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  • Hello lovely people,

  • Now I know, I know, you're getting pretty sick of being told about Coronavirus and how

  • you should be washing your hands and blah blah blah and oh my god it's so oversaturated

  • in your daily content consumption but at the same time you're morbidly fascinated and

  • still eating up every single thing you see about it

  • - clearly. Since you clicked on this video.

  • Well I'm feeling much the same. And I'm feeling pretty out of control. And when I

  • feel out of control, I turn to the history books, because knowing that massive, global

  • pandemics have happened before but the world kept turning and life continued on and clearly

  • it wasn't so Earth-shattering in the end because here I am: alive, existing and talking,

  • and here you are: alive, existing and watching…? Well, that makes me feel a whole lot better.

  • What DOESN'T make me feel better, as someone who has an underlying health condition and

  • is therefore 'vulnerable' when it comes to the coronavirus is people not understanding

  • the importance of how symptom-free carriers can spread sickness.

  • - and thus maybe you're watching this video because it was sent to you as you're a bit

  • of a wally who won't STAY HOME.

  • Social distancing. It works. Do it.

  • [calming sigh]

  • And that's why today we're going to be learning about poor, tragic Mary Mallon, otherwise

  • known as 'Typhoid Mary', one of the first identified 'super-spreaders' of disease.

  • Mary's case demonstrates how an unwitting carrier can be the root of a disease outbreak,

  • but also sparks debate about how far personal autonomy can go when it's pitted against

  • public health.

  • This video is part of my historical profiles series, in which we learn the fun history

  • we should have been taught in school through the lives of queer and/or disabled people.

  • You'll find all of the previous episodes in a playlist in the card above. If you have

  • a suggestion of who I should cover next, please leave it in the comments below and subscribe

  • to make sure you don't miss future episodes!

  • Mary was a breakthrough in our learning of how disease can spread

  • and how unwitting asymptomatic

  • carriers can harm others even if they aren't themselves at risk. A century later and we're

  • still learning about how quarantine can save lives. But before we can think about what

  • it means in current times, let's learn about her story

  • Mary Mallon was born in 1868 in Cookstown, County Tyrone, in what is now Northern Ireland.

  • She migrated with a sister to the United States of America in around 1883 to live with her

  • aunt and uncle and work as cooks for affluent families in New York City.

  • In 1900 she began working in Mamaroneck, New York, where within two weeks of her employment,

  • residents developed typhoid fever and she thus had to move on. In 1901 she worked for

  • a family in Manhattan where, again, members of the family for whom she worked developed

  • fevers and diarrhea, and their laundress died. She switched to working for the family of

  • a lawyer but left when seven of the eight people in the household took ill. In August

  • 1906, Mary took a position with a wealthy family in Oyster Bay, Long Island, but within

  • two weeks 10 of the 11 family members were hospitalized with typhoid.

  • We might look at that history and think:

  • - “gosh, seems fishy…”

  • But typhoid fever is a bacterial infection typically spread through food and water contaminated

  • by salmonella. Patients fall ill with high fever, diarrhoeaand, before antibiotics

  • were developed to treat it, sometimes delirium and death. This was the early 1900s however

  • and since there were no regulated sanitation practices in place, the disease was fairly

  • common and New York had battled multiple outbreaks. This wasn't particularly strange to Mary

  • and, because she was completely oblivious, she just kept moving on.

  • Mary went back to New York City and changed jobs three more times. Unsurprisingly, the

  • same thing kept happening.

  • But the wealthy family who lived in Oyster Bay hired a typhoid researcher and civil engineer

  • named George Soper to investigate, expecting perhaps to find a contaminated water source.

  • Through a process of elimination he realised however that it was the family's cook who

  • had been the missing link.

  • Soper began tracing other outbreaks in the local area and realised that in a number of

  • cases an Irish cook, who fit the same physical description, had worked for the families.

  • At first he was unable to locate her because she generally left immediately after an outbreak

  • began and without leaving a forwarding address.

  • All he could do was wait.

  • As the months turned warm again Soper learnt of an active outbreak in a penthouse on Park

  • Avenue: two of the servants had been hospitalised and the family's daughter had died. When

  • Soper arrived, he discovered that Mary had not only been their cook... but was also still

  • there. However, when confronted with his evidence and a request for urine and faeces samples,

  • she surged at Soper with a carving fork.

  • - the word 'confronted' probably explains that, to be fair.

  • He sought the help of the authorities but Mary evaded them for five hours before being

  • betrayed by a scrap of her dress, caught in the door of her hiding place.

  • George Soper was a civil engineer by training and had become an expert in sanitation, but

  • he was not a doctor. Despite this, he had deduced that typhoid could be spread by one

  • person serving as a carrier, whether or not they had any symptoms. With Mary refusing

  • to give samples, Soper instead compiled a five-year history of Mallon's employment.

  • He found that of the eight families that hired Mary as a cook, members of seven had contracted

  • typhoid fever- 22 infected people in total.

  • It hadn't raised red flags at first because in 1906, the year Soper began his investigation,

  • a reported 639 people had died of typhoid in New York. But never before had an outbreak

  • been traced to a single carrierand definitely not one without any symptoms themselves.

  • In fact it wasn't even common knowledge that someone could HAVE typhoid without symptoms.

  • Finally, Mary was escorted by five policemen to a hospital whereafter a nearly

  • successful escape attemptshe tested positive as a carrier for Salmonella typhi, a bacteria

  • that causes typhoid. The key was in the fresh fruit dishes Mary served on Sundays in the

  • summer months. Whilst cooking the food she had touched killed the bacteria transferred

  • from Mary's hands, uncooked foods were the perfect way to spread the disease.

  • The New York City Health Inspector determined she was a carrier and thus was quarantined

  • in a small house on the grounds of Riverside Hospital, an isolated facility on North Brother

  • Island just off the Bronx

  • for three years!

  • - so stop complaining about social distancing for three months!

  • In prison, she was forced to give regular stool and urine samples. Despite never developing

  • symptoms (or receiving treatment) she tested positive every time. Authorities suggested

  • removing her gallbladder because they believed typhoid bacteria resided there but stopped

  • just short of doing it against her will as she attracted a lot of media attention. Mary

  • continued to believe that it was impossible for her to actually have the disease: She'd

  • seen people die from typhoid! They looked ill! She felt fine!

  • A 1908 issue of the Journal of the American Medical Association named herTyphoid Mary

  • and the public ran with it. Mary's resentment and distrust grew.

  • In 1909, she sued the New York City Department of Health and the case was brought to the

  • Supreme Court. Mary's case stirred a debate over individual autonomy and the state's

  • responsibility in a public health crisis. America was then, as it is today, a culture

  • founded on personal liberty, that takes the rights of the individual very seriously. Her

  • lawyer argued that she had been imprisoned without due process and the court of public

  • opinion was on her side. Despite the judge declining to release her, on the grounds that

  • the courtmust protect the community against a recurrence of spreading the disease”...

  • she was freed the following year by the city's new health commissioner

  • who wanted some good press, so...

  • On the grounds that she stopped cooking.

  • - Which, why would she do that? She didn't have symptoms so she didn't have typhoid.

  • Right? Riiight?

  • February 19, 1920, Mallon agreed that she was "prepared to change her occupation, and

  • would give assurance by affidavit that she would upon her release take such hygienic

  • precautions as would protect those with whom she came in contact, from infection."

  • Good luck with that.

  • Oh sure, sure, to start with Mary triedon her release she was given a job as a laundress

  • but it paid SO much less than cooking and it wasn't good for her hands to be in hot

  • water all day

  • - except, it WAS good for her hands because the heat killed the disease shed from them,

  • but oh well!

  • After a few years she changed her name to Mary Brown and returned to cooking, despite

  • the explicit instructions not to.

  • For the next five years she worked in a number of

  • kitchens, again followed by outbreaks of typhoid. She changed jobs frequently, always trying

  • to outrun George Soper and his detective team!

  • BUT in 1915, Mary started a MAJOR outbreak, this time at Sloane Hospital for Women in

  • New York City, infecting twenty-five people. She left after the first two deaths but this

  • time the police managed to outpace her and she was arrested, still protesting that the

  • outbreak had nothing to do with her-

  • - She was healthy! Healthy people didn't have typhoid!

  • Except they did. They were just less likely to die from it

  • She was returned to quarantine on North Border Island on March 27, 1915 and, because she

  • refused to believe she was a danger, remained confined for the next 23 years.

  • - Twenty Three Years! Are you paying attention?

  • Mary remained confined for the remainder of her life, despite becoming a minor celebrity.

  • People were told not to accept even a glass of water from her and, although she was later

  • allowed to work in the hospital laboratory, washing glass bottles, it must have been an

  • incredibly lonely existence.

  • Although doctors frequently tested her and told her she was still positive, they left

  • her largely ignorant about her condition, failing to explain HOW she could carry the

  • virus and kill those weaker than her without feeling any symptoms herself.

  • - So aren't we lucky that today we have doctors on the news trying to explain things

  • for us?

  • Mary died from pneumonia in 1938 at age 69, vilified in folk memory asthe most dangerous

  • woman in America”, a patient zero who had to be locked up and isolated until her death

  • because she refused to work for the public good.

  • History has been unkind to Mary and today the colloquial termTyphoid Maryis

  • used for anyone who, knowingly or not, spreads evil or disease.

  • - There is even a Marvel comic book villain named after her: a female assassin who has

  • a cruel temper

  • But by her second capture and quarantine there were a number of other healthy typhoid carriers

  • identified, but they were not treated as harshly as Mary. Having said that, due to her use

  • of aliases and refusal to cooperate, the exact number of deaths attributable to Mary is not

  • known. Some have estimated that she may have unwittingly caused as many as 50 fatalities.

  • Scholars believe however that as a poor, unmarried Irish immigrant, and a woman, she suffered

  • prejudice not shown to other asymptomatic typhoid carriers, including some who infected

  • more people than Mallon but were quarantined for only a few weeks.

  • Today we see workers in service industries and gig work across the world facing a choice

  • about whether to isolate and stop working as a precaution against coronavirus, possibly

  • forfeiting pay and health insurance, or to continue on.

  • In a 2001 the late television chef Anthony Bourdain defended Mallon as a kindred spirit

  • who worked because she needed to work: “Cooks work sick. They always have. Most jobs, you

  • don't work, you don't get paid. You wake up with a sniffle and a runny nose, a sore

  • throat? You soldier onit's a point of pride, working through pain and illness.”

  • Mary's legacy as an asymptomatic vessel for disease led to the theory ofsuperspreaders”,

  • which has helped end disease outbreaks faster ever since. The problem of carriers in relation

  • to infectious diseases is now justly recognised as immensely important to effective public

  • health work.

  • Today we know that being a carrier of disease is not that unusual: Up to 6 percent of people

  • who've had typhoid, which is still common in the developing world, can spread it long

  • after they've recovered, even if they experienced few or no symptoms.

  • Dr Denise Monack, a microbiologist

  • at Stanford has shown that genetic mutations might allow bacteria to climb unnoticed into

  • immune cells, where they can take up long-term residence, meaning the carrier can go on infecting

  • people for years.

  • For years medical scholars have used Mary's case in debates over when the government is

  • justified in depriving someone of their freedom for a perceived greater good. Mary's refusing

  • to isolate and practice social distancing killed others and ruined her own life.

  • - just as it might ruin the life of a healthy COVID-19 carrier to accidentally infect and

  • kill someone else.

  • I know if you've watched this far into the video you've probably already got the point

  • I'm making but it doesn't hurt to be on the nose occasionally.

  • In 2015, a super-spreading event led to 82 people being infected by a single hospital

  • patient with Middle East respiratory syndrome (Mers), a coronavirus distantly related to

  • COVID-19. And in the Ebola epidemic in West Africa, 61% of cases were spread from just

  • 3% of patients.

  • Today we face social distancing and self-isolation, travel restrictions, bans on public gatherings

  • and strict surveillance. In some parts of China there are rewards for informing on sick

  • neighbours and their drastic measures DO seem to be working as (at time of filming this)

  • they are now only reporting a handful of internally transmitted coronavirus cases a day, rather

  • than the hundreds we were seeing just a few weeks ago.

  • The debate about how far to curb individual liberty in order to protect public health

  • rages on and whilst Mary is certainly a cautionary tale in how the government can get the balance

  • wrongit also shows that we DO have a personal responsibility to NOT infect other people-

  • - especially after a doctor tells us we're infectious!

  • It is our duty to educate ourselves on what being a carrier means and how to reduce the

  • spread of infection.

  • If you are having symptoms or have come into contact with someone who has PLEASE isolate

  • yourself and seek medical attention as soon as possible if your symptoms worsen. For the

  • rest of us, both those with and without underlying health conditions, it's our responsibility

  • to take care of ourselves: practice social distancing to slow the spread of the disease,

  • DO NOT do anything stupid that may land you in the hospital-

  • - especially not if it's just to make a TikTok video!

  • even if it's a hilarious one...

  • And please, please take care of others in your community, especially vulnerable people

  • including the elderly or those with disabilities who may have trouble accessing

  • food right now and the medicine they need.

  • Lastly, as much as I've spent this segment of the video nagging you not to spread

  • diseasewe need to be careful with the language we use when it comes to infected

  • people, particularly superspreaders. They've picked something up through no fault of their

  • own and (as long as they're not spreading infection for the fun and licking public property)

  • they need our support.

  • Lecture over! Congrats! You made it to the end of the video. I promise to berate you

  • less in the next one.

  • See you soon.

  • [kiss]

Hello lovely people,

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B1 中級 新型コロナウイルス 新型肺炎 COVID-19

腸チフスのマリアがコロナウイルスについて教えてくれること【CC (What Typhoid Mary teaches us about the coronavirus [CC])

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    林宜悉 に公開 2021 年 01 月 14 日
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