Tuesday, October 26, 2021

Public Health is a victim of its own success

Americans used to kill each other with communicable diseases. 


Now we mostly kill ourselves, one at a time.


We need to think of COVID as like VD, not cancer.

Disease and death used to come suddenly. Rich and poor, young and old, people caught smallpox, bubonic plague, yellow fever, polio, and a multitude of other diseases. We got them directly from each other or from some vector like fleas, mosquitoes, or bacteria from human waste. There were solutions that involved public cooperation. We had mass vaccinations. We built public sewerages. We have rules regarding wells and septic systems. It mostly worked.

Polio iron lung room
My parents used to worry about polio, but by the time I was old enough to worry about it I stood in line and ate a sugar cube. Smallpox and bubonic plague were things in the history books, no more a worry than were dinosaurs. I got chicken pox, measles, and mumps, like all the kids my age, and I thought it was a rite of passage, like losing front teeth. I never really worried about Ebola, because it was so awful that Americans who had it were deathly sick and isolated in hospitals.

The exception in Americans' thinking regarding infectious diseases involves sexually transmitted ones. We own those, and they spread and we know it. AIDS scared us. We know gonorrhea and syphilis are here. When I started my term as a County Commissioner I thought the county's role in controlling the spread of sexually transmitted diseases would be controversial. It wasn't. No one wanted to talk about sexually transmitted disease. Then and now, no one advocates for the God-given American right to spread gonorrhea.

There has been a change in Americans' notion of where disease comes from. Except for VD, disease has stopped being seen primarily as something that spreads. Disease is a consequence of lifestyle choices or unlucky DNA. Either way, it is on us, personally.

The heart attack victim ate cheeseburgers. When a slender vegan marathoner dies young from heart disease, we see it as proof that you can't fight unlucky DNA. One does not "catch" heart disease. Nor cancer. There must have something in the environment, some chemical they ate or drank, or again, unlucky DNA. Old men get prostate cancer, so there is an explanation: They are old, and had unlucky DNA.

Good health is self-care. We value early detection; get your mammograms; get that mole checked. And of course, get regular exercise, take 10,000 steps. Since disease is on us, disease prevention is on us. If someone smokes at home or eats cheeseburgers, it is nobody's business but that person.  

That brings us to COVID. The GOP/Fox News line in the sand has moved from vaccinations to "vaccine mandates." A few people criticize vaccinations per se, but most of the opposition and outrage goes like this: "We're not anti-vaxxers, but we strongly oppose vaccine mandates. Mandates are tyranny!" That position is possible because it floats atop the idea in general circulation that health decisions are inherently personal, not social. People analogize COVID to the other great killers of Americans: heart disease, cancer, diabetes, strokes, accidents. It is a false analogy. People with COVID give it to others, some of whom get very sick and die from it. 

COVID is like VD. Not cancer.


At my local Costco store, people are required to put on masks as they enter. Mask-wearing is enforced at the door. Once in the store, by my count on Saturday, about 7% of shoppers take off their masks. A mask does little to protect oneself. One wears a mask to protect others. Maskless shoppers don't appear embarrassed at having taken off their masks. They look "normal" and at ease. They appear to consider COVID is a personal choice, not a social one, so going maskless is a different category from smoking a cigar, having a dog that is pooping in the aisle, or walking down the aisle pointing a loaded gun. Those would be a public act, affecting others. Surely they would be embarrassed. Going maskless is in the category of a private matter, like whether or not they had gotten a colonoscopy in the past ten years, their own business.

Thousands of Americans every year would avoid dying from colon cancer if people over age 40 got colonoscopy screens. Insurance companies encourage colonoscopies but there are no colonoscopy mandates. Colon cancer is not communicable. COVID is.






11 comments:

Sally said...

The Asian countries that successfully controlled this virus learned to use masks thanks to SARS and MERS. They did so uncomplainingly and near universally with SARS-COV-2.

The numbers speak for themselves.

Meanwhile, we endlessly yap.

Rick Millward said...

Precisely...great analogy!

Wearing a mask is better than no mask. Is it perfect? Of course not.

A vaccination is better than no vaccination. Is it perfect? Of course not.

There's no elevated virtue in wearing a mask, it's just common sense public health protocol, nor is one some kind of Minute Man if you don't. There's something abjectly silly about that Mr. (and Mrs.) Maskless in the COSTCO daring you to say something about his anti-social behavior, like the dolts who toss their cigarettes in the parking lot or tailgate.

Republicans politicized a public health crisis because their base consists of a significant number of individuals who utterly completely mistakenly hold the belief that they know better than, well everyone, or as a wise man once said, "A legend in their own mind".

Nothing could be farther from reality.

Bob Warren said...

In respect to the incredibly ignorant, uncaring, narcistic anti-vaxxers Walt Kelley's character Pogo aptly described our present situation when he declared, "We have met the enemy and he is us!". Perhaps a more regressive system of government is needed in the political arena where ignorance is always rewarded with respect and forbearance. In China or Russia the government has only to "suggest" that all citizens should be vaccinated and within a very short period of time "Lo and behold!" it magically occurs. Meanwhile, our nation engages in a time killing debate about the "God given rights of all Americans!" Unfortunately when God mandated these rights to all he neglected to include a functioning brain for all, but who's perfect?

Bob Warren

John F said...

Anonymous's post regarding "blue paper masks" is without data to support his pronouncement. We now know the SARS-CoV-2 virus to be airborne and linger in the air. We know that vaccinated individuals can be infected with the Delta variant. We also know that to become infected you need to inhale a critical viral load, that is how much of the virus you inhale and for how long you are in an area where you can be exposed to the virus that will overwhelm your immune system and cause Covid19 infection. Face covering are not perfect, but they reduce the spread of aerosols that may contain the virus. We do our part by attempting to lower the amount of virus that is released by breathing and talking while we are in a crowed public space.

Michael Steely said...

Getting vaccinated against COVID-19 isn’t about “personal freedom.” It’s a public safety issue, like smallpox or drunk driving.

People who don’t trust the medical establishment enough to get vaccinated are filling up our medical establishments. What they need are alternative facilities willing to provide them the quack cures they see peddled on social media. Medical personnel who’d rather quit than get vaccinated could staff the facilities and administer the hydroxychloroquine, disinfectant, horse dewormer or whatever. It would be a win-win.

John C said...

This comment is not meant to be snarky in any way. I try to listen or read more carefully these days. Anonymous's comment was very informative, in the sense that it provides insight to the power of small words. Like many who oppose efforts to combat the spread of Covid, they use the term "which we know" as universal acceptance of their argument. So just who are the "we" and what is it we "know"?

Using "we" implies that everyone (including and especially the reader) agrees to the assertion, whether they admit it or not. They are not saying "I" or "some of us". This effectively infuriates those who are not in the group. Using the word "know" rather than "believe" or "are convinced that"- they assert superior knowledge.

Some of us believe (not "we know") blog posts and other social media are not very good at promoting useful dialog, so these kinds of assertions become food fights. or worse

Mc said...

The people who refuse to wear masks probably don't wash their hands after using the toilet.
That is also a public safety mandate.

Sally said...

Government “suggestions” have worked in Asia, Mr Warren, but not in Russia. Latest reports are about 1/3 vaccinated. Lockdown just imposed in Moscow (yesterday’s news).

I’m told by a friend who’s from there that were a lab leak to be established as origin, it would shoot up because then it would be an issue of national security.

Up Close: Road to the White House said...

On reflection and after reading some comments here, I deleted a comment by anonymous. It was referred to by several posts that remain up. I decided that John C's comment was exactly right, that the post contained dangerous misinformation.

The post had a faux civil tone, which is why I left it up. But on reflection I realized the calm tone included manipulative dishonesty about presumed consensus that masks don't work and vaccines don't work. A lie, said conversationally, is as dishonest as a lie shouted. Find some other place to tell anonymous lies,

If anonymous wished to identify himself or herself, cite sources, and bear the burden of owning the comments, then he or she may do so.


Peter Sage

Low Dudgeon said...

The comparison between COVID-19 and sexually transmitted disease is an interesting one, HIV/AIDS especially when we also address the social ethics of personal freedom and responsibility, identity politics, and evolving historical blame-assessment for THAT discrete killer malady. To begin with, between 700,000 and 800,000 have died in America from both HIV/AIDS so far, like COVID-19.

At first amid general fear and uncertainty, the gay community particularly wanted literally nothing to do with the disease in any realistic way. Epidemiological measures such as posting names of carriers were rejected indignantly as homophobic invasions of privacy. Even as gay deaths began to predominate statistically, defiant and decimating jags of unprotected anonymous anal sex were the response.

How dare you call it a “gay” disease, was the cry of those in denial. Personal, politicized social attacks, the resentful claimed. An epidemic of the unvaccinated today, and the unprotected back then? Sure, it isn’t and wasn’t JUST them—just mostly. A few years passed and presto—the gay community suddenly wrapped itself in the AIDS quilt like Red anti-vaxxers do the Gadsden flag or the Stripes & Stripes.

Suddenly HIV/AIDS not only WAS a gay disease after all, but the very symbol and cultural linchpin of their supposed sinister, perpetual victimhood at the hands of society, especially concerning supposed deadly mixed messages from government and public medicine. Contrasts? Dr. Fauci then WAS greatly concerned with therapeutics. And no controversy about a blameworthy origin of AIDS/HIV.

Stay tuned! Who knows where we’ll all be on COVID in a decade or two.

Mike said...

Dungeon:

1. COVID-19 has killed more people in less that two years than HIV killed in over four decades.

2. No gay person I know considers HIV to be "the very symbol and cultural linchpin of their supposed sinister, perpetual victimhood at the hands of society." In fact, I'm sure they'd dismiss whoever concocted that notion as insane.

3. Despite what you may hear on Fox Noise, Dr. Fauci remains far more credible that his detractors. He has devoted his life to serving others. You don't make yourself any taller by trying to behead your betters.