Time to Get Serious About Public Health

In Sierra Leone, where recent public health campaigns are saving children’s (and parents’) lives.

by Richard Conniff

The PBS/Channel 13 show “The Open Mind” has just aired its interview with me about my book Ending Epidemics: A History of Escape from Contagion. You can take check out the interview here or if 28 minutes is too big a commitment, take a look at the transcript below

HEFFNER: I am Alexander Heffner, your host on The Open Mind, and I’m delighted to welcome our guest today, Richard Conniff. He’s author of Ending Epidemics, A History of Escape from Contagion. Richard, thank you so much for joining me today.

CONNIFF: Thanks. Good to be here.

HEFFNER: Richard, there’s some dispute about whether three years since COVID-19 struck we’re still in what you could call a pandemic. Where do you come out on that?

CONNIFF: Yeah, I think we’re still in a pandemic in the sense that it’s going to come back again seasonally. It’s going to be global, it’s evolving everywhere, and those who aren’t protected, who haven’t gotten vaccinated will be at risk.

HEFFNER: When you titled your book Ending Epidemics: A History of Escape from Contagion, and specifically you identify epidemic, as opposed to pandemic, that was intentional?

CONNIFF: Yeah, that’s intentional. Epidemics are a lot more common. They occur regionally or in individual nations, and pandemics, where it’s the entire world are relatively rare events.

People, especially in this country take for granted our current state of health
and have no conception of the frequency of epidemic disease in our past.

Richard Conniff

HEFFNER: Take us through, in your mind, whether or not the public sufficiently understands that what we encountered in this pandemic was something that for decades and centuries, many strata of society had suffered in what you call epidemics, as opposed to pandemics. Is that fully understood or was that one of the motivations in writing this book?

CONNIFF: Yeah, I don’t think it’s understood at all. It is the reason I wrote the book that is I think people, especially in this country take for granted our current state of health and have no conception of the frequency of epidemic disease in our past and not even in our distant past. So I think I wrote it partly because I’m old. I was born in the middle of the 20th Century, and my father and my uncle both had polio. When I was five, I was in kindergarten. The polio vaccine became available for the first time. And at that point you know, what had been polio season became summer again. And two years before I was born, there was still smallpox in this country. And whooping cough was quite common. It killed 4,000 people a year in the United States. Children. I shouldn’t just say people. It was children under the age of five for the most part. Diphtheria. I live in New England, and there was a massive epidemic of diphtheria in the middle of the 18th century. Okay, I’m going back ways now, but it’s interesting because entire families, 13 children in one family just gone over a period of days. So yeah, there’s a long history of highly infectious diseases. One other example I had measles. People think measles is a trivial disease now. Doctors don’t even see measles anymore, but measles was a brutal experience about 550,000 kids had it the year I had it. 550 died. And so yeah, these are things that people don’t even think about anymore and don’t think about why we are free of these diseases.

How We Lived (and Died) Before Vaccines

By Richard Conniff/National Geographic

This piece originally appeared in 2019. I’m republishing it now because it’s part of what motivated

my new book Ending Epidemics: A History of Escape from Contagion (MIT Press).

Like most American children of my generation, I lined up with my classmates in the mid-1950s to get the first vaccine for polio, then causing 15,000 cases of paralysis and 1,900 deaths a year in the United States, mostly in children.  Likewise, we lined up for the vaccine against smallpox, then still causing millions of deaths worldwide each year. I’ve continued to update my immunizations ever since, including a few exotic ones for National Geographic assignments abroad, among them vaccines for anthrax, rabies, Japanese encephalitis, typhoid, and yellow fever.

Having grown up in the shadow of polio (my uncle was on crutches for life), and having made first-hand acquaintance with measles (I was part of the pre-vaccine peak year of 1958, along with 763,093 other young Americans), I’ve happily rolled up my sleeve for any vaccine recommended by my doctor and the U.S. Centers for Disease Control and Prevention, with extra input for foreign travel from the CDC Yellow Book.  I am deeply grateful to vaccines for keeping me alive and well, and also for  helping me return from field trips as healthy as when I set out.

One result of this willingness, however, is that I suffer, like most people, from a notorious Catch-22: Vaccines save us from diseases, then cause us to forget the diseases from which they save us. Once the threat appears to be gone from our lives, we become lax. Or worse, we make up other things to worry about. Thus, some well-meaning parents avoid vaccinating their children out of misplaced fear that the MMR vaccine (for measles, mumps, and rubella) causes autism. Never mind that independent scientific studies have repeatedly demonstrated that no such link exists, most recently in a study of 657,000 children in Denmark.  This irrational fear is why the United States has experienced almost 1200 cases of measles so far this year, almost two decades after public health officials proudly declared it eliminated. About 124 of these measles victims, mostly children, have been hospitalized, 64 of them with complications including pneumonia and encephalitis, which can cause brain damage or death.

And yet autism can still seem like a bigger threat than measles, if only because it appears in countless television shows and movies such as “Rain Man” and “Gilbert Grape.” Meanwhile, you’re more likely to catch measles at a movie theater than see the disease featured onscreen.

And so, parents forget, or more likely never knew, that 33 of every 100,000 people who experienced actual measles ended up with mental retardation or central nervous system damage. (That’s in addition to those who died.)

They forget that an outbreak of rubella in the early 1960s resulted in 20,000 children being born with brain damage, including autism, and other congenital abnormalities.

They forget that, before it was eradicated by a vaccine in the 1970s, smallpox left many survivors