Every day, Breidagerdi School’s second graders went out for morning recess. It mattered not if the skies were gray (most of the time) or blue (some of the time). Wind gusts and pouring rain or meters of snow did not equate to indoor recess. But Icelandic moms dressed their children appropriately. They were no strangers to arctic winds. And the kids, with some exceptions, sprinted outside like stallions out of stables. But there was one morning, that eight-year-old-me asked if I could stay indoors. I’d felt poorly and skipped my breakfast, coffee, and bread with butter. My body shook, and my face was burning. “Nei, allir fara út ad leika,” my teacher said. So instead of playing hopscotch with my friends, I found shelter under the cement steps leading to the classroom.
The next day, I was whisked away in an ambulance, not to return home for a year plus. Tuberculosis, or “the consumption” as people called it, spoke to the awfulness of this disease. It attacks the young and the old with no regard to little girls who looked forward to playing hopscotch. Little by little, TB sucks the life out of its victims. Days in bed sleeping are interrupted by coughing up blood-stained sputum into a metal cup. Eventually, the tubercle bacillus, the cause of tuberculosis, turns its prey into an emaciated shell and then strikes the death blow. I lived because of the scientist who discovered what it was and how to treat it.
Most people see science as a vehicle for the advancement of the human race. Ever-changing and evolving. Progress. But there is also a small number of people who insist they know what they know and refuse to investigate their hard-held “truths.” Societies with rigid paradigms, stagnant unchangeable “truths,” block progress. “It’s how we have always done it.” But when we leave room to question our truths, we create space for new ideas, as in the case of tuberculosis, that eases the suffering and find ways to make the world better for everyone. The great economist, John Maynard Keynes said, “When the facts change, I change my mind. What do you do, sir?”
At the time of this writing, I’ve been in quarantine for months. The encroacher is COVID-19. What better time than right now, to look at the timeline of a bacteria that near killed me. Whom do I owe gratitude? Behind medical progress, microscopes, and vaccines are stories of people who asked questions and set out to answer them.
Robert Koch a German physician and microbiologist is credited for identifying the bacteria that caused tuberculosis. Son of an engineer, he taught himself to read the newspaper at age five. Earning a medical degree from the University of Göttingen, Germany (1866), his specialty was pathology and infectious diseases. Unhappy with the prevailing process of identifying the cause of infectious disease, he established (1882) what came to be known as the “Koch’s postulates.” First, the suspected pathogenic organism must be found in all cases of the disease and absent from healthy animals. Second, organism is isolated from the diseased animal and cultivated in sterilized culture. Third, inject into healthy animals which should result in disease symptoms. And fourth, the removed pathogens from infected animal should match the original pathogen. A hundred years later, we may take this for granted, but this was a watershed moment in medical history. In 1905, Dr. Koch won the Nobel Prize.
Dr. Koch discovered the cause of tuberculosis, a germ he called “tubercle bacillus.” Another seismic moment. He and hundreds of other scientists then focused their attention on how the bacteria entered the human body.
At the 1908 International Congress on Tuberculosis in Washington, Dr. Koch disagreed with the findings of other researchers. He insisted that no evidence supported the idea that cattle gave TB to man. John M. Barry, the author of The Great Influenza, The Story of the Deadliest Pandemic in History (the source of much of my information), writes, “arguments broke out all over the room. But the International Congress as a whole was convinced; a few days later, it passed a resolution calling for preventive measures against the spread of tuberculosis from cattle to man.”
Reaching out to microbiologist Dr. Iona Bartek, I asked her if Dr. Koch’s method was still the gold standard for pathology experiments. “Research still pretty much follows Koch’s postulates,” she said, “but now researchers repeat the experiment multiple times to give statistical power.”
Pasteurization of milk killed the TB virus, but its airborne contagion continued. Patients were isolated in sanatoriums. With the discovery of antibiotics in 1928 the bacillus bacteria found its match. TB still kills people, but mostly in third world countries, and is still considered a serious contagious disease. But the work of many means that today, it’s almost always curable.
COVID-19 is not a bacteria like the tubercle bacillus. Bacteria are single-celled microorganisms that live in different environments, the soil surrounding your plants, and your intestines where they help digest your food, etc. Bacteria is fully alive and has a metabolism, requires food, produces waste, and reproduces by division. Bacteria causes strep throat and urinary tract infections. Most bacteria don’t cause harm to people.
Viruses are smaller than bacteria and need a home—people, plants, or animals— to thrive and multiply. Without a home, they die. A virus has one function, to replicate itself. When it enters your body, it invades cells and takes them hostage and forces them to make thousands or hundreds of thousands of new viruses. “When a virus successfully invades a cell, it inserts its own genes into the cell’s genome, and the viral genes seize control from the cell’s own genes.” Our invaded cells stops serving our needs and produce what the virus demands. Viruses may be primitive, but they are singular in their focus and “become nearly perfect infectious organisms.”
When the body survives an infection, it has an advantage. Our white blood cells, called “memory T cells,” remember the bad guys, the viruses. Recognizing the invader, our immune system responds quicker, resulting in fewer (or no) symptoms. Vaccinations expose people to the disease to mobilize the immune system to respond to the particular infection.
The coronavirus disease 2019 (COVID-19) is a new coronavirus. We build up immunity to seasonal flu, but with this new virus, we have none, which makes it a serious public health risk. How politicians and scientists deal with outbreaks determines the ultimate breath and depth. In 1918, Rupert Blue, the head of the US Public Health Service, failed to heed a warning and prepare for the Spanish Flu epidemic, resulting in a higher rate of infection and death. In the end, those who led the research in the fight against the influenza virus concluded that they’d learned much too little, but they did conclude that quarantine was the most effective way to halt its spread.
John M. Berry’s book, The Great Influenza: The Story of the Deadliest Pandemic in History, reads like a medical thriller. The gruesome details sparked my imagination, resulting in elaborate descriptions to Tim of every ache I felt and sore throat sensed.
After living in COVID-19 conditions for months, my confidence in the federal government’s —under the leadership of Donald Trump— response to pandemics has dwindled as my trust in the local governance has strengthened. But as surely as the sun will rise, my faith in the scientific community, its intellect, and determination to outsmart viruses no matter their singular determination has rooted deeper.