DOCSLIB.ORG

John Snow and Joseph Goldberger

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
John Snow and Joseph Goldberger Nevada Journal of Public Health Volume 2 Issue 1 Article 3 2005 The Contributions of Two Public Health Pioneers: John Snow and Joseph Goldberger Timothy J. Bungum University of Nevada, Las Vegas, [email protected] Follow this and additional works at: https://digitalscholarship.unlv.edu/njph Part of the History Commons, and the Public Health Commons Recommended Citation Bungum, Timothy J. (2005) "The Contributions of Two Public Health Pioneers: John Snow and Joseph Goldberger," Nevada Journal of Public Health: Vol. 2 : Iss. 1 , Article 3. Available at: https://digitalscholarship.unlv.edu/njph/vol2/iss1/3 This Article is protected by copyright and/or related rights. It has been brought to you by Digital Scholarship@UNLV with permission from the rights-holder(s). You are free to use this Article in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s) directly, unless additional rights are indicated by a Creative Commons license in the record and/ or on the work itself. This Article has been accepted for inclusion in Nevada Journal of Public Health by an authorized administrator of Digital Scholarship@UNLV. For more information, please contact [email protected]. Journal of the Nevada Public Health Association, volume 1, issue 2 14 The Contributions of Two Public Health Pioneers: John Snow and Joseph Goldberger Timothy J. Bungum, DrPH, Associate Professor, University of Nevada-Las Vegas Department of Health Promotion – UNLV Similar to many professional disciplines, public was believed that a mysterious uncle on his mother’s health was shaped by pioneers who made important side of the family, a Charles Empsom, helped with contributions. Two trailblazers, whose work current these expenses (Vinten-Johanson et al., 2003). public health officials should be aware of are Drs. It was during his internship that Snow John Snow and Joseph Goldberger. Although Snow became a vegetarian, began exclusively drinking is a well known public health figure, mentions of his water that he had distilled and concluded that a work in contemporary health promotion and public healthy colon was a key to a healthy life. He was also health text books are generally limited and typically an ardent walker and strongly disapproved of alcohol comment only on his study of the Broad Street Pump usage. The apprenticeship provided Snow’s first (BSP) cholera outbreak. The accomplishments of exposure to cholera when he helped treat victims at a Joseph Goldberger receive even less coverage than mine in Killingsworth during 1832 (Vinten-Johansen those of Snow. Goldberger’s work in identifying the et al., 2003). cause of pellagra was instrumental in creating the Upon completing the internship in 1836 field of nutritional epidemiology (Elmore, & Snow applied to and was accepted into the Hunterian Feinstein, 1994). Because of the scant coverage of Medical School which, was located in the Soho these men’s accomplishments, and their importance, section of London. Snow made the trip from York to these two men’s professional contributions and London on foot, a distance of about 400 miles. His similarities in their lives and careers will be discussed circuitous route to medical school took him through in this paper. Liverpool and Wales and lasted four to five weeks. Dr. John Snow (1813-1858) Much of medical school at this time was self-directed John Snow was the first of eight children and students were required to purchase tickets to born to Frances and William Snow of York, England attend special lectures and presentations. Many of the on March 15, 1813. Little is known about Snow’s lectures that Snow attended were held at the childhood but it is recognized that his parents were Westminster Hospital, which was near the Hunterian not wealthy. Snow’s father was a carman, who pulled Medical School (Galbraith, 2002). carts to transport goods (Vinten-Johansen, Brody, In 1838 Snow passed a test to become a Paneth, Rachman, & Rip, 2003). surgeon and was duly admitted to the Royal College Education in 1820’s was a privilege for of Surgeons. He also held at certificate of apothecary, British children, as universal schooling was not but had yet to earn one as a physician, which was the instituted in England until the 1880’s. Considering third and most prestigious component of medical Snow’s lot in life he would have been considered training at the time. It was not until 1844 that Snow fortunate to be allowed to attend school. It is believed sat for a test that was offered at the University of that Snow was a student at the Dodsworth London to achieve his vocational goal of becoming a Elementary School in York, which was an licensed physician, he passed (Vinten-Johanson et inexpensive private school (Snow, 1995; Vinten- al.,, 2003). Johansen et al., 2003). Upon graduation Snow hung a shingle on During June of 1827 at the age of 14 Snow his Frith Street apartment and opened a medical entered into a medical apprenticeship under the practice. Unfortunately, at the time, London was supervision of a Dr. Hardcastle in the town of home to 21 medical schools and there were a plethora Newcastle. His first assignments as an apprentice of doctors in town. Snow was not especially were likely to deliver drugs to patient’s homes. successful as a practicing physician as competition Apprentices such as Snow were allowed to see for patients was fierce and his bedside manner was patients, but usually only those who could not pay for described as “very peculiar.” In spite the bedside a doctor’s services. During this training period Snow manner issue Snow was immensely respected by his was not allowed to attend university lectures, but Dr. peers (Vinten-Johansen et al., 2003). Hardcastle did invite him to occasionally follow Snow, a regular attendee of scientific along on hospital rounds (Galbraith, 2002). It was not meetings and conferences, attended a presentation by known how Snow paid for his medical training but it Francis Boott, a Boston physician, on December 19, Journal of the Nevada Public Health Association, volume 1, issue 2 15 1846 that would change his career. Boott performed a anesthenologist he knew that to have an effect tooth extraction using ether to thwart the pain that airborne substances such miasmas had to be inhaled was associated with the procedure. The use of ether at close range, which did not happen in most cholera was important because nothing was previously cases. He further noted that those who lived adjacent known to decrease the pain and suffering that was to ill people and seemingly breathed the same air, but associated with many medical procedures. Besides had different water sources, did not become ill. He reducing pain, there were two peripheral, yet additionally reported that people working in the important benefits of using ether. First, patients were “offensive trades,” such as tanners, where miasmas more apt to sit still during procedures, which allowed were ever present, did not suffer from higher rates of doctors to operature with more precision. Secondly, cholera than the general population. Snow also patients were more likely to submit to needed learned that some people got the disease and lived in surgeries, knowing that much of the anticipated pain areas where miasmas were not present (Snow, 1855). would be attenuated (Vinten-Johansen et al., 2003). Snow’s beliefs on cholera transmission Through experiments conducted on animals, would have classified him as a contingent and experience with patients Snow learned that all contagionist, as he believed that the disease arose people were susceptible to the effects of ether. The from people drinking water or ingesting food that had effects, were however, influenced by a person’s been contaminated by the fecal wastes of the ill. He breathing rate, body size, age and whether or not the also believed that alcohol could make a person more person was alcoholic. By 1847 Snow had developed susceptible to the disease and that dust from feces of an apparatus that could deliver ether in a controlled the ill could be inhaled and cause cholera (Vinten- dosage while accounting for temperature and the Johanson, 2003). saturation of the ether. This delivery method was an A law passed by Parliament aided Snow improvement over the practice of placing an ether- with his cholera research. By the year 1855 it was saturated cloth over patient’s mouths. Snow was law that no company could draw drinking water from appropriately recognized as an anesthelogy expert the tidal zone of the Thames River where the water and his services were in great demand (Vinten- was known to be contaminated with sewage. At the Johansen et al., 2003). time two businesses provided most of the drinking Because the effects of ether were rather slow water to south London residents with rather random and it was expensive, Snow was always on the geographic overlap. The Lambeth Company moved lookout for other substances that might be more their intake pipes upstream to meet the new legal effective and cheaper. After experimenting with requirement before their rival the Southwark and chloroform on animals, he extended his testing to Vauxall Company (S&V) did so. Snow anticipated humans and found it to be less pungent, more easily the natural experiment that would occur if the next inhaled, produced effects quickly, and was less cholera outbreak came about before the S & V intake expensive than ether. Thus, although he continued pipes had been moved upstream When it did occur searching for other compounds, and for a period Snow compared disease rates of S&V with Lambeth thought that amylene might be more effective than customers and he was able to show that those using S ether or chloroform, he principally used chloroform & V water were 14 times as apt to suffer from for the remainder of his practice.
Load more

Recommended publications
  • Vpublic HEALTH REPORTS .V .OL~35 NOVEMBER 12, 1920 No
    vPUBLIC HEALTH REPORTS .V .OL~35 NOVEMBER 12, 1920 No. 46 A STUDY OF THE RELATION OF FAMILY INCOME AND OTHER ECONOMIC FACTORS TO PELLAGRA INCIDENCE IN SEVEN COTTON-MILL VILLAGES OF SOUTH CAROLINA IN 1916.1 By JOSEPH GOLDBERGER, Surgeon; G. A. WHzzLER, Passed Assistant Surgeon; and EDGAR SYDEI- STRICKEE, Statistician, United States Public Health Service. CONTENT& I. Review of literature. III. Fellagra incidence according to eco- II. Plan aid methods of present study. nomic status. Locality. Discussion. Population. (a) Bad hygiene and sanita- Pellagra incidence. tion. Season. (b) Difference in age and Dietary data. sex composition. Data relating to economic condi- (c) Differences in diet. tions. Differences in incidence Family income. among households. Availability of food supply. Differences in incidence Economic classification. among villages. Method of classification ac- IV. Discussion. cording to economic status. V. Summary and conclusions. Results of classification. VI. References. In the spring of 1916 we began a study of the relation of various factors to-pellagra incidence in certain representative textile-mill communiities of South Carolina. On a varying scale the study was continued through 1917 and 1918. The results of the first year's (1916) study with respect to diet,2 to age, sex, occupation, disabling sickness,3 and to sanitation4 have already been reported. At the present time we wish to record the results of the part of the study dealing with the relation of conditions of an economic nature to the incidence of the disease. L REVIEW OF LITERATURE. A close association of pellagra with poverty has been repeatedly remarked upon since the time of the first recognition of the disease.
    [Show full text]
  • Cholera, Migration, and Global Health – a Critical Review
    Int J Travel Med Glob Health. 2018 Sep;6(3):92-99 doi 10.15171/ijtmgh.2018.19 J http://ijtmgh.com IInternationalTMGH Journal of Travel Medicine and Global Health Review Article Open Access Cholera, Migration, and Global Health – A Critical Review Niyi Awofeso1*, Kefah Aldabk1 1Hamdan Bin Mohammed Smart University, Dubai, UAE Corresponding Author: Niyi Awofeso, PhD, Professor, Hamdan Bin Mohammed Smart University, Dubai, UAE. Tel: +97-144241018, Email: [email protected] Received February 1, 2018; Accepted April 7, 2018; Online Published September 25, 2018 Abstract Cholera is an acute diarrheal infection caused by the ingestion of food or water contaminated with the bacterium Vibrio cholerae. The causative agent of this disease was originally described by Filippo Pacini in 1854, and afterwards further analyzed by Robert Koch in 1884. It is estimated that each year there are 1.3 million to 4 million cases of cholera, and 21 000 to 143 000 deaths worldwide from the disease. Cholera remains a global threat to public health and an indicator of inequity and lack of social development. A global strategy on cholera control with a target to reduce cholera deaths by 90% was launched in 2017. Before 1817, cholera was confined to India’s Bay of Bengal. However, primarily following trade and migration between India and Europe, by the 1830s, cholera had spread internationally. The global spread of cholera was the driving force behind the first International Sanitary Conference in Paris, in 1851. The global health significance of cholera is underscored by its inclusion as one of four priority diseases in the 1969 and 2005 International Health Regulations.
    [Show full text]
  • Cholera and the Pump on Broad Street
    CChhoolleerraa aanndd tthhee PPuummpp oonn BBrrooaadd SSttrreeeett:: THE LIFE AND LEGACY OF JOHN SNOW Laura Ball Senior Division Paper AFTER ALL, IT REALLY IS ALL OF HUMANITY THAT IS UNDER THREAT DURING A PANDEMIC. -- Dr. Margaret Chan, Director General of the World Health Organization There is still a pump in the Golden Square neighborhood on what was once called Broad Street. It does not work, for it is merely a replica of the original, and like the original its handle is missing. It serves as a curiously simple monument to the events that took place over one hundred years ago, when the real pump supplied water to the Broad Street residents. In 1854, hundreds of these hapless locals dropped dead within days of each other as Soho experienced one of the most brutal outbreaks of cholera that London has ever seen.1 Not even the most eminent physicians could say what caused the disease, or why it came and went as it did. John Snow’s solution to the cholera crisis broke the medical conventions of his era, slowed the progress of a virulent intercontinental disease, and forever changed the way society confronts public health problems. CHOLERA, THE BLUE DEATH Cholera plagued civilization for many generations before John Snow’s breakthrough. Medical researchers confirm that cholera was present in India in the seventeenth and eighteenth centuries, though records of diseases with cholera-like symptoms extend back as far as the fifth century B.C. The first intercontinental surge, referred to as the First Pandemic, occurred from 1 John Snow, “On the Mode of Communication of Cholera," 2nd ed., Snow on Cholera (New York: Hafner Publishing, 1965): 38.
    [Show full text]
  • The Myth of John Snow in Medical Geography
    Social Science & Medicine 50 (2000) 923±935 www.elsevier.com/locate/socscimed Our sense of Snow: the myth of John Snow in medical geography Kari S. McLeod* Yale University School of Medicine, Section of the History of Medicine, Stirling Hall of Medicine, P.O. Box 208015, New Haven, CT 06520-8015, USA Abstract In 1854, Dr. John Snow identi®ed the Broad Street pump as the source of an intense cholera outbreak by plotting the location of cholera deaths on a dot-map. He had the pump handle removed and the outbreak ended...or so one version of the story goes. In medical geography, the story of Snow and the Broad Street cholera outbreak is a common example of the discipline in action. While authors in other health-related disciplines focus on Snow's ``shoe-leather epidemiology'', his development of a water-borne theory of cholera transmission, and/or his pioneering role in anaesthesia, it is the dot-map that makes him a hero in medical geography. The story forms part of our disciplinary identity. Geographers have helped to shape the Snow narrative: the map has become part of the myth. Many of the published accounts of Snow are accompanied by versions of the map, but which map did Snow use? What happens to the meaning of our story when the determinative use of the map is challenged? In his book On the Mode of Communication of Cholera (2nd ed., John Churchill, London, 1855), Snow did not write that he used a map to identify the source of the outbreak.
    [Show full text]
  • The Forgotten Plague
    AmericanHeritage.com / THE FORGOTTEN PLAGUE http://www.americanheritage.com/articles/magazine/ah/2000/8/... December 2000 Volume 51, Issue 8 THE FORGOTTEN PLAGUE A MURDEROUS DISEASE WAS RAVAGING THE SOUTH. THEN ONE BRAVE AND DETERMINED DOCTOR DISCOVERED THE CURE—AND NOBODY BELIEVED HIM. BY DANIEL AKST Oblivion is a virtue in a disease. Cancer, AIDS, diabetes, and even tuberculosis are too much with us, but hardly anyone knows what pellagra is because the disfiguring deadly illness is virtually nonexistent in America today. For the first third of this century, pellagra was a scourge across the American South, killing thousands and afflicting hundreds of thousands more. Its cause was unknown, and there was no treatment, let alone cure. Victims were shunned like lepers, and by 1914 the sickness was a national scandal. The conquest of pellagra was a triumph of epidemiology over an affliction perhaps as ancient as the Bible, but it was also a triumph of one remarkable man, a medical Sherlock Holmes who fought ignorance, politics, and injustice as well as the disease. Even when the mystery of this preventable killer was solved, pellagra raged for another generation. It was as if the disease mocked science as crucial but insufficient. Pellagra is no longer a national health threat, and that is exactly why the experience of its conqueror is worth retelling. Pellagra was known as the disease of the three D’s: dermatitis, diarrhea, and dementia. Victims suffered scaling, leprous skin, intestinal distress, lethargy, and depression. The trademark symptom was a butterfly rash—an ugly symmetrical blotch that spread across the victim’s face—marking him or her for all to see.
    [Show full text]
  • Environmental Development 1 (2012) 3–9
    Author's personal copy Environmental Development 1 (2012) 3–9 Contents lists available at SciVerse ScienceDirect Environmental Development journal homepage: www.elsevier.com/locate/envdev John Snow, the Broad Street pump and the precautionary principle Bernard D. Goldstein University of Pittsburgh, Pittsburgh, PA, United States article info abstract Article history: In 1854 John Snow was responsible for a major advance in Accepted 30 August 2011 environmental health science when he demonstrated that cholera epidemics were waterborne rather than airborne. By mapping the Keywords: disease outbreak he identified a specific London water source, the John Snow Broad Street pump, as its proximate cause. Removal of the pump Precautionary principle handle was temporally related to the end of the epidemic. For his Environmental science very careful mapping of an epidemic resulting in a new under- Epidemiology standing of the cause of disease John Snow is considered to be the Toxicology father of the science of epidemiology. More recently, many who advocate the precautionary principle have adopted this historic event as paradigmatic of action taken under precaution. They point out that Snow’s efforts occurred before the identification of the cholera microbe or an understanding of the germ theory of disease. Snow’s example seems to demonstrate that it is important to act on the possible association of a cause with an effect without a theoretical underpinning for the association and in preference to obtaining the scientific information needed to appropriately inform the decision. In contrast, I argue that Snow, an accomplished inhalation toxicologist, used his basic science knowledge to discard the erroneous associations that had previously led to the belief that cholera was an airborne disease.
    [Show full text]
  • Medicine in Eighteenth and Nineteenth Century Britain, C.1700-C.1900
    Year 10 History Knowledge Organiser – Key topic 3: Medicine in eighteenth and nineteenth century Britain, c.1700-c.1900 2. Key dates 1. Key terms 1 1796 Edward Jenner tested his vaccine on James Phipps. He infected him with cowpox, and this 1 Microbes A living organism which is too small to see prevented him catching smallpox. without a microscope, this includes 2 1842 Edwin Chadwick published his ‘Report on the Sanitary Conditions of the Labouring Classes’. bacteria. 1847 James Simpson discovered that chloroform could be used as an anaesthetic. 2 The A movement of European intellectuals that 3 Enlightenment emphasised reason rather than tradition. 4 1848 First Public Health Act – set up Boards of Health but was not compulsory. 3 Decaying Matter Material, such as vegetables or animals, that has died and is rotting. 5 1854 John Snow mapped the spread of disease around the Broad Street pump to prove that cholera was caused by dirty water. 4 Bacteriology The study of bacteria. 6 1858 The Great Stink near the Houses of Parliament prompted action on sewage. 5 Tuberculosis A disease which affects the lungs causing serious difficulties in breathing. 7 1861 Louis Pasteur published the Germ Theory 6 Cholera A waterborne disease which killed many 1865 Joseph Lister used carbolic acid for the first time. He wrapped up a leg after an operation in th 8 people in the 19 century by causing the acid-soaked bandages and the wound healed cleanly. body to become dehydrated. 9 1875 Second Public Health Act, made government intervention in public health compulsory.
    [Show full text]
  • Water's Deadly Connection
    WaterAid Water Wise Key stage 2/3 activities Water’s deadly connection WaterAid transforms lives by improving access to clean water, hygiene and sanitation in the world’s poorest communities. Registered charity numbers 288701 (England and Wales) and SC039479 (Scotland) Water’s deadly connection Today we know that tiny microbes carried in water can cause all sorts of diseases. However, the connection between germs and illness was not always recognised. In fact, before the mid 1800s, diseases were thought to be caused by stale or "bad" air. There was little understanding about how microscopic life could affect humans. In 1861, things changed. With the presentation of the "germ theory of disease", microscopic organisms were identified as the cause of many diseases. In 1854, a cholera outbreak in London was studied and analysed by the British physician John Snow. By plotting the location of cases, Snow was able to discover that the cluster of cases seemed to suggest an association with water not “disease causing” air. Can you do the same type of investigative work? In this activity, you'll model Snow's strategy as you plot and analyse the location of victims of a mysterious waterborne epidemic. Materials Pencil Copy of Snow's London map and victim location table Steps 1. Examine the map entitled "John Snow's Map of London". Note how an overlay of the grid lines divides the map into 49 square regions. Each of these regions is identified by a letter (horizontal row) and a number value (vertical column). 2. Examine the table that illustrates the location of the disease victims.
    [Show full text]
  • 28Th Pumphandle Lecture 2020 “Africa CDC: a New Public Health Order” by John Nkengasong
    Broad Sheet The newsletter of the John Snow Society Summer 2020 28th Pumphandle Lecture 2020 “Africa CDC: A New Public Health Order” by John Nkengasong Dr. John Nkengasong is Director of the Africa He has received numerous awards for his Centres for Disease Control and Prevention. work including the Sheppard Award, and the William Watson Medal of Excellence, Prior to his current position, he served the highest recognition awarded by CDC. as the acting deputy principal director He is also recipient of the Knight of Honour of the Center for Global Health, United Medal by the Government of Cote d’Ivoire, States Centers for Disease Control and was knighted in 2017 as the Officer of Lion Prevention (U.S. CDC), and Chief of the by the President of Senegal, H.E. Macky Sall, International Laboratory Branch, Division and Knighted in November 2018 by the of Global HIV and TB., U.S CDC. government of Cameroon for his significant contributions to public health. He is an He received a Masters in Tropical adjunct professor at the Emory School of Biomedical Science at the Institute Public Health, Emory University, Atlanta, GA, of Tropical Medicine in Antwerp, and serves on several international advisory Thursday Belgium and a Doctorate in Medical boards including the Coalition for Epidemic 10th September Sciences (Virology) from the University Preparedness Initiative (CEPI) and the International AIDS Vaccine Initiative (IAVI). 3:00 pm London time of Brussels, Belgium. Because of the Covid-19 Please note that places are limited and thus prior registration is necessary. crisis, the lecture will be Members are being informed first, with this Broadsheet notice, and are delivered remotely.
    [Show full text]
  • The Role of Urban Planning in the Spread of Communicable Diseases
    I have seen the greatest wonder which the world can show to the astonished spirit. - Poet Heinrich Heine on London, 18271 uring the 19th century, London emerged diseases such as obesity, diabetes, and heart Das a center of commerce and industry. disease, communicable diseases – infectious As the city urbanized, the population rapidly diseases that are transmissible by direct grew from one to six million residents. contact with an affected individual, through This unprecedented growth resulted in the individual’s discharges, or by indirect London becoming an “infamously filthy”2 means, such as a vector13 – make up seven city complete with cemeteries “bursting with of the top ten causes of death in low-income stinky corpses,”3 air filled with soot, and nations.14 An increasingly globalized world streets lined with feces.4,5 These concerns has opened all nations up to the possibility were not simply aesthetic; the dirt and filth of a deadly disease outbreak, even nations that defined 19th-century London caused that previously believed these communicable serious health complications, including the diseases to be eradicated. In this paper, I The Role of Urban spread of cholera.6,7,8 expand upon the impact our increasingly urbanized and globalized world has on the Three cholera epidemics struck London spread of the flu, diarrheal diseases, and Planning in the Spread of between 1832 and 1866, killing tens of Severe Acute Respitory Syndrome (SARS). thousands.9 Cholera can induce vomiting Additionally, I discuss how land use planning and diarrhea so severe that they lead to can increase the exposure and spread of Communicable Diseases dehydration, and death can occur within Ebola Viral Disease (EVD).
    [Show full text]
  • Joseph Goldberger & the War on Pellagra
    Joseph Goldberger & the War on Pellagra Dr. Joseph Goldberger & the War on Pellagra Pellagra no longer stalks the nation as it once did. But during the early part of the 20th-century, pellagra, a disease that results from a diet deficient in niacin, killed many poor Southerners. Dr. Joseph Goldberger, a physician in the U.S. government's Hygienic Laboratory, the predecessor of the National Institutes of Health, discovered the cause of pellagra and stepped on a number of medical toes when his research experiments showed that diet and not germs (the currently held medical theory) caused the disease. He also stepped on Southern pride when he linked the poverty of Southern sharecroppers, tenant farmers, and mill workers to the deficient diet that caused pellagra. Table of Contents Introduction The Early Years: An Immigrant Youth The Bright Young Dr. Goldberger Goldberger and the "Pellagra Germ" Ashes on the Potomac Acknowledgments Photography Credits Display Case in Building One Dr. Joseph Goldberger discovered the cause of pellagra, a disease resulting from a diet deficient in vitamin B. Pellagra killed many poor Southerners in the early part of the 20th century. Introduction Eighty years ago, long before Dr. C. Everett Koop and a new generation of public health professionals suffered social criticism in their public health pronouncements on AIDS, Dr. Joseph Goldberger, Surgeon in the United States Public Health Service, was doing much the same thing. Even as Koop has been critical of personal behavior and social policies that could put populations at risk of acquiring the AIDS virus, Goldberger warned Americans about the crucial link between poor nutrition as the result of poverty and the onset of a scourge known as pellagra.
    [Show full text]
  • The COVID-19 Wicked Problem in Public Health Ethics: Conflicting
    COMMENT https://doi.org/10.1057/s41599-021-00839-1 OPEN The COVID-19 wicked problem in public health ethics: conflicting evidence, or incommensurable values? ✉ Federica Angeli 1 , Silvia Camporesi 2 & Giorgia Dal Fabbro3 While the world was facing a rapidly progressing COVID-19 second wave, a policy paradox emerged. On the one side, much more was known by Autumn 1234567890():,; 2020 about the mechanisms underpinning the spread and lethality of Sars-CoV- 2. On the other side, how such knowledge should be translated by policymakers into containment measures appeared to be much more controversial and debated than during the first wave in Spring. Value-laden, conflicting views in the scientific community emerged about both problem definition and subsequent solutions surrounding the epidemiological emergency, which underlined that the COVID-19 global crisis had evolved towards a full-fledged policy “wicked pro- blem”. With the aim to make sense of the seemingly paradoxical scientific dis- agreement around COVID-19 public health policies, we offer an ethical analysis of the scientific views encapsulated in the Great Barrington Declaration and of the John Snow Memorandum, two scientific petitions that appeared in October 2020. We show that how evidence is interpreted and translated into polar opposite advice with respect to COVID-19 containment policies depends on a different ethical compass that leads to different prioritization decisions of ethical values and societal goals. We then highlight the need for a situated approach to public health policy, which recognizes that policies are necessarily value-laden, and need to be sensitive to context-specific and historic socio-cultural and socio- economic nuances.
    [Show full text]