Epidemiologists serve as detectives in rooting out the causes of disease. Not only are they often successful in identifying the multifactorial origins of specific causes of morbidity and mortality, they also can show how all aspects of a given condition are connected. A death certificate may contain the singular label cardiovascular disease, but a more accurate descriptor involves connections among several factors in the form of social determinants, such as inadequate nutrition, residence in unsafe neighborhoods, unemployment/underemployment, and exposure to pollution.
A vivid illustration from the public health realm of the importance of establishing connections is an epidemiological study of a deadly cholera outbreak in London in 1854. John Snow was convinced that the disease was caused by a contagious agent. He conducted interviews with residents of the area about their water sources, while meticulously recording the time, person, and place of disease events. He integrated the interview data with disease-event information and concluded that cholera was occurring mostly in victims who were drawing their water from the Broad Street water pump. He convinced skeptical authorities to remove the pump handle and the outbreak was brought to a halt.
As described in a paper appearing in the October 5, 2020 issue of the journal Current Biology, it wasn’t until 30 years later when the renowned microbe hunter, Robert Koch, independently discovered V. cholerae that its responsibility for cholera became common knowledge. Koch and his contemporaries were part of the golden age of microbe hunting during which microscopes were trained onto many disease states and linked with their causative pathogens, leading to the widespread acceptance of the germ theory of disease underpinned by his famous four postulates. Snow’s pioneering epidemiological methods for tracing disease now could be coupled with microbiological methods that identify causative pathogens. Connecting disease and infection proved to be pivotal for the management of infectious agents.
Rolling ahead to the current pandemic, weekly reports from the CDC indicate that for only 6% of deaths, COVID-19 is the only cause mentioned. Other underlying conditions or comorbidities, such as influenza/pneumonia, respiratory failure, hypertension, diabetes, and cardiac arrest account for the remaining 94% of mortality. Another important connection pertains to perceived collateral damage from social lockdown policies that are associated with lower childhood vaccination rates, fewer cancer screenings, and deteriorating mental health that can lead to greater excess mortality.
Moreover, a steady growth in the size of the human population has led to increased encroachment on forests that previously were inhabited only by animals. Greater exposure to zoonotic diseases that jump from other species (e.g., bats) to humans can result in more infectious disease epidemics and pandemics. Successful virus mutations in humans then can be transmitted from human to human. Hence, it is likely our species is in it for the long haul regarding infectious disease outbreaks.
More October 2020 TRENDS Articles
IN SEARCH OF CONNECTIONS
Discusses COVID-19 in the context of a 19th century cholera epidemic and its subsequent linkage to the germ theory of disease that was based on four famous postulates involving causative pathogens. Read More
DUELING COVID-19 AID PACKAGES
Looks at efforts to add increased stimulus funding to address a wide range of problems stemming from this disease. Read More
HEALTH REFORM DEVELOPMENTS
Points how out to achieve near-universal health insurance coverage, Medicare prices paid by private plans, and how a Supreme Court confirmation hearing involved discussions of the Affordable Care Act. Read More
DEVELOPMENTS IN HIGHER EDUCATION
Describes the impact of the coronavirus on higher education, fostering research integrity, and launching of a new FAFSA cycle. Read More
QUICK STAT (SHORT, TIMELY, AND TOPICAL)
American Adolescents And Mental Illness Treatment Variation
Alcohol-Induced Deaths Among Adults Aged 25 And Over, U.S., 2000-2018
Use Of Holographic Imaging To Detect Viruses And Antibodies
Cell Revival Following A Heart Attack Read More
AVAILABLE RESOURCES ACCESSIBLE ELECTRONICALLY
U.S. Women Living In Areas Devoid Of Proper Maternity Care
Mental Health Of U.S. Adults
Integrating Systems And Sectors Toward Obesity Solutions Read More
BIG DATA, RESEARCH, AND ETHICS CHALLENGES FOR IRBs
Examines how shifts in biomedical research have led to questions regarding which oversight bodies should be involved for this kind of research. Read More
HISPANIC GENDER DIFFERENCES IN HOSPITALIZED HEART PATIENTS
Pertains to the significant underrepresentation of women in heart failure studies and the need to develop health care strategies. Read More