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Pandemic: Bigger Than We Think—Part Two

The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.

By Burden Lundgren
December 9, 2020

The most recent human experiences with pandemics have been largely associated with respiratory transmission. But widespread communicable disease is by no means limited to respiratory spread. It can also arrive by water. My late mother-in-law, born in the 19th century and raised in Eastern Europe, was well acquainted with epidemics. The only one she feared was cholera. She was not wrong. There is a particularly horrifying original Star Trek episode where a “salt monster” kills its victims by draining their bodies of salt. Cholera does the same thing except it also takes the body’s other electrolytes along with the salt. And it is fast. A person can be healthy at breakfast and dead by lunch. The historian William McNeill described the effects as making, “Mortality uniquely visible; patterns of bodily decay were exacerbated and accelerated, as in a time-lapse motion picture, to remind all who saw it of death’s ugly horror and utter inevitability.” 

From 1817 to the 1970s, seven epidemic cholera waves swept the globe from Asia to Africa to Europe to the Americas, killing millions. The 1854 epidemic in London marked a landmark in public health when a water contaminant (if not the actual pathogen) was identified as the cause of the disease. Nonetheless, the disease waves continued unabated. Today we think of cholera as a disease that occurs in parts of the world with desperate poverty and/or lack of civil authority. But the disease still lurks awaiting only a relaxation in vigilance—and warming seas may lead to more outbreaks.

And we can be killed by our food. We are familiar with the so-far limited disease outbreaks caused by the mass production of crops and cattle. Those outbreaks are the tip of the iceberg. The drive for meat production is especially problematic. Most of us have read news accounts of the dangers of bushmeat and wet markets. But conventional meats are a bigger problem—a problem that is increasing with the higher demand for meat in the developing world. Meat production in the global South has increased 260% in the past 50 years. More meat production means more opportunities for pathogens to jump species.

Additionally, there is growing evidence that the widespread practice of routinely administering antibiotics to food animals causes the proliferation of antibiotic resistant organisms that can be passed on to humans. Antibiotic resistance in food animals has nearly tripled since 2000. The World Health Organization has identified antibiotic resistance as one of the biggest threats to global health, food security and development today. Already many infections such as pneumonia, tuberculosis, septicemia, gonorrhea and food-borne illnesses have become harder to treat. Annual deaths from antibiotic-resistant infections are expected rise to 10 million by 2050. The production of meat also contributes to climate change which in itself also promotes communicable diseases such as Dengue and malaria.

This column and my last (September 9, 2020) point out how human drives for land, water and food let loose pathogens that can kill us—millions of us. Population pressure is causing us to break more and more into the environment with less and less thought as to the long-term outcomes. We are on track to have 10 billion people on this planet by 2100. How can the planet safely sustain a population this large? And how can we provide a good life to all those who want it? It has been estimated that for the world population to live like Americans, we would need the resources of five Earths. Sadly, as poorer countries become richer and healthier, they are using more of the planet’s resources, which contributes to the conditions that create pandemics. The Earth’s resources are being exploited to the point where a million plant and animal species, many on which our own lives depend, are in danger of extinction.  

On our present course, we could be one of those species facing extinction. We have had warning after warning in this century alone. Swine flu. Avian flu. Ebola. SARS. MERS. COVID-19 will not be the last. This has become a greater issue than infectious disease and public health specialists alone can manage. This is an all-hands-on-deck problem. Scientists who study the planet and its resources, social scientists, far-sighted political, business and faith leaders and, yes, program administrators with the capacity to look across disciplines and execute interconnected programs in complex environments are also required. In the end, prevention of pandemics comes down to respecting the only planet we call home.

The 18th century inventor of the smallpox inoculation put is thusly: “The deviation of man from the state in which he was originally placed by nature seems to have proved to him a prolific source of disease.” We should have listed more closely to Dr. Jenner.


Author: Burden S Lundgren, MPH, PhD, RN practiced as a registered nurse specializing in acute and critical care.  After leaving clinical practice, she worked as an analyst at the Centers for Medicare and Medicaid Services and later taught at Old Dominion University in Norfolk VA.  She has served as a consultant to a number of non-profit groups.  Presently, she divides her time between Virginia and Maryland. She can be reached at [email protected].

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