A public health expert who once won the United States Pulitzer Prize but was more confused by the prediction of success again and again

Laurie Garrett, born in 1951, is 69 years old this year. Because of the numerous warnings of infectious diseases, people are known as the prophet Cassandra in Greek mythology-she succeeded The demise of Troy was predicted, but no one heard his predictions and warnings. Her labels for herself are: writers, world health policy analysts, speakers, public intellectuals, and Pulitzer Prize-winning journalists.

From Joshua Bright, Laurie Garrett is striving for New York to fight the new crown on the roof of his house. This article from the micro-channel public number: end to end sauce (ID: DuanduanReport), Author: end to end Sauce (US Fulbright Visiting Scholar public health programs)

Laurie Garrett, a science journalist and public health expert who won the Pulitzer Prize for reporting the Ebola virus outbreak, has been exhausted in the past few months. In an interview, her important tasks range from previous public health knowledge popular science and policy interpretations to constant rumors after Trump issued a statement-this is as important as reporting the truth.

“I never thought I was rumoring the stupid remarks of this country’s leader every day.” Garrett said, from the beginning Trump declared that the United States has the ability to control, to promote the new drug results to promote the injection of disinfectant, she felt terrible , Calling Trump “the most incompetent and stubborn harlequin.”

She also expressed disappointment with the US professional institutions. From the beginning of the outbreak, she has been continuously inquired from the CDCs around the world, except that there is no US CDC. “.

Her professional background and smooth public expression have always been a rare voice. As a talented student graduating from Stanford University, Garrett spent his entire life in scientific writing and science communication. She is a true expert science reporter: an undergraduate biology major, a graduate student in microbiology and immunology at Berkeley, California, and a PhD candidate following the famous geneticist Leonard Herzenberg at Stanford University School of Medicine.

She was a research fellow at the Harvard School of Public Health, a senior fellow in global health at the US Foreign Relations Commission, and a consultant for the 2011 American film “Infectious Diseases”, and she has a deep understanding of the global pandemic of infectious diseases. It is worth mentioning that the movie “Infectious Disease”, which was affected by the new crown epidemic and described the fatal impact of the fictitious virus MEV-1, is back on the online hot list.

Stills of the movie “Infectious Diseases”

On January 25, 2020, at the early stage of the spread of the new crown virus, Garrett urgently wrote an article “How to ensure safety in the face of new viruses”, pointing out that the spread of contact with hands and the spread of droplets are the main reasons for the spread of the virus epidemic. Fully considering the difference between public health and clinical medical protection, it has been repeatedly emphasized that wearing gloves is the simplest and most effective way to prevent the spread of contact between hands. Whether it is disposable plastic gloves or daily warm gloves, as long as it is kept dry and clean, it can be effectively blocked The spread of new coronaviruses.

(Note: At that time, the International Virus Taxonomy Commission and WHO had not officially named Covid-19.)

Over the past two or three decades, she has told the media and the public numerous times that to fight the epidemic of infectious diseases, the hospital is only the last line of defense, and the Public Health system is crucial. Now that the world is so closely connected, every country should prepare its public health system before the infectious disease arrives, and always update itself.

But she was still confused, whether her cry of exhaustion had been accepted.

“I told CNN that I will no longer accept (their) interviews unless they can respond to my doubts about the hygienic environment in their editing room.” Garrett said that everyone in CNN’s editing room uses the same set all day long Sunburn brushes, lipsticks and makeup artists can hardly imagine that such an environment will not spread viruses.

Americans call Garrett a prophet because she predicted the outbreak of this large infectious disease in advance. “Garret not only predicted the impact of HIV, but also had a prophetic vision for the emergence and spread of more infectious diseases worldwide,” said Frank Bruni, a columnist for the New York Times.

As early as the early 1990s, Garrett attracted attention because of his excellent coverage of AIDS. In 1996, she won the Pulitzer Prize for writing “The Approaching Plague”. In the book, Garrett recorded the process of the outbreak and research of plagues around the world in the second half of the 20th century in a literary style, calmly analyzed the root causes of the plague, and described human discovery, research on Ebola, Lassa fever, The history of AIDS and other infectious diseases reflects on the relationship between humans and infectious pathogens, and proposes that modern society has profoundly changed the nature of diseases. Human activities are actually one of the reasons for infectious diseases.

Garrett’s writings

More Westerners likened her to the prophet Cassandra, a female prophet in Greek mythology who successfully predicted the demise of Troy, but her predictions and warnings were not heard.

One of the myths about the ability of prophecy is: Cassandra rejected Apollo ’s idea of ​​having a relationship, and Apollo cursed her with all his anger: all the prophecies she said would be sent out, but no one believed it. . Cassandra has been issuing warnings of prophecy, but her predictions are all the worst results-betrayal, negligence, human death, the fall of the country. People not only didn’t believe her, they mocked her and hated her. Her ability to predict will become the source of her endless suffering in the future. Another way to predict the source of the predictive power is “the god snake uses his tongue to wash his ears, so he can foresee the future.”

Cassandra

Also in 1996, Garrett wrote the article “Return of Infectious Diseases”, which pointed out that the great improvement of the public health environment in the 20th century gave Western countries an “unrealistic optimism” for infectious diseases. The epidemic and other viral outbreaks show that the Western medical community’s argument that “humans are very immune to infectious diseases” is still too early to say.

Garrett found that after the Second World War, in order to eradicate the spread of infectious diseases, the global public health system was committed to developing medical technologies such as antibiotics and vaccines to eliminate pathogens such as viruses, germs and parasites. The anti-epidemic experts at that time were optimistic that this near-military anti-bacterial fight would save humans from the interference of infectious diseases before the 21st century and only face the risk of chronic diseases such as cancer, heart disease and Alzheimer’s disease.

In 1977, with the World Health Organization’s announcement that the last known case of smallpox was discovered and successfully cured in Ethiopia, human optimism towards the victory of the virus also peaked.

In 1978, the World Health Organization issued the “Health for All by the Year 2000” strategy (Health for All by the Year 2000), which set ambitious goals for the elimination of disease and expected that the poorest countries will also be in the millennium Prior to completing the transformation of public health, significantly increased life expectancy. At the same time, antibiotics, insect repellents, chloroquine, other powerful antimicrobial drugs and vaccines have been continuously innovated, and water treatment and food preparation technologies have been significantly improved. It seems to provide humans with powerful weapons to fight microbes.

However, the formation of this optimism stems from two false assumptions: first, the microorganisms are constant in the biological sense; second, the disease can be geographically blocked. These two assumptions make North American and European health professionals take it lightly in the battle against infectious diseases. In fact, in addition to static microorganisms, any microorganism and its transmission receptors (such as insects, rodents and other animals) are by no means static. They continue to evolve.

Darwin pointed out that certain gene mutations can make animals and plants better adapt to environmental conditions, so as to multiply and reproduce; he believes that the process of natural selection is the evolutionary mechanism. Less than ten years after the US military first provided penicillin to field doctors in the Pacific theater, geneticist Joshua Lederberg proved the role of natural selection in the bacterial world. Staphylococcus and streptococcus strains that happen to carry drug resistance genes will multiply quickly when the drug-sensitive strains are expelled. Therefore, the use of antibiotics can select bacteria with higher drug resistance.

In recent years, scientists have witnessed an amazing mechanism for microorganisms to adapt to the environment-a random mechanism that relies less on inheritance. These stable DNA or RNA molecules not only carry genetic information that can improve the adaptability of microorganisms, but also can jump between different bacteria, even fungi and parasites to spread this information.

This mechanism allows microorganisms to escape from the infestation of antibiotics and other drugs, thereby evolving the viability to adapt to new environments, being able to resist multiple antibiotics or special drugs, possessing greater toxicity and infectivity, as well as disinfectants, chlorine, and high temperatures And tolerance to acidic environments. Microbes have emerged that can grow on soap, swim in bleach, and tolerate penicillin doses much higher than those used in 1950.

The large and constantly evolving genetic database of the microbiome provides them with countless ways to fight drugs. In contrast, the weapons that humans fight against seem to be diverse, but in reality they are limited. In 1994, the Food and Drug Administration (FDA) approved only three new antimicrobial drugs, two of which were used to treat AIDS, but none of them had antibacterial effects.

Since humans have developed ways to imitate microorganisms competing in the human gastrointestinal tract to eliminate viruses, bacteria, fungi, and parasites, the current research and development of antibiotics is almost stagnant. Researchers have been unable to deal with the damage caused by many microorganisms.

In addition, for those microorganisms that mainly appear in less developed countries, local research institutions lack the financial capacity to develop drugs against related microorganisms. James Hughes, then director of the National Center for Infectious Diseases, said: “We are indeed facing a global crisis.”

Garrett knew that people ’s memories were short-lived. Every time the epidemic was the worst, everyone would be angry, disappointed, and determined to change the bad reality. Some voices even crossed generations and dimensions, but it did n’t take long for the epidemic to disappear. , People will leave everything behind.

No matter how she shouts, fewer and fewer countries are investing money to improve the health of the poor. In fact, they are the high-risk group for outbreaks of infectious diseases.

Investment in public health has also declined. Not only did she remember the days when she was doing research at Harvard Medical School, the entire medical school campus was full of splendid buildings, but the School of Public Health was a ugly and ugly building, which made people worry about the ceiling at any time. drop down.

“This is in the United States?” The New York Times reporter asked her.

“This is in America!” She answered.

In 2014, when the Ebola outbreak came again, developed countries seemed to have been convinced that its advanced medical facilities and perfect rescue system could stop the spread of the virus until it was infected by Spanish nurse Teresa Romero Ramos in Madrid After the first Ebola patient in the United States was diagnosed, the talents were awakening “the virus is spreading to the United States, and no one can be alone.”

She is neutral to all the new crown drugs that are circulating in the world today, because the “sacred medicine” is only effective to shorten the recovery time, and “what we really need is a curable drug or vaccine.”

There are new reports about the time when the vaccine was developed, and the fastest has already claimed to be available in the fall. But Garrett insisted that “the fastest time is next year.”

“The United States already has the fastest testing and action, but what people really need is not these. What they need is a truly perfect public health system. What they need is scientifically accurate test design and thorough reform.” Garrett emphasized.

When the reporter repeatedly asked how the Garrett epidemic will progress, she said that the crystal ball in her hand was black. People dreamed of returning to normalcy immediately, but maybe never, and we will enter the “new normal”- — “The epidemic will fluctuate like waves, rather than a sudden attack like a tsunami, but then it will retreat all over again, at least in the United States.”

“The best result is that the epidemic will end in 36 months.” Garrett predicted again.

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