July 5, 2020

Fighting fires

By the time this gets published tonight, the US will pass 130,000 deaths from COVID-19 with almost 3 million confirmed cases. The numbers of infections are growing exponentially, deaths will start increasing in 2-3 weeks. This is not good news.

How can we fight this? It will take will, innovation, and adaptation. I read this insightful article from UW’s magazine about William Foerge, who led the CDC and helped eradicate smallpox. Smallpox was a deadly disease that killed millions over the centuries, with evidence showing that smallpox alone massively decreased the indigenous population in the Americas. Smallpox (Variola virus) was the disease that helped people figure out about vaccination. People were inoculated with a tiny amount of fluid from a smallpox lesion, which caused some to get deathly ill, but most became less ill and survived. An astute physician, named Edward Jenner in Great Britain in 1796, noticed that milk maids did not get smallpox, and concluded that they had been previously infected with cowpox (Vaccinia virus) so were protected. He started innoculating people with material from a cowpox lesion. Thus vaccinations were born from the Vaccinia virus. Safer than inoculation with smallpox virus and just as effective. But infections and outbreaks of smallpox persisted.

William Foerge worked for the forest service fighting fires in Washington and Oregon in his late teens. There he learned this: “The principles were simple and drilled into us repeatedly: separate the fuel from the flames and the fire stops.”  Early in his career he helped adapt the effort to eradicate smallpox by approaching outbreaks the same way. Go to the site of the outbreak and immunize the surrounding community so that there would be no fuel. This approach worked and smallpox was declared officially eradicated in 1980 by the WHO.

Many countries are using this approach by identifying and then isolating people with COVID-19 infections so there is no fuel. It is working. This is the goal of public health departments in the States and elsewhere. But testing people is a complex entity and requires supplies, people to obtain the specimens, and people to run the lab tests, possibly exposing workers in the process. If we can get more people easily tested and cases identified, we can then help isolate them, so there is no fuel to infect others.

Lucky for us there are lots of people looking for ways to help solve the problems and some simple and innovative home tests are being developed and close to approval. A Harvard ID doctor that I follow closely, Dr. Paul Sax agrees this plan would be a big help. People can easily test themselves regularly at home so that infections can be diagnosed early. I highly recommend reading his blog. The link is below. Plus he has a bonus video of Mabel and Olive. You know which Olive and Mabel I am talking about, don’t you?

Wash your hands, cover your nose, and keep safe six.

And finally, my caveat is that this is my experience and my opinions, which are subject to change as more information is available, and not related to the organization I work for. Thanks for reading.