Thank You, Dr. Fauci | Opinion

Public health officials, like Dr. Anthony Fauci, are the folks who worry about things like sanitation grades for restaurants and vaccination programs. It is a profession that the less you hear about the better. The fact Dr. Fauci is now a household name is not, strictly speaking, a good sign—no slight intended. But while we have some time on our hands, we should all sit down and write a thank you note to our epidemiologists, biostatisticians, medical assistants, public health nurses, medical microbiologists, sociologists, geneticists, data managers and public health inspectors who, for the most part, go unrecognized and un-thanked. Because as bad as C-19 is, it would be much, much worse without them.

For as long as there have been humans, we've been at war with germs. Mark Woolhouse and Eleanor Gaunt of the University of Edinburgh estimate there are about 1400 human pathogens out there, and about 150 of those have epidemic potential. We've been fighting the same dozen or so bacteria, fungi, protozoa and viruses ever since we began aggregating in communities large enough for germs to take hold and multiply. The U.S. has had seven deadly outbreaks of measles, ten of smallpox and eight of yellow fever—the Ebola of its day. An outbreak caused George Washington and the Continental Congress to flee Philadelphia in 1793. Recurring local epidemics of cholera, scarlet fever, diphtheria, polio, pneumonia, dysentery and typhus were all relatively common events less than a century ago. And of course there is the flu: Spanish, Russian, Hong Kong, swine, avian.

Because of public health efforts, pandemics are becoming both less frequent and less deadly. Notwithstanding terrible epidemics like HIV/AIDS and Ebola, we are winning the war. Although estimates for the death toll of infectious diseases are all over the place, it's believed the Black Death killed more humans than any other event in history, an astounding and awful 200 million, equivalent to four billion deaths today. Starting in the 1500's, smallpox wiped out an estimated 90% of Native Americans and virtually the entire population of Mexico. The Spanish flu killed around 50 million. If it occurred today and affected the same percentage of the population, it would kill almost five times that.

This has taken a lot of work. Much is due to improved sanitation. Cholera, typhus, dysentery, and many of the diseases that once-ravaged populations are all related to contaminated water and food. It's also due to vaccinations. Globally, immunizations prevent around 2 million to 3 million deaths each year. Throughout the 20th century, nine vaccine preventable diseases including polio, smallpox, measles and mumps afflicted an average of 1,245,232 people in the United States each year. By 2016, instances the same diseases fell to 21,178 cases. Many who grew up in the fifties will have stories of school trips to see the dreaded Iron Lung, the life-saving prison where victims of polio often spent much of their lives. To the post-war generation of parents, polio vaccine inventor Jonas Salk was a beloved hero.

Improvements in education and treatment played their part as well. Thanks to health education initiatives, ideas that save lives—wash your hands, don't defecate in the fields you eat from—are becoming globally accepted. As for treatment, it's been estimated that half of the deaths from the Spanish flu weren't from the flu itself, but from secondary infections which today would be easily treated with antibiotics. And of course, the HIV/AIDs pandemic would be even worse without new drug regimens.

We have also gotten very good at dealing to outbreaks. Ebola, SARS, and MERS were all incredibly dangerous diseases—some of the most lethal in history, with mortality rates of 50 percent, 15 percent and 34 percent. Had they occurred a thousand or even a hundred years ago, the death toll would have been much higher. Here's an example. The last recorded outbreak of the Black Death took place in India in 1994. But instead of 200 million deaths, this time around there were 56.

There is nothing natural or inevitable about our success in the war against pathogens. The world is more crowded and interconnected than any time other time in history and the risk of spread greater. Preventing epidemics requires massive global infrastructure and resources, not to mention an army of thousands of public health professionals. If anything, the C-19 epidemic is a wakeup call that more could be done. For every dollar we spend on global health, we spend $67 on the military. Pathogens kill more innocent people than terrorists.

So let's give a shout out to our soldiers on the frontline—the doctors, nurses, medical professionals and those in public health; from Dr. Fauci to the hospital cleaners and porters—and make sure they will always have resources they need to go into battle.

David L. K. Lambert is a writer and researcher who has worked for Partners In Health, the Centre for Effective Altruism (UK,) and the United Nations Office of Dr. Paul Farmer, Special Adviser to the Secretary-General on Community-Based Medicine and Lessons from Haiti. Sam Hill is a frequent contributor to Newsweek.

The views expressed in this article are the authors' own.​​​​​