057. Infection

A discussion spreading to others.

Due to the pandemic, we will meet remotely on March 9 at 7 PM EST (Zoom link here)

Questions to ponder

  1. Who are you and how are you holding up on this pandemiciversary?
  2. Communicable, infectious, and “tropical” diseases kill millions each year. Tuberculosis, HIV/AIDS, typhoid, influenza, hepatitis, meningitis, pertussis, malaria, dengue, leishmaniasis, Chagas disease, ebola, and others causes by bacterial, viral, and parasitic infection have ended the lives of billions of the humans who have ever lived. And yet, these infections do not kill equally. According to the WHO, of the top 10 leading causes of death in high-income countries, only one is due to infection. In low-income countries, 6 of the top 10 are from infections. What is it about money that protects populations from infection?
  3. Certainly, we can all agree that we each have a responsibility to avoid (as best we can) infecting others with diseases we might have. To what extent do we have a responsibility to prevent infectious spread between others?
  4. If you could eliminate one infectious disease, which would it be and why?
  5. It is argued by some that vaccines development could be accelerated/improved by conducting controlled human infection studies. That is, if we infect folks with a known virus at a known time and subject them to a known treatment, researchers could potentially get “better” data than what presents (sporadically) in clinical situations. Under what conditions would intentional infections in human studies be acceptable? Could similar arguments be made for the intentional breaking of bones or the development of cancer within human beings to “improve” treatment for those disorders?
  6. Infectious diseases can be and has been used as weapons against others. From small pox blankets to HIV-infect men raping others, the purposeful spreading of contagion can be a means of inflicting a unique form of violence. And at least to my mind, a singularly onerous form. What facet(s) of this violence make it distinct from others?
  7. In war there is violence: violence “justified” by state actors (or their equivalents) for state interventions (or their equivalents). Can/Could/Should infectious disease ever be a legitimate form of violence waged in war? Why or why not?
  8. When does a herd have a right to demand immunity? What just means do we have at our disposal to enforce it? Put more practically, could/should/will the University of Michigan require proof of a Covid-19 vaccination to be a student campus?
  9. Morens & Fauci (2007) suggest “if a novel virus as pathogenic as that of 1918 were to reappear today, a substantial proportion of a potential 1.9 million fatalities (assuming 1918 attack and case-fatality rates in the current US population) could be prevented with aggressive public-health and medical interventions”. Was the United States’ response to the novel coronavirus met with sufficiently aggressive public-health and medical interventions? Is it currently meeting it aggressively enough?
  10. When will SARS-CoV-2 infections end?

Readings to consider