Saturday, August 7, 2021

We Learned This at Valley Forge

The news today carries the tragic story of a Dickenson, Texas city councilman who died of Covid-19 just days after posting on social media about “the folly of vaccinations”.  It is strange to read about so many people being opposed to vaccinations, since I (evidently mistakenly) thought that this was a long-settled topic. 

Being almost as old as dirt, I remember the mass inoculations against smallpox and polio of the fifties—I still have a faint smallpox vaccination scar to prove it.  The vaccines were an incredible success—smallpox has been completely conquered and polio remains endemic only in Afghanistan and Pakistan.   

And those mass vaccinations some seven decades ago are far from the first such endeavors in American history.  Indeed, the very existence of our country may have depended on the very first large-scale inoculation program conducted at public expense.

In the mid eighteenth century, while smallpox was ravaging most parts of the world, the small British colonies of North America were usually spared from the epidemic.  Outside of a small handful of large settlements like Boston, Philadelphia, and New York, most colonists lived in relatively isolated settlements with very little contact with the rest of the world.  While smallpox was not unknown, it was relatively rare.

In 1751, seventeen-year-old George Washington took his half-brother, Lawrence—then suffering from consumption (tuberculosis)—to Barbados for his health.  While there, he accepted an invitation to dine with a wealthy planter despite being warned that members of his family had contracted smallpox.  Ominously, Washington recorded his misgivings about the visit in his diary.  Shortly after the dinner, he writes “Was strongly attacked with the small Pox,”—his last entry in the diary for 24 days.  Washington, of course, eventually recovered, though it took weeks.  Having once had smallpox, Washington carried antibodies, making him immune to the disease.

During the American Revolution, most of the European troops brought to America were immune or benefitted from herd immunity because most had contracted the disease in childhood.  Not so, the American troops:  For the first time in their lives, these soldiers were brought from all of the corners of North America, living in camps with poor sanitation, which provided a perfect breeding ground for all kinds of diseases.  The cases of smallpox immediately began to increase.

There was something that Washington could do:  he could inoculate his troops against smallpox through a process called variolation (named after variola, the virus that causes smallpox).  It involved infecting a thread with live pustular matter from someone with the disease, then embedding the thread into an incision on a healthy person’s arm, deliberately infecting the person with smallpox.  While the patient always became sick, the disease was usually a milder form of the disease.  Still, depending on the source you read, somewhere from 3 to 5% of those treated died from the inoculation…And the patient always took weeks to recover.

Variolation had originated in Western Asia—probably Turkey—and had slowly spread west across Europe.  While the preventive treatment was known, it was still highly controversial and seldom used in the New World.  

Note.  There is a persistent story that Washington inoculated his troops with a different but close variety of the disease, specifically cowpox.  The story goes that milkmaids caught the disease from the cows they cared for, and some alert doctor realized that these milkmaids never caught the more virulent form of the disease.  While the story is quite true, the cowpox method of inoculation was not discovered by Edward Jenner until 1796, well after the end of the Revolutionary War.

Washington had considered inoculating his troops in 1775, but rejected the idea because the treatment would incapacitate at least a third of his troops, inviting an attack from the British.  The general issued orders forbidding the army doctors from using the variolation technique on the troops.  Instead, the general issued travel bans, forbidding visitors from Boston (which was then suffering from a smallpox epidemic) from entering his camp.  In addition, those soldiers who did come down with smallpox were quarantined at a special hospital near Cambridge.

Then, as now, quarantines and travel bans had only limited success.  Over the next year and a half, increasing numbers of Washington’s troops succumbed to the disease.  There were even rumors that the British were intentionally sending infected people to strategic areas in a deliberate attempt to spread the disease.  Though this theory remains unproved, England had employed this tactic during the earlier French and Indian War.

Washington grew increasingly desperate, forcing him to reconsider using variolation to treat his troops.  In a January 6, 1777, letter to John Hancock, Washington wrote "Necessity not only authorizes but seems to require the measure, for should the disorder infect the Army . . . we should have more to dread from it, than from the Sword of the Enemy."

Finally, in February 1777, Washington ordered a mandatory inoculation of the troops, to be done in absolute secrecy to prevent a British attack, and to be carried out in stages beginning with the new recruits.  It was hoped that by the time the recruits received their uniforms, weapons, and a modicum of training, they would have recovered from the symptoms caused by the inoculation.  

This was the first mass public health initiative of the new country—one carried out with government funds.

“Finding the smallpox to be spreading much and fearing that no precaution can prevent it from running through the whole of our army, I have determined that troops shall be inoculated,” he wrote. “This expedient may be attended with some inconveniences and some disadvantages, but yet I trust in its consequences will have the most happy effects.”

Seldom mentioned in history books, but among the horrific conditions experienced by the troops during the winter of 1777-78 at Valley Forge was that the poorly fed, inadequately clothed, freezing troops were also suffering from the fevers and chills as a result of variolation.  Still, because of the treatment, not a single regiment among the revolutionary army was unable to fight due to the disease.

While Washington treated his troops, the British felt no need to initiate a similar program in their troops who enjoyed a measure of herd immunity.  As a result, the disease quickly spread among colonials, Native Americans, and slaves who chose to fight alongside the British, often making such units more of liability to the British cause than assets.

By the end of the war, Washington had inoculated some 40,000 of his troops and had lost only fifty due to the illness.  Despite the horrors of battle, a little math reveals that compared to the general population of the colonists left to suffer the ravages of smallpox epidemics that swept across America as the European troops traveled across America, a colonist had a better chance to survive the war as an inoculated soldier on the battlefield than as an uninoculated civilian.  

Then, as now, while there are a few dangers of being vaccinated, they pale in comparison to not being vaccinated.  There is no way of telling how many people have been saved by vaccinations, but the number is at the very least many millions of souls.  Vaccines work so well that most of us—unlike any previous generation in America—do not personally know anyone who has died of smallpox, diphtheria, measles, or polio.  After 250 years, you would think this debate would have ended.

2 comments:

  1. Hate to be a naysayer and I am fully cognizant of the benefits of vaccination throughout history. , however (you knew there would be a "however" didn't you?) I haven't done the vaccination thing yet. My unvaccinated daughter and son-in-law were unvaccinated and came down with CoVid last week. They're pretty much over it. My 4 year old grandson hasn't got it at all. My wife and I are pretty much shut-ins anyway and one recent experience with the flu vaccine makes us very hesitant. In October 2019 just before we made a trip back home to Texas we both got the annual flu vaccine. Being isolated from most other humans we hadn't had one except sporadically for the previous decade. We were about to fly south, so we decided to protect ourselves by getting the shot. We were told we might experience "a few symptoms" over the next couple of weeks. A week later we boarded a plane for Texas. We were sick during most of our 2 week stay and were sick for 2 weeks after we got home. We might as well have got the flu. Having discovered we could be sensitive to flu vaccines, when the CoVid 19 vaccine appeared on the market, we were hesitant. My wife is a clean freak. Our house could be one of those computer clean rooms, so I wasn't worried about any infection growing here. We only get out once a month to go grocery shopping and we dutifully mask up and maintain some distance. The wife is and makes me be a compulsive hand-washer. She puts OCD people in the shade and makes sure I'm almost as obsessive about it. We've also noticed that the same people with underlying health issues are the ones having a very bad reaction to the vaccine. For us it's a choice between avoiding situations where we could be exposed and staying as healthy as possible to resist infection, or deliberately exposing ourselves to a form of the virus and hoping for the best. We've chosen to be careful rather than take the risk with the vaccine.

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  2. I don't ridicule anyone who wants to take the vaccine. If I was younger, not afflicted with the ravages of old age, and had to be out and about, I'd get the vaccine. But since people like me are the ones who react badly to the vaccination more so than kids and youth, we've elected to bet on our ability to hole up in our place surrounded by woods and wildlife and fight off invasive germs with soap, bleach and Lysol. I think what's happening is that people, seeing the myriad ways our current government seems to be gleefully encroaching on our liberties and feel obligated to meddle with everything from where we go, what we wear in public and seemingly hell-bent to make us carry a card that says whether we can fly, ride a bus, train or taxi or enter a grocery store or Walmart, you can't blame folks for being a little nervous when they start demanding we get injected with a form of the very disease that looks more and more like it came out of a bio-weapons lab in China, the research for which was funded by the very "expert" who tells us one day that masks don't work and the next day saying we have to wear them because they do work. The problem with vaccinating everybody under government orders and giving us passports to prove we've submitted to the commands of our betters, is primarily due to the loss of confidence in the current federal government which seems determined to do the modern equivalent of what God told the Israelites NOT to do - number the people. Here in Washington State public health officials are planning to send federal agents around with data collectors to knock on doors and demand to see your CoVid vaccination proof. At the same time state officials of a certain political persuasion have been talking gleefully about having government agents that are going along on the door-to-doors,look for "revolutionary War flags, MAGA hats and other indicators that vaccine resistors are also potential right wing terrorists. They plan to create a nice database. They also plan to find out if you have guns in the house. You can hardly blame some of us country folk for treating these people like we used to treat revenoo'ers back in Prohibition days. One very smart Public Health official down in the conservative regions of Washington State said she wouldn't do house to house vaccine patrols because, and I quote, "I don't want to get shot!" 37 of 39 Washington State county sheriffs have said they would not enforce gun collection or forced vaccinations or any other laws that violate the Constitutional rights of their county's citizen. and signed a statement to that effect. The only two who didn't sign were the Sheriffs of Seattle's King County and a neighboring county that used to be part of King County. And King County is shifting the sheriff's job from an elected position to an appointed position in case any sheriff gets too frisky. It's not because people are stupid that there are so many who distrust the vaccination mandate. It's that they have learned some things in the past decade including remembering what Rahm Immanuel said. "Never let a crisis go to waste." Since we're in a crisis, a lot of us are wondering how they are not going to let it "go to waste." So far we're not very impressed with the new administration's ideas of "improving America." We don't much feel improved, so we're more than a little suspicious of our betters giving orders. The trouble with Americans is that we don't think we have any betters.

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Normally, I would never force comments to be moderated. However, in the last month, Russian hackers have added hundreds of bogus comments, most of which either talk about Ukraine or try to sell some crappy product. As soon as they stop, I'll turn this nonsense off.