A Future Full of Plagues

 

Happy New Year, y’all.

The late nineteenth and the twentieth century was an amazing time of medical progress. Nearly every disease at least began to submit to scientific eradication. Not just infectious diseases, but cancer and nutritional diseases also. It seemed as if nothing could stop the progress of medicine.

But, it was apparent by the late twentieth century, one thing could stop the progress of medicine against bacterial diseases: the evolution of antibiotic resistance. Many bacteria that cause disease (which most do not) evolved resistance against many antibiotics, rendering them obsolete. This actually occurred by the process of natural selection: resistance evolved. By the end of the twentieth century, two things became apparent. The first is that we needed to keep developing new antibiotics. The second is that we had to decrease our reliance on antibiotics.

With regard to the first, we have done an inadequate job. Private pharmaceutical companies have not been developing new antibiotics as rapidly as the old ones become obsolete. This is because new antibiotics are not profitable. When a corporation develops a new antibiotic, it has a limited time span of use. First, each patient takes the antibiotic for a limited time, usually ten to fifteen days. Second, after a few years, the bacteria evolve resistance. It is much more profitable for pharmaceutical corporations to develop and market new drugs against diseases that cannot evolve resistance, and for which the patient must take the drug every day for the rest of his or her life. An example would be depression. The result is that our “armamentarium” (medical historians like military metaphors) of antibiotics is growing smaller each year.

With regard to the second, there are clearly things that we can do. Doctors used to prescribe antibiotics with little regard as to whether they were necessary. Since antibiotics do not work against viruses, doctors began to prescribe antibiotics only after they knew the infection was bacterial, not viral, in origin. This was and continues to be a good thing. But another thing we can all do to reduce the use of antibiotics is to prevent the spread of diseases.

There are many ways to reduce the spread of disease, and everyone knows what they are. As the covid pandemic broke out, and before vaccinations were available, we were told to practice social distancing and to wear masks. These practices were very effective, so that covid incidence began to decline even before vaccinations were widely available. It is now very clear that we can reduce our dependence on antibiotics by using vaccination, masking, and social distancing to control the spread of bacterial diseases. If we do these things, the old antibiotics will become obsolete more slowly, or, if we are lucky, not at all. Penicillin almost became obsolete, but it remains effective for some uses even after almost eighty years of use.

But there are no antibiotics against viruses. For viral diseases such as the various kinds of coronavirus, we have only vaccination, masking, and social distancing. That’s it. (Well, there is one alternative: massive dieoff, in which natural selection produces a resistant population of humans. I have actually had people tell me that this is an acceptable solution to the problem.)

Political conservatives in many countries, however, have shown hostility against all three of these ways of preventing the spread of disease. The Islamic fundamentalists have been rejecting vaccination for decades, with the result that many diseases that could have been eradicated are still in the world. And now Christian fundamentalists, and fierce conservatives (often the same people) reject masking, social distancing, and vaccination with unbridled fervor. They would, literally die—and have you die, too—than to participate in any of these.

New infectious diseases will come along. They always do. And when the next one comes, millions of fierce conservatives will make sure that the disease gets a free ride to spread through the world as much as possible. It is almost as if death from covid (even their own deaths) are a badge of honor to them. If the disease is bacterial, these conservatives who would rather die than to wear a mask will get the germs to spread faster than antibiotics can be used to control them.

The nurse in this photo is showing a headline to a man who is confined to a ventilator because the polio virus destroyed the nerves that allowed him to breathe. The news came too late for him, but the nurse intended it as good news that, at least, the next generation of people would not have to suffer from polio. Neither of them would have guessed that millions of people would consider the polio vaccine to be evil. When Edward Jenner developed the smallpox vaccine; when Louis Pasteur developed the rabies vaccine; when Jonas Salk developed one of the polio vaccines—they could not have imagined that people would consider them evil and actively work against them.

We are, it appears, entering a new dark age of plagues. We have political conservatives to thank for it.

This Is Starting to Get Crazy

 

Many of the Americans who oppose covid vaccination and mask mandates are fierce and even crazy. There has been nothing like it in medical history. Never before have so many people vehemently attacked medical science, at least not since Edward Jenner performed the first vaccination about 1800.

On Tuesday, September 28, a man in Wichita Falls, Texas, tried to enter a hospital without a mask. A security guard told him that the hospital required masks. The man became so angry that he attacked the guard and bit his thumb clear to the bone. You can read about it here from a local Texas newspaper.

This is beginning to look like a plague of insanity.

An Open Letter to the Governor of Oklahoma

In your delusions of defending the freedoms of Oklahomans, you and the legislature have guaranteed the absolute and inalienable rights of some Oklahomans to breathe coronaviruses into the faces of other Oklahomans. You have forbidden mask mandates in state agencies, such as the university where I work, and forbidden vaccination requirements. As a result, I am unable to defend myself from getting germs breathed in my face, and I cannot protect my students from having germs breathed into their faces, by a minority of Oklahomans who proudly refuse vaccination and refuse to wear masks. You have guaranteed that our current flood of covid cases will continue unabated. You must be proud of yourself for promoting the unnecessary sickness of thousands of Oklahomans.

Why don’t you go ahead and finish your work? Why stop with covid? There are other germs that can sicken Oklahomans. There are currently state laws that protect Oklahomans from exposure to these germs. Why don’t you strike down those state laws, and leave us even more vulnerable to contagious diseases? You have gone just partway in your blaze of conservative glory.

I refer in particular to salmonella. Some people are asymptomatic carriers of salmonella, and some of them work as food handlers. At the present time, salmonella outbreaks are rare because employees of food service providers are required by state law to wash their hands after using the restroom. This simple measure prevents infected food service workers from spreading the disease. But this state law, from your viewpoint, infringes on the fundamental freedom and dignity of food service workers by requiring them to wash their hands. Why don’t you eliminate this law? The deaths of a few hundred Oklahomans from salmonellosis is a small price to pay for the absolute freedom of food service workers to do whatever they want. Will you be a champion of freedom all the way, or only partway?

A disease that used to be common in America is typhoid fever. Like salmonella, it was spread from the unwashed hands of symptomless carriers to the people who eat the food they prepared. Frequently, the people who eat the food would die. The most famous of the symptomless carriers was a cook named Mary Mallon, now known as Typhoid Mary. Law enforcement caught her as she fled, and forbade her from ever again working as a cook. This was, of course, an infringement upon her American freedom. But they did it anyway. When she refused to stop working as a cook, she was imprisoned for the rest of her life.

But, today, in Oklahoma, according to the principles that you hold so dear, it would be illegal to prevent Typhoid Mary from working as a cook in a public school cafeteria. A school would be required to hire her if she was, in other ways, qualified for the job. The deaths of a few hundred schoolchildren would be, from your viewpoint, a small price to pay for Typhoid Mary’s freedom to choose whatever line of work she wishes.

Finally, there is a disease that was singlehandedly responsible for the deaths of about ten percent of people who have ever died in human history. That disease is smallpox. Through massive, often forced, vaccination of millions of people throughout the world (mostly Asia and Africa), a project led by the United Nations World Health Organization (of which you have a low opinion), this disease has now been eradicated. Nobody will ever again die of smallpox from natural transmission. There are still smallpox germs in freezers in the USA and Russia. We can only hope there are no bioterrorist groups that have the germs in their freezers. By your principles—that nobody should be forced to be vaccinated—smallpox would still be killing thousands if not millions of people.

And why is it okay to require measles vaccinations, but not covid vaccinations? Perhaps your crusade for freedom should expand to include the repeal of all vaccination requirements. Measles and mumps could then make a comeback for which you could claim the honor.

Schoolkids dying of measles, salmonella, and typhoid fever, and millions of people dying of smallpox—this is the kind of paradise that the world would be if it had followed your principles of “freedom.”

Video about covid and evolution

Here is a link to a video on my Darwin channel about covid and evolution, as explained in the previous essay. The current surge is due to low vaccination rates. With more viruses, you have more new mutations, and more cumulative risk.

https://www.youtube.com/watch?v=MJCl9QfityU&t=5s

An Artificial Pandemic

I am reporting to you from inside the covid pandemic in America in 2021. Back in 2020, when we had mask mandates, the number of covid cases began to decline a little, then steeply declined in 2021 because of widespread vaccination. By early summer 2021, it seemed to most of us that the end of the pandemic was in sight.

But only a couple of months later, the pandemic had come back. There were as many people sick from covid (though fewer dying) as during the previous surge. The differences this time:

• The vaccine (from whichever company) proved remarkably effective. “Breakthrough” cases, in which fully vaccinated people became ill, were very rare. Almost all of the covid cases were unvaccinated people. It is a pandemic primarily of the unvaccinated.
• In many southern, conservative states, vaccination rates are very low. In Oklahoma, only about one-third of the people are even partially vaccinated. The main, though not the only, reason for this is that the extremely right-wing people think that the government, at any level, has no right to require vaccination or masks.
• Right-wing politicians rammed through an agenda of blocking mask requirements. In some states, such as Texas and Florida, Republican governors issued executive orders prohibiting mask mandates, even at schools and hospitals. In Oklahoma, not only did Governor Kevin Stitt issue an executive order, but the state legislature passed a law, prohibiting mask mandates. It is illegal for me, or the university at which I work in Oklahoma, to require students to wear masks.

The result is many thousands of people who are sick from, and many more thousands are carriers of, the coronavirus. That is, Oklahoma and other states have a huge population of viruses lurking inside the bodies of humans.

In many other countries, large numbers of people are sick from covid because of limited access to vaccines. But in America, it is because the majority of people refuse the vaccines that are freely available to them—even when incentives are offered. At my university, you can get $100 for getting the vaccine.

And from there, evolution runs the show. Here’s how:

• Mutations occur all the time. The result is mutant viruses. Not all of them, but just a few.
• The greater the population of viruses, the more chance there is that a dangerous mutation will occur. This is where the delta variant came from. This is a matter of probability. If there had been fewer sick people, the population of viruses would have been smaller, and this particular variant might not have occurred. If you have ten times as many sick people, the mutation is ten times more likely to occur. This is exactly what happened as a result of people refusing vaccination.
• If the mutation enhances the ability of the virus to spread to other people, natural selection will favor it. If a mutant strain of virus can infect ten times as many people as a previous strain, it will spread ten times as fast. Soon it will become the dominant, or maybe the exclusive, strain of virus. This is exactly what happened with the delta variant, which is almost the only strain of covid now in the United States.
• Evolution cannot be stopped, even if the majority of Oklahomans reject evolution. It happens anyway.

If you have refused vaccination for reasons other than a health condition, you have helped to create an artificial pandemic. The pandemic would have “burned itself out” and our population might have reached “herd immunity,” to use popular phrases, if almost everyone had been vaccinated. If you refused vaccination, you have contributed to the illness of hundreds of thousands of people and the deaths of hundreds.

If you decided to not get vaccinated, it is not just a personal decision, but one that you have foisted on everybody. On me, for example. I am required to teach in-person classes at my university. Even if I wear a mask, there is at least a slight risk that I will get infected by the virus. The risk is cumulative. If my odds of getting infected in a typical laboratory session are one in a hundred thousand, by the end of the semester with 50 lab meetings, my odds will have increased to one in two thousand. Is this a risk I am willing to take? I should make this decision, but in Oklahoma, that decision has been made for me by the governor, the legislature, and the seventy percent of people who have refused vaccination. Unvaccinated people hold the power of life or death over me. Even if I do not die, I could bring the virus home to infect my wife, daughter, son-in-law, and/or two grandchildren.

Therefore, in Oklahoma, a majority of the people believe that “I have an absolute, God-given right to spread germs to other people, and maybe kill them.” Their right to be free from societal responsibility is more important than the right of other people to live.

The huge number of covid victims, nearly all of them unvaccinated, has clogged our health care system. Health administrators in Oklahoma have repeatedly warned that the system is on the brink of collapse. In some places, covid patients have to wait in the ER for admission to the hospital. In other states, patients are being put in beds in the cafeteria. This is almost all due to people refusing vaccination. Thanks a lot, right-wingers!

In one state, Arkansas, the Republican governor (Asa Hutchinson) issued an executive order banning mask mandates. The order was struck down in court. Hutchinson’s response was to say he had reconsidered, and that his order against mask mandates had been wrong. He welcomed the court’s decision. As far as I am aware, he is the only prominent Republican who has had this change of heart.

The pandemic will probably never stop. The reason is evolution. There will be new variants, and they will spread, even if the delta variant eventually dies out. Thanks to right-wing extremists, who will continue to refuse vaccination, the covid pandemic will become a permanent aspect of our culture forever into the future. I hope events will prove me wrong, but the facts and the reasoning above seem indisputable. That is, unless, maybe, the virus kills most of the right-wingers. But this will probably not happen. They will just remain a permanent strain on our health care system, and continue to add billions of dollars to our collective debt.