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Our public health history and mandates — a virologist’s perspective

In a letter published in Foster’s and the Concord Monitor, virologist Walter King describes how public health efforts to control disease have been successful, despite naysayers’ resistance.

For as long as we have been plagued by the COVID-19 pandemic, we have also been beset by the ongoing battle between personal choice and mandates. For most of us, it has been an exhausting experience, and I speculate that the result has been that many are unsure about where they stand on this issue.

This situation harkens back to a similar controversy more than 50 years ago surrounding the link between cigarette smoking and lung cancer. Both sides cited scientific studies that supported their position. The tobacco industry resisted government regulation of its products by conducting public relations campaigns and buying scientific and other expertise to create controversy about established facts.

While I am a virologist by training, I realize that providing scientific explanations publicly about the biology and spread of disease are not necessarily compelling for many. In the end, the overwhelming and unbiased scientific studies clearly showed the relationship between smoking and lung cancer, and so the anti-smoking campaign prevailed. It is seen as a major success with few parallels in the history of public health. Many arguments used by the naysayers then are identical to what we are now hearing and reading: “I have the freedom to smoke whenever and wherever I want… just because you don’t smoke should not be a reason why I cannot smoke in your presence” and so forth. This notion is simply scientifically false, and one cannot use this argument to justify endangering the broader public. Too many people require ironclad results before they will accept something as true. While nothing is 100% effective — not vaccines, not seatbelts, not recovery programs — the harm reduction these things will provide is, and has been, easily provable.

Perhaps a more compelling approach for those still unsure about public health mandates is to look back at our public health history which cannot be refuted. In addition to the history of smoking and lung cancer, there are plenty of precedents in regard to public protection from infectious diseases. The most relevant example is our State School Immunization Requirements per New Hampshire law He-P 301.13-15 that “requires that all children enrolled in any school, pre-school, or child care have certain immunizations to protect them and those around them from vaccine preventable diseases.”

So, all of us, including our parents and grandparents, did follow mandates that were based on sound science. The adherence to those mandates resulted in the dramatic decrease in the number of cases of most vaccine-preventable diseases, which is at an all-time low. It has been estimated that vaccination with 7 of the 12 routinely recommended childhood vaccines prevents an estimated 33,000 deaths nationwide and 14 million cases of disease in every birth cohort, saves $10 billion in direct costs in each birth cohort, and saves society an additional $33 billion in costs that include disability.

There can be no dispute on the success of these mandates; our public records have clearly demonstrated the drop in disease with the advent of immunizations. While one cannot say that vaccines eradicate all disease, the ability of vaccines to significantly reduce disease, almost to the point of eradication, is quite evident in many cases. Take diphtheria as an ex

ample: diphtheria cases have been eliminated but in the 1920s, there were between 100,000 and 200,000 cases of diphtheria each year with 13,000 to 15,000 deaths, and during 2004–2017, state health departments reported 2 cases of diphtheria. This and many other examples clearly show that we have been through this before. The important lesson is that our history shows us that we have relied on science to successfully control the spread of disease, and that together with our innate compassion for the protection of others, there is the way forward.


About the author:

Walter is a retired research and development executive who worked at several leading global healthcare companies including GE Healthcare, Whatman and Abbott Diagnostics. He developed FDA-cleared products for several cancer and prenatal genetic diseases as well as infectious diseases. He is an emeritus member of the American Association for Cancer Research. He completed his college and graduate studies at the University of California, Berkeley and the University of Chicago respectively and completed his postdoctoral studies at the Columbia University Medical Center. He serves on the Advisory Board of the Health Care Voices of New Hampshire and the City of Dover Energy Commission. He chairs Strafford County Democrats, is a member of Dover Democrats and serves on its Executive Committee.

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