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January 9 - January 31, 2021
what Avery accomplished was a classic of basic science. He started his search looking for a cure for pneumonia and ended up, as Burnet observed, “opening . . . the field of molecular biology.”
He had found the cause of influenza, at least in swine. It was a virus. We now know that the virus he found in swine descended directly from the 1918 virus, the virus that made all the world a killing zone. It is still unclear whether humans gave the virus to swine, or swine gave it to humans, although the former seems more likely.
In England in 1933, Andrewes and his colleagues applied Shope’s methodology to human material and found the human pathogen. It was a filter-passing organism, a virus, like Shope’s swine influenza. In 1938, Thomas Francis and Jonas Salk created a vaccine, growing inactivated virus in chicken eggs; it protected soldiers during World War II and in 1946 was given to civilians. Salk of course later developed the first polio vaccine.
In the end, for all we know about influenza—and we know a lot—at this point does not do us much good.
vaccines target the head portion, which mutates rapidly and is a part of the virus that can change without interfering with the functioning of the virus. That’s part of the reason influenza vaccines are not particularly good: between 2003 and 2017 their effectiveness ranged only from 10 percent to 61 percent. (Even at those levels, they prevent millions of cases and thousands of deaths and are well worth getting.)
the U.S. government was spending more money on the West Nile virus than on influenza. While influenza was killing as many as 56,000 Americans a year, West Nile in its deadliest year killed 284.
Developing this vaccine should be one of the very highest priorities for medical research.
the problems presented by a pandemic are, obviously, immense. But the biggest problem lies in the relationship between governments and the truth.
Part of that relationship requires political leaders to understand the truth—and to be able to handle the truth.
Emotion is not the absence of reason; emotion corrupts reason.
whether a politician saw an advantage and knowingly did something at best unproductive or whether he or she acted out of incompetence or fear, the human factor, the political leadership factor, is the weakness in any plan, in every plan.
as horrific as the disease itself was, public officials and the media helped create that terror—not by exaggerating the disease but by minimizing it, by trying to reassure.
if there is a single dominant lesson from 1918, it’s that governments need to tell the truth in a crisis. Risk communication implies managing the truth. You don’t manage the truth. You tell the truth.
Terror rises in the dark of the mind, in the unknown beast tracking us in the jungle.
In 1918 the lies of officials and of the press never allowed the terror to condense into the concrete. The public could trust nothing and so they knew nothing. Society is, ultimately, based on trust; as trust broke down, people became alienated not only from those in authority, but from each other.
The fear, not the disease, threatened to break the society apart.
Those in authority must retain the public’s trust. The way to do that is to distort nothing, to put the best face on nothing, to try to manipulate no one. Lincoln said that first, and best.
