Today's post is about a great moment in history. Lots of things can kill us. Only once in human history have we WORKED TOGETHER to eradicate a disease that can kill us. That is what I think of when I want to be inspired about the possible.
Those of us born before 1972 (and some military members) have a souvenir of what I consider to be the most amazing achievement of worldwide cooperation in the history of the planet.
The Inspiration
I’ve received a few comments from loyal readers about how I choose my topics to post. I would not go so far as referring to my approach as a process. I believe a subset of the topics emerge when I am walking on my treadmill or listening to the radio news or a podcast. The inspiration for tonight’s post is unusual. A couple of months ago, in my book club, we discussed “The Lost City of the Monkey God” by Doug Preston. While I was reading the book I was struck by the belief that I had read a book by the same author. I was mistaken although I had read a book written by his brother Richard Preston. The Richard Preston book of my memory was “The Demon in the Freezer”. At the time I read the book, I came away from it feeling like the achievement discussed in the book was one of the greatest achievements in human history. I thought that was sufficient motivation for a post.
The Setup
I will now share my OPINION of some of the greatest achievements of mankind. I expect many of you would choose differently and I would cheerfully welcome your opinions in the comments. A useful criterion that I invite each of you to challenge in the comments is the number of lives saved by the achievement. Of course, since this is just my opinion, the list below could just have a name like the one I included:
Stuff That Inspires Me
The Green Revolution trailblazed by an American agronomist from the University of Minnesota named Norman Borlaug. The scourge of mass-starvations continued to occur with rising frequencies as the world population exploded. As a child, our elementary school teachers implored us to collect pennies for the missions. The news had reports of emaciated children on the brink of starvation. The pennies undoubtedly intervened to save lives. A much grander intervention was the green revolution with a pivot to the aggressive application of crop science, genetic modification, and dependence on the nitrogen cycle and heavy fertilization. In the sixty years since, many consider the rise of obesity and co-morbidities in the developing world as a larger problem now than starvation! Now that is a tremendous success when we’ve altered our focus from starvation to obesity. The link above references Borlaug winning the Nobel Prize for peace in 1970. Scholars believe the Green Revolution has saved more human lives than ANY action in human history.
Mankind leaving the earth, landing on the moon, and returning safely to the earth. The audacity to try to do something so difficult, because it is hard. The payoff for me, is the singular photo that defines the trips. President Kennedy said it best in a series of speeches inspiring the effort. That will definitely be the inspiration for future posts.
The evolution of public health emerged as the number of people “on the rock” continued to grow. As societies started crowding together, the necessity for consistent practices was the key for a society to flourish. Once a critical number of people are crowded together, one particularly well-focused disease can threaten the whole society. If you look at the graph at the bottom of this list, such an event occurs in the 14th Century in Europe as the “Black Plague”. The estimates of morbidity are hotly debated but the high-side estimates are 40% of the world’s population of 500M people (200M in all) die during the plague. The absence of a systematic approach and focus on public health means humanity could be wiped out by an especially virulent condition with high morbidity. Did you know that even 600+ years ago, the importance of a mask was not controversial as it is memorialized in art of the period?
The eradication of smallpox. In the HISTORY of the world, only one disease has been completely eradicated. Smallpox has been detected and documented in ancient Egypt around 3,000 years ago. Variations of the disease seems to emerge for many different animals and remains species-specific like camelpox, rabbitpox, cowpox, and monkeypox as well as the variation we are speaking of just referred to as smallpox. It is estimated that smallpox killed 300 million people in the 20th century and eradication was largely accomplished in the 1960s and finished in the 1970s. That is about 3X more than the two World Wars COMBINED!
The shape of this curve is AMAZING. The VERY SLIGHT dip around 1400 is the Black Plague. Depending upon the source this graph displays the period when humans settled down, abandoned hunter-gatherer status, and became farmers. The scale not represented is that the previous 1.99 million years of human-like existence was pretty much a flatline. This is only the last 1% of human existence. We have been very busy lately!
Which of the Four is “Worth” a Post Tonight?
I have previously posted that progress in our modern world is sure and steady. That does not mean that paranoia and undermining the organizations that have made these breakthroughs possible is a reasonable course of action. Rash and unreasonable behavior can have consequences and when it involves the tragic loss of human lives, it is difficult to understand. I think all four of the topics above are worth discussion but since I came to this topic due to Richard Preston, tonight it shall be #4, The Eradication of Smallpox that I will focus on. I think that current events make this a good choice. The subtitle of my post is a play on words and a commentary on societal priorities that ail us. Dr. Edward Jenner, despite what pop culture might contribute to the discussion is a person who changed history. Bruce/Caitlin Jenner and all the Kardashians are non-sensical by comparison. I am afraid and sad that when the name Jenner is brought up, our minds might think of the reality TV circus.
Dr. Edward Jenner was ostracized and warned by colleagues in his day that the idea of “vaccination” would only bring a tragic loss of reputation. Jenner persisted after several refinements and brought the world its FIRST vaccine.
The beginning of world exploration brought different cultures into contact. In every case, smallpox decimated the population with tragic results. The loss of life was greatest in the newly explored areas without domesticated animals. Generations of living with animals, raising them for food, milk, coats, or most importantly for work multiplication (pulling a plow) had exposed European and Middle East populations to myriad diseases and eventually SOME immunity. Eventually in these cultures, smallpox emerged, and over time people established some immunity. Smallpox made its way to each of the continents as the previously unknown disease raced through new populations. Smallpox was especially debilitating to society, killing 30% of the infected and scarring many of the survivors for life.
Dr. Jenner began the development and evangelization of vaccination in the late 1700s. A concerted effort over nearly two centuries was required to eliminate the virus from the planet. Prior to formalizing vaccination, it was common to intentionally spread the discharge from smallpox sores as a means of intentional exposure. The book “The Demon in the Freezer” presents two stories in one. The first part explores the details of the public health effort to end the scourge of the disease. The second part relates the actions of the United States and the Soviet Union amidst the cold war of maintaining the virus for “research”.
Both sides needed to retain the smallpox virus, perhaps in another commitment to mutually assured destruction. The consequences of a militarized modification to the virus could threaten the entire human race. If a virus were to emerge with the virulence of the flu, coupled with the morbidity of smallpox, such a disease might very well end the human race over a short period of time or at least turn back the clock for humankind by centuries. A little spoken of consideration of the 9/11 attacks was speculation and early targets of the Al Qaeda attacks. Until the attacks were winnowed from ten to five airplanes, one of the considered targets was the Center for Disease Control (CDC) headquarters in Atlanta where “the demon in the freezer” is stored.
Humankind suffers from hubris and I suppose that is what being at the top of the food chain can do. Context is helpful in understanding our place in this world. The consensus estimate of experts states that 99.9% of ALL SPECIES that have ever existed on this planet are today extinct. That is the underlying story of slow mutation and change through evolution. One of the advantages of being at the top of the food chain is you get to write the history. The genus and species of homo sapien are interesting and unusual. Our earth only has one mammal of the genus homo and that is us. That was a conscious choice to place us in a very distinct place in the taxonomy.
At least three other examples like neanderthals died out and quite recently on the scale of time (about 40,000 years ago). The other genus homo examples are also extinct. Paleontology coupled with the tracing of mitochondrial DNA helps us understand that humans (homo sapiens) approached extinction as their numbers reduced to between 30,000 to 40,000. That is the time in the human story when the great exodus out of Africa occurred.
A DNA Tangent
I have an avid interest in genealogy and the accompanying and complementary science of personal DNA testing. For me, the most fascinating thing I have learned is about mitochondrial DNA. In my case, I know my mom was Polish because she made great pierogies. That of course is a joke. Mitochondrial DNA refers to DNA we can ONLY get from our mothers because the male-only contributes details from the Y chromosomes (23 of them). This leads to an exciting result. If we examine mitochondrial DNA we will be able to show the female-only contribution to what makes us unique going back generations. This leads to understanding the areas of the world where our maternal side originates. For me, that is eastern Europe. This is the synopsis in my case from 23AndMe. My maternal haplogroup is H1C. For that reason ALONE, personal DNA testing for me is fascinating! The next time someone tells you this stuff is just a theory, just let it whisk by without a care. By the way, because I am H1C, that means at one point I branched from H and later from H1. Pretty cool stuff and a great hobby!
Back to the Story
The success of the smallpox vaccination was improved greatly by the development of the bifurcated needle. I chose not to include a photo because I do not want to contribute to people avoiding vaccinations. People my age often have a small scar on their arms where they got their smallpox vaccinations. In those days people lined up and got their shots. There was no leadership at the top reporting what the National Enquirer might have opined. Leadership and sensibility carried the day and we chose not to be torn apart by conjecture.
Smallpox, in comparison to influenza, is not nearly as virulent (not airborne) with much higher morbidity (high percentage of death upon exposure) coupled with delayed symptomatic presentation (about five days). That combination in a world that no longer vaccinates is a tremendous risk for the human race. Since a very small percentage of people may develop the disease when vaccinated, once eradication was documented, continuing vaccination does not make sense. The one large-scale exception is the US Military which vaccinates a subset of its members for smallpox.
Lessons Learned?
I think that many would agree that our recent battle with the novel coronavirus has been sobering. So many of us have balkanized and become unwilling to engage with our fellow citizens. Even the appearance of being in disagreement about a single issue is now grounds to separate ourselves as like wheat from the chaff. A crisis requires leadership and leadership begets unity. Absent such leadership, alas, could doom the human race to a loss of life beyond any historical precedent. Thirty percent (which is very conservative in an unvaccinated pool) would translate to about 2.5B lives lost.
Hollywood and a largely left-leaning ill-informed group of celebrities carried the flag for anti-vax ideas from the 1990s through the mid-2010s. The baton was passed to a right-leaning group of ill-informed people energized on social media who provide the bulwark challenge amidst the coronavirus to achieve herd immunity. They were BOTH ill-informed and in both cases set out to MANIPULATE public opinion. For me, the takeaway is this is not a left or right issue. It is a lack of education/ignorance issue.
What is the takeaway for me? Robert DeNiro is a PERFECT EXAMPLE. He carried the flag for fringe anti-vax ideas. At some point, he transitioned to a vocal Donald Trump critic and conveniently became pro-vaccine! The truth is his reasoning was tragically suspect and he used his influence to subvert rational thinking. I think it is important to recognize that his thinking and reasoning were ALWAYS dangerous. Think for yourself and reward those that have been CONSISTENT in their leadership and their criticism.
COVID has much higher morbidity than the flu virus but is much less than smallpox. It is pure dumb luck that the genetic makeup of this current virus has given the world of public health a dress rehearsal for the actions required to ensure the continuation of the human race. I think the last three years and the reactions of state legislatures throughout the country do not appear to have been a positive long-term response. The need for coordinated and worldwide public health when there are eight billion people on the rock is an issue worth worrying about.
In my opinion, Dr. Jenner (no relation to the Jenner / Kardashian cabal) and the deployment of public health on a worldwide basis in the 1960s and 1970s is the greatest achievement of humankind in its history. Hundreds of millions of people had died in the first fifty-plus years of the twentieth century due to smallpox. Smallpox did not threaten the extinction of the human race but its impact had been a depressing and ongoing genocide. The inspiration that humanity came together led by organizations like the WHO, NIH and CDC (yeah those guys who some consider incompetent nowadays) worked together and accomplished the task of eradicating a disease! The last natural occurrence in the United States was in 1949. A case of transmission from Bangladesh to India occurred in 1975. The last natural case of the disease was identified in Somalia in 1977. The important lesson of eradication was the approach. When a case emerged:
(1) the outbreak area was surrounded and ALL TRAFFIC in and out were stopped with no exceptions.
(2) Mandatory vaccinations were administered and quarantines were enforced for significant periods with no exceptions.
(3) Any bodies of the diseased were carefully managed with disposition via cremation.
This may seem extreme to many but this was the approach and procedure to accomplish what has only happened once in the history of this planet. Hooray for humankind and public health.
In 1979, the WHO declared, with the consensus of coordinated groups all over the world that smallpox had been eradicated from the earth. The postscript is a world that has worked together and developed more and more vaccines in the intervening period. A virus called rinderpest is now considered as likely to have been eradicated. Work continues to eradicate malaria and river blindness in the future. This is something for the human race to celebrate and it all started with my favorite Jenner. Raise a toast to Edward Jenner, a man who made a difference.
I feel great after this post. Here is a song that fits my mood.
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I thought it was very well-written! And I'm so happy to be on Substack. I blogged in the glory days of blogging, and Substack reminds me of them. So I totally agree that the best thing about it is the connections we make!
This is a wonderful post. I am leaving it open so I can come back and read it more carefully, but you are great at research and distilling facts. Good stuff!
I thought it was very well-written! And I'm so happy to be on Substack. I blogged in the glory days of blogging, and Substack reminds me of them. So I totally agree that the best thing about it is the connections we make!
This is a wonderful post. I am leaving it open so I can come back and read it more carefully, but you are great at research and distilling facts. Good stuff!