RESUMO
The article takes the renewed popularity and interest in epidemiological modelling for Covid-19 as a point of departure to ask how modelling has historically shaped epidemiological reasoning. The focus lies on a particular model, developed in the late 1920s through a collaboration of the former field-epidemiologists and medical officer, Wade Hampton Frost, and the biostatistician and population ecologist Lowell Reed. Other than former approaches to epidemic theory in mathematical formula, the Reed-Frost epidemic theory was materialised in a simple mechanical analogue: a box with coloured marbles and a wooden trough. The article reconstructs how the introduction of this mechanical model has reshaped epidemiological reasoning by shifting the field from purely descriptive to analytical practices. It was not incidental that the history of this model coincided with the foundation of epidemiology as an academic discipline, as it valorised and institutionalised new theoretical contributions to the field. Through its versatility, the model shifted the field's focus from mono-causal explanations informed by bacteriology, eugenics or sanitary perspectives towards the systematic consideration of epidemics as a set of interdependent and dynamic variables.
Assuntos
Epidemias , Estudos Epidemiológicos , Epidemiologia/história , História do Século XX , Humanos , Modelos TeóricosRESUMO
Although every emerging infectious disease occurs in a unique context, the behaviour of previous pandemics offers an insight into the medium- and long-term outcomes of the current threat. Where an informative historical analogue exists, epidemiologists and policymakers should consider how the insights of the past can inform current forecasts and responses.
Assuntos
COVID-19/epidemiologia , Epidemiologia/história , Pandemias/história , História do Século XIX , História do Século XX , História do Século XXI , Humanos , Influenza Humana/epidemiologia , Influenza Humana/história , Modelos TeóricosRESUMO
A 19th century physician was crucial to the establishment of 2 medical specialties-anesthesiology and public health. Everyone whose interest in public health has increased in the last year will be amazed at Dr John Snow's career in anesthesiology. Those who recognize him as the first full-time physician anesthetist will be struck by his development of medical mapping during the Cholera Pandemic of 1848, resulting in one of the fundamental techniques of epidemiology and public health that has continued through today. Snow's accomplishments in anesthesiology and epidemiology reflected a concatenation of science, focus, and creativity. His training in the early 19th century integrated science, medicine, and his keen interest in respiratory physiology. His early clinical exposure to colliery workers in Newcastle was likely influenced by the earlier development of pneumatic medicine. He was committed to the notion that chemistry, especially the use of medicinal gases, would be transformative for medicine. Thus, he was "primed" when the news of the American anodyne ether reached London in 1846. When the third cholera pandemic reached London shortly thereafter, in the fall of 1848, his academic and practical understanding of gas chemistry and pharmacology, respiratory physiology, and anesthetic agents led him to question the popularly promulgated miasma-based theories of transmission. His methodical investigations, research, and perseverance were mirrored in his scholarly work, numerous presentations, and public advocacy. He articulated many scientific principles essential to the early practice of anesthesia-anesthetic potency, quantitative dosing of anesthetic agents, engineering principles required for conserving the latent heat of vaporization, and minimizing the contribution of anesthetic equipment to airway resistance. He moved easily and methodically between these worlds of physiology, chemistry, engineering, clinical medicine, and public health. In his role as the first medical epidemiologist, Snow understood the power of medical mapping and the graphic presentation of data. He was a pioneer in 2 nascent fields of medicine that were historically and remain contemporarily connected.
Assuntos
Anestesiologia/história , Epidemiologia/história , Ciência/história , Anestesia/história , Anestesiologistas , Cólera/história , Inglaterra , Epidemiologistas , História do Século XIX , Médicos , Saúde PúblicaRESUMO
BACKGROUND: The worldwide tragedy of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic vividly demonstrates just how inadequate mitigation and control of the spread of infectious diseases can be when faced with a new microorganism with unknown pathogenic effects. Responses by governments in charge of public health, and all other involved organizations, have proved largely wanting. Data infrastructure and the information and communication systems needed to deal with the pandemic have likewise not been up to the task. Nevertheless, after a year of the worldwide outbreak, hope arises from this being the first major pandemic event in history where genomic and related biosciences - relying on biomedical informatics - have been essential in decoding the viral sequence data and producing the mRNA and other biotechnologies that unexpectedly rapidly have led to investigation, design, development, and testing of useful vaccines. Medical informatics may also help support public health actions and clinical interventions - but scalability and impact will depend on overcoming ingrained human shortcomings to deal with complex socio-economic, political, and technological disruptions together with the many ethical challenges presented by pandemics. OBJECTIVES: The principal goal is to review the history of biomedical information and healthcare practices related to past pandemics in order to illustrate just how exceptional and dependent on biomedical informatics are the recent scientific insights into human immune responses to viral infection, which are enabling rapid antiviral vaccine development and clinical management of severe cases - despite the many societal challenges ahead. METHODS: This paper briefly reviews some of the key historical antecedents leading up to modern insights into epidemic and pandemic processes with their biomedical and healthcare information intended to guide practitioners, agencies, and the lay public in today's ongoing pandemic events. CONCLUSIONS: Poor scientific understanding and excessively slow learning about infectious disease processes and mitigating behaviors have stymied effective treatment until the present time. Advances in insights about immune systems, genomes, proteomes, and all the other -omes, became a reality thanks to the key sequencing technologies and biomedical informatics that enabled the Human Genome Project, and only now, 20 years later, are having an impact in ameliorating devastating zoonotic infectious pandemics, including the present SARS-CoV-2 event through unprecedently rapid vaccine development. In the future these advances will hopefully also enable more targeted prevention and treatment of disease. However, past and present shortcomings of most of the COVID-19 pandemic responses illustrate just how difficult it is to persuade enough people - and especially political leaders - to adopt societally beneficial risk-avoidance behaviors and policies, even as these become better understood.
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Vacinas contra COVID-19 , COVID-19/prevenção & controle , Pandemias/história , Vacinas/história , Pesquisa Biomédica/história , COVID-19/história , Controle de Doenças Transmissíveis/história , Doenças Transmissíveis/história , Epidemiologia/história , História do Século XIX , História do Século XX , História do Século XXI , História Antiga , Humanos , Classificação Internacional de Doenças , Saúde Pública/históriaAssuntos
Humanos , Masculino , Médicos/tendências , Pensamento/ética , Infecções por Coronavirus/prevenção & controle , Médicos/história , Higiene/história , Epidemiologia/história , Epidemiologia/tendências , Infecções por Coronavirus/epidemiologia , Epidemias/história , Epidemias/prevenção & controle , Pandemias/história , Pandemias/prevenção & controleAssuntos
Epidemiologia/história , Saúde Mental , História do Século XX , História do Século XXI , HumanosRESUMO
The subdiscipline of historical epidemiology holds the promise of creating a more robust and more nuanced foundation for global public health decision-making by deepening the empirical record from which we draw lessons about past interventions. This essay draws upon historical epidemiological research on three global public health campaigns to illustrate this promise: the Rockefeller Foundation's efforts to control hookworm disease (1909-c.1930), the World Health Organization's pilot projects for malaria eradication in tropical Africa (1950s-1960s), and the international efforts to shut down the transmission of Ebola virus disease during outbreaks in tropical Africa (1974-2019).
Assuntos
Epidemiologia/história , Saúde Global/história , Promoção da Saúde/história , Doença pelo Vírus Ebola/história , Infecções por Uncinaria/história , Malária/história , África , Controle de Doenças Transmissíveis/história , Doença pelo Vírus Ebola/prevenção & controle , Doença pelo Vírus Ebola/transmissão , História do Século XX , Infecções por Uncinaria/prevenção & controle , Humanos , Malária/prevenção & controle , Prática de Saúde Pública/história , Organização Mundial da Saúde/históriaRESUMO
Abstract The subdiscipline of historical epidemiology holds the promise of creating a more robust and more nuanced foundation for global public health decision-making by deepening the empirical record from which we draw lessons about past interventions. This essay draws upon historical epidemiological research on three global public health campaigns to illustrate this promise: the Rockefeller Foundation's efforts to control hookworm disease (1909-c.1930), the World Health Organization's pilot projects for malaria eradication in tropical Africa (1950s-1960s), and the international efforts to shut down the transmission of Ebola virus disease during outbreaks in tropical Africa (1974-2019).
Resumo A subdisciplina epidemiologia histórica se propõe a criar um alicerce robusto e refinado para o processo de tomada de decisões em saúde pública global, aprofundando registros empíricos que nos ensinam sobre intervenções passadas. Este artigo se baseia na pesquisa epidemiológica histórica de três campanhas globais de saúde pública para ilustrar essa proposta: os esforços da Fundação Rockefeller para controle da ancilostomose (1909-c.1930), os projetos-piloto da Organização Mundial da Saúde para erradicação da malária na África tropical (décadas de 1950-1960), e os esforços internacionais de interrupção da transmissão do vírus Ebola durante surtos na África tropical (1974-2019).
Assuntos
Humanos , História do Século XX , Saúde Global/história , Epidemiologia/história , Doença pelo Vírus Ebola/história , Promoção da Saúde/história , Infecções por Uncinaria/história , Malária/história , Organização Mundial da Saúde/história , Prática de Saúde Pública/história , Controle de Doenças Transmissíveis/história , Doença pelo Vírus Ebola/prevenção & controle , Doença pelo Vírus Ebola/transmissão , África , Infecções por Uncinaria/prevenção & controle , Malária/prevenção & controleRESUMO
BACKGROUND AND AIM OF THE WORK: Few know that Lombroso was also involved in epidemiological research. In particular, Lombroso's scientific reflections on Medical Geography were addressed to the theme of climate influences and meteorological conditions on human conduct. The authors analyze the scientific production and the works of Lombroso devoted to medical geography. DISCUSSION: Lombroso carried out accurate epidemiological investigations using the statistical method with great modernity, combining health data with geographical and climatic data to demonstrate the relationship between man, the environment and health in a social vision of preventive and curative medicine. CONCLUSIONS: The theory of Cosmotellurism in Lombroso's work is not only a source of unquestionable interest in the History of Medicine. The heritage of Medical Geography within the pre-bacteriological medical culture can continue with its teachings to correctly address the clinician's thinking even in the current historical context in which endemic and epidemic pathologies re-emerge in various parts of the world. (www.actabiomedica.it).