Showing posts with label medical care. Show all posts
Showing posts with label medical care. Show all posts

Saturday, April 18, 2020

The Plague, the Spanish Flu, and the Coronavirus: Equivalence and Progress in Infectious Diseases

History forgotten is history to be repeated, for evolution occurs over such vast oceans of time that for our purposes, human biological nature is fixed. Yet history kept fresh can permit progress such that the species is better equipped to combat problems such as pandemics. At the time of the coronavirus pandemic of 2020, serious comparisons to the Spanish Flu of 1918 and the Black Death of the fourteenth century were lacking in the American media, including by public health officials and government officials even as claims of vague equivalence were made. Such claims, I submit, were erroneous. In fact, they did more harm than good by instilling excessive fear in the population.

Hearing the coronavirus being referred to as a plague on National Public Radio in the United States, I instinctively bristled at the assumed equivalence. A plague is a contagious bacterial disease with a high mortality rate. Coronavirus is a virus rather than a bacterium. The Black Death was a plague pandemic that “devastated Europe from 1347 to 1352 CE, killing an estimated 25-30 million people.”[1]  Paris buried 800 dead each day of the peak, or apex, there. “On average 30% of the population of affected areas [in Europe] was killed, although some historians prefer a figure closer to 50%, and this was probably the case in the worst affected cities.”[2] In 2020, two months after the first recorded death from the coronavirus in Europe, 97,000 people there were dead. The global mortality rate of coronavirus as of March 3, 2020, according to the World Health Organization (WHO), was just 3.4%, which is much closer to the 1% from seasonable flu.[3] Therefore, the coronavirus pandemic was not a plague.

The coronavirus pandemic was also publically likened to the Spanish Flu, which hit the U.S. in 1918. At least both were viruses, unlike the Plague. “The Spanish flu of 1918 lasted only a few months but took an estimated 50 million to 100 million lives around the globe, including 675,000 in the U.S.”[4] Ten days short of two months since the first death from the coronavirus in the U.S., 38,917 people were dead from the disease and less than 5% of the population had been infected. Worldwide, at least 158,000 people had died.[5] Clearly, the two pandemics were not equivalent. The assumed equivalence in the comparisons in 2020 demonstrates not only ignorance, but also a lack of interest in acquiring even a bit of historical knowledge so as to make tolerable comparisons.

In spite of historical knowledge being available and there being advances in knowledge, weaknesses of our species exerts a countervailing wind on the road of progress. The Spanish flu itself may not have been more virulent, however, because medical and public-health knowledge was so significantly less in 1918 than a century later. To put the two eras in perspective, model-T cars were on the road in 1918, whereas electric (and hybrid) cars were being driven and self-driving cars were being tested by 2020.

Parades and “other large public gatherings were common, contributing to the spread” of the Spanish Flu.[6] American governments facing the coronavirus pandemic prohibited or recommended people to maintain a physical distance from each other and stay home as much as possible (e.g. shelter-in-place orders). Retail businesses either shut voluntarily or by government order. Medically, antibiotics “to treat secondary bacterial infections that often accompany the flu had yet to be discovered” by 1918.[7] In addition to antibiotics, physicians in 2020 could put patients struggling to breath on ventilators.

It cannot be assumed, however, that people in 2020 could not have improved their chances of staying healthy by learning more about the 1918 societal protocols. During the Spanish Flu, it was thought “that keeping windows open would deter the spread.”[8] Trolley cars in Cincinnati, Ohio displayed fliers encouraging the practice, “which was utilized nationwide.”[9] In contrast, bus drivers in Phoenix, Arizona kept the bus’s narrow upper windows closed during the coronavirus pandemic a century later. Missing the larger point, the bus company’s management claimed that even open slits were unsafe because passengers could throw small objects out of the buses. Even though medical knowledge was clear that the coronavirus stays airborne relatively long due to its small size among flus and could even be transmitted by normal breathing, the bus company in the desert did not bother to read up on how trolley companied had dealt with the pandemic in 1918. Nor did the passengers figure that physical distancing applied to getting on the bus (i.e., giving deboarding passengers some space). In grocery stores in Phoenix, employees and customers alike overwhelmingly ignored the store policies on keeping at a distance from other people. In spite of the signs and announcements, the managements did not have control over their own employees.



In grocery stores in Phoenix, employees and customers alike overwhelmingly ignored the store policies on keeping at a distance from other people. In spite of the signs and announcements, the managements did not have control over their own employees.

Arizona at the time had one of the worst public education systems in the U.S.; even bad judgment could be traced back to this factor. Perhaps it is too idealistic to assume that everyone can be educated enough to reason his or her way to better secure even self-interested self-preservation. Even with historical knowledge and advances thereof available, human nature presents a limit as to how much actual progress can be made against infectious diseases.


[1] Marak Cartwright, “Black Death,” Ancient History Encyclopedia (accessed on April 18, 2020).
[2] Ibid.ev
[3] Tedros Ghebreyesus, press briefing of March 3, 2020. As Director-General, he headed the World Health Organization at the time.
[4] Aaron Kassraie, “Spanish Flu: How America Fought a Pandemic a Century Ago,” AARP (accessed April 18, 2020).
[5] Ben Westcott et al, “Global Coronavirus Death Toll Passes 158,000,” CNN.com, April 18, 2020.
[7] Ibid.
[8] Ibid.
[9] Ibid.

Thursday, October 27, 2016

CO2 Record-Level in Atmosphere: Implications for Human Population

In 2015, average global CO2 levels for the year surpassed 400 parts per million for the first time, the WMO revealed in its 2016 annual Greenhouse Gas Bulletin. At the time, any scientists regarded that ratio of carbon dioxide to other gases in the atmosphere as a “climate change touchstone.”[1] Curiously, however, 400 ppm was not considered a tipping point. It was still possible to reverse the progression of the ratio—yet no one seems to ask how long that would take. In this regard, the ratio’s accelerating rate is particularly telling. Practically speaking, 400 ppm may in fact be a tipping point.

CO2 concentrations in 2015 “were about 144 percent higher than pre-industrial levels. Other emissions measured in the report, methane and nitrous oxide, were up 256 percent and 121 percent from pre-industrial levels, respectively. Among those, however, CO2 contributes the most to warming and [was] responsible for about 81 percent of the increase in radiative forcing from 2005 to 2015.”[2] Ralph Keeling, who runs the Scripps Institution of Oceanography’s carbon dioxide monitoring program, pointed to the irreversibility of the ratio of CO2 in the atmosphere. “[I]t already seems safe to conclude that we won’t be seeing a monthly value below 400 ppm this year ― or ever again for the indefinite future.”[3] Practically speaking, 400 ppm may be a tipping point in that the likelihood of getting below it again in the foreseeable future is nil.
Lest it be thought that the Paris treaty could turn things around, that the vows are voluntary and without repercussions for failing to adhere to the promised cuts. Moreover, “even if all Paris pledges are fully implemented, predicted emissions in 2030 will still place the world on track for a temperature rise of 2.9 to 3.4 degrees this century,” according to UNEP in 2016.[4] CO2 emissions would have to be cut an additional 25 percent by 2030 to avoid the worst effects of climate change.[5] I assume even that would not be enough to get CO2 levels down below 400.

Sadly, we weren’t even going in the right direction at the time of the U.N. Environment Program’s report. In other words, the CO2 ratio’s rate was accelerating. “The increase of CO2 from 2014 to 2015 was larger than that observed from 2013 to 2014 and that averaged over the past 10 years,” the report noted.[6] Predictably—though not in terms of the acceleration—studies at NASA and the University of California at Irvine showed in 2016 that Smith and Pope Glaciers in Antarctica were “growing thinner” and “retreating at the fastest rate ever observed.”[7] Since 1996, “Smith Glacier’s grounding line retreated at an annual rate of 1.24 miles per year and Pope’s at an annual rate of 0.31 mile per year,” according to NASA.[8] Smith Glacier “lost between 984 and 1,607 feet of ice thickness between 2002 and 2009.”[9] That this pace “is nearly six times faster than a previous estimate” is in line with the accelerating ratio of Carbon parts per million in the atmosphere. I contend that the estimates of the impact of the ratio were low because the ratio’s accelerating rate of increase had not been detected. By implication, estimates of how much carbon-emissions should be reduced by have also been too low.
In fact, even the focus on reducing carbon-emissions may be insufficient. The accelerating rate of the ratio as well as the likelihood that we won’t see anything less than 400 ppm may indicate that we have not yet gotten to the underlying causes. According to the WMO’s report, the bulk of the increase in the ratio was due to unbridled human activities ranging from “growing population, intensified agricultural practices, increase in land use and deforestation, industrialization and associated energy use from fossil sources.”[10] Even among these causes, that of growing population is most fundamental. The human being necessarily takes energy from the environment and expends waste, including pollution. Simply put, our species has been too successful genetically; we have multiplied. Yet the climatic data suggests that we have over-multiplied.

Crucially, the rate of increase in the global population has been increasing. It took 123 years for the total to go from 1 to 2 billion, then only 33 years to reach 3 billion in 1960.[11] The population reached 4 billion in 1974, 5 billion in 1987, 6 billion in 1999, and 7 billion in 2011.[12] How could there not be an astounding impact on the planet’s climate? As a maximizing variable, human population may be out of control, with the ecosystems bearing the brunt. An analysis in 2014 claims there is a 70% chance that the human population “will rise continuously” from 7 billion in 2014 to 11 billion in 2011.[13] This poses “grave challenges for food supplies, healthcare and social cohesion”—not to mention climate change.[14] The head of the research team stressed that population should return to the top of the international agenda.
Unfortunately, population decrease is typically viewed as a problem in many countries, while those with the largest populations—China and India—have not set population decline as a policy goal. To be sure, decreasing population too fast presents social problems, such as not having enough wage-earners to support retired people. Even so, the accelerating feature of the CO2 ratio and its effects on the climate—most notably, on glaciers and oceans more generally—suggests that serious attempts to reduce reproduction-rates globally—and especially where the rates are highest—are warranted. In addition to international agreements to decrease CO2 emissions, declining population targets should also be negotiated. Both individually and as a group, governments can no longer afford to skirt the underlying cause of the problem, which looks increasingly likely to result in the extinction of our species.

Genetically speaking, our species has been very successful in terms of multiplying our DNA in many, many individual members, yet this very success may be short-lived; it may be breeding extinction, which is failure in genetic terms. Put another way, our short-term thinking that reigns on Wall Street may apply even genetically. It may be up to the people serving in governments around the world to make hard choices in order to extend our species’ perspective enough that we can self-regulate our species back to a reasonable number rather than continue to spiral out of control and be at the mercy of nature’s constraints rather than those of our own choosing. Considering the population growth during the twentieth century alone, we can no longer afford as a species to skip over the underlying cause of climate change, for the acceleration is not limited to the ratio of CO2 and glacier-melt. Add in the lifespan-extending advances in medical science, and it becomes clear just how severe we need to be as a species in limiting our reproduction.


[1] Lydia O’Connor, “The Planet Just Crossed Another Major Carbon Milestone,” The Huffington Post, October 25, 2016.
[2] Ibid.
[3] Ibid, italics added.
[4] Nick Visser and Dominique Mosbergen, “UN: Paris Deal Won’t Be ‘Enough’ To Stave Off Worst Effects Of Climate Change,” The Huffington Post, November 3, 2016.
[5] Ibid.
[6] O’Connor, “The Planet.”
[7] David Freeman, “Glaciers’ Rapic Retreat Should Be ‘Alarm Bell to Everyone’s Ears,’” The Huffington Post, October 26, 2016.
[8] Ibid.
[9] Ibid.
[10] O’Connor, “The Planet.”
[11]The World at Six Billion: Introduction,” United Nations (1999).
[12] Jasmin Coleman, “World’s ‘Seventh Billionth Baby’ Is Born,” The Guardian, October 31, 2011.
[13] Damian Carrington, “World Population to Hit 11bn in 2100—with 70% Chance of Continuous Rise,” The Guardian, September 18, 2014.
[14] Ibid.


Sunday, September 7, 2014

Natural Rights in Europe and America: Shoring-Up Each Other’s Weak Spots

The Declaration of Independence made by the thirteen newly sovereign American states in 1776 recognizes “that all men are created equal, that they are endowed by their Creator with certain inalienable rights, that among these are Life, Liberty and the pursuit of Happiness.” These rights are not dependent on any government, and thus exist equally so in the state of nature. The Declaration of the Rights of Man and the Citizen, made in Europe thirteen years later, omits any mention of a creator-deity. “Men are born and remain free and equal in rights.” The equality here is more limited, being solely in terms of rights, “man’s natural and imprescriptible rights” in particular. These “are liberty, property, security, and resistance to oppression.” We can thus compare and contrast the two sets of rights, which important implications for public policy for both America and Europe.

Liberty is shared by both declarations; the value placed on freedom was likely salient in the last quarter of the eighteenth century at least. Liberty represented the emerging paradigm of popular sovereignty as against monarchy and the associated divine right of kings. Interesting, the American Declaration pivots the divine source over to liberty, whereas the European Declaration implies a basis in Nature. Basing a new paradigm on the basis of the prevailing one has the advantage of the transference of legitimacy, while bypassing the old foundation may be likened to kicking the chair out from under the reigning paradigm, hence weakening any potential resurgence. So, both documents had a valid strategy.

In terms of “ever closer union” pertaining to the E.U. and U.S., we might try combining the other salient rights to get a sense of a more holistic, or balanced, basis to government. John Locke would no doubt be very pleased. To liberty, we can add life, property, security, resistance to oppression, and the pursuit of happiness. I have ordered these rights along the lines of Maslow’s hierarchy of self-actualization—physiological sustenance and physical security being the most fundamental, and happiness residing at the top. The right to security implies life, but the latter does not include the former.

Hence we find a more complete safety net in the E.U. than in the U.S. The ideological belief that a person must work in order to survive, a vestige of the proverbial state of nature although without the greater specialization making people more dependent on each other, has more currency among Americans than Europeans, generally speaking. A balanced approach to public governance would include the right to life buttressed by the right to security. That is to say, more could be done in the U.S. with respect to ensuring basic shelter, medical care, and food to the people in most need such that they need not live in fear from day to day.

Furthermore, the right to resist oppression can be coupled with the right to pursue happiness, for the oppressed are rarely very happy. Striking workers in the 1930s in America felt the weak spot in the American variant of rights as companies hired Pinkerton cops to beat the strikers as local police looked on or even participated. Europeans weighed down by onerous regulations would benefit in terms of quality of life were happiness a more explicit factor used by regulators.


In any culture, some rights are valued more than others; valuing itself involves prioritizing. Accordingly, governments tend to have distinctive weak spots. Political development can be facilitated, I submit, by comparing different though related sets of values in order to detect and strengthen areas that potentially could undercut the system of public governance itself. That is to say, Europeans and Americans can learn from each other and both come out with stronger systems of governance.