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Covid and the Miasma Theory

With the benefit of hindsight, we now know that COVID-19 can be spread through the air, which is why wearing masks is so effective (far more than social distancing) and arguably necessary to stem the spread of the disease. This is particularly true indoors where ventilation is limited and the air carries the virus for longer than outdoors where the wind can blow it away. 

Representation of miasma or bad air that can cause disease

What is interesting is that this theory was not accepted by many virologists (or even the WHO who resisted the claim that the virus can be carried in the air. It took more than 200 experts arguing in support of the airborne nature of the virus to convince the WHO to declare it so. The reason for this discrepancy (and resistance to the airborne theory) is interesting, and surprisingly, relates to none other than the granddaddy of medicine, Hippocrates. 

It was Hippocrates who first noticed (back in 5th century BCE) that people in one region often got sick with the same symptoms and concluded that it was caused by bad air, or "miasma." He proposed that  “whenever many men are attacked by one disease at the same time, the cause should be assigned to that which is most common, and which we all use most. This it is which we breathe in.” This theory became so popular that it lasted for centuries and caused problems for other diseases that are not airborne. For example, an English physician who tried to argue that cholera was spread by infected water was ridiculed and likewise, doctors refused to accept that handwashing could limit disease and improve childbirth mortality. People's likely argument was if disease was caused by bad air, why would water or hygiene matter?

When the germ theory (that different germs caused different diseases) was finally proven and widely accepted, it was the turn of the miasma theory to be ridiculed and shunned by the medical world. Apparently, medical experts still recoil at the mention of airborne spread because it suggests that they support an antiquated theory of disease. However, the reality is that Hippocrates was partially correct in his conclusion that disease (can) spread by bad (infected) air because some pathogens are in fact airborne. Others like malaria and dengue are definitely not (they are carried by mosquitos).

It took more than a year of the pandemic for the WHO and the US Center for Disease Control (CDC), to finally accept that airborne spread of the SARS-CoV2 virus is possible, effectively supporting the miasma theory (modified version of course!). So what we have to learn and keep in mind is that lessons from the past are not to be ignored or ridiculed, neither are they to be taken as the fundamental truth. It does provide us with a great jumping point towards new truths and a better understanding of medicine.

Aerial transmission of coronavirus according to the EU


Sources:

https://www.nytimes.com/2020/07/04/health/239-experts-with-one-big-claim-the-coronavirus-is-airborne.html
https://www.telegraph.co.uk/global-health/science-and-disease/every-medical-authority-failed-realise-covid-airborne-late/
https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/sars-cov-2-transmission.html#anchor_1619805184733
https://ec.europa.eu/jrc/en/news/covid-19-how-better-understanding-airborne-transmission-key-break-chain-infection


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