Prevention remains effective as any cure
February 18, 2021
To The Eagle:
While researching germ transmission in 1897, German physician Carl Flugge measured how far bacteria laden spittle traveled from the mouths of volunteers. Six feet was determined to be the average.
That figure remains the universal standard for adequate social distancing. In Sweden there are caution signs exhorting folks to “Please keep a distance the size of a small moose between yourselves and others.”
Doctor Flugge was obsessed with hygiene. In his day there were few effective medicines to offer the sick beyond opium and quinine. Few vaccines were available. Some physicians decided that the best way to help was to find out how to keep patients from getting sick in the first place. While Flugge was measuring droplet travel, New York City was being overcome by Tuberculosis, a fatal respiratory disease that was claiming ten thousand lives a year. A local doctor, Hermann Biggs, proposed actions that he believed could save lives: reporting all TB patients to the health department and tracking everyone with whom those patients had close contact.
Other physicians protested, calling the moves “aggressive tyrannies” and “offensively dictatorial.” Dr. Biggs also pushed for another novel concept: that people cover their mouths while coughing and for tubercular patients to be isolated from healthy people. Even with no advances in medication, Bigg’s careful attention to the “sharing of air” helped cut the number of citywide TB cases in half.
In the post-antibiotic decades that followed, the old physical precautions were abandoned. Antibiotic resistant strains of TB emerged. Case numbers doubled between 1980 and 1990.
Despite access to powerful antibiotics, New York was doing worse than Dr. Biggs had done ninety years before through education and no antibiotics at all. Inexpensive public health interventions like covering one’s mouth, maintaining distance, case tracking and isolation saved more lives than advances in clinical medicine. Yes, Covid-19 vaccines have become available but please, do not abandon your safety precautions. Prevention remains as effective as any cure.