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A comment on How Devastating was the Black Death?.

Re:How Devastating was the Black Death? by sillysaurus3 on Wednesday July 19, 2017 @07:48PM (#14808983)
Malaria is also intriguing. According to Michael Stevens, as many as half of all humans who have ever lived (~50 billion) have died to Malaria. I've always wondered whether this was true. https://youtu.be/1T4XMNN4bNM?t=235
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Re:How Devastating was the Black Death? by vacri on Wednesday July 19, 2017 @10:10PM (#14809575)
I remember reading an article by an African bloke in healthcare (can't recall the actual role) who was saying that the West's obsession with malaria is patronising. He said that malaria is like the flu - you get it, you're sick for a little while, then you get over it. Yes, some people die, but they tend to be the old and weak, just like the flu - yet the west doesn't go bananas over the flu like it does with malaria.

Looking at the wikipedia articles for both, it seems he has a point. 300M cases of malaria in 2015, with 750k deaths. 3-5M cases of influenza annually, with 350k deaths.

https://en.wikipedia.org/wiki/Malaria https://en.wikipedia.org/wiki/Influenza

Given those numbers, I'm not sure I'd believe that half of all humans died from malaria.

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Re:How Devastating was the Black Death? by ddeck on Thursday July 20, 2017 @04:55AM (#14810942)
>Yes, some people die, but they tend to be the old and weak, just like the flu

Actually they tend to be children. Of the 438k estimated deaths from Malaria in 2015, 75% (306k) were under the age of 5. [1]

But your comparison with influenza is a good one. Despite the estimated 12000 influenza associated deaths in the US in the 2015/16 seasons, there were only ~85 influenza associated pediatric deaths. [2][3]. By comparison, globally from 2000-2015 Pneumonia was responsible for 16% of deaths in children under the age of 5, while Malaria was 5%. [4]

The data suggests that the high impact of Malaria on infant mortality has more to do with inadequate availability of healthcare. Unsurprising given that the under 5 mortality rate in sub-Saharan africa is 14 times that of developed regions. [5]

[1] http://www.who.int/malaria/media/world-malaria-day-2016/en/

[2] https://www.cdc.gov/flu/about/disease/2015-16.htm

[3] https://www.cdc.gov/flu/about/season/flu-season-2015-2016.ht...

[4] http://www.who.int/gho/child_health/mortality/causes/en/

[5] http://www.who.int/mediacentre/factsheets/fs178/en/

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Re:How Devastating was the Black Death? by fiblye on Wednesday July 19, 2017 @10:18PM (#14809603)
To be fair though, think about getting the flu without access to clean water or decent food.

When you're vomiting several times a day, it's necessary to stay hydrated. If you live in a place without a steady supply of clean water, you're kind of screwed and dehydration is a very big risk.

Looking at the symptoms of malaria, fever, vomiting, and diarrhea are all problems. Before the modern era I could see that being very dangerous.

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Re:How Devastating was the Black Death? by ajarmst on Thursday July 20, 2017 @01:02AM (#14810108)
There are several different strains, with different lethality. Also, in Africa the disease has been endemic long enough that the population has developed resistance. Malaria is much more dangerous to naive hosts, hence the high mortality rate amongst caucasians in Africa, described as the "White Man's Grave" in the 19th century. There has also been some research done on the burden to economic productivity from chronic malaria, which is quite significant. Malaria is also a contributor to higher infant and childhood mortality in endemic regions: you get the disease as a child and it either kills you or your immune system learns how to keep the chronic disease in check.
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Re:How Devastating was the Black Death? by bkohlmann on Wednesday July 19, 2017 @11:24PM (#14809833)
Could the numbers also be influenced, literally, by survivorship bias? Those that survived malaria likely had a genetic advantage that they passed along, while those that didn't died. Malaria may have far less impact today than in the past.
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Re:How Devastating was the Black Death? by ajarmst on Thursday July 20, 2017 @12:51AM (#14810076)
At least one such genetic advantage has already been identified: the gene mutation that causes Sickle Cell Anemia when present as two copies conveys malaria resistance as a singleton. In areas where malaria is endemic, it would be selected for.
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Re:How Devastating was the Black Death? by Brockenstein on Thursday July 20, 2017 @09:50AM (#14812395)
When you're living with the threat every day, and mostly every day you're fine and no one you know typically dies from the threat, maybe for years at a time, it's pretty normal for humans to dismiss that threat as not worth worrying about. Most people in the west don't take influenza seriously because most people don't get it, and even fewer people know someone who died from it. It's actually to the point where people don't really know what the flu is anymore, and attribute all sorts of other things colloquially to flu; stomach flu, 24-hour flu, etc.

Malaria is this foreign, exotic, tropical disease. Malaria is a disease somewhere else, not in mid-Michigan. When all you have to go on is news stories and statistics, and no personal experience, it's easy to go off the deep end without personal experience.

People do this with everything. Dangers you live with and manage are fine, foreign threats, un-experienced threats, unknown threats are magnified regardless of the actual threat. People are pretty bad when left to their own devices at relative risk management.

I mean how do you think driving in a blizzard sounds to someone who lives in a place where they only see snow on TV and in movies? Compared to a person who lives in a place with 3-5 months of winter driving every year. Or hurricanes for people who live through hurricane season and people who just see it on the weather channel. Drastically different experience certainly color a lot of worldviews on every sort of danger and threat.

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Re:How Devastating was the Black Death? by ajross on Thursday July 20, 2017 @12:26AM (#14810011)
Influenza has a cheap and very effective family of vaccines. Malaria doesn't. People in "the west" "go bananas" over Malaria because it's not reasonably preventable.
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Re:How Devastating was the Black Death? by maxerickson on Thursday July 20, 2017 @07:27AM (#14811505)
Malaria was eradicated in the US and Europe. It used to be endemic. Eradication is a pretty solid way to prevent it.

https://www.cdc.gov/malaria/about/history/elimination_us.htm...

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Re:How Devastating was the Black Death? by ajross on Thursday July 20, 2017 @10:52AM (#14812975)
Except it hasn't worked everywhere. The point was that this was a practical issue and not a cultural one. Someone in "the west" who is paranoid about getting the flu just gets a flu shot. The same paranoia for Malaria has no treatment, so the same person with the same fears ends up "going bananas" about travel to Central America or whatnot.
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Re:How Devastating was the Black Death? by melling on Thursday July 20, 2017 @07:13AM (#14811458)
A lot of work is going into reducing the effects of malaria:

https://www.gatesnotes.com/Health/Mapping-the-End-of-Malaria

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Re:How Devastating was the Black Death? by sametmax on Thursday July 20, 2017 @08:01AM (#14811680)
There is indeed a bit gap between how we perceive it and how it is lived in Africa. But it's also because we don't get sick the same way. I lived in mali for 2 years and got malaria. The yearly crisis I get are very strong. But many people I met there were experiencing malaria like I'm experiencing the flu.
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Re:How Devastating was the Black Death? by protomyth on Wednesday July 19, 2017 @10:33PM (#14809662)
Might be where I’ve lived (North Dakota & Minnesota), but we do go nuts over the flu. The number of places that start advertising flu shoots and never mind all the reminders. Plus, the fun when they miss a strain in their formula.
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Re:How Devastating was the Black Death? by abritinthebay on Thursday July 20, 2017 @02:58AM (#14810524)
Given the flu is killer and we spend most of autumn and winter warning people about it and to get vaccinated against the newer strains...

... I’m ok with that comparison

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Re:How Devastating was the Black Death? by josefx on Thursday July 20, 2017 @07:14AM (#14811459)
> yet the west doesn't go bananas over the flu like it does with malaria.

At least in Germany we had a few killer flu scares. With politicians buying ( and throwing away ) tons of third rate vaccines that had a higher likelihood of making you sick than you had of catching the flu.

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Re:How Devastating was the Black Death? by honestoHeminway on Thursday July 20, 2017 @05:26AM (#14811056)
My uncle got this particular type of flue- after he was in africa, every 2 months. Malaria kills in combination with other diseases and malnourishment.
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Re:How Devastating was the Black Death? by ericd on Thursday July 20, 2017 @03:42AM (#14810692)
Yeah, I was really surprised when a friend from Tanzania told me he'd had Malaria >10 times, and shrugged it off as if it was no big deal.
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Re:How Devastating was the Black Death? by akhatri_aus on Thursday July 20, 2017 @04:49AM (#14810919)
Have had it a couple of times. It's only a problem if you don't get any medication to get rid of it. It doesn't go away on its own easily. Otherwise its like a flu..

You would have to stay ill for weeks for it to start becoming life threatening. Keep in mind the immune system can't easily fight it on its own so its not like the flu in certain ways. Having 'semi immunity' only means you don't get it as bad as it can be, but you still get ill.

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Re:How Devastating was the Black Death? by jlg23 on Thursday July 20, 2017 @06:39AM (#14811306)
> the West's obsession with malaria is patronising

It is and it is also a consequence of history: Malaria was the unexpected enemy western cultures had to fight in their colonies. The one thing a bullet to the head or chopping off slaves' hands[0] won't fix. We are afraid of malaria and therefore try to eradicate it. Problem is: People who live in malaria-infested places usually have more important things to worry about. Imagine, you are a hungry African and some humanitarian aid workers come by in air-conditioned 4WDs to help you: With fscking mosquito nets![1] What do you say? "Thank you, the 0.82 kids I can statistically expect to die from malaria[2] will survive. Now all my 7 kids can starve to death! Thank you!"

[0] https://en.wikipedia.org/wiki/Congo_Free_State#Economy_durin...

[1] https://www.nytimes.com/2015/01/25/world/africa/mosquito-net...

[2] I made up that number.

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Re:How Devastating was the Black Death? by _nalply on Thursday July 20, 2017 @07:53AM (#14811631)
I wonder if malaria was really unexpected, since parts of Europe were malarious, too.

In Italy about one third of the country was affected[0]. Even Switzerland had serious problems with malaria, especially near the Lake of Bienne, because the alluvial sands caused the Aare river to repeatedly flood the plains between Murten and Solothurn, turning agricultural land into marsh[1].

[0]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3340992/figure/...

[1]: https://www.bernerzeitung.ch/region/bern/Als-der-Aareteufel-... (German)

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