Throughout history, humanity has struggled against infectious diseases, enduring some of its darkest moments during pandemics and epidemics. However, in the 20th century, we witnessed a remarkable decline in mortality rates from diseases such as measles, scarlet fever, diphtheria, typhoid, and whooping cough. While vaccines are often credited with this achievement, a closer examination of historical data suggests that the true unsung heroes may be advancements in public health infrastructure, sanitation, and nutritional awareness. This post explores how improvements in sewage treatment, access to clean drinking water, refrigeration, the development of antibiotics, and enhanced living conditions—along with better nutrition—have played crucial roles in this significant health improvement, often overshadowing the impact of vaccines.
Read MoreRandomized control trials (RCTs) have long been considered the gold standard for determining the effectiveness of a drug, surgery, or other medical intervention. But observational studies, although long regarded as second-rate compared to RCTs, have contributed invaluable information to the medical sciences. Indeed, analyses of RCTs compared to observational studies have concluded that well-run observational studies are comparable. I will explain RCTs and observational studies later in this post, but first, I want to tell the story of John Snow and how he used his powers of observation to lower worldwide death rates, perhaps more than anyone in history.
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