, as always in any affliction, die in droves, while the better off have access to the best care and are less likely to be infected in the first place.

One by one through the nineteenth and twentieth centuries, diseases that had killed hundreds of millions over thousands of years were brought under control with vaccines and other public health measures, such as better sanitation. There have always been people of skeptical of the effectiveness of vaccines or suspicious of the motives of the medical people, often affiliated in one way or another with a government entity, who administered the vaccines. The difference in then from now is that before about 1980 evidence of a world without vaccines was still readily available to everyone, rich and poor, living in the industrialized northern hemisphere or in the largely agricultural southern hemisphere.



In 1947, when the threat of disfigurement or death from smallpox was still very real to everyone, the citizens of New York City lined up for blocks to receive vaccinations in order to stem a possible outbreak.

 

Today, people in richer countries no longer see the effects of smallpox at all, and rarely do they see the effects of less disfiguring, less deadly diseases like measles. If COVID-19 were to leave visible scars on those who suffered and survived, instead of just the internal scars it does leave, one wonders if at least some of the people ready to dismiss the seriousness of the disease and the severity of the outbreak would be as obstinate about complying with public health measures.

If there were still children crippled by polio in every neighborhood, would there still be people who are more willing to believe an insane theory about vaccines they read in their Facebook “news” feeds than the scientific fact of once rampaging infections brought to heel in the past two hundred years? No doubt there will always be some hard cases who can’t be reached through reason, no matter what. The amount of the U.S. population vaccinated against COVID-19 is currently about 43 percent, and it needs to be over 70 percent to reach herd immunity. It will be best to cross that threshold before cold weather sets in again, forcing people back indoors. If it’s not, then COVID-19, a disease that will likely never be eradicated, only controlled, could surge once more, making this summer of relative freedom appear in retrospect like a fool’s paradise.
— Vita

 

In the Time of the Virus

 

Schools around the country have either started the fall semester or are about to, some opening their buildings to students and others not, and everywhere there is confusion and apprehension about the changed circumstances due to coping with the coronavirus. Will students, especially the very young ones, be able to maintain their concentration when learning remotely? If they attend classes in person, will they endanger themselves and everyone in school as well as at home because of failure to maintain the new disciplines of social distancing, mask wearing, and frequent, conscientious sanitation?

 

Back in 1918 and 1919 during the worldwide outbreak of the Spanish Flu, remote learning meant home schooling. Social distancing was barely understood, and other measures to contain the deadly flu were haphazardly implemented from locality to locality. Where city-wide rules went into effect, such as in Milwaukee, Wisconsin, where officials closed the schools and banned some public gatherings (notably excepting saloons), the contagion’s effects were limited in comparison to places like Boston, Massachusetts, where public life went on much as before.

Rosana.Educaçao
Rosana Martinelli, mayor of Sinop, a city in the Brazilian state of Mato Grosso, meets with schoolchildren in May 2020, before the coronavirus pandemic gripped that country. Photo provided by Rosana Martinelli.

Schoolchildren, however, are a special case, then as now. Besides having a limited understanding of what’s at stake and the measures necessary to protect everyone from the coronavirus, many are incapable of respecting boundaries. Children, the younger ones particularly, by nature lack social control. For proper development, children need social contact of all kinds, whether that means actual touching or merely being in the presence of other children and adults. Can children, especially the very young, be expected to sit still and apart from each other for six hours or more every day, never getting close enough to play and roughhouse with each other?

The experiment of returning children en masse to in-person learning from teachers in school buildings is bound to fail. The primary reason for trying it out is to mollify those right wing supporters of the current president who are clamoring loudly for schools to reopen for a number of reasons, but mostly to do with denying the reality of the pandemic while somehow boosting their cult leader’s chances of reelection in November. The experiment will fail before November, and the school boards responsible for catering to right wing extremists can then say that they tried. Meanwhile, thousands of people will fall ill unnecessarily and some will die, sacrificed to the experiment.

An episode of Pocoyo called “Don’t Touch!” wherein Pocoyo, a very young boy, tries and fails to restrain himself from touching, demonstrating a lack of self-control natural to small children. Narration is by Stephen Fry.

There are other people, surely, with reasons for wanting the schools opened for in-person attendance. Working class families, for instance, many with only a single parent, have managed with great difficulty the extra burden of their children staying home more than usual. Those are the people most in need of assistance now, both financially and by having school districts reach out to them with help in keeping their children safe at home and learning. Family circumstances have changed in the century since the Spanish Flu outbreak, when it was more likely that one parent would be home during the day.

It would not serve today’s parents well to have their children exposed to risk at school, where they might easily pick up the coronavirus from classmates and then bring it home to their families. Working class parents already expose themselves to risk because they cannot afford to quarantine at home, but most go out in public to work, many of them in low-paid service economy jobs with few, if any, health benefits. Keep the kids at home for now, where being out of touch during a pandemic can be a good thing.
— Vita

 

It Hurts All the Same

 

It’s no surprise MAGA Mussolini has called the imminent danger of a coronavirus pandemic a hoax, nor is it a surprise his MAGA followers swallowed that lie and called for more. They always do. These developments have become so predictable that they no longer warrant the bother of linking to the news stories about them. All the rest of us can do, those of us who live in the fact-based world, that is, is resist the implementation of damaging policies by those who live in the fantasy world of MAGA hate-based politics.

 

J. Bond Francisco - The Sick Child - 1991.9 - Smithsonian American Art Museum
The Sick Child, an 1893 painting by the American artist J. Bond Francisco (1863-1931).

The great surprise is how well scientists and doctors have done in the past 100 years in restricting another pandemic like the Spanish Flu outbreak of 1918 and 1919, which killed 100 million people around the world. The Spanish Flu came on the heels of the close of World War I, and after it had finally flamed out it had claimed more lives than that most horrific “War to End All Wars”. That was the way the balance had worked throughout history, with battlefield deaths generally being outpaced by the communicable diseases unleashed in the gatherings of large armies and refugees. The later twentieth century holds the dubious distinction of tipping that balance toward human mayhem as the major cause of death in wars.

What is most remarkable about the efficiency of modern science in preventing the kind of communicable disease pandemics which have periodically scourged humanity is that scientists and doctors have done this despite the huge increase in population at the same time worldwide travel has skyrocketed in volume and speed. More people than ever before are moving faster and more frequently from one part of the world to the next, and all the while they are sharing untold numbers of germs both dangerous and mundane with local populations.

In the taking over of the New World by European colonists only two and more centuries ago, those sorts of introductions – though at a slower pace – led to genocidal destruction of the indigenous population through their exposure to an array of unfamiliar diseases. People more often lived in lighter concentrations then than they do now. Travel was certainly far slower, and most people then lived their entire lives in the familiar surroundings of one city or of a handful of farm villages.

The great danger now is the introduction of an unfamiliar permutation of a familiar virus or bacterium. And yet for 100 years the world’s scientific and medical professionals have forestalled the disaster that could easily overtake us if they weren’t vigilant. Calling their sincere efforts a hoax helps no one, and acting on such misinformation would amount to carelessly flipping a lit cigarette butt onto dry brush.
— Vita

 

Can This Be Flu?

 

Since gastroenteritis is commonly known as stomach flu, and since this is influenza season, people can mistake one illness for the other or believe they are different names for the same illness. They are not. Gastroenteritis is technically not influenza, though it is most often caused by a virus and usually presents with some of the same symptoms in the early stages – headache, body aches, chills, and fever. It is in the lack of respiratory distress symptoms that the two illnesses diverge, that and the continued nausea and diarrhea brought on by gastroenteritis. Nausea may subside to a low level, and vomiting may cease after the first bouts simply because of a lack of contents to regurgitate as the sufferer no longer desires solid food. Diarrhea continues, however, since the sufferer’s inflamed intestines do not absorb liquids as they should.

Influenza Pandemic Masked Typist
Typist wearing mask, New York City, October 16, 1918, during the “Spanish flu” influenza pandemic. Wearing a mask would have helped stave off the influenza virus, which is most often inhaled, but done little to protect the wearer from a gastroenteritis virus, which is ingested.

That last part is the most important in understanding how to treat gastroenteritis. Fluid intake becomes even more important than in treating a case of true influenza because while the overall risk of life-threatening complications is less, the risk of life-threatening dehydration is greater. As with any illness affecting them, pregnant women need to carefully monitor their symptoms as well as take special care using medications. In poor areas of the world, where access to clean water may be limited, dehydration is the biggest killer in cases of gastroenteritis. In wealthier areas, even though a sufferer got the infection by ingestion of contaminated food or water, access to cleaner supplies of both after the illness develops makes chances for recovery much greater. The important things to remember in getting well from a bout with this illness which, dreadful as it feels at the time, are that the risks of developing something more serious are lower than with the actual flu virus, and that dehydration needs to be remedied not just by drinking water but by replenishing salts, sugars, and electrolytes in the right combination.
— Ed.