Public Health, Universal Health Care and the COVID19 Virus – Part 1

I enjoy reading art history, particularly biographies.  One of the things that intrigues me is an artist’s lifespan.  Some artists, like Impressionist Claude Monet, lived to age 86 and painted into the last years of his life.  He left behind a huge body of work paintings, for generations to enjoy.  Egon Schiele gave us thousands of drawings and paintings before he died at the young age of 28.  Schiele married his wife Edith, who posed for many of his paintings, in 1915.  In 1918, Edith, six months pregnant, died during the great flu epidemic (so-called Spanish Flu) and Egon died three days later, also from the flu.  We can only wonder what Schiele might have created had he lived as long as Monet.  I am left with a sense of loss for things unseen.

Because of advances in medicine most Americans have no idea of how precarious life was due to disease, illness, and injury just a century ago:

“The changes that have occurred in medicine over the centuries and particularly during the past 100 years have profoundly affected the way we perceive our lives and our mortality.  We no longer expect to die from diseases that in the past killed thousands and even millions.  Illnesses which would have been deadly, such as a burst appendix, heart attack, pneumonia, or an infection, are treatable, and we are shocked when we hear that someone died from one of these conditions.  We are aware of our mortality but are more likely to see it as the result of advanced years rather than the consequence of a disease that a few generations ago would have struck without consideration of age.  And with the advances that medicine promises even old age may not be the best predictor of morality.”[1]

When I wrote that several years ago, I had no idea that something like COVID19 would come along to spoil that description of health and medicine; life once again is precarious due to disease.  The musician George Harrison once wrote a song entitled All Things Must Pass and that’s true of the current health crisis.  And it will pass, because as I noted above, medical research, science, and technology will disclose effective treatments and possibly even a vaccine.

In early February I posted an article about COVID19, then just referred to as the corona virus, and looking back just a few, short weeks, I got some things right and some things very wrong.  Like many observers, I compared COVID19 to seasonal flu and concluded the risk of getting COVID19 or dying from it was very low.  Wrong.  We now know that because it has a long incubation period and that the symptoms can flair up quickly, it is more likely to be spread person-to-person without the carrier realizing it.  We also don’t have a good grip about its mortality rate, as it depends many factors including the health status of the infected person, the person’s age, the number of infected people within a given population, and the timeframe on which the mortality rate is being counted.  For example, I’ve been tracking the number of deaths per confirmed cases and it has varied between 1.2% to 3.9% depending on the number of people infected and being treated over a given number of days.  That’s a significant range, particularly if the virus continues to spread to large numbers globally.

Like many people, I did not appreciate that the virus spreads exponentially;[2] therefore, it can quickly propagate throughout a population and, as health officials fear, rapidly overwhelm the health care system.  (For an excellent explanation of this process check out this YouTube video: That’s why segregating from other people can slow progression of the virus throughout the population and also why it will take so long before we’ll begin to see a slowing of the spread of the disease.

I’m currently reading The Red Rose Girls by Alice A. Carter (Harry Abrams, 2000) the story of three early 20th century painters and illustrators, Jessie Wilcox Smith, Elizabeth Shippen Green, and Violet Oakley.  Like Impressionist painter Mary Cassatt, Smith and Green were known for their magazine and book illustrations of women and children.  Oakley gained fame as a muralist and designer of stained glass windows.

Oakley, born in 1874, was one of three daughters.  One of her sisters, Cornelia, died of diphtheria at the age of six.  In the early 1900’s Violet Oakley’s surviving sister, Hester, gave birth to a daughter who, when just a toddler, subsequently died from an infection and then Hester herself died shortly afterward from scarlet fever.  Life even just a century ago was uncertain, but four things happened that helped create the prospect of longer life.

First was the discovery that germs (bacteria and virus) were the cause of many diseases.  Second, was the development of antibiotics to combat bacteria borne diseases.  Third, was investment in public health activities to combat disease, such as assuring clean drinking water, sewage treatment, and sanitation (trash collection).[3]  And fourth has been the development of antiviral vaccines. 

Advances in medical science such as this is why, although we are concerned about the lethality of COVID19, we are also reassured that a vaccine or medication to assist treatment will be developed.  And it is a reminder why universal health care – access to health care for all Americans, without concern for ability to pay – should be another of our nation’s health care priorities.

[1] Colton, David (2019).  The Case for Universal Health Care. Clarity Press, Atlanta, GA. P. 45.

[2] An example of exponential expansion is something that doubles each time it reproduces, such as 2, 4, 8, 16, 32, 64, etc.  As you can see, it doesn’t take long for a few cases to expand into thousands and tens of thousands of cases.

[3] Public health activities have essentially eradicated diseases such as diphtheria and cholera from the United States.

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