With regards to tuberculosis, there are excellent counterexamples from places that were unable to institute public health reforms. Even with access to antibiotics, these countries suffer under immense tuberculosis burdens in the modern day. I'm a tuberculosis researcher, and we're still struggling to bring down TB cases using antibiotics alone.
While I can't find the citation right now, I recall that South Africa was a strong example that had relatively comprehensive antibiotic access in the mid- to late-20th century. However, public health infrastructure changes were not made, and thus the TB burden remains high to this day. With high burden comes higher chances of antibiotic resistance, and resistant TB is an important global health threat. So if we don't address these problems that COVID is making clear to us today, we're going to have even more trouble from these previously "defeated" diseases.
As always, great read. For another example from the 19th century, economist Jason Barr and I have been looking at the late 19th and early 20th century tenement acts in NYC. While the results are preliminary, the wards (neighborhoods) with the most new construction - which would be buildings in compliance with better standards of ventilation and sanitation mandated by the tenement acts - have far lower rates of infectious disease mortality than wards with older less ventilated, less sanitary building stock. The wards that were safer and had the most new construction had the most dense living conditions in the city and were some of the most impoverished neighborhoods. So, there seems to be good evidence that the new building standards had a large effect on keeping people safer. We have a two part blog story on this. The first demonstrates the difference across neighborhoods, the second discusses our initial investigation into why the difference existed.
In seems in both instances, the approaches chosen (public health messages for behavioral change, or vax and relax) were made to maintain the profits of the ruling class.
Masking, social isolation, air management, vaccination, anti-virals where indicated. Together these are the critical strategies to minimising the spread of COVID, and minimising hospitalisation, deaths, and long COVID.
Still people fight them. Not only that, they couldn’t give a damn about harming others. And some have no choice: take their sick selves to work or their family starves - government support has ended.
It’s as if society would rather millions of people continue to die unnecessarily just so we can pretend that everything is “normal”.
It is not that people wanted this situation - it has been forced on us. Even right at the beginning, our leaders pushed for infection as the way out - In the UK for example - PM Johnson publicly stated aim being to "take it on the chin". Every measure that helps has been deliberately and systematically undermined. The pretence that infection is irrelevant is pushed everywhere by the rich and powerful (except for themselves, of course). In short - our ideas do not come out of thin air but are manufactured by those who rule society. Those ideas were always dangerous, but in a pandemic, much more so!
TB is a complex example. The vaccine we have is only modestly effective - it's moderately effective against extrapulmonary (outside the lungs) TB, such as spinal TB and TB meningitis (which often affect children, and are often fatal), but not very effective against pulmonary TB. Furthermore, it has walls itself away, so antibiotics and other antimicrobials struggle to kill it, requiring very long periods of treatment; and many strains have become extremely resistant to many antimicrobials; and the antimicrobials that continue to work are often more toxic to the patient.
Better vaccines are being developed, and could make a massive difference. I wouldn't downplay the benefit of Vaccines, particularly for diseases like measles, where the [in this case] virus mutates very slowly.
Nevertheless, the article is correct. Clean air and water, and good nutrition, are the most important elements in protecting us from TB and many other infections diseases.
What will become painfully apparent in time is the callous disregard for caution in dealing with a virus the lingers in an infected person's body. Yes, TB may be more dramatic in its inducement to leading unfortunates off their mortal coil, but harsh times are coming due to the lack of respect for a dangerous disease for many who think they recovered from a bad 'cold'.
Intelligence (presumed without justification), does not countermand arrogance. We do not rule Mother Nature and she is not susceptible to the propaganda that bolsters our unacknowledged ignorance.
Forgotten is a frequent occurence, when there's an expense more lies can avoid.
Making it an individual responsibility and pretending useless masking by >90% who did it to get by, voluntarily or otherwise, was a reasonable response, when it was one of the most absurd and contradictorily effected processes of my lifetime, had other benefits. Got rid of many of the most costly and left more attacking each other in another spasm of distracted ignorance, as the oligarchs wealth exploded.
It'd be so much easier to just go to the darkside. Must be really sweet, for those who can't conceive of, and don't even consider there's an alternative paradigm.
Unfortunately, Greg Travis' claim is not supportable. Depending on the year, there were between 20k and 50k flu deaths annually before 2020. Not to diminish the toll of SARS-2 on an annual basis since it is much less seasonal than influenza. Also, there has been no estimate of the toll of SARS related mortality after the acute stage. Also not to diminish the simple fact that like covid-19, the influenza toll could be controlled by better air quality as was shown in the 2020 season.
Covid is not at all seasonal. Each wave so far is driven by a new variant, not by a season. There is so far no correspondence between season and infection rates.
Simply calculating increased mortality is one of the safest ways to measure the effect of a new virus. If we take 2016 to 2019, and we compare to 2020 to 2023 we would get a very reliable figure for the death rate over a comparable 4 years.
Lastly, the problem with Covid is no longer really the acute stage (vaccination and prior infection have helped). The problem is that each infection carries so much long term risk with it. 10% of infections lead to symptomatic Long Covid and some unknown percentage of infections lead to no symptomatic problems (vulnerability to other illness, strokes, heart attacks, cognitive problems, etc). Just how high this burden is remains unknown, but we know it will be big.
After only four years and a changing landscape (population is different with immunity and susceptible mortality) and a significantly mutating virus we don't know for sure except to say that it isn't highly seasonal like flu, no? The two highest waves of infection in the US have been in the winter, but there have been big waves in other seasons as well. Is it vitally important at this point? Our data are very poor in the US, excess mortality and wastewater monitoring are about all we have.
Same with long term effects. We know it's very bad, but it's still an open question how devastating it will be. Time will tell. Our data are even worse for this aspect of the disease.
What we do know is our times aren't that different from the days of John Snow and Ignaz Semmelweis. We as a species cannot mount a rational response to the clear and present danger of an infectious disease in a time frame when it would be most effective.
In April 2013, public health in England and Wales was transferred from the NHS to local authorities who were having their budgets slashed by central government. People warned of dire consequences. Has anyone done any research into how much this affected the public health response in the UK?
Vaccines must be an integral part of every public health strategy, which must necessarily be a broad and layered strategy.
We learned this during the 20th century, after years of urbanization and the growth of town infrastructures to deal with waste, to clean water, and to in the 1970s, clean our air. Cleaning environments is only one area of defense.
None of those environmental changes had a direct effect on the quelling the spread of Measles, Mumps, Rubella, Whooping Cough, and other viruses and infectious diseases that did not die out -- though are still a threat -- until there was a concerted, national (though it went state-by-state, if I remember correctly) effort to mandate vaccinations for all children. It is only by the end of the 20th century that the spread of MMR and other viruses was in the lowest percentages -- to the point where people had no living memory of their dangers and so thought that the body had innate defenses against those viruses and that only be remaining healthy that they would be free from disease and sickness.
This is not a fact. The body does not possess innate defenses against those specific viruses. It has learned to defend against them ONLY by vaccination. It is only by vaccination that we are protected from the worst ravages of these diseases. It is only by mass vaccination that we are protected -- almost to prophylaxis -- from these diseases.
Alternatively - most vaccines had a negligible effect compared to public health measures which long preceeded them.
"When we look at the actual data, we see that although many people did die from whooping cough in the early part of the 1900s, by the time the vaccine had been introduced the death rate in the United States had declined by more than 90 percent. Using the source that was referenced to make the statement in the Pediatrics paper, we see that the decline in deaths from the peak was approximately 92 percent before the introduction of the DTP
vaccine."
"England began keeping statistics in 1838, which was 62 years before official U.S. statistics were gathered. Looking at this data, we can see that the death rate from infectious diseases was high during the 1800s and declined from the mid-1800s to the mid-1900s to almost zero. Looking at the whooping coughs death from England, deaths had decreased by more than 99 percent before any vaccine." First UK Public Health Act was 1848.
With regards to tuberculosis, there are excellent counterexamples from places that were unable to institute public health reforms. Even with access to antibiotics, these countries suffer under immense tuberculosis burdens in the modern day. I'm a tuberculosis researcher, and we're still struggling to bring down TB cases using antibiotics alone.
While I can't find the citation right now, I recall that South Africa was a strong example that had relatively comprehensive antibiotic access in the mid- to late-20th century. However, public health infrastructure changes were not made, and thus the TB burden remains high to this day. With high burden comes higher chances of antibiotic resistance, and resistant TB is an important global health threat. So if we don't address these problems that COVID is making clear to us today, we're going to have even more trouble from these previously "defeated" diseases.
And if anyone finds that cross-country comparison TB article I would be extremely grateful if you'd post it here!
As always, great read. For another example from the 19th century, economist Jason Barr and I have been looking at the late 19th and early 20th century tenement acts in NYC. While the results are preliminary, the wards (neighborhoods) with the most new construction - which would be buildings in compliance with better standards of ventilation and sanitation mandated by the tenement acts - have far lower rates of infectious disease mortality than wards with older less ventilated, less sanitary building stock. The wards that were safer and had the most new construction had the most dense living conditions in the city and were some of the most impoverished neighborhoods. So, there seems to be good evidence that the new building standards had a large effect on keeping people safer. We have a two part blog story on this. The first demonstrates the difference across neighborhoods, the second discusses our initial investigation into why the difference existed.
https://troytassier.substack.com/p/how-deadly-were-gothams-tenements
https://troytassier.substack.com/p/how-deadly-were-gothams-tenements-512
Very interesting thanks
In seems in both instances, the approaches chosen (public health messages for behavioral change, or vax and relax) were made to maintain the profits of the ruling class.
Illuminating. Thank you. One correction - the UK MP is a woman, Bridget Phillipson, shadow education secretary.
Thanks!
Masking, social isolation, air management, vaccination, anti-virals where indicated. Together these are the critical strategies to minimising the spread of COVID, and minimising hospitalisation, deaths, and long COVID.
Still people fight them. Not only that, they couldn’t give a damn about harming others. And some have no choice: take their sick selves to work or their family starves - government support has ended.
It’s as if society would rather millions of people continue to die unnecessarily just so we can pretend that everything is “normal”.
It is not that people wanted this situation - it has been forced on us. Even right at the beginning, our leaders pushed for infection as the way out - In the UK for example - PM Johnson publicly stated aim being to "take it on the chin". Every measure that helps has been deliberately and systematically undermined. The pretence that infection is irrelevant is pushed everywhere by the rich and powerful (except for themselves, of course). In short - our ideas do not come out of thin air but are manufactured by those who rule society. Those ideas were always dangerous, but in a pandemic, much more so!
Excellent article.
TB is a complex example. The vaccine we have is only modestly effective - it's moderately effective against extrapulmonary (outside the lungs) TB, such as spinal TB and TB meningitis (which often affect children, and are often fatal), but not very effective against pulmonary TB. Furthermore, it has walls itself away, so antibiotics and other antimicrobials struggle to kill it, requiring very long periods of treatment; and many strains have become extremely resistant to many antimicrobials; and the antimicrobials that continue to work are often more toxic to the patient.
Better vaccines are being developed, and could make a massive difference. I wouldn't downplay the benefit of Vaccines, particularly for diseases like measles, where the [in this case] virus mutates very slowly.
Nevertheless, the article is correct. Clean air and water, and good nutrition, are the most important elements in protecting us from TB and many other infections diseases.
But
What will become painfully apparent in time is the callous disregard for caution in dealing with a virus the lingers in an infected person's body. Yes, TB may be more dramatic in its inducement to leading unfortunates off their mortal coil, but harsh times are coming due to the lack of respect for a dangerous disease for many who think they recovered from a bad 'cold'.
Intelligence (presumed without justification), does not countermand arrogance. We do not rule Mother Nature and she is not susceptible to the propaganda that bolsters our unacknowledged ignorance.
Forgotten is a frequent occurence, when there's an expense more lies can avoid.
Making it an individual responsibility and pretending useless masking by >90% who did it to get by, voluntarily or otherwise, was a reasonable response, when it was one of the most absurd and contradictorily effected processes of my lifetime, had other benefits. Got rid of many of the most costly and left more attacking each other in another spasm of distracted ignorance, as the oligarchs wealth exploded.
It'd be so much easier to just go to the darkside. Must be really sweet, for those who can't conceive of, and don't even consider there's an alternative paradigm.
Given our history and the fact that we're repeating it almost verbatim, I'm frankly amazed that our species has managed to "prosper" the way it has.
Unfortunately, Greg Travis' claim is not supportable. Depending on the year, there were between 20k and 50k flu deaths annually before 2020. Not to diminish the toll of SARS-2 on an annual basis since it is much less seasonal than influenza. Also, there has been no estimate of the toll of SARS related mortality after the acute stage. Also not to diminish the simple fact that like covid-19, the influenza toll could be controlled by better air quality as was shown in the 2020 season.
https://www.cdc.gov/flu/about/burden/past-seasons.html
Covid is not at all seasonal. Each wave so far is driven by a new variant, not by a season. There is so far no correspondence between season and infection rates.
Simply calculating increased mortality is one of the safest ways to measure the effect of a new virus. If we take 2016 to 2019, and we compare to 2020 to 2023 we would get a very reliable figure for the death rate over a comparable 4 years.
Lastly, the problem with Covid is no longer really the acute stage (vaccination and prior infection have helped). The problem is that each infection carries so much long term risk with it. 10% of infections lead to symptomatic Long Covid and some unknown percentage of infections lead to no symptomatic problems (vulnerability to other illness, strokes, heart attacks, cognitive problems, etc). Just how high this burden is remains unknown, but we know it will be big.
After only four years and a changing landscape (population is different with immunity and susceptible mortality) and a significantly mutating virus we don't know for sure except to say that it isn't highly seasonal like flu, no? The two highest waves of infection in the US have been in the winter, but there have been big waves in other seasons as well. Is it vitally important at this point? Our data are very poor in the US, excess mortality and wastewater monitoring are about all we have.
Same with long term effects. We know it's very bad, but it's still an open question how devastating it will be. Time will tell. Our data are even worse for this aspect of the disease.
What we do know is our times aren't that different from the days of John Snow and Ignaz Semmelweis. We as a species cannot mount a rational response to the clear and present danger of an infectious disease in a time frame when it would be most effective.
So it goes.
“We grow so soon old and so late smart” is an old, but timeless, adage.
Excellent read, any book recommendations on these topics?
This was written in the late 50s but is great and still relevant https://www.press.jhu.edu/books/title/11246/history-public-health
I will read that for sure then! Thank you!
In April 2013, public health in England and Wales was transferred from the NHS to local authorities who were having their budgets slashed by central government. People warned of dire consequences. Has anyone done any research into how much this affected the public health response in the UK?
Vaccines must be an integral part of every public health strategy, which must necessarily be a broad and layered strategy.
We learned this during the 20th century, after years of urbanization and the growth of town infrastructures to deal with waste, to clean water, and to in the 1970s, clean our air. Cleaning environments is only one area of defense.
None of those environmental changes had a direct effect on the quelling the spread of Measles, Mumps, Rubella, Whooping Cough, and other viruses and infectious diseases that did not die out -- though are still a threat -- until there was a concerted, national (though it went state-by-state, if I remember correctly) effort to mandate vaccinations for all children. It is only by the end of the 20th century that the spread of MMR and other viruses was in the lowest percentages -- to the point where people had no living memory of their dangers and so thought that the body had innate defenses against those viruses and that only be remaining healthy that they would be free from disease and sickness.
This is not a fact. The body does not possess innate defenses against those specific viruses. It has learned to defend against them ONLY by vaccination. It is only by vaccination that we are protected from the worst ravages of these diseases. It is only by mass vaccination that we are protected -- almost to prophylaxis -- from these diseases.
Alternatively - most vaccines had a negligible effect compared to public health measures which long preceeded them.
"When we look at the actual data, we see that although many people did die from whooping cough in the early part of the 1900s, by the time the vaccine had been introduced the death rate in the United States had declined by more than 90 percent. Using the source that was referenced to make the statement in the Pediatrics paper, we see that the decline in deaths from the peak was approximately 92 percent before the introduction of the DTP
vaccine."
"England began keeping statistics in 1838, which was 62 years before official U.S. statistics were gathered. Looking at this data, we can see that the death rate from infectious diseases was high during the 1800s and declined from the mid-1800s to the mid-1900s to almost zero. Looking at the whooping coughs death from England, deaths had decreased by more than 99 percent before any vaccine." First UK Public Health Act was 1848.
https://learninggnm.com/SBS/documents/Vaccines_Peek_beneath_the_hood.pdf
https://visionlaunch.com/wp-content/uploads/2015/12/vaccine-charts-4.jpg