By Bill Darrow
Mary Mallon was human. The media portrayed her as a monster, “a menace to the public health.” They called her “Typhoid Mary” and accused her of being “The Most Dangerous Woman in America.”
The sad and sordid tale of a poorly educated and “a little too heavy” Irish immigrant “buxom woman” who loved to cook puddings and cakes as told by historian Judith Walzer Leavitt inspired Stempel College doctoral student Amani Othman to draw parallels between communicable disease outbreaks during the early 20th century with infectious disease outbreaks we are experiencing today.
Toxic shock, Legionnaires, Marburg, HIV, Lassa Fever, Ebola, SARS, MERS, Zika, and now COVID-19.
Using testimonials captured on social media, newspaper clippings and other available documents and accessible materials, we arrived at an answer: “We have not learned our lessons from earlier generations.”
As evidence about COVID-19 and how the etiologic agent spreads is revealed, we continue to discern patterns predicted by our knowledge of the past. A series of articles recently published in the New York Times, Miami Herald, and South Florida Sun-Sentinel are examples.
In late March 2020, the buzz was about “the China virus” and how that designation led to insults, stigmatization and discrimination against Asian-appearing Americans. In early April, attention shifted to reports of higher morbidity and mortality rates due to infections with the novel coronavirus among African Americans, Latinos and Latinas, and other vulnerable minorities.
Articles presenting new information about COVID-19 and its toll appeared under catchy headlines of “Spit On, Yelled At, Attacked: Chinese-Americans Fear for Their Safety,” “Black Miamians dying at a greater rate than whites,” and “There’s Something About a Typhoid Mary.”
You didn’t need a crystal ball to foresee these headlines. These articles could have been anticipated by public health professionals aware of health disparities, social determinants and The New Public Health.
Health disparities have been known in the United States since the arrival of slave ships loaded with human cargo in the 17th century and subsequent waves of indentured servants and other immigrants. Social determinants are just as relevant in understanding the distributions of disease, disability and death in a community as the epidemiologic triad of person (hosts and susceptibles), place (physical environments), and pathogen (germs, as COVID-19).
The New Public Health and Public Health 3.0 are crucially important when it comes to designing and developing health promotion and disease prevention programs, implementing them, and evaluating them to make sure they are effective, efficient and ethically defensible.
Social distancing, contact tracing and other viable interventions employed to contain, mitigate and control diffusion of the virus must be properly carried out and assessed by adequately trained practioners to assure continuous quality improvement of our very best public health programs.
Bill Darrow came to FIU 25 years ago from the Centers for Disease Control and Prevention (CDC) to help establish the Stempel College of Public Health & Social Work and “to train the next generation of public health professionals for the challenges that lie ahead.”
"I perceive my role as a health promoter to ensure health as a human right, especially for disadvantaged communities. From this paper, I hope that the reader can see how discrimination against minorities at that time caused health disparities that affected the health of the whole population, and this remains as valid now as it did then.”
Othman will soon join the growing list of public health graduates from Stempel College who are meeting the challenges of COVID-19 and solving a host of other seemingly intractable and complex public health problems.