Skip to content

The Great Thing about Infectious Disease

2026-08-25 · letter vlog · John · 6:22 · watch on YouTube

Topic: Health (also: Global development) · mode: Personal essay · tags: heavy topic, fundraising ask

John argues that the one great thing about infectious disease is that prevention and treatment end lines of transmission, but warns that people are forgetting life before vaccines, antibiotics and clean water, which with misinformation drives regression; the 2,000th birth at the MCOE reminds him progress is also possible.

What is said

The parts of the video and what is said in each (★ — how much it matters to the video).

00:00:00 — Infectious disease can be ended by prevention and treatment, which protects whole communities; today's preventable diseases

  • ★★★ John says the only great thing about infectious disease is that lines of transmission can be ended through prevention and treatment. — 00:00:00
  • ★★ Preventing one person's cancer, for example through colonoscopy screening, does not protect the neighbor, but preventing a polio case by vaccination lowers the neighbor's risk too. — 00:00:00 · cancer, vaccine
  • ★★★ This makes preventing and treating infectious disease doubly valuable: it saves the recipient and improves the length and quality of lives in the surrounding community. — 00:00:29
  • ★★ Today HIV can be prevented with a lenacapavir shot, TB with prophylactic antibiotics and cholera with sewage systems, while mumps, whooping cough, measles and diphtheria are vaccine-preventable. — 00:00:29 · tuberculosis, vaccine

00:00:58 — John's generation and his mother's: vaccines and antibiotics; unequal benefits in measles and TB deaths

  • ★★ John is part of the first generation of Americans who never had to fear measles or polio, thanks to vaccines, or death from TB or scarlet fever, thanks to antibiotics. — 00:00:58 · United States, tuberculosis, vaccine
  • ★★ John's mother's life was different: she was two when the first polio vaccine came, eight when TB became curable with combined antibiotics, eleven at the first measles vaccine. — 00:00:58 · Sydney Green, tuberculosis
  • ★★ The benefit has not been universally shared: two people died of measles in the US last year (2025), and nearly 100,000 globally, mostly young children. — 00:01:27 · United States
  • ★★ TB remains a US problem with about 10,000 active cases a year, but only 572 of the 1.25 million people who died of TB last year (2025) died in the US. — 00:01:27 · tuberculosis, United States

00:01:56 — Forgetting life before: TB in 1890, John's staph and Hank's scarlet fever, cholera, raw-milk TB, The Baby's Cross, TB beds in 1900

  • ★★ As recently as 1890 more Americans died of TB than of heart disease and cancer combined; TB not being a leading US cause of death is younger than Dr Pepper or Maxwell House. — 00:01:56 · tuberculosis, cancer, United States
  • ★★★ No one alive remembers 1890, and John worries we are collectively starting to forget life before vaccination, antibiotics and clean water. — 00:01:56 · vaccine
  • ★★ John would not exist: he had childhood staph infections that would have killed him without antibiotics. — 00:02:26
  • ★★ Hank probably would not exist either: he had scarlet fever as a kid, easily cured, but a common cause of childhood death in the 19th century. (hedged) — 00:02:26 · Hank Green
  • ★ Cholera epidemics ravaged the United States as late as the early 20th century. — 00:02:26 · United States
  • ★★ Before milk pasteurization, as a poster from 85 years ago shows, children caught TB from caregivers, told not to kiss them, and from raw milk of infected cows. — 00:02:55 · tuberculosis
  • ★★ TB from raw cow's milk often invades the bones, causing intense pain, lifelong disability and very commonly death. — 00:02:55
  • ★★ Researching Everything Is Tuberculosis, John read Gail Perkins's memoir The Baby's Cross: infected by raw milk at three, she spent over 13 years in a sanatorium and came home unaccustomed to touch. — 00:03:24 · Everything Is Tuberculosis
  • ★★ We have forgotten that in 1900 there were almost as many beds just for TB patients as hospital beds for all conditions combined. — 00:03:24 · tuberculosis

00:03:53 — Regression: rising TB and measles, falling vaccination rates, misinformation, less faith after COVID, forgetting pain

  • ★★★ John thinks this forgetting is partly why the fight against infectious disease is regressing even in rich countries. — 00:03:53
  • ★★ TB rates have gone up in the US, and vaccine-preventable diseases such as measles and whooping cough are increasing. — 00:03:53 · tuberculosis, United States
  • ★★ US childhood vaccination rates fell only modestly in the last couple of years, from about 95% to 92%, but even that lets highly infectious diseases prosper. — 00:03:53 · vaccine, United States
  • ★★★ John says the vaccines used against measles, mumps, rubella and others are safe and effective. — 00:04:23 · vaccine
  • ★★★ John says misinformation sown by very high-level government figures like Robert F. Kennedy Jr. has left many people concerned or confused about vaccines. — 00:04:23
  • ★★ Six years ago a novel infectious disease emerged that has killed over 20 million people. — 00:04:23 · COVID-19 pandemic
  • ★★★ John calls it curious that, five years after a vaccine dramatically cut serious illness and death, people on average trust preventive health less than before COVID. — 00:04:52 · COVID-19 pandemic, vaccine
  • ★★ John lists reasons: survivorship bias, recency bias, misinformation, the politicization of the pandemic, and a fractured media landscape that makes public health campaigns almost impossible. — 00:04:52
  • ★★★ But John thinks one reason is that we are quick to forget illness and pain. — 00:04:52

00:05:21 — Progress is never final but possible: the 2,000th baby at the MCOE and generational returns; sign-off

  • ★ John's back hurt terribly yesterday; today it hurts less and he cannot call to mind how bad it was. — 00:05:21

  • ★★★ In the fight for better human health, John says, progress is never final, but it is also possible. — 00:05:21

    “in the fight for better human health, progress is never final”

  • ★★★ The 2,000th baby has been born at the Nerdfighteria-supported the Maternal Center of Excellence in Sierra Leone since it opened in February; all will have access to vaccination at Koidu Government Hospital or local clinics. — 00:05:21 · Nerdfighteria, Maternal Center of Excellence, Sierra Leone, Koidu Government Hospital, vaccine

  • ★★★ A stronger maternal and child health system in Kono reminds John that investing in health and public trust brings generational returns, and so does not investing. — 00:06:06

    “when we don't, we also see generational returns”

In the description and comments

Threads in this video

Where the stories that moved here went next

Mentioned

Central: infectious disease · preventive healthcare · tuberculosis · vaccine

Also: People: Gail Perkins · Robert F. Kennedy Jr. · Sydney Green

Works: Everything Is Tuberculosis · The Baby's Cross

Organizations: Koidu Government Hospital · Maternal Center of Excellence

Concepts: Antibiotic · bovine tuberculosis · cancer · cholera · collective memory · colonoscopy · Coronary artery disease · diphtheria · herd immunity · HIV/AIDS · Lenacapavir · measles · misinformation · Mumps · pain · Pasteurization · polio · primary health care · raw milk · recency bias · Rubella · sanatorium · sanitation · scarlet fever · Staphylococcus aureus · Survivorship bias · tuberculosis preventive therapy · Vaccine hesitancy · Whooping cough

Places: Kono District · Sierra Leone · United States

Events: COVID-19 pandemic

Products: Dr Pepper · Maxwell House · Measles vaccine · Polio vaccine

Only in the description or credits: Partners In Health

Also centred on infectious disease: I Predicted the Pandemic (over and over and over again) · Why the Deadliest Virus Was the Easiest to Kill

← Previous: Not (Just) Dunking on Jeff Bezos · Next → Jad Abumrad on Dolly Parton: 'The Unicorn of Unicorns'