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Do an Eye Op

Was a time when surgeons would get someone to hold open the pages of a book and do their first-ever eye op, squinting at the pages through their monocle. And they’d get someone else to hold open the lids of the eye!

Often none of these assistants, and often not the surgeon, would wash their hands. What for?

In 1847, a young Hungarian obstetrician noticed the dramatically high maternal mortality following births assisted by doctors and medical students. However, those attended by midwives were relatively safe. Investigating further, he realized that these physicians had often come directly from autopsies. He decided that something was contagious, and that matter from autopsies was implicated. So he made doctors wash their hands with chlorinated lime water before examining pregnant women. He then documented a sudden reduction in the mortality rate in the next year from 18% to 2%.

So they thanked him, right? Never! Semmelweiss and his theories were rejected by most of the contemporary medical establishment. How dare a 29yr-old come up with new evidence when all the eminent old surgeons already KNEW everything!?

Fourteen years later, in 1861, he wrote about his theory and was ridiculed. Eminence triumphed over evidence. What caused those deaths was not cadaverous infection, for goodness sake! It was ‘conception and pregnancy, uremia, pressure exerted on adjacent organs by the shrinking uterus, emotional traumata, mistakes in diet, chilling, and atmospheric epidemic influences.’ Anything BUT what this unpopular man and his evidence suggested! We do NOT have to wash our hands, understand?

Semmelweis got depressed, started drinking and acting weirdly and was eventually tricked into visiting a mental institution where he was held captive. He tried to leave and was severely beaten by several guards, secured in a straitjacket, confined to a darkened cell, doused with cold water and administered laxatives. He died after two weeks, on August 13, 1865, aged 47.

We’re a whole lot luckier 144 years later!

But we still have to keep a wide-awake wary eye out for the ever-present danger of ’eminence over evidence!’

~~~oo0oo~~~

134yrs later it happened again. The so-called Semmelweis reflex—a metaphor for a certain type of human behaviour characterized by reflex-like rejection, ridicule, and rejection by contemporaries of new knowledge because it contradicts entrenched norms, beliefs, or paradigms—is named after Semmelweis. In 1981, in his third year of internal medicine training, Barry Marshal in Perth, Aussie realised bacteria caused ulcers. Well, he was ridiculed. Eminence over evidence again. Us important, established old bullets who haven’t done the research just KNOW you’re wrong. You’re 29yrs old, keep quiet! You’re threatening a $3bn industry! It took till 1993 before he was believed. At least this time, Barry Marshal eventually got recognised while he was still alive: Twenty four years later he got the Nobel Prize!

~~~oo0oo~~~

Yes, we could talk about germ theory denial and hand-washing avoidance in 2020 too . . .

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COVID and Ordinary People

Trying to stay on top of COVID news? We have no choice but to do so, to best protect ourselves and our loved ones. It’s stressful and draining, but we have to do it.

This post is paraphrased and shortened from an article by Alanna Shaikh, a global public health expert and a TED Fellow, for tips on how to navigate this information overload while staying safe and sane (for full article, see here ).

1. Look for news that you can act on

When you’re trying to figure out what stories to stay on top of, ask yourself: “Will having this information benefit my life or my work? Will it allow me to make better-informed decisions?”

Accumulating masses of information that you can’t use isn’t so helpful.

For most people, the most critical information for you to follow is how the virus is transmitted. Scientists are still learning every day about how people get infected.

2. Turn to trusted sources

If something reaches you on your whatsapp or instagram in Blikkiesdorp, chances are people professionally covering the pandemic heard it before you did.

So go and see what they say about it. COVID-19 has been heavily politicized, and even some major news sources are basing their content more on opinion than on science.

You can generally trust the accuracy of top news sources like Nature, Wired and The New York Times — to name three examples. Why? Cos their reputations are at stake. And they have the kind of budget that lets them hire full-time journalists who will stand by the facts or who rely on fact-checkers to verify their information. Unfortunately, you also have to check your fact-checkers. Use reputable ones like these eight listed here. In Africa we have Africa Check.

3. Check where their information is coming from

No-one actually KNOWS, so be wary of articles or sources that claim to have a definite answer to a complex question. Be especially wary of forwarded stuff on your social media. The way posts go viral is by being controversial or scary, not by being true.

For example, Dr. Anthony Fauci is currently saying that there should be a vaccine for COVID-19 in early 2021;

the Gates Foundation has a longer estimate; and others are warning that we may never have a vaccine for it.

Right now, there is no consensus about a timeline — these people and organizations are simply offering their best guesses. Use fact-checking sites – find one here. Even when a vaccine “arrives” it will be a while before you or I get one; and a while before enough people get one to potentially be effective; and even then, only time will tell the actual outcome. The much-hyped ‘fastest’ vaccines are using RNA for the first time. Proven vaccines actually injected an antigen which your body responded to; RNA vaccines will inject instructions to your body cells to MAKE an antigen, which your body will THEN need to respond to. There’s an extra step. Let’s hope it works, lasts, etc.

4. Look for news that works for you

For ordinary people whose expertise lies outside global health — i.e. most people — look for trusted sources of information that you can read and digest without having to devote your whole day (or brain) to it. Like the Think Global Health website; it’s aimed at passionate non-experts. It’s not dumbed down, but it doesn’t assume you have a PhD.

Johns Hopkins University is publishing some great work on COVID — more technical, but not too technical.

So is Vox; they have some terrific explainers.

5. Be prepared to change your behavior based on new information

No source is perfect, but that doesn’t mean you should disbelieve all sources. Research constantly changes and informs and shapes our ideas.

Remember when wiping down surfaces was the MAIN thing? Now, reputable organizations and scientists basically agree on masks, contact tracing and the existence of transmission of COVID by people who aren’t showing symptoms. If you get sick you will probably never know who ‘gave it to you,’ as they would have felt as healthy as you did the day the virus was transmitted.

Some of this info may change again, but we need to keep going along with best practice AS FAR AS WE KNOW TODAY.

6. Refrain from arguing with people who ignore the facts

Save your breath. Yours and theirs might be contagious!

You WON’T change their minds.

You are not a law enforcer.

Like it or not, this situation isn’t going anywhere. This pandemic is awful and complicated and changing. Finding our way through it won’t be smooth, nor easy, nor emotionally comfortable. It’s a constant, dynamic process of learning new things and adapting as we learn.

~~~oo0oo~~~

That lovely pic is from the cover of Wits Review Oct 2020, magazine for University of the Witwatersrand alumni.