Quotes that trace a shift. “the unconditional surrender of microbes”. Dwight D. Eisenhower “Children born in…

Quotes that trace a shift. “the unconditional surrender of microbes”. Dwight D. Eisenhower “Children born in the next decade would no longer face the ancient scourge of pestilence”. JFK “The future of infectious diseases will be very dull.” Macfarlane Burnet & David White. /1

This was early-to-mid 20th century political attitudes to infectious disease. The US Surgeon General a decade after JFK’s quote talked about closing the book on infectious disease. I think Paul Ewald says it well: “The twentieth century has left us with a clear message:…/2

…it will not be enough to just try to find a drug to use as a lethal weapon against the pathogens of our future. We must understand why they are the way they are, and use this understanding to manage their evolution.” (From his ‘Plague Time’ book.) /3

The ‘normal’ that’s being rammed down our throats now with Covid, of mass and continuous infection, to try to create herd immunity, wasn’t the normal those great leaders were talking about. It was the first stage of the gradual collapse of that effort. Again, as always from…/4

…the 1970s onwards, the time when old hierarchies began to claw back power from the public, that had been shifted during WW1 and WW2, and the Spanish Flu. Suddenly infection became common again, part of a ‘natural’ and ‘normal’ life. ‘Living with the virus’ began a long time…/5

…before Covid arrived. It was what humans did for most of history, for all pathogens, until those years from the late-19th to mid-20th centuries, when for the first time national and global efforts were mobilised against them. But also this isn’t just about politics. /6

It’s about paradigms. While there were lots of fast gains during that birth of public health, the gains have hit a plateau in our lifetimes with more money than ever devoted to medical research and treatment, but more marginal gains in morbidity and mortality. We’ve made…/7 https://t.co/yJuDmtmuFP

very few gains against chronic disease, and the major gains we have made suggest (as Ewald does) that the paradigm we’ve been using has been wrong. Those major gains have nearly always been the finding of the infectious origin of a chronic disease. /8

When that infectious origin has been found, often curative treatment and prevention has been possible for the first time. Vaccines of course, though progress there has slowed considerably since the last century. Microbes are not a one-trick pony. /9

They live in ecosystems, with us, and they evolve constantly. Political libertarianism has encouraged a medicalisation of infectious disease, but it’s much, much more a question of the entire public ecosystem, of our societies. As Ewald argues (it’s a superb book), there are…/10

…often very simple and very cheap ways to modulate not just infection and disease, but also the virulence of those infections. That’s a crucial thing, because microbes will always vastly outnumber us. The idiot politics today suggests this means we should just ‘live with’…/11

…them, and that’s true. But not by letting them just infect us repeatedly, without changing any of the conditions in which we and they live. That’s a recipe for sick and dying populations, and the reversal of life expectancy gains. /12 https://t.co/FgtlFhnrOL

It’s no surprise that the same politics that refused to consider ecosystem/ecological thinking in addressing environmental damage and climate change, is also refusing the same thinking with Covid. For them we’re each an ecosystem of 1, which is ridiculous. Also no surprise…/13

…that ‘Big Pharma’ came out of the ‘land of the free’, a major proponent of medicalised infection, because a drug saves having to change the actual conditions of your society. Like making battery chickens gorge themselves on antibiotics to reduce infection. /14

See those original quotes. This is not the US some of us still remember, magnificent in its ambition to do public things. It’s the Wormtongue-infected US (and UK) of the post-1970s libertarian lunacy. The small-State fanatics, who are really just the pre-20th century elites…/15 https://t.co/jPb87JRnmd

…trying to wrestle control back of society from the public. Infection has always been by far the greatest source of human morbidity and mortality. These wormtongues are making it that again, after several decades of revolutionary progress. But science also needs to shift. /16

It’s in a rut. Infection has become normalised, and its chronic impacts are not getting the same funding as treatments for the chronic diseases those chronic infections are likely causing. Infection is THE biggie, in human health. We should never, ever accept it as normal. /end