What pandemics have people in the west directly experienced in living memory? As far as I am aware, all pandemics in recent memory have happened in Africa or Asia.
The closest thing that people in the US might have a living memory of is the polio epidemic in the US in 1952. [0] Granted anyone who is old enough to have lived through that and remember it is probably on lock down in a nursing home right about now. The people in power now would have been children around that time so who knows if it would have a made an impression on them.
It made a huge impression on many children in the 50s still - there were still tens of thousands dying and being paralyzed each year until the late 50s, and by this point they were predominantly small children being affected. My parents are in their early 60s and they remember it well - when she was five her friend was partially paralyzed for life by it. https://www.historyofvaccines.org/content/us-polio-cases-195... had friends who died. They were given behavior restrictions.
Mitch Mcconnell, the person who sets the legislative agenda in the Senate, wrote this in his memoir:
It’s one of my life’s great fortunes that Sister’s home was only about sixty miles from Warm Springs, Georgia, where President Franklin D. Roosevelt had established a polio treatment center and where he’d often travel to find relief from the polio that paralyzed him at the age of thirty-nine.
My mother took me there every chance she had. The nurses would teach her how to perform exercises meant to rehabilitate my leg while also emphasizing her need to make me believe I could walk, even though I wasn’t allowed to.
In addition to AIDS, there were major American flu pandemics in 2009 and 1968. 1957 too, depending on how old you consider to be "living memory" - many federal leaders were teenagers at the time.
IIRC, I was a teenager when AIDS came out. It was not classified as a global pandemic.
It's quite hard to catch and was mostly limited in the US to IV drug users and gay men. It became a human rights issue because both of those populations were generally deemed to be sinners and people tended to not care if they died.
The fight was not just against the disease itself. It was very much against prejudice and the threat of draconian measures aimed at specific populations.
Non drug using heterosexual populations in the US mostly didn't care. It was largely deemed to be irrelevant if you weren't one of the "sinners" that most folks wished would drop dead anyway because we're so loving and Christian and all that.
I don't think we've ever had a global pandemic in my life. SARS was the closest and it was mostly in Asia, IIRC.
>>> It became a human rights issue because both of those populations were generally deemed to be sinners and people tended to not care if they died.
My father was a medical doctor at the time, specializing in diagnosing and treating brain cancer, and told me that although docs were scrambling to treat a growing flood of AIDS patients, there was a quiet resentment at the need to reallocate scarce resources for a disease that was largely preventable (except for tainted blood transfusions). Cancer was (and is) a much larger problem, killing hundreds of thousands of people every year; then there's heart disease which kills 647,000 Americans every year.
To say IV users and gay men were "generally deemed to be sinners" who didn't deserve to be cured is a vast exaggeration. Certainly there were and are people who think this way, but the general population, both lay and medical, certainly didn't. That would include the general non-fundamentalists among the American religious community.
The fact is that thousands of unsung researchers worked long hours, first to understand HIV's structure and mechanism, then to figure out how to prolong life, and most recently, how to actually cure it. Unfortunately, some gay activist groups such as ActUp felt these efforts were insufficient, and showed up at medical conferences to chant "killers!" at the scientists who were presenting findings. This created more resentment.
Look, everyone's feelings are inflamed in a time of crisis. It's important to let cooler heads prevail, and not descend to name calling or deriding this or that group. Especially in the current situation, we're all in this together, and we will sink or rise together.
there was a quiet resentment at the need to reallocate scarce resources for a disease that was largely preventable
This is all too often how prejudice gets expressed. The resentment and hostility towards the group in question gets justified on some reasonable grounds other than racism, homophobia, etc.
I believe people suffering addiction are self medicating in the most literal sense for either medical or mental health issues that are going largely unrecognized and for which they aren't getting appropriate care. I think blaming them for "getting something preventable" is not significantly different from blaming those who got AIDS via transfusions for being so awful as to be in need of blood.
Gays were often living in the closet. The need to hide their orientation had a lot of real world negative consequences with serious implications for their health choices. Blaming them for getting something "preventable" is similar to telling women their abusive husband wouldn't beat them if they just didn't piss the guy off so much.
For the record, let me apologize to Christians and to the mods. I'm not anti-Christian and I've spoken in their defense before. I was in no way trying to start a religious flame war. My disgust with homophobia and with society's attitudes towards people suffering from addiction wasn't intended to impugn Christians or the Christian religion.
> To say IV users and gay men were "generally deemed to be sinners" who didn't deserve to be cured is a vast exaggeration. Certainly there were and are people who think this way, but the general population, both lay and medical, certainly didn't.
This just is not true. The sidelining of AIDS as someone else’s problem is well documented in Randy Shilts’ book. People were still making jokes about AIDS in 1983 when people had been dying for several years. Ronald Reagan, President throughout this whole time, did not publicly acknowledge AIDS until 1987.
In the 1980s, the general population absolutely reviled gay people and gay men in particular. Don't downplay the deep stigma that gay people experienced at the time.
For years, all diagnosed AIDS patients were expected to die within 12 months. It wasn't spread as broadly, and the flu pandemics weren't as deadly, but the general concepts that pandemics can strike hard and fast were definitely within leaders' personal knowledge.
But you don’t have to shut down the economy to deal with AIDS because it’s sexually transmitted. That’s my point: the vast majority of people have never had to make serious changes to their behavior or lifestyle to avoid contagion before.
That I agree with, but as far as I can tell the degree of measures we're trying to take are unprecedented even in non-living memory. School closures and public gathering bans, sure, but those measures happen pretty frequently during lesser scale outbreaks. If anyone tried to ban social calls during the Spanish Flu, I'm not aware of it.
> as far as I can tell the degree of measures we're trying to take are unprecedented even in non-living memory.
This is exactly my point. Nobody in the west has ever lived through something that has necessitated these kinds of measures. People thought this kind of thing only happened in the movies, Asia, or Africa. That it couldn’t happen to us. And that lack of personal experience is why, in my opinion, our response was probably always going to be slower than it needed to be.
But my concern is, are these kinds of measures actually necessitated? The entire argument for doing them appears to be that China did them; in fact, I'm not sure I've seen anyone make an argument, rather than just silently assuming "extreme social distancing" must mean Wuhan-style authoritarian control. You say "Asia and Africa", but before 2020, is there any precedent at all for controlling a pandemic by mandatory universal lockdown of its healthy citizens?
In other words, what are the chances that we look back in a decade, and realize that we inflicted a month of trauma on the country because we assumed authoritarian China must have a good reason for it?
I mean, there’s the basic logic that reducing human interaction will inhibit the virulence of something which spreads by human interaction. My personal opinion is that we probably could have avoided blanket shutdowns if we had ramped up testing capacity in late January and February. Now the hope is that we avoid becoming Northern Italy. I think the Chinese have demonstrated that it’s possible to avoid an outcome like that. Whether we’ll be severe enough in our lockdowns to pull that off is another story. Doesn’t seem like people around me are taking this seriously enough. But I’ve been self isolating since late February.
They didn't. That's why it killed tens of millions of people back when the global population was about 1/4 of what it is today, and mobility was much more constrained. No jets in 1918.
The expected death toll from Covid, assuming an overall mortality rate of 1%, would be about 75 million people. So far the death toll worldwide is about 13,000. That's a big number, but only about 0.02% of the expected total without intervention.
In Case you think I’m making this up, here’s what I said elsewhere in this thread:
> According to this Wikipedia page about the 2009 flu pandemic (which is what the term “swine flu” references, as best as I can tell), worldwide fatalities are estimated at 575 thousand (upper bound) and worldwide infections are estimated at 700 million (lower bound). Given those numbers, the worst case fatality rate is 0.08%. Then there is this quote:
> A follow-up study done in September 2010 showed that the risk of serious illness resulting from the 2009 H1N1 flu was no higher than that of the yearly seasonal flu.
Okay, but my original point is that nobody in the West has gone through something like what we’re going through. You’re actually making my point even stronger: not only has no one in the West ever actually lived through a pandemic that took a bunch of lives and requires societal level sacrifice, we’ve all had false alarms that have made us less likely to take potential pandemics seriously.
That leaves swine flu. According to this Wikipedia page about the 2009 flu pandemic (which is what the term “swine flu” references, as best as I can tell), worldwide fatalities are estimated at 575 thousand (upper bound) and worldwide infections are estimated at 700 million (lower bound). Given those numbers, the worst case fatality rate is 0.08%. Then there is this quote:
> A follow-up study done in September 2010 showed that the risk of serious illness resulting from the 2009 H1N1 flu was no higher than that of the yearly seasonal flu.
So my point remains: no one in the west had direct experience of a pandemic.
AIDS was not easily avoided. The blood supply was not screened early on. Many people early in the epidemic were infected from simple transfusions. Famous American tennis player Arthur Ashe contracted it and died in this manner.
It's not possible to screen for certain if someone has just acquired HIV, so to this day, they try to exclude people with risk factors from donating blood. Which then is treated as a human rights issue by some.
No, there are a series of screening questions that rule out high-risk donors (gay men, IV drug users, and travelers to high/risk areas are disqualified from donating). All blood is tested regardless.
If you are gay, they don't want you to donate blood. The problem is that if you are, say, at work and they do a blood drive and you say "I can't. Sorry." that potentially outs you to your coworkers that you are gay or have some other issue that disqualifies your blood.
In practice, they will let you donate and then mark it for destruction so you can hide the fact from your coworkers that you don't qualify. (Or they did at one time.)
This was a big issue in the US military during the "don't ask, don't tell" era where they would throw you out if they knew, but official policy was to encourage you to just remain closeted. Being outed as gay was career ending if you were career military at that time. Blood drives are common in the military. They had to have some mechanism to honor the "don't ask, don't tell" policy and let you keep hiding your sexual orientation.
"The problem is that if you are, say, at work and they do a blood drive and you say "I can't. Sorry." that potentially outs you to your coworkers that you are gay or have some other issue that disqualifies your blood."
I never heard about that as a concern, and I have to dismiss that as silly, given the many reasons why you can be disqualified. I mean, you could just have low iron or some other minor health issue.
What I was alluding to is that some people feel it is not acceptable or just to have a blanket exclusion of men who have sex with men. I can't imagine that your answers to the questionaire are allowed to be shared with anyone though.
I've never heard of anyone being offended by the exclusion of people who have spent time in Africa or Europe though.
It wouldn't be directly shared with your employer. But if everyone is there and you decline to participate in giving blood, it can point to information about you that you don't want people to know.
Whether you did or did not have some procedure done is definitely private medical information in Europe. There is no way for them to know whether I did or did not participate - maybe through the on site doctor if that is the one doing the procedure, but they're bound by very serious regulation to keep their mouths shut. Regardless, me not wanting to go would be a perfectly normal thing as well.
Blood donation tends to not be treated in the US as a medical procedure. It tends to be treated as a feel good community event. I'm a bit weirded out to have that reflected back to me as a medical procedure, though it certainly is. We don't quite seem to get that fact in some important way.
We're basically savages in huts over here about some things.
When I had a corporate job, lower level employees were instructed to keep their mouths shut and not tell everyone they were being promoted or whatever until it could be officially announced. Meanwhile, it was common for more than one middle manager type to drop by their cubicle to loudly congratulate them and make small talk, clearly trying to get in good with someone whose skills and such they might need.
I guess we were all supposed to be stupid or something and be incapable of inferring they had been promoted or something.
This was at a Fortune 500 company, so "the best of the best, sir." And it drove me crazy for so many reasons.
My mother is a German immigrant who came from a family of twelve kids. I am routinely shocked and appalled at how bad so many people are at thinking about the larger social landscape and how this will be viewed by others and what knock on effects it may have.
That type of thing seems to be shockingly common in the US and probably plays a large role in a lot of our social issues.
> A pandemic (from Greek πᾶν pan "all" and δῆμος demos "people") is a disease epidemic that has spread across a large region, for instance multiple continents, or worldwide.
> An epidemic (from Greek ἐπί epi "upon or above" and δῆμος demos "people") is the rapid spread of disease to a large number of people in a given population within a short period of time.
AIDS does not meet those definitions, unless you restrict “given population” to mean male homosexuals or recipients of blood transfusions.
AIDS cases have been to every country in the world which easily satisfies as a pandemic.
Epidemic is different with Covid19 not yet qualifying.
What’s useful about separating the ideas is discovering the root cause. Scurvy used to be epidemic among sailers, making it easier to find the root cause and treatments. Highly localized diseases generally have a specific local cause.
AIDS has not spread very rapidly. It has taken nearly 4 decades to reach its current spread. Covid has the potential to infect most people in the span of 12-18 months. It’s categorically different. And AIDS is easily avoided!
Rate of spread has nothing to do with the definition of pandemic. It took literally thousands of years for Smallpox to reach the America’s, but it achieved worldwide spread before eradication.
Malaria on the other hand has also killed hundreds of millions of people but as it’s a tropical disease with 93% of the cases occurring in Africa it’s not a pandemic.
Again person to person spread results in pandemics, making a definition based on geographic spread useful.
The definition of epidemic that I quoted above uses the word “rapid” and the phrase “short period of time”. The definition of pandemic requires there to be an epidemic. Those are not my invention, they are from Wikipedia!
Rapid as in a large number of cases a week, thus “within a short period of time.” Not rapid as in how long the disease existed.
The malaria epidemic is thousands of years old, nobody cares how quickly it spread 20 thousands years ago. Edit: Excluding academic intrest.
PS: And by Covid 19 not qualifying as an epidemic I meant it’s not an epidemic in every country. It however is an epidemic in several countries and will likely become an epidemic in most if not all country’s very quickly.
Malaria is not a tropical disease, although it's been eradicated in most tropical areas and not yet eradicated in most non-tropical areas.
The reason malaria is not a pandemic isn't the fact that it's been eradicated in some areas, but the fact that it's endemic. Only epidemic diseases can be pandemics; endemic disease (e.g. seasonal flu) cannot be. This is by definition.
Epidemics and pandemics relate to some change from the previous situation whereas endemic diseases refer to stability. This informs our policy responses.
I think you meant the reverse of what you said in the first paragraph. It’s true that Malaria (ague) cases occurred in Medival Europe as far north as England, but it was very much climate dependent. With massive differences between what became the Nordic countries vs say Italy. However, I have never heard a significant objection to calling it a tropical disease.
Even there, the spread has not been rapid or in a short period of time, which are both part of the definition of epidemic which I mentioned above. AIDS has taken decades to reach its current prevalence.
AIDS? Legionnaire's disease? People forget the panic these caused until they were understood.
In addition, we have had some horrible flus over the years. 1994(ish) and 1977(ish) stick out in my mind.
Anyone who says: "Oh, it's just a nasty flu" has never had a bad flu. I can't imagine being more sick than being stuck in bed for two solid weeks not wanting to move because it hurts so bad but you have to make yourself some food and then choke it down only to throw it up.
And Covid-19 is WORSE THAT THAT! Holy hell, people, I'd do ANYTHING to avoid that.
Yes, but that usually lasts a lot longer. My stepdad had that and nearly died from it. Spent a long time in a ventilator and the remainder of his life in a wheelchair.
Urgh, yet another auto-immune disease ? I really hope that a massive breakthrough in medical knowledge will happen regarding that general subject. Unfortunately the matter seems to be more complex than anything I, as a developer, can imagine…
Please explain how a disease transmitted by unprotected sex and IV drug use (once the blood supply was screened) is in any way comparable to an airborne illness.
It’s not, the vast majority of western society (hell, eastern too) has never been at risk of contracting HIV/AIDS. The vast majority are at risk of COVID-19.
HIV/AIDS is technically a pandemic, but not one that affects all populations/demographics. Completely different.
You do realize there was a time where HIV/AIDS wasn't at all understood right? HIV/AIDS is not "technically a pandemic" it is a pandemic period. Pandemic is a geographic relative term it does not need to to "affect all populations/demographics." That is not a qualification. That appears to be some something you made up. The role of epidemiology is the same whether something is a flu pandemic or some other disease. The reason Dr Deborah Birx is qualified in her current role is because of her research in the early days of the HIV/AIDs pandemic. Nobody is claiming she is not qualified because that wasn't a flu pandemic.
It has nothing to with semantics. If you reread the OP's original comment they state:
>"The problem is that the west has nobody in power with living memory of a pandemic."
And that is not true. And this HIV/AIDS is particularly relevant because Dr Deborah Birx was chosen as response coordinator for the White House Coronavirus Task Force because of her work on a previous pandemic, that of HIV/AIDS.
> AIDS is not a pandemic. Pandemic requires epidemic, which requires rapid spread in a short period of time. AIDS has been slow. Calling it a pandemic is, IMO, motivated by politics (it mostly affects male homosexuals and sub-Saharan Africans). Ctrl-F for my discussion elsewhere in this thread.
So you're stating that AIDS was never an epidemic? Right. And that's based on your opinion I guess? Well there's actual facts too:
"In late 1983, the global presence of the mysterious virus motivated European authorities and the WHO to classify the growing number of diagnoses as an epidemic. In addition to the outbreak in the U.S., patients with similar symptoms were documented in 15 European countries, 7 Latin American countries, Canada, Zaire, Haiti, Australia and Japan. Of particular concern was an outbreak in central Africa among heterosexual patients."[1]
I mean, I’m just pointing out that it doesn’t match the definition of a pandemic or epidemic from Wikipedia unless you restrict the population in question to male homosexuals or sub-Saharan Africans and ignore that fact that it didn’t spread that quickly (an STD kinda cant spread that fast). But I’m not surprised that people classified it as an epidemic when it’s cause and mode of transmission was unknown, since all they saw was a rapid increase in diagnosis. But of course, given the way it spreads, it had been spreading, undiagnosed, for a while (probably years) in most places.
>"I mean, I’m just pointing out that it doesn’t match the definition of a pandemic or epidemic from Wikipedia unless you restrict the population in question to male homosexuals or sub-Saharan"
Since wikipedia seems to be the only bar for your argument. Here's two wikipedia entries where it's clearly stated they are both epidemic and pandemic.
Since epidemics are indeed specifically bound to a particular population, especially a geographical population, there can be no doubt the AIDS is an epidemic if it only epidemic in sub-Saharan Africa.
The question then is whether it is also epidemic in a greater region, for instance multiple continents or world wide. Since there are subsets of the population in all areas where it is widespread, it seems fair to say that it is pandemic.
Cause and mode of transmission are not relevant to the definition of epidemic or pandemic that you have selected.
So your argument goes like this:
P1. An epidemic is the rapid spread of a disease to a large number of people in a given population within a short period of time. (definition)
P2. AIDS has spread rapidly through people in sub-Saharan Africa and male homosexuals worldwide. (observation)
P3. People in sub-Saharan Africa are not a population. (assertion)
P4. Male homosexuals worldwide are not a population. (assertion)
P5. AIDS spreads sexually, via blood transfusions etc. (observation)
---------- (by P1-P5)
C1. Therefore, AIDS is not an epidemic.
P6. A pandemic is a widespread epidemic, spreading through multiple populations e.g. multiple continents or worldwide. (definition)
----------- (by C1 and P6)
C2. Therefore, AIDS is not a pandemic.
But from this, P3 and P4 are obviously false and P5 is not relevant since mode of transmission is not referred to in P1.
I don't feel like I'm at risk of getting AIDS, so it's a little hard for me to worry about AIDS as if it's a pandemic. But that doesn't mean AIDS isn't a pandemic. It's definitely epidemic according to the definition you picked - I'm just not part of the relevant populations through which it is spreading. You're definitely arguing poorly, since you demand we hold premises that are obviously false and you introduce irrelevant points that have nothing to do with your case.
My objection to labeling AIDS as a pandemic is the "rapidly" part of the definition of epidemic. I don't think AIDS spread all that rapidly. It took decades to become a problem in sub-Saharan Africa. And it was probably spreading for years among male homosexuals before anybody noticed anything. That would put it on the slower end of the continuum when measured against most communicable diseases that I can think of.
> Obesity pandemic: causes, consequences, and solutions-but do we have the will?
> Abstract
> Obesity has become pandemic owing to an obesogenic environment (inexpensive calorie dense food, technologies and structure of communities that reduce or replace physical activity, and inexpensive nonphysical entertainment) and excessive emphasis on low fat intake resulting in excessive intake of simple carbohydrates and sugar. . .
Until we find an infectious cause of obesity, calling it an obesity pandemic is a rhetorical act it grounded in the widely accepted meaning of the word.
A pandemic is a form of epidemic (according to Wikipedia's definition, which you have referred to).
An epidemic is an outbreak of a disease (according to Wikipedia's definition, which you have referred to).
A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not due to any immediate external injury... A disease may be caused by external factors such as pathogens or by internal dysfunctions. (according to Wikipedia's definition, which is included by link by its definition of epidemic).
There is no requirement on the definition of epidemic that you have referred to that requires it to be infectious.
Please pick a definition and stick to it. You want a pandemic to be a global outbreak of a disease to which the overwhelming majority of the population is susceptible and which is spread via a pathogen without physical contact. If there's an authority that uses that definition, find them and cite them. Otherwise please stick the definitions you've already cited and move on.
The wikipedia definition of epidemic that I cited uses the phrase "rapid spread of disease". I think most people would agree that for a disease to spread it must be communicable in some way.
Wikipedia's page on Adenoviridae lists these human adenovirus types that cause obesity or adipogenesis: HAdV-A type 31; HAdV-C type 5; HAdV-D types 9, 36, 37
One of the references:
Voss JD, Atkinson RL, Dhurandhar NV (November 2015). "Role of adenoviruses in obesity". Reviews in Medical Virology. 25 (6): https://zenodo.org/record/1229348
So yes, obesity can be caused by contagious disease.
Obesity can be caused by a infectious disease is not the same thing as obesity, in general, being caused by an infectious disease. It would have to be caused by a contagious, in general, to be able to describe the widespread prevalence of obesity as a pandemic, since the term pandemic is concerned with infectious diseases.
Doesn't really matter what you are aware or not. USA and the major countries have thousands of people that do just that, monitor epidemics. https://www.cdc.gov/coronavirus/2019-nCoV/index.html That's their job and they have ways to notify leadership. Other look out for steroids, others for hackers hacking power plants, others look out for terror threats and so on.
from Jan 1st, which is 8 days earlier than your second link, but with only 3 points and zero comments, I'm not sure how much that counts.
The BBC story that you linked to is from Jan 3rd, the AP had a story[1] on the 5th, so the public had opportunity to know about it in early January. I can't get Reddit's search to cooperate, so I can't say if there's an earlier mention there (plus Google's dates about Reddit don't agree with Reddit's). Wikipedia has an early timeline page with a lot of details.[2] Public statements were made on December 30th about pneumonia of unknown cause.
If there had been a US pandemic response team, we could have started mobilizing December 30th. Hong Kong did.
That DW article is pretty poor, dating sars 1 to around 2009/2010 - confusing it with swine flu perhaps? A later comment, presumably from another source since the article is tagged AFP/AP/Reuters, gives a correct and more precise dating to sars 1. Yet the editor/collator didn't notice the discrepancy.
