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March 31 - April 3, 2023
They were not blinded by politics or personal ambition. They were blinded, instead, by an idea.
That such local uncleanliness prevailed most intensely throughout the suffering districts, is evident from the reported results of house-to-house visitation.
Perhaps if they had spent a little more time investigating the patterns of water consumption on Broad Street, and a little less time compiling data on the meteorology of Dunino, they might have found Snow’s argument more compelling.
Psychologists call this type of faulty reasoning “confirmation bias”: the tendency to force new information to fit one’s preconceptions about the world.
Hall’s initial biases had structured the inquiry in such a way that most of the relevant data never came before the committee.
Eventually, Snow’s and Whitehead’s parallel investigations would be seen as the turning point in the battle against cholera.
Snow’s intervention did not just help bring the outbreak to a close. It also prevented a second attack.
For each house that had suffered a loss, Cooper drew a black bar by the address, followed by a succession of thin lines indicating how many deaths had occurred at that address.
Both maps were well-crafted specimens of the new art of dot mapping—that is, representing the spatial path of an epidemic by marking each case with dots (or bars) on a map.
John snow began working on his first map of the Broad Street outbreak sometime in the early fall of 1854.
eleven of the pumps were shown to be entirely clear of local cholera cases.
Cholera wasn’t lingering over the neighborhood in a diffuse form. It was radiating out from a single point.
Part of what made Snow’s map groundbreaking was the fact that it wedded state-of-the-art information design to a scientifically valid theory of cholera’s transmission. It was not the mapmaking technique that mattered; it was the underlying science that the map revealed.
the second version of the map contained Snow’s most significant contribution to the field of disease mapping.
And so the ghosts of the Broad Street outbreak were reassembled for one final portrait, reincarnated as black bars lining the streets of their devastated neighborhood.
But the real innovation lay in the data that generated that diagram, and in the investigation that compiled the data in the first place.
The tide of scientific opinion would eventually turn in Snow’s favor, and when it turned, the Broad Street map grew in stature.
John Snow may have been instrumental in first identifying the pump as the likely culprit behind the outbreak, but Whitehead ultimately supplied the crucial evidence for establishing the pump’s role.
Somehow the most notorious cloud of miasmatic air in the history of London had failed to produce even the slightest uptick in disease mortality.
DR. JOHN SNOW—This well-known physician died at noon on the 16th instant, at his house in Sackville-street, from an attack of apoplexy. His researches on chloroform and other anaesthetics were appreciated by the profession.
the great stink finally motivated the authorities to deal with the crucial issue that John Snow had identified a decade before: the contamination of the Thames water from sewer lines emptying directly into the river.
But reports had surfaced of some customers discovering live eels in their drinking water, which suggested that the filters were not perhaps working optimally.
Farr’s conversion to Snow’s doctrine was so complete that he literally rewrote history to make it appear as though Snow’s ideas had more initial success than they had actually enjoyed.
It pleased Whitehead to know that he had once again helped his old friend’s ideas find a larger audience.
He traced the history of cholera. We owe to him chiefly the severe induction by which the influence of the poisoning of water-supplies was proved.
No greater service could be rendered to humanity than this; it has enabled us to meet and combat the disease, where alone it is to be vanquished, in its sources or channels of propagation….
Robert Koch isolated Vibrio cholerae while working in Egypt in 1883.
Establishing sanitary water supplies and waste-removal systems became the central infrastructure project of every industrialized city on the planet.
The changes ushered in by the sewer system were manifold: fish returned to the Thames; the stench abated; the drinking water became markedly more appetizing.
One such outbreak hit Chicago in 1885, after a heavy storm flushed the sewage collecting in the Chicago River far enough into Lake Michigan that it reached the intake system for the city’s drinking water.
A strain of V. cholerae known as “El Tor” killed thousands in India and Bangladesh in the 1960s and 1970s.
An outbreak in South America in the early 1990s infected more than a million people, killing at least ten thousand.
The megacities of the developing world are wrestling with the same problems of uncharted and potentially unsustainable growth that London faced 150 years ago.
It’s entirely possible that a quarter of humanity will be squatters by 2030.
Over 1.1 billion people lack access to safe drinking water; nearly 3 billion—almost half the planet—do not possess basic sanitation services: toilets, sewers.
Each year 2 million children die from diseases—including cholera—that result directly from these unsanitary conditions.
Increase the knowledge that the government has of its constituents’ problems, and increase the constituents’ knowledge of the solutions offered for those problems, and you have a recipe for civic health that goes far beyond the superficial appeal of “quality of life” campaigns.
Henry Whitehead died in 1896, at the age of seventy. Until death, a portrait of his old friend John Snow hung in his study—to remind him, as Whitehead put it, “that in any profession the highest order of work is achieved, not by fussy empirical demands for ‘something to be done,’ but by patient study of the eternal laws.”
“Urban areas offer a higher life expectancy and lower absolute poverty and can provide essential services more cheaply and on a larger scale than rural areas.”
All the world needs is for a single strain of H5N1 to somehow mutate into a form that is transmissible between humans, and that virus could unleash a pandemic that could easily rival the 1918 influenza pandemic, which killed as many as 100 million people worldwide.
But the more likely scenario is that H5N1 will borrow the relevant genetic code directly from another organism, in a process known as transgenic shift.
Some experts think a pandemic on the order of 1918 is a near inevitability.
With some books, finding your way to the subject matter is the hardest part of the challenge.
