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Posts Tagged ‘infectious disease

“Thought is an infection. In the case of certain thoughts, it becomes an epidemic.”*…

Frank M. Snowden, a professor emeritus of history and the history of medicine at Yale, examines the ways in which disease outbreaks have shaped politics, crushed revolutions, and entrenched racial and economic discrimination. Epidemics have also altered the societies they have spread through, affecting personal relationships, the work of artists and intellectuals, and the man-made and natural environments. Gigantic in scope, stretching across centuries and continents, Snowden’s account seeks to explain, too, the ways in which social structures have allowed diseases to flourish. “Epidemic diseases are not random events that afflict societies capriciously and without warning,” he writes. “On the contrary, every society produces its own specific vulnerabilities. To study them is to understand that society’s structure, its standard of living, and its political priorities.”…

Epidemics as a mirror for humanity- Isaac Chotiner (@IChotiner) interviews Frank Snowden: “How Pandemics Change History,” conducted on the occasion of the publication of Snowden’s new book, Epidemics and Society: From the Black Death to the Present.

See also: “Late-Stage Pandemic Is Messing With Your Brain.”

And for thoughts on addressing the issues raised, see “Governing In The Planetary Age.”

* Wallace Stevens

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As we reflect, we might spare thought for August Paul von Wassermann; he died on this date in 1925. A bacteriologist and hygienist, he was director of the Institute for Infectious Diseases in Berlin, where he developed (in 1906) a universal blood-serum test for syphilis that helped extend the basic tenets of immunology to diagnosis. “The Wassermann reaction,” in combination with other diagnostic procedures, is still employed as a reliable indicator for the disease. He also he developed inoculations against cholera, typhoid, and tetanus.

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“You’re mugging old ladies every bit as much if you pinch their pension fund”*…

Who benefits from the commercial biomedical research and development (R&D)? Patients-consumers and investors-shareholders have traditionally been viewed as two distinct groups with conflicting interests: shareholders seek maximum profits, patients – maximum clinical benefit. However, what happens when patients are the shareholders?…

Adding investments by governmentally-mandated retirement schemes, central and promotional banks, and sovereign wealth funds to tax-derived governmental financing shows that the majority of biomedical R&D funding is public in origin. Despite this, even in the high-income countries patients can be denied access to effective treatments due to their high cost. Since these costs are set by the drug development firms that are owned in substantial part by the retirement accounts of said patients, the complex financial architecture of biomedical R&D may be inconsistent with the objectives of the ultimate beneficiaries…

It has been estimated that of the total $265 billion spent annually on biomedical research worldwide, over a third – $103 billion comes from public sources. Nevertheless, as public input capital is allocated predominantly into early stage research, nearly all output – medicines – is ultimately brought to the market by private firms. Importantly, these firms are not independent agents. They have owners-shareholders to report to. Until the end of the previous century the major type of owners-shareholders were individual households. At the turn of the millennium, however, they have been displaced by institutional investors, the largest of which are public retirements schemes or quasi-public funds, such as occupational pensions.

First, government money underwrites the basic R&D that goes into drug discovery and development, then public pension monies fund the private companies that bring those drugs to market. As the private companies are solving for highest profits, as opposed to optimal public health, those drugs are often priced out of the reach of the very people whose pension contributions funded their development. Drugs “priced out of reach” is certainly not a new phenomenon; AIDS drugs (to take one example) were priced by Western pharma companies at prices that rendered them inaccessible to most citizens of low-income countries in Africa and Asia. The pensioners in wealthy nations were, effectively, living off of the misery of those in poorer companies.

But the dynamic has continued, deepened– and come home to roost. Now patients in high-income countries are denied access to effective treatments due to their high cost, while these costs are being set by the drug development firms, owned in substantial part by the retirement accounts of those same patients, and benefiting from direct and indirect governmental support.

Investing in one’s own misery– the painful irony of pharma funding: “Pension and state funds dominating biomedical R&D investment: fiduciary duty and public health.”

[Image above: source]

* Ben Elton, Meltdown

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As we untangle unintended consequences, we might send healthy birthday greetings to Charles Value Chapin; he was born on this date in 1856. A physician and epidemiologist, he was a pioneer in American public health. He co-founded in first bacteriological laboratory in the U.S. (in 1888) in Providence, were he was Superintendent of Health– a position he held for 48 years. In 1910, he established Providence City Hospital where infectious disease carriers could be isolated under aseptic nursing conditions; his success inspired similar health control measures throughout the U.S. A professor (at Brown) and prolific writer, his impact on health policy and practice was so broad that he was hailed as “the Dean of City Public Health Officials.”

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“When it was in the extremity there was no such thing as communication with one another, as before”*…

 

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The island of Lazzaretto Nuovo, shown here, was one of the isles where the city of Venice quarantined plague-stricken individuals in the 15th century

 

Just beyond the shores of Venice proper—a city comprised of dozens of islands—lie two uninhabited isles with a rich history. Today these landmasses are landscapes of grasses, trees, and worn stone buildings. But once they were among the most important gateways to this storied trading city.

The islands, known as Lazzaretto Vecchio and Lazzaretto Nuovo, are now yielding fascinating insights into Venice’s response to one of the most famous pandemics in history. In the mid-14th century, Venice was struck by the bubonic plague, part of an outbreak, known as the Black Death, that may have killed up to 25 million people, or one-third of the population, in Europe. This spread was just one of several waves of the plague to strike Northern Italy in the centuries that followed.

Venice, as a trading center, was especially vulnerable. “They saw that the only solution was to separate people, to take away the sick people, or suspected sick people,” says Francesca Malagnini, of the University for Foreigners, Perugia, who is herself a Venetian, linguist, and member of an interdisciplinary team researching Lazzaretto Nuovo. “This was the only way to protect everyone’s health and allow the economy to continue.”

Beginning in the early 15th century, the island of Lazzaretto Vecchio was designated for isolating and treating plague-stricken Venetians. Later, Lazzaretto Nuovo became a spot where ships coming from places experiencing the plague, or those with suspected sick passengers or crew, anchored. There, people and goods spent a period of quarantine before being allowed into the heart of the city. (We owe the English word “quarantine” to the Italian term for 40 days, quaranta giorni.)…

Archaeological research is unearthing Venice’s quarantine history to illuminate how the Italian city created a vast public health response 700 years ago and helped lay the modern foundation for coping with pandemics: “Venice’s Black Death and the Dawn of Quarantine.”

See also: “How the Black Death Radically Changed the Course of History (and what that can teach us about the coronavirus’ potential to do the same).”

* Daniel Defoe, A Journal of the Plague Year

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As we stay safe, we might spare a thought for Charles Louis Alphonse Laveran; he died on this date in 1922.  A physician and public health and infectious disease researcher, he served as Chair of Military Diseases and Epidemics at the École de Val-de-Grâce, then joined the Pasteur Institute, then founded the Société de Pathologie Exotique; through his career, he published over 600 papers, journal articles, and books on infectious diseases and their agents.  In 1907 he won the Nobel Prize in Physiology or Medicine for his discoveries of parasitic protozoans as causative agents of diseases like malaria and trypanosomiasis.

220px-Charles_Laveran_nobel source

 

Written by LW

May 18, 2020 at 1:01 am

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