Miasma
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Reviewing the COVID-19 experience in the last two and a half years makes us pause and wonder how the public health response was managed. Beyond the obvious incompetence of Trump, there were chaotic decisions by the CDC and WHO that contributed to the terrible toll of the pandemic. A Nature article that just came out (https://www.nature.com/articles/d41586-022-00925-7l) looks at the scientific dogmas that hindered a proper assessment of the spread of the disease and, based on that, the correct guidance of the public.
As someone who has gone through this period, and tried to understand and follow the instructions given out by the CDC, I have memories of wildly inadequate instructions. Using masks was supposed a waste of time. Viruses were supposed to stick to surfaces, and avoiding to touch these surfaces and putting them in touch with your orifices, most importantly mouth and eyes, was supposed to keep you out of harm’s way. In our house, many food takeout orders were first kept in the mud room to “breathe” for a while, and then microwaved, salads included, to kill every single virus attached.
At the time I never understood why a virus that thrived in the respiratory system would not use airborne suspensions as a favorite vehicle of transmission. It would have made sense, from all I understood from evolution, but at the start of 2020, when COVID-19 took hold, myths were circulated without basis by people with science background who were formally in positions of leadership: the CDC. The most obvious pathway of transmission did not get the official blessing until much later, after many lives were lost that could have been saved.
The article I’m talking about makes an important historical connection. For two millennia, transmission of diseases was attributed to “miasma” — something like ‘bad air”. It originated with Hippocrates (460 – c. 370 BC) and was uncontested as mechanism of transmission until, in the 19th century, the germ theory took hold.This theory evolved with the discovery of germs causing debilitating diseases such as cholera and typhus, all connected to improper hygiene. Bacterial pathogens were in the end discovered, and the case was closed.
Henceforth, the miasma theory was banned as an old wives tale, but this was the thing: it probably contained wisdom gained from the common experience, over generations, of the evident transmission of viral, airborne diseases. In contrast, the germ theory held that bacteria and other germs were the physical substrate of transmission by direct contact.
Nobody could imagine, it appears, that both theories could be true: that a pathogen could be transmitted through the air. In fact, the Nature article shows, the elimination of the miasma theory was so radical that it influenced decisions made at the start of COVID-19. The most that scientista could envision was that big droplets — the ones you see if someone talks to you with gusto — filled with virus particles could be shared, but now it is known from many studies that viruses survive in aerosoles that are widely and swiftly circulated in the interior of apartments and houses.
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