Health Care/Joan Retsinas

Enough with Health-Isolationism!

Let’s put a stake in the perfidious but appealing notion that we can isolate ourselves, as a community, from the world. The zeal to isolate ourselves is strong. Yet wars spread. Famine sends refugees across borders. When the economies of China, Europe, Africa, falter, ours is not immune.

So too infectious diseases leap across borders. The word “infectious” means that the diseases spread, heedless of immigration controls. Some diseases are hard to transmit, but others spread almost like the dandelion spores children blow in the air. We should have learned the lesson: not only is no man an island (thank you, John Donne), but crucially, no nation is an island. Not even island-nations.

Start with COVID. Whether or not it began in Wuhan, China, it spread, even to South Dakota, even to Mexico, even to New Zealand which erected stringent barriers, including mandatory “managed isolation,” even to Tonga, an island flooded more with lava than with tourists. Yet COVID spread. Early in the United States’ lockdown, individual states tried to bar travelers from less-infected states: a traveler from Rhode Island needed a reason to cross the border to Massachusetts. (Since Rhode Island is 1,200 square miles, most Rhode Islanders cross state lines regularly.) In retrospect, the state-bans emerge as silly as a tiny dam trying to hold back the ocean.

History — that great teacher whom we easily ignore —documents the spread of polio, smallpox, diphtheria, influenza, tuberculosis. Vaccines staunch the spread, but if some people do not get those vaccines, the diseases gain a foothold. Depending upon the “infectiousness,” the disease will spread across classes, across communities, across national boundaries, across oceans.

The ongoing war in Ukraine has made all of us who follow the mayhem on-line, with real-time videos, shudder. We ache for the citizens.

We should ache for Europe, for the United States, for the world.

Diseases are getting a toehold in the Ukraine and in Russia.

Start with COVID. The data-gatherers report 2,800 new cases each day.

Before Russia advanced, only 35% of Ukrainians were vaccinated (not too different in Poland and Hungary). At the same time, Omicron was surging, with as many as 60% of tests showing positive. The country’s usual safeguards against the spread of COVID — masks, “social distancing,” hand-washing — don’t work when planes are raining down bombs. Indeed, the fact that Doctors Without Borders was supplying help to people in Mariupol, a city under siege, showcases the idiocy of fighting a virus at the same as time as a war is destroying homes, hospitals, water systems, sanitation infrastructure. People, hovering for shelter in crowded basements, are not washing their hands.

Those refugees in turn bring COVID to camps, which become breeding grounds for diseases. And, as refugees spread beyond the camps, the diseases follow. Trackers are watching cases of polio, tuberculosis, HIV, and measles rise — all infectious. (Ukraine has one of the highest rates of multi-drug resistant tuberculosis in the world.)

Almost as crucially, wars halt much scientific research. We depend on clinical trials, which, like clean water, sanitation, hospitals, and transit, suffer when bombs are falling. Scientists do not develop treatments in a vacuum; they begin in laboratories, often with animals, then progress to stages of trials, testing for adverse reactions, for effectiveness, testing against placebos and alternate treatments. Millions of dollars; millions of tests; millions of patients.

The Food and Drug Administration reports over 250 active trials based in Ukraine, for cancer, multiple sclerosis, schizophrenia and COVID. One estimate is that Russia and its neighbors account for 10% of patients in clinical trials.

In Russia, researchers have paused their trials. Moscow State Medical University, for instance, has 120 ongoing clinical trials. The reason: the laboratories cannot transport samples to laboratories in Europe and the United States because airlines cannot fly to and from Moscow. Merck & Co (MRK.N) and Roche have about 100 clinical trials underway there.

As we debate how best to stop this war that is killing so many people, we should recognize that the fate of Ukraine and its neighbors does not stop at their borders, but will cross into our vulnerable country.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email retsinas@verizon.net.

From The Progressive Populist, May 1, 2022

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