By Sarah Becker

Infectious Diseases Throughout the Years

Today it is the unexpected arrival of an acute febrile respiratory disease, COVID-19 that sickens America.  COVID-19, a relative of SARS (Severe Acute Respiratory Syndrome) was first discovered in China in December 2019.  The United States recorded its first COVID-19 case on January 21, 2020; on March 11 the World Health Organization (WHO) declared the “novel coronavirus” a pandemic.  Fifteen days later one third of the world’s population was on lockdown.

The first seemingly flu-like case was diagnosed in Wuhan, China; then Europe, Italy and Spain especially.  Now the United States is infected, all 50 states: Washington and New York States; New York City (the epi-center); Los Angeles, New Orleans and Detroit; rural populations as well.

Disease surveillance “is the continuing scrutiny of all aspects of occurrence and spread that are pertinent to control.”  The speed of COVID-19’s spread boggles the mind.  It is transmitted by droplet spread including oral contact (sneeze, cough) and hands (touch and contaminated surfaces).

By March 25, 2020, the stay at home health crisis had given way to economic chaos: supply shortages including personal professional equipment [PPE]; prolonged school and business closings; job layoffs and a historic $2.2 trillion Federal relief bill.  The Defense Production Act of 1950 was revived, albeit slowly.

Disease occurs when cells in the human body are damaged as a result of infection.  Infectious diseases are caused by living organisms including viruses, bacteria, fungi, protozoa and parasitic worms.  The South succumbed to hookworm in 1909.

Infectious diseases spread by direct contact: via vectors like the mosquito; contaminated food, water and blood; and airborne droplets.  The pandemic Spanish influenza slowed the First World War, and in 1918 in Alexandria “expectorating on sidewalks” became punishable by law.  Today’s law enforcement officers spend their time scattering social groups of more than ten people, a class one misdemeanor in Virginia.

In 1617 Jamestown’s Indian villages suffered a fatal smallpox epidemic.  In 1793 Alexandria’s Superintendent of Quarantine inspected incoming ships to prevent the spread of yellow fever.  In 1862 President Lincoln’s son Willie died of typhoid fever and during the Civil War more soldiers died of diarrhea than battle wounds.

“The [civil] war is over, but the hospitals are fuller than ever,” hospital volunteer Walt Whitman wrote.  “I should say of the sick, from my observation, that the prevailing maladies are typhoid fever and camp fevers generally, diarrhea, catarrhal affections and bronchitis, rheumatism and pneumonia.”

Beginning in 1861, concurrent with the Civil War, Louis Pasteur developed his germ theory of disease.  In 1861 U.S. Army bacteriologist George Sternberg isolated the pneumococcus bacterium “that is responsible for pneumonia.”  Sternberg’s announcement of his discovery “came almost simultaneously with Louis Pasteur’s statement of the same.”  Pneumonia is an acute respiratory disease sometimes coincident with coronavirus Covid-19.

Revolutionary War General George Washington understood the maladies associated with infectious diseases.  He survived smallpox as a youth.  Washington favored smallpox inoculation, so much so he countermanded the Continental Congress and ordered the Continental army immunized.

“Necessity not only authorizes but seems to require the measure, for should the disorder infect the Army…we should have more to dread from it, than from the Sword of the enemy,” Washington told Dr. William Shippen, Jr., in 1777.

“[General] Washington’s unheralded and little-recognized resolution to inoculate the Continental forces must surely rank among his most important decisions of the war,” historian Elizabeth A. Fenn wrote.  No COVID-19 vaccine exists as yet.

“Future nations will know by history only that the loathsome small-pox has existed and by you[r vaccine] has been extirpated,” President Thomas Jefferson wrote English physician Edward Jenner in 1806.  Thanks to the courage of men like Washington and Jefferson smallpox was wholly eradicated in 1979.

Infectious diseases account for a quarter of the deaths worldwide.  As air travel continues, as weather patterns change; as food is now traded, as water and sanitation practices fail infectious diseases will spread.  Alexandria understood as early as 1810 excreta contaminated its groundwater.

Some health solutions, like repeated hand washing with soap, are simple.  Others including physical, i.e. social distancing require greater effort.  The polio virus, which slowed with the 1953 Salk vaccine, remains prevalent in Pakistan, Afghanistan and northern Nigeria.  The 2018 Polio Endgame Plan includes the introduction of female vaccination teams, a strategy local Taliban oppose.  Remarkably fewer women have died of coronavirus COVID-19 than men.

Question: why is it the United States seems so poorly primed?  Perhaps because President Donald Trump’s National Security adviser John Bolton dismissed the White House’s Pandemic Response team, its Global Health Security team in May 2018.  Yes, the country lived through the 2003 SARS outbreak: the complexities of state, federal and corporate supply chains.  But product globalization; China-only supply chains including antibiotics and medical supplies?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 

SARS originated in China’s Guangdong province and lasted perhaps six months.  “The disease known as severe acute respiratory syndrome (SARS) is the first new infection in decades that can be spread from one person to another,” The Washington Post reported on March 25, 2003.  “SARS is believed to have first emerged in Southern China.  From there the disease spread globally…by international travelers across Europe and America.”

“Evidence indicates that the cause of the mysterious outbreak is a new member of a family of microbes known as coronaviruses,” The Post continued. “Coronaviruses…traditionally cause common illnesses like colds and upper-respiratory tract infections.  They can be quite contagious [and] this virus is unlike any other human or animal coronavirus we have seen before.”  It may be a mutated strain.

“Although more research is needed…scientists using a powerful microscope have seen the distinctive crown-like shape of a coronavirus,” The Post concluded.  “In addition, scientists have found evidence of a coronavirus in lung and kidney tissue, as well as antibodies…in the blood of three patients.”

“The Center for Disease Control (CDC) is now working on tests for the [SARS] virus,” The Washington Post said on April 6, 2003.  “That is crucial for determining which patients…actually have SARS, how often infected people get sick, and how long they can spread the virus.”  The Food and Drug Administration approved a rapid COVID-19 test on March 27, 2020.  Patient payment is a separate issue.

“Left alone coronaviruses can survive for several hours on inanimate objects,” The Post explained.  “But it is unclear how often door knobs, elevator buttons, water or sewage contaminated by the virus can infect people.”

“The CDC has [asked for]…help to develop better tests, analyze the viruses’ genes, and screen at least 2,000 existing antiviral drugs to see if any work,” The Post concluded.  “None of that would be possible without having first identified the unknown [SARS] virus.”

Seventeen years later the previously unidentified coronavirus COVID-19 infects the country.  Did the SARS epidemic teach us nothing about pathogens and preparedness?  I leave it to you, the reader, to decide.

Three weeks in Dr. Anthony Fauci, Director, National Institute for Allergy and Infectious Diseases, predicted “we could see 200,000 deaths and millions of cases” before COVID-19 kips.  The worldwide tally surpassed 1.4 million cases on April 7, 2020.  As of Easter Sunday more than 20,000 Americans had died.

U.S. deaths from COVID-19 now exceed 9/11.  It will not be a missile that does the United States in Microsoft and Gates Foundation founder Bill Gates said in 2015, it will be a pandemic.  The Bill and Melinda Gates Foundation has pledged $250 million dollars to the development of a COVID-19 vaccine.  That said, the vaccine itself may not be available for another 14-18 months.

In the interim the U.S. government has given Director Fauci an extra security team.  It seems conspiracy theorists blame him, not the “novel coronavirus” for the country’s ongoing medical dilemma.  President Trump also has suspended federal payments to the WHO.

Governor and medical doctor Ralph Northam expects Virginia’s COVID-19 spread to peak, the curve to flatten sometime in late May.

About the Author: Sarah Becker started writing for The Economist while a graduate student in England. Similar publications followed. She joined the Crier in 1996 while serving on the Alexandria Convention and Visitors Association Board. Her interest in antiquities began as a World Bank hire, with Indonesia’s need to generate hard currency. Balinese history, i.e. tourism provided the means. The New York Times describes Becker’s book, Off Your Duffs & Up the Assets, as “a blueprint for thousands of nonprofit managers.” A former museum director, SLAM’s saving grace Sarah received Alexandria’s Salute to Women Award in 2007.