We need to talk about disease eradication. Those delighted with the uncontrolled spread of Covid often…

We need to talk about disease eradication. Those delighted with the uncontrolled spread of Covid often justify it by saying nothing else can be done, that it can’t be eradicated. Like most public narratives in this pandemic, that’s a blancmange of half-truths. /1 https://t.co/CYH9BiZfjW

Famously smallpox is the only human disease that’s ever been eradicated. But there’s more to that story than is often told. For example as you can see in this image, it was as good as eradicated in richer countries decades before the official eradication effort even began. /2 https://t.co/xGeDfkmG9V

This is just one way Covid minimisers are dishonest. Earlier in this pandemic there was much debate about the difference between disease elimination, and disease eradication. Elimination of spread in a community is what we do for many other pathogens already. /3

Through continuous public health action, monitoring for outbreaks, controlling those outbreaks using a range of measures, to prevent the pathogen achieving wide spread in a community. What’s not said enough is that this really IS effectively a type of eradication. /4

For those countries who eliminated smallpox early in the 20th century, for residents of those countries smallpox was eradicated in all but name. Nobody was really catching it, in any meaningful or notable numbers. You could live as if it didn’t exist. /5 https://t.co/uPNuhERBxr

This was what living with Covid was like in counties like Australia and New Zealand, earlier in the pandemic, when community spread was wiped out. Again in all but name, Covid was eradicated for people in those counties. You could live a normal life, without infection. /6 https://t.co/sWJA6zrGnf

This is disease elimination - the disease’s spread was controlled, preventing widespread community infection. Inside that red oval. But again, for the purposes of daily life, it’s effectively the eradication of that pathogen, *for those communities*. /7 https://t.co/E6SHFT5ioW

Now of course Infinite Covids will jump up and down here and say it’s only because we ‘locked down’ those communities for 2 years. Which is just more politicised fantasy, if you lived in these communities you know that’s hyperbolic nonsense. /8

Yes some activities were strictly controlled, such as international flights, and there were short periods of the shutting down of much community activity, but for most of the time people lived normal lives. /9

This was exactly how rich countries were living with smallpox for nearly a century before it was eradicated. Nobody in those countries was frothing at the mouth about how ‘you can’t eradicate smallpox’, and welcoming smallpox back into their communities. /10 https://t.co/liAn4tVPSa

They were delighted to be free of it, for it not to be in their lives any more. This is the important point - disease eradication IS a global process. But the *elimination* of disease from individual territories was effectively eradication, for those territories. /11

The only difference global eradication made for those territories was the opportunity to cease all public health action for smallpox, which was continued all through those decades, to maintain disease elimination. This is THE critical point. /12

Disease elimination i.e. control of community spread of any pathogen, IS effectively disease eradication, *for that community*. Public health methods, continuously applied. creates effective eradication of an infectious threat, for a community. /13

And it’s what we do for EVERY serious infectious disease, except smallpox, to this day. It’s why we live without getting infected with most serious infectious diseases, in rich countries. It’s disingenuous to say we should do nothing for Covid because it can’t be eradicated. /14

We should do with Covid what we do for every other serious infectious disease that hasn’t been eradicated. We should control it. Stop it spreading in the community. Many are not even aware of this herculean annual effort from public health people. /15

To maintain effective eradication of serious infectious disease from our lives. Your local garbage collection and water and wastewater treatment plants are part of that whole infrastructure. All ongoing public health interventions. /16

It’s the invisibility of much of this work that makes so many prey to dumb slogans about ‘living with’ Covid. Their entire lives thousands of people have worked day and night to prevent them living with other serious infectious diseases. Covid is not anything new there. /17

It was just one more disease to create an effective control guideline for, to be implemented in an ongoing way, to prevent community transmission. Public health business as usual. Until the politics of populism swept the public health systems to one side. /18

Historically this also goes to something else I Tweet about. The only reason the world pushed ahead with smallpox eradication, which many at the time described as impossible, was the creation of a post-WW2 *institution*. The WHO. I often Tweet about that period. /19

When the total catastrophe of two world wars and the Spanish Flu left countries completely broken, incapable of functioning. This was when ‘the public’ was truly created and implemented, by global institutions designed by these societies, to save societies. /20

And why we then had 70 years of unprecedented wealth and health, globally, as these institutions acted. The same institutions the populist libertarian politics of the late 1970s until today has been dismantling with relish. Describing them as ‘red tape’, as ‘bureaucracies’. /21

Supposedly impinging upon the freedoms of individuals in fantasy free markets. Why we now have the ludicrous situation of the uncontrolled spread of a serious disease that has killed millions being described as a return to ‘normal life’. /22

It’s this sociopathic politics that not only prolonged Covid into an ongoing pandemic, but actually created the pandemic in the first place. If the richer nations had done as Oz and NZ did, early in the pandemic, it would never have occurred. /23

We’d have all had a relatively short period of disease control, followed by a return to a normal life, free of this new infection. Instead places like the US and UK, the vanguard of the global populist libertarian movement, created breeding grounds for Covid. /24

Which meant countries who had followed basic public health procedures and controlled Covid to the point of elimination, quickly, were then faced with the impossible decision of what to do with this mass of infected people overseas, in a global community that mixed freely. /end