More on SARS
Even though my earlier post on SARS and disease was long, I actually broke off without including all that I had ready.
Meanwhile, a nurse in Toronto has died of SARS, and I think we are being told this is the first medical staff person to actually die of the disease here. Other deaths have been elderly or frail patients--the kind who die of flu every year.
Some numbers:
There are about 1500 deaths a year in Canada from good old influenza. The figure may be as high as 2000 if deaths caused by pneumonia which results from the flu are factored in.
For some reason, this is not 10% of the U.S. figure; it is less, since there are about 36,000 deaths from the flu, on average, in the U.S. every year. In both countries, a very high proportion of these deaths occur among people 65 and over. The flu vaccine is not consistently given to this population, and even if it is, they apparently remain vulnerable.
Seniors are also highly vulnerable to a virus that until recently was believed to be confined to children under 5: respiratory syncytial virus (RSV). There are 11,000 deaths annually in the U.S. caused by this virus, and it is now estimated that 78% of these deaths occur among seniors 65 and older.
There are more deaths in the U.S. from this virus, which is hardly mentioned in the media, than from AIDS.
Another question from before: is the public sector a proven failure both at managing epidemics, and at achieving big public-health breakthroughs, like the vaccines and antibiotics of the 20th century?
Mark Steyn wrote in the National Post in April that the incidence of SARS in Toronto proves the failure of the public sector. The over-stressed public system can't cope--not because of a shortage of funds, but apparently simply because it is in the public sector.
The National Post link is gone, but there is a friendly discussion of the Steyn piece here.
I have to say again I am no expert in any of the relevant fields. A quick Google, trying to confirm what I've seen in the media recently, reveals that many things about SARS are still unknown: did it start with a type of cat or other animal, or an isolated group of humans? How exactly does it spread? What distinguishes the super-spreaders?
Many reputable people believe the main reason there were so few cases of SARS in the U.S. was "dumb luck." (Link may be gone).
I also did some digging into both the polio vaccines and antibiotics, but I won't go into great detail now. Both initiatives were more a result of private sector efforts than public sector in the U.S.; a bit more public sector in Canada. The Rockefeller Foundation was involved in both. The March of Dimes spent a fortune on polio victims and their families, and was basically a volunteer fund-raising organization; but it got at least a boost from President Franklin D. Roosevelt, who had polio himself.
In both cases, when it came to mass production, it seems that government money and authority was needed, but only the private sector, i.e. several different companies, had the infrastructure to deliver drugs to a lot of people.
Polio vaccine.
Penicillin.
Some of the pro-capitalist right like to say that if polio had been left to the public sector, all we would have today would be a space-age iron lung. I think that's an exaggeration.
One interesting detail on polio: improved hygiene made things worse. As long as everyone was poor, and had poor hygiene (there was no awareness of the germ theory of disease), polio was probably fairly common, but it would affect very young babies. A few would get quite sick, maybe even die, but the vast majority would get something like a cold. There were much worse diseases affecting children in those days. Once the middle class started to keep their babies clean, however, babies wouldn't be exposed to polio until age 5 or 6, or later. As with chicken pox, the older you are when first exposed, the worse it is. So the huge epidemics of polio in the 20th century disproportionately affected the hygienic middle class.
I'm also interested in antibiotic-resistant bacteria. It was inevitable that such bacteria would become more common once anti-biotics were used; the drug kills the bugs that are not resistant; there are always some that have mutated to be resistant; they now multiply. Still, medical practice has made the problem bigger: over-prescribing anti-biotics, treating frail patients in hospital very aggressively. My family experienced the fact that if you have good health care in the U.S., you are treated like a valuable customer; they want you to come back; they will treat complaints very aggressively, because they know patients like that. To some extent, private-sector thinking, such as the customer is always right, as flattering as it can be, has contributed to the problem.
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