Written by Leigh Henderson
On the 40th anniversary of the global eradication of smallpox, there are calls for attacking the COVID-19 pandemic as smallpox was attacked. One hallmark of smallpox eradication has been undertaken with enthusiasm—research. Scientists around the world are investigating COVID-19. Scientific journals are waiving their usual access fees to ensuring rapid and widespread communication of results.
Can smallpox eradication be a model for tackling the COVID-19 epidemic? Yes and no. Smallpox eradication could not have succeeded without its basic management, organization, and epidemiologic principles. These ‘lessons’ apply broadly and can influence the success or failure of global public health programs.
However, the two diseases are very different. Smallpox had many characteristics that made it a viable candidate for eradication, and the strategies used took advantage of these. Confronting COVID-19 will require different strategies.
Written by Leigh Henderson
COVID-19 has dominated the headlines, quarantined much of the U.S. population, and devastated the U.S. economy. As of June 12, the United States reported 2 million confirmed and probable cases with 111,000 deaths.1 There were, an estimated 271,000 hospitalizations.2
When COVID-19 was first reported, most of the population was self-quarantined and non-essential businesses were closed. We were told that this would ‘flatten’ the epidemic curve. It would extend the duration of the epidemic but would ease the burden on overtaxed hospitals. The number of patients would be distributed over a longer period, but there would be fewer at any one time.
Why did we not take the most obvious step to ‘ease the burden’?
Written by John Hoffman
I am not sure that leaders at all levels fully appreciate the grave danger we face with our food supply, our economy and our nation. The food system in the United States represents one sixth of our economy. Historically, as the food system goes, so goes the economy. The national food infrastructure has always had a direct impact on confidence in government.
Many in our nation face growing food supply insecurity today. This is particularly true in the large cities. Today we have broad shortages that are in the range of 20% of key protein products. Food prices are rising as a consequence of production cuts that have created these shortages and supply disruptions. This is all the result of the COVID-19 pandemic and the failure of the federal interagency team to take the necessary steps to assure full access to the things every family needs every day. What we are seeing today need not have been the case.
Written by Dennis Haugh, Dave Morgan and Ron Scott
Everyone in the United States has now become painfully aware of how computer models can impact their lives. We can no longer ignore their existence. Every citizen needs to have a rudimentary understanding, not of modeling itself—but of when it can be trusted and when it cannot.
There is a fundamental question of knowing the future. In 2007, The Black Swan explored the bounds of our knowledge in a world of uncertainty and introduced the “ludic fallacy”—using the past to predict the future. This paper puts some of the concepts from that book into the context of computer modeling.
The response to the Covid-19 pandemic response has largely been based upon the published predictions from models like the ones constructed by the Imperial College and the Institute for Health Metrics and Evaluation (IHME). Had these models not produced the fear they did, the impact of the pandemic would have been reduced significantly.
Written by Leigh Henderson
One of the most significant anniversaries in human history passed recently with little fanfare. Forty years ago, on May 8, 1980, the World Health Assembly declared that smallpox had been eradicated.
Smallpox had been transmitted in an uninterrupted chain from person to person for at least 3,000 years. Unlike bubonic plague, it was endemic—always present—killing some 20-30% of those infected and leaving many of the survivors blind and most horribly scarred. Children bore the brunt of smallpox—many adults had survived the disease or been successfully vaccinated. Children under 15 could account for 75% of all deaths in an epidemic.
On January 1, 1967, the World Health Organization (WHO) started a global smallpox eradication program. Smallpox control efforts had ended endemic smallpox in much of the world, but epidemics introduced by travellers were rife. Smallpox was conservatively estimated to infect 10 million people annually, causing 2 million deaths.
On October 26, 1977, a Somali man became the last victim of smallpox in the world. Two years of exhaustive searches for any remaining smallpox reservoirs followed. A global commission reviewed the evidence and concluded that smallpox had indeed been eradicated.
Written by John T. Hoffman
“The food supply chain is breaking,” wrote board Chairman John Tyson in a full-page advertisement published Sunday in The New York Times, Washington Post and Arkansas Democrat- Gazette. Anyone visiting a grocery store already has figured this out. Tyson Foods is also warning that “millions of pounds of meat” will disappear from the supply chain as the corona virus pandemic pushes food processing plants to close, leading to product shortages in grocery stores across the country.
YOU DO NOT NEED TO RUN TO GROCERY STORE TODAY. THE SHELVES WILL NOT BECOME BARREN, but your selections will become limited and hundreds of thousands of hogs and chickens will be culled and buried while tens of thousands of Americans are lined up in front of food banks that are challenged to keep up with the demand.
Written by Peter R. Jutro, PhD
The recent name-calling regarding COVID-19 (Wuhan virus, Chinese virus, or Kung Flu) is hardly without precedent, but certainly not helpful for preventing the next pandemic.
History provides us with many examples of nations attempting to shift blame for disease problems. Although the 14th Century Black Death, or Black Plague’s Yersinia Pestis bacterium most likely moved westward from Asia to Europe along the Silk Road, it never acquired a geographic name. Perhaps the earliest disease to become the cause of international blame-shifting, took place in the 15th and 16th centuries, when many countries tried to assign responsibility for one particular disease to other countries.
Written by A. J. Kay
On March 15th, Janet Mills of Maine became the first US Governor to recommend statewide cancellation of all elective medical procedures. Governor Mills proclaimed that such action would, “relieve the strain on the healthcare system as Maine prioritizes COVID-19-related cases.”
That same day, the American Hospital Association (AHA), in cooperation with three other healthcare advocacy organizations, published an open letter to the Surgeon General rejecting the idea that the COVID response necessitated such sweeping measures. They stated declaratively,
“Our ability to respond to patients must not be prevented by arbitrary directives.”
In the following weeks, a cascade of 35 states included similar restrictions on elective procedures in their stay-at-home and shelter-in-place (commonly known as “lockdown”) orders. These directives ranged from instruction on the prioritization of “grey area” elective surgeries to compulsory cancellation and postponement of all non-emergent procedures. Orders in seven of those states outlined explicit civil and criminal penalties (some including imprisonment) for doctors who failed to comply.
In the weeks since the unprecedented multi-state lockdowns, the US Healthcare system has been left with an opaque patchwork of the very same ‘arbitrary directives’ against which the AHA cautioned. The lockdown orders and elective procedure bans were instituted with the intent to save lives. However, our failure to safely and quickly resume elective surgeries when lockdowns helped blunt the impending crisis has financially crippled our hospitals and private practices, led to mass furloughs, and denied healthcare to those who need it most.