My Morning Musings: Purpose of Public Health

Let’s take a walk back in time and place to 1854 London.  During the mid 1800s, the deadly bacterial disease, cholera, was sweeping though Britain, and a particularly hard-hit area was the London suburb, Soho.  Dr. John Snow, who lived in Soho, suspected that the disease might be water born and transmitted when people drank contaminated water from the Broad Street town well.  When over 600 people who used the well died, Snow began his quest for isolating the cause.  He ultimately convinced town officials to remove the pump handle.  Within a short period of time, cholera cases dropped in the area; the story is much longer, because causation versus correlation had to be shown, but this vignette serves as an introduction into public health.  Today, Snow is considered a pioneer in epidemiology, and his processes are still used to track diseases.

Purposes of public health are many, including educating about diseases and disorders, keeping people safe from disease, and working with local, state, and federal governments to enhance the wellbeing of citizens.  In so doing, it helps maintain the economy because only healthy people are able to work.  Evidence of public health measures are so commonplace that you likely don’t even realize they exist.  For example, water is fluoridated to reduce tooth decay; cars and car seats must pass safety inspections; cancer-causing agents have been identified, banned, or clearly listed on labels; healthy mothers and healthy babies initiatives are in place; work places must comply with safety regulations; restaurants must comply with health and safety regulations; water quality signs are posted on beaches; smoking is prohibited in public places; and vaccinations are given to prevent disease.  A major role for public health is disease control, whether that disease is infectious (like coronavirus), environmental (ensuring clean air), or habitual (linking tobacco use to cancers and other health conditions).

Public health measures are not meant to dampen your personal freedoms, they are meant to protect us from health hazards.  In fact, many public health measures are ignored, as humans still smoke, disregard physical activity protocols, and drive in excess of the speed limit.  Some of those ignored health policies affect only the self, while others are meant to protect us all.  Those meant to protect us all can’t be part of the cherry-picking from the fruit tree.  The reason is because we have a social contract with one another.  When we live in a free society, and use resources and facilities meant for us all, we have an implicit agreement with one another to sacrifice some individualism for the benefit of the common good.  While I may have a few too many drinks because that’s my individual right, I can’t have too many drinks, get behind the wheel of a car, and drive home.  I can smoke all the cigarettes I want in my house, but I can’t smoke cigarettes in a public space and pollute the air breathed by my fellow citizen.

It absolutely breaks my heart to see the number of COVID-19 related deaths.  It’s disheartening to see evidence-based public health policies such as mask-wearing and social distancing totally disregarded.  Doing these two simple measures would save lives.  Everybody, including our public service workers, healthcare personnel, and first responders, would be safer, too.  Here are some statistics of coronavirus-related deaths of first responders and health care workers.  Note that these people died as a result of virus exposure while on duty, and these numbers are far greater than deaths resulting from the job itself.

2020 Coronavirus-Related Deaths of First Responders and Healthcare Workers

Profession                               Deaths             Source

Police Officers                        114                  National Law Enforcement Officers Memorial Fund

EMTs and Paramedics            37          

Nursing Home staff                767                  Centers for Medicare and Medicaid Services

Nurses                                     169                  National Nurses United

Physicians                               278                  May 2020 Paper in Occupational Medicine

All categories of health professionals = 1120 National Nurses United

As of today, over 215,000 people have died.  Let’s process that a little bit: If we said the name of each person who died out loud, it would take us nearly 60 hours.  The United States of America should be kicking this coronavirus to the curb.  We have more Nobel laureates than any other country in the world, we publish more high-quality science papers than any other country, the U.S. has the most biotech firms worldwide, and we have the most universities in the world and stand as the leader in quality of such facilities.  And, if you didn’t know, on this day in history 73 years ago, U.S. Air Force Captain, Chuck Yeager, became the first person to fly faster than the speed of sound.  So, how is it that with everything we have going for us, we have more COVID-19 cases and more COVID-19 deaths?  We’re number one in the world on both counts.  This is where we should be proud to be last.  Now is not the time to be numb when considering our death toll.  Engage that can-do American spirit by following the science, drawing on our collective humanity, and striving for a certificate of participation.  Let’s be a caring society and love our neighbor as ourself (except if you’re a self-loather).  And, if you’re my neighbor and make really good chocolate chip cookies, feel free to leave them on the front porch.

Signing Off For Science