In King County our budget process has always been placed above political ambition and the parochial self-interest of different branches. It is my fervent hope that that tradition will continue as we grapple with the most difficult budget the County has ever faced. Unfortunately, that isn’t the tempo of recent public discussions.
Who stands to lose if we continue down the battle path, you the taxpayer, voter, and resident of King County? So the question for you: do you have any skin in this budgetary game?
With all of the recent posturing, press releases, press conferences and rumor mongering, one of the most critical services the County provides has received very little discussion. In this day and age of confrontational politics and news, it could become the unfortunate victim.
So, let me digress a bit. Remember these points. The human body is an ecosystem, flourishing and nurturing hundreds of millions upon billions of bacteria and microbes; the history of disease should worry us; human beings are not a stationary species; and, when we kiss, hold or shake hands, share our food, or engage in sex, we are simply mixing up a new batch of microbial material!
History is replete with the impacts of infectious diseases. Insects, birds, rats, plants, and humans have transmitted these diseases. They have reshaped history and retired entire cultures. Germs reshaped the history of the lands we now call the United States. Disease nearly eradicated the Native American population of North America. It is estimated that two thirds of the Native American population died of illnesses introduced by Europeans. Do we face these same threats today? According to all of the experts, the threat is growing at an ever-increasing rate. These organisms are mutating and evolving with remarkable speed with increasing resistance to medical treatment: they are genetically shrewd and wish to survive. SARS, avian influenza, hantavirus and extensively drug resistant tuberculosis are just a few recent examples of newly identified infectious agents that have caused serious human illness. Our food production and distribution system makes it easier than ever for contaminated products to reach large numbers of persons spread over wide geographic areas. So far this year the US has seen more measles cases than any time since 1996, primarily do to infected persons from other countries traveling to the US and setting off a series of outbreaks. How does all of this happen?
Wikipedia provided this description of the skin: ”The skin supports its own ecosystems of microorganisms, including yeasts and bacteria, which cannot be removed by any amount of cleaning. Estimates place the number of individual bacteria on the surface of one square inch (6.5 square cm) of human skin at 50 million though this figure varies greatly over the average 20 feet2 (1.9 m²) of human skin. Oily surfaces, such as the face, may contain over 500 million bacteria per square inch (6.5 cm²).” That is just the skin!
But, it isn’t just our skin that houses bacteria and microbes. Dr. Trudy M. Wassenaar, in “Bacteria more than Pathogens” says, “We house millions of bacteria on our skin and in our nose, mouth, and gut:
- Up to 500 species can be found as normal oral flora
- There can easily be 25 species living in a single mouth
- A milliliter of saliva can contain as many as 40 million (4 x 107) bacterial cells
- 108 bacterial cells present in the cecum (the initial part of the colon) per milliliter of content is normal and many of these species are different from those found in the mouth
- We are born sterile (free of bacteria) but within hours we are colonized by our little friends, not to be left alone again.”
NPR reports, “The human body contains 20 times more microbes than it does cells. In fact, a visitor from outer space might think the human race is just one big chain of microbe hotels.” Inside and out, we are just one big carrier of other life forms!
But, why should King County government care about your body or mine?
Typically, we live in a natural, harmonious balance with the multitude of organism we naturally carry within our bodies and even more potential pathogens living in innumerable natural reservoirs in the environment, including animals, water and soil (I.e., influenza and avian influenza viruses, Legionnaire’s disease, leptospirosis, E. coli, salmonella and other food-borne diseases). We’re literally surrounded by infectious agents.
But, all too often, that natural balance is upset, leaving us vulnerable to disease. Germs constantly learn new tricks – development of drug resistance and new virulence traits allow them to cause disease more effectively in human populations. In addition, new infectious agents emerge when we upset the balance between man and nature, encroaching on new habitats (SARS).
As Mary Wilson from the Harvard School of Public Health and the Harvard Medical School in her seminal paper “ Travel and the Emergence of Infectious Diseases” states, “Today’s massive movement of humans and materials sets the stage for mixing diverse genetic pools at rates and in combinations previously unknown. Concomitant changes in the climate, technology, land uses, human behavior, and demographics converge to favor the emergence of infectious diseases caused by a broad range of organisms in humans, as well as in plants and animals.” Simply put, the introduction of an infectious disease can happen any day, and at anytime. It is not a matter of if, but when. They will arrive with someone, likely a visitor, relative, friend, or a neighbor.
What organizations are there to protect us? The United Nation’s World Health Organization, the US Center for Disease Control, and most importantly, our King County Department of Public Health are responsible for our health safety. The Department of Public Health is our key local first responder, our community’s immune system. It is that department that has the primary responsibility to prevent, detect, treat, and control the widespread introduction of diseases.
Our local Public Health Agency quietly protects us from infectious diseases every single day. They insure that our food and water are safe to consume. If the local and national health and economic security of the general population were our highest priority, public health would also be our highest priority. It is there that the greatest number of lives can be saved and protected. It is that department who we will all turn to when the infection eventually lands as SeaTac; or arrives at our ports; or drives here on I-90 or I-5. If the Department of Public Health fails, we all lose.
Balancing a budget is a challenge. Public Health must be a priority. One can make a compelling case for the preservation of social safety nets, public safety, and justice. We will need a balanced approach. This is not a time for the cynical and expected game of political one-upmanship. Nor should we tolerate the voices that play to our fears, suspicions, distrust, and our base interest. We are a better community when the voices we hear speak to our optimism, even in the most trying times. Maybe we’ll be pleasantly surprised. Maybe, there is a glimmer of a chance that the common good will be united with common sense. Maybe.
- CDC: Traveler’s Health
- Foreign Affairs Magazine: Preparing for the Next Pandemic
- Viruses, Plagues, and History
- How Columbus sickened the New World: Why were Native Americans so vulnerable to the diseases European settlers brought with them?
- When Germs Travel
- When bugs outwit drugs
- Diseases Decimate Native American Populations
- Threat of infection: Microbes of high pathogenic potential – strategies for detection, control and eradication
- Preparing for the Next Pandemic
- Antimicrobial resistance
- Infection Control Today Magazine
- Microbial Threats to Health: The Threat of Pandemic Influenza
- The Global Threat of Emerging Infectious Diseases
- Can We Detect ‘The Coming Plague’