Your link does a good job showing this, but for those who don't click and scroll down it's probably worth mentioning that the vast majority of those deaths are in central Africa. So it's not just a lot of deaths, but it's a really significant portion of the population and, as you said, mostly children.
It's also the gift that keeps on giving. Once you get it, it does a reunion tour, every now and then, for the rest of your life.
At the dinner table, we (expats) used to have a bowl of quinine tablets, set out like a condiment.
I really hope this works out, because, thanks to climate change, the lower 48 may get a chance to find something in common with our neighbors to the south.
I was born and raised in Uganda and I'm shocked by this. Ebola was 100x more scary than malaria growing. At least way back before this recent vaccine. Get Ebola you are basically screwed, get malaria have a pill
To be fair on your part, as an 'expat' (I have a lot of qualms with this word, see https://www.theguardian.com/global-development-professionals... as a starter), its harder as your immune system didn't grow up with it and so when you get it, its much worse. Quinine in my head is a hard core malaria drug for the tough cases (well atleast in was 10-20 years back). But for folks born and raised it really was like the flu. When I go back these days though, I'm in the same boat and actually start a dosage of anti malarials a week before I arrive
As an example, I always found it interesting that when I moved to the US, I found the words use suddenly disappears despite there being lots of people that could fit that mold. Has anyone experienced otherwise? I'd be curious to know
Then what do you call it when the Haves trend light in skin tone and the Have Nots trend dark in skin tone?
Malaria is why the first attempt at the Panama canal failed. Kerosene is partly why it became successful.
Do you first try to heal your kid or everyone at the same time?
I had no idea of that, as I suspect many given the time past if you wasn't around then. Did a little digging and nicely covered here: https://www.cdc.gov/malaria/about/history/index.html
Which makes me wonder - what the cost of malaria drugs are and how much would it cost to eradicate it. Equally have the true environmental and ecological aspects of eradication methods been analysed. I wasn't aware that mosquito's were pollinators until a while back, not that anything usurps Bee's, but many insects are pollinators and in some area's they may even be crucial as a species.
After all the 1950's approach was basic killing of the mosquito's and whilst that may of been a solution for one area like the US, I'm not sure that approach would be taken as much today and for Africa, certainly as I mentioned, the whole pollinator aspect of mosquito's may make for a more fragile ecosystem that removal of a species would be more impaction than the gains.
I always found it fascinating that malaria has been around so long that a genetic mutation evolved in some that makes them immune to it.
Bats eat tons of mosquitoes. Some outfits encourage and help people set up bat friendly enclosures to deal with local mosquito problems.
Lets face it, if the same Malaria mortality rate happened in the West, we wouldn't (and historically didn't) wait for vaccines - we'd pave over an entire ecosystem if we had to. We'd do the same even if we had the same death rate as the group that got vaccinated.
Even rogue nanoswarms are less worrisome than mosquitos as a vector.
No doubt the indigenous Americans had it bad, to put it mildly, but reading the accounts of early colonization efforts in that book, I mean, damn. Wave after wave of colonists, each losing 50+% in the first year (and it’s not like the survivors stopped dying then). For years on end, across multiple colonies. Mostly to disease.
Maybe only certain strains of malaria do that? I had malaria many years ago. It was a very unpleasant experience, but I recovered in a couple of weeks with no lingering effects.
Growing up in India, malaria was common. But I don't recall anyone living in terror of it. Mosquito nets, mosquito repellent incense, repellent cream, turning the ceiling fan on to full speed were common countermeasures we employed at bedtime.
Or at least I hope so. I lived in Tanzania for a few years and I got malaria (I think falciparum) a few times. The first time it was the worst headache I've ever experienced. By the third or fourth time, I barely noticed that I had it and yet it was at maybe 5x or more the concentration it was when I first contracted it.
I don't live in a malaria-prone locality anymore, but when I did, the people did not consider it a deadly disease. I think access to medical facilities and good nutrition are the key factors why some populations consider it a deadly disease, and other populations don't.
Edit: Or there just aren't many donors who have had malaria, so they err on the side of safety.
The way it was explained to me, is that it's a parasitic disease, and the parasites would embed eggs in tissues, with the possibility of the eggs (or whatever they are -spores?) being re-released in the future.
I'm interested to read more about the possibilities that in africa we contracted so many diseases that explains the rather shocking covid mortality rate. It could be because of mean age too.
It is treated pretty much the same way Americans treat getting the Flu
I also remember my sister getting caught in one of those 'squito swarms, near the Delta. That was freaking awful.
Uganda was a bit worse; but we also had other things to be scared of.
I should also mention that Ebola wasn't actually around (that we knew of), when I was a kid, but we hasd some fun diseases. The parasitic ones (like Elephantitis and Belhartzia) were pretty difficult to look at.
To be fair, it does sound like you were in rural Nigeria, so my Malaria experience is likely different from yours
But I'm still here. I seem to have survived.
My African friends would run around barefoot over the most God-awful crap, and were some of the healthiest people I've ever known.
I wish the rest of the world would realize that Africa first and foremost benefits from this new Malaria vaccine.
It's hard to be productive when you are sick all the time and/or caring for someone sick.
Sure, Malaria is unlikely to spread like covid or it would have done so a long time ago, but the absolute numbers don't tell the whole story about how bad each disease is.
It's a good point about absolute numbers versus population relative numbers.
Some say climate change killed it, some say the extinction of a mosquito species carrying it, some better nutrition, some say quinine.
https://www.cdc.gov/malaria/about/biology/index.html
> Inheritance of this mutated gene from both parents leads to sickle cell disease and people with this disease have shorter life expectancy. On the contrary, individuals who are carriers for the sickle cell disease (with one sickle gene and one normal hemoglobin gene, also known as sickle cell trait) have some protective advantage against malaria. As a result, the frequencies of sickle cell carriers are high in malaria-endemic areas.
> . . .It was found that that the sickle cell trait provides 60% protection against overall mortality.
Sickle cell has separately arisen in at least four populations in Africa and some in South East Asia.
In 1882, the range of malaria in the USA extended from the Canadian border on the north to southern border with Mexico on the south. The only states of the current 48 contiguous states unaffected were Nevada, Utah, Arizona, Idaho, Main, Vermont, and New Hampshire. Something like 41 states had malaria cases (the maps are a bit hard to read).
Approximately 375 cases acquired in the USA per 100,0000 population were reported in 1920.
Eradication efforts continued until the 1950s when the USA essentially became free of malaria. See [1].
[1] https://www.cdc.gov/malaria/about/history/elimination_us.htm...
The Little House on the Prairie family caught malaria, and was so sick they almost died of dehydration because they couldn’t get down to the river to drink.
https://littlehouseontheprairie.com/dr-george-a-tann-pioneer...
Crucially, they didn't need to get rid of all the mosquitoes to do this: they just needed to drive mosquito-to-human transmission low enough for long enough.
https://en.wikipedia.org/wiki/National_Malaria_Eradication_P...
Clearly that hasn't happened.
I know here in Louisiana the local abatement program has trucks that spray synthetic pyrethroid chemicals (resmethrin, sumithrin and prallethrin) at night and uses an organophosphate (naled) from planes.
And residents are routinely urged to be aware of and eliminate standing water on their property.
We just don't use DDT anymore -- we almost wiped out our state bird with it.
Edit: I have to wonder how much housing changes also mattered. With modern air conditioning and well sealed homes it's fairly rare to have mosquitoes in the home at night.
In fact, of the ~200 mosquito species which occur in the United States, only 12 are known spread any sort of human disease [2].
[1] https://en.wikipedia.org/wiki/Anopheles
[2] https://www.cdc.gov/mosquitoes/about/mosquitoes-in-the-us.ht...
https://upload.wikimedia.org/wikipedia/commons/b/b3/MalariaM...
Probably DDT. Not thwebest of ideas!
And yes, malaria is not discussed enough. I remember Bill Gates releasing mosquitos in a room before a speech to get the public attention "these could carry a deadly disease we have no cure for"
A more deadly virus, as we saw with SARS, was that it was actually easier to control because the high death rate made it very easy to contact trace and identify infected.
In many ways covid19 is a challenge exactly because it doesnt kill too many people.
HIV is extremely deadly without treatment, but has an asymptomatic stage that can last over a decade despite still being infectious during that time.
The silver lining with HIV is that its modality of transmission is primarily sex and blood, which greatly limits the number of contacts an infected individual will have.
An airborne disease with the lethality, incubation length of infectivity, and vaccine resistance of HIV would be a slow moving disaster of an unimaginable magnitude.
I am not aware of any theoretical reason such a disease cannot exist.
COVID is bad, but in some ways we got lucky because there could have been way worse pandemics that acted more like smallpox or measles.
Malaria, like HIV or Herpes, is a chronic disease. Once you're infected, you're affected by it until you die. The debilitating effects of malaria also have disastrous economic impacts.
That said, I agree that many of those resources would be better spent on eradicating hunger and slavery, as well as the poverty diseases.
It is heartening to see many here agreeing we could do better.
With just a few examples in blue states where the virus took hold early on in dense urban areas in blue states, i can't think of any explanation except that red states were much less vigilant with lockdowns.
Cherry-picking of course makes this worse - introducing arbitrary and potentially contaminating boundaries such as governmental policy (red vs blue). Did red states generally employ higher CT's? Do we even have that data? No, sometimes its discretionary or not even recorded. We do know Trump was heavily encouraging more testing, as this painted a better (and, to his credit, ever more accurate) picture of mortality rate, so even just that may plausibly explain such a result.
Conversely, at least regarding all of the testing data as mixed establishes a better starting point for analysis less subject to such foibles.
We call that selfishness :-)
And we can't force people to help others, no matter how much we dislike the attitude.
We can, and we do all the time, via taxation. You're forced to pay taxes to fund the people who empty the bins in the park you never even go to.
It's a good thing.
It's just that those regions are warm and humid, and this creates great living conditions for mosquitoes.
To make things worse, many countries in these regions are poor, so they can't afford treatment or prevention (pesticides to kill mosquitoes, draining swamps, etc.).
Rich countries in the same regions most likely don't have big problems with malaria (or if malaria is still a problem, it's probably a minor problem).
It's just "bad" geography (from this point of view) and poverty.
If you see someone drowning and refuse to throw them the life ring because you might damage your newly painted nails, you're not technically killing them on purpose, but you're still killing them through your inaction
It would cost a fraction of what we spend on research for a vaccine, but no cigar.
Of course, there is the argument that we risk developing resistant bugs. But the truth is, if suddenly all mosquitoes were moved magically to the US, you would see the drug massively used for everybody without a second though.
I first started taking anti-malarial medicine as a child. My entire life I’ve been hearing of resistance to one drug and then another drug, and then another. Also, whenever we took chloroquine or any other drugs on a regular basis, we were well aware that having the medicine in our body would not prevent malaria—-we took it just to help reduce the severity of malaria when we’d become infected. Looks like there are already strains resistant to your drug of choice:
https://malariajournal.biomedcentral.com/articles/10.1186/14...
So preventing and even treating malaria has never been a sure thing with ANY drug that I’ve ever known.
The only solution then is rapid and large-scale intervention. Massive use of the most effective/least side-effect variety of drug for all at risk populations for 3(?) months, then bring in the alternatives and quickly and widely ensure their use in those areas where resistant strains still spread.
How? There are literally 3 times more deaths in the last year than peak Malaria, and that's only deaths that were actually counted.
Covid-19 is hopefully going to be short-lived thanks to the vaccines, but even if it weren't for that it would likely become more virulent but less deadly over time like the other Coronaviruses that are endemic in humans.
There is a also a big difference in lives lost at the end of life versus at the beginning.
Over the last year it's be come more virulent and more deadly.
We have no idea how well the vaccines are going to work. We have a situation right now where a country(india) with 100 million people vaccinated is getting 350,000 cases a day, and it's doubling every 10 days. That's a scenario where the evolution around the protection a vaccine offers becomes a very real and distinct possibility.
Evolution is a somewhat random process at its heart, but I stand by what I said as the likely outcome, because that's the path new diseases normally take. It's early days yet.
> We have no idea how well the vaccines are going to work
I think we have a petty good idea by now actually. A bigger question is how much will it be hampered by people afraid or unwilling to be vaccinated? I have never in my life seen such widespread and illogical fear of vaccines.
We may have to just accept that there will be an ongoing toll in the unvaccinated population that keeps the virus circulating in quantity and keeps the hospitals busy. Until sufficiently many develop natural antibodies through infection.
> We have a situation right now where a country(india) with 100 million people vaccinated is getting 350,000 cases a day, and it's doubling every 10 days. That's a scenario where the evolution around the protection a vaccine offers becomes a very real and distinct possibility.
Yes, that's a tail risk that's real and terrifying. I think the risk is small given such a mutation would possibly render the virus much less virulent. The vaccines tend to target the spike protein, without which it can't even infect humans. But nature finds a way. We can and will also adapt the vaccines in that case though. The money, motivation, and technical expertise are all there. But nobody knows how likely a risk that is.
So that's why malaria is less deadly now? I've seen this said many times with zero backing, and it just really doesn't correlate with the history of disease. The reason we don't deal with the majority of deadly diseases is vaccines, not because they've evolved to become less deadly.
>I think we have a petty good idea by now actually
We have an idea of how well they work on the original covid-19 strain that we saw last year. We don't know how well they will work on actually eradicating the virus.
>I think the risk is small given such a mutation would possibly render the virus much less virulent
Based on what? It's already evolved to evade antibodies produced by infections from the first wave (P1 strain in Manaus specifically is a good example). Those have been mutations in the spike protein, and have made the virus more virulent and deadlier.
Apparently our DNA is literally encoded with lots of viruses, as they've evolved to become utterly harmless to people. Our bodies are loaded with various bacteria and viruses that have evolved a symbiotic relationship to the point where we'd die without them, and they can't live without us.
I seriously doubt they started out that way.
Diseases can be severely lethal far longer than you or human memory can survive.
It's interesting, in the UK we had ridiculous reaction to the MMR jab after a fraudulent claim, fired up by the media - from the ever populist Daily Mail to Private Eye [0], which led to a collapse in MMR takeup and a resurgence in measles.
But we haven't seen that with covid, perhaps because the printed press is (mostly) on the side of the current government (flag waving populists), and the vaccine rollout has been branded aprt of the generational "battle" between the UK, standing alone against Europe (many in the UK don't realise WW2 ended 76 years ago).
I wonder if we'd had a Corbyn or Starmer led coalition in charge if things would be different.
Or imagine if the lib dems had held on to 20-30 seats that the tories gained in 2015 -- likely another coalition, with a 5 year fixed term, no brexit referendum, and then the GE having to be delayed (it would have been set for May 2020)
[0] https://behavioralscientist.org/how-fraud-and-a-broken-publi...
Source?
Malaria's victims are mostly under 5 years of age. In terms of life-years lost, Malaria is far far worse.
You also have to take into account the health of those involved. Saving a life only for that person to live a few low quality years in poor health is worth less than saving the life of a healthy young child.
The resulting measure is the QALY, the quality adjusted life year.
Unfortunately there has not been nearly enough research or discussion about QALYs and their applicability to the coronavirus. There are a few studies out there, though, here's one: https://onlinelibrary.wiley.com/doi/full/10.1002/hec.4208
TLDR: the mean discounted QALYs lost by someone dying of the coronavirus in the US is 4.3.
Globally, malaria kills 1-3 million people annually despite many people having some natural resistance to it and there being many effective treatments for it and it already having been eradicated in many areas. Covid killed the same amount in a much larger population that had no pre-existing defenses or treatments.
There are far more influenza deaths over the last 3 decades than ebola, but ebola is far more severe and greater concern.
I think that's probably wrong? The most likely outcome would be that after the initial pandemic subsided (with lots of deaths), most people would catch it when they were reasonably young and then be mostly protected.
This is different from malaria, which is much more deadly.
We have a number of Coronaviruses endemic to humans that cause the common cold (among other viruses.) That's probably how covid19 would turn out, left to its own devices.
(Both are RNA viruses. https://en.wikipedia.org/wiki/Orthornavirae)
Part of what's so exciting about the vaccines is that the antibodies seem to decay at a slower rate, meaning that it could result in longer immunity (though we obviously don't know for sure yet).
If that were the case we would see large amounts of re-infection, since the pandemic started over a year ago
Then why hasn't that happened with malaria?
Getting malaria doesn't inherently make you less likely to get it again (if anything, it's the other way around)
A child dying robs them and the world of 60+ years of human life. An 80 year old dying of COVID-19 was not going to live much longer anyway, so the loss is less severe. Old people have already had the opportunity to live a "full" life.
Imagine two societies – one where a disease kills 50% of < 10s every year, and another that kills 50% of > 70s every year. Which society would do better? Which society would you rather live in?
A society of just children wouldn't work, just as a society without wouldn't work.
Yes, of course more 55-74s have died – there are far, far more of them than there are >85s. Normalized, COVID is far more lethal (8x more lethal) for >85s than for your range. Here's the mortality rates:
55-74: 0.28%
85+: 2.5%
https://www.statista.com/statistics/241488/population-of-the...
The actual numbers are more representative than lethality percentages when we're talking about contribution to society.
https://www.nature.com/articles/s41598-021-83040-3
And, dismissing the death of someone by saying "they were going to die soon anyway, so what" is disgusting.
It may be "disgusting" - but it's also statistics
It was sad when my grandfather died a couple years ago at 87 - but not exactly "unexpected"
Compare that to friends who lost their 18-year-old daughter before she graduated high school
Which one is shocking? Which one "hurts more"?
Deaths rates follow a bathtub curve - ultimately leading to a 100% mortality rate (ie, everyone dies eventually)
If you have to choose between saving a 5-year-old and an 85-year-old, the "smart money" says "save the kid"
If you don't have to choose, then by all means - save both
But that's not how economics works: choices must be made
My parents are 60+ yr old surgeons. They work during the pandemic not because they have to. It's because you run the QALYs and the morality is clear. You participate or make way.
Yet there seems to be no better alternative for simple mosquito nets when it comes to safe, efficient way of protecting ourselves from mosquitoes.
P.S. I've been tracking mosquito control strategies, it's the very first problem I posted on my problem validation platform - https://needgap.com/problems/6-safe-affordable-and-efficient...
Malaria affects poor people with no power (young children in poor countries with limited access to medicine)
Millions have perished from being denied it.
Been awhile since I researched the topic, but it was clear Africa counties got a lot heat each time they tried to use DDT.
So I will stick by millions dead.
Btw, I don't think it's a pandemic since it doesn't affect the entire globe. It's an epidemic, isn't it?
For the most part, malaria is considered an endemic disease with a high incidence rate.
Stillwater deposits (i.e. no fish) are the perfect breeding grounds for mosquitoes. If you have a very wide area with poor transportation infrastructure, or if you don't have funds to fumigate for mosquitoes...you are toast.
The incidence rate should not be surprising for anyone that has lived in a tropical country with a rainy season.
You can't run and you can't hide. Mosquitos come out when you sleep, and use body heat and breathing to find their victims. You will be bit by mosquitoes. Many times. Sometimes multiple times a day. The question is whether you get enough bites that chance will deliver a malaria bite.
The EDCTP is funded by the European Union as well as the individual member countries. The Wellcome Trust and Oxford are both British.
Perhaps wealthy nations could/should be doing more, but it seems like wealthy countries are responsible for this breakthrough.
The vaccine is showing 77% efficacy in trials in Burkina Faso.
That's an ongoing pandemic that makes covid-19 look like a case of the sniffles. Malaria deaths peaked around 930,000 a year in 2004, and is around 600,000 a year now. I believe covid-19 death toll stands around 3 million deaths, most above the age of 70. Malaria is over 100 million, most under the age of 5.
Source: https://ourworldindata.org/malaria