Last year I attended a seminar by Laurie Garrett, a Pulitzer Prize winning journalist and public health expert. Hearing from Garrett about the human impact on the environment and the resulting emergence of new and mutating deadly viruses was frighteningly enlightening. As early as 1995, Laurie Garrett’s book, The Coming Plague: Newly Emerging Diseases in a World Out of Balance pointed to the present we are now living.
Before I share a passage from Garrett’s book, the thing that struck me from her seminar was the sad pattern of human response to plagues:
1] Garrett stated that religious bigotry and religious exceptionalism accompanied plagues throughout history. We only have to think of HIV. Religious bigotry creates division: “us versus them”; “clean versus unclean”; “protected versus punished”. Religious exceptionalism encourages non-compliance of health precautions and reckless complacency towards the disease. The pandemic is spiritualised, for example, Covid-19 is seen as a demon, not a disease; a test of faith, not science.
2] Blaming the victim also stains the history of plagues. Today we note an increase in the stigmatisation of those who test positive for the coronavirus. This is very concerning. Blaming and banishing the victim creates a context of fear that ultimately discourages people to be tested and to seek care. https://www.iol.co.za/capeargus/news/call-to-stop-covid-19-stigma-as-it-often-causes-people-to-avoid-care-47923253
In response to this sad human pattern, we ask: “What does the Lord require of us in response to Covid-19?” Answer: What the Lord has always required of us. Namely, “To do justice, love mercy and walk humbly with God” [Micah 6:8]. I invite you to allow this single sentence to take hold of you. Take time to reflect on what, justice, mercy and humility mean in our pandemic present. We will re-visit this question over and over again.
I now share with you an extract from Garrett’s fascinating and detailed book, in which she introduces us to the human lung and viruses and the 1970s oil crisis and globalisation via the airline industry. Her gift is seeing connections where none may even look. It is the gift of a prophet. Another name for prophet is a ‘seer’. A seer of the past and present with such truthful clarity that she enables us to see a bit of tomorrow…
The human lung, as an ecosphere, was designed to take in 20,000 liters of air each day, or roughly 60 pounds. Its surface was highly variegated, comprised of hundreds of millions of tiny branches, at the ends of which were the minute bronchioles that actively absorbed oxygen molecules. The actual surface area of the human lung was, therefore, about 150 square meters, or “about the size of an Olympic tennis court,” as Harvard Medical School pulmonary expert Joseph Brain put it.
Less than 0.64 micron, or just under one one-hundred-thousandth of an inch, was all the distance that separated the air environment in the lungs from the human bloodstream. All a microbe had to do to gain entry to the human bloodstream was get past that 0.64 micron of protection. Viruses accomplished the task by accumulating inside epithelial cells in the airways and creating enough local damage to open up a hole of less than a millionth of an inch in diameter.
Some viruses, such as those that caused common colds, were so well adapted to the human lung that they had special proteins on their surfaces which locked on to the epithelial cells. Larger microbes, such as the tuberculosis bacteria, gained entry via the immune system’s macrophages. They were specially adapted to recognize and lock on to the large macrophages that were distributed throughout pulmonary tissue. Though it was the job of macrophages to seek out and destroy such invaders, many microbes had adapted ways to fool the cells into ingesting them. Once inside the macrophages, the microbes got a free ride into the blood or the lymphatic system, enabling them to reach destinations all over the human body.
The best way to protect the lungs was to provide them with 20,000 liters per day of fresh, clean, oxygen-rich air. The air flushed out the system. Dirty air—that which contained pollutant particles, dust, or microbes —assaulted the delicate alveoli and bronchioles, and there was a synergism of action. People who, for example, smoked cigarettes or worked in coal mines were more susceptible to all respiratory infectious diseases: colds, flu, tuberculosis, pneumonia, and bronchitis.
Because of its confined internal atmosphere, the vehicle responsible for the great globalization of humanity—the jet airplane—could be a source of microbial transmission. Everybody on board an airplane shared the same air. It was, therefore, easy for one ailing passenger or crew member to pass a respiratory microbe on to many, if not all, on board. The longer the flight, and the fewer the number of air exchanges in which outside air was flushed through the cabin, the greater the risk.
In 1977, for example, fifty-four passengers were grounded together for three hours while their plane underwent repairs in Alaska. None of the passengers left the aircraft, and to save fuel the air conditioning was switched off. For three hours the fifty-four passengers breathed the same air over and over again. One woman had influenza: over the following week 72 percent of her fellow passengers came down with the flu; genetically identical strains were found in everyone.
Following the worldwide oil crisis of the 1970s, the airlines industry looked for ways to reduce fuel use. An obvious place to start was with air circulation, since it cost a great deal of fuel to draw icy air in from outside the aircraft, adjust its temperature to a comfortable 65°—70°F, and maintain cabin pressure. Prior to 1985 commercial aircraft performed that function every three minutes, which meant most passengers and crew breathed fresh air throughout their flight. But virtually all aircraft built after 1985 were specifically designed to circulate air less frequently; a mix of old and fresh air circulated once every seven minutes, and total flushing of the aircraft could take up to thirty minutes. Flight crews increasingly complained of dizziness, flu, colds, headaches, and nausea. Studies of aircraft cabins revealed excessive levels of carbon dioxide—up to 50 percent above U.S. legal standards. Air quality for fully booked airliners failed to meet any basic standards for U.S. workplaces.
In 1992 and 1993 the CDC investigated four instances of apparent transmission of tuberculosis aboard aircraft. In one case, a flight attendant passed TB on to twenty-three crew members over the course of several flights. Similar concerns regarding confined spaces were raised about institutional settings, such as prisons and dormitories, where often excessive numbers of people were co-housed in energy-efficient settings.
In preparation for the June 1992 United Nations Earth Summit in Rio de Janeiro, the World Health Organization reviewed available data on expected health effects of global warming and pollution. WHO concluded that evidence of increased human susceptibility to infectious diseases, due to UV-B immune system damage and pollutant impacts on the lungs and immune system, was compelling. The agency was similarly impressed with estimates of current and projected changes in the ecology of disease vectors, particularly insects.
It wasn’t necessary, of course, for the earth to undergo a 1°—5°C temperature shift in order for diseases to emerge. As events since 1960 had demonstrated, other, quite contemporary factors were at play. The ecological relationship between Homo Sapiens and microbes had been out of balance for a long time. The “disease cowboys”—scientists like Karl Johnson, Pierre Sureau, Joe McCormick, Peter Piot, and Pat Webb—had long ago witnessed the results of human incursion into new niches or alteration of old niches. Perhaps entomologist E. O. Wilson, when asked, “How many disease-carrying reservoir and vector species await discovery in the earth’s rain forests?” best summed up the predicament: “That is unknown and unknowable. The scale of the unknown is simply too vast to even permit speculation.”
Thanks to changes in Homo Sapiens activities, in the ways in which the human species lived and worked on the planet at the end of the twentieth century, microbes no longer remained confined to remote ecospheres or rare reservoir species: for them, the earth had truly become a Global Village.
Between 1950 and 1990 the number of passengers aboard international commercial air flights soared from 2 million to 280 million. Domestic passengers flying within the United States reached 424 million in 1990. Infected human beings were moving rapidly about the planet, and the number of air passengers was expected to double by the year 2000, approaching 600 million on international flights.
Garrett, Laurie. The Coming Plague (pp. 569-571). Farrar, Straus and Giroux. Kindle Edition.
You can find her book: https://www.amazon.com/Coming-Plague-Emerging-Diseases-Balance-ebook/dp/B005FGR6RO Or follow her: Twitter: @Laurie_Garrett.
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