Deadliest Enemy: Our War Against Killer Germs

by Mark Olshaker

The only way we are going to confront and deal with the ever-present threat of infectious disease is to understand those challenges so that the unthinkable does not become the inevitable.

John Snow, an English physician born in 1813, is considered the patron saint of epidemiology and public health.

In 1900, the average life expectancy in the United States was forty-eight years. By 2000, just one hundred years later, it was seventy-seven.

Public health science is based on statistics and probabilities. But we as a population don’t think in those terms. If we did, no one would ever buy a lottery ticket. Rather, we think emotionally, especially about things like disease and death.

In a 2015 TED Talk, Bill Gates asserted, “If anything kills over 10 million people in the next few decades, it’s most likely to be a highly infectious virus rather than a war. Not missiles, but microbes. Now, part of the reason for this is that we’ve invested a huge amount in nuclear deterrents. But we’ve actually invested very little in a system to stop an epidemic. We’re not ready for the next epidemic.”

As President Dwight D. Eisenhower said, “In preparing for battle, I have always found that plans are useless, but planning is indispensable.”

There are only four events that truly have the power to negatively affect the entire planet. One is all-out thermonuclear war. Another is an asteroid striking earth. The third is global climate change. And the fourth is infectious disease.

When everyone is involved in a pandemic, no one has extra help or supplies or food or medicine to send around, unless there was sufficient planning. There is a naïve belief that the kinds of supplies we need to respond to a pandemic, such as medical products, drugs, vaccines, and N95 respirators—commonly known as face masks—will be a click away on the Internet. Not so.

by overusing and misusing antimicrobial drugs, we humans are forcing microbes to adapt to continual stresses and giving them opportunities nature never did.

This is the cautionary tale with which we approach the subject of gain-of-function research of concern (GOFRC) and dual-use research of concern (DURC). Gain-of-function, as you will remember from chapter 4, is an intentionally created mutation through one of several methods, which gives the microbe new functions or abilities. DURC is life-science research that could be directly misapplied and pose a significant threat to public health and safety.

As it is, according to the CDC, each year in the United States at least 2 million people become infected with antibiotic-resistant bacteria and at least 23,000 people die as a direct result of these infections. More people die each year in this country from MRSA (methicillin-resistant S. aureus, often picked up in hospitals) than from AIDS.

It is a high-probability, low-frequency threat. So it will happen; that is a given. The variables are when and how severe; and, of course, how prepared mankind will be to respond. As you know, Mother Nature is the greatest bioterrorist of them all, with no financial limitations or ethical compunctions—at least that we understand—and no limit on the level of effort expended. Our most dangerous adversary will not originate in the tribal areas of Afghanistan or some other remote place. It is everywhere man and animal live in close proximity. Just ask the chickens. As we used to say at HHS: If you’re a chicken, it’s already a pandemic.