Did you know that the bubonic plague is still around? That pesky little bug that killed up to 200 million people in the Middle Ages still pops up from time to time. A boy in Idaho got it a couple of years ago, I kid you not.
“Hey Jimmy, what’d you do all Summer?”
“Actually, I was sick for most of it with bubonic plague”
It’s almost worth getting, just so you can bring it up in Show’n’Tell. So much better than “Visited the grandparents in Wichita and miked some cows”.
Jimmy (probably not his real name) is fine… completely cured with a routine course of modern antibiotics. Jimmy is lucky he wasn’t born 500 years ago, because his pocket full of posies would have done nothing for his ring around the rosie.
The bacteria that causes bubonic plague has been quietly around for at least 6,000 years, but every once in a while, it makes a big splash. The Black Death, which peaked in the mid-14th century, was the biggest known pandemic of that particular bug, but there have been many outbreaks over the centuries… and while they’ll never achieve the magnitude of what happened in the Middle Ages, two breakouts is 2014 and 2017 in Madagascar killed around 200 people. And it’ll keep showing up, because it’s bacteria and it’s alive.
Unlike bacteria, viruses aren’t alive in the sense that they can just procreate on their own. They need a host, and in the current case, that host is a human… and in particular, human noses and airways. That’s a relevant point, which differs, for example, from SARS, also a coronavirus… which appeared and died-off in 2003. It incubated deep in people’s lungs. There are many other differences as well. SARS was far deadlier (~10%) but also less contagious. And the biggest difference is that while COVID-19 is still around, SARS-CoV is gone… extinguished from existence, except deeply-buried is research laboratories. Extinguished because of the way it was managed; the same gameplay of testing and isolating until every known host was known, and then kept away from infecting others. No host to jump to means it dies off, and that’s that. As has been widely quoted… if we could 100% isolate everyone on the planet for 14 days (probably a little longer, but not much) and keep completely isolated those who develop symptoms in that time — this thing would be squashed out of existence. That’s impossible to achieve, so the next best thing is a vaccine, which can, in due course, achieve the same thing. Has that ever actually been done?
Yes — and it’s one of the greatest achievements of medicine. Smallpox is gone, entirely, as of 1980, after a concerted effort that took decades. Smallpox was a horrible disease, with awful symptoms and a mortality rate of 30%, and you could catch it from someone coughing or sneezing on you, or touching contaminated surfaces… the usual that we are all familiar with these days.
But back in the day, medieval epidemiologists (heh) did not have a lot at their disposal, and it’s hard to blame them. Germ theory was centuries away from being figured out. Plague doctors wore those famous plague masks with the long noses, full of good-smelling herbs… which, if they didn’t help keep them safe, at least helped mitigate the stench of dying people all around them. In fact, back then, it was thought that illness was transmitted through miasma… bad-smelling air. A kind of chicken-and-egg causality where you assume the bad smell in the air is cause of all this illness… not the result. The name “malaria” literally means “bad air” in latin. But at least to some extent they’d figured out that keeping away from sick people was a good idea; the first versions of social distancing. Those Venetian masks with the long noses? It’s hard to cough/sneeze on someone when you can’t get too close. They understood at least that: stay away. I have this image of a medieval Dr. Henry, standing at the top of the Rialto Bridge, yelling down to the gondoliers on the Grand Canal… “Hey you down there! You shouldn’t be oot and aboot! Go home!” She wouldn’t be yelling, of course… more like softly but strongly suggesting.
Germ theory eventually sorted it out, but there was an interesting little overlap of time where smallpox “vaccines” from the Far East arrived in Europe, and worked… but nobody understood why. That didn’t fit with any known medical knowledge of the time, but it seemed that taking powdered smallpox scabs and inhaling them… would lead you to develop a mild form of the disease, from which you would recover. Well, most of you. There was a 2% mortality rate with that treatment… which is still a lot better than 30% if you get it. Game-theorists of the day could have tried to figure out what gave them better odds… a certain 2% chance of death vs. a N% chance of contracting something with a 30% chance of death. Here, I’ll do the math… if you thought your chances of contracting smallpox were greater than 7% (one in 14), go for the scab inhalation. I’ve bet on enough 14-1 shots in my life to know that I should take my chances with the scabs.
I say all this because the people back then, flying blind as they were, made the best of what they had and what they knew. We are way ahead these days… but as we’re all experiencing, there’s always plenty more to learn… and I think it’s going to really heat up in the next few weeks. We have a perfect storm overlapping of emerging antibody tests, conflicting studies from around the world regarding how widespread this is, data from jurisdictions that are doing things very differently and so on. And much of this is saddled with a conformity bias that makes it very difficult to navigate. When you start with a conclusion you’re hoping to reach, it’s not difficult to find the data to support it. It’s all out there. We will navigate it as best we can.
Speaking of we — we around here, and in Canada in general, saw a good day of numbers… a line of green… everything trending nicely… for now. This week we’ll start seeing the effects, if any (and hopefully, none)… of the long weekend.