Showing posts with label herd immunity. Show all posts
Showing posts with label herd immunity. Show all posts

Saturday, March 21, 2015

Selma marchers needed strong hearts and lungs and thanks to open commensal penicillin, they had them

Conservatives have always opposed health care for all. Partly because their opponents must first be healthy to be effective protesters...


Gary May
, the most through historian of the historic 1965 March on Selma, has made it clear just how physically demanding the whole march was for leaders and ordinary marchers alike.

Forget, for a moment, the stress of possible fatal violence that they all faced ---- most of us, even fifty years later, can sense that side of the story.

I mean what it must have been like walking all day for days and days --- and then trying to sleep on non-beds, always outside, often in March's wild rain and wind, with almost no washing or bathroom facilities and doing all this while surviving on extremely basic meals.

Develop a painful foot blister - as Dr King did on this protest - and most of us would not walk much for a few days until it heals.

But what if you can't stop - must walk on and on and on ?

Well the pain can, well the pain alone --- shooting up your foot to the hair on the top of your head with every step you take --- that pain alone can give you pneumonia.

It did so for me in August 1984, under somewhat similar circumstances, when I felt I just had to keep on marching to do right.

All this got me thinking as why the Selma March didn't happen in 1925 or 1935 or 1945 or 1955.

To be a pioneer of Sixties Civil Rights, it is often said you needed a strong heart.

This expression is meant figuratively and I can't really fault its reasoning.

Successful protesters must have strong lungs


But what if we do take it literally and added a requirement of a strong lungs as well ?

Diseases that affected the heart and lungs hit the young adults of the poor, immigrants and minorities particularly hard.

Patients with heart valve problems caused by Rheumatic Fever (then the leading killer of school age kids - again particularly kids of the poor, immigrants and minorities) were told to avoid activities like dancing, sexual acts, childbirth and child-rearing, so as to not further strain their heart and lungs.

TB was very common in slightly older youth among these  groups, also gravely straining the heart and lungs.

Obviously no great protest marching, no loud verbal protests or prolonged protest singing was medically on the cards for either type of sufferer !

But by 1945, it was clear that wartime conservatives had totally failed to make wartime penicillin an expensive patented drug, available only for the well to do whites.

Instead the extensive post-war use of inexpensive (Public Domain) penicillin to prevent Strep Throat soon created a sort of Herd Immunity effect that had reduced new cases of Rheumatic Fever to almost nothing.

A varying cocktail of new antibiotics similarly greatly reduced youthful deaths from TB, though not to the invisible small levels soon obtained with Rheumatic Fever.

So a whole postwar generation of kids with a healthy set of lungs had grown up by 1965.

Some obviously became loud-mouthed rock 'n' rollers --- but others just as loudly and relentlessly led the chants at protest rallies for blacks, chicanos and reservation natives all over America.

Simply put : better health for the poor and minorities proceeded better civil rights for the poor and the minorities and was its necessary pre-condition --- just as conservatives had feared all along ...

Monday, November 3, 2014

Is Super-Hero violence the only way to "do good" ?

If you are a parent , grandparent or loving care-giver, you can't help but worry about the moral values the entertainment media is trying to foster upon our very young : the claim that one has to be big and powerful and violent , a comic book styled Super Hero , to do good.

"Un-Super heroes" is an attempt to offer an alternative vision : to tell a true story from 1940s Gotham when agape love , not super hero violence, brought about as much good as this world has ever seen.

The original Penicillin - Penicillin G - remains naturally grown and hence un-patentable.

Because of that , it is that rarest of drugs - cheap, abundant , safe and highly effective and so it enabled the world to reduce those pools of long endemic deadly bacterial infections among the world's poorest and most powerless.

It greatly - and directly - benefitted the poor and weak of course.

But then , in a form of Herd Immunity , it also greatly benefitted all the rest of the world - indirectly - by cutting off the flow of deadly strains of common bacteria.

Diseases like Rheumatic Fever, long the leading cause of school age deaths (Polio killed comparatively few , by contrast) quickly became a word in a dusty history book , rather than the cause of your grandchild's death.

Ten billion of us - so far - have better healthier lives as a result of  a series of miraculous events begun in Gotham City on October 16th 1940.

Dr Martin 'Henry' Dawson - himself dying from a terminal illness - gathered around him a tiny team of unfits and misfits.

That little team was dedicated to combatting the Allied consensus that natural penicillin was unfit to be used as a mainstream medicine - and that some unfit patients were to be Code Slowed to death , to better aid the war effort against Hitler.

Dr Dawson argued we can never really hope to beat Hitler by racing him to the moral bottom - killing off the unfit to aid the war effort was already well underway in Germany under the name of Aktion T4.

Our best rebuttal was to publicly demonstrating that we still care for our most weak and powerless --- even under the demands of Total War.

Dawson held off his own failing body and his own government  just long enough to see his vision of abundant natural penicillin-for-all grip the global imagination .

So WWII, despite its terrible scenes of hunger and homelessness, did not see global epidemics like WWI's war-ending Spanish Flu that killed tens of millions.

Now is that epic enough a tale for a child raised to think that only mighty Batman is fit enough to save a world in woe ?

Tuesday, September 16, 2014

the NON-TOXIC mold - ten billion served since Oct 16 1940 : the story of natural penicillin ... and how we almost lost it

Every time we hear about a building closing its doors because of toxic mold , let us always remind ourselves that for every door that closes sometimes a thousand or a million , nay billions upon billions,  open in its place.


Yes ,some strains of some mold species , under highly specific environmental conditions,  are somewhat toxic (even highly toxic to immune weak individuals).

But other molds - such as the mold that produces the original natural penicillin - are resoundingly non-toxic and continue to be the biological base from which almost all of today's best anti-bacterial agents are still made.

Thanks to the herd-immunity-like effect that happened when public domain natural penicillin became ultra cheap and globally available , I estimate ten billion of us have lead healthier happier lives since Henry Dawson gave the first antibiotics injection on October 16th 1940.

Cheap ,widely available penicillin allowed even poor nations to reduce the incidence of endemic pools of pathogenic strains of common virulent bacteria among their poor and the rurally isolated.

These national pools of poverty, isolation and infectious diseases had kept these diseases globally endemic for thousands of years .

For example, a short twenty years after penicillin's introduction, Rheumatic Fever (until 1960 the leading cause of school age death due to infection) quickly became something that younger doctors only read about in a medical history book - but never themselves saw in their entire careers.

So loudly curse the toxic molds - but spare a moment to silently thank the Non-Toxic mold - saving lives for seventy five wonderful years as of next October 16th 2015 .

Because as once famous advertising firm Ayer's reminds us, we almost lost natural penicillin - thanks to the best of Allied science - it almost got away....

Tuesday, May 27, 2014

Penicillin G : its very low price has given all of us a quasi Herd Immunity against many once endemic infections

I would claim my book a complete success if it only got a single favourable review on Amazon.com - if that review came from Ramzi Yousef himself.

Recall that in 1993, Ramzi became the first to attempt to blow up the World Trade Center, hoping to kill tens of thousands to revenge those killed by the Atomic bombs of the best known wartime Manhattan Project.

I want Ramzi Yousef and others akin to him worldwide to see that like most things in life, Manhattan is Janus-faced.

Yes it has a Gordon Gekko side, but it also has its Emma Lazarus side.

Plutonium 239, with its half life of more than 24,000 years is atomic Manhattan's dubious gift of death that keeps on giving.

But inexpensive natural penicillin ,the wartime gift from the other face of Janus Manhattan, is a gift of life that just keeps on giving.

Beginning in 1940, in a selfless act of Agape, a dying Manhattan doctor, Henry Dawson, sacrificed his own life to try and save the lives of ten others, insisting (against the Allied governments' dictates) that wartime penicillin should be produced and released in quantities enough for ALL humanity.

Since 1940, Martin Henry Dawson's selfless act has indirectly benefited ten billion of us -- all through a form of quasi Herd Immunity against formerly dreaded bacterial infections.

Because of Dawson's moral argument,  penicillin G is today not just our best loved and most effective lifesaver.

It is also are cheapest and this has allowed poor people not normally treated for lack of money to be cured .

This in turn means that the untreated don't act as reserve pools of virulent strains that have kept these dreaded killers endemic or epidemic for millenniums.

Dawson's gift should go on benefiting billions more, in the years ahead.

Ten billion (plus), all freely benefiting from a single act of selflessly helping ten : 'Bread cast upon waters' indeed !

Thursday, October 31, 2013

The OTHER Manhattan Project only made moral arguments rather than A-Bombs : but its impact has been immense

Moral conservatives such as today's American Republican Party frequently argue that morally medical care (such as expensive life saving drugs like Avastin) should only go to those who have worked hard enough to afford them.

They maintain this argument ( hello Obamacare !) even if this means that these drugs as a result of this limited market demand will remain in limited production forever and so be expensive forever.


The opposite moral argument (as made by Dr Martin Henry Dawson in his battle with the Allied governments in WWII) calls for the government to greatly expands the lifesaver's potential market by initially subsidizing the drug so that it available to all regardless of income, geography, race ,gender etc.

It is claimed this will encourage new producers to come in and try and find ways to compete with the established producer by lowering their production costs and hence ultimately reduce the price of the drug to the consumer.

Penicillin G provides the best possible example of this argument, proving the validity of this economical argument beyond all measure.

But greatly expanding the universe of people with affordable access to lifesaving Penicillin G also had an unexpectedly profound impact on the entire world's health.

Unusually cheap abundant public domain Penicillin G saved the lives of many people who are ordinarily too poor or in two remote regions to be treated and who thus remained reserve pools of highly virulent - and contagious - strains of the bacterial diseases that were endemic or epidemic worldwide for millenniums.

In a form of quasi Herd Immunity, billions of us (I estimate ten billion of us so far) have indirectly benefited when tens of millions of us directly had their lives saved by penicillin G shots.

Dangerously contagious bacterial diseases that terrified our grandmothers, that hung like the Sword of Damocles over all households rich or poor, are no more.

Those of us under the age of fifty have never even heard of most of them and few doctors practising today have even seen a single case of them.

The Big Manhattan Project made the A Bomb and made a huge array of massive buildings - it was big in every concrete sense of the word.

By contrast, the other Manhattan Project, that of Dr Dawson, only made moral arguments (and a little home brew penicillin) rather than Bombs or Buildings.

But who can save that this project's impact  - 75 years on - is not way, way bigger than that of the project headed by Robert Oppenheimer and Leslie Groves.... 

World's most effective lifesaver is also the most beloved AND the cheapest


That's not at all like Big Pharma, the world's least beloved industry.

Usually their effective lifesavers cost a big fortune and their ineffective ones merely cost a small fortune.

By contrast, our beloved inexpensive penicillin G has seen wide use among the world's poorest patients and as a result  billions of us have had a 'free ride' :  a quasi-herd immunity to millennium old contagious bacterial infections like Rheumatic Fever.

Diseases today most of us under the age of 50 have never even heard of and most doctors have never seen.

But it almost didn't happen ; we almost lost inexpensive- penicillin-for-all

At the height of WWII, when the only other anti-bacterial agent, the Sulfa drugs, were visibly failing, Big Pharma in Britain and America held off mass production of the only alternative (Penicillin) until they had synthesized it and patented it.

Meanwhile , in the middle of that desperate world war, American and British diplomats sat down to leisurely haggle over how to divide the massive world profits on synthetic penicillin ; visions of post-war sugar plums dancing through their heads.

Now you don't have to be a student of foreign affairs to suspect that America is very, very, very reluctant to sign international treaties --- so this alone suggests how profitable the two superpowers thought patented penicillin would be.

That could only mean sticker shock at the drugstore cash register for ordinary families, of course.

And the world's poor ? Forget it !

One doctor bucked the combined Anglo-American scientific-medical establishment ,and eventually when even Doctor Moms joined in,  the American politicos smelling electoral disaster backed off.

The British politicians did not and the election shock of 1945 was the price they paid.

The story of the smallest Manhattan Project and its battle for inexpensive-penicillin-for-all is fascinating  ---- and almost totally unknown even to penicillin historians....

I'm today's go-to-expert on yesterday's battle over "penicillin-for-all" - by default


While I consider myself the world's leading expert on the wartime battle over the principle of penicillin for all, I also recognize I am also probably the only person in the world who gives a tinker's damn over that 75 year old battle.

A pity that.

Because there are still lessons for today in that old battle, particularly with regards to drugs now costing cancer patients $300,000 a year per person.

For when the wartime general public bested the scientific elites and Big Pharma over the principle of penicillin-for-all, it changed our whole world for the better, forever , in ways few then imagined.

Because penicillin remained totally in the public domain and now had the entire world's public loudly clambering for it, its cost fell quickly to record low levels for such an effective, safe lifesaver.

It was thus given to the poorest patient in the most remote parts of the world , people normally left untreated due to cost.

It thereby knocked out the traditional residual pools for virulent strains of bacteria that kept their names household scourges by remaining endemic or epidemic for millenniums.

Millions were directly treated by penicillin G to save their lives but billions of us indirectly benefited - free of charge ! - by a form of quasi-herd immunity.

As we move to rationing expensive drugs, let us ask ourselves if the example of the battle over wartime penicillin does not suggest a better way ...

Thursday, October 24, 2013

Penicillin is not Avastin, but it could have been...

My book - The smallest Manhattan Project  - is about us , all 10 billion of us , here today or years dead, whose lives have been improved by the advent of inexpensive penicillin.

In a sense, this book is a rarity : one written from the patient's eye view of how that drug came to be ; a welcome change after decades of endless books exclusively devoted to how penicillin looked to the people who discovered and developed it.

Penicillin is frequently called the Miracle Drug but few consider that its biggest medical miracle was really in fact its cost, or rather 'lack of cost'.

Because the diseases that penicillin treats are contagious,  patients too poor to afford a cure remains a reservoir of the most virulent strains, waiting to infect the rest of us.

There actually were methods of preventing much of these diseases before the development of penicillin : they included the ready availability of good jobs, good food, cleaner and bigger homes, greater social respect.

Baring that, only the worldwide availability of a drug that would cure those diseases once they started up, at a price that almost all could readily afford , could reduce these diseases from being endemic or epidemic to just names in a dusty medical textbook.

That is why I can say, with absolute assurance, that even those of us who have never had a single treatment of beta-lactam (penicillin family) antibiotics are in better health today because the grandparent of them all, Penicillin G , is water cheap - literally a lifesaver "too cheap to meter" .

But it almost didn't happen , we almost lost "inexpensive penicillin".

We almost got an expensively patented synthetic drug more akin to Avastin and all those other $100,000 a year plus medications.

"The smallest Manhattan Project" is the story of a doctor ( himself slowly dying of another unrelated disease) who sacrificed his own health to see penicillin from the patient's point of view.

His name should be honoured for all time.

This, despite the fact that he did not discover penicillin and then neglect it (Fleming) nor did he start its re-discovery and eventual development, albeit while pursuing a pathway that nearly killed off that development (Florey).

Dr Martin Henry Dawson, for that was his name, merely said penicillin should be made available - now! - for every single patient whose life could be saved by it , even during the height of a Total War .

Nay, he went much, much further.

Dawson in fact said all should have access to life-saving penicillin, particularly in the middle of a Total War.

That was because that war was supposedly being fought against one opponent in particular, solely because that opponent's core philosophy said that 'some lives are more worthy than others'.

How could we continue to conduct that war with any moral vigour when our own medical establishment was 'me-tooing' Hitler's doctors ?

Now the mantra 'Penicillin for all who needed it regardless of their income level or skin colour' in the mid-1940s meant its mass production, given the vast amount of infectious disease endemic in those years.

And mass production has its myriad ways of driving production costs down, down , down --- as happily happened in the case of Penicillin G in almost textbook manner.

'Penicillin for all' quickly became 'inexpensive penicillin for all' and once that happened, penicillin began to work almost like the way a good public health vaccine program should work : the treatment of the many ultimately offering 'herd protection' to all the rest of us, free of charge.

Insulin is another drug frequently called a miracle drug.

But the sad fact is that it is far more common today than it was beforeinsulin was discovered, for a variety of reasons.

By contrast, the names of all those bacterial household scourges that so terrified our mothers and grandmothers are not even known to most of us under the age of 50, and most doctors practising today have never seen a case of them.

And that is just the sort of modern day miracle that Dawson's mantra of 'penicillin for all' can produce.

For the complex truth is that our choice of medical ethics has economic consequences and these in turn feedback and have medical consequences.

The case of what the mantra of 'penicillin for all' ultimately led to should be taught in every health economics and health ethics oriented university department for just those very reasons....

Archive of older posts

Why My Urgency ?

My photo
Nova Scotia
Histories of WWII all start with the presumption that it was a war raged between humans and human ideologies, with Nature’s climate and geography as side issues easily surmounted.My blog, on the contrary will only accept that it was conflict between humans and their ideology that STARTED the war but that it was the barriers thrown up by Mother Nature (geography & climate) that turned it into a war that lasted between 6 to 15 years and expanded to thoroughly involve all the world’s oceans and continents. High Modernity may have started the war convinced that Nature had been conquered and was about to be soon replaced by human Synthetic Autarky and that only human Tiger tanks and human Typhoon planes were to be feared. But by the end, more and more people had lost their naive faith in Scientism and were beginning to accept that humanity was thoroughly entangled with both the Nature of plants, animals & microbes as well as the Nature of so called “lesser” humanity. By 1965, the world was definitely entering the Age of Entanglement. Billions still believed - at least in part -with the promises of High Modernity but intellectually & emotionally, it was no longer dominant...

PEER REVIEW

The best form of 'peer review' is a diversity of comments from around the world - I welcome yours.