The scent of sickness: 5 questions answered about using dogs – and mice and ferrets – to detect disease
Could medical detection animals smell coronavirus?
14 January, 2021
Leon Neal/Getty Images
As COVID-19 continues to spread worldwide, scientists are analyzing new ways to track it.
<p> One promising approach is <a href="https://doi.org/10.1038/d41586-020-03149-9" target="_blank">training dogs to detect people who are infected</a> by smelling samples of human urine or sweat. Research scientist Glen Golden, who has trained dogs and ferrets to detect avian flu in birds, explains why certain animals are well suited to sniff out sickness.</p><h2>1. Which species have a nose for disease?</h2><p>Some animals have highly developed senses of smell. They include rodents; dogs and their wild relatives, like wolves and coyotes; and <a href="https://www.britannica.com/topic/list-of-mustelids-2058294" target="_blank">mustelids</a> – carnivorous mammals such as weasels, otters and ferrets. These species' brains have three or more times more functional olfactory receptor neurons – nerve cells that respond to odors – than species with less keen smelling abilities, including humans and other primates. </p><p>These neurons are responsible for detecting and identifying volatile olfactory compounds that send meaningful signals, like smoke from a fire or the aroma of fresh meat. A substance is volatile if it changes readily from liquid to gas at low temperatures, like the acetone that gives nail polish remover its fruity smell. Once it vaporizes, it can spread rapidly through the air.</p><p>When one of these animals detects a meaningful odor, the chemical signal is translated into messages and transported throughout its brain. The messages go simultaneously to the olfactory cortex, which is responsible for identifying, localizing and remembering odor, and to other brain regions responsible for decision-making and emotion. So these animals can detect many chemical signals over great distances and can make rapid and accurate mental associations about them. </p>
<h2>2. How do researchers choose a target scent?</h2><p>In most studies that have used dogs to detect cancer, the dogs have identified physical samples, such as skin, urine or breath, from patients who either have been diagnosed with cancer or have <a href="https://doi.org/10.1016/j.applanim.2004.04.008" target="_blank" rel="noopener noreferrer">undiagnosed cancer at an early stage</a>. Scientists don't know what odor cue the dogs use or whether it varies by type of cancer.</p><p>The U.S. Department of Agriculture's <a href="https://www.aphis.usda.gov/aphis/ourfocus/wildlifedamage/programs/nwrc" target="_blank" rel="noopener noreferrer">National Wildlife Research Center</a> in Colorado and the <a href="https://monell.org/" target="_blank" rel="noopener noreferrer">Monell Chemical Senses Center</a> in Pennsylvania have trained mice to detect <a href="https://doi.org/10.1371/journal.pone.0075411" target="_blank" rel="noopener noreferrer">avian influenza in fecal samples from infected ducks</a>. Bird flu is hard to detect in wild flocks, and it <a href="https://www.cdc.gov/flu/avianflu/avian-in-humans.htm" target="_blank" rel="noopener noreferrer">can spread to humans</a>, so this work is designed to help wildlife biologists monitor for outbreaks.</p><p>The Kimball lab at Monell taught the mice to get a reward when they smelled a confirmed positive sample from an infected animal. For example, mice would get a drink of water when they traveled down the arm of a Y-shaped maze that contained feces from a duck infected with avian influenza virus.</p><p>By chemically analyzing the fecal samples, researchers found that the concentration of volatile chemical compounds in them changed when a duck became infected with bird flu. So they inferred that this altered smell profile was what the mice recognized.</p><iframe src="https://www.youtube.com/embed/0UxLt3yugUA?wmode=transparent&start=0"></iframe><p>Members of the mustelid family, such as ferrets, badgers and otters, have highly developed senses of smell. Here a wolverine sniffs out frozen meat buried deep in the snow.</p><p>Building on that work, we've trained ferrets and dogs to detect avian influenza in fowl, such as wild ducks and domestic chickens, in a collaborative study between Colorado State University and the National Wildlife Research Center that is currently under review for publication.</p><p>With ferrets, we started by training them to alert, or signal that they had detected the target odor, by scratching on a box that contained high ratios of those volatile compounds and to ignore boxes that contained low ratios. Next we showed the ferrets fecal samples from both infected and noninfected ducks, and the ferrets immediately began alerting to the box containing the fecal sample from an infected duck.</p><p>This approach is similar to the way that dogs are trained to detect known volatile odors in explosives or illegal drugs. Sometimes, though, we have to let the detector animal determine the odor profile that it will respond to.</p>
<h2>3. Can animals be trained to detect more than one target?</h2><p>Yes. To avoid confusion about what a trained animal is detecting, we can teach it a different behavioral response for each target odor.</p><p>For example, the dogs in the U.S. Department of Agriculture's <a href="https://www.aphis.usda.gov/aphis/ourfocus/wildlifedamage/programs/nwrc/sa_spotlight/sniffing+out+disease" target="_blank" rel="noopener noreferrer">Wildlife Services Canine Disease Detection Program</a> respond with an aggressive alert, such as scratching, when they detect a sample from a duck infected with bird flu. When they detect a sample from a white-tailed deer infected by the prion that causes <a href="https://www.cdc.gov/prions/cwd/index.html" target="_blank" rel="noopener noreferrer">chronic wasting disease</a>, they respond with a passive alert such as sitting down.</p><p>Research at the University of Auburn has shown that dogs can remember and respond to <a href="https://doi.org/10.1007/s10071-020-01362-7" target="_blank" rel="noopener noreferrer">72 odors during an odor memory task</a>. The only limitation is how many ways a dog can communicate about different odor cues.</p>
<h2>4. What kinds of factors can complicate this process?</h2><p>First, any organization that trains animals to detect disease needs the right type of laboratory and equipment. Depending on the disease, that could include personal protection equipment and air filtering.</p><p>Another concern is whether the pathogen might infect the detection animals. If that's a risk, researchers may need to inactivate the samples before they expose the animals. Then they need to see whether that process has altered the volatiles that they are teaching the animals to associate with infection.</p><p>Finally, handlers have to think about how to reinforce the desired response from detection animals in the field. If they are working in a population of mostly noninfected people – for example, in an airport – and an animal doesn't get a chance to earn a reward, it may lose interest and stop working. We look for animals that have a strong drive to work without stopping, but working for a long time without reward can be challenging for even the most motivated animal.</p>
<h2>5. Why not build a machine that can do this?</h2><p>Right now we don't have devices that are as sensitive as animals with well-developed senses of smell. For example, a dog's sense of smell is <a href="https://doi.org/10.1016/j.applanim.2005.07.009" target="_blank" rel="noopener noreferrer">at least 1,000 times more sensitive than any mechanical device</a>. This could explain why dogs have detected cancer in tissue samples that have been <a href="https://doi.org/10.1016/j.applanim.2004.04.008" target="_blank" rel="noopener noreferrer">medically cleared as not cancerous</a></p><p>We also know that ferrets can detect avian flu infection in fecal samples before and after laboratory analysis shows that the virus has stopped shedding. This suggests that for some pathogens, there may be changes in volatiles in individuals who are infected but are asymptomatic.</p><p>As scientists learn more about how mammals' sense of smell works, they'll have a better chance of creating devices that are as sensitive and reliable in sniffing out disease.<img src="https://counter.theconversation.com/content/151832/count.gif?distributor=republish-lightbox-basic" alt="The Conversation"></p><p><a href="https://theconversation.com/profiles/glen-j-golden-1186384" target="_blank">Glen J. Golden</a>, Research Scientist/Scholar I, <em><a href="https://theconversation.com/institutions/colorado-state-university-1267" target="_blank" rel="noopener noreferrer">Colorado State University</a></em></p><p>This article is republished from <a href="https://theconversation.com/" target="_blank" rel="noopener noreferrer">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-scent-of-sickness-5-questions-answered-about-using-dogs-and-mice-and-ferrets-to-detect-disease-151832" target="_blank" rel="noopener noreferrer">original article</a>.</p>
Keep reading
Show less
People in these countries think their government did a good job of dealing with the pandemic
Spoiler: Most people actually approved of their government's approach.
22 December, 2020
Photo by Matthew Waring on Unsplash
How well did your country respond to the pandemic?
<p>It's a subjective question, the answers to which are reflected in new research recording the diversity of opinion around the world.</p><p>Spoiler alert: globally, more people approved of their own country's response than disapproved.</p><p>A Pew Research Center survey of more than 14,000 adults across 14 advanced economies in Europe, Asia, North America and Australia, found <a href="https://www.pewresearch.org/global/2020/08/27/most-approve-of-national-response-to-covid-19-in-14-advanced-economies/" target="_blank">73% thought their own country had done a good job of tackling the coronavirus outbreak</a>.</p><h3>It's a matter of trust</h3><p>Respondents' attitude to their own country's pandemic response – and its impact on national unity – were linked to feelings of trust in others, the survey found.</p>
<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDk4Nzc2NS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY2MDQ4NTY2OH0.7aCNwI30_-qmgMOu854flTXuD1eh_iBAkO2zDlKPzS8/img.jpg?width=980" id="8d49e" class="rm-shortcode" data-rm-shortcode-id="a8db10a752157ee0a82c50dfe6a1eb90" data-rm-shortcode-name="rebelmouse-image" alt="With the exception of the UK and the US, countries believed they handled the pandemic well." data-width="462" data-height="852" />
Image: Pew Research Center
<p>Denmark recorded the highest government response approval rating of the countries surveyed (95%), followed closely by Australia.</p><p>Support for their government's actions was also shown in countries like South Korea and Canada, along with European nations like Germany, the Netherlands, Italy and Sweden, where more than two-thirds of respondents approved.</p><p>But a different picture emerged in the US and UK, where delayed action to combat COVID-19 received less emphatic support. More than half of those polled in each country said they thought the pandemic had been handled poorly.</p><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDk4Nzc2OC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzNjYxMjA0Mn0.ZyQK6F1fJ1Z5ZtBQLWnwUECKRpopoZzXmPyyG-WETi4/img.jpg?width=980" id="6f92f" class="rm-shortcode" data-rm-shortcode-id="a9e2479f24a45ee19f9cb80c3e2742e2" data-rm-shortcode-name="rebelmouse-image" alt="Americans stand out in their belief that they're more divided as a result of the pandemic." data-width="421" data-height="820" />
Image: Pew Research Center
<h3>Divided or united?</h3><p>Opinions were also split on whether the pandemic had increased the sense of national unity.<br><br>Again, Denmark proved to have the most optimistic outlook with 72% of respondents believing the country more united following the virus outbreak. In Canada, Sweden, South Korea and Australia, over half of respondents believed their country was more united.<br><br>Despite approving of their country's response to the pandemic, in European nations like Spain, Belgium, Italy and the Netherlands, a majority of people thought their country was more divided post-lockdown.<br><br>In the US, in an era of divisive politics and with no coordinated response to the pandemic in place, more than three-quarters of respondents believed their country was now more divided than before the pandemic.</p><p>The perceived strength of national unity is linked to trust in others, the report found. As a general principle, people who thought others couldn't be trusted were more likely to see divisions in their own country.<br><br>National divisions were most pronounced in France, where almost two-thirds of respondents who think people can't be trusted also see the country as more divided than before the pandemic.</p><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDk4NzgwNC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY2MzU4NDYwOH0._oLZklchjnz5tVF5q9NSiTrcBgHTG5frZGAcgU1wtW0/img.jpg?width=980" id="e0f0b" class="rm-shortcode" data-rm-shortcode-id="c8134181a7a12218b9e6ae3bd37a9573" data-rm-shortcode-name="rebelmouse-image" alt="Prevailing view that more international cooperation would have reduced coronavirus cases." data-width="369" data-height="826" />
Image: Pew Research Center
<h3>The role of international cooperation</h3><p>But did this perceived drop in national cohesion prevent countries seeking international help to combat the spread of the virus? And would cross-border cooperation have resulted in fewer cases?<br><br>For the majority of respondents, the answer was yes.<br><br>Across the 14 countries surveyed, 59% of respondents believed greater international cooperation would have reduced the number of coronavirus cases in their own country. In Europe, this average increases to 62%, with seven of the nine countries surveyed expressing belief in the benefits of international cooperation, which was strongest in countries like Belgium, the UK and Spain.</p><p>Outside of Europe, support for international cooperation was also notable in the US (58%) and South Korea (59%), according to the report.</p><p>In Denmark, however, 78% of people thought international cooperation would not have reduced the number of cases. A majority of people in Australia, Germany, Canada and Japan also held little store in international cooperation to tackle the pandemic.<br><br>The World Bank, in collaboration with the World Economic Forum and other stakeholders, held a virtual roundtable to devise an action plan <a href="https://www.worldbank.org/en/news/statement/2020/04/21/the-world-bank-wef-gsma-and-itu-mobilized-in-the-fight-against-covid-19" target="_blank">to facilitate international cooperations and communications to better tackle the pandemic</a>.</p><p>International <a href="https://www.chathamhouse.org/expert/comment/hurdles-developing-covid-19-vaccine-why-international-cooperation-needed" target="_blank" rel="noopener noreferrer">cooperation is a key element of producing an effective vaccine at scale</a> to protect the global population against COVID-19, according to Chatham House. By working together, researchers, business leaders, policy-makers and other stakeholders can more quickly overcome scientific, regulatory and market challenges to developing and distributing a vaccine.</p><p>Reprinted with permission of the <a target="_blank" href="https://www.weforum.org/" rel="noopener noreferrer">World Economic Forum</a>. Read the <a target="_blank" href="https://www.weforum.org/agenda/2020/09/covid-19-survey-trust-unity-cooperation/" rel="noopener noreferrer">original article</a>.</p>
Keep reading
Show less
How do pandemics end? History suggests diseases fade but are almost never truly gone
Instead of looking forward, we should be consulting the past.
21 October, 2020
Andrew Redington/Getty Images
When will the pandemic end? All these months in, with over 37 million COVID-19 cases and more than 1 million deaths globally, you may be wondering, with increasing exasperation, how long this will continue.
<p>Since the beginning of the pandemic, epidemiologists and public health specialists have <a href="https://doi.org/10.1038/s41591-020-0883-7">been using</a> <a href="https://doi.org/10.1001/jama.2020.6585" target="_blank">mathematical</a> <a href="https://doi.org/10.1073/pnas.2006520117" target="_blank">models</a> to forecast the future in an effort to curb the coronvirus's spread. But infectious disease modeling is tricky. Epidemiologists warn that “<a href="https://doi.org/10.1038/d41586-020-01003-6" target="_blank">[m]odels are not crystal balls</a>," and even sophisticated versions, like those that <a href="https://doi.org/10.1101/2020.08.19.20177493" target="_blank">combine forecasts</a> or <a href="https://covid19-projections.com/" target="_blank">use machine learning</a>, can't necessarily reveal when the pandemic will end or <a href="https://covid19.healthdata.org/united-states-of-america?view=total-deaths&tab=trend" target="_blank">how many people will die</a>.</p><p>As a <a href="https://sc.edu/study/colleges_schools/artsandsciences/history/our_people/directory/nukhet.php" target="_blank">historian who studies disease and public health</a>, I suggest that instead of looking forward for clues, you can look back to see what brought past outbreaks to a close – or didn't.</p>
<h2>Where we are now in the course of the pandemic</h2><p>In the early days of the pandemic, many people hoped the coronavirus would simply fade away. Some argued that it would <a href="https://www.npr.org/2020/04/21/837348551/timeline-what-trump-has-said-and-done-about-the-coronavirus" target="_blank" rel="noopener noreferrer">disappear on its own</a> <a href="https://theconversation.com/coronavirus-may-wane-this-summer-but-dont-count-on-any-seasonal-variation-to-end-the-pandemic-136218" target="_blank" rel="noopener noreferrer">with the summer heat</a>. Others claimed that <a href="https://www.theatlantic.com/health/archive/2020/03/coronavirus-pandemic-herd-immunity-uk-boris-johnson/608065/" target="_blank" rel="noopener noreferrer">herd immunity</a> would kick in once enough people had been infected. But none of that has happened.</p><p>A combination of public health efforts to contain and mitigate the pandemic – from rigorous testing and contact tracing to social distancing and wearing masks – <a href="https://www.endcoronavirus.org/countries" target="_blank" rel="noopener noreferrer">have been proven to help</a>. Given that the virus has <a href="https://www.aljazeera.com/news/2020/09/14/which-countries-have-not-reported-any-coronavirus-cases/" target="_blank" rel="noopener noreferrer">spread almost everywhere in the world</a>, though, such measures alone can't bring the pandemic to an end. All eyes are now turned to <a href="https://time.com/5887199/coronavirus-vaccine-race/" target="_blank" rel="noopener noreferrer">vaccine development</a>, which is being pursued at unprecedented speed.</p><p>Yet experts tell us that even with a successful vaccine and effective treatment, <a href="https://www.theatlantic.com/health/archive/2020/08/coronavirus-will-never-go-away/614860/" target="_blank" rel="noopener noreferrer">COVID-19 may never go away</a>. Even if the pandemic is curbed in one part of the world, it will likely continue in other places, causing infections elsewhere. And even if it is no longer an immediate pandemic-level threat, the coronavirus will likely become endemic – meaning slow, sustained transmission will persist. The coronavirus will continue to cause smaller outbreaks, much like seasonal flu.</p><p>The history of pandemics is full of such frustrating examples.</p>
<h2>Once they emerge, diseases rarely leave</h2><p>Whether bacterial, viral or parasitic, virtually every disease pathogen that has affected people over the last several thousand years is still with us, because it is nearly impossible to fully eradicate them.</p><p>The only disease that has been <a href="https://www.cdc.gov/smallpox/history/history.html" target="_blank" rel="noopener noreferrer">eradicated through vaccination is smallpox</a>. <a href="https://theconversation.com/a-massive-public-health-effort-eradicated-smallpox-but-scientists-are-still-studying-the-deadly-virus-139468" target="_blank" rel="noopener noreferrer">Mass vaccination campaigns</a> led by the World Health Organization in the 1960s and 1970s were successful, and in 1980, smallpox was declared the first – and still, the only – human disease to be fully eradicated.</p><p>So success stories like smallpox are exceptional. It is rather the rule that diseases come to stay.</p><p>Take, for example, pathogens like <a href="https://www.sciencedaily.com/releases/2010/06/100617120718.htm" target="_blank" rel="noopener noreferrer">malaria</a>. Transmitted via parasite, it's almost as old as humanity and still exacts a heavy disease burden today: There were about <a href="https://www.who.int/news-room/fact-sheets/detail/malaria" target="_blank" rel="noopener noreferrer">228 million malaria cases and 405,000 deaths</a> worldwide in 2018. Since 1955, global programs to eradicate malaria, assisted by the use of DDT and chloroquine, brought some success, but the disease is <a href="https://www.who.int/malaria/media/world-malaria-report-2018/en/" target="_blank" rel="noopener noreferrer">still endemic in many countries of the Global South</a>.</p><p>Similarly, diseases such as <a href="https://www.who.int/news-room/fact-sheets/detail/tuberculosis" target="_blank" rel="noopener noreferrer">tuberculosis</a>, <a href="https://doi.org/10.1126/science/1109759" target="_blank" rel="noopener noreferrer">leprosy</a> and <a href="https://doi.org/10.1126/science.368.6497.1324-o" target="_blank" rel="noopener noreferrer">measles</a> have been with us for several millennia. And despite all efforts, <a href="https://ourworldindata.org/eradication-of-diseases" target="_blank" rel="noopener noreferrer">immediate eradication is still not in sight</a>.</p><p>Add to this mix relatively younger pathogens, such as <a href="https://www.nature.com/articles/d42859-018-00008-6" target="_blank" rel="noopener noreferrer">HIV</a> and <a href="https://www.who.int/news-room/fact-sheets/detail/ebola-virus-disease" target="_blank" rel="noopener noreferrer">Ebola virus</a>, along with <a href="https://www.who.int/health-topics/influenza-avian-and-other-zoonotic#tab=tab_1" target="_blank" rel="noopener noreferrer">influenza</a> and <a href="https://www.niaid.nih.gov/diseases-conditions/coronaviruses" target="_blank" rel="noopener noreferrer">coronaviruses</a> including <a href="https://www.who.int/ith/diseases/sars/en/" target="_blank" rel="noopener noreferrer">SARS</a>, <a href="https://www.who.int/news-room/q-a-detail/middle-east-respiratory-syndrome-coronavirus-(mers-cov)" target="_blank" rel="noopener noreferrer">MERS</a> and <a href="https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/q-a-coronaviruses" target="_blank" rel="noopener noreferrer">SARS-CoV-2 that causes COVID-19</a>, and the overall epidemiological picture becomes clear. Research on the <a href="https://doi.org/10.1016/B978-012373944-5.00185-1" target="_blank" rel="noopener noreferrer">global burden of disease</a> finds that annual mortality caused by infectious diseases – most of which occurs in the developing world – is nearly one-third of all deaths globally.</p><p>Today, in an age of global air travel, climate change and ecological disturbances, we are constantly exposed to the threat of <a href="https://wwwnc.cdc.gov/eid/about" target="_blank" rel="noopener noreferrer">emerging infectious diseases</a> while continuing to suffer from much older diseases that remain alive and well.</p><p>Once added to the repertoire of pathogens that affect human societies, most infectious diseases are here to stay.</p>
<h2>Plague caused past pandemics – and still pops up</h2><p>Even infections that now have effective vaccines and treatments continue to take lives. Perhaps no disease can help illustrate this point better than <a href="https://www.visualcapitalist.com/history-of-pandemics-deadliest/" target="_blank" rel="noopener noreferrer">plague, the single most deadly</a> infectious disease in human history. Its name continues to be synonymous with horror even today.</p><p><a href="https://www.who.int/health-topics/plague#tab=tab_1" target="_blank" rel="noopener noreferrer">Plague</a> is caused by the bacterium <em>Yersinia pestis</em>. There have been countless local outbreaks and at least three documented plague pandemics over the last 5,000 years, killing hundreds of millions of people. The most notorious of all pandemics was <a href="https://www.livescience.com/what-was-the-black-death.html" target="_blank" rel="noopener noreferrer">the Black Death</a> of the mid-14th century.</p><p>Yet <a href="https://scholarworks.wmich.edu/medieval_globe/1/" target="_blank" rel="noopener noreferrer">the Black Death</a> was far from being an isolated outburst. Plague returned every decade or even more frequently, each time hitting already weakened societies and taking its toll during <a href="https://doi.org/10.1017/npt.2020.27" target="_blank" rel="noopener noreferrer">at least six centuries</a>. Even before the <a href="https://doi.org/10.1136/bmj.39097.611806.DB" target="_blank" rel="noopener noreferrer">sanitary revolution</a> of the 19th century, each outbreak gradually died down over the course of months and sometimes years as a result of changes in temperature, humidity and the availability of hosts, vectors and a sufficient number of susceptible individuals.</p><p>Some societies recovered relatively quickly from their losses caused by the Black Death. Others never did. For example, medieval <a href="https://utpress.utexas.edu/books/borbla" target="_blank" rel="noopener noreferrer">Egypt could not fully recover</a> from the lingering effects of the pandemic, which particularly devastated its agricultural sector. The cumulative effects of declining populations became impossible to recoup. It led to the gradual decline of the Mamluk Sultanate and its conquest by the Ottomans within less than two centuries.</p><p>That very same state-wrecking plague bacterium remains with us <a href="https://www.cnn.com/2020/08/08/us/second-plague-death-new-mexico-man/index.html" target="_blank" rel="noopener noreferrer">even today</a>, a reminder of the very long persistence and resilience of pathogens.</p><p>Hopefully COVID-19 will not persist for millennia. But until there's a successful vaccine, and likely even after, no one is safe. Politics here are crucial: When vaccination programs are weakened, infections can come roaring back. Just look at <a href="https://www.cdc.gov/media/releases/2019/s0424-highest-measles-cases-since-elimination.html" target="_blank" rel="noopener noreferrer">measles</a> and <a href="https://www.nytimes.com/2019/07/15/health/polio-pakistan-afghanistan.html" target="_blank" rel="noopener noreferrer">polio</a>, which resurge as soon as vaccination efforts falter.</p><p>Given such historical and contemporary precedents, humanity can only hope that the coronavirus that causes COVID-19 will prove to be a tractable and eradicable pathogen. But the history of pandemics teaches us to expect otherwise.<img src="https://counter.theconversation.com/content/146066/count.gif?distributor=republish-lightbox-basic" alt="The Conversation"></p><p><a href="https://theconversation.com/profiles/nukhet-varlik-1155360" target="_blank">Nükhet Varlik</a>, Associate Professor of History, <em><a href="https://theconversation.com/institutions/university-of-south-carolina-1755" target="_blank" rel="noopener noreferrer">University of South Carolina</a></em></p><p>This article is republished from <a href="https://theconversation.com/" target="_blank" rel="noopener noreferrer">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-do-pandemics-end-history-suggests-diseases-fade-but-are-almost-never-truly-gone-146066" target="_blank" rel="noopener noreferrer">original article</a>.</p>
Keep reading
Show less
Quarantine rule breakers in 17th-century Italy partied all night – and some clergy condemned the feasting
17th-century outbreaks of plague in Italy reveal both tensions between religious and public health authorities.
27 September, 2020
Hulton Archive/Getty Images
Since the beginning of the COVID-19 pandemic, conflicts between religious freedom and public health regulations have been playing out in courts around the world.
<p>Churches from California to Maine have flouted public health orders by convening in person, indoors, unmasked and accompanied by choirs. When an underground church in South Korea seeded one of the country's largest outbreaks in February, the <a href="https://www.bbc.com/news/world-asia-53803011" target="_blank">government responded</a> by arresting its leader for obstructing contact tracers and violating public health regulations. </p><p>I am a <a href="https://press.uchicago.edu/ucp/books/book/chicago/F/bo60921208.html" target="_blank">historian of science and religion in the Renaissance</a>, and what strikes me as remarkable about the current moment is not that some religious communities are defying public health measures, but that so many religious institutions and individuals are piously working to implement them.</p><p><a href="https://books.google.com/books/about/Cristofano_and_the_Plague.html?id=iAjbAAAAMAAJ%20pp.79-80" target="_blank">Historical accounts</a> from 17th-century outbreaks of plague in Italy reveal both tensions between religious and public health authorities and also examples for collaboration. </p>
<h2>Sites of conflict</h2><p>In the summer of 1630, <a href="https://books.google.com/books/about/Cristofano_and_the_Plague.html?id=iAjbAAAAMAAJ" target="_blank" rel="noopener noreferrer">a plague epidemic packed</a> the plague hospitals known as "lazaretti" with over 15,000 people in Milan. Smaller towns also faced outbreaks that taxed their community resources.</p><p>In the <a href="https://books.google.com/books/about/Cristofano_and_the_Plague.html?id=iAjbAAAAMAAJ" target="_blank" rel="noopener noreferrer">Tuscan town of Prato</a>, public health officials were beginning to doubt the wisdom of treating plague patients at the "lazaretto" located within the city walls. They feared a risk of further infection if the healthy were in such close proximity to the sick.</p><p>The city officials <a href="https://books.google.com/books/about/Cristofano_and_the_Plague.html?id=iAjbAAAAMAAJ" target="_blank" rel="noopener noreferrer">needed to identify an alternative location</a> that was far enough to keep the city safe, but close enough that they could conveniently move the sick patients. They determined that the Convent of St. Anne, located a couple of kilometers outside town, <a href="https://books.google.com/books/about/Cristofano_and_the_Plague.html?id=iAjbAAAAMAAJ" target="_blank" rel="noopener noreferrer">should serve as the lazaretto and requisitioned it</a>.</p><p>The seizure of church property by the nominally secular powers of the Tuscan grand duke infuriated the friars of St. Anne. They petitioned Grand Duke Ferdinando II de' Medici to <a href="https://books.google.com/books/about/Cristofano_and_the_Plague.html?id=iAjbAAAAMAAJ" target="_blank" rel="noopener noreferrer">overturn the act</a>, but he ignored their objections.</p><p>This was not because the grand duke was persecuting Catholics – he ruled a Catholic state, and two of his brothers became cardinals. However, during this outbreak of plague, it appeared that the grand duke deemed such emergency measures to be a necessity.</p>
<h2>Limits to jurisdiction</h2><p>However, the grand duke's jurisdiction did have limits. In late-Renaissance cities, civil authorities <a href="https://books.google.com/books/about/Faith_Reason_and_the_Plague_in_Seventeen.html?id=aqOrYdo8xnUC" target="_blank" rel="noopener noreferrer">could punish citizens</a> for public health infractions, but they did not have direct authority over the clergy.</p><p>When a priest in Florence broke quarantine by staying out late at night drinking and playing guitar with family members, the <a href="https://yalebooks.yale.edu/book/9780300196344/florence-under-siege" target="_blank" rel="noopener noreferrer">health board punished his sisters</a> but not him.</p><p>To discipline priests who broke public health laws, civil authorities had to petition local church officials, like bishops, to intervene. For example, as the plague spread in the Tuscan city of Pistoia in September 1630, public health officers <a href="https://uwpress.wisc.edu/books/0907.htm" target="_blank" rel="noopener noreferrer">resolved to broach with the archbishop</a> the possibility of emptying the fonts of holy water in case they were spreading disease.</p><p>Although no records confirm the outcome, throughout this epidemic the archbishop of Florence <a href="https://yalebooks.yale.edu/book/9780300196344/florence-under-siege" target="_blank" rel="noopener noreferrer">repeatedly reinforced the importance of the policies</a> of secular health commissioners.</p><p>State and religious officials alike were concerned about plague spreading through air, water and wine and curtailed traditional activities to minimize contagion.</p>
<h2>Case of Father Dragoni</h2><p>Much like today, when civil authorities <a href="https://www.sfgate.com/bayarea/article/SF-archbishop-protest-Catholic-march-covid-15584389.php" target="_blank" rel="noopener noreferrer">canceled religious services and ceremonies</a>, local protests ensued.</p><p>During the plague outbreak of 1631 in the small Tuscan town of Monte Lupo, a <a href="https://books.google.com/books/about/Faith_Reason_and_the_Plague_in_Seventeen.html?id=aqOrYdo8xnUC" target="_blank" rel="noopener noreferrer">fight broke out</a> between the guards tasked with preventing gatherings and a group of armed civilians from the surrounding countryside and their parish priest.</p><p>The worshipers insisted on congregating to <a href="https://books.google.com/books/about/Faith_Reason_and_the_Plague_in_Seventeen.html?id=aqOrYdo8xnUC" target="_blank" rel="noopener noreferrer">pray at the crucifix</a> in the local church and threatened to shoot with an arquebus – a long gun used during the Renaissance period – anyone who got in their way.</p><p>The health officer <a href="https://books.google.com/books/about/Faith_Reason_and_the_Plague_in_Seventeen.html?id=aqOrYdo8xnUC" target="_blank" rel="noopener noreferrer">tasked with managing the delicate situation</a> at Monte Lupo was a 60-year-old Dominican friar, Father Giovanni Dragoni, who was both a public health officer and a member of the clergy.</p><p>Father Dragoni was <a href="https://books.google.com/books/about/Faith_Reason_and_the_Plague_in_Seventeen.html?id=aqOrYdo8xnUC%2056" target="_blank" rel="noopener noreferrer">stated to be furious</a> with the parish priest for his disregard for the public health measures. He promptly dispatched a message to the regional health commissioner: "It is necessary to take measures against these agitators of the people. The evidence is serious, and … the reverend parish priest is largely responsible for these uprisings."</p><p>Father Dragoni was unable to prevent the parish priest and congregants from gathering and feasting. He found himself further burdened the next morning with sorting out the events that had followed the procession, when prayer and feasts had turned into late-night drunken parties of revelers who tore down part of the wooden stockade that had been erected to enforce the quarantine.</p><p>When the plague outbreak finally ended and the town reopened, Father Dragoni offered the following report <a href="https://books.google.com/books/about/Faith_Reason_and_the_Plague_in_Seventeen.html?id=aqOrYdo8xnUC" target="_blank" rel="noopener noreferrer">on his own actions</a>: "I have not acted unjustly and have accompanied severity with compassion and charity. … In more than a year that I have held this office, no one has died without sacrament or confession."</p><p>In a period that has been characterized by faith's opposition to science, Father Dragoni demonstrated through his actions that carrying out public health measures and God's sacraments went hand in hand.</p>
<h2>Then and now</h2><p>Four centuries later, there are similar examples of religious resistance to public health measures and striking examples of religious collaboration with public health regulations.</p><p>Although <a href="https://www.bostonglobe.com/2020/08/31/metro/i-want-people-god-enjoy-liberty-pastor-maine-super-spreader-wedding-gives-defiant-indoor-sermon/" target="_blank" rel="noopener noreferrer">there are instances of church leaders</a> rallying congregants against public health measures, there are <a href="https://www.bostonglobe.com/2020/09/12/metro/new-england-evangelical-leaders-maine-sermon-reflects-deepening-rifts-faith-community/?s_campaign=8315" target="_blank" rel="noopener noreferrer">far more examples</a> of people and institutions who, like Father Dragoni, bring together religious devotion and disease control.</p><p>When the coronavirus swept into Italy in February, the patriarch of Venice – the bishop – promptly complied with the government's edict to cancel Masses, eagerly doing his part to <a href="https://www.repubblica.it/cronaca/2020/02/23/news/coronavirus_italia-249329434/" target="_blank">stem the epidemic</a>. And in the Italian churches around Turin that remained open for private prayer, the cisterns of holy water were promptly <a href="https://www.repubblica.it/cronaca/2020/02/23/news/coronavirus_scuole_chiuse_e_niente_carnevale_tutti_i_provvedimenti-249355737/" target="_blank">emptied</a>.</p><p>To be clear, there is a long history of religious resistance to public health measures during disease outbreaks. But cooperation between church and state in attempting to stem the spread of disease has its precedents too.<img src="https://counter.theconversation.com/content/146473/count.gif?distributor=republish-lightbox-basic" alt="The Conversation"></p><p><a href="https://theconversation.com/profiles/hannah-marcus-1156731" target="_blank">Hannah Marcus</a>, Assistant Professor, Department of the History of Science, <em><a href="https://theconversation.com/institutions/harvard-university-1306" target="_blank">Harvard University</a></em></p><p>This article is republished from <a href="https://theconversation.com/" target="_blank">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/quarantine-rule-breakers-in-17th-century-italy-partied-all-night-and-some-clergy-condemned-the-feasting-146473" target="_blank">original article</a>.</p>
Keep reading
Show less
‘Morality pills’ may be the US’s best shot at ending the coronavirus pandemic, according to one ethicist
COVID-19 is a tragedy of the commons.
05 September, 2020
Photo by Adam Nieścioruk on Unsplash
COVID-19 is a collective risk.
<p>It threatens everyone, and we all must cooperate to lower the chance that the coronavirus harms any one individual. Among other things, that means <a href="https://www.cdc.gov/coronavirus/2019-ncov/index.html" target="_blank">keeping safe social distances and wearing masks</a>. But <a href="https://www.pewresearch.org/fact-tank/2020/06/23/most-americans-say-they-regularly-wore-a-mask-in-stores-in-the-past-month-fewer-see-others-doing-it/" target="_blank">many people choose not to do these things</a>, making spread of infection more likely.</p><p>When someone chooses not to follow public health guidelines around the coronavirus, they're defecting from the public good. It's the moral equivalent of the <a href="https://en.wikipedia.org/wiki/Tragedy_of_the_commons#:%7E:text=The%20tragedy%20of%20the%20commons,resource%20through%20their%20collective%20action." target="_blank">tragedy of the commons</a>: If everyone shares the same pasture for their individual flocks, some people are going to graze their animals longer, or let them eat more than their fair share, ruining the commons in the process. Selfish and self-defeating behavior undermines the pursuit of something from which everyone can benefit.</p><p>Democratically enacted enforceable rules – mandating things like mask wearing and social distancing – might work, if defectors could be coerced into adhering to them. But <a href="https://www.aarp.org/health/healthy-living/info-2020/states-mask-mandates-coronavirus.html" target="_blank">not all states have opted to pass them</a> or <a href="https://www.clickondetroit.com/news/local/2020/05/15/several-michigan-sheriffs-say-they-wont-enforce-parts-of-executive-orders/" target="_blank">to enforce the rules</a> that are in place.</p><p><a href="https://scholar.google.com/citations?user=oEHIR14AAAAJ&hl=en&oi=ao" target="_blank">My research in bioethics</a> focuses on questions like how to induce those who are noncooperative to get on board with doing what's best for the public good. To me, it seems the problem of coronavirus defectors could be solved by moral enhancement: like receiving a vaccine to beef up your immune system, people could take a substance to boost their cooperative, pro-social behavior. Could a psychoactive pill be the solution to the pandemic?</p><p>It's a far-out proposal that's <a href="https://slate.com/technology/2017/03/why-we-are-so-alarmed-by-the-idea-of-a-moral-enhancement-pill.html" target="_blank">bound to be controversial</a>, but one I believe is worth at least considering, given the importance of social cooperation in the struggle to get COVID-19 under control.</p>
<h2>Public goods games show scale of the problem</h2><p>Evidence from experimental economics shows that defections are common to situations in which people face collective risks. Economists use <a href="https://en.wikipedia.org/wiki/Public_goods_game#:%7E:text=The%20public%20goods%20game%20is,put%20into%20a%20public%20pot." target="_blank" rel="noopener noreferrer">public goods games</a> to measure how people behave in various scenarios to lower collective risks such as from climate change or a pandemic and to prevent the loss of public and private goods.</p><p>The evidence from these experiments is no cause for optimism. <a href="https://doi.org/10.1073/pnas.0504902103" target="_blank" rel="noopener noreferrer">Usually everyone loses</a> because people won't cooperate. This research suggests it's not surprising people aren't wearing masks or social distancing – lots of people defect from groups when facing a collective risk. By the same token, I'd expect that, as a group, we will fail at addressing the collective risk of COVID-19, because groups usually fail. <a href="https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html" target="_blank" rel="noopener noreferrer">For more than 150,000 Americans so far</a>, this has meant losing everything there is to lose.</p><p>But don't abandon all hope. In some of these experiments, the groups win and successfully prevent the losses associated with the collective risk. What makes winning more likely? Things like keeping a running tally of what others are contributing, <a href="https://doi.org/10.1038/s41598-019-50964-w" target="_blank" rel="noopener noreferrer">observing others' behaviors</a>, <a href="https://doi.org/10.1073/pnas.1102493108" target="_blank" rel="noopener noreferrer">communication and coordination</a> before and during play, and <a href="https://doi.org/10.1038/nature13530" target="_blank" rel="noopener noreferrer">democratic implementation of an enforceable rule requiring contributions</a>.</p><p>For those of us in the United States, these conditions are out of reach when it comes to COVID-19. You can't know what others are contributing to the fight against the coronavirus, especially if you socially distance yourself. It's impossible to keep a running tally of what the other 328 million people in the U.S. are doing. And communication and coordination are not feasible outside of your own small group.</p><p>Even if these factors were achievable, they still require the very cooperative behavior that's in short supply. The scale of the pandemic is simply too great for any of this to be possible.</p>
<h2>Promoting cooperation with moral enhancement</h2><p>It seems that the U.S. is not currently equipped to cooperatively lower the risk confronting us. Many are instead pinning their hopes on the rapid development and distribution of an enhancement to the immune system – a vaccine.</p><p>But I believe society may be better off, both in the short term as well as the long, by boosting not the body's ability to fight off disease but the brain's ability to cooperate with others. What if researchers developed and delivered a moral enhancer rather than an immunity enhancer?</p><p>Moral enhancement is the use of substances to make you more moral. The psychoactive substances act on your ability to reason about what the right thing to do is, or your ability to be empathetic or altruistic or cooperative.</p><p>For example, oxytocin, the chemical that, among other things, can induce labor or increase the bond between mother and child, may cause a person to be more empathetic and <a href="https://doi.org/10.1126/science.1189047" target="_blank" rel="noopener noreferrer">altruistic</a>, <a href="https://doi.org/10.1371/journal.pone.0001128" target="_blank" rel="noopener noreferrer">more giving and generous</a>. <a href="https://doi.org/10.1093/ijnp/pyx047" target="_blank" rel="noopener noreferrer">The same goes for psilocybin</a>, the active component of "magic mushrooms." These substances have been shown to <a href="https://doi.org/10.1007/s40732-015-0139-y" target="_blank" rel="noopener noreferrer">lower aggressive behavior in those with antisocial personality disorder</a> and to improve the <a href="https://doi.org/10.1016/j.psyneuen.2017.07.483" target="_blank" rel="noopener noreferrer">ability of sociopaths to recognize emotion in others</a>.</p><p>These substances interact directly with the psychological underpinnings of moral behavior; others that make you more rational could also help. Then, perhaps, the people who choose to go maskless or flout social distancing guidelines would better understand that everyone, including them, is better off when they contribute, and rationalize that the best thing to do is cooperate.</p>
<h2>Moral enhancement as an alternative to vaccines</h2><p>There are of course pitfalls to moral enhancement.</p><p>One is that the science isn't developed enough. For example, while oxytocin may cause some people to be more pro-social, it also <a href="https://doi.org/10.1073/pnas.1015316108" target="_blank" rel="noopener noreferrer">appears to encourage ethnocentrism</a>, and so is probably a bad candidate for a widely distributed moral enhancement. But this doesn't mean that a morality pill is impossible. The solution to the underdeveloped science isn't to quit on it, but to direct resources to related research in neuroscience, psychology or one of the behavioral sciences.</p><p>Another challenge is that the defectors who need moral enhancement are also the least likely to sign up for it. As some have argued, a solution would be to <a href="https://global.oup.com/academic/product/unfit-for-the-future-9780198707929" target="_blank" rel="noopener noreferrer">make moral enhancement compulsory</a> or <a href="https://doi.org/10.1111/bioe.12496" target="_blank" rel="noopener noreferrer">administer it secretly, perhaps via the water supply</a>. These actions require weighing other values. Does the good of covertly dosing the public with a drug that would change people's behavior outweigh individuals' autonomy to choose whether to participate? Does the good associated with wearing a mask outweigh an individual's autonomy to not wear one?</p><p>The scenario in which the government forces an immunity booster upon everyone is plausible. And the military has been <a href="https://www.theatlantic.com/technology/archive/2012/02/more-than-human-the-ethics-of-biologically-enhancing-soldiers/253217/" target="_blank" rel="noopener noreferrer">forcing enhancements like vaccines or "uppers" upon soldiers</a> for a long time. The scenario in which the government forces a morality booster upon everyone is far-fetched. But a strategy like this one could be a way out of this pandemic, a future outbreak or the suffering associated with climate change. That's why we should be thinking of it now.<img src="https://counter.theconversation.com/content/142601/count.gif?distributor=republish-lightbox-basic" alt="The Conversation"></p><p><a href="https://theconversation.com/profiles/parker-crutchfield-775987" target="_blank">Parker Crutchfield</a>, Associate Professor of Medical Ethics, Humanities and Law, <em><a href="https://theconversation.com/institutions/western-michigan-university-2102" target="_blank" rel="noopener noreferrer">Western Michigan University</a></em></p><p>This article is republished from <a href="https://theconversation.com/" target="_blank" rel="noopener noreferrer">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/morality-pills-may-be-the-uss-best-shot-at-ending-the-coronavirus-pandemic-according-to-one-ethicist-142601" target="_blank" rel="noopener noreferrer">original article</a>.</p>
Keep reading
Show less
Popular
