Books You Should Read: "When Germs Travel" by Howard Markel

Anyone who knows me knows that one of the big things I detest about Public Health as it is set up today is the interference of people who don’t know better into the things that we – the peons working the daily outbreaks and looking for cases of stuff – need to do without restrictions. Of course, I’m talking about politicians. The one issue that has painfully brought this to the forefront in my professional life is immigration. Time after time, I’ve seen politicians at all three levels of government call for the denial of basic health services to immigrants and their children. They reason that it is a waste of resources that could go to Americans.

It’s as if they think that viruses and bacteria know the difference between Pablo, the young apple picker from Oaxaca, and Paul, the corporate up-and-comer from Omaha with the dashing good looks. Pathogens don’t give a crap about who they’re infecting. To them, we’re all just sacs of growth media. The sooner we come to understand this, the sooner we can let go of the stigma that we cause to people based on their ethnicity and/or nationality and move on with what needs to be done.
The book “When Germs Travel” does a great job at telling us all about what happens when germs cross international boundaries and come to a new population – or society – and the kind of craziness that they cause. It covers six epidemics that were triggered by immigrants (or returning travelers) and the stupidity that ensued. For example, an outbreak of bubonic plague in Chinatown causes the authorities to cordon-off the area and not permit people who look Asian from interacting with the other ethnicities. Any epidemiologists worth his weight in salt will tell you that such an intervention by itself is useless.
You can’t quarantine or impose social distancing on just one group of people. You need to do it with all who are susceptible, regardless of race, ethnicity, gender, sexual orientation, disability, etc.
The book also covers the mistreatment of Jewish immigrants as they arrived in New York Harbor from Eastern Europe. They were screened for Chlamydia trachomatis, the causative agent of trachoma, which is an infection of the eyes. In that time, the infection was not treatable with antibiotics, for there were none. People were screened and told to go back to their country if they were found to be infected. On the other hand, if they had the right amount of money or the right connections in New York City, they were allowed to go on through.
A lot of help that screening did.
Not only that, but the screeners – medical doctors –  did not practice good hygiene. A high-ranking government official inspecting the intake points noticed this. That official? The President of the United States. Bo-yah!
I won’t spoil the rest of the book for you, but you know where this is going. You know of the treatment of Hatian immigrants because of HIV/AIDS. You know of the treatment of other immigrants because of Tuberculosis. Oh, you don’t know?
Everyone should.
One thing that resonates throughout the book is the hypocrisy of the decisions taken by politicians and the public health officials influenced by them. That’s right, not all public health workers are infallible and incorruptible. Many of them can be bought or intimidated into taking the wrong course of action when they need to protect the public’s health. And that’s one main reason why I will never, ever become a politician or play the politicians’ games.
I never want someone to write a book about how wrong I was in letting the next big epidemic or a small outbreak of diarrhea associated with a diner get out of control. That’s just plain embarrassing.
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