Those old time diseases are coming back

By Morf Morford
Tacoma Daily Index

To put it mildly, we certainly live in interesting times. Among other things, those old time diseases – you know, those plagues that wiped out thousands of people at a time and vanquished civilizations and collapsed empires, are coming back.

If you know much about human history over the past thousand years or so, one dominant feature is the rise of crippling, contagious, and many times, fatal disease.

Plagues rocked Europe wiping out about a third of the human population in the mid 1300s.

A little over a century later, Europeans carried diseases (like smallpox, typhus, measles, mumps, and scarlet fever) and wiped out somewhere in the neighborhood of 90% of the North American Native population – unleashing cultural upheaval and, by some accounts, major climate change (https://www.theguardian.com/environment/2019/jan/31/european-colonization-of-americas-helped-cause-climate-change) which impacted seasonal migratory patterns of everything from bears to butterflies.

Diseases are the ultimate opportunistic parasite – always seeking hospitable climates and conditions – and suitable hosts.

Oddly enough, modern cites and lifestyles of many – if not all of us – are the ideal medium for the cultivation of bugs and bacteria of all kinds from antibiotic resistant bugs to re-emerging diseases once thought conquered by modern medicine.

As if you didn’t have enough things to worry about, we are on a trend line of increasing health concerns that seem to be converging.

One reality is the decreasing effectiveness of antibiotics. The growing resilience, resistance and virulence of “super-bugs” and the accompanying ineffectiveness of antibiotics means that all too soon, we will have no functional antibiotics.

One of the problems is that bugs can develop resistance to antibiotics within days, if not hours, while effective antibiotics can take years to develop.  (1*)

As I mentioned above, bugs of all kinds are opportunistic parasites that have found ideal habitats in our homes and cities.

All kinds of creepy potentially toxic things love our garbage, and if you have been in any good sized city, you seem to see garbage everywhere.

Homeless camps are probably the worst – or at least the most visible.

All across Seattle, and some pockets of Tacoma, and even in a few areas of outlying areas like Puyallup, clusters of homeless people (and their garbage) seem to accumulate in every empty lot or neglected corner.

Homeless encampments seem to pop up almost anywhere. I'd guess that no one likes them - even - or maybe especially - those that find themselves in them.  Photo: Morf Morford

Homeless encampments seem to pop up almost anywhere. I’d guess that no one likes them – even – or maybe especially – those that find themselves in them. Photo: Morf Morford

These camps are not only unsightly and unsafe (and certainly uncomfortable) but they are also human-sized petri dishes featuring the ideal incubation medium for who knows what new, resurgent or recombinant disease, bug, virus or infection.

Diseases once thought long gone are coming back with a vengeance. Some have been gone – or at least out of sight – (like typhus) for centuries, others have been out of view for a generation or so (which means that many young doctors have never encountered them before).  (2*)

Most of us probably never even think about it, but a home and workplace that is clean, largely insect free, dry and kept at a moderate temperature (protected from the constant variability of cold and heat) is a relatively modern development. A typical home, especially with central heating and indoor plumbing, (all of which we take as basic) would have been seen as inconceivable luxury just a few generations ago.  (3*)

We might take the little luxuries of our home for granted, but homeless people don’t.

In a recent Canadian study 8 out of 10 people (80%) of those experiencing homelessness reported having a chronic health condition.

In my work with homeless, I am always struck by how common injuries are. These are often the result of falls, fights or being struck by a  car. Deaths due to  unintentional overdose of drugs or alcohol, or both, are also common. Exposure to the elements is a major and constant hazard. In cold weather, the risk of frostbite and hypothermia is substantial, and deaths due to freezing are common. In hot weather, severe sunburn and heatstroke can occur. Suicides among homeless people are also common.

Typical of most cities, Toronto found that in one year 40% of people who were homeless had been assaulted, and 21% of homeless women had been raped. Another study found that homeless men are about 9 times more likely to be murdered than men who are housed.

If you ever see homeless people, you will certainly see a higher than usual number of people limping or being visibly in pain.

Health issues that affect joints, ligaments and tendons (like arthritis) are common among people experiencing homelessness. If you think about yourself after an extended time cold, wet and sleep-deprived, being in constant pain is understandable.

As we might guess, many homeless people use drugs or alcohol to cope with their pain because their history of missed appointments or drug use prevents doctors from prescribing standard over-the-counter pain medication.

Lack of standard hygiene leads to a virtual laundry list of skin and foot diseases and conditions from scabies, lice, impetigo, callouses and miscellaneous wounds, scars and conditions.

Dental problems, hepatitis A, B, and C, tuberculosis, HIV/AIDS, hypertension, diabetes, anxiety and stress are only a few of the issues, physical and mental that frame the life of a typical homeless person.   (4*)

I mention all this because diseases that threaten us all are being cultivated in the dank corners of every city and literally on the bodies of people who used to live and work or go to school among us.

Homelessness is not a social issue that is limited to “those people.” And homelessness is not a social dilemma that lends itself to easy answers.

Articles and television specials (like KOMO’s Seattle is Dying or responses like Crosscut’s proclaim problems and potential solutions and inspire further conversation – and, one would hope – steps towards a lasting solution.

Mix all this in with the resurgence of measles thanks to the avoidance of routine vaccinations, the prevalence of obesity and the sheer abundance of cases of diabetes and you have the ideal circumstances for a 21st Century version of a plague year.

It doesn’t need to be this way of course. Getting people off the streets, getting them the physical and mental care that they need (at almost any cost) is far cheaper than confronting the cauldron of virulence, desperation and rage that is bubbling barely out of site on our city streets.

Our homeless problem took years, if not decades, to congeal into the seemingly intractable problem we see almost every day.

It should not take decades to fix, but the longer we wait, the worse it will become.

 

(1*)    You can see more on this threat to our health here – https://www.nytimes.com/2016/05/27/health/infection-raises-specter-of-superbugs-resistant-to-all-antibiotics.html?.

(2*)    For more on the resurgence of medieval diseases, look here – https://www.theatlantic.com/health/archive/2019/03/typhus-tuberculosis-medieval-diseases-spreading-homeless/584380/.

(3*)    Somewhere among my family photos is a picture of my Norwegian great-grandmother in the doorway of  her sod-block home in North Dakota in 1907. No heat, no plumbing and blankets acting as doors and windows.

(4*)    You can see more of the health related issues homeless people face here – https://homelesshub.ca/blog/what-are-top-10-health-issues-homeless-people-face.