Contagion: Commonalities Among Epidemic Diseases

UnknownNicholas Bagley:

‘A couple of weeks ago, my wife (also a law professor) and I wrapped up the final session of a seminar that we co-taught called Contagion. We wanted to offer an introduction to the outbreaks of infectious disease that have reshaped American life and law.

…Really more of a book club than a formal class, we focused on a different disease each time we met: cholera, Spanish flu, polio, AIDS, SARS, and Ebola.

…The class …had a surprising coherence. Every disease provokes its own unique dread and its own complex public reaction, but themes recurred across outbreaks:

  • Governments are typically unprepared,, and resistant to taking steps necessary to contain infectious diseases, especially in their early phases.
  • Local, state, federal, and global governing bodies are apt to point fingers at one another over who’s responsible for taking action. Clear lines of authority are lacking.
  • Calibrating the right governmental response is devilishly hard. Do too much and you squander public trust (Swine flu), do too little and people die unnecessarily (AIDS).
  • Public officials are reluctant to publicize infections for fear of devastating the economy.
  • Doctors rarely have good treatment options. Nursing care is often what’s needed most. Medical professionals of all kinds work themselves to the bone in the face of extraordinary danger.
  • In the absence of an effective treatment, the public will reach for unscientific remedies.
  • No matter what the route of transmission or the effectiveness of quarantine, there’s a desire to physically separate infected people.
  • Victims of the disease are often thought to deserve the affliction, especially when those victims are mainly from marginalized groups.
  • We plan, to the extent we plan at all, for the last pandemic. We don’t do enough to plan for the next one.
  • Historical memory is short. When diseases fall from the headlines, the public forgets and preparation falters.

Not every one of those themes was present for every disease; the doughboys who died of the Spanish flu, for example, were not thought to deserve their fate. But the themes were persistent enough over time to establish a pattern.

The books we assigned were outstanding. If you want to learn about the intersection of infectious disease, history, and public health, you could do worse than to start with them:

  • Charles Rosenberg, The Cholera Years: The United States in 1832, 1849, and 1866.
  • Alfred W. Crosby, America’s Forgotten Pandemic: The Influenza of 1918.
  • David Oshinsky, Polio: An American Story.
  • Randy Shilts, And the Band Played On.
  • Thomas Abraham, Twenty-First Century Plague: The Story of SARS.
  • David Quammen, Ebola: A Natural and Human History of a Deadly Virus.
  • Laurie Garrett, Ebola’s Lessons: How the WHO Mishandled the Crisis….’

Via The Incidental Economist


Why the silent spread of coronavirus might actually be a good sign.

502805 5’In China, the death rate has been reported as zero in children under 10 and very low, 0.2 percent, in healthy adults. Unfortunately, the rate is far higher, as high as 14.8 percent, in the sick and elderly (though as is always the case in outbreaks like this, it is hard to know how many of these older and often chronically ill hospitalized patients died with COVID–19, not of COVID–19). The reported overall death rate of 2 percent is essentially a weighted average of these numbers.

So what does the case of a young and otherwise healthy patient contracting the disease despite no obvious exposure to a contagious source patient imply? That there are likely many asymptomatic cases in our communities already.…’

Via Slate


Big media is covering up Trump’s terrifying incoherence in a time of emergency

Screen Shot 2020 02 27 at 11’Wednesday’s briefing was arguably the most abnormal moment yet in a profoundly abnormal presidency.

But top news organizations, rather than accurately representing Trump’s alarming behavior, made it sound like nothing untoward happened at all.

They made it sound like some real news was made: That Trump put Vice President Mike Pence in charge of the government’s response to the coronavirus; that the president urged calm.

But even the Pence “news” appears to be a sham, and a clusterfuck: In addition to being basically a fuck-you to the medical community — given Pence’s proud defiance of scientific truths — it was apparently a last-minute decision based on political optics that blindsided Health and Human Services Secretary Alex Azar, who at the same time insisted that he was still in charge.

This one really wasn’t hard. It was obvious to anyone listening to Trump’s rambling, often incoherent, self-centered, stream-of-consciousness ad-libbing – much of it straight out of his political rallies — that:

Trump had no real understanding of what he was talking about.
He had no sense of what was required of him as president.
He sees this as being all about him.
There are only so many things that can come out of his head.…’

Via Press Watch


R.I.P. Freeman Dyson


The man behind the sphere is dead at 96:

’Freeman Dyson, a physicist whose interests often took him to the edge of science fiction, has died at the age of 96. Dyson is probably best known for his idea of eponymous spheres that would allow civilizations to capture all the energy radiating off a star. But his contributions ranged from fundamental physics to the practicalities of using nuclear weapons for war and peace. And he remained intellectually active into his 90s, although he wandered into the wrong side of science when it came to climate change.…’

Via Ars Technica