A major premise in my public health training was to prevent illness and disease from occurring, whenever possible. In 1854, the cholera plague was out of control in London where there was a shared public water source. Dr. John Snow used his common sense to remove the handle from the Broad Street water pump, and new cases of the infectious disease declined. While the responsible bacteria Vibrio cholerae was discovered that year, it was not then accepted as the cause of the epidemic. There was a competing theory that “miasma,” or dirty air particles, was the culprit. Also, Pasteur’s germ theory had not been established.
The lesson to be learned is that effective action in preventing exposure to a disease-causing agent does not require full understanding of the pathogen. The Broad Street pump scenario is commonly accepted as the founding event for the field of epidemiology, the study of health and disease in particular human populations. It was Benjamin Franklin who advised the fire-threatened citizens of Philadelphia, “An ounce of prevention is worth a pound of cure.” Physicians and public health experts agree that it is more effective to stop an illness from becoming established than it is to treat the condition once it is causing symptoms and complaints.
The public health of Americans is under attack. Approximately 2,000 research projects conducted through the National Institutes of Health have recently been defunded. Many thousands of patients have had their treatments ended. Studies have been discontinued prematurely, rendering the data unusable. The Department of Labor of the current administration has reduced the frequency of worksite safety inspections while loosening child labor protections.
The secretary of Health and Human Services testified at his confirmation hearings that high deductibles and co-pays are major problems for our country’s Medicaid system. Medicaid has no deductibles nor co-payments for its current 72 million adult and children’s members. Secretary Robert F. Kennedy, a skeptic of vaccines, dismissed all members of the Advisory Committee on Immunization Practices (ACIP) who had been well vetted. The current ACIP is taking action to undermine confidence in the safety and effectiveness of vaccines for influenza, COVID-19, and MMRV (mumps, measles, rubella and varicella/chicken pox).
Meanwhile, measles outbreaks have spread from West Texas to Idaho, North Dakota, the Midwest and Canada. There is now a measles outbreak among adult men who are being held at the Luna County Detention Center. Not long ago, measles had been considered eradicated in the U.S. Dr. Casey Means, a holistic medicine doctor, has replaced the prior controversial nominee for surgeon general. Susan Monarez, who has a doctorate degree in microbiology and immunology, is the current nominee for director of the Centers for Disease Control and Prevention. Like Dr. Casey, Dr. Monarez replaces a controversial nominee. Should she be confirmed, this microbiologist will be the first CDC director with no medical training.
Along with proposed reductions in Medicaid funding, the leadership of and the cutbacks to the NIH, HHS, ACIP, CDC and the office of the Surgeon General will adversely affect the health of Americans. Vaccines will be less available. Confidence in federal health guidelines will lessen. National medical organizations are boycotting or opposing many new federal health care directives. Once seen as a model for developed nations in the world, the U.S. is being viewed critically by physicians, hospital administrators, health policy experts and research scientists in other countries.
Americans and New Mexicans need to use the common sense employed by Dr. Snow in the 19th Century. Basic, effective health care is a right due to citizens of this prosperous nation. Stand up for your rights.