Keynote Celebrates Past Medical Advances, Progress Amid COVID-19
By Emma Freer

Before the onset of the COVID-19 pandemic, bestselling author Steven Johnson planned to release his most recent book, Extra Life: A Short History of Living Longer, in 2020. It marked a century since the end of the Spanish flu pandemic, during which time global life expectancy roughly doubled from 35 years to 70.

The ongoing COVID-19 pandemic drives home the book’s message, which was the subject of his keynote speech at the Texas Medical Association’s 2022 Winter Conference on Jan. 29: This extra life, enabled by the discovery of vaccines and other public health breakthroughs, is one of humanity’s greatest achievements. But it also underscores the barriers to continued progress, including anti-science rhetoric and inequitable gains.

“If the first 100 years was about extending the overall average [life expectancy], then the next 100 years should be about reducing those gaps,” Mr. Johnson said.

He arrived at the topic of extra life while researching one of his previous books, which focused on the 1854 cholera epidemic in London. It wasn’t that long ago, he said, that someone could drink a glass of water and be dead within 48 hours of a bacterial infection. Since then, however, medical advances have paved the way for longer, healthier lives.

Before microscopes were powerful enough to see cholera in the water, London physician John Snow, MD, ventured into the center of the cholera outbreak and mapped detected cases. This early data collection effort helped pinpoint the source – a neighborhood water pump – and revolutionized public health. “Data is a big part of this story,” Mr. Johnson said.

He next spotlighted the chance discovery of penicillin in 1928 and the U.S. effort to mass-produce it during World War II. In 1941, there wasn’t enough penicillin in the world to keep one person with a bacterial infection alive, he says. But three years later, when U.S. soldiers landed in Normandy on D-Day, they had penicillin in their kits thanks to the Operation Warp Speed of their day.

The work of agronomists, who cultivated the mold from which penicillin is derived, and Pfizer, which scaled production of the antibiotic, pales in comparison to the Manhattan Project in many Americans’ minds, Mr. Johnson said. But he thinks it’s of least equal significance to – and much more beneficial to society than – the creation of the atomic bomb.

“It’s interesting that we don’t tend to tell these kinds of stories,” he said.

Similarly, the story of pasteurization includes its famous invention in 1862 and the much longer, less publicized process by which it became mainstream. Mr. Johnson celebrates Macy’s co-owner Nathan Straus, who took up the political cause of pasteurization in the late 19th century and set up milk depots in low-income New York City neighborhoods. This proved critical, since contaminated milk was a common source of tuberculosis and cause of childhood mortality. By the early 20th century, pasteurized milk was commonplace, and life expectancy continued its upward climb.

“It takes science and that kind of advocacy,” he said. “You can’t have one without the other.”

Of all the public health developments of the past century, Mr. Johnson singles out vaccines as the most significant. But he laments they are often forgotten because of how effective they are at containing disease. For instance, he says, American students continue to learn about the moon landing in 1969, but far fewer study the global eradication of smallpox around the same time.

“We took this terrifying killer that dates back to the pharaohs, and we wiped it off the face of the earth,” he said. “The idea that this is not a central milestone in every history textbook is one of the reasons why we see the vaccine resistance that we see today, because we haven’t told those stories.”

These history lessons have newfound resonance during the ongoing COVID-19 pandemic, which has ended more than 5.6 million lives worldwide. But Mr. Johnson hopes they also serve as a reminder of the progress made by physicians, scientists, and advocates in recent decades.

“I’ve written in the spirit of reminding people what is possible,” he said.

TMA members who joined the live general session, which included Mr. Johnson’s keynote speech, are eligible for up to 2.5 AMA PRA Category 1 Credits™ and can report their attendance using the TexMed portal.

Recordings of many of the general session talks will be made available. Read Texas Medicine Today for updates.

Last Updated On

April 05, 2022

Originally Published On

February 01, 2022

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Emma Freer

Associate Editor

(512) 370-1383

Emma Freer is a reporter for Texas Medicine. She previously worked in local news, covering city politics, economic development, and public health. A native Clevelander, she graduated from Columbia Journalism School and the University of St. Andrews.

More stories by Emma Freer