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We Have Met the Germs and They Are Us

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

By Burden Lundgren
August 4, 2021

This is a story of biological and social germs. I have killed a lot of the former. As an American child, I was taught, as historian Nancy Tomes puts it, the gospel of germs. Germs were bad, they caused disease and they had to be eliminated. Frequent baths and showers, handwashing, clean preparation of food, enthusiastic house cleaning and lots of laundry were the daily rituals of health. When I went to nursing school, my game was amped up to include sterile technique and a great deal of autoclaving.

Americans do largely practice the gospel of germs, but in the year of COVID, this became an obsession. Fortunately, only a few people actually took the President’s advice and ingested bleach, but even now, when we know we are dealing with an airborne disease, many are still wiping down grocery bags and practically bathing in hand sanitizers.    

Germs have been with us from our beginnings. The organisms in the picture are tubercule bacilli. Near global-wide evidence of tuberculosis infections date from at least 5000 B.C., but some place the progenitor of the bacillus more than 150 million years ago with evidence of hominid infection three million years ago.

By the mid-20th century, many declared the age of infectious diseases to be over, but tuberculosis is among those that never went away. Today 2 billion people are infected with 10.4 million new cases, and there are 1.4 million deaths every year. Nearly 1/3 of the world’s population are carriers of the disease. There is no infectious disease that has withstood our efforts to kill it better than this one.

Hyper-cleanliness may be at the bottom of a number of autoimmune conditions, and the widespread use of antibiotics has brought blowback in the development of resistant organisms. The number of people dying from resistant organisms is 700,000 per year. This number could reach 10 million by 2050. Our expectation that we could look forward to an infectious disease-free world was a delusion.     

Most of our efforts concerning germs have been to kill them. Germs were either pathogens (disease-causing) or non-pathogens (disease neutral). It has just recently dawned on us that some germs are beneficial. We would not even exist without them.

We have known there were microorganisms associated with the human body since the invention of the microscope, but it wasn’t until the report from the Human Genome Project that we discovered that we have about 10 times as many microbial cells (bacteria, microphages, fungi, protozoa and viruses) as we do human cells in our bodies. Nearly half of our DNA is of viral origin. (There is evidence of corona virus infection at least 25,000 years ago.) We are them, and they are us.  

And many of these organisms do yeoman work in keeping us healthy. Those in our gut promote digestion, interact with the nervous system, fight inflammation and make important contributions to our immune systems – so much so that we have sometimes reversed our “kill them all” ways and purposefully introduced microorganisms into our bodies to fight disease and on our bodies in probiotic washes and lotions. We know that both viruses and some bacteria can destroy bacteria, but we are at just the beginning of learning how to leverage the “good germs” against the bad.

For an epidemic to happen, the biological germ must be present, but social “germs” pour gasoline on the fire. While we need to attend to the specifics of each epidemic wave, we should also be paying attention to the social phenomena inherent in most epidemics for as long as we have records.

  • It is typical government behavior to ignore epidemics for as long as possible. The former President didn’t invent this.
  • The first victims are usually blamed for the disease.
  • Epidemics are bad for business.
  • Epidemics enlarge the cracks in societies to yawning chasms with those of different races, ethnicities, genders and incomes caught in different realities. In the worst case, societies can shatter as recounted by Thucydides in his description of the plague of Athens.
  • Those with the fewest resources suffer the most.
  • Good basic population health cuts down on fatalities.
  • People have crazy and often paranoid ideas about epidemics and health authorities.

From the notion that Jews were poisoning the wells during the Black Death to magnetized vaccines, lunacy will show up for the duration.

Yes, we need to develop the science necessary to address the next epidemic diseases—whether they be due to resistant bacteria, new viruses or fungal infections (which are increasing at a frightening rate). But the problems listed above are issues of governance, and they are utterly predictable. As we have seen, following the science is nearly impossible if the listed problems are not addressed—and during the epidemic is not the time to fix them. Between outbreaks, while the scientists toil in their laboratories, government officials should be addressing the social fundamentals that will hinder their response no matter what the cause of the next epidemic—or else it all will happen again.                        

Author: Burden 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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