Animator : Mrigankasekhar Ganguly
The current struggle: lessons from the past
Dr. Anirban Dutta
In the mid 19th century, John Snow, an English Physician, credited with pioneering anaesthesia, did something remarkable. Contrary to prevailing beliefs of the era that certain contagious illnesses were to be found in 'bad air', he meticulously and methodically detected a harmless looking water pump, which proved to be source of contaminated water that caused an outbreak of cholera in London in 1854, which was also part of a wider cholera pandemic. This discovery and his painstaking approach to solving the mystery was not only a turning point in the way contagious illnesses affecting masses were viewed in medicine but it also paved the way to the development and understanding of epidemiology. This discipline is dedicated to the understanding and quantification of the collective state of health and illness in a community or defined populations, which truly aims to detect causative agents, transmission processes, outbreak patterns, and evidence based treatment protocols in order to ultimately preserve human life and promote positive health on this planet.
Fast forward to the start of the 20th century, and history will also remember Mary Mallon, an Irish American cook, who was named as 'Typhoid Mary', a most unfortunate and infamous tag bestowed on her in 1908. An asymptomatic carrier of typhoid fever, she was responsible for the spread of the illness across several affluent households in New York, where she worked as a cook. After being discovered following a thorough investigation, which was subsequently published in a reputed medical journal, she was asked to provide biological samples for testing, which she refused. As a result, she was initially kept in isolation for a few years until 1910. Following her release on the condition that she would not engage in any kind of work, including cooking, which could result in another outbreak, Mary Mallon started her new career as a laundress. Within a few years, she changed her name to avoid detection and restarted cooking. Unfortunately, that resulted in another outbreak at a hospital in New York in 1915. She was identified and arrested, and apparently refused to undergo a surgery to get her gall bladder removed. Mary Mallon was kept in quarantine for the rest of her life until she finally died at the age of 69 in 1938.
Such was the drastic measure taken by authorities to prevent a single woman from spreading a major outbreak of a contagious illness, just because she would not cooperate. This story has suddenly become even more meaningful in 2020, when most of the world finds itself in a lockdown to prevent the rapid transmission of SARS-COV-2, which has resulted in over 1.4 million affected with more than 80,000 dead in a span of a few months. We could draw several parallels from Mary Mallon's era. There was no treatment for typhoid fever then, as there is no effective treatment or vaccine for COVID 19 yet.
The current global problem is definitely more serious and alarming than the past typhoid outbreak in New York, yet many of us cannot wait for the lockdown to be over. However, such haste would most definitely result in many more asymptomatic 'Covid Marys' transmitting this novel virus to healthy individuals at an alarming rate, much to our detriment. The several weeks of lockdown and self isolation for the collective wellbeing is pale in comparison to the forced confinement 'Typhoid Mary' endured for a major part of her life. Her freedom was ultimately snatched away by society. We should not forget this lesson, if we wish to enjoy our freedom to roam, to travel, to experience life around us in the long run that we almost took for granted until now.
It is the fear and the panic associated with this new illness that is doing much more damage to our ability to survive several weeks of voluntary isolation. So, it is also time to think of John Snow after all these years. What many of us do not realise is that there are thousands of John Snows, working tirelessly and continually in the medical and scientific community to achieve a breakthrough in finding effective treatment and discovery of a vaccine at a speed, aided by technology and vast knowledge, unimaginable even a decade ago. They are being aided by thousands of other John Snows in the wider health care community, essential services like the police force, financial, logistics and transportation sectors, and hundreds of charities, ensuring that the society does not come to a standstill. We should draw strength from the fact that over three hundred thousand individuals have already recovered since the start of the outbreak, as a result of such heroic effort.
Although, we are in a state of lockdown, we need to realise that we are better connected to the whole world and better informed than any other generation in history, thanks to the progress in information technology and social media that has kept the institutions running in spite of the current epidemic. The fact that you are being able to read this article is a proof of such progress. Many of us are also being able to spend time with our loved ones, and appreciate the rejuvination of nature that is unfolding right in front of our eyes. Mary Mallon was not so fortunate. Hence, we should not complain about our current difficulty but fully cooperate and abide by the rules of lockdown to overcome this crisis. We should also take time to think of others who have already lost a close relative or have developed the illness, and those who are struggling to make ends meet. The right knowledge and correct attitude, based on facts, and the knowledge that there is at least one John Snow close by, will help us allay our fears and emerge victorious in this collective battle against an hidden enemy.
